Background: Effective analgesia during positioning and postoperative recovery is essential in femur fracture surgery. The Pericapsular Nerve Group (PENG) block has recently emerged as a targeted technique with potential advantages over the Fascia Iliaca Compartment Block (FICB). Material and Methods: This prospective comparative study included 30 patients undergoing femur fracture surgery, who received either a PENG block or an FICB. Pain during positioning for spinal anaesthesia, postoperative analgesia duration, and hemodynamic parameters were recorded. Results: The PENG block provided lower pain scores during positioning, prolonged postoperative analgesia, and greater hemodynamic stability compared with the FICB. Conclusion: The PENG block may be considered a more effective regional anaesthesia technique for femur fracture surgery due to its superior analgesic and physiological profile.

Background: Type 2 Diabetes Mellitus (T2DM) is a growing global health concern, with poor glycemic control leading to serious complications. Emerging evidence suggests a role of vitamin D in glucose metabolism. Aim: To evaluate the correlation between serum vitamin D levels and glycemic control (HbA1c) in T2DM patients. Methodology: A cross-sectional study was conducted on 50 T2DM patients aged 30–70 years. Serum 25(OH)D levels were measured using CLIA and HbA1c by HPLC. Vitamin D status was categorized as deficient, insufficient, or sufficient. Correlation was analyzed using Pearson’s coefficient. Results: Vitamin D deficiency was observed in 62% of patients, while 72% had poor glycemic control. Mean HbA1c was highest in deficient (8.4±1.1%) and lowest in sufficient groups (6.7±0.6%). Most deficient patients (26/31) had poor control, whereas better control was seen with sufficient vitamin D levels. Conclusion: An inverse relationship exists between vitamin D levels and HbA1c. Vitamin D deficiency is associated with poor glycemic control, suggesting its potential role in T2DM management.

Background: Recent demographic and epidemiological trends indicate that populations are living longer with an increasing burden of chronic diseases worldwide. Metabolic disorders such as fatty liver changes, hypercholesterolemia and impaired glycemic control are rising globally and may influence ocular refractive status through biochemical and osmotic mechanisms. However, the relationship between metabolic disorders and refractive errors has not been adequately explored. Objective: To evaluate the prevalence and age-wise concurrence of metabolic disorders (fatty liver changes, hypercholesterolemia, and elevated HbA1c levels) with refractive errors (normal vision, myopia, presbyopia and astigmatism). Methods: A cross-sectional observational study was conducted among adults aged 20–60 years. Participants were stratified into four age groups. Metabolic parameters were assessed using ultrasonography for fatty liver changes, serum cholesterol estimation for hypercholesterolemia and HbA1c levels for glycemic status. Other investigations such as blood pressure monitoring, electrocardiography (ECG) and treadmill test (TMT) were performed but excluded from the present analysis. Refractive status was determined using standard refractive examination techniques. The association between metabolic disorders and refractive errors was analyzed using the chi-square test. Results: Fatty liver changes and hypercholesterolemia peaked in the 30–50 years age group, while elevated HbA1c predominated in the 50–60 years group (88.9%). Refractive errors showed a transition from myopia in younger subjects to presbyopia in the older age group (81.5% in 50–60 years). Significant associations were observed between age group and metabolic disorders (p < 0.0001) and between age group and refractive errors (p < 0.0001). Conclusion: The present study highlights the association between metabolic disorders and refractive errors across different age groups, emphasizing the importance of metabolic evaluation in patients presenting with refractive abnormalities.

The medial collateral ligament (MCL) is commonly injured in the setting of anterior cruciate ligament (ACL) injuries. Because the MCL has better healing capacity than the ACL, the general perception is that MCL inju-ries can be treated conservatively. Treating these injuries conservatively, however, can lead to residual valgus laxity. Furthermore, it delays time to surgery, which prevents acute treatment of concomitant ACL injuries us-ing primary repair or acute reconstruction. Several treatment methods for MCL injuries have been proposed, including primary repair, augmented repair with autograft tissue, or primary reconstruction. In this surgical technique article, we present the technique of acute primary MCL repair with internal bracing with 2 lim-ited/mini-open incisions. With this technique, early surgical intervention is possible, and early rehabilitation is safe because of the internal bracing. Advantages include fast recovery, avoidance of muscle atrophy because of early mobilization, prevention of residual valgus instability, and maintenance of proprioception.

Purpose: To evaluate the efficacy of posterior subtenon interferon alpha-2b (IFN-α2b) combined with intravitreal bevacizumab (IVB) on central macular thickness (CMT) and best-corrected visual acuity (BCVA) in patients with macular edema. Methods: This observational analytical study included 40 eyes diagnosed with macular edema secondary to diabetic macular edema (DME), retinal vein occlusion (RVO), or age-related macular degeneration (ARMD). All patients received a single session of intravitreal bevacizumab (1.25mg/0.05ml) with posterior subtenon IFN-α2b (1mlU/ml). Outcomes were evaluated through CMT using spectral-domain optical coherence tomography (OCT) and BCVA on the LogMAR scale at baseline and post-injection follow-up. Results: Mean CMT decreased significantly from 507.9 ± 162.8 µm to 286.5 ± 78.6 µm (mean change −221.4 µm, p < 0.001) changes seen on October one month post injection. Mean BCVA improved from 1.13 ± 0.36 to 0.78 ± 0.25 LogMAR (mean gain −0.35 LogMAR, p < 0.001). All etiological groups (DME, RVO, and ARMD) showed significant anatomical and visual improvement. Severe macular edema (>500 µm) showed the largest CMT reduction (−354.4 µm) and BCVA improvement (−0.46 LogMAR). CMT reduction correlated strongly with visual improvement (ρ = 0.689, p < 0.001). Conclusion: Posterior subtenon IFN-α2b combined with intravitreal bevacizumab significantly reduces macular edema and improves visual outcomes. It is a promising steroid-sparing adjunct especially in severe or refractory cases.