Evaluation of tumor budding and its correlation with histomorphological prognostic markers in oral squamous cell carcinoma and its association with the epithelial-mesenchymal transition process

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.

Factors Affecting Under-Five Mortality Rate (U5MR) in India- National Family Health Survey (NFHS) 5 Factsheet What It Speaks?

Introduction: In developing countries various factors lead to Under-5 Mortality and irreversible losses which can be prevented by proper measures take on factors affecting to it. Objective: This study was conducted to analyse the changing trends of Under-5 Mortality in India. The new National Family Health Survey (5th round) which was published recently came up with several new findings, which were both encouraging and disheartening and also one of the major Sustainable Development Goals.Method: A secondary data analysis was conducted of NFHS factsheets to study the U5MR in India. The indica-tors which had a correlation either positive or negative with the Under-five mortality rate were included.Result- When we look at the result, few states' performance is encouraging because they have shown some of the best declines. Correlation was found between dependant variable that is U5MR which is a dependent vari-able and several independent variables which concluded that factors like Women literacy, Men literacy, Breastfeeding, Nutritional insufficiencies, Caesarean delivery, ANC visits and IFA consumptions are negatively associated withU5MR. Conclusion: Various steps have been taken in order to improve our healthcare sector since independence, every government had their fair share of contribution, that’s the reason why we are this stage. Now it’s time to increase efforts with targeted interventions to solve this problem and complete our commitment towards the SDGs.

Wind-driven roof turbines' effectiveness in enhancing household ventilation: a potential tool to reduce tuberculosis infection

Background: South Africa's overburdened healthcare systems have led to criticism of its unsustainable tuberculosis management interventions. In 2011, the National Department of Health implemented an outpatient, decentralised care model, but this increased costs and jeopardised the long-term viability of prevention measures. Home confinement is now recognised as a viable intervention option, when combined with safety precautions such as ventilation and medical support. However, little is known about the risk of infection in this context. Objectives: To assess the effectiveness of wind-driven roof turbines in enhancing ventilation and their potential to lower the risk of Mycobacterium tuberculosis infection in a residential setting. Methods: Eight houses were selected and divided equally into intervention (wind turbines installed) and control groups, using a pairwise comparison method. The CO2 decay method was used as a proxy to determine ventilation in the houses. The wind-driven roof turbines' potential to lower the risk of Mycobacterium tuberculosis infection was stochastically evaluated using the Wells-Riley mathematical model. Results: During two seasons, installation of a roof turbine resulted in twofold ventilation rates compared to the control houses. Consequently, the WellsRiley model predicted a twofold reduction in the probability of infection in the intervention compared to the control households. Conclusion: Low-cost, low-maintenance wind-driven roof turbines are effective in increasing ventilation in houses, and should be considered as an additional layer of protection against Mycobacterium tuberculosis and other infections in residential settings.

Spectrum of histopathological changes and its quantification using a scoring system in patients with gastroesophageal reflux disease

Aim: The aim of this study was to evaluate the role of histopathological and histomorphometric features in oesophageal biopsy of patients presenting with symptoms of Gastroesophageal Reflux Disease (GERD). Material and Methods: Present study included 42 patients and 12 controls. Complete clinical evaluation followed by endoscopic examination of the patients was done and multipleoesophageal biopsies were taken. Biopsies were processed routinely and stained with Hematoxylin and Eosin and examined for any changes related to GERD. Morphometric assessment was done by using Leitz optical micrometer. The histological scoring was done based on the parameters: basal cell hyperplasia, stromal papillae elongation, cells with irregular nuclear contour (CINC), eosinophilic infiltrate, gastric and intestinal metaplasia. A numerical score was assigned to each parameter and sum of these scores represented the total score. Statistics: The statistical analysis was done using graph pad prism, Medcalc software and Windows MS office. P value and mean standard deviation (SD) was calculated. Results: The endoscopic findings of all the controls and 83.33% of patients were normal. Only 16.67% of patients had reflux associated changes of varying grades on endoscopy. Oesophageal biopsy of all patients had changes related to GERD on histology. Immunohistochemistry confirmed that cells with irregular nuclear contour were T- lymphocytes. The mean (SD) histological scoring of control and patients were 1.75 (0.62) and 5.66 (1.31) respectively. The difference was considered to be statistically significant (P < 0.001). Thus, it was suggested that a cut-off of histological score > 3 can be used to indicate GERD. Conclusion: Patients with gastroesophageal reflux symptoms can have normal endoscopic findings but can be diagnosed on the basis of histological changes in the squamous epithelium. Scoring of the histopathological parameters along with the cut-off value can give a definitive diagnosis of GERD.

