Cervical cancer is the second most common gynecological malignancy worldwide. According to HPV Information Centre, Spain (Aug'2014), in India approximately 1,22,844 women are diagnosed with the disease every year and of them 67,477 die due to the disease. CaCx is said to be mediated by HPV but recent data published reveal the role of Oxidative Stress in different Cancers. Arsenic is also one of the agents for causing Oxidative Stress. Arsenic has been linked with different types of cancer. Arsenic is considered responsible for generation of free radicals and eventually for apoptosis. Early diagnosis of CaCx is presently a matter of concern and clinical presentation in advanced stages become difficult for complete clinical response. For determination of oxidative stress, Malondialdehyde (MDA) was taken as an identifier and arsenic estimation was performed with the help of Atomic Absorption Spectrometer (AAS). RBC count and Haemoglobin levels were performed according to standard protocol. MDA was in direct proportion with arsenic concentration and inversely proportional to RBC and Haemoglobin in CaCx patients. Arsenic is one of the major causative agents for oxidative stress and hence may be a risk factor leading to cancer including CaCx.

The term tension pneumocephalus (TP) means raised intracranial pressure due to air in the cranial cavity. This presentation is a rare case report and review on TP. Decompressing this raising intracranial pressure is a surgical emergency. Therefore, this presentation emphasises the importance of timely identification and management of TP in saving life. In this case, the acute signs of raising intracranial pressure were identified and promptly addressed surgically along with the maxillofacial injury management. This restored the deteriorating neurological status as well as his facial form and function. The etiological factors, pathophysiology and various treatment options are reviewed.

There is high incidence of cervical cancer in Bihar, India. Vaccination for cervical cancer in developed countries has played a crucial role in limiting the incidence rate of cervical cancer worldwide. In consideration of debate on clinical efficacy of Human Papilloma Virus (HPV) vaccine in India, study on the prevalence of high risk HPV 16/18 strains in different regions of the nation becomes very crucial. Few individual states have started vaccination but centralised vaccination program does not exist due to lack of sufficient genotypic study of Human Papilloma Virus in different parts of India. Bihar is the third most populous state of India and HPV 16/18 distribution has not been reported yet. The nationwide data of HPV 16/18will help to develop a unified centralised vaccination program. We carried out a distribution study of high risk HPV type 16 and 18 in cervical cancer patients attending a tertiary care hospital of Bihar, India.HPV 16/18 types were analysed in cervical cancer tissues (n = 96) of patients attending the regional cancer hospital of Bihar. Tissue samples were analysed for HPV 16 and HPV 18 using a Real Time PCR technique. The results suggest very high prevalence of HPV 16/18. HPV was identified in all the samples (96/96). About, 74 (77.08%) samples presented with HPV 16 whereas, 16 (16.67%) of the samples presented with HPV 18. 6 Co-infection was presented in 6 (6.25%) of the samples of cervical cancer tissues. HPV 16/18 prevalence is more in the women aged between 41 to 61 years.We report 100% prevalence of HPV16/18 in the cervical cancer tissue samples. A way to minimise this gynaecological concern would be to introduce prophylactic vaccines and early screening in the state of Bihar. The data generated would be crucial in drafting for community screening of HPV. We strongly emphasize the prophylactic HPV Vaccination against HPV 16 to control the alarming rate of cervical cancer in one of the most populous state of India, Bihar.

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Nuchal cords have been invariably seen in pregnancies, sometimes discovered antenatally while more often as an incidental finding during birth. It sometimes can present as a complication to active labour, leading to unpredictable maternal and peri-natal morbidity and mortality. However, as often as nuchal cords are witnessed in clinical scenarios, only little is known in peer reviewed literature about their significance. There is an existing practical deficiency of guidelines and algorithmic measures to ensure maternal and neonatal wellbeing in a case of cord around neck. Diagnosis of nuchal cord is still a challenge during antenatal evaluation and not often taken in concern by obstetricians. In our study we study the incidence of nuchal cords with its overall aftermath with respect to maternal and neonatal parameters and attempt to probe the likely importance for its screening and developing guidelines.

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