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Background: The objectives of this study were to bring out the results of application of pleural wrap in primary repair of tracheo - esophageal fistula (TEF) with long-gap oesophageal atresia (LGEA) and also define the role of neonatologists and paediatric intensivists in post-operative management in these patients by laying down standard neonatal management protocol., Materials and Methods: This was a retrospective descriptive observational study conducted between March 2011 and April 2019 on 23 cases of LGEA with TEF. The study was conducted at two tertiary care paediatric surgery centres in Northern part of India wherein these newborn babies were operated by two paediatric surgeons with variable experience of 8-12 years. It also describes the neonatal management protocol used in post-operative period., Results: Out of 23 patients, 15 were boys and 8 were girls, with a mean age of 32.25 weeks and a mean birth weight of 2.02 kg. The mean hospital stay was 23.5 ± 8 days. Eleven cases had gap between 3 and 3.5 cm, 8 cases between 3.5 and 4 cm and 4 cases had gap more than 4 cm. The incidence of associated anomalies was 52%. Anastomotic leak rate was 8.69%, and 3 (13.04%) patients died in the post-operative period. All the operated patients were managed postoperatively as per strict neonatal management protocol exclusively by the team of neonatologists and neonatal intensivists., Conclusion: Application of pleural wrap over anastomosis following primary repair of LGEA with TEF significantly reduced the incidence of anastomotic leak in our study. Apart from the pleural wrap, the key to successful outcome also is contributed by the little prolonged, controlled ventilation and patience and perseverance in post-operative feeds. This post-operative management protocol that has been followed by us in our study is easily reproducible and can be adopted by paediatric surgeons working alongside neonatologists as a team., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Introduction: Therapeutic plasma exchange (TPE) is an extracorporeal process of separation of plasma from the cellular components of blood and its replacement with analogous fluids. This process is effective in treatment of disease conditions from dysregulation of the humoral immune system by removal of various humoral pathogenic substances like antibodies, immune complexes, monoclonal proteins, toxins or cytokine(s) and/or the replenishment of a specific plasma factor., Aim and Objective: To evaluate major indications of therapeutic plasma exchange in neurological disorders. To identify major complications associated and factors associated with premature cessation of the therapeutic plasma exchange cycle. Materials and Methods: This is a hospital based retrospective study conducted by analyzing medical records of patients, who had undergone therapeutic plasma exchange (TPE) for various neurological disorders at IMS & SUM hospital. Medical records total 118 patients who underwent TPE from January 2016 to December 2021 were analyzed. The demographic data, blood group pattern and indications for TPE were enumerated from the records. Various complications of TPE and reasons for incomplete TPE cycle were documented and analyzed., Results: A total of 508 TPE procedures were performed on 118 patients. In this study 61 patients were male and 57 patients were female. O-blood group was commonest blood group among the patients. GBS is the commonest indication of TPE. 57.6 % of patients could complete all sessions TPE cycle. Blockage of vascular access is the commonest cause of incomplete TPE session. Cramps (33%) and mild transient hypotension (27.1%0 were the commonest complications observed., Conclusion: TPE is a safe and effective treatment option for various immune-mediated neurological disorders and should be considered in managing these disorders., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Background: Hypospadias is one of the common congenital anomalies of male genitalia. Although over 300 different operative techniques have been described, post-operative complications are still common, of which glans dehiscence (GD) is the most severe complication requiring redo urethroplasty. Some surgeons use the vascular flap to cover the glanular part of the neourethra to prevent GD, but there are controversies regarding its usefulness. There is a paucity in the literature, about articles evaluating the risk of GD associated with vascular flap coverage of the glanular neourethra during primary urethroplasty., Materials and Methods: We planned a single-blinded, parallel-design, randomised controlled trial involving 56 cases of hypospadias treated with single-stage urethroplasty amongst the admitted cases of hypospadias for primary urethroplasty in the Department of Paediatric Surgery, AIIMS, Bhubaneswar, from November 2017 to December 2019 as an M.Ch. thesis project. This was approved by the Institutional Ethics Committee and enrolled in the national registry of clinical trial. 28 patients were randomised into Group A (without flap coverage of the glanular part of the neourethra) and 28 patients were randomised into Group B (with flap coverage of the glanular neourethra)., Results: Only 2 (7.1%) cases amongst the Group A patients developed GD, while 9 (32.1%) cases of Group B had GD (P = 0.013)., Conclusions: Extending the vascular flap coverage up to the glanular part of the neourethra till the neo-meatus during primary urethroplasty is significantly associated with GD., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Background: Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. Although majority of them improve with time, none of the existing diagnostic modalities can accurately predict which hydronephrotic kidney is at the risk of progressive renal damage and will benefit from early surgery. Postural variations in the anteroposterior pelvic diameter (APPD) of the hydronephrotic kidney in children during follow-up postnatal ultrasonography (USG) reflect the intrapelvic tension, which might help in predicting the need of surgery amongst these patients., Materials and Methods: We designed this prospective observational study in all unilateral UPJO patients on postural variation in the APPD of renal pelvis on ultrasonography. The mean age of all patients were 2.15 years (0-5 years) and managed at our institute at All India Institute of Medical Sciences, Bhubaneswar. The study duration was from July 2019 to May 2021. The management of these patients was done as per the standard institutional protocol and there was no deviation due to inclusion in this study. We documented the variations in postural APPD both amongst the conservatively managed group and the surgically managed group of patients. Linear correlation between two continuous variables was explored using Pearson's correlation (if the data were normally distributed) and Spearman's correlation (for non-normally distributed data)., Results: We found a higher prone APPD than supine APPD in all these patients indicating the obstruction at ureteropelvic junction. However, in the surgical group, there was less variation in the postural APPD compared to the conservative group, and when there was no variation in the postural APPD, the need of surgery was 100%. The limitation of our study was the small sample size (n = 36). A study involving a larger population or involving multiple institutions may further add significance to our findings., Conclusion: We found less postural variation in APPD on USG to be more likely associated with severe UPJO requiring early surgery. This may indicate a non-compliant renal pelvis. However, it was statistically not significant., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Introduction: Metabolic syndrome (MetS) and hypothyroidism are well-established forerunners of atherogenic cardiovascular disease (CVD). It is possible that patients suffering from both these disease entities may have a compounded risk. This study aimed at determining the prevalence of hypothyroidism in MetS., Materials and Methods: This cross-sectional study was conducted from September 2017 to August 2018 in the department of medicine at a tertiary care hospital in Northern India. Ethical approval was obtained from the institutional ethical committee. The study subjects consisted of 157 patients with MetS, the diagnosis of which was based on the International Diabetes Federation criteria. After a detailed history and physical examination, relevant investigations including complete thyroid profile were done. The data were analyzed using appropriate statistical tests (P < 0.05)., Results: In our study, the age of subjects ranged between 14 and 92 years, with a mean ± standard deviation of 48.1 ± 17.01 years. There were more females than males with a male-to-female ratio of 1:1.3. The prevalence of hypothyroidism was 46.5%. Hypothyroidism was more common in females (58.9%) as compared to males (41.1%). Patients with hypothyroidism had significantly higher body weight and body mass index (BMI) in comparison to euthyroid patients. The rest of the anthropometric parameters were comparable. Waist circumference and BMI of overt hypothyroid patients were found to be higher as compared to subclinical hypothyroid patients. Total cholesterol and triglyceride were significantly higher (P = 0.001 and P < 0.001, respectively), while high-density lipoprotein levels were significantly lower in patients with hypothyroidism than the euthyroid group (P < 0.001)., Conclusion: Hypothyroidism, especially subclinical hypothyroidism, is a common endocrine disorder in patients with MetS. As MetS and hypothyroidism are independent risk factors for CVD, hence there is a need for screening for hypothyroidism and the treatment of the same can be beneficial in reducing the cardiovascular morbidity and mortality in patients with MetS., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Background: Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing., Aim: The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India., Materials and Methods: This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed., Results: Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%)., Conclusion: The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Background: Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal (ICC) at the narrow adynamic part of UPJ has been implicated as a causative factor., Materials and Methods: This prospective study was conducted between October 2019 and March 2022 to find out the density of ICC by the immunohistochemical method using CD117 (c-kit) antibody, in resected segments of UPJ in obstruction patients and in renal tumour patients as control. ICC/high power field (hpf) was also studied from the margins of the resected segment in the obstruction group. The pre-operative and post-operative sonographic and renal scintigraphic features were compared., Results: The median age of patients in the study group (n = 25) was 36 months and in the control group was 39 months. The mean ICC/hpf at the stenotic part of UPJ in the study group was 3.56 ± 1.26 and in the control group was 12.56 ± 1.89 (P = 0.0001). ICC density from the proximal and distal margins of the resected segment was 11.12 ± 2.12 and 11.68 ± 1.62, respectively (P < 0.001). The post-operative antero-posterior diameter of the renal pelvis and differential renal function showed significant improvement in comparison to the pre-operative value (P = 0.0045 and 0.0005, respectively)., Conclusions: The significant decrease in the density of ICC at the stenotic part of UPJ compared to controls suggests a pacemaker role of these cells in ureteral peristalsis and the aetiopathogenesis of UPJ obstruction. Histopathological analysis of ICC should not only be limited to the stenotic part of UPJ but also should focus on the anastomosed ends of the ureter, which reflects post-pyeloplasty outcome., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Background: The nature of aberrant salience in schizophrenia, whether it is a state or a trait phenomenon, remains unclear., Aim: To assess and compare aberrant salience in patients with schizophrenia at different stages of the illness and to explore its association with symptom severity and medication use., Methods: A total of 113 subjects were included, comprising 83 patients with schizophrenia divided into three groups: group A (acute drug-free symptomatic stage, n = 23), group B (chronic-medicated symptomatic stage, n = 30), and group C (chronic-medicated asymptomatic stage, n = 30). These were compared with a healthy control group (group D, n = 30). Participants were assessed using the Aberrant Salience Inventory (ASI) and clinical rating scales, including Psychotic Symptom Rating Scales, Scale for Assessment of Positive Symptoms, and Scale for Assessment of Negative Symptoms (SANS)., Results: Significant differences were observed across almost all domains of aberrant salience. The most notable differences were between the symptomatic groups (A, B) and the healthy controls (D). Subgroup analysis showed no significant differences between the acute (A) and chronic groups (B, C), but significant differences were found between the symptomatic (A, B) and asymptomatic (C) groups in several domains and in the total ASI score. A highly significant positive correlation was noted between the total ASI score and the symptom rating scales, except for SANS., Conclusion: Aberrant salience is significantly elevated in patients with prominent positive symptoms, particularly delusions and hallucinations. It appears comparable to the general population in chronic remitted patients, suggesting that aberrant salience is state-dependent. Medication did not significantly influence aberrant salience as both medicated and nonmedicated symptomatic patients continued to exhibit it. However, medication may contribute to reducing aberrant salience by alleviating positive psychotic symptoms., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Psychiatry.)

