Background: Chronic liver disease (CLD) is associated with a spectrum of cardiovascular changes, often leading to cirrhotic cardiomyopathy. Aim: To assess echocardiographic changes in patients with CLD over a 12-month period in a tertiary care center. Materials and Methods: A total of 40 CLD patients were evaluated using transthoracic echocardiography at baseline, 6 months, and 12 months. Parameters were compared with 40 healthy controls. Results: Significant increases in interventricular septal thickness and left ventricular posterior wall thickness were observed over time. Doppler parameters also revealed early diastolic dysfunction in CLD patients. Conclusion: Serial echocardiography is valuable in detecting subclinical cardiac changes in CLD, enabling early intervention and optimized patient care. Keywords: Chronic liver disease, Echocardiography, Cirrhotic cardiomyopathy.

Background: Mobile phone usage has increased drastically in the present day, and that increases sedentary behaviour like using the mobile phone in a lying down posture or in a sitting posture without any physical activity. Earlier studies assessed the reaction between the screen time with the depression mainly not with anxiety and stress scores. Aim and objectives: The present study was undertaken to assess the screen time in young adults and assess the depression, anxiety, and stress scores. Materials and Methods: The present cross-sectional study recruited a total of 100 young adults after obtaining voluntary, written, informed consent. Mobile screen time was recorded using Apple's Screen Time and Google's Digital Wellbeing apps, respectively. Depression, anxiety, and stress scores were recorded using the DASS 21 questionnaire, which is a self-administered questionnaire. Results: Depression scores were significantly higher in the individuals using screen time for more than 6 hours. Anxiety scores were significantly higher in the individuals using screen time for more than 6 hours. Stress scores were significantly higher in the individuals with screen time of more than six hours. Conclusion: The present study results support that excessive screen time is associated with the excess amounts of depression, anxiety, and stress. Further detailed studies are recommended in this area and also to recommend to educate the young adults regarding excessive use of mobile phones. Keywords: Stress, Screen time, Young adults, Anxiety, Depression.

Background: Academic role play has immense importance in teaching and learning methods where students can perform the roles of a case study and explain the condition more clearly. They participate enthusiastically and with full attention and concentration.The details mentioned in the AETCOM are also be covered in the role play. However, the studies on role play implementation in the medical education in India are relatively less. Hence, the present study was undertaken. Aim and objectives: The present study was undertaken to observe the effectiveness of role play in vertical integration between physiology with forensic medicine. Materials and Methods: All the students were divided into 15 groups with 10 students in each group. The clinical topics were distributed to them, that is, drowning, carbon monoxide poisoning, Rigor mortis, Diabetes mellitus, and Parkinson’s disease. They have the freedom to select any of the topics. Groups are made based on their role numbers; that is, roll number 1 to roll number 10 is one group. This improves the interaction between the students. Teachers of both departments were appointed as mentors for each of the groups. To encourage the students a competition is announced and with three prizes. To test the importance of the role play an MCQ test for 20 marks was conducted on these topics before the preparation of the role play and also after the role play performance; one more MCQ test was conducted with different questions. Feedback was obtained at the end after the post-MCQ test. Results: There was a significant increase in the students' performance in the MCQ test conducted after the role play performance by the students. The majority of the students perceived that the role play was an effective tool to promote the active learning of the clinical topics. The majority of students agreed to implement the role play in the curriculum. Conclusion: The study provides results to support the implementation of role play in medical education to promote active learning and to promote the communication skills in the students. Further detailed studies with more integrations are recommended. Keywords: Role play, Academics, Medical Education, Teaching methods.

Background: The kidney exhibits significant anatomical and developmental variability that is crucial for clinical practice and embryological understanding. This study integrates cadaveric morphometry with histogenesis analysis to provide comprehensive insights into renal anatomy and tissue architecture. The present study conducted to quantify morphometric parameters (length, breadth, thickness, hilar anatomy) in 100 cadaveric kidneys and to analyse histogenesis features (nephron maturation, vascular patterning, incidental pathology) through microscopic examination. Materials and Methods: - Sample: 100 kidneys (50 paired specimens) from cadavers with no demographic restrictions. - Morphometry: Measurements of dimensions and hilar structures using Vernier calipers; photographic documentation. - Histology: Tissue sections stained with H&E, PAS, and Masson’s trichrome; evaluated for developmental and pathological patterns. - Analysis: Descriptive statistics (mean ± SD); comparative analysis (right vs. left kidneys). Results: In present study we found the morphometric measurements, Length: 6–11.5 cm (mean 9.2 ± 1.3 cm); right kidneys longer than left (p < 0.05). • Hilar variations: Classic arrangement (62%); atypical patterns (38%). • Renal arteries: Single (70%); multiple (30%). Histogenesis • Normal glomerulogenesis (88%); immature glomeruli (8%). • Vascular anomalies: Aberrant arteriolar branching (12%); fibromuscular dysplasia (5%). • Incidental pathology: Subcapsular hematoma (3%); cystic dilatation (2%). Conclusion: This study delineates the spectrum of renal morphometric variability and histogenesis patterns in cadaveric specimens. The findings underscore the importance of anatomical variations for surgical interventions and highlight subclinical developmental anomalies. Keywords: Kidney morphometry, cadaveric study, histogenesis, renal anatomy, developmental anomalies.

Background: Tobacco consumption is the most important preventable cause of disease and death among adults. In India according to GATS 2016-172 India tobacco prevalence is 28.6% of adults (42.4% males and 14.2% females) are tobacco consumers.10.7% adults (19% males and 2.0% females) use smoking tobacco.21.4% adults (29.6% males and 12.8% females) use smokeless tobacco2. Barrier factors such as sociocultural and demographic factors play crucial role and has impact on trends and patterns of prevalence among the rural population. Objective: To estimate the prevalence of tobacco consumption among rural population of both males and females in RHTC field practice area, Nalgonda District. Materials and Methods: Community based cross sectional study, was carried out in 11 adopted villages under RHTC field practice area in Nalgonda district under tertiary care teaching hospital from October 2021 to September 2022. Sample size of 488 study participants were obtained by multistage sampling technique. Results: The prevalence of tobacco consumption in the study population.106(21.5%) of the study group were tobacco consumers and 382 (78.5%) were non-consumers. Among the study population 71(29.7%) of males and 35(14.1%) of females consume tobacco and it shows statistically significance. 283(58%) knew that tobacco consumption causes cancer,121(25%) knew that it causes Respiratory disease,30(6%) knew that it causes CVD and 49(10%) knew it causes coronary heart diseases. Conclusions: This study concludes that the prevalence of tobacco consumption is mainly associated due to factors like having no formal education, doing skilled work and belong to middle and lower middle socio-economic groups. Education is the key area where majority of the tobacco consumers started between the age 11 – 20 years. So anti-tobacco education should be made compulsory in schools and colleges in their academic curriculum. Keywords: Tobacco consumption, Household, ex-smoker, Socio-demographic factors.

Background: Tuberculosis is one of the most common causes of death in world. Drug resistance has become more common in previously treated patients, who were treated irregularly or with improper regimens and doses. Aim is to look the clinico-microbiological profile, treatment outcomes, and follow-up of patients registered for DRTB and IRL at Puducherry tuberculosis unit. Materials and Methods: This study included 73 patients who were treated for drug-resistant tuberculosis at DRTB/IRL during 2014-2020. Their clinical condition, microbiological parameters, resistance pattern, laboratory profiles, and radiological results were taken. Patients with favourable and unfavourable outcomes were followed up using random sampling method and their current clinical findings, sputum smear status, and radiological data were recorded. Results: 73 patients were included with mean age of 43.83±15.20 years. Treatment outcomes as 78.08% cured, from cured patients 16% were died during follow up period, 1.4 % completed treatment, 4.1% died before completing treatment, 4.1% were lost to follow up and 2.7% had treatment failure. Previous TB history exists in 79.45% and 20.55% newly diagnosed. Conclusion: Treatment success occurred more than 3/4th of cases, which is higher than WHO of 75% success rate. 16% patients who died the follow up period of study, resulted an unfavourable outcome. Keywords: DRTB, Clinico-microbiological profile, Treatment outcomes, WHO.

Background: Tuberculosis (TB) is a major global health concern caused by Mycobacterium tuberculosis. First-line anti-tubercular drugs (ATT) are highly effective in treating TB, but their use is frequently associated with drug-induced hepatotoxicity, which may lead to treatment interruption, non-adherence, and potential development of drug-resistant TB. Aim: This study aims to evaluate the approach to diagnosing and managing patients with anti-tubercular therapy (ATT)-induced hepatitis, focusing on identifying risk factors and providing effective treatment strategies. Materials and Methods: This prospective observational study was conducted over a 24-month period, involving 300 patients diagnosed with TB. Among the study population, 180 patients had pulmonary TB, 100 had extrapulmonary TB, and 20 had multidrug-resistant (MDR) TB. Of the 300 patients, 270 did not develop hepatitis, while 30 experienced hepatotoxicity. The onset of hepatitis was predominantly observed at 3 weeks following the initiation of ATT. Patients’ liver function was closely monitored through regular serum transaminase and bilirubin level assessments. Results: The incidence of ATT-induced hepatotoxicity was found to be significant, with 10% of patients developing hepatitis. The onset of liver dysfunction typically occurred around 3 weeks after starting ATT. Hepatotoxicity was more prevalent in elderly patients and those with pre-existing comorbid conditions such as diabetes and hepatic dysfunction. Conclusion: ATT-induced hepatotoxicity remains a common complication in TB treatment, necessitating close monitoring of liver function, especially in high-risk groups. Regular monitoring of liver enzymes, particularly in older patients or those with comorbidities, is crucial to prevent severe liver damage and to ensure effective management of TB. Keywords: Tuberculosis, ATT-induced hepatitis, Transaminases, Bilirubin.

