BackgroundInfection rates in revision total hip arthroplasty are lower when antibiotic loaded cemented stems are utilized. Inspired by this technique, a point-of-care coating of antibiotic-loaded calcium sulfate (CaSO4) was applied to cementless revision stems in aseptic revision and 2nd stage reimplantation total hip arthroplasty. MethodsOne hundred eleven consecutive femoral stems were coated. Just prior to insertion, 10 cc of CaSO4 was mixed with 1 g vancomycin and 240 mg tobramycin with the paste applied to the stem. The results were compared to a matched cohort (N = 104) performed across the previous 5 years. The surgical methods were comparable, but for the stem coating. The study group was followed for a minimum of 3 years. ResultsIn the study cohort of 111 patients, there were 69 aseptic revisions with one periprosthetic joint infection (PJI) (1.4%) and 42 second-stage reimplantations with 2 PJIs (4.8%). In the control cohort of 104 patients, there were 74 aseptic revisions with one PJI (1.4%) and 30 second-stage reimplantations with 7 PJIs (23.3%). There was no significant reduction in PJI rate in the aseptic revision subgroup (1.4% study vs 1.4% control group), P = 1.000. Antibiotic stem coating reduced PJI rate in the 2nd stage reimplantation subgroup (23.3% control vs 4.8% study group), P = .028. In both groups, there were no cases of aseptic stem loosening. ConclusionsPoint-of-care antibiotic coating of cementless revision femoral stems reduces PJI infection rate in 2nd stage reimplantations only. We theorize that microbes persist in the endosteal cortices after resection and may contribute to infection recurrence.

Abstract AIM To evaluate the association of GDM and pre-eclampsia in women with obstetric cholestasis MATERIAL AND METHODS Pregnant women with >28weeks gestation attending ANC, OPD and labour room of J.N.M.C.H,AMU, Aligarh U.P (India) from 2020-2022 were included in the study after taking informed consent and ethical approval from the Institute. Women were divided into two groups ie group 1 having 200 women with IHCP and group 2 having 200 healthy pregnant women, both the groups were followed up for the development of GDM and pre-eclampsia. RESULTS A statistically significant association was observed between IHCP and development of GDM (26.5% & Odds ratio 1.64) and pre-eclampsia (17% & Odds ratio 1.95) (p<0.05), also GDM and pre-eclampsia were found to be significantly associated with the severity of cholestasis (p<0.05). Thus on calculating odds ratio, we found higher odds of developing GDM and Pre-eclampsia in IHCP group with raised serum bile acid levels, maximum at 60μmol/L level as compared to 10-40 μmol/L (GDM: OR:8.647 & Pre-eclampsia: OR:6.303). Induction and cesarean rate was significantly higher in IHCP group (p<0.05). CONCLUSION Our study concludes significant association of IHCP with GDM and Pre- eclampsia as all three shares common pathogenetic pathways and greater risk of development was at higher serum bile acid levels.

<abstract> <p>The convergence of biomedical science and robotics has ushered in an era of innovation and transformation within healthcare. This article, delves into the profound impact of this synergy, showcasing their symbiotic relationship and the potential they hold in revolutionizing patient care, medical research and healthcare delivery. From the evolution of surgical robots to advancements in medical imaging, we explore how this collaboration is redefining the boundaries of what's achievable. The exploration extends to social robots that alleviate caregiver workloads and therapeutic robots that aid patient recovery. While the benefits are evident, challenges and ethical considerations are also scrutinized. As we explore the dynamic intersection of technology and medicine, a promising transformation emerges, offering the potential for improved clinical outcomes and fresh opportunities in healthcare. This article aims to offer readers insights into the importance, challenges and possible future advancements in the fusion of biomedical science and robotics. It serves as a call to action for researchers, scientists and healthcare professionals to continually push the boundaries, explore uncharted territories and leverage this synergy to bring us closer to a world of healthier and happier lives.</p> </abstract>

The surgical theatre is a vital and intricate setting where time and resources are typically limited. Laparoscopic surgical procedures demand specific technical and analytical skills from operating room personnel, as there is a high chance of mistakes leading to potentially fatal repercussions in laparoscopic surgery [1]. The acquisition of complete, precise, and appropriate knowledge about linkage and interaction between human beings and laparoscopic equipment in operation theatre must be considered of utmost importance. To avoid difficulties during surgery, a surgeon must become familiar with this equipment and instruments [2].

