Background: Acute appendicitis is a very common cause of acute abdomen, particularly associated with the young and middle age groups. Its diagnosis and management are primarily based on the clinical signs and symptoms. Many scoring systems have been made collaborating the signs and symptoms but do not cater to all population. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system is a relatively newer clinical scoring system, which has been used worldwide with good efficacy in the quick diagnosis of acute appendicitis. Methods: Research was done on 50 patients whose signs and symptoms were clinically suggestive of acute appendicitis. The patients were evaluated using RIPASA scores primarily on admission and were operated on the basis of the surgeon's decision. The scores were compared with the histopathological analysis, and efficacy was analyzed. Results: The sensitivity of the RIPASA score was 94.11%, specificity was 93.75%, positive predictive value was 96.96%, the negative predictive value of RIPASA score was 88.23%, and the diagnostic accuracy of RIPASA score was 94%. Conclusion: RIPASA scoring system is a simple and effective scoring system, which can be used in a bedside manner for an accurate diagnosis of appendicitis.

Background: Oral squamous cell carcinoma (SCC) is the major malignancy reported in Sharad Pawar Dental College and Hospital, Sawangi Meghe, Wardha, Maharashtra, India. The treatment of choice is radical neck dissection, while performing surgery frozen section (FS) analysis is done. FS helps in rapid intraoperative diagnosis. It is commonly used during surgical procedures to detect malignancy so that modifications of surgery can be decided at the time of surgery on the table. FS is also performed for the evaluation of surgical margins and detection of lymph node metastasis. In addition, it is applied for the detection of unknown pathological processes. Aims and Objectives: The objective of this study was to assess the accuracy of FS diagnosis in comparison to gold standard histopathological diagnosis and to find concordance and discordance rate of FS with histopathological report. Materials and Methods: We retrospectively reviewed records of frozen section from the department of Oral Pathology and Microbiology. The frozen section diagnosis was compared with permanent sections stained by haematoxylin and eosin stain. The frozen section results were compared with final histopathological diagnosis. Results: Sensitivity = 97.97%,Specificity = 100%, Percentage of false negative = 2%, Percentage of false positive = 0%. Conclusion: In our study frozen section diagnosis was coinciding with histopathological diagnosis.

Statement of Problem: Teeth are weakened after endodontic treatment and should, preferably, be crowned, especially posterior teeth. However, this is not always possible due to certain reasons. Information about the appropriate treatment modalities. This retrospective study was carried out to evaluate the survival of endodontically treated teeth (ETTs) without crown coverage on the basis of various parameters in the region of Vidarbha in Maharashtra, India. Purpose: The aims of this cohort study were to evaluate the survival rate for endodontically treated molars without crown coverage and to identify possible related factors. Materials and Methods: Relevant data from 300 subjects for 148 ETTs was recorded at the Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Wardha, Maharashtra. Follow-up data were derived from a clinical examination and review of the dental record and radiographs. Subjects were not included in the study if teeth had provisional crowns, definitive restorations with cuspal coverage, or with dowel and core and/or crown restorations. The outcome evaluated was defined as a failure if there were negative findings in the condition of a tooth that required a restoration, tooth repair, or extraction. Tooth loss due to endodontic and periodontal reasons was excluded. The independent variables assessed were patient age, gender, location (maxilla or mandible), the existence of an opposing dentition and adjacent teeth, remaining tooth structure, and types of restorative material. One hundred and forty-eight teeth restored using glass-ionomer cement (GIC), SF, and composites were considered successful during the observation time of 3 years because no intervention was needed in these teeth were labeled as “survived.” The teeth restored with composite were 90. The teeth restored with GIC were 14. The teeth restored with silver amalgam were 44. Out of 148 teeth were considered successful during the observation time of 3 years because no intervention was needed in these teeth were labeled as “survived.” Follow-up was done at regular intervals after 5, 7, and 10 years, respectively. At the end of 10 years, the number of teeth survived was 26. The teeth restored with composite were 14. The teeth restored with GIC were 4. The teeth restored with silver amalgam were 8. Results: At the end of the observation time period (10 years), 13 teeth had to be extracted at the end of 6 years and 19 restorations were repaired or replaced at 5, 7, and 9 years. Conclusion: Within the limitations of this study, the amount of remaining tooth structure and types of restorative material have a significant association with the longevity of endodontically treated molars without crown coverage. ETTs evaluated after 10 years showed positive survival and success in long time period. Various parameters were significantly seen to influence the outcome and thereby survival of teeth in the arch when no crowns were placed on ETTs.

Background: Habit of tobacco consumption is a known etiologic factor in the development of oral precancer and cancer. Exploring the age at which a person starts earning and starts adverse habit is vital. Materials and Methods: Healthy 120 controls, who were not having oral cancer, oral precancer and had no history of any major illness in the past were recruited for the study. The patient, were briefed about the study and a thorough case history was taken including demographic details and adverse habit. Results: Ninety-four (78.33%) were male and 26 (21.66%) were female. All the individuals studied were between the age group of 24–70 years and the mean age was 49.6 ± 10.3 years. Mean age of starting working was 18.37 ± 2.16 years, mean age of starting habit was 22.99 ± 3.86 years. Mean frequency and duration of habit was 5.00 ± 1.9958 was 25.75 ± 11.28 years, respectively. Data were subjected to Pearson correlation test, the r value was 0.252, P = 0.006 which showed the positive correlation between age of starting working and the mean age of starting habit. Conclusions: Evaluating various types of adverse habits in each and every patient visiting to dental clinic is of utmost importance. Exploring the habit of snuff/gul/gudakhu for cleaning teeth is important and the clinician should be alert and aware to this insidious aspect of tobacco use. The precancerous lesions and conditions are the preventable aspect of the tobacco disease spectrum. It provides an opportunity for early detection and thus helps in the prevention of malignant transformation.

