Introduction: Laparotomy, especially midline, is vital for abdominal access in emergencies and complex surgeries despite the rise of minimally invasive techniques. It remains crucial in cases of severe ascites, intestinal obstructions, and trauma. However, high wound failure rates necessitate proper closure techniques. This study aims to identify predictors of abdominal wound dehiscence post-laparotomy. Methods: This interventional prospective study included patients over 18 undergoing elective or emergency midline laparotomy, who consented to participate. A structured questionnaire assessed incision types and postoperative complications. Follow-up at intervals monitored wound dehiscence and incisional hernia risks. Predictor variables included surgery duration, illness duration, procedure type, and wound management practices. Results: In this study, 50 participants were included with a male-to-female ratio of 3.5. Emergency surgeries (76%) showed significantly higher wound dehiscence rates than elective ones (13.8%). Most dehiscence cases occurred in midline incisions (75%), with hollow viscus perforation as the leading cause (37.5%). Postoperative wound infection rates differed but lacked statistical significance. Conclusion: Abdominal wound dehiscence (AWD) remains a significant postoperative risk, especially in midline incisions and emergency surgeries. Factors like hollow viscus perforation, patient nutrition, and postoperative infections contribute to AWD. Effective prevention strategies and reinforced closure techniques are crucial for improving outcomes. Continued research and vigilance are essential for reducing AWD incidence.

DOI: 10.5281/zenodo.

Background: Cervical cancer is the second most common cancer in females and is a major cause of morbidity and mortality. Pap smear is simple, cost effective and sensitive tool for screening of various non-neoplastic and neoplastic lesions of cervix. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears. Aim of this study was to study the role of Pap smear in detecting premalignant and malignant lesions as well as non-neoplastic lesions of cervix. Methods: It is a retrospective study of 350 pap smears studied from April 2023 to September 2023 and received in pathology department of a tertiary care hospital. Samples are collected from women between 21 to 65 years presenting with some gynecological problems. Smears were reported as per the 2014 Bethesda system. Results: Out of 350 women, 89 were having normal cytology and 90 cases with inflammatory changes. 30 cases were unsatisfactory. 9 cases of ASCUS, 5 case of SCC, 6 cases of HSIL, 7 cases of LSIL and 2 cases of adenocarcinoma were observed. Conclusions: Pap smear test is a simple, safe, noninvasive, economical OPD based procedure to detect pervasive cervical epithelial lesions. Every woman should undergo Pap test at least once in her life before the age of 45 years.

DOI: 10.5281/zenodo.

Background and Aim: Irritable bowel syndrome (IBS) patients commonly experience psychiatric disorders, such as depression and anxiety. This study aimed to assess the various subtypes of IBS according to the Rome IV criteria, assess anxiety and depressive symptoms in patients with IBS at baseline and also at various phases of follow-up over one year, and see the impact of the treatment of both IBS and associated anxiety and depressive symptoms if present, in the severity of IBS and other psychiatric symptoms. Material and Methods: Seventy patients were recruited in the initial 6 months of the study. Of them, 50 patients continued their follow-ups till the end of the study. A thorough history taking was performed followed by a mental status examination and clinical examination. The Bristol stool chart was used to classify the form of human fecal material. The classification of IBS patients according to the Rome IV criteria was performed as follows: IBS with predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), IBS with mixed bowel habits (IBS-M), and IBS unclassified (IBS-U). The patients were then assessed on the Hamilton Rating Scale for Depression (HAM-D)⁹ and the Hamilton Rating Scale for Anxiety (HAM-A). Results: The most common physical comorbidity was diabetes mellitus (38%). It was seen that the scores significantly decreased over the time frame, thus showing that adequately treating not only the IBS symptoms but also the concomitant anxiety and depressive symptoms helps in a significant decrease in the IBS severity score and thus improvement in all baseline symptoms. It was seen that there was a significant positive correlation between the IBS severity score and HAM-A and HAM-D scores at most of the time frames, showing that the more severe the symptoms of IBS are, there are more depressive and anxiety symptoms. Conclusion: The presence of anxiety and depressive symptoms in patients of IBS shows the importance of their screening in both psychiatry and GI clinics. The association of the severity of IBS symptoms and HAM-D and HAM-A scores points to a common ground and thus the need for adequate treatment of all domains for a better recovery and improved quality of life.

DOI: 10.5281/zenodo.

Background: Very frequently Drug-induced toxicity occurs in the kidney. Renal uptake, renal accumulation, and renal biotransformation of drugs could contribute to this susceptibility of kidneys to toxic damage. Aminoglycosides are often indicated in treatment of infections caused by aerobic gram-negative bacteria and resistant mycobacteria causing drug resistant TB. Nephrotoxicity is one of the most important side effects and therapeutical limitations of these antibiotics, especially gentamicin and kanamycin. Traditional medicinal plants and their products like nigella sativa oil may offer nephroprotection. Materials and Methods: Plant material: nigella sativa oil experimental animals: healthy adult albino rats weighing 100-200g of either sex. Experimental models I) Aminoglycoside induced nephrotoxicity models a) Gentamicin induced nephrotoxicity. Nephrotoxicity was induced by Gentamicin in the dose of 80mg/kg/day through i.p route daily for 8 days. b) Kanamycin induced nephrotoxicity. Nephrotoxicity was induced by Kanamycin in the dose of 300mg/kg/day through i.p route daily for 14 days. II) Nigella sativa: Nephroprotective model: Nigella sativa oil was administered in two different doses in the study i) low dose 1ml/kg body weight/day and ii) high dose 2ml/kg body weight/day for evaluating the nephroprotective role of the Nigella sativa oil. Results: In the animals treated with gentamicin and kanamycin, values of biochemical parameters were altered as compared with normal control values. Administration of kanamycin or gentamicin along with N. sativa oil in doses of 1ml/kg (low dose) and 2ml/kg(high dose) led to decrease in the level of alteration in values of biochemical parameters and markers of histopathological changes. Conclusion: Nephrotoxicity induced by Gentamicin is more as compared to Kanamycin . Nigella sativa oil used for studying its nephroprotective effect is found to be nephroprotective against gentamicin and kanamycin induced nephrotoxicity.

