Gossypiboma: a surgical menace

Gossypiboma is a rare yet devastating complication. It may be a sequela to any kind of surgical procedure, however intra-abdominal surgeries are commonly implicated as the cause for this entity. In chronic cases, it may even lead to severe morbidity. We report a case of gossypiboma post vaginal hysterectomy, diagnosed and treated successfully by laparoscopy

Goitre-A Clinical Image

Goiters are clinically discernible thyroid gland enlargements defined by uncontrollable growth and structural and/or functional alteration of one or more regions inside the normal thyroid tissue. They form an entity known as simple nodular goitre when dysregulation, thyroiditis, autoimmune thyroid disease, and thyroid cancer are absent [1]. This is regularly observed in nations without a public health initiative to prevent iodine deficiency [2].The case is relevant as it signifies a rare clinical condition which in future causes systemic complications. Furthermore, even when the gland is normal to palpate, up to 50% of the general population has thyroid nodules on sonography [3-5]. This could be one of the reasons for the rising use of diagnostic imaging in the evaluation of such patients, in addition to functional characterisation with blood Thyroid Stimulating Hormone (TSH), at least among thyroidologists [6-9]. It is noticed as a palpable or obvious swelling of the gland near the base of the neck. It could be associated with hypothyroidism, hyperthyroidism, or euthyroidism [10]. The symptoms are linked to adrenergic stimulation. Clinical signs and symptoms frequently involve hypermetabolism (increased metabolism), excessive thyroid hormone, a rise in oxygen consumption, alterations in protein metabolism, immunologic stimulation of widespread goiter, and ocular abnormalities. However, the non-specific nature of these symptoms makes diagnosis challenging. A 72-year-old male patient came to the out-patient department with the complaints of a diffused swelling over the throat region.The patient noticed the swelling three months back, which was increasing gradually. The swelling was associated with minor pain while speaking and swallowing. On clinical examination,lymphadenopathy was noticed at cervical lymph nodes of size 4 cm in length and 5 cm in width at front side of neck region. The overlying skin was not movable and was non-tender during palpation. On laboratory examination, only the thyroid profile was done by the patient, which was within normal limits. It was thus diagnosed to be a non-toxic goiter. Since, the swelling was diffused and large, a surgical excision was advised. After the surgical excision of the nodular goiter, the swelling was relieved and patient was free from any symptoms with a significant reduction in the size of the nodule. These images could be useful for differential diagnosis with anaplastic thyroid carcinoma, carotid artery aneurysm, and subacute thyroiditis [Figure 1,2]. Similar outcomes were seen in later investigations, which demonstrated a goitre size decrease of 40% to 60% within 1-2 years of medication [11-13]. The 131I technique is easy, affordable, and secure. After a single dosage of 131I, it is expected that thyroid volume decrease to 40% (total as well as nodule volume) and a cure rate of 75% (normalisation of scintigraphy and serum TSH) will occur [Table/Fig-3] [14-22,23]. Similar findings have been made for toxic solitary thyroid nodules [24,25]. The minor side effects include hypothyroidism, which is unrelated to any kind of dose planning. Patients who additionally have thyroid autoimmune disease or prolonged absorption by extranodular thyroid tissue are more likely to have hypothyroidism [26]

Role of Social Media Strategies with Advertising, Public Relations and Campaigns in Customer Revolution

Purpose: In this article, the growing impact of social media has been highlighted which helps in creating a base for certain facets. In compliance with this, the world of advertising observes an active association of social media channels. Moreover, public relations are effectively vital for brands to manage their image, thereby, trends of digital networks are inherently followed for its management. The conception of the customer revolution too undergoes a massive change due to the emphasis on the digital age.   Theoretical Framework: The theoretical framework of the study includes the various studies conducted by various researchers regarding the role of social media strategies in boosting customer value.   Design/methodology/approach: This study has developed with the use of journals and articles. The data presented in developing this research study is critically analyzed to explain the importance of the topic of research.   Findings: The major findings of this study explains that in this digital era with the onset of e-commerce business, social media strategies form the primary fundamental principle of every business activities. Research, Practical and Social implications: The main objective of this study is to identify and evaluate the roots of social media in the digital age and to analyse the impact of social media strategies implemented by organisations. Moreover, the study aims to identify the connection between social media strategies and advertising, public relations and customer revolution.   Originality/value: The value of the study is that it helps to identify the implications of Social Media Strategies on advertising, public relations, and customer revolution