Background: Crush injury occurs as a result of direct physical crushing of the muscles by a heavy weight and usually involves compression of the legs, arms, and/or trunk. Crush injuries are typically associated with accidents but can occur in nontraumatic patients as well. Crush injuries may result in permanent disability or death; therefore, early recognition and aggressive treatment are necessary to improve outcomes. Methods: Skin grafting is the transfer of cutaneous tissue from one portion of the body to another, often used to cover large wounds. The rationale of skin grafts is to take skin from a donor site that will heal and transfer the skin to an area of need. Results: After incorporation, skin grafts provide wounds with protection from the environment, pathogens, temperature, and excessive water loss like normal skin. Conclusion: The current study presents a case of Crush Injury with its entire course and final management in a 51 year old male who presented to ACHARYA VINOBHA BHAVE RURAL HOSPITAL, SAWANGI, (M), WARDHA, with traumatic amputation distal to level of metacarpals and degloving injury involving the arm proximal to elbow.

Background: Social determinants of the health (SDH) arise from the social and economic condition in which they are living and their interaction produces direct impact on the health. Wider socioeconomic context, social exclusion, poverty, etc. are considered as the SDH. Objectives: This study was conducted to assess sociodemographic profile, job characteristics, and the association of the social determinants on the well-being of rural construction workers. Materials and Methods: It was cross-sectional study carried out among the rural construction workers employed at one of the medical institutes in Central India. Results: About more than half of the study participants belonged to the lower class of socioeconomic status by Modified B. G. Prasad classification 2017. Sixty-three percent participants were laborers, followed by 32% in assistance services. Musculoskeletal pain was the most common self-reported health issue, whereas near about 3/4^th of study participants were found to have low or no risk on Kesseler's Distress Scale. The association between education and socioeconomic condition with well-being of rural construction workers was not found to be statistically significant. While, the association between Kesseler's Distress Scale and the presence of addiction was found to be statistically significant. Conclusion: Maximum study participants belonged to lower socioeconomic class, and musculoskeletal pain was the most common self-reported illness. The association between well-being and Kesseler's Distress Score and addiction was found to be statistically significant.

Background: Diabetes mellitus (DM) is a significant public health problem all over the world because of the comorbidities it causes. Serum ferritin, an acute phase reactant, is a measure of the body's iron reserves. Increased body iron reserves and subclinical hemochromatosis have been linked to the development of glucose intolerance, type 2 diabetes, metabolic syndrome, and possibly diabetic retinopathy, nephropathy, and vascular dysfunction, according to recent research. Materials and Methods: A total of 64 subjects out of which 32 type 2 diabetic patients as cases enrolled in the study and 32 healthy subjects as controls from the Medicine outpatient department. Fasting blood glucose, glycated hemoglobin (HbA1C), high-sensitivity C-reactive protein (hs-CRP), and serum ferritin were estimated in both cases and the control group. Results: In type 2 diabetics, FBG, HbA1c, and hsCRP levels are higher than in healthy people. With an increase in HbA1C, there was a significant increase in serum ferritin in type 2 diabetes individuals. In poorly controlled diabetes, HbA1c >7%, HbA1c has a positive correlation with FBG, serum ferritin, and hs CRP. Conclusion: In our study, the mean concentrations of fasting blood glucose, high-sensitivity C-reactive protein, ferritin, and HbA1C were significantly higher in type 2 diabetes patients than in controls. The hbA1c level >7 (poor control group) had higher fasting blood glucose, hs-CRP, and ferritin levels than the hbA1c level <7 groups (good control group). Fasting blood glucose, hs-CRP, and HbA1C were found to have a strong relationship in type 2 diabetes patients with poor control. Serum ferritin and hs CRP levels increased in diabetics as long as glycemic control was not achieved.

Background: Diarrhoea in India estimates about 2 million episodes per year. An average Indian child less than 5 years of age will have 2-3 episodes of diarrhoea per year. Every year, 2.2 million deaths are attributed to diarrhoea alone, with the vast majority of deaths among children under the age of five. Aims and Objectives: The present study aims to study the association between hygiene practices of mother or caregiver with diarrhea among under five children. Methods: The study was carried out in Seloo block, which is the field practice area and the study participants were the mothers or caregivers of the children between 6 months to 5 years of age of the selected villages. Results : It was found that the frequency of diarrhoeal disease was 53.33% among girls, while it was 38.75% among boys. On asking about the method of purification and filtration used, 68.6% mother or caregivers were using straining through cloth or strainer followed by 20.5% were using water filter (ceramic/composite) while 6.9% would boil the water and 0.98 used electronic purifier. When binary logistic regression was applied for hand washing practices and diarrhoea, it was found that regression coefficient was significant for hand washing before cooking showing regression coefficient value of - 0.84 (odd ratio-0.432) and hand washing before meal regression coefficient value of - 0.73 (odd ratio-0.481) Conclusion: The association between hand washing before meals and before cooking was found to be statistically significant indicating the importance of hand washing before cooking and before meals in preventing diarrhoeal episode in under five children.