Clinico-pathological and Immunophenotype Analysis of Hairy Cell Leukemia Cases – A Single Institute Experience

Background: Hairy cell leukemia is a mature lymphoid B cell disorder, characterized by hairy cells, a specific genetic profile, different clinical course and the need for an appropriate treatment. It is seen primarily in elderly, characterized by a triad of splenomegaly, pancytopenia and monocytopenia. Aim: To evaluate clinicopathologically and with immunophenotyping hairy cell leukemia cases received at our institute in conjunction with similar studies. Material and methods: This is a retrospective study which included 7 cases over a period of 3 years (2019-2021) confirmed on morphology and flow cytometry. Results: The study revealed 7 cases which showed patients with age ranging from 34-65 years. M:F ratio was 6:1. Two cases were covid positive (28.5%). Most of the cases presented with fever, weakness (28.5%). Splenomegaly was seen in three of the cases (42.6%). Laboratory investigations revealed anemia in 71% cases, leucopenia in 56.8%, lymphocytic prominence in 100% and pancytopenia in 14.2%. One patient presented with leukocystosis (14.2%). Marrow was hemodiluted and aparticulate in 3(42.6%) cases. Hairy cells were seen on morphology of peripheral smear and marrow aspirate. On flow cytometry, CD5 negative in all cases (100%), CD10 positive in 2(28.5%) and CD23 in 2 cases (28.5%). Few cases confirmed BRAF v600e mutations. Conclusion: Unusual findings like leukocytosis, absence of spleen, presence of lymphadenopathy can be present in hairy cell leukemia. Classical fried egg appearance in trephine biopsy may not be afeature in all the cases. CD123 is expressed in covid patients unlike other studies and further research is needed to establish the loss of CD123 in covid patients.

Knowledge of rural women regarding activities of accredited social health activist in three different villages of District Amritsar: A cross-sectional study

Background: Accredited Social Health Activist (ASHA) is the grass root level worker and hence plays a prime role in making primary healthcare accessible to rural areas. She creates awareness on health and persuading the community toward local health planning and hence plays major role in increasing utilization of health services. The knowledge of the people about the availability of ASHA in their area and about the activities performed by her also play important role in utilization of services given by ASHA. Hence, keeping this in view the present study was conducted. Aim and Objectives: (1) The aim of the study was to assess the knowledge of the rural women about the availability of ASHA in their area and (2) to assess the knowledge of the rural women about the activities performed by ASHA. Materials and Methods: The study was conducted in rural field practice area of Government Medical College, Amritsar, Punjab. The study was a cross-sectional type and the adult decision maker female of the family was interviewed using a pre-designed and semi-structured pro forma after approval from Institutional Ethics committee. A total of 1521 females were interviewed. Results: The present study revealed that majority (52.3%) of the respondents were in the age group of 24–45 years, 41.7% illiterate and 54.6% in the upper lower class. It was found that 45.8% respondents were visited by ASHA and out of these, majority of the respondents (78.2%) were visited for Maternal and child health services followed by health awareness (20.7%) and minor illnesses (9.9%). Conclusion: The visits by ASHA were irregular and majority of the respondents were visited by ASHA for maternal and child health services in all the three villages and hence knowledge regarding these activities was seen to be more among the respondents. However, overall less knowledge was seen among the villagers about other activities being performed by ASHA worker.

Water quality challenges in buildings during prolonged low or no occupancy: a cause for concern during COVID-19 lockdowns and related building closures

