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: Improper Biomedical Waste (BMW) management by healthcare facilities can pose severe hazardous effects on the larger population, the environment, and its resources. Due to resurgence in number of clinics in urban areas, there is need to understand the practices and compliance to BMW management. It can be understood by studying and observing their practices and processes of BMW management and understanding the knowledge, attitude, and practice among the staff in the clinics. Aim: The objective of the study was to analyze the BMW management process across the healthcare clinics in Udupi taluk. Methods: A cross-sectional, observational study was conducted using self-administered questionnaires and checklists across 15 clinics in Udupi taluk. The sample size is 130 out of which Doctors, Nurses, housekeeping staff and descriptive Statistics were reported. Results: Of the 15 clinics only eight of them had basic requirements of BMW management; lack of trained workforce, non-compliance to segregation of waste, and non-compliance to collection and storage of waste are seen among majority of the clinics. Other findings during our study are 73.3% had inadequate transportation facility, while only 13.3% had adequate storage space. Doctors and nurses had 100% knowledge and positive attitude, environmental health workforce (housekeeping staff) had poor knowledge and attitude.

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A denture which is fabricated having adequate retention helps in patient's esthetic, physiological, and functional factors. The diagnostic assessment of the posterior palatal seal (PPS) and its placement is of pronounced significance. With an accurate recording of PPS area, we can establish the border seal in the posterior region of the maxillary denture. There are a number of dentures which have become unsuccessful due to the inadequate establishment of the posterior limit and an improper PPS. This article review focuses on the importance of the PPS and about different techniques associated with recording of it.

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Background: The significance of the presence of immature germ cells (IGCs) and leukocytes in semen have not very frequently been highlighted in the diagnostic criteria of male infertility. Round cell count differentiation aids in better clinical correlation. Aim and Objectives: To differentiate the round cells into IGCs and leukocytes in the semen and to find their correlation with the total sperm count and sperm motility. Materials and Methods: Semen samples from patients at Bharati hospital, Sangli for evaluation of infertility from July 2014 to January 2015 were analyzed as per the WHO criteria. After the consent and collection of the semen sample, routine semen analysis was done. Smears of semen were prepared and stained by Leishman stain. The round cells were counted and differentiated into IGCs and leukocytes. Results: We studied 103 cases. Semen parameters such as total sperm count, motility were noted. The smears were studied for differential counts of round cell count into IGC count and leukocyte. The cases were divided into four groups based on total sperm count. Maximum number of cases was found in group III. Our study shows that round cell count is 5%–10% of the total sperm count. Negative correlation was noted between the total sperm count and IGCs. The correlation of total sperm count and leukocytes was negative and significant. Conclusion: The present study shows that differentiation of round cells in the semen can be effectively differentiated into spermatogenic and nonspermatogenic cells with the use of simple and cost-effective stain like Leishman stain. The correlation of sperm count with the IGCs and leukocytes and sperm motility is of immense use to find out the possible cause of infertility.

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Background: Chronic fissure in ano is one of the most common anal disorders in all age groups which causes significant distress to the patient even though the disease is benign in nature. Several treatment options are available ranging from medical to surgical of which surgical division of sphincter, lateral internal anal sphincterotomy, is one the most common surgical procedures done to relieve anal sphincter spasm and aid healing of fissure. Most commonly, surgery for fissure in ano is performed under regional or general anesthesia due to severe pain associated with disease. Patient acceptance is also low as the perianal area is very sensitive to pain which may be aggravated by patient positioning during surgery. Materials and Methods: This is a prospective study was done in Osmania General Hospital over a period of 3 years in patients who were treated in our unit with acute and chronic fissure in ano. All patients were counseled regarding disease and treatment options. Informed and written consent was obtained from all patients willing to undergo sphincterotomy under local anesthesia. These patients include females and males >15 years of age and also patients having medical comorbid conditions, such as chronic obstructive pulmonary disease, uncontrolled diabetes, and others in whom surgery under regional or general anesthesia was deferred or contraindicated due to high risk. Results: All lateral internal anal sphincterotomies were performed under local anesthesia. There was significant pain relief following surgery. Intraoperative complications related to administration and drug, and surgery were negligible, and the duration of surgery was very less compared to regional or general anesthesia cases. Patient acceptance was also very good as local anesthesia provided good pain relief during and after surgery and fissure healing rates were high with less complications and no recurrences. Conclusion: Local infiltrative anesthesia is a very effective and safe form of anesthesia for lateral anal sphincterotomy for acute and chronic fissure in ano in terms of minimal complications, ease of giving anesthesia, and cost-effective as no extensive pre-operative preparation and investigations are required. It can also be safely administered in all age group, and also in patients with medical comorbid conditions which precludes administration of spinal or general anesthesia.

