Background: Pacific Medical College and Hospital (PMCH) is a 900 bedded, multispecialty, tertiary level health care centre with state of the art equipment, infrastructure and a team of highly experienced, qualified, skilled and motivated teachers, doctors and technical manpower. The hospital has well established department and wards dedicated to COVID-19 positive patients and facilities for sample collection.

01-05

Background: The prevalence of Allergic Rhinitis (AR) has increased recently. The symptoms of Allergic rhinitis hamper the daily activity of an individual causing difficulty in concentrating at work. Before treating the patient of AR thorough symptomatic assessment should be done so that there is a relief in symptoms of the patient and ability to carry out work is efficient. Symptomatic score for Allergic rhinitis (SFAR) questionnaire is a scoring tool that is cheap, accessible and efficient to assess AR symptoms and its severity. It can be easily carried out on OPD basis and a faster way to treat the patient efficiently early.

06-10

Schizophrenia is a known as a severe, chronic psychiatric disorder which affects a person's thoughts, perceptions, feelings and behaviour. The causal relationship between psychiatric disorders and chronic cannabis use is a debatable topic. Cannabis use has shown to affect a person's mental health, often presenting with symptoms resembling schizophrenia or mood disorders. There are evidences in its support but the connections are not completely understood. This article reports a case of a young adult presenting with depressive symptoms, which further evolved into psychosis, perhaps secondary to an underlying use of cannabis for a long period of time. This also discusses the rare phenomenological presentation of delusion of grandiosity in the absence of accompanying mood symptoms in the background.

11-14

Millions of individuals are affected by Depression, known as one of the most common mental illnesses worldwide. The role of psychological stresses in onset of depression and its numerous negative health outcomes is well established. The psychosocial impact of depression is deemed to be considered with respect to the psychological factors and social factors. However, taking a closer look at stress vulnerabilities in individuals is warranted for implementing adequate and appropriate interventions in management of depression. There are both pharmacological and non-pharmacological treatment modalities for management of depressive symptoms, of which the role of psychotherapy is considered to have a good potential. In addition, behavioural therapy, cognitive therapy and interpersonal psychotherapy are also considered to be efficacious. This case report illustrates how psychosocial stressors can impact presentation of major depressive disorder and describes the bidirectional nature of relationship between stress and mental health. This may help with better understanding of how mind-body therapies can benefit individuals with a higher risk of stress and/or Depression.

15-18

Psychosomatic Disorder is an illness which includes mind and body as a whole. The symptoms of these diseases have physical causes which originate from emotional or mental stress, anxiety or depression. Psychological and behavioural factors have been seen to affect the course of many medical illnesses. Psychosomatic disorders (according to DSM II, 1968) are defined as “psychosomatic symptoms that are caused by emotional factors and which involve a single organ system are usually under autonomic nervous system innervations”. The combination of both pharmacological and psychosocial factors is used for the management of Psychosomatic Disorders. Failure of the psychiatrist or physician to establish a good rapport is the postulated as a major reason for the ineffectiveness of treatments. This case report presents a young female with psychosomatic disorder.

19-22

We report a rare case of a19-year old boy suffering from Dengue Fever who presented with shortness of breath, bradytachyrrythmias, hypotension, hypercarbia with acute myocarditis where L.V.E.F. was only 20%. Instead of administering very high dose of liberal fluid therapy,he was restricted to only oral liquids and supportive measures in Medical ICU. The patient improved clinically with resolution of cardiac function at the time of discharge from hospital.

23-25

Tuberculosis (TB) of breast is considered as one of the rarest form of extra-pulmonary tuberculosis. With millions and billions of people affected with tuberculosis worldwide, primary TB of breast is still rarely reported; even secondary TB of breast (metastasized from any primary source such as pulmonary TB) is sparsely seen. TB of breast can often be mistakenly misdiagnosed as a case of breast carcinoma or breast abscess due to similar clinical presentation. TB breast is most commonly seen in reproductive age of female, multiparous, lactating mothers; however women of older age with primary TB breast have [1] been infrequently reported .

26-28

Introduction: The embryological development defects mostly present as anomalies of Branchial arch such as sinus, cyst and fistula. The most common presentation is unilateral discharge from neck and recurrent infection. Case Report: We are presenting a case of 66 year old male patient who had been diagnosed with unilateral left branchial cleft fistula with ear discharge. Conclusion: Detailed history and clinical examination followed by appropriate imaging leads to delineation of entire tract which in turns leads to complete excision with low recurrence rate. Keywords: Brachial, Unilateral, Fistula.

29-30

31-34

Introduction: The embryological development defects mostly present as anomalies of Branchial arch such as sinus, cyst and fistula. The most common presentation is unilateral discharge from neck and recurrent infection. Case Report: We are presenting a case of 66 year old male patient who had been diagnosed with unilateral left branchial cleft fistula with ear discharge. Conclusion: Detailed history and clinical examination followed by appropriate imaging leads to delineation of entire tract which in turns leads to complete excision with low recurrence rate. Keywords: Brachial, Unilateral, Fistula.

33-35

36-39