With multiple options available to restore an endodontically treated tooth, endocrowns represent a simple, conservative, and esthetic alternative to conventional crowns. Endocrown is a one-piece restoration, usually indicated in cases with decreased crown height. The preparation comprises “sidewalk” as the cervical margin and a preparation into the pulp chamber that may or may not extend into the root canals. It prevents interferences with periodontal tissues, due to the presence of supragingival position of the restoration margins. The rationale of this technique is to use the surface area available in the pulpal chamber to assume the stability and retention through adhesive procedures. Principally, endocrowns are full ceramic restorations. A case report is presented here, where a porcelain-fused-to-metal endocrown was fabricated using the similar protocols and clinical procedures.

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Objective: The objectives of this study are to study the pattern of tobacco use in Indian school children aged 10–15 years in Wardha district and to study the role of psychosocial factors in initiation and prevention. Materials and Methods: A descriptive questionnaire cross-sectional study to evaluate the patterns of tobacco use in India among school children aged 10–15 in Wardha district. Results: Of the total of 1000 children selected, 5.9% were tobacco users and out of these 3.7% claimed to be addicted to it. Among the habitués, the mean age of initiation of tobacco use was 11.65 ± 2.62. The possible causes being peer pressure (35.08%), tension (49.12%), to achieve the aim (5.26%) and influence from parents (10.52%). Among the habitués, a mean number of 2.71 ± 2.03 children were using tobacco regularly with the range of 1–5 times per day. Conclusion: The peer group influence was the reason for initiating this habit in majority of the users. It is better to prevent the initiation of the habit than trying to stop the habit. The present study suggests the need for school-based tobacco prevention programs. Joint efforts from family, school, and social welfare groups are needed to address these factors for effective prevention, in addition to raising awareness against tobacco use among the school students.

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All-ceramic restorations are widely and successfully used for a fixed dental prosthesis. The properties such as biocompatibility, high strength, and superior esthetic have made this veneering material popular among the dental practitioners and patients. This case report describes the enhancement of esthetics by replacing missing anterior teeth with a zirconia-based all-ceramic prosthesis.

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Context: In the Indian subcontinent and Southeast Asia, habit of chewing areca nut has been recognized as one of the most important risk factors leading to a ubiquitous oral potentially malignant disorder (OPMD), oral submucous fibrosis (OSMF).In OSMF, owing to fibrosis in the connective tissue, there is narrowing of blood vessels which further results in compromised blood supply to the local tissue milieu. This tissue hypoxia elicits the activation of the transcription factor Hypoxia-inducible factor 1-alpha (HIF-1 α). In OSMF, its expression shows significant correlation with degree of epithelial dysplasia. Aim: This study aims to evaluate the expression of HIF-1 α in OSMF. Settings and Design: Seventy-five histopathologically proven cases of OSMF were included in the study. The tissue sections were studied for histopathological evaluation and HIF-1α expression. Statistical Analysis Used: Descriptive and inferential statistics using one-way ANOVA and multiple comparison using Kruskal–Wallis test were used. Results: Comparison of HIF-1α expression in different grades of OSMF was done. There were 47 cases without dysplasia, whereas 16 and 12 were of low-risk and high-risk dysplasia, respectively. On comparison of HIF-1α expression in different grades of OSMF, it was found to increase significantly from normal oral mucosa (1.43 ± 0.89) to no dysplasia (3.97 ± 2.75) to low-risk epithelial dysplasia (4.93 ± 1.76) to high-risk epithelial dysplasia (5.66 ± 2.01). Conclusion: The altered expression of HIF-1α can signify the disturbed epithelial-mesenchymal interaction which indicates progression toward the malignant transformation of OSMF. Thus, HIF-1 α expression showed good correlation with increase in grades of epithelial dysplasia and thus can assist for grading/quantifying oral epithelial dysplasia in OSMF.

