Manual jet ventilation to rescue a patient with pinhole tracheal stenosis: A case report

Background: Airway management of patients with tracheal stenosis is highly challenging and even establishing a surgical airway may be difficult in these patients. Case: A 24 year old female developed pinhole tracheal restenosis after undergoing tracheal web resection and reconstruction. After other modes of ventilation had failed, we used the Manual jet ventilator endotracheal tube assembly as a rescue device and performed intermittent low-frequency jet ventilation until a definitive surgical airway could be established. Conclusion: Central airway obstruction in severe tracheal stenosis can cause life-threatening hypoxia. Jet ventilation through the pin hole opening buys some time for the surgeon to secure the airway.

The kynurenine pathway in Alzheimer's disease: a meta-analysis of central and peripheral levels

Objective: Changes in the kynurenine pathway are recognized in psychiatric disorders, but their role in Alzheimer's disease (AD) is less clear. We aimed to conduct a systematic review and meta-analysis to determine whether tryptophan and kynurenine pathway metabolites are altered in AD. Methods: We performed a systematic review and random-effects meta-analyses. Inclusion criteria were studies that compared AD and cognitively normal (CN) groups and assessed tryptophan or kynurenine pathway metabolites in cerebrospinal fluid or peripheral blood. Results: Twenty-two studies with a total of 1,356 participants (664 with AD and 692 CN individuals) were included. Tryptophan was decreased only in peripheral blood. The kynurenine-to-tryptophan ratio was only increased in peripheral blood of the AD group. 3-Hydroxykynurenine was decreased only in cerebrospinal fluid and showed higher variability in the CN group than the AD group. Kynurenic acid was increased in cerebrospinal fluid and decreased in peripheral blood. Finally, there were no changes in kynurenine and quinolinic acid between the groups. Conclusions: Our results suggested a shift toward the kynurenine pathway in both the brain and in the periphery, as well as a shift towards increased kynurenic acid production in the brain but decreased production in peripheral blood. In addition, our analysis indicated dissociation between the central and peripheral levels, as well as between plasma and serum for some of these metabolites. Finally, changes in the kynurenine pathway are suggested to be a core component of AD. More studies are warranted to verify and consolidate our results.

A cross-sectional study of musculoskeletal disorder and their environmental determinants among cycle rickshaw pullers of Delhi: A geographical information system-based analysis

Introduction: Rickshaw pulling is among the major activities in the informal sector. Cycle rickshaw pulling involves the task of prolonged sitting, fixed posture, and vibrations which could increase the risk of developing many health problems including one of the major problems of musculoskeletal disorder (MSD). Rickshaw pulling remains important for urban transport system, and such activities contribute in terms of employment and transportation services. The injury and illness resulting from work leads to lower productivity and quality employment which force them to increase their daily hours of working. The work environment and various other environmental determinants for MSD were assessed. The spatial variability of these environmental determinants and MSDs of cycle rickshaw pullers was studied in Delhi. Material and Methods: A cross-sectional study was conducted among cycle rickshaw pullers of Delhi. Five districts were randomly selected, and out of 448 study subjects, a total of 425 were included in the study. Consent was obtained before the study. The Nordic Musculoskeletal Questionnaire instrument for MSDs was used. The spatial distribution of MSD and risk factors was studied using QGIS software. Results: MSD was observed in 51.5% of the cycle rickshaw pullers and the prevalence increased with age from 9.6% to 34.7%. A statistically significant association of MSD with duration of work, sleeping hour, and sleeping place was observed. Poor road condition and posture were also having an association with MSD. Conclusion: Every second cycle rickshaw puller was having MSD. Lifestyle, road conditions, harsh environmental condition, strenuous physical exertion, and ergonomics of the cycle rickshaw were important factors contributing for MSD.

