Bacterial Isolates Of The Respiratory Tract Infection And Their Current Sensitivity Pattern Among Patients Admitted In Tertiary Care Hospital.

Background & Objectives: This study was aimed to observe the susceptibility pattern of bacterial isolates from respiratory tract infection (RTI). Respiratory tract infection is considered as one of the major public health problems and a leading cause of morbidity and mortality in many developing countries. Respiratory tract is the part of the human system that plays a vital role in breathing processes. In human, the respiratory system can be subdivided into an Upper respiratory tract and a Lower respiratory tract based on anatomical features. The respiratory tract is constantly exposed to microbes due to the extensive surface area. The present study was conducted retrospectively for a periodMethods: of one year November 2021 to October 2022. All respiratory specimens included Sputum, BAL, throat swab; endotracheal aspirate specimens were collected aseptically from patients and cultured on the appropriate bacteriological media (Blood agar, MacConkey agar & Chocolate Agar). Bacterial isolates were identified by biochemical tests and antimicrobial susceptibility performed by standard methods as per CLSI 2022. 152Results: (72.3%) of total 210 samples were positive for bacterial culture. 126 (82.8%) were gram negative bacilli (GNB) and 26 (17.1%) were gram positive cocci (GPC). The predominant pathogen isolated was K. pneumoniae 46 (30.2%) followed by Escherichia coli 28 (18.4%).The overall susceptibility of GNB was highest towards Imipenem, Meropenem followed by Piperacillin tazobactam and Amikacin. Gram positive organisms exhibited highest susceptibility towards Vancomycin and Linezolid. Imipenem is the most sensitive antibiotic followed by Piperacillin tazobactamConclusion: and Amikacin which can be used for empirical therapy for respiratory tract infections (RTI). The antibiotic therapy should be modified as per the culture and sensitivity report. Regular determinations of the type of bacterial pathogens and updation of antibiogram must be followed in every institution to aid in better patient management by helping the clinician in the judicious use of antibiotics.

Evaluation of Diaphragmatic Thickness and Dysfunction by Ultrasonography in Mechanically Ventilated Children for Assessment of Extubation Success

Objectives: This study aimed to evaluate diaphragm thickness (DT) and diaphragmatic thickening fraction (DTF) in mechanically ventilated children, and study the association of these measurements with extubation success. Methods: Consecutive children aged one month to 18 years, who required mechanical ventilation (MV) for more than 24 hours at our institution, were enrolled between April, 2019 to October, 2020. Ultrasonographic measurements of DT were documented, and DTF was calculated from baseline (within 24 hours of MV) until 14 days of MV, and up to three days post-extubation. Results: Of the 54 childrenenrolled, 40 underwent planned extubation trial, of which 9 (22.5%) had extubation failure. Pre-extubation and post-extubation DTF between children in extubation-success and extubation-failure groups were comparable (P=0.074). There was no significant difference in the diaphragm atrophy rate between the two groups (P=0.819). Binary logistic regression showed significantly decreased probability of successful extubation with total ventilation duration (P=0.012) and mean DTF% before extubation (P=0.033). Conclusion: Despite evidence of diaphragmatic atrophy in critically ill children receiving mechanical ventilation, there was no significant difference in DTF between extubation success and failure groups.

Point-of-Care Thoracic Ultrasound in Children with Bronchiolitis

Objective To characterize thoracic (lung and diaphragm) ultrasound fndings in children<2 y with bronchiolitis, evaluate correlation between lung ultrasound severity score (USS) and bronchiolitis severity score (BSS), and study the interobserver agreement of USS between study pediatrician and radiologist. Methods In this prospective observational study, thoracic ultrasound was performed on children with bronchiolitis by the study pediatrician and USS score was assigned. A radiologist blinded to all clinical information, performed an independent thoracic ultrasound. Demographics, clinical course, and other relevant details were recorded. Results Fifty-three children were enrolled; 29/53 patients (54.7%) were classifed as mild bronchiolitis and 24/53 (45.2%) had moderate bronchiolitis as per clinical score; 13.2% (7/53) patients had both anterior and posterior subpleural consolidation and went on to require higher respiratory support either in the form of continuous positive airway pressure in 71.4% (5/7), oxygen for>24 h in 14.2% (1/7), or heated humidifed high-fow nasal cannula in 14.2% (1/7). These results were statistically signifcant (p<0.001). A statistically signifcant correlation was found between the USS and type and duration of respiratory support (p value 0.002) and with the mean duration of hospital stay (p value<0.001). There was signifcant correlation between the BSS and USS (p<0.001). There was a very good agreement between the ultrasound fndings of study pediatrician and radiologist (kappa 0.83). Conclusion The fndings of lung ultrasound (LUS) are not specifc for bronchiolitis. However, LUS can be used as a good prognostic tool in patients with bronchiolitis.