Background: Individuals experiencing alcohol dependence syndrome (ADS) may struggle with relapse due to various factors, even after receiving successful inpatient treatment. While motivation enhancement therapy (MET) and pharmacotherapy are commonly used interventions for ADS, incorporating task-centered casework (TCP) - a nondirective, goal-oriented, and time-limited approach - may yield promising outcomes., Aim: This study examined the effects of adjunctive TCP in conjunction with pharmacotherapy and MET on frequently relapsing patients with ADS., Materials and Methods: This study utilized a case-control design to evaluate the efficacy of combined therapies (pharmacotherapy, MET, and TCP) on 60 male subjects with a diagnosis of ADS and multiple admissions in a tertiary deaddiction center. The participants were divided equally into experimental and control groups, with the experimental group receiving all three therapies and the control group only receiving pharmacotherapy and MET. Both groups maintained their pharmacotherapy regimens throughout the 2-month study period. Assessments were conducted at baseline and the end of the study using various measures, including social-demographic and clinical data, the SAD-Q, ACQ SF-R, SOCRATES-8A, CIWA-Ar, and WHOQOL-BREF Hindi version., Results: The results of the study indicate that the experimental group exhibited a marked decrease in alcohol cravings, an increased willingness to make positive changes, and overall better treatment outcomes and quality of life compared to the control group. In patients with ADS who underwent treatment with MET, TCP, and pharmacotherapy, it was observed that cravings were a significant predictor of their quality of life and readiness to make changes., Conclusions: TCP can be complemented with existing addiction therapies in the treatment of addiction because it has additional advantages in the form of nondirectiveness, goal orientation, time-limitedness, and collaboration between the therapist and the patient. ADS patients can benefit from this therapy by discovering their inert potential and identifying their shortcomings., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Psychiatry.)

