Objective: This study examined the qualitative and quantitative analysis of tartrazine in specific commercial food products utilizing chemical and spectrophotometric methods. Methods: Samples comprising candy, badam milk, turmeric powder, custard powder, lemon-flavored beverage, and saffron were procured from local retail markets. Initial processing entailed centrifugation succeeded by microwave-assisted extraction (MAE) to effectively isolate synthetic colors. Qualitative identification was conducted with the azo dye test, which relies on diazotization and coupling reactions, hence verifying the presence of azo dyes in the majority of samples. Quantitative analysis was conducted utilizing UV–Visible spectrophotometry at 427 nm, the peak absorption wavelength of tartrazine. Results: The azo dye test confirmed the presence of azo dyes in most samples. Quantitative analysis revealed that tartrazine concentrations ranged from 1.63 ppm to 94.25 ppm. Custard powder showed the highest concentration, while the lemon-flavored beverage had the lowest. All measured values were within the permissible regulatory limit of 100 ppm for synthetic food colorants. Conclusion: The research indicates that centrifugation along with MAE improves dye extraction efficacy, while UV–Visible spectrophotometry offers a dependable, quick, and economical approach for the regular assessment of synthetic food colorants.
Objective: The primary aim of this study was to determine the prevalence of obesity among first-year undergraduate medical students. Additionally, the research sought to evaluate the correlation between Body Mass Index (BMI) and various cardiovascular risk factors, specifically blood pressure (systolic and diastolic) and lipid profiles, including total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Methods: This descriptive cross-sectional study was conducted between April 2018 and August 2019 at a medical college in Northern India, involving 100 students aged 18–30 y. Anthropometric measurements (height, weight, waist, and hip circumference) were taken to calculate BMI, classifying participants as normal, pre-obese, or obese. Blood samples were analyzed for lipid profiles, and blood pressure was measured using a calibrated digital instrument. Qualitative data regarding exercise habits and family history were collected via a self-structured questionnaire. Result: The study found that 58% of students had a normal BMI, while 29% were pre-obese and 13% were obese. Statistical analysis revealed a significant positive correlation between BMI and total cholesterol (r=0.866), triglycerides (r=0.788), and LDL (r=0.864), alongside a significant negative correlation with HDL (r=-0.809). Furthermore, BMI showed a strong positive correlation with both systolic (r=0.785) and diastolic (r=0.718) blood pressure. Physical inactivity was significantly associated with higher BMI and poorer cardiovascular markers (p<0.0001). Conclusion: Pre-obesity and obesity are prevalent among medical students and are strongly linked to adverse lipid profiles and elevated blood pressure. The findings indicate that a lack of physical exercise significantly contributes to increased BMI and associated cardiovascular risks. Immediate interventional strategies, including the promotion of regular physical activity and dietary modifications, are essential to prevent long-term health complications in this young adult population.
Objective: To assess the prescribing patterns of pharmacological medicines for alcohol dependence syndrome at a tertiary care hospital in Northeast India, emphasizing adherence to WHO core prescribing parameters. Methods: A observational prospective research project was carried out over a three-month period in the psychiatry unit of a tertiary care hospital. Analysis was conducted on prescriptions for patients identified as having alcohol dependence syndrome. The evaluation of data utilized WHO core prescribing indicators, assessing the frequency of use of drug categories including benzodiazepines, anti-craving agents, and vitamins. Descriptive statistics were utilized for the analysis. Results: Seventy-one prescriptions were reviewed. The mean age of patients was 27.79 y, with a predominance of males at 94.29%. Vitamins were prescribed most frequently, with 108 instances, followed by benzodiazepines at 82 instances and anti-craving drugs at 72 instances. The mean number of medications per encounter was 1.87. Generic prescribing constituted 95.42%, with no instances of antibiotic prescriptions recorded. Injections were prescribed in 2.86% of encounters, while 74.81% of medications were sourced from the National List of Essential Medicines (NLEM) 2022. Conclusion: The research demonstrates a rational prescribing pattern in alcohol dependence management, particularly in the use of benzodiazepines and vitamin supplementation. However, underutilization of anti-craving agents and partial adherence to the essential medicine list indicate areas for improvement. Strengthening prescriber awareness and ensuring availability of evidence-based pharmacotherapies are recommended.