Background: Evaluation of Response and Toxicity in Patients Receiving NACT with Platinum + Taxane Vs Platinum+Taxane+5FU for Head and Neck Squamous Cell Carcinomas. Materials and Methods: The present longitudinal observation study was conducted in Department of Radiation oncology, Gandhi Medical College and associated Hamidia Hospital (GMC & HH), Bhopal (M.P) and Jawaharlal Nehru Cancer Hospital (JNCH), Bhopal (M.P), on a total of 54 patients of Head and Neck Squamous Cell Carcinoma from 1st July 2022 to 31st December 2023, a period of 18 months. Fifty-four patients were randomized into two groups, receiving either TPF or TP regimens Responses were assessed using RECIST 1.1 criteria, and toxicities were evaluated using CTCAE v5.0. Results: Partial responses were observed in 65% and 48% of patients in the TPF and TP groups, respectively. Grade 3-4 toxicities, including hematological and gastrointestinal events, were more frequent in the TPF group (72%) compared to the TP group (41%). Conclusion: While the TPF regimen demonstrated superior response rates, it was associated with higher toxicity. The TP regimen may be preferred for patients with poor performance status or significant comorbidities. Keywords: Neoadjuvant therapy, chemotherapy, squamous cell carcinoma, oral cavity

Background: hs-cTnI (high-sensitivity cardiac troponin) is a biomarker that is used widely in the identification and assessment of ischemic heart pain in the emergency departments of Indian Institutes. However, the clinical effect of the eCABG (emergency coronary artery bypass grafting) is underestimated. Aim: The present study was aimed to evaluate the clinical effect of measuring high-sensitivity cardiac troponin at the emergency department by comparison of eCABG in subjects with (NSTE-ACS) non-ST-segment elevation acute coronary syndrome that includes UA (unstable angina) and NSTEMI (non–ST-segment– elevation myocardial infarction). Materials and Methods: The present study assessed 484 subjects who underwent emergency coronary artery bypass grafting and were divided into groups based on serum high-sensitivity cardiac troponin levels. The primary outcome assessed was a major cardiovascular cerebral event (MACCE) defined as stroke, repeat revascularization, myocardial infarction, and all-cause death collectively. The incidence of each MACCE along with postoperative complications such as hospital duration, atrial fibrillation, re-surgery, and acute kidney injury were compared. Results: 484 subjects were divided into 2 groups unstable angina with <0.04 ng/ml and comprised of 204 subjects and NSTEMI with ≥0.04 ng/ml and comprised of 280 subjects. MACCE incidence showed no difference in the two study groups. In the NSTEMI group, postoperative acute kidney injury was more frequently seen with p=0.03. Also, hospital stay duration was significantly higher in the NSTEMI group compared to the UA group with p=0.007. Conclusions: The present study concludes that emergency coronary artery bypass grafting in non–ST-segment–elevation myocardial infarction and unstable angina subjects result in comparable outcomes. However, elevated levels of hd-cTnI in an emergency can be correlated to immediate postoperative complications. Keywords: coronary artery bypass grafting, eCABG, MACCE, NSTEMI, hs-cTnI (high-sensitivity cardiac troponin).

Background: AMH levels are usually high in subjects with high BMI and obesity, which is a peculiar feature of PCOD. Hence, higher AMH levels in females with PCOD can be attributed to increased AMH secretion from an increased number of small antral follicles. Aim: The present study aimed to evaluate the relationship between BMI (bone mass index) and serum AMH (anti-mullerian hormone) levels in infertile females with and without PCOD (polycystic ovarian disease). Materials and Methods: The present study assessed 400 females who visited the Institute within the defined study period. All subjects underwent gynecological assessment and basic infertility tests, including BMI. All females' AMH levels were assessed, and subjects were divided into two groups: subjects with PCOD and subjects without PCOD. Results: The study results showed an overall AMH level of 4.84±4.42 ng/ml. No significant correlation was seen in AMH and BMI levels in females without PCOD with p>0.05. However, in subjects with PCOD, a significant inverse correlation was seen in AMH and BMI levels with p<0.05. Conclusions: The present study concludes that there is no significant correlation between AMH and BMI levels in infertile females without PCOD. However, in females with PCOD, there is a significant inverse correlation between serum AMH levels to BMI. Keywords: Antimullerian hormone, body mass index, Infertility, polycystic ovarian disease.

Background: Accurate selection of endotracheal tube (ETT) size in paediatric patients is critical to ensure safe and effective airway management. Traditional age-based formulas, such as the Motoyama formula, may not account for individual anatomical variations. Aim: This study aimed to evaluate the reliability of ultrasonography (USG) in determining the appropriate ETT size and compare it with the Motoyama formula. Materials and Methods: A prospective observational study was conducted on 64 paediatric patients aged 2–12 years undergoing elective surgeries under general anaesthesia at a tertiary care hospital in Gujarat. Subglottic diameter was measured using ultrasonography, and the appropriate ETT size was selected accordingly. This was compared with the size predicted by the Motoyama formula. The number of ETT changes required, time taken for USG, and clinically best-fit tube based on air leak test were recorded. Results: The mean subglottic diameter measured by USG was larger than the inner diameter predicted by the Motoyama formula. USG-based selection showed fewer tube changes and better correlation with the clinically best-fit ETT. The average time taken for USG was brief, supporting its feasibility in routine clinical practice. Conclusion: Ultrasonographic assessment provides a more accurate and individualized method for selecting ETT size in paediatric patients compared to traditional age-based formulas. Its routine use can enhance safety and efficiency in paediatric airway management. Keywords: Ultrasonography, Endotracheal Tube, Paediatric Airway.

Background: Total thyroidectomy is the standard surgical approach for benign and malignant thyroid diseases, traditionally performed via a transverse cervical (Kocher’s) incision. While effective, conventional methods often lead to increased scarring, postoperative pain, and longer recovery times. The Single Lateral Incision Total Thyroidectomy (SLITT) technique aims to minimize these drawbacks while maintaining surgical efficacy. Materials and Methods: This prospective observational study, conducted from January 2021 to January 2025, evaluated the feasibility, safety, and outcomes of the Single Lateral Incision Total Thyroidectomy (SLITT) technique in 270 patients. The SLITT technique was introduced by a surgeon from North Kerala, India, at EMS Memorial Co-operative Hospital, Perinthalmanna, and aims to provide a less invasive, cosmetically favorable alternative to conventional thyroidectomy. Patients underwent comprehensive preoperative assessment, and the surgery was performed through a single lateral incision, ensuring preservation of vital structures. Postoperative monitoring focused on complications, recovery, and patient satisfaction. The study highlights SLITT as a promising technique with potential advantages in cosmesis, recovery time, and surgical safety. Results: The retrospective analysis of 270 SLITT procedures demonstrated excellent surgical and postoperative outcomes. The majority of patients were female (86.3%) with a mean age of 44.6 years. Multinodular colloid goitre (76.3%) was the most common histopathological finding, and 95.6% underwent a right lateral incision with minimal blood loss (mean 13.9 mL) and a short operative time (mean 13.8 min). Postoperatively, complications were rare, with 87% experiencing no adverse events, and the mean hospital stay was just 2 days. Pain levels were minimal, with 100% pain-free status by 30 days. By 90 days, all scars were completely invisible, indicating excellent cosmetic and recovery outcomes. Conclusion: The SLITT technique offers a safe, efficient, and minimally invasive alternative to conventional thyroidectomy. In 270 patients, it demonstrated minimal blood loss, a short operative time, low complication rates, excellent pain control, and complete scar resolution by 90 days. These findings highlight its superior recovery, aesthetic benefits, and high patient satisfaction. KeyWords: Conventional Open Approach, Lateral Approach, National Comprehensive Cancer Network, Single Lateral Incision Total Thyroidectomy.

Background: The aim is Toxicity Analysis in Carcinoma Breast Patients Treated with Conventional and Hypofractionated Radiotherapy. Materials and Methods: A Longitudinal observation study was carried out at the Department of Radiation Oncology, Gandhi Medical College, along with the associated Hamidia Hospital (GMC & HH), Bhopal (M.P), and Jawaharlal Nehru Cancer Hospital (JNCH), Bhopal (M.P) from 1st July 2022 to 30th Dec 2023.This study involved a cohort of 68 patients diagnosed with breast cancer. Results: In our study, comparable rates of cardiac toxicity, assessed using RTOG criteria, were observed among breast carcinoma patients treated with either conventional or hypofractionation radiotherapy across various intervals. At 0 months, both treatment arms reported Grade 1 cardiac toxicity in 1 patient (2.94%) and no toxicity in 33 patients (97.06%), showing no significant difference (P = 1.0000). Conclusion: We conclude that hypofractionated radiotherapy is comparable to conventional radiotherapy in terms of adverse effects and locoregional tumor control, making it a safe and effective alternative for postmastectomy breast cancer patients in adjuvant settings. Hypofractionated radiotherapy results in similar cardiac and pulmonary toxicities as conventional fractionation and is a viable alternative for breast cancer patients. Keywords: Breast cancer, hypofractionated radiotherapy, late skin toxicity, survival.

