Brucellosis caused by species of Brucella, is among the most prevalent zoonotic disease that can involve any organ. Here we present a case of deep vein thrombosis as a complication of brucellosis.  We reported a 44 years old male patient diagnosed with brucellosis with deep vein thrombosis on his bilateral legs with features of polyarthritis. The patient was treated with anticoagulants. The patient was discharged with warfarin therapy and antibrucellosis treatment. Although rare, some infectious agents may cause vascular pathologies. Patients presenting with symptoms of DVT or similar vascular pathologies should be assessed for infectious agents, particularly in those coming from Brucella-endemic areas.

DOI: 10.5281/zenodo.

Background: Post-partum haemorrhage is the leading cause of maternal death in India. However, it is not accurately and adequately diagnosed resulting from inaccurate and suboptimal estimation of blood loss in absence of hemodynamic instability in low risk pregnancies. This study was undertaken to ascertain the incidence of undiagnosed occult post-partum haemorrhage in low risk pregnancies. Material & Methods: Total of 280 low risk pregnancies out of 957 deliveries at Command Hospital Air Force Bangalore for one year period was evaluated for more than 10% drop in haematocrit during pre and post-delivery period. Result: Incidence of occult post-partum haemorrhage was found to be 16.78% in low risk pregnancies. 57% of occult post-partum haemorrhage was seen in 19-30 years age group compared to 43% in 31-35 years age group. Majority (62%) of occult post-partum haemorrhage was seen in multiparous compared to primiparous (38%). Conclusion: Monitoring of post-natal mothers should invariably include haematological evaluation to look for significant drop in haematocrit and post-partum anaemia.

DOI: 10.5281/zenodo.

Background: The Robson classification also known as the 10 groups classification (TGCS) system is a global standard for assessing, monitoring and comparing caesarean section rates. Aim: The aim of the present study was to calculate the overall caesarean section rate and to identify group that contributed most to the overall caesarean section rate and to analyse caesarean rate within groups in our institute. Methods: A retrospective observational study conducted for a period of 1 year from June 2022 to Dec 2023.All pregnant women with gestational age of more than 28 weeks were classified according to Robson’s classification. Results: The overall caesarean section rate was 42.6 %.Group 5, all multiparous women with at least one previous uterine scar, with a single cephalic pregnancy, > 37 weeks gestation was the largest contributor to overall caesarean section rate (19.74%). Conclusion: Women with previous caesarean contribute to majority of cesarean section rates. Proper and strictly adherent labor protocols can reduce cesarean section rates among nullipara thereby reducing numbers in group 5 in future.

DOI: 10.5281/zenodo.

Klebsiella pneumoniae, a Gram-negative bacterium of the Enterobacteriaceae family, possesses a rod-shaped morphology. Exhibiting opportunistic behavior, it thrives in individuals with compromised immune systems. This study aims to ascertain the presence of the CTX gene within Extended Spectrum Beta-Lactamase (ESBL) enzymes in Klebsiella pneumoniae isolates from clinical samples. Identification of these isolates was carried out using a conventional disc diffusion technique alongside the combined double disc method, while ESBLs were screened accordingly. Analysis of antimicrobial susceptibility patterns revealed notable resistance rates, with CAZ, CTX, exhibiting the highest resistance percentages. The majority of the ESBLs positive isolates were from Pus 100 (45.66%). The CTX genes were 61.8% recorded respectively.

DOI: 10.5281/zenodo.

Introduction: This research examined the possible correlation between the severity of Retinopathy of Prematurity (ROP) and neurodevelopmental issues in children. Upon doing data analysis, a distinct pattern emerged: there was a clear and substantial rise in the likelihood of problems such as Cerebral Palsy and cognitive impairments as the severity of ROP escalated. Although ROP is often linked to visual impairment, it may also have an influence on motor abilities, speech, and auditory functions. Material and Methods: A statistical analysis was performed on N=50 normal and abnormal groups of children having ROP disease. The objective included the analysis of different types of neurological disorders occurring in children leading to preterm defects. The inclusion criterion included preterm births with ROP disease, and the exclusion criterion included any other retinal eye defects. Results: Timely identification and medical intervention (during Stages 1-2) might be pivotal in mitigating these hazards. In addition, the analysis of ROP stages indicated that the control group had better identification of early-stage ROP, while the abnormal group had a more significant occurrence of ROP throughout all stages. This underscores the need for vigilant monitoring and action to avert advancement. Conclusion: Present research provided evidence for the correlation between abnormal ROP and visual impairment. In summary, the results indicate a significant association between the severity of retinopathy of prematurity (ROP) and neurodevelopmental problems in children. This highlights the crucial role of early intervention in enhancing outcomes.

DOI: 10.5281/zenodo.

The foundation of the herbal medication business is the ethnomedical values of plants. In order to create herbal medications with minimal side effects, India has contributed its expertise in traditional system medicines (Ayurveda and Siddha). These plants have historically been utilized by tribal communities in India as extracts, powders, or pastes to cure conditions including anti- microbial activity, cough and colds, fever, stomach, kidney, and liver diseases, pain, inflammation, and wounds. According to WHO data, plant extracts are used to treat more than 80% of the world’s population for fundamental ailments. Natural remedies are popular in Asian nations provides a full overview of past human plant connections. Traditional medicinal plants have a diverse spectrum of bio-active compounds that are used to treat both chronic and infectious ailments.
The objective of the present study is to formulate and evaluate a polyherbal ointment. Ointment was formulated using ethanolic extracts of Carica Papaya and methanolic extract of Leptadenia Pyrotechnica. The total phenolic content (TPC) was determined by Folin-Ciocalteu method and total flavonoids content (TFC) were determined using aluminum chloride method. Formulations were prepared using different ointment bases with different concentrations of the extracts such as 1% and 2% w/w. Formulations were tested for its physicochemical properties like pH, spreadability, extrudability and viscosity. The TPC in Carica Papaya and Leptadenia Pyrotechnica extract were found to be 105.5 mg/gm of extract and 104.5 mg/gm of extract respectively. TFC in Carica Papaya and Leptadenia Pyrotechnica extract were found to be 20.5 mg QE/gm of extract and 22.5 mg QE/gm of flavonoid in dry extract respectively. Ointment was formulated using simple ointment base with 2 %w/w of dry extracts was found to most stable in its physicochemical properties. The ointment consisting of 2% extract of Carica Papaya and Leptadenia Pyrotechnica shows satisfactory physical properties and stability.

