Background: Renal stones are a painful urological disorder resulting from the combined influence of epidemiological, biochemical and genetic risk factors. A high recurrence risk has been reported for renal stones, and 0.6%–3.2% cases may progress to end stage renal disease. Modern lifestyle, sedentary habits and unhealthy dietary practices are primary promoters of the stone boom in this millennium. Aims and Objectives: The aim of the present study is to evaluate the percentage of the stone type according to chemical composition and their association with epidemiological factors like sex and age. A retrospective analysis of the chemical composition of the stone samples received was done. Material and Methods: Stones samples were processed by Stone Analysis Set (BIOLABO S A, France). Qualitative chemical analysis was done for calcium, phosphorus, ammonium ion, oxalate, cystine, magnesium, carbonate and uric acid. Results: Type of renal stone and its incidence with age and sex have been evaluated. The total number of patients reporting to the hospital with renal stones was 123. Of these, 69.11% were male and 30.89% were female, with a male to female ratio of 2.23:1. The maximum occurrence was in the third and fourth decade of life. On analysis, 72.35% of total stones comprised calcium oxalate and 23.57% of nonoxalate (phosphate, magnesium, carbonate, ammonium ion) stones, whereas uric acid was positive in 4.06%. Conclusion: The occurrence of renal stones according to epidemiological factors such as age and sex in our study are similar to those reported in studies from developed countries. The data on urinary stones indicate that 98% were located in the upper urinary tract. Oxalate stones represent the main form of urolithiasis, affecting males more than females. The most important cause studied for renal stone formation is metabolic disturbances, but the genetic factors associated with the occurrence and recurrence of stone and mineral homeostasis of ions in kidney of stone formers should be further evaluated.

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Background: COVID-19 outbreak is known to have a psychological impact on patients. Background and Objective: The main aim of the study was a to study the attitude and behavior of health care professionals (HCPs) in the emergency department towards chronic patients during COVID-19 pandemic and also the accessibility of healthcare system during COVID-19 period and to compare it with the pre-COVID period. Materials and Methods: A random sampling technique was used, and a pre-designed questionnaire named the Brief Emergency Department Patients' Satisfaction Scale was adopted to record the patient's satisfaction with the healthcare services. Results: The patients admitted to the emergency ward felt that the nursing and physicians' care in the emergency department was highly satisfactory in the pre-COVID period. In the COVID period, the same set of patients who got admitted felt that there was a deterioration in the behaviour and attitude of the HCPs towards them. In the COVID period, 30% of the patients felt that there was a marked deterioration in the general services in the emergency department. It was also observed in the study, that there was a marked change in the attitude and behaviour of the HCPs in the emergency department at the time of the COVID pandemic. Conclusion: COVID-19 has significantly changed the attitude and behaviour of HCPs. The disease has critically transformed the working environment and the approach of HCPs to treat the patients. It is imperative to employ productive strategies to care for the health of our HCP.

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Cervical cancer is the fourth most common cancer in women worldwide and is a significant public health problem. Currently, there are three bivalent human papillomavirus (HPV) vaccines targeting high-risk HPV types (16, 18), two quadrivalent vaccines targeting two high risk HPV types (16,18) and two low risk types (6,11) and one nonavalent vaccine against HPV 16,18, 31, 33, 45, 52, 58, 6 and 11. All are WHO approved vaccines and show excellent seropositivity (>95%) even at 5–10 years' post-vaccination irrespective of dosing schedule. These vaccines are relatively safe with minor local side effects. The WHO recommends two dosage vaccination schedule for girls aged 9–14 years with an off-label recommendation for a single-dose schedule. HPV vaccination has shown efficacy against the reduction of cervical intraepithelial neoplasia, invasive cervical cancer, anogenital warts and vulvovaginal intraepithelial neoplasia in numerous population/registry-based cohort studies worldwide. Countries such as Australia and Sweden where vaccination began as early as 2006–2008 have seen a major reduction in the incidence of cervical cancer in the vaccinated cohorts. Model based projection studies have also indicated significant vaccine efficacy with two doses and single dose in catch-up programmes. In this article, we provide an update on the vaccine recommendations, immunogenicity and efficacy data derived from registry-based cohort studies and trials published mostly in the last 5 years.

