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Introduction: Alcohol is one of the major substances used in our country, affecting people of young age to old age. It has become a significant concern as a public health burden across all of India. Although the consequences of alcohol dependence in terms of impulsivity are widely assessed, the depth of the burden of alcohol dependence changes with respect to place, time, and socio-economic conditions. Aim: To understand the role of impulsivity and Adverse Childhood Events (ACE) in alcohol dependence among male patients. Materials and Methods: A hospital-based cross-sectional study was conducted between January 2020 and December 2020 among 190 male cases of alcohol dependence syndrome based on ICD-10 criteria. These patients visited the outpatient or inpatient psychiatry department at SRM Medical College Hospital and Research Centre, Potheri, Chengalpattu, Tamil Nadu, India. During the first visit, socio-demographic and clinical details were collected, along with the Barratt Impulsiveness Scale (BIS) and ACE Questionnaire. During the second visit, the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Scale and Severity of Alcohol Dependence Questionnaire (SADQ) scales were used. Pearson’s correlation was used for analysis using statistical software Statistical Package for Social Sciences (SPSS) version 21.0. Results: Out of the 190 patients enrolled in the study, the majority had completed middle school level education (34.2%). Among the alcoholics, 63.7% were married, and approximately 73.2% were from the lower and middle socio-economic class. A family history of alcoholism was found in nearly 78% of the participants. The maximum number of participants had 1-3 months of abstinence. Pearson’s correlation showed a positive correlation between impulsivity and its subscales with alcohol dependence score and ACE (p

Introduction: According to research by the World Health Organisation (WHO), there are 347 million diabetics worldwide, and by 2030, it will overtake smoking as the seventh leading cause of death and diabetic people have a lifetime risk of up to 25% for developing a foot ulcer. Many novel techniques are emerging to fasten wound healing, including cellular therapies using Platelet-Rich Plasma (PRP) and collagen-based dressings. Aim: To compare the efficacy between instillation of autologous PRP and conventional dressing using normal saline/povidone iodine in Diabetic Foot Ulcers (DFU). Materials and Methods: This randomised control clinical study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India. The duration of the study was 18 months, from April 2021- September 2022. A total of 174 DFU patients were included in the study, meeting inclusion and exclusion criteria’s. Patients were divided into case (n=87) and control group (n=87). For six weeks, the case group got autologous PRP, while the control groups regularly had standard dressings. Wound areas were measured using ruler scale weekly and percentage of healing was monitored for 12 weeks. The data were analysed with International Business Machines (IBM)- Statistical Package for Social Sciences (SPSS) version 21.0. Results: In a group of 87 each, 174 patients with chronic non healing DFUs were randomly assigned to the study group (PRP) or the control group (conventional dressing method) throughout the 9 months study. Age ranged from less than 40 years to more than 61 years in the present study of 174 patients, with the age group between 51 and 60 years having the highest percentage of patients (50.6%), followed by the age group over 61 years (23.6%). About 12 weeks after the treatment, it was discovered that, the case group had a 86% reduction in wound area of 86.51±15.71 mm, whereas, the control group had a 61% reduction in wound area of 65.47±30.18 mm and 65.1% of patients from the case group showed wound healing, while 42.7% of patients from the control group showed wound healing. These findings were found to be statistically significant (p-value

Introduction: Inflammation is body’s immune response to harmful stimulus. Commonly used conventional anti-inflammatory agents are Non-Steroidal Anti-inflammatory Drugs (NSAIDs). But on prolonged long-term use, it causes serious adverse events. So, the search towards natural agents which have anti-inflammatory property are increasing nowadays. Sinapis arvensis is an annual flowering plant which has proven multipurpose medicinal phytoconstituents. Aim: To evaluate in-vitro anti-inflammatory effects of flower extracts of Sinapis arvensis with diclofenac as standard. Materials and Methods: This in-vitro study assessed the laboratory based anti-inflammatory activity, performed using Bovine Serum Albumin (BSA) assay in December 2021 at Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India. BSA at pH of 6.8 generated denatured proteins. The anti-inflammatory activity of the sample (flower extracts of Sinapis arvensis) and standard (Diclofenac) was assessed by adding to BSA and percentage of inhibition of denaturation were calculated using the formula based on the absorbance measured. Descriptive statistics was used for analysis of collected data. Results: The concentration-dependent inhibition of protein denaturation was observed for both Sinapis arvensis and Diclofenac. At 100 μg concentration, percentage of inhibition reached up to 81.8% and 100% for Sinapis arvensis and Diclofenac, respectively. Conclusion: The present study showed that flower extracts of Sinapis arvensis exhibited concentration dependent anti-inflammatory property invitro which proves to be nearly equivalent with that of the standard Diclofenac.

