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BACKGROUND: Body temperature is a vital parameter in patient assessment. Fever is a common presentation in patients arriving at all health care setups. [1] It is a transient pathological state characterised by a disturbance in the hypothalamus thermoregulation system and, as a result, an increase in the body's temperature above the normal range. Normal body temperature values range from 36.5 to 37.4 °C depending on physiological variations, patient characteristics, and measurement sites. [2] Fever is a sign of underlying pathology – infection, infestation, inflammation, autoimmune diseases, malignancy, medication adverse reaction, intracranial haemorrhage or pulmonary embolism. Fever is also an important symptom in COVID-19 patients, typically appearing 12–14 days after exposure. And that made screening patients for elevated body temperature an essential initial triaging tool during the pandemic. [3] [4] A clinical thermometer is the equipment used for measuring body temperature. Several thermometers are available, each with its advantages, disadvantages, applicability, reliability and sensitivity. [5] Mercury-in-glass thermometers were the standard way to measure temperature for many years. They were taken off the market in the late 2000s because mercury is toxic to the environment. After that, many thermometers came into use, including digital, tympanic or axillary thermometers and non-contact infrared thermometers. Presently digital thermometers occupy the bedside at both homes and hospitals, including clinics. [6] [7] [8] The COVID-19 pandemic brought in, at large scales, the use of a non-contact infrared thermometer as a screening tool to measure body temperature. [9] [10] Our knowledge of the relative performance of different types of thermometers, including differences in temperature measured, is limited despite the essential role they play in clinical practice. So, it's essential to understand how different thermometers work and how accurate they are at making diagnoses. [11] [12] This is especially crucial considering the triage significance of fever measurement in clinical settings, especially emergency care, to refer patients to appropriate care pathways. OBJECTIVES: To evaluate the diagnostic accuracy of non-contactable infrared thermometers in comparison with mercury and digital thermometers. METHODOLOGY: The prospective observational study was conducted on 210 patients of both genders, of all age groups, presenting with or without fever to the ED of AIMS, Kochi, and a quaternary during the period from January to June 2022. The data we collected and statistically analysed from the study population are age, sex, presenting complaints, co-morbidities, heart rate, blood pressure, respiratory rate, SpO2, and body temperature being simultaneously measured with mercury, digital and non-contact infrared thermometers. The temperature of all patients was recorded using mercury, a digital thermometer placed in each axilla simultaneously, and a non-contactable infrared thermometer on the forehead. Mercury in glass thermometer was placed in axilla with the bulb of the thermometer in the tip of the axilla for 2 minutes. The digital thermometer was placed in a similar fashion in the other axilla and removed from the axilla after the beep was heard and temperature displayed was noted. The infrared thermometer is placed near the forehead or wrist, with a 5cm gap between the two. The trigger button is gently pressed, and the temperature shown on the LCD screen is recorded. RESULT: The study group included 53% males and 47% females. 58% belonged to the age group between 46 and 75 years, 30% between 16 and 45 years of age, 11% between 76 and 99 years and 1% below 15 years of age. Fever was present in 20.5% of the patients and the rest had other symptoms like vomiting, diarrhoea, cough, dyspnoea, fatigue, weakness, body pain and pedal oedema. 57% had two comorbidities, 29% were with more than 2 comorbidities while 14% had no known comorbidities. The body temperatures measured by mercury and digital thermometers were almost identical – Normal in 85.5%, above normal in 14% and below normal in 0.5%; but with a non-contact infrared thermometer, the same were 97.5%, 2.5% and 0% respectively. DISCUSSION: This study is highly relevant in the current scenario where the pandemic situation is almost over and a lot of institutions who invested in NCIT have started considering them for use as alternative devices for recording temperature. In our study, non-contact infrared thermometer failed in detecting fever in several affected patients, or misread normal temperature as elevated and was not capable of detecting hypothermia. Additional research is required to compare its accuracy and precision to other invasive and non-invasive core body temperature testing methods. The study finding of a rise in heart and respiratory rates in fever patients, though non-specific, concur with inferences from other similar studies. CONCLUSION: Our study concluded that the accuracy of non-contactable infrared thermometers is less reliable than mercury and digital thermometers for routine clinical practice. Though, the non-contact infrared thermometer was widely being used during the pandemic scenario, our study results do not favour its use other situations like the clinics, intensive care units or emergency departments. Key words: [Mercury, Digital, Infrared, Thermometer, COVID, Healthcare technology]

