The term neurodegenerative refers to diseases that are usually recognized by symptoms like decreased motor control, mood disorders, and cognitive deficits. Some of the common neurodegenerative diseases are Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and the spinocerebellar ataxias. These diseases are complex and diverse in their pathophysiology with some causing memory and cognitive impairments and others affecting a person's ability to move, speak, control, and breathe. There are some prevalent drugs and therapies, which seems to be effective in improving the disease condition. Thus, it is need of the hour to develop new and more effective therapeutic approaches and strategies to manage and potentially tackle these devastating neurodegenerative diseases.

Head injury occurs as a result of trauma to the scalp, skull/ brain. It may be closed where there is no cut to the skin or penetrating (skin/bone of the skull is broken). India has an unenviable distinction in having Highest rate of death due to injury in the world. More than 100,000 lives are lost every year with over one million suffering from serious head injuries. Sub-arachnoid haemorrhage is most common in Traumatic Brain Injury.

Antibody therapy has shown to be effective in preventing hospitalization among patients infected with SARS-CoV-2. Rare hypersensitivity reactions have been reported to occur within one hour of infusion onset which prompted regulators to require a minimum of one hour of observation. We report a case of a hypersensitivity reaction that occurred after this time frame.

As the human-to-human transmitted disease, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been an emergency global public health event. Mucormycosis (previously called zygomycosis) is a serious, sporadic but cosmopolitan, rare opportunistic fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people with serious underlying diseases such as diabetic acidosis and acute leukemia and in patients treated with corticosteroids or cytotoxic drugs⁷. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. Mucormycosis is a rare infection, which when detected early can be controlled. Histopathological confirmation and fungal culture are of significant use in diagnosis of the infections.

Hypertension is an independent disease and one of the major risk factors contributing to the development of coronary heart disease, myocardial infarction, stroke, and ultimately disability and mortality. The appearance of hypertension in childhood is fraught with the risk of its maintenance in later years and an unfavorable prognosis in connection with the occurrence of the above-mentioned cardiovascular diseases. The paper aims to know the description of the problems and cases of high blood pressure in children at a Hospital, Baghdad, Iraq. Data were collected from Baghdad Hospital, where 40 children with high blood pressure were collected. A full study was conducted on the causes related to taking the patient's specifications and according to various sources, arterial hypertension (AH) is recorded in 1-3% of all children, in most cases, high blood pressure in children is secondary to diseases of the kidneys, heart, blood vessels, and endocrine diseases. However, in adolescents in the absence of signs of these diseases, a diagnosis of essential hypertension can be established, especially if a moderate rise in blood pressure is associated with increased weight and/or a familial predisposition to hypertension. More pronounced high blood pressure usually indicates a causal role for kidney damage.

We present a case of inguino-scrotal tumor involving seven years old children caused by Burkitt’s lymphoma and analyse the literature on this rare condition. At presentation, clinical examination showed impressive left inguino-scrotal tumor placed on the pubis. Blood analysis indicated mild anaemia and abnormal serum electrolytes. There were no signs of tumour lysis syndrome. Microscopic analysis of the tumor biopsy adduced the diagnosis of Burkitt’s lymphoma. Early and aggressive therapy is the key to ensure a good outcome.

Background: Gallbladder stone disease is a very common problem encountered by general surgeons thereby making cholecystectomy one of the most frequently surgical operations performed across the globe. The size of stone may vary from few millimetres to as large as the size of a golf ball. The size of the stone can pose technical challenges to the surgeon especially during laparoscopic cholecystectomy. Case Report: A 63 years old male presented to our OPD with chief complaints of recurrent right upper abdominal pain & dyspepsia for 6 months. An ultrasound of whole abdomen was suggestive of single gallbladder stone of approximately 5cm size. Laparoscopic converted to open cholecystectomy was done. The stone retrieved from the gallbladder had almost replaced whole of the gallbladder and was found to be approximately of the size of 7x2.5 cm, making it one the largest gallbladder stones reported in literature.Conclusion: Gallbladder stone disease is a very common entity. Incidence of very large gallstones is rare especially >5 cm. Larger the size of the stone; higher the risk of complications. Laparoscopic cholecystectomy is a standard treatment for gallstone disease, however in case of large stones laparoscopic cholecystectomy may be limited by technical factors including grasping gallbladder wall, obscured Calot’s triangle anatomy, dissection and delivery of gallbladder specimen at the end of the procedure.

