Introducton: Constipation is a worldwide problem. Current research aimed to study the various determinants of functional constipation and clinical spectrum in north Bihar. Thus creating tangible evidence for the policy makers. Material and methods: Retrospective hospital record based cross sectional study was conducted at tertiary care Darbhanga medical college and hospital (DMCH). Children between 2-12 years with chief presenting complaint of constipation in pediatric OPD and IPD during July 2013 to June 2014 were identified. Only those who fulfilled the ROME 3 criteria of functional constipation were included in the study. Children with any organic cause of functional constipation and children getting treatment for functional constipation were excluded from the study. Results: Total 892 children were examined during the study period, of which 343 children were diagnosed to have constipation. Among them 315 (35.31%) children were qualified to have functional constipation as per ROME 3 criteria. 28 cases (3.14%) have organic cause of which 15(53.57%) had Hirschprung's disease Mean age of toilet training was 17.2 months. Females were more affected (61.58%) than males. Maximum cases were between 2-5 yrs (62.2%), lower socioeconomic status (56.19%)and rural background (50.15%).lack of indoor toilets and dirty school toilets precipitates constipation particularly in girls. Conclusion: constipation causes physical, psychological morbidity and poor quality of life, hence early diagnosis and management is of utmost importance. Lack of indoor clean toilets, early toilet training, unhygienic school toilets, improper roughage intake should be taken care of by parents/ authority.

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Background: Antithrombotic medications are used in the primary and secondary prevention of ischemic stroke. Previous studies have identified that up to 5.2% of ischemic strokes are associated with antithrombotic interruption, leading to significant mortality and healthcare burden. Our study aims to identify the prevalence of ischemic strokes presenting to a regional stroke centre associated with antithrombotic interruption, and to understand common reasons for medication interruption. Methods: A retrospective chart review was performed, which included 193 patients with ischemic stroke presenting to Greater Niagara General Hospital from January 2018-December 2019. Baseline demographics were recorded and patient medical records were reviewed for evidence of antithrombotic interruptions. Results: Table 1. Conclusions: Our cohort identified a significant proportion (8.3%) of ischemic strokes with documented antithrombotic interruption. Most common reasons for interruption were non-adherence and discontinuation due to previous adverse event. The results identify possible areas for improvement within patient education and safe re-initiation of antithrombotics following adverse events.

Context: Assessment of medical education is important to identify the deficiencies in medical educational environment. Dundee Ready Education Environment Measure (DREEM) is a pre-validated inventory tool that helps to assess and thereby address those deficiencies. Aims: To know about the student’s perception regarding the education environment at Rajendra Institute of Medical sciences (RIMS), Ranchi. Methods and Material: This cross-sectional study was conducted amongst the undergraduate medical students of 2017, 2018 and 2019 batch studying at RIMS, Ranchi; between the periods of January 2020 to March 2020. Statistical analysis used: Means (with standard deviations) were used to describe sample variables. Mann Whitney U test was used to compare the individual as well as the subscale and overall scores with gender and the Kruskal Wallis H test was used to compare the subscale and overall sores with the batch to which respondent belonged to. Results: Out of a total 450 students, 291 submitted the Google forms representing an overall response ratio of 65%. Most number of responses was submitted by undergraduates from 2019 batch (93%).