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Introduction: Mishaps such as the accidental ingestion of endodontic instruments and crowns may occur during dental treatment in children. Although such accidents are rare, they can be potentially harmful to patients. The use of a rubber dam is not always possible in paediatric dentistry; thus, the attachment of floss to endodontic files is commonly done during the pulpectomy procedure. However, there are some challenges associated with using Flossed Endodontic Files (FEFs). To overcome these difficulties, a system called i-Grip was introduced. Aim: To evaluate the perception and compare the ease, convenience and safety of i-Grip versus FEFs as perceived by Paediatric Dentists during pulpectomy procedures in children. Materials and Methods: A post-test quasi-experimental study was conducted in the Department of Paediatric and Preventive Dentistry, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India, among 40 Paediatric Dentists over a period of three months. The Paediatric Dentists were asked to use the i-Grip for four weeks, after which they completed validated questionnaires. Statistical Package for the Social Sciences (SPSS) software version 23.0 was used for data analysis. The answers to the questions were statistically analysed using the Z-test of proportion. Results: The mean age of males were 35±0.743 years and females were 25.37±0.543 years. A total of 27 (67.5%) participants found placing the file in the i-Grip to be very easy. 22 (55%) found the i-Grip to be very convenient to use. 31 (77.5%) Paediatric Dentists found the i-Grip to be extremely safe, 6 (15%) considered it to be moderately safe and none found it to be extremely unsafe. There was a statistically significant difference between the ease, comfort and safety of i-Grip compared to FEF (p<0.05). Conclusion: Paediatric dentists reported that the i-Grip was easy to use, convenient and safe when compared to FEF. The i-Grip is an innovative safety tool that can be utilised in paediatric patients during pulpectomy procedures instead of FEF. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Ankle Instability (CAI) is an injury that presents persistent instability and "giving way" symptoms. The higher rate of reinjury following an initial Lateral Ankle Sprain (LAS) is associated with the development of CAI, which affects athletic and functional performance. Impairment of musculotendinous receptors following an initial ankle sprain may result in recurrent ankle instability. Some studies have suggested an association between CAI and issues with static and dynamic balance. Comparisons of static balance between recreational badminton and volleyball players and dynamic balance between recreational badminton and volleyball players with CAI are required to provide athletes with the proper balance training exercises. Aim: To analyse the static balance of badminton and volleyball recreational players with CAI using the Balance Error Scoring System (BESS) and a Plantar Pressure Analysis System (PPAS), as well as the dynamic balance of those players using the Y Balance Test (YBT). Materials and Methods: A cross-sectional study was conducted where recreational players with CAI who play badminton and volleyball were screened using the Cumberland Ankle Instability Tool (CAIT), and 46 participants were selected based on inclusion and exclusion criteria. The study was conducted in the indoor and outdoor stadiums of NITTE (Deemed to be University), Mangaluru, Karnataka, India. The study duration was from March 2023 to March 2024. Ethical clearance was obtained from the same university for the study. Following this, static and dynamic balance of each group was assessed using BESS (number of errors), PPAS (sway velocity), and YBT (distance reached by the limb). The static balance between the groups and dynamic balance between the groups were analysed in Jamovi software using independent sample t-test. Results: Following the analysis, static balance between badminton and volleyball recreational players using BESS showed a non significant difference with a p-value of 0.282, while PPAS showed non significant differences with p-values of 0.174 for double leg stance and 0.063 for single leg stance. Similarly, dynamic balance between badminton and volleyball recreational players using YBT showed non significant differences with p-values of 0.467, 0.768, and 0.299 for anterior, posteromedial, and posterolateral directions, respectively. Conclusion: The study concluded that there was no significant difference in static as well as dynamic balance between badminton and volleyball recreational players with CAI. However, it is important to evaluate the static and dynamic balance of recreational players to enhance performance and prevent injuries. [ABSTRACT FROM AUTHOR]

Introduction: Resin composites have been commonly used in restorative dentistry over the years. The longevity of restorations depends upon various physical properties like as solubility. Composite solubility can lead to deleterious effects on the polymer structure. Aim: To evaluate and compare the solubility of a single shade resin composite in comparison to a conventional resin composite in artificial saliva. Materials and Methods: In the present in-vitro study, 44 pellets (10 mm x 1 mm) were prepared from each material. The pellets were divided into two groups (n=22) based on the immersion period of two days and seven days. They were incubated, weighed using an analytical balance, and then immersed in artificial saliva. Weighing was done again after the completion of the immersion period, and solubility was calculated. Paired and independent sample t-tests were used to compare the solubility of both materials after two days and seven days. Results: The differences of solubility values for the single shade composite and conventional composite at two and seven-day intervals were (p=0.031) and (p=0.019), respectively, which were statistically significant. On inter-group comparison, the difference in solubility of the single shade composite at two days was significantly lower compared to conventional composites (p=0.024). Whereas, no significant difference was observed in solubility values between both groups at seven days (p=0.102). Conclusion: The performance of the single shade composite in terms of solubility was better in comparison with conventional composite. [ABSTRACT FROM AUTHOR]

Vitamin D has multifaceted roles in brain function beyond its traditional role in bone health, impacting neurotransmitters, inflammation, and mood-regulating brain areas where its receptors are present. Conversely, Vitamin D deficiency is often observed in obese individuals. Metreleptin, a synthetic form of human leptin, has demonstrated efficacy in promoting weight loss and alleviating depression among obese patients. However, there is limited direct evidence linking metreleptin to depression reduction or establishing an interaction between metreleptin and Vitamin D in this context. Vitamin D’s neurotrophic and immunomodulatory properties influence neurotransmitter regulation, including serotonin, dopamine, and norepinephrine, vital for mood stability. The presence of Vitamin D Receptors (VDR) in regions of the brain linked to depression further supports its role in mood regulation. Moreover, Vitamin D’s anti-inflammatory effects contribute to mitigating brain inflammation associated with depression. Given the inverse relationship between obesity and Vitamin D levels, obese individuals are at higher risk of Vitamin D deficiency. Metreleptin, as a synthetic leptin analogue, has demonstrated significant efficacy in reducing obesity. Thus, the plausible combination of Vitamin D and metreleptin presents a potential novel strategy for managing depression in obese individuals. Though these therapies may address the intricate interplay of depression in the context of obesity, rigorous research is essential to validate their efficacy and safety in tandem. [ABSTRACT FROM AUTHOR]

The new advancement in percutaneous intervention procedures, which provides more accurate needle placement compared to other modalities, is Augmented Reality (AR). It provides the operator with 3-dimensional (3D) or 2-dimensional (2D) structures of the anatomy along with the target during surgery to get a precise needle placement into the target. The review highlights that using AR systems for needle navigation and placement can become productivity in various interventional procedures. The AR navigation system reduces radiation exposure, procedural time, risk to the patient, and ensures higher accuracy of needle placement than conventional Computed Tomography (CT)-guided percutaneous procedure systems. The AR system can provide precisely guided needle insertion and reduce the risk of complications. As technology and research are increasing, new techniques, such as automatic image-hologram registration, can be brought into the picture. This review compares conventional image-guided procedure systems with the AR system in the interventional radiology field. This review also provides detailed information about AR as a promising tool for optimising needle placement in interventional procedures, paving the way for safer and more effective clinical practices. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco smoking is a common addiction in our society. The toxic chemical compounds present in tobacco smoke cause epithelial damage and inflammation of the airways. Chronic smoking results in the thickening of the pulmonary arterial wall and vasoconstriction, leading to the development of pulmonary arterial hypertension. Hence, measurement of pulmonary artery diameter using Contrast Enhanced Computed Tomography (CECT) may be helpful in the early detection of pulmonary arterial hypertension. Aim: To compare the diameters of the Main Pulmonary Artery (MPA), Right Pulmonary Artery (RPA), and Left Pulmonary Artery (LPA) using CECT thorax in smokers and non-smokers. Materials and Methods: A cross-sectional study was conducted from April 2021 to March 2022 in the department of radiodiagnosis, KS Hegde Hospital, Karnataka, India, consisting of 100 patients referred for CECT thorax in the age group of 18-85 years. They were divided into two groups: smokers and non-smokers, with 50 patients in each group. They were further categorised into three age groups: < 50 years, 50-60 years, and >60 years. The widest diameters of the MPA were measured at the level of bifurcation of the artery and perpendicular to the long axis of the artery. At this level, RPA and LPA diameters were measured at the widest portion on 1.25 mm axial images of the arterial phase. Variation in the pulmonary artery diameter was compared between smokers and non-smokers with respect to age and analysed by unpaired t-test and Pearson correlation. Results: Diameters of MPA, RPA, and LPA were statistically significant (p<0.05) in smokers compared to non-smokers. In smokers, MPA and RPA diameters correlated with age, which was statistically significant (p<0.05). No significant correlation (p>0.05) was shown between age and MPA, RPA, and LPA diameter in non-smokers. The mean MPA diameter showed a significant difference (p<0.05) in all three age groups. Conclusion: The diameter of the pulmonary artery is statistically significant in smokers compared to non-smokers. Hence, assessment of pulmonary artery diameters among smokers using CECT thorax will help to diagnose Pulmonary Hypertension (PH) at an early stage. [ABSTRACT FROM AUTHOR]

Introduction: In 20-49% of patients with Systemic Lupus Erythematosus (SLE), Lupus Nephritis (LN) is a major complication and, therefore, an important prognostic determinant of SLE. The Activity and Chronicity Indices (AI and CI), used as adjuncts to the histological classification of LN, assist in identifying patients who will benefit from immunosuppressive therapy. Aim: To investigate the correlation of AI and CI in patients with biopsy-proven LN with clinical and laboratory findings. Materials and Methods: A cross-sectional study was conducted as the Departments of Pathology and Nephrology, JSS Medical College and Hospital Mysore, India from January 2023 to March 2023, by retrieving the data of 56 patients with biopsy proven LN. AI and CI were assessed and classified. Data from multiple groups were compared using Pearson's chi-square test, and between two groups using independent samples t-test with Statistical Package for Social Sciences (SPSS) version 21.0. Pearson's correlation coefficient (r-value) was calculated using Microsoft excel 2021. Results: Renal biopsies from 56 cases with biopsy-proven LN were studied, with a mean age of 28±10.30 years and a M:F ratio of 1:10.2. Of the 56 biopsies studied, active lesions were seen in 47 (83.9%) and chronic lesions in 21 (37.5%). AI showed statistical significance with hypertension (p=0.049) and haematuria (p=0.005), with proteinuria (p=0.001, r=0.72), serum creatinine (p=0.037, r=0.62), and blood urea nitrogen (p=0.003, r=0.55) showing a statistically significant positive correlation. CI showed a statistically significant positive correlation with proteinuria (p=0.028, r=0.039) and serum creatinine (p=0.010, r=0.58). Both AI and CI showed statistical significance with the degree of renal insufficiency, with CI (p=0.008) displaying a stronger statistical significance than AI (p=0.012). Conclusion: In conclusion, the management and prognosis of patients with suspected LN are greatly facilitated through information obtained from renal biopsy, especially AI and CI, which are useful guides to treatment. It is important to study renal biopsy for the constellation of features in LN for better patient management. [ABSTRACT FROM AUTHOR]

