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Bowel obstruction is known to be caused by intussusception, which is far more common in pediatric patients. The majority of people with adult intussusception require a predisposing cause, which might be a benign lesion, a malignant lesion, or an irregularity of the intestinal wall such as inflammatory bowel disease. Adult intussusception is a very rare condition. We present the case of a patient presenting with upper abdominal pain, nausea, vomiting, and weakness. The patient had ongoing mild intermittent abdominal pain for months which was investigated with an upper gastrointestinal endoscopy that showed gastritis. There were features of peritonism on clinical examination and this was associated with raised inflammatory markers. A contrast-enhanced multidetector computed tomography (MDCT) scan showed a long-segment telescoping of the ileum into the cecum with ascending colon with proximal bowel distension suggesting bowel obstruction: Ileocolic intussusception. The patient underwent emergency surgical resection with a double-barrel stoma. Histopathology assessment did not identify a causative factor for the intussusception. An uncommon instance of adult idiopathic enteroenteric intussusception is presented here. The diagnosis can be established with the use of the clinical history of chronic intermittent abdominal pain, entire abdomen ultrasonography, and abdomen MDCT. In patients who are unstable and exhibit indications of peritonitis, surgery remains the only choice, even though a more cautious strategy is outlined in the literature. Adult intussusception is a rare and challenging diagnosis to make. Individuals suffering from intussusception may experience prolonged bouts of sporadic abdominal pain that intensify suddenly as a result of acute obstruction. The most helpful investigative technique for confirming the intussusception diagnosis is CT.

Background: Myofascial pain syndrome (MPS) is a muscle pain disorder characterized by the presence of Myofascial Trigger Point (MTrP) within a taut band, local tenderness, referral of pain to a distant site, restricted range of motion, and autonomic phenomena. The upper trapezius is the muscle most often affected by MTrPs. Manual myofascial release (MFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) are techniques of soft tissue release that are used to resolve MPS. Fifty six percent of physiotherapists complain of pain in multiple areas due to the massage and manual therapy that they have to perform. Objective: The objective of this study is to find whether IASTM is better than manual MFR in treating patients with MPS in upper trapezius. Methods: This study was a single-blinded randomized controlled trial that included 31 participants, both males and females between the age groups of 18–50 years. Participants were randomly divided into two groups. Three sessions were given over a period of one week for both groups. Group A received IASTM along with conventional treatment and Group B received Manual MFR along with the conventional treatment. The outcome measures evaluated were pain, cervical range of motion, pain pressure threshold (PPT) of trigger points, and the neck disability index. Pre- and post-measurements were taken and the analysis was done. Results: Both the treatment methods significantly reduced pain, improved PPT, range of motion, and function. The effects between the groups showed that IASTM was significantly better than manual MFR to reduce pain. The improvement in PPT, range of motion and function were equal in both the groups. Conclusion: IASTM and manual MFR both are effective individually as treatment procedures for pain, PPT, range of motion, and function. Neither of the treatment options can be considered better that the other. The clinician can decide based on the availability of the instrument, training, patient’s preference, and his/her comfort whether which of the two treatment methods should be used.

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.

In today’s complex financial markets, “Algorithmic Trading” has become very important. The study delves into the amalgamation of four pivotal indicators - Relative Strength Index (RSI), Exponential Moving Average (EMA), Volume-Weighted Average Price (VWAP), and Moving Average Convergence/Divergence (MACD) Relative Strength Index (RSI), Exponential Moving Average (EMA), Volume-Weighted Average Price (VWAP), and Moving Average Convergence/Divergence (MACD) to create and develop a potent trading strategy. Through intensive backtesting and parameter tuning, our study demonstrates 60.63 % profitable trades on the National Stock Exchange (NSE), India, surpassing the standalone indicators. The Weapon Candle Strategy created using the four indicators presents its efficiency as it was able to achieve a profit factor of 1.882. This suggests that when these four technical indicators combined to make a strategy, it can provide significantly more accurate and reliable trading signals compared to using a combination of two or three indicators. Algorithmic traders should use a multi-indicator approach to achieve a more comprehensive understanding of the market and make informed trading decisions.

