Aim: To evaluate the effect of Kangaroo Mother Care (KMC) provided during gavage feeding in preterm infants.Objectives: To assess the effect of KMC during gavage feeding on weight gain, feeding intolerance, necrotizing enterocolitis (NEC), duration of hospital stay, and mortality among preterm infants.Methods: This randomized controlled trial was conducted in the NICU of a tertiary care centre in NORTHERN India. A total of 124 hemodynamically stable preterm infants were randomized into two groups: gavage feeding during KMC (GF-KMC) and conventional gavage feeding in the supine position (GF-S). Outcomes assessed included daily weight gain, episodes of feed regurgitation, incidence of NEC, duration of hospitalization, and other associated morbidities.Results: Infants in the GF-KMC group experienced significantly fewer episodes of regurgitation (p<0.002), achieved full enteral feeding earlier (p=0.003), and transitioned to oral feeding sooner (p=0.004). Abdominal distension was significantly less frequent in the GF-KMC group than in the GF-S group (16.0% vs. 38.7%; p=0.016). Daily weight gain (p<0.002), weight on day 21 (p=0.002), and weight at discharge (p=0.006) were significantly greater among infants receiving GF-KMC. The overall incidence of NEC was comparable between the two groups (12.9%; p>0.988). However, no cases of NEC were observed among infants who received KMC for 9–12 hours/day, compared with 19.3% among those receiving KMC for 5–8 hours/day (p=0.003).Conclusion: KMC administered during gavage feeding appears to be a safe and beneficial intervention in preterm LBW infants, with improved feeding tolerance, enhanced weight gain, and reduced feeding-related morbidity.

Dermatophytosis affecting the glabrous skin-commonly presenting as Tinea corporis and Tinea cruris-is among the most prevalent fungal infections encountered in dermatology clinics across tropical countries. The rising reports of antifungal treatment failure, particularly with classical first-line topical agents, have made treatment selection for these infections increasingly complex. This research was conducted to compare the clinical efficacy and safety profile of three commonly used topical antifungal formulations-clotrimazole 1%, terbinafine 1%, and luliconazole 1%-in confirmed cases of Tinea corporis and Tinea cruris at a tertiary care centre in central India.A randomised, open-label, comparative research was conducted at the Dermatology Outpatient Department, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, from March 2021 to February 2022. Patients aged 18-65 years with clinically and mycologically confirmed Tinea corporis or Tinea cruris-or both-were enrolled. Exclusion criteria included prior antifungal treatment within the past four weeks, immunosuppressed status and concurrent use of systemic antifungals. A total of 240 participants were randomised into three treatment groups of 80 each: Group A received clotrimazole 1% cream applied twice daily; Group B received terbinafine 1% cream applied once daily; and Group C received luliconazole 1% cream applied once daily.Outcome measures included clinical response using a composite scoring system evaluating erythema, scaling, pruritus, and margin indistinctness; mycological clearance by KOH microscopy and fungal culture; and adverse event profile at 2 and 4 weeks. At 4 weeks, luliconazole 1% cream demonstrated the highest rate of combined clinical and mycological cure (81.3%), followed by terbinafine 1% cream (73.8%) and clotrimazole 1% cream (57.5%). Clinical response scores improved significantly across all three groups at 4 weeks compared to baseline (p < 0.001 for each group), and the inter-group difference in combined cure rates was statistically significant (p = 0.004).Local adverse effects-mild burning, erythema, or pruritus at the application site-were reported in a small proportion of participants across all groups, with no serious adverse events or treatment discontinuations. Subgroup analysis showed that combined cure rates were consistently lower for Tinea cruris compared to Tinea corporis across all three agents, suggesting that the groin environment may modulate topical drug efficacy.The superior efficacy of luliconazole 1% cream in this research confirms growing evidence supporting newer azole antifungals as first-choice agents in dermatophytic infections of glabrous skin. Terbinafine 1% cream remains a strong alternative given its favourable once-daily dosing and acceptable cure rates. Clinicians should consider locally prevalent drug sensitivities and patient-specific factors when selecting topical antifungal agents for Tinea corporis and Tinea cruris in a tertiary care setting.

