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Tuberculosis (TB) is one of the most common contagious diseases worldwide. Over the past few decades, researchers have made significant efforts to prevent TB. Recent predictions indicate that the prevalence of Diabetes Mellitus (DM) will reach 552 million by 2023 due to ongoing epidemiological changes in several countries across the globe. India is expected to have 62-80 million people with diabetes by 2030, making it the "Diabetes Capital" of the world. Present review discusses the urgent need to understand the mechanisms and implications of DM on the immune systems of TB patients. The correlation between TB and DM has been shown to be bidirectional. Numerous studies have revealed a higher prevalence of diabetes in TB patients, as their immune systems are compromised. TB patients with DM experience progressive deficits in both innate and adaptive immune cell activity, reducing their ability to suppress Mycobacterium tuberculosis (M. tuberculosis) and increasing their risk of developing TB. Increased inflammation and elevated levels of inflammatory cytokines in circulation are characteristics of TB with DM co-morbidity, which indicate the active involvement of the angiogenesis-inflammation nexus. Therefore, to alleviate the burden of both disorders, it would be beneficial to make informed therapy choices by gaining a better understanding of TB immunology in the context of DM. [ABSTRACT FROM AUTHOR]

Introduction: Fracture management is one of the well-established concepts in Ayurveda with numerous fracture healing drugs mentioned for topical application. The present study is an attempt to form a compound of few of those drugs which can be used as a plaster cast. The effect of this Herbomineral ayurvedic plaster cast on fractures would be studied both in aspects of immobilisation and fracture healing. Shallakyadi plaster which is a novel compound composed of resin of Boswellia serrata Roxb, resin of Acacia nilotica (Linn.) Willd.ex Del, root of Glycirrhiza glabra Linn, whole plant of Cissus quadrangularis Linn, Stem of Rubia cordifolia Linn, bark of Terminalia arjuna Wight & Arn (W&A), resin of Commiphorawightii Arn, Kaolinite (phyllosilicate of aluminium) and hydrated magnesium silicate can be used as a herbomineral ayurvedic compound for the healing of fractures. Need of Study: Standard Plaster of Paris (POP) cast has no therapeutic role on healing of fracture other than the purpose of immobilisation, whereas the drugs in Shallakyadi Plaster have known effects on bone healing and also provide the adequate immobilisation provided by Standard POP cast. Hence, the present study will compare the efficacy of Shallakyadi Plaster and Standard POP in the management of simple fractures of long bones of upper limb. Aim: To study and compare the efficacy of Shallakyadi plaster and standard POP in the management of simple fractures of long bones of upper limb. Materials and Methods: The present study is designed as a randomised control trial which would be conducted in Mahatma Gandhi Ayurveda College Hospital and Research Centre (MGACHRC), Salod Hirapur (H), Maharashtra, India for three months, in which 60 patients will be enrolled. Standard POP Plaster or Shallakyadi plaster will be applied for local application over the fractured area. Parameters like pain, swelling, loss of function, tenderness would be studied subjectively and callus formation would be taken as the objective parameter. Statistical analysis would be done using GraphPad Prism 7.0 V software and statistical tests- Chi-square test, Wilcoxon's rank sum test and Wilcoxon's signed rank test will be applied with level of significance as 0.05. [ABSTRACT FROM AUTHOR]

Introduction: Vascular dysregulation is a common underlying factor between migraine and glaucoma. Fluctuations in Ocular Perfusion Pressure (OPP) can lead to ischaemia and damage to the optic nerve head. It is unclear if the risk of glaucoma in migraine patients is due to low OPP. Aim: To compare the OPP of migraine patients with healthy controls and assess the role of OPP as a risk factor for glaucoma in migraine patients. Materials and Methods: This case-control study was conducted from June 2019 to May 2020 at Yenepoya Medical College Hospital, Mangaluru, Karnataka, India. Adult patients of either gender, aged between 18 and 40 years, diagnosed with migraine, were included in the study. Intraocular Pressure (IOP), blood pressure, and OPP were measured in 94 migraine patients and compared with 94 age-matched controls. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. Independent t-tests were used for comparison. Adjusted odds ratios were calculated using binary logistic regression, and a p-value <0.05 was considered statistically significant. Results: The mean IOP was 13.27±2.02 mmHg among cases and 13.38±1.87 mmHg among controls. The mean Systolic Blood Pressure (SBP) was 118.91±4.67 mmHg among cases and 116.09±5.18 mmHg among controls. The mean Diastolic Blood Pressure (DBP) was 77.72±4.48 mmHg among cases and 75.77±4.89 mmHg among controls. The mean OPP was 47.69±2.43 mmHg among cases and 46.08±2.46 mmHg among controls. The t-test values showed a statistically significant difference in SBP, DBP, and OPP between the two groups (p-value<0.05). Conclusion: The OPP in migraine patients differed significantly from that of the controls. However, further studies are needed to evaluate the relationship between perfusion pressure abnormalities and the risk of glaucoma in migraine patients. [ABSTRACT FROM AUTHOR]

