Indian Journal of Pharmaceutical and Biological Research

Comparative Efficacy and Safety of Ketamine-Dexmedetomidine (Ketodex) Versus Ketamine-Propofol (Ketofol) for Procedural Sedation in Pediatric Patients

2026-06-18T08:21:05+00:00

Background: Pediatric procedural sedation requires safe, effective agents to ensure patient comfort while maintaining physiological stability. Combinations such as ketamine-dexmedetomidine (Ketodex) and ketamine-propofol (Ketofol) are increasingly utilized to balance the desirable effects of each component while mitigating their respective side effects.
Objective: This review aims to compare the safety and efficacy of Ketodex and Ketofol for procedural sedation in children aged 0–12 years.
Methods: A narrative synthesis of available clinical evidence, including meta-analyses and randomized controlled trials, was conducted to evaluate respiratory safety, hemodynamic stability, and recovery profiles.
Results: Comparative analysis demonstrates that Ketodex is associated with a significantly lower risk of respiratory depression, making it a safer option for patients with anticipated airway challenges. Conversely, Ketofol is consistently associated with a shorter recovery and discharge time, providing an advantage in fast-track surgical or procedural settings. Both combinations demonstrate similar hemodynamic stability, clinician satisfaction, and incidence of common adverse events such as nausea or vomiting.
Conclusion: The choice between Ketodex and Ketofol should be personalized based on the clinical priority, with Ketodex favored when respiratory safety is paramount and Ketofol preferred when rapid recovery and discharge are the primary objectives.

A Hospital-Based Study to Estimate the Prevalence of Dry Eye and Factors Attributed to IT

2026-06-20T09:47:22+00:00

Background: Dry eye disease (DED) is a multifactorial disorder affecting the ocular surface and tear film, leading to discomfort, visual disturbance, and reduced quality of life.
Aim: To estimate the prevalence of dry eye and identify associated risk factors among patients attending a tertiary care hospital.
Methods: A cross-sectional study was conducted in the Department of Ophthalmology, Government Medical College, Pali, over one year (2025). A total of 300 patients aged ≥18 years were included. Dry eye was diagnosed using a combination of McMonnies and HO dry eye questionnaire, Schirmer’s test, and Tear Film Break-Up Time (TBUT). Statistical analysis included chi-square test and logistic regression.
Results: The prevalence of dry eye was 16.3% (49/300). Females had higher prevalence (22.5%) compared to males (11.1%) (p=0.018). Increasing age, outdoor occupation, and environmental exposure were significantly associated (p<0.05). Mean Schirmer’s value in dry eye patients was 7.2 ± 2.1 mm, and mean TBUT was 7.8 ± 1.9 seconds.
Conclusion: Dry eye is a common yet under-recognized condition. Early detection and modification of risk factors can reduce disease burden.

Platelet-Rich Plasma (PRP) Augmentation in Arthroscopic Knee Meniscal Repair

2026-06-20T09:55:22+00:00

Background: Meniscal injuries are among the most common orthopaedic issues, especially in young, physically active people. The meniscus is essential for load transfer, stress absorption, joint stability, and knee joint lubrication. However, its inherent healing capacity is limited, particularly in the inner avascular zones, resulting in unsatisfactory outcomes after restoration. In recent years, biological augmentation treatments such as platelet-rich plasma (PRP) have gained popularity due to their capacity to improve tissue recovery. PRP includes a high concentration of growth factors that increase cellular proliferation, angiogenesis, and extracellular matrix synthesis, which may improve meniscus repair outcomes.
Objective: To determine the efficacy of PRP augmentation in improving healing rates, lowering discomfort, and improving functional results in patients following arthroscopic meniscal repair.
Methods: A prospective observational study was undertaken over 11 months, with 50 patients undergoing arthroscopic meniscal repair. Patients were separated into two groups: the PRP group (n=25), who got PRP augmentation during surgery, and the control group (n=25), who had routine repair without PRP. Meniscal healing was clinically and radiologically evaluated, pain was measured using the Visual Analogue Scale (VAS), and functional ability was assessed using the Lysholm knee score method. Statistical analysis was conducted using suitable comparative tests, with a p-value <0.05 indicating statistical significance.
Results: The PRP group showed considerably greater healing rates than the control group (82% vs 62%, p<0.05). Furthermore, patients who received PRP reported reduced postoperative pain levels and improved functional results, as evidenced by higher Lysholm scores. These findings imply that PRP promotes biological healing and improves clinical recovery.
Conclusion: PRP augmentation in arthroscopic meniscal repair increases healing rates, decreases postoperative pain, and improves functional outcomes. It is a promising supplementary therapy in meniscus preservation techniques, with the potential to improve patient recovery and long-term joint health.

