Background: The mental health of medical and paramedical college students is likely to be severely affected by the second wave of COVID-19 pandemics, affecting their learning process. Aim and Objectives: The aim of the study was to assess the prevalence and level of stress, anxiety, and depression of health-care students living in Erode district, and their sleep quality during the second wave of COVID-19 pandemic. Methodology: This is a cross-sectional study and it was conducted via Google Form survey completed by students studying health-care-oriented courses such as MBBS and nursing students in Erode district. Results: A total of 318 students had completed data on demography details, sleep quality by Pittsburgh Sleep Quality Index, and mental health by Depression Anxiety Stress Scales questionnaires. The prevalence of borderline abnormal depression, anxiety, and stress was 25.5%, 25.2%, and 16%, respectively. The prevalence of poor sleep was 45% and overweight and obese students (P = 0.03) had more poor sleep scores than others. Nursing students had significant depression (P = 0. 03), anxiety (P = 0.04), and stress (P = 0.03) score than others. Conclusion: During the second wave of the COVID-19 epidemic, there was a significant rise in the incidence of unpleasant feelings and attitudes among health-care students stationed in COVID treatment hospitals, as well as poor overall sleep quality. We hope that this research will lead to an additional investigation into the mental condition of health-care students during public health emergencies. Furthermore, special emphasis must be devoted to improving the sleep quality of health-care students who are constantly exposed to the current viral pandemic due to their profession.

Background and Aims: This study aimed to ascertain a number of SARS-CoV-2 infections in patients who had received either dose of vaccination, admitted in a tertiary care center, in New Delhi, and make a comparison with morbidity and mortality. Methods: Data were collected from COVID-19 patients admitted from April 1, 2021, to May 31, 2021. It included the type of vaccination (ChAdOx1 nCoV-19 or BBV152) and the number of doses taken. Mortality and morbidity data were collected and compared based on the computed tomography (CT) severity score. Results: Among 1730 patients, 477 (27.5%) were vaccinated, of which 389 received ChAdOx1 nCoV-19 and 63 received BBV152 vaccine. In 46 patients with breakthrough infection, 7 succumbed. Observed mortality rate was 11.4% (197), of which 53 received a single dose, 11 were completely vaccinated, and 144 were unvaccinated. Among patients who took only one dose, CT severity was mild in 24, moderate in 131, and severe in 27 cases. In fully vaccinated, it was mild in 7, moderate in 22, and severe in just 1 case. Among unvaccinated, 53 had a mild, 349 moderate, and 67 a severe score. Comorbidities were noted in 103 expired patients. Conclusions: The study shows that <30% of patients were vaccinated. Only a handful had completed both doses. Reassuringly, only one among the fully vaccinated had a severe CT score. Although comorbidity influences the prognosis, most of the completely vaccinated who succumbed had no comorbidity. Hence, more research and larger data need to be gathered regarding postvaccination COVID-19 infection.

Aims and Objectives: Dengue is a mosquito-borne illness caused by Flaviviridae. Although presents with mild symptoms, occasionally deterioration of circulatory parameters results into dengue hemorrhagic fever (DHF) and/or Dengue shock syndrome (DSS) the later presents with plasma leakage and narrow pulse pressure. The objectives of this study are to quantify and characterize dengue shock syndrome among patients with diagnosed dengue fever at the Holy family hospital in Rawalpindi, Pakistan. Methods: A cross-sectional study was conducted between August 2016 and April 2017. Patients with DF were enrolled, and clinical information was abstracted while following the 2011 World Health Organization classifications and guidelines. Results: In our sample (n = 280), we found a higher proportion was of males (71.1%), <30 years old (~64%) and patients with primary type of infection (~71%). 22.1% suffered from DSS. The average duration of illness among patients was 3.6 days. DSS percentage was higher among patients who were aged <30 years (63%), males (64.5%) had a duration of illness <5 days (82.3%) and suffered from primary infection (60%). The odds of DSS were higher among patients with secondary infection (odds ratio [OR] = 2.0, confidence interval [CI] = 1.12–3.62, P = 0.02) and duration of illness <5 days (OR = 15.58, CI = 7.55–32.13, P < 0.0001) compared to the counterpart groups. Conclusion: The identification of complications of dengue is important in preventing the mortality and morbidity of the disease and reducing the burden on the health-care systems as well as on the community.