DOI: 10.5281/zenodo.

Introduction: This study aimed to investigate the maternal and perinatal outcomes associated with SARS-CoV-2 infection in pregnant women. Previous research indicates increased risks of maternal death, pre-eclampsia, thromboembolic disease, and preterm birth, with a low likelihood of vertical transmission. Understanding these impacts is crucial for optimizing pregnancy care. Methods: This ambidirectional study, conducted at GSL Medical College, assessed maternal and neonatal outcomes in SARS-CoV-2 positive pregnant women between June 2020 and October 2021. Data on delivery mode, maternal outcomes, neonatal birth weight, APGAR scores, and COVID-19 symptoms were collected. Statistical analysis used SPSS version 20.0 with significance set at P<0.05. Results: Total 172 pregnant women were included. Majority (82.6%) belong to 21 – 30 years, 66.8% (115) pregnant women were multigravidae. The mean gestational age (GA) was 31.19 ± 8.61 weeks, ranged between 14 and 42 weeks. COVID-19 was detected in 3 new born. Statistically there was no significant difference between severity of infection and mode of delivery, birth weight, NICU admission respectively. Conclusion: The study found no significant differences in neonatal COVID-19 severity, delivery mode, birth weight, or NICU admissions, suggesting maternal SARS-CoV-2 infection does not significantly impact these outcomes. The low incidence of vertical transmission and mild neonatal COVID-19 indicate a relatively low risk to newborns, emphasizing the need for continued research.

DOI: 10.5281/zenodo.

Introduction: In developed nations, colorectal cancer ranks second in cancer-related mortality, emphasizing its public health impact. Early detection and advanced treatment are vital for mortality reduction. CT scans, increasingly preferred for diagnosis, aid in assessing colorectal cancer (CRC). Histopathological examination (HPE) complements this by confirming diagnosis, guiding treatment, and correlating CT staging with histopathological examination results. Methods: In a cross-sectional study, patients referred to radiology with symptomatic etiology, suspected large bowel lesions, or high-risk factors were included. Exclusion criteria encompassed contraindications to CT, absence of HPE correlation, biopsy refusal, or abnormal renal parameters. Preparatory procedures included fasting, medical history review, hydration, and contrast administration with subsequent imaging. Results: Thirty participants (mean age: 55.37 ± 15.82 years; male-female ratio: 1.15) were included. Abdominal pain was the predominant clinical presentation in benign and malignant cases, with common rectal involvement. Significant differences in attenuation pattern, thickness, and length correlated with histopathological examination. CT diagnosis effectively distinguished between benign and malignant lesions. Conclusion: CRC poses a significant global health burden, with an increasing incidence in India. Recent advancements in diagnosis include genetic studies and imaging techniques. CRC predominantly affects individuals aged 50 and above, with symptoms varying between benign and malignant lesions. CT demonstrates high sensitivity and specificity in detecting CRC, aiding in accurate diagnosis and treatment planning.

DOI: 10.5281/zenodo.

Introduction:  High blood pressure in pregnancy (HDP) harms both mothers and babies. It disrupts blood flow, reducing oxygen and nutrients to the fetus. This can lead to stunted growth, premature birth, and even death. Early detection of HDP is crucial for better outcomes. This study explores how HDP impacts fetal health. Methods: This hospital study examined how mothers with pregnancy hypertension impact newborns. Excluding other health issues, researchers followed hypertensive mothers receiving prenatal care. With consent, mothers reported health history and newborns were examined. Data on mothers and babies was collected and analyzed to assess the effects of hypertension on fetal outcomes. (74 words). Results: The study examined factors affecting newborn health in 82 pregnancies. Magnesium sulfate, C-sections, and earlier preeclampsia diagnosis improved baby outcomes. Maternal pregnancy history (first vs. subsequent) didn’t impact baby weight. Conclusion: Study finds no link between mom’s pregnancy history and baby weight. Magnesium sulfate and earlier preeclampsia diagnosis improve baby weight, likely due to better placenta health and timely intervention.

DOI: 10.5281/zenodo.

Background: Alpha-2 (α2) adrenergic receptor agonists, such as clonidine and dexmedetomidine, are commonly used as adjuvants during anesthesia due to their analgesic, sedative, sympatholytic, and cardiovascular-stabilizing effects. This study aimed to compare the effectiveness of intravenously administered clonidine and dexmedetomidine in achieving hemodynamic stability and postoperative analgesia during laparoscopic surgery. Methods: This randomized, double-blind, prospective study involved two groups of patients. Group C received 2 µg/kg of clonidine diluted in 10 ml of normal saline, administered as a slow intravenous infusion over 10 minutes before the induction of general anesthesia. Group D received 1 µg/kg of dexmedetomidine, also diluted in 10 ml of normal saline, administered in the same manner. Results: Data were presented as Mean ± SD. An independent student’s t-test was used to compare the groups. A repeated measure analysis of variance (ANOVA) using general linear models (GLM) was also conducted. The mean systolic blood pressure (SBP) scores were higher in Group C throughout the procedure compared to Group D. The mean diastolic blood pressure (DBP) scores were similar in both groups, although slightly higher in Group C, particularly from 30 minutes post-induction until extubation, compared to Group D. Conclusion: The study concludes that α2 agonists attenuate the hemodynamic response to pneumoperitoneum during laparoscopic surgeries and provide reliable postoperative analgesia and sedation when used as premedication agents.

