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Background: This study aims to report the increasing incidence of second primary malignancies to better understand the association of multiple primary cancers and the duration of their occurrence. Keeping in view the current trends in dual malignancies and to further emphasize the importance of screening and follow?up diagnosis, we reviewed the records of patients who were diagnosed with dual malignancies. Material and Methods: This is a retrospective observational study. We collected data from the hospital database, of patients presenting with either histologically proven synchronous or metachronous double primaries between January 1, 2017, and December 31, 2021. The time interval to differentiate between synchronous and metachronous has been taken as 6 months. Results: During the period of five years, twenty?three patients presented with dual malignancy. Out of 23 cases, seven were synchronous (30.43%), and 16 were metachronous (69.56%). In the synchronous malignancy group, the most common site of first and second primary malignancy was breast [5 cases (71.4%) and 3 cases (42.8%), respectively]. In the metachronous malignancy group, the most common site of the first primary was breast (7 cases; 43.75%), followed by the head and neck (4 cases; 25%), and the most common site of the second primary was also the breast (6 cases; 37.5%), followed by the lung (5 cases; 31.25%). Conclusion: Second primary malignancies are not rare and can occur at any age. Regular follow?up and screening procedures by the treating oncologist can play a major role in early detection followed by appropriate treatment of second primary tumors.

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Background: The purpose of this study was to evaluate the dosimetric benefits of carotid?sparing IMRT (intensity?modulated radiation therapy) over 3DCRT (three?dimensional conformal radiation therapy) in early glottic cancer patients. Material and Methods: Ten patients with histologically proven early?stage squamous cell cancer of glottis (T1N0), treated with definitive radiotherapy, were selected retrospectively for the dosimetric analysis. Patients were originally treated with 3DCRT technique. For comparison purpose, IMRT plans were generated for each patient. Dosimetric comparison was done between two techniques (IMRT and 3DCRT) in terms of PTV (planning target volume) coverage, HI (homogeneity index), CI (conformity index), and doses to right carotid artery, left carotid artery, and spinal cord. Results: V95% for the PTV was higher in IMRT plans (98.26%) as compared to 3DCRT plans (95.12%) (P?value <0.001), whereas V105% for PTV was significantly higher in 3DCRT plans (16.77%) as compared to IMRT plans (0.32%) (P?value 0.11). In terms of both HI and CI, IMRT plans showed better conformity as compared to 3DCRT plans, with statistically significant difference. Both right and left carotid arteries’ average mean and maximum doses were significantly lower in IMRT plans as compared to 3DCRT plans (P?value <0.001). IMRT plans resulted in significant carotid?sparing as compared to 3DCRT plans in terms of V35 and V50 (P?value <0.001). Conclusion: Carotid?sparing IMRT resulted in better PTV coverage and lower carotid artery dose as compared to 3DCRT in early glottic cancer patients.

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Background: Head and neck cancers (HNC) are the malignant tumours of oral cavity, nasopharynx, oropharynx, hypopharynx, larynx and salivary glands. Incidence of HNC across the geographical area is highly variable and there is also variability in the management of these patients.Aim and Objectives: To study the demographic profile, sites involved, histopathological pattern and treatment response evaluation of HNC at SGRD Cancer Hospital, Amritsar. Material and Methods: This is a retrospective observational study conducted at Sri Guru Ram Das Cancer Hospital, Amritsar, Punjab. Data was collected retrospectively from the year 2018 to 2019. Only histopathologically confirmed cases of malignancies of head and neck were included in this study. Treatment response evaluation was done at 3 months post treatment using radiological imaging (RECIST1.1) Results: A total of 200 cases were included in the study. There were 163 (81.5%) males and 37 (18.5%) female patients. The most common site involved was found to be oral cavity (55%) followed by larynx (10.5%) and hypopharynx (10.5%). Squamous cell carcinoma (SCC) was the most common histopathology in all the HNC. After 3 months, post treatment, 69.50% patients were found to have complete response, 24.5% partial response, 4% progressive and 2% stable disease.Conclusion: This study reveals that prevalence and treatment outcome of HNC is almost uniform across India as was observed in other studies. This study also highlights the high prevalence of HNC in Punjab that entails the need for early detection, multimodality treatment approach and compliance of patients for better outcome.

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Background: Decreased amniotic fluid is related to adverse maternal and perinatal outcomes. The purpose of this study was to evaluate the role of amino acid infusion in patients of oligohydromnios and compare the perinatal outcome in the two groups.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, ASCOMS Hospital, Jammu for a period of one year from October 2017 to September 2018. A total of 50 women with AFI <8 cm were enrolled in the study . They were divided into two groups of 25 each. Group A were given amino acid infusion and Group B were not given any intervention. These were compared for increase in AFI and perinatal outcome.Results: In the present study, the gain in AFI in Group A was 2.32 ± 0.67 and in group B was 1.32 ± 1.03 which was statistically significant. The perinatal outcome was better Group A compared to Group B with decreased incidence of meconium stained liquor, low birth weight, low APGAR scores and NICU admissions and increase in vaginal deliveries as compared to caesarean sections.Conclusions: The present study suggests that parentral transfusion of amino acid in cases of oligohydromnios significantly increases the AFI of the patient and decreases the incidence of caesarean sections, meconium stained liquor, low APGAR scores and NICU admissions.

