Background: Diabetes mellitus is a chronic metabolic disorder associated with long-term complications, among which diabetic foot ulcer (DFU) is one of the most common and debilitating. DFUs frequently result in prolonged hospitalization, increased risk of infection, and limb amputation. Conventional wound dressings have limitations in infection control and healing efficiency. Aims: To evaluate the efficacy of nanocrystalline silver dressings in the management of diabetic foot ulcers. Methodology: This prospective comparative study was conducted at Chikkamagaluru Institute of Medical Science over a one-year period (01.08.2024–01.08.2025). A total of 100 patients with Wagner’s grade II diabetic foot ulcers were randomly allocated into two groups: Group A (nanocrystalline silver dressing, n=50) and Group B (conventional dressing, n=50). Outcomes assessed included number of dressings required, percentage reduction in ulcer size (measured using ulcer planometry), and length of hospital stay. Results: Group A demonstrated significantly better outcomes compared to Group B. The mean number of dressings required was lower (10.28 vs 21.74), mean hospital stay was shorter (20.26 vs 43.16 days), and mean percentage reduction in ulcer size was higher (95.24% vs 83.32%). These differences were statistically significant. Conclusion: Nanocrystalline silver dressings are safe, effective, and superior to conventional dressings in the management of diabetic foot ulcers, offering faster healing, reduced hospital stay, fewer dressing changes, and better patient compliance.

Background: Tubal ligation remains the most common method of surgical sterilization globally, accounting for approximately 37.8% of contraceptive methods in India according to National Family Health Survey-5 data. Both laparoscopic and minilaparotomy approaches achieve permanent contraception but differ significantly in safety profiles, recovery trajectories, and suitability for peripheral healthcare settings. Objective: To compare efficacy, safety, and clinical outcomes of laparoscopic versus minilaparotomy tubal ligation in young multiparous women at a district hospital setting. Methods: Prospective observational cohort study conducted at District Hospital Kishtwar from 2021-2023. Study population: 400 women aged 25-29 years (mean age 27.23 ± 1.8 years) with parity 2-5 (46% parity 3; 40% parity 2; 14% parity ≥4). Laparoscopic group (n=200): Falope ring tubal occlusion. Minilaparotomy group (n=200): Pomeroy technique via pfannenstiel incision. Primary outcomes: operative time, postoperative pain, surgical site infection (SSI), hospital stay, intraoperative complications. Secondary outcomes: >24-month contraceptive efficacy, patient satisfaction. Results: Operative efficiency: Laparoscopic mean operative time 10 minutes (range 6-15 min) vs minilaparotomy 14 minutes (8-20 min; p<0.001). Postoperative pain: 9% (18/200) in laparoscopic vs 29% (58/200) in minilaparotomy group (p<0.001). Surgical site infection: 5% (10/200) laparoscopic vs 12% (24/200) minilaparotomy (p=0.02). Hospital stay: Laparoscopic mean 2 days (range 1-3 days) vs minilaparotomy mean 4 days (3-6 days; p<0.001)—a 50% reduction. Major intraoperative complications: 0% (0/200) minilaparotomy  vs 3.5% (7/200) (p=0.01) laparoscopy, comprising 4 cases of tubal/round ligament injury with hemorrhage requiring emergency laparotomy and 3 cases of non-visualized tubes requiring exploratory laparotomy. Long-term efficacy: 1% pregnancy rate (2/200) in laparoscopic group vs 0% in minilaparotomy at >24-month follow-up (p=0.50). Conclusion: Laparoscopic tubal ligation demonstrates comprehensive superiority across efficacy and recovery metrics compared to minilaparotomy in young multiparous women. The 50% reduction in hospital stay (2 vs 4 days), lower postoperative morbidity, and equivalent long-term efficacy establish laparoscopy as the gold standard procedure for peripheral hospitals with laparoscopic capability.

Background: The postpartum period is associated with significant psychological vulnerability, and anxiety disorders during this phase are increasingly recognized as important contributors to adverse maternal and neonatal outcomes. Despite its high prevalence, postpartum anxiety remains underdiagnosed, particularly in resource-limited settings. Early identification of anxiety and associated risk factors is essential for comprehensive postnatal care. Objectives: To assess the severity of postpartum anxiety among postnatal women using the Perinatal Anxiety Screening Scale (PASS) and to examine its association with selected socio-demographic, obstetric, and neonatal factors. Materials and Methods: A hospital-based observational study was conducted among postnatal women admitted to a tertiary care teaching hospital. Data were collected using a structured proforma and medical record review. Postpartum anxiety was assessed using the Perinatal Anxiety Screening Scale (PASS). Based on PASS scores, participants were categorized as asymptomatic (0–20), mild to moderate anxiety (21–41), or severe anxiety (≥42). Associations between anxiety severity and variables such as age, socioeconomic status, family pattern, gravidity, mode of delivery, history of abortions, pregnancy-related complications, and NICU admission were analyzed using descriptive statistics. Results: Most participants were asymptomatic, while a substantial proportion exhibited mild-to-moderate anxiety; severe anxiety was relatively uncommon. Higher anxiety severity was observed among women belonging to lower socioeconomic status, primigravida mothers, and those who underwent cesarean delivery. NICU admission of the newborn showed a strong association with increased anxiety severity, with a majority of these mothers experiencing mild-to-moderate or severe anxiety. A history of previous abortions, particularly multiple abortions, and pregnancy-related complications were also associated with higher anxiety levels. Conclusion: Postpartum anxiety is a common but under-recognized mental health condition influenced by multiple socio-demographic, obstetric, and neonatal factors. Routine screening using validated tools such as PASS during the postnatal period can facilitate early identification of high-risk mothers. Integrating mental health assessment and psychosocial support into standard postnatal care may significantly improve maternal well-being and overall postnatal outcomes.

Background: Hypertension and type 2 diabetes mellitus frequently coexist and synergistically increase cardiovascular risk. Although the chronic benefits of aerobic exercise are well established, data comparing the acute hemodynamic and glycemic responses to exercise among hypertensive patients with and without diabetes and healthy individuals remain limited. Objective: To compare the acute effects of one hour of brisk walking on blood pressure and fasting blood glucose among hypertensive patients with diabetes, hypertensive patients without diabetes, and healthy controls. Methods: This prospective, observational, comparative study included 90 participants aged 30–60 years, divided into three groups: hypertensive patients (Group H, n=30), hypertensive patients with type 2 diabetes mellitus (Group HDM, n=30), and healthy normotensive non-diabetic controls (Group N, n=30). All participants performed one hour of moderate-intensity brisk walking. Systolic and diastolic blood pressure and fasting blood glucose were measured at baseline, immediately post-exercise, and at 1, 6, 12, and 24 hours post-exercise. Results: Both hypertensive groups demonstrated significant reductions in systolic and diastolic blood pressure immediately after exercise, with maximal decreases observed at 6 hours post-exercise. Blood pressure values gradually increased thereafter but remained below baseline levels at 24 hours. The magnitude of post-exercise hypotension was greater in hypertensive participants than in healthy controls. Fasting blood glucose levels decreased in all groups following exercise, with the most pronounced and sustained reduction observed in hypertensive patients with diabetes, reaching a nadir at 6 hours post-exercise. Healthy controls exhibited minimal changes in blood pressure and glycemia. Conclusion: A single session of one hour of brisk walking produces significant acute reductions in blood pressure and improves glycemic levels, particularly in hypertensive patients with diabetes. These benefits peak around 6 hours and persist up to 24 hours, highlighting brisk walking as a simple, safe, and cost-effective non-pharmacological intervention for immediate cardiovascular and metabolic risk reduction.

