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We present here a case of an uncommon complex uterine anomaly – Obstructed HemiVagina with Ipsilateral Renal Agenesis (OHVIRA), also known as Herlyn-Werner-Wunderlich syndrome in a 14-year-old girl along with sonographic (trans-abdominal and trans labial), and MRI findings. The patient underwent surgery wherein imaging findings were confirmed. An MRI has proved to be of great help in correct diagnosis avoiding surgical interventions/ laparoscopy, which were needed in past to diagnose this rare anomaly. We also discuss the development of this anomaly with the help of a relatively new theory of uro-genital development by Acien and review the literature.

Background: The assessment of doctors’ perceptions and understanding about generic medicines may help in recognizing the key areas which may act as hurdle to mass scale use of generics. The primary objective of this study was to explore the knowledge, attitude, and practice (KAP) of doctors toward generic medicines.Methods: A cross-sectional study was carried out using a pretested questionnaire in a tertiary care teaching hospital of Jammu (J and K). The questionnaire was designed to assess the KAP about generic medicines. The doctors working in this institute during the study period were included. Data was compiled and analysed using online website, http://www.graphpad.com. P-values of < 0.05 were considered to indicate statistical significance.Results: A 62.9% doctors agreed to the fact that generic medicines were intended to be interchangeable with a branded drug (p=0.0139). Among the doctors, 77.5% were aware that generic drug manufacturers need to conduct studies to show bioequivalence between the generic medicine and their branded counterparts (p =0.0001). 88.8% of the doctors agreed that importance of generic medicines should be taught in early part of internship. 80.9% doctors did not think that switching a patient from a brand-name to generic drug may change the outcome of the therapy (p <0.0001).Conclusion: The present study showed that a good percentage of doctors were well aware of generic medicines’ usage. However due to concerns expressed by a certain fraction of participants, further work is needed on how interventions for medical professionals and for the public can lead to increase in the awareness and acceptability of generic medicines.

Lymphangiomas are benign tumors of unknown etiology often seen in children, involving the neck (75%), and axillary (20%) region, but rarely the kidney [Zapzalka et al. (2002) Lymphangioma of the renal capsule. J Urol 168:220.]. We report a case of unilateral renal lymphangiectasia, where the diagnosis was made on imaging.

Background: Osteoarthritis(OA) is a major cause of chronic pain and lower extremity disability among the elderly due to its predilection for lower extremity joints such as the knee and hip. Although Paracetomol is the initial drug of choice, NSAIDS are also frequently used in the symptomatic relief of osteoarthritis. But still, there is a need for safe and effective alternative treatments which would provide both symptomatic improvement and disease modifying effects in OA. The primary objective was to study the prescribing pattern of drugs used in the treatment of osteoarthritis.Methods: A cross-sectional, prospective, observational study was conducted on newly diagnosed as well as old treated patients with osteoarthritis from orthopaedic outpatient department in a tertiary care teaching hospital. A total of one hundred and eighty-eight patients were enrolled after screened for the inclusion and exclusion criteria. Data was recorded in a specially designed proforma which include information regarding the demographic profile of the patients and about the pattern of drugs prescribed.Results: Out of one hundred eighty-eight patients who were affected with Osteoarthritis, females (57.9%) were more commonly affected than males (42%). OA knee (77%) either unilateral or bilateral was most commonly affected, followed by hip joint, spine and other joints. NSAIDS were more frequently prescribed in 76.6% patients than paracetamol which was prescribed in only 34 % of patients and that only in combination with NSAIDS and opioids. Various other drugs were also used as adjunct therapies that included gastroprotective agents in 49% of patients, Calcium in 54% of patients, Vitamin D3 supplements in 51% of patients and symptomatic slow acting drugs for OA (SYSADOA) which included diacerin and glucosamine sulfate as combination in 11% of patients.Conclusions: Our study showed Osteoarthritis knee being most common among female patients. Paracetamol and SYSADOA being under prescribed and NSAIDS are the most frequently used drugs in OA. National drug policy is needed to rationalize the drug use and bring awareness among the prescribing doctors.

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Graduate student training in global trauma and disaster psychology requires engagement with stressful learning contexts of both an academic and practical nature. These learning contexts require exposure to traumatic academic and practical material, and considerations of vicarious traumatization of graduate students are crucial. In this article, literature describing the potential negative impact of trauma exposure in the mental health field and in training is presented. Developmental concepts from attachment theory such as felt security that is enhanced by a secure base are then suggested to inform graduate training approaches of this nature. These concepts shed light on educational (i.e., teaching and supervision) strategies that may buffer against the negative impact of trauma exposure and promote student resilience, learning engagement, and skill development in global trauma and disaster psychology. Recommendations that may further graduate student trainee felt security in classroom and in supervision contexts domestically and internationally are suggested that may inform a trauma-informed educational approach to graduate training in this challenging global field.

Background:In the recent years, large number of human pharmaceuticals have been introduced to the environment by landfill when household medications are thrown to trash and liquid medications gain access to the environment via liquid drainage systems. There is lack of knowledge and awareness in the general public regarding the safe disposal of unused and expired medicines. The objective was to assess the awareness regarding disposal of unused medicines among consumers at a tertiary care teaching hospital of north India Methods: It was a cross-sectional observational questionnaire-based study carried out on 220 consumers in medicine outpatient department (OPD) of a tertiary care teaching hospital in North India for 3 months. All the participants were provided the pre-validated self-administered questionnaire. The final questionnaire consisted of twelve questions to assess participants' knowledge and attitude towards disposal of the medicines. The data was analyzed with the help of descriptive statistics. Results: It is quite evident from the present study that majority of participants 56.36% stated 1-5 drugs were left-over drugs at their homes. Most of the leftover medicines were analgesics in 59.1% followed by antibiotics in 51.36%. Most common dosage form of these leftover medicines were tablets in 85.9% of respondents. Majority of the respondents (55.9%) were not aware of the adverse outcomes of the pharmaceuticals in the environment. The most common method followed by majority of the participants for disposing of the solid, semi-solid and liquid dosage forms was garbage in 95%, 91.4% and 76.4% of consumers respectively. About 9.31% of the participants were in favour of initiating a program to collect unused medications from home. Conclusions: It can be concluded from the present study that the consumers had poor knowledge regarding the safe drug disposal techniques. Therefore, efforts need to be done by the health care professionals to make people educate regarding the safe drug disposal techniques.