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.