Traumatic Dental Injuries (TDIs) to the maxillary anterior teeth occur frequently in paediatric and adolescent populations. Prompt diagnosis, correct treatment planning, and a multidisciplinary approach are pertinent aspects of successfully managing multiple TDIs in a patient. The present case report of a 13-year-old female patient describes a multidisciplinary approach necessary to successfully manage dental trauma of an avulsed maxillary central incisor and a complicated crown fracture involving the maxillary left lateral incisor in an adolescent. The complicated crown-root fracture was treated with endodontic therapy, followed by the placement of a fibre-reinforced post, core build-up, and the cementing of a porcelain-fused-to-metal crown. Bone grafting with a mandibular symphysis block autograft, followed by prosthetic rehabilitation with transitional implants, was performed to restore the aesthetics, form, and function of the avulsed maxillary central incisors. The use of osseointegrated implants has gained wide acceptance in the adult population. However, due to concerns regarding growth, their use in the paediatric population is not as common. This accounts for a scarcity of clinical cases reported in the literature. There are no established guidelines for the placement of implants in growing patients. Thus, authors believe that the present case report contributes to the literature on this subject. The treatment of this complex, multi-dental injury in the maxillary anterior region of a young female required a holistic approach with a step-wise progressive, long-term treatment plan. Traumatic injuries in adolescent patients can adversely impact their oral health-related quality of life if not treated correctly. [ABSTRACT FROM AUTHOR]

Introduction: Hysterosalpingography (HSG) is a radiographic procedure used to visualise the fallopian tubes and uterine cavity by injecting a contrast medium, commonly employed for diagnosing infertility cases. However, due to the associated radiographic and fluoroscopic exposure, there is an increased risk of chromosomal damage to the gonads. Aim: To investigate the impact of radiographic and fluoroscopic exposure on chromosomal integrity in peripheral blood lymphocytes using the Cytokinesis Blocked Micronucleus (CBMN) assay. Materials and Methods: This cross-sectional time-bound study included 10 patients (n=10) scheduled for HSG procedures at the Department of Radiology, Justice KS Hegde Hospital, Mangaluru, Karnataka, India from April 2021 to March 2022. Following radiation exposure, the CBMN assay was conducted to evaluate chromosomal damage in both test and control group blood samples. Blood samples from healthy donors were divided into three cryo vials, with one serving as the control and the remaining two exposed to radiation at the entrance and exit areas during the HSG procedure. The data were expressed as mean±Standard Deviation (SD). A p-value <0.05 was considered statistically significant. The analysis was performed using Statistical Package for Social Sciences (SPSS) version 20.0. results: A statistically significant (p<0.05) increase in biological damage was observed when comparing the Micronucleus (MN) frequency of the test groups (entrance=0.022±0.005 and exit group=0.0172±0.005) with the control group (0.006±0.003). Additionally, a decrease in MN frequency was noticed within the test groups, particularly in the exit group, although the results were not statistically significant (p=0.066). conclusion: The HSG is an effective clinical diagnostic technique. However, the present study indicates a potential risk of chromosomal damage associated with the procedure, emphasising the need for judicious use of radiation exposure during HSG. [ABSTRACT FROM AUTHOR]

Smiling is an essential aspect of daily life, and a confident smile can greatly impact an individual's self-esteem. Aesthetic correction of the anterior teeth poses a challenge in dentistry, particularly in cases where there is spacing between the teeth. This can lead to a lack of confidence and negatively affect a person's self-image. Laminate veneers, a cosmetic dental procedure, involve attaching a thin layer of porcelain or resin composite material to the surface of a tooth. Compared to conventional methods, digital technology offers greater precision and efficiency in placing laminate veneers. Computerised templates guide the teeth preparation process, ensuring minimal tooth structure removal and accurate fitting of the veneers. The present report presents a case (43-year-old female patient) of spacing in the maxillary anterior that was corrected using a minimally invasive technique with laminate veneers and a fully digital workflow using lithium disilicate. The use of this material enhances the aesthetics of the patient's smile, requiring minimal tooth reduction and providing a natural appearance. The paper also includes a nine-month follow-up. Incorporating digital technology in the creation and placement of laminate veneers offers numerous benefits, including improved accuracy, reduced turnaround time, and the ability for patients to preview their enhanced smile. [ABSTRACT FROM AUTHOR]

Introduction: Gastric ultrasound is a non-invasive tool for assessing gastric content and volume. Aspiration of gastric contents is a serious perioperative complication that contributes to mortality and morbidity following general anaesthesia. The Enhanced Recovery After Surgery (ERAS) protocol and Indian Society of Anaesthesiology (ISA) fasting guidelines recommend consuming a carbohydrate drink two hours before surgery in adults. However, evidence supporting this recommendation, particularly regarding volume, is still limited and variable. Aim: To examine Gastric Residual Volume (GRV) using Ultrasonography (USG) six hours after a light breakfast and compare it with GRV two hours after consuming clear liquids. Materials and Methods: A randomised clinical study was conducted involving 100 patients who were assigned randomly to two groups: Group-C (Oral Carbohydrate, CHO) and Group-A (Apple juice), with 50 patients in each group; each patient underwent gastric USG twice: once within the first six hours after a light breakfast and again two hours after consuming 400 mL of clear liquid. USG was performed with the patient in a supine position and a Right Lateral Decubitus (RLD) position, and GRV was estimated by measuring the Antral Cross-sectional Area (ACSA) using a mathematical model. The final reading was taken from the RLD position, and qualitative analysis of the antrum was conducted using the Perlas grading system. A GRV of <1.5 mL/kg is considered low risk for aspiration. Statistical tests such as Chi-square, paired t-test, and one-way Analysis of Variance (ANOVA) were applied. Results: A total of 100 patients were analysed in the present study. The mean age was 41.04 years and 39.94 years in Group-A and Group-C, respectively. There was no significant difference in GRV between six hours after a light breakfast and two hours after clear liquid intake in either group (p>0.05). The mean GRV was 7.75 (7.23) mL and 8.01 (7.58) mL six hours after a light breakfast, and 7.71 (8.92) mL and 8.49 (9.47) mL two hours after clear liquid intake in Group-A and Group-C, respectively, among non-CKD patients. GRV was higher in CKD patients and those with an increased Body Mass Index (BMI). Conclusion: The GRV remains within safe limits after consuming 400 mL of clear liquid two hours before surgery. This finding supports the recommended volume of preoperative clear liquid intake in the ERAS protocol and ISA fasting guidelines. However, careful consideration is necessary for patients with CKD and an increased BMI. [ABSTRACT FROM AUTHOR]

Introduction: Neonates and infants are more prone to desaturation during the apnoeic period of laryngoscopy and intubation. Various options exist to reduce this risk beyond conventional preoxygenation. Aim: To assess whether continuous apnoeic oxygenation via nasal prongs during intubation can extend the safe apnoea period compared to standard management with preoxygenation alone. Materials and Methods: A randomised controlled, two-group parallel clinical study was conducted at the Department of Anaesthesiology, Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India, from July 2019 to November 2020. The study involved 63 infants aged one day to six months undergoing elective or emergency surgeries under general anaesthesia. Preoxygenation via a mask was followed by sevoflurane induction and vecuronium-induced muscle relaxation. Conventional laryngoscopy and intubation were performed in 32 infants in Group-C (Control group), while 31 infants in Group-O (Apnoeic Oxygenation group) also received oxygen (O2) via nasal prongs at 4 L/min in addition to preoxygenation. The primary outcome parameter was the time taken for desaturation by 1%. The time taken to desaturate by 2%, 3%, 4%, and 5%, as well as their incidences, lowest observed saturation, safe apnoea period, and Heart Rate (HR) trends, were also noted. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and OpenEpi version 3.01. Results: Demographic and clinical parameters were comparable between the groups. The mean time for 1% desaturation was 18.33±4.3 seconds in Group-C, while all Group-O cases maintained 100% saturation during the study period. No significant difference was found in the safe apnoea period between the groups (p=0.503). The average lowest O2 saturation observed in Group-C was 98.81±1.28%, while it was 100% in Group-O. Only one infant in Group-C showed desaturation down to 95%. Both groups exhibited similar HR trends. Conclusion: Apnoeic oxygenation by nasal prongs in healthy infants helps prolong the time to desaturation and can be beneficial for those at risk of desaturation and hypoxia. [ABSTRACT FROM AUTHOR]

Below-knee amputation in high-risk patients is associated with significant mortality and morbidity. Spinal anaesthesia is linked to an increased incidence of hypotension and bradycardia, and it is relatively contraindicated in patients with coagulation abnormalities. General anaesthesia is used as an alternative when spinal anaesthesia is contraindicated, but it is associated with a considerable increase in perioperative morbidity and the need for postoperative ventilatory support and Intensive Care Unit (ICU) care. A combination of sciatic nerve block and femoral block has been employed for below-knee surgeries as it provides complete anaesthesia below the knee. Adductor canal block, compared to femoral nerve block, is motor-sparing and, when combined with popliteal sciatic nerve block, offers complete anaesthesia below the knee. Below-knee amputation requires complete motor and sensory blockage, making regional block for below-knee amputation more challenging for the anaesthesiologist. Present case series is of five cases of below-knee amputation performed under a combination of ultrasound-guided popliteal sciatic nerve block and adductor canal block. Ultrasound-guided popliteal sciatic nerve block was administered with a combination of 10 mL of bupivacaine 0.5% and 5 mL of lignocaine 2% with adrenaline (1:200,000) diluted with 5 mL of distilled water to a total volume of 20 mL. Ultrasound-guided adductor canal block was performed with 8 mL of bupivacaine 0.5% and 4 mL of lignocaine 2% with adrenaline (1:200,000), diluted with 4 mL of distilled water to a total volume of 16 mL. All patients achieved adequate surgical anaesthesia, and none experienced any anaesthesia-related complications. [ABSTRACT FROM AUTHOR]

Introduction: Corneal Abrasion (CA) is the most common ophthalmic complication that occurs after General Anaesthesia (GA) in non ocular surgeries. GA results in reduced basal tear volume, loss of light reflex, and lack of pain perception, resulting in corneal drying. This makes the cornea susceptible to abrasion and keratitis. Research suggests that preventing corneal mechanical exposure and providing artificial tears can help mitigate these risks. Aim: The aim of this study was to assess the efficacy of eye taping with and without Hydroxypropyl Methylcellulose (HPMC) drops in preventing perioperative CA. Materials and Methods: This prospective comparative interventional study was conducted in the Department of Anaesthesia, Justice Hegde KS Charitable Hospital in Mangaluru, India, from June 2021 to November 2021. A total of 122 patients who underwent GA for non ocular surgeries lasting more than 45 minutes were grouped into group T or group D, depending on whether their eyes were only taped during GA (T) using hypoallergenic adhesive tape or had HPMC drops instilled in their eyes along with tape (D). Participants were evaluated 2 and 12 hours after the end of GA in the postanaesthesia care unit using a questionnaire to assess eye symptoms. Conjunctival hyperaemia and chemosis were evaluated using scoring systems. Other parameters noted included age, gender distribution, type, and duration of surgery. Statistical analysis using the chi-square test/likelihood ratio was performed to assess the association between the eye protection method used and postsurgical outcomes. Results: Out of the 122 patients who received either of the two eye protection methods under GA, 68 (55.7%) were females and 54 (44.3%) were males. A total of 85 (69.6%) were between the ages of 20-60 years, while 29 (23.8%) were above the age of 60 years. There was no statistically significant association found between the age or gender of the patients and the eye protection method used. No statistically significant difference was noted between the duration, type of surgeries, and the eye protection method used in this study. There was no statistical significance (p-value >0.05) noted with respect to the conjunctival hyperaemia and chemosis scoring in the two groups. However, 15 (24.6%) patients in group D were found to have adhesive lids two hours postsurgery. There was an association (p-value <0.05) between the occurrence of adhesive lids at two hours postsurgery and the eye protection method used. Conclusion: Eye protection is mandatory in all non ophthalmic cases under GA. Both eyelid taping alone and eyelid taping with HPMC drops are equally effective in preventing perioperative ocular injury. [ABSTRACT FROM AUTHOR]

