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Introduction: Photography has always been thought to be an important part of dentistry. Since the introduction of digital technology; imaging has become simpler and more accessible. Colour matching is critical for the success of restorative and prosthetic dental treatments, also communication with the dental laboratory is still subjective, and further research is needed on this aspect. Aim: To compare the colour difference of digital photography equipment to standardise colour assessment in dental photography. Materials and Methods: A single blind clinical study was conducted after Clinical Trial Registry of India (CTRI) registration and informed consent, and a total of 22 participants were enrolled in accordance with the selection criteria. A spectrophotometer was used to determine the CIELAB (Colour space defined by International Commission on Illumination) values of the right central incisor for each participant. They were then photographed with five different photography equipment along with a grey reference card. Group A: Canon 1300D Digital Single Lens Reflex (DSLR) with 100 mm lens and pop-up flash (N=22). Group B: Canon 1300D DSLR+100 mm lens+70 GSM white tissue paper (N=22). Group C: Canon 1300D DSLR+ 100 mm lens with ring flash (N=22). Group D: Canon 1300D DSLR+100 mm lens+ring flash+diffuser (N=22). Group E: Iphone 11 (N=22). CIELAB values were obtained for all the groups using adobe Photoshop software after white balancing. Delta E was calculated by comparing CIELAB values of each group with the spectrophotometer values. The data was tabulated and analysed with one way ANOVA and Post-hoc test using IBM SPSS 20 software with p<0.05 considered statistically significant. Results: Mean value of Delta E was least in group D (DSLR+ ring flash with diffuser) (5.033) followed by group B (DSLR+ pop up flash with white tissue paper) (6.57), group A (DSLR+pop-up flash) (10.70), group E (Iphone11) (10.74) and highest in group C (DSLR+ ring flash) (11.32). Conclusion: Group D (DSLR+ ring flash with diffuser) was determined to be closest to the standard spectrophotometric values for colour assessment in dental photography. [ABSTRACT FROM AUTHOR]

Introduction: Early Clinical Exposure (ECE) was incorporated into the Competency-based Medical Education (CBME) curriculum in 2019. ECE in a classroom setting is conducted through Clinical Case Discussion (CCD) using paper-based clinical case scenarios. The assessment pattern of CBME and Maharashtra University of Health Sciences (MUHS) includes clinical case-based questions. Therefore, assessing and developing clinical reasoning skills and critical thinking has become the need of the hour. Aim: To measure the effectiveness of the modified One-minute Preceptor (OMP) model as a teaching-learning tool for CCD to enhance the knowledge and reasoning skills of Phase I Bachelor of Medicine Bachelor of Surgery (MBBS) students and to assess the perception of students and faculty towards the modified OMP model. Materials and Methods: This prospective interventional study was conducted in the Department of Biochemistry at Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India from February 2020 to May 2020. Out of 250 Phase I MBBS students, 180 who had given consent and participated in all the sessions were included. Eight faculty members voluntarily participated in the study. The faculty involved in CCD for the control and study groups were different and selected through randomisation. After a didactic lecture, a pretest was administered, and then students were divided into Control group A (n=90) and Study group B (n=90). For CCD, the modified OMP model was used for the study group and the traditional unstructured method for the control group. A post-test was given after CCD, and feedback was collected from faculty and students. Quantitative analysis of the feedback was done using a 5-point Likert scale, and open-ended questions were qualitatively assessed. Pretest and post-test scores were analysed using an unpaired t-test. Learning gain was measured, and program evaluation was conducted using Kirkpatrick's model. Results: There was a statistically significant difference in the post-test scores obtained by the control group and study group (p-value <0.001). A higher normalised learning gain (0.83) was observed in the study group. The modified OMP model was perceived as an effective, interactive teaching-learning tool for CCD by both students and faculty. Conclusion: CCD using the modified OMP model significantly improved knowledge, critical thinking, and reasoning skills of students. Even after modifications to the original OMP model, the effectiveness of this model for preclinical subjects remains unaffected. [ABSTRACT FROM AUTHOR]

Respiratory Syncytial Virus (RSV) is a highly contagious seasonal virus that is the leading cause of acute Lower Respiratory Tract Infections (LRTI) in the paediatric age group and is one of the leading causes of death in children under five in developing countries. There is evidence that severe RSV infection and hospitalisation in early life increase the risk of recurrent wheezing, childhood asthma, and allergic sensitisation. Even though RSV being a major global health concern, very few papers concentrate on the neonatal period in India. The present case series presents four cases (three females and one male baby) highlighting the impact of RSV in neonatal and post-neonatal infants in India. The cases highlight the diversity of presentation; one infant required prolonged High-flow Nasal Cannula (HFNC) support, while two needed just symptomatic care. The importance of Polymerase Chain Reaction (PCR) in resource-constrained situations is highlighted as diagnostic issues are examined. Treatment focuses on supportive care; oxygen and respiratory support are provided in more severe cases. The present study emphasises the need for early detection and preventative measures, such as using novel treatments like nirsevimab. The present case series advocates for focused therapies and additional research in the Indian paediatric environment, adding insightful perspectives to the expanding body of knowledge on RSV. [ABSTRACT FROM AUTHOR]

Introduction: Many viral and bacterial respiratory tract infections can present with respiratory signs and progress to complicated pneumonia. In the recent Coronavirus Disease-2019 (COVID-19) pandemic, it is crucial to test all Severe Acute Respiratory Infection (SARI) patients for other microbial infections in addition to COVID-19, enabling timely diagnosis and treatment to reduce morbidity and mortality. The automated system, BioFire FilmArray, utilises multiplex Polymerase Chain Reaction (PCR) to rapidly detect and identify multiple respiratory pathogens, including selected Antimicrobial Resistance (AMR) genes, within an hour. Aim: To detect bacterial and/or viral pathogens associated with hospitalised COVID-19-negative SARI patients using the BioFire FilmArray Pneumonia Panel (BFPP). Materials and Methods: This laboratory-based cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India, from June 2020 to February 2021. Respiratory samples, such as sputum, tracheal aspirate, Endotracheal (ET) secretions, and Bronchoalveolar Lavage (BAL), were collected from COVID-19-negative hospitalised SARI cases. A total of 81 patients were included in the study. The samples were tested using the BFPP (multiplex PCR) system and processed using conventional culture techniques. Patient characteristics, clinical and laboratory investigation data, and findings of respiratory viral and bacterial agents, as well as antibiotic resistance genes detected by BioFire FilmArray, were recorded using paper case reports. The data were collected and analysed using Statistical Package for Social Sciences (SPSS) software. Results: Out of the 81 clinical samples processed, the BFPP detected 168 bacterial and 18 viral pathogens. Bacterial-viral codetection was observed in 13 (16%) samples. Atypical bacteria were detected in 3% of cases. Among the bacterial pathogens, the AMR gene for New Delhi Metallo-beta-lactamases (NDM) was detected in 42 (25.9%) cases, followed by CTX-M betalactamases, VIM, and the oxacillinase group of β-lactamases. Conclusion: The BFPP test is a valuable tool for the rapid detection of a wide range of pathogens, including associated AMR genes, with high sensitivity and specificity. This can greatly aid in treatment decisions. [ABSTRACT FROM AUTHOR]

Introduction: During a pulpectomy, the infected or inflamed pulp tissues are removed, and the root canal is thoroughly cleaned with mechanical instrumentation and copious irrigation. Various endodontic irrigants are available, such as Sodium Hypochlorite (NaOCl), Chlorhexidine (CHX) gluconate, Ethylene Diamine Tetra Acetic Acid (EDTA), Mixture of doxycycline, citric acid, and a detergent (MTAD), etc. Among these, CHX gluconate is widely used as an endodontic irrigant and medicament due to its antibacterial effect and substantivity. Enterococcus faecalis is the most common bacterial species found in necrotic teeth, with high viability and antibiotic resistance. A 3.8% Silver Diamine Fluoride (SDF) has antimicrobial properties and has been shown to eliminate E. faecalis from the root canals of permanent teeth. However, there are no studies in the literature that have evaluated its efficacy as a root canal irrigant in primary teeth. Aim: To evaluate the antimicrobial efficacy of 3.8% SDF against E. faecalis in primary teeth. Materials and Methods: This was a in-vivo double-blinded randomised clinical trial conducted at Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India in children aged 3-8 years old. The study included 60 primary teeth that required pulpectomy. The teeth were divided into two groups and irrigated: 30 teeth with 3.8% SDF (Group I) and 30 teeth with 2% CHX (Group II). In all cases, two microbiological samples were taken using sterile absorbent paper points: the first after access opening and the second after the final irrigation. All samples were assessed using the agar plate method. The results were analysed statistically using a Student's paired t-test. Results: After analysing the pre- and postirrigation samples, there was a statistically significant reduction in Colony Forming Units (CFU)mL (p<0.05) in both groups. When comparing the two groups, no statistical difference was observed in the percentage reduction of bacterial colonies (p>0.05). Conclusion: The reduction in CFU/mL of E. faecalis was comparable in both groups. Thus, 3.8% SDF can be used as an alternative root canal irrigant to 2% CHX. [ABSTRACT FROM AUTHOR]

Introduction: The primary goal of cholesteatoma surgery is to eradicate it from the middle ear cleft. However, due to linear axis of illumination of the microscope, in some of the recesses or hidden areas in middle ear are not visualised. To overcome this, many studies have been done on the complimentary use of endoscopes in visualising these hidden areas. Aim: To assess the outcome of complimentary use of endoscopes in addition to microscope on improved access to hidden areas in the middle ear and resultant cholesteatoma clearance. Materials and Methods: In this systematic review, literature search was conducted using the keywords both manually and electronically in PubMed, Google scholar and Directory of Open Access Journals for articles published till December 2021 at ESIC Medical College and PGIMSR, Bengaluru, Karnataka, India. The primary inclusion criteria used was all full text original, both prospective and retrospective, articles in which endoscopes were used as an adjunct to microscope for cholesteatoma clearance from middle ear cleft. Retrieved articles were reviewed by two independent authors for their eligibility for inclusion in the study. The selected original papers were analysed. Data was entered in Microsoft Excel 2007 and analysed for descriptive statistics like frequency and proportions. Results: A total of 48 studies were identified initially. After removing duplicates, screening was done for title, abstracts and full text retrieval to check for inclusion criteria being met. Six studies were found using complimentary endoscopes for cholesteatoma surgery and were analysed. Of these, four were prospective and two were retrospective studies. Total 604 patients underwent endoscopic examination after microscopic clearance. Residual cholesteatoma was seen in 105 patients (17%), which were cleared with endoscopic assistance. Conclusion: Complimentary endoscopy detects residual cholesteatoma in significant number of cases during primary cholesteatoma surgery. In cholesteatoma surgery, they are predominantly used as observational tools. [ABSTRACT FROM AUTHOR]