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Conventionally, endometrial cancers have been risk-stratified as per the clinco-pathological factors. The Cancer Genome Atlas project identified four distinct molecular subtypes within endometrial cancers which further lead to the clinical validation of molecular classification by various research groups. The molecular classification has influenced the risk stratification, thereby impacting adjuvant treatment decisions and prognostication. Molecular classification has paved the precision oncology in gynaecological cancers further strengthening the ongoing advances in targeted therapies and immunotherapy. This review elaborately presents the development of a new molecular classification of endometrial cancers; its evidence-based clinical utility with a brief overview of future perspectives.

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Screening along with treatment is the foremost tool for cervical cancer elimination in addition to vaccination strategies. At present, India lacks a comprehensive screening programme. There are huge issues in terms of feasibility, acceptability and implementation of the existing cervical screening programme in the country. Less than 2% (Urban-2.2% and Rural-1.7%) of women in India have been screened. The current strategy recommended by Ministry of Health and Family Welfare is Visual Inspection with Acetic Acid (VIA) every 5 years for women aged between 30 and 65 years. A significant improvement in terms of decreasing incidence and mortality of cervical cancer has been seen in two randomized controlled trials conducted in India. However, VIA lacks sensitivity, requires extensive training to be given to the medical staff for accurate diagnosis, has substantial operator variability and has less acceptability among women when compared to the newer methods of cervical cancer screening such as human papillomavirus (HPV) self-sampling. HPV self-sampling is a more sensitive, accurate and more acceptable method of cervical cancer screening for women in India and abroad. It can help the existing VIA-based strategy of cervical screening by increasing participation resulting in more population being screened in the various geographical regions and populations in India. However, VIA-based screening should also be continued because of its affordability and cost-effectiveness in India where there is a significant population belonging to low socio-economic background. There are numerous evidences such as systematic reviews, meta-analyses, randomised controlled trials of India and abroad that have been used as sources in this review article to come to the conclusion that HPV self-sampling is an acceptable, accurate and sensitive method that can be used as a primary screening tool in cervical cancer screening programmes globally and in India. It can also be used as an effective triage test for prioritising high-risk populations who require urgent and effective treatment for cervical pre-cancer and cancer. To conclude, HPV self-sampling should be integrated and implemented by the government and private sector in addition to VIA-based screening strategies for achieving the goal of cervical cancer elimination in India.

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Cervical cancer remains a health burden in our country and is the 2^nd most common cancer in Indian women. Effective screening can reduce the incidence as well as the morbidity and mortality of this disease. Cervical cytology and the more recent human papilloma virus (HPV) DNA test are the two main pillars of screening. Liquid based cytology has improved the cytological preparations and has shown certain advantages while advancements in molecular techniques for detection of high-risk HPV DNA/RNA has opened up new frontiers. These technological advancements have led to the changes in screening practices and paradigms and are evolving at a rapid pace. This article gives an overview of the screening modalities currently available, the technological advancements, recent updates of the screening guidelines and the future directions.

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A 38-year-old male was diagnosed with aortoiliac aneurysm while evaluating for new-onset hypertension. On further workup, the cause was identified as tubercular aortoiliac aneurysm. His aneurysm had stormy course and disseminated further while ongoing antitubercular therapy with multiple episodes of aneurysmal rupture and endovascular interventions. Management of this case was complicated with several other rarer entities, such as haemophagocytosis and thrombotic microangiopathy with disseminated intravascular coagulation resistant to steroids and plasmapheresis, within a span of few weeks. Moreover, first-line antitubercular therapy had to be regularly modified in view of emerging complications. While case reports for each individual entity exists in literature, this is the first case to the best of our knowledge where such varied complications were present in a patient of tubercular mycotic aneurysm.

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