Background: Chronic venous insufficiency and its associated complications are a common condition affecting 15%–20% of the general population. Endovenous laser ablation (EVLA) is an effective day care treatment procedure. Tumescent anesthesia is given during EVLA to for pain relief and to prevent thermal damage to surrounding soft tissue by the laser energy. Regional nerve blocks can be given to reduce the pain of tumescent anesthesia and EVLA procedure. This study was aimed to evaluate pain score in varicose vein patients undergoing laser ablation with or without femoral nerve block. Materials and Methods: A total of 60 patients having only great saphenous vein disease were enrolled and divided into two Groups A and B using random number table. Group A was given tumescent anesthesia before laser EVLA procedure. Group B patients were given ultrasound guided femoral nerve block before tumescent anesthesia and laser ablation. Pain score was recorded intraoperatively, immediate and delated postoperative period (0, 1, and 3 h) on the Visual Analog Score. Data were analyzed using the standard statistical analysis tools. Results: Intraoperative and postoperative pain was significantly lower in Group B patients as compared to Group A (P < 0.0001).Volume of tumescent anesthesia used in Group B was significantly lower as compared to Group A. Conclusion: Femoral nerve block under ultrasound guidance is a safe, easy, and effective technique to reduce intra-operative and postoperative pain in patients undergoing EVLA without significant complications.

Background: Partial- or full-thickness necrosis is normally encountered complication postoperatively in skin flap patients. The chief causes of necrosis are reduced arterial flow, venous insufficiency, or both. Particularly, necrosis of the skin flap occurs in the more distal portion of the flap, if arterial or venous flux insufficient. The other factors owing to the necrosis of skin flap are qualitative and quantitative deficiency of local growth factors (GFs) and lack of regulation of various GFs. Platelet-rich plasma (PRP) is the concentrate of plasma prepared by serial centrifugation and contains high concentrates of platelets. It is rich in various GFs which are essential for wound healing. Materials and Methods: Six patients were included in the study. All the patients had traumatic degloving injuries of lower limbs. After primary cleaning and closure of the flaps, from postoperative day 1, all the flaps were infiltrated with autologous PRP infiltration according to STARS therapy till the wounds healed. Results and Observations: All the wounds healed completely with PRP. PRP sessions required ranged from 4 to 7 with an average of 5.4. There was no need of any additional procedure for wound healing such as serial debridements and skin grafting in any of the patients. Two patients required additional procedures for associated fractures which involved K-wire removal and amputation of the fifth toe. Complications such as infection, abscess, or sinus formation were not seen in any of the patients. After suture removal, the mean ± 2 standard deviation total wound area was 31.5 ± 17.6 cm², mean necrotic area was 7.75 ± 5 cm², and mean surviving area was 23.75 ± 13.8 cm². The mean percentage survival of the flaps was 75.119%. This value is comparable with other studies. Conclusion: In our study, it was found that local autologous PRP infiltration in the skin flap of degloving wounds according to the STARS therapy increases the chances of survival of flap.

Introduction: The 21^st century is often called as the “Age of Ageing.” Globally, the share of older people who are above 60 years of age grew from 9.2% in the year 1990–2011, 7% in the year 2013, and following this trend, it will reach to 21.1% by the year 2050. Aim and Objective: The aim of this study is to determine the risk factors of suicides in the elderly population who committed suicide. Methodology: The study was a community-based cross-sectional study conducted in the Wardha district, located in the Central part of India from July 2015 to October 2017. The total cases of suicides among elderly population of more than or equal to 60 years, recorded with the appropriate authority during the year 2013–2014 and 2014–2015 was included in this study. The study participants were the survivor of suicide (people intimately and directly affected by a suicide), who was knowledgeable about the events or circumstances, leading to the suicide by the elderly. Results: problems faced by elderly that led them to suicide. Near about all the elderly (98.6%) except one were having some mental health issues in the form of anxiety and depression. Furthermore, about 78.9% of study participants were having clinical comorbidities in the form of chronic physical pain, major accident or paralysis, history of fits, stupor, loss of consciousness, and chronic illness such as tuberculosis or cancer. Conclusions: In the present study, near about half of the elderly were in the age group of 60–69 years of age. While maximum elderly who committed suicide were male by gender indicating, male gender is more prone for suicide.

Introduction: Necessity is the mother of invention, is not only an English language proverb but it has been proved several times in several ways, and recently it has been proved during this COVID-19 outbreak that online medical education has erupted as one of the inventions during these stressful situations as a necessity. In these difficult situations, universities seek to deliver medical education through various new methods or modalities, to ensure the continuous learning of medical students. Novel ways of online teaching should be considered in new medical curriculum development, as well as methods of delivering lectures and practical skills for medical students. In this pandemic situations, medical faculty administrators also had to improvise to make an adjustment, from the formerly class-based lecture to online lecture. This study aimed to measure the perception of medical students regarding the quality and effectiveness of online medical education during COVID-19 Pandemic. Materials and Methods: This study was held in Santosh Medical College, Ghaziabad, from April 2020 to August 2020. This is a cross-sectional survey done by using an electronic questionnaire which was based on the result of previously conducted lectures, practical, and small group discussions. It is carefully checked for validation and reliability before considering it for a study. Questionnaires were made on Google Forms and then this e-questionnaire was sent via WhatsApp to all of students. All the data were collected, tabulated, and analyzed. Results: Three hundred and ninety-nine number of students responded to the electronic survey conducted via WhatsApp. Students' perception about the effectiveness and quality of medical online education revealed few supportive and few inhibitory factors. Conclusions: Data obtained in this study can be used as a valuable input to judge the effectiveness and utility of the online methodology in the future.

