Introduction: Ovarian cancer predominantly spreads within the peritoneal cavity causing peritoneal carcinomatosis, which is associated with poor prognosis. Rare distant metastases beyond the abdomen, including sites such as the liver parenchyma, lungs, brain, bone, and distant lymph nodes, represent a distinct and aggressive disease subset with limited clinical data. Aims: To evaluate clinical profiles and patterns of rare distant metastases in ovarian and peritoneal cancer. Materials and Methods: This retrospective, observational cohort study was conducted over a period of one year in the Department of Gynaecology & Obstetrics, Murshidabad Medical College and Hospital, West Bengal 742101. The study included a total of 400 patients with histologically confirmed primary ovarian or peritoneal carcinoma. Result: Out of 400 ovarian cancer patients, rare distant and intra-abdominal metastases showed varied frequency and prognosis. CNS (12%) and bone (8%) metastases had poor survival (10 and 7.5 months, respectively). Eye and skin metastases (4% each) had slightly better outcomes (14 and 12 months). No cases involved supraclavicular or inguinal nodes, while mediastinal–cardiophrenic (4%) and breast node (8%) metastases showed better survival (18 and 16 months). Among intra-abdominal sites, the spleen was most common (20%), followed by GI tract (12%), bronchus/trachea (8%), heart (4%) and placenta/fetus (4%) with survival ranging from 7 to 17 months. Prognosis varied significantly by site. Conclusion: Rare distant metastatic disease in ovarian cancer represents a biologically aggressive pattern with poorer prognosis than peritoneal carcinomatosis. Improved diagnostic vigilance and individualized treatment strategies are crucial. Future studies should focus on molecular profiling to better understand the metastatic behavior and identify therapeutic targets.

Introduction: Acute Coronary Syndrome (ACS) is a significant cause of morbidity and mortality globally with differing risk profiles and pathophysiological mechanisms across age groups. Objectives: To compare the angiographic characteristics of coronary artery involvement in patients diagnosed with ACS in two distinct age groups: those aged <40 years and those aged >60 years. Methods: This analytical cross-sectional study was conducted over 18 months, from March 1, 2023 to August 31, 2024at the Department of Cardiology, Nilratan Sircar Medical College and Hospital, Kolkata. The study population comprised adult patients below 40 years and above 60 years of age admitted with acute coronary syndrome. Results: In this study of 192 Acute Coronary Syndrome (ACS) patients, two age groups were compared: those below 40 years and those above 60 years. Younger patients showed a marked male predominance (84%), whereas the elderly group had a more balanced gender distribution. The mean TIMI score was significantly higher in older patients (3.56 ± 1.51) compared to the younger group (2.87 ± 1.69), indicating a greater risk profile in the elderly. Single-vessel disease was most common in the younger cohort (69%), while older patients had a higher prevalence of triple-vessel disease (29%). The left anterior descending artery (LAD) was the most frequently involved vessel across both groups, with higher involvement in the elderly. Additionally, left main coronary artery (LMCA) disease was significantly more common in older patients (29% vs. 11%). SYNTAX II scores further supported these findings, with younger patients more often falling into the low-risk category, whereas a significant portion of older patients had intermediate to high scores. Conclusion: Younger ACS patients tend to have less extensive but more thrombotic coronary involvement, often limited to a single vessel, with modifiable lifestyle-related risk factors predominating. Older patients, however, typically present with diffuse, multi-vessel atherosclerotic disease, correlating with higher rates of comorbidities. These findings underscore the need for age-specific preventive and interventional strategies in the management of ACS.