The economic and social costs of visual impairment and blindness in India

Purpose: To provide a current estimate of the economic and social costs (or welfare costs) of visual impairment and blindness in India. Methods: Using evidence from the recently conducted Blindness and Visual Impairment Survey across India, the Lancet Global Health Commission on Global Eye Health and other sources, we developed an economic model that estimates the costs of reduced employment, elevated mortality risk, education loss for children, productivity loss in employment, welfare loss for the unemployed, and caregiver costs associated with moderate and severe visual impairment (MSVI) and blindness. Probabilistic sensitivity analyses were also conducted by varying key parameters simultaneously. Results: The costs of MSVI and blindness in India in 2019 are estimated at INR 1,158 billion (range: INR 947–1,427 billion) or $54.4 billion at purchasing power parity exchange rates (range: $44.5–67.0 billion), accounting for all six cost streams. The largest cost was for the loss of employment, whereas the the second largest cost was for caregiver time. A more conservative estimate focusing only on employment loss and elevated mortality risk yielded a cost of INR 504 billion (range: INR 348–621 billion) or $23.7 billion (range: $16.3–29.2 billion). Conclusion: Poor eye health imposes a non?trivial recurring cost to the Indian economy equivalent to 0.47% to 0.70% of GDP in the primary scenario, a substantial constraint on the country’s growth aspirations. Furthermore, the absolute costs of poor eye health will increase over time as India ages and becomes wealthier unless further progress is made in reducing the prevalence of MSVI and blindness

An investigation of the efficacy of di fferent statistical mod els in malaria forecasting in the semi-arid regions of Gujarat, India

Background & objectives: Robust forecasting of malaria cases is desirable as we are approaching towards malaria elimination in India. Methods enabling robust forecasting and timely case detection in unstable transmission areas are the need of the hour. Methods: Forecasting efficacy of the eight most prominent statistical models that are based on three statistical methods: Generalized linear model (Model A and Model B), Smoothing method (Model C), and SARIMA (Model D to model H) were compared using last twelve years (2008–19) monthly malaria data of two districts (Kheda and Anand) of Gujarat state of India. Results: The SARIMA Model F was found the most appropriate when forecasted for 2017 and 2018 using modelbuilding data sets 1 and 2, respectively, for both the districts: Kheda and Anand. Model H followed by model C were the two models found appropriate in terms of point estimates for 2019. Still, we regretted these two because confidence intervals from these models are wider that they do not have any forecasting utility. Model F is the third one in terms of point prediction but gives a relatively better confidence interval. Therefore, model F was considered the most appropriate for the year 2019 for both districts. Interpretation & conclusion: Model F was found relatively more appropriate than others and can be used to forecast malaria cases in both districts.

Intrinsic Capacity of Rural Elderly in Thar Desert using World Health Organization Integrated Care for Older Persons Screening Tool: A Pilot Study

Integrated Care for Older Persons (ICOPE) screening tool helps to address declines in physical and mental capacities in older people. In India, majority of the older population resides in rural areas and there is a paucity of studies that demonstrates the utility of the ICOPE screening tool in India. Thus, a cross-sectional study was conducted to demonstrate the feasibility of using the World Health Organization ICOPE screening tool in a rural population. Comprehensive geriatric assessment of intrinsic capacity revealed cognitive decline in 31.5% (n = 142) participants, diminished mobility 52.1% (n = 235) participants, eye problems in 49.4% (n = 223) participants, and hearing loss in 68.3% (n = 308) participants. Gender difference was statistically significant with mobility limitation (P = 0.005; ?2 = 7.95) and feeling of pain (P = 0.001; ?2 = 15.64), being more in females than males. This tool seems suitable in identifying the intrinsic capacity of the rural elderly.

