Purpose: The purpose of the study is to determine the cut-off value of SED at the level of the thyrohyoid membrane significant for predicting difficult direct laryngoscopy. Methodology: This cross-sectional study was conducted in the Department of Anaesthesiology at Government Medical College, Idukki, over six months following IEC clearance. The study aimed to determine the cut-off value of sonographically assessed skin to epiglottic distance (SED) at the thyrohyoid membrane for predicting difficult direct laryngoscopy and its association with standard clinical parameters. The inclusion criteria were ASA I, II, and III patients over 18 years undergoing elective surgery under general anesthesia, who consented to participate. Exclusion criteria included patients with skin lesions on the anterior neck, pregnant women, and patients with any mass at the thyrohyoid membrane. A total of 50 participants were selected through consecutive sampling. Result: The study’s analysis of SED and BMI in predicting intubation difficulty provides key insights. For SED, the optimal cutoff value was 18.10 mm, yielding an AUC of 0.444, indicating poor discriminatory ability (p = 0.532). Sensitivity was 46.7%, specificity was 94.3%, PPV was 48.5%, and NPV was 96.0%. Despite the high NPV, the low AUC and PPV suggest limited overall reliability in predicting difficult direct laryngoscopy. The chi-square test showed a significant association between BMI and intubation difficulty (P = 0.03, X² = 7.493), suggesting that higher BMI may correlate with more challenging intubation experiences. Conclusion: The study examined various predictors of difficult intubation, including thyromental distance, mouth opening, temporomandibular joint insinuation, MMPC, skin-to-epiglottis distance (SED), and BMI categories. For SED, the optimal cutoff value was 18.10 mm, with an AUC of 0.444 and poor discriminatory ability (p = 0.532). BMI categories showed a statistically significant association with intubation difficulty (p = 0.03), with higher BMI correlating with more challenging intubation experiences.

DOI: 10.5281/zenodo.

Aim: The present study was planned to find the prevalence of INH and Rifampicin resistance in the treatment naïve new tuberculosis cases. We also tried to find a correlation between sputum grading, sociodemographic factors, and resistance patterns. Methods: It was a cross-sectional study done conducted in the Department of TB and Chest, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India for the period of 2 years. 100 patients were included in the study. All Adult patients attending Department of TB and Chest who were diagnosed with new sputum smear-positive tuberculosis and have not received ATT drugs for more than 2 weeks were included in the study after taking informed written consent. Results: A total of 100 newly diagnosed microbiologically confirmed cases of pulmonary tuberculosis were recruited in the study. Most of the patients were male (n=80, 80%) and a mean age of 45.435 (SD ±12.18) years. Based on the Modified Kuppuswamy socioeconomic scale 55% cases belonged to the lower socioeconomic group, whereas 35% belonged to the upper lower group. 20% were smokers and 80% were non-smokers. 85% patients presented with cough as chief complaint followed by Fever in 35%, loss of appetite in 50%, and loss of weight in 45% cases. Among comorbidities, Diabetes mellitus was most common followed by asthma. None of the cases had a previous history of anti-tubercular drug intake. All cases were HIV-Sero-negative. Conclusion: INH resistance was found to be low (5.6%) with negligible MDR in the current study. Regular and large studies are needed to quantify and tackle the problem of primary MDR TB.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess timely initiation of breastfeeding and associated factors among mothers of children less than 12 months old. Methods: The present study was conducted in Department of Pediatrics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India and mothers who have a child less than 12 months of age were included in the study. Total 1000 mothers were included in the study. Results: In this study, 500 mothers had infants less than 12 months participated in this study making the response rate 98%. The mean age of mothers that participated in this study was 24.96 with the standard deviation of (±0.970). About 700 (70) of respondents were Hindus in their religious affiliation. About 400 (40%) of mothers completed primary school and 750 (75%) of them were housewives. Around 520 (52%), and 480 (48%) of them were females and males respectively. About 900 (90%) of the study participants had exposure to mass media and the majority of respondents. The highest majority, 850 (95) of respondents had received antenatal care (ANC). About 800 (88.88%) of participants started their antenatal care before fifth month of gestation. Majority, 520 (57.77%) had four antennal visits. 586 (65.12%) of the study participants had gotten counseling on breast feeding. 500 (55.55%) were receiving counseling on timely initiation of breastfeeding. 800 (80%) respondents delivered at health institutions and 440 (88%) of them were assisted by health professionals. 860 (86%) of the mothers had spontaneous vaginal delivery. About 34% mothers did not give breast milk within 1 hour after delivery to their infants because of maternal illness. The Bivariate logistic regression analysis yielded that sex of the child, place of delivery for the current child, mode of delivery, exposure to media and family type were statistically associated. Conclusion: Prevalence of timely  initiation of breast feeding experienced by mothers was 80%. Being male infant, living with nuclear family, spontaneous vaginal delivery and counseling on timely initiation of breast feeding during ANC were factors associated with early initiation of breastfeeding.

DOI: 10.5281/zenodo.

Introduction: Thyroid hormone abnormalities frequently coexist with liver diseases, impacting disease progression and treatment outcomes. This study aims to explore the spectrum of thyroid dysfunction in liver diseases, elucidating underlying mechanisms to guide targeted interventions and improve patient care. Methods: The study enrolled eligible inpatients with liver disease, conducting detailed history-taking, clinical examinations, and investigations including thyroid function tests. Symptom duration categorized liver disease as acute or chronic, with ascites and hepatic encephalopathy graded for severity. Institutional ethical approval and informed consent were obtained. Child-Pugh scores assessed chronic liver disease severity. Results: Ninety-six participants were included, 12 with acute liver disease (ALD). Mean ages were 44.83 ± 15.33 for ALD and 46.13 ± 13.99 for chronic liver disease (CLD). Gender distribution: ALD (91.7% male), CLD (20.2% female). Significant associations were found between ALD and CLD in ascites severity and thyroid hormone levels. Conclusion: The study elucidates the diverse presentations and underlying mechanisms of liver diseases, highlighting age and gender disparities, as well as the intricate interplay between liver and thyroid function. These findings underscore the importance of personalized management strategies tailored to individual patient characteristics, optimizing clinical outcomes in liver pathology.

DOI: 10.5281/zenodo.