Introduction: Pre-eclampsia is a hypertensive disorder of pregnancy associated with maternal and fetal morbidity and mortality. Cancer antigen-125 (CA-125), a glycoprotein traditionally used as a tumor marker, has been reported to rise in pre-eclampsia and may correlate with disease severity. Aims and Objective: To evaluate the relationship between maternal serum CA-125 concentrations and the severity of pre-eclampsia. Methods: This observational analytical case-control study was conducted from May 2021 to April 2022 at the Department of Biochemistry in collaboration with the Department of Obstetrics and Gynaecology, Burdwan Medical College and Hospital. A total of 306 pregnant women were enrolled, comprising 153 pre-eclamptic cases and 153 normotensive controls. Maternal demographic and anthropometric data were recorded. Serum CA-125 levels were measured using chemiluminescent immunoassay. Pre-eclampsia cases were stratified into mild, moderate and severe categories. Statistical analysis included unpaired t-tests, ANOVA, and correlation analyses, with p < 0.05 considered significant. Results: Mean maternal age was comparable between case (27.88 ± 1.31 years) and control groups (28.12 ± 1.43 years, p = 0.115). Mean height was significantly higher in cases (159.56 ± 5.32 cm) compared to controls (153.87 ± 28.37 cm, p = 0.015), while weight differences were not significant. Serum CA-125 levels were significantly elevated in pre-eclamptic women (45.81 ± 11.05 IU/mL) versus controls (12.74 ± 2.13 IU/mL, p < 0.0001), with higher levels observed in severe cases. CA-125 positively correlated with blood pressure and proteinuria, indicating association with disease severity. Conclusion: Maternal serum CA-125 is significantly elevated in pre-eclampsia and correlates with disease severity. It may serve as a potential biomarker for risk stratification and monitoring in pre-eclamptic pregnancies.

Introduction: Gestational Diabetes Mellitus (GDM) is increasing globally, linked to obesity, age, and lifestyle changes. While insulin is the standard treatment, metformin is emerging as a safe, effective alternative. It improves insulin sensitivity and may reduce maternal and fetal complications. This study compares outcomes in GDM pregnancies treated with insulin versus metformin. Aims: To compare maternal and fetal outcomes in patients with gestational diabetes mellitus treated with Insulin or Metformin. Materials and Methods: This prospective observational comparative study was conducted from December 2022 to November 2023 at the OPD, antenatal, and postnatal wards of the Department of Obstetrics and Gynaecology, Chittaranjan Seva Sadan College of Obstetrics, Gynaecology and Child Health. A total of 106 pregnant women diagnosed with Gestational Diabetes Mellitus were included. The study aimed to compare maternal and fetal outcomes between insulin and metformin treatments. Results: In this study, insulin and metformin provided similar glycemic control in women with GDM. However, metformin was associated with significantly fewer neonatal complications such as hypoglycaemia (p=0.002), NICU admission (p=0.019), and respiratory distress (p=0.022). Neonatal birth weight was also lower in the metformin group (p=0.037), indicating a potentially safer neonatal profile. Conclusion: Untreated Gestational Diabetes Mellitus (GDM) can lead to serious maternal and neonatal complications. While insulin is the standard treatment, metformin has emerged as an effective and cost-efficient alternative. Widely accepted in the West and increasingly used in India, metformin effectively controls blood sugar levels in GDM. It is also linked to fewer pregnancy complications and better neonatal outcomes. These findings support metformin as a safe and effective option for GDM management.

