Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a rare condition characterized by hemolytic anemia triggered by certain drugs, food substances, and infections. Very few case reports till date have highlighted on the dental aspects of G6PD deficiency. The aim of the present report was to present a dental management of an 8-year-old male patient.

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Background: Female genital tuberculosis (FGTB) is an important cause of infertility. The Fallopian tubes are involved in almost 90% of the cases. Materials and Methods: All 50 participants were women with complaints of infertility to whom FGTB was suspected as a cause of infertility or women with infertility of unknown etiology. After selecting the patient according to inclusion criteria, women were posted for diagnostic laparoscopy and endometrial aspirate/biopsy was sent for TB polymerase chain reaction (TB PCR). Results: In our study, infertile women who had clinical and hysterosalpingography findings suggestive of genital TB underwent endometrial biopsy for TB PCR and hysterolaparoscopy for further evaluation. Among them, 7 (14%) endometrial TB PCR-positive cases were found in the study. Clinical and hysterolaparoscopy findings in these cases were carefully reviewed, although laparoscopic findings were suggestive of TB in 9 (18%) women. Conclusion: Direct visualization of the female genital tract by laparoscopy is most confirmatory and should be considered for starting the antitubercular treatment on the basis of laparoscopic findings.

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Background: Hypotension during off pump coronary artery bypass graft (CABG) surgery is commonly due to positioning of the heart or due to intraoperative ischemia, but sometimes, it is deliberate and controlled during aortic clamping. Due to hypotension, the risk of cerebral hypoperfusion or stroke is high during CABG surgery in patients with bilateral carotid artery stenosis. Methods: Various cerebral monitoring techniques are recommended to detect cerebral hypoperfusion during CABG. Results: Entropy is used for the assessment of depth of anesthesia. In our patient for CABG with associated bilateral carotid artery disease, entropy helped in timely detection of cerebral hypoperfusion. Conclusion: The best management approach of carotid artery disease associated with coronary artery disease still remains debatable.

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Background: Cardiopulmonary resuscitation (CPR) is an important link in the chain of survival during the early minutes of cardiac arrest. Prompt identification and immediate help increase the chances of survival for victims. As dental students start working on patients from their 3^rd year of professional life, important life-threatening situations and lifesaving skills should be known to them. Aims and Objectives: The aim of the present study was to assess the awareness of CPR among dental students from 3^rd and final year. Materials and Methods: In this study, students of 3^rd year and final year of dental colleges of the Vidarbha region were included to access the basic knowledge regarding basic life science skills while performing CPR through a questionnaire that consisted of 20 questions. The questionnaire was circulated among students in Google forms and responses were noted. After excluding the incomplete response, the results were then analyzed. Results: The results were expressed in appropriate graphs and tables. It was observed that the participants included were lacking about complete knowledge of CPR. Among 206 students who responded, a large number of them (around 94%) had not heard of basic life support (BLS)/CPR. Rescue breathing in infants was not known to around 85% of students, chest compression and ventilation ratio in a child was known by only about 11% of students, and the first response in suspected foreign body obstruction was not known to about 90% of the students. The overall result was not favorable and the students had low confidence in performing BLS/CPR. Conclusion: The result of the current study indicates a strong need for emphasis on both theoretical and practical training in CPR for undergraduate dental students. This might prove beneficial to save more lives while avoiding medicolegal complications which may occur in the dental clinic also, thus benefiting both the patient and the dental practitioners as well.

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Background: Placental weight and its relationship to infant size at birth have been studied for more than a century.^[1] A low placental weight is associated with the medical complications in the mother.^[2] The risk of essential hypertension in adult life falls with increasing birth weight and rises with increasing placental weight and that the mothers at highest risk are those with a high placental weight relative to birth weight-that is, a high placental ratio.^[3] Aims/Objective: To study association of placental weight with birth weight, gestational age and maternal morbidity, diet, activity and rest. Settings and Design / Methods and Material: A cohort of 1876 apparently healthy pregnant women registered and attending antenatal clinic of Krishna Hospital was studied to find out the correlation of the placental weight with the LBW and preterm births and their association with selected maternal risk factors. Statistical Analysis Used: Correlation (r), Chi-square test, Analysis of Variance (ANOVA) and Boneferroni test, Unpaired 't' test, were used. Results: There was a statistically significant association of the mean placental weight with the mean birth weight and proportion of LBW of the baby as indicated by ANOVA test. (F= 29.627; p<0.001) and (χ2 =102.6; p<0.001) respectively. There was a statistically significant association of the mean placental weight with the mean gestational period of the baby and proportion of the preterm births as indicated by ANOVA test. (F= 7.694; p<0.001) and (χ2=18.377;p<0.001) respectively. Daily frequency of meals < 4, antenatal morbidity of preeclampsia, PIH and APH were associated with lesser placental weight. Conclusion: There was a significant association of placental weight with birth weight, gestational age, maternal morbidity and frequency of maternal meals.

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Background: Aerobic capacity (VO_{2 max}) in multiple sclerosis (MS) is considered to be a key physiological measure as it is a strong health and performance predictor. Fatigue is the common disabling symptom in MS patients. The study was done to assess correlation between aerobic capacity and fatigue in MS patients. Methodology: A study was carried on 30 patients of relapse remitting MS across Multiple Sclerosis Society of India, Pune, chapter participate in study and assess for aerobic capacity and fatigue. These patients were selected according to inclusion and exclusion criteria and were evaluated for assessing aerobic capacity (VO_{2 max}) by 2 min walk test and fatigue by Modified Fatigue Impact Scale (MFIS). Results: Our study found aerobic capacity (VO_{2 max}) (17.71 ± 2.966), MFIS (60.712 ± 22.191) with (P < 0.0001, r = −0.7168) and very significant correlation between aerobic capacity with fatigue in MS patients. Conclusion: The study concludes that there is a significant negative correlation of aerobic capacity with fatigue in MS patients.

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Lower gingivobuccal (GB) malignant tumors are very common in India due to tobacco chewing. Elastography is a recent advance in ultrasound technology having a great role in cancer management. We are presenting a case report of lower GB cancer and imaging finding on USG computed tomography and elastography with pathological correlation.

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Purpose: To study and compare the postoperative astigmatism following phacoemulsification with scleral incision and posterior chamber foldable and rigid (nonfoldable) intraocular lens (IOL) implantation. Materials and Methods: It was a hospital-based prospective observational study which included 200 eyes with presenile and senile cataract and were divided into two groups. Group I; included hundred cases with superior scleral incision (3.2 mm) phacoemulsification and foldable posterior chamber IOL (PCIOL) implantation. Group II; included 100 cases with superior scleral incision (5.5 mm) phacoemulsification and rigid (nonfoldable) PCIOL implantation. The data were analyzed by Chi-square test and P < 0.05 was considered statistically significant. The surgically induced astigmatism (SIA) at 6 weeks was compared between the two groups. SIA was calculated by the vector analysis. Results: The mean SIA in Group I was 0.67 ± 0.46 D, whereas in Group II was 1.17 ± 0.44 D. There was statistically significant difference between the two groups P < 0.05. Group II showed higher mean SIA than Group I at 6 weeks. Postoperatively, majority of patients developed against the rule astigmatism, 62% in Group I and 76% in Group II. Conclusion: SIA is less in 3.2 mm incision as compared to 5.5 mm incision with increase in against the rule astigmatism postoperatively.