Introduction: Thyroid disorder is the second most common endocrine disorder in pregnancy, after diabetes. The present study was designed to assess the prevalence of thyroid disorder in first trimester in pregnant women in a tertiary care centre. Materials and Methods: This was a descriptive cross sectional study in which thyroid hormone levels and Anti- TPO antibodies levels were measured in one hundred and forty two pregnant women. The analytes were measured using Cobas e 411 autoanalyzer which is based on ECLIA principle. Results: From our study we found that 51.4% of the pregnant women had thyroid dysfunction. 40.9% of the pregnant women were found to have subclinical hypothyroidism with high TSH levels but normal FT4 levels. Hypothyroidism is diagnosed to be much more common that hyperthyroidism in pregnant women. In addition, 10.5% of our study population was found to have autoantibodies to thyroid peroxidase enzyme. Conclusion: The increased prevalence of thyroid disorders makes it necessary to start universal screening of pregnant women for thyroid disorders which would help in the early identification and rectification of thyroid disorders in pregnant women. Further, early screening and treatment of thyroid disorders would prevent to a large extent the incidence of thyroid disorders in the newborns, which is one of the leading causes of mental retardation.

Aims and Objectives: To observe the variability in the branching pattern of the arch of aorta (AA) in the cadaver, to find out the most common branching pattern, to determine the percentage of variations of the AA and describe their clinical importance. Materials and Method: The study was conducted in 47 formalin-fixed cadavers of both sexes of 30–80 age groups. All the observations regarding morphology, as well as variations in the branching pattern of the AA were studied. Result: The most common pattern was three-branches arising from the AA which was found in 36 cadavers (76.5%); variations in branching pattern were found in 11 cadavers (23.4%); four cadavers had four branches (8.5%) namely, brachiocephalic trunk (BCT), left common carotid (LCC), left vertebral artery (LVA), and left subclavian artery (LSA); and one (2.1%) cadaver showed three branches with variation, namely, Common trunk (CT1) (that gave origin to BCT and LCC) proximally, LVA in the middle and LSA distally; and six (12.7%) cadavers had two branches, of which five cadavers with proximally CT1 and distally LSA and one cadaver with two common trunks (CT1 and CT2), where CT1 was proximal whereas CT2 giving origin to LVA and LSA was distal. Conclusion: The wide spectrum of variations in the anatomical arrangements of the aortic arch branches in our study was at par with other populations of the world. Although anomalous origins of the branches of AA are merely anatomic variants, accurate information about them is vital for vascular surgery in the thorax, head-and-neck region.

Objective: The purpose of this article is to introduce a newer presurgical nasal cartilage molding device–Sawangi presurgical cartilage molder (SPCM) used extraorally for treating infants with unilateral cleft lip and alveolus; classified as type D according to the Daigavane and Hazarey classification. Methods: A 7-day-old male presented with unilateral cleft lip and alveolus categorized as type D according to the Daigavane and Hazarey classification. A head tape with a rectangular frame was used to support and mold the nasal cartilage with wireframe and nasal component fabricated with 0.8-mm stainless steel loaded with a soft liner nasal ball which was activated with the elastic. Discussion: The position of the nasal cartilaginous septum, nasal alar cartilage tip, medial and lateral crura were restored to normal. SPCM can be a helpful device in cleft lip ± alveolus to mold the cartilage and promote breastfeed simultaneously. It is easy to fabricate, less time-consuming, comfortable for the infant, and cost-effective.

Background: During the COVID pandemic period, our home-restricted life led to many undesirable physical, physiological, and mental alterations. Yoga a traditional system of medicines by virtue of its holistic approach toward health and disease and also due to reasonable cost, the technique has an edge in dealing with health problems and with primary prevention of disease. Aim: The current study has been designed to assess the effect of short-term (for 3 months for 5 days in a week or 40 days) yoga practice on lipid profile, and blood glucose level, C-reactive protein (CRP), and other physical and physiological parameters among healthy controls. Materials and Methods: Students went for yoga practice for 3 months (90 days) for 5 days in a week under the supervision of trained yoga instructor. Yoga activity was conducted via Google Meet app through broadband connectivity. The procedure began with Surya Namaskar (Sun Saluation) with a session of 12 asanas (fixed postures) for 20 min, followed by 15 min Pranayam (breathing exercise including anulome-vilome, surya bandana, sheetali, and bhramari). The session ended with 10 min meditation. Yoga program was started on September 27, 2020, and ended on December 27, 2020, after the completion of 3 months. Biochemical investigation (lipid profile, fasting blood glucose, CRP) and physiological parameters (blood pressure [BP], pulse), and other anthropometric parameters including weight, height body mass index reports were collected before September 27 and after December 27 in 5 days after the completion of 3 months tenure. Results: Results of the study clearly indicate fasting sugar, systolic BP, and low-density lipoprotein were significantly decreased (with value <0.02, 0.007, and 0.001, respectively) in the postyoga phase as compared to preyoga baseline investigation. Conclusion: The The present study substantiates some good results of the yoga training. Although all the tested parameters could not show desired changes and they were statistically insignificant.

Background: Fine-needle aspiration cytology (FNAC) is a well-established technique for the evaluation of salivary gland lesions, but because of the heterogenicity and morphological overlap between the spectrum of the lesion, there are a few challenges in its wide use. Recently, “The Milan system for reporting salivary gland cytopathology” was introduced, providing guide for diagnosis and management according to the risk of malignancy (ROM) in different categories. The present study was conducted to assess the Milan System for Salivary Gland Cytopathology on salivary gland lesion aspirate and to correlate the reporting categories with conventional reporting methods and to use as objective tool in implication and uniformity at the management of salivary gland lesions. Materials and Methods: A total of 102 cases of salivary gland lesion were enrolled in the study, who underwent FNAC in the division of cytopathology. The FNA results of this study were recategorized according to the Milan system and compared with the final histopathological diagnosis. Results: Milan system FNAC sensitivity was 82.5%; specificity was 90.90%, while the diagnostic accuracy was 84.31%. The positive and negative predictive values were 97.05% and 58.82%, respectively. ROM was calculated for each category. It was 33.3% in Cat I, 9.0% in Cat II, 100% in Cat III, 9.3% in Cat IV A, rest 100% in the remaining categories. Conclusion: The present study concluded that the Milan system has cytodiagnostic advantages over the conventional reporting system. It has the advantage to know the ROM and as a systematic nomenclature, it may reduce the rate of surgery where it was not indicated.

