Background: Due to the lack of agreement on the best surgical technique, treating thoracolumbar spine fractures can be difficult. Surgeons frequently use anterior, posterior, or a combination of anterior-posterior instrumentation techniques to reduce fractures, stabilize patients, and decompress neural canals. Comparative studies assessing the effectiveness of these strategies are few, despite their availability. This literature gap highlights the need for more study to fully evaluate and contrast the different surgical techniques for thoracolumbar spine fractures. Objective: The present study aims to compare and critically evaluate the anterolateral and posterior approach for surgical management of thoracolumbar spine fractures in order to identify the best treatment. Material and method: A literature search was performed in research articles published between 2000 and 2023. Ultimately, nine articles meeting the inclusion criteria were chosen. Data was extracted using a prestructured matrix made for systemic review. Data was analyzed and interpreted for common variables reported in the studies. Results: The nature of the study was range from simple observational study to the randomized control trials (RCTs).  The mean age patients among all studies were 42.01 ± 4.012 years with predominance of males. The mean follows up period among all studies was 26.30 ± 15.70 months with highest follow up to 47.5 months and lowest follow up to 12 months. The mean blood in anterolateral approach was 836.8 ± 458.3 ml which is higher as compared to the blood loss in posterior approach in which mean blood loss was 451.1 ± 303.4 ml. The mean hospital stay in the posterior approach was 13.63 ± 3.063 days whereas in the anterolateral approach was 14.68 ± 8.132 days. Conclusion: Every surgical technique has pros and cons of its own. To create clear recommendations for surgical decision-making in thoracolumbar spine fractures, further research is necessary, as evidenced by the absence of agreement and established techniques.

Background: Early detection of potentially malignant disorders (PMDs) and oral cancers significantly improves prognosis and treatment outcomes. Adjunctive diagnostic aids such as vital dyes are cost-effective and non-invasive tools that enhance lesion detection during clinical screening. Objective: To evaluate and compare the diagnostic efficacy of three commonly used dyes—toluidine blue, methylene blue, and Lugol’s iodine—in identifying dysplastic and malignant changes in oral lesions. Methods: This prospective comparative study included 90 patients with clinically visible oral lesions. Participants were divided into three equal groups (n=30 each) based on the dye used. Each lesion underwent dye application, followed by biopsy. Staining outcomes were compared with histopathological results. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated. Results: Toluidine blue showed the highest diagnostic accuracy (91.4%), sensitivity (92.9%), and specificity (90.0%). Methylene blue demonstrated moderate diagnostic value with an accuracy of 85.9%, while Lugol’s iodine showed lower accuracy (77.1%). Buccal mucosa was the most common site for positive staining across all groups. Conclusion: Toluidine blue is the most effective dye for identifying dysplastic and malignant oral lesions. Methylene blue is a viable alternative. Lugol’s iodine shows limited diagnostic potential and should be used cautiously in screening settings.

Introduction Maxillofacial injuries and orthopedic fractures are common in polytrauma cases, often resulting from high-impact trauma such as road traffic accidents (RTAs), falls, and assaults. Understanding the incidence, prevalence, and clinical outcomes of these injuries is crucial for improving trauma management. Objective: This study aimed to assess the incidence and prevalence of maxillofacial injuries and orthopedic fractures in polytrauma patients, analyze their distribution patterns, and evaluate the relationship between Injury Severity Score (ISS) and clinical outcomes. Methods: A prospective observational study was conducted on 250 polytrauma patients admitted to a tertiary care hospital. Data on demographic details, injury mechanisms, fracture distribution, and hospital stay duration were analyzed. Radiological assessment and statistical analysis were performed to determine injury patterns and their impact on patient prognosis. Results: RTAs were the leading cause of polytrauma (60%), with mandibular fractures (30%) and long bone fractures (40%) being the most prevalent. Patients with higher ISS (>35) had significantly longer hospital stays (18.9 ± 4.7 days) and higher mortality rates (30%). Conclusion: Polytrauma cases frequently involve maxillofacial and orthopedic injuries, with RTAs being the predominant cause. Timely intervention and improved trauma care protocols are essential in reducing morbidity and mortality.

