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Mandeep Garg,1 Muniraju Maralakunte,1 Suruchi Garg,2 Sahajal Dhooria,3 Inderpaul Sehgal,3 Ashu Seith Bhalla,4 Rajesh Vijayvergiya,5 Sandeep Grover,6 Vikas Bhatia,1 Priya Jagia,7 Ashish Bhalla,8 Vikas Suri,8 Manoj Goyal,9 Ritesh Agarwal,3 Goverdhan Dutt Puri,10 Manavjit Singh Sandhu1 1Department of Radiodiagnosis & Imaging, PGIMER, Chandigarh, India; 2Department of Dermatology, Aura Skin Institute, Chandigarh, India; 3Department of Pulmonary Medicine, PGIMER, Chandigarh, India; 4Department of Radiodiagnosis, AIIMS, New Delhi, India; 5Department of Cardiology, PGIMER, Chandigarh, India; 6Department of Psychiatry, PGIMER, Chandigarh, India; 7Department of Cardiovascular Imaging & Endovascular Interventions, AIIMS, New Delhi, India; 8Department of Internal Medicine, PGIMER, Chandigarh, India; 9Department of Neurology, PGIMER, Chandigarh, India; 10Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, IndiaCorrespondence: Mandeep GargDepartment of Radiodiagnosis and Imaging, PGIMER, Sector-12, Chandigarh, IndiaTel +91 9914209390Email gargmandeep@hotmail.comAbstract: COVID-19 is an ongoing pandemic with many challenges that are now extending to its intriguing long-term sequel. ‘Long-COVID-19ʹ is a term given to the lingering or protracted illness that patients of COVID-19 continue to experience even in their post-recovery phase. It is also being called ‘post-acute COVID-19ʹ, ‘ongoing symptomatic COVID-19ʹ, ‘chronic COVID-19ʹ, ‘post COVID-19 syndrome’, and ‘long-haul COVID-19ʹ. Fatigue, dyspnea, cough, headache, brain fog, anosmia, and dysgeusia are common symptoms seen in Long-COVID-19, but more varied and debilitating injuries involving pulmonary, cardiovascular, cutaneous, musculoskeletal and neuropsychiatric systems are also being reported. With the data on Long-COVID-19 still emerging, the present review aims to highlight its epidemiology, protean clinical manifestations, risk predictors, and management strategies. With the re-emergence of new waves of SARS-CoV-2 infection, Long-COVID-19 is expected to produce another public health crisis on the heels of current pandemic. Thus, it becomes imperative to emphasize this condition and disseminate its awareness to medical professionals, patients, the public, and policymakers alike to prepare and augment health care facilities for continued surveillance of these patients. Further research comprising cataloging of symptoms, longer-ranging observational studies, and clinical trials are necessary to evaluate long-term consequences of COVID-19, and it warrants setting-up of dedicated, post-COVID care, multi-disciplinary clinics, and rehabilitation centers.Keywords: ongoing symptomatic COVID-19, post-COVID-19 syndrome, chronic COVID, Long-COVID-19, post-COVID, Long-COVID

Diffusion tractography is a new imaging technique to display the traumatic region for valuable preoperative information with prognostic significance. We present a case of 54 year male with quadriparesis showing reduced FA values and increased ADC in injured segment with depiction of disrupted tracts on tractography.In the near future, DTI will become a part of routine imaging in trauma patients as experience with this novel method gains acceptance.

Portal vein aneurysm is an uncommon anomaly. Both congenital and acquired cases are reported. We report a case of idiopathic probably congenital portal vein aneurysm incidentally detected on contrast CT. There was no evidence of any chronic liver disease or portal hypertension in this patient.

Unusual site metastasis as presenting complaint of renal cell carcinoma (RCC) has been reported previously in literature. RCC is a notorious tumor with unpredictable behavior. We present a case of RCC who presented with scrotal mass and on subsequent investigation was found to have metastasis to scrotum and spermatic cord. Both testes were normal with no evidence of metastasis.

Secondary pneumothorax is a very common medical emergency. At times it is associated with pneumomediastinum, which could be fatal at times if not identified. We present a case of a 11 years old sputum positive child who presented with both these conditions and was diagnosed on chest x ray.

Newer non-pharmacological therapies for heart failure are being evaluated for patients of congestive heart failure (CHF). Mechanical support with left ventricular assist devices and heart transplantation are reserved for the minority of patients who have severely decompensated heart failure1. Despite these therapeutic advances, it is generally accepted that current therapies do not adequately address the clinical need of patients with heart failure, and additional strategies are being developed. Cardiac resynchronization therapy (CRT) is a new modality that involves synchronization of ventricular contraction and has shown a lot of promise in managing symptomatic patients of CHF who are on optimal medical therapy and have interventricular conduction delay (IVCD). It has improved exercise tolerance and NYHA functional class in such patients in sinus rhythm and a recent meta-analysis has also shown mortality benefits in CHF. Recently benefits of CRT have also been observed in CHF patients who do not have wide QRS complexes on electrocardiogram (EKG). It has also been shown to benefit drug refractory angina in CHF. Recent studies have also focused on the combined use of CRT and implantable cardioverter defibrillator (ICD) and it has shown encouraging results. Our aim in this descriptive review is to define practice guidelines and to improve clinicians' knowledge of the available published clinical evidence, concentrating on few randomized controlled trials.

