The fifty-five word story form is gaining popularity within the field of medical humanities. Health-care professionals, particularly in the USA, are exploring the form as a means of creative expression to describe their encounters with patients, or comment on the practice of medicine. Its brevity and exactness are especially appealing for busy professionals. In addition, its potential as a method for personal reflection and teaching, which can lead to personal and professional growth, is also being realized. Medical institutions in the USA have encouraged their faculty and students to write about their experiences of the unprecedented challenges arising due to the COVID-19 pandemic by using this form, which has elicited a good response. The 55-word story form offers great promise for health-care professionals in India and other developing countries, for giving vent to their experiences while practicing in diverse settings.

The competence levels of faculty members in teaching-learning, assessment and curriculum development have been identified as one of the key attributes for imparting the desired skills to the medical students and in the overall process of producing a medical graduate. Thus, evaluation of the faculty performance is bound to have a strong impact on the educational environment of the entire course. Under ideal circumstances, it is essential to have a positive outlook towards the entire process of faculty evaluation targeting the skills of teaching-learning and assessment. In conclusion, the process of faculty evaluation targeting the domains of teaching-learning, assessment and contribution in the curriculum has multiple benefits for the students, faculty and the medical college, and thus should be always encouraged in a systematic manner.

Overweight and obesity are termed as excessive or abnormal fat accumulation which eventually leads to major life-threatening problems. The up strike is due to demographic transition, modernization, and industrialization. Irregular physical activity, high-calorie diet, and unhealthy lifestyle are the major reasons for obesity. The management of obesity or overweight comprises diet restrictions, by increasing physical activity, certain weight-loss program, and medical management that is by certain drugs that had a great challenge in reduction of weight. The article tried to discuss various weight reduction strategies adopted by obese and overweight individuals. The search strategy includes using the words “weight reduction strategies,” “obese,” and “overweight.” The platforms which the authors searched include PubMed, Google Scholar, and Scopus.

The infrahyoid flap (IHF) is a myocutaneous pedicled flap, which is mostly supplied by the superior thyroid vessels through the infrahyoid muscle perforators. The flap is thin as well as pliable which provides a skin island that is approximately 7 by 4 cm from the central part of the anterior neck. The flap can be transferred on its pedicle of the superior thyroid artery and vein to reconstruct medium-sized head and neck defects created after cancer excision. One of the best substitutes considered for the reconstruction of moderate defects is the infrahyoid myocutaneous flap. It can be carried out for the defects in the oral cavity, oropharynx, or hypopharynx carcinomas. The flap can be either unilateral or bilateral superior thyroid pedicle flaps but the main limitations are restricted arc of rotation and small flap volume. The IHF is contraindicated in cases with prior irradiation as well as cases of neck metastasis. The flap is reliable, easy to harvest during neck dissection, oncologically it is safe, and it carries a negligible donor site morbidity. The data from various databases PubMed/Medline, Scopus, Web of Science, and Google Scholar were included. The inclusion criteria were that only the review papers were included and that too published in the English language. This review paper highlights how the IHF can represent an excellent reconstructive solution to head and neck surgery as a tongue flap.

The branch of medicine continues to expand with each day and it becomes a major challenge for the physicians to stay abreast with the developments. The purpose of the current review is to explore the role of the TikTok application in improving medical education and healthcare delivery services. An extensive search of all materials related to the topic was carried out on the PubMed search engine between April 20, 2022 and May 24, 2022, and a total of 49 articles were selected based upon their suitability with the current review objectives. As single search engine was used, there were no duplication and search was performed by a single investigator. The inclusion criteria included availability of complete version of the articles and those articles published in only English language. Keywords used in the search include TikTok and medicine in the title alone only (viz. TikTok [ti] AND medical education [ti]; TikTok [ti] AND content [ti]; TikTok [ti] AND COVID-19 [ti]; TikTok [ti] AND misinformation [ti]; TikTok [ti] AND video [ti]; TikTok [ti]). It was a non-funded study and the review was not registered. TikTok has emerged as one of the very popular video sharing applications, and has been extensively used to share videos pertaining to medicine, and public health-related topics. The application has been used in different parts of the world to post content pertaining to coronavirus disease 2019 (COVID-19), handwashing, promotion of community engagement, nutrition, vaccine, autism, climate health, eating disorders, stress & anxiety, etc. Like any other social media application, even TikTok has its share of constraints, and these need to be carefully dealt with to enhance the overall effectiveness of the app. To conclude, the TikTok application has brought about significant reforms in social media networking. However, considering the fact that the application appeals to users from all streams, it is the need of the hour to explore and use the app for augmenting the healthcare delivery, improve management of public health problems, and facilitate better delivery of medical education.