Aim: The present study has been conducted on cases of infiltrating ductal carcinoma of the breast to correlate cytological Robinson's grading system with histological Nottingham modified Bloom–Richardson grading system. Settings and Design: This is a retrospective study conducted on fifty cytologically diagnosed breast carcinoma cases in the Department of Pathology, VIMSAR, Burla, Odisha. Materials and Methods: Fifty cases of cytologically diagnosed breast carcinoma were graded according to Robinson's system, and the respective histopathology slides were graded according to Nottingham modified Bloom–Richardson scoring system. The axillary lymph node (if any) status was also checked for any metastases. The sensitivity, specificity, positive predictive value, and negative predictive value of Robinson's cytological grading system were calculated. Results: The absolute concordance rate between cytological and histological grades was 78% which indicates a strong correlation and significant association. Sensitivity was maximum for Grade II tumors (88.00%) while specificity was maximum for Grade III tumors (97.50%). The positive predictive value was maximum for Grade III tumors (85.71%) while the negative predictive value was maximum for Grade I tumors (94.11%). Lymph node metastases were found in 42% (21 cases) of all the tumors; maximum was (100%) in Grade III tumors. Conclusion: Cytological grade strongly correlates with histological grade and is helpful in selecting the treatment regimen.

Introduction: Doppler velocimetry is a rapid, noninvasive test that provides valuable information about the hemodynamic situation of the fetus and is an efficient diagnostic test of fetal jeopardy which helps in timely intervention and management of high-risk pregnancy for the better perinatal outcome. Aim: The aim of this study is to assess the role of color Doppler imaging in the prediction of high-risk pregnancies and their perinatal outcome. Objectives: The objecti evaluate the role of color Doppler in normal and high-risk pregnancies in relation to perinatal outcome. Materials and Methods: The study was carried out from August 1, 2016 to December 31, 2017 in the Department of Obstetrics and Gynecology in coordination with Central laboratory, and Department of Radiology, Jawaharlal Nehru Medical College Sawangi (M), Wardha, Maharashtra, India. A total of 120 pregnant women (study group and control group) attending a clinic in the Department of Gynecology and Obstetrics, AVBRH was examined for high-risk pregnancy. Results: There was a significant difference between the color Doppler indices of the three vessels (umbilical, uterine, and middle cerebral artery [MCA]) in the study and the control group. In women with abnormal Doppler indices, there was a high incidence of cesarean section, low-birth weight babies, low Apgar score, higher admission rate to neonatal intensive care unit. Conclusion: The color Doppler findings with abnormal indices of the uterine artery, umbilical artery, and MCA show a consistent relationship with poor perinatal outcome.

Aim: The present series aims to highlight the sites,clinical presentation, histopathological features, anddiagnostic dilemmas of extra-nasal rhinosporidiosis. Materials and methods: A review of pertinent demographic and laboratory data for patients diagnosed with extra-nasal rhinosporidiosis, over a period of 7 years (2012- 2019) was done. Results: Amongst the 8 cases of extra-nasal rhinosporidiosis, the sites of involvement were medialcanthus (2/8), trachea (2/8), skin and bone (1/8), hard palate (1/8), and concurrent multiple sites (2/8). Clinical differential diagnoses included fungal osteomyelitis, laryngeal papilloma, conjunctival tumor, disseminated rhinosporidiosis, and carcinoma palate.The presence of sporangia, endospores,chronic inflammation, histiocytes was the most consistent histopathological features. Sevencases were managed with a laser-guided excision, and one underwent wide local excision with cauterization. Recurrence was seen in 5/8 cases (62.5%). Conclusion: The diagnosis of extra-nasal rhinosporidiosisis often missed due to an unusual site of presentation, or mistaken for a tumor. A proper history and histopathological examination must be carried out in patients with bleeding polyps, especially in an endemic region. The rate of local recurrence is high, which may be reduced by the use of lasers during surgery.

Background: p53 mutations are the most frequent genetic alterations in breast cancer, observed in 30% of breast carcinomas. Their distribution is highly linked to molecular subtypes. Aim: The aim of the study was to establish an association between p53expression with various tumor variables such as age, histological grade, molecular subtypes, ki67, and Nottingham prognostic index (NPI). Materials and Methods: This was a cross-sectional analysis in VSSIMSAR, Burla, Odisha, India, from November 2015 to October 2017. Immunohistochemical study was done using DAKO primary antibody for estrogen receptors, progesterone receptors, human epidermal growth factor receptor (HER2/neu), Ki-67, and p53. Results: A total number of 62 cases were studied. p53 was positive in 10 (55.6%) cases of T2 tumors, 15 (60%) cases of T3 tumors, and 13 (76.5%) cases of T4 tumors. Among 26 basal-like tumors, 16 (61.5%) were p53 positive. In 12 HER2 enriched tumors, 10 (83.3%) were p53 positive, and in 8 luminal B tumors, only 2 (25%) cases came out to be p53 positive. p53 expression has a very significant association with lymph node metastasis (P < 0.01). p53 positivity increases with higher histological grades, and its reactivity is significantly associated with Ki-67 expression (P < 0.05) and NPI (P < 0.01). Conclusion: p53 association is mostly associated with more adverse phenotype and worse overall survival. There is an increased interest in p53 based therapy.