Immediately sequential bilateral cataract surgery in Down syndrome

The exponential increase in world population and average human lifespan is expected to result in geriatric population globally. The problem of preventable blindness due to cataract will increase manifold. Simultaneous Bilateral cataract surgery (SBCS) is a viable option in such subset of patients. Despite faster visual recovery, economic benefits to patients and health care providers, decreased risk of complications associated with General anaesthesia, there is significant resistance in accepting SBCS as a routine procedure. Bilateral endophthalmitis is the main deterrent in performing ISBCS. This case highlights successful ISBCS in 36 years old female patient with Down抯 syndrome.

Emphysematous pancreatitis presenting as new-onset diabetes mellitus with multi-organ dysfunction: Managed successfully with medical management alone

Emphysematous pancreatitis is one of the rare and potentially fatal complications of acute pancreatitis. We present here the case of a 69-year-old man who presented with abdominal discomfort, vomiting, and constipation with features of sepsis due to Klebsiella pneumoniae bacteremia and new-onset diabetes mellitus. Elevated serum lipase levels and abdominal computed tomography scan showing pancreatic necrosis with air bubbles suggestive of emphysematous pancreatitis. He was managed conservatively as the surgical intervention was differed in view of unstable hemodynamics and thrombocytopenia. The entire emphysematous pancreatitis and sepsis resolved with medical management alone although surgical necrosectomy may be indicated at presentation.

Management of human epidermal growth factor receptor 2杗egative metastatic breast cancer: Role of poly adenosine diphosphate (ADP?ribose) polymerase inhibitors

Human epidermal growth factor receptor 2 (HER2)?negative subset is the most heterogeneous group of metastatic breast cancers (MBCs) as it includes both hormone receptor (HR)?positive and HR?negative breast cancer (or TNBC), which have different therapies and treatment challenges. Though endocrine therapy (ET) remains the treatment backbone in HR?positive HER2?negative cases, about 40% of the patients show intrinsic or acquired resistance to ET due to multiple mechanisms. Combining different therapies such as ET and other targeted therapies with or without chemotherapy fails to give continued benefit, unlike cyclin?dependent kinase (CDK) 4/6 inhibitors that have shown a great benefit. TNBC has conventionally been treated ineffectively with systemic chemotherapy. Recently, poly (ADP?ribose) polymerase inhibitors (PARPi) have emerged for HER2?negative breast cancer (BC) patients, including TNBC. Olaparib and talazoparib have recently been approved in germline BRCA?mutated (gBRCAm) HER2?negative MBC. Additionally, ongoing trials of PARPi in combination with various therapies are expected to provide more and better treatment options for gBRCAm HER2?negative breast cancer.

Constant score in asymptomatic shoulders varies with different demographic populations: derivation of adjusted score equation

Background@#In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. @*Methods@#The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. @*Results@#Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18–78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. @*Conclusions@#Mean CS and its change with age differed from previous studies among various population cohorts.

Comparative evaluation of diode laser and simvastatin gel in pulpotomy of primary molars A randomized clinical trial

Background: Pulpotomy is a vital pulp therapy performed in carious pulp exposures in teeth in which the inflamed coronal pulp is removed and medicament is placed to conserve the vital root pulps. Recently, simvastatin which is a cholesterol-lowering drug has been found to be associated with the pulp regenerative potential. Aim: The aim of this parallel two-arm randomized control trial was to evaluate and compare the clinical and radiographic efficacy of diode laser (DL) and simvastatin gel (SG) in pulpotomy of carious primary molars. Methods: Hundred primary molars (in 98 children, 65 males, 33 females with age 4–8 years) requiring pulpotomy were randomized into the DL or SG group. Pulpotomy was performed as per the standardized protocol; thereafter, all teeth were restored with resin modified glass ionomer cement followed by stainless steel crowns. Follow-up evaluations were done at 3 and 12 months using clinical and radiographic criteria. Statistical analysis was done using Chi-square test at a significance level of 0.05. Results: At 12 months, out of 92 teeth available for clinical and radiographic evaluation by blinded evaluators, DL group showed clinical and radiographic success rates of 76.1% and 52.1%, while SG group showed 80.4% and 65.2% success rates, respectively. There was no statistically significant difference between the efficacy of two techniques clinically (P = 0.49) or radiographically (P = 0.30). Conclusions: Both SG and DL had similar efficacy for primary tooth pulpotomy, clinically and radiographically after 12 months. Considering its ease of application and low-cost, SG can be recommended as a potential pulpotomy medicament in primary molars.

