Background: Until the results of the bone marrow biopsy (BMB) are known, an early diagnosis can be determined using the morphological evaluation of a bone marrow aspiration (BMA). This makes it possible to begin treatment right away, particularly in cases of haematological malignancies where prompt treatment is necessary. The purpose of this investigation was to evaluate the value and sensitivity of bone marrow aspiration in the detection of haematological malignancies.

Methods: Between January 2023 and 2024, patients, who had bone marrow aspiration and bone marrow biopsy had their data retrospectively were examined. In all, 500 patients had BMA and BMB procedures done concurrently for the purpose of this study.

Results: In 270 (54%) of the patients, abnormalities in the total blood count were the reason for a bone marrow evaluation. Based on 475 (95%), the diagnosis was made based on the BMA examination. Of the 475 individuals, 456 (96%) had a diagnosis of BMA that was consistent with a BMB diagnosis. BMA was insufficient for the diagnosis of lymphoma and solid organ metastases, whereas BMB and BMA agreed 100% in cases of acute and chronic leukemia.

Conclusion:  our research demonstrated that the assessment of BMA exhibited a high degree of sensitivity in the identification of haematological malignancies, including multiple myeloma, acute leukemia, and chronic leukemia.

Leptospirosis is an anthropozoonotic disease, which remains under diagnosed in most of the regions of our country due to the lack of awareness, atypical presentation and lack of proper diagnostic facility and set up. Diagnosis usually depends on Microscopy, Culture and Serological tests like ELISA, MAT (Microscopic agglutination test). MAT is the gold standard diagnostic test but it requires live Leptospires and it can only be done in a reference laboratory. Hence, ELISA is the most preferred cost-effective serological method and is genus specific with both sensitivity and specificity of 95%.  Aim of the present study is to estimate the seroprevalence of Leptospirosis among suspected Acute Febrile illness (AFI) cases presented to Government General Hospital Kurnool. The study was conducted from August 2023 to March 2024 on 260 AFI cases. Detection of IgM antibody was done by using Recombilisa Leptospira IgM ELISA kit. Out of 260 clinically suspected cases of Leptospirosis, 30 (11.53%) were positive. Majority of cases belonged to 21-40 years age group. Seroprevalence was found to be higher in Males (14.1%) as compared to Females (8.5%). A high seroprevalence of Leptospirosis was noted in AFI cases, so a programmatic approach for prevention, control and management of such emerging zoonotic diseases through NOHP-PCZ (National One Health Program for Prevention and Control of Zoonoses) will be a very useful step towards achieving optimal health.

Background: The purpose of this study was to assess the change in PaO2/FiO2 before, during, and after prone positioning in ARDS patients.

Methods: This prospective observational study enrolled 60 patients with moderate and severe ARDS. The study duration was one year. The study excluded patients who did not meet the inclusion criteria. A lung ultrasound was performed under guidance. Eight different regions of the chest wall along a longitudinal axis for each patient were examined, and lung aeration scores (xi) were calculated. The enrolled patients underwent prone positioning for 12 hours. The oxygenation response was calculated using arterial blood gas analysis. The mean anterior-posterior lung aeration score among responders was then analyzed. Data were collected using a structured questionnaire and statistically computed using SPSS version 25 for Windows. Anterior-posterior lung aeration scores were expressed as mean and standard deviation. The change in PaO2/FiO2 score was expressed as a repeated measure (ANOVA) or its non-parametric equivalent based on distribution. P values < 0.05 were considered significant.

Results: The improvement in PaO2/FiO2 score before prone positioning, 2 hours after prone positioning, and 2 hours post 12-hour prone session was statistically significant with a p-value <0.001. The mean lung aeration scores were compared between the anterior and posterior lung aspects using lung ultrasound, and it was found that there was a significant relation between the prone position oxygenation response and the lung ultrasound pattern of the anterior and posterior regions, with a p-value of 0.045.

Conclusion: Lung ultrasound could be used to predict the prone position oxygenation response in ARDS patients. Patients with a higher posterior lung aeration score may have benefited more from prone positioning.

Background: Our study aims to the compare the duration of post-operative analgesia, times of post-operative opioid consumption, post-operative sedation score, and haemodynamic changes between the groups on using 8mg Dexamethasone and 75 μgm clonidine as an adjuvant to 0.25% Ropivacaine in ultrasound-guided bilateral TAP block in patients undergoing total abdominal hysterectomy.

Study design: Prospective, randomized, double blinded study with 56 patients were included and allocated using a -generated randomization code into:

Group A (n=28 patients): Received USG guided bilateral TAP block with Injection Ropivacaine (0.5%) 20ml + Dexamethasone (8 mg) 2ml + Normal Saline 18 ml and

 Group B (n=28 patients) Received USG guided bilateral TAP block with Injection Ropivacaine (0.5%) 20ml + clonidine (75mcgs) 0.5 ml + Normal Saline 19.5 ml.

Results: The duration of pain relief was highest (14.3 ± 4.7 hours) in group B patients compared to group A (11.1 ± 5.1 hours). The duration of analgesia provided by 75 mcg clonidine was statistically significant (p<0.001). Post-operative opioid consumption was higher in group A  compared to group B which is statistically not significant. (P>0.05). There was also no significant difference in between the study groups for sedation scoring and haemodynamic changes.

Conclusion: The addition of dexamethasone 8mg or clonidine 75 mcgs to 0.25% ropivacaine significantly prolongs the duration of analgesia and reduces postoperative opioids requirement, thereby facilitating early recovery and ambulation. On comparing, clonidine appears to be superior adjunct, in terms of pain relief.

Background:  In type 2 diabetes mellitus (T2DM), achieving HbA1c target value <7% has been shown to reduce diabetic vascular complications¹, however laboratory determinations of plasma HbA1c are yet not widely available and standardized in all services in addition to its high cost². Previous studies give prominence on HbA1c being used as a valuable biomarker for prognosticating serum lipid status in T2DM. However, dyslipidemia can predict HbA1c level suggesting that screening of dyslipidemia and its better control could be of great benefit in optimizing HbA1c³. Measuring serum triglyceride (TG) level as part of TyG index can be a useful and cost-effective marker and represent the glycemic and cardiovascular status of an individual concurrently. Methods: A retrospective study with 197 T2DM patients divided into 2 groups: HbA1c >7(n=170) and HbA1c <7(n=27) were recruited. Result: FBS was 165.69 ±60.60 with correlation coefficient of 0.67 (n=197), Triglycerides was 160.77 ± 83.88 with correlation coefficient of 0.16 and TyG Index was 5.01 ± 0.31 with correlation coefficient on the entire dataset. On dividing into 2 groups, FBS and TyG had a moderate but significant correlation with HbA1c in the group with HbA1c >7 with 0.65 and 0.45 corelation coefficients respectively (n=170). Conclusion: TyG index calculated from glucose and triglyceride values is less expensive than HbA1c. TyG index has a significant correlation with HbA1c and can be used as a surrogate marker for assessing the glycemic status. It can be particularly useful in those groups of patients where HbA1c cannot be estimated due to preanalytical factors.

Background: Dexmedetomidine is a highly selective, α2 adrenoreceptor agonist drug, which has sedative, analgesic and anxiolytic property without any respiratory depressive action. Dexmedetomidine causes post synaptic activation of α2 adrenoreceptors in the CNS resulting in hypotension and bradycardia through sympatholysis. Preoperative administration of dexmedetomidine can successfully attenuate the laryngoscopic stress response via intravenous, intramuscular or intranasal routes. Material and Methods: 80 adult patients of either sex between the age group of 18 to 60 years of ASA-I and ASA-II undergoing elective major surgeries were divided randomly into two groups of 40 patients each. Group – D(IV) received intravenous dexmedetomidine (0.50μg/kg) diluted in 50 ml syringe with normal saline through an infusion pump over 40 min before induction. Group – D(IN) received intranasal dexmedetomidine (1 μg/kg) in undiluted form which was prepared from parenteral preparation (100μg/ml). Intranasal drug dripped into both nostrils in equal volume using a 1 ml syringe in supine head down position about 40 min before induction. Result: The mean baseline heart rate in group D(IV) was (82.73 ± 5.95) per minute and it decreased to (80.33 ± 5.93) per min at 10 minutes time interval but was statistically insignificant. The p-value became statistically significant at 30minute (0.024) and 40-minute (0.011) time interval in pre induction period. During laryngoscopy and intubation time interval Mean heart rate was (87.18 ±5.54) beats/minute in group D(IV) and (90.95±6.02) beats/minute in group D(IN) and the p-value in intergroup comparison came out to be 0.004 which was statistically significant. Conclusion: Dexmedetomidine drug when given in group D(IN) through intranasal route at a dose of 1 µg/kg body weight forty minutes before induction of anesthesia produced similar haemodynamic changes as when given through intravenous route as infusion in group D(IV) at a dose of 0.5 µg/kg body weight in patients undergoing major surgeries under general anaesthesia.

Introduction: Difficult tracheal intubation is associated with serious morbidity and mortality and cannot be always predicted based on preoperative airway assessment using conventional clinical predictors. Ultrasonographic airway assessment could be a useful adjunct, but at present, there are no well-defined sonographic criteria that can predict the possibility of encountering a difficult airway. 

Aims: To.assess the usefulness.of USG in predicting difficult laryngoscopy.

Materials and methods: . It is a descriptive observational study done conducted in a total of 80 patients were enrolled for.the study and informed. consent was obtained from all the patients. ASA grade I / II, Age 18-60.years of either sex, Patients.undergoing elective. surgery under.general anaesthesia.

Results:  The incidence of difficult intubation was 23%. We found that Skin to Epiglottis Distance at level of Thyrohyoid membrane on USG (USG-SET) > 1.67 cm had a sensitivity of 78.9% and specificity of 90.2% in predicting a CL Grade of 3 or 4, which was higher than that of physical parameters like MMPC, Wilson’s score, Neck circumference or BMI.

Background: Hypoxemic respiratory failure is an important cause of intensive care unit (ICU) admissions. Oxygen index (OI) and Oxygen saturation index (OSI) are important parameters used for diagnosing and monitoring critically ill children with hypoxic respiratory failure in ICU.

Objectives: To find out the correlation between OI and OSI and to determine the reliability of OSI in predicting the success of extubation.

Methods: This prospective study included children aged 1 month to 14 years requiring mechanical ventilation at a tertiary care teaching hospital over a period of 2 years. Arterial blood gas analysis was done; OI and OSI values were calculated as per protocol.

Results: A total of 148 children were included (boys:girls = 2:1). Mean (± SD) OI of 4.9  2.3 and OSI of 5.7  2.8 were recorded with a mean difference of 0.75  1.90. A good correlation was found between OI and OSI (0.73). The equation of correlation obtained was OI = 1.5 + (0.6 x OSI). A sensitivity of 89.7% at an OSI cut off of 4.15 (= OI of 4) in diagnosing P-ARDS was found. Good degree of correlation was found between predicting success of extubation and OSI (r = 0.32).

Conclusions: Although good correlation exists between OI and OSI, many factors significantly affect the difference between the two. Therefore, OSI can be used as a reliable monitoring method in controlled settings after ensuring good patient selection, proper method of sampling and sample handling, good quality electronic devices and invasive monitoring facilities.

Introduction : The pandemic made us realize that we have to explore new channels in order to spread wellness among corporate employees and the masses in shortest time with cost efficient and  maximal coverage. We wanted to explore whether we can make on online(virtual) event as effective as onsite event. We experimented to do a cardiopulmonary resuscitation (CPR) training online as well as onsite and compare whether it had similar impact. Hence we conducted a webinar for corporate employees online (across India) and collected the response from the participants. For this we contacted professionals from a NGO who were already doing CPR training online and requested them to do a similar onsite training at another exclusive urban corporate office. Feedback was taken from corporate employees of both the organizations and compared. Methodology : We have conducted online webinars as well as live demonstration with mannequin for awareness generation amongst different corporate employees. The study was conducted through online webinar on 24 August 2022 and on 18^th January 2023 with live demonstration and hands on practical with mannequin. Total 178 participants attended in online webinar and 40 participants attended live demonstration and hands on practical with mannequin. The data were statistically analysed using Microsoft Excel and SPSS version 20 software. Results :  Overall 95% participants of online webinar and 98% participants of live demonstration workshop opined that webinar and live demonstration content were directly related to content, detailed and simple. Overall 95% participants of online webinar opined that webinar conducted efficiently and it was an innovative learning experience and 92% opined that time was adequate for webinar. Overall 95% participants of online webinar and 98% participants of live demonstration workshop were agreed that the webinar and live demonstration workshop learning were extremely practical and will be useful for implementing if emergency situation arises. Conclusion : An overall 100% rated Webinar and live demonstration as 8/10 and above. Video-based online learning help employees to deep understand the benefits and value of utilizing this method CPR skill for nonmedical individuals which increase their satisfaction and skill acquisition

This prospective study aimed to assess the accuracy of electrocardiography (ECG) and 2D echocardiography (2D-ECHO) in identifying the infarct vessel in acute myocardial infarction (AMI), correlating findings with coronary angiography (CAG). Seventy-five AMI cases were included, diagnosed by ECG and cardiac enzymes, and underwent 2D-ECHO and CAG. Statistical analysis was conducted using SPSS and R environment. Results showed significant correlations between ECG, 2D-ECHO, and CAG findings, aiding in accurate identification of infarct vessels. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ECG and 2D-ECHO in identifying coronary artery involvement were evaluated. Findings suggest ECG and 2D-ECHO as valuable tools in AMI diagnosis, with implications for patient management

Introduction: Sickle-cell anaemia is a hereditary disorder characterised by the presence of sickle-cell haemoglobin genes acquired from both parents. Sodium (Na+), potassium (K+), and chloride (Cl-) are indispensable electrolytes that play a crucial role in facilitating the proper functioning of cells and organs. The current investigation was conducted to assess and establish the correlation between electrolyte levels in individuals diagnosed with Sickle cell anaemia. Objective: To assess the relative amounts of serum electrolytes in the Sickle cell group compared to the control group. Method: A meta-analysis was conducted on the results of 10 published research pertaining to the serum electrolyte levels of individuals diagnosed with sickle cell anaemia. A random-effects model was employed to determine the pooled mean for serum electrolytes. Results: The combined average of serum sodium levels was lower in individuals with sickle cell anaemia, with a p-value of 0.04. Nevertheless, the potassium levels in patients were significantly elevated compared to controls, with a p-value of 0.01. Conclusion: The utilisation of pooled mean, as presented in this study, holds potential value in the formulation of strategies for managing sickle cell anaemia.

Background: Pulmonary hypertension (PH) is a progressive disorder characterized by elevated pulmonary arterial pressure. It is caused by a multitude of intrinsic and extrinsic pulmonary vascular disease processes that cause hemodynamic alterations which overcome the normal pulmonary vaso regulatory mechanisms. PH is diagnosed when the mean pulmonary artery pressure (mPAP) is ≥25 mmHg at rest in right heart catheterization (RHC). Pulmonary hypertension (PH) in patients with interstitial lung diseases (ILDs) is not well recognized and can occur in the absence of advanced pulmonary dysfunction or hypoxemia. Methodology: The above study was conducted at the tertiary care hospital, department of radiology on total of 130 patients. Patients fulfilling the inclusion criteria were selected for the study. HRCT was performed. All patients were scanned from lung apices to lung bases at full suspended inspiration using standard exposure parameters (90 mA and 120kVp) in a single breath hold. The results were analyzed, studied and also compared with similar studies of the past with elucidation of the diseases where HRCT gave a specific diagnosis. Results: The mean size of main or central pulmonary arterial diameter(dPA) is 27.16±3.96, ratio between main pulmonary and aorta diameter(rPA) is 9.53±1.43, right pulmonary arterial diameter (RPAD) 19.62±3.02 and left pulmonary arterial diameter (LPAD) is 18.77±3.63. Conclusion: Main pulmonary artery is dilated more in smoking related lung disease than the rest of the Interstitial Lung disease.

Introduction: Propofol a routinely used intravenous induction agent for general anaesthesia is known to cause pain on injection due to its lipid emulsion property.Various methods have been tried to address propofol induced pain but have produced variable results. Pretreatment with Ondansetron a 5- HT3 antagonist has been shown to alleviate pain on propofol injection.

Aim: To compare the efficacy of intravenous granisetron versus a placebo(normal saline) to reduce pain on propofol injection.

Materials and Method: This randomised double blinded trial included18-60 year old American Society of Anaesthesiologists Physical Status(ASA PS) I and II patients for elective surgery under general anaesthesia.110 patients were randomly allocated into two groups of 55 each.They received either 2ml granisetron(1mg/ml) or 2ml 0.9 %saline. After receiving the test or control drug, patients were asked to score the pain on a four point categorical scale.

Results: Pain in the control group was 92.7% when compared to 10.9% in the intervention group(p < 0.0001). The severityof pain was also less in the intervention group pre-treated by 2ml of granisetron.

Conclusion: We found that intravenous Granisetron was effective in reducing pain on propofol injection

Introduction: Carcinoma cervix is the most common cancer and  the invasive stage of cervical cancer is preceded by pre-invasive phases and all the phases can be picked up and diagnosed by Pap smear. p16INK4 is a tumour suppressor protein which serves as a surrogate marker for the oncogenic activities of Human Papilloma virus  and its overexpression is well established in cervical intraepithelial neoplasia (CIN) and invasive cancers.

Aim: To evaluate the pattern of cervical cytology at a tertiary care hospital and to correlate the findings with histopathological diagnosis  and to determine the importance of  p16INK4a as a diagnostic marker of HPV by IHC staining method.

Materials and Methods: This is a two year  retrospective  study done on Pap smears reported between April 2021 to  May 2023 in the Department of Pathology , Gayatri Vidya Parishad Institute of  Healthcare and Medical Technology, Visakhapatnam .Frequency and percentage statistics was used to present the results.

Results: A total of 844 Pap smears  were included in the study, out of which 52 were cytologically abnormal. Biopsy was done on 42 cases, out of which 33 cases showed concordance which included18 LSIL, 8 HSIL , 5 squamous cell carcinoma and 2 cases of adenocarcinoma , among them  p16INK4a was found to be positive in 6 cases of LSIL, 5 cases of HSIL and  4 cases of SCC and 2 cases of adenocarcinoma.

Conclusion: Pap smear is a sensitive and cost effective screening modality for premalignant and malignant lesions of cervix and expression of  p16 as IHC marker has the potential to accredit the lesions with an increased risk of progression to high-grade lesions.

To explore mental health and self-management in glaucoma patients during the COVID-19 pandemic inCentral India and to describe the correlation between anxiety, depression, glaucoma and self-management.

METHODOLOGY:This cross-sectional study included glaucoma patients who enrolled in a case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), the Patient Health Questionnaire (PHQ-9) and the Glaucoma Self-Management Questionnaire (GSMQ).

OBSERVATION AND RESULTS:Among the 218 glaucoma patients enrolled in this study, the proportion of patients experiencing depression and anxiety during the COVID-19 pandemic was 26.5% and 20.3%, respectively. In these glaucoma patients, a statistical association was found between depression and self-control (r = -0.25, P = 0.01).

CONCLUSIONS: High rates of anxiety and depression were found in glaucoma patients during the COVID-19 pandemic.

Background: The primary lesions of the mandible have a wide range of pathological features but similar imaging appearances, which often pose a great diagnostic dilemma.

Objective: To devise a diagnostic algorithm using audit information obtained by correlating clinical, radiological and pathological characteristics of mandibular lesions and subsequent histopathological diagnosis available.

Methods: A total of 64 cases were taken. Out of the 64 cases, 4 (6 %) had only OPG available, 42 (65 %) cases had only CT and 5 (7.8 %) patients had only MRI available.

Results: The most common lesions encountered were Ameloblastoma comprising of 25 cases (39 %), followed by Osteosarcoma- 7 (10.9 %) and Odontogenic keratocyst-5 (7.8%). The majority of the cases had both OPG and CT done, whereas in 3 (4%) cases all three imaging modalities were performed.

