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Abstract The land use transition plays an important role for terrestrial environmental services, which had a mixed impact of positive and negative on the groundwater and terrestrial water resource. The health of ecological systems and groundwater depends on the mapping and management of land use. The Ganga basin is one of the most densely populated and agriculture-intensive river systems in the South Asia and the world. The multi-temporal spatial database includes land use (ESA-CCI), satellite-based gravity anomaly (GRACE/GRACE-FO), and well log (CGWB) adopted in this study for assessment of the impact of land use transition on groundwater depth, groundwater drought, and terrestrial water storage. The methodology includes the computation of land use transition, trend magnitude by Sen’s slope, Innovative Trend Analysis (ITA) for graphical visualization, clustering techniques employ to identify pattern & structure, and finally space-time transformation was assessed based on multi-dimensional scaling using Alternating Least Squares Scaling (ALSCAL). The land use transition over two decades shows an increase in forest (2.23%), wetland (2.2%), settlement (208.4%), bare area (3.18%), water (5.18%), and a decrease in agriculture (-1.16%), grassland (-4.5%), & vegetation (-2.8%). The non-parametric climatological trend of groundwater depth, drought, and terrestrial water loss was maximally observed during the post-monsoon season in the Ganga basin. The seasonal climatological trend statistics shows that, the upper Ganga and northern (left) of the Ganga basin shows an alarming rate of groundwater depletion, with increased in the severity of groundwater drought in near future with the loss in terrestrial water storage. The ITA shows the monotonic decreasing trend depicting loss of groundwater and terrestrial water resources. Bi-dimensional regression, ALSCAL shows that the model is efficient based on the input data having stress value and RSQ (proportion of variance) of 0.09 and 0.97 with excellent linear fit. The impact assessment of land use transition was obtained in low dimensional space showing that the conversion from sparse vegetation, agriculture, grassland, wetland and forest to settlement has the maximum impact on groundwater and TWSA loss, although the persistent settlement area is also responsible. The results are extremely useful for the policymakers, scientists, concern Govt. section, and local communities must work together to manage groundwater sustainably. Water resource management can also help to lessen the effects of climate change on groundwater and terrestrial water loss by focusing on the environmental, economic, social, and institutional dimensions of UN-SDG.

Key Clinical Message Osteoblastoma of the frontal sinus, although rare, can manifest with seizures and pneumocephalus, underscoring the importance of thorough evaluation and complete surgical excision to prevent serious complications and ensure optimal patient outcomes. Abstract Osteoblastoma is an infrequent bone tumor, with origins typically in the vertebrae and long bones. While craniofacial involvement is rare, it may occur in regions such as the paranasal sinuses. We present a case of osteoblastoma located in the frontal sinus, an exceptionally uncommon site, resulting in seizures secondary to pneumocephalus. A 21‐year‐old male presented with a generalized tonic–clonic seizure and postictal confusion. Imaging studies revealed a well‐defined lesion in the left frontal sinus causing cortical breach, destruction of the posterior wall, and pneumocephalus. A total surgical excision was performed through bifrontal craniotomy. Histopathological analysis confirmed the diagnosis of osteoblastoma. Postoperative recovery was uneventful, with a follow‐up CT scan showing complete lesion excision. Osteoblastomas, especially in the cranial sinuses, are rare entities that may present asymptomatically but can lead to severe complications. The risk of recurrence underscores the importance of complete surgical resection for optimal patient outcomes.

Introduction: Scrotal reconstruction remains a challenging problem to the surgeons. The various techniques used for scrotal reconstruction includes residual tissue re-arrangement, skin grafts, pedicled and free tissue transfer. There is lack of unified approach to deal with the issue. Aim: To discuss the surgical techniques performed for scrotal reconstruction in a tertiary care centre along with its epidemiological factors. Materials and Methods: This observational descriptive study was conducted on 33 cases in a tertiary care centre located in Eastern India over a period of three years. Scrotal reconstruction was planned according to aetiology, defect size, associated co-morbidity and age of the patient. Evaluation to assess the efficacy of each procedure was done with patient’s satisfaction scoring. At the time of discharge, with simple four level Likert scale, patient’s satisfaction was assessed. Descriptive statistics was used and results were expressed in terms of frequency and percentage. Results: The mean age of the patients with scrotal defects was 48±15.98 years. Fournier’s gangrene (n=21) was the leading cause of scrotal defects followed by trauma (n=8). The most common scrotal defect size was 50-75% (n=12). The most common scrotal reconstruction performed was Pudendal artery flap (Singapore flap) (n=12). Donor site scar was limited and acceptable. Wound related complications detected clinically as partial tissue necrosis, was observed in two cases. Most patients were satisfied with the final outcome, assessed by Likert scale. Conclusion: Scrotal reconstruction should be performed taking in account its aetiology, associated co-morbidity, age and the scrotal defect size. Aesthetically and psychologically, well planned flap is reliable and better in comparison to Split-Thickness Skin Graft (STSG) and most of the complications can be managed conservatively.