Clinical Profile and Hormonal Patterns in Women with Newly Diagnosed PCOD Attending a Tertiary Care Hospital

2026-06-20T09:59:19+00:00

Background: Polycystic ovarian disease is an endocrine condition of hormonal imbalance, irregular menstrual periods, and high androgen levels and is the most common endocrine disease in women of reproductive age. It commonly presents with metabolic derangements such as insulin resistance, obesity and dyslipidaemia, which may cause infertility and raise the risk of diabetes and cardiovascular disease in the long run.
Objective: To evaluate the clinical profile and hormonal patterns in newly diagnosed PCOD patients.
Methods: This cross-sectional study was conducted at PMCH, Patna, from September 2025 to February 2026, including 200 women diagnosed with PCOD. Clinical features, BMI, and hormonal parameters (LH, FSH, testosterone, prolactin) were assessed. Statistical analysis included chi-square test and t-test, with p<0.05 considered significant.
Results: The majority of patients were either overweight or obese (70%). The most prevalent symptom was irregular menstruation (70%). Increased LH levels were detected in 65% of patients and increased testosterone levels in 55% of individuals. BMI was significantly associated with hormonal imbalance (P<0.05).
Conclusion: PCOD is strongly associated with obesity and hormonal disturbances. Early diagnosis and lifestyle modification are crucial for management.

Morphological Variation in Lumbricals of Hand

2026-06-20T12:02:45+00:00

Background: The lumbrical muscles of the hand are unique intrinsic muscles responsible for coordinated finger movements and fine motor functions. Variations in their morphology, origin, insertion, and innervation may influence hand biomechanics and surgical outcomes.
Aim: To analyze the morphological variations of lumbrical muscles of the hand in terms of number, origin, insertion, and morphometry.
Materials and Methods: This cross-sectional cadaveric observational study was conducted in the Department of Anatomy, Jawaharlal Nehru Medical College, Bhagalpur, from 2023–2026. Forty hands obtained from 20 formalin-fixed adult cadavers were dissected. Morphological parameters including number of lumbricals, origin, insertion, muscle belly length, tendon length, and variations were documented. Measurements were taken using digital Vernier calipers. Statistical analysis was performed using Microsoft Excel and descriptive statistics.
Results: All four lumbricals were present in 80% of hands, while 12.5% showed only three lumbricals and 7.5% demonstrated supernumerary lumbricals. The first and second lumbricals were predominantly unipennate, whereas the third and fourth lumbricals were mainly bipennate. Accessory insertions and bifid insertions were observed in a few specimens. The mean muscle belly lengths of the first, second, third, and fourth lumbricals were 3.5 ± 0.5 cm, 3.3 ± 0.6 cm, 3.0 ± 0.5 cm, and 2.8 ± 0.5 cm respectively.
Conclusion: Considerable morphological variations exist in the lumbrical muscles of the hand. Awareness of these variations is important for anatomists, hand surgeons, and clinicians during surgical procedures, diagnosis of entrapment neuropathies, and rehabilitation.

Exploring the Link Between Hematological Disorders and Autoimmune Thyroid Diseases

2026-06-20T13:12:27+00:00

Background: Autoimmune thyroid disorders (AITDs), which include hypothyroidism and hyperthyroidism, are frequently accompanied with hematological abnormalities like anemia, leukopenia, and thrombocytopenia. Understanding this link is critical for early diagnosis and management.
Methods: This retrospective analysis comprised 100 patients diagnosed with autoimmune thyroid disease over the course of a year. Hematological markers were examined and linked with thyroid function. The Student’s t-test and the Chi-square test were used in the statistical analysis.
Results: Hematological abnormalities were seen in 62% of individuals. The most prevalent observation was anemia (40%), followed by leukopenia (15%), and thrombocytopenia (7%). A strong link was discovered between hypothyroidism and anemia (p=0.01). Patients with hematological disorders had considerably different thyroid profiles.
Conclusion: Autoimmune thyroid illnesses are strongly associated with hematological problems, particularly anemia. Routine hematological examination is advised in patients with thyroid dysfunction for early diagnosis and therapy.