Background: COVID-19 presents with varied clinical presentations. Most of the patients have a good prognosis, but some patients rapidly progress to severe disease. Hence, early identification of severity becomes important. Aims and Objectives: This study aimed to compare the ferritin, troponin I, and D-dimer in intensive care unit (ICU) (severe) and non-ICU (nonsevere) patients of COVID-19. Materials and Methods: Data were collected from COVID-19 laboratory (n = approximately 2700). The patients were divided into ICU and non-ICU group. Ferritin and troponin I were estimated by chemiluminescence immunoassay and D-dimer was estimated by turbidimetric immunoassay. Results: Troponin I levels were comparable between the groups. Ferritin was elevated (P = 0.0001) in ICU patients compared to non-ICU patients. The levels of D-dimer were increased (P < 0.0001) in the ICU group compared to the non-ICU group. Conclusion: Despite the fact that troponin I may not be a decent indicator for the seriousness of the infection, it might be of use in patients with cardiovascular risk factors. Raised levels of ferritin might be a significant marker that demonstrates the chance of requiring escalated care for the COVID-19 patients. D-dimer can be used as a judicious marker for suggesting the severity and prognosis of the disease.

Currently, India is lagging behind in the medical doctors-to-population ratio, and the problem is even critical for postgraduate (PG)-qualified specialist doctors. However, there are rapidly advancing measures that are being taken toward improving health care for the whole population. The Government has the mandate to increase the number of seats for PG medical education and the teaching faculty to address the shortage of specialized medical doctors. The future of the PG medical education curriculum would include enhancements such as broader use of technology and inclusion of courses such as medical ethics and health economics. In addition, incorporating virtual learning, flipped classroom models, simulation studies, and interprofessional education in PG medical education would help to improve the quality and efficiency of medical education. Integration, innovations, and implementation are crucial keys to the reforms and should help PG medical education to achieve new heights in India in the near future.

According to the history of vaccine development, no vaccine for infectious disease has ever been developed in a shorter time than COVID-19. With the enabling scientific efforts and governments support, few vaccines for the COVID-19 have been developed across the globe. Using the keywords COVID-19 or coronavirus and vaccine supply chain management, and review of the literature are conducted on the databases of PubMed, Scopus, and Google Scholar. Study, collected the most up-to-date information on the COVID-19 vaccine supply chain, and then assessed it to find potential challenges and opportunities. Our prior understanding of the structure and function of the coronavirus family has also contributed to the quick development of several vaccination technologies. However, there is still a long way to go in terms of actually getting the vaccinations to people, as well as others that are on the way. In 2021 and beyond, the complicated logistics of controlling the vaccine cold chain, combined with limited government funding to assist distribution, will make mass immunization difficult. We have identified various challenges and opportunities related to the supply chain and logistics for COVID-19 vaccines. The solution to these challenges would play a crucial role to enhance the health quality infrastructure across the world. The present study discusses the various aspects of the COVID-19 vaccine supply chain and logistics that make its biggest challenges. The scale and short time required for global vaccination will teach lessons not only to researchers and manufacturers but also to supply chain managers. Scientists, researchers, and diverse sectors have all also benefited from the influx of opportunities.

