Introduction: Rickettsial infections are reemerging infections in various parts of the world. Although there can be protean manifestations of rickettsial infection, epididymo-orchitis is by far uncommon. Materials and Methods: Fifty patients with a mean age of 35.1 (17–67) years with signs and symptoms suggestive of acute epididymo-orchitis were evaluated and 15 of these positive for Weil–Felix Reaction were included in the study after ruling out the common causes of epididymo-orchitis. Results: Fifteen patients had positive Weil–Felix reaction and were considered to have rickettsial epididymo-orchitis. Seven patients had right, 5 had left, while 3 had bilateral epididymo-orchitis. Most of the patients presented within 2 weeks of onset of symptoms. Five patients were positive for OX2, four patients were positive for OXK titers, four for OX19 and OX2, while two were positive for OX19 Weil–Felix reaction. These patients were started on doxycycline 100 mg bd for 7 days and followed up. In the follow-up, none of them developed complications of testicular abscess or chronic epididymo-orchitis. Conclusion: Rickettsial epididymo-orchitis is a very rare entity and it as an emerging threat in endemic areas. We strongly recommend that in the areas endemic for Rickettsia, all cases of epidiymo-orchitis should be evaluated for the presence of rickettsial infection, as early identification of such an infection would lead to prompt and precise management.

Background: Raja-Yoga meditation (RM) is a behavioral intervention which is practiced in India and worldwide. It appears to be the easy, practicable method of meditation, which one can follow on the day-to-day basis. Materials and Methods: Interventional, randomized, pre- and post-study. All diabetic patients in the age group of 30–60 years including both sexes and taking treatment since 5–10 years. Results: Pre- and post-mean difference in blood sugar levels showed a significant mean difference in Group A which was 34.82 ± 50.53. Multiple comparisons of fasting blood sugar in the three groups using Tukey test. The finding between Group A and Group C was found to be significant which means that the effect of Group A is better than Group C. Post meal finding between and within groups using one-way anova test. The F value was 8.24 and P value was 0.001 which is a significant finding. In Group C, the mean difference of hemoglobin A1c (HbA1C) level was 0.86 ± 1.48 and P value was 0.048, which is a significant finding. Conclusion: The effect of RM as a complementary intervention is better than other groups in improving glycemic control. In addition, all the three interventions namely meditation, diet, and exercise favorably affect HbA1C level.

Introduction: Human immunodeficiency virus (HIV) stands for immunodeficiency virus in humans. HIV destroys the immune system of the body, phasing out its capacity to combat diseases and other cancers. HIV can develop into acquired immunodeficiency syndrome (AIDS) when left untreated. It is the severest HIV level and is typically fatal. There is no treatment for HIV at this moment. This can take as long as 10 years to experience more serious symptoms after the infection. A person with <200 cells/mm³ is beginning to develop severe infections called opportunistic diseases and is moving toward AIDS. A free radical can be described as any molecular species capable of independent life in an atomic orbital that contains an unpaired electron. Antioxidants function as a radical scavenger, a donor of hydrogen, a donor of electrons, a decomposer of peroxides, a single quencher of oxygen, an inhibitor of enzymes, a synergist, and a metal chelator. In the intracellular and extracellular environment, both enzymatic and nonenzymatic antioxidants exist for detoxification of reactive oxygen species (ROS). Aim: The aim was to study the free radicals and antioxidant status in HIV-positive patients. Materials and Methods: The present study includes a total of sixty participants that include thirty HIV-positive patients and thirty healthy individuals. Blood samples collected from the participants were obtained for serum glutathione reductase (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) estimation. Results: The GSH, SOD, and MDA levels in HIV-positive patients were statistically significant. Conclusion: ROS was described as playing a critical role in accelerating and regulating AIDS development. In addition, it was found that antioxidant depletion was a typical sign at the onset of HIV infection, resulting in extreme OS.

Background: There is growing evidence that damage to spermatozoa by reactive oxygen species (ROS) plays a key role in male infertility. Human spermatozoa are susceptible to ROS as their plasma membrane contains abundant polyunsaturated fatty acid which can undergo lipid peroxidation which may cause damage to the sperms. Lipid peroxidation of sperm membrane is an important mechanism of this ROS-induced sperm damage leading to infertility. The present study was undertaken using malondialdehyde (MDA) for assessing oxidative stress which is an end product of lipid peroxidation. Aim and Objectives: The aim of this study was to evaluate the oxidative stress by estimating MDA (marker of lipid peroxidation) in seminal plasma of different groups of individuals and to correlate the levels with different seminogram parameters. Materials and Methods: Semen samples were obtained and analyzed for routine seminogram parameters from 150 male partners between ages 20 and 58 years of infertile couples attending reproductive biology unit. The patients were grouped into abnormal ejaculate (asthenoteratozoospermic [AT], oligoasthenoteratozoospermic, and azoospermic) and normal ejaculate groups. Oxidative stress was measured spectrophotometrically by estimating MDA. Results: Higher MDA levels of seminal plasma were observed in the AT and azoospermic groups as compared to normozoospermics though the difference was not statistically different. A significant rise in MDA levels was observed in the oligoasthenoteratozoospermic group. Seminogram parameters were found to be negatively correlated with seminal MDA level. Conclusion: Increased seminal plasma lipid peroxidation is likely to have an association with poor semen quality. Hence, MDA may be used as one of the biomarkers for assessing oxidative stress on sperm.