Introduction: Vernal Keratoconjunctivitis (VKC) is a common allergic disease seen in children. The allergic component is caused by Immunoglobulin E (IgE) and mast cell-mediated pathway. It is proposed to be a combination of immune system, genetic, and environmental factors. Secondary dry eye develops secondary to inflammatory disease namely vascular, allergic, environmental conditions like allergens, cigarette smoke, hormonal changes, systemic disorders, such as diabetes mellitus, eye surgeries such as refractive surgery and systemic medications, such as diuretics and antihistamines. Co-existence of dry eye and VKC can worsen the symptoms of the patient and may also lead to prolonged and unnecessary treatment of the disease. Aim: To study the association of dry eye with VKC by Schirmer's test and Tear Film Breakup Time (TBUT). Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Opthalmology, Sri Siddhartha Medical College and Research Centre, Tumkur, Karnataka, India, from December 2020 to June 2022. Thirtythree patients of age group between 5-20 years with symptoms of VKC were evaluated for dry eye using Schirmer's test and TBUT, respectively. Each patient was subjected to detailed history taking, followed by ocular examination as per the predesigned proforma. The patients were subjected to the tear film analysis using Schirmer's test and TBUT. A total of 33 patients were evaluated and the data was compiled. The association between categorical variables were analysed by using Chi-square test. The data was analysed by using Statistical Package fot the Social Sciences (SPSS) software version 21.0. The parameters compared were the type of dry eye with the type of VKC. Results: The mean±Standard Deviation (SD) age of the study group was found to be 11±1.5 years. Out of 33 patients, 69.69% of all the cases were seen in the 5-12 years age group. There was male preponderance in the present study with 63.63% of patients being male child. VKC was most commonly seen as mixed accounting for 57.57% of cases. In the current study, it was discovered that 60.6% of cases showed no sign of dry eye, whereas 39.82% of cases had dry eye. The dry eye was more commonly seen in mixed type of VKC. The p-value was statistically significant (p-value<0.001) for association of dry eye with mixed type of VKC. Conclusion: The present study highlighted the co-existence of dry eye with VKC. There was a significant association of dry eye with VKC and type of VKC as well, which might have long-term effects on the ocular surface. These ocular surface alterations exist during active and the quiet phase of VKC. The patients of VKC may need a long-term follow-up and treatment for this ocular surface alteration. [ABSTRACT FROM AUTHOR]

Introduction: India has impacted severely by multiple waves of Coronavirus Disease-2019 (COVID-19) and still struggling with limitation of resources to cater such a huge population. Available triage methods to treat COVID-19 are either too complex to use or time-consuming. A triage score, that should be independent of any laboratory investigations and exclusively based on clinical parameters was required, so that the healthcare provider at the first contact can segregate patients on the basis of intensity of care required to save, as many lives as, possible. Simple Clinical Parameters (SCIP) score may be a useful tool for fast triage of patients at the point of care and can help to screen patients, who will benefit from early hospitalisation, from those, who can be managed as outpatients. Aim: To validate the usefulness of SCIP score in triage of COVID-19. Materials and Methods: This single-centre, retrospective, observational study was conducted at a Tertiary Care Hospital. The duration of the study was six months, from Nov 2021 to May 2022. A total of 945 patients were involved in the present study. SCIP score was formulated using basic clinical parameters like Pulse Rate (PR), Respiratory Rate (RR), and arterial oxygen saturation at room air (SpO2). The risk score ranges from 1 to 10. The lower the score, more severe the disease and hence, more intense care is warranted. All the parameters required for calculating the SCIP score are continuous variables, expressed in mean±Standard Deviation (SD) and categorical data of patients in specific levels of care are represented as proportions. Data was collected and analysed using Microsoft Excel 2007 and the Python statistics module. Results: The mean age of the study participants was 49.7±16.5 years. A total 945 patients were included in the study, out of which 552 (58.4%) were males and 393 (41.6%) were females. In more than half patients, the LOC predicted by the proposed SCIP score, matched the actual Level of Care (LOC) received. The mean scores were within the proposed score ranges. SCIP score was 97% sensitive in detecting the patients, who can be managed at Outpatient Department (OPD) and 99% specific in detecting those, who did not require intensive treatment at Intensive Care Unit (ICU). SCIP score showed the need for ICU with 92% accuracy and the patients, who can be treated at OPD, without requiring hospitalisation with 90% accuracy. Conclusion: SCIP scoring system based on routine clinical parameters, is helpful in early detection of severity of the disease and in making a fast decision to predict the LOC required. A score based on clinical parameters ensures the availability of a fast and simple triage method to ensure optimal utilisation of available resources and help healthcare provider to make quick decisions. [ABSTRACT FROM AUTHOR]

Introduction: Hypotension after Subarachnoid Block (SAB) can affect mother and foetus and can be prevented by prophylactic use of vasopressors. Phenylephrine (PE) has been a popular and effective drug as prophylaxis against hypotension. Norepinephrine (NE) is recently tried for this purpose. Aim: To compare PE infusion with NE infusion prophylactically against SAB induced hypotension during Lower Segment Cesarean Section (LSCS). Materials and Methods: This randomised clinical study was conducted in the Department of Anaesthesiology at a Tertiary Care Hospital, Ballari, Karnataka, India. The duration of the study was 12 months, from December 2018 to November 2019. A total of 156 primigravida and multigravida with singleton term pregnancy, posted for caesarean section under SAB received prophylactic infusions of either NE 5 µg/minute (group NE) or PE 50 µg/minute (group PE) immediately after SAB till end of the surgery. The primary outcome of the study was to assess the incidence of hypotension. The secondary outcomes included incidence of nausea, vomiting, hypertension, tachycardia, bradycardia and the neonatal outcomes. Related categorical and numerical variables were subjected to suitable statistical tests and analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: The mean age of the study participants of group NE was 24.47±2.52 years and group PE was 23.91±2.63 years, respectively. The age, parity and surgical duration was comparable between the groups. The incidence of hypotension was 17.9% in group NE and 26.8% in group PE (p-value=0.182). No significant differences in total doses of vasopressors used were noted. The incidence of bradycardia in group NE was 3.8% and 21.8% in the group PE (p=0.053). No adverse events or neonatal outcomes were observed. Conclusion: The incidence of hypotension and the total dose of vasopressors administered were similar in the two groups receiving prophylactic infusion doses (NE or PE). Incidence of bradycardia was greater in the parturients receiving PE infusion. [ABSTRACT FROM AUTHOR]

Introduction: Digit sucking is a most common oral fixation observed in children, which involves placement of thumb or fingers into the mouth. Knowledge of the risk factors for the presence of this habit helps to provide a better understanding of the phenomena and is of great significance to the establishment of preventive measures, which can avoid the damage caused by the persistence of these habits. Aim: To evaluate the knowledge and attitude of parents of children aged between 3-6 years regarding digit sucking habit. Materials and Methods: A cross-sectional study was carried out in the Department of Paediatric and Preventive Dentistry, belonging to urban and semiurban area of Pune, Maharashtra, India from December 2020 to May 2021. A total of 310 parents of children, aged between 3-6 years were included. A closeended questionnaire was administered to parents to assess their knowledge and attitude regarding digit sucking habit in children. Completely filled questionnaires were considered for result synthesis. The data obtained was tabulated and descriptive data were statistically analysed using software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Although 229 (73.9%) of parents agreed that for achieving good oral health prevention of digit sucking habit is essential, but 197 (63.5%) parents were unaware of the predisposing factors for digit sucking habit. A total of 195 (62.9%) parents did not agree that inadequate parental attention may lead to thumb sucking habit. A total of 197 (63.5%) parents agreed that prolonged digit sucking can cause misaligned teeth but majority of the parents 205 (66.1%) and 166 (53.5%) disagreed on its effects on facial growth and speech respectively. A total of 219 (70.6%) parents did not receive any scientific information or counselling from healthcare worker regarding sucking habit. A total of 299 (96.5%) of parents agreed that guidance from healthcare workers is needed regarding oral habits in children. Conclusion: Present study concluded that the attitude towards learning about digit sucking habit was good the knowledge of the study participants was poor. [ABSTRACT FROM AUTHOR]

Partial nephrectomy, also called Kidney-sparing Surgery (KSS) or Nephron-sparing Surgery (NSS), is an operation wherein, only a cancerous renal tumour or diseased renal tissue is surgically removed; leaving behind as much healthy renal tissue as possible. Understandably, it was initially preferred in patients with solitary kidney and those, with concurrent bilateral tumours. Over the first two decades of the 21st century, Partial Nephrectomy (PN) has become the standard procedure for many renal tumours; even in unilateral disease. This is because of early pick up due to significant developments in imaging modalities and also, due to better understanding of the biology of renal tumours. With advances in minimal access surgery, partial nephrectomy too has come under its ambit. In the present case series, it's fascinating journey has been discussed-its exciting rise, subsequent downfall and then its unique rise again; as the preferred surgical therapy for many renal tumours, around the world. The purpose of reporting the present case series on Laparoscopic Partial Nephrectomy (LPN) performed for renal cancer, was to share the authors' early experience and results on the topic and to compare them with the world literature. Also, the aim was to underscore the fact that, in an advanced laparoscopy set up, with optimum patient selection and availability of advanced laparoscopic skills, it is an effective and feasible operation. Herein, the authors have described three cases of totally LPN and review of literature on the same. Over an average follow-up period of 23 months, all three patients continue to be asymptomatic and disease free. [ABSTRACT FROM AUTHOR]

