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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Background: Metabolic syndrome, insulin resistance, so-called prediabetes (impaired glucose tolerance and impaired fasting glucose), and overt type 2 diabetes are all associated to more extensive and even premature atherosclerosis both in the coronary and the carotid arteries. They are all found to be associated with cardiovascular risk factors. Carotid intima-media thickness (CIMT) is considered surrogate marker of atherosclerosis. Early and cheap method of detecting atherosclerosis rules out the burden of cardiovascular disease in society. Materials and Methods: This was a prospective case–control study of CIMT in patients having prediabetes. A total of 100 patients of prediabetes and equal number of age- and sex-matched controls were enrolled. Bilateral assessment of IMT was done in common carotid artery. Statistical analysis was done using descriptive statistics and inferential statistics, using Chi-square test, odd's ratio, Pearson's correlation coefficient and multiple regression analysis. The software used in this analysis was SPSS version 17.0 and GraphPad Prism version 5.0. P <0.05 was considered as a level of statistical significance. Results: About 56% of cases were male and 44% were females, and in controls, 58% were male and 42% were female. Mean age of cases was 45.06 ± 13.08 and that of controls was 44.15 ± 13.64. Mean value of CIMT for cases (0.79 ± 0.06 mm) was higher than for controls (0.72 ± 0.02 mm). The difference between the two groups was found to be statistically significant (P < 0.05, S). Conclusion: Mean CIMT was higher in prediabetes group in comparison to controls; however, in both groups, CIMT was not in the abnormal range. Body mass index and waist-hip ratio were significantly higher in prediabetes as compared to controls. Systolic and diastolic blood pressures were significantly higher in prediabetes as compared to controls. Total cholesterol, low-density lipoprotein (LDL), triglyceride (TG), and very LDL were significantly higher in prediabetes, and high-density lipoprotein (HDL) was significantly lower in prediabetes as compared to controls. According to this model, among cases, serum Tg and age were found to be responsible for the maximum variability of CIMT.

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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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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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Background: Each year approximately 1 million patients develop the pleural effusion. Tuberculosis (TB), the single most frequent infectious cause of death worldwide, also is one of the leading causes of pleural effusion. Despite the advent of novel improvements in the diagnosis and treatment of pulmonary TB, a definite diagnosis of TB in a significant number of patients is problematic. Measurement of the level of adenosine deaminase (ADA) enzyme in body fluids is a helpful diagnostic tool. The level of ADA elevates as the lymphocyte (T-cell) activity increases. The present study was carried out to evaluate the ADA activity in pleural fluid for early diagnosis and management of tubercular pleural effusion (TPE). Objectives: The main objective is to determine the tubercular pleural fluid ADA level and its sensitivity and specificity. Materials and Methods: The prospective analytical study was conducted at Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), in 105 patients of suspected case of TPE. A structured proforma was used for documenting the history, symptoms, side of effusion, hemogram and erythrocyte sedimentation rate (ESR), pleural fluid findings which included pH, glucose, proteins, lactate dehydrogenase (LDH), total leukocyte count (TLC) and differential leukocyte counts and serum ADA level was also calculated. Results: ADA sensitivity, specificity, positive predictive value, and negative predictive value (NPV) are 89.47%, 48.28%, 81.93%, and 63.65%, respectively, for TB. Pleural fluid ADA activity has been shown to be a valuable biochemical marker that has a high sensitivity for TB diagnosis. Conclusion: Pleural fluid ADA is markedly raised in tubercular effusions. ADA estimation is a simple, reliable, cost-efficient, and diagnostically useful investigation.

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Background: Being world's largest outreach program targeting infants & children below six years of age, expectants & nursing mothers, ICDS has generated interest worldwide amongst academician, planners, policy makers, administrators & those responsible for implementation. Consequently, many research studies have been conducted to evaluate & assess impact of program. The need for revitalization of ICDS has already been recommended toward better maternal and child health especially in rural areas. Inspite of repeated measures to enhance effectivity of ICDS program, impact is not observed as desired by policy makers or administrators. And hence knowledge of AWWs regarding ICDS program can be assessed & evaluated so that some of attributable reasons may be pointed out. Hence present study was undertaken to find out knowledge of AWW. Aim & Objectives: The AIM is to find out knowledge of Anganwadi Workers under ICDS with regards to ECD. Materials and Methods: This was a community based Cross-Sectional study, carried out at Seloo block of Wardha district, having total under five population approx. 7634. Study participants included 167 AWWs were included in the study. The study period was one year. Data were double entered and analysed in Microsoft excel (2007). The quantitative data was presented as proportion or mean with SD. Chi square test of significance was used wherever appropriate. Results: Shows that maximum no. of AWW (37.72%) were non matriculate. AWW with SSC and HSC qualification were 22.76% & 29.34% respectively. 64% AWW were Trained workers, 19% AWW received revised training while 17% were untrained workers. Conclusions: AWWs are actually the main resource person of the program and whose knowledge and skills do have a direct impact on the implementation of the programme. As the Anganwadi Workers play an important role due to their close and continuous contact with the people of community, especially the children and women, so there is an utmost need to assess their knowledge and the level of awareness regarding services provided by them in Anganwadi Centres.