Background: Paravertebral block(PVB),for inguinal hernia repair has been found to be effective than conventional spinal anaesthesia in terms of anaesthetic and analgesic technique , early ambulation and better postoperative pain score. Bupivacaine, an amide local anaesthetic, having a slow onset of action, provides early onset , prolonged duration of analgesia and adequate sedation in case of PVB with an adjuvant dexmedetomidine ,a highly selective alpha2 adrenergic agonist. Aims: To compare the efficacy as well as onset and duration of sensory and motor block ,duration of post operative analgesia ,any complication of the drugs bupivacaine and a combination of bupivacaine with dexmedetomidine in paravertebral block for inguinal hernia repair. Material and Method: 60 patients aged between 18-60 yrs of ASA physical status I and II , randomized in two groups of 30 to receive bupivacaine (0.5%) 1mgkg—1 in control group A and bupivacaine (0.5%) 1mgkg —1combined with dexmedetomidine (1 μgkg—1) in study group B for PVB. Results: Gr A vs Gr B was significant (P < 0.05) in sensory block ,8.2 ± 0.89 vs 4.95 ± 0.53 min in onset, 191.27 ± 7.12 vs 436.10 ± 16.33 min in duration , in motor block 12.20 ± 0.96 vs 7.66 ± 1.00 min in onset, 267.17 ± 9.67 vs 498.03 ± 22.94 min in duration. Duration of analgesia in Gr A vs Gr B was significant (P < 0.05) , 267.17±9.67 vs 498.03±22.94 min with no adverse effect. Conclusions: Bupivacaine dexmeditomine combination is superior to bupivacaine alone in onset, duration of sensory and motor block, postoperative analgesia in paravertebral block for inguinal hernia surgeries.

Introduction: Technology can be referred as assortment of tools, including machinery, change, adjustment, and procedures. Technology changes the resources that present naturally into goods that can be consumed by people and which can be used by the society. IT has invented gadgets that are attracting the focus of the present generation. Due to such Innovative devices and services , the youth has become addicted towards these devices in large number. Long-term obsession to technology can lead to psychological problems such as insomnia, irritability, and depression. Sudden depression, loss of self-confidence, and problems in concentrating in studies are often symptoms of Internet addiction. Objectives: (1) To examine the time spent by the students with their technological devices. (2) To study the motive of using these electronic gadgets by the students. (3) To study the effects of the obsessive use of the tech-gadgets and services on mental health and lifestyle of students. (4) To examine the effects of technological gadget usage on the physical health of the students. Material and Methods: The selection of the study area was purposive one. For the analysis of the data, both the quantitative and qualitative methods were used. The study was conducted in DMIMS and AVBRH. All the undergraduate students in the age group of 18–22 years and postgraduate in the age group of 24–28 years at the time of record were included in the study. Observations: Sixty-six percent of the total students are spending more than 6 h/day with their technological devices. Sixty-six percent of the students are spending their time on gadgets for the purpose of entertainment and and remaining 18% of the time they are spending for the purpose of study. About 65% of the students obtained high dependency score. Fifty-two percent for the students spending 4–6 h of their time on gadgets have hearing problems. 68.18% of the students who spend 4–6 h of their time on gadgets had vision problems. 52.27% of the students who spend >6 h of their time on gadgets have sleep problems. 71.97% of the students who spend >6 h of their time on gadgets have neck and shoulder problems. Conclusion: The scientific world is changing rapidly. To be in the same pace as that of this change is definitely a challenging task. Therefore, one must know how to exercise control and know what is priority and what is not at a specific time. About 65% of the students obtained high dependency score. Fifty-two percent for the students spending 4–6 h of their time on gadgets have hearing problems. 68.18% of the students who spend 4–6 h of their time on gadgets had vision problems. 52.27% of the students who spend >6 h of their time on gadgets have sleep problems. 71.97% of the students who spend >6 h of their time on gadgets have neck and shoulder problems.

Aim and Objectives: Assessment of feeding practices in children of age group 6 months–3 years in urban slums of Arvi Naka. The study determines breastfeeding as one of the four strategies for improving child survival and nutrition. Materials and Methods: The study uses various methodologies to determine breastfeeding practices in slum areas of Arvi Naka and uses a lottery method to determine the place of people to be taken; the sample size was 100 individuals, and the study was conducted for 3 months. The study uses various variables and methods to determine the objectives. Data collection was done by making two groups. Results: 2.29% of hospital-delivered children started breastfeeding within 1 h, 43.67% were started within 4 h, 50.57% were started within 8 h, and the remaining 3.47% were started ≥8 h. 30.76% of home-delivered children started breastfeeding within 4 h, 61.53% were started breastfeeding within 8 h, and 7.71% were started breastfeeding ≥8 h. Conclusion: Study reinforces the planning and strategies for building up health education more towards slum areas.

Background: Diagnostic imaging, particularly magnetic resonance imaging (MRI), plays a crucial role in evaluating and detecting spinal trauma. Subtle bone marrow, soft-tissue, and spinal cord abnormalities, which may not be apparent on other imaging modalities, can be readily detected on MRI. Early detection often leads to prompt and accurate diagnosis, expeditious management, and avoidance of unnecessary procedures. Material and Methods: The depiction of parenchymal spinal cord injury (SCI) on MRI not only correlated well with the degree of the neurologic deficit but also bears significant implications in regard to prognosis and potential for neurologic recovery. This prospective observational study was conducted over a period of 18 months from June 2017 to December 2018 on 65 patients with spinal trauma who underwent MRI of the spine. Prior written informed consent was obtained. In our study, it can be concluded that MRI plays a major role in the diagnosis of spinal trauma, directing early and prompt management and predicting prognosis of neurological recovery. Cord edema and normal cord were associated with favorable neurological outcome. Results: Vertebral body fractures, especially in association with cord edema, showed poor neurological recovery, as compared to cord edema and normal cord. Cord transection and cord hemorrhage were associated with complete SCI and with poor neurological recovery. Conclusion: MRI findings in acute SCI correlate well with the initial neurological deficits on admission and at the time of discharge according to the American Spinal Injury Association impairment scale.

