Abstract: Background: The rising global incidence of Caesarean section (CS) potentially reflects healthcare disparities between Particularly Vulnerable Tribal Groups (PVTG) and non-PVTG populations. This study analyzed CS patterns, indications, and outcomes between these groups at a district hospital in Gajapati, India. Methods: This prospective observational study examined 1,374 CS cases (177 PVTG and 1,197 non-PVTG) from October 2023 to October 2024. The analysis incorporated CS indications, APGAR scores, Robson classification, maternal age, and delivery timing using descriptive statistics and chi-square tests. Results: Previous CS emerged as the primary indication in both groups (PVTG, 29.9%; non-PVTG, 39.3%). PVTG women demonstrated higher rates of malpresentation (4.0% vs. 1.0%) and younger maternal age (23.2% vs. 19.3% for ages 18-20). Robson Group 5 predominated in non-PVTG cases (41.0% vs. 28.4%), while nocturnal CS rates were elevated among PVTG women (4.1% vs. 1.4%). Conclusions: The identified disparities necessitate targeted interventions, including enhanced antenatal care for young PVTG mothers, VBAC promotion among non-PVTG women, and improved round-the-clock obstetric services in the tribal regions.
Key words: Caesarean section, Particularly Vulnerable Tribal Groups (PVTG), Healthcare disparities, Robson classification, Maternal health outcomes.

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: Oncocytic cells are thyroid follicular derived cells, associated with non-neoplastic and neoplastic thyroid lesions. Aim: The aim of the study is to discuss the spectrum of Oncocytic cell lesions with respect to their demographic, clinical, cytological and histopathological features. Materials and Methods: This is a 2-year retrospective study in which thyroidectomy specimens with diagnosis of Oncocytic cell lesions were analysed. Patient data was obtained from the Medical Records Department. Fine needle aspiration (FNA) and histopathology slides were retrieved from pathology archives. Results: Amongst 360 thyroid cases, 16 cases showed Oncocytic cell lesions. Of these 16 cases, 3 cases were Oncocytic cell nodules, 10 were Oncocytic adenomas, and 3 were Oncocytic carcinomas. In this study, ultrasound and FNA were not effective in differentiating benign and malignant Oncocytic cell lesions. Age range was 33-74 years, and male to female ratio was 1: 4.3. On FNA, cases ranged from Bethesda II to Bethesda V. On histology, Oncocytic cell lesions showed various patterns-follicular, trabecular, nested, solid and papillary. Association with lymphocytic thyroiditis and papillary carcinoma was observed. Follow up data was available for 12 cases. Conclusion: Oncocytes are found in non-neoplastic as well as in neoplastic conditions in the thyroid. While the clinical significance of oncocytic cells is still not well established in literature, identification of Oncocytic cell carcinomas is necessary, as these are aggressive neoplasms.
Key words: Adenoma, fine needle aspiration, oncocytes, thyroid

Abstract: Purpose: β-lactamase mediated resistance mechanisms in gram-negative bacteria play a pivotal role in spreading antimicrobial resistance. We conducted this study to understand the prevalence of β-lactamases in Gram-negative bacteria in our region. Methodology: We conducted a cross-sectional study that included 3710 clinical specimens for culture tests from 2021 to 2023 following standard CLSI guidelines. Result: Extended spectrum β-lactamase resistance was the leading antimicrobial resistance mechanism detected in 53% E. coli isolates, followed by metallo β-lactamases (14%). Klebsiella pneumoniae was the second most predominant organism isolated, where 28% isolates exhibited metallo β-lactamase-mediated resistance. Comparative analysis of resistance levels in 2021 and 2022 revealed an increase in the prevalence of MBL resistance by 33% in K. pneumoniae. The prevalence of MBL producing P. aeruginosa increased by 51% from 2021 to 2022. Conclusion: The comparative resistance analysis between 2021 and 2022 highlights the impact of COVID-19 on the expedited rise of antimicrobial resistance.
Key words: Antimicrobial resistance, β-lactamases, Gram-negative bacteria, Carbapenem resistance, ESBL, AmpC BL.

Abstract: This case report presents a rare instance of an osteolytic giant cell tumor (OGCT) in a 12-year-old child, who presented with sudden onset paralysis. The patient was evaluated with MRI, CE-MRI, and PET scans, which revealed an extradural lesion extending from D5 to D6 with erosion of the pedicles of DV5-DV6. CE-MRI displayed a well-defined, solid extradural lesion measuring 11x25x24 mm in the posterior epidural region between the DV4 and DV6 vertebrae. A laminectomy was performed, and histopathology confirmed the diagnosis of OGCT. This report highlights the rarity of such cases, emphasizing the significance of early diagnosis and effective treatment.
Key words: Osteolytic Giant Cell Tumor, Thoracic Vertebra, Pediatric Spine Tumor, Histopathology, Extradural Lesion

Abstract: Introduction: Posttraumatic diaphragmatic hernias (PTDH) with delayed presentation are rarely encountered in clinical practice. They may be asymptomatic and detected incidentally or else lead to respiratory and gastrointestinal symptoms. Here, we present an experience of PTDHs at a general surgical division of a medical college in Kashmir valley. Methods: Retrospective analysis was conducted on all the patients treated for PTDH between 2010 and 2024. Results: There were 7 patients (5 females and 2 males) with a mean age of 37.7 years. The index abdominal injury was blunt in 6 and penetrating in 1 case. The interval between index injury and presentation of PTDH ranged from 5 months to 7 years (mean 4.6 years). Abdominal pain was the most common symptom. All the patients were definitively diagnosed with imaging and managed surgically. The postoperative phase was uneventful, and there were no recurrences. Conclusion: Posttraumatic diaphragmatic hernias with delayed presentation are rare; they can manifest even years and decades after trauma. Successful diagnosis requires a high index of suspicion and proper utilization of imaging modalities. Following diagnosis, PTDH must undergo a surgical operation to reduce the risk of further problems.
Key words: Diaphragmatic hernia, Laparoscopy, Trauma, Omentum, Recurrence, Imaging

Abstract: The sciatic nerve is the largest nerve in the human body. It originates from L4-L5 and S1-S3 spinal segments of the spinal cord and travels posteriorly through the lower limb providing significant portion of innervation to this anatomical region. The surgical procedures at the infragluteal region and transgluteal approaches to the sciatic nerve involves different incisions, level of dissection and are based on good knowledge of regional anatomy. During anatomical dissection of a 75 years-old cadaver, the course of the branches of the sacral plexus, the features of their origin and innervation zones were studied. To our knowledge there is only one report of a similar variation when the sciatic nerve bifurcates and then merges until its division into the tibial and fibular nerves.
Key words: Sciatic nerve, Anomaly, Developmental variation.

Abstract: Thyroid cancer is an emerging problem worldwide. Patients undergo surgery based on the results of cytology classified according to the Bethesda System for Reporting Thyroid Cytopathology. However, patients with Bethesda III and IV often undergo surgery due to “suspicion” of malignancy. In reality up to 68% of cases do not require surgery as the mass is not malignant. Core-needle biopsy (CNB) is an emerging new diagnostic method that can be useful to diagnose thyroid malignancies. It is potentially useful in cases of Bethesda III and IV as the obtained tissue can undergo immunohistochemistry and genetic testing. We present a case of 58-year old female initially diagnosed with a thyroid mass suspicious for thyroid cancer who undergone CNB that demonstrated benign nature of the tumor and eventually undergone organ-sparing surgery.
Key words: Thyroid surgery, Follicular tumor, Core-needle biopsy, Thyroid cancer.