Assessment and comparison of distal radial artery diameter in anatomical snuff box with conventional radial artery before coronary catheterization

Background: The distal radial artery (dRA) approach at anatomical snuff box has gained attention of the interventional cardiologist in last few years. The procedural success rate by this novel approach depends on size of the radial artery and therefore the study was planned to study the size of distal radial artery. Methods: Total of 1004 patients of >18 years of age undergoing coronary catheterization were included in the study. The vessel diameter was measured from media to media in the anatomical snuff box a day prior to coronary catheterization. Results: The mean diameter of right radial artery at conventional access site was 2.56 ± 0.35 mm and at distal access site 2.23 ± 0.39 mm (p < 0.001). Females had significantly smaller radial artery diameter as compared to males at right conventional access site (2.42 ± 0.36 mm vs 2.60 ± 0.34 mm; p < 0.001) and distal access site (2.09 ± 0.38 mm vs 2.27 ± 0.39 mm; p < 0.001). The diameter of the right dRA was not significantly correlated with age (r2 linear ¼ 0.002, p ¼ 0.0475) but was positively correlated with height and weight (r2 linear ¼ 0.076, p ¼ <0.001 and r2 linear ¼ 0.005, p ¼ <0.001) and negatively correlated with BMI (r2 linear ¼ 0.076, p ¼ 0.519). Conclusions: This study has shown the size of right dRA 2.27 þ 0.39 mm in males and 2.09 þ 0.38 mm in females. Diabetes, hypertension, height and weight are important predictors of dRA diameter

Hindi Translation and Validation of Childhood Asthma Control Test (C-ACT)

Objective: Hindi translation and validation of the Childhood Asthma Control Test (C-ACT). Methods: Children aged 5-11 years with newly diagnosed asthma were enrolled and followed every 4-weeks for 12 weeks. Asthma control was assessed with C-ACT and Global Initiative for Asthma (GINA) criteria. Results: 60 children (34 boys, 56%) were enrolled. C-ACT showed a statistically significant correlation with GINA criteria at all visits. Cronbach’s alpha to assess the internal consistency was 0.74, and the intraclass correlation coefficient to measure test-retest reliability was 0.83. The maximum area under the curve (AUC) for C-ACT was 0.95 (95% CI: 0.89-1.0; P<0.001). At a cutoff score of ?20, the sensitivity, specificity, positive predictive value, and negative predictive value of C-ACT were 97.9%, 25%, 88.7%, and 87.5%, respectively. Conclusions: Hindi version of the CACT score is valid, reliable, and correlates well with the GINA criteria for asthma control in children. It has a high sensitivity at a cutoff score of ?20, but the specificity was poor in differentiating asthma control.

Green synthesis and characterization of iron oxide nanoparticles using Coriandrum sativum L. leaf extract

Green nanoparticle synthesis is a promising, eco-friendly and safe approach. In the current study, Iron oxide nanoparticles (FeONPs) were synthesized using aqueous leaf extract of Coriandrum sativum L. Further, the characterization of synthesized FeONPs was performed using ultraviolet-visible spectroscopy, transmission electron microscopy (TEM), dynamic light scattering (DLS), vibrating sample magnetometer (VSM) and differential scanning colorimetry (DSC). The surface plasmon resonance effect confirmed the synthesis of FeONPs. Dynamic light scattering (DLS) revealed mean particle size of FeONPs around 163.5 and polydispersity index 0.091 with a zeta potential of ?13.8 mV. Differential scanning colorimetry (DSC) exhibited an endothermic peak at 176.91°C. Vibrating sample magnetometer (VSM) analysis showed superparamagnetic properties of iron nanoparticles with a magnetization value of 3.483 emu/g and the results indicated superparamagnetic behavior of prepared iron nanoparticles at room temperature, thus highlighting their potential as magnetically targeted drug delivery system. This biosynthetic method has been proven to be cost-effective, environment friendly and promising for use in biomedical sciences.

Telemedicine during coronavirus disease-19 pandemic: a paradigm shift in cardiovascular care / La telemedicina durante la pandemia del COVID-19: un cambio de paradigma en la atención cardiovascular

Abstract Introduction: Severe acute respiratory syndrome due to coronavirus disease (COVID-19) has overwhelmingly affected the health-care systems globally. Delivering cardiovascular care has become unusually difficult both for caregivers and physicians in these unprecedented times. Methods: We briefly reviewed how cardiac care can be delivered to patients while limiting the exposure of both patients and healthcare workers through telemedicine services. We made a comparison at our institute of outpatient services through routine and telemedicine visits. Results: We found that telemedicine can be an equally effective alternative cardiac care during the times of pandemic with no significant difference in patients profile admitted through telemedicine services. Conclusions: We concluded that telemedicine can prove to be an effective tool in delivering cardiac care by limiting exposure of both patients and physicians with better triage of cardiac patients in the situation of COVID-19 pandemic and may complement to regular cardiac care in routine times.