Introduction: Cognitive function has been addressed as a hallmark feature of substance use disorders, with alteration in “executive” domains of attention, inhibition/regulation, working memory, and decision-making. Poor cognition or cognitive dysfunction has been recognized as a fundamental impairment in addiction and a potentially important target for intervention. The present study was planned with the aim to assess the cognitive functions and general health in patients with substance dependence and also to correlate general health with the level of cognitive function. Methodology: Ninety participants were included in the study and were categorized into three groups of thirty each as patients taking alcohol, opioids, and nicotine. Consecutive sampling was adopted for the sample collection. Each participant was assessed for dependence, demographic data, and tested by the Addenbrooke's Cognitive Examination Scale-III and General Health Questionnaire-12. Descriptive statistics were applied to calculate the frequencies, percentage, mean, median, and standard deviation. Data were further analyzed for significance using the Chi-square, correlation, and Mann–Whitney test. Results: There is a statistically significant difference seen in marital status (P = 0.005), education (P = 0.001), family type (P = 0.008), and locality (P = 0.000). Furthermore, with substance use, there is a significant change in the domains of general health with P < 0.001, and there is a significant decline in sustaining attention with P = 0.007. Conclusion: Thus, we conclude that substance use has a significant negative impact on cognition mainly attention and working memory with the impact on general health as well.

Background: In the modern era, persons working in software companies are increasing, and there is an emergence of computer-related health problems. Objectives: The aim of this study is to estimate the prevalence of various morbidities among software professionals and to assess the factors associated with these problems. Materials and Methods: A cross-sectional study of 4 months from March 2016 to June 2016 was conducted among software professionals. Two hundred and sixty software professionals in the current job for the past 1 year were included in the study. A Google form was created through Google drive of the primary investigator. The E-mail id of persons working in software companies was collected through friends, relatives, and Internet. One person can send one response option was selected. The Google form was sent to their mail id with a request to forward the Google form to their contacts working in software. Results: Among the study participants, 53.8% of persons feel they were having health problems due to prolonged computer use. More than 70% had visual problems such as eye pain, eye strain, eye redness, blurring of vision, or watery eyes. It was observed, 63% of software professionals had some type of musculoskeletal problems. About 40% had headaches frequently and 47% had gastrointestinal problems. About 67.7% feel stressed due to their prolonged work and 35% feel depressed. A significant association was found between participants with visual and musculoskeletal complaints using antiglare screen and soft keypads and those not using, respectively. Conclusion: Ocular discomfort, musculoskeletal disorders, and psychosocial problems were main health problems among constant computer users which needs urgent intervention.

Background: The proceedings of destroying the body of human by putting in acid or some other injurious materials in order to prevent any individual identification is drawing a great deal of importance in forensic field. The idea of such crime is to destroy any physical evidence of cause of death, time interval of death to body identification, and victim identification. Teeth are also good reservoirs for the identification of individuals by morphological as well as identification by mitochondrial DNA extraction. Aims and Objectives: To assess the morphological changes and duration of dissolution of teeth from different acids. Materials and Methods: Concentrated hydrochloric acid (HCl), nitric acid (HNO₃), and sulfuric acid were employed for tooth. Results: Results showed that compared to sulfuric acid, HCl and HNO₃ have more destructive capacity. Conclusion: Sulfuric acid, HNO₃, and HCl criminals may be used to destroy the person identification; still, the individuals can be identified using teeth because it is the strongest structure of the human body and can preserve some structures even after exposure to the concentrated acids.

Background: Investigations are classified as routine and specific. Specific investigations are done to confirm or exclude a strongly suspected diagnosis, and routine investigations are done to find occult disease not detected during clinical evaluation. Mostly, these are done as an institutional policy or custom and for medicolegal reasons in the event of any complications. The value of these routine investigations in all patients is controversial. Data suggest that these have little influence on patient management and perioperative complications. Aims and Objectives: The objective of this study was to evaluate the usefulness of routine preoperative investigations in patients undergoing elective surgical procedures and their influence on perioperative management. Materials and Methods: We included various laboratory, radiological, and hematological investigations which were performed routinely in all patients irrespective of diagnosis. Results: A total of 1671 investigations were performed in 170 patients. Only 153 (9.2%) investigations were found to be abnormal. Complete blood picture was performed in 168 (98.2%) patients; random blood sugar estimation was done in 147 (86.4%) patients. Chest X-rays were performed in 166 (97.6%) patients. Electrocardiography was performed in 160 (94.2%) patients. The percentage of overall abnormal results was very low. None of these abnormal investigations influenced surgical management and had adverse perioperative complications. Conclusion: Preoperative investigations should be done based on clinical examination and comorbid conditions. Routine preoperative investigations do not influence patient management and predict complications and should not be done in all patients.

Background: Neonatal hyperbilirubinemia (NH) is the commonest abnormal physiological finding during the 1^st week of life. More than two-third of newborn babies develop clinical jaundice. The clinical finding such as yellowish discoloration of the skin and sclera in newborns is because of accumulation of unconjugated bilirubin. In most infants, however, unconjugated hyperbilirubinemia is a normal physiological phenomenon. Aim of the Study: The aim of the study was to predict the development of NH at birth in term newborns using cord blood bilirubin and albumin as a risk predictor. Materials and Methods: The present cross-sectional study was performed on 150 healthy term newborns, i.e., both males (n = 84) and females (n = 66) with gestational age >38 weeks delivered by caesarian section from the Department of Obstetrics and Gynaecology and Department of Pediatrics and Department of Biochemistry, Santosh Medical College, Ghaziabad. Results: Cord serum albumin (CSA) level of ≤2.8 g/dl cutoff value is chosen based on the receiver operating characteristics (ROC) analysis. Shows the neonates who developed NH, 95.2% of these cases had CSA level ≤2.8 g/dl (20/21). If CSA level ≤2.8 g/dl, 28.9% probability of developing NH, and if CSA >2.9 g/dl, then 97.7% chance of not developing NH. Similarly, if CSA level ≥3.4 g/dl, nil or 0% chance of developing NH. Hence, CSA level ≤2.8 g/dl can be considered as critical value or risk factor for the development of NH, whereas newborn with CSA level ≥3.4 g/dl is safe for early discharge. Conclusion: Increasing incidence of kernicterus in healthy term neonates as Kernicteus is the chronic sequelae of acute bilirubin encephalopathy. Hyperbilirubinemia is one of the most common causes for readmission of the newborns. Incidence of kernicterus is unknown. Hence, defining a certain bilirubin level as physiological can be misleading and potentially dangerous. NH is a potentially correctable and kernicterus is preventable.