Objective: The Family Adoption Program, at the behest of the National Medical Commission, aims to enhance community-based learning among undergraduate medical students. However, active participation has been limited by constraints such as logistical barriers. Mobile health applications, including the WHO EYES app and the NHS Heart Age Calculator, could be integrated to engage students better, while also improving learning outcomes and community interaction. The objective of the study was to assess the impact of mobile Apps (WHO eyes app and NHS heart age calculator) on perception regarding Family Adoption program among phase 2 MBBS students. Methods: A before-and-after study was conducted over a three-month period (October–December 2025) involving 250 Phase 2 MBBS students participating in the FAP at Madurai Medical College. The pre-test evaluated participants' knowledge and perceptions regarding FAP and mobile health tools using a structured, pre-validated Likert-scale questionnaire. Subsequently, participants received training in utilizing the WHO EYES app for vision screening of individuals aged ≥8 years and the NHS Heart Age Calculator for assessing cardiovascular risk in individuals aged 30 to 95 years. These tools were employed during successive FAP visits. The same questionnaire was administered for the post-test survey. Data analysis was performed using SPSS version 25, employing a paired t-test and descriptive statistics. Results: The average self-assessed learning score showed a significant increase, rising from 2.93±0.87 before the test to 3.86±0.75 after the test (t = 12.19, p<0.001). Participants demonstrated a marked improvement in their understanding of preventive health and the primary goal of FAP following the intervention. Most students reported high levels of confidence and ease in using the apps, which facilitated better interactions with families. Feedback from families indicated a heightened awareness of vision and cardiovascular risks, along with a greater motivation to engage in health-seeking behaviors. Conclusion: The incorporation of mobile health applications into family adoption program (FAP) has markedly improved students' perceived knowledge, confidence, and community engagement, thereby affirming their efficacy as valuable tools for community-oriented medical education.
Objective: To measure the anteroposterior (AP) and transverse diameters of the foramen transversarium bilaterally, determine the mean diameter on both sides, classify the shape of the foramen transversarium and record the incidence of accessory foramen transversarium. Methods: A descriptive osteological study was conducted on 120 dry cervical vertebrae. Measurements were taken using a digital vernier caliper and analyzed statistically. Results: Elliptical foramina predominated over round types. Minor side-to-side differences were observed. Accessory foramina were present in unilateral and bilateral forms. Conclusion: Considerable morphometric and morphological variations exist in the foramen transversarium, emphasizing the importance of anatomical knowledge during cervical spine procedures.
Objective: Cerebrospinal fluid (CSF) rhinorrhoea results from a communication between the subarachnoid space and the nasal cavity due to defects in the skull base and dura. Accurate localization of the leak site is crucial for effective management and surgical planning. Imaging modalities such as CT cisternography and MR cisternography play an important role in identifying the site and cause of CSF leaks. The objective is to compare the diagnostic performance of CT cisternography and MR cisternography in the localization of CSF rhinorrhoea and to correlate the imaging findings with endoscopic evaluation. Methods: This prospective comparative study included 60 patients with clinically suspected CSF rhinorrhoea. All patients underwent both CT cisternography and MR cisternography. CT cisternography was performed following intrathecal administration of iodinated contrast through lumbar puncture, while MR cisternography utilized heavily T2-weighted sequences. Imaging findings were compared with nasal endoscopy and surgical findings to determine sensitivity, specificity, and diagnostic accuracy. Results: CT cisternography demonstrated higher accuracy in detecting skull-base bony defects, whereas MR cisternography showed superior capability in identifying soft-tissue abnormalities such as meningocele and encephalocele. Both modalities showed high diagnostic performance with no statistically significant overall superiority. Conclusion: CT and MR cisternography are complementary imaging techniques, and their combined use improves the localization and diagnostic evaluation of CSF rhinorrhoea.