Introduction: Even though Mortality and Morbidity meetings (M&Ms) are incorporated into postgraduate training programs for imparting the attributes of self-appraisal, audit and quality control, they are not uniformly structured across institutes. This study describes the pattern of conducting M&M at a Medical College in North Karnataka in the context of the perceptions of faculty and residents of our medical college and proposes recommendations. Aim: To generate recommendations for conducting structured M&Ms meetings derived from the perceptions of faculty and residents, and prior feasibility experience at a medical college hospital. Materials and Methods: The present mixed method study was conducted in the Department of General medicine, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India, in the month of July 2022. The perceptions of faculty and residents of medicine were obtained by a paper survey. The results of the survey were compiled and analysed by the one of the authors. The responses were matched with the records of M&Ms as conducted in the Department of General Medicine from November 2017 to May 2019. The cases were thematically analysed as deviation from standard protocols of care, multidisciplinary consults, iatrogenic cause of death, unresolved diagnosis and system failure by other authors. Any recommendations recorded were noted. The attendance for such meetings were measured as a surrogate of importance attached. Data was entered in the Microsoft Excel spread sheet. Descriptive statistics were calculated by frequency and proportions for qualitative variables. Results: A total number of 150 participants (65 were faculty including senior residents and the remaining 85 were postgraduate residents) completed the survey. The participants of the survey preferred the presentation by 3rd year residents and junior faculty. While selecting the cases for M&Ms, they preferred systematic selection turn-wise. The participants of the survey considered that while analysing M&M cases; conflicts in multidisciplinary consults, iatrogenic cause of death, human error and deviation from standard protocols of care should be emphasised. During November 2017 to May 2019, a total of 38 M&Ms were held (19 mortality and 19 morbidity meetings). The criterion for mortality case selection was subjective. Five cases were presented during each meeting. Predominant case presentations included interdepartmental transfer issues and procedural lapses. The Department of General Medicine had 30 postgraduate residents and 25 faculty members. The average attendance of residents and faculty was 90% and 78%, respectively. Conclusion: Regularly conducted M&M in a medical college hospital are important in training medical students for audit of medical errors, quality control and appraisal in a safe environment. Prospective selection of cases by recognising potential incidents; and evidence based, structured, uniform conduct of M&Ms by participation of teams involved in healthcare can reduce errors. [ABSTRACT FROM AUTHOR]

Introduction: Placenta previa is a condition characterised by abnormal placental implantation and usually presented as painless vaginal bleeding in second or third trimester of pregnancy. Various studies have reported adverse outcomes in the cases of placenta previa. Aim: To find incidence, maternal and perinatal outcomes in placenta previa. Materials and Methods: This retrospective study was carried out during April-June 2021 at a Government Tertiary care centre in Maharashtra. Total 260 cases of placenta previa managed at the institute between 1st January 2017 to 31st December 2019 were included in study. Primary data from labour room and operation theatre was collected and detailed case papers were accessed from medical records section. Data was analysed using Microsoft Excel Windows 2013. Results: Incidence of placenta previa was 1.09%. Majority of cases were from age group of 26-30 years, booked, gravida 2-3, belonging to low socio-economic status and without any history of risk factors. In 81.15% cases Lower Segment Cesarean Section (LSCS) was required. Post Partem Haemorrhage (PPH) (32.30%) and need for blood transfusion (86.15%) were major complications. Maternal mortality in cases of placenta previa was 4.23%. In perinatal outcome, prematurity was reported 44.30% cases while 57.46% needed NICU admission. Perinatal mortality was 17.53%. Conclusion: There is need for regular Antenatal Care (ANC) check-up and timely referral to tertiary care obstetrical care centre with availability of Blood bank and NICU for better outcome. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroidism is an emerging public health concern, which need to be of due significance. Inspite of iodine supplementation started three decades ago, hypothyroidism is still a problem to be tackled. Apart from iodine deficiency, the contributing factors of hypothyroidism have to explored. Aim: To identify the contributing factors of hypothyroidism in adults. Materials and Methods: A systematic literature search was done using PubMed, MEDLINE, Embase, Google Scholar and the internet search from 2000 to 2018. The key words used were hypothyroidism, thyroid disorders, underactive thyroid, contributing factors, causes and associative factors. All the articles were analysed and the data were extracted using eligibility (inclusion and exclusion criteria) criteria. A total of 14 articles, which are either review articles or systematic reviews, in English language, and are fully retrievable were analysed and a systematic review was performed. Among the reviews, nine were review analysis and five were systematic reviews. The risk of bias assessment was done at the study level and data synthesis was done based on the criteria satisfied by the checklist. Results: The present analysis has included studies related to contributing factors of hypothyroidism. The analysis revealed the following contributing factors of hypothyroidism. Too little or too much iodine (43%), excess fluoride (7%), female gender (14%), presence Thyroid Per Oxidise (TPO) antibodies (36%), smoking status (14%), age above 70 years (21%), unregulated use of pesticides (14%), contaminated drinking water (14%), certain medicines (29%), use of plastic bottles contain Bisphenol A (BPA) and paper cups insulated with plastics (7%) and exposure to goitrogens (7%). Conclusion: Hypothyroidism is a leading emerging health problem in India. The prevalence is 11-15%. Despite the fact iodine fortification since 1983, hypothyroidism is a major public health to be tackled. In the current review five studies from India were included. Most of the studies showed the iodine as the contributing factor either in too much level or too little level. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, social media use has been increased by healthcare professionals (HCPs) in their healthcare practice and it has emerged as a new platform for disseminationof knowledge, information exchange, and interpersonal communication. Aim: This study was conducted with an aim to assess the use of social media in dental practice among dental practitioners in India. Materials and Methods: This cross-sectional survey was conducted from October 2019 to March 2020 at Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, Maharashtra, India by implementing a 15-item questionnaire to 36218 dental practitioners in India registered with Indian Dental Association through an Electronic Survey Application. The questionnaire consisted of a section on demographic details of the participants which included their age, gender, type and number of years of practice. Second section consisted of items about the use of social media in dental practice and one open ended question on the topic. Data was analyzed using descriptive statistics and comparisons were made using a chi-square test. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. Level of significance was kept at 5%. results: A total of 3180 dentists responded and returned the filled questionnaire. Social media was used by 1980 (62.3%) of dentists in their practice and the most commonly used platform was WhatsApp 1650 (83.3% of social media users). Most common reason for using social media in dental practice was for learning new things related to dentistry and staying updated 1470 (74.2%) followed by participation into discussion related to dentistry 1170 (59.1%). Dentists younger than 45 years (p=0.002), dentists with practice of less than 10 years (p<0.001), dentists with specialty practice (p<0.001) and dentists having practice website (p<0.001) were more likely to use social media in their dental practice. conclusion: Dental practitioners are actively incorporating social media in their practice and non-users also showed interest in incorporating social media into their practice in near future albeit some of them were lacking in the knowledge of the same. [ABSTRACT FROM AUTHOR]

Introduction: Due to the lack of cadavers, anatomists across the nation are facing trouble in teaching. Plastinated specimens can be used to get around this deficiency and reliance. Aim: To assess the change in weight during plastination using melamine. Materials and Methods: A cross-sectional cadaveric study was conducted in the Department of Anatomy at GMC Kota, Rajasthan, India, using nine specimens from cadavers obtained between June 2016 and June 2017. Freshly dissected specimens from a fresh cadaver were used for plastination. The weight reduction after dehydration using acetone (three changes of seven days each), degreasing using xylene (three changes of seven days each), impregnation with a melamine-xylene mixture (10 days in a vacuum), and curing was recorded. Weight was measured using a digital weighing balance and recorded after each step. All statistical analyses were performed using Analysis of Variance (ANOVA) in MedCalc software version 22.009. Results: There was a gradual weight loss after each step except for impregnation. The percentage of mean weight after dehydration was 58.59±4.03%, after degreasing was 56.21±2.55%, after impregnation was 66.06±4.69%, and after curing was 48.26±5.39% and p-value was highly significant (<0.05). Conclusion: Continuous reduction in weight without distortion of anatomy resulted in lightweight plastinates which were odorfree and aesthetically pleasing. [ABSTRACT FROM AUTHOR]

Introduction: Informed consent is an essential component in research involving human participants. However, the informed consent obtained may be incomplete and not fulfill the essential criteria of Informed Consent Forms (ICFs). Although the guidelines for developing ICFs have been clearly spelled out by various research bodies, these guidelines are not followed completely. Aim: To analyse the ICFs submitted to the Institutional Ethics Committee (IEC) of a Medical Institute in Southern India. Materials and Methods: The present study was a crosssectional observational study analysing ICFs submitted to the IEC of McGann District Teaching Hospital, Shimoga Institute of Medical Sciences (SIMS), Shivamogga, Karnataka, India, for the period 2014 to January 2023. All research projects containing ICFs during the study period were included in the study. Of the research projects submitted, only 70 had ICFs, and these were subjected to analysis as per Indian Council of Medical Research (ICMR) guidelines criteria. The criteria for ICFs were: statement of research, purpose/methods of the study, duration/frequency of the study, benefits to participants/community, foreseeable risks, discomfort/inconvenience, confidentiality, payment/reimbursement for participation. In addition to these, ICFs were also analysed for additional elements as per ICMR criteria for tissue and blood samples. The results were then subjected to descriptive statistical analysis and presented as mean and percentages. Results: Many of the required essential elements were present in nearly 50% of ICFs submitted to the IEC, which include information on the basic purpose/methods of the study 70 (100%), identity of the principal investigator/research team 57 (81.42%), freedom to participate/withdraw from the study 55 (78.57%), confidentiality of records 54 (77.14%), and foreseeable risks, discomfort, and inconvenience to participants 35 (50%). Other essential elements like benefits were present to participants/community 28 (40%), payment/reimbursement for participation 28 (40%), duration and frequency 12 (17.14%), statement of research 9 (12.85%), treatment/compensation for injury 4 (5.71%). Regarding additional elements of ICFs for biological samples, ICFs adhered to the ICMR requirements except none of the submitted forms had any information on the period of storage of biological samples. Conclusion: The ICF is an essential requirement for conducting research. Ensuring adherence of ICF to guidelines is important from a research perspective. The present study concludes that the majority of the essential elements were present in ICFs with a few exceptions like study as research and information on the storage of biological samples, which was nil. [ABSTRACT FROM AUTHOR]

Introduction: The measurement of cervical vertebrae is a valuable diagnostic aid since it provides data on skeletal maturity and potential for growth. Research suggests the existence of a relationship between dentofacial characteristics and craniocervical morphology and posture. This relationship can provide insights into the development and treatment of malocclusions, particularly malocclusions in the vertical dimension. Aim: To compare cervico-vertebral dimensions, morphology, and cranio-cervical postures in subjects with different skeletal growth patterns such as average, horizontal and vertical. Materials and Methods: The study was cross-sectional in design and was conducted for a period of two years between January 2014 and December 2016 at KLE Society's Institute of Dental Science and Research, Bengaluru, Karnataka, India. A total of 102 lateral cephalograms were taken for the study and classified into three groups according to Frankfurt Mandibular Plane Angle (FMA angle) and Jarabak ratio as Horizontal (HR), Vertical (VR), and Average (AV) groups. Each group comprised 34 subjects (17 males, 17 females). A total of 28 morphological parameters of C3, C4, and C5 in the lateral cephalogram were measured and analysed. Each lateral cephalogram was scanned with a Konica Minolta Bighub Laser printer, and the area measurement was made with IMAGE J software to measure the area of cervical vertebrae. Oneway Analysis of Variance (ANOVA) was used to compare the various parameters between the three groups, and pair-wise comparisons were done using the Least Significant Difference (LSD) test. Student's t-test was done to assess the differences between males and females. A p-value less than 0.05 was considered statistically significant. Results: The mean chronological age of subjects was 21.2±3.14 years for the HR group, 21.3±3.78 years for the VR group, and 21±3.76 years for the AV group. There was a statistically significant difference between the three groups in the measurements of the anterior body height of C3 (ABHC3) (p=0.023), posterior Body Height of C3 (PBHC3) (p=0.007), vertical measurements of C3 (H3) (p=0.010) and (W3) (p=0.013), anterior body height of C4 (ABHC4) (p=0.010), Posterior Body Height of C4 (PBHC4) (p=0.005); H4 (p=0.002); Ratio of H4 and W4 (H4/W4) (p=0.048); area of the third cervical vertebrae (C3) (p=0.039) and area C4 (p=0.024). For cranio-cervical angulation, there were statistically significant differences found for the angle between the Nasion Sella Line (NSL) and the tangent to the Odontoid Process (NSL/OPT) (p<0.001), where the VR group had significantly larger values than the HR and AV groups. There was no significant difference found in fusion anomalies of cervical vertebrae among all three (HR, VR, and AV) groups. Conclusion: The study found that individuals with a horizontal growth pattern tend to have larger cervical vertebral dimensions compared to average and vertical growers. Individuals with a vertical growth pattern exhibited a large cranio-cervical angulation. Overall, males had larger cervical vertebral dimensions compared to females. The studied population did not exhibit any fusion anomalies. [ABSTRACT FROM AUTHOR]