Introduction: Antegrade intramedullary nailing in humeral shaft fracture allows a stable fixation with satisfactory outcomes. However, shoulder impairment remains an important complication of intramedullary nailing. The procedure involving the splitting of supraspinatus tendon to expose humeral head for nail insertion has been attributed for it, even though it is followed by the repair of the tendon. Aim: To evaluate rotator cuff integrity with Ultrasound (USG) in patients who underwent humeral fracture fixation with an intramedullary interlocking nail and to evaluate the clinical outcome of the shoulder joint in patients with and without rupture of the rotator cuff using constant murley and QuickDASH scores. Materials and Methods: This prospective interventional study was conducted in the Department of Orthopaedics of AJ Institute of Medical Sciences, Mangaluru, India, from August 2018 to September 2020 in which 20 adult patients with acute humeral shaft fractures were treated with closed intramedullary nailing in antegrade manner. Patients were followed-up for six months clinically and radiologically. The USG evaluation of rotator cuff was done at six months follow-up, along with clinical evaluation using constant Murley and QuickDASH scores. Association between variables was analysed by using Chi-square test for categorical variables. Unpaired t-test was used to compare the mean of quantitative variables. The level of significance was set at 0.05. Data were entered into Microsoft excel (Windows 7; Version 2007) and analyses were done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 22.0; SPSS Inc, Chicago). Results: At six months follow-up, patients were evaluated by USG showing ruptured supraspinatus tendon in 3 (15%) of the study patients. The results by constant murley score were 76.50±12.61 for the entire series, 77.82±12.75 for patients without rotator cuff rupture, and 69±10.53 for patients with partial rupture of the rotator cuff, with no statistical difference (p=0.275). QuickDASH scores were 9.90±7.69 for the entire series, better in the group without rupture of the rotator cuff (9.41±7.92 versus 12.70±6.84) but without statistically significant difference (p=0.510). Conclusion: The functional outcome of the shoulder joint is satisfactory and is not influenced by the presence or absence of a rotator cuff tear following the procedure. [ABSTRACT FROM AUTHOR]

Introduction: Cervical spondylosis is a degenerative disorder of the cervical spine and has varied pathological forms of presentation. It presents as either varying degrees of intervertebral disc bulge, spinal cord compression, altered cord signals, neural exit foraminal stenosis, annular tears, facet joint degeneration and ligamentum flavum hypertrophy in combination or isolation. Magnetic Resonance Imaging (MRI) being known for its excellent soft tissue resolution helps assess and grade these pathologies efficiently. Aim: To evaluate the flexion-extension MRI in regular cervical spondylosis imaging by assessing the effect of flexion and extension positioning on the severity of cervical spondylotic canal stenosis and spinal canal dimensions. Also, to compare the change in cervical canal dimensions on flexion and extension with that of neutral positioning. Materials and Methods: A cross-sectional study was conducted in the Department of Radiodiagnosis, JSS Medical College, Mysuru, Karnataka, India, from January 2021-June 2022. A total of 50 participants, aged above 18 years with a clinical suspicion of cervical spondylosis and without history of trauma, tumour, infection, prior cervical surgery and with Nurick grade <3 were included in the present study. In all the subjects, spinal canal dimension, degree of stenosis was assessed and graded, further assessment for presence of foraminal stenosis, ligamentum flavum hypertrophy and facetal arthropathy were also documented. Data were statistically analysed using Chi-square test and Mc Nemer's test. Results: Out of total 50 cases, 26 (52%) were males and the rest were females with mean age of 46 years. Least cervical canal space dimension of 0.4 cm at C6-7 level in the neutral position and at C3-4, C5-6 and C6-7 levels in extension were noted thus, proving the importance of extension positioning in recognising maximum levels and severity of involvement. Narrowest diameter was demonstrated on flexion and extension. Additionally, the elderly was seen more affected by central disc bulge, foraminal stenosis, facetal arthropathy and ligamentum flavum hypertrophy as compared to the middle aged and the younger patients, more so in extension (12%). Conclusion: Disc bulge and grade of stenosis vary extensively and are more conspicuous on additional flexion and extension imaging. Severity of the grade of stenosis and demonstration of maximum number of levels involved on extension as compared to flexion or neutral positioning thereby, benefitting clinical management plan. [ABSTRACT FROM AUTHOR]

Introduction: Academics amid the lockdown in Coronavirus Disease-19 (COVID-19) outbreak have experienced massive reforms worldwide. This survey was conducted after the lockdown to evaluate its effect on academic activities in ophthalmology. Aim: To assess the effect of lockdown and related restrictions on ophthalmology postgraduate (PG) training programmes. Materials and Methods: An online cross-sectional survey using google forms was designed and sent to postgraduates of Opthamology Department across India through various social media platforms for one week. A total of 45 questions were included, related to opthalmology practice, clinical opportunities, surgical training and online teaching. Data was entered in Microsoft Excel software and descriptive statistics was used to describe the results. Results: A total of 84 postgraduates were surveyed, of whom majority were from Karnataka (n=41) followed by Kerala (n=35). 38 (45.2%) participants observed a reduction in Outpatient Department (OPD) patients and 78.6% decline in Operation Theatre (OT) procedures, 74 (88.10%) trainees required almost a month to restart OT and most of them 81 (96.54%) wore an N95 mask while operating. Nearly, 72 (85.7%) got Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test as an additional investigation for all of their patients. Majority of the responders, 81 (96.4%) felt that the webinars were helpful. Conclusion: This survey shows that majority of the ophthalmology postgraduates (mainly in Karnataka and Kerala) felt that the COVID-19 lockdown adversely affected their curriculum learning, especially the surgical training. Most of them benefited from the webinars and other online teaching programmes. Regulatory bodies should take a note of the issue and appropriate guidelines should be set up to optimise the training loss due to this pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Intraoral translocation of periodontal pathogens from untreated intraoral niches can lead to recolonisation and reinfection of recently treated periodontal pockets. Poor oral health hampers the patient's Quality of Life (QoL) as it causes social isolation, inferiority and the development of psychiatric conditions. Full Mouth Disinfection (FMD) performed within 24 hours using chlorhexidine has reported significant improvements in clinical, microbiological and psychological parameters when compared to conventional periodontal treatment. Aim: To investigate the long-term effect of FMD on Oral Health-Related Quality of Life (OHRQoL) in patients with generalised chronic periodontitis. Materials and Methods: This study was a prospective clinical study conducted in the Department of Periodontology, Dr DY Patil Dental College and Hospital, Pune, Maharashtra, India, from October 2019 to December 2021. Study consisted of 60 participants who were allotted into two groups; 30 periodontally healthy volunteers (control group) and 30 patients (test group) diagnosed with generalised chronic periodontitis. The test group was asked to fill out the Oral Health Impact Profile-14 (OHIP-14) questionnaire to assess the OHRQoL at baseline followed by FMD protocol. All the patients were kept at periodic recall, and the OHRQoL was assessed again taken after one months three months, and six months. The control group was asked to fill out the questionnaire at the baseline. Repeated measure analysis of variance with post-hoc bonferroni test was used to compare differences in variation present from baseline to one month, three months and six months. For intergroup comparison at different time intervals, an unpaired t-test was applied. Results: The age group of participants ranged from 25-55 years with a mean age of 41.3 years. Test group had 18 males and 12 females and, 20 males and 10 females were in the control group. The mean OHIP-14 score at baseline was 3.58±3.29 in the control group and 42.35±4.32 in the test group at baseline, showing a mean difference of -38.76±0.93, which was statistically significant. After one month there was a significant improvement in the OHIP-14 scores of the test group (26.35±2.60), which was further reduced to -13.58±0.81 and -9.0±0.88 by the end of three and six months. Therefore, a notable improvement in the QoL and periodontal conditions of the patients following FMD was appreciated. Conclusion: Periodontitis negatively impacts the OHRQoL. FMD provides an improvement in the perceived QoL among periodontitis patients. [ABSTRACT FROM AUTHOR]

Introduction: Although traditional local anaesthetic technique by injection is considered as gold standard for dental procedure, the resultant pain and anxiety caused by the needle prick makes the patient less compliant for further treatment. Many alternatives have been developed by the researchers in the last two decades. Jet anaesthesia and the topical gel are the commonly used alternatives to anaesthetise the local area. Aim: To evaluate and compare the effectiveness of topical anaesthetic gel (MucopainR gel) and jet anaesthesia (Sure ShotR needle free jet injection) during root planing. Materials and Methods: After taking consent, 20 patients who required root planning in the maxillary quadrant bilaterally were recruited for this study. A split mouth study was planned where one quadrant was anaesthetised with benzocaine 20% (MucopainR) gel, whereas sure shotR jet anaesthesia was used on the adjacent quadrant. The side and order of placement of topical gel and jet anaesthesia were randomised. The same operator delivered anaesthesia on both the sides. The root planning was carried out by another operator at two sittings and pain was assessed immediately using Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and Verbal Response Scale Statistical. Results: The mean NRS score of the jet injection group was 1.50±1.54 and that for the gel group was 3.15±2.16. Also, the mean VAS score of the jet injection group was 1.50±1.54 and that for the gel was 3.15±2.16. The difference between two groups were statistically significantly (p-value=0.008). Conclusion: Jet anaesthesia was significantly superior to gel in providing anaesthesia during root planing. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is associated with right ventricular overloading and pulmonary hypertension. In COPD patients co-morbidities determine the outcome and quality of life. Cardiac Troponins (cTn) are suspected to be elevated in right ventricular failure. Aim: To find the incidence of cardiac Troponin-I levels and association of elevated cTnI levels with clinical outcome in acute exacerbation of COPD. Materials and Methods: The cross-sectional study comprised of 102 patients with acute exacerbation of COPD. These patients were admitted in medical wards and Intensive Care Unit (ICU) in the Department of General Medicine, Karnataka Institute of Medical Sciences Hospital, Hubli, Karnataka, India, from 2018-2020. Investigations included complete blood count, renal function tests, serum electrolytes, liver function tests, Electrocardiography (ECG), ECHO and chest X-ray. Association of cardiac troponin I and acute exacerbation of COPD was evaluated. The cTnI level =0.01ng/mL was considered positive. Results: The serum cTnI was found to be positive in 43 (42.2%) patients with acute exacerbation of COPD. The patients with cTnI levels ≥0.01 ng/mL had significantly higher need for Non Invasive Ventilation (NIV) 32 (74.4%), invasive ventilation support 5 (11.6%), prolonged duration of hospital stay 33 (76.7%), and higher mortality 15 (34.9%) rate as compared to patients having cTnI <0.01 ng/mL. Conclusion: The cTnI is elevated in a significant subset of patients with acute exacerbation of COPD. cTnI elevation was associated with higher need for NIV and invasive ventilator support. Levels of cTnI =0.01 ng/mL may be considered as a biomarker to predict morbidity and mortality in acute exacerbation of COPD patients. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is characterised by reduced bone mass and structural destruction of bone tissue which increases the brittleness of bone that leads to increased fracture risk. It is very common among postmenopausal women. Since osteoporosis is closely related to oestrogen deficiency, postmenopausal women are predisposed to it. The decrease in oestrogen during the menopausal transition period causes more bone resorption than formation, resulting in osteoporosis. Aim: To assess the quality of life of among the postmenopausal osteoporotic women without fracture and to find out the association of quality of life with selected demographic variables. Materials and Methods: The present cross-sectional was conducted at the Osteoporosis Clinic of Orthopaedic Outpatient Department of Kasturba Medical College Hospital, Manipal, India, between June 2019 and September 2021, after obtaining the permission from concerned authorities. The sample was 120 postmenopausal osteoporotic women who belong to the age group 45-65 years. Postmenopausal women with uncomplicated osteoporosis without fractures were included in the study. The independent variable was of quality of life of the postmenopausal women and the dependent variables were the age, religion education occupation, and Bone Mineral Density (BMD). After obtaining the informed consent, the participants were interviewed using Short Form-36 (SF-36) quality of life questionnaire. The questionnaire consisted of 36 items and eight subscales which are summarised in two domains: Physical Component Summary (PCS) and Mental Component Summary (MCS). The statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) software version 22.0. The collected data was analysed using descriptive and inferential statistical measures. One way Analysis of Variance (ANOVA) and the Pearson correlation coefficient test was used to find out the association. Results: The mean±Standard Deviation (SD) age of the participants was 56.8±2.5 years, 99 (87.5%) participants were Hindus and n=52 (56.25) belonged to general category. Higher proportions of the women were housewives i.e., n=85 (68.75%). Higher scores show a better quality of life. The results of this study showed that participants scored less (29.99±9.56) in role limitations due to emotional problems. Also, the participants scored less (43.39±4.57) in the domain of MCS in comparison to PCS (47.78±4.53). Further, association of PCS and MCS scores of quality of life were tested (p-value<0.05) with selected demographic variables such as age, religion, education, occupation and BMD. The results showed that there was no significant association found between PCS scores and age (p-value=0.84), religion (p-value=0.94), occupation (p-value=0.805) and BMD (r= -0.058, p-value >0.05). Also, there was no significant association between MCS scores and age (p-value=0.69), religion (p-value=0.86), occupation (p-value=0.70) and BMD (r-value=-0.0604, p-value >0.05). Conclusion: The participants scored less in the subscale of role limitations due to emotional problems of the SF-36 questionnaire. The quality of life was less in the mental component subscore. This indicated that osteoporosis make the postmenopausal women anxious and affects their daily activities. [ABSTRACT FROM AUTHOR]

