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Purpose: The purpose of this study is to describe the demographic profile, clinical features, visual outcomes, and follow-up patterns after successful cataract surgery in children from the tribal community in Odisha, India. Methods: We retrospectively reviewed records of tribal children aged 4 months–16 years, who underwent public health financed cataract surgery at our institute from January 1, 2015, to December 31, 2019. Collected data included demographic profile, clinical features, outcomes, and follow-up. Univariate and multivariate linear regression identified factors affecting the visual outcome at a 6-week follow-up. Results: During this period, a total of 352 children [536 eyes; mean age: 9.11 ± 4.4 years, 219 boys (62%)] underwent cataract surgery. The most common etiology and presenting complaints were idiopathic congenital cataract and decreased vision, respectively. In 304 children (86%), presenting best-corrected visual acuity (BCVA) was

Background: There is a huge spectrum of skin tumors which can be confused clinically with malignancies, particularly when they are pigmented or inflamed, and histopathological examination of a biopsy specimen is required to establish a definitive diagnosis and to facilitate appropriate intervention and follow up. Aim: To evaluate all skin tumors and categorize them according to their origin. Methods: The present study was conducted over a period of 4 years (July 1, 2013 to June 31, 2017) comprising of 1.5 years prospective and 2.5 years retrospective analysis in the departments of Dermatology and Pathology, at a tertiary hospital in North India. All specimens of skin tumors were analyzed grossly and microscopically. Immunohistochemistry was done wherever possible. Results: A total of 232 skin tumors were seen; of which 123 cases were benign (53.0%) and 109 cases were malignant (47.0%). The mean age of patients with benign and malignant skin tumors was 40.3 ± 19.9 and 60.8 ± 14.8 years, respectively. The most common site was face (n = 106; 45.7%) followed by limbs (n = 44; 19.0%). The male:female ratio of benign and malignant tumors was 1.01:1 and 1.31:1, respectively. Among the benign tumors, keratinocytic tumors were the commonest (n = 57; 46.3%) followed by the melanocytic tumors (n = 37; 30.1%) and appendageal tumors (n = 29; 23.6%). The most common malignant skin tumors were the keratinocytic tumors (n = 87; 79.8%) followed by 12 cases (11%) of hematolymphoid tumors and five cases (4.6%) each of melanocytic and appendageal tumors. Limitations: The lack of clinical and dermatoscopic correlation and inclusion of retrospective data are the limitations of this study. Conclusions: Skin tumors affect people of all ages. The benign tumors are seen in the younger age group as compared to malignant tumors. Face is the most common site and keratinocytic tumors are the most common skin tumors in both benign and malignant categories.

Aims: The etiological spectrum and clinical profile of admitted patients presenting with pancytopenia were studied. Study Design: This was a prospective study conducted on 200 patients presenting to the Department of Medicine, Department of Oncology and the Allied Specialities of Medicine, Dayan and Medical College and Hospital, Ludhiana and were found to have pancytopenia during hospital stay. Results: Mean age of the patients was 45.69 ± 17.05 years with maximum number of patients (23%) in the age group of 51-60 years and 119 patients were males and 81 patients were females. Most common physical finding was pallor (95%), followed by splenomegaly (22%) and hepatomegaly (17%). Total of 107 patients were vegetarians (53.5%) and 93 patients (46.5%) were non-vegetarians. Mean hemoglobin was 7.16 ± 2.04 g/dl, mean total leucocyte count was 2.51 ± 1.02 x 103/cu. mm, mean platelet count was 54885.37 x 103/ul ± 40320.96 and mean the absolute neutrophil count was 1.59 x 103 /cu.mm ± 0.84. Ten patients of pancytopenia were because of tropical fever which included 4 cases of dengue, 3 cases of malaria, 2 cases of enteric fever and 1case of mixed infection (malaria + scrub typhus). Viral markers were positive in 14 out of the 63 patients tested. Out of these 14 patients, 4 were HBsAg reactive, 7 were HCV +ve and 3 were HIV +ve. Most common red blood cell picture on peripheral blood film was normocytic normochromic (34.5%), followed by mixed morphology (33.5%). Macrocytic and microcytic morphology was seen in 19.5% and 12.5% of the patients respectively. Hypercellular marrow was seen in 82 patients (42.9%), normocellular marrow was seen in 58 patients (30.3%) and hypocellular marrow was seen in 51 patients (26.7%). The most common cause of pancytopenia in this study was megaloblastic anemia in 59 patients (29.5%), the 2nd common cause was leukemias in 28 patients (14%) and the 3rd cause was aplastic anemia in 22 patients (11%). Drug induced pancytopenia was seen in 21 patients (10.5%) and hypersplenism in 9 cases (4.5%). Conclusion: This study has helped us in knowing the various etiologies of pancytopeniain this hospital. Megaloblastic anemia was the most common etiology in this study followed by leukemiasand aplastic anemia. The study helped us in understanding of the age and gender distribution, the hematological parameters, the peripheral blood film in pancytopenia and the bone marrow picture in these patients.

