Smt. Kashibai Navale Medical College is a full-fledged medical college in Pune, Maharashtra. The college imparts the degree Bachelor of Medicine and Bachelor of Surgery (MBBS). It is recognised by Maharashtra University of Health Sciences and Medical Council of India. Selection to the college is done on the basis of merit through the National Eligibility and Entrance Test. Yearly undergraduate student intake is 150..
Background: Unilateral biportal endoscopy (UBE) is an established minimally invasive technique for the surgical management of lumbar spinal stenosis (LSS). However, prospective evidence regarding its effectiveness in severe stenosis, particularly Schizas Grade D disease, remains limited. This study evaluated the clinical and radiological outcomes of UBE with unilateral laminotomy for bilateral decompression in patients with LSS, with particular emphasis on severe stenosis. Methods: This prospective single-surgeon study included 134 consecutive patients with LSS who underwent UBE decompression between April 2021 and September 2023. Patients with pre-existing instability or other indications for fusion were excluded. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) at a minimum follow-up of 12 months. Particular attention was paid to the outcomes of patients with Schizas Grade D stenosis. Results: Of the 134 patients, 128 completed the 12-month follow-up. Mean VAS leg pain improved from 7.92 to 0.63 (p<0.001), while mean ODI improved from 69.66 to 39.34 (p<0.001). Among the 42 patients with Schizas Grade D stenosis, two patients (4.8%) required revision surgery, with one patient (2.4%) subsequently undergoing instrumented fusion. Two dural tears (4.8%) occurred in this subgroup. No patient developed postoperative instability requiring unplanned fusion during the follow-up period. Conclusions: UBE provides safe and effective decompression for carefully selected patients with lumbar spinal stenosis, including severe Schizas Grade D disease, resulting in significant pain relief and functional improvement. The low revision and subsequent fusion rates observed in this series suggest that motion-preserving decompression may be a viable treatment strategy for selected stable spines, although larger comparative studies with longer follow-up are required.
Context:In India, women bear a multitude of obligations, including caring for dependents, raising children, and managing the home, all while compromising their own health. Numerous studies have demonstrated that women are experiencing higher levels of stress. Aims and Objectives:(1) To assess health- and wellness-related practices among working women in India. (2) To determine demographic and work-related factors associated with wellness among the working women. Settings and Design:It was an online cross-sectional study conducted by investigators at a tertiary care hospital. Subjects and Methods:Snowball sampling method was used in the study to get the responses from the participants. Total 441 responses were received, which were analyzed. Statistical Analysis Used:Descriptive statistics was calculated based on the type of data. The Chi-square test of significance was used to show the association. Results:The mean age of the participant was 39.61 years with standard deviation ± 7.89 years. Most of the participants were married, had higher education, and belonged to a nuclear family. They were working in different occupational sectors. Though the majority, i.e., 70.75% of the women, had good health and wellness score, a notable portion of women showed poor score, which had significant association with younger age and long job hours. Conclusion:The findings indicate that younger age and long working hours are associated with poor scores. While a majority of women in this study report good health scores and satisfactory work-life balance, the significant percentage experiencing poor scores highlights critical areas for improvement.
Background: Conventional bedside airway assessment tests have limited accuracy in predicting difficult laryngoscopy. Point-of-care airway ultrasound provides objective anatomical information and may improve preoperative airway evaluation. This study evaluated the role of ultrasonographic airway measurements alone and in combination with conventional clinical assessment in predicting difficult laryngoscopy. Methods: In this prospective observational study, 40 adult patients undergoing elective lumbar spine surgery under general anaesthesia underwent preoperative airway evaluation using Modified Mallampati classification, sternomental distance, mentothyroid distance, and mentohyoid distance. Airway ultrasound was performed using a high-frequency linear probe to measure skin-to-epiglottis distance (SED) and skin-to-midpoint of the vocal cords distance (SVD). Direct laryngoscopy was performed by an anaesthesiologist blinded to the airway assessment findings, and laryngoscopic view was graded using the Cormack-Lehane classification. Logistic regression and receiver operating characteristic (ROC) analyses were used to determine predictive performance. Results: Thirteen patients (32.5%) had difficult laryngoscopy. Among the ultrasonographic parameters, SED was the strongest independent predictor of difficult laryngoscopy (p=0.035). Ultrasound-based assessment demonstrated higher diagnostic accuracy than conventional clinical tests alone. The combined clinical-ultrasound model achieved the best performance with a sensitivity of 92.3%, specificity of 96.2%, positive predictive value of 85.7%, and negative predictive value of 96.2%. Conclusion: Airway ultrasound complements conventional bedside assessment and improves prediction of difficult laryngoscopy. Incorporation of SED into routine preoperative airway evaluation may facilitate better airway planning and enhance patient safety. Keywords: Airway ultrasound, Difficult airway, Difficult laryngoscopy, Skin-to-epiglottis distance, Preoperative airway assessment.
Background:'Time is brain' goes the adage. Rapid and precise management of stroke is of the utmost essence. The modified National Institutes of Health Stroke Scale (mNIHSS) and the modified Rankin Scale (mRS) predict stroke severity and functional disability outcomes. However, the mRS can be administered more rapidly than the mNIHSS and therefore might be better to assess patient outcomes. Hence, the aim of this study was to assess the correlation of stroke severity on admission and functional disability outcomes on the day of discharge or on the 8th day of hospitalization.Materials and Methods:This was an observational, cross-sectional study with a sample size of 61 participants. The mNIHSS score was calculated on admission for patients with clinical features suggestive of stroke and mRS was calculated on the 8th day of hospitalization or on discharge. Evaluation of the association between continuous variables was done using Spearman's correlation analysis.Results:Correlation between mNIHSS and mRS was positive and statistically significant (rho = 0.866, 95% CI [0.751, 0.925]. For each point increase in the mNIHSS, the odds of having higher mRS scores are 153% more than the odds of having lower mRS scores (aOR = 2.534, 95% CI [1.904, 3.560]).Conclusion:Our study concluded that mRS can be reliably used to predict the functional outcomes for patients with stroke in circumstances where the mNIHSS may prove to be lengthy. Thus, where 'time is brain', the mRS can be used with a similar power to predict the outcome.
