Background: Osteosarcoma of the jaw (OSJ) is a less common malignant mesenchymal-origin tumor that represents less than 10 percent of all cases of osteosarcoma. In comparison with its long-bone counterpart, OSJ is less progressive, less likely to metastasize, and has a relatively more favorable outcome. Its diagnosis and treatment, however, remains a source of major dilemma. Clinically, the OSJ presents with swelling, pain, tooth movement, or paraesthesia, symptoms that may resemble the appearance of odontogenic lesions or benign lesions of the jaw and lead to a delay in diagnosis. The radiographic appearance is non-specific and the typical sunburst appearance is rarely noted in the jaws. Histopathological heterogeneity also makes it more difficult to differentiate with other sarcomas, and molecular and genetic markers are promising but not adopted in practice yet. Tumor-free radical excision of the tumor is the mainstay of treatment. However, the fact that most critical structures are close to each other limits achievement of maximum excision in the maxillofacial skeleton leading to recurrence. Chemotherapy has been well established in long-bone osteosarcoma and is still debated in OSJ because of low chemosensitivity, and radiotherapy is applied sparingly despite radioresistance and local toxicity concerns. Regardless of the fact that overall survival is better than with appendicular osteosarcoma, high recurrence rates and functional impairment following radical surgery are critical issues. This review notes the diagnostic uncertainties and treatment uncertainties that still remain in relation to OSJ as well as the significance of multidisciplinary management. Innovative molecular biology, targeted therapy, and biomarker development promises the future, but the additional large-scale and multicentric studies are necessary to develop the standard diagnostic and treatment protocols.

Background: Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond already experienced by modern society. (1,2) Several potential causes have been identified for the poor sleep quality based on various studies that have taken place in the past and to add to all these factors is the constant increase in usage of digital devices among the recent batches who have joined medical colleges . According to one study, 96% of medical students in India own smart phones. (5) The study which was conducted aimed at finding an association between sleeping patterns of students in medical colleges and their association with usage of digital devices. A total of 350 students from 2020, 2021 and 2022 admission batches were asked to take a predesigned, pretested, semi structured self-administered questionnaire including information on socio demographic profiles and lifestyle questions, between the months of March 2024 to April 2025.The data collected was assessed and tabulated. The Pittsburgh Sleep Quality Index (PSQI) scale was applied along with Internet Addiction Test (IAT) and both the data were tabulated and compared. Statistical analysis was performed using SPSS version 23.0. It was observed that there is a very strong correlation between poor sleep quality and usage of digital devices especially prior to sleep,( p <0.01). This correlation increased with the increase in duration of usage. Scores of IAT were assessed in relation to sleep quality, showing that with an increased average total score of internet addiction (39.93 ± 10.36), there was an increasing occurrence of poor sleep quality (P < 0.05). A sizable percentage of students also wanted to adopt changes to improve their sleep quality because they understand its an essential lifestyle modification that will help them lead a better life.

Background: Objective: To evaluate outcomes of multimodality therapy including neoadjuvantly administered chemotherapy, surgery, and radiation therapy for patients with meibomian gland adenocarcinoma. Methods: Retrospective observational evaluation was conducted for cases of 42 histopathologically proven meibomian gland carcinoma patients from a decade-old tertiary eye oncology center. Clinical staging was established through AJCC 8th edition. Individualized multimodality therapy was given that included neoadjuvant chemotherapy for advanced disease, surgical resection or exenteration, and adjuvant radiotherapy accordingly. Overall survival, disease-free survival, and eye salvage were the main outcomes. Results: Mean age was 58.6 years, and there was a female predominance (64.3%). Neoadjuvantly, chemotherapy was administered in 29 patients, with complete or partial response in 86.2%. Surgery was performed in 85.7% cases, and adjuvant radiotherapy was administered in 26.2%. Overall survival at a median follow-up of 46 months was 78.6%, disease-free survival was 66.7%, and eye salvage was established in 80.9%. Recurrence was observed in 16.7% cases, and lower disease-free survival was observed in T4 tumors in relation to T2 and T3. Kaplan–Meier analysis established superior survival in patients treated with multimodality therapy in relation to those treated by surgery. Conclusion: Multimodal therapy has positive oncologic and functional outcomes for meibomian gland carcinoma, allowing for improved survival and eye salvage in relation to conventional surgical therapy. These findings favor inclusion of systemic chemotherapy in treatment protocols for advanced disease, yet prospective trials in more patients are required for demonstration of long-term benefit.

Background: COVID-19 emerged as a viral pandemic in the year 2019. The practice and scope of surgery and medicine transformed radically as the virus spread across the world. There is an urgent need to understand the outcomes of COVID-19 infected patients who undergo surgery. A significant patient safety concern relates to the notion that asymptomatic carriers of the SARS-CoV-2 virus may deteriorate in respiratory function, subsequent to endotracheal intubation for general anaesthesia, and require prolonged mechanical ventilation, which has been associated with increased mortality in COVID-19 .We did a retrospective study to compare mortality in COVID 19 positive vs COVID 19 negative patients who underwent emergency surgery .This study was an effort to understand the impact of COVID 19 infection on morbidity and mortality of emergency operated surgical patients, with the hope that it will enable us to form guidelines for elective surgery in Covid positive patients. With the resurgence of cases in India this study is highly relevant and can provide valuable information for guiding emergency surgical care and resource allocation. Objective- To evaluate the influence of Covid 19 infection on post operative outcomes of emergency operated surgical cases. Patients and Methods- Historical patient records were analyzed of all patients undergoing emergency general surgery at a tertiary hospital in a metropolitan city in India from 11th March,2020 to 11th March,2022.Data was collected to compare post operative outcome in terms of mortality and morbidity in Covid positive and Covid negative patients. Results -300 Covid positive patients were operated for emergency surgery and these were compared with the 300 Covid negative patients undergoing emergency surgery. We observed that 108 (36%) of the Covid positive patients died in the hospital, while 189 were discharged after recovery. On the other hand, only 59 patients (19.67%) in the Covid negative group died, while 239 (79.67%) were discharged. Conclusion: Cardiac arrest, sepsis/shock, respiratory failure, pneumonia, acute respiratory distress syndrome, and acute kidney injury were more common in those with COVID-19 infection.