Sawai Man Singh Medical College, also known as SMS Medical College, is a government medical college in Jaipur, Rajasthan state, India. It was established in 1947 and was the 15th centre for medical education in India.
Retrograde ejaculation remains one of the most distressing complications following conventional transurethral resection of the prostate (TURP). Modified techniques that preserve critical anatomical structures such as supramontanal tissue, have been proposed to maintain antegrade ejaculation without compromising urinary outcomes. To compare urinary and sexual outcomes between conventional TURP and ejaculation-preserving TURP in patients with benign prostatic hyperplasia (BPH). This prospective, randomized observational study was conducted in the Department of Urology, SMS Medical College and Hospital, Jaipur, from February 2024 to May 2025. Sixty-four patients with BPH were randomized into two groups: conventional TURP (Group A, n = 32) and ejaculation-preserving TURP (Group B, n = 32). Functional outcomes were assessed using the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual urine (PVR), and Question of the International Index of Erectile Function (IIEF-9). Patients were followed for six months postoperatively. Both groups showed significant postoperative improvement in IPSS and Qmax. At six months, mean Qmax was 22.1 ± 5.9 mL/s in Group A versus 24.5 ± 4.7 mL/s in Group B (p = 0.04). Antegrade ejaculation was preserved in 28 of 32 patients (87.5
Background: Postoperative nausea and vomiting (PONV) is a common and distressing complication after laparoscopic cholecystectomy. 5-HT3 receptor antagonists, including ondansetron and granisetron, are widely used for prophylaxis, but their comparative efficacy remains clinically relevant. Objective: To compare the effectiveness of intravenous granisetron and ondansetron in preventing PONV after laparoscopic cholecystectomy under general anaesthesia. Methods: This hospital-based randomized double-blind interventional study included 86 patients aged 20–60 years undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups of 43 each. Group A received intravenous ondansetron 0.1 mg/kg, and Group B received intravenous granisetron 0.04 mg/kg before induction. Patients were monitored for nausea, vomiting, need for rescue antiemetics, and adverse effects for 24 hours postoperatively. Results: Baseline demographic and perioperative variables were comparable between the two groups. Nausea and vomiting occurred more frequently in the ondansetron group than in the granisetron group at most time intervals. The cumulative incidence of nausea over 24 hours was 51.2% in Group A and 23.3% in Group B, while vomiting over 24 hours was 34.9% in Group A and 11.6% in Group B. The need for rescue antiemetics was significantly higher in Group A (41.9%) than in Group B (11.6%). Post-extubation adverse effects such as headache, dizziness, and myalgia were mild and comparable in both groups. Conclusion: Intravenous granisetron was more effective than ondansetron in reducing PONV and the need for rescue antiemetics after laparoscopic cholecystectomy, with a similar safety profile.
Relevance. Obsessive–compulsive disorder has been increasingly linked to autonomic nervous system dysregulation, which may confer elevated cardiovascular risk. Heart rate variability is a non-invasive marker of sympathovagal balance and autonomic flexibility. However, comprehensive heart rate variability assessment incorporating nonlinear indices in young, drug-naïve obsessive–compulsive disorder patients remains limited. Aim. To compare time-domain, frequency-domain, and nonlinear heart rate variability parameters between patients with obsessive–compulsive disorder and healthy controls. Materials and methods. The present cross-sectional comparative study included 80 participants aged 20–30 years: 40 newly diagnosed obsessive–compulsive disorder patients and 40 age- and sex-matched healthy controls. Heart rate variability was assessed using a 5-minute resting electrocardiography recording under standardized conditions. Results: Patients with obsessive–compulsive disorder demonstrated a significant reduction in heart rate variability compared with healthy controls. Time-domain heart rate variability parameters were significantly lower in the obsessive–compulsive disorder group, indicating reduced parasympathetic cardiac modulation. In the frequency domain, total power and high-frequency normalized units were significantly decreased in obsessive–compulsive disorder patients, whereas low-frequency power, very-low-frequency power, and the Low Frequency/High Frequency ratio did not show statistically significant differences between the two groups. Nonlinear heart rate variability analysis revealed a significant reduction in Standard Deviation 2, reflecting impaired long-term heart rate variability dynamics, while the Standard Deviation 1/ Standard Deviation 2 ratio remained preserved. Conclusion. Patients with obsessive–compulsive disorder demonstrates significant autonomic imbalance characterized by parasympathetic withdrawal, reduced overall heart rate variability, and diminished autonomic flexibility. These findings support impaired cardiovascular autonomic regulation as a consistent physiological feature of obsessive–compulsive disorder and highlight the potential role of heart rate variability assessment in early cardiovascular risk stratification and integrative psychiatric evaluation.
