Various psychosocial factors play a vital role in mental health. India's rich cultural, traditional, and social value system is well-known throughout the world. However, a considerable proportion of women are disadvantaged in these systems, and as a result, they are more likely to experience a significant psychosocial burden that affects their physical, mental, social, and spiritual well-being. These psychosocial burden also have an impact on their quality of life, personal well-being, and some fundamental human rights. In the light of the current Indian situation, this narrative review depicts the psychosocial burden that a significant proportion of Indian women are likely to face.

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Robotic surgery has started to emerge as one of the effective and sought-after approaches in the field of surgery in the last couple of decades. The quick adoption and propagation of robotic surgery is primarily because of the numerous benefits attributed to the same. The purpose of the current review was to explore the inclusion of competencies pertaining to robotic surgery within the undergraduate and postgraduate medical curriculum. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 16 articles were selected based upon the suitability with the current review objectives and analyzed. In the current set-up, the majority of the medical colleges don't offer much to their undergraduate or postgraduate surgical residents in terms of exposure to robotic surgery. However, considering that sooner or later, every future medical student or resident will have an encounter with a patient who has already undergone a robotic surgery or will be undergoing the same, we have to ensure formal introduction in the teaching curriculum. In conclusion, the future of robotic surgery is changing and it is finding numerous applications in different surgical streams. Acknowledging the scope of the same, as medical educators, it is our responsibility to introduce in the curriculum, provide adequate number of learning opportunities and supplement with periodic assessments for a better patient care.

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Due to the recent rise in the trend of urological malignancies, noninvasive tumor biomarkers are being researched and used for many different clinical settings. Thus, the identification of specific and effective biomarkers in the form of liquid biopsy has become a major focus, mainly due to the necessity of selecting potentially responsive patients and predicting their outcomes. The rationale for using liquid biopsies instead of solid tissue samples is to avoid unnecessary invasive procedures which will provide the same diagnostic information. The main liquids tackled in patients with urological malignancies are blood and urine. In this review, we provide a detailed discussion on the potential clinical utility of diagnostic materials found in these liquids and will focus on cell-free DNA and other circulating molecules, such as circulating tumor cells, RNAs (microRNAs, long noncoding RNAs, and messenger RNAs), cell-free proteins, peptides, and exosomes as cancer biomarkers.

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The field of telemedicine has shown exponential growth across the last few decades and has opened gateways for people living in distant geographical locations to access health care. The purpose of the current review was to explore the introduction of telemedicine during the medical education training period. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 13 articles were selected based upon the suitability with the current review objectives and analyzed. It is a fact that for the successful implementation of a telemedicine unit, the medical personnel plays a defining role. This calls for an indispensable need to expose the medical students to telemedicine during their training period, so that they are not only aware of the same but even prepared to use it in their future clinical practice. The need of the hour is to systematically introduce the telemedicine-related competencies in a standardized manner without stretching the overall duration of the medical training. In conclusion, telemedicine has emerged as an important aspect of the health-care delivery system, and thus it is quite essential that we expose medical students to telemedicine during their undergraduate period of training. We must remember that a lot of effort is required to ensure that the training of medical students in telemedicine remains meaningful, relevant, and holistic.

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Background: Internet dependence ordinarily alludes to a person's powerlessness to control their utilization of the Internet (counting any online-related, impulsive, or compulsive conduct), which finally leads to one's stamped trouble and practical debilitation in everyday life. The signs and indications of Internet Addiction Disorder can be seen in both physical and psychological (emotional) appearances. Few psychological symptoms include: Sadness, nervousness, disconnection, sensation of blame, mindset swings, depression, dread, and so forth. Objective: To assess the prevalence of Internet addiction and its impact on mental health among dental students of Belagavi city. Materials and Methods: A cross-sectional study was conducted, involving 168 dental students of age 17-25 years of Belagavi city. Students were selected using convenient sampling method and data were collected using pretested structured questionnaire. The ethical clearance was obtained from the institutional ethics committee JNMC Belagavi. Written consent was obtained from participants before collecting data which was analyzed in SPSS version 22. Results: The percentage of the normal use of Internet and potential addiction of Internet was 83.3% and 16.7%, respectively. Internet addiction was not associated with depression. But was significantly associated with anxiety, stress, and insomnia. Conclusion: The prevalence of potential Internet addiction among dental students is 16.7%. Hence, it becomes necessary to not only address the Internet addiction among dental students but also the mental issues related to it.

