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A 74-year-old male patient presented with anaemia, thrombocytopenia, and extensive haemorrhages over both thighs and back. A coagulation work-up revealed markedly elevated Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT). Reduced functional values of fibrinogen as determined by clot-based assay (126.4 mg/dL), as well as factor V (17.5%) and factor X (27.8%), were noted. These abnormalities were corrected by mixing studies with normal plasma. Neoplastic plasma cells were seen in the bone marrow biopsy, while abdominal fat biopsies showed no amyloid deposition. Serum electrophoresis and immunofixation were positive for monoclonal gammopathy. The patient was diagnosed with multiple myeloma complicated by multiple acquired factor deficiencies. The patient showed a complete response within six months of treatment, which included bortezomib and cyclophosphamide. Multiple myeloma is a monoclonal proliferation of plasma cells that results in increased production of free immunoglobulin light chains, resulting in increased paraproteins. These paraproteins bind with and inhibit various clotting factors, resulting in their inactivation and depletion. Factor X deficiency in these cases is usually attributed to concomitant amyloidosis, whose fibrils bind to Factor X. However, these deficiencies can occur in the absence of amyloidosis as well. While various reports of this entity have highlighted isolated factor deficiencies including factors V, VII, IX, and X, multiple factor deficiency is a rare occurrence, with no other cases being reported from southern India.

Multiple Coagulation Factor Deficiency (MCFD) is an uncommon haematological disorder characterised by simultaneous deficiency of multiple clotting factors, which leads to an increased risk of bleeding and compromised haemostasis. The present series aimed to provide a comprehensive analysis of MCFD, shedding light on its aetiology, clinical manifestations, and potential therapeutic interventions in a case-by-case manner, highlighting the individualised treatment options that are needed for many of these cases. A prospective combined clinical and laboratory study was performed on all patients who presented with bleeding tendencies and were subsequently diagnosed with MCFD. Clinical records and laboratory data of all these patients were reviewed to identify commonalities and variations among affected individuals. Haematological assays were performed to quantify the extent of coagulation factor deficiencies. The present series identified a diverse cohort of eight individuals (2 females and 6 males) with MCFD, showcasing variability in age of onset, severity of symptoms, and potential underlying genetic mutations. Clotting factor assays revealed deficiencies of Factor V and Factor VIII (F5F8D), Vitamin K-dependent clotting factor deficiency, and failure of synthesis of clotting factors of hepatic origin. Clinically, patients presented with a spectrum of bleeding phenotypes, ranging from mild to severe, requiring tailored therapeutic strategies. The present series provides an overview of some of the presentations of MCFD, emphasising the need for a multidisciplinary approach in its diagnosis and management. Clinicians should be vigilant in recognising the varied clinical presentations of MCFD and consider genetic testing for precise diagnosis and management.

Mucormycosis is an opportunistic fungal infection that typically affects patients with diabetes mellitus or immunosuppression. The fungus invades nearby blood vessels, leading to thrombosis and organ necrosis. While Mucorales can infiltrate any organ in the body, the gastrointestinal system is an uncommon site for infection. Gastric mucormycosis is a rare but potentially lethal fungal infection resulting from the invasion of Mucorales into the gastric mucosa, exhibiting angioinvasive characteristics. It can lead to high mortality rates due to the increased risk of complications in immunocompromised patients. Common predisposing factors include diabetes mellitus, neutropenia, iron overload states, malnourishment, and other immunocompromised conditions. Mucormycosis is a fatal infection, necessitating prompt intervention to ensure survival. In this case report, authors present a 42-year-old man with a history of chronic alcoholism and chronic kidney disease who presented with complaints of abdominal pain and vomiting for six months, significant weight loss, and loss of appetite for one month. Initially suspected clinically and radiologically as a malignant gastric ulcer, an endoscopy was performed, and a gastric biopsy was sent for Histopathological Examination (HPE). Histological analysis of the gastric biopsy revealed multiple fragments of gastric mucosa with areas of ulceration, neutrophilic abscess, and numerous broad aseptate obtuse-angle fungal hyphae resembling Mucorales. The presence of the organisms was confirmed through special stains for fungus. Very few cases of invasive gastric mucormycosis associated with uncontrolled diabetes, alcoholism, and chronic kidney disease have been reported in the literature.

Viral hepatitis is a common cause of acute liver injury that can lead to chronic liver disease, cirrhosis, and liver cancer. Viral hepatitis shares similarities with kamalai in Siddha medicine and is managed in accordance with Siddha treatment. Present case is of a 14-year-old male patient who presented with symptoms of fever, fatigue, malaise, and jaundice. Laboratory investigations, abdominal ultrasound features, and clinical findings indicated positive viral hepatitis. The patient was started on Siddha management to suppress Hepatitis B Virus (HBV) replication and prevent progression to chronic hepatitis B infection. The patient’s symptoms gradually improved over the next few weeks, and follow-up blood tests showed a significant reduction in the values of elevated liver enzymes, indicating a good response to Siddha medicine treatment. The unique aspect of this case study was that it demonstrates a successful management of viral hepatitis B infection with the Siddha system of medicine.

Actinomycosis is a rare infection caused by filamentous, non acid fast staining and gram positive bacteria. The diagnosis is rarely made preoperatively, and only histopathological examination can confirm it, as the condition presents with varied clinical manifestations, often resembling a malignant lesion on radiographic images. Hereby, the authors present a case of a 67-year-old female, who was admitted for evaluation of an abdominal mass. Radiologically, the mass resembled a desmoplastic fibroma, and clinically, it was suspected to be the same. The mass was excised and sent for histopathological examination. Grossly, two specimens were received. The first consisted of adherent bowel loops, including the ileum, appendix, caecum and descending colon, with the mass arising from mesentery involving the bowel, measuring 11.5x9.5x6 cm. The second specimen was a partial cystectomy specimen, with the abdominal wall mass infiltrating the bladder anteroposteriorly, measuring 11x10x8 cm. Microscopic examination revealed extensive areas of inflammation with actinomycotic organisms exhibiting the Splendore-Hoeppli phenomenon, along with numerous multinucleated giant cells and acute on chronic inflammatory infiltrate. Surrounding areas showed dense collagen bundles. The prognosis after complete surgical resection is good, along with the administration of broad spectrum intravenous antibiotics.