DOI: 10.5281/zenodo.

Fungal infections pose a significant health concern globally, with a rising incidence of resistance to conventional treatments. Topical drug delivery systems offer a promising approach to enhance the efficacy and safety of antifungal agents while minimizing systemic side effects. This review explores the design, development, and optimization of bigel-based topical drug delivery systems containing Amphotericin-B and Fluconazole for the treatment of fungal infections. It discusses the challenges associated with current treatment modalities, the rationale for utilizing bigel formulations, and recent advances in this field. Additionally, the review highlights the optimization strategies, including formulation variables, rheological properties, and in vitro/in vivo evaluation methods, aimed at enhancing the therapeutic outcomes of these novel formulations.

DOI: 10.5281/zenodo.

Purpose: The purpose of this study was to investigate the efficacy of ultrasound-guided measurement of skin to epiglottic distance (SED) at the level of the thyrohyoid membrane in predicting difficult direct laryngoscopy. Methodology: The study was designed as a cross-sectional investigation conducted within the Department of Anaesthesiology at the Government Medical College, Idukki, over a period of six months following clearance from the Institutional Ethics Committee (IEC). Result:  The study’s demographics indicate that the majority of participants were aged between 36 to 55 years (40%), with a female predominance at 68%. Body Mass Index (BMI) analysis showed 54% at a healthy weight, 28% overweight, 14% underweight, and 4% obese. Physiologically, participants had varying vital measurements, including weight (average 59.826 kg), height (average 158.62 cm), systolic blood pressure (average 122.04 mmHg), diastolic blood pressure (average 74.58 mmHg), heart rate (average 69.88 bpm), and skin to epiglottis distance (average 19.56 cm), indicating diverse airway anatomy. The comparison of sonographically assessed skin to epiglottic distance (SED) and Cormack-Lehane grades revealed a significant association (χ2 = 35.737, p = .000), with SED showing potential as a predictor of difficult laryngoscopy. However, Modified Mallampati classification did not correlate significantly with Cormack-Lehane grades (p = 0.439). Conclusion: In our study, we found that the Modified Mallampati classification did not show a significant association with Cormack-Lehane grades. In contrast, sonographically assessed SED emerged as a better predictive tool for difficult laryngoscopy compared to Mallampatti classification alone. This suggests that SED may offer more reliable insights into preoperative risk assessment and patient safety during intubation procedures.

DOI: 10.5281/zenodo.

Background: The incidence of distal radius fractures has increased due to longer life expectancy and a higher occurrence of road traffic accidents and sports-related injuries among young people. These fractures account for about one-sixth of all fractures treated. This study aims to analyze the clinical outcomes of open reduction and internal fixation of these fractures using volar plates and screws. The current study aimed to determine the clinical outcomes of intra-articular and extra-articular distal radius fractures treated with open reduction and internal fixation through a volar approach. Methods: This prospective, hospital-based study was conducted at the Department of Orthopedics. It included patients from the Department of Orthopaedics diagnosed with distal radius fractures who met the specified criteria and consented to surgery and participation in the study. A total of 25 patients were enrolled in this study. Postoperative evaluation of clinical and functional outcomes was conducted using Gartland and Werley’s demerit system. All patients were followed up postoperatively for a minimum of 12 months, with assessments at 6 weeks, 6 months, and 12 months. The results were analyzed both clinically and radiologically. Results: Most patients (36%) belonged to the 18-30 year age group. Motor vehicle accidents were the most common cause of injury (84%). Locking implants were the preferred choice for volar plating (92% of patients). The treatment approach resulted in mostly favorable clinical outcomes (good or excellent) for all fracture classifications (72.0% – 88.0%). There might be a slight trend towards less favorable outcomes with more complex fractures. All patients (100%) achieved good or excellent radiological outcomes, regardless of fracture classification or implant type. There was no statistically significant difference in clinical outcomes between patients who received locking vs. non-locking implants. Both groups achieved similar results. Conclusion: This study suggests that volar plating with locking implants might be an effective treatment option for various distal radius fractures, resulting in mostly favorable clinical outcomes and excellent radiological outcomes. However, further research with larger and more balanced patient groups might be necessary to confirm these findings and explore the potential benefits of different implant types for specific fracture characteristics.

DOI: 10.5281/zenodo.

Background and Aim: There has been a significant increase in interest surrounding antibiotic coatings in orthopedic procedures in recent years. There are various coating strategies available for clinical use, including antibiotic-coated nailing, cements, beads, and on-demand antibiotic release. Multiple studies have demonstrated a decrease in implant-related infections with the use of antibiotic-coated implants. Material and Methods: This study was conducted in the Department of Orthopaedics at a medical college and associated hospital. During a span of one year, a group of 60 patients received treatment using a tibia interlocking nail coated with gentamicin. Sixty patients were selected with open fracture of shaft tibia, treated operatively with antibiotic coated intramedullary interlocking nail and were followed up for a minimum of six months duration. Radiological Union was assessed using RUST Score and clinical assessment results were graded as excellent, good, fair and poor. Results: According to the findings of the study, there were a significantly higher proportion of males, which accounted for 83% of the total. After a period of three months, the majority of patients, twenty-two in total, had an RUST score of eight. Patients who received a score of 10 came in a close second, while the population of patients who received a score of 4 was the least numerous. The length of time spent in the hospital was, on average, fifteen days. Although the majority of patients had a functional outcome that was satisfactory, there were sixteen patients who had a positive outcome. Conclusion: The combination of two procedures into one, antibiotic cement impregnated nailing, provides a dependable solution for infection control and stability. When treating open tibial fractures, one treatment option that may prove to be beneficial is the utilization of an antibiotic-coated tibia interlocking nail.

DOI: 10.5281/zenodo.

Transverse maxillary discrepancies are the most common. The narrowed upper arch is the most prevalent problem an orthodontist encounter while treating adolescent and adult patients. Maxillary expansion is a technique used to increase the upper arch’s transverse dimension to apply forces to widen the upper arch. For young children, a narrow maxillary arch has to be corrected using orthopedic and orthodontic treatments. In an orthodontic treatment plan, it is crucial to update transverse maxillary defeat. There are various clinical manifestations associated with a transverse maxillary deficiency which include a narrow palate, crossbite mainly seen in posteriors (unilateral or bilateral), severe crowding in anterior teeth, and cone-shaped hypertrophy can be seen. Some frequently used therapies for constricted upper arch include slow maxillary expansion, rapid maxillary expansion, and surgically assisted rapid maxillary expansion. Slow maxillary expansion requires light and constant force, whereas rapid maxillary expansion needs heavy pressure for activation.