Conclusions: Imaging is very helpful in diagnosis of the primary lesion of the jaw. It gives a clue about the type of periosteal reaction and effect on the surrounding bone (lytic, blastic or mixed tumors).

Objective: This study aimed to examine the relationship between placental thickness at the 32nd and 36th weeks of gestation and fetal outcomes, specifically NICU admission rates, birth weights, and APGAR scores. Methods: In an observational study involving 112 singleton pregnancies, placental thickness was measured using ultrasound at 32 and 36 weeks. The outcomes assessed included NICU admissions, birth weights, and APGAR scores at 1 minute post-birth.Results: Significant associations were found between placental thickness outside the range of 3.01-3.67 cm and adverse fetal outcomes. Placental thickness less than 3.01 cm or greater than 3.67 cm at 32 weeks was associated with increased NICU admissions (43.3% and 60%, respectively), lower birth weights, and reduced APGAR scores (23.3% and 32% with scores <4, respectively). A similar pattern was observed at 36 weeks. Statistical analysis revealed a chi-square value of 10.4688 (p=0.005) for the association between placental thickness at 32 weeks and birth weight <2.5 kg, and a chi-square value of 10.2362 (p=0.006) for the relationship between placental thickness at 36 weeks and APGAR scores <4. Conclusion: Placental thickness measurements at 32 and 36 weeks are significant predictors of fetal outcomes. Abnormal placental thickness is associated with higher NICU admission rates, lower birth weights, and reduced APGAR scores. These findings highlight the importance of routine placental evaluation in prenatal care.

Histologically cirrhosis is characterised by vascularised fibrosis septa that link portal tract with each other and with central veins leading to hepatocyte islands that are surrounded by fibrotic septa which are devoid of a central vein. The major clinical manifestations of cirrhosis are impaired hepatocyte function and increased intrahepatic resistance and development of portal hypertension and hepatocellular carcinoma. Liver has multiple functions including key role in metabolism, control of infection, elimination of toxins and byproducts of metabolism. This was a prospective study from 1st January 2023- 31^st December 2023 with a total of 100 deaths with presence of cirrhosis of liver detected during autopsy conducted in mortuary, Department of FMT, PMCH was analysed. Complete demographic, clinical details were obtained from accompanying relatives of the diseased, information sourced from police IO, inquest paper and medical records of the treatment furnished at the time of autopsy. Higher incidence of liver cirrhosis was found in age group 31-50 years, 74 percent of them were males, 30 percent were diabetic, alcohol was the etiological factor in 65 percent cases, NASH was etiological factor in 19%, hepatitis B and C was etiological factor in 12 % of the cases.

Background: Healthcare professionals (HCPs) working in intensive care units (ICUs) face unique challenges due to the demanding nature of patient care and high mortality rates, potentially leading to burnout. Burnout, characterized by exhaustion and disengagement, can adversely affect both HCPs and patient care outcomes.

Methodology: A single-center, questionnaire-based survey was conducted among HCPs working in ICUs of a tertiary care hospital in Bhubaneswar, Odisha. Demographic data and burnout levels were assessed using the Oldenburg Burnout Inventory (OLBI) questionnaire.

Results: A total of 70 HCPs participated, with 82.8% exhibiting burnout levels exceeding two. High exhaustion (71.4%) and disengagement (80%) were prevalent. No significant gender differences were observed, but neonatal ICU staff reported lower burnout. Experienced HCPs exhibited lower burnout. Longer work durations and shorter sleep durations correlated with increased burnout.

Discussion: Factors contributing to burnout include work duration, sleep duration, and work area. COVID-19 likely exacerbated burnout, though not directly assessed. Targeted interventions are crucial for mitigating burnout and improving patient care outcomes.

Conclusion: Working in ICUs presents significant challenges for HCPs, leading to high burnout levels. Addressing burnout through periodic assessment and interventions is vital for enhancing job satisfaction and patient care quality in ICU settings.

Introduction: Hydatid cysts of the liver (HCL) are a severe yet unappreciated public health concern in underdeveloped nations such as India. HCL is mostly caused by the tapeworm Echinococcus granulosus [1]. In 2010, a research conducted by the World Health Organisation (WHO) estimated the incidence of cystic echinococcosis per 100,000 individuals in Southeast Asia to be 0.8 (95% confidence interval (0.2-2)) [2]. Estimating HCL's influence in India is difficult, though, for a variety of reasons. First, the total frequency of the illness is greatly underreported in many epidemiological studies and series due to a lack of thorough research and surveys covering the whole endemic population. Furthermore, there is a propensity for the Health Management Information System, the government of India's monitoring system, to underreport.

Aim: To evaluate hepatic hydatid cyst patients' clinical symptoms, therapy, and sociodemographic characteristics in a poor country.

Materials And Methods: During the course of 24 months, the Department of General Surgery at FM Medical College and Hospital in Balasore, undertook this retrospective study. A retrospective, descriptive study was performed on 23 patients who had been identified with a liver hydatid cyst based on clinical symptoms, imaging testing, or serology. To present the study's findings, the data was assessed and statistically analysed using IBM SPSS 23.0 for Windows.

Results: The age group of 25 to 45 was the most commonly affected (10, 43.47%), with an average age of 36 among the patients. Female patients made up 56.5% of the total patients. Palpable liver (7, 30.4 %) and stomach discomfort (21, 91.3 %) were the most common symptoms. Abdominal ultrasonography and computed tomography were the two primary imaging techniques used to establish a diagnosis. Anechoic, unilocular cystic lesions were the most prevalent kind. Most liver cysts in these individuals were found in the right lobe. In 44.4 percent of the patients, hydatid cysts were surgically removed; the most common kind of surgical operation was pericystectomy.

Conclusion: In India, hepatic hydatid cysts are frequently the source of illness. For most patients, surgery remains the primary course of treatment; diagnosis requires a clinical examination accompanied by imaging investigations.

Background : Older adults' health issues are a vital part of any system that delivers health care. On April 7, 1999, the world health day topic was "ACTIVE AND HEALTHYAGEING"As stated by Dr. Shigeru Omi, the former Western Pacific Regional Director of WHO, "Our goal is not only to add years to life, but to add quality to those years."

OBJECTIVES:

1. To study the socio-demographic profile of the elderly population in the field practice area of Rural Health Training Centre.

2. To study the health problems among the elderly population in the field practice area of Rural Health Training Centre.

MATERIAL & METHODS: Study Design: Community based cross-sectional study. Study area: The study was conducted at village Venkatachalam which is one of our villages in the field practice area, under department of community medicine, Narayana Medical College, Nellore.   Study Period:  1 year (October 2019 to September 2020).  Sample size: Study consisted a total of 290 subjects. The First part consists of personal data. It specifies the name, age, sex, religion, education, occupation, marital status, living arrangement, and approximate per capita monthly income. The Second part specifies data regarding habits like tobacco, alcohol, or any other medicine use. The form of tobacco use like smoking, chewing, or snuff was determined. The subjects were classified as current users, former users, and non- users. Current consumers are those who were presently consuming tobacco or alcohol. Former consumers used to consume tobacco or alcohol earlier, but not during the past year.

Results: Underweight and obesity were defined according to the BMI. Table 40 shows that 21% of the elderly populations were underweight, 13.4% are overweight, 15.9% are pre-obese, and 2.4% are obese. Our study showed that 53.4% of the elderly had difficulty in vision. Out of those who had trouble in vision (155), only 15.48% (24) used a visual aid. And 25.9% of the elderly had difficulty in hearing. Of them, 97.3% are not using any aid for their hearing disability. In our study, chewing difficulty was present among 32.4% of the older people.

Background: Hypertension is powerful cardiovascular risk factors for Coronary Artery Disease (CAD). In this study Uric acid levels and Lipid profile are estimated to be evaluate risk of CAD in Hypertensive patients.

Methodology: In this study 90 subjects divided into 3 groups are taken. Group 1)30 Hypertensive patients Group 2) Hypertensive patients who had Myocardial Infarction (M.I.) Group 3) Age and sex matched healthy controls.                                                          Results: In Hypertensive patients increased Uric acid levels and Dyslipidemia are observed.                                                                                                                             .

Background Speech and language is the most common form of social interaction and communication. Delay indicates that children are acquiring language skill in a slower rate. Language delayed children may exhibit poor scholastic performances, behavioural problems and impaired psychosocial functioning. Timely screening and identification of speech and language delay can lead to early intervention and better outcome.

Aim and objective To assess the prevalence of speech and language delay among 0-3 years old children  and to detect the risk factors of language delay

Methodology A cross sectional hospital based descriptive study was conducted among 400 children of 0-3 years. Language delay was assessed using Language evaluation scale Trivandrum (LEST 0-3) and the risk factors were studied

Results Out of 400 children studied, 13.5 % had speech and language delay and 3% had questionable delay. Male gender, prematurity low birth weight, perinatal complications, second born child  and rural residence were found to be associated with language delay. Negative home environment and screen time  more than 2 hours a day had deleterious association with speech and language development.

Conclusion Language evaluation scale Trivandrum (LEST 0-3) is a simple validated screening tool to detect the prevalence of speech and language delay which is a common problem in Paediatric population. The high prevalence of language delay implies the need for routine speech and language screening of children among 0-3 years. Modifiable risk factors of language delay require appropriate  interventions to reduce the hazardous effects.

BACKGROUND This study was conducted to examine the recovery times following cemented or uncemented total hip arthroplasty for patients with avascular necrosis of the femoral head and to examine the clinical and functional outcomes of cemented versus uncemented total hip replacements in patients with this agonizing condition.

METHODS

This was a 17-month study that took place in a hospital setting and involved 30 patients with hip joint arthritis brought on by avascular necrosis of the femoral head. The patients gave written informed consent and the approval of the institutional ethics committee before being referred to the Department of Orthopedics at the Princes Esra Hospital/Deccan College of Medical Sciences, Hyderabad, Telangana, India.

RESULTS

Before surgery, the mean functional gait score was 10.53±6.96, and after surgery, it was 30.33±2.31. Prior to surgery, the functional activity score was 5.17±1.62, and following surgery, it was 11.40±1.07. The study group's preoperative and postoperative scores showed statistically significant variation. The average Harris hip score was 32.27±8.11 before surgery and 92.60±3.16 after surgery. The differences in scores before and after surgery were statistically significant. Before surgery, the study group's mean ROM score was 2.40±1.25, and after surgery, it was 4.63±0.49. In the preoperative and postoperative phases, there was a statistically significant difference in ROM evaluations.

CONCLUSION

The current generation of uncemented implants used in total hip replacement for AVN-caused hip arthritis yields, satisfactory clinical and radiological outcomes after a reasonable period of follow-up. Despite a few problems with the course of treatment, functional and clinical outcomes have been good to exceptional overall.

BACKGROUND A retrosternal goiter is an enlarged thyroid which extends below clavicle and sternum. Retrostemal goitre can be defined as thyroid which extends below manubrium but some include only goitres that extends more than 50% or 3 cm below thoracic inlet. Because they are expansions or extensions of multinodular goitres based on the superior or inferior thyroid vasculature, the majority of intrathoracic or substernal goitres are referred to be secondary." They spread outward into the mediastinum anterior.

AIM

To find out the differences for the need for cervical approach or if it mandates a median sternotomy based on various factors.

MATERIAL AND METHODS

The present retrospective comparative study was conducted among 31 patients of Retrosternal goitre admitted in PSGIMSR and Hospital over the past 10 years from period 2013-2023. Patient details, history, relevant investigations, operating procedure, post-operative complications and duration of hospital stay were collected. The following factors were examined in these patients' medical records: clinical symptoms, prior thyroidectomy history, surgical technique (only cervical or cervical with median sternotomy), thyroid histology results, thyroid weight, and complications following surgery.

RESULTS

Of the thirty-one patients, twenty-six (83.87%) had thyroidectomies by cervical incisions, while five (16.13%) required median sternotomies. Mean operative time (min) and hospital stay (days) among subjects who underwent surgery through cervical and thoracic approach was 214.81, 7.92 and 321.92, 15.83 respectively. Hence mean operative time (min) and hospital stay (days) was significantly more in thoracic as compared to cervical approach as p<0.05. Most common postoperative complications among the study subjects was transient hypocalcemia followed by postoperative bleeding.

CONCLUSION

Due to the low surgical morbidity, high incidence of compression-related symptoms, lack of effective medicinal treatment, and possibility of cancer, the existence of an RSG is an indication for surgery. Although surgically removing a retrosternal goitre is a difficult procedure, it can usually be done safely using a cervical approach. The rate of complications associated with this procedure is slightly higher than that of a cervical goitre thyroidectomy, particularly in regards to hypoparathyroidism and bleeding after surgery.

Background: The transition into medical school marks a significant juncture in the academic journey of aspiring healthcare professionals. The first year of MBBS education lays the groundwork for foundational knowledge in the biomedical sciences, with theory paper writing serving as a pivotal component of the assessment process. Students often lack clarity on how to articulate their thoughts and meet teachers' expectations, revealing a noticeable gap in their preparation.

Objectives: This scholarly article explores the importance of enhancing quality in theory paper writing for first MBBS exam aspirants. It delves into various facets of quality paper writing, including planning strategies, examination techniques, and skill development.

Materials and Methods: The study conducted in the Department of Physiology for first MBBS students of batch 2020 involved an online presentation aimed at elucidating examination preparation and paper writing strategies. Feedback from students highlighted the efficacy of the session in aiding study planning, understanding exam patterns, and building confidence in completing syllabi within preparatory periods.

Results: Students' suggestions underscored the need for additional sessions on essential topics and unit-wise tests. The study showed that interventions such as online presentations can significantly impact students' understanding and confidence in paper writing and exam preparation.

Conclusion: We hereby conclude by emphasizing the critical role of educators in nurturing writing skills among medical students, ultimately preparing them for success in academia and future medical practice. This study highlights the importance of explicit instruction and support in theory paper writing to bridge the gap between students' current skills and the expectations of their medical education.

Background: To accomplish daily activities, proper fitness and wellbeing of musculoskeletal system is one of the essential factors. Handgrip strength is a common clinical evaluation done for various pathologies as it is a physiological variable that is influenced by multiple factors including body size, sex, age, fat percentage, BMI and hand perimeters. Grip strength is a standard criterion for assessment of hand grip function. As grip strength estimation using hand dynamometer is easy and economical, it is generally used in upper limb injuries for outcome assessment.                                   .

Materials and Methods: The present study is conducted to find relationship between Waist and HIP ratio, BMI and Handgrip endurance. This study included 90 subjects aged between 18-21.  The subjects who had a BMI below 30 and those with no history of smoking or alcoholism were included in the study. The height was measured with stadiometer. We have used Quetlet’s index for calculating subjects Body Mass Index (BMI). We have used a handgrip dynamometer to measure the handgrip strength and endurance of the dominant hand. Measurement of waist and hip was taken in centimetres using stretch-resistant measuring tape. Waist hip ratio was calculated by dividing the circumference of the waist to that of the hips in centimetres. All the data were recorded and expressed in Mean +SD, SPSS software was used to analyses data.                           .

Results: In present study total 90 students were involved. There was significant mean difference between male and females in case of height, weight, waist circumference, hip circumference, WHR, right hand grip and left-hand grip with gender. There was significance difference and positive correlation was observed for right hand grip in male students with weight, BMI and WHR. Significant and positive correlation was also observed for left hand grip in male and female students with height.

Background: Many schoolchildren confront serious health problems as a result of their familial, environmental, or risk-taking behaviours. These health hazards are frequently linked and may share common underlying determinants, which may impair the child's capacity to learn.

Aim: To assess the implementation of school health services in the primary schools of Nellore City.

Objective: To study the extent of implementation of various aspects of school health services in the primary schools of Nellore city.

Material & Methods: Study Design: Community-based Cross-sectional study. Study area: The study was conducted in Primary schools which consists of classes I to V, in Nellore city.  Study Period: 2 years. (Jan 2014 to Jan 2016). Sample size: The study consisted of a total of 163 schools. Sampling Technique:  Simple Random sampling. Study tools and Data collection procedure. A pre-tested, structured questionnaire was used for data collection,2. Data regarding certain aspects of school health services like Health facilities, Nutrition facilities, Health education and Maintenance of Health records are obtained by interviewing the Head Master of the school who is the key informant. 3. The remaining data regarding the Healthful school environment and sanitation facilities was collected by examining the school environment.

Results: In the present study 46 (28.2%) schools provided treatment for minor ailments like fever, stomach ache etc., and referred the students to the nearest hospital for health problems that were beyond their purview. In the present study, it was revealed that 27 (16.6%) schools provide Eye Health Services by conducting eye health screening and referring students with vision problems to the nearest eye hospital.

Conclusion: The current study's findings emphasize the need for the government and health organizations to make the required efforts to improve school health services to establish a healthy community. As a result, emphasis should be placed on a multidisciplinary approach to improving school health care. Aside from a multidisciplinary approach, social and political commitment is essential to improve the quality of school-based health services.

Background Research comparing the efficacy of phenylephrine and norepinephrine in managing post spinal hypotension among pregnant patients is limited.

Objective To assess the effectiveness of phenylephrine and norepinephrine bolus doses in treating hypotension during elective cesarean section under spinal anesthesia in pregnant females hypothesizing similar neonatal outcomes.

Materials and Methods : The present randomized controlled study is a single-centre, tertiary care hospital based study conducted on 90 pregnant women with singleton pregnancies experiencing postspinal hypotension during cesarean section. Patients received intravenous phenylephrine (50 μg) or norepinephrine (4 μg) for hypotension treatment, defined as ≥ 20% drop in baseline systolic BP or absolute value < 100 mmHg. Primary outcome measure was umbilical artery pH while secondary measures were Apgar scores, hypotensive episodes, vasopressor requirements, cardiac complications, maternal outcomes.

Results : Umbilical artery pH did not differ between phenylephrine and norepinephrine groups (8.26 ± 0.06 vs. 8.27 ± 0.06, respectively; P = 0.93). Median hypotensive episodes were higher with norepinephrine (2[1to3] vs.1 [1to2],  P=0.014). Apgarscores, va so press ordoses, BP trends, and maternal complications were similar. Phenylephrine group had lower heart rates (P = 0.026); one had bradycardia (HR < 50 bpm) vs. none with norepinephrine (P = 1.000).

Conclusions In pregnant women undergoing elective cesarean section, phenylephrine (50 μg) and norepinephrine (4 μg) bolus doses for spinal anesthesia-induced hypotension are equally effective with similar neonatal and maternal outcomes.

Conclusion: Morphological and morphometric analysis of the glenoid cavity of the scapula is very important during designing and fitting of glenoid components in total shoulder arthroplasty and its associated shoulder pathology.

:    Introduction: Diabetic retinopathy is the most common complication of Diabetes mellitus. It can lead to blindness if not identified early and treated. Most of the cases are undiagnosed as there is lack of knowledge in the patients. This study was conducted to assess the knowledge, attitude and practices of diabetes patients towards Diabetic Retinopathy.

Materials and Methods: A cross sectional study was conducted on randomly selected  82 type 2 diabetes mellitus patients attending as out-patients in the department of Ophthalmology at Kanachur Institute of Medical Sciences. The patients were requested to answer the questionnaire which had 19 questions related to knowledge, attitude and practice by using face to face interview method.

Results: A total of 82 diabetes mellitus patients were enrolled in which 56 were males and 26 were females. 90.2% of the patients were aware of the tests done to diagnose DM, but 87.8% of the patients did not know how to keep DM under control. 85.4% were not aware of the eye problems DM can give. 53.7% agreed that DM can cause blindness. 51.2% agreed that eating sweets occasionally was alright. 56.1% agreed that they should not forget to take medications ever. Our study participants had positive attitude. Study patients had good practices on taking medicines regularly as advised by the physicians (87.8%). And they did go for regular follow up advised by their physician (85.4%).

