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Background: In the era of minimal invasive surgical techniques, laparoscopic drainage provides faster recovery, shorter hospital stay, less surgical site infection and better cosmesis than open surgical drainage does with added advantage of accurate positioning of drainage catheter and simultaneous treatment of the abscess and underlying abdominal pathology. Methods: A total of 33 patients of age group 18-65 years were enrolled. Diagnosis was made using ultrasonography and CECT abdomen and laparoscopic drainage done and drain placed. Adequacy of drainage of abscess was analyzed using ultrasonography on POD- 5, 20 and 30 and were followed upto 3 months. Day of intra-cavitary drain removal, duration of post operative hospital stay, complications after surgery, requirement of readmission and intervention after readmission were recorded and analyzed. Results: Out of 33 patients, 1 patient developed sinus tract formation at intracavitary drain site. 3 patients had inadequate drainage for which drain change was required. 33% (N=11) patients showed complete resolution of abscess at post operative day 20 where as 72.7% patients (N=24) showed complete resolution of abscess on post operative day 30. All 33 patients showed complete resolution of abscess after 3 months of surgery. Conclusions: Laparoscopic procedure provides every advantages of open surgical drainage of liver abscess while avoiding complications of open surgeries. It allows breakdown of loculations, drainage of viscid pus, necrotic tissues, adequate irrigation of abscess cavity and should be considered for patients with large, complex, septated or multiple abscesses and failed percutaneous drainage.

Background: Modified radical mastectomy is commonly performed surgery for breast carcinoma. The present study was conducted to compare intra-operative and post-operative surgical outcomes by using monopolar electrocautery and ultrasonic shears in MRM. Methods: A randomized prospective study was conducted with a sample size of 60 patients who were randomized into two groups. One group underwent MRM using ultrasonic shears (Group A) and the other one using monopolar electrocautery (Group B). Intra-and post-operative outcomes were compared. Results: Group A had less intra-operative blood loss and it was statistically significant. Group A had less pain score on post op day 1 and it was statistically significant. However, Group A had less intra-operative time and less drain output but it was statistically insignificant. Group A had less post-operative complication (seroma formation, wound infection, hematoma formation and flap necrosis) compare to Group B and it was statistically significant. Group A, patient had early drain removal compare to Group B, and was statistically significantly. Conclusions: Ultrasonic shears group had significantly lesser intra-operative bleeding, lesser post operative complications, post-operative early drain removal, less post operative pain score, when compared to electrocautery group. However, the two groups had no significant difference in post-operative drain output and operative time.

Sepsis is a leading cause of neonatal mortality and morbidity in low and middle-income countries. We designed a double-blinded randomised controlled trial in a neonatal intensive care unit (NICU) of a tertiary care teaching hospital to determine the role of intravenous immunoglobulin (IVIG) in decreasing hospital stay. Eighty neonates with clinical features of sepsis were enrolled in the study and placebo groups to receive 500 mg/kg of IVIG for three consecutive days or a placebo. The primary outcome measure was duration of hospital stay in days. The babies in both groups were comparable in terms of birth weight, gestation and sex distribution. There was no significant difference in duration of hospital stay (days) in the study and placebo groups. We found that treatment with IVIG did not shorten the duration of hospital stay in our setting.

Chemokines are well equipped with chemo-attractive signals that can regulate cancer cell trafficking to specific organ sites. Currently, updated concepts have revealed the diverse role of chemokines in the biology of cancer initiation and progression. Genomic instabilities and alterations drive tumor heterogeneity, providing more options for the selection and metastatic progression to cancer cells. Tumor heterogeneity and acquired drug resistance are the main obstacles in managing cancer therapy and the primary root cause of metastasis. Studies emphasize that multiple chemokine/receptor axis are involved in cancer cell-mediated organ-specific distant metastasis. One of the persuasive mechanisms for heterogeneity and subsequent events is sturdily interlinked with the crosstalk between chemokines and their receptors on cancer cells and tissue-specific microenvironment. Among different metastatic niches, skeletal metastasis is frequently observed in the late stages of prostate, breast, and lung cancer and significantly reduces the survival of cancer patients. Therefore, it is crucial to elucidate the role of chemokines and their receptors in metastasis and bone remodeling. Here, we review the potential chemokine/receptor axis in tumorigenesis, tumor heterogeneity, metastasis, and vicious cycle in bone microenvironment.

