Background: Pseudomonas aeruginosa is a significant opportunistic pathogen frequently causing nosocomial infections, particularly among immunocompromised patients. The rise in multidrug-resistant (MDR) strains has heightened morbidity and mortality, emphasizing the importance of routine antimicrobial susceptibility testing. Objectives: This study aimed to isolate P. aeruginosa from diverse clinical specimens and assess their antimicrobial susceptibility patterns. Methods: A total of 500 clinical samples from patients at Government General Hospital, Ongole, Andhra Pradesh, were analyzed between July and November 2024. Samples included pus (n=223), urine (n=183), sputum (n=60), and blood (n=34). Standard microbiological techniques were employed to isolate and identify P. aeruginosa. Antibiotic susceptibility testing (AST) was performed using the Kirby-Bauer disc diffusion method. Results: Out of 500 samples, 34 isolates were confirmed as P. aeruginosa. Isolates exhibited sensitivity to polymyxin-B (80%), cefepime (78%), meropenem (75%), tobramycin (70%), piperacillin-tazobactam (68%), ciprofloxacin (64%), amikacin (50%), gentamicin (42%), and imipenem (6%). Resistance patterns were highest against cefazolin/sulbactam (65%), cefixime (60%), ciprofloxacin (50%) and ceftazidime (15%). Conclusion: Given the increasing prevalence of multidrug-resistant P. aeruginosa in healthcare settings, periodic monitoring and antibiotic susceptibility assessments are essential. This approach assists in preventing the spread of resistant strains, thereby reducing associated morbidity and mortality rates.

Background: Understanding the variations in renal arterial anatomy is crucial for clinical procedures such as renal transplantation, surgeries, and diagnostic imaging. Variations can affect surgical outcomes and the interpretability of diagnostic procedures. Objective: To assess the prevalence and types of renal arterial variations in a cross-sectional population. Methods: This retrospective, cross-sectional study analyzed data from 120 patients who underwent computed tomography angiography at a tertiary care center. The study identified and categorized variations in renal arterial anatomy, including single renal arteries, multiple renal arteries, early branching, and unusual origins. Results: Out of the 120 patients studied, a single renal artery was present in 81.67% (n=98) of the cases, multiple renal arteries were found in 14.17% (n=17), early branching in 2.50% (n=3), and unusual origins in 1.67% (n=2). The prevalence of multiple renal arteries and their clinical implications were statistically significant, with P-values of 0.03 for multiple arteries, 0.25 for early branching, and 0.31 for unusual origins. Conclusion: The majority of the population exhibited a single renal artery, consistent with existing literature. However, the presence of multiple renal arteries and other variations highlights the need for careful preoperative assessment to mitigate surgical risks and improve diagnostic accuracy. This study underlines the importance of recognizing these anatomical variations in the planning and execution of renal-related medical procedures

Background: Spinal fusion surgery is a common therapeutic intervention for various spinal conditions, with evolving techniques aimed at improving patient outcomes. This study compares the postoperative recovery metrics between minimally invasive spinal fusion (MIS) and traditional open spinal fusion techniques. Methods: This cross-sectional study included a total of 140 patients, evenly divided into two groups: those undergoing minimally invasive spinal fusion (n=70) and those undergoing traditional open spinal fusion (n=70). Data on operative time, intraoperative blood loss, postoperative opioid use, pain levels, hospital stay duration, return to normal activities, complication rates, and long-term functional outcomes were collected and analyzed using t-tests and chi-square tests for continuous and categorical variables, respectively. Results: The MIS group demonstrated significantly lower average operative times (120 minutes vs. 145 minutes, p=0.02), reduced intraoperative blood loss (150 ml vs. 300 ml, p=0.001), and decreased postoperative opioid usage (10 mg vs. 30 mg, p=0.0001). Postoperative pain levels were also significantly lower in the MIS group at all measured time points (immediate, 6 hours, and 24 hours post-surgery; p<0.001). Additionally, patients in the MIS group experienced shorter hospital stays (2 days vs. 5 days, p=0.0001) and faster returns to normal activities (18 days vs. 30 days, p=0.0001). The complication rate was significantly lower (11.4% vs. 35.7%, p=0.002), and long-term functional outcomes were better in the MIS group compared to the traditional open surgery group. Conclusions: Minimally invasive spinal fusion techniques offer significant advantages over traditional open methods in terms of reduced surgical trauma, faster recovery, and better overall postoperative outcomes. These findings support the continued adoption and refinement of MIS techniques in appropriate surgical candidates.