DOI: 10.5281/zenodo.

Introduction: Nearly 75% of the total length of the gastrointestinal tract is occupied by small intestine (duodenum, jejunum and ileum) and it constitutes more than 90% of the mucosal surface area and the sites for broad array of diseases. The large intestine is composed of 4 parts. It includes the cecum, ascending colon, transverse colon, descending colon and sigmoid colon. The large intestine performs an essential role by absorbing water, vitamins, and electrolytes from waste material. Clinical and radiological findings of these lesions are non-specific therefore, biopsy is requiring for diagnosis of lesion. Thus, the present study was conducted to find out the profiles of various histological lesions of the small intestine and large intestine. Methods: This was a retrospective study conducted in the Department of Pathology, C.U. Shah medical college, Surendranagar on received specimen with intestinal lesions over a period of five year. Results: Of the total of 100 cases, 58 were from small intestine, 27 were from large intestine and 15 from Meckel’s diverticula there were 63 males and 37 females with a male to female ratio of 1.8:1. 24 lesions were neoplastic, while 76 non-neoplastic. The majority of lesions had inflammatory pathology, which constituted 76 cases in all. 10 lesions were malignant and 14 were benign. The most common age group for non-neoplastic lesion was 51-60 years in male and in female; it was 61 -70 years. The most common age group for benign lesion in male was 0-30 year and in female it was 21-60 years. The most common age group for malignancy was 51-60 years in both males and females in the present study. Male to female ratio for malignancies is 2.3:1. Conclusions: In developing countries, infective etiology remains dominant cause of intestinal obstruction and perforation. Intestinal resection in older age group demands effective preventive measures in this part of world to prevent morbidity and mortality. Histopathological examinations of resected intestine provides definite evidence of underling etiology guiding better healthcare planning for preventive measures.

DOI: 10.5281/zenodo.

Background: Neonatal respiratory distress syndrome is leading cause of hospital admission of newborn. Diagnosis of cause of respiratory distress is challenging. Chest X – ray only imaging modality and we had to depend on clinical sig and symptoms in past. We have now USG along with X- ray for diagnosing cause of respiratory distress in NICU set up now days. In this study we attempted to compare the sensitivity and specificity of X ray and USG in diagnosing NRDS and evaluating them their efficacy in ruling out or excluding other causes of respiratory distress in newborn. Method: 52 patients, who are clinically suspected of NRDS, are included in this study. USG and X- ray were done to all Neonates. Sensitivity and specificity were calculated, for X-ray and USG. Results: 40 cases out of 52 cases show “Pleural line abnormality”, and do not show features of any other disease like Meconium aspiration syndrome or TTN by Chest X-ray. These 40 cases were finally diagnosed to have NRDS. Out of these 40 cases 33 were found to be positive for “Sub pleural consolidation”. Only 25 cases show reticulo granular or ground glass pattern. Sensitivity and specificity of “Pleural line abnormality”, “Sub pleural consolidation” and “Chest X-ray” were calculated. Conclusion: Chest X-ray was used as the only imaging mode for diagnosis in past. Hence forth we consider Chest X ray as the gold standard for diagnosing NRDS. Ultrasound was found to be more sensitive whereas X-ray found to be more specific. “Pleural line” and “Sub-pleural consolidation” were found to be positive in most cases of clinically suspected cases of NRDS.

DOI: 10.5281/zenodo.

Nutraceutical have emerged as a vital frontier in healthcare, offering innovative solutions that bridge the gap between food and pharmaceuticals. Nutraceuticals are mainly characterized into dietary products supplements and functional foods that provide the body with medical or health benefit. This article review provides a comprehensive overview of the recent advancements in nutraceutical medicines, focusing on their potential to revolutionize the way we approach health and well-being. We delve into cutting-edge research and clinical studies that highlight the efficacy of nutraceuticals in preventing and managing various health conditions. The review also explores the evolving regulatory landscape and consumer trends shaping the nutraceutical industry. As we navigate the ever-expanding landscape of nutraceutical medicine, this review sheds light on the promising developments and challenges that lie ahead, emphasizing their potential to reshape the future of healthcare. Nutraceuticals are dietary supplements that have shown to provide biological advantages or to offer some defence against long-term illnesses. Nutraceutical have become a billion-dollar industry in US, Europe and Japan with multiple factors contributing to the growth of nutraceutical industry in India. The Indian nutraceutical industry has been growing at 25% annually during the pandemic.

DOI: 10.5281/zenodo.

A Series of newer 5-substituent N-(substituent phenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine analogues 4a-f was subjected to molecular properties prediction by mol soft and Molinspiration software and was synthesized in satisfactory yields. All the compounds followed the Lipinski “rule of five “which makes them potentially active agents. 3 Compound (4a, 4b & 4f) were evaluated for their anticancer activity in one dose assay and showed moderate activity on various cell lines. Compound N-(4-chlorophenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4b) showed maximum activity with growth percent (GP) of 59.73 on SR (Leukemia), 72.77 on  NCI-H522 (Non-Small Cell Lung Cancer A549/ATCC) and mean growth percent (GP) of 96.31. and Compound N-(2-methoxyphenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4f) showed maximum activity with growth percent (GP) of 66.70 on T-47D (Breast Cancer), 68.96 on NCI-H522 (Non-Small Cell Lung Cancer A549/ATCC), 75.64 on SNB-75 (CNS Cancer) and mean growth percent (GP) of 92.62. Compound N-(4-bromophenyl)-5-(3, 4, 5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4a) could be considered as lead further discovery and could be modified to potentiate the anticancer activity.

DOI: 10.5281/zenodo.