Introduction: Coronary atherosclerosis is common in diabetics, and it is diffuse in form, with multivessel involvement. It demonstrates the involvement of multiple vessels rather than a single vessel. Aim: To evaluate the angiographic profile of diabetic patients with ST Elevation Myocardial Infarction (STEMI). Materials and Methods: The present study was a cross-sectional study which enrolled 104 diabetic patients presenting with STEMI from December 2019 to March 2020. Seventy percent or more stenosis in any major coronary artery or its major branches (>2.5 mm) was considered as significant. Results: Mean age of the patients was 55.61±11.32 years, with 75 subjects being males and 29 subjects being females. A total of 28 (26.92%) had Anterolateral Wall Myocardial Infarction (ALWMI), 4 (3.84%) had Anteroseptal Wall Myocardial Infarction (ASWMI) 39 (37.5%) had Anterior Wall Myocardial Infarction (AWMI), 1 (0.96%) had extensive AWMI, 2 (1.9%) had Inferolateral Wall Myocardial Infarction (ILWMI), while 30 (28.84%) patients had Inferior Wall Myocardial Infarction (IWMI). Furthermore, 51 (49.0%) were thrombolysed while 53 (50.96%) patients were non thrombolysed. Thirty eight (36.53%) had single vessel disease, 40 (38.46%) had double vessel disease, while 26 (25%) had triple vessel disease. Among these patients, Left Main Coronary Artery (LMCA) was involved in 3 (2.88%) of patients. Seventy three patients had a Glycated Haemoglobin (HbA1c) of greater than 8.5 and had multivessel involvement, whereas 31 had a HbA1c of less than 8.5. Major Adverse Cardiac Events (MACE) was observed during hospital stay in the form of death, recurrent myocardial infarction and cardiovascular stroke, which occurred in 20 (19.23%) patients of the total 104 diabetic patients. Conclusion: In the present study, the severity and extent of Coronary Artery Disease (CAD) and incidence of triple/multivessel disease was significantly high in diabetics. Diabetic patients with high HbA1c had more coronary vessel involvement. In this case, Coronary Artery Bypass Graft (CABG) is the mode of treatment. [ABSTRACT FROM AUTHOR]

Introduction: Patients scheduled to undergo elective surgeries should be assessed, well in advance, by anaesthetists with a view to plan optimal preparations and perioperative management regarding their anaesthetic requirements. Aim: To assess the knowledge of the role of anaesthetists during the perioperative period and the importance of preanesthetic check-up among patients undergoing elective surgery. Materials and Methods: A cross-sectional study was conducted in Khaja Bandanawaz Institute of Medical Sciences, Kalaburgi, Karnataka, India, from August 2019 to February 2020. The study involved 300 patients posted to the preanesthetic check-up clinic, over a span of six months for elective surgeries. Patients were asked to complete a questionnaire consisting of 17 questions. Statistical analysis was carried out using Statistical Social Science Packages (SPSS) version 16.0 for Microsoft Windows and Excel. Results: A total of 66% (198) patients were males. The mean age of participants was 38.68±10.35 years. Graduates made up 28.6% of the participants, and 44.3% of them either had some schooling (primary or secondary) and the rest 27% did not have any education. Overall, 23% (69) participants had a history of surgery and except one, all received both Preanaesthetic Check-up (PAC) and anaesthesia during their previous surgery. The mean percentage (89.3%) of awareness was highest among the participants with a history of previous surgery (p-value <0.001). Conclusion: The present study concluded that demographic characteristics such as age, sex, occupation, education and residence do not influence the awareness and importance of preanesthetic check-up clinic however, history of previous surgery was statistically significant. [ABSTRACT FROM AUTHOR]

Introduction: Meningoencephalitis is a syndrome leading to fatality and neurological damages. Worldwide, infection of the central nervous system is the most common cause of meningoencephalitis. In encephalitis, a leptomeningeal involvement along with inflammation of brain parenchyma is invariably present and the clinical symptoms reflect both diffuse and focal cerebral pathology as well as meningitis. Correct immediate diagnosis and introduction of early symptomatic and specific therapy has a dramatic influence upon survival and reduces the extent of permanent brain injury and also has major impact on the outcome. Aim: To study the clinical profile and aetiological causes of meningoencephalitis and also to analyse the mortality and morbidity due to meningoencephalitis in a tertiary care centre. Materials and Methods: It was a prospective observational study conducted between December 2018 to December 2020 in a tertiary care centre, Karnataka Institute of Medical Sciences, Hubali, Karnataka, in which 184 patients of meningoencephalitis who fulfilled inclusion criteria were included. Detailed history and clinical examination was done followed by laboratory investigations, complete haemogram, serum electrolytes, liver function tests, Fundoscopy, Electroencephalography (EEG). Cerebrospinal Fluid (CSF) analysis including CSF culture and Cartridge Based Nucleic Acid Amplification Test (CBNAAT), Computed Tomography (CT)/Magnetic Resonance Imaging (MRI) brain were also done and results analyzed. Microsoft (MS) Excel and MS word was used to obtain various types of graphs such as bar diagram, pie diagram. Percentages and means were calculated using Statistical Package for Social Sciences (SPSS) statistics software version 22.0. Results: Out of 184 patients, majority of patients were in the age group of 31 to 50 years accounting for 85 (46.2%) of cases. Majority of patients were males (n=113) than females (n=71). Tubercular aetiology was found in 51.6%, viral cause in 25%, bacterial cause in 21.2%, fungal cause in 2.17% of patients. Out of 184 patients of meningoencephalitis, 50% patients recovered, 27.17% patients recovered with residual neurological deficit, 11.95% patients died and 10.86% were discharged. Conclusion: Detailed history and clinical examination along with appropriate investigations are necessary to confirm the diagnosis of meningoencephalitis. Tubercular (TB) Meningitis was common with high morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Distal Peripheral Neuropathy (DPN), which first affects the lower limbs and then the upper limbs, is one of the common complications of Type 2 Diabetes Mellitus (T2DM). In addition to DPN, diabetic patients have lower muscle quality than non diabetic patients, which is exacerbated by longer duration of diabetes and poor glycaemic control. Diabetic induced peripheral neuropathy and changes in the muscle strength may interfere with bimanual coordination, which refers to a wide range of situations in which the brain must control multiple movements at the same time such as performing a task with two hands. Aim: To assess and compare Efficiency Index (EI) of bimanual coordination in T2DM and controls. Materials and Methods: This case-control study was conducted conducted in the Department of Physiology at Shri RL Jalapa Hospital, Kolar, Karnataka, India, from August 2019 to September 2019. The study included 50 participants, 25 with T2DM and 25 age matched controls. The bimanual hand coordination test apparatus was used to assess the efficiency of bimanual hand coordination. The data obtained was analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: The mean age of the study participants was 57.16±9.54 years and controls was 54.15±5.52 years and were age matched with p-value >0.426. Mean HbA1C of the cases was 8.36±1.88 mmol/mol. There was significant decrease in efficiency of bimanual coordination among type 2 diabetics as compared to non diabetics (p-value <0.001). Conclusion: The findings of the present study showed a decrease in bimanual coordination efficiency among diabetics, indicating the importance of performing hand function tests in T2DM alongside other routine examinations. [ABSTRACT FROM AUTHOR]

Introduction: The standard isolation and expansion of human Dental Pulp Stem Cells (DPSCs) under invitro conditions normally involve the usage of Fetal Bovine Serum (FBS). However, its animal-origin poses possible concerns for clinically relevant procedures. This critical issue compels the use of Xenogeneic-Free (XF) or human-origin alternatives to FBS for culture expansion and differentiation of DPSCs to determine the usefulness for translating into therapeutic clinical applications. Aim: To evaluate the cellular characteristics and expression of pluripotent markers in DPSCs cultured using Serum-Containing Medium (SCM-DPSCs) and Serum-Free Medium (SFMDPSCs). Materials and Methods: This in-vitro descriptive study was conducted at NITTE (Deemed to be University), Mangaluru, Karnataka, India, from June 2019 to August 2020. DPSCs were isolated from impacted third molars. The culture expanded DPSCs in serum-containing and serum-free media were analysed on their morphology, viability, proliferation rate, Population Doubling Time (PDT), Alkaline Phosphatase (ALP) activity, cell surface markers expression, osteogenic and adipogenic potential, and the relative expression of selected pluripotent genes. Results: The primary culture of DPSCs established in SCM and SFM showed spindle shaped fibroblastic morphology with >80% viability from passage 1 (P1) to P4. A significant (p-value<0.05) difference in the proliferation rates in terms of cell numbers between SCM-DPSCs and SFM-DPSCs was observed (day 6: 3×105 vs 0.8×105; day 9: 5.8×105 vs 1.27×105; day 12: 7.8×105 vs 1.56×105, respectively). The average PDT values recorded in SCM- and SFM-DPSCs were 44.33 hours and 58.41 hours, respectively. A slightly higher expression of ALP activity was observed in SCM-DPSCs than in SFM-DPSCs. Flow cytometry analysis showed that both DPSCs were positive for CD29, CD73, CD90, and negative for CD34 and CD45. The expression of OCT4 and NANOG was relatively higher in SCM-DPSCs compared to SFM-DPSCs. Further, SCM-DPSCs showed the higher levels of SOX2 and SSEA4, but did not exhibit any significant differences in their expression levels. Conclusion: The results showed that DPSCs in FBS displayed better growth kinetics and stemness markers expression along with more propensities towards lineage differentiation. SFM can be used to establish and expand DPSCs with characteristics of multipotent stem cells, but needs further research for its optimisation. [ABSTRACT FROM AUTHOR]

