Background: Scar revision surgery is commonly performed to improve the appearance and function of mature scars. However, satisfactory healing is not always achieved, and some patients develop poor scar quality after surgery. Platelet-rich plasma (PRP), prepared from the patient’s own blood, contains a high concentration of platelets and growth factors that may improve wound healing and scar maturation. Objective: To compare the outcomes of surgical scar revision with intraoperative PRP application and surgical scar revision alone in terms of scar quality, wound healing, postoperative complications, and patient satisfaction. Methods: This prospective randomized study included 60 patients with mature linear or post-traumatic scars. Patients were randomly divided into two equal groups. Group A underwent surgical scar revision with intraoperative PRP application, while Group B underwent surgical scar revision alone. All patients were followed for six months. Scar quality was assessed using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Wound healing time, postoperative complications, and patient satisfaction were also evaluated. Results: Both groups showed improvement after surgery. However, patients treated with PRP had better scar outcomes. The mean VSS score improved from 8.2 ± 1.4 before surgery to 3.3 ± 1.2 at six months in the PRP group, compared with 8.1 ± 1.5to 5.0 ± 1.4 in the control group. The average wound healing time was shorter in the PRP group (12.3 ± 2.2 days) than in the control group (15.1 ± 2.6 days). Patient satisfaction was higher in the PRP group (90%) compared with the control group (70%). Postoperative complications were fewer in the PRP group, and no PRP-related adverse effects were observed. Conclusion: Intraoperative PRP application during surgical scar revision improved scar quality, promoted faster wound healing, and increased patient satisfaction without increasing complications. PRP appears to be a safe and useful adjunct in scar revision surgery.

Background: Proximal humerus fractures are among the most common fractures of the upper extremity and are frequently encountered in both elderly individuals with osteoporotic bone and younger adults following high-energy trauma. Open reduction and internal fixation (ORIF) using a proximal humerus locking plate (PHILOS) has become a widely accepted treatment option for displaced fractures because of its ability to provide stable fixation and facilitate early mobilization. However, evaluation of functional recovery, radiological healing, and postoperative complications remains essential to determine the effectiveness of this treatment modality. Aim: To evaluate the functional and radiological outcomes of proximal humerus fractures in adults treated with open reduction and internal fixation using a proximal humerus locking plate. Methods: A prospective observational study was conducted in the Department of Orthopaedic Surgery at Ramkrishna Care Hospital, Raipur, Chhattisgarh, from April 2025 to March 2026. A total of 40 adult patients with proximal humerus fractures underwent ORIF using a proximal humerus locking plate. Patients were followed for six months. Clinical outcomes were assessed using the Visual Analogue Scale (VAS), Constant–Murley Score, and Disabilities of the Arm, Shoulder and Hand (DASH) Score, while radiological union and postoperative complications were evaluated at regular follow-up intervals. Data were analyzed using SPSS version 26.0. Repeated measures ANOVA was used for comparison of continuous variables, and a p-value of <0.05 was considered statistically significant. Results: The mean VAS score significantly decreased from 7.02 ± 0.69 at baseline to 1.07 ± 0.72 at six months (p < 0.001). The mean Constant–Murley score improved significantly from 37.45 ± 2.77 to 77.67 ± 3.92 (p < 0.001), while the mean DASH score decreased from 72.82 ± 6.12 to 20.67 ± 2.21 (p < 0.001). Radiological union was achieved in 90% of patients by three months, and complete fracture consolidation was observed in 100% of patients at six months. Postoperative complications were minimal, with only isolated cases of stitch line infection, stiffness, malunion, and avascular necrosis observed during follow-up. Conclusion: Open reduction and internal fixation using a proximal humerus locking plate is a safe and effective treatment modality for proximal humerus fractures in adults. The procedure provides excellent pain relief, significant functional improvement, satisfactory radiological healing, and a low complication rate, supporting its role as a reliable option for the surgical management of displaced proximal humerus fractures.