Background: Adenosine Deaminase (ADA) and inflammatory markers like high-sensitive C-reactive protein (hsCRP), Serum uric acid (SERUM URIC ACID) and serum ferritin have shown correlations with psoriasis area severity index (PASI) score. Aims: The aim of this study was to evaluate Adenosine Deaminase (ADA) and inflammatory markers like hsCRP, Serum uric acid, and Serum ferritin in psoriatic patients and their correlation with PASI score.(Psoriasis Area and Severity Index) Patients and Methods: This study included 75 psoriatic patients divided according to PASI score into three groups (mild, moderate, and severe) containing 25 patients. PASI score <10 was defined as mild, (10–20) moderate, and >20 as severe. Twenty-five healthy subjects of matched age and sex were included as control. Serum ADA, hsCRP, Serum uric acid, and Serum ferritin were evaluated for patients and controls. Correlations of ADA, hsCRP, Serum uric acid, and Serum ferritin with PASI scores were done. Results: While ADA, hsCRP, serum uric acid, and Serum ferritin showed a significant increase in psoriatic patients compared with that of the controls (P<0.001), they showed significant difference between different psoriatic groups (P<0.01) and with PASI score (P<0.01). They showed a significant difference between different psoriatic groups (P<0.01) and correlations with PASI score (P<0.01). Conclusion: Serum ADA, hsCRP, serum uric acid and serum ferritin showed higher levels among psoriatic patients than in controls. The increased ADA in psoriatic patients supports the role of T-cell activation and proliferative disorder in the pathogenesis of psoriasis. There is significant correlations found between these biomarkers and PASI score. Further studies are needed to validate these biomarkers as diagnostic and prognostic factors in psoriasis

Background and Objectives: Stroke is one of the leading causes of mortality and morbidity worldwide, with ischemic stroke being the most common subtype. Microalbuminuria, a marker of endothelial dysfunction and systemic capillary leak, has been associated with various cardiovascular diseases. However, its role as a prognostic indicator in acute ischemic stroke remains underexplored. This study aims to evaluate the significance of microalbuminuria in predicting prognosis and severity in patients with acute ischemic cerebrovascular stroke. Methods: A cross-sectional observational study was conducted on 50 patients admitted with acute ischemic stroke in a tertiary hospital from May 2023 to November 2024. Patients aged 18 years and above, presenting within 72 hours of stroke onset, and with ischemic lesions confirmed by CT/MRI were included. Patients with hemorrhagic stroke, diabetes, hypertension, renal disease, neoplastic disease, recent surgery, or trauma were excluded. The presence of microalbuminuria was assessed, and its association with clinical parameters, NIHSS (National Institutes of Health Stroke Scale) score, and mRS (Modified Rankin Scale) score was analyzed using chi-square and Z-tests. Results: The mean age of the study participants was 56.28 ± 17.2 years, with a male predominance (66%). Microalbuminuria was present in 70% of cases. A significant association was found between microalbuminuria and loss of consciousness (p=0.032). However, no significant differences were observed in systolic and diastolic blood pressure, serum cholesterol, random blood sugar, or creatinine levels between patients with and without microalbuminuria. Notably, microalbuminuria was significantly associated with NIHSS scores >10 (p<0.001) and mRS scores >3 (p=0.004), indicating its potential role in predicting stroke severity and poor functional outcomes. Conclusion: Microalbuminuria is a prevalent finding in acute ischemic stroke and correlates with stroke severity and poorer functional outcomes. Its routine assessment may serve as a valuable prognostic marker for risk stratification in ischemic stroke patients.