MUC16, membrane-bound mucin, plays an oncogenic role in pancreatic ductal adenocarcinoma (PDAC). However, the pathological role of MUC16 in the PDAC progression, tumor microenvironment, and metastasis in cooperation with Kras(G12D) and Trp53(R172H) mutations remains unknown. Deletion of Muc16 with activating mutations Kras(G12D/+) and Trp53(R172H/+) in mice significantly decreased progression and prolonged overall survival in Kras(G12D/+); Trp53(R172H/+); Pdx-1-Cre; Muc16(−/−) (KPCM) and Kras(G12D/+); Pdx-1-Cre; Muc16(−/−) (KCM), as compared to Kras(G12D/+); Trp53(R172H/+); Pdx-1-Cre (KPC) and Kras(G12D/+); Pdx-1-Cre (KC) mice, respectively. Muc16 knockout pancreatic tumor (KPCM) displays decreased tumor microenvironment factors and significantly reduced incidence of liver and lung metastasis compared to KPC. Furthermore, in silico data analysis showed a positive correlation of MUC16 with activated stroma and metastasis- associated genes. KPCM mouse syngeneic cells had significantly lower metastatic and endothelial cell binding abilities than KPC cells. Similarly, KPCM organoids significantly decreased the growth rate than KPC organoids. Interestingly, RNA-seq data revealed that the cytoskeletal proteins Actg2, Myh11, and Pdlim3 were downregulated in KPCM tumors. Further knockdown of these genes showed reduced metastatic potential. Overall, our results demonstrate that Muc16 alters the tumor microenvironment factors during pancreatic cancer progression and metastasis by changing the expression of Actg2, Myh11, and Pdlim3 genes.

All the four language skills: reading, writing, speaking and listening are equally important for language learners. Studies show that students learning English as a second language face challenges in learning these four skills. However, production skills i.e., writing and speaking seem to pose greater challenge to learners especially in non-English countries. The challenges related to speaking might be related to several psychological or environmental factors. Self-confidence is one of those areas of concern. Therefore, the present study aims to find out if there is a correlation between self-confidence and speaking grades of first year university students at a public sector university in Pakistan. In this regard, a self-confidence questionnaire (SCQ) was administered to 31 participants from a class of Business Administration department. The collected data was analysed using the Statistical Package for the Social Sciences (SPSS) 20.0 software and Pearson product-moment correlation coefficient was calculated. The data analysis revealed that there is a positive but statistically non-significant correlation between self-confidence and speaking grades. Therefore, the study suggests that some experimental studies on the subject should be conducted, and more variables could be brough in to obtain a broader picture of the phenomenon. Small sample size stands as a limitation of the study.

Patient acceptance of pediatric formulations is critical to compliance and consequently therapeutic outcomes; thus, having anThe discriminating potential of the method was examined using tribology profiles (coefficient of friction (COF) vs. sliding speed) for commercially available products and products made for this study with widely varying sweetness, thickness, and grittiness; these formulations were used to judge the sensitivity of the method. Samples were measured using 3M Transpore™ surgical tape to simulate the tongue surface, steel half ring geometry, constant gap setting, target axial force of 2 N in a 600 s exponential ramp for rotation speed.The COF ranged from 0.1 to 0.6. For the speeds studied, the high viscosity commercial suspension ibuprofen drops and acetaminophen suspension show a classic Stribeck curve with an increasing COF at the higher rotation speeds, which indicates these formulations entered the hydrodynamic lubrication phase, while the lower viscosity suspensions only reached the mixed lubrication phase.The contribution of particles affects the COF in a dynamic tribologic pattern compared to products that are categorized as either low gritty or high viscosity. These results are important as they provide a potentially rapid

Teacher leadership is pivotal for the development of educational institutions. However, teachers’ perceptions about teacher leadership have been under explored. In this study, the researchers review sixteen studies conducted in the USA, South Africa and other European, Asian, and Middle Eastern countries. Four themes emerged after analysis of the texts: perceptions of teachers about teacher leadership practices, factors influencing teacher leadership, teacher leadership development, and barriers to teacher leadership. Results show that teacher leaders are engaged in mentoring teachers, coordinating with administration, curriculum development and implementation, and subject matter development. The physical environment of the school, teachers’ age, experience, qualification, and support from the administration also influences teachers’ perceptions about teacher leadership. Teacher leadership development is influenced by teachers’ own beliefs, principals’ support and teachers’ professional development. Some barriers to teacher leadership are also discussed in this paper.

