Saumya Singh

Permanent transformation is achieved by inculcating a culture of cleanliness; it depends on shared responsibility, collective care and conscious involvement of all citizens

A devastating fire in Lucknow's Vikas Nagar has destroyed 300 shanties. Join Madad Karona to provide 15-day ration kits to displaced migrant families.

Background and aim Peripheral arterial disease (PAD) of the lower limbs causes significant morbidity and risk of limb loss. Endovascular interventions such as angioplasty with stenting may improve outcomes, but comparative prospective data are limited. This study aimed to evaluate the benefit of endovascular intervention (angioplasty with thrombolysis and stenting) and medical management in critical limb ischemia. Materials and methods A prospective observational study was conducted in a tertiary center. Forty-two adult patients with infrainguinal PAD were prospectively enrolled during the study period and received either medical management (Group A; n = 22) or endovascular intervention involving angioplasty with catheter-guided thrombolysis and nitinol stenting (Group B; n = 20). Outcomes, including pain relief, wound healing, need for amputation, mortality, and quality of life (measured by SF-36 and EQ-5D), were assessed over six months. Results Pain relief was observed in 72.7% of patients in Group A vs. 85% of patients in Group B. Wound healing showed a significant advantage in the intervention group: among those who presented with wounds, 81.8% healed in Group B vs. 20% in Group A (p = 0.0046). Amputation rates were 18.2% in Group A vs. 5% in Group B, and mortality was 18.2% in Group A vs. 5% in Group B, although these differences were not statistically significant. Conclusions Angioplasty with thrombolysis and stenting in patients with infrainguinal PAD yielded significant improvement in wound healing and self-care, with trends toward lower amputation and mortality compared with medical management.

``This is a submission for the GitHub Finish-Up-A-Thon Challenge What I...

Emergency laparotomies carry profound physiological morbidity, yet the adoption of minimally invasive surgery (MIS) in acute care remains hindered by laparoscopic limitations. While robotic platforms offer 3D visualization and wristed articulation to overcome these barriers, their application in emergency general surgery (EGS) and visceral trauma remains controversial. This systematic review aims to define the clinical and physiological boundaries of robotic surgery in the acute care setting. A PRISMA-compliant systematic review was conducted using PubMed/MEDLINE, Embase, Scopus, the Cochrane Library, and Web of Science from database inception through March 2026. Eligible studies included adult patients undergoing robotic surgery for EGS or visceral trauma. To minimize analytical confounding, studies were synthesized within two predefined cohorts: EGS and visceral trauma. Primary outcomes included conversion to open surgery, technical success, and timing of intervention. Secondary outcomes included operative time, length of hospital stay, postoperative morbidity, and cost-related outcomes. Thirty-six primary studies met the inclusion criteria, comprising 22 EGS studies and 14 visceral trauma studies. Within the EGS cohort, several comparative studies reported lower conversion-to-open rates with robotic surgery (0.0%-11.5%) compared with conventional laparoscopy (0.0%-28.7%), particularly in acute cholecystitis and complex hernia repair. Operative times were generally longer in robotic procedures, reflecting platform setup and docking requirements, whereas some studies reported shorter postoperative hospital stays. The visceral trauma literature consisted predominantly of case reports, case series, and observational studies. Robotic intervention was almost exclusively performed in hemodynamically stable patients during a delayed or semi-acute phase of care, with a median reported intervention interval of approximately 76 hours in the largest registry analysis. Reported applications were concentrated in complex diaphragmatic, thoracic, pancreatic, and pelvic reconstructions, with high rates of successful completion via minimally invasive techniques. Current evidence suggests that robotic surgery is a feasible minimally invasive option in selected acute care scenarios. In EGS, robotic platforms may facilitate completion of complex procedures while maintaining low conversion rates in appropriately selected patients. In visceral trauma, robotic surgery appears most applicable during delayed or semi-acute reconstruction following physiological stabilization rather than during damage-control interventions. Further prospective studies are required to define patient selection criteria, clinical effectiveness, and cost-effectiveness in acute care surgery.

Abstract Poor understanding of children's agency, which underpins their actions, is problematic when the looming environmental crisis endorses children-led environmental action.