Katihar Medical College and Hospital

Background: General anesthesia (GA) is usually used during total laparoscopic hysterectomy (TLH). Thoracic spinal anesthesia (TSA), however, might be a useful substitute, particularly for patients who are at high risk. The purpose of this randomized controlled experiment was to evaluate the safety and effectiveness of GA and TSA in TLH patients. Methods: Group T (TSA) and group G (GA), each consisting of 15 patients, were randomly assigned to 30 patients scheduled for elective TLH. While group T received TSA (sub-arachnoid block at T8/9 or T9/10 with hyperbaric levo-bupivacaine 0.5%, 0.7 ml along with dexmedetomidine 4 g, followed by isobaric levobupivacaine 0.5% 1.5 ml with dexmedetomidine 6 g while seated), group G received conventional GA with intubation and mechanical ventilation. Our main goal was to examine the hemodynamic changes, and our secondary goal was to compare the two methods' intraoperative and postoperative side effects and need for rescue analgesia. Results: For the study, all 30 individuals were examined. Patients in Group T had better hemodynamic stability, and after 30 minutes, the mean SBP of the two groups differed significantly (at 40 minutes p=0.043, at 60 minutes p=0.007). In group G, there were noticeably more patients in need of rescue analgesia. Group G experienced greater adverse events, such as intraoperative hypertension and postoperative sore throat. Conclusion: For TLH, TSA offers a safe substitute for GA with improved hemodynamic stability, fewer adverse effects, and a lower need for rescue analgesia.

Background Focal liver lesions (FLL) range from benign entities to malignant tumours, and accurate characterisation is essential for management decisions. This study assessed the diagnostic utility of sonoelastography (SE) and triphasic computed tomography (CT) in evaluating FLL, comparing their diagnostic efficacy and correlation with histopathological findings. Methods This cross-sectional study was conducted in the Department of Radiodiagnosis, Katihar Medical College, Katihar, from July 2022 to December 2024, involving 60 patients with clinically suspected FLL. All patients underwent SE using shear wave elastography and triphasic CT. Diagnostic parameters (sensitivity, specificity, positive and negative predictive values, and accuracy) were calculated and compared against histopathological examination (HPE), the reference standard. Results The mean age was 48.0 ± 17.2 years, with a male predominance (83.3%). Amoebic abscess and metastasis were the most common diagnoses (25.0% each), followed by hemangioma and hepatocellular carcinoma (16.7% each). Overall, 30 lesions (50.0%) were benign and 30 (50.0%) were malignant. Arterial-phase peripheral rim hyperenhancement (30.0%) and delayed-phase hypoenhancement (50.0%) were the commonest CT patterns. SE stiffness values greater than 2.44 m/s were strongly suggestive of malignancy. Triphasic CT showed 100% sensitivity, specificity, and accuracy against HPE. Conclusion SE and triphasic CT are complementary, reliable, non-invasive modalities for characterising FLL. Triphasic CT demonstrated excellent diagnostic accuracy, while SE provided additional stiffness-based information; together, they improve diagnostic confidence and may reduce reliance on invasive biopsy. Recommendation Triphasic CT combined with SE should be considered as a first-line, non-invasive strategy for the diagnostic work-up of FLL, with further validation in larger, prospective, multicentric studies before wider adoption into routine clinical protocols.

Achieving a hermetic three-dimensional seal of the root canal system remains a primary objective of endodontic therapy, yet comparative evidence on the sealing efficacy of contemporary bioceramic and resin-based sealers remains limited. Therefore, it is interest to compare the sealing ability of three bioceramic sealers (Bio-C Sealer, CeraSeal and EndoSequence BC Sealer HiFlow) with two resin-based sealers (AH Plus and ThermaSeal Plus) using micro-computed tomography. Seventy-five extracted single-rooted human premolars were obturated using single-cone technique for bioceramic sealers and warm vertical compaction for resin-based sealers, followed by three-dimensional assessment of void volume and sealer adaptation. Bioceramic sealers demonstrated significantly lower total void percentages (0.89-1.24%) compared with resin-based sealers (1.78-2.15%) (p < 0.001), with EndoSequence BC Sealer HiFlow showing the best adaptation and lowest void volume. Thus, we show that contemporary bioceramic sealers provide superior sealing ability and canal wall adaptation compared with resin-based sealers, supporting their clinical use for predictable root canal obturation.

BACKGROUND:Recurrent aphthous stomatitis (RAS) is a common oral mucosal condition characterized by painful, recurrent ulcers that affect quality of life. Topical corticosteroids such as triamcinolone acetonide are the standard treatment due to their anti-inflammatory effects, but concerns about side effects and patient preference have prompted interest in alternative therapies. Aloe vera, known for its anti-inflammatory and wound-healing properties, has emerged as a potential natural option. However, comparative evidence with standard treatments remains limited, necessitating further evaluation of its clinical efficacy in RAS management. AIM:This study aims to show the clinical efficacy of Aloe vera as compared with triamcinolone acetonide in the management of recurrent aphthous stomatitis (RAS). MATERIALS AND METHODS:This comparative study was conducted on 60 patients (17-40 years) with RAS, who were randomly divided into two groups: Group A ( n = 30) on triamcinolone acetonide paste, and Group B ( n = 30) on Aloe vera gel. Both were applied at 6-hour intervals daily for 7 days under blinded conditions. Pain was self-assessed daily using the Numerical Pain Rating Scale (0-10), and healing was evaluated on Day 7 with the WHO Oral Mucositis Grading Scale. Data were analyzed with SPSS version 21.0, applying Student's t -test for parametric and Mann-Whitney U test for non-parametric variables. RESULTS:Sixty participants completed the trial. Males predominated in Group A, females in Group B. Both groups showed significant improvement by Day 7 with no post-treatment scores above 2. Males in Group A showed faster mid-phase improvement (Days 3-6, P = 0.026-0.002), while females demonstrated similar progress across groups. Overall, Aloe vera achieved comparable efficacy to triamcinolone, though steroid therapy offered quicker relief in males. CONCLUSION:Both triamcinolone acetonide and Aloe vera were effective in managing minor RAS. Triamcinolone provided faster recovery in males, whereas Aloe vera was equally effective overall. CLINICAL SIGNIFICANCE:Aloe vera offers a safe, natural alternative for patients unable or unwilling to use corticosteroids, while Triamcinolone may be preferable when faster symptom relief is desired.

The occurrence of ipsilateral cervical micrometastases in Oral squamous cell carcinoma (OSCC) is not uncommon.However, OSCC patients with negative ipsilateral neck nodes having contralateral lymph node metastases are still rare. Clinical and histopathologic factors provide predictive information on contralateral lymph nodal recurrence (CLNR) in OSCC.This study evaluated the predictive value of the clinical-histopathologic factors potentially related to contralateral occult lymph node metastasis in OSSCand formed a rational basis for elective contralateral neck management. The observational study analyzed 1360 OSCC patients treated from January 2018 to September 2023 at an Indian medical university.CLNR-confirmed cases were included in the study but without ipsilateral or local recurrence. Statistical analysis was performed using SPSS v. Univariate, and multivariate analysis was performed for the predictor analysis. Survival outcomes were assessed using Kaplan-Maier analysis; p < 0.05 was considered statistically significant. A total of 48 patients (3.5