Objective: Spinal anaesthesia providing better postoperative analgesia, less nausea and vomiting, more hemodynamic stability and fewer side effects has several advantages in comparison to general anaesthesia in ambulatory surgery. Addition of adjuvants to local anaesthetics provide better haemodynamic profile as it reduces its dose and provides prolonged duration of analgesia. This study assessed 5 mcg and 10 mcg of dexmedetomidine with 25 mcg fentanyl as an adjuvant to low dose hyperbaric bupivacaine 0.5%. Methods: A total of 120 patients, 25-65 y, scheduled to undergo ambulatory surgery under spinal anaesthesia, were randomly allocated into 3 groups of 40 each. Group D5 received 1.5 ml hyperbaric bupivacaine 0.5%+5 μg dexmedetomidine, group D10 received 1.5 ml hyperbaric bupivacaine 0.5%+10 μg dexmedetomidine and group F received 1.5 ml hyperbaric bupivacaine 0.5%+25 μg fentanyl. Duration of analgesia and time for ambulation along with hemodynamic vitals were recorded during perioperative period. Results: The three study groups were comparable in terms of demographic variables, duration of surgery and haemodynamic variables during perioperative period. In our study, duration of analgesia was longest in group D10 with p<0.001. Duration of sensory and motor blockade was also statistically significant among the three groups. Conclusion: The addition of 10μg dexmedetomidine as an adjuvant to 0.5% hyperbaric bupivacaine prolongs the duration of analgesia without any significant adverse effect during subarachnoid block. Prolongation of duration of analgesia significantly delay the time of requirement for first rescue analgesia.
Objective: Unstable intertrochanteric femur fractures with concomitant lateral wall disruption have a higher risk of varus collapse, medialization, and fixation failure because the lateral buttress is compromised. Augmenting intramedullary nailing with a trochanteric buttress plate (TBP) is intended to restore lateral wall support and improve construct stability. Methods: In this single-center prospective case series, 50 adult patients with unstable intertrochanteric fractures associated with a broken lateral wall were treated with a proximal femoral intramedullary nail augmented with a TBP. Patients were followed at 6 w, 3 mo, 6 mo, and 12 mo. Radiological union, complications, and functional outcome using the Harris Hip Score (HHS) were assessed. Statistical analysis was descriptive. Results: The mean patient age was 59.5±6.5 y, and the male-to-female ratio was 33:17. mean operative time was 95.3±10.9 min and mean intraoperative blood loss was 160.8±5.8 ml. Radiological union was achieved at a mean of 11.1 w. Reduction quality graded as Chang score 4 was observed in 47/50 cases (94%). mean HHS at final follow-up was 95.3, with 80% excellent, 16% good, and 4% fair outcomes. One patient (2%) had a screw-related complication; no implant breakage was observed. Conclusion: Augmentation of intramedullary nailing with a TBP produced reliable union and excellent short-term functional outcomes in this cohort of unstable intertrochanteric fractures with lateral wall disruption. Comparative studies with standardized radiographic measurements are required to confirm whether TBP augmentation reduces collapse and improves gait-related outcomes versus nailing alone.
Objective: Primary open angle glaucoma (POAG) required long term management, which may need more than one drug to control the intraocular pressure after certain period of time. This study is aimed to compare the adherence between fixed combination verse unfixed Brinzolamide 1%and Timolol 0.5% for glaucoma patient. Methods: A prospective study was conducted over three years in the department of Pharmacology in collaboration with department of Ophthalmology. A total of 83 patients age>40 y were screened for POAG, 71 recruited for treatment and 40 patients completed the study. Patients were randomized into two group, one group is given fixed combination of brinzolamide1%/timolol0.5% and other group is given unfixed Brinzolamide 1% and Timolol 0.5%. Assessment of Adherence was done using Green Levine Morisky scale and was compared between the groups using Chi square method. Results: Overall out of 40 patients, Low adherence was seen in 15%, Medium adherence in 30% and High adherence in 55% of glaucoma patients. On Comparison of adherence assessment using morisky green levine adherence scale between two groups, Fixed combination group of Brinzolamide/Timolol shows high adherence of 75%. Which is statistically significant p<0.05 while efficacy is equivalent between the group. Conclusion: In our study, adherence to POAG treatment was significantly more with fixed combination of Brinzolamide/Timolol. This shows the patients preference of selecting fixed combination drug therapy over multidrug therapy and without compromising efficacy.
