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In the medical image analysis, recognition of tumor in brain is very important task and it leads cancer which should be diagnosed at early stage. It is an irregular cell population in brain and for the cancer diagnosis; medical imaging techniques play an important role. The mostly used and efficient technique for the segmentation is Magnetic resonance imaging (MRI). There is huge progress the field of MRI imaging technique for accessing the brain injury and the brain anatomy exploring. The segmentation and detection of the tumor from the MRI images are done by the image processing techniques. Manual detection of brain tumor is the complex task, so the different image segmentation methods are developed for detection and segmentation of the tumor from the MRI images. The various recent brain tumor segmentation techniques are thoroughly discussed in this paper. The quantitative analysis of existing techniques and the performance evaluation is done and detailed. The paper revealed different image segmentation methods are briefly discussed. This survey article provides the detailed information of the different segmentation methods along with their merits and demerits. Effectiveness of the methods is shown in terms of the performance parameters.

Dental Implants have changed the face of dentistry over the last 25 years. As with most treatment procedures in dentistry today, dental implants not only involve scientific discovery, research and understanding, but also application in clinical practice. As the implants are so successful in the field of dentistry there are also various complications associated to it. These complications are divided into two sections. The first section focuses on oral soft tissue complications and the second segment addresses hard tissue dilemmas. The complications may occur at any stage but the purpose of this review is to describe the complications in implantology during prosthetic phase that may be encountered during the construction of fixed implant retained prosthesis.

Anti-MDA5-associated dermatomyositis (MDA5-associated DM) is an uncommon presentation of idiopathic inflammatory myositis, typically amyopathic, associated with rapidly progressive, treatment refractory interstitial lung disease and poor prognosis, particularly in patients with concomitant rapidly progressive interstitial lung disease (RP-ILD). We report two cases of MDA5-associated DM with fatal outcome in one of the patients, despite 'aggressive triple therapy' for RP-ILD.

Background: Mental disorders are showing a discerning upward trend globally and it is projected that by 2030, depression would be the leading cause of disease burden globally. Depression has not only confined the developed world but is increasingly seen as a major public health problem in the developing world too. Methods: A stratified two-stage design was used to conduct a house-to-house survey in selected villages among consenting eligible members of the family. A three-part questionnaire, with the first part eliciting sociodemographic information was used. Patient Health Questionnaire (PHQ-9), the second part of the questionnaire was used to screen those positive for depression and Beck's Depression Inventory (BDI-II). The third part was used for rating the depression. Data thus collected was analyzed and Chi-square test was used as test of significance. Results: The prevalence of depression was found to be 8.94% (73/816). Beck's Depression Inventory (BDI- II) for rating the depression revealed that mild depression was present in nearly half of the cases (47.95%), while 39.7% and 9.5% of the cases had moderate and severe depression, respectively. Among the various variables, literacy level, marital status, alcohol intake, chronic illness, and socioeconomic status were significantly associated with the depression. Conclusions: Prevalence of depression to the tune of 8.94% in rural adults seems to be a cause of concern for the health planners. Prevention and treatment of depression must be taken on priority and as a challenge by the health professionals.

Background: For tackling unforeseen health expenditure and improving healthcare accessibility in general, it is important that people should not only be aware but also be covered under health insurance schemes. The present study was conducted with the aim to assess the health expenditure, health insurance awareness, and coverage among rural households. Materials and Methods: This was a community-based cross-sectional study carried out in randomly selected families falling under a rural health block in Jammu district of Jammu & Kashmir, Union Territory. A predesigned, pretested, and semistructured questionnaire was used for data collection. Results: A total of 380 families were surveyed, of which 14.5% belonged to the priority household group. Among the priority and nonpriority households, 8.80% and 5.69% of monthly income were spent on health-related activities and 9.91% of household expenditure was on health. A total of 24.32% of priority households had even borrowed money to meet health expenditures. A total of 28.15% families had heard about the Ayushman Bharat scheme. Attitude towards health insurance was positive in both groups. A total of 29.23% of nonpriority households and 14.54% of priority households had health insurance coverage. Conclusion: A significant proportion of household expenditure was health related. The absence of good insurance coverage raises the need for policies and laws to cover all the households under health insurance schemes.

