Background: Hypertension is a leading non-communicable disease and a major contributor to cardiovascular morbidity and mortality globally. School teachers, as an occupational group, are uniquely exposed to high levels of psychological stress, sedentary work patterns, and inadequate health surveillance, rendering them particularly vulnerable. There is a paucity of data on the prevalence of hypertension and its associated sociodemographic determinants among school teachers in mid-sized urban centres like Prayagraj. The objective is to estimate the prevalence of hypertension and evaluate its association with sociodemographic variables among school teachers in urban Prayagraj. Materials and Methods: A community-based cross-sectional study was conducted among 320 school teachers (TGT and PGT) from government and private schools in urban Prayagraj, selected by multistage random sampling, over a 12-month period (February 2025–January 2026). Hypertension was diagnosed as SBP ≥140 mmHg and/or DBP ≥90 mmHg per JNC-7 criteria. Sociodemographic data were collected via semi-structured interview. Chi-square test and logistic regression were performed using SPSS version 20 (p<0.05 considered significant). Results: Of 320 participants (males 60.93%, mean age 40–49 years), 31.56% were hypertensive and 5.93% were prehypertensive. Hypertension was significantly associated with marital status (χ²=20.38, p=0.0004); divorced/widowed teachers had the highest prevalence (64.52%). On logistic regression, divorced/widowed marital status was the only independent sociodemographic predictor (AOR=1.242; 95% CI: 1.001–1.512; p=0.027). Age, school type, religion, socioeconomic status, and sole-earner status showed no statistically significant association. Conclusion: Nearly one-third of school teachers in urban Prayagraj have hypertension, with divorced/widowed marital status as the sole independent sociodemographic determinant. Regular occupational screening, targeted health education, and workplace wellness programs are urgently warranted for this group. Keywords: Hypertension, School teachers, Prevalence, Sociodemographic factors, Urban Prayagraj, Occupational health.

Background: Rapid expansion of digital technology has significantly transformed the way adolescents access information, communicate, and engage with their social environment. Adolescents represent one of the most active user groups of smartphones, utilizing them for communication, entertainment, academic purposes and information seeking. With potential benefits, excessive smartphone use has been associated with negative physical and psychological outcomes, including sleep disturbances, anxiety, depression, and reduced academic performance. Aim: To estimate the prevalence of smart phone usage and utilization of smartphone in seeking health related information among rural adolescent students. Materials and Methods: We adopted a cross-sectional study design with systematic random sampling technique to select 200 students aged in between 13 to 19 years. After obtaining written informed consent, we collected socio-demographic data, smartphone usage pattern and its purpose, source of health-related information was assessed using a self-directed questionnaire. Results: Out of 200 students enrolled, 151 (75.60%) of them had access to smartphones out of which 47% of them had their own smartphones and 14% of them were using smartphones for more than 3 hours per day. It was seen that YouTube and social media network such as Facebook/Instagram were the major source for health-related information students were using. Conclusion: Smartphone usage among rural students is widely increasing and source of health-related information varies widely. Matter of concern is that the source of health-related information accessed stands unscrutinised with questionable authenticity. Keywords: Smart phone, adolescents, health information, students.