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Aim: The aim was to do appropriate screening of the patients of primary open angle glaucoma (POAG) visiting ophthalmology OPD in AVBRH, Sawangi(Meghe) and to compare Visual Acuity(VA), Intraocular Pressure(IOP) retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) and visual field defects(VFD) with age and sex. Materials and Methods: In this cross-sectional, observational, clinical study ,100 eyes of 50 patients with POAG above 40 years of age were examined. They underwent investigations like visual acuity, intra ocular pressure, fundus examination, gonioscopy, optical coherence tomography (OCT) of optic disc examination and perimetry. Only patients who had intraocular pressure (IOP) greater than 21 mmHg were enrolled into the study. Results: A total of 100 eyes of 50 patients were examined. Mean age of 50 patients was 54.22±13.28 (25-82 yrs), out of which, were 54% were females and 46% were males. At presentation,34% had blurring of vision and 16% had eye pain or photophobia. The mean IOP was 27.49±5.50 mmHg, and the mean CDR was 0.65±0.1. Conclusion: Visual Acuity(VA),Intraocular Pressure(IOP) retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) and visual field defects(VFD) are correlated to each other and show a correlation with age but not with gender.

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The term plexiform unicystic ameloblastoma (UA) refers to a pattern of epithelial proliferation that has been described in the cystic cavity. Due to the unilocular presentation, it is commonly misdiagnosed with an odontogenic (dentigerous) cyst. However, they may often behave clinically as biologically aggressive tumors. The location of the UA within the jawbones shows a marked predominance of the mandible irrespective of the variant. The posterior mandible, including the ascending ramus, is the region most often affected in both variants. In the present case too, the ramus was primarily involved. These tumors show a high incidence of cortical perforation, tooth resorption, and a high rate of recurrence after simple enucleation. Hence need to be carried out of segmental resection due to the extensive size of the lesion. This case report aims to provide an insight into this biologically and radiographically distinct entity. An accurate and timely diagnosis of the character and extent of UA should be done which is only possible after a thorough microscopic examination of the lesion. A literature review on the topic has been added along with a case report highlighting the approach of diagnosis and management of such ameloblastomas.

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A 32-year-old male presented with chief complaint of ocular injury in the left eye, in spite of wearing a helmet, in a road traffic accident. His uncorrected visual acuity in the injured eye was 6/9, and he had a full thickness lid laceration. There was a 25 mm upper eyelid laceration at the level of the eyebrow, splitting it horizontally. Early repair resulted in less tissue edema and better wound decontamination. We report this case to highlight an unusual mechanism of injury by the pro shield of a helmet and to show the need for eye protection in spite of wearing a helmet.

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Objectives: The objectives of this study were to study the mentolabial sulcus in Nepalese, to compare the sulcus between male and female, and to classify the sulcus according to the angle. Materials and Methods: This study was conducted in 160 university students (65 males and 95 females) between April and September 2016. Photographs of all the students were taken using a digital camera. Mentolabial sulcus angles were measured from the lateral photographs using an angle instrument. The data were analyzed using SPSS 22. The comparison of sulcus between male and female was done using two-sample t-test at 95% confidence interval. Results: The mean mentolabial sulcus angle in Nepalese was 118.19° ±12.28° (male: 119.43° ± 9.99° and female: 117.61° ± 13.23°). There was no statistically significant difference of sulcus angle between males and females (P = 0.098). The sulcus was classified as deep, average, and shallow in males and females. In total students, the average was more predominant followed by deep and shallow. Conclusions: The mean mentolabial sulcus angle in Nepalese was 118.19° ± 12.28°, in male was 119.43° ± 9.99°, and in female was 117.61° ± 13.23°. The sulcus was classified as deep, average, and shallow. There was no statistically significant difference of sulcus angle between males and females. The average type of sulcus was more predominant in Nepalese.

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Introduction: Tumors of the central nervous system (CNS) are rare neoplasm constituting <2% of all malignancies. In India, CNS tumors constitute about 1.9% of all tumors. The objective of this study is to have an insight into the pattern of CNS lesions over a period of 3 years in a tertiary care hospital retrospectively. Materials and Methods: A retrospective study was conducted at the Department of Pathology, Pandit Bhagwat Dayal Sharma, Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, a tertiary care hospital, over a period of 3 years. Two hundred and thirty-nine cases of CNS lesions reported during this period comprised the patients of the study. All data and information were archived from the case records maintained in the histopathological division of the Department of Pathology. Results: The age of the patients ranged from 2 to 65 years, with the mean age of 43.28 years. Majority of the cases were seen in the age group of 28–58 years (70%). Overall, males slightly outnumbered females; however, meningioma is an exception with higher rates in females. Majority of tumors were intracranial (96.2%) and remaining (3.76%) were spinal. Of the intracranial cases, frontal lobe was the most common site (25.5%) followed by temporoparietal lobe (13.2%). Astrocytomas comprising 84 (35.2%) cases constituted the largest group of the present study, followed by meningioma constituting 22.2% of all CNS tumors and glioblastoma forming the largest subtype of astrocytic tumor (35.7%). Among 16 pediatric cases, astrocytomas (6 cases) were more common as compared to medulloblastoma (4 cases). Conclusion: The most frequent type of CNS tumor in the present study was astrocytoma, followed by meningioma. The ratio of male: female for all CNS tumors was 1.06:1. Females outnumbered males in meningioma (2.8:1).

