Squamous cell carcinoma of the renal pelvis is a rare neoplasm, often unsuspected clinically due to its rarity and ambiguous clinical and radiological features, and hence patients present at advanced stages resulting in poor prognosis. We report here four cases of incidentally diagnosed primary renal squamous cell carcinoma, treated at our hospital over a short span of one year, and review the relevant literature. Mean age of the patients (3 males, 1 female) was 60 years. All suffered from staghorn stones. Interestingly, renal carcinoma was unsuspected clinically in all patients. In one case, a computerised tomography scan showed a suspicious nodule. All underwent nephrectomy for nonfunctioning kidney. In just two cases, tumor was identified on gross examination, while the other two only showed thickened pelvis. Our series emphasises the need for pelvicalyceal biopsy during treatment for long-standing nephrolithiasis, and thorough sampling of the renal pelvis in nephrectomy specimen of such patients.

Isolated spinal involvement of juvenile xanthogranuloma (JXG) is extremely rare. There are only seven prior published cases of spinal JXG, of which only one has been reported in an adult. We report here the eighth case of spinal JXG and the second in an adult. The patient, a 22-year-old female, presented with progressive upper backache. Radiological examination revealed a well-defined osteolytic hypointense mass in the T7 vertebral body, with a large soft tissue paraspinal extension causing cord compression. Complete resection of the mass was performed, with resolution of symptoms. Histology showed a histiocytic tumour with numerous Touton, foreign body and osteoclastic giant cells, immunopositive for CD68 and vimentin and negative for S100 and CD1a, corresponding to a diagnosis of JXG. Literature regarding spinal JXG is reviewed and discussed.

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Introduction: Diabetic ketoacidosis is one of the most severe acute complications of diabetes mellitus characterised by hyperglycemia, hyperketonemia, and metabolic acidosis. Prompt diagnosis and treatment of diabetic ketoacidosis can decrease severity, hospital stay, and possible mortality. This study aimed to find out the prevalence of diabetic ketoacidosis among diabetic patients admitted to the department of medicine of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted at a tertiary care centre. Data from 1 March 2022 to 1 December 2022 were collected between 1 January 2023 and 1 February 2023 from the hospital records. The ethical approval was taken from the Institutional Review Committee of the same institute (Reference number: 466/2079/80). All the diabetic patients admitted to the Department of Medicine during our study duration were enrolled for the study. Diabetic patients who left against medical advice and those with incomplete data were excluded from the study. Data were collected from the medical record section. Convenience sampling method was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 200 diabetic patients, the prevalence of diabetic ketoacidosis was 7 (3.5%) (3.47-3.53, 95% Confidence Interval) among which 1 (14.29%) patients had type I diabetes mellitus and 6 (85.71%) had type II diabetes mellitus patients and the mean HbA1C level was 9.77%. Conclusions: The prevalence of diabetic ketoacidosis among diabetes mellitus patients admitted to the department of medicine of a tertiary care centre was found to be higher than in other studies done in similar settings.

Handwriting has continued to persist as a means of communication and recording information in day-to-day life even with the introduction of new technologies. The constant development of computer tools lead to the requirement of easier interface between the man and the computer. Handwritten character recognition may for instance be applied to Zip-Code recognition, automatic printed form acquisition, or cheques reading. The importance to these applications has led to intense research for several years in the field of off-line handwritten character recognition. „Hindi‟ the national language of India (written in Devanagri script) is world‟s third most popular language after Chinese and English. Hindi handwritten character recognition has got lot of application in different fields like postal address reading, cheques reading electronically. Recognition of handwritten Hindi characters by computer machine is complicated task as compared to typed characters, which can be easily recognized by the computer. This paper presents a scheme to recognize Hindi number numeral with the help of neural network.

Introduction: Comorbidities are frequently seen in admitted COVID-19 patients most common being hypertension, diabetes, cardiovascular diseases and chronic kidney disease. Chronic kidney disease is a slowly progressive chronic illness due to the gradual loss of kidney function or structure. The available data regarding the prevalence of chronic kidney disease and COVID-19 comorbidities is still limited. The aim of this study was to find out the prevalence of chronic kidney disease among COVID-19 patients admitted to the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine of a tertiary care centre. Data of medical records between 1 August 2020 to 1 December 2022 were reviewed retrospectively. The data was collected from 20 January 2023 to 20 March 2023. Ethical approval was obtained from the Institutional Review Committee (Reference number: 646/2079/80). Data on chronic kidney disease patients among COVID-19 patients were collected from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 584 COVID-19 patients admitted, the prevalence of chronic kidney disease was 43 (7.36%) (5.24-9.48, 95% Confidence Interval). A total of 30 (69.77%) were male and 13 (30.23%) were female with a mean age of 55±16.22 years. Conclusions: The prevalence of chronic kidney disease among COVID-19 patients admitted in the department of Medicine of a tertiary care centre was found to be slightly higher than other studies done in similar settings.

Background: Oral cancer is the most common cancer and constitutes a major health problem. Tobacco and alcohol remains the most important etiologic factors. Molecular level changes in the lesion occur before clinical and histopathological changes. The prognostic evaluation of this neoplasia is given by histological and immunohistochemical findings, including staging, histological grade, tumor size, lymph node involvement, immunohistochemical expression of p53 and Ki-67.In squamous cell carcinomas of oral cavity, p53 and Ki-67 are related to large tumors, metastasis to lymph nodes and very likely to a worse prognosis.Aim and objectives: To assess and compare the expression p53, Ki-67 and their combination markers in squamous cell carcinoma of oral cavity in relation to lymph node status, degree of histological differentiation and pathological staging. Materials and Methods: The prospective study was conducted in N.I.M.S medical college carried out with 108 cases of oral cavity squamous cell carcinoma with lymph node resection. The p53 and Ki-67 labelling indices were expressed as the percentage of Ki-67 and p53 immunolabelled tumor nuclei per 1000 tumor nuclei counted.Results: The maximum numbers of cases were found to be in the age group of 40-60 years (61.8%), mostly being men (85.1%). Female comprised of only 14.9% of the patients. All cases were subjected to immunohistochemical study for Ki-67 and p53. Positive expression of Ki 67 detected was in 92 cases and p53 was detected in 72 cases. Both Ki -67 and p53 were positive in 58 cases. Ki -67 marker was tested in all 108 cases. Out of total 108 cases 92 (85.2%) were found to be positive for Ki -67 and only 16(14.8%) were found negative. In the histological grading 48 (44.4%) were low grade (well differentiated), and 30 (55.6%), were high grade (moderately and poorly differentiated). Out of 48 low grade cases 14(29.2%) cases and out of 60 high grade cases 44(73.3%) were positive for p53and Ki 67 which was statistically significant The relationship of p53 and Ki -67 expression was statistically significant when compared with lymph node status. Conclusion: Male to female ratio was 5.7:1 with age ranging from 40-60 years. The most common site of squamous cell carcinoma was buccal mucosa followed by tongue in oral cavity. Positive expression of Ki 67 was detected in 92 cases and p53 positive expression was detected in 72 cases.

Abstract:In this paper,we specialized parameters and argument, Hypergeometric function