Administration of local anesthesia via injection is the main reason for inducing anxiety in children and if not intervened it aggravates the anxiety in subsequent appointments. There are many approaches, including pharmacological and non-pharmacological methods that can be used to reduce children’s perception of pain and anxiety. A frequently used non-pharmacological behaviour management method to reduce anxiety and procedure pain is distraction. The rationale of distraction is to shift the attention to avert the brain from receiving unwanted stimulus which induce anxiousness. Many approaches including music, television, portable video games, virtual reality (VR) helmet, and virtual reality audio-visual eyewear, have been implemented so far. Kaleidoscope and virtual reality goggles may help as distraction techniques in reducing the levels of anxiety caused during administration of local anesthesia. By the aid of which the operator may be able to make the dental experience child friendly and ultimately provide quality dental care to anxious children. Non pharmacological measures of reducing pain are cost effective and best means that can be used while performing dental procedures. This is a research protocol for a study aimed to evaluate and compare the effectiveness of kaleidoscope and virtual reality goggles to reduce dental anxiety in young children.

Haemoparasitic diseases constitute a significant constraint to economic livestock farming. Diagnostic techniques that are inexpensive, rapid, reliable, and precise are crucial for the management of diseases. In this context, PCR assays are very valuable yet expensive since the samples must be processed before being included in the PCR reaction. Accordingly, the goal of the current study was to lower the PCR costs without jeopardizing the assay’s sensitivity and specificity. For that purpose, the alkaline solution was optimized for low cost and quick DNA extraction (blood lysate), and PCR reagents were modified for optimum reaction. In comparison to purified whole blood genomic DNA, the currently developed and optimized blood lysate method was found to be 95.5% less expensive, as well as being equally sensitive and specific for the molecular detection (PCR) of haemoparasites like Babesia, Theileria, Trypanosoma and rickettsiales in cattle, buffaloes, horses, and dogs. The assay was also demonstrated to be quick, less likely to cross-contaminate, and appropriate for use in laboratories with limited resources. Therefore, the currently developed and optimized blood lysate method could serve as a viable alternative to purified whole blood genomic DNA for molecular detection (PCR) of haemoparasites in animals particularly in resource-limited settings.

Abstract This research investigates the biogenic synthesis of silver nanoparticles (AgNPs) using the leaf extract of Chromolaena odorata (Asteraceae) and their potential as antibacterial and antifungal agents. Characterization techniques like ultraviolet–visible, Fourier transform infrared (FTIR), Dynamic light scattering and zeta potential (DLS), X-ray diffraction (XRD), transmission electron microscopy (TEM), and field emission scanning electron microscopy and energy-dispersive X-ray spectroscopy (FESEM-EDX) confirmed the formation of spherical (AgNPs). UV–vis spectroscopy reaffirms AgNP formation with a peak at 429 nm. DLS and zeta potential measurements revealed an average size of 30.77 nm and a negative surface charge (− 0.532 mV). Further, XRD analysis established the crystalline structure of the AgNPs. Moreover, the TEM descriptions indicate that the AgNPs are spherical shapes, and their sizes ranged from 9 to 22 nm with an average length of 15.27 nm. The X-ray photoelectron spectroscopy (XPS) analysis validated the formation of metallic silver and elucidated the surface state composition of AgNPs. Biologically, CO-AgNPs showed moderate antibacterial activity but excellent antifungal activity against Candida tropicalis (MCC 1559) and Trichophyton rubrum (MCC 1598). Low MIC values (0.195 and 0.390 mg/mL) respectively, suggest their potential as effective antifungal agents. This suggests potential applications in controlling fungal infections, which are often more challenging to treat than bacterial infections. Molecular docking results validated that bioactive compounds in C. odorata contribute to antifungal activity by interacting with its specific domain. Further research could pave the way for the development of novel and safe antifungal therapies based on biogenic nanoparticles.

