Nalanda Medical College and Hospital

Background: Incisional hernia is a common complication following laparotomy, causing pain, functional limitation, and reduced quality of life. Both open and laparoscopic ventral hernia repairs are widely practiced, but comparative data on perioperative outcomes and recurrence remain limited. Aim: To compare laparoscopic versus open ventral incisional hernia repair regarding operative parameters, postoperative pain, complications, recovery, and short-term recurrence. Methodology: A prospective observational study was conducted on 186 patients undergoing elective ventral incisional hernia repair at Nalanda Medical College and Hospital, Patna, Bihar, India. Ninety patients underwent open repairs and 96 laparoscopic repairs. Data on demographics, operative findings, postoperative pain, complications, recovery, and six-month recurrence were collected and analyzed using SPSS v26. Results: Baseline characteristics were comparable between groups. Laparoscopic repair had longer operative time (104.7 ± 28.3 vs 78.4 ± 20.6 min, p<0.001) but lower blood loss (18 ± 12 vs 65 ± 40 ml, p<0.001) and fewer drains placed. Postoperative pain scores were significantly lower in the laparoscopic group at all time points (p<0.001). Surgical site infections were reduced (5.2% vs 17.8%, p=0.006), and recovery was faster with earlier ambulation, oral intake, shorter hospital stay, and quicker return to work (p<0.001). Six-month recurrence rates were similar (8.3% vs 11.1%, p=0.52). Conclusion: Laparoscopic ventral hernia repair offers reduced pain, fewer infections, faster recovery, and comparable short-term recurrence compared to open repair, making it a favorable minimally invasive option.

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine condition that leads to infertility as a result of prolonged anovulation. Pharmacological ovulation induction (OI) using drugs like Letrozole and Clomiphene Citrate (CC) is a fundamental approach to reinstating fertility. Aim: To evaluate the effectiveness, endometrial response, ovulation, pregnancy outcomes, and tolerability of Letrozole compared to Clomiphene Citrate in women with PCOS. Methodology: This prospective, randomized, open-label comparative study was conducted at a tertiary care center in Patna from August 2024 to July 2025. Ninety women with PCOS were randomized into two groups: letrozole (5 mg) or CC (100 mg) from day 3–7 of the cycle. Follicular monitoring, endometrial thickness, ovulation, pregnancy outcomes, and adverse effects were assessed. Results: Ovulation rate was higher with letrozole (86.7%) than CC (75.6%), though not statistically significant. Endometrial thickness was significantly greater in the letrozole group (9.2 ± 1.1 mm vs 8.0 ± 1.3 mm; p<0.01). Clinical pregnancy rates were 33.3% with letrozole and 22.2% with CC. Adverse effects were slightly lower with letrozole. Conclusion: Letrozole demonstrated better endometrial response and a trend toward higher ovulation and pregnancy rates, with comparable safety, making it an effective alternative to clomiphene citrate in PCOS.

Background: Uterine fibroids are the most common benign tumors of the female reproductive system and can lead to significant reproductive and gynecological complications. Although several non-modifiable risk factors have been identified, the role of modifiable lifestyle factors remains less clearly understood. Aim: To identify modifiable factors associated with uterine fibroids among women of reproductive age. Methodology: A hospital-based cross-sectional study was conducted among 278 women aged 18–44 years attending the Department of Obstetrics and Gynecology at Nalanda Medical College and Hospital, Patna, India, over nine months. Data were collected through structured questionnaires, clinical examination, anthropometric measurements, and pelvic ultrasonography. Statistical analysis was performed using SPSS, and associations were assessed using Chi-square tests and logistic regression with odds ratios (OR) and 95% confidence intervals (CI). Results: The prevalence of uterine fibroids was 33.8%. Overweight (OR=1.89; 95% CI: 1.05–3.41) and obese women (OR=2.67; 95% CI: 1.45–4.92) had higher odds of fibroids compared with women with normal BMI. Irregular physical activity (OR=1.82; 95% CI: 1.06–3.11) and high-fat diet (OR=1.77; 95% CI: 1.04–3.01) were also significantly associated with fibroid occurrence. Family history showed a strong association (OR=3.12; 95% CI: 1.79–5.44). Conclusion: Modifiable lifestyle factors such as increased BMI, physical inactivity, and unhealthy dietary patterns are significantly associated with uterine fibroids. Lifestyle modifications may help reduce the risk and improve reproductive health outcomes.