Introduction: Varicose Veins (VV) are enlarged, convoluted, and elongated veins that primarily affect the superficial veins in the lower limbs and are one of the most prevalent indications of vascular diseases. The reasons for elevated venous pressure are understood, but the inflammatory cytokines that initiate the ultimate pathways of tissue destruction and are in charge of the clinical characteristics of Chronic Venous Insufficiency (CVI) are yet unknown. Although inflammation plays a crucial role in the process of tissue apoptosis, it also plays a crucial role in tissue repair and regeneration. Aim: To investigate changes in blood markers of varicose vein inflammation and endothelial damage and compare them with systemic markers in VV patients and conclude that they are increased in VV blood. Materials and Methods: The comparative cross-sectional study was conducted in the Department of Biochemistry on 70 patients with primary VV who were scheduled for Outpatient Sclerotherapy at Nootan Medical College and Research Centre, Sankalcahnd Patel Vidyadham in Visnagar, Gujarat, India from April 2021 to June 2023. Chronic lower extremity Venous Disease (CVD) was categorised using the Clinical Aetiology Anatomy Pathophysiology (CEAP) classification method. Blood samples were obtained above the knee from the tortuous and dilated varicose tributaries of the great saphenous vein (local) and from the antecubital (systemic) vein by standard venipuncture. Erythrocytes, leukocytes, platelets, haemoglobin, and haematocrit were determined using an automatic haematology analyser. D-dimer and High sensitivity C-reactive Protein (hsCRP) were determined by an immune turbidimetric assay. IL-6 and von Willebrand factor (vWF) were measured by Enzyme Linked Immunosorbent Assay (ELISA) using commercially available kits according to the manufacturers' instructions. An Independent samples t-test was used to compare group difference, and p-value =0.05 were considered significant in all two-sided statistical tests. Results: Basic haematologic test results {systemic versus (vs) varicose blood samples} were comparable. In VV, the following parameters were significantly increased compared to systemic blood: Haemoglobin (12.85±1.81 g/dL vs. 15.82±1.57 g/dL, p<0.001), hsCRP (1.34±1.01 mg/L vs. 3.78±1.67 mg/L, p<0.001), IL-6 (2.65±1.07 pg/mL vs. 4.17±1.51 pg/mL, p<0.001), vWF (90.73±16.72% vs. 127.30±19.92, p<0.001). D-dimer was also substantially higher in samples extracted from leg VV than in systemic blood (105.87±17.72 ng/mL vs. 85.61±18.18 ng/mL, p<0.001). Conclusion: Blood from VV has shown a higher level of several inflammatory markers and signs of endothelial dysfunction. This is most likely the result of worsening venous pressure and dilated, convoluted superficial veins that restrict blood flow. The procoagulant qualities of the local blood and damage to the venous wall, leading to a chronic inflammatory response, may accelerate the disease's progression and thrombotic consequences. [ABSTRACT FROM AUTHOR]

Introduction: Training young doctors is essential for carrying out need-based research. The field of Traditional Medicine (TM) has made significant contributions to modern medicine, and there is unlimited scope for exploring it further in search of improved treatment options. However, there is a lack of systematic research studies on traditional medicines. It was, therefore, considered necessary to assess the interest and awareness among modern medicine practitioners regarding Traditional Medicine Research (TMR). Aim: To assess the need for training in TMR among modern medicine practitioners. Materials and Methods: A cross-sectional questionnaire-based study was conducted in the Department of Pharmacology and Therapeutics at Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India, from March 2020 to September 2020 among modern medicine practitioners from the Western region of India. A validated questionnaire was used to collect data regarding the level of training in research methodology, research experience including TMR, areas for training, attitude towards training in TMR, challenges in TMR, and therapeutic areas to focus TMR efforts. The data were analysed using descriptive statistics. Results: Out of 109 participants, 96 (88.1%) were trained in research methodology. At least one research project was undertaken by 91 (83.5%) participants. Ninety-seven percent of participants felt that TMR was necessary. TMR was conducted by 19 (17.4%) participants. Approximately 65 (59.6%) participants felt that conducting TMR poses challenges such as lack of funds, infrastructure, lack of belief in TM, unavailability of literature pertaining to TM, lack of expertise, and lack of corporate attention and marketing. Therapeutic areas identified to focus research efforts included lifestyle-related disorders, diabetes mellitus, cancer, ageing, allergic disorders, osteoarthritis, and obesity. Conclusion: All the participants expressed the need to undergo training in TMR. However, the experience of conducting TMR was limited. Lack of funds, infrastructure, and expertise were mentioned as the main hurdles in undertaking TMR. It is essential to conduct systematic and need-based training programs for modern medicine practitioners in basic research methodology and TMR. [ABSTRACT FROM AUTHOR]

This advanced review focuses on preventing and managing Diabetic Foot Ulcers (DFUs), with a particular emphasis on the Indian context. It explores a range of strategies, including patient education, empirical therapeutics, advanced diagnostics like Polymerase Chain Reaction (PCR), and innovative treatments such as maggot therapy, Negative Pressure Wound Therapy (NPWT), Proximal Tibial Cortex Transverse Distraction (PTCTD), Platelet-rich Plasma (PRP), Leukocyte-Platelet-rich Fibrin (L-PRF), regenerative stem cell interventions, and novel applications like sucrose octasulfate dressings. The study underscores the critical role of patient education and timely interventions in preventing DFU complications. Advanced therapies, including maggot therapy, NPWT, PTCTD, PRP, and L-PRF, show promising results in expediting wound healing and reducing recurrence rates. Innovative approaches like antibioticloaded nano fibres and electrical stimulation offer new avenues for inhibiting bacterial growth and promoting wound healing. In summary, the prevention of DFU infections hinges on the trifecta of patient education, empirical therapeutics, and scrupulous wound management. Advanced therapeutic modalities offer a frontier of exciting possibilities for refining outcomes, particularly in regions like India with its unique infection profiles. This multidisciplinary tapestry, interwoven with emerging technologies, holds great potential for elevating the management of DFUs and ultimately enhancing the quality of life for those afflicted by this ailment. This advanced study represents the vanguard of DFU research, offering insights into pioneering strategies that warrant further exploration through rigorous research and large-scale clinical trials, thereby guiding the evolution of DFU management practices. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular Disease (CVD) is the leading cause of death and disability globally. The Thrombolysis in Myocardial Infarction (TIMI) score is calculated to assess the risk outcome among myocardial infarction patients. Researchers found that diabetic patients with myocardial infarction have relatively unfavourable outcomes when compared to myocardial infarction patients without diabetes. Aim: To evaluate Glycated Haemoglobin (HbA1c) levels, the TIMI score in Acute Myocardial Infarction (AMI) patients and compare them between ST Elevation Myocardial Infarction (STEMI) and non STEMI (NSTEMI) patients. Materials and Methods: This cross-sectional study was conducted at the Intensive Care Unit (ICU) of the Department of Cardiology at SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India, from July 2022 to June 2023. A total of 100 myocardial infarction patients were included and divided into two groups based on Electrocardiogram (ECG) findings and Creatine Phosphokinase-MB (CK-MB) values, with 50 STEMI and 50 NSTEMI. Patients blood samples were evaluated for HbA1c, total cholesterol, Triglycerides (TGL), High-density Lipoprotein Cholesterol (HDL-C), Low-density Lipoprotein Cholesterol (LDL-C), Very High-density Lipoprotein Cholesterol (VLDL-C), and CK-MB parameters. The TIMI score was calculated to evaluate the risk of developing complications among myocardial infarction patients. Pearson's correlation was used to correlate biochemical parameters with the TIMI score. Results: A total of 100 myocardial infarction patients were analysed in the present study, with 50 being STEMI (mean HbA1c%: 8.0±0.2.8) and 50 being NSTEMI (mean HbA1c%: 7.2±2.0) with a p-value of <0.01*, a high TIMI score in STEMI patients (means 5.38±2.76) and 50 NSTEMI (mean 3.24±1.20) with a p-value of <0.0001*. Also, HbA1c was strongly positively correlated with the TIMI score in both the STEMI and NSTEMI groups, with r-value of 0.6 (p=0.0001*) and 0.7 (p=0.0001*), respectively. CK-MB was correlated with the TIMI score in both STEMI and NSTEMI, with r-value of 0.308 (0.03) and 0.375 (0.007). There was no correlation between the TIMI score and the lipid profile. Conclusion: The study concluded that HbA1c, along with the TIMI score, is a significant predictor of risk outcome in AMI patients. [ABSTRACT FROM AUTHOR]

Introduction: Iron Deficiency Anaemia (IDA) is a major public health problem in India. Iron plays a role in hepatic lipogenesis, being an integral part of some enzymes and transporters involved in lipid metabolism. Since information on the association between iron metabolism and dyslipidemia in adults is limited, it is important to assess the lipid status in iron-deficient patients. Aim: To study the association of iron indices with the lipid profile among patients with iron deficiency anaemia. Materials and Methods: This hospital-based cross-sectional study was conducted at the Department of Paramedical and Health Sciences, Parul Institute of Paramedical and Health Sciences, Faculty of Medicine, Parul University, Vadodara, Gujarat, India, from December 2022 to May 2023. In the present study, 100 IDA patients aged between 25-45 years were included. All the participants underwent different tests including Total Cholesterol (TC), Triglyceride (TG), High Density Lipoprotein-Cholesterol (HDL-C), and Low Density Lipoprotein-Cholesterol (LDL-C). Furthermore, the association between IDA patients and lipid levels was analysed. The data were statistically analysed using Pearson's correlation test and Chi-square test. Results: In the present study, out of a total of 100 patients, 38 were males and 62 were females. The majority of IDA patients had lower levels of TC, TG, and LDL-C. Low levels of TC and LDL were found in 52 (83.87%) of females and 30 (78.94%) of males. A total of 28 (73.68%) of males and 52 (83.87%) of females had lower values for TG levels. In contrast to TC and TG, a substantial correlation between Haemoglobin (Hb) levels and HDL-C and LDL-C was found. However, Hb had a positive association with TG, HDL-C, and LDL-C and a negative correlation with TC. These results also suggest a substantial correlation between Serum Iron (SI) and TC, TG, and HDL-C, but not a significant correlation with LDL-C. Conclusion: When observed for dyslipidemia, IDA patients showed significantly lower levels of TC, TG, and HDL-C with respect to their SI levels. [ABSTRACT FROM AUTHOR]

