The loss or disfigurement of a body parts specially that pertaining to the face has a deep psychological and social impact on the patient. After enucleation, evisceration or exteneration of the eye, the aim of an ocular prosthesis should be to restore the natural appearance, install confidence and a sense social acceptability in the patient. Custom made prosthesis has several advantages over the stock eye prosthesis. This article illustrates rehabilitation of the enucleated right eye of a patient with a custom made ocular prosthesis.

Objective: To determine the incidence of accidentally diagnosed genital malignancies in women undergoing gynecological surgeries for pathologies presumed to be benign. Methods: Data of all women who underwent hysterectomy for benign indications were retrieved from hospital records. A total of 628 cases of hysterectomy and 35 cases of myomectomy were included. The final histopathology was accessed through the computer records, and the total number of genital tract malignancies was included. Results: The incidence of occult uterine, ovarian, and cervical malignancies in women undergoing hysterectomy was 0.47%, 0.31%, and 0.15%, respectively. The incidence of uterine corpus malignancies in women undergoing myomectomy was 2.8%, and 3 cases of smooth muscle tumor of uncertain malignant potential (STUMP) were also identified. Endometrial stromal sarcomas were the most common pathology among uterine malignancies, followed by leiomyosarcoma and endometrial adenocarcinoma. Conclusion Postoperative diagnosis of malignancies in women undergoing surgery for benign indications poses great challenges to the treating surgeon. Occult malignancies must be ruled out by thorough preoperative assessment, especially in some subsets of women. Morcellation is an inevitable technique and complement to laparoscopic surgeries, although little chances of malignancy spread is related to its use. Nevertheless, thorough preoperative investigations and always ensuring contained morcellation can minimize these chances.

Objective: The primary objective of this study was to establish the presence of nerve fibers in the eutopic endometrium of women with endometriosis and to determine whether these nerve fibers are exclusive to endometriosis or are also found in other pelvic pathologies associated with dysmenorrhea. Methods: Endometrial tissue was obtained by aspiration (Pipelle), endometrial curettage, or following hysterectomy in women with endometriosis confirmed through histopathological examination, leiomyomas, and adenomyosis. The eutopic endometrium was subjected to immunohistochemical staining to detect PGP 9.5, which is a highly specific pan-neuronal marker. The nerve fiber density was correlated with the patient’s pain score, as indicated by the Visual Analog Scale. A control group was formed by staining the endometrium of women presenting with dysmenorrhea but without the above-mentioned disorders. Results: Nerve fibers were observed in sections of the endo-myometrium (in the deep endometrium) in 68% of patients with endometriosis who underwent hysterectomy or a deep endometrial biopsy. Nerve fibers were not observed in the aspirated endometrium of women with endometriosis. Only 13.7% of women with adenomyosis and 3.3% of women with fibroids had nerve fibers in their endometrium. Nerve fiber density was correlated with pain score in women with endometriosis. Conclusion Nerve fibers were found in the functional layer of eutopic endometrium in women with endometriosis; hence, we concluded that the presence of nerve fibers in the eutopic endometrium could diagnose endometriosis with a fairly good specificity of 92.7%. However, the absence of nerve fibers does not always exclude the disease.

Objective: To determine the incidence of accidentally diagnosed genital malignancies in women undergoing gynecological surgeries for pathologies presumed to be benign. Methods: Data of all women who underwent hysterectomy for benign indications were retrieved from hospital records. A total of 628 cases of hysterectomy and 35 cases of myomectomy were included. The final histopathology was accessed through the computer records, and the total number of genital tract malignancies was included. Results: The incidence of occult uterine, ovarian, and cervical malignancies in women undergoing hysterectomy was 0.47%, 0.31%, and 0.15%, respectively. The incidence of uterine corpus malignancies in women undergoing myomectomy was 2.8%, and 3 cases of smooth muscle tumor of uncertain malignant potential (STUMP) were also identified. Endometrial stromal sarcomas were the most common pathology among uterine malignancies, followed by leiomyosarcoma and endometrial adenocarcinoma. Conclusion Postoperative diagnosis of malignancies in women undergoing surgery for benign indications poses great challenges to the treating surgeon. Occult malignancies must be ruled out by thorough preoperative assessment, especially in some subsets of women. Morcellation is an inevitable technique and complement to laparoscopic surgeries, although little chances of malignancy spread is related to its use. Nevertheless, thorough preoperative investigations and always ensuring contained morcellation can minimize these chances.