Background: Aim: Descriptive study of female factor infertility by clinical, hormonal, sonological and endoscopical evaluation. Materials and Methods: Prospective Observational study conducted with a detailed history, clinical examination and basic investigations including HSG, USG, FSH, thyroid profile, prolactin were done in 100 cases of infertile women. Results: Out of 100 cases 68 cases were primary infertile and 32 were secondary infertile. The major infertile patients having duration of infertlity is 1-5 yrs i.e. 54%, in that Primary Infertile are 57%, Secondary infertile are 47%. Majority of secondary infertile women, 19 cases (59%) had previous history of abortions. Uterine factors accounted for 6% of infertility cases. 23 (33.82%) primary, 17 (53%) secondary infertile women had abnormal HSG findings. Most common being B/L tubal block, which contributes 15%, in this 13% primary and 22% secondary. Ovarian factors contributed to 49% of the cases in which laparoscopy was performed. 36% of primary and 13% of secondary infertility was caused by ovarian factors. PCOS was the leading ovarian factor responsible for infertility. Tubal factors were responsible for 22% primary and secondary infertility cases. Out of 8 cases of B/L tubal blocks, 6 were primary and 2 were secondary infertile. Uterine abnormalities contributing to 14% of total cases in which laparoscopy was performed. Peritoneal factors accounted for 21% cases of infertility. Among peritoneal factors, pelvic adhesions was found to be the leading factor. Majority of Infertility patients (70%) had B/L positive chromopertubation. Bilateral negative dye test was seen in 14% cases. Conclusions: All the clinical, harmonal, sonological and laproscopic findings are required in evaluation of all infertile patients. It will also be possible in formulating a specific plan of management and segregate the patients who will need ART at the earliest. Keywords: Assisted Reproductive Technology(ART), PolyCystic Ovarian Syndrome(PCOS), Hysterosalpigography (HSG).

Background: Oral squamous cell carcinoma (OSCC) is the most common type of oral cavity malignancy, with the tongue being one of the most commonly affected sites. It can also cause dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and paresthesia (numbness) of the tongue or mouth. The use of tobacco products, excessive alcohol consumption, HPV infection, a weak immune system, genetics, and oral irritation are the main factors that cause tongue cancer. Surgical excision with negative margins is the primary goal . Obtaining clear margin especially deep margin is difficult due to complex anatomy and poor assessment of spread of tumour . Aims and objectives: The study aims to identify whether USG-guided assisted resection of primary tongue lesions will help in the resection of adequate margins when compared with final histopathology. Materials and Methods: A total of 91 patients with diagnosed tongue malignancies were observed at Krishna Institute of Medical Sciences' surgical oncology department from 2020 to 2023, after obtaining written consent. Cases studied prospectively without randomization. A single pathologist reviewed the pathology specimen. The primary goal of this study is to delve into the potential impact of ultrasound-guided assistance during the resection of primary tongue lesions. Results: A total of 91 patients were included in the study. Most of the patients in our study are in the T2 stage, 36/91 i.e., 39.5 %. Deep margin as an outcome measure. The mean deep margin assessed by USG in our study was 0.901cm+/- 5.2 mm (mean +/- SD), and the mean deep margin assessed by the frozen section is. 0.762 cm +/- 4.8 mm. Higher stage T3 and T4 were strong predictors for inadequate deep margin but they were assessed correctly by USG assessment and allowed us to revise the margins to prevent close and positive margins. Conclusion: Ultrasound-guided surgery for tongue cancer resection is a technique that increases the chances of achieving clear margins and reduces the likelihood of positive margins compared to standard methods. Performing ex-vivo ultrasound on the resected specimen enables the assurance of extra clear margins. However, it's important to maintain consistent orientation of the specimen during both surgery and histopathological evaluation. Keywords: Ultrasonography, tongue, squamous cell carcinoma.

Background: Hemorrhoidal disease is one of the most common proctological disease and affects between 7 and 30% of the general population. Open hemorrhoidectomy is the current gold standard. However, it is associated with significant pain, bleeding and wound infection which can result in prolonged hospital stay. Laser hemorrhoidoplasty (LHP) is a new minimally invasive and painless procedure for symptomatic hemorrhoids. But there is conflicting evidence regarding their resolution of symptoms and recurrence rates. Materials and Methods: This is a prospective observational study conducted in a tertiary hospital in Visakhapatnam from January 2021 to December 2023. A total of 80 patients presenting with symptomatic grade III hemorrhoids were included in the study, of whom 40 underwent Laser Hemorrhoidoplasty (LHP) and 40 underwent open hemorrhoidectomy. Group selection was done by simple randomization using the lottery method. Postoperative pain levels were measured every day at rest during the entire hospital stay using the Visual Analog Scale (VAS). All patients received a follow-up after 15 days, 3months, 6 months and 1 year postoperative. Results: The MM procedure presented longer mean operative time (27 ± 3.7min vs 15 ± 2.3 min, p < 0.0001) and longer hospitalization (3.8 ± 1.2 vs 1.3 ± 0.7 days, p < 0.0001). Mean postoperative pain score evaluated through the visual analog scale (VAS) was significantly lower in LHP group (p < 0.0001) at each follow-up point. Patients after LHP returned to regular activity after 6.8± 1.4 days vs 13.6± 2.8 days after MM procedure (p < 0.001). 1 year follow up showed a higher recurrence rate after LHP procedure (15% vs 2.5%, p < 0.05). Conclusion: LHP is a safe, minimally invasive procedure with benefits in operative time, blood loss, postoperative pain and quicker return to activity, though recurrence rates might be higher. Though MM has immediate postop disadvantages including significant postoperative pain, this technique does result in a low risk of symptom recurrence. Keywords: LHP- Laser Hemorrhoidoplasty, MM- Milligan-Morgan (open haemorrhoidectomy), Hemorrhoidal disease.

Background: Labour pain is one of the most intensifying pain a women experience in her lifetime surpassing all expectations. A variety of labour analgesia options are available but neuraxial techniques such as epidural analgesia have emerged as the most acceptable world wide in managing labour pain effectively while minimizing the adverse effects in the parturients and the fetus. The aim & objective are 1. To estimate efficacy of 0.0625% bupivacaine &0.0002% fentanyl combination on Labour outcome 2. To study the effect of 0.125% bupivacaine alone on Labour outcome 3. To compare the effectiveness of 0.0625% bupivacaine & 0.0002% fentanyl combination with 0.125% bupivacaine alone on Labour. Materials and Methods: This randomized study was undertaken in department of Anaesthesiology in collaboration with Obstetrics & Gynaecology department and the Dept. of paediatrics in Hi-Tec medical college over a period of 2 years. Sixty ASA category I parturients at term with vertex presentation of a single live foetus in the 18-35 years age group were divided into two groups randomly, one receiving 0.0625% bupivacaine with 0.0002% fentanyl (Group A) and the other 0.125% bupivacaine alone(Group B). A 12ml bolus dose of the test solution at the rate of 2-3 ml/min followed by a continuous infusion of test solution at the rate of 10 ml/hr (range 8-15 ml/hr) till complete cervical dilatation. Maternal heart rate, blood pressure, foetal heart rate, visual analogue scale (VAS) score, intensity of analgesia, duration of labour, mode of delivery, maternal outcome were assessed. Results: No significant difference (P>0.05) were observed in haemodynamic profile, foetal heart rate, duration of labour, intensity of analgesia, mode of delivery, maternal satisfaction or neonatal outcome in both the groups. Group A required a higher infusion rate for maintenance, shorter time of onset of analgesia, lower quantity of bupivacaine, lesser incidence of motor paresis with a higher ambulation rate of 96% as compared to group B. Conclusion: Low dose bupivacaine with the short acting fentanyl can make labour and delivery a pain free process without compromising maternal and neonatal outcome while improving maternal satisfaction by enabling ambulation and reducing motor paresis thus providing a wholesome, satisfying experience to the obstetrician, anaesthesiologist and paediatrician. Keywords: Labour analgesia, Bupivacaine, Parturients, Epidural anaesthesia.

Background: Thrombocytopenia is a common haematologic abnormality in pregnancy, with moderate-to-severe cases potentially leading to adverse maternal and foetal outcomes. This study aimed to evaluate the maternal and foetal outcomes in pregnant women with mild-to-severe thrombocytopenia. Materials and Methods: This prospective observational study included 100 pregnant women at the Institute of Obstetrics and Gynaecology, Madras Medical College, over a year. Women in their third trimester with mild-to-severe thrombocytopenia (platelet count <100 × 109/L) were included. Clinical data, including maternal age, parity, gestational age, diagnosis, mode of delivery, and complications, were recorded. Foetal outcomes, such as birth weight, APGAR scores, neonatal complications, and platelet counts, were also analysed. Results: The most common cause of thrombocytopenia was severe preeclampsia (48%), followed by gestational thrombocytopenia (31%) and immune-mediated thrombocytopenia (7%). Most patients (92%) had moderate thrombocytopenia, whereas 8% had severe thrombocytopenia. Most deliveries were vaginal (59%), followed by emergency caesarean sections (37%). Postpartum haemorrhage (17%) and acute kidney injury (7%) were the most frequent maternal complications. Neonatal complications included transient tachypnoea of the newborn (23%) and perinatal asphyxia (11%). The overall live birth rate was 97%, with two stillbirths and one intrauterine foetal death. Conclusion: Moderate to severe thrombocytopenia during pregnancy, particularly in association with hypertensive disorders, is linked to increased maternal morbidity and adverse foetal outcomes. Early recognition and appropriate management can improve the prognosis. Notably, gestational thrombocytopenia had no significant adverse effects, and platelet counts normalised postpartum. Keywords: Thrombocytopenia in pregnancy, severe preeclampsia, maternal outcomes, foetal outcomes, platelet count.