Purpose: To identify the predisposing factors, clinico-microbiological profiles, and treatment responses in patients with atypical mycobacterial keratitis., Methods: The study retrospectively analyzed patients who presented at a tertiary eyecare center in eastern India with atypical mycobacterial keratitis between 2008 and 2021. The diagnostic criteria included cases positive for acid-fast bacilli on Ziehl-Nielsen stain or culture. The antibiotic susceptibility pattern was observed, and treatment was initiated accordingly., Results: Out of the 29 cases, ocular predisposing factors were present in 62.1% with an antecedent history of trauma, and vegetative matter was the most common risk factor. There was no predisposing association with systemic conditions in any case. A long lag time was observed between the onset of corneal infection and presentation in 79.3% of cases, with the average time being 43.7 days. Clinical signs mimicked fungal keratitis in most cases. Typical cracked windshield appearance was only observed in two cases. Two patients presented with clinical pictures like peripheral ulcerative keratitis. Topical amikacin was used as treatment in 28 cases. Based on disk diffusion assay, 28 (96.5%) isolates were sensitive to amikacin. Twelve (41.3%) were sensitive to vancomycin, six (20.6%) to gatifloxacin, six (20.6%) to ciprofloxacin, and four (13.7%) to moxifloxacin. Twelve participants showed good final visual acuity posttreatment, which improved to over two lines of Snellen's visual acuity chart (44.5%)., Conclusion: Atypical mycobacteria keratitis may not present with classically described clinical features. The duration of presentation, clinical presentation, special microbiological stains, targeted therapy, and antibiotic susceptibility patterns are the key to successfully managing these intractable infections and obtaining favorable outcomes., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Competing Interests: There are no conflicts of interest.

Abstract: Epigastric hernia with divarication of recti is uncommon in children, and the aetiology remains incompletely understood - as does the optimal management strategy - whether to repair epigastric hernia alone or both defects. We present an innovative technique utilising subcutaneous endoscopic surgery to address both epigastric hernia and divarication in children. Our approach yields excellent cosmetic outcomes, avoids the need for a larger laparotomy scar and mitigates the risks associated with the transperitoneal laparoscopic approach. It is a viable option with all the advantages of minimally invasive surgery for repairing epigastric hernia and divarication of recti in symptomatic cases, particularly when the aetiology is uncertain and multiple defects are anticipated. Its use may be extrapolated to isolated diastasis recti as working in subcutaneous space involves lesser risk with excellent cosmesis., (Copyright © 2024 Copyright: © 2024 Journal of Minimal Access Surgery.)