Background: Attention-deficit hyperactive disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood and has the potential for continuity into adolescence and adulthood. Its presence increases difficulties in academic performance and social interactions besides leading to low self-esteem. The present study aimed to determine the prevalence of ADHD among children of age 6–12 years in Government schools of a rural area in Jammu district of J and K. Methods: The present study was conducted in R.S. Pura block of Jammu district. Miran Sahib zone of R.S Pura block was chosen randomly and all the government primary schools in this zone were included in the survey. The presence of ADHD was assessed using Vanderbilt ADHD diagnostic teacher rating scale. The children positive for ADHD were visited at their residential places and a personal information questionnaire (PIQ) was administered to their parents—preferably the mother. The data thus collected was presented as proportions. Results: ADHD prevalence was found to be 6.34% (13/205). Majority (69.3%) of the ADHD-positive children were living in a joint family and belonged to lower/lower middle class. Family history of ADHD was absent in all the ADHD-positive children. Conclusion: The current study conducted in a rural area among 6- to 12-year-old children of Government schools has shown a reasonably high ADHD prevalence of 6.34%.

Objectives The PROSE trial purpose is to investigate whether the incidence of thromboembolic—related complications is reduced with a current generation mechanical prosthesis (On-X Life Technologies/CryoLife Inc.—On-X) compared with a previous generation mechanical prosthesis (St Jude Medical—SJM). The primary purpose of the initial report is to document the preoperative demographics, and the preoperative and operative risk factors by individual prosthesis and by Western and Developing populations. Methods The PROSE study was conducted in 28 worldwide centres and incorporated 855 subjects randomized between 2003 and 2016. The study enrollment was discontinued on August 31, 2016. The preoperative demographics incorporated age, gender, functional class, etiology, prosthetic degeneration, primary rhythm, primary valve lesion, weight, height, BSA and BMI. The preoperative and operative evaluation incorporated 24 risk factors. Results The total patient population (855) incorporated On-X population (462) and the St Jude Medical population (393). There was no significant difference of any of the preoperative demographics between the On-X and SJM groups. The preoperative and operative risk factors evaluation showed there was no significant difference between the On-X and St Jude Medical populations. The preoperative and operative risk factors by valve position (aortic and mitral) also documented no differentiation. The dominant preoperative demographics of the Western world population were older age, male gender, sinus rhythm, aortic stenosis, congenital aortic lesion, and mitral regurgitation. The dominant demographics of the Developing world population were rheumatic etiology, atrial fibrillation, aortic regurgitation, mixed aortic lesions, mitral stenosis and mixed mitral lesions. The Developing world group had only one significant risk factor, congestive heart failure. The majority of the preoperative and operative risk factors were significant in the Western world population. Conclusions The preoperative demographics do not differentiate the prostheses but do differentiate the Western and Developing world populations. The preoperative and operative risk factors do not differentiate the prostheses BUT do differentiate the Western and Developing world populations.

India’s large stray dog population, estimated to be about 25 million, poses substantial risks to human health, motivating some civic bodies to employ cruel methods to control dog populations. This article argues that while human health is certainly a priority, it is also important to consider animal welfare and to handle dog population control measures without causing unnecessary animal suffering. Triangulating the issues of rabies control, dog population management and state intervention, the article identifies recent practical difficulties in local management of dog population control laws and policies in India’s model city of Chandigarh. Based on a survey of local opinions, this shows how rising human–animal conflicts require new ways of handling existing challenges.

The World Health Organization defined palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. The patient centric primary care model (PCCM) promises to provide a solution to control these health-care challenges. The model is largely based on the chronic care model (CCM) and the model developed by the Organized Medicine Academic Guild (OMAG) for delivering health care in India.

Choosing an antithrombotic regime in patients with acute coronary syndrome (ACS) and a concomitant indication for anticoagulation is a challenge commonly encountered by clinicians. Our aim in this article is to evaluate the safety and efficacy of triple antithrombotic therapy (TT, anticoagulant plus dual antiplatelet) versus dual antithrombotic therapy [dual therapy (DT), anticoagulant plus single antiplatelet] in patients with ACS. We included all randomized trials comparing the outcomes of single versus dual antiplatelet therapy in patients with ACS on anticoagulants. The primary outcome was major adverse cardiac events (MACE). Other outcomes studied were all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stroke, stent thrombosis (ST), and major bleeding. The Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data. Six studies, with a total of 11,437 patients, met our selection criteria. With a follow-up duration of 9-14 months, there was no significant difference between DT and TT in terms of MACE [RR 0.96; 95% confidence interval (CI), 0.79-1.17], all-cause mortality (RR 1.00; 95% CI, 0.77-1.29), cardiovascular mortality (RR 1.03; 95% CI, 0.79-1.34), MI (RR 1.14; 95% CI, 0.90-1.45), stroke (RR 0.83; 95% CI, 0.56-1.23), and ST (RR 1.32; 95% CI, 0.87-2.01). Compared with TT, DT was associated with significant reductions in major bleeding 4.1% versus 6.5% (RR 0.61; 95% CI, 0.45-0.81; number needed to treat = 42), clinically significant bleeding 10.5% versus 16.4% (RR 0.62; 95% CI, 0.48-0.80) and intracranial hemorrhage 0.4% versus 0.8% (RR 0.43; 95% CI, 0.24-0.77). In patients on anticoagulant therapy, the strategy of single antiplatelet therapy (DT) confers a benefit of less major bleeding with no difference in MACE, all-cause mortality, cardiovascular mortality, MI, stroke, and ST.

