Mysore Medical College

Thyroglossal duct cyst carcinoma (TGDCCa) is a rare malignancy, accounting for approximately 1% of thyroglossal duct cysts. Preoperative diagnosis is challenging because clinical and imaging findings often mimic benign lesions. Papillary thyroid carcinoma is the most common histological subtype, and optimal management, particularly the role of total thyroidectomy remains controversial. A 24-year-old female presented with a slowly progressive midline neck swelling of three years’ duration. Ultrasonography and computed tomography (CT) revealed a cystic infra-hyoid lesion with a small solid component and microcalcifications. She underwent a Sistrunk procedure. Histopathological examination demonstrated a 4 mm focus of papillary carcinoma confined to the cyst wall with tumour-free margins, no hyoid bone invasion, and a normal thyroid gland. After counselling, she opted for surveillance rather than thyroidectomy. Postoperative thyroglobulin levels and serial imaging remained normal. This case highlights the indolent nature of low-risk TGDCCa and supports individualized management, with Sistrunk alone being adequate in select patients.

Aim:To assess attitudes of Indian psychiatrists and caregivers toward covert medications (CM) and evaluate the reliability of the Staff and Caregivers Attitude towards Covert Medication Scale (SCACMS) in an Indian context.Materials and Methods:This exploratory cross-sectional study, conducted at Krishna Rajendra Hospital, Mysuru, India, administered the 15-item SCACMS to 90 psychiatrists across India and 90 caregivers from Mysuru. Data were analyzed using descriptive statistics, Chi-square tests, Cronbach’s alpha, and Cohen’s Kappa.Results:Both groups attributed CM use to limited resources and security issues, deeming it appropriate for aggressive patients or those lacking insight. Non-compliance was the primary reason for CM (89%). Patient awareness of CM led to anger in 58% of cases, while 89% improved with CM. The SCACMS showed satisfactory reliability among staff (alpha = 0.75) but less among caregivers (alpha = 0.45). Psychiatrists showed less support for CM compared to caregivers.Conclusion:While psychiatrists and caregivers recognize CM’s utility in specific cases, particularly due to resource scarcity and security concerns, staff show less support for the practice. Findings suggest a need for standardized CM procedures in Indian mental health settings, improved resources, and staff training to potentially reduce CM reliance.

The urachus is a fibrous remnant connecting the urinary bladder to the umbilicus, and its anomalies are rare in adults, often remaining asymptomatic until infected. Infected remnants, such as a urachal sinus, can present with variable clinical features, including purulent umbilical discharge. We report a case of an infected urachal sinus in a 64-year-old male, known to have uncontrolled diabetes, who presented with a one-month history of copious purulent umbilical discharge, lower abdominal distension on, and recurrent fever. Physical examination revealed an everted, erythematous umbilicus with a discharging ulcer. Imaging with CECT abdomen was diagnostic, showing an ill-defined, peripherally enhancing tract, approximately 9 cm in length, connecting the umbilicus to the dome of the urinary bladder. Definitive management was achieved via laparotomy and complete surgical excision of the infected urachal tract. Urachal remnant infection should be strongly considered in the differential diagnosis for adults presenting with purulent umbilical drainage, particularly in immunocompromised patients like those with diabetes. A high index of suspicion, combined with appropriate imaging, leads to timely diagnosis and definitive treatment, consisting of surgical excision following antimicrobial therapy.

Loss of signals from substantia nigra (SN) and locus coeruleus (LC) on neuromelanin (NM)-sensitive sequences of MRI is reported as a potential biomarker in patients with Parkinson's disease (PD) and related diseases. This scoping review aims to consolidate current knowledge on MRI techniques to visualize and quantify these signals and their clinical applications in PD. Publicly available databases were searched for original studies using MRI to quantify NM in PD and other related disorders. Different studies were compared based on MRI sequence, quantification techniques and correlations with clinical scores. Furthermore, studies on genetic forms of PD and prodromal PD were also evaluated and compared. The most common MRI sequences used were T1-weighted sequences and gradient echo sequences. Different studies used different quantitative measures such as signal-to-noise ratio, contrast-to-noise ratio and contrast ratio. Morphometric evaluations such as volume and area of the SN and LC signals were also used. Most studies showed evidence of significant difference in the signals in different stages of PD compared to controls both at the SN and LC. There were significant correlations between the SN and LC signals and clinical scores. Hence, quantification of these signals may be reliable in diagnosis and disease monitoring in PD. The relative ease of signal quantification and widespread availability of MRI may make it a quantitative surrogate biomarker.