Introduction: Intrauterine insemination (IUI) is a widely used first-line treatment for selected cases of subfertility due to its simplicity, cost-effectiveness, and minimal invasiveness. However, its success is influenced by multiple factors related to the couple, ovarian stimulation protocol, and semen parameters. Identifying predictive factors for pregnancy following IUI can help in optimizing patient selection and improving outcomes. Objectives: To evaluate the clinical, hormonal, and procedural factors associated with successful pregnancy following IUI and to identify significant predictors that influence the likelihood of conception. Materials and Methods: This prospective interventional open-label study was conducted in the Department of Obstetrics and Gynecology, Eden Hospital, Medical College and Hospital, Kolkata, over one year. Protocol development began in November 2016, and patient recruitment and data collection took place from January to July 2017 after ethics committee approval, followed by data analysis and thesis preparation. Women seeking infertility treatment in the OPD were counselled and enrolled after meeting the inclusion and exclusion criteria. Based on a previous study [xiv] and the formula n = 4pq/l², the calculated sample size was 257; however, due to time constraints and single-researcher limitations, 50% of this number (≈130 IUI cycle) were included. Results: In our study, female age, male age, BMI, and type of infertility were not significantly associated with pregnancy outcomes, although no women were older than 35 years and most pregnancies occurred in men over 35 years, contrasting with Mathieu et al., who reported poorer outcomes with increasing male age [93]. The majority of pregnancies (75%) occurred in women with infertility duration less than six years, with the highest conception rates seen in unexplained infertility (75%) followed by endometriosis (25%). Laparoscopic tubal patency assessment were more common in the conception group. Hormonal analysis showed that all who conceived had LH and FSH ≤10 mIU/mL, significantly lower prolactin (p = 0.0298), and no significant differences in TSH. Fasting and postprandial blood sugar levels were higher in the conception group but within normal limits. All pregnancies occurred when two preovulatory follicles were present, while endometrial thickness had no significant effect. Semen analysis revealed significantly higher semen volume, pre-wash sperm count, motility, and post-wash count among those who conceived. Conclusion: Several factors including cause of infertility, infertility duration, FSH, LH and PROLACTIN level, follicular response, semen volume, prewash sperm count, motility and post-wash sperm count are predictive of IUI success. Careful selection of patients and individualized stimulation protocols based on these predictors can enhance pregnancy outcomes in IUI cycles.

Introduction: Myofascial trigger points in the upper trapezius are a common cause of neck pain and functional limitation, contributing to increased neck disability in affected patients. Aims: This study aimed to compare the efficacy of dry needling, ultrasound therapy, and lignocaine injection in reducing neck disability in patients with upper trapezius myofascial trigger points. Data were collected through history, clinical examination, and recorded in a pre-designed proforma after obtaining informed consent. Materials and Methods: Comparative and randomized study conducted at the Department of Physical Medicine & Rehabilitation, Sambhu Nath Pandit Hospital, Kolkata, over 1 year, including 60 adults patients with myofascial trigger points of the upper trapezius muscle associated with myofascial pain syndrome. Result: All three interventions led to a progressive reduction in NDI scores over time. At the first and second visits, differences between groups were not statistically significant. By the third visit, Group B (ultrasound therapy) demonstrated a significantly greater improvement in NDI compared to Group C (lignocaine injection) (p = 0.009), while dry needling showed comparable but slightly lesser improvement. Demographic factors such as age, sex, occupation, handedness, and BMI did not significantly influence outcomes. Conclusion: Dry needling, ultrasound therapy, and lignocaine injection are all effective in reducing neck disability in patients with upper trapezius myofascial trigger points, with ultrasound therapy providing slightly superior functional improvement. These findings support the use of ultrasound-guided therapy as part of a multimodal approach to managing myofascial pain syndrome.

Introduction: Preeclampsia, a hypertensive disorder of pregnancy, is a leading cause of maternal and perinatal morbidity and mortality worldwide. Low-dose aspirin has been shown to reduce the risk of preeclampsia, preterm birth, and fetal complications, particularly when started before 16 weeks of gestation in high-risk women. Aims: To evaluate the efficacy of 75mg aspirin versus 150mgaspirin in prevention of pre eclampsia and its complications in high risk pregnant population. Materials and Methods: This observational study was conducted over 1.5 years at Nilratan Sircar Medical College, Kolkata, including 150 patients (75 in each group). Participants were followed at 24, 28, 32, 36 weeks, and weekly thereafter until delivery. The efficacy of two aspirin doses was evaluated in preventing preeclampsia and its complications. Result: In our study of 150 high-risk pregnant women, most were aged 21–25 years (39.3%) with primary education (42%). Baseline risk factors, including BMI ≤25, previous preeclampsia, and multifetal pregnancies, were similarly distributed between the two aspirin groups. Pregnancy complications occurred in 34% of participants, with gestational hypertension (21.3%) and preeclampsia (33–36%) being most common, while 68% showed a positive response to aspirin prophylaxis. Conclusion: We concluded that younger women with lower educational attainment made up a sizable share of the cohort in our study comparing 75 mg and 150 mg aspirin for the prevention of preeclampsia in high-risk pregnancies.

