Abstract: Background: Often obesity and hypertension are bracketed with developed countries, urban locations, and affluent societies. Yet, there is a recent secular trend in rising adiposity and cardiovascular risks, even in rural locations in developing countries like India. Objectives: Our study aimed to assess the prevalence of obesity and hypertension among the Chakhesang adults, emphasizing the association between body mass index (BMI) and blood pressure (BP) traits and their socio-demographic correlates. Methods: A cross-sectional study was conducted among the Chakhesang adults of Nagaland. The total sample comprises 209 participants (102 females and 107 males) aged 18-50 years. BMI was classified according to the classification given by WHO for adult Asians. Whereas BP traits were classified based on the Joint National Committee (JNC) protocols. Results: The overall prevalence of overweight and obesity was 42.6% and 13.4%, respectively, while systolic and diastolic hypertension was prevalent at 22.5% and 28.2%, respectively. Results of the linear regression depicting the relationship between BMI and BP traits presented significant figures. Further, the multivariate multiple regression (MMR) analyses yielded a positive association of sex, age, occupation, and income with BMI and BP traits. In contrast, education was found to have a negative impact on both BMI and BP. Conclusion: The prevalence of overweight/obesity and hypertension in this tribal community is relatively high for a rural setting. Socio-economic changes pertaining to occupation shift and adoption of modern lifestyle are the causal factors for high cases of obesity and hypertension among the Chakhesang adults.
Key words: Body mass index, blood pressure, adults, Chakhesang tribe, Nagaland

Abstract: Background: Children's social cognition, an ability to understand and infer the thoughts and feelings of others influences how they develop a unique view of the world. Higher social cognitive capacities are associated with better prosocial skills whereas difficulties in understanding and thinking about others’ mental states can lead to disruptive social functioning and increase the risk of major mental health problems. Impairment in the development of social cognition is considered to be the most important reason behind a child’s disruptive behaviour. Therefore, this paper aimed to understand different factors involved with disrupted social cognition which results in disruptive behaviour in children. Methods: The review was done by systematically using the keywords such as social cognition AND disruptive children OR anger children OR externalizing disorders OR conduct disorder and the timeline selected was from 2008 to 2023. Articles published on PubMed and Google Scholar were included in the study. The PRISMA was followed for reporting the systematic review. Results: The contribution of biological factors involving the role of callous-unemotional trait, disturbed neuropsychological processes, imbalance in the behavioural regulation system, hostile parenting, poor attachment patterns and poor environmental factors were considered as major causes of anger among children. Conclusions: The paper concludes that, although considerable progress has been made in understanding this topic, there is a need to further refine our conceptualisation of the problem to develop an effective treatment plan for dealing with children with disruptive behaviour.
Key words: Biological, Psychological, Social cognition, Disruptive behaviour

Abstract: Introduction: Urinary tract infections (UTIs) represent widespread human microbial disorders involving any part of the urinary tract. Urinary tract infections (UTIs) are prevalent all over the world and are known to affect approximately 150 million people each year worldwide. Objectives: The aim of this study was to assess the demographic and bacterial profile of patients presenting with symptoms of urinary tract infections. Methods: A retrospective study on urine bacteriology over a period of one year between June 2021 to July 2022 was done in the Department of Microbiology, University College of Medical sciences and associated GTB Hospital, Delhi. The data collected was analyzed using Statistical Package for Social Sciences (SPSS) software, Chicago,version 20.0. Result: In this study, a total of 21359 samples were received for urine culture and sensitivity testing. 2265 samples were positive with an overall positivity rate of 10.60% with majority of the positive samples from females. The majority of positive samples (1559; 68.83%) were from age group between 21-60 years of age, females again being predominant gender (914; 58.62%). In outpatient department, inpatient department and in ICU services, Gram negative bacilli were the predominant microorganisms isolated. In case of Staphylococcus aureus, majority ,i.e., 66 (61.68%) out of total 107 of isolates were resistant to methicillin. Conclusion: Our findings support the fact that females in the age group 21-60 are more prone to develop UTIs as compared to males. There is a shift in methicillin resistance of Staphyloccus aureus from hospital acquired to community acquired cases.
Key words: Urinary tract infection, Uropathogens, Methicillin Resistant Staphylococcus aureus, Methicillin Susceptible Staphylococcus aureus