Introduction: Stroke, a cerebrovascular accident, results from vascular causes, including ischemic or hemorrhagic events. Its diagnosis relies on clinical assessment and imaging studies. With a significant global health burden, stroke ranks among leading causes of morbidity and mortality. Prevention and management strategies, including Mean platelet volume (MPV) association studies, are vital for mitigating its impact. Methods: This cross-sectional study involved thorough clinical assessments using a pre-designed questionnaire and diagnostic tests. Stroke severity was evaluated using the Modified Rankin Scale (MRS), providing insights into disability-adjusted life years (DALY). Statistical analysis utilized a significance level of P< 0.05 to determine meaningful associations. Results: The study involved 92 participants, mean age 60.39 ± 7.75 years, with 53.3% male and 46.7% female. Prevalence rates included hemiplegia (34.8%), altered sensorium (22.8%), headache (19.6%), vomiting (18.5%), convulsions (4.3%), hypertension (47.8%), coronary artery disease (32.6%), dyslipidemia (31.5%), and smoking history (28.3%). Glasgow Coma Scale categorized severity. MPV remained stable across time points. Conclusion: The study underscores the significant impact of stroke, with consistent findings across age, gender distribution, symptomatology, comorbidities like CAD and severity based on GCS scores. Furthermore, it highlights a notable association between MPV and stroke severity.

DOI: 10.5281/zenodo.

Introduction: Bloodstream infections (BSIs) are a leading cause of morbidity and mortality in hospitalized patients. Coagulase negative staphylococcus (CoNS) is the leading cause for the contamination of blood cultures (BCC). With this a study was conducted to find the various pathogens isolated in the blood cultures those with BSIs. Methods: It was a prospective research, conducted in the department of Microbiology, Rangaraya Medical College, Kakinada between March to May 2024. Individuals aged >18 years suspected with BSIs were included, those on antimicrobial treatment were not considered. Two blood samples were collected as per the guidelines and Brain heart infusion (BHI) biphasic media was used for culture. Blood culture, identification were carried as per the guidelines. Results: Total 74 members were included and 22 (30%) blood cultures were positive. Klebsiella (8) was the leading isolate followed by Esch.coli (5), Staph. aureus (4) Acinetobacter baumannii (3) and CoNS (2). Maximum drug resistance (DR) was observed to ampicillin and there was no Vancomycin resistance. Conclusions:  In this study, 30% blood culture were positive. GNRs are the common isolates and Klebsiella was the common isolate. No significant DR was identified. Short duration is the limitation of this research.

DOI: 10.5281/zenodo.

Aim of the Study: To assess the incidence of contrast induced nephropathy, defined as a raise in post-procedural creatinine by >25% over the baseline, in patients undergoing cardiac catheterization studies. Material & Methods: Patients were identified as hypertensives if already diagnosed and on treatment or newly detected with a Blood pressure of 140/90 or more as defined by JNC. Patients with Diabetes mellitus were defined as known diabetics on treatment or patients with a random blood sugar value of >200mg/dl as defined by ADA guidelines. Blood. Results: Results are presented as mean ± SD or a percentage of the total. The significance of difference in means between two groups was calculated by means of Student’s t test and the significance of difference in proportions were compared with Pearson’s χ2 (chi-square) test. Statistical significance was taken to be significant at 1% level when P value was < 0.001, significant at 5% level when P value was between 0.011 to 0.05, and not significant at 5% level when P value was >0.05. Conclusion: It was noted that among the 200 patients followed up in the Department of Cardiology 56 developed CIN (28%). Among the patients who developed CIN, it was noted that common risk factors were increased Age, elevated baseline serum creatinine, low baseline creatinine clearance, and multi-vessel coronary disease. Identification of these risk factors before subjecting the patient to angiogram studies gives us an opportunity to anticipate development of CIN and to use prophylactic measures to prevent CIN.

DOI: 10.5281/zenodo.

Background: Proximal femoral nail antirotation-2 (PFNA-2) has been extensively utilized for treating intertrochanteric fractures, with previous studies reporting varied outcomes. The entry point of the nail is crucial for achieving acceptable reduction, stable fixation, and minimizing implant-related complications. This study aims to determine the optimal greater trochanteric entry point for PFNA-2 in managing unstable intertrochanteric femur fractures. Methods: A retrospective analysis was conducted to assess the outcomes of PFNA II nail fixation in unstable intertrochanteric fractures. The study cohort comprised 20 patients (15 males and 5 females) with a mean age of 58.66 years (range: 35-70 years). Right hip involvement was observed in 12 patients, while the remaining 8 patients sustained fractures in the left hip. The majority of fractures (10) were attributed to low-energy falls. The remaining cases were caused by high-energy mechanisms such as motor vehicle accidents or falls from a significant height. Preoperative radiographs were used to classify the fractures according to the AO classification system, with distribution as follows: 10 (31.A1), 7 (31.A2), and 3 (31.A3). Results: PFNA II nails showed promise for intertrochanteric fractures (n=20). Small (200mm) nails were the most common (50%). Most patients achieved good fracture healing (75%) and alignment (75%). Intraoperative complications were limited (fracture of the greater trochanter in 15%). Postoperative complications were mostly minor (nail mismatch 10%, pain 5%). Functional outcomes were positive, with 80% of patients achieving good or excellent scores on the Harris Hip Score. Conclusion: In conclusion, our study suggests that the PFNA II nail presents a promising option for the surgical management of unstable intertrochanteric fractures. This fixation method offers potential advantages of reduced operative time and a demonstrably low complication rate.

DOI: 10.5281/zenodo.

Background: According to the World Health Organization (WHO), obesity is one of the most common neglected public health problems in both developed and developing countries. Undernutrition due to poverty, dominated in the past is being rapidly replaced by obesity associated with affluence. Aim: To study the prevalence of undernutrition and overnutrition among young medicos. Materials and Methods:  The study was done among young medicos who joined in Ⅰ MBBS in Government Medical College, Ananthapuramu from all over India. A total of 150 students were included in the study. Out of them, 73 were females, 77 were males. Anthropometric measurements of Height and Weight of each student were taken. BMI was calculated. Subjects were categorized based on BMI, as Underweight, Normal, Overweight and Obese. Waist Hip Ratio was measured and calculated. Random blood sugar values were measured to assess the glycemic status. Hemoglobin levels were measured and assessed for the presence of anaemia. Results: Based on BMI, the overall prevalence of Malnutrition in the present study was 38.6 %, Under nourished was 16.6 %, and over nourished was22 %. Based on WHR, prevalence of Obesity is more in females (47%) when compared to males (23.3%). The prevalence of Anaemia was more in males (44.2%) compared to females (41%). In this study, BMI was not significantly related with anaemia. In the present study, all 150 students RBS values were within the normal range. Conclusion:  Overnutrition, incidence is increasing in all ages including adolescence. Hence nutritional evaluation should be done in all ages which will help in giving proper preventive measures like Lifestyle modification thereby prevention of various metabolic and cardiovascular diseases.

DOI: 10.5281/zenodo.

