Search

Background: The result of increased occlusal stresses might be fractures in the teeth. It is still unclear how possible risk factors may affect the occurrence of tooth cracks after dental implants with prostheses in nonendodontically restored teeth. Aim: To evaluate the correlation of dental implants with prostheses as a risk factor for the development of cracks in teeth restored nonendodontically. Materials and Methods: Records of 414 patients with 570 teeth who underwent tooth restoration nonendodontically were obtained. The data was obtained regarding the number of implants with prostheses placed before the diagnosis of cracks in nonendodontically treated teeth, the time interval between placement of dental implants, and appearance of cracks in teeth, location of dental implants with respect to cracked tooth. Results: Cracks in tooth was observed in 160 teeth out of 570 teeth evaluated (28.07%) and 144 patients out of 414 patients (34.78%). It was observed that out of 160 teeth with cracks, 66 teeth (41.25%) had cracks after placement of dental implants with prosthesis. Conclusion: Placement of a dental implant with a prosthesis can be a risk factor for appearing cracks in teeth treated nonendodontically. [ABSTRACT FROM AUTHOR]

Background: The usual procedure for nasolacrimal duct obstruction is dacryocystorhinostomy (DCR). Flap‑based DCR techniques lead to better surgical outcome provided flaps do not dislocate in the post‑operative period. Objectives: This study was conducted to compare gelfoam with merocel tamponade for fixation of mucosal flaps in endoscopic DCR. Materials and Method: Merocel tamponade was used for fixation of flaps in 26 patients. Gelfoam was used in 26 patients, and surgical results were compared. Results: The surgical success rate was greater in merocel tamponade fixation with less complications. Conclusion: Merocel tamponade can be used successfully for mucosal flap fixation in endoscopic DCR for better surgical outcome. [ABSTRACT FROM AUTHOR]

Objective: The physiological delay in bedtime among adolescents, compounded with the early start of school, results in insufficient sleep, especially on school days. The present study compared the sleep pattern and moods of students attending two schools with different start timing. Materials and Methods: The study involved adolescents from two schools with different start times: School A (7 am) and School B (8 am). Pittsburgh Sleep Quality Index, Depression Anxiety Stress Scales-21, and Pediatric Daytime Sleepiness Scale questionnaires were used to assess students’ mood, sleep duration, sleep quality, and daytime sleepiness. The clinical trial registry number is CTRI/2022/06/043556. Result: A total of 640 students (mean age 13.7 ± 2.0 years; 47.5% male) participated in this study. Students from School B had longer sleep duration, with 72.9% reporting sleep deprivation compared to 87.1% of School A (P = 0.00001). School A students reported having (P ≤ 0.001) higher daytime sleepiness, higher daytime dysfunction (P = 0.023), and poorer sleep quality. Students at School A scored higher for all mood derangements, with significantly higher scores for depression (P = 0.041). Conclusion: The study illustrates that though not much differences are observed in the bedtime of adolescents of the two schools, however, due to the early school start time of School A, students have to compulsorily wake up early, leading to higher sleep deprivation and greater mood derangements among them. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the relationship between diabetes mellitus (DM) and the disintegration of the residual alveolar ridge. Methods and Materials: The study sample comprises 144 participants (64 diabetics and 80 controls). Each participant had their orthopantomagram (OPG) taken. Considering the mandibular foreman (MF) and the lower border of mandible in OPGs as landmarks, resorption of residual ridge (RRR) in mandible was evaluated. Results: The resorption in diabetic study participants was 36.9%, while it was 19.1% in the healthy control study participants. The RRR in the diabetic group was greater than the control group (P = 0.0039). Conclusion: The resorption of RRR was greater in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Pediatric facial fractures are fairly uncommon injuries and comprise less than 15% of all facial fractures in the literature. Objectives: To analyze the pattern of pediatric facial fractures and compare the results with similar studies performed in India and the rest of the world. Materials and Methods: A total of 231 patients were admitted for the treatment of maxillofacial fractures. Data on etiology, anatomical location, mode of treatment, duration of stay, and X-ray advice were recorded. Results: Pediatric trauma comprised 27% of the total population. The most common cause of injury was road traffic accident (RTA), that is, 28 (43.8%) patients. Conclusion: The incidence of pediatric facial trauma is high in the hilly Garhwal–Himalayan region of Uttarakhand state in India as compared to other states of India. [ABSTRACT FROM AUTHOR]