Introduction: Optimising post-strike ball velocity is essential for success in football. Biomechanical factors play a significant role in determining ball speed. However, further investigation is needed to understand the specific relationships between the biomechanical factors and post-strike ball velocity in football players. Aim: To identify the key biomechanical factors contributing to post-strike ball velocity and provide insights for enhancing performance in league-level football players. Materials and Methods: A cross-sectional study was conducted in the Department of Arthroscopy and Sports Medicine at the Sri Ramachandra Centre for Sports Science, Tamil Nadu, India. The duration of the study was five months, from January 2022 to May 2022. The study included 25 professional male football players from national-level league teams. Participants performed maximal instep kicks while various kinematic variables were measured using Vicon cameras, Advanced Mechanical Technology Inc., (AMTI) force footplates, and a radar speed gun. Data processing was performed using Vicon Nexus software version 2.7. The data were analysed using R statistical software version 4.0.2. The Analysis of Variance (ANOVA), followed by Tukey’s Honestly Significant Difference (HSD) post-hoc tests, were used to compare the various kick matrices across the players. Pearson’s r correlation analysis was used to check for a correlation between post-strike ball velocity and other kick matrices. Multiple regression analysis was conducted to examine the relative effects of various kick matrices on post-strike ball velocity, with significance set at a p-value

Introduction: Blood transfusion remains the primary modality of treatment for many serious and common diseases. According to the International Society of Blood Transfusion (ISBT), there are about 349 blood group antigens, out of which only about 25-28 antigens are known to cause acute or delayed type of haemolytic transfusion reactions which could be prevented by Pretransfusion Testing (PTT). Regulated pretransfusion tests include ABO blood grouping, Rh typing, antibody detection, antibody identification and compatibility testing. The purpose of compatibility tests is to demonstrate invitro red cell antigen-antibody reaction. The Antihuman Globulin (AHG) crossmatch testing can assure ABO compatibility between donor and patient blood as well as detect most clinically significant antibodies. Type and Screen (T&S) is a procedure carried out as part of PTT in which the recipient’s blood sample is tested for ABO group, RhD T&S for unexpected antibodies. Aim: To compare T&S method of PTT with AHG crossmatch. Materials and Methods: This cross-sectional study was conducted in the department of Transfusion medicine at Government Royapettah Hospital, Chennai and The Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India from June 2012 to December 2013. T&S was performed on 1,040 recipients’ (510 males and 530 females) samples. All these samples were subjected to AHG crossmatch with ABO group and RhD type matched donor samples to assess the compatibility between donor and recipient by using column agglutination technology. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 11.0. Results: The prevalence of unexpected antibodies in the recipient population was 1.06%. Among the 1,040 recipients’ blood samples, 11 samples were found to have unexpected antibodies. Out of these 11 samples, 10 showed exact antibodies and the remaining one sample with negative antibody screening was found to be incompatible with AHG crossmatch. The sensitivity and specificity of T&S method in comparison to AHG crossmatch was 87.50% and 99.71%, respectively. Conclusion: The sensitivity and specificity of T&S is as acceptable as AHG crossmatch. However, in view of one sample with false negative antibody screening in the study population, it is imperative to know the phenotyping of Red Blood Cells (RBC) antigens of the native population before getting away with AHG crossmatch.

Introduction: The primary surgical options for treating breast cancer involve mastectomy or Breast Conservative Surgery (BCS), which may or may not include reconstruction procedures. BCS helps achieve complete tumour excision with an acceptable cosmetic result. Contour deformities and asymmetry are associated with tissue excision in the lateral aspect of the breast. To address this issue, various techniques of volume replacement, such as the modified Lateral Intercostal Artery Perforator (LICAP) flap, can be performed. Aim: To demonstrate the outcomes of a modified LICAP flap when a muscle flap is not available or desired. Materials and Methods: A retrospective cohort study was conducted, reviewing all modified LICAP flaps performed for breast tumours in Department of Surgical Oncology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India, a tertiary-level cancer centre, from June 2018 to August 2020. Patient demographics, surgical details, histopathology reports, and postoperative complications were collected. Results: Ten patients underwent modified LICAP flaps over a two-year period. All patients had pT2 tumours with marginnegative resection, and the mean resection volume of the specimen was 370 cm3 . Intraoperative patient repositioning was not necessary during the modified LICAP flap procedure. One patient experienced marginal wound necrosis, which was managed conservatively. No patients had scars extending beyond the posterior axillary line, and axillary dissection was performed without a separate incision. Conclusion: The present study demonstrates the advantages of using a modified LICAP flap for breast reconstruction. The modified LICAP flap can be considered as an option for tumours located in the outer aspect of the breast, providing good access to the breast as well as the axilla, with an aesthetically acceptable scar.

Introduction: Nomophobia is the fear of being away from mobile phone contact or in other words nomophobia is the irrational fear of being without mobile phone. Nomophobia is an emerging psychological public health problem. Aim: To determine the prevalence of nomophobia and pattern of mobile phone usage among medical students in Chennai. Materials and Methods: This cross-sectional study was done among 400 undergraduate medical students of Tagore Medical College and Hospital, Chennai, Tamil Nadu, India, studying from 1st year to 4th year, over a period of two months (July 2019 and August 2019). A structured questionnaire, developed by Yildirim C and Correia AP, was used to determine the prevalence of nomophobia among the study population. Stratified simple random sampling technique was used, where 100 students from each study year were selected. Descriptive statistics and chi-square test were done to compare the severity of nomophobia with various variables. Results: Out of 400 students, 50% (200) were males and 50% (200) were female students. Overall, 85% (340) used mobile internet. The top three reasons for using mobile internet were WhatsApp (95%), YouTube (81.3%) and Instagram (74.3%). The overall prevalence of nomophobia was 99% (396); 17.5% (70) showed severe nomophobia, 56.3% (225) moderate nomophobia, and 25.3% (101) had mild nomophobia. Severe nomophobia was associated with mobile usage >5 hours in a day (p-value=0.013). Conclusion: Health education and health awareness campaigns regarding nomophobia should be created among the undergraduate medical students.