Background: Morphological features of the liver serve as important landmarks for radiologists and surgeons in the diagnosis and interpretations of liver diseases. Accessory fissures and accessory lobes often mislead the clinicians in the diagnosis of liver pathologies. Aim: This study is aimed to determine the morphological variations of the liver and implicate its clinical significance. Materials and Methods: The present study was conducted in the department of anatomy, with 50 formalin-fixed livers obtained from the cadavers of both sexes. Morphological surface features were observed, photographed, and studied. Results: About 22 (44%) livers showed variations such as accessory fissures (24%) present in the right, left, caudate, and quadrate lobe. Diaphragmatic fissures or grooves were seen in 10 (20%). Pons hepatis was seen in 3 (6%) livers. Riedels lobe was seen in 4 (8%), and the absence of quadrate lobe was seen in 1 (2%) specimen. Conclusion: The knowledge of abnormality in surface features of the liver is clinically significant and will help the radiologists and surgeons in the interpretation of normal and abnormal liver.

Background: Job satisfaction among nurses is a global concern for its crucial impact on nursing shortage and quality of care. Missed nursing care defined as nurses' decision to omit or delay aspects of patient care activities is hypothesized to influence nurses' job satisfaction. Aim: The aim of this study was to explore the relationship between missed nursing care and nurses' job satisfaction. Materials and Methods: The study used a cross-sectional design, and data were collected using the MISSCARE survey and Nurses' Work Satisfaction Scale from 205 randomly selected nurses working in the medical–surgical units of four tertiary care hospitals in India. Data were analyzed using IBM SPSS version 23. Results: Nurses' job satisfaction was significantly related to missed nursing care, hospital types, and education which together explained 27% of the variance in nurses' job satisfaction. Conclusion: Focused strategies to decrease missed nursing care can improve job satisfaction among nurses. Nurse leaders can use missed nursing care as a process indicator to assess and predict nurses' job satisfaction.

Background: In the last few decades, mushrooming of technology institutes and engineering colleges has led to saturation of graduate engineers. For most technology and engineering graduates, the future seems gloomy and uncertain. With the recent worldwide recession, employability chances of many technology and engineering graduates have gone down. Survival of the most skilled is the thumb rule in recent years. The condition is further augmented by the COVID-19 pandemic and its consequences of the lockdown. The graduates pursuing technology education and engineering are badly affected by this phase. Aim: The current study aims at assessing the impact of lockdown due to COVID-19 on the psychosocial behavior of the technology and engineering students. Study Design: This is an online survey. Study Population: Technology and Engineering students in the age group of 17–25 years, both males and females. Sample Size: The sample size was 779. Materials and Methods: A psychological impact scale for students was developed by the investigators (r = 0.85). It is a 5-point scale with 0 as minimum score and 120 as the maximum possible score. Results: The mean age of the students was 20.49 ± 1.45 years. Nearly 95.4% of the students were living with their parents during this period of lockdown. Approximately 34.79% of the students experienced borderline negative impact, 18.74 reported mild negative impact, and 4.24% reported moderate negative impact of lockdown in just 30 days of the lockdown period. Most surprisingly, despite being with parents, 23.1% of the students had been out on roads during the lockdown. Conclusion: The lockdown has shown its adverse impact on the technology and engineering students. There is an urgent need to take steps to improve the employability of technology and engineering students. Else such a skilled workforce will be victim of psychological problems and a very important asset of the country shall be a waste.

Introduction: Accidents and injuries are the leading cause of morbidity and mortality. According to the World Health Organization, 1.35 million deaths occurred due to road traffic accident (RTA) globally in every year. In India, fatality rate of road accidents is twenty times higher than developed countries. Objectives: The objective of this study is to assess the epidemiological factors responsible for RTA and to know the pattern of accidents. Materials and Methods: A hospital-based, cross-sectional study was conducted among RTA victims admitted at a tertiary care hospital of Odisha from August to November 2019. The data were collected by using predesigned and pretested interview schedule and analyzed with the help of SPSS 20. Results: Out of 147 accident victims, 81% were male; mean age was 36.6 ± 13.67 years. Maximum accidents (43.5%) had taken place between 11 a.m. and 5 p.m. Bike-riders (81.6%) were the major victim involved in accidents followed by pedestrian (9.5%) and cyclist (8.9%). Among bike riders, 44.16% did not wear helmet during accident and 3.33% did not have a valid driving license. About 25.2% were due to alcohol intake. Unusual behavior of animals and defective road contributed around 10.2% and 16.90%, respectively. Among injuries, the most common was laceration (38.1%) followed by abrasion (22.4%). Fracture was found in 7.5% cases. Most common sites involved were head, face, upper limb, and lower limb. Conclusion: Public awareness should be initiated regarding various factors associated with RTA and measures to prevent accidents.