Background and Aim: The natural history of cervical cancer is unique that it is preceded by a precancerous condition for a long time. Morphometry as a tool can be used in early and accurate diagnosis of these precancerous and cancerous lesions. The present study aims at assessing the utility of cellular and nuclear morphometry in differentiating squamous cell abnormality from benign conditions and also differentiating the categories of squamous cell abnormalities. Materials and Methods: Forty-eight diagnosed cases of squamous epithelial cell abnormality, that is, 10 cases each of atypical squamous cell of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), high-grade SIL (HSIL), and squamous cell carcinoma (SCC) and eight cases of ASC-H (ASC cannot exclude HSIL), were made the sample population and compared with a control population of 10 cases of negative for intraepithelial lesion or malignancy (NILM). Parameters like nuclear area (NA), nuclear perimeter (NP), nuclear diameter (ND), nuclear compactness (NC), cellular area (CA), cellular diameter (CD), cellular perimeter (CP), and nucleocytoplasmic (N/C) ratio were used. Results: There was a significant difference in the six groups of squamous cell abnormality based on NA, NP, ND, CA, CP, and CD (P < 0.05) using one-way analysis of variance. Nuclear morphometry parameters like NA, NP, and ND were found to be the maximum for HSIL, followed by LSIL, ASC-H, ASC-US, SCC, and NILM groups in decreasing order. The mean CA, CP, and CD were found to be the maximum for NILM, followed by LSIL, ASC-US, HSIL, ASC-H, and SCC in decreasing order. On post hoc analysis, the lesions can be divided into three groups: NILM/normal; ASC-US and LSIL; and ASC-H, HSIL, and SCC, based on N/C ratio. Conclusion: In cervical lesions, holistic parameter of cytonucleomorphometry should be taken rather than taking nuclear morphometry only. N/C ratio is a highly statistically significant parameter that can differentiate between low-grade lesions and high-grade lesions. [ABSTRACT FROM AUTHOR]

Background: Post-stroke cognitive impairment (PSCI) is a clinical entity that encompasses all types of cognitive impairment following an index stroke. Yoga has been proven to have a beneficial effect not only on cardiovascular risk factors but also on cognition. Hence, this study explored the PSCI spectrum and assessed the effect of yoga on PSCI. Methods: Forty stroke patients were enrolled in each yoga and control arm in this study. After the baseline assessment, control arm was administered standard care (including physiotherapy) while yoga arm received additional yoga intervention. Change in MoCA scores by 2 points in either direction, or FAB scale by 2 points at 6 months was taken as primary outcome, whereas improvement in MRS, CDPSS, CBS, and P300 values were considered as secondary outcomes. Results: Significant improvements were observed in MoCA, FAB, MRS, CPDSS, and CBS scores in both groups after 6 months. However, intergroup comparisons revealed better MoCA (25.5, IQR 22-27) and FAB scores (15.5, IQR 14-17) in yoga group compared to controls (24, IQR20-25.75) and (14, IQR12-15.75). Equivalent improvement was observed in MRS and CBS scores in both groups at 6 months; however, CDPSS score was better in yoga group (p = 0.0008). Both P300 amplitudes and latencies improved in all patients and median P300 amplitudes were significantly better in control group; however, no difference could be appreciated in P300 latencies improvement on intergroup comparisons at follow-up. Conclusion: Study reveals that early yoga intervention in stroke survivors leads to better improvement in cognitive abilities which would further facilitate in early reduction of caregiver burden. [ABSTRACT FROM AUTHOR]

Background: Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseases. The conventional treatment options include positive pressure ventilation with or without tracheostomy, surgical correction of external compression and airway stenting.Aim: To use "synchronized" nasal Dual positive airway pressure (DuoPAP), a non-invasive mode of ventilation as an alternative treatment option for bronchomalacia to avoid complications associated with conventional treatment modalities.Study Design: Prospective observational study conducted in Army Hospital Research and Referral from Jul 2019 to Dec 2020.Material and Methods: We diagnosed seven cases of TBM post-cardiac surgery at our institute, incidence of 4.2%. Four infants were diagnosed with left sided bronchomalacia, 2 were diagnosed with right sided bronchomalacia and one with tracheomalacia. Those infants were managed by "synchronized" nasal DuoPAP, a first in ventilation technology by Fabian Therapy Evolution ventilator (Acutronic, Switzerland).Results: All seven infants showed significant improvement with synchronized nasal DuoPAP both clinically as well as radiologically. None of the infant required tracheostomy and discharged to home successfully.Conclusion: The synchronized nasal DuoPAP is a low cost and effective treatment option for infants with TBM. It could be attributed to synchronization of the breaths leading to better tolerance and compliance in paediatric age group. [ABSTRACT FROM AUTHOR]