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Tubular ectasia of epididymis is a benign condition affecting patients predominantly in the age group of 50–60 years. It is a cystic dilatation of tubules of epididymis with stippled appearance appearing hypovascular on color Doppler and demonstrates soft colors on sonoelastography. Here, we present a case report of a 58-year-old postvasectomy male patient who presented with complaints of dull-aching pain and the palpable lump in the scrotum for 10 months. Subsequent ultrasound imaging demonstrated anechoic dilated cystic tubular structures in bilateral epididymis suggesting tubular ectasia. Doppler and sonoelastography helped in confirming the diagnosis.

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Background: Toxic gases and carcinogens released from manufacturing and burning of plastics cause environmental pollution. Aims and Objectives: The objectives of this study are to study the knowledge, attitude, and practice on uses of plastic products, their disposal and environmental pollution among school-going adolescents. Materials and Methods: The cross-sectional study was undertaken in one of the senior secondary schools of Wardha city. Purposive sampling was done. Seventh standard students who were present on the day of data collection and willing to participate were instructed to fill up the pro forma. Results: The hazards of plastics could be reduced by their reduced usage (75.78%) and reuse at home (41.05%) followed by segregation and proper disposal (12%). Students (26.32%) told that plastics are not biodegradable. Students (37.89%) had knowledge regarding plastic bags banned in Wardha city. Students (35.79%) knew about fine imposed for using plastic bags. Main source of information was school (83.15%) followed by television and radio (80%) and parents (24.21%). Students (65.26%) agreed for ban on plastic bag usage, whereas 69.48% of students agreed to campaign for harmful effect of plastics in daily use. Conclusions: Proper disposal of plastic waste reflected the habit of family is a thrust area which needs to be improved. Good thing is that students are having attitude to give up the use of plastic bags and to aware others about the ill health of using plastics.

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Context: Prevalence of irritable bowel syndrome (IBS) in Indian community according to studies varies from 10% to 20%. Only 20% seek medical care which is just a tip of an iceberg. Early detection is needed as it affects the quality of life markedly. Magnitude is not known in slums of Mumbai due to scarcity of studies. Aims: The aim of the study was to study epidemiological factors related to IBS in an urban slum population. Settings and Design: This study design was a cross-sectional and conducted in urban slum. Subjects and Methods: The study was conducted among the slum population by systematic random sampling with a predesigned, pretested, semi-structured questionnaire as a study tool. Statistical Analysis Used: Statistical analysis used Excel and SPSS software packages. Results: The prevalence of IBS was 12.27%, of which 56% were males and 44% were females. Majority were aged between 25 and 44 years (66%) and married (64%). Most common symptoms were relief of pain after bowel movement (68%), change in frequency of stools (65%) with 51.52% showing diarrhea-predominant subtype, and only 15.15% had visited a gastroenterologist. Psychiatric disorders, sexual dysfunction, and pelvic pain each at P < 0.01 and decreased quality of life (P < 0.01) had shown a significant association with IBS. Conclusions: Psychiatric disorders, sexual function, work absenteeism, pelvic pain, and gastroesophageal reflux diseases were significantly associated with IBS, while sex, marital status, religion, and socioeconomic status were not.

