Dr. Panjabrao Deshmukh Memorial Medical College

Internet Addiction (IA) and Internet Gaming Disorder (IGD) may provide significant challenges for medical students as it is linked to sleep and mental health can obstruct academic pursuits, affect long-term professional aspirations and yield extensive adverse effects on society at large. To find the prevalence of IA, IGD, insomnia and depression amongst medical undergraduates and to examine their correlation. A mixed-methods study was conducted amongst 402 undergraduate medical students at a rural medical college. Data were gathered by a semi-structured, self-administered questionnaire encompassing socio-demographic information, the Young Internet Addiction Test, the short form of the Internet Gaming Disorder Scale (IGDS-SF), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire. Focus group discussions were done with 56 students chosen for their high scores in IA and IGD. Thematic analysis was employed to discern patterns and themes within the qualitative data. Data triangulation was conducted to interpret and elucidate the quantitative results using qualitative observations. The mean age of the study participants was 20.39 ± 1.43 years. IA was present in 41.04%, gaming disorder in 20.89%, insomnia in 36.56% and depression in 14.42% participants. Year of study and hostel stay had a statistically significant association with all (P < 0.002). There was a strong and statistically significant association found between IA and IGD with depression and insomnia (P < 0.0001). Furthermore, a statistically significant correlation was found between scores and grades of IA and IGD; and insomnia and depression. Internet usage amongst medical students was notably high (40%) and showed a significant association with insomnia and depression. Hence, early identification of students at risk for IA and IGD is crucial, as these addictions often overlap with other psychological issues.

Platelet-rich plasma (PRP) therapy has gained prominence in orthopedics as a regenerative approach that utilizes autologous platelets enriched with growth factors to facilitate tissue healing. Innovations such as protein-enriched filtered PRP and the integration of PRP with biomaterials, including 3D-printed scaffolds and bioactive molecules like kartogenin, have been developed to enhance outcomes in cartilage and bone repair. Clinical studies have demonstrated the efficacy of PRP in managing conditions such as knee osteoarthritis, rotator cuff tendinopathy, and lateral epicondylitis, often showing superior long-term benefits compared with conventional treatments. Emerging therapies that combine PRP with mesenchymal stem cells and peptide-based treatments have shown synergistic effects, further enhancing tissue regeneration and functional recovery. Despite these promising developments, variability in PRP preparation methods and application protocols underscores the need for standardized guidelines and large-scale clinical trials to fully establish the role of PRP in orthopedic practice.

General anesthesia (GA) is often preferred for cervical spine surgeries; however, it may pose risks for patients with severe comorbidities. This case report describes management of cervical decompression laminectomy using continuous thoracic spinal anesthesia (TSA) with hypobaric levobupivacaine in a high-risk elderly patient. This technique provided an effective alternative to GA.

Hailey-Hailey disease (HHD), also known as benign familial pemphigus, is a rare genodermatotic disorder characterized by painful blistering and erosions in intertriginous areas. Exacerbations are often triggered by sweating, minor trauma, and secondary infections, leading to significant morbidity and reduced quality of life. This case series presents three biopsy-proven recalcitrant HHD patients treated with low-dose naltrexone (LDN), an off-label, low-cost, and low-risk therapeutic option. The patients, who had failed multiple conventional treatments, were administered LDN hydrochloride starting at 3 mg/day and titrated to 6 mg/day over eight weeks. All three showed marked clinical improvement, including resolution of erosions and ulcerations, reduced pain, and decreased erythema, with sustained results over four months without flare-ups. While these findings suggest LDN may be an effective adjunct or alternative therapy for HHD, further research is needed to confirm its efficacy, long-term safety, and potential applicability in other calcium transport-related disorders.

Vacuum-assisted closure (VAC) is an alternative method of wound management, which uses negative pressure to prepare the wound for spontaneous healing or for lesser reconstructive options.Aims and Objectives: To determine the effectiveness of VAC dressings in the healing of chronic wounds, as compared to normal wound dressings. The study was conducted among 60 patients with chronic wounds randomly divided into groups of 30 each, to compare VAC dressing with conventional dressings. There was a significant difference in total hospital stay, granulation tissue fill up and graft take up in both groups. The mean duration of hospital stay in Group A and Group B was 22.4 ± 5.61 and 28.57 ± 6.45 days, respectively. The mean percentage of granulation tissue formation in Group A was 94.12 ± 6.03, and in Group B was 91.2 ± 2.71. Activated Carbon dressing was found to be more beneficial and patient- patient friendly with lesser hospital stay and thus lesser cost than conventional dressings.

