Background: Laparoscopic surgeries performed in steep Trendelenburg position with pneumoperitoneum cause significant intraocular pressure (IOP) elevation, posing a potential risk for perioperative ocular complications. Anaesthetic technique plays a crucial role in modulating these changes. This study compares the effects of Total Intravenous Anaesthesia (TIVA) using propofol versus desflurane-based inhalational anaesthesia on IOP and haemodynamic stability. Methodology: A prospective, randomized comparative study was conducted on 60 patients (ASA I–II) undergoing elective laparoscopic surgery. Patients were assigned to either the Propofol TIVA group (Group P, n=30) or the Desflurane group (Group D, n=30). Intraocular pressure was recorded at baseline, post-induction, after pneumoperitoneum, and at 10, 30, and 60 minutes of Trendelenburg, followed by the return to supine position. Haemodynamic parameters were also assessed. Statistical analysis was performed using t-tests and chi-square tests, with p<0.05 considered significant. Results: Baseline demographics were comparable across groups. Group D showed significantly higher IOP at all surgical stress points—after induction (p=0.01), after pneumoperitoneum (p<0.001), and during Trendelenburg at 10, 30, and 60 minutes (all p<0.001). IOP returned toward baseline after resuming supine position but remained significantly higher in Group D (p<0.001). Haemodynamic variables including mean arterial pressure showed no significant intergroup differences at any time point. Conclusion: Propofol-based TIVA is more effective in attenuating intraoperative IOP rise than desflurane anaesthesia during laparoscopic surgeries requiring pneumoperitoneum and Trendelenburg position. Both techniques provide stable haemodynamics; however, TIVA may be preferable in patients at risk for ocular hypertension or glaucoma.

Introduction: The optimal operative strategy for managing inguinal hernia (IH) in the adolescent population remains undetermined. This investigation sought to analyse and contrast the short-term perioperative results and the durable long-term prognosis among young patients suffering from IH who were treated either with minimally invasive laparoscopic hernia repair (LHR) or conventional open hernia repair (OHR). Methodology: This was a retrospective cohort study examining historical clinical and pathological characteristics of adolescent IH patients who initially received either LHR or OHR at VIMSAR, Burla between March 2018 and February 2024. Prognostic indicators associated with patient survival and outcome were isolated using univariate and subsequently multivariate Cox regression modelling. To mitigate potential selection bias, Propensity Score Matching (PSM) analysis was implemented to establish equivalent cohorts of patients from the LHR and OHR groups, matching them in a 1:1 ratio. Results: The initial cohort of adolescent IH patients comprised 122 individuals in the LHR group and 126 individuals in the OHR group. Following the execution of PSM, 94 patients were successfully matched in each study arm. Relative to the OHR cohort, the LHR group exhibited numerous advantages, including a shorter duration of hospital stay, reduced intraoperative haemorrhage, a lower incidence of total postoperative morbidities, and decreased rates of both recurrence and persistent postsurgical pain. Furthermore, the LHR cohort demonstrated markedly improved recurrence-free survival compared to the OHR group, a finding confirmed both prior to and following the PSM procedure. Conclusion: Laparoscopic management of inguinal hernia in adolescent patients represents a viable and safe therapeutic option, consistently yielding superior perioperative measures and favourable long-term outcomes.

Background: Laparoscopic surgeries performed in steep Trendelenburg position with pneumoperitoneum cause significant intraocular pressure (IOP) elevation, posing a potential risk for perioperative ocular complications. Anaesthetic technique plays a crucial role in modulating these changes. This study compares the effects of Total Intravenous Anaesthesia (TIVA) using propofol versus desflurane-based inhalational anaesthesia on IOP and haemodynamic stability. Methodology: A prospective, randomized comparative study was conducted on 60 patients (ASA I–II) undergoing elective laparoscopic surgery. Patients were assigned to either the Propofol TIVA group (Group P, n=30) or the Desflurane group (Group D, n=30). Intraocular pressure was recorded at baseline, post-induction, after pneumoperitoneum, and at 10, 30, and 60 minutes of Trendelenburg, followed by the return to supine position. Haemodynamic parameters were also assessed. Statistical analysis was performed using t-tests and chi-square tests, with p<0.05 considered significant. Results: Baseline demographics were comparable across groups. Group D showed significantly higher IOP at all surgical stress points—after induction (p=0.01), after pneumoperitoneum (p<0.001), and during Trendelenburg at 10, 30, and 60 minutes (all p<0.001). IOP returned toward baseline after resuming supine position but remained significantly higher in Group D (p<0.001). Haemodynamic variables including mean arterial pressure showed no significant intergroup differences at any time point. Conclusion: Propofol-based TIVA is more effective in attenuating intraoperative IOP rise than desflurane anaesthesia during laparoscopic surgeries requiring pneumoperitoneum and Trendelenburg position. Both techniques provide stable haemodynamics; however, TIVA may be preferable in patients at risk for ocular hypertension or glaucoma.