Background: Acute upper gastrointestinal bleeding (UGIB) is one of the most common causes of medical emergencies and associated with high morbidity and mortality in adults. Although there is decline in peptic ulcer bleed as an etiology of acute UGI bleed due to discovery of proton pump inhibitors, the Emergency Room (ER) visits for UGI bleed are increasing due to other etiologies including variceal bleed and drug-induced gastrointestinal (GI) bleed. This study was designed with the aim to assess the endoscopic profile of UGIB presenting to our tertiary care center in south India. Materials and Methods: This was a prospective analytical study. It was done over a period of 6 months from January 2020 to June 2020. All adult patients presenting with acute hematemesis and/or melena were included in the study. All included patients underwent detailed history, clinical examination, blood tests, and upper GI endoscopy. Results: One hundred and eighty-two patients were included in the study. Out of 182 patients, 76% were males. The most common age group was 51–60 years contributing to 34%. The commonest presentation was hematemesis than that of melena. Out of all patients, 69% of patients were hemodynamically stable and 31% patients were unstable at the time of admission. The causes of bleed included esophageal varices, gastric varix, peptic ulcer, portal hypertensive gastropathy (PHG), Mallory-Weiss tear, gastric cancer, drug-induced gastritis, and esophageal tear. Variceal bleed was the most common cause of UGI bleed comprising 34.16% of cases. Conclusions: From our study, we conclude that the most common cause of upper GI bleed in our part of India is portal hypertension related bleeding which included esophageal varices, gastric varices, and severe PHG. This was in contrary to most of the studies from other part of the country as peptic ulcer is far more common than variceal bleed in other studies.

COVID-19 has impacted the way work is conducted across the globe. In this unprecedented pandemic, people, processes, and employers have had to re-assess the way work is conducted. However, it is also evident that these changes have not been applied throughout all the organizations. A sample of 150 employees comprising of 100 males and 50 females was collected from various organizations such as banks, retail, health care, information technology, and education. The sample was segregated according to gender and an independent samples t-test was performed to assess whether there is a statistically significant difference between them with respect to fourteen factors which may lead to workplace anxiety. These 14 factors were identified through a comprehensive review of literature. The results showcase that with respect to the factors of irritability, access to equipment and communication and communication tools are the areas where there is a statistically significant difference between male and female perceptions.

Context: International academy of cytology (IAC) has established a standardized reporting system for fine-needle aspiration (FNA) cytology of breast lesions. They have introduced five categories (Code C1 to Code C5) for reporting breast cytology, each with clear descriptive term for the category, risk of malignancy (ROM) and a suggested management algorithm. Aim: Aims of the present study were to reclassify and correlate the breast FNA (IAC guidelines) with histopathological findings and to calculate the ROM for each category with special emphasis on assessing the diagnostic efficacy of cytological evaluation of code 3 and code 4. Materials and Methods: A 3 years' retrospective cross sectional study included 448 breast FNA samples that were reassessed and reclassified according to the IAC reporting system. The ROM for each category was analyzed. Results: The breast FNA samples were distributed in following categories as: C1 (insufficient material)− 1.78% (n = 8), C2 (benign) – 71.66% (n = 321), C3 (Atypical but benign) –10.81% (n = 45), C4 (Suspicious for malignancy) – 4.91% (n = 22), and C5 (Malignant)– 11.60% (n = 52). Out of the 448 cases, histopathological correlation was available for 205 cases. The ROM for each category was calculated as: 0% for C1, 2.04% for C2, 10.8% for C3, 85.71% for C4, and 100% for C5. The ability of C3 and C4 lesions to diagnose breast malignancy was statistically significant, P value 0.042 (P < 0.05). Conclusion: The IAC system for reporting of breast cytology effectively helps in accurate diagnosis and assessment of ROM for each category which helps in better patient management and further research.

Background: In our society, females are blamed for infertility. Females especially in rural places face many problems socially and emotionally. Infertility is an obstacle in the development of couple when it does not take place normally. Infertility is a curse for women, the cause of which should be diagnosed accurately and early. Taking the abovemaintained silent plight of infertile females, this study was conducted based on uterine infertility as a step to increase understanding of pathological causes of primary infertility and serve community on the whole. Aim: This study aims to study histomorphological features of endometrium in primary infertility to know the etiological factors in a rural setup. Objectives: (1) To find various histomorphological patterns of endometrium in primary infertility. (2) To categorize the various etiologic causes under the following heads: (i) Hormonal cause. (ii) Infectious cause. (3) To find the principle cause for primary infertility in the ruler setup. (4) To know the importance of endometrial biopsy/dilatation and curettage (D and C) in primary infertility. Materials and Methods: A total of 99 endometrial sample of primary infertility were received from Department of Obstetrics and Gynecology of confirmed case of primary infertility. The endometrial biopsy or D and C were send in 10% formalin to department of pathology. The samples were processed, stained with hematoxylin and eosin and were studied and categorized into normal proliferative phase, inadequate proliferative phase, anovulatory phase, normal secretory phase, inadequate secretory phase/luteal phase defect (LPD), glandulostromal disparity (GSD), acute endometritis, chronic nonspecific endometritis, and tubercular endometritis. Observation and Results: It was observed that 42.42% patients had normal secretory phase or normal proliferative phase, i.e., it correlates with day of menses. The most common etiological cause for primary infertility was anovulation which was 28.28%. The second most common was LPD/inadequate secretory phase which was 15.15%. Inadequate proliferative phase was 8.08%. GSD was 3.03%. Endometrial hyperplasia was 4.04% among which 3.03% patients had simple hyperplasia without atypia and 1.01% patient had atypical complex hyperplasia. In infections, tubercular endometritis was 2.02% and chronic nonspecific endometritis was 1.01%. In the present study, anovulation was the principle cause of female primary infertility. There were 51.51% patients of primary infertility with hormonal cause and 3.03% patient with infective cause. Conclusion: Anovulation was the principle cause of female primary infertility and LPD was the second common cause of female primary infertility. In infections, tubercular endometritis was common whereas chronic nonspecific endometritis was less. Endometrial biopsy/D and C is a standard tool to know causes of primary infertility, which gives information at cellular level and detects hormonal causes, infective causes for infertility. Thus, by endometrial biopsy/D and C, we come to know the probable cause of female primary infertility, and accordingly, the treatment can be given to patient.