DOI: 10.5281/zenodo.

Background: In this study, we wanted to study the knowledge, attitude and, practices of breastfeeding among mothers in the postnatal ward and mothers attending immunization clinic in GGH Kurnool, to study the demographic and socio-economic factors associated with breastfeeding practices. Methods: This was a Hospital Based Descriptive and Observational Study conducted among 600 Mother’s admitted in postnatal ward and mother’s attending immunization clinic, who have children less than 2 years of age at Department of Paediatrics in the Government General Hospital Kurnool, from November 2018 to August 2020, after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: Age, education, occupation, economic status, religion, and type of family were found to be significant associates of their knowledge & attitude. Significantly higher numbers of mothers married at greater than eighteen years of age. A significantly higher number of mothers had taken full requirement of iron tables. A significantly higher number of mothers had taken a full dose of TT injection. The type of delivery was significantly associated with the prelacteal feed Initiation. A significantly higher number of literate mothers initiated breastfeeding in an appropriate time as compared to illiterates. A significantly higher number of mothers who underwent LSCS delayed initiation of breastfeeding. There was a significant association between gender and the initiation of breastfeeding. The significantly higher number of mothers given the colostrum. A significantly higher number of literate mothers had given colostrum compared to illiterate mothers. A significantly higher number of mothers had not started artificial feeding. Conclusion: Compulsory education for all children, especially the girl child, and special attention to the nutritional needs of the girl child, adolescents, and women, has to be considered. This will go a long way in improving breastfeeding practices.

DOI: 10.5281/zenodo.

Introduction: Secondary intraocular lens implantation refers to intraocular lens insertion at a time remote from the initial cataract extraction (or less commonly, from the trauma that led to the loss of the lens). There are a variety of cataract extraction methods, including phacoemulsification, extracapsular cataract extraction and intracapsular cataract extraction. An IOL can be placed in the anterior chamber between the cornea and iris, as in iris-fixated and closed- or open-loop anterior chamber IOLs (AC IOLs), or it can be implanted in the posterior chamber within the ciliary sulcus posterior to the iris, as in sutured iris-fixated and sclera fixated posterior chamber IOLs (PC IOLs). Aims and Objectives: To evaluate surgical outcomes and complications in patients undergoing intrascleral fixated posterior chamber intraocular lens surgery. Purpose: To evaluate the surgical outcomes and complication of sutureless, glueless, flapless scleral fixated posterior chamber intraocular lens (SFIOL) of patients presented at a tertiary care hospital in Gujarat. Methods: This prospective clinical study was conducted on 36 patients in department of Ophthalmology, GMERS Medical College, Gandhinagar, Gujarat. Result: 36 patients were included who presented to Department of Ophthalmology. These patients were followed up for a period of 4 weeks postoperatively and BCVA with Snellen’s distance visual acuity chart was noted.7 cases (19.44%) had BCVA 6/9 and above after 4 weeks post operatively. 3 cases (8.33%) had a BCVA 6/36 or less. Post operatively complications like striate keratopathy was seen in 9 Cases (25%). 2 patients (5.55%) had high IOP. 1 patient (2.77%) developed hyphema. 1 patient (2.77%) had IOL decentration on 1st postoperative day. Conclusion: The proportion of males was higher than females. Maximum number of patients was found in the age group of 61-70 years followed by 51-60 years. Total 9 (25%) patients had history of trauma. Scleral fixated intraocular lens implantation in the posterior chamber is safe and effective method for correcting aphakia with a better visual outcome. It avoids the disadvantages associated with spectacles and contact lens usage like aniseikonia, relative spectacle magnification (RSM), spherical aberrations, heavy lenses (glasses), visual field limitation. Scleral fixated intraocular lens implantation in the posterior chamber has less chances of complications like bullous keratopathy, UGH syndrome, iritis, CME etc, which were commonly seen in ACIOLs and iris fixated IOLs.

DOI: 10.5281/zenodo.

Introduction: Safe and effective vaccines were urgently needed to contain the COVID-19 pandemic. Indian drug regulators had given emergency approval to Covishield and Covaxin for vaccination of its health care and frontline workers in the first week of January 2021, and vaccination was started in the second week of January 2021. Objectives: To monitor the adverse event following vaccination (AEFI) following the COVID-19 vaccination (Covishield or any other approved vaccines). Material and Methods: A cross–sectional observational study was conducted after ethics committee approval. All the vaccinated staff and students at the tertiary care centre were eligible to participate in the study.  Monitoring of AEFIs was done until 28 days after the first dose of vaccination. Data was collected as per the Pharmacovigilance Programme of India (PvPI) using Suspected Adverse Drug Reaction Reporting Form.  An analysis of professional status, vaccine type, age, gender, weight, symptoms or signs, and causality was done, and the results were summarised. Results: Data from 163 participants were included for analysis. A total of 211 AEFIs were reported by 115 (70.55%) participants. The remaining 48 (29.45%) participants did not report any AEFIs. Pain at the site of injection (43.60%), fever (14.21%), headache (8.53%), myalgia (6.63%), bodyache (5.21%), etc., were the common ADRs recorded in this study. Conclusion: The majority of AEFIs reported were mild to moderate in severity. No serious AEFIs were noted during this study. These findings may act as supporting evidence for other research studies as well as clinical trials conducted in India, suggesting the safety of the vaccines approved in India.

DOI: 10.5281/zenodo.