Background: Because of its high rates of morbidity and death, oral squamous cell carcinoma (OSCC) poses a serious threat to world health. To maximize patient care and direct clinical decision-making, it is important to comprehend treatment results and survival rates., Methods: Treatment results and survival rates for OSCC patients treated at a tertiary care facility between 2010 and 2022 were assessed in this retrospective research. Demographic data, tumor features, treatment options, and follow-up results were all included in the data. The relationships between treatment methods and survival rates were evaluated by statistical analysis., Results: There were 107 OSCC patients in all. Compared to radiation and chemotherapy, surgery had reduced recurrence rates and greater overall survival rates as the most common treatment option. There were notable variations in survival rates across the various treatment regimens ( P < 0.05)., Conclusion: Surgery is the mainstay. Adjuvant treatments, however, are complementary in the management of illness. The significance of customized treatment strategies based on unique patient attributes and tumor features is highlighted by this study in order to maximize results for patients with OSCC. To confirm these results and investigate cutting-edge treatment approaches, more investigation is necessary., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Purpose: The purpose of this study was to compare the efficacy of various suturing methods used in deep third molar extraction procedures., Methods: A total of four suturing method groups-simple interrupted, horizontal mattress, vertical mattress, and figure-of-eight-were randomly allocated to 100 patients having deep third molar surgery. Assessments were conducted on wound healing, operation time, intraoperative problems, postoperative pain scores, swelling measures, and patient satisfaction questionnaires. Appropriate tests were used for statistical analysis, with P < 0.05 being regarded as significant., Results: Compared to other procedures, the figure-of-eight technique showed better results in terms of postoperative pain scores, swelling measures, wound healing percentages, and patient satisfaction ( P < 0.05). There was no discernible difference in the operating time or intraoperative problems between the groups., Conclusion: In conclusion, there seems to be a benefit to using the figure-of-eight suturing approach for deep third molar surgery in terms of improved postoperative results and patient satisfaction. It is recommended that clinicians give this strategy some thought to improve patient care and surgical results., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Objective: The purpose of this research is to estimate the effectiveness of non-laser surgery and laser surgery in the management of periodontitis., Methods: One hundred participants with a chronic periodontitis diagnosis participated in a randomized controlled experiment. Two cohorts of patients were created: Cohort B underwent non-laser surgery and Cohort A underwent laser surgery. Pre- and postoperative assessments were conducted at 3, 6, and 12 months for clinical criteria such as "pocket depth (PD), gingival index (GI), and clinical attachment level (CAL)"., Results: There was a noticeable improvement in clinical parameters following both laser and non-laser operations. However, laser surgery showed superior results in terms of decreased PD and raised CAL., Conclusion: In conclusion, compared to non-laser surgery, laser surgery seems to be a more successful treatment option for periodontitis. Larger sample sizes and longstanding follow-up are required for future research in order to validate these results and evaluate the longstanding sustainability of the treatment effects., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: The anterior loop of the inferior alveolar nerve is the portion of the nerve that is located anterior to the mental foramen before it exits the canal., Objectives: The objective of the research was to assess anterior loop in the Odisha population., Materials and Methods: For this study, a random selection of 100 CBCT scans representing 200 hemi-mandibles was made. Descriptive statistics were used to compute the distribution of the mental nerve pattern according to gender, age, and the presence or absence of dysplastic features. Frequency and percentages were then used to show the results., Results: There was significant difference among male and female on left and right side for anterior loop. 28% of studied population had loop and 72% without loop out of 100 participants. Pattern III was common type followed by patter I. Right side had slightly more loop than left side. Loop length distribution was significant., Conclusions: It was concluded that loop is a common finding; hence it must be evaluated before doing any surgical procedure in that anatomical location., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Purpose: There is a rising demand for highly qualified workers in today's ever-changing healthcare job environment. Recognizing higher education's critical role in closing the healthcare skill gap is critical for the long-term growth and prosperity of individuals, healthcare organizations, and the larger economy., Design/methodology: Within the healthcare sector, education emerges as a pivotal mechanism to address the prevailing skill gap. Universities and colleges offer a wide range of academic programs meticulously designed to cultivate critical thinking, problem-solving capabilities, effective communication, and collaborative teamwork among students. Furthermore, higher education institutions actively collaborate with healthcare employers to tailor specialized programs that precisely align with the requirements of various healthcare roles., Originality/value: This paper delves into the multi-faceted ways in which universities and colleges can significantly contribute to mitigating the healthcare skills gap. The author emphasizes the critical role played by education in bridging this gap, ensuring that the healthcare workforce is suitably equipped to navigate the swiftly changing job market., Future Scope: By promoting partnerships with industry stakeholders, developing pertinent academic curricula, and offering continuous professional development opportunities, educational institutions empower individuals and healthcare organizations to excel within the dynamic landscape of healthcare delivery., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: Temporomandibular joint (TMJ) ankylosis frequently results in mandibular asymmetry, which impairs an affected person's ability to function and look good. Because of the intricacy of TMJ ankylosis and the variety of surgical procedures available, correcting mandibular asymmetry surgically can be difficult., Methods: Patients with mandibular asymmetry and TMJ ankylosis who had surgery at a tertiary care facility between certain periods were the subject of a retrospective investigation. Medical records were used to gather information on patient demographics, pre-operative imaging, surgical methods, and post-operative results. Surgical methods included condylectomy with or without reconstruction, joint reconstruction with or without orthognathic surgery, and unilateral or bilateral mandibular distraction osteogenesis (MDO). Occlusion, patient-reported results, and facial symmetry made up the evaluation criteria., Findings: The study had a total of 50 patients, with different surgical method distributions. Comparing unilateral and bilateral MDO to condylectomy and joint reconstruction, notable gains in face symmetry and occlusion were seen. The largest complication rate was seen with condylectomy, mostly from recurrence and device-related issues, albeit the rates of other procedures varied as well., Conclusion: In conclusion, customized treatment planning is necessary for the correction of mandibular asymmetry in individuals with TMJ ankylosis. Although mandibular distraction osteogenesis produces better results for occlusion and facial symmetry, it is crucial to carefully weigh the risks involved. While still feasible treatments, condylectomy and joint reconstruction require strict monitoring for any consequences. In order to enhance patient care in this difficult patient group, future research should concentrate on improving treatment procedures and long-term results., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: Complete eradication of microorganisms from the root canal and three-dimensional obturation of the canal space are necessary for a successful root canal therapy. In root canal failures, Enterococcus faecalis is the most often detected bacterium. Microorganisms can be eliminated with the aid of chemical irrigation., Objectives: The current research was conducted to evaluate the antimicrobial effect of triphala, neem, and chlorhexidine root canal irrigants., Materials and Method: Mueller-Hinton agar plates were inoculated with the E. faecalis (ATCC) bacterial culture after it had been cultured overnight in brain heart infusion (BHI) broth. Agar well diffusion was used to measure antibacterial inhibition. After being introduced to their appropriate wells in agar plates, the three research irrigants were incubated for 24 hours at 37°C. Every well's bacterial inhibition zone was noted. After tabulating the results, statistical analysis was done., Result: When triphala and A. indica extract (neem) were added to chlorhexidine, the highest inhibitory zone against E. faecalis was observed., Conclusion: The herbal remedy triphala and the extract from A. indica exhibited an inhibitory zone when tested against E. faecalis . As a result, these irrigants might be utilized as a substitute for root canal irrigants., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: In order to obtain satisfactory treatment outcomes, orthodontic space closure frequently requires trustworthy anchoring devices. Because they are easier to install and smaller than regular implants, mini-implants have become a viable option. The purpose of this study was to evaluate the effectiveness of regular implants versus mini-implants as orthodontic anchoring devices for closing gaps in a tertiary care context., Methods: A total of 100 patients who needed space closure were split into two groups at random and given regular implants (group B, n = 50) or mini-implants (group A, n = 50). The rate of space closure, anchoring loss, and patient pain were measured using visual analog scales as the primary end measures. Resonance frequency analysis was used to assess implant stability. Based on implant survival and the lack of peri-implant problems, success rates were calculated., Findings: Mini-implants showed much lower rates of patient pain ( P < 0.001) and anchoring loss ( P < 0.05) than normal implants; however, they did show comparable rates of space closure ( P = 0.42). In addition, mini-implants had comparable success rates ( P = 0.78) and greater implant stability ( P < 0.01) when compared to normal implants., Conclusion: In conclusion, mini-implants have benefits in anchorage preservation, patient comfort, and implant stability over regular implants when used as orthodontic anchoring devices for space closure. They also offer equivalent effectiveness. These results provide credence to the use of mini-implants as practical substitutes in orthodontic practice., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: In the realm of fixed prosthodontics, the transition from conventional to digital impressions has been a subject of ongoing debate. This study aims to provide a comparative analysis of digital versus conventional impressions in terms of accuracy and efficiency., Materials and Methods: Twenty patients requiring fixed prosthodontic treatment were selected for this study. Each patient received both digital and conventional impressions. The digital impressions were obtained using an intraoral scanner, while conventional impressions were taken using polyvinyl siloxane material. The impressions were then used to fabricate fixed prostheses for each patient. Accuracy was assessed through measurement of marginal fit using a standardized technique, and efficiency was evaluated based on time taken for impression procedures., Results: The mean marginal discrepancy for digital impressions was found to be 38 micrometers (±5), whereas for conventional impressions, it was 45 micrometers (±7). Additionally, the average time taken for digital impressions was 12 minutes, compared to 20 minutes for conventional impressions., Conclusion: Digital impressions demonstrated superior accuracy and efficiency compared to conventional impressions in fixed prosthodontics., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: The COVID-19 epidemic has affected all facets of patient care, including dentistry services, and placed hitherto unheard-of demands on healthcare systems throughout the world. More and more emphasis is being paid to psychological discomfort and dental anxiety that epidemic patients face when seeking dental care. The purpose of this research was to examine the psychological distress and dental anxiety levels of patients receiving dental care during the COVID-19 pandemic in a tertiary care setting between 2021 and 2022., Methods: For this study, 300 patients with regular dental checkups were selected as a convenience sample. Self-report questionnaires measuring dental anxiety and psychological discomfort were filled out by participants. Descriptive and inferential statistics were used to analyze the data once demographic information was gathered., Findings: The majority of participants experienced psychological anguish (66.7%) and dental anxiety (73.3%) at moderate-to-severe levels. When compared to pre-pandemic values, there was a substantial increase in psychological distress ( P < 0.001) and dental anxiety ( P < 0.001) throughout the pandemic period., Conclusion: Current research shows how the COVID-19 pandemic significantly affected the mental health of patients receiving dental care, underscoring the need of catering to patients' mental health needs in dental practices during public health emergencies., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Introduction: The most prevalent conditions in the population are temporomandibular disorders (TMDs), which are linked to a number of morbidities. A number of treatment options have been proposed, and some of the most successful ones include low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) therapy., Objectives: The purpose of this study was to examine the effectiveness of two therapies-TENS treatment and LLLT-in the management of morbidities related to temporomandibular joint (TMJ) disorders., Materials and Methods: Based on inclusion and exclusion criteria, a total of 50 patients who had been sent to the oral medicine outpatient department and had been pre-diagnosed with TMJ disorders were randomly assigned to two groups, with 25 patients in each: Group I received TENS therapy, while Group II received LLLT. The acquired data was assessed statistically., Result: Both groups showed a substantial decrease in discomfort, an increase in mouth opening, and a decrease in muscular tenderness when compared to within groups. LLT was more effective than TENS for TMD treatment., Conclusion: While TENS and LLLT both had good results, LLLT appeared to outperform TENS therapy in terms of muscle tenderness factors., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Objective: Liver derangement underlies the development of metabolic syndrome in perimenopause. Previously, we have observed that durva swaras (DS) improved metabolic-associated fatty liver disease (MAFLD) and abnormal liver enzymes (aspartate aminotransferase and alanine aminotransferase) along with other complications of menopause in ovariectomized rats. We aimed to decipher the hepatoprotective mechanisms of DS in acetaminophen (APAP)-induced liver injury model, which is analogous to the pathophysiology of MAFLD., Materials and Methods: Male Swiss albino mice were distributed into three groups at random. Group I (Control) was administered with vehicle (distilled water) for 7 days. Group II (APAP) received vehicle for the first 6 days and APAP (350 mg/kg - single dose) on the 7th day. Group III (APAP + D) received test compound DS (quality complied) at a dose of 133 mg/kg for 6 days and APAP (350 mg/kg - single dose) on the 7th day. Subsequently, blood and liver tissues were subjected to biochemical, ultrastructural, and gene expression analysis., Results: DS pretreatment protected the liver from APAP-induced disruption of sinusoids and necrosis. DS prevented the elevation of liver enzymes - AST and ALT induced by APAP. Importantly, DS inhibited the APAP-elicited increase in messenger ribonucleic acid levels of hepatic nuclear factor-kappa beta (NF-κB) and pro-inflammatory cytokines, namely interleukin-1 beta, interleukin 6, and tumor necrosis factor-alpha. Moreover, DS activated gene expression of nuclear factor erythroid 2-related factor 2 and liver-X-receptor-alpha (LXR-α) to combat the liver damage., Conclusion: DS hinders APAP-induced liver damage by activating LXR-α and inhibiting the NF-κB-associated pro-inflammatory cytokine gene expression. These observations confirm the protective role of DS in metabolic dysfunction-associated liver conditions., (Copyright © 2024 Copyright: © 2024 Indian Journal of Pharmacology.)