Objective Taking leads from the available research, we aimed to develop a synergy-based herbal combination of Tinospora cordifolia (TC), Phyllanthus emblica (PE), and Piper nigrum (PN). Also, evaluating their synergistic effect on CP-induced immunosuppression in mice model and exploring the possible mechanisms involved in reversing the damage. Methodology The immunomodulatory activity of combination, of TC stem, PE fruits, and PN dried fruits, was determined by in vitro assays (splenocyte proliferation and pinocytic activity of peritoneal macrophages of mice) and in vivo study using CP-induced immunosuppression model in Swiss Albino mice. The ratio was optimized for combining three by in vitro MTT assay. The combination was further evaluated for anti-oxidant activity by DPPH scavenging method and quantified for its bioactive metabolites by HPTLC. Serum collected on day 0, 4, 7 and 14 was employed for estimation of haematogram (haematocrit, TLC, DLC, and haemoglobin, etc) and immune parameters (IL-10, IL-6 and TNF-α) by ELISA. Results The study demonstrated, that combination of herbal extracts at an intermediate dose could inhibit the proliferation of spleen cells and peritoneal macrophages (P ≤ 0.0001) and induce suppression of pro-inflammatory mediators, and also certified that combination exerts synergized effects. The results showed that the combination possess potential antioxidant activity by DPPH scavenging method (IC50-113.5 µg/ml). It was identified that combination significantly (P ≤ 0.0001) improved the immune markers, haematogram parameters, and histological parameters, with maximum protection offered by an intermediate dose. Conclusion The results suggested that present combination could be further explored clinically as potent synergy-based therapeutic approach for immune modulation.

Brain metastasis (BrM) is a major threat to the survival of melanoma, breast, and lung cancer patients. Circulating tumor cells (CTCs) cross the blood-brain barrier (BBB) and sustain in the brain microenvironment. Genetic mutations and epigenetic modifications have been found to be critical in controlling key aspects of cancer metastasis. Metastasizing cells confront inflammation and gradually adapt in the unique brain microenvironment. Currently, it is one of the major areas that has gained momentum. Researchers are interested in the factors that modulate neuroinflammation during BrM. We review here various epigenetic factors and mechanisms modulating neuroinflammation and how this helps CTCs to adapt and survive in the brain microenvironment. Since epigenetic changes could be modulated by targeting enzymes such as histone/DNA methyltransferase, deacetylases, acetyltransferases, and demethylases, we also summarize our current understanding of potential drugs targeting various aspects of epigenetic regulation in BrM.

Aim: Kushta-e-Murdarsang a herbo-mineral calx preparation was prepared as per classical and contemporary method and its physico-chemical and elemental analysis for standardization and safety evaluation (by heavy metal estimation) was performed. Methods: Murdarsang (Litharge mineral) was subjected to Mudabbar / Shodhan (processing) by Sheere- Madar (Latex of Calotropis gigantea Linn. R. Br. ex. Ait.) and calcined by classical and muffle furness method. Comparative Physico-chemical investigation for safety evaluation and standardization were done by X-ray diffraction (XRD), inductively coupled plasma mass spectrometry (ICP-MS), Atomic absorption spectroscopy (AAS) and other analytical parameters. Results: Both the sample Kushta-e-Murdarsang classical method (KM-CM) and Kushta-e-Murdarsang Muffle Furnace method (KM-MFM) passed specification tests as per Unani Medicine. Both the sample KM-CM and KM-MFM showed presence of heavy metals. In XRD analysis both the samples showed presence of Lead, sample KM-MFM revealed presence of Litharge syn- PbO phase, where KM-CM revealed presence of Lead syn- Pb, Galena syn- Pb S and Litharge syn- PbO phase. In ICP-MS analysis the Cadmium (Cd) content was 0.65 ppm and 0.65 ppm; Mercury (Hg) 54.17 ppm and 68.08 ppm and Arsenic (As) was 21.27 ppm and 0.11 ppm accordingly, in AAS analysis the Lead (Pb) content was 55.0 % and 51.4% in KM-MFM and KM-CM respectively. Conclusion: KM-MFM can be a better choice in respect of only ease of preparation, both the sample prepared by classical along with muffle furnace method contains heavy metal above permissible limit and KM-CM contain reduced quantity of heavy metal in respect of MF method. XRD and other standardization data for the formulation were set in. Key words: Murdarsang, Lead monoxide, Litharge, Unani Medicine, Kushta, Safety.