Objective: This study aimed to systematically identify and assess randomized controlled trials (RCTs) that evaluated the efficacy of transcranial magnetic stimulation (TMS) for increasing tobacco abstinence. Methods: Five electronic databases were searched from inception to May 2021 to identify RCTs evaluating the efficacy of TMS interventions for tobacco cessation or abstinence. Using predetermined eligibility criteria, two reviewers screened literature and assessed the quality of included studies using the Critical Appraisal Skills Programme tool. Results: Out of 222 records, six RCTs with TMS intervention were shortlisted. Two studies assessed TMS in conjunction with other active tobacco cessation treatment, while other four studies used TMS as only active form of treatment. The limited number of included studies had short follow-ups, large dropout rates, and heterogeneous interventions and comparators, which precluded clear detection of treatment effect of TMS interventions. Conclusions: TMS intervention differed significantly from comparator group in their effects on tobacco use. However, low-quality limited evidence with variability in study design among existing studies suggests the need for high-quality, long follow-up and robust RCTs to be conducted.

Background: Deliberate self-poisoning (DSP) is one of the leading causes of mortality and morbidity in India. Drug overdose is one of the most common methods for the same and is a growing public health concern globally. It is important to know the spectrum of drugs used for the same and to identify any specific groups at risk. Methodology: This retrospective cohort study included patients presenting with medication drug overdose to the emergency department (ED) from January 2017 to December 2018. Patient data were obtained from the ED triage registry software and clinical workstation. Following this, their hospital outcome was determined. Results: During the study period, 1802 patients presented with DSP among which drug overdose comprised 27.6% (498/1802). The mean age was 32.8 years (SD-12.6) with a higher incidence in the age group comprising young adults (16–30 years, 52%), majority being females (68%). The most commonly consumed drugs belonged to the drug class of benzodiazepines (22%), NSAIDs (19.2%), antihistamines (15%), antidepressants (12%), and antipsychotics (10.2%). The mortality rate was 0.2%. Conclusion: Benzodiazepines were the most commonly consumed class of drugs used for DSP, followed closely by NSAIDs. Drug overdose showed a higher incidence in the age group of highly productive young adults. The incidence exhibited a seasonal pattern with peak in April and May. Although the mortality rate following drug overdose remains low, drug overdose is a commonly used method for DSP and continues to be a growing public health concern.

Purpose: Eccentric exercises may cause fatigue. Fatigue in lower body causes decline in dynamic balance which may cause injury. The purpose of the study was to examine the changes in dynamic balance before and after an acute bout of eccentric exercise using Y-balance test (lower quarter) among athletes and nonathletes and to find injury risk by change in balance. Materials and Methods: This study investigated 39 subjects which were divided into two groups: Group 1 (n = 19) athletes (mean age, 21.89 ± 2.62 years; height, 2.96 ± 0.25 m; mass, 66.52 ± 10.05 kg) and Group 2 (n = 20) nonathletes (mean age, 23.95 ± 1.73; height, 2.77 ± 0.30 m; mass, 60.12 ± 8.25 kg). Before and after acute bout of eccentric exercise, all subjects underwent an assessment for dynamic balance using Y-balance test-lower quarter. Results: After an acute bout of eccentric knee exercises, dynamic balance was not reduced significantly (P > 0.05) in Group 1 (athletes) as well as in Group 2 (nonathletes). Conclusion: In the current study by performing eccentric knee exercises, dynamic balance was not reduced in both the groups. Therefore, these eccentric knee exercises can be done by both the groups without risk of getting injured.