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As an anesthesiologist and critical care intensivist, it is mandatory to have thorough knowledge of variable partial pressure of oxygen, at different fraction of inspired oxygen (FiO₂), and effect of various atmospheric pressures in alveoli, diffusion, and transport of oxygen to tissue. The partial pressure of oxygen in arterial blood gas shall always be expressed with respect to the atmospheric pressure and FiO₂; unless these conditions are mentioned, one may not be able to assess the exact respiratory status of patient.

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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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Background: Immunohistochemistry (IHC) is used to assess hormone receptor status evaluating hormone receptors (estrogen receptor and progesterone receptor [ER/PR]) in infiltrating ductal carcinoma of breast and determined by scoring systems: Allred (quick) and H scoring system. The present study intended to evaluate the values of these score systems in terms of correlation with Bloom-Richardson grading system of breast carcinoma. Aim: To compare Allred and H scoring systems for evaluating hormone receptors in carcinoma of breast by IHC with modified Bloom-Richardson's grading system. Objective: (1) To confirm and classify histopathology of breast tissue by routine hematoxylin and eosin staining. (2) To obtain grading by Bloom-Richardson grading system. (3) To evaluate breast carcinoma by IHC and assess by Allred and H scoring system of hormone receptors. (4) To compare these scoring systems with Bloom-Richardson grading system. Study Design: Observational, cross-sectional, and comparative. Materials and Methods: BR grade and HR status of 65 surgically resected specimens of carcinoma breast were determined by routine histopathological examination and IHC. Allred and H scoring systems were employed to evaluate HR status. Statistical Analysis: Using Chi-square test and P < 0.05 considered as level of significance. Results: The common grade was Grade II accounting to 73.85% followed by Grade I and Grade III, i.e., 16.92% and 9.23%, respectively. Immunohistochemical analysis was done and most cases belonged to ER(−)/PR(−) category, i.e., 30 cases (46.16%). Allred and H scores were analyzed and compared these scores with Bloom-Richardson Grading system. According to Pearson's correlation matrix, it was observed that a statistical significant correlation was found between Allred and H score system and had an equivalent value for ER and PR (P < 0.0001). Conclusion: The present study had shown that there was no difference between Allred and H score system and had a good correlation with BR grading system as both being semi-quantitative methods and can be practiced regularly for assessment of HR.

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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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Gingival enlargement is caused by gingival inflammation, fibrous overgrowth, or a combination of both, leading to adverse consequences, such as difficulty in plaque control, mastication, altered speech, and esthetic and psychological problems. A 24-year-old male reported with the chief complaint of spacing between the teeth in the front region of the jaw. This article reported a case of extreme gingival enlargement which was periodontally treated, by the removal of all gingival tissue excess using gingivectomy and gingivoplasty. After a 6-month follow-up period, the fixed orthodontic treatment is continued with monthly periodontal checkups that were scheduled to control the gingival inflammation. The collaboration between the periodontist and orthodontist is the most important key to successful treatment of hyperplasia in patients undergoing orthodontic treatment.

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Background: Superficial skin infections (SSI) are quite common but often avoidable public health problem which requires early diagnosis and prompt treatment to prevent complications. Despite the high prevalence of certain skin diseases in developing countries, they have so far not been regarded as a significant health problem in the development of public health strategies. Methodology: This was a cross-sectional clinic-based study conducted from December 2016 to January 2017 among 160 study participants attending a rural health facility in Singur block of West Bengal using a predesigned structured schedule and clinical examination. Data were collected regarding sociodemographic profile, occupational details, housing condition, personal hygiene practices, and history of any skin diseases. Data were analyzed using appropriate statistical methods using SPSS (version 16). Results: A total of 27 (16.9%) of 160 study participants were suffering from SSI. Tinea corporis and tinea cruris were the two most prevalent types of SSI. Nature of work adjusted odds ratio ([AOR]-4.88 [1.38–17.20]), water source for bathing (AOR-4.27 [1.15–15.80]), persons/room (AOR-3.22 [1.26–8.21]), poor personal hygiene (AOR-1.67 [1.18–2.36]), and diabetes (AOR-3.34 [1.08–10.31]) were found to be significant predictors of SSI. Conclusions: Superficial fungal infection is the most prevalent type of SSI in the present study. More emphasis should be given to improving hygiene practices, living conditions, controlling diabetes, and creating awareness to reduce the risk of skin infection.