Background: Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukin-8, and various other cytokines are positive regulators of angiogenesis. Increased levels in urine, serum, and plasma are associated with increased angiogenesis, growth, and metastasis in solid tumors. The aim of the study was to estimate the serum VEGF levels in various hematological malignancies and in solid tumors. Materials and Methods: Enzyme-linked immunosorbent sssay was used to measure VEGF concentration in serum samples from 62 patients with newly diagnosed hematological malignancies and solid tumors. Samples from 10 cases of normal persons were taken as control. Results: Overall, mean serum VEGF levels of the patients in study groups of hematological malignancies and solid tumors (133.96 ± 47.50 pg/ml) were significantly higher than those of control group (40.3 ± 8.27 pg/ml). Among all the subgroups, highest serum VEGF levels were found in central nervous system tumors followed by equivalent levels of multiple myeloma and lymphomas. Among leukemias, patients of acute myeloid leukemia showed higher VEGF levels than acute lymphoblastic leukemia patients. Conclusion: Serum VEGF levels of the patients with hematological malignancies as well as solid tumors were higher compared to controls. Further studies are needed to determine the therapeutic implications of this finding.

Background: Lecturing is a commonly used teaching method for communicating conceptual knowledge in a large group. However, students' attention span is limited. The introduction of a lecture capture system would, therefore, be advantageous in filling this void. Material and Methods: The study was conducted on 202 first-year Medical Undergraduate students (96 males & 106 females). The students were exposed to 'Impartus,' i.e., a lecture capture system for four months. In the end, the usage & perception of the students regarding the lecture capture system was documented using a validated questionnaire. Results: Results were expressed in frequency & percentage. The usage of the lecture capture system helps in understanding the concepts better as agreed by 76.83% of the student population. The majority of the students watch the lectures online as per convenience (79.30%). About 55.44% stated that the lecture capture system is easy to use. Students (62.87%) believed that watching lectures online would help to recall the points that they had failed to understand in the class. However, 70.78% of students preferred face to face classroom lecturing system. Topics on Embryology & Neuroanatomy were strongly favored by a majority of the students (72.38%) to be viewed in Impartus. Conclusion: The lecture capture system is beneficial as it favors the teaching-learning process and can supplement traditional lecturing. Face to face lecturing is, however, preferred over online lectures. Issues such as poor internet connectivity and other technical glitches should be taken care of to promote better use of the lecture capture system.

Background: Biomedical sciences can be said to be a collective of multiple scientific subjects to obtain, organise, apply, analyse information for the betterment of public healthcare. The stream of biomedical sciences comprises not only one but also multiple subjects under its roof such as microbiology, epidemiology, statistics, engineering as well as anatomy, physiology, and biochemistry. The adherence to the subject is of prime importance to attune the learner and prepare him/her for learning the psychomotor domain pertaining to the said subject. The present study attempts to delineate the curricular inclusions for the said curriculum of Bachelor of Science in Biomedical Sciences under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) as against typing of curriculum based on problem centricity. Materials and Methods: Rapid review of the literature with reference to the curriculum of Bachelor of Science in Biomedical Sciences under faculty of Allied Health Sciences, Datta Meghe Institute Of Medical Sciences (Deemed to be University) in the academic year 2020–2021 for purpose of their “Typing” with principles of curriculum design' was done. Results: The total number of curricular inclusions was 305. Ideally taking the ratio of curricular inclusions as 6:3:1, there should be 184 subject-centered inclusions, 91 problem--centered inclusion, and 30 learner centered. Out of this, there were 143 inclusions which were observed to be subject centered, 133 inclusions were problem centered and 29 were centered upon the learner. Thus, the overall percentage of typing of the inclusions was 46.88% subject centricity, 43.60% problem centricity and 9.5% learner centricity. The observed deficit in subject-centered inclusions was 41, a surplus of 42 objectives was observed for problem-centered inclusions and a deficit of 1 was observed for learner centricity. Conclusion: The undergraduate course curriculum of Bachelor of Science in Biomedical Sciences under Faculty of Allied Health Sciences included in the present study for typing of included curricular inclusions has been typed based on their centricity upon the problem.

Background: The discipline of clinical psychology is the one that deals with assessment, diagnosis, treatment, and prevention of psychological illnesses and disorders with the aim to improve mental health. It is highly vital that the learner interested in faring for the said subject of clinical psychology must be subjected to competencies which are targeted around the learner himself/herself. These may include those which grant the learner the right to choose the direction of his further studies or the topics of their choice combining all the domains of learning with special emphasis on the affective domain therein. In the academic year 2020–2021, an undergraduate course curriculum on clinical psychology was launched in the Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University), the curricular inclusions for which were the document of interest for the present study. It is vital to determine the standing of the curriculum prepared for a new course for undergraduates with regard to its centricity – learner based, subject based, or problem based. Here, the cognitive domain can be viewed in the subject-based inclusions. The present study attempts to delineate the curricular inclusions for the said curriculum of Bachelor of Science in Clinical Psychology under Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be university), as against typing of curriculum based on subject centricity. Materials and Methods: Rapid review of literature with reference to curriculum of Bachelor of Science in Clinical Psychology under faculty of Allied Health Sciences, Datta Meghe Institute Of Medical Sciences (Deemed to be University) in the academic year 2020–2021 for purpose of their “Typing” with principles of curriculum design was done. Results: The total number of curricular inclusions was 236. Ideally taking the ratio of curricular inclusions as 6:3:1, there should be 142 subject-centered inclusions, 71 problem-centered inclusion, and 23 learner–centered inclusions. Out of this, there were 184 inclusions which were observed to be subject centered, 40 inclusions were problem centered, and 12 were centered upon the learner. Thus, the overall percentage of typing of the inclusions was 77.96% subject centricity, 16.94% problem centricity, and 5.08% learner centricity. There was observed surplus of 42 objectives for subject centricity, deficit of 31 was observed for problem centricity and learner centricity showed a deficit of 11. Conclusion: The undergraduate course curriculum of Bachelor of Science in Clinical Psychology under Faculty of Allied Health Sciences included in the present study for typing of included curricular inclusions has been typed on the basis of their centricity upon the learner.