Introduction: The incidence of bile stones in India is known to be around 4%. This incidence is 7 times higher among the north Indians when compared to the south Indians. The incidence in western countries is as high as 10-15%. Most of them are asymptomatic (>80%). Each year, about 1–2% of asymptomatic patients develop symptoms that necessitate surgery. AIM: To study the age and sex distribution, various modes of presentations, types of gall stones, various treatments available and its outcome. Material & Methods: A prospective observational study was conducted in the Department of General Surgery, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka over a period of Six Months consist of 30 cases were included in our study. Institutional Ethical committee permission was taken prior to the commencement of the study. Demographic data like age, sex, name, occupation are noted; clinical symptoms of presentation with duration, associated complaints, past medical and surgical history, personal history like diet history, OCP usage, alcohol ingestion, and family history will be noted. Results: USG abdomen was the primary investigation of choice and was done for all the patients included in the study. Multiple stones in GB were the most common finding in this study account for 67% of patients. 30% of cases had single stone in GB. Thickened gall bladder wall was seen in 17% cases. 1 patient (3%) presented with Cholelithiasis with choledocholithiasis. Conclusion: Laparoscopic cholecystectomy is considered as the treatment of choice in these patients as it has better outcomes and is associated with fewer perioperative complications and morbidity in experienced hands. One should not hesitate to convert to an OC if significant adhesions or inflammation are identified during laparoscopy.

Introduction Small bowel obstruction (S.B.O) is being one of the common causes of hospital admission worldwide for acute onset of abdominal pain and requiring emergency surgical intervention. Laparoscopy has recently superseded traditional laparotomy as an elective treatment for a variety of diseases because to its reduced risk of morbidity and shorter hospital stay.  AIM: To study the role of laparoscopy in small bowel obstruction and to compare the outcomes of laparoscopic approach and open approach. Material & Methods: A prospective comparative study was conducted in the Department of General Surgery, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka over a period of Six Months. Consist of 30 cases were included in our study. Institutional Ethical committee permission was taken prior to the commencement of the study. All the patients in the study were examined clinically after obtaining a thorough clinical history which included the symptoms, time of onset and the duration of symptoms along with associated co-morbidities. Results: In the present study, in open surgeries majority belonged to 41-60 years of age group with 80% (12 cases), followed by 13% (2 cases) belonged to 21-40 years of age group, followed by 7% (1 case) belonged to 61-80 years of age group. In laparoscopic surgeries, majority belonged to 41-60 years of age group with 53% (8 cases), followed by 33% (5 cases) belonged to 21-40 years of age group, followed by 13% (2 cases) belonged to 61-80 years of age group.  Conclusion: Laparoscopic surgery is a better treatment modality as found in our study compared to open surgery in terms of duration of surgery, bowel injury, post-operative pain, hospital stay, wound infection, cosmetic benefit etc as seen in our study.