Introduction: Jejunoileal atresia (JIA) is a frequent cause of intestinal obstruction in the newborn and it occurs in 1-3 per 10,000 live births. The condition is caused by vascular accident in utero. The antenatal diagnosis is difficult even though prenatal imaging has improved. Neonates with JIA normally manifest within the first 24-48 hours of birth with biliary emesis and inability to empty meconium with or without abdominal distension. The gold standard is surgical resection of the atresia segment and end to end anastomosis. When neonates are in severe sepsis or in poor general state or in severe bowel distension, other surgical methods- stoma or a chimney procedure (e.g Santulli ) can be used. Survival rates in developed countries are more than 90% due to early diagnosis, neonatal intensive care advancements, pediatric anaesthesia expertise and access to total parenteral nutrition (TPN). Aims and Objectives: This paper seeks to carry out an institutional review based on cases of jejunoileal atresia that have been conducted over a period of 5 years basing on short term outcomes and survival influencing factors. Materials and Methods: A retrospective study was conducted on neonates admitted with jejunoileal atresia who were operated between January 2020 to December 2024. The data that was recorded include the demographics, clinical presentation, and preparation, surgical details and outcomes along with associated anomalies if any. To establish the significant predictors of survival, statistical analysis was done. Results: 33 neonates with jejunoileal atresia were operated with a male-female ratio of 1.36:1. 79% were low birth weight, and 64 % were very low birth weight. The average age of presentation was around 9.5 days. Our study indicated the timing of presentation and birth weight as significant factors of survival. Even though the overall survival which was 72% at the time of initial discharge had declined to 64% at least 6 months follow up, the switchover to Santulli ( chimney) procedure in the final 2 years yielded a survival of more than 90% Conclusions: Neonates with late presentation and low birth weight did poorly. High index of suspicion of intestinal obstruction in neonates who have biliary emesis is essential for early diagnosis. Survival might be enhanced by antenatal diagnosis by intervening in time. A chimney operation such as Santulli, which was found to have a higher survival rate than primary anastomosis in neonates of unfavorable general condition and massive luminal disparity, has turned out to be  saviour in resource-limited tertiary centres.

Introduction: Breast cancer is one of the leading causes of cancer-related morbidity and mortality in women worldwide. It is a heterogeneous disease, with genetic, hormonal, and environmental factors contributing to its development and progression. Among the most significant genetic factors influencing the risk and prognosis of breast cancer are mutations in the BRCA1 and BRCA2 genes, which are known to predispose individuals to hereditary forms of breast and ovarian cancers. Aims: This study aims to determine the incidence of BRCA1 gene mutations among breast carcinoma patients and analyze its impact on tumor characteristics, clinical outcomes, and prognosis. Additionally, the study will explore the potential for personalized treatment strategies based on BRCA1 mutation status. Materials & Methods: This is a prospective study conducted at the Institute of Postgraduate Medical Education and Research, SSKM Hospital, Kolkata, from January 2016 to August 2017, with a sample size of 50 breast carcinoma patients with BRCA1 gene mutations. Result: BRCA1 levels were highest in Grade I tumors (mean 102.73 ng/ml), followed by Grade II (mean 27.61 ng/ml) and Grade III tumors (mean 26.11 ng/ml). These findings suggest that BRCA1 expression decreases with increasing tumor grade, indicating its potential role in tumor aggressiveness. Conclusion: We concluded that according to our research, there were substantial differences in BRCA1 gene mutation levels among tumor stages, histological grades, and lymph node involvement groups. This suggests that BRCA1 expression may be correlated with the aggressiveness and progression of tumors.