Background: Biomedical waste poses direct risks to patient safety, healthcare workers, and the environment. While the Bio-Medical Waste Management Rules 2016 strengthened regulations in India, compliance gaps remain. Accreditation is promoted as a quality driver, yet evidence on its impact on waste management and environmental safety is limited. The aim is to assess how accreditation-driven quality assurance systems influence biomedical waste management practices, occupational safety, and regulatory compliance in a tertiary care hospital. The objective is to assess compliance with biomedical waste segregation practices at the point of waste generation and adherence to color coded BMW protocols. To assess staff training coverage and competency in biomedical waste management practice. To evaluate the effectiveness of internal audits and the implementation of corrective and preventive actions. Material and Methods: A hospital-based cross-sectional study was conducted over six months in a 500-bed accredited teaching hospital. We included 325 healthcare workers involved in waste handling. Compliance with segregation, color-coding, training, PPE use, waste generation, and regulatory standards was measured through direct observation, audits, and record review. Chi-square tests compared observed rates with 90% benchmark standards. Results: Among the 325 Healthcare workers, 319 (98.15%) Healthcare workers were covered in the training and 297 (91.38%) were covered in refresher training. Segregation compliance was observed in 313 (96.30%), color-coding in 308 (94.76%), and bin labelling in 304 (93.53%). PPE compliance was observed in 303 (93.23%) and Hepatitis-B vaccination in 310 (95.4%). Mean waste generation was 1.82 kg/bed/day. Collection within 24 hours occurred for 317 (97.5%) of waste and disposal within 48 hours for 100%. Needle-stick injuries were low at 2.1 per 100 workers/year with 100% investigation. SOP compliance was 95.2% and regulatory compliance 97.3%. All indicators significantly exceeded benchmark levels and were higher than previously reported studies. Conclusion: Accreditation-driven quality systems were associated with high compliance across biomedical waste management domains. Strong training, audit, and safety practices likely underpin these outcomes. The findings support integrating structured quality assurance into routine waste management to improve environmental safety and regulatory adherence. Keywords: Biomedical Waste Management, Medical Waste Disposal, Healthcare Waste Management, Hospital Accreditation, Quality Assurance, and Health Care.

Background: Liquid-Based Cytology (LBC) has increasingly been adopted in cervical cancer screening due to its improved sample adequacy and cleaner and more clear background compared to Conventional Smears (CS). Objectives: (1) To compare the adequacy of epithelial cell component in CS versus in LBC. (2) To evaluate the clarity of the background in CS versus LBC (3) To evaluate epithelial abnormalities detected on CS and LBC prepared from split cytobrush samples. Materials and Methods: A prospective study was conducted over one year at a teaching hospital, analysing 102 cervical cytobrush samples split for CS and LBC preparation. Five blinded pathologists reported each smear. Categorical variables were compared using Chi-square test; p < 0.05 was considered statistically significant. Results: Adequate cellularity was significantly higher in LBC (97%) than CS (85%) (p = 0.003). LBC produced significantly reduced inflammatory backgrounds (p < 0.0001), less haemorrhage, debris (scoring Likert scale). Percentage of cases with diagnostic architectural/morphological changes was found to be higher in LBC (96%) compared to CS (79%) (p = 0.0003). LBC yielded fewer unsatisfactory samples (2%) than CS (15%), and a higher proportion of NILM diagnoses (p = 0.0023). Conclusion: LBC is significantly superior to CS in terms of adequacy, background clarity, and detection of diagnostic morphological changes. Adoption of LBC can reduce unsatisfactory rates and improve diagnostic accuracy by reducing misinterpretation of artefactual changes in cervical cancer screening and in turn reducing the need for a repeat smears. Keywords: Liquid-based cytology, Conventional smear, Cervical cytology, Cytobrush, Diagnostic accuracy.

Background: One dangerous consequence of diabetes mellitus is diabetic foot ulcers (DFUs), which can lead to prolonged hospital admissions, infections, and even amputations. Topical insulin has emerged as a viable treatment for enhancing wound healing due to its angiogenic and proliferative properties. The aim is to evaluate the effectiveness of topical insulin dressings against conventional normal saline dressings in promoting wound healing in people with persistent diabetic ulcers. Materials and Methods: Fifty diabetic patients with chronic foot ulcers were enrolled at the Department of Surgery, Mahatma Gandhi Memorial Government Hospital, Trichy. Patients were randomly assigned to two equal groups: Group A received topical insulin dressings, while Group B received conventional normal saline dressings. Participants were followed for 21 days, with assessments on wound size reduction, granulation tissue formation, slough disappearance, and microbiological findings. Results: Significant improvements were observed in Group A in terms of earlier granulation tissue appearance, faster slough disappearance, and greater reduction in wound area by Day 21 (p < 0.05). The pus culture findings also showed a higher rate of sterile cultures in the insulin group, suggesting improved wound cleanliness. Conclusion: For diabetic foot ulcers, topical insulin dressing is a safe and efficient way to promote wound healing. It is advised that more multicentric studies be conducted to confirm these results. Keywords: Topical insulin, Diabetic foot ulcer, Wound healing, Granulation tissue, Normal saline dressing, Chronic wounds.