Introduction: Postoperative Acute Kidney Injury (AKI) occurs as the consequence of intraoperative risk factors associated with cardiac surgery. Biochemical monitoring of patients undergoing cardiac surgery enables early detection of AKI. Serum albumin and Blood Urea Nitrogen (BUN): creatinine ratio serves as a simple tool for identifying increased risk of AKI. Aim: To determine serum albumin and the BUN: creatinine ratio as a predictive tool for AKI risk in patients undergoing cardiac surgery. Materials and Methods: The present prospective observational study was conducted at Cardio Thoracic super specialty unit of SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, between July 2020 to March 2021. A total of 30 patients undergoing coronary artery bypass grafting in the age group between 40 to 70 years with normal serum creatinine levels were included. Preoperative and postoperative parameters such as urea, creatinine, total protein, serum albumin, BUN: creatinine ratio and estimated Glomerular Filtration Rate (eGFR) were calculated. Data were analysed statistically by Analysis of Variance (ANOVA) and Student’s t-test. A p-value

Introduction: Tinospora cordifolia (Tc), a well-known ayurvedic herb commonly known as giloy, has demonstrated multifaceted benefits, such as anti-inflammatory, analgesic, antibacterial and antioxidant properties, in animal, as well as, in-vitro studies. All these are properties which can be collectively applied in the management of periodontal conditions which demonstrate infective as well as inflammatory facets. But prior to its applications as such, it is necessary to definitively determine the optimal concentration and mode of application of the medication. Aim: To evaluate the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of Tc on general subgingival microbiota. Materials and Methods: The in-vitro, analytical study was conducted in Krishnadevaraya Dental College and Hospital, Bengaluru, Karnataka, India for duration of two and half months starting from November 2021 to January 2022. Ethanolic extracts of Tc were prepared in serial dilutions. Subgingival plaque samples of 12 chronic periodontitis patients were collected, cultured on Brain Heart Infusion (BHI) agar and subject to serial dilutions of Tc. In-vitro antibacterial activity of the ethanolic extracts was assessed using agar well diffusion method with Chlorhexidine (CHX) as positive control and Dimethyl sulfoxide (DMSO) as negative control, MIC and MBC were determined based on the zones of inhibition after 48 hours of anaerobic incubation. The Statistical Package for Social Sciences (SPSS) for windows version 22.0 was used to perform statistical analyses. Results: The MIC of Tc was noted to be 100 mg/mL where the maximum zone of inhibition was 11.42 mm. MBC was noted at a concentration of 25 mg/mL. The zones of inhibition at these concentrations was comparable to the CHX. The difference in the diameter of the zones produced by Tc, DMSO/Saline and CHX were statistically significant. Conclusion: Although CHX remains the gold standard, Tc extract has significant antimicrobial activities and can be considered for further clinical trials.

Introduction: Solid Organ Transplants (SOT) is at increased risk of Coronavirus Disease 2019 (COVID-19) infection, which may result in acute graft dysfunction and even death. While the disease has been well studied in the general population, it is not the case in renal transplant recipients. The poor immunological response of the vaccine in post renal transplant patients, the emergence of newer strains, and the possibility of a third wave in India, makes it even more important to know more about the course and outcome of the disease in post renal transplant patients. Aim: To evaluate the demographics, clinical presentation, biochemical profile, course of hospitalisation in post kidney transplant patients with COVID-19. Materials and Methods: This retrospective observational study study with 18 patients was conducted in Madurai Medical College, Tamil Nadu, India for duration of four months, from May 2021 to August 2021 and data collection from May 2021 to July 2021 and data analysis in August 2021. All post kidney transplant patients having evidence of COVID-19 were included. Detailed clinical history, biochemical profile, radiological findings, treatment, and final outcomes were collected and compared. Non parametric statistical tests were used, in addition to Chi-square test and odds ratio. Kaplan-Meier plot was used for survival analysis. Results: The most common presentation was fever 15 (83.3%), followed by cough 10 (55.6%). C-reactive Protein (CRP) {65 mg/L (11.48-94.48)}, D-dimer {0.72 mcg/mL (0.59-1.1)}, serum creatinine {3.5 mg/dL (2.12-5.93)}, and platelet count {200,000 cells/cu.mm (1.75-2.22)} and showed statistically significant (p