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Background: The pharmacists were trained mainly to dispense medicines only over prescriptions. Despite guidelines, practice of dispensing medicines without prescription has been widely practiced worldwide. The problem and burden of drug resistance are increasing worldwide due to this practice. Objective: The objective of this study is to assess the knowledge and practice of pharmacists on drug dispensing practices without prescription in Belagavi City. Materials and Methods: A cross-sectional study was conducted between January and April 2021 among 80 pharmacists in different areas of Belagavi city. Pharmacists were selected by the simple random technique. Data were collected using the structured questionnaire. The obtained data were tabulated, and the Chi-square test was used to determine the association between the nominal variables. Results: Pharmacists had a good knowledge about laws regarding practice of dispensing without prescription. The practice of dispensing nonover-the-counter drugs without prescription was found to be 32.5% in an average. Pharmacists' fear of losing customers was the primary reason for dispensing without prescription. A significant association was found between knowledge score of pharmacists and job status of pharmacist (P = 0.043*) and location of pharmacy (P = 0.05*). The frequency of dispensing medicines without prescription was found to be significantly associated with age of staffs dispensing (P = 0.04*) and with their education status (P = 0.04*). Conclusion: Pharmacists had an average level of knowledge regarding the practice of dispensing drugs without prescription in India. However, pharmacists tend to dispense medicines without prescription on request of patients.

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Background: Bangladesh is declared as “Digital Bangladesh” however, medical students are least acquainted with the necessary information and communication technology (ICT) knowledge in the context of medical education. We have conducted a survey to know about digital equipment ownership, therefore, carried out a self-reported assessment of knowledge and utilization of ICT in relation to educational and clinical development. Materials and Methods: A cross-sectional, multi-centered questionnaire survey was conducted among the medical students during the period of October 2019. Results and Discussions: In total 467 medical students responded to the questionnaire in which 92% of the students owned a Google android smartphone and accessed the Internet on their devices. Sixty-nine percent of students have (1–5) medical-related apps in their device and drug formulary apps most commonly used 43%. Fifty-nine percent of students have gained their present computer knowledge through self-learning. For study work with fellow student, 90% of students preferred Facebook group, WhatsApp, and Viber. While there was a range of variation in the usage of nonacademic search engines 72% of Google and no usages were found for more dedicated academic services such as PubMed and Medscape. According to 74% of students, inadequate integration of ICT knowledge into their syllabus culminated in insufficient future professional skills. All students were keen on a basic ICT learning program at the beginning of their medical courses. Conclusion: The study revealed that to prepare medical students for using ICT in their academic work adequately, introducing ICT training at the initial stage of the undergraduate program and designing the curriculum to develop a multiplicity of skills is essential in addition to an integrated teaching method.

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Encouragement of research has been recognized as one of the most important reasons for the advancement in the field of medicine and the same stands true for the adoption of curricular innovations in the delivery of medical education. However, there have been significant concerns about the fact that many of the medical doctors are not participating in clinical research or basic research. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of eight articles were selected based upon the suitability with the current review objectives. These are ominous signs for the field of medical education and research in medicine and call for an urgent need to expose medical students to the basic skills of performing research at an early stage in their training period. The idea is that students should be informed about the set of research skills which they should develop during their graduation period and the ways in which these research skills will help them in their academic career and professional practice. In conclusion, a medical student has to master multiple research skills during their undergraduation period to ensure effective patient care as well as enhance their contribution in the field of medical research. However, considering the already packed curriculum, it is a must that the research should be integrated within the curriculum in a longitudinal manner throughout the duration of medical training.