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

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Introduction: There is a rising incidence of Oriental cholangiohepatitis (OCH) also known as recurrent pyogenic cholangitis (RPC), in Indian population. The condition which presents with classical triad of recurrent upper abdominal pain, obstructive jaundice and fever is characterized by biliary sludge, intrahepatic bile duct calculi, strictures, duct dilatation and cholangitis resulting from chronic biliary parasitic infestation and associated chronic secondary portal bacteremia. Aim: The purpose of this retrospective study was to understand the spectrum of radiological manifestations of oriental cholangiohepatitis by MRI which helps in differentiating it from other differential causes of biliary obstruction and cholangitis. Materials and Methods: This was a retrospective study of cases of oriental pyogenic cholangitis diagnosed by MRI over a period of 3 years in department of radio diagnosis who were referred from gastroenterology department with clinical suspicion of cholangitis and diagnosed as having OCH based on MRI finding's and later confirmed by ERCP or biochemical parameters. Results: Out of the total 950 MRCP scans evaluated, 150 cases were of suspected cholangitis and only 9 cases had features of oriental pyogenic cholangitis. These patients showed the characteristic MRCP finding's like ductal changes including intraductal calculi with dilatation and strictures in RHD and LHD, segmental and subsegmental IHBRs and in extrahepatic biliary tree i.e. CHD and CBD with decreased arborization of peripheral biliary radicals; wall thickening in biliary tree and pneumobilia; and parenchymal abnormalities like fatty liver, hepatomegaly, segmental atrophy or diffuse liver atrophy. Complications like portal hypertension, splenomegaly and ascites that occur were also observed. Though literature mentions complications like hepatic mass/SOL i.e. hepatic abscess or malignancy, we didn't have any in our case series. Conclusion: To summarise, presence of hepatolithiasis and choledocholithiasis with significant biliary duct dilatation and short segment strictures in the biliary tree with peripheral IHBR pruning, usually in the absence of gallstones on MRCP is nearly pathognomonic of oriental pyogenic cholangitis in patients presenting with classical clinical triad of abdominal pain, jaundice and fever and obviates the need for diagnostic ERCP.

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The study aimed at comparing the scalpel, laser, and abrasion techniques used in the treatment of gingival hyperpigmentation. Scalpel, laser, and abrasion techniques were used for gingival depigmentation in three adults with gingival hyperpigmentation. using scalpel technique in the removal of the hyperpigmented gingival epithelium, along with a layer of the underlying connective tissue, under adequate local anesthesia has an advantage when compared with other techniques used of being effective and requires minimum time and effort besides the least rate of recurrence. Gingival depigmentation using scalpel technique is superior when compared to abrasion and laser techniques.

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Background: It is well known that framing of questions can be a valuable learning exercise. The designing of questions requires knowledge and understanding of the subjects being taught. We designed a study to improve the student understanding of the basic human functions, in the physiology class, whereby 1^st-year medical students were asked to create multiple true-false (MTF) questions, based on their learning objectives. Aim: The present study was undertaken to find the effectiveness of question construction as a strategy for learning. Methods: The current study was conducted on 1^st-year medical students (n = 222) of Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India. The study was conducted in one of the muscle physiology revision classes, where students were asked to prepare a set of MTF questions. Following the activity, the questions prepared by the students were collected and analyzed by the subject experts. A questionnaire with ten questions, on a 4-point Likert scale was administered to the student groups to understand perceptions of this activity. The pre- and postclass tests were conducted and scores were computed and analyzed. The comparison of scores was done using Student's t-test. Results: The MTF questions prepared by students showed that the majority of the MTF questions tested knowledge (23.5%) and comprehension (45%). However, 20% of the MTF questions were in the application level and 11.5% of the questions produced had ability of testing higher-order cognitive skills. The student feedback regarding the construction of MTF questions revealed that activity helped them in better understanding of muscle physiology (70%), increased their critical thinking skills (62.5%), and helped them to revise the muscle physiology in a short duration of time (85%). There was no statistical significance between the pre- and postclass test scores. However, 115 (52%) students scored better in posttest than pretest. Conclusion: Our current study results revealed that the interest and active participation of 1^st-year medical students in question setting was proved to be an activity which encouraged active learning. This student learning activity is adaptable to all systems in physiology and to other subject specialties.