Introduction: In compliance with the COVID-19 lockdown restrictions, many nonessential workplaces and public spaces were closed or left sub-operational with no or low occupancy for several months. The abrupt and unprecedented long periods of building closures have raised concerns about the proliferation of opportunistic premise plumbing pathogens that may be a biohazard for returning occupants. Objective: In this review paper, we discuss microbiological water quality concerns during periods of no or low occupancy, as experienced during the COVID-19 lockdowns. Methods: PubMed and Google Scholar databases were searched for peer-reviewed articles using specific keywords. The literature search was extended to grey literature. The paper focuses on Legionella, as a pathogen of concern, in building water systems that are not well managed and the potential risks to workers and other occupants. Results: Most articles suggest a positive relationship between stagnation or reduced water usage and compromised microbiological quality of building water systems, but the effects are site-specific and are associated with biofilm formation and disinfectant decline. Considerations for building water risk assessment are discussed as a decision-making framework for selecting appropriate responses to anticipated changes in water quality. Conclusion: The unprecedented building closures due to COVID-19 lockdowns present a hazardous event likely to impact building water quality. Building owners and facility managers, especially in high-risk settings, should consider conducting risk assessments of water systems during low-occupancy periods to identify potential risks and apply appropriate corrective measures, where necessary.

A rare case of benign fibrous histiocytoma of the cornea

Fibrous histiocytoma (FH) commonly occurs in the superficial layers of the skin. Orbit and limbus are documented ophthalmic sites of involvement but isolated corneal FH has never been reported in literature. We present the first case of FH exclusively involving the cornea where a 10-year-old male child presented with a 3-month history of a painless growth on the superior cornea of the right eye with deterioration of vision. Tumor excision with therapeutic penetrating keratoplasty was done and the histopathological examination confirmed the diagnosis. There was no recurrence and the corneal graft was clear at 1 year.

Results of Open Reduction and Internal Fixation of Humeral Shaft Fractures using Locking Compression Plate

Introduction: Fractures shaft of the humerus is common in an orthopedic practice. Open reduction and plating of these fracturesallow anatomical reduction without affecting elbow and shoulder function but involve extensive soft tissue stripping. We treat22 cases of humeral shaft fractures using locking compression plate (LCP).Objective: The objective of this study was to measure the clinical outcome which includes fracture healing, radial nerve recovery,infection, and functional range of motion in the shoulder and elbow. Radiographic measurements included fracture alignment,time to healing, delayed union, and non-union.Materials and Methods: Twenty-two skeletally mature patients with acute humeral shaft fractures requiring surgical stabilizationas indicated by the fracture pattern, failure to maintain reduction by conservative method, and associated injuries were treatedby open reduction and internal fixation (ORIF) using LCP. Follow-up was possible only on 20 patients.Results: Nineteen Humeral shaft fractures united completely, one fails to unite necessitating subsequent procedure whichwas united afterwards within 1½ years. Two superficial wound infections in patients with an open fracture and one transientpost-operative radial nerve palsy were the only complications. A functional range of motion in the elbow and shoulder wasregained in all except in one patient who had severe bone and soft tissue injuries in the same extremity.Conclusion: ORIF with locking compression plating becomes the treatment of choice with increased popularity for humeralshaft fracture as it can give good results by providing both biologic and mechanical advantages.

Tumor budding in infiltrating breast carcinoma: Correlation with known clinicopathological parameters and hormone receptor status

Introduction: Tumor budding (TB) is proposed as an essential step in the invasion and metastasis of various tumors. However, there is limited information about its role in breast cancer. This study was designed to assess the prognostic significance of TB in clinical practice. Objectives: To study and grade TB in patients with invasive breast cancer and to correlate it with known prognostic parameters. Materials and Methods: In this prospective study, 40 cases of invasive breast cancer were studied over a period of 1.5 years. Tumor buds were defined as comprising five tumor cells or less at the invasive front of the tumor. Cases were separated into two groups according to TB density as low grade and high grade. Significance and correlation between TB with established clinicopathological parameters and hormone receptor status were studied by Chi-square test. P value <0.05 was considered significant. Results: All 40 cases in this study were newly diagnosed cases, who did not receive any therapy. The majority of patients were premenopausal (55%), had small tumor size ?5 cm (67.5%), had negative lymph nodes (67.5%), had grades 2 and 3 (75%), and presented in stages 1 and 2 pathological stage (62.5%). The majority were estrogen-receptor-negative (62.5%), progesterone-receptor-negative (65%), and human epidermal growth factor receptor-2-positive (52.5%). Higher grade TB was observed in larger tumor (P = 0.03), in higher stage (P = 0.046), and in tumor having lymphovascular emboli (P = 0.03) when compared with small size, lower stage, and tumor with no lymphovascular emboli, respectively. Conclusion: As higher grade TB was associated with larger, higher stage tumor, and in tumor having lymphovascular emboli, it can be recognized as an easily identifiable prognostic factor.