English language has grown to be a lingua franca of the present day world. Therefore, even non- English European and Asian countries have adopted English as a medium of instruction. English has continuously been the medium of instruction in the higher education of Pakistan in spite of having a great linguistic diversity and national language Urdu as the medium of instruction at school level. This study aims to explore the perceptions of undergraduates about EMI, challenges they face in EMI classrooms and solutions they suggest for mitigation of their issues. The qualitative data collected through semi-structured interviews reveals that students perceive EMI to be beneficial for higher education, employment and progressive thought. However, they face challenges related to teachers' English proficiency, code-switching, vocabulary and receptive as well as productive skills. They suggest that English-proficient instructors, continuous use of English, language support from university can help them overcome these challenges effectively.

A pediatric formulation workshop entitled "Pediatric Formulations: Challenges of Today and Strategies for Tomorrow" was held to advance pediatric drug product development efforts in both pre-competitive and competitive environments. The workshop had four main sessions discussing key considerations of Formulation, Analytical, Clinical and Regulatory. This paper focuses on the clinical session of the workshop. It provides an overview of the discussion on the interconnection of pediatric formulation design and development, clinical development strategy and pediatric clinical pharmacology. The success of pediatric drug product development requires collaboration of multi-disciplinary teams across the pharmaceutical industry, consortiums, foundations, academia and global regulatory agencies. Early strategic planning is essential to ensure alignment among major stakeholders of different functional teams. Such an alignment is particularly critical in the collaboration between formulators and clinical pharmacology teams.

Bone remodeling is a continuous and dynamic process of bone formation and resorption to maintain its integrity and homeostasis. Bone marrow is a source of various cell lineages, including osteoblasts and osteoclasts, which are involved in bone formation and resorption, respectively, to maintain bone homeostasis. Epigenetics is one of the elementary regulations governing the physiology of bone remodeling. Epigenetic modifications, mainly DNA methylation, histone modifications, and non-coding RNAs, regulate stable transcriptional programs without causing specific heritable alterations. DNA methylation in CpG-rich promoters of the gene is primarily correlated with gene silencing, and histone modifications are associated with transcriptional activation/inactivation. However, non-coding RNAs regulate the metastatic potential of cancer cells to metastasize at secondary sites. Deregulated or altered epigenetic modifications are often seen in many cancers and interwound with bone-specific tropism and cancer metastasis. Histone acetyltransferases, histone deacetylase, and DNA methyltransferases are promising targets in epigenetically altered cancer. High throughput epigenome mapping and targeting specific epigenetics modifiers will be helpful in the development of personalized epi-drugs for advanced and bone metastasis cancer patients. This review aims to discuss and gather more knowledge about different epigenetic modifications in bone remodeling and metastasis. Further, it provides new approaches for targeting epigenetic changes and therapy research.

Background There is inconclusive evidence on the role of nebulized magnesium sulphate (MgSO4) in the management of acute asthma in paediatric population. Objectives Whether the use of nebulized salbutamol with or without MgSO4 in the management of acute asthma results in clinically significant improvement in lung function in Indian children? The primary outcome measure was to assess improvements in peak expiratory flow rate (PEFR), heart rate, respiratory rate and SpO2. Methods This was a single centre; prospective double-blind randomized control trial conducted in paediatric intensive care unit of a tertiary care centre. Ninety children of 6–14 years with acute exacerbations of bronchial asthma were enrolled to receive either inhaled magnesium sulphate (95 mg) with salbutamol (5 mg) or inhaled salbutamol (5 mg) alone. All patients got three nebulizations done during the first hour at 20 min intervals, two nebulizations during the second hour at 30 min intervals, hourly for the next 2 h and then at 24 and 48 h. Results Eighty-five patients were finally analysed as per protocol analysis. The trial showed that PEFR increased gradually in both groups over the study duration, but it was statistically not significant. Heart rate decreased significantly in both groups over the study duration. Respiratory rate decreased significantly between the groups at 24 and 48 h only. SpO2 improved too in both groups but was not significant statistically. Conclusion The addition of nebulized MgSO4 to salbutamol does not seem to result in improvement in lung function in the management of acute asthma in Indian children.