Resumen Introducción: El síndrome respiratorio agudo grave dado por el COVID-19 ha afectado de manera abrumadora a los sistemas de salud a nivel mundial. La prestación de servicios de atención cardiovascular se ha tornado inusualmente difícil tanto para los cuidadores como para los médicos en estos tiempos inéditos. Métodos: Realizamos una revisión breve de cómo se puede brindar atención cardíaca a los pacientes a la vez que se limita la exposición tanto de pacientes como del personal de la salud a través de los servicios de telemedicina. Comparamos los servicios ambulatorios habituales con las visitas de telemedicina en nuestro instituto. Resultados: Encontramos que la tele medicina puede ser una alternativa igualmente efectiva de atención cardíaca durante tiempos de pandemia, sin ninguna diferencia significativa en el perfil de los pacientes ingresados a través de los servicios de telemedicina. Conclusiones: Concluimos que la telemedicina puede convertirse en una herramienta efectiva para proporcionar atención en salud cardíaca al limitar la exposición tanto de pacientes como de médicos con un mejor triage de pacientes cardíacos en el contexto de la pandemia por COVID-19, y puede llegar a ser un complemento de la atención cardíaca habitual en tiempos normales.

Development and Validation of Perceived Oral Health Benefits on Yoga Scale (POBYS) / Desenvolvimento e validação da Escala de Benefícios da Saúde Oral Percebidos no Yoga (POHBYS)

Objective: Sustained practice of Yoga leads to self-awareness, physical strength and high sense of energy. Yoga stimulates antioxidant levels in the body and reduces likelihood of dental disorders. No research has been undertaken connecting perception on yoga and oral health behaviors. The present study is an attempt to develop a psychometric scale entitled Perceived Benefits on Yoga Scale (PBYS) to measure individuals' perception on Yoga in relation to oral health behaviors. Material and methods: The psychometric tool was developed based on the concepts of Health Benefit Model (HBM). Among the four components of the model, the present study considered "perceived benefits" component. A total of 206 individuals participated in the study. To analyze the scale theoretically, face and content validity were assessed. Reliability of the scale was tested using Cronbach's alpha and Spearman-Brown coefficient. Using exploratory and confirmatory factor analysis, construct validity was tested. Cronbach alpha and Spearman- Brown coefficient were applied to test the reliability of scale. Results: There were six items in the final scale, with a Spearman- Brown coefficient of 0.92 and Cronbach's alpha of 0.91. Statistically significant (p < 0.001) positive correlation was found between POBYS scores and Yoga Self-Efficacy Scale (YSES). Validity of scale is within accepted range as indicated by Goodness of Fit indices. Conclusion: POBYS is a reliable and valid measure of perception on yoga outcomes with specific reference to oral health behavior. (AU)

Objetivo: A prática continua de Yoga leva ao autoconhecimento, força física e a sensação de energia elevada. O yoga estimula os níveis de antioxidantes no corpo e reduz a probabilidade de desordens dentais. Nenhuma pesquisa foi realizada conectando a percepção sobre o yoga e os comportamentos da saúde bucal. O presente estudo é uma tentativa de desenvolver uma escala psicométrica intitulada Escala de Benefícios Percebidos no Yoga (PBYS) para medir a percepção dos indivíduos sobre o Yoga em relação aos comportamentos da saúde bucal. Material e Métodos: A ferramenta psicométrica foi desenvolvida com base nos conceitos do Modelo de Benefícios à Saúde (HBM). Dentre os quatro componentes do modelo, o presente estudo considerou o componente "benefícios percebidos". Participaram do estudo 206 indivíduos. Para analisar teoricamente a escala, foram avaliadas a validade de face e de conteúdo. A confiabilidade da escala foi testada usando o alfa de Cronbach e o coeficiente de Spearman-Brown. Usando análise fatorial exploratória e confirmatória, a validade do construto foi testada. O alfa de Cronbach e o coeficiente de Spearman-Brown foram aplicados para testar a confiabilidade da escala. Resultados: Havia seis itens na escala final, com coeficiente de Spearman-Brown de 0,92 e alfa de Cronbach de 0,91. Estatisticamente significativo (p <0,001) foi encontrada correlação positiva entre os escores do PBYS e a Escala de Autoeficácia do Yoga (YSES). A validade da escala está dentro da faixa de aceitabilidade conforme indicado pelos índices de Goodness of Fit. Conclusão: PBYS é uma medida confiável e válida de percepção sobre os resultados do yoga com referência específica ao comportamento de saúde bucal. (AU)