Background: Hand grip strength is an integral part of performing precise and refined fine motor activities. In the physical assessment of various diseases affecting musculoskeletal neuromuscular and cardio respiratory systems in children, elderly and obese populations, HGS measurement is also used as a commonest part of the assessment. Obesity has become a major health problem in today’s world. The relationship of the anthropometric parameters like height, weight, BMI with Hand grip strength and endurance among the healthy young adults has not been properly explored to determine the influence of the former on the  later.

Materials and Methods: This study included 90 subjects, 45 boys and 45 girls. All were aged between 18-21 years. The only healthy students were included in study. The students who were on medication or suffering from any ill-health were excluded from study. The students especially upper limb fractured or with limb deformity were excluded and the student with disorders like cardiovascular and respiratory were excluded. The subjects who are below 30 BMI were selected for study. The height and weight were measured, BMI was calculated by using Quetlet’s index.  In present study we have used a handgrip dynamometer to measure the handgrip strength and endurance of the dominant hand. Dynamometer was used to measure for same parameters. All the data were recorded and expressed in Mean +SD, SPSS software was used to analyses data.

Results: In present study we have calculated the BMI after measuring weight and height of subjects. The P-value in both male and female, between underweight, normal weight and overweight was <0.001. In case of Handgrip Strength (Kg) in present the P-value in both male and female, between all three groups was >0.05. In case of Handgrip endurance (Sec) in present study the P-value in both male and female, between all three groups was <0.001(Table1).

Conclusion: The present study findings shows parameters like BMI positively correlated with hand grip muscle strength and height positively correlated with muscle endurance. The present study parameters may be considered before measuring hand grip muscle strength and endurance. The finding will add knowledge about the BMI, Handgrip muscle strength and endurance in present study group.

Background:  Coronary artery diseases are condition arises due to the clogging of atherosclerotic plaque coronary artery of heart; results decrease in the blood flow to the heart muscles.  Formation of atherosclerotic plaques is the major cause of coronary artery disease (CAD). Among the several cardiovascular diseases, coronary artery disease (CAD) is the most prominent and prevalent. Cardiac biomarkers have become frontline diagnostic tools for myocardial infarction (MI); clinicians can make faster diagnostic decisions and design a more effective treatment plan, which reduces mortality. Detection of cardiac biomarkers plays an increasingly important role in evaluating and diagnosing patients with chest pain. Micro-vascular complications are increasingly linked to chronic hyperglycemia. Meta analysis of ten likewise studies on type-II diabetes have shown a potential association among cardiovascular disease and glycated hemoglobin and that have highly significant association (18%) of cardiovascular diseases risk by every 1% of elevated glycated hemoglobin concentration. Materials and Methods:  The total study group consists of 400 subjects, of which 200 premature coronary artery disease patients (cases) & 200 were healthy individuals (controls). Venous blood was used for analysis. Cardiac markers (Tropnin-I & Myoglobin) were done by Immunofluorescence & HbA1c was done by Ion exchange HPLC method Bio-Rad D-10 Analyzer. The data analysis was done by using mean, standard deviation & student t-test. Results:  Trop-I (0.58 ± 0.48 vs. 0.02 ± 0.006), Ck-MB (39.1 ± 11.02 vs. 14.79 ± 4.0) & Myoglobin (84.01 ± 8.22 vs. 38.99 ± 7.06) were higher in CAD patients than control subjects. The HbA1c (6.51 ± 0.36 vs. 4.66 ± 0.41) was higher in CAD patients than control subjects.  The level of serum cardiac markers & HbA1c were significantly increased in CAD patients as compared to healthy individuals. Conclusion: The present study concluded that increased level of cardiac markers & HbA1c in Premature CAD patients as compared to healthy individuals.

Background:  The horizontal plates of the palatine bone, the pre-maxilla, and the palatine processes of the maxilla combine to form the hard palate, an essential part of the skull. It has an arched structure with varied depth and breadth, is widest in the molar area, and separates the oral cavity from the nasal cavity. This vital anatomical structure plays a crucial role in various forensic investigations. This study sheds light on its forensic significance, offering valuable insights for forensic scientists and anthropologists. Through meticulous analysis, this study aims to contribute to the understanding of craniofacial anatomy and its implications in forensic sciences.Future research can use the data collected from this study as a baseline in anthropometrics, dentistry, forensic sciences, and anatomy. The present study aimed to measure the morphometric characteristics of the hard palate in dried human skull bone that belonged to the North Indian population. Materials and Methods: The present study was conducted on 50 dried skulls obtained from the Department of Forensic Medicine & Toxicology and Anatomy, at Indira Gandhi Institute of Medical Sciences in Patna, Bihar. The age and sex of the skulls were not known. With the help of a digital vernier caliper, we measured the length of the hard palate, breadth of the hard palate, and height of the hard palate, palatine index (PI), and palatine height index (PHI). The obtained data was analyzed using Statistical Package for Social Sciences (SPSS, version 24.0) software. Results: The mean palatine length, breadth, and height in the present study were 46.30 ± 3.87 mm, 32.73 ± 2.66 mm, and 11.27 ± 2.03 mm, respectively. The mean values of the palatine index and palatine height index were 71.12 ± 7.80 mm and 34.66 ± 6.79 mm respectively. The most frequent type of hard palate was leptostaphyline (84%), followed by mesostaphyline (12%) according to the palatine index, while brachystaphyline type (4%) was the least commonly reported. While, the most frequent type of hard palate was orthostaphyline (62%), followed by hypsistaphyline (20%) according to the palatine height index, while the chemostaphyline type (18%) was the least commonly reported. Conclusion: The study's information will be helpful in the fields of anthropometric, dental, and medical sciences. A thorough anatomical knowledge of the hard palate is essential for executing certain surgical treatments in the hard and soft palate, anthropological research, complete maxillary denture fabrication for edentulous patients, and ethnic and racial classification of crania. Oral maxillofacial surgeons may benefit from knowledge of the palatal index when performing surgery to fix a cleft palate or lip.

Background:  Alcohol may foster the initiation of sexual activity by removing inhibitions, but it impairs performance in the long run, which leads to marked discomfort and relationship problems. The correlation between alcohol dependence and sexual dysfunction is multifaceted. Chronic alcohol abuse can lead to physiological changes in the body, disrupting hormonal balance, neurochemical pathways, and vascular function, all of which contribute to sexual dysfunction. These problems, in turn, would amplify alcohol misuse. Some studies have looked into sexual dysfunction due to alcohol, but there are only a few case-control studies reported from India. Methods:  This is a prospective and case control study was conducted among the patients with the history of alcohol dependence admitted in a tertiary care hospital over a period of 6 months. Patients with 21 years of age and above were included. The nature and the purpose of the study were explained briefly to the study population in the informed consent form and then the study population was recruited according to inclusion-exclusion criteria as mentioned above. During the study period, all the recruits were given standardized self- answering questionnaires as mentioned below in the instruments used. ICD-10 F52 criteria were used to diagnose sexual dysfunction. Results:  The current study determined occurrence of at least one sexual dysfunction among case (76.6%) which is higher than that of control (36.6%). Furthermore, occurrence of more than one sexual dysfunction in case (63.3%) came out to be higher than that of control (23.3%). No vast difference between case (54.3%) and control (71.4%) can be found with regards to premature ejaculation. In addition, researcher did not find any significant difference. A negative association between erectile function, sexual desire, overall satisfaction, and intercourse satisfaction domains of IIEF and duration of alcohol consumption was observed [r = -0.015, -0.271, -0.04, and -0.168, respectively]. This means an increase in the scores of sexual desire and intercourse satisfaction can be observed with the duration of alcohol consumption, while scores of overall satisfactions tend to decrease. Conclusion:  The study highlights the global nature of sexual dysfunction in men with alcohol dependence. It emphasizes the need for clinicians to routinely assess the sexual problems in their alcohol drinking patients, especially those with liver disease.

This study compares Retrograde Light-Guided Laryngoscopic (RLGL) intubation with Conventional Direct Laryngoscopic (DL) intubation in emergency operating theatres. Given the challenges and varying success rates among novices performing tracheal intubations via DL, alternative methods that are cost-effective and simpler to execute are continually sought. RLGL, utilizing retrograde transtracheal light transmission, offers a promising approach by simplifying the identification of the glottis. This randomized, open-label, parallel-arm superiority trial involved 205 patients and aimed to evaluate the effectiveness and practicality of RLGL against DL, focusing on glottic exposure, intubation success rates, and the learning curve for novice intubators. Results suggested that RLGL could significantly improve success rates and reduce the time for both glottic exposure and tracheal intubation, demonstrating its potential as a valuable tool for novice intubators.

Background: Dyslipidemia, characterized by elevated levels of low-density lipoprotein (LDL) cholesterol, is a significant risk factor for cardiovascular diseases. Rosuvastatin, a statin medication, is commonly prescribed to lower LDL cholesterol levels. However, comprehensive observational studies assessing its effectiveness and safety in real-world settings are limited.This observational study aimed to evaluate the effectiveness and safety of rosuvastatin in reducing LDL cholesterol levels among individuals with dyslipidemia.

Methods: A sample of 100 participants with dyslipidemia, aged 45-65 years, was enrolled in a 12-week observational study. Baseline characteristics, including age, gender distribution, and baseline LDL cholesterol levels, were recorded. Participants received rosuvastatin therapy as per standard clinical practice. The primary outcome measure was the change in LDL cholesterol levels from baseline to the end of the 12-week treatment period. Safety assessments included monitoring for adverse events, liver function tests, and creatine kinase levels. Compliance and adherence to medication were also evaluated.

Results: Following 12 weeks of rosuvastatin therapy, a significant reduction in LDL cholesterol levels was observed across the sample (mean reduction: 30 mg/dL ± 5 mg/dL). Subgroup analysis based on baseline LDL cholesterol levels demonstrated consistent reductions, with greater reductions observed in participants with higher baseline LDL cholesterol levels. Rosuvastatin therapy was well-tolerated, with no serious adverse events reported. Common adverse effects were mild and transient, including muscle aches, gastrointestinal discomfort, and headache. Compliance with therapy was high, with 95% of participants completing the treatment period and adherence rates exceeding 90%. Secondary outcomes indicated improvements in total cholesterol (mean reduction: 35 mg/dL ± 6 mg/dL), triglycerides (mean reduction: 25 mg/dL ± 4 mg/dL), and HDL cholesterol (mean increase: 5 mg/dL ± 2 mg/dL).

Background:  The foramen ovale of the sphenoid bone is located  anteromedial to the foramen spinosum and posterolateral to the foramen rotundum.  The morphology of the foramen ovale has been described by ambiguous terms such as almond / D shap, elongated oval, oval, round semicircular, slit, pear and truly oval. The border of the foramen ovale may be irregular and bony spurs, spines, and tubercles have been documented to project into the foramen ovale. The present study morphometric data has been reported length, width, and area of the foramen ovale and morphological shapes of foramen ovale. Materials and Methods:We have collected the adult dry skulls from first years medical and dental students in multiple medical and dental colleges. We have used digital vernier callipers for measurements to measure length and breadth. We have calculated area of foramen ovale by using formula ((3.14 X Length X Beardth) /4). We have observed the shapes and categorised as oval, round, almond and irregular.

Objective: This study aimed to examine the relationship between placental thickness at the 32nd and 36th weeks of gestation and fetal outcomes, specifically NICU admission rates, birth weights, and APGAR scores. Methods: In an observational study involving 112 singleton pregnancies, placental thickness was measured using ultrasound at 32 and 36 weeks. The outcomes assessed included NICU admissions, birth weights, and APGAR scores at 1 minute post-birth.Results: Significant associations were found between placental thickness outside the range of 3.01-3.67 cm and adverse fetal outcomes. Placental thickness less than 3.01 cm or greater than 3.67 cm at 32 weeks was associated with increased NICU admissions (43.3% and 60%, respectively), lower birth weights, and reduced APGAR scores (23.3% and 32% with scores <4, respectively). A similar pattern was observed at 36 weeks. Statistical analysis revealed a chi-square value of 10.4688 (p=0.005) for the association between placental thickness at 32 weeks and birth weight <2.5 kg, and a chi-square value of 10.2362 (p=0.006) for the relationship between placental thickness at 36 weeks and APGAR scores <4. Conclusion: Placental thickness measurements at 32 and 36 weeks are significant predictors of fetal outcomes. Abnormal placental thickness is associated with higher NICU admission rates, lower birth weights, and reduced APGAR scores. These findings highlight the importance of routine placental evaluation in prenatal care.

Introduction: Urinary tract infections are one of the most commonly encountered problems in outpatient departments. More than the detection of bacteria during urine analysis, detection of MDR pathogens and their AST pattern plays a vital role to treat the patient accordingly. We would like to project the data clinicians about ESBLs pathogens and its susceptibility pattern.

Materials and Methods: This is a prospective observational study conducted on urine samples collected from UTI patients by testing the pathogen and its sensitivity at the Department of Microbiology. All gram negative bacterial isolates were further evaluated for ESBL detection by using combined disc diffusion test (CDDT) and double disc synergy test (DDST).

Results: Among the urinary pathogenic isolates, Esch.coli (22.85) was the predominant pathogen followed by S.aureus (19.2%), Klebsiella species (11.6%).Among the gram negative bacteria isolates, n=70 (25.6%) were ESBL producers. ESBL producers include 62.85% of Escherichia coli, 35.71% of Klebsiella and 1.4% of Proteus mirabilis isolates.ESBL producers showed highest sensitivity to amikacin, imipenem, nitrofurantoin, colistin and polymyxin B and the poorest sensitivity to cefotaxime and amoxyclav. The overall percent agreement between CDT and DDST was 99.2%. The positive percent agreement (PPA) and negative percent agreement (NPA) between the two tests were also substantial, 97% & 100% respectively.

Conclusion: Active screening of UTI suspected patients for ESBLs colonization is important to initiate appropriate infection control measures that includes cohorting, de-escalating the antibiotics and confined to narrow spectrum antibiotics, and adherence to hospital infection control protocols.

Background: Although there is still disagreement on the microbiological profile, bacteria in the peri-implant area are responsible for the development of peri-implantitis (PI). Methodology: After 14 unsuccessful implants were extracted, they were immediately prepared for scanning electron microscope examination. Three equally distributed sub-crestal levels of the exposed area were used to photograph the dental implants. Three inspectors recognised and measured the different bacterial morphotypes. Results: In our research, the implants showed evidence of diverse bacterial morphotypes that were unrelated to the development of the disease. Filaments dominated several implants, while combinations of cocci/rods or spirilles/spirochetes were seen in several. Overall, the morphologic biofilm makeup of all devices varied. Conclusion: Although there were notable variations amongst the implants, identical morphological types in each implant were frequently observed over the whole region.

Background: Electroconvulsive therapy (ECT) is a critical treatment modality for certain psychiatric conditions, though it can induce transient cardiovascular changes. The choice of anesthetic agent can influence these hemodynamic responses, necessitating a careful selection process.

Methods: This observational study compared the cardiovascular effects of intravenous etomidate, propofol, and thiopentone in 90 patients undergoing ECT. Heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured at baseline, 1 minute, 5 minutes, and 10 minutes post-ictal.

Results: No significant inter-group differences were observed in heart rate, SBP, DBP, or MAP at any time point. All groups exhibited a significant increase in heart rate and blood pressure at 1 minute post-ictal, with values returning to near-baseline by 10 minutes. Specifically, the heart rate increased significantly from baseline at 1 minute postictal (Group E p < 0.001, Group P p = 0.00182, Group T p = 0.00011), with similar patterns observed for SBP and DBP. By the 10-minute mark, changes from baseline were not statistically significant, indicating a transient cardiovascular response to ECT.

Conclusion: Etomidate, propofol, and thiopentone are comparable in their cardiovascular safety profiles when used as anesthetic agents in ECT. These findings support the clinical flexibility in selecting an anesthetic based on factors other than cardiovascular effects.

Background:   Purpura fulminans (PF) is a life-threatening disorder of coagulation clinically characterized by acute onset, rapidly progressive hemorrhagic skin infarction and necrosis, accompanied by vascular collapse and disseminated intravascular coagulation1. The diagnosis is made by laboratory evidence of consumptive coagulopathy and histopathological evidence of widespread thrombosis1,2. The condition is fatal (up to 50% mortality) and survivors may suffer loss of digits, limbs or areas of skin. We report 3 cases of this rare condition, 1child and 2 adults which are of different causes. One case was related to non-inflammatory (intravascular) causes other 2 causes were related to inflammatory (infectious) causes of purpura fulminans. Conclusion: - Though the dermatologist role is less in management of purpura fulminans, dermatological signs can be decisive in arriving at the correct diagnosis and treatment (possible infectious origin on the basis of the first presenting symptoms). The problem is to distinguish a PF from a vasculitis with cutaneous involvement and this is not always easy to do- acral involvement, hemorrhagic bullae, a tendency to necrosis and hypovolemic shock are all suggestive of PF. Hence, a high index of suspicion and prompt treatment with multidisciplinary approach always enhance therapeutic outcomes in such fatal condition. We report these 3 cases for its rarity, very few cases have been reported in literature especially puerperal sepsis and polycythemia vera related PF and hence proves its heterogeneity with common clinical presentation

Background:   Superior mesenteric artery (SMA) syndrome is a rare cause of small bowel obstruction due to extrinsic compression of the duodenum. This study aimed to evaluate the presentation, surgical management, and outcomes of seven patients with SMA syndrome treated at two tertiary care centers in India between June 2015 and January 2023.All patients presented with chronic vomiting, nausea, epigastric pain, and weight loss. Diagnosis was confirmed by radiological findings, including CT scans demonstrating a narrowed aortomesenteric angle (<22 degrees) and dilated proximal duodenum. Surgical intervention was the mainstay of treatment due to minimal success with non-operative management. All patients except one underwent laparoscopic duodenojejunostomy. One patient with a post-operative stricture required conversion to a Roux-en-Y duodenojejunostomy. Methods:   We have managed seven cases of duodenal obstruction due to SMA syndrome during the time period of June 2015 to January 2023. The study included cases pooled from two tertiary care centers of Andhra Pradesh. The primary evaluation was done by gastroenterologists, psychologists and followed by detailed surgical evaluation. Ultrasonography and upper endoscopy were done for all cases followed by CT scan of the abdomen in all the cases. All the patients had clinical and radiological findings consistent with SMA syndrome. Data collected included patient demographics, clinical presentation, operative data, and outcomes. Data are presented as mean ± standard deviation for continuous variables and as percentages for categorical variables.  Results:   The seven patients included 5females and 2 males (female to male ratio was 2.5:1). The mean age of the cases was 21.29 ± 4.15 years (range 13 – 26 years). The Comorbidities identified in these cases included Psychiatric/anxiety (14.29%), anorexia (28.57%), Pancreatitis (14.29%), Mild scoliosis (14.29%), Binge/fasting (14.29%). No clear reason was identified in one case (14.29%) and attributed to fibromyalgia. One patient had previous laparoscopic appendicectomy, but no other patient had any history of abdominal or spinal surgery.

Parkinson's disease is a neurological condition that progresses over time and causes terrible socioeconomic consequences for affected people, their families, and society as a whole. It is linked to both motor and non-motor symptoms, which has a substantial negative impact on older people's quality of life. Methods:  This one-year hospital-based observational cross-sectional study was carried out in the K.R. Hospital's neurology and medicine departments from November 2022 to October 2023. The study covered all Parkinson's disease patients who visited the K.R. Hospital's medicine and neurology outpatient and inpatient departments. Both the clinical signs and symptoms and the demographic information were noted.  Results:  Males outnumbered girls by a significant margin. The average age of the research participants was 63.87±6.52 years. A total of 100%, 70%, and 26.67% of the participants reported having cardinal, motor, and non-motor symptoms, respectively. Subjects with both motor and non-motor symptoms had higher mean ages than their counterparts, indicating a statistically significant difference. Conclusion:  The features of the PD patients included in this study closely resemble those of other populations in India and other developing countries. However, the paucity of research and data on Parkinson's disease highlights the need for additional study of this neurodegenerative illness to gain a deeper understanding of its clinical and epidemiological features in our area.  

