Abstract: An anganwadi center provides essential services to extremely vulnerable and underprivileged communities, ensuring that these services are accessible at the beneficiaries' doorsteps to promote their active participation. Inadequate nutrition among children can lead to the development of infectious diseases, potentially resulting in long-term physical and mental impairments. This study aims to evaluate the impact of Anganwadi centers on the nutritional status of the children involved. The study employs a cross-sectional approach, examining 780 children aged 24 to 60 months from 50 Anganwadi centers in Bilaspur, Chhattisgarh, India. Anganwadi centres supplied information on socio-demographic characteristics, and facilities offered in Integrated Child Development Services (ICDS) centres and anthropometric measures were taken by researcher. The study reveals that the prevalence rates of stunting, underweight, and wasting among the children are 48.7%, 46.3%, and 28.8%, respectively, highlighting a critical situation. Children who did not regularly receive supplementary food from Anganwadi centers exhibited poorer nutritional status compared to those who did. Additionally, a lack of strong rapport between the workers and the mothers and children may significantly contribute to undernutrition. Continuous nutrition surveillance is essential, with particular emphasis on the poorest and most severely malnourished children. Efforts should focus on providing food of better quality and variety to improve nutritional outcomes.
Key words: Nutrition, Stunting, Underweight, Wasting, Anganwadi

Abstract: Approximately 1 in 16 women worldwide face an unwanted pregnancy each year. According to the latest round of NFHS-5 (2019-22), in India, eight per cent of women reported unwanted birth during the last five years and exhibited a nine percent unmet need for contraception. The paper attempted to examine the association of different predictor variables on the unwanted bearing using the IHDS panel data conducted in 2004-05 and 2011-12. The bivariate and multivariable logistic regression model was employed to examine the determinants of unwanted births among Indian women. The results show that out of the total women who wanted to cease childbearing in 2004-05, 26% experienced unwanted births in between the surveys. The multivariable logistic model showed that Muslim women were more likely to report unwanted childbearing than Hindu women (AOR-2.81, 95% CI (1.73,4.59)). Contraception use also determined the unwanted bearing among the women, and contraceptive users were 80% less likely to report unwanted pregnancy (AOR-0.21 95% CI (0.18, 0.24)) than non-users. Husbands’ involvement can never be neglected in infertility decisions, especially in India. When husbands desire additional children, women are more likely to experience unwanted births (AOR-5.80, 95% CI (4.72,7.11). The multivariate analysis also found that the odds of reporting unwanted pregnancy were low among those with at least one son (AOR- 0.52, 95% CI (0.43, 0.63)). There is a need to educate couples about the importance of small family size and reform the existing girl-child policies. In addition to women, husbands should also be counselled about the benefits of contraception use and the importance of a girl child.
Key words: Unwanted birth; India Human Development Survey-I and II; India; Fertility Intentions, Male Involvement

Abstract: Background: Breast cancer is the second most common malignancy in Indian women. The role of estrogen and progesterone receptors (ER and PR) is well established in predicting the prognosis and management of therapy. However, the role of androgen receptor (AR) expression is unclear in the Indian context. This study aims to evaluate the expression of AR in breast cancer and to find its association with clinicopathological parameters and hormone receptor status like ER, PR, HER2/neu and Ki 67 and also molecular subtypes of breast cancer. Materials and Methods: A retrospective study included 64 patients of histopathologically proven breast cancer with known hormone receptor and Ki 67 status. Demographic and histopathologic details were retrieved. Immunohistochemistry for AR was done and was correlated with clinicopathological parameters and hormone receptor status, Ki 67 status and molecular subtypes of breast cancer to find its association. P value <0.05 was considered significant. Results: AR expression was noted in 67.2% of the cases. Out of 42 ER positive and 33 PR positive cases, 34 (81%) and 27 (81.8%) showed AR expression respectively. AR positivity was noted in 30.8% of triple?negative tumors. AR expression was significantly associated with ER (P=0.001 ), PR (p=0.010), Luminal B (P=0.002) and triple negative cancer patients (p =0.003). No significant association was found with pathological parameters studied like laterality, tumor size, histological type, grade, lymphovascular invasion and lymph node status. Conclusion: We conclude that breast cancer express AR which is significantly associated with ER and PR and is significantly expressed in Luminal B and triple negative cases. Since a subset of triple negative cases showed positive AR expression, further studies are required to determine whether AR could be of therapeutic target in these patients.
Key words: Androgen Receptor, Estrogen Receptor, Triple Negative, Breast Cancer, Hormone status, Molecular subtypes.