Background: Hyperbaric 0.75% ropivacaine has been widely used nowadays due to early recovery and better safety profile. We planned this study to compare the effect of intrathecal hyperbaric 0.75% ropivacaine and hyperbaric 0.5% bupivacaine in spinal anaesthesia for transurethral resection of prostate surgeries to evaluate effect on post spinal hypotension, sensory motor block characteristics and adverse effects. Materials and Methods: 120 patients were randomly allocated into 2 groups of 60 patients each in Group B and R to receive spinal anaesthesia with 2.8 ml (14 mg) of 0.5% hyperbaric bupivacaine and 2.8 ml (21 mg) of 0.75% hyperbaric ropivacaine, respectively. The primary outcome measured was the incidence of hypotension. The secondary outcomes measured were vasopressor requirement, onset and duration of sensory‐motor block, degree of motor block, haemodynamic profile and adverse effects. P < 0.05 was considered statistically significant. Results: Group R patients had significantly lower incidence of hypotension (20 % vs 45%, P = 0.01) and bradycardia (3.3% vs 16%, p=0.03) compared to group B. The mean time for the onset of sensori-motor block was faster in Group B. The duration of sensory and motor block were lesser in ropivacaine group. The patients in ropivacaine group exhibited a lesser degree of motor block as compared to bupivacaine group. The duration of analgesia and haemodynamic parameters in both groups were statistically comparable. Conclusion: Despite a slower onset time of block, intrathecal hyperbaric ropivacaine provides a better alternative to intrathecal hyperbaric bupivacaine for transurethral resection of prostate surgeries by providing a stable haemodynamic profile, shorter duration of sensorimotor block, a lesser degree of motor block, and thus allowing early ambulation.

Background: Thrombocytopenia is a common hematological abnormality encountered in routine clinical practice and may result from a wide spectrum of pathological conditions ranging from benign transient disorders to life-threatening diseases. Platelet volume indices such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) are increasingly recognized as useful diagnostic markers for differentiating the underlying causes of thrombocytopenia. These platelet parameters are readily available through automated hematology analyzers and may reduce the need for invasive investigations. Aim: To assess the diagnostic utility of platelet volume parameters in patients with thrombocytopenia and evaluate their correlation with different etiological categories. Materials and Methods: A retrospective observational study was conducted in the Department of Pathology, All India Institute of Medical Sciences (AIIMS), over a period of three years from January 2022 to December 2024. A total of 300 thrombocytopenic patients with platelet count below 150 × 10⁹/L were included. Platelet parameters including MPV, PDW, plateletcrit (PCT), and P-LCR were analyzed using an automated hematology analyzer. Cases were categorized into hyperdestructive and hypoproductive thrombocytopenia based on clinical and bone marrow findings. Statistical analysis was performed using IBM SPSS Statistics version 26.0. Independent t-test, Chi-square test, and ROC curve analysis were applied. A p-value <0.05 was considered statistically significant. Results: Among 300 cases, hyperdestructive thrombocytopenia constituted 188 cases (62.7%), while hypoproductive thrombocytopenia accounted for 112 cases (37.3%). Mean MPV and PDW values were significantly higher in hyperdestructive thrombocytopenia compared to hypoproductive thrombocytopenia (p<0.001). ROC analysis demonstrated MPV cutoff value of 10.4 fL with sensitivity of 84.6% and specificity of 78.3% in differentiating hyperdestructive from hypoproductive thrombocytopenia. Significant association was observed between platelet indices and underlying etiology. Conclusion: Platelet volume parameters, particularly MPV and PDW, are valuable non-invasive diagnostic tools in evaluating thrombocytopenia and may help differentiate hyperdestructive from hypoproductive causes. Combined assessment of platelet indices improves diagnostic accuracy and may reduce unnecessary invasive procedures.

Background: The radial forearm free flap (RFFF) is widely used for head and neck reconstruction because of its reliable anatomy, long vascular pedicle, pliability, and high success rate. However, venous congestion and thrombosis remain important causes of flap compromise. The communicating vein provides a connection between the superficial and deep venous systems and may permit dual-system drainage through a single venous anastomosis. Aim: To evaluate the reliability of single venous anastomosis using the communicating vein in RFFF reconstruction for head and neck cancer. Methods: This prospective study included 60 patients who underwent RFFF reconstruction for head and neck squamous cell carcinoma between March 2023 and September 2025. Venous drainage patterns, number of venous anastomoses, re-exploration, venous thrombosis, venous congestion, hematoma, flap salvage, partial flap loss, and total flap loss were recorded. Results: Single-vein anastomosis was performed in 51 cases (85.0%), while two- and three-vein anastomoses were performed in 8 (13.3%) and 1 (1.7%) cases, respectively. The common trunk using the median cubital or common cephalic vein was used in 35 cases (58.3%). Venous congestion occurred in 4 cases (6.7%), including 3 cases of venous thrombosis, all successfully salvaged. Hematoma requiring re-exploration occurred in 7 cases (11.7%). One total and one partial flap loss occurred. Overall complete flap survival was 96.7%. Conclusion: Single venous anastomosis using the communicating vein is a reliable option for RFFF reconstruction, providing dual-system venous outflow while simplifying microvascular anastomosis.