A case of adrenal cortical carcinoma with inferior vena cava thrombus extending into the right atrium: a two staged procedure

We present a case of adrenal cortical carcinoma (ACC) with tumor thrombus involving the inferior vena cava (IVC) and right atrium in a morbidly obese, middle-aged female. ACC is a rare type of cancer with a poor outcome. Most cases present with metastasis at the time of initial presentation. This patient presented with breathing difficulty and flank pain. With endocrinology evaluation and collaborative effort of multidisciplinary teams, the patient successfully underwent staged procedures of atrial clot evacuation after thoracotomy with cardiopulmonary bypass (CBP) along with inferior vena cava thrombectomy (IVCT) and left radical nephroadrenalectomy. The two staged procedure reduces the mortality when compared with a single staged procedure. The patient underwent atrial clot evacuation, performed by cardiothoracic surgery team under CBP and deployment of IVC filter by interventional radiologist as a first staged procedure. At six months of follow-up, the patient had locoregional disease spread but with good functional status. This case report highlights that even a high-volume disease, with proper planning by an experienced surgical team, can be operated successfully with an acceptable post-surgery quality of life for the patients.

Laparoscopic Paediatric Hernia Repair Using Tuohy Needle - Our Preliminary Experience of 100 Cases

Congenital inguinal hernia repair is one of the most commonly encountered paediatric surgical procedures. With advancements in minimal access surgery, there is an increasing inclination towards the repair of paediatric inguinal hernia (PIH) laparoscopically over an open procedure. Currently, a single port laparoscopic percutaneous extraperitoneal closure, a simple and reliable method, is being used widely. METHODS100 patients with PIH were treated using a single port LPEC technique from August 2014 to July 2018. The study was conducted with a modified LPEC technique using a Tuohy needle. The deep ring was encircled with the help of Tuohy needle under laparoscopic visualization and a suture was passed through it. The needle was then used to encircle the ring from the opposite side and the initial suture was retrieved with the help of a loop, and a purse string was created to obliterate the deep ring with extracorporeal knotting. RESULTS100 congenital hernias were repaired by LPEC method. Mean age was 5.85 ± 2 years. Male to female ratio was 7.3 : 1. 96% of cases were unilateral and 4 % were bilateral preoperatively. PPV was found in 8% of cases intraoperatively. Mean operating time was 22.08 ± 10.2 and 27.6 ± 11.47 minutes for unilateral and bilateral cases respectively. There were no intraoperative complications and no recurrences. Only one patient developed wound infection. CONCLUSIONSLPEC of hernial sac using a Tuohy needle is a safe and effective method for the repair of PIH. It is easy to perform, faster, and offers good cosmesis with cure for imminent contralateral hernias.

A curious case of electric wire in urethra

We present a case of discharging urethral fistula in a sexually active young male, who was found to have an impacted electrical wire in the urethra. Polyembolokoilamania is a condition, where one inserts foreign bodies via natural orifices, either for autoerotism, in inebriated states or due to psychological conditions. A wire was inserted into the patient’s urethra and it remained impacted for a year, leading to pain, dysuria and discharging urethral fistula. The wire was removed and the fistulous tract was excised. Patients, if diagnosed with autoerotism needs follow up with psychiatrist to address the underlying condition.

