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Purpose: Pleuropulmonary blastoma (PPB) is a rare malignancy associated with mutations in the DICER1 gene. Early-stage disease (PPB type I) mimics cystic lung malformations and develops in infants <1 year of age, and PPB type II and III arises in older children. The objective of this study was to analyze predictive factors of mortality in pediatric patients aged 0-19 years diagnosed with PPB between 2000 and 2019 in the USA. Methods: A retrospective analysis of pediatric patients (0-19 years) in the Surveillance Epidemiology and End Results database was conducted from 2000 to 2019 with a diagnosis of PPB using International Classification of Disease for Oncology, third edition code 8973/3 and rare tumor code 45. Demographics, incidence, staging, treatment, and mortality were extracted. A mortality risk predictive equation was developed using logistic regression. Statistical analysis was conducted through Microsoft Excel Analysis ToolPak and Solver. Results: There were a total of 71 new cases of PPB during the study period, with 16 (22%) deaths. The demographic analysis demonstrated that 40/71 (56.3%) patients were female, 57/71 (80.3%) were White, and 64/71 (90.1%) resided in metropolitan areas. Regression analysis demonstrated a statistically significant correlation between mortality and stage (P = 0.029), need for chemotherapy (P = 0.047), and female sex (P = 0.019). There was no significant correlation between mortality and need for radiation, race, or age at diagnosis. Multiple logistic regression analysis generated a predictive equation of mortality dependent on the stage of PPB, need for chemotherapy, and sex. This equation has an 82% accuracy, 81% sensitivity, and an 18% false positive rate. Conclusion: PPB is a rare disease. Distinguishing PPB from benign cystic lung malformations in infancy is important to avoid progression to Type II and III PPB. Advanced stages of PPB have a greater need for systemic chemotherapy and radiation with a poor prognosis. [ABSTRACT FROM AUTHOR]

Background: Acute lymphoblastic leukemia (ALL) has survival rates of greater than 90% in developed nations. However, various sociodemographic factors adversely affect outcome rates in low- and middle-income countries (LMICs). Objective: To study induction outcome of ALL and various factors affecting it. Methods: This was a prospective cohort study which enrolled 86 children up to the age of 18 years with newly diagnosed ALL registered in newly established pediatric hematology and oncology division over the duration of 3 years. Sociodemographic and clinical data was collected. Outcome was assessed using morphological remission, minimal residual disease (MRD) and mortality rate. Results: Of the 170 children with malignancies registered, 86 were ALL. Mean age was 7.09 ± 4.07 years and the M: F ratio of 1.32:1. Sixteen (38.09%) of them had severe acute malnutrition and another 16 (38.09%) had moderate acute malnutrition. Thirty (68.18%) children over 5 years were undernourished. Seventy-four (86.05%) were B-ALL and 12 (13.95%) T-ALL. In total, 28.77% had WBC counts greater than 50 × 109 /L. t (12;21) was the most common cytogenetic abnormality. Majority (60.46%) of the patients belonged to lower socioeconomic status. Seventy-one (93.42%) patients completed induction of which 100% attained morphological remission and 64 (90.14%) were MRD negative. There were five mortalities, three (60%) due to sepsis and 2 (40%) due to hemophagocytic lymphohistiocytosis. Fifty (65.78%) children had morbidities during induction, febrile neutropenia being the commonest. Conclusions: Successful induction outcome rates at par with high-income countries can be achieved even in resource-limited settings of LMIC with support from government and NGOs. Decentralized cancer care centers can effectively pave the way in reducing cancer mortality in children of lower socioeconomic status residing in rural areas. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use is one of the most significant public health concerns globally as it is a risk factor for chronic illnesses. GATS-2 concluded that 28.6% of all adults currently use Tobacco in India and 17.8% in Delhi. It is important to conduct such surveys in local areas to make specific and effective action plans. Materials and Methods: Community-based cross-sectional study conducted between January 2020–June 2021 in Aliganj, an urbanized village in South Delhi. Four hundred ninety participants were enrolled using simple random sampling. The first author conducted the interview using GATS and Fagerstrom nicotine dependence test. Data was analyzed using SPSS-21. Results: Median age-35 (26.75–75.00), range-15–84 years. Of the 490 participants, 20.0% were current tobacco users (10.6% smokeless, 7.3% smoked, and 2.2% both). Among current smokers, 78.3% had low, 17.4% moderate, and 4.3% had high dependence on nicotine dependence. Among current smokeless tobacco users, 52.4% had, low, 36.5% moderate, and 11.1% had high dependence. Males had significantly higher odds [6.6 (2.9-15.1)] of tobacco use than females. Higher education [0.3 (0.2-0.8)] compared to no formal education had significantly lower odds of using tobacco. Students [0.1 (0.04-0.4)] and homemakers [0.1 (0.01-0.5)] had significantly lower odds of using tobacco as compared to those employed. Conclusions: One in every five adults is a tobacco user in Aliganj. Manufactured cigarettes, bidi, and water pipes were the most common products among smokers. Among smokeless tobacco users, the most common products were chewing tobacco gutka, and khaini. A larger proportion of smokeless tobacco users had high nicotine dependence than smoked tobacco users. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infection (ARI) is one of the leading causes of morbidity and eventually mortality in under-five children across the globe. Awareness regarding ARI among mothers of these children is very essential to detect danger signs early, prevent the delay in health-seeking and thereby limiting its progression to severe illness. The present study was undertaken to assess the awareness of mothers regarding ARI in their under-five children and their healthcare-seeking behavior for the same. Materials and Methods: The present cross-sectional study was carried out among 200 mothers of under-five children attending the outpatient department of a rural health center in Tamil Nadu. A predesigned questionnaire was used to assess their sociodemographic characteristics, awareness about ARIs, and healthcare-seeking behavior regarding ARIs in under-five children. Descriptive and inferential statistics were applied for data analysis. Results: The mean awareness score (±standard deviation) of mothers regarding ARI in their under-five children was 8.34 ± 1.49, and overall, 94.50% of mothers had fair awareness regarding ARI. The association between occupation and awareness level of mothers regarding ARI was found to be statistically significant, while that of other variables was not statistically significant. Most of the mothers (88.0%) preferred to consult a qualified allopathic doctor for their child's ARI. Those who do not seek health-care services for their child's illness believe that the disease is self-limiting, while others try traditional medicines at home before seeking health-care services. Conclusion: Majority of mothers had fair awareness regarding childhood ARI in this study. It is necessary to put more effort into educating these mothers about the importance of early detection and seeking appropriate health care for ARI in their children. [ABSTRACT FROM AUTHOR]