Background:  The present study aimed to estimate the salivary immunoglobulin A and total salivary proteins in minor RAS and in healthy controls. 50 patients with known history of minor RAS were diagnosed based on the major criteria with the absence of any other systemic disease or conditions and presenting with single and multiple ulcers and 50 healthy control group were included in the study. Minor aphthous were selected as they are more common than the major and herpetiform ulcers. Unstimulated saliva was collected by spit method in a calibrated measuring cup from 100 participants (50 RAS and 50 healthy controls) to assess the salivary IgA levels and total salivary proteins. A detailed case history and informed consent was taken from all the participants prior to our study. As results we found the mean age of study group was 31.58 years where as in control group it was 30.16 years with a range of 20-50 years in study group and 19-50 years in the control group with a p value of 0.03 that’s significant. Out of 50 participants 36 (72%) were males and 14 (28%) were females in the study group where as in control group 38 (76%) were males and 12 (24%) were females. When compare between group A and group B showed significantly higher in study group as compare control group and concluded in our study RAS showed a male predominance with maximum number of patients in the age group of 20-50 years. The salivary immunoglobulin A levels was significantly higher in minor RAS group than the healthy control group

Background:  Peptic ulcer perforation is a serious complication which affects 2-10% of peptic ulcer patients. Peptic ulcer perforation presents with an overall mortality of 10% although various authors had reported incidence between 1.3% and 20%. Being a life-threatening complication of peptic ulcer disease, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be contained. Aim: -Was comparative study of Graham's omentopexy versus modified Graham's omentopexy in gastric perforation   Methods:  This prospective, single centre study done in Birsa Munda, GMC Shahdol Madhya Pradesh from 2021 to 2023 for two years of periods. Total 160 patients, Divided into two groups-Graham's omentopexy 80 cases group 'A'. & modified Graham’s omentopexy 80 cases group 'B'. Results: 146 [91%] were males and 14[9%] were females with M:F Ratio 10:1. Most of the patients 20-78 years of age in both group. Post operative leakage was 7.5% and 1.25% respectively. Mortality rate in Group A (3.75%) and in Group B (1.25%). The overall mortality rate was 7.14%. In this study average hospital stay was 12.4 days in group A and 9.0 days in group B. Conclusion: This study showed that modified Graham's patch repair is as effective as Graham's patch repair in terms of mean operative time period, timing of oral feed allow and mean hospital stay timing.

Background:  The management of renal stones measuring 1-2 cm has evolved with the introduction of miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS). These procedures offer less invasive alternatives to standard PCNL, aiming to reduce complications and improve patient outcomes. While guidelines traditionally favor PCNL for stones larger than 2 cm and RIRS for smaller stones, mini-PCNL is emerging as an effective option even for smaller stones. Economic considerations further influence the choice of treatment, particularly in resource-constrained settings. Methods:  This study compared local clinical outcomes of mini-PCNL and RIRS in managing renal stones of 1-2 cm in a tertiary care hospital in central India. The study included 55 patients undergoing RIRS (Group 1) and 45 patients undergoing mini-PCNL (Group 2), performed by a single surgeon. Preoperative assessments, surgical techniques, and postoperative follow-up protocols were standardized across both groups. Statistical analyses were conducted to evaluate differences in demographic features, stone characteristics, surgical features, and complications between the two groups. Results:  Comparison of demographic and stone characteristics revealed no significant differences in age, gender distribution, or body mass index (BMI) between Group 1 and Group 2. However, comorbid disorders differed significantly, with Group 1 showing a higher prevalence of hypertension (ht), diabetes mellitus (dm), chronic obstructive pulmonary disease (COPD), and antiplatelet medication use. Stone size was slightly larger in Group 2.Surgical features analysis demonstrated that mini-PCNL (Group 2) had shorter operation and fluoroscopy times compared to RIRS (Group 1). Hemoglobin levels decreased significantly post-operation in both groups, with a greater reduction observed in Group 2. Stone-free rates (SFR) at different time points were similar between the groups, but Group 2 reported higher visual analog scale (VAS) pain scores and longer hospital stays. Group 1 also required more general anesthesia. Conclusion:  In conclusion, mini-PCNL and RIRS are both effective methods for managing renal stones measuring 1-2 cm. Mini-PCNL offers advantages in terms of shorter surgical duration and potentially higher stone-free rates, albeit with higher postoperative pain and longer hospital stays compared to RIRS. RIRS, on the other hand, shows benefits in terms of reduced pain, lower analgesic requirements, and shorter hospitalization. The choice between these techniques should consider patient-specific factors, including stone location, comorbidities, and economic considerations, to optimize outcomes and patient satisfaction.  

Background:  Vitamin D deficiency is prevalent among individuals with type 2 diabetes mellitus (T2DM) and is associated with increased risk of cardiovascular complications. This study aimed to investigate the impact of vitamin D supplementation on cardio-metabolic health markers in T2DM patients. Methods:  A prospective cohort study was conducted among T2DM patients aged 40 to 60 years. Demographic, clinical, and lipid profile parameters were assessed at baseline and after vitamin D supplementation. Statistical analysis was performed to compare parameters across groups and evaluate the efficacy of supplementation. Results:  The study revealed a high prevalence of vitamin D deficiency among T2DM patients, with significant associations between deficiency, obesity, and longer diabetes duration. Vitamin D supplementation led to restoration of sufficiency in most patients, resulting in improved lipid profiles and cardio-metabolic health markers, particularly in those with profound deficiencies. Conclusion: Administering vitamin D supplementation to T2DM patients with insufficient levels led to significant improvements in cardio-metabolic health, highlighting the importance of addressing vitamin D deficiency in managing T2DM-related complications.

Background:   Effective postoperative pain management in children is a pivotal aspect of pediatric surgery, with caudal blocks being a commonly employed technique. This study aimed to compare the efficacy and safety of two adjuvant drugs, Fentanyl and Midazolam, when combined with Ropivacaine for pediatric single-shot caudal blocks. Methods: A total of 80 pediatric patients scheduled for infraumbilical surgeries were randomized into two groups to receive either Ropivacaine with Fentanyl or Ropivacaine with Midazolam. The primary outcomes measured were postoperative pain scores using the CHIPPS scale and the duration of analgesia. Secondary outcomes included the incidence of side effects and the requirement for additional postoperative analgesics. Results: The Ropivacaine + Fentanyl group exhibited significantly lower pain scores at 2, 4, 6, 12, and 24 hours post-surgery (p-values 0.03, 0.04, 0.01, 0.05, and 0.02, respectively) compared to the Ropivacaine + Midazolam group. The duration of analgesia was significantly longer in the Ropivacaine + Fentanyl group (8 ± 1.5 hours) than in the Ropivacaine + Midazolam group (6 ± 1.7 hours, p < 0.001). There were no significant differences in the incidence of side effects or the need for additional postoperative analgesics between the two groups. Conclusion: The combination of Ropivacaine and Fentanyl for pediatric caudal blocks significantly improves the quality and duration of postoperative analgesia without increasing adverse effects, making it a superior choice over Ropivacaine with Midazolam.

Background:   Menopause is defined by The WHO as ‘the permanent cessation of menstruation as a result of the loss of ovarian activity’. A woman today will live approximately one third of her life after menopause. Menopause develops due to low estrogen production by disturbed hormonal cycle of ovulation. Menopause is a natural  process in the ageing of a women & it denotes the end of the reproductive capacity  which manifests as cessation of cyclic ovarian function and cyclic Menstruation. Objectives-The present study was undertaken on patients attending the OPD of Dr D Y Patil Medical College Hospital Pimpri, Pune to evaluate lipid profile status in post-menopausal women and compare with premenopausal women. Materials & Methods 50 post-menopausal women and 50 pre-menopausal women in the reproductive age group were selected in the study. We measured  serum lipid profile [total cholesterol (TC), triglyceride (TG), HDL-Cholesterol, LDL-Cholesterol, and VLDL-Cholesterol.] in both pre and post-menopausal women. The comparison of  lipid profile was done using correlation test and P value less than 0.05 was considered significant. Lipid profile determinations were done by enzymatic method. Software Used: MS Excel (Microsoft 365), RStudio (Version: 2023.08.0-daily+170) and IBM SPSS Statistics 27. Results: This study showed mean of serum  total cholesterol in post menopausal group was185.28 mg/dl  and 158.28 mg/dl  in pre menopausal group. The mean of serum Triglycerides was145.59 mg/dl in post menopausal group as compared to116.34mg/dl in pre menopausal group.Mean of serum VLDL was 29.12mg/dl in post menopausal grp as compared to23.24 mg/dl in pre menopausal group. Mean of serum LDLwas116.96 mg/dl in post menopausal grp as compared to 98.86 mg/dl in pre menopausal females. Lipid profile determinations were done by Enzymatic methods on Alinity C – fully Automated Analyzer. Conclusion: Dyslipidemia is an important risk factor for arteriosclerotic cardiovascular disease (ASCVD). Due to decreased estrogen in post-Menopausal women and increased levels of cholesterol and LDL levels, chances of cardiovascular diseases are increased. It is necessary to educate Women about Menopause and Lipid Profile should be done to assess the risk of cardiovascular diseases.

Background: Spinal tuberculosis, predominantly affecting the thoraco-lumbar region, often requires surgical intervention when conservative treatments fail. This study evaluates the effectiveness of the posterior approach debridement, decompression, and stabilization with pedicle screw fixation in patients with thoraco-lumbar spinal tuberculosis. Methods: A prospective study was conducted on 17 patients, with surgical outcomes assessed through kyphotic angle correction, ESR, VAS, and ODI scores. Results: Post-operative results demonstrated a mean kyphotic angle correction of 12 degrees. ESR levels significantly decreased from a pre-operative mean of 37 mm/h to 9 mm/h post-operatively. Pain and functional disability also improved markedly, with VAS scores reducing from 6.0 to 0.6, and ODI scores from 34 to 3. Conclusion: The posterior approach for thoraco-lumbar spinal tuberculosis is effective in achieving significant spinal alignment correction, reducing inflammation, and improving pain and functional outcomes. This study supports its use as a viable surgical option in appropriately selected patients.  

Background: The posterior cranial fossa and the foramen magnum are the key anatomical components of the craniovertebral junction, which contain and transmit numerous vital neurovascular structures. Through foramen magnum important neural elements, the 7th to 12th cranial nerves, the cervical spinal nerves, the brainstem, the rostral aspect of the spinal cord, the cerebellum and the vermis, as well as various vascular structures such as the vertebral artery and its branches, the meningeal vessels and the venous sinuses. Materials and Methods: The present study conducted with 154 adult dry skull. .We have observed the shapes of foramen magnum and classified as oval, round, tetragonal, pentagonal, hexagonal and irregular in shape. We have recorded morphometric measurements like anterior-posterior diameter and transverse diameter of foramen magnum. Values of each measurement were expressed in the form of Mean+SD. Results: Oval shape foramen magnum was observed in 52 number of skulls and the incidence was 33.76%, tetragonal shape was observed in 31 number of skulls and the incidence was 20.12%, hexagonal shape was observed in 18 number of skulls and the incidence was 11.68%, round shape was observed in 26 number of skulls and the incidence was 16.88%, pentagonal shape was observed in 13 number of skulls and the incidence was 8.44%  and pear shape was observed in 14 number of skulls and the incidence was 9.12%. The Anterior – Posterior diameter (mm) Foramen Magnum was 36.84+4.62mm. The transverse diameter (mm) foramen magnum 30.45+2.82mm. Conclusion: In present study findings concludes hat the results may be helpful to the neurosurgeon in analysing the morphological anatomy of craniovertebral junction. The findings are also assisting in their pracice for the anthropologists, morphologists and clinical anatomists.

Background: Staphylococcus aureus is a Gram-positive cocci commonly inhabiting the nasal cavity as a commensal. Methicillin-resistant type of Staphylococcus aureus results in invasive infections that are difficult to treat with regular antibiotics. This study helps us determine the prevalence of MRSA  among healthcare workers who pose a potential risk of being the carriers of the  MRSA strains, leading to infections in hospital patients. Materials & Methods: A descriptive cross-sectional study was conducted six months (January-June  2023 ) at a Tertiary care hospital, Ananthapuramu. A total of 100 nasal swabs from healthcare workers were collected, and Staphylococcus aureus was isolated and identified using standard conventional culture methods and biochemical tests. The isolated  Staphylococcus aureus was tested for the presence of  MRSA  by using a cefoxitin (30 µg) disc in Muller Hinton Agar Medium by Kirby-Bauer disk diffusion method according to Clinical Laboratory Standards Institute (CLSI) guidelines. Results: Out of  100 samples, 14(14%)  samples were positive for nasal carriage of Staphylococcus aureus, and 4 (4%) isolates were positive for MRSA. The prevalence of MRSA was 4%  in our study among the healthcare workers. Conclusion:  The study revealed the prevalence of Methicillin-Resistant Staphylococcus aureus in nasal carriers among healthcare workers as 4%, which may threaten the spread of MRSA among patients admitted to the hospital. Thus, the present study helps us highlight the need to regularly screen carriers in apparently asymptomatic healthcare workers to prevent nosocomial infections.

Background:Pain is a product of Man's highly complex nervous system, which integrates all parts of his body, making each closely interrelated with every other part. Pain has become the price man has to pay for his superiority in the evolutionary scale. Objective:To compare the analgesic effects of Diclofenac sodium, pentazocine and Ketoralac administered by intramuscular route in post-operative conditions.  Methods:This study was undertaken at Government General Hospital and Basaveshwara Teaching and General Hospital, Gulbarga which are attached to M.R. Medical College. Gulbarga. The study included 150 patients who had come to the hospital for surgery below the umbilicus either abdominal or non-abdominal.

Introduction:Forensic experts play a crucial role in personal identification in mass disasters such as airline crashes, tsunamis, and earthquakes. In forensic practice, sex determination plays a significant role in establishing identity. Various anthropometric procedures are employed by forensic anthropometrists to ascertain the gender from dismembered corpse pieces. These anthropometric methods seek to determine the measurement threshold for certain body parts or bones that distinguish between male and female. The objectives of the study were to determine cutoff points for hand dimensions and to correlate hand dimensions in both sexes.Materials and Methods:The study was conducted at the Department of Forensic Medicine & Toxicology, at Indira Gandhi Institute of Medical Sciences in Patna, Bihar. This included 100 healthy MBBS students (50 males and 50 females) aged between 20-30 years, from the first year to the final year, who gave their informed consent to participate in the study. In this study, we recorded three morphometric parameters for each hand in cm, using vernier calipers i.e. length of the hand, breadth of the hand and hand index. The obtained data was analyzed using Statistical Package for Social Sciences (SPSS, version 24.0) software.Results:We observed that the mean values of hand dimensions and hand index were more in males than in females. There was a slight bilateral difference in the length and breadth of the hands in the male and female subjects. The anticipated cut-off marks for hand length are 18.31 cm, hand breadth is 7.79 cm, and hand index is 42.58 cm. Hand breadth, followed by hand length and hand index, were more accurate in identifying the sex.Conclusion:Hand dimensions and indices show sexual dimorphism. It was observed that there were minor variations in both sides of the same sex. Cut-off points were determined regardless of the side. A measurement above the cut-off point indicates male sex, while a measurement below the cut-off point indicates female sex. These cut-off points are specific to a particular population and their accuracy has also been calculated. The results of this study may be helpful in identifying the gender of a severed hand during a medicolegal examination. Even in cases where a portion of the hand is retrieved and brought in for analysis, the study has consequences for medicine and law.

Background:The prevalence of facial dermatoses varies with the level of awareness, socio- economic status, geographic area, climatic condition, and various other factors. It is important to identify all facial dermatoses to elaborate on the treatment of these apparent pathologies. Hence this study has been undertaken to determine various skin disorders, their epidemiological and clinical aspects predominantly affecting the face in our setup? Research Question: What is the epidemiology and the clinical presentation of various skin disorders affecting the face? The setting of the study was at department of Dermatology, Government General Hospital, Government Medical College, Ongole, Andhra Pradesh. A one year observational study was conducted during the period from October 2022 to November 2023 on about 200 patients of various facial skin disorders attended to DVL OPD during the above period in the department of Dermatology by studying their socio-demographic profiles, Type of skin lesions, clinical pattern and associated risk factors etc. Results: The majority of patients in the present study were belonged to 20-29 years (23.5%), followed by 40-49 years (19.5%), 30-39 years (17%),10-19 years (17%), 50-59 years (9%), <10 years (8%), and  > 60 years (6 %). In the above study females were more in number (56%) when compared to males (44%) and the mean age of the study subjects was 31.9 years. Among total facial dermatoses patients majority were Pigmentary disorders (29%) followed by Acne, Rosacea and perioral dermatitis (19.5%), Infections (19.7%), Eczemas (13%) and Miscellaneous (10.5%) and Tumors (9%) etc. And among all, the most common presentation is melasma. About 24% of patients were agriculture labourers, followed by housewives (21.5%), students (20%), daily-wage workers (19%), professionals like teachers and other employees (9%), and the least incidence was seen among children <5 years(6.5%) and the most common type of lesion was patches 67 (23.5%), followed by papules 56 (21.05%), and the least presentations were erosions

Background: The enlargement of Cervical lymph nodes is quite significant in that there are so many etiological agents and is an index spread of infections, malignancy, autoimmune disorders, and some other miscellaneous conditions etc. is very much difficult to  diagnosis. So the purpose of our study is to systematically identify the many pathogenic conditions presenting with enlarged lymph nodes in the neck, as well as the scenario of  different ways of presentation of these disorders both clinically and pathologically with the help of FNAC and Ultrasonography diagnostic techniques there by better management services could be rendered to the affected individuals in our set up. Research Question: What is the scenario of different ways of presentation of cervical lymphadenopathy both clinically and pathologically in our set up?  The setting of the study was at department of General Surgery, Government General Hospital, Government Medical College, Machilipatnam, Andhra Pradesh. A one year observational study was conduct during the period from October 2022 to September 2023 on about 60 Cervical lymphadenopathy cases visited General Surgery OPD during the above period by studying their socio-demographic profiles, histopathological examination of Lymphadenopathy, distribution of presenting complaint, distribution of primary cancerous site with neck secondaries and treatment & outcome of the study subjects etc. Results: It was observed that the majority about 35% of cases were belongs to the age group 41-50 years followed by 23.5% between 21-30 years, 16.6% between  both 31-40 years & 51years and above  and 8.5% between 12-20 years of age group with the mean age was 58.3 years. And regarding the sex males were more in number  significantly when compared to females that was 1.7:1. Regarding histopathological diagnosis and categorisation, majority of the cases were Tuberculosis lymphadenopathy (43.5%) followed by Secondaries (28.3%) Reactive lymphadenopathy (23.3%), Hodgkin´s lymphoma (3.3%) and Non-Hodgkin´s lymphoma (1.6%). Related to distribution of presenting complaint almost all the cases were visited the hospital with the complaint h/o neck swelling and among the other symptoms fever was the common one (33.3%) followed by cough (30%), decreased appetite (26.6%), weight loss, pain (20%), painful swallowing (3.3%) and voice change (1.6%). With reference to Primary cancerous sites with neck secondaries, Oral cavity occupies major position (23.5%) followed by Larinx (11.7%), Stomach (11.7%), Esophagus (5.8%) and Thyroid (5.8%) respectively and regarding histopathology Squamous cell carcinoma was the commonest one observed. The overall recovery rate was 65% and the complete recovery (100%) was observed among Tubercular cervical lymphadenitis and Reactive lymphadenitis and the maximum number of cases missed for the followup was observed in Secondaries neck and mortality was observed in Secondaries neck and Hodgkin`s lymphoma.

