Introduction: Asymptomatic bacteriuria (ASB) in pregnancy is associated with adverse maternal and fetal outcomes, including pyelonephritis, preterm labor, and low birth weight. Physiological changes during pregnancy, such as ureteral dilation, urinary stasis, and hormonal alterations, increase the risk of ASB. Escherichia coli is the predominant uropathogen, followed by Klebsiella pneumoniae and Staphylococcus aureus. This study aimed to determine the prevalence of ASB among pregnant women in a tertiary care hospital in Gujarat, India. Materials and Methods: A cross-sectional study was conducted over six months, enrolling 220 asymptomatic antenatal women. Midstream urine samples were collected, cultured, and analyzed for bacterial growth. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method per CLSI guidelines. Data were analyzed using SPSS version 21, with categorical variables compared using chi-square or Fisher’s exact test. A p-value <0.05 was considered statistically significant. Results: Among 220 antenatal women, 17.3% had ASB. ASB prevalence was significantly higher in antenatal women with lower socioeconomic status, prior UTI, diabetes, and hypertension. Escherichia coli was the most common isolate (57.9%), followed by Staphylococcus aureus and Enterococcus faecalis (10.5% each). E. coli showed high sensitivity to amikacin (90%), gentamicin (100%), and piperacillin-tazobactam (90%) but moderate resistance to ampicillin (40%). Conclusion: ASB prevalence in antenatal women was 17.3%, underscoring the need for routine screening, especially in high-risk women with a history of UTIs, diabetes, or hypertension. Empirical treatment should follow local antimicrobial susceptibility patterns to prevent resistance. Targeted health education and counselling for women from lower socioeconomic backgrounds should emphasize ASB risks, personal hygiene, and the benefits of early screening.

Introduction: The aim is to introduce flipped classroom as teaching learning method and to assess its effectiveness for students in anaesthesia postings. Methods: The present study was conducted after taking institutional ethical clearance and informed consent of the participants. One hundred fifty students participated and were divided into two Groups A and B. Two topics of anaesthesiology were taught to both groups using either FC-assisted self-directed learning (SDL) sessions or online lecture classes. A cross-over of groups was done to prevent any bias. Pretest and posttest scores of all topics were assessed using multiple-choice questions (MCQs) and feedback was taken. Program evaluation was done. Results: There was no significant difference in performance in pretest MCQ examinations between the two groups. Students of both Groups A and B performed significantly better in posttest MCQ examinations as compared to pretest MCQ examinations. However, the posttest results of the FC group were better. 46.40% strongly agree that there will be increased interest in subject by FC method.47.40% agree that enhancement in learning by FC method .43.30% agree that FC should be preferred teaching learning method .40.20% feel there is improved understanding and course satisfaction.42.30% agree that exam performance will improve by FC method. Conclusion: Faculty and students provided positive views in support of the sessions. Students were highly satisfied with the program. The flipped classroom approach proves to be a superior teaching method, promoting better academic outcomes and greater student engagement and satisfaction More than 40% students believe that it is a better teaching tool and will improve their performance. Teacher’s feedback is the same but they fear that too much effort and resources are required in this FC method.

Background: Ultrasound guidance (USG) for brachial plexus blocks has been described for the supraclavicular, infraclavicular  and axillary approaches. These reports have shown that USG guided brachial plexus blocks have high success rates and few complications. Compared with the axillary approach, the brachial plexus block at the level of the clavicle can anaesthetize all four distal upper extremity nerve territories without the requirement for a separate block of the musculocutaneous nerve. Aim and Objective: The aim of the study was to compare the effect of both supraclavicular and infraclavicular brachial plexus blocks in terms of time taken for onset, duration, block performance, and block success and incidence of adverse events. Materials and Methods: This study conducted on patients of age group between 18 – 60 years of either sex belonging to ASA Grade 1-3 with BMI<35 in patients undergoing elective upper limb surgery. 60 patients were randomised into two groups. Supra clavicular (group S) and infra clavicular (group I). All the patients were given 25 ml of 0.5% ropivacaine (p) as local anesthetics. The block performance time, time taken for onset of sensory and motor blockade, total duration of block, and hemodynamic parameters were observed. The block performance times and the onset of the sensory blockade were the primary outcomes while the duration of the block, success of block, patient satisfaction and hemodynamic parameters were secondary outcomes. Results: The block performance time for the infraclavicular group was 16.1 ± 3.17 min, whereas for supraclavicular group, it was 10.53 ± 2.80 min with similar success rates . Onset of sensory blockade was achieved earlier (8.31 ± 1.23 min) in Group I than Group S (14.20 ± 1.50 min, P = 0.041). The onset of motor blockade was similar in Group I (11.22 ± 1.20 min) and Group S (16.52 ± 28.42 min, P = 0.462). The duration of action, block success and patient satisfaction were similar in both the groups. Adverse events are more in Group S. Conclusion: Ultrasound-guided infraclavicular block is a relatively safer technique when compared to the supraclavicular technique with faster onset, better patient satisfaction and fewer complications.