A Series of newer N-(substituent phenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine analogues 4a-f was subjected to molecular properties prediction by mol soft and Molinspiration software and was synthesized in satisfactory yields. All the compounds followed the Lipinski “rule of five “which makes them potentially active agents. 3 Compound    (4a, 4d & 4f) were evaluated for their anticancer activity in one dose assay and showed moderate activity on various cell lines. The compound N-(2,4-dimethylphenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4d) showed maximum activity with mean growth percent (GP) of 97.75 followed by N-(2,4,6-trimethylphenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4f) showed mean GP of more than 85.81. The compound 4f was highly active on T-47D (Breast Cancer) [GP=66.70], NCI-H522 (Non-Small Cell Lung Cancer A549/ATCC) [GP=68.96], SNB-75 (CNS Cancer) [GP=75.64]. The compound 4d showed maximum activity on A498 (Renal Cancer) [GP=78.31], SF-268 (CNS Cancer) [GP=83.14], TK-10 (Renal Cancer) [GP=84.77]. The compound 4d showed maximum activity on SR (Leukemia) [GP=59.73], NCI-H522 (Non-Small Cell Lung Cancer A549/ATCC) [GP=72.77], LOX IMVI (Melanoma) [GP=76.63], MCF7 (Breast Cancer) [GP=81.32]. The maximum activity was observed with 4a on SR (Leukemia) with GP=59.73. The compound N-(phenyl)-5-(3,4,5-trimethoxyphenyl)-1,3,4-oxadiazol-2-amine (4a) could be considered as lead further discovery and could be modified to potentiate the anticancer activity.

DOI: 10.5281/zenodo.

The exploration of oxadiazole derivatives as promising anticancer agents holds significant promise for the development of novel therapeutics. Through extensive research and experimentation, these compounds have demonstrated remarkable potential in targeting cancer cells with high specificity and efficacy. The diverse structural modifications available for oxadiazole derivatives offer a wide range of opportunities for further optimization and fine-tuning of their anticancer properties. Despite the challenges ahead, continued investigation and refinement of oxadiazole-based compounds are essential for advancing cancer treatment strategies and ultimately improving patient outcomes. With ongoing efforts, the therapeutic potential of oxadiazole derivatives in combating cancer remains a compelling area of research warranting further exploration and development.

DOI: 10.5281/zenodo.

Introduction: Beyond being little copies of adults, infants are unique. Individuals differ in terms of their illnesses, symptoms, priorities, and therapy requirements. Adolescents may not experience typical adult outcomes. Since the majority of birth disorders are self-limiting, transient, and physiological, treatment is not necessary. Parents who experience anxiety often seek advice from their child’s physician regarding skin imperfections. For this reason, it’s critical to recognise which skin lesions require immediate attention and to have a thorough awareness of both common and unusual newborn cutaneous lesions. Material and Method: Since the lesion was discovered, ambient light from windows letting natural light into the building was used to inspect it first visually and then under a magnifying lens. For a more precise description, the maximum length and width of the lesion were measured in cm using a ruler. Result: To detect skin lesions in babies admitted to a sick newborn care unit or a neonatal intensive care unit, taking into account the kind, extent, size, and relationship of the lesion to sex, gestational age, and sociodemographic variables. The purpose of this study was to examine the clinical characteristics of various skin conditions in a group of infants from India who were admitted to a level III neonatal care facility, taking into account the previously described criteria, and to analyse a few of the most noteworthy instances. Conclusion: The current study was conducted at the paediatrics and skin and VD departments of the SCB MCH & SVPPGIP, Cuttack, Odisha, from May to October 2014. Over the course of the research period, 3161 neonates were admitted to hospitals; of them, 1480 developed skin lesions and spent an average of 22 days there. It was notable that the skin lesion proportion was 46.82% when compared to the newborns admitted for other causes. At birth, there are more males than females: 1063 (71.82%) compared to 417 (28.18%). The current study discovered a total of 27 distinct types of skin diseases, with an average of about 0.018 skin issues per neonate.

DOI: 10.5281/zenodo.

Introduction: Cytopathology is a specific subspeciality of Pathology in which Fine needle aspiration cytology (FNAC) always play a crucial role in early detection abnormal cell morphology. FNAC Procedure is fast, safe and help in early detection of Head and Neck Lesions with more than 90% accuracy. Material and Methods: This is retrospective observational study including 415 cases having Head and neck Lesions. This study was conducted in Department of Pathology, ASMC Firozabad. FNAC procedure was performed by aspiration and non-aspiration techniques and cytological diagnosis was given and confirmed by Histopathology where ever it is indicated. Findings were also correlated with Clinic radiological findings. Results: The most common age group affected was 05-78 years with mean age group 41.8 years. Male to female ratio was 0.87 spectrum of these lesions was including ReactiveLymphadenitis132(65.3%), GranulomatousLymphadenitiswasfoundin70 (34.6%), Epidermal inclusion cyst 98, Necrotising Lymphadenitis 49  followed by salivary gland Lesions 14 cases. Out of theses 14 cases pleomorphic Lesions were most common (09). This study shows 380 cases (91.56%)  were benign and the malignancy was seen only in 35 cases (8.43%). Conclusion: This study concluded out that role of FNAC in finding out early pathological changes in Head and Neck Lesions is very crucial. FNAC is very simple, safe and with minimal invasive procedure is sufficient to differentiate between Benign and Malignant Lesions and avoid unnecessary Tests and Financial burden on patients

DOI: 10.5281/zenodo.