Background: Intertrochanteric femur fractures in elderly patients are linked with significant morbidity, premature decline in function and fixation failure in osteoporotic bone. Intramedullary devices decrease the bending moment and could allow earlier mobilization. PFN has a double screw construct, while PFNA2 has a helical blade that is designed to have better purchase in osteoporotic cancellous bone and lessen rotational instability. The present study is a prospective study comparing PFN vs PFNA2 for elderly patients with AO/OTA 31-A2 intertrochanteric fracture. Methods: In this prospective comparative study, 84 consecutive elderly patients (age >=60 years) with AO/ OTA 31-A2 fractures were treated with PFN (n=42) or PFNA2 (n=42) at a tertiary trauma center over 18 months. Primary outcomes were functional score (Harris Hip Score-HHS) upto 6 months and fixation failure. Operative time, blood loss, fluoroscopy Time, Time to union, and complications were secondary outcomes. Continuous variables were analyzed using independent-samples t-test or Mann-Whitney U test and categorical variables: ISW peroxidase test using chi-square/Fisher exact test. p<0.05 was significant. Results: Groups were similar with regard to age, sex, ASA class, fracture subtype, and baseline mobility. PFNA2 showed less operative time (54.8 sometime of 11.2 vs. 63.6 time of 12.5 minutes; p=0.001), lower estimating blood loss (164 mL of 58 vs. 198 mL of 72; p=0.018) and force dose of fluoroscopy (58 seconds of 14 vs. 71 seconds of 18; p<0.001). Mean radiographic union time was marginally less with PFNA2, 13.2 at 2.6 weeks versus 14.1 at 2.9 weeks (p=0.12). It was used less times with PFNA2 (2.4% vs 11.9%; p=0.09) to fix a buttonhole. HHS was in favor of PFNA2 at 6-months (82.7 +- 8.9 vs 78.1 +- 9.6; p=0.028). Conclusion: In elderly AO/OTA 31-A2 intertrochanteric fractures, PFNA2 was associated with superior early functional results and a more efficient intraoperative feature with a trend to less mechanical failures. Optimization of reduction quality and position of implant is critical to reduce cut-out and reoperation.

Introduction: Gynaecological malignancies are tumours of female genital tract, including neoplasms of ovary, fallopian tube, uterus, cervix, vagina and vulva which contribute considerably to female morbidity and mortality. In this study, our objectives were to analyse the histopathological types of gynaecological malignancies and determine the frequency of distribution of these malignant neoplasms among patients who were managed surgically at our institute. We also evaluated the association between the type of gynaecological cancer and FIGO stage at presentation. Materials and Methods: This was a cross-sectional, observational study that included 465 cases of malignant neoplasms of female genital tract reported over ten years. The site, histologic type and histologic grade of tumours were noted. The pathologic stage in case of radical hysterectomies was recorded. Chi-square test was used to analyse the frequency distribution of categorical data. Results: Most of the cases were of cervical carcinoma (n: 335, 72.1 %) followed by ovarian carcinoma (n: 73, 15.6%) and endometrial carcinoma (n: 57, 12.3 %). The difference in frequency distribution of these malignancies was statistically significant with cervical carcinoma occurring far more frequently than the other two types. There was significant association between type of gynaecological cancer and FIGO stage at presentation. Conclusion: Our study reveals cervical carcinomas are the most common gynaecological malignant tumours followed by ovarian and endometrial cancers. This indicates the need for a more widespread screening system for cervical carcinoma. Most of the cases of cervical, ovarian and endometrial cancer present at early stage. Ovarian cancers have higher proportion of advanced stage cases as compared to cervical and endometrial cancers.

Introduction: Peripheral nerve block is now a well-accepted component of comprehensive anaesthetic care. Almost all upper limb surgeries can be performed by blocking of brachial plexus using local anaesthetic solution, with the advantage of providing isolated and dense motor and sensory anaesthesia with lesser drug requirement, good surgical field, haemodynamic stability, post-operative analgesia and patient satisfaction, minimally affecting other systems of the body. This study was undertaken to compare bupivacaine and chloroprocaine with addition of opioids (fentanyl), in brachial plexus block with respect to onset, duration, quality of sensory and motor block, side effects, and effectiveness of anaesthesia for short upper limb surgeries, thereby reducing the hospital stay. Method: A prospective, randomized, double-blinded study was performed after obtaining Ethical approval from the institution and consent from patients. A total of 100 patients, who were scheduled for upper limb orthopaedic surgery with ASA type I and II, of either sex or age, ranging from 20 to 50 years old, were taken in 2 groups of 50 each. Group C (n = 50): Patients were given 30 ml of 1% chloroprocaine with 1 ug/kg of fentanyl. Group B (n=50): Patients were given 30 ml 0. 5%Bupivacaine with 1 ug/kg of fentanyl. Result: The onset of sensory and motor block was earlier in group C compared to group B. The duration of sensory and motor blocks was significantly shorter in group C as compared to group B. The mean duration of analgesia was prolonged in group B in comparison with group C, and the data was statistically significant. Conclusion: Chloroprocaine and fentanyl combination, has a better profile for supraclavicular brachial plexus block in terms of early onset of sensory and motor block with rapid recovery and a shorter time to discharge in comparison with bupivacaine and fentanyl combination for ambulatory surgeries.

Background: In critically ill patients, the accurate assessment of intravascular fluid volume is vital for effective management and optimal outcomes. Fluid resuscitation is a cornerstone of treatment in various conditions including sepsis, trauma and major surgery. Materials and Methods: This study was a prospective randomized control study, to compare the IVC diameter and central venous pressure for evaluating intravascular fluid volume status in critically ill patients. And patients admitted in intensive care units at Government Mohan Kumaramangalam Medical College, Salem, from December 2022 and November 2023. Results: Baseline MAP values were comparable between the treatment groups, indicating that patients began with similar levels of perfusion. MAP is a critical measure of hemodynamic stability and is essential for ensuring adequate organ perfusion. The lack of statistically significant differences in MAP suggests that both groups were experiencing similar initial hemodynamic states. The positive correlation between IVC diameter and MAP suggests that larger IVC diameters may be associated with better hemodynamic stability. However, the weaker correlation with urine output indicates that IVC diameter alone may not sufficiently predict renal outcomes. Conclusion: The findings underscore the need for clinicians to consider both IVC diameter and CVP in fluid assessment and management. While CVP remains a staple in critical care, the potential for ultrasonographic measurements, such as IVC diameter, to offer more dynamic and responsive insights into fluid status warrants further exploration. The combination of these assessments may provide a more comprehensive understanding of a patient’s hemodynamic status, potentially leading to improved outcomes.