Introduction: Anemia is a considerable public health issue affecting children globally, particularly in developing countries. It leads to impaired cognitive and physical development, increased infection risk, and poor quality of life. Nutritional deficiencies, particularly iron deficiency, are the primary causes of pediatric anemia. This study aims to evaluate the clinical, hematological, and biochemical profiles of anemia in the pediatric population, and to analyze the relationship between anemia, nutritional status, and socioeconomic factors. Methods: A Cross-sectional study was conducted in the Department of Paediatrics. Infants between 6 months to 12 months who are admitted in an inpatient ward. Infants of age group between 6 months to 12 months admitted to hospital were included. Infants who have H/O Bleeding disorder, H/O Blood transfusions, Hemolytic anemia, acute blood loss were excluded. The parents were interviewed for collection of necessary information using the pre-tested, semi structured questionnaire method. The questionnaire was prepared by a thorough review of literature. Results The present study included 100 cases (100%), of which 59 cases (59%) were male and 41 cases (41%) were females. Most common age group affected was 1-5 years of age group with maximum 16 cases (15.6%). Microcytic Hypochromic, Normocytic Normochromic anemia, Normocytic hypochromic anemia, Macrocytic Hypochromic anemia & Macrocytic Normochromic anemia, were reported in 48.9%, 22.2%, 13.3%, 8.9% & 6.7% respectively.  Iron deficiency anemia was the commonest nutritional deficiency anemia seen in 39 cases (39%). Anemia of chronic inflammation/infection was the second most common etiology of anemia with 24 cases (24%). Conclusions Besides haematological investigations for typing of anemia, Haemoglobin electrophoresis establishes the disease in haemoglobinopathies. Adequate health and healthy nutritional habits and prescription of Iron supplements are of great importance in prevention and management of anemia in children assisted by public health services.

Introduction: The addition of adjuvants to local anesthetics in brachial plexus block enhances the efficacy of the nerve blockade. Dexamethasone and Clonidine are commonly used adjuvants with distinct mechanisms of action. This study aims to compare these adjuvants in terms of onset of action, duration of analgesia, hemodynamic stability, and adverse effects when used with Bupivacaine and Lignocaine with Adrenaline in an interscalene brachial plexus block. The findings will provide insight into selecting the optimal adjuvant for prolonged postoperative analgesia. Materials and Methods: This prospective, randomized, double-blind, comparative clinical study was conducted in the Department of Anaesthesia Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre after obtaining ethical committee approval and written informed consent from all patients.The participants were divided into two groups: Group D (Dexamethasone) and Group C (Clonidine). The onset time, duration of analgesia, hemodynamic stability, and adverse effects were analyzed. Results: Group D (Dexamethasone) had a slightly faster onset of sensory and motor blockade (12.3 ± 2.1 min) compared to Group C (Clonidine, 13.0 ± 2.3 min), but the difference was not statistically significant (p > 0.05). Dexamethasone significantly prolonged analgesia (780 ± 50 min) compared to Clonidine (610 ± 45 min), with p < 0.05 (statistically significant). Excellent satisfaction was higher in Group D (85%) compared to Group C (72%), suggesting that patients experienced better pain relief and comfort with Dexamethasone. Fewer patients rated their satisfaction as "Fair" in the Dexamethasone group (3%) compared to Clonidine (8%), further supporting its superior efficacy in pain management. Conclusion: Dexamethasone provides a longer duration of analgesia than Clonidine when used as an adjuvant in interscalene brachial plexus block, making it a preferred choice in clinical settings requiring prolonged postoperative analgesia.

Introduction: Cardiovascular risk factors (CVRFs) have an important role in the development of almost all CVDs. They can be divided into two categories: modifiable factors, including hypertension, diabetes, high cholesterol, obesity, physical inactivity, and inadequate intake of fruits and vegetables; and non-modifiable factors such as age, sex, family history and ethnicity. Cardiovascular diseases are a significant global health challenge, accounting for nearly one-third of all deaths annually. The increasing burden of CVDs is linked to rapid urbanization, changes in dietary habits, physical inactivity, and rising prevalence of metabolic disorders such as obesity and diabetes. Understanding the risk factors associated with CVDs is essential for implementing effective preventive measures and guiding public health policies.  Material and Methods: A cross-sectional study was conducted between January and June 2023 at a tertiary care hospital. This study evaluates the risk factors contributing to CVDs in a sample size of 90 patients attending a tertiary care hospital. The study aims to identify key determinants such as age, gender, smoking, hypertension, diabetes, dyslipidemia, obesity, and physical inactivity. Data were collected through structured interviews, clinical examinations, and review of medical records. Variables studied included demographic details, smoking history, blood pressure, fasting blood glucose levels, lipid profile, body mass index (BMI), and physical activity levels. Results: Hypertension was the most prevalent risk factor (70%), underscoring its critical role in the pathogenesis of CVDs. Smoking (50%) highlights behavioral risks, while diabetes (40%) points to metabolic influences. Dyslipidemia (35%), obesity (30%), and physical inactivity (45%) further emphasize the contribution of lifestyle factors. The majority of patients (60%) had two or more risk factors, illustrating the clustering effect that significantly elevates cardiovascular risk. The presence of three or more risk factors in 40% of the sample underscores the complexity of CVD management in these patients. Smoking was notably higher in males (70% vs. 20%), reflecting potential cultural or behavioral influences. Hypertension and diabetes were relatively balanced across genders, suggesting universal susceptibility. Obesity and physical inactivity were higher among females, which may indicate barriers to physical activity or gender-specific health disparities. Conclusion: The study emphasizes the importance of preventive measures and lifestyle modifications to reduce the burden of CVDs. This study identifies hypertension, smoking, and diabetes as the leading risk factors for cardiovascular diseases in the study population. Addressing these factors through early detection, patient education, and lifestyle interventions can significantly reduce the burden of CVDs.