Introduction: Nonmetric dental traits have a crucial role in ethnic classification of populations that help in forensic racial identification. Many studies have demonstrated the differences in the expression and frequency of dental traits between various ethnic groups for ancestry determination in the context of forensic dental anthropology. The present study is an attempt to assess the frequency and variation in nonmetric traits for establishing ethnicity in the Vidarbha subpopulation. Aim: The aim of the study was to assess the frequency and variation of nonmetric traits in permanent teeth for establishing ethnicity in the Vidarbha subpopulation. Materials and Methods: Participants of the Vidarbha subpopulation were selected by random sampling method. Molars, premolars, and incisors were evaluated for frequency of nonmetric traits, and variations were graded according to Dentoanthropological System of State University of Arizona criteria. Descriptive statistics, Chi-square test, and Student's t-test were used for analysis of data. Results: The most common occlusal morphology in mandibular first and second molar was 5 cusp and 4 cusp, respectively, with the “+” groove pattern. Cusp 3 and cusp 4 were observed frequently in the maxillary molars. One lingual cusp was most commonly seen in mandibular premolars show while incisors showed faint shoveling. Conclusion: Our study concludes that nonmetric traits were present and showed variation in permanent maxillary and mandibular teeth among the Vidarbha subpopulation. Cusp 5 and Cusp 4 in first and second mandibular molars, respectively, groove pattern “+” and grade 1 protostylid were the most frequent grades observed in permanent mandibular molars. One lingual cusp was most commonly seen in mandibular premolars and faint shoveling was a notable feature in incisors of this population.

Aim: This analysis was conducted to review the number, and describe the characteristics of first-in-human (FIH) Phase 1 clinical trials registered in India from 2008 to 2022. Materials and Methods: The data were extracted from the Clinical Trials Registry – India database for all FIH Phase 1 clinical trials registered between 2008 and 2022. Early-phase trials that were not FIH trials (e.g., pharmacokinetic studies and drug–drug interaction studies) were excluded from the study. Results: A total of 1891 trials were retrieved and 220 were included in the analysis. Most of the investigational products were drugs (55%) followed by vaccines (38.2%). The most common therapeutic class of drugs was cancer chemotherapy (19.8%), followed by antimicrobial chemotherapy and endocrinology (18.2% each). The most common vaccine was the influenza vaccine (21.4%), followed by the measles–mumps–rubella vaccine (15.5%). The pharmaceutical industry was the predominant sponsor for most (91%) of the Phase 1 trials. Of the top five sites where most of the Phase 1 trials were conducted, three were private nonacademic centers (cumulatively 31%) and two were tertiary care medical colleges (cumulatively 9%). Conclusion: Phase 1 clinical trials seem to be conducted in India predominantly with industry sponsorship. There is a need to have an alternate ecosystem to take forward molecules that do not receive adequate attention from the industry and molecules that are of national health priority other than areas such as chemotherapy, antimicrobials, and endocrinology. The Indian Council of Medical Research is setting up Phase 1 clinical trial capacity for molecules that predominantly may arise from nonindustry channels.

Trends and factors associated with cervical cancer screening (CCS) among women of reproductive age are essential for designing cancer prevention strategies to reduce mortality. The present study investigates the factors contributing to CCS in India through multilevel modeling on data from women files of the fifth round of the National Family Health Survey (NFHS- 5). Districts, villages, and individuals were considered as the levels under investigation. Age, contraception use, and wealth index impacted the CCS significantly. The percentage of CCS is 1.2, and it varies across socioeconomic factors. The prevalence of cervical cancer screening is high among women in the 30–49 age group, in the rich wealth index, and not utilizing condoms as contraception. The screening percentage was found to be highest in southern states. A pressing need was felt for organizing awareness camps and all-inclusive dissemination of information, especially in the Northern part of India.

Securing data generated from diverse sensors poses a critical challenge in contemporary applications, particularly due to the escalating volume of data and its vulnerability to security breaches. Blockchain technology has emerged as a promising solution, yet the implementation of blockchain applications entails significant costs. Assessing the feasibility of such implementations through simulation is imperative but has been hindered by a lack of details survey about the simulation tools leading to wrong choice of tools by the researchers, as every application is unique and requires specific blockchain platform as per use.This paper covers an extensive survey of 32 simulation tools used in blockchain, focusing on their advantages, limitations, platform used, and capability to evaluate performance metrics of blockchain applications. This enables the researchers to choose the correct simulation tool for their work. The work allows the programmer to test their application using the correct simulation tool, saving implementation costs and time. Furthermore, we discussed CBlockSim, a simulation tool designed specifically for blockchain applications, elucidating its functionality through a comparative study of Bitcoin and Ethereum.Our work contributes to advancing the understanding and application of simulation tools in blockchain-based sensor data security, offering insights that can significantly enhance the security posture of sensor networks.