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Objective: To study whether introduction of an ‘antimicrobial justification form’ deters clinicians from prescribing restricted antimicrobials and results in de-escalation of these antimicrobials. Methods: Clinicians were asked to fill a justification form if prescribing an antimicrobial from the pre-identified restricted group. Antimicrobial usage pattern over next year was compared with that in the one year preceding the introduction of justification form. Results: Significant overall decrease in antimicrobial usage (40.5% vs 34.6%) was noted in the post-intervention group along with a significant increase in the de-escalation of antibiotics. Conclusion: Introduction of a justification form before prescribing antimicrobials or at the time of deferring de-escalation can be useful in restricting usage of antimicrobials

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Context and objective: The molecular characterization of local isolates of Toxoplasma gondii is considered significant so as to assess the homologous variations between the different loci of various strains of parasites. Design and setting: The present communication deals with the molecular cloning and sequence analysis of the 1158 bp entire open reading frame (ORF) of surface antigen 3 (SAG3) of two Indian T. gondii isolates (Chennai and Izatnagar) being maintained as cryostock at the IVRI. Method: The surface antigen 3 (SAG3) of two local Indian isolates were cloned and sequenced before being compared with the available published sequences. Results: The sequence comparison analysis revealed 99.9% homology with the standard published RH strain sequence of T. gondii. The strains were also compared with other established published sequences and found to be most related to the P-Br strain and CEP strain (both 99.3%), and least with PRU strain (98.4%). However, the two Indian isolates had 100% homology between them. Conclusion: Finally, it was concluded that the Indian isolates were closer to the RH strain than to the P-Br strain (Brazilian strain), the CEP strain and the PRU strains (USA), with respect to nucleotide homology. The two Indian isolates used in the present study are known to vary between themselves, as far as homologies related to other genes are concerned, but they were found to be 100% homologous as far as SAG3 locus is concerned. This could be attributed to the fact that this SAG3 might be a conserved locus and thereby, further detailed studies are thereby warranted to exploit the use of this particular molecule in diagnostics and immunoprophylactics. The findings are important from the point of view of molecular phylogeny. .

Contexto e objetivo. A caracterização molecular de isolados indianos de Toxoplasma gondii é importante para a investigação de variações genéticas existentes entre cepas do parasito em diferentes locos gênicos. Delineamento e disposição. A presente comunicação realizou a clonagem e o sequenciamento dos 1158 pares de base correspondendo à totalidade do quadro de leitura do antígeno de superfície 3 (SAG3) de Toxoplasma gondii em dois isolados indianos (Chennai e Izatnagar) mantidos em um biorrepositório localizado em IVRI. Método. As sequências do SAG3 dos dois isolados indianos foram clonadas, sequenciadas e posteriormente comparadas com sequências SAG3 de Toxoplasma gondii disponíveis em publicações. Resultados. A comparação das sequências revelou 99,9% de homologia com a cepa RH padrão; 99,3% de homologia com as cepas P-Br e CEP; e 98,4% de homologia com a cepa PRU. Os dois isolados indianos eram 100% idênticos no que diz respeito à sequência SAG3. Conclusão. Concluiu-se que os isolados indianos são filogeneticamente mais próximos da cepa RH em relação à cepa brasileira P-Br, ou às cepas CEP e PRU (USA). No entanto, a análise de outros genes de Toxoplasma gondii destes dois isolados indianos mostrou diferenças na composição de nucleotídeos, ao contrário do que foi encontrado para o locus SAG3. Estes resultados poderiam ser atribuídos ao fato do locus SAG3 ser altamente conservado, necessitando de estudos adicionais para determinar se SAG3 poderia ser utilizado no diagnóstico da toxoplasmose. No entanto, estes resultados são importantes do ponto de vista da filogenia molecular. .

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Objective: To compare histopathology and PCR based detection in diagnosis of experimentally induced toxoplasmosis of RH human strain of the parasite in murine models. Methods: A comparison of histopathology and PCR based detection was done to diagnose experimentally induced toxoplasmosis in ten inbred swiss albino mice after intraperitoneal inoculation of 100 tachyzoites of laboratory mantained human RH strain of the parasite. Tissue samples from lung, liver, spleen, brain, heart and kidney were taken and processed for histopathological examination while all the samples also were subjected to PCR, using primers directed to the multicopy of SAG 3 gene, in dublicates. Results: Histopathology revealed presence of tachyzoites only in liver while along with lung, liver, spleen and brain tissue yielded desired positive PCR amplicons. Conclusions: The SAG 3 based PCR is able to diagnose toxoplasmosis in those tissues which are declared negative by histopathological assay.