Introduction Secure airway for proper ventilation during anesthesia is one important component of a successful surgery. Endotracheal intubation is one of the most important methods in this context. Intubation method and used medication are considerably important in attenuating complications. This research aimed to investigate the impact of two different doses of dexmedetomidine in mitigating cardiovascular responses to endotracheal intubation in candidate cases sup Materials and Methods One hundred elective surgery cases were consecutively enrolled in this prospective study after obtaining informed consent. The patients were randomly allocated into two groups, each comprising 40 cases. Group A received intravenous dexmedetomidine at 0.5 mcg/kg, while Group B received 1 mcg/kg, both diluted with 20 ml of normal saline over a 10-minute infusion using a pump. Hemodynamic responses from both the groups were then recorded.porting voluntary operation Results The extubation quality became better, sedation and incidence of bradycardia in the post-operative period increased with a higher dose of dexmedetomidine. Attenuation of hemodynamic parameters was observed after 4 min of starting infusion and during extubation in each group and was found to be significant (P < 0.001). Conclusion A dose of 0.5µg/kg of dexmedetomidine administered as a bolus infusion before extubation attenuates the stress response to extubation as effectively as 1µg/kg. Higher sedation scores and longer time to extubate are seen with a dose of 1µg/kg without causing respiratory depression

Introduction The PCPNDT Act 1994 enacted by the Parliament of India came into existence to stop female feticide and to maintain the sex ratio in India. The act prohibits sex discrimination both before and after conception. Various studies have been done in the past about the PCPNDT Act, however, the impact of this law on society is a continuous ongoing process. This study is being conducted to assess the awareness among the general population about the PCPNDT Act and to study the impact of it on the attitude of the people regarding sex ratio, after its inception almost 30 years ago.

Methods An observational, cross-sectional study was conducted at Multispecialty Hospital, Whitefield, Bengaluru South for 3-month period among women of the reproductive age group (15-49yrs) visiting obstetrics OPD by using a pre-tested semi-structured questionnaire as a study instrument.

Results The majority of the females included in the study were aged between 21 to 30 years (56.1%) and are graduates accounting for about 50 (37.9%). Though the majority had a graduate degree, 65.2% were unemployed. Knowledge about the sex ratio was known by 72 (54.5%) and 71 (53.8%) were aware of the Act. 67(50.8%) responded that even in the child sex ratio males were higher. 103 (78%) had opined that knowing about the sex ratio is important.

Conclusions 21(15.9%) believed that foetal sex determination is done in India with the primary motive of family members and most of them had the idea that it is done at private hospitals by foetal USG. None of them had the attitude of terminating their pregnancy even if they knew the sex of their foetus and 129 (97.7%) study population were willing to educate people about the PCPNDT Act.