Background: To compare the intraocular pressure (IOP) measurements with Non Contact Tonometry (NCT) and Goldman Applanation tonometry (GAT) and to compare NCT IOP and GAT IOP and Schiotz IOP among various central corneal thickness (CCT) group. Aims: To compare the intraocular pressure (IOP) measurements with Non Contact Tonometry (NCT) and Goldman Applanation tonometry (GAT) and to compare NCT IOP and GAT IOP and Schiotz IOP among various central corneal thickness (CCT) groups. Settings and Design: This was a cross sectional, observational study. 120 patients were sequentially collected after taking inclusion and exclusion criteria into consideration. Methods and Material: IOP measurements were done by NCT and then by GAT followed by Schiotz. Them followed by CCT. All IOP readings were taken in the sitting position over fifteen minutes. 120 patients were included in this study. Statistical analysis used: Statistical analysis was done by using descriptive and inferential statistics using Pearson's Correlation Coefficient and software used in the analysis was SPSS 24.0 version and p<0.05 is considered as level of significance Results: The IOP measured with both GAT and NCT showed no significant change with increasing CCT. The difference between the means increases with increasing CCT upto 600 microns. At lower IOPs ≤ 20 mm Hg, GAT measures are higher than NCT and this relationship is reversed at high IOPs. Conclusions: Both the tonometers showed a significant correlation with the gold standard technique (Goldman's applanation tonometer) over a range of IOP and CCT with the Schiotz tonometer better than the NCT.

Background: Immunohistochemistry (IHC) is used to assess hormone receptor status evaluating hormone receptors (estrogen receptor and progesterone receptor [ER/PR]) in infiltrating ductal carcinoma of breast and determined by scoring systems: Allred (quick) and H scoring system. The present study intended to evaluate the values of these score systems in terms of correlation with Bloom-Richardson grading system of breast carcinoma. Aim: To compare Allred and H scoring systems for evaluating hormone receptors in carcinoma of breast by IHC with modified Bloom-Richardson's grading system. Objective: (1) To confirm and classify histopathology of breast tissue by routine hematoxylin and eosin staining. (2) To obtain grading by Bloom-Richardson grading system. (3) To evaluate breast carcinoma by IHC and assess by Allred and H scoring system of hormone receptors. (4) To compare these scoring systems with Bloom-Richardson grading system. Study Design: Observational, cross-sectional, and comparative. Materials and Methods: BR grade and HR status of 65 surgically resected specimens of carcinoma breast were determined by routine histopathological examination and IHC. Allred and H scoring systems were employed to evaluate HR status. Statistical Analysis: Using Chi-square test and P < 0.05 considered as level of significance. Results: The common grade was Grade II accounting to 73.85% followed by Grade I and Grade III, i.e., 16.92% and 9.23%, respectively. Immunohistochemical analysis was done and most cases belonged to ER(−)/PR(−) category, i.e., 30 cases (46.16%). Allred and H scores were analyzed and compared these scores with Bloom-Richardson Grading system. According to Pearson's correlation matrix, it was observed that a statistical significant correlation was found between Allred and H score system and had an equivalent value for ER and PR (P < 0.0001). Conclusion: The present study had shown that there was no difference between Allred and H score system and had a good correlation with BR grading system as both being semi-quantitative methods and can be practiced regularly for assessment of HR.

Introduction: Anemia is one of the most important health problems throughout the world. The prevalence of anemia among adolescents is 27% in developing countries, and 6% in developed countries. Aim: This study aims to assess the prevalence of anemia among adolescents of the age group of 10–15 years in rural population. Objectives: The objective is to study the prevalence of anemia in adolescents in the age group of 10–15 years. To correlate anemia with the socioeconomic status (SES) of adolescents. Materials and Methods: The study was a cross-sectional study of the Department of Pediatrics, AVBRH, Sawangi (Meghe), Wardha, which is tertiary care rural hospital catering western zone of Maharashtra. A total number of 1010 adolescents from the age group of 10–15 years of both sexes were included in the study. Results: In our study, we found that 61.19% of the total individuals were found to be anemic. The prevalence of anemia was 53.79% in boys and 71.7% in girls. Anemia was very common in adolescents from lower classes of SES. Conclusion: Adolescent nutrition should be viewed more seriously with adequate improvement in the standards of living, supplementary programs and timely health education.