Objective: The primary objective of this study was to establish the presence of nerve fibers in the eutopic endometrium of women with endometriosis and to determine whether these nerve fibers are exclusive to endometriosis or are also found in other pelvic pathologies associated with dysmenorrhea. Methods: Endometrial tissue was obtained by aspiration (Pipelle), endometrial curettage, or following hysterectomy in women with endometriosis confirmed through histopathological examination, leiomyomas, and adenomyosis. The eutopic endometrium was subjected to immunohistochemical staining to detect PGP 9.5, which is a highly specific pan-neuronal marker. The nerve fiber density was correlated with the patient’s pain score, as indicated by the Visual Analog Scale. A control group was formed by staining the endometrium of women presenting with dysmenorrhea but without the above-mentioned disorders. Results: Nerve fibers were observed in sections of the endo-myometrium (in the deep endometrium) in 68% of patients with endometriosis who underwent hysterectomy or a deep endometrial biopsy. Nerve fibers were not observed in the aspirated endometrium of women with endometriosis. Only 13.7% of women with adenomyosis and 3.3% of women with fibroids had nerve fibers in their endometrium. Nerve fiber density was correlated with pain score in women with endometriosis. Conclusion Nerve fibers were found in the functional layer of eutopic endometrium in women with endometriosis; hence, we concluded that the presence of nerve fibers in the eutopic endometrium could diagnose endometriosis with a fairly good specificity of 92.7%. However, the absence of nerve fibers does not always exclude the disease.

Objective: The study was conducted to determine the frequency of alloimmunization to various blood group antibodies in pregnant women, and the risk of hemolytic disease in the fetus and newborn. Methods: All antenatal women, irrespective of the period of gestation or obstetric history, were included, whereas those taking anti-D immune-prophylaxis or with a history of blood transfusion were excluded. Antibody screening and identification were performed using a Bio-Rad ID microtyping system. Results: Of 2,084 antenatal females, 1,765 were D‐antigen positive and 319 D‐antigen negative. Sixty-five (3.119%) women alloimmunized. Out of 54 (2.591%) who had sensitized to D-antigen, 11 (0.527%) also sensitized to other antibodies. These 11 alloantibodies identified included: anti-M (n=6; 9.23%), anti-C (n=1; 3.076%), anti-E (n=1; 1.538%), anti-e (n=1; 1.538%), anti-Lewis (a) (n=1; 1.538%), and unspecified antibodies (n=1; 1.538%). Multiple antibodies were seen in four patients that combined: anti-D and anti-C (n=2; 3.076%), anti-e and anti-c (n=1; 1.538%), and anti-D and anti-G (n=1; 1.538%). Conclusion The rate of alloimmunization in D-antigen-negative women was high. Apart from this, the alloimmunization rate in women with bad obstetric history was very high, at 8.1%. In developing countries such as India, universal antenatal antibody screening, though desirable, may not be justified at present, as the cost and infrastructure required would be immense because of the lower alloimmunization rates in RhD antigen-positive women. However, it is necessary to impose properly formulated protocols to screen pregnant women with bad obstetric history.

Objective: Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods. Methods: This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the ‘plan-do-study-act’ (PDSA) cycle was implemented to improve the OSCE. Results: Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE. Conclusion The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.

Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4–6 – year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4–6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham’s anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.