Background: Thalassemia is a genetic disorder marked by reduced or absent globin chain synthesis in haemoglobin. Approximately 15 million people globally suffer from thalassemia, with 240 million carriers of β-thalassemia. In India, 30 million are carriers, and 12,000 infants are born annually with severe forms. This study aim to evaluate serum ionized calcium levels in thalassemia major patients and explore the correlation between serum ferritin and calcium levels. Methods: An observational study (March 2023 – March 2024) at C. U. Shah Hospital, Gujarat, involved 50 children (ages 1-18 years) with transfusion-dependent beta thalassemia. Exclusion criteria included those on calcium, vitamin D supplements, or non-deferasirox iron chelators. Data collection comprised patient’s histories, clinical examinations, and blood tests (serum ferritin and ionized calcium). Pearson correlation test was used for statistical analysis. Results: The majority of patients were in the 5-10 year age group, with a male predominance (64%). Most were from rural backgrounds and the mean age was 8 years. Most children were diagnosed between 6-12 months (52%).A significant negative correlation was found between serum ferritin and serum ionized calcium levels (r = -0.674, p < 0.001). Treatment with deferasirox significantly reduced serum ferritin levels over time. Conclusion: This study shows a significant inverse relationship between serum ferritin and ionized calcium levels in transfusion-dependent beta thalassemia major patients. Regular monitoring and effective use of iron chelators are crucial to prevent complications. Future research should explore combined therapies and genetic mechanisms of iron-induced hypoparathyroidism to optimize care.

DOI: 10.5281/zenodo.

Background: The Branchial artery is a continuation of the axillary artery, begins at the distal border of the tendon of the teres major and about a centimeter distal to the elbow  joint i.e.  at the level of the neck of the radius it is dividing into radial and ulnar arteries. There are so many variations in the bifurcation of brachial artery like higher level, low level bifurcation etc. Variations in bifurcation are clinically significant while during arterial canulation to the clinicians. Materials & Methods: During routine dissection of adult cadavers of 30-60 years age at department of Anatomy in Rangaraya Medical College, Kakinada & Government Medical College, Ananthapuram. While performing dissection of upper limb, level of bifurcation of brachial artery is observed in 40 upper limb specimens [20 cadavers]. Results: Among 40 upper limb specimens, in 2 right upper limb specimens [out of 20] higher level bifurcation of brachial artery is observed. Out of 20 left upper limb specimens, 2 left upper limb specimens show bifurcation at higher level. In 36 specimens, bifurcation is at normal level. Low level bifurcation is not seen in any specimen. Conclusion: Knowledge about the morphological variations of the brachial artery and its course, branching of artery and anastomoses is crucial while analyzing the angiograph, planning orthopedic reconstructive and vascular procedures in damaged upper limbs. This information is crucial to Anaesthesia doctors, Emergency physicians, General surgeons.

DOI: 10.5281/zenodo.

Background: Bladder cancer is one of the most common urological malignancies. Bladder cancer is caused by genetic abnormalities and external risk factors, including carcinogen exposure, nutritional factors, fluid intake, alcohol, inflammation, infection, chemotherapy, radiation and possibly artificial sweeteners. Arsenic consumption as a causative factor in bladder carcinoma is studied here. Aims: To study whether arsenic levels in serum, urine and bladder tissue are higher in carcinoma bladder patients and the relationship between blood arsenic levels and the grade of bladder cancer. Methods: This cross-sectional observational study was conducted at coming to Ramakrishna Mission Seva Pratishthan Hospital between June 2014 to June 2016. 102 patients who underwent TURBT were assessed for blood arsenic levels and tumour arsenic levels. 51 of them were already diagnosed with bladder carcinoma and 51 were controls. Results: Significantly (p<0.001) higher percentage of bladder tumour with advanced clinical stage was found among arsenic positive cases than that of arsenic negative cases. A significantly higher level of expression of PCNA was recorded in tumour samples compared to the control. A higher frequency of expression of PCNA in arsenic-positive samples compared to that of arsenic-negative samples in both cases and controls was found (p<0.001). Conclusions: Arsenic endemicity is associated with a higher incidence of high-grade cancers in comparison to low grade bladder cancers. Detecting arsenic positivity in bladder cancers may help in changing our way of managing of arsenic-positive bladder cancers, i.e., arsenic-related bladder cancers do demand more aggressive therapeutic intervention and more intensive follow-up.

DOI: 10.5281/zenodo.

Background: A number of risk factors, including central obesity, high blood pressure, raised blood sugar, high triglycerides, and low levels of high-density lipoprotein (HDL) cholesterol, are associated with metabolic syndrome (MetS). MetS has been linked to an increased risk of death, cardiovascular disease (CVD), and type 2 diabetes. Several population-based studies have demonstrated that people with MetS are more likely to develop cardiovascular disease (CVD) than people without the syndrome. MetS has also been associated with non-traditional risk factors, such as microalbuminuria, inflammatory indicators, and elevated uric acid levels. Studies have shown a link between obesity and elevated uric acid levels, which makes obesity and MetS a substantial risk factor for CVD. MetS is becoming more and more common in both developed and developing countries. Adults from Bangladesh are especially prone to MetS, and its prevalence has significantly increased in recent years. According to a recent assessment, 32% of women and 25% of men in Bangladesh have MetS, which has a high prevalence (30%). Material and Method: The Department of General Medicine was the site of this cross-sectional investigation. Those between the ages of 30 and 49 who had no prior history of gout, diabetes, cancer, heart attack, stroke, or renal illness met the eligibility requirements. Three people with kidney and heart failure were eliminated from the group that was chosen, leaving 30 people in the MetS group and another 30 in the control group. Additionally excluded were subjects on lipid-lowering, antihypertensive, or anti-diabetic drugs, as well as hypouricemic agents. Before the test, participants were told to eat only vegetables for three days. Before participating in the study, each subject gave written, informed consent. Results: Serum uric acid levels in the MetS group were considerably greater than those in the non-MetS group, even after controlling for confounding variables. In comparison to the non-MetS group, the MetS group participants showed lower levels of high-density lipoprotein (HDL) and higher levels of triglycerides (TG), total cholesterol (TC), waist circumference (WC), lean body mass (LBM), body fat mass (BFM), trunk fat mass, insulin levels, HOMA index, fasting plasma glucose (FPG), and systolic and diastolic blood pressure (DBP). Even after controlling for age, sex, and BMI in this investigation, the mean serum uric acid level in the MetS group remained considerably higher. After correcting for gender and age, the odds ratios (ORs) rose. The regression model results indicated that in model III (adjusted for age, sex, and BMI), each 1 mg/dl increase in serum uric acid level approximately doubled the odds of developing metabolic syndrome. Conclusion: Serum uric acid almost increased the chance of developing MetS and showed an independent correlation with its components. Future studies should examine the function of uric acid in the pathophysiology of MetS and the clinical significance of these findings, given the high prevalence of obesity and MetS and the possible link between hyperuricemia and CVD. According to this study, there is a high correlation between serum uric acid and the metabolic syndrome and its constituents, including serum triglycerides and waist circumference.