Objectives: Conflicting studies have resulted in several systematic reviews and meta-analyses on the relationship between COVID-19 and body mass index (BMI). Methods: This systematic review of systematic reviews followed an umbrella review design, and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines; Medical literature analysis and retrieval system online (MEDLINE) and SCOPUS databases were searched for systematic reviews on the topic. A predefined screening and selection procedure was done for the retrieved results based on the population, intervention/interest, comparator, outcome, study (PICOS) framework. Results: The search strategy yielded 6334 citations. With the predefined selection and screening process, 23 systematic reviews were retrieved for inclusion in the present study. Twenty-three (n = 23) systematic reviews met the inclusion criteria. As expected, there was overlap across the reviews in the included primary studies. Available evidence suggests that Class III obesity (morbid obesity) is strongly associated with increased mortality risk in patients with Covid-19. It is difficult to draw a firm conclusion about Class I and Class II obesity due to conflicting outcomes of metanalyses. Increased obesity was consistently associated with increased risk of invasive mechanical ventilation (IMV) in all the reviews with low to moderate heterogeneity. Conclusions: Available evidence suggests that Class III obesity (morbid obesity) is strongly associated with increased mortality risk in patients with Covid-19. Increased BMI is positively associated with the risk of IMV and the severity of COVID- care. [ABSTRACT FROM AUTHOR]

Large tumours occupying one half of the thoracic cavity are rare and may cause life-threatening complications by compression or invasion of vital structures that results in cardiovascular and/or respiratory insufficiency. In-depth preoperative planning is necessary after assessment of perioperative risk of hemithoracic masses. By providing lung isolation, one-lung ventilation technique provides improved surgical conditions compared to conventional dual-lung ventilation for thoracic surgery. As double-lumen tubes are not available for smaller children, balloon-tipped bronchial blockers remain the technique of choice, especially under the age of 6 years. Huge intrathoracic masses in small children with radiological and clinical findings suggesting airway compression are high risk for airway complications. Fibreoptic bronchoscope-guided intubation should be preferred in view of tracheobronchial compression by the mass and placement of an endobronchial blocker helps in one-lung ventilation in small children. The management of these tumours is challenging and should be performed only in specialised centres. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the influence of outdoor activity on myopia progression.Methods: It was a hospital-based longitudinal prospective observational study. Children between 7 and 14 years of age with a myopia of - 0.5 D or worse were included. Myopia progression was evaluated by cycloplegic refraction, every 6 months for 18 months. Parents were asked to record the daily outdoor activity of the child in hours per day at school and at home during weekdays and at weekends separately, based on which the daily outdoor activity score was calculated. The independent variables measured included age and gender of the participant, degree of myopia, and the daily outdoor activity score. Progression of myopia was defined as an increase in the spherical equivalent (SE) over 18 months. The magnitude of the association was determined by two mixed-effects models.Results: A total of 495 participants (250 males and 245 females) completed three visits during the study period. On taking age groups and paired observations as a random effect and adding SE at the last visit as the random slope in Model 1, each unit increase in outdoor activity had a negative effect on change in SE of - 0.01 (-0.02 to 0.00; P = 0.045). The same inverse relationship between outdoor activity and absolute SE as - 0.06 (-0.07 to - 0.03; P < 0.001) is estimated in Model 2.Conclusion: The study demonstrates a statistically significant inverse relationship between outdoor activity and myopia. [ABSTRACT FROM AUTHOR]

