National Journal of Integrated Research in Medicine 2020-03-23T11:33:33-07:00 Chinmay shah Open Journal Systems <p>This is an official publication of&nbsp;<strong>"</strong><strong>Association of Health Professionals and Health Educators".&nbsp;</strong> National Journal of&nbsp; Integrated Research in Medicine&nbsp; will publish article of research in various type of therapy for the benefit of mankind i.e. allopathy, ayurvedic, Homeopathy, Sujok therapy, Unani and Siddha Medicine. All the Content of Journal are Open Access and <strong>can be accessed by all without login or payment . We follow Creative Commons license CC BY-NC-SA for access of article.</strong></p> Recent Amendment in the Eligibility Criteria for Medical Teachers in India -A Bird’s Eye View 2020-03-23T11:33:33-07:00 Chinmay Shah Swpnil Parlikar <p>Recently, the Board of Governors (BoG) in supersession of the Medical Council of India, has issued new guidelines for the eligibility and promotion of teachers in Medical Colleges across India. In this article, we are going to summarise these changes.</p> 2020-03-01T00:00:00-08:00 Copyright (c) Diagnostic Utility Of Fine Needle Aspiration Cytology In Thyroid Lesions 2020-03-04T00:52:27-08:00 Shikha Goel Deepti Agarwal Swaran Kaur Parveen Rana M.K.Garg Uma Garg <p>Abstract: Background: Fine-needle aspiration cytology (FNAC) cited as an inexpensive and highly accurate means in diagnosing neoplastic and non-neoplastic lesions of the thyroid. It is safe, quick, and cost effective outpatient department (OPD) procedure. Aim: The current study was done to evaluate the diagnostic utility of FNAC in thyroid lesions and to calculate sensitivity, specificity and diagnostic accuracy of FNAC in the diagnosis of thyroid lesions. Materials And Methods: The present study was conducted in the Department of Pathology, BPSGMC(W),Khanpur Kalan,Sonipat over a period of 1 year. A total of 278 cases of thyroid swelling were studied in whom FNAC of thyroid was done and diagnosis was given on conventional cytology.It was further categorized according to the Bethesda System. Cytological diagnosis was compared with the histopathology wherever available. Result: Statistical analysis of the data showed the diagnostic accuracy of fine needle aspiration cytology to be 92.2%. Fine needle aspiration cytology showed a sensitivity of 76% and a specificity of 100%.On conventional cytology, the commonest lesion in the thyroid gland was colloid goiter 124(44.6%). Fine needle aspiration cytology results revealed Category II 172 (61.86%), Category IV 30 (10.8%), Category VI 20 (7.19%) , Category V 9 (3.27%) , Category III 4 (1.43%) Category I 43 (15.45%) in thyroid lesions according to the Bethesda System. Conclusion: FNAC may be considered as a significant tool in the diagnosis of patients with thyroid lesions. [Goel S Natl J Integr Res Med, 2020; 11(1):3-10]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Comparative Study Of Effect Of Mediation On Autonomic Nervous System In Healthy Meditators And Non Meditators 2020-03-04T01:05:59-08:00 Ashok Solanki Shaista Saiyad <p>Abstract: Background: Meditation is a type of relaxation technique produced by focusing attention to a particular theme. Meditation produces profound changes in almost all systems of human body including nervous system. The changes occurring can be recorded by assessment of various autonomic nervous system tests. Objectives: To assess and evaluate parasympathetic nervous system tests in meditators and non meditators. Methods: After approval by ethical committee, 200 subjects were included in the study. 100 were healthy meditators and 100 were healthy non meditators. Parasympathetic function tests of all 100 subjects were recorded after informed consent. Results: and interpretation: Parasympathetic function tests showed that Expiration : Inspiration (E:I) ratio, Valsalva ratio and 30:15 ratio was significantly higher in meditators than non-meditators (p&lt;0.001). Conclusion: Regular meditation increases parasympathetic dominance in our body. Meditation helps to maintain normal homeostasis in our body. Hence, meditation should be practiced daily for overall well-being of the body. [Solanki A Natl J Integr Res Med, 2020; 11(1):11-15]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Clinicoepidemiological Study Of Acute Skin Failure: A Prospective Study From Tertiary Care Center Of Gujarat 2020-03-08T19:36:00-07:00 Dr. Khushbu R. Modi Dr. Raju G Chaudhary <p>Background: The concept of skin failure is not well known and the need for intensive care in dermatology is overlooked. Skin failure has been defined as loss of normal temperature control with inability to maintain the core body temperature, and failure to prevent percutaneous loss of fluid, electrolytes