A study of expressed emotion, perceived stress and socio-demographic profile in patients of dissociative disorder

Background: Dissociation is understood as one of coping mechanism to deal with intense stressors. Individuals vary widely in their subjective response to a similar stressful event depending on number of factors including their family and social support system. So, authors tried to study the expressed emotion in patients of dissociative disorder along with other socio-demographic factors and its relation with perceived stress.Methods: This cross-sectional descriptive study was done on 100 patients with primary diagnosis of dissociative disorder. Hamilton depression rating scale (HAM-D) was used to assess comorbid Depressive symptoms and Hamilton anxiety rating scale (HAM-A) was used to asses comorbid anxiety symptoms. Perceived stress scale (PSS) was used to assess the perception of stress. Family emotional involvement and criticism scale (FEICS) was used to measure perceived criticism (PC) and intensity of emotional involvement (EI).Results: Mean perceived stress in this study was 25.8. Mean score for perceived criticism (PC) was 16.5 and emotional involvement (EI) was 15.7. Both measures of expressed emotions were significantly higher in females and subjects belonging to joint families and rural area. In this study perceived stress by subjects was significantly (p=0.001) correlated to perceived criticism (Pearson r = 0.78) and emotional involvement (Pearson r = 0.77).Conclusions: High perceived criticism and emotion over involvement of family member was associated with perceived stress in dissociation patients.

Significant perceived stressors in irritable bowel syndrome: a stress interventional module analysed

Background: Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidences are showing that IBS is a combination of irritable bowel and irritable brain. As IBS is a stress sensitive disorder, its treatment should focus on managing stress and stress-induced responses.Methods: This is a hospital based longitudinal study. 72 patients fulfilling the Rome IV criteria for irritable bowel syndrome were enrolled into the study. Perceived stress was assessed using student stress dimension questionnaire (SSDQ) while IBS severity was assessed using IBS severity scoring system (IBS-SSS). The stress interventional module (SIM) consist of specific domain targeted psychological interventions given to the patients weekly based on the stress domain mapping. The effectiveness of these interventions on reducing stress as well as IBS severity was assessed at baseline, and weeks 2, 4 and 6 follow-ups.Results: Of the studied IBS patients, most had SPS in multiple life domains while familial and interpersonal domains were affected in 78%. Also, total stress load in form of mean cumulative stress load at baseline was 451.1 which decreased significantly to 274.4 over 6 weeks. This SIM brought about a reduction in mean irritable bowel syndrome severity score from 27.5 to 20.6 in 6 weeks. This reduction in IBS severity score overtime was significant (p=0.001).Conclusions: Patients of irritable bowel syndrome show significant stress in multiple domains of life, which require proper assessment and management. Authors propose that individual-specific interventions aimed at reducing stress in all psychosocial life domains are efficacious and should be an integral part of managing IBS.

Retrospective Study of Varicose Vein and its Management in IGIMS, Patna

Introduction: The management of varicose veins haschanged rapidly in recent years. Conservative therapy istypically the first-line treatment for many patients withsymptomatic varicose veins. The present study was conductedfor retrospectively analyzing the profile of varicose vein andits management.Material and methods: A total of 100 patients within the agegroup of 15 to 65 years with varicose vein complications wereincluded. Complete demographic details of all the patientswere obtained from the data record files. Clinical details werealso obtained. A Performa was made and results of routineinvestigations were recorded. Details regarding the treatmentprotocol used (conservative, sclerotherapy, surgical) andfollow-up data was also recorded separately. Patients were notwilling and unfit for surgery and patients with complicationsaccording to data record files, were treated by conservativemanagement.Results: Dilated veins only were found to be present in 18percent of the patients while dilated veins with pain waspresent in 64 percent of the patients. Dilated veins withulcerations and dilated veins with bleeding were present in40 percent and 8 percent of the patients respectively. In 33patients undergoing Sclerotherapy, complete response wasseen in 17 patients, recurrence was seen in 6 patients whilethe remaining 10 patients did not come back on follow-up. In31 patients undergoing surgical therapy, complete resolutionat time of discharge was seen in 28 patients while residualvaricosities were seen in 3 patients.Conclusion: Varicose veins are a frequently encounteredpathology affecting the middle aged group with commonestpresentation being unilateral limb involvement. Hence agood clinical assessment with investigations is necessary forreducing the morbidity associated with it.