Background: Seizure disorders represent a significant proportion of paediatric neurological presentations, with febrile convulsions being the most common cause in children under five years of age. Understanding the clinical characteristics and etiological factors is essential for appropriate management and parental counselling. Aim of this study is to evaluate the etiological spectrum and clinical characteristics of febrile convulsions and epilepsy among paediatric patients presenting to a tertiary care center. Methods: A prospective observational study was conducted at Government Medical College Krishnagiri in Department of Paediatrics over one year. Paediatric patients presenting with seizures were consecutively enrolled. Comprehensive clinical evaluation, laboratory investigations, and neurological assessments were performed. Data were analyzed using appropriate statistical methods. Results: Among 209 seizure cases, 83 (39.7%) were febrile seizures with an overall incidence of 2.57%, while 126 (60.3%) were epileptic seizures with an incidence of 3.9%. Male predominance was observed in both groups (febrile seizures 62.65%, epilepsy 58.73%). Simple febrile seizures constituted 67.47% of cases, with upper respiratory tract infections being the leading cause (63.85%). In epilepsy cases, generalized seizures were most common (67.46%), with acute symptomatic causes accounting for 47.62% of cases. Mortality was observed in 12.70% of epilepsy cases, predominantly in the acute symptomatic group (73.33% of deaths). Conclusions: While febrile seizures are generally benign, they cause significant parental anxiety and require accurate clinical assessment. Epilepsy in the pediatric population shows higher prevalence in developing countries, with infectious etiologies playing a major role. Comprehensive evaluation and appropriate management strategies are essential for optimal outcomes.

Aim: The primary aim of this study was to perform a comprehensive morphological and morphometric analysis of adult dry forearm bones (radius and ulna) from Indian individuals to assess sexual dimorphism. Specific objectives included measuring key parameters such as maximum length (ML), distal epiphyseal breadth (DEB), minimum shaft diameter (MSD), coronoid process height (CPH), olecranon width (OWL), and maximum head diameter (MHD) on both right and left sides. This research addresses the need for population-specific standards in forensic anthropology for the Indian population, where regional variations influence dimorphic expression. By establishing discriminant functions, the study aims to provide reliable tools for sex estimation from fragmentary forearm remains, crucial for medico-legal identifications in India. Materials and Methods: Dry adult forearm bones (n=200; 100 males, 100 females; aged 25-65 years) of known sex and Indian origin were sourced from anatomy departments in Bhopal and surrounding regions. Bones were selected excluding pathology, damage, or immaturity. Measurements were taken using digital Vernier calipers (0.01 mm precision) and osteometric board by two observers following standard protocols. Six parameters per bone (radius: ML, DEB, MSD, radial head diameter, proximal breadth, distal breadth; ulna: ML, DEB, MSD, CPH, OWL, trochlear notch width) were recorded bilaterally. Results: Males exhibited significantly larger dimensions across all parameters (p<0.001), with right-side dominance indicating functional asymmetry. For radius ML, males averaged 248.5±12.3 mm vs. females 225.7±10.4 mm (dimorphism ratio 1.10). Ulna ML showed 272.1±13.5 mm in males vs. 248.3±11.2 mm in females. Stepwise discriminant functions achieved 87-92% accuracy: Radius right: DF = 0.023(ML) + 0.045(DEB) – 28.4 (>0 male); Ulna left: DF = 0.019(ML) + 0.052(MSD) + 0.038(CPH) – 32.1 Overall classification accuracy was 89.5%. Conclusion: Forearm bones demonstrate marked sexual dimorphism in Indian adults, with metric parameters enabling >85% sex estimation accuracy. These findings validate forearm bones as reliable forensic indicators, comparable to humerus studies. Population-specific equations enhance medico-legal applications in India. Future multi-regional validations are recommended.

Background: Community engagement is a key determinant of the success of public health interventions, particularly in rural and underserved regions where sociocultural beliefs, awareness levels, and accessibility influence healthcare utilization. Active participation of community members, local leaders, and frontline health workers has been shown to enhance acceptance and sustainability of health programs. Objectives: To assess the association between community engagement and utilization of government health programs among beneficiaries linked to a rural tertiary care institution in Bihar. Methods: A prospective observational study was conducted from 20 January 2025 to 20 December 2025 involving 70 participants enrolled in various public health programs, including immunization, antenatal services, and non-communicable disease screening. Data were collected using structured questionnaires assessing awareness, participation in community activities, sources of information, and perceived barriers. Descriptive statistics and association analyses were used to evaluate the impact of community engagement on program uptake. Results: Participants who reported exposure to community engagement activities—such as outreach by ASHA workers, village health and nutrition days, awareness meetings, and peer group support—showed higher levels of program awareness and service utilization compared to those with limited engagement. Trust in healthcare providers, culturally sensitive communication, and involvement of local influencers were major facilitators. Barriers included low literacy, misconceptions about health programs, and logistical challenges such as transportation and financial constraints. Conclusion: Community engagement significantly enhances awareness, acceptance, and utilization of health services. Strengthening grassroots communication networks, empowering community health workers, and integrating participatory approaches into program design can substantially improve the effectiveness and sustainability of public health initiatives.

Background: Obsessive–Compulsive Disorder (OCD) is a chronic psychiatric illness characterized by intrusive thoughts and repetitive behaviors that significantly impair functioning and quality of life. Emerging evidence suggests that neuroinflammation and immune dysregulation may contribute to the pathophysiology of OCD. Peripheral inflammatory markers and composite indices such as the Systemic Immune-Inflammation Index (SII) have gained attention as potential biomarkers reflecting the interplay between immune activation and neuropsychiatric disorders. Objectives: To assess and compare markers of inflammation and the Systemic Immune-Inflammation Index in patients with Obsessive–Compulsive Disorder and healthy controls, and to evaluate their potential association with the disorder. Methods: This case–control study included 60 participants, comprising 30 patients diagnosed with OCD and 30 age- and sex-matched healthy controls. Diagnosis of OCD was established using standard clinical diagnostic criteria. Venous blood samples were collected from all participants under aseptic conditions. Laboratory parameters assessed included total leukocyte count, neutrophil count, lymphocyte count, platelet count, erythrocyte sedimentation rate (ESR). The Systemic Immune-Inflammation Index was calculated using the formula: SII = Platelet count × Neutrophil count / Lymphocyte count. Statistical comparisons between groups were performed using appropriate parametric or non-parametric tests, with p < 0.05 considered statistically significant. Results: Patients with OCD demonstrated significantly higher levels of inflammatory markers, including neutrophil count, platelet count, ESR, compared to healthy controls. Lymphocyte counts were relatively lower in the OCD group. Consequently, the calculated SII values were significantly elevated among OCD patients, indicating heightened systemic inflammatory status. The findings suggest a measurable inflammatory imbalance in individuals with OCD. Conclusion: The study indicates that patients with OCD exhibit increased systemic inflammation and elevated SII compared to healthy individuals. These findings support the hypothesis that immune-inflammatory mechanisms may play a role in the pathophysiology of OCD. Peripheral inflammatory markers and SII may serve as accessible adjunct biomarkers for understanding disease mechanisms and guiding future research on targeted therapeutic approaches.

Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) is an acute-onset clinico-radiological syndrome characterized by headache, seizures, visual disturbances, altered sensorium, and distinctive neuroimaging findings. Although classically involving the parieto-occipital regions, PRES may affect atypical brain locations such as the frontal lobes, basal ganglia, and cerebellum, brainstem, and watershed zones. Recognition of these atypical presentations is crucial, as delayed diagnosis may result in irreversible neurological injury despite the potentially reversible nature of the syndrome. This study aimed to systematically evaluate atypical presentations of PRES, focusing on etiological factors, clinical manifestations, management strategies, and patient outcomes, to improve recognition and understanding of this under-recognized variant. Materials and Methods: A prospective observational study was conducted over 24 months at a tertiary care teaching hospital. Among 218 patients diagnosed with PRES, 37 patients (16.97%) with atypical clinical and/or MRI features were included. Patients with involvement of uncommon brain regions or non-classical radiological patterns were selected. Detailed demographic data, clinical presentation, underlying etiologies, laboratory findings, neuroimaging characteristics, treatment details, and outcomes were systematically recorded and analyzed using appropriate statistical methods. Results: The cohort showed a significant female predominance (64.86%), with a mean age of 32.8 years (range: 19–63 years). Pregnancy-related hypertensive disorders (pre-eclampsia/eclampsia) were the most common etiological factors (35.13%), followed by hypertension (24.32%) and sepsis (13.51%). Management strategies were similar to those for typical PRES, emphasizing blood pressure control, seizure management, treatment of underlying causes, and supportive care. Clinical outcomes were favorable, with complete recovery in 94.59% of patients. Mortality was 5.40% and was related to severe underlying systemic illness rather than PRES itself. Conclusion: Atypical PRES constitutes a significant subset of PRES cases. Despite atypical radiological patterns, prognosis remains favorable with early diagnosis and prompt management, underscoring the importance of heightened clinical awareness.

