Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required.

IntroductionMetastatic tumors are the most common intra-ocular malignancies and choroid is by far the most common site for intra-ocular malignancies. Multiple foci are usually involved, and bilateral involvement is frequently seen. The primary sites for choroidal metastasis in decreasing order and by gender are: breast, lung, unknown primary, gastrointestinal and pancreas, skin melanoma and other rare sources in females, and lung, unknown primary, gastrointestinal and pancreas, prostate, kidney, skin melanoma and other rare sources in males. Available treatment options are external beam radiotherapy and plaque radiotherapy, while new methods like surgical resection, transpupillary thermotherapy and intravitreal chemotherapy offer promises for the future. The use of chemotherapy alone for choroidal metastases is not widely reported.Case presentationWe report the case of a 50-year-old Indian man who had a unilateral solitary lesion in his right eye. He was found to have an adenocarcinoma of the lung with choroidal metastasis as the first presenting sign. There were no findings of metastasis involving his contralateral eye. He was administered chemotherapy based on gemcitabine and carboplatin. He had significant progressive subjective and objective improvement since his first chemotherapy. His current best corrected visual acuity is 20/60 after three cycles of chemotherapy.ConclusionsChemotherapy alone can be used as an effective mode of treatment in patients who have primary tumors that respond to chemotherapy.

No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

Background: Dermatologists often play a significant role in its management. Cutaneous features of hyperandrogenism in Polycystic ovarian syndrome (PCOS) have varied presentation. Aim of this study was the pattern of dermatologic manifestations in polycystic ovarian disease in northern Indian females.Methods: Patients registering for treatment of polycystic ovarian disease at Dermatology outpatients department during April 2016 to March 2017 formed the study population. Residents interviewed the study subjects at the OPD. General physical examination, systemic examination, breast and pelvic examination, along with detailed dermatological examination were conducting after taking the history. Hormonal analysis was performed after an overnight fasting using enzyme immunoassay.Results: FSH and LH levels were 5.05±1.86 IU/L and 8.14±5.21 IU/L respectively. Testosterone levels were found to be 61.01±25.32 ng/dl. DHEAS levels among them were 130.05±41.21μg/dl. Two commonest cutaneous manifestations were hirsutism and acne seen in 83.8% and 59.5% of subjects. Female pattern hair loss was seen in 45.6% females. Three most frequent hormonal abnormalities noted in our study subjects were raised L/H ratio, testosterone and LH levels seen in approximately 45%, 35% and 21% cases.Conclusions: The cutaneous manifestations of PCOS reserve a major role in its management by dermatologists. A lifestyle modification along with systemic treatment remains mainstay of treatment. Monitoring for the foreseen cardiovascular risks should start early to downgrade the morbidity.

Background: The common etiologies of obstructive jaundice have been reported to vary from one centre to another and from one individual to another. Only a very few studies have been conducted on this topic and none from the state of Madhya Pradesh, India. The present study was planned to study the profile and pattern of obstructive jaundice cases in the region of Madhya Pradesh, India.Methods: A retrospective cohort of patients with obstructive jaundice admitted to SRMS Institute of Medical Sciences, Bareilly, Uttar Pradesh, India during past one year i.e. January to December 2014 formed the study population. In this study, all the eligible patients positively diagnosed as extrahepatic obstructive jaundice were included in this study. Study tools were records of the patients such as information/records from MRD department and clinical case sheets.Results: Malignant causes (63.89%) were more frequent than benign causes (36.11%). More than 50% cases were in the age group of 55-75 years. Sex wise males outnumbered females. Among the malignant causes of obstructive jaundice, cancer head of pancreas (60.87%) and cholangiocarcinoma (17.39%) were common causes whereas among the benign causes of obstructive jaundice, choledocholithiasis (76.92%) and benign biliary strictures (15.38%) were common causes.Conclusions: Jaundice (91.67%), loss of appetite (77.78%) and pain abdomen (75%) were three most common modes of presentation of obstructive jaundice cases.