Background Zinc deficiency is common in decompensated chronic liver disease (DCLD) and may contribute to the pathogenesis of hepatic encephalopathy (HE). This study investigated the relationship between serum zinc levels and severity of HE in DCLD patients.

Methods This cross-sectional study enrolled 30 patients with DCLD. Serum zinc levels were measured at admission. The grade of HE was assessed clinically using the West Haven Criteria. The association between serum zinc and HER grade was analyzed using correlation analyses.

Results The mean age of study subjects was 43.4 ± 9.8 years. The mean serum zinc level was 63.97 ± 11.1μg/dL. Lower serum zinc correlated with higher HE grades (r = -0.679, p < 0.001). Patients with overt HE (grade 3) had significantly lower zinc levels (43.5 ± 0.71μg/dL) compared to those with grade 2 (57.9±11.7μg/dL) and without HE or minimal HE (grade 1) (69 ± 6.7μg/dL) (p < 0.001)

Conclusions Serum zinc levels inversely correlate with hepatic encephalopathy severity in DCLD patients. Zinc deficiency may represent a modifiable risk factor for overt HE, and zinc supplementation warrants further study as a potential therapeutic intervention to improve neurological outcomes in this population.

Introduction Hypertensive disorders in pregnancy (HPD) and abnormal patterns of growth of the fetus, such as small-for-gestational-age (SGA), are among the leading causes of perinatal and maternal morbidity and mortality in the world. These conditions often contribute to long-term negative effects on the mother and the unborn child. An association was reported between preeclampsia and elevated third trimester hCGlevels, whereas early experience with second trimester levels suggests a link between increased hCGand other adverse pregnancy outcomes. Considerable evidence suggests an association between serum hCG levels and preclampsia.  Material and Methods This is prospective, non-randomized and observational study was conducted in the Department of Biochemistry, Index Medical College over a period of 2 year.  First time pregnant women, who was aged 16- 40 years with singleton pregnancy, was included in the study. Women at POG >22 weeks with Singleton pregnancy were included a one hundred thirty Hypertensive women as case group and control group include another one hundred thirty normotensive women after matching the parity and gestation age. The gestational age at recruitment was 14-24 weeks (second trimester). Gestational age was estimated from the date of last menstrual period (LMP), if it was available, and confirmed from the abdomen/pelvic ultra sound scan.  Results In this study Gestational Hypertension: Mean beta-hCG: 25,206.19 mIU/mL, which is the lowest among the three groups. Standard deviation (SD): 3,696.9, indicating relatively low variability in beta-hCG levels. This suggests that gestational hypertension is associated with relatively moderate beta-hCG levels compared to the other, more severe conditions. Preeclampsia: Mean beta-hCG: 61,697.67 mIU/mL, significantly higher than in gestational hypertension. Standard deviation (SD): 5,498.57, indicating moderate variability in beta-hCG levels within this group. The marked increase in beta-hCG levels compared to gestational hypertension highlights the association of higher beta-hCG levels with the severity of the condition. Eclampsia: Mean beta-hCG: 84,106.38 mIU/mL, the highest among the three groups. Standard deviation (SD): 7,295.05, showing greater variability in beta-hCG levels within this group. The extremely elevated beta-hCG levels reflect the severity and critical nature of eclampsia. The p-value indicates a statistically significant difference in mean beta-hCG levels across the three groups. The difference in beta-hCG levels is unlikely to be due to cha Conclusion This study showed that estimation of serum Beta HCG levels in early second trimester of pregnancy is a useful indicator to identify women who are likely to develop gestational hypertension in the same pregnancy. The level of beta HCG is strongly associated with development of GHT

Introduction The meniscus is frequently damaged in anterior cruciate ligament (ACL) injuries or in the   degenerative process over a period of several years. The predominance of lateral meniscal tears has been demonstrated with acute ACL rupture, whereas the incidence of medial meniscal tears significantly increases with chronic ACL insufficiency.