Introduction: Blood transfusion is an independent risk factor for death and perioperative infection in trauma patients. Hospital Length Of Stay (LOS) is an indicator of morbidity and can be used to assess wound healing in burns patients. Aim: To analyse the factors influencing hospital length of stay in burns patients, with relevance to blood transfusion. Materials and Methods: This was a cross-sectional study on burns patients admitted at burns ward, Government Kilpauk Medical College, Tamil Nadu, India, between September 2014 to August 2015. Patients with age more than 16 years with 15-40% Total Burnt Surface Area (TBSA) and had survived treatment were included after obtaining informed consent. Age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, blood component transfusion, storage age of red cells, surgical procedures and wound infection were studied. Results were analysed using Chi-square test, Analysis of Variance (ANOVA) and Pearson correlation. Results: Of the 122 burns patients studied, mean age was 35.38±12.93 years, 54.09% were males, mean LOS was 22.39±1.23 days, mean TBSA was 26.11±0.40%, mean APACHE II score was 5.02±0.06, 85 (69.67%) patients had received red blood cell transfusion, 59 (48.36%) underwent surgical procedures and 103 (84.43%) developed culture proven wound infections. APACHE II score at admission (r-value=0.260, p-value=0.004), blood transfusions (r-value=0.504, p-value

Introduction: The new Coronavirus Disease 2019 (COVID-19) has put a strain on healthcare workers, and the virus offers major personal and professional threats. Mental health has been affected by the COVID-19 epidemic, causing them to be fear of becoming sick. During the COVID-19 pandemic, healthcare professionals have been psychologically impacted including fear, anxiety, and depression. Aim: To determine the level of COVID-19 fear among hospital nurses in tertiary hospital care hospital, Erode dristrict, Tamil Nadu. Materials and Methods: This cross-sectional survey study was conducted among employees of Government Erode Medical College Hospital and nearby Hospitals in Erode district, Tamil Nadu, India, from July 2020 to August 2020, to evaluate the fear of COVID-19 using the Fear of COVID-19 Scale (FCV-19S). It used a self-administered questionnaire (online Google form survey). It consisted of two parts, first was socio-demographic details and second was fear of COVID-19 Scale (FCV-19S). The inclusion criteria of participants were all staff nurses working in COVID-19 ward, for minimum of three months in Erode district and willingness to participate. One-way Analysis of Variance (ANOVA), F-test and student Independent t-test analysis was performed to examine the relationship between demographic characteristics and fear levels. Results: The study included a total of 277 staff nurses. The participant’s mean age was 32.25±6.45 years, with females accounting for 93.5% of the total. The scale’s internal reliability was excellent, with a Cronbach’s alpha of 0.902. Overall, the mean COVID-19 fear score was (59.3%) 20.8 out of 35. The maximum fear score was for the statement “I am most afraid of Corona” (65%) and the minimum fear score was for “I cannot sleep because I am worried about getting Corona” (51.8%). Fear levels were higher in females (p-value=0.02), overweight people (p-value=0.001), those living in joint families (p-value=0.01), married individuals (p-value=0.03), participants with two children (p-value=0.001), and Primary Healthcare Centre (PHC) staff (p-value=0.001). Conclusion: The survey found a high level of fear in staff nurses who work in COVID-19 wards. Steps must be taken to preserve their health, by providing adequate resources to relieve their worries and anxiety, enabling them to carry out their frontline duties in the face of the COVID-19 epidemic.

Introduction: Incisional hernia is one of the common complications following abdominal surgery in patients undergoing laparotomy. Various surgical procedures are performed by creating a potential space and placing a foreign body (mesh), which may render the wound susceptible for many postoperative complications. It is clinically important to evaluate the efficacy of Incisional Negative Pressure Wound Therapy (INPWT) in reducing wound complications. Aim: To compare the efficacy of INPWT dressing with traditional gauze dressing in reducing postoperative complications following meshplasty in incisional hernia repair. Materials and Methods: This was a hospital-based randomised controlled trial, conducted in the Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, from October 2013 to July 2015. Total 64 consenting patients with incisional hernias undergoing meshplasty were included in this study. After being randomised into the two study groups, they had their postoperative wounds dressed with either INPWT (group A) for five days, or traditional gauze (group B) based dressings. Operative parameters like duration of surgery, type of dissection and type of skin sutures used were studied and analysed. Also, postoperative outcomes like Surgical Site Infection (SSI), seroma, duration of drain, hospital stay were analysed using Chi-square or Fisher’s-exact test. Results: Group A and B had the mean age of 47±11.61 years and 43±10.53 years respectively. Out of total 64 patients, there was a statistically significant reduction in the volume of drain (p=0.004) and duration of wound drainage (p=0.029) with the use of INPWT. There was also a reduction in the incidence of SSI (6.7% vs 17.6%) and seroma (6.7% vs 11.8%) and the duration of postoperative hospital stay (6.03±1.99 days vs 7.09±2.31 days) in the INPWT group, which were however not statistically significant. Age, co-morbidities, Body Mass Index (BMI), duration of surgery, type of dissection and type of skin sutures were not found to have any effect on the parameters assessed. Conclusion: Incisional negative pressure wound therapy in postoperative wounds, following meshplasty for incisional hernia significantly reduces the volume and duration of wound drainage. It also reduces the incidence of SSI, seroma and the duration of hospital stay.

Oncocytoma is a rare epithelial tumour composed of oncocytes which are epithelial cells with excessive amount of mitochondria. The tumour is most often benign, and diagnosis can be made on the basis of histopathological examination. Here, the authors present a 64-year-old female patient, with complaints of abdominal discomfort and flank pain, along with history of loss of weight and appetite for one month. Radiology showed a left renal mass of measuring 9×7×4.5 cm involving the upper and middle pole suggestive of malignancy. Following which radical nephrectomy was done. Examination of gross specimen showed a fairly circumscribed brownish lesion in the upper and middle pole of left kidney measuring 8.8×7×4.5 cm with a central scar. There was no evidence of hilar and perirenal fat invasion. Histology showed sheets of large polygonal eosinophilic cells with centrally placed nucleus. The differentials were eosinophilic variant of clear cell renal cell carcinoma, chromophobe renal cell carcinoma and oncocytoma. A panel of Immunohistochemical (IHC) markers was performed for further categorisation and the lesional cells were positive for CD 117 and negative for CD 7 and CD 10. This ruled out the differentials and confirmed oncocytoma, thus ruling out the necessity for chemotherapy