Background: Sosman and Steidl (1923) had described “diabetic tuberculosis” a specific radiological pattern in patients with diabetes mellitus associated with pulmonary tuberculosis. These lesions usually consist of wedge-shaped area of density in which there is often cavitation in the neighborhood of hilum and spreading toward periphery including the bases occurring in diabetics over the age of 40 years. The present study was undertaken to study and highlight this specific radiological pattern of “diabetic tuberculosis” along with the clinical profile of this association. Materials and Methods: The present study was carried out in patients with pulmonary tuberculosis admitted to Poona Chest Hospital Aundh Pune, between July 1, 1991, and June 30, 1992. The patients diagnosed as pulmonary tuberculosis were subjected for diabetic status by detailed history, clinical examination, and investigations. Results: Among 440 cases of pulmonary tuberculosis prevalence rate of diabetes mellitus was 9.55% (42/440) and a specific radiological pattern “diabetic tuberculosis” was observed in 16.66% (7/42) in diabetics associated with tuberculosis. Conclusion: All patients with pulmonary tuberculosis above the age of 40 years should be screened for diabetes and all patients with diabetes should be screened to rule out pulmonary tuberculosis every year. A specific radiological pattern of “diabetic tuberculosis” and lower zone lesions on X-ray observed during clinical examination should be screened to rule out pulmonary tuberculosis as well as diabetes.

Introduction: Tuberculous lymphadenitis is seen in nearly 35% of extrapulmonary tuberculosis. Early and accurate detection of active cases remains an important objective for appropriate treatment and reduction in the spread of the disease. Microscopy has many advantages when it comes to speed feasibility, and if its sensitivity could be improved. Liquefaction of specimens by sodium hypochlorite (NaOCl, bleach) and concentration of bacilli through centrifugation significantly increases the sensitivity of direct microscopy. Thus, the bleach concentration method has been recently described for sputum and other extra-pulmonary specimen. Aim: The aim of study is to evaluate the role of bleach concentration method in FNAC lymph nodes over conventional Ziehl–Neelsen (ZN) direct smear microscopy. Methods and Material: The prospective, cross-sectional and observational study carried out for a period of one year from December 2017 to November 2018. The study included 50 cases suspected clinically of having TB with lymphadenopathy referred for FNAC to the division of cytopathology in department of Patholology, All the aspirates by FNAC were processed for direct microscopy using conventional ZN staining and routine cytology and compared with the findings of the bleach method. Of these 50 cases 5 cases were eliminated from the study. Results: Of total 45 cases, 14 cases were positive by conventional ZN method and 29 cases by bleach concentration method. AFB positivity by bleach concentration method was more in comparison with the routine ZN stain. Conclusion: The study could establish AFB positivity in 64.44% of cases with the bleach method. This detection rate is far better than routine ZN staining.

Background: The specialty of intensive care of patients, also known widely as “critical care medicine” is one that includes how to properly look after and take care of patients who are critically ill. In the academic year 2020–2021, an undergraduate course curriculum on intensive care technology was launched in the Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University), the curricular inclusions for which were the document of interest for the present study. It is vital to determine the standing of the curriculum prepared for a new course for undergraduates with regard to its centricity– learner based, subject based or problem based. Here, the cognitive domain can be viewed in the subject based inclusions. The present study attempts to delineate the curricular inclusions for the said curriculum of Bachelor of Science in Intensive Care Technology under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) as against typing of curriculum based on subject centricity. Materials and Methods: Rapid review of the literature with reference to the curriculum of Bachelor of Science in Intensive Care Technology under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) in the academic year 2020–2021 for purpose of their “typing” with principles of curriculum design' was done. Results: According to principles of curricular design by Schweitzer based on centricity of curriculum, the curricular inclusions were divided into three types–subject centred inclusions, problem-centered inclusions and learner-centered inclusions. The total number of curricular inclusions was 539. Ideally taking the ratio of curricular inclusions as 6:3:1, there should be 323 subject-centered inclusions, 162 problem-centered inclusion, and 54 learner centered. Out of this, there were 313 inclusions which were observed to be subject centred, 206 inclusions were problem centered and 20 were centred upon the learner. Thus, the overall percentage of typing of the inclusions was 58.07% subject centricity, 38.21% problem centricity and 3.7% learner centricity. The observed deficit of inclusions in subject centricity was 10, a surplus of 44 inclusions was observed in problem-centered inclusions whereas the learner-centered inclusions showed a deficit of 34 objectives. Conclusion: The undergraduate course curriculum of Bachelor of Science in Intensive Care Technology under Faculty of Allied Health Sciences included in the present study for typing of included curricular inclusions has been typed based on their centricity upon the subject.

Introduction: Pseudomonas aeruginosa is an important opportunistic pathogen associated with majority of the hospital-acquired infections in immunocompromised patients, worldwide. Biofilms formed by this bacterium increase its resistance toward antibiotics, which in turn increase morbidity and mortality. As environmental isolates of P. aeruginosa are also capable of producing virulence-associated traits, they can be considered as potential pathogens. Materials and Methods: This study was undertaken to compare the expression of some of the biofilm genes such as algD, pslA, pslB, pelA, and pelD in environmental and clinical isolates of P. aeruginosa isolated from Coastal Karnataka. The expression of biofilm-forming genes in strong biofilm-forming P. aeruginosa isolated from sputum (HS26), wound swab (HW20), and environment (EN4) were quantified at different time points of incubation (18, 25, 48, and 72 h). In addition, the sensitivity of the selected isolates to commonly used antibiotics (amikacin, aztreonam, carbenicillin, ciprofloxacin, cefotaxime, imipenem, and gentamicin) was investigated. Results: The current investigation revealed the presence of a multidrug-resistant environmental isolate with higher expression of the biofilm genes as compared to the clinical ones. In the environmental isolate, the relative expression of pslA, pslB, pelD, and pelA gene was increased by 11, 10, 10, and 9 folds, respectively, at 48 h. Conclusion: The study suggests the possibility of such multidrug-resistant biofilm-forming environmental isolates of P. aeruginosa getting transferred to the hospital setting and causing life-threatening biofilm-associated infections.

