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Introduction: The technique for harvesting Split-thickness Skin Grafts (STSG) varies among surgeons. To control bleeding from split-thickness skin graft donor sites, the use of several haemostatic agents has been reported. The tumescent technique involves injecting tumescent fluid into the subcutaneous fat, obtaining swelling and firmness (tumescence) of the surgical area. This creates regional anaesthesia of the skin and subcutaneous tissue, allowing painless cutaneous surgery, with adrenaline acts as a haemostatic agent. Aim: To compare the surgical outcomes in terms of blood loss during the harvesting of STSG, postoperative pain experienced by the patient, healing of the donor site, and graft take rate with tumescent versus non tumescent techniques of STSG. Materials and Methods: The present prospective cohort study was conducted in the Department of General Surgery, M S Ramaiah Medical College, Bengaluru, Karnataka, India, from November 2017 to March 2019. A total of 56 patients were enrolled after applying inclusion and exclusion criteria. Patients were alternately assigned into the groups of tumescent or non tumescent technique groups. Intraoperative bleeding was assessed, postoperative pain was assessed using the Visual Analogue Score (VAS), and healing of the donor and recipient sites were assessed. Student’s t-test (two-tailed, independent) was used to find the significance of study parameters on a continuous scale between the two groups. The Chi-square/Fisher’s-exact test was used to assess the significance of study parameters on a categorical scale between two or more groups. Results: The mean±Standard Deviation (SD) age of patients in the tumescent group was 48.25±12.79 years and in the non tumescent group was 52.79±12.91 years. Intraoperative bleeding ranged from 0-25% in all 28 patients in the tumescent group, while it ranged from 76-100% in all 28 patients in the control group (p-value

Introduction: Emergency laparotomies carry significant morbidity and mortality. Preoperative risk assessment is the key part for all emergency laparotomies. Therefore, the use of Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) and National Emergency Laparotomy Audit (NELA) scores helps stratify the risk and highlight the importance of high-risk patients, aiding in the provision of appropriate treatment plans and care. Aim: To determine and compare the Portsmouth-POSSUM (P-POSSUM) score and NELA score in predicting mortality at 30 days and 60 days in patients undergoing emergency laparotomies. Materials and Methods: This retrospective cohort study included all patients who underwent emergency laparotomy at a tertiary care centre from January 2021 to March 2023. A total of 116 patients were included, and demographic variables, laboratory values, and operative details were recorded. Mortality on postoperative day 30 and 60 was observed. All data were recorded in an MS excel spreadsheet, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 19.0. An independent sample t-test was used. Results: Among the total study sample of 116 patients, the 30-day mortality rate was 8.6% (10 out of 116), and the 60-day mortality rate was 13.8% (16 out of 116). The area under the ROC curve (AUC) for mortality prediction was 0.533 (0.361-0.726) for the P-Possum score and 0.873 (0.799-0.948) for the NELA score, which was significantly higher. Conclusion: The NELA Score demonstrated greater accuracy in predicting early and late mortality compared to the P-POSSUM score in this study. Therefore, the authors highly recommend the use of the NELA score for risk assessment in all emergency laparotomies.

Introduction: Every year, nearly two million children die before their 5th birthday, with 21.5% of all under five deaths attributed to vaccine-preventable diseases. Approximately 50% of undervaccinated children come from three countries, including India. In India, the Universal Immunisation Program (UIP) has played a crucial role in eliminating polio and maternal and neonatal tetanus. Both parents and healthcare providers play vital roles in children’s immunisation, with healthcare providers raising awareness about the importance of immunisation and parents understanding its significance. Aim: To estimate and assess the responsibilities of parents and healthcare providers in routine immunisation practices. Materials and Methods: A cross-sectional study was conducted in the Department of Community Medicine, Shivamogga Institute of Medical Sciences (SIMS), Shimoga, Karnataka, India among 153 parents or guardians of children aged six months to five years in urban and rural areas of Shimoga district. A questionnaire designed for the study was used, and a pilot study was conducted to test its effectiveness. The study duration was three months, from July 2022 to September 2022. Sociodemographic details and information on child immunisation were collected. Data were described in terms of frequencies and percentages. The association between knowledge of immunisation and the parents’ residence was tested using the Chi-square test, with a significance level set at p