Context: Comparative study of visual outcome, astigmatism, and complications between conventional extracapsular cataract extraction (CECCE) and manual small incision cataract surgery (MSICS). Aims: To study and compare the visual outcome, astigmatism, and complications between CECCE and MSICS. Settings and Design: This is a hospital-based, prospective, case–control observational study of 2 years' duration; 110 eyes of 110 patients with cataract attending the ophthalmology outpatient department/inpatient department at Acharya Vinoba Bhave Rural Hospital were selected for the study after taking the inclusion and exclusion criteria into consideration. Informed consent was obtained from all subjects after approval by the institutional ethical committee of the college. Materials and Methods: After enrollment, the patients were divided into two groups, one which underwent cataract extraction by CECCE and other which underwent cataract extraction by MSICS. All surgeries were done by the same surgeon under same setting, and visual outcome, astigmatism, and complications were studied and compared between the two groups. Statistical Analysis Used: Statistical analysis was carried out using descriptive and inferential statistics using Chi-square test and Student's unpaired t-test and software used in the analysis was SPSS 17.0 version and Graph Pad 6.0 version and P < 0.05 is considered as level of significance. Results: Patients who underwent cataract extraction by MSICS had better and early visual rehabilitation. Surgically induced astigmatism (SIA) in MSICS was comparatively less as compared to CECCE. In terms of complications, not much difference was noted between the two groups. Conclusions: In the present study, we found that MSICS needs to be a better surgical procedure for cataract extraction as compared to CECCE in terms of better and early visual rehabilitation and lesser SIA.

Introduction: Hypothyroidism is a endocrine disorder which results in neurological dysfunction. It also affects brain, peripheral nerves and muscular system. The neurologic manifestations, which may be noted incidently, occur in conjunction with the systemic features of the disease. Peripheral neuropathy occurs early in hypothyroidism and its detection is necessary for early diagnosis and treatment. Study aimed to know the sensory nerve conduction in patients of hypothyroidism and to compare sensory nerve conduction parameters in patients of hypothyroidism with normal healthy controls. Materials and Methods: Comparative study. Study Design: Total 100 subjects were taken in the study in the age group of 18–66 years. Out of 100 subjects 50 were diagnosed thyroid dysfunction patient and 50 subjects were healthy individual. Informed written consent was taken from all the subjects. Nerve conduction study consists of sensory nerve conduction study of Median, Ulnar and Sural nerves. In the department of Physiology. Electrophysiological parameters such as Sensory Nerve Action Potential amplitude and conduction velocity were evaluated. Results: It was found that sensory nerve action potential amplitude and conduction velocity were significantly reduced in median and ulnar nerves in cases as compared to controls. Conclusion: Nerve conduction study very effective test for early diagnosis of peripheral neuropathy in thyroid dysfunction.

Context: Evaluation of corneal curvature by corneal topography in myopic patients. Aims: To evaluate corneal topographical changes in corneal curvature in patients having myopia. Settings and Design: This is a prospective observational study conducted in a period of 6 months. A hundred eyes of fifty patients coming to the eye outpatient department (OPD) with complaint of diminution of distant vision having myopia were examined after they gave their informed consent and taking into consideration the inclusion and exclusion criteria. Subjects and Methods: A hundred eyes of fifty patients coming to the eye OPD with complaint of diminution of distant vision having myopia were examined. Patients were divided into low myopes, moderate myopes and high myopes, and corneal topography was performed in those patients and refractive error was observed. Corneal asphericity, astigmatism, and ratio of axial length (AL) and corneal radius of curvature (CRC) were observed. A correlation between refractive error and astigmatism, correlation between corneal asphericity and astigmatism, and correlation between corneal asphericity and ratio of AL with CRC were studied. Statistical Analysis Used: Statistical analysis was done using descriptive and inferential statistics using Chi-square test, one-way analysis of variance, and Pearson's correlation coefficient, and software used in the analysis were SPSS 24.0 version and GraphPad Prism 7.0 version. P < 0.05 is considered as level of significance. Results: A negative significant correlation was seen between corneal asphericity and astigmatism, corneal asphericity, and ratio of AL and CRC. A significant correlation was observed between refractive error of patients and astigmatism associated with it. Conclusions: Patients having high refractive error (high myopes) found to have higher astigmatism and corneal asphericity in high myopes. With increasing myopia, the tendency of the cornea to flatten less rapidly in the periphery was observed. In high myopes, corneal asphericity was observed to be more positive than low myopes.

Background: Pancytopenia is a common occurrence in paediatric patients. Aetiology of bicytopenia/ pancytopenia varies widely children, ranging from transient marrow suppression to marrow infiltration by life threatening malignancies. In time recognition of the underlying pathology will not only have an impact on mortality and morbidity but also help in treating simple and easily treatable conditions causing pancytopenia. Aim: To evaluate the etiological and clinicohaematological profile in children with cytopenias. Objectives: To study the clinical presentations in patients with pancytopenia/bicytopenia and evaluate hematological parameters and the bone marrow aspirates. Materials and Method: The present work was carried out in the hematology section of Department of Pathology, of a central Indian medical college and rural hospital from December 2017 to December 2018. 100 patients in paediatric age group having pancytopenia/bicytopenia on peripheral smear were included in the study. All relevant investigations were carried out including Bone marrow aspiration. A correlation between bicytopenia/ pancytopenia with symptoms and etiology was made. Result: The main presenting features of children with both pancytopenia and bicytopenia was fever and the commonest non-malignant conditions causing bicytopenia was megaloblastic anaemia and aplastic anaemia in pancytopenia and the commonest malignant condition which was associated with bicytopenia and pancytopenia was acute leukaemia. Conclusion: Primary haematological investigations along with bone marrow aspiration in cytopenic patients which will be helpful for understanding the disease process; diagnosis, or will help to rule out the causes of, cytopenia; and in planning further investigations and management of cytopenic patients.

