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Aim: To assess alteration in the protein levels of major organs and induction of micronuclei in the freshwater fish, Channa punctatus following exposure to chlorpyrifos, while also investigating the potential mitigating effects of extracts from Melissa officinalis and Mentha piperita on the adverse impacts induced by this pesticide. Methodology: Two weeks of acclimatized healthy fish were divided into four different groups. Group G1 served as the control group, while G2 contained chlorpyrifos (LC50/10, 96 hr). Group G3 was exposed to chlorpyrifos (LC50/10, 96 hr) along with 8 mg l-1 of Melissa officinalis ethanolic extract, and similarly, G4 contained chlorpyrifos (LC50/10, 96 hr) along with 8 mg l-1 ethanolic extract of Mentha piperita. Sampling was conducted over various durations of 7, 14, 21, and 28 days. The ethanolic extracts of Melissa officinalis and Mentha piperita were used as remedial compounds as they are rich in several bioactive compounds, primarily polyphenols. Results: The investigation revealed a notable decrease in the total protein content of kidney, liver, gills and muscles following exposure to chlorpyrifos after each sampling duration. While, upon exposure to remedies containing the ethanolic extracts of Melissa officinalis and Mentha piperita, the protein levels exhibited a significant recovery (p < 0.05) in a duration-dependent manner, compared to the control group. This suggests a promising ameliorative capability of Melissa officinalis and Mentha piperita against chlorpyrifos toxicity. Further, the induction of micronuclei by chlorpyrifos and their subsequent recovery through the application of phytoextracts Melissa officinalis and Mentha piperita displayed a similar pattern, indicating the potential protective effects of these extracts against chlorpyrifos-induced genotoxicity. Interpretation: It is plausible to conclude that standardized doses of Melissa officinalis and Mentha piperita hold the potential to enhance aquaculture practices and safeguard fish production in agriculturally contaminated water bodies. These findings emphasize their valuable contribution in sustaining fish health amidst toxic environments.
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Aim: The aim of this study was to investigate the effects of Environmentally Relevant Concentration of Copper (ERCC) on anti-oxidant defense machinery and genotoxicity as well as their ultimate threats on the liver of Channa punctatus. Methodology: After acclimatization, fish were categorized into four separate groups. Group I served as control Group, while II, III and IV were exposed to ERCC, 10% and 20% increase in ERCC (0.85 mg l-1, 0.935 mg l-1 and 1.02mg l-1, respectively) for 15, 30, 45 and 60 days. Post-completion of stipulated exposure period, oxidative stress, DNA damages and hepato-architectural modifications were assessed. Results: The activities of Superoxide dismutase, catalase, glutathione reductase, and lipid peroxidation were enhanced, while glutathione level decreased significantly (p<0.05) with elevated levels of reactive oxygen species in a dose-dependent manner. Micronuclei induction and COMET assay confirmed the genotoxic potential of ERCC. Elevated levels of serum glutamic oxaloaceticacid transaminase, glutamic pyruvate transaminase and alkaline phosphatase along with the distorted liver architecture validated hepato-toxicity. Interpretation: Fish are prone to toxicity at ERCC. Further increase by 10% or 20%, would be hazardous to fish, and eventually to humans at various tropic levels.
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Background & Objectives: Pyoderma is defined as any purulent skin disease and represents infections in epidermis and dermis including hair follicles. Thus, this study was conducted to find out incidence and bacteriological profile of pyodermas as well as to determine their antibiotic susceptibility test of isolated bacteria. Materials and Methods: The samples were collected in dermatological OPD and sent the collected samples immediately to bacteriology laboratory for culture and sensitivity tests from December 2018 to May 2019 A.D. Antimicrobial susceptibility testing was done using Kirby–Bauer disc diffusion method and the results were interpreted according to the CLSI guidelines. Quality control of the test was done by standard ATCC strains of S.aureus (ATCC 25923), E.coli (ATCC 25922). Results: The incidence of pyoderma was 3.24%. Maximum cases were detected in the age group below 13 years of age. Primary pyoderma (61.8%) was more frequent when compared to secondary pyoderma (38.2%). The highest number of organism isolated was S. aureus (24.7%) from different cases of pyoderma followed by E. coli (8.2%), CONS (6.1%) and Klebsiella pneumoniae (5.1%) whereas other organisms were found in less number. Gram positive bacteria mainly S. aureus and other isolates for the cause of pyoderma were mostly resistant to penicillin (100%), ciprofloxacillin (75.0%) and clindamycin (79.2%). Gram negative E. coli (8.2%) was second most bacterial isolates and others GNB isolates were (14/63) where resistance pattern were seen more (75.0%) in each ceftrixone and imipenem. Conclusion: Incidence of pyoderma was low among the patients visiting to the Dermatology Department. Antibiotic resistance is increasing day by day; therefore, routine culture and sensitivity tests are essential to guide proper treatment procedure.