Background: Prolonged mechanical ventilation can increase significantly both mortality and morbidity of patient. It is imperative to initiate weaning procedures at the earliest. Recent advancements in lung and diaphragmatic ultrasound techniques have shown promising avenues for evaluating lung aeration, diaphragmatic function and assessing suitability for extubation. Objectives: To assess the ability and accuracy of diaphragmatic and lung ultrasound in predicting successful extubation among adult patients on invasive mechanical ventilation. Methods: This is a hospital-based, prospective cohort study conducted among patients presenting to the Department of Critical Care Medicine between January 2023 to June 2024. Results: Out of 40 patients studied, 92.5% were successfully extubated, while 7.5% experienced extubation failure. Patients who failed extubation had a significantly longer duration of ventilation (8.0 vs. 4.3 days, p<0.05), ICU stay (12.3 vs. 6.5 days, p<0.05), and total hospital stay (15.0 vs. 10.0 days, p<0.05). The Rapid Shallow Breathing Index (RSBI), Lung Aeration Score (LAS), diaphragm excursion (DE), and diaphragm thickening fraction (DTF) were significantly different between the successful and failed extubation groups. RSBI was higher (80.3 vs. 51.4, p<0.05), and DE was lower (1.4 vs. 1.6, p<0.001) in the failed extubation group and these parameters were useful predictors of weaning outcomes. RSBI, LAS, DE, and DTF all demonstrated statistically significant predictive value with AUCs ranging from 0.787 to 0.843. RSBI had a sensitivity of 66.7% and specificity of 88.9%, while the LAS, DE, and DTF also showed high positive predictive values, indicating their utility in predicting extubation success. Conclusion: The findings highlight the potential use of lung and diaphragmatic ultrasound in guiding clinical decisions regarding weaning and extubation from mechanical ventilation.Thus, using lung and diaphragmatic ultrasound provides information to improve extubation success.

Background: Tuberculosis (TB) remains the leading cause of infectious disease mortality worldwide, and vitamin D (Vit-D) has emerged as a potentially important modulator of host defense against TB infection. Methods: This cross-sectional study was conducted over one year at a tertiary care hospital, enrolling 180 patients aged 18–60 years with confirmed pulmonary TB through simple random sampling. Serum 25(OH)D levels were measured using the Elecsys Vit-D3 assay and classified per Endocrine Society guidelines, with associations analyzed using SPSS version 20. Results: The majority of patients (55.6%) were above 51 years, with a male preponderance (62.2%). Vitamin D deficiency was highly prevalent, affecting 75% of patients, while 19.4% had insufficient and only 5.6% had sufficient levels (mean 25(OH)D: 16.68 ng/mL). Deficiency was significantly associated with female gender (92.6% deficient, p=0.026) and bilateral lung involvement (p=0.002), while age (p=0.473) and area of residence (p=0.829) showed no significant association. Conclusion: Vitamin D deficiency is highly prevalent among pulmonary TB patients, particularly among women and those with more extensive lung disease, supporting routine screening and supplementation as a potential therapeutic adjunct.