Background: Preference for a male child by the family leading to a sex-selective abortion has been a leading factor for the skewed sex ratio in India. This has long-term social and demographic consequences. The present study was conducted with the aim to assess the awareness and attitudes regarding prenatal sex determination and preconception and prenatal diagnostic technique act (PC-PNDT) among females of reproductive age group (15–45 years) attending a tertiary care teaching hospital in Jammu district of J and K state in North India. Materials and Methods: A hospital-based cross-sectional study was carried out among 210 females of reproductive age group. The study participants were administered a predesigned and pretested questionnaire. Data thus obtained were analyzed using SPSS Version 20.0 and expressed in percentages. Chi-square test was used as test of statistical significance with P < 0.05 taken as statistically significant. Results: Awareness about sex determination among respondents was 94%. Higher proportion of urban respondents knew about ultrasound as the technique for sex determination than their rural counterparts (P < 0.05). Awareness regarding the PC-PNDT act and determination of sex of a child being a crime was higher among urban respondents (P < 0.05). Among the attitude, more rural females would prefer to know the sex of the child (P < 0.05) than their urban counterparts. Conclusion: Respondents had high awareness about sex determination as well as technique used for it. Awareness about PC-PNDT act was on the lower side. Education programs for the women about gender equality and wider publicity of the act in the mass media need to be scaled up.

Despite the stated aim of Medical Council of India (body regulating medical education in India) to produce an Indian Medical Graduate with requisite knowledge, skills, attitudes, values and responsiveness, so that he or she may function appropriately and effectively as a doctor of first contact of the community while being globally relevant, it appears that we failed. The joint working group extensively consisting of medical teachers have come up with suggestions which may work as the game changer in Indian Health care system. The key is to dedicate medical education towards primary care.

Background: Aging is associated with both physical impairment and functional disability. One of the areas of concerns is a derangement in the activities of daily living (ADL) where the elderly people are unable to perform their basic personal care tasks. The present study was planned with the aim to evaluate functional impairment among rural elderly using ADL scale. Materials and Methods: The study was conducted as a cross-sectional population-based survey using multistage randomized sampling technique from August 2015 to October 2015 in Miran Sahib Health Zone of R S Pura health block in Jammu District in North-West India. The study involved 418 elderly individuals above 60 years of age. Results: A higher proportion of elderly (378/418; 90.43%) were classified as functionally independent. Among the study participants 9.54% (40/418) were found to have some had some impairment. Among the elderly impaired individuals, 5.26% (22/418) were moderately impaired while 2.64% (11/418) were severely impaired. However, importantly only a small proportion (7/418; 1.67%) of elderly individuals was completely dependent on others. Conclusion: The total impairment prevalence reported among the geriatrics in the current study was 9.5%. With the increase in the geriatric population expected in near future, this number will be significant. Policies with a clear focus on geriatric health-care need to be developed to reduce the dependency among elderly.

Background: Studies suggest that approximately half of patients with raised blood pressure (BP) are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive) of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP) regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61%) were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01). Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01). Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

Background COVID-19, since its emergence, has become a global health problem with countries adopting unprecedented measures to control the spread of this pandemic. Adherence of the populations to control measures is affected by their knowledge, attitude, and practices (KAP) towards the disease. It was with this aim that the present study was conducted among the residents of UT of J&K to assess their KAP toward COVID-19. Methodology A cross-sectional online survey of 464 J&K residents was conducted between 1st May and 10th May 2020. Survey Monkey tool was used to develop a link and KAP questionnaire was used for data collection. The survey instrument consisted of demographic characteristics, 11 items on knowledge, 5 items on attitudes, and 7 items on practices. Data collected was represented in descriptive statistics, and one-way analysis of variance was the test of significance. Results Mean knowledge, attitude, and practice scores were 7.69 ± 0.74, 4.70 ± 0.57, and 4.32 ± 0.68, respectively, among the respondents. Majority (99%) knew the sign and symptoms, mode of transmission of the disease and avoided attending large gatherings. Use of mask was almost universal and about 38% were taking supplements like vitamins or herbal medicines. Good knowledge, positive attitude, and appropriate practices among the respondents about COVID-19 suggest that community based health education programs play a key role in containment and mitigation of this disease. Conclusion Sustained messaging and updates from the national and local health authorities on COVID-19 to the public are likely to help control the transmission of the disease.