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Total pulses area in Uttar Pradesh, contributes of pulses through the Bundelkhand region, more than half but the productivity is low because lack of technological approaches for pulse growing area. This review paper assessed the cultivation of pulses production, productivity and area, of Bundelkhand and in India also. The technologies and infrastructure need to be accepted pulses cultivation and accurate policies for the farmers through government. Pulses are next to cereals regarding their nutritional and economic significance to human health. The pulses crop highly water sensitive like chickpea, lentil, mung bean and black gram are dominant in drought prone areas and improve soil fertility by fixing atmospheric nitrogen. Rainfed Agriculture has emerged as an opportunity in raising pulse production which is depend on amount and distribution of rainfall growing area. The cropping system of pulses cultivation year-after-year has observed that incidence of disease, insect-pests and weeds increase in Bundelkhand region. In pigeon pea, chickpea and lentil crops, important biotic agent for affecting production. United Nations declared 2016 ' "International Year of Pulses" was to increase production and consumption of pulses 10% by 2025 and raise public awareness towards health through social media. The many initiatives schemes govern by government of India for increase the pulses growing area and production such as ISOPOM (Integrated Scheme of Oilseeds, Pulses, Oil palm and Maize) (2004-05 to 2009-10), NFSM Pulses (National Food Security Mission, 2007-08), for Technology demonstration. The Bundelkhand regions as 5 lakhs farmers of 14 districts of two states of Madhya Pradesh and Uttar Pradesh should be linked with Rani Lakshmi Bai Central Agricultural University (RLBCAU) and benefited from this university to produce pulses.
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A field experiment entitled “Effect of foliar application of borax and zinc sulphate on growth, yield and quality of guava (Psidium guajava L.) cv. Gwalior-27” was carried out at Agrotechnology Park, Krishi Vigyan Kendra, College of Agriculture, Gwalior (M.P.) during 2016-2017. The experiment was consisting of 9 treatments having two levels of each Borax (0.2 per cent and 0.4 per cent) and Zinc sulphate (0.4 and 0.6 per cent). The experiment was laid out in Factorial randomized block design with three replications. Among different doses of foliar spray of nutrients, Zinc sulphate @ 0.6 (T5) were found significantly superior over control with respect physiological loss in weight (g) and shelf life of guava. While the minimum spoilage % was recorded with treatment B2Z2 (Borax@ 0.4% + ZnSo4@ 0.6%) at 5th, 10th and 15th day of storage respectively.
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Bleeding is a lesser-known complication of rectal self-expandable metal stents (SEMS). Most of these bleedings are self-limiting. Life threatening bleeding as a complication of SEMS reported only rarely. In the present paper, we are reporting a rare case of near fatal intraluminal bleeding from rectal SEMS. Traumatic pseudoaneurysm formed in superior rectal branch of the inferior mesenteric artery because of pressure induced by rectal stent. Severe bleeding leads to haemorrhagic shock. Patient was stabilized and angioembolization of pseudoaneurysm with superior rectal branch of inferior mesenteric artery was done. Bleeding stopped post procedure and patient discharged in stable condition. This case presentation highlights the fact that we should decide management strategy for a patient in multidisciplinary meeting and utilize the available resources in best possible ways. Though rectal stents are good alternatives, they have their own set of complications. These should be considered while deciding strategy for the upfront stoma versus rectal stent. For cases as in this article upfront stoma may have avoided the associated complication.