Introduction: Fear of the unknown causes anxiety in paediatric patients. The use of tell-show-do, along with audiovisual distraction, promotes positive behaviour and reduces anxiety. The use of a Dental Operating Microscope (DOM) as a visual distraction aid provides better cooperation in paediatric patients. Aim: To evaluate the effects of a DOM on anxiety, behaviour, and treatment time during a restorative procedure in paediatric dental patients. Materials and Methods: The present study was a parallel-arm, randomised clinical trial conducted at IGIDS, Puducherry, India, in 2022, over a period of four months. Healthy five to seven-year-old children on their first dental visit were selected (n=90) and divided into two groups using simple randomisation. Group A: Restoration of teeth without a DOM, and group B: Restoration of teeth using a DOM. Anxiety and behaviour were measured as soon as the child entered the operatory (T1), after tell-show-do for the procedure (T2), after cavity preparation (T3), and after completion of the restoration (T4). Caries removal efficacy and treatment duration were also assessed. The data obtained were statistically analysed using the Chi-square test and independent sample t-test (p<0.05). Results: Out of the 90 children who participated in the study, 47 (52%) were girls, and 43 (47%) were boys. There was a decrease in anxiety and improved patient behaviour during cavity preparation (T3) and after completion of restoration (T4) in group B (p<0.001). The operator also reported higher visual (71.10%) and tactile (95.60%) scores in caries removal, with a shorter treatment duration in groups where DOM was used (p<0.001). Conclusion: The use of DOM reduced anxiety levels and improved the compliance of children during dental procedures. Operator ergonomics and the quality of treatment could be enhanced by recommending DOM in regular paediatric dental practice. [ABSTRACT FROM AUTHOR]

Introduction: The eyes are the most precious human organ for the function of vision, expression and beauty. Good vision contributes to improved athletic ability, better driving skills, improved learning, comprehension and better quality of life. Eye helps to participate in occupation, hobbies, and even to perform most everyday tasks. Aim: To assess the practice of ocular hygiene and the risk for ocular disorders among undergraduate students in a selected college in Southern India. Materials and Methods: A cross-sectional study was conducted in Yenepoya Ayurvedic College, Mangaluru, Karnataka, India from October 2021 to September 2022. It was conducted among 178 subjects recruited by convenience sampling technique. Undergraduate students between the age group of 18-24 years were selected as study participants. Students who underwent special training in ocular hygiene were excluded from the study. One time data was collected using demographic proforma, ocular hygiene practice scale and risk assessment checklist for ocular disorders. Participants were required to take 30 minutes to complete the data collection questionnaires. The collected data was coded and transformed into a master data sheet for statistical analysis. Data was analysed by descriptive and inferential statistics. Results: The results of this study showed that 47 (26.4%) of the students had a very good practice and 124 (69.7%) of them had good practice of ocular hygiene. The results of risk assessment for ocular disorders showed that 146 (82%) had low-risk and a very less percentage 3 (1.7%) of them had a high-risk for the development of ocular disorders. There was a significant association between practice scores and demographic characteristics such as age (p-value=0.04) and using eye accessories (p-value=0.03). Conclusion: In this study, there was a negative correlation between practices of ocular hygiene and risk for ocular disorders among undergraduates. Vision impairment and eye conditions are associated with poor quality of life. An initiative can be taken to improve the practice of ocular hygiene to reduce the risks for ocular disorders among undergraduates. [ABSTRACT FROM AUTHOR]