Background: Sex determination plays a crucial role in forensic science and anthropology. The mandibular ramus, due to its robust structure and dimorphic characteristics, serves as a reliable indicator for determining sex. This study aims to evaluate the efficacy of mandibular ramus morphology as a tool for sex determination in the Indian population. Materials and Methods:  A retrospective study was conducted using 200 orthopantomographs (OPGs) from individuals aged 20 to 50 years, comprising 100 males and 100 females of Indian origin. The measurements taken included ramus height, maximum ramus width, minimum ramus width, condylar height, and coronoid height. Data were analyzed using statistical software, applying independent t-tests to compare differences between sexes and discriminant function analysis to evaluate accuracy. Results:  Significant sexual dimorphism was observed in all parameters measured, with males exhibiting higher values compared to females. The mean ramus height was 70.2 ± 5.3 mm for males and 62.8 ± 4.9 mm for females (p < 0.001). Maximum ramus width was 38.5 ± 2.5 mm for males and 34.3 ± 2.3 mm for females (p < 0.001). Discriminant function analysis achieved an accuracy of 82.5% in correctly identifying the sex of the individuals. Conclusion: Mandibular ramus morphology presents a reliable method for sex determination in the Indian population. The high accuracy achieved through discriminant analysis suggests its applicability in forensic and anthropological studies. Further studies with larger sample sizes are recommended to enhance accuracy and applicability.

Background: Cervical cancer is a primary global health concern. Its early detection playing a crucial role in reducing morbidity and mortality. Pap smear cytology is widely used for screening cervical lesions, aiding in the identification of premalignant and malignant changes. However, histopathological confirmation remains the gold standard for diagnosis. This study aims to analyze uterine cervical lesions histopathologically and correlate findings with Pap smear results, evaluating diagnostic accuracy. Methods: Cervical smears were obtained from the Department of Gynaecologists, Ayres Spatula. The smear was covered with Biofix Spray, and the slides were taken to the Department of Pathology. These smears were immersed in Papanicolaou fixative (equal volumes of 95% ethanol and ether) for a minimum of 30 min and stained with Papanicolaou stain using the standard protocol. Results: During the period of our study, we studied n=75 women in whom both cytological and histopathological samples were obtained. This included n=40 cases of punch biopsies, n=30 total hysterectomies, and n=5 pan-hysterectomies. It was found that 68.3% of cases were with features of chronic cervicitis. The Pap smear was excellent at confirming cervical abnormalities when the result is positive (100% PPV) and ruling out abnormalities in healthy individuals (100% specificity). Conclusion: cervical cytology is a valuable tool for detecting cervical abnormalities, with high specificity and PPV. However, its moderate sensitivity highlights the need for complementary diagnostic methods to improve early detection and reduce false-negative rates. The integration of cytological and histopathological findings provides a comprehensive approach to cervical cancer diagnosis and underscores the importance of multidisciplinary collaboration in optimizing patient outcomes.

Introduction: Burns are a significant public health concern, leading to high morbidity and mortality. This study aimed to analyze the clinical profile and outcomes of burn patients admitted to a tertiary care hospital. Methodology: A cross-sectional observational study was conducted from October 2022 to August 2024, including 210 burn patients. Data on demographics, burn characteristics, and outcomes were collected and analyzed using SPSS version 22. Results: The majority of burn patients were females (62.38%) and aged 21-30 years (35.23%). Flame burns were most common (64.76%), and 90% of burns occurred at home. Most patients (75.71%) had second-degree burns, with a burn surface area of 11-20% in 60.95% of cases. The overall mortality rate was 13.33%, with increased mortality in patients with co-morbidities, suicidal burns, and delayed hospital admission (≥12 hours). Conclusion: Burns predominantly affected females in the productive age group, with flame burns being the leading cause. Mortality was associated with larger burn surface areas, delayed admissions, and co-morbidities.