Background: Thalassemia major causes chronic anemia and iron overload from repeated transfusions, both of which contribute to impaired growth in affected children. Elevated serum ferritin and inadequate pretransfusion hemoglobin are believed to independently and jointly worsen linear growth outcomes. This study examines their combined impact in a large pediatric cohort. Methods: A prospective, hospital-based cohort study enrolled 174 transfusion-dependent thalassemia major patients aged 1–16 years over a 1-year period. Patients were stratified by mean pretransfusion Hb (<8 g/dL vs ≥8 g/dL), and anthropometric measurements were compared against serum ferritin levels using SPSS-based statistical analysis. Results: Short stature was present in 35 patients (20.1%), significantly more common in the Hb <8 g/dL group (32.8%) than the Hb ≥8 g/dL group (13.8%, P = 0.045). Serum ferritin showed a strong inverse relationship with height percentile (P = 0.0004), with short-statured patients having markedly higher mean ferritin (6380 ng/mL) than taller patients (3050 ng/mL). Patients with Hb <8 g/dL also had significantly higher mean ferritin (5300 ng/mL) than those with Hb ≥8 g/dL (4230 ng/mL, P = 0.012). Conclusion: Growth failure in transfusion-dependent thalassemia major is strongly associated with both suboptimal pretransfusion hemoglobin and elevated serum ferritin, emphasizing the need for optimized transfusion and chelation practices.

Introduction: Mixed acid base disorder in CCU patients can be defined as independently coexisting disorder characterised by varied proportions of metabolic acidosis (decreased bicarbonate, decreased pH), metabolic alkalosis (increased bicarbonate, increased pH), respiratory acidosis (increased PaCO₂) and metabolic alkalosis (decreased PaCO₂) depending on specific diagnosis of the patient. AIM (Objective): To identify incidence of acidosis and alkalosis (respiratory and metabolic) in CCU patients of SCCGMCH, Uluberia, based on ABG parameters considering their normal range. Method:  Cases comprised of 100 CCU patients whose blood samples were tested in ABG analyser of the institutional CCU within a period of six months. Diagnosis of acid base disorder was made considering normal ranges of the parameters ascertained by prevailing worldwide standards. Result: Incidence of metabolic acidosis in our sample of CCU patients was found to be higher followed by respiratory alkalosis, while incidence of metabolic alkalosis was much lower followed by respiratory acidosis. Conclusion: The early diagnosis of acid base imbalance and its monitoring has been helpful in the diagnosis and treatment of the terminally ill patients. Improved arrangement for more running ABG analysers in peripheral medical colleges like SCCGMCH will surely help to reduce the mortality and morbidity of rural population.

Introduction: Urolithiasis is a common and recurrent condition influenced by metabolic, dietary, and environmental factors, with calcium-containing stones accounting for the majority of cases. Although calcium plays a central role in stone formation, the relationship between serum calcium levels and the calcium content of urinary stones remains unclear. This study aimed to evaluate whether serum calcium can serve as a reliable indicator of stone calcium burden in patients with urolithiasis. Methodology: A cross-sectional observational study was conducted over one year (November 2024 to October 2025) at KPC Medical College, Kolkata. A total of 70 patients aged 18–80 years with diagnosed urolithiasis were included. Urinary stones were collected post-surgically, processed, and analyzed qualitatively and quantitatively using standard biochemical methods. Serum calcium levels were estimated using the OCPC method on an full-automated analyzer. Statistical analysis, including Spearman correlation, was performed using SPSS version 23. Results: The study population had a mean age of 45.57 ± 17.17 years, with a male predominance (47 males, 23 females). Most patients were overweight or obese (mean BMI: 27.24 ± 4.14 kg/m²). The mean stone weight was 2.93 ± 2.55 g, with a mean calcium content of 0.74 ± 0.73 g. Serum calcium levels were within the normal range (9.32 ± 0.9 mg/dL). Correlation analysis revealed a very weak negative and statistically insignificant relationship between serum calcium and stone calcium content (rs = -0.05, p = 0.69). Conclusion: Serum calcium levels do not correlate with the calcium content of urinary stones and are not a reliable marker for assessing stone burden. These findings highlight that urolithiasis is primarily driven by urinary and metabolic factors rather than systemic calcium levels. Comprehensive metabolic evaluation, particularly urinary analysis, is essential for effective management and prevention of stone disease.