and protein, with resulting imbalance, and failure of the mechanical barrier to prevent penetration of foreign materials. However, acute skin failure is no less serious than visceral dysfunctions like cardiac, pulmonary, renal or hepatic failure. Aims: The aim of this study is to study the clinicoepidemiological profile of the acute skin failure. Methods: This is a prospective study which was conducted over period from September 2014 to December 2016.In this study we included conditions in which acute skin failure is a consequence of various primary dermatological disorders like erythroderma,severe drug reaction,Immunobullous conditions,infections and acute generalised pustular psoriasis. After ethical institutional approval, detailed history of all the patients was taken and recorded with all demographic details and clinical examinations. Results: Out of 59 patients, 34 were male and 25 were female. Maximum 17(28.81%) patients were in the age group of 31-40 years. Among 9 conditions included in this study, 16 (27.11%) cases were of erythroderma, 12(20.33%) were of pemphigus vulgaris,11(18.64%) were of SJS .At the time of first presentation 52.60% patients were having mucosal involvement, 49.35% patients were having various systemic involvement. 46(77.9%)patients were having body surface involvement &gt;70%. Conclusion: Effective management is more accurate only when the underlying etiology of each event of acute skin failure is clear. [Mody K Natl J Integr Res Med, 2020; 11(1):16-21]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Evaluation Of Secondary Peritonitis A Record Based Study 2020-03-04T01:26:54-08:00 Dr. Astha K. Trivedi Dr. Het B. Upadhyaya Dr. Archana D. Dalal <p>Background: Secondary peritonitis is the most common indication for exploratory laparotomy in India. However the etiology of perforation varies from the western world. The objective of this study is to assess the etiology, presentation, management and post-op outcome of patients operated for secondary peritonitis at our hospital. Method: Hospital based retrospective study of 50 cases of secondary peritonitis during the period of 2015-2018. Pediatric patients, primary peritonitis and anastomotic leak patients were excluded from the study. Result: Maximum number of patients were in age group of 11-30 years with male: female =4:1. Out of 50 cases the most common clinical presentation was abdominal pain in all of the patients. Most common site of perforation was peptic perforation (44%), followed by small bowel perforation (36%), appendicular perforation (10%) and colonic perforation (10%). Overall rate of complication was 25%. Conclusion: In our setup the major etiology of perforation was infective and presentation of patients immediately after first symptom and timely surgical intervention resulted in good prognosis and less post-op complications. Complications in our study were wound infection (22%), electrolyte imbalance (20%), pulmonary complication (12%), septicemia (12%), intestinal obstruction (2%), fecal fistula (2%), burst abdomen (2%) and mortality (16%). [Astha Trivedi Natl J Integr Res Med, 2020; 11(1):22-25]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Histopathological Analysis Of Hysterectomy Specimens In Women Of Different Age Groups 2020-03-04T23:44:45-08:00 Dr Anjana Mittal Dr Shweta Sharma <p>Background: Abnormal uterine bleeding is of considerable clinical significance because of its numerous causes. Utrine fibroid , polyp , adenomyosis , endometrial hyperplasia and malignancies are common causes for abnormal uterine bleeding. Material &amp; Method: The present study was carried out on total of 424 hysterectomy specimens of patients with AUB during period of January 2018 to July 2019 . Data including age , symptoms and clinical indication for hysterectomy was collected and the histopathological findings were correlated. Result: Women in the perimenopausal age (41 – 50 yrs) accounted for the highest number of cases (74.05% ) presenting with symptoms of AUB. Adenomyosis was found to be the most common cause of abnormal uterine bleeding in women of perimenopausal age group. Conclusion: Adenomyosis was found to be the most common cause of abnormal uterine bleeding in perimenopausal age group. [Mittal A, Sharma S Natl J Integr Res Med, 2020; 11(1):26-27]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Students Perception About Educational Environment During The Entire Course Of Physiotherapy: A 4 Years Longitudinal Study 2020-03-04T01:42:15-08:00 Suvarna Ganvir Aditi Arbat Shyam Ganvir <p>Background: Students perception about educational environment in their four years of education may change and its information may prove to be crucial to improve the institutional profile. The Dundee Ready