In view of India unlocking, to secure a large population of this country, the healthcare facilities delivering primary care as well standalone health facilities need to be secured from impacts of COVID-19 pandemic. This document dwells on the broader guidelines for primary care practitioners/standalone private health facilities/frontline healthcare facilities to mitigate the impact of COVID-19 Pandemic. The authors understand that the situation is evolving, so the guidelines too will keep evolving.

Context: Emergency contraception (EC) is use of drug or device to prevent pregnancy after unprotected sexual intercourse. Unlike other regular methods of contraception which are taken prior to the sexual act, EC is used after the unprotected sex. Aim: To assess the knowledge and attitude toward use of emergency contraceptives among medical students. Setting and Design: A cross-sectional questionnaire based study was conducted among all the medical students in the Government Medical College in North-West India. Subjects and Methods: A questionnaire seeking information on knowledge and attitude of undergraduate medical students was administered over a period of 4 weeks in the month of February and March 2014. Statistical Analysis: The data were entered in MS excel and expressed using percentages. Chi-square test was used as a test of statistical significance. Results: About 61.6% (247/401) of the participants were aware about the timing of use of EC. Audio visual media (76.6%; 307/401) was the most common source of information for of these medical students. Conclusions: The lack of appropriate in-depth knowledge of EC among future health care professional should alarm the medical teaching system as EC is the only method that can be used to prevent pregnancy after unprotected sex or contraceptive accident.

Introduction: Chronic respiratory diseases are an important cause of disability across the globe. The global burden of these diseases is showing a discernible upward trend. It is estimated that 500 million people suffer from them. Materials and Methods: The study was conducted with the aim to estimate the prevalence of chronic obstructive pulmonary disease (COPD) in a rural Indian population. For this, a population-based survey was conducted using modified British Medical Research Council questionnaire. This was followed by subjecting the respondents to Wright's mini peak flow meter to find out the peak expiratory flow rate to diagnose the COPD cases. Results: The prevalence of chronic bronchitis, bronchial asthma, and COPD was found to be 3.36%, 1.18%, and 4.21%, respectively. Conclusions: Chronic respiratory disorders are more prevalent among rural adults hinting to a rural-urban divide. Therefore, the focus of preventive strategies should take into account this difference.

Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6–12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch) children age 6–12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400) to estimate iodine content in the salt. Results: The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9–12 years age group as compared to 6–9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02). Estimation of iodine content of the salt samples revealed that all of them (100%) had adequate iodine content. Conclusion: Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence.

Zoonotic diseases are an important public health problem. Keeping this in way, a panel reviewed the discussion around “one health” strategy of the WHO in combating zoonotic diseases during Seventh annual conference of Consortium Against Rabies (CAR) with the theme of “Zoonoses: Thinking beyond Rabies” held on 14th and 15th June 2019. The panel came out a manuscript discussing the need, background, and rationale for basic framework of possible roadmap for one health. Background —About CAR: CAR has been established with the aim to serve as a platform for the control of the rabies menace in India. It will evolve into a full fledged struggle against rabies in the country. The association comprises of medical professionals, veterinary doctors, and public health persons. The idea behind CAR is to bring the best minds in the country for research and information dissemination in the field of rabies. About Academy of Family Physicians of India (AFPI): AFPI is the official association of family physicians in India. Dedicated to provide professional leadership, conduct healthcare advocacy, policy development and a change in health system within the domain of family medicine, and larger public health system in the country, the academy is the recipient of the Healthcare Leadership Award 2012 in the category of Healthcare Governance and Public Administration. The white paper development Process: More than 100 medical experts, veterinary doctors, and public health persons from across the country and belonging to the fields of internal medicine, family medicine, public health, veterinary sciences, nursing science and environmental science and representing reputed medical institutions, government funded research institutions, and policy making bodies participated in discussions on topic of “one health” made during 7th Annual national conference of CAR with the theme of “Zoonoses: Thinking beyond Rabies” held on 14th and 15th June 2019. The panel steering the discussion included leading expert from ICMR, medical colleges, veterinary college, family medicine, private practitioners, and health program managers. The panel committee had prepared a draft document well in advance of the conference, which was communicated to all participants for feedback and comments. The panel was steered by ICMR expert. The discussion of the panellist was presented to the consensus group and unanimously adopted. A writing group worked on the manuscript, which was again circulated by email to all for any comments and suggestions before final publication.

