Background: End-stage renal disease is the final stage of chronic renal failure where there is a progressive irreversible worsening of renal function. This requires dialysis, a technique in which substances move from the blood through a semipermeable membrane and into a dialysis solution (dialysate). It corrects fluid and electrolyte imbalances and removes waste products in renal failure. Hemodialysis (HD) remains an important form of therapy in end-stage renal disease (ESRD) patients. Dialysis is known to have variable effects on various blood components. It has been reported that dialysis lowers the hemoglobin (Hb) level and red blood cell (RBC) count. This study was primarily conducted to determine the differences between various hematological parameters that occur in renal failure patients before and after HD. Materials and methods: This study is a prospective observational study in which we enrolled 51 patients suffering from renal failure and who are on hemodialysis. The following parameters were recorded: Hb, RBC, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), total leukocyte count (TLC), differential leukocyte count (DLC)—neutrophil and lymphocyte percentage, platelet count, platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Serum creatinine and blood urea were also observed to assess the improvement with dialysis. All parameters were recorded both pre- and postdialysis. Statistical analysis of data was performed. Results: The RBC count, Hb levels, PCV, MCHC, and percentage neutrophils show significant elevation (p-value < 0.05) in samples obtained after dialysis compared to those obtained before dialysis. On the other hand, there is significant decrease in MCV, lymphocyte percentage, and P-LCR in postdialysis samples compared to predialysis samples. The study showed no significant alterations in many parameters like MCH, RDW, platelet count, TLC, and PDW. The biochemical findings were significant decrease in the blood urea and serum creatinine levels postdialysis which was expected and desirable in patients with chronic kidney disease. Conclusion: The effects of dialysis on Hb and RBC parameters have been studied in many studies but they also have conflicting reports. This may be due to the fact that there can be other factors that may have influence on the values of these parameters that may have not been taken into account. We have documented effects on many other parameters as well but studies with larger sample size that take into account confounding factors like position of patient, gender, etc., need to be done to obtain more conclusive evidence.

Psoas minor, which is present anterior to the psoas major in a variable proportion of the population. The study aimed to examine the psoas minor, a vestigial muscle in the posterior abdominal wall, in terms of its presence, morphology, variations, and measurements within a western Maharashtra population using 41 formalin-fixed cadavers. Results showed that the psoas minor was present in 48.78% of the cadavers, with equal occurrence between male and female subjects. No variations in the muscle's proximal and distal attachments were identified, except for a unique “double-headed” psoas minor found in one specimen. The mean length and maximum width of the muscle belly were 7.29 ± 0.129 cm and 1.45 ± 0.60 cm, respectively, on the right side, and 7.08 ± 0.147 cm and 1.33 ± 0.148 cm on the left side. For the tendon, the mean length and maximum width were 16.87 ± 0.302 cm and 0.92 ± 0.08 cm on the right, and 17.10 ± 0.35 cm and 0.80 ± 0.087 cm on the left. The findings suggest that the presence or absence of the psoas minor is important for various medical professionals, including anatomists, clinicians, radiologists, sports medicine specialists, and physiotherapists. The prevalence of this muscle varies by race, but not by gender. Additionally, no connection was found between the absence of the psoas minor and the absence of other vestigial muscles. This study provides valuable insights into the characteristics of the psoas minor in a specific population.

Background: Stress affects medical students in various ways, such as academic performance, substance abuse, and burnout. To deal with this stress, students apply different coping strategies or mechanisms. This study aims to evaluate the level of perceived stress and the coping strategies used by students during exams. Aims: (a) To assess the level of perceived stress among undergraduate medical students, and (b) to identify the various coping strategies used by students to handle stress. Materials and methods: The current study was done among Bachelor of Medicine, Bachelor of Surgery (MBBS) students in a government medical college. After obtaining informed consent, all the students belonging to the 2nd and final years were included. A self-administered questionnaire was used to gather data on social factors, perceived stress, and coping strategies. Results: The study with 423 medical students showed that final-year students faced more moderate to severe stress (70 and 11%) compared to 2nd-year students (60.7 and 6.1%) 3 months before exams, with similar patterns just before exams. Female students reported higher severe stress levels (15.4%) than males (5.1%) 3 months prior (p = 0.001), but not before exams (p = 0.305). Active coping (p = 0.011) and planning (p = 0.001) correlated with lower perceived stress, while distraction (p = 0.001), denial (p = 0.009), and self-blame (p = 0.001) were linked to higher stress. Conclusions: As exams approached, stress levels increased, particularly among final-year students, who initially used problem-focused strategies but later shifted to dysfunctional coping strategies (distraction, venting, self-blame). In contrast, mildly stressed 2nd-year students consistently employed adaptive coping strategies such as planning and seeking emotional support. Clinical significance: Screening students with a stress scale early on allows us to effectively help them manage stress through peer-support groups, incorporating mindfulness, physical activities, and counseling.