Background: Vaginal hysterectomy (VH) is a cornerstone gynecological procedure prioritized for its minimized postoperative morbidity, reduced pain, and rapid convalescence. However, maintaining optimal intraoperative visualization remains a challenge due to vascularity during dissection. Hydrodissection with standard or vasoconstrictive agents is widely utilized to establish surgical planes and minimize bleeding. Objectives: To evaluate and compare the quantitative efficacy and physiological impact of diluted adrenaline, diluted vasopressin, and plain normal saline infiltration during hydrodissection in elective vaginal hysterectomy. Material and Method: A double-blind Randomized Controlled Trial (RCT) was conducted over 1 .5 years at the Rajendra Institute of Medical Sciences (RIMS), Ranchi, involving 69 women randomized into three equal groups (n=23 each). Group 1 received 40 mL of plain Normal Saline; Group 2 received 40 mL of diluted Adrenaline (1:1 20,000 in 1 % lignocaine); Group 3 received 40 mL of diluted Vasopressin (0.1 U/mL, total 4 U). Primary outcomes measured quantitative intraoperative blood loss using calibrated sponge weight differentials. Secondary outcomes included surgical ease of dissection, intraoperative hemodynamic trends, and postoperative complications. Results: The mean intraoperative blood loss was significantly lower in the vasoconstrictor arms compared to the saline arm (p < 0.05). Group 2 (Adrenaline) and Group 3 (Vasopressin) provided superior surgical cleavage planes with reduced requirements for electrocautery. Hemodynamically, Group 3 (Vasopressin) exhibited a transient yet statistically significant spike in systolic blood pressure at 1 minute (1 25.39 ± 1 0.31 mmHg, p = 0.01 7), while Group 2 (Adrenaline) exhibited a significant increase in pulse rate at 5 minutes (94.43 ± 5.1 5 bpm, p < 0.001). All vital parameters normalized to baseline values within 5 minutes without clinical intervention. Conclusion: Both diluted vasopressin and diluted adrenaline are highly effective pharmacological adjuncts for hydrodissection in vaginal hysterectomy. They substantially minimize intraoperative hemorrhage and enhance the clarity of surgical planes. The associated transient hemodynamic fluxes are brief and self-limiting, confirming safety profiles appropriate for elective clinical deployment when screening rules are strictly implemented.

Background: Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition associated with severe maternal hemorrhage, hysterectomy, intensive care admission, and adverse neonatal outcomes. Early diagnosis remains challenging, particularly in resource-limited settings where advanced imaging modalities are not readily available. Objectives: To evaluate maternal serum alpha-fetoprotein (MSAFP) as a biomarker for placental adherence in women with low-lying placenta and to assess associated fetomaternal outcomes. Materials and Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Rajendra Institute of Medical Sciences (RIMS), Ranchi, over one year. Sixty antenatal women with ultrasonographically documented low-lying placenta or placenta previa in the third trimester were included. Maternal serum AFP levels were measured by ELISA and correlated with intraoperative findings and fetomaternal outcomes. Results: Among 60 women studied, 8 (13.3%) had PAS. Mean MSAFP levels were significantly higher among PAS cases compared to non-PAS cases (731.92 ± 421.37 ng/mL vs. 155.53 ± 69.73 ng/mL; p<0.001). Elevated MSAFP (>250 ng/mL) was observed in 100% of PAS cases compared with only 7.7% of non-PAS cases. Placenta accreta accounted for 62.5% of PAS cases, placenta increta 12.5%, and placenta percreta 25%. All PAS cases underwent cesarean hysterectomy. Maternal morbidity was significantly higher in PAS cases, including ICU admission, bladder injury, and vesicovaginal fistula. One maternal death and one early neonatal death were reported. Conclusion: MSAFP is a promising, inexpensive, and easily accessible biomarker for the early identification of PAS in women with low-lying placenta. Its incorporation into antenatal risk assessment may facilitate timely referral and improve maternal and neonatal outcomes.