Background: Elderly malnutrition is caused by a multifaceted interaction of physiological, biochemical, and psychological changes related to aging. It leads to elevated morbidity and mortality through loss of muscle, vitamin deficiencies, and compromised immunity. Hip fractures in the elderly, frequently coupled with osteoporosis and comorbid illnesses, add fuel to these vulnerabilities. Postoperatively, elevated nutritional requirements increase the susceptibility of elderly patients to complications like wound infection, impaired fracture healing, and adverse functional recovery. To assess the influence of nutritional status on the outcomes of surgery in geriatric patients with hip fractures admitted to Assam Medical College & Hospital. Method: A total of 70 elderly patients with hip fractures were observed over one year, from admission to 12 weeks postoperatively. Nutritional status was assessed using anthropometric measurements (BMI, MUAC, and triceps skinfold thickness), biochemical parameters (haemoglobin, albumin, transferrin, and total lymphocyte count), and the Mini Nutritional Assessment (MNA). Postoperative outcomes, including hospital stay, wound infection, fracture healing, and functional recovery (Harris Hip Score), were recorded. Results: 41.43% of the participants were malnourished, and 27.14% were at risk. Malnutrition had a significant relationship with age and biochemical markers. Poorly nourished patients experienced longer hospitalization (>14 days), increased rates of wound infections, compromised fracture healing, and poorer functional status. Conclusion: This research emphasizes the important role of nutritional status in older hip fracture patients. Nutritional screening and intervention early on are key to enhancing surgical results and overall recovery in this at-risk group.

Background: The cotton workers are significantly exposed to cotton dust, leading to respiratory diseases such as byssinosis and chronic obstructive pulmonary disease (COPD). Spirometry is one of the major investigations for assessing pulmonary function in occupational settings. Objectives: To compare Pulmonary function indices of cotton industry workers with age and sex matched controls. Material and Methods: The research was conducted on 250 cotton industry workers and 100 age and sex-matched control group individuals with no exposure to cotton dust at their work environments. Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), FEV₁/FVC ratio, and Peak Expiratory Flow Rate (PEFR) were measured using spirometry. The workers were classified based on years of exposure (<5 years, 5-10 years, and >10 years) and the results were statistically examined. Results: Both restrictive and obstructive patterns were noticed in workers with considerably greater prevalence in those with long-term exposure. Comparisons with control group showed that exposure to cotton dust caused lower FEV₁ and PEFR in the worker group. Conclusion: Exposure to cotton dust is the cause of impaired lung function and the extent of impairment increases directly with exposure time. The study highlights regular health monitoring, preventive measures, and increased work environment ventilation as ways of overcoming the adverse effects of breathing cotton dust.

Background: During the last century evolution of neurosurgical techniques has occurred with the aim to reduce the pre-, intra and post-operative traumatisation of patients undergoing diagnostic and therapeutic neurosurgical procedures. This study was undertaken to investigate the advantages and limitations of endoscopy assisted cranial microneurosurgery in non-neoplastic lesions. Materials and methods: This prospective study was carried out for a period of 24 months. Study included all the admitted patients with intracranial space occupying lesions and intracranial aneurysms who underwent micro neurosurgical techniques during study period. Study parameters included demographic and clinical profile of patients, size of craniotomy, complex anatomy incidence and identification, visualization of posterior part of aneurysm clip immediately post clip application. Results: The mean age of study patients was 33.5 years, and majority were in the age group of 41-50 years, with female predominance (22). In majority of cases, lesion was located in posterior cranial fossa. In 11 patients, nature of pathology was non-neoplastic, which included aneurysms, A-V malformations, and neuralgias. Post clipping endoscopic examination of aneurysms showed re-application of clip in 2 patients, and perforator injury in 2 patients. The most common approach used in this study was Pterional. Follow-up CT angiogram was performed in 5 patients. Conclusion: Addition of endoscope to neurosurgeon’s armamentarium offers the surgeon a freedom to look beyond the scope of the traditional microneurosurgery.

