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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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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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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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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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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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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Imaging and laboratory test are vital components for accurate diagnosis of any medical condition. In the current scenario, computerized tomography and magnetic resonance imaging (MRI) have dominated the field of imaging. Although much is spoken and written about the radiation hazards of computerized tomography, safety aspect of MRI hardly receives any importance. A recent accident involving a diagnostic MRI unit in Mumbai highlights the importance of safety aspects being neglected in MRI. The authors of this article have made an attempt to highlight the facts about MRI-related fatal accidents and briefly review the safety protocol and 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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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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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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Introduction: Clinical manifestations of blood stream infections (BSIs) range from transient bacteremia to fulminant septic shock with high mortality. Regular surveillance of BSI etiology is important in monitoring the spectrum of bacterial pathogens and their sensitivity pattern in a particular area and thus helps in rationalizing therapy. Objective: The present study was undertaken to know the bacteriological etiology of BSIs and the antibiotic susceptibility pattern of the isolated strains to formulate effective empirical treatment. Materials and Methods: During the 1-year study, 5588 blood samples from patients with a clinical diagnosis of sepsis were processed at Microbiology Laboratory of a 1200–bedded tertiary care hospital of Western India. Bacteriological identification and antimicrobial susceptibility testing were performed for all bacterial isolates by following the standard protocol. Results: A culture positivity was seen in 10.73% of the septicemic cases. Contamination was observed at a rate of 1.96%. Of the total 600 bacterial isolates gram-negative Enterobacteriaceae, Gram-negative nonfermenters and Gram-positive cocci contributed to 38%, 31%, and 31%, respectively. The predominant organisms were Acinetobacter spp followed by Klebsiella spp. and Staphylococcus aureus. All Gram-negative bacteria showed low sensitivity to fluoroquinolones and beta lactam drugs such as ampicillin and cephalosporins. Aminoglycosides, carbapenems, chloramphenicol, βeta lactam-β lactamase inhibitor combinations such as Piperacillin tazobactam were effective in treating Gram-negative bacteremia. Chloramphenicol, glycopeptides, and linezolid were effective in treating Gram-positive bacteremia. All Gram-positive isolates showed low sensitivity to fluoroquinolones. Conclusions: This study stresses the need for the continuous screening and surveillance for antibiotic resistance in septicemic cases.

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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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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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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: Parkinson's disease (PD) is a chronic and progressive disorder of movements of body parts which affect muscles of face, mouth, and throat. This can lead to affect the speech production in various aspects such as changes in voice, difficulty in forming sounds, and slow speech rate. Diadochokinetic (DDK) rate is the most common measures to see the speech production in persons with PD. Methods: This study was carried out on seven persons with PD with the control of medications and compared with the age- and gender-matched control group. Speech sample of DDK (alternating motion rate and sequential motion rate) was recorded in quiet environment. All the participants were instructed to produce syllable with rapid rate in a single breath. PRAAT software was used for the analysis of speech rate. Result and Conclusion: DDK rate was lower in PD group compared to control group. This could be due to limited muscle control and movements of lips and tongue.

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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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Background: Duplication of ureter is a developmental anomaly of urogenital system. The possible embryological reasons for the formation of a duplicated ureter could be splitting of ureteric bud, resulting two ureters draining into single kidney. Prevalence occurs in approximately 1% of the population. It may be associated with or without other congenital defects. Aim: To study the major anatomical variations of the ureter in routine dissection method. Materials and Methods: The present study conducted in the Department of Anatomy on 156 formalin-fixed cadavers of both sex and focus on the ureteric anomaly in routine dissection method. The ureter was followed from the renal pelvis to the uretrovesical junction, an opening into the urinary bladder (UB). Out of them, we got in one cadaver that two ureters were draining a single kidney into the UB separately and were not associated with any other congenital anomaly. There was complete duplication of ureter on unilateral side (left). Right kidney and its ureter were entirely normal. Conclusion: The knowledge of abnormality in renal collecting system is necessary for effective endo-urological applications and intrarenal surgeries. The present study adds on to the literature and will be helpful and interesting for the radiologists and urologists as it describes the ureteric anomaly in the Central Indian population.

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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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