Background: A ventilated middle ear space is an essential component of a functioning middle ear transformer mechanism. A mastoid ventilation tube (MVT) placed post-aurally in the antrum near the aditus is used in this study for the benefit of improvement in results of tympanoplasty. In support of this concept, very few experimental documents are reported. Aims and Objectives: The aims of this study were to find out if the MVT has any effect on the outcome of tympanoplasty in cases of chronic suppurative otitis media (CSOM) tubo-tympanic disease. Materials and Methods: This study was performed in 50 cases which were selected from the total number of cases using stratified random sampling method. In the research, patients with CSOM, who did not respond to medical therapy and required a combined approach tympanoplasty, were enrolled. Patients who needed just myringoplasty and those found to have cholesteatoma intraoperatively were not included in the research. Results: The study showed significant improvement in graft uptake, air-bone closure, and hearing in cases with MVT, thus resulting in better success rate in cases with MVT than cases without MVT. Furthermore, most of the cases had sclerosed mastoids and very few cases had complications such as MVT block and post-operative discharge. Conclusion: The MVT had a beneficial effect on the final outcome of combined approach tympanoplasty in cases of CSOM tubo-tympanic type active stage.

Background: Phyllodes tumors (PT) are rare biphasic neoplastic breast lesions. They account for 0.3–0.5% of female breast tumours1 and have an incidence of about 2.1 per million, the peak of which occurs in women aged 45–49 years. There is sometimes difficulty in dividing tumors into the three recognized grades based on histomorphological features. It is because of the subjective variation and absence of a definitive grading system. More importantly, they do not always correlate with clinical outcome in terms of predicting recurrence, malignant transformation, metastasis, and overall survival. Aims and Objectives: (1) The aim of the study was to study the clinicopathological and histomorphological features of the PT and classify the tumors based on 2019 WHO classification. Materials and Methods: This study was done in the Department of Pathology at Government General Hospital Nizamabad. Total 68 cases are included in this study over a period of 5 years (3 1⁄2 years retrospective and 11/2 year prospective) from 2017 March to 2022 March. PT cases were analyzed based on 2019 WHO classification criteria. The age of the patients, tumor locations, and the relevant details were obtained from the pathology records. Results: Of the 68 PT cases, 53 (78%) were classified as benign, 8 (12%) borderline and 7 (10%) malignant PT based on histomorphological features based on 2019 WHO classification. Conclusion: Our study showed that tumors occurring in older age group with a large tumor size and the presence of malignant heterologous elements, infiltrating borders, and surgical margins <1 cm were usually malignant phyllodes.

Background: Breast lesions are areas of abnormal breast tissue. It is estimated that 20% of women develop breast lesions. Breast lesions are either benign or malignant. Breast carcinomas are the most common cause of deaths in women accounting for 10.6% deaths in India, 6.9% deaths per year globally. Aims and Objectives: To study various histopathological patterns of breast lesions in women admitted in Government General Hospital. Materials and Methods: It is a prospective study in the department of pathology, Government General Hospital, Nizamabad, from December 2020 to July 2022. Grossing was done and details noted, tissue bits were processed and sections were stained with conventional H and E Staining. Results: Out of 70 cases of breast lesions, 55 (78.5%) are benign breast lesions and 15 (21.5%) are malignant breast lesions. Fibroadenoma is the most common breast lesion accounting for 33 cases, that is, 60 %, followed by fibrocystic diseases (21.8%). Infiltrating ductal carcinoma of No Special Type is the most common malignant breast lesion accounting for 10 cases, that is, 66.6%. Among invasive breast carcinomas, the majority of cases are Grade II (69%). Conclusion: Study of histopathological patterns of breast lesions plays an important role in diagnosis, treatment, and prognosis of breast lesions. This study highlighted incidence and pathological characteristics of a wide range of breast lesions.

The Hoffa fracture is an uncommon coronal plane fracture involving the femoral condyles. The coronal nature of the fracture makes it hard to diagnose clinic-radiologically. A 42-year-old male patient developed pain associated with swelling in his right knee after a two-wheeler accident. He consulted his general practitioner who missed the Hoffa fracture on plain radiographs and treated him conservatively with analgesics. The pain did not subside and he visited our emergency department where a computed tomography (CT) scan revealed a Hoffa fracture of the lateral condyle. He was taken up for open surgery, and while fixing the lateral condylar fracture, we found an undisplaced medial condylar Hoffa fracture of the ipsilateral femur. This fracture was initially missed on the CT scan. Both the fractures were internally fixed and the patient was put on rehabilitation. At the end of the 6-month follow-up, the patient had a full knee range of motion. Careful and detailed CT imaging and looking for fractures other than Hoffa is important, so as not to miss any associated bony injuries. Furthermore, the treating surgeon needs to look for other bony injuries during open or arthroscopic fixation of Hoffa's fracture.