Objective: Using WHO prescribing indicators, to investigate the drug usage pattern of antifungal drugs used in patients with dermatophytosis attending Outpatient Department of Dermatology in a Tertiary Care Hospital. Methods: A prospective, observational, and cross-sectional study was carried out over three months (April to June 2024) in the Dermatology Outpatient Department at Silchar Medical College and Hospital, Assam after obtaining approval from Institutional Ethics Committee (vide no. SMC/ETHICS/M1/2024/36). WHO prescribing indicators, including the average number of drugs per encounter, percentage of generics, and essential drug list compliance, were employed to evaluate prescription quality. Results: Among the 250 analyzed cases, Tinea corporis emerged as the most prevalent clinical form (65.2%). Miconazole was the most commonly prescribed topical agent (50.8%), while Itraconazole was the predominant systemic antifungal (79.04%). The average number of drugs per prescription was 1.42, with antifungal-specific average at 1.11. Notably, 90.42% of drugs were prescribed by generic name, and 72.11% were from the National List of Essential Medicines (NLEM) 2022. Antibiotics were co-prescribed in 30.8% of encounters, while injectable formulations were entirely absent. Conclusion: While prescribing practices showed strength in terms of avoiding unnecessary injections and favoring generics, areas such as adherence to the NLEM and minimizing unnecessary antibiotic use require further improvement.
Objective: Delayed emergence after neurosurgical anesthesia is a critical perioperative event requiring rapid differentiation between reversible pharmacologic causes and potentially life-threatening intracranial complications. Methods: A 48 y old female underwent elective right frontal meningioma excision under general anesthesia. Despite discontinuation of anesthetic agents and stable intraoperative parameters, she failed to regain consciousness 45 min postoperatively. A structured diagnostic evaluation was undertaken. Airway and hemodynamics were stable, and neuromuscular blockade was adequately reversed. Arterial blood gas revealed mild metabolic acidosis. High cumulative intraoperative opioid administration raised suspicion of residual opioid effect, a recognized cause of delayed recovery. Titrated naloxone resulted in gradual neurological recovery. Postoperative computed tomography of the brain ruled out hemorrhage or cerebral edema. Results: Postoperative delayed recovery from anesthesia in this 48 y old female was most likely due to residual opioid effect (opioid-induced respiratory/CNS depression). Conclusion: Delayed emergence in neurosurgical patients mandates systematic evaluation prioritizing airway stabilization, exclusion of metabolic abnormalities, and urgent neuroimaging when indicated. Early recognition of pharmacologic causes can prevent unnecessary interventions and optimize outcomes.
Objective: Study to establish the effectiveness of role of Neurolysis pure decompression of ulnar nerve in restoration of functional recovery of Claw Hand deformity to prevent recurrent ulceration and further progress of Paralysis in Preventing deformity disability henceforth Handicaps. To identify the restoration of duration of disease process with the degree of deformity with reference to Neurolysis. Methods: Fifty five Lepra patient underwent Surgical Decompression i. e. Neurolysis of Ulnar Nerve, at cubital tunnel, posterior to medial condyle after fulfilling the prerequisites of surgery. After Surgical exploration of Ulnar Nerve External and Internal Decompression was done and Nerve was Transposed Anteriorly under muscle coverage. Results: The Result was found to be good, most of patient of younger age group 23.63%. No of finger were 26.30. 90% cases had fair result with 34 fingers and poor in 45.45% with 50 finger. Conclusion: Surgical Decompression {Neurolysis} of Ulnar Nerve is supposed to be a simple technique and suitable for those hands having some degree of contracture, the duration of deformity being less than Two years.