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Backgroud: Hepatic encephalopathy (HE) is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of other known causes of brain disease. In India hepatic encephalopathy is considered as indicator of poor prognosis in patients of cirrhosis of liver with 1 year survival in just 42% patients and 3 year survival in 23% of patients. Aim and Objective: Study clinical profile for adverse outcome in patients of hepatic encephalopathy due to cirrhosis of liver. Methods and Methodology: This was a cohort type of study done for a period of 2 years from September 2016 to September 2018 on a study population of 130 patients. Cirrhosis of liver was confirmed by ultrasound of liver. Results: Study included 130 patients of HE secondary to cirrhosis of liver, 82% were males, 44% and 45 % of patients were in grade 2 and grade 3 of West Haven criteria respectively. Icterus, ascites and asterexis were present in almost 65% patients. Cirrhosis was associated with alcohol dependence among 75% of patients followed by NAFLD in 6.15% of patients. Other unknown causes were among 19(14.62%) patients. In our study lactulose was found as the leading treatment modality in 73.84% of patients. Conclusion: Most of the patients were in grade III of HE, alcohol was the most common etiology of cirrhosis, icterus was the most common sign of liver cell failure, most common drug used was lactulose.

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Context: Supraclavicular brachial plexus block is the most flavored technique for upper limb surgeries in the day-to-day anesthetic practice. Adjuvants are commonly used along with local anesthetics to improve the overall quality of block. Dexmedetomidine is a α2 adrenoceptor agonist, nowadays gaining popularity due to its favorable outcomes. Aims: The aim of this study is to compare the block characteristics of 0.5% 30 ml ropivacaine alone with 0.5% 30 ml ropivacaine combined with 50 mcg of dexmedetomidine. Settings and Design: This was a prospective randomized controlled study. Materials and Methods: One hundred patients in the age group of 20–60 years, of American Society of Anesthesiologists Grade I and II, scheduled for elective upper limb surgeries were included in this study. Patients were divided into two groups of 50 each to receive either ropivacaine alone (Group A) or ropivacaine-dexmedetomidine combination (Group B). Onset and duration of sensory and motor blockade were assessed. Statistical Analysis Used: Standard qualitative and quantitative tests were used to compare data. P < 0.05 was considered statistically significant. Results: The onset of sensory and motor blockade was faster in Group B when compared to Group A (17.32 ± 2.05 min, 24.23 ± 5.83 min vs. 22.58 ± 1.75 min, 28.61 ± 2.78 min), the duration of sensory and motor blockade was longer in Group B when compared to Group A (635.0 ± 27.12 min, 513.21 ± 26.14 min vs. 501.1 ± 33.14 min, 402.17 ± 18.16 min), and the duration of analgesia was also longer in Group B compared to Group A (338.16 ± 10 min vs. 247.20 ± 12 min). Conclusion: Dexmedetomidine as an adjuvant to ropivacaine fastened the onset of block, prolonged the duration of block, and prolonged the duration of analgesia.

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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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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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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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Background: Adnexal masses result from benign or malignant lesions of ovarian, tubal and paratubal origin as well as pregnancy related causes such as mullerian anomalies, infectious causes and ectopic pregnancy. The current study aimed to evaluate the preoperative diagnosis, surgical procedure and histopathological findings of adolescent girls who underwent laparoscopic surgery for adnexal mass in our hospital. Materials and Methods: A retrospective chart review of patients with adnexal mass was conducted over a period of one year from Jan 2014-2015. Overall 96 patients were included in the study after reviewing clinical records. In all the patients' malignancy was excluded by preoperative imaging with sonography, CT or MRI and tumor marker study. Results: Laparoscopy was the operative approach for all 96 patients. None resulted in malignant histology. Majority of the adnexal masses were simple cyst (28%), 11.4% were dermoid cyst, 2% were endometriotic cyst. One patient had tubal ectopic, 3 patients had Koch's abdomen and pelvis. Among them one 13 year old girl underwent rudimentary horn excision who presented as a para tubal mass with acute abdomen. Almost half of the patients (68.7%) presented with acute abdomen of which 41.6% were adnexal torsion. All adnexal masses were resected laparoscopically and the outcome was uneventful in all the patients. Conclusion: Laparoscopy is regarded as an appropriate surgical method for benign adnexal masses which was safe and effective even for giant ovarian cyst in well selected cases as most of the pelvic adnexal masses seen in adolescents and young girls are of benign nature.

