Background: The necessity of closed-suction drainage in the era of tranexamic acid (TXA) during total knee arthroplasty (TKA) is still up for debate. This prospective randomized study aimed to compare the clinical and hematological outcomes of primary TKA performed with and without a drain, all while following a standardized TXA protocol. Methods: We enrolled thirty patients undergoing unilateral primary TKA, who were then block-randomized into two groups: the Drain group (n = 15) and the No-Drain group (n = 15). Each patient received weight-based intravenous TXA at the time of induction and again three hours after the incision. The primary outcome measured was mid-patellar swelling at 24 hours, while secondary outcomes included visual-analogue pain scores, total drain output, active knee flexion (measured on post-operative days [POD] 1, 3, 5; and at weeks 2 and 6), hemoglobin levels on POD 1 and 3, transfusion rates, wound complications, length of hospital stay, and skin-to-skin surgical time. Assessors were kept blind to the group allocations. Continuous data were analyzed using independent t-tests or Mann-Whitney U tests, and repeated measures were evaluated with mixed-effects models. Results: The drainage group had an average output of 330 mL by POD 2. At the 24-hour mark, swelling was less in the drain group (2.8 cm ± 0.7 vs 3.5 cm ± 0.9; p = 0.02), although this difference disappeared by 48 hours. The decline in hemoglobin, transfusion rates (Drain 13% vs No-Drain 7%; p = 0.55), pain scores, complications, and length of stay (4.8 ± 0.9 vs 4.3 ± 0.8 days; p = 0.09) were similar between the two groups. Interestingly, the No-Drain group achieved better knee flexion at week 2 (112° ± 10 vs 105° ± 11; p = 0.04), but this advantage faded by week 6. There were no reported cases of deep infections or thrombo-embolic events. Conclusion: In conclusion, when it comes to primary total knee arthroplasty (TKA) using modern tranexamic acid (TXA) protocols, using routine closed-suction drainage doesn’t really provide much early advantage and doesn’t enhance either bleeding control or functional results. So, ditching the drains could make postoperative care easier without putting safety or recovery at risk.

Background: Non-scarring hair loss is a very common complaint at the skin OPD.  Vitamin-D deficiency is one of the possible causes, and other contributing factors that influence increased hair shedding should be thoroughly investigated. So the treatment plan can be made accordingly. Aims:  The aim of this study was to assess the prevalence of vitamin D deficiency and other contributing factors among patients of non-scarring hair loss. Material and methods: A cross-sectional prospective study was performed in the period between August 2024 and January 2025.  The study included 100 patients, 18-45 years of age, with the complaint of increased hair loss who were never on treatment and supplementation. Full history and physical examination were performed, and laboratory investigations for serum levels of vitamin D, vitamin B12, hemoglobin (Hb), and thyroid function test were done after taking a written consent for the study. Result: Total  100 patients ,71 females and 29 males,( 16 cases of female pattern hair loss(FPHL), 22 male pattern hair loss(MPHL) and 62 telogen effluvium(TE) were investigated for serum level of vitamin-D, vitamin- B12, hemoglobin and thyroid function test, in the result relatively higher proportion of patients with TE showed deficiency of vit-d (74.19%) than AGA (55.26%), vit-B12 (75.80%) than AGA (68.42%) and Hb (38.70%) than AGA (13.13), vit-D insufficiency was more in AGA (26.31%) than TE (16.12%). In comparison to FPHL vs MPHL   vit-D levels (56.25), (54.54) respectively were almost similar in both groups, vit-B12 deficiency was relatively more in MPHL (77.27%) than FPHL (56.25%), Hb deficiency seen in (31.25%) of FPHL and nun in MPHL. Conclusion: Our study found a  significant deficiency in vitamin D, vitamin B12, and hemoglobin levels across all types of hair loss. This highlights the importance of evaluating these factors and tailoring treatment accordingly.