Due to explosive growth in technology and internet usage in the last few years, internet gaming disorder (IGD) has manifested as rapidly growing public health problem mainly affecting the teen and preteen population worldwide. It has a negative impact upon physical, psychological, social, and occupational functioning of the affected individual, often leading to severe consequences. It was only recently that it has been recognized as a separate diagnosable disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. Not much data is available regarding the exact prevalence and the various sociodemographic, clinical, and other risk factors to identify the individuals vulnerable to develop this disorder, especially in the developing countries such as India. According to a recent report, India ranks 22nd in the list of highest revenue-generating countries from gaming-related businesses, thus highlighting the magnitude of risk faced by Indian population. The aim of this review is to provide an insight about the disorder to identify the risk factors and clinical features, to understand the effect of IGD upon the psychological and physical health with a special focus on neural changes, and to provide information on the various upcoming preventive and treatment strategies.

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Introduction- Total Intravenous anaesthesia(TIVA) is widely used procedure. We compared the effect of propofol-ketamine combination with propofol-fentanyl combination on hemodynamic parameters and recovery of patients undergoing TIVA. T Aims and Objective- o compare the effect of combination of propofol and ketamine and combination of propofol and fentanyl for TIVA, on hemodynamic parameters and recovery from anaesthesia. Patients aged 20- to 60-year-old, ASA-PS I and II, undergoing elect Material and Method- ive surgeries were selected for the study and were divided into two groups (1 and 2) of 90 each. TIVA was administered in the two groups as- Group-1 Induction- Propofol 1.0mg/kg+Ketamine 1.0mg/kg, iv boluses. Maintenance- Propofol 2.0 mg/kg/h and Ketamine 2.0 mg/kg/h, iv infusion. Group-2 InductionPropofol 1.0mg/kg+Fentanyl 2.0µg/kg, iv boluses. Maintenance- Propofol 2.0mg/kg/h and Ketamine 2.0µg/kg/h, iv infusion. All the patients were mechanically ventilated with 100% oxygen. Neuromuscular blockade achieved with Vecuronium-bromide. Vital-parameters were recorded at regular intervals and DJ Steward recovery score was calculated. Following i Result- nduction, heart rate (HR) increased in Group-1 and decreased in Group-2 and mean blood pressure (systolic and diastolic) increased in Group-1 while it decreased in Group-2. HR and blood pressure(BP) returned towards baseline during maintenance in both the groups. HR and BP increased in both the groups following extubation but gradually returned to baseline. Group-1 scored higher on ventilation, whereas Group-2 scored higher on wakefulness and movement. Though the difference became insignicant post 10 minutes. Both propofol-ketamine and propofol-fentanyl combinations Summary- can be utilized in TIVA for short elective procedures because they offer effective surgical anaesthesia with little strain on hemodynamic parameters, which helps to preserve stability and speed up recovery