Interesting and Unusual Presentation(s) of Leprosy Resulting in Delayed diagnosis

In the post elimination phase of leprosy programme, it continues to be an important health problem in India. Further various atypical forms are seen resulting in delayed diagnosis. A retrospective analysis of 2 years (January 2016 to December 2017) records of all in and out patients of leprosy cases who were treated at a service hospital in northern India was done. At this hospital a total of 97 leprosy cases were seen during the study period out of which 18 (18.5%) cases where the diagnosis was missed due to various reasons resulting in delay in initiation of MDT were included. These cases were examined to describe the clinical presentation, delay in diagnosis and its significant outcome. 61% (11/18) were males while 39% (7/18) females. 22.2% (4/97) had Histoid Hansen's disease; 22.2% (4/18) had chronic symmetrical polyarthritis, there was no hypoaesthetic or anesthetic patches or enlarged nerves in these patients and these were initially diagnosed and managed as Rheumatoid arthritis. 16.6% (3/18) had spontaneous ulceration of extremities and had no skin infiltration or thickened nerve on examination. Interestingly two of these three patients had associated hypoaethesia of extremities which was not taken into consideration for making diagnosis as no suspicion of leprosy was made, one patient in this group had developed foot drop (L) and Right ulnar claw. 16.6% (3/18) had pure neuritic leprosy while greater auricular nerve thickening was seen in 11.1% (2/18) atypical cases. 5.5% (1/18) patient had swelling of upper lip but there no lesion on face or nerve and was managed by a Dentist. Lichenoid lesions were seen in 5.5% (1/18) cases. Out of 18 atypical cases 83.3% (15/18) were in multibacillary pole while 16.6% (3/18) were in paucibacillary pole. 27.7% (5/18) each were BL and LL while 22.2% (4/18) each were Pure neuritic and Histoid Hansen's. 83.3% (15/18) patients were Bacillary positive. Grade 2 deformity developed in 22.2% (4/18) of these cases. The total duration elapsed between presenting to the primary care giver and the dermatology center where the final diagnosis was made ranged from 2 weeks to 3 years. Increase in awareness about various presentations of leprosy in post-elimination era should be emphasized to the health care physicians as well as other workers involved in detection/diagnosis of leprosy

Estimation Of Bacoside-A In Bacopa Monnieri Aerial Parts Using Tlc Densitometry

Objective: The objective of the present work was to formulate and evaluate a stable, odour free garlic powder loaded floating matrix tablet for the treatment of peptic ulcers. Methods: A gastro-retentive floating matrix tablet (FMT) formulation of garlic powder (GP) was prepared using various concentrations of hydroxypropyl methylcellulose K4M (HPMC K4 M) and effervescent system (sodium bicarbonate and citric acid in 1:1 % w/w) to achieve desirable floating time (FT), floating lag time (FLT) and drug release. Wet granulation method was selected using ethanol as a binder for preparation of tablet. 32 full factorial designs were used for selection of suitable polymer concentration and effervescent system. Nonenteric film coating was applied to mask GP odour. Results: It was observed that FMT with optimum quantities of HPMC K4M and the effervescent system showed 97 % of drug release in 12 h with FT up to 10 h and minimum FLT of 3 min. There was no significant change in FLT, FT and drug content during the stability study of FMT. Conclusion: A stable, sustained release FMT of GP tablets using HPMC K4M and an effervescent system was successfully prepared. This formulation can overcome problems of taste and odour masking, gastric irritation, and loss of active constituents present in garlic.

Incidence, Demographic Distribution and Treatment Rendered for Facial Fractures at Department of Dentistry, Government Medical College, Jagadalpur, Chhattisgarh