Education Environment Measure (DREEM) is a validated tool to assess the EE. Purpose of this study was to collect information about students perception during their four years of graduation in a longitudinal manner and to report the changes over time. Methods: 2014 batch students were included in the present study. Perception of these students was measured with the help of DREEM questionnaire after the declearation of results in each professional year under five domains : students’ perceptions of learning; students’ perceptions of teachers; students’ academic self-perceptions; students’ perceptions of atmosphere; and students’ social self-perceptions. Results: The mean global DREEM score was 113.3/200 in the first year, 118.9/200 in second year, 129.9 in third year which increased to 141.9/200 in the final year. One-way analysis of variance followed by post hoc Tukey-Kramer multiple comparisons test revealed that there was statistically significant difference between first and fourth year scores with p value &gt;0.05. Similar trend was observed in all five domains of DREEM questionnaire. Conclusion: The present study revealed Students in their final year of education found the EE to be more positive as compared to when they were in their first year. This may be due to remedial measures taken by the institute in due course of time as well as longer association of students with the institute. [Ganvir S Natl J Integr Res Med, 2020; 11(1):28-34]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Development Of Competency In Communication Skills In Third Year MBBS Students Based On AETCOM Module: A Pilot Study 2020-03-04T01:54:33-08:00 Dr. Parul Sharma Dr. Neeraj Mahajan <p>Background: Good communications skills should be taught and practiced in medical curriculum to increase clinical competence. Objectives: To conduct and analyse Faculty Development Program (FDP) on communication skills and teach basic communication skills undergraduate students using modified AETCOM Module and assess improvement these skills. Material and Methods: An interventional study was carried out for 6months period. Twenty faculties including interns were trained followed by training of sixty 6th semester students during community medicine clinical posting at GMERS Medical College, Dharpur, Patan through consecutive sampling. A modified version of AETCOM (video clips) was used. Assessment was done using Pre-post-test structured SAQs for faculty and Pre-post-test structured SAQs, OSCE (Kalamazoo and SPIKES) and Reflections for students. Feedback was obtained from students, faculty and simulated patients. Statistical Analysis: Microsoft excel, Primer software were used. Paired-t test was used for before and after comparison. Thematic analysis of reflections was done. Results: There was significant improvement in communication skills of students with respect to Structured SAQs (Mean Diff=-30.83, t=18.88, p=0.001, df33); OSCE for basic communication skills (Mean Diff=-3.44, t=6.380, t=6.380, p=0.002, df=33); OSCE for spikes (Mean Diff=-16.18, t=8.190, p=0.001, df=33). A positive feedback was obtained from majority (&gt;80%) of students, faculty and simulated patients. Themes extracted from reflections were based on empathy, respect for doctors, violence, SPIKES, trust and competency. Conclusion: AETCOM module was effective and perceived well by all stakeholders. Its implementation would make a big impact.<br>[Sharma Parul Natl J Integr Res Med, 2020; 11(1):35-40]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Study Of 18 Cases Of Superior Mesenteric Artery Syndrome At Tertiary Care Hospital 2020-03-04T02:03:21-08:00 Dr. Kaushal D. Suthar Dr. Sandip D. Patel <p>Background: Superior mesenteric artery (SMA) syndrome is a rare condition of duodenal obstruction, caused by the overlying SMA. Objective: To report on our experience with the management of SMA syndrome, drawing attention to its existence. Material And Methods: We reviewed our records to identify cases diagnosed with SMA syndrome, in the period from january 2010 to June 2018. Results: Eighteen patients were identified, six male and twelve females.Vomiting and abdominal pain were presenting complaints in all patients and history of weight loss was present in all of them. Only after radiological investigations was the diagnosis declared. Either Barium meal studies or computerized axial tomography (CT) scans with oral contrast was done. Surgery was performed in all patients with open duodenojejunostomy. Long lasting improvement was sustained in all patients except three in the surgery group who, despite initial improvement, still has infrequent attacks of abdominal pain. Interpretation and Conclusion: Although the clinical manifestations of SMA syndrome are shared with