Background: Several mutations including the single nucleotide polymorphisms (SNPs) in the GSTP1 and deletional mutations of GSTM1 and GSTT1 isoforms of the glutathione S transferase gene are of significant importance in the etiology and severity of prostate cancer (Pca) with varying degrees of association in different population groups. We investigated the association of these mutations with the prevalence and severity of the Pca in an urban population of Eastern India. Materials and Methods: In the present case–control study, deletional mutations of the GSTM1 and GSTT1 were detected by their presence or absence in the gel electrophoresis after the polymerase chain reaction (PCR). The A to G SNP of the GSTP1 gene resulting in Ile105Val was detected using Restriction Fragment Length Polymorphism after PCR. Severity of Pca was assessed by International Society of Urological Pathology (ISUP) grading. Polymorphic variations obtained were correlated to the prevalence and severity of Pca. Results: The Chi-square tests showed a significantly greater prevalence of all three mutations in the case group. However, the post hoc ANOVA and multiple logistic regression analysis revealed that only the A to G SNP of the GSP1 gene among the three mutations showed significant association with the severity of the Pca as indicated by the ISUP gradings. Conclusion: The results indicated that although the A to G transitional SNP of the GSTP1 and the deletional SNPs of GSTM1 and GSTT1 acted all as important factors for increasing the prevalence of Pca, the A to G SNP of the GSTP1 gene resulting in Ile105Val only contributed to the severity and spread of the disease in our study population.

Background: The haphazard use of supplements without proper consultation from a health expert can lead to side effects, especially in youngsters. These supplements have very few regulations nationwide, and practically, no effort has been taken to make the public aware of its ill effects, besides warnings issued by the manufacturing companies on the products. Methodology: A cross-sectional study among 2^nd -3^rd MBBS students studying in a medical college was carried out to study the prevalence of use of supplementary nutrition, its type, source of information, and preferred type of supplements. Results: The overall proportion of dietary supplement use among medical college students participated in this study was 29.4%. Multivitamins, protein powders, and energy drinks were the most preferred type and the reasons mentioned for intake were for general well-being to avoid future illness and muscle-building purpose. Conclusion: More awareness among frequent and haphazard users who are on supplementary nutrition without any medical opinion should be incorporated to avoid side effects created by unregulated nutritional supplements available in market.

Introduction: Microteaching (MT) is innovative teaching–learning method to honed and refined teaching skills in teachers. The training of medical teachers in India in pedagogical technique is not mandatory. Hence, the quality of teaching imparted in medical school is heterogenous. In today's era of Competency Based Medical Education and society's increasing high expectation on health professionals, it is essential to make competent medical teachers with improved pedagogical skills. Hence, the study was conducted to assess the baseline knowledge, practice, and attitude about MT among health professionals. Methods: A cross-sectional study was conducted during the period September 18–19 among all postgraduate (PG) students and teachers who have < 5 years of teaching experience after taking written consent in all constituent colleges under an university of Health science in Navi Mumbai. Results: Nearly 76.6% of health professionals were aware about concept of MT and 56.3% of health professionals could defined correctly MT. Only 12.6% of health professionals had correctly enumerated phases of MT. Nearly 65.1% of health professionals reported that MT as a teaching training tool should be included in PG training. Overall, 20–40% of health professionals were strongly agree to agree on various merits of MT. 57.8% health professionals suggested that experts should demonstrate teaching skills, whereas 50.6% of health professionals said that it should be made as mandatory exercise so that PG students and novice medical teachers would improve their teaching Skills. Conclusion: These observations suggest that microteaching exercise should be mainstreamed in health professional's curriculum in phase wise manner in future.