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Objective: The aim of this study was to find the occurrence of dental caries and gingivitis among pregnant women and to compare it with those in nonpregnant women. Materials and Methods: A total of 303 pregnant and 238 nonpregnant women were recruited from the Department of Obstetrics and Gynaecology, Acharya Vinoba Bhave Rural Hospital, Sawangi (M), Wardha. Dental caries and gingivitis were defined clinically according to the World Health Organization (WHO) diagnostic criteria. Results: Over 63.3% of pregnant women had caries, and 71.9% had gingivitis. A significant difference came out between pregnant women and nonpregnant women with regard to dental caries (P = 0.0001) and gingivitis (P = 0.0007). The pregnant women were 2.2 times more likely to suffer from dental caries and 1.94 times more from gingivitis compared to nonpregnant women. Dental caries was significantly seen in pregnant women above 25 years of age, illiterate, and homemakers. Poor oral hygiene, poor dental care knowledge, and poor attitude were all important risk factors for dental caries and gingivitis. Conclusion: Proper dental healthcare programs should be conducted to improve the dental health and to increase the awareness of hygienic practices in pregnant women.

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Objective: To study maternal and neonatal outcome in postdated pregnancies. Study Design: Prospective observational study. Results: Of 100 cases 79(79%) cases were under 20 to 25 years, majority cases were primigravida (62%), overall caesarean rate was 34%, Meconium stained liquor with fetal distress was the most common indication for LSCS 8(23.5 %) , fetal distress was the most common fetal complications, rate of NICU admission was 33.33% at 41 weeks 1 day to 42 weeks, rate of induced labour is 71.43% at 41 weeks 1 day to 42 weeks. Conclusion: In our study we concluded that prolonged pregnancy was associated with significant risk of perinatal complications like fetal distress, meconium aspiration syndrome and IUGR. There was significantly increased risk of obstetric complications like oligohydramnios, perineal tear, atonic pph and shoulder dystocia.

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Introduction: Following traumatic brain injury (TBI), there are different innovative approaches to improve or enhance the recovery of brain. Musical therapy has shown promising results in better improvement of TBI patients. Such studies from our country are meager. The present study investigates the effect of musical therapy on TBI patients who have undergone brain surgery. Methodology: It is a prospective study conducted at Tertiary Hospital at Nellore. Moderate-to-severe brain injury patients who have undergone neurosurgery were selected. Three Indian classical ragas were selected and given as follows; Hindola in the morning, Todi in the afternoon, and Kalyani in the evening. The mp3 music was given over earphones at specific time for 30 min duration throughout a week. Vitals parameters such as heart rate, systolic blood pressure (SBP), respiratory rate, pupillary movement, and motor activity of patients were documented before and after music therapy. The SPSS version 20.0 software was used for statistical analysis. Results: Ten selected patients were undergone through predefined session for three times a day with consecutive 7 days. Mean age of the patients was 48.5 (23–71 years) and majority (90%) were male. Two hundred and ten responses of each, like this for ten patients, heart rate changes were observed in 77% with mean change of 0.92 units. On average, 5.20 units heart rate was decreased and 6.20 units increased after music therapy. Changes in SBP were observed in 63%with mean change of 1.36 units. About 9.10 units were lower and 10.95 units were higher after therapy. Nearly 64% responses of patients were changed for respiratory rate, with mean change of 0.13 units. On an average of 3.00 units, respiratory rate was decreased, and 4.22 units increased after musical therapy. Conclusion: The present study reports that musical therapy for TBI patients after neurosurgery has an important role in changing the vitals parameters such as respiratory rate, heart rate, and SBP. Detail prospective studies with larger number of patients are required to get in-depth knowledge on effect of musical therapy.

