Coronavirus disease 2019 (COVID-19) is highly infectious and primarily a respiratory infection. The presentation is often in the form of atypical pneumonia which if not detected and managed effectively, progresses to acute respiratory distress syndrome (ARDS). Due to the atypical nature, rapid spread and sheer magnitude of the COVID-19 pandemic, the guidelines for mechanical ventilation in COVID-19 ARDS are still evolving. In this review, we have attempted to examine the emerging evidence on the same to further our knowledge on the subject.

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Background: Data show that the prevalence of depression, anxiety, and stress is more among medical students compared to general population and thus proving that the community of the medical students is a vulnerable group or high-risk group, where we need to take adequate measures to counter this issue among this particular community. Objective: The objective of the study was to study the prevalence of depression, anxiety, and stress among one of the private Medical college students. Materials and Methods: An institution-based cross-sectional study was conducted in a private medical college among 450 medical students of 1^st, 2^nd, 3^rd, and 4^th year and interns and postgraduate (PG) students for 6 months. “Depression Anxiety Stress Scale 21” which was already validated and standardized was used for the present study. “The internal consistency, i.e., Cronbach's alpha value was 0.87 that was suggestive of high reliability.” Data collection was done in batches for undergraduates and for interns and PGs, whenever they were free and available. Anonymity was maintained. Results: Prevalence of depression, anxiety, and stress among medical students was 58.2%, 68.7%, and 35.3%, respectively. The most common was moderate grade of depression (30.7%), severe anxiety (39.6%), and moderate stress (15.8%). After testing for associated factors with depression, anxiety, and stress, it was fond that only belonging to joint family type and being undergraduate were found to be significantly associated with high levels of stress (P < 0.05). Conclusion: Prevalence of depression, anxiety, and stress among medical students was very high in this medical college. These results cannot be generalized to other medical students of other medical colleges but definitely reflect that medical students are depressed, anxious, and stressed.

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Background: Oral submucous fibrosis (OSMF) affects all age groups in Orissa. Rampant use of tobacco, gutka, and betel chewing made it a significant public health problem. Various modalities of treatments have been tried to ameliorate consequences of disease including antioxidants, local and systemic steroid, physiotherapy alone or with assisted devices, placental extract injection, and split skin grafting with varying success rate. Objective: The objective of the study was to compare effect of antioxidants and intralesional steroid infiltration in OSMF. Materials and Methods: Hospital-based prospective study was carried out among fifty patients presenting with OSMF. Only Stage two patients with Grade 2 and 3 trismus were included. History, clinical examination, and punch biopsy were taken. They were divided into two groups of 25 each irrespective of age and sex. Patients in Group A were given injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml). It was injected submucosally once a week for 8 weeks over multiple sites in oral cavity. Patients in Group B were given oral antioxidant capsule (containing lycopene 4 mg, zinc 7.5 mg, and selenium 35 mg) once daily for 8 weeks. All patients were followed up for 8–12 weeks at weekly intervals and then monthly once for 1 year. Results: Majority belonged to 26–35 years. Majority were consuming areca nut with Pan (52%). Burning sensation on taking food and trismus were common symptoms. Most common sign was fibrosis (70%). Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was significantly effective in trismus compared to oral antioxidant capsule daily once for 8 weeks. Conclusion: Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was more effective than oral antioxidant capsule daily once for 8 weeks.

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Neural tube defects (NTDs) are the most common congenital malformations (CMFs) in developing fetus. The study was done to determine the incidence and clinical profile of NTDs at a tertiary care hospital. The study was done at Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, from June 2019 to June 2020. Ten pregnant women with confirmed NTDs were admitted and subjected to medical termination of pregnancy. Fetuses with NTDs were collected and observed externally for sex, type of NTD, and other associated anomalies. Anencephaly was the most prevalent anomaly among all NTDs. Ten babies with NTD were observed; male predominance was seen. Prenatal screening of the fetus is important to rule out the CMF of fetus.

