Krishna Institute of Medical Sciences Deemed University

Background: Arthroscopic anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) autografts is very popular, and could result in knee flexion weakness and harvest-related morbidity. An alternative of constant diameter, with arguably reduced donor-site morbidity, has developed in the form of the peroneus longus tendon (PLT) at the expense of ankle function. Methods: It was a prospective randomized self-controlled study that was undertaken in a tertiary orthopaedic unit (2023-2025). The participants were randomly divided into 30 individuals with isolated unilateral ACL rupture who received ACLR with either PLT autograft (n=15) or quadrupled HT autograft (n=15). The measurement of functional outcomes was preoperative, 1.5, 3, 6 months using Modified Cincinnati Score (MCS), Lysholm score, and Subjective IKDC 2000. Donor-site complications were measured using AOFAS (PLT group), thigh circumference deficit, sensory symptoms, pain, ankle range of motion, and handheld dynamometry-based strength. Knee stability was evaluated using Anterior Drawer, Lachman, Pivot Shift and KT-1000 arthrometer at the follow-up. Independent t-tests/Mann-Whitney U tests and chi-square tests were conducted in groups (due to the independent test, 1=0.05). Results: PLT had more mean graft diameter than HT (8.68±0.23 mm; and 7.65±0.59 mm, respectively, p<0.001). Both groups had also improved but at 12 months, PLT had better MCS (90.1±2.9 vs 86.8±2.7), Lysholm (89.9±3.8 vs 86.3±2.1) and IKDC (92.4±4.3 vs 89.1±5.2) (all p<0.05). With enduring effects, recovering the stance favoring PLT actions and dynamics with time of 3 months and above, there was less KT-1000 side-to-side difference in final follow-up (1.2±0.5 vs 1.8±0.6 mm, p<0.01). PLT had a reduced donor-site morbidity (thigh deficit 0.520.2 cm vs 1.22.04 cm, p=0.001), and comparable outcomes of the ankle near outcome normalcy at 12 months (AOFAS 97.62.4). Conclusion: Even though PLT autograft ACLR yielded thicker grafts, faster mobilization, better 12-month stability and less donor-site morbidity and ankle functionality, it helps to support the idea that PLT is a strong alternative to HT in primary ACLR.

Introduction: The Journal of Pediatric Critical Care (JPCC), launched in 2014 by the Indian Academy of Pediatrics–Pediatric Intensive Care Chapter, is the first pediatric critical care journal from a low- and middle-income country (LMIC). Designed to nurture context-specific research and amplify LMIC scholarship, it has evolved into a key academic platform. We aimed to describe its 10-year growth, academic impact, and lessons for LMIC-driven publishing. Methods: We retrospectively analyzed JPCC’s publications from 2014–2024 using the journal’s archives and editorial database. Metrics included article type, geographic and institutional authorship, reviewer diversity, indexing status, submission trends, acceptance rates, and readership. Results: JPCC published 711 articles: 22% original research, 23% reviews, 27% case reports, and 28% other content (guidelines, editorials, updates). Submissions increased from 36 (2014) to 107 (2024), while acceptance rates declined from 95% to 46%, reflecting improved selectivity. Authors grew from 28 to 1,612, and the reviewer pool expanded to 151, including 46 international reviewers. Indian authors contributed 87% of articles, with increasing participation from 20+ countries, led by Pakistan, the UAE, and the U.S.. Maharashtra, New Delhi, and Karnataka were leading national contributors. Indexing milestones included DOAJ (2020) and Scopus (2024), alongside rising global readership (25,758 full-text users in 2024). Research from JPCC has informed national guidelines, quality improvement initiatives, and regional training programs. Conclusions: In its first decade, JPCC has evolved from a society newsletter to a Scopus-indexed journal with global readership, establishing a replicable model for LMIC-driven publishing. Its growth underscores the value of mentorship, inclusive editorial policies, and focus on context-relevant research. Future priorities include PubMed indexing, South-South collaborations, and expanded digital engagement to strengthen its role in shaping pediatric critical care scholarship globally.

Antenatal care is essential for ensuring a healthy pregnancy, especially in first-time mothers (primigravida) who may experience greater uncertainty and risks. The present study aimed to evaluate the effect of a perinatal education program on maternal outcomes among primigravida mothers. A total of 144 primigravida mothers attending the antenatal outpatient department at a tertiary care hospital were enrolled. The intervention group ( n = 72) received perinatal education covering antenatal care (diet, hygiene, exercise, and relaxation), intranatal guidance (back massage, breathing techniques, and labor expectations), and postnatal education (breastfeeding, newborn care, maternal health, and family planning) in seven sessions. The control group ( n = 72) received routine care. Maternal outcomes were assessed throughout pregnancy, during labor, and postpartum, and data were analyzed using appropriate parametric and nonparametric statistical tests. The posttest knowledge scores were significantly higher ( t = 20.59, p < .001) in the intervention group (33.9 ± 2.5) than the control group (21.2 ± 4.6). The intervention group had lower stress scores and a higher rate of normal vaginal births compared with the control group. The intervention group showed a significantly shorter duration of labor in the second and third stages, increased placental weights, and lower blood loss during birth ( p < .001 for all). The perinatal education program significantly improved maternal knowledge and outcomes in primigravida mothers, including higher rates of normal vaginal birth, shorter labor duration, reduced blood loss, and fewer complications. These findings support integrating structured perinatal education into routine antenatal care to enhance maternal knowledge and clinical parameters and improve overall pregnancy outcomes.