One of the most common diseases causing the destruction of enamel and remaining tooth structure is dental caries which further leads to pulpal and periapical inflammation if not treated. As tools for revealing important factors in identifying targets disease and pathophysiology for the evolution of prevention and treatment strategies, molecular and cellular biology plays a pivotal role. Finding an accurate diagnosis that will serve as the foundation for effective treatment continues to be one of the key issues in endodontics. Inflammatory biomarkers play a diverse and broad role in endodontics, with the potential to become a key factor in determining treatment plans by assisting in diagnosis and prognosis. Inflammatory biomarkers have the potential to become a key factor in determining treatment plans by assisting in diagnosis and prognosis. Endodontists are still divided on issues such as vital pulp therapy versus traditional root canal therapy and retreatment versus periapical surgery. Furthermore, clinical challenges such as determining the appropriate tissue fluid to analyse, establishing a precise inflammatory threshold, and delivering results at the chairside must be overcome. Endodontists may soon be able to use chairside genetic tests to make more informed treatment decisions for their patients. [ABSTRACT FROM AUTHOR]

A woman's health should reach beyond the narrow perspective of maternal and reproductive health and should encompass physical as well as mental health across the life cycle. The focus should be shifted to a broader, social, legal, and economic factors rather than just immersing on lifestyle and individual factors. Recognition of mental health issues among women, education, training, and interventions at various levels would contribute to the improvement of mental health issues among women. [ABSTRACT FROM AUTHOR]

Background: Root repair material ideal characteristics are its ability to adapt to the walls of root canal and avoid leakage of microorganisms and their by‑products into the peri‑radicular tissue. They should be biocompatible, able to produce osteogenesis and cementogenesis, bacteriostatic, radiopaque, and remain unaffected by blood and moisture. Tissue inflammation and metabolic acidosis following bacterial colonization in pathological condition such as necrotic pulp or periapical abscess lead to change in neutral pH. The pH near periapical tissue lowers to around 5.5. The purpose of this research is to determine the effect of acidic media such as butyric acid on bond strength on mineral trioxide aggregate (MTA), Biodentine (BD), and EndoSequence root repair materials (ERRM) with root dentin wall. Methodology: The research was conducted in Vasantdada Patil Dental College. About 60 extracted teeth without any curve canal were selected. They were further divided into three groups of 20 each. Using diamond saw disc, mid root dentin were sectioned horizontally to thickness of 2.0–2.1 mm, further root repair materials were mixed according to instruction given by manufacturer. Result: The result concluded that push‑out bond strength in both phosphate‑buffered saline and acidic environment was higher with ERRM. Conclusion: Thickening agent and fillers added in ERRM result in higher push bond strength than MTA and BD. [ABSTRACT FROM AUTHOR]

Introduction: To study the clinical characteristics and treatment outcomes of patients with anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis (DM). Methods: This was a retrospective study done between 2019 and 2021 in a tertiary care center in South India. All consecutive patients, presenting to the adult rheumatology department, classified as idiopathic inflammatory myositis (IIM), and positive for anti-MDA5 antibodies, were included in the study. Baseline characteristics of anti-MDA5 patients were compared with the data of non-MDA5 patients over the last 10 years. Clinical, biochemical, and treatment responses were assessed on follow-up. Complete and partial responders were identified using predefined criteria. Factors predicting mortality were determined by logistic regression analysis. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Results: A total of 29 adult patients of IIM were positive for anti-MDA5 antibody during the study period. The mean (±standard deviation) age of the patients was 40.3 (±13.02) years with a female:male ratio of 1.4:1. Panniculitis, calcinosis, palmar papules, and ulcerated Gottron's were the specific cutaneous manifestations, seen in 3 (10%), 7 (24%), 4 (13.4%), and 7 (24%) patients, respectively. A total of 14 patients (48.1%) had clinically amyopathic DM and 17 patients (60.7%) had interstitial lung disease (ILD) diagnosed by high-resolution computerized tomography scan, of which organizing pneumonia was the predominant pattern. Complete response was seen in 10 patients (43.4%), while a partial response was seen in 8 patients (34.7%). Five patients died on follow-up, accounting for mortality of 21%. Age >50 years was significantly associated with mortality (P = 0.025). Gottron's sign (P < 0.001), panniculitis (P < 0.001), calcinosis (P < 0.001), cutaneous ulcerations (P < 0.001), inflammatory arthritis (P < 0.001), and ILD (P < 0.02) were present more commonly in the anti-MDA5 IIM group, whereas myopathy (P < 0.001), elevated creatine phosphokinase (P < 0.001), and lactate dehydrogenase (P < 0.001) were more frequently present in the non-anti-MDA5 IIM group (n = 421). Conclusions: Anti-MDA5 DM represents a distinct and unique subset of IIM with characteristic clinical manifestations. Elderly age is a poor prognostic factor of mortality. [ABSTRACT FROM AUTHOR]