Background: The co-epidemic of Type 2 Diabetes Mellitus (T2DM) and pulmonary tuberculosis (PTB) constitutes a major public health challenge, particularly in low- and middle-income countries. Diabetes is recognised as a significant modifiable risk factor that adversely alters the clinical presentation, immune response, and treatment outcomes in PTB patients. The objective is to characterise the clinical and radiological profile of newly diagnosed PTB patients with T2DM, assess their glycaemic status at enrolment using fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c), and determine the impact of glycaemic control on treatment outcomes. Materials and Methods: A prospective, observational, hospital-based study conducted over 18 months at a tertiary care centre. Consecutive newly diagnosed PTB patients were enrolled and stratified into TB-DM (n=95) and TB-only (n=95) groups. Glycaemic status was assessed at baseline and at 2, 5, and 6 months. Primary outcomes included sputum conversion rates at 2 months, treatment success, failure, relapse, and mortality. Results: TB-DM patients exhibited higher symptom burden, lower BMI, and atypical radiological features including lower lobe involvement (58.9% vs 21.1%, p<0.001) and bilateral cavitary disease (44.2% vs 24.2%, p=0.006). Mean HbA1c at enrolment was 9.8 ± 2.1%. Sputum culture conversion at 2 months was significantly delayed in TB-DM (54.7% vs 78.9%, p<0.001). Poor glycaemic control (HbA1c ≥8%) was independently associated with treatment failure (OR 3.12, 95% CI 1.67–5.83), relapse (OR 2.94, 95% CI 1.41–6.13), and death (OR 2.17, 95% CI 1.03–4.57). Conclusion: T2DM significantly modifies the clinical and radiological phenotype of PTB and independently worsens treatment outcomes. Routine screening for diabetes in all newly diagnosed TB patients and integrated glycaemic management are essential for improving treatment success. Keywords: Pulmonary tuberculosis, Type 2 diabetes mellitus, HbA1c, glycaemic control, treatment outcomes, TB-DM comorbidity, sputum conversion.

Background: Despite advances in reperfusion and pharmacotherapy, patients with acute coronary syndrome (ACS) remain at substantial risk of recurrent major adverse cardiovascular events (MACE), and identifying readily available bedside predictors can refine risk stratification. The objective is to evaluate the clinical, laboratory, electrocardiographic, echocardiographic, and angiographic characteristics of patients with ACS and to identify independent predictors of MACE during 12 months of follow-up. Materials and Methods: In this single-centre, retrospective, observational cohort study, 412 consecutive patients admitted with ACS were analysed. MACE was defined as a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned revascularisation, and heart-failure hospitalisation. Univariable and multivariable logistic regression identified independent predictors; Kaplan-Meier analysis and the area under the ROC curve assessed the GRACE score. A P value below 0.05 was considered significant. Results: MACE occurred in 98 patients (23.8%). Independent predictors were advancing age (adjusted odds ratio [OR] 1.38 per decade), diabetes mellitus (OR 1.92), Killip class greater than one (OR 2.14), LVEF below 40% (OR 2.46), eGFR below 60 mL/min/1.73m² (OR 1.89), and a GRACE score above 140 (OR 2.27). The GRACE score discriminated MACE well (area under the curve 0.78). Conclusion: A small set of routinely recorded variables independently predicts 12-month MACE after ACS and can support pragmatic, resource-efficient risk stratification. Keywords: Acute Coronary Syndrome, Myocardial Infarction, Risk Factors, Prognosis, Heart Failure.

