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Context: A school-based novel tobacco control model can play a crucial role in encouraging tobacco prevention and cessation among students. Tobacco use is a global public health concern, and targeting prevention and cessation efforts at a young age is essential to curb the long-term health consequences associated with tobacco consumption. Incorporating games, interactive activities, and educative movies can significantly enhance tobacco prevention and cessation efforts. This multifaceted approach engages individuals in various ways, making the message more memorable and impactful. By combining these elements, we can create a comprehensive approach that caters to different learning styles and preferences especially for younger audiences who are more accustomed to digital and interactive experiences. The key is to make the educational experience engaging, informative, and motivating, ultimately increasing the likelihood of successful tobacco prevention and cessation outcomes. Aim: To create a comprehensive and effective program that can raise awareness, prevent initiation and promote cessation of tobacco. Design: Pre-Post Intervention Quasi-Experimental Study. Setting: Schools across Bangalore city, India. Participants: High school Students. Methods: A 90-minute comprehensive session on tobacco awareness was developed for a classroom setting to educate, train, and promote positive changes in attitudes and behaviours among school children, which includes five components: an antitobacco short film, educational games and a mobile app, an interactive PowerPoint presentation, and small group activities for brainstorming and practicing resistance skills. These tools are strategically designed as motivational aids to encourage tobacco cessation and prevention. Main Outcome(s) and Measure(s): Knowledge enhancement, attitude change, behaviour modification, engagement and participation and program effectiveness. Measures used were pre-and post-intervention assessments, feedback from students, educators, and quantitative data analysis. Results: Results suggest students' positive perceptions of the games within the tobacco control model, specifically user‑friendliness (P < 0.05), usefulness (P < 0.01), and acceptability (P < 0.01), and higher intention to quit tobacco. This finding underscores the importance of creating engaging and well‑designed interventions, such as interactive games, to effectively influence School‑based Novel Tobacco Control Model for Encouraging Tobacco Prevention and Cessation Sujatha Sampangi Reddy1, Shwetha Venkataramana1, Rakesh Nagaraju1, Pavan Kumar Tupakula1, Ankita Kar1,2, Priyadharshini Ramkrishnan1, Divya Gupta1, Z. Ummu Salma3, Radha Prashanth4 Access this article online students' attitudes and behaviours related to tobacco use. Conclusions and Relevance: The school-based novel tobacco control model stands as a promising and relevant approach to addressing tobacco prevention and cessation among students. [ABSTRACT FROM AUTHOR]

Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN. Methods: For this study, the retrospective ISGPN database was reviewed, which included patients who underwent RAPN for renal masses at 14 centers across India from September 2010 to September 2022. Demographic, clinical, radiological, perioperative, and functional data were collected and analyzed. Ethics approval was obtained from each of the participating centers. Results: In this study, 782 patients were included, and 69.7% were male. The median age was 53 years (interquartile range [IQR 44-62]), median operative time was 180 min (IQR 133-240), median estimated blood loss was 100 mL (IQR 50-200), mean warm ischemia time was 22.7 min and positive surgical margin rates were 2.5%. The complication rate was 16.2%, and most of them were of minor grade. Trifecta and pentafecta outcomes were attained in 61.4% and 60% of patients, respectively. Conclusions: This is the largest Indian multi-centric study using the Indian Robotic PN Collaborative database to evaluate the outcomes of robot assisted PN, and has proven its safety and efficacy in the management of renal masses. [ABSTRACT FROM AUTHOR]