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections of childhood. Among febrile infants, sick children and older children with urinary symptoms, 6%–8% will have a UTI. Prevalence varies with age, peaking in young infants, toddlers and older adolescents. Aims: To identify causative bacteria causing UTI in under five children and their antibiotic susceptibility pattern. Materials and methods: This descriptive cross-sectional study was conducted from April 2021 to October 2022 in the Department of Microbiology, Bankura Sammilani Medical College, Bankura. A total of 271 under-five children with urinary symptoms were included, representing all urine samples received from this age group during the study period. Result: 99 (36.90%) patients were affected in Escherechia coli., 35 (12.91%) patients were affected in Klebsella pnumoniae, 4 (1.40%) patients were affected in Citrobactor koseri, 42 (15.49%) patients were affected in Klebsella oxytoca, 11 (4.05%) patients were affected in Enterobactor Species, 24 (8.85%) patients were affected in Staphylococcus aureus, 7 (2.58%) patients were affected in Pseudomonas aeruginosa, 39 (14.39%) patients were affected in Enterococcus Species, 3 (1.10%) patients were affected in Coagulase Negative Staphyloccus, 3 (1.10%) patients were affected in Proteus Mirabilis, 3 (1.10%) patients were affected with Proteus vulgaris and 1 (0.40%) patient was affected in Citrobactor species. Conclusion: This study suggests that urinary tract infection is the one of the common disease causing morbidity and mortality in under five children. It can cause significant disease burden in the paediatric age group and around thirty to forty percent of neonates and children need admission in hospital.

Background: Musculoskeletal trauma, largely driven by road traffic accidents in India, frequently requires operative fixation, but early postoperative complications such as surgical site infection, wound dehiscence, and thromboembolism remain common, contributing to morbidity and extended hospital stays. Identifying predictors in resource-limited tertiary settings is essential to guide preventive strategies and improve patient outcomes in high-burden regions like West Bengal. Material and Methods: Our prospective observational study was conducted over a year at a tertiary care center. Consecutive adult patients (≥18 years) with acute fractures or dislocations undergoing operative management were enrolled (n=312) after ethical approval and informed consent. Data included demographics, injury mechanism, fracture type (open/closed, AO/OTA), comorbidities (diabetes, smoking), time from injury to surgery, operative duration, and complications within 30 days (using CDC criteria for SSI and clinical/radiological assessment for others). Follow-up occurred at 2, 6, and 12 weeks. Univariate analysis (χ², t-test) and multivariate logistic regression identified independent predictors (p<0.05). Result: Mean age was 38.5±12.3 years; 78% male. Road traffic accidents caused 62% of cases; open fractures comprised 28%. Early complications occurred in 17.3% (54/312), primarily SSI (9.6%), wound dehiscence (3.8%), and DVT (2.2%). Multivariate analysis revealed open fracture (aOR 3.8, 95% CI 1.9–7.6, p<0.001), diabetes (aOR 2.7, 95% CI 1.3–5.6, p=0.01), delay >24 hours to surgery (aOR 2.4, 95% CI 1.2–4.8, p=0.02), smoking (aOR 1.9, 95% CI 1.1–3.3, p=0.04), and operative time >90 minutes (aOR 1.02 per minute, 95% CI 1.01–1.03, p=0.03) as independent predictors. Conclusion: In this high-volume Indian tertiary setting, open fractures, diabetes, surgical delay, smoking, and prolonged operative time strongly predict early complications. Implementing early surgery protocols, glycemic control, smoking cessation advice, and operative efficiency could substantially lower rates and enhance recovery.

Background: Pontine strokes represent a critical subset of posterior circulation strokes due to the compact arrangement of vital neural pathways within the pons, often resulting in severe neurological deficits and high mortality. Data on their clinical profile and outcomes from North-Eastern India remain limited. Objectives: To study the prevalence, clinical spectrum, radiological characteristics, severity, and in-hospital outcomes of patients with pontine stroke admitted to a tertiary care center. Methods: This hospital-based observational cross-sectional study was conducted in the Department of Medicine, Agartala Government Medical College and G.B. Pant Hospital, Tripura, from January 2025 to December 2025. All consecutive adult patients admitted with acute stroke were screened. Patients with radiologically confirmed pontine involvement on NCCT and/or MRI brain were included. Demographic data, vascular risk factors, clinical presentation, neurological findings, imaging characteristics, hospital course, complications, duration of stay, and in-hospital outcomes were recorded using a standardised proforma. Stroke severity and outcomes were analyzed, and associations were assessed using appropriate statistical tests, with p < 0.05 considered significant. Results: Out of 138 acute stroke admissions, 24 patients (17.39%) had pontine stroke, accounting for 66.7% of posterior circulation strokes. The mean age was 63.33 years, with male predominance. Hypertension was the most common risk factor (50%). Pontine hemorrhage was the predominant subtype (91.6%), while pontine infarction accounted for 8.4% cases. Hemiparesis was the most frequent presenting symptom, followed by crossed neurological deficits and altered sensorium. Clinical severity and outcome strongly correlated with hematoma volume. Patients with massive pontine hemorrhage had uniformly poor outcomes, whereas those with small hemorrhages or infarcts showed favorable recovery. Aspiration pneumonitis was the most common in-hospital complication. Overall in-hospital mortality was 33.3%, occurring exclusively in patients with moderate to massive pontine hemorrhage (p < 0.001). Conclusion: Pontine strokes contribute significantly to posterior circulation stroke burden and are associated with high in-hospital mortality, particularly in hemorrhagic cases with larger hematoma volumes. Early recognition, prompt neuroimaging, and aggressive supportive care are essential to improve short-term outcomes.