Background: Aim: Carbide gun-induced ocular trauma has emerged as a distinct and preventable pattern of thermochemical eye injury in India. The present review was prepared to synthesize the available evidence on epidemiology, mechanisms, clinical profile, management, outcomes, and prevention of carbide gun-related eye injuries, while comparing the present institutional dataset with the findings of the published studies. A secondary aim was to clarify whether our cases reflect the same trend described in recent Indian literature, namely unilateral severe injuries associated with direct inspection of a malfunctioning gun, limbal ischemia, corneal haze, epithelial defects, and persistent visual morbidity despite treatment. Materials and Methods: This systematic-style review was based on our center’s analysis, and compares it with a public health editorial on carbide gun-associated ocular injuries, one case-series report of five children and young adults from central India, one retrospective analysis of 28 eyes with calcium carbide-related thermochemical injury and one ophthalmic perspective article .The available studies were reviewed for patient demographics, setting of injury, mechanism, laterality, presenting visual acuity, ocular findings, acute management, surgical intervention, complications, and visual outcomes. Data from the spreadsheet were interpreted as an index institutional cohort and were compared descriptively with the supplied publications to identify shared patterns and important differences. Because the evidence base consisted mainly of case series, retrospective clinical data, and expert commentary, the review emphasizes qualitative synthesis and pragmatic clinical interpretation rather than pooled meta-analysis. Results: Across the attached literature, carbide gun injuries consistently affected predominantly young males and commonly occurred when the user peeped into a gun after delayed or failed ignition, leading to combined thermal and alkali damage from acetylene combustion and calcium hydroxide residue. The five-patient central India case series reported a mean age of 16.2 years, universal monocular involvement, and presenting vision ranging from 6/36 to no light perception. The larger retrospective series included 28 eyes of 23 patients with a mean age of 28.48 years; severe injuries carried significantly poorer presenting and final visual acuity, more limbal stem cell deficiency, and occasional phthisis bulbi. Our institutional spreadsheet similarly showed that most patients were male, many were from urban or semi-urban settings, and several had corneal haze, epithelial defects, limbal ischemia, retained particulate matter, or need for amniotic membrane grafting. Taken together, the evidence indicates that carbide gun trauma is not a trivial firecracker substitute but an evolving public health problem capable of causing long-term ocular surface failure and visual disability. Conclusion: The cumulative evidence supports classifying carbide gun-induced ocular trauma as an emerging, preventable cause of severe visual morbidity, particularly in resource-limited Indian settings where cheap devices, easy availability of calci

Background: Study of Electrocardiogram and Echocardiography parameters of post covid-19 patients. Materials and Methods: This was a Cross Sectional study carried out in Department of Cardiology. This study was conducted at the Department of Cardiology out-patient section in GGH, Ongole, Prakasam district, Andhra Pradesh, India. This study was approved by the Institutional Ethical Committee of the Rajiv Gandhi Institute of Medical and Sciences [RIMS], Ongole. This study was carried out for a period of 6 months. The total of 500 post Covid-19 patients. Both In and Out patients with >18 and <60 and who develop cardiovascular diseases in 6 months, 1 year, and 1 ½ - 2 years after corona virus exposure were included in this study who are infected with SARS-COV-2. Results: This study shows Predominance of Males over Females In our study 31-40 age group patients were commonly affected by Covid – 19. In this study we observed E.C.G and 2D ECHO parameters of Post Covid – 19 patients. Total 500 patients were evaluated. Among 302 people were found to be abnormal. The mean age of patients was 42.95±8.35 years. Tachycardia and Irregular Heart rhythm 88.56±23.0 were observed in our study. In current study we observed Short PR Interval, ST Segment Depression, Prolong R wave, Chamber Size, Sclerosis abnormalities were found. Patients who were affected with moderate- severe Covid-19 infection the presence of ST (or) T wave Inversion, Depression should be a concern for the occurrence of Cardiovascular disease in future. Patients with Severe Covid – 19 are at risk of Cardiac involvement in future. Periodic Cardiac assessment of these patients is essential. Conclusion: ECG and 2D ECHO Cardiography investigations are prerequisite in the evaluation of cardiovascular disease. Our Study have shown some significant findings from ECG and 2D ECHO Cardiogram hence our study concludes that ECG and 2D ECHO Cardiography must consider as a important diagnostic tools for evaluation of cardiovascular disease in Covid – 19 patientsegies. Keywords: COVID-19, ECG,2D ECHO Cardiography, ST Segment Depression, Prolong R wave.