Introduction: Human walking is very complex; and requires coordinate movement in the lower limb, pelvis, spine and upper limb. There is a common belief that men and women walk differently; this study aimed to compare the muscle forces between genders during normal walking pattern and co-relate with important musculoskeletal and clinical gait implication. Aim: To analyse the potential relationships between uses of muscle forces activity pattern of major muscle between genders. Method: The Vicon® motion capture system with force plate was used to collect the normal walking pattern in 26 healthy subjects. Subject Joint parameters, e.g., joint angle, moment, force were calculated using the Vicon® Plug-in-Gait model. Gait parameters were collected using the motion capture system. Suitable captured gait trials after an initial review were input into an in-house Model of Inverse dynamics for calculating muscle force. Result: Gait cycle showed a similar pattern in male and female genders, though female, showed earlier foot off and narrower step width, in comparison to male counterpart. There was a significance difference [p<0.001] between male and female gender muscle forces. Males generated higher muscle forces in all the major muscles of the lower limb while in few females produced higher forces than males. Conclusion: Majority of muscles forces in lower limb were found to be higher in male. Hip flexor and knee extensor muscles force were higher in females. Higher muscle force could be attributed to mass, leg length, the height difference between genders.

Introduction: Foramen Lacerum is bounded in front by the body and adjoining greater wing of sphenoid, behind by the apex of petrous temporal bone and medially by basilar part of occipital bone. The  Foramen  Lacerum  acts as  a  channel  for the  intracranial  spread  of infections and  various  malignant  tumours. Variations in the size of the foramen along with its obliteration by the ossification of fibro cartilaginous tissue results in compression of the neurovascular bundle which passes through it.  Hence, the knowledge about morphometric variations in Foramen Lacerum   is essential to improve the outcome of procedures done which are necessary to give relief to the patient. Aims and Objectives: The aims of the present study are to compare the Transverse diameter and the Anteroposterior diameter of the Foramen Lacerum on both sides of the skull. Materials and Methods: After getting the approval from the Institute Ethics Committee, the present study was conducted in the Department of Anatomy and Department of Forensic Medicine at Guntur Medical College, Guntur, Andhra Pradesh, India from September 2024 - December 2024. A total of 36 dry skulls, out of which 21 male skulls and 15 female skulls were taken for the study and 72 Foramen Lacerum on either side were studied. The measurements of Transverse diameter and the Anteroposterior diameter of the Foramen Lacerum were measured using a well-calibrated digital Vernier caliper and recorded. Results: In the present study the mean Transverse diameter on the right side is 6.41mm and on left side 6.52 mm in male skulls. The mean Transverse diameter on the right side is 5.72mm and on left side 5.76 mm in female skulls. In the present study the mean AP diameter on the right side is 6.71mm and on left side 6.38 mm in male skulls. In the present study the mean AP diameter on the right side is 4.69 mm and on left side 5.23 mm in female skulls Conclusion: As there is association of tumor spread through foramen lacerum, there is a need for further studies, and large clinical studies based on imaging from various geographical regions.