Spiral CT angiography is a new, minimally invasive technique for vascular imaging that is made possible by combining two recently developed techniques: slip-ring CT scanning and computerized three-dimensional (3D) reconstruction. CT angiography done to diagnose and evaluate blood vessel disease or related conditions, such as aneurysms or blockages, Arteriovenous malformation (AVM), hemangioma, stenosis, AV fistula, aortic dissection, pulmonary embolism, thoracic outlet syndrome etc.
Over the past decade, noninvasive imaging of the arteries has evolved into a highly reliable alternative to invasive digital subtraction angiography. Here we presents few rare cases where diagnosis was made possible by CT Angiography.
(1) Bilateral renal AVM with aneurysmal dilatation of feeding arteries on left side, which was diagnosed by renal CT Angiography. (2) Cerebral arterio-venous malformation involving left temporo-parietal lobes, diagnose by carotid CT Angiography. (3) Takayasu arteritis (Type-V), diagnosed by Aortogram. (4) Arterio-venous malformation involving postero-lateral aspect of middle third of left leg, diagnosed by peripheral CT Angiography. (5) Non-calcified soft tissue plaque seen at the proximal part of LAD near its origin results in moderate luminal stenosis with negative remodeling, diagnosed by Cardiac CT Angiography.
CT angiography is a type of medical test that combines a CT scan with an injection of a special dye to produce pictures of blood vessels and tissues in a part of our body. The dye is injected through an intravenous (IV) line started in our arm or hand. Before Multi-Detector Computed Tomography (MDCT), the main barriers to the clinical implementation of CT angiography (CTA) were acquisition speed and both spatial and temporal resolution.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the histopathological features of various lesions in the urinary bladder. Methods: The present study was conducted in the  Department of Pathology, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India for the period of 1 year. 50 cystoscopic biopsies from patients attending Darbhanga Medical College and Hospital, Darbhanga, Bihar, India were studied. Results: Among 50 cases, 35 were neoplastic, 15 non- neoplastic and one was classified as biopsy specimen inadequate or unsatisfactory for evaluation. There was clustering of cases between 41-80 years with maximum cases seen in 51-70 years of age together having 21 cases. Hematuria was the most frequent complaint that the patients presented with followed by Dysuria, increased frequency of micturition, urgency and pain abdomen. Among the non-neoplastic lesions 11 were chronic non-specific cystitis, 2 were Acute or chronic cystitis, 1 granulomatous cystitis of tubercular etiology and 1 was polypoidal cystitis. In our study out of 35 cases, 1 was inverted papilloma’s, 2 were Papillary urothelial neoplasms of low malignant potential, 12 were Low grade papillary urothelial neoplasms. 10 were high grade papillary urothelial neoplasms, 8 were Invasive urothelial neoplasms and one case each of Squamous cell carcinoma and Sarcomatoid carcinoma. Conclusion: Urinary bladder biopsy is one of the most common biopsies in urology practice. In our study bladder tumors were the commonest lesions seen in cystoscopic biopsies and TCC was the predominant tumor type. Hematuria was a common symptom in our series and the clinicians showed a keen awareness to the dangers of this symptom and investigated these patients further, which led to discovery of the urothelial tumors.

DOI: 10.5281/zenodo.

Aim: This study was undertaken to study the various histopathological patterns of ovarian lesions, their classification and relative distribution of these lesions. Methods: The study was undertaken as a retrospective study using existing patient data retrieved from the records of the Department of Pathology, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India during the period of 12 months. 200 ovarian mass specimens were received for evaluation, either as solitary specimens, or as part of total abdominal hysterectomy (TAH) specimens. Results: Majority of the Patients were in the age group of 10-39 years. A total of 170(85%) cases were unilateral while 20(15%) cases were bilateral. 39 cases were asymptomatic. Associated findings in specimens of Hysterectomy with salpingo-oophorectomy were also found. Most common was leiomyoma either alone or in combination with adenomyosis. Other associated findings were chronic cervicitis, carcinoma endometrium, carcinoma cervix; hydrosalpinx etc. Other non-neoplastic lesion were Cystic follicle (14 cases), Follicular cyst and Parovarian cyst (6 cases each), hemorrhagic cyst, ectopic gestation, Torsion ovary, Inclusion cyst and oophoritis. Conclusion:  Ovarian lesion comprises of wide spectrum of lesions and their presenting clinical, radiological and gross features are very similar. Hence Histopathology forms the mainstay of definitive diagnosis and categorization of these lesions.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to analyze the post-operative pain management in elective laparotomies in a tertiary care centre. Methods: This prospective observational study conducted in the Department of General Surgery, Darbhanga Medical College and Hospital, Darbhanga, Bihar, India for the period of one year. All patients who underwent elective laparotomy were provided details about the study and method. Informed written consent was obtained. A total of 200 patients were included. Detailed history of the patient, condition, surgery performed, analgesics used were documented. NRS score was calculated. Results: A total of 200 patients were included among which 40 (40%) were female and 120 (60%) were the male patients. The patients who underwent elective laparotomies were aged between 20-70 years and 80 (40%) patients were in the age group of 40-50 years. The 20 different types of surgeries were recorded. The most common surgery performed in our study was open appendectomy which included 42 (21%) patients followed by open cholecystectomy (for carcinoma gall bladder and other indications) which included 18 (9%) patients. Most common was general anaesthesia with transverse plane block which was used in 76 (38%) patients, followed by general anaesthesia with quadratus lumborum block which was used in 42 (21%) patients. Most common mode of analgesia used was combined analgesia. Injection tramadol 50 mg in 100 ml normal saline with continuous epidural bupivacaine followed by injection diclofenac AQ 75 mg in 100 ml N.S with continuous epidural. Severity of pain gradually reduced from post -operative days 1-3 with the use of various analgesics. Conclusion: Multimodal analgesia was used in most of the patients for management of post – operative pain combined analgesia was better mode of pain management method than a single analgesic. Due to different multimodal analgesics used in different institutions patients experienced different degrees of pain, hence we need a standard protocol for a best pain management method.

DOI: 10.5281/zenodo.

Introduction: Haematological disorders constitute a broad spectrum in which patients can present with various clinical presentations. Megaloblastic anemia is deficiency anemia, the reason is that DNA synthesis is inhibited in the red blood cell production process. The disease state of megaloblastosis is characterized by the presence of many large, immature, and dysfunctional red blood cells in the bone marrow with excessive division of neutrophils. Material & Methods: Total 60 patients with indications of bone marrow evaluation referred to Department of Pathology, Gandhi Medical College Bhopal, were included in the study. Only patients with Known serum Vitamin B12 levels, PS findings and bone marrow aspiration were included. Pregnant females, patients with blood transfusion, medication or any bleeding disorders were excluded. Serum vitamin levels, PS and marrow findings were studied and compared. Observation & Results: Total 60 patients were included. It was found that mean hemoglobin level (6.2 gm%) WBCs count (3400/cumm) and platelet count (0.80 lakh/cumm) was least in elderly age group. Mean serum Vitamin level was least in elderly age group i.e. 96pg/ml. Vitamin B12 level was found borderline low in younger age group (148 pg/ml). Peripheral examination and morphology typing shown pancytopenia in 19 patients followed by anemia with thrombocytopenia in16, bicytopenia 13 and dimorphic anemia 12 patients. Conclusion: Megaloblastic anemia is a common anemia most commonly caused by Vitamin B12 deficiency.  Prevalence of this anemia is higher in our society due to strict vegetarian diet in various communities of our country. Marrow erythroid shows erythroid hyperplasia and megaloblastosis pointing towards the increased erythroid activity of bone marrow. Prompt diagnosis and timely treatment can prevent the serious neurological effects of Vitamin B12 deficiency.

DOI: 10.5281/zenodo.