Background: Effective postoperative analgesia is central to enhanced recovery following laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. Fascial plane blocks such as the Quadratus Lumborum (QL) block and the Transversus Abdominis Plane (TAP) block represent widely used opioid-sparing regional anaesthetic techniques. While TAP block provides somatic analgesia to the anterior abdominal wall, the QL block may additionally cover visceral nociceptive pathways through paravertebral spread. This study prospectively compared the analgesic efficacy and perioperative outcomes of bilateral transmuscular QL block versus bilateral posterior TAP block in patients undergoing elective laparoscopic TAPP repair.​ Methods: A prospective observational comparative study was conducted at the Institute of Anaesthesiology, Madurai Medical College, Government Rajaji Hospital, Madurai. Eighty adult patients (ASA I–II) were equally allocated into two groups: Group A received bilateral transmuscular QL blocks and Group B received bilateral posterior TAP blocks, each using 20 mL of 0.25% bupivacaine per side under ultrasound guidance following induction of general anaesthesia. The primary outcome was postoperative pain assessed by Numerical Rating Scale (NRS) at 0, 1, 2, 4, 6, 12, and 24 hours. Secondary outcomes included time to first rescue analgesia, total fentanyl consumption, postoperative nausea and vomiting (PONV), QoR-18 quality of recovery score, patient satisfaction, and intraoperative haemodynamic parameters. Data were analysed using unpaired t-test and Chi-square test; p < 0.05 was considered significant.​ Results: Both groups were demographically comparable at baseline (p > 0.05 for all variables). NRS scores were equivalent at 0–2 hours but diverged significantly from 4 hours onward, with the QL group maintaining lower scores through 24 hours (NRS 2 vs 4; p = 0.001). Time to first rescue analgesia was significantly longer in Group A (6.78 ± 0.83 hrs vs 3.45 ± 0.50 hrs; p < 0.05). Total fentanyl consumption was significantly lower in the QL group (415.77 ± 57.50 µg vs 616.62 ± 96.71 µg; p = 0.001). PONV-free rate was 95% in Group A versus 70% in Group B (p = 0.026). QoR-18 scores ≥16 were achieved by 90% of QL patients versus 55% TAP patients (p = 0.011). Patient satisfaction (Satisfied/Very Satisfied) was 90% in Group A versus 37.5% in Group B (p = 0.001). Haemodynamic parameters remained stable and comparable throughout in both groups.​ Conclusion: The transmuscular Quadratus Lumborum block provides superior, longer-lasting postoperative analgesia with significantly reduced opioid consumption, lower PONV incidence, and higher patient satisfaction compared to the TAP block in laparoscopic TAPP inguinal hernia repair. The QL block may be recommended as the preferred regional technique within enhanced recovery protocols for this surgical population.​

Background: Primary acquired nasolacrimal duct obstruction (PANDO) is a common cause of epiphora in adults and is effectively treated by dacryocystorhinostomy (DCR). External dacryocystorhinostomy (Ex-DCR) has traditionally been considered the gold standard, while endoscopic dacryocystorhinostomy (En-DCR) has emerged as a minimally invasive alternative with cosmetic advantages. Aim and Objective: To compare the surgical outcomes of endoscopic and external dacryocystorhinostomy. Materials and Methods: This prospective comparative study was conducted at a tertiary care center over 18 months on 80 patients with PANDO. Patients were randomly divided into two groups: En-DCR (n = 40) and Ex-DCR (n = 40). All patients underwent detailed preoperative evaluation and standard surgical procedures. They were followed up for 6 months. Outcome measures included anatomical success (patency on syringing), functional success (relief of epiphora), operative time, intraoperative blood loss, hospital stay, and postoperative complications. Results: The anatomical success rate was 90.0% in the En-DCR group and 95.0% in the Ex-DCR group, while functional success was 87.5% and 92.5%, respectively, with no statistically significant difference (p > 0.05). The mean operative time was significantly shorter in the En-DCR group (48.6 ± 7.8 minutes) compared to the Ex-DCR group (62.4 ± 8.5 minutes) (p < 0.001). Intraoperative blood loss and hospital stay were also significantly lower in the En-DCR group. Visible scar formation was observed only in the external DCR group. Conclusion: Both endoscopic and external dacryocystorhinostomy are effective procedures for the treatment of PANDO. While external DCR showed slightly higher success rates, endoscopic DCR offered advantages such as shorter operative time, lower morbidity, and a superior cosmetic outcome. Endoscopic DCR represents a safe and effective alternative to the external approach.

Ophthalmic pathology, a subspecialty within histopathology, focuses on diagnosing and characterizing a wide range of ocular diseases. It involves the examination of tissues obtained from surgical procedures such as enucleation and evisceration, as well as from minor biopsies. The lesions affecting the eye range from benign and pre-malignant to malignant, and accurate diagnosis relies on a combination of clinical and histopathological evaluation.

The present study aimed to develop and evaluate a controlled-release microsphere-based sunscreen formulation incorporating Benzophenone-3 (Oxybenzone) as an organic UV filter. Microspheres were prepared using the solvent evaporation technique with ethyl cellulose as the polymer. A 3² full factorial design was employed to investigate the influence of stirring speed and polymer concentration on particle size, entrapment efficiency, percentage yield, and in-vitro drug release. Preformulation studies confirmed the purity and identity of the drug through melting point determination, FTIR spectroscopy, UV spectral analysis, and solubility studies. The prepared microspheres exhibited high entrapment efficiency (72.00–86.07%), particle size ranging from 107–375 µm, and satisfactory percentage yield (32.18–87.89%). SEM analysis revealed spherical morphology with smooth surfaces. In-vitro drug release demonstrated sustained release up to 120 minutes with 41.56% cumulative release, indicating diffusion-controlled behavior. Sunscreen creams incorporating microspheres showed enhanced UV protection compared to formulations containing free drug. The combination of microspheres with inorganic UV filters such as Zinc oxide and Titanium dioxide exhibited superior photoprotective efficacy. Ex-vivo permeation studies using Franz diffusion cells demonstrated minimal systemic permeation (0.7%) and predominant drug retention (>90%) within the stratum corneum, confirming surface-retentive behavior. The developed microsphere-based sunscreen formulation provides improved photostability, controlled release, enhanced efficacy, and reduced systemic exposure, making it a promising strategy for advanced topical photoprotection.

Brain metastases represent the most common intracranial tumors, significantly outnumbering primary central nervous system (CNS) neoplasms. While the majority originate from lung, breast, melanoma, renal, and colorectal primaries, metastases from rare tumors such as Acinic Cell Carcinoma (ACC), Hepatocellular Carcinoma (HCC), and Alveolar Soft Part Sarcoma (ASPS) are exceptionally uncommon. Intracranial dissemination of ACC is exceedingly rare, and brain involvement in HCC occurs in less than 1% of cases. In contrast, ASPS, a TFE3-rearranged sarcoma, demonstrates a comparatively higher tendency for hematogenous spread, with brain metastases reported in 20–30% of advanced cases.
We present three rare cases of brain metastases arising from ACC, HCC, and ASPS, highlighting their clinicopathological features, radiological findings, histomorphology, and immunohistochemical profiles. Accurate diagnosis in such unusual presentations requires meticulous morphological evaluation, appropriate use of immunohistochemical markers, and correlation with current WHO CNS classification criteria. Reporting these rare metastatic entities contributes to improved diagnostic awareness, prevents misclassification as primary CNS tumors, and enhances understanding of their metastatic patterns and biological behavior.

Background: Pharmacology is a core subject in the undergraduate medical curriculum, providing the scientific basis for rational therapeutics. However, it is frequently perceived by students as complex and difficult to translate into clinical practice when taught predominantly through traditional didactic lectures. Contemporary medical education emphasizes student-centred, active learning strategies that promote clinical reasoning and long-term retention. Case-based learning (CBL) is one such approach that integrates theoretical knowledge with real-life clinical scenarios, encouraging active participation, problem solving, and meaningful learning. Objectives: The present study aimed to compare the effectiveness of traditional lecture-based teaching and case-based learning sessions in pharmacology among second-year MBBS students. Methods: This prospective interventional study was conducted among second-year MBBS students at a tertiary care teaching institution. Participants were divided into two groups: one group received conventional didactic lectures, while the other participated in CBL sessions facilitated by faculty using prevalidated clinical case scenarios. Baseline demographic characteristics, including age and gender distribution, were recorded. Knowledge acquisition was assessed using pre-test and post-test questionnaires with a maximum score of 15. Data were analyzed using descriptive statistics, and results were expressed as mean ± standard deviation and percentages. Results: Baseline characteristics and pre-test scores were comparable between the traditional lecture and CBL groups, indicating similar baseline knowledge levels. The mean pre-test scores were 7.0 ± 2.2 in the lecture group and 7.1 ± 2.1 in the CBL group. Following the intervention, post-test scores improved in both groups; however, the improvement was substantially greater in the CBL group. The mean post-test score in the CBL group was 9.2 ± 3.8 compared with 7.2 ± 2.3 in the traditional lecture group, demonstrating superior learning outcomes with CBL. Student feedback revealed a high level of acceptance of CBL. More than four-fifths of participants expressed that CBL should be continued for other pharmacology topics. Conclusion: CBL was more effective than traditional lectures in improving knowledge acquisition and was highly acceptable to undergraduate medical students. Incorporating CBL routinely into pharmacology teaching may better equip medical students with essential clinical reasoning skills and promote long-term learning.