Background: Head and facial injuries account for 30% of all injuries and cause 26% of deaths. Cervical spine injuries associated with these injuries causes hemiplegia, paraplegia and quadriplegia. When such morbid injuries occurs, the only bread winner of the family loses source of income and the entire family suffers. The hospital stay significantly increases further leading to financial burden. Methods: A retrospective study was conducted at Department of Dentistry, Government Medical College, Dimrapal, Jagadalpur over a period of 5 years. This is a cross sectional study with descriptive analysis of the data. Cases of Maxillofacial Injuries were retrieved from database of the medical records department and from Department OPD register. Demographic data included gender, age group, the region from where the patient represented. The clinical presentation of the fracture site, etiology, and associate injuries was included in the study. Data is presented as frequency tables and percentages. Results: Of the 658 patients with facial fractures, 321 were males, 217 females and the rest 120 in the pediatric age group (up to 14 years of age). Road traffic accidents amounted to predominant group of patients with facial fractures(n=341), Inter-personal fights lead to 49 facial fractures. 132 patient’s had facial fractures due to fall. Animal attacks caused 11 facial fractures. 125 patients were categorized in the “other category”. Conclusion: The incidence and pattern of maxillofacial fractures vary from country to country depending upon prevailing geographical, social, cultural and environmental factors. Management of maxillofacial injuries in a pre-hospital setup is definitely different from the regular protocol of managing abdominal or long bone injuries. The importance of cervical spine control and its undue consequences is well known to all medical professionals.

Oxidative stress in metabolic syndrome & its association with DNA-strand break

Background & objectives: Oxidative stress (OS) is associated with numerous components of metabolic syndrome (MetS). This study was aimed to investigate if hydrogen peroxide (H2O2) as the reactive oxygen species was capable of depicting OS in MetS, and If MetS patients showed DNA damage in the form of DNA strand breaks (DSB). Methods: A total of 160 participants (90 males, 70 females) ?20 yr of age were categorized into four groups based on the number of MetS risk parameters (n=40 in each group). Sugar and lipid profile, H2O2concentration in blood and DNA-strand breaks were measured. Results: DSB was significantly more in those with MetS (n=40) than those without (n=120) whereas H2O2levels were the same in both the study groups. The number of DSB differed significantly between the control and 3 risk factor groups. DSB was also higher in groups with 2 and 1 risk factors compared to 0 risk but the difference was not significant. H2O2 level was higher in groups with 3, 2 and 1 risk factors compared to 0 risk group but the difference was not significant. The H2O2level correlated positively with triglyceride values but not with other MetS risk parameters. There was no significant correlation between DSB and MetS risk parameters. Interpretation & conclusions: Our findings showed a cumulative and synergistic effect of the risk factors of MetS on DSB. Individuals with three risk parameters had a greater effect on DNA damage than in those with two or one risk parameter. Although plasma H2O2level increased with an increase in the fat depots, use of H2O2to depict OS in MetS should be coupled with an adjunct and estimation of DSB in peripheral blood lymphocytes may be used as indicator of OS in MetS patients.

An echocardiographic study in patients with non haemorrhagic cerebral infarction to find cardiac abnormalities.

Background: Strokes are a major cause of morbidity and mortality worldwide. Majority are due to ischemic cerebral infarction. Ischemia may result from occlusion of blood vessels due to a disease process intrinsic to carotid and intracranial vessels or may relate to coexisting heart diseases, predisposing to embolic phenomenon. Objective: Echocardiographic study in patients with cerebrovascular accident, confirmed to be of non hemorrhagic nature on CT scan/MRI, for evidence of potential cardiac abnormalities as a predisposing cause for the vascular event. Material and Methods: An observational study was conducted in department of medicine, GNDH, Amritsar. 50 patients of ischemic stroke were taken and 2D transthoracic echocardiography was done to find potential cardioembolic abnormalities. Results: 76% of patients had echocardiographic abnormalities and 42% had potential cardioembolic abnormalities, out of which most common were ventricular wall hypokinesia, calcific aortic valve, rheumatic heart disease and dilated cardiomyopathy. The prevalence was almost similar in different age groups and both the sexes. Conclusion: Prevalence of potential cardioembolic abnormalities is high (42%) in ischemic stroke patients and 2D echocardiography is therefore recommended in the management and secondary prevention of cardioembolic stroke, which has a higher mortality and more chances of recurrence than atherothrombotic type of ischemic stroke.

Anaesthetic Profile of Women Undergoing Caesarean Section.