Background: The information regarding the prescribed medication has to be given to the patients who consume the same. Most medicines now need a valid prescription for dispensing by a registered pharmacist. This chain of medicine distribution takes away the decision-making rights of the consumers, thereby greatly increasing the responsibility of the prescribers and dispensers. The availability of Package Inserts (PIs) has been made mandatory by most agencies globally. Materials and Methods: Each saleable unit of all the available medicines in the medical stores were analyzed for the availability of the PIs. The medicines for which PIs were available were classified into those manufactured within India and outside. All the PIs were assessed for their completeness. Results: Only a minor fraction (20.9%) of the saleable units of the available medicines carried PIs. All PIs carried information on therapeutic indications including posology and method of administration. The main difference between the imported and indigenous medication PIs was with regard to information on antidotes for overdosings, list of excipients, incompatibilities, shelf life, and specific instructions for use/handling.Conclusion: The availability and quality of PIs must be checked regularly by the concerned regulators and suitable punishment clauses must be introduced through legislations to ensure all manufacturers to adhere the same. The ultimate goal of good PIs must not only be to provide information to health care professionals but also to enhance the knowledge of the healthcare consumers to make informed decision-making and thereby enhancing the quality of healthcare.

Background: This hospital-based study was done to estimate the prevalence of uncorrected refractive errors in adults attending to our outpatient department (OPD). Aims and Objectives: 1. To estimate the prevalence of uncorrected refractive errors in adults attending to our OPD. 2. Effects of uncorrected refractive errors on education, social life, job, psychological impact. Materials and Methods: In this hospital-based retrospective study, 570 refractive error patients above 18 years of age were included. All known cases of refractive error, not using glasses, were also included in this study. As per the WHO criteria, visual acuity <6/18 of Snellen visual acuity chart was taken as visually impaired while legal blindness was defined as visual acuity of 6/60 or less. Those who had ocular or any kind of systemic illness were excluded from this study. Manual retinoscopy followed by subjective verification, detailed slit lamp examination, and dilated fundus evaluation was done in all cases at the time of presentation. Postmydriatic refraction was mandatory in all who were below 21 years of age. All statistical analysis later on conducted in SPSS version 27 retrospectively. Results: Out of 570 patients with refractive error analyzed, 55.81% (N = 317) were found males and 44.19% (N = 251) were females. Refractive error was 50.18% (N = 285) among Hindu population whereas in the Muslim population, it was found 49.82% (N = 283). Refractive error was mostly encountered in students (46.65%, N = 265) followed by housewives (31.87%, N = 181). The most common cause of hospital visit was headache (71.48%, N = 406). The most common refractive error was compound myopic astigmatism (43.56%, N = 248). The prevalence of refractive error was 3.8% with a legal blindness of 39.40% (N = 99) in male and 37.10% (N = 118) in female. A total of 435 (76.58%) patients were freshly diagnosed in our study. A total of 20.25% (N = 115) patients refused to wear glasses because of social factors. A total of 2.10% (N = 12) patients were rejected for various jobs, whereas among 10.56% (N = 60) of cases, refractive error had the social and psychological effect in their life. Poor performance in education was found among 11.27% (N = 64) of cases. Conclusions: Adult screening for uncorrected refractive errors should be incorporated into the health-care system, especially for housewives, and always wearing a glass in cases of refractive error should be encouraged and campaigned.

Background: Methicillin-resistant staphylococcus aureus (MRSA) are responsible for many hospital-acquired infections. Clindamycin (CL) is used to treat methicillin-sensitive S. aureus (MSSA) and MRSA. Antibiotic sensitivity testing (AST) can miss out the inducible CL resistance (CL-R) and result in failure of treatment. D-test detects inducible CL-R. Subjects and Methods: One hundred and ten S. aureus strains were tested. D-test was performed using erythromycin (ER) (15 mcg) and CL (2 mcg). The absence of inhibition around ER and a zone of inhibition around CL with flattening of the zone facing ER side is taken as positive D-test. Results: Of the total S. aureus strains, 36% were MRSA and 74% were MSSA. A total of 20 (18.18%) strains out of 110 were found to have inducible CL-R. In this study, MRSA (19.4%) were found to have higher percentage of D-test positivity as compared to MSSA (17.56%). Conclusion: D-test must be performed routinely as a part of AST for the presence of inducible phenotype.