Background: Garhwali is spoken by people in Uttarkashi, Chamoli, Tehri Garhwal, Pauri Garhwal, Dehradun, Rudraprayag, and Haridwar districts of Uttarakhand, India. Aims and Objectives: The present study focused on the development of spondee words in Garhwali language. Materials and Methods: The final spondee word list included 50 words. A total of 30 adults were participated in the present study. The test started with obtaining thresholds of AC and BC between the frequencies 250 and 8 KHz of the individual. Results: The mean pure tone average for frequencies 500 Hz, 1 KHz, 2 KHz, and 4 KHz was 10.46 dBHL, then the spondee word list was presented at the level of 20 dBSL. The speech recognition threshold (SRT) mean threshold was 11 dBHL. Conclusion: This study provided evidence on the quality of being especially suitable for paired words for testing SRT in Garhwali people. This test material can be used in selecting appropriate rehabilitative options and also to measure the efficacy of different rehabilitative devices.

Background: Birth companionship, and continuous support during labor and delivery, can improve women's childbirth experience and birth outcomes. Aims and Objective: To assess the effect of Intra-natal Gentle Birthing Care (IGBC) on Labor Outcome. Material and Methods: The post-test only control group design and a evaluate approach was used on 30 parturient mothers who were admitted in the Krishna Hospital & Medical Research Centre, Karad. The Intra-Natal Gentle Birthing Care was administered in separate unit and post test for labor outcomes of parturient mothers was assessed. The informed consent was obtained from mothers. All calculations were carried out using SPSS V20. Results: Out of 30 (100%) mothers only 2(6.6%) mothers were administered injection Oxytocin and 2(6.6%) mothers' injection Drotin / Epidosin. Rest all 26(86.66%) mothers were not administered any type of analgesia and anesthesia. There was statistically significant difference found between Mean ± SD coping(with labor pain) score of the mothers who completed labor process within 6hrs, 8hrs, 10hrs and 12hrs (P<0.0001). Majority parturient mothers, 27(90%) completed 1st stage within 10 hours. Intra natal gentle birthing care was having significant effect on decent of fetal head and dilatation of cervix (P<0.0001). The Bonferroni multiple comparison test, 1st stage Vs 2nd and 4th stage, 2nd stage Vs 3rd and 4th stage, 3rd stage Vs 4th stage among all comparison showed significant difference(P<0.001) except 1st stage Vs 3rd stage (P>0.05).Conclusion: The mean coping score of parturient mothers was more and there was significant difference in mean score of duration of labor stages, cervical dilatation and decent of fetal head after administration of “Intra-natal gentle birthing care” thus the Intra-natal gentle birthing care was effective.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects individuals across social, ethnic, and geographic groups. Autistic children have difficulty with gross motor and fine motor functioning difficulties including a wide range of signs and symptoms. Toe walking due to tendo-achilles (TA) tightness is commonly observed gait in autistic children altering foot posture in them. The knowledge about the abnormalities may be useful for the assessment and treatment planning of ASD children. Material and Methods: We evaluated TA tightness, ROM of the ankle joint, and compare the effect of Manual Therapy (MET) and conventional therapy for improving TA flexibility and foot posture. Procedure: A comparative study included twenty diagnosed autistic children as per inclusion criteria which were divided into two groups, Group A was given conventional therapy in the form of passive stretching, whereas Group B was given manual therapy in the form of muscle energy technique. The participants were clinically examined and evaluate TA tightness in the form of elastography, range of motion, and foot posture. Data were taken at baseline pre and after postintervention. Results: There was a significant improvement in elastography readings, range of motion, and foot posture index in both groups postintervention but significant improvement was observed in Group B as compared to Group A, i.e., P > 0.05. Conclusion: It was concluded that there is a significant effect of manual therapy in the form of muscle energy technique for improving TA flexibility and foot posture as compared to conventional therapy.

Objectives: Oxidative stress (SOX) in overt hypothyroidism (OHT) has been reported with unclear outcomes. Furthermore, the studies assessing SOX in subclinical hypothyroidism (SHT) were limited. Our present study was taken up to establish oxidative/antioxidative status in hypothyroids patients. Design and Material and Methods: One hundred and seventy-six patients with hypothyroidism diagnosed as OHT (n = 176) or SHT (n = 176) were included along with 176 healthy euthyroid controls. Serum lipid profile, malondialdehyde of plasma (MDA), protein carbonyls (PCO), glutathione reduced (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT), and antioxidant enzyme ratio SOD-to-(GPx + CAT) were projected. Results: Compared with euthyroid controls, hypothyroid patients had dyslipidemia, notably higher MDA concentrations and PCO, significantly reduced GSH, SOD, SOD/(GPx + CAT) ratio and a noteworthy increase in GPx activity. Although CAT activity in hypothyroids was unchanged when compared to euthyroid controls. In OHT patients, the SOX was markedly more when compared to SHT patients. MDA had a positively associated with excess TSH in the OHT group. fT3 and fT4 showed positive and negative correlation, respectively, with TC, whereas TSH showed a positive correlation with low-density lipoprotein cholesterol in the OHT group. PCO was seen to have positive relations with TSH and MDA in hypothyroids. Conclusions: We found increased peroxidation of lipid, carbonylation of protein, and diminished antioxidant defense system in hypothyroids. Higher points of SOX were seen in OHT patients than SHT patients. SOX was related to change in hormone condition related to hypothyroidism.