Introduction: The portable Chest Radiograph (CXR) has an indispensable role in large scale screening and diagnosis of Coronavirus Disease-2019 (COVID-19), especially in developing countries with limited resources. It can help in predicting the severity of lung involvement in the patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, especially in areas where the Computed Tomography (CT) is unavailable. Aim: To determine the prognostic value of CXR at clinical presentation in assessing the disease severity and its correlation with inflammatory markers in COVID-19 hospitalised patients. Materials and Methods: This was a single-centre retrospective study, conducted at Sri Ramachandra Institute of Higher Education and Research, from October 2020 to December 2020, on hospitalised COVID-19 patients. Clinically, the patients were categorised as mild, moderate and severe, based on their peripheral oxygen saturation- more than or equal to 94%, between 90-93%, and less than or equal to 89%, respectively. Blood samples, drawn at presentation to the hospital tested for various inflammatory markers proven to be predictive of disease severity, were documented for the analysis purpose. The CXRs done at the presentation, were scored based on the number of zones involved and type of abnormality present (ground glassing, consolidation and septal thickening). The CXRs were scored a minimum ‘0’ to a maximum of ‘9’. Correlation between the radiograph score and inflammatory markers were further analysed. Results: Among the 456 study patients, 71.9% had mild, 15.1% had moderate and 13% had severe COVID-19 infection. The mean CXR score in each category was 1, 3 and 4, respectively (p-value

Introduction: Chikungunya (CHIK) infection has caused many outbreaks in India with more than 13 lac people affected by the disease. Epidemics of CHIK infection occur during post monsoon period when there is a high vector density. Evidences on the prevalence of CHIK infection during non epidemic periods are limited. Aim: To determine the seroprevalence of CHIK infection during non epidemic periods among patients attending fever clinic in Chennai, Southern India. Materials and Methods: This cross-sectional study was done in 180 suspected cases of CHIK infection between the months of September 2014 and February 2015. A 5 mL of blood samples were collected from the suspected cases and serum was separated to detect for the presence of CHIK-IgM antibody by using CHIK-IgM antibody capture Enzyme Linked Immunosorbent Assay (ELISA) kit. Chi-square test was done to find out the statistical significance with p-value

Introduction: Primary full thickness Peroneus Longus Tendon Graft (PLTG) for Anterior Cruciate Ligament Reconstruction (ACLR) has been used with good clinical outcome. Recently, it is designated as a promising graft option for ACLR. The effect of harvesting PLTG on donor ankle function is still not completely understood. Peroneus Longus Tendon (PLT) is thought to play a major role in proprioceptive regulation of the ankle joint. All the studies till date did cross-sectional assessments of ankle and foot function at or after 6 months that might have overlooked the timely detection of donor site morbidities. Aim: To evaluate the ankle function and compare the affected and sound limb function in subjects with an ACLR with autologous PLTG starting at an early postoperative visit upto six months. Materials and Methods: A prospective cohort study was conducted at a tertiary rehabilitation centre from March 2019 to March 2021 including the follow-up evaluation. As per the inclusion criteria, 63 participants after ACLR with PLTG were considered for assessment using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot scale and Foot and Ankle Ability Measure (FAAM) scale at 6 weeks, 3 months and 6 months post-ACLR follow-up. Comparison between sound and affected limbs was done during all follow-ups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 18.0. Both FAAM and AOFAS ankle and foot scores were analysed with non parametric tests. Results: Mean age of 63 participants were 29.25 years. Median of AOFAS and FAAM score at 6 week, 3 month, and 6 month postACLR follow-ups were (88, 98 and 100) and (97.22, 98.80 and 100), respectively. Statistically significant increase in AOFAS and FAAM scores were observed at 3 month and 6 month as compared to 6 week follow-ups with p=0.001 and p-value=0.001 respectively. The group comparison between the affected and sound side functional scores at different study visits showed statistically significant greater values for the sound ankle than the affected ankle (FAAM: 6 week: p-value=0.001; 3 month: p-value=0.001; 6 month: p-value=0.001 and AOFAS p-value=0.001; p-value=0.001; p-value=0.001, respectively). Conclusion: The evaluation of functional outcomes showed gradual and linear improvement at subsequent postoperative visits and restores fully to 100% at 6 month indicating a nearnormal to normal donor ankle function following ACLR with PLTG by 6 months. The group comparison showed only marginal but significant difference between affected and sound ankle function.