Abstract: Laryngeal lesions can be benign, premalignant, or malignant. Patient history, clinical symptoms, and indirect laryngoscopy with a rigid or flexible fibre optic scope and stroboscopy can identify vocal nodules and polyps. This study seeks to identify laryngeal lesion-related diseases and their clinical and histological presentations. A cross-sectional study included histological data from individuals who had laryngeal surgery for lesions between February 2022 and April 2023. 80 histopathology reports were examined for various patterns. In the 80 patients, laryngeal lesions were 1.17:1 between men and women. 37 lesions (46.25%) were non-neoplastic, while 43 (53.75%) were neoplastic. 18 patients (48.64%) had vocal cord polyp, the most common non-neoplastic lesion. 36 individuals (74.41%) had squamous cell carcinoma, the most common of the 43 neoplastic lesions. Squamous cell carcinoma is the most common laryngeal lesion in our studies. Given the high occurrence of malignant neoplasms, all methods must be used to diagnose early. Histopathology determines the illness's treatment. This study examines laryngeal lesions such keratosis, pleomorphic adenoma, and papilloma histopathologically. This study will explain these lesions' morphology and pathophysiology. This study may improve laryngeal lesion diagnosis and treatment.
Key words: Keratosis, histopathology, laryngeal lesions, pleomorphic adenoma, papilloma.

Abstract: Introduction: There are multiple studies about the developmental variations of the arterial and venous system of the kidneys. However, the description of developmental variations of the excretory system are not abundantly present in the literature. Material and Methods: The structure of the renal excretory system was studied by means of macroscopic dissection on 90 kidneys. Results: Intrarenal pelvis (type I) when the pelvis is completely located inside the sinus, closed by the parenchyma was encountered in 45 specimens, which corresponds to 50% of cases. The extrarenal pelvis that is located outside the sinus and is not covered by the renal parenchyma was encountered in 9 specimens (10% of cases). Extrarenal type of pelvis with an open posterior surface, when, the posterior surface of the pelvis is free from the parenchyma and the anterior one is covered by the groove of the kidney was encountered in 18 specimens (20% of cases). The mixed type, in which the pelvis is located partly inside the sinus, partly outside of it, was encountered in 16 specimens (17.78% of cases). A special type of pelvis, when the pelvis as such is anatomically absent, and two elongated large calyces, connect and form the ureter was found in 2 cases (2.22%). Pearson correlation analysis demonstrated that calyces’ lengths correlated best when there were two calyces (r=0.51; p<0.001). When the number of calyces increases, this correlation decreased and when there were four of them – disappeared. At the same time, the length of the calyces decreased with an increase in their number (r=0.37; p=0.012). Conclusions: Developmental variations of the renal excretory system are frequent. There are multiple classifications that can be used in clinical practice depending on the surgical or endoscopic procedure. Most of the available classifications aim at assessment of the drainage area of the calyces and anatomical structure of the pelvis.
Key words: Renal pelvis, Major calyces, Kidney.