Introduction: Trigger thumb is a flexion deformity of the interphalangeal joint caused by stenosing tenosynovitis of the flexor pollicis longus tendon. It is a common pediatric hand condition that can affect hand function and fine motor development. While some cases resolve spontaneously, persistent or severe deformities may require surgical intervention. There is ongoing debate regarding the optimal timing and choice between conservative and operative management in children. Methods: This prospective comparative study was conducted at B.C. Roy Children Hospital over 3 years on 50 pediatric trigger thumb patients (6 months–6 years). Demographic, clinical, and outcome variables were analyzed. Statistical tests included independent t-test and chi-square/Fisher’s exact test, with p < 0.05 considered significant. Results: A total of 50 children with trigger thumb were studied (25 surgical, 25 conservative). The mean ages were 4.8 ± 2.1 and 4.5 ± 2.3 years, respectively (p = 0.65), with no significant differences in gender distribution, laterality, or disease stage at presentation. Complete resolution occurred in 80% of surgical and 72% of conservative cases (p = 0.45). Complications were minimal; one infection occurred in the surgical group, while recurrence (8%) and residual flexion contracture (12%) were noted only in the conservative group. Parental satisfaction scores were comparable between groups and no significant differences (8.0 vs. 8.2, p = 0.18). Conclusion: In this study of 50 children with trigger thumb, surgical management showed superior outcomes compared to conservative treatment. Spontaneous resolution was rare, and delayed surgery often led to fixed flexion deformity with poor parental satisfaction. While children under 2 years may be managed conservatively, those over 2 years benefit from early surgical correction to achieve complete resolution and better functional outcomes.

Introduction: Recurrent patellar dislocation is a common cause of knee instability in the pediatric population, often resulting from injury or insufficiency of the medial patellofemoral ligament (MPFL). Surgical reconstruction of the MPFL has emerged as a reliable option to restore patellar stability, improve function, and prevent recurrence, especially in skeletally immature patients where traditional procedures may risk growth plate injury. Methods: The present study was a prospective comparative study conducted over 3 years at B.C. Roy Children Hospital. The study included 30 pediatric patients with recurrent patellar dislocation who underwent physis-sparing MPFL reconstruction and/or ACL reconstruction. Results: In this study of 30 pediatric patients undergoing medial patellofemoral ligament reconstruction, the mean age was 12.5 ± 2.1 years, with a slight male predominance (18 males, 12 females) and nearly equal distribution of affected knees (16 right, 14 left). The mean BMI was 19.8 ± 3.2 kg/m². Significant functional improvement was observed postoperatively, with the mean Kujala score increasing from 56.4 ± 8.7 to 89.3 ± 5.2 (p < 0.001) and the mean Lysholm score from 58.7 ± 7.9 to 91.1 ± 4.8 (p < 0.001). Recurrent patellar dislocation occurred in 2 patients (6.7%), and minor complications such as transient pain or swelling were noted in 4 patients (13.3%), with no major complications reported. Gender-wise comparison showed comparable functional outcomes between males and females, with no statistically significant differences in postoperative Kujala or Lysholm scores (p = 0.32 and 0.28, respectively). Conclusion: MPFL reconstruction in pediatric patients is safe and effective, improving knee stability and functional outcomes with low recurrence and minimal complications. Physeal-sparing ACL techniques, using the gracilis tendon and patellar suture anchor, preserve growth plates while providing stable fixation. Overall, these procedures reliably restore patellar and knee stability and improve quality of life in skeletally immature patients.