Background:Airway management is of prime importance to the anaesthesiologist. For securing airway, tracheal intubation using direct laryngoscopy remains the method of choice in majority of the cases. No anaesthetic drug is safe unless diligent efforts are made to secure and maintain an intact airway.  Objective: this study was undertaken to compare the various airway assessment predictors (ULBT, HLM, Thyromental Distance (TMD) and Sternomental Distance (SMD), ) for difficult endotracheal intubation.  Methods: Prospective observational study was conducted among 400 patients undergoing elective surgery under general anaesthesia in hospitals attached to Bangalore Medical college and research institute for a period of two years. Results: In the study majority of subjects were in the age group 31 to 40 years (35.75%), Majority of subjects were males and had ASA grade 1. Based on Cormack Lehane scoring, 59% had Score 1, 23% had Score 2, 16% had Score 3 and 2% had Score 4. 72 subjects with difficult grade in CL, 37.5% were graded difficult in TMD, 75% were graded difficult in SMD, 2.8% were graded difficult in ULBT, 5.6% were graded difficult in HLM, 4.2% were graded difficult in HNM and 90.3% were graded difficult in RHTMD.

Conclusions: Thyromental Distance (TMD) and Sternomental Distance (SMD) had highest Specificity, Positive Predictive value (PPV) compared to the other tests.

Background: In individuals suffering from liver cirrhosis, portal hypertensive gastropathy (PHG) emerges as a critical complication. Ongoing studies are delving into the role of Helicobacter pylori (H. pylori), particularly strains positive for Cytotoxin-associated gene A (CagA), in influencing the development of gastropathy among these patients. This research aims to elucidate the prevalence of H. pylori in patients with PHG who have liver cirrhosis and to examine the extent of association between the presence of the bacteria and the severity of the gastropathy.Methods: An analysis was conducted on a cohort of one hundred patients afflicted with PHG due to liver cirrhosis. Information on demographic characteristics, the causes of liver cirrhosis, the incidence of H. pylori (with differentiation between strains), and the severity of gastropathy (evaluated according to the Baveno criteria) was collected and analyzed.Results: The cohort's age range was 35–65 years old, with a median age of 50. It was made up of 60% males and 40% females. Liver cirrhosis has multiple aetiologies, with non-alcoholic steatohepatitis (NASH) accounting for 25%, viral hepatitis for 35%, and alcoholic liver disease for 40% of cases. In 45% of the patients, H. pylori was detected; strains that tested positive for CagA were responsible for 70% of these infections. CagA positive. Results: The study group had an age distribution from 35 to 65 years, with a median age of 50. The composition was 60% male and 40% female. The underlying causes of liver cirrhosis varied, with non-alcoholic steatohepatitis (NASH) responsible for 25% of cases, viral hepatitis for 35%, and alcoholic liver disease accounting for 40%. Helicobacter pylori was identified in 45% of the patients, with 70% of these infections being due to strains positive for CagA. There was a significant link between CagA-positive H. pylori strains and severe forms of gastropathy, with 76.19% of patients with CagA-positive strains experiencing severe gastropathy. This highlights a strong association between these strains and the worsening of gastropathy.Conclusion: This research highlights a significant link between the severity of gastropathy and the prevalence of H. pylori, especially strains positive for CagA, in patients experiencing PHG due to liver cirrhosis. The findings suggest that management strategies for reducing gastropathy severity in these patients might need to concentrate on addressing H. pylori infections, particularly those involving CagA positive strains.

Background: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort along with change in frequency and consistency of bowel habits. Abdominal distension, bloating and altered bowel habits are common clinical presentations. IBS affects around 3% to 15% of the population. Aim :To validate Birmingham Questionnaire (BQ) in assessing symptoms in IBS patients in South Indian scenario.  Use of Functional Bowel Disease Severity Index (FBDSI) in assessing the severity of IBS patients.  To correlate BQ with FBDSI in assessing the outcomes with respect to the severity of IBS.Methods : One hundred patients who fulfilled Rome IV criteria for IBS were enrolled in the study. All patients were subjected to clinical examination.  Routine investigations, abdominal ultrasound, sigmoidoscopy, fecal calprotectin were done. Patient were asked to answer the BQ questionnaire pre and post treatment and the FBDSI score pre-treatment.Results: 100 participants were included in the study among which, 71 males and 29 were females.  The mean age of males was 28.7 years while that of females was 29.62 years. years.  None of the BSQ scores for the above mentioned symptoms were found to be significant with FBDSI scores. p value for all the correlations was above the 0.05 level of significance. None of the BSQ scores for the above mentioned symptoms were found to be significant with FBDSI scores. p value for all the correlations was above the 0.05 level of significance.Conclusion: There was a good correlation between the pre-treatment and post-treatment Birmingham symptom questionnaire scores. This has definitely helped to monitor the clinical response once the treatment was initiated. Our study failed to show a significant difference comparing the pre-treatment BQ with the FBDSI

Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, characterized by a spectrum of clinical manifestations and associated comorbid conditions.Methods: This cross-sectional study analyzed 500 women attending a Government District Hospital, assessing the prevalence of PCOS, its clinical features, comorbid conditions, and impact on fertility. Results: PCOS prevalence was established at 18.2%. The most common clinical presentations included menstrual irregularity (79.1%) and ultrasound evidence of polycystic ovaries (91.2%). Metabolic syndrome was identified in 28.6% of the women, type 2 diabetes mellitus in 15.4%, and hypertension in 19.8%. Psychological comorbidities were significant, with depression and anxiety present in 18.7% and 17.6% of participants, respectively. Regarding fertility, 30.8% reported a history of infertility, and 17.6% had undergone fertility treatments, with a 9.9% success rate in achieving pregnancy. Conclusion: The study highlights the heterogeneity of PCOS manifestations and the significant burden of metabolic and psychological comorbidities. These findings advocate for a comprehensive, multidisciplinary approach to management, emphasizing the need for targeted interventions to address both reproductive and non-reproductive aspects of PCOS.

Background: Hypothyroidism is associated with metabolic syndrome. Several studies have shown that hypothyroidism is linked to dysglycemia and dyslipidemia that leads to diabetes mellitus and atherosclerosis with clinical manifestations.

Aim: To determine the relationship of   dyslipidemia and dysglycemia with the thyroid status in patients with hypothyroidism. Methodology: 100 subjects were included, 50 hypothyroid patients and 50 controls were selected in the age group of 20-50yrs. the parameters determined were waist circumference, fasting serum glucose, oral glucose tolerance test, thyroid profile, lipid profile, fasting serum insulin, and HOMA-IR.

Results and Discussion: In this study it was found that hypothyroidism was associated with obesity. Waist circumference (p=0.004) was significantly increased in hypothyroid patients when compared to controls. The mean value of triglycerides in test group was 159.22 ± 19.88 mg/dl compared to the mean of the control group which was 143.14 ± 28.97 mg/dl and was highly significant (p<0.001).The mean value of LDL in test group was 184.26±24.75 mg/dl compared to the mean of the control group which was 148.08±41.57 mg/dl and was statistically significant p<0.001.The mean value of HDL in test group was 39.74±5.67 mg/dl compared to the mean of HDL in the control group which was 44.06±8.83 mg/dl and was statistically significant p=0.003. The mean of HOMA-IR in test group was 9.10 ± 3.73 when compared to the mean in the control group which was 4.95 ± 2.08 and was found to be statistically significant (p<0.001). TSH correlated positively with insulin (0.64) and HOMA-IR (0.69) and it was statistically significant p<0.001.Summary and conclusion: Central obesity in hypothyroidism is well established in this study with elevated waist circumference. Hypercholesterolemia is a constant feature of hypothyroidism with elevated LDL-cholesterol and decreased level of HDL-cholesterol. Impaired glucose tolerance was found to be more prevalent in hypothyroid patients, they are also found to have elevated insulin resistance. Together impaired glucose tolerance and elevated insulin resistance imply that hypothyroid patients are more prone to develop type 2 diabetes mellitus.

Introduction:A cirrhosis patient may be observed in both the asymptomatic and symptomatic stages, with the latter showing signs of liver damage. In the presentation above, the phrases "compensated" and "decompensated" are used. Patients with cirrhosis who present with jaundice, ascites, hepatic encephalopathy, or bleeding varices are considered to be in a state of decompensation. Hepatorenal syndrome, spontaneous bacterial peritonitis, and hypernatremia may also appear. In order to determine therapy and prognosis, the terms given above are essential. 50% of compensated cardiac patients will survive for ten years, compared to 50% of decompensated patients who will survive for eighteen months. Decompensation occurs 10% of the time in people with compensated liver disease. Liver transplantation is typically required for decompensated people[2]. Materials & Methods:Following approval from the institutional ethics committee and the patient's signed informed permission, data collection began. a thorough clinical examination and history, recorded using the pre-made proforma. The following headings were used for the investigations: 1. Noting the symptoms and complaints that are now present, as well as the demographics. 2. A thorough clinical assessment. 3. Investigations related to routine care: total protein and albumin, serum electrolytes (sodium, potassium, and calcium), fasting blood sugar (FBS), postprandial blood sugar (PPBS), liver function test (LFT), renal function test (RFT), complete blood count (CBC). Result:A total of 140 individuals registered for the study. The patients that were enrolled in them had a mean age of 43.7 years. Age groupings were further created based on the completed ages of each participant. The next group (25.0%) was made up of people between the ages of 31 and 40, while just over 57 (40.3%) were in the 41–50 age range. Just 2 (1.4%) of the patients fell between the ages of 10 and 20, making this age group the smallest of all. Of the total participants, around 122 (87.1%) were men, while the remaining patients were women. Conclusion:Serum ferritin and transferrin levels are substantial and accurate prognostic markers that can be used to determine a patient's date of death early upon diagnosis of end-stage liver disease. In addition to these markers' ability to predict death after 90 days, serum ferritin levels were found to be greater than 400 and transferrin levels lower than 150 in all deceased patients. The indicators that this study utilized to predict mortality in patients with end-stage liver disease performed similarly to those that were employed in earlier score calculations, indicating that the investigation was effective.

Background: The dengue virus has four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. Even though the four of them Serotypes have similar antigens, yet they differ enough from one another to offer cross-protection for a short while. Any infection with any one virus serotype confers lifetime immunity to that serotype (WHO 1999). 2. They possess antigens that exhibit cross-reactivity with viruses of the same genus, such as those responsible for west nile, yellow fever, and Japanese encephalitis. Nucleotide sequencing has shown several genotypes for each serotype. In DEN-1, 6 in DEN-2, 4 in DEN-3, and 5 in DEN-4, there are 3 genotypes.Primates under DEN-2 and DEN-4 have a single non-human genotype. Various kinds of Aedes mosquitoes are in charge of spreading the dengue virus spreads between people. Arthropods, particularly female Aedes mosquitoes, are the vector for dengue. In the daytime, they sting people. When feeding is stopped, Ae. aegypti can change hosts and begin spreading dengue immediately, or it can wait until the virus has grown in the salivary gland for eight to ten days during incubation. After infection, the mosquito host is infectious for life. Although transovarian transmission of the dengue virus has been documented, its epidemiological importance has not yet been established. Material And Method:The study included 100 patients aged - 14 years with dengue virus infection admitted to the department of Medicine, SCB Medical College, Cuttack between January 2018 to December 2019. All suspected cases of dengue as defined under National Vector Borne Disease Control Programme (NVBDCP), Govt. of India were evaluated and tested for enzyme-linked immunosorbent assay (ELISA) based NS1 antigen and IgM capture ELISA (MAC ELISA). Government of India recommends use of ELISA based antigen detection test (NS1) for diagnosing the cases from 1st day to 5th day and antibody detection test IgM capture ELISA for diagnosing the cases after 5th day of onset of disease for confirmation of dengue infection.Result:This prospective study was conducted to assess the clinical and pathological impact of dengue virus on various haematological profile mainly on platelet count and haematocrit along with different clinical manifestations and predictors of thrombocytopenia in 100 serologically confirmed cases of dengue infection during a period from January 2018 to December 2019 in the department of medicine, SCB Medical College, Cuttack.Conclusion:Haematological abnormalities associated to platelet and endothelial dysfunction that are typically seen in severe dengue include thrombocytopenia, coagulopathy, and vasculopathy. Previous research has indicated that one of the causes and effects of DIC may be an imbalance between the clotting and fibrinolysis systems. A small percentage of individuals experiencing severe or protracted shock may have substantial abnormalities. These abnormalities, when combined with severe thrombocytopenia and the downstream consequences of acidosis and hypoxia, can lead to massive bleeding and real DIC. DIC is mostly brought on by the release of TF, and in dengue patients, it can activate the PAR membrane receptor on circulating monocytes and vascular endothelial cells, creating an important connection between inflammation and coagulation.

Background:  Lumbrosacral spondylolisthesis is a common spinal ailment affecting 4-6% of the population. It occurs when the morphology of the neural foramen changes, trapping nerve roots in a restricted area. Lower back pain can range from moderate to severe and can present with or without radiculopathy. Surgical methods like posterior instrumented interbody fusion (PLF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF) are commonly used. However, high-level evidence on the best surgical method is still lacking. The primary focus of this study is to evaluate the surgical outcomes and documenting any complications. Methods: This prospective observational study enrolled 40 consecutive patients at a tertiary care hospital in Ongole, Andhra Pradesh, who were scheduled for surgical intervention for a low-grade degenrative spondylolisthesis. The study excluded patients with long-term medications, facet tenderness, previous spinal surgery, diabetic neuropathy, or vascular claudication. Data was collected through radiological assessments, operative time, blood loss, technique, and intraoperative complications, with post-operative normalization assessed using VAS scores and Oswestry Disability Index. Results: The study involved 11 men and 29 women with low-back pain, neurological claudication, and radiating pain in the lower extremities. The most common radiographic finding was decreased disc space (72.5%) and loss of lumbar lordosis (17.5%). Surface-level wound infection was seen in 11 patients, but it was effectively treated with oral antibiotics. The mean follow-up period was 8.5 months. The neurological and functional recovery of patients showed significant improvement throughout the follow-up period. Lower grades of radiological fusion were associated with higher VAS scores for pain. Conclusion: Surgery for symptomatic low- and mid-grade spondylolisthesis has demonstrated superior functional clinical outcomes and enhanced pain control. Opting for posterior decompression and spinal fusion can result in a successful fusion process with few complications. A higher pelvic incidence may be crucial in the progression of developing spondylolisthesis.

Background: Introduction: Allergic rhinitis (AR) stands as the prevailing chronic ailment in the pediatric demographic. Identifying the allergen responsible for the condition proves challenging in limited medical settings where IgE assessment and allergy testing remain inaccessible. This study aims to assess the efficacy of nasal smear eosinophil count, a straightforward, non-invasive, and cost-effective method, in diagnosing allergic rhinitis, and to explore its correlation with blood absolute eosinophil count (AEC) among pediatric patients diagnosed with AR. Method: This prospective hospital-based study involved 123 pediatric patients diagnosed with allergic rhinitis. Participants were recruited from the pediatric outpatient department of a tertiary level care medical institute, if they presented with symptoms indicative of allergic rhinitis. Results: Seventy-five percent of the subjects exhibited nasal eosinophil counts exceeding 10 cells/high-power field (hpf) (p <0.05). Although a positive correlation was observed between nasal eosinophil count and blood eosinophil count, the association was weak (r = 0.22, p = <0.05). Conclusion: Nasal eosinophil count demonstrates potential as a modest predictor of blood eosinophil count and a robust indicator of allergic rhinitis.

Background: Glucose 6 Phosphate Dehydrogenase deficiency is the most common erythrocyte enzymopathy being present in more than 400 million people worldwide which presents in the neonatal period as unconjugated hyperbilirubinemia and is inherited as an X- linked recessive disorder. G6PD enzyme deficiency leads to impaired production of reduced glutathione and predisposes the red blood cells to damage by oxidative metabolites causing haemolysis. Deficient neonates may manifest clinically as indirect hyperbilirubinemia or even kernicterus. Methods: This prospective observational study was conducted in Neonatal Intensive Care Unit, Gauhati Medical College and Hospital, over a period of one year from December 2022 to November 2023. A total number of 320 neonates with hyperbilirubinemia were included in this study. Data collection was done by history taking, meticulous clinical examination and essential laboratory tests. Results: Physiological jaundice was found to be the most common cause of neonatal hyperbilirubinemia (59.6 %) followed by ABO incompatibility (22.5%).  G6PD deficiency was found in 5.6 % of neonates. The sex distribution was male 198 (61.9%) and female 122 (38.1%). The total serum bilirubin in G6PD deficient groups was found to be significantly higher (Mean 21.06 mg/ dl) than due to other causes (Mean 18.2mg/dl). Conclusion: WHO recommends population screening in regions where the prevalence of G6PD deficiency is 3–5% or more, but this has yet to become routine practice in many parts of India. It is well known that hemoglobinopathies are common among people of Assam. Hence screening for G6PD deficiency in neonatal jaundice may be adopted as a non-mandatory screening test in Assam, especially in case of severe neonatal hyperbilirubinemia. Further, diagnosis of G6PD deficiency status also helps in prevention of future hemolysis due to exposure to offending agents.

Introduction: Posterior fossa extradural hematoma (PFEDH) is an infrequent occurrence in traumatic brain injuries, constituting approximately 4–7% of all extradural hematomas (EDHs). Despite its rarity, PFEDH demands urgent attention as it can swiftly lead to a fatal outcome unless promptly identified and addressed. The posterior fossa's confined space means that even a relatively small hematoma volume can result in clinical deterioration. Early detection through cranial computed tomography is imperative, and immediate evacuation is essential for a positive prognosis. The critical nature of PFEDH underscores the necessity for rapid intervention to prevent irreversible neurological damage and reduce the risk of mortality. Materials and methods: This study was conducted at Department of Neurosurgery, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India  from a period of July 2021 to June 2023 of 23 cases of PFEDHs. Records of patients with PFEDHs were reviewed for the mode of injury, Glasgow Coma Scale (GCS) at admission, imaging, type of intervention, outcome, and follow‑up. GCS was assessed at 6 months. Results: Of these 23 patients, 17 were males and 6 females. The mean age of patients was 25 year .12 patients had GCS 15 at admission, and only 4 of them had GCS <8. Mean EDH volume was 25 ml. 20 patients were operated, 3 managed conservatively. 21 patients were discharged, Two patients died. At 6 months follow‑up, 20 patients had good reovery (Glasgow Outcome Score [GOS] 5). Conclusions: Posterior fossa extradural hematomas (PFEDH) are uncommon occurrences often linked with occipital bone fractures and occasionally accompanied by supratentorial hematomas. The rapid fatality of PFEDH results from hematoma expansion, which compromises the limited space in the posterior cranial fossa. This compression can lead to severe consequences such as brainstem compression, tonsillar herniation, and obstructive hydrocephalus. Timely identification and urgent evacuation through medical intervention are pivotal for a positive outcome in PFEDH cases.

Background:   The present study attempts to assess the role of BCL-2 and p53 family of genes in chronic myeloid leukemia (CML) and correlation of their immunoreactivity with the status of remission on followup. Objectives: Primary objective of the study is to assess and score the expression of BCL2 and p53 in bone marrow trephine biopsies of cases of CML and to correlate the expression of these markers with the prognosis of the patients. Assessment of demographic distribution of CML were also included as secondary objective. Methods: Present study is a cross-sectional study conducted in the Department of Pathology, Govt. Medical College, Kozhikode from January 2017 to December 2020. The study population included confirmed cases of CML received in Pathology Department during the study period. 55 cases were selected. The paraffin embedded blocks of bone marrow trephine biopsy were retrieved and immunohistochemical testing were done in the department. Clinical details of patients were obtained from patient records. All variables needed for study were collected. Consecutive sampling technique was adopted for the study. Statistical analysis was done by chi square test. A p value less than 0.05 was considered as statistically significant. Results: Among the study population, majority (69%) of patients were in chronic phase at initial presentation. Most of the patients in chronic phase were in remission(62%). 25% of the study population presented in the blast crisis phase. Majority of the patients in blast crisis were not in remission and were in an elderly age group. Most of the patients presented with massive splenomegaly at diagnosis and only 5 patients didn’t have significant organomegaly. It was found that there is an association between BCL2, haemoglobin, platelet and age with the status of remission (p<0.05) and there is no association between P53 and total count with the status of remission (p>0.05). Conclusion: These findings are in line with numerous studies that discovered a unique approach to eliminate quiescent stem cells in CML that cause relapse by targeting BCL-2 coupled with BCR-ABL and inhibiting the MDM2 protein that breaks down p53.