Worth of Laparoscopy in Undiagnosed Chronic Abdominal Pain: A Tertiary Care Center Study

Introduction: Chronic abdominal pain which is difficult to diagnose initially not only encumbers the patient but it also affectstheir daily routine, leading to physical and psychological disability, here comes the role of diagnostic laparoscopy which provesto be beneficial aiding in diagnosing most of these cases. Hence, the aim was to evaluate the diagnostic value of laparoscopyin cases with chronic abdominal pain.Materials and Methods: This study was done in the Department of General Surgery at Indira Gandhi Institute of Medicalsciences, Patna, Bihar, from July 2019 to March 2020 in 40 patients. Prior Institutional Ethical Committee approval was alsoobtained for this study.Results: Out of 40 patients included in this study, maximum number of patients were females. Male-to-female ratio was 1:1.4.The maximum number of patients were in the age group of 21–40 years (60%). Maximum patients 45% (n = 18) had complaintof pain in the right lower quadrant of abdomen. The most common finding during diagnostic laparoscopy was found to bepathology in the appendix accounting for 27.5% of cases (11/40).Conclusion: Diagnostic laparoscopy is a safe and effective tool to establish the etiology of chronic abdominal pain and allowsfor appropriate interventions. It can serve as a time saving and cost-effective implement for these patients.

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Background: Any criteria (clinical, pathologic, microbiological or histo-pathologic) attributing a case of Paediatric gastrointestinal perforation to Typhoid would be of help in reaching a proper diagnosis to guide appropriate management.Aims and Objectives: To review all cases of Typhoid perforation for their clinical, pathologic and intra-operative findings.Materials and Methods: A retrospective study was conducted on all cases of typhoid perforation (gastrointestinal perforation with positive Widal test) operated at a tertiary care centre from September 2015 to September 2018. Data regarding their clinical findings, investigation results, intraoperative findings, nature of thesurgical intervention, postoperative results and histopathological findings were collected from their records and analysed.Results: A total of 13 patients were operated during this period with positive Widal’s test at presentation. 6/13 had single ileal perforation; two patients had multiple ileal perforations; perforation at atypical sites were found in four patients (one each at gastric, duodenal, caecal and rectal); one patient presented with Meckel’s band obstruction with multiple ulcers –this patient was sick and died despite a diverting ileostomy in the postoperative period. While 8/13 patients had primary closure of the perforation site, diversion through ileostomy was performed in five patients. All patients did well in the post-operative period except one patient of multiple ulcers and obstructing Meckel’s band who died in the post-operative period. Conclusion: On encountering a gastrointestinal perforation, no definite symptomatology or its pattern, no clinical examination findings, no intraoperative characteristics of the perforation and no biopsy can definitively point towards Typhoid as the cause. Therefore, we still have to depend on serological tests in correlation with clinical features to reach a conclusive diagnosis. Cultures and PCR, although sensitive are either time-taking or expensive to guide management. Typhoid perforation can have vivid and atypical presentation depending on the number and site of perforation

Study of ectopic pregnancy in a tertiary care centre

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.

Does a staged treatment of high energy tibial plateau fractures affect functional results and bony union? A case series / 中华创伤杂志(英文版)

PURPOSE@#Tibial plateau fracture (TPF) is a devastating injury as it shatters lower articular surface of the largest joint. Apart from bony injury, TPF can lead to great soft tissue envelope compromise which affects the treatment plan and outcome. In the present study, clinical results were assessed in cases of high energy TPFs treated in staged manner.@*METHODS@#Twenty-three (20 males and 3 females) patients of high energy communited TPFs (Schatzker type V and VI) were consecutively treated. All the patient had compromise of overlying skin conditions. They were all successively scheduled for staged treatment plan which comprised of application of bridging knee external fixator on the first day of admission and definitive internal fixation after skin and soft tissue overlying the fracture were healed. Schatzker type I, II, III and IV were excluded from the study. Primary survey was done and patient who had head injury, chest and abdominal injury, pelvic injury and contralateral limb injury and open fractures were excluded from the study. The patients were also evaluated in terms of wound complications, axial and rotary alignment of limb, fixation failure, articular congruity and range of motion of the knees and post injury employment. Statistical analysis was done using SPSS software.@*RESULTS@#Maximum follow-up period was 13 months. All the fractures were united at final follow-up. Clinical evaluation was done with the Tegner Lysholm knee scoring scale. Excellent results were found in 78% cases and good and fair results in 22% cases. There was significant correlation between range of motion and the Tegner Lysholm knee score (p < 0.001, Pearson correlation coefficient = 0.741). The correlation between the score and the radiographical union duration was significant (p = 0.006, Pearson correlation coefficient = -0.554).@*CONCLUSION@#A staged treatment plan allows healing of soft tissue envelope, with avoidance of dreadful complications such as compartment syndrome and chronic infection. In addition, a staged treatment strategy does not hamper the fracture reduction, bony union and the functional results.