Background: Injectable platelet-rich fibrin (i-PRF) being in liquid form keeps graft particles clumped together forming agglutinated steak of bone graft. It has been shown to contain more platelets and long-term deliverance of growth factors in comparison with platelet-rich fibrin (PRF). Aim: The aim of the present study was to assess regenerative potential of i-PRF and comparing it with PRF, along with demineralized freeze-dried bone allograft (DFDBA) in the treatment of intrabony alveolar defects. Materials and Method: Thirty defect sites in 15 patients with bilateral intrabony defects were assigned randomly into two groups (Group I (Control group)- DFDBA + PRF and Group II (Test group)-DFDBA + i-PRF). Gingival index (GI), plaque index (PI), pocket probing depth (PPD), and relative attachment level (RAL) were recorded at baseline, 3 months, and 6 months. Linear bone growth (LBG) was recorded radiographically at baseline and 6 months. Statistical Analysis: ANOVA test and post hoc Tukey test were used to assess intragroup comparison of clinical parameters. Paired t-test was used to assess intragroup comparison of the radiographic parameter. Unpaired t-test was used to assess intergroup variations in all the clinical as well as radiographic parameters. Results: Statistically significant PPD reduction (P = 0.005) and RAL gain (P = 0.003) were found in Group II than in Group I, and no significant difference was found in other parameters. Percentage LBG was higher in Group II than Group I but the difference was not statistically significant. Conclusion: i-PRF with DFDBA showed more favorable results as compared to PRF with DFDBA in the management of intrabony periodontal defects. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate and compare the compressive strength, Vickers microhardness number, and wear resistance of amalgam (DPI), Filtek Z350 nanohybrid (3M ESPE), and Zirconomer (Shofu) restorative materials after 24 h and 3 months. Methodology: The restorative materials were divided into Zirconomer (Group I), Filtek Z350 (Group II), and amalgam (Group III). These materials were placed in cylindrical molds to prepare the specimens. The specimens were stored in distilled water at 37°C. The specimens were tested at 24 h and 3 months for compressive strength, wear resistance, and microhardness. Results: Group I showed significantly less maximum load (N) and compression strength (MPa) when compared with Group III (control) and Group II (P < 0.01). There was no significant difference in microhardness between the three groups. Group I showed significantly more wear (weight loss [g]) and wear (weight loss [%]) when compared with Group III (control) and Group II. Conclusion: The study concludes that amalgam and nanohybrid composite performed better than Zirconomer at the end of 24 h and 3 months. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to evaluate the effect of hand files, rotary nickel-titanium files, and self-adjusting file (SAF) on the incidence of crack formation during retreatment. Materials and Methods: Eighty extracted human mandibular molar teeth with intact mesial roots were selected. They were divided into 8 groups of 10 teeth each; Group 1: Control, Group 2: Obturated control, Group 3: Hand files, Group 4: ProTaper Universal Retreatment, Group 5: Twisted File Adaptive, Group 6: Reciproc Blue, Group 7: XP-endo Finisher R, Group 8: SAF system. All teeth had the coronal portions and distal roots removed by a diamond-coated disc with water cooling, leaving roots approximately 13 mm in length. Except for Group 1, all canals were similarly instrumented and obturated at an apical size of 40.02. Retreatment was performed in each group according to manufacturer's recommendations except for Groups 1 and 2. The roots were sectioned horizontally at 3, 6, and 9 mm from the apex with a low-speed saw. Stereomicroscopic evaluation of the sections was done to assess the presence or absence of defects. Results: The groups that were not retreated (Groups 1 and 2) showed no defects. Hand files showed the least number of defects followed by the SAF. Reciproc Blue showed the most dentinal defects. Conclusion: All NiTi instruments tend to induce various degrees of dentinal damage during retreatment procedures. The SAF and hand instrumentation presented satisfactory results with minimal dentinal microcracks. [ABSTRACT FROM AUTHOR]

Effective and safe ophthalmic anesthesia is essential for the delivery of ophthalmic perioperative care both for children and adults. Recent years have seen a major change in form of smaller incisions for most ophthalmic surgical techniques, thus making them less invasive. Additionally, most ophthalmic surgeries are now day-care surgeries at ambulatory surgical centers. The parallel advancements in the field of anesthesiology have boosted the standard of perioperative care. The purpose of this narrative review was to evaluate current trends in anesthetic agents and techniques for ophthalmic anesthesia primarily centered around deep sedation and general anesthesia as per the concerns of practicing anesthesiologists while briefly acquainting with local anesthesia advances. [ABSTRACT FROM AUTHOR]

Background: In the recent years, there has been a rapid increase in the use of robot assisted neck dissection (RAND) as an alternative method for conventional neck dissection. Several recent reports have emphasized upon the feasibility and effectiveness of this technique. However, substantial technical and technological innovation is still essential in spite of the availability of multiple approaches for RAND. Materials and Methods: The present study describes a novel technique, i.e., Robotic Infraclavicular Approach for Minimally Invasive Neck Dissection (RIA MIND) used in head and neck cancers with the help of Intuitive da Vinci Xi Surgical System. Results: After RIA MIND procedure, the patient was discharged on the third post operative day. Also, the total wound size was less than 3.5 cm which enhanced the patient recovery time and required minimal post operative care. The patient was further reviewed 10 days after the procedure for the removal of sutures. Conclusion: RIA MIND technique was effective and safe for performing neck dissection for oral, head and neck cancers. However, additional detailed studies will be required for establishing this technique. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of repeat deep anterior lamellar keratoplasty (DALK) in patients of previous failed DALK. Methods: A retrospective analysis of records of seven patients who had undergone repeat DALK following the failure of the primary DALK was done. The indications for repeat surgery, time elapsed since the first surgery, and pre- & postoperative best-corrected visual acuity (BCVA) were noted for all the patients. Results: The follow-up period ranged between one- to four-year post repeat DALK. The indication of primary DALK was keratoconus with vernal keratoconjunctivitis (VKC) (n = 3), corneal amyloidosis (n = 2), Salzman nodular keratopathy (n = 1), and healed keratitis (n = 1). The need for repeat surgery arose when the BSCVA dropped to less than 20/200. The time interval elapsed since the first surgery ranged from two months to four years. Postoperatively, the BSCVA improved from 20/120 to 20/30 at the end of one-year post repeat DALK in all except one patient. All regrafts were clear at the most recent examination, performed after a mean period of 18 months after the secondary graft. No complication was encountered during the resurgery. The dissection of the host bed was easier in the second surgery owing to weaker adhesions. Conclusion: The prognosis for repeat DALK for failed DALK is excellent, and the outcomes of secondary grafts were comparable to those of primary DALK grafts. Re DALK offers the advantage of an easier dissection and lower chances of graft rejection compared to penetrating keratoplasty. [ABSTRACT FROM AUTHOR]

