Introduction: CAUTIs are common ICU infections caused by bacterial colonization and biofilm formation on catheters, leading to increased morbidity and antimicrobial resistance. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are predominant pathogens. Prolonged catheterization and poor aseptic practices heighten infection risks. Early catheter removal and strict infection control are key to reducing CAUTI rates in ICU patients. Materials and Methods: This hospital-based prospective observational study was conducted in a 15-bedded Medical ICU over one year, enrolling 100 patients requiring Foley’s catheterization. Patients were followed from catheter insertion to discharge or death. Inclusion criteria included >48 hours of catheterization and clinical signs of infection, while those with pre-existing UTIs or fungal infections were excluded. Urine samples were collected aseptically and processed using standard microbiological techniques, with antibiotic susceptibility testing (AST) conducted per CLSI guidelines. Data analysis was performed using SPSS version 21.1, with statistical significance set at p<0.05. Results: In our study, 12% of catheterized patients developed CAUTI, with a rate of 8.4 per 1000 urinary catheter days. The majority of patients were 51–70 years old (36%), with a male predominance (55%). Escherichia coli was the most common pathogen (6%), followed by Enterococcus (4%) and Pseudomonas (3%). CAUTI incidence increased with catheter duration, rising from 2.86% in 1–5 days to 50% beyond 11 days. Antibiotic susceptibility testing showed high efficacy of Nitrofurantoin (100%), Imipenem (91.67%), and Colistin (91.67%) against Gram-negative bacteria, while Enterococcus exhibited 100% susceptibility to High Gentamycin and Linezolid. Conclusion: CAUTI remains a significant concern in ICU patients, with prolonged catheterization increasing infection risk. Strict infection control measures, timely catheter removal, and targeted antibiotic therapy are essential to reducing CAUTI rates and improving patient outcomes.

Fowl adenovirus (FAdV) infects chickens and leads to hepatitis, in a condition called inclusion body hepatitis (IBH), and hepatitis with accumulation of fluids in the pericardial sac of the heart in a condition known as hepatitis hydropericardium syndrome (HHS). Both conditions are associated with other pathologies in several organs in addition to these stated features. However, the fluid in pericardial sac distinguishes HHS from IBH. IBH is caused by Fowl adenoviruses group D, serotype 2-11, and group E, serotypes 8a, 8b and 11. The adenoviruses that cause HHS is of group C, serotype 4. In this study, the postmortem and pathologic findings found characteristic hepatitis and hydro pericardium of HHS. Hepatitis and hydropericardium were confirmed grossly, histologically and biochemically by testing ALT and AST in infected chickens. Deformity In the heart, renal and hepatic hemorrhages, necrosis in liver, kidney and heart muscle, and expansion of the pericardial sac, inclusion body in hepatocytes are reported in this study. The PCR, Hexone gene sequence and phylogenic tree confirmed the involvement of adenovirus group E in HHS. This finding was reported for the first time. The discovery that HHS is caused by group E will have implications for vaccine usage in the field.

Introduction: Stroke is a leading cause of disability and mortality worldwide, with a rising incidence in young adults. Stroke in young adults has significant socio-economic and health impacts. Modifiable risk factors such as hypertension, diabetes, obesity, smoking, and alcohol consumption contribute to this rise. This study aims to analyze the risk factors, clinical features, and outcomes of stroke in young adults. Materials and Methods: This cross-sectional study was conducted at a tertiary care hospital over six months, including young adults aged 18-45 years diagnosed with acute stroke. Data were collected from medical records and clinical evaluations using a semi-structured questionnaire, covering demographic details, risk factors, and clinical features. Stroke severity was assessed with the NIHSS (National Institutes of Health Stroke Scale) and functional outcomes with the MRS (Modified Rankin Scale). Results: Mean age of the patients was 37.2 ± 8.23 years with male predominance (66.3%). Modifiable risk factors such as overweight and obesity (55.0%), hypertension (38.8%), smoking (27.5%), and diabetes mellitus (26.3%) were commonly observed. The anterior circulation was the most commonly affected (70.0%). At the time of admission, 32 patients (40.0%) presented with moderate stroke (NIHSS score: 5 to 15), and 35 patients (43.8%) had moderate disability (MRS score: 3 to 4). The majority of patients survived (95.0%), with significant improvement in their NIHSS and MRS scores at discharge. Conclusion: Early intervention and lifestyle changes, including weight management, smoking cessation, and blood pressure control, are vital in preventing stroke recurrence. Regular screening for risk factors in high-risk populations and prompt, aggressive treatment can improve outcomes and reduce disability in young stroke patients.