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Anterior crossbite is one of the major challenges faced by pediatric dentists. An abnormal labiolingual relationship between one or more maxillary and mandibular incisor teeth is called anterior crossbite. The early detection of crossbites will ease the management of developing malocclusion. The current paper includes case series of crossbite which was corrected using short-span wire-fixed appliances. The sectional appliances offered great advantage over removable appliances to correct the crossbites of dental origin.

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Background: Cancer is the world's most hazardous and severe disease in the 21^st century, and it is the world's second-largest cause of death. A patient's cancer therapy is decided by the stage of cancer at diagnosis, the type and location of cancer, and the patient's country's normal medical procedures and treatment recommendations. Surgery, chemotherapy, and radiation therapy are just a few of the cancer treatment options accessible. However, these treatments are rarely curative and might cause a variety of negative effects in individuals. Materials and Methods: This retrospective observational study was carried out in Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha. Prechemotherapy hematological profiles: laboratory results of hematological profiles at the time of cancer diagnosis. Postchemotherapy hematological profiles: laboratory results of hematological profiles following the completion of Phase 4 chemotherapy treatments. Results: There were 97 males (41.27%) and 138 females (58.72%) in the group. Breast cancer, lymphoma, and sarcoma were the most common kinds of cancer in this study, accounting for 37.44%, 25.1%, and 11.06%, respectively. Stage II was found in 8.93% of the study participants, 62.12% in stage III, and 28.93% in stage IV, but no stage I was found. Conclusion: Postchemotherapy hematological profiles, with the exception of lymphocytes, were found to be considerably lower than prechemotherapy. Biochemical profiles such as urea and creatinine reduced insignificantly, but aspartate aminotransferase and alanine aminotransferase levels increased nonsignificantly after treatment compared to before.

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Background: Hypertension is defined as a blood pressure level of 140/90 mmHg measured twice with a 6-h interval between each measurement during pregnancy. The rise in systolic and diastolic blood pressure is critical in determining whether or not someone has pregnancy-induced hypertension (PIH). PIH, also known as toxemia or preeclampsia, is a type of high blood pressure that occurs during pregnancy. Materials and Methods: A total of 67 pregnant women who presented to our hospital with PIH were enrolled using the following inclusion and exclusion criteria. Women with 20 weeks of gestation and those who willing to participate in this study. Results: Pregnancy-induced hypertension was more prevalent among nulliparous (56.7%). Out of 29 women, 13 (44.8%) have past h/o of PIH, 24.1% had previous preterm delivery, and 68.9% had previous lower segment cesarean section. The clinical presentation in mothers with PIH which shows that 47.8% had lower abdominal pain and 19.4% had vomiting/epigastric discomfort followed by headache (11.9%), convulsion (8.95%), and no any complaint (13.43%). Conclusion: Pregnancy-induced hypertension is a frequent medical condition that occurs during pregnancy. We discovered that PIH is more common in children under the age of 18 and in moms who are nulliparous. PIH causes a variety of clinical manifestations, some of which can be used to detect PIH early.

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Background: Ablative CO₂ laser resurfacing and dermaroller are proven effective modalities for the treatment of acne scarring. However, one out of two techniques is done exclusively in a patient. We have compared the sequential fractional CO₂ laser and dermaroller in one group of patients, while the other group was subjected to exclusive fractional CO₂ laser treatment. Materials and Methods: A total of 28 patients were recruited for the study. Fourteen patients (aged 21–35 years) with moderate-to-severe acne scars underwent one sitting of fractional CO₂ laser, followed by dermaroller after 6 weeks to follow the same sequence making total of four sittings over 6 months, while other 14 patients (aged 21–36 years) underwent total of four fractional CO₂ laser sittings within a gap of 6 weeks each. Outcomes were based on scar severity scores as described by Lipper and Perez and patients' subjective ratings. Results: Acne scarring improved significantly in all 28 patients. Mean scar severity scores decreased to 34.3% as compared to 80.7% before treatment, decreasing by a mean of 56.9% in Group A, while in Group B, the mean scar severity scores decreased to 40.5% as compared to 76.3%, decreasing by a mean of 46.9%. Mean patients' subjective score was recorded as 2, which represents a good improvement (25%–50%) in Group A, while it was recorded as 1, representing mild improvement (0%–25%) in Group B. Conclusions: Successfully combining fractional CO₂ laser with dermaroller constitutes a safe and extremely effective treatment modality for acne scarring.

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Context: Paracetamol exerts its analgesic effect by inhibiting prostaglandin synthesis in the central nervous system and peripheral action by blocking the generation of pain impulses. It has also a serotonergic (5Ht) mechanism and a cannabinoid agonist mechanism. Aims: We planned this study to compare intravenous and intramuscular tramadol as labor analgesia. Settings and Design: This prospective single-blinded randomized study was conducted in primigravida labor patients at tertiary care hospital between January 2016 and December 2018 after getting the permission of the ethical committee. Methods: Patients were randomly divided into two groups using a computer-generated random table in the Paracetamol group (Group A) and Tramadol group (Group B). Group A (60 patients) received IV PCM 1000 mg in the active phase of labor single dose over 15 min. Group B, received intramuscular tramadol hydrochloride 100 mg. Labor was monitored using partograph, pain intensity was recorded before, 1 h, and 3 h of drug administration using the Mac Gill pain intensity scale. Statistical Analysis Used: We did statistical analysis using IBM SPSS version 22.0 software. We used an independent t-test to analyze the difference in continuous dependent variables in two groups. The MacGill's pain intensity scale score was examined using repeated measures of analysis of variance for mean scores on 3 outcome measures: Before drug delivery, 1 h after drug delivery and 3 h after drug delivery. Results: Overall paracetamol was well tolerated as compared to tramadol. Patients who received paracetamol experienced fewer side effects including nausea and vomiting. The difference was statistically significant (Chi-square = 8.091; df = 2; P = 0.018). In the paracetamol group, 8 (15%) patients had nausea and 1 (2%) experienced vomiting; while in the tramadol group, 6 (11%) patients had nausea and 10 (19%) patients experienced vomiting. Conclusions: Paracetamol is safe labor analgesic as compared to intramuscular tramadol. Further studies consisting of a greater number of patients are needed to validate the results of this study.