Study of pulmonary functions in male current smokers and never smokers

Background: Cigarettes smoking is the principal cause of preventable disease, disability, and premature death in the world. Tobacco smoking affects multiple organ systems resulting in numerous tobacco-related diseases. The study aimed to investigate interrelationship of pulmonary functions between current smokers and never smokers. Methods: Asymptomatic, 50 males current tobacco smokers and 50 healthy never smokers aged between 25 to 50 years were selected as cases and controls. Detailed description of the subject’s selection, data collection and methods used for performing the test. Results: Maximum incidence was seen in >31 yrs of age with mean of 38.681±4.5. The study found that never smokers had significantly higher pulmonary functions as compared to current smokers:- FVC in liters (3.43±0.55 Vs 2.44±0.58; p<0.05); FEV1 in liters (2.86±0.57 Vs 1.76±0.32; p<0.05); FEV1/FVC in percentage (82.72±8.67 Vs 73.72±11.40; p<0.05); FEF 25-75 ratio in percentage (3.18±0.91 Vs 1.60±0.45; p<0.05); PEFR in liters per second (6.63±2.00 Vs 3.16±1.26; p<0.05); breath holding time in seconds (25.54±2.14 Vs 21.36±2.10; p<0.05); 40mm endurance test in seconds (22.36±1.58 Vs 17.70±2.01; p<0.05); MEP in mmHg (83.48±5.28 Vs 64.38±5.31; p<0.05) were found significant. Conclusions: The strong relationship between cigarette smoking and respiratory disease has been seen independent of the other risk factors in a number of well-designated epidemiologic studies. Spirometry is an excellent screening test to detect chronic airflow obstruction, but may be useful in detecting restrictive disorders as well to study the effect of tobacco smoking on pulmonary functions

Effectiveness of planned health education on knowledge of nurses working at tertiary care hospital regarding early detection of cancer cervix Karad, Western Maharashtra, India

Background: Cervical cancer is a major and devastating cause of mortality worldwide with an estimated global incidence of 5 lakhs new cases and 2.7 lakhs deaths annually among women. The objective of this study was to assess the existing level of knowledge and to determine the effectiveness of planned health education among the nurses regarding early detection and prevention of ca cervix.Methods: Evaluative approach with Quasi experimental one group pre-test-post-test design was used.168 sample were selected with simple random sampling technique, who those are working in tertiary care hospital, Karad. A pre-test given related to cervical cancer questionnaires followed by planned health education imparted for the duration of 45 minutes. Post-test using the same questionnaire were conducted after 7 days.Results: The study results showed that, the planned health education was effective in increasing the knowledge at the level of P <0.001.Conclusions: It is seen that training of nurses less than 30 years, even with lesser experience lesser than 5 years and with unmarried status benefited most. In service education training at the time of induction program and also frequently to refresh to sensitize the nurses with updating knowledge is recommended so that they can motivate the symptomatic and asymptomatic women who those are attending hospital as an outdoor patient or coming with the indoor patient as caretakers

The spectrum of microvascular patterns in adult diffuse glioma and their correlation with tumor grade

Background Primary brain tumors constitute the leading cause of cancer-related mortality. Among them, adult diffuse gliomas are the most common type, affecting the cerebral hemispheres and displaying a diffuse infiltrative pattern of growth in the surrounding neuropil that accounts for about 80% of all primary intracranial tumors. The hallmark feature of gliomas is blood vessel proliferation, which plays an important role in tumor growth, tumor biological behavior, and disease outcome. High-grade gliomas exhibit increased vascularity, the worst prognosis, and lower survival rates. Several angiogenic receptors and factors are upregulated in glioblastomas and stimulate angiogenesis signaling pathways by means of activating oncogenes and/or down-regulating tumor-suppressor genes. Existing literature has emphasized that different microvascular patterns (MVPs) are displayed in different subtypes of adult diffuse gliomas. Methods We examined the distribution and biological characteristics of different MVPs in 50 patients with adult diffuse gliomas. Haematoxylin and eosin staining results, along with periodic acid–Schiff and CD34 dual-stained sections, were examined to assess the vascular patterns and correlate with different grades of diffuse glioma. Results The present observational study on adult diffuse glioma evaluated tumor grade and MVPs. Microvascular sprouting was the most common pattern, while a bizarre pattern (type 2) was associated with the presence of a high-grade glioma. Vascular mimicry was observed in 6% of cases, all of which were grade 4 gliomas. Conclusions This study supplements the role of neo-angiogenesis and aberrant vasculature patterns in the grading and progression of adult diffuse gliomas, which can be future targets for planning treatment strategies

The Educational and Health Impact of COVID-19 on Children With Special Needs: A Systematic Review

RESEARCH OBJECTIVE: Governments across the world were forced to impose social distancing and lockdown measures to prevent the spread of COVID-19, caused by coronavirus SARS-CoV-2 that emerged in December 2019. Following the declaration of COVID-19 as a pandemic, the disruptions, including restrictive measures such as school closures had severe impacts on the physical, emotional and mental health of all people, especially children with special needs. There was also scant data, particularly in low-to-middle-income countries. Existing literature stems mostly from western countries, thus the need to perform a comprehensive review on this topic. THE RESEARCH PROBLEM AND METHODS: The primary objective of the systematic review is to understand the impact of COVID-19 and restrictive measures such as school closures on the educational outcomes and physical and mental health of school-going children with special needs. THE PROCESS OF ARGUMENTATION: This systematic review used the PRISMA 2020 checklist where four databases  and grey literature were searched for full text articles, peer reviewed publications in the English language that were published during January 2019–December 2021. RESEARCH RESULTS: The literature search identified 1294 publications, of which 25 key papers were selected. These studies investigate the impact on children with special needs across the globe, with a majority of papers from Europe. We found that COVID-19 and the digitalization of schooling had severe impacts on the physical and mental health of children with special needs and their parents/caregivers. CONCLUSIONS, RECOMMENDATIONS AND APPLICABLE VALUE OF RESEARCH: These studies highlight the need for an inclusive school environment to ensure that the learning outcomes for children everywhere are achieved. Further, a hybrid model that includes classroom learning with novel inventive methods would be beneficial for children with special needs.