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Introduction: COVID 19 is an unknown virus affecting mankind creating a deadly experience to all. It is true for Bangladesh also. So the objectives of the present study are to find the clinicopathological features and outcome of COVID patients admitted to three COVID dedicated hospitals of Chittagong, Bangladesh. Methods: This was an observational study where a total of 209 patients admitted to three COVID dedicated hospital were recruited. Clinicopathological data were recorded and patients were under observation till discharge and thus outcome were recorded. Prior consent was taken from the patients and ethical clearance was also taken. Data were compiled and analyzed by Statistical Package for Social Sciences-20. Results: Among 209 patients most of them were male 139 (66.5%) and male to female ratio was 1.98:1. Age group distribution revealed more were aggregated in the age group of 41–50 years 36 (17.2%), 51–60 years 54 (25.8%), and 61–70 years 57 (27.3%). Among all 92 (44%) patients were reverse transcription-polymerase chain reaction (RT-PCR) positive and 117 (56%) were probable cases. Fever was present in 195 (93.3%) cases, cough in 180 (86.1%), respiratory distress in 105 (50.2%) anosmia in 123 (58.8%), aguesea in 112 (53.58%) and lethargy was present in 143 (68.42%). Chest X-ray findings revealed 73 (34.9%) had bilateral patchy opacities, 20 (9.6%) had unilateral opacities 65 (31.1%) had consolidations, 6 (2.9%) had ground glass opacities, and 2 (1.0%) had pleural effusion. Supplemental O2 was given in 173 (82.8%) patients, Favipiravir in 59 (28.2%), Remdesivir in 111 (53.1%), Methylprednisolone in 87 (41.6%), Dexamethasone in 93 (44.5%), Antibiotics in 204 (97.60%), Toccilizumab in 34 (16.3%), plasma in 18 (8.6%), and low molecular weight heparin (LMWH) in 200 (95.7%) patients. Regarding outcome of the COVID patients admitted, 85 (92.4%) patients improved, 6 (6.5%) died who were RT-PCR positive and 107 (91.15%) improved, 9 (7.7%) died who were probable cases. Total death rate was 7.1%. Conclusion: The present study findings were some early activities among COVID patients in the years 2020. Male were more affected and middle age group people were the most victims.

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Parotid swellings presenting with facial nerve palsy usually imply that the swelling is malignant in nature. In rare cases, it has been reported to have occurred in the setting of benign parotid swellings and parotid abscesses. Our case is one of bilateral parotid abscesses in a reverse transcription polymerase chain reaction negative, CORADS five patients, with left-sided lower motor neuron type of facial nerve palsy with near-total recovery of the facial nerve palsy after resolution of abscess. The likely mechanisms behind the development of facial nerve palsy in case of parotid abscess include perineuritis, ischemia, and direct virulence of the pathogen. Furthermore, coronavirus has a propensity for affecting salivary glands, and parotitis could be an atypical presentation of the COVID 19. In most cases, as in ours, there has been improvement of facial nerve palsy with resolution of the abscess after combined conservative, surgical, and supportive treatment.

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Background: In 2003, the COTPA act was enacted to control and prohibit tobacco use all over India. It has focused on advertisement, prohibition of sale of tobacco products to below 18 years individual, etc., Objective: The objective was to determine the awareness of cigarette and tobacco legislation among college students of Belagavi city. Materials and Methods: A pre-post study was conducted, comprising 101 urban participants and 96 rural participants of average age 17.35 ± 0.657 years in colleges in and around Belagavi taluka. The students were selected randomly. The awareness on COTPA was assessed using a pretested structured questionnaire before and after an educational intervention. Paired t-test was calculated to identify the difference in the pre- and post-test awareness scores. Results: The mean age of the participants was 17.35 ± 0.657 years. The pretest and posttest awareness scores among the urban participants was 8.22 ± 2.982 and 11.80 ± 1.995, respectively. Similarly, the pretest and posttest awareness scores among the rural participants was 10.28 ± 1.845 and 12.67 ± 0.496, respectively. The result showed a significant difference in pre- and post-test scores, indicating increase in awareness of both urban and rural participants after an effective interventional program. Conclusion: The study concludes that the health education had a good impact on awareness on COTPA among all participants.

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The delivery of medical education has shown a significant shift from the conventional mode of training to the competency-based training. Assessments have been identified as the most significant difference between the two approaches of training. The purpose of the current review was to explore the employment of objective structured clinical examination (OSCE) tool in the delivery of medical education. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 30 articles were selected based upon the suitability with the current review objectives. It is quite obvious that during assessments, we plan to assess knowledge, skill, and affective domains, which actually gives inference about the overall learning progression. OSCE is an assessment tool that is being employed in medical training owing to its objectivity and structured nature. With the passage of time, OSCEs have been widely used in both undergraduate and postgraduate examinations. Acknowledging the fact that the OSCE can be of immense significance in monitoring the learning and its progression, it becomes quite essential to ensure its quality. In conclusion, the scope of OSCE as an assessment tool in medical education training is immense. It is the need of the hour to use the tool in an objective and structured manner to assess the level of learning in students and even monitor the progression in learning.