Abstract: Introduction: Schwannoma is a benign neoplasm of neural origin, commonly associated with cranial nerves. The aim of the study is to study the spectrum of demographic and clinical presentation of this neoplasm with special emphasis on unusual sites. We also discuss the histopathological features at these sites and analyse these with the available literature. Materials and Methods: This is a retrospective cross-sectional study of 3 years, where all diagnosed cases of Schwannoma at unusual sites were studied for histopathological parameters along with the clinical and radiological details. Results: 18 cases of Schwannoma at unusual locations were analysed. The age range was 20-82 years with mean age being 45.5 years. The sex ratio was equal. The most common presenting symptom was painless swelling with a duration ranging from 5 days to 7 months. Mean size was 4 cm. The most common site was the head and neck region and lower limbs constituting 28% cases each. All patients underwent complete surgical excision. Clinico-histopathological correlation was 70%. Histopathology confirmed the diagnosis in all cases. Conclusion: Schwannomas are benign lesions with good prognosis and minimal chance of malignant progression. However, the unusual sites and misleading presentations may pose diagnostic challenge for both the clinicians and pathologists alike. The lack of awareness of occurrence of this benign entity at unusual location may lead to unnecessary treatment. Pathologists should keep Schwannoma as a differential diagnosis even if the lesion is present at unusual site.
Key words: Benign, Neural, Schwann cells, Schwannoma

Abstract: Background: The study was carried out to evaluate the pulmonary fibrosis cases secondary to Covid-19 pneumonia and it’s relation with inflammatory markers in patients presenting at Indira Gandhi Medical College, Shimla, Himachal Pradesh. Materials and Methods: This was a Prospective Cohort study conducted from 1^st August 2021 to 31^st July 2022 and included 40 RT-PCR confirmed COVID-19 pneumonia patients who completed six months follow up. Demographic and clinical characteristics were recorded. Laboratory and radiological indices including pulmonary fibrosis were collected at admission and at three and six months and analysed using Epi Info version 7 software. Results: Among the totalof 40 patients, 26(65%) were males and 14 females (35%). Majority of patients belonged to age group of 51-60 years (35%). In 15(37.50%) patients, fibrosis was present at 3 months and at 6 months, fibrosis was present in 11 (27.50%) patients. Fibrosis was absent when dexamethasone was administered for a duration of 6.7(±3.94) days at 3 months and at 6 months when it was given for a duration of 7(±3.8) days which was found to be statistically significant (p value = 0.0047,0.009) . At 3 months fibrosis was present in majority of patients with deranged TLC, QCRP, NLR, LDH (40%,38.24%,42.86% and 42.42% respectively) and also D-dimer and ferritin (60% and 46.67% respectively), which was found to be statistically significant while At 6 months fibrosis was present in majority of patients with deranged QCRP, NLR, LDH, D-dimer (29.41%,31.43%,33.3% and 40% respectively) along with ferritin(36.67%), which was significant. Conclusion: Our study concluded that in most of the patients with mild lung involvement at presentation, fibrosis was significantly lower at 3 months and 6 months of follow up in comparison to patients with severe lung involvement and steroids for average duration of 10 days at presentation was significantly associated with improvement in fibrosis.
Key words: Covid-19 Pneumonia, Pulmonary Fibrosis, Inflammatory markers

Abstract: Background: The emergence of drug-resistant tuberculosis (DR-TB), a challenging health condition to treat, poses serious problems for public health in India. Unfavorable socioeconomic conditions, limited access to healthcare and insufficient diagnostic tools all increase vulnerability. Comorbidities also make it more difficult to treat TB and promote the development of DR-TB. Objectives: The primary goal of this review study was to focus particularly on the DR-TB epidemic in India. Our understanding of DR-TB will be expanded as a result of this study, which will also make it easier to develop focused interventions and public health regulations to deal with this problem. Methods: A meticulous systematic literature review was carried out using a wide range of electronic databases from around the world, including reputable sources. Results: The prevalence of DR-TB is rising over time. The main factors contributing to the disease's rising prevalence are genetic changes in Mycobacterium tuberculosis, and the appearance of comorbidities in TB patients. In contrast, these elements impair immunity, increase the likelihood of side effects from treatment, and promote the spread of DR-TB. Conclusion: To address the problems brought on by DR-TB, the TB epidemic necessitates a thorough, multi-sectoral approach. Initiatives for targeted public health education and awareness are essential to lowering the prevalence of DR-TB and improving general health outcomes in India.
Key words: Drug-resistant tuberculosis, India, Comorbidities, Treatment challenges, Diagnosis challenges

