Procedural pain management in neonates: A Narrative review.

Over the past three decades, awareness regarding pain management in neonates has risen significantly. It has been very well established that neonates can perceive, feel, and react to stimuli that cause pain and discomfort to them. Neonates admitted to neonatal intensive care units (NICUs) are repeatedly subjected to invasive treatments, most of which are painful.

Developmental delay and its associated factors among children of 9 months and of 18 months attending primary health facilities in an urban resettlement area of East Delhi.

Background: Early identification of developmental delay in children can help in making early intervention for its management. Routine developmental screening is not being practised in India due to lack of trained field workers, lack of awareness among parents and lack of feasible assessment screening tool. There is lack of studies that focuses on home environment provided to the children as it is associated with developmental delay.

Amend the Mental Health Care Act 2017: A Survey of Indian psychiatrists (Part 2).

Background: Information about the experience of practicing psychiatrists with the use of the Mental Health Care Act (MHCA), 2017, India, after 5 years of its promulgation has not been available.

Aim: The present study was carried out to understand the experience of the practicing psychiatrists in using and complying with the MHCA 2017 and to bring out the problems and suggested reforms, if any, in various provisions of the MHCA 2017.

Methods: An online survey by practicing psychiatrists of Indian Psychiatric Society on the various sections and provisions of the MHCA 17 was carried out through structured and open-ended responses.

Evaluation of Vulvar Disorders by Vulvoscopy Index and N-S-P Scheme Using Three Rings Vulvoscopy (TRIV).

Background And Objective: TRIV is a new and promising technique based on the fact that Vulva can be divided into three circular zones based on anatomy, embryology, and histology- Outer, Middle, and Inner ring. The Vulvoscopy Index and N-S-P scheme are objective tools to improve the systematization of vulvoscopy findings and to simplify information management using TRIV.

Methods: Hundred women with vulvar complaints (Cases) and 100 asymptomatic women (Controls) underwent TRIV and findings were documented as per N-S-P Scheme and Vulvoscopy Index.

Pesticide exposure promotes disease activity by decreasing lymphoproliferative activity and increasing IL-4 production in systemic sclerosis patients.

Background: One of the common findings in systemic sclerosis (SSc) patients has been long-term exposure to environmental toxins such as pesticides. However, the data available shows an equivocal association between pesticide exposure and autoimmunity in SSc.

Methods: We investigated the levels of organochlorine pesticides (OCPs) in blood of 20 SSc patients and 17 healthy controls, and also studied their effect on T lymphocytes and their functional responses.

Exploring Gonadal Functions in Patients With Alcoholic Liver Disease: A Correlative Analysis With Disease Severity.

Background and objective Alcoholic liver disease (ALD) encompasses a spectrum of liver conditions caused by excessive alcohol consumption, including fatty liver, alcoholic hepatitis, and cirrhosis. Both phenotypical and biochemical changes in gonadal hormones are observed across these stages. This study aimed to evaluate the clinical, biochemical, and hormonal abnormalities in patients with varying degrees of ALD and to assess their correlation with disease severity.

Caffey disease in an infant.

A previously healthy female infant was brought to the paediatrics outpatient department by her mother reporting increased irritability and swelling behind her left shoulder, accompanied by restricted movement in her left arm. The irritability had been present for the past 5 months, with swelling also noticed at that time, gradually increasing in size. On examination, a large, firm, immobile mass was detected on the left scapular region.

Expression of Immune Checkpoint Regulator Cytotoxic T Lymphocyte Antigen 4 (CTLA-4) and Programmed Cell Death Protein Ligand 1 (PD-L1) in Invasive Ductal Carcinoma Breast.

Despite significant advancement in the diagnostic and therapeutic aspects of breast carcinoma, the prognosis remains dismal. Recently, with advances in its understanding, various immune system-based management strategies have been developed. CTLA-4 suppresses lymphocyte reactivity, IL-2 secretion, and IL-2 receptor expression and triggers cell cycle arrest.