Globally, spine disorders are the leading cause of disability, affecting more than half a billion individuals. However, less than 50% of G20 countries specifically identify spine health within their public policy priorities. Therefore, it is crucial to raise awareness among policy makers of the disabling effect of spine disorders and their impact on the economic welfare of G20 nations. In 2019, SPINE20 was established as the leading advocacy group to bring global attention to spine disorders. Recommendations were developed through two Delphi methods with international and multi-professional panels. In 2022, seven recommendations were delivered to the leaders of G20 countries, urging them to: Develop action plans to provide universal access to evidence-based spine care that incorporates the needs of minorities and vulnerable populations. Invest in the development of sustainable human resource capacity, through multisectoral and inter-professional competency-based education and training to promote evidence-based approaches to spine care, and to build an appropriate healthcare working environment that optimizes the delivery of safe health services. Develop policies using the best available evidence to properly manage spine disorders and to prolong functional healthy life expectancy in the era of an aging population. Create a competent workforce and improve the healthcare infrastructure/facilities including equipment to provide evidence-based inter-professional rehabilitation services to patients with spinal cord injury throughout their continuum of care. Build collaborative and innovative translational research capacity within national, regional, and global healthcare systems for state-of-the-art and cost-effective spine care across the healthcare continuum ensuring equality, diversity, and inclusion of all stakeholders. Develop international consensus statements on patient outcomes and how they can be used to define and develop pathways for value-based care. Recognize that intervening on determinants of health including physical activity, nutrition, physical and psychosocial workplace environment, and smoking-free lifestyle can reduce the burden of spine disabilities and improve the health status and wellness of the population. At the third SPINE20 summit 2022 which took place in Bali, Indonesia, in August 2022, 17 associations endorsed its recommendations. SPINE20 advocacy efforts focus on developing public policy recommendations to improve the health, welfare, and wellness of all who suffer from spinal pain and disability. We propose that focusing on facilitating access to systems that prioritize value-based care delivered by a competent healthcare workforce will reduce disability and improve the productivity of the G20 nations.

Abstract Introduction: Paederus dermatitis is an acute irritant dermatitis caused by accidental crushing of an insect belonging to the genus Paederus, releasing the vesicant pederin. It is commonly seen in the rainy season, especially in tropical regions. Methods: The aim of this study is to analyze the epidemiological and clinical findings of paederus dermatitis and factors associated with this condition in patients attending the dermatology, venereology and leprosy (DVL) department at a tertiary care hospital. This is a 3-year retrospective study from November 2016 to December 2019. This study was undertaken as a large number of cases with similar complaints attended D.V.L outpatient department during the same period (November–January) in 3 consecutive years. A total of 120 girls clinically diagnosed with paederus dermatitis residing in residential girls’ hostels were included in the study. All the cases were evaluated using a standard pro forma which included a detailed history and clinical examination. All the patients were treated appropriately and control measures were advised to prevent further attacks. Patients were followed up until the lesions healed for 2 weeks. Results: Age of the children ranged from 10 to 16 years. The mean age of patients was 13.4 years. The majority of the cases were reported in November (57) and December (42) for 3 consecutive years and the remaining cases were observed randomly during the study period. Most of the patients presented within 48–96 h of lesion onset. The chief complaints were redness of the skin with itching and burning. The most common presentation was widespread erythema, edema, erosions, and desquamation involving larger areas, not localized which is uncommon with paederus dermatitis. Facial involvement is significant and observed in 99 (82.5%) cases. In addition to the face, other sites affected were the neck in 82 (68.3%), forearms in 41 (34.16%), and upper trunk in 30 (25%) patients. Constitutional symptoms although mild were reported in 3% of patients. Conclusion: An atypical variant of paederus dermatitis was observed in the majority of the cases with diffuse erythematous and desquamative lesions predominantly involving the face and neck. A careful history and awareness about varied clinical features will help in early diagnosis and to undertake preventive measures.