Background: Fine needle aspiration cytology (FNAC) is a simple cost effective procedure which is being practiced in routine OPD setup and offers a better alternative to excision biopsies. Martin HE and Ellis EB were the first to present a paper on obtaining tissue by needle puncture and aspirations from suspected neoplasms. Fine needle aspiration plays a major role in clinical evaluation and surgical planning for referring physicians. Advantages in paediatric population of patients include lack of need for sedation or general anaesthesia. Material and Methods: This was a retrospective descriptive study of patients who came with lesions of head to neck to our institute Raichur Institute of Medical Sciences (RIMS), Raichur from the period of January 2019 to January 2022. Clinical details and radiological investigations were collected from the case reports maintained in Central Laboratory at RIMS, Raichur. FNAC reports were analysed and classified the lesions according to the recent classification criteria of respective lesions. Results: Out of the 544 cases available, only 454 cases were included in the study owing to exclusion of inadequate sampling or insufficient material for the reporting. There was female preponderance of 237(52.2%) compared to 217(47.79%) male cases. Majority of the cases belonged to 2nd decade (27.09%) and 3rd decade (24.89%) of life. Palpable head and neck lesions constituted lesions of thyroid, lymph nodes, salivary glands and miscellaneous lesions. Majority of the cases presented with thyroid swellings constituting to 181(39.86%) cases. 144(31.05%) of the lesions were lymph node swellings. Only 14(3.08%) of the salivary glands lesions were noted. Various miscellaneous lesions constituted to 115 (25.33%) cases. Distribution of head and neck lesions is represented pictorially. Conclusion: FNAC is an important noninvasive tool for assessing head and neck lesions. Classifying the lesions into inflammatory and neoplastic helps in planning of treatment and categorising them into specific reporting systems helps in standardisation of reports and identifying risks of malignancy.

Background: The need for mobile-based ambulatory heart rhythm monitoring arises from its potential to provide convenient and continuous tracking of heart rhythms, improving early detection and management of cardiac issues while accommodating patients' active lifestyles.  The present study aims to compare and validate the 24 h ECG monitoring between the traditional Holter and Vigo Heart wearable patch. Method: One hundred and nineteen patients with a workup of pre-diagnosed arrhythmias or suspicious arrhythmic episodes were evaluated. Each participant wore both devices simultaneously, and the cardiac rhythm was monitored for 24 h. Selective ECG parameters were compared between the two devices and the cardiologist independently compared the diagnoses of each device. Results: The indication for ECG monitoring in the ent study was patients who were presented with suspicious arrhythmia-related symptoms (47.8%). The Vigo Heart ECG showed a negligible amount of mean noise percentage (1.94 ±6.68%) when compared with the traditional Holter 17.84±23.95% of the total recording time.  For the maximum heart rate, there was significant correlation between the Holter monitoring and Vigo Heart patch (129.69 ± 22.5 vs. 113.31 ± 23.6 beats/min, p = 0.02). The results also showed significant correlation for the average heart rates (74.85 ± 10.8 vs. 76 ± 10.3 beats/min, p = 0.02) and minimum heart rates (47.94 ± 9.5 vs. 59.21 ± 8.9 beats/min, p = 0.02), for the Vigo Heart ECG and Holter monitoring, respectively. The cardiologist made coherent clinical diagnoses for all the 119 study participants using both the ECG monitoring devices. The findings also revealed comparable coherent detection of cardiac arrhythmias in both the ECG monitoring devices. Conclusion: The single-lead adhesive device presents itself as a viable and acceptable alternative for conducting ambulatory ECG monitoring in individuals with arrhythmia or suspicious symptoms of arrhythmias.

Background:  Renal Anomalies are relatively common. Problems with congenital anomalies of kidney are important as they may cause renal failure. Failure in Ascent of kidney can result in a pelvic kidney alternatively, the kidneys may fuse together at their caudal poles produces Horseshoe kidney. Objectives: The present study is to evaluate renal developmental anomalies Radiologically. Material and Methods: The present study was a Cross Sectional study in Tertiary Care Hospital who were referred to radiology department for CT abdomens. 3500 abdominal CT scans were observed for a period of 6 months. Among those male CT abdominal scans are 2060 and female CT abdominal scans are 1440, from Tertiary care hospital in Andhra Pradesh and observed for renal malformations. Results: 3500 abdominal C.T scans were studied for a period of 6 months. Out of the 3500 ct’s males are 2060 and females are 1440. Conclusion: Renal Anomalies all though asymptomatic and accidental finding in most of the cases thorough evaluation of the patient is utmost important to rule out serious pathological conditions prior to the arrival of symptoms.

Background: Coronavirus disease-2019 (COVID-19) infection is a multisystem disease. It has a worse effect on the cardiovascular system by causing myocardial damage, vascular inflammation and myocardial infarction. Poor prognostic sign being the presence of myocardial injury. Electrocardiogram (ECG), a simple bedside diagnostic test with high prognostic value and Various abnormalities in ECG like ST-T changes, arrhythmia, and conduction defects have been reported in COVID-19. We aimed to find out the ECG abnormalities of COVID-19 patients during second wave. Methods: We performed a cross-sectional, hospital-based prospective study among 300 COVID-19 in-patients who underwent ECG recording on admission. Patients’ clinical profiles were noted from their records, and the ECG abnormalities were studied. Results: Among the abnormal ECGs among 250 (83%), rhythm abnormalities were seen in 9 patients (3.6%), rate abnormalities in 115 patients (46%), and prolonged PR interval in 3.9%. Short QRS complex was seen in 9.3%. QT interval was prolonged in 7.3% of the patients.  ST and T segments changes (41.9%) were observed. In logistic regression analysis, ischemic changes in ECG were associated with systemic hypertension and respiratory failure.  Conclusion: In our study, COVID-19 patients had ischemic changes, rate, rhythm abnormalities, and conduction defects in their ECG. With this ongoing pandemic of COVID-19 and limited health resources, ECG—a simple bedside noninvasive tool is highly beneficial and helps in the early diagnosis and management of cardiac injury.

Background: Different investigations found electrolyte abnormalities in hypothyroidism. Basal processes and thyroid hormone effects on electrolytes like salt, potassium, and chloride are poorly understood. Few thyroid-electrolyte disorder data exist. We investigated the electrolyte imbalance between hypothyroidism and hyperthyroidism and their association. The mechanism and effect of thyroid hormones on mineral metabolism are also unknown. The present study examined the association between TSH and serum electrolytes (Sodium, Potassium, Chloride), Calcium, and Phosphorous in hypothyroid and hyperthyroid patients. Objective: We measured serum electrolytes (Sodium, Potassium, Chloride) and minerals (Calcium and Phosphorous) in hypothyroid and hyperthyroid patients and correlated them with serum TSH. Methods: 25 hyperthyroid and 294 hypothyroid cases were studied. 100 healthy controls were used. The thyroid profile (FT3, FT4, TSH), blood electrolytes (Sodium, Potassium, Chloride), and serum minerals (Calcium, Phosphorous) were determined and compared between patients and controls. Thyroid hormones were correlated with serum calcium, phosphorus, and electrolytes. Results: Hyperthyroid patients showed a substantial increase (p < 0.001) in serum calcium (11.14 ± 0.38) and phosphorous (4.48 ± 0.49) through statistical analysis. Significantly higher serum potassium (4.58±0.49) was observed in the hyperthyroid group. In the hyperthyroid group, serum sodium (133.11 ± 2.20) and chloride (100.73 ± 0.60) significantly decreased (p value <0.001) compared to the control group. A significant drop (p < 0.001) in serum calcium (7.66 ± 0.27) and phosphorous (2.83 ± 0.61) levels was predicted in hypothyroid patients. Conclusion: This study found highly unbalanced serum electrolytes in hypothyroid and hyperthyroid patients. To avoid complications, these individuals should have serum electrolytes monitored periodically. The present study also found that hypothyroid and hyperthyroid patients had abnormal mineral metabolism, which may cause metabolic problems.

Background: Assessing the paediatric airway poses significant challenges for anaesthesiologists. However, recent advances in ultrasonography offer promise for more precise evaluations. This study aims to compare the externally calculated diameters of endotracheal tubes using traditional formulas based on physical indices with those determined using ultrasound. Materials and Methods:This prospective study conducted at Jodhpur hospitals from September to December 2022 included children under six years undergoing elective surgery with general anesthesia. Clearance was obtained from the Institutional Ethical Committee, and informed consent was secured. Ultrasound measured subglottic diameter, and ETT sizing was assessed using both ultrasound and age-based formula. Statistical analysis involved calculating mean and standard deviations, intra-class correlation (ICC), and McNemar's test for comparison of proportions. Result: Sixty-six children aged 4 days to 72 months were included. Age-wise distribution revealed varying proportions across different age groups, with a mean age of 30.30 months. Gender distribution showed 75.76% boys and 24.24% girls. Weight-wise, most children (54%) fell in the 10.1-15 kg range. Height-wise, the majority (31%) were between 91-100 cm. ASA grades 1 and 2 constituted 75.76% and 24.24%, respectively. Agreement analysis indicated that ultrasound-guided ETT sizing matched clinically used sizes in 45.45% of cases, while age-based formulas matched in 13.64%. Comparison between methods showed statistically significant differences (p < 0.001), favoring ultrasound. Intraclass correlation coefficient (ICC) supported the superior reliability of ultrasound (ICC = 0.902) over age-based formulas (ICC = 0.841). Conclusion: Ultrasound-guided endotracheal tube (ETT) sizing demonstrated superior accuracy compared to age-based formulas in paediatric patients undergoing anaesthesia. This study underscores the importance of incorporating ultrasound as a reliable tool for ETT sizing, leading to improved patient safety and outcomes in paediatric anaesthesia practice.

Background:  To assess the morphology of breast masses with the help of routine ultrasound and elastography. To evaluate the role of elastography and conventional B – mode ultrasonography in differentiation of benign and malignant breast masses. To correlate elastography and B – mode ultrasonography results with the pathologic findings. A prospective observational study was done over a sample of 80 cases with 100 clinically palpable breasts breast lumps of the females who had undergone B-mode ultrasound and elastography of the breast. The final diagnosis was compared with the baseline data, sonographic features, a modified color score and mean strain ratio.Ultrasound had shown a sensitivity of 88.9%, specificity of 95.23%, positive predictive value (PPV) of 94.42 % and negative predictive value (NPV) of 90.45% and overall diagnostic accuracy of 92.67 % was noted. New modified dual color score had shown sensitivity of 96.4%, specificity of 85.78%, positive predictive value of 85.92% and negative predictive value of 86.87 % and a diagnostic accuracy of 91.67%. The risk to miss a malignant case with new modified dual color score was 2.2%. Mean strain ratio had shown a sensitivity of 100%, specificity of 97.27%; positive predictive value being 96.78 % and negative predictive value is 99.67%, the diagnostic accuracy is 99.23 %. This study shows the definitive nature of identifying the possible breast malignancies thus preventing the invasive procedures which are not the required in the situation.

Introduction:    Healthcare-associated infections (HAIs) are one of the leading causes of morbidity and mortality among hospitalized patients all over the world. HAIs, are also called ‘nosocomial infections’, these are infections acquired during. The frequency of occurrence of infection among patient to the ICU/ Ward may vary from one geographical region to another, from one hospital to another and even among the ICU within one hospital. Therefore, this study was conducted a study to determine the microbiological profile of HAIs and to identify potential microorganisms and their antimicrobial susceptibility pattern. Methods:   This study was conducted on 861 samples from patients who were clinically suspected with HAIs and admitted in the Intensive Care Unit and wards of Govt. R. D. B. P. Jaipuria Hospital and Hospital of RUHS College of Medical Sciences, Jaipur during the study period from September 2022 to February 2023.Microbiological identification was based on colony characteristics, microscopical characteristics and biochemical tests as per standard guidelines/SOP. Results:    Out of 749 (861 samples) patients, 97 (12.95%) patients (105 samples) were confirmed for HAIs infections. CAUTI, VAP, SSI and CLABSI were found in 43/105, 29/105, 29/105 and 4/105 samples respectively. More percentage of patients having HAI was observed in ICU (44/95, 46.31%) as compared with ward (53/654, 8.1%). E. coli (19/43, 44.18%) was the predominant isolate in cases of CAUTI, Pseudomonas in cases of VAP (8/29, 27.58%) and SSI (6/29, 20.68%) while Acenatobacterbaumanii (3/4, 75%) in CLABSI. Staphylococcus spp.(N-15) isolates showed sensitivity (100%) to Linezolid. The sensitivity for Amikacin, Amoxiclav, Co-Trimoxazole, and Tetracycline was 60.0%, 60%, 66.67%, and 73.33% respectively. On the other hand, 60% isolates were resistant to Azithromycin, 66.7% to Levofloxacin, 60% to Oxacillin and60% to Cefoxitin. All Enterococcus (N-2) isolates were sensitive to Linezolid and resistant to Amikacin, Cefoxitin and Co-Trimoxazole, 50% were resistant to Amoxyclav, Tetracycline and Gentamicin. Conclusion:  Pathogens that are associated with HAIs are usually multidrug resistant thus making the treatment more complicated. Combination therapy should be used rather than monotherapy for HAIs strains. Polymyxin B, tigecycline, tobramycin, and Piperacillin +Tazobactam showed high sensitivity so these drugs should be used as reserved drugs.

Introduction:    The burden of type 2 diabetes mellitus(T2DM) has steadily increased over the past quarter-century in India and across the globe. Onset of nephropathy in T2DM patients increases the CVD risk. India is facing an enormous healthcare burden in managing patients with different acute and chronic complications of T2DM. Present study is planned to assess the role of estimated glomerular filtration rate (eGFR) and albuminuria as risk parameters to evaluate cardiovascular disease risk in patients with type 2 diabetes mellitus.  Methods:   This was a cross-sectional study conducted on 100 T2DM patients at RUHS College of Medical Sciences and Associated Hospitals, Jaipur. Participants’ demographic and biochemical data were collected. Urine albumin excretion over 30 mg/L were considered as having albuminuria, and eGFR was calculated using MDRD formula and study participants were divided into three eGFR categories: ≥90, 60-89, <60 ml/min/1.73 m2. Ten-year coronary heart disease risk (CHDR) was calculated using United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Results Out of total 100 patients, 63% were males and 37% females, 45% were more than 60 years of age. Age (mean ±SD) and duration of diabetes were 56.57±12.78 and 5.82 ±4.59 years, respectively. Patients with eGFR <60 ml/min/1.73m2 were older in age with longer diabetes duration compared to those who had eGFR >60 ml/min/1.73m2. A significant association between CHDR and eGFR (p=0.014) and CHDR and albuminuria (p <0.001) was observed. Conclusion:  CHDR score based on UKPDS risk engine shows a significant association with eGFR and albuminuria in patients with T2DM without symptomatic CVD. Findings of the study would be useful for physicians to make therapeutic decision and earlier intervention for T2DM patients.

Background: Cardiovascular disease includes various modifiable and nonmodifiable risk factors which account for most of the non-communicable disease mortality. The WHO/ISH risk prediction chart yield approximate risk stratification approach in limited resources countries to reduce the burden of CVD mortality. Objective: To assess the 10-year risk for fatal or nonfatal cardiovascular events among adults aged ≥40 years, utilizing the WHO/ISH Risk prediction chart.    Methods:   A cross-sectional study was conducted in a tertiary care hospital among patients who were ≥40 years attending outpatient department of community medicine. Participants were selected using purposive sampling method. A predesigned questionnaire was used to collect data from consented participants for the study. The WHO/ISH CVD risk prediction chart is used to stratify the individual into ten-year risk category. Results:    A total of 214 participants (mean age 55.4 years; male and female ratio = 1.4:1) were included in this cross-sectional study. The estimated 10-year risk of a cardiovascular event was <10, 10-<20, 20-<30, 30-<40, >40% in 68.69, 19.62, 7.94, 2.33 and 1.40 participants respectively. Smoking (p = 0.01) and insufficient physical activity (p = 0.005) were found significantly associated with higher risk of CVD event. Conclusion:  Around 11.67% of the participants were found at high cardiovascular risk whereas 19.62% were at moderate risk. Early recognition of individuals with moderate and high risk for cardiovascular disease can be likely benefited from primary preventive measures.

Autonomic nervous system is vital for homeostasis and its potency is gradually reduced with aging.  Aging may affect cardiac autonomic nerve functions, disrupting the complex interactions with several physiologic mechanisms that maintain the heart rate and blood pressure within normal limits. This may ultimately lead to the development of many cardiovascular diseases. This study was carried out in 150 healthy male subjects in the age group of 20yrs – 70 yrs. of Guwahati city and to assess the effect of age on the Parasympathetic Balance. The standard bedside non- invasive Parasympathetic Function tests (Valsalva maneuver, Heart rate variation during deep breathing, and Heart rate response to standing) was performed in each subject. This study thus demonstrated that ageing is associated with a decrease in the function of the autonomic nervous system in apparently healthy individuals. Therefore, it can be said that in the diagnosis and treatment of autonomic-related diseases, physiological differences in the cardiovascular autonomic functions due to age should be considered.

Introduction: The Triceps brachii gets its name from tri, referring to “three" muscle heads or points of origin (with Brachii referring to the arm). These include the Medial head, Lateral head, and Long head. All three heads of the triceps brachii muscle are classically said to be innervated by the radial nerve. The radial nerve’s axillary and Ulnar collateral branches are previously unrecognized sources of triceps brachii innervations. However, some recent studies have claimed the presence of innervation from the axillary nerve to the long head. Aims and Objectives: To study the anatomy of the motor branch and the long head of the triceps brachii.  Materials and Methods: 52 formalin-embalmed superior extremities were dissected and studied. The age, gender and cause of death is unknown. The period of study is for one year. Inclusion Criteria: Formalin embalmed upper limb specimens irrespective of age, gender and cause of death. Exclusion Criteria: Upper limbs showing gross asymmetry. Any injury to the nerve of the triceps will be excluded. Results: Out of 52 dissected cadaveric limbs, 46 long-head triceps have shown a normal motor innervation of the radial nerve, 6 long-head triceps have shown axillary nerve innervations, and none of the specimens have shown motor branches arising from posterior cords of brachial plexus. Conclusion:  The inconsistency in the variations of innervations to triceps compared with similar studies could be due to differences in the population and race under study. These findings could be relevant for the surgical treatment of Shoulder dislocations, Humerus fractures, nerve transplant procedures, etc.