Introduction: Up to 80% of people will experience chronic low back pain (CLBP) at some point in their lives, making it one of the most common musculoskeletal conditions in the world.  CLBP has a complex aetiology that frequently includes ligamentous instability, facet joint arthropathy, intervertebral disc degeneration, and sympathetic nervous system involvement. Aims: The study aimed to evaluate the efficacy of Gray Rami Communicantes Block (GRCB) in alleviating pain and improving functional outcomes in patients with chronic low back pain, while also comparing changes in pain scores, disability indices, serum biomarkers, and adverse events between the GRCB group and those receiving standard therapy. Materials & Methods: This prospective, randomized, controlled clinical study was conducted over one year (from 1st August 2023 to 31st July 2024) and included 32 patients with chronic low back pain.16 in Gray Rami Communicantes Block (GRCB)and 16 in control group (received conventional management only). Result: In our study of 32 patients, the GRCB group (n = 16) showed significantly better clinical outcomes than controls (n = 16), with 10 patients (62.5%) markedly improved, 4 (25%) moderately improved, and 2 (12.5%) slightly improved, while none worsened. In the control group, only 2 (12.5%) were markedly improved, and 3 (18.8%) showed no change or worsening (p < 0.001). Conclusion: We came to the conclusion that Gray Rami Communicantes Block (GRCB) was quite effective at treating persistent low back pain.  Because both groups were similar at baseline, the evaluation was objective.

Background: Endotracheal intubation using the Macintosh laryngoscope is the standard technique for securing the airway but is associated with significant haemodynamic stress due to direct laryngoscopy. The Intubating Laryngeal Mask Airway (ILMA) provides an alternative method that may attenuate this response by avoiding direct stimulation of upper airway structures. This study compares the haemodynamic changes, intubation characteristics, ventilation parameters, and complications between ILMA and Macintosh laryngoscope (ML) in adult elective surgical patients. Methods: A randomized prospective study was conducted on 60 ASA I–II patients aged 18–60 years undergoing elective surgery under general anaesthesia. Participants were allocated into two groups of 30 each: ILMA-guided intubation and ML-guided intubation. Standardized anaesthetic induction was followed by intubation using the assigned device. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and EtCO₂ were recorded at baseline, pre-induction, at intubation, and at 3-, 5-, 10-, and 15-minutes post-intubation. Intubation time and complications were also assessed. Statistical analysis was performed using Student’s t-test, with p < 0.05 considered significant. Results: Baseline demographic variables were comparable between groups (p > 0.05). The ML group exhibited significantly higher HR, SBP, and DBP from intubation through 15 minutes post-intubation (p < 0.05), indicating a stronger haemodynamic response. In contrast, ILMA maintained more stable cardiovascular parameters across all time points. EtCO₂ values showed no significant difference between groups at any interval (p > 0.05), indicating similar ventilation efficacy. Intubation time was significantly longer with ILMA (64.36 ± 6.58 sec) compared to ML (21.33 ± 4.16 sec; p < 0.0001). Complication rates were low in both groups; however, dental injury occurred only in ML, while a single case of laryngospasm occurred with ILMA. Conclusion: Both ILMA and Macintosh laryngoscope are effective for airway management, but ILMA offers superior haemodynamic stability during and after intubation, with fewer trauma-related complications. The Macintosh laryngoscope allows faster intubation but is associated with a more pronounced pressor response. ILMA may be preferred in patients where minimising cardiovascular stress is essential, whereas ML remains advantageous in situations requiring rapid airway access.

Background: Protein Energy Malnutrition (PEM) remains a major pediatric health burden in developing countries, frequently accompanied by anemia that worsens morbidity, impairs immunity, and negatively affects growth and neurodevelopment. Understanding hematological alterations in PEM is essential for timely diagnosis and effective intervention. Objectives: To evaluate the clinical profile and hematological patterns of anemia among children with PEM attending a tertiary care hospital. Methods: A cross-sectional study was conducted over 12 months in the Department of Pediatrics, including 120 children aged 6 months to 5 years with PEM, classified using WHO criteria. Detailed clinical assessment, anthropometric measurements, complete blood count, peripheral smear, and serum ferritin analysis were performed. Anemia was categorized by WHO hemoglobin cut-offs and morphologic patterns. Results: Of the 100 children, 58.3% were males, with a mean age of 27.4 ± 10.6 months. Pallor (82%), lethargy (65%), and recurrent infections (48%) were common presenting features. Anemia was observed in 88.3% of children, predominantly microcytic hypochromic (56.6%), followed by normocytic normochromic (28.3%) and macrocytic (15%). Severe anemia was significantly more prevalent in Grade III and IV PEM (p < 0.05). Mean hemoglobin and red cell indices showed a significant decline with increasing severity of PEM. Conclusion: Anemia is highly prevalent in children with PEM, with microcytic hypochromic anemia being the most common pattern. The severity of anemia correlates strongly with the degree of malnutrition. Routine hematological evaluation and early correction of nutritional deficiencies should be integrated into PEM management to reduce morbidity and improve long-term outcomes.

Background: Obesity is strongly associated with insulin resistance which contributes to the development of diabetes and other metabolic disorders. Conventional lifestyle and pharmacologic therapies often fail to sustain long-term metabolic improvement. Yoga a holistic mind–body intervention may enhance insulin sensitivity via stress reduction, autonomic balance and increased physical activity. Objectives: This interventional study aims to assess whether a structured yoga program can improve insulin sensitivity and metabolic function in obese individuals. Materials and Method: An interventional study was carried out in 200 Obese individuals in which 100 are cases and 100 controls in Physiology YOG OPD. A 3-month of yoga session minimum 5 days in week was given to the subjects in the morning hours for 40 minutes completing a set of select yogic exercises for 3 month by a trainer. Insulin resistance (IR) was determined using the homeostasis model assessment of IR (HOMA-IR) formula at baseline, 1 month and after 3 month. Results: The study found a significant improvement in insulin resistance among obese individuals who practiced yoga for three months. Participants demonstrated a notable reduction in fasting insulin levels from 15.55 µIU/mL to 12.49 µIU/mL, HOMA-IR: 4.05 → 2.87 compared to baseline measurements. Conclusion: These results suggest that yoga may be an effective non-pharmacological approach to managing insulin resistance in obese patients.

