Introduction: The Zuckerkandl tubercle (ZT) is an anatomic landmark that can be used for the identification of the RLN intra –operatively. The ZT is a lateral or posterior projection from the lateral thyroid lobe. Adequate recognition and dissection of the ZT is essential for successful thyroid surgery. Objectives: To estimate the proportion of Zuckerkandl tubercle in individuals. To determine the association between Identification of Zuckerkandl tubercle and tracing of recurrent laryngeal nerve in individuals who underwent thyroidectomy. Methods: Hospital based cross sectional study design. This study is conducted in the Department of General Surgery, Dr. SMCSI Medical College, and Karakonam. November2020–October2022 (2 years). A period of 18 months from the date of institutional ethical committee clearance. Result: In this study the mean age was 44.76 +/- 6.131 in the study population. The minimum was 32 maximum was 57 in the study population. Majority of the study population, 65.5 percent were females and 34.5 percent were males. RLN was found posterior to ZT in 56.4 percent of the individuals. RLN was found anterior to ZT in 9.1 percent of the individuals. After identifying ZT in 38 out of the 55 individuals RLN was identified in 35 out of 38 individuals and in the remaining 3, RLN was not identified with the help of ZT. Size of ZT was assessed and ZT less than 10mm was found in 37.5percent of the study population, ZT More than 10mm in 34.5 percent of the study population and ZT not visualized in 30.9 percent. Conclusion: In this study in 69% of individuals, ZT was visualized during thyroidectomy. Also ZT was visualized more on the right side (38.2%).Among 38 patients in whom ZT was visualized, in 35 patients it was helpful to identify RLN. Thus this study concludes that ZT is an important pointer which helps in identifying RLN during thyroidectomy.

Background/Introduction: The Zuckerkandl tubercle (ZT) is a posterior projection of the lateral thyroid lobe and serves as an important anatomical landmark for identifying the recurrent laryngeal nerve (RLN) during thyroid surgery. Recognition of ZT can reduce the risk of RLN injury, a common complication in thyroidectomies. Given its close anatomical relationship with the tracheoesophageal groove, the study aimed to assess the frequency and size distribution of ZT in individuals undergoing thyroidectomy and its role in aiding RLN identification. Objectives: To estimate the proportion of Zuckerkandl tubercle in patients undergoing thyroidectomy and evaluate its anatomical variations. Materials and Methods: A hospital-based cross-sectional study was conducted over 2 years (November 2020 – October 2022) at the Department of General Surgery, Dr. SMCSI Medical College, and Karakonam. Fifty-five patients undergoing thyroidectomy for benign thyroid conditions were included using non-probability sampling. Patients with malignancy, prior neck surgery or radiation, or unfit for surgery were excluded. ZT presence, laterality, size, and its utility in RLN identification were recorded intraoperatively. Data were analyzed using SPSS software with Chi-square test applied for association. A p-value <0.05 was considered statistically significant. Results: ZT was identified in 38 out of 55 patients (69.1%), while absent in 30.9%. ZT was found more frequently on the right side (38.2%) than the left (27.3%), and bilaterally in 3.6% cases. The size distribution among those with ZT showed equal proportions of ZT <10 mm and ZT >10 mm (both 50%). There was a highly significant association between ZT presence and its size (χ² = 55.000, df = 2, p < 0.001). No significant association was found between ZT presence and age (p = 0.219) or gender (p = 0.250). Mean age was 44.76 ± 6.13 years with a female predominance (65.5%). Conclusion: ZT was observed in nearly 70% of individuals undergoing thyroidectomy and served as a consistent and reliable anatomical marker for RLN identification. The tubercle was more frequently located on the right side and presented either as a small (<10 mm) or large (>10 mm) structure with equal prevalence. Recognizing and preserving this structure is essential to prevent RLN injury during thyroid surgeries.