Aims and Objectives: The primary objective is to study the incidence of POUR after Spinal Anaesthesia using Levobupivacaine and Ropivacaine. The secondary objectives includes correlation between POUR and modified bromage score and to correlate  time to ambulation. Background: Postoperative urinary retention (POUR), a frequent complication after surgery in which patients cannot urinate despite having a full bladder. POUR is common, with occurrence rates varying from 5% to 70%, depending on the type of surgery. The condition arises from disturbances in the nervous system pathways that regulate bladder function, often due to anesthesia, medications, pain, or the physiological effects of surgery. Bladder overstretching from urine retention can lead to long-term complications like detrusor muscle damage. Although catheterization is a common solution, it carries risks such as infection or trauma. Effective management of POUR involves identifying at-risk patients before surgery, using preventive strategies, and ensuring postoperative care to avoid bladder overdistension. Materials and Methods: An observational hospital based study was conducted at the Department of anaesthesiology in Gandhi Medical College Bhopal spanning from August 2022 to December 2023. 60 patients were divided into 2 groups. GROUP L-30 patients received 15 mg (3ml) of Hyperbaric Levobupivacaine 0.5% (Total volume-3ml) and GROUP R -30 patients received 22.5 mg (3ml) of Hyperbaric Ropivacaine 0.75% (Total volume-3ml). Incidences of POUR, Bromage scale and time of ambulation was noted postoperatively. Results: There was no statistically significant difference in demographic data, mean pulse rate, mean diastolic BP between the two groups in this study while sensory regression and motor regression showed variations. The trend showed faster regression of sensory block and motor block in Group R compared to Group L at 5 hours marking and 6 hours marking respectively. the observed differences in POUR incidence between Group L and Group R were not significant. no significant association between intrathecal levobupivacaine and ropivacaine and the severity of POUR. Conclusion: Comparison between intrathecal Levobupivacaine and intrathecal ropivacaine concluded that Intrathecal Levobupivacaine provides long duration of sensory and motor blockade in lower limb surgeries as compared to intrathecal ropivacaine. Therefore, can be used for anticipated long lower limb orthopaedic surgeries. There was no significant difference in the incidence of POUR between the two groups. Although POUR can depend on various other risk factors like gender, age or presence of BPH.

Background: Carcinoma breast, accounts for about 23% of all cancers in women worldwide. Correlation of various prognostic variables of breast carcinoma helps us in assessment of prognosis and to assess the response to treatment. This study aimed to correlate the histological grade of the tumour with hormone receptor expression. Materials and Methods: This was a prospective study, conducted by the Department of Pathology, in a government medical college for a period of 6 months. Histopathological examination and ER, PR, Her-2- neu status was assessed for 50 patients who had underwent mastectomy. Hormone receptor status was then correlated with histological grade of the tumour. Results: Majority of the samples were found to be diagnosed as Infiltrating Ductal Carcinoma No Special Type with Ductal Carcinoma In Situ (IDC-NOS-DCIS) (50%). Most of the cases belonged to grade II carcinoma. Correlation of histological grading with the hormone status indicates that the hormone receptor expression decreases with increasing grade of the tumour and was found to be statistically significant. Conclusion: Hormone receptor expression carries an inverse relationship with the histological grade of the tumor. Evaluating the prognostic factors helps us to provide better treatment and to understand the prognosis of the patient.