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Introduction: Femur length (FL) is a fetal biometric parameter used for estimation of gestational age. Gestational age determination by ultrasonography (USG) is very essential as it gives an accurate estimation. Aim and Objectives: This study is an attempt to measure FL of the fetus for the prediction of gestational age in the II^nd and III^rd trimester of pregnancy by USG. Materials and Methods: Five hundred pregnant women in the II^nd and III^rd trimester with the single live fetus and having no other complications either in mother or fetus, were selected for the study. Fetal FL was measured, and results were analyzed for accuracy in estimation of gestational age and were compared with findings of other workers. Observation and Results: Gestational age estimated from FL in 500 cases between 20 and 36 weeks of gestation showed that in the mean FL in each week of gestation the maximum difference of ±0.7 mm was found in the II^nd trimester and ±2 mm was in the III^rd trimester. The accuracy of the correctly diagnosed cases and P value decreases as pregnancy advance. Conclusion: Sonographic examination was found to be effective to assess the accurate FL parameter for different weeks of gestation. FL was found to be more appropriate in predicting gestational age in the II^nd trimester and its reliability decreases in the III^rd trimester.

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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: 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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Aims: A comparative study of Cilostazole and Pentoxifylline on intermittent claudication in patients of peripheral arterial disease. Materials and Methods: A total of 70 patients clinically proven occlusive peripheral arterial disease admitted at wards of General Surgery at Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha. It was prospective study the patients were randomized in two groups in 1:1 ratio. The randomization was done using a random allocation sequence generated by computer program and sequential patient consenting to participate in the study was allocated in the respective treatment arms - Cilostazole and Pentoxyphylline per the allocation sequence. Group I Patients (n=35) were administered Tab. Pentoxifylline 400 mg thrice a day; Group II (n=35), Tab Cilostazol 100 mg twice a day. History, clinical examination, all routine investigation including lipid profile, color Doppler study of lower limb and Angiography of lower limb vessels was performed at the start of the trial. Patients were re-evaluated at the time of enrolment and at 24 weeks for Intermittent Claudication Distance (ICD), Absolute Claudication Distance (ACD), and Ankle Brachial Index (ABI). Results: The group II (Cilostazole Group) showed more rise in intermittent claudication distance and Acute Claudication Distance as compared to Pentoxifylline. There was also statically improvement in ankle brachial index of Group II (Cilostazole Group) as compared to Group I (Pentoxifylline). Conclusion: Thus, the comparative analysis revealed that the efficacy of Cilostazole is more than the Pentoxifylline in increasing the ICD and ACD in patients of occlusive peripheral arterial disease with stable intermittent claudication in patients of peripheral arterial disease.

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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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Ectopic breast tissue can present in any part of the body except normal breast region. Ectasia of the breast is a condition where the lactiferous ducts are dilated and blocked by secretions. Both accessory breast tissue and duct ectasia are common entities presenting separately, but the coexistence is rare with a normal breast finding. Here, we report a case of a 28-year-old lactating female presented with firm bilateral painful axillary lump of 6-month duration. This case is reported for its rarity and to give an overview of simultaneous coexistence of bilateral axillary accessory breast with duct ectasia, in a lactating normal breast.

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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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