Background: Visual impaired children have been generally reported to have poor oral health. The present study aimed to evaluate the impact of artificial intelligence guided videos versus other audio-visual aids on oral health status in visually impaired children. Materials and methods: This prospective cross-sectional study was conducted in a school for specially abled children after obtaining permission for conducting this study from institutional ethical committee and school authorities. This studycomprised100 visually impaired children aged between 8 to 15 years age belonging to both genders selected using randomization technique. Students were equally distributed in four groups which comprised of 25 subjects each: a) Group A: Students were given oral health education using pamphlets written in Braille, b) Group B: Subjects were trained using audios, c) Group C: Subjects were trained using combination of Braille pamphlets and audio and d) Group D: Children were trained using artificial intelligence guided videos. The study data was collected in three stages. In stage 1, assessment of knowledge regarding oral health was evaluated by means of a questionnaire written in Braille at baseline i.e., before conducting oral health education training. The clinical oral examination was performed at oral health status was assessed using the ‘oral hygiene index - Simplified’ (OHI-S) scores by recording plaque scores. In second stage, study participants received educational training on oral health regarding importance of good oral health and maintenance of oral hygiene, techniques for brushing, dental caries, periodontal health and fluoride use and in stage three, OHI-S scores were observed and recorded. A postintervention questionnaire was again distributed and responses were recorded after four weeks. Statistical analysis was performed by use of statistical software, Statistical Package for the Social Sciences (SPSS) statistics 25.0 (IBM, NY, US). Descriptive statistics was done and Chi-square, Wilcoxon and post-hoc analytical tests were performed. Confidence interval was kept at 95% with P value < 0.05. Results: Statistically significant improvement in mean ± S.D. scores for OHI-S index and knowledge scores were obtained after providing oral health training to the children. Conclusion: Providing oral health education by any means has been demonstrated to improve oral health status as well as knowledge scores.

BACKGROUND: Patient safety is an important aspect of healthcare system. Owingto improper training, there is high mortality and morbidity involved in patient care in hospitals worldwide. This study aimed to analyze the patient safety culture awareness among healthcare professionals in India. MATERIALS AND METHODS: This prospective cross-sectional study was conducted in different hospital settings following Institutional ethical Committee approval. The study sample comprised of 1800 healthcare professionals (physicians, dentist, nurses, patient care assistants, pharmacists, physiotherapists, and hospital administrators) selected using nonprobability convenient sampling method. Hospital survey on patient safety culture developed by Agency Healthcare Research Quality professionals was used which comprised of thirty questions grouped in 11 dimensions including supervisor’s/managerial expectations, actions promoting patient safety, organizational learning, continued improvement and hospital teamwork. Statistical analysis: The Pilot study was conducted using the SPSS Statistical tool software version 20.0 (IBM, NY) for testing the reliability of the questionnaire by usingthe Cronbach alpha test. The calculated sample size was found to be 100 for performing the pilot study. Cronbach alpha score of 0.734 was obtained which was indicative of study validity. Responses were recorded on 5-point Likert scale, i.e., 1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = strongly agree). The Chi-square test/goodness of fittest was usedfor determination of statistical significance of qualitative variables, while Chi-square and Mann–Whitney U tests were used for intergroup comparisons. P < 0.05 was considered to have statistical significance. RESULTS: The ‘hands off’ and transitions domain required demonstrated lower positive responses (35.56%). Higher positive responses were obtained from dimensions: teamwork within a unit (92.21%), organizational learning and continued improvement (89.49%), frequency of reported events (82.31%), and feedback and communication errors (69.19%). Least positive responses were obtained from two dimensions—(a) general perception (20.23%) and (b) nonpunitive response to errors (09.12%). On comparison between perception responses by use of‘Chi-square’ test, statistically significant difference (<0.05) was obtained between following variables—(a) perception regarding patient safety dimensions and position and (b) experience level of healthcare professionals. CONCLUSION: There is requirement of improvement in few domains to strengthen patient safety culture in India which can be done by means of training programs in hospitals.