Background: Inguinal hernia repair remains a cornerstone procedure in general surgery. While mesh use, exemplified by Lichtenstein’s technique, is prevalent, its suitability is compromised in complex hernias and resource-constrained settings. The Desarda no-mesh repair offers a promising tissue-based solution. Objective: This study sought to evaluate the outcomes of Desarda’s repair in a cohort of patients with complicated inguinal hernias where mesh repair was contraindicated. Methods: A prospective observational study was conducted on 30 patients undergoing Desarda’s repair at a tertiary care centre between March 2024 and June 2025. Data captured included patient demographics, operative variables, pain assessments, complication rates, and time to activity resumption. Results: Mean patient age was 55.2 ± 16.2 years, exclusively male. The right side was predominant (66.6%). Mean operative time was 96 minutes, and average hospitalization was 4.5 days. Postoperative pain showed a significant decrease from day 1 (VAS 4.8) to day 7 (VAS 0.3), with no chronic pain at 30 or 90 days. Complications were observed in 23.3% (seroma, wound infection, hematoma), all minor and manageable. No recurrences were documented. A remarkable 93% of patients returned to normal activities within 15 days. Conclusion: Desarda’s repair is a safe, effective, and cost-beneficial alternative to mesh hernioplasty, particularly advantageous for complicated inguinal hernias.

Introduction: The shift from traditional open techniques to minimally invasive approaches in hernia surgery has been widely embraced, with laparoscopic methods demonstrating advantages such as reduced long-term post-operative discomfort, lower risk of wound-related complications like infections and hematomas, and faster recovery. This analysis focuses on evaluating two laparoscopic inguinal hernia repair modalities: transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) techniques. Methodology: The Purpose of the study is to assess the clinical outcomes and procedural efficiency of TAPP and TEP in the treatment of inguinal hernias, emphasizing their comparative strengths and limitations. A systematic review was conducted, incorporating peer-reviewed randomized controlled trials (RCTs) comparing TAPP and TEP procedures, sourced from PubMed, Embase, and the Cochrane Library up to December 2024. Key metrics evaluated included operative duration, postoperative pain intensity, and length of inpatient stay, stratified by hernia type. Results: The analysis included 12 RCTs involving 905 participants randomized into TAPP or TEP groups. TEP was associated with prolonged operative times, abbreviated hospitalization, and diminished postoperative pain levels. However, a notable subset required conversion to open surgery in TEP cases. Conversely, TAPP demonstrated shorter procedural times but did not consistently reduce inpatient duration. Conclusion: Both TAPP and TEP offer distinct clinical benefits. TEP proves advantageous in minimizing postoperative pain and reducing hospitalization for primary hernia cases, albeit with potential trade-offs in procedural duration and conversion rates. TAPP, while expedient in terms of operation time, may not consistently yield superior outcomes in recovery metrics. These findings underscore the importance of patient-specific factors and collaborative decision-making when selecting between these two laparoscopic techniques for inguinal hernia repair.

Introduction: Cardiovascular disease is one of the major causes of mortality in the world. India has also shown an increase in the incidence of mortality related to cardiovascular disease. The establishment of Von Willebrand factor (vWF) as a new risk factor for cardiovascular disease is one of the initiatives towards its prevention and moreover, it has been widely studied in the western countries. Aims and Objectives: Distribution of Von Willebrand factor and platelet count and its correlation among different age groups in Guwahati city. Materials and Methods: This cross sectional study was carried out on 200 Healthy adult individuals over 1 year duration. The estimation of vWF concentration was done in MINIVIDAS machine and Platelet count was enumerated by direct method of platelet estimation. The study protocol was presented to the institutional ethics committee for approval and was approved.  Informed consent was obtained from all participants. Results: the mean vWF levels with standard deviation increased with the increasing age with subjects for the age group of >50 years measured the highest (86.38±17.64IU/dl) as compared to age group 41-50 years (77.57±15.98 IU/dl); age group 31-40 years (77.63±17.38 IU/dl) and age group 21-30 years (70.10±9.75IU/dl). The Platelet count for age group 21-30 years was the highest (1.88±0.25lacs/cu.mm) as compared to the age group of 31-40 years (1.83±0.21 lacs/cu.mm); age group 41-50 years (1.80±0.21 lacs/cu.mm) and the age group of subjects >50 years (1.75±0.27 lacs/cu.mm). Conclusion: Our study showed a significant statistical difference between vWF and Platelet count among different age groups. As it is an established fact that increased vWF levels are associated with incidence of arterial and venous thromboembolism vWF levels may become an important parameter to be recognized as a new risk factor in the development of the cardiovascular disease.