Histopathological Spectrum of Prostatic Lesions and Correlation with Total Serum Prostate-Specific Antigen: A Prospective Observational Study

2026-06-20T13:17:00+00:00

Background: Prostatic lesions range from benign hyperplasia to malignant lesions, with serum prostate-specific antigen (PSA) serving as an important biomarker for screening and disease monitoring. However, PSA levels often overlap between benign and malignant conditions, making histopathological confirmation essential.
Objective: To evaluate the histopathological spectrum of prostatic lesions and correlate findings with serum PSA levels.
Methods: This prospective observational study was conducted at DMCH from February 2025 to October 2025, including 90 patients presenting with lower urinary tract symptoms. Serum PSA levels were measured, and histopathological examination was performed on biopsy or resection specimens. Statistical correlation between PSA levels and histological diagnoses were analyzed.
Results: Benign prostatic hyperplasia (BPH) was the most common lesion (62.2%), followed by prostatitis (15.6%), carcinoma (16.7%), and prostatic intraepithelial neoplasia (PIN) (5.5%). Mean PSA levels were significantly higher in malignant lesions (36.8 ± 12.4 ng/mL) compared to benign conditions (6.2 ± 3.1 ng/mL) (p < 0.001). A strong positive correlation was observed between elevated PSA levels and malignancy.
Conclusion: PSA is a useful screening tool but lacks specificity. Histopathological examination remains the gold standard for diagnosis. Combined evaluation improves diagnostic accuracy.

Evaluation of Iron Status Biomarkers and Cognitive Performance Among Pediatric Patients with Iron Deficiency Anemia

2026-06-27T10:02:12+00:00

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency among children worldwide and is associated with impaired neurocognitive development. Iron plays a crucial role in neurotransmitter synthesis, myelination, and energy metabolism in the developing brain. Early identification of cognitive impairment associated with iron deficiency may facilitate timely intervention and improve developmental outcomes.
Objectives: To evaluate iron status biomarkers among pediatric patients with iron deficiency anemia and assess their association with cognitive performance.
Materials and Methods: A hospital-based cross-sectional study was conducted among 100 children aged 6–12 years attending the pediatric outpatient department of a tertiary care teaching hospital. Fifty children diagnosed with iron deficiency anemia constituted the study group, while fifty age- and sex-matched healthy children served as controls. Hemoglobin concentration, serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation were measured using standard laboratory methods. Cognitive performance was assessed using age-appropriate standardized cognitive assessment tools evaluating memory, attention, processing speed, and executive functions. Statistical analysis was performed using SPSS version 25.0. Independent t-test and Pearson correlation analysis were used to determine differences and associations. A p-value <0.05 was considered statistically significant.
Results: Children with iron deficiency anemia (IDA) had significantly lower hemoglobin (9.2 ± 1.1 vs. 12.8 ± 0.9 g/dL), serum ferritin (11.4 ± 4.2 vs. 42.8 ± 8.5 ng/mL), serum iron (38.7 ± 9.3 vs. 86.5 ± 12.1 μg/dL), and transferrin saturation (8.7 ± 2.1 vs. 27.4 ± 4.5%) compared to controls, while TIBC was significantly higher (445 ± 35 vs. 325 ± 28 μg/dL) (p<0.001). Cognitive performance scores, including attention, memory, processing speed, and executive function, were significantly lower in the IDA group (p<0.001). Overall cognitive performance showed positive correlations with hemoglobin (r=0.52, p<0.001) and serum ferritin (r=0.48, p<0.001), whereas TIBC demonstrated a negative correlation (r=-0.41, p=0.004). Cognitive scores declined progressively with increasing severity of anemia.
Conclusion: Pediatric patients with iron deficiency anemia exhibited significantly altered hematological and iron status biomarkers along with impaired cognitive performance compared to healthy controls. Lower hemoglobin and ferritin levels were significantly associated with poorer cognitive outcomes. These findings highlight the importance of early screening, diagnosis, and treatment of iron deficiency anemia to improve cognitive development and academic performance among children.