many other disease entities, it has unique radiological as well as endoscopic features, which enables a confident diagnosis to be made. Once diagnosed, conservative treatment with nutritional support should be tried first. In case of unresponsiveness, surgery may give a cure. [Suthar K Natl J Integr Res Med, 2020; 11(1):45-48]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Role Of Serum Procalcitonin As An Adjunct Biomarker In Early Diagnosis Of Sepsis 2020-03-04T02:14:11-08:00 Dr Margeyi Mehta Dr Jigish Shah <p>Background: A very high morbidity and mortality is associated with patients admitted with sepsis. While other biomarkers take some time for confirmation of sepsis, role of serum procalcitonin (PCT) for early diagnosis of sepsis has been explored in recent years. Several studies have widely advocated positively for its use. Current study was carried out to explore common sources of sepsis, determine validity of PCT as a test in determining sepsis and its relationship with sepsis. Materials and Methods: 42 individuals with a probability of sepsis admitted in ICU of a tertiary care hospital in western India were taken as study subjects. Along with necessary microbiological, laboratory and other tests, serum PCT was assessed on admission. PCT values &gt;0.5 ng/ml were considered as positive. Relationship of PCT values was assessed in confirmed cases of sepsis and non-sepsis. Sensitivity, specificity and positive predictive value for PCT were also calculated. Current study was carried out in a private sector. In unavailability of institutional review body, due consents were taken from the stake holders prior to the study. Confidentiality and anonymity of the patients were maintained throughout the periods of study. Results and conclusions: Incidence of sepsis was more in males and people aged 55 years or more. More than half of study subjects were confirmed for sepsis. Respiratory and urinary tract infections were common causes of sepsis. Serum PCT proved to be a good indicator of sepsis in critically ill patients with sensitivity of 82.6%, specificity of 73.3% and positive predictive value of 79.2%. Relationship between PCT and sepsis was statistically significant (Chi-square 11.3 at df 1, p&lt;0.05). PCT as an adjunct biomarker can prove helpful in Indian settings for early diagnosis of sepsis. [Mehta M Natl J Integr Res Med, 2020; 11(1):49-53]</p> 2020-03-01T00:00:00-08:00 Copyright (c) A Prospective Observational Study On The Correlation Of Non Stress Test In The Latent Phase Of Labour With The Fetal Outcome In Singleton Term Pregnancies (37 – 42 Completed Weeks) With Vertex Presenting Part 2020-03-08T19:35:48-07:00 Dr. Nivetha S Dr. Dipti C. Parmar <p>Background: Present study is to know the fetal outcome by doing Non Stress test in latent phase of labour. The Non Stress Test is the most accepted method of antenatal fetal surveillance. This test involves the use of Doppler-detected fetal heart rate acceleration coincident with fetal movements perceived by the mother. Materials and Methods: This study was conducted in the Department of Obstetrics and Gynecology, after approval from the Ethics Committee, from April 2018 to June 2019 on 200 patients who were admitted to the labour room with labour pains with the consent of the patient. Non stress test was done and the results interpreted. Results: Of 173 vaginal delivery patients, 103 patients(59.54%) had full term normal delivery without episiotomy, 57 patients (32.95%) had full term normal delivery with episiotomy and 13 patients(7.51%) had full term vacuum assisted vaginal delivery with episiotomy. 182 patients (91%) had reactive NST and 18 patients(9%) had a non reactive NST. 31 neonates(15.5%) were admitted to NICU, 168 neonates (84%) were healthy and on mother side,1 neonate(0.5%) was stillborn. Conclusions: Non Stress test is a non-invasive test which can be used as a good predictor of healthy fetus in normal pregnancies. NST is a useful tool to avoid obstetric litigation as parental expectation of a good outcome is extremely high.