An Unusual Case of a Stuck Catheter in a Sick Neonate.

The umbilical vein can be reliably used for central venous access in neonates less than 14 days old. The catheter used in the umbilical vein normally extends proximally to the inferior vena cava and can be utilized for drug delivery as well as venous sampling. Herein, we describe a neonate with a broken umbilical vein catheter (UVC) stuck in the right atrium and inferior vena cava (IVC), and its successful, uneventful removal via the transfemoral route.

Diagnosis and management of subungual and periungual verruca: A clinical review.

Nail unit verruca is the most common nail tumor encountered in clinical practice and may be highly distressing to patients due to reduced functionality, cosmesis, and stigmatization. Subungual and periungual verrucae present a challenge for treatment compared to cutaneous warts of other sites and recurrence rates are high. The risk of spread to other skin and mucosal areas inherent to all warts may be increased given location on the fingertips.

Amend the Mental Health Care Act 2017: A Survey of Indian Psychiatrists (Paper 1).

Aim: This paper highlights the difficulties and lacunae in the Mental Health Care Act 2017 that hinder its implementation and use for the care and treatment of persons with mental illness in India.

Methods: An online nationwide survey, involving structured questions as well as open-ended questions, to elicit the level of implementation, experience in complying with the provisions of the Act, and level of satisfaction, of practicing psychiatrists was carried out. Responses were analyzed using appropriate statistics.

Furcuncular Myiasis of the Scalp Caused by Chrysomya bezziana.

We report a rare case of furuncular myiasis in a 7-year-old boy presenting with a discharging nodule over the scalp. The report details the clinical presentation, examination findings, and dermoscopic features of furuncular myiasis. To the best of our knowledge, Chrysomya bezziana has never been reported to cause furuncular myiasis.

Effect of Vitamin D Supplementation on Glycemic Control in Newly Diagnosed Patients With Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

Objective: Vitamin D deficiency is commonly associated with type 2 diabetes and it has been linked to impaired glycemic control in these patients. This study was done to determine if vitamin D supplementation improves glycemic parameters in type 2 diabetes.

Methods: This randomized controlled trial was done in 140 newly diagnosed adult patients with type 2 diabetes.

An Instructional Module for Functional Dissociative Seizures (FDS) in Hindi: Enhancing Communication and Management in India.

Background And Objectives: Functional dissociative seizures (FDS) are very common in neurology clinics, they straddle both neurology and psychiatry. In India, scarce resources and guidelines are available for effectively conveying their diagnosis and management, which leads to a substantial gap in care. We aimed to provide an instructional module for FDS, tailored to clinicians, patients, and caregivers in Hindi, to enhance communication of diagnosis and facilitate suitable management strategies.

Reliability and Validity of Hindi Version of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) for Diagnosis of Delirium: A Cohort Study.

Background: The confusion assessment method for the intensive care unit (CAM-ICU) is a bedside tool to diagnose delirium in critically ill patients. This study aims to determine the reliability and validity of the Hindi version of CAM-ICU against the Diagnostic and Statistical Manual (DSM), fourth edition text revision (DSM-IV-TR), and DSM, fifth edition (DSM-5) criteria for diagnosis of delirium.

Methods: Seventy-five Hindi-speaking consenting patients ≥18-year-old with Richmond Agitation Sedation Scale ≥-3 and an anticipated ICU stay > 48 hours were included.

Eye movement desensitization and reprocessing therapy as an adjunct to pain management during dental extraction in children - a randomized control trial.

Background: Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions.

Efficacy of Sentinel Cerebral Embolic Protection Device in Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies.

Transcatheter aortic valve replacement (TAVR) is frequently associated with stroke due to debris embolization. Although the risk of stroke with newer-generation devices is lower, stroke still represents a significant cause of mortality and morbidity post-TAVR. The Sentinel cerebral embolic protection device (CEPD) is a dual-embolic filter device designed to capture debris dislodged during TAVR.