Background HIV infection is still a serious public health issue globally. Suboptimal vitamin D status is highly prevalent in HIV-infected children and adolescents throughout the world. Objectives To evaluate the outcome of vitamin D supplementation on CD4 count in HIV-infected children and adolescents with suboptimal vitamin D status. Methods Vitamin D level of HIV-infected children and adolescents were measured at enrolment. Suboptimal vitamin D level was defined as 25(OH)D Results This was a single-centre, non-randomized comparative study enrolling 50 eligible participants. There were 20 patients who were vitamin D sufficient, 7 were vitamin D insufficient and 23 were found to be vitamin D deficient at enrolment. However, after supplementation, the status of sufficient remained same and 7 insufficient become sufficient, whereas in 23 deficient, 18 (78.3%) become sufficient and 5 (21.7%) become insufficient and this change was found statistically significant among the groups (χ2 = 6.52, p = 0.038). There was a significant improvement of CD4 count from baseline to 4 months in deficient group on vitamin D supplementation (p value Conclusion Vitamin D should be supplemented in HIV-infected children on ART with low CD4 counts.

The English language has grown to be a lingua franca of the present day world. Therefore, even non-English European and Asian countries have adopted English as a medium of instruction. Despite having a great linguistic diversity in the country and varied medium of instructions at different educational levels, English has continuously been the medium of instruction in the higher education of Pakistan. Although the attitudes of undergraduates have been studied in urban centers in the country on a smaller scale, very little attention has been paid to exploring specifically the challenges undergraduates face in universities located in small cities. Therefore, this study aims to explore undergraduates’ perceptions about EMI, particularly the challenges they face in EMI classrooms and solutions they suggest for mitigation of their issues. The qualitative data collected through semi-structured interviews reveal that students perceive EMI to be beneficial for higher education, employment and progressive thought. However, they face challenges related to teachers’ English proficiency, code-switching, vocabulary and receptive as well as productive skills. They suggest that English-proficient instructors, continuous use of English, language support from university can help them overcome these challenges effectively. The study offers recommendations for further exploration of the research area in the context of Pakistan.

Education is a key component of progress in the present-day world. But this progress cannot be made without efforts of teachers. Therefore, teacher education, in particular teacher training becomes extremely important. In this regard, several trainings programs are initiated and executed across Pakistan but the desired outcomes have not been achieved so far. Hence, this study was conducted to explore the challenges in teacher training in Pakistan and the ways through which these issues can be resolved. The sources for the data of the study were the published studies in the field in the context of Pakistan, national education policy, and other relevant literature. Based on secondary data, the study concludes that the issues with teacher training in Pakistan are administrative as well as faculty related. The findings reveal that the challenges related to policy and planning, poor induction of teachers, lack of resources in teacher training institutions, demotivation among teachers, and unequal distribution of skilled and productive teachers, dual training system and infrequent trainings. These issues can be fixed by fostering encouraging environment, ensuring accountability and merit, providing necessary resources, systematizing professional training programs and their continuation. The findings of this study will, therefore, positively guide policymakers to develop the right and effective policy to improve the standard of teacher education in the country.

The porcellanid crab Lissoporcellana demani Dong & Li, 2014 is reported for the first time from southeast Africa, based on material collected from trawls off Mozambique during the International Indian Ocean Expedition in 1963-1964. Lissoporcellana demani has been known only from the western Pacific, and the present specimens greatly extend the previously known distribution range of this species to the western Indian Ocean. Illustrations of a specimen are provided. Morphological variations of L. demani and characters distinguishing it from closely related congeneric species are discussed.

Chemokines are recognized as the major contributor to various tumorigenesis, tumor heterogeneity, and failures of current cancer therapies. The tumor microenvironment (TME) is enriched with chemokines and cytokines and plays a pivotal role in cancer progression. Chronic inflammation is also considered an instructive process of cancer progression, where chemokines are spatiotemporally secreted by malignant cells and leukocyte subtypes that initiate cell trafficking into the TME. In various cancers, prostate cancer (PCa) is reported as one of the leading cancers in the worldwide male population. The chemokines-mediated signaling pathways are intensively involved in PCa progression and metastasis. Emerging evidence suggests that chemokines and cytokines are responsible for the pleiotropic actions in cancer, including the growth, angiogenesis, endothelial mesenchymal transition, leukocyte infiltration, and hormone escape for advanced PCa and therapy resistance. Chemokine's system and immune cells represent a promising target to suppress tumorigenic environments and serve as potential therapy/immunotherapy for the PCa. In this review, an attempt has been made to shed light on the alteration of chemokine and cytokine profiles during PCa progression and metastasis. We also discussed the recent findings of the diverse molecular signaling of these circulating chemokines and their corresponding receptors that could become future targets for therapeutic management of PCa.