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Aim: The purpose of this clinical study was to determine the correlation between the horizontal visible iris diameters with the mesiodistal width of the central incisor respectively in the Central India population aged between 18 and 26 years. Background: Can the Iris Diameter be correlated with the mesiodistal width of maxillary central incisor. If thus results obtained, the iris diameter can be used as a tool for the selection of maxillary anterior tooth in completely edentulous patients. Materials and Methods: Seventy Five Central Indian participants aged between 18 and 26 years participated in this study. Standardized digital photographs of the face generated from the frontal aspect were made using a digital camera. The measurements of the iris diameter and the mesiodistal width of the maxillary central incisor at the incisal edge, middle third, and cervical third were assessed with photoimaging software. The data obtained have undergone the statistical analysis by using the paired-sample t-test to compare the right and left sides, and independent-sample t-tests to compare between gender, and the Pearson correlation coefficient (r) to evaluate the relationship between variables. Results: A positive correlation between the horizontal visible iris diameter and the mesiodistal width of the maxillary central incisor was found in men and women. In men, the r = 0.276, 0.373, 0.378 (right side) and 282, 158, 429 (left side) respectively were found for cervical third, middle third, and incisal third region. In women, the r = 0.329, 0.415, 0.192 (right side) and 0.053, 0.469, 0.163 (left side) were found respectively in cervical third, middle third, and incisal region were found. Conclusions: The conclusion was that the horizontal visible iris diameter can be used as a reference point to estimate the mesiodistal width of the maxillary central incisor tooth.

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Amelogenesis imperfecta (AI) is a hereditary disorder that displays a group of conditions which cause developmental alterations in the structure of enamel. This disorder has an adverse impact on oral health and quality of life of the individual. The correction of such severely worn out dentition may require extensive restorative treatment to achieve appropriate results. It is important to identify the factors that contribute to the excessive wear and loss of vertical dimension. The correction of the defects has to be done without violating the biological or mechanical principles. Rehabilitation in such patients improves esthetics, function, and comfort. This case report presents a systematic approach in rehabilitating a case of AI hypomature type using full mouth metal-reinforced porcelain and metal restorations.

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Background: Acne vulgaris is thought to be the most prevalent skin disease seen in clinical practice, and it is caused by a combination of causes that start in the pilosebaceous follicle. Subjects and Methods: There were a total of 114 patients, 32 men and 82 women. Patients with acne vulgaris who came to the outpatient department and agreed to participate in the study were included, but those who refused or had drug-induced or other acne-related eruptions were excluded. Results: The most prevalent age group to be involved was 20–25 years of age (36.0%), followed by 15–20 years of age (31.6%) and 25–30 years of age (19.3%). Cheeks 8.61%, forehead 64.9%, mandible 33.3%, and chin 27.2% were all damaged in all cases. Truncal involvement was lower in the chest (10.5%), back (13.2%), shoulder (9.6%), and upper arm (.3.5%). Around 43.9% of people had grade III acne, 29.8% had grade II acne, 14.9% had grade IV acne, and 11.4% had grade I acne. Females (50.0%) had more grade II and III acne than males (23.7%). Conclusion: The majority of the patients were from 20-25 years of age group. The survey also revealed a rise in the number of adult acne cases. In every case, the face was implicated, with the cheek area being the most engaged. The most prevalent grades were II and III, and females outnumbered males with these grades. Scarring corresponded to the length of acne, with icepick scars being the most common. In most cases, postacne hyperpigmentation was seen, which corresponded to the inflammatory nature of the lesions.

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Background: Tobacco consumption is a major health problem worldwide. India the second largest consumer of tobacco products and the third largest producer of tobacco in the world that places India in the second rank after China in tobacco-related mortalities. Commonly, the habit of tobacco consumption begins at adolescence, carry forwarded into adult life. Hence, if awareness has been created in adolescence then will help to eradicate tobacco consumption habit from India. Hence, a comparative study to determine the awareness regarding hazardous effect of tobacco consumption habit among rural and urban children has been planned. Materials and Methods: A cross-sectional study was conducted among schoolgoing children from rural and urban areas. The study was conducted in schools present in the districts of central India on students from classes 3^rd–10^th standard (age 8–16 years). Total numbers of students enrolled were about 806, of which about 380 students were from rural schools and 426 students were from urban schools. A pretested, close-ended, self-administered questionnaire that was derived from the GYTS-based questionnaire has been distributed after consent, and then analysis was done. Results: The prevalence of tobacco use in urban and rural areas has been calculated which came more in rural areas with 5.5%, age of commencement of habit at rural areas was from 10 years of age while in urban it was in teen ages, i.e., from 12 years. Furthermore, the smokeless form of tobacco was preferred in rural areas while in urban it was smoke form of tobacco. In rural area parents, 3.9% knowing about habit of their children and themselves were also habitual while urban areas parents were unaware of habit. Conclusion: There is more prevalence of tobacco consumption in rural schoolgoing children than urban schoolgoing children. Urban and rural area children were aware of hazardous effect of tobacco but still consumption is more in children from rural area. Hence, the focus of tobacco cessation program should be in rural area as well as in urban areas. However, the programs should be specifically designed for the area where it should be implementing keeping the difference between socioeconomic status in mind to eradicate tobacco consuming habit from India.

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Radiology is one of the branches of medical science that has made rapid progress over the past decades. The newer imaging modalities are highly accurate and use less of ionizing radiation. Therefore, when a radiologist interprets a radiographic image a lot of additional information is displayed on the images compared to the conventional imaging modalities. Artificial intelligence (AI) could be a possible modality which can reduce the workload of the radiologist thus allowing more time for the imaging of challenging cases. The field of Dentomaxillofacial radiology can also be benefited with AI since the number of qualified maxillofacial radiologist are lesser in number. AI can be helpful in various diagnostic procedures involving maxillofacial radiology. The applications could vary from age estimation using radiographs which could be beneficial for orthodontic and pedodontics purposes to radiographic detection of caries. The AI can perform a number of tasks, which could reduce the workload on a maxillofacial radiologist. However, there is a growing anxiety that AI may reduce the relevance of a radiologist in the near future. The purpose of this review is to focus on analyzing the benefits and drawbacks of AI and its application in the field of maxillofacial radiology.

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Background: Nonalcoholic fatty liver disease (NAFLD) is a term used to describe a category of liver illnesses that include everything from mild steatosis to cirrhosis. Fatty liver disease is a global problem that affects people all over the world. Materials and Methods: We enrolled 115 individuals in this trial after removing those with a history of alcohol consumption. Male and female patients aged 19 and up were included in the study only after the patient gave their informed consent. Results: 115 individuals (72 [62.6%] males and 43 [37.3%] females) with an average age of 46.6 were evaluated. Patients over the age of 19 who had been identified with fatty liver by ultrasonography and had no history of alcohol intake were included in the study. Males were 46.2 years old on average, whereas females were 43.5 years old. The majority of the patients were in the 45–55 age range (33.9%), followed by 35–45 (26.1%) and 55–65 years old (20.9%). Conclusion: Fatty liver was more common in men of 45–55 years of age. The use of ultrasound to grade the severity of NAFLD is linked to anomalies in patients' metabolic profiles. Based on ultrasound, the Federal Reserve System is linked to increased NAFLD severity.