Introduction: Caries in primary teeth rapidly advances owing to its thin structure, thereby requiring restoration. However, restorations often fail due to various causes such as secondary caries and reduced microtensile bond strength (μTBS), which calls for the use of antimicrobial agents such as silver diamine fluoride (SDF)., Aim: This study aims to measure and analyse the effect of SDF application on the μTBS of three regularly used restorative materials to dentin of primary teeth as well as compare the types of bond failure interfaces under SEM., Materials and Methods: The study comprised 60 samples equally divided into six groups among three restorative materials, namely, glass ionomer cement (GIC, Groups I and II), resin-modified glass ionomer cement (RMGIC, Groups III and IV), and composite resin (Groups V and VI) with subdivisions of A and B, where A represented samples with SDF application and B represented samples without SDF application., Results and Observations: It was observed that μTBS of RMGIC to sound and carious dentin irrespective of SDF application was found to be statistically significant (P < 0.05), and when GIC, RMGIC, and composite resins were compared to both sound and carious dentin irrespective of SDF application, it was statistically significant (P < 0.05). SEM analysis revealed predominantly cohesive failures among all the groups., Conclusion: Based on the results, it was concluded that SDF has no adverse effect on the μTBS of GIC, RMGIC, and composite resin to both carious and sound dentin of primary teeth., (Copyright © 2024 Copyright: © 2024 Journal of Indian Society of Pedodontics and Preventive Dentistry.)

Pituitary carcinoma is a rare entity comprising 0.1-0.2% of all pituitary tumors and presents significant diagnostic and therapeutic challenges. Intraspinal drop metastasis in these tumors is even rarer. We report a case of a prolactin secreting pituitary carcinoma with intracranial metastasis and multiple intraspinal drop metastasis. This is the first case where 68Gallium labelled [1,4,7,10 - tetraazacyclododecane - 1,4,7,10 - tetraacetic acid] -1- NaI3 - octreotide (68Ga-DOTANOC) whole-body positron emission tomography-computed tomography (PET-CT) has been used in a case of malignant prolactinoma, in an attempt to ascertain the somatostatin receptor (SSTR) expression on tumor cells. Through this paper, we suggest that SSTR targeted radionuclide therapy could have a potential role in aggressive pituitary tumors and pituitary carcinomas similar to the promising role of lutetium-labelled peptides in inoperable or metastasized gastroentero-pancreatic neuroendocrine tumors (GEP-NETs)., (Copyright © 2024 Copyright: © 2024 Neurology India, Neurological Society of India.)

Background and Purpose: Cerebral venous and sinus thrombosis (CVST) leads to perfusion abnormality in the brain. Our aim was to assess perfusion abnormalities in the center and periphery of the parenchymal lesion in CVST patients and correlate with the clinical outcome., Materials and Methods: Dynamic susceptibility contrast (DSC) perfusion imaging was performed in patients with CVST. Relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and mean transit time (MTT) values were obtained in the center and periphery of the parenchymal lesion., Results: A total of 30 consecutive patients of CVST were included in the study. Parenchymal lesion was present in 21 (70%) patients. In rest 9, perfusion map was showing some abnormality although conventional MRI was normal. Mean rCBV and MTT were increasing from periphery of the lesion to the center (rCBV 69.93 ± 29.79 at periphery (PL2) to 92.49 ± 32.07 at center of the lesion and 69.19 ± 25.52 at normal appearing contralateral brain parenchyma (NABP). MTT 11.83 ± 3.76 at periphery (PL2) to 15.27 ± 5.49 at center of the lesion and 10.63 ± 3.37 at NABP). rCBV and MTT from abnormal perfusion areas from 9 patients without parenchymal abnormalities are 92.89 ± 17.76 and 15.92 ± 3.66 respectively., Conclusion: There is an increasing trend of MTT and rCBV from periphery to center of the parenchymal lesion. MTT is the most consistent parameter to be abnormal in patients of CVST even in patients without parenchymal lesion. Residual neurological deficit was found in patients with increased rCBV and having large hemorrhagic infarct., (Copyright © 2024 Copyright: © 2024 Neurology India, Neurological Society of India.)