Background: Peripheral intravenous cannulation (PIVC) is one of the most frequently used invasive procedures in hospitalised patients. Despite its routine use, PIVC is associated with a range of medical device–associated adverse events (MDAEs) that can compromise patient comfort, interrupt therapy, and increase healthcare burden. Systematic documentation of PIVC-related adverse events within the framework of materiovigilance remains limited in tertiary care settings in India. Objectives: To evaluate adverse events due to PIVC in terms of numbers, types, severity, seriousness, preventability and causality. Methods: A cross-sectional, single-centre observational study was conducted over three months in the in-patient wards of a tertiary care teaching hospital. A total of 289 hospitalised patients with PIVC in situ were  enrolled. Data were collected using a pre-tested case record form capturing demographic details, device characteristics, dwell time, number of drugs administered, fixation method, and adverse events. All MDAEs were assessed for severity, seriousness, preventability, and causality using standard materiovigilance tools. Associations between risk factors and MDAEs were analysed using Pearson’s correlation coefficient and chi-square test (p < 0.05). Results: Among 289 patients, 41 PIVC-related MDAEs were identified out of which swelling (70.7%) was the most common adverse event, followed by phlebitis (24.4%) and occlusion (4.9%). All adverse events were of moderate severity (Level 3), non-serious, non-preventable, and showed a possible causal association with PIVC use. A strong positive correlation was observed between PIVC dwell time and MDAEs (r = 0.98, p = 0.019), as well as between the number of drugs administered and MDAEs (r = 0.97, p = 0.008). A statistically significant association was found between fixation method using microporous tape  and occurrence of MDAEs (p = 0.015). Conclusion: PIVC-related adverse events are relatively less common, moderate in severity (level 3), nonserious, nonpreventable and with “possible” causality assessment. Prolonged PIVC dwell time, administration of multiple drugs and the use of microporous tape for fixation of PIVC are identified as associated  risk factors for occurrence of MDAE.

Background: Organophosphorus compounds (OPCs) are widely used pesticides and a major cause of poisoning-related mortality in India. Severe toxicity results from acetylcholinesterase inhibition leading to cholinergic crisis. Reliable prognostic markers are essential for early risk stratification. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is extensively used in ICUs, but its utility in OPC poisoning remains incompletely defined. Aim: To evaluate the predictive accuracy of the APACHE II score in assessing severity and clinical outcomes of organophosphorus poisoning. Methods: A prospective and retrospective observational study was conducted in the Department of Medicine, Jorhat Medical College & Hospital, including 75 adults with confirmed OPC poisoning. Clinical parameters, laboratory variables, and APACHE II score calculated within 24 hours of ICU admission were analyzed. Outcomes were compared between survivors and non-survivors. Results: Of 75 patients, 52% survived and 48% died. Most were males (64%) and 18–30 years old. Triazophos (26.7%) and acephate (20%) were the most frequent agents. Significant predictors of mortality included elevated temperature (p=0.010), lower GCS (p=0.048), high respiratory rate (p=0.005), metabolic acidosis (pH; p=0.019), elevated creatinine (p=0.033), hyponatremia (p=0.011), and higher APACHE II score (p=0.009). No significant association was noted with age, MAP, heart rate, hematocrit, or time to admission. Conclusion: APACHE II is a reliable prognostic tool in organophosphorus poisoning, correlating significantly with mortality risk. Temperature dysregulation, respiratory distress, acidosis, and electrolyte abnormalities emerged as key clinical predictors. Early scoring may facilitate timely triage and targeted interventions.

Aim: This study investigates the association between screen time exposure and language development outcomes in toddlers aged 12-36 months. The primary objective was to quantify how daily screen time duration influences expressive and receptive language skills, while controlling for socioeconomic factors, parental interaction, and content type. We hypothesized that excessive screen time (>2 hours/day) would correlate with delayed language milestones, reduced vocabulary acquisition, and poorer parent-child conversational turns, based on prior epidemiological evidence. Materials and Methods: A cross-sectional observational study was conducted on 500 toddlers (aged 12-36 months) recruited from pediatric clinics between January 2025 and December 2025. Screen time was assessed via parent-reported logs and Language Development Survey (LDS) scores. Inclusion criteria: healthy toddlers without neurodevelopmental disorders. Exclusion: preterm birth or hearing impairments. Statistical analysis used multivariate regression and ANOVA, with p<0.05 significance. Results: Toddlers with >2 hours daily screen time showed 28% lower expressive language scores (mean LDS: 45.2 vs. 62.7, p<0.001) and 1.7-fold higher odds of delay (OR=1.71, 95% CI:1.48-1.98). Each additional screen hour reduced adult words heard by 159/day and child vocalizations by 118/day. Educational content mitigated effects by 15%, but passive viewing dominated (72% cases). Low SES amplified risks (interaction p=0.02). Conclusion: Excessive screen time significantly impairs toddler language development by displacing vital parent-child interactions. Guidelines limiting exposure to <1 hour/day are reinforced, with emphasis on co-viewing high-quality content. Longitudinal interventions targeting high-risk families are recommended to safeguard early linguistic foundations.

Background: Spinal anaesthesia is very popular in lower limb surgeries because it is effective and safe. Bupivacaine is widely used, however due to its short duration of postoperative analgesia fentanyl and clonidine are used to increase the efficacy. Aim: To determine the effectiveness and safety of intrathecal bupivacaine with fentanyl to that of bupivacaine with clonidine during lower limb surgeries. Methodology: It was a prospective, randomized, double-blinded clinical study conducted on 80 ASA I–II patients undergoing elective lower limb surgeries. Group F received 2.5 ml of 0.5% hyperbaric bupivacaine with 25 µg fentanyl intrathecally, while Group C received 2.5 ml of 0.5% hyperbaric bupivacaine with 50 µg clonidine intrathecally. Sensory and motor block characteristics, duration of analgesia, sedation levels, and side effects were observed and statistically analyzed. Results: The onset of sensory and motor blocks was similar in both groups. However, the duration of sensory block (225.75 ± 28.55 min vs. 180.40 ± 22.65 min), motor block (210.45 ± 24.60 min vs. 160.85 ± 21.20 min), and analgesia (320.75 ± 34.85 min vs. 250.35 ± 31.25 min) were significantly longer in the clonidine group (p < 0.001). Side effects were minimal and comparable. Conclusion: Both adjuvants are effective, but clonidine provides longer sensory, motor, and analgesic duration with mild sedation and stable hemodynamics, making it a superior alternative to fentanyl.