Introduction: The transmission mechanism of Mycobacterium leprae is not clearly known. There are evidences available showing healthy individuals living in close contact with active leprosy patients are at high risk. In studies from India itself, Mycobacterium leprae DNA, have been isolated from environmental samples such as soil and water which shows shedding of organism from active leprosy cases. The possibility of transmission of infection from environment being as a source of infection has yet to be proven. These findings challenged the long-held belief that M. leprae transmission occurred solely through human-to-human contact (respiratory route like in Tuberculosis). Aim/Objective: The central aim of this investigation was to detect Mycobacterium leprae DNA in environmental samples like fomite (pillow cover/ towel/ bedsheet etc.) by targeting the RLEP sequence using Polymerase Chain Reaction. Methods: This study is a prospective analytical study done for a study period of six months at an institute of national importance situated in Raipur, Chhattisgarh, India in which newly diagnosed patients of active leprosy disease attending the institute during study period were registered and samples from their household were collected. A total 147 sample were collected from 29 cases. DNA was extracted using salting out – proteinase K method. Detection of M. leprae was done using RLEP-PCR. Result: A total of 63 water samples and 84 fomite swab samples were collected from the houses of 29 patients and from various water bodies in and around their residence area. In this study, we analyzed 84 fomite samples, including swabs from beds, towels, and door handle, using LP-1 and LP-2 primers to amplify a 129 bp RLEP sequence. Among these, one door/floor sample and one towel sample from the household of a multibacillary (MB) case tested positive for RLEP-PCR. All remaining fomite samples, as well as all 63 water samples, were PCR negative. Conclusion: The detection of Mycobacterium leprae DNA in two fomite samples (door/floor and towel) from the household of a multibacillary case suggests the shedding of bacilli from the active case. However, M. leprae DNA were absent in all water samples and the majority of fomite samples.

Introduction: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective surgical interventions for end-stage osteoarthritis and other degenerative joint diseases. While pain relief is well established, assessment of functional outcomes and quality of life postoperatively remains critical for evaluating overall success. This study aimed to assess functional outcomes in patients undergoing primary or revision total knee or hip arthroplasty. Methods: This prospective observational study was conducted in the Department of Orthopaedics, Burdwan Medical College & Hospital, from June 2023 to June 2024, including 40 adult patients undergoing primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA). Patients were evaluated for demographic variables such as age, gender, and BMI, along with comorbidities. Clinical outcomes were assessed using validated functional scores (WOMAC, KSS for TKA; HOOS for THA), pain scores (VAS), range of motion (ROM), and objective performance tests (6-minute walk test and Timed Up & Go test). Postoperative complications were recorded and analyzed. Data were collected systematically and subjected to appropriate statistical analysis to evaluate functional outcomes, pain relief, and complication rates following arthroplasty. Results: This study of 40 patients (20 TKA, 20 THA) demonstrated significant postoperative improvements in pain, function, and mobility with both procedures. TKA patients showed reductions in WOMAC (58.6 to 23.4) and gains in KSS (45.7 to 85.2), while THA patients improved in HOOS (55.3 to 20.7) (all p < 0.001). ROM, VAS, 6-minute walk distance, and TUG time improved significantly in both groups, with no significant difference in complication rates (3 cases each). Pearson’s correlation confirmed a strong negative association between pain reduction and functional improvement (TKA: r = –0.65, p = 0.002; THA: r = –0.58, p = 0.006). Conclusion: Total knee and hip arthroplasty provide significant improvement in pain relief and functional outcomes. Early postoperative rehabilitation and careful patient selection contribute to favorable results. These procedures demonstrate high efficacy and safety, significantly enhancing the quality of life in patients with degenerative joint disease.

