Background: Alcohol Dependence Syndrome (ADS) is a major public health concern in India and is strongly associated with Alcoholic Liver Disease (ALD). The severity of liver damage correlates with multiple factors including nutritional status, anthropometry, and biochemical parameters. Objective: To evaluate factors associated with liver disease in individuals with alcohol dependence, including nutritional intake, anthropometric indices, liver function tests (LFT), and severity of dependence. Methods: A cross-sectional study was conducted among 60 male patients diagnosed with ADS (ICD-10 criteria) in a tertiary care hospital. Data on sociodemographic profile, anthropometry (BMI, MAC, WHR), dietary intake (24-hour recall), LFT, ultrasound abdomen, and Severity of Alcohol Dependence Questionnaire (SADQ) were collected. Statistical analysis included descriptive statistics and inferential tests (Chi-square, Fisher’s exact test, Mann-Whitney U, Kruskal-Wallis). Results: Mean age was 41.53 ± 9.44 years. Nutritional deficiency was highly prevalent (energy 95%, protein 83.3%, fat 70%). Fatty liver was the most common ultrasound finding (68.3%). Majority had severe dependence (48.3%). No significant association was observed between anthropometric indices, nutritional intake, and severity of dependence with ALD. However, direct bilirubin (p=0.038) and alkaline phosphatase (p=0.020) showed significant association with ultrasound findings. Conclusion: Liver disease is highly prevalent among ADS patients. However, anthropometry, dietary intake, and dependence severity did not appear to have significant correlation . Direct bilirubin and ALP may serve as better indicators of liver damage. Larger studies are needed.

Background: Fluorosis remains a significant public health concern in several regions of India where groundwater fluoride concentration exceeds permissible limits. To address this burden, the Government of India launched the National Programme for Prevention and Control of Fluorosis (NPPCF). Effective implementation of the programme is essential for reducing disease burden through surveillance, diagnosis, treatment, health education, and intersectoral coordination. However, evidence regarding district-level implementation remains limited. Objectives: To assess the implementation status of NPPCF in Kanker district, Chhattisgarh, and to identify barriers affecting programme performance. Materials and Methods: A mixed-methods cross-sectional study was conducted in Kanker district. Quantitative assessment included review of programme records, facility observations, and beneficiary data. Programme components were evaluated using a structured checklist covering human resources, training, diagnostics, IEC activities, logistics, reporting, and coordination. Qualitative data were collected through key informant interviews with programme officials and healthcare workers. Descriptive statistics were used for quantitative analysis, while thematic analysis was performed for qualitative findings. Results: The overall implementation score of NPPCF in Kanker district was 62.5%, indicating moderate implementation. Diagnostic services showed the highest performance (83.3%), whereas IEC activities and community awareness components scored lower. Dental fluorosis prevalence among screened individuals was 45.6%, while skeletal fluorosis prevalence was 0.7%. Major operational challenges included shortage of trained human resources, irregular monitoring, limited community participation, inadequate convergence with Public Health Engineering Department, and delayed reporting. Conclusion: NPPCF implementation in Kanker district was moderate with satisfactory diagnostic services but gaps in manpower, awareness generation, and coordination. Strengthening human resources, monitoring systems, intersectoral collaboration, and community-based IEC activities is essential for improving programme effectiveness.