Introduction: Abdominal tuberculosis poses a diagnostic challenge due to its nonspecific symptoms and varied imaging features. CT plays a key role in its evaluation, with oral contrast agents influencing image clarity. This study compares the diagnostic utility of neutral versus positive oral contrast in CT imaging of abdominal TB. Aims: The main purpose of our study is to evaluate intestinal and extra intestinal findings in patients with abdominal tuberculosis on CT using positive or neutral oral contrast. Materials and Methods: This cross-sectional analytic study was conducted in the Department of Radio-diagnosis, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, over a period of one year. A total of 40 patients diagnosed with abdominal tuberculosis were included in the study. Result: The neutral oral contrast group showed greater bowel distension across all segments (e.g., jejunum: 2.10 ± 0.52 cm vs. 1.70 ± 0.42 cm) and better fold visibility (Grade II in 65% vs. 45%). Appreciable mural enhancement was more frequent with neutral contrast (80% vs. 20%). Among 31 patients with lymphadenopathy, 54.83% had multi-compartment involvement, with mesenteric nodes most common (96.7%) and homogenous enhancement seen in 77.41% of cases. Conclusion: Neutral oral contrast agents showed better bowel distension, fold visibility, and mural enhancement than positive contrast on CT. These findings improve small bowel assessment and diagnostic accuracy. Mesenteric lymphadenopathy was the most common, often with multi-compartment involvement. Overall, neutral contrast enhances CT diagnostic yield in abdominal evaluations.

Background: Surgical Site Infections (SSIs) are a leading postoperative complication, particularly after cesarean sections (C-sections), impacting patient outcomes and healthcare resources. The risk of SSIs is significantly higher in emergency procedures compared to elective surgeries, due to multiple modifiable and non-modifiable factors. Aim of the study: To study and compare surgical site infections in emergency and elective Caesarean surgeries. Methodology: This prospective comparative study was conducted on 560 pregnant women undergoing either elective or emergency lower segment cesarean sections (LSCS) at the Government Maternity Hospital, Tirupati over a one-year period. Participants were assessed preoperatively, intraoperatively, and postoperatively for demographic characteristics, clinical risk factors, and signs of wound infection. Data were analyzed using SPSS v24, with chi-square and t-tests employed for statistical significance. Results: SSIs were observed in 8.2% (n=23) of emergency LSCS cases versus 1.07% (n=3) of elective LSCS cases. Emergency procedures showed higher association with risk factors like postoperative anemia (39.13%) and obesity (34.78%). Klebsiella spp. and Staphylococcus aureus were the predominant pathogens isolated in emergency and elective groups, respectively. Wound gaping and need for resuturing were significantly higher in the emergency group. Conclusion: Emergency LSCS is significantly associated with a higher incidence of SSIs compared to elective procedures. Identifying key risk factors like obesity, anemia, and hypothyroidism, along with targeted antibiotic therapy, can help reduce postoperative infections. Preoperative optimization and standardized infection control protocols are crucial to improving maternal outcomes.

Background: Medical education is increasingly adopting student-centered approaches, with Game-Based Learning (GBL) emerging as a cutting-edge method to boost engagement, motivation, and knowledge retention. In the past, teaching and learning methods predominantly emphasized knowledge acquisition over immersive educational experiences. Today, there is a growing embrace of playful approaches, with game-based learning (GBL) seamlessly integrating engagement and education. We implemented game-based applications and traditional learning methods using multiple-choice questions (MCQs) to evaluate their effectiveness in creating an engaging and productive learning experience for medical students. Methods: An interventional study was conducted among 60 Phase 3 Part 1 MBBS students at a Medical College and tertiary care Hospital in Eastern India. A crossover design was used, where two groups comprising 30 students in each group experienced both TL and GBL for different topics. Pre- and post-tests were conducted and student satisfaction was assessed using a Likert scale. Statistical analysis was done using paired, unpaired t-tests and the Wilcoxon Signed-Ranks Test, p value < 0.05 was considered significant. Results: In our study, post-test scores showed significant improvement within both groups (p < 0.05). The GBL group demonstrated a greater increase in scores compared to the TL group, with a statistically significant difference (p < 0.01). Student satisfaction ratings were notably higher for GBL, indicating a strong preference for this approach (p = 0.0001). Conclusion: GBL is an effective addition to traditional lectures, enhancing knowledge retention and learner satisfaction. While the study supports the use of GBL in medical education, larger studies are needed for broader validation.