Training healthcare professionals in research methodology is essential to promote research and innovation. This is particularly relevant in India, where there is a wealth of potential drug candidates from Indian Traditional Medicine (TM) systems that await exploration and scientific validation using modern medicine principles. Surprisingly, there is a lack of reported activities to train modern medicine practitioners in TM research in the literature. Recognising this need, a structured training program was planned and conducted under the auspices of the Indian Council of Medical Research (ICMR) to train modern medicine practitioners in TM research. A survey was conducted among modern medicine practitioners to assess training gaps and identify key areas to be covered in the workshop modules. The workshop received a positive response, as evidenced by the numerous registration applications and positive feedback from participants. The present article shares the experiences of conducting the pilot workshop, which may serve as a valuable resource for planning similar workshops.

Background/Objectives: The prevalence of atrial fibrillation (AF) has been on the rise over the last 20 years. It is considered to be the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The need for in-hospital management of patients having AF is increasing. Acute decompensation of cardiac rhythm is an indication for hospital admission. In the existing literature, several studies on different pathologies have observed that the risk of death was greater for patients with an increased neutrophil-to-lymphocyte ratio (NLR) and suggested that the NLR can be a useful biomarker to predict in-hospital mortality. This study aims to evaluate the link between the neutrophil-to-lymphocyte ratio at admission and death among the patients admitted to the medical ward for the acute manifestation of AF, and to gain a better understanding of how we can predict in-hospital all-cause death based on the NLR for these patients. Methods: A single-center retrospective study in an academic medical clinic was conducted. We analyzed if the NLR at in-hospital admission can be related to in-hospital mortality among the patients admitted for AF at the Medical Ward of Municipal Emergency University Hospital Timisoara between 2015 and 2016. After identifying a total of 1111 patients, we divided them into two groups: in-hospital death patients and surviving patients. We analyzed the NLR in both groups to determine if it is related to in-hospital mortality or not. One patient was excluded because of missing data. Results: Our analysis showed that patients who died during in-hospital admission had a significantly higher NLR compared to those who survived (p < 0.0001, 95% CI (1.54 to 3.48)). The NLR was found to be an independent predictor of in-hospital death among patients with AF, even for the patients with no raised level of blood leukocytes (p < 0.0001, 95% CI (0.6174 to 3.0440)). Additionally, there was a significant correlation between the NLR and the risk of in-hospital death for patients admitted with decompensated AF (p < 0.0001), with an area under the ROC curve of 0.745. Other factors can increase the risk of death for these patients (such as the personal history of stroke, HAS-BLED score, and age). Conclusions: The NLR is a useful biomarker to predict in-hospital mortality in patients with AF and can predict the risk of death with a sensitivity of 72.8% and a specificity of 70.4%. Further studies are needed to determine the clinical utility of the NLR in risk stratification and management of patients with AF.

Background: Minimum clinically important difference (MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides development of new outcome measures. Objectives: To provide a comprehensive summary of MCID thresholds of various symptom severity scales reported in movement disorder. Methods: We conducted systematic review of the literature and included studies of one or more movement disorders, and reporting MCID scales. Results: 2763 reports were screened. Final review included 32 studies. Risk of bias (RoB) assessment showed most studies were of good quality. Most commonly evaluated scale was Unified Parkinson's Disease Rating Scale (UPDRS) (11 out of 32). Four studies assessing MDS-UPDRS had assessed its different sub-parts, reporting a change of 2.64,3.05,3.25 and 0.9 points to detect clinically meaningful improvement and 2.45,2.51,4.63 and 0.8 points to detect clinically meaningful worsening, for the Part I, II, III and IV, respectively. For Parts II + III, I + II + III and I + II + III + IV, MCID thresholds reported for clinically meaningful improvement were 5.73, 4.9, 6.7 and 7.1 points respectively; while those for clinically meaningful worsening were 4.7, 4.2, 5.2 and 6.3 points, respectively. MCID thresholds reported for other scales included Abnormal Involuntary Movement Scale (AIMS), Toronto Western Spasmodic Torticollis Rating Scale (TWSRS), and Burke-Fahn-Marsden Dystonia Scale (BFMD). Conclusion: This review summarizes all the MCID thresholds currently reported in Movement disorders research and provides a comprehensive resource for future trials, highlighting the need for standardized and validated MCID scales in movement disorder research.