Psoriasis is a chronic inflammatory skin disease increasingly linked to metabolic syndrome, yet the extent of this association remains unclear. This cross-sectional study examined the relationship between psoriasis severity and metabolic syndrome among 122 adults with chronic plaque psoriasis. Psoriasis Area and Severity Index (PASI) scores were significantly higher in patients with metabolic syndrome, indicating greater disease severity. Central obesity and dyslipidemia were the most prevalent metabolic factors associated with elevated PASI scores. Thus, we show the importance of routine metabolic screening in psoriasis patients to improve disease management and outcomes.

The transfer of residents from rural areas to cities, the resulting decline in rural populations, and the ways in which communities adapt to these changes are taken into consideration of urbanization. Surface water quality and quantity are also impacted by increasing urbanization. The biological, physical, and chemical characteristics of water are commonly used to assess its quality. The major objective of this study is to ascertain how urbanization impacted the surface water's physicochemical properties in Mangalore—the Gurupura and Netravati rivers—which are used for drinking. To determine whether the surface water characteristics of the Netravati and Gurupura rivers in the Dakshina Kannada District, Karnataka, are suitable for household and drinking use in the city of Mangalore, a thorough monitoring program was conducted. The monitoring took place in before-monsoon, after the-monsoon, monsoon seasons of 2018 and 2019. Eighty-four surface water samples from the Gurupura and Netravati rivers were analyzed for a number of physicochemical factors. Majority of the metrics are within the WHO and BIS allowed ranges after the monsoon season, because of the increase in fresh rainwater during and after the monsoon. The Weighted Arithmetic Index (WAI) method was applied to categorize the quality of surface water. According to this method, Five categories are utilized to classify surface water quality, Such as: Excellent (0 to 25), Good (26 to 50), Bad (51 to 75), Very Poor (76 to 100), and Unfit for Consumption (more than 100). Considering the outcomes of the Weighted Arithmetic Index (WAI) method, samples of surface water collected during the monsoon season are of good quality.

Primary vaginal squamous cell carcinoma (SCC) is a rare malignancy, representing only 1–2% of all gynecologic cancers. Its occurrence in association with longstanding third-degree uterovaginal prolapse (UVP) is extremely uncommon, occurring in <1 % of cases. This overlap presents unique diagnostic challenges, as ulcerative lesions in prolapse may mimic benign decubitus ulcers, leading to delayed detection and treatment. A 70-year-old multiparous postmenopausal woman presented with a 25-years history of third-degree UVP, accompanied by foul-smelling vaginal discharge and difficulty in defecation for 6 months. Clinical examination revealed a 10 × 8 × 2 cm ulcerative, exophytic lesion involving the entire left lateral part of the vaginal wall with a small ulcer free area below the introitus. The cervix appeared hypertrophied with keratinization. The prolapsed portion was irreducible even under anesthesia. Histopathologic examination of a biopsy specimen confirmed moderately differentiated Vaginal Squamous Cell Carcinoma. Pelvic MRI demonstrated bilateral iliac lymphadenopathy without invasion of adjacent organs. In view of the patient’s advanced age and frailty, she was deemed unsuitable for surgical intervention. Definitive external beam radiotherapy was initiated and she continues to be monitored under oncologic care. This case highlights the importance of maintaining a high index of suspicion for malignancy in elderly patients with longstanding pelvic organ prolapse and atypical vaginal ulcerations. Early biopsy and imaging are critical for timely diagnosis. Clinicians should be vigilant for malignancy masquerading as decubitus ulcers in UVP, as early detection can significantly alter management strategies and improve outcomes.

The rapid advancement of robotics and artificial intelligence has transformed modern agriculture, addressing challenges such as labour shortages, resource inefficiency, and environmental sustainability. This paper introduces a novel smart agriculture robot designed to enhance precision farming practices. The robot integrates advanced sensors, machine learning algorithms, and autonomous navigation systems to perform tasks such as planting, monitoring crop health, and optimizing irrigation. Equipped with real-time data analytics, farmers are empowered to make well-informed decisions, improving yield quality and quantity while minimizing resource waste. The system’s modular design ensures adaptability to diverse agricultural environments, promoting scalability and cost-effectiveness. By leveraging cutting-edge technologies, this smart agriculture robot offers a sustainable solution to meet the growing global food demand, contributing to the evolution of intelligent farming systems