Guru Gobind Singh Medical College and Hospital

Children with epilepsy are particularly vulnerable to stigma, inadequate management, and exclusion from educational opportunities, especially in low-resource school environments. Despite the high prevalence of epilepsy, current school-based educational interventions are often fragmented and lack a structured, evidence-informed framework. This study aimed to develop a competency-based epilepsy education curriculum for school teachers to enhance seizure identification, appropriate response, and inclusive classroom support.

A mixed-methods, Delphi-guided study was conducted from February to July 2024 across five diverse Indian regions (urban and rural). Curriculum development followed Kern's six-step model, informed by Social Cognitive Theory and Adult Learning Principles. A comprehensive needs assessment identified core domains, including focus group discussions, stakeholder interviews, and literature review. A 42-member multidisciplinary expert panel participated in two Delphi rounds to refine content and learning objectives. Quantitative analysis (mean scores, per cent agreement, IQR) guided item consensus classification. Reflexive thematic analysis was applied to qualitative inputs.

A comprehensive competency-based epilepsy awareness curriculum for school teachers was developed. A needs assessment involving 60 participants across three centres identified eight thematic domains, including knowledge gaps, misconceptions, emergency response limitations, communication barriers, and resource constraints. This and the literature review informed the identification of 11 curriculum domains. Expert consensus through a two-round Delphi process (n = 42) finalised ten core domains and one introductory topic. An interdisciplinary panel formulated 58 competencies and 170 SMART learning objectives. The curriculum underwent preliminary field testing, and iterative refinements were made based on feedback from end users to enhance clarity, relevance, and applicability in school settings.

A telehealth-delivered, competency-based epilepsy curriculum was developed to address key knowledge and response gaps among school teachers. Informed by stakeholder input and expert consensus, it offers a scalable, evaluable model for improving school-based epilepsy care and may inform similar interventions for other chronic conditions.

Degenerative cervical myelopathy is a progressive neurological disorder resulting from extradural compression of the spinal cord at the cervical level. Clinically, it manifests with motor dysfunction, including hand clumsiness, gait instability, and signs of upper motor neuron involvement. In patients with multilevel cervical involvement, posterior decompressive laminectomy combined with lateral mass screw fixation is aimed at achieving effective spinal cord decompression while maintaining postoperative spinal stability.

This prospective case series aims to evaluate the clinical outcomes and quality of life following posterior decompression and lateral mass fusion in patients with multilevel compressive cervical myelopathy.

A total of 30 patients with compressive cervical myelopathy involving two or more levels were included in the study. Radiological assessments, including X-rays, MRI, and CT scans, were performed for evaluation. All patients underwent posterior cervical decompressive laminectomy combined with lateral mass fusion. Functional outcomes and quality of life were assessed preoperatively and at the one-year postoperative mark using the Japanese Orthopaedic Association (JOA) score and the Denis Pain and Work Scale as primary outcomes. Secondary outcomes assessed were perioperative complications, such as blood loss, neurological deterioration, infections, and implant failure.

The mean age of the patients was 49.5 years. Surgical intervention involved two-level decompression in nine patients (30%), three-level decompression in 14 patients (46%), and four-level decompression in seven patients (24%). The average blood loss was 202.6 mL, and the mean operative time was 135.3 minutes. At the one-year follow-up, the modified Japanese Orthopaedic Association (mJOA) score improved from a preoperative mean of 7.3 to 12.4. The Denis Pain Scale showed an improvement from 3.9 to 1.8, while the Denis Work Scale improved from 4.8 to 3.2. Postoperative complications included wound infections in two patients and transient neurological worsening in four patients, all of which resolved over time. There were no instances of implant failure.

Multilevel cervical laminectomy combined with lateral mass screw fixation is a reliable and effective surgical approach for the management of multilevel cervical myelopathy. This technique facilitates adequate spinal cord decompression, minimizes the risk of postoperative spinal deformities, and preserves the structural integrity of the posterior tension band.

Melasma is a common cause of facial hyperpigmentation with significant cosmetic deformity. Chemical peeling is a common office procedure which has evolved over the years. Peeling has stood the test of time as a simple procedure to rejuvenate the skin.

To evaluate and compare the therapeutic efficacy and safety of lactic acid peel 90% versus pyruvic acid peel 40% in epidermal melasma.

A total of 60 patients were enrolled and randomly divided into two groups of 30 patients each. Priming was done by 0.025% tretinoin cream daily for 2 weeks prior to the peeling. Group A received 90% lactic acid peel every 2 weekly, while group B received 40% pyruvic acid peel every 2 weekly for 12 weeks. Patient evaluation was done using Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MELASQoL) scores. Photographic records were kept.

The mean age of presentation in group A was 33.57 years, and that in group B was 33.36 years. The most common pattern noted was centrofacial in 56.7% of patients in group A and 63.33% patients in group B. The mean MASI score decreased from 10.42 at baseline to 4.59 in group A, while in group B, it decreased from 9.65 at baseline to 4.53. At the 24-week mark, the percentage reduction was 55.44% in group A and 52.07% in group B. The mean baseline MELASQol was 36.83 in group A and 37.7 in group B. At 24 weeks, MELASQol reduced to 21.3 and 20.10 in groups A and B, respectively.

Small sample size.

There was significant reduction in MASI and MELASQol scores as compared to baseline using both lactic acid and pyruvic acid peel, but lactic acid 90% peel showed slightly better results compared to pyruvic acid 40% peel, though not statistically significant. Both peels were safe. Mild burning sensation was reported by a few patients.