Background: Chronic renal diseases (CRDs), a progressive and irreversible decline in renal function with the most implications in dentistry. Kidneys have the following functions: filtering waste metabolic products, maintaining electrolyte balance and the volume of extracellular liquid, and regulating the acid–base balance and endocrine secretions (prostaglandins, erythropoietin, rennin, and Vitamin D). Objectives: To find a correlation between chronic renal conditions and oral cavity and to evaluate the manifestations of CRDs in the oral cavity. Results: Various oral manifestations such as mucosal pallor, petechiae, ecchymosis, uremic stomatitis, and periodontal changes are observed in patients with CRDs. Conclusions: CRDs have a significant impact on oral health, which needs intervention at an early stage of disease and its management to improve the general health status of patients.

Aim: To present perception of orthodontic faculty as a part of broader needs assessment for designing competency-based interprofessional educational (IPE) model for postgraduates in orthodontics. Methods: A cross-sectional survey was formulated consisting of 12 close- and two open-ended questions to identify profession specific and interprofessional curricular gap in orthodontics using Kwick surveys software and sent to the experts from the orthodontic faculty. Results: The response rate was 51.25%. 69.8% faculty were unaware of the basic concept of IPE, while 76.74% were unaware of interprofessional core competencies. 95.3% perceived that team-working skills are essential for postgraduates, while 88.4% faculty thought that postgraduates require training in interprofessional competencies to provide collaborative care. 79.1% agreed that orthodontic postgraduate curriculum needs modification. Ninety-three percent faculty felt that IPE will result in improved communication between health professional students and patients. 83.7% faculty agreed that there is a need to assess the current quality of collaborative care provided by postgraduates to the patients. 95.3% agreed that patient's optimum well-being lies in interprofessional collaborative care offered by different health professionals and that faculty should be trained to deliver IPE. In response to open-ended questions, the faculty suggested different topics under IPE to be included in postgraduate syllabus and cited faculty resistance, overcrowded curriculum, time constraints, and lack of infrastructure to be the main challenges in implementing IPE. Conclusion: This study has given us insight regarding the need for developing a new interprofessional educational model in the specialty of orthodontics from the orthodontic faculty's point of view.

Aim: To evaluate the effectiveness of Coronoidotomy as an adjunctive procedure to Fibrotomy in terms of improvement in intraoperative mouth opening during surgical management of Oral Submucous Fibrosis. Subjects and Method: 30 patients clinically diagnosed with OSMF (Grade IVa) underwent surgical intervention comprising of Bilateral Fibrotomy and Coronoidotomy. The inter-incisal distances were measured following Bilateral fibrotomy, Unilateral Coronoidotomy and Bilateral Coronoidotomy and compared. We evaluated the percent improvement in the inter-incisal distance after Unilateral and Bilateral Coronoidotomy compared to fibrotomy as well as the associated complications of coronoidotomy. Results: We found a striking improvement of 76.68% after performing Bilateral Coronoidotomy in comparison to fibrotomy. Furthermore, there was a mean increase of 34.56 ± 5.96 mm when compared to baseline pre-operative mean value (5.46 ± 4.04 mm). All the comparisons were statistically significant (P = 0.0001). Conclusion: Coronoidotomy is an effective adjunctive procedure to fibrotomy in terms of improvement in the intraoperative mouth opening in advanced cases of OSMF.

Aim: this study was conducted to compare the effects of different intracanal medicaments on microhardness of dentin. Materials and Methods: The dentin disc of third molars (n = 45) was obtained and was randomized into three groups. Group metapex, modified triple antibiotic paste (MTAP), and control group according to the medicaments used. Teeth were incubated in 100% humidity for 7 days. For each group, teeth were subjected to microhardness testing. The one-way analysis of variance test was used to check mean differences among the groups. Post hoc analysis was done using Tukey's Honest Significant Difference test. Results: Significant differences (P < 0.001) in mean microhardness of dentin between the control group and medicament group. The intergroup comparisons of metapex and MTAP group did not show any statistically significant variations (P > 0.05) in mean microhardness of dentin after the 7^th day of application. Conclusion: Under the condition of this study, MTAP affects the microhardness of dentin adversely compared to the metapex.

Introduction: Oral squamous cell carcinoma (OSCC) represents 95% of all head and neck cancers, and its incidence has increased by 50% in the past decade. Accumulation of genetic alterations (mutations, loss of heterozygosity, loss or gain of chromosomes) is the basis for the progression from a normal cell to a cancer cell. OSCCs are frequently preceded by oral potentially malignant disorders (PMDs). It is difficult to predict the malignant transformation of these PMDs. Thus, early detection of genetic changes in PMDs can facilitate detection of those lesions, which may have potential to progress to malignancy. p63 is a protein coded by p63 gene which is a homolog of p53 gene. It has a critical role in cell cycle regulation and is associated with epithelial tumorigenesis. The present study aims to evaluate the role of p63 in carcinogenesis in PMDs (Leukoplakia, Oral submucous fibrosis and Lichen planus) and OSCCs using immunohistochemistry. Aims and Objectives: The aim is to evaluate the expression of the p63 IHC marker in oral premalignant disorders and to compare its expression in OSCC. Materials and Methods: Tissue sections of PMDs (105 cases) and OSCCs (35 cases) were stained for IHC marker p63. The percentage of positive cells and staining patterns were assessed for all the lesions. Results and Conclusions: Progressive accumulation of p63-immunopositive cells from PMDs to OSCC reflects its major role in the development of OSCC according to a multiple-stage model of carcinogenesis and can be a useful indicator of dysplastic change, thus serving as a biomarker for cancer progression.