DOI: 10.5281/zenodo.

Background: Temporomandibular disorders (TMDs) are a group of conditions that cause pain and dysfunction in the jaw joint and muscles controlling jaw movement. Managing pain associated with TMDs is critical for improving patients’ quality of life. Gabapentin, an anticonvulsant, is commonly used for pain management. This retrospective study aims to compare the efficacy of gabapentin alone and in combination with nortriptyline, a tricyclic antidepressant, in managing pain-related TMDs over an 18-month period. Materials and Methods: A retrospective analysis was conducted on 40 patients diagnosed with pain-related TMDs at a tertiary care center in Darbhanga. Patients were divided into two groups: Group A received gabapentin alone, while Group B received gabapentin combined with nortriptyline. Pain levels were assessed using the Visual Analog Scale (VAS) at baseline, 3 months, 6 months, 12 months, and 18 months. Additional parameters such as functional jaw movements and patient satisfaction were also evaluated. Results: The study included 40 patients (20 in each group). Group A showed a significant reduction in pain scores from a mean VAS score of 7.5 at baseline to 4.2 at 18 months (p < 0.05). Group B demonstrated a more pronounced reduction in pain scores, from a mean VAS score of 7.6 at baseline to 2.8 at 18 months (p < 0.01). Improvement in functional jaw movements and higher patient satisfaction were observed in Group B compared to Group A. No significant adverse effects were reported in either group. Conclusion: The combination of gabapentin and nortriptyline is more effective in reducing pain and improving functional outcomes in patients with pain-related TMDs compared to gabapentin alone. This combination therapy may offer a superior treatment option for managing pain-related TMDs.

DOI: 10.5281/zenodo.

Background: Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. The incidence of pregnancy-related uterine rupture of 1 per 1,416 pregnancies (0.07%). Aims and Objectives: (1). To study the incidence and risk factors of prelabour uterine rupture in a tertiary care hospital. (2). To study the maternal and foetal outcomes. Materials and Methods: This is retrospective study conducted in a tertiary care hospital of east India for period of 4 years (October 2017 to September 2021). 33 cases of prelabour uterine rupture who had come to the emergency labour room department were included in the study. The data of these patients were analyzed and the data regarding demographic characteristics, risk factors, maternal and fetal outcomes, and postoperative complications was studied. Result: The incidence of prelabour uterine rupture was 0.097%. Majority of women were >30years (73%), multigravida (64%), unbooked (76%), beyond term pregnancies (82%). 84.7% women had history of scarred uterus and 15.3% had unscarred uterus. In 73% cases repair of rupture was done and in 27% cases hysterectomy was done. Postoperative complications included fever (33%), wound infection (9%), scar dehiscence (6%). 97% required blood transfusion. Maternal mortality occurred in 3% cases. 18% babies were alive and healthy. 73% were IUD. 6% needed NICU admission. 3% were stillbirth. Conclusion: Prelabour rupture uterus is rare but preventable cause of maternal and foetal compromise. Better healthcare facilities and outreach programmes can eliminate the risk factors and lead to prevention.

DOI: 10.5281/zenodo.

Introduction: Indeed, concentrating only on patients who require extended stays in the intensive care unit may miss crucial information about how patients who require shorter stays recover. Following a brief ICU stay, recovery might bring new considerations and problems. For example, even brief episodes of severe illness and ICU admission can result in functional limits, psychological discomfort, cognitive decline, and physical weakening. A patient’s quality of life and capacity to reintegrate into regular activities may be greatly impacted by these problems. Materials & Methods: Routine data gathering included access to retrospective information about the ICU stay. Some of these were length of stay in the intensive care unit and amount of time on mechanical ventilation. Notably, the study sample purposefully included patients who had brief stays in the intensive care unit. The data showed in the table are represented as “n” which is number of patients and (%) percentage calculated. Results: Sixty two of the 232 participants had at least one post-ICU impairment that was identified six months after they were released from the ICU. Of these, 39 patients (17%) had only been in the ICU for less than 72 hours. Conclusion: Six months after being discharged, a number of patients who were in the ICU for less than 72 hours are reporting post-ICU impairment. Research and treatments pertaining to this group are sometimes neglected. Further research on post-ICU damage in patients who stay shorter periods is warranted.

DOI: 10.5281/zenodo.

We Present a Patient of Phenol Poisoning Induced Acute Haemolysis with Methemoglobinemia with Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency. G6pd Deficiency Commonly Presents with Acute Intravascular Haemolysis Precipitated by Oxidative Stress Induced by Various Infections, Medications and Drugs. Additionally, We Discuss the Mandatory Requirement of G6pd Analysis Before Methylene Blue Injection.

DOI: 10.5281/zenodo.

Background and Objectives: Spirometric measurement of post bronchodilator FEV1 is essential for assessment of severity in COPD. Six minute walk test (6MWT) is a simple, objective and reproducible test used to measure functional capacity of COPD patient. The COPD Assessment Test (CAT) score is a validated test for evaluation of COPD impact on health status. Our objective is to find relationship between Spirometry, 6MWT and CAT Scores in assessing COPD severity. Methods: This is hospital based Observational study. Fifty patients of COPD were enrolled after applying inclusion and exclusion criteria. All patients underwent spirometric measurement of FEV1, FVC, and FEV1/FVC1. 6MWT was done using ATS protocol of.

DOI: 10.5281/zenodo.

Background: Early and accurate diagnosis of acute respiratory failure leads to improved outcomes of patient management. It relies on reliable imaging modality, which is difficult in an emergency setting. 3 Patients admitted in intensive care units are difficult to mobilize for modalities like CT thorax. Hence the importance of bedside ultrasonography in such scenario emerges. It is useful in diagnosis of pneumonia, pleural effusion, pneumothorax, interstitial lung disease etc. Objective: To study the sensitivity and specificity of chest ultrasound in patients with acute respiratory failure. Methods: This was an observational study conducted in the Department of Pulmonary Medicine, Gauhati Medical College and Hospital from December 2022 to July 2023. Sixty one patients of acute respiratory failure were enrolled in the study and were evaluated with chest X ray, CT Thorax and chest ultrasonography. Results: Out of the sixty one cases, twenty three patients were diagnosed as pleural effusion (38%), thirteen patients were diagnosed as consolidation (21%), five patients were diagnosed as pneumothorax (8%), eight patients were diagnosed as COPD (13%) and remaining twelve cases were diagnosed to be pulmonary oedema (20%). Overall sensitivity of USG in our study was found to be 86.8%. However, it was found to be least useful for COPD with sensitivity of 62.5%. Conclusion: Chest ultrasonography with sensitivity of 85.2% is found to be a superior bed side imaging modality compared to standard chest radiography in identifying pleural effusion, pneumothorax, consolidation, pulmonary oedema and COPD. It is also very useful in differentiating an effusion from pleural thickening or consolidation.