Background and Objectives: Fixed Drug Eruption (FDE), is a mucocutaeous eruption occurring as a part of adverse drug reaction. They are often localised, well defined, and reoccur on the same sites upon restarting the drug. Here, we are reporting a case series of 309 patients who developed FDE after consuming these commonly used drugs. Methods: This study was conducted at the dermatology outpatient department (OPD) in collaboration with the Adverse Drug Reaction (ADR) Monitoring Centre of the pharmacology department of MLB Medical College, Jhansi, under the Pharmacovigilance Programme of India. A total of 309 cases of Fixed Drug Eruption (FDE) reported between March 2014 and December 2023 were reviewed. The analysis focused on patient demographics, the type of suspected drug, and the number and distribution of FDE lesions across various body sites. Results: Total of 309 patients were diagnosed with fixed drug eruption of this 274 were males and 35 were females with gender ratio of 8:1 approx. Most patient presented in the age group of 30-45 years contributing about 52.10% of patients. Antimicrobials were the most frequent culprit drugs contributing to 206 (66.67%) of 309 total cases followed by NSAIDs 100 (32.36%). In the antimicrobials fluroquinolones + Nitro-Imidazole was the commonest causing 185 (89.81%) of cases while fluroquinolone alone contributed 6 (1.94%). This was followed by penicillin + cephalosporin group 14 (4.53%) of which amoxicillin + clavulanic acid 8 (2.59%) was the commonest drug. Most common indication for drug intake was diarrhea 184(59.55%) followed by fever and pain 111 (35.92%). Conclusion: Fixed drug eruptions are one of the commonest types of Cutaneous adverse drug reactions which should be assessed and reported.  Since occurrence of FDE to a particular drug cannot be stopped, pigmentation often persists indefinitely and does not respond to treatment its prevention is the key. This can be done by increasing awareness and encouraging general population about the FDE, common causative drugs, and maintenance of personal drug register.

DOI: 10.5281/zenodo.

Background: The correlation between TSH (Thyroid-Stimulating Hormone) levels and vitamin D levels has gained attention in research, especially in thyroid disorders. Studies suggest low vitamin D levels may be linked to higher TSH levels, indicating potential involvement in thyroid dysfunction, particularly in autoimmune thyroid diseases like Hashimoto’s thyroiditis. We in the current study tried to correlate the values of TSH with Vitamin D levels in cases with hypothyroidism and euthyroid controls. Methods: This was a cross-sectional, case-control observational study conducted at a single center. Data on demographics, clinical examinations, and laboratory investigations, including TSH and Vitamin D levels, were collected and recorded in 50 hypothyroid patients, forming the case group, and compared with 50 matched controls. Vitamin D levels and TSH levels were measured using the Chemiluminescent Microparticle Immunoassay (CLIA) with 5 ml of venous blood. Results: A comparative analysis of TSH and Vitamin D levels between 50 hypothyroid patients (cases) and 50 euthyroid individuals (controls) revealed significant differences between the two groups. Patients with hypothyroidism exhibited significantly higher TSH levels compared to the control group. Hypothyroid patients demonstrated significantly lower Vitamin D levels compared to the control group. This finding suggests a potential association between hypothyroidism and Vitamin D deficiency. Conclusions:  The study revealed a significant prevalence of Vitamin D insufficiency in both groups, with a statistically significant higher incidence in females than males. However, Vitamin D insufficiency was not found to be significantly more common among hypothyroid patients compared to euthyroid patients in the study population.

DOI: 10.5281/zenodo.

Background: Fistulotomy and fistulectomy are common surgical procedures for treating simple anal fistulas, a condition involving abnormal connections between the anal canal and skin. This study aims to compare these two methods, focusing on key outcomes such as healing time, recurrence rates, and postoperative complications, including incontinence, to determine the most effective treatment. Methods: A simple fistula was defined as one having a single external and internal opening along with a palpable tract. Group I consisted of 25 patients who underwent fistulotomy with marsupialization, while Group II comprised 25 patients who received the fistulectomy procedure for their low-lying anal fistula. The patients were matched based on age, sex, and other physical factors. Results: The mean duration of surgery was 29.5 minutes for fistulotomy and 32.2 minutes for fistulectomy, with no statistically significant difference (p-value = 0.891). The duration of wound healing was significantly longer in the fistulectomy group (21 ± 5.5 days) compared to the fistulotomy group (12 ± 2.5 days) (p-value = 0.004). Postoperative pain, as assessed by the Visual Analogue Scale (VAS), was comparable between the two groups, with a mean VAS score of 3.8 ± 1.51 in the fistulotomy group and 3.5 ± 2.19 in the fistulectomy group (p-value = 0.217). The incidence of anal incontinence was 10% (4 cases) in the fistulotomy group and 2.5% (1 case) in the fistulectomy group, although the difference was not statistically significant (p-value = 0.191). The recurrence rate was low and similar in both groups, with 1 case (2.5%) in each group. Conclusion: Fistulotomy demonstrated shorter operative time and wound healing compared to fistulectomy in the management of simple anal fistulas. However, it was associated with a higher incidence of anal incontinence, although not statistically significant. Both procedures exhibited low recurrence rates. The choice between fistulotomy and fistulectomy should be individualized based on patient factors and fistula characteristics.

DOI: 10.5281/zenodo.

Background: Melasma is a common, acquired hyperpigmentation disorder characterized by irregular brown patches on sun-exposed areas, particularly the face. The exact pathogenesis of melasma remains unclear, but it is believed to be multifactorial, involving genetic predisposition, ultraviolet radiation, hormonal influences, and other environmental factors. Dermoscopy, a non-invasive diagnostic tool, offers enhanced visualization of skin surface and subsurface structures, aiding in the assessment and differentiation of pigmented lesions. Aim and Objectives: To evaluate the clinical features and dermoscopic patterns of melasma to better understand its pathophysiology, improve diagnostic accuracy, and guide therapeutic decisions. Materials and Method: A cross-sectional observational study was conducted on patients clinically diagnosed with melasma. Detailed clinical examination and dermoscopic evaluation were performed on all participants. The dermoscopic findings were documented and analyzed to identify common patterns and their correlation with clinical features. Results: The study included 100 patients with melasma, predominantly affecting females (83%). Nearly 74% of the patients had malar type of melasma were present. Majority of the patients had their morphological typer was dermal, followed by epidermal and mixed. Conclusion: Dermoscopy proves to be a valuable tool in the assessment of melasma, offering insights into its heterogeneity and aiding in distinguishing it from other pigmented lesions. The identification of specific dermoscopic features can enhance diagnostic accuracy and potentially guide personalized treatment strategies. Further studies are warranted to establish standardized dermoscopic criteria for melasma and to explore its implications for patient management.