Objective: To evaluate the clinical presentation, etiological factors, severity, and immediate outcomes of acute pancreatitis in hospitalized patients. Methods: A prospective observational study was conducted on 66 patients diagnosed with AP based on the Revised Atlanta Classification (2012). Demographic data, clinical features, laboratory parameters, imaging findings, and hospital outcomes were analyzed. Results: The mean age of patients was 45.2±12.5 y, with a male predominance (63.6%). The most common etiology was gallstones (51.5%), followed by alcohol (30.3%). Abdominal pain (100%) and vomiting (72.7%) were the most frequent symptoms. According to severity, 57.6% had mild, 30.3% moderate, and 12.1% severe AP. Complications included pancreatic necrosis (9.1%), pseudocyst formation (6.1%), and acute kidney injury (7.6%). The mortality rate was 4.5%. Conclusion: Gallstone disease remains the leading cause of AP. Early recognition of severe cases and prompt management can reduce complications and mortality.
Objective: To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEIs) compared with placebo on cardiovascular mortality in adults with heart failure or left ventricular dysfunction, using evidence derived exclusively from randomized controlled trials. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from inception to the most recent search date for randomized, double-blind, placebo-controlled trials evaluating ACEIs in adults with chronic heart failure with reduced ejection fraction or left ventricular dysfunction following myocardial infarction. Cardiovascular mortality was the primary outcome. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a fixed-effect model. Heterogeneity was assessed using Cochran’s Q test and the I² statistic. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and certainty of evidence was assessed using the GRADE framework. Results: Three randomized controlled trials (SOLVD-Treatment, SAVE, and TRACE) involving a total of 6,549 participants met the inclusion criteria. ACE inhibitor therapy was associated with a significant reduction in cardiovascular mortality compared with placebo (pooled RR = 0.83; 95% CI: 0.77–0.90). No significant heterogeneity was observed among the included studies (I² = 0%). All trials demonstrated low overall risk of bias, and the certainty of evidence was rated as high. Conclusion: This meta-analysis provides high-certainty evidence that ACEIs significantly reduce cardiovascular mortality in adults with heart failure and left ventricular dysfunction, supporting their continued role as cornerstone therapy in heart failure management.
Objective: The objective of this study was to find out electrophysiological changes in lower limb in patient of diabetes mellitus of different duration and correlation with glycemic control. Methods: This cross-sectional observational study was conducted at Maharani Laxmi Bai Medical College, Jhansi, over a one-year period (2019–2020). Participants We recruited 100 patients with type 1 or type 2 diabetes mellitus from inpatient wards and outpatient departments. Inclusion was based on the ADA 2017 criteria (FPG 126 mg/dl, 2h PG 200 mg/dl, or HbA1c 6.5%). Patients with confounding causes of neuropathy-including alcoholism, smoking, pregnancy, chronic renal/liver disease, or lower limb injuries-were excluded. Data Collection Detailed socio-demographic data, medical history (including duration and treatment type: insulin vs. OHAs), and family history were recorded for all subjects. Clinical and Electrophysiological Assessment All participants underwent standardized physical examinations for tendon reflexes, vibration, and touch responses. Electrophysiological evaluation consisted of a complete Nerve Conduction Study (NCS) using an EMG EP MARK 2 (Medicaid Systems), following standard clinical protocols to identify diabetic sensorimotor neuropathy. Results: The study cohort (N=100) was predominantly male (58%) and aged>45 y (78%). Type 2 diabetes mellitus (T2DM) was the most common diagnosis (90%), with type 1 (T1DM) accounting for the remaining 10%. Regarding disease chronicity, 37% of patients had a duration>10 years, followed by 5–10 y (36%) and<5 y (27%). Glycemic status and neuropathy-Target glycemic control (HbA1c<7%) was achieved by only 16% of the population, while 45% exhibited poor control (HbA1c>9%). Electrophysiological and clinical evaluation revealed a higher prevalence of neuropathy in patients with T2DM compared to those with T1DM. Conclusion: This study demonstrates that diabetic peripheral neuropathy (DPN) is highly prevalent among patients with diabetes, particularly those with Type 2 Diabetes Mellitus (T2DM). Nerve Conduction Studies (NCS) proved to be a significantly more sensitive tool for early diagnosis than clinical examinations, identifying abnormalities in 37% of patients compared to the 14% detected via ankle jerk reflex. The development of electrophysiological abnormalities is strongly correlated with two primary factors: Disease duration: Neuropathy prevalence escalated from 7.5% in patients with<5 y of diabetes to 62% in those with>10 y. Glycemic control: A statistically significant association exists between elevated HbA1c and abnormal NCS findings (p = 0.001), with 71% of patients with HbA1c>9% exhibiting neuropathy.