Purpose: The second wave of coronavirus disease 2019 (COVID-19) pandemic triggered a mucormycosis epidemic in India. Diabetes mellitus and dysregulated immune response were contributors, and rhino-orbital-cerebral mucormycosis (ROCM) was the most common presentation. It is however not known whether bio-chemical parameters at presentation correlate with stage of ROCM or final outcome in terms of vision or mortality. Methods: This retrospective, hospital-based study included all in-patients of mucormycosis with ophthalmic manifestations at presentation admitted during June 1, 2021 to August 31, 2021. It aimed to evaluate the association between severity of infection, serum levels of HbA1c, ferritin, interleukin-6 (IL-6), C-reactive protein (CRP), and D-dimer levels at presentation and outcome. Results: There were altogether 47 eligible cases having a mean age of 48.8 ± 10.9 years with a male:female ratio of 2.6:1; forty-two (89.4%) had pre-existing diabetes, and five (10.6%) had steroid-induced hyperglycemia. The mean HbA1c among diabetics was 9.7 ± 2.1. HbA1c and serum CRP showed an increase over subsequent stages, which was not statistically significant (P = 0.31). IL-6 values for all stages were similar (P = 0.97). Only serum ferritin levels showed a statistically significant increase over stages (P = 0.04). IL-6 was significantly lower (P = 0.03) in patients who survived, whereas CRP levels were significantly lower in patients who had final visual acuity (VA) better than only perception of light (P = 0.03). Conclusion: Uncontrolled diabetes mellitus is a significant association of ROCM. Serum ferritin levels at presentation best correlate with extent of the disease. CRP levels are best to prognosticate cases that will have sufficient VA to carry on activities of daily living, whereas IL-6 levels are best associated with survival. [ABSTRACT FROM AUTHOR]

Purpose: To reveal early intervention outcomes for patients describing with choroidal metastasis. Methods: A retrospective interventional case series on 27 eyes of 22 patients treated for choroidal metastasis with external beam radiation therapy (EBRT) With and without intravitreal injections. The prescribed radiation dose was a mean and median 30 Gy (range of 30--40 Gy in 180--200 cGy daily fractions). Outcome measures included change in tumor thickness, subretinal fluid, visual acuity, radiation oculopathy, and survival. Results: Decreased vision was the most common presenting symptom (n = 20/27, 74%). Pre-treatment vision for subfoveal lesions was a mean 20/400, median 20/200, and range 20/40 to hand motions (HM). Pre-treatment vision for extrafoveal tumors were a mean 20/40, median 20/25, range 20/20 to counting fingers (CF) which improved to a mean 20/32, median 20/20, range 20/12.5 to 20/200. Local control, with ultrasonographic height regression (44.5%; mean: 2.7--1.5 mm), was observed in all eyes at mean follow-up of 16 months (range: 1--72 months). Intravitreal anti-vascular endothelial growth factor (anti-VEGF) was given in nine cases (n = 9/27, 33%) to slow the growth of the metastasis and suppress their exudative detachments and to treat radiation maculopathy in 10 cases (n = 10/27, 37%). Late radiation complications included keratoconjunctivitis sicca in four cases (n = 4/27, 15%), exposure keratopathy in two cases (n = 2/27, 7%), and radiation retinopathy in 10 cases (n = 10/27, 37%). Of the 23 phakic eyes, four (n = 4, 17%) developed cataract. Conclusion: Radiation therapy with or without intravitreal anti-VEGF injections was a safe and effective treatment for choroidal metastasis. It was associated with local tumor control, reduction of secondary retinal detachments, and vision preservation. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is one of the most common dermatoses in the pediatric population and pruritus is its leading symptom; however, the clinical aspect of pruritus has not been studied much. The aim of the study was to explore clinical aspect of pruritus in pediatric AD and to analyze correlation of intensity of pruritus to the severity of AD. Methods: A hospital-based cross-sectional study of 106 pediatric patients of AD, between the age group of 6 months and 16 years was conducted. Diagnosis was made using the UK Working Party's Diagnostic Criteria for AD. The severity of pruritus and sleep disturbances were assessed using the Numerical Rating Scale, and the severity of AD was assessed using SCORing of AD index. Results: Mean age at onset was 4.73 years and the mean duration of disease was 1.07 years. Pruritus was localized in 66.03%, intermittent in 89.7%, and continuous in 10.3%. Winter aggravation was observed in 36.8% and sleep disturbances were observed in 39.62%. "Pruritus intensity" was moderate or severe in 92% of patients and had significant correlation to the duration and severity of the disease, sleep disturbances, and coexistence of other atopic diseases. Conclusion: A pediatric patient with AD usually presents with localized or generalized, moderate or severe pruritus, and with sleep disturbances. Exacerbation of pruritus was the most common in winter and due to woolen garments and sweating. The intensity of pruritus was in direct proportion with the duration and severity of AD and coexistence of other atopic diseases. [ABSTRACT FROM AUTHOR]