Histomorphological spectrum of fungal infections

Background: Fungal infections have become very common resulting in a wide range of diseases from superficial infections to invasive fungal lesions. These organisms are now capable of affecting not only the immunocompromised patients but also healthy immune-competent individuals. All other non-culture methods except histologic method cannot detect all the types of fungi and are not available widely especially in developing countries like India.Methods: This retrospective study conducted in the department of Pathology for a period of 5 years. A total of 29 cases were studied. The aim of this study was to detect the type of fungal infections and their distribution according to age, sex, and organ involvement in histopathologic specimens received in our department.Results: Twenty-nine cases with fungal infections were studied. Of these (22; 75.8%) were males, (7; 24.1%) were females with male dominance. The cases displayed extensive range of age prevalence between 12 and 77 years. The most common type of fungal infection encountered in this study was mucormycosis. The most common site involved in infection was maxillary sinus. Maxillary sinus was the most common site for mucormycosis.Conclusions: The histopathologic examination can provide a swift provisional identification of infectious fungal organisms and remains the only existing reliable means to identify certain pathogens.

Diagnostic utility of semen analysis in infertile couples: a prospective study

Background: Infertility is defined as a failure to conceive after at least 12 months of unprotected intercourse. It is broadly established that 40% cases of infertility has male factor. Semen analyses is an imperative diagnostic tool in the valuation of the male partners of infertile couples.Methods: We carried out a prospective study wherein semen analyses of the male partners of infertile couples presented to Department of Pathology, Government Medical College and Associate Hospital, Jammu was done. A total of 300 cases were studied and comparison of each abnormality and combined defects were subjected to incidence distribution.Results: We analysed 300 samples in this study. Mean age of the men was 32.5 years. Duration of infertility in (200; 66.6%) was seen in men married for less than 5 years, (84; 28%) between 5-10 years of married life and there were (16; 5.3%) with more than 10 years of infertility period after marriage. Addiction to alcohol made the majority in our study (187; 62.3%), followed by tobacco chewing and addiction to both tobacco chewing and alcohol consumption (89; 29.6%) and (24; 8%), respectively, men were amongst those with abnormal seminograms.Conclusions: Male infertility is an alarming global health issue. Males contribute towards infertility in couples significantly and further study and assessment is required to accurately predict the importance of this.

Role of image guided fine needle aspiration cytology in the diagnosis of intra-abdominal and intra-thoracic lesions

Background: Intrathoracic and intra-abdominal tumors at inaccessible sites pose difficulty in diagnosis. Ultrasonography and computed tomography guided fine needle aspiration cytology has an important role in the diagnosis and distinguishing them as benign and malignant lesions. Image guided FNA has proved to be safe, quick, reliable and cost-effective method for obtaining tissue for cytopathological examination. The objective was to describe the pattern of intra-abdominal and intra thoracic masses on FNAC.Methods: This cross-sectional study was done in the postgraduate Department of pathology Government, Medical college Jammu i.e. 1st September 2017 to 30th September,2018 for a period of one year under image guided FNAC. Air dried and wet fixed smears were stained with may Grunwald Giemsa (MGG) and Papinacolau (PAP) stains respectively. Acid fast bacilli stain was done on additional smears in case of suspected tubercular lesions.Results: A total of 60 patients were subjected to ultrasonography and CT guided intra-abdominal and intra thoracic FNACs in a period of one year. FNAC was performed from various anatomical sites of which intra-abdominal lesions were 40 (liver:21 cases, gallbladder:8 cases, ovary: 3 cases, lymph nodes 3 cases, pancreas: 2 cases, omentum 2 cases, GIT 1 case).  Intrathoracic lesions were twenty (20); out of which lung cases were eighteen (18) and two (2) were mediastinal aspirations.Conclusions: Percutaneous fine needle aspiration cytology under image guidance well described the pattern of deep-seated lesions.