Introduction: Long bone fractures are among the most common orthopedic injuries and require stable fixation for optimal functional recovery. Two widely practiced internal fixation methods are intramedullary (IM) nailing and plating. While IM nailing offers the advantages of load sharing, preservation of periosteal blood supply, and early mobilization, plating provides direct fracture visualization, anatomic reduction, and rigid fixation. The choice of method remains a matter of debate, particularly with regard to union rates, complications, and functional outcomes. Methods: This study was a prospective comparative observational study conducted in the Department of Orthopaedics at Burdwan Medical College & Hospital from July 2024 to July 2025. A total of 70 adult patients with diaphyseal fractures of the femur, tibia, humerus, or forearm were enrolled and divided equally into two groups: intramedullary nailing and plating. Data were collected on patient demographics (age and gender), fracture characteristics (site), intraoperative parameters (mean operative time, mean blood loss, and fluoroscopy time), postoperative outcomes including complications, and patient satisfaction. All patients were managed according to standard surgical protocols, and follow-up was conducted to assess fracture union, functional recovery, and overall satisfaction. Results: In this study of 70 patients with long bone fractures (35 IM nailing, 35 plating), baseline demographics and fracture characteristics were comparable. IM nailing showed shorter operative time (72.3 ± 15.6 vs. 98.7 ± 18.2 min, p <0.001), lower blood loss (120 ± 40 vs. 250 ± 60 ml, p <0.001), but higher fluoroscopy time (95 ± 25 vs. 60 ± 20 sec, p <0.001). Fracture union occurred earlier (16.5 ± 3.2 vs. 18.2 ± 3.5 weeks, p = 0.03), with similar rates of nonunion and malunion. Complications were low and comparable. Functional outcomes favored IM nailing, with lower DASH scores (12.5 ± 4.3 vs. 14.8 ± 5.1, p = 0.04) and earlier full weight bearing (14.1 ± 2.5 vs. 15.6 ± 3.0 weeks, p = 0.02). Patient satisfaction was high in both groups. Conclusion: Both intramedullary nailing and plating are effective methods of fixation for long bone fractures. Intramedullary nailing has advantages in terms of less operative morbidity, faster union, and earlier mobilization, making it more suitable for lower limb fractures. Plating remains valuable where precise anatomic reduction is required, especially in forearm fractures. An individualized approach considering fracture pattern, bone involved, and patient factors should guide the choice of fixation method.

Introduction: Fracture fixation implants play a critical role in achieving stable bone healing. With the development of novel implant designs, there is a need for rigorous biomechanical evaluation to assess their stability, load-bearing capacity, and resistance to failure under physiological conditions. Understanding these characteristics helps guide clinical decision-making and ensures patient safety. Methods: This study was a prospective experimental biomechanical investigation conducted at the Department of Orthopaedics, Burdwan Medical College & Hospital, from March 2019 to March 2020. A total of 100 adult synthetic bone models simulating human long bones were utilized to assess various parameters, including age, gender, fracture site, complications, patient satisfaction, mean operative time, mean blood loss, and fluoroscopy time. Standardized experimental protocols were applied to evaluate the biomechanical performance of the implants under controlled conditions, ensuring reproducibility and allowing comparative analysis of mechanical stability and failure modes. Results: The demographic and baseline characteristics of the bone models, including age, gender distribution, and bone density, were comparable between the Implant A and Implant B groups. Biomechanical testing demonstrated that Implant B outperformed Implant A, showing significantly higher load to failure (1380 ± 160 N vs. 1250 ± 150 N; p = 0.032), greater stiffness (245 ± 40 N/mm vs. 220 ± 35 N/mm; p = 0.014), superior cyclic loading resistance (53,000 ± 5,500 cycles vs. 48,000 ± 6,000 cycles; p = 0.008), and reduced deformation under load (3.9 ± 0.7 mm vs. 4.5 ± 0.8 mm; p = 0.045). Analysis of failure modes indicated that while screw pull-out and plate bending were more common in Implant A, these differences were not statistically significant, whereas bone fractures at the implant site were significantly higher in Implant B (60% vs. 30%; p = 0.009). Conclusion: The new fracture fixation implants exhibit superior biomechanical properties compared to conventional implants, including higher load tolerance, increased stiffness, and improved resistance to cyclic loading. These findings suggest potential clinical advantages in fracture stabilization, although in vivo studies are recommended to confirm efficacy and safety.