Epidemiological studies have established alcohol and smoking as independent risk factors for recurrent acute pancreatitis and chronic pancreatitis. However, the molecular players responsible for the progressive loss of pancreatic parenchyma and fibroinflammatory response are poorly characterized.Tandem mass tag-based proteomic and bioinformatics analyses were performed on the pancreata of mice exposed to alcohol, cigarette smoke, or a combination of alcohol and cigarette smoke. Biochemical, immunohistochemistry, and transcriptome analyses were performed on the pancreatic tissues and primary acinar cells treated with cerulein in combination with ethanol (50 mmol/L) and cigarette smoke extract (40 μg/mL) for the mechanistic studies.A unique alteration in the pancreatic proteome was observed in mice exposed chronically to the combination of alcohol and cigarette smoke (56.5%) compared with cigarette smoke (21%) or alcohol (17%) alone. The formation of toxic metabolites (P.001) and attenuated unfolded protein response (P.04) were the significantly altered pathways on combined exposure. The extracellular matrix (ECM) proteins showed stable malondialdehyde-acetaldehyde (MAA) adducts in the pancreata of the combination group and chronic pancreatitis patients with a history of smoking and alcohol consumption. Interestingly, MAA-ECM adducts significantly suppressed expression of X-box-binding protein-1, leading to acinar cell death in the presence of alcohol and smoking. The stable MAA-ECM adducts persist even after alcohol and smoking cessation, and significantly delay pancreatic regeneration by abrogating the expression of cyclin-dependent kinases (CDK7 and CDK5) and regeneration markers.The combined alcohol and smoking generate stable MAA-ECM adducts that increase endoplasmic reticulum stress and acinar cell death due to attenuated unfolded protein response and suppress expression of cell cycle regulators. Targeting aldehyde adducts might provide a novel therapeutic strategy for the management of recurrent acute pancreatitis and chronic pancreatitis.

Social entrepreneurship orientation (SEO) is a behavioral construct of social entrepreneurship (SE); therefore, we examined the influence of SEO of the organization on social and financial performance. A random sample of 810 employees was drawn from social enterprises of Pakistan during the COVID-19 pandemic. Although increasing research focuses on SE, the discipline continues to disintegrate, and this has led to appeals for a careful investigation of the associations of firms’ SE. In the recent decade, “social entrepreneurship” has earned its importance as a segment of entrepreneurship. Instead of mixed activity, firms are more likely to engage in either for-profit or non-profit activities. The causes for and consequences of this conduct has been mainly studied using objective measures of SEO, social performance, and financial performance, with little attention paid to the subjective experiences of social enterprises. We rely on the theory of stakeholder and mixed structuring to postulate that social performance intermediates the SEO-financial performance relation. By assessing a sample of 810 employees from active enterprises, we discover that social performance mediates positively and partially between SEO and financial performance, and both direct and indirect paths are in the same direction and significant. Our findings exhibit that social performance variance explained 74% of the mediating role, and the remaining 26% of the effect is because of SEO. We consider the functions by which an SEO influences enterprise performance and delivers more prominent understanding into multiple spectrums of performance. We discuss the prospective suggestions of our research and foster an encouraging pathway for more enquiry on the SEO paradigm. The study adds contribution to the literature, which has not been testified before on hybrid firms. SEO is a newly defined construct and requires more prospective research. This research gives the researchers/scholars new directions to address related disciplines and further explore this domain.

Parked vehicles can create deadly environments for young children who are left unattended. This study was a descriptive analysis to describe circumstances leading to death in children left unattended in parked motor vehicles in India. Between 2011 and 2018, there were 16 incidents that resulted in 28 fatalities across India, mostly in the summer months. The majority of children (19/28) were aged 4–6 years, of whom 25 (89%) gained access to unattended vehicles and became accidentally locked in. Hyperthermia-related deaths are a poorly recognised type of vehicular injury in India; there has been no analysis to describe circumstances leading to such fatalities.

Femoral shaft fractures following oil massage in newborns are very rare. We describe our observations at a tertiary centre in northern India. Three such cases encountered during the study period from July 2014 to June 2019 were evaluated. Sociocultural details, neonatal illnesses, mode of delivery, history of child abuse, type of fracture and management were recorded and analysed. All patients had a mid-shaft fracture after forceful oil massage by caring grandmothers. They all had complete union of fractures by the end of four weeks. This case series shows that mid-shaft fracture femur in neonates has excellent long-term prognosis, but the practice of oil massage needs to be modulated.