Initial stability at the placement and development of osseointegration are 2 major issues for implant survival. Many of the presently used noninvasive methods of evaluating the stability of implants are highly subjective. The resonance frequency analysis (RFA) device is claimed to offer a more objective means to assess implant stability. Limited information is available on the interexaminer reliability and repeatability of the RFA device, used to measure implant stability. Two blind in vivo studies were conducted using 50 implant cases. In the first clinical study, 3 investigators took implant stability quotient (ISQ) readings for each implant to check the interoperator reliability for the RFA device. In the second clinical study, implant stability was measured by the same operator using the RFA device for each implant 3 times on the same day with a 15-minute interval, to check the repeatability of the RFA device. Within the limitations of this study, the RFA device demonstrated a high degree of interoperator reliability and repeatability.

India with a high number of diabetic patients needs a simple, cost-effective, and efficient tool to screen and diagnose the huge pool of undiagnosed diabetics in the country. The purpose of this study was to estimate the utility of MDRF-IDRS in identifying risk for diabetes mellitus in rural adult population aged 30 years and above in Jammu (J&K). A cross-sectional study was conducted in RS Pura block of Jammu district in J&K state of India. The rural adults >30 years were surveyed by using a predesigned and pretested protocol which had MDRF-IDRS as a part of it. Further, the subjects were evaluated for their status as far as presence or absence of diabetes was concerned. A total of 2085 respondents comprising of 1116 males and 969 females were included in the study. 170/2085 of those screened with MDRF-IDRS score were known cases of diabetes mellitus. One hundred twenty out of these 170 had IDRS of ≥60 (70.58 %). The association between IDRS and diabetes mellitus patients was statistically significant. The study proves the utility of MDRF-IDRS in detecting those people who are at high risk of developing diabetes mellitus.

BACKGROUND: Self-medication is the treatment of common health problems with medicines that are taken an patient's own initiative or on advice of a pharmacist, without professional supervision. It is now becoming a common practice in many countries mainly due to lack of access to health care, easy availability of OTC drugs in market and poor drug regulatory practices. OBJECTIVE: To assess the knowledge and practices of self-medication among medical students. METHODS: A cross-sectional study was carried out among the students of GMC Jammu in August 2011, after faking approval from IEC. A 16-item, open-ended, pretested questionnaire was administered to students. Data was then analysed using SPSS version 12 and results expressed as counts and percentages. RESULTS: A total of 282 students participated in the study, among which 96 were from 1st semester, 88 from 3rd and 98 from 6th semester. Knowledge of self-medication was adequate in 68% of 1st semester, 81 % of 3rd and 87% of 6th semester students.85% of respondents from 1st semester, 79% from 3rd and 78% from 6th practised self-medication. CONCLUSION: Since seniors hod better knowledge of drugs , self medication was practised less as compared tb juniors. There is a need to review educational programs especially clinical pharmacology, focusing on rational use of drugs. JMS 2012;15(2):141-44

BACKGROUND: IDD (Iodine Deficiency Disorders) is still a major public health problem in J&K as in other parts of country despite measures taken to combat it. Repeated surveys are only means to monitor the situation. OBJECTIVE: To study the present prevalence of goiter in various districts of Jammu province. METHODS: Using EPI 30 cluster methodology, 10800 school children (aged, 6-12 years) were selected from three randomly chosen districts of Jammu province. Subjects were clinically examined and graded for goiter as per joint WHO/UNICEF/ ICCIDD recommendations. RESULTS: The goitre prevalence in three districts was observed to be 19.84% with a highest prevalence of 26.75% in Samba district (p = 0.0001). Understandably the prevalence of goitre in age group of 6-9 years was lower than that in 9-12 age group. ( (p=0.005) CONCLUSIONS: Total goiter prevalence rate remains to be at an unacceptable high rate. Preventive public health measures need to be augmented in area along with strengthening of monitoring and surveillance of IDD. JMS 2012;15(1):28-31.

Anhydrotic ectodermal dysplasia is a rare congenital disease that can affect several ectodermal structures, such as hair, teeth, skin, nails, sweat and sebaceous glands. It is commonly a difficult condition to manage with prosthodontics because of the typical oral deficiencies and also patients are quite young when they are evaluated for treatment. This clinical report describes the management of two brothers affected by ectodermal dysplasia, prosthodontically. It is important that these patients should get dental treatment at an early stage for physiologic and psychosocial reasons. Dental treatment can vary depending upon the severity of the disease. This case report describes the use of removable partial dentures to replace congenitally missing teeth, and composite resin material to restore the conical maxillary central incisors to achieve a favorable esthetic result. This approach rehabilitates patients without sacrificing healthy dental tissues.