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Background: The cesarean section is one of the common obstetrical surgery. Multimodal techniques can provide the mother with the best pain alleviation. One of the simplest and safest procedure is wound infiltration. The study is to compare the analgesic efficacy of bupivacaine wound infiltration and a mixture of tramadol and bupivacaine for postoperative pain relief. Materials and Methods: After receiving approval from the institutional ethics committee, 60 pregnant women aged 18–35 years who had undergone elective cesarean section under spinal anesthesia were included in the study. The patients were randomized into two groups of 30 each. Group B patients received 0.25% bupivacaine 0.7 mg/kg (diluted to 20 ml with normal saline), while group BT patients received 2 mg/kg tramadol mixed with 0.25% bupivacaine 0.7 mg/kg (diluted to 20 ml with normal saline). Time to first analgesia request, pain score by visual analogue scale, and diclofenac consumption in 24 h were compared. Adverse effects such as nausea, vomiting, and shivering were also noted. Results: The time to the first request for analgesia in Group T was 386.17 ± 233.84 min compared to Group B which was 192.50 ± 134.77 (P < 0.0002). Total diclofenac consumption in the first 24 h was significantly reduced in Group T compared to Group B (P < 0.0068). Conclusions: Subcutaneous infiltration of the wound with tramadol and bupivacaine prolongs the absence of pain and the consumption of analgesics after cesarean section and at the same time increases patient satisfaction.

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Congenital heart and vessel malformations occur in 5–8 per 1000 live births, resulting in an occurrence of around 0.7%. Some of these malformations (10%–15%) do not need correction. The key aims of recovery are to remove impairments, disabilities, and disabilities, improve quality of life (QOL), and minimize disease-related morbidity and postoperative disease. Aim: This study aimed to investigate the effect of exercise programs of 2 weeks on the outcomes of functional capacity and QOL in a postoperative surgery. A 12-year ventricular septal defect survivor underwent primary treatment consisting of open-heart surgery. The patient was given an exercise program comprising techniques of clearance, re-expansion maneuver, vibration, percussion, compression, manual hyperinflation, positioning, postural drainage, cough stimulation, aspiration, breathing exercise, and increased expiratory flow mobilization. For 2 week (three times/day), functional capacity and QOL were measured before and after completion of the exercise program. Considerable improvement in functional capacity and QOL was observed after 2 weeks of the multiple techniques and exercise intervention. The complementation intervention was found to be effective for improving various physiological aspects associated with open-heart surgery. This case study concluded that the complementation intervention was effective for improving various physiological aspects associated with open-heart surgery including QOL.

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Pleural effusion has been reported in 7%–30% of patients with Hodgkin's lymphoma.^[1] Unilateral and bilateral effusions are equally prevalent. Increasing stage, any extranodal involvement, and bulky mediastinal disease were each predictive of pleural effusions.^[2] Pleural fluid Adenosine deaminase (ADA) levels in such cases may be elevated, normal, or in the indeterminate range (40–60 IU/l), which alone should not be the criteria for starting anti-tubercular therapy without comprehensive radiological and pathological investigations to look for any malignant etiology.

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Background: In India, tobacco is used in various forms, leading to an addictive behavioral disorder. Usually the homeopathy medicines are considered to be free from any side effects. The employees of a bus depot were addicted to tobacco and were contemplating on giving up the habit. Aim and Objective: To compare the effectiveness of non nicotine replacement therapy with behavioural councelling and placebo with behavioural councelling in tobacco abstinence at 6th and 12th month. Material and Methods: A triple blind, parallel group, placebo controlled, randomized clinical trial was conducted amongst 51 workers of bus workshop. Demographic data was recorded. Tobacco dependency was assessed using Fagerstrom questionnaire; Oral mucosa condition, CPI and LOA was recorded using WHO oral health assessment form 1997 and stains on teeth surfaces was recorded by Lobene stain index (1968). The intervention group received homeopathy medicine, control group received placebo and both groups received behavioural counseling and were followed up to 12 months. Results: Tobacco abstinence was seen in both the groups, but there was no statistically significant difference between the two groups at the end of six and twelfth month (p>0.05). The mean reduction in the frequency of tobacco consumption and the dependency score within both the groups was statistically significant (p=0.00). The intervention and the control group helped 6 Vs 5 participants to abstain from the habit. Conclusion: Homeopathy medication ie. Tabaccum, Avena Sativa, Nux Vomica, Staphysagria, Caladium have shown to be beneficial in tobacco cessation.

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Background: Adropin has been revealed to be a powerful regulatory hormone involved in insulin sensitivity and energy homeostasis. Materials and Methods: A total of 100 subjects were included in the study, out of which 50 were type 2 diabetic patients and 50 were healthy subjects as controls. Type 2 diabetes mellitus (T2DM) was defined using the American Diabetes Association criteria. Controls were recruited from healthy men who were visited by endocrinologists of the same clinic and were excluded if they had a history of diabetes mellitus in their first-degree relatives. Results: There were significant differences regarding body mass index of diabetic patients and healthy controls. T2DM patients had expectedly significantly lower fasting blood sugar (FBS), glycosylated hemoglobin, and homeostasis model assessment of insulin resistance (HOMA-IR) levels compared to healthy controls (P < 0.001) and decreased insulin level in type 2 diabetic patients. Conclusion: Adropin level was found to be significantly lower in type 2 diabetic patients compared to healthy subjects. Adropin was inversely correlated with FBS in type 2 diabetic patients and was also negatively correlated with HOMA-IR.

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Mandible fractures are one of the most common sites of maxillofacial injuries due to their anatomical location which makes its vulnerable to direct impacts. The main promoters of this kind of injury are assault, road traffic accidents, and gunshot injuries. The prevalence of comminuted mandibular fracture is 30%–50% when compared to other facial bones. It is often associated with the presence of multiple bones involving several lines of fracture, resulting in small fragments within the same area. This often leads to functional and esthetic problems. Management of comminuted mandibular fractures includes various modalities such as closed reduction, external pin fixation, wire osteosynthesis, and open reduction and internal fixation (ORIF) using miniplates, reconstruction plates, titanium mesh tray, and bone grafts. The objective of this case report is to highlight a 31-year-old male patient with comminuted mandibular fracture treated with ORIF using a 2.7 mm reconstruction plate, followed by a short period of maxillomandibular fixation

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The oral cavity provides an environment for the growth of various microorganisms. Occasionally, these microorganisms become pathologic and cause infections. Children are more susceptible to viral, bacterial, and fungal infections due to immature immune system. The clinical presentation of various viral infections in children is discussed in this article. This will provide a broader overview of the disease and their manifestations to the pediatrician for better diagnosis and management.

