Background: Anaesthesia plays a critical role in ensuring safe childbirth, particularly during cesarean deliveries. However, the choice of anaesthesia (general vs. regional) may have significant iSmplications for maternal and fetal outcomes. Objective: To evaluate the impact of anaesthesia type on maternal and fetal outcomes in cesarean deliveries. Methods: A prospective observational study was conducted at a tertiary care hospital, including 400 women undergoing cesarean delivery. Participants were divided into two groups: general anaesthesia (GA) and regional anaesthesia (RA). Maternal outcomes included hemodynamic stability, postoperative pain, and complications. Fetal outcomes included Apgar scores, umbilical cord pH, and neonatal intensive care unit (NICU) admissions. Results: RA was associated with better maternal hemodynamic stability (p<0.01) and lower postoperative pain scores (p<0.001) compared to GA. Fetal outcomes were also superior in the RA group, with higher Apgar scores at 1 and 5 minutes (p<0.05) and fewer NICU admissions (p=0.02). Umbilical cord pH was comparable between groups (p=0.45). Conclusion: Regional anaesthesia is associated with improved maternal and fetal outcomes compared to general anaesthesia in cesarean deliveries. These findings support the preferential use of RA when feasible.

Background: Most cataracts arise because of ageing of the crystalline lens. Surgery is currently the only treatment option once the lens has opacified and vision is decreasing. Hence; the present study was conducted for evaluating complications and postoperative visual outcomes of cataract surgery.  Materials & Methods: A total of 100 patients scheduled to undergo cataract surgery were enrolled. Complete demographic and clinical details of all the patients were obtained. The etiology of the cataract, whether it was primary or secondary due to factors such as trauma or steroid use, was documented. All ocular comorbidities were meticulously noted. Additionally, systemic comorbidities, including systemic hypertension, diabetes mellitus, and respiratory conditions, were also recorded. The duration of the surgical procedure was analyzed independently. Postoperative complications were systematically documented. Best corrected visual acuity was assessed by hospital optometrists at 12 weeks following the surgery and the results were recorded.  Results: Mean age of the patients was 40.8 years. 55 percent of the patients were males. Positive history of past ocular surgery was seen in 11 percent of the patients. Right eye was operated in 54 percent of the patients. Photo emulsification, Extracapsular cataract extraction (ECCE) and Intracapsular cataract extraction (ICCE) were done in 63 percent, 33 percent and 4 percent of the patients respectively. Complications were seen in 13 percent of the patients which comprised of corneal edema, wound dehiscence and raised intraocular pressure. Visual outcome was good in 69 percent of the patients.  Conclusion: Cataract surgery has progressed from the technique of intracapsular cataract extraction (ICCE) to extracapsular cataract extraction (ECCE) and has now advanced to the method of phacoemulsification. Good outcome with fewer complications were seen.

Background: Untreated cataracts continue to be the leading cause of blindness globally, despite the fact that this condition can be effectively and affordably addressed through a standard surgical procedure. Hence; the present study was conducted for assessing the visual outcome following cataract surgery. Materials & methods: A cohort of 100 patients, all diagnosed with cataract as the primary cause of their visual impairment and scheduled for surgical intervention, participated in this study. The inclusion criteria specified that patients must have a visual acuity of less than 6/60 in the affected eye due to cataract. An appropriate anesthetic was administered for each procedure. The presenting and best-corrected vision of the operated eye were evaluated on the day of discharge and again six weeks after surgery. Visual improvement was quantified using the World Health Organization's recommended method for assessing postoperative visual status. All data were documented in a Microsoft Excel spreadsheet and analyzed using SPSS software. Results: Out of 200 patients, 96 underwent surgery on the right eye. Among these, 56 were males (28% of total patients) and 40 were females (20% of total patients).A total of 92 patients had surgery on the left eye, with 48 males (24%) and 44 females (22%). twelve patients underwent bilateral cataract surgeries, comprising six males (3%) and six females (3%).The study included 110 males (55%) and 90 females (45%). The mean age of the study participants was calculated to be approximately 62.50 years, with male and female participants having estimated mean ages of 63.42 and 65.50 years, respectively. majority (84%) of patients exhibited severe visual impairment preoperatively, with visual acuity less than 3/60.Only 4% had moderate visual impairment (6/24 to 6/60), and none had visual acuity better than 6/60.Postoperatively, there was a substantial improvement in visual acuity. Specifically, 22% of patients achieved visual acuity between 6/60 to 6/18, and 38% attained moderate visual acuity (6/24 to 6/60). The number of patients with severe visual impairment (less than 3/60) decreased to 30%. These improvements are statistically significant, with a p-value of 0.001. Conclusion: To optimize outcomes in cataract surgeries, eye care staff can take several key steps like Promoting cataract surgeries at an earlier age to achieve better results and improve the patient's quality of life & providing thorough counseling to manage patient expectations, especially in cases with co-morbidities. This helps enhance patient satisfaction and outcomes by ensuring realistic expectations and informed decision-making.

