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Introduction: A substantial portion of children worldwide are afflicted with congenital heart disease (CHD), which is a collection of structural cardiac defects that are apparent at birth. Although the cardiovascular aspects of CHD have received a lot of attention, the dental health of these children is still a topic that needs more research. There are variations in the reported findings of different research that describe the oral health status of kids with and without CHD. Aim and Objective: To conduct a systematic review and meta-analysis of published results to elucidate the role of CHD on the oral health of children compared to the healthy group. Materials and Methods: A manual search was conducted using four databases to find pertinent studies from 2000 to 2023. In this review, patients with and without CHD were compared with respect to their periodontal health, dental health, salivary changes, and objective and subjective manifestations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed while reporting the results. Result and Conclusion: The results of this study demonstrated that, despite a few limitations, patients with CHD had an increased risk of acquiring periodontal disease and other oral symptoms. Thus, compared to healthy peers of the same age and gender, concomitant CHD has been shown to exacerbate oral health issues in children with CHD. [ABSTRACT FROM AUTHOR]

Primary neuroendocrine carcinoma of the breast is a very rare occurrence accounting for <0.1% of all breast cancers. For the diagnosis, it requires the diffuse expression of neuroendocrine markers (chromogranin, synaptophysin, neuron-specific enolase) and the lack of simultaneous neuroendocrine carcinoma in extramammary sites. The breast carcinomas with focal neuroendocrine differentiation are defined as scattered tumor cells that stain positive with neuroendocrine markers. These tumors are usually seen in elderly women around sixth or seventh decade of life, as reported in literatures. The high nuclear grade and regional lymph node metastasis was also significant negative prognostic factors for overall survival. We study a case of primary neuroendocrine carcinoma of breast in a 46-year-old lady, on the basis of histopathology and immunohistochemistry. [ABSTRACT FROM AUTHOR]

Immature gastric teratoma is an uncommon germ cell tumor of the stomach. A 6-month-old male child was born through full-term vaginal delivery. After 1 month presented with a history of abdominal distension and palpable mass along with a history of Malena for the past 10 days. Computed tomography scan showed the presence of a large well-defined multilobulated solid cystic lesion with multiple calcifications in the abdominopelvic region. Radiological findings were suggestive of germ cell tumors. The exploratory laparotomy findings showed a large tumor mass with variegated consistency arising from the lesser curvature of the posterior wall of the stomach. The total excision of mass and primary closure of the gastric wall was done. Histopathology of excised specimens showed immature teratoma of the stomach. The child is still on follow-up regularly visited as outpatient, doing well day-to-day activity. We report a very rare case of immature gastric teratoma in an infant on the basis of clinicoradiological and pathological findings. [ABSTRACT FROM AUTHOR]

Context: A non-healing ulcer occurs due to multiple causes and possesses a great impact on the quality of life. Autologous platelet-rich fibrin and the application of a triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) have emerged with a good response in the treatment of non-healing ulcers. Aims: To compare the therapeutic efficacy of autologous platelet-rich fibrin matrix versus the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in non-healing ulcers. Settings and Design: Hospital-based interventional comparative study. Materials and Method: Twenty-four patients with non-healing ulcers were randomly divided into two groups. One group received platelet-rich fibrin (PRF) therapy every week for up to 5 weeks and the second group applied triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) again for 5 weeks. In the end, the ulcer area was measured. Statistical Analysis Used: Student's paired t-test was used to evaluate the correlations between variables. A P-value of < 0.05 was considered significant. Results: Group A showed a mean reduction in the ulcer area by 8.26 mm2 (75.99%). Group B showed a mean reduction in the ulcer area by 4.799 mm2 (47.75%), which was statistically significant with a P-value of 0.004. Conclusion: We conclude that autologous platelet-rich fibrin matrix is much more effective than the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in the treatment of non-healing ulcers. [ABSTRACT FROM AUTHOR]

Background: Presence of preoperative motor deficits in patients poses a distinct challenge in monitoring the integrity of corticospinal tracts during spinal surgeries. The inconsistency of the motor-evoked potentials is such patients, limits its clinical utility. D-wave is a robust but less utilized technique for corticospinal tract monitoring. The comparative clinical value of these two techniques has not been evaluated in the patients with preoperative deficits. Objectives: The objective of the study was to compare the predictive utility of myogenic Motor Evoked Potentials (m-MEP) and D-wave in terms of recordability and their sensitivity and specificity in predicting transient and permanent new motor deficits. Materials and Methods: Thirty-one patients with preoperative motor deficit scheduled to undergo spinal surgery were included in the study. Intraoperative m-MEP and D-wave changes were identified and correlated with postoperative neurology in the immediate postoperative period and at the time of discharge. Results: The mean preoperative motor power of the patient pool in left and right lower limb was 2.97 ± 1.56 and 3.32 ± 1.49, respectively. The recordability of m-MEPs and D-wave was observed to be 79.4% and 100%, respectively. The m-MEP predicted the motor deterioration in immediate postoperative period with 100% sensitivity and 80% specificity, while D-wave had 14% sensitivity and 100% specificity. At the time of discharge, m-MEPs' specificity reduced to 61%, while D-wave demonstrated 100% specificity. Conclusions: D-wave has a better recordability than m-MEPs in neurologically compromised patients. D-wave predicts development of long-term deficits with 100% specificity, while m-MEPs have a high sensitivity for transient neurological deficit. A combination of D-wave and m-MEP is recommended for monitoring the integrity of the corticospinal tract in patients with preoperative motor deficits. [ABSTRACT FROM AUTHOR]

