Context: Automated cell counters have revolutionised laboratory medicine and are being used worldwide. They give accurate results, can run large number of samples and generate accurate results within a short span of time. Quality check procedures in this equipment ensure accuracy of results. However, for platelet counts, the pathologist is still dependent on confirming the results by manual methods, especially in situations of low platelet count and flagging by the electronic counter. Different laboratories use different methods for manual estimation of platelet counts. Aims: This study was done to compare the platelet counts assessed on peripheral smear examination by different multiplication factors, and to identify the multiplication factor which derives the most accurate platelet count. Settings and Design: This was an observational study. Methods: Peripheral smears prepared from 100 ethylenediaminetetraacetic acid-anticoagulated blood samples were manually examined under oil immersion field (OIF) for platelets. Platelet count was further calculated by multiplying the number of platelets per OIF using multiplication factors of 10,000, 15,000 and 20,000. This was compared with platelet (PLT)/red blood cell (RBC) method and automated platelet counts. Accuracy of various manual methods was evaluated by calculating the per cent difference of the methods with automated analyser counts. Statistical Analysis Used: Descriptive statistics was used for statistical analysis. Results: Manual platelet count estimation on peripheral smear employing multiplication factor of 15,000 was found to have comparable accuracy to analyser counts, followed by the PLT/RBC ratio method. Conclusions: This study confirms that for manual estimation of platelet counts on peripheral smear, a standard multiplication factor of 15,000 on OIF gives the most accurate result, which is closest to counts obtained by automated analysers.

Background: Bone marrow metastasis is an uncommon yet significant presentation of many non haematological malignancies. Aims: The present study was conducted with the aim of analysing the clinical, haematological and biochemical parameters of the patients with bone marrow metastases and determines the parameters which could possibly indicate the presence of bone marrow metastases. Patients and Methods: Bone marrow aspirate, imprint and biopsy slides of 22 cases with bone marrow metastases were reviewed and the haematological and biochemical data of all these cases were compared with that of 20 controls without any evidence of metastases. Results: The mean values of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR) and serum lactate dehydrogenase (LDH) were found to be significantly different (P < 0.001) between the cases and controls. MPV <8.1 fL, NLR >3.5 and LDH >452 U/L showed a high likelihood ratio in predicting bone marrow metastases. Conclusion: Parameters such as MPV, NLR and LDH can be used as efficient and easily available methods to predict bone marrow metastasis for a rapid diagnosis.

Background: With better imaging technologies, the frequency of detecting GB polyps has increased, however, their effective management remains a clinical dilemma. Aims: This study was aimed to assess the true outcome of lesions suspected or diagnosed as gallbladder (GB) 'polyp' on ultrasound. Patients and Methods: Computerised hospital-based medical records between June 2008 and June 2014 at a medical sciences institute in Kerala were accessed to identify and review the follow-up of all cases identified as GB polyp on ultrasound. Results: Ultrasound examination was performed in 108 cases. Of these 46% had symptoms suggestive of gall bladder disease, 20% had nonspecific abdominal symptoms and for the remaining 34% it was part of routine health check-up. The mean polyp size was 4.7 mm. During follow-up, 20 (18.5%) patients underwent cholecystectomy and none of them came as true polyps on histopathology, 25 (23%) patients were lost to follow-up after primary ultrasonography and 10 (9.25%) patients died due to reasons unrelated to GB disease. Conclusion: Radiologists tend to over diagnose GB polyps due to the risk of malignant transformation of GB polyps and increased usage of imaging modalities. It is observed in this study that higher imaging modalities do not add significant specificity in the diagnosis of the true polyp. However, there is a need for a large cohort study to confirm the outcome.

Background: Chhattisgarh is one of the worst performing states of India in terms of maternal mortality ratio figures. Slums carry the unfortunate burden of maximum maternal deaths. Birth Preparedness and Complication Readiness(BPCR) advocates planning of birth and being ready for any obstetric complications. Aim: To evaluate the BPCR index among first and second trimester pregnant women and those delivered within 6 months living in urban slums of Raipur city. Methods: A population-based, cross-sectional descriptive study was conducted among 160 pregnant and 70 recently delivered women residing in urban slums of Raipur city selected by multistage random sampling using an interview method. BPCR index was calculated using Johns Hopkins Program for International Education in Gynaecology and Obstetrics guidelines. BPCR components were correlated for any association with sociodemographic variables of the participants using Z test. Results: BPCR index came out to be 34.1%, which was very low. Factors associated with ≥4 antenatal care visits were general category women (P = 0.0375) and homemakers (P = 0.0057). Identifying skilled provider was higher in educated women (P = 0.0001), those with educated husbands (P = 0.0085), working (P = 0.0167) and with higher socioeconomic status (P = 0.0013). Saving money for childbirth was more among general category (P = 0.0067), educated (P = 0.0094) and women with low socioeconomic status (P = 0.0004). Conclusions: BPCR index of the study area was found to be very low.

