Esophageal cancer is the fourth common cause of cancer-related deaths in India. It is prevalent among both men and women. Squamous cell carcinoma (SCC) accounts for up to 80% of these cancers, although adenocarcinoma is on the increase due to changing lifestyles. The etiological factors for SCCs show a regional variation in different parts of India, but tobacco consumption in various forms, alcohol, hot beverages, and poor nutrition remain the predominant predisposing factors. Generally, these cancers present late and therefore have a poor prognosis. The current status of esophageal cancer in India in relation to the demographics, diagnosis, staging, multimodality treatment, surgical therapy, and the future perspectives are discussed in this review article.

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Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic random sampling of every 10^th woman exiting the antenatal clinic was done. Results: We studied 382 pregnant women. Of them, 188 (49.2% [95% confidence interval (CI): 44%–54%]), 104 (27.2% [95% CI: 23%–32%]), and 81 (21.2% [95% CI: 17%–26%]) women had sufficient knowledge about danger signs during pregnancy, labor, and childbirth, respectively. On multivariable analysis, lack of exposure to formal awareness raising health counseling classes was the only factor found to be significantly associated with a lack of knowledge about danger signs of pregnancy (adjusted prevalence ratio, 95% CI: 1.8 [1.2–2.7]) and after childbirth (1.4 [1.1–1.7]). Lower education level was significantly associated with a lack of knowledge about danger signs of labor (1.2 [1.1–1.4]). Conclusion: We found that lack of exposure to formal awareness raising health counseling classes is a modifiable risk factor to improve knowledge about danger signs. We recommend structured mandatory health awareness sessions addressing the danger signs of pregnancy and child health to all pregnant women.

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Giant cell fibroma (GCF) is considered a distinct variant among the fibrotic soft tissue lesions. It usually occurs in young people without any gender predilection. Mandibular gingiva is affected more commonly. This report describes a fibrotic lesion occurring in a 33-year-old man on the maxillary buccal gingiva. GCF was one among the various differentials considered, and the final diagnosis was confirmed on histopathological examination.

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Background: Achilles tendinitis is a common overuse injury among both elite and recreational athletes involved in activities such as repetitive jumping and running. Aim: The aim of this single-blinded randomized study was to compare the efficacy of muscle energy technique (MET) and eccentric loading exercise (ELE) interventions on improving functional ability and pain reduction among athletes with Achilles tendinitis. Methods: A single-blinded, pilot, randomized study was conducted in the Department of Physical Therapy, Global Hospitals and Health City, India, with 6-week follow-up. A total of 30 patients with Achilles tendinitis were randomly allocated to receive either MET (n = 15) or ELE (n = 15) treatment. Treatment effects were evaluated by pre- and post-treatment assessment of visual analog scale (VAS) and Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire. Measures were performed by single-blinded evaluators at baseline and at 2, 4, and after 6 weeks of treatment. Results: Both groups showed a significant difference in VAS after 6 weeks' ELE group showed a significant improvement during treatment at 2 and 4 weeks in comparison with MET group. The VISA-A scale score significantly improved in both groups. Yet, comparison of VISA scores between groups showed marginally significant difference (P = 0.012). Conclusion: This pilot randomized controlled trial (RCT) showed the efficacy of ELE in reducing pain and improving functional ability among patients with Achilles tendinitis. The findings of this study provide the rationale for undertaking a large-scale RCT. A large sized trial is needed to establish evidence for clinical practice of ELE in Achilles tendinitis cases.

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Context: Intrauterine fetal death (IUFD) causes emotional distress and could result in intrauterine infection. In view of these complications, medical induction is recommended, if it is safe. Aim: The aim of this study was to compare the efficacy and safety of a combination of mifepristone and misoprostol with oral misoprostol alone for induction of labor in IUFD. Settings and Design: This is a randomized placebo-controlled trial conducted at a tertiary care teaching hospital in southern India. Patients and Methods: We recruited 72 women with IUFD in a singleton pregnancy after 28 weeks with intact membranes. Thirty-six women received oral placebo followed by misoprostol. In other group, 36 women received 200 mg oral mifepristone followed by misoprostol (both groups received 50 μg orally 4^th hourly up to 5 doses). The interval between mifepristone/placebo and the first dose of misoprostol was 24 h. Results: Successful delivery occurred within 72 h in 31 of 36 (86%) women who received mifepristone before misoprostol and in 28 of 36 (78%) women who received only misoprostol (P = 0.541). Median (interquartile range) induction to delivery interval was 3.5 (2–5) and 4 (3–5) h in the combination group and misoprostol group, respectively (P = 0.465). Conclusions: Addition of mifepristone to misoprostol appears to be marginally more effective than misoprostol alone for induction of labor in intermediate and late IUFD, although the differences were not statistically significant.

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Bacterial meningitis in childhood is a life-threatening disease leading to neurological sequelae. A 35-day-old male infant presented with pneumococcal meningitis and had a recurrence of seizures, and magnetic resonance venography revealed multiple cerebral venous thromboses. The baby was managed with anticoagulant therapy. Neurological examination and neuroimaging were normal at 3-month follow-up. A high index of suspicion and early neuroimaging led to earlier diagnosis and normal neurodevelopmental outcome.

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Hepatic encephalopathy is the most common neurologic complication of cirrhosis of the liver, while acquired hepatocerebral degeneration (AHD) is an underestimated neurologic manifestation. It is characterized by parkinsonism, ataxia, and neuropsychiatric symptoms. It is an underdiagnosed cause of psychomotor retardation in patients with chronic parenchymal liver disease with portosystemic shunting. Manganese deposition in the basal ganglia has been proposed as a mechanism for AHD. Here, we report a case of AHD in a patient with chronic parenchymal liver disease who responded to dopamine agonist.

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Sarcoidosis is a multisystem disease that might involve the heart during its course. Isolated cardiac involvement can occur in sarcoidosis without pulmonary and other systemic manifestations, and it could be the presenting manifestation. Cardiac involvement is an important cause of death in patients with sarcoidosis. Only 5%–10% cases of cardiac sarcoidosis are symptomatic. However, in autopsy series, cardiac involvement has been found in 50%–85% of cases. Here, we report the case of a middle-aged lady presenting with recurrent presyncope and complete heart block. A final diagnosis of cardiac sarcoidosis was made.

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