Phytophthora nicotianae Breda de Haan induced stress changes in citrus rootstock genotypes

Phytophthora spp. are the most serious threat to citrus industry worldwide. Being a soil borne problem, use of tolerant rootstocks is the most ecofriendly approach to manage the deadly diseases caused by this fungus. Here, we assessed the reaction of eight citrus rootstock genotypes including sour orange, Troyer citrange and six variants of C. jambhiri Lush. viz., RLC-5, RLC-6, RLC-7, Grambiri, rough lemon and Italian rough lemon against the inoculation of Phytophthora nicotianae. Inoculation of P. nicotianae infected the feeder roots of tested rootstocks to varying degree, expressing higher disease incidence (81.25%) and number of infected feeder roots (54.25-60.62%) depending on the rootstock. Troyer citrange and sour orange proved most tolerant rootstocks against the inoculated fungus. Phytophthora inoculation tended to increase the levels of reactive oxygen species (H2O2 and O2-), antioxidant enzymes (catalase, peroxidase, glutathione reductase, superoxide dismutase and β-1,3-glucanase) and protein content. However, it significantly reduced the levels of macro- (N, P, K Ca and Mg) and micro- (Cu and Zn) nutrients, although the extent of variation was rootstock specific. Overall, Troyer citrange and sour orange expressed the lowest variation in the levels of ROS, peroxidase (POX), superoxide dismutase (SOD) and β-1,3-glucanase, protein and nutrient contents, while rough lemon proved most strongly affected. Of the various variants of Citrus jambhiri, RLC-5 and Italian rough lemon proved more tolerant for Phytophthora nicotianae than rest of the clones tested.

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

Background: In high risk neonates' incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycemia. This study was undertaken to know the incidence, clinical profile, sequential blood glucose level upto 72 hours and short-term outcome of neonatal hypoglycemia.Methods: Blood sugar was screened at admission, after feed or D10 bolus, 6, 12, 24, 48 and 72 hours of age. Detailed maternal history and neonatal history, clinical manifestation, management and short-term outcome of hypoglycemic neonates were noted. Statistical analysis of data was done by SPSS 22.0 software.Results: 200 neonates with blood glucose less than 40mg/dl at admission to NICU in which 47 had repeat episode of hypoglycemia. Incidence of hypoglycemia at admission was 22.49% and 5.29% was incidence of repeat episode of hypoglycemia. Pre-term (p=0.005), low birth weight (p=0.020) and SGA (p=0.012) had repeat episode of hypoglycemia. GDM (p=0.040), birth asphyxia (p=0.046) and early septicaemia (p=0.0001) were common risk factors for hypoglycemia. Poor feeding, jitteriness and respiratory abnormality were common presentation of hypoglycemic neonates. The blood glucose levels at admission were less than 30 mg/dl in neonates who later had repeat episode of hypoglycemia. Most hypoglycemic episode after admission occurred within 24 hours of life.Conclusions: LBW especially Preterm SGA neonates are at increased risk of hypoglycemia. Maternal and neonatal risk factors are GDM and birth asphyxia, early septicaemia. Screening for hypoglycemia is essential for high-risk neonates.

Spectrum Of Cervical Lesions By Papaincolau (PAP) Smears, Screening In A Tertiary Care Hospital In Jammu. A 3 Year Retrosceptive Study.

Background:Cervical cancer is the second most common cancer world wide. It is preventable and curable if detected at early stages. Conventional cervical cytology using pap smears is most commonly used cervical screening method throughout the world. The aim of the study is to evaluate and interpret the cervical pap smear cytology in a tertiary care hospital . The interpretation and reporting of the cervical pap smears is based on the Bethesda system. Material and methods: This is a retrosceptive study conducted in a tertiary care hospital in Jammu over a period of 3 years. All the cervical pap smears received in the Department of Pathology, GMC Jammu, in the study period were included (expect menstruating women, pregnant women and women who had undergone hysterectomy). Results: A total of 300 cases were reported in the Cytology section of the Department of Pathology in the study period of three years. Majority of the cases were Negative for Intraepithelial lesions or malignancy(79%). Reactive cellular changes associated with inflammation were the most common finding (71.6%) followed by bacterial vaginosis(3.33%), candiasis(2%) and trichomanas(2%). Epithelial cell abnormality (6.33%) comprised of ASCUS, LSIL,HSIL& SCC. Conclusion : Pap smears is a simple and cost effective screening method to detect various preinvasive cervical lesions. It should be done routinely in all women in reproductive age group.

Flipped Classroom: A Concept for Engaging Medical Students in Learning

Technological advances have created immense pressure on our younger generation to keep themselves abreast with the newerdevelopments in medical sciences. Educators have to evolve innovative pedagogy to help prepare this generation for future challengesas the training periods are getting relatively shorter. Flipped classroom or Inverted classroom is one such innovation that can empower alearner to develop critical thinking skills and master ways to imbibe vast information by engaging students in active learning process.Reading and understanding are carried at home, and the class-time is utilized for higher levels of learning like analyzing, evaluating, andapplication of the basic information. This review article is aimed to guide the educators in applying the concept of flipped classroom intheir teaching learning armamentarium.