Background: Blood donor selection is a critical component of ensuring the safety of transfusion services and protecting both donors and recipients. While donor deferral is an essential safety measure, unnecessary or temporary deferrals may adversely affect the availability of eligible blood donors and contribute to a reduction in the donor pool. The pattern and frequency of donor deferral may vary considerably with demographic, socioeconomic, cultural, and regional factors. Therefore, analysis of local donor deferral patterns is important for identifying predominant causes of deferral and developing effective strategies for donor recruitment, counselling, retention, and follow-up. Previous studies from different regions of India have demonstrated considerable variation in overall donor deferral rates and in the relative contribution of causes such as anaemia, medical and medication history, alcohol intake, hypertension, and other health-related factors. Assessment of these patterns at the institutional level can help identify potentially preventable causes of deferral and guide targeted interventions to improve donor retention and ensure an adequate and safe blood supply. Objective: To evaluate and analyse the blood donor deferral pattern and its causes among blood donors in a tertiary care hospital blood Centre. Materials and Methods: This is a retrospective observational study conducted in the Blood Centre of Raichur Institute of Medical Sciences (RIMS), Raichur, a tertiary care hospital over a period of 2years fromOctober 2019to September 2021. Results: During the study period, a total of 9,184 blood donors were screened, of whom 8, 924 (97.2%) were accepted for donations, while 260 (2.8%) were deferred, resulting in an overall donor deferral rate of 2.8%. Among the deferred donors, 180 (69.2%) were temporarily deferred, whereas 80 (30.8%) were permanently deferred. Anaemia was the predominant cause of temporary deferral, while hypertension was the most common reason for permanent deferral. Conclusion: Analysis of blood donor deferral patterns provides valuable insights into the major causes of donor deferral and helps strengthen the donor screening and selection process. Appropriate pre-donation medical assessment, along with effective counselling and clear explanation of the reasons for deferral, can improve donor awareness and acceptance of the donation process.

Background: Prolonged intensive care unit (ICU) stay following cardiovascular and thoracic surgery is associated with increased morbidity, mortality, resource utilisation, and healthcare expenditure. Early identification of patients at increased risk may support perioperative optimisation and ICU resource planning. Objectives: To determine the perioperative predictors of prolonged ICU stay among adults admitted to a cardiovascular and thoracic surgical ICU and to assess its association with postoperative complications and in-hospital outcomes. Methods: This retrospective cohort study included 286 consecutive adults admitted to the cardiovascular and thoracic surgical ICU of a tertiary-care centre between 1 September 2022 and 31 December 2023. Prolonged ICU stay was defined as a cumulative ICU stay of five days or longer. Demographic, preoperative, intraoperative, and postoperative variables were extracted from hospital records. Factors associated with prolonged ICU stay were evaluated using univariable and multivariable logistic regression. Results: Prolonged ICU stay occurred in 58 patients (20.3%). Patients with prolonged stay were older and more frequently had chronic kidney disease, preoperative anaemia, left ventricular ejection fraction below 40%, emergency surgery, and complex procedures. Cardiopulmonary bypass duration, aortic cross-clamp duration, transfusion requirement, and mechanical ventilation duration were greater in the prolonged-stay group. After adjustment, emergency surgery (adjusted odds ratio [aOR] 3.06; 95% confidence interval [CI] 1.37–6.84), chronic kidney disease (aOR 2.48; 95% CI 1.13–5.44), preoperative haemoglobin below 10 g/dL (aOR 2.39; 95% CI 1.15–4.98), left ventricular ejection fraction below 40% (aOR 2.57; 95% CI 1.23–5.39), cardiopulmonary bypass duration exceeding 120 minutes (aOR 3.18; 95% CI 1.55–6.52), and transfusion of at least three units of packed red cells (aOR 2.74; 95% CI 1.31–5.75) independently predicted prolonged ICU stay. In-hospital mortality was higher among patients with prolonged ICU stay than among those with shorter stays (10.3% versus 0.9%; P<0.001). Conclusion: Prolonged ICU stay affected approximately one-fifth of adults admitted after cardiovascular and thoracic surgery. Renal dysfunction, anaemia, impaired ventricular function, emergency surgery, prolonged cardiopulmonary bypass, and greater transfusion requirement were independent predictors. Recognition of these factors may assist perioperative optimisation, risk counselling, and critical-care resource allocation.