Background: The second wave of COVID-19 was disastrous and claimed many lives in India and abroad. The most challenging task was to provide the required treatment as per the patient's condition, within a limited span of time. The lack of prognostic predictors at the time of admission led to failure in prioritizing the patient's need for intensive care. Aim: This study was conducted to find out the clinical and laboratory parameters at the time of admission to ICU as predictors of outcomes in COVID-19 patients, which can help in judicious utilization of the available resources for better patient care. Subjects and Methods: Study comprises of 161 ICU admitted patients. Study of clinical traits, comorbidities, test results, and demographic variables were carried out among survivors and non-survivor. Result: Maximum death were patients of age group 21–30 years and male gender. Mortality in hypertensives, diabetics, and patients with sepsis were found to be statistically significant. Patients who developed ARDS and pneumonia or needed ventilation died invariably. High levels of laboratory parameters like IL-6, LDH, PT, INR, aPTT, ferritin, WBC count, and D-dimer were significantly associated with poor outcomes and at a particular cutoff had optimum sensitivity and specificity to predict mortality in ICU admitted COVID-19 patients. At the same time, low lymphocyte count and PaO2/FiO2 ratio was significantly associated with bad prognosis (P < 0.05). Conclusion: This paper will help in prioritizing patients in ICU who need special attention especially at the time of meager supply of resources. [ABSTRACT FROM AUTHOR]

Introduction: Placenta accreta is a general term, when part of the placenta or the entire placenta invades and is inseparable from the uterine wall. The incidence is considerably higher in women with both a previous caesarean delivery and placenta praevia, occurring in around 1 in every 20 such women. Resorption of the retained, poorly perfused placenta can be augmented by concurrent treatment with methotrexate when fertility is desired. In cases where operative measures are required, placement of Internal Iliac artery (IIA) balloons preoperatively and their inflation intraoperatively, reduces maternal morbidity and mortality. Materials and Methodology: We present a case series of 14 patients with placenta accreta diagnosed preoperatively, 7 of whom had IIA balloons placed before undergoing Caesarean section and 7 did not have such an intervention. The maternal and foetal morbidity and mortality were studied, including the need for blood and blood product transfusions. Results: Internal Iliac Balloon placements did not change the requirement for blood and blood product transfudion in both groups. The group who had IIA balloon placed preoperatively had better maternal and fetal outcome as compared to the group who had no such intervention. [ABSTRACT FROM AUTHOR]

Background: Advances in neonatal and pediatric intensive care have increased the number of children who survive with disabilities. The management of the tracheostomized child is a complex and demanding assignment as they have higher rates of complications. Ideally, the decannulation process should proceed once the child no longer requires mechanical ventilation and the underlying pathology has resolved or been reversed. This study highlights our experience in managing pediatric tracheostomy decannulation at a tertiary care center. Subjects and Methods: This was a single-center, prospective study conducted at the tertiary care pediatric hospital for a period of 1 year. Children with tracheostomy in situ who got admitted for laryngotracheobronchoscopy and decannulation were included. Results: Indication of tracheostomy was broadly divided into reasons causing upper airway obstruction and those requiring prolonged intubation. It showed that 82% were due to prolonged intubation, in which 85.3% were due to neurological reasons. The success rate for decannulation was 97%. Age of child, duration of intubation, posttracheostomy period, and type of tracheostomy tube had no significant correlation with outcome of tracheostomy decannulation. Conclusions: Resolution of primary indication for tracheostomy is required before planning of tracheotomy decannulation. Bronchoscopic airway evaluation and decannulation trial in operation theater is needed for successful decannulation. There was no impact of age, duration of intubation, posttracheostomy period, and type of tracheostomy tube on the outcome of tracheostomy decannulation. [ABSTRACT FROM AUTHOR]

Immunoglobulin G4-related disease (IgG4-RD) is a systemic autoimmune disorder with a variety of manifestations. Association with other systemic autoimmune diseases is uncommonly reported in the literature. Hence, we intended to understand better the uniqueness of the overlapping associations of IgG4RD with other systemic autoimmune diseases. Retrospective electronic medical records-based review of IgG4RD occurring as an overlap with other systemic autoimmune diseases seen in the rheumatology department was done. We present two cases of IgG4 disease overlapping with systemic rheumatic diseases with a brief review of the literature. The first case was an overlap IgG4RD with lupus and the second interesting case had IgG4RD overlapping with 2 autoimmune diseases (lupus and rheumatoid arthritis) in the same patient. Both patients were treated with high-dose steroids and mycophenolate mofetil with good response, however, the second patient needed to be additionally treated with rituximab for better control of arthritis. Although uncommon, here, we report the first case series of 2 patients with IgG4 disease overlapping with other systemic autoimmune diseases. In our case series, the presence of the overlap did not impact the immediate clinical outcome or treatment response of IgG4RD or the co-existent systemic autoimmune disease. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) of the thyroid gland is extremely rare, even in areas where the prevalence of TB is very high. Only a few such cases have been reported in the literature. The clinical course may resemble toxic goiter or acute thyroiditis. We report the case of a 23-year-old male who presented with painless swelling of the thyroid gland associated with mild fever and weight loss. On ultrasound neck, a large echogenic solid lesion was seen. Fine-needle aspiration cytology was suggestive of colloid goiter, but histopathology study suggested TB of the thyroid gland along with colloid goiter. We report this case to emphasize that TB of the thyroid gland, although rare, should be kept in the differential diagnosis of thyroid nodules, especially in countries such as India which are endemic for TB. [ABSTRACT FROM AUTHOR]