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Aims and objectives: 1. To study the rotator cuff pathologies and association of rotator cuff pathologies with acromion morphology and biceps (long head) pathologies. Material and Methods: 100 patients clinically suspected of rotator cuff pathologies were evaluated using 1.5 tesla MRI for the rotator cuff tendon tears/tendinosis and associated acromion morphology and biceps tendon(long head) pathologies. Results : The average age of the patients was 41.73±16.55 years with male dominance (84%).Out the 100 patients, supraspinatus was the most common pathological tendon with 81% cases showing abnormalities. The rotator cuff tears were more common in the later age groups and tendinosis more common in the early age groups. Partial tears of rotator cuff were more common than complete tears.58% cases showed partial tears in supraspinatus as compared to 14% cases of complete tears. Articular surface tears were most common partial tears seen in 46.5% cases.Variation in the acromion morphology Biceps(long head) pathologies showed positive correlation with the rotator cuff pathologies Conclusion: MRI is a valuable modality to diagnose and characterise the rotator cuff and associated pathologies.

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Introduction: As per the WHO estimates in 2013, about 289,000 women died of complications related to pregnancy or childbirth. The present study aimed at assessing the status of birth preparedness (BP) and complication readiness (CR) among rural pregnant women and its correlates in coastal Karnataka in Southern India. Methods: This cross-sectional study was conducted in Udupi taluk. In all, 305 pregnant women in the second and third trimesters of pregnancy were interviewed. Two-stage cluster sampling was used to select 320 women. To achieve this sample size, of 16 clusters using simple random sampling, 20 pregnant women in the second and third trimesters were selected from each village with the help of lay health workers in the community. Results: Among 305 pregnant women, 157 pregnant women (51.47%) were prepared to face birth. The factors associated with preparedness were awareness about expected date of delivery (odds ratio [OR] = 2.48, 95% confidence interval [CI]: 1.15–5.35) and at least one danger sign during delivery (OR = 2.88, 95% CI: 1.28–6.51). The identification of skilled birth attendant and arrangement for transportation were high at 99% and 100%. However, only about 42.3% of the respondents had identified a health facility for an emergency. Conclusion: The low preparedness level may be due to inadequate maternal knowledge on BP/CR practices as a result of inadequate information being provided to pregnant women. This study places emphasis on the need to plan and implement training programs for the health-care providers (ASHA, auxiliary nurse midwife's, staff nurse) on the components of BP/CR.

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Background: Delayed reporting is a common problem in patients with low socioeconomic group and may be responsible for advanced stage disease. Aim: To evaluate association of socioeconomic risk factor with patients delay in presentation of Oral Squamous Cell Carcinoma (OSCC). Material and Methods: Thorough case history of 120 histopathologically confirmed OSCC patients was taken and were categorized according to TNM staging. Their SES was assessed by Aggarwal OP et al (2005) scale. Patients delay in presentation was calculated by measuring the time between the onset of the first symptoms of OSCC and the first consultation with primary health care provider. Association of socioeconomic status (SES) with patients delay in presentation was sought. Observations and Results: Out of 120 OSCC patients, there were 04 (3.33%) patients from stage II, 31(25.83%) from stage III, 85 (70.83%) from stage IV. Thirteen (10.80%) patients reported within 3 months of onset of the first symptoms, 14 (11.66%) patients reported upto 3 months, 72 (60.00%) reported between 3-6 months, 20 (16.66%) between 6-9 months and 14 (11.66%) between 9-12 months. Association of clinical staging and patient delay was sought by subjecting to chi square test, and the x2 value was 43.80, P = 0.0001, suggesting statistically significant difference. An association of clinical staging, SES and period of patient's first presentation was also carried out and data subjected to chi square test which was statistically significant in all the subgroups of SES. Conclusion: From this study, it can be concluded that there is significant association of socioeconomic status with patients delay in presentation of oral squamous cell carcinoma