Background: The obstetric patient for Caesarean section usually presents more challenges to the anaesthesiologist than other patients. Spinal anaesthesia is perhaps the most accepted approach to these challenges. It offers a fast, profound, definite and higher quality of sensory and motor blockade for Caesarean delivery. Spinal anaesthesia is associated with some complications, the commonest of these being hypotension of a reported incidence of greater than 80% despite fluid preload and lateral uterine displacement. To study the anesthetic profile of women undergoing the cesarean section delivery. Methods: The present randomized controlled study was conducted among 100 subjects. Results: The age, weight, height and parity are comparable in both the groups. The mean values of maternal baseline heart rate in Group P and E are 89.52 ± 11.89 and 92.20 ± 11.56 respectively. The mean SBP values obtained in Group P and Group E are 123.52 ± 7.84 and 123.14 ± 8.98 respectively. Similarly, diastolic blood pressure values in Group P and Group E are 80.94±8.10 and 81.18±9.12. Baseline mean arterial pressure in the Group P and Group E are 95.00 ± 7.20 and 95.00 ± 8.26 mm of Hg. Conclusion: Apgar score at 1 and 5 minutes is comparable in both Group P and Group E.

Molecular characterization of community- & hospital-acquired methicillin-resistant & methicillin-sensitive Staphylococcus aureus isolates in Sikkim.

Background & objectives: The two major genotypic markers that distinguish community acquired (CA) from hospital acquired (HA) methicillin resistant staphylococcus aureus (MRSA) isolates are the architecture of mobile genetic element (SCCmec type) and presence of panton valentine leukocidin (PVL) toxin. This study was conducted to determine the molecular characteristics of CA- and HA- MRSA and methicillin sensitive S. aureus (MSSA) isolates in Sikkim. Methods: A total of 150 clinical isolates of S. aureus isolated from various clinical specimens were subjected to duplex (mec-A and pvl gene) and multiplex (SCCmec typing) PCR. Results: of the 150 isolates, 53 (35.33%) and 66 (44%) were positive for mec-A (MRSA) and pvl genes, respectively. Thirty eight (25.33%) met the definition of CA-MRSA and 15 (10%) of HA-MRSA and the remaining 63 (42%) and 34 (22.66%) as CA- and HA-MSSA, respectively. No significant difference was seen in the distribution of PVL toxin in MRSA and MSSA isolates, but it was significantly (P<0.001) high in overall MRSA isolates than in MSSA. The majority of the MRSA isolates showed a double amplification band of SCCmec type III plus V (54.71%), and only a fewer isolates were amplified by single DNA fragments of type I (1.88%), III (3.77%), IVa (1.88%) and V (11.32%). SCCmec types I, III, IVa, were found only in HA-MRSA isolates, whereas type V in both the CA- and HA-MRSA. AST pattern showed that 18.42 per cent (7/38) and 46.66 per cent (7/15) were multidrug resistant (MDR)-CA-MRSA and MDR-HA-MRSA, respectively. Interpretation & conclusions: The present results show that SCCmec type V MRSA has been on the rise, and genotypic markers such as pvl gene detection used for the differentiation of these clinically distinct isolates of MRSA may not be reliable.

Gallbladder cancer incidence in Gwalior district of India: Five-year trend based on the registry of a regional cancer center.

BACKGROUND: We have reported here the 5-year incidence (2004–2008) of gallbladder cancer (GBC) in North Central India along with its descriptive epidemiology. This provides potential clues for better prevention. The present study has also evaluated the association of ABO blood groups with GBC. PATIENTS AND METHODS: The study comprised 742 GBC cases referred to the regional cancer hospital, Gwalior, during 2004–2008. The demographic statistics of Gwalior district was considered to calculate the relative risk and incidence rates. ABO blood group distribution amongst 90,000 healthy subjects registered in the local blood bank during 2002–2007 was taken as controls to study the association of blood groups with GBC. RESULTS: The age-standardized total incidence rate of GBC was calculated to be 7.16/1,00,000. The relative risk of females getting GBC was 2.693 at 95% confidence interval of 2.304–3.151 (P < 0.0001). The females formed 69.5% of total cancer cases, with age-standardized incidence rate of 10/1,00,000. The mean age of male and female GBC cases was found to be 55.4 years (SD = 13, SE = 0.77) and 51.5 years (SD = 12.3, SE = 0.50), respectively. The blood groups A (P = 0.0022) and AB (P < 0.0001) had a positive association with GBC with significant level of differences in comparison to controls. CONCLUSION: Our study provided an estimate of a 5-year incidence of GBC in North Central India for the first time. With regard to the association of risk factors like obesity, age, and urban living with GBC, the findings of the present study are contradictory to the general opinion. Blood groups A and AB were found to be associated with GBC, which would be provisional for further investigations.