[S N Natl J Integr Res Med, 2020; 11(1):54-57]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Abruptio Placenta-Retrospective Study On Maternal And Foetal Outcome 2020-03-04T02:34:04-08:00 Dr Nilam Badani Dr Dipti.C.Parmar <p>Background: It is a form of antepartum haemorrhage where the bleeding occurs due to separation of placenta partially or totally from its implantation site after 20 weeks of gestation before the delivery of feteus. It is one of the major causes of antepartum haemorrhage which complicates 3% of pregnancies. Aims And objective: Aim of study is to maternal and perinatal outcome of Abruptio placenta in Government Medical College Bhavnagar, Gujarat And To know incidence of Abruptio placenta.Material and Method: This is a retrospective study analysing the case sheets of abruptio placenta in Government Medical College Bhavnagar, Gujarat from June 2018-June 2019. As most of the patients were admitted as emergencies placental abruption was suspected based on clinical features of abdominal pain ,vaginal bleeding, uterine tenderness, hypertonic uterus and diagnosis was confirmed by retroplacental clots after delivery which was used to estimate the amount of bleeding and severity of abruption. Fetalwell being was assessed with ultrasonography and cardiotocography. Results: The total number of deliveries from June 2018 to June 2019 at Sir T hospital, Bhavnagar were 5947 deliveries , out of which 45 cases were found to be Abruption .The incidence of Abruption placenta was 0.7%. We found 48.38% of patients with severe preeclampsia, 6.6% patients with eclampsia, 11.1 % patients with chronic hypertension and 33.42% patients with normotensive. Conclusion: Antenatal care which identifie the risk factors like PIH plays an important role in decreasing incidence of abruptio placenta and improving maternal and fetal outcome. Regular antenatal check up , anaemia correction, early diagnosis and identification of gestational hypertension and pre eclamptiatoxemia would reduced the maternal and perinatal morbidity and mortality. [Badani N Natl J Integr Res Med, 2020; 11(1):62-65]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Comparison Of Oral Clonidine And Intravenous Esmolol For Attenuation Of Stress Response To Laryngoscopy And Endotracheal Intubation In Middle Ear Surgeries 2020-03-05T01:31:57-08:00 Dr Akash Chavda Dr Kashmira Pander Dr Hemal Prajapati Dr M P Golwala <p>Background: Induction of anesthesia is recognized as a hazardous phase in management of the patient during operative procedure. Laryngoscopy and intubation being noxious stimuli produce cardiovascular stress response, which result in an increase in cardiac work load, may terminate in pre operative myocardial ischemia and acute heart failure in susceptible individuals. So, this study was conducted with an objective to compare the efficacy of oral Clonidine and intravenous Esmolol for attenuation of cardiovascular stress response following laryngoscopy and intubation. Method: This study was conducted among 50 patients of ASA I &amp; II who were scheduled for middle ear surgery at SSG hospital, Vadodara, Gujarat. All patients were divided in 2 groups of 25 patients each, depending upon drug they received - Group C: Patients received Tab. Clonidine 4 fxg/kg 90 min before induction with sips of water and Group E: Patients received Inj. Esmolol 1.5 mg/kg bolus intravenous 5 min before induction. All patients were premedicated with Inj. Glycopyrrolate 10 g/kg intramuscular 45 min before induction. Anesthesia were induced with Thiopentone sodium 2.5% (4-7 mg/kg) followed by Succinylcholine 1.5 mg/kg intravenously. All parameters like pulse rate, systolic BP, diastolic BP, MAP and RPP were recorded at regular intervals. Complications (if any) were also observed during perioperative period. Result: Pulse rate, SBP, DBP, MAP and RPP were comparable at baseline, at time of induction, during laryngoscopy and intubation and throughout whole study period it was not statistically significant in both groups. However In Intergroup comparison, SBP was comparable at base line and after 5 min of laryngoscopy and intubation in both groups, but SBP was significantly higher after 1 and 3 min of laryngoscopy and intubation in Group E than Group C. Also, there was statistically significant increase in MAP in Group E following laryngoscopy and intubation at one min in Group E than Group C. RPP was significantly higher after 1 and 3 min of laryngoscopy and intubation in Group E than Group C. Postoperative complications like dryness of mouth, excessive sedation, PONV, hypotension, Bradycardia, bronchospasm were not observed in any case in both groups. Conclusion: Oral clonidine and intravenous esmolol both controls rise in pulse rate following laryngoscopy and endotracheal intubation. Intravenous esmolol is not effective in obtunding hypertensive response following laryngoscopy and intubation and associated with significant rise in SBP, MAP and RPP. So, oral clonidine (4 g/kg) is more effective in attenuating stress response than intravenous esmolol(1.5mg/kg). [Pander Kashmira B Natl J Integr Res Med, 2019; 10(6):66-71]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Perception of first MBBS students from a medical college in Ahmedabad, Gujarat about one month’s foundation course during the year 2019 2020-03-04T02:43:46-08:00 Sheetal Vyas Urvish Joshi Jay Sheth <p>Background: Medical Council of India (MCI) has introduced Foundation Course (FC) in the undergraduate medical curriculum from the admission year 2019 in view of GMER 2019. The students admitted for MBBS course during the year 2019 were the first batch exposed to such kind of program. Medical students come from varied backgrounds and require a bridge for transition from school to a professional course. Aims: To study the perceived learning of medical students during FC about various modules and their competencies in the very first year of its implementation. Materials and Methods: Predesigned and pre-tested questionnaire was used to assess the self-reported learning perception of FC among the newly admitted first MBBS students during the year 2019. Five modules of FC were assessed (except sports and extra-curricular activity). Overall impact of FC was also assessed. Five-point Likert scale was used to assess the perceived learning by the students. The survey was carried out on the last day of the FC i.e. 31-08-2019. Data so collected were entered in Microsoft Excel and analysed for percentages, proportions, mean, standard deviation etc. Results: Responses of 189 out of total 200 students were obtained on the day of survey and subsequently analysed. Mean score of perception of students about learning during FC for all the five modules ranged from 3.8 to 4.5. Overall impact of FC was assessed by using five questions. Maximum i.e. 96 (50.8%) students strongly agreed that it led to confidence-building before start of the formal learning of medical subjects followed by 81 (42.9%) students who strongly agreed that the transition to medical college was smooth due to FC. Conclusions: Early response and feedback regarding the introduction of FC in undergraduate medical curriculum is overwhelming. The self-perception of learning during FC by the students is having higher agreement. [Vyas S Natl J Integr Res Med, 2020; 11(1):72-78]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Bilberry Extracts As An Adjunct To Scaling And Root Planing 2020-03-04T02:52:08-08:00 Aakriti Sharma Shivjot Chhina Sanjeev Sharma <p>Background: Anthocyanins are antioxidant compounds which reduces lipid peroxidation and deleterious effects of ROS in vitro. The anthocyanins of bilberry can help reduce the risk of unwanted inflammation of gums. Thus, study was done to compare clinical soft tissue parameters around periodontal pockets treated with &amp; without bilberry extracts as an adjunct to scaling &amp; root planing. Materials &amp; Method: 10 patients having bilateral localized periodontal pockets of 4-6 mm were chosen. Each site was randomly allocated to either group 1(test)or group 2(control),where in group 1,scaling &amp; root planing was done while in group 2 , bilberry extracts in situ gel was delivered as an adjunct to SRP .Following parameters were recorded at baseline &amp; after six weeks : PD,RAL,PI &amp; GBI in both the groups. These parameters were subjected to statistical analysis to evaluate the effect of bilberry extracts, paired t test was done. Results: There was a statistically significant decrease in PD &amp; gain in RAL at sites treated with bilberry extracts in situ gel delivered as adjunct to SRP. Conclusion: The treatment was effective in the treated patients &amp; it was concluded that bilberry is a valuable drug clinically applicable in improving the periodontal health condition. [Sharma A Natl J Integr Res Med, 2020; 11(1):79-84]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Dual Malignancy, Single Kidney ; Synchronous Papillary And Clear Cell Carcinoma 2020-03-05T01:21:11-08:00 Prashanth Adiga Manjunath Shetty Anuj Mahajan Nanda Kishore <p>Background: Renal carcinoma is one of the most common solid organ malignancies in adults . Various pathological types such as clear cell , papillary and chromophobe carcinoma are present . Clear cell carcinoma is most common subtype ,However simultaneous occurence of two types in a single kidney is extremely rare. We present a case of 64 years old male diagnosed to have a renal mass . The patient was taken up for radical nephrectomy .Post surgery HPE showed synchronous clear cell and papillary carcinoma [Adiga Prashanth Natl J Integr Res Med, 2020; 11(1):85-86]</p> 2020-03-01T00:00:00-08:00 Copyright (c) Masson’s Tumor – Not Rare Anymore? 2020-03-04T03:02:52-08:00 Dr. Rattan N Dr. Vijay N Dr. Samriti G <p>Masson’s tumor is an unusual intravascular hemangioendothelioma, a rare condition affecting the vessels and known to simulate an angiosarcoma, or lesions like intravascular pyogenic granuloma and intravascular fasciitis. Despite being an uncommon tumor, we present 3 cases of Masson’s tumor – one each in the nasal cavity, cheek and neck. [N Rattan Natl J Integr Res Med, 2020; 11(1):87-88]</p> 2020-03-01T00:00:00-08:00 Copyright (c)