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Background: Fast-track cardiac anesthesia refers to extubation within 6 h of the end of surgery, whereas ultra-fast-track anesthesia (UFTA) refers to extubation within 2 h of the end of surgery. Objectives: We have tested a protocol for early extubation to see safety, efficacy of ultra-fast tracking, and its cost containment in the present study of forty patients in cardiac surgery department in a tertiary care rural center. Materials and Methods: We have observed in our study the outcome of UFTA on a set of forty patients posted for cardiac surgery, using a protocolized approach and have prospectively noted the duration of mechanical ventilation, extubation time, length of Intensive Care Unit (ICU) stay, rate of re intubation, and other complication. Results: Extubation could be achieved within 30 min in 29 patients (72.5%). Mean length of ICU stay could be cut to 1.6 days (39 h). 55% patients could be mobilized on postoperative day 1, With approximate cost savings of 5000 rupees/patient/day. No cases of reintubation or serious complications noted. Conclusion: Ultra-fast-tracking is found to be feasible in our cardiac surgical setup. It is safe in all age groups, with proper selection of cases and rational utilization of available resources, besides it is found to be cost-effective.

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Objective: To study the risk factors responsible for diabetic retinopathy (DR). Material and Methods: One hundred and six cases of DR were included for the study. Detailed history including age and sex of the patient, duration of diabetes, anterior segment, and detailed fundus examination was carried out. Fasting blood sugar (FBS), postmeal blood sugar (PMBS), hemoglobin A1c (HbA1c), serum magnesium, lipid profile, and microalbuminuria were performed. Results: Of 106 patients of DR, 69.81% were males and 30.18% females. Average duration of diabetes was 7.67 years. Average age was 57.16 years. Nonproliferative DR (NPDR) was present in 87.73% and proliferative DR (PDR) in 12.26%. Raised FBS was present in 78.30%, raised PMBS in 69.81%, raised HbA1c in 77.35%, hypomagnesemia in 22.64%, and microalbuminuria in 7.55% patients. Raised low-density lipoprotein was present in 32.11% NPDR, 3.67% PDR, 19.81% clinically significant macular edema (CSME). Raised triglycerides were present in 37.74% NPDR, 1.88% PDR, and 21.70% CSME. Raised total cholesterol was present in 28.30% NPDR, 1.88% PDR, and 18.87% CSME. Conclusion: Risk factors for developing DR were duration of diabetes, uncontrolled blood sugar, raised HbA1c, hypomagnesemia, presence of microalbuminuria, and raised serum lipids. Therefore, good glycemic control with early diagnosis and management is required to prevent DR.

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Objectives: To study the clinical profile of patients with thyroid swellings. To study the radiological findings of these patients. To study the histopathological outcome. To correlate these factors in order to make diagnosis of malignant thyroid swellings in patients more accurate. Study Design: The present study: 'Study and correlation of clinical, radiological, cytological with histopathological findings in the diagnosis of thyroid swellings' was carried out in Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi Wardha from July 2013 to October 2015 It was carried out as a cross sectional observational study involving OPD based patients requiring further management. The sample size was fixed at 60 patients. All the patients of any age and either gender having goitre requiring surgery were included. Every patient was evaluated in terms of detailed history, thorough examination and relevant investigations. Results: Out of 60 patients, 51 (85%) were female and 9 (15%) were males. Maximum i.e. 22 (36.67%) cases belonged to the age group 41-60 years. More than half i.e. 34 (56.67%) of the patients came with a swelling on one side of the neck. 11 (18.33%) patients came with complains of Solitary nodule of Thyroid. The main complaint was anterior neck and was of grade 3 as per WHO Grading in 28 patients (46.67%). The duration of swelling was between 1-7 years in 30 (50%) patients followed by < 1 year in 17 (28.33%) patients. On clinical examination, 53 (88%) were diagnosed as benign and remaining 7(22%) as malignant swellings. Later on FNAC (done under ultra sound guidance), 8 (13%) patients were diagnosed with malignant swellings. Malignancy was noted in 13 (21.67%) cases on histopathology. A correlation between the diagnosis made pre-operatively on clinical examination, USG and FNAC was made with the Gold Standard for diagnosis of malignant thyroid swellings i.e. Histopathology. Conclusion: Goitre was common in females of middle age and majority had single lobe enlargement. Most of them presented with large goitres which were present since many years. On clinical evaluation, the symptoms suggestive of malignancy were pressure symptoms and lymph node enlargement. Multinodular goitre and colloid cysts were the commonest findings on FNAC. FNAC is a reliable tool of investigation for thyroid nodule. Using a thorough clinical examination, ultrasound and FNAC, a surgeon can reliably diagnose malignancy in thyroid glands and choose appropriate surgery for the treatment of the same. Histopathology is gold standard for confirmation of the diagnosis of malignancy post operatively.