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Background: One-stage full-mouth disinfection (OSFMD) may provide more effective treatment in generalized aggressive periodontitis (GAP) by targeting tissue-invasive bacteria. The present randomized, placebo-controlled, double-masked clinical trial aimed to compare the effectiveness of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) in OSFMD treatment of patients with GAP. Materials and Methods: Twenty-two patients were randomly allotted into two groups: Group 1 (Test): 11 patients receiving OSFMD with NaOCl gel and mouthwash and Group 2 (Control): 11 patients receiving OSFMD with CHX gel and mouthwash. Clinical measurements such as plaque index (PI), modified sulcus Bleeding Index (mSBI), probing depth (PD), and clinical attachment level (CAL) were measured at baseline and 6 months. Results: Both groups showed a nonsignificant difference. At 6 months, mean PI, mSBI, PD, and CAL for the NaOCl group were 0.47 ± 0.23, 0.42 ± 0.15, 2.85 ± 0.61, and 3.06 ± 0.67, respectively, as against 0.35 ± 0.17, 0.30 ± 0.13, 3.04 ± 0.66, and 3.35 ± 0.86, respectively, for the CHX group. Using Student's t-test, patients in Groups 1 and 2 demonstrated no significant difference (P > 0.05) at the end of 6 months. Conclusions: Both treatment modalities seemed to benefit the patients. Although NaOCl is a safe, effective, and inexpensive antiseptic, its short-term use as a mouthwash and gel, at 0.05% concentration, does not contribute to any added clinical benefits in comparison with CHX in GAP patients. Further clinical research is required for testing the longer periods of administration and/or higher concentrations to signify whether this antimicrobial may truly be used as a long-term chemical plaque control.

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Aim: The aim of this study is to predict the response of neoadjuvant chemotherapy (NACT) based on preoperative molecular subtyping of locally advanced breast cancer patients. Materials and Methods: The present single-blind, observational study was conducted at the tertiary health-care center of Acharya Vinoba Bhave Rural Hospital from October 2018 to September 2020. This study comprised 46 patients suffering from breast cancer with TNM stage IIIA and IIIB. The patients received either NACT with cyclophosphamide/adriamycin/5-fluorouracil or paclitaxel, respectively, followed by the standard surgical procedure of modified radical mastectomy. Baseline ultrasound was followed by Trucut biopsy of the tumor which was done with 18-G Bard Trucut biopsy needle under local anesthesia in all aseptic conditions. The specimens were collected and preserved in formalin and were sent for the assessment of tumor histological examination, Scarff-Bloom-Richardson grade, and immunohistochemistry (IHC) evaluation. Depending on the luminal status obtained by IHC preoperatively, further response to chemotherapy was assessed. Results: In the CAF group, patients with human epidermal growth factor receptor 2/neu (HER2/neu)-enriched status had (91.40% ± 7.76%) tumor response followed by luminal B status (89.33% ± 5.77%), triple-negative status (87.34% ± 9.55%), and finally luminal A status with (84.87% ± 8.11%) a statistically nonsignificant relation. In the paclitaxel group, patients with triple-negative status had a tumor response of (96.59% ± 4.48%) followed by luminal B status (96.28% ± 3.27%), HER2/neu-enriched status (91.33% ± 6.85%), and finally luminal A status (82.40% ± 11.29%) with a statistically significant relation (P = 0.023). Conclusion: It can be concluded from the results that overall, HER2/neu-enriched and triple-negative status patients showed better tumor response to NACT in both groups.

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Background: Henoch Schonlein Purpura (HSP) is a systemic vasculitis which manifests as a triad of skin rashes, joint pain and abdominal pain. The cutaneous manifestations include nonthrombocytopenic, nonblanching palpable purpura. The skin lesions are usually seen mainly in the lower limbs and this has been ascribed to the effects of gravity. The disease is common in childhood and relatively rare in adulthood. Case Report: A 60 year old female presented with two weeks history of rashes, abdominal pain, loose stools, knee and shoulder pain .The rashes were multiple and symmetrical and first noticed by her in left upper limb, within a day appeared on the other limb and lower limbs also. Skin biopsy report revealed leukocytoclastic vasculitis with neutrophilic infiltration and prominent nuclear fragmentation, involving the upper and middle layers of the dermis with IgA deposition on immunofluorescence. She was treated with Oral Prednisolone 20 mg BID. The rash had resolved at follow up with resolution of symptoms. The unique feature of this case was involvement of upper limbs and age of the patient. Conclusion: This case underlines the points that occasionally even the upper limb can be involved and even elderly adults can have this condition. There is a need for clinicians to be aware of the varied presentations of this condition.

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To evaluate the antifungal and antimicrobial property of chitosan (CS) nanoparticles (NPs) incorporated in denture base published in the literature, for rehabilitating the patient with removable prosthesis. This systematic review was conducted as per the preferred reporting items for systematic reviews and meta-analyses guidelines which is the most opted reporting protocol. A protocol was developed prior, which covered all the aspects of the review. Electronic database PubMed and Cochrane library were searched. The Population, Intervention, control and outcomes (PICO) model included the studies in which patients rehabilitated with removable dental prosthesis. An electronic search was conducted comprised of peer review restricted to the English language dental to identify the relevant scientific article on CS NP in dental prosthesis. A hand search was also carried out the result being the selection of six articles that were considered in this systematic review. Qualitative analysis. The documented 5 articles associated with the incorporated CS NP were reviewed systematically. CS incorporated prosthesis helps in minimizing fungal and bacterial colonization; findings of all studies confirmed the inhibitory effect of nano-CS particles on biofilm formation.

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Context: The study objective was to compare precorneal tear film in terms of amount and stability in diabetic individuals. Aims: The aim was to study the effect of diabetes on the amount and stability of precorneal tear film. Settings and Design: This is a hospital-based, prospective, case-controlled, observational study of 1-year duration. Sixty-five sequentially collected patients with diabetes attending the Ophthalmology outpatient department/inpatient department at AVBRH were selected for the study after taking the inclusion and exclusion criteria into consideration. Informed consent was obtained from all participants after approval by the Institutional Ethical Committee of the college. Subjects and Methods: After enrollment of the participants in the study, all underwent a thorough ophthalmic examination. Tear film break up time (TBUT) and Schirmer test without anesthesia followed by with anesthesia were calculated. Statistical Analysis Used: Statistical analysis was done using descriptive and inferential statistics using Chi-square test and Student's unpaired t-test, SPSS 17.0 version and GraphPad 6.0 version software (Biomatters, Ltd. NZ and GSL Biotech, USA) were used in the analysis, and P < 0.05 was considered the level of statistical significance (P < 0.05). Results: Patients with diabetes showed unstable tear film. The amount of tear film measurement also decreases in diabetics. A higher number of positive test results for both Schirmer test and TBUT test were found in patients having a duration of diabetes >5 years. Conclusions: Longer duration of diabetes is associated with dry eye. Diabetes is associated with a reduction in the amount of precorneal tear film as well as an unstable precorneal tear film.