DOI: 10.5281/zenodo.

Transurethral resection of the prostate (TURP) is a longstanding endoscopic surgery for severe urinary symptoms. Regional anesthesia is preferred, but complications like hypotension are managed cautiously. This study compares Buprenorphine and Dexmedetomidine as adjuvants to Bupivacaine spinal anesthesia (SA) in elderly males undergoing TURP for enhanced postoperative pain management. Methods: This prospective study included adults aged 18-60 undergoing TURP under GA, ASA grades I & II, Mallampati grades 1-2. Participants were randomly assigned to receive either Buprenorphine with Dexmedetomidine or Buprenorphine alone intrathecally. Group A received 1.8 mL 0.5% hyperbaric Buprenorphine with 0.2 mL Dexmedetomidine (5 µg), drawn from a 100 µg/mL ampoule.  Sensory and motor blocks were assessed using predefined measures after administering respective spinal anesthetics in the operating room. Results: In this study of 120 participants (60 in each group), demographics and procedural details were comparable. While segment regression times did not differ significantly between groups, motor recovery times varied significantly (246 ± 61.3 vs. 244 ± 58.5 minutes). Group A required more intraoperative fentanyl (20%) compared to group B (3.3%), with group B experiencing a significantly longer time to first post-operative analgesic (284 ± 23.1 vs. 233 ± 14.1 minutes). Conclusion: Dexmedetomidine proves superior to Buprenorphine as a SA adjuvant for prostate surgery in elderly males, offering extended analgesia, reduced opioid use, and stable hemodynamics despite potential bradycardia. Tailoring anesthesia to patient needs, including age and surgical specifics, is vital for optimizing outcomes and ensuring perioperative comfort and safety.

DOI: 10.5281/zenodo.

Introduction: Urinary tract infections (UTIs) are significant concern for individuals undergoing gynecological and surgical interventions, often leading to increased morbidity and healthcare costs. Key risk factors include catheterization, surgical complexity, and inadequate antibiotic prophylaxis. This study explores the incidence and risk factors of UTIs in these populations to improve patient outcomes. Methods: This prospective study, conducted at KIMS Amalapuram from January to March 2024, investigated UTI incidence and risk factors in patients undergoing gynecological and surgical procedures. Data on demographics, surgery details, and postoperative urine cultures were collected. Quantitative and qualitative analyses identified UTI risk factors. Ethical approval and informed consent were obtained. Results: Among 500 patients, 70 (14%) developed postoperative UTIs. The highest rate was in hysterectomy patients (42.8%). Prolonged catheterization (OR: 2.5), complex surgeries (OR: 3.0), lack of antibiotic prophylaxis (OR: 2.2), age ≥65 years (OR: 1.8), and diabetes (OR: 2.0) were significant risk factors. Conclusion: This study underscores the high incidence of UTIs post-gynecological and surgical interventions, identifying key risk factors like prolonged catheterization, surgery type, and inadequate antibiotic prophylaxis. Targeted interventions, such as early catheter removal, proper antibiotic use, and improved postoperative care, can reduce UTI incidence. Future research should validate these findings in larger studies.

DOI: 10.5281/zenodo.

Introduction: The Stop Light Sign approach, based on identifying anatomical landmarks of the Brachial Plexus, is routinely used for ISBPB (InterScalene Brachial Plexus Block) during Proximal Humerus surgeries. Recently, SUIT (Sequential Ultrasound Imaging Technique) approach is practiced in human volunteers for the identification of elements of Brachial Plexus successfully. We aimed to compare the efficacy of the SUIT approach versus Stop Light Sign approach for ISBPB for the patients posted for Proximal Humerus surgeries. Methods: It was a prospective, randomized comparative study conducted in Rangaraya Medical College, Kakinada over a period of 6 months from 1st December 2023  to 1st June 2024. A total of 70 patients aged 18–65 years, classified as ASA I or II, scheduled for elective unilateral proximal Humerus surgeries were randomly divided into Group A (ISBPB by Stop Light Sign approach) and  Group B (ISBPB by SUIT approach). Study procedures followed standard guidelines. An experienced anaesthesiologist performed the ISBPB procedure in both research groups. Parameters like Quality, Effectiveness and Incidence of complications were studied. Levene’s test, Welch’s unpaired T-test were used. P<0.05 was considered statistically significant. Results: There was no significant statistical difference in block procedure time and onset of sensory and motor blockade, but there was a significant statistical difference in effectiveness and incidence of complications. Block failure was detected in ISBPB by Stop Light Sign approach. Conclusion: The SUIT approach reliably identifies individual elements, ensuring perfect visualization of the SPA arrangement of the superior trunk of the brachial plexus during ISBPB for proximal humerus surgeries. Its accuracy and lower complication rates, compared to the traditional stoplight sign, make it a valuable addition to routine practice before any brachial plexus block (BPB).

DOI: 10.5281/zenodo.