Oral submucous fibrosis (OSMF) is a chronic insidious disease of the oral cavity mucosa which often occurs due to areca nut chewing, consumption of spicy foods, autoimmunity and genetic predisposition. Burning sensation in the mouth, intolerance to spicy foods, and increasing restriction of mouth opening owing to oral mucosa fibrosis are all clinical signs of OSMF. Advanced cases of OSMF cause hearing loss by blocking of eustachian tube. The extension of the fibrosis towards nasopharynx results in blockage of the eustachian tube opening at the nasopharynx and cause hearing loss. OSMF reduce the eustachian tube patency and cause conductive hearing loss. Involvement of the palatal muscles in OSMF patient may reduce the patency of the eustachian tube, resulting in conductive hearing loss. OSMF patients need audiological early assessment and tympanogram to detect involvement of eustachian tube and middle ear. Pure tone audiometry is a common audiological test which determines the types, degree and configuration of the hearing impairment. As these audiological tests is non-invasive and less time consuming, so useful to help early detection of hearing loss and appropriate therapeutic intervention. There are very few literatures are available related to OSMF and hearing loss. This review article discusses about the etiopathology, epidemiology, clinical manifestations and management of the OSMF and hearing loss.

There is a lack of detailed information on the epidemiology, prevention, and treatment of gambling disorder (GD) in Nigeria, a country that has the second-largest online sports gaming market in Africa. The objective of this review article was to emphasize the need for a nationwide epidemiological study on the GD caused by compulsive sports betting in Nigeria. The literature searches were carried out using the PubMed, Scopus, and Web of Science electronic databases regarding articles concerning sports betting, problem gambling, GD, and mental health in Nigeria using the following medical subject headings: Pathological Gambling AND Gamblings AND Federal Republic of Nigeria AND Social Epidemiology. A nationwide surveillance is necessary to determine the epidemiology, risk factors, and prevention and treatment measures for GD in Nigeria. To prevent negative public health consequences, sports gambling activities in Nigeria should be restricted and controlled. There is a need to set aside strict measures to control both legal and illegal online and offline sports betting activities in Nigeria. Moreover, the implementation of an effective mental health-care delivery policy to tackle gambling addiction and associated psychiatric comorbidities in Nigeria will enable efficient diagnosis and treatment of individuals with GD and improve relapse prevention. A well-funded and functional mental health-care system and research framework will facilitate effective mental health-care delivery among individuals at risk of GD and patients with GD in Nigeria. Expanding access to and use of mental health treatment services could substantially reduce the prevalence of GD and associated comorbidities in Nigeria.

Modern technologies offer several new applications and have several benefits in health-care delivery. These technologies include the Internet of things, artificial intelligence, wearable devices, telemedicine, virtual reality, and robotics. These enable targeted personalized health and well-being services. At present, the pharmaceutical industry is confronted with considerable hurdles and financial burdens related to clinical trial, retention, and adherence. Modern technologies allow participation in clinical studies from the comfort of home or any other location as per requirement. In the present digital era, patients can regularly expect more information about their health by using these technologies. These also reduce the chances of errors and precisely evaluate the amount of data and better analysis. Therefore, health-care service providers are now taking a proactive approach by adopting in wearable technology that can enable real-time monitoring of high-risk patients to predict the possibility of a catastrophic health crisis. Telecommunication equipment is more user-friendly and has been utilized by a large population all over the world, which is helpful to reduce the communication gap. In this review, we aimed to identify and discuss the significant capabilities of modern technologies for health-care delivery.

Aneurysmal bone cysts (ABCs) are vascular, cystic, benign osseous tumors that can expand rapidly and cause local destruction of surrounding tissues. These tumors are typically found in tubular bones and spines. An aneurysmal bone cyst is an extremely rare bony lesion in the head-and-neck region. We present the case of a 7-year-old girl with a left side nasal block and proptosis of the left eye for 3 months. On examination with anterior rhinoscopy, it showed a mass with a smooth surface inside the left nasal cavity. Biopsy confirmed the diagnosis of ABC, and she underwent complete endoscopic excision of the sinonasal mass. A giant ABC in the sinonasal area is highly uncommon, particularly in the pediatric age group. It is often confusing in its differential diagnosis with other malignant and vascular lesions of the head-and-neck region or sinonasal tract. Surgical removal is the treatment of choice.