Pediatric Cerebral Vascular Accidents (CVA), a term used to describe neurological accidents caused either by ischemia or hemorrhage. It needs rapid diagnosis and intervention, a golden hour is present for intervention or else severe sequelae may develop. Our case is that of a 10 years old girl with no significant past medical history presenting with sudden onset of stabbing headache with altered level of consciousness. She was found to have bilateral cerebellar hemorrhage associated with Antithrombin III deficiency. The patient developed cardiopulmonary arrest despite prompt evaluation and therapeutic intervention attempts. To our knowledge, this is the first case reported at this age group from Lebanon.

The sebaceous gland carcinoma of the eyelid is highly malignant with a high rate of local recurrence, regional and distant metastasis. It is a slow-growing tumor arising from Meibomian glands located in the tarsal plate, glands of Zeiss, sebaceous glands of the caruncle, and periocular skin. It usually occurs in elderly women and can be frequently misdiagnosed as chalazion or blepharitis or blepharoconjunctivitis. Herein, we present a case of sebaceous carcinoma of the upper eyelid in a young male previously incised and curetted for several times but without improvement and had to undergo wide local excision double freeze-thaw cryotherapy in all margins of skin and conjunctiva and reconstruction of the eyelid using cutler beard technique with a favorable outcome. There were no signs of local recurrence, regional or distant metastasis after surgery.

This study evaluated the treatment outcomes of retinal vein occlusion (RVO). In a study that lasted for 6 months. 38 patients with low vision due to MC with RCVO (9 patients) or RCVO (29 patients) participated in one eye. The age of the patients was 46-72 years, and the average age was 52 years. Immature cataracts were diagnosed at old age in 14 patients with concomitant eye diseases. The maximum corrected visual acuity (MCVA) was 0.06-0.4, the retinal thickness in the central region was ≥430 μm, and the duration of macular edema was from 4 weeks to 9 months. All patients underwent ophthalmological examination prior to implantation, after 1 and 7 days, 1, 4, and 6 months. After the injection. At each follow-up examination, visual acuity was determined according to the Sivtsev-Golovin table, ocular tension measurement, and ophthalmoscopy microscopy using a 78 dioptric aspherical lens or Goldman contact lenses. Retinal thickness was estimated using OCT "SPECTRALIS" OCT Heidelberg Engineering, initially in microns, size - in mm3, as well as retinal structure - thickness and cystic changes, subepithelial detachment, after 1, 4, 6 months. With a decrease in OZ observed after the treatment effect in the form of an increase in BCVA was achieved in the first months. Fundus imaging was performed using a seven-field computer suture of the retina (Visucam 500 ZEISS) before implantation and 6 months later; At a period of 10-14 weeks, PAH was performed in the retina according to the standard technique. Statistical Analysis: The data were processed using the Statistical program using the paired Student's t-test for related samples. Results with an error of less than 5% (p <0.05) were considered significant.

To study the prevalence and clinical severity of dry eye syndrome (DES) in patients before refractive operations, as well as the structure of its clinical and pathogenetic variants and etiological prerequisites. Patients and methods. In 600 people with myopia with or without astigmatism (234 men, 366 women; 30.1 ± 6.26 years), who applied for a refractive surgery, a survey was conducted on the OSDI scale; lipid interference test; Norn's tests and Schirmer-1, -2; lacrimal meniscus; accounting for the LIPCOF indicator; assessment of epitheliopathy and micro erosion according to Tseng; identification of the "wipers" symptom. The structure of etiological prerequisites was studied both in patients with identified DES and in those without DES, with the calculation, the Pearson chi-square test. To assess the strength of the relationship between the etiological prerequisite and DES, the normalized value of Pearson's coefficient (C ') was used. Results. The prevalence of DES was 38.83%. Of these, on the SSG light degree accounted for 71.67%, and moderately severe DES - 28.33%. Clinical and pathogenetic variants of DES with its mild degrees included: lipid deficiency (53.29%); lipid-mucin deficiency (26.95%); mucin deficiency (11.38%); condition without signs of lipid, mucin deficiency (8.38%). An isolated water deficit (6.06%) was found in patients with moderate DES; water-lipid deficiency (34.85%); water-mucin deficiency (7.58%); water-lipid-mucin deficiency (51.52%). Statistically significant (p <0.01) etiological prerequisites of the disease in patients with diagnosed DES included: wearing contact lenses (C '= 0.349); use of the monitor (C '= 0.337); the use of drugs that affect the production of tears or the stability of the tear film (C '= 0.41); the use of a cosmetic eyeliner (C '= 0.44); dysfunction meibomian glands (C '= 0.782); chronic allergic conjunctivitis (C '= 0.543); the presence of gynecological pathology (C '= 0.413); diseases of the thyroid gland (C '= 0.32); allergic pathology (C '= 0.563); female sex (C '= 0.559). Conclusion: - Raising awareness of ophthalmologists about the significant prevalence of early manifestations DES in patients before refractive surgery will optimize the detection of this pathology. Received data about the structure of clinical and pathogenetic variants and etiological prerequisites of DES can serve as a basis for the development of reasonable therapy. One of the most common and significant prerequisites for DES turned out to be DMZ, leading to lipid deficiency, which determines the direction of etiopathogenetic treatment - therapeutic hygiene of the eyelids.