Background and Aim:Spinal anaesthesia is one of the most widely used regional anaesthesia. But when a difficult lumbar puncture is encountered, multiple attempts can lead to patient discomfort and heightened anxiety and other complications. Anticipating such difficulty can enhance patient safety, procedural efficiency, and decision-making. This study aimed to assess the correlation between the grade of lumbar puncture and a five-variable bedside scoring system in adult patients scheduled for elective infra-umbilical surgeries.Methods: In this study, 157 ASA I–II patients aged 18–80 years were evaluated preoperatively using five parameters: age, abdominal circumference, spinal deformity (assessed via axial trunk rotation using a scoliometer), anatomical landmark visibility (graded using the Spinous Landmark Grading System)and patient position. Each variable was scored from 0 to 3, yielding a total bedside score ranging from 0 to 15. Spinal anaesthesia was performed by a blinded anaesthesiologist using a 25G Quincke needle. Lumbar puncture grade was classified as easy (1st attempt), moderate (2–4 attempts or ≥2 interspaces), or difficult (≥5 attempts or ≥3 interspaces). Correlation between bedside score and grade of lumbar puncture was analyzed using Spearman’s correlation.Results: Of the 157 patients, 102 (65%) had easy, 41 (26%) moderate, and 14 (9%) difficult lumbar punctures. A significant positive correlation was found between total bedside score and lumbar puncture grade (r = 0.71, p < 0.001). Among individual parameters, SLGS grade showed the strongest correlation with grade of lumbar puncture (r = 0.53), followed by patient position (r = 0.54), abdominal circumference (r = 0.51), age (r = 0.41), and spinal deformity (r = 0.39).Conclusion: The five-variable bedside scoring system shows a strong correlation with the grade of lumbar puncture. It is a practical, non-invasive tool for pre-procedural risk stratification, allowing anaesthesiologists to anticipate challenging cases and adopt appropriate strategies.

Background: Airway management in paediatric patients presents unique challenges due to anatomical and physiological differences, including a relatively larger tongue, cephalad larynx, and reduced functional residual capacity. Supraglottic airway devices (SGADs) have emerged as valuable tools not only for ventilation but also as conduits for tracheal intubation. Among these, AIR-Q Intubating Laryngeal Airway (ILA) and Ambu AuraGain are widely used in clinical practice. Objective: To compare the efficacy of AIR-Q ILA and Ambu AuraGain as conduits for blind tracheal intubation using microcuff endotracheal tubes in paediatric patients. Methods: This prospective randomized comparative study included 100 paediatric patients aged 1–18 years, categorized as ASA physical status I or II. Patients were randomly assigned into two groups: Group A (AIR-Q) and Group B (AuraGain), with 50 patients in each group. Primary outcomes included first-attempt intubation success rate, total intubation time, and number of attempts. Secondary outcomes included ease of device insertion and incidence of complications. Results: The AIR-Q group demonstrated a significantly higher first-attempt success rate (88%) compared to the AuraGain group (64%). Mean intubation time was significantly lower in the AIR-Q group (18.5 ± 6.2 seconds) compared to the AuraGain group (29.8 ± 9.4 seconds). The number of attempts required was fewer in the AIR-Q group. Complication rates were comparable between the two groups. Conclusion: AIR-Q ILA is superior to Ambu AuraGain as a conduit for blind tracheal intubation in paediatric patients, offering higher success rates and faster intubation.

Background: Femoral shaft fractures are common high-energy injuries associated with significant morbidity, particularly in young adults. Antegrade intramedullary interlocking nailing has become the gold standard for their management due to its advantages of minimal soft tissue disruption, stable fixation, high union rates, and early mobilization. In addition to fracture union, functional recovery has emerged as a key outcome measure. This study aimed to evaluate the functional outcomes of femoral shaft fractures managed with antegrade intramedullary interlocking nailing in a tertiary care setting. Materials and Methods: A prospective observational study was conducted over 18 months at AIMS & RC Hospital, Rajasthan. A total of 56 adult patients (≥18 years) with fracture shaft of femur, including closed and Gustilo-Anderson type I and II fractures, were included. All patients underwent antegrade intramedullary interlocking nailing under spinal anaesthesia. Clinical and radiological evaluations were performed pre- and postoperatively, with regular follow-up. Fracture union was assessed radiologically, and functional outcomes were evaluated using the Thoresen et al. scoring system. Results: The mean age was 31.54 years, with the majority in the 18–30 years group (50%), and a male predominance (66.07%). Road traffic accidents accounted for 94.64% of cases. Type III fractures were most common (46.4%). Most patients had a hospital stay of 10–15 days (53.57%). Partial weight bearing was achieved within 12 weeks in 71.4% of patients, while 71.4% achieved full weight bearing between 13–16 weeks. Radiological union was most commonly observed between 17–20 weeks (39.2%), with an average union time of 20.27 weeks; delayed union occurred in 3.57% and no non-union was observed. Full knee range of motion was achieved in 69.6% of patients. Malunion was seen in 10.71% (valgus 7.14%, varus 3.57%) with no rotational deformities. Limb length discrepancy was absent in 92.8% of patients. Complications included superficial infection in 1 case and knee pain in 6 patients. Functional outcomes were excellent in 69.64%, good in 19.64%, and fair in 10.71% of patients, with no poor outcomes. Conclusion: Antegrade intramedullary interlocking nailing is an effective and reliable modality for the management of femoral shaft fractures, providing high union rates, satisfactory alignment, low complication rates, and favourable functional outcomes.

Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis, particularly in developing countries. Early and accurate diagnosis is essential for timely management and prevention of complications. This study evaluates the concordance between cytopathology using fine needle aspiration cytology (FNAC) and Gene Xpert MTB/RIF assay in diagnosing lymph node tuberculosis. Materials and Methods: A prospective study was conducted on 120 patients presenting with lymphadenopathy clinically suspected for tuberculosis. FNAC was performed, and aspirates were subjected to cytological examination and Gene Xpert testing. Cytological findings were categorized into granulomatous lymphadenitis with necrosis, without necrosis, suppurative lesions, and reactive lymphadenitis. Results: Out of 120 cases, cytopathology suggested tuberculosis in 85 cases (70.8%), while Gene Xpert detected Mycobacterium tuberculosis in 78 cases (65%). Concordance between FNAC and Gene Xpert was observed in 72 cases, yielding an overall agreement of 85%. Gene Xpert showed higher specificity in detecting Mycobacterium tuberculosis, particularly in necrotic and suppurative lesions. However, FNAC demonstrated higher sensitivity in identifying granulomatous inflammation even in Gene Xpert-negative cases. Conclusion: The combined use of cytopathology and Gene Xpert significantly improves diagnostic accuracy. While FNAC remains a rapid, cost-effective screening tool, Gene Xpert provides microbiological confirmation and detects rifampicin resistance. The dual diagnostic approach is therefore recommended for better clinical decision-making in lymph node tuberculosis.

Background: Tracheoesophageal fistula (TEF) is a rare congenital anomaly with significant morbidity and mortality, particularly in resource-limited settings. Prognosis is influenced by factors such as birth weight, associated anomalies, and postoperative complications. Objective: To evaluate the diagnosis, outcome, and prognosis of patients with tracheoesophageal fistula at a tertiary care centre. Methods: A retrospective and prospective study was conducted in the Department of General Surgery over five years (2020–2024). A total of 46 neonates diagnosed with TEF were included. Data on demographics, clinical presentation, associated anomalies, surgical management, and postoperative outcomes were analyzed. Statistical analysis was performed using SPSS version 25. Results: The mean age at presentation was 1.91 days, and mean birth weight was 2.04 kg. Type C TEF was the most common (93.5%). Associated anomalies included cyanotic congenital heart disease (23.9%) and spinal anomalies (28.3%). Postoperative ventilator support was required in 58.7% of cases. Overall mortality was 52.2%, with ventilator-associated pneumonia (21.7%) and sepsis (19.6%) being the leading causes of death. Survival was poorest in neonates weighing <1.5 kg and those with associated cardiac anomalies. Conclusion: Outcomes in TEF are strongly influenced by low birth weight, associated congenital anomalies, and postoperative infectious complications. Early diagnosis, multidisciplinary care, and improved neonatal intensive care support are essential to reduce mortality, particularly in high-risk groups.