Objectives: Some patients with obstructive sleep apnea (OSA) do not respond to Continuous Positive Airway Pressure (CPAP) and for these patients, Bi-level PAP is the next level modality. This study by a theory driven hierarchical approach, tries to identify the predictors for CPAP failure among OSA patients. Methodology: The potential predictors for the model were identified from a theoretical framework rooted in clinical examination, laboratory parameters, and polysomnographic variables pertaining to OSA patients. All patients of OSA who underwent manual titration with CPAP or Bi-level PAP (in case of CPAP Failure) between June 2015 and October 2017 were included in model building. This study compared five competitive models blocks deliberated by increasing order of diagnostic complexity and availability of resources. The fitting of the model was determined by both internal and external validation. Results: Among the five competitive models, the selected model has the significant deviance reduction (−2LL = 121.99, X2 = 25.55, P < 0.0001) from the baseline model (−2LL = 217.356). This logistic regression model consists of the following binary predictors – Age >60 years (odds ratio [OR] = 3.23 [1.27–8.23]), body mass index >35 Kg/m2 (OR = 4.25 [1.78–10.13]), forced expiratory volume <60% (OR = 7.33 [2.83–18.72]), apnea-hypopnea index >75 (OR = 4.31 [1.61–11.56]) and T90 > 30% (OR = 6.67 [2.57–17.36]). Conclusion: These five factors (acronym as BIPAP) may aid to the clinical decision-making by predicting failure of CPAP and therefore may assist in more vigilant clinical care. [ABSTRACT FROM AUTHOR]

Context: Stroke is a condition that may affect the functionality of a person to a significant degree; however, there is very little data available that speaks about the objective state of a patient from a revalidated scale after the post-stroke event. Aims: To fill the knowledge gap and generate first-hand evidence about the post-stroke events in the community. To study post-stroke well-being of patients discharged from health facility and assess them longitudinally by Relevant Physical Examination, National Institute of Health stroke scale, and Modified Rankin Scale. Methods and Materials: Forty patients who suffered from first episode of stroke were followed in their home longitudinally by Relevant Physical Examination, National Institute of Health (NIH) stroke scale and Modified Rankin Scale. Patients under study were first visited after 2 months of discharge from the hospital set up after which two more follow-up visits were conducted at 2 months interval each. Results: There was an improvement in muscle power, sensation in the upper and lower limb, gait, and posture as well as language and vision in the patients in three subsequent visits. There was no significant difference in the fine movements of the patients. There was a gradual improvement in NIH score and there was a dominant presence of moderate-severe disability among the patients. Conclusions: Quantitative scales largely showed on a primary basis that on the physical dimension of the disease, the effects of Stroke were affecting the functioning of the body at optimum capacity and harmony. [ABSTRACT FROM AUTHOR]

Introduction: Blunt abdominal trauma substantially contributes to mortality and morbidity in patients with polytrauma. Appropriate clinical assessment is important in setups lacking facilities of advanced diagnostics (abdominal computed tomography scans and ultrasonography) to decide if the patients' needs exceed the facilities available. This study aimed to assess the utility of the commonly used trauma scores in predicting the outcome (favorable or unfavorable) in patients with predominantly blunt abdominal trauma. Study Design and Methods: In this prospective observational study of 12-month duration, we calculated three scores (Glasgow Coma Scale [GCS], Revised Trauma Score [RTS], and Injury Severity Score [ISS]) in patients brought to emergency department and fulfilling the inclusion criteria. These patients were categorized into two categories (favorable and unfavorable) depending on their treatment outcome. The difference in the mean scores for both outcomes in each score was calculated and further inferences were obtained by using the unpaired t test. A receiver-operating characteristic curve for each score was drawn to understand the trade-off between sensitivity and specificity at each cutoff value and for determining area under curve (AUC) for all three scores. Result: A total of 103 patients were recruited in the study (88 men and 15 women) with the mean age of 31.03 (±13.40) years and 34.47 (±18.04) years, respectively. The difference in the scores was maximum for ISS and minimal for RTS. The visual impression, as well as AUC values, shows that ISS performed well to discriminate between the favorable and unfavorable outcomes in each cutoff values (AUC –0.806, lower bound 0.678 to upper bound 0.934) compared to GCS and RTS scores. The Youden's J statistic for ISS value of 42 was maximum (0.298) and corresponding sensitivity and specificity were 0.651 and 0.647. Conclusion: ISS is superior as compared to GCS and RTS in predicting outcome in polytrauma patients with a blunt abdominal injury. ISS value of <42 predicts a favorable outcome. [ABSTRACT FROM AUTHOR]

