Acrometastasis of Lung Adenocarcinoma to the Fibula: A Report of a Rare Case.

Acrometastasis is an extremely rare diagnosis, invariably associated with poor prognosis. A 60-year-old female with complaints of cough and breathing difficulty also presented with pain and swelling in her left leg. Radiological investigations suggested a double primary in the lung and leg; histopathology and immunohistochemistry (IHC) confirmed the lesion in the leg to be metastatic from the lung primary.

Effects of Slow Breathing Exercises on Cardiac Autonomic Functions in Anxiety Disorder-A Randomised Control Trial.

Background: Anxiety disorders are commonly associated with a higher risk of fatal cardiovascular diseases (CVD). Anxiety disorders lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the key neuronal components of the autonomic nervous system (ANS) that are involved in cardiovascular functions, leading to increased cardiovascular risk.

Purpose: Impaired ANS activity, as reduced parasympathetic tone is strongly associated with an increased risk of CVD in anxiety disorders.

Anterior Approach to Retracted Anterosuperior Cuff Tear With Biceps Superior Capsular Reconstruction and Subscapularis Release and Repair With Transosseous Equivalent Double-Row Repair.

The incidence of a subscapularis tear combined with any other rotator cuff tear is around 19% to 49% among all rotator cuff lesions. On the contrary, less attention has been given to the treatment of anterosuperior rotator cuff tears, particularly by arthroscopic methods. Subscapularis lesions are hard to access and require advanced surgical technique along with optimum visualization to achieve an anatomic repair.

Assessment of Severity of Substance use for Outcomes Research and Treatment (ASSORT): A substance use severity scale developed and validated across six tertiary care centers in India.

Background And Aims: Assessment of the severity of substance use disorders (SUDs) in a culture-sensitive manner can help gauge the current condition of the substance user and assess change with time. The present study aimed to develop a scale for the assessment of the severity of SUDs in the Indian clinical context.

Methods: Based upon the review of literature on previously available instruments and a consultative meeting of experts, a clinician-rated scale was developed that finally comprised 41 items.

Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study.

Purpose: To evaluate the surface, compositional, and histological changes in the overlying soft tissues of retrieved stainless-steel mini-plates and screws used for rigid internal fixation in the maxillofacial skeleton.

Materials And Method: A prospective study was conducted comprising 60 patients who sustained maxillofacial trauma and underwent ORIF in our unit previously and who required hardware retrieval in the post-operative phase. The retrieved hardware was evaluated for surface and compositional changes with the help of a scanning electron microscope for surface roughness and corrosion changes.

Presurgical depressive symptom and anaesthetic requirements in patients undergoing surgery for malignant and non-malignant conditions: A prospective observational cohort study.

The incidence and magnitude of depression are rarely assessed during preanaesthetic evaluation. The shared physiological mechanisms of depression and anaesthetic drugs are likely to alter the pharmacodynamics of propofol. Therefore, the study aimed to evaluate the burden of presurgical depression and its effect on propofol consumption during anaesthesia.

Can "Aseptic" Looking TIBIA Non-union be Result of an Unrecognized Subclinical Infection?

Introduction: The usual cause of a distal tibial fracture is a high-energy trauma. Although multiple options are available for their treatment such as intramedullary nailing, open plating, and external fixator, each of these options might result in a non-union. Knowing the type of non-union not only allows us to guess the cause but also directs us toward the best possible treatment.

Voriconazole-induced psychosis in rhino-orbital invasive aspergillosis.

Aspergillosis is a challenging fungal infection. Voriconazole is an antifungal drug belonging to the triazole group, commonly used for treating invasive aspergillosis, and candida infections. We present a case of a man in his late 70s diagnosed with rhino-orbital invasive aspergillosis who developed voriconazole-induced psychosis as an idiosyncratic, adverse drug reaction (ADR); however, he responded to the cessation of intravenous voriconazole and, after starting on an oral antipsychotic, haloperidol.

Pristine wild sugarcane () as a biosorbent for removal of methylene blue from wastewater: isotherm, kinetics and regeneration studies.

, popularly known as Kashful (KF) is a seasonal perennial grass with thin culms, mostly an abundantly growing shrub during the autumn season in southern Asia. It is used as no-cost scavenger to convincingly arrest methylene blue, a recalcitrant dye from colored effluent. FTIR, FESEM-EDX, and BET surface area characterize the material well whereas the surface activity was evaluated from zero-point charge (pH = 6.

Evolution of TNM Classification for Clinical Staging of Oral Cancer: The Past, Present and the Future.

Purpose: The AJCC (American Joint Committee on Cancer) Cancer Staging Manual, 1st Edition, was published in 1977 which focused on the TNM classification and staging of cancer to allow easy communication, formulation of a treatment plan and predict the prognosis, among the medical fraternity.

Methods: Ever since the beginning, various modifications of the classification were introduced and released by the joint collaboration of AJCC and UICC (International Union Against Cancer) in various editions of cancer staging manuals.

Results: The present review article was kept focused onto the changes introduced in the clinical staging of cancers of oral cavity.

