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.