Snakebite is an environmental and occupational hazard in India. Death and disabilities due to snakebite remains a major public health challenge. For the fight against this battle a greater investment should be focused on the preventive measures. This includes understanding of the common seasons of snake bites, location and also the site of snake bite. Understanding these will help in taking better preventive measures. Materials and Methods: This is a 6-year retrospective observational study of 70 venomous snake bite cases admitted to a tertiary care center in South India. Inclusion criteria has been all confirmed case of envenomation by venomous snake bite. Chi square test was done to find the association between categorical variables. Result: The study sample size is 70. Mean age in our study is 34.66 ± 18.57 years. 57.1% were male. 79% snake bites occurred outdoor. 57.1 % patients had local reaction along with hemotoxic/neurotoxic symptoms. 28.5% patients had only local reaction. 84% bites occurred in lower limb. 43% bites occurred in the foot. Statistically borderline significant correlation between site of bite and local reaction alone (p=0.05). We could not find a statistically significant correlation between site of bite and local reaction with hemotoxic / neurotoxic symptoms (p=0.236). 59% snake bites occurred during Monsoon season this was followed by post monsoon season. Conclusion: Snakebite is a neglected tropical disease and remains as an underestimated cause of accidental death in modern India. Significance of bite site along with seasonal variations in snakebites helps in formation of effective preventive strategies, which along with prompt primary treatment holds the key in reducing the impact of venomous snakebite. Keywords: Emergency department, Envenomation, Local Reaction

Maddah-Ali and Niesen, in a seminal paper, introduced the notion of coded caching. The exact nature of the fundamental limits in this context has remained elusive even as several approximate characterizations have been found. A new optimal scheme for the (3, 3) cache network, operating at the memory rate pair (5/3, 1/2) for the demand where all the users request for distinct files, was introduced recently to partially address this issue. In this paper, an extension of this scheme to the general (K, K) cache network, operating at the memory rate pair ((K2 −K −1)/K, 1/(K −1), is proposed. A new lower bound is also derived which demonstrates the optimality of the proposed scheme for the demand where all the users request for distinct files.

Orbital injuries are often missed out when they occur concomitantly with other facial bone fractures. Clinical examination and plain radiographic findings alone may prove inadequate in the detection of orbital floor fractures. Refined imaging techniques like CT scans and MRI are immensely helpful in the diagnosis of orbital blowout fractures. A case of ‘impure’ orbital blowout fracture which went undetected at the time of initial examination and its secondary surgical reconstruction is reported here. This case report emphasizes the importance of careful clinical and radiologic evaluation in orbital injuries. How to cite this article Kumar KPM, Kumar VVH, Varma S. Orbital Trauma: Keep an Eye for the Details! J Contemp Dent Pract 2012;13(2):232-235.

Genus Macrobrachium includes freshwater prawns which inhabit most diverse habitats ranging from low saline areas to inland hill streams and impounded water bodies. Being morphologically conserved, this genus has been exposed to severe disputes related to their taxonomy, systematics and phylogeny. Macrobrachium striatum and M. equidens represent two morphologically related congeneric species within this genus. Earlier, M. striatum was considered as a striped form of M. equidens. Though these species are now well-described morphologically and differentiated into two species, no molecular level investigation has been carried out in support of their speciation. We report a study on M. striatum and M. equidens with emphasis to their molecular data through mitochondrial markers (16S ribosomal RNA and cytochrome oxidase subunit I). Results obtained from developed molecular markers of the two species revealed considerable genetic differentiation between them. Phylogram generated using Minimum evolution and Neighbour joining analyses differentiated M. striatum and M. equidens as two independent species. Genetic distance data showed high interspecific divergence (ranging from 3.9% to 17.0% for 16S rRNA sequences and 13.8% to 21.0% for COI sequences) between M. striatum and M. equidens confirming the findings of phylogram. Hence, it could be delineated that M. striatum and M. equidens represent two distinct species within genus Macrobrachium with emphasis to their morphology and genetics.

Horner's syndrome is characterized by triad of blepharoptosis, miosis, and anhydrosis on the lateral part of the face. Incidence of iatrogenic Horner syndrome resulting from neck surgeries has been reported between 10% to 18.5%. Iatrogenic Horner syndrome resulting from excision of cervical vagal nerve schwannoma is uncommon, and has rarely been mentioned in literature. We report a rare case of iatrogenic preganglionic Horner's syndrome resulting from excision of a cervical vagal schwannoma. An 18 years old female presented with the complaints of sudden drooping of right upper lid associated with reduced sweating on right side of face for the past 3 months. There was history of excision of a right cervical vagal schwannoma. Ocular examination revealed mild ptosis, miosis with anisocoria more in scotopic illumination. Photographs of the patient prior to surgery showed no evidence of ptosis. Preoperative Magnetic resonance imaging revealed a mass suggesting a vagal nerve schwanomma. A diagnosis of iatrogenic preganglionic Horner's syndrome was made and the patient was kept under follow up. Horner's syndrome is an uncommon sequelae of cervical vagal schwannoma excision that results from injury of the cervical sympathetic chain intraoperatively and hence should be discussed with the patient during pre-operative counseling.