Background: Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac artery (CA) compression syndrome, is a rare condition characterized by persistent post-meal or post-exercise abdominal discomfort, often more pronounced during expiration. Additional symptoms include nausea, vomiting, and weight loss., Aims and Objectives: To document the clinical presentation, diagnostic process, and treatment outcomes of seven patients diagnosed with MALS and to evaluate the effectiveness of surgical release of the median arcuate ligament (MAL) over a follow-up period of at least six months., Materials and Methods: The study included seven patients diagnosed with MALS from 2019 to 2021. Diagnosis was based on the presence of chronic abdominal pain and associated symptoms, absence of alternative diagnoses after various clinical assessments, and angiographic evidence of CA compression. The primary treatment involved surgical decompression of the CA by releasing the MAL through either open or laparoscopic techniques., Results: All seven patients underwent successful surgical release of the MAL. The patients were followed up for at least six months post-surgery. The study evaluated the persistence of symptoms and the need for additional interventions such as revascularization techniques., Conclusion: Surgical release of the MAL is the primary treatment for MALS, providing relief for many patients. However, long-term follow-up is essential as some patients may continue to experience symptoms post-surgery, necessitating further interventions., (Copyright © 2024 Copyright: © 2024 Journal of Minimal Access Surgery.)

Abstract: Clitoral enlargement (clitoromegaly) due to non-hormonal causes, particularly due to vascular malformation, is rare. Only eight such cases are reported in the literature. We report an additional case of isolated vascular malformation implicating the clitoris of a young girl child and its surgical management., (Copyright © 2023 Copyright: © 2023 African Journal of Paediatric Surgery.)

Competing Interests: There are no conflicts of interest.

Background: Posterior urethral valves (PUV) are the most common obstructive anomaly of the lower urinary tract in children. End-stage renal disease (ESRD) in 17% of the children is due to PUV. The present study helps know the spectrum of the disease, management options, and the outcome in these children., Methods: The present study is a descriptive type of study by review of medical records of all the children presented to the hospital from 2015 to 2019. Profile of PUV includes any abnormality in antenatal ultrasonography (USG), age at presentation, presenting complaints, general condition at the time of presentation, biochemical investigations like serum creatinine and electrolytes at admission, clinical progression during hospital stay and the type of intervention. Outcome variables studied were improvement in the stream and overall well-being of the child, renal function, recurrent urinary tract infections (UTIs). Follow-up period varied from 1 to 6 years., Results: A total of 73 patients were included in the study. The mean age of presentation was 3.4 years. The most common presenting complaints were poor urinary stream and dribbling of urine. Antenatal USG showed abnormality in 23 patients. Renal function was abnormal in 28 patients. Out of 73 patients, 51 underwent endoscopic ablation of valves, 19 underwent vesicostomy, and three patients underwent supravesical diversion. During the follow-up recurrent UTI was observed in 11 patients, 15 patients progressed to chronic kidney disease, and 15% of patients were hypertensive. Mortality in the present study was 4%., Conclusion: PUV includes a spectrum of diseases from mild form to lethal conditions. Early intervention by relieving obstruction may prevent or delay the ESRD; hence, timely intervention is necessary in these children., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)

Chest wall reconstruction poses significant challenges. One of those challenges is choosing the correct material for reconstruction. There is debate on using prosthetic materials versus autologous tissues and rigid versus nonrigid materials. This article showcases the novel use of fascia lata for chest wall reconstruction in children., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)

Anesthetic management of extremely low-birth-weight (ELBW) neonates is always accompanied by many dilemmas and challenges. Here, we report a case in which 512 g of ELBW newborns underwent exploratory laparotomy for perforation. Anesthesia management of such ELBW infants has not been reported in the literature., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Saudi Journal of Anesthesia.)

Lipoblastoma in the inguinal regional is a rare occurrence in children and can present as a surgical surprise during pediatric herniotomies. Irreducible inguinal hernia is one of the most common surgical problems dealt by pediatric surgery residents in emergency. We report a case of inguinal lipoblastoma presenting as irreducible groin swelling. Complete excision of the mass was done with no recurrence till date., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Indian Association of Pediatric Surgeons.)

Introduction: The role and function of P-selectin levels in various inflammatory and immune-mediated diseases have been established. Whether they have an association with inflammatory skin diseases such as vitiligo and psoriasis needs to be established., Objective: The objective of this study was to assess P-selectin levels in psoriasis and vitiligo and to compare them with matched controls without skin disease., Materials and Methods: The study included a total of 90 subjects with age- and sex-matched - 30 each in psoriasis, vitiligo and 30 controls without skin disease. Psoriasis and vitiligo severity was assessed using the Psoriasis Area and Severity Index and the Vitiligo Area Scoring Index scores. P-selectin levels were assessed and compared among the groups. P-selectin levels were also compared with the severity of psoriasis and vitiligo. Chi-square and analysis of variance tests were used to compare the data., Results: The mean age of subjects was 36.28 ± 11.80 years. Majority of the subjects were males (65.6%). The three groups were matched for age, sex, and other demographics. The mean P-selectin levels were 610.43 ± 134.19, 292.52 ± 60.99, and 158.97 ± 34.76 ng/ml, respectively, in the psoriasis, vitiligo, and control groups, respectively (P < 0.001). No significant association of P-selectin levels was observed with psoriasis severity; however, with increasing vitiligo severity, there was a significant increase in P-selectin levels (P < 0.001)., Conclusion: Patients with skin diseases have raised P-selectin levels. Within skin diseases, inflammatory diseases such as psoriasis have higher P-selectin levels as compared to autoimmune diseases such as vitiligo. A significant association of P-selectin levels was observed with vitiligo severity but not with psoriasis severity., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