Introduction: The ongoing outbreak of the coronavirus disease 2019 (COVID-19) infection has posed significant threats to international health and economy. On 30th January 2020, the World Health Organisation (WHO) declared it to be a Public Health Emergency of International Concern. Despite exponential rise of COVID-19 cases, there are limited studies on COVID19, so an observational study to assess the demographic and clinical status of COVID-19 patients at a Tertiary Care Centre was conducted. Aim: To study the demographic and clinical status of COVID-19 patients in a tertiary care hospital in Chengalpattu district. To assess the co-morbid status and its influence on the outcome among the study population. To find the doubling rate and weekly trend of COVID-19 cases. Materials and Methods: A cross-sectional study was conducted in Chengalpattu Medical College Hospital, Chengalpattu district among the COVID-19 patients during April to June 2020. By nonprobability sampling technique (convenient sampling), all the COVID-19 patients (n=3028) admitted in the institution during the study period were included. A semi-structured questionnaire was administered to collect the data.The questionnaire had three sections A, B, and C. Section A dealt with sociodemographic details, Section B with symptom status and co-morbidity status and section C with COVID test results. Ethical clearance was obtained from the Institutional Ethics Committee. Data was entered in MS Excel and analysis was done using SPSS Software. Results: In this study, there were 1932 (64%) males and 1096 (36%) females; 1489 (49%) were affected in the age group of 21-40 years, which was the most commonly affected group; 704 (23%) were in the age group above 50 years; 2574 (85%) of cases were from urban areas of Chengalpattu district; 1145 (38%) were found to be symptomatic, fever being the predominant symptom 753 (66%); 712 (24%) of the patients were associated with co-morbid conditions, the most common being diabetes mellitus 391 (55%); mean duration of stay was found to be 9.21±3.26 days; doubling rate was found to be 18.91 days; the overall swab positivity rate was 14.56%; the overall case fatality rate was 2.47%; 3028 (59%) of the district cases were treated in the institution. Conclusion: This study found that the patients aged >50 years with co-morbidity are at a higher risk of mortality than others. The present work predicts that the number of cases double in 19 days. Hence, strict containment measures are recommended to lengthen the doubling rate.

Introduction: The prevalence of Celiac Disease (CD) is known to be significantly higher in children with Type1 Diabetes (T1DM) as compared to the general population. Non-gastrointestinal symptoms are predominant manifestations of CD in these children. Aim: To estimate the prevalence of CD in children with T1DM and to assess the clinical presentation of CD in them. Materials and Methods: Data was collected retrospectively from the medical records of children with T1DM who were treated in a Paediatric endocrinology unit of a tertiary referral centre between January 2012 to December 2015 and screened for CD with Anti Tissue Transglutamase (ATTG) test. ATTG >15 U/mL was considered positive and Marsh criteria used for duodenal biopsy classification. The clinical manifestations of CD were analysed. Descriptive statistics (mean, standard deviation) were used to summarise the study variables. Results: Among the 152 children screened for CD, 18.4% (28) were positive for celiac serology and 78.5% (11) of the 14 children who underwent duodenal biopsy had mucosal changes. Unexplained asymptomatic hypoglycaemia, poor glycaemic control, and growth retardation were the most common indications for screening CD. Conclusion: This study emphasises that gastrointestinal symptoms of CD may be minimal in diabetic children and recognition of non-gastrointestinal symptoms helps in early detection. If resources permit universal screening for CD is recommended in T1DM children.

Introduction: Frozen shoulder is a condition of uncertain etiology characterised by progressive loss of both active and passive range of motion in the Glenohumeral (GH) joint. It is clear that the GH joint and the scapula do not function independently. Obviously, dysfunction in either joint has a direct impact on the other. Reverse scapulohumeral rhythm means that the scapula moves more than the humerus and it is evident with frozen shoulder. Current manual therapies for the frozen shoulder focus primarily on GH joint mobilisation. Very few studies have addressed the scapular restriction. Aim: To evaluate the effectiveness of scapular mobilisation in patients with frozen shoulder by comparing with conventional treatment. Materials and Methods: A total of 30 subjects with frozen shoulder were selected based on the selection criteria. The participants were then randomly allocated into two groups A and B. Group A were given wax therapy, capsular stretching, scapular mobilisation and home exercises and Group B were given wax therapy, capsular stretching, home exercises. Pain, Range of motion (ROM) and functional disability was measured using a Numerical Pain Rating Scale (NPRS), universal goniometer and shoulder constant score for both the groups. The two groups received therapy for five days in a week for two weeks. Pre and post treatment evaluation were compared and statistically analysed. Results: Group A had significant improvement in NPRS (Z=4.39, p=0.001), shoulder abduction (Z=3.51, p=0.001), shoulder external rotation (Z=4.08, p=0.001) and shoulder constant score (Z=5.39, p=0.001) when compared to group B. Conclusion: Both the treatment approaches are effective in reducing pain, improving ROM and functional disability in patients with frozen shoulder. However the patients who received scapular mobilisation had significantly higher improvement than the control group.

