This article reviews and describes the theoretical concept of organ donation (OD) and transplantation, historical milestones, need, shortage, status of global activities, health system capacity, survival outcome, and update on legislative environment in India, Central/State contribution and Nongovernment Organizations actively involved in OD.

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Successful kidney transplantation offers the best possible quality of life for patients with end stage renal disease (ESRD). Despite this, renal transplantation rates in the developing world are considerably lower than in the developed world. Identified reasons for this include lack of awareness, low education levels, lack of a clear national policy, absence of functional dialysis and transplant units with adequately trained staff, and absence of an organized system of organ retrieval from deceased donors and lack of opportunities to fund long-term immunosuppression. Measures to improve the quality of care should center on improvement of the socioeconomic status of the country. Key action points include the implementation of: (1) Chronic kidney disease (CKD) screening and prevention programs; (2) ESRD and transplantation registries; (3) transplantation legislation, covering both living and deceased organ donation; (4) international and regional collaborations for transfer of knowledge and technology. The government should make transplantation more affordable by strengthening the public sector hospitals and by making the transplant medication more affordable. With the National Organ Transplant Programme (NOTP) in the process of being established in India, the transplant community should strive to increase the organ donation awareness, improve the infrastructure for organ retrieval, storage and allocation in an equitable way.

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Over the last 17 years, liver transplant in India has evolved from a rarity to a common procedure available along the length and breadth of the country with survival data comparable to the best centres in the world. India is now in the forefront of Living donor liver transplant (LDLT) in the world, led by the team of the principal author. LDLT is possible for all types of recipients and indications with 95% success, with low incidence of vascular complications and biliary complications. While Deceased donor liver transplants (DDLTs) have picked up steam in Southern India, there is still a large gap between demand and supply of organs. LDLT is essential to bridge this gap and continues to be the main curative option for the majority of patients in India suffering from end-stage liver disease and Hepato cellular carcinoma (HCC) confined to the liver.

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Dengue fever over the recent years has gained attention of not only the health care professionals and researchers, but also public at large and it is a major seasonal health care problem in the tropics and the developing countries. Mortality due to complications such as hemorrhage and shock is well-known and is a major concern for the physician. Neurological manifesations include myelitis and encephalitis have started to gain attention as they present with high mortality and morbidity. We report a case of dengue fever with predominant neurological manifestations of acute disseminated encephalomyelitis (ADEM). The patient presented with fever, vomiting, and altered sensorium of recent onset. On evaluation, the patient was positive for dengue serology and magnetic resonance imaging picture suggested ADEM.

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A hamartoma is a tumor-like lesion made up of tissues indigenous to the part but lacks the true growth potential of a true neoplasm. Hamartomas are rare in head and neck region. Since they are often asymptomatic, they are easily missed during routine examination. To the best of our knowledge, lymphangiomatous hamartoma of parapharyngeal space has not been reported in medical literature so far. We report a rare case of lymphangiomatous hamartoma of parapharyngeal space in an 8-year-old child managed by surgery.

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Background: Plastination is the process to preserve the perishable biological tissues for long time using curable polymers. This technique was invented by Gunther Von Hagens, a German anatomist, in 1977. Since then, there have been many modifi cations according to the need and availability of infrastructure in various institutions. Many deviations from the standard plastination procedure have been suggested and used successfully. Methods: Modified short plastination protocol using epoxy resin has been adopted and standardized by the Department of Anatomy, Maulana Azad Medical College. Results and Conclusion: This technique provides dry, odorless, durable, nontoxic specimens that are easy to handle and can be stored at room temperature indefi nitely. This can be performed in a short period of time with limited and less expensive infrastructure. Our department organizes regular national workshops on “body preservation techniques” to train young anatomists.