Introduction: The COVID-19 pandemic has posed an increased burden on the health care delivery system in India and has been associated with a wide range of opportunistic bacterial and fungal infections. Amis and Objectives: To know the prevalence of fungal infections among the post covid patients. Material and Methods: A total number of 482 samples from clinically suspected mucormycosis cases attending various departments and transported to department of Microbiology, All samples are processed according to standard Microbiological procedures. Results: In a total of 482 clinically suspected individuals, fungal culture and microscopy were used to evaluate mucormycosis. Out of 482 samples analysed in this study, 263 cases (54.5%) were found to have fungal elements with a 10% KOH mount, while 219 cases (45.5%) were found to be negative. Out of 482, 247 (51.2%) samples were positive for culture, and 235 (48.8%) samples were sterile. Of the 247 fungal isolates, 91 (36.8%) are Mucorales, of which 90 are Mucor species. But one of them was identified as Rhizopus, while the remaining 112 (45.4%) are Aspergillus species, 43 (17.4%) are Candida species, and 1 (0.4%) is a Penicillium species. Conclusion: Despite the hype, mucormycosis cases were well handled by using simple microbiological methods for an early diagnosis and initiation of antifungal therapy in our hospital.

DOI: 10.5281/zenodo.

AI applications include precision diagnostics, therapies, and medicine, which use machine learning and deep learning to improve clinical procedures. Effective AI systems require a problem-solving, human-centered strategy that addresses issues such as data quality, infrastructure, ethics, and regulations. Future breakthroughs include augmented care and AI-enabled healthcare personnel. Furthermore, they help to forecast disease development, guide treatment approaches, and enable personalized medicine for more effective therapies. AI and machine learning have the potential to transform healthcare delivery and management by optimizing hospital operations, reducing administrative procedures, and allocating resources more efficiently. Furthermore, AI-powered chatbots and virtual assistants improve accessibility and patient engagement by giving personalized health advice, answering patient questions, and providing triage support. AI simplifies medical procedures and offers quick assistance. Ethical considerations are critical to responsible AI use. Emerging medical technologies have the prospect of revolutionizing healthcare delivery. Collaboration is vital for incorporating AI into healthcare. Furthermore, AI helps to accelerate drug research by assessing biomedical data and optimizing medication compositions. AI can significantly improve clinical research and personalized health product development by discovering relevant interventions and assessing their efficacy. The effective deployment of personalized medicine depends on the improvement of assays and procedures for data management, including storage, aggregation, access, and integration. Artificial intelligence (AI) in healthcare improves efficiency and accuracy in medical processes including diagnosis and treatment planning. AI is fast evolving because to breakthroughs in computing power, large data, and machine learning. ChatGPT is a significant AI tool for natural language processing.

DOI: 10.5281/zenodo.

Background and Aim: Distal radius intraarticular fractures can have a significant impact on clinical outcomes. Treatment of intraarticular fractures is a topic of debate in the medical community, with varying outcomes reported in the literature. Our study aimed to assess the effectiveness of radius bone plate fixation in the treatment of radius bone fractures. Material and Methods: A group of fifty patients who had fractures in the distal part of their radius underwent treatment using the fixed angle plate fixation method. Patients were monitored through radiographs, physical examination, ASA and VAS score. Results: Among the 50 patients, 30% (15) were found to have 2R3A1, while 22% (11) were found to have 2R3B1. Out of the total number of patients, 20% (10) were found to have 2R3B1. Out of the 28 patients, 14 were diagnosed with 2R3A2.1 types of fracture based on the AO fracture classification. According to this retrospective study, fractures were found to occur more frequently on the left side of the radius (56%) compared to the right side (44%). Based on data from the American Society of Anaesthesiologists (ASA), the majority of patients (84%) were classified as grade 1, indicating that they were normal and healthy. A smaller percentage of patients (16%) were classified as grade 2, indicating that they had mild systemic disease. Conclusion: The utilization of radius plates in the treatment of unstable distal end radius fractures has been found to result in favorable functional outcomes and few complications.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to evaluate the efficacy of Intravenous (IV) opioids in attenuating the stress response and serum cortisol levels during endotracheal intubation. Methods: This study was undertaken in the Department of Anaesthesiology & Critical Care, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India .90 patients, with 30 in each group, in different age group, either sex, belonging to ASA I and ASA II scheduled for elective surgical procedures under General Anesthesia were included. Results: There was equal distribution of male and female in all the three groups. The mean age in Fentanyl Group, Morphine Group and Nalbuphine Group was 33.2, 32.08 and 29.12 respectively. The rise in blood pressure was much less in fentanyl group as compared with morphine and nalbuphine group at all measured time intervals. The rise in Diastolic blood pressure was much less in fentanyl group as compared with morphine and nalbuphine group at all measured time intervals. The result showed no statistical significance in serum cortisol levels between the three groups at SCL_0. Serum cortisol levels are statistically significantly lower at SCL_1 and SCL_2 among all the three groups. Conclusion: At the dose used in this study, fentanyl was significantly reducing stress response during laryngoscopy and intubation followed by morphine and nalbuphine Hence Intravenous Fentanyl given at the dose of 2 mcg/kg effectively attenuates the stress response after laryngoscopy and intubation as compared to Morphine 0.1mg/kg and nalbuphine0.2mg/kg in that respective order.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the effects of yogic practice on cardiovascular system in apparently healthy volunteers at tertiary health care center. Methods: This was a cross sectional study carried out in the department of physiology  during the six-month period. 100 apparently healthy individuals were selected out of these with written and explained consent 50 individuals were instructed and trained in the yogic practices (Yogic group n=50) and rest 50 individuals were control (Non yogic group n=50). Results: The age was comparable 35.55 ± 4.36 and 36.18± 5.35 (p>0.05). There was male predominance. The Pulse rate (beats/min) was significantly lower. Systolic B.P. (mm Hg) significantly lower and Diastolic B.P. (mm Hg) was significantly in Yogic as compared to non-yogic apparently healthy individuals. Conclusion: It can be concluded from our study that the yogic individual were having significantly lesser Pulse rate, Systolic and diastolic BP as compared to non-yogic individuals hence Yoga should be practiced for prevention of hypertension and its complications.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the Diffusion-weighted imaging effects of intravascular contrast agent on apparent diffusion coefficient measures of ovarian neoplasms. Methods: This was a Prospective Study was conducted on 50 patients at department of Radiology, with Study population being women with newly diagnosed ovarian tumors who underwent CEMRI study to evaluate the nature of tumor and extent. Results: Most of the patients belonged to >60 years of age. 30 were benign and 20 were malignant. Most of the patients had size of tumor from 101-200 mm. In benign ovarian tumors, Pre contrast mean ADC was 1.49± 0.47 and Post contrast mean ADC value was 1.42±0.68 with statistically insignificant P value. In malignant ovarian tumors, Pre contrast mean ADC was 0.91±0.20 and post contrast mean ADC value was 0.94±0.23 with statistically insignificant P value. Conclusion: ADC measures using our approach were not significantly changed after contrast administration for ovarian tumors at 1.5T. Our findings support the possibility that DWI optimized may be obtained before or after DCE-MRI without compromising important clinical information. Benign ovarian tumors had higher ADC values compared to malignant tumors, consistent with some of the previous studies.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the efficacy of vacuum-assisted biopsy (VAB) excision system for the removal of benign breast lesions in terms of complete excision rate and incidence of complications. Methods: The prospective study was done in department of Interventional radiology from December 2022 to November 2023. 8 patients with 12 Fibroadenoma (4 patient’s single lesion, 4 patients-2 Lesions) were included in the study. Patients were followed up at 1, 6 & 12 months. Results: The mean age of the patients was 27.5 years. Hematoma formation was not statistically significant related to size of lesion. The correlation between hematoma developments was clinically significantly related to occurrence of pain intra- procedural, although there was not significant difference between hematoma and post-procedural pain statistically. Conclusion: The study showed that the use of vacuum-assisted biopsy excision system could provide a safe method for complete excision of fibroadenomas, with low rate of complications as incomplete excision, pain, and hematoma formation.