Introduction: Chronic wounds in orthopedic patients present a significant challenge due to their complex etiology and prolonged healing time. These wounds, defined as those that fail to progress through the normal stages of healing in an orderly and timely manner, are frequently associated with underlying conditions such as diabetes, vascular insufficiency, and immobility. The intersection of orthopedic and dermatological care is crucial in addressing these complex wounds, as orthopedic injuries often compromise skin integrity, while dermatological interventions can optimize wound healing. This study explores a dermatological approach to managing these wounds, focusing on the integration of dermatological principles and orthopedic care. Materials and Methods: A prospective cohort study was conducted on 150 orthopedic patients with chronic wounds. Inclusion criteria included patients with non-healing wounds for over 6 weeks, while those with malignant wounds or systemic infections were excluded. Dermatological interventions, including topical therapies, debridement, and advanced dressings, were employed. Data on wound healing rates, infection control, patient satisfaction, and cost-effectiveness were collected at baseline, 4 weeks, and 12 weeks. Results: The majority of patients were male (60%), with a mean age of 58.4 years. Half of the patients had diabetes mellitus, a known risk factor for chronic wounds. By 12 weeks, 75% of the wounds had healed, demonstrating the effectiveness of the dermatological approach. Infection rates decreased significantly from 30% at baseline to 6.7% at 12 weeks, highlighting the role of antimicrobial therapies and debridement. 90% of patients reported being either "very satisfied" or "satisfied" with the wound care provided, indicating high patient acceptance of the dermatological approach. Surgical site infections had the highest healing rate (80%), while diabetic foot ulcers had the lowest (65%), likely due to underlying vascular and metabolic issues. Conclusion This study demonstrates that a dermatological approach significantly improves wound healing outcomes in orthopedic patients, reducing infection rates and enhancing patient satisfaction. By integrating dermatological principles into orthopedic practice, clinicians can address the complex needs of these patients, ultimately improving their quality of life.

Background: Patients with acute appendicitis need immediate surgical intervention to prevent adverse outcomes thus requiring proper and early diagnosis. The diagnosis process becomes more effective using two clinical scoring systems known as RIPASA and Alvarado. The Alvarado scale is commonly utilized but RIPASA demonstrates better detection capacity when used in Asian patient groups. The study analyzes diagnostic accuracy by comparing both scores against radiological findings and histopathology results to develop a more effective method for acute appendicitis detection and reduce unnecessary appendicectomies. Methods: This study included 100 patients with Acute Appendicitis over 18 months. A detailed history was obtained according to the protocol. Information regarding age, nature of symptoms, duration of symptoms, history of similar complaints, and other comorbidities was obtained. History of pain (onset, type, progression, aggravating, and relieving factors), fever (onset, duration, type), vomiting and nausea, and anorexia. Personal history (mainly alcohol addiction) was recorded. Clinical abdominal examination included inspection, palpation, percussion, and auscultation. The clinical scores of RIPASA and ALVARDO were calculated according to the history and physical examination. The relevant data are tabulated in the master chart. Results: 100 cases were studied based on inclusion and exclusion criteria. Males comprised 62% and females 36%. The most affected age group was 21-30 years (40%), followed by 31-40 years (25%). RIPASA scoring showed that 91% had a score above 40. Right iliac fossa pain was present in 77% of cases. Migratory pain was noted in 71% (RIPASA) and 47% (Alvarado). Ultrasound revealed an inflamed appendix in most cases, and histopathology confirmed appendicitis in 95%, with 5% negative appendectomies. Conclusion: In conclusion, the RIPASA score demonstrates higher sensitivity, specificity, PPV, and overall diagnostic accuracy compared to the Alvarado score, particularly in Asian populations. Its statistical significance and reliability make it a preferred tool for diagnosing appendicitis, reducing misdiagnosis and unnecessary surgeries

Introduction: Nasal polyps (NPs) and chronic rhinosinusitis (CRS) are common inflammatory conditions of the paranasal sinuses, often associated with microbial dysbiosis and recurrent infections. Understanding the microbiological aspects of these conditions is crucial for developing targeted therapies. This study aims to explore the microbial profiles associated with NPs and CRS and their clinical implications. Materials and Methods: A prospective study was conducted on 150 patients diagnosed with CRS with or without NPs. Nasal swabs and tissue samples were collected for microbiological analysis, including bacterial culture, polymerase chain reaction (PCR), and next-generation sequencing (NGS). Inclusion criteria included adults aged 18–65 with persistent symptoms for >12 weeks, while exclusion criteria included recent antibiotic use or immunodeficiency. Results: The study identified significant microbial diversity in CRS patients with and without NPs. Staphylococcus aureus, Pseudomonas aeruginosa, and anaerobic bacteria were predominant in NP-associated CRS, while Streptococcus pneumoniae and Haemophilus influenzae were more common in non-NP CRS. Fungal colonization was also observed in 25% of NP cases. Six tables were generated to summarize microbial distribution, antibiotic resistance patterns, and correlations with clinical severity. Conclusion: The microbiological landscape of NPs and CRS is complex, with distinct microbial profiles associated with disease phenotypes. These findings highlight the need for personalized treatment strategies targeting specific pathogens.