DOI: 10.5281/zenodo.

Alcoholism is one of the most serious global public health problem. Regarding disease Burden Alcohol is the world’s third largest risk factor. It is estimated that the total number of the population classified as alcohol consumers in the world goes up to 2 billion, while 76.3 million people develop alcohol use disorder. Alcoholism is characterised by increased tolerance and physical dependence on alcohol, affecting an individual’s ability to control alcohol consumption safely. Impact of alcohol on haematopoitic system divided into direct and indirect effects. Direct effect seen in bone marrow and involves red cell, white cell and platelet lines. Indirect effect due to metabolic or physiologic alterations resulting in liver disease and nutritional abnormality such as folate deficiency. Objective of study was to  compare haemoglobin, RBC counts PCV, Blood Indices changes in severe alcoholics as compare to non-alcoholics. 50 patients who are severe alcoholics and 50 adults patients who are non-alcoholics are included in study. Present study  shows mean haemoglobin content and RBC count was less than normal values which tells that most of alcoholics are anemic. Mean values of MCV was more than normal range, which shows anemia seen in alcoholics was macrocytic.

DOI: 10.5281/zenodo.

Background: The COVID-19 pandemic had caused sudden and significant changes in the lives of the students. To protect the health of the students, the education institutions were closed and there had been quick transition to online classes. There was lockdown and they had constraints on physical movement and social activities. Because all these changes were unprecedented and intensive, it was bound to affect the mental health of the students. Hence, this study was undertaken to assess the prevalence of depression, anxiety and stress among college going students and their utilization of Mental Health Services. Methods: A Descriptive cross-sectional study was conducted among 440 Undergraduate students of 10 colleges of Guwahati city, age group between 16- 25 years from April 2022 to September 2022. A predesigned, pretested questionnaire consisting of socio-demographic profile, personal characteristics of students, the 21- item DASS scale and information on utilization of Mental Health Services by the college students was used. Data were entered in IBM SPSS 26. Descriptive statistics like frequencies and percentages were used to express data. Chi-square test was used to check significance between proportions. Results: Present study findings revealed that stress (44.5%), anxiety (24.78%) and depression (17.05%) were prevalent among the college students of Guwahati city during the COVID-19 pandemic. Gender is significantly associated with stress, with males being 3.7 times more at risk compared to females. Socioeconomic status was significantly associated with stress, anxiety and depression. Students who lived in hostels, paying guests etc. were more prone to develop psychological distress compared to the students who lived with their families. Only 29.9% of the students had access to mental health counsellors in their educational institutions. Among the participants who had access to mental health counsellors, only 7.8% ever used the services. Conclusion: There was concerning prevalence of stress, anxiety and depression among college students during COVID-19 pandemic and availability of mental health services in their study institutions and utilisation of mental health services were alarmingly low. Awareness programmes about mental health among college students and emergency preparedness for major worldwide disasters like the COVID-19 pandemic are necessary.

DOI: 10.5281/zenodo.

The study aims to explore the diverse physiological and pathological skin changes experienced by pregnant women, including pigmentary alterations, vascular variations, glandular shifts, and infections. By understanding these changes, the goal is to enhance understanding of their impact on women’s lives and improve pregnancy-related dermatological care. Methods: A prospective observational study was conducted at GSL Medical College’s Obstetrics and Gynaecology department. Pregnant women over 18 attending the hospital outpatient services were included. Detailed obstetric and clinical histories were collected via questionnaire, followed by physical and obstetric examinations, including dermatological assessments. Routine antenatal investigations were conducted, with additional tests as needed for diagnosis confirmation. Results: Among 183 participants (mean age: 23.58 ± 3.95 years, mean gestational age: 27.88 ± 8.06 weeks), pigmentary changes (79.4%) and striae gravidarum (76.7%) were common. Melasma was predominantly centrofacial (60.8%). Specific dermatoses significantly differed between primi and multi, peaking in the third trimester. Infections showed no significant difference between primi and multi. Conclusion: The study underscores the prevalence of pigmentary changes, striae gravidarum, and other dermatological alterations during pregnancy, influenced by hormonal fluctuations and mechanical stretching. Differences in specific dermatoses between primiparous and multiparous women are noted, particularly in the third trimester, while infection rates remain consistent regardless of parity.

DOI: 10.5281/zenodo.

Introduction:  Beta-thalassemia, a common blood disorder, causes severe anemia in children with Beta-Thalassemia Major (BTM). This study at a tertiary care center in India aims to identify liver, kidney, and hormone function in children with BTM, a disease highly prevalent in this region. Methods: This hospital-based study observed children under 15 with BTM. With parental consent, researchers collected detailed medical histories, demographics, and conducted physical exams. Blood samples (3ml) were drawn for tests like liver and kidney function, blood counts, and hormone levels. Blood was stored cold for further analysis. Results: The study enrolled 38 children with BTM, with an average age of 9.4 years. There were more boys than girls (boy: girl ratio of 0.9). The study found that 40% of the children had liver involvement and 7.9% had thyroid involvement. The children also required an average of 9.8 blood transfusions per year. Conclusion: This study in children with BTM identified potential liver involvement in 40% and thyroid dysfunction in 7.9%. The high transfusion burden (9.8 annually) highlights the need for iron chelation therapy to manage complications. These findings emphasize the importance of monitoring liver, thyroid function, and iron overload for better BTM management.

DOI: 10.5281/zenodo.

Introduction: This research investigates maternal and fetal outcomes in post-term pregnancies, aiming to assess associated risks beyond 40 weeks of gestation. Increased fetal macrosomia risk, stillbirth risks, and complications like oligohydramnios and were reported in the literature. Methods: This prospective study focused on antenatal cases beyond 40 weeks of gestation, selecting participants with regular menstrual cycles and known LMP or confirmed by first-trimester ultrasound. Singleton pregnancies were included, while high-risk cases were excluded. Data on maternal and fetal outcomes were retrospectively analyzed at a tertiary care center. Results: The study included 138 women with a mean age of 22.97 ± 3.59 years, majority aged 21-25 years. Most had normal vaginal delivery (63%), while 32% underwent cesarean section. Newborns weighed predominantly over 2.6kg (96.4%). Gestational age correlated with increased rates of non-reactive CTG, labor induction, meconium-stained liquor, cesarean section, and maternal complications. Conclusion: Post-term pregnancies pose increased risks for adverse maternal and neonatal outcomes, including higher rates of cesarean section, maternal complications, and NICU admissions. Vigilant monitoring and timely intervention are crucial in mitigating these risks and optimizing outcomes for both mothers and newborns.