Background: Adopting interactive teaching in dermatology will encourage the students to acquire a deeper understanding of the subject, increase attention span and retention of knowledge, and enhance self-directed learning. Aim and Objectives: To introduce Quiz as an Interactive teaching tool in dermatology and assess the perception of the undergraduate students and faculty about using quizzes in dermatology. Methodology: This prospective study was conducted in the department of dermatology. Participants are the 2nd year MBBS students. After sensitizing the students and taking informed consent, quizzes were conducted on four topics, at appropriate time intervals using the "POLL EVERYWHERE" software. During the lecture, a quiz was conducted as follows: At the beginning of the lecture (a), after 20 min (b) and at the end of the lecture (c). At the end of the 4 interactive lectures, questionnaires were provided to the students and faculty to get feedback on their perception regarding the interactive teaching sessions. The responses of the feedback forms were graded using a 5-point Likert's scale. Statistical Analysis: The data were entered in Microsoft Excel and analyzed using SPSS (Statistical Packages for the Social Sciences, software version 21.o. Armonk, NY: IBM corp). Open-ended questions were analyzed by thematic qualitative analysis and expressed as percentages. Results: About 44.6% agreed that quizzes do make dermatology more interactive. Around 53% students agreed that interactive learning helps in better retention of knowledge. All faculty perceived that interactive learning is an appropriate motivator for the undergraduate students to do self-directed learning and that quiz is an effective tool. Conclusions: Interactive teaching learning methods such as quizzes will encourage the students in the better understanding of dermatology. [ABSTRACT FROM AUTHOR]

Background: Life during the COVID-19 pandemic was miserable, most of the people were in a panic situation either because of being affected by COVID-19 or losing their near and dear ones. Majority of Indian population was in the trauma condition impacting physical and mental health directly or indirectly either due to the infection or repeated lockdowns. Aim: The present study was carried out to gain knowledge of people's physical and mental health such as anxiety, depression, and stress during the period of the pandemic in the year 2021. Material and methods: The standard questionnaires were used to conduct the online survey using google form. The questionnaire contains five sections and collects the information on anxiety, stress, depression, and physical activities. The survey started on May 23, 2021, and ended on June 2, 2021 by circulating the link through emails, WhatsApp, and messages. Result: A total of 291 people participated in this survey process and all responses were analyzed, out of which 165 were men and 126 were women. It was calculated that 59.4% of men and 40.6% of women were affected by COVID-19. Total 49.5% of people affected by COVID-19 were in favor of improvement in physical and mental performance while taking dietary supplements. Whereas 19.8% denied the statement and 28.7% of people saw slight changes in their health status. Conclusions: During the pandemic people were mostly affected by anxiety, depression, stress, and physical health and to cope with these situations dietary supplements surely be the utilitarian for the society. Through this study, it was found that if a person includes both exercise and nutraceutical products in their lifestyle, there will be a chance of living a sustainable and healthy life. [ABSTRACT FROM AUTHOR]

Background and Objective: There is a paucity of guidelines about the diagnosis and management of Pott's spine. In this study, we report the pattern of practice of diagnosis and treatment of Pott's spine among the specialists and super-specialists in India.Subject and Methods: Response to a 22-item questionnaire regarding the diagnosis and treatment of Pott's spine has been reported. The responses were compared between medical and surgical specialists, residents and consultants, and specialists and super-specialists. There were 84 responders: 42 physicians and 42 surgeons; 48 residents and 36 faculty or consultants; 53 specialists and 31 super-specialists.Results: Thirty-eight responders rarely recommended biopsy whereas others recommended biopsy more frequently, especially the surgeons (P < 0.007). Twenty-five responders recommended immobilization even in an asymptomatic patient whereas 38 would immobilize those with neurological involvement only. All but 4 responders would repeat imaging at different time points. The response of medical treatment was judged at 1 month by 53, and 3 months by 26 responders. Surgery was recommended in a minority of patients-in those with neurological involvement or abscess. Surgeons more frequently biopsied, immobilized the patients, and recommended surgery compared to the physicians. The residents also recommended biopsy and recommended immobilization more frequently compared to consultants or faculty members. Super-specialists more frequently recommended biopsy compared to specialists.Conclusion: There is marked variation in investigations and treatment of Pott's spine patients, suggesting the need for consensus or evidence-based guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child's overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross-sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in 'dmft' using the WHO oral health assessment form for children 2013. The mothers' knowledge, attitude, and practice were determined by a professionally administered 10-item pre-tested short questionnaire with Cronbach's alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school-educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non-assisted (17.8%) (P = 0.044). Conclusion: Although mothers' knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres. [ABSTRACT FROM AUTHOR]

Background: Internet addiction has been described as an emerging behavior related to the development of new technologies. Impulsivity is a risk factor for addictive behaviors. Maladaptive use of the Internet has been coined as compulsive Internet use. Dysfunctional belief is an irrational thinking pattern where there is a negative view of self, the outer world, and future. Aim: The present study aims to assess the role of impulsivity, compulsivity, and dysfunctional belief leading to problematic Internet use. Materials and Methods: A total of 300 undergraduate medical students were assessed on this cross-sectional scale. Demographic details, Internet Addiction Test, Urgency Perseveration Premediation Sensation Seeking Positive Urgency Scale, Compulsive Internet Use Scale, and Dysfunctional Attitude Scale were filled by the participants using Google Forms. One hundred students could not be assessed due to nonresponse. Results: This study had a response rate of 66.6%, and of the respondents, 74.4% were mild, 25.2% were moderate, and 0.76% were severe in nature. A positive correlation was observed between Internet addiction and compulsive Internet use. There was a positive correlation between Internet addiction and lack of perseverance and positive urgency. There is an overall significance between level of dependency, achievement, and self-control in problematic and nonproblematic users. Conclusions: In the emerging era of Internet use, we must learn to differentiate excessive Internet use from addiction and be vigilant about psychopathology. [ABSTRACT FROM AUTHOR]