Objective: Variations in the branching pattern of the celiac trunk and hepatic arterial system are commonly seen in clinical practice and are important in upper abdominal surgery and interventional radiology. Lack of awareness of these variations may increase the risk of vascular injury during procedures. Our aim was to find out variations in celiac trunk and hepatic artery branches using multidetector computed tomography (MDCT) in an Indian population. Methods: The study was conducted at a tertiary care center in Cuttack, Odisha, India. MDCT examinations performed between January 2024 and March 2026 were reviewed. CT angiography (CTA), triple-phase CT studies and high-quality arterial phase CT images obtained using a 128-slice multidetector CT scanner were studied. Variations of the celiac trunk were classified according to the Uflacker classification (Type I-VIII) and the hepatic arterial variations were categorized using the Michels classification (Type I-X). Results: Out of 355 patients included in the study, 143 were males and 212 were females. Type I celiac trunk anatomy was found in 317 patients (89.30%) and 38 patients (10.70%) had variant branching patterns. Among the variants, Type II was the most frequent (5.07%), followed by Type V (2.54%) and Type III (1.41%). Normal hepatic arterial anatomy (Michels Type I) was found in 264 patients (74.37%). Hepatic arterial variations were present in 91 patients (25.63%). The most common hepatic arterial variant was Michels Type V (9.58%). Conclusion: Variations in the celiac trunk and hepatic arterial anatomy are relatively common. MDCT is valuable for preoperative vascular assessment in upper abdominal surgery, interventional radiology as well as drug delivery and chemotherapy.
Objective: To analyse the drug utilization pattern among patients with anxiety disorders attending the psychiatry outpatient department of a tertiary care teaching hospital and to evaluate prescribing practices using WHO core prescribing indicators. Methods: A prospective observational study was conducted in the Psychiatry Outpatient Department of a tertiary care hospital in southern Rajasthan Maharana Bhopal Hospital, Udaipur, over a period of 12 mo (July 2024–June 2025) following institutional ethics committee approval. A total of 245 patients aged 18–60 y with confirmed anxiety disorders were included. Demographic data, diagnostic profiles, and prescription details were collected, compared and analysed. Results: Among the 245 patients, in our study, females (55.10%) slightly outnumbered males (44.90%). The majority of patients belonged to the 21–30 y age group (21.63%). Generalized Anxiety Disorder was the most common diagnosis (43.27%), followed by Panic Disorder (20.82%), Mixed Anxiety–Depressive Disorder (19.59%), and Social Anxiety Disorder (16.33%). A total of 443 drugs were prescribed. Selective serotonin reuptake inhibitors constituted 55.30% of prescriptions, while benzodiazepines accounted for 44.70%. Clonazepam (23.93%) and alprazolam (20.77%) were the most frequently prescribed medications. Combination therapy was observed in 80.82% of patients. All drugs were administered orally, and the most common duration of therapy was four weeks (37.92%). All drugs were prescribed by generic names and from essential drug list. Most prescriptions contained four to five drugs per encounter. Conclusion: The prescribing pattern was largely consistent with current treatment guidelines, with SSRIs being the predominant first-line agents. However, the substantial use of benzodiazepines and combination therapy highlights the need for regular prescription audits and reinforcement of rational pharmacotherapy practices in anxiety disorder.