Abstract: Objective: To identify the characteristic morphological features of benign prostate lesions, chiefly the mimickers of carcinoma, and to distinguish them from malignancy. Materials and Methods: All prostate specimens diagnosed as benign lesions during the two-year period from January 2022 to December 2023 were included. Malignant prostate lesions and autolyzed specimens were excluded. Haematoxylin and eosin-stained tissue sections were examined, and their medical records were reviewed. Results: A total of 173 prostate specimens were studied. The most common alteration was Basal cell hyperplasia, and the least common was Nephrogenic metaplasia. For comparison, the lesions were broadly classified into five categories: hyperplasia, atrophy, metaplasia, inflammation, and premalignant lesions. Conclusion: Various prostatic atrophy patterns, metaplasias, and hyperplasias mimic prostatic adenocarcinoma. Transitional cell metaplasia and basal cell hyperplasia mimic HGPIN. HGPIN mimics and leads to carcinoma. Hence, it is important to identify them correctly and prevent any false positive interpretation.
Key words: Prostate, Benign, Carcinoma, Mimickers

Abstract: Aims & Background: There is a lack of studies which determine the clinical outcomes and the characteristics of Gram-negative bacterial bloodstream infections (GNBSI) from India. In this retrospective study, we determine the risk factors for mortality in patients admitted at a tertiary care hospital with GNBSIs with focus on carbapenem resistant GNBSIs. Materials and Methods: A total of 375 patients admitted to the hospital from August 2020 to May 2022, with monomicrobial GNBSI were included in the study. The baseline characteristics of the patients were compared based on the carbapenem susceptibility of the pathogen. The independent risk factors for mortality were assessed at 7 days and 30 days since the GNBSI episode by Cox proportional hazards model. A sub-analysis was also performed in the subset of patients with event of intensive care unit (ICU) admission during the hospital stay. Results: Carbapenem resistant GNBSIs were detected in 36.53% (137/375) patients. Overall crude in-hospital mortality rate was 40.8% (153/375) among patients. The most common pathogens isolated were Escherichia coli (28.0%,105/375), Klebsiella pneumoniae (26.7%,100/375) and Acinetobacter species (17.3%, 65/375). Conclusion: Use of immunosuppressive drugs, ICU admission and need for vasopressors were independent risk factors for mortality. Among the 232 patients with ICU admission, carbapenem resistant Acinetobacter GNBSIs (CRA-GNBSIs) and Carbapenem resistant Klebsiella pneumoniae GNBSIs (CRKP-GNBSIs) were independent risk factors for mortality. There is a need for monitoring the carbapenem resistance and measures need to be taken to reduce it. Similarly, measures also need to be taken for early identification and effective treatment of GNBSIs to facilitate better outcomes.
Key words: Gram negative bacteria, blood stream infections, GNBSI, Carbapenem resistance, mortality, antibiogram, epidemiology, antibiotic resistance