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Oligohydramnios is a rare condition characterised by decreased amniotic fluid volume for gestational age. To determine the causes and effectiveness of oligohydramnios treatment in oligohydramnios pregnant women. We conducted a prospective and observational study at GMH (Government Maternity Hospital) in Hanamkonda over a period of 6 months. We included 203 oligo patients in this study and in which patients were grouped as 3 categories based on amniotic fluid index (AFI) as mild, moderate, severe. Information of the patients were collected from patient case reports and face to face interactions. The data was analysed through EXCEL. From our study we can conclude that oligohydramnios treatment is showing improvement in mild, moderate and severe oligohydramnios patients. But patients with uncontrolled hypertension were not showing liquor improvement because of their decreased placental perfusion. Gestational diabetes and thyroid do not cause oligohydramnios in pregnancy condition.
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Background: Diabetes mellitus is characterized by rise in the level of glucose concentration. Diabetes increases the risk of heart attack by four times in women and two times in men. An attenuated HRR immediately after exercise is considered an index to identify silent autonomic dysfunction. Individuals with low values for HRV and HRR present a higher risk of cardiovascular outcome. Methods: 50 diabetic participants with a mean age of 54.52 and SD±8.63 years. All the participants were assessed for heart rate and blood pressure before the assessment and after the 3-minute YMCA step test. Post test heart rate was assessed immediately after 1, 2 and 3 minutes. Heart rate recovery was calculated by subtracting heart rate immediately after 3 minutes of test to heart rate after 1 minute. Results: 50 diabetic women with the mean age of 38.96 and SD±9.36, the age ranged from 20 to 50. The resting heart rate mean was 98.08 and standard deviation was ±9.82. Mean and SD of heart rate immediately after 3 minutes was 142.66 and SD was ±8.05 and after 1 min was 130.86 and ±7.84 respectively. The heart rate recovery mean was 11.8 and SD was ±4.25. Conclusions: Study concluded heart rate recovery is delayed in diabetic women and it is associated with increased risk of cardiovascular disease.
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Background: Worldwide, the population of elderly people is constantly increasing. Elderly population is at risk of under nutrition due to age related physical, cognitive, functional decline and lack of financial support. Malnutrition contributes to decline in health status, increased utilization of healthcare services and increased mortality. Aim of this study was to assess nutritional status of the elderly by MNA and to find association between nutritional status and socio- demographic profile of elderly. Methods: After ethical approval, a community based cross sectional study was conducted among elderly people residing at Mandawar village, rural field practice area of JMC, Jhalawar during August to October 2022. Complete enumeration technique was used to enrolled participants in study. Door to door household survey was conducted using predesigned questionnaire. Nutritional status was assessed by using standard mini nutritional assessment questionnaire. The data was analyzed through SPSS28.0 (trail version). Results: Out of 287 elderlies, 139 (48.4%) were male and 148 (51.6%) were female. According to MNA, 73 (25.4%) were found malnourished while 119 (41.4%) were at risk of malnutrition and 95 (33.1%) were well nourished. A statistically significant (p<0.05) association was found between nutritional status with increasing age, gender, marital status, education, occupation, morbidity, financial dependance and substance abuse. Conclusions: This study showed that malnutrition has multidimensional background. So, to improve nutritional status of elderly approach should be focus on those who are older, illiterate or low educational status, female gender and financially dependance.
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Background: The study aimed to get drug utilization pattern using WHO prescribing indicators in pediatric patients. Methods: It was an observational prospective study carried out in pediatric in-patients with a sample size of 280 patients based on inclusion, and exclusion criteria for a period of 6 months. The study data were collected using patient case record and analysis was done. Results: Out of 280 patients data collected, majority of patients were in the gender male category 168 (60%) and many were from the age group of early childhood (1-5 years) 126 (45%). Respiratory tract infections were the major diagnosis made among the sample size. The drug class commonly prescribed were oral antibiotics 261 (28.38%). The average number of drugs per prescription were 3.28%. Among the total number of prescription percentage of drugs prescribed by generic name and antibiotics were 2.7%, 76.07%. Percentage of patients prescribed with injection were 79.28%. Conclusions: This study highlights WHO prescribing core indicators in evaluating the usage of rational prescription. It helps in reinforcing rational prescribing practices and increases awareness among physicians and medical students. Irrational prescriptions may result in harmful events. A rational prescription should follow the standard treatment guidelines of WHO. The assessment of these indicators can also help us to decrease the cost burden on the patient. Continuous education with focus on rational drug usage and evidence-based medicine can further increase the understanding and improves health care policies.