In this modern era, though some of us start our surgical career with phacoemulsification (PHACO), still today, some scholars believe that manual small-incision cataract surgery (MSICS) has the similar efficacy with PHACO. Objectives: The study objective was to analyze cataract surgery outcomes in terms of vision, complications, and postoperative quality of life. Study Design: This is a retrospective study. Materials and Methods: All surgeries were performed under peribulbar block. Lens power calculation was done by A-scan. Glaucoma, corneal pathology, pterygium, uveitis, and all the posterior-segment pathology cases were excluded from the study. The total follow-up duration was 6 weeks. MSICS was strictly performed for mature cases. Results: Out of 336 cases, MSICS was performed in 151 cases, whereas PHACO was performed in 185 cases. The majority of cases was between 61 and 70 years of age. After 6 weeks, the minimum cylindrical number was encountered as − 0.75 D in small-incision cataract surgery (SICS) and − 0.5 D in PHACO. Visual acuity of 6/6 was found in 6.6% (n = 10) cases of SICS and 15.6% (n = 29) cases of PHACO. The levels of visual acuity after cataract surgery were categorized using the World Health Organization (WHO) guidelines with good outcome being 6/6–6/24, borderline outcome being 6/24–6/60, and poor outcome being < 6/60. According to the WHO guideline, good vision was present in 84.10% (n = 127) and 97.83% of cases of SICS and PHACO, respectively. Postoperative day 1 cornea was found absolutely clear in 91.97% (n = 336) of cases (P < 0.001). There was not a single case of endophthalmitis. Nucleus drop was seen in one case of PHACO. Conclusions: Visual acuity of 6/6 can be provided to SICS patients, and there is no need to try PHACO especially in intumescent white, black, and brown cataract cases.

Introduction: According to the available statistics, 53% of deaths are related to lifestyle. The aim of this study was to evaluate health-promoting lifestyles in medical students of a medical college of Western Maharashtra, India. Objectives: To determine the health-promoting lifestyle behaviours among undergraduate medical students and to find out sociodemographic determinants of HPLP. Material and Methods: This cross-sectional study was performed on 307 undergraduate medical students. Health Promotion Lifestyle Profile Proforma (HPLP)was prepared which consists of two parts, Part I deals with the sociodemographic characteristics of the participants and Part II of the proforma deals with Health-promoting lifestyle information which was a modified version of HPLP II. It consists of 46 items divided into 7 subscales. Permission of Institute Ethical Committee was taken. Data was analyzed by using analysis of variance (ANOVA) and Mann Whitney test and predictors were determined by multiple linear regression analysis. Results: Medical students of this Institute showed good level of health-promoting lifestyle in total HPLP II score. The overall HPLP-II mean score and all subscales of HPLP except interpersonal relations were significantly more among the first and third year students than 2nd year students. Female students practiced significantly better food practices while Male students showed a significantly higher level of physical activity and self-concept. Income was the significant predictor of overall HPLP; age was the significant predictor of Health responsibility, sex and income were the significant predictor of physical activity, sex, living with family and income were significant predictor for food practices; sex, living with family were predictors of spiritual growth; BMI and income as a predictors for Interpersonal relations; and age was a predictor for stress management. Conclusion: The study results showed that Medical college students in Pune had reasonably good orientation towards health promoting practices.

