ABSTRACT
Abstract: Background: Basal Cell Carcinoma (BCC) is locally destructive and rarely metastasizing skin tumor occurring on face in fair skinned people. Chronic exposure to sunlight is the most common precipitating factor for its development. The commonest region for occurrence is on the face and forehead region above an imaginary line joining the angle of mouth to tragus of external ear. Case Report: We present a case of BCC in a 57 years old male over left side of forehead region who was managed surgically by wide local excision and rotational flap. The final histopathology report was nodular variant of BCC with clear margins. Conclusion: Surgical excision of superficial, low-risk nodular BCC is the most common modality of treatment. Although topical agents like 5% fluorouracil or localized laser ablation or cryotherapy are good alternatives for low -risk superficial BCC, modalities like immunotherapy and radiotherapy should be offered to patients with locally advanced, recurrent or metastatic BCC.

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Abstract: Arteriovenous Malformationis a rare primary lesion of the spine. The lesion could be located extra or intra dural. The conus medullaris malformation is a special lesions which leads to progressive myelopathy or radiculopathy. The lesion is characterized by multiple feeding arteries, multiple niduses, and complex venous drainage. The neurological deficits may be improved dramatically over time when these lesions are successfully treated, however, the numerous feeding arteries and multiple niduses create a potential for recurrence.We report a case of a 36-year-old man complaining of serious lower limbs muscle weakness. The MRI scan showed multiple arteriovenous systems go around the conus medullaris. The spinal cord is enlarged with spinal cord edema. Embolization was proformed to stop the blood flow of main feeding artery. Post-operation the lower limb muscle weekness has been significantly improved. The patient can walk without additional support. Until the 3 months follow-up, the clinical result was satisfied.

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Abstract: Fournier’s gangrene is a necrotising fasciitis of the perineum due to synergistic infection. The aim of this study is to know the presentation and the predisposing factors of Fournier’s gangrene and the various management modalities. This is a retrospective study over the period of 2 years from June 2018 to June 2020. In which there were a total of 35 patients included and were analysed for the age at presentation, duration of symptoms at presentation, associated co-morbidities, isolated organisms and the length of stay in the hospital. Most of the patient’s age was above 50 years and had associated co-morbidities like diabetes mellitus. At presentation the patients were in SIRS and were subjected to immediate surgery followed by broad spectrum antibiotics and regular dressing. Once the wound was healthy either primary closure was done or skin grafting was done. Despite of advances in medical field the mortality remained pretty high in Fournier’s gangrene cases.

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Abstract: Traumatic head injuries are a prominent cause of death. The privilege of intracranial hemorrhage is one of the fatal problems. CT-scan is considered the gold standard for the traumatic brain injuries diagnosis. GCS of the patients is helpful in patient evaluation. Patient with high GCS are neglected but it may be considered that they can develop significant problems. However, it is controversial whether to perform CT-scan in patients that have 13-15 GCS or not. Purpose: I hereby to evaluate the patients of head trauma with high GCS 10-15 on CT-scan that may be neglected but they may develop symptoms. My aim of study was to determine whether it is safe to discharge such patients or performing CT scan is safe. Besides this, I mainly found the frequency of different types of ICH in 50 patients that have 10-15 GCS. Approach: 50 patients of head trauma injuries were evaluated on computed tomography. All the patients had undergone non-contrast computed tomography scan of brain with the axial images and slice thickness of 5mm from foramen magnum to vertex. A Performa was filled for patient’s name, age, gender and other findings. Any statistical variables were correct by putting some exclusion criteria i.e. bleeding disorder and anti-coagulant therapy so that it might not influence the desired conclusions. Results: Out of 50 patients 22 (44.00%) patients had intracranial hemorrhage. Out of these 22 patients 9 (40.91%) had EDH, 9 (40.91%) had subdural, 2 (9.09%) had SAH and 2 (9.09%) had ICrH. Conclusion: This study demonstrates that the frequency of ICH is 44% and the incidence of SDH and EDH is equally higher than other types. Patients with RTA have higher risk of ICH and it is more in females than in males. Data analysis for different variables was done by using Microsoft excel 365. Graphs and charts were used to explain the results.

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Abstract: As we herald into the 21st century, the quality of life and the repertoire of HAART (Highly active anti retro viral therapy) has considerably improved. However considerable work is still needed to educate the population about primary and secondary prevention modalities. Moreover regular monitoring of immune response with patients on HAART with conventional biomarkers is still a problem in low resource settings which needs to be addressed. We aim to review hsCRP as a potential biomarker in this regard.

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Abstract: Regenerative therapies with platelet concentrate are used as they are physiological reservoirs of growth factors (FCs) and proteins, capable of accelerating tissue regeneration. The purpose of this work has been to evaluate the regenerative effect of allogenic platelet lysate through pathological findings in deep dermal burns. A cross-sectional, observational, descriptive study was carried out to determine the clinical effect of platelet lysate on tissue regeneration in 30 patients with deep dermal burns, in the Caumatology and Plastic Surgery Service, Hospital General "Dr. Juan Bruno ZayasAlfonso”, fromSantiago de Cuba, in the period from February 2013 to February 2014.The female sex prevailed in ages between 18 and 45 years, with the lower limbs standing out as the most affected region, in both groups of treatments. The application of platelet lysate favored healing and epithelialization in a shorter time than that described with conventional treatment, with minimal adverse events, without complications, achieving a better quality of the final. Histopathological findings showed that acts directly in the healing phases, stimulating early tissue regeneration.

ABSTRACT
Herpes zoster ophthalmicus (HZO) is a disease which occurs when the ophthalmic division of the trigeminal nerve is impaired as a result of reactivation of the varicella-zoster virus. Ophthalmic involvement has been considered the most important and potentially serious of all sites of Herpes Zoster virus. Objective of thispresent case study was to understand the modes of presentation and manifestations (ocular and extraocular) of HZO.This case study was conducted in the Outpatient Department of Ophthalmology at Indira Gandhi Medical College, Shimla (Himachal Pradesh). The Patient diagnosed with HZO was underwent a comprehensive ocular and extraocularexamination. The ocular manifestations of HZO in the Patient was acute vesicular, dermatomal ,painful, unilateral skin rash, hyperesthesia over his left forehead skin, Hutchinson sign present,Conjunctivitis in left eye with no exudates or obvious corneal scarring , Superficial punctate keratitis, stromal keratitis,Visual acuity Right eye-6/12, Left eye -6/18, IOP digitally normal bilaterally, Fundus cannot be assessed (CNBA) in the left affectedeye, normal ocular movements in all planes with no diplopia, normal direct and consensual pupillary reflexes. Patient was medically treated with antiviral, antibiotic, cycloplegic and other supportive drugs and followed up.