Necrotizing fasciitis (NF) is rapidly spreading bacterial infection of a facial plane. It has a higher mortality rate in patients with diabetes and immunocompromised state. The initial presentation mimics cellulitis and most of the cases are misdiagnosed. Delayed diagnosis and treatment increase mortality by nearly 100%. Our case developed NF with septic shock following a monkey bite. The patient underwent prompt fasciotomy along with extensive wound debridement. Later, the patient underwent secondary suturing with a skin graft for wound cover. NF following money bite is not reported in the literature till now. Hence, early diagnosis and prompt surgical debridement in monkey bites will reduce the incidence of mortality due to NF.

Web at the carotid bulb is overlooked in routine practice. Carotid web is to be thought of as the causative factor in the absence of major risk factors or in cryptogenic stroke and familiarity of this entity is important among the radiologists and treating physicians. We report a case of recurrent ischemic stroke in young man who presented with limb weakness despite best medical therapy without any risk factors. There was left middle cerebral artery infarct on computed tomography (CT) scan. The evaluation of the cause of his stroke revealed carotid web on CT angiogram which was further confirmed by digital subtraction angiography and treated by carotid stenting to prevent further episodes of stroke.

Despite increasing information on Pseudoangiomatous Stromal Hyperplasia of Breast (PASH), the challenges of management of giant PASH remain for the surgeon. A pragmatic and individualized approach is the solution in the absence of reliable algorithms for management. This instance of a giant PASH tumor producing gigantomastia with severe ptosis is a case to point. When PASH presents as a giant mass, leading to gigantomastia with inevitable severe ptosis, the surgical options range from the excision of mass with reduction mammoplasty or a simple mastectomy with or without reconstruction. The key to surgical decision-making is individualization of surgery.

Ovarian edema is a rare solid tumor-like condition, usually seen in women of reproductive age. It occurs due to the accumulation of interstitial fluid in the stroma of the ovary, because of partial or complete torsion of the ovary causing interference with the venous or lymphatic flow but not the arterial flow. It is a misleading condition, difficult to diagnose visually and can lead to oophorectomy resulting in loss of fertility and hormonal function. We report the case of a 13-year-old girl who presented with acute abdomen. The ovary gave a visual impression of malignancy at laparoscopy and a frozen section was done. The frozen section ruled out malignancy and reported as ovarian edema which is a benign condition. The patient underwent ovarian detorsion and the ovary was conserved. Ovarian conservation is important in young girls and oophorectomy should not be done on visual suspicion. When possible frozen section should be done to confirm a benign pathology intraoperatively before taking a decision of surgical removal of the ovary.

Calcium channel blockers (CCBs) are one of the most commonly prescribed cardiovascular medicines. Overdose with prescribed CCBs can lead to a lethal outcome and high mortality rates. Here, we are report a case of amlodipine poisoning, with shock in a young male. The patient was saved by proper supportive care, inotropic medicines, and calcium gluconate. This report highlights the complications related to CCBs overdose and their management strategies.

Gastric adenocarcinoma usually has a poor prognosis due to its late diagnosis in most cases. Gastric adenocarcinomas account for 95% of all malignant tumors of the stomach. In this report, we described a case of a 63-year-old man who presented with pain in the epigastric region for 1 month which was associated with hematemesis and loss of appetite. The upper gastrointestinal endoscopy (UGIE) revealed an ulcer of size 3 cm × 3 cm in the lesser curvature of the stomach. The patient underwent open total gastrectomy, dissection D2, and a jejunal pouch of 30 ml additional capacity was created 20 cm distal to duodenojejunal flexure and passed retrocolic from a rent in transverse mesocolon. The patient was sent to chemoradiotherapy after the surgery and discharged on the 24^th day after surgery. Postoperative biopsy revealed tumor tissue showing irregular, ill-defined, and glandular clouding with loss of polarity. Infiltration was up to the muscularis layer and mesenteric lymph nodes showed partial effacement of architecture with reactive changes and few multinucleated foreign body giant cells confirming the diagnosis as poorly differentiated adenocarcinoma of the stomach of II B class (T2 N2 M0) as per the Union for International Cancer Control guidelines.