Background: Acute appendicitis is the most frequent surgical emergency and a leading cause of acute abdominal pain, carrying a lifetime risk of approximately 6%. Clinical presentation is often misleading and hyponatremia has been proposed as a biochemical marker for complicated acute appendicitis. This study evaluated the role of serum sodium as a marker of appendicitis severity. Methods: This hospital-based, observational prospective study was conducted in the department of general surgery, SMS Medical College, Jaipur, from August 2024 to September 2025, and enrolled 100 adult patients (>18 years) diagnosed with appendicitis. Patients were categorized into hyponatremic (serum sodium <135 mEq/l) and normonatremic groups. Data were collected on demographics, clinical presentation (Alvarado score), white blood cell count, surgical findings, and postoperative recovery. The primary objective was to evaluate serum sodium as a marker of appendicitis severity; secondary objectives were to assess its impact on surgical site infection rates and duration of hospital stay. Results: Hyponatremic patients (mean age 36.76±17.54 years) were significantly older and predominantly male compared with normonatremic patients. Gastrointestinal symptoms including nausea/vomiting (84% versus 32%) and anorexia (76% versus 48%), were more prevalent in the hyponatremic group, and 94% of hyponatremic patients required hospitalization for 3 days or longer, compared with 66% of normonatremic patients. Hyponatremia showed a strong association with complicated pathology, but its predictive value for surgical site infection was weak (16% versus 12%), and white blood cell counts lacked specificity for differentiating disease severity between groups. Conclusions: Serum sodium appears to be a reliable, objective surrogate marker for predicting complicated appendicitis, reflecting systemic inflammation and increased hospital resource utilization, and may aid early identification of high-risk patients who require urgent intervention, particularly when Alvarado scores are equivocal.
Background: Delayed cord clamping (DCC) has emerged as an important intervention for improving neonatal hematological parameters and iron stores. Major international organizations including the World Health Organization (WHO), American College of Obstetricians and Gynecologists (ACOG), and Royal College of Obstetricians and Gynaecologists (RCOG) recommend delayed cord clamping in vigorous term and preterm neonates. However, concerns regarding neonatal jaundice, polycythemia, hyperviscosity, and maternal postpartum hemorrhage continue to limit widespread implementation of prolonged DCC practices, particularly in low-resource settings. Objective: To evaluate maternal and neonatal safety outcomes following delayed cord clamping with cord milking at 60 seconds and 180 seconds. Methods: This randomized controlled comparative study was conducted in the Department of Obstetrics and Gynaecology, SMS Medical College and Attached Hospitals, Jaipur. Sixty singleton pregnancies beyond 34 weeks gestation fulfilling inclusion criteria were enrolled and randomized into two groups. Group A underwent delayed cord clamping with cord milking at 60 seconds, while Group B underwent delayed cord clamping with cord milking at 180 seconds. Maternal demographic characteristics, neonatal hematological parameters, and maternal and neonatal adverse outcomes were analyzed. Results: Baseline maternal characteristics including maternal age, body mass index (BMI), gestational age, parity, and mode of delivery were comparable between groups. Mean neonatal hemoglobin at birth and followup was significantly higher in Group B compared to Group A. No statistically significant increase in maternal postpartum hemorrhage, neonatal jaundice, NICU admission, or polycythemia was observed in the prolonged clamping group. Conclusion: Delayed cord clamping with cord milking up to 180 seconds appears safe and effective for improving neonatal hematological outcomes without increasing maternal or neonatal complications.