Background: Laparoscopic anterior resection (LAR) is a standard surgical approach for rectal cancer, with anastomotic techniques influencing postoperative outcomes. The use of circular staplers, either manual or powered, is critical in rectal reconstruction. While manual circular staplers are widely used, powered circular staplers have been introduced to improve precision and reduce complications. This study compares the short-term outcomes of rectal reconstruction using manual versus powered circular staplers in laparoscopic anterior resection. Materials and Methods: This prospective comparative study included 100 patients who underwent LAR for rectal cancer, randomized into two groups: 50 patients underwent anastomosis with a manual circular stapler (Group A), and 50 patients with a powered circular stapler (Group B). Short-term outcomes, including anastomotic leakage rate, operative time, postoperative pain, and hospital stay, were assessed. Data were analyzed using statistical software, with a significance level set at p < 0.05. Results: The mean operative time was 145 ± 15 minutes in Group A and 130 ± 12 minutes in Group B (p = 0.02). Anastomotic leakage occurred in 10% of patients in Group A and 4% in Group B (p = 0.04). Postoperative pain scores at 24 hours were significantly lower in Group B (3.2 ± 1.1) compared to Group A (4.8 ± 1.3, p = 0.01). The mean hospital stay was 7.5 ± 1.2 days for Group A and 6.2 ± 1.0 days for Group B (p = 0.03). Conclusion: The use of a powered circular stapler in laparoscopic anterior resection demonstrated improved short-term outcomes, including reduced anastomotic leakage, shorter operative time, lower postoperative pain, and decreased hospital stay. These findings suggest that powered circular staplers may offer a safer and more efficient alternative to manual staplers in rectal reconstruction.

Background: Hypertensive disorder in pregnancy are one of the major cause of maternal mortality and morbidity especially in developing countries. It complicates 5-10 % of all pregnancies. Maternal mortality due to hypertensive disorders is reported to be around 10%, more over half of these are preventable. Hypertensive disorder of pregnancy is a sign of underlying pathology which may appear for the first time during pregnancy. Numerous etiology alone or in combination have been suggested to be responsible, they are vascular remodeling of feto-maternal interface, excessive immune response to paternal antigen, systemic inflammatory response and dysfunctional placental or endothelial response; all of these processing being modulated by genetic and environmental parameters Methods: A prospective observational study in which 240 normotensive, pregnant women selected between the gestational age of 14 to 20 weeks attending the ANC clinics, irrespective of parity. Pregnant women with essential hypertension, multiple pregnancy, gestational trophoblastic diseases and associated systemic disease like heart disease, diabetes mellitus and renal disease were excluded from the study. Arterial Doppler of both uterine artery was done. All patients were kept in the regular ANC follow up till the delivery at regular interval for the development of sign and symptoms of hypertension. The patient develop new onset hypertension in pregnancy was noted. Result: Using uterine artery Doppler study is significantly useful in early prediction of hypertensive disorder having sensitivity and specificity of parameters- PI 77.4%and 81.5%, RI as 67.7% and 67.4% and SD ratio as  69.4% and 81.5% respectively. Conclusion: Abnormal uterine artery Doppler studies at 14-20 weeks may be associated with subsequent adverse outcomes. Among the Doppler parameters (PI, RI, S/D) PI is the most sensitive indicator. It can be a useful screening tool for early prediction of hypertensive disorders and the associated perinatal morbidity such as small for gestational age, preterm delivery and IUD.