Surgical Site Infections in Digestive Surgery: A Meta-Analysis of Hospitals in BBMCH BALANGIR

2026-06-27T11:24:14+00:00

Objective: To study the characteristics of surgical site infections (SSI) in digestive surgery in BBMCH BALANGIR.
Patients and Methods: This was an analytical, crosssectional, and multicenter study conducted from March 1 to September 30, 2024, in the digestive surgery departments of GENERALSURGERY the BBMCH BALANGIR. All hospitalized patients aged at least 18 years who underwent abdominal surgery were included in the study. Patients were followed up within 30 days of surgery.M
Results: During the study period, 493 patients were included, 73 cases of SSI were recorded, representing a frequency of 14.8%. Was the center with the most cases of SSI were found in the university hospital (58 patients or 79.4%). The median age was 41 years. Male sex was predominant with a sex-ratio of 1.35. Among the SSIs, 74% were superficial; 20.5% deep and 5.5% organ. Acute generalized peritonitis was the most common pathology of infected patients (60.3%). Of the 73 samples analyzed, 70 cultures were positive, representing 95.8%. Escherichia coli were the most identified microorganism (36.5%), followed by non-coagulase Staphylococcus (15%) and Klebsiella pneumoniae (12.2%). Multivariate analysis showed that SSI was statistically associated with ASA score, operative mode, and NNISS score.
Conclusion: SSIs represent a major public health problem. Prevention relies on rigorous epidemiological surveillance and compliance with good perioperative hygiene practices.

Comparative Study of Anisometropic Amblyopia treatment with Spectacles alone and Combined spectacles with Patching

2026-06-27T13:10:21+00:00

Comparative study of anisometropic amblyopia treatment with spectacles alone and combined spectacles with patching
Purpose: To compare duration and amount of improvement with spectacles alone and spectacles with patching in anisometropic amblyopia.
Study Design: Prospective comparative interventional study
Methods: This prospective study was conducted at Department of Ophthalmology GMC Doda ,GMC Rajori, GMC Handwara , GMC Anatnag and District hospital pulwama J&K for period of five years. Difference in BCVA of 2 snellen lines or more in absence of any structural abnormality or visual pathway was considered indicative of amblyopia.
Inclusion criteria: Unilateral amblyopia, V/A < 6/9, Age 4 to 10 years, Anisometropia > 1D
Exclusion criteria: Stimulus deprivation amblyopia, Age <4 & >10 years, Bilateral Amblyopia, Already treated or under treatment amblyopia. 68 Amblyopic children were either treated with spectacles alone or with combined spectacle and patching. Follow up was done after every 2 months.
Results: Among 68 amblyopic children 30 were treated with spectacles alone and 38 were treated with combined spectacles and patching. Mean age at start of treatment in former was 6.2 +/-2.3 and 5.8 +/- 2.6 in combined group. Final V/A after treatment was 20/40 and 20/25 respectively among two groups. Mean time of amblyopia improvement was 7.3 +/- 4.1 and 6.2 +/- 3.5 in spectacles alone and combined spectacles and patching respectively.
Conclusion: Amblyopic children treated with combined spectacles and patching showed better results in amount as well as duration of treatment than those treated with spectacles alone.

Uterine Fibroids and Hysterectomy Route: Comparative Perioperative Outcomes of Abdominal, Vaginal, Laparoscopic, Robotic, and vNOTES Approaches