The increased frequency of dry spells related to climate change has posed a major threat to food security globally. Recently, a surge has been observed in the disease incidences caused by the phytopathogens that flourish under hot and dry conditions. Macrophomina phaseolina is one such pathogen that can cause an absolute loss of productivity in host plants including Vigna radiata (mungbean). In the current study, six mungbean cultivars were screened for the combined stress caused by simultaneous exposure to M. phaseolina infection and drought. Both the drought stress (D) and M. phaseolina infection (F) were applied to ten days old plants in three combinations i.e. DF (one week drought stress followed by fungal infection and normal watering), DFD (one week drought stress followed by fungal infection with extended drought) and FD (normally watered plants exposed to fungal infection followed by drought stress). The growth, physiological (photosynthetic efficiency) and biochemical parameters (antioxidant enzyme activity, callose, soluble sugars, proline, lipid peroxidation and hydrogen peroxide content) were recorded in one month old mungbean plants. The yield and nutritional quality of seeds were also determined. The data revealed that the cultivar RMG-975 consistently maintained the yield under all the stress conditions; the maximum decrease (19.1%) was recorded in the total seed weight of phytopathogen inoculated plants. With 60.6% increase in mean variability in yield (weight of seeds) under DF treatment, the cultivars (except ‘SML-668′) previously exposed to drought stress performed exceptionally better in terms of nutritional quality (increase in mean variability of seed protein-26.45% and total antioxidant capacity-14.84%) when subjected to M. phaseolina infection. Therefore, the strategy of short-term drought stress followed by the application of an elicitor that mimics the induction of biotic stress response could be opted for the increased production of seeds rich in protein and antioxidants. The combined stress tolerance and susceptibility was subject to the cultivar type and varied with the changing environmental conditions. The increased resistance under DF was attributed to callose deposition whereas under FD, it was due to higher accumulation of proline and soluble sugars. The increase in mean variability in proline (drought stress marker) levels under FD (133.41%) and DFD (21.25%) and reduction under DF treatment (39.75%) showed that already stressed plants switch their response strategies on encountering another sequential stress condition.

Adverse childhood experiences (ACEs) are potentially traumatic events that occur before 18 years of age. Studies emphasize the importance of childhood adversity as a risk factor for developing non-communicable diseases, including type-2 diabetes mellitus (T2DM) in adulthood. This case-control study involved 137 patients with T2DM and 134 non-diabetic adults of both genders (mean age 46.9 and 45.7 years, respectively). In addition to collecting socio-demographic, behavioral, and anthropological data, a 10-item ACE scale was utilized to gather information regarding childhood adversities, while perceived stress was assessed using the perceived stress scale-4. Fasting and 2-hour post glucose load blood sugar levels, HbA1c, and fasting lipid profiles were measured. Both univariable and multivariable binary logistic regression analyses were performed to investigate whether ACE is a potential risk factor for T2DM, with a significance level of 0.05. Around two-thirds of T2DM patients reported having ACE scores of 4 or higher, with the mean ACE score significantly higher in the case group than in the control group (3.96 vs. 3.34; p