Background: Coronavirus disease (COVID-19) is making these terrifying and unsure occasions. We as whole have a story to tell-whom we know, how we are being affected and how our lives are evolving. Certain patient populaces are confronting remarkable encounters and difficulties. The proof on prebirth, intrapartum, and baby blues hazards and transmission is restricted, the circumstances are quickly evolving. We do realize that in pregnancy, immunologic, and physiologic changes do happen, which could make pregnant ladies more defenseless to viral respiratory diseases, including COVID-2019. The World Health Organization has acknowledges that the hard work and selfless service provided by India's health workers, including nurses and midwives, have no doubt contributed to the country's impressive recovery rate of 31.5%. In a series of profiles, nurses described their challenges in keeping their charges and themselves safe on a COVID-19 repatriation flight in hospital and ICUs, providing antenatal care, elderly care, and psychosocial support in the context of COVID-19. Objective: The aim of this was to assess the knowledge of nurses regarding the management of pregnant women during COVID-19. Materials and Methods: A Nonexperimental Descriptive Research Approach is used. Sixty samples were selected using Nonprobability Purposive Sampling Technique. Data were collected using knowledge-based questionnaire on the management of pregnant women during COVID-19 outbreak through online Google form. Results: The tool included two sections; the first section had demographic data and the second section included an assessment of the knowledge of nurses regarding the management of pregnant women during COVID-19 outbreak. The data were analyzed further which revealed that the study findings show that the majority (55%) of the staff nurses are having age between 22 and 30 years. It also shows that 55% were female and 45% were male nurses. The majority of nurses (60%) were done BSc nursing. Majority of them having experience between 0 and 5 years (25%). The assessment is made for the knowledge of nurses regarding the management of pregnant women during COVID-19 of the rating were selected from YES or NO. The assessment result shows that majority of the nurses are having knowledge regarding the management of pregnant women during COVID-19. Conclusion: The findings indicate that the questionnaire was effective in assessing the knowledge of nurses regarding the management of pregnant women during COVID-19.

Background: To evaluate the knowledge and awareness of consent among interns and post-graduates of Jawaharlal Nehru Medical College,Sawangi (Meghe),Wardha. Objectives: To study about awareness of consent. To study the knowledge of obtaining consent in special circumstances like Medical management of Minors and drunken persons, etc. Materials and Methods and Study Design: Cross sectional Observational study. Collective sampling method. Sample size: 200 students (Interns and residents) studying in JNMC & AVBRH were included by purposive sampling method. A semi-structured questionnaire was prepared to obtain all the information. Study duration: 6 months. Inclusion criteria: Interns and Post-graduate students. Exclusion criteria: Not willing to participate.

Objective: C-peptide has been the most technically appropriate and theoretically reasonable substitute for β-cell activity. In equimolar concentration, insulin and C-peptide are co-secreted into the portal circulation. Methods: A total of 150 participants of diagnosed diabetes mellitus (DM) and 18–45 years aged were studied. Those diabetics were classified into three groups supported by fasting serum C-peptide (FC) level and low FC cluster comprised participants with FC level <0.6 ng/ml. Intermediate FC group comprised subject with FC level >0.6–1.8 ng/ml and high FC group comprised participants with FC >1.8 ng/ml. Results: The cutoff set of C-peptide was taken as 0.3–2.45 ng/ml. The prevalent diabetes among males was 85%–65% female. For the 150 diabetic participants, 18 (12%) were classified as type 1 DM (T1DM), 77 (51.3%) with type 2 DM, and the rest 55 (36.7%) as latent autoimmune diabetes in adults or MODY were perceived. In participants with T1DM, the mean serum C-peptide was slightly lower than in other diabetes forms. Considering the family history of diabetics in our research, detectable C-peptide in people with the family experience of diabetes was identified. Family diabetes history presence was seen in 15.5% of type 1 DM T1DM cases, while 84.5% of the remainder of the cases. Such classification is focused solely on family records and C-peptide rates which are subject to antibody screening, a genetic study for improved identification of the forms of diabetes. Conclusions: This result indicates that the diabetes measure C-peptide should be used in scientifically linked diabetes diagnosis, diabetes period, and subject age for appropriately managing persons with diabetes.

Introduction: Ectopic pregnancy is one of the life-threatening complications that can occur in any sexually active woman during reproductive age. Changing trends have been observed because of the availability of assisted reproductive techniques, better diagnostic facilities, conservative management approach, newer drugs for medical termination of pregnancy, and newer contraceptives. Materials and Methods: This was a cross-sectional study of all cases of ectopic pregnancy managed at the tertiary care center from January 2009 to December 2013. In all, there were 64 cases of ectopic pregnancies. Most of the women were between 20 and 30 years age and all except three were married. Risk factors could be identified in about 50% of women only. Results: The classical triad of amenorrhea, pain, and bleeding per vaginum was seen in 28.12% of subjects. Most of them were tubal ectopic pregnancies but we had one case of secondary abdominal pregnancy, two cases of heterotrophic pregnancy, one case of twin tubal pregnancy, and two cases of cornual pregnancy. All the cases were managed by laparotomy. An unsuccessful attempt to terminate a second-trimester pregnancy by the medical method should arouse suspicion of cornual pregnancy. Conclusion: History of use of levonorgestrel – emergency contraceptive pills should be looked for apart from other risk factors. Though not mandatory, ultrasonography should be done to rule out ectopic pregnancy, before terminating a pregnancy by the medical method.