Ewing's sarcoma is the second most common primary bone malignancy in children after osteosarcoma. It represents 4 to 9% of primary malignant bone tumors and affects the bones of the skull (maxillary, frontal, parietal, ethmoid, temporal bones) in only 1 to 4% of cases. Therefore, it rarely affects the head and neck. In this case report, we describe a case of a 13-year-old boy with left temporal Ewing sarcoma. When this patient presented with left temporal swelling and headache, imaging studies showed a mixed mass originating from the left temporal bone. During the biopsy and surgery (incomplete resection), the mass was invaded the facial nerve, which then required a nerve transplant. Postoperatively, he then underwent radiotherapy with induction and adjuvant chemotherapy. Although it is a rare tumor of the temporal bone, physicians should consider Ewing's sarcoma in the differential diagnosis of children and adolescents with facial nerve palsy. With a generally poor prognosis due to early metastasis to the lungs and other bones.

Background: In late December 2019, COVID-19, commonly referred to as the Coronavirus was identified in China because of the main explanation for recent human respiratory health cases. The virus was first detected in Wuhan City, and during a space of months, it had covered the whole globe. There are yet no therapeutics and vaccines available. The virus has engendered huge drastic changes to world healthcare, economic, transportation, and education systems around the world. Purpose: the general purpose of this study was to explore truck drivers’ views regarding commuting to the workplace under the COVID-19 circumstances of selected counties in Alabama. Methods: The research paper goal necessitated the truck drivers’ views regarding commuting to the workplace. Following a summary of the literature review research phase, the researcher conducted a variety of semi-structured interviews with truck drivers in Alabama through Survey Monkey by a postgraduate student in June-July 2020. Overall, 50 truck drivers have completed the survey. The info was stored on Survey Monkey servers within the Center for Urban and Rural Research (CURR), Department of Community and Regional Planning, Alabama A&M University. Results: The data analysis reveals their main workplace before the COVID-19 pandemic 94% of the truck drivers residing in Alabama especially from Jefferson county provided information about commuting to workplaces, while 4% to the places of educations (lecture room0 and a couple of production site. Furthermore, 92% of the truck drivers reported NO change within the means of transport in commuting trips during the COVID-19 pandemic, while 8% indicated changes within the means of transport. Conclusion: This research paper contributes important new empirical analysis of the truck drivers’ views regarding commuting to the workplace under the COVID-19 pandemic to some extent where there's an abundance of conceptual papers and opinion pieces but still scant evidence on the particular road safety of the pandemic for researchers to think about on potential person and situation factors related to COVID-19 that would affect road safety during and after the pandemic. Collaborative efforts by researchers and public and personal sectors are going to be needed to collect data and develop truck drivers' road safety strategies in reference to the new reality of COVID-19.

Periapical cysts are the most common inflammatory odontogenic cyst of the jaws with a prevalence of 52-68%. Trauma or dental caries is the most common aetiology for occurrence of such cystic lesions. Most commonly they are associated with the maxillary anterior teeth and are very rare in the maxillary third molar region. Here, we report a rare case of a radicular cyst associated with a partially erupted maxillary third molar, which could be a diagnostic dilemma.

Background: Cherubism is a rare fibro-osseous disease with genetic predisposition, characteristically involving the mandible and maxilla and causing their diffuse enlargement. The course and presentation of the disease is variable, following a benign course with remission of disease in a spontaneous manner with variable degrees of complications and residual disease. The CT imaging features of Cherubism are consistent with multilocular, variable size, irregular radiolucencies involving the maxilla and mandible with sparing of mandibular condyles. Case Report: Brothers, aged 9 and 11 years, presented with painless progressive swelling in bilateral cheeks and mandible. Non contrast CT with 3D reconstruction showed diffuse and extensively involved maxilla and mandible with gross bony expansion and appearance of irregular multiloculated areas of reduced bone density with hallmark imaging feature of sparing of bilateral mandibular condyles. Histopathological evaluation of biopsy of the mandible from left side of both the brothers was done.