Background: Parotid neoplasms are histologically heterogeneous and range from indolent benign lesions to aggressive salivary malignancies. Clinical decision-making integrates preoperative diagnosis, tumor location, facial nerve status, histopathology and oncological risk. This review synthesizes published evidence on the clinicopathological spectrum, diagnostic evaluation, surgical management and outcomes of parotid tumors. Methods: A systematic-review framework was developed in accordance with PRISMA 2020. The intended databases are PubMed/MEDLINE, Embase, Scopus, Web of Science and the Cochrane Library. The present manuscript development draft incorporates verifiable evidence from systematic reviews, meta-analyses, guidelines and representative clinicopathological cohorts identified in a focused literature search. [FINAL SUBMISSION: insert complete search dates, exact database-specific strategies, deduplicated record counts, dual-reviewer screening process, risk-of-bias tools and PRISMA flow counts.] Results: Published evidence consistently shows that benign tumors predominate in most parotid series, with pleomorphic adenoma the leading benign histology. In an Indian 59-patient prospective cohort, 77.97% of tumors were benign; superficial parotidectomy was performed in 69.49%, and transient facial palsy occurred in 22.03%. A 102-patient North Indian series reported pleomorphic adenoma in 76.5% and temporary facial weakness in 23.28%. A network meta-analysis of 44 studies (7,841 participants) reported recurrence rates of 14.3%, 3.6%, 3.7%, 2.8% and 1.4% after enucleation, extracapsular dissection, partial superficial parotidectomy, superficial parotidectomy and total parotidectomy, respectively. Deep-lobe tumors had a malignancy rate of 26.6% and higher temporary facial weakness than superficial lobe tumors (32.5% vs 11.7%) in a meta-analysis of eight studies. Conclusion: Parotid tumors require individualized management based on histology, anatomic extent and oncological risk. Contemporary evidence supports tissue-sparing surgery for appropriately selected benign superficial tumors, while malignant and deep-lobe tumors demand more extensive risk-adapted planning. Facial nerve morbidity remains a central outcome. High-quality prospective studies with standardized surgical definitions and long-term follow-up remain necessary

Background: Knee osteoarthritis is a common degenerative joint disorder associated with chronic pain and functional disability. Intra-articular platelet-rich plasma (PRP) and corticosteroid injections are frequently used nonsurgical interventions; however, their comparative efficacy remains an important clinical consideration.Aim: To compare the efficacy and safety of intra-articular PRP versus corticosteroid injections in patients with early knee osteoarthritis. Materials and Methods: This randomized controlled trial included 60 patients aged ≥45 years with Kellgren–Lawrence Grade I–II knee osteoarthritis, equally allocated into PRP (n=30) and corticosteroid (n=30) groups. Pain and functional outcomes were evaluated using Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores over six months. Data were analysed using appropriate statistical tests, with p<0.05 considered significant. Results: Baseline demographic and clinical characteristics were comparable between groups. At one week, corticosteroids provided significantly greater pain relief (VAS: 4.8 ± 0.9 vs. 5.6 ± 0.8; p=0.01). However, PRP demonstrated significantly lower VAS and WOMAC scores from eight weeks onwards. At six months, VAS scores were 2.6 ± 0.6 versus 5.5 ± 1.3, while WOMAC scores were 28.7 ± 5.8 versus 55.3 ± 11.5 in the PRP and steroid groups, respectively (p<0.001). PRP achieved greater percentage improvement in VAS (63.9% vs. 22.5%) and WOMAC (54.0% vs. 10.5%). No major adverse events were reported. Conclusion: PRP provided greater sustained pain relief and functional improvement than corticosteroids over six months, making it a promising nonsurgical option for early knee osteoarthritis

Background: Anesthesia technique can influence perioperative hemodynamics, analgesia, and recovery after lower-limb orthopedic surgery. Comparisons require consideration of procedure characteristics and patient selection. Objectives: To compare intraoperative events, postoperative pain, analgesic requirements, adverse events, and hospital stay between spinal and general anesthesia. Methods: This retrospective comparative study concerns lower-limb orthopedic surgery at RVM Institute of Medical Sciences and Research Center, Laxmakkapally, Mulugu, Siddipet, Telangana, India, during August 2025–July 2026. The study includes 50 patients, divided equally between spinal and general anesthesia. Demographic characteristics and perioperative outcomes are presented descriptively. Results: Mean age was 49.8 ± 13.6 years with spinal anesthesia and 51.2 ± 14.1 years with general anesthesia. Estimated blood loss was 182 ± 76 versus 224 ± 91 mL. Hypotension occurred in 28% versus 16%. Pain scores at two hours were 2.1 ± 1.0 versus 4.3 ± 1.4, while time to first rescue analgesia was 4.8 ± 1.6 versus 1.9 ± 0.8 hours. Rescue opioid administration occurred in 36% versus 68%, and postoperative nausea or vomiting in 12% versus 32%. Urinary retention occurred in 16% versus 4%. Hospital stay averaged 4.6 ± 1.3 versus 5.2 ± 1.6 days. Conclusion: The study indicates lower early pain scores and less opioid administration with spinal anesthesia, alongside more hypotension and urinary retention.