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Background: The study aimed to get drug utilization pattern using WHO prescribing indicators in pediatric patients. Methods: It was an observational prospective study carried out in pediatric in-patients with a sample size of 280 patients based on inclusion, and exclusion criteria for a period of 6 months. The study data were collected using patient case record and analysis was done. Results: Out of 280 patients data collected, majority of patients were in the gender male category 168 (60%) and many were from the age group of early childhood (1-5 years) 126 (45%). Respiratory tract infections were the major diagnosis made among the sample size. The drug class commonly prescribed were oral antibiotics 261 (28.38%). The average number of drugs per prescription were 3.28%. Among the total number of prescription percentage of drugs prescribed by generic name and antibiotics were 2.7%, 76.07%. Percentage of patients prescribed with injection were 79.28%. Conclusions: This study highlights WHO prescribing core indicators in evaluating the usage of rational prescription. It helps in reinforcing rational prescribing practices and increases awareness among physicians and medical students. Irrational prescriptions may result in harmful events. A rational prescription should follow the standard treatment guidelines of WHO. The assessment of these indicators can also help us to decrease the cost burden on the patient. Continuous education with focus on rational drug usage and evidence-based medicine can further increase the understanding and improves health care policies.
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Background & Objectives: The COVID-19 pandemic has presented the world community with its greatest challenges so far. Paramedics play a crucial role in providing pre-hospital care to patients who require urgent medical attention in clinical settings. Therefore, the aim of the study was to evaluate the knowledge on COVID-19 among health assistant (HA) students studying in different paramedical colleges in Janakpurdham. Material and Methods: A descriptive cross-sectional study was performed utilizing a structured questionnaire to acquire responses from HA Students studying in different colleges of Janakpurdham in the months of April and May 2022. Descriptive analysis was applied to calculate the frequencies and proportions. A p-value less than 0.05 were considered as significant. Results: Out of total 360 students, 280 were enrolled. The majority of students were under 20 years old. All of the students were aware of the COVID-19 infection at National Human Resource Development Academy (NHRDA) and Mithila Technical Academy (MTA) colleges, with the exception of 3.61% Care Medical Center (CMC) students. A large percentage of students (52.80% boys , 47.19% girls) responded that the respiratory tract is the primary route by which COVID-19 infections are spread, followed by the students from NHRDA and CMC. Most of the students from all colleges received satisfactory scores on the COVID-19 knowledge test. There was negative association of score of knowledge between 1st, 2nd and 3rd year students of CMC and MTA (p=0.96 and p=0.11) respectively. However, there was positive association of score of knowledge between 1st, 2nd and 3rd year NHRDA students (p=0.01). Conclusion: The majority of college students studying at different colleges had satisfactory knowledge, while a moderate number of students had poor and just a few had good knowledge scores on the COVID-19. In order to increase knowledge, various kinds of strategies, regulations, and initiatives should be accomplished and implemented effectively throughout the lower to higher level education.
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Objective: To evaluate the association of tumor budding (TB) with prognostic histomorphological parameters in oral squamous cell carcinoma (OSCC) and to investigate the correlation of TB intensity with epithelial to mesenchymal transition (EMT). Material and Method: A total of 200 cases diagnosed as OSCC were selected and their TB status was reviewed using Hematoxylin and eosin (H and E) and Immunohistochemistry (IHC). Correlation with histomorphological prognostic parameters was done. Also, IHC for Vimentin and E-cadherin was performed to look for EMT. Results: On H and E examination, TB was observed in 154/200 (77%). About 88/154 (57.14%) cases showed a high TB (>5 TB/10 hpf) which increased to 100/154 (64.9%) cases on IHC staining. The intensity of TB was significantly associated with tumor grade and depth of invasion. It was also significantly associated with reduced expression for E-Cadherin and upregulation of Vimentin establishing a pathogenetic correlation between the TB and EMT. Conclusion: Therefore, our results suggest that TB is associated with poor prognosis and histologically represents EMT in OSCC which further adds to the aggressiveness of the tumor.