Aim: To compare the diagnostic accuracy and clinical efficacy of color Doppler ultrasound (CDU) and digital subtraction angiography (DSA) in patients with lower limb ischemia due to occlusive arterial disease, with assessment of sensitivity, specificity, and cost-effectiveness. Materials and Methods: A prospective comparative study was conducted on 85 consecutive patients presenting with symptoms of lower limb ischemia (claudication or rest pain) due to suspected arterial occlusive disease. Both color Doppler ultrasound and digital subtraction angiography were performed sequentially within 7 days. Arteries were graded on a 5-point scale (0=normal to 4=complete occlusion). Demographic data, clinical presentation, imaging findings, and procedural complications were recorded and analyzed using chi-square test and Cohen’s kappa for agreement. Results: Of 85 patients (mean age 62.3 ± 8.9 years, 71% male), color Doppler demonstrated 89.4% sensitivity and 86.7% specificity compared to DSA as the gold standard. Color Doppler showed superior performance in hemodynamically significant stenoses (≥70%) and was superior in detecting soft plaques and recanalization. DSA was superior in detecting calcification and complex lesions. Doppler-related complications were absent, while DSA showed 7.1% minor complications. Conclusion: Color Doppler ultrasound is a reliable, non-invasive alternative to digital subtraction angiography for initial assessment of lower limb occlusive arterial disease with excellent agreement and diagnostic accuracy. It should be the first-line imaging modality for hemodynamically significant lesions, with DSA reserved for therapeutic interventions or cases requiring precise anatomical detail.

Skin disinfection before any central neuraxial block is of immense importance as it can prevent undue dreaded systemic infections. Though Povidone-iodine has been traditionally used for the disinfection process, Chlorhexidine gluconate has demonstrated equally satisfactory or even superior results in recent studies. This study was thus undertaken to investigate and compare the overall efficacy of Chlorhexidine and Povidone-iodine for skin disinfection before subarachnoid block. Materials and Methods: 130 patients, aged between 18 to 65 years of either sex, American Society of Anesthesiologists physical status I and II, undergoing elective surgery requiring subarachnoid block were allocated into two groups. Group-P received skin preparation with aqueous solution of 10% Povidone iodine and Group-C received that with alcoholic solution of 0.5% Chlorhexidine at intended sites. Two quantitative skin swab samples, each before and after skin disinfection with either solution were obtained, in a 4-cm diameter soya agar contact plate. The results were recorded as number of Colony Forming Unit in pre and post sample plates. Results: The mean reduction of colony count was significantly higher in Group C than in Group P. Conclusion: 0.5% Chlorhexidine is more effective than 10% Povidone-iodine for skin disinfection prior to Central Neuraxial Block.

Background: Transfusion-transmissible infections (TTIs) like HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria can pose a significant threat to blood safety despite the obligatory screening. TTIs in blood donors vary considerably geographically in India and voluntary non-remunerated blood donors are usually thought safer, than replacement donors. This paper has compared TTIs seroprevalence rates between voluntary and replacement donors in the Silchar Medical College and Hospital (SMCH) Blood Centre, Assam, and explained demographic predictors of TTI positivity. Methods: The study under question was a prospective cross-sectional study carried out between 1 February 2023 and 31 January 2024 at the SMCH Blood Centre, which is a tertiary care hospital in North-East India. All the potential donors between the ages 1865 years were enrolled through written informed consent. The demographic data and type of donor (voluntary or replacement) was used. HBsAg, anti-HCV and HIV-1/2 antibody and p24 antigen screening of sera were performed in third and fourth-generation ELISAs; syphilis and malaria were detected in rapid immunochromatographic assays; in line with the national regulations. Seroprevalence was calculated and the proportions analyzed by Pearson chi-square test (p<0.05). Results: Out of 7, 536 donors, 5,394 (71.6) were replacement and 2,142 (28.4) were voluntary donors; 93.1% of them were men. In general, the TTI prevalence was 2.96 percent with 223 donors being seroreactive to at least one of the TTI. The most common diseases were HBV (0.97) and syphilis (1.02) and then there was HIV (0.50), HCV (0.40) and multiple infections (0.07); not a single donor was positive to malaria. Most infections were due to replacement donors (e.g. 92.2% of syphilis and 87.7% of HBV cases), however, the mixing of specific TTIs by type of donor was also statistically non-significant (2.931, p=0.569). Conversely, TTI positivity was highly age-dependent (2=31.266, p=0.002), with the highest percentage of seropositive donors being 2435 years old, and sex-dependent ( 2=13.909, p=0.008), where 96.4% of the seropositive donors were male. Conclusion: TTIs still continue to be a significant issue among blood donors in this tertiary care centre and close to 3 percent of seemingly healthy blood donors have demonstrated some form of infection. TTI positivity was significantly dependent on age and male sex but not the donor type. It is necessary to improve the recruitment of voluntary non-remunerated donors, improving pre-donation counselling, and ensuring a high level of screening to increase the level of blood safety even further.

Background: Errors in the total testing process are being increasingly recognized as an important cause of preventable patient harm, and pre-analytical phase has the highest percentage of these events. Contemporary data on the prevalence and spectrum of pre-analytical error in routine biochemistry laboratories, especially in low- and middle-income settings, are still sparse. Methods: This observational single centre cross-sectional study was conducted in the laboratory of clinical biochemistry at Department of Biochemistry, Government P.D.U. Medical College, Churu, Rajasthan, India, from May 2024 to December 2024. Every serum and plasma sample admitted to routine and urgent chemistry analyses was screened on arrival in line with International Federation of Clinical Chemistry (IFCC) quality indicators as sample identification, request form, collection, transporting, or specimen quality-related errors. The frequencies of pre-analytical errors were computed as the percentage of samples with 1 or more error. Chi-square test and multivariate logistic regression were used to compare patient location (outpatient, inpatient, and intensive care) and request priority (routine vs emergency). Results: Out of 45,126 samples, 810 contained at least one error of pre-analysis meaning a total prevalence of error of 1.8. The most commonly occurring problems were quality problems of the specimen (52.1%), hemolysis (28.5%), lack of volume in the sample (21.0%), and anticoagulation clotting of the sample (18.6%). The deficiencies of request forms shared 26.5 percent consisting of mostly non-completely clinical detail as well as physician signature and patient / sample identification errors constituted 8.3 percent. Error rates on pre-analytical were considerably much greater among inpatient and outpatient samples (2.2% vs 1.3% p<0.001) and between emergency and routine requests (2.5% vs 1.6% p<0.001). Inpatient origin and emergency status realized their status as independent predictors of error, after adjustment. Conclusion: This medium level biochemistry laboratory had close to 1 out of 55 samples with at least one pre-analytical error, with hemolysis and inadequate volume being the most common. Centralization of errors in emergency and inpatient samples indicates that a specific intervention, such as standardized training on phlebotomy, improved communication with clinical areas, and ongoing monitoring with harmonized quality indicators will be necessary.