Introduction: Subclinical hypothyroidism (SCH) is the most common thyroid disease in patients with type 2 diabetes mellitus (T2DM). There is growing evidence that SCH may adversely affect glycemic control and contribute to the development of diabetic microvascular complications. However, data from the Indian subcontinent are limited and inconsistent. Objectives: To determine the prevalence of SCH in patients with T2DM and to assess its correlation with glycemic status and microvascular complications like diabetic nephropathy, diabetic retinopathy and diabetic neuropathy. Methods: A cross-sectional study was conducted in a tertiary care teaching hospital among 114 adult patients with T2DM. Thyroid function tests, fasting blood glucose, postprandial blood glucose, glycated hemoglobin (HbA1c), urinary microalbumin estimation, fundus examination, nerve conduction studies were done. SCH was defined as elevated serum thyroid stimulating hormone (TSH) levels (>4 mIU/L) with normal free thyroxine (FT4) concentrations. Statistical analysis was carried out using SPSS version 20. Results: Among 114 participants, 42 patients (36.8%) had SCH. Mean HbA1c was significantly higher in SCH group in comparison to euthyroid individuals (9.19±2.21% vs. 8.16±1.65%; p=0.005). Neuropathy was present in 15 (13.2%) participants, retinopathy in 30 (27.0%) and nephropathy in 53 (46.5%) . There was a finding of SCH in 8 patients with neuropathy (54%) and 15 patients with retinopathy, but these associations were not statistically significant. Conversely, diabetic nephropathy was significantly associated with SCH with 39 of 53 patients with nephropathy having SCH (p<0.001). Conclusion: SCH is very common in T2DM patients and is associated with worse glycemic control and significantly increased burden of diabetic nephropathy. Routine screening of the thyroid may help to identify early those patients who are at increased risk for microvascular complications.

Background: Etomidate is a commonly used intravenous agent because of its stable haemodynamic properties but the myoclonus following etomidate induction may be the distressing and clinically undesirable effect. Aim & Objectives: To evaluate the efficacy of dexmedetomidine pre-treatment in reducing the incidence and severity of etomidate induced myoclonus during induction of general anaesthesia. Material & method: In this double blind prospective, randomized study of 88 adult surgical patients, allocated into two equal groups: Group I received Dexmedetomidine (0.5ug/kg) pre-treatment and Group II received saline over 10 minutes prior to 0.3 mg/kg Etomidate induction. Patients were observed continuously for 1 minute for the occurrence and severity of myoclonus. Haemodynamics and saturation were recorded at different intervals and complication were noted if occurred. The presentation of the Categorical variables was done in the form of number and percentage (%). The quantitative data were presented as the means ± SD. Result: Myoclonus was absent in 77.27% of patients in the Dexmedetomidine group versus saline group (p < 0.0001). Moderate and severe myoclonus were also markedly lower in the Dexmedetomidine group. Hemodynamic parameters showed favourable trends. While systolic blood pressure (SBP) was significantly lower in the Dexmedetomidine group from 4 minutes post-induction onward (p < 0.0001), values remained clinically stable. Diastolic blood pressure (DBP) and heart rate were largely comparable, with a few intervals showing significantly lower values in the Dexmedetomidine group, suggesting its expected hypotensive and mild bradycardia effects. Oxygen saturation (SpO₂) remained stable in both groups throughout. Conclusion: Dexmedetomidine in a dose of 0.5 µg/kg can be used safely as premedication prior to the induction with etomidate to reduce Etomidate induced myoclonus.

Background: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus associated with delayed healing, prolonged hospitalization, and increased risk of amputation. Topical insulin has emerged as a promising adjunct in wound management. Methods: This interventional study was conducted in the Department of General Surgery, People’s Hospital, Bhopal, from March 2024 to October 2025. Fifty patients with Wagner Grade I and II diabetic foot ulcers were enrolled and divided into two groups: topical insulin dressing (Group 1) and normal saline dressing (Group 2). Wound depth, ulcer size, granulation tissue formation, hospital stay, satisfaction, adverse events, and healing outcomes were assessed over 3 weeks. Results: Baseline characteristics were comparable between groups. The insulin group showed significantly greater reduction in wound depth and ulcer size from Week 2 onward (p<0.05). Granulation tissue formation and overall patient satisfaction were higher in the insulin group. Mean hospital stay was significantly shorter in the insulin group (12.38 ± 2.14 days vs 22.72 ± 2.67 days; p<0.0001). No major adverse effects were observed. Conclusion: Topical insulin dressing significantly accelerates healing of diabetic foot ulcers and appears safe, effective, and economical compared to normal saline dressing.