Mobile Medical Units (MMUs) are one of the major initiatives under the National Rural Health Mission. These MMUs help people in remote, underserved areas access healthcare at affordable prices on their doorstep. The present record-based study aimed to assess the morbidity profile of the patients attending Mobile Medical Unit camps in the Yadadri-Bhuvanagiri district between April 2022 and December 2022. The MMU is run by the Department of Community and Family Medicine, AIIMS, Bibinagar, in six selected villages of the Yadadri-Bhuvanagiri district. (Figure 1). A register is maintained to record the details of patients visiting the MMU camp. Patient's name, age, gender, place, mobile number, height, weight, blood pressure (BP), glucometer Random Blood Sugar, diagnosis, and details of medication dispensed were entered in the register. Diabetes, hypertension, and obesity were diagnosed using the World Health Organization (WHO) criteria, the Eighth Joint National Committee guidelines, and WHO Asia Pacific guidelines, respectively. Mobile Medical Unit Camp data are entered into the Excel database at the end of every month. Since it is a record-based analysis, we used data for analysis between April 7, 2022, and December 31, 2022. A total of 1494 patients were treated in the MMU camps during this period. Among them, 89.4% were adults, and 10.6% were children (less than 18 years). Among 1,336 adult patients, the majority of participants suffered from osteoarthritis, followed by non-communicable diseases (NCDs). The mean scores of systolic and diastolic BP of the adult population were obtained at 131±21 and 77±13 mm Hg, respectively. The mean random blood glucose level of the adult population was 150±74 mg/dl. A total of 158 children were younger than 18 years old, out of whom 78 and 80 participants were males and females, respectively. Moreover, 23.1% and 25% of males and females suffered from upper respiratory tract infections, respectively. The study further suggests that the NCD epidemic is spreading to rural areas where necessary health infrastructure is insufficient. MMUs can bring a significant change to the public health system, which needs to re-orient its priorities. [ABSTRACT FROM AUTHOR]

Reviews currently available legal writing books in terms of their suitability for use in English for legal academic purposes. Concludes that, while certain aspects of the available books can be useful, most are generally not suitable for use in such contexts. (Author/VWL)

Research Question: What are the health-related problems of the aged and why do they feel lonely? Objective: To study the health-related problems and loneliness among the elderly in different micro-environment groups. Participants: Aged persons of age 65 years and above. Setting: Urban and rural area of Chandigarh. Design: Cross-sectional. Statistical Analysis: t-test and Z test. Results: During the study, it was found that out of the total 361 aged persons of Chandigarh, 311 (86.1%) persons reported one or more health-related complaints, with an average of two illnesses. The illness was higher among the females (59.5%) as compared to males (40.5%). The main health-related problems were disorders of the circulatory system (51.2%), musculoskeletal system and connective tissue (45.7%). It was also found that loneliness was prevalent more in females (72.8%) as compared to males (65.6%). Loneliness was more prevalent among persons who lived alone (92.2%) as compared to those who lived with their spouse (58.9%) or when husband and wife lived with the family (61.4%). It was higher among the widows (85.2%) and widowers (75.8%) who lived with the family as compared to the aged who lived with the spouse (58.9%) and the aged husband and wife who lived with the family (61.4%). Conclusion: Special geriatric services should be started in the hospitals as the majority of the aged have one or more health-related problems. The aged persons should be involved in social activities to avoid loneliness among them.

Newer non-pharmacological therapies for heart failure are being evaluated for patients of congestive heart failure (CHF). Mechanical support with left ventricular assist devices and heart transplantation are reserved for the minority of patients who have severely decompensated heart failure1. Despite these therapeutic advances, it is generally accepted that current therapies do not adequately address the clinical need of patients with heart failure, and additional strategies are being developed. Cardiac resynchronization therapy (CRT) is a new modality that involves synchronization of ventricular contraction and has shown a lot of promise in managing symptomatic patients of CHF who are on optimal medical therapy and have interventricular conduction delay (IVCD). It has improved exercise tolerance and NYHA functional class in such patients in sinus rhythm and a recent meta-analysis has also shown mortality benefits in CHF. Recently benefits of CRT have also been observed in CHF patients who do not have wide QRS complexes on electrocardiogram (EKG). It has also been shown to benefit drug refractory angina in CHF. Recent studies have also focused on the combined use of CRT and implantable cardioverter defibrillator (ICD) and it has shown encouraging results. Our aim in this descriptive review is to define practice guidelines and to improve clinicians' knowledge of the available published clinical evidence, concentrating on few randomized controlled trials.