Ascaris lumbricoides is one of the most common helminthic infections of the intestinal tract. Ascariasis is an endemic disease in our country due to the prevailing poor sanitary conditions. We report a unique and extremely rare case of Ascaris lumbricoides extracted from Psoas abscess in an adult female.

Background: Scrub typhus is endemic and documented zoonotic disease in the state of Himachal Pradesh as the climatic and geographical conditions are conducive for spread of vector of this disease. The most pathognomonic sign of scrub typhus is the presence of an eschar which is formed by the bite of chigger mite that inoculates the causative agent of Scrub typhus Orientia tsutsugamushi. The aim of this study is to determine the prevalence as well as the most common sites of eschars over the bodies of patients with Scrub typhus. Materials and Methods: This cross-sectional Sero-Epidemiological study was conducted in the department of Paediatrics, Indira Gandhi Medical College, and Shimla from 1st June 2017 to 30^th Nov 2018. The study participants were newly diagnosed paediatric cases(n-102) of scrub typhus with a positive Scrub typhus IgM ELISA test. We studied the distribution of eschars over the bodies of all 102 patients with Scrub typhus. Results: Eschar was present in 39(38.24%) patients. Among these 39 patients 21(53.8%) were males while 18 (46.2%) were females. There was a significant difference in the distribution of eschars between males and females with a preponderance of the chest and abdomen among females and the inguinal and axilla in males. Conclusion: The eschar is the most useful diagnostic clue in patients with acute febrile illness in areas endemic for Scrub typhus and therefore should be thoroughly examined for its presence especially over the covered areas such as the inguinal, chest, abdomen and axilla.

Background: The World Health Organization has reported scrub typhus one of the world’s most under diagnosed and under reported disease that often requires hospitalization. The aim of this study is to determine the Hematological manifestations among patients with Scrub typhus. Materials and Methods: This cross-sectional Sero-Epidemiological study was conducted in the department of Paediatrics, Indira Gandhi Medical College, and Shimla from 1st June 2017 to 30^th Nov 2018. The study participants were newly diagnosed paediatric cases(n-102) of scrub typhus with a positive Scrub typhus IgM ELISA test.  Results: Out of 102 cases 75 (73.5%) cases had increased ESR (>20), 51(50.0%) cases had low haemoglobin level (Hb < 11), followed by 33(32.4%) cases had leucocytosis (TLC >12000/cumm ) with mean value of 11363±6426, leucopenia was documented in 1 case(0.9%), lymphocytosis(>40%) was present in 30 (29.4%) cases and Neutrophillia >75% in 15(14.7%) cases. Thrombocytopenia (platelets < 150,000/cumm) was present in 31(30.4%) cases Conclusion:  Early recognition and focused management of Hematological complications may help reducemorbidity and mortality associated with Scrub typhus infection.

When a vascular etiology cause damage to the brain it is known as a stroke. The risk of stroke is more, during or immediate post-pregnancy. The symptoms of stroke depend on the site of the brain affected by the insult. Thrombolysis is a process used to breakdown abnormal blood clots that constrain blood flow in veins and arteries. The case study exemplifies a 27-year-old female, primigravida with a history of Middle cerebral artery infarct with the complaint of rambling speech, post thrombolysis. The speech characteristics were reduced loudness with reduced maximum phonation duration, shallow and fast breathing pattern on speech and at rest. Detailed Speech-language assessment done using Frenchay’s Dysarthric Assessment divulges mild dysarthria.

Hysteria, now classified as Conversion Disorder in DSM-IV and ICD-10, is characterized by neurological symptoms without an identifiable organic cause. These symptoms commonly involve motor or sensory deficits and are often associated with psychological stressors. We report a case of a 23-year-old male who presented to the emergency department with unresponsiveness lasting 2–3 hours. Clinical examination and vital parameters were within normal limits, and there were no features suggestive of seizure activity. Extensive laboratory investigations and neuroimaging, including CT scan of the head, revealed no abnormalities. The patient regained consciousness spontaneously and showed no neurological deficits on examination. Psychiatric evaluation revealed significant interpersonal stress related to marital conflict, with a history of a similar self-resolving episode following stress. Mental status examination was unremarkable, and there was no past or family history of psychiatric illness or substance abuse. Based on clinical findings and exclusion of organic pathology, a diagnosis of Conversion Disorder was made. The patient was managed with supportive care, counseling, and psychiatric intervention, following which he showed complete recovery. No recurrence was noted during hospital stay or subsequent follow-ups.