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Context: Hypothyroidism has been associated with neurocognitive deficit, but status of cognitive function in subclinical hypothyroidism is unclear. Also, cognitive impairment found in these patients has been associated with aging. Aims: The purpose of this study was to evaluate cognitive function in hypothyroid and subclinical hypothyroid patients using objective methods and to correlate it with age, thyroid stimulating hormone (TSH) level, and education status of patients. Settings and Design: It was a cross-sectional study conducted on 90 female participants aged 30-50 years. Thirty patients diagnose with subclinical hypothyroidism (group 1) were compared with 30 age- and sex-matched hypothyroid patients (group 2) and euthyroid controls (group 3). Subjects and Methods: Cognitive function was evaluated using three parameters such as mini mental scale examination (MMSE), event-related potentials - P₃₀₀latency and amplitude, auditory and visual reaction time. Statistical Analysis Used: SPSS version 17 was used for statistical analysis. The data were also analyzed for variables related to age, TSH, and education level. Results: Significant delay in P₃₀₀latency and prolonged reaction time was found in both subclinical hypothyroid and hypothyroid group compared to controls (P < 0.001). P₃₀₀amplitude and MMSE score showed no significant difference in all groups. In hypothyroid patients, P₃₀₀latency at Fz, Pz was positively correlated with age while nonsignificant correlation was observed in subclinical hypothyroid patients. TSH and education level of patients showed no significant correlation with cognitive function tests. Conclusions: Delayed P₃₀₀latency and prolonged reaction time in both subclinical hypothyroid and hypothyroid patients shows that cognitive function is affected adversely. Event-related potentials may be more sensitive than clinical evaluation by MMSE, for early diagnosis of mild cognitive impairment in subclinical hypothyroidism.

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A case of spontaneous inferior vena cava dissection and aneurysm with ilio caval fistula in a 40 years male presenting with complaints of pain and swelling in right illiac fossa and swelling of right leg with no history of trauma is reported. The diagnosis was based upon the ultrasound, Doppler and contrast CT findings with clinical profile.

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Objectives: The objective of the study was to estimate direct medical/nonmedical and indirect costs incurred by patients diagnosed with tuberculosis (TB) residing in an urban slum of Mumbai. Subjects and Methods: A longitudinal study of 16 months duration (June 2013-September 2014) was undertaken in a directly observed treatment short-course (DOTS) center of an urban slum area. The method of sampling was universal sampling and thus all the patients who were registered in the period June 2013 to December 2013 were enrolled as study participants. These subjects were then followed for their completion of treatment. All the subjects were interviewed using a semistructured questionnaire to obtain the desired information. Permission from the Institutional Ethics Committee was obtained. Statistical analysis was performed using SPSS software version 19. Results: Of the 232 patients enrolled in the study, 176 (75.9%) completed the entire course of treatment. The median direct, indirect, and total costs for 176 patients were: pretreatment direct medical cost, direct nonmedical cost, and pretreatment indirect cost was Rs. 1200 ($20), Rs. 800 ($13.3), and Rs. 1250 ($20.8), respectively. However, during the course of treatment direct medical cost, direct nonmedical cost, and indirect cost were nil, Rs. 360 ($6) and Rs. 400 ($6.6), respectively. Conclusion: Despite the free availability of diagnostic and treatment component of TB in India, the majority of the tuberculosis patients still have to spend a significant amount of money.

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Objective: This study was conducted, with the aim to analyze the pattern of use of antirheumatic drugs in a Tertiary Care Hospital in Delhi, India. Methodology: The study was carried out in 150 patients who were on treatment with antirheumatic drugs at least for the past 6 months. Patient demographic details, duration of illness, comorbid conditions, drugs prescribed, adverse drug reactions (ADRs), and usage of complementary and alternative medicine (CAM) were used to analyze the pattern of drug use. Results: In our study, we observed that in patients with rheumatoid arthritis (RA), the most commonly prescribed disease-modifying antirheumatic drugs (DMARD) was methotrexate followed by hydroxychloroquine and sulfasalazine. DMARD combination with 3 drugs (59.3%) was the most common regimen followed by DMARD combination with 2 drugs (32.6%). Polypharmacy was seen in most of the prescriptions, but 76.3% of the drugs were from Essential Medicine List of Government of National Capital Territory, Delhi. About 40.7% of the prescriptions were prescribed by generic names. CAM was used by 13.3% of the study patients. Conclusion: The drug use pattern in RA was found to be DMARDs dependent. The concomitant use of three DMARDs was the preferred therapy. Biologics were not being used although indicated as per guidelines. ADRs associated with RA treatment were generally mild in severity and involved gastrointestinal tract.

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