BACKGROUND AND OBJECTIVES: Disability has been drastically increasing globally among elderly population and contributing significantly to morbidity and mortality. This study was planned to assess the prevalence of functional disability and to assess its determinants among elderly population of Davangere city in Karnataka. MATERIALS AND METHODS: This was a cross-sectional study carried out between July 2019 and June 2020 in Davangere city, involving 600 elderly aged ≥60 years. Participants were selected using 30 cluster sampling technique. Approval from the institutional ethics committee review board was obtained. The study was done by interview method. Consent was taken before conducting the interview. Questionnaire consisted of sociodemographic details, personal history, h/o chronic illness, and components of functional disability (activities of daily living [ADL], mobility, vision, and hearing). ADL was assessed by Barthel's scale of 10 items, mobility was assessed using “get up and go test,” vision was assessed by Snellen's vision chart, hearing was assessed by whisper test followed by Rinne's and weber's test. RESULTS: The mean age of the elderly was 71.31 years ± 6.8 years, ranges from 60 years to 95 years. The prevalence of functional disability was found to be 38.2%. It was increased with the advancing age (≥80 years), socioeconomic status, disturbed sleep, and chronic illnesses found to be having significant association. CONCLUSION: Nearly half of the elderly were suffering from functional disability, this can be improved by lifestyle modification, early diagnosis, and treatment of chronic illnesses.

Introduction: Pilonidal Sinus Disease (PSD) is a tract or cavity commonly seen in the sacrococcygeal region, usually containing a tuft of hair. It is mostly observed in drivers who have excessive hair in the natal cleft region. Although several surgical procedures have been described for the management of PSD, none have been universally accepted as the gold standard. Limberg flap reconstruction, following wide excision, offers a tension-free repair using a well-vascularised flap. This technique flattens the natal cleft, avoiding a midline scar and reducing the chance of recurrence. Aim: The aim of this study was to determine the outcomes of Limberg flap reconstruction in sacrococcygeal PSD. Materials and Methods: A retrospective descriptive study was conducted in the Department of General Surgery at M S Ramaiah Medical College, Bangalore, Karnataka, India. The study duration was six years, from January 2011 to January 2017. The study included a total of 40 patients aged between 15-70 years, with Tezel type III sacrococcygeal Pilonidal Disease (PND), who underwent the Limberg flap procedure. Data was collected and analysed from January to June 2021. Outcome measures such as duration of hospital stay, time required to return to work, and procedure-related complications associated with procedure were analysed and entered into an Excel sheet. Results: The mean age of the study participants was 18.02±6.87 years. Out of the 40 patients, 4 (10%) developed complications. Superficial wound infection was observed in 1 (2.5%) patient, which healed within two weeks. Minimal flap necrosis was observed in 2 (5%) patients, who underwent debridement and dressings on an outpatient basis. The wounds healed within three to four weeks. Recurrence was reported in 1 (2.5%) patient. The mean time to return to work was 18.7±4.88 days. Conclusion: Limberg flap reconstruction for sacrococcygeal PSD is a simple technique with a lower complication rate, faster return to normal activity, and a low recurrence rate.