The UN recommends that the 'Washington Group questionnaire (WGQ) on functioning' is used for data collection on disability. There are few studies on the WGQ from India.To evaluate the prevalence of disability in a community-health project, using this tool: to examine if the use of the WGQ identifies more people with disability than the tools used previously.We performed a systematic sample survey using the WGQ in the community-health project covering a population of 50,000 residents. The questionnaire was administered to 2203 individuals.The age and sex distribution of the sample studied matched the National Census data 2011. The study identified 41 individuals with a disability. The prevalence of disability in our sample was 1.86% (95% CI 1.3%-2.43%) compared to 2.21% in India-Census-2011. Receiver operating characteristic (ROC) curve showed that disability was more prevalent after the age of 44 years (p-value0.0001 and AUC 0.806). The odds ratio of disability was 10.1 above this age compared with those below that age (95% CI: 5.1 to 20).Use of the WGQ did not yield better data on disability prevalence than that identified by the Census. Another study, this one in Telangana, south India, by the London School of HygieneTropical Medicine found that self-reporting identifies only a third of the cases of disability. More direct and leading questions are needed to empower the disabled in developing countries to identify barriers which prevent their full participation in society.

Context: Coronavirus disease 2019 (COVID-19) has been one of the deadliest pandemics in recent decade. The virus has specifically targeted the comorbid population in terms of mortality. The present systematic review and meta-analysis aimed to determine the overall mortality and diabetes-associated mortality in COVID-19 patients. Methods: To obtain the related data, six databases, including Pubmed, Embase, MEDLINE, Web of Science, Google Scholar, and DOAJ, were searched. The full-texts of articles presenting the data of COVID-19 mortality and diabetes-associated mortality were screened and retrieved. Statistical analysis was performed using the Stata (version 13). The odds ratio (OR) of mortality in diabetic patients was calculated with 95% confidence interval (CI). Random-effects model was used to synthesize data for the relevant outcomes. Heterogeneity was evaluated using I2 statistic. Forest plots visually showed the effect estimates of the included studies. We used funnel plots to evaluate potential publication bias. A two tailed P < 0.05 was considered as statistically significant. Results: A total of 35 studies with 25,934 patients were finally included for meta-analysis. The pooled prevalence of diabetes mellitus in patients with COVID-19 was 16.8% (n = 4381). The overall mortality seen in all the studies was 12.81% (n = 3159), and diabetes-associated mortality was 22.14% (n = 970). The pooled analysis of included studies showed that diabetes mellitus had a significantly higher mortality rate (22.14% vs. 12.81%, P < 0.05) with higher odds of death (pooled OR 1.83, 95% CI: 1.61 - 2.05). The funnel plot was symmetric, thereby indicating a low risk of publication bias. Conclusions: In conclusion, the presence of diabetes was associated with a significantly increased risk of mortality in patients admitted to the hospital with COVID-19. Thus, this subpopulation must be continuously monitored for glycemic levels, coagulation abnormalities, and inflammatory surge.