Introduction and Background: Chronic kidney Disease (CKD) is defined as the presence of Kidney damage or a decreased level of kidney function for a period of 3 months or more. Auditory system abnormalities commonly occur in patients with Chronic Kidney Disease and End Stage Renal Disease patients undergoing hemodialysis. This Study was done to evaluate Brainstem Auditory Evoked Potentials in CKD patients, and patients undergoing hemodialysis and to document the reversibility of the BAEP changes after successful Renal Transplantation. Aims: The aim of our study was to evaluate Brainstem Auditory Evoked potentials in chronic kidney disease patients and patients on hemodialysis and in those who have undergone Renal transplantation. Methodology: The Experimental Group included 20 patients with CKD, 20 patients with CKD stage 5 undergoing hemodialysis and 20 Pateints who have undergone Renal Transplantation within one year of Diagnosis of CKD. Control Group Had 20 Healthy volunteers. Measurements included Absolute Peak Latencies I, II, III, IV & V and Inter peak Latencies I-III, III-V & I-V of the Auditory Brainstem Responses. Results: Abnormal BAEP Recordings were seen in CKD patients and hemodialysis patients in the form of Prolonged Absolute Peak Latencies and Interpeak Latencies. There was a significant improvement in the BAEP Waveforms after Renal Transplantation. Hence this study showed that neural conduction along the Auditory Pathway is delayed in patients with CKD and CKD patients who were on hemodialysis. Renal transplantation significantly improves the auditory function.

Background: Chronic Rhinosinusitis (CRS) is a common illness that reduces a patient’s quality of life. When medication is inadequate, Functional Endoscopic Sinus Surgery (FESS) can improve quality of life and symptoms of sickness both temporarily and permanently. However, 65% of patients with FESS experienced mild to severe pain on postoperative Day 1 (POD1). Although Remimazolam is a new ultrashort-acting benzodiazepine with minimal side effects and hemodynamic stability, it is rapidly becoming a sedative-anesthetic in clinical practice. Remimazolam have anti-inflammatory, immunomodulatory and analgesic properties. Aim: The current study aims to compare the effects of remimazolam and dexmedetomidine with respect to the QoR-40 score of patients who have undergone FESS. Method: GMERS Medical College in Junagadh, Gujarat, was the place to conduct a single-blind, randomized controlled clinical trial for this investigation. The university’s ethical committee accepted the study, and regular procedures were followed to ensure the research’s validity. A 1:1:1 random assignment was used to place the 120 eligible patients in Group R, Group D, or Group C.  Age between 18 and 65 years, synchronous sinonasal symptoms that have persisted for more than 12 weeks, sinusitis as shown by a sinus computerized tomography (CT) scan, physical status I or II as defined by the American Society of Anesthesiologists (ASA), and a scheduled elective FESS were the criteria used to prospectively enroll CRS subjects. Results: QoR-40 scores of Groups R (154.5, 152.0–159.0) and D (155.0, 154.8–159.3) had lower QoR-40 (median, IQR) scores overall at POD1 than Group C (139.0, 136.8–142.0) (P < 0.001). The overall QoR-40 score did not differ significantly between Groups R and D. Moreover, the emotional intelligence scores on POD1, Groups R and D had lower state, physical comfort, and pain dimensions than Group C (P < 0.005). Moreover, the maximal VAS pain score was lower in the PACU and ward in Groups R and D than in Group C (P < 0.001). The RASS score was lower upon PACU arrival in Groups R and D than in Group C (P < 0.001). Conclusion: From the analysis of study, it has been concluded that after FESS, remimazolam and dexmedetomi-dine may lower the intensity of pain and enhance the quality of recovery. Remimazolam’s efficacy and safety are on par with dexmedetomidine.