Background: Chronic lymphocytic leukemia (CLL), the most prevalent adult leukemia in Western countries, is relatively uncommon in India, where it accounts for <5% of all leukemias. Studies from India suggest that patients often present at a younger age, with distinct clinical and molecular characteristics compared to Western cohorts [6–12]. Limited data exist from northern India, particularly the Kashmir region. Objective: To evaluate the clinico-pathological characteristics, molecular profile, treatment indications, therapeutic approaches, and short-term outcomes of CLL patients at a tertiary care center in Kashmir. Methods: This retro-prospective observational study included 100 consecutive CLL patients diagnosed between January 2023 and June 2025 at Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar. Clinical, hematological, immunophenotypic, cytogenetic, and molecular parameters were analyzed. Staging was performed using Modified Rai and Binet systems. Treatment decisions followed iwCLL criteria. Outcomes assessed included overall survival (OS), progression-free survival (PFS), response rates, and complications. Results: The mean age at diagnosis was 63.3 years (range: 40–83), with 60% aged >60 years. A male predominance was noted (M:F = 1.43:1). Forty-one percent were asymptomatic; lymphadenopathy (26%), splenomegaly (28%), and fatigue (20%) were common findings. Anemia (30%) and thrombocytopenia (22%) were frequent laboratory abnormalities. Flow cytometry confirmed classic CLL phenotype (CD5/CD19/CD23 positivity in 95%). The most common cytogenetic lesion was del(13q) (49.4%). IGHV was unmutated in 80% and TP53 mutations were rare (3%). Modified Rai stages 0–II constituted 62% of cases; Binet Stage A comprised 52%. Fifty-two percent had no treatment indication; BR chemotherapy was the most common regimen (23%). Novel agents were used in 8% of cases. At a median follow-up of 23 months, OS was 92% and PFS was 85%. Advanced stage and cytopenias correlated with worse outcomes. Conclusion: CLL patients in Kashmir present at a younger age and predominantly in early stages. Favorable cytogenetics (del13q) and low TP53/del17p burden contribute to excellent short-term outcomes. BR remains the main therapy due to economic constraints, though limited use of targeted agents is increasing. Larger multicenter studies with longer follow-up are required to assess long-term outcomes and optimize treatment strategies.

Introduction: Colour vision serves as a critical indicator of cone photoreceptor function and offers valuable complementary information to assessments of spatial visual performance, such as best-corrected visual acuity (BCVA), contrast sensitivity and inherited and acquired retinal disorders. Aim & Objectives: 1. To investigate the relationship between cone photoreceptor function and hue discrimination ability using the Farnsworth-Munsell 100 Hue Test (FM100). 2. To explore the potential of the FM100 Hue Test as a clinical tool for detecting and monitoring cone-related retinal dysfunction. Material & Methods: An Observational, Cross-sectional research study was systematically conducted in the Physiology department in association with the Ophthalmology department in SMS Medical College, Jaipur, to assess the prevalence and characteristics of colour vision deficiency (CVD) among 170 medical students. Participants were screened for CVD using the Ishihara pseudoisochromatic plates and further evaluated using the Farnsworth-Munsell 100 Hue (FM100) Test to assess hue discrimination ability. All collected data were systematically entered and organized in tabular form. A p-value of <0.05 was considered statistically significant. Result: A total of 170 medical students (age range: 18- 25 years; mean age: 21.5± 2.45 years) were included in the final analysis. Revealed significant variation in Hue discrimination ability in Medical students. The result exhibits Mean Box specific Error Score (ES) and Mean Total Error Score (TES) were significantly elevated. Conclusion: This study’s findings support the application of the FM100 Hue Test as a sensitive tool for evaluating functional aspects of cone-mediated vision, particularly in clinical and occupational screening settings.

Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) classifies thyroid fine-needle aspiration cytology (FNAC) results into six diagnostic categories, offering a standardized and evidence-based method for interpretation and management of thyroid nodules. Aim of our study is to establish the correlation between cytological findings categorized by TBSRTC and histopathological outcomes, and to assess the spectrum and prevalence of thyroid lesions in patients attending a tertiary care hospital in the Nilgiris district. Materials and Methods: A retro-prospective analytical study was conducted on 235 patients with thyroid swellings between July 2018 and August 2020. FNAC was performed using a non-aspiration technique, and smears were stained with Hematoxylin and Eosin. Results were categorized as per TBSRTC. Histopathological correlation was available for 68 patients who underwent surgery. Data were statistically analyzed to determine concordance rates. Results: Out of 235 cases, 210 (89.3%) were benign (Bethesda II), 9 (3.8%) nondiagnostic, 5 (2.1%) atypia/FLUS, 6 (2.5%) follicular neoplasms, 4 (1.7%) suspicious for malignancy, and 2 (0.8%) malignant. Histopathological correlation showed 92.6% overall concordance. The most common benign lesion was nodular colloid goitre (72.6%), while papillary carcinoma was the predominant malignancy. Conclusion: FNAC, interpreted under the Bethesda framework, is a highly reliable, cost-effective diagnostic tool for evaluating thyroid nodules. Despite occasional diagnostic challenges in follicular-patterned and cystic lesions, FNAC substantially reduces unnecessary surgeries and remains essential in clinical decision-making.