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Context: It has been proposed that oral squamous cell carcinoma (OSCC) arising in preexisting oral submucous fibrosis (OSMF) constitutes a clinicopathologically distinct disease than the OSCC arising without OSMF. Expression of myofibroblasts is an early event in tumorogenesis, and its expression in malignant lesions has been suggested to represent an important participant in invasion. Aim: To evaluate the expression of myofibroblasts in OSCC arising in OSMF and OSCC without OSMF. Settings and Design: Thirty each histopathologically proven cases of OSMF, OSCC with OSMF, and OSCC without OSMF were included in the study. The tissue sections were studied for histopathological evaluation and alpha-smooth muscle actin (α-SMA) expression. Statistical Analysis Used: Descriptive and inferential statistics using Kruskal–Wallis test, Mann–Whitney test, and Chi-square test. Results: The expression of α-SMA was found to be high in OSCC with OSMF and OSCC without OSMF group as compared to OSMF group. However, the difference between α-SMA expression in OSCC with OSMF and OSCC without OSMF group was found statistically nonsignificant. Comparison of α-SMA score with histopathological grading and tumor, node, metastasis staging in OSCC with OSMF and OSCC without OSMF groups showed statistically nonsignificant difference, whereas comparison of α-SMA score with lymph node metastasis was statistically significant. Conclusion: The altered extracellular matrix in OSCC with OSMF could be responsible for modified epithelial–mesenchymal transition, which is further proven by reduced intensity and distinct pattern of α-SMA staining in OSCC with OSMF.

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Introduction: Malnutrition continues to be one of the major causes of morbidity and mortality among under-five children in developing countries. There are numerous factors that directly or indirectly affect the nutritional status of the children. Aim: This study aims to study the prevalence and associated risk factors of acute malnutrition in children 6 months to 5 years of age in an urban slum. Subjects and Methods: This community-based cross-sectional study was carried out in an urban slum in Mumbai. A total of 270 children of age 6 months to 5 years were enrolled in the study. Samples were selected by simple random sampling from various sectors. All mothers/informant were interviewed, and anthropometric measurements were recorded. Data were analyzed using SPSS version 20.0 and Chi-square test was used to find out the association between two qualitative variables. Results: The prevalence of underweight, stunting, and wasting were 52.2%, 42.2%, and 50.4%, respectively. The factors associated with acute malnutrition were age of the child, mother's educational status, occupation of mother, type of family, socioeconomic status, age at marriage below 18 years, children who were given prelacteal feeds, were not exclusively breastfed and were partially immunized. Conclusions: The findings of the present study revealed that higher prevalence of acute malnutrition was found in the children of urban slum in Mumbai. Socioeconomic development along with counseling on breast-feeding practices and nutrition education among the urban slum masses needs to be ensured which is an important factor to combat malnutrition.

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Background and Objectives: Dysphagia refers either to the difficulty someone may have with the initial phases of a swallow (usually described as “oropharyngeal dysphagia”) or to the sensation that foods and or liquids are somehow being obstructed in their passage from the mouth to the stomach (usually described as “esophageal dysphagia”). Upper gastrointestinal GI endoscopy is an important tool in the initial investigation of dysphagia. Endoscopy is indicated in patients with dysphagia to determine the underlying etiology, exclude malignant and premalignant conditions, assess the need for therapy, and perform therapy, such as dilation. Endoscopy-guided biopsy is indicated in structural causes observed during the endoscopic evaluation for confirming the diagnosis with histopathological correlation. Material and Methods: A study of 150 patients who presented with dysphagia, and the study focuses the importance of endoscopic (biopsy when needed) evaluation in these patients. Results: Study shows that the sensitivity of endoscopy was 1.000 (95% confidence interval [CI]: 0.942–1.000), specificity was 0.875 (95% CI: 0.787–0.936). The PPV was 0.849 (95% CI: 0.746–0.922). The NPV was 1.000 (95% CI: 0.953–1.000). Conclusion: Upper GI endoscopy is a safe and effective way to evaluate dysphagia and has both diagnostic and therapeutic value.