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Introduction: Fungal infections are mostly an opportunistic infection in immunocompromised patients and posttraumatic in immunocompetent adults. However, there has been a recent increasing trend of cases among immunocompetent adults with no history of trauma. Very few case series describing the clinicopathological picture of prevalent fungi are available from the various regions of India. Aims and Objectives: The present study aims to analyze clinicopathological features of various cases of fungal etiology with unique or rare presentations. Materials and Methods: This study included a clinicopathological analysis of surgical specimens received for histopathological examination at our hospital with special emphasis on cases with rare or unique presentations during the 1-year period from June 2019 to June 2020. Results: A total of 11 cases of fungal lesions with rare or unique clinicopathological presentations were selected for analysis. Majority of the patients were male, and most of them were from a rural background. There were four cases of aspergillosis, two cases of fungal keratitis, one case of renal aspergillosis, and one case of a subcutaneous swelling with discharging sinus. There were three cases of chromoblastomycosis, which presented as subcutaneous swellings with no lesion of overlying skin. There was an incidental finding of Candida sp. in two esophageal endoscopic biopsies, which primarily revealed esophageal adenocarcinoma. There was one case each of eumycetoma and mucormycosis. However, the mucormycosis case occurred in the setting of fungal abscess with osteomyelitis of the left mandible. Conclusion: Fungal lesions have revealed an increasing trend of infections in immunocompetent individuals in recent years, with various unique clinicopathological presentations. Therefore, there is a need for increased vigilance and analysis of such cases.

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Background: Evaluation of body temperature is one of the important diagnostic methods and signs of health and disease, both in everyday life and medical care. Study of Automated versus Manual Measurement of Body Temperature: a comparative study. It is one of the frequently performed clinical observations. Materials and Methods: We took 148 apparently healthy medical students in the age group of 18–23 years (n = 90 females, n = 58 males). Their oral and axillary temperatures were recorded using mercury and digital thermometers. Data were collected and analyzed using Student's “t”–test, and P < 0.05 was taken as scientifically significant. Results: In our study, we found that the difference in the temperatures between mercury and digital thermometers is so negligible that it will not cause any problems in the clinical interpretation. Conclusion: Hence, we would like to recommend the use of digital thermometer to that of mercury thermometer because it is very simple, easy, accurate, and convenient to use.

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Background: Routine closure of parietal peritoneum during cesarean section has been a custom. However, current evidence argues against peritoneal closure. Methods: A total of 100 pregnant women who had to undergo cesarean delivery were taken for the study. They were divided into two groups: Group C (50 patients) and Group NC (50 patients). Group C included the patients in whom parietal peritoneum was sutured during cesarean delivery, whereas, Group NC included the patients in whom parietal peritoneum was left unsutured during cesarean delivery. The two groups were then compared in terms of postoperative morbidity and outcome. Results: The mean operating time was significantly less in Group NC than in Group C (P < 0.001). The mean analgesia requirement in Group C was 210.4 ± 31.45 mg, whereas it was 178.5 ± 28.63 mg in Group NC (P < 0.001). Mean time for ambulation after cesarean delivery in Group C was 12.9 ± 3.42 h, whereas it was 10.1 ± 3.19 h in Group NC (P < 0.001). There was a longer duration of hospital stay in the C group (mean = 4.3 ± 1.07 days) than NC group (mean = 2.9 ± 0.95 days). Conclusion: Nonclosure of parietal peritoneum at cesarean delivery is associated with reduced operation time, lesser postoperative analgesia requirement, and lesser duration of hospital stay with no increased morbidity.

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Adrenocortical carcinomas (ACCs), are rare, with an incidence of <2 per million cases per year. One of three patients with ACC presents with involvement of the venous system and inferior vena cava (IVC) thrombus. Tumors of the right adrenal gland are more likely to involve the IVC, as it drains directly into it. We report on a 70-year-old male who presented with vague abdominal pain and on evaluation with computed tomography of the abdomen showed a well-circumscribed heterogeneously enhancing lesion 4.7 cm × 4.7 cm × 4.1 cm in the right suprarenal region. The lesion was extending into the IVC through the adrenal vein. The tumor and its extension into the IVC were excised following cross clamping of the IVC. Histopathological examination revealed an ACC. The incidence of ACC is low thereby personal experience in managing such tumors is usually limited. An aggressive approach is required in view of the poor prognosis attached to it.