Abstract: Introduction: The escalating prevalence of multidrug resistance is a global threat to human health particularly in critically ill patients with bloodstream infections (BSIs). Delay in the administration of the appropriate antimicrobial treatment is associated with higher mortality rates and adverse consequences. This study attempted to estimate the rapid antimicrobial susceptibility testing (RAST) breakpoints directly from flagged BacT/Alert blood culture bottles in clinical practice. Material & Methods: A descriptive, cross-sectional study conducted at a tertiary care hospital in Delhi over a period of two months. The RAST was performed directly from the clinical samples for blood cultures received in our laboratory in parallel with the routine antimicrobial testing as per standard CLSI guidelines. Blood cultures were routinely incubated in BacT/Alert 3D. The inhibition zones were read at 4, 6, 8 and 16-20 hour of incubation as per European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The identification of the isolates was confirmed by Vitek-2 compact system. Results: In our study, the area of technical uncertainty (ATU) percentage was initially high at 4 hours but decreased significantly in later incubation periods. At 4 hours, none of the S. aureus isolates showed >90% categorical agreement (CA) for any antimicrobial tested. However, clindamycin achieved the highest CA (100%) at 6 hours and 90% thereafter, with no very major errors (VME) or major error (ME). Cefoxitin required 8 hours to reach >90% CA, with no VME observed at any time point, but up to 75% ME at 8 hours. At 4 hours, most antimicrobials had high (>1.5%) rates of VME among Enterobacteriales. By 6 hours, only Meropenem and Gentamicin had >90% CA, with no VME observed for other antibiotics. Conclusion: The RAST method is relatively easy to implement in clinical microbiology labs, offering cost-effectiveness, simplicity, and rapid results, especially in resource-limited settings. However, reporting RAST results can be complex due to potential challenges with CA, VME, and ME, particularly in the initial hours of incubation and within the ATU.
Key words: RAST, EUCAST, Breakpoints, Vitek-2 compact system, Categorical agreement.

Abstract: In recent years taking selfies and posting them on social media has become a social, cultural phenomenon globally. But this behaviour can be detrimental to a person’s mental health, if they are regularly indulging in it. In this study we estimated the prevalence of selfitis and investigated its relationship with self-esteem, appearance anxiety and narcissistic personality trait among 403 students of a medical college in south India, using a cross-sectional study design. Standardised tools such as Selfitis Behaviour Scale, Rosenberg Self-Esteem Scale, Appearance Anxiety Inventory and Narcissistic Personality Inventory-16 were used to collect data and Pearson's correlation coefficient was utilised to investigate relationship between the study variables. The prevalence of selfitis was found to be 68.4%, with 51.1% having borderline, 16.13% acute, 1.24% chronic-selfitis. A mild positive correlation was found between selfitis and appearance anxiety (r = 0.376). This could be due to the need to seek approval and reassurance about their appearance through increased engagement with selfie-taking behaviour. Also, since the majority of students had features of selfitis (borderline, acute and chronic), they would be spending a large part of each day taking selfies and uploading them on social media. This could interfere with their academic performance and also impede social interactions. We recommend that adolescents need to be educated about the consequences of indulging in excessive selfie-taking behaviour and its negative impact on their perceived self-image.
Key words: Selfie, Self-esteem, Appearance anxiety, Narcissistic personality trait

Abstract: Background: Recently, Otoendoscopy, a novel technique, serves as a pivotal non-invasive diagnostic tool for the initial evaluation of ear disorders. Retraction pockets of the tympanic membrane are clinically significant because they can lead to hearing loss. Therefore, they necessitate careful evaluation and ongoing monitoring. Oto-endoscope because of the wide viewing angle gives a good view of the tympanic membrane status.The objective of this study was to clinically evaluate and grade tympanic membrane retractions and compare otoscopy and otoendoscopy findings. Material and Methods: This was a cross-sectional prospective study. A total 190 ears with tympanic membrane retractions of 111 patients were included in the study. Each of the patients was evaluated for retractions grade according to the Sade and Tos system of classification using pneumatic otoscope and otoendoscope. Results: In 79 (71.2%) patients had bilateral tympanic retraction whereas 32 (28.8%) patients had unilateral. Isolated pars tensa and pars flaccida retraction was found in 109 (57.3%) ears, and 4 (2.1%) ears respectively, while 77 (40.5%) ears having both type of retraction. A cross-tabulation of retraction grades revealed a significant association (p<0.001) between otoscopy and otoendoscopy. A difference in retraction grade findings was seen in 23 (12.1%) ears between otoscopy and otoendoscopy. Conclusion: Otoendoscopy has the potential to become the standard and routine diagnostic, monitoring and teaching procedure for examining tympanic membrane retractions in the outpatient setting. Otoendoscopy having certain definite advantages over otoscopy.
Key words: Retraction pockets, Chronic otitis media, Otoscopy, Otoendoscopy.