Background: Endometrial carcinoma (EC) is the most common malignancy of the female genital tract that accounts for about 7% of all invasive cancer in women. Therefore, the first step is to find predictive and prognostic factors, then to define clinically relevant risk groups and finally design clinical trials and treatment options. Hence, to improve the treatment and follow-up of EC patients, the importance of various prognostic factors has been extensively studied. The present study is intended to evaluate the various prognostic parameters of EC. Aim: The aim of the study was to evaluate various prognostic factors in patients of diagnosed case of EC at a tertiary health center. Objectives: The objectives of the study were (1).to diagnose EC by routine H and E staining and grade (FIGO) it and (2) and to evaluate various prognostic parameters including clinical, gross, and histopathological factors. Study Design: This was a observational and retrospective study. Materials and Methods: Fifty cases of EC were diagnosed on histopathology, then evaluate various prognostic factors. Results: Most of the cases belonged to the postmenopausal group, endometrioid type, stage I that means confined to the endometrium alone. The most common grade was Grade II accounting to 40.00%, followed by Grade I and Grade III, i.e., 34% and 18%, respectively, and 8% were included in the unknown grade. Conclusion: Knowledge of prognostic factors may enable physicians to find the best appropriate treatment for the prevention of recurrence. Patients at risk for an aggressive or advanced disease could be referred to centers and clinicians with special expertise in managing advanced or recurrent EC.

Introduction: The cytodiagnosis of melanocarcinoma achieved on Fine Needle Aspiration Cytology is cytomorphologically dicey at metastatic site. This is due to various morphologies achieved by melanocarcinoma as observed in histopathological examination. Therefore, it becomes imperative for cytopathologist to know about cytomorphological patterns observed at the diagnosis of melanocarcinoma. More so when melanocarcinoma is amelanotic and the clinical evidence of primary melanocarcinoma in the skin and other places is absent. Aim and Objectives: The present poster describes the experience with the cytomorphological patterns and diagnosis of melanocarcinoma, where the clinical evidence of presence of growth of melanocarcinoma in skin at any body site was absent. Materials and Methods: Fine needle aspiration done in 15 cases from metastatic sites, slides prepared were processed conventionaly. Result and Conclusion: It was observed that the certain cytomorphological features and typified cytomorphological arrangements in the presence of melanin containing cells or even amelanotic cells is enough characterizing melanocarcinoma which is described in the poster.

Horseshoe kidney is a congenital fusion anomaly of kidneys associated with many complications. A 57-year-old male presented with abdominal pain, hematuria, and burning micturition which on ultrasound examination was diagnosed to be a case of horseshoe kidney with multiple bilateral renal calculi. High-resolution sonography, radiography, and intravenous urography findings are discussed.

Landau Kleffner syndrome (LKS)/acquired epileptic aphasia classically develops in healthy children who acutely or progressively loose receptive and expressive language ability coincidentally with the appearance of paroxysmal Electro Enchepalo gram (EEG) changes. At present, LKS is considered as a part of the syndrome of electrical status epilepticus in sleep, which is also known as continuous spike and wave during slow wave sleep. It is a rare childhood neurological syndrome. In this article, hereby, we report a case of a 7-year-old female child with LKS and unique characteristics.

This is a case report of a rare malignant mesenchymal tumor, juxtacortical (periosteal) osteosarcoma arising from the mandible in a 17 year old boy. About 4%-6% of osteosarcomas occur in the maxillofacial region, while incidence of osteosarcoma occurring in jaw is 0.7 per million population. Due to its unique feature , they are high number of chances of misdiagnosing the tumor with other peripheral fibro-osseous lesions. The prognosis of the tumor is good if detected early and a wide margin resection is performed to make the recurrence obsolete.

Desmoid tumor also known as aggressive fibromatosis , has similarities with malignant tumor fibrosarcoma , but are benign as they don't metastasize to other parts of body.desmoid tumoursare very rare with an incidence of 2-4 per million per year and constitute 0.03 % of all tumor . Here we are presenting a rare case of 45 year old woman who presented with pain and lump in abdomen.

Accessory mammary gland is an uncommon lesion, which occurs in 0.4%–6% of women. It is mostly located in the axilla of both sides, but when it presents unilateral large in size and sessile, it can cause difficulty in clinical diagnosis, which mimics lipoma or adipose tissue lesion, usually, it is bilateral and presents asymptomatic lump in the axilla during pregnancy and lactational period. Anxiety is the major cause of concern, as the general population are not aware of accessory breast. Histopathological diagnosis is very important as axillary mass or breast tissue may undergo changes like mastitis, fibrocystic disease, and rarely carcinoma. We present an axillary mass on the left side in 24-year-old female, which has been diagnosed with accessory mammary gland on fine-needle aspiration cytology study, which was mimicking sessile lipoma as a rare clinical presentation.

Gestational choriocarcinoma is rare but highly malignant tumor of trophoblastic tissue. Although choriocarcinoma has a greater tendency to metastasize to various sites, it also has a very high cure rate. Our study emphasizes the case of choriocarcinoma developed after molar pregnancy which was treated successfully with the combination of surgery and chemotherapy.