Background: Numerous cross-sectional and retrospective case-control studies have linked elevated total homocysteine levels to peripheral, cerebral, and coronary vascular disease. . These investigations have also identified homocysteine as a unique risk factor that goes beyond the traditional risk factors. Because they might be influenced by a variety of factors, epidemiological findings suggesting a correlation between high HCY levels and cardiovascular risk do not establish a causative relationship. Moreover, other clinical studies revealed that vitamin supplementation had no discernible impact on cardiovascular risk, despite lowering HCY levels. Hence, our study aimed to evaluate the association between homocysteine and coronary and cerebral vascular disease without other risk factors like hyperlipidemia, diabetes mellitus, hypertension, smoking and old age. Methods: This was a case-control study involving 100 subjects of either sex of age group between 13 and 40 years, with 50 cases with myocardial and cerebral infarct and 50 controls. Plasma total homocysteine was determined by HPLC (High Performance Liquid-Chromatography). Results: The mean homocysteine level was 19.36±8.06090 among cases, while among controls it was 13.88±4.69. Hyperhomocystinemia was seen in a higher percentage of cases, 58%, compared to 38% among the control group. The cases had a 1.50-fold higher risk for MI or stroke than controls (the relative risk ratio), and the odds ratio is 2.25. The percentage of hyperhomocystinemia was 36% in the non-vegetarian group and 62% in the vegetarian group. The mean homocysteine was 18.92 µmol/L in stroke and 19.56 µmol/L in MI. Conclusion: Hyperhomocystinemia is an independent risk factor for coronary artery disease and cerebrovascular disease. In the present study, the cases had a 1.50-fold higher risk for MI or stroke than the controls. It is strongly recommended to screen for hyperhomocystinemia especially among young patients with arterial occlusive disease or venous thrombosis without other risk factors.

Background: Criminal behaviour often stems from poor social upbringing, disturbed family dynamics, substance dependence, and undiagnosed psychiatric conditions. The overlap between mental illness and substance abuse among offenders poses a major concern for both healthcare systems and the legal framework. Aim: To study the association between substance abuse and psychiatric disorders in relation to criminal behaviour among alleged offenders. Methods: This prospective, descriptive observational study was conducted in the Department of Forensic Medicine and Toxicology at SMS Medical College, Jaipur, from August 2019 to November 2020. A total of 250 alleged offenders were selected based on informed consent and eligibility for medico legal evaluation. Information was gathered on their demographic profile, criminal background, substance use habits, family circumstances, and mental health status. Results: Out of 980 individuals examined, 250 (25.5%) met the inclusion criteria. Most participants were male (98.4%) and within the 18–30 year age group (64.8%). Substance use was observed in 45.2% of cases, with alcohol (60.2%) and smack (31.9%) being the most used substances. Strong links were found between substance use and factors such as low educational attainment, exposure to family conflict or abuse, and involvement in property-related crimes. Although only 4% of offenders displayed identifiable mental disorders, those with psychiatric issues had a higher incidence of childhood trauma and substance dependence. A history of repeat offenses was strongly associated with long-term addiction (77.4%). Conclusion: This study reveals a clear connection between substance abuse and criminal behaviour, especially when combined with unstable family and social conditions. These findings highlight the urgent need for prison-based rehabilitation, mental health assessment, and early family-focused interventions to reduce repeat offending and support offender recovery.