2026-06-29T11:56:32+00:00

Background: Uterine fibroids are the most prevalent benign pelvic tumour in women of reproductive age and up to 70% of women are affected by the age of 50. For symptomatic non-responsive fibroids, surgery to remove the uterus (hysterectomy) is the last resort. There are several surgical approaches: total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), total laparoscopic hysterectomy (TLH), laparoscopically-assisted vaginal hysterectomy (LAVH), robotic-assisted total laparoscopic hysterectomy (R-TLH), and the increasingly popular transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy. Although a lot of literature has been written, the best route selection is still not agreed.
Objectives: To systematically review and meta-analyze operative time, estimated blood loss (EBL), length of hospital stay (LOS), intraoperative and postoperative complication rates and conversion rates for all major hysterectomy approaches for the benign uterine fibroid indication (2022–2026).
Methods: Systematic review and meta-analysis in accordance with the PRISMA 2020 guidelines. Databases: PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus and Web of Science (January 2022–June 2026). Random-effects models (DerSimonian-Laird) were used; assessment of heterogeneity using the I² statistic.
Results: Nine studies (total of 1,116,000 patients) of minimally invasive hysterectomy (MIH) showed lower EBL, shorter LOS, and lower overall complication rates compared to TAH in each study. The most common approach was TLH (54.4% in high volume centers). Robotic hysterectomy vs. open: OR 0.42 (0.27–0.66) complications; 6.31-fold risk for transfusion in abdominal. R-TLH vs. C-TLH: similar peri-operative outcomes, with R-TLH having a slightly shorter LOS (MD −0.64 days, 95% CI: −1.10 to −0.17). TLH had a 7.54-fold greater risk of ureteral injury compared to TVH for large uteri (at or above 250 g). The vNOTES hysterectomy was demonstrated to be non-inferior to TLH, and had shorter operative time and better pain scores. Laparoscopic myomectomy demonstrated significantly reduced EBL (105 mL versus 317 mL), shorter operative time, and quicker recovery when compared with open myomectomy.
Conclusion: Hysterectomy is the standard of care for the treatment of uterine fibroids and minimally invasive procedures are the usual treatment. The ‘vaginal-first’ or ‘laparoscopic-first’ algorithm allows for the best possible outcomes while keeping surgical flexibility.A ‘vaginal-first algorithm’ or ‘laparoscopic-first algorithm’ with vNOTES as a teaching tool and safety net. Patient size, surgeon experience, patient comorbidities and fertility status should all be taken into account when developing the route of selection.

Morphometric Analysis of Foramen Magnum in Adult CT Images: A Cross-Sectional Study

2026-07-01T12:40:47+00:00

Background: The foramen magnum is a vital anatomical structure located at the base of the skull, transmitting the lower brainstem, vertebral arteries, meninges, and associated neurovascular structures. Accurate morphometric assessment of the foramen magnum is important in neurosurgery, radiology, anthropology, and forensic medicine. Computed tomography (CT) provides precise measurements of cranial base anatomy and facilitates evaluation of morphometric variations in living populations.
Aim: To evaluate the morphometric dimensions of the foramen magnum in adult CT images and establish baseline data useful for clinical, surgical, and forensic applications.
Materials and Methods: A cross-sectional observational study was conducted using CT images of adult patients attending the Department of Radiology, Government Medical College, Medak. Adult subjects between 18 and 79 years of age who underwent cranial CT examination were included. Patients with craniovertebral junction anomalies, fractures, neoplasms, or pathological conditions affecting the skull base were excluded. Morphometric parameters including anteroposterior diameter, transverse diameter, right oblique diameter, and left oblique diameter of the foramen magnum were measured using CT imaging. Data were analyzed using appropriate statistical methods, and morphometric differences between sexes were evaluated.
Results: Morphometric assessment demonstrated that the anteroposterior diameter was consistently greater than the transverse diameter in the majority of subjects. Male participants exhibited larger mean dimensions of the foramen magnum compared with female participants. Significant variations were observed among the measured parameters, reflecting normal anatomical diversity within the study population. The findings established normative morphometric values for the adult population studied and highlighted the utility of CT imaging in evaluating cranial base anatomy.
Conclusion: The present study provides valuable morphometric data regarding the dimensions of the foramen magnum in adults. These measurements may aid neurosurgeons in planning craniovertebral junction procedures, assist radiologists in anatomical assessment, and contribute to forensic identification and anthropological research. CT-based morphometric evaluation offers a reliable and non-invasive method for studying variations of the foramen magnum in living populations.