Aims and Objectives: Haematological malignancy may show varied presentation in different regions of world, however, Uttarakhand lacks any recent data about them. The present study was therefore conducted to study the pattern of haematological malignancies on bone marrow examination in institute of Uttarakhand. Materials and Methods: This study was conducted at All India Institute of Medical Sciences, Rishikesh, Uttarakhand, over a period of 3 years. It included patients of haematological malignancies diagnosed on bone marrow examination. Patient's age, sex, clinical history and bone marrow diagnosis were noted for every case. All the data were entered into the excel sheet and statistically analysed. Results: The study included total 256 cases of haematological malignancies with male:female ratio of 1.13:1 and mean age of 39.3 years. Chronic myeloproliferative neoplasm (CMPN) was the most common haematological malignancy (49%) with chronic myeloid leukaemia (CML) being its most common type (40%). All the haematological malignancies showed male preponderance except for non-Hodgkin's lymphoma. Mean age of CMPN was 45.81 years and of acute myeloid leukaemia was 36.92 years. Bone marrow aspirate (BMA) and trephine biopsy (BMT) together were able to diagnose 81.3% of cases of haematological malignancies. Conclusion: The study concludes that haematological malignancies present at lesser age with male preponderance in Uttarakhand. CML is the most common haematological malignancy followed by acute lymphoblastic leukaemia. BMA and BMT are complimentary to each other for diagnosis of haematological malignancies and should be used together to avoid missing of any case.

The World Health Organization declared COVID-19 outbreak as a pandemic in March 2020. It had opened doors to several issues that were never envisaged. The global economy and the health equilibrium were disturbed. This review systematically assesses and compiles the literature describing the influence of COVID-19 on the psychological or mental health of the younger generation. Databases such as PubMed, SCOPUS and Google Scholar were searched electronically for relevant data. The results indicate that the mental health of the younger generation was affected to a large extent. The school and college students had to adapt to the new way of online education. COVID-19 had affected childhood, family dynamics and students' lives in schools and colleges. It increased the number of domestic violence cases, which had severe effects on the mental health status of the younger generation.

A proportion of individuals affected with severe acute respiratory syndrome coronavirus 2 continue to have COVID-19 symptoms even after recovering from illness. These are termed as post-COVID condition (PCC)/long-COVID. Evidence suggests that symptoms of COVID-19 along with other generalised sequelae may persist in some patients with severe and very severe disease, as well as in patients who had mild or no symptoms. The management of PCC is a challenge as there is limited understanding about the issue even in healthcare professionals. Then, there is not enough documentation of post-COVID and long-COVID in India. From public health perspective, the health services and facilities have not been re-designed to tackle the situation. This review article aims to explore PCC and compilation of current international and national public health response along with recommendations to identify and manage the PCC at the primary. The article concludes the urgent need to document the burden of PCCs in India, develop standard case definition and equip primary healthcare facilities and providers with the requisite skills to manage the PCC. The governments, health care providers and facilities and public health bodies should also encourage and foster continuing country specific data, analysis and research into the determinants, duration and probable treatment modalities of PCC. The post and long-COVID conditions would require sustained policy and programmatic attention in all countries with special focus in low and middle income country settings.

The recommendation of a Rural Indemnity Bond after MBBS aims to address the rural-urban disparity in the Indian healthcare system. It is a radical reform in medical education curriculum and generates searching questions: How to affect the attitudes of medical graduates? Are there other successful models we can learn from? Do the healthcare challenges need a more integrated action? A policy enforcing the shunting of doctors needs to take the apprehensions of all the stakeholders into consideration. The broader issue of Rural Health Iniquity, that plagues the country requires interventions at multiple levels with a properly financed healthcare system at its foundation.