Background: Peak expiratory flow rate (PEFR) is an efficient measure of effort-dependent airflow. It is easier to perform and can be carried out in the field using a portable instrument. This study was done to evaluate the effect of various anthropometric parameters like age, height, weight, body mass index (BMI), and body surface area (BSA) of PEFR in healthy elderly female subjects and differences in urban and rural areas, and to establish local reference standards. Materials and methods: The PEFR was measured in 67 urban and 50 rural female subjects in the age group of above 65 years of Amritsar district with the help of a mini Wright peak flow meter in a standing position. The best out of three trials were recorded. Its correlation with age and various anthropometric parameters was calculated. Results: The mean PEFR was highest in the age group 65–74 years for both urban and rural females and it decreased as age increased. The correlation of PEFR with age was negative and highly significant (HS). The correlation of PEFR with age was negative and HS. Correlation with height was a positive and significant correlation with height and a non-significant correlation with weight, BMI, and BSA. The value of PEFR in urban and rural female subjects was found to be similar and the difference was non-significant.

Introduction: Clavicle is S shape modified long bone placed horizontally in the body. Nutrient artery is the principal source of the blood to a long bone, it enters the bone shaft through the nutrient foramen, predominantly during its growth period in the embryo, as well as during the early phases of ossification during childhood. Vascularized bone and joint allograft survival depend strongly on the blood supply of that bone. Aims and objectives: Estimated the number, location, direction, and distance of nutrient foramina from two ends, and were observed, photographed, and analyzed. Materials and methods: In this study, 100 clavicle bones were observed, 50 on the right side and 50 on the left side of unknown age and sex. The clavicle bones were obtained from the department of anatomy in a tertiary care medical institute in Punjab. Results: In this study, nutrient foramina were present in all clavicles (100%), out of which single foramina in 33 clavicles of right (66%) and 46 clavicles of left (92%), double foramina in 11 clavicles of the right (22%) and 3 clavicles of the left (6%), and three foramina in 1 clavicle of left (2%) and 6 clavicles of right (12%). Foramina directed toward the acromial end were 76.5% and toward the sternal end were 23.5%. Mostly nutrient foramina were present on middle one-third of the shaft (75%) and predominantly seen on the posterior surface (68.4%). Conclusion: Nutrient foramen plays a crucial role in surgical, and orthopedical procedures such as bone grafting and bone transplantation, and is useful to safeguard arterial circulation during radiation treatment given during carcinoma in the neck.

Introduction: Obesity has become a global health problem and every year its prevalence is on the rise. The rise in obesity prevalence has been most prominent in women of reproductive age (postadolescent and premenopausal) with women tending to gain 0.5–1 kg each year from early adulthood until middle age. This has significant impacts on reproductive health in women as they enter pregnancy at a higher body mass index (BMI). The purpose of this study is to evaluate obstetric complications and perinatal outcomes in pregnant women with obesity (BMI ≥ 30.0 kg/m²). Materials and methods: In this prospective study, antenatal women with increased BMI (>30 kg/m²) were followed up in the outpatient department (OPD) of the Department of Obstetrics and Gynaecology from December 2020 to December 2021 at a tertiary care hospital in Amritsar, Punjab, India, and maternal complications and neonatal outcome were studied in them. Women were counseled on the optimization of body weight before planning further pregnancy. Results: The data revealed that 42.5% of the study participants developed gestational diabetes mellitus (GDM), 23.75% of the participants developed both GDM and hypertensive disorder of pregnancy (HDP), 17.5% developed only HDP, 12.5% developed fetal growth restriction (FGR), 3.75% of study participants lost to follow-up. Conclusion: Obesity is a clear contributor to a wide range of maternal and fetal complications. The risks associated with obesity in pregnancy cannot necessarily be influenced by the intervention. Preventive measures aiming at normalizing body weight before conception are thus the most important and rewarding.

Introduction: In human beings, peroneus longus (PL) adopts a great implication as it has the function of maintenance of the plantigrade position of the foot and also conserves the arches of the human foot. The distal attachment of PL has shifted from the lateral margin of the foot to its inner margin as a result of evolution; however, its insertion encroaches on the adjacent areas of the medial most cuneiform and proximal part of the first metatarsal. Therefore, some anomalous insertions in PL are commonly expected. Methods and results: While doing dissection of cadavers for first-year MBBS students, we spotted a variation at the distal attachment of PL unilaterally in the right foot of a male cadaver. In addition to its normal insertion at the first metatarsal and medial cuneiform, an additional slip was found inserted on the base of the fifth metatarsal. Clinical relevance: Numerous pathologies are linked with the PL tendon consisting of injuries, inflammation of the tendon, fractures, tenosynovitis, rupture due to accident, tear, and dislocation.

Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton and peripheral joints. It is immune-mediated common in the second and third decades having symptoms such as sacroiliitis, synovitis, and difficulty in movement of the spine. It is treated with non-steroidal anti-inflammatory drugs (NSAIDs), JAK 2 inhibitors, and other biologicals such as infliximab and etanercept. This is the case report of a 24-year-old male student who presented with lower backache, and morning stiffness which improved with activity. On investigation, his HLA B 27 was positive and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were raised. He was treated with tofacitinib for 1 year, later he developed pott's spine as its side effect. This case report represents the rare side effect of tofacitinib as pott's spine.

Erlotinib is a reversible inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase, competitively inhibiting adenosine triphosphate (ATP) binding at the active site of the kinase. It is approved for treatment of advanced and metastatic cancers. The objective of this report is to find out the cause of the papulopustular lesion while the patient is on tyrosine kinase inhibitor. Our 57-year-old male known case of metastatic pancreatic cancer is on injection gemcitabine 1400 mg (D1 and D8), injection carboplatin 450 mg (D1), and tablet erlotinib 150 mg OD since 1.5 months and after 3 weeks of therapy he developed papulopustular lesions over legs and face which is a side effect of tablet erlotinib and thus it is discontinued and now the patient is being treated for papulopustular lesion by oral and topical antibiotics.