Introduction and background: The percentage of senior citizens in India has been growing at an increasing rate in recent years and the trend is likely to continue. Traumatic Brain Injury (TBI) still remains a major cause of morbidity and mortality. In developing countries like India where motorized travel is quickly growing without accompanying safety precautions and adherence to traffic rules and regulations, road traffic accidents are more frequent leading to increase in traumatic brain injuries. Elderly patients sustaining TBI have higher morbidity and mortality and prolonged recovery trajectories than younger patients. The current “One size fits all” approach to traumatic brain injury management of adult patients neglects special issues of elderly population. Aims: Aim of the study is to analyze demographic data, clinico-radiological features, co-morbid illness of elderly patients with traumatic brain injuries treated either with surgical or conservative management, to evaluate the risk factors predicting poor prognosis among elderly TBI patients, to study the outcome and mortality among elderly (65-75) and very elderly ( >75 years) age groups and to study the validation of eTBI (Elderly Traumatic Brain Injury) score in predicting mortality. Methodology: This is a prospective single center study conducted at the Institute of Neurosurgery, Madras Medical College, Chennai, Tamilnadu, India. We enrolled 200 patients of ≥ 65 years of age with Traumatic brain Injury between May 2021 and October 2021. Information about patients, demographic data, clinical and radiological features, co-morbid conditions, in-hospital course of treatment and associated complications as well as outcome was recorded. The collected data were analyzed with IBM-SPSS statistics software 23.0 Version. To find the significance in categorical data Chi-Square test was used. The probability value .05 is considered as significant level. Results: Mean age among the patients is 70.16 and maximum age enrolled in this study is 88. 144 were males and 38 were females. There were 91 patients with mild injury (50%), 68 patients with moderate injury (37.4%) and 23 patients with severe injury (12.6%). About 127 (69.8%) patients had favorable outcome and 55 (30.2%) patients had unfavorable outcome. Road traffic accidents accounted for most injuries (n=100) followed by ground level falls (n = 74) with other causes accounting for very few numbers. Most common associated comorbidity found was systemic hypertension which was seen in 34.1% followed by diabetes in 25.3%. Statistical analysis showed poor GCS score at admission, absent/effaced basal cisterns and/or presence of midline shift in CT, presence of co-morbidities like diabetes, hypertension and CAD, preinjury intake of antiplatelets or anticoagulants or beta blockers were all associated with unfavorable outcome. Lower eTBI scores were associated with unfavorable outcome. Prolonged ICU stay and prolonged mechanical ventilation both of which was found to adversely affect the clinical outcome in our study.

Introduction and Background: Sural nerve can be used for diagnostic purposes like nerve conduction velocity study and for nerve biopsy for various neuromuscular disorders. It is also widely used for electrophysiological studies. Knowledge about the course of the sural nerve and variations in its course would be hugely helpful in carrying out the aforementioned studies. This knowledge will also be helpful while performing procedures like autologous peripheral nerve grafting and nerve biopsy. Aims and Objectives: The aim of this study is to study the variations of sural nerve formation, its course in the leg and its relations with Tendo-Calcaneus, short saphenous vein and lateral malleolus for its clinical application. Methodology: This was a descriptive study done in the Institute of Anatomy, Madras Medical College, Chennai, Tamilnadu, India. The study was conducted by following the guidelines of Cunningham’s manual. This study included 50 lower limb specimens from 25 cadavers fixed in 10% formalin. Both male and female cadavers were included in the study. The data was collected by dissection method by using dissection instruments and parameters (measurements) were obtained by using measuring tape and Vernier’s calliper. Results: The mean length of leg measured from flexor crease to heel in our study was 43.96 cm. The most common type of sural nerve formation is Type-A. In males, Type-A sural nerve formation was most commonly located at lower 1/3rd of leg with 63.7% specimens (n=7) on right side. In females, Type-A sural nerve formation was most commonly located at lower 1/3rd of leg with 71.4% specimens (n=5) on right side and 75% specimens (n=6) on left side. The symmetricity of sural nerve formation between right and left lower limbs was noted in 11 male cadavers (78.6%) and 6 female cadavers (n=54.5%). Sural nerve formation was asymmetric in 3 male (21.4%) and 5 female (45.5%) cadavers. Sural nerve pierced deep fascia most commonly at lower 1/3rd of leg as noted in 50% of specimens. The mean distance between the site of sural nerve piercing deep fascia and lower border of lateral malleolus was 18.07 cm. The mean length of sural nerve measured from its formation to lateral malleolus was 31.54 cm. the mean distance between sural nerve and posterior border of lateral malleolus at its midpoint was 0.95 cm. The mean distance between the site of sural nerve crossing lateral border of Tendo-calcaneus and lower border of lateral malleolus was 4.82 cm. The mean distances noted at 5cm reference point was 0.17 cm lateral to Tendo-calcaneus. At 7cm and 10cm reference points, sural nerve was medial to lateral border of Tendo-calcaneus with mean distances -1.5cm and -3.92 cm respectively.

Background: Medication adherence and compliance are crucial for effective chronic disease management. Poor adherence can lead to disease progression, increased hospitalizations, and higher healthcare costs. This study examines the patterns and factors influencing medication adherence among chronic disease patients. Objectives: To assess medication adherence levels, identify barriers to compliance, and explore strategies to improve adherence in chronic disease patients. Methods: A cross-sectional survey was conducted with 150 chronic disease patients. Medication adherence was evaluated using a standardized questionnaire. Statistical analyses, including Chi-square tests and logistic regression, were performed to identify factors influencing adherence. Results: The study found that 62% of patients were non-adherent to their prescribed medication regimen. Key barriers included forgetfulness (32%), medication cost (27%), and side effects (21%). Patients with higher health literacy showed better adherence rates (p < 0.05). Conclusion: Medication non-adherence is prevalent among chronic disease patients, primarily due to forgetfulness, cost, and side effects. Interventions focused on patient education and cost reduction could improve adherence.