Nowadays, the search for new chemotherapeutic agents with low toxicity and high selectivity is a major concern. In this paper, we report the synthesis and characterization of a hybrid thiosemicarbazone/hydrazone ligand in its neutral form (L1H2) and as the chloride salt ([L1H3]Cl)-, three diorganotin (IV) complexes, and one complex with Sn (IV). The compounds have been fully characterized by IR, mass spectra, 1H, 13C, and 119Sn NMR, 119Sn CP/MAS NMR, and by single crystal X-ray diffraction. The organotin compounds have the empirical formula [SnR2L1] (R = Me, Bu, and Ph), but in the solid state, they are polymeric species with seven coordination number due to weak coordination of the pyridine nitrogen, whereas in solution, the polymeric structure is lost to afford hexacoordinate monomeric species. Reaction with SnI4 yields complex [Sn (L1)2]·EtOH, with the metal in a distorted dodecahedral arrangement. We have evaluated the antiproliferative activity of the two forms of the ligands and the four coordination compounds against MDA-MB-231, HeLa, PC3, and HepG2 cancer cell lines, and WI-38 normal cell line, and all the compounds present higher activity than cisplatin, used as the standard control. To investigate the mode of action, we have selected the most active complex, containing phenyl substituents, and used the triple negative breast cancer cell line MDA-MB-231. The results show that the complex induces apoptotic cell death promoted by generation of reactive oxygen species and by disruption of mitochondrial membrane potential.

Background: Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods: A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10–18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm–5 mm), and fragmentary rugae (

There is a growing awareness of the significance of using minimum clinically important differences (MCIDs) in stroke research. An MCID is the smallest change in an outcome measure that is considered clinically meaningful. This review is the first to provide a comprehensive summary of various scales and patient-reported outcome measures (PROMs) used in stroke research and their MCID values reported in the literature, including a concise overview of the concept of and methods for determining MCIDs in stroke research. Despite the controversies and limitations surrounding the estimation of MCIDs, their importance in modern clinical trials cannot be overstated. Anchor-based and distribution-based methods are recommended for estimating MCIDs, with patient self-evaluation being a crucial component in capturing the patient’s perspective on their health. A combination of methods can provide a more comprehensive understanding of the clinical relevance of treatment effects, and incorporating the patient’s perspective can enhance the care of stroke patients.

Background: Cardiomyopathies (CMs) represent a heterogeneous group of primary myocardial diseases characterized by structural and functional abnormalities. They represent one of the leading causes of cardiac transplantations and cardiac death in young individuals. Clinically they vary from asymptomatic to symptomatic heart failure, with a high risk of sudden cardiac death due to malignant arrhythmias. With the increasing availability of genetic testing, a significant number of affected people are found to have an underlying genetic etiology. However, the awareness of the benefits of incorporating genetic test results into the care of these patients is relatively low. Aim: The focus of this review is to summarize the current basis of genetic CMs, including the most encountered genes associated with the main types of cardiomyopathies: hypertrophic, dilated, restrictive arrhythmogenic, and non-compaction. Materials and Methods: For this narrative review, we performed a search of multiple electronic databases, to select and evaluate relevant manuscripts. Results: Advances in genetic diagnosis led to better diagnosis precision and prognosis prediction, especially with regard to the risk of developing arrhythmias in certain subtypes of cardiomyopathies. Conclusions: Implementing the genomic information to benefit future patient care, better risk stratification and management, promises a better future for genotype-based treatment.

Administration of local anesthesia via injection is the main reason for inducing anxiety in children and if not intervened it aggravates the anxiety in subsequent appointments. There are many approaches, including pharmacological and non-pharmacological methods that can be used to reduce children’s perception of pain and anxiety. A frequently used non-pharmacological behaviour management method to reduce anxiety and procedure pain is distraction. The rationale of distraction is to shift the attention to avert the brain from receiving unwanted stimulus which induce anxiousness. Many approaches including music, television, portable video games, virtual reality (VR) helmet, and virtual reality audio-visual eyewear, have been implemented so far. Kaleidoscope and virtual reality goggles may help as distraction techniques in reducing the levels of anxiety caused during administration of local anesthesia. By the aid of which the operator may be able to make the dental experience child friendly and ultimately provide quality dental care to anxious children. Non pharmacological measures of reducing pain are cost effective and best means that can be used while performing dental procedures. This is a research protocol for a study aimed to evaluate and compare the effectiveness of kaleidoscope and virtual reality goggles to reduce dental anxiety in young children.