Background: Patients with diabetes has 2-fold higher chances of suffering from hypertension. Hypertension is risk factor for development of diabetes as well for complications like nephropathy, CAD and neuropathy etc. Hypertension control is vital to prevent and retard progression of microvascular and macrovascular complications. Therefore, we undertook this study to evaluate treatment patterns in diabetic patients with hypertension, those are being followed. Methods: This study was conducted on diabetic patients who had hypertension as well attending Medicine Department. Prescribing Pattern of Antihypertensive drugs was analysed on all diabetic patients reporting to medicine OPD from August 2014 to December 2014 at our institute were screened.  Results: Out of n=224 patients, 122 were males and 101 were females. Mean age of group was 48.6 years. 46.18% patients were on mono therapy and remaining patients were on combination antihypertensive drugs. There was total 393 antihypertensive drug exposures. Patient needed mean antihypertensive drug of 1.88. Angiotensin receptor blockers were the most commonly prescribed drugs. Angiotensin inhibitors (angiotensin receptor blockers and ACE inhibitors) were utilized in 71% patients. Hypertension control was achieved in 37.66% patients. About 81.2%) aware about disease.  Conclusion: Our study showed that majority of diabetic hypertensive patients needed multiple drug therapy to control hypertension. Most of the patients were on ARBs/ACE inhibitors. This was according to recommendation by ADA or JNC8.

Aim: To evaluate and compare the therapeutic effectiveness of topical amorolfine, luliconazole, sertaconazole, and terbinafine in the treatment of tinea corporis and tinea cruris.  Materials and Methods: This was a prospective, randomized, open-label, parallel-group study conducted in the Department of Dermatology. Designed as a pragmatic trial, the study aimed to assess the clinical response to commonly used topical antifungal agents in the current dermatophytosis scenario. Clinically diagnosed, immunocompetent adult patients (≥18 years) with localized tinea corporis or tinea cruris, and no history of antifungal therapy in the preceding week, were enrolled.A total of 80 patients were included, with 20 patients allocated to each treatment arm. Eligible participants were assigned to receive one of the following topical agents in a sequential manner: amorolfine 0.25%, luliconazole 1%, sertaconazole 2%, or terbinafine 1%. The same brand of each drug was used consistently throughout the study. Amorolfine and luliconazole were applied once daily, whereas sertaconazole and terbinafine were applied twice daily.  Results: The mean age of participants was 34 years (range: 18–70 years), with a male-to-female ratio of 1.1:1 (35 males, 32 females). Thirteen participants were lost to follow-up despite telephonic reminders. Luliconazole demonstrated the greatest improvement in pruritus (mean: 1.47), erythema (mean: 1.53), and scaling (mean: 1.53). In contrast, terbinafine showed the least improvement, with mean values of 0.73 (pruritus), 0.60 (erythema), and 0.67 (scaling). The difference in mean improvement scores for luliconazole was statistically significant for pruritus (P = 0.020) and highly significant for erythema and scaling (P = 0.004 and 0.007, respectively). Based on cumulative improvement in all three parameters, patients were categorized as follows: poor response (score 0–2), moderate response (score 3–4), and good response (score 5–6). In the luliconazole group, 12 patients (66%) demonstrated a good response, which was statistically significant compared to the other groups (P = 0.018, Fisher’s exact test).  Conclusion: Luliconazole appears to be more effective than amorolfine, sertaconazole, and terbinafine in the treatment of tinea corporis and cruris. Although classified under the azole group, luliconazole may exhibit fungicidal activity. Further studies involving larger sample sizes are warranted to confirm these findings.

Background: Dermatophytosis is a common, superficial fungal infection of the skin. Recently, there has been tremendous increase in the incidence of dermatophytosis attributed mainly to misuse of steroids in the management of fungal infection. Methods: A cross sectional study of  6  months  duration  was  done  in  patients  with  dermatophytic fungal  infections,  diagnosed  clinically,  with  history  or  findings  of  some  form  of  steroid  use.  Both quantitative and qualitative data were collected regarding steroid formulations about type, duration of use, route of administration and their availability by prescription or “over the counter”.  Various cutaneous and systemic adverse effects of steroids were also observed. Results: Out of  the  total  200  patients  of  dermatophytosis,  120  patients  (60%)  had  used  steroid formulations either topical(80%), oral(12.5%), intralesional or injectable(7.5%).The mean duration of illness in patients who had used steroids was 24 ± 3 weeks. Multiple site infection of dermatophytosis was present in 65% with steroid misuse and in 40.8% with nonsteroid use patient group. Cutaneous adverse effects were common in patients with steroid misuse, as suggested by relatives, friends, chemist, general practitioners or due to self-medication. Conclusions: Misuse of  steroid  formulations  in  dermatophytic  infections  may  result  in  various cutaneous and systemic side effects. Strict drug control policies and awareness of adverse effects of steroid abuse are truly the need of the hour to control this menace.