Background: Psychosis during adolescence represents one of the most challenging areas in psychiatry, both diagnostically and therapeutically. Adolescence is marked by neurobiological vulnerability and psychosocial transitions, and the emergence of psychotic symptoms during this critical period can result in lasting social and cognitive impairments. Despite the increasing recognition of adolescent psychosis, data from developing countries remain limited. Aim of this study is to analyze the sociodemographic characteristics and clinical presentation of adolescents with psychosis attending psychiatric consultation at a tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted at the Institute of Mental Health over 12 months (November 2021–November 2022). One hundred adolescents aged 10–19 years, diagnosed with psychotic disorders as per ICD-10 criteria (F10–F39), were included. Individuals with intellectual disability, neurological disorders, or childhood-onset conditions were excluded. Each participant underwent detailed sociodemographic and clinical assessment using standardized tools including the Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), and CRAFFT questionnaire, Leeds Dependence Questionnaire (LDQ), Adolescent Stress Questionnaire (ASQ), and the Kuppuswamy Socioeconomic Scale (2022). Statistical analysis was performed using SPSS v26 with descriptive statistics and chi-square tests. Results: Among 100 adolescents, 55% were male and 45% female, with a mean age of 14.49 ± 2.89 years. Urban participants accounted for 53%, while 53% belonged to lower socioeconomic strata. Family history of psychosis was present in 22%. The mean BPRS score was 42.53 ± 10.44, indicating moderate severity. YMRS scores revealed that 64% had mild mania, 14% moderate, and 12% severe. CRAFFT scores ≥2 were noted in 64%, indicating risky substance use. LDQ revealed medium dependence in 50% and high dependence in 35%. The majority (75%) had moderate stress and 20% had severe stress on ASQ. Conclusion: Adolescent psychosis is closely associated with socioeconomic deprivation, high psychosocial stress, and comorbid substance use. Early identification and multi-pronged psychosocial interventions are essential to reduce chronicity and improve long-term functional outcomes.

Introduction:  Paraquat is a widely used herbicide associated with high morbidity and mortality following ingestion. Early recognition and prompt management are critical, yet clinical presentations can be variable. Understanding the presenting features and outcomes of paraquat poisoning is essential for improving patient care. Aims: This study aims to conduct a comprehensive analysis of patients admitted with alleged paraquat poisoning to a tertiary care hospital, focusing on their presenting features, clinical course, and outcomes. By identifying key determinants of mortality and morbidity, the study seeks to inform clinical practices and public health strategies to mitigate the impact of paraquat poisoning. Methods: This was a hospital-based cross-sectional observational study conducted over a period of one year at Jalpaiguri Medical College and Hospital. A total of 46 patients admitted with alleged paraquat poisoning were included in the study. Data were collected on demographic variables such as age and gender, as well as clinical features including oral ulcers, acute kidney injury, abdominal pain, and respiratory symptoms such as hemoptysis and shortness of breath. Laboratory parameters and clinical severity scores were also recorded to assess the extent of organ involvement and predict outcomes. The study aimed to evaluate the relationship between these variables and patient outcomes, including discharge or mortality, to identify key clinical and laboratory predictors of prognosis in paraquat poisoning. Results: In this study of 46 patients with alleged paraquat poisoning, 40 (87%) were discharged and 6 (13%) expired. Most patients were aged 21–30 years (30.4%), followed by 11–20 years (26.1%) and 31–40 years (23.9%), with no significant association between age or gender and outcome. Clinically, oral ulcers were common (93.5%) but not linked to mortality. In contrast, acute kidney injury (63%) and respiratory symptoms such as hemoptysis and shortness of breath (15.2%) were significantly associated with death. Abdominal pain was reported in 47.8% of patients but showed no significant correlation with outcomes. Patients who expired had higher mean [parameter] values (16.0 ± 5.66) compared to those discharged (10.88 ± 6.52). Conclusion: Paraquat poisoning continues to be associated with significant morbidity and mortality. Early identification of high-risk patients based on presenting features and laboratory parameters may improve outcomes. Public health measures to prevent accidental and intentional exposure, coupled with standardized management protocols, are essential.