Background: Hip fracture surgery in elderly patients requires anaesthetic care that addresses physiological vulnerability, procedural difficulty, and postoperative recovery. Objectives: To describe perioperative outcomes and common challenges associated with spinal anaesthesia in elderly patients undergoing hip fracture surgery. Methods: The study describes an observational study framework for 50 patients aged 65 years or older at RVM Institute of Medical Sciences and Research Center, Laxmakkapally, Mulugu, Siddipet, Telangana, India, between March and August 2026. Baseline characteristics, block adequacy, intraoperative events, procedural challenges, and postoperative outcomes are summarised descriptively. Results: Mean age was 76.4 ± 7.2 years; 28 patients (56%) were women. ASA physical status III accounted for 31 patients (62%). Spinal anaesthesia was adequate without conversion in 48 patients (96%); two (4%) required general anaesthesia. Hypotension occurred in 18 patients (36%), vasopressor administration in 16 (32%), and bradycardia in six (12%). Positioning pain affected 21 patients (42%); landmark identification was difficult in 14 (28%). Postoperative delirium occurred in seven patients (14%), urinary retention in five (10%), and respiratory complications in four (8%). Thirty-five patients (70%) mobilised within 48 hours. Median hospital stay was 6 days (interquartile range, 5–8); in-hospital mortality was 2%. Conclusion: Positioning pain and haemodynamic instability emerge as prominent care priorities in the reported summaries.

Background: Objective: To assess the clinical & functional outcome of fractures of distal end of radius managed with conservative & surgical management. Methods: The present study is an analytical study of 30 Patients with distal end radius fractures. 15 were treated with conservative management, 15 with surgical management. Out of 15 cases treated surgically, 3 were managed by K-wire, 3 with External fixator & 9 with Plating from August 2025 to September 2026 in Department of Orthopaedics, Government General Hospital, Government Medical College, Paderu. Result: In our series of 30 patients, 17 were male & 13 female. Most of the patients were between 20-30 yrs. (minimum 20, maximum 80 & mean 40.35 years). Most commonly the mode of injury, wrist involvement & fracture type were self fall (50%), Left side (60%) & Frykmans III (63%) respectively. Excellent results were seen in 60% in surgical group & 40% in conservative group. Conclusion: Conservative management is better in managing minimally displaced fractures of the distal end radius whereas Surgical management is better in the treatment of minimal/highly comminuted, displaced fractures of distal end of radius with intra-articular extension.

Background: Social media has become an important source of health information for adults; however, it also facilitates the rapid spread of inaccurate and misleading health content. Exposure to health misinformation may influence treatment choices, self-medication, healthcare-seeking behavior, vaccination decisions, and use of unverified remedies. This study assessed the association between health misinformation on social media and healthcare decision-making among adults. Materials and Methods A community-based cross-sectional study was conducted over a period of three months in the urban field practice area of Katuri Medical College and Hospital. A total of 350 adults aged 18 years and above who used at least one social media platform were included. Data were collected using a structured interviewer-administered questionnaire assessing sociodemographic characteristics, social media use, exposure to health misinformation, verification practices, trust in information sources, and healthcare-related decisions. Associations were examined using appropriate statistical tests, and multivariable binary logistic regression was used to identify independent predictors of healthcare decision-making influenced by social media. A p-value <0.05 was considered statistically significant. Results Among 350 participants, 79.7% reported exposure to health misinformation on social media, while 48.3% reported that social media health information had influenced at least one healthcare-related decision. Moderate and high misinformation exposure were observed in 41.4% and 33.7% of participants, respectively. The proportion reporting influenced healthcare decisions increased from 25.3% among participants with low exposure to 47.6% with moderate exposure and 66.1% with high exposure (p<0.001). Conclusion Exposure to health misinformation on social media was common and was significantly associated with healthcare decision-making among adults. Greater misinformation exposure was associated with progressively higher likelihood of altered healthcare decisions

Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit, affecting young adults globally with documented effects on quality of life and psychological well-being. Although India bears a considerable burden of this condition, detailed clinical profiling combined with treatment outcome data from tertiary care centres remains sparse. This research documented the clinical profile and evaluated 12-week treatment outcomes in young adults attending the Dermatology Outpatient Department (OPD) of a tertiary care hospital in central India.A prospective cross-sectional observational research was carried out at Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, from January 2019 to June 2020. A total of 310 participants aged 18-35 years with a confirmed diagnosis of acne vulgaris were enrolled after applying predefined inclusion and exclusion criteria. Clinical parameters including lesion type, anatomical distribution, Global Acne Grading System (GAGS) score, and self-reported triggers were systematically documented. Treatment was assigned according to severity and treatment response was assessed at 4, 8, and 12 weeks using percentage reduction in lesion count and GAGS score.The mean participant age was 21.4 ± 3.7 years; females comprised 54.8% of the cohort. Papulopustular acne was the most common presentation (48.4%), followed by comedonal (20.6%), mixed (15.8%), and nodulocystic (15.2%) types. The face was the primary affected site in 91.9% of participants, with concurrent chest involvement in 23.2%. Mild-to-moderate severity was recorded in 67.1% using GAGS scoring. Combination therapy with topical retinoids and clindamycin achieved the highest response rate (78.6%) at 12 weeks in the moderate severity group. Systemic doxycycline demonstrated favourable outcomes in severe presentations with a complete response rate of 64.3% at 12 weeks. Dietary factors and stress were the most frequently cited triggers.Acne vulgaris in young Indian adults shows a female-predominant pattern with papulopustular morphology and responds effectively to combination topical regimens. Integrated management addressing clinical, nutritional, and psychosocial dimensions produces the best outcomes in this population.

Background: Lymph node yield (LNY) and lymph node ratio (LNR) are increasingly recognized as potential prognostic factors in oral cavity squamous cell carcinoma (OCSCC). Their prognostic significance in clinically node-negative patients undergoing elective neck dissection remains incompletely defined. Aims and Objectives: To evaluate the association of LNY and LNR with overall survival (OS) in patients with clinically and radiologically node-negative OCSCC undergoing elective neck dissection. Methodology: This retrospective cohort study included 250 consecutive patients with cN0/rN0 OCSCC treated with curative-intent primary tumor resection and elective neck dissection between January 2022 and January 2026. LNY was defined as the total number of lymph nodes examined and categorized as <18 or ≥18 nodes. LNR was calculated as the number of metastatic lymph nodes divided by the total number examined. Survival was assessed using Kaplan-Meier analysis and the log-rank test. Cox regression was used to evaluate prognostic associations. Results: The median LNY was 20 nodes, with 104 (41.6%) patients having <18 and 146 (58.4%) having ≥18 nodes. Occult nodal metastases were identified in 78 (31.2%) patients, and ENE was present in 26 (10.4%). Five-year OS was 67.41% for LNY <18 versus 72.73% for ≥18 (p=0.234). In contrast, 5-year OS was 89.92% versus 55.67% according to LNR category (p=0.004). Conclusions: LNY ≥18 was not significantly associated with OS, whereas LNR demonstrated a significant association with survival. LNR may provide useful prognostic information in clinically node-negative OCSCC undergoing elective neck dissection.

Background: Ketoacidosis is a clinically important cause of high-anion-gap metabolic acidosis in the Emergency Department. Diabetic ketoacidosis (DKA) is common, whereas starvation ketoacidosis (SKA) is less frequently recognized and can present with substantial ketonaemia despite normal or near-normal glucose concentrations. Objectives: To compare the clinical presentation, precipitating factors, biochemical profile, and severity of acidosis in patients with DKA and SKA presenting to an Emergency Department. Methods: This prospective observational comparative study was conducted in the Emergency Department of Manipal Hospital, Varthur Road, Bengaluru, Karnataka, India, from February to June 2026. Adults with biochemically confirmed ketoacidosis were consecutively evaluated. Clinical features, precipitating factors, glucose, glycated haemoglobin, blood pH, bicarbonate, anion gap, β-hydroxybutyrate, electrolytes, renal indices, lactate, and calculated serum osmolality were recorded. Between-group comparisons were performed using appropriate parametric or categorical tests. Results: Of 108 patients assessed, 100 were analysed: 70 with DKA and 30 with SKA. Mean age was 42.6 ± 15.8 years and 56.0% were male. Polyuria/polydipsia was more frequent in DKA, whereas generalized weakness was more frequent in SKA. DKA showed higher glucose (392.6 ± 118.4 vs 87.9 ± 21.6 mg/dL), HbA1c (10.3 ± 2.1% vs 5.4 ± 0.5%), anion gap (24.8 ± 5.7 vs 20.5 ± 4.4 mmol/L), and β-hydroxybutyrate (5.7 ± 1.8 vs 4.3 ± 1.5 mmol/L), with lower pH and bicarbonate. Moderate-to-severe acidosis occurred in 72.9% of DKA and 40.0% of SKA patients. Conclusion: DKA and SKA share overlapping symptoms but demonstrate distinct glycaemic and acid-base profiles. Simultaneous assessment of glucose, β-hydroxybutyrate, pH, bicarbonate, anion gap, and dietary history can support early differentiation in emergency care.