Background: Airway management in patients with restricted mouth opening in emergency and elective surgeries becomes a major concern for anaesthesiologist. Although fiberoptic intubation is the generally accepted method for managing difficult airway, it may not be available in all the hospitals, requires patient cooperation and appropriate training. So awake blind nasal intubation can be useful in management of difficult airway. The aim of this study was to evaluate the usefulness of blind nasal awake intubation as an alternative technique when fiberoptic equipment is unavailable and insertion of ILMA not possible in patients of restricted mouth opening. Materials and Methods: This prospective observational study was carried out in 150 adult patients of either sex aged between 30 and 65 years with restricted mouth opening posted for elective surgery. Awake blind nasal intubation was carried out in a conscious sedated patient with proper airway preparation. The monitoring of breath sound becomes the key for successful intubation. We carried out awake intubation with the help of cuff inflation technique (the cuff of ETT is inflated in the oropharynx to help guide the tip of the tube into the trachea) along with monitoring by capnography and breath sounds. We have recorded manipulation in position of head and neck, number of attempts, failure of intubation and complications. Results: Out of 150 patients, 81(57.4%) patients were intubated in sniffing position, 32(22.6%) patients required increased neck flexion and 28(19.8%) required increased neck extension. 9 patients had failed intubation.47 patients(31.3%) were intubated in 1st attempt,43 patients (28.6%) were intubated in 2nd attempt and 51 patients (34 %) were intubated with 3 attempts. Conclusion: Awake blind nasal intubation is an alternative technique when there is non- availability of fibre optic or ILMA in patients of restricted mouth opening. Key words: Difficult airway, Restricted mouth opening, Blind nasal awake intubation.

Background: Medical Termination of Pregnancy (MTP) is a critical component of reproductive healthcare legally permitted under specific conditions. Understanding the trends and justifications for MTP is essential for optimizing clinical practice and ensuring legal compliance. This study aimed to evaluate the indications and socio-demographic factors associated with MTP over a three-year period at a tertiary care teaching hospital in India. Materials and Methods: A retrospective analysis was conducted on 355 women who underwent MTP between January 2022 to December 2024. Data was collected from hospital records using a structured proforma. Variables included age, parity, area of residence, gestational age, method of MTP, indication for MTP, presence of fetal congenital anomalies, and post-MTP contraception advised. Only cases with complete records and procedures conducted within the legal framework were included. Descriptive statistics were used for analysis. Results: Maximum women were belonging to age group of 26–30 years (37.18%), and the majority were rural residents (58.59%). Most women (88.45%) were married, and 42.54% had ≤2 children. MTPs were predominantly performed within 12 weeks of gestation (48.73%). The leading indication was contraceptive failure in married women (60.56%) followed by presence of fetal anomalies (23.66%) and pregnancies resulting from sexual assault (rape) (11.27%). Among anomaly-related terminations, syndromic disorders (3.94%), cystic hygroma (3.10%), and neural tube defects (2.82%) were most common. Post-MTP contraception predominantly included tubal ligation (44.51%) and barrier methods (40%). Conclusion: Contraceptive failure remains the dominant indication for MTP underscoring the urgent need for robust contraceptive counselling and access, especially in rural areas. Keywords: Medical Termination of Pregnancy, Tubal Ligation, Contraceptive Failure, Maternal health.

Background: Worldwide, acute appendicitis ranks high among the most common reasons for urgent abdominal surgery. To avoid complications like perforation and peritonitis, an early and precise diagnosis is crucial. Because it does not involve any radiation, is inexpensive, and does not require any incisions, ultrasonography (USG) has found extensive application. Nevertheless, there is still some debate regarding the veracity of specific ultrasonographic results. Acute appendicitis is the intended diagnosis, and this study intends to assess the diagnostic utility of particular USG markers in that regard. Materials and Methods: One hundred fifty patients admitted to a tertiary care hospital with symptoms of acute appendicitis were followed prospectively for a year. This study was conducted at the department of Pathology, Government Medical College Mancherial, Telangana, India from the May 2024 to December 2024. Ultrasound was used to evaluate all patients, checking for important signs including appendiceal diameter, wall thickening, peri-appendiceal fluid, hyperaemia, and appendicolith. Intraoperative and histological findings were compared with the ultrasonographic findings. Results: After reviewing the surgical and histological results, 110 out of 150 individuals were determined to have acute appendicitis. Hyperaemia on Doppler imaging (sensitivity: 88.2%, specificity: 82.5%), peri-appendiceal fluid (sensitivity: 72.3%, specificity: 89.1%), and an appendiceal diameter >6 mm (sensitivity: 85.4%, specificity: 78.9%) were the most dependable ultrasonographic markers. A specificity of 92.3% and a lesser sensitivity of 45.5% were observed in 30 cases when appendicolith was present. A diagnosis accuracy of 93.5% was achieved through the integration of various ultrasonographic results. Conclusion: When diagnosing acute appendicitis, ultrasonography is still quite useful. Hyperaemia and appendiceal diameter > 6 mm were highly sensitive results, while appendicolith and peri-appendiceal fluid were highly specific. Misdiagnosis is less likely when numerous ultrasonographic markers are combined. If we want to see better clinical results and more accurate diagnostic techniques, we need more large-scale investigations. Keywords: Acute appendicitis, Ultrasonography, Appendicolith, Sensitivity, Specificity.

Background: Psychological stress (PS) leads to different physiological responses including increased heart rate (HR) as well as decreased heart rate variability (HRV) through alterations in the autonomic nervous system (ANS), specifically increased sympathetic nervous system (SNS) activity and decreased parasympathetic (PNS) activity. Emerging evidence indicates that PS advances to certain alteration in the kidneys, which leads to increase in protein excretion and expression of high and low molecular weight proteins in the urine. Currently investigated biochemical markers for confirmation of stress include invasive, cumbersome and costly markers. This issue arises a need to introduce non-invasive and affordable stress markers which can be used globally. Materials and Methods: A total of 120 cases and 106 controls (who were without any obvious stress) belonging to age group of 20 to 60 years were selected. Patients were evaluated for clinical history and assessed by the psychiatric stress scale, perceived stress scale (PSS) and presumptive social life event scale (PSLE). HRV was measured by ECG using lead II configurations using both time domain and frequency domain methods. Urinary protein was analysed by Vitros 5.1 FS from Ortho Clinical diagnostics by Johnson and Johnson USA. Results: PSS was most strongly correlated with Power (ms2) LF/HF followed by Power (nu) HF and Power (nu) LF with a correlation coefficient of 0.805, -0.695 and 0.592 respectively. PSLE had a significant relation with Protein: Creatinine ratio. Conclusion: In short term HRV, frequency domain parameters had significant correlation with perceived stress and proteinuria had significant correlation with PSLE. Keywords: Stress, PSS, PSLE, HRV, Proteinuria.

Background: Vertebral compression fractures (VCFs) are common in aging populations and can result from osteoporosis, trauma, malignancy, or infection. Differentiating between benign and malignant causes is critical for appropriate treatment. MRI is a key diagnostic tool, but its sensitivity and specificity in identifying the etiology of VCFs require further evaluation. This study aims to assess the diagnostic accuracy of MRI in distinguishing different causes of vertebral compression fractures. Materials and Methods: This prospective study was conducted at Apollo Hospital, Hyderabad, including 49 patients with vertebral collapse who underwent MRI. Patients were categorized based on the etiology of VCFs: osteoporotic, traumatic, malignant, or infectious. Various MRI features such as pedicle involvement, posterior element destruction, epidural mass, and paraspinal soft tissue involvement were analyzed for their sensitivity and specificity in diagnosing VCF causes. Histopathology and clinical follow-up were used as reference standards. Results: Among 49 patients, 53% were male and 47% female, with the majority (67%) having dorsal vertebral involvement. Osteoporotic fractures accounted for 35%, malignant 27%, traumatic 20%, and infectious 18%. MRI features such as pedicle involvement (92% sensitivity, 91% specificity), convex posterior border (53% sensitivity, 94% specificity), and epidural mass had high specificity for malignancy. Contiguous vertebral involvement and endplate disruption were more indicative of benign fractures. A combination of MRI features significantly improved diagnostic accuracy. Conclusion: MRI is a highly specific tool for differentiating malignant from benign VCFs, particularly when multiple significant features are present. Pedicle involvement and convex posterior border are among the most reliable indicators of malignancy. Early and accurate MRI-based diagnosis is essential for guiding appropriate clinical management. Keywords: Vertebral compression fracture, MRI, malignancy, osteoporosis, pedicle involvement, diagnostic accuracy, spinal imaging.

Background: Transitional cell carcinoma of the bladder is a common malignancy of the urinary tract, with lymph node involvement being a key determinant of prognosis and treatment strategies. While lymph node metastasis is generally associated with invasive bladder cancer, its presence in non-invasive transitional cell carcinoma remains uncertain. This study aims to evaluate the incidence, risk factors, and prognostic implications of pelvic lymph node involvement in patients with non-invasive transitional cell carcinoma of the bladder. Materials and Methods: A retrospective analysis was conducted on 50 patients diagnosed with non-invasive transitional cell carcinoma of the bladder. Data on clinical presentation, tumor grade, pathological staging, lymph node dissection status, and recurrence rates were collected. Patients were categorized based on lymph node involvement and assessed for correlations with tumor characteristics and disease progression. Statistical analyses were performed to identify predictors of lymph node metastasis in this cohort. Results: Among the 50 analyzed cases, lymph node metastasis was identified in a subset of patients with non-invasive transitional cell carcinoma. The presence of lymph node involvement correlated with higher tumor grade, multifocality, and carcinoma in situ. Additionally, patients with lymph node-positive disease exhibited a significantly higher recurrence rate and reduced disease-free survival compared to those without lymph node involvement. Conclusion: Although rare, lymph node involvement can occur in patients with non-invasive transitional cell carcinoma of the bladder and is associated with a more aggressive disease course. Careful risk stratification is essential to identify patients who may benefit from more extensive staging and early intervention. Further prospective studies are required to refine treatment guidelines and improve outcomes in this subset of bladder cancer patients. Keywords: Transitional Cell Carcinoma, Bladder Cancer, Non-Invasive Bladder Cancer, Lymph Node Metastasis, Pelvic Lymph Node Dissection, Carcinoma in Situ, Bladder Tumor Staging, Disease Recurrence.