Introduction: Traditional Siddha Medicine literatures suggest to use the decoction of Vernonia cinerea (VC) to alleviate toxic effects caused by metals. Cisplatin, a metal used in cancer treatment is known to cause nephrotoxicity. Aim: To evaluate and compare protective activity of aqueous extract and fractions of VC in Human Embryonic Kidney (HEK293) cells and Human Cervix Epitheloid Carcinoma (HELA) cell lines against cisplatin induced cytotoxicity. Materials and Methods: The Crude Aqueous Extract (CAE) was obtained from whole plant of VC. CAE was fractioned using nonpolar to polar solvents, and Butanol Fraction (BF) as well as Aqueous Fractions (AF) were obtained. The cell lines were exposed with the IC50 dose of cisplatin, then treated with different doses of the extract or fractions. After 48 hours of incubation, viable cell growth was determined by MTT reduction assay in all the treatments by observing at absorbance of 540 nm. Dose response (% cell viability) curve was drawn and the values were statistically compared using One-Way ANOVA, followed by Dunnett’s (2-sided) post-hoc test. Results: Aqueous fraction showed 2.8 times higher cytoprotection (improvement in cell viability by 54%) than CAE against cisplatin induced toxicity in HEK293 cells. BF did not show protective activity in HEK293 cells. In HELA cells, AF showed 1.73 times higher cytoprotection than CAE and 1.55 times higher cytoprotection than BF against cisplatin, as evidenced by improvement in cell viability by 30%, 11% and 13% in AF, CAE and BF respectively. AF exhibited 80% higher cytoprotection against cisplatin cytotoxicity in normal HEK293 than cancer HELA cells. Whereas, CAE and BF showed lesser cytoprotective activity than AF. Conclusion: This study created scientific basis for using Vernonia cinerea against metal toxicities in Siddha system and suggests that the AF is suitable for further discovery of drug that selectively protect normal renal cell during cisplatin treatment in cancer patients.

Introduction: Adiponectin, a beneficial adipocytokine plays a crucial role that regulates insulin sensitivity and also has a role in the ovulation process. Visceral adiposity adversely affects the reproductive hormone production and ovulation that impacts fertility in reproductive females. Adiponectin may be considered as the vital link between central obesity and insulin resistance that regulates ovulation to occur. Aim: To compare the levels of Adiponectin in insulin resistant and non-insulin resistant infertile women with ovulatory dysfunction and to correlate Adiponectin levels with hormones such as Luteinising Hormone (LH), Follicle-Stimulating Hormone (FSH), LH/FSH ratio, Thyroid Stimulating Hormone (TSH), insulin and variables like Waist Circumference (WC) and Waist-Hip Ratio (WHR). Materials and Methods: The present cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, SRM Medical College and Research centre, Tamil Nadu, India. The study included 88 married women of reproductive age group between 20 to 40 years attending the infertility clinic. All the participants had a complete physical examination with measurements of weight (Kg), height (m), WC (cm) and HC (cm) to calculate the BMI and WHR. After overnight fasting, blood samples were collected on second or third day of menstrual cycle for estimating LH, FSH, TSH, insulin and Adiponectin levels. Based on HOMA-IR calculation the individuals were categorised as Insulin resistant Group (A) n=48 with HOMAIR ≥2 and non-Insulin resistant Group (B) n=40 with HOMAIR

Introduction: Miswak (Salvadora persica) is a tooth cleaning stick made from the Salvodora Persica tree. It serves as a natural dentifrice with anti-bacterial, anti-plaque and antifungal properties. Fluoride, impregnated in chewing sticks will bestow comparable safety against dental caries as the fluoride containing dentifrice. Aim: The aim of the present study was to assess and compare the anti-bacterial effect of 0.5% sodium fluoride impregnated miswak and plain miswak sticks on Streptococcus mutans. Materials and Methods: A randomized controlled concurrent parallel triple blind clinical trial was conducted for a period of 8 days. The trial included 30 subjects aged 20–23 years, who were randomly allocated in 1:1 ratio to Group A [0.5% Sodium Fluoride (NaF) impregnated Miswak sticks) and Group B (Plain Miswak sticks) respectively. The participants were instructed to chew miswak sticks for 6 minutes in the morning before breakfast. Unstimulated saliva was collected at baseline and after chewing miswak sticks to estimate S. mutans count using Mitis Salivarius Bacitracin agar. Data was statistically analyzed using paired and unpaired t-test. Results: A statistically significant reduction in S. mutans Colony Forming Units (CFU) count in saliva was observed after using fluoridated miswak sticks compared to the baseline count (p=0.001). There was no significant difference in anti-bacterial effect of fluoridated miswak sticks and plain miswak sticks on S. mutans count (p=0.58). Conclusion: The efficacy of miswak impregnated with 0.5% NaF and plain miskaw sticks in reducing S. mutans counts in saliva is analogous.