DOI: 10.5281/zenodo.

Introduction: Gynecological emergencies (GEs) require swift intervention, traditionally led by gynecologists. This study investigates the crucial role of general surgeons in GEs, emphasizing their surgical expertise and interdisciplinary collaboration, aiming to improve patient outcomes and identify areas for enhancement. Methods: A prospective study was conducted at KIMS, Amalapuram, from January to March 2024. Female patients aged 18 and above requiring emergent surgical intervention for gynecological conditions were included. Primary outcomes included time to intervention, surgical outcomes, complication rates, hospital stay, and mortality. Secondary outcomes encompassed patient satisfaction and recovery times. Data were collected, analyzed, and supplemented by surveys and case studies. Results: The study involved 100 patients with GEs, where general surgeons participated in 60% of cases. General surgeons led to faster surgical intervention (2.5 vs. 3.8 hours), lower complication rates (12% vs. 18%), shorter hospital stays (3.2 vs. 4.5 days), and higher patient satisfaction (85% vs. 70%). Interdisciplinary collaboration received strong medical staff support (90%). Conclusion: This study underscores the benefits of integrating general surgeons into GE management, leading to improved outcomes, shorter hospital stays, increased patient satisfaction, and faster recovery. Interdisciplinary collaboration between general surgeons and gynecologists holds promise for enhancing patient care and optimizing resource utilization in healthcare systems.

DOI: 10.5281/zenodo.

Introduction: Screen time (ST) is increasingly common in children’s lives, impacting language development. Research shows direct parent-child interactions are crucial for language acquisition, with excessive ST hindering this process. While educational screen content can help, personal interaction is essential. A study investigated ST in 1-5 year-olds to understand these effects. Methods: This hospital-based observational study included 1-5-year-old children with access to digital devices from the pediatric OPD. Using a questionnaire and the Receptive–Expressive Emergent Language Scale (REELS), it assessed ST and language skills to analyze the impact of digital exposure on early childhood language development. Results: The study included 318 children (61.3% boys, 58.5% rural). Higher ST correlated significantly with language delays: 3.11 hours/day led to receptive language delay, while 1.58 hours did not. Similarly, 2.94 hours/day resulted in expressive language delay, unlike 1.48 hours. Statistical analysis confirmed these associations (P < 0.05). Conclusions: Higher ST in young children is significantly associated with both receptive and expressive language delays. Limiting screen exposure and encouraging interactive, language-rich activities are crucial for fostering healthy language development in early childhood. Timely intervention is essential for mitigating these negative impacts.

DOI: 10.5281/zenodo.

Background: Chronopharmacology is a branch of medicine that investigates the relationship between biological cycles and medication effectiveness. It is underappreciated, underrepresented, and underutilised in drug research, regulatory affairs, and clinical practice. Improving medical personnel’s grasp of chronotherapeutic principles can encourage reasonable medication use, prevent overexposure, and reduce the incidence of adverse drug reactions. The purpose of this study was to assess doctors knowledge, attitudes, and behaviours regarding chronopharmacology in a tertiary care hospital. Methods: 196 doctors participated in a cross-sectional, descriptive study with a pretested and validated questionnaire. The questionnaire measured knowledge of individual drugs and their optimal timing, attitudes towards chronotherapy, and self-reported practices for medication timing and patient counselling. Results:  Most doctors correctly recognised the optimal timing for some prescriptions (e.g., nifedipine for hypertension in the morning, statins at night), but considerable gaps occurred for others (e.g., H2 blockers for ulcers before dinner, bronchodilators for asthma in the evening). Doctors were largely favourable about chronotherapy, believing it may lessen bad medication effects and improve efficacy. They also advocated for incorporating chronotherapy into patient counselling and including chronotherapeutic information in pharmacological reference materials. Most doctors include precise medication timing in prescriptions and coach patients on timing in their practice. Only a quarter of trainees got formal chronopharmacology coursework. This study demonstrates the potential benefits of chronotherapy and clinicians’ positive opinions towards its use. However, it also indicates a major information gap regarding the best scheduling for various drugs. Integrating chronopharmacology information into medical curricula and updating pharmacological references could help to close this gap. Additional research is required to determine the cost-effectiveness of chronotherapy programmes. Limitations: The study used self-reported data and had a small sample size. More research is needed to see whether this is applicable in other healthcare settings. Conclusion: Doctors have positive attitudes towards chronotherapy, but lack thorough understanding. Addressing this knowledge gap through focused education will help to optimise pharmaceutical regimens and possibly enhance patient outcomes.

DOI: 10.5281/zenodo.

This research delves into the intricate spectrum of outcomes observed in individuals with burns injury by comparing objectives with our own score with other established scores to access prognosis. This is single centered, observational, prospective & comparative study for patients admitted at tertiary health care institute.50 patients satisfying the inclusion exclusion criteria admitted in the burns wards of the hospital were included. In the present study 86% subjects were survived while the mortality was among 14% study subjects. We observed mortality was greater among the subjects with comparative higher SPBSS score. Background: Burns are devastating injuries that can produce permanent disfigurement, physical dysfunction, psychological morbidity, and death. The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low-level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level more than five thousand people (18.9 per 100,000 population) 1 are hospitalized for an average of 13 days, with a mortality rate of 4.1%. Early prediction of outcome (i.e., survival or mortality) may help triage effectively, and to implement early medical and surgical interventions efficiently. In tum, better care could reduce hospital complications, shorten length of stay, improve quality of life, and enhance survival.

DOI: 10.5281/zenodo.