This study aims to investigate the relationship between pachychoroid spectrum disorders and retinitis pigmentosa (RP) or rod-cone dystrophy through a comprehensive literature review. The purpose is to explore the association between these disorders, understand their underlying mechanisms, and summarize the existing hypotheses and opinions. A thorough review of the literature was conducted using PubMed, focusing on articles related to central serous chorioretinopathy (CSC), RP, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, focal choroidal excavation, peripapillary pachychoroid neovasculopathy, and peripheral exudative hemorrhagic chorioretinopathy. Relevant studies were selected for a detailed narrative review and analysis. Several studies have reported the coexistence of CSC and RP, indicating a potential association between the two conditions. The dysfunction of the retinal pigment epithelium is proposed as a common factor. Choroidal thinning is observed in RP, but conflicting results exist regarding choroidal thickness (CT). While some studies support choroidal thinning in RP, others suggest preserved or increased thickness. Additionally, cases of pachychoroid neovasculopathy and polypoidal choroidal vasculopathy in RP have been reported, suggesting an overlap between these conditions. The literature suggests conflicting reports on CT changes in RP. Future research should focus on large-scale studies using comprehensive imaging techniques, genetic analysis, and long-term follow-up to uncover the underlying mechanisms and determine the prevalence of pachychoroid spectrum disorders in RP patients., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Aim: The aim of the study was to analyze the techniques and outcomes of deep anterior lamellar keratoplasty (DALK) done in eyes with healed hydrops., Methods: Thirty-one eyes with paracentral scars following acute hydrops underwent DALK and were included in the study. Manual layer-by-layer dissection with stromal air injection was done in all cases, keeping dissection of the site of preexisting perforation to the end., Results: Out of the 31 eyes, in 28 eyes, DALK could be completed, and in 3 eyes, procedure had to be converted to penetrating keratoplasty. Visual outcomes in all cases were good, with 26 out of 28 eyes (92.8%) achieving a best-corrected visual acuity (BCVA) of 6/12 or better. Preoperative mean BCVA of LogMAR 1.19 ± 0.27 improved to a postoperative mean BCVA of LogMAR 0.23 ± 0.08 ( P < 0.00001). Postoperative mean refractive astigmatism at the last follow-up was -2.69 ± 0.82 D with postoperative a spherical equivalent of -2.31 ± 0.7 D. Complications included double anterior chamber in one eye and secondary angle closure in two eyes. Stromal rejection in one eye was managed with steroids and one eye with suture infiltrate needed selective suture removal., Conclusion: Layer-by-layer dissection with limited air injection into the stroma has shown good visual outcomes in patients undergoing DALK following healed hydrops, and DALK can very well be the primary treatment option even in such cases with a paracentral posthydrops scar., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Oman Ophthalmic Society.)

Purpose: The purpose of this study was to assess the safety and efficacy of large-scale use of vancomycin injection in an infusion bottle during vitreoretinal procedures., Materials and Methods: This was a retrospective evaluation of all vitreoretinal procedures done in the last 70 months, where intraoperatively vancomycin injection (0.2 mg/mL) was used in an infusion bottle prophylactically as standard care. Vitreoretinal procedures were categorized as major (duration >30 min), minor (duration <30 min), and silicone oil removal. Postoperatively, a detailed ocular examination was done to rule out hemorrhagic occlusive retinal vasculitis (HORV) or signs of postoperative bacterial endophthalmitis., Results: Over the last 70 months, a total of 31,720 vitreoretinal procedures were performed, which included 24,371 major vitreoretinal procedures, 1401 minor vitreoretinal procedures, and 5948 silicone oil removal cases. None of these cases developed HORV or bacterial endophthalmitis., Conclusion: Vancomycin (0.2 mg/mL) in infusion fluid during vitreoretinal procedures is safe and can be advocated as a prophylactic measure against postvitrectomy bacterial infections., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Oman Ophthalmic Society.)

Competing Interests: There are no conflicts of interest.

Background: Digitalization in the form of increased Internet use through screen media has also shown its ramification like cyberbullying. They are aggressive acts with the intention or motivation to harm another person through technology. The aim is to study the prevalence of cyberbullying and its association with mental illness in the adolescent age group (15-19 years)., Methods: This community-based cross-sectional study was rolled out among adolescents aged 15-19 years. A total of 387 were given a semistructured interviewer-administered questionnaire consisting of general details, cyberbullying victimization, and offending questions, PHQ-9 and GAD-7., Results: The mean (SD) age was 16.8 (1.3) years. More than half (53.2%) were males, and nearly three-fourths (74.4%) were school-going. Around 28.2% reported being cyberbullied at least once in their lifetime. About 7.0% of adolescents were cyberbullied more than once, and 0.8% more than five times in the past 30 days. The most common ways were posting a mean or hurtful picture (31.9%) and the concerned person's comments (24.2%) online. Multivariable logistic regression analysis found that adolescents attending colleges (AOR 1.9, 95% CI 1.1 to 3.4), using tobacco (AOR 2.5, 95% CI 1.4 to 4.5), and depressed (of any severity, AOR 2.0, 95% CI 1.1 to 4.3) were at significantly increased risk of being cyberbullied ( P < 0.05)., Conclusion: The prevalence of cyberbullying among adolescents aged 15-19 is notable, with significant associations found between cyberbullying and attending college, tobacco use, and depression. Understanding the correlates of cyberbullying can inform targeted interventions to support mental health and well-being among adolescents., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Psychiatry.)

Background and Aim: In hydrocephalus patients, after ventriculoperitoneal (VP) shunt, decrease in pulsatility index (PI) correlates with decrease in ventricle size. Also, increase in PI is noted in obstructed or malfunctioning VP shunts. However, previous studies were either done in infants and children or included patients of all age groups. Our aim was to compare PI before and after successful VP shunt surgery in adult patients and also the trend of transcranial Doppler (TCD) parameters for 3 days after surgery., Materials and Methods: A prospective, observational study was done in 20 adult patients undergoing VP shunt. Clinical features, vitals, Evans index, and TCD parameters were noted in the preoperative period. A computed tomography (CT) head was repeated 4-6 h after surgery, and the position of ventricular end of shunt was confirmed and Evans index was calculated. The vitals and TCD parameters were noted at same time and for the next 2 days. Repeated measures analysis of variance (ANOVA) and paired t-test were uses for statistical analysis., Results: A total of 18 patients were included for statistical analysis. The mean preoperative PI was 1.19 ± 0.24 and the postoperative PI after surgery was 0.97 ± 0.17, 0.97 ± 0.23, and 0.94 ± 0.21 (P = 0.0039) on postoperative day (POD) 1 (POD1), POD2, and POD3, respectively. The mean preoperative value of Evans index was 0.37 ± 0.06 and there was statistically significant (P = < 0.001) reduction to 0.33 ± 0.07 after VP shunt surgery. The change in PI and change in Evans index were found to be positively correlated (r = 0.34 and P = 0.0013)., Conclusions: The decrease in PI after VP shunt surgery correlates with decrease in ventricular size. Any increase in PI in the postoperative period should raise the suspicion of malfunctioning of VP shunt., (Copyright © 2024 Copyright: © 2024 Neurology India, Neurological Society of India.)