This study aimed to assess better effectiveness between regenerative endodontic procedures (REP) and apexification procedures (AP) with mineral trioxide aggregate (MTA) and calcium hydroxide for inducing root end apex closure. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and registered in PROSPERO-CRD42023398997. Electronic databases were searched for studies evaluating effectiveness of REP and AP in terms of survival rate, success rate, increase in root length, root width and decrease in apical diameter. Cochrane risk of bias (RoB) -2 tool was used for quality assesssment using RevMan 5.3. The risk ratio (RR) and standardized mean difference (SMD) was used as summary statistic measure with random effect model (P < 0.05). Nine studies were included in qualitative synthesis and eight studies for meta-analysis. Quality assessment revealed moderate to low risk of bias. The pooled estimate through RR and SMD favoured REP being superior to AP for better survival rate (RR = 1.01 (0.96 - 1.06)), success rate (RR = 1.09 (0.96 - 1.24)), increase in root length (SMD = 0.25 (-0.14 - 0.63)), root width (0.66 (0.22 - 1.10)) and decrease in apical diameter (SMD =0.66 (-0.51 - 1.83)). Funnel plot did not show any heterogeneity indicating absence of publication bias. REP significantly improved apical root end closure. AP are equally effective in forming calcific barrier, however it was concluded that regeneration procedures are comparably superior to apexification procedures with greater outcomes. Clinicians should consider employing the REP in cases when root development is severely deficient and where tooth's prognosis is hopeless even with an apexification procedure. [ABSTRACT FROM AUTHOR]

Transfusion of blood and blood products has many adverse effects and should be done only if patient benefits outweigh the associated risks. Current understanding of blood transfusion has improved dramatically, revolutionising the care of surgical, trauma, obstetric and critically ill patients. Most guidelines advise a restrictive approach for stable patients with non-haemorrhagic anaemia for red blood cell transfusion. The rationale for red blood cell transfusion has historically been to improve oxygen transport capacity and consumption-related parameters in anaemic patients. Current understanding casts serious doubts about the true potential of red blood cell transfusions to improve these factors. There may not be any benefit from blood transfusion beyond a haemoglobin threshold of 7 g/dL. In fact, liberal transfusion may be associated with higher complications. Guideline-based transfusion policy should be adopted for the administration of all blood products including fresh frozen plasma, platelet concentrates and cryoprecipitate etc. This should be integrated with clinical judgement. [ABSTRACT FROM AUTHOR]

Angiosarcoma (AS) is a rare malignant tumor of vascular or lymphatic epithelium, typically presenting as a bruise-like patch over the face or scalp in the seventh–ninth decades. Here, we report a case of cutaneous AS (cAS) in a 51-year-old male patient who presented with a cauliflower-like growth in the groin with skin-colored shiny flat-topped satellite papules in the surrounding areas, some of which were umbilicated. Based on examination, the patient was considered retro positive and the following differentials were considered: Buschke–Lowenstein tumor with giant molluscum, Kaposi sarcoma, and squamous cell carcinoma. Histopathological examination suggested the diagnosis as AS, which was confirmed by immunohistochemistry that was positive for CD31 and CD34. The report highlights the unusual site and clinical presentation of cAS. [ABSTRACT FROM AUTHOR]

Aim: This study aims to compare the fracture resistance of simulated immature teeth after using different thicknesses of Mineral Trioxide Aggregate (MTA) and Biodentine apical plug. Materials and Methods: Forty human maxillary anterior teeth were selected. Teeth were randomly divided into eight groups of five teeth in each group. Positive control group = 5 teeth; prepared without access cavity preparation. Access cavities of the remaining 35 teeth were prepared, and instrumented with Peeso reamers. Negative control = 5 teeth; filled with calcium hydroxide. Thirty teeth divided into Groups 1 and 2 of MTA (MTA-Angelus, Londrina, Brazil) and Biodentine (Septodant, Saint Maur des Fosses, France) and each group divided into three subgroups: subgroup A - 3 mm apical plug; subgroup B - 6 mm apical plug; and subgroup C: full canal length. The rest of the canals in subgroups A and B were filled with gutta-percha and AH Plus sealer. After the required storage period, all the samples were subjected to fracture testing under universal testing machine and fracture strength was recorded. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test for multiple comparisons. Results: The negative control group showed the lowest fracture resistance compared with the other groups (P < 0.0001). The 6-mm apical plug subgroup of biodentine showed the highest fracture resistance. Conclusion: Within the limitations of this study, MTA and Biodentine can be used as an apical plug instead of root canal filling material to increase the fracture resistance of immature teeth. [ABSTRACT FROM AUTHOR]