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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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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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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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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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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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Aim: The aim is to determine the effectiveness of rotary instrumentation (ProFile 0.06 tapered rotary NiTi instruments) in conjugation with solvent (chloroform) in the removal of resilon compared to gutta-percha during root canal retreatment. Materials and Methods: Sixty recently extracted human mandibular permanent premolars with straight roots with single canals were used. Decoronation of samples done at cementoenamel junction using the diamond disk. The length of each canal was determined with a size 15 K file and canals were instrumented using a crown down technique with ProFile 0.06 tapered NiTi rotary instruments. Irrigation done followed by obturation. Result and Conclusion: Statistical evaluation was done using paired t-test (P < 0.05) which showed that the samples obturated with resilon showed significantly better results at the apical third when compared to samples obturated with gutta-percha and the time required for Group 2 is significantly less than Group 1.

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Aim and Objectives: To compare effectiveness of surgical blade, electrosurgery, free gingival graft (FGG), and diode laser for the management of gingival hyperpigmentation. Materials and Methods: Forty patients who were concern for the unesthetic anterior gingival due to melanin hyperpigmentation were treated in this study. Of 40 patients, 10 patients were treated using surgical blade, 10 by electrosurgery, 10 using FGG, and 10 patients using diode laser. The gingival hyperpigmentation was recorded preoperatively and 3 months postsurgery by measuring area of hyperpigmentation in square millimeters and severity of hyperpigmentation using Dummet's oral pigmentation index. Results: Healing was uneventful and required no supportive therapy. No patients experienced severe pain during or postsurgically. Mild discomfort was more common in FGG during the 1^st week. At 3 months localized area of repigmentation was seen in group treated by surgical blade and electrosurgery. However, no repigmentation was noticed at 3 months in diode laser group and free gingival group. Conclusion: Depigmentation of gingival hyperpigmentation using diode laser and FGG were found to be effective procedures. However, diode laser yields esthetically acceptable results along with patient satisfaction.

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Aim: The present study was conducted with the aim to define the incidence and type of field change in clinically apparent normal mucosa of new patients with unilateral oral squamous cell carcinoma (OSCC). Materials and Methods: Biopsy was carried out from clinically apparent normal oral mucosa on the contralateral site (mirror image site) in 38 consecutive newly diagnosed patients with unilateral OSCC. The mirror image tissue was analyzed histologically for abnormal features of dysplasia by two oral pathologists. Results: According to observer 1, 22 (57.89%) mirror image biopsies showed dysplasia of which 19 (50%) mirror image biopsies showed mild dysplasia and 3 (7.89%) mirror image biopsies showed moderate dysplasia. According to observer 2, 17 (44.74%) mirror image biopsies showed dysplasia of which 16 (42.11%) mirror image biopsies showed mild dysplasia and 1 (2.63%) mirror image biopsy showed moderate dysplasia. Conclusions: Histological observation of dysplasia at mirror image site was noted in about half of a sample of cases. Results displayed vulnerability to field change of oral mucosa chronically exposed to carcinogens. It acknowledges the risk for development of second or multiple primary tumors.

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Objectives: The aim is to compare the results of type I tympanoplasty alone and tympanoplasty with cortical mastoidectomy in safe chronic suppurative otitis media (CSOM) patients in terms of graft uptake, improvement in hearing and clinical improvement. Study Design: This was prospective study. Materials and Methods: Sixty cases of safe type of CSOM were included in the study. Type I tympanoplasty was done in thirty cases and tympanoplasty with cortical mastoidectomy was done in another thirty cases. Patients were followed up postoperatively at 3, 6, and 12 weeks for graft uptake and any complication. Pure-tone audiometry was done at 6^th and 12^th week postoperatively to note the hearing improvement. Results: Graft uptake was 76.67% in tympanoplasty alone group and 83.33% in tympanoplasty with cortical mastoidectomy group. In the present study, pre- and post-operative pure-tone average was compared and the statistical difference between tympanoplasty group and tympanoplasty combined with cortical mastoidectomy group was not statistically significant. Recurrence of discharge was seen in 6 cases of tympanoplasty alone group. Although tympanoplasty combined with cortical mastoidectomy is better in hearing yield, graft acceptance rate, and clinical benefit, but the difference in two groups is statistically insignificant. Conclusion: Hearing outcome, graft acceptance rate, and clinical benefit were statistically unequalled in two groups. Tympanoplasty combined with cortical mastoidectomy will not give an additional advantage in terms of hearing gain, disease clearance, and graft uptake.

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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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