European Journal of Cardiovascular Medicine

Introduction: Surgical field clarity is crucial in middle ear microsurgery where even minimal oozing deteriorates visibility and increases operative time. Total intravenous anaesthesia (TIVA) with propofol–remifentanil is hypothesised to reduce mucosal blood flow and improve visibility versus volatile maintenance (sevoflurane or desflurane). Materials and Methods: Prospective, parallel-group randomised study in adult ASA I–II patients undergoing elective tympanoplasty/mastoidectomy. Patients received either TIVA (propofol–remifentanil target-controlled infusion) or inhalational anaesthesia (sevoflurane/desflurane with remifentanil). Primary outcome was surgical field quality measured on a 6-point Boezaart bleeding scale at fixed timepoints. Secondary outcomes included blood loss, hemodynamics, operative time, emergence and recovery milestones, postoperative nausea–vomiting (PONV), and complications. Results: 120 patients were analysed (TIVA n=60; Inhalational n=60). Mean Boezaart score was lower with TIVA (2.2±0.6 vs 2.7±0.7; p<0.001). Blood loss (ml) and operative time (min) were reduced with TIVA (120±46 vs 148±52 ml, p=0.001; 84±18 vs 92±20 min, p=0.008). Emergence was faster with inhalational agents (extubation 7.6±2.1 vs 9.1±2.4 min; p<0.001) but readiness for discharge (Aldrete ≥9) was similar. PONV at 24 h was lower with TIVA (18.3% vs 38.3%; RR 0.48; p=0.014). No serious adverse events occurred. Conclusion: For middle ear surgery, propofol–remifentanil TIVA improved surgical field visibility and modestly reduced blood loss and operative time, while inhalational agents yielded slightly faster emergence. TIVA significantly decreased PONV without delaying discharge readiness.

Objective: To assess the relationship between levels of CRP, IL-6, and fibrinogen with the incidence of cardiovascular events with known cardiovascular risk factors. Methodology:  This prospective cohort study aimed to investigate the predictive role of inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], and fibrinogen) in forecasting cardiovascular events. The study included 500 participants aged 40 to 75 years with at least one cardiovascular risk factor, such as hypertension, diabetes, hyperlipidaemia, or smoking history. Baseline blood samples were collected to measure CRP, IL-6, and fibrinogen levels, and participants were followed for 5 years. Cardiovascular events, including myocardial infarction, stroke, and sudden cardiac death, were recorded during the follow-up period. Results: The study found that elevated levels of CRP, IL-6, and fibrinogen were significantly associated with an increased incidence of cardiovascular events. Participants in the highest quartiles of these biomarkers had notably higher event rates compared to those in the lowest quartiles (p = 0.03 for CRP, p = 0.04 for IL-6, and p = 0.02 for fibrinogen). Cox proportional hazards regression analysis revealed that each unit increase in CRP, IL-6, and fibrinogen corresponded to a 45%, 23%, and 31% higher hazard of experiencing a cardiovascular event, respectively (p ≤ 0.05 for all biomarkers). Conclusion: This study highlights the significant role of inflammatory biomarkers in predicting cardiovascular events, especially in individuals with established cardiovascular risk factors. Elevated levels of CRP, IL-6, and fibrinogen were found to be strong predictors of adverse cardiovascular outcomes, suggesting that these biomarkers may improve cardiovascular risk stratification and help identify high-risk individuals for early intervention. Further research is needed to explore their potential integration into clinical practice for more effective prevention strategies

INTRODUCTION Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. MATERIALS AND METHODS A prospective study, for a period of 1 years at Department of Pathology, Chalmeda AnandRao Institute of Medical Sciences was conducted. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. Routine Investigations for anaemia and its causes were done. Anaemia was classified morphologically based on peripheral smear findings. Packed-cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) were determined by automated cell counter. Hemoglobin was estimated by Sahli’s method and expressed in gm%, peripheral smear was stained by Leishman’s stain. Reticulocyte count was done by brilliant crystal stain method, serum iron determination was done by Ramany’s dipyridyl method, Total iron binding capacity was determined by Ramsay’s method, serum vitamin B12 and folic acid was determined by architect method. Results The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour. The current study was taken up, keeping this need in view