Introduction: The median artery typically originates as a branch of the anterior interosseous artery. In its normal configuration, it is a small vessel that passes laterally between the flexor digitorum profundus and flexor pollicis longus muscles to reach the median nerve. From an embryological perspective, the median artery represents a remnant of the original axial arterial stem that extends into the limb. The persistence of this embryonic arterial pattern into adulthood, known as a persistent median artery (PMA), is an anatomical variation that has been the subject of numerous studies. The prevalence of PMA has been increasing over time, suggesting a potential microevolutionary change in the human population. Aim of the study: This study aims to investigate the prevalence and types of persistent median artery in a sample population from Pondicherry, India. Material and Methods: A total of 40 upper limb specimens from 12 cadavers and 16 separate upper limbs were included in the investigation. A vessel accompanying median nerve is considered a median artery. The frequency, origin, termination, type and relation to median nerve and anterior interosseous nerve were noted. Results: The presence of PMA was observed in seven forearms (17.5%), with a slight predilection for the left side (n=4). Common and anterior interosseous arteries are the source of PMA. All the PMA are of antebrachial type and none of them reached the palmar arches.Notably one PMA crossed the anterior interosseous nerve anteriorly and the other one posteriorly. Conclusion: Knowledge of the prevalence and anatomical variations of PMA is crucial for clinicians, as it can have significant implications in the diagnosis and management of carpal tunnel syndrome and other wrist pathologies. Additionally, awareness of PMA is essential for surgeons performing procedures in the carpal tunnel region to avoid potential complications. [ABSTRACT FROM AUTHOR]

Guillian-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of covid 19 infection. Here we present a case of 64 years old female who presented to us with worsening respiratory failure and progressive flaccid symmetrical sensorimotor neuropathy following covid infection. She was diagnosed to have GBS as post covid complication . Hence started on Intravenous Immunoglobulin infusion following which she had improvement in respiratory failure and prevented from intubation and mechanical ventilation.

Guillain–Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of COVID-19 infection. Here, we present the case of a 64-year-old female who presented to us with worsening respiratory failure and progressive flaccid symmetrical sensorimotor neuropathy following COVID infection. She was diagnosed to have GBS as post-COVID complication. Hence, started on intravenous immunoglobulin infusion following which she had improvement in respiratory failure and prevented from intubation and mechanical ventilation.

We report the case of a 71-year-old female who was incidentally found to have nonoliguric acute kidney injury on a routine workup for new-onset visual hallucination. Further history revealed inadvertent usage of nitrofurantoin for 3 months for an anticipated urological procedure. Renal biopsy demonstrated acute granulomatous interstitial nephritis. The renal function significantly improved following discontinuation of nitrofurantoin and corticosteroid administration. We highlight a rare association of nitrofurantoin with acute granulomatous interstitial nephritis through this case report.

A 66-year-old male patient with coronavirus disease-19 (COVID-19) developed cardiogenic shock with echocardiographic evidence of decreased left ventricular ejection fraction and global hypokinesia concomitant with a robust systemic inflammatory response. Following the administration of convalescent plasma therapy and inotropic support, left ventricular function recovered fully in accordance with the decrease in the concentration of the inflammatory markers. Thus, we demonstrate the presence of transient reversible cardiomyopathy in a patient with severe COVID-19 and illustrate the association of acute cardiac dysfunction with profound systemic inflammation among COVID-19 patients.

Recent reports have suggested an increased risk of QT prolongation and subsequent life-threatening ventricular arrhythmias, particularly torsade de pointes, in patients with coronavirus disease-2019 (COVID-19) treated with hydroxychloroquine and azithromycin. In this article, we report the case of a 75-year-old female with a baseline prolonged QT interval in whom the COVID-19 illness resulted in further remarkable QT prolongation (>700 ms), precipitating recurrent self-terminating episodes of torsade de pointes that necessitated temporary cardiac pacing. Despite the correction of hypoxemia and the absence of reversible factors, such as adverse medication effects, electrolyte derangements, and usage of hydroxychloroquine/azithromycin, the QT interval remained persistently prolonged compared with the baseline with subsequent degeneration into ventricular tachycardia and death. Thus, we highlight that COVID-19 illness itself can potentially lead to further prolongation of QT interval and unmask fatal ventricular arrhythmias in patients who have a prolonged QT and low repolarization reserve at baseline.