Introduction: Aortic arch is a continuation of ascending aorta, being located in the superior mediastinum.The most common branching pattern in humans consists of three great vessels originating from the arch of the aorta i.e. the Brachiocephalic trunk, Left common carotid artery & Left subclavian artery. The Brachiocephalic trunk again gives off Right common carotid artery & Right subclavian artery. Vertebral artery originates from the first part of Subclavian artery. Objective: To study and identify variations in the branching pattern of Aortic Arch. Materials And Methods: The anomalies in the branching pattern of the Aortic arch were identified during routine dissection in a study conducted over a period of 3 years on 30 formalin-fixed cadavers allotted for undergraduates in Osmania Medical College, Hyderabad. After removal of the anterior thoracic wall, fat, and the pericardium covering the ascending aorta, arch of aorta, and the great vessels, the variation in the branching pattern was observed. The aortic arch and its variation in branching were coloured red for their visualisation. Results: Out of total 30 formalin-fixed cadavers, three cadavers were found to have the left common carotid artery originating from the brachiocephalic trunk which then crossed the trachea anteriorly from right to enter the left side of the neck. The further course, branching, and termination of these arteries (brachiocephalic trunk, left common carotid, and left subdavian arteries) were normal. In another two cadavers, the left vertebral artery was seen to be originating directly from the arch of aorta in between the left subdavian and left common carotid arteries. Its course was traced above up to the foramina transversarium of the C6 vertebra and was found to be normal. Conclusion: Although anomalous origins of the aortic arch branches are merely anatomic variants, a detailed knowledge of it is needed by Interventional Radiologists, Cardiologists, and Cardio-thoracic surgeons to avoid complications during procedures like Anterior cervical spine surgery, Thyroid surgery, four-vessel cerebral angiography & intervention, Diagnostic & Therapeutic catheter-based Aortic interventional procedures, Thoracic and Head & Neck surgeries. It has been reported that anomalies of the aortic arch branching pattern particularly anomalous origin of the Vertebral artery could lead to cerebral abnormalities by altering the pattern of blood flow in cerebral vessels. In addition, knowledge of abnormal branches originating from the aortic arch is also important in the diagnosis of intracranial aneurysms following subarachnoid hemorrhage.

DOI: 10.5281/zenodo.

Background: Obesity in pregnancy predisposed to various serious pregnancy complications and to higher long-term morbidity and mortality rates. Overweight and obese women have reproductive disadvantages. Obesity in pregnancy puts the mother and baby at the risk of several complications such as preeclampsia eclampsia, diabetes mellitus, preterm labour, Malpresentations, assisted vaginal delivery, instrumental delivery, elective caesarean delivery, shoulder dystocia, post-partum haemorrhage, pelvic infection and wound infection. Neonates of these mothers were mostly large for gestational age, macrosomia, congenital malformation particularly spina bifida, cleft lip and palate heart disease and still birth. Aim: To study the antenatal complications, obstetric outcome and neonatal outcome in overweight and obese women and women with normal BMI. Material & Method:  Prospective comparative Study, done in 400 pregnant women attending Outpatient and Inpatient of Government Maternity Hospital, Tirupati for two years period. Results & Conclusion: In our study the numerous maternal and neonatal complications were observed among overweight and obese pregnant women which were a considerable challenge in obstetrics. In addition, overweight and obesity among women of reproductive age group was associated with a number of health risks factors. This shows the importance what we should give and what level of measures we should take to reduce the increasing incidence of obesity among reproductive women. The ideal time of intervention is before women become pregnancy, because it is not advised to reduce weight during pregnancy as it causes harm to both mother and baby. This shows the need of pre-pregnancy weight reduction and counseling to young reproductive women. Obese women, who became pregnant, should be aware of all risk that maternal obesity leads to during course of pregnancy and its adverse neonatal effect.

DOI: 10.5281/zenodo.

Aim: To assess the efficacy of Collagen dressing versus conventional silver sulfadiazine dressing in patients with second-degree burns, focusing on pain during dressing changes, infection rates, wound healing rates, and the necessity for higher-grade antibiotics and painkillers. Methods and Materials: 60 patients were enrolled, with 30 receiving conventional dressings and the other 30 receiving collagen dressings. Various factors including wound healing rate, pain experienced during dressing changes, infection rate, use of higher-grade antibiotics, and analgesic consumption were evaluated for both groups. Results: Effectiveness of collagen dressing was better in terms of rate of wound healing, pain on dressing change, rate of infection and use of analgesics in comparison with conventional dressing like silver sulfadiazine. Higher antibiotics were not used in either dressing. Conclusions: Collagen stands out as an optimal choice for dressing second-degree burns due to its unique properties, distinguishing it from conventional dressings.

DOI: 10.5281/zenodo.

Background: Neck swellings present a diagnostic challenge, often requiring differentiation between benign and malignant lesions. Fine Needle Aspiration Cytology (FNAC) is widely used for its minimally invasive nature and rapid results. This study aims to compare FNAC with histopathology to determine its diagnostic accuracy and reliability. Aim and Objective: To evaluate the correlation between FNAC and histopathology findings in patients with neck swellings, assess the diagnostic accuracy of FNAC, and identify any discrepancies between these two diagnostic modalities. Materials and Method: This prospective observational study conducted over a period of one year at Prathima Institute of Medical sciences The study was approved by the institutional ethical committee, and informed consent was obtained from all participants. 60 Patients presenting with neck swellings from department of pathology were included in the study after following Inclusion  and exclusion criteria. Results: Majority of the patients were from the age group of 31-40years, followed by others and male to female ratio was 3:7. Majority of the patients had location of swelling on right side of neck ant. Nonspecific lymphadenitis were most common neck swellings. Conclusion: FNAC is a minimally invasive, cost-effective, and reliable initial diagnostic tool for neck swellings, with high sensitivity and specificity. However, histopathological examination remains essential for definitive diagnosis, especially in cases where FNAC results are inconclusive or suspicious. Combining FNAC with histopathology enhances diagnostic accuracy, guiding appropriate clinical management and treatment strategies.

DOI: 10.5281/zenodo.

Preservation of human wet bone and cartilage following dissection is critical for anatomical studies, medical education, and forensic investigations. Traditional preservation methods often involve the use of chemicals that may pose health and environmental risks. In this study, we propose a novel dry preservation technique utilizing waterproof glue, offering a safer and more effective alternative. This study investigated the feasibility and efficacy of waterproof adhesive glue for preservation of bones and cartilages. The results showed effective binding of glue to the bones and tissues. The results showed promising efficacy by which the preserved specimen can be easily transported to different places and needs less maintenance. These preserved specimens can add value to academic teaching to a great extent as they can be taken to classrooms for teaching and also the students can take it to their hostels for self-study. Moreover these specimens can also be used in examination to assess the knowledge of the students.

DOI: 10.5281/zenodo.