Background: Proximal humerus fractures constitute approximately 5% of appendicular skeletal injuries, predominantly affecting elderly patients with osteoporotic bone. Surgical intervention is frequently required for displaced fractures, yet the optimal fixation method remains debatable. Materials and Methods: This retrospective observational study analyzed hospital records from January 2020 to December 2024, identifying 100 patients with isolated proximal humerus fractures treated surgically. Patients were stratified into PHILOS plating (n=50) and K-wire fixation (n=50) groups. Demographic characteristics, operative parameters, duration of hospitalization, complication rates, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores at 1, 3, and 6 months postoperatively were systematically evaluated. Results: Both groups demonstrated comparable demographic profiles. K-wire fixation exhibited significantly reduced mean operative time (32.4±7.9 minutes versus 85.6±12.1 minutes, p<0.0001), diminished blood loss (21.2±6.8 ml versus 91.5±15.7 ml, p<0.0001), and abbreviated hospital stay (3.6±0.7 versus 11.3±1.4 days, p<0.0001). DASH scores revealed no statistically significant difference at 6-month follow-up (K-wire 13.8±4.5 versus PHILOS 12.9±4.2, p=0.38). Complication rates were minimal and comparable between groups. Conclusion: Both PHILOS plating and K-wire fixation achieve equivalent functional outcomes. K-wire fixation demonstrates substantial advantages in operative efficiency, minimal surgical trauma, and reduced healthcare resource utilization, establishing it as a viable minimally invasive alternative for proximal humerus fracture management.

Introduction: TORCH infections are major causes of congenital anomalies. Among them, cytomegalovirus (CMV) is the most frequent perinatal viral infection and the leading cause of congenital CMV disease, with seroprevalence ranging widely from 30.4% in Ireland to 98.9% in Turkey. Herpes simplex virus type-2 (HSV-2), a common sexually transmitted infection, can be transmitted in utero, during delivery, or postnatally, resulting in congenital or neonatal disease. These infections are often asymptomatic, making clinical diagnosis difficult. Serological testing, particularly ELISA, offers a sensitive and specific method for detection. This study aimed to determine the seroprevalence of CMV and HSV-2 among pregnant women. Methods: A cross-sectional study was conducted on 100 pregnant women attending the antenatal clinic of a tertiary care hospital. Five milliliters of venous blood were collected, and sera were analyzed for anti-CMV and anti-HSV-2 IgM and IgG antibodies using ELISA. Results: Most participants were between 21 and 25 years of age, from rural areas (76%), in the third trimester (84%), nulliparous (69%), and from lower socioeconomic status (59%). None of the women tested positive for anti-CMV or anti-HSV-2 IgM antibodies. The seroprevalence of anti-CMV IgG was 67%, while anti-HSV-2 IgG was 47%. Conclusion: A substantial proportion of pregnant women showed prior exposure to CMV and HSV-2, although no active infections were detected. Greater awareness of these infections and their adverse outcomes is needed. Routine antenatal screening and preventive education should be emphasized to reduce maternal and neonatal morbidity and mortality.

Background: Environmental pollution has emerged as a major public health concern worldwide. Chronic exposure to air, noise, and industrial pollutants has been linked not only to cardiopulmonary morbidity but also to dysregulation of the autonomic nervous system and cognitive disturbances mediated through stress pathways. Objective: To determine the prevalence of stress-related autonomic symptoms and cognitive complaints among individuals chronically exposed to environmental pollution. Methods: A cross-sectional questionnaire-based study was conducted among 360 adults residing in high-pollution zones. Stress-related autonomic symptoms were assessed using a standardized autonomic symptom checklist, while cognitive complaints were evaluated using a validated subjective cognitive assessment questionnaire. Data were analyzed using descriptive statistics, independent t-tests, and correlation analysis. Results: Autonomic symptoms were reported by 61.4% of participants, while cognitive complaints were present in 54.2%. Individuals with higher pollution exposure duration demonstrated significantly greater autonomic symptom scores and cognitive complaints (p < 0.001). A moderate positive correlation was observed between autonomic symptom burden and cognitive complaints (r = 0.49). Conclusion: Chronic exposure to environmental pollution is associated with a high prevalence of stress-related autonomic symptoms and cognitive complaints. Early identification and stress-mitigation strategies may reduce the neurophysiological impact of environmental pollution.

Background: Ocular trauma remains a significant global contributor to visual impairment, often leading to complex structural damage within the eye. Specifically, blunt trauma can trigger a cascade of pathological events, particularly affecting the delicate architecture of the macula, the area responsible for central, high-resolution vision. Understanding the precise macular changes early on is vital for accurate prognostication and timely intervention. The primary aim of this observational study was to assess the spectrum and prevalence of macular involvement in patients who presented with blunt ocular trauma at a tertiary eye care hospital. Material and Method: A prospective, hospital-based study was conducted from September 2018 to October 2019, enrolling 51 patients who had sustained blunt ocular injuries. Following a comprehensive history and routine clinical examination, all participants underwent detailed slit-lamp examination, fundus examination, and crucially, Optical Coherence Tomography (OCT). OCT provided non-invasive, high-resolution cross-sectional imaging, allowing for microstructural analysis of the macula. Data, including demographic details, mechanism of injury, and clinical findings, were analyzed to draw statistical conclusions. Result: The results indicated a pronounced male predominance (75%), with the highest incidence occurring in the young population aged 11–20 years, often students (41.18%). The most common cause of injury was sports-related, specifically trauma by a ball (23.53%). Anteriorly, the pupil was the most frequently affected structure (41.17%), typically presenting with traumatic mydriasis. Posteriorly, Retinal Detachment (11.76%) was the most common gross pathology. Utilizing OCT, subtle macular involvement was widely detected, with the most frequent findings being Berlin’s Oedema, Lamellar Macular Hole, Macular Oedema, and Macular Scarring (all at 3.92%). Conclusion: Blunt ocular trauma severely impacts young males and can result in significant visual impairment due to a range of anterior and posterior segment injuries. The study confirms that OCT is an indispensable tool, revealing fine microstructural macular changes that might be missed by conventional clinical examination. Early OCT evaluation is therefore recommended for all blunt trauma cases to guide subsequent management and improve visual outcomes.