To overcome the limitations of implant placement in knife-edge ridges, Summer introduced the osteotome technique in 1994. It has been claimed that using bone condensing to prepare the implant site in soft maxillary bone avoids the risk of heat generation, and implants can be placed precisely with increased primary stability. The purpose of this clinical study was to evaluate the crestal bone loss exhibited by the bone around early nonfunctionally loaded implants placed with conventional implant placement technique and with Summer's osteotome technique and to evaluate whether the bone-compression technique provides better primary stability than the conventional technique. A total of 10 Uniti implants were placed in the maxillary anterior region of 5 patients. One implant site was prepared using the conventional technique with drills (control group A), and second site was prepared using the osteotome technique (experimental group B) and an MIS bone compression kit. Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and on the 180th day after implant fixture placement. The peri-implant alveolar bone loss was evaluated radiographically. Differences between the alveolar crest and the implant shoulder in radiographs were obtained immediately after implant insertion and on the 180th day after implant placement. The RFMs demonstrated a significantly higher stability of implants in control group A than in experimental group B on the day of surgery (P = .026). However, no statistically significant difference in stability was found between both groups on 180th day after implant placement (P = .076). A significant difference was found in the crestal bone levels after 180 days of surgery between two groups (P = 0) with less crestal bone loss with group A. Within the limitations of this study we concluded that the osteotome technique is good for the purpose for which it was introduced, that is, for knife-edge ridges, and it should not be considered a substitute for conventional procedures for implant placement.

Background: Deaths due to organ failure are reaching alarming numbers mainly due to paucity of organ donation. The medical students who are the future doctors hold promise to alleviate this paucity by willing to register as a donor themselves as well as facilitating cadaver organ donation process. Objective was to assess the perspectives (awareness and attitudes) of medical students regarding organ donation.Methods: The present cross sectional descriptive study was conducted among 280 undergraduates’ students of Government Medical College Jammu, J and K, India. A pretested and self administered 22 item questionnaire was used to collect information on socio-demographic characteristics (5), to assess awareness (11) and attitude (6) about organ donation.Results: Higher proportion of female students were aware about transplantation of human organ act (p

Background: Hand hygiene remains the most cost effective strategy in prevention of health care associated infections as it may limit or completely stop the transmission of microorganisms. Poor hand hygiene practices, especially of the mothers of under five children are likely to pose a major threat to the health of their children. The present study aimed to assess the knowledge, attitude and practices of under-five mothers visiting an outpatient department in a tertiary teaching care hospital in North India.Methods: This cross-sectional study was conducted among 330 mothers who were attending with their under five children in paediatrics OPD of Government Medical College, Jammu. A self-administered questionnaire which was pilot tested was administered to the consenting mothers. The questionnaire consisted of socio demographic information followed by knowledge, attitudes and practices of the respondents about hand washing.Results: Knowledge about spread of disease was excellent among the respondents. Other knowledge parameters like responsibility of mother to ensure proper hand washing among children and long nails can spread bacteria were better among the urban mothers (p

The rehabilitation of patients with acquired defects of the maxilla is a challenge in terms of re-establishing oronasal separation. In most patients these goals are met by means of prosthetic rehabilitation with an obturator prosthesis. Prosthetic rehabilitation can be achieved satisfactorily if all facets of treatment planning and design consideration are taken well into account prior to the rehabilitation process. In many cases effective obturation is achieved but in the relative majority, the prosthesis is usually rejected by the patient as being non-retentive and the outcome is a failure. So, making the prosthesis hollow and the placement of attachments can have a dramatic effect on the stability and retention of the obturator prosthesis in partially dentulous maxillectomy patients. This paper describes a clinical case of post maxillectomy due to adenocystic carcinoma, rehabilitated with the hollow bulb obturator stabilized with Dalla Bona type of radicular attachment.

Introduction: The largest numbers of diabetic patients are present in our India. Research in diabetes has largely focussed on estimating the burden of disease. However identifying the risk factors is also important. The current study was undertaken with the aim to determine the risk factors of type 2 diabetes mellitus among rural population (30 yrs and above) of Jammu and Kashmir, India. Material and Methods: A two stage design was used for assessment of risk factors. The first stage involved a questionnaire based assessment for risk factors and second stage involved taking blood samples for fasting plasma glucose. Results: A total of 170 adults out of 2085 submitted to investigation were found to be diabetic giving us a crude prevalence of 8.1%. Body Mass index (BMI), diet and physical activity seems to be strong predictors for diabetes mellitus. Conclusions: Identifying the risk factors for Diabetes mellitus is the key in planning prevention strategies