DOI: 10.5281/zenodo.

Introduction: Sleep is a vital physiological process, which promotes and maintains good health. Sleep curtailment has increased widely especially among the students at medical colleges who have recently shifted to hostels. Sleep loss has been shown to result in metabolic and endocrine alterations. Hence, it is essential to correlate sleep quality with its adverse impacts like obesity and excessive daytime sleepiness so that timely corrective measures can be taken to create healthy future doctors. Objectives:  1) to assess the sleep quality of the first year MBBS students. (2) Examine the correlation of sleep quality with BMI. Methods:  This is a Descriptive and Cross Sectional study. Study subjects are the first professional MBBS students, who are willing to participate in the study. BMI is calculated as per the standard protocol. Sleep quality is assessed by the “Pittsburgh Sleep Quality Index (PSQI)” questionnaire administered to the students via the Google forms. They are given instructions on how to correctly answer the questionnaire. Results:  No significant difference was detected in the PSQI sleep scores and sleep duration of the different BMI categories as tested by ANOVA. Pearson correlation coefficient showed a weak positive correlation between PSQI scores and BMI. Although the study does show, a trend towards longer sleeping hours in normal BMI subjects. Conclusion: Present study shows the presence of low sleeping duration in overweight and obese population. PSQI scores were not significantly different among the different BMI categories. However, the PSQI scores were towards poor side for all the categories showing that the sleep quality is poorer in our students.

DOI: 10.5281/zenodo.

Background and Aim: Intrathecal adjuvants have gained popularity for prolonging duration and quality of subarachnoid block. Hence, this study was undertaken to evaluate the effect of addition of magnesium sulphate with bupivacaine (hyperbaric) in spinal anesthesia for prolongation of analgesia. Material and Methods: This randomized controlled study enrolled 80 patients, comprising both males and females with American Society of Anesthesiologists physical status I or II, who were scheduled for lower limb orthopedic surgeries. Patients were randomly allocated in two groups and were given following drug intrathecally as per group. Group BM – bupivacaine 15 mg(0.5% heavy) with magnesium sulphate (100 mg) Group B – bupivacaine 15 mg (0.5% heavy) with 0.5 ml normal saline. Parameters monitored were onset of sensory and motor block, duration of analgesia, hemodynamic parameters, sedation score and intra and postoperative complication. Data analyzed by student’s t test and chi square test. Results: The time of onset of sensory block was comparable in both the group, the time of onset of motor block was delayed in group BM (77.37 ± 8.69) compared to Group B (72.50 ± 12.40). The mean duration of motor blockade was 322.25 ± 23.91 min in group BM and 272.50 ± 23.01 min in group B. It was statistically significant. The postoperative analgesia was found to be prolonged with addition of intrathecal magnesium sulphate (24 hr VAS score 2.13 ± 1.17 in BM group, and 3.40 ± 1.79 in Group B) and it provided better hemodynamic stability. Conclusion: The addition of 100 mg of magnesium sulfate to hyperbaric bupivacaine has effectively extended analgesia duration, influenced motor blockade onset, and improved hemodynamic stability without notable adverse effects, making it a valuable adjunct in lower limb orthopedic postoperative pain management. Additional research and trials are warranted to fully understand its therapeutic benefits and optimize its clinical utility.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the hand grip strength & fine motor skills in skilled & non skilled persons. Methods: The current investigation was carried out in the Department of Physiology. We enrolled a cohort of 200 physically fit individuals between the ages of 20 and 40 who shown no difficulty in complying with the researcher’s instructions, possessed enough muscular strength to do the assigned activity, and exhibited no restrictions in joint mobility. Results: There were no statistically significant differences between the groups in terms of general characteristics (p > 0.05). There were no notable differences between the groups in the time it took to complete the CMT assessment before and after the intervention. There were no notable differences between the experimental and control groups in terms of the duration of the pre-intervention PPT time and post-intervention PPT time (experimental group: 52.80 ±6.31 s; control group: [missing value]). Conclusion: When opposed to those who are not competent, skillful individuals have a decrease in their muscular strength, which results in an improvement in fine motor skills such as FT and PDT.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to study effect of amlodipine, atenolol, enalapril and chlorothiazide on arterial blood pressure, heart rate and renal function tests. Methods: The study was carried out in the Department of Pharmacology in collaboration with Department of Medicine, Darbhanga Medical College, Darbhanga, Bihar, India. Total 160 patients with hypertension were included in the study. These patients were assigned to one of the 4 groups randomly. There were 40 patients in each group. Patient prescribed with tablet amlodipine 5mg or 10 mg was be considered as Group I, likewise, prescription of tablet atenolol 25 mg or 50 mg was be considered as group II, prescription of tablet enalapril 2.5 mg or 5 mg was considered as group III and prescription of tablet thiazide diuretics 12.5 mg or 25 mg was be considered as group IV. Results: The effects of drugs on systolic blood pressure (mmHg) before & after were studied. Mean change in systolic blood pressure was analyzed by chi square test. It was statistically significant. Highest decrease in blood pressure was seen by Enalapril followed by thiazides, Atenolol & Amlodipine. The effects of drugs on diastolic blood pressure (mmHg) before & after were studied. Mean change in diastolic blood pressure was analyzed by chi square test. It was statistically significant. Highest decrease was seen by Atenolol followed by amlodipine, enalapril & thiazide. The effects of drugs on mean heart rate before & after were studied. Mean change in blood pressure was analyzed by chi square test. It was statistically significant. Highest decrease was seen by Atenolol followed by enalapril, amlodipine & thiazides. Conclusion: Antihypertensives have effect on blood pressure, heart rate, renal functions. Patient’s renal function, heart rate should always be considered while prescribing antihypertensive drugs.