Introduction: Diaphyseal forearm fractures are among the most common fractures in the pediatric population. While conservative management with closed reduction and casting remains standard for most cases, unstable fractures, open fractures, or fractures failing conservative treatment often require surgical intervention. Titanium elastic nailing (ten) has emerged as a minimally invasive and effective method for internal fixation, offering advantages of early mobilization, excellent alignment, and rapid functional recovery. Methods: This institutional-based, prospective observational study was conducted at the department of orthopaedics, burdwan medical college & hospital, over a period of 18 months from may 2020 to october 2021. The study included 10 pediatric patients presenting to the outpatient department and emergency with diaphyseal forearm fractures, all of whom were treated with titanium elastic nailing. Written informed consent was obtained from all participants after explaining the study details. The study variables included age, sex, injury-to-surgery interval, postoperative complications, range of movement, and overall functional outcome. All patients were followed up to assess radiological union, range of motion, complications, and functional recovery. Results: In this study of 10 pediatric patients, the majority (80%) were aged 9–12 years, with a male predominance (80%). Surgery was performed within 14 days for most patients (90%), and radiological union was achieved within 10 weeks in 70% of cases. Postoperative complications were minimal, with only 3 patients experiencing issues such as granulation tissue, nail protrusion, or bending. Functional recovery was generally excellent, with 60% achieving full flexion and extension, and 70% attaining full supination and pronation, while minor restrictions were observed in a few patients. Overall, functional outcomes were excellent in 70% and good in 30% of patients, with no fair or poor results, indicating favorable recovery following surgical management. Conclusion: Titanium elastic nailing provides a safe and effective method for the surgical management of diaphyseal forearm fractures in children. It ensures stable fixation, allows early mobilization, and achieves excellent functional and radiological outcomes with minimal complications. Ten should be considered the preferred surgical option for pediatric forearm fractures unsuitable for conservative treatment.

Introduction: Post-arthroplasty joint infection (PJI) is a serious complication following joint replacement surgeries, associated with significant morbidity, prolonged hospitalization, and increased healthcare costs. Early diagnosis and appropriate management are crucial to optimize functional outcomes and reduce implant failure. Methods: This prospective observational study was conducted in the Department of Orthopaedics at Burdwan Medical College & Hospital over a period of one year, from May 2022 to May 2023. A total of 50 adult patients undergoing primary or revision total hip and knee arthroplasty were included. Data were collected on patient demographics (age and gender), type of arthroplasty performed, risk factors for post-arthroplasty joint infection, causative organisms, and management approaches. All patients were followed postoperatively to identify the occurrence of joint infections, and appropriate interventions were recorded. The study aimed to analyze the incidence, risk factors, microbial profile, and treatment outcomes of post-arthroplasty infections in this cohort. Results: In this study of 50 patients undergoing total hip or knee arthroplasty, the majority were aged 60 years or older (60%) and male (56%), with total knee replacement being the most common procedure (70%). Post-arthroplasty joint infections occurred in 8 patients (16%). Diabetes mellitus and prolonged surgery duration (>120 minutes) were significantly associated with infection, while obesity and revision surgery showed a non-significant trend. Staphylococcus aureus was the predominant pathogen (50%), followed by coagulase-negative staphylococci and Gram-negative organisms. Management outcomes demonstrated that two-stage revision arthroplasty achieved 100% infection control, whereas debridement with implant retention was successful in 66.7% of cases. Conclusion: Post-arthroplasty joint infections, though relatively uncommon, present significant challenges in orthopedic practice. Early recognition and timely intervention tailored to infection type and patient factors are critical to improving outcomes. Multi-disciplinary approaches combining targeted antibiotic therapy and appropriate surgical intervention remain the cornerstone of effective management.