Introduction: Midline laparotomy wound is closed in layers co-opting the various layers separately from historical times; however various methods of closure had come into vogue in the recent years. One such is the single layer mass closure technique, in which all the layers of the abdominal wall are closed in single layer, except for the skin and subcutaneous tissue. Yet another method described is the retention closure technique incorporating all layers including skin and subcutaneous tissue are closed in a single layer. Aim: To compare the postoperative wound complications in layered closure with retention closure technique in midline laparotomy. Materials and Methods: This was a longitudinal cohort study done on 57 consecutive patients who underwent midline laparotomy on an elective or emergency basis over a 12 months period from January 2014 to January 2015 in the Department of General Surgery at Mahatma Gandhi Medical College and Research Institute, Puducherry, India. They were divided in to two groups depending on the closure type, layered closure (Group A) and retention closure (Group B) depending on the operating surgeon: retention closure was done in a single surgical unit and layered closure was done in rest of the respective units. Patients were followed up meticulously and immediate postoperative complications were recorded up to four weeks. Statistical analysis was carried out using SPSS version 19.0 (IBM SPSS, US) software with regression modules installed. Chi-square test and t-test were used to analyse the data. Results: In Group A there was 30 patients while in Group B there were 27 patients. In layered closure technique out 30 patients 12 (40%) patients developed wound infection, 1 (3.3%) patient developed partial dehiscence, and 2 (6.6%) patients developed complete dehiscence. In retention closure technique out of 27 patients only 5 (18.5%) patients developed wound infection, 3 (11%) patients developed partial dehiscence and none of them had complete dehiscence in this group. There was significant association between wound complications and patients with uraemia and hypoalbuminemia. Out of 12 uremic patients 8 (66%) developed wound infection (p-value=0.002), 2 (16.7%) patients developed partial dehiscence and 2 (16.7%) patients developed complete dehiscence (p-value=0.06). In patients who had hypoalbuminemia, out of seven patients, 5 (71.4%) patients had wound infection and 2 (28.6%) patients did not have wound infection (p-value=0.01). Four (57.1%) patients had partial dehiscence and 2 (28.6%) had complete dehiscence only 1 (14.3%) patient did not have any dehiscence (p-value=0.001). Conclusion: Retention closure has some advantages over layered closure in preventing wound infections and burst abdomen. Various risk factors are associated with postoperative wound complications, among which hypoalbuminemia and uraemia have a strong association.

Lacrimal sac tumours are rare tumours in ophthalmology but may have serious complications when misdiagnosed. Lacrimal sac tumours can be either epithelial or non epithelial tumours. Epithelial tumours account for 60-94% of tumours. Pseudostratified ciliated columnar epithelium lines the lacrimal sac. Squamous cell carcinoma, transitional cell carcinoma, mucoepidermoid carcinoma, oncocytic adenocarcinoma, adenoid cystic carcinoma and metastasis are the commonly occurring epithelial tumours. Inverted papilloma is a locally aggressive tumour. Non epithelial tumours (25%) are rarer than the epithelial tumours. Lymphoproliferative, melanocytic, and mesenchymal tumours are the non epithelial tumours, among which the lymphoproliferative tumours constitute 2-8%. Very rarely Non Hodgkin’s lymphoma can occur as a primary in the lacrimal sac. Melanoma can occur as a primary from the melanocytes of the lining in the lacrimal sac or as a secondary from the conjuctival melanoma. Kaposi sarcoma and rhabdomyosarcoma are the mesenchymal tumours. Here is a case of Non Hodgkin’s Lymphoma (NHL) occurring in the lacrimal sac in an 80-year-old male. The patient came with the chief complaint of swelling around the right eye since two months. On radiological examination, Computed Tomography (CT) revealed a homogenous solid mass in the right medial canthus, causing bony erosions of the orbit and extending into the nasolacrimal canal. An incisional biopsy of the mass was consistent with the diagnosis of Non Hodgkin’s lymphoma which was further confirmed by immunohistochemistry. This unusual presentation and histopathological features are described.

Introduction: Coronavirus Disease-2019 (COVID-19) pandemic has forced the union government to close the educational institutions. The medical teaching had to go digital. Digital learning has advantages but not without limitations and challenges. Aim: To analyse the impact of lockdown due to COVID-19 pandemic on undergraduate ophthalmology teaching and learning and explore the perception of faculty and students regarding its advantages, limitations and recommendations. Materials and Methods: This cross-sectional survey was conducted among ophthalmology faculty and pre final year students from six government and 11 private medical colleges through online Google questionnaire which was initially validated by three faculty and 10 students had Cronbach’s value-0.70. Based on the pilot study, the questionnaire was modified. Valid responses were entered in data sheets and Statistical Package for the Social Sciences (SPSS) version 24.0 was used to analyse the data. Chi-square test was used to find out the association between symptoms post online classes and duration of online classes and gender of the students. The p-values 0.05) and in those with extended duration of attending online classes (p-value

Introduction: A subgingivally extending proximal carious defect can be adequately restored with an adhesive indirect aesthetic restoration only when the proximal margins can be raised coronal to the Cementoenamel Junction (CEJ) using various Margin Elevation Materials (MEM). This approach is commonly referred to as the Proximal Box Elevation (PBE) technique. However, there is a lack of evidence in the literature regarding the quality of the marginal seal at the root dentine- MEM interface when using PBE technique. Aim: The purpose of this systematic review was to summarise the available evidence on the the quality of the marginal seal at the root dentine- MEM when using the PBE technique during the placement of adhesive indirect aesthetic restorations. Materials and Methods: Comprehensive electronic search was performed in PubMed Central, Cochrane Library and Google Scholar from their inception to January 2021 at the Department of Conservative Dentistry and Endodontics, Sri Ramachandra Institute of Higher Education and Research (SRIHER) between May 2020 to January 2021. Full text articles published in english language which have performed an indirect restoration with and without PBE technique were included in the review. A total of 249 articles were screened initially in the review. The main keywords used were: “PBE”, “Cervical Margin Relocation (CMR)”, “Deep Margin Elevation (DME)” and “coronal margin relocation”. The review protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias assessment of the included studies was performed independently. Results: A total of 9 in-vitro studies were included in the present systematic review. Resin based composites of different viscosities seemed to perform adequately as MEM. It may be prudent to perform the margin elevation in multiple layers. Self etch adhesives had a better marginal seal than the total etch adhesives. Regarding the effect of indirect restoration on the marginal seal at the root dentine- MEM interface, there was no conclusive evidence. PBE may provide a congenial environment for predictable and efficient bonding of indirect adhesive aesthetic restorations. Conclusion: Based on the moderate quality of evidence from the included articles in this systematic review, it can be concluded that while performing a PBE technique, the quality of marginal seal at root dentine- MEM interface is satisfactory under in-vitro conditions.