To study and compare the efficacy and safety profile of Rho-kinase inhibitor (netarsudil 0.02%) and prostaglandin analog (bimatoprost 0.01%) both as monotherapy and in combination. Prospective, randomized, monocentric, open-label clinical trial. Patients ≥20 years of age with primary open-angle glaucoma or ocular hypertension (IOP >21 mmHg) were recruited and randomized to receive either netarsudil 0.02%, netarsudil 0.02% + bimatoprost 0.01%, or bimatoprost 0.01% once daily for a period of 12 weeks. IOP and side effects were documented at 4, 8, and 12 weeks. The mean treated IOP ranged 17.51-18.57 mmHg for netarsudil, 15.80-16.46 mmHg for bimatoprost, and 14.00-14.87 mmHg for the combination therapy group. The mean IOP reduction from baseline at 4, 8, and 12 weeks was found to be statistically significant ( P < 0.001) in all three groups. The safety profile of netarsudil/bimatoprost combination was consistent with each constituent individually. The only frequently observed ocular adverse event was conjunctival hyperemia, which was seen mostly in netarsudil and netarsudil + bimatoprost groups ( P < 0.001). The IOP-lowering effect of netarsudil 0.02% once daily is non-inferior to bimatoprost 0.01% in patients with POAG and ocular hypertension with acceptable ocular safety, and the combination therapy achieved a higher IOP-lowering effect. This group of medications can be a useful adjunct in patients on maximal therapy.

This study aimed to investigate the incidence of Ocular Surface Disorders (OSDs), including Dry Eye Disease, Chemosis, and Exposure Keratitis, among patients admitted to the Neurocritical Care Unit (NCC). Additionally, we sought to assess the correlation between these OSDs, the length of hospitalization at NCC, and the Glasgow Coma Score (GCS). The heightened risk of OSD development in the NCC environment, coupled with pre-existing neurological impairments, can lead to conditions like dry eye disease, chemosis, corneal abrasions, and infectious keratitis, ultimately resulting in corneal opacities and perforations that significantly impact visual acuity and overall quality of life. In this observational cross-sectional study, we examined the ocular health of all patients admitted to an NCC unit from February to May 2022. We assessed the presence of Conjunctivitis, chemosis, Keratitis, and Dry Eyes in relation to the duration of stay at NCC, GCS, lagophthalmos, adherence to the prescribed eye care protocol in NCC, and the use of mechanical ventilation. Our study comprised one hundred subjects over a four-month period, with a mean age of 51.92 ± 18.73 years (ranging from 17 to 89), including 70% males and 30% females (gender ratio of 2.33). Our findings revealed that 26 eyes (13%) exhibited Conjunctival Hyperemia, 23 eyes (11.5%) displayed Chemosis, and severe dry eye was prevalent in 41 (20.5%) eyes. A statistically significant association was observed between GCS (p-value <0.001) and Keratitis (p-value 0.0035) with dry eyes (Chi-Square Test). Notably, the incidence of dry eyes was significantly higher among patients with a prolonged stay of ≥10 days (p-value 0.003). Patients admitted to Neurocritical Care Units necessitate meticulous eye care and structured protocols to mitigate the risk of long-term ocular complications such as exposure keratitis. Given their heightened susceptibility to these conditions, proactive measures are imperative to ensure optimal ocular health among NCC patients.

BackgroundCardiovascular disease (CVD) and dengue are both significant global health concerns, and their intersection presents a growing clinical challenge. Emerging evidence suggests that individuals with pre-existing CVD may face an elevated risk of severe dengue outcomes. The present study aims to perform a systematic review to assess the relationship between CVD and the severity of dengue. MethodsWe conducted a literature search across multiple databases from inception to November 25, 2023. Primary studies reporting the number of dengue patients with CVD in severe dengue and non-severe dengue groups were included. Quality assessment was performed using the Newcastle-Ottawa Scale, and a meta-analysis was conducted using R software version 4.2 to determine the pooled Relative Risk (RR). The study protocol has been registered in PROSPERO. ResultsBased on data from 5 studies involving 274,576 dengue patients, our meta-analysis revealed a significant association between CVD and an increased risk of severe dengue, with a calculated RR of 2.71 (95 % CI: 1.03 to 7.10). However, substantial heterogeneity was observed among the included studies (I2 = 79 %). ConclusionThe current evidence suggests an association between CVD and severe dengue, emphasizing the importance of closely monitoring individuals with pre-existing cardiovascular disease and providing them with targeted interventions upon dengue diagnosis to mitigate the risk of severe outcomes.

Melanotic neuroectodermal tumors (MNTI) also known as retinal anlage tumor and melanotic progonoma is highly aggressive lesion found in children within 6 months of age. It is a relatively rare pathology and is also rare to metastasise. MNTI can be seen in various locations within the oral cavity, the most common being maxillary jaw. Presently advent technology of has enabled us to utilise various different modalities ranging from radical excision, incomplete resection to chemotherapy. Chemotherapy is preferred in cases of contraindication of surgical approaches. The results regarding each approach can be mixed, successful tumour regression or complete failure. The present article focuses on successful subtotal excision of MNTI in a one year old infant.