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Objectives: The objectives of this study were to evaluate the parental responses about sleep-disordered breathing (SDB) and its association with mouth breathing (MB) in their children. Subjects and Methods: A structured questionnaire consisting of 10 questions was framed. Out of 110 children, 30 parents who responded to a questionnaire-based study were included after obtaining their consent. After obtaining their responses, all the questions were evaluated to understand the parental responses to associate their knowledge about SDB of their children with the presence of MB in their children. Chi-square test was used as the study consisted of qualitative questions. Results: Responses in order of chronological sequence received from parents for their children were as follows: child feels thirsty (25 [83.33%]), strange position of child during sleep (24 [80%]), child struggles to breathe (16 [53.33%]), child feels dry mouth on waking (14 [46.66%]), child has upper respiratory tract infections (6 [20%]), child unusually sleepy during day time (5 [16.66%]), and child appears to be more hyperactive (5 [16.66%]). Other less common responses were related to restless sleep of child and snoring. Conclusions: Parental responses for its association with MB in children are important to help us diagnose early symptoms; further, it can be correlated with clinical predictors to confirm the MB habit in their children.

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Background: Most of the induction agents cause hypotension. Accurate assessment of the depth of anesthesia using various monitors contributes to tailor drug administration, thus maintaining anesthetic depth and improving hemodynamic stability. Aim: The aim of this study is to compare the hemodynamic responses during induction and intubation between etomidate and thiopentone and to compare their doses, using entropy-guided hypnosis levels, in patients of coronary artery bypass surgery (CABG). Methodology: After ethics committee clearance, 60 patients for CABG were randomly allocated into the etomidate or thiopentone group, based on induction agents. Anesthesia was induced using intravenous etomidate or thiopentone titrated to state entropy (SE) level of 40–60. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressures, response entropy, and SE were recorded before, during, and after induction of anesthesia. Statistical analysis was done using descriptive and inferential statistics using Chi-square test, Students paired and unpaired t-test. Results: Stable hemodynamics was maintained with both etomidate and thiopentone. There was 33.3% and 34% less dose requirement in the etomidate and thiopentone groups, respectively. Minimal drug side effects and lesser complications were observed with equipotent doses, using entropy to guide equivalent hypnosis levels. Conclusion: The use of etomidate and thiopentone titrated to entropy leads to reduced etomidate and thiopentone dosage translating into increased hemodynamic stability during induction with adequate anesthetic depth.

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Several viruses show a very high mutation rate and can rapidly evolve to yield new variants resulting in a novel expression of disease. The virus mutation rate is a significant parameter to understand the evolution and pathogenesis of the viruses, to combat them, and has biomedical implications. At the epidemiological and evolutionary levels, the mutation rate is one of the factors that can define the risk of emergent infectious disease. In the wake of the recent novel virus pandemic COVID-19, we review the viral mutation rates, virus dynamics, and various vaccination strategies.

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Background: Most patients develop lower respiratory tract infections of infectious etiology during the course of human immunodeficiency virus (HIV) infection. High burden of tuberculosis (TB) among HIV-infected patients leads to lowering of immunity, thus increasing the incidence of other opportunistic infections. The present study was conducted to discuss the impact of lower respiratory tract infections(LRTI's) including TB in HIV-infected patients. Materials and Methods: A prospective case–control study was done on 180 treatment-naive HIV-seropositive patients and 100 HIV-seronegative controls having LRTIs for a period of 1 year. Expectorated and induced sputum samples were collected and screened for Mycobacterium tuberculosis by smear microscopy. Five milliliter of venous blood was collected from each patient for determination of cluster of differentiation 4+ (CD4+) T-cell lymphocyte counts. Results: Acid-fast bacilli were observed in 40.55% (73/180) of HIV-infected patients compared to 17% (17/100) in seronegative patients (P < 0.001). About 69.86% (51/73) of HIV-TB co-infected patients had CD4 + T-cell lymphocyte count < 200 cells/μl (P < 0.05). CD4 + T-cell lymphocyte counts of HIV-TB co-infected patients were comparable to patients having LRTI's other than TB (P > 0.05). Conclusion: LRTIs lead to a significant lowering of CD4 + T-cell lymphocyte counts among HIV-positive patients. Hence, routine screening along with laboratory confirmation for all lower respiratory tract infections in addition to TB is essential to manage coinfections in HIV patients.

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Background: Abnormal thyroid function leads to a lot of health complications. Apart from the levels of T3 and T4, abnormal levels of thyroid stimulating hormone are a matter of concern. Hypothyroidism has been reported to be associated with symptoms of a variety of musculoskeletal (MSK) dysfunction. Inflammation is the primary cause of MSK dysfunction. Adipocyte secreting adiponectin plays a crucial role in the establishment of inflammatory conditions in the whole system. Aims and Objectives: The present study is aimed to evaluate the interrelationship between adiponectin and thyroid abnormalities to induce the inflammatory markers associated with MSK dysfunction. Materials and Methods: Elevated gene expression and synthesis of interleukin 6 (IL 6) and tumor necrosis factor alpha (TNF α) have been implicated in a variety of immunologically driven inflammatory diseases. Patients with thyroid complications were included in the study (n = 300). Thyroid function test, lipid profile, adiponectin, IL 6, and TNF α levels were measured. Compared to hyperthyroidism significant decrease in high density lipoprotein cholesterol was observed in hypothyroid individuals. Results: Significantly decreased adiponectin levels were observed in hypothyroid patients. Elevated levels of inflammatory markers such as IL 6 and TNF α were also observed in the patients with hypothyroidism as compared to the hyperthyroid individuals. Results observed in the present study revealed that conditions of hypothyroidism synergistically favor the progression of rheumatoid arthritis complication. Conclusion: We observed significantly decreased levels of adiponectin in hypothyroid patient samples as compared to the samples of hyperthyroid patients.

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Malignant proliferating trichilemmal tumor (PTT) is a rare adnexal tumor with follicular differentiation. It mainly occurs in the scalp region of elderly females. It is a solitary, large ulceroproliferative lesion that can have an aggressive clinical course with metastases. Clinically and histologically, it is a close mimicker of squamous cell carcinoma. We report a middle-aged female who came with sudden enlargement of a longstanding nodular scalp lesion in the left parietal region. Incisional biopsy revealed a malignant PTT of the scalp. She underwent wide local excision of the mass and is doing well without any evidence of recurrence after 5 months of follow-up.

