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: Almost in every country, the proportion of people aged over 60 years is growing rapidly than any other age group as a result of both longer life expectancy and declining fertility rates. Aims: The aim of this study is to assess the oral health status, oral health-related quality of life (OHRQoL), and the dental care utilization of institutionalized and homebound elderly in Satara district, India. Materials and Methods: A descriptive cross-sectional study was conducted among the 150 institutionalized elderly participants of Satara district. Type 3 clinical examination was done to detect dental caries, missing tooth, periodontal diseases, and any other oral findings followed by interview with elderly patients. A questionnaire was administered to assess OHRQoL according to the Geriatric Oral Health Assessment Index (GOHAI), dental visiting pattern, and sociodemographic and self-perceived oral health status of elderly. The descriptive and analytic statistics were used to analyze the data; Chi-square test or Fisher's exact test was performed to determine the prevalence of poor OHRQoL by independent variables. Results: Poor OHRQoL according to GOHAI was observed among 64.7% of the men and 67.1% of the women, and there was no statistically significant difference observed. In community periodontal index, 42.6% of men and 36.6% of women had all sextants excluded, and of those remaining, 95.6% of men and 96.3% of women needed one or other periodontal treatment. Regarding decayed, missing, and filled teeth index, mean was 22.5 in men and 24.2 in women. Conclusion: Institutionalized elderly with 65 years and older showed higher prevalence of poor oral health status and unmet needs for dental care that were associated with poor OHRQoL. Therefore, it is necessary to improve health and social importance of oral health care for elderly.

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Introduction: Dermatoglyphics has proved to have a potential role in predicting the anomalies related to orofacial regions. Aim: The aim of the present study was to explore an association if any, between the dermatoglyphic patterns and type of malocclusion among the Malaysian dental and medical students. Materials and Methods: A total of 104 Malaysian dental and medical students were included in the study. The fingerprints and palm prints were recorded to analyze the type of pattern. Occlusion status was clinically assessed using Angle's classification of malocclusion. Results: Statistically significant association was seen between the left thumb ridge pattern and type of malocclusion. Individuals with loop ridge pattern on their left thumb showed high frequency of Class I normal occlusion and Class III malocclusion, and those with whorl ridge pattern were witnessed to have Class I malocclusion. Conclusion: Dermatoglyphics serves to strengthen the diagnostic impression of malocclusion at an early age and hence can aid in predicting malocclusion and plan preventive and interceptive orthodontics in pediatric patients.

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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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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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Aim: To study the safety and efficacy of diathermy as a modality to give skin incisions. Study Design: Observational study conducted in department of surgery at AVBRH, over 2 years from 2013 to 2015. Material and Methods: 100 cases were studied. In 50 cases incision was given by scalpel and in 50 incisions was given by diathermy. Primary outcome variable was the incisional blood loss, calculated by measuring the weight of swabs used exclusively during incision until complete hemostasis was achieved. Secondary outcome variables were incision time, operative time, pain verbal rating scale (VRS), wound healing, and wound complications. Incision time was defined as the time from the beginning of skin incision until subcutaneous fat arrived, with complete haemostasis; it was expressed in s/cm². Severity of pain was defined using VRS. Results: we reported shorter time for skin incision, lesser blood loss during surgery and lesser wound complication in cases of diathermy incision, and has more significant pain reduction as compared to scalpel group. Conclusion: The findings of the present study shows that diathermy seems to provide some benefit with respect to postoperative wound pain and has obvious safety advantages to the surgical team compared with scalpel.

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Introduction: Cervical cancer is an emotive disease, with multiple connotations. Cervical cancer is major health problem worldwide. Cervical malignancy is the commonest malignancy amongst Indian women. The life time estimated risk of cervical cancer is 2-4%. In Indian women, Cervical malignancy accounts for 26.1- 43.8% of all cancers. Cancer cervix is a preventable and curable disease provided, it is diagnosed early by screening tests and appropriate measures are taken. Aim and Objectives: 1)To compare the efficacy of Visual Inspection with Acetic acid, cytology(Pap smear) and colposcopy in detection of cervical intraepithelial lesions. 2) To assess the role of Visual Inspection with Acetic acid as an alternative to cytology (Pap smear), in screening for cervical cancer in low resource set- up. Material and Method: 200Women in 30-50 years age group who attended the gynecology department OPD, at Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), Wardha for routine check up. Results: In the present study, the sensitivity of Pap smear came to be 90.48% and Specificity came out to be 81.40%.The sensitivity of VIA in detecting cervical cancer was 95.24% and the Specificity was 44.19%. The sensitivity of colposcopy in detecting cervical cancer was 90.48% and the Specificity was 67.44%. Conclusion: VIA as compared to Pap smear(cytology) and colposcopy can be a better screening test due to its high sensitivity, simple administration and low cost.

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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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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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