Introduction: Vecuronium and cisatracurium are neuromuscular blocking agents used in abdominal surgeries under general anesthesia. Vecuronium may cause mild bradycardia and hypotension, whereas cisatracurium offers better hemodynamic stability due to minimal histamine release and predictable effects. This study compares their impacts on heart rate and blood pressure to determine the preferable agent. Methods: This prospective study involved general and systemic examinations, airway assessments, and necessary investigations. Patients fasted for 8 hours and were connected to a multi-parameter monitor. Premedication included IV glycopyrrolate, midazolam, and fentanyl, followed by propofol induction. Patients received either vecuronium or cisatracurium, with hemodynamic parameters and neuromuscular function monitored throughout surgery. Results: A total of 90 patients were included, 45 in each group. Group C had a mean onset time of 86.3 seconds and recovery time of 46.6 minutes. Group V had a mean onset time of 114.22 seconds and recovery time of 58.2 minutes. Hemodynamic parameters showed no significant differences between groups. Conclusion: Cisatracurium demonstrated a faster onset and recovery time compared to vecuronium, with both agents showing no significant differences in hemodynamic parameters. Thus, cisatracurium may be preferable for surgeries requiring rapid onset and recovery, ensuring efficient postoperative care without compromising cardiovascular stability.

DOI: 10.5281/zenodo.

Background: Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods: This prospective study was carried out on patients admitted in burn unit of department of General Surgery at JLNMCH, Bhagalpur. Records of the patients admitted from June 2023 to May 2024 were studied. Bed head tickets of the patients evaluated in detail. Results: In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion: Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

DOI: 10.5281/zenodo.

Background: Oil pulling treatment has been used extensively as a traditional Indian folk remedy for many years to strengthen teeth, gums, and jaws as well as to prevent decay, oral malodor, bleeding gums, dry throat, and cracked lips. The increased frequency of side effects from modern medications and dental hygiene products has led many to turn back time to more conventional methods of maintaining dental health and hygiene. Aim: This survey was conducted to evaluate and compare the knowledge, attitude and practice of undergraduate Ayurvedic students towards oil pulling and its role in maintaining oral hygiene. Methodology: This survey was conducted using a pre-validated questionnaire consisting of 16 questions about the knowledge, attitude and practice regarding oil pulling and its effects on oral health that was circulated among the ayurvedic students.Descriptive statistics along with chi-square test were used to check the association between the survey questions. Results: Out of 120 ayurvedic students, students in the age group of 21-23 years had better knowledge regarding benefits of oil pulling as compared students in the age group of 18-20 years and 24-26 years. Conclusion: This research emphasizes the necessity for educational initiatives that emphasize the value of oil pulling.Ayurvedic students need to be made more aware of the ways in which oil pulling improves dental health and is a safer, more economical substitute for pharmaceutical drugs.

DOI: 10.5281/zenodo.

Background: Corona virus disease (COVID) emerged as pandemic outbreak affecting most of the countries worldwide. Hand hygiene was advised as preventive measure other than face covering. This study emphasized on the alcohol concentration and cost variation analysis of different laboratory made and commercially available hand sanitizers used in COVID pandemic. Methods: This prospective, descriptive analytical study including laboratory procedure was conducted in the Department of Pharmacology, Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar for two months. Different sanitizers were assessed for the concentration variation in alcohol. Cost disparity was also analyzed between laboratory based and commercial preparations. Results: Isopropyl and ethyl alcohol were found to be very effective agents against microbial bacteria, fungi, and viruses, ranging between 70% and 90% alcohol concentration. Observed concentration merely altered than expected concentration in most of the laboratory based and commercial branded (mean diff. value in the range 0.33-1.33, p<0.05) whereas locally made sanitizer (mean diff. value in the range 0.5-6.17, p>0.05) and herbal sanitizers (mean diff. value in the range 0.33-4.67, p>0.05) were shown with relatively more variation. Price valuation suggested that laboratory made sanitizers were more cheaper than individual ingredients estimated cost and no price change was noticed in commercial sanitizers as their prices were fixed and controlled by government in public interest. Conclusion: The study concluded that alcohol concentration variation was found in most of commercially available hand sanitizers and cost can be minimized in public interest. Manufacturing companies need to be prepared clinically effective cheaper sanitizers to ensure prevention of severe and rapid transmission of airborne infectious diseases like COVID in the developing countries like India.

DOI: 10.5281/zenodo.

Aim: The purpose of the research was to evaluate how intra-myometrial vasopressin affects blood loss and associated cardiovascular issues after myomectomy. Methods: A total of 64 patients were enrolled in the study and split into two groups: 1) Vasopressin group: in the space between the myometrium and the myoma, the surgeon gave 15 milliliters of diluted vasopressin. 2) Control group: The same amount of ordinary saline was administered to the patients. The prevalence of bradycardia, tachycardia, abnormalities in the electrocardiogram, and blood troponin I level, necessary blood transfusion, and the volume of blood loss were among the indicators that were tracked. Results: The preoperative data indicates that the vasopressin and control groups have comparable clinical and demographic characteristics. The application of vasopressin resulted in a brief rise in mean arterial blood pressure, which peaked at T3, and a larger decrease in heart rate, particularly at T4. When Group A and Group B were compared, they had about the same amount of blood loss and similar quantities of blood transfusions, even though Group B’s operation lasted much longer (395 vs. 110 minutes). This implies that blood loss and the need for transfusions were not substantially impacted by extended surgery in Group B. Conclusion: Although intramyometrial vasopressin reduces blood loss and blood transfusions, other studies have shown that it is linked to potentially dangerous cardiovascular side effects. As a result, gynecologists and anesthesiologists need to take the necessary steps to prevent and reduce the risk of ‘intramyometrial vasopressin’ problems.

DOI: 10.5281/zenodo.

Background: Ultrasound guided technique reduces the risk of vascular puncture and ensures targeted delivery of local anaesthetics to the nerve cords producing profound sensory and motor blockade.  Levobupivacaine has been shown to produce effective sensory and motor block (MB) characteristics as comparable to Bupivacaine in various approaches of brachial plexus block (BPB). The aim of this research was to evaluate the efficacy of axillary versus costoclavicular approach for BPB under ultrasound guidance for forearm, wrist and hand surgeries. Methodology: Axillary block was performed to group A and Costoclavicular block to Group C under Ultrasound guidance. A Volume of 19 ml of 0.5% Levobupivacaine and 1 ml of Fentanyl 50 ug, total volume of 20 ml was administered in both the groups. Performance time, onset and duration times of sensory and MB characteristics, time to first request analgesia and side effects were compared. Results: The performance time and mean onset of sensory block were significantly less in group C. There were no statistical significant difference between the groups with respect to mean onset of MB, and mean duration of sensory and MBs. Time to first request analgesia is significantly high in group C (7.00 ± 1.7 hrs.’) compared to group A (5.47 ± 1.8 hrs). Conclusion: Costoclavicular Block is efficacious in providing prolonged post operative analgesia with shorter performance time when administered with Levobupivacaine and Fentanyl compared to Axillary plexus block.

DOI: 10.5281/zenodo.