Context: Sore throat is a common complaint to both laryngeal mask airway (LMA) insertion and endotracheal tube intubation. Its incidence in LMA has been found to vary between 5.8% and 34%. Administration of medicated lozenges in the preoperative period is also a route available for the prevention of postoperative sore throat (POST). Aim: The aim of this double-blinded randomized controlled study was to evaluate the efficacy of turmeric-based lozenges given preoperatively in patients undergoing general anesthesia (GA) under LMA insertion for the prevention of POST. Settings and Design: This study was conducted at the Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Rama Nagar, Dehradun, over a period of 12 months. Subjects and Methods: Two hundred and fifty patients of the American Society of Anesthesiologists classes I and II posted for elective surgeries under GA with insertion of LMA were included in our study. Randomization was done by the sealed envelope technique. Turmeric extract with menthol and eucalyptus oil lozenges was given in Group A (n = 125), while plain turmeric extract with orange flavor lozenges was given in Group B (n = 125) 30 min preoperatively. The patients were assessed for POST in the recovery room post-LMA removal at 30 min, 6 h, 12 h, and 24 h. Statistical Analysis: The data were analyzed using Chi-square test, Fisher's exact test, and Student's t-test. P < 0.05 was considered statistically significant. Results: The turmeric lozenges containing 6.4 mg eucalyptus oil and 6.3 mg menthol oil along with turmeric extract 100 mg significantly reduced the incidence of POST across all time intervals (P < 0.05) as compared to orange-flavored plain turmeric lozenges containing turmeric extract 100 mg. Conclusions: POST was reduced with preoperatively administered eucalyptus oil and menthol oil containing turmeric lozenges. [ABSTRACT FROM AUTHOR]

A 15-year-old healthy boy presented with multiple eruptive brown-colored to hyperpigmented papules all over the body for 1 year. His serum lipids were normal, and HIV serology was negative. Biopsy revealed hyperplastic epidermis along with an ill-defined lesion in the dermis that was composed of spindle-shaped fibroblastic cells and multiple cholesterol clefts within foamy macrophages. A diagnosis of cholesterotic dermatofibroma was made. The case is unusual for the young age of presentation and the presence of multiple eruptive papules. [ABSTRACT FROM AUTHOR]

A Clinical Scoring System for Pediatric Hand-Foot-Mouth Disease Hand-foot-mouth disease (HFMD), a viral exanthem that commonly affects children, is caused by Coxsackie virus (CV) A16 and Enterovirus 71. The optimal cutoff score was 7 which meant that a score of 7 or more was suggestive of HFMD while a score <7 could be considered as non-HFMD.[2] One often comes across atypical presentations of HFMD in practice. Patients were then divided into the HFMD (1094 patients) group or non-HFMD (341 patients) group based on a positive or a negative result from the assay, respectively. [Extracted from the article]

A case study of a 70-year-old retired man with no known co-morbidities presented with a slowly progressive area of ulceration over the right shin of a 1-year duration. Topics include the patient was diagnosed as having chromoblastomycosis (CBM) with the typical ‘sclerotic bodies' in histology; and secondary ulceration of the exophytic or verrucous growths is a common complication regarding the number of cases with ulcerative morphology.

Objectives: The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis. Methodology: Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5% NaOCl, Group B: 20% T. vulgaris, Group C: 12.5% S. persica, Group D: 10% A. nilotica, Group E: 10% C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37°C for 24 h. Bacterial zones of inhibition were recorded. Results: The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey's t-test. The highest zone of inhibition against E. faecalis was shown by 5% NaOCl, followed by 10% C. arvensis, 20% T. vulgaris and 10% A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. Conclusion: 5% NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl. [ABSTRACT FROM AUTHOR]

Anaplastic thyroid carcinoma (ATC) is a rare, highly malignant thyroid tumor with dismal prognosis. Osteoclastic giant cell variant of ATC is extremely rare and is characterized by the presence of a large number of multinucleated giant cells resembling osteoclasts. We report here this unusual variant in a 67-year-old female with a history of long-standing goiter of 13 years duration. Histologically, many multinucleated osteoclast-like giant cells were seen accompanying the malignant spindle cell component. Despite extensive sampling, no evidence of differentiated thyroid malignancy could be elucidated. [ABSTRACT FROM AUTHOR]