Background: Aim: The study aims to evaluate the role of ultrasonography in assessing first-trimester vaginal bleeding, identifying potential risk factors, and correlating ultrasound findings with clinical and laboratory parameters to predict pregnancy outcomes. Materials and Methods: This prospective observational study was conducted on 120 pregnant women aged 18–40 years presenting with first-trimester vaginal bleeding at a tertiary care hospital. Inclusion criteria included gestational age between 5–13 weeks confirmed by the last menstrual period (LMP) and/or ultrasound. Patients with ectopic or molar pregnancies, uterine anomalies, or hemodynamic instability were excluded. All participants underwent transabdominal and/or transvaginal ultrasound evaluation for gestational sac, fetal pole, cardiac activity, subchorionic hematoma, cervical length, and adnexal structures. Laboratory investigations included serum β-hCG levels, hemoglobin levels, Rh typing, and inflammatory markers. Statistical analysis was performed using SPSS 25.0, with significance set at p < 0.05. Results: The majority of participants were in their late twenties, with a mean gestational age of approximately 9 weeks. Ultrasonographic assessment confirmed the presence of a gestational sac in most cases, with fetal cardiac activity detected in over 70% of cases. Subchorionic hematoma and cervical length abnormalities were notable findings. Patients were categorized into viable intrauterine pregnancies, threatened abortion, inevitable abortion, incomplete abortion, missed abortion, complete abortion, and molar pregnancy. Laboratory findings revealed elevated β-hCG in most cases, with a significant proportion exhibiting anemia and inflammatory markers. While over half of the pregnancies continued successfully, a substantial number resulted in miscarriage, necessitating surgical intervention in some cases. Conclusion: Ultrasonography is a crucial tool in the evaluation of first-trimester bleeding, allowing for early detection of pregnancy complications. Laboratory investigations complement ultrasound findings in predicting pregnancy outcomes. Early identification of high-risk pregnancies enables timely medical intervention, improving maternal and fetal outcomes. A multidisciplinary approach involving obstetricians, radiologists, and laboratory specialists is recommended for optimal patient management. Keywords: Ultrasonography, First-trimester bleeding, Pregnancy outcomes, Subchorionic hematoma, Foetal viability.

Background: Intramedullary interlocking is currently considered the treatment of choice for femoral shaft fractures, with high rates of fracture union, advantage of early stabilization which decreases the morbidity and mortality rate in patients, allows early mobilization, reduces the incidence of infection, malunoin, non union or implant failure. Objectives of the study: To assess the time taken for bone union and the functional outcome in patients with fracture shaft of femur. Materials and Methods: We studied a total of 30 patients of fracture shaft of femur admitted in the Orthopaedic Department of Kakatiya Medical College, Warangal treated with closed intramedullary interlocking nailing. 23 patients were male and 7 were females and age group ranged from 18-49 years with mean age 30 Yrs. right side fractures encountered in 18 cases and 12 left side. 24 fractures were closed and 6 fractures were open type. 5 fractures were in proximal third, 19 fractures were in the middle third and 6 in distal third of femur. Duration of study 1 year{From September 2023 to August 2024}. Results: Duration between injury and surgery was <24 Hours in 6.67%, 24-72 hours in 50% and 4-7 Days in 43.3%.Duration of hospital stay was average 11.43 days ranging from 06-22days. Mean time for union was 21.3 weeks ranging from 16-32weeks.There were two cases of superficial infection and no deep infection. Excellent to Good result in 90% cases. Conclusion: We conclude that closed intramedullary interlocking nailing after is an excellent technique for the treatment of femoral shaft fracture. It is an excellent mode for treatment of complex, comminuted and unstable femoral fracture. It reduces the incidence of malunoin and maintains length of the bone. Minimal soft tissue injury during surgery, early rehabilitation ensures complete restoration of motion. It is a safe method in management of Type I& II compound fractures Key-words: Fracture; shaft; femur; closed; interlocking; intramedullary; nail; diaphyseal.

Background: To study the functional and radiological outcome of Acetabular fractures treated by open reduction and internal fixation. Materials and Methods: It was a prospective study, in our study we have selected cases of unstable acetabular fractures. The study was done from November 2023 to December 2024.The age group differs from 18 – 70 years, among them16 males and 4 females.Among 20 patients right side involvement is seen in 13patientsand left side involvement is seen in 7 patients.Mean follow up was done for 12 months. All the classification have been classified by Letournel and Judet classification. All the cases were followed up and were evaluated for radiological and functional outcome .X-ray pelvis isused for assessing the radiological outcome, AP view, Obturator Oblique view and Iliac oblique views were used for assessment. For evaluating the functional outcome Merle D’Aubigne and Postel modified clinical grading system is used. Results: In the present study, According to Matta’s criteria, 8 patients had anatomical reduction, 8 patients had satisfactory reduction and 4 patients had poor reduction (>3mm gap). Out of 20 patients, 6 patients had excellent, 3 patients very good, 6 patients good, 3 patients fair, 2 patients had poor results. 70% of the patients are having near normal life and 10% patients are having satisfactory result in our study Functional outcome score for the patients ranged from11 –18, (maximum score –18).The poor result (score – 8,9) in 2 patients was due to post traumatic arthritis, improper post op mobilisation due to poly trauma. All patients with anterior column fracture, posterior wall had excellent or good result 00 ‘except one patient who had fair result due to Heterotopic ossification. Three patients with fair outcome had minor wound infections treated with antibiotics and it healed. Conclusion: From our study we conclude that complex acetabular fractures treated by open reduction and internal fixation have satisfactory functional outcome. Keywords: Acetabular fractures, Matta’s Criteria, Anatomical Reduction, Heterotopic Ossification, Poly trauma.

Background: Low back pain (LBP) is a major health and socioeconomic problem in modern society. It constituted about 37% of occupational risk factor and occupies first rank among the disease complications caused by work. Aim: To study the effectiveness of epidural steroid injection in alleviating symptoms caused by prolapsed intervertebral disc. Materials and Methods: It was a prospective study, Patients with low backache visiting Mahatma Gandhi Memorial Hospital, Warangal, from October 2023 to September 2024. Results: Out of 60 cases, 30 were given Epidural steroid and 30 were given Normal saline among them36 were interlaminar, 13 were transforaminal and 11 w ere caudal approach. In our study the mean age of the patients was 47.7. In our study out of 60 patients 40 were females and 20 were males. Significant results were seen when patients were followed at 2nd,3rd and 4th month when observed with VAS and ODI scores. Epidural steroid injection has also shown significant improvement compared to saline on SLRT.In case of SF36 bodily pain, general health and role of emotional showed a significant outcome at 6 months, however by 1 ½ years not much difference was seen. Interlaminar approach is found as the best approach for ESI (Interlaminar>Transforamina l > Caudal). The only one patient that shifted from epidural to discectomydidso due to worsening deficits and pain. Conclusion: The present study concluded that ESI is a viable modality for selected patients, the evidence is good for radiculitis secondary to disc herniation with local anesthetics and steroids, involving minimal risk. Keywords: Epidural Injection, VAS, Low back pain, SLRT, ODI.

Background: To study the effects of intravenous fluids given intraoperatively on graft function postoperatively. Materials and Methods: In this double blind study, patients were randomized into two groups (n1=35,n2=39) to receive either combination of normal saline & half normal saline or combination of normal saline & ringer lactate during renal transplantation. Arterial blood gas analyses were performed before induction of anesthesia, during vascular anastomosis, one hour after bladder clamp release and after extubation. Blood urea and serum creatinine were measured on first postoperative day and on second postoperative day. Urine output was recorded on first & second postoperative days. Results: There was a statistically significant increase in the highest serum potassium level, highest chloride level and increase in the serum chloride measured at the end of study in patients who received combination of NS & half NS. Statistically significant increase in blood urea & serum creatinine was seen in immediate postoperative period in patients who received combination of NS & Half NS. Conclusion: Serum creatinine was higher in group 1 than in group 2 preoperatively & immediate postoperatively. However the decrease in serum creatinine from baseline level to immediate postoperative level and that measured on first & second postoperative day were similar in both the groups. Keywords: Intravenous fluids, Renal transplantation, Acid-base balance, postoperatively.