Introduction: A quality night sleep is essential for physical, cognitive, and emotional well-being. The amount of sleep may have an effect on both weight and metabolism. In India, for the last few years, decline in sleep duration has been noted with an average sleep duration of 7 hours per night and one-third sleeping less than 7 hours per night. Televisions and smartphones which came into households as remarkable source of information and entertainment has caused the voluntary sleep restriction. Aim: To evaluate the sleep quality, Body Mass Index (BMI) and Blood Pressure (BP) of the healthcare students and also to find the correlation of sleep quality with BMI and BP. Material and Methods: The present cross-sectional study was conducted on 138 healthy males and females healthcare students residing in hostel premises of Yenepoya (Deemed to be University), Karnataka, India from November to December 2021. Pittsburgh Sleep Quality Index (PSQI) questionnaires administered to assess the sleep quality by adding the seven components of PSQI score ranging from 0 to 21. A weighing scale, sphygmomanometer, and stadiometer instruments were used to record the weight, BP, and height. Data were computed in International Business Management (IBM) Statistical Package for Social Sciences (SPSS) software version 23.0 to analyse descriptive and inferential statistics. Results: The mean age in present study was 23±0.72 years and 71 (51.4%) belonged to 22-23 years, majority 112 (81.2%) were female students. In present study, moderately obese students (33.15±0.72) and severely obese (35.39±0.10) had mean sleep score of 6.00±3.46 and 11 respectively indicating poor sleep quality. The underweight (16.91±1.17), normal weight (21.49±2.04) and overweight (26.49±1.48) had mean sleep score of 3.08±1.62, 3.08±1.12 and 4.66±3.05 respectively, which indicated good sleep quality. Students with hypotension, normal BP and hypertension stage-1 showed mean sleep score of 3.52, 2.71 and 4.77 respectively, showing good sleep quality. A statistically significant positive correlation of BMI was found with SBP (r-value 0.273, p-value 0.001) and DBP (r-value 0.181, p-value 0.033). Conclusion: BMI and BP were positively correlated with sleep quality. Therefore, creating awareness among healthcare students on healthy lifestyles such as exercise, healthy sleep and regular health supervision is essential to prevent prehypertension and maintain normal BMI status. [ABSTRACT FROM AUTHOR]

Introduction: Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) is an alternative medical system and has found acceptance globally for its use of rich medical plants, minerals, and other natural commodities in treating different illness. In November 2020, AYUSH changed its curriculum guidelines for its postgraduate students, which allowed them to perform a variety of general surgery, including orthopedic, ophthalmology, Ear Nose Throat (ENT), and dental treatments. Aim: To assess the awareness and perception among the dentists of these new AYUSH guidelines and to record their opinion. Materials and Methods: The cross-sectional study was conducted in Department of Oral Medicine and Radiology at Saveetha Dental College, Chennai, Tamil Nadu, India, from January 2021 to February 2021. A self-constructed questionnaire of 15 questions was circulated via google forms. The response was collected from 123 dentists. Statistical analysis was done on the IBM software 24 version. Chi-square test was used to assess the relationship between dentists' awareness of dental procedures included under the new AYUSH curriculum and their perception of ayurvedic practitioners performing the dental treatment efficiently. Results: Only 58.5% (n=79) of dentists were aware of the term AYUSH and 53 (43%) dentists were aware of the new guidelines added to the postgraduate curriculum in AYUSH. About, 57.7% of dentists reported that the Ayurvedic practitioners cannot handle the complications occurring during dental procedures. Conclusion: Dentists were not in favor of AYUSH practitioners performing dental treatments. The present study also concluded that dental procedures cannot be effectively and efficiently performed by AYUSH practitioners. [ABSTRACT FROM AUTHOR]

Introduction: Chemical peels have become a useful modality in the management of acne in addition to topical and systemic medications. Studies done to evaluate the effectiveness of peels have compared only lower concentration of Glycolic Acid (GA) (35%) and Salicylic Acid (SA) peels. Higher concentrations of glycolic acid i.e., (70%) are reported to be safe and more effective than lower concentrations. Despite reported advantages of higher concentration of glycolic acid peel, no published data is available regarding its efficacy, safety and tolerability in comparison with other peels. Aim: To compare the effectiveness of 70% GA peel with 30% SA peel in the management of mild to moderate acne. Materials and Methods: The present study was a cross-sectional retrospective study conducted from December 2021 to April 2022 in which, 60 participants were enrolled. They were diagnosed with mild to moderate acne, based on the Indian Acne Alliance (IAA) grading system and all of them underwent chemical peel treatment. Among them 30 had received 70% GA peel (group 1) and 30 had received 30% SA peel (group 2). The number of sittings and the individual lesional count at baseline and at each sitting were recorded. Acne lesional count (sum of comedones, papules, pustules, and nodules) was recorded at baseline, 2, 4, 6 and 8 weeks. Categorical variables were presented as frequency and percentages. Continuous variables were presented as Mean±Standard deviation. Results: There was a significantly greater decrease in mean acne lesional count in group 2 from the baseline of 25.73 to 13.83 at the end of 2nd week in comparison to group 1 wherein the values reduced from 26.30 to 17.73 (p-value of 0.003). At the end of eight weeks, the mean acne lesional count of both groups (group 1-2.17 and group 2-1.50, p-value of 0.097) were comparable. Conclusion: Higher concentration of GA (70%) has comparable effectiveness to 30% SA peel in management of mild to moderate acne. SA peel has an advantage of earlier decrease in lesional count. [ABSTRACT FROM AUTHOR]