This study aims at developing a calcium magnesium phosphate‐based bone biocement that combines a natural polymer and regenerative properties of bone bonding materials. The formulation of this biocement consists of oxidized guar gum, polydopamine, and calcium magnesium phosphate. The oxidized guar gum is easily soluble in water and has a slightly basic pH, unlike unmodified guar gum, thus allowing a homogenous paste to form in the alkaline environment of calcium magnesium phosphate. Three different oxidized degrees of guar gum were made, and the impact on the biocement properties was studied. The modified guar gum‐reinforced biocement (OGG C2) displayed higher mechanical strength and lower degradation rates than OGG B1 and OGG A0. Furthermore, samples with polydopamine exhibited better results, thus, improving the already reinforced biocement. Morphological studies of the biocement displayed a highly porous structure with porosity varying among biocement containing different oxidized guar gum and polydopamine levels. [ABSTRACT FROM AUTHOR]

Mediastinal teratoma makes nearly 8%–13% of all mediastinal tumors, with peak incidence seen in young patients. A 26-year-old male presented with complaints of nonproductive cough, breathlessness, right side chest pain, and fever for 1-week duration. Chest X-ray showed homogeneous opacity of the right hemithorax with blunting of the right costophrenic angle. Contrast-enhanced computed tomography thorax showed multiloculated cystic lesion with the area of fat calcification in the right side of the upper mediastinum. Ultrasonography-guided biopsy shows feature suggestive of benign teratoma. Most teratoma tends to exhibit heterogeneous attenuation on computer tomography imaging.

Kidneys are bean shaped organs with the length of 1 lcms, breadth of 6cms and thickness of 3cms in anteroposterior dimension. Variations in morphology of the kidneys are either congenital or acquired. The present paper deals with two cases with abnormal morphology. During routine dissection of abdomen for the under graduate students in MVJ Medical College, Bengaluru, it was found that there were kidneys with morphological variations in two cadavers. Both these specimens were analysed morphologically and sent for histopathological examination. The specimen No: 1 was a case of Ask Upmark kidney and Specimen No: 2 was a case of Granular contracted kidney. Morphological changes in kidney could be congenital or acquired. It is usually associated with various pathologies of kidneys. The pathogenesis is controversial attributed to vesicoureteric reflux with intrarenal reflux or localised developmental arrest, arteriolar nephrosclerosis and glomerulonephritis. The morphology and histopathology of the cases have been discussed.

On average, one in every eight women is diagnosed with breast cancer during their lifetime, and accounts for 14% of cancers in women. Since early diagnosis could improve treatment outcomes and longer survival times for patients, it is absolutely necessary to develop techniques to classify lesions within breast cancer mammograms and ultrasound images. The main goal is to determine the class of tumor present within the image, which is pivotal in diagnosing breast cancer patients. In this paper, we propose an Sobel-Canny-Gabor (SCG) model, which is a hybrid model that implements three different edge detection filters; Sobel filter, Gabor filter, and Canny filter. This model is used to enhance the appearance of the mammogram and ultrasound images, which is then fed into a classification model. Through classification, there could be a potential improvement in the results of the overall classification. Post-classification, the model is then evaluated using the metric Peak Signal-to-Noise Ratio (PSNR), which measures the quality between the original image and the compressed image. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most affecting carcinoma for women from long time. Early detection is necessary to increase the lifespan of patients. In this study deep learning and machine learning approaches are applied to histopathological, mammogram and ultrasound breast cancer modalities. In-order to increase the efficacy of diagnosis of these modalities. Study has been carried out in majorly four phases. First phase involved collection of the datasets of all the three modalities mentioned earlier. Second phase consists of extracting relevant features using ResNet-18. Third phase involves feeding the extracted information to enhanced firefly or to the existing optimization techniques. Fourth phase consists of considering selected features as input to the classifiers. Then enhanced firefly based classifier compared with the existing ant colony and genetic algorithm based classifier. Enhanced firefly based classifier displays better results compared to the state of art approaches. [ABSTRACT FROM AUTHOR]

Background: Disability associated with mental illness is a major contributor to the global burden of diseases, accounting for 25% of total disability and 16% of total burden as reported by World Health Organisation (WHO). Aim: To assess and compare the level of disability in various psychiatric disorders. Methods: A semi structured interview consisting of socio demographic details, and the Indian Disability Evaluation and Assessment Scale (IDEAS) were used to assess the level of disability among patients attending the psychiatric out- patient department. Results: Majority of the sample had mild and moderate disability. Conclusion: Appropriate intervention programmes of management and rehabilitation can improve the outcome.