Objective: The objective is to determine the efficacy and safety of paracetamol in preterm babies with hemodynamically significant patent ductus arteriosus (hsPDA)., Background: In preterm babies, patent ductus arteriosus, when hemodynamically significant, causes considerable morbidity and mortality and also affects 20% of very low birth weight infants. Medical therapy is the mainstay of treatment. Currently used drug cyclooxygenase inhibitor has multiple serious adverse effects, including gastrointestinal perforation, bleeding, and renal failure. Hence, an alternative drug like paracetamol has been proposed for the treatment of hsPDA for fewer side effects. Hence, we used paracetamol in our neonatal intensive care unit in preterm neonates with hsPDA., Methods: A total of 14 preterm babies diagnosed to have hsPDA on clinical and echocardiographic evaluation in neonatal ICU on days 3-14 of life during 13 months were included. Birth weight was between 1000 g and 1650 g and gestation was between 28 weeks and 33 weeks. Paracetamol in a dose of 15 mg/kg/dose every six hourly given to all the included babies for 3 days and re-evaluated echocardiographically after 3 days of treatment., Results: In 12 (86%) out of 14 cases, PDA was closed, whereas in 2 (14%) hemodynamic closure with insignificant residual flow was achieved. Paracetamol was effective in 100% of cases. No adverse event was observed during treatment., Conclusions: Paracetamol is a very safe and efficacious drug for treating hemodynamically significant patent ductus arteriosus in premature babies., (Copyright © 2024 Copyright: © 2024 Indian Journal of Pharmacology.)

In research, outcomes are often categorized as primary and secondary. The primary outcome is the most important one; it determines whether the study is considered 'successful' or not. Secondary outcomes are chosen because they provide supporting evidence for the results of the primary outcome or additional information about the subject being studied. For reasons that are explained in this paper, secondary outcomes should be cautiously interpreted. There are varying practices regarding publishing secondary outcomes. Some authors publish these separately, while others include them in the main publication. In some contexts, the former can lead to concerns about the quality and relevance of the data being published. In this article, we discuss primary and secondary outcomes, the importance and interpretation of secondary outcomes, and considerations for publishing multiple outcomes in separate papers. We also discuss the special case of secondary analyses and post hoc analyses and provide guidance on good publishing practices. Throughout the article, we use relevant examples to make these concepts easier to understand. While the article is primarily aimed at early career researchers, it offers insights that may be helpful to researchers, reviewers, and editors across all levels of expertise., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Psychiatry.)

Purpose: The study was undertaken to look into the clinicodemographic profile, management, and clinical outcomes of advanced retinoblastoma at a tertiary care center., Methods: A prospective cohort study was conducted from Jan 2019 to Dec 2022. Forty-two patients of intraocular advanced retinoblastoma were assessed. The treatment protocol was formulated based on size, extension of tumor, and laterality. Primary outcome measure was response to the treatment in terms of regression of tumor and seeds and no evidence of recurrence after 12 month in enucleated eyes. Secondary outcome measures were complications like implant exposure, metastasis, and death associated with each treatment modality., Results: The mean age of the study group was 13 months. The most common presentation was leukocoria with diminished vision. Most of the patients had group E retinoblastoma ( n = 40, 95%) as per the International Classification of Retinoblastoma. In 12 patients with group E retinoblastoma, primary enucleation was performed and in six patients, secondary enucleation was done, in which initially, globe salvage treatment was tried. In 30 patients, globe salvage treatment was attempted and we could manage to save 23 eyes. The most common treatment modality was intra-arterial chemotherapy using a triple-drug regimen. One patient developed intracranial spread and died due to systemic metastasis during the follow-up period., Conclusion: The current study showed that globe salvage is possible in advanced retinoblastoma if appropriate therapy is instituted depending upon the extent of the tumor and availability of latest treatment modalities. Intra-arterial chemotherapy using triple drugs can be offered as a first-line therapy in advanced unilateral retinoblastoma as it has been found to be very effective in the present study., (Copyright © 2023 Copyright: © 2023 Indian Journal of Ophthalmology.)

Background: Gamma Knife Radiosurgery (GKRS) has established a role in treating various benign brain pathologies. The radiosurgery planning necessitates a proper understanding of radiation dose distribution in relation to the target lesion and surrounding eloquent area. The quality of a radiosurgery plan is determined by various planning parameters. Here, we have reviewed various GKRS planning parameters and analyzed their correlation with the morphology of treated brain lesions., Method: A total of 430 treatment plans (71 meningioma, 133 vestibular schwannoma/VS, 150 arteriovenous malformation/AVM, 76 pituitary adenoma/PA treated with GKRS between December 2013 and May 2023) were analyzed for target coverage (TC), conformity index (CI), homogeneity index (HI), and gradient index (GI)., Result: The values of CIPaddick and CILomax for PA were lower and differed significantly from meningioma, VS, and AVM. The value of HI for PA was higher and differed significantly when compared with meningioma, VS, and AVM. The values of HI for AVM were also significantly higher than VS and meningioma. The mean GI was 3.02, 2.92, 3.03, and 2.88 for meningioma, VS, AVM, and PA, respectively. The value of GI for meningioma and AVM was significantly higher when compared with the values for VS and PA. The mean TC was 0.94 for meningioma, 0.96 for VS, 0.95 for AVM, and 0.90 for PA. The value TC of PA was lower and differed significantly when compared with VS, AVM, and meningioma. Lesions with a volume of ≤1 cc had poor planning metrics as the spillage of radiation may be higher., Conclusion: The GKRS planning parameters depend on the size, shape, nature, and location of intracranial lesions. Therefore, each treatment plan needs to be evaluated thoroughly and a long-term follow-up is needed to establish their relation with clinical outcome., (Copyright © 2024 Copyright: © 2024 Journal of Cancer Research and Therapeutics.)