Objective: Total knee arthroplasty (TKA) is an established surgical intervention for advanced degenerative knee disorders. With the increasing volume of TKA procedures in the Indian population, it is essential to evaluate technical variations that may influence functional outcomes. This study aimed to compare anterior-referencing and posterior-referencing techniques in TKA with respect to postoperative knee function and clinical outcomes. Methods: A prospective comparative study was conducted on 100 patients undergoing primary TKA. Patients aged over 45 y with advanced knee osteoarthritis or rheumatoid arthritis were included and allocated into two groups based on the femoral referencing technique employed: anterior referencing (Group I, n = 50) and posterior referencing (Group II, n = 50). All surgeries were performed using a standardized medial parapatellar approach, with femoral component sizing and rotational alignment determined according to the respective referencing method. Postoperative rehabilitation protocols were identical for both groups. Functional and clinical outcomes were assessed and compared using the chi-square test, with statistical significance set at p<0.05. Results: The mean age was 63.8 y in the anterior-referencing group and 60.1 y in the posterior-referencing group, with comparable gender distribution between cohorts. At three months postoperatively, both groups demonstrated significant improvement in knee range of motion, Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). However, intergroup differences were not statistically significant (p>0.05). Intraoperative blood loss and overall functional recovery were similar between the two techniques. Conclusion: Anterior-and posterior-referencing techniques in total knee arthroplasty yield comparable short-term functional outcomes, range of motion, and intraoperative parameters. The absence of statistically significant differences suggests that both referencing methods are equally effective and safe when performed using standardized surgical protocols.
Objective: To compare the efficacy and safety of 0.5% hyperbaric levobupivacaine alone versus in combination with two different doses of fentanyl (12.5 µg and 25 µg) for spinal anaesthesia in elective LSCS. Methods: A prospective, randomised, double-blind comparative study was conducted on 150 ASA Grade I–II pregnant females (20–40 years) undergoing elective LSCS at Rajindra Hospital, Patiala. Patients were allocated into three equal groups (n=50 each): Group I received 2 ml (10 mg) of 0.5% hyperbaric levobupivacaine+0.5 ml normal saline; Group II received the same levobupivacaine+12.5 µg fentanyl; Group III received levobupivacaine+25 µg fentanyl. Haemodynamic parameters, sensory and motor block characteristics, sedation level, duration of analgesia, and complications were recorded. Results: All groups were demographically comparable. Onset of sensory block was significantly faster in Group III (1.66 min) compared to Group II (2.41 min) and Group I (3.90 min) (pandlt; 0.05). Time to maximum sensory level was shortest in Group III. Motor block onset was earliest in Group III. Duration of analgesia was significantly prolonged in Group III (372.8±22.59 min) versus Group II (306±26.34 min) and Group I (220±18.94 min) (p<;0.001). Haemodynamic parameters were stable across all groups. Nausea, vomiting, and pruritus were significantly more frequent in Group III. Conclusion: Addition of 25 µg fentanyl to 0.5% hyperbaric levobupivacaine for spinal anaesthesia in LSCS provides the fastest sensory and motor block onset and the longest duration of analgesia with acceptable haemodynamic stability. However, the higher dose carries a greater risk of pruritus and nausea/vomiting compared to 12.5 µg fentanyl.
Chondroblastoma is a rare benign lesion of chondroid origin arising from the epiphysis of the immature skeleton. Traditionally, surgery has been the gold standard of management of these lesions. Radiofrequency ablation is approved minimally invasive technique of management of chondroblastoma. We share our experience, practical difficulties faced and method to avoid these potential risks while using radiofrequency ablation for management of chondroblastoma in this case series.