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Background: Epithelial-mesenchymal transition (EMT) is the heart of invasion. EMT associated with cancer progression and metastasis is known as type III EMT. Beta-catenin, E-cadherin, and MMP9 markers of EMT are routinely employed for diagnostic purposes. Aims: We employed these markers to study EMT by immunohistochemistry (IHC) in gall bladder cancer (GBC) with respect to depth of tumor invasion, clinical outcome, and disease-free survival. Settings and Design: This was a prospective case-control study. Material and Methods: Seventy gall bladders were included (50 GBC and 20 CC). After detailed histology, immunoexpression was studied in terms of percentage and strength of expression. Statistics Analysis Used: Expression was compared between CC and GBC by Student t test and analysis of variance. Kaplan–Meier was used for survival analysis, and the extent of agreement (“Kappa”) was calculated. Results and Conclusions: The age of incidence of GBC was 49.40 (+11.6) years with female predominance (F:M = 4:1). In 88% (44/50) of GBC, the fundus was involved. Moderately differentiated adenocarcinoma was most frequent [54%; 27/50]. Significant downregulation of E-cadherin (P = 0.022) and beta-catenin (P < 0.001) and upregulation in MMP9 (P < 0.001) were seen in GBC with respect to CC with significant association among them. MMP9 expression was significantly associated with higher tumor stage but with chemotherapeutic response. Our results display that epithelial-mesenchymal transition type III plays a role in GBC invasion. MMP9 overexpression and loss of membranous beta-catenin may be considered a marker for poor clinical outcomes and advanced disease.
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Background: Personality traits along with well-known factors like socioeconomic status and cognitive ability, predict important life outcomes such as health and lifespan, educational and occupational attainment, and may promote specific types of task effectiveness, which occurs in part via the processing of information. Reaction time provides an indirect index of the central nervous system’s integrity and processing ability. Material and Methods: The 111 healthy subjects (aged 17 -23 years) interviewed to pre-designed proforma regarding socio-demographic profile, “Glazer-Stress Control Lifestyle” questionnaire for personality trait and reaction time recorded by “Audio-Visual reaction time apparatus”. Statistical analysis was done using IBM SPSS Statistics 20, and the P-value <0.05 was considered significant. Results: The mean age of the study participants was 19.21±1.40 years, with a mean body mass index 20.65±4.32 kg/m2. Male subjects (68%) outnumbered the female participants (43%), and more than half of the subjects doing exercise. The nuclear family was the preferred mode of living belonging to class-II socioeconomic status (86%). The association of personality traits with auditory (low and high frequency) and visual (red and green light) reaction time was non-significant. Type-A personality subjects were maximum (13/20th), followed by Type-AB (6/20th) and least of Type-B personality (1/20th). Conclusion: The personality trait has no impact on auditory and visual reaction time. Though maximum participants belong to type A personality, still ambitious, proactive, and competitive nature does not influence the basic neurophysiological characteristics of the human body.
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Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full?text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India.
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Background: High-grade pelvic serous carcinoma is a common cause of death in women worldwide and India. Recent evidence has clearly implicated the changes in the mucosa of the fimbrial end of the fallopian tube in its pathogenesis. Objective: 1) To study histopathology features of surgically resected specimens of fallopian tubes received with non-neoplastic lesions of the uterus and ovary for the presence of any precursor lesions [secretory cell outgrowth (SCOUT), serous tubal intraepithelial lesion (STIL), p53 signatures, and serous tubal intraepithelial carcinoma (STIC)]. 2) To confirm the findings with immunohistochemistry. 3) To correlate the prevalence of precursor lesions with clinical parameters and benign lesions of the uterus and ovaries. Materials and Methods: Assessment of histopathological changes in 100 specimens of distal fallopian tubes was done using the sectioning and extensive examination of the fimbrial end (SEE-FIM) protocol. H and E stain followed by immunohistochemistry for Bcl-2, p53, and Ki-67. The statistical significance of the difference in the mean values of precursor areas was evaluated by an unpaired t-test. Results: Among 100 specimens taken on H and E, precursor lesions were suspected in 49% of the cases. SCOUT, suspicious for STIC, suspicious for STIC with areas of SCOUT, and unequivocal for STIC with areas of SCOUT were seen in 8%, 4%, 33%, and 4% of the cases, respectively. However, on IHC, SCOUTS were confirmed in 45% of the cases, p53 signature in 2%, STIL in 9%, and STIC in 4% of the cases. Conclusion: Sectioning and extensive examination of the fimbrial end (SEE-FIM) should be routinely done as it provides the opportunity to detect the early malignant changes. It may help in evolving the strategies for early detection, management, and reducing mortality.