Abstract: A patient with no comorbidities presented with stroke. On evaluation, right lower limb cellulitis and compartment syndrome was seen. Investigations revealed sepsis. Subsequent day culture of pus and blood revealed the pathogen to be Shewanella algae. Our case report highlights the management and follow-up of the condition.
Key words: Algae, Cellulitis, Shewanella, Septicemia, Stroke

Abstract: Gout is the most prevalent inflammatory arthropathy in men caused by elevated serum uric acid levels.This article presents a case study of a 40-year-old male patient with chronic untreated gout exhibited as decompensated global dilated cardiomyopathy, painful nodular joints in the hands and feet, pitting pedal edema, elevated JVP, and crepitations in lower lung fields. Laboratory tests revealed high levels of NT-ProBNP, serum uric acid, azotemia. Echocardiography showed dilated ventricles with ejection fraction of 32%. X-ray images showed punched-out bony erosions in the joints of hands. Although there is substantial evidence indicating that uric acid may be an indicator of cardiovascular diseases, it has not been conclusively proven that hyperuricemia is a causative factor. Though it is uncommon, more studies are necessary to investigate the correlation between the severity of gout and heart failure. This case highlights the importance of regulating urate concentration in patients with gout.
Key words: Gout, Dilated cardiomyopathy, Hyperuricemia, Chronic Kidney Disease.

Abstract: Background: K. ohmeri is seen predominantly in cutaneous, endocarditis, fungemia and catheter-related bloodstream infections. Neonates are predisposed to systemic fungal infections due to prematurity, immunocompromised state, invasive procedures, intubation, prolonged stay on ventilator and antibiotic usage in neonatal intensive care unit. The prevalence of K. ohmeri in a new born has seldom been reported. Case Presentation: We present an unusual case of K. ohmeri fungemia in a full-term neonate. A term male baby born to a 25-year-old primigravida mother at 39 weeks of gestation age with birth weight of 2.5kgs via normal vaginal delivery, with episodes of hypoglycemia and multiple seizures was referred to our institution for further medical management. Sepsis screen showed elevated C Reactive protein levels. Blood samples were sent for microbial analysis. Culture yielded high growth of white dry colonies which was identified as K. ohmeri by VITEK 2 Compact System, and, matrix-assisted laser desorption/ionization - time of flight based automated bacterial identification system. Gram stain of the positive blood culture sample had shown numerous gram-positive oval-budding yeast like cells. Anti-fungal susceptibility patterns were evaluated and the child was put on fluconazole. Conclusion: Clinical antifungal treatment strategy for K. ohmeri should be adjusted promptly according to the susceptibility reports of the clinical isolates rather than empirical drug use.
Key words: K. ohmeri, endocarditis, fungemia, neonatal

Abstract: Squamous cell carcinoma (SCC) of cervix that spreads superficially to the inner surface of the uterus replacing the endometrium with carcinoma cells is called superficial spreading SCC, which is a rare phenomenon. A 65-year-old woman presented with foul smelling, white discharge per vagina since 1 month. Biopsy from cervix and endometrium revealed severe squamous dysplasia. The patient underwent hysterectomy with bilateral salpingoophorectomy. Microscopically, the cervix showed carcinoma in situ with upward contiguous superficial spread to the endometrium and left fallopian tube. Immunohistochemistry (IHC) with p16 was strongly positive in the dysplastic stratified squamous epithelium in all the sites. Superficial spreading carcinoma in situ of cervix with surface extension into endometrium and fallopian tube is rare and fewer than twenty cases are reported. IHC with p16 was used as a surrogate marker to establish the histogenesis. We are reporting this case with review of literature.
Key words: Superficial spreading carcinoma, Cervix, Endometrium, Fallopian tube, P16