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Multidrug-resistant Pseudomonas aeruginosa is being increasingly recognized as a cause of endogenous endophthalmitis in critically ill patients. Three patients were included in this case series. Antibiogram profile in all three cases showed sensitivity to colistin only. All cases were treated with systemic and intravitreal colistin. Although there was clinical improvement, final visual outcome was poor in all cases. Intravitreal colistin can be tried in multidrug resistance cases. Final prognosis depends on early diagnosis and quick institution of appropriate therapy.

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The second wave of COVID-19 pandemic has overwhelmed the health system across India leading to not only the loss of innumerable human lives but also exposed the various shortcomings of healthcare infrastructure. This emphasizes the need for a better preparedness of the health system across the nation to tackle the potential third wave of COVID-19 pandemic more importantly now as the cases and test positivity rate has started to show a downward trend all over India. The key areas which need to be targeted are augmenting the vaccine production and streamlining delivery mechanism, strengthening the existing pediatric emergency units and sick newborn units, expanding the oxygen production capacity in the country, ensuring the availability of drugs, strengthening of health infrastructure, logistic support and surveillance systems, expanding the free testing and diagnostic facilities, improved access to healthcare facilities, and reinforcement of COVID appropriate behavior in the community.

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A trifid pelvis is an extremely rare anomaly. It represents either a peduncular arrangement or elongation of the major calyces in association with a rudimentary pelvis. This anomaly becomes significant only in the presence of pathological conditions. We report a case of left sided trifid pelvis with a staghorn calculus managed by percutaneous nephrolithotomy.

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Introduction: There is a high burden of cervical cancer in our environment. Most patients present late when the prognosis is guarded. Hence, accurate diagnosis of preinvasive lesions from cervical biopsies is important for clinical decision and patient management. Therefore, the use of immunohistochemistry in most difficult cases is paramount and justifies the study. The aim of the study is to evaluate the expression and diagnostic role of p16INK4a Immunohistochemistry in preinvasive cervical lesions. Materials and Methods: The paraffin blocks of all histologically diagnosed preinvasive and normal/reactive lesions of the cervix seen in two histopathology laboratories in Nnewi: Nnamdi Azikiwe University Teaching Hospital and Pathocon Specialist Clinic and Research Institute over a 10-year retrospective period (2011–2020) were retrieved from the archives. Fresh h and e slides were produced and reviewed for diagnostic consistency and a consensus diagnosis rendered for each case. The cases were subjected to immunohistochemistry using p16INK4a monoclonal antibodies. Results: A total of 402 cervical biopsies were seen in the records of both facilities. Ninety of them were noninvasive lesions (62 preinvasive lesions and 28 normal/reactive lesions). Thus, the prevalence of preinvasive lesions in this study was 15.4% (⁶²/402). However, 51 cases met our inclusion criteria. The consensus H and E diagnosis consists of 15 normal/reactive, 12 low squamous intraepithelial lesion (LSIL), and 24 hIL. The diagnosis using immunohistochemistry consisted of 23 normal/reactive (45.1%), 6 LSIL (11.8%), and 22 hIL (43.1%). The age range of the patients was 34–80 years. The mean and median ages were 49.7 and 47 years respectively. The peak ages for LSIL and high squamous intraepithelial lesion (HSIL) were 41–60 years and 51–60 years, respectively. Only 21.5% (ca in situ-3.9% and squamous intraepithelial lesion-17.6) of the patients were biopsied on account of preinvasive cervical lesions. The sensitivity and specificity of p16INK4a in the diagnosis of HSIL were 75% and 85%, respectively. There was a significant statistical difference between the diagnosis before and after the application of p16INK4a (P < 0.001). Conclusion: There is a high prevalence of preinvasive lesions in our environment. Majority of the preinvasive lesions were incidental findings. Immunohistochemistry using p16INK4a is a very useful adjunct to H and E for diagnosing preinvasive cervical lesions, especially in challenging cases.

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