Background: There are about 1387 prisons in the country with an authorized accommodation of 356,561; however, the total number of jail inmates is 418536 indicating severe overcrowding in prisons. Prison population is an underserved section of the society. Often their health problems are neglected. They carry a much greater burden of illness than other members of the society; they harbour diseases that are determined both by the environment out of which they come and by the prison in which they live. Therefore, present study was conducted with the aim of studying the mental health status of persons from a section of our society, who were condemned by law and are behind the high walls.Methods: A cross sectional study was carried out on 400 convicted inmates in district jail, Rohtak, Haryana over the period of one and half years. Data was collected by interview method using DASS-21 scale and analysed by SPSS 20.0 and Chi square test was applied for results.Results: The prevalence of depression came out to be 18.5%, anxiety came out to be 8% and stress was found to be prevalent in 8% of the convicted inmates confined in jail which was much higher in comparison to general population.Conclusions: As the prevalence of depression, stress and anxiety was found much higher in convicts than the general population, there should be a timely screening, diagnosis and appropriate intervention to combat the mental health problems.

Introduction Gynecomastia is benign proliferation of male breast tissue that can be idiopathic or secondary to hormonal imbalance. Consumption of steroids plays a major role in the development of gynecomastia. The increased consumption of anabolic androgenic steroid (AAS) in youngsters to boost the physical strength and improve appearance is associated with increased prevalence of gynecomastia. True estimation of AAS-associated gynecomastia is difficult to calculate and prone to underestimation because of low social acceptance. Accurate estimation is required to assess future healthcare, for prevention and to give appropriate treatment. Aims and Objectives The aim of this study was to calculate the steroid consumption in gynecomastia patients accurately so that appropriate treatment can be given and their response to treatment could be analysed. Methods This is a prospective study done in a tertiary care hospital from June 2019 to June 2022. All the gynecomastia patients treated during this period in Burns & Plastic Surgery Department of PGIMS Rohtak were included in the study. Patient's detailed history was recorded and also after 3 months of surgery patients were again enquired about their history to record any change. Results Real prevalence of AAS-associated gynecomastia (39.19%) was much higher than that recorded in preoperative period (4.05%). Also, AAS users were having higher body mass index and a greater proportion of patients were bodybuilders. Conclusion Patients with high body mass index, athletic body, and history of recent weight gain should raise the suspicion of anabolic steroid intake. Surgery is not always indicated in AAS-associated gynecomastia. If gynecomastia persisted, surgery necessitates and it involves meticulous intraoperative hemostasis and careful glandular excision to minimize recurrence and achieve low complication rates.

Post cholecystectomy gall stone ileus is very rare with only few cases reported in the literature. This condition poses diagnostic challenges both because of its rarity and since the gall bladder had been removed previously. A high index of suspicion is needed for the diagnosis. Here, we report the case of a young female presented to the emergency room with acute intestinal obstruction. Patient underwent cholecystectomy followed by LSCS 20 yrs back. Patient was managed with explorative laparotomy which revealed an adherent, fibrosed and narrow segment of ileum containing a small impacted gall stone 120 cm from ileocaecal junction. Following the Resection anastomosis the patient made a satisfactory recovery and was discharged without any complication and is doing well.

Background: Severe traumatic brain injury (TBI) is a neurosurgical emergency and timely intervention is critical for favorable outcome. We aimed to evaluate certain demographic, clinical and radiological factors for outcome prediction in TBI patients in terms of morbidity and mortality.Methods: A prospective observational study was conducted in 100 patients of severe TBI admitted to our hospital from September 2016 to June 2018. Those with penetrating head injury, associated severe chest, abdominal or orthopedic trauma and pregnant or lactating women were excluded. Clinical outcome was assessed at the time of discharge and after three months according to Glasgow outcome score (GOS).Results: Majority of patients were adults in the age group 20 to 39 years. Road-side accident (75%) was the commonest mode of injury followed by fall (23%) and assault (2%). Out of 100 patients, 51 had in-hospital mortality. Of 49 patients who survived for GOS assessment at 3 months, three (6.1%) patients had unfavourable GOS I to III. Presence of hypoxemia, pupil non-reactivity, computerised tomography (CT) head findings of hemorrhagic contusion, subarachnoid hemorrhage (SAH), midline shift and effacement of basal cisterne were associated with significantly increased risk of unfavorable early and late outcome after severe TBI (p<0.05). Poor GCS score and fracture skull were associated with adverse early and late outcome respectively (p<0.001).Conclusions: Low GCS score at admission, pupil non reactivity, presence of hypoxemia, abnormal CT head findings (hemorrhagic contusion, SAH, midline shift and effacement of basal cisterne) were strong predictors of adverse outcome after severe TBI.

Background: Reconstruction of weight bearing region of plantar foot defects present a challenge to surgeons because of lack of the options available and requirement of durable tissue. Among the limited options available medial plantar artery ap serve an ideal one. It can be raised in antegrade as well as retrograde fashion. In its anterograde form it is used for heel reconstruction and in retrograde form it is used for the reconstruction of the forefoot defect. The aim of this article is to assess Aim: the outcome of using medial plantar artery ap for reconstruction of heel and forefoot defect with a focus on ap survival, donor site morbidity and functional outcome. In the present study, we Material and method: present our experience with the use of medial plantar artery ap to cover plantar foot defect in the weight bearing region. Total of 12 patients, those underwent medial plantar artery ap re-construction, from January 2018 to January 2022 were included in this study. Out of the 12 patients Result: with the medial plantar artery aps, 10 were male and 2 were female. The indications for surgery were, traumatic tissue loss, unstable scar over previous grafted skin, neuropathic ulcer. All the aps survived, without major complications and provided adequate wound coverage with minimal donor site morbidity. Medial plantar artery ap for reconstruction of heel and forefoot i Conclusion: s associated with a very high ap survival rate with very few ap related complications including donor site complications.