Background: Management of diabetes is complex and requires multiple lifestyle modifications, drug therapy, and a sustained regular follow-up. Complexities of health-seeking pattern in individuals with diabetes have been poorly characterized. Objectives: To understand the health-seeking patterns, and reasons of provider preference and switching among persons with diabetes. Materials and Methods: We performed a mixed methods study in an urban slum setting of Bhopal. This urban slum was chosen as being a field practice area of the institute, a complete sampling frame with listing of households, and individuals with chronic disease conditions (including diabetes) was available. To be included in the study, the individual should have been an adult, aged ≥20 years, and diagnosed as type 2 diabetes mellitus. Descriptive statistical analysis of sociodemographic and disease management variables was performed. For qualitative component, interviews were transcribed and primary coding was done by two investigators followed by condensation of codes into themes or categories. The frequency of these content categories was presented with count and proportions. Results: In total, 60 individuals with diabetes were interviewed. Of all individuals, 36 (60%) were asymptomatic at the time of the first diagnosis, and 57 (95%) were currently under treatment from some healthcare provider. About 25 (41.6%) switched their first provider and remaining continued with the same provider. Second provider was sought by 9 (36%) of 25 patients. Reasons for switching were perceived nonrelief, cost of care, distance of facility, and behavior of care provider. Conclusions: Healthcare provider switching is common among persons with diabetes which has implications on continuity of care. [ABSTRACT FROM AUTHOR]

Context: Tuberculosis (TB) and diabetes mellitus (DM) remains a worldwide global public health problem. About 95% of patients with TB live in the low and middle-income countries and more than 70% of patients with DM also live in the same countries, especially in South East Asia. Screening for diabetes in patients with TB will not only ensure early case detection but also better management of diabetes and will lead to better TB treatment outcome. Aims: This study aims to determine the prevalence and its associated factors of diabetes and prediabetes among diagnosed cases of TB patients registered under Revised National Tuberculosis Control Programme (RNTCP) in Bhopal city. Settings and Design: The current study was a longitudinal follow-up study conducted among registered TB patients under RNTCP in all 5 TB units of Bhopal District. Subjects and Methods: Participants were contacted and interview was conducted after obtaining consent using predesigned and pretested Performa during October 2013–September 2014. Statistical Analysis Used: Continuous variable were summarized as frequency, mean, and standard deviation. All variables were analyzed using Chi-square test of significance; P < 0.05 was taken as statically significant. Results: Out of the total 662 TB patients, 352 were male and 310 were female. Out of the total, 82 (12.39%) patients were diagnosed as diabetic and 108 (16.3%) were prediabetic. significant association found with six variables which are age, sex, body mass index, type of TB, Category of TB, and smoking. Conclusion: This study shows feasibility and importance of screening of TB patients. [ABSTRACT FROM AUTHOR]

Web-based conversational learning provides an opportunity for shared knowledge base creation through collaboration and collective wisdom extraction. Usually, the amount of generated information in such forums is very huge, multidimensional (in alignment with the desirable preconditions for constructivist knowledge creation), and sometimes, the nature of expected new information may not be anticipated in advance. Thus, concept maps (crafted from constructed data) as “process summary” tools may be a solution to improve critical thinking and learning by making connections between the facts or knowledge shared by the participants during online discussion This exploratory paper begins with the description of this innovation tried on a web-based interacting platform (email list management software), FAIMER-Listserv, and generated qualitative evidence through peer-feedback. This process description is further supported by a theoretical construct which shows how social constructivism (inclusive of autonomy and complexity) affects the conversational learning. The paper rationalizes the use of concept map as mid-summary tool for extracting information and further sense making out of this apparent intricacy. [ABSTRACT FROM AUTHOR]