Chin-on- chest deformity is not uncommon sequelae of ankylosing spondylitis. Apart from difficult airway, several other considerations might include co-existing cardio-respiratory embarrassment, osteoporotic bones, and neurological perturbations. We describe the successful anesthetic management of a case of chin-on-chest deformity with no access to midline neck structures and extremely difficult airway posted for corrective spine surgery. [ABSTRACT FROM AUTHOR]

Hemophagocytic lymphohistiocytosis (HLH) is a rare, poorly recognized and underdiagnosed syndrome of excessive immune activation, which is rapidly fatal. HLH can occur as a familial or secondary disorder. Secondary HLH is most commonly associated with infections, malignancies, or autoimmune diseases. It primarily affects patients with a compromised immune system and rarely presents in immunocompetent individuals. Acute cytomegalovirus (CMV) associated HLH in the immunocompetent individual is extremely rare and only documented in five case reports till date. We, hereby, report a case of 18 years old young immunocompetent man who was diagnosed to have HLH secondary to CMV infection. [ABSTRACT FROM AUTHOR]

Background: Prediabetes is increasingly being studied in the context of its association with cardiovascular disease (CVD). Besides raised HbA1c and sugar levels, the major underlying defect seems to be insulin resistance (IR). Subclinical atherosclerosis, measured by high sensitivity C reactive protein (hsCRP) and carotid artery intima media thickness (CIMT) underlies the pathogenesis of CVD in prediabetes. Heart-type fatty acid binding protein (H-FABP), a novel cardiac biomarker also might have a role in predictin prediabetic heart disease. Aims: The aim of the study is to compare serum levels of H-FABP in prediabetics and controls and correlate them with the atherosclerotic markers, hsCRP and CIMT. Setting and Design: 50 prediabetic patients and 50 age, sex and BMI matched controls were employed in the case control study. Serum F & PPBS, (HbA1c), fasting insulin levels were measured in cases and controls. Serum H-FABP was measured in both cases and controls. All cases and controls were subjected to bilateral CIMT measurements and Serum hsCRP levels. The values were compared between both the groups and subjected to appropriate statistical analysis. Statistical Analysis Used: Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected then non parametric test was used. Quantitative variables were compared using Independent t test/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-Square test/Fisher's Exact test. Spearman rank correlation coefficient was used to find out the correlation of various parameters with each other. Univariate linear regression was used to find out the cause and effect relationship between various parameters. A p <0.05 was considered statistically significant. The data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: The mean serum levels of H-FABP among cases and controls were 6.38± 2.76ng/ml and 3.24 ± 2.47 ng/ml respectively (p <0.0001). Mean CIMT was found to be higher in prediabetics (0.59 ± 0.11 mm) compared to controls (0.45 ± 0.07mm) (p <0.0001). Serum hsCRP levels were also statistically higher in prediabetics (5.75± 4.16 mg/l) then that of controls (1.86± 1.67 mg/l) (p <0.0001). The correlations of the two variables, hsCRP and CIMT with H-FABP were both strongly positive (r = 0.687) & (r = 0.779) respectively [both cases (p < 0.0001)]. Conclusion: The novel cardiac biomarker H-FAPB might be a good predictor of cardiovascular risks in prediabetics. [ABSTRACT FROM AUTHOR]

Polycythemia vera (PV) is a myeloproliferative disorder most commonly associated with JAK2V617F mutation. Cerebral venous sinus thrombosis (CVST) has a wide range of etiologies and PV is one of them. CVST associated with PV has a poor prognosis. Some patients with classical PV lack JAK2V617F mutation and the molecular basis of JAK2V617F-negative PV is not known. We hereby report a case of a young man who presented with headache, vomiting and altered sensorium and was found to have recurrent CSVT. The patient had primary polycythemia and was subsequently diagnosed to have JAK2-negative PV. [ABSTRACT FROM AUTHOR]

Mumps is an acute communicable self-limiting swelling of the parotid or other salivary glands. Various organs can be involved including the testes, central nervous system, mammary glands, ovary, pancreas, kidneys, and heart. We hereby present a rare case of an 18-year-old unvaccinated male with acute disseminated encephalomyelitis following mumps without parotitis. [ABSTRACT FROM AUTHOR]