DOI: 10.5281/zenodo.

Aim: The current research set out to examine the clinical characteristics of tertiary hospitalized patients experiencing acute sensorineural hearing loss. Methods: The ENT department of Zydus Medical College and Hospital in Dahod, Gujrat, India, provided the setting for the current retrospective investigation. Two hundred case records were reviewed. This study used case records from the last three years to look at individuals who had sensorineural hearing loss that came on suddenly. Results: All patients were compared by recovery. The recovery rate was 40% in 80 patients and 60% in 120 individuals. 43% of patients were 41-60 years old, followed by 30% from 21-40. Patients with recovery had a significantly higher mean age (42.88 ± 8.32 years) compared to those without recovery (51.52 ± 11.79 years) (p<0.05). No significant gender difference was seen among total patients or those with or without recovery (p>0.05). Hypertension (35%), diabetes (20%), dyslipidemia (20%), and thyroid disease (8%) were common comorbidities. The difference in vertigo between patients with and without recovery was statistically significant (p<0.05). Patients with recovery (40%) and those without recovery (60%) had similar tinnitus (p>0.05). The majority of patients had flat, U-shaped, reverse U-shaped (45%), descending (40%) and ascending (15%) audiogram curves. Hearing loss was modest (8%), moderate (10%), fairly severe (20%), severe (25%), and profound (37%). A significant difference (p<0.05) was seen in the incidence of individuals without recovery with increasing hearing loss severity. Conclusion: Individuals under the age of 40 who experience sudden sensorineural hearing loss may have a higher chance of recovery if they start therapy within 14 days of onset, do not have any other medical conditions, and have a less severe degree of hearing loss.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the effect of nutritional variables in children with iron deficiency anemia in Bihar population. Methods: The present study was conducted in the Department of Paediatrics,  In the current study, the main variable was IDA, which is a categorical variable. Blood samples of 250 randomly selected children (6-59 months) living in the urban and rural areas were taken. Children who had history of liver infectious disease, liver cancer or high fever were excluded from the study. Results: There were 3 groups among them; majority of families had 1-2 children. Highest range of IDA was seen in the families with 6-9 children. 23.6% of rural families with IDA child had 6 or more children in their family while in the urban areas IDA was mostly seen in the families with 1-2 children. Logistic regression analysis indicated the association in the families with more than 6 children and IDA. Conclusion: The prevalence seems to be the same in urban and rural areas and similar in both sexes. Statistically it was proven that young mothers and families with 6 or more children were the best predictors for increased prevalence of IDA among fewer than 5 years old children in this research. It was shown that there are several main risk factors for iron deficiency and anemia in the children.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to assess the Correlation of Hs Troponin I & Uric Acid in patients of Myocardial Infarction. Methods: 200 patients who came to cardiac emergency in the Department of Medicine, Nalanda medical College and Hospital, Patna, Bihar, India. Serum samples were taken for Hs Troponin I and Uric Acid for patients of Myocardial Infarction and run on VITROS 5600/7600 which is based on dry chemistry. Results: Among the 200 patients of more than 40 years of age 120 were males & 80 were females. For both males & females age mean & SD was 60.6±11.72 and 58.6±12.70. For Hs Trop I males were 22.78±46.84 & females 15.75±54.56. For uric acid for males were 6.534±3.750 & for females 6.316±1.860. For Hs Trop I males were 22.78±46.84 & females 15.75±54.56. For uric acid for males were 6.534±3.750 & for females 6.316±1.860. Therefore Hs Trop I & uric acid were both significant when compared with age P value was 0.0040.Whereas when compared with sex that is male and female to both Hs Trop I and uric acid then Hs Trop I was more significant with P value 0.0001. Conclusion: In acute MI, patients with hyperuricemia had higher mortality. Serum uric acid levels correlated with Killip classification in acute MI. Serum uric acid can be used as a marker of short term mortality in patients. Hyperuricemia is an indicator of poor prognosis in acute MI. Uric acid is an economical biomarker that is readily, quickly and reliably obtainable, it can be one of the predictable prognostic indicator in acute Myocardial Infarction.

DOI: 10.5281/zenodo.

Aim: The aim of the present study was to evaluate and compare the efficacy and hemodynamic stability of ketamine / fentanyl along with propofol and also assess recovery profile, post-operative analgesia and complications in patients undergoing Dilatation and Curettage. Methods: The present study was carried out in the Department of Anaesthesia, BMIMS Pawapuri, Nalanda, Bihar, India.  the study was conducted in 50 patients, aged 18-35 years of ASA Grade 1&2 scheduled for Dilatation and Curettage procedures lasting up to 30 minutes. Results: Pre-induction heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, spo2 were comparable in both the groups with a statistically no significant difference between them (p<0.05). Conclusion: It may be concluded from our present study that propofol with ketamine as an adjuvant in the dose of 0.75 mg/kg compared to propofol with fentanyl as adjuvant in the dose of 2 mcg/kg provides deep sedation. But propofol-ketamine group is more efficacious and provides better peri-operative hemodynamic stability during anaesthesia as compared to propofol-fentanyl group. Also the propofol-ketamine combination produces good analgesia with less requirement of rescue drug in post-operative period with fewer peri- operative complications than propofol-fentanyl combination. We have not encountered any psychotomimetic effects of injection Ketamine in the 0.75mg/kg dose. Hence propofol-ketamine combination is a better choice especially when hemodynamic stability is of great importance in patients undergoing dilatation and curettage.

DOI: 10.5281/zenodo.