Background: Body image is an essential aspect of young girls' self-definition and individual identity and is influenced by multitude of factors including cultural, social, cognitive, affective, and biological. In recent times, excessive concern about the body image has been reported and the prevalence of body image dissatisfaction (BID) has increased among adolescent and young girls. Objectives: The objective of this study was to estimate the prevalence of BID, its pattern and the factors associated with it among female undergraduate students and also to assess the level of concern about their body image. Methods: This cross-sectional study was conducted among 180 female undergraduate students using a contour drawing rating scale and a body shape questionnaire to assess BID and its pattern, and the level of concern about body image, respectively. Binary logistic regression was applied to identify the factors determining body image perception. Results: The prevalence of body mage dissatisfaction was 76.7% with overweight and obesity, and media influences being significantly associated with it. Nutritional status, mother's educational status, and media influences were the determinants. Body shape concerns were found among 30.6% of the participants out of which 7.3% reported marked to moderate concerns. Conclusions: Our findings highlighted a higher prevalence of perceived dissatisfaction with the body image and also that it is not simply the outcome of sociocultural pressure to conform to a certain body type but is the result of a complex interaction between individual differences in actual body mass and preference for a thin body ideal. [ABSTRACT FROM AUTHOR]

PURPOSE: Although multifocal intraocular lenses (IOLs) are effective methods of dealing with surgical presbyopia, there are associated limitations (cost, technique, and patient‑reported symptoms). Given their scalability challenge (due to economic factors), it is imperative to explore alternative low‑cost and sustainable solutions to achieve good near vision postcataract surgery. This study aimed to determine the proportion of and the factors associated with good near vision in patients following cataract surgery with monofocal IOL implantation. METHODS: We conducted a hospital‑based cross‑sectional study at a tertiary eye hospital in southern India from September 2019 to January 2020. Inclusion criteria: Uncomplicated postcataract surgery cases with monofocal IOL at least 30 days ago. Exclusion criteria: patients with any ocular condition (other than refractive errors) that could decrease the vision with best‑corrected distance visual acuity < 0.18 Logarithm of the Minimum Angle of Resolution (LogMAR) units. Data collection: we assessed near vision (at 40 cm distance by using near vision card with Early Treatment of Diabetic Retinopathy Study format), distance visual acuity (uncorrected and best‑corrected), refractive error (amount and type), type of astigmatism, pupil size, axial length, and contrast sensitivity. We considered a near vision of 0.2 LogMAR units or better as good near vision. RESULTS: Of the 82 patients (82 eyes), 71 (86.59%) had good near vision. Multiple logistic regression analysis found found that the presence of myopia or myopic astigmatism was significantly associated with good near vision (adjusted odds ratio: 72.63; 95% confidence interval: 1.02–5193.5, p = 0.049). CONCLUSION: About eight of every ten participants had good near vision postcataract surgery with monofocal IOL implantation. Myopia/myopic astigmatism was associated with good near vision. [ABSTRACT FROM AUTHOR]

Corona virus disease 2019 (COVID-19) has been documented to have a spectrum of neuro-ophthalmic manifestations. However, bilateral non-arteritic anterior ischemic optic neuropathy (NAION) post-COVID-19 has not been reported in the literature. We studied the case of a 45-year-old male who presented to our outpatient department (OPD) with bilateral blurring of vision following an episode of COVID-19, 1 month back. Examination and investigations were conclusive of a bilateral NAION. The patient was given a trial of oral steroids. However, the vision loss could not be recovered. Thus, through this case report, we would like to highlight the importance of a close follow-up of patients following COVID-19 infection to detect any sequelae. [ABSTRACT FROM AUTHOR]

Fahr's disease is a rare degenerative neurological disorder, characterized by bilateral symmetrical cerebral calcification and presents with different manifestations. We present the case of a 42-year-old male who presented with psychotic feature, mannerisms, and bilateral symmetrical calcification of basal ganglia. Hence, our case suggests that psychiatrists should evaluate the cases of psychosis thoroughly when the age of presentation is atypical and they should rule out organicity. Neuroimaging may help arrive at the correct diagnosis in patients presenting with psychiatric symptoms. [ABSTRACT FROM AUTHOR]

CONTEXT: Alloimmunization by foreign red cell antigens is a matter of concern as it may lead to hemolysis in transfused patients as well as fetus of pregnant females. AIMS: This study aimed to perform a comparative analysis of prevalence and type of irregular antibodies in healthy donors, vis-a-vis blood transfusion recipients. SETTINGS AND DESIGN: Blood samples of 4000 individuals comprising healthy donors, exposed patients, and nonexposed patients were collected and were analyzed for irregular antibodies. MATERIALS AND METHODS: Commercially available three-cell antigen panel was used for the antibody screening. The samples positive in antibody screen were further subjected to an extended 11-cell panel for antibody identification in low-ionic strength saline with and without enzyme. STATISTICAL ANALYSIS: Statistical analysis was done using SPSS for Windows 15.0 program. Chi-square test was used for detecting statistical significance of exposure to red blood cell antigens in the formation of alloantibodies. RESULTS: Of the 4000 samples, antibodies were identified in 105 (2.6%) samples. Overall, nonexposed group showed a seropositivity of 0.36%, while the exposed group showed a seropositivity of 9.4%. Anti-D was the most common antibody found in 38 patients (33.3%). Anti-E was the most common antibody in males, while anti-D was the most common antibody in females. CONCLUSIONS: Since the risk of alloimmunization is more common in multitransfused patients, it is advisable to screen at least those cases for irregular antibodies. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents are the pillars of a healthy society. Researches have explored significantly higher rate of psychopathology in children whose parents (either) have psychiatric illness in comparison to the general community (25%-50% v/s. 20%). Parental psychiatric illness (PPI) has significant long-term consequences on child's development-general health, cognitive stimulation, social, emotional, and behavioral maturity. Objectives: The objective of this study is to assess the cognitive, emotional, and behavioral problems of children of parents with psychiatric illness. Methodology: The present cross-sectional study attempted to evaluate the factors linked with the PPI and overall child's development. Two hundred and six parents with psychiatric illness (>1-year duration) were included in the research. Results: A total of 206 families (either mother/father) and their children 353 in number (<18 years) were included in the study. Slightly higher percentage of mother as participant was observed (56.8% v/s. 43.2%). In 80% of the families, mother was the primary caregiver of the children. Marital discord was prevalent in these families (17.9% reported by mother v/s. 31.5% reported by father). Conclusion: Early identification of the soft indicators of the children of PPI should be identified along with the treatment of their parents. Schools should be oriented to initiative an early assessment by the evaluation of the children with psychiatrist/psychologist. [ABSTRACT FROM AUTHOR]