Introduction: Nurses are important paramedical staff taking care of potential organ donors, poor knowledge and attitude of nurses towards organ donation may worsen the nonavailability of organ for transplantation. Hence, in such scenario the nurses should be given interventions in the form of workshops, audiovisual presentations and certificate courses to develop their knowledge and attitude in organ donation. Aim: In the present systematic review, an attempt was made to find the current scenario of knowledge and attitude of nurses and the effectiveness of the programmes conducted to foster them. Materials and Methods: The MEDLINE database was used to retrieve the articles. The MeSH term used was “Knowledge, Attitude and Practice (KAP) study, organ donation, nurses, organ transplantation, workshop, education programme, intervention”. The Pubmed advanced search was used. Boolean operator ‘AND’ was used in between the MeSH terms in the advanced search. A descriptive analysis was done on the data available in the articles. Results: From the literature it was evident that in most of the circumstances the knowledge and attitude regarding organ donation among nurses is not satisfactory. However, few studies state that nurses do possess adequate knowledge regarding organ donation and are influenced by many factors like age, experience and the unit in which they work. The studies concluded that the knowledge of nurses has improved after the intervention programmes. Conclusion: From this systematic review it was found that the knowledge and attitude of nurses towards organ donation is not to the expected level and the interventions like workshop and peer education do improve their knowledge to considerable level.

Introduction: During this COVID-19 lockdown period, telemedicine is widely being used by doctors for continuing clinical care of patients so that physical distancing can be maintained and the risk of contracting the virus can be avoided. Aim: To assess perception of doctors regarding quality of healthcare by telemedicine as compared to traditional face to face consultation and, to assess the opinion of doctors on whether telemedicine could be an option for future practice after lockdown period. Materials and Methods: A questionnaire based cross-sectional study was conducted in which perception of doctors regarding their telemedicine usage for general practice during this lockdown period has been evaluated. The study was done during April to June 2020 among doctors working in a medical college attached to a tertiary care hospital in Chennai and using telemedicine for their practice during COVID-19 lockdown period. After collection of responses, data obtained were entered in excel sheet and analysed using SPSS version 23.0. Chi-square test was used to assess the association between different variables associated with perception regarding telemedicine usage for general practice. A p-value

Collision tumours are relatively rare entities and are thus, not well recognised. Collision tumour can be defined as two coexisting but histologically different malignancies involving the same organ or adjacent organ with an equivocal intermediate transitional zone between them. Collision tumours of the lung and oesophagus are very rare. Such cases are diagnosed by Computerised Tomogram (CT) Scan or Chest X-Ray for complaint of dysphagia. Definitive diagnosis is made by tissue biopsy. Here, a 66-year-old male is admitted for evaluation of an anterior mediastinal mass. Radiology revealed an anterior mediastinal mass extending in to the left hilar region and upper lobe of right lung anteriorly and in to the lower end of oesophagus posteriorly. Biopsy was performed. Microscopically, transbronchial biopsy revealed a cellular lesion, composed of round-to-oval cells with streaming nucleus, positive for Immunohistochemistry (IHC) markers, CD-56 and Synaptophysin pertaining to a diagnosis of small cell carcinoma. Biopsy of the oesophageal growth shows nest of dysplastic squamous epithelium which infiltrates into underlying muscularis propria showing features of a squamous cell carcinoma. Multiple fragments of squamous epithelium are also seen with necrotic tissue in vicinity and acute inflammatory exudate. Few cells show multinucleation, molding and margination of chromatin, showing the characteristic morphological features of Herpes oesophagitis. The patient was administered platinum-based Chemotherpy.

Planum sphenoidale meningiomas are rare slow growing tumours that impair cognition and lead to behavioural changes. Other common presentations of this condition include persistent headache followed by vision diminution. Dismissing cognitive impairment and behavioural changes as part of dementia, depression or aging might lead to loss of opportunity to treatment. The common symptoms manifested in sphenoid (spheno-orbital) wing meningioma is bulging of the eyes which may be painless, visual impairment and ocular paresis. Headache is also a common symptom, in addition to ptosis. Variants of the clinical syndrome include the following: Eye swelling and hearing loss, optic atropy, Kennedy syndrome and mental changes. Patient had severe headache for which he went for the eye checkup, where the loss of vision in the left eye was confirmed, through the field test. The MRI confirmed the tumour presence. Though the diagnosis was informed it took one year to convince the patient for the surgery. Hence, the author wishes to emphasise the role of tumour support systems. Physician’s serve as patients’ first point of entry into the health care system and as the continuing focal point for all necessary health care services along with their team they play a vital role in convincing patients from postdiagnosis to surgery and recovery.

Introduction: Rheumatoid Arthritis (RA) is one of the most common autoimmune diseases that require early diagnosis and treatment. There are various methods by which these tests are done. The present study was carried out to compare Anti-Cyclic Citrullinated Peptide (Anti-CCP) ELISA, Rheumatoid Factor (RF) IgM ELISA and RF latex agglutination tests and their combined sensitivity and specificity in the diagnosis of RA. Usually, Anti-CCP Antibodies (Ab) appear early before RF in patients with RA. The values of these tests are given in titres. The higher the titre, the higher the chance for it to represent RA (specificity increases). Lower titres can be positive in some normal elderly patients, in other autoimmune disorders, post viral syndromes, and in some cancers. Aim: To comparatively evaluate second generation Anti-CCP Ab with RF isotype in diagnosis of RA. Materials and Methods: This cross-sectional descriptive study was conducted in Department of Microbiology, in a tertiary care hospital, from November 2016 to May 2018. After obtaining informed consent, blood samples were collected from 60 RA patients diagnosed using the American College of Rheumatology-European League Against Rheumatism (ACR/ EULAR) classification criteria for RA. Serum was separated and three tests were performed: RF by latex agglutination test, RF by IgM ELISA and Anti-CCP by ELISA test. The sensitivity and specificity of Anti-CCP, RF factor, RF IgM ELISA were calculated using Non-parametric tests (McNemar test) keeping the clinical diagnostic criteria as the gold standard. Results: Among the 60 study participants, female were 51 (85%), Male/female ratio was 1:5.6. Out of 60, 39 (65%) were positive for RF by latex agglutination test. Around 41 (68.3%) were positive for RF IgM by ELISA and 42 (70%) were positive for Anti-CCP done by ELISA. Both RF ELISA and Anti-CCP had a higher sensitivity of 47.5% and 50% when compared to RF latex. Also, the specificity of Anti-CCP and RF ELISA were higher, that is 82.4% and 80.4% when compared to RF latex which had a specificity of 76.5%. Conclusion: This study concludes and suggests that both RF IgM ELISA and Anti-CCP test should be included in the investigation panel for undifferentiated arthritis.