Aim The aim of the study is to evaluate whether 6-h sepsis bundle component compliance (complete vs. incomplete) decreases mortality in pediatric patients with severe sepsis and septic shock. Methodology The study was conducted at a tertiary care hospital. Patients aged 1 month-13 years admitted to pediatric intensive care unit with severe sepsis, or septic shock were prospectively enrolled. The clinical data and blood investigations required for sepsis bundle were recorded. Predicted mortality was calculated at admission by the online pediatric index of mortality-2 (PIM-2) score calculator. Patients who fulfilled all the components of 6-h sepsis bundle were taken as compliant while failure to fulfill even a single component rendered them noncompliant. The outcome was recorded as died or discharged. Results Of 116 patients, 90 (77.59%) had 100% sepsis bundle component compliance and were taken into the compliant group while the rest 26 (22.41%) were noncompliant. Forty out of 90 patients (44.4%) died in compliant group in comparison to 5 out of 26 (19.3%) in noncompliant group, P = 0.020. The pre- and post-interventional lactates were significantly higher in compliant group as compared to the noncompliant group, P < 0.0001 and 0.019, respectively. Rising lactate level parallels increasing predicted mortality by PIM-2 score in compliant group, but this association failed to reach significance in noncompliant group which can be attributed to less number of subjects available in this group. Conclusion Irrespective of sepsis bundle compliance (complete/incomplete), outcome depends on the severity of illness reflected by high lactate and predicted mortality.

To determine the incidence of hypertension among children during the induction and re-induction phases of acute lymphoblastic leukemia (ALL) therapy and association with possible risk factors. A retrospective analysis of 208 consecutive pediatric (age

Sweet's syndrome is characterized by erythematous tender nodules and plaques over face and extremities. Fever, leukocytosis with neutrophilia, and a neutrophilic infiltrate in the dermis are characteristic features. Neutrophilic dermatosis of dorsal hands is a rare localized variant of Sweet's syndrome occurring predominantly over dorsa of hands. Various degrees of vascular damage may be observed on histopathology of these lesions. Both Sweet's syndrome and its dorsal hand variant have been reported in association with malignancies, inflammatory bowel diseases, and drugs. We report a patient with neutrophilic dermatoses of dorsal hands associated with erythema nodosum. He showed an excellent response to corticosteroids and dapsone.

Medical writing has become an unaccountable alternate subject in the curriculum of doctors. It starts from the undergraduate level where a medical student has to write some projects in the Preventive and Social medicine department. Apart from that, case summaries in the various clinical subjects begin in the final year of undergraduation. At the postgraduate level, Indian medical students have a big task in front of them in the form of a thesis. The protocol writing in the initial 3 months of the tenure seems such a daunting subject and it puts so much of pressure on the naive mind who is mastering a particular medical field. The focus starts deviating from the learning of the clinical skills to completing the protocol writing without any specific tutorial-based guidance on the technology to write a protocol for the thesis or a complete thesis itself. Nonetheless, this is superseded by one/two compulsory research publications in the postgraduation. The increasing population in our country, increasing workload in the departments, especially surgical fields in the government hospitals, has led to an undue burden on medical students for medical writing. The complete digitalization of the dissertations has warranted a complete knowledge of the computers and writing softwares such as Microsoft word, Excel, and PowerPoint and the various plagiarism tools for an easy and errorless completion of the dissertation during the medical tenure. The following core competencies are addressed in this article: Interpersonal and communication skills, Professionalism, Systems-based practice.

Papillary carcinoma arising in thyroglossal cyst is rare and is usually detected on postoperative histopathology after routine Sistrunk operation. Further management is a matter of debate and the choice lies between regular follow-up after Sistrunk operation or total thyroidectomy with or without radioiodine ablation and thyroxine suppression therapy. Here, we present a case of papillary carcinoma of thyroglossal duct cyst in a 26- year-old lady. Papillary carcinoma was detected after a routine Sistrunk operation was done for a seemingly innocuous thyroglossal cyst. A total thyroidectomy was carried 1 week later followed by hormone replacement therapy to suppress serum thyroid-stimulating hormone levels.How to cite this articleMunjal M, Garg B, Sood N, Bhardwaj V. Papillary Carcinoma of the Thyroglossal Duct Cyst: A Case Report and Review of Literature. Int J Otorhinolaryngol Clin 2013;5(3):148-150.