Background: The position of the dental midline is significant to enhance dentofacial esthetics. This study aimed to assess the closest anatomical landmark to the facial and mouth's midline applicable to dentate male and female Indian youths. Materials and Methods: A full-face photo of 100 males and 100 females with a broad smile showing visible anterior dentition was taken. An esthetic facial frame was developed digitally on the photographs taking the reference of facial anatomical landmarks. Relative facial midline values for nasion, the nose tip, the philtrum tip, and dental midline were obtained. The relative commissural midline value was obtained by dividing the variables by the constant. Statistical analysis: Data were statistically analyzed using the t-test. Results and Conclusions: Anatomic landmarks correlated with facial midline and with the inter-commissural midline (P < 0.01). The nasion is nearest to the facial midline, followed by dental midline, commissure, tip of the philtrum, and nose tip in that order. The anatomic landmarks nearest to the inter-commissural midline are the tip of the philtrum, followed by the dental midline, nasion, and nose tip. The nose tip was the farthest landmark from the face's midline and the inter-commissural midline. In gender-wise comparison, landmarks did not differ significantly (P > 0.05). All the measurements were almost equal in males and females. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to identify the incidence of anxiety, depression, and stress in health-care workers managing COVID-19 patients in a tertiary care hospital in North India. Methodology: A cross-sectional online survey was conducted using Depression, Anxiety, and Stress Scale-21 Questionnaire (Google Form). All health-care workers (HCWs) of the hospital were included in the study. HCWs with a past or current history of psychiatric illness and on psychotropic medication were excluded from the study. Results: Two hundred and twenty HCWs answered the questionnaire, of whom 114 (51.8%) were female. Of the 220, 128 (58.2%) were single, 97 (44.1%) were physicians. Level one exposure (direct interaction with COVID-19 patients) was seen in 111 (55.5%). One hundred and thirty-three (60.5%) HCWs worked for 8–12 h/day. Conclusions: Our findings highlight the factors which need to be taken into consideration to protect the mental well-being of doctors while fighting with a disaster that has major impacts on society worldwide. [ABSTRACT FROM AUTHOR]

The relentless efforts among dental professionals to refine their practice and to reduce human error have collectively contributed to transform dentistry. Digital technology has made possible to provide the highest quality of dental care. It has transformed the way of diagnosis and treatment planning. 3D printing has revolutionized dentistry by enabling the fabrication of precise dental components. It has diverse applications as well as allows for greater customization, ultimately improving patient outcomes. Today, 4D printing is considered an advancement that includes time as a fourth dimension with the utilization of smart biomaterials and further change in the shape and size of the printed structure upon application of any external stimuli. It enables the development of customized, patientspecific dental solutions with improved precision and responsiveness, contributing to advancements in dental care. This poster describes the integration of 4D printing in dentistry, its process, current upgradation, and the potential current and future applications in pediatric and preventive dentistry. [ABSTRACT FROM AUTHOR]

Cuff pressure of endotracheal tube (ETT) must be high enough to seal the trachea, and must be low enough to allow adequate perfusion of tracheal mucosa. Compared with polyvinyl chloride (PVC) cuffed tubes, polyurethane cuffed tubes protect more efficiently. Different methods of ETT cuff pressure maintenance in practice have been reported. We planned to compare ETT cuff pressure using different techniques in PVC and polyurethane microcuff tubes in a prospective randomized study. Eighty surgical patients between 16–65 years belonging to American Society of Anesthesiologists physical status I–III, scheduled for orotracheal intubation under general anaesthesia, were included. All enrolled patients were randomized into four groups (n = 20 per group), followed by corresponding treatments, including intubation by PVC ETT or polyurethane microcuff ETT and cuff inflation by auscultation of audible leak or pressure volume loop. Amount of air required to inflate cuff was more in polyurethrane tube as compared to polyvinyl tube. While comparing the two methods of cuff inflation, less volume of air was required in pressure volume loop method. We concluded that PVC cuff tube and polyurethane microcuff tube both are safe tubes used in adult patients. However, when inflated using same technique polyurethane microcuff tubes required larger volume to inflate cuff. Further, pressure generated in polyurethane microcuff tubes in much lower than PVC tubes. The study was approved by the Institutional Ethics Committee of Pt B D Sharma, PGIMS, Rohtak (No. IEC/Th/18/Anst15) on January 20, 2018 and registered with Clinical Trials Registry-India (registration No. CTRI/2019/01/017170) on January 18, 2019. [ABSTRACT FROM AUTHOR]