Background: Acute Coronary Syndrome (ACS) in young adults is an emerging public health concern associated with significant morbidity and mortality. Traditional cardiovascular risk factors do not completely explain the occurrence and severity of coronary artery disease (CAD) in this population. Serum homocysteine has been identified as an independent risk factor for atherosclerosis and thrombotic cardiovascular events. The Gensini score is a validated angiographic scoring system used to quantify the severity of coronary artery disease. This study was undertaken to evaluate the correlation between serum homocysteine levels and Gensini score among young ACS patients admitted to a tertiary care hospital. The aim is to evaluate the correlation between serum homocysteine levels and the severity of coronary artery disease as assessed by the Gensini score in coronary angiography among young patients presenting with acute coronary syndrome. Materials and Methods: It was an observational cross-sectional correlation study. This study was conducted at the department of cardiology, In-patient section of tertiary care Government general hospital (GGH), Ongole, Prakasam dist, Andhra Pradesh. This study was submitted to the Institutional Ethics Committee (IEC), Government general hospital, ongole. Approval was obtained before initiation of the study. Written informed consents was obtained from all the participant’s.This study was carried out for a period of 6 months. Patients who are less than or equal to 45 years. Patients with confirmed diagnosis of acute coronary syndrome undergoing coronary angiography. Patient who accepted informed consent form. Results: The present study evaluated the relationship between serum homocysteine levels and the severity of coronary artery disease (CAD) among young patients diagnosed with acute coronary syndrome (ACS). The analysis of demographic, clinical, biochemical, and angiographic findings demonstrated several important observations regarding the role of homocysteine in cardiovascular disease among young individuals. The study also revealed a strong positive correlation analysis between serum homocysteine levels and the Gensini score, with a correlation coefficient of r = 0.79. This strong correlation indicates that higher homocysteine levels are closely associated with more severe coronary artery involvement as assessed by coronary angiography. These findings suggest that serum homocysteine may serve as a useful biochemical marker for assessing the severity of coronary artery disease in young patients with acute coronary syndrome. Conclusion: These results suggest that homocysteine may play an important role in the pathogenesis and progression of coronary artery disease. Serum homocysteine levels show a significant positive correlation with the Gensini score in young patients presenting with Acute Coronary Syndrome. Elevated homocysteine may serve as a useful biomarker for identifying patients at risk of severe coronary artery disease and may contribute to improved risk stratification and early intervention strategies. Keywords: Acute Coronary Syndrome, Coronary Artery Disease, Homocysteine, Gensini Score, Coron

Background: To study the relationship between lipoprotein(a) levels and severity of coronary artery disease in young patients with acute coronary syndrome at Tertiary Care Hospital. Materials and Methods: The present study was conducted as a cross-sectional observational study to evaluate the association between Lipoprotein(a) levels and the severity of coronary artery disease in young patients with acute coronary syndrome. The study was carried out in the Department of Cardiology, Government General Hospital (GGH), Ongole. The study protocol was submitted to the Institutional Ethics Committee (IEC), Government General Hospital, Ongole. Approval was obtained before initiation of the study. Written informed consent was obtained from all participants (English and Telugu formats). The study was conducted over a period of 6 months. Patients aged less than 45 years who were diagnosed with Acute Coronary Syndrome (ACS) and admitted to the cardiology department were included in the study. Results: The cross sectional study evaluated the relationship between Lipoprotein(a)[Lp(a)] levels and the severity of Coronary Artery Disease(CAD) in young patients presenting with Acute Coronary Syndrome(ACS). A total of 100 young ACS patients underwent clinical evaluation, measurement of Lp(a) levels, and coronary angiography. Disease severity was assessed using the SYNTAX score. Most patients were aged 36–40 years (33%), with a predominance of males (75%). Elevated Lp(a) levels (>30 mg/dL) were observed in 66% of patients, with a mean level of 52 mg/dL. Angiographic findings showed that single vessel disease was most common (58%), followed by double vessel disease (28%) and triple vessel disease (14%). The Left Anterior Descending (LAD) artery was the most frequently involved vessel. Based on SYNTAX scoring, 56% had low scores, 26% intermediate, and 18% high scores, with a mean score of 24. A significant positive correlation was found between Lp(a) levels and SYNTAX score (r = 0.68, p < 0.001), indicating increased CAD severity with higher Lp(a) levels. Conclusion: These findings suggest that elevated Lipoprotein(a) is an important independent risk factor for premature CAD and may serve as a useful biomarker for risk assessment in young ACS patients. Keywords: Acute coronary syndrome, CAD, Left Anterior Descending (LAD). Lipoprotein Lp(a), SYNTAX scoring.