Background: Abnormal uterine bleeding (AUB) is a common gynaecological condition requiring accurate diagnosis and effective treatment. Hysteroscopy, dilatation, and curettage (D&C) are widely used procedures for managing AUB. Aim and Objective: This study compares hysteroscopy’s diagnostic accuracy, safety, and treatment of hysteroscopy D&C in women with AUB. Materials and Methods: A prospective, comparative study was conducted on 200 women aged 30-50 presenting with AUB at a tertiary care centre. Participants were randomly assigned to undergo either hysteroscopy (Group A) or D&C (Group B). The primary outcomes included diagnostic accuracy, detection of intrauterine pathologies, procedure time, patient discomfort, and complication rates. Follow-up was conducted over six months to evaluate treatment outcomes. Results: Hysteroscopy demonstrated a higher diagnostic accuracy (95%) compared to D&C (75%) for detecting intrauterine pathologies (p < 0.001). The mean procedure time was significantly shorter for hystehysteroscopy± 5 minutes) than for D&C (28 ± 6 minutes) (p < 0.001). Patient discomfort was lower in the hysteroscopy group (VAS score: 3.2 ± 1.1) compared to the D&C group (VAS score: 4.5 ± 1.3) (p < 0.001). The overall complication rate was lower in the hysteroscopy group (5%) compared to the D&C group (8%), though this difference was not statistically significant (p = 0.41). At six-month follow-up, 92% of women in the hysteroscopy group reported complete resolution of AUB symptoms, compared to 80% in the D&C group (p = 0.02). Conclusion: Hysteroscopy is superior to D&C in diagnosing and treating AUB. It offers higher diagnostic accuracy, shorter procedure time, lower patient discomfort, and better treatment outcomes. Hysteroscopy should be considered the preferred modality for managing AUB, especially when precise diagnosis and targeted treatment are necessary.

DOI: 10.5281/zenodo.

The objective of this study is to evaluate the nephroprotective role of Nigella sativa oil against Kanamycin-induced nephrotoxicity in rats. The nephroprotective potential was evaluated on basis histopathological changes in renal tissue. Healthy adult albino rats of either sex (100-200 g) were randomly and equally into six groups of five animals each. Group I animals (normal control: DWNC) were administered distilled water intra peritoneally for 14 days. Group II animals (LNSO) were administered low dose nigella sativa oil 1ml/kg orally for 16 days. Group III animals (HNSO) were administered High dose nigella sativa oil 2ml/kg orally for 16 days. Group IV animals (KNCG)Kanamycin negative control group. were administered Kanamycin (300mg/kg ) From day 1-14  Intra-peritoneally. Group V animals(KLNSO) were administred Low dose of Nigella sativa oil (1ml/kg) orally (From day 1-16) + Kanamycin (300mg/kg) (From day 3-16) Intra-peritoneally. Group VI animals (KHNSO) were administered high dose Nigella sativa oil. (2ml/kg) orally (From day 1-16) + Kanamycin (300mg/kg) (From day 3-16) intra-peritoneally. On the 16 ^th day(14^th day for normal control group) the rats were sacrificed. The kidney was removed for histolopathological evaluation . Kanamycin treated group i.e Group IV showed increased damage to renal tissue as compared to normal control group Group I. Also renal tissue histological examination reveals decreased nephrotoxicity in Group V and Group VI compared with Group IV. It is seen that Nigella sativa oil has a nephroprotective role against Kanamycin-induced nephrotoxicity in rats as is evident from histopatholgical examinations of tissue samples.

DOI: 10.5281/zenodo.

A survey was conducted among 200 medical students to gather their perspectives on anatomy as both a subject and a potential career path. The students responded to a questionnaire containing 12 statements, and the results were analyzed. The findings were largely positive, with 90% of students recognizing anatomy as a crucial foundation in medical sciences. A significant majority (84%) believed that a strong understanding of anatomy greatly aided them during their clinical rotations in hospitals. However, more than half of the respondents found anatomy challenging to grasp, and three-quarters agreed that the teaching of anatomy should extend beyond a single academic year. While 31 % of students rated anatomy on par with clinical subjects, only a small number viewed teaching anatomy as favorably as patient care. In India, limited job opportunities and insufficient research facilities have hindered the popularity of anatomy as a career choice. Even with a revised curriculum, only 29% of the students expressed interest in pursuing a career as an anatomist. Nonetheless, most students were open to the idea of enrolling in a formal teaching course if they decided to specialize in anatomy.

DOI: 10.5281/zenodo.

Introduction: Limited literature and controversy regarding the studies for the assessment of efficacy of intrathecal Ropivacaine Heavy with fentanyl and intrathecal Bupivacaine Heavy with fentanyl for infraumbilical surgeries provided the need for a study to be conducted in a well-designed manner. Aim and Objectives: To study and compare the Onset and Duration of Sensory and Motor blockade in Intrathecal Ropivacaine Heavy with Fentanyl and Intrathecal Bupivacaine Heavy with Fentanyl. To study and compare haemodynamic changes and postoperative analgesia along with side effects (if any) between these two groups. Material and Methods: Present prospective study was conducted at Department of Anesthesiology and critical care, Saraswathi Institute of Medical Sciences, Hapur among 100 patients posted for infraumbilical surgeries. Patients were divided in two groups. Group RF received 3ml intrathecal Roipvacaine Heavy 0.75% with 25mcg (0.5ml) fentanyl. Group BF received 3ml intrathecal Bupivacaine Heavy 0.5% with 25mcg (0.5ml) fentanyl. Total Volume 3.5ml in each group. Mann-Whitney U test, independent t test and Chi-Square test was applied. ‘p’ value<0.05 indicated a statistically significant association. Results: The mean onset times for Sensory and Motor Block were comparable between the two groups. The mean duration of Sensory block was significantly higher in BF Group (220.50±18.49 min) compared to RF group (160.62±15.39 min). The mean duration of Motor Block was significantly higher in BF Group (194.88±17.96 min) compared to RF group (126.74±19.81 min). Time to rescue analgesia was significantly higher in BF group (365.64±59.44) compared to RF group (293.56±80.69). Hemodynamic parameters were comparable between the two groups. No significant adverse effects were observed. Conclusion: Intrathecal Bupivacaine Heavy with Fentanyl provides a longer duration of sensory and motor block, prolonged postoperative analgesia and also overall less analgesic drug requirement as compared to Intrathecal Ropivacaine Heavy with Fentanyl.