Background: Neonatal sepsis is a significant cause of morbidity and mortality, particularly in developing regions such as Bundelkhand, Central India. The emergence of multidrug-resistant organisms has complicated the management of sepsis, making the identification of prevalent bacterial pathogens and their antimicrobial sensitivity patterns crucial. This study aims to analyze the clinico-bacteriological profile of neonatal sepsis and assess the antimicrobial sensitivity patterns of the isolated pathogens in a tertiary care center in Bundelkhand. Materials and Methods: An observational cross-sectional study was conducted, including 300 neonates with suspected sepsis admitted to the Neonatal Intensive Care Unit (NICU). Blood cultures were obtained, and the antimicrobial sensitivity patterns of the isolated pathogens were determined using standard laboratory methods. The neonates were categorized based on the onset of sepsis as early-onset (EOS) or late-onset (LOS). Results: Out of 300 neonates with clinical sepsis, 52% were culture-positive. Among the culture-positive cases, 75.6% were classified as EOS and 24.4% as LOS. The most commonly isolated pathogens were Gram-negative bacteria, including Klebsiella pneumoniae and Acinetobacter spp. The study also identified significant resistance patterns, particularly against commonly used antibiotics such as ampicillin and cephalosporins. Vancomycin and carbapenems showed higher sensitivity among Gram-positive and Gram-negative isolates, respectively. Conclusion: The high prevalence of multidrug-resistant organisms in neonatal sepsis underscores the need for continuous surveillance and tailored antimicrobial therapy in this region. The findings highlight the importance of region-specific studies to inform empirical treatment protocols and reduce neonatal mortality. Keywords: Neonatal sepsis, Antimicrobial sensitivity, Bundelkhand Central India, Gram- negative bacteria, Multidrug -resistant organism.

Background: The aim is to evaluate the impairment of oral sensations in patients treated with Three-Dimensional Conformal Radiotherapy (3DCRT) and Intensity Modulated Radiation therapy (IMRT) in head and neck cancer. Materials and Methods: This Longitudinal Observational study will be conducted in patients receiving IMRT and 3D-CRT from July 2022 to Dec 2023 in Department of Radiation Oncology at Gandhi Medical College (GMC), Bhopal (M.P) and Jawaharlal Nehru Cancer Hospital & Research Centre (JNCH & RC) Bhopal (M.P) from July 2022 to Dec 2023. Results: Both 3DCRT and IMRT are effective in managing head and neck cancers, IMRT offers superior outcomes in reducing dysphagia during and shortly after treatment. Both modalities ultimately achieve high rates of complete recovery, underscoring the effectiveness of modern radiotherapy approaches in managing treatment-related side effects. Conclusion: Our findings reveal that both treatment modalities have distinct impacts on dysesthesia and dysphagia, reflecting their differing mechanisms and target precision. The results indicates that, while pretreatment dysesthesia and dysphagia grades were similar between the two groups, significant differences emerged post-treatment. Keywords: Dysesthesia, Radiotherapy, Intensity Modulated Radiation therapy, Three-Dimensional Conformal Radiotherapy.

Background: The aim is to compare between intensity modulated radiation therapy with or without simultaneous integrated boost in locally advanced oral cavity carcinomas in patients admitted/visited to hospital. Materials and Methods: The present study entitled was conducted in Department of Radiation oncology, Gandhi Medical College and associated Hamidia Hospital (GMC & HH), Bhopal (M.P) and Jawaharlal Nehru Cancer Hospital (JNCH), Bhopal (M.P), on a total of 54 patients of advanced oral cavity carcinomas. Results: After means follow up with patients’ comparison between intensity modulated radiation therapy with or without simultaneous integrate boost was done and noted details in tables. Conclusion: The study concluded that there were no statistically significant differences in demographic distributions, clinical characteristics, acute and long-term toxicities, and post-treatment responses between the two groups treated with and without Simultaneous Integrated Boost (SIB) in locally advanced oral cavity carcinomas. Both treatment modalities demonstrated similar efficacy and safety profiles. Keywords: Clinical outcomes, head and neck cancer, intensity-modulated radiotherapy, sequential, simultaneous integrated boost.

Background: Prostate cancer is a leading cause of cancer-related mortality among men, with diagnostic limitations in current methods like PSA assays, DRE, and TRUS biopsies. This study aimed to evaluate the correlation between various biomarkers, including Ki-67/MIB-1 and ERβ, and the recurrence of prostate cancer. Materials and Methods: This prospective observational study included 110 patients diagnosed with prostate cancer at a tertiary care hospital in New Delhi. Patients were monitored over 12 months, with data collected on PSA indices, Ki-67/MIB-1, ERβ expression, and MRI PI-RADS scores. Statistical analyses were conducted to assess the significance of these parameters in predicting disease recurrence. Results: Higher Ki-67/MIB-1 expression and increased PSA velocity were significantly associated with recurrence. Although the correlation between PI-RADS scores and recurrence was not statistically significant, 60% of recurrent cases had a PI-RADS score of ≥4. ERβ expression was notably higher in patients with recurrence, indicating its potential as a prognostic marker. Conclusion: The study concludes that combining PSA indices, immunohistochemical markers (Ki-67/MIB-1, ERβ), and advanced imaging techniques (MRI PI-RADS) offers a more robust approach to predicting prostate cancer outcomes. Regular follow-up with tailored diagnostic strategies is essential for early detection and timely intervention, particularly in patients with high-risk markers. Keywords: Prostate cancer, PIRADS, Ki-67, MIB-1.

Background: Acute kidney injury (AKI) is a leading cause of morbidity and mortality globally, particularly in resource-limited settings. The etiology and severity of AKI vary based on multiple factors, including infections, dehydration, drug use, and environmental exposures. This study aimed to investigate the etiology, clinical manifestations, and predictors of severity in community-acquired AKI. Materials and Methods: This retrospective observational study was conducted at a tertiary care center. A total of 246 patients diagnosed with AKI were included retrospectively for a period of 5 years. Data were collected on demographic characteristics, clinical presentation, laboratory parameters, and etiology. AKI severity was classified as stage 1, 2, or 3 based on serum creatinine levels and clinical condition. Multivariate logistic regression was used to identify predictors of stage 3 AKI. Results: The most common etiologies of AKI were infectious causes (46.7%), dehydration-related (22.4%), and drug-induced (18.3%). Infectious causes were more prevalent in stage 3 AKI cases (54.3%), while dehydration-related AKI was more frequent in stage 1 cases (35.6%). The mean serum creatinine was significantly higher in stage 3 cases compared to stage 1 and stage 2 cases (3.4 ± 1.5 mg/dL). Factors associated with increased risk of stage 3 AKI included elevated serum creatinine >4 mg/dL (OR 4.2, 95% CI 2.1–8.6), blood urea nitrogen >60 mg/dL (OR 3.7, 95% CI 1.8–7.2), hypotension (OR 2.8, 95% CI 1.5–5.2), oliguria (OR 5.6, 95% CI 3.1–10.2), and advanced age (>60 years) (OR 1.6, 95% CI 1.0–2.9). Conclusion: Infectious causes, dehydration, and hypotension were the most common etiologies and significant predictors of stage 3 AKI. Early identification of at-risk patients, especially those with elevated creatinine, oliguria, and hypotension, can help improve clinical outcomes. Further studies are needed to validate these findings and identify additional biomarkers for AKI progression. Keywords: Acute kidney injury, serum creatinine, oliguria, hypotension, community-acquired AKI.

Background: Aims and objectives: the study was conducted to compare fistulectomy v/s fistulotomy in the management of low anal fistulae. Materials and Methods: The study is conducted among indoor patients of general surgery department in a tertiary care hospital of South Gujarat. 60 patients are included in the study which are divided randomly into 2 groups: Group A – Patients undergoing Fistulectomy Group B – Patients undergoing Fistulotomy. Results: The mean operating time for fistulotomy is 42.83 minutes with SD of 8.38 while the mean operating time for fistulectomy is 50.17 minutes with SD of 7.71. Mean duration for wound discharge for fistulotomy comes to be 20.47 days with SD of 5.22; while the mean duration of wound discharge for fistulectomy comes to be 33.53 days with a SD of 5.58. This time was noted for each operated case and the mean wound healing duration for fistulotomy was 35.97 days with SD of 7.32 while the mean duration for fistulotomy was 47.07 days with SD of 7.72. Mean hospital stay for fistulotomy was 2.37 days while mean hospital stay for fistulectomy was 3.03 days. Conclusion: From our study we can conclude that perianal fistula has a male predominance in incidence and more in young adults. Inter-sphincteric fistulae are more common than trans- sphincteric fistulae in patients suffering from low perianal fistulae. Keywords: Fistulotomy, Fistulectomy, Fistula-in-ano, Pain.

Background: Blood transfusion continues to be an important source of pathogens in transfused patients. An unsafe blood transfusion is extremely costly, both in terms of human lives and economic impact. Transfusion-transmitted infections (TTIs) pose a significant risk associated with blood transfusions. Accurate risk assessments of TTIs are crucial for ensuring the safety of the blood supply. The objective of this study is to assess the seroprevalence of transfusion-transmitted infections (TTIs) among healthy blood donors in North India population. Materials and Methods: A retrospective observational study was conducted in the department of Transfusion Medicine of a tertiary care hospital of North India. The study period spanned from January 2018 to December 2023, during which data from all blood donors was reviewed and analyzed for the prevalence of TTIs. Results: The present study included 44,016 donors for seroprevalence of TTIs. Overall, 1675 donors (3.8%) had a reactive result for one or more TTIs. Conclusion: Raising public awareness about voluntary blood donation, along with thorough donor screening, counseling, and the use of highly sensitive tests, can help reduce the risk of TTIs. Keywords: Blood Transfusion, Blood Donors, Donor Screening, Seroprevalence, Transfusion-Transmitted Infections.

Background: ENT disorders can manifest with varied ocular symptoms due to involvement of orbit and its content. Early diagnosis and treatment help in reducing the mortality associated with it. The aim of this study is to evaluate the causes of various ophthalmological presentations in relation to primary ENT diseases at a tertiary referral centre. Materials and Methods: The present prospective study was carried out in Department of otorhinolaryngology of Government Medical College, Pali, Rajasthan, India during one-year period and comprised of 30 cases. Data regarding age, gender, clinical profile, etiology and management were collected and statistical analysis was done. Results: The greatest number of patients were in the age group 51 to 60 years (7; 23.33%) followed by 41 to 50 years (20%). There were 14 (46.66%) males and 16 (53.33%) females. Most common ophthalmological symptom among the study population was periorbital oedema (50%) followed by epiphora (46.66%). The most common aetiology was infective or granulomatous (10, 33.33%), traumatic (8, 26.66%) and neoplastic (8, 26.66%). Conclusion: Rapid diagnosis and treatment is necessary for preserving vision and life in these patients. Teamwork between ophthalmologist and the otolaryngologist is required for the appropriate management of such lesions. Keywords: Ophthalmologic Presentations, ENT Diseases, Proptosis, Periorbital Oedema.