Background: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus associated with delayed healing, prolonged hospitalization, and increased risk of amputation. Topical insulin has emerged as a promising adjunct in wound management. Methods: This interventional study was conducted in the Department of General Surgery, People’s Hospital, Bhopal, from March 2024 to October 2025. Fifty patients with Wagner Grade I and II diabetic foot ulcers were enrolled and divided into two groups: topical insulin dressing (Group 1) and normal saline dressing (Group 2). Wound depth, ulcer size, granulation tissue formation, hospital stay, satisfaction, adverse events, and healing outcomes were assessed over 3 weeks. Results: Baseline characteristics were comparable between groups. The insulin group showed significantly greater reduction in wound depth and ulcer size from Week 2 onward (p<0.05). Granulation tissue formation and overall patient satisfaction were higher in the insulin group. Mean hospital stay was significantly shorter in the insulin group (12.38 ± 2.14 days vs 22.72 ± 2.67 days; p<0.0001). No major adverse effects were observed. Conclusion: Topical insulin dressing significantly accelerates healing of diabetic foot ulcers and appears safe, effective, and economical compared to normal saline dressing.

Background: Abdominal tuberculosis remains a major health problem in developing countries and is associated with significant diagnostic and therapeutic challenges because of its nonspecific clinical presentation and varied radiological manifestations. The present study aimed to evaluate the diagnostic predictors and treatment outcomes of abdominal tuberculosis. Methods: This descriptive observational and analytical study was conducted in the Department of General Surgery, People’s Hospital, Bhopal, from April 2024 to March 2026. A total of 58 clinically suspected cases of abdominal tuberculosis were enrolled. Clinical profile, radiological findings, operative details, diagnostic predictors, and treatment outcomes were analyzed. Diagnostic modalities including AFB Ziehl–Neelsen staining, CBNAAT, AFB culture, and histopathology were evaluated using an Integrated Reference Standard (IRS) as the gold standard. Results: The mean age was 37.31 ± 13.91 years, with male predominance (55.17%). Common symptoms included loss of appetite (82.75%), weight loss (79.31%), abdominal pain (74.13%), and fever (67.2%). Acute intestinal obstruction was the most common presentation. CBNAAT demonstrated the highest sensitivity (100%) and diagnostic accuracy (95.83%). Operative management was required in 79.31% of patients, with resection and end-to-end anastomosis being the commonest procedure. Mortality was 6.52%. Conclusion: Early diagnosis using molecular techniques such as CBNAAT and timely surgical intervention significantly improve outcomes in abdominal tuberculosis.

Background: The foramen magnum (FM), located in the occipital bone at the cranial base, is the largest opening of the skull and serves as the conduit for the medulla oblongata, vertebral arteries, spinal accessory nerves, meninges, and associated vascular structures. Its morphology has attracted considerable attention because of its importance in forensic anthropology, neurosurgery, radiology, and craniovertebral junction surgery. The dimensions and shape of the FM demonstrate inter-population variability and may aid in sex estimation when other skeletal components are unavailable. Accurate morphometric assessment is also essential for planning surgical approaches to lesions involving the craniovertebral junction while minimizing neurovascular injury. Aim: To evaluate the morphometric characteristics of the foramen magnum in adult human dry skulls and determine their forensic and neurosurgical significance. Materials and Methods: A cross-sectional osteological study was conducted on 150 adult human dry skulls obtained from the Department of Anatomy of a tertiary care teaching institution. The anteroposterior diameter, transverse diameter, circumference, and foramen magnum index were measured using a digital Vernier caliper with an accuracy of 0.01 mm. The shape of the foramen magnum was classified into predefined morphological categories based on visual assessment. Morphometric parameters were analyzed descriptively and compared according to sex where identification was available. Statistical analysis included descriptive statistics, independent-samples t-test, chi-square test, and Pearson correlation. Statistical significance was considered at p < 0.05. Results: The mean anteroposterior diameter of the foramen magnum was 35.18 ± 2.41 mm, while the mean transverse diameter was 29.42 ± 2.08 mm. The average foramen magnum index was 1.20 ± 0.09. Oval morphology constituted the most common shape (38.7%), followed by round (22.0%), hexagonal (14.7%), tetragonal (10.0%), pentagonal (8.7%), and irregular forms (6.0%). Male skulls demonstrated significantly greater anteroposterior and transverse diameters than female skulls (p < 0.001). The morphometric measurements showed moderate positive correlations, suggesting proportional growth of the cranial base. Conclusion: The present study provides comprehensive morphometric data regarding the foramen magnum in adult human skulls. The findings contribute valuable baseline anatomical information for forensic identification, anthropological research, radiological interpretation, and neurosurgical planning. The observed sexual dimorphism supports the use of foramen magnum measurements as supplementary indicators for sex estimation when complete skeletal remains are unavailable.