Caregivers of cancer patients were prone to deterioration of their QOL due to the caregiving burden. A high caregiving burden and low QOL were common among CG. In India, only a few studies were done on the caregivers of cancer patients. Hence this study was undertaken.
 The aim: To study psychopathology, quality of life and burden in caregivers of cancer patients
 Materials and methods: The study was done on 100 caregivers of cancer patients attending after fulfilling the inclusion criteria. A semi-structured Proforma was administrated to collect the socio-demographic details. Following by Mini International Neuropsychiatric Interview (MINI), WHO-QOL and Burden assessment scale was administered to the caregivers. Data were analysed using SPSS. Descriptive statistics, Pearson and Spearman Correlations and ANOVA were used.
 Results: 31 % of caregivers suffer from generalised anxiety disorders (15 %) and depression (16 %). The environmental domain of QOL (mean-18.2, SD-15.4) was the most affected. 83 % of caregivers experienced a moderate burden, and 17 % had a severe burden. These variables are significantly associated with caregiver relation with patient and socio-economic status (<0.05). A significant correlation was found between Psychiatric morbidity, QOL and Burden in caregivers.
 Conclusion: psychiatric morbidity, quality of life and burden in CGs influence one another. The least attention was paid to caregivers' mental health, many of them left unidentified and untreated. These results highlight the need to educate them about mental health and counsel and treat them for their psychiatric problems

Background: Congenital nasolacrimal duct obstruction (CNLDO) is the most common disorder leading to epiphora and is usually due to failure of canalization of the nasolacrimal duct (NLD) at its distal end Objectives: To study the efficacy of probing in congenital nasolacrimal duct obstruction in 2 to 4 years of children. Methodology: Probing was carried out through the punctum by using bowman’s probe which was available in various sizes from 0.7mm to size 1.1mm. Appropriately sized probe was directed vertically first then gently directed medially until bony feeling was encountered. Firm pressure was applied to probe, attempted to advance probe beyond obstruction in NLD. Left the probe for 1 minute in that position. After the procedure topical antibiotic eye drops were advised for 2 weeks. Results: The overall success rate of probing in 2 to 4 years age group was 63.8%. In total 50 patients with 57 eyes 7 were bilateral cases in that 3 (42.9%) were treated successfully. In 43 unilateral cases 30 (69.8%) were treated successfully. The success rate of probing in right eye (70.8%) and left eye (68.2%). Conclusion: Probing can be still viable option for children aged 2years and more with CNLDO.

Background: Ultrasonography is one of the most useful non-invasive techniques for evaluation of the Posterior segment of the eye. Objectives: to evaluate the posterior segment and identify any posterior segment disorders, using diagnostic B - scan ultrasonography in patients presenting with opaque ocular media. Methodology: Patients with opaque media were subjected for evaluation of the Posterior segment using a standard Ultrasound unit - MARVEL B-scan, consisting of diagnostic B scan and A scan biometry. Ultrasound probe was placed over the globe of the closed eye after applying coupling gel over the probe. The globe was scanned thoroughly using transverse, longitudinal, oblique and axial scans.Ultrasound image was analysed for any abnormalities both in real time and after freezing the image and findings were documented Results: Almost ¾ th of the patients with ocular trauma were found to have detectable posterior segment pathologies on b scan. Retinal detachment combined with vitreous hemorrhage was most common b scan finding in patients with ocular trauma.Posterior vitreous detachment was commonly observed pathology in 10 eyes followed by vitreous hemorrhage in 7 patients. Conclusion: B-scan ultrasonography is useful in the assessment of ocular traumatic and non – traumatic lesions and supplements clinical examination with valuable information.

Background: Diuretics increase urine flow and sodium excretion are used to maintain the volume and composition of body fluids in a variety of clinical situations Objectives: To evaluate the diuretic activity of alcoholic (AERMI) extract of roots of Mangifera indica in albino rats. Methods: 5 groups of Albino rats were used to evaluate the diuretic activity by using metabolic cages. The group I serves as normal control received vehicle, the group II received Furosemide (10 mg/Kg, p.o) ; other groups III, IV, V were treated with low, medium, and high doses of AERMI and immediately after extract treatment all the rats were hydrated with saline (15 ml/kg) and placed in metabolic cages. Total volume of urine collected was measured at the end of 5 h. Concentration of Sodium, Potassium, Chloride in the urine were estimated. Results: Compared to control group the AERMI at different dose levels (100,200 and 400 mg/kg) has significantly increased the urine volume and also enhanced the elimination of Sodium, Potassium and Chloride. Conclusion: Single dose of AERMI as 100, 200 and 400 mg/Kg and Frusemide have increased the urine output along with an increase in concentration of Sodium, Potassium, and Chloride.