Background: Medico-legal cases form an important component of emergency and trauma care. The medico-legal report has clinical and legal value, and incomplete documentation may affect investigation, judicial proceedings and patient rights. This study assessed the effect of integrating the speciality of Forensic Medicine on the quality of medico-legal documentation in an anonymised level 1 trauma centre. Materials and Methods: This before-and-after retrospective observational study was conducted at an anonymised level 1 trauma centre over a three-year period. The pre-integration period was from April 2022 to March 2023, and the post-integration period was from April 2023 to March 2025. A total of 3768 medico-legal case records were reviewed, comprising 840 cases in the pre-integration period and 2928 cases in the post-integration period. Demographic profile, nature of injury, dominant type of injury and predefined documentation errors were analysed using frequencies and percentages. Results: Males constituted 82.5% of medico-legal cases, while females constituted 17.5%. The commonest age group was 18–35 years, accounting for 64% of cases. Road traffic accidents were the most common cause of injury, accounting for 62.8% of cases, followed by falls at 12.6%. Blunt injury was the predominant type in 82.8% of cases. After the integration of the speciality of Forensic Medicine, the average monthly number of medico-legal cases increased from 70 cases/month in the pre-integration period to 122 cases/month in the post-integration period, representing a 1.75-fold increase. Missing date and time of examination decreased from 28.5% to 2.45%, improper documentation of mark of identification decreased from 65.7% to 14.75%, missing injury size decreased from 54.2% to 3.27%, missing injury site decreased from 38.5% to 2.45%, and missing age of injury decreased from 91.4% to 8.2%. Conclusion: Integration of the speciality of Forensic Medicine was associated with increased medico-legal case documentation and a reduction in major documentation errors. The findings suggest that structured involvement of Forensic Medicine may improve the completeness and quality of medico-legal documentation in tertiary trauma care settings. Keywords: Forensic Medicine; medico-legal case; medico-legal report; documentation errors; emergency department; trauma centre,

Background: Adenoid cystic carcinoma (ACC) is a rare malignant epithelial tumour that is most commonly found in the salivary glands but can also occur at extra-salivary locations. It can present clinically in many ways, leading to diagnostic difficulties despite the characteristic histopathological features. Case Presentation: This case series describes ACC of the nasal cavity, base of tongue, lung, and breast. The age of the patients ranged from 38 to 76 years. Clinical, radiological, histopathological and immunohistochemical data were analysed. All cases showed the typical tubular and cribriform patterns on histological examination, with pseudocystic areas containing hyaline basement membrane–like material. The nasal cavity lesion had invaded the perineurium, and the tongue lesion had invaded skeletal muscle. CD117 and p63 were consistently positive by immunohistochemistry. The pulmonary case was negative for Napsin A, confirming primary pulmonary ACC. The breast tumours were triple negative and showed the typical morphological characteristics of ACC. Conclusion: ACC is consistent in its histomorphological and immunohistochemical features across different anatomical locations. Its characteristic tubular and cribriform architecture is essential for accurate diagnosis, particularly at unusual sites, and is confirmed by CD117 and p63 immunostaining. Pathological examination and long-term follow-up are important because of the potential for local recurrence and delayed metastasis. Keywords: Adenoid cystic carcinoma; CD117; p63; immunohistochemistry; cribriform pattern.