Introduction: The documentation of the maxillomandibular relationship and the recording values of condylar guidance is the most critical, yet essential step in fabrication of complete denture prosthesis and it also helps in diagnosing, treatment planning, and fabrication of the balanced complete denture prosthesis that aids in enhancing the aesthetics, and maintenance of the stomatognathic system. Various techniques are available to record the condylar guidance; One of them being axiographic technique and panoramic radiograph followed by programming the semi adjustable articulators. Aim: The aim of the present study was to evaluate and compare the condylar guidance using the conventional technique the gothic arch tracing with that of axiographic technique and the panoramic radiographs. Materials and Methods: The observational study with the clinical set up was carried out over a period between October 2018-March 2019. Twenty completely edentulous patients were selected for the study. The comparative evaluation of axiographic tracing technique, panoramic radiographic technique and the extraoral gothic arch tracing technique was conducted. The horizontal condylar guidance values obtained with these techniques were assessed. The data obtained was statistically analysed using Karl Pearson correlation test to determine the correlation between the values obtained from all the three techniques on the right side and the left side of the subjects. Paired t-test and Bonferroni Post-Hoc test were used to compare the extraoral gothic arch tracing values and Orthopantomogram values and axiographic tracing values on right side and left side of the subjects. Results: A statistically significant correlation was observed between the extraoral Gothic arch tracing technique and the panoramic radiographic technique on right (r=0.047, p-value 0.04) and left sides (r=0.55, p-value 0.01) of the subjects. The axiographic tracing showed lower values when compared with gothic arch tracing technique and the panoramic radiographic technique. (95%CI of difference was -0.49 lower). Significant differences were obtained on comparison between all three techniques on right (p-value<0.001) and left sides.(p-value 0.008). On pairwise comparison of right side between Extraoral gothic arch Tracing and Axiographic tracing (p-value<0.001) and between axiographic tracing and Orthopantomographic tracing (p-value<0.001), were significant, while pairwise comparison on left side between Orthopantomogram and Axiographic tracings (p-value 0.01) was significant. Conclusion: The panoramic radiographic images can be used as an alternative method to that of conventional gothic arch tracing technique to obtain the condylar guidance values. The values obtained using axiographic tracings method was comparatively lower. Thus, the values obtained from axiographic technique should be used with caution or the values needs to be compared to gold standard techniques to further analyse the accuracy of the values that can be used as a valuable aid in setting the condylar guidance in semi-adjustable articulators. [ABSTRACT FROM AUTHOR]

Introduction: Oral submucous fibrosis (OSMF) is a potentially malignant disease with a prevalence of 7-13%. It is characterised by the fibroelastic changes due to excessive deposition of collagen which results in dense fibrous bands and epithelial changes. About 90-95% of oral cancers are Oral Squamous Cell Carcinoma (OSCC). Stroma produced by the invading neoplastic cells are rich in collagen fibres. These collagen fibers have been the main focus of study to understand the pathogenesis of these lesions. Hence, these fibres have been evaluated under polarised microscopy following staining with Picrosirius red stain. Aim: To evaluate changes in birefringence, thickness and orientation of collagen fibres in different histopathological stages of OSMF and OSCC. Materials and Methods: This observational study involved sections of clinically and histopathologically confirmed cases of OSCC and OSMF from Department of Oral Pathology and Microbiology, Rajarajeswari Dental College and Hospital, Bangalore. The study was conducted for a duration of one year from April 2017 to March 2018. The study included total 60 cases among which 20 for each-normal mucosa, OSCC and OSMF. Tissue sections were stained with Picrosirius red stain and collagen fibres were analysed for colour, thickness and orientation under polarised microscope. Chi-square test was used for statistical analysis. Significance was set at p-value <0.05. Results: Comparison of birefringence of collagen fibres between OSMF, OSCC and normal mucosa was not statistically significant (p-value=0.37). Orientation of collagen fibres between OSMF, OSCC and normal mucosa was statistically significant with (p-value=0.02). Conclusion: This study showed a change in colour from yellow orange to orange red in advanced OSMF cases which indicated progression of disease and tightly packing of collagen fibres, suggestive of presence of thick fibres in the extracellular matrix. In OSCC, the colour change from yellow orange to orange red and haphazardly arranged collagen fibres was indicative of transformation of preneoplastic to carcinoma stage. [ABSTRACT FROM AUTHOR]

The p73 gene is an important member of the p53 gene family, which includes p53, p63, and p73 genes. The p73 gene was identified by Mckeon's group in 1997 and localised to 1p36 region. The p73 shows a complex interplay with both, p53 and p63 genes. Similar to p63, but unlike p53, p73 has an important role in development especially neuronal development, apart from tumourigenesis. The p73 gene plays a vital role in the development of tumours and exhibits both tumour suppressor and oncogenic behaviour. This dual function is attributed to the presence of the two different variants: TAp73 and ?Np73 with mutually divergent functions. There exists a dynamic relationship between the multiple p73 isoforms. The p73 has a major role in regulating apoptosis, and Deoxyribonucleic Acid (DNA) damage related cell cycle arrest. It can replace p53 in various apoptotic pathways, as it is capable of transcription of p53 responsive genes. The p73 also participates in myriad processes including angiogenesis, epithelial-mesenchymal transformation, senescence, and maintaining genomic stability. The p73 overexpression has been detected in a number of human cancers. Since it is frequently overexpressed rather than mutated, it is a promising potential candidate for developing therapeutic strategies in various cancers as well as, for predicting the prognosis. It is also implicated in the lack of response to chemotherapeutic drugs. However, the entire spectrum of cellular mechanisms with respect to p73 is still not understood clearly. This article explores the multiple roles of p73, especially in tumour development processes, and also, its recent novel applications in therapeutics. [ABSTRACT FROM AUTHOR]

Introduction: Incidence of stroke is more frequently found among the elderly who are mostly dealing with co-morbidities and polypharmacy, were found to be significant in high risk of potential Drug-drug Interactions (pDDIs). Aim: To identify potential drug-drug interactions in ischaemic stroke patients. Materials and Methods: This retrospective study was conducted in the General Medicine Department at Justice KS Hegde Charitable Hospital, Mangaluru, Karnataka, India, from January 2018 to August 2020. All the stroke patient's data were collected based on the inclusion criterion. Prescriptions were obtained from the case sheets and the pDDIs were identified using UpToDate software. Results: The mean age of the study population (N=350) was found to be 61.07±11.460 years, The incidence of stroke was high in males (66%) than in females (34%) from the total of 350 patients. The prescribing patterns were antiplatelet single (69.4%) and fixed-dose combination (1.42%), anticoagulants (11.14%), antihypertensive agents (63.42%), followed by lipidlowering agents (65.14%) as single and fixed dose combinations (0.85%), gastrointestinal agents (70.57%). The class prescribed the most was antiplatelet agents (aspirin 61.4%). The total number of 402 pDDIs were found among 350 patients. Based on the Lexi-Interact® severity scale moderate interactions were the most commonly found then followed by the major and minor with 301 (74.87%), 66 (16.41%) and 35 (8.70%) respectively. The most frequent interaction found were clopidogrel with pantoprazole, and atorvastatin with clopidogrel with same incidence of in 44 (12.57%) patients. Conclusion: The majority of the interaction was found to be moderate interactions which were followed by major and minor interactions. The pDDIs mostly occurred among the antiplatelet agents, gastro-intestinal agents and antihypertensives. [ABSTRACT FROM AUTHOR]

Introduction: Tympanoplasty is the surgery performed in Chronic Otitis Media (COM) to improve the hearing function and prevent ear discharge. Platelet Rich Fibrin (PRF) is one of the materials that can be used to improve the graft uptake and hearing outcome. It is obtained by centrifugation of blood. The PRF contains leukocytes, cytokines, structural glycoproteins and growth factors which accelerates healing. It has been used in various surgical procedures to improve the outcome. Aim: To determine the efficacy of autologous PRF in closure of tympanic membrane perforation after tympanoplasty and to study the influence of PRF on the hearing outcome in the study population. Materials and Methods: This prospective interventional study was conducted in Department of Ear, Nose and Throat at SDM Medical College, Dharwad, Karnataka, India, from November 2018 to June 2020. The study included 60 patients with safe type of COM, who underwent tympanoplasty. Two group were made, group A consisted of 30 consecutive patients with safe type COM who underwent tympanoplasty with PRF application and group B, consisted of 30 patients who underwent tympanoplasty without PRF application. The outcome was assessed by endoscopic evaluation every month for three months to look for graft uptake. Hearing gain was evaluated by Pure Tone Audiometry (PTA) after three months of surgery. Statistical analysis was done using Chi-square test. results: The majority of cases belonged to young adults between 21 to 30 years of age. Group A had 29 cases with complete tympanic membrane closure and only one failure. However in group B, three out of 30 cases had failure. Thus, the overall the success rate was 96.66% in group A and 90% in group B. Postoperative PTA in group A showed that 18 cases (60%) had an improvement of >15 dB whereas in group B, 12 cases (40%) had hearing improvement of >15 dB. conclusion: Considering the higher success rate of tympanoplasty with group A compared to group B and no noticeable side effects, it is recommended that tympanoplasty with autologous PRF should be preferred. [ABSTRACT FROM AUTHOR]

Oral disease represents a major concern among all populations. Despite great efforts that have been made in the past few decades to overcome these diseases; a large part of the world population still suffers from oral diseases which are considered a major reason for the loss of a tooth. Different bacterial species colonizes the oral cavity, some of the bacteria are found to be associated with the cause of one of the most common disease called periodontitis. The infectious nature of periodontopathogens has been studied extensively. Currently, treatment of various oral diseases includes supragingival as well as subgingival debridement, root canal treatment and in severe cases, extraction along with antibiotic therapy to help achieve a pathogen-free environment. Continued research and development in the field of dentistry have brought new approaches in treatment modalities. The use of ozone is one of the latest therapies that has gained the interest of researchers in thepast few decades. Ozone is a pale blue colour gas and is the natural constituent of the atmospheric layer of Earth. It is a modern pharmacological approach that is biocompatible and has shown its effectiveness against bacteria (gram-positive and gram-negative bacteria), viruses, and fungi. The beneficial biological effect of ozone has made its usage at all stages of disease propitious. The explication of the mechanism of ozone at the molecular level has proved to be beneficial in different medical and dental treatments. The use of ozone in clinical practice can be advantageous to the patient in terms of pain relief and treatment time. Therefore, this article briefly reviews the chemical nature of ozone, its therapeutic uses, and the benefits it can provide in the treatment of various oral diseases. [ABSTRACT FROM AUTHOR]

Introduction: Laboratory parameters are crucial in diagnosis and prognosis of Coronavirus Disease 2019 (COVID-19). It would be of interest to explore morphological changes in infected White Blood Cells (WBCs). A detailed examination of peripheral smears may shed light on pathophysiology of infected cell lines and differentiate them from those in established viral infections like dengue and infectious mononucleosis. Aim: To study morphological changes of WBCs in peripheral smears of severe and non severe cases of COVID-19 patients. Materials and Methods: This cross-sectional study was conducted at a tertiary care centre, Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Ramanagara, Karnataka, India, from April 2021 to August 2021 on 120 peripheral smears of adult COVID-19 positive cases. Abnormal morphological features were graded by counting 100 cells in each of neutrophils, lymphocytes and monocyte lineage. Changes were compared and analysed between severe and non severe groups using Statistical Package for Social Sciences (SPSS) software version 26.0. A p-value <0.05 was considered as significant. Results: The study included total of 120 cases (59 severe and 61 non severe) with a mean age of 47 years. Male to female ratio in severe and non severe categories were 1:1.2 and 1:0.6, respectively. Severe category patients (n=59) were associated with statistically significant leucocytosis (p-value=0.04), absolute neutrophilia (p-value=0.03) and higher grades of morphological changes-abnormal nuclear morphology (p-value=0.002) and Pseudo-Pelger-Huët anomaly in neutrophils (p-value=0.029), plasmacytoid lymphocytes (p-value=0.03), cytoplasmic granularity and atypical lymphocytes (p-value=0.04). Monocytes showed large coalescent vacuoles and cytoplasmic granules (p-value=0.03). Though present in non severe category (n=61), they were proportionately of lesser grades. Conclusion: Viral cytopathic effects in WBC cell lines on peripheral smear had significant clinical implications on disease severity, undermining need for a comprehensive study of viral induced morphological changes in hospitalised COVID-19 patients. [ABSTRACT FROM AUTHOR]