Introduction: COVID-19 pandemic is the most daunting challenge for humankind in the current scenario. Healthcare personnel (HCPs) being at forefront dealing with pandemic, have been prioritized to get inoculated against COVID-19. However, literature has limited information regarding HCPs intention to get vaccinated and their concerns regarding the same. Therefore, this study was done to assess Indian HCPs awareness, attitude, and perception toward the COVID-19 vaccine. Materials and Methods: An online cross-sectional study was conducted using the convenience sampling method. A validated questionnaire was designed in English and was mailed to all the participants through link of Google form and also through social media platforms. A total of 815 HCPs responses were obtained. Results: Of the 815 responses 452 were willing for the COVID-19 vaccine. Five hundred and eighty-three HCPs have shown trust in the Science and Ministry of Health for the development of safe and effective vaccines. Four hundred and sixty-one of HCPs were of the opinion that India is going slow on the vaccination drive and 620 of them feel the need to accelerate the drive. Conclusions: High acceptance and low hesitancy for COVID-19 vaccine demands increased vaccine coverage by Indian HCPs. Addressing this demand requires possible intervention by the participation of the private sector which will help to accept the national vaccination program to a wider scale, thereby combating the future wave of the pandemic.

Purpose: Patient satisfaction plays a critical role in determining the competitiveness of health-care organizations. This study is aimed to develop and test a comprehensive conceptual model of the antecedents and outcomes of patient satisfaction, to establish the relationships between the variables. Methodology: The relationships between them were tested using partial least squares-structural equation modeling technique (PLS-SEM), utilizing a sample of 348 patients from dialysis centers in the state of Goa in India. Results: Patient satisfaction was found to mediate the relationship between antecedent-service quality and outcomes – trust, loyalty, and word of mouth. Similarly, trust was found to mediate the impact of patient satisfaction on loyalty and word of mouth. Research Implications: The study integrates the scattered literature on the topic, providing a holistic model with novel insights, which will help researchers in understanding and analyzing the impact of variables influencing as well as influenced by patient satisfaction. Practical Implications: The study determines and shows the importance of antecedents such as trust in health care. While health-care organizations should improve patient satisfaction, they should not stop only at patient satisfaction but rather further work on building trust. Trust, in turn, helps to build patient loyalty and positive word of mouth. The model shows how patient satisfaction and trust play key roles in influencing loyalty and word of mouth, which are important for competitive reasons. Thus, a complete understanding of the findings will assist practitioners in improving the competitiveness of their organizations. Originality/Value: A lot of research exists on the antecedents of patient satisfaction, namely service quality, and outcomes of satisfaction, namely loyalty and word of mouth. On the other hand, there exists limited research on constructs such as trust and its impact on loyalty and word mouth. This research combines both to develop a comprehensive model and tested it using PLS-SEM, providing important findings. The testing of model in dialysis centers adds a novel feature, since not much research is done in this setting. Conclusion: A comprehensive model linking the antecedents and outcomes of patient satisfaction was developed and tested in the dialysis departments of 8 hospitals and all the 9 hypotheses developed were supported.

Background: In recent decades, the overlap between thyroid abnormalities and renal diseases has been a serious concern. Thyroid hormones are required for the kidney's embryological development and growth. On the other hand, thyroid hormone metabolism, degradation, and elimination are all influenced by the kidney. It has been discovered that people with kidney disease, particularly those on dialysis, have a significant prevalence of thyroid abnormalities. Subjects and Methods: Total of 89 patients had hemodialysis dialysis at the IQ City Medical College and Hospital during the study period. Patients with thyroid disorders, taking thyroid hormones, having a thyroidotomy, and having a family history of thyroid disorders were excluded, as were patients on thyroid-affecting medications (amiodarone, glucocorticoids >50 mg, phenytoin, or lithium), patients under the age of 20, and patients who had recently undergone contrast imaging. Results: Dialysis patients were on average 57.6 14.5 years old. We discovered 15 (16.9%) hypothyroid patients among the 89 participants included in this study. There were 8.9% of people with overt hypothyroidism and 7.8% with subclinical hypothyroidism (SCH). Only one patient (1.1%) had subclinical hyperthyroidism, while none of the others had overt hyperthyroidism. The baseline characteristics of euthyroid with overt hypothyroidism and SCH hypothyroidism patients were studied. When compared to euthyroid patients, no significant differences in age, gender, dialysis duration, weight, or comorbidities (hypertension and diabetes) were detected. As for laboratory variables, creatinine was significantly lower in overt hypothyroid patients compared to euthyroid patients (P = 0.01) and we also detected a significant difference between SCH and euthyroid in bicarbonate level (P = 0.02). Conclusion: Hypothyroidism, including SCH and overt hypothyroidism, was common among dialysis patients. Even with euthyroid dialysis patients, hypothyroidism symptoms are common. Because of the overlap between End-stage renal disease (ESRD) symptoms and hypothyroidism, identification of hypothyroidism is challenging, and it is commonly ignored in the ESRD population. Early detection and treatment of hypothyroidism protect the patient's health from deteriorating and increases their chances of survival.