Context: Postextubation airway complications are one of the most undesired side effects of airway manipulation. Pharmacological and nonpharmacological measures have been utilized for minimizing the morbidity. Lignocaine lozenges, a new modality, used to reduce post-extubation airway complications is an area yet to be explored. Aims: The aim of this study is to evaluate and compare the effects of lignocaine nebulization versus lignocaine lozenges in decreasing immediate postextubation airway complications in patients presenting for direct laryngoscopic biopsy. Settings and Design: This randomized study was conducted at tertiary care teaching hospital in northern state of India. Subjects and Methods: A total of 90 patients, 40–70 years, the American Society of Anesthesiologists (ASA) physical status Classes I, II, and III of either sex, posted for elective direct laryngoscopic biopsy, requiring general anesthesia with endotracheal intubation were included and randomly divided into groups (n = 30) to receive lignocaine nebulization (Group A), lignocaine lozenge (Group B), control (Group C). The patients were assessed for a cough after extubation after 5 min then every 10 min up to 30 min postextubation. Statistical Analysis Used: Categorical variables were compared using the Chi-square test or Fisher's exact test and continuous variables by using one-way Analysis of variance and Kruskal–Wallis test, respectively. Results: Comparison of a cough at various time intervals starting from extubation up to 30 min in post-extubation period was highly significant in between groups. Among Group A (lignocaine nebulization) 33% of patients had a decrease in the severity of a cough within the first 5 min; although among Group B (Lignocaine Lozenges), the decrease in the severity of a cough (40%) was more as compared to that of Group A. Similar decrease in the severity of a cough was observed through various time interval from 10 min to 30 min postextubation. After 30 min, 73% of patients in Group A and 76% of patients in Group B had an incidence of a decrease in the severity of cough. Conclusions: Lignocaine Lozenges have been found to have a better result. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine which leads to ossification and formation of a classical bamboo spine. This poses a challenge to the anesthetist both in terms of administering general and regional anesthesia due to the limited mobility of the spine. With the advent of ultrasound as an aid in regional anesthesia, it has been relatively easy to perform a central neuraxial blockade in such patients though the skill requires some degree of expertise. Here, we have described the use of ultrasound as a guide for administering regional anesthesia to a patient with AS after initially attempting a blind approach which had failed due to difficult anatomy. [ABSTRACT FROM AUTHOR]

Extramammary Paget's disease is an intraepithelial neoplasm, usually found in areas rich in apocrine gland concentration. The clinical features, histopathology, immunohistochemistry and management details of five patients (F = 3, M = 2) have been described here. While a well-defined persistent plaque with crusting and erosion was the most common presentation, hyperpigmentation, hypopigmentation and depigmentation were also observed in two patients. Characteristic Paget's cells with cytokeratin 7 and EMA positivity were seen on histopathology examination. Authors conclude that pigmentary alterations may be under-reported in extra mammary Paget's disease in the skin of colour. [ABSTRACT FROM AUTHOR]

Intermittent vagus nerve stimulation (VNS) can reduce the frequency of seizures in patients with refractory epilepsy, but can affect respiration in sleep. Untreated obstructive sleep apnea (OSA) can worsen seizure frequency. Unfortunately, OSA and VNS-induced sleep disordered breathing (SDB) may occur in the same patient, leading to a therapeutic dilemma. We report a pediatric patient in whom OSA improved after tonsillectomy, but coexistent VNS-induced SDB persisted. With decrease in VNS output current, patient's SDB improved, but seizure activity exacerbated, which required a return to the original settings. Continuous positive airway pressure titration was attempted, which showed only a partial improvement in apnea–hypopnea index. This case illustrates the need for clinicians to balance seizure control and SDB in patients with VNS. [ABSTRACT FROM AUTHOR]

The article presents the case study of a 10‑month‑old boy who was referred because of greenish pigmentation on his deciduous teeth from the time of eruption. It mentions that intra‑oral examination revealed yellowish‑green pigmentation in the crown of the incisors. It reveals that treatment options include composite resin restorations, bleaching techniques, and transillumination with ultraviolet light.