Schwannomas are benign soft-tissue tumors originating from Schwann cells in the myelin sheath of peripheral nerves as well as from nerve roots. Retroperitoneal schwannomas, accounting for 1%–3% of all schwannomas, are rare and often mimic gynecological malignancies, posing diagnostic challenges. This report highlights a case of a 40-year-old female presenting with abdominal pain, heavy menstrual bleeding, dysmenorrhea, and passage of clots. Clinical examination and ultrasonography revealed a right ovarian mass (10.2 cm × 6.3 cm), a left ovarian cyst (3.7 cm × 2.7 cm), and an intramural fibroid of size 1.9 cm (International federation of Gynecology and Obstetrics [FIGO] type 3). Tumor markers (CA-125, CEA, and CA19.9) were within normal limits, ruling out typical ovarian malignancies. Other tumor markers human chorionic gonadotropin and Inhibin had not done. The patient underwent a panhysterectomy with bilateral salpingectomy with excision of the retroperitoneal mass. Intraoperatively, the operating surgeon had sent a specimen of retroperitoneal mass for frozen section examination. A gross examination revealed a firm mass with degenerative changes. Panhysterectomy specimen on histopathology revealed simple endometrial hyperplasia, an intramural leiomyoma, and chronic cervicitis with an inflammatory cervical polyp and normal bilateral fallopian tube. Excised retroperitoneal mass on histopathology identified an ancient schwannoma with focal nuclear atypia. Immunohistochemistry confirmed the schwannoma diagnosis, with positive SOX10 and S100, and negative SMA and CD34. Concurrent intramural leiomyoma and normal fallopian tube histology were also noted. Retroperitoneal schwannomas, particularly of ancient type, often mimic ovarian malignancies due to overlapping symptoms, demanding comprehensive diagnostic workups. Imaging, histopathology, and immunohistochemistry are pivotal for distinguishing schwannomas from gynecological malignancies, ensuring accurate diagnosis and management. This case highlights the importance of considering rare differential diagnoses in patients with complex presentations. Surgical excision remains essential for definitive diagnosis and symptom resolution, with histopathological evaluation key to identifying prime and concurrent pathologies, in cases of overlapping gynecological and retroperitoneal masses.

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity around the world. Hysterectomy is commonly performed when other conventional treatment attempts fail. DR. BURKES balloon tamponade is a novel conservative management option for PPH. PPH is a serious complication during delivery. Uterine balloon tamponade (UBT) is a novel, conservative management option for controlling this hemorrhage. Aims and Objectives: To evaluate the efficacy and safety of UBT in managing atonic PPH at a tertiary care hospital and assess its impact on maternal outcome. Methodology: A period-based study was conducted in the department of obstetrics and gynecology at a tertiary care hospital for 1 year. All the women with atonic PPH after vaginal or cesarean delivery after obtaining informed consent were enrolled in our study. Results: Among a total of 48 cases 46 (95.83%) cases of bleeding got controlled within 15–30 min of tamponade insertion. In 2 (4.17%) cases, bleeding persisted even after 30 min. Blood transfusion was given for 95.8% of cases in whom balloon tamponade was put to control atonic PPH. Conclusion: Balloon catheter is a noninvasive, effective, conservative method of PPH management.

Detecting anaemia in resource-limited settings is challenging due to limited access to diagnostic tools, healthcare infrastructure, and trained personnel, often resulting in underdiagnosis and delayed treatment. This study aims to evaluate HemoQR, a novel point-of-care (POC) diagnostic method for haemoglobin (Hb) level detection using a smartphone-based system integrated with a paper strip without needing any reagent or additional auxiliary device. The goal is to assess the efficacy of this portable, user-friendly, rapid and accurate alternative for Hb measurement in large-scale intervention programmes such as Anaemia-mukt Bharat (AMB), which is crucial for diagnosing anaemia and monitoring various health conditions. The method involves the transfer of one drop of the blood sample to a paper strip that is made indigenously using plant based cellulosic sources for optimal functionality. The colour signal around the test spot is quantitatively analysed using a smartphone camera equipped with a custom application. The application processes the images through a machine learning algorithm to determine the Hb concentration. The system was evaluated in a clinical trial involving 200 participants, comparing its performance with the gold-standard laboratory Hb assay using automated haematology analyser. The smartphone-based method demonstrated high sensitivity (87.09 %) and specificity (96.11 %) for anaemia screening, as compared with laboratory results. The average detection time was significantly reduced to under q minute, and the system showed excellent user-friendliness and portability with no auxiliary device needed beyond the smartphone. Clinical trial results indicated that the device was accurate and reliable across different Hb levels. Summarily, HemoQR evidenced to be a promising tool for POC diagnostics. Its high accuracy, rapid results, and ease of use make it suitable for both clinical settings and remote areas with limited access to laboratory facilities. Future research will prioritize further validation and integration of the anaemia screening outcome with electronic health records from a large population cohort. This will help identify early indicators and signals of numerous emerging disease burdens that could escalate into secondary and tertiary health crises if not addressed in time.