Background: The quadriceps angle (Q angle), an indicator of knee dysfunction, is formed by the line connecting the anterior superior iliac spine to the center of the patella and the line connecting the center of the patella to the tibial tuberosity. It is affected by the flexion and tonicity of the quadriceps femoris muscles. In females, the angle falls between 15 and 20°. The left and right legs are not always equal. Females tend to have a larger angle than men due to a broader pelvis. An increase in the angle is linked with instability of the patella and extensor dysfunction of the knee. Materials and methods: The study was conducted in the anatomy department of a tertiary care center over 5 years, involving 370 females residing in the hilly and plain regions of Uttarakhand. The females were in the age-group of 18–65 years. Samples were collected in the supine position with the help of a universal goniometer. Results: The Q angle was found to be higher in females from the plains compared to those from the hills. The mean value of the right Q angle was calculated as 12.02° in the hills and 13.27° in the plains. The mean value of the left Q angle was calculated as 11.49° in the hills and 12.62° in the plains. Conclusion: In the plains, height has a nonsignificant correlation with the Q angle and may not be a strong predictor in this population. The left and right Q angles are highly correlated with each other. Height shows a weaker correlation with angle measurements in the hills.

Introduction: Clinicians in the current scenario are persistently exposed to a heavy workload and an enormous degree of stress, which can hamper the musculoskeletal component of the body significantly. The health of doctors is a critical component in the goal of creating a disease-free society since they form a resolute pillar of the healthcare sector. Aim of the study: The objective was to determine the effect of body mass index on hamstring flexibility in clinicians. This will establish a relationship between obesity and body stretchability. Materials and methods: The study was conducted in outpatient department (OPD) clinics of various departments at Punjab Institute of Medical Sciences, Jalandhar, and OPDs of NIMS Hospital, Jaipur, over a period of 2 years from July 2019 to June 2021. BMI was calculated as the ratio of weight (kg) to the square of height (m). Hamstring flexibility was checked by obtaining the sit-and-reach test score using a sit-and-reach test box. Results: Body flexibility reduced significantly with advancing age and increasing body mass index (BMI). Above-average back and hamstring flexibility was seen in only 8.5% of the doctors, while 12% of the clinicians demonstrated poor flexibility range. Conclusion: The present study yields a significant association in terms of linear correlation between hamstring flexibility and obesity among clinicians. The professionals can take note of this information and use it as caution to protect their own health.

Simulation plays a critical role in identifying and mitigating latent safety threats (LSTs) within healthcare systems, specifically during cardiac arrest scenarios. Simulation-based training provides a controlled environment where healthcare teams can practice emergency protocols and refine their skills without patient risk. By replicating realistic clinical scenarios, simulations reveal systemic vulnerabilities in protocols, equipment readiness, and teamwork dynamics. This proactive approach allows healthcare organizations to implement targeted improvements, enhance interdisciplinary collaboration, and foster a culture of continuous learning and safety. Advancements in simulation technology, such as virtual reality (VR) and artificial intelligence (AI), further enhance training realism and analytical capabilities, enabling deeper insights into LSTs and refining emergency response strategies. By prioritizing simulation-based training, healthcare institutions bolster their readiness to manage cardiac arrest effectively, ultimately improving patient outcomes and ensuring high standards of emergency care delivery.