Introduction: Atraumatic extraction is the need of the hour to best preserve both hard and soft tissues. A novel instrument was designed, needle probe, in an effort to achieve the same efficacy with respect to extraction of maxillary teeth broken root fragments. Aim: The aim of the study was to assess the efficacy of using needle probe in removing fractured maxillary tooth apical sections in terms of application, use and its handling. Materials and Methods: In the present clinical, cross-sectional study, Fifty patients requiring removal of fractured maxillary tooth root fragment as a complication of routine extraction were enrolled. The study was conducted between June 2020 and June 2021. Patients were assigned, irrespective of gender, age or tooth, to group A (n=25) where extraction of root pieces was done using endodontic H files and group B (n=25) in whom extraction was done using the novel needle probe. Data was tabulated accordingly and analysed using Statistical Package for the Social Sciences (SPSS) ver. 22 and categorical data between groups were analysed using student's t-test. with significance level set at 0.05. Results: The average time taken for successful removal of the root fragment in Group A was 3 minutes 3 seconds±23 seconds and 2 minutes 12 seconds±46 seconds in Group B. All inclusive, the needle probe proved to have excellent ease of operation, access and visibility in 24%, 24% and 36% cases as opposed to the conventional use of H files with minimal complications and tissue trauma. Conclusion: Failure to retrieve the broken root is mostly associated with ankylosed and hyper cementosis roots. The needle probe can be promising in its use for atraumatic root fragment extraction. The novel needle probe is easy to use, quick in application and hence results in better patient compliance. [ABSTRACT FROM AUTHOR]

Introduction: It is suitable for a patient to wear a respirator or face mask during any radiological investigation during Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) pandemic. Some face masks may have nanoparticles, or antimicrobial coating, which may comprise metal to help shape the mask according to user face shape. This kind of ferromagnetic substances can cause artefacts in the image. Aim: To detect and compare the artefacts while using different types of respirators and surgical masks in the Magnetic Resonance Imaging (MRI) phantom images. Materials and Methods: This was a prospective cross-sectional study which was conducted from July 2021-September 2021. Two Not resistant to oil-based aerosols with 95% efficiency to airborne particles (N95) respirators and two types of three-ply surgical disposable masks with a metal and plastic nose holder were used. The N95 respirators were of Halo N95 Filtering Facepiece 2 Particulate Matter (FFP2) PM 2.5 and Suchi N95 S-7400, while the surgical masks were from Venus 3 ply V-1010 with a metal nose holder and the Thea Tex Filtra 3 ply with plastic nose holder. A polymethyl methacrylate plastic phantom was used with 1.5 Tesla (Siemens Magnetom Avanto) MRI scanner for imaging. Results: When exposed to the metal detector both N95 respirators and one of the surgical masks with a metal nose clip showed strong ferromagnetic attraction. Both respirators and a surgical mask with a metal nasal holder showed magnetic susceptibility artefacts. The signal loss is caused by dephasing of spins from metal strip on the image. Conclusion: All the patients must have a recognised MR safe masks prior to an MRI investigation. When this is not possible to follow, metallic components from the face mask should be removed before the patient's arrival at the MR room. After removing the metal strip from the mask, the paper tape may be applied across the nasal bridge region for adequate transmission control and to maintain the intended function of the mask. The mask with a plastic nasal holder was ideal to use in an MR environment since it doesn't have any distortion in the image. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has imposed an unprecedented burden on our healthcare system. Serological testing for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibodies serves as an useful marker for determining an infection by the virus in the recent past and the immune response. The immune response, including the humoral response to the infection is one of them and the knowledge in this area is still evolving. Virus specific antibodies are expected to help in eliminating the virus and to provide protective immunity against reinfection. Aim: To serially monitor the total antibody response to SARSCoV-2 in order to gain better insight into the duration of antibody persistence. Materials and Methods: This prospective observational study was conducted in 66 Healthcare Workers (HCW) with a history of Reverse Transcription-Polymerase Chain Reaction (RTPCR) proven COVID-19 infection. The study was conducted between May 2020 to April 2021 at the Suburban diagnostics Central Processing Laboratory, Mumbai, Maharashtra, India. Serum samples were serially examined for the presence of total antibodies against the Nucleocapsid (N) protein of SARS-CoV-2 upto 180 days postinfection. A further follow-up examination was done at 360 days. A qualitative Electrochemiluminescence Immunoassay (ECLIA) assay was used for assessment of the antibody response. The chi-square or Fisher-exact test was used to compare categorical variables and the Mann-Whitney U test, Kruskal Wallis test and student t-test were used to compare continuous variables across groups. For assessing relationship between variables, the Pearson test or linear regression were used as appropriate. Results: Out of 66 healthcare workers, 32 were male (48.5%) and 34 were females (51.5%) with the median age of 29.5 years. Out of 66 cases, 62 (94%) cases developed antibodies against SARS-CoV-2 at different time intervals, 48 cases during the 14-30 day interval, 10 cases during the 31-60 day interval, three cases during the 61-90 day interval and one case during the 90-120 days interval. Thirty one out of 35 (88%) cases that could be followed-up at 360 days showed persistence of antibodies. No patient reported symptoms which would warrant a repeat RT-PCR test. Conclusion: This study showed that the antibody response to SARS-CoV-2 virus was sustained for 12 months postinfection in most cases. The absence of fresh infection in these cases during the study period suggests that the antibodies might protect against reinfection with the virus. So, it may be safe to defer vaccination in postinfection cases by 6-9 months thereby saving precious resources. [ABSTRACT FROM AUTHOR]

The first teeth to erupt in the oral cavity are the mandibular molars which are more prone to endodontic and periodontal involvement. This may lead to significant issues like an increase in pocket depth, furcation involvement, loss of clinical attachment and mobility of teeth ultimately resulting in tooth loss. Thus, it necessitates cautious oral hygiene measures. Advances in dentistry have led to treatment modalities for preserving teeth which were earlier indicated for extraction. Hence, periodontally compromised tooth with severe furcation involvement, which may not be amenable for regeneration, may be retained by bicuspidisation. Bicuspidisation is a surgical technique which involves separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually, followed by rehabilitation with fixed prosthesis of the individual segments. This not only eliminates furcation involvement but also facilitates effective oral hygiene maintenance. In the present case report, a 50-yearold male patient reported with the chief complaint of pain, sensitivity and food lodgement in left mandibular first molar. Clinical and radiographic examination revealed grade III furcation involvement, significant pocket depths, delayed electric pulp test response and bone loss in furcation area. Bicuspidisation was opted as the suitable treatment modality. Root canal treatment was done, followed by bicuspidisation and subsequent rehabilitation with novel prosthetic technique. The bicuspids were restored using combination of deep margin elevation, and non splinted Lithium Disilicate table-top restorations. Six month follow-up showed good healing of hard and soft tissues around the bicuspidized sections, which was indicative of a successful treatment outcome, and can be attributed to a careful case selection, choice of restorative materials and techniques as well as good oral hygiene compliance. [ABSTRACT FROM AUTHOR]

Introduction: Ribonucleases (RNases) are enzymes involved in degradation of excess messenger Ribonucleic Acid (mRNA) and deadenylation of the poly(A) tail is the most common mechanism involved in mRNA degradation. Among the various RNases involved in deadenylation-dependent mRNA decay, Poly(A)-Specific Ribonuclease (PARN) plays the major role in the deadenylation-mediated mRNA decay. Although PARN is primarily involved in mRNA stability, recent studies suggest other functions of PARN including a role in telomere maintenance, DNA-damage response, and p53 regulation. Altered expression of PARN was also observed in cancers including acute leukaemia, lung squamous cell carcinoma and gastric cancer. Aim: To determine the levels of PARN transcripts in solid tumours and haematopoietic malignancies. Materials and Methods: This study was conducted on a cohort obtained from the Department of Oncology at Justice KS Hegde Charitable hospital in Mangaluru, Karnataka, India during January 2017 to June 2017. A total of 26 clinical samples and 14 controls were included. The expression level of PARN in plasma and tissue samples obtained from patients with solid organ tumours and haematopoietic malignancies were analysed by quantitative real-time Polymerase Chain Reaction (PCR) by calculating relative expression using Microsoft excel 2010. Results: A consistent down regulation of PARN in 88.23% (15 out of 17) of the samples were observed. All the plasma samples (100%, 10 out of 10) obtained from the lung cancer cases, showed down regulation of PARN at statistically significant level, regardless of the subtype of the cancer. In case of haematopoietic malignancies, PARN transcript level was down regulated in five out of seven samples analysed (71.42%), with statistically significant decrease in three of them. Conclusion: Despite a small sample size, the data presented here show that PARN is down regulated in solid organ cancers, suggesting a tumour-suppressive function of PARN. Screening of a large number of samples would be required to evaluate the true potential of PARN as a novel biomarker in solid organ and haematopoietic cancer. [ABSTRACT FROM AUTHOR]

Introduction: Periodontitis poses a major burden to the society because of lack of awareness about periodontal health among the population. Patients diagnosed with periodontitis require special attention which usually goes unnoticed due to lack of comprehensive periodontal examination. The standard of periodontal care varies among the dentists. Aim: To assess the perception of the dentists towards periodontal diagnosis, treatment and referral. Materials and Methods: A cross-sectional web-based questionnaire survey was conducted in the Department of Periodontics, KLE Academy of Higher Education and Research (KAHER), VK Institute of Dental Sciences, Belgaum, Karnataka, India, between October 2020 to January 2021 among the dentists in Belagavi district of Karnataka. A total of 19 custom designed multiple choice, open ended and checklist questions were formulated and an online link to the questions was circulated via email and whatsApp among professional colleagues. The questions were designed to embark on periodontal diagnosis, treatment provided by the dental practitioners and their routine referral to a periodontist. The data acquired was statistically evaluated using descriptive analysis with the IBM Statistical Package for the Social Sciences (SPSS) software (Version 20.0 Chicago IL, USA) and Chi-square test with a significance level of p<0.05. Results: Of the total responses obtained (n=150), 98.6% of the dentists carried out full mouth examination. Dentists surveyed were aware of the parameters for periodontal diagnosis, 73.3% used periodontal probe and 92.7% were aware of the critical probing depth. A total of 68.6% of the dentists provided scaling followed by referral to a periodontist. Statistical significance was observed between the years of experience of a dental practitioner towards the awareness of interrelationship between periodontitis and systemic health (p=0.009). Female practitioners contributed more to education and motivation regarding periodontal health (p=0.048). Treatment outcomes and longer periodontal recall were the factors considered by 66% of the dentists that influenced a periodontal referral. Conclusion: Within the limitations of the study, it was found that the dentists were able to diagnose periodontitis, majority of them provided scaling followed by periodontal consultation. Mucogingival deformity was most often planned for a periodontal referral. Contribution towards patient education, motivation and reinforcement to have a regular periodontal maintenance therapy was positively implemented in their practice. [ABSTRACT FROM AUTHOR]