Introduction: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide. Although pulmonary TB is well characterized, its cardiovascular manifestations remain underexplored. This study aimed to evaluate electrocardiographic and echocardiographic changes in untreated sputum-positive pulmonary TB patients. Methods: This prospective descriptive study was conducted in the Department of Respiratory Medicine at J.J.M. Medical College and Chigateri General Hospital, Davangere, over 1.5 years (March 2021–August 2022). A total of 72 newly diagnosed sputum-positive pulmonary TB patients were enrolled after fulfilling inclusion and exclusion criteria. ECG and ECHO assessments were conducted before the initiation of ATT. Data were analyzed using SPSS v.23, with descriptive and inferential statistical methods applied. Results: The study population had a mean age of 43.64 ± 15 years, with a male predominance (61.1%). Common symptoms included cough (91.7%), fever (73.6%), and generalized fatigue (63.9%). ECG abnormalities were observed in 59% of cases, with sinus tachycardia (50%), P pulmonale (9.7%), and T wave inversion (9.7%) being the most prevalent. ECHO abnormalities were identified in 23.6% of patients, with findings such as left ventricular systolic dysfunction (9.3%), pulmonary hypertension (13.9%), and right ventricular hypertrophy (11.1%).Conclusion: A significant proportion of untreated pulmonary TB patients exhibited ECG and ECHO abnormalities. These findings highlight the need for routine cardiovascular assessment in TB patients to facilitate early detection and management of cardiac complications, ultimately improving patient outcomes.

Introduction: Parenting a child with mental retardation presents unique challenges that can significantly impact parental well-being. This study aims to assess and compare the levels of stress and anxiety among parents of children with different severities of mental retardation and chronic medical conditions. Methods: A cross-sectional study was conducted involving 143 parents (both mothers and fathers) of children diagnosed with either mild-moderate mental retardation, severe-profound mental retardation, or thalassemia (as a control group) at a district hospital. Stress was measured using a standardized perceived stress scale, and anxiety was assessed through the Hamilton Anxiety Rating Scale. Data were analyzed using chi-square tests for categorical variables and ANOVA for continuous variables to compare stress and anxiety levels across the three groups. Results: The study found that parents of children with severe-profound mental retardation reported significantly higher levels of anxiety compared to those with mild-moderate mental retardation and thalassemia (p<0.001). Mothers generally reported higher stress and anxiety levels than fathers across all groups. No significant differences in stress levels were found across the groups (p>0.05). Demographic and socioeconomic characteristics were similar across all groups, indicating that the observed differences in anxiety and stress are likely attributed to the child's condition severity. Conclusion: The findings underscore the profound impact of a child’s disability severity on parental anxiety, particularly among mothers. These results highlight the necessity for targeted psychological support and interventions tailored to the needs of families affected by severe disabilities in children.

Introduction: Lumbar disc herniation (LDH) is a common spinal disorder that leads to significant morbidity, affecting millions worldwide. The condition arises from degenerative changes in the intervertebral discs, leading to nerve compression and associated pain syndromes. This systematic review evaluates the causes, symptoms, and diagnostic approaches for LDH based on peer-reviewed studies published between 2000 and 2024. The primary causes of LDH include age-related disc degeneration, mechanical stress, genetic predisposition, and lifestyle factors such as obesity and sedentary behavior. The symptoms range from localized lower back pain to radiating leg pain, numbness, weakness, and, in severe cases, cauda equina syndrome. The diagnosis of LDH involves a combination of clinical evaluation, imaging modalities such as MRI and CT scans, and electrophysiological studies. This review aims to provide a comprehensive understanding of LDH’s etiology, symptomatology, and diagnostic methodologies, highlighting current research trends and future directions for improved diagnosis and management.