Background: Post-operative pharyngolaryngeal complications are commonly reported following laryngeal mask airway (LMA) insertion. Airway structures fall backwards due to gravity after induction of anaesthesia, which contributes to difficulty in placement of an LMA. External airway alignment by lifting the larynx during insertion of an airway may avoid collision of the airway with laryngeal structures. Objectives: The objective of the study was to compare pharyngolaryngeal complications and success rate of LMA insertion among the external larynx lift technique, classical technique, rotational technique (back to front) and triple airway manoeuvre (mouth opening, head extension and jaw thrust) technique. Materials and methods: 104 patients were randomised into four groups for LMA placement: C, classical insertion technique; R, rotational technique; T, triple airway manoeuvre technique and E, external laryngeal lift technique with partially pre-inflated cuff. Success rate of insertion and   pharyngolaryngeal complications over 24 hours post-operative period were observed. Main outcome measures: Pharyngolaryngeal complications include dysphonia, dysphagia, sore throat and blood on LMA at removal. Result: Among the 104 patients 100 patients were studied, there were no difference of insertion attempts among the groups. Incidence of sore throat (C; 56.5%, R; 33.3%, T; 25% E; 20.8%, P=0.047) intensity of sore throat on 10 point scale (C; 3.26±3.12, R; 1.96±2.91, T; 1.38±2.58, E;1.04±2.2, p=0.009) and also, presence of blood on LMA was significantly lower in E group compare than other groups (C; 56.5%, T; 29.2%, R; 25%, E;8.4%, p=0.025). Conclusion: External larynx lift technique has a higher success rate of LMA insertion comparable to other three techniques although it is not significant. It is also associated with lower incidence of blood staining on LMA after removal, intensity and severity of sore throat suggesting that this technique is less traumatic than other three techniques.

Background: Jugular foramen of human skull is one of the most interesting foramina. It is a complex bony canal, numerous vital structures, including nerves and vessels are transmitted through it. Most of the intracranial and extra cranial lesions of posterior cranial fossa might affect the structures in jugular foramen in addition to intrinsic abnormalities. It is very important foramen for neurosurgeons. Material and Methods: The present study was conducted in 72 adult dry skulls, which were collected for study in multiple medical and dental institutions in Karnataka.  We have measured the jugular foramen - Anteroposterior diameter, Mediolateral diameter, the fossa width and depth of fossa. All these measurement with help of vernier callipers. All the measurements were taken bilaterally and expressed in Mean+SD. Results: We have observed that anteroposterior diameter was less than medial to lateral diameter. The anteroposterior diameter was ranged between 4 - 16 mm and medial to later diameter was 12 – 25mm. We have also seen about dome of jugular fossa, in 28(38.88%) skulls we have observed the presence of a prominent superior jugular bulb was present bilaterally. Depth of the fossa was measured. Most of the foramina were having depth between 5 and 20 mm. Conclusions: The present study concluded that the morphometric data and variations observed in the present study are of enormous value to neurosurgeons and otolaryngologists, while performing middle ear surgeries for various jugular foramen tumours.

Chronic non-healing ulcers pose significant challenges in clinical management, particularly when complicating conditions such as hypertension and dyslipidaemia are present. We present a case of a 38-year-old male with a neglected non-healing ulcer over the dorsum of his right foot, complicated by underlying hypertension and dyslipidaemia. Despite conventional wound care measures, the ulcer failed to heal over a period of six months. Subsequently, the patient underwent successful treatment with skin grafting, resulting in complete wound closure and restoration of foot function. This case underscores the importance of considering advanced interventions like skin grafting in the management of chronic ulcers, especially in patients with comorbidities that may impair wound healing.

Background: Metabolic syndrome is linked to a heightened susceptibility to cardiovascular illnesses and type 2 diabetes. The incidence of metabolic syndrome is escalating to epidemic levels, not just in rich countries and other urbanised regions, but also in developing nations. Hence, it is crucial to identify metabolic syndrome within the population in order to commence the necessary preventive and treatment interventions. Objective: The primary objective of this study is to determine the prevalence of metabolic syndrome in the urban field practice region of CIMS Bilaspur among individuals aged 20-80 years. Methodology: A cross-sectional study was undertaken in Yadunandan Nagar, an urban field practice area of Chhattisgarh Institute of Medical Science (CIMS) Bilaspur, from November 2021 to October 2022. 540 individuals between the ages of 20 and 80 were surveyed using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP-III) guideline and a questionnaire to collect socio-demographic information. Prior to the survey, signed agreement was obtained from each participant. Anthropometric data, such as body size and proportions, along with blood pressure, fasting blood glucose levels, and lipid profile were recorded. Result: The study consisted of a total of 540 participants, with a prevalence of metabolic syndrome being 55% (297 individuals). The prevalence of the condition was greater among females, with 65% (183) affected, compared to males, with 44% (114) affected. Conclusion: The study demonstrates a substantial disparity between genders in the occurrence of metabolic syndrome, highlighting the necessity for customised therapies and health efforts that are specifically designed for each gender to reduce its impact. 

Regenerative medicine and stem cell therapy are two of the most innovative new treatments in modern medicine. They are completely changing how a wide range of illnesses and accidents are treated. This presentation presents a thorough examination of the present condition, difficulties, and future possibilities of regenerative medicine and stem cell treatment. We provide an overview of important technologies such as tissue engineering, gene therapy, and the utilization of mesenchymal stem cells (MSCs), focusing on their potential uses in the treatment of illnesses and injuries such as cardiovascular disease and spinal cord injuries. The paper also delves into the ethical, legal, and social implications (ELSI) of these therapies, as well as the diverse regulatory landscapes across different countries. Technical challenges, including stem cell selection and understanding their action mechanisms, are discussed alongside the potential and limitations of current therapies. The future of regenerative medicine is examined, with a focus on personalized medicine, bioengineering advancements, and the expansion of clinical applications. Although there are many complicated issues that must be resolved as the area of regenerative medicine and stem cell treatment develops, this overview highlights the field's promise to transform healthcare.

Background: Several elements that are either anesthesia-related (the type and span of sedation), medical procedure related (the sort of a medical procedure and the degree of the surgery), or patient-related (age, orientation, body weight, and their typical body core temperature) impact body core temperature. Strangely, not much information is available about patients' temperatures and their body mass index (BMI). The point of this study was to assess the effect of BMI on body core temperature in patients undergoing General versus Spinal anesthesia during the surgery. Duration of the surgery is also compared. Materials and Methods: An observational study was conducted in Chettinad hospital and research institute. Two sub-groups (General and spinal anesthesia), Body Mass Index and the duration of the surgery were evaluated. The actual hypothermia prevention guidelines were followed when treating patients. Temperature was measured in axilla after inducing the patient with anesthesia throughout the procedure. Each sub-group was divided into BMIs of less than and greater than 30 kg/m² with mild and moderate hypothermia. Result: A sum of 100 patients were assessed. Fifty patients went through General anesthesia and fifty patients received spinal anesthesia for surgery. Temperature was decreased in all subgroups after the induction of anesthesia, but the decrease was more pronounced during spinal anesthesia, even in patients with BMI<30kg/m² (less than 30). Regardless of the type of anesthesia, the type of surgery, or the BMI, throughout the course of the procedure, there was a noticeable drop of temperature. Conclusion: We conclude that, in General Aanesthesia, even the patients BMI >30 kg/m² are less prone to hypothermia. In spinal anesthesia, even patients with BMI <30 kg/m² are more prone to hypothermia. As the duration of surgery increases, irrespective to the type of anesthesia, surgery and BMI, the chances of hypothermia increases.

Objective: This research sought to investigate the impact of COIVD 19 on the pregnancy outcome comparing that to the non-COVID pregnancies.   Methods: This study undertook a retrospective comparative observational study design, among 68 randomly selected single tone pregnancy cases (34 RT-PCR diagnosed COVID positive and 34 RT-PCR diagnosed COVID negative) who were admitted in the selected hospital in their third trimester to attain medical care for delivery purpose. The study has been carried out between the period of March 2023 to October 2023 on the hospital records of patients admitted between July 2022 to February 2023. Data regarding maternal, fetal and neonatal outcomes have been inspected and compared among the COVID and non-COVID cases.  Results:   Only 14.7% of the COVID cases had mild symptoms, and rests were asymptomatic. In this study the adverse outcomes of the pregnancy were higher among COVID positive cases compared to non-COVID cases. Gestational age at delivery was significantly lower and hospital stay was significantly higher among COVID mothers (p<0.05). Prolonged labor, preterm delivery, ante-partum and post-partum complications, requirement of oxygen therapy and intensive care treatment were higher in proportion among COVID positive cases (p>0.05). Fetal distress, requirement of oxygen therapy and NICU, breathing difficulties found to be evident only among newborn of COVID positive cases (p>0.05). Conclusion: Maternal adverse outcomes were more common than the fetal outcomes when compared between COVID and non-COVID pregnancies.

Background: Lactational breast abscesses are a significant complication of mastitis in breastfeeding women. This study aimed to compare the efficacy and patient outcomes of open drainage versus percutaneous negative pressure suction drainage in the treatment of lactational breast abscesses. Methods: A total of 100 lactating women with diagnosed breast abscesses were randomly assigned to either open drainage or percutaneous negative pressure suction drainage. The study evaluated abscess resolution rates, recurrence rates, time to recovery, pain management, breastfeeding continuation, patient satisfaction, and complication rates. Results: Both groups showed high abscess resolution rates by the one-month follow-up. The percutaneous group had a significantly shorter mean recovery time (12.8 vs. 14.2 days, p=0.04) and lower pain scores at one day and one week post-procedure (p<0.001 and p=0.001, respectively). Patient satisfaction regarding procedure discomfort, cosmetic outcomes, and overall satisfaction was significantly higher in the percutaneous group (p<0.001, p=0.005, and p<0.001, respectively). The incidence of scar formation was lower in the percutaneous group (p=0.05). Conclusion: While both open drainage and percutaneous negative pressure suction drainage are effective for the management of lactational breast abscesses, the percutaneous approach offers advantages in recovery time, pain management, patient satisfaction, and cosmetic outcomes. These findings suggest a preference for the minimally invasive percutaneous method in clinical practice.

Left atrial thrombus formation is well known complication associated with rheumatic mitral valve stenosis causing significant morbidity and mortality. Initiation of anticoagulation with vitamin K antagonist (VKA) is the most common strategy employed for left atrial thrombus but is ineffective for organized thrombus. This case series present six patients of severe rheumatic mitral valve stenosis with giant organised left atrial thrombus. All patients underwent surgical thrombectomy with concomitant valve surgery. The left atrium and mitral valve was approached by an inverted T-shaped biatrial incision. The surgical technique of thrombectomy included careful blunt dissection and creating plane between organized thrombus and left atrial wall. There was one postoperative death due to cardiac failure. In conclusion, surgical thrombectomy should be offered to all patients with organised left atrial thrombus. The surgical technique of ‘en bloc’ thrombectomy is safe and effective. The raw area on the left atrium should be covered with autologous pericardium in a situation where it is difficult to remove all the thrombotic material without leaving residual material behind after removal of thrombus.

Background: Pseudomonas aeruginosa is anaerobic, motile gram-negative rod which is responsible for 10% of all hospital acquired or nosocomial infections. Present study was conducted to determine the incidence, risk factors and antimicrobial resistance pattern of P. aeruginosa isolated from different clinical samples. Materials and method: A total of 7293 patients presenting with different complains in different OPD and IPD of our hospital were included in the study. From all the 7293patients’ clinical samples such as pus, swab, urine, sputum, blood, cerebrospinal fluid, pleural fluid, peritoneal fluid, tissue biopsies and bronchial lavage were collected and received to our laboratory without delay for further processing. All the samples were processed for aerobic culture and organisms were identified by standard protocol. The P.eruginosa was tested for antimicrobial resistance by Kirby Bauer disc diffusion method according to CLSI guidelines. Results: Out of 7293 clinical samples cultured, 3865 (52.9%) yielded significant growth and the rest 3428 (47.1%) samples were either sterile or showed non-significant growth. From 3865 growth positive samples, a total of 355 (9.18%) P. aeruginosa were isolated. From 355 isolates, majority 249 isolates (70.14%) were isolated from IPD in the hospital and rest 106 isolates (29.85%) were isolated from out-patients (community-acquired infection). 206 (5.32%) of P. aeruginosa were isolated from pus and swab samples followed by urine 126 (3.26%) and blood 01 (0.02%) samples. The maximum age of patients infected with P. aeruginosa was 31-40 years old and male to female ratio was 1.25:1. Pseudomonas aeruginosa was highly resistant to Ceftazidime 81.97%, Cefepime 64.50%, Piperacillin 41.42%, Ciprofloxacin 44.50%, Levofloxacin 36.05%, and Amikacin 30.42%. Conclusion: This type of epidemiological study will help the better infection control strategies in hospitals and improve the knowledge of antibiotic resistance patterns among clinicians so that the appropriate antibiotic prescribed to the patients and also control of irrelevant, irrational use of antibiotic. Thus, there is a need for periodical antimicrobial surveillance to monitor the resistance patterns in tertiary care hospitals. Study shows the frequency of multidrug resistant among P. aeruginosa.

Background: Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality globally. Decompressive craniectomy (DC) is a lifesaving procedure for managing severe TBI. This study aims to investigate the predictive value of pre-operative neurological status, radiological findings, and post-operative neurological changes on functional outcomes at discharge. Methods: An observational, prospective cohort study was conducted on 174 TBI patients undergoing DC at a tertiary care center. Patients were categorized into early and late DC groups. Data on pre-operative anisocoria, CT findings (side of injury, midline shift, mass effect), post-operative anisocoria, and Glasgow Coma Scale (GCS) scores were collected. The Glasgow Outcome Scale Extended (GOSE) assessed functional outcomes at discharge. Results: Pre-operative anisocoria was significantly associated with outcomes, being absent in 95.40% of the late DC group compared to 27.59% in the early DC group (p<.0001). CT findings indicated a significant relation between the side of injury and surgical outcomes (p<.0001). Post-operative anisocoria persisted significantly in the early group across all days (p<.0001). Improvement in GCS scores at discharge was more pronounced in the early DC group (mean improvement 2.83 ± 3.54) than in the late group (1.45 ± 4.13, p=0.043). The right side of injury was significantly associated with favorable GOSE outcomes in the early decompression group (p=0.033). Conclusion: Pre-operative anisocoria, specific CT findings, and early improvements in GCS scores are significant predictors of functional outcomes at discharge in TBI patients undergoing DC. These findings advocate for a nuanced approach to patient selection and timing for DC.

Introduction: The parotid gland is the most common site for salivary gland neoplasms. Cancers of the parotid gland occur rather often. Nearly eighty percent of parotid tumors are noncancerous neoplasms. Most benign parotid tumors (80%) are found in the superficial lobe. Cancer is more likely to develop in deep lobe neoplasms. This study has been done to study the various modes of presentation of parotid tumors and to compare the FNAC of parotid tumor with the biopsy post operations. Materials and methods: This is a prospective observational study conducted from 2021 January to 2023 January at Siddhartha Medical College, Vijayawada over 30 patients attending the surgical OPD. Patients who are immunocompromised, on chemotherapy, less than 15 years have been excluded from the study. Results: The age incidence of the patients in the study group ranged from 14-76 years. The malignant tumors occurred between the age group of 17-60 years. Most patients in this series were in the 4th decade of life (33.33%). The mean age was 37.6 years for benign tumors and 43 years for malignant tumors. Out of 30 patients, 5 patients presented with pain (16.67%) in swelling, out of which 4 were benign and 1 was malignant. Pain occurred in 20% of the patients with malignant tumors and 16% of the patients with benign tumors. Superficial parotidectomy was performed in 25 patients (83.33%), and conservative total parotidectomy in 5 patients (16.67%). Conclusion: Parotid tumors are mostly benign and they involve the superficial lobe whereas the malignant tumors arise from the deep lobe. Pain is the most common presenting symptom. Ultrasound can detect the tumors and FNAC aids in confirming the diagnosis.

Introduction: Metabolic syndrome (MetS) is a major public health burden associated with a 5-fold risk of developing type-2 Diabetes Mellitus (T2DM) and a 2-3fold risk of cardiovascular disease (CVD). Individuals with MetS tend to have more adipose tissue leading to overproduction of proinflammatory cytokine like hs-CRP, by monocyte derived macrophages in adipose tissues. Aim: To determine the association of serum osteocalcin with MetS and to assess its correlation with hs-CRP. Materials and Methods: A case-control study was carried out in the department of Biochemistry at VIMSAR medical college, Burla, Sambalpur, Odisha, India. The study included 50 cases, between 25-60 years of age, diagnosed as having metabolic syndrome defined by NCEP ATP III criteria and 50 age and sex matched normal healthy subjects as control. Fasting blood glucose, lipid profile and hs-CRP were estimated in Roche Cobas-311. Serum osteocalcin was estimated by Enzyme-linked Immunosorbent Assay (ELISA) LISA SCAN READER. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS v26.0) software. Results: Serum osteocalcin was found to be lower in cases as compared to controls (6.17± 2.18 ng/dl and 20.62±4.77 ng/dl) whereas, serum hs-CRP was found to be higher in cases as compared to controls (2.11±0.7 and 1.07±0.43), respectively. Conclusion: Serum osteocalcin was found to be significantly negatively correlated with hs-CRP in individuals with MetS (r= -0.879, p<0.001).

Background: This study explores the association between subclinical hypothyroidism and gallstone disease, with a particular focus on gender disparities, comorbid conditions, and cholesterol levels. Methods: A prospective analysis was conducted on 120 patients diagnosed with gallstone disease at the Department of General Surgery, Bangalore Medical College and Research Institute. The study assessed the prevalence of subclinical hypothyroidism, its correlation with patient demographics, comorbid conditions such as hypertension and diabetes mellitus, and total cholesterol levels. Results: Subclinical hypothyroidism was identified in 17.5% of the gallstone patients, with a higher prevalence in females (21%) compared to males (10%), resulting in a statistically significant gender disparity (p < 0.05). Comorbid conditions were present, with hypertension in 14% and diabetes mellitus in 15.8% of the patients. Elevated total cholesterol levels (>160 mg/dL) were observed in 64.2% of the subjects, predominantly among those over 40 years of age. Conclusion: The findings highlight a significant association between subclinical hypothyroidism and gallstone disease, especially in females. The study underscores the necessity of including thyroid function tests in the routine clinical evaluation of gallstone patients, to identify and manage those at increased risk due to thyroid dysfunction. The results advocate for a nuanced understanding of the metabolic and endocrine factors influencing gallstone pathogenesis, aiming for improved patient outcomes through targeted screening and intervention strategies.

Background : Dengue is a vector borne disease with various grades of severity. Pregnancy is a high-risk group and is prone for complications of dengue haemorrhagic fever. Dengue fever has rapidly emerged as the most common arboviral infection globally.  Objectives: The primary objective of the study was to assess maternal and fetal outcomes of pregnancies affected with dengue fever. Materials and methods: It was an institutional based prospective observational study. It was conducted in Department of Gynaecology and Obstetrics, College of Medicine & Sagar Dutta Hospital, Kamarhati, Kolkata, West Bengal, India. After receiving the clearance from the ethical committee study was conducted from June 2022 to December 2022. All pregnant patients reporting to the hospital with fever and serologically confirmed dengue infection (40 confirmed cases) were included in the study. Clinical and laboratory data of patients were collected. The cases were followed up till their delivery to monitor the effect of dengue. The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Result: In the present study platelet count of 9 (22%) patients were <25000 lac and platelet count of 13 (33%) patients were 15000 to 50000 lac. In the present study 3 (7.50%) patients need ICU care followed by 9 (22.50%) need platelet transfusion, 7 (17.50%) need C PAP, 8 (20%) need PPH, 7 (17.50%) need abortion and 2 (5%) patients need abruption. In the present study 5 (12.5%) fetals suffered from fetal distress followed by 2 (5%) suffered from Oligohydramnios. In the present study 4 (35%) neonatal were normal. 8 (20%) neonatal need SNCU admission, 2 (5%) neonatal need NICU admission. Conclusion: Pregnancy-related dengue illness progressed quickly and caused serious consequences. For both the mother and the fetus to have a positive outcome, close materno-fetal monitoring and prompt obstetric care are necessary. 