Introduction: Endodontic irrigants play a role in disinfection of root canal. Inspite of wider options on selection of irrigant, there is always a search on ideal antibacterial irrigant against recurrent infections. Aim: To comparatively evaluate the antibacterial efficacy of chlorhexidine, Mixture of Tetracycline, Acid and Detergent (MTAD) and Chitosan against Enterococcus faecalis when used as a root canal irrigant. Materials and Methods: The bacterial E. faecalis culture was grown overnight in Brain Heart Infusion (BHI) broth and inoculated in Mueller-Hinton agar plates. The root canal irrigants were divided into four groups as follows. (Group I)-4% Sodium hypochlorite solutions; (Group II)-2% Chlorhexidine (CHX); (Group III)-MTAD; (Group IV)-2% Chitosan. Bacterial inhibition was assessed using agar well diffusion method. All four study irrigants were added to respective wells in agar plate (n=10) and incubated at 37°C for 24 hour. Diameter of bacterial inhibition zone around each well was recorded. The results obtained were statistically evaluated using one-way ANOVA test and the intergroup comparison was done using student’s t-test. Results: All the materials had statistically significant difference in zone of bacterial inhibition when compared to other materials. Based on the mean diameters, 4% sodium hypochlorite had the least zone of inhibition and MTAD had the highest zone of inhibition. 2% Chitosan polymer had greater zone of inhibition than 4% sodium hypochlorite, but less than 2% CHX and MTAD. Conclusion: MTAD showed the highest antibacterial efficacy against Enterococcus faecalis followed by CHX and Chitosan.

Individuals with Swyer syndrome have an XY karyotype and are phenotypically female. The prevalence of Swyer Syndrome is about 1 in 30,000 and it is an extremely rare condition. The present study aimed to describe the phenotypic and genotypic variations of two patients with Swyer syndrome. Case 1: A 24-year-old female who presented with primary amenorrhea, infertility with increased FSH level (59.91 mLU/mL) and Case 2: A 29-year-old female with primary infertility was referred. A 2 mL of peripheral blood was drawn for karyotyping. Cytogenetic analysis was carried out using standard GTG banding technique. Cytogenetic analysis revealed a 46,XY karyotype in Case 1 and 46,XY,15cenh+ in Case 2. Q-Banding confirmed the presence of Y chromosome. In addition, Fluorescence In Situ Hybridization (FISH) using CEP X and Y probe and LSI SRY/CEPX probe confirmed the presence of SRY on the Y chromosome. The result showed the presence of sex-determining region of the Y chromosome and also validating the cytogenetic and molecular cytogenetic interpretations. Earlier diagnosis is important and karyotyping is mandatory in these cases.

Introduction: In modern dentistry, as the patient’s demand for aesthetic dentistry increases, the use of tooth-coloured restorative material increase correspondingly. One among them is the use of Porcelain Fused to Metal (PFM) restorations. However, fracture of PFM crown is a common problem in restorative dentistry. Various methods have been advocated to repair fractured porcelain. Aim: The aim of present study was to evaluate the efficiency of the two different bonding systems in reference to three different surface treatments on Nickel Chromium (Ni-Cr) alloys by evaluating the shear bond strength at metal and resin interface. Materials and Methods: A total of 80 Ni-Cr alloys measuring 1x1 cm square blocks were cast using lost wax technique. After casting, the specimens were grouped into four groups based on the surface treatments planned. The four groups were further subdivided into two subgroups based on the bonding technique. The subgroup A samples was treated with Single Bond Universal (SBU) and subgroup B samples was treated with Alloy Primer (AP) and SBU. After surface treatment of the sample, a clear plastic tube measuring 4 mm diameter and 4 mm length was placed and composite resin was packed and cured. Shear bond testing of all the groups was performed on Universal testing machine. Results: The means and standard deviations of Shear Bond Strength (SBS) values in MPa were calculated for each group, and the results were statistically analysed with one-way ANOVA and Tukey HSD tests. All statistical analyses were performed using the SPSS software version 10.0. Conclusion: Within the limitations of this in vitro study, Erbiumdoped Yttrium Aluminium Garnet (Er-YAG) Laser treated alloy surfaces bonded along with AP displayed highest shear bond strength and subgroup B samples bond strength was significantly higher.

Introduction: Depression is a mental disorder that is pervasive and affects people all around the World. In India about one in five people are affected by depressive disorders. Autonomic Nervous System (ANS) affected by depressive disorder can affect salivary composition, since salivary secretion is controlled by the sympathetic and parasympathetic innervations. Likewise, antidepressants are the drugs which can elevate mood in depressive disorders, and also have potential to alter salivary secretion rate and their composition. Alteration in salivary composition can affects oral health and makes them vulnerable for oral infection. Aim: To study the sialochemical alteration in depressive individuals and to compare the effect of antidepressant therapy (selective serotonin reuptake inhibitors-two month course) on the same patients. Materials and Methods: A total of 80 subjects-Group I (40 controls), Group II (40-depressive individuals) and Group III (Group II depressive individuals after two months course of antidepressant therapy). Depression level was assessed with Hospital Anxiety and Depression Scale (HADS). Whole unstimulated saliva was collected and subjected to sialochemical analysis (sodium, potassium, chloride, total protein, urea, salivary amylase, calcium, pH). The parameters were statistically analysed using Unpaired t-test to compare Group I and II and Paired t-test to compare Group II and III. Results: It showed statistically significant alteration in parameters such as total protein, salivary α-amylase, chloride, and calcium. While comparing Group II and Group III it showed significant reduction in total protein and calcium levels in Group III individuals. Conclusion: The post-treatment sialochemical analysis showed that depressive individuals got stabilised and reverted back to the normal baseline value of the healthy individuals which proves that Selective Serotonin Reuptake Inhibitors (SSRI) does not produce profound sialochemical alteration.