Methods This is a Prospective study. 50 patients in the age group of 18-50 years with internal derangement of knee, which underwent arthroscopic ACL reconstruction. All patients in the age group of 18 – 50 years with internal derangement of knee who underwent arthroscopic ACL reconstruction were included in the study.

Results A total of 50 patients presented with complete ACL tears, of which 45 were male and 5 were female. The modes of injury were road traffic accidents in 23 patients, contact sports in 19 patients and injuries during ADL in the remaining 8 patients. On the whole Right knee (56%) was more commonly involved than left (44%). Isolated lateral meniscal tear was seen in 15 patients, isolated medial meniscal tear in 16 and both menisci tears was 4, 15 patients had isolated ACL injury with no meniscal involvement. 34 patients presented within 6months following trauma (early group) of which 20 patients (59%) had meniscal tear and 16 patients presented after 6 months following trauma (late group) out of which 15 (94%) had meniscal tears.

Conclusions Early ACL reconstruction restores the normal biomechanics of the knee joint and thereby prevents further derangement of the ligamentous structures of the knee avoiding development of secondary osteoarthrosis

Introduction

Managing Type 2 Diabetes Mellitus (T2DM) poses a complex challenge, with patient outcomes often influenced by various factors such as treatment adherence, socio-economic status, body mass index (BMI), and health literacy. The World Health Organization emphasizes the importance of diabetes self-management training, with health literacy playing a pivotal role in patients' knowledge and awareness of their disease.

Materials and Methods This is a prospective, case control and Randomized study with and without family history of type 2 diabetes was conducted in the Department of Biochemistry, Index Medical College.  Documentation of basal and anthropometric parameters: The participants were told to empty their bladders before beginning the anthropomorphic assessment. A stadiometer in the upright position was used to measure height, and a weighing machine was used to assess weight.

Results Mean TAOS: Controls have a mean TAOS level of 2.49 mM, while cases have a much lower mean of 0.75 mM. This suggests that cases with a family history of type 2 diabetes have lower antioxidant status compared to controls. Mean MDA: Controls have a mean MDA level of 8.18 mM, while cases with a family history have a mean of 13.09 mM. This substantial difference indicates that individuals with a family history of type 2 diabetes have much higher levels of MDA, suggesting increased oxidative stress. This indicates a highly significant difference between the two groups, supporting that individuals with a family history of type 2 diabetes have elevated MDA levels compared to controls.

Conclusions As a result, it can help with decisions about drug selection, dosage titration, duration of treatment, and preventing adverse drug reactions.

Introduction Experts define diabetes mellitus as a group of metabolic diseases that are characterized by hyperglycemia. This condition arises from defects in insulin secretion, insulin action, or both. There are two types of presentation of diabetes which are Type 1 and Type 2 diabetes mellitus. Type 2 diabetes (known as non-insulin-dependent) is a chronic condition in which the body resists the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels.

Materials   And Methods This is a prospective, case control and Randomized study with and without family history of type 2 diabetes was conducted in the Department of Biochemistry, Index Medical College. Every experiment was carried out in the research lab of the biochemistry department of Index Medical College in Indore. Anthropometric and baseline measurements was made prior to the assessment of cardiopulmonary fitness.

Results Mean Visceral Fat: Controls have a mean visceral fat percentage of 8.48%, while cases with a family history have a higher mean of 9.51%. Mean Distance: Controls have a mean of 2773.0 meters, while cases have a mean of 2319.9 meters. The controls run significantly farther in 12 minutes compared to cases with a family history of type 2 diabetes. This indicates that the difference in the distance covered in the 12-minute run is statistically significant, suggesting that individuals with a family history of type 2 diabetes have lower endurance compared to those without such a history.

Conclusions Exercise's potential to prevent type 2 diabetes in young people has not been the subject of any completed RCTs. However, a few studies indicate that young people should aim to reduce their daily screen time (video games, computers, and television) to less than 60 minutes per day and engage in at least 60 minutes of physical activity per day in order to avoid and control type 2 diabetes.