Introduction: Clinical manifestations of blood stream infections (BSIs) range from transient bacteremia to fulminant septic shock with high mortality. Regular surveillance of BSI etiology is important in monitoring the spectrum of bacterial pathogens and their sensitivity pattern in a particular area and thus helps in rationalizing therapy. Objective: The present study was undertaken to know the bacteriological etiology of BSIs and the antibiotic susceptibility pattern of the isolated strains to formulate effective empirical treatment. Materials and Methods: During the 1-year study, 5588 blood samples from patients with a clinical diagnosis of sepsis were processed at Microbiology Laboratory of a 1200–bedded tertiary care hospital of Western India. Bacteriological identification and antimicrobial susceptibility testing were performed for all bacterial isolates by following the standard protocol. Results: A culture positivity was seen in 10.73% of the septicemic cases. Contamination was observed at a rate of 1.96%. Of the total 600 bacterial isolates gram-negative Enterobacteriaceae, Gram-negative nonfermenters and Gram-positive cocci contributed to 38%, 31%, and 31%, respectively. The predominant organisms were Acinetobacter spp followed by Klebsiella spp. and Staphylococcus aureus. All Gram-negative bacteria showed low sensitivity to fluoroquinolones and beta lactam drugs such as ampicillin and cephalosporins. Aminoglycosides, carbapenems, chloramphenicol, βeta lactam-β lactamase inhibitor combinations such as Piperacillin tazobactam were effective in treating Gram-negative bacteremia. Chloramphenicol, glycopeptides, and linezolid were effective in treating Gram-positive bacteremia. All Gram-positive isolates showed low sensitivity to fluoroquinolones. Conclusions: This study stresses the need for the continuous screening and surveillance for antibiotic resistance in septicemic cases.

Background: Domestic accidents in and around home are a leading cause and preventable death of children under 5 years and are the major cause of ill health and serious disability. Creating awareness among parents of under-five children is a cost-effective strategy to prevent domestic accidents among children. Objectives: (1) The aim of this study is to assess the baseline knowledge and practices regarding the prevention of domestic accidents among parents of under-five children and (2) To evaluate the effectiveness of safe home toolkit among parents of under-five children. Research Design: Randomized control trial. Setting: Community setting in the Wardha district. Population: Parents of under-five children. Sample Size: The sample size was 20. Sampling: Simple Random Sampling. Materials and Methods: Demographic datasheet, Knowledge Questionnaire – developed by researcher and Standardized Home safety checklist. Intervention: Standard Safe home toolkit comprises Information handouts regarding home safety, which include Engineering measures, Environmental measures, Legislation, and standard. Education material and skills, Videos on home safety, and Safe home model demonstration. Results: The difference in means in pre-test and post-test of experimental group and posttest of the experimental and control group for knowledge and practices regarding the prevention of domestic accidents was statistically significant as P = 0.000 for all comparisons. Conclusion: Safe home toolkit for under-five children, the 2 day intervention for creating awareness regarding the prevention of domestic accidents, is found effective in improving the knowledge and practices of parents of under-five children.

Introduction: Pregnancy is associated with various physiological changes. There is an increase in heart rate (HR) due to increase volume overload or decrease baroreceptor sensitivity. It occurs mainly due to changes in the autonomic activity. The aim of the study was to assess the HR response during rest and deep breath in pregnant women in the different trimester and to compare with nonpregnant women. Material and Methods: In this case-control observational study, after the approval of the institutional ethics committee and board of research committee a total of 160 women aged from 20 to 25 years without any recent history of respiratory diseases were selected. One hundred and twenty participants were pregnant (case group) and 40 were nonpregnant (control group). The case group was equally divided into three trimesters. Resting HR (RHR) and HR response to deep breathing (E: I ratio) were measured in both the study group by automatic “Cardiac Autonomic Neuropathy Analyzer” Statistical analyses were performed by One-way analysis of variance between the study groups and P < 0.05 was taken as significant. Results: Pregnancy is associated with a significant increase in RHR in 1^st, 2^nd, and 3^rd trimester of pregnancy as compared to nonpregnant (control). In all trimesters of pregnancy, there was a significant decrease in HR during deep breathing as compared to nonpregnant women. Conclusion: These observed changes possibly reflect decreased vagal baroreflex control of the heart.

Context: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are commonly performed procedures for degenerative conditions of knee and hip joints, respectively. Lower limb arthroplasty involves visible and hidden blood losses leading to a routine requirement of blood transfusion. Postoperative rehabilitation and recovery is also dependent on hemoglobin (Hb) and packed cell volumes (PCVs) following surgery. Aims: The aim is to determine changes in Hb and PCV values in patients undergoing primary lower limb arthroplasty in the first 2 weeks' postoperatively. We also aimed to find out any correlation between length of hospitalization following lower limb arthroplasty with preoperative Hb and PCV values. Setting: This study is a cross-sectional, analytical study analyzing the postoperative changes in Hb and PCV in patients undergoing primary lower limb arthroplasty. Subjects and Methods: Forty patients undergoing primary TKA or THA were studied with a compilation of demographic, hematological, and clinical outcomes over a period of 14 days' postoperatively. Statistical Analysis Used: Chi-square test, unpaired t-test, analysis of variance (ANOVA), and Mann–Whitney U-tests. Results: On comparing the data within the groups at multiple intervals using repeated measures ANOVA, significant difference was found in the Hb at various time intervals for THA patients (F = 46.32, P < 0.0001) and for TKA patients (F = 55.26, P < 0.0001). The mean PCV levels of THA and TKA patients were comparable at various time intervals, except postoperative day 1, when the PCV levels were significantly lower in THA group than TKA group (P = 0.0331). Conclusion: There was a definite postoperative decrease in Hb levels, with the highest fall on the 5^th day postsurgery, with respect to the preoperative Hb and PCV levels.