Background: Cervical cancer is the fourth most common cancer worldwide. It is well-known that cervical carcinoma progresses from a preinvasive disease, which can be picked up easily by routine cervical smear examination. Studies have shown that dysplasia is five times more common in females with human immunodeficiency virus (HIV) than in healthy controls. This study aimed to find if any association existed between CD4 count, viral load, parity, hemoglobin level, age at first childbirth, duration of highly active antiretroviral therapy, and cervical epithelial abnormalities. Methods: The present study was a 4-year retrospective study conducted in the Department of Pathology at a tertiary care hospital of Western Maharashtra. The liquid-based Pap smear slides of HIV patients reported during the period were retrieved and reviewed. The data collected were tabulated and analyzed using the SPSS software. Statistical test was used to find an association between various clinicopathological variables and smear findings. Results: Pap smear abnormalities were found in 14% of the patients. The present study found a statistically significant association between Pap smear abnormalities and CD4 count, viral load, and the hemoglobin level of the patient. Conclusion: There is a high prevalence of Pap smear abnormalities in HIV-positive patients. CD4 count, hemoglobin level, and viral load can be used as surrogate markers for deciding the frequency of Pap smear in HIV patients.

Paragangliomas are rare neuroendocrine neoplasms that arise from chromaffin cells. They most commonly arise in adrenal medulla and are called as pheochromocytoma. About 10% of paragangliomas arise at extra-adrenal sites. Of the functioning extra-adrenal paragangliomas, majority present with intermittent hypertensive attacks. Very rarely, paragangliomas secreting other hormones including adrenocorticotropic hormone, endorphins, pancreatic polypeptide, androgens, and insulin have been reported. Patients should be evaluated with imaging studies along with appropriate hormonal assays keeping in mind the variety of hormones paragangliomas may secrete in turn leading to diagnostic dilemmas. This case report describes a patient with uncontrolled high blood glucose levels and an abdominal mass initially suspected for a glucagonoma which was later discovered to be a functioning retroperitoneal paraganglioma.

In injuries caused due to firearms, the appearance of the wound has immense medicolegal implication since it can determine the type of projectile, its trajectory, and range of firing. Such observations can also assist in determining the manner of death. Herein, we report a case of homicidal gunshot injury caused by a smoothbore firearm. The characteristics of distant-range shotgun injury are presented. The need for appropriate forensic evaluation, documentation of injuries, and proper handling of evidentiary material in the clinical settings is highlighted.

Follicular lymphoma (FL) is the second most frequent non-Hodgkin lymphoma accounting for about 10%–20% of all lymphomas. FL usually presented with peripheral adenopathy involving cervical, inguinal, and femoral regions. FL presenting as a scalp swelling without involvement of underlying cerebral parenchyma or systemic manifestation in a nonimmunocompromised patient is an extremely rare medical condition requiring aggressive treatment and neurosurgical intervention. We report the case of a 33-year-old male presenting with progressively increasing painless large left-sided frontal scalp swelling. The patient underwent near-total excision of lesion. Histopathology report suggested FL. We report this case for discussion regarding pathophysiology, diagnosis, and appropriate clinical management.

Acute abdominal aortic occlusion is a rare injury with potentially devastating consequences. Clinically, patients present with severe pain of the bilateral lower limbs with paresthesia or paraplegia. Here, we present a case of thrombotic occlusion of the infrarenal portion of the abdominal aorta with extension to bilateral iliac arteries following a road traffic accident in a young adult. It also highlights the complications associated with thromboemboli arising from blunt abdominal trauma probably due to delayed hospital presentation.

Marchiafava-Bignami disease (MBD) is a rare neurodegenerative disorder affecting the corpus callosum. It is usually seen in chronic alcoholics. MBD is an alcohol-associated disorder characterized by demyelination and necrosis of the corpus callosum. MBD was initially described in wine drinkers. It was considered to be either due to the toxic effect of alcohol or due to nutritional deficiency. Modern imaging techniques like MRI helps in the early detection of MBD even in the absence of classical clinical symptoms. WE report a case of chronic alcoholism since 20 years who presented to us with clinical signs of disorientation, dysarthria, behavioral symptoms, irrelevant talk, lapses in memory, sensory ataxia, and MRI findings suggestive of demyelination and subsequent atrophy of corpus callosum.