Background: Hepatitis B and Hepatitis C are among the major public health problems in the world and students in the medical schools as a group is highly vulnerable to these infections. The current study aimed to assess the perspectives (knowledge, attitude and practices) of these students about both Hepatitis B and Hepatitis C.Methods: The present cross-sectional study was conducted in a medical school in northwest India using a self administered questionnaire. This study was carried out in the month of July 2017 using a convenience sample of Pre-final MBBS students.Results: The knowledge of the respondents was found to be good on most of the parameters except for living with Hepatitis B/C patient being a risk factor for disease and Hepatitis B being curable. On the same pattern, attitudes were also found to be positive on most of the parameters except willingness to undergo screening for the diseases. Practices of the respondents were also adequate except for use of gloves while examining a patient/collecting blood sample. An important positive practice observed was that 92.8% of the respondents were protected against Hepatitis B.Conclusions: The study has concluded that perspective of medical students towards Hepatitis B and Hepatitis C are reasonably good and areas of concern need to be taken care of. Both these diseases remain a challenge for health community in general and medical students in particular due to their being an occupational hazard, so the need for infection control training before they start clinical education is strongly recommended.

Background: Emergency contraception (EC) which is the only method indicated after the unprotected sexual intercourse prevents unintended pregnancies and its harmful consequences like unsafe abortion or unintended child delivery. Since medical students are the future medical professional and would be the main channel to provide preventive, promotive and curative services to the population at large, their knowledge and attitude towards EC is an important context in the overall health scenario of India. The study aimed to assess the knowledge and attitudes of medical students towards use of EC.Methods: This cross sectional questionnaire based study was conducted among 2nd professional MBBS students in a Government Medical College in North India. The self administered questionnaire intended to seek information on knowledge and attitude of the students. The data so collected was expressed in percentages and Chi square test was used as test of significance.Results: All the respondents had heard of EC with mass media as the main source of information. More than 90% of the respondents knew about the indications for use of EC as well as the timing of the use of EC. Female respondents had better knowledge about composition of EC as well mechanism of action (p

Background: Sex selective abortions have grossly distorted the child sex ratio in India. Role of medical technology in declining sex ratio at birth cannot be undermined. To combat this social evil, PC-PNDT (Pre-conception Prenatal Diagnostic Test) was promulgated in 2003 by Government of India. Enhancing the knowledge of medical fraternity with focus on undergraduate students can imbibe an enduring commitment towards this predicamentMethods: The present cross-sectional study was conducted in Government Medical College of Jammu. Students of 1st year MBBS of Batch 2016-2017 were administered the pre-designed and pretested questionnaire. Information was collected regarding sex determination as well as PC-PNDT Act.Results: 80% respondents knew about the declining sex ratio and 95% knew that sex determination is possible during pregnancy. Only 24.29% had heard about PC-PNDT Act although 95% knew that prenatal sex determination is punishable. Higher proportions of female respondents were aware of both fine and imprisonment as punishment under the act. (p

Background: WHO is advocating a policy towards 100% voluntary non-remunerated blood donation by year 2020. The youth in general and medical students in particular constitute the core group for recruitment and retention of voluntary donor population in order to ensure safe and sustainable blood transfusion practices in India. The objective of the present study is to elucidate the knowledge, attitude and practices about voluntary blood donation among medical undergraduate students.Methods: A pretested, close ended questionnaire was administered to second and third year MBBS students of a tertiary care teaching hospital in Northwest India. Results were expressed in proportions and chi-square test was used as a test of significance (p

Background: Elderly population (age group with >60 years of age) is usually beset with multiple morbidities. Many medications (drugs) are generally prescribed for the management and care of such morbidities. For majority, consumption of such medications on a regular basis is not an easy option, therefore giving rise to nonadherence for medications. The study was conducted with the objective to assess adherence to medication for hypertension and Type 2 diabetes mellitus (T2DM) among rural elderly. Materials and Methods: A cross-sectional observational study was conducted among all rural elderly (more than 60 years of age) being managed for hypertension and type 2 diabetes, using a pretested and semi-structured questionnaire. Results: The number of female elderly was more than the male. Nearly 56% of the elderly with hypertension were not taking regular medication, whereas the comparative figure was 50% for elderly with T2DM. Compliance of treatment in geriatrics with both hypertension and diabetes in relation to the genders was found to be nonsignificant (P> 0.05). The main reasons identified for this were costs of medications, adverse events of drugs, fear of addiction, and declining memory. Conclusions: Nonadherence to medication among the elderly for hypertension and T2DM in this rural study was not uncommon.