Background and Objectives: Diabetes mellitus (DM) is a chronic metabolic disease with high morbidity and mortality. Musculoskeletal disorders (MSDs) are a wide range of problems resulting in pain and impaired physical function in these patients. These disorders are usually neglected and pose a hindrance in delivering an effective exercise regimen, which is the mainstay in the treatment of DM along with diet and medications. Hence, we conducted this study to identify and describe the MSDs seen in Type 2 DM (T2DM) and to correlate it with glycemic control. Methodology: A prospective cross-sectional study was conducted in a tertiary care hospital in the coastal district of Dakshina Kannada in Karnataka for 18 months. Patients with T2DM were screened for MSD and if present were included for the study. Demographic data, symptoms of MSD, and laboratory data like fasting and postprandial blood sugars and glycated hemoglobin (HbA1C) were collected using suitable data collection form. Data were analyzed using descriptive statistics. Results: A total of 80 patients with T2DM and MSD were included in the study, where 40 (50%) were male and 40 (50.0%) were female. The mean age of the study population was 58.54 ± 10.09 years. The mean fasting blood sugar level was 185 ± 36.12, Postprandial blood sugar level was 251.70 ± 55.51 and HbA1C level was 9.92 ± 1.46. The most common MSD among the patients with T2DM was frozen shoulder which accounted for 42/80 (52%) patients. Subjects with carpal tunnel syndrome (CTS) (P– 0.004) and Charcot joint (P– 0.003) had significantly higher mean HbA1c values than in subjects without these disorders. The mean HbA1C values among subjects with trigger finger (P– 0.012) and frozen shoulder (P– 0.011) were significantly lower than in subjects without the respective disorders. Conclusion: MSDs are highly prevalent among patients with T2DM. The most common MSD to manifest in patients with T2DM is frozen shoulder. There is positive correlation between HbA1c and presence of CTS and Charcot's joint and negative correlation between HbA1c and presence of trigger finger and frozen shoulder. Many of these disorders are treatable especially if diagnosed early and can improve quality of life in diabetic patients by reducing morbidity associated with these disorders.

Background: Workers in the mining industry are prone to multiple health problems including musculoskeletal disorder. Very few studies are available assessing the occurrence of work-related musculoskeletal disorder (WMSD) among manual and mechanized mine workers due to unergonomic working conditions. Aims: The aim of this study is to establish and compare the prevalence of WMSD due to unergonomic working conditions among the manual and mechanized miners with age and work exposure and also to identify the most commonly affected body region. Materials and Methods: A questionnaire-based survey of about 889 manual and mechanized miners was conducted in different states of India. Results: It was also observed that vibration exposure was relatively higher among manual miners (62%) as compared to mechanized workers (45%) and also manual lifting of heavy loads is common practice in manual miners with 73% miners engaged in it as compared to only 23% mechanized miners. WMSDs were significantly higher in manual miners (61%) as compared to mechanized miners (36%). Odds ratio of WMSDs in relation to the age group of 18–40, 41–50, and 51–60 years was 2.56, 2.25, and 2.76, respectively, and in relation to work exposure of 0–10, 11–20, and >20 years was 3.38, 2.17, and 2.59, respectively, indicating that manual workers are much more prone for WMSDs. Conclusion: Our study showed that due to unergonomic working conditions, manual mine workers are more prone for WMSDs as compare to mechanized mine workers and work exposure is more relevant factor than age to study WMSDs.

Background: Many conditions affect the salivary glands. Acute sialadenitis is infectious or inflammatory disorders of the salivary glands. The exact frequency of submandibular sialadenitis is unclear. The acute conditions more typically involve the parotid and submandibular glands. Submandibular gland and its duct calculi are known entities, but their typical presentation is rare. Material and methods: During an acute inflammatory process, there is swelling of the affected gland, overlying pain, gland tenderness, fever, and on occasion, difficulty in opening the mouth. Results and Conclusion: Here, we present a case of 23-year-old male with unilateral left submandibular gland and Wharton's duct calculi expelling calculus and pus and impacted calculus in the proximal duct and gland from its opening under surface of the tongue and left submandibular sialoadenectomy done through the submandibular external approach.

Obsessive–compulsive symptoms (OCS) and obsessive–compulsive disorder (OCD) occur frequently in schizophrenia. Comorbid OCS or OCD can influence the course of schizophrenia. Comorbid OCS or OCD is associated with an increased severity of schizophrenia and poorer prognosis. Lacunar infarcts though not always, but often considered benign as they do not usually cause clinically significant neuropsychiatric or neurological deficits. In the current case report, we highlight a rare case of a 23-year-old male who presented with schizophrenia with OCS in the background of lacunar infarct in the left corona radiata on computed tomography of the brain, which later followed by focal ischemic changes in the subcortical left temporal, peritrigonal, and periventricular regions on magnetic resonance imaging of the brain. In the current case report, index patient suffering from schizophrenia showed a temporal association between the worsening of findings on neuroimaging and worsening of OCS, depicting the growing importance of neuroimaging in the field of psychiatry.

Bursitis involving the upper limb can present with swelling, pain and restriction of movements. Clinically, bursitis can mimic joint pathologies, and hence, it is important to differentiate it from the latter. Sonoelastography is an excellent initial and inexpensive imaging modality of choice for diagnosis.