Background: Epistaxis is one of ^‘the most common otolaryngologic emergencies encountered in emergency departments (ED). Although most cases are self-limiting, some patients experience recurrent episodes requiring repeated ED visits and active intervention. Aim: To identify risk factors associated with recurrent ED visits for epistaxis and evaluate the treatment modalities used in emergency management. Methodology: A retrospective observational study was conducted in the Department of ENT at GMERS Medical College, Himmatnagar, Gujarat, over a period of 12 months. A total of 80 patients presenting with epistaxis in the emergency department were included. Patients were categorized into single-episode and recurrent-episode groups based on ED visits within one month. Data regarding demographic characteristics, blood pressure, comorbidities, treatment procedures, and outcomes were analyzed using descriptive statistics and appropriate statistical tests. Results: Of the 80 patients, 58 (72.5%) had a single ED visit and 22 (27.5%) had recurrent visits. Common management procedures included anterior nasal packing with Merocel, topical vasoconstrictor drops, Surgicel/Surgifoam application, and cauterization techniques. No significant association was observed between the type of procedure and recurrence (p>0.05). Higher systolic blood pressure was noted during the winter–spring season (p=0.03), and Surgicel/Surgifoam use was significantly higher in this period (p=0.04). Conclusion: Epistaxis in the emergency setting is commonly managed with conservative procedures. Male gender and hypertension appear to be important factors associated with recurrence, highlighting the need for early risk stratification and structured management pathways.

Background: Knee injuries are common and often involve complex ligamentous, meniscal, and osseous structures. Early and accurate diagnosis is essential ^‘to guide management and prevent long-term complications. Magnetic resonance imaging (MRI) has become the preferred non-invasive modality for evaluating internal knee derangements. Aim: To assess the spectrum and frequency of knee injuries detected on MRI in patients presenting with trauma and analyze associated age- and gender-specific patterns. Methodology: A retrospective observational study was conducted on 90 patients who underwent knee MRI following trauma at the Department of Radiodiagnosis, DRPGMC, Tanda, Kangra, India. MRI scans were evaluated for ligamentous (ACL, PCL, MCL, LCL), meniscal, and osseous injuries, including bone contusions. Data were analyzed using descriptive statistics and Chi-square tests. Results: ACL injuries were the most common ligamentous pathology, often accompanied by medial meniscus tears and bone contusions. Collateral ligament injuries were generally low-grade. Younger adults predominantly sustained ACL injuries and bone contusions, while meniscal injuries were more frequent in middle-aged patients. Males were more commonly affected, but gender did not significantly influence injury type. Conclusion: MRI provides detailed assessment of knee injuries, enabling accurate diagnosis, detection of associated lesions, and informed clinical decision-making. It remains a crucial tool in managing traumatic knee injuries.

Background: Tubal factor infertility constitutes a considerable percentage of female infertility, and precise evaluation of tubal disease is crucial for efficient treatment. Laparoscopy is the definitive method for assessing tubal patients and related pelvic anomalies. Aim: To evaluate the prevalence and pattern of tubal factors in infertile women using laparoscopic assessment and to correlate findings with the type of infertility. Methodology: This prospective observational study involved 70 women aged 20 to 40 years with primary or secondary infertility, conducted at a tertiary care facility. All participants underwent diagnostic laparoscopy with chromopertubation. Tubal patency, morphology, and associated pelvic pathologies were documented and analyzed using descriptive statistics and chi-square tests. Results: Laparoscopy revealed tubal pathology in 60% of cases. Unilateral tubal block was seen in 14.3%, bilateral block in 17.1%, hydrosalpinx in 11.4%, and peritubal adhesions in 17.1% of women. Primary infertility was more commonly associated with bilateral tubal block, whereas adhesions were more frequent in secondary infertility. Conclusion: Tubal factors contribute substantially to female infertility. Laparoscopic evaluation provides comprehensive diagnostic information and aids individualized management planning.

Background: Primary amenorrhea is an important clinical condition in adolescent gynecology that indicates possible abnormalities in the hypothalamic–pituitary–ovarian axis, reproductive anatomy, or systemic health. Early identification of the underlying cause is essential for appropriate management and prevention of long-term complications.Aim: To evaluate the etiological spectrum and clinical, hormonal, and radiological characteristics of adolescents presenting with primary amenorrhea. Methodology: A hospital-based observational cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Nalanda Medical College and Hospital, Patna, India, over nine months. A total of 29 adolescents aged 14–18 years with primary amenorrhea were included. Data were collected through detailed history, clinical examination, anthropometric assessment, hormonal evaluation (FSH, LH, estradiol, prolactin), TSH and pelvic ultrasonography. Statistical analysis was performed using SPSS version 25. Results: Normogonadotropic hypogonadism was the most common diagnosis (48.3%), followed by hypergonadotropic hypogonadism (31.0%) and hypogonadotropic hypogonadism (20.7%). Auxological parameters showed no significant differences among groups, while hormonal levels demonstrated significant variation. FSH and LH were markedly elevated in hypergonadotropic hypogonadism, whereas estradiol levels were highest in normogonadotropic cases. Conclusion: Primary amenorrhea in adolescents shows diverse etiologies, with normogonadotropic hypogonadism being the most frequent. A systematic approach combining clinical evaluation, hormonal analysis, and imaging is essential for accurate diagnosis and appropriate management.

Background: Breast lesions show a wide histopathological spectrum, and early diagnosis is vital. Core needle biopsy (CNB) offers architectural detail and higher diagnostic accuracy than FNAC, especially in resource-limited settings. Aim: To evaluate the histopathological spectrum of breast lesions and assess the diagnostic accuracy of CNB. Methodology: A retrospective study of 110 breast lesion cases was conducted at Department of Pathology, Darbhanga Medical College, Laheriasarai, Darbhanga, Bihar, India.   (Feb 2025–Oct 2025). CNB findings were categorized using NHSBSP (B1–B5) and correlated with excision histopathology (n=60). Statistical measures including sensitivity, specificity, PPV, NPV, and accuracy were calculated. Results: Malignant lesions (25.5%) and benign lesions (27.3%) formed major categories, with infiltrating duct carcinoma and fibroadenoma being most common. CNB showed sensitivity 88.2%, specificity 92.3%, PPV 93.7%, NPV 85.7%, and overall accuracy 90%. Diagnostic concordance was high, though false negatives (n=4) and false positives (n=2) occurred. Accuracy reached 100% when ≥3 cores were obtained, while fewer cores reduced sensitivity. B3 lesions posed diagnostic challenges. Conclusion: CNB is a reliable diagnostic modality with high accuracy in breast lesions; adequate sampling and cautious interpretation are essential, especially in borderline cases.

Background: Preeclampsia (PE) is a multisystem pregnancy disorder associated with significant maternal and neonatal morbidity and mortality. Disease severity influences peripartum outcomes, yet data from tertiary care centers remain limited. Aim: To evaluate the impact of preeclampsia severity on maternal and neonatal outcomes in a tertiary care setting. Methodology: A retrospective observational study was conducted at Department of obstetrics and gynecology, SNMMCH, Dhanbad, analyzing records of 82 women diagnosed with PE over one year. Patients were categorized as severe (n=34) or non-severe (n=48) based on clinical and laboratory criteria. Maternal outcomes included mode of delivery, ICU admission, postpartum blood pressure management, and hospital stay. Neonatal outcomes included gestational age, birth weight, Apgar scores, NICU admission, and complications. Statistical analysis used t-tests, Chi-square, and Fisher’s exact tests, with p<0.05 considered significant. Results: Severe PE was associated with higher cesarean rates (79.4% vs. 58.3%, p=0.041), maternal ICU admission (14.7% vs. 2.1%, p=0.032), prolonged hospitalization, and HELLP syndrome (17.6% vs. 0, p=0.001). Neonates had increased preterm birth (70.6% vs. 37.5%, p=0.004), low birth weight (64.7% vs. 33.3%, p=0.006), NICU admission (52.9% vs. 22.9%, p=0.007), and lower Apgar scores. Conclusion: Severity of preeclampsia significantly worsens maternal and neonatal outcomes. Early recognition and close monitoring are essential to reduce complications.