Background: Acute biliary pancreatitis is a severe gastrointestinal condition often triggered by gallstones. The timing of laparoscopic cholecystectomy in these patients is crucial for optimizing outcomes and reducing complications. This study aims to compare the effectiveness of early versus late laparoscopic cholecystectomy in managing acute biliary pancreatitis. Objective: To determine whether early laparoscopic cholecystectomy (performed within 72 hours of symptom onset) results in better clinical outcomes compared to late laparoscopic cholecystectomy (performed after initial conservative management of inflammation). Methods: This prospective randomized study enrolled 120 patients diagnosed with acute biliary pancreatitis at JIET Medical College and Hospital, Jodhpur, Rajasthan. Patients were randomly assigned to either early or late cholecystectomy groups. Primary outcomes measured included length of hospital stay, complication rates, and recurrence of pancreatitis. Secondary outcomes focused on overall patient recovery and cost-effectiveness of treatment approaches. Results: The study anticipates that early laparoscopic cholecystectomy will reduce the length of hospital stay, decrease complication rates, and prevent the recurrence of pancreatitis compared to the late intervention group. Statistical analysis will be employed to evaluate the data collected, providing a robust comparison between the two approaches. Conclusion: The findings are expected to clarify the optimal timing for laparoscopic cholecystectomy in patients with acute biliary pancreatitis, potentially influencing clinical guidelines and improving patient management. Demonstrating the benefits of early intervention could lead to a shift in surgical practices and enhanced recovery rates for patients suffering from this condition.

Background: Cystic swellings of the scrotum, including spermatoceles and epididymal cysts, are common benign conditions that can cause discomfort and warrant clinical intervention. The choice between conservative management, sclerotherapy, and surgical excision remains subject to debate due to varying efficacy and patient outcome profiles. Objective: This study aims to evaluate and compare the effectiveness of conservative management, sclerotherapy, and surgical excision for treating cystic swellings of the scrotum, focusing on symptom resolution, recurrence rates, and patient satisfaction. Methods: The study was conducted at the Department of General Surgery, JIET Medical College and Hospital, Jodhpur, Rajasthan, India from feb 2024 to December 2024 . 100 male patients diagnosed with cystic scrotal swellings. Participants were randomly assigned to receive conservative management, sclerotherapy, or surgical excision. Outcomes measured included symptom resolution, complication rates, recurrence within a year, and patient satisfaction assessed through standardized questionnaires. Results: The study is expected to demonstrate varying effectiveness of the treatment modalities, with surgical excision likely showing the highest efficacy in symptom resolution and lowest recurrence rates. However, less invasive treatments such as sclerotherapy might offer a favorable balance of outcome and lower risk of complications. Conclusion: The findings will provide valuable insights into the optimal treatment strategies for cystic swellings of the scrotum, aiding in the refinement of clinical guidelines and improving patient management. This study will help establish evidence-based practices that can enhance patient outcomes and satisfaction.

Background: Iron deficiency anemia (IDA) is a critical health concern worldwide, particularly in developing countries where it affects a significant portion of the pediatric population. Known primarily for its role in impairing cognitive development and physical growth, IDA has also been suspected to influence neurological functions. Given the high prevalence of febrile seizures in young children, which represent a major pediatric emergency, understanding the potential link between IDA and these seizures is essential for developing preventive strategies. Objectives: This study aims to quantitatively determine the prevalence of IDA in children who experience febrile seizures and to investigate the potential association between iron deficiency and the frequency, severity, and clinical outcomes of these seizures. Methods: A comprehensive prospective observational study was conducted involving a cohort of 120 children under the age of five, presenting with febrile seizures at Department of Pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India. Iron status was assessed using standardized hemoglobin and serum ferritin measurements upon hospital admission. Detailed patient histories, including dietary iron intake and previous medical history of febrile episodes, were also collected to adequately adjust for confounding variables in the analysis. Results: Preliminary findings suggest a significantly higher rate of IDA in children with febrile seizures compared to the national average for pediatric IDA. Initial statistical analyses indicate a robust correlation between reduced iron levels and increased risk of recurrent and severe febrile seizures. Conclusion: The study underscores a potential modifiable risk factor for febrile seizures in the form of iron deficiency. The data advocate for routine screening for IDA in children and suggest that correcting iron deficiency could diminish the incidence or severity of febrile seizures, thereby improving pediatric health outcomes.