Physiology and Anatomy

Rhabdomyosarcoma is the most common soft tissue sarcoma encounered in childhood and adolescence; that arises from embryonic mesenchyme. It is most common found in the head and neck region, and the parameningeal location has the least favorable prognosis because of its tendency to local and intracranial extension. Parameningeal Rhabdomyosarcoma represents a diagnostic and therapeutic problem. We present the case of a child who got treated for her local nasopharyngeal rhabdomyosarcoma for over 1 month, and then got admitted for cranial nerve paralysis (peripheral facial palsy and Orbital apex syndrome) after the cranial extension of the tumor.

We report a case of a young patients with a residual mass surgery of a testicular cancer which was outside the recommended territories. This surgery was justified by the persistence of mass after chemotherapy , and more than a year after surgery our patient presents good evolution both clinical , biological and radiological .

Leech therapy is experiencing revivification in health care today, primarily in pain management for knee osteoarthritis and in modern science in plastic and reconstructive surgery(Sandhana Karma) as a treatment of venous congestion which can threaten positive surgical outcomes. Similarly leech therapy in wound care is an emerging bio surgical entity which is assuring promising results in the treatment of chronic non healing wounds(Dushta Vrana). The first description of leech therapy, classified as bloodletting, was found in the text of Sushruta Samhita (dating 800 B.C.) .Diseases where leech therapy was indicated were skin diseases, sciatica, and musculoskeletal disorders like Arthritis (Sandhigata Vata)etc. Acharya Sushruta has mentioned Avsechana Karma or Raktamokshana as one of the important procedure in the treatment of Vranashopha. Leech therapy (Jallaukavacharan) is said to be of prime importance due to its multifold actions and indications being an anushastra ie a para surgical tool and which can be used in children, weak persons or in the absence of surgical instruments. Such is the legacy of bloodletting by leech in Ayurveda. It has been observed that post graduate & under graduate students and paramedical staff have had no formal training in administering the therapy or in maintaining the medicinal leeches i.e. Hirudo medicinalis, the species of freshwater amphibian worm used therapeutically. Yet students and paramedical staff are expected to participate in this therapy in a variety of clinical settings, in variety of diseases, and hence can use the guidelines given in the article for the safe and effective use of the leeches in treatment. Keywords- Leech Therapy, Raktamokshana, bloodletting, Avsechana Karma, Anushastra, Vranashopha, Inflammation

The Coronary artery development is a delicate process that includes a complex interaction among the pericardium and the myocardium which leads to involving of multiple cellular pathways. There has been a growing engrossment in the study of the coronary artery development. These leads to identify some of the important causes of anomalous coronary development.There are different kinds of anomalous coronary arteries, having variable risk in myocardial ischemia, malignant arrhythmias, and sudden cardiac death also. A good understanding of this process could help us insharing new avenues in the treatment of clinically relevant anomalous coronary arteries.

Generally, Gonadal Dysgenesis is a condition which can be characterized by the underdeveloped or imperfect formation of the gonads. This occurs either due to the absence of the sex determining region of the Y chromosome (SRY) gene and therefore differentiation of the indifferent gonad would not occur. Hence, the other activities such as development of testes, production of its specific hormones and the formation of the other internal reproductive organs that needs those hormones in order to develop would be under developed.

WHO defines Overweight and obesity as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.

Blue rubber bleb nevus syndrome (Cutaneous and digestive angiomatosis) is a vascular malformation that is not well known. The gastrointestinal lesions occurring during this syndrome are clinically more relevant than those of the skin and soft tissues. Adherence to standard surgical principles results in successful results with minimal morbidity.The diagnosis of Bean syndrome must be evoked in the presence of acute intestinal occlusion and angiomatous skin lesions.We report a particular case of this syndrome by its late revelation following a volvulus on a huge bowel vascular lesion, giving the opportunity to a review of the literature.

Suitable clinical learning environment results in appropriate learning outcomes in clinical area. The objective was to analyse the influence of clinical environment on clinical learning. Cross sectional research design was used. Study targeted 200 participants sampled purposively. Data was recorded in SPSS version 21.0 and analysed using t-test for means. Statistical significance was determined at p=0.01 the data was presented in form of tables. The study found that clinical placement (p=0.015), and length of clinical attachment (p=0.04) were predictors of clinical learning. The study recommends teaching facilities to establish appropriate schedule for clinical placements in order to enhance clinical learning.

The aim of this paper is to evaluate current regulatory guidelines for clinical research, drug development and the evolution and reforms in current and evolving practices in the United States, and Canada, with a detailed focus on India’s regulatory reforms and growing market. The United States is the largest pharmaceutical market, and the epicenter of clinical trials and research. Canada is the world’s second largest center of clinical trials and has pioneered many discoveries in diabetes care. India is gaining ground in clinical research with strengths in research, large drug manufacturing capabilities, world class hospital and medical facilities and infrastructure. The proficiencies of researchers in English, good clinical skills, a large population and prevalence of most disease types in India’s are also reasons for its position in clinical research and a favorable destination. India’s regulators have undertaken reforms of regulatory requirements to improve processes and ensure consistency with international standards. The over reliance by the Indian pharmaceutical industry on generics in sustainability and future growth of the industry may be dampened as the inevitable crowded space by international competitors and other manufacturers will likely cause ceding of some market share. Utilizing the immense talents in new drug development may provide new areas of economic opportunities. The promise for developing innovative and next generational products and marketing are immense. Continued investment in quality, discovery, achieving parity with international regulatory standards will expectedly fulfill great expectations and the inarguable tremendous potential India holds. The regulatory affairs and drug development discussion in India is further related to Type 2 Diabetes in India, as the incidence of Type 2 Diabetes is escalating exponentially worldwide and needs urgent therapeutic and management solutions.

Background and objectives Length of the ring finger is more as compared to the index finger in males and they are almost equal in females. The ratio between 2D:4D is less in males (<1) but in females it is more (>1). This is directly related to exposure of more testosterone during intrauterine life of the fetus. The persons who are having 2D:4D ratio less than one are more aggressive and masculine characters. The present study is to find out the aggressive behavior of the persons and its relation to ratio of index finger length and ring finger length. (2D:4D). Methodology Fifty male and fifty female medical students in the age group ranging from 19 to 25 years studying in first year M.B.B.S. were selected. The students were selected randomly. The 2D and 4D length were taken and the ratio between them is calculated. The aggressive questionnaire was administered according to Aggression Questionnaire. Results Of the four types of aggression physical, anger and verbal was more seen in males (Scale T-score >55) as compared to hostility that was more in females (>55) but statistically not significant (p=0.422). Conclusion The co-relation between 2D:4D length ratio and aggressive behavior of the subjects was not significant statistically (P = 0.217).