Journal of Medical Evidence

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Gallbladder duplication is a rare congenital anomaly. Knowledge of its various types is important since it can complicate cholecystectomy. Many varieties of gall bladder duplication and its classification are reported in the literature. Pre-operative diagnosis plays a crucial role in the planning of surgery and preventing possible injuries or re-operation if the accessory gallbladder has been overlooked during the initial surgery. Gallbladder duplication though rare requires special attention to pre-operative anatomy and its variation. The operative challenge is more than the usual laparoscopic cholecystectomy and should be done by fundus first approach by an experienced laparoscopic surgeon. We report a case of a 44-year-old -male who presented with biliary colic. His pre-operative imaging confirmed the diagnosis of the duplicated gall bladder, and he underwent successful laparoscopic cholecystectomy.

Background: North India has a very high incidence of Carcinoma gallbladder (GBC). The aim of the study was to identify the hotspot regions and relationship of gallstones to GBC in two northern states of India. Materials and Methods: It was a retrospective, observational, hospital-based cohort study. The data of patients with locally advanced (LA) or metastatic GBC from January 2019 to December 2019 were evaluated for geographical distribution of cases, and their clinical spectrum was compared with the presence or absence of associated cholelithiasis. Statistical analysis was performed using R Statistical software version 3.6.2. Results: Forty-two patients were enrolled in our study. A high burden of GBC was observed from Western Uttar Pradesh (District Bijnor 12(29%) and Muzaffarnagar 7(17%)) and Uttarakhand (District Haridwar 7(17%), whereas the remaining 16(38%) patients were residents of other districts of Uttarakhand (UK) and Western Uttar Pradesh (UP). In our study, only 17(40.5%) patients had associated cholelithiasis. Metastatic disease at presentation was seen in nearly 59% of patients with cholelithiasis and 52% of patients without cholelithiasis. Jaundice was the most common presentation in 12(70.6%) patients, followed by pain in 9(nearly 53%) patients with GBC associated with gallstones. Whereas in patients with GBC without gallstones, loss of appetite and loss of weight was the most common presentation in 16(64%) followed by jaundice in 13(52%). Conclusion: Most cases with LA or metastatic GBC in the present study were not associated with cholelithiasis. Clinical spectrum of either LA or metastatic GBC is similar, irrespective of presence or absence of gallstones.

Coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in massive health and economic burden. There has been substantial morbidities and mortalities owing to its high transmission rate. Therefore, effective strategies for treatment and prevention are crucial. Vaccines offer a ray of hope for the prevention and controlling the spread. Various new technological platforms have been utilised for vaccine production. The current review provides a brief description of these platforms for vaccine production and an update on the available and upcoming COVID-19 vaccines, discussing their results and outcomes from different trial phases. We have also focused on COVID-19 vaccination drive in India, emergency use authorisation, other candidate vaccines in Indian landscape, and issues involved with their clinical use and current recommendations.

An ideal medical college not only delivers medical education but also introduces new trends in medicine. There are numerous elements of an ideal medical college. In this article, a comprehensive list of some of the elements is given, which are often ignored by medical students and medical institutions. The list includes acceptance to change, medical research, technical advancements in medicine, communication skills, public health, some structural changes in medical education, teaching methods and assessment of students, burnout and mental health issues among students. However, this list is not exhaustive, and only continuous feedback can help a medical establishment to reach the epitome of idealism.

Online since 29^th May 2020