Background: In developing countries with low income, one of the most common causes of hospitalization is Dagdha (burn) and it also contributes to secondary problems, such as disfigurement, contractures, and scar tissue development. On the basis of degree/depth of tissues involved the burn may be classified as superficial, superficial partial, and deep partial, deep. Physiotherapists and occupational therapists, as part of the specialist burn multidisciplinary team, have many overlapping expertise and positions in the treatment of burn injury victims by delivering drills and splintering. Methodology: The data were collected from the electronic databases, including PubMed, Web of Science, Cochrane Library, EMBASE, Google Scholar, ResearchGate, Springer publications, Statewide Burn Injury Service, McGraw-Hill publications, etc., This review included burn patients of all age groups and both genders. Results: This systematic review indicated that physiotherapeutic intervention played a vital role in the management of Dagdha (burn) injury not only to reduce pain and scar but restoring the musculoskeletal and cardiopulmonary functions and making patient functionally independent so that they can enjoy their rest of life independently. Conclusion: This systematic review study concluded that physiotherapy played an important role in the management of all types of Dagdha (Burn) injuries of all age groups.

Periodontitis is one of the most common diseases involving tooth and its supporting structures. Management of periodontitis is important for improvement of quality of life of the patient that ultimately has its impact on the overall health of an individual. Nanotechnology has evolved as a promising mode of treatment with upsurge of various treatment methodologies for the treatment of periodontitis. Nanotechnology has proven to be a reliable technology in dentistry as it provides different types of innovative nanomaterials which can be used in a variety of dental treatment options. A systematic search was conducted using Medline, PubMed, Scopus, and Google Scholar up to and including the year 2014, to identify relevant studies. All cross-reference lists of the selected studies were also screened. The inclusion criteria were articles in English or those having a detailed summary in English, published between 2000 and 2014. Review, case reports, abstracts, letters to editors, and editorials were excluded. In vivo studies were excluded from this systematic review. This paper will help the reader to understand nanoscience and the benefits and limitations of nanotechnology in periodontics by addressing its ethical, social, and health implications.

The COVID-19 pandemic is now a global problem that has significantly impacted the safe practice of Maxillofacial Surgery. It is important to compile information and experiences that have been gained worldwide and define a set of guidelines for best practice for staff performing these procedures and for patients undergoing maxillofacial surgery procedures. As such, these recommendations should be treated as “expert opinion” and are based mostly on personal communication, guidelines put forth by various national and international societies, and peer-reviewed data when possible. Surgical procedures involving the nasal–oral–endotracheal mucosal region are high risk due to aerosolization of the virus, which is known to be in high concentration in these areas when compared to swabs from the lower respiratory tract1. Further, it appears that if viral particles become aerosolized, they stay in the air for at least 3 h, if not longer. Based on experience in Wuhan, China, and Northern Italy, N95 masks were not enough to control this spread of the disease and it was not until powered air-purifying respirators were introduced that transmission of the virus was controlled among medical personnel. The current paper focuses on setting basic guidelines for dental operating surgeons in taking up an emergency operative procedure.

It is well recognized that plaque microbiota alone cannot account for periodontal tissue destruction, as some individuals are relatively at a higher risk for tissue destruction than others. Probably, some host factors have a role to play in this field. It is well documented that the human leukocyte antigens (HLA) system is a complex genetic polymorphic system in man. HLA have been considered a candidate of genetic risk markers for aggressive periodontitis (AP). The HLA play an important role in immune responsiveness and may be involved in antigen recognition of periodontal pathogens. These cell surface molecules have a key role in antigen presentation and activation of T-cells. The polymorphisms of HLA can directly affect the binding capability of antigen peptides and thus affect the antigen-specific T-cell response. Hence, these polymorphisms could represent an important susceptibility or resistance factor to periodontitis.

The 2019-2020 coronavirus is a progressing pandemic disease spreading worldwide. The outbreak was first identified in Wuhan, Hubei Province, China, in December 2019. The World Health Organization (WHO) declared the occurrence to be a Public Health Emergency of International Concern on January 30, 2020, and recognized it as a pandemic on March 11, 2020. This review article describes and suggests the various tips and precautionary measures urged by the WHO and other health-care centers so that one ought to follow and help the nation to break its chain and reduce it spread in future.

Basal cell carcinoma (BCC) is an exceedingly common cutaneous malignancy. Its frequency is rising worldwide by up to 10% a year. Even though mortality is very low as BCC hardly ever undergoes metastasis, this malignancy is highly devastating, has high morbidity rate, and is troublesome for healthcare services worldwide. Furthermore, people who have this condition are at high risk of developing further BCC and other malignancies such as squamous cell carcinoma and malignant melanoma. This review aims to present a comprehensive overview of this pivotal condition, concentrating on recent advances in our understanding of its epidemiology, risk factors, molecular genetics, diagnosis, and treatment in Southeast Asia.

In 2019, number of cases diagnosed with coronavirus pneumonia aroused in China. Number of studies were done that showed clinical characteristics of this disease. The aim of this brief informative draft is to summarize the clinical features, virulence, transmission, and various treatment modalities for the treatment of the disease. Also the various protective measures for the general population and health care professionals to prevent the growing pandemicity and control the outbreak of the condition.

The field of medical education and patient care is quite complex and demanding for both teachers as well as the students. It is no surprise that a teacher has to be supported and trained to efficiently discharge their roles. It is of utmost importance that the faculty members should be exposed to the medical education-related faculty development programs (FDPs). However, the issue that needs to be looked in depth is the quality of these FDPs and the extent to which these programs have brought about a difference in the daily habits of the medical teachers. The ideal approach of evaluation of the FDP will be to employ the Kirkpatrick model of evaluation and then derive a conclusion based on the results obtained. In conclusion, it is not only essential to organize, but even evaluate the medical education-related faculty development programs. The process of evaluation of FDPs is indispensable as it will aid in not only improving the effectiveness of the programs, but will also play an important part in improving the skills of medical teachers.