Introduction: Semen parameters, especially sperm count, concentration, progressive motility and volume have been said to be diminishing over time among men in developing countries like India. Aim: To compare the semen parameters (semen concentration, normal forms, progressive motility and defects) of sub-fertile males visiting ARC fertility Centre in Chennai. Materials and Methods: This cross-sectional study was conducted in Advanced Reproductive Care, Inc. (ARC) International Fertility and Research Centre located in Chennai, Tamil Nadu, India, from the period of January 2015 to December 2019. Total 50 semen samples were selected randomly each year bringing the total to 250 samples which were included in the study. Masturbation was the major method of semen collection. The semen was analysed for the various semen parameters like semen concentration, normal forms, progressive motility and defects in the laboratory under microscope on wet preparation of slides as per the standard guidelines. The various semen parameters along with the age of the participants were entered in Microsoft excel and analysed by Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Total 250 semen reports were included in the study. They belong to age group of persons between 20 to 60 years. More than half of them were 30 to 40 year for all the five years. It was found that there was a statistically significant mean difference among progressive motility (25.14±16.37 in 2015 to 17.30±11.41 in 2019; p-value=0.009), semen concentration (78.1±61.15 in 2015 to 65.96±57.85 in 2019; p-value=0.001) among the semen samples over the years. There was a decreasing trend with the semen parameters being lower than optimal over the years. Conclusion: The study findings suggested that there is a decrease in semen parameters over the years and further studies have to be carried out to find the various environmental and lifestyle factors which could be responsible for the same. [ABSTRACT FROM AUTHOR]

Introduction: Radiation therapy and chemotherapy are the standard treatment given for cancer, which leads to the variety of adverse effects of which Oral Mucositis (OM) is one of the common side-effects. It is responsible for patient discomfort and decreases their level of functioning. Both Chlorhexidine and Povidone Iodine have got antimicrobial and antifungal activity which decreases the severity of mucositis. Aim: To compare the effectiveness of Povidone Iodine and Chlorhexidine mouthwash on OM among cancer patients undergoing radiation therapy or chemotherapy. Materials and Methods: A prospective observational study was conducted in the tertiary care hospital of Mangaluru, Karnataka, India for the duration of one year and three months from December 2015-March 2017. Fifty cancer subjects aged between 25 to 65 years and who developed OM after radiation therapy or chemotherapy were selected by purposive sampling technique. Data were collected using the demographic profile, clinical proforma and World Health Organisation (WHO) OM grading scale (2004) from 19.09.2016 to 17.12.2016. Experimental group I received 10 mL of diluted Povidone Iodine mouthwash and group II received 10 mL of diluted chlorhexidine mouthwash. Level of OM in the group I and group II were assessed on the 1st, 3rd, 5th and 7th day using WHO OM grading scale (2004). The data were analysed by descriptive and inferential statistics (Wilcoxon signed-rank test, Mann-Whitney U test, Repeated measures ANOVA) using SPSS version 16.0. Results: Among the 50 cancer subjects, majority 30 (60%) were in the age group between 55-64 years and majority 35 (70%) were receiving radiation therapy. On day 7, in the group I (Povidone Iodine) majority 14 (56%) subjects had mild level of mucositis whereas in the group II (Chlorhexidine) majority 14 (56%) subjects had moderate mucositis. Comparison of the effect of Povidone Iodine and Chlorhexidine mouthwash using Friedman's ANOVA showed that there was a difference in the level of mucositis (p<0.05) at 5% level of significance among two groups. The study findings also revealed a difference in the level of mucositis between day 1 to day 3, 5 and 7 (Mann-Whitney U test) (p<0.05) in both the groups. Conclusion: Povidone Iodine mouth wash was more effective than Chlorhexidine mouthwashes in reducing OM, and the patients were more comfortable after the use of the mouthwash. [ABSTRACT FROM AUTHOR]