Introduction: Female Healthcare Workers (FHCWs) played a crucial role during the Coronavirus Diseases-2019 (COVID-19) pandemic, diligently donning Personal Protective Equipment (PPE) to deliver essential care to patients. While PPE effectively shielded FHCWs from infections, it simultaneously imposed limitations on their ability to perform fundamental human activities, including using restrooms and managing menstruation. During menstruation, the restricted access to sanitary pads, combined with the challenges of working in PPE, heightened vulnerability among FHCWs, resulting in discomfort, distress, and a decline in work efficiency. Aim: To assess the perceptions, experiences, and challenges of FHCWs regarding PPE usage while providing healthcare services during the COVID-19 pandemic. Additionally, it aimed to explore the challenges experienced in managing Menstrual Health and Hygiene (MHH) during the COVID-19. Materials and Methods: A cross-sectional study was conducted in the western region of India at a tertiary care hospital of the medical college of Symbiosis International (Deemed to be University) in Pune, Maharashtra, India from September 2020 to November 2020. A total of 300 FHCWs who were assigned COVID-19 duties and utilised PPE were included. Data was collected through a semistructured proforma, covering topics on PPE usage, challenges encountered, personal experiences, and the management of menstruation. The collected data underwent analysis using Statistical Package for Social Sciences (SPSS) software version 21.0, with a primary emphasis on descriptive statistics. Results: A total of 194 (64.7%) perceived that PPE imparted protection, and 267 (89.1%) believed that work efficiency was compromised. Challenges reported by FHCWs while working in PPE included sweating, difficulty in making eye contact, triggers of headaches, nausea, and earaches. A total of 161 (53.9%) reported experiencing a menstrual cycle while on duty with COVID-19 patients, out of which 40 (24.8%) experienced irregular periods, 23 (14.2%) experienced premenstrual stress, and 98 (60.8%) suffered from dysmenorrhoea during menstruation. Additionally, 155 (96.4%) were unable to change sanitary pads, 18 (11%) had stained PPE suits, and 146 (99.9%) experienced challenges in the disposal of sanitary napkins. Conclusion: Many FHCWs felt that PPE offered protection but also compromised work efficiency. Sweating, discomfort, and managing menstrual hygiene within PPE were common challenges encountered. Providing training on PPE usage, adjusting shift durations, implementing policies for the supply of sanitary pads, permitting breaks for changing, ensuring proper disposal arrangements, providing necessary medications and additional PPE if required, leaves, or creating alternative duty arrangements would be beneficial for FHCWs. [ABSTRACT FROM AUTHOR]

Introduction: As per the new classification of Cancer Cachexia (CC), the clear distinct precachexia stage can be identified, enabling early interventional strategies to retard the progression of CC. Given its recent classification and potential to prevent the onset of CC, it is imperative to study its awareness among Oncology Health Care Providers in India. Aim: To assess the Knowledge, Attitude, and Practices (KAP) of diagnosing and managing CC in a group of oncologists and Onco-physiotherapists in India. Materials and Methods: This was a survey-based crosssectional study. The surveys were disseminated through various Indian Oncology professional organisation bodies in the country via emails from May 2020 to April 2021. Two survey questionnaires were formulated and validated based on a literature review and input from experts in the field. A total of 64 oncologists with an average of 11.96±8.49 years of experience and 53 physiotherapists with an average of 3.86±4.89 years of experience participated in the survey. Data was analysed using descriptive statistics. Results: In the knowledge domain, oncologists considered muscle wasting (37, 58%), weight loss (36, 57%), and loss of appetite (18, 14%) as the most accurate determinants of CC, and Onco-physiotherapists considered weight loss (18, 34%), muscle wasting (16, 30%), and loss of appetite (11, 21%) as the most accurate determinants. In the attitude domain of both surveys, nutritional therapy was considered an extremely important treatment. In the practice domain, the results showed that the majority of Oncologists (25, 39%) would initiate treatment at a weight loss of >5% when the stage of cachexia or refractory cachexia may have set in, while Oncophysiotherapists (23, 43%) would do so at 5%. Conclusion: These surveys suggest a knowledge-to-action gap and highlight the need for increased awareness about CC among cancer healthcare providers for optimal patient care. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia not only impairs physical growth but also affects behavioral and cognitive abilities. Past studies have proved that increased haemoglobin levels result in improved Central Nervous System (CNS) functions. However, there is a significant lacuna between cognition and anaemia among young adults, especially females. Aim: To assess the cognitive ability of female undergraduate dental students with and without anaemia. Materials and Methods: This cross-sectional study included 100 young female dental students, aged between 18 and 23 years, who presented in the Department of Physiology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India, from February to July 2019. Haemoglobin levels were analysed using the colourimetric cyanmethemoglobin method with Drabkin's solution, and based on this, the students were divided into anaemic and non anaemic groups. Cognitive status was assessed using the Digit Symbol Substitution Test (DSST), letter cancellation test, and Stroop test. The Student's t-test and Pearson's correlation were used to examine the association between haemoglobin levels and cognition. Results: The mean age in the anaemic group and non anaemic group was 19.95±1.80 years and 19.64±1.60 years, and the Body Mass Index (BMI) was 19.54±1.62 kg/m² and 19.32±1.43 kg/m², respectively. Haemoglobin levels were significantly lower in the anaemic subjects at 10.408 gm/dL compared to the non anaemic subjects (p-value<0.001). A statistically significant difference was observed between the two groups on DSST scores (21.10±2.99 versus 32.60±14.69), letter cancellation test (25.80±4.63 versus 35.80±4.56), and Stroop test (132.10±8.15 versus 123.56±10.52). Conclusion: The present study reported a significant association between anaemia and cognitive function. Therefore, early screening and prompt treatment of anaemia are crucial for improving both physical as well as mental health. [ABSTRACT FROM AUTHOR]

Introduction: Women undergo menstruation as part of their normal physiological cycle. In Indian society, it is associated with taboos, myths, misbelieves and malpractice. Majority of adolescent girls are unprepared in terms of knowledge, attitude and hygienic practices for managing the menstrual cycle when they enter menarche. A better understanding of the scientific process of menstruation and good menstrual hygiene is very crucial for the health and well-being of adolescent girls. Unsafe practices are associated with unwanted outcomes. Aim: To assess the knowledge, beliefs and sources of information adolescents have about menstruation, along with their management of menstrual hygiene. Materials and Methods: The present school-based crosssectional study was conducted in 2019 in Vadodara, Gujarat, India, among 240 adolescent girls of 14-17 years of age using multistage sampling methods. Data were collected by using pre tested, structured self-administered questionnaire after having informed consent. Results: A total of 98 (40.8%) of girls were aware of menstruation before attaining menarche; 19.58% and 54.17% of girls did not knew about the cause and source of the menstrual bleeding, respectively; 55.42% girls used only sanitary pads whereas 43.33% used both old clothes and sanitary pads as the absorbents. A 46.25% changed absorbent frequently (≥4 times in a day). A 54.17% washed their genitals frequently. The most common method of absorbent disposal was disposal in a dustbin. Mother was the main source of information regarding menstruation. Conclusion: Majority of adolescent girls were not having enough knowledge regarding menstruation and their menstrual practices are inexact. This is requisite for menstrual hygiene programme. [ABSTRACT FROM AUTHOR]

Introduction: Dementia is a broad medical term that describes the progressive cognitive decline of brain function due to disease or impairment, resulting in interference with daily activities. Magnetic Resonance Imaging (MRI) is commonly used for the clinical diagnosis of dementia by identifying cerebral atrophy and structural alterations. Furthermore, Magnetic Resonance Spectroscopy (MRS) can detect biochemical abnormalities in dementia patients, which may be beneficial for early diagnosis and treatment. Aim: To provide a comprehensive protocol and a guidance tool for radiologists to effectively diagnose dementia and its subtypes {Alzheimer's Disease (AD), frontotemporal lobe dementia, etc.} based on radiological findings coupled with volumetry, spectroscopy, and Arterial Spin Labelling (ASL) findings. Materials and Methods: A retrospective observational study was conducted in the Department of Radiology, Nanavati Max Superspeciality Hospital, Mumbai, Maharashtra, India, between June 2022 and June 2023. A total of 125 patients were analysed to observe the correlation between whole brain volume, Intracranial Volume (ICV) of different cortical regions, hippocampal atrophy, and MRS findings. Descriptive statistics were used, and results were expressed as means and standard deviations for continuous variables, and as frequencies and percentages for categorical variables. Results: Out of 125 patients, 71 (56.8%) were males, and 54 (43.2%) were females, with ages ranging from 41 to 96 years. The majority presented with Mild Cognitive Impairment (MCI) 36 patients (28.8%) and Vascular Dementia (VaD) (18 patients - 14.4%). Some clinical features and imaging findings overlapped, resulting in some cases being a combination of different types of dementia. MRI, MRS, and Medial Temporal Atrophy (MTA) played a crucial role in allowing clinicians to perform a differential diagnosis. Conclusion: The use of MR volumetry and spectroscopy aids in classifying the type of dementia, which, in turn, gives treating clinicians a better perspective for further treatment and its outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The use of absorbable suture materials in surgical procedures is a critical aspect of wound closure and tissue repair. In recent years, there has been growing interest in exploring the potential benefits of incorporating Hyaluronic Acid (HA), a naturally occurring biopolymer, into these sutures. By shedding light on the interactions between HA and absorbable sutures, the present study seeks to provide valuable insights that could enhance the quality of surgical wound management. Aim: To assess the mechanical properties and antimicrobial effects of HA-coated and uncoated absorbable suture material. Materials and Methods: The in-vitro study was conducted at Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India in a year 2022. A total of 70 samples of HA-coated and uncoated Vicryl 4-0 suture material were tested for tensile strength using an Instron machine. An anti-bacterial effect against Pseudomonas aeruginosa and Streptococcus mutans was assessed using a Mueller Hinton agar (MHA) plate, and the zone of inhibition was measured. Additionally, both the uncoated and HA-coated Vicryl 4-0 suture materials were analysed under the Scanning Electron Microscope (SEM) to determine the surface characteristics. An independent t-test was used to compare the tensile strength of coated and uncoated suture materials. Results: The mean tensile strength of uncoated and HAcoated suture material was 6.47±0.23 MPa and 3.78±1.02 MPa, respectively. The difference between both groups was statistically significant (p<0.05). For Pseudomonas aeruginosa and Streptococcus mutans, the zone of inhibition was 8.0±0.5 mm in diameter and 9±0.5 mm in diameter, respectively, around coated Vicryl 4-0 suture material, whereas no zone of inhibition was observed for both Pseudomonas aeruginosa and Streptococcus mutans around uncoated suture material. SEM analysis showed superior surface characteristics of HA-coated suture thread when compared to uncoated suture thread. Conclusion: HA-coated suture material does not exhibit superior tensile strength when compared to the uncoated suture material. However, HA-coated suture material has potent antibacterial effects against Pseudomonas aeruginosa and Streptococcus mutans. Additionally, SEM analysis showed improved surface characteristics in favour of the coated suture material. [ABSTRACT FROM AUTHOR]

Introduction: The Self-Directed Learning (SDL) approach is an important component of the Competency-Based Medical Education (CBME) curriculum. However, learning independently can be challenging, even for the brightest and most motivated students. Moreover, self-evaluation is quite difficult. If SDL is used in combination with formative assessment and constructive feedback for individual topics, it would facilitate self-modulation by learners and guide them towards higher academic achievement. Aim: To compare the academic performance of first-year medical students in Anatomy Practical class using SDL with formative assessment and feedback versus conventional teaching methods. Materials and Methods: A comparative evaluation was conducted using a longitudinal study design in the Department of Anatomy, Medical College Kolkata, West Bengal, India, from November 2022 to June 2023. During Anatomy Practical classes, 250 first-year medical students, (Batch 2022-2023), were divided into two equal groups using simple random sampling through a lottery method. One group (study group) was taught by implementing SDL followed by formative assessment with immediate feedback, and the other group was taught by the traditional method (control group). Following the completion of each of the first three consecutive regions (superior extremities, inferior extremities, and thorax) during Anatomy Practical classes, summative assessments were conducted. The collected data were calculated in an Excel sheet and computed using JAMOVI software (free version). Independent t-test statistics for the three summative assessments were evaluated, and the p-value of each assessment was determined. A p-value <0.05 was considered to be statistically significant. Additionally, students' feedback was documented and analysed. Results: It was observed that there was an improvement in academic scores in both groups. However, higher academic performance was progressively attained in the group which was provided SDL sessions and formative assessment with immediate feedback. A total of 55 (80%) students passed the third summative assessment in comparison to 40 (59.7%) students of the control group who passed the same exam. Differences between the means of the control and study group were found to be statistically significant (p-value≤0.001 and 0.023 in two summative assessments). Conclusion: The present study revealed that SDL with formative assessment followed by immediate feedback during Anatomy Practical classes had a remarkable positive impact on students' academic performance compared to those students taught using conventional teaching methods and might be implemented in the future for better learning and improved academic achievement of students. [ABSTRACT FROM AUTHOR]