To improve the overall health scenario of the nation, the need of the hour is to produce quality doctors and not just the quantity. To achieve this, medical education needs to be updated keeping in mind the current trends. Physiology, one of the basic subjects of medical education forms the foundation of many medical branches and students should have its proper understanding. The aim of the study was to assess the current practices and attitudes of the medical students in two medical colleges of North India in the Jammu Province of J&K towards learning of physiology. 500 medical students participated in this study, 300 from the ASCOMS & Hospital, Sidhra, Jammu and 200 from the Government Medical College(GMC), Jammu. A questionnaire consisting of 13 questions was provided to each of them to elicit their feedback regarding learning of physiology. The results revealed that 89% were in favour of lectures, 51.2% of tutorials and 83.45% were of the opinion that practical's were useful. Enthusiasm of the students ’in learning physiology was so much that 36.2% considered lecture notes insufficient, so 87.4% were using advised reference books, 51.2% previous examinations and 57.6% previous exam papers to guide them. When faced with difficulty in learning physiology majority preferred to consult advised reference book, class fellows and seniors in that order, while consulting teachers was found to be the last option. The potential to self-study was so much that 64.8% used internet and 21% scientific journals to get the latest information in the learning of the subject. We can conclude that medical students are motivated in learning physiology by using hybrid techniques which include using advised reference books, consulting among themselves to solve problems and using online sources Fewer consultation with teachers and lesser interest in tutorials can be improved by initiative from teachers, by becoming more friendly with students, encouraging them, creating an open and positive atmosphere, being more responsive and empathetic to them.

Introduction: An extensive search on PubMed reveals very little in terms of evidence regarding the current knowledge, attitude, and practices (KAP) of the population in general and rural population, in particular, in this part of the country. Therefore, a study was conducted with the aim to assess the communities′ knowledge of malaria transmission, recognition of signs and symptoms, treatment seeking. Materials and Methods: A stratified two-stage design was used to conduct a house-to-house survey using a semi-structured questionnaire in RS Pura block of Jammu District of Jammu and Kashmir State in North India. Results: A total of 300 households were included in the study. However, data on 4 households was found to be incomplete at the time of analysis and, therefore, were excluded. Out of 296 study participants interviewed 65.5% were males, while 34.5% females. All of the study participants (100%) had heard of malaria, and the main source of their information was television/newspaper. 92.5% of the study population considered malaria to be a serious health problem, thus reflecting their attitude to the disease. Regarding practices, 71.6% of the study participants preferred going to doctors at government hospitals for malaria treatment, and 56% were willing to seek medical help in

The autonomic nervous system is a division of peripheral nervous system that controls automated body functions like heart rate, blood pressure, digestion and metabolism. Women have been seen to have lower cardiovascular risk and this is believed to be because of the regulatory influence of oestrogen on autonomic nervous system. The current study was conducted on 326 healthy medical students, 163 each of both sexes, in age group of 19 to 25 years, divided into Group-1 (males) and Group-2 (females). The parameters recorded and tests used were pulse rate, standing to lying ratio, 30: 15 ratio, valsalva ratio and expiratory-inspiratory ratio for assessment of parasympathetic activity and pulse rate, blood pressure, orthostasis, cold pressor test, mental arithmetic test and corrected QT interval for assessment of sympathetic activity. Our findings show that young adult females have lower parasympathetic activity as compared to males of the same age group, who have a higher sympathetic activity.

It is the god given right of human being to appear human, and the face is a person’s visiting card. We can hide everything but we can’t hide our face. Eyes are generally the first feature of the face to be noticed and the presence of a pair of eyes is quite essential to maintain the balance and the esthetics of the face. Loss of eye has a crippling effect on the psychology of the patient. The aim of all ocular prosthetic procedure is to enable rehabilitation of the patient in the society with a normal appearance and self esteem. This article describes a clinical report of rehabilitating post evisceration patient due to glaucoma of right eye with custom made artificial prosthesis using stock eye shell that can create esthetically pleasing results.

Background: Antenatal care (ANC) is an effective tool to reduce both infant and maternal mortality rates. In spite of all efforts to reach and register every antenatal mother, the results are not up to desired level. Objectives: To assess the level of knowledge of pregnant women about ANC services and to find out the ANC utilization and factors affecting them. Materials and Methods: This cross-sectional study was carried out in October-November 2013 in Krishna Nagar village of Miran Sahib zone of block R.S. Pura. All the mothers (aged 15-49 years) in this village were interviewed using a predesigned, pretested, and semi-open-ended questionnaire. Results: The respondents had adequate knowledge about ANC services except for the minimum number of visits for ANC. Here, 89.6% (189) of the respondents had registered for ANC, of which 64.5% (136/211) and 9.9% (21/211) had registered in the 2 nd trimester and 1 st trimester, respectively. The results revealed that 79.1% of the deliveries were institutional. The age, literacy status, socioeconomic status (SES), and type of family had statistically significant associations with the utilization of ANC services. Conclusion: The results show that maternal literacy remains a key factor in the better utilization of antenatal services. Moreover, the role of health workers in increasing awareness among mothers about the importance of ANC in general and the danger signs of pregnancy in particular is of paramount concern.

The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.