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Background: Since anemia is the most prevalent disorder in India, it got the significance to be studied and understood about. It is necessary to make people aware of the causes, the preventive measures, and the importance of nutritional supplements, proper diet required to prevent anemia. Objective: The objective of the study was to study prevalence, knowledge, and risk factors of anemia among school-going adolescent girls. Materials and Methods: This was a school-based cross-sectional study among 260 randomly selected adolescent school girls (10–19 years) from different private and government schools were included in the study. Study subjects were interviewed using a preformed and pretested, semi-structured questionnaire. Hemoglobin was measured using hemoglobinometer. Results: Mean age was 12.64 ± 1.53 years. Only 10% knew about anemia. Only 20% opined that decrease in red blood cells causes anemia. Majority did not know which mineral deficiency causes anemia. Nearly 10% said that hemoglobin is measured to find anemia. Only one-fourth felt that heavy blood loss during menstruation can cause anemia. Nearly 50% felt that anemics have weakness, breathlessness, and are more prone to infectious diseases. Less than 10% of the study participants knew about iron-rich foods. Less than 5% knew that coffee, tea, and milk hamper iron absorption and Vitamin-C enhances. Half of them knew that anemia is a life-threatening condition in severe cases and may require blood transfusion. Only 20% knew about anemia prophylaxis program. There was no significant difference among different variables such as different age groups, religion, socioeconomic status, type of family, and diet. However, there was a significant difference among different categories of body mass index and anemia. Conclusion: Prevalence of anemia is higher (96.5%) among school-going adolescents in a rural community of Telangana. Overall, the knowledge levels are quite low.

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Background: Patellar fractures are injuries of a serious nature. Among the skeletal injuries, they constitute about 1%. Males are affected double than that compared to the females. It is not easy to perform a stable form of reconstruction of the facture of the patella, and it is a major challenge to the surgeons. Objective: The objective of the study was to study the clinical profile of patients with patellar fractures. Materials and Methods: We conducted this study on forty patients with fracture patella in 2-year duration. The period of follow-up was 4–14 months. Management options included partial and/or total patellectomy and internal fixation with tension band wiring with K wire. All the fracture of patella cases by accident or due to fall were included. Careful clinical examination and history taking was carried out. X ray of the knee joint, anterior posterior, lateral view was also advised. Results: Male-to-female ratio was 4:1. Twenty percent of patients underwent conservative management. Among them, internal fixation with K wire banding was done in 60% of the cases, while 5% required total patellectomy and 15% required partial patellectomy. Majority, i.e., 85% had fracture of the patella due to road traffic accidents. Fifty-five percent of the cases had no complications. The most common complication was infections in 20% of the cases, followed by effusion in 10% and wire breakage in 10% of the cases. Only two cases had delayed union. Conclusion: As for as possible patella should be preserved with good surgical techniques, proper antibiotics and with good physiotherapy results are excellent.

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The majority of the freshly joined medical students have limited knowledge of the topics which are being taught and predominantly depend on the knowledge which is passed on to them by the medical teachers. It has been acknowledged that professional doctors have different learning needs in their workplace settings and thus, we have to encourage them for more of self-directed or self-determined learning to ensure that they keep moving forward in their professional career. The term heutagogy refers to a form of self-determined learning, wherein the learner takes the decision about what they wish to learn based on their needs and the approach they wish to adopt for learning the same. In conclusion, heutagogy is the vision for today and tomorrow and all the teachers should facilitate the learning among professionals and medical graduates to improve their proficiency level in the workplace.

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Cervical pregnancy is a rare form of ectopic pregnancy. Incidence is <1% of all ectopic pregnancies. It is defined as pregnancy that is implanted in the cervical canal below the internal os with cervical glands noted histologically. It is a rare variant of ectopic pregnancy and the diagnosis may be missed unless the clinician and the radiologist are aware of this entity. Here, we present a case of cervical pregnancy in a 26-year-old female G3P2L2 who was diagnosed as missed abortion and was planned for termination of pregnancy. During suction evacuation, she had severe uncontrolled bleeding. Laparotomy revealed the presence of an ectopic cervical pregnancy for which hysterectomy had to be done. Thus, this case illustrates the importance of its early and accurate diagnosis in order to avoid complications and for planning appropriate management accordingly.

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