Background: Chronic suppurative lung disease (CSLD) is the end result of chronic airway inflammation that is driven by persistent infection. The aim of this study to evaluate the prevalence and associated risk factors with isolation of multidrug resistant pathogens in chronic suppurative lung disease. Materials and Methods: The present prospective study was conducted in fifty-two chronic suppurative lung disease patients between the age of 18-90 years at Respiratory Medicine Department of TB & Chest Hospital, Badi in R.N.T. Medical College, Udaipur during one-year period, after getting approval from institutional ethical committee. Results: Suppurative lung diseases were more frequent in male patients. Male female ratio is 2.06. More than three fourth patients of suppurative lung disease belong to rural area. In both type of suppurative lung disease, pseudomonas was the most common organism isolated from the biological samples. Second common organism isolated was klebsiella in patients of bronchiectasis and lung abscess. Risk factors for MDR pathogen were multifactorial for both pseudomonas and klebsiella. Conclusion: While dealing with suppurative lung disease antibiotic should be judicious and adequately used and underlying lung and systemic disease should be appropriately managed. Keywords: Chronic suppurative lung disease (CSLD), Pseudomonas, Bronchiectasis, Lung abscess, Klebsiella, MIC.

Background: Urothelial carcinoma comprises 90% of bladder tumor. The p53 gene is a tumor suppressor gene located on chromosome 17p; important for genome stability, response to genotoxic stimuli, and activation of apoptosis. Nuclear antigen Ki-67 coded by gene on chromosome 10 is absent in resting cells (G0 phase) and hence exclusively positive in the nuclei of proliferating cells. Materials and Methods: This was a prospective study. All cases presenting with hematuria were subjected to ultrasonography and cystoscopy then TURBT chips or cystectomy was performed in patients showing growth by cystoscopy. In the IHC the homogenous nuclear positivity was seen as dark brown colour. The percentage of immunopositivity was calculated by counting atleast 1000 tumor cells in areas of maximum positivity. The cells having nuclear positivity are calculated in the ratio of total number of cells. The results were interpreted taking the cutoff value as 20% and divided into three categories as immune negative, 20% as high expression for both immunomarkers positivity. Data was analysed using chi square statistical methods. P value less than 0.05 was considered as significant. Results: P53 positivity with more than 20% expression was found in high grade urinary bladder carcinomas and cases with pT2 stage. Some Low grade urothelial carcinomas with lamina propria invasion (pT1) also showed high p53 expression. There were high grade tumors also showing low expression of p53. So, prognosis was good in those cases. Ki67 expression was increased with increased grading and staging of bladder carcinomas. In Squamous cell carcinoma p53 showed low expression and ki67 showed high expression. Adenocarcinoma of the bladder showed high p53 and ki67 expression. Other high grade non papillary urothelial carcinomas also showed high p53 and ki67 expression. Conclusion: Urothelial carcinoma is the seventh most common cancer in the world. Many factors have been known as risk factors of this condition. Spectrum of p53 and Ki67 are useful as potential prognostic markers in bladder cancers. Key words: p53, Ki67, Urinary bladder carcinoma.

commonest cause of death from cancer in women worldwide. Breast cancer is one of the most frequent cancers among women in developing country. The combined study of p53 expression and Ki-67 in breast carcinoma is very helpful in assessing the prognosis & patient outcome. Materials and Methods: 50 cases of breast carcinoma was carried out in the department of pathology. The haematoxylin and eosin(H&E) stained sections of the cases were made and diagnosed and selection of representative tumour paraffin blocks was done on which IHC was performed. Immunohistochemical staining is conducted and the proportion of the malignant cells staining positive for the nuclear antigen Ki-67 is evaluated in a quantitative and visual way using light microscopes. Evaluation of p53 immunostaining was also done. Descriptive statistical analysis has been carried out in the present study. Results on continuous measurements are presented on mean±SD (min-max) and results on categorial measurement are presented in number (%). Results: Majority 23 cases (45.9%) showed moderate proliferative activity, followed by 16 cases (31.9%) showing low proliferative activity. 11 cases (22.2%) showed high proliferative activity. The majority of 44 cases (88.9%) were positive for p53 expression of which maximum 18 cases (36.1%) showed>50% of p53 expression. 19 cases (38.9%) had 20-50% of p53 expression. In our study 41.6% of Grade 1 tumors showed moderate p53 expression. Maximum no of Grade II tumors showed moderate to high p53 expression. 40% of Grade III tumors showed high p53 expression. In our study IDC (NOS) showed maximum moderate to high p53 expression. In our study the maximum number of cases (23) belong to Grade 2 showing moderate Ki-67 expression, and >49% of p53 expression. Conclusion: In breast cancer, we suggested that the over expression of Ki67 & p53 protein in the nucleus is an indicator of poor prognosis. Key words: Breast Cancer, p53, Ki67.

Aim: Regional anaesthesia offers significant advantages over general anaesthesia for lower abdominal and lower limb surgeries, with intrathecal and epidural techniques being the most commonly used. The aim of this study is to evaluate complications and hemodynamic stability of dexmedetomidine with bupivacaine vs fentanyl with bupivacaine used for intrathecal anaesthesia in patients undergoing orthopaedic lower limb surgeries. Materials and Methods: The study cohort was categorised into two groups, each consisting of 20 participants. Group 1 received an injection of 2.5 mL of hyperbaric bupivacaine combined with 25 µg of fentanyl in 0.5 mL, while Group 2 was administered 2.5 mL of hyperbaric bupivacaine along with 5 µg of dexmedetomidine in 0.5 mL. A comprehensive pre-anaesthetic assessment, which included a general and systemic examination, was conducted the evening prior to the surgical procedure. Standardised investigations were performed on all subjects. Following the acquisition of informed written consent for both the study and the surgical intervention, each patient was prescribed 0.5 mg of alprazolam and 150 mg of ranitidine to be taken orally the night before surgery. Additionally, patients were instructed to refrain from oral intake from midnight on the day preceding the surgery. The intraoperative hemodynamic profiles of the two study groups were subsequently compared. All the statistical calculations were done through SPSS software. Results: Mean age of the patients of group 1 and group 2 was 45.3 years and 42.9 years. Alterations in hemodynamic variables in group 1 occurred gradually, ultimately reaching a stable state that persisted throughout the duration of the surgical procedure. In contrast, group 2 exhibited more pronounced changes and declines in hemodynamic variables, which were found to be statistically significant. Complications were seen in 15 percent of the patients of group 1 and in 45 percent of the patients of group 2. Conclusion: The addition of dexmedetomidine to intrathecal bupivacaine resulted in a more rapid onset and extended duration of the block when compared to intrathecal fentanyl. Both medications did not exhibit significant adverse effects, with the exception of transient abruptly decline in hemodynamic response with dexmedetomidine. The dexmedetomidine group demonstrated a more favourable profile regarding postoperative complications. Keywords: Bupivacaine, Fentanyl, Dexmedetomidine.

Background: Cataract represent the primary cause of preventable blindness globally. Cataract surgery is primarily indicated when there is a significant decline in visual acuity and/or an increased sensitivity to light. Hence; the present study was conducted to evaluate complications and postoperative visual outcomes of cataract surgeries. Materials and Methods: A total of 50 patients undergoing cataract surgery were enrolled. Complete demographic and clinical details of all the patients were obtained. A comprehensive pre-operative assessment of the eye, including an evaluation of visual acuity, was conducted. All patients subsequently underwent cataract surgery. Post-operative evaluations were conducted using a slit-lamp biomicroscope on the first day following surgery and again within the first week, focusing on the cornea, surgical wound, anterior chamber, and the implanted lens. During follow-up visits, the eyes were examined for any post-operative complications, and visual acuity was measured using Snellen’s chart and pinhole testing to establish best corrected visual acuity (BCVA). All the results were evaluated using SPSS software. univariate analysis was done for evaluation of the level of significance. Results: A total of 50 patients were evaluated. The mean age of the patients was 46.2 years. Among them, 66 percent were males while the remaining were females. Complications were seen in 18 patients (36 percent). Among them, Striate keratopathy, Corneal edema, Anterior uveitis, Macular edema and Acute onset endophthalmitis was seen in 10 percent, 6 percent, 6 percent, 12 percent and 2 percent of the patients. Good outcome was seen in 90 percent of the patients while borderline outcome and poor outcome was seen in 4 percent and 6 percent of the patients. Conclusion: The findings indicated a significant prevalence of striate keratopathy and corneal edema, likely attributable to the initial incision made in the corneoscleral region. Notably, ninety percent of the cases that underwent surgery exhibited favorable outcomes. Keywords: Visual Outcome, Cataract surgery.