Introduction: Self-directed Learning (SDL) has been suggested as a principle of adult learning to promote lifelong learning abilities among students. Though SDL is not a new concept, there is a lack of uniform implementation across the institutions in India. The Competency-based Medical Education (CBME) proposed by the National Medical Commission in 2019 has emphasised SDL for medical students. Aim: To evaluate the effectiveness of an online, case-based SDL activity in Biochemistry for the first-year MBBS students. Materials and Methods: This was a quasi-experimental study conducted at Father Muller Medical College, Mangaluru, Karnataka, India from May to July 2021. A purposive sampling technique was used, and 138 first-year MBBS students were enrolled for the research. The topic of lipid metabolism was chosen for SDL. Parallel to the online didactic lectures, a casebased, team-based, online SDL was implemented. Students were provided with case scenarios and were instructed to discuss the case scenarios and find answers to the accompanying questions in allotted groups for 15 days. A three-hour session was held for the presentation of the SDL, followed by a posttest and reflections of students. The data were analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The significance of the difference in pretest and post-test scores was assessed by paired t-test, and the level of significance was set at a p-value <0.05. Qualitative data were subjected to descriptive statistics, and thematic analysis of reflections was conducted. Results: The average post-test score of the participants was significantly higher by 99.3% compared to the pretest score (p-value <0.001). On average, 108 out of 138 (78.2%) agreed (agree/strongly agree) that SDL helped them to achieve the learning objectives,115 (83.3%) agreed that SDL helped them to develop as lifelong learners, 115 (83.3%) agreed that SDL helped them to develop as a health professional, and 83 (60.1%) agreed that enjoyed learning in online mode. The inclination of 110 (79.7%) students to have more SDL sessions in the future shows a behavioural change in favour of SDL. Time constraints and internet connectivity were the main challenges. Conclusion: SDL was effective and was received positively by the majority of the students. It is the need of the hour to develop lifelong learning and critical thinking among medical students and to make learning interesting with the use of case scenarios. Future research should assess the intermediate and long-term outcomes of case-based SDL on learning, behavioural changes, and its impact on patient care and the health of society. [ABSTRACT FROM AUTHOR]

Introduction: Patients who have had a stroke often experience issues with static balance while sitting and standing. Additionally, they may encounter problems with dynamic balance, particularly when transitioning between sitting and standing positions, leading to reduced postural stability in both static and dynamic standing. This also contributes to weakness in the affected lower limb and decreased engagement in Activities of Daily Living (ADL). Nevertheless, few studies have investigated the impact of sit-to-stand training on balance, muscle strength, and ADL in stroke patients. Aim: To assess the impact of sit-to-stand training on balance, muscle strength, and ADL in patients who have had a stroke. Materials and Methods: This trial was an experimental, parallel, and assessor-blinded allocation with a computer-generated randomisation sequence. Sixty-six stroke patients (33 in each group) were enrolled from the inpatient Department of Medicine and the neurosurgery ward of Justice KS Hegde Charitable Hospital in Deralakatte, Mangaluru, Karnataka, India based on specific selection criteria. The trial was conducted from March 2022 to March 2023. Inclusion criteria included patients who had experienced a stroke involving the Anterior Cerebral Artery (ACA) and Middle Cerebral Artery (MCA), encompassing both ischaemic and haemorrhagic types of stroke, aged between 35-60 years, and including both male and female stroke patients who were able to effectively communicate and comprehend instructions. Other criteria included a Mini-Mental State Examination (MMSE) score greater than or equal to 23, the ability to independently have a transition from a supine position to a seated position, and a minimum score on the trunk impairment scale. In the experimental group, participants received sit-to-stand training for 45 minutes over five days, while the control group received conventional physical therapy, including tandem walking, single leg stance, double leg stance, early mobilisation, position and balance training exercises for 45 minutes over five days. The primary outcomes used for balance assessment were the Berg Balance Scale (BBS), and for ADL, the Barthel Index (BI) Scale was used, with muscle strength being measured using a push and pull dynamometer. The independent sample t-test was used to compare between groups, and within-group comparisons were conducted using the paired t-test. A p-value <0.05 was considered significant. Results: Significant differences (p-value=0.044) were observed in BBS score and muscle strength between the groups during both the pretest (Day-1) and post-test (Week-1). The BI exhibited a significant difference (p-value=0.016) during the post-test (Week-1) only. Additionally, a significant difference (p-value<0.001) was found in muscle strength, specifically in the Hip Extensors (HE) between the groups. Conclusion: The results of the current study showed a statistically significant difference in muscle strength of the HE. However, no significant difference was observed in BI and BBS between the groups. No side-effects or harms were reported, indicating that the approach is safe and feasible for stroke patients. [ABSTRACT FROM AUTHOR]

Introduction: Public awareness of the COVID-19 pandemic has resulted in a reduction in healthcare utilisation for other diseases. Understanding how the COVID-19 pandemic affects hospital admissions and the disease patterns is crucial for proper triaging and planning of health resources in future pandemics. Aim: To compare the clinical spectrum of paediatric inpatients in the post-COVID-19, pre-COVID-19 and during COVID-19 pandemic periods in a tertiary level teaching centre. Materials and Methods: This ambispective study was conducted at the Paediatrics Department of SAT, Govt. Medical College, Thiruvananthapuram, Kerala, India. The analysis included all cases hospitalised from April 2019 to March 2022, with the data divided into three time periods. The discharge diagnoses of all cases admitted during the study period were coded according to the ICD-10 criteria and included in the analysis. Differences in admissions, disease patterns, and ICU admissions during the three time periods (pre-COVID-19, post-COVID-19, and during COVID-19) were compared using oneway ANOVA and Tukey's post-hoc test. Results: In the present study, ward admissions (p-value <0.001), respiratory infections (p-value 0.031), asthma (p-value 0.009), and chronic systemic diseases (p-value 0.018) decreased in the post-COVID-19 period compared to the pre-COVID-19 period, whereas ICU admissions (p-value 0.010) and Diabetic Ketoacidosis (DKA) (p-value 0.002) increased. When comparing COVID-19 and post-COVID-19 periods, there was an increase in ward admissions (p-value 0.01), respiratory infections (p-value 0.018), and diarrhoea (p-value 0.029), but a decrease in the proportion of ICU admissions (p-value 0.01). There was no significant difference in mortality among the three time periods. Conclusion: There was a significant difference in the clinical spectrum of paediatric inpatients. The significant decrease in admissions of chronic systemic diseases, which require regular follow-up for management changes, raises concerns about the potential impact on patient care. [ABSTRACT FROM AUTHOR]

Introduction: During the Coronavirus Disease-2019 (COVID-19) pandemic, the world has experienced many changes, including increased computer and internet usage. Spending more time on computers can lead to the development of various postural problems, resulting in pain and inefficiency in the workplace. Aim: To assess the knowledge of computer ergonomics among third and final year Bachelor of Dental Surgery (BDS) students at VSPM's dental college in Nagpur, Maharashtra, India. Materials and Methods: This cross-sectional, questionnairebased study was conducted on third and final year students between November 2020 and February 2021 in the Department of Oral Medicine and Radiology at VSPMDCRC, Nagpur, Maharashtra, India. Ethical clearance was obtained from the Institutional Ethical Committee (IEC/VSPMDCRC/15/2020). A self-administered questionnaire, formulated and validated by independent subject experts, was used. A total of 216 students were included in the study over a two-month period. Informed consent was obtained from the students. The questionnaire consisted of 34 questions on computer usage and knowledge of ergonomics, and the responses were recorded. Descriptive statistics were performed using Statistical Packages for Social Sciences (SPSS) version 20.0 for Windows. Quantitative data were expressed as mean and standard deviation. The association between categorical variables was checked using the Chi-square test, with a significance level set at 5%. Results: The mean age of the students was 22.20 years total of 216 students, including 158 females and 58 males, were included in the study. The results showed that 20.37% of third year students (44/96) and 31.48% of final year students (68/96) were aware of the term "ergonomics". The majority of students were unaware of the principles of ergonomics. However, 169 (78.2%) students knew the correct position of the head and neck while using a computer. Additionally, 164 (75%) students were aware of the need for lower back support, 167 (77.3%) were aware of the placement of input devices, and 174 (80.6%) were aware of the alignment of devices. Moreover, 168 (77.8%) subject knew that the monitor and working surface should be glare-free, and 120 (55.6%) were aware that a sloped desk surface is required for reading or writing. Furthermore, 157 (72.7%) subjects used a headset or speakerphone while writing, typing, or talking on the phone, and 164 (75.9%) subjects took regular eye breaks. Conclusion: The present study highlights a lack of practical knowledge and application of ergonomics among the participants. There is a need to prioritise creating awareness and developing healthy ergonomics practices among dental students through Continuing Dental Education programs (CDE). The authors also recommend that the curriculum for healthcare courses should incorporate healthy ergonomics practices as a part of the curriculum. [ABSTRACT FROM AUTHOR]

Introduction: The success of root canal procedures depends on cleaning and shaping of canals. There are several instrumentation techniques available for root canal preparation. Recently, exclusive rotary file systems called Kedo-SG Blue and Prime-Pedo have been introduced for root canal preparation in primary teeth. The inherent flexibility of these files allows them to preserve the anatomy of curved canals in primary molars. Aim: To compare the instrumentation time, obturation time, and quality of obturation using two paediatric rotary file systems, Kedo-SG BlueTM and Prime-PedoTM, in mandibular primary molars. Materials and Methods: A randomised clinical trial was conducted in the outpatient Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore Andhra Pradesh, India, from February 1, 2019 to January 20, 2020. Fifty primary molars with necrotic pulp were included and randomly divided into two groups, with 25 teeth in each group. Group 1 and Group 2 were instrumented with Kedo-SG BlueTM and Prime-PedoTM, respectively. The time taken for instrumentation and obturation was noted in minutes, and the quality of root canal filling was recorded as optimal, underfilled, or overfilled. The data were statistically analysed using an independent Student's t-test for time measurements and a Chi-square test for the quality of obturation. Results: There was a statistically significant difference in instrumentation time and obturation time between the two groups (p-value=0.009; 0.011). The Kedo-SG BlueTM rotary system showed a better quality of obturation compared to the Prime-PedoTM rotary system, although the difference was not statistically significant (p-value=0.22). Conclusion: The Kedo-SG BlueTM rotary system demonstrated shorter instrumentation and obturation times, as well as a higher number of optimally filled canals compared to the Prime-PedoTM rotary system. Therefore, the Kedo-SG BlueTM rotary system exhibited better clinical performance in primary molars than the Prime-PedoTM rotary system. [ABSTRACT FROM AUTHOR]