Introduction: Mutation in p53 gene and accumulation of p53 protein is a common genetic event in colorectal carcinomas. p53 mutation can be detected by various techniques such as DNA sequencing, polymerase chain reaction and immunohistochemistry (IHC). However, IHC is simple and is consistent with other techniques. Aim: To establish a correlation between overexpression of p53 with the clinical features, tumour histopathology and stage of Colorectal Carcinoma (CRC). Materials and Methods: This prospective and retrospective study of clinical, histopathological and IHC features of CRC was conducted on colectomy and abdomino-perineal resection specimens received from January 2008 to June 2013. For each case, the clinical features, tumour morphology and p53 status (by IHC) were evaluated. Results: The most common histologic type of CRC was Non-Specific Type (NST) and grade II tumours were seen predominantly (60%). Overall, 67.5% of CRCs showed p53 positivity on IHC. Intense p53 positivity was observed in 37.5% of CRCs of NST type and 33.3% of mucinous adenocarcinomas showed moderate positivity. Grade III tumours showed variable p53 positivity and those with lymph node metastasis showed moderate (55.6%) or intense positivity (53.8%). But there was no statistically significant correlation of p53 status and various clinicopathological prognostic factors. Conclusion: As p53 protein overexpression is seen in a relatively high percentage of CRCs, it seems that p53 mutation plays an important role in development of CRC. However, no direct correlation could be established between p53 results and the patients’ age, sex, tumour site, size, histological type, grade, lymph node status, or TNM stage. A prolonged follow up is necessary to conclude whether p53 status has any influence on the long, term prognosis and patient survival.

Calcifying Epithelial Odontogenic Tumour (CEOT) or Pindborg tumour is a rare odontogenic tumour of epithelial origin. They constitute less than 1% of odontogenic tumours. Intra-ossseous variant of CEOT are more common compared to extra-osseous variant. Although benign, these can exhibit deceptively aggressive presentation. Here we report a rare case of CEOT in a 36-year-old female patient who presented with aggressive intra-osseous lesion with cortical breach and exuberant soft tissue proliferation. The lesion was treated with resection and reconstructed with titanium reconstruction plate.

Urinothorax is a rare condition defined by the presence of urine in the pleural cavity. Here we report a case of a patient with left sided transudative pleural effusion which developed following left adrenalectomy with perisplenic collection. The pleural fluid to serum creatinine ratio was found to be greater than one which confirmed the diagnosis. The objective of this case report was to describe this rare case and to alert the physicians to include urinothorax in their differential diagnosis of transudative pleural effusion especially following abdominal surgery.

Introduction: Life events, recognized as stressors, due to their unanticipated nature, can cause psychiatric illness. Also there is some line of continuity between neurotic illness and antecedent personality traits. Aim: To study generalized anxiety disorder in relation to Life events and personality dimensions. Materials and Methods: Certain hypotheses were tested in two groups, namely 30 Generalized Anxiety Disorder patients (GAD) and 30 matched controls, by utilizing assessment tools. These include: GAD patients experience more undesirable Life events than normal; GAD patients with high level of anxiety experience more undesirable Life events; Neuroticism is related to the severity of anxiety; Extroverts experience more anxiety; Level of anxiety in females is higher; GAD patients with higher education level experience more anxiety, while those with lower education level somatize more. The group differences were examined using Chi-Square test, Student t-test and ANOVA. Pearson’s Correlation Co-efficient was used to find the correlation between anxiety and the undesirable Life events. The level of statistical significance was set at p

Penetrating craniofacial trauma, although uncommon, has a high potential for death or catastrophic consequences from head injury or vital neurovascular injuries. The foreign body may cause significant challenge, especially when it is a large one. Airway obstruction, vascular injuries, intracranial communication, ocular injury and injuries to any other adjacent vital structures when involved may change the treatment objectives from simple foreign body retrieval to a comprehensive multidisciplinary approach to stabilize the patient. Retrieval of foreign bodies may be challenging because of many factors including the size of the object, its site, and the surrounding anatomical structures. Accurate localization of the foreign body before removal is essential in craniofacial region. We present a case of penetrating craniofacial trauma from a wooden stick, with an in situ foreign body, that was managed by emergency surgical exploration in general anaesthesia and retrieval of foreign body in Toto under antibiotic coverage and tetanus prophylaxis.

We report the case of a 52-year-old female, a known case of Chronic Liver Disease with portal hypertension. She presented with dyspnoea, platypnoea, melena, cyanosis, clubbing and orthodeoxia. She had oesophageal varices and splenomegaly indicating portal hypertension. Her arterial blood gas revealed hypoxaemia and orthodeoxia. From this clinical background and investigation, a diagnosis of hepatopulmonary syndrome was made. Patient was managed conservatively as she was not willing for liver transplantation.

Introduction: During tooth movement the success of sliding mechanics is dependent upon various factors which include frictional resistance at bracket-archwire interface, surface roughness of archwire materials and elastic properties of archwires. Ion implantation techniques reduce the frictional force and allow better tooth movement clinically. Aim: The main objective of this study was to evaluate and compare the frictional properties, load deflection rate and surface characteristics of Honey dew and Purple coloured (Ion implanted) TMA wires with uncoated TMA wires. Materials and Methods: Fifteen archwire samples were divided into three groups comprising of five samples in each group namely, Group I – Uncoated TMA wires (Control), Group II – Purple coloured TMA wires and Group III- Honey dew TMA wires. Friction and load deflection rate testing were performed with the Instron Universal testing machine and the surface characteristics of the wires were evaluated before and after sliding using Scanning Electron Microscope. Results: The mean frictional characteristics and surface roughness for Honey dew TMA wires was lesser than Purple coloured TMA wires which was statistically significant. Both the coloured TMA wires showed low frictional characteristics and less surface roughness than uncoated TMA wires (the control). The mean load deflection rate was low for both coloured ion implanted TMA wires when compared to uncoated TMA wires which was statistically significant. Conclusion: Coloured ion implanted TMA wires, especially Honey dew TMA wires have low friction, low load deflection rate and improved surface finish. Hence they can be used in frictionless as well as sliding mechanics, where uncoated TMA wires are inefficient.