A wide prevalence of socio‑religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ‘Henna’ use causes IgE‑mediated hypersensitivity reactions and contact dermatitis. ‘Kumkum' application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ‘bindis' and ‘alta’ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ‘Holi' colors. Threading and drawstring dermatitis lead to koebnerization of pre‑existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ‘Mudichood' represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device “kangri” is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause. [ABSTRACT FROM AUTHOR]

Leukoplakia of larynx has remained a debatable topic in laryngeal pathology for decades as per classification, histology and treatment is concerned. Smoking and alcohol are the major causes and there is sufficient evidence implicating gastroesophageal reflux and human papilloma virus in its pathogenesis. A wide range of therapeutic strategies are available for different grades of dysplasia. Despite this, a significant proportion of patients progress to carcinoma for which the patients with dysplasia need to be kept in regular follow-up. [ABSTRACT FROM AUTHOR]

Post-operative sore throat (POST) is an undesirable side effect of endotracheal intubation. Pharmacological and non-pharmacological measures have been utilized for minimizing the morbidity caused by POST. We have tested use of Strepsils lozenges in providing efficacy for decreasing POST in smokers presenting for surgery under general anesthesia with endotracheal intubation. Materials and Methods: 100 patients, 20-65 years, American Society of Anesthesiologists (ASA) physical status I and II, either sex, history of smoking, posted for elective surgical procedure of more than 1 hour, requiring general anesthesia with endotracheal intubation were included and randomly divided into groups (n = 50) to receive Strepsils (Group A) and sugar candy (Group B). The patients were assessed for cough, sore throat, and hoarseness of voice after extubation, 30 min, 12 hrs, and 24 hrs after extubation. Results: At extubation no cough was seen in 39 (78%) patients (group A) compared to 23 (46%) patients (Group B), and mild cough in 22% (Group A) and 52% (Group B). Incidence of sore throat at extubation was lower in group A compared to Group B (P = 0.04). At other times of observations (30 min,12 hrs and 24 hrs) there was a significant decrease in incidence of sore throat in Group A compared to Group B (P = 0.000). Hoarseness of voice was not observed in any patient in either group. Conclusions: Use of preoperative Strepsils lozenges decreases incidence of POST and maybe utilized as a simple and cost-effective measure for decreasing the symptoms of POST and increasing the satisfaction of patients. [ABSTRACT FROM AUTHOR]

Meningiomas at extracranial sites are uncommon clinical presentations. They may present in the form of benign, slow.growing masses or may exhibit aggressive malignant behavior. We report two cases of intracranial meningiomas presenting at extracranial sites that are, at the sinonasal tract/external auditory canal and as a neck mass. The clinical presentations, histopathological features and appropriate management are discussed. [ABSTRACT FROM AUTHOR]

We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina. [ABSTRACT FROM AUTHOR]

Acrodermatitis enteropathica is an autosomal recessive inherited disorder of zinc absorption. Acquired cases are reported occasionally in patients with eating disorders or Crohn's disease. We report a 24-year-old housewife with acquired isolated severe zinc deficiency with no other comorbidities to highlight the rare occurrence of isolated nutritional zinc deficiency in an otherwise normal patient. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 50-year-old man with skin patches who was diagnosed with acute infectious purpura fulminans (PF) caused by Group A β-hemolytic Streptococci (GABHS) and mentions the efficacy of antimicrobial therapy for the treatment.

A letter to the editor regarding the medical condition of a 65-year-old man with seborrheic keratosis (SK) is presented.

A letter is presented asserting that a report examining the relationship between disease severity and metabolic syndrome in South Indian patients with psoriasis vulgaris was a cross-sectional study rather than a hospital-based case-control study. The authors replied that contrary to the letter's claims, a case-control study design can be used in a prospective manner to determine the prevalence of a suspected risk factor of a disease between two groups of subjects at a certain point in time.