Background: Blood components play a crucial role in the treatment of various clinical conditions and help mitigate complications associated with whole blood transfusions. Assessing the utilization patterns of blood components, monitoring demand, and implementing effective audit procedures are essential steps in ensuring the optimal utilization of this invaluable resources. The purpose of this study is to evaluate the utilization of various blood components, packed red cell volume, fresh frozen plasma, and platelet concentrate, at a tertiary care centre. Methods and Materials: In this retrospective cross-sectional study, data regarding the utilization of blood products was collected over the span of one year, from January 2022 to December 2022. This data was obtained from blood centre registers and compiled in Microsoft Excel sheet for subsequent analysis, allowing for the assessment of the utilization patterns of different blood components in various departments. Results: A total of 2,647 blood units were issued in the study duration. The most frequently used blood product was Packed Red Blood Cells, followed by Fresh Frozen Plasma and Random Donor Platelets. Packed Red Cells were predominantly utilized by Medicine department, closely followed by the Surgery department. Notably, patients with anemia and those undergoing surgery had the highest demand for Packed Red Cells. Conclusion: Conducting regular audits on the usage of blood components is imperative for every blood bank. These efforts serve multiple purposes, not only partially fulfilling the current demand for blood products but also curbing unnecessary wastage of these vital resources. Keywords: Blood component, PCV, FFP, RDP, Utilization.

Biliary atresia is a rare and life-threatening liver disease that primarily affects infants. Early diagnosis and timely intervention are crucial for improved outcomes. This retrospective study aimed to diagnose cases of biliary atresia through histopathological examination and confirm the diagnosis using immunohistochemical stains. Additionally, the study sought to correlate the histological findings with the clinical presentation. In 3 years (2019- 2022),11 cases of biliary atresia were analyzed, comprising 6 male and 5 female patients. All patients presented with elevated bilirubin levels (both direct and total) along with deranged liver enzymes. The key histopathological finding that consistently led to the diagnosis of biliary atresia in all 11 cases was characterized by portal tract expansion and oedematous fibroplasia, accompanied by bile ductular proliferation. Inflammatory cell infiltrates were also noted in the liver biopsies. Therefore, biliary atresia is a complex disorder with variable outcomes, underscoring the importance of prenatal screening and early postnatal detection. Timely surgical intervention and histological examination play crucial roles in managing this condition effectively. Further research and awareness are essential to optimize diagnostic and therapeutic strategies for biliary atresia, ultimately improving the prognosis for affected infants. Keywords: Biliary Atresia, Bile Duct Proliferation, Neonatal Jaundice, Kasai Procedure, Liver Biopsy.

Background: Dengue is the most common arthropod-borne viral fever in travellers returning from most tropical and subtropical destinations worldwide. The common symptoms associated with dengue fever is fever, myalgia, headache etc. Materials and Methods: This is a hospital based, retrospective study conducted at Tezpur medical college and hospital, Tezpur, Assam. It included confirmed dengue cases from January 2021 to October 2023. The objective of the study is to analyze the clinical and laboratory parameters of dengue to facilitate early diagnosis and better management of dengue cases. Results: On analysis, it has been found out that among 98 patients included in the study, 29% of patients are in 30-39 years, 27% of patients fall in age group of 21-29years,16% in 40-45 years, 11% in 18-20 years, 8% each in age group of 50-59 years and 60-69 years and 1% in 70-79 years. On evaluation it was calculated that 74% of patients are males and 26% females. Regarding the duration of fever, it has been found out that 45% of patients had 5-10 days, 36% had < 5 days,12% had 11-20 days, 5% had 21-30 days,2% had >30 days. On evaluating the dehydration status, 19% of the patients had dehydration. Bleeding symptoms were manifested in 11% of the patients. Conclusion: Dengue fever is associated with high morbidity and mortality. Early diagnosis and treatment of dengue fever is necessary to prevent complications. Keywords: Dengue fever, hematological profile, duration of fever, dehydration, bleeding manifestation.

Background: Various scoring systems have been devised throughout the years to determine the gravity of patients' ailments or their prognosis. Our inquiry delved into the effectiveness of the Mannheim Prognostic Index (MPI) in predicting mortality risk, complications, extended hospital stays, and the need for intensive care unit (ICU) admission among all patients presenting with secondary peritonitis. Furthermore, we aimed to ascertain the practicality, convenience, and simplicity of this assessment as a tool for integration into the clinical practices of surgeons and critical care physicians. Materials and Methods: A retrospective, comparative, observational and analytical study was conducted. One hundred patients diagnosed with secondary peritonitis presenting to the general surgery department were assessed and Manheim peritonitis index and APACHE II scores were calculated and compared. Results: The efficacy of the MPI was contrasted with that of another commonly utilized mortality prediction system, such as Apache II, involving a cohort of 100 patients from a tertiary care centre of north india. The predictive accuracies were determined to be 93.3% and 86.9%, respectively. Conclusion: Although Mannheim offers a commendable response in predicting mortality, its evaluation is not foolproof as it overlooks certain factors; thus, a patient deemed to have a low mortality risk may, in fact, succumb. Keywords: Secondary peritonitis, acute abdomen, abdominal cavity, intra-abdominal infection, abdominal pain.

Background: Urinary tract infections (UTIs) represent one of the most prevalent bacterial infections among pregnant women, with increased risk in those with diabetes mellitus (DM). This cross-sectional study investigates the prevalence, clinical presentation, microbial etiology, and antibiotic sensitivity of symptomatic UTIs in diabetic pregnant women. Material and Methods: A total of 108 diabetic pregnant women presenting with symptomatic UTIs were evaluated. Data on age, trimester, parity, type of diabetes, and symptoms were collected. Urinalysis and urine cultures were performed to determine infection presence and to identify bacterial pathogens. Antibiotic susceptibility testing followed standard microbiological protocols. Results: Results showed the majority of women were in their second trimester (57.4%) and multiparous (65.7%), with gestational diabetes (82.4%) being most common. The leading symptoms were dysuria (69.4%), lower abdominal pain (58.3%), and urgency (42.6%). Escherichia coli (48.1%) was the predominant organism isolated, with high sensitivity to Nitrofurantoin (100%), Gentamicin (95.4%), and Cefixime (95.4%). Conclusion: The findings underscore the importance of early screening and appropriate antibiotic treatment in this population to prevent maternal and neonatal complications. Culture-guided therapy is essential in preventing resistance and ensuring optimal outcomes. Keywords: Urinary tract infection, diabetic pregnancy, Escherichia coli

Background: Hysterectomy is performed for various uterine pathologies like fibroids, endometriosis, uterine prolapse and various types of cancer. Hysterectomy is the most common gynaecological study performed in women. It is a life saving procedure and it improves the quality of life. Myometrial lesions account for the majority of causes for abnormal uterine bleeding. Aims and objectives: 1. The aim of this study is to analyse the various spectrum of histomorphological lesions in uterus from hysterectomy specimen. 2. Correlation of preoperative clinical diagnosis with histopathological diagnosis in hysterectomy specimens Materials and methods: This study is a prospective and a retrospective analysis of 80 hysterectomy specimens reported to the department of Pathology, January 2020-2021 in Sri Lakshmi Narayana institute of medical sciences. The histopathological findings of hysterectomy specimens were noted and these findings are correlated with clinical diagnosis Results: The most common type of hysterectomy was total abdominal hysterectomy with bilateral salpingo-ophorectomy (52.5%). Most common clinical diagnosis is fibroid. Most common age group was 41-50yrs. The most common clinical indication for hysterectomy was fibroid uterus. In case of myometrium leiomyomas are the most common lesions followed by adenomyosis. Conclusion: The histomorphological analysis is mandatory for all hysterectomy specimens for confirming the preoperative clinical diagnosis and to improve the quality of life.

Background: To assess the prevalence of overweight and Obesity among school children near the BPT Hospital and explore it's associations with socioeconomic factors, dietary habits and physical activity. Materials and Methods: A retrospective cross-sectional study utilised data from thesis conducted in 2013.Total of 1050 children aged 6-12years from three schools representing different socioeconomic backgrounds were enrolled. Anthropometric measurements were taken and BMI was calculated using standard guidelines. Information on dietary intake, physical activity and socioeconomic status was collected through questionnaires. Results: Out of the total sample set, 16 children were underweight,880 had normal BMI,126 were overweight and 28 were obese. Overweight and Obesity were more prevalent in in high income groups (15.2% and 3.4%) compared to low income groups (5.4% and 1.1%). Boys had a higher prevalence of overweight and Obesity than girls. Additionaly, junk food consumption was significantly higher among children from high-income families. Conclusion: The findings emphasize the need for school based interventions to promote healthy dietary habits and physical activity particularly targeting high income groups. Addressing gender-based disparities in physical activity is also essential. Keywords: Body mass index, school children, Obesity, Overweight, socioeconomic status.

Background: Suicide is an increasing community health issue with hanging being the commonest adopted method. The study of hanging cases gives information about distribution of suicide fatalities thus revealing information about a community's mental and personal health. Objectives: This study was selected with objectives of determining the distribution of hanging victims related to age, sex, ligature material used and associated risk factors. Materials and Methods: The present descriptive retrospective study was conducted in the department of Forensic Medicine and Toxicology of a tertiary care center, Bengaluru north, from 2021 to 2022, with data collected from postmortem records of all the cases brought for medico-legal autopsies with alleged history of suicide by hanging. After analyzing, the data was tabulated and graphs were used to tabulate the results. Results: Majority of the victims: were males, belonging to age group of 21-30 years, residing in urban areas, chose hanging as suicidal method, using soft material like saree as a ligature material, with knot on right side of neck, in close confinement like house; and depression was found to be a common causative factor due to various reasons. Conclusion: This study emphasizes the need of preventive strategies like health education, psychiatric & psychological counselling for livelihood, creation of social welfare groups with usage of media, desensitization to manage stressors due to various causes; use of government aided schemes & helpline numbers for vulnerable population. Keywords: Suicide, hanging, knot mark, ligature material, causative factors.