A 47-year-old male was brought to the hospital with the chief complaints of fever, breathlessness and cough since one week. He was a known case of Type 2 Diabetes Mellitus (T2DM) for five years and was on oral hypoglycaemic drugs. On presentation, he was hypoxemic with a SpO2 of 91% at 13 L O2 and his sugar level was 286 mg/dL. Further, chest imaging and Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) was suggestive of severe COVID-19 pneumonia and his hypoxemic respiratory failure required Intensive Care Unit (ICU) stay. He was started on high flow oxygen therapy and due to further worsening of his condition he required endotracheal intubation and mechanical ventilation. On 18th day after admission, he developed blackish blister lesion, insidious on onset and gradually spreading over right forearm over a week. Skin lesions have grown Mucor spp. in microbiological culture. It was diagnosed as primary cutaneous mucormycosis with no involvement of rhinocerebal region and pulmonary region. Immediately antifungal therapy was started and the lesion started resolving. The patient developed secondary bacterial infection, multiorgan dysfunction, the patient couldn't be revived. This case report demonstrates cutaneous mucormycosis as a rare possible complication of Coronavirus Disease 2019 (COVID-19) infection and emphasises the risk factors and diagnostic measures which helped to arrive at the diagnosis. [ABSTRACT FROM AUTHOR]

Lacrimal sac tumours are rare tumours in ophthalmology but may have serious complications when misdiagnosed. Lacrimal sac tumours can be either epithelial or non-epithelial tumours. Epithelial tumours account for 60-94% of tumours. Pseudostratified ciliated columnar epithelium lines the lacrimal sac. Squamous cell carcinoma, transitional cell carcinoma, mucoepidermoid carcinoma, oncocytic adenocarcinoma, adenoid cystic carcinoma and metastasis are the commonly occurring epithelial tumours. Inverted papilloma is a locally aggressive tumour. Non-epithelial tumours (25%) are rarer than the epithelial tumours. Lymphoproliferative, melanocytic, and mesenchymal tumours are the non-epithelial tumours, among which the lymphoproliferative tumours constitute 2-8%. Very rarely Non-Hodgkin's lymphoma can occur as a primary in the lacrimal sac. Melanoma can occur as a primary from the melanocytes of the lining in the lacrimal sac or as a secondary from the conjuctival melanoma. Kaposi sarcoma and rhabdomyosarcoma are the mesenchymal tumours. Here is a case of Non-Hodgkin's lymphoma occurring in the lacrimal sac in an 80-year-old male. The patient came with the chief complaint of swelling around the right eye for two months. On radiological examination computed tomography revealed a homogenous solid mass in the right medial canthus, causing bony erosions of the orbit and extending into the nasolacrimal canal. An incisional biopsy of the mass was consistent with the diagnosis of Non-Hodgkin's lymphoma which was further confirmed by immunohistochemistry. This unusual presentation and histopathological features are described. [ABSTRACT FROM AUTHOR]

Giant Chorioangioma of placenta is a rare nontrophoblastic tumour of placenta. It may lead to various maternal and foetal complications like massive antepartum haemorrhage, sudden intrauterine foetal demise and non-immune hydrops, although in few cases mother and the foetus remain unaffected. This report is of a 35-year-old G3P1L1A1, presented to hospital at 32 weeks gestation with pain abdomen followed by watery discharge from vagina. Ultrasonography at 30 weeks revealed a huge mass on anterior wall with placenta on posterior wall of uterus although her previous antenatal sonography did not reveal any abnormality either in the foetus or in placenta. Diagnosis of preterm rupture of membranes was confirmed. Hence, she was kept on conservative management; received antibiotics and steroids for foetal lung maturity. Subsequently, the foetus developed mild, steady non-immune hydrops probably due to high output cardiac failure as Values of Middle Cerebral Artery's Peak Systolic Velocity (MCA-PSV) were within normal limits. Biophysical profile and nonstress test were normal. Guarded foetal prognosis was given due to non-immune hydrops but she delivered a normal female baby with good Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score with huge chorioangioma of placenta. Although rare, chorioangiomas of placenta should be kept in differential diagnosis of non-immune hydrops that needs regular foetal surveillance and timely intervention in affected foetuses to increase survival after birth. [ABSTRACT FROM AUTHOR]

