Atal Bihari Vajpayee Institute of Medical Sciences

Acute compartment syndrome (ACS) is a time-critical surgical emergency requiring prompt diagnosis to prevent irreversible tissue damage. Current diagnostic methods rely on subjective clinical findings and invasive intracompartmental pressure measurement, both with significant limitations. Serum biomarkers may provide non-invasive adjuncts, particularly in patients with unreliable clinical examinations. This study aims to evaluate the diagnostic association of serum creatine kinase (CK) and lactate levels with ACS in patients with extremity trauma. A systematic literature search was performed in PubMed, Embase, and Scopus as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline (PROSPERO Registration: CRD420261351683) from inception through February 2026. Studies evaluating serum CK or lactate in patients with suspected or confirmed ACS with comparison groups were included. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Threshold-based analyses pooled odds ratios (ORs) with 95

Objective:This study systematically evaluates the predictive value of preoperative glycaemic biomarkers, including fructosamine, compared with HbA1c and glycated albumin. Methods:The databases of PubMed, Embase, and Scopus were searched from inception to September 2025 for studies that assessed preoperative fructosamine levels and postoperative complications in orthopaedic patients. Cohort studies reporting infections, wound complications, readmissions, or reoperations were included. Data extraction and quality assessment were performed independently. A random-effects meta-analysis was used to pool risk estimates, with heterogeneity quantified using the I2 statistic. Results:Seven cohort studies (N = 5217) met the inclusion criteria. Elevated preoperative fructosamine (≈292-293 μmol/L for arthroplasty; ≈238 μmol/L for foot/ankle surgery) was consistently associated with a higher risk of postoperative infection and complications (pooled RR 7.20; 95% CI 1.49-34.91). HbA1c demonstrated a smaller, less consistent effect (pooled RR 2.36; 95% CI 1.04-5.34). Direct comparisons between high fructosamine and high HbA1c cohorts revealed no statistically significant difference, although fructosamine more accurately reflected short-term glycemic status. Conclusions:Preoperative fructosamine is a robust short-term glycaemic biomarker that frequently outperforms HbA1c in predicting postoperative infectious complications in arthroplasty and other orthopaedic surgery. Standardised cut-offs, multicenter validation, and interventional trials are needed to define its role in perioperative risk stratification.

Abstract Background Our recent estimate of the global 1-year prevalence of headache among those aged 18–65 years was 65%: considerably higher than previous estimates, but based solely on high-quality epidemiological data derived from a large population-based sample. Here we present complementary estimates of 1-day prevalence. Methods We performed a meta-analysis of individual participant data from cross-sectional surveys among population-representative samples (age range 18–65 years) from 15 countries and all world regions. All used the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, including the question “did you have a headache yesterday?”, from which 1-day prevalence was determined. An algorithmic process applying modified ICHD criteria yielded separate estimates for migraine, tension-type headache (TTH) and probable medication-overuse headache (pMOH: the association of headache on ≥ 15 days/month and medication overuse). We analysed associations with age, gender and country-income level, and adjusted prevalence estimates for these factors. We calculated predicted 1-day prevalence from 1-year prevalence and reported headache frequency. Results Among the 38,512 participants, females (53.4%) and participants from low- (17.1%) or lower-middle-income countries (64.6%) were overrepresented, but age distribution fairly matched that of the world. Overall, 13.7% (95% CI: 13.3–14.0) reported headache yesterday, females (17.1% [16.6–17.6]) more than males (9.7% [9.3–10.2]). Migraine was the most common headache type yesterday (6.0% [5.8–6.3]), followed by TTH (4.1% [3.9–4.3]) and pMOH (2.3% [2.2–2.5]). One-day headache prevalence was higher in low/lower-middle-income countries (13.9% [13.6–14.3]) than in high/upper-middle-income countries (12.4% [11.6–13.2]). Predicted 1-day prevalence (10.9% [10.7–11.1]) was considerably lower than observed 1-day prevalence (13.7% [13.3–14.0]), although not among those with pMOH (3.1% [3.0-3.3] versus 2.3% [2.2–2.5]). Adjusted for age, gender and country-income level, global 1-day prevalence estimates were 13.1% (12.8–13.5) for any headache, 5.7% (5.5–5.9) for migraine, 3.9% (3.7–4.1) for TTH and 2.4% (2.3–2.6) for pMOH, with 1.0% undiagnosed. Conclusion Assuming yesterday was no different from any other day, an estimated 13.1% (N = 641,900,000) of the world’s population aged 18–65 years will have headache tomorrow; almost half will be migraine. People with migraine or TTH underestimate the frequency of headache episodes. Since headache-attributed burden is usually estimated from recalled frequency over 1–12 months, this also may be underestimated.

To compare the efficacy, safety and cost of Single Maintenance and Reliever Therapy (SMART) with low dose inhaled budesonide-formoterol combination vs. conventional budesonide plus as-needed levo-salbutamol, in 6-11-y-old children with asthma. In this randomised controlled trial (RCT), 84 children (6–11 y) with treatment-naïve asthma were randomised to either SMART with inhaled budesonide-formoterol combination, or budesonide plus as-needed levo-salbutamol. Peak expiratory flow (PEF), asthma symptom score, number of rescue doses, exacerbations, adherence, inhalation technique, adverse events and cost were recorded over the first 12 wk of follow-up. Baseline PEF, asthma symptom score, and other characteristics were comparable. At the end of 12 wk, the median (IQR) improvement in PEF was 16