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Background: Anaemia continues to be a major public health concern in the country owing to varied dietary practices, socio-demographic and cultural influencers. Poor nutrition as a principal underlying factor is less explored among the adolescents among the high focus states in India. Objectives: To study the dietary diversity i.e., food habits, preferences, frequency of food consumption among adolescents and its association with anaemia. Material and Methods: This cross-sectional study, from a baseline adolescent health survey (November 2017 – March 2018) included 3213 adolescents (10-19 years). The participants were selected using multi-stage stratified random sampling technique from 6 districts of Madhya Pradesh. Data collection was done by filed investigators through paperless real time method that included sociodemographic details, anthropometric measurements, haemoglobin food frequency questionnaire. Results: The most common daily consumed food items were cereals, tea and pulses by adolescents. Overall prevalence of anaemia was 1715 (53.4%). Those consuming occasional fruits, green non leafy vegetables, red and yellow vegetables, roots and tubers and milk products were at higher risk of developing anaemia compared to other food items regularly. Conclusion: Although association exists between occasional consumption of certain food groups, their temporal relationship needs to be established.
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Background: The Internet is an inevitable part of life especially in the education sector, but at the same time irrational use of the Internet causes behavioral disorders. A high number of personality disorders such as impulsive behavior, depression, anxiety, and stress were also observed among medical students. Aim and Objectives: Hence, the present study hypothesized to find out the association of depression, anxiety, and stress with Internet addiction (IA) among young medical students. Materials and Methods: A cross-sectional survey was conducted among 250 1st-year medical students after taking ethics approval and written informed consent. Personal information and socio-demographic profile of participants were obtained. Young IA Test and Depression Anxiety Stress Scale (DASS-21) survey questionnaire was self-administered by participants. To identify the risk and protective factors for IA with DASS-21 step-wise multiple linear regression analyses were performed. Results: The prevalence of IA was 24.0 % with mean scores (±Standard Deviation [SD]) of 39.01 (±16.99) among the medical students. Depression, anxiety, and stress mean scores (±SD) were 5.44 (±4.21), 4.94 (±3.84), 6.77 (±3.83), respectively. Students with IA had a statistically significant difference (P = 0.001) in all domains of DASS-21 over the non-internet addicted. A statistically significant positive relationship of IA with depression (coefficient of determination (R2), (R2 = 0.22)), anxiety (R2 = 0.26), and stress (R2 = 0.33) were observed. Conclusions: 1/4th of the medical students were internet-addicted and 3.0% having severe anxiety. 22.0% of depression, 26.0% of anxiety, and 33.0% of stress among young medical students are attributable to IA. The rational use of the internet should be learned for psychological health and well-being.
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An estimated ratio (i.e., 1 in 10) babies are born too early every year. Roughly 1 million children die each year due to impediments raised pertaining to preterm birth. One such extreme preterm male baby was presented in the neonatal care unit with respiratory distress and grunting. Baby was confirmed to have ventricular septal defect along with patent ductus arteriosus and craniosynostosis which was treated with medications and surgical managements. He was also engaged with various prophylactic and empirical antibiotic therapies to cover the microbial growth. The most disturbing stage here was the appearance of liver mass sizing 5.8 cm × 1.3 cm accompanied with area of necrosis, diagnosed with hepatoblastoma which was evident with the aid of ultrasound. Hence, chemotherapy was commenced which was in accordance with Societe Internationale d Oncologie Pediatrique Epithelial Liver Tumor Study Group-3. Although the existing comorbidities haunted the baby for a long time, he finally made it successfully to get into track by fighting all the hurdles bravely, which was a sheer miracle. Along with the clinicians/surgeons, we Clinical Pharmacists worked hand in hand to ensure the baby to be receiving optimized drug regimen keeping in mind the risk-benefit ratio.