Background: Fetal growth restriction (FGR) poses challenges in antenatal care due to its association with adverse perinatal outcomes. The cerebroplacental ratio (CPR), derived from Doppler ultrasound measurements, has emerged as a potential marker for evaluating fetal well-being in FGR pregnancies. Aim and Objective: To assess the predictive value of CPR in identifying adverse perinatal outcomes in suspected FGR cases. Materials and Methods: Conducted at Jaipur Golden Hospital, New Delhi, from July 2018 to May 2019, the study included 80 pregnant women with clinical suspicion of FGR, singleton pregnancies, and gestational age over 30 weeks. Doppler studies evaluated the umbilical artery pulsatility index (UA PI) and middle cerebral artery pulsatility index (MCA PI) to calculate CPR. Perinatal outcomes were analyzed, including delivery mode, birth weight below the 10th percentile, APGAR score < 7 at 5 minutes, neonatal interventions, and neonatal intensive care unit (NICU) admission > 24 hours. Statistical analysis employed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (p < 0.05). Results: 47.5% had CPR < 1, and 52.5% had CPR ≥ 1. CPR significantly correlated with adverse perinatal outcomes (p < 0.001). It outperformed UA PI and MCA PI, with a sensitivity of 97.6%, specificity of 91.8%, PPV of 93%, and NPV of 97.1%. Conclusion: CPR is valuable in predicting adverse perinatal outcomes in suspected FGR pregnancies, surpassing UA PI and MCA PI in diagnostic accuracy. Further validation and optimization are necessary for managing high-risk pregnancies.

 Introduction: Hypertension is the commonest cardiovascular disorder and a major public health problem. The Seventh Report of the Joint National Committee (JNC 7) defined pre-hypertension as persons with blood pressure (BP) above optimal levels [systolic BP (SBP) of 120-139 mm Hg or diastolic BP (DBP) of 80-89 mm Hg]. Community-based studies in India have demonstrated close to a third of the studied population with pre-HTN.(1,2) The incidence of pre-hypertension and hypertension among young adults is increasing day by the day.(3,4) In a multi-center study across 11 cities in India, the prevalence of prehypertension was found to be 40.2% among males and 30.1% in females.The prevalence of prehypertension among medical students in a study conducted in Orissa was 67%. Aims: To Study the prevalence of pre-hypertension and risk factors among resident doctors and to correlate pre-hypertension and risk factors in this specific Population. Materials and Methods: It was a Cross sectional study. this study was conducted from June2017 to June 2020 at the department of Medicine at Jawaharlal Nehru Medical College, Wardha.155 patients were included in this study. Result: Of the 155 patients, men made up 58.1% and females 41.9%. While 55.5% of the people surveyed had normal blood pressure, 44.5% showed signs of prehypertension. Importantly, just 23.9% of patients admitted to smoking, whereas 76.1% denied doing so. In 36.1% of instances, alcohol usage was prevalent, while 63.9% abstained. Regarding their way of life, 54.2 percent acknowledged eating junk food and 51.1 percent were regularly active. Overall, 57.4% said they eat fruit often, while 30.4% said they eat extra salt. The average age was 26.59 and the body mass index was 23.8 kg/m². Conclusion: this study reiterates the importance of risk factors in the causation of prehypertension, let alone hypertension and it is emphasised that prehypertension and risk factors should be vigorously sought in the general population and necessary interventions be implemented. This will go a long way in saving manhours and health care expenditure and improve the productivity of nation

Background: The present study is undertaken to compare the conventional modes of ventilation namely pressure controlled and volume controlled ventilation and their impact on the ventilatory and hemodynamic parameters. This will throw light on the fluctuations in pressure and volume in a specific altered physiological state - obesity with pneumoperitoneum and add to the knowledge of optimizing ventilatory parameters to permit adequate oxygenation and establish superiority amongst the plethora of modes. Objectives: To assess and compare pressure controlled ventilation and volume controlled ventilation in patients with BMI≥25Kg/m² undergoing laparoscopic cholecystectomy. Methods: A hospital based cross sectional comparative study was conducted in 42 overweight and obese patients of (18-60) years of either sex with ASA I and II who were scheduled for elective laparoscopic cholecystectomy under general anaesthesia in  Assam Medical College and hospital. Patients were ventilated using a definite algorithm that was previously determined and divided into PCV and VCV groups. Mechanical ventilation parameters - Respiratory Rate, ETCO₂, Tidal volume, Peak airway pressure, Plateau pressure, were recorded at baseline - at the time of induction (before insufflation of pneumoperitoneum) , at 15 minutes after insufflation of pneumoperitoneum ,at 30 minutes and 45 minutes after pneumoperitoneum. Results: In the present study, we have found that the Tidal volume was higher for VCV group at 45 mins of pneumoperitoneum (p<0.01) than in the PCV group.  In the present study,  we have found statistically significant findings in the Peak Airway Pressure (Peak P) at 15 minutes (p<0.05),30 minutes (p<0.05) and 45 minutes(p<0.01) after insufflation of pneumoperitoneum .The Peak pressures were lower in the PCV group. In the present study, we have found statistically significant lower Plateau Airway Pressures (Plat P) at 15 minutes (p<0.05) and 30 minutes (p<0.05) in PCV group than VCV group after insufflation of pneumoperitoneum. Conclusion: Patients in the PCV group were able to maintain lower airway pressures while delivering target ETCO₂ values which is desirable in obese patients. Hence, PCV can be considered as a more efficacious mode for ventilation in patients with BMI25 Kg/m². However, both modes can be safely used in these patients.

Surfactant therapy now a days become the primary modality of treatment in Preterm neonates with respiratory distress mainly Respiratory Distress Syndrome(RDS). In Extremely low birth weight babies such as birth weight < 1000g, incidence of RDS as a significant cause of mortality and morbidity remains high. Present study was aimed to assess the immediate outcome of surfactant therapy in preterm neonates with RDS. Material and Methods: Present study was a single-center, prospective, observational study, conducted in preterm neonates less than 34 weeks gestation (estimated from mother’s 1st trimester ultrasound report or based on Ballard’s score if ultrasound report not available) diagnosed with RDS, required mechanical ventilation were treated with surfactant therapy. Results: In our study we included a total of 122 preterm neonates, 94 were males and 28 were females. Common clinical features were tachypnea (99.2%), chest indrawing (99.2%), grunting (97.5 %), apnea (37.7 %) & cyanosis (35.2 %). Mean respiratory rate before surfactant therapy was 82.9 ± 5.5, but it was drastically improved after surfactant administration which was 50.6 ± 10.3. Same pattern observed with SPO2 which showed 83.5 ± 2.6 before and after was 94.4 ± 2.1 and heart rate was 146.8 ± 8.7 before and after was 126.7 ± 8.3. Mean Silverman Anderson Score (SAS) in case of preterm neonate was 6.7 ± 0.7 before and 2 ± 1.2 after surfactant therapy. In our study of 122 neonates in which surfactant has been administered 78 were discharged (63.9 %) while 34.4 % (42) were expired. 2 patients were LAMA. Conclusion: Surfactant therapy significantly improved survival in Respiratory Distress Syndrome (RDS) as indicated by significant improvement in vital parameters as well as Silverman Anderson Score.

Background: The regulation of important body function such as blood pressure (BP), heart rate, temperature, respiration, gastrointestinal, bladder, and sexual function is dealt by the autonomic nervous system and its dysfunction lead to many diseases. The good mental health and control and development of mind can be taken care of by practicing Yoga. The autonomic system is affected widely by exercise. Therefore, this research  was planned to compare the effects of comprehensive yogic breathing program (kapalbhati and anulom- vilom) and aerobic exercise on autonomic functions in healthy individuals. Materials & Methods: This was a non-randomized comparative study, carried out    between January   2019 to December 2020. Total 150 subjects were incorporated  in the study. The participants of study were split in three groups, Yoga group, Aerobic Exercise group and Control group. Each group comprised of 50 subjects.  Study   was conducted in individuals of 30-50 age group, doing yoga (anulom-vilom and kapalbhati) and aerobic exercise fast walking and cycling. For Sympathetic Functions- Cold pressure test and Sustained handgrip test and for Parasympathetic Functions Deep breathing test, Valsalva maneuver test, Lying to standing test. Results: All participants were aged between 30 to 50 years with 40.5±6.9yrs as the mean age of all participants. There were a total of 112 males and 38 females who engaged in this study. Mean values of baseline Systolic BP was higher in Control group (123.8 ± 4.7 mmHg), compared to Aerobic Exercise group (121.4±3.8 mmHg) and Yoga group (119.2±4.8). By applying one-way ANOVA test comparison of baseline Systolic BP in all three group was statistically significant (p<0.05).  Mean values of baseline Diastolic BP were higher in control group (78.8±2.9 mmHg), compared to Aerobic Exercise group (76.6±3.1 mmHg) and Yoga group (76.4±5 mmHg). Conclusion: Three months of   yoga training has lead to decrease in the baseline Heart rate, Systolic blood pressure &   Diastolic blood pressure within normal limit which is a potential beneficial effect of yoga on cardiac autonomic function. Three months of aerobic exercise training may increase Parasympathetic nervous system activity.

Vascular injuries in paediatric patients, though infrequent, pose significant risks and challenges due to the scarcity of literature and the unique characteristics of the paediatric vascular tree. Trauma and iatrogenic causes, such as the inadvertent radial artery injury detailed in this case, are identified as primary culprits. The small calibre of paediatric vessels complicates diagnosis, and distinguishing true injuries from vasospasm is challenging, with potential consequences like thrombosis and limb-length discrepancies. This case underscores the importance of heightened awareness during routine procedures, especially in immunocompromised children or those on steroids, as even seemingly simple actions like surgical dressing can lead to catastrophic complications. The discussion emphasizes the lack of consensus in managing paediatric vascular injuries and explores repair techniques, postoperative care considerations, and the role of heparin therapy in preventing thrombosis. The presented case aims to raise awareness about the gravity of such complications and the need for vigilant care in paediatric patients with underlying health issues.

AIM:   To determine the role of ultrasound elastography of breast mass lesions.  Methods:  A prospective research was conducted at the radiology department of Continental Hospitals in Nanakaramguda, Hyderabad. 50 women with breast edema verified by ultrasonography were part in this research. Results:   Out of the 50 individuals in the research, 26 (52%) exhibited benign characteristics, whereas 24 (48%) had malignant characteristics. Out of the 50 patients in the research, 22 (44%) exhibited benign characteristics and 28 (56%) exhibited malignant characteristics as per elastography results. In a study of 50 patients, ultrasonography revealed malignancy signs in 24 patients (48%). Subsequent elastography conducted on these 24 patients indicated malignant features in 23 of them (95.8%). Out of 26 patients in the study, 52% exhibited benign characteristics on ultrasound. Among these 26 patients, 21 (80.7%) showed benign features on elastography. When comparing ultrasound and elastography findings in these 50 patients, the sensitivity for detecting malignant lesions was 82% and the specificity was 95%, resulting in an overall accuracy rate of 88%. Conclusion: We found that using elastography in conjunction with conventional B-mode ultrasonography enhances the diagnostic accuracy in differentiating between benign and malignant breast lesions, leading to a significant reduction in needless biopsies for benign lesions.

Background:   Globally 1.62 billion people are anemic, while among the preschool children the prevalence of anemia is 47.4%. In India, about 89 million children are anemic. Thus, India is the highest contributor to child anemia among the developing countries.  Methods:  The demographic details were noted and a blood sample was obtained for the assessment of hemoglobin. On the basis of outcome of hemoglobin assessment, the subjects were categorized for their anemic status based on the WHO criteria.  Results:   The prevalence of moderate to severe anemia was observed to be higher among those who had exclusively breastfed up to 1–2-month (29.2%) than 5-6 (27.8%), 3-4 (20.5%) and >6 (14.3%) month.  However, this trend was statistically not significant (p>0.05). Conclusion:   Prevalence of moderate to severe anaemia was significantly associated with malnutrition, but not with breastfeeding.

Background:   Chronic kidney disease (CKD) poses a growing global health challenge, with profound systemic implications affecting multiple bodily systems. The kidney and eye share intricate structural, developmental, physiological, and pathological pathways. CKD, along with prevalent eye disorders like glaucoma, cataracts, and retinopathy, are interconnected with age and various metabolic and systemic risk factors such as hypertension, diabetes, and smoking. CKD patients often present a diverse array of ocular manifestations. Notably, lid oedema, conjunctival pallor, and elevated serum lipids stand out as significant visual signs in the anterior segment associated with CKD. Moreover, secondary hyperparathyroidism may contribute to the calcification of the cornea and conjunctiva.  Methods:  This was a hospital-based Observational study conducted between December 2019 and June 2021. The study was conducted on 100 CKD patients diagnosed with chronic kidney disease attending the medical and ophthalmology departments and the dialysis centers in the government medical college, Srikakulam, Andhra Pradesh. A complete physical and ocular examination was done, and results were tabulated. Data were statistically analyzed using IBM SPSS software. Results:   Significant Hypertensive Retinopathy was seen in patients. 52% of the participants (104 eyes) showed hypertensive retinopathy changes that were statistically highly significant (p-value 0.001). The majority of patients with hypertensive retinopathy have Grade III HR (42%), followed by Grade II HR (29%), Grade I HR (19%), and Grade IV HR (10 %). Hypertension and CKD have a cause-and-effect relationship. A degrading kidney function with advanced CKD can lead to increased blood pressure, whereas sustained elevations in Blood pressure can deteriorate kidney function. Conclusion:  In our study, hypertension emerged as the predominant cause of CKD. Grade 3 to Grade 4 Hypertensive Retinopathy is vision threatening as the CKD progresses from Stage 1 to End Stage Renal Disease. In the Advanced stages of chronic kidney disease, the highest percentage of eyes affected were with Grade 3 Hypertensive Retinopathy. In conclusion, we assert that the eye is a crucial indicator of kidney health, enabling timely identification and intervention to mitigate the risk of vision impairment.

Background:   Children bear a substantial proportion of the enteric fever disease burden in endemic areas. Controversy persists regarding which age groups are most affected, leading to uncertainty about optimal intervention strategies. We performed a systematic review and meta-analysis of studies in Asia and Africa to compare the relative proportion of children with enteric fever in the age groups. Materials and methods: This prospective research was conducted at Tertiary Care Teaching Hospital over a Period of 1 year. A total of 90 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for Salmonella with suggestive clinical features. A total of 200 children aged one to 15 years who were either blood culture positive for the Fastidious Antibiotic Neutralization (FAN) or had significant Widal test titer (at least four-fold rises or 1:160 dilutions of both O and H antibodies) were included in the study. Those who had enteric fever with comorbidities (malignancy, nephrotic syndrome, chronic kidney disease, chronic liver disease, etc.) or complications (multiorgan failure, encephalopathy, etc.) were excluded from the study. Result: The clinical features of the study population, where all patients suffered from both fever and anorexia. 60% of patients had vomiting, 54.4% had diarrhea, half had abdominal pain, 43.3% had constipation, and only 3(3.3%) patients had myalgia. According to the Widal test report, 56 (62.2%) patients were reported positive, and 34 (37.8%) patients were reported negative. In the Blood C/S test report, 56 (62.2%) reported negative and 34 (37.8%) patients reported positive. The study population by the total leucocyte count, 45% of patients had >11000 count/mm3, 32.81% of patients had <4000 count/mm3, and 21.88% of patients had 4000-11000 count/mm3. Conclusion: Our findings indicate variability in disease presentation in adults compared to children, in different regions and in resistant vs sensitive cases. Majority of studies are from hospitalized cases, and are not disaggregated by age. Despite higher complications in MDR enteric fever, case fatality rate are comparable to sensitive cases, with an overall hospital based CFR of 2%, which is similar to recent global estimates.

Background:   The purpose of this research is to determine whether or not there is a correlation between a high neutrophil-to-lymphocyte ratio (NLR) and a high platelet-to-lymphocyte ratio (PLR) and nonalcoholic fatty liver disease (NAFLD).  Methods:  This was a retrospective study in the medicine department of a tertiary care facility. The demographic and clinical data was retrieved in a methodical fashion from the case records. Along with this, the data regarding the biopsy and other laboratory parameters was recorded to. This data was compared with non-NAFLD patients. Results:  The non-NAFLD participants were separated from the NAFLD subjects and placed in one of the two groups. According to the findings of our investigation, a low PLR score was connected with a higher risk of NAFLD (P 0.001), whereas a high NLR score was not significantly linked to NAFLD (P > 0.05). While there was shown to be a positive correlation between NLR and NAFLD, a negative association between PLR and NAFLD was discovered to exist. Conclusion:   The findings of this study indicated that a strong association exists between NLR and PLR and NAFLD. we According to the findings, a lower PLR and NLR could be a risk factor for morbidity in NAFLD patients.

Background: Doxorubicin is one of the most efficient chemotherapy medicines, but it also produces a dose-dependent cardiomyopathy that can result in heart failure. Fractional shortening and other traditional ventricular function indicators are ineffective at spotting early doxorubicin cardiomyopathy. Objective: Present study was aim to analyze the doxorubicin induced cardiac dysfunction on 2D ECHO in children with cancer. Methodology: Total 53 children with aged 1 year to 18 years who came to department of paediatrics and received doxorubicin therapy were included in the study. Left ventricular performance was assessed by a baseline 2 D Echocardiography before the start of doxorubicin i.e., before the first dose, prior to each subsequent dose, and every two to three months following the last dose of doxorubicin. Results: The mean age of patients was 8.792 ± 4.796 years with a higher number of male patients (71.69%). 2D ECHO finding revealed that LVEF was >50% in 49 patients whereas 4 patients have the LVEF<50%. In patients having normal LVEF≥50%, the LVEF was found to be decreased by 1 to 4 points after starting of doxorubicin therapy but was within normal limits. Among total 4 patients who have the LVEF<50%, the LVEF was found to decreased by 2 to 8 points. At follow up of three to six months, among total 4 patients who have the LVEF<50%, the LVEF was found to increase by 1 to 3 points. Conclusion: Present study revealed that one patient who received the CDD <200 mg/m2 and three patients who received the CDD ≥200 mg/m2 was found to have cardiotoxicity indicated by LVEF<50%. Cardiac function assessment needs to be analyzed critically in children undergoing chemotherapy to improve prognosis.

Introduction: Postpartum hemorrhage (PPH) continues to be a major cause of maternal morbidity and mortality in both developing and wealthy countries despite significant therapeutic improvements. This is one of the most difficult complications a clinician will encounter. The third stage of labor is the most essential stage, and its effective management would dramatically lower maternal mortality as postpartum hemorrhage, which accounts for 30% of maternal fatalities in India, is the primary cause of maternal mortalityAims: To compare the effectiveness of intramuscular oxytocin (10units) and intramuscular carboprost tromethamine (125μg) in prophylaxis of post-partum haemorrhage. Materials and Methods: A total of 100 women fulfilling the inclusion criteria were recruited and were divided into two groups, each having 100 women. One group received injection oxytocin (10 units) IM and the other group received injection carboprost tromethamine (125 mcg) IM after delivery of the baby Result: Injection Carboprost (125MCG) IM: The mean BMI was 18.06 (SD = 0.27) with a range of 18.00 to 22.00. The median BMI was 17.50. The p-value (0.1040) was not statistically significant.Injection Oxytocin (10 Units) IM: The mean BMI in this group was 18.08 (SD = 0.17), ranging from 17.00 to 20.20. The median BMI was 17.50. Injection Carboprost (125MCG) IM: The mean gestational age was 39.02 weeks (SD = 0.14), with a range from 38.00 to 40.10 weeks. The median gestational age was 38.00 weeks. The p-value0.2005 was not statistically significant. Injection Oxytocin (10 Units) IM: Participants in this group had a mean gestational age of 38.05 weeks (SD = 0.23), with ages ranging from 38.00 to 40.00 weeks. The median gestational age was 38.00 weeks. Conclusion: According to the findings of the study, injection carboprost tromethamine (125 microgram) IM is more effective than injection oxytocin (10 unit) IM in the active management of the third stage of labor. however with a higher risk of adverse effects