Background: The informational continuity for a diabetic patient is of paramount importance. This study on a pilot basis explores the process utility of structured educational modular sessions grounded on the principle of near-peer mentoring. Methodology: Visual modules were prepared for diabetic patients. These modules were instituted to 25 diabetic patients in logical sequences. In the next phase, 4 persons of these 25 patients were designated as diabetic-diabetes ongoing sustainable care and treatment (DOST). Each diabetic-DOST was clubbed with two patients for modular session and informational deliverance during the next 7 days. Process analysis was performed with "proxy-indicators," namely, monthly glycemic status, knowledge assessment scores, and quality of life. Data were analyzed by interval estimates and through nonparametric analysis. Results: Nonparametric analysis indicated a significant improvement in glycemic status in terms with fasting blood sugar (W = 78 z = 3.04, P = 0.002), 2 h-postprandial blood sugar (W = 54, z = 2.01, P = 0.035), and in knowledge score (χ² = 19.53, df = 3; P = 0.0002). Quality of life score showed significant improvement in 2 out of 7 domains, namely, satisfaction with treatment ([difference in mean score = 1.40 [1.94 to 0.85]) and symptom botherness (difference in mean score = 0.98 [1.3-0.65]). Conclusion: Because of inherent methodological limitations and innate biases, at this juncture no conclusive statement can be drawn. Although, primitive process evidences indicate the promising role of the diabetic-DOST strategy. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PHT), if present, can be a significant cause of increased morbidity and mortality in children undergoing surgery for congenital heart diseases (CHD). Various techniques and drugs have been used perioperatively to alleviate the effects of PHT. Intravenous (IV) sildenafil is one of them and not many studies validate its clinical use.Aims and Objectives: To compare perioperative PaO 2 - FiO 2 ratio peak filling rate (PFR), systolic pulmonary artery pressure (PAP) - systolic aortic pressure (AoP) ratio, extubation time, and Intensive Care Unit (ICU) stay between two groups of children when one of them is administered IV sildenafil perioperatively during surgery for CHDs.Materials and Methods: Patients with ventricular septal defects and proven PHT, <14 years of age, all American Society of Anesthesiologists physical status III, undergoing cardiac surgery, were enrolled into two groups - Group S (IV sildenafil) and Group C (control) - over a period of 14 months, starting from October 2013. Independent t-test and Mann-Whitney U-test were used to compare the various parameters between two groups.Results: PFR was higher throughout, perioperatively, in Group S. PAP/AoP was 0.3 and 0.4 in Group S and Group C, respectively. In Group S, mean group extubation time was 7 ± 7.34 h, whereas in Group C it was 22.1 ± 10.6. Postoperative ICU stay in Group S and Group C were 42.3 ± 8.8 h and 64.4 ± 15.9 h, respectively.Conclusion: IV sildenafil, when used perioperatively, in children with CHD having PHT undergoing corrective surgery, improves not only PaO 2 - FiO 2 ratio and PAP - AoP ratio but also reduces extubation time and postoperative ICU stay. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes can be envisaged as a lifelong phenomenon having the ominous odds for multisystemic involvement in the duration of disease. The probabilities of the occurrence of these events are influenced by the adopted lifestyle. Hence, information about the disease and lifestyle modification are vital from the perspective of prognostics. This study attempts to explore the potential of a "visual dynamic tool" for imparting knowledge and consequently received acumen by diabetic patients. Objectives: To appraise the effectiveness of a constructed visual dynamic module (encompassing the various dimensions related to and affected by diabetes) by capturing the opinions, perceptions, and experiences of the diabetic patients who underwent intervention through the module. Materials and Methods: A visual e-module with dynamically imposed and animated images in the vernacular (Hindi) was prepared. This module was instituted among the diabetic patients in a logical sequence for consecutive 3 days. All the diabetic patients who underwent this intervention were interviewed in depth in order to ascertain the effectiveness of the module. These interviews were analyzed by thematic and framework analyses. Result: The visual module was perceived by the diabetic patients as an optically engaging tool for receiving, connecting, and synthesizing information about diabetes. They sensed and expressed the ease to connect with the images and labeled the received information as inclusive. Conclusion: Initial evidences suggest that visual e-module is an effective and efficient tool for knowledge management in diabetes. This issue may be further explored at diverse academic and clinical settings for gathering more information for efficacy. [ABSTRACT FROM AUTHOR]

Aim: To compare the uniqueness of human dentition in both orthodontically treated and untreated populations and evaluate the reliability of bitemark analysis. Materials and Methods: A total of 1464 maxillary and mandibular casts were fabricated from orthodontically treated and nontreated population. After careful examination of the study teeth, 326 nontreated maxillary cast (Group 1), 333 nontreated mandibular cast (Group 2), 336 orthodontically treated maxillary cast (Group 3), and 320 orthodontically treated mandibular casts (Group 4) were selected for the analysis. For uniformity, the sample size of 320 was selected from each group for comparison. Results: The arch width was a major cause of variance. In Group 1, only 6.87% of similarity rate was seen, whereas in Group 3, the match rate increased to 55% showing similarity. In Group 2, only 1.87% similarity and Group 4 showed 42.7% match rate. Conclusion: The human dentition may be unique, but it loses its uniqueness once any dental treatment is carried out. [ABSTRACT FROM AUTHOR]