Background: Proximal tibial plateau fractures are complex intra-articular injuries that affect the weight-bearing surface of the knee joint. These fractures commonly result from high-energy trauma in younger individuals and low-energy falls in elderly patients with osteoporosis. The management of tibial plateau fractures is challenging due to associated soft tissue injury, fracture comminution, and the need to restore joint congruity and stability. Hybrid external fixation has emerged as an effective treatment modality, particularly in fractures with severe soft tissue compromise, as it provides stable fixation while minimizing additional soft tissue damage. Aim of the study: This study aim is evaluate the function of hybrid external fixatorin treating high-energy tibia plateau fractures with minimal invasion and tissue damage. Objectives 1. To assess the performance of the Hybrid External Fixator in the treatment of tibial plateau fractures (Schatzker type V & VI). 2. To evaluate the functional outcome, soft tissue healing and fracture union and radiological outcome. 3. To evaluate the biomechanical and biological advantage of hybridexternal fixator. Materials and Methods: This a prospective study conducted from October 2019 to March 2021.Thirty patients with schatzker type-5 and type-6 with high energy tibial plateau fractures admitted in Narayana Medical College and Hospital,Nellore, were included in the study after their valid informed written consent. Approval of the Ethical Committee was obtained before the commencement of the study.Patients meeting the inclusion criteria were enrolled and followed up at regular intervals. Fractures were classified according to the Schatzker classification system. Clinical and radiological assessments were performed to evaluate fracture healing and alignment. Functional outcomes were assessed using the Rasmussen Functional Score and/or other validated knee scoring systems. Complications such as pin tract infection, malunion, nonunion, knee stiffness, and post-traumatic osteoarthritis were documented. Results: Hybrid external fixation provided satisfactory fracture stabilization and facilitated early mobilization in most patients. Fracture union was achieved in the majority of cases within an acceptable time frame. Functional assessment demonstrated good to excellent outcomes in a significant proportion of patients, with satisfactory knee range of motion and restoration of function. Complications were generally minor and manageable, with pin tract infection being the most commonly observed complication.. The difficulties are mainly related to sepsis, either superficial pin track infection or deep infection, preventable, treatable, and curable. We feel that the technique merits a place in the armamentarium for managing complex, high-energy tibial plateau fractures. Conclusion: Hybrid external fixation is an effective treatment option for proximal tibial plateau fractures, especially in cases associated with severe soft tissue injury. It provides stable fixation, promotes fracture healing, allows early knee mobilization, and yields favorable functional outcomes with a relatively low complication rate. Care

Background: Acute ischemic stroke is a major cause of mortality and long-term disability worldwide and accounts for the majority of cerebrovascular accidents. Early diagnosis and accurate characterization of ischemic lesions are essential for timely therapeutic intervention, prognostication, and prevention of neurological deterioration. Computed tomography (CT) and magnetic resonance imaging (MRI) are the principal imaging modalities used in the evaluation of ischemic stroke. While CT remains the first-line imaging technique because of its rapid availability and ability to exclude hemorrhage, MRI, particularly diffusion-weighted imaging (DWI), offers superior sensitivity in detecting acute ischemic changes. Correlation of lesion characteristics, vascular territory involvement, infarct severity, and infarct volume using these modalities can improve diagnostic accuracy and guide clinical decision-making. Aim: To evaluate the role of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the assessment of ischemic stroke and to correlate lesion characteristics, vascular territory involvement, and infarct volume detected by the two imaging modalities. Objectives: To compare CT and MRI findings in ischemic stroke, assess lesion characteristics, determine vascular territory involvement, evaluate infarct severity using the Alberta Stroke Program Early CT Score (ASPECTS), measure infarct volume, correlate ASPECTS score with infarct volume, and determine the diagnostic value of combined CT and MRI evaluation. Materials and Methods: This hospital-based observational cross-sectional study included 132 consecutive patients with imaging-confirmed ischemic stroke who underwent both CT and MRI examinations. Lesion characteristics evaluated included side of involvement, lesion location, number of lesions, hemorrhagic transformation, contrast enhancement, gray-white matter differentiation loss on CT, and diffusion restriction on MRI. Vascular territory involvement was categorized as anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebrobasilar, lacunar, or multiple territories. Infarct severity was assessed using ASPECTS, and infarct volume was measured by manual planimetric analysis and classified as small (<30 mL), moderate (30–70 mL), or large (>70 mL). Results: Left-sided infarcts were the most common (36.4%), followed by right-sided (32.6%) and bilateral lesions (31.1%). Cortical lesions accounted for 50.8% of cases, and single lesions were observed in 73.5% of patients. Haemorrhagic transformation and contrast enhancement were present in 36.4% and 46.2% of cases, respectively. Gray-white matter differentiation loss on CT was identified in 53.8% of patients, while diffusion restriction on MRI was detected in 66.7%. ACA territory infarction was the most frequent vascular distribution (22.0%), followed by MCA (19.7%) and PCA (18.9%) territories. Severe ASPECTS scores (0–4) were observed in 35.6% of patients, while small infarct volumes predominated (54.5%). A clear inverse relationship was noted between ASPECTS score and infarct volume. Conclusion: CT and MRI provide complementary