DOI: 10.5281/zenodo.

Objective: To study the demographic profile of Hepatocellular cancer patients and the pattern of clinical characteristics in a tertiary care centre of north western India. Methods: A retrospective study of the patients diagnosed with HCC presenting in the OPD/IPD of Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab. Results: We studied 164 patients diagnosed with Hepatocellular carcinoma. The Demographic profile showed higher mean age than the data for the whole India (58 +14.4 years) (range 18–88 years). Etiological profile showed Hepatitis C as the most prevalent cause 44.6% followed by Hepatitis B. This pattern is different from the pattern of rest of India and matches that of western world.

DOI: 10.5281/zenodo.

In the modern era of human evolution, integrating the human mind with artificial intelligence (AI) is upcoming area of interest. This human mind and AI relationship further offers to understand unlimited potential, optimization and innovation. This complex relationship has capability to move humanity at another level. The human mind involves cognitive functions, which is helpful in creativity, critical thinking and problem-solving qualities. With the help of cognitive abilities individual use digital technology in the form of AI as tool for multiplying potential of innate abilities. Research demonstrates vital role of cognitive abilities in improving human potential, specifically in AI related advancement. At the same time, AI works as important landmark for human progress, delivering different types of tools and resources for boost cognitive functions and strengthen productivity. From basics of AI to virtual reality simulation, technology offers possibilities for learning, collaboration and problem-solving. By involving AI into daily life individual improve work quality, search required information immediately and connect with global platform, thereby expanding the horizon of cognition and strive for continuous improvement in the current scenario, information is the key but how to organize, utilize and make use of it with the help of AI revolutionize decision-making across different domains. This technology easily process and analyses information, uncovers patterns, trends and is beyond human capabilities. By creating information into useful for implementing actions, AI supported technology support individual to make informed choices more precisely and efficiently. Finally, Synergizing of human mind and AI explores a new era of possibilities, human potential does not have limit. Embracing this change will transform human journey towards excellence, collective power of intellect and AI technology make a better and brighter future for humanity.

DOI: 10.5281/zenodo.

Background: COPD is a very common preventable disease. Cardiac involvement is common in COPD patients. Early detection of cardiac involvement by ECG, Echocardiography can prevent morbidity and mortality in COPD patients. Aim: To study clinical profile and to assess cardiac dysfunction in COPD patients by ECG and Echocardiography. Method: An observational study was done in COPD patients age >30 years in civil hospital, navsari. ECG, Echocardiography were done .Responses were collected and analysed by Microsoft excel. Result: ECG findings in copd patients – right axis deviation (44%), P pulmonale (37%), and low voltage QRS complex (10%) poor R wave progression (39%), right ventricle hypertrophy (26%). Echocardiography findings were PAH (62%), corpulmonale (56%), RVD (45%), RAD (37%) right ventricle hypertrophy (27%), left ventricle systolic dysfunction(31%), left ventricle diastolic dysfunction(6%). Conclusion: COPD is a common and preventable disease. COPD patients should be assessed by ECG and echocardiography for better prognosis and to prevent complication.

DOI: 10.5281/zenodo.

Background: Abnormal uterine bleeding (AUB) is a common gynecological issue leading to significant morbidity in women of reproductive and postmenopausal age. Histopathological examination of endometrial tissue obtained from hysterectomy specimens provides essential insights into the underlying causes of AUB. This study aims to analyze the histopathological spectrum of endometrial changes in hysterectomy specimens from patients presenting with AUB. Materials and Methods: A retrospective study was conducted on hysterectomy specimens from 150 women with AUB, collected over a period of One year. Patient demographic data, clinical presentation, and histopathological findings were recorded and analyzed. Specimens were fixed in formalin, processed, and stained with hematoxylin and eosin. The histopathological diagnosis was categorized into benign, premalignant, and malignant lesions. Results: Out of 150 cases, 60% were in the age group of 41-50 years. The most common histopathological finding was endometrial hyperplasia (30%), followed by chronic endometritis (25%) and leiomyomas (20%). Premalignant lesions such as atypical hyperplasia were observed in 10% of cases, while endometrial carcinoma was found in 5% of cases. Benign conditions like endometrial polyps and adenomyosis were present in 10% of the specimens. Conclusion: The histopathological spectrum of the endometrium in hysterectomy specimens from AUB cases is diverse, with benign lesions being the most common. Endometrial hyperplasia and chronic endometritis are significant contributors to AUB. The detection of premalignant and malignant lesions highlights the importance of histopathological examination in the management of AUB.

DOI: 10.5281/zenodo.