Background: Knee osteoarthritis is a leading cause of chronic pain and functional limitation. In patients who are unsuitable for or unwilling to undergo surgical intervention, minimally invasive interventional pain management techniques are increasingly utilized. Intra-articular corticosteroid injections provide short-term pain relief, whereas cooled radiofrequency ablation (CRFA) of genicular nerves has emerged as a promising modality for longer-lasting analgesia. Objectives: To compare the safety and effectiveness of cooled radiofrequency ablation with intra-articular corticosteroid injection in the management of chronic knee pain due to osteoarthritis. Materials and Methods: This prospective, randomized clinical trial was conducted at a tertiary care center after obtaining institutional ethics committee approval. Eighty patients aged 40–70 years with radiographically confirmed knee osteoarthritis (Kellgren–Lawrence grade III or IV) and baseline Numeric Rating Scale (NRS) pain score >6 were enrolled. Patients were randomly allocated into two groups: the CRFA group (n = 40) and the intra-articular steroid (IAS) group (n = 40). Outcomes were assessed at baseline and at 1-, 3-, and 6-months following intervention. The primary outcome was the proportion of patients achieving a ≥50% reduction in NRS pain score at 6 months. Secondary outcomes included changes in pain scores at follow-up, analgesic consumption, and adverse events. Results: Both treatment modalities resulted in significant pain reduction during the early follow-up period. However, patients in the CRFA group demonstrated significantly greater and sustained reduction in NRS pain scores at all follow-up intervals compared to the IAS group. At 6 months, a higher proportion of patients in the CRFA group achieved clinically meaningful pain relief and required fewer rescue analgesics. No serious adverse events were observed in either group. Conclusion: Cooled radiofrequency ablation provides superior and longer-lasting pain relief compared to intra-articular corticosteroid injection in patients with knee osteoarthritis, with a comparable safety profile. CRFA represents an effective minimally invasive treatment option for long-term management of chronic knee pain in patients unsuitable for surgical intervention.

Background: Hydrocelectomy is the definitive treatment for symptomatic adult hydrocele, a common scrotal condition amenable to day-care surgery. Local anaesthesia (LA) offers potential advantages over spinal anaesthesia (SA) including reduced complications and faster recovery, though direct comparative data remains limited. Objective: To compare postoperative pain, hospital stay, and need for extra analgesia between LA and SA in 144 adults undergoing unilateral hydrocelectomy. Methods: Prospective and retrospective randomized study of 144 patients (72 LA, 72 SA) undergoing hydrocelectomy. Spermatic cord block with lignocaine used for LA whereas low-dose bupivacaine – fentanyl was used for SA. Outcomes measured included VAS pain scores (2-24h), hospital stay, rescue analgesia (diclofenac/tramadol if VAS≥4) and complications. Results: LA showed lower VAS scores (2h: 2.4±1.1 vs 3.6±1.4; 6h: 2.8±1.2 vs 4.3±1.5. Hospital stay shorter (20.8±6.4 vs 26.1±7.9h. Rescue analgesia needed by 30.6% LA vs 59.7% SA. SA had more urinary retention (12.5% vs 1.4%) and headache (8.3% vs 0). Conclusion: LA provides superior pain control, shorter stay, and fewer complications than SA for adult hydrocelectomy, supporting its use as preferred technique in day-care settings.

Background: The care of critically ill children in paediatric intensive care units (PICUs) is essential for improving outcomes in resource-limited settings. This study aimed to analyse the clinical profile and causes of admissions (morbidity patterns) in children admitted to a PICU in a tertiary care hospital in Northeast India, focusing on demographic factors, system involvement, and morbidity distribution. Methods: This prospective observational study was conducted from July 2019 to June 2020 in the PICU of Silchar Medical College and Hospital, Assam. Children aged 1 month to 12 years admitted to the PICU were included, excluding those who died within 2 hours of admission, stayed beyond the study period, or left against medical advice. Data on demographics, source of admission, socioeconomic status (modified Kuppuswamy scale), and system involved, specific diagnoses, length of stay, and outcomes were collected using a predesigned proforma. Statistical analysis was performed using SPSS version 25, with chi-square tests for categorical variables (p < 0.05 considered significant). Results: Of 747 children (58% male, Male:female ratio 1.38:1), 54.5% were under 1 year, 25.7% aged 1-5 years, and 19.8% aged 5-12 years. Mean length of stay was 7.99 ± 2.66 days (range 3-24 days). Admissions were primarily from emergency (42.6%), outpatient department (23.4%), and wards (22%). Most families were upper lower socioeconomic class (modified Kuppuswamy scale). Respiratory system disorders accounted for 24.9% of admissions (pneumonia 47.8%, bronchiolitis 22%), followed by infections/sepsis (19.7%), central nervous system (CNS) disorders (12.2%; meningitis 29.4%, febrile convulsions 25.3%), and renal disorders (12%; urinary tract infection 45.6%). Other systems included gastrointestinal (11%), cardiovascular (8.7%), haematological (3.1%), surgical (3.9%), poisoning (2.4%), and miscellaneous (2.1%). Differences in system involvement were not statistically significant (p = 1.693). Conclusion: Respiratory and infectious diseases dominate PICU admissions in this setting, with infants most affected. Targeted interventions for preventable causes like infections and improved community education could reduce morbidity.