Introduction: Psoriasis is a chronic inflammatory skin disease characterized by epidermal hyperproliferation, abnormal differentiation and inflammatory infiltration in the dermis. The dermal microvascular expansion associated with abnormal orientation and dilatation of capillaries in the biopsies of the psoriatic skin suggest that the disease is dependent on angiogenesis. Aim: To analyze and compare the immunohistochemical expression of angiogenic factors - Vascular Endothelial Growth Factor (VEGF), von Willebrand Factor (vWF) and CD 34 in skin biopsies of psoriasis cases with control skin samples; and to correlate the expression of angiogenic factors with Psoriasis Area and Severity Clinical Index (PASI SCORE). Materials and Methods: This was a prospective case control study conducted over a period of 15 months. Thirty-two psoriasis cases and thirty control skin samples were included in the study. Skin biopsy specimen was taken from clinically diagnosed psoriasis cases who did not receive any treatment. The diagnosis of psoriasis vulgaris was confirmed after microscopic examination. Immunohistochemical expression for VEGF, vWF and CD 34 was studied. Results: VEGF expression in epidermis was significantly higher in cases when compared to control skin (p

Spontaneous abortion or loss of fetus prior to 20 weeks of gestation is observed in 15-20% of clinically recognized pregnancies. Recurrent Miscarriage (RM) is defined as three or more consecutive pregnancy losses and it affects 1-2% of women. Parental chromosomal rearrangements account for 2-5% of RM. This report describes two couples with a clinical history of RM who were subjected to conventional cytogenetic analysis to ascertain the chromosomal aetiology. Analysis of GTG-banded metaphases obtained from cultured lymphocytes at approximately 500-band resolution revealed balanced translocation in the female spouses as 46,XX,t(8;11) (p11.2;q23.3) in BR27W and 46,XX,t(5;7)(p15.1;q32) pat in BR49W. Both the male partners exhibited 46,XY karyotype. Fluorescent In Situ Hybridization (FISH) analysis was subsequently carried out to confirm the balanced translocation using suitable whole chromosome paint probes. These balanced chromosomal abnormalities in the parents could be responsible for the repeated fetal losses. Hence, karyotype analysis should be a mandatory etiological investigation for couples with RM towards genetic counselling. Disruption of critical genes through these rearrangements could also underlie the pregnancy outcome.

Introduction: An integrated strategy for blood safety is required for the provision of safe and adequate blood. Recruiting a sufficient number of safe blood donors is an emerging challenge. The shortage of blood in India is due to an increase in the demand, with fewer voluntary blood donors. A study on the knowledge, attitude and the practice of donors may prove to be useful in the successful implementation of the blood donation programme. Our aim was to find the level of the knowledge, attitude and practice of blood donation among voluntary blood donors. Material and Methods: A structured questionnaire was given to 530 voluntary blood donors to assess their knowledge, attitude and practice with respect to blood donations. The statistical analyses were done by using the SPSS software. The associations between the demographic factors were analysed by using the Chi square test. Results: Among the 530 donors, 436 (93%) were males and 36 (7%) were female donors. 273 (51.2%) donors knew about the interval of the donation and 421 (79.4%) donors knew about the age limit for the donation. 305 (57%) donors felt that creating an opportunity for the donation was an important factor for motivating the blood donation and 292 (55%) donors felt that the fear of pain was the main reason for the hesitation of the donors in coming forward to donate blood. Conclusion: A majority of the donors were willing to be regular donors. The donors showed positive effects like a sense of satisfaction after the donation. Creating an opportunity for blood donation by conducting many blood donation camps may increase the voluntary blood donations.

Introduction: Enhanced External Counter Pulsation (EECP) is a non-invasive treatment option for patients with Coronary Artery Disease (CAD). The treatment has shown to augment diastolic pressure and reduce Left Ventricular (LV) after-load by reducing systemic vascular resistance. The effect of EECP in standard brachial blood pressure and central haemodynamic parameters are not known. Aim: We hypothesized that EECP may have differential effect in CAD patients with low systolic blood pressure when compared to normal systolic pressure and the mechanism underlying this differential effect may be due to improvement in LV function. Materials and Methods: A total of 72 consecutive patients who underwent EECP treatment for symptomatic CAD with LV dysfunction were divided into two groups based on cut-off value of 100mmHg for systolic blood pressure. First group had patients with brachial systolic blood pressure of >100mmHg and second group had patients with brachial systolic blood pressure of ≤100mmHg. We measured central aortic systolic pressure, pulse pressure, augmentation index and augmentation pressure by SphygmoCor device and Ejection Fraction (EF) was measured by echo-cardiography. All these measurements were carried out prior to and after completion of 35 days of EECP sessions. Results: Central systolic pressure, brachial systolic pressure, aortic pulse pressure, augmentation pressure and augmentation index significantly decreased in patients with normal brachial systolic pressure with baseline moderate LV dysfunction. Brachial systolic, aortic systolic and aortic pulse pressure significantly increased with no change in augmentation index and pressure is observed in patients with baseline severe LV dysfunction associated with low systolic pressure post EECP treatment. Conclusion: EECP treatment has haemodynamically favourable differential effect in normal and low brachial systolic pressure and this is mainly driven by improvement in LV function in patients with symptomatic CAD with LV dysfunction.

Introduction: Typhoid fever is endemic in India and other developing countries, causing major public health problems with high morbidity and mortality. The resistance of Salmonella enterica serovar Typhi (S. Typhi) towards commonly prescribed antimicrobials is increasing in developing countries. However, there have been several reports of the therapeutic failure of fluoroquinolones in patients with Salmonella infection. Resistance to quinolones/ fluoroquinolones commonly arises due to target site mutation. Aim: The present study was planned to analyze mutation in Quinolone Resistance Determining Region (QRDR) of quinolone resistant Salmonella isolates. Materials and Methods: A total of 133 S. Typhi isolates (blood (n = 131), stool (n=1) and bone marrow aspirate (n=1)) from tertiary care hospitals in Chennai and Puducherry, were included in this study. Minimum Inhibitory Concentrations (MIC) were carried out according to the Clinical Laboratory Standard Institute (CLSI) guidelines 2014. Mutations in gyrA and parC genes were analyzed by PCR-RFLP (Restriction Fragment Length Polymorphism) method followed by DNA sequencing. Results: Of the 133 S. Typhi, 99.2% were resistant to nalidixic acid and 21% were resistant to ciprofloxacin by MIC method. 94% of isolates showed Ser 83 mutation in gyrA and 21.8% of isolates showed Trp106-Gly mutation in parC. Conclusion: Mutations in gyrA and parC genes are highly prevalent among Salmonella species. Irrational use of fluoroquinolones may increase the accumulation of mutations in the DNA gyrase and topoisomerase encoding genes, which lead to the emergence of high level fluoroquinolone-resistant Salmonella strains in future.