Morphological and Morphometric Study of Atlas (C1) and Axis (C2) Vertebrae in Human Skeletons

2026-07-02T12:58:53+00:00

Background: The atlas (C1) and axis (C2) vertebrae are specialized cervical vertebrae that facilitate head movement and provide stability to the craniovertebral junction. Detailed morphometric knowledge of these vertebrae is essential for neurosurgical procedures, spinal fixation techniques, and forensic investigations.
Aim: To analyze the morphological variations and morphometric dimensions of atlas and axis vertebrae in human skeletal specimens and evaluate their clinical significance.
Methods: A retrospective osteological study was conducted in the Department of Anatomy, Government Medical College, Jammu, over 3 months. Thirty dry human vertebrae (15 atlas and 15 axis vertebrae) were examined. Various morphometric parameters including transverse diameter, anteroposterior diameter, vertebral canal dimensions, superior articular facet measurements, dens dimensions, and vertebral foramen dimensions were recorded using digital Vernier calipers. Morphological variations were documented. Statistical analysis was performed using SPSS version 26. Student’s t-test and Pearson correlation analysis were applied, with p<0.05 considered statistically significant.
Results: The mean transverse diameter of the atlas was 76.4 ± 4.8 mm, while the mean anteroposterior diameter measured 44.2 ± 3.5 mm. The average length of the dens in axis vertebrae was 15.8 ± 1.7 mm and the mean width was 9.1 ± 1.2 mm. Morphological variations were observed in 26.7% of specimens. Significant positive correlations were found between vertebral body dimensions and dens measurements (p<0.001).
Conclusion: Atlas and axis vertebrae exhibit significant morphometric variability. These findings provide valuable anatomical data for craniovertebral junction surgery, cervical instrumentation, and forensic anthropology.

Aerobic Bacteriological Isolates of Burn Wound Infections and Their Antimicrobial Sensitivity Pattern in the Burn Unit of a Tertiary Care Hospital in Bihar: A Prospective Observational Study

2026-06-30T07:36:18+00:00

Background: Burn wound infections are among the leading causes of morbidity and mortality in burn patients due to loss of skin barrier, immunosuppression, prolonged hospitalization, and emergence of antimicrobial-resistant organisms. Continuous monitoring of the bacteriological profile and antimicrobial susceptibility pattern is essential for effective management of burn wound infections.
Aim: To study the aerobic bacteriological isolates of burn wound infections and evaluate their antimicrobial sensitivity pattern among patients admitted to the Burn Unit of Patna Medical College & Hospital (PMCH), Patna.
Materials and Methods: A hospital-based prospective observational study was conducted in the Burn Unit of PMCH, Patna, from October 2022 to September 2023. A total of 100 burn wound patients clinically suspected of wound infection were included. Wound swabs/pus samples were collected under aseptic precautions and processed using standard microbiological techniques for aerobic bacterial isolation and identification. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was performed using SPSS version 25.0.
Results: Among the 100 burn wound samples studied, bacterial growth was obtained in 79 samples, while 21 samples showed no growth. Of the culture-positive samples, 69 (87.34%) demonstrated monomicrobial colonization and 10 (12.66%) demonstrated polymicrobial colonization. A total of 89 bacterial isolates were recovered. Pseudomonas aeruginosa was the predominant isolate accounting for 41.57% of isolates, followed by Staphylococcus aureus (25.84%), coagulase-negative staphylococci (14.60%), Klebsiella pneumoniae (8.98%), Escherichia coli (5.61%), and Proteus mirabilis (3.37%). Gram-negative organisms constituted 59.55% of isolates, whereas Gram-positive organisms accounted for 40.45%. Imipenem demonstrated the highest sensitivity against Gram-negative isolates, while vancomycin and linezolid showed 100% sensitivity against Gram-positive isolates.
Conclusion: Pseudomonas aeruginosa was the predominant aerobic bacterial isolate recovered from burn wound infections in the present study, followed by Staphylococcus aureus. Gram-negative organisms were more common than Gram-positive organisms. Imipenem showed excellent activity against Gram-negative isolates, while vancomycin and linezolid remained highly effective against Gram-positive isolates. Regular bacteriological surveillance and rational antibiotic use are essential for effective management of burn wound infections and prevention of antimicrobial resistance.