FAST scan is an important constituent of imaging in case of trauma. We are presenting a case of maxillofacial trauma without any external abdominal injury, in whom liver trauma was incidentally diagnosed on focused assessment with sonography for trauma scan. Ultrasonography and computed tomography features of liver trauma are discussed.

Nontraumatic hemarthrosis is caused by variety of bleeding disorders which could be hereditary or acquired. Hereditary includes hemophilias and other coagulation factor deficiency disorder. Most of the coagulopathy patients present with uncontrolled spontaneous bleeding without any trauma. Here, we are presenting a case of 12-year-old boy who presented with stiffness and swelling of the right knee without any history of trauma.

Endocrown restorations are single unit prostheses fabricated from metal. These restorations are indicated for endodontically treated teeth, molars especially, that have significant loss of coronal structure. Endocrowns gain their retention from the coronal portion integrated into the apical projection that fills the pulp chamber space, and possibly the root canal entrances. In this case report a new style Fixed Partial Denture is introduced. Here mandibular second molar had compromised tooth structure and hence Endocrown was planned with the tooth. For replacement of missing first molar a three unit fixed partial prosthesis was planned. This unique three unit prosthesis had Endocrown on mandibular second molar and a full veneer crown on mandibular second premolar as an abutment fabricated in metal. This innovative design of Fixed Partial Denture is better suited in cases where there is compromised tooth structure and the tooth is strategically important and has to be retained.

Mutilation of any facial structure, especially eye, affects the health of the patient psychologically and functionally. “Its the right of every human being to appear like human” and hence facial prosthesis plays a major role in rehabilitation. Silicone among all materials used for facial prosthesis gives a life-like appearance and better marginal adaptation. This case report presents a straightforward technique for the rehabilitation of ocular defect owing to surgical management of rhabdomyosarcoma with silicone orbital prosthesis.

Fibrous Dysplasia (FD) is a benign, congenital, skeletal, and metabolic entity of immature bone-forming mesenchyme that is characterized as a defect of differentiation and of maturation of osteoblasts of unknown etiology, wherein pathogenesis is uncertain, and which shows varied histopathology. FD represents all bone tumors and all benign tumors of about 2.5% and over 7%, respectively. FD commonly involves long bones, pelvis, ribs, and craniofacial bones. Facial and cranial bones are affected in nearly 50% of polyostotic FD patients and in 10%–27% of monostotic FD (MFD). The mandible is less commonly involved than the maxilla in MFD jawbone lesions. Clinical examination revealed tender firm to hard buccal cortical expansion. Radiographic examination revealed mixed radiopaque and radiolucent picture giving ground-glass appearance. Bone biopsy was performed for confirmatory diagnosis of FD. The lesion was subjected to surgical curettage. The patient was kept on regular follow-ups once every 3 months up to 3 years and then once every year till the 5^th year. At the conclusion of 5 years, the patient was disease free. The purpose of the current report is to enlighten the case of a 32-year female patient complaining of painful bony swelling over the left back region of the lower jaw successfully treated with surgical curettage.

A successful complete denture depends on the principles of retention, stability, and support. The skill here lies in the application of these principles proficiently in various difficult situations. Extremely resorbed maxillary edentulous ridges that show increased inter-ridge space provide lesser support, retention, and stability. The denture weighing more only compromises them further. This article discusses a case report of an edentulous patient having resorbed ridges where a simple yet effective technique of fabrication a lightweight maxillary complete denture effectively.

The management of resorbed mandibular ridge and the flabby ridge has always been a challenge for prosthodontist. Many patients cannot be suitable for implant denture therapy. Hence, in such patients to use a technique with routinely used impression materials becomes a justified option. Hence, the stability of denture in such patients becomes a distinguishable factor between failure and success. This article outlines a combination of different impression materials to improve denture stability in atrophied mandibular ridge, and management of flabby tissue keeping in mind further ridge resorption.

Waardenburg syndrome type 1 (WS1; MIM #193500) is a rare autosomal-dominant auditory-pigmentary syndrome characterized by pigmentary abnormalities of the hair, skin, and eyes; congenital sensorineural hearing loss; and “dystopia canthorum.” The lateral displacement of the ocular inner canthi was caused by heterozygous mutation in the PAX3 gene on chromosome 2q36. This is the case report of a 7-year-old girl showing the characteristic features of WS1 with familial history. Four generations of the patient's family, comprising 32 members, were undertaken to determine the pattern of inheritance, expression of syndrome, and phenotypes. The clinical examination of the 32 family members (18 females, 14 males) showed that ten females (31.25%) and eight males (25%) were affected by WS1. The age of the patients ranged between 3 years and 76 years (mean 24.67 years). Out of 18 family members with WS1, ten members showed white forelock, six members showed dystopia canthorum, eight members had congenital sensorineural hearing loss, seven members had iris heterochromia, and three members had bilateral brilliant blue irises. Dental abnormalities were shown by nine family members including enamel hypoplasia, peg-shaped maxillary laterals, conical teeth, and class 3 malocclusion.

Squamous cell carcinoma arising from burn scar of 20 years is rare. Here, we present a case of a 50-year-old female with ulceroproliferative lesion over heel and dorsum of foot following thermal burn sustained 20 years ago. The patient was not willing for surgical debridement and skin grafting following which he went into septicemia and ultimately landed into below-knee amputation without any adjuvant therapy. Post amputation, the patient survived for 5 years.