Introduction: Oral carcinoma is a global health problem. India accounts for one-third of world burden with high prevalence rate of 2.5 million and mortality rate of 5.5 lacs per year. Oral carcinogenesis is a multistage process that frequently involves invasion and metastasis that needs early detection and treatment to improve the overall quality of life. The ability of Oral Squamous Cell Carcinoma (OSCC) to metastasize to lymph nodes does not always show a relationship with clinical staging. A spectrum of molecular mechanisms is involved in carcinogenesis, where defect in the regulation of apoptosis is assumed to contribute to the pathogenesis and progression of cancer. Apoptosis regulatory genes include the antiapoptotic protein such as B-cell lymphoma-2 (Bcl-2) gene that might be used as a molecular marker to evaluate the biological behaviour of oral cancer. Aim: To evaluate and correlate the Bcl-2 expression in OSCC patients with lymphnode metastasis and without metastasis. Materials and Methods: The study comprised of 30 samples, 15 cases of metastatic and 15 non-metastatic primary OSCC. All the cases were stained for routine Hematoxylin and Eosin (H&E), and Bcl-2 antibody by immunohistochemistry. The H&E stained sections were evaluated for Lymphocytic Infiltrate (LI) and Pattern Of Invasion (POI). Bcl-2 stained sections were evaluated for staining intensity and distribution. The differences between the groups were statistically analysed using chi-square test. Results: The histopathological parameters, LI and POI did not show any statistical difference between the study groups. Expression of Bcl-2 in OSCC was 33.3% among the study groups, where metastatic group showed a positive expression of 13.3% and 20% in non-metastatic OSCC that did not show statistically significance among the study groups. Conclusion: There was no significant difference in the expression of Bcl-2 between the study groups. Apoptosis is regulated by interaction among the Bcl-2 gene family. Hence, evaluation of Bcl-2 along with other apoptotic regulating proteins could define the role in pathogenesis and prognosis of metastatic and non-metastatic OSCC. [ABSTRACT FROM AUTHOR]

Introduction: The parent oocyte from which the embryo is derived, determines its quality and the perifollicular vascularity (PFV) determines the micro-environment of the developing ovum. The PFV correlates well with the follicular oxygenation, oocyte maturation and embryo viability. PFV is imaged with Power Doppler Ultrasound. Aim: To study and compare the association of the PFV of follicles with the quality of the oocytes and embryos in agonist and antagonist protocol, employed in Assisted Reproductive techniques (ART). Study Design: A prospective observational study was conducted on 75 patients, who were recruited for ART cycles, out of which 25 were given the Agonist protocol and the remaining 50 received the Antagonist protocol. Materials and Methods: The patients underwent the stimulation protocol. The PFV of preovulatory follicles were studied with Transvaginal Power Doppler and graded. Each oocyte retrieved carried the same label of its parent follicle. Embryos were cultured. The embryologist was blinded. The oocyte and embryo quality were assessed and compared with the PFV of parent follicle. Results: Follicles with grade 1 and 2 PFV were predominantly observed. The yield of oocytes was independent of PFV. The mean yield of good quality embryos in conjunction with the PFV of the parent follicle was found to be highly significant in both the groups. The antagonist group had statistically significant yield of mature oocytes and embryos, compared to the agonist group. Conclusion: Antagonist protocol had favourable outcomes compared with the agonist protocol. The retrieval of oocytes, even the mature ones and the yield of high grade embryos were found higher. As the PFV increased, the yield and overall pregnancy rates were higher. PFV as assessed by Power Doppler is a useful non-invasive biomarker of embryo quality and can be employed in conjunction with other biomarkers in ART to predict successful outcome. [ABSTRACT FROM AUTHOR]

Rhabdomyosarcoma (RMS) comprises 3% of all childhood malignancy. Commonly it involves head and neck, extremity and genitourinary systems. Pure primary RMS of breast is a rare malignacy. Here, we present a case of adolescent girl presented with breast lump which was initially treated as benign lesion with excision. Again she presented with recurrent mass which was operated and microscopically showed features of small blue round cell tumour which has lead to many diagnostic confusions both clinically and histopathologically. Immunohistochemistry with strong nuclear myogenin positivity in >50% of tumour cells confirms the diagnosis of primary mammary RMS. Postoperative period was uneventful. [ABSTRACT FROM AUTHOR]

Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin's Lymphoma (NHL). Primary retroperitoneal DLBCL is uncommon and has seldom been reported. Extrinsic compression of the duodenum due to lesions originating from the retroperitoneum is also rare. We present a case of a 39-year-old man who presented with inability to tolerate oral intake, abdominal pain, an upper abdominal mass and postprandial bilious vomiting caused by a large DLBCL arising from the retroperitoneum causing extrinsic compression of the duodenum. The cause of compression was initially presumed to be a neoplasm arising from the uncinate process of the pancreas or duodenum because of its proximity to the uncinate process and apparent widening of the C loop of duodenum. Repeat Computed Tomography (CT) scans were obtained because of the rapid increase in the size of the mass, normal levels of tumour markers such as Cancer Antigen (CA) 19-9, Carcinoembryonic Antigen (CEA) and no evidence of jaundice in spite of the large size of the mass. It revealed encasement of the uncinate process of pancreas with no involvement of parenchyma of the pancreas, thereby mimicking a pancreatic tumour. The neoplastic lymphoid cells were positive for Leukocyte Common Antigen (LCA), Cluster of Differentiation (CD)20, CD10, B-cell Lymphoma 2 (Bcl-2) and were negative for Creatine Kinase (CK), CD23, CD30, Anaplastic Lymphoma Kinase (ALK) and cyclin D1, D3 and D5. The Ki67 proliferative index was greater than 95%. Retroperitoneal DLBCL although rare should be considered in cases of duodenal obstruction. [ABSTRACT FROM AUTHOR]

Background: Quality of Life (QOL) among elderly is a neglected issue especially in developing countries including India. Aim: To assess the QOL and its associated factors among elderly population. Materials and Methods: A community based cross-sectional study was conducted among 300 elderly subjects in urban Puducherry, India. Data on QOL was assessed by World Health Organization Quality of Life BREF (WHOQOL-BREF) and Activities of Daily Living (ADLs) by Katz ADL scale. Socio-demographic factors and chronic morbid conditions were recorded by using structured questionnaire. Statistical Analysis: Independent sample test and multiple linear regression analysis. Results: Majority (64%, 192) were in the (60-69) years' agegroup. Overall mean Standard Deviation (SD) score of QOL was 49.74 (10.21). QOL was significantly low among those with no schooling, nuclear family, not receiving pension, not with partner, having musculoskeletal disorder, low vision and impaired ADL groups in univariate analysis. Multiple linear regression analysis revealed that older age (p=0.014), no schooling (p=0.004), without spouse (p=<0.001), nuclear family (p=0.039), musculoskeletal disorder (p=<0.001), low vision (p=0.049) and hearing impairment (0.001) were associated with low QOL score. Conclusion: QOL score among elderly is average, while social relationship domain of QOL score was found to be low. Health education with regard to activity and environmental changes and increase in social relationship may help in improving the QOL among the elderly population. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the second commonest form of cancer among women. Several studies have been conducted to identify potential risk factors. However, role of trace elements or metals in causing breast cancer has not been studied to great extent. Aims: To estimate the serum levels of calcium, copper, magnesium, iron, phosphorus and zinc and determine their role in causing breast cancer in female patients. Settings and Design: A case-control study on female patients with breast cancer was conducted in a private superspecialty hospital and Cancer centre situated in Southern part of India. Materials and Methods: Newly diagnosed female patients with breast cancer in the age group of 30-60 y attending Oncology clinic were included in the study. These cases were selected irrespective of type and stage of the disease. The age matched control subjects were drawn from apparently healthy women attending master health check at superspecialty hospital. The patients or controls suffering from co-morbid conditions which affect serum levels of metal ions and other malignancies, and those undergoing treatment for breast cancer were excluded from the study. Serum was separated and tests were performed according to standard procedure for each metal ion on the same day. The estimation of metal ions was done by UV-Visible Spectrophotometer-CHEM 7. Statistical Analysis: Independent Samples T-test was used to calculate difference between the two means. The p-value of <0.05 was considered as significant. Results: The study was conducted on 54 female patients with breast cancer and 54 female controls with mean age of 47.2±8.14 y and 46.8±8.4 y respectively. There was statistically significant increase in serum levels of calcium, copper, iron and phosphorus in patients with breast cancer when compared to controls. The increase in serum levels of magnesium was insignificant. A statistically significant decrease in serum zinc levels was observed in patient with breast cancer when compared to controls. Conclusion: The present study highlights the role of calcium, copper, iron, phosphorus, magnesium and zinc in the pathogenesis of breast cancer. The estimation of serum levels of these metal ions has a potential role in early detection and monitoring of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Tongue-tie (more formally known as ankyloglossia) is a congenital anomaly characterized by an abnormally short lingual frenulum, which may restrict the mobility of the tongue tip impairing its ability to fulfil its functions. Ankyloglossia is uncommon, but not rare. Incidence figures reported in the literature vary widely, ranging from 0.02% to 4.8%. Incidences of upto 10.7% have been reported. Since the literature provides no uniformity of information with regard to the incidence of tongue tie. The aim of this study was to evaluate the occurrence of tonguetie in general population and mentally challenged population, measure the grades of tongue-tie and also to determine the relations of gender with tongue-tie. Materials and Methods: Seven hundred school children in the age group of 9-17 years were examined for the presence of tongue-tie, 350 from regular schools and 350 from special schools. The presence of tongue-tie was evaluated, measured and graded into grades 1 to 5 according to KOTLOW's method and data subjected to statistical analysis. Results: Significantly higher incidence of 16.4% population having tongue-tie was identified, of which 18.57% were from general schools and 13.71% from special schools but the differences were not statistically significant. Males showed greater incidence than females and grades I, II, III were more predominantly seen than grade IV, but the differences were not significant statistically. Conclusion: Diagnostic criteria and definitive classifying systems are needed to allow for further comparative studies. [ABSTRACT FROM AUTHOR]