A 17-year-old boy presented in oculoplastic department with complain of painless swelling in lower lid for 1 year. Examination revealed a firm and mobile mass located infero-lateral aspect of left orbit with normal extraocular movements. The visual acuity, slit lamp bio-microscopic and fundus examination were within normal limit. The Computed tomography in axial and coronal sections showed soft tissue shadow homogenously enhancing with contrast.  The tumor was completely excised with swinging eyelid approach and histopathologic examination confirmed the diagnosis of angioleiomyoma. Herein, we present a case of rare orbital angioleiomyoma located inferolaterally and complete surgical excision with swinging eyelid approach. 

Introduction: Hoffa in 1904 first described fractures of the femoral condyle in tangential plane and are now known as Hoffa fractures. Approach to isolated medial Hoffa fracture is, however, confusing. On reviewing literature, majority cases are operated using parapatellar arthrotomy, some through a medial (subvastus) approach, and few was fixed percutaneously.Materials and Methods: We studied 6 patients of medial Hoffa fracture presenting in Orthopedics department of Kalpana Chawala Government Medical College, Karnal. They were evaluated radiologically with X-rays of knee anteroposterior and lateral view. All patients were approached through subvastus approach, and were treated with screws and buttress plating. The follow up of patients was done after 2 weeks, 1 month, 3 months and 6 months post operatively. Results: The age of the patients ranged from 27-31 (Mean 29 years). Mean range of motion was 125.83(range 120-130). All our patients had radiological bony union at 6 months. Functional outcome was calculated by Knee society score which was average 84.16 (range 80-88), which comes under excellent category (80-100). Conclusion: We concluded that outcome results of operated case of isolated medial Hoffa’s fracture using medial subvastus approach and fixation of fracture with screws and buttress recon plate are excellent (as per knee society score).

Cor triatriatum sinister is a rare congenital condition characterized by the presence of a membrane within the left atrium dividing it into two chambers the upper one which receives the pulmonary veins and the lower part contains the atrial appendage and empties into the mitral valve. Case Description: A 7 months old baby girl presented to the emergency department for respiratory symptoms including cough and tachypnea. She was initially treated with intravenous antibiotics, bronchodilators and oxygenation. Later with thorough investigations cor triatiatum sinister was diagnosed. Discussion: Cor triatriatum sinister patients usually present during infancy with cyanosis which helps in their early diagnosis. In fewer cases, cor triatriatum is diagnosed later in life due to atypical presentation with respiratory symptoms that may mimic asthma or respiratory infections. Conclusion: Recurrent respiratory complaints that do not respond to the common treatments must raise the suspicion of cardiac anomalies including cor triatriatum sinister. Early surgical treatment can protect the patient from short- and long-term complications.

AMR is defined as the ability of microorganism to survive the exposure of antibiotics at a dose that would kill or hinder their growth. Large population of India is usually a blame for easy dissemination of resistant strains. Poor public health indicators, growing incomes, and the availability of cheap antibiotics over the counter without a prescription are merged to generate the optimal conditions for a large-scale selection and spread of resistant genes in India. In the previous years the use of antibiotics has been increasing steadily. The data from Medline, Google search and others were collected and later evaluated by authors for discrepancies and recent advancements was presented in the form of description tables and figures.  This review discusses about the development of multidrug resistant bacteria that increased at an alarming rate over the past decades and caused serious problems. There is a vital need to promote new antibiotic therapies due to substantial increase of resistant strains of bacteria. Hence it requires the combined efforts of all members of society including patients, prescribers, pharmacist, individual to international regulators and policy makers to combat against this global burden of AMR.

Hydatidosis is a parasitic infestation caused by larval form of the tapeworm, Echinococcus. Even in countries where the Echinococcus infestation is endemic, primary hydatid cyst in the subcutaneous tissue and skeletal muscles of thigh, with no involvement of any thoracic or abdominal organs is very entity. We report an unusual case of primary hydatid cyst over posterior aspect of left thigh. Thus, emphasising upon considering echinococcal disease as the differential diagnosis of every subcutaneous cystic mass. This case is presented here for its rarity and importance of aspiration cytology as the first line diagnostic procedure.