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Leiomyosarcoma of the renal pelvis is an extremely rare mesenchymal tumor of the kidney. A 68-year-old male presented to the Urosurgery Department with hematuria, right flank pain, and burning micturition. On ultrasonography of the abdomen and pelvis, a soft tissue density mass lesion involving right renal pelvis and lower calyx measuring 2.5 cm × 1.5 cm × 1.4 cm in the right renal calculi, mild right hydronephrosis and hydroureter, mobile vesicle calculus, and mild prostatomegaly with changes of cystitis with significant postvoid residue were noted. The primary diagnosis based on imaging findings computed tomography (CT) abdomen and pelvis multiple detector CT scan, was given as suggestive of malignant tumor of the right kidney and pelvis. The right radical nephrectomy was done. On histopathology, it was confirmed as leiomyosarcoma of the right renal pelvis. We report an extremely rare tumor leiomyosarcoma of the renal pelvis for its clinical, radiological, and histopathological findings.

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Background: Music is an inexpensive, easily available anxietolytic known to mankind since ages. Cataract extraction surgery is one of the widely performed surgeries under local anesthesia. India is a developing country where limited resources are spent over health infrastructure which has to cater to a large population. In our study, we have tried to utilize the anxietolytic effect of music in combating the anxiety and stress patients suffer from during surgery to essentially better the postoperative prognosis of the patients in the most inexpensive way possible. Materials and Methods: The sample size was decided taking into consideration various prevalence studies. The patients were consequently recruited for the study considering the inclusion and exclusion criteria. Patients were divided into two groups – both undergoing phacoemulsification surgery under local anesthesia by the same surgeon in the same operating room where one group was made to listen to "Classical Sitar Music," whereas the other group was not made to listen to music. Blood pressure and heart rates were measured before and after surgery and compared in all patients. Results: Blood pressure and heart rates were statistically significantly normalized (lowered) postoperatively as compared to their preoperative values in the group which were made to listen to music. Conclusion: Music can be used widely used in decreasing anxiety levels in patients undergoing cataract extraction surgery, thereby improving the postoperative prognosis in patients in a cost-effective way.

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Mirror syndrome, by definition, is maternal edema with fetal hydrops. Majority of the pregnancies in developing countries are complicated by preeclampsia and intrauterine growth retardation. Fetal ascites, on the other hand, is a part of spectrum of the condition under hydrops fetalis. Abnormal umbilical artery Doppler is an indicator of fetal growth retardation and not many cases are found with such diversely intermixed conditions. A 26-year-old primigravida with 36 weeks gestation by the last menstrual cycle and 34 weeks by ultrasound presented to our hospital with a history of decreased fetal movements, headache, fever, weakness, dizziness, and new-onset raised blood pressure. Her blood pressure was 164/118 and 3+ proteinuria on the urinary dipstick test. A diagnosis of preeclampsia was made. An antenatal ultrasound was performed, which showed fetal ascites, mild thickening of fetal skin, oligohydramnios with reversed umbilical artery flow but normal uterine arteries, and middle cerebral arteries. The blood pressure was controlled and she later delivered a low-birth weight baby that needed neonatal intensive care unit stay for fetal distress and abdominal distention. The baby did not survive the coming few days and died due to increasing fluid in the body cavity. The mother continued to have raised blood pressure in the postpartum period. Mirror syndrome is when the maternal pathology mirrors that of the fetus. Preeclampsia, fetal hydrops, and placental edema are the conditions lead to suspicion of it. In the case, we present, the mother had preeclampsia, and there was fetal ascites and reversed umbilical flow. The fetal and maternal outcome was in the form of intrauterine growth retardation, impending hydrops fetalis and chronic hypertension, respectively.

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Splenic abscess is an infrequently encountered condition. Diagnosis becomes especially challenging when a patient is a healthy asymptomatic individual with incidental finding of a cystic lesion in the spleen on imaging. The prognosis of splenic abscesses is better if they are diagnosed early since successful management of splenic abscess depends on early initiation of treatment. We present one such case report of a healthy, relatively asymptomatic adult with incidentally detected splenic abscess with no history of toxic symptoms.

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Introduction: Areca nut (AN) affects oral cavity as well as various body systems. Its adverse effects on oral cavity are widely reported in the literature. However, limited studies described its systemic effect. Thus, the present study was undertaken to evaluate the association of AN habit with diabetes mellitus (DM) and its correlation with liver toxicity. Aim: The aim of the present prospective study was conducted in the Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital and the Department of General Medicine, AVBRH Sawangi (Meghe), Wardha, to determine the correlation between AN, DM, and liver toxicity. Methods: The present study included 280 patients suffering from DM. They were assessed for medical history which included age at the onset and duration of DM. Detailed AN habit history was recorded that included the type of the habit, age at which the habit was started, and duration of habit. To evaluate the correlation of DM with liver damage, liver enzymes were estimated. Results: The positive correlation was observed between duration of DM and duration of AN chewing habit. The habitual patients suffered from disease at an early age (36.25 ± 7.62 years) as compared to nonhabitual (47.56 ± 4.89 years). Furthermore, there was a positive correlation between duration of disease and duration of habit with increased liver enzymes which is an important factor determining liver toxicity. Conclusion: A positive association was noted between AN habit and DM and also with liver toxicity.

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Background: The metabolic syndrome (MetS), a cluster of abdominal obesity, dyslipidemia, hypertension and hyperglycemia, is a common basis for atherosclerotic vascular diseases in industrial countries exposed to overnutrition. Adiponectin is an adipose-derived plasma protein with anti-atherogenic and insulin-sensitizing activities. Materials and Methods: There were 46 subjects with MetS and 46 control groups. Mean serum level of adiponectin and high sensitive C-reactive protein (CRP) were lower and higher in subjects with MetS than control groups, respectively. Results: The serum adiponectin in the cases 2.43 ± 0.83 μg/ml was lower compared to the controls 7.54 ± 0.94 μg/ml (P value was 0.001), the difference was statistically significant. The serum hs-CRP in the cases 3.8 ± 1.26 μg/ml was lower compared to the controls 1.4 ± 0.74 μg/ml (P value was 0.001), the difference was statistically significant. Conclusion: The high hs-CRP and low adiponectin have a positive and negative relationship with certain MetS components. High sensitive C-reactive protein (hs-CRP) was found to have a stronger link to the MetS than adiponectin. It appears that high-sensitivity CRP (hs-CRP) may be a substantial risk factor for MetS. In contrast to prior findings, this study suggests that hs-CRP is more relevant than adiponectin as a diagnostic biomarker for MetS. These variations could be related to changes in lifestyle and food habits among Sambalpur residents with MetS.