Introduction: Transurethral Resection of the Prostate (TURP) is a gold standard treatment for Benign Prostatic Hyperplasia (BPH). The Clavien classification system was proposed in 1992 to grade complications of general surgery, which was then modified in 2004 by Dindo. In 2017, the European Association of Urology (EAU) endorsed its use for reporting complications in urological procedures. However, the system relies on observers to grade complications, and different observers may assign different grades to the same negative outcome, highlighting the need for uniformity. Aim: To assess the inter-observer reliability and uniformity among urologists in reporting complications of TURP using the modified Clavien-Dindo classification system. Materials and Methods: A retrospective observational study was conducted at Department of Urology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2018 to May 2023. The study included symptomatic patients with BPH and prostate gland sizes greater than 40 cc. Negative outcomes were evaluated and complications were rated by nine different raters. Inter-observer reliability was tested using weighted kappa with Statistical Package for Social Sciences (SPSS) version 21.0 (Fleiss’s kappa test). Results: A total of 523 men with BPH who underwent TURP were evaluated, with a mean age of 66.7±5.2 years and a mean prostate volume of 62 cc. Adverse events occurred in 96 patients (18.36%), and these complications were classified according to the Clavien-Dindo System (CDS) by nine different blinded observers. The rating of these complications was then assessed for concordance. A concordance rate using weighted kappa of 0.847 was observed, indicating high inter-observer reliability for TURP. Conclusion: Clavien-Dindo’s system demonstrated good interobserver concordance and reliability. Some modifications to the grading system are needed, taking into account the impact of pre-existing co-morbidities and auxiliary procedures. Largescale prospective studies are recommended to further validate these findings. [ABSTRACT FROM AUTHOR]

Introduction: In Laryngopharyngeal Reflux (LPR), refluxate rich in acid, pepsin, and bile regurgitates above the upper oesophageal sphincter onto the laryngeal mucosa. However, not all patients with LPR present with subjective voice changes. This may be due to a gradual change in voice that remains unnoticed. The clinical subtlety is important for diagnosis or at least awareness for better treatment and care. Aim: To objectively determine preclinical acoustic changes in patients with LPR who have not reported any voice complaints. Materials and Methods: This cross-sectional study was conducted on adult patients visiting the Out-patient department of a Tertiary Care Teaching Institute in Northern India, from September 2022 to October 2022. Patients with LPR but without voice changes were included in the study. They underwent multidimensional voice analysis during the phonation of the vowel /a/. Mean fundamental frequency (MF0), absolute jitter, absolute shimmer, and Soft Phonation Index (SPI) were analysed for the sample and compared to the gender-specific mean values provided by the software used. Statistical significance was determined using the one-sample t-test. Results: A total of 27 participants (20 females, 7 males) completed the study. In the female group, the mean MF0 (204.30±32.49 Hz) was significantly lower, absolute jitter (92.41±87.93 μs), absolute shimmer (0.38±0.31 dB), and SPI (25.62±15.24) were significantly higher than the reference mean. In the male group, the mean MF0 (138.03 Hz), absolute jitter (104.01±84.28 μs), and absolute shimmer (0.34±0.16 dB) were not significantly different from the reference mean. However, SPI (25.09±16.95) remained significantly higher than the reference mean. Conclusion: Increased jitter, shimmer, and SPI are primary acoustic changes observed in patients with LPR. These changes appear even before patients experience any voice changes. [ABSTRACT FROM AUTHOR]

Introduction: The course of outcome in non traumatic neurological illnesses, such as acute encephalitis syndrome, meningitis, paediatric stroke, metabolic encephalopathy, etc., can be affected by various risk factors. While there have been many studies evaluating the effects of blood pressure on outcomes in traumatic brain injury, there is a dearth of studies assessing Mean Arterial Pressure (MAP) in non traumatic injury, particularly in the paediatric age group. Aim: To examine the association between MAP and outcomes in children with acute non traumatic neurological illnesses in the Paediatric Intensive Care Unit (PICU), focusing on mortality and length of PICU stay. Materials and Methods: This prospective cohort study was conducted at Gandhi Medical College, Bhopal, Madhya Pradesh, India from September 2021 to August 2022. A total of 249 children aged between 1 to 14 years with acute non traumatic neurological illnesses were included, and their mean blood pressure was recorded. Associated co-morbidities (severe anaemia, respiratory failure, sepsis, and acute kidney injury), mean length of hospital stay, and outcome were also assessed. Categorical variables were analysed using either the Chi-squared (χ² ) test or Fisher’s exact test, while continuous variables were assessed using the Analysis of Variance (ANOVA) test for mean length of stay. Results: Out of the 249 subjects, 157 (63.1%) were male, and 143 (57.4%) belonged to the age group of 1-5 years. Among them, 36 (14.5%) experienced hypotension, and 17 (6.8%) had hypertension during their PICU stay, while 196 (78.7%) had normal blood pressure. Abnormal MAP was significantly associated with a higher mortality rate among the study subjects (p-value<0.001), and the mean length of PICU stay was significantly longer (p-value<0.001) in study subjects with abnormal MAP. Conclusion: Both high and low MAP were significantly associated with higher mortality and longer duration of stay in children with acute non traumatic neurological illnesses. [ABSTRACT FROM AUTHOR]

Introduction: Acute myocardial infarction has reached epidemic proportions in the Indian population. The premature onset of acute myocardial infarction has shifted the focus of research. An abnormal frontal QRS-T angle can be used as a marker of acute myocardial infarction and can also predict Major Adverse Cardiac Events (MACE) such as heart failure, complex ventricular arrhythmias (sustained ventricular tachycardia or ventricular fibrillation), early post-infarction angina, mechanical complications, and cardiac death resulting from acute myocardial infarction. Predicting the likelihood of serious adverse cardiovascular events and mortality in patients who have experienced an acute myocardial infarction aids in developing immediate and short-term treatment plans. Aim: To assess the association between the Frontal QRS-T angle and MACE among patients with Acute Myocardial Infarction (MI). Materials and Methods: A cross-sectional study was conducted on adult patients admitted with a diagnosis of acute MI at the Department of Medicine, BLDE (Deemed to be University) Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India from January 2021 to June 2022. A total of 95 patients were enrolled in the study and classified into two groups: Group A (n=68) with a frontal QRS-T angle of <100 degrees, and Group B (n=27) with a frontal QRS-T angle of >100 degrees. The patients were monitored for the emergence of serious MACE such as heart failure, pulmonary oedema, cardiogenic shock, arrhythmias, and death while they were in the hospital. Statistical analysis was performed using the Chisquare test, Independent t-test, and Mann-Whitney U test as applicable. A p-value of <0.05 was considered statistically significant. Results: The most common age group in Group A was 60-70 years, while in Group B it was 50-60 years. A total of 95 patients with acute MI were enrolled and divided into two groups. Out of 95 patients, 68 patients with a frontal QRS-T angle <100 degrees were in Group A, and 27 patients with a frontal QRS-T angle >100 degrees were in Group B. There was a significant difference between the two groups with respect to MACE, including heart failure (Group A=8.8%, Group B=77.8%, p=0.00), pulmonary oedema (Group A=10.3%, Group B=77.8%, p=0.00), and cardiogenic shock (Group A=7.4%, Group B=40.7%, p=0.00). Conclusion: A frontal QRS-T angle of >100 degrees was a reliable factor for assessing in-hospital major adverse cardiac outcomes such as heart failure, pulmonary oedema, and cardiogenic shock. Hence, a frontal QRS-T angle of >100 degrees on a 12-lead ECG is a cost-effective, reliable, and noninvasive parameter of MACE in patients with acute MI. [ABSTRACT FROM AUTHOR]

Introduction: Challenging behaviours are frequently observed in children diagnosed with Autism Spectrum Disorder (ASD), potentially hindering their daily functioning. As the prevalence of autism continues to rise, the array of challenging behaviours, including repetitive patterns, stereotypes, and self-harm, emphasizes the importance of developing effective interventions in occupational therapy. These interventions aim to manage these challenging behaviours and enhance the overall wellbeing and functionality of these children. Aim: To compare the effectiveness of Functional Communication Training (FCT), Sensory Integration Therapy (SIT), and Behavioural Interventions (BI) on challenging behaviours in children with ASD. Materials and Methods: An experimental study with prepost test design was conducted in the Paediatric Unit of the Department of Occupational Therapy, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India. The duration of the study was nine months, from September 2020 to May 2021. A total of six (N=6) children selected through convenience sampling. The SIT took place at the paediatric unit of the occupational therapy department at SRM Medical College Hospital & Research Centre, Kattankulathur, Chennai, Tamil Nadu, India. Due to Coronavirus Disaese-2019 (COVID-19) restrictions, FCT and BI were conducted simultaneously at the participants’ homes. Outcomes were measured using Functional Behavioural Assessment (FBA) and the Repetitive Behaviour Scale-Revised (RBS-R). Within-group analysis involved utilising the Wilcoxon signed-rank test, while between-group analysis entailed the application of the Kruskal-Wallis and one way Analysis of Variance (ANOVA) test. Results: The mean age of the study participants was 7.83±1.83 years. A significant reduction in challenging behaviours was seen in all six children in the three intervention groups when outcomes were measured using FBA (p<0.05). Among these interventions, BI proved to be the most effective in reducing the frequency of challenging behaviours in children with ASD, as evidenced by a mean post-test score of RBS-R (19.50±12.02 for BI, compared to 20±1.41 for SI and 23±11.31 for FCT, p=0.047). Conclusion: The results of the study indicated that all three interventions - SIT, FCT, and BI successfully decreased the occurrence of challenging behaviours in children with ASD. [ABSTRACT FROM AUTHOR]

Introduction: The quality of Gutta-percha (GP) filling techniques depends on canal dimensions and anatomy. Thermoplasticised GP obturation techniques need to be modified in accordance to the root canal space anatomy. Aim: To evaluate the efficacy of continuous wave and modified continuous-wave compaction GP techniques in obturating ovoid canals. Materials and Methods: The present in-vitro study was carried out in the Department of Conservative Dentistry and Endodontics in MGMDCH, Navi Mumbai, Maharashtra, India, from October 2019 to December 2019 on 45 single rooted human teeth were selected and mounted in Eppendorf tubes. The canals were cleaned and shaped using the Protaper Next rotary system. The specimens were divided into three groups based on the obturation technique: Group 1-Lateral Compaction (LC), Group 2-Continuous Wave Compaction (CWC), and Group 3-modified continuous-wave compaction. After obturation, the specimens were radiographed in labial and distal views. Subsequently, the specimens were removed from the Eppendorf tubes, and the extrusion of filling materials was assessed. The radiographic images were analysed using image analysis software, and the void area was measured. The obtained data was tabulated and statistically analysed using the Kruskal-Wallis test, followed by Post-hoc Dunn’s test. Results: The warm compaction techniques showed denser obturations compared to LC and were statistically significant (p<0.0001) by the Kruskal-Wallis test in the distal view. Post-Hoc analysis using Dunn’s test for the density of obturation in the distal view showed a statistically significant difference between Group 1 compared to Group 2 (p=0.000002*) and Group 3 (p=0.000204*). Extrusion in Group 3 was comparable to Group 1, while the highest extrusion was observed in Group 2. Conclusion: The modified continuous warm compaction technique showed dense and homogenous obturation comparable to the continuous wave technique and outperformed the LC technique. Additionally, the modified continuous warm compaction technique exhibited less extrusion compared to the continuous warm compaction technique. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition is a critical health problem in many countries, including India. The main reason for this is incorrect dietary habits that lead to illness and infections in early childhood. Inadequate food intake can hinder the growth and development of children. Childhood malnutrition can impair psychological and intellectual development, which can subsequently result in low school performance and behavioural disturbances. Therefore, child nutrition is of utmost importance. The knowledge and feeding practices of mothers can significantly influence child nutrition. Hence, it is essential to study the knowledge, feeding practices, and nutritional status of children as influenced by their mothers. Aim: To was to determine the correlation between the knowledge of mothers regarding child nutrition, their feeding practices, and the nutritional status of children. Materials and Methods: A cross-sectional correlational study was conducted in a 1050-bed multispecialty tertiary care hospital in Mangaluru, Karnataka, India, from December 30, 2021, to August 30, 2022. A total of 150 children under the age of five, visiting the hospital accompanied by their mothers, were selected as study participants using a non probability convenience sampling technique. Data was collected using a demographic proforma, a structured knowledge questionnaire on child nutrition, a structured checklist on feeding practices, and anthropometric measurements of children, which were taken using a digital weighing scale and stadiometer. Descriptive statistics including mean, frequency, percentage, Karl Pearson's correlation coefficient, and World Health Organisation (WHO) Anthro software were used for statistical analysis. Results: The majority of the study participants, 96 (64%), had average knowledge regarding child nutrition, while all of them had good child feeding practices. Regarding the nutritional status of the children, the majority fell under the normal category based on weight for height (123, 82%), weight for age (118, 78.67%), and height for age (104, 69.33%). The study also revealed a significant correlation between the knowledge of mothers, feeding practices, and nutritional status of children (p-value <0.05). Conclusion: The study concluded that although majority of the study participants had a normal nutritional status and their mothers had average knowledge, regular awareness programs could be conducted, and the nutritional status of children needs to be regularly monitored. [ABSTRACT FROM AUTHOR]