Artificial intelligence neuroscience (AI) in combination with neural sciences gives rise to the Intelligent Neurohealth Systems, or rather INHS, that disrupt both diagnostics and treatment therapies. Such systems apply techniques of machine learning, deep learning, and neuroinformatics to boost the accuracy of ascertaining neurological disorders, planning treatments, and monitoring patients. By analyzing massive datasets from neuroimages, genomics, and electronic health records, INHS provides unprecedented insights into the detection and progression of neurological diseases at productivity peak levels. Furthermore, AI technology, through personalized pharmacogenomics, optimizing drug regimens tailored to individuals’ genetic profiles, along with adaptive deep brain stimulation, has shown tremendous capability to improve therapeutic results. This paper discusses the major technologies enabling INHS, which include machine learning–based algorithms, brain-computer interfaces, and robotic rehabilitation. It focuses on their uses in neurology through AI-aided diagnostic tools for Alzheimer's and Parkinson's diseases, pacemaker systems for seizure prediction, and remote caregiving telemedicine systems for uninterrupted patient monitoring. Also, we analyze the limitations of implementing such systems, like the privacy of complex data, bias of AI models, and lack of governance policies. With studies and more AI case studies showcasing advanced technologies, we demonstrate the new solutions engineered with AI for neurohealth. We consider directions such as the implementation of quantum computing for quicker analysis of neuromata, AI-powered mental health applications, and the creation of explainable AI models to be used in clinical settings to enhance trust in AI outputs. Intelligent Neurohealth Systems, incorporated with modern technologies, have the potential to revolutionize the diagnosis, management, and treatment of neurological disorders, paving the way towards enhanced, customized healthcare.

Diabetes mellitus, especially type 2 diabetes, is a global health challenge with growing prevalence and limitations in existing therapies. Herbal medicines present promising alternatives due to their safety, accessibility, and multi-target mechanisms. Alstonia scholaris (L.) R.Br., widely recognized in Ayurvedic and folk medicine, exhibits diverse pharmacological activities, including antidiabetic effects. This study aimed to develop and characterize a nanosuspension of A. scholaris leaf extract and evaluate its in vitro antidiabetic potential. The nanosuspension was formulated using the antisolvent precipitation method and characterized for physicochemical properties. Dynamic light scattering revealed an average particle size of 97.1 nm, Z-average of 86.9 nm, and a Polydispersity Index (PDI) of 0.398, confirming uniform distribution. Zeta potential (-17.8 mV) indicated moderate stability. In vitro enzyme inhibition assays demonstrated concentration-dependent α-glucosidase (51.55% at 1000 µL) and α-amylase (58.01% at 1000 µL) inhibition, though less potent than standard drugs. Overall, the nanosuspension shows potential as a natural adjunct in diabetes management.

GPC is a rare, indolent sinonasal neoplasm with an excellent prognosis after complete excision. It comprises 0.5% of all the sinonasal tumours. A 40-year-old female presented with complaints of left-sided intermittent nosebleeds and nasal obstruction for 4 months. Nasal endoscopy showed a soft mass medial to the left middle turbinate, which bled on touch. Computed tomography (CT) of paranasal sinuses showed a well-defined lobular soft tissue mass with no bony erosion. Complete endoscopic excision of the tumour was performed. Histopathological examination and immunohistochemistry studies confirmed the diagnosis of GPC. Epistaxis and nasal obstruction are the common presenting features of glomangiopericytoma (GPC). Complete excision is the treatment of choice. CT and magnetic resonance imaging facilitate in diagnosis, but definitive diagnosis is achieved by tissue sampling. It is essential to recognise GPC in differential of sinonasal masses as they seldom necessitate intensive treatment beyond local excision.

Objective: To evaluate the accuracy of nurse-led triage using a three-level institutional protocol in a tertiary care emergency department (ED) and identify predictors of triage discordance. Methods: This cross-sectional study included 1,249 adult ED patients. Nurse-assigned triage levels were compared with emergency physician (EP) triage, considered the gold standard. Accuracy, under-triage, and over-triage rates were calculated. Cohen's Kappa (κ) assessed agreement. Univariate chi-square (χ²) analysis was performed to identify associations between variables and triage inaccuracy, with odds ratios (OR) and 95% confidence intervals (CI) calculated from cross-tabulations. Results: Triage accuracy was 94.6%, with 4.88% over-triage and 0.48% under-triage. Agreement between nurse and EP triage was κ = 0.91 (95% CI: 0.89–0.93), indicating excellent concordance. Univariate analysis identified significant associations between over-triage and elevated respiratory rate (≥25/min; p=0.002) and elevated systolic blood pressure (≥160 mmHg; p=0.039). Under-triage was rare (n=6, 0.48%). No variables significantly predicted under-triage. Conclusion: Nurse-led triage demonstrated high accuracy and excellent agreement with emergency physicians. Over-triage occurred more often than under-triage and was strongly associated with abnormal physiological parameters. Reinforcement of vital-sign interpretation, structured training, and periodic audits may improve further accuracy in resource-limited settings. Keywords: Triage accuracy; Under-triage; Over-triage; Emergency department; Physiological predictors; Kerala