Hydatid disease or echinococcosis is one of the oldest known zoonotic diseases. Although known to be found in liver and lungs, these cysts are rarely found in the pancreas. We report a patient who not only had hydatid cyst in the pancreas but also pancreatitis and subsequently diabetes because of it. [ABSTRACT FROM AUTHOR]

Highly active antiretroviral therapy (HAART) is nowadays universally available to patients with HIV/AIDS. This has led to increased longevity in people living with HIV/AIDS. However, these patients frequently face chronic and rarely acute life-threatening complications of HAART. Herein, we report the case of a patient who was on HAART and developed zidovudine-induced lactic acidosis, acute pancreatitis, and myopathy. Although these acute complications are rare, a high index of suspicion is required for early diagnosis and to reduce significant morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: There is very little data on the consequence of menopause on women in South East Asia region, especially from rural India. Importance is always given to reproductive health from menarche to menopause. Menopausal health demands priority in Indian scenario due to rising population of postmenopausal women. Objectives: The aim was to determine the mean age at attaining menopause and the prevalence of various self-reported menopausal symptoms complained by postmenopausal women (40-54 years). Furthermore, to determine the prevalence of anxiety and depression among postmenopausal women. Materials and Methods: A cross-sectional study was conducted in a rural area of New Delhi among 252 postmenopausal women from October 2011 to March 2013. A pretested, self-designed, semi structured, interview based, oral questionnaire was used. The Statistical Package for Social Sciences software Version 21.0 (SPSS) was used for analyses. Results: The mean age at attaining menopause was 46.24 (Standard Deviation = 3.38) years. Only 4 (1.6%) postmenopausal women had premature menopause. A total of 225 (89.3%) postmenopausal women experienced at least one or more menopausal symptom(s). The most common complaints of postmenopausal women were sleep disturbances (62.7%), muscle or joint pain (59.1%), hot flushes (46.4%) and night sweats (45.6%). A total of 32.1% (n=81) postmenopausal women suffered from depression and 21.0% (n=53) postmenopausal women suffered from anxiety. Conclusion: It is necessary to critically introspect health needs of postmenopausal women and specific components can be incorporated in the national health programs. [ABSTRACT FROM AUTHOR]

Context: Ultrasonic scaling is a routinely used treatment to remove plaque and calculus from tooth surfaces. These scalers use water as a coolant which is splattered during the vibration of the tip. The splatter when mixed with saliva and plaque of the patients causes the aerosol highly infectious and acts as a major risk factor for transmission of the disease. In spite of necessary protection, sometimes, the operator might get infected because of the infectious nature of the splatter.Aim: To evaluate the aerosol contamination produced during ultrasonic scaling by the help of microbiological analysis.Materials and Methods: This clinico-microbiological study consisted of twenty patients. Two agar plates were used for each patient; the first was kept at the center of the operatory room 20 min before the treatment while the second agar plate was kept 40 cm away from the patient's chest during the treatment. Both the agar plates were sent for microbiological analysis.Statistical Analysis: The statistical analysis was done with the help of STATA 11.0 (StataCorp. 2013. Stata Statistical Software, Release 13. College Station, TX: StataCorp LP, 4905 Lakeway Drive College Station, Texas, USA). Statistical software was used for data analysis and the P < 0.001 was considered to be statistically significant.Results: The results for bacterial count were highly significant when compared before and during the treatment. The Gram staining showed the presence of Staphylococcus and Streptococcus species in high numbers.Conclusions: The aerosols and splatters produced during dental procedures have the potential to spread infection to dental personnel. Therefore, proper precautions should be taken to minimize the risk of infection to the operator. [ABSTRACT FROM AUTHOR]

Context: Vitiligo is an acquired pigmentary disorder of the skin that is characterized by circumscribed, depigmented macules, and patches. Aims: To compare the therapeutic efficacy and safety of microneedling combined with topical 5-fluorouracil solution versus microneedling alone on stable patches of vitiligo. Settings and Design: Hospital-based interventional prospective study. Methods and Material: We selected 46 patients in the age group of 10–50 years having patch stability of at least 1-year duration. The patients were randomly assigned into two groups of 23 patients each. Group A was treated with microneedling followed by application of 5-fluorouracil which was available in the form of a solution (50 mg/mL) whereas Group B was treated with microneedling alone. The procedure was repeated after every 15 days up to 4 months and patient follow-up along with the grading of repigmentation was done till 6 months. The side effects were noted. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) software, version 25.0. The results were analyzed using the Chi-square test and t-test and P < 0.05 was considered significant. Results: At the end of 6 months, excellent response (>75% repigmentation) was reported in 35 patches (48.6%) in Group A treated with microneedling combined with 5-fluorouracil whereas only 12 patches (16.9%) showed an excellent response in Group B treated with microneedling alone. Conclusions: Combining microneedling with 5-fluorouracil is a simple, safe, well tolerable, and effective modality than microneedling alone for treating small localized vitiligo patches. [ABSTRACT FROM AUTHOR]