Background: Uncommon neoplasms seen within the brain include corpus callosum lipoma and pericallosal lipoma. Their percentage of all cerebral tumor lesions is <1%. The development of adipocytes from primitive meninges that persist into adulthood is the root cause of many conditions. Nevertheless, the exact cause of this lesion remains unknown. The Sylvian cistern, superior cerebellar cistern, suprasellar cistern, and quadrigeminal cistern are some other possible sites. Although headache is a rare symptom, many lesions are painless. Case description: These parents took their 6-week-old baby to the doctor because their child had been experiencing nongrowing edema in the frontal region since birth. Upon external inspection, a soft swelling was detected in the midline of the frontal region. To characterize the lesion, ultrasonography (USG) was performed. On USG, a hyperechoic lesion was observed in the midline subcutaneous area of the anterior region. A hyperechoic lesion in the corpus callosum region with a hyperechoic stalk that extended into the subcutaneous region was seen on transcranial ultrasound. The results were validated by magnetic resonance imaging (MRI) scan. A stalk was found to be attached to the corpus callosum lipoma on the MRI, which was located in the frontal region and revealed it on the subcutaneous plane. Dysgenesis of the corpus callosum was also seen. As a result, a diagnosis of corpus callosum dysgenesis and subcutaneous lipoma was rendered. Conclusion: The patient was kept on follow-up as it is an incidental finding. It is important to image any lesion in the head region to rule out the possibility of intracranial extension or intracranial complications.

During a routine dissection class of undergraduate medical students, unilateral variations of the major superficial veins of the face and neck were observed in an adult male Indian cadaver. The standard anatomical description of the external jugular vein (EJV) consists of the posterior auricular vein joining the posterior division of the retromandibular vein (RMV). The variations were observed on the left side of the face. The RMV exhibited normal formation but was not divided into anterior and posterior divisions. The EJV was formed by the union of the facial vein and the undivided RMV. The posterior auricular vein was also absent. The EJV bifurcated into two branches, which terminated into the cephalic vein. The veins on the right side displayed normal anatomy. The RMV is an important anatomical structure in radiology practice that can be used to localize a tumor in the parotid gland and is also used as a guide to expose the facial nerve branches in superficial parotidectomy and in open reduction of mandibular condylar fractures. The present paper reports a variation in the superficial veins of the face and neck and is an attempt to reinforce awareness of such variations among clinicians and plastic surgeons in view of reconstructive procedures.

The nonneoplastic infective lesions are infrequently studied and under-documented in histopathology literature despite their common occurrence in developing countries like India. So, we enlisted and analyzed the cases from the last 6 months at our tertiary care hospital to emphasize the clinical and histomorphological clues to infective etiologies. The spectrum of the lesions encountered ranged from bacterial to fungal to viral to even parasitic infestations.

Aims and background: Adrenocortical carcinoma and pheochromocytoma are distinct adrenal malignancies with different clinical presentations and origins. Adrenocortical tumors often manifest through hormone overproduction, whereas pheochromocytomas secrete catecholamines, necessitating meticulous diagnostic evaluation due to their varied clinical and radiographic features. This report aims to elucidate the diagnostic approach, surgical management, and clinical outcomes in a case of pheochromocytoma. Case description: A 36-year-old woman presented with sporadic episodes of palpitations, sweating, flushing, and abdominal discomfort. Elevated plasma metanephrines were detected during laboratory investigations. Imaging revealed a well-defined, round lesion in the right suprarenal region, exhibiting solid-cystic features and vascularity. Surgical exploration uncovered a tumor in the right adrenal gland. Histopathological analysis confirmed the diagnosis of pheochromocytoma. Postoperative management led to significant symptomatic relief and a marked reduction in plasma metanephrine levels. Conclusion: Pheochromocytoma should be considered in patients exhibiting episodic symptoms such as palpitations, sweating, and flushing, particularly when associated with elevated plasma metanephrines. Imaging is vital for tumor localization, and surgical resection is the definitive treatment. Clinical significance: This case highlights the critical importance of comprehensive diagnostic evaluation for adrenal masses and underscores the clinical presentation of pheochromocytoma. Early diagnosis and surgical intervention can result in symptomatic improvement and normalization of catecholamine levels, thereby enhancing patient outcomes.