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Background: Malaria, a condition that affects immunological responsiveness, appears to interfere with immune processes during pregnancy. During pregnancy, females are especially vulnerable to illnesses, which can have catastrophic repercussions for both the mother and the fetus. Materials and Methods: A total of 64 participants out of which 32 pregnant nonmalaria participants in Group A and 32 pregnant malaria participants in Group B. The study included participants between 20 and 42 years of age. Participants presenting with the symptoms of malaria such as headache, fever, weakness, and nausea were included. Results: The hematological parameters among the study participants. The mean transferrin level in Group A and Group B was 3.42 ± 1.26 and 4.86 ± 2.37 [Figure 1]. There was a significant difference between the two groups. The total iron-binding capacity and serum iron also showed a significant difference between the two groups. The transferrin saturation in Group A was 25.6 ± 8.51 and in Group B was 26.24 ± 5.61. There was no significant difference in the transferrin saturation and hemoglobin levels between the groups. Conclusion: Hematological and biochemical indicators may be effective in detecting malaria in pregnant women with parasites deep in tissues that are difficult to identify using a microscope.

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Background: Classically, pulmonary veins (PV) open to the left atrium (LA) through four ostia on its posterior wall. Variations from this pattern in the form of a common venous ostium or additional ostia are not uncommon. The myocardium of the LA extends into the PVs as myocardial sleeves (MS) which are often the site of focal electrical activity that initiates atrial fibrillation. The aim is to study the morphology of pulmonary venous ostia and posterior wall of LA and to find their correlation. Materials and Methods: Forty formalin preserved specimens of the heart were included in this study. The number and position of PV ostia were noted and categorized into six types. The dimensions of ostia and posterior wall of LA were measured. Data were statistically analyzed. The pulmonary venous wall was examined microscopically for the presence of myocardial tissue. Results: Classical pattern was the commonest (62.5%) followed by additional middle PV (MPV) on the right (12.5%) and common ostium on the left (10%). The mean diameter was maximum for the common right PV ostium (14.7 mm ± 0.5) and minimum for the right MPV ostium (8 mm ± 1.4). The mean sagittal and coronal dimensions of LA were 56.4 mm ± 11.4 and 47.9 mm ± 8.7, respectively. R Square value of 43% and Pearson's correlation of 0.58 showed a strong association between ostial and atrial area. MS was found microscopically in the venous wall. Conclusion: The morphometry of PV ostia and LA can provide useful information for cardiothoracic surgery.

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In postpubertal age, one of the most common genital tract malformations is imperforate hymen and the patient usually presents with abdominal pain of cyclical nature with palpable abdominal mass and increased frequency of micturition. We report an unusual case of a 15-year-old girl who had a history of hematocolpos for which she underwent simple hymenotomy and drainage of collected menstrual blood from the genital tract, 2 months later, she again developed similar complaints of increased frequency of micturition and some palpable masses in the lower abdomen. On further investigation, magnetic resonance imaging showed recurrent hematocolpos but with a transverse vaginal septum. For which she again underwent hymenotomy and septal excision with Z-plasty. Imperforate hymen is a rare congenital malformation of the vagina that can be treated and diagnosed easily. An adequate early management requires proper knowledge and clinical history of pain with amenorrhea in young girls for diagnosis.

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Purpose: Whether electric arc welded and laser-welded Ni-Cr alloys can resist tensile stresses in the oral environment is unknown. Materials and Methods: Sixty Ni-Cr bars (0.8 mm × 60 mm) with a circular cross-section were cut in half and welded using laser welding and electric arc welding. Fifteen bars from both the group were immersed in artificial saliva at pH 7 and pH 2 at room temperature for 60 days and remaining 15 samples were used as control. After the stress corrosion simulation, the tensile strength was determined using universal testing machine. Results: On comparison between the electric arc welded and laser welded samples, the laser welded samples showed a significant decrease in the tensile strength after simulation in artificial saliva (P = 0.05). Oral condition simulation did not affect the tensile strength of electric arc welded samples (P < 0.001). Conclusion: Oral simulation decreased the tensile strength of laser welded Ni-Cr bars.

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Background: Comparative study of visual outcome and astigmatism between manual small-incision cataract surgery (MSICS) done through a 5.5 mm and 4.5 mm superior scleral incision. Aim: The aim of this study is to compare the visual outcome and astigmatism in manual small-incision cataract with superior scleral incision size of 4.5 mm and 5.5 mm. Settings and Design: This is a hospital-based, prospective, case–control observational study of 6-month duration; 110 eyes of 110 patients with cataract attending the ophthalmology outpatient department/inpatient department at Acharya Vinoba Bhave Rural Hospital were selected for the study after taking the inclusion and exclusion criteria into consideration. Informed consent was obtained from all participants after approval by the institutional ethical committee of the college. Materials and Methods: After enrollment, the patients were divided into two groups, one which underwent cataract extraction by MSICS with 4.5 mm superior scleral incision and the other which underwent cataract extraction by MSICS with 5.5 mm superior scleral incision. All surgeries were done by the same surgeon under the same setting and visual outcome and astigmatism were studied and compared between the two groups. Statistical Analysis Used: Statistical analysis was carried out using descriptive and inferential statistics using Chi-square test and Student's unpaired t-test and software used in the analysis was SPSS 17.0 version and GraphPad 6.0 version and P < 0.05 is considered a level of statistical significance. Results: Surgically induced astigmatism (SIA) in MSICS with 4.5 mm superior scleral incision was comparatively less as compared to that in patients in whom 5.5 mm incision was used. Conclusions: In the present study, we found that MSICS with 4.5 mm scleral incision has a better visual prognosis for cataract extraction as compared to conventional extracapsular cataract extraction in terms of better and early visual rehabilitation and lesser SIA.

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One of the most common causes of mortality of females in the first trimester is ectopic pregnancy. Ectopic pregnancy can occur at different anatomic locations of which the fallopian tube is most common. Very rarely implantation of blastocyst can occur in the lower uterine segment at the site of the previous transverse cesarean section; this very rare type of ectopic pregnancy is known as cesarean scar pregnancy. Cesarean scar pregnancy is usually associated with the risk of uterine rupture leading to hemorrhage and hence diagnosis at an early stage and a proper management is necessary to avoid any serious complications. We present an interesting case of a 39-year-old elderly woman of G3P2 L2 who complained of amenorrhea for the past 7 weeks. Her urine tested positive for β-human chorionic gonadotropin, and she was further sent for antenatal ultrasound scan to confirm the pregnancy. On transvaginal ultrasound examination, there was a single gestational sac with yolk sac, fetal pole, and cardiac activity seen at the anterior end of the lower uterine segment near the old healed scar of the previous cesarean section corresponding to the gestational age of 6 weeks and 6 days. A diagnosis of cesarean scar ectopic pregnancy was made. The woman underwent a laparotomy with excision and termination of the pregnancy. Ectopic pregnancy of any location should be promptly diagnosed and adequately treated. In cases where transvaginal ultrasonography is inconclusive, magnetic resonance imaging is performed. Diagnosis is important to avoid any further complications and in young females to preserve fertility.

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