Introduction: Direct Pulp Capping (DPC) aims to retain the pulp's health by sealing it against microbes and stimulating the formation of a dentin bridge at the exposure site. It has been proven that natural antimicrobial proteins, when used as therapeutics in conjunction with traditional chemotherapeutic agents, have increased efficacy and presumably diminished the incidence of chemoresistance. Hence, the efficacy of Bromelain with Biodentine and Biodentine as isolation materials for DPC will be evaluated and compared in the present study. The success and durability of DPC depend on the type of material used. Thus, the present study focuses on evaluating and considering a combination of materials for DPC that can be used in clinical practice. Need for the study: By addressing the limitations of current materials and formulating a novel combination, the present study aims to contribute to the advancement of material science, providing solutions that meet the demands of this era. Such a breakthrough would not only enhance the performance and longevity of materials but also have a significant positive impact on the preservation of pulp vitality, promoting overall well-being and improved outcomes in healthcare applications. Aim: To evaluate and compare the efficacy of Bromelain with Biodentine and Biodentine in isolation as DPC materials. Objectives: The study aims to evaluate and compare the setting time, flow, solubility, compressive strength, adhesion, and radiopacity of bromelain with biodentine and biodentine in isolation. Materials and Methods: An in-vitro study will be conducted in the Department of Conservative Dentistry and Endodontics at Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India, for a duration of nine months from May 2023 to February 2024. Standard discs of freshly mixed materials (n=10 samples per material) will be prepared. Compressive strength, solubility in distilled water, setting time, flow, radiopacity, and adhesion of Bromelain with Biodentine and Biodentine in isolation will be evaluated and compared in accordance with the International Standard ISO 6876:2001. Results will be analysed using Tukey's Honest Significant Difference (HSD) posthoc test, one-way Analysis of Variance (ANOVA), and student's t-test. [ABSTRACT FROM AUTHOR]

Introduction: Many school children experience psychological inflexibility, which leads to anxiety regarding their academic wellbeing, subsequently affecting their psychological well-being. The objectives of the present study were to investigate the relationship between psychological inflexibility and academic anxiety among school children, understand the sociodemographic characteristics of the selected participants, and identify significant mean differences in subgroups based on sociodemographic details in relation to psychological inflexibility and academic anxiety. Aim: To examine the relationship between psychological inflexibility and academic anxiety in students who were preparing for their board exams. Materials and Methods: A cross-sectional study involved the selection of 348 school children from 9th to 12th grade in Madurai, Tamil Nadu, India, using simple random sampling. Data collection took place from March 2021 to June 2021. The study employed a 17-item Acceptance and Fusion Questionnaire (AFQ-17), a 25-item academic anxiety scale, and a semi-structured interview schedule. The data analysis was performed using the Statistical Package for Social Services (SPSS) software, version 19.0. Descriptive statistics were used, and the Pearson's correlation method was employed to determine the relationship between variables. Additionally, a one-way Analysis of Variance (ANOVA) was conducted to identify significant mean differences between demographic variables, with a 95% confidence level and p-value<0.05 considered as statistically significant. Results: Out of the total 348 participants, majority 184 (52.9%) were in the age group of 16 to 18 years. The results indicate a positive correlation (r=0.117, p<0.05) between the level of psychological inflexibility and academic anxiety among school children. Furthermore, significant relationships were found between psychological inflexibility and academic anxiety in terms of age and gender. Conclusion: The present study highlights a positive correlation between psychological inflexibility and academic anxiety. It emphasises the importance of raising awareness, promoting psychological flexibility, and reducing academic anxiety among school children. [ABSTRACT FROM AUTHOR]

Introduction: The challenge in restorative dentistry is related to changes in the colour of composite over time when exposed to a variety of common beverages, which necessitates additional expenses for the patients. Aim: To compare the colour changes of various composites currently available on the market after exposure to commonly consumed beverages. Materials and Methods: This in-vitro study was conducted from May 2022 to December 2022 in the Department of Conservative Dentistry and Endodontics at Karnavati School of Dentistry in Gandhinagar, Gujarat, India. A total of 120 disc-shaped composite pellets, with 40 specimens for each type of composite (nanohybrid, nanofilled, and microhybrid), measuring 6×2 mm, were prepared and divided into four subgroups based on the beverages used (Distilled water, coca-cola, Tea, and Coffee). The samples were submerged in the respective beverages and kept at 37°C for seven days. Colour assessment was performed using a spectrophotometer before and after immersion. The obtained Commission International de l Eclairage (CIE) ΔE values were recorded after measuring the CIE L*a*b* values. Data analysis was conducted using Statistical Package for Social Sciences (SPSS) software version 20.0, utilising a paired t-test, post hoc Tukey's test, and one-way Analysis of Variance (ANOVA). A significance level of p<0.05 was used. Result: Among all the beverages, the nanofilled composite showed the highest mean colour change, while the nanohybrid composite exhibited the lowest. Overall, the greatest colour change was observed with tea, followed by coffee, coca-cola, and the least with distilled water. In tea, coffee, and cocacola, the nanohybrid composite and nanofilled composite showed a statistically significant difference in mean colour change: 16.74 (p<0.001), -7.29 (p<0.001), and -1.02 (p=0.018), respectively. However, the difference between the nanohybrid and microhybrid composite was statistically insignificant. Conclusion: The nanohybrid composite demonstrated the least mean colour change, followed by the microhybrid composite, while the nanofilled composite exhibited the highest colour change. [ABSTRACT FROM AUTHOR]

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are among the greatest public health challenges around the globe. India ranks the third largest HIV epidemic in the world. People Living With HIV (PLWH) are highly susceptible to life threatening conditions as HIV destroys the body's immune system. Despite anti-retroviral treatments, tackling HIV and AIDS has been an uphill task for decades with all the countries contributing their best to decrease the incidence and mortality rate. But this has been difficult as there are problems in plenty across the globe. Loss of life, economic burden, psychological effects, stigma, discrimination are the perennial problems of HIV and AIDS. Awareness about HIV/AIDS and factors influencing the disease progression is the key to break this cycle. One of the important factors influencing the disease outcome is immune status of an individual. The immune system is highly influenced by nutrition which is an integral part in managing HIV. Nutrition has always contributed to the robust functioning of the immune system of an individual. PLWH almost always have malnutrition which, if not corrected, influences the outcome of HIV infection drastically. With people across the globe showing malnutrition, either under or excess, the immune system functioning is impaired, particularly so in PLWH. Unfortunately, nutrition has been ignored or sidelined in managing HIV/AIDs. This review gives an overview of the interrelation of nutrition and immune system and how these influence the outcomes in PLWH. [ABSTRACT FROM AUTHOR]

Introduction: Passive Microvolume Irrigation (PMI) with Sodium Hypochlorite (NaOCl) has been proposed as a new method for root canal disinfection. It is based on the concept that irregular surface characteristics of endodontic instruments can carry NaOCl into the canal space with controlled fluid volume, without applying any pressure. Aim: To compare and evaluate the efficacy of 3% and 5% NaOCl PMI, Saline PMI, and 3% NaOCl Standard Irrigation (SI) in removing the Smear Layer (SL) from the root canal walls at the cervical, middle, and apical thirds of single-rooted teeth. Materials and Methods: This study was conducted in the Department of Conservative Dentistry and Endodontics at Vishnu Dental College, Andhra Pradesh, India. The study was conducted in February 2018. Forty maxillary central incisors with a single canal, extracted within three months of the study, were collected. The teeth were divided into four groups (n=10) based on the irrigation method: Group-1 (3.0% NaOCl SI), Group-2 (3.0% NaOCl PMI), Group-3 (5.0% NaOCl PMI), and Group-4 (Saline PMI). All samples were instrumented upto F4 size with Protaper rotary files, and a final rinse of 17% Ethylenediaminetetraacetic Acid (EDTA) was used. SL removal was evaluated using Scanning Electron Microscope (SEM). The data were analysed using Statistical Package for Social Sciences (SPSS) 21.0. Statistical tests used were Kruskal Wallis and Mann-Whitney-U tests. A p-value of <0.05 was considered statistically significant for all comparisons. Results: There was no significant difference (p>0.05) in SL removal between 3.0% NaOCl SI, 3.0% NaOCl PMI, and 5.0% NaOCl PMI in the middle and apical thirds of the root canals. However, 5.0% NaOCl PMI showed significantly higher efficiency in SL removal at the cervical third compared to the other groups (p<0.05). Conclusion: Passive microvolume irrigation with 3% and 5% NaOCl showed comparable efficacy to 3% hypochlorite SI in the middle and apical thirds of the root canal. [ABSTRACT FROM AUTHOR]

Introduction: Episiotomy is a common surgical procedure used during childbirth. Approximately 52% of women who have vaginal births undergo episiotomy, with 93.3% of primiparous women and 30.2% of multiparous women being affected. Perineal pain is a prevalent issue among mothers and can negatively impact their daily functioning and early experiences of motherhood. The use of an ice pack on the perineum is a simple, non pharmacological treatment for pain relief that may have an impact on postpartum recovery. However, no study has been conducted to determine the effect of an ice pack on postnatal mothers' compliance with Activities of Daily Living (ADL) following episiotomy. Aim: To evaluate the effect of an ice pack on pain and ADL after episiotomy. Materials and Methods: This trial is an experimental, parallel, and assessor-blinded allocation with a computer-generated randomisation sequence. A randomised controlled trial conducted in the Department of Obstetrics and Gynaecology (OBG) at Justice KS Hegde Charitable Hospital in Deralakatte, Mangaluru, India. The study duration was one year, from March 2022 to March 2023. A total of 64 postnatal mothers (32 in each group) were included. This trial is an experimental, parallel, and assessorblinded allocation with a computer-generated randomisation sequence. The inclusion criteria were primiparous women aged between 18-35 years, who underwent episiotomy within 6 to 24 hours postpartum, delivered a live baby, complained of pain at the incision site, had a full-term labour, and had no other complications during pregnancy or labour. The participants were also required to be literate. Age, Numerical Pain Rating Scale (NPRS), and Barthel Index (BI) were compared between the groups using the independent sample t-test. The paired t-test was used for within group (pre to post-test) comparison of NPRS and Barthel index. A p-value of <0.05 was considered significant. Results: There was a significant difference in pain experienced by the groups, as assessed by NPRS (p<0.001). However, there was no difference in ADL between the groups (p>0.05). No side effects or harms were reported. Ice pack application, once daily for two days, was found to be safe and feasible for postepisiotomy patients. Conclusion: The current randomised controlled trial concludes that the application of an ice pack once daily for two days is significantly effective in reducing pain after episiotomy. However, it does not improve ADL in patients with post-episiotomy. [ABSTRACT FROM AUTHOR]