Introduction: External Beam Radiotherapy plays a major role in the management of Carcinoma Cervix. The Radiotherapy treatment portals are designed to adequately cover the gross disease and areas of microscopic spread. The upper border of Radiotherapy field is traditionally placed at the level of L4-L5 intervertebral space to cover the common iliac nodal area. It is determined based on anatomical and surgical series which have shown that division of Abdominal aorta occurs at that level. Aim: To study the level of the division of abdominal aorta in relation to the lumbar vertebral levels. To propose the change in the upper border of Radiotherapy portals used in the treatment of Cervical Cancers. Materials and Methods: Patients who underwent Radiotherapy for Cervical Cancer from December 2010 to January 2012 formed the subjects of this prospective study. All the patients underwent aquaplast immobilization in supine position and contrast enhanced Computed Tomography (CT) simulation for Radiotherapy planning following bladder protocol. The Radiotherapy planning was done on commercial treatment planning system, Prowess version 4.71. The level of division of Abdominal Aorta into right and left Common Iliac arteries with respect to vertebral level was determined and studied. Results: The division of abdominal aorta into common iliac arteries occurred at the level of L3-L4 intervertebral space, in front of body of L4 vertebra and L4-L5 intervertebral space in 53.84%, 30.76% and 15.40% of the patients respectively. Conclusion: The division of abdominal aorta occurs at a higher level than L4-L5 intervertebral space in majority of patients. It is highly recommended to use CT scan based planning. However, in institutes where there are no facilities for CT based planning, it is advisable to shift the upper border of Radiotherapy treatment portal above the L3-L4 intervertebral space for delivering adequate doses to the common iliac lymphnodes.

Introduction: Normal vascular is associated with gradual change of vascular structure and function, resulting in increased arterial stiffening and decreased arterial compliance. Arterial stiffness is a marker of vascular ageing and a predictor of cardiovascular events. Premature or early vascular ageing is measured by pulse wave velocity or the arterial augmentation index based on pulse wave analysis. Aim: To study the predictor of vascular dysfunctions in high risk young adult offsprings of type 2 diabetes mellitus and hypertensive parents. Materials and Methods: The analytical cross-sectional studies were carried out in 90 subjects (45 males and 45 females), aged 18–25 years. They were divided into three groups based on their family history, known case of type 2 DM or hypertension in their parents. Group 1- control, Group 2- DM, Group 3-Hypertensive. In all subjects, anthropometrical data, blood pressure and peripheral pulse wave velocity were measured. One-way ANOVA was applied to determine the predictor factors of pulse wave velocity within and between groups. The following parameters were included in these analyses: age, gender, body mass index, hip waist index, heart rate, blood pressure and pulse wave velocity. Results: A post-test analysis revealed that peripheral pulse wave velocity (PWV), early part of systolic phase (P1) was increased significantly than later part systolic phase (P2), p-value in both diabetic and hypertensive groups were compared with control group. (p≤0.001, ANOVA) Augmentation index (P2/P1) was also increased significantly in both diabetic and hypertensive groups than control group (p≤0.001, ANOVA). Conclusion: The findings of present study suggest that, although related, peripheral augmentation index AIx and PWV provide early identification of high risk groups. Implication of life style modification is the first intervention to consider in adults followed by drug therapy to control risk factors. Specifically, AIx might provide a more sensitive marker of arterial aging in younger individuals.

Background: Non-communicable diseases like hip fractures are a significant problem in a developing country like India. The risk factors for hip fractures vary according to local practices and the availability of preventive health care delivery systems. There is paucity of data on risk factors for hip fracture in the south Indian population. Aim: This study was undertaken to assess risk factors associated with femoral neck (FN) fracture in South Indian postmenopausal women along with subsequent one year mortality. Materials and Methods: One hundred four postmenopausal women with FN fracture and 104 age and BMI matched controls were included. Sedative use, visual impairment and other relevant risk factors were assessed. Bone biochemistry and Bone Mineral Density (BMD) were evaluated. A telephonic interview was done at the end of one year to ascertain the well-being. Results: Sedative use, visual impairment, low FN BMD and vitamin-D deficiency (

Introduction: PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim: The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design: The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods: In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results: In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion: The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis.