Body image perception, eating attitude and influence of media among undergraduate students of medical college in Delhi: a cross sectional study

Background: Body image perception is being shaped by unrealistic ideals portrayed in the media. Body dissatisfaction is one of the most consistent and robust risk factors for eating disorders, low self-esteem, depression, and obesity. Therefore, the objective of the current study is to ascertain the body image perception, abnormal eating attitudes and the role of media among undergraduate students of a medical college in Delhi, India.Methods: Cross-sectional study on 370 undergraduate medical students of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India selected using stratified random sampling. India. Students completed a self-administered questionnaire which consist of demographic information, perceived body image, Eating Attitudes test (EAT-26) to assess eating attitudes, Socio Cultural Attitude Towards Appearance Questionnaire 3(SATAQ-3) scale for the role of media on body image perception. Data was analyzed using SPSS v21.Results: A total of 370 students (57.6% males and 42.4% females) aged 17-30 years, mean age of 20.30 years±2.02(SD). Abnormal body image perception was seen in 35.4%, 21.1% had abnormal eating attitude (EAT-26≥20), 36.5%, 40.5% agreed to be influenced by models and athletic figures in media respectively, 42.2% accepted that media was their source of information regarding standards of attractiveness, 27.6% felt pressured to be attractive according to SATAQ-3. Males more than females had disordered eating attitudes and felt media pressure to achieve an ideal body image. Significant association was observed between age and perceived body image (p=0.033), gender and EAT-26 score (p=0.039), EAT 26 and perceived body image (p=0.006), general internalization of media and perceived body image (p=0.003), internalization-general, internalization-athlete, media as source of information and EAT-26 score (<0.001, 0.001, 0.003 respectively).Conclusions: The media should take more responsibility to not represent unrealistic ideals of body image concerning both males and females. Educational and preventive efforts at institutional levels should be made to promote a healthy body image and eating behaviours.

Prevalence of depression, anxiety and stress among school going adolescents in Delhi: a cross sectional study

Background: Adolescence is a stressful period due to physical, psychological, sexual changes and the presence of psychiatric disorders such as depression, anxiety and stress at this stage of life is a matter of concern. Depression is a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. The objective of this study is to find the prevalence and associated factors of depression, anxiety and stress among school going adolescents.Methods: This was a school based descriptive cross-sectional study conducted in the month of July 2018 in an urban school in New Delhi. A semi-structured, self-administered questionnaire to assess socio-demographic profile as well as depression anxiety stress scale (DASS)–21 was used to assess depression, stress and anxiety.Results: Overall prevalence of depression, anxiety and stress were found to be 47.9%, 65.3%, and 51.8% respectively. Most of student suffered from moderate depression (46.8%), anxiety (33.3%) and mild stress (60.9%). It was noted that these were more common among female students, late adolescent age group, students alone/ away from family, students from separated/ single parents, consuming alcohol and family pressure to perform well in school.Conclusions: The alarming risk of depression, anxiety and stress among students with low academic satisfaction as well as those who face family pressure to perform better calls for need of parents-student counselling sessions, as well as frequent extracurricular activities to help create a healthier school environment.