Hemophagocytic lymphohistiocytosis (HLH) is a rare hematological entity in children that presents with unremitting fever, organomegaly, cytopenias, hemophagocytosis by activated macrophages, and results in a fatal outcome in untreated cases. Other biochemical abnormalities include hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, increased soluble interleukin-2 receptor levels, histological evidence of benign hemophagocytic macrophage, and impaired natural killer cell activity. It is the result of an aberrant hyper inflammatory response that usually does not respond to conventional treatment. Secondary HLH is mostly associated with infection, malignancy, and autoimmune diseases and usually resolves on the treatment of the primary condition. Severe acute malnutrition (SAM) causing secondary HLH is rare, although hemophagocytosis in bone marrow without other diagnostic features of HLH is seen in many deficiency states including SAM. Here, we present a 1-year-old female child with SAM and secondary HLH focusing on clinical manifestation, diagnosis and treatment.

Prune Belly syndrome (PBS) is a triad of absence of abdominal muscles, urinary tract malformations, and undescended testes. Due to partial or complete lack of abdominal muscles and flat diaphragm, there could be difficulty in breathing and effective coughing. It can also be associated with chest wall deformities which can cause increased incidence of respiratory infections and lead to complications in the peri and postoperative period. Here, we have discussed about the anesthetic challenges in 1-month-old baby diagnosed with PBS who was posted for cystoscopy.

Cornu of the uterus is one of the uncommon sites of ectopic pregnancy. Molar cornual ectopic pregnancy is extremely rare and only few cases are reported in the literature. A 25-year-old gravida 3, para 1, abortion 1 lady reported with complaints of amenorrhea of 9 weeks and pain in the lower abdomen for 1 day. Sonography revealed an anechoic structure of 20 mm at the left adnexa with evidence of hemoperitoneum. The patient was managed with laparoscopic cornuostomy. Histopathologic analysis demonstrated placental tissue with features consistent with a complete molar pregnancy. It is emphasized that histopathological examination of the retrieved tissues should be considered after each case of surgical management of ectopic pregnancy to rule out molar pregnancy.

Intracranial arterial dolichoectasia is a disorder of cerebral vasculature characterized by abnormal elongation, tortuosity, and dilatation of the cerebral arteries. The posterior circulation is more frequently affected than the anterior circulation. Dolichoectasia of internal carotid arteries (ICAs) presenting with binasal hemianopia is rare. We report a case report of a 48-year-old male who presented with a history of binasal hemianopia. Magnetic resonance (MR) imaging of the brain with MR angiography showed bilateral dolichoectasia of ICAs compressing bilateral optic nerve and optic chiasm. Diagnosis of bilateral optic neuropathy due to dolichoectasia of ICAs was made after thorough investigation and ruling out of other possible etiologies of bilateral optic neuropathy. Dolichoectasia is a rare cause of bilateral optic neuropathy and should be suspected in patients who present with gradually progressive visual field loss with onset in the nasal field.

Myiasis is a disease caused by the larvae of Diptera flies infesting living tissue. The most common type of myiasis is cutaneous involvement. Imported infections are becoming more common as a result of international travel to tropical regions. After a 3 month stay in Congo, a 29-year-old developed furuncular myiasis on returning to India.

Acute confusional state is characterized by disturbed consciousness, cognitive function, or perception. It can develop over a period of hours to days. It can be because of intracranial hemorrhage, central venous sinus thrombosis, stroke, meningoencephalitis, metabolic abnormalities, adverse drug reactions, etc. Moya–moya disease is a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in the basal ganglia and means “puff of smoke” appearance which describes the look of the tangled vessels. It can present as stroke or recurrent transient ischaemic attacks. Secondary moya–moya disease can be caused by infections, connective tissue disorders, vasculitis, autoimmune disorders, trauma, hematological conditions, atherosclerosis, etc. Here, we present a case of 14-year-old female, known case of Beta Thalassemia who presented with acute confusional state, incidentally diagnosed with secondary moya–moya and tuberculous meningitis. Acute confusional state here was attributed to tuberculous meningitis.