Bronchogenic cysts are the most common cystic mediastinal lesion in children. Bronchogenic cyst causing unilateral obstructive emphysema is a rare presentation. We report the case of a one and half month old infant who presented with respiratory distress which was initially suspected as left pneumothorax on frontal chest radiograph but was later found to be due to hyperinflated left lung and hence the possibility of congenital lobar emphysema was considered. CT thorax and limited MRI sections revealed a cystic lesion in mediastinum causing obstructive emphysema and mediastinal displacement. He underwent an emergency thoracotomy and excision of the cyst via an extrapleural approach. Post operatively, rapid improvement of the infant was noticed both clinically as well as radiologically. Cross sectional imaging like CT or MR is required for reaching the correct and early diagnosis in paediatric patients with respiratory distress, when there is diagnostic dilemma based on chest radiograph.

Both hemangiomas and vascular malformations are endothelial malformations that closely resemble normal vessels and can be found in all organs of the human body. This pictorial essay encompasses a spectrum of imaging appearances of hemangiomas and vascular malformations. Familiarity of the MR and CT findings can help differentiate these lesions, to confirm the suspected diagnosis, classify the anomaly and document the associated abnormalities.

Background: The prevalence and incidence of urolithiasis is increasing worldwide. Type 2 diabetes mellitus is well known to be associated with insulin resistance which increases the risk of urolithiasis by altering the composition of urine. Both urolithiasis and diabetes mellitus are associated with inflammation. The aim of the study was to assess the serum levels of inflammatory markers i.e. high sensitivity C-reactive protein (hsCRP) and Interleukin-6 (IL-6) in diabetes mellitus patients with urolithiasis in comparison to those without urolithiasis. Materials and Methods: The study involved two groups. Group A consisted of diabetic mellitus patients with urolithiasis (n=30) and Group B consisted of diabetic mellitus patients without urolithiasis (n=30). Blood samples were obtained and analysed for HbA1C, lipid profile, calcium, phosphate and uric acid, and inflammatory markers (C-reactive protein and Interleukin-6) were also measured. Results: We found a significant increase in CRP and IL-6 levels in diabetic urolithiasis cases as compared to diabetes mellitus cases without urolithiasis. However, no significant difference was observed in calcium, phosphorus and uric acid in diabetic patients with and without urolithiasis. We also found that total cholesterol, triglycerides, LDL-cholesterol and VLDL-cholesterol levels were significantly increased, and HDL-cholesterol was significantly decreased in diabetic urolithiasis cases. IL-6 was significantly correlated with total cholesterol in diabetic urolithiasis cases. Conclusion: The data from the present study shows that lipid profile is altered, and Interleukin-6 and C-reactive protein levels are significantly increased in patients with diabetes mellitus and urolithiasis when compared to diabetes mellitus alone.

A pseudotumour is a rare presentation of bronchopulmonary tuberculosis which occurs in immunocompetent patients, which can simulate malignancy, both clinically and radiologically, and may cause delay in its diagnosis and treatment. The incidence of bronchopulmonary pseudotumours was found to vary from 2-4%, as was seen in various studies. A mycobacterial pseudotumour of the pleura is a rare entity. We are reporting a case of a pleura based tubercular pseudotumour in a 59 years old patient who presented with a four month history of the nonspecific symptoms of cough and chest pain. The radiological investigations showed that a pleural based mass lesion was occupying the right lower hemithorax. The initial biopsy was suggestive of a hyalinizing variant of an inflammatory pseudotumour. The follow-up surgical resected mass was consistent with the features of a tubercular granuloma. The clinical presentation and the histopathological findings have been presented, with a brief review of the literature. Due to its varied and unusual presentation, bronchopulmonary tuberculosis should always be kept in mind when a patient with a similar clinical and a radiological picture is being evaluated.

Children and adolescents are subject to a wide variety of gingival infections. Epidemiological studies indicate that gingivitis of varying severity is nearly a universal finding in children and adolescents. The shorter life span of the primary dentition may be the reason why in general little attention is given to periodontitis in children. Since early diagnosis is important for successful treatment, it is imperative that children receive a periodontal examination as part of their routine dental visit. Furthermore destructive periodontal disease occurs in children with certain systemic diseases. Indeed the presence of severe periodontitis may be an early sign of systemic disease. A general medical evaluation to determine if systemic diseases are present should be considered in children who exhibit severe periodontitis, especially if the disease appears resistant to therapy. Though periodontal health awareness and therapy are increasing day by day in our country compared to earlier days, it is much restricted to adults rather than children. Oral cavity examination in children is much oriented in hard tissue evaluation than soft tissue health. Hence, this article enlightens about the prevalence of various soft tissue diseases and importance of long term overall oral health maintenance in childhood.