Spindle cell sarcoma of the thigh is a rare entity. It is important to raise the awareness and improve clinical diagnosis. Spindle cell sarcoma often presents as a recurrent swelling at the primary site with many patients having pulmonary metastasis on further examination. The current study presents a case of spindle cell sarcoma with clinical, imaging and pathological examination of a 30-year-old male who presented to Acharya Vinobha Bhave Rural Hospital, Sawangi, (M), Wardha, with recurrent swelling on right thigh with a huge mass on the left anterior chest wall and severe emaciation.

Lumbosacral (L-S) radiculopathy is one most common reasons for low back pain occurring due to etiologies of discopathies and lumbosacral disc herniation. The treatment which is used for radiculopathies is pain killers, physiotherapy, and spine surgeries. Many of the patients opt for conservative treatment and one of the better conservative treatments is through yoga therapy. The case study reveals electrodiagnostic findings before and after completion of yoga therapy module given for 3 weeks duration. Electrodiagnostic findings show improvement in the nerve conduction study parameters after the yoga therapy was given. The result of the case study reveals that yoga therapy module may be used as a complementary tool for conservative treatment purpose of L-S radiculopathy.

During biomechanical preparation of root canal, the most common mishap is instrument separation within the canal. When instrument separation occurs, it causes hindrance in proper cleaning and shaping of the canal. Therefore, retrieval of separated instrument can always be attempted, and if retrieval is not possible, bypassing of the fractured instrument is another option. Due to the increase in use of nickel-titanium instruments in the recent years, incidences of instrument separation have increased. Successful retrieval of separated instrument depends on a number of factors. Various retrieval kits are also available for this purpose. This paper illustrates a case report of retrieval of a fractured instrument from mesiobuccal canal of a mandibular molar using a modified 18-gauge needle, which was separated during chemomechanical preparation of the canal.

Epistaxis is often encountered among pediatric patients as otorhinolaryngological emergency. However, massive epistaxis in a child is extremely rare, especially arising from the pseudoaneurysm of the cavernous part of the internal carotid artery (ICA). Here, we present the case of a 13-year-old boy presented with the sudden onset of massive epistaxis with a previous history of head injury 1 month ago. The nasal bleeding was controlled by nasal packing followed by computed tomography angiography confirmed the diagnosis of cavernous ICA pseudoaneurysm. Then, the patient underwent endovascular coil embolization and symptom free at 6 months and 1-year follow-up. Massive epistaxis in a pediatric patient is a potentially lethal clinical condition. It needs timely diagnosis and early treatment.

Schwannomas are benign neurogenic neoplasm arise from the peripheral Schwann cells of the nerve sheaths. These tumors present as solitary and encapsulated lesions. Intraoral schwannoma is not commonly found in the palate and extremely rare at the junction of hard and soft palate. These benign lesions are slow-growing tumors with low potential for malignant transformation and need complete excision as treatment. As it has uncommon occurrence and nonspecific clinical presentations, the diagnosis is usually confirmed by histopathological examination and immunohistochemical evaluation. Here, we report a case of a large schwannoma at the junction of the hard and soft palate, which is an extremely rare location of this tumor.

The mucosal epithelium of the oral cavity plays a vital role in protecting the hard tissue, from mechanical, bacterial and chemical aggressions. This seal is made by the junctional epithelium and by collagen fibres. The screw bone builder (GF0) from TRATE, is a cover screw that will be used during the implant placement to cover the implant. The cover screw platform will not be in contact with the implant platform. After screwing the GF0, it will always maintain a space of 1mm between the two platforms implant and cover screw. This space will be a room for the bone to grow and to fill this space. Hence this case series describes a modified cover screw to enhance long term bone stability around two-stage implants.

Clinical diagnosis of septicemia in neonates is challenging as symptoms and signs are vague. Blood culture, the gold standard test takes at least 48–72 h to get a positive culture report and 5–7 days for reporting negative results. Blood culture may give false negative results in about 30% cases due to blood specimen being collected after antibiotic therapy or low volume of specimen or fastidious and slowly growing organisms. There is a need of rapid, sensitive, specific, diagnostic test for neonatal septicemia that can detect all relevant microorganisms in a low blood sample and is not affected by maternal antibiotics. In view of all the above mentioned facts this article focuses on the laboratory methods evaluated for the diagnosis septicemia in neonates.

Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male neonates, with an incidence of 1 in 8000–25,000 live births. The clinical course of PUV diagnosed late in life is quite unpredictable. The prognosis of late-diagnosed PUV depends chiefly on the renal function at presentation. A literature search was performed on the delayed presentation of PUV. Serum creatinine at presentation, nadir serum creatinine (defined as the lowest creatinine attained in the year after valve ablation), and renal parenchymal echogenicity were significant predictors of final renal outcome. A generalization cannot be made regarding the prognosis of late-presenting PUV patients. The prognosis varies from case to case. If renal function at presentation and after valve ablation is preserved, then late-presenting PUVs carry good prognosis. Age per se does not carry any prognostic significance.

Platelet-rich fibrin (PRF) is an autologous platelet concentrate with intimate assembly of cytokines, glycan chains, and structural glycoproteins, increased concentration of growth factors enmeshed within a slowly polymerized fibrin network, has the capability to accelerate soft tissue as well as hard-tissue healing. Platelets play a crucial role in the field of regenerative dentistry. A systematic search was conducted using Scopus, Medline PubMed, and Google Scholar up to and including March 2017, to identify relevant studies. All cross-reference lists of the selected studies were also screened. The inclusion criteria were articles those having detailed summary in English, published between 2006 and 2017. This review article concludes the literature in brief, role of PRF in healing, its clinical applications, and also the advantages and the disadvantages.