Background: Fine Needle Aspiration Cytology (FNAC) is a well-established diagnostic procedure for evaluating thyroid nodules. The introduction of ultrasound guidance (USG) aims to improve the accuracy of FNAC by providing real-time visualization of the nodule and needle placement. This study compares the diagnostic accuracy of conventional FNAC and USG-guided FNAC in the evaluation of thyroid nodules. Materials and Methods: A total of 100 patients with thyroid nodules, who underwent FNAC at SKMCH Muzaffarpur between January 2023 to June 2023, were included in this study. The study was divided into two parts: a retrospective analysis of 50 cases of conventional FNAC performed from January 2023 to June 2023, and a prospective analysis of 50 cases of USG-guided FNAC performed from January 2023 to June 2023. Data on patient demographics, nodule characteristics, FNAC procedure details, and cytological outcomes were collected and analyzed. The diagnostic accuracy was assessed by comparing FNAC results with histopathological findings from subsequent surgical specimens. Results: Out of the 100 patients, 70% were female and 30% were male, with an age range of 25 to 65 years. In the retrospective group, the sensitivity and specificity of conventional FNAC were found to be 75% and 80%, respectively. The prospective study of USG-guided FNAC demonstrated improved sensitivity and specificity, with values of 90% and 95%, respectively. Additionally, the rate of inadequate or non-diagnostic samples was significantly lower in the USG-guided FNAC group (5%) compared to the conventional FNAC group (20%). Conclusion: USG-guided FNAC significantly enhances the diagnostic accuracy of thyroid nodule evaluation compared to conventional FNAC. The increased sensitivity, specificity, and reduced rate of non-diagnostic samples highlight the advantages of incorporating ultrasound guidance into the FNAC procedure. This approach should be considered a standard practice for the evaluation of thyroid nodules to ensure more reliable diagnostic outcomes.

DOI: 10.5281/zenodo.

Background: Accurate assessment of ovarian reserve is critical for managing reproductive health, especially in perimenopausal women. This study evaluates and compares the effectiveness of transvaginal ultrasound (TVUS) and Anti-Mullerian Hormone (AMH) levels in assessing ovarian reserve in this population. Aim: To compare the diagnostic accuracy and clinical utility of TVUS and AMH in evaluating ovarian reserve in perimenopausal women. Materials and Methods: In this cross-sectional study, 30 perimenopausal women (ages 40-55) were recruited from the Department of Obstetrics and Gynecology in collaboration with the Radiology Department. Each participant underwent TVUS to measure antral follicle count (AFC) and ovarian volume, and a blood sample was taken to measure serum AMH levels. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Correlation between AMH levels and AFC was also analyzed. Results: The mean AFC was 8.3 (±2.1), and the mean ovarian volume was 7.2 cm³. The mean AMH level was 1.2 ng/mL (±0.5). A strong positive correlation (r = 0.78, p < 0.01) was observed between AMH levels and AFC. TVUS had a sensitivity of 85%, specificity of 90%, PPV of 70%, and NPV of 95%. AMH testing showed higher sensitivity (90%) with comparable specificity (85%), PPV of 75%, and NPV of 92%. Conclusion: Both TVUS and AMH are valuable in assessing ovarian reserve in perimenopausal women. AMH testing provides higher sensitivity and a stable biochemical measure of ovarian reserve, while TVUS offers detailed anatomical insights. Integrating both methods enhances diagnostic accuracy and clinical management, aiding in effective reproductive health planning.

DOI: 10.5281/zenodo.

Background: PAS disorders which include placenta accreta/Placenta accreta spectrum involves the abnormal anchoring of the placenta in the uterine wall. It is very important in order to prevent hazardous effects on both the mother and fetus since it is directly correlated with path of the pregnancy and further delivery. Ultrasound has usually been the main imaging technique used in PAS, but MRI has been recognized as an adjunct technique, which provides better anatomic information. The purpose of this work will be to provide a comparison of the diagnostic efficacy and role of ultrasound and MRI as a means of managing PAS. Objective: This work therefore aims and assesses the diagnostic accuracy, and clinical management implication of ultrasound in PAS disorders relative to MRI. Methods: This is a case study presented on patients with PAS who underwent both, ultrasound and MRI 3 years in a tertiary care hospital. Cohen’s kappa coefficients of agreement between the two modalities of diagnostic metrics were also computed. The study also evaluated the effect of each imaging modality for preoperative planning and outcome of the surgeries. Results: Harrington et al (2004) noted that MRI has better diagnostic sensitivity of 93% than ultrasound at 85% while its specificity stands at 95 % as compared to the 92% of ultrasound. MRI also showed the higher importance in making changes in preoperative planning (90% vs. 75%) and surgical results (95% vs. 80%). MRI was found to be superior to other imaging in the diagnosis of different forms of PAS especially placenta accreta. Conclusion: MRI is found to give better diagnostic sensitivity and better influence on management and surgical intervention of PAS than ultrasound. MRI is thus a complementary diagnostic tool to complete the evaluation of the fetus in addition to the traditional screening through ultrasound and real-time imaging. Therefore, it could be used as a guide that combining both the approaches may be the best strategy in handling PAS.

DOI: 10.5281/zenodo.

Introduction: Anxiety disorders are prevalent psychiatric illnesses, and the search for effective treatments with minimal side effects continues. Zinc, an essential micro-nutrient, plays a crucial role in central nervous system physiology and has been implicated in neuropsychiatric disorders. Methods: This study evaluated the anxiolytic activity of zinc oxide in albino rats using the elevated plus-maze model. Rats were divided into seven groups and administered zinc oxide (7.5, 15, 30 mg/kg) or diazepam (1, 2 mg/kg) intraperitoneally. Parameters recorded included time spent in open and closed arms and number of entries into each arm. Results: Zinc oxide (15 mg/kg) significantly increased time spent in open arms (113.33±3.6 sec) and entries into open arms (3.55±0.23) compared to controls. Diazepam (2 mg/kg) also showed significant anxiolytic effects. The combination of zinc oxide (7.5 mg/kg) and diazepam (1 mg/kg) produced antianxiety activity, indicating potentiation. Conclusion: This study demonstrates the anxiolytic effects of zinc oxide (15 mg/kg) and diazepam (2 mg/kg) in albino rats using the elevated plus-maze model. Zinc oxide’s mechanism of action may involve inhibition of post-synaptic NMDA receptors. The potentiation of diazepam’s effect by low-dose zinc oxide suggests a potential therapeutic combination for anxiety disorders. Further studies are necessary to confirm these findings and explore zinc’s role in treating central nervous system disorders.

DOI: 10.5281/zenodo.