Occurrence of eclampsia before 20 weeks of pregnancy and after 48 hours of delivery in the absence of typical signs of hypertension and or proteinuria is termed as atypical eclampsia. Atypical or non-classic eclampsia will have some symptoms of eclampsia but without the usual proteinuria or hypertension. All patients with atypical onset should undergo neurological evaluation to rule out neurologic causes of seizures. Cerebral tuberculosis is a rare and serious form of disease secondary to haematogenous spread of Mycobacterium tuberculosis. Here we present a case of cerebral tuberculoma with seizures in late pregnancy mimicking eclampsia.

Yolk sac tumour also known as primitive endodermal tumour is the most common malignant germ cell tumour (GCT) in the paediatric age group. Most common sites of involvement are ovaries and testes, but rarely can occur in the extragonadal sites. In the head and neck region, yolk sac tumours have been reported in the nasopharynx, sinonasal tract, orbit, ear and parotid gland. Nasopharynx is an uncommon site for yolk sac tumour and very few cases of nasopharngeal pure yolk sac tumour have been reported so far. Yolk sac tumours are highly malignant and have a poor prognosis. This is a case of pure GCT in a three-year-old female child who presented with a rapidly growing nasopharyngeal mass. Histopathological examination followed by immunohistochemistry and serum AFP study clinched the diagnosis of yolk sac tumour. The tumour responded well to chemotherapy as evidenced by decrease in serum AFP levels.

Synovial sarcoma is one of the poorly differentiated malignant soft tissue tumour occuring commonly among young adults in the extremities. We report a 50-year-old female presenting with a soft tissue mass in the right palm. On examination, a single firm and non tender swelling was noticed adjacent to the thenar muscles. Radiology suggested a benign soft tissue lesion. The swelling, clinically thought to be a lipoma, was excised and sent for histopathological examination. Microscopy showed a highly cellular tumour arranged in nests, cords and pseudo glandular pattern separated by dense fibrocollagenous tissue. An interesting and baffling finding was the presence of a distinct mucin vacuole in many of the tumour cells. A diagnosis of soft tissue sarcoma with epithelial features was considered and a panel of immunohistochemical stains done. Tumour cells showed strong positivity for cytokeratin 7, vimentin, EMA & Bcl2. CD 99 and S100 were focally positive. CD 34 and CEA were negative. In view of the above microscopic and immunohistochemical findings, a diagnosis of monophasic synovial sarcoma of epithelial type was rendered. This case is being documented for the rare morphological appearance of mucin vacuoles in a monophasic epithelial type synovial sarcoma.

Budd- Chiari syndrome is caused by obstruction of hepatic venous outflow. There are numerous causes for Budd-Chiari syndrome. One of the causes is systemic lupus erythematosus due to antiphospholipid antibodies. Only few cases have reported Budd-Chiari syndrome as an initial manifestation of systemic lupus erythematosus (SLE). This is a case report of Budd-Chiari syndrome due to SLE.

Myoclonic jerks are brief involuntary twitching of a muscle or a group of muscles. It is a medical sign and not a diagnosis of a disease. It occurs in number of secondary conditions like hepatic failure, renal failure, dyselectrolytaemia, etc in addition to the physiologic, epileptic, essential and psychogenic causes. Myoclonic jerks secondary to uraemia usually occur in the end stage renal failure and is resolved by renal replacement therapy. Here we report a case of uremic myoclonic jerk presented to our emergency department which occurred secondary to obstructive uropathy secondary to neurogenic bladder caused by old traumatic paraparesis and it was resolved by simple and timely intervention by bladder catheterization and it prevented the patient from going into uremic encephalopathy.

Background: Coagulase negative Staphylococci (CoNS) are common inhabitants of human skin and mucous membranes. With the emergence of these organisms as prominent pathogens in patients with ocular infections, investigation has intensified in an effort to identify important virulence factors and to inform new approaches to treatment and prevention. Aim: To isolate CoNS from ocular specimens; to study the possible virulence factors; speciation of coagulase negative staphylococci (CoNS) which were isolated from ocular complications; antibiotic susceptibility testing of ocular CoNS. Materials and Methods: The specimens were collected from the target patients who attended the Microbiology Laboratory of a tertiary care eye hospital in Coimbatore, Tamilnadu state, India. The isolates were subjected to tube and slide coagulase tests for the identification of CoNS. All the isolates were subjected to screening for lipase and protease activities. Screening for other virulence factors viz., slime production on Congo red agar medium and haemagglutination assay with use of 96-well microtitre plates. These isolates were identified upto species level by performing biochemical tests such as phosphatase test, arginine test, maltose and trehalose fermentation tests and novobiocin sensitivity test. The isolates were subjected to antibiotic susceptibility studies, based on the revised standards of Clinical and Laboratory Standards Institutes (CLSI). Results: During the one year of study, among the total 260 individuals who were screened, 100 isolates of CoNS were obtained. Lipolytic activity was seen in all the isolates, whereas 38 isolates showed a positive result for protease. A total of 63 isolates showed slime production. Of 100 isolates, 30 isolates were analyzed for haemagglutination, where 4 isolates showed the capacity to agglutinate the erythrocytes. The results of the biochemical analysis revealed that of the 100 isolates of CoNS, 43% were Staphylococcus epidermidis. The other isolates were identified as S. xylosus (n=8), S. captis (n=16), S. haemolyticus (n=10), S. saccharolyticus (n=2), S. hominis (n=5), S. saprophyticus (n=6) and S. intermedius (n=1). On the other hand, 9 isolates were not identified. In the antibiotic susceptibility analysis, it was found that most of the isolates were sensitive to vancomycin, amikacin and linczolid and resistant to cefatoxime, oxacillin, bacitracin and nalidixic acid. Conclusion: S. epidermidis was found to be predominant in causing the ocular complications. Slime production, heamagglutination, protease and lipase activities could be the putative virulence factors of CoNS. Antibiotic susceptibility patterns of CoNS against antibacterial agents revealed maximum resistance to beta lactam groups, and the resistance was found to be higher to oxacillin, and lowest to vancomycin.