Aim: Most of the previous studies with topical amphotericin B (AmB) have been done in chronic rhinosinusitis (CRS) patients with controversial results and studies targeting the discrete subgroup of allergic fungal rhinosinusitis (AFRS) are lacking. The purpose of the present study has been to evaluate and compare the efficacies of intranasal lavage by 200μg/mL AmB solution versus normal saline in AFRS patients after functional endoscopic sinus surgery (FESS). Materials and Methods: Sixty adult AFRS patients were divided postoperatively into two groups for intranasal lavage: group A with normal saline (control) and group B with 200μg/mL AmB solution (intervention). Symptom and nasal endoscopy scores were calculated and assessed in both the groups preoperatively, at 2 weeks, 1 month and 3 months follow-up along with recurrence post-surgery. Results: In group A, there were marked improvement in the mean symptom and nasal endoscopy scores at 2 weeks follow-up from the preoperative scores. Symptom scores deteriorated slightly at 1 and at 3 months follow-up while nasal endoscopy scores improved at 1 month and further at the end of 3 months. Similarly, group B showed significant improvement in the both the symptom and nasal endoscopy scores at 2 weeks. Mean symptom score deteriorated at 1 and 3 months follow-up while mean nasal endoscopy score improved at 1 month but deteriorated at 3 months follow-up. The intergroup differences were not significant. In group A, 46.66% patients had recurrence whereas in Group B, 70.0% had recurrence. Conclusion: We concluded that although there was a definite improvement in both the groups after 3 months, post-FESS intranasal lavage with 200µg/mL of AmB, a higher dose than conventionally used, did not confer a greater benefit as compared to normal saline irrigation. Clinical Significance: Efficacy of post operative topical AmB therapy, even in higher concentration, is no better than that with normal saline when studied exclusively in patients of AFRS.

Background: Diabetes mellitus is associated with impaired wound healing due to metabolic disturbances, vascular insufficiency, and immune dysfunction. Surgical patients with diabetes are therefore at increased risk of postoperative wound complications, which may lead to prolonged hospitalization and increased healthcare burden. Aim: To determine the incidence of wound healing complications and identify independent risk factors among diabetic patients undergoing surgery. Methodology: A retrospective observational study was conducted at Department of General surgery, Patna Medical College and Hospital, Patna, Bihar, India. Medical records of 87 diabetic patients who underwent surgical procedures over 8 month period were reviewed. Demographic, clinical, and surgical data were collected. Univariate analysis was performed to identify associated factors, followed by multivariate logistic regression to determine independent risk factors. Results: Wound healing complications occurred in 28 patients (32.2%). Surgical site infection was the most common complication (17.2%), followed by wound dehiscence (8%) and delayed wound healing (6.9%). Univariate analysis showed significant associations with age >60 years, diabetes duration >10 years, poor glycemic control (HbA1c ≥9%), emergency surgery, and lack of antibiotic prophylaxis. Multivariate analysis identified poor glycemic control (AOR=3.12), diabetes duration >10 years (AOR=2.47), emergency surgery (AOR=2.15), and absence of antibiotic prophylaxis (AOR=2.68) as independent risk factors. Conclusion: Wound healing complications are common among diabetic surgical patients. Optimizing glycemic control, ensuring appropriate antibiotic prophylaxis, and careful perioperative management may reduce postoperative complications.

Background: Acute abdomen is a common surgical emergency requiring rapid diagnosis. Ultrasonography (USG), with its real-time imaging and safety profile, has become a key first-line modality. Aim: To evaluate the role of ultrasonography in diagnosing acute abdomen and its impact on management decision-making. Methodology: A prospective observational study was conducted at Department of General surgery, Patna Medical College and Hospital, Patna, Bihar, India. 68 patients (1–80 years) presenting with acute abdominal pain over seven months. All patients underwent clinical evaluation, laboratory tests, and ultrasonography. Findings were correlated with final diagnosis and management outcomes. Results: USG demonstrated high diagnostic accuracy, with overall sensitivity reaching up to 100% in several conditions. It was diagnostic in 76.47% of cases, with only 4.41% misdiagnosis and 19.12% requiring further tests. USG confirmed clinical diagnosis in 58.82%, altered it in 14.71%, and aided differential diagnosis in 17.65%. Most patients (58.82%) were managed conservatively, while 41.18% required surgery. Conclusion: Ultrasonography is a reliable, non-invasive, and effective first-line tool in acute abdomen, significantly aiding diagnosis and guiding management decisions, though complementary investigations may be needed in select cases.

Background: Pediatric emergency admissions ^.reflect the burden of acute childhood illnesses and the efficiency of healthcare systems, especially in tertiary care settings. Aim: To assess the epidemiological profile and clinical pattern of pediatric emergency admissions in a tertiary care hospital. Methodology: A hospital-based cross-sectional observational study was conducted in the Department of Pediatrics, Government Medical College and Hospital, Bettiah, Bihar, over 8 months. A total of 90 pediatric patients (0–12 years) admitted through the emergency department were included using consecutive sampling. Data were analyzed using SPSS 27.0. Results: The majority of admissions were among children aged 1–5 years (37.8%) and infants (31.1%). Males (57.8%) and rural residents (67.8%) predominated. Respiratory diseases (28.9%) were the leading cause, followed by infectious (22.2%) and gastrointestinal diseases (20%). Most patients were discharged (75.6%), while 13.3% were referred and 11.1% died. Conclusion: Pediatric emergency admissions are mainly driven by preventable communicable diseases, with higher vulnerability among young children and rural populations. Strengthening primary care, early diagnosis, and referral systems is essential to improve outcomes.

Background: Maternal anemia during pregnancy remains a major public health issue in India and is linked to adverse fetal and neonatal outcomes, including impaired growth and development. Aim: To assess the association between maternal anemia and developmental outcomes in infants, particularly low birth weight (LBW) and developmental delay. Methodology: A retrospective cohort study was conducted on 84 mother–infant pairs at Samarpan Multi-Speciality Hospital, Surat, India. Maternal hemoglobin levels were classified as non-anemic or varying degrees of anemia. Infant outcomes, including birth weight and developmental status at 12 months (assessed via standardized tools), were analyzed using chi-square tests and logistic regression. Results: Among participants, 73.8% of mothers were anemic, with moderate anemia most common (44%). LBW (46.4%) and developmental delay (23.8%) were prevalent. Anemic mothers had significantly higher rates of LBW (54.8% vs. 22.7%, p=0.002) and developmental delay (30.6% vs. 4.5%, p=0.001). Risk increased with anemia severity; severe anemia showed highest LBW (75%) and delay (50%). Moderate (OR 2.8) and severe anemia (OR 4.5), along with LBW (OR 3.2), were significant predictors of developmental delay. Conclusion: Maternal anemia is strongly associated with adverse infant outcomes, highlighting the need for early detection and effective antenatal interventions.