Status of Substance use among Undergraduate Medical Students in a Selected Government Medical College in Puducherry - An Explanatory Mixed Method Study.

Background: Studies have shown increase in health-risking behavior and a decline in health-promoting behavior among medical students during their stay in medical school. This study aims to determine the prevalence and reason for substance abuse among the undergraduate medical students in a selected medical college in Puducherry.

Material And Methods: This was a facility-based explanatory mixed method study conducted from May 2019 to July 2019.

Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?

Background: Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare through the National Health Insurance Program (NHIP) of Nepal, its implementation is challenging with low enrolment and high drop-out rates. Program performance can often be linked with political economy considerations and interests of stakeholders. This study aimed to develop an in-depth understanding of organizational and systemic challenges in implementing NHIP.

A Cross-Sectional Study to Assess the Frequency of Restraint, and Knowledge and Attitudes of the Caregivers of Patients Toward Restraint in a General Hospital Psychiatry Setting from South India.

Background: There is limited Indian data on the epidemiology of hospital-based restraint practices and the knowledge and attitude of caregivers toward restraint. Therefore, this study aimed to report the frequency and pattern of restraints in a general hospital psychiatry setting and assess the knowledge and attitude about restraint practices among caregivers of patients.

Methods: We calculated the frequency of restraints (physical and chemical) over one year.

Polymorphisms in vitamin B12 and folate metabolising genes and their association with adverse pregnancy outcome: secondary analysis of a population based case control study.

Vitamin B12 and folate deficiency leads to accumulation of homocysteine that increases the risk of adverse pregnancy outcomes like preterm birth and low birth weight (LBW) of the neonate. We explored the association of genetic variants of key vitamin B12 and folate metabolising enzymes (MTHFR C677T and A1298C, MTR A2756G, TCN-2 C776G) with preterm birth and LBW in South Indian women. MTHFR A1298C heterozygotes (AC) were at higher risk for preterm delivery, whereas TCN-2 C776G heterozygotes (CG) were at higher risk for both preterm delivery and LBW.

GPU-Accelerated implementation of a genetically optimized image encryption algorithm.

This paper presents a GPU-accelerated implementation of an image encryption algorithm. The algorithm uses the concepts of a modified XOR cipher to encrypt and decrypt the images, with an encryption pad, generated using the shared secret key and some initialization vectors. It uses a genetically optimized pseudo-random generator that outputs a stream of random bytes of the specified length.

Postpartum Mental Health Status & Role Transition to Mother in Primigravid Women: A Cross-Sectional Study.

Objective: : To assess the incidence of postpartum depression, maternal confidence about parenting and maternal-infant bonding characteristics in first-time mothers.

Background: : First-time mothers are usually unprepared for the transition into motherhood and may find it difficult to cope-up with this challenge leading to parenting stress, maternal-infant bonding disorders, and mental health problems.

Methods: : This cross-sectional study was conducted in a tertiary centre in South India, on 151 primigravid mothers who delivered a live-born healthy infant after 37 weeks' gestation.

Video teleconsultation services for persons with epilepsy during COVID-19 pandemic: An exploratory study from public tertiary care hospital in Southern India on feasibility, satisfaction, and effectiveness.

Purpose: During the COVID-19 pandemic, there is a large unmet need for follow-up services, particularly for chronic diseases such as epilepsy. Alternative methods to reach these people have become necessary. We assessed the feasibility, satisfaction, and effectiveness of video teleconsultation using mobile phones for managing persons with epilepsy (PWEs) on follow-up at a tertiary care center in the southern part of India.

Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women.

Background: Vitamin B12 is an essential micronutrient for neurological function, as it leads to the regeneration of methionine from homocysteine, which is precursor of biologically active molecule S-Adenosyl Methionine (SAM). Pregnancy is a state of increased demand and delayed postpartum repletion of nutrients may predispose women to depression.

Methods: We included women who visited the hospital at 6-weeks postpartum for a regular checkup.

Five-Year Trend in Issuing Disability Certificates from a General Hospital Psychiatric Unit in South India.

Background: Mental disability is a common condition but is considered as an invisible disability. The disability certificate in psychiatry remains underexplored. Some reasons are issues of confidentiality, stigma, lack of awareness in the public, and the hesitancy in the mental health professionals.

Postpartum depression and its risk factors in women with a potentially life-threatening complication.

Objective: To assess the incidence of postpartum depression (PPD) and its risk factors in women with potentially life-threatening complications.

Methods: Eight hundred and ninety women admitted to a tertiary center in South India with potentially life-threatening complications were recruited for the study. Within seven days of delivery, women underwent mental health assessments using the EPDS and PHQ-9 scale.

Where is my reusable bag? Retailers' bag use before and after the plastic bag ban in Dharan Municipality of Nepal.

Banning single-use plastic bags is a popular policy intervention among cities in developing countries such as Nepal. While the policy marks some success in curbing plastic bag usage, it confronts two major challenges. First, the effect of the ban often dilutes and becomes ineffective over time.