Introduction: Arterial supply of hand is by two arterial anastomotic arches formed by radial and ulnar arteries and their branches. The anastomoses between the branches of radial and ulnar arteries such as palmar carpal and dorsal carpal arches at the wrist and superficial and deep palmar arches in the palm, maintain a rich arterial supply to the wrist and palm. Effective collateral circulation in palm is essential in peripheral arterial diseases such as Raynaud's disease and in harvesting radial artery or the ulnar artery for CABG (Coronary Artery Bypass Graft) surgery. Aim: To observe the variations in the formation of superficial palmar arch. Materials and Methods: A descriptive study was performed on 45 formalin fixed upper limbs of both sex in the Department of Anatomy, JSS Medical College, Mysuru, Karnataka, India. The study was conducted during routine dissection of upper limbs for undergraduates as per the Cunningham's manual for practical anatomy. Few rare variations in the formation of superficial palmar arch and the arterial pattern of hand were noticed. The variations found were classified according to Coleman and Anson classification. Results: Out of 45 limbs, complete arch was found in 36 limbs and incomplete arch in 09 limbs. In complete arch type, we found an arterial arcade, bifurcation of ulnar artery and in incomplete arch type, radial-radial anastomosis. Another rare findings of highly tortuous ulnar artery in forearm and in the palm. Conclusion: The findings in the variations of superficial palmar arch are essential in microvascular surgery, forearm fasciocutaneous flap, radial artery and ulnar artery harvesting in coronary artery bypass graft procedure. [ABSTRACT FROM AUTHOR]

Introduction: As for any other organ system, diagnosis of skin disease involves history and examination. An instant diagnosis can be arrived upon by virtue of visibility of the skin taking into account various visual clues such as scaling, colouring, arrangement and the site of distribution of lesions. Although this appears effortless, the pattern of recognition is complicated while factoring in the individual components and analysing them separately. Aim: To study the varying histopathological findings in cases of psoriasis. Materials and Methods: Prospective study was conducted for two years. All patients who have been clinically diagnosed/ suspected and untreated cases of psoriasis attending the Department of Dermatology were taken for the study. Wedge biopsy was taken under local anaesthesia. Results: In the present study, the age group of patients ranged between 8-83 years with 17 of them being males and 07 of them being females. The ratio being 2.4:1 and the mean age was 43 years. The most common histopathological finding was elongated rete ridges, suprapapillary thinning and acanthosis within the epidermis. Munroe microabscess, hyperkeratosis and parakeratosis were the other findings noted within the epidermis. Within the dermis the most common finding was aggregates of lymphocytes which varied from mild to marked along with perivascular infiltration of lymphocytes. Conclusion: Histopathological diagnosis forms the diagnostic tool for the dermatologists to arrive at a conclusion for their differential diagnosis since many skin disorders overlap with clinical presentations of psoriasis. This helps in excluding the differential diagnosis given by the clinician and to arrive at a definite histopathological diagnosis for the betterment of the patient. [ABSTRACT FROM AUTHOR]

Introduction: Obesity and metabolic syndrome frequently coexist and are one of the major health problems around the globe and its prevalence is 25-30%. In India prevalence of metabolic obesity is ≥30%, among females who have higher levels as compared to males. There is a significant proportion of the population who are obese (BMI >25 kg/m²) but metabolically healthy, likewise some people with normal BMI status, but metabolically obese. In this study, we have evaluated the association between metabolic obesity and severity of Coronary Artery Disease (CAD) in stable angina patients. Aim: To assess the association of severity of angiographic CAD based on the Metabolically Obese (MO) status and Body Mass Index (BMI). Materials and Methods: Total 408 subjects with stable angina and with positive stress test were included in the study and severity of CAD was measured by SYNTAX score. Obesity was defined as BMI ≥25 kg/m2, and normal weight was defined as BMI <25 kg/m2. The metabolic obesity was determined using the National Cholesterol Education Program-Adult Treatment Panel III (NCEPATP-III) classification in which Asian-specific cutoffs for abdominal obesity is used. Therefore, study subjects were categorised as follows: 1) Metabolically Healthy and Normal Weight (MHNW); 2) Metabolically Obese but Normal Weight (MONW); 3) Metabolically Healthy but Obese (MHO); and 4) Metabolically Abnormally Obese (MAO). Statistical analysis was carried out using statistical package for social sciences (SPSS) version 20. Baseline clinical, demographic, anthropometric and laboratory data are presented as mean±Standard Deviation (SD), median (range), or number (%) unless specified. Comparison among groups was calculated with an analysis of variance (ANOVA) test and Kruskal-Walis test for continuous variables and the Pearson chi-square test for categorical variables. Association between groups and severity of CAD was done by Kruskal-Wallis test. The p-value <0.05 was considered statistically significant. Results: Out of 408, 70.3% (n=287) subjects were male, 52.7% (n=215) subjects were hypertensive, and 42.9% (n=175) subjects had high BMI. Metabolic obesity showed higher prevalence of CAD (MO, OR=0.25, 95% (1): 0.31-1.03) than patients with higher BMI status (BMI, OR=1.39, 95% (1): 0.79-2.4). Syntax score which measures the severity of CAD is marginally high in MONW group (p-value-0.003) when compared to MHNW group. Conclusion: MO group was associated with a high prevalence and severity for CAD than metabolically healthy group irrespective of their weight status. [ABSTRACT FROM AUTHOR]

Introduction: Endodontically Treated Teeth (ETT) are most likely to get fractured, if it is left unrestored compared with the vital teeth due to the loss of tooth structure and reduced modulus of elasticity. Aim: To gain insight into the rationale for choice of endodontic posts and the different endodontic post systems currently used by dental practitioners in western region of Saudi Arabia. Materials and Methods: For this survey-based study, a questionnaire was designed consisting of eight questions to assess the details of why, when and how general practitioners restore ETT and to determine contemporary use of endodontic post from 1st of November 2018 till the end of January 2019. This questionnaire was sent online to 250 private dental practitioners in western region of Saudi Arabia, out of which 202 participants responded. Data was entered in the excel sheet. Descriptive statistics like frequency and proportion was calculated for qualitative data. Results: This study included 202 participants with the mean age group of 25-50 years, out of which 108 (53.4%) male participants and 94 (46.5%) female participants. 120 (59%) of the study sample were general practitioners and 82 (41%) of them were specialists. A total of 60 (29.70) of the study sample were into general practice, reported restoring ETT with post and core followed by the crown, whereas, 30 (14.85%) of them did the crown without post, 15 (7.42%) of them completed restoration with composite and 15 (7.42%) of them did buildup with post and core. An 82 (40.59%) of the study sample who were specialists, reported restoring ETT with post and core build-up and then proceed with crowns. An 80 (39.60%) of the study sample were into general practice, reported using prefabricated fiber post whereas, 23 (11.38%) of them using cast post and 17 (8.41%) of them using prefabricated metal posts. 72 (35.64%) of the study sample were specialists reported using prefabricated fiber posts and 10 (4.95%) of them used cast metal post. Conclusion: Based on the results of the study, it can be concluded that majority of the participants practiced reinforcement of ETT by using fiber posts with resin cements followed by crowns. [ABSTRACT FROM AUTHOR]

Introduction: These days, individuals seem to have more expectations regarding their dental health compared to the past. There are various treatment options available for the replacement of missing teeth and associated structures, which include removable prosthesis, fixed prosthesis, and implant supported prosthesis. Most of the patients require aesthetics and functional comforts with prosthodontic treatment and it can be easily achieved with dental implants and tooth coloured restorations and prostheses. Aim: To assess the trends, awareness, and attitude of patients towards replacement of missing teeth in western region of Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among the 20-60 years aged population of Western region of Saudi Arabia from 1st December 2018 to 1st March 2019. A questionnaire consisting of 11 close ended, pre-tested questions was developed to determine patients' attitude and need with regard to their dental prosthesis. The data were tabulated and analysed using Statistical Package for the Social Sciences (SPSS) version 21. Chi-square test was used to assess the attitude and awareness among the patients towards replacement of missing teeth. The p-value of less than 0.05 was considered statistically significant. Results: The study included 350 patients; 162 males (46.3%) and 188 females (53.7%). Among the participants, 233 (66.60%) of them desired fixed treatment and 115 (33.40%) of them desired removable treatment. Treatment options explained by clinicians were as follows: 67 (19.1%) were suitable for Fixed Partial Denture (FPD)/dental Implant, 11 (3.1%) suitable for FPD, Removable Partial Denture (RPD) and dental Implant and 272 (77.7%) of them suitable for RPD and dental Implant. A total of 67 (19.1%) of them opted for FPD, 115 (32.9%) of them opted for RPD and 168 (48.0%) of them opted for dental Implant. Conclusion: Awareness and attitude of the participants towards prosthodontics treatment were mostly high. Majority of the participants wanted to replace missing teeth for mastication and aesthetics and had favourable knowledge and attitude towards implant as a mode of treatment for replacement of missing teeth. Participants preferred fixed treatment over removable. [ABSTRACT FROM AUTHOR]

Introduction: Although the Coronavirus Disease-2019 (COVID-19) pandemic is creating a major global health crisis, the risk factors for mortality and the detailed clinical course of disease has not yet established. Aim: To determine association of the demographic data of COVID-19 patients with clinical profile and disease outcomes. Materials and Methods: The cross-sectional single-center study considered adults patients of both the gender from March to June 2020 with an estimated sample size of 2000 patients diagnosed with COVID-19 infection by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) technique. Necessary demographic and clinical data were collected and selected subjects were followedup until discharge or death. Subjects were classified as those who survived (1839 patients) and succumbed (138 patients) to death. T-test was used for comparing continuous variables and chi-square test for categorical data between the groups. Results: The study included 1977 patients with a male-tofemale ratio of 1:0.62. Fever, dyspnea and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (p-value <0.001). Statistically significant variables noted between the groups were age (survived mean age-42.74±15.15 years vs mean age 59.12±12.95 in those who succumbed to death, p-value <0.001), age groups (p-value <0.001), gender (p-value 0.042), haemoglobin, Total Leucocyte Count (TLC), neutrophil, lymphocytes, Neutrophil to Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), ferritin, all the comorbidity variables and the asymptomatic status. Variables identified as significant predictors of disease outcomes were Haemoglobin (Hb), TLC, neutrophils, lymphocytes, NLR, LDH and ferritin (p-value <0.001). Most of the subjects belonging to the mortality group required oxygen and other Intensive Care Unit (ICU) facilities when compared to the survival group (p-value <0.001). The mean days of viral clearance noted in COVID subjects was around 8.98±3.54 days. Conclusion: Hb, TLC, neutrophils, lymphocytes, NLR, LDH and ferritin are noted as significant predictors of COVID-19 outcome. Biochemical monitoring of COVID-19 patients helps in identifying critically ill patients early and can reduce mortality and improve the recovery. [ABSTRACT FROM AUTHOR]