Actinic granuloma is a self-limiting chronic disorder with elastolytic granulomas, mainly of the sun exposed skin and unknown pathogenesis. We report a case of a middle aged woman with multiple annular erythematous lesions. Histopathology revealed degenerated elastic fibres with histiocyte aggregates surrounded by multiple giant cells suggestive of elastolytic granulomas. She also had associated dyslipidemia and hypothyroidism. Actinic granuloma is relatively rare in the Indian population and needs to be differentiated from conditions like sarcoidosis and granuloma annulare. [ABSTRACT FROM AUTHOR]

The article describes the case of a 24-year-old primigravida with monochorionic monoamniotic pregnancy who was presented with gestation with leaking per vaginum.

Yolk sac tumour also known as primitive endodermal tumour is the most common malignant germ cell tumour (GCT) in the paediatric age group. Most common sites of involvement are ovaries and testes, but rarely can occur in the extragonadal sites. In the head and neck region, yolk sac tumours have been reported in the nasopharynx, sinonasal tract, orbit, ear and parotid gland. Nasopharynx is an uncommon site for yolk sac tumour and very few cases of nasopharngeal pure yolk sac tumour have been reported so far. Yolk sac tumours are highly malignant and have a poor prognosis. This is a case of pure GCT in a three-year-old female child who presented with a rapidly growing nasopharyngeal mass. Histopathological examination followed by immunohistochemistry and serum AFP study clinched the diagnosis of yolk sac tumour. The tumour responded well to chemotherapy as evidenced by decrease in serum AFP levels. [ABSTRACT FROM AUTHOR]

There has been an increase in the occurrence of fungal infections in humans in the recent years due to the discrete use of broad spectrum antibiotics and immunosuppressive therapies. The genus candida is the most frequently found fungi in humans. Candida albicans is a mucosal microbiota although it can cause infections which can be mucosal or life threatening infections in susceptible individuals. Candidiasis is the most common oral opportunistic fungal infection in humans. Candidiasis usually affects oral mucosa (buccal mucosa) and hard palate. Candidiasis affecting gingiva is not so common, but when it occurs, it is often misdiagnosed as desquamative gingivitis because of its clinical appearance. This paper discusses a case of Candidal infection of gingiva that mimics desquamative gingivitis. [ABSTRACT FROM AUTHOR]

Intra articular synovial lipomas are very rare and only few cases have been reported till now. We are reporting a rare case of intra articular synovial lipoma of the tarsometatarsal joint in the right foot in a 38-year-old male who presented with dull aching pain in the plantar aspect of the foot while walking. The lesion was resected and subjected to histopathological examination, which showed well defined lobules of mature adipocytes separated by thin fibrous septa and covered by synovial lining. Immunohistochemistry with S100 antigen showed membrane positivity. A diagnosis of intra articular synovial lipoma of the tarsometatarsal joint of the right foot was made. Our English literature search failed to yield any information regarding the occurrence of synovial lipoma in small joints and our case may be the first of its kind. [ABSTRACT FROM AUTHOR]

Small cell carcinoma of the cervix is a rare and a very aggressive tumour. Once being considered to be a rare type of squamous cell carcinoma, evidence has proven that most of the tumours express one or more markers of neuroendocrine differentiation. The behaviour of this rare malignancy is different from that of squamous cell carcinomas, with a high propensity for nodal and distant metastases. Hence, there is a need to highlight this histopathological entity. [ABSTRACT FROM AUTHOR]