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Background: Maternal factors could help determine the potential incidence of hyperbilirubinemia. This study was performed with the purpose of establishing the role of the various maternal factors previously indicated as being responsible for exaggerated physiological hyperbilirubinemia in term neonates with serum bilirubin level of 12 mg/dL or more. Materials and Methodology: It was a prospective, cross-sectional study conducted from July 2012 to August 2014 in Pimpri, Pune. A total of 2000 healthy term deliveries were screened, out of which 100 neonates with exaggerated hyperbilirubinemia were included. Data were collected with maternal information. The data were analyzed using t-test (for parametric distributions). Results: During the period of study, 330 babies out of 2000 deliveries had achieved the serum bilirubin level of >12 mg/dL. Thus, the prevalence of exaggerated neonatal hyperbilirubinemia in the current study was 16.5%. There is strong association between maternal infection and serum bilirubin even when only 5 mothers had infection (Z = 2.31 and P < 0.05), whereas no correlation was found with maternal diabetes mellitus, toxemia, and oxytocin infusion. Conclusions: Maternal infection was found to have a significant effect on neonatal exaggerated hyperbilirubinemia. Therefore, interventions should be prioritized to prevent maternal sepsis. The first approach targets facility-based deliveries and requires increased provision and uptake of proper antenatal care early in pregnancy.

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Introduction: Preeclampsia is associated with substantial risks for the fetus and the mother. Women with preeclampsia have a significant difference in lipid parameters compared to normal pregnancy. The association of serum lipid profile with gestational proteinuric hypertension is highly suggested to reflect a new diagnostic tool. Materials and Methods: The present study is a prospective case–control comparative study done over a period of 2 years, i.e., from October 2015 to July 2017. The study takes into account 100 normotensive pregnant women (control group) and 100 pre-eclamptic women (study group) in their third trimester of pregnancy. Serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-C (HDL-C), and very LDL-C (VLDL-C) were estimated in both groups. Aims: The study aims to analyze the lipid profile in normotensive pregnant patients, to analyze the lipid profile in pregnancy-induced hypertension patients, and to investigate the alteration in lipid profile in both groups. Results: There was a significant rise in serum TC, TGs, LDL-C, VLDL-C, and a significant decrease in HDL-C in the study group as compared to controls. Conclusion: Altered lipid profile also has a potential role in the genesis of endothelial dysfunction and expression of preeclampsia. Early detection of these lipid parameters may help pregnant patients by preventing maternal and fetal complications in preeclampsia and is going to aid in better management of preeclampsia.

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Background: Due to the rapid expansion of technology, internet has become the most vital part of human life and youth are found to be more dependent on it for various purposes. Aim: This study aims to estimate the prevalence of internet addiction and identify its associated factors among undergraduate college students. Materials and Methods: A cross-sectional study design was adopted. A total of 1304 college students were included through convenient sampling. A self-administered questionnaire was used which consisted of a semi-structured pro forma on sociodemographic profile, characteristics of internet usage, Young's Internet addiction test and depression, anxiety and stress test. Descriptive statistics were reported, and Chi-square test was used to assess the relationship between expected outcomes. Results: Out of the total 1304 participants, 716 (54.9%) were females and 588 (45.1%) were females. The mean age of the participants was 19.16 years. The prevalence of internet addiction was found to be 44% and it was significantly associated with factors such as gender, father's occupation, mother's education, availability of personal gadgets, use of smartphone, exposure to internet at young age; and with increase in internet addiction, there was subsequent increase in the level of depression, anxiety, and stress. Conclusion: Although internet technology is considered the most effective tool and one is compelled to use it for various purposes, however, every individual should be able to recognize the point where internet starts to overrule one's life and further hinders other activities of daily living.

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Transposable elements (TEs) comprise almost 45% of the human genome. There are DNA transposons and RNA transposons. Retrotransposons like long interspersed nuclear element 1 (LINE 1) is abundant among all the TEs and present in 17% of the genome. These elements have repetitive sequences. Retrotransposons are regulated by epigenetic modification like methylation alteration of which leads to aberrant expression of LINE1. The literature says that loss of methylation of global DNA is associated with the imitation and progression of cancer. LINE 1 methylation status can be considered as a biomarker for cancer. The hypomethylation of LINE 1 causes transcriptional deregulation, genomic instability, chromosomal recombination, activation of oncogenes, and repression of tumor suppressor genes. There is less evidence on genomic instability and the mechanism underlying the cancer progression due to hypomethylation of LINE 1 elements. Hence, the methylation of LINE1 could be the possible marker for the prognosis of cancer.

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