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OBJECTIVE@#To compare histopathology and PCR based detection in diagnosis of experimentally induced toxoplasmosis of RH human strain of the parasite in murine models.@*METHODS@#A comparison of histopathology and PCR based detection was done to diagnose experimentally induced toxoplasmosis in ten inbred swiss albino mice after intraperitoneal inoculation of 100 tachyzoites of laboratory mantained human RH strain of the parasite. Tissue samples from lung, liver, spleen, brain, heart and kidney were taken and processed for histopathological examination while all the samples also were subjected to PCR, using primers directed to the multicopy of SAG 3 gene, in dublicates.@*RESULTS@#Histopathology revealed presence of tachyzoites only in liver while along with lung, liver, spleen and brain tissue yielded desired positive PCR amplicons.@*CONCLUSIONS@#The SAG 3 based PCR is able to diagnose toxoplasmosis in those tissues which are declared negative by histopathological assay.

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Toxoplasma gondii, an apicomplexan parasite, is capable of infecting a broad range of intermediate warm-blooded hosts including humans. The parasite seems to be capable of altering the natural behavior of the host to favor its transmission in the environment. The aim of this study was to evaluate the course, alterations in behavior along with normal kinetics of the abnormally induced experimental acute toxoplasmosis in murine models. Ten Swiss albino mice were intraperitoneally inoculated with 100 virulent RH strain tachyzoites and finally, the alterations in behavior were described and compared with other known alterations in humans and animals. The behavior and the other symptoms of the acute toxoplasmosis were recorded. Such mice showed typical symptoms like normal coat, severe ascites with pendulous abdomen and tachypnoea exhibited by resting fore legs either on walls of the cage, or nozzle of water bottle or other resting mice and yielded a creamy colored cloudy natured peritoneal fluid on aspiration. Finally the alterations in behavior were described and compared with other known alterations in humans and animals. The study has generated some important data related to possible causes of behavioral alterations and generation of suitable strategies for control of these alterations in behavior vis-a'-vis better understanding of the effect of acute infection of parasite on normal behavior of infected intermediate host

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Resident doctors often resort to strikes for reasons concerning safety at the workplace, better working conditions, better remuneration, and policy issues such as caste-based reservations and appointments to institute positions . Although many articles have discussed whether or not physicians should resort to strikes, few have analysed the prevalence of strikes, their direct impact on healthcare delivery, and beneficial outcomes, if any, for physicians . We conducted a single centre retrospective study for analysing the same.

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Background: Smoking is the most important factor contributing to the development of chronic obstructive pulmonary disease and is one of the major health risks in modern times. Aim: The purpose of the present study was to determine the relationship between cigarette smoking and pulmonary function tests between various groups of smokers and non-smokers. Methods: The study was carried out in 100 male subjects between 19-52 years of age. The subjects were drawn from the community such that they could be grouped as non-smokers (25), mild smokers (25), moderate smokers (25), and chronic smokers (25) according to their questionnaire response. Pulmonary Function Tests were carried out in each subject with a computerized spirometer. The various data was collected, compiled, statistically analyzed and valid conclusions were drawn Results: Results indicate that smoking is generally associated with lower levels of pulmonary functions. . It was established that pulmonary functions decreased with increasing number of pack years. The negative association was evident in most lung functions and capacities, but was largest and most progressive in FEV1, FEV1/FVC, FEF25-75% and PEFR. Conclusion: Pulmonary function data in smokers indicate narrowing of smaller airways, chiefly bronchioles. Rapidly declining pulmonary functions in smokers with increasing number of pack years is predictive of increased risk of development of chronic obstructive pulmonary disease (COPD). The study observed that spirometry was an effective and easy method for detection of COPD in risk group population like smokers and thus promotes smoking cessation efforts to reduce the burden of COPD in the community.

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Pharmaceutical companies use a variety of strategies, including gifts, to influence physicians. In December 2009, the Medical Council of India amended the Code of Medical Ethics to ban medical professionals from accepting gifts from pharmaceutical companies. In view of this ban, it is important to find out the magnitude and contours of the problem amongst Indian medical professionals. We aimed to study, through an e-mail based survey, the attitudes and practices of young resident doctors and interns from two medical colleges of New Delhi regarding acceptance of gifts from the pharmaceutical industry. We e-mailed the questionnaire to 150 fresh graduates. We found that the majority of graduates agreed with existing guidelines: they accepted low cost gifts but considered expensive gifts unrelated to patient welfare unethical. Despite the low response rate, this study is important because data from India on attitudes and practices of medical professionals regarding gifts from the pharmaceutical industry are virtually non-existent.

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The simultaneous occurrence of hypodontia and supernumerary teeth in the same individual is termed 'concomitant hypo-hyperdontia'. There appears to be a correlation between concomitant hypo-hyperdontia and some syndromes, but this anomaly is very rare in the general population. Its etiology is still obscure. Very few cases have been reported in the literature of this condition. Presented here is a rare case of simultaneous presence of supernumerary teeth [distodens/retromolar] and missing teeth in a family

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The study involves the gross and microscopic examination of coronary arteries of 200 cases of all age groups brought to mortuary of Rajindra Hospital Patiala for post mortem from Malwa Region of Punjab. The study was carried out to find out prevalence, pattern, frequency and severity of atherosclerotic changes in coronary arteries. The study was conducted in the department of Forensic Medicine and Department of Pathology Government Medical College Patiala.