Abstract: Endometriosis is a prevalent gynecological condition affecting women of reproductive age and is often associated with infertility. The role of chronic inflammation as a significant etiological factor is supported by the frequent co-occurrence of conditions such as salpingitis isthmic nodosa in our case series. In this study, we present a rare case of synchronous endometriosis and Enterobius vermicularis infection in the ovary, underscoring the necessity for clinicians to consider diverse etiologies and pathologies in their diagnostic and treatment approaches. This case series emphasizes the importance of recognizing the varied presentations and potential complications of endometriosis to improve patient outcomes.
Key words: Endometriosis, Enterobius, Ovary, Appendix, Scar , Tuboovarian mass.

Abstract: Aim and objective: This study aims to determine the level of origin, branching pattern, and exit in relation to the psoas major muscle of the lateral femoral cutaneous, and genitofemoral nerves. Additionally, we determine the intraabdominal course, relations, and branching pattern of these nerves. Materials and Methods: A total of twenty-four lateral femoral cutaneous, and genitofemoral nerves of the lumbar plexus were dissected. The level of origin, branching, and exits in relation to the psoas major muscle were carefully examined. Moreover, we noted each nerve's unique origin, course, branching pattern and their relations. All these observations were recorded through photography. Results: In 2 cases (8.33%), we found accessory lateral femoral cutaneous nerves. 4 cases (16.67%) showed that the genital and femoral branches of the genitofemoral nerve had separate origins. The present study observed rare variations in the genital branch’s anatomical pattern and relations. Conclusion: To the best of our knowledge, this type of intraabdominal course and branching pattern in the genital branch of the genitofemoral and accessory lateral femoral cutaneous nerves have not been documented in any published data. Knowledge of anatomical variations in the course, branches, and their relations in the intraabdominal segments of the genitofemoral and lateral femoral cutaneous nerves is helpful for the proper clinical diagnosis and surgical procedures to avoid injuries and complications to the nerve.
Key words: Anatomic variation, Accessory nerve, Genitofemoral nerve, Lateral femoral cutaneous nerve, Lumbar plexus

Abstract: Cutaneous Leiomyosarcomas (CL) are rare, constituting just 3% of malignant soft tissue sarcomas. We present a case involving a 40-year-old male with a forearm nodule. Histopathological examination revealed atypical spindle cells with immunohistochemistry confirming Cutaneous Leiomyosarcomas. While the patient had a prior excision for a similar swelling, reports were unavailable. Treatment involved a wide resection with a lesion-free specimen. Cutaneous Leiomyosarcomas commonly presents as a nodular growth in extremities, with a microscopic appearance characterized by spindle-shaped cells exhibiting palisading and atypia. Differential diagnoses include other spindle cell lesions necessitating IHC for confirmation. Recurrence rates underscore the importance of wide excision. Distant metastasis, primarily to the lungs, and identified prognostic factors, such as lesion size and histological grade, contribute to the complex clinical landscape. This case emphasizes the rarity of Cutaneous Leiomyosarcomas, emphasizing the need for thorough diagnostic evaluation and a multidisciplinary approach for effective management.
Key words: Cutaneous Leiomyosarcoma, multidisciplinary approach