Introduction: The mere placement of a restoration after obturation carries the risk of the presence of voids between them. These voids reduce overall strength and allow for leakage. The placement of Intraorifice Barriers (IOB) between the restoration and the obturated material has been known to have several advantages, including the prevention of microleakage, enhancement of strength, and improvement in Fracture Resistance (FR). Aim: To evaluate if, Smart Dentin Replacement (SDR) flow plus, Resin Modified Glass Ionomer Cement (RMGIC), and Biodentine increase the FR of Endodontically Treated Teeth (ETT) as IOB. Additionally, the study aimed to compare the FR between roots sealed using Endosequence and AH Plus sealers. Materials and Methods: This in-vitro study was carried out in the Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India over a period of four weeks, from October 2020 to November 2020. The study sample consisted of 160 mandibular premolar roots instrumented using ProTaper gold rotary files. These roots were obturated with Gutta Percha (GP) and divided into two groups based on the sealer used (Group I=Endosequence; Group II=AH Plus). Each group was further divided into four subgroups, including a control group, with each subgroup receiving an IOB. FR was tested using a universal testing machine, and the forces were statistically analysed using Two-way Analysis of Variance (ANOVA), One-way ANOVA, and posthoc Bonferroni tests. Results: SDR offered the greatest FR values of 583.08 N and 612.13 N in groups I and II, respectively. Roots sealed with AH Plus showed greater FR than those sealed with Endosequence. In both groups, the differences between IOB and the control group in terms of FR were found to be highly significant (p<0.001). [ABSTRACT FROM AUTHOR]

Introduction: Baseline expression of p16INK4a characterises cellular senescence. Similarly, the measurement of 1-Gamma-H2AX (1-H2AX) foci levels in cells provides a reliable method for quantification of Deoxyribonucleic Acid (DNA) damage. Aim: To explore the role of p16INK4a and 1-H2AX as biomarkers of senescence in skin tissue. Materials and Methods: This was a cross-sectional study conducted in the Department of Anatomy, PGIMER, Chandigarh, Punjab, India from June 2022 to January 2023. Skin tissue was obtained from 30 cadavers, aged 20-90 years, from the anterior abdominal wall. The time duration of sample collection after death varied from six hours to 12 hours. Samples were divided into two groups: Group-I <30 years and Group-II >70 years, with n=15 in each group. The relative change in the expression pattern of p16INK4a and 1H2AX markers, as well as the microstructure of the skin (thickness of epidermis and dermis, distribution of collagen I/II/III fibres, architecture of sebaceous glands), were statistically analysed using an unpaired t-test. Results: Intense staining was observed with p16INK4a in Group-II, showing positivity in 60.75% of the cells, while Group-I depicted a weak staining pattern (15%). On immunostaining with 1-H2AX, only Group-II cells showed intense positivity (45%). Significant differences were observed in the epidermal and dermal thickness: Group-I (165.5267±37.73 µm; 2394.6±874.13 µm); Group-II (54.6±22.79 µm; 566.67±242.23 µm), and collagen Type-II/III fibres were found predominantly in aging skin tissue. Conclusion: The present study provides comprehensive data regarding age-associated changes between p16INK4a, 1-H2AX, and skin microstructure, which result in decreased repair and regenerative capacity of skin tissue and various age-related skin diseases. [ABSTRACT FROM AUTHOR]

Introduction: Pit and fissure sealants are a reliable and safe method of occlusal caries prevention. Accurate preconditioning of the enamel surface is essential for long-term sealant retention. Aim: To assess the retention rate of pit and fissure sealants applied to first permanent molars treated with air abrasion and acid etching in children aged 6 to 9 years. Materials and Methods: This split-mouth randomised study was conducted in the Department of Paediatric Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India from March 2019 to March 2020. The study included 45 children aged 6-9 years with 180 completely erupted maxillary and mandibular first permanent molars. The children were randomly divided into two groups: Group-I (Air Abrasion) and Group-II (Conventional Acid Etch). After pretreatment of the enamel surface with either air abrasion or acid etching, sealant was applied. Sealant retention was evaluated at 6- and 12-month intervals using Tonn and Ryge's scoring criteria under a dental operating microscope. Statistical analysis was performed using the Wilcoxon Signedrank Test and the Mann-Whitney U Test. Results: The mean age of the study participants was 7.6±0.5 years. At the 12-month interval, complete sealant retention was observed in 23% of teeth in the air abrasion group and 21% in the acid etch group. The p-value of 0.657 indicates that the difference was not statistically significant. The comparison of sealant retention rates in maxillary and mandibular molars treated with both air abrasion (p=0.191, p=0.881) and acid etching (p=1.000, p=0.574) showed no statistically significant differences at both the 6- and 12-month intervals. Conclusion: The retention rate of fissure sealants on enamel surfaces treated with air abrasion was comparable to acid etching. There was no difference in sealant retention rates between maxillary and mandibular molars in both the air abrasion and acid etch groups. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic continues to impact livelihoods worldwide, and in the absence of specific antivirals, the vaccine remains the main weapon against it. Assessing the effectiveness of vaccines against Coronovirus Disease 2019 (COVID-19) in practice is crucial as COVID-19 variants continue to emerge, and public health decisions must be supported by scientific risk-benefit considerations. Aim: To determine the Vaccine Effectiveness (VE) of two doses of the ChAdOx1 nCoV-19 (Covishield) vaccine in preventing laboratory-confirmed COVID-19. Materials and Methods: A test negative case control design was used to determine the VE in total of 702 individuals which included 351 laboratory confirmed cases using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and 351 controls who tested negative among those who attended the testing sites of the Urban Family Health Centre of Government Medical College Kottayam, Kerala, India from July 2021 to September 2021. Details regarding vaccination status, sociodemographic factors, symptoms, and co-morbidities were collected from consented and eligible participants. The collected information was entered into a proforma, which was later entered into MS Excel and analysed using R software version 4.1.3. The groups were compared using binary logistic regression to calculate the adjusted Odds Ratio (aOR) with adjustment for gender, age group, education, occupation, presence of symptoms, and comorbidity status. VE% was calculated as 100 * (1-aOR). Results: The median age (interquartile range) of cases and control was 44 (33-57) years and 50 (35-60) years, respectively. The VE of two doses of the ChAdOx1 nCoV-19 vaccine in protecting against laboratory-confirmed COVID-19 was 87% (95% CI 78-92), with an aOR of 0.13. A separate analysis was conducted to determine the VE among symptomatic individuals, which showed a VE of 89% (95% CI 79-94), with an aOR of 0.11. Conclusion: Two doses of the ChAdOx1 nCoV-19 vaccine are protective against laboratory-confirmed cases of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: In Cerebral Palsy (CP), sensory perception is affected in addition to the motor symptoms. Now-a-days, treatment solely focuses on diagnosed motor deficiencies, often overlooking underlying sensory abnormalities and their examination. Therefore, including a clinical sensory examination in the evaluation of children with CP is crucial. Aim: To develop a validated measure for assessing sensory processing among children with CP. Materials and Methods: This study, conducted as part of a Ph.D. research project, employed an exploratory sequential research design. It commenced on March 1, 2020, and concluded on October 18, 2021, at the Physiotherapy Out Patient Department (OPD) of Swami Vivekanand Subharti University in Meerut, Uttar Pradesh, India. Validity tests, including Scale Level Content Validity Index (CVI) and Spearman rank correlation methods, were used alongside other subtests. The study consisted of two phases: Development and Validation. An extensive literature search and parent interviews were conducted to comprehensively understand and collect information on sensory issues. Based on this information, a preliminary questionnaire draft was created. Three categories of validity-content, face, and concurrent-were tested. Content validation involved employing a three-round online Delphi approach. Face validity was assessed through opinions from clinicians regarding the questionnaire's appearance. Concurrent validity was established by comparing the Sensory Outcome Measure (SOM) with the criterion measure scale, Short Sensory Profile (SSP). Results: For all items, Content Validity Ratio (CVR) and item-level CVI values ranged from 0.8 to 1. The overall Scale Level CVI (average) for the scale was 0.890625. Experts exhibited a 96% agreement regarding the appearance of the questionnaire, indicating complete agreement. The Spearman rank correlation coefficient value was 0.866, and the correlation graph indicated a positive association between the two scales in terms of concurrent validity. Conclusion: The Sensory Outcome Measure (SOM) has been developed as a valid scale with high content and face validity, along with excellent concurrent validity. SOM is the first measuring scale developed in India and used for assessing sensory deficits in children with CP. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety, depression, and poor sleep quality are the most common mental health issues in post-acute Coronavirus Disease-2019 (COVID-19) syndrome. Healthcare professionals (HCPs) were overburdened and unable to focus on their own health issues. Previous epidemic diseases, such as Severe Acute Respiratory Syndrome (SARS) in 2003, also accompanied psychiatric issues in HCPs. In light of this, the purpose of this study was to identify the symptoms of COVID-19 that continue to affect HCPs and their associations with fatigue, poor sleep, anxiety, depression, and activity levels, in order to provide better care and treatment for them. Aim: To analyse the impact of post-acute COVID-19 syndrome on the mental health of HCPs and compare the results with non COVID-19 infected participants. Materials and Methods: A cross-sectional study was conducted at PGIMS, Rohtak in Haryana, India from October 2021 to September 2022. A total of 280 participants between 25-45 years of age, including doctors, nurses, and dentists involved in direct COVID-19 patient care, were included in the survey. They were divided equally into a non COVID-19 infected group and a post-acute COVID-19 syndrome group, with atleast three months having passed since infection. The survey included scales addressing anxiety, depression, and sleep quality, including the Zung Self-rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI). The mean scores were compared between both groups using an Independent sample t-test. Results: The data of 240 participants were analysed and compared between both groups. The mean age was 32.41 years in the post-acute COVID-19 syndrome group and 31.24 years in the non COVID-19 infected group. The post-acute COVID-19 syndrome group consisted of a large proportion of doctors (60, 42.9%) and nurses (53, 37.9%), whereas the non COVID-19 infected group included doctors (47, 33.5%) and nurses (56, 40%). The results showed statistically significant differences for anxiety (p-value=0.001) and sleep quality (p-value =0.001), while no significant differences were found for depression (p-value>0.05). Conclusion: Anxiety and poorer sleep quality occur in healthcare workers suffering from post-acute COVID-19 syndrome. Creating multidisciplinary rehabilitation health teams in hospitals with clinician psychologists, physiotherapists, nurses, and psychiatrists is essential to address mental health issues in the post-COVID-19 population. [ABSTRACT FROM AUTHOR]

Background: Studies in different parts of India and the world have found the undergraduate health professions curriculum in nutrition to be inadequate. Promoting the health of the community is one of the prime objectives of all health professions. A number of serious illnesses can be prevented or mitigated by following good nutritional practices. Are the graduates of health profession programme ready for shouldering this social responsibility? In general, the nutrition curriculum has been found lacking in addressing this key health professions capacity-building requirement. Can authentic learning in nutrition bridge the gap between theory and practice? Description: This paper emphasises the need for preparing health professions graduates with the required nutritional competencies to serve as health promotion leaders. This will enhance the social accountability of the institutions. Nutrition education has to evolve from the knowledge domain to the skills and values domain. Authentic learning in nutrition can go a long way in improving the health of the professional community as well as promoting the health of the populations by preparing capable advocates for nutrition. Outcome: Authentic learning, as compared to the fact-based approach to education in the field of nutrition, has the potential to change the nutrition behaviour of the health professions students. This is bound to reflect in the role of the graduates as competent advocates for nutrition and health. Conclusion: Authentic learning in nutrition can support behaviour change of the learners as well as prepare them for a role as nutrition advocate justifying the social accountability of the health professions institutions. [ABSTRACT FROM AUTHOR]