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Background and Aims: Angiosarcoma (AS) is a rare malignant vascular tumor that phenotypically and functionally recapitulate normal endothelium. They constitute approximately 2–4% of soft tissue sarcomas. We present 36 cases of head and neck AS diagnosed for 11 years at a tertiary care hospital in South India to analyze the clinical, pathological, and immunophenotypic profiles with special emphasis on their differential diagnoses and diagnostic pitfalls. Materials and Methods: Head and neck AS diagnosed from January 2006 to December 2017 were included. Clinical characteristics, treatment received, and follow-up data were obtained from electronic medical records. Hematoxylin and eosin (H&E)-stained slides and immunohistochemistry (IHC) slides were reviewed, and the histomorphological features, immunohistochemical staining, and their utility in resolving differential diagnosis were assessed. Results: Twenty-two females and 14 males were diagnosed with head and neck AS in the study period. Histomorphological patterns observed were mixed vasoformative and solid (n = 22), pure vasoformative (n = 13), and pure solid (n = 1). Neoplastic cells showed epithelioid, spindly, signet cell-like, clear cell, and rhabdoid morphology. CD31 was positive in 100% of cases, and CD34 was positive in 40% of cases. Differential diagnoses included melanoma, rhabdomyosarcoma, and large-cell lymphoma. Surgery, radiotherapy, and chemotherapy were the treatment modalities used. Twelve patients developed local recurrence, and 12 patients developed metastasis on follow-up. Twenty-five patients died of disease, on an average of 24 months after diagnosis. Conclusion: Head and neck AS pose a significant diagnostic challenge due to their broad morphologic spectrum. Proper clinicopathologic correlation is necessary to avoid misdiagnosis.

Purpose: To study the risk factors, clinical features, and treatment outcomes of patients with culture-negative keratitis (CNK). Methods: A retrospective data review of 933 patients with CNK was performed from January 2018 to December 2020. The variables such as the history of injury, visual acuity, slit-lamp findings with measurements of size and depth of ulcer, microbiological evaluation, duct patency, blood glucose levels, and treatment were considered, and clinical outcome was analyzed. Results: Of the 933 patients with CNK, 763 (81.8%) were medically managed, with a mean treatment duration of 2.08 ± 1.7 weeks. Among them, 622 (66.7%) were both smear and culture-negative, and 311 (33.3%) showed only smear positivity. Smear-positive patients showed a positive correlation with the history of injury. A higher incidence of fungal growth on repeat culture was observed. Surgical interventions were done only in 18.2% of the patients; the rest were treated with topical medications alone. Conclusion: High clinical suspicion, differentiation of causative organisms based on clinical findings, and initiating empirical therapy with broad-spectrum antibiotics and antifungals improve the ultimate prognosis in patients with CNK, even though a standard protocol for empirical medical treatment may differ among institutions and surgeons based on their clinical experience and geographical variations.

Aim: Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are made to improve the denture material by addition of antimicrobials without compromising original properties. The aim of the study was to evaluate flexural strength and microhardness of self-cured polymethyl methacrylate (PMMA) denture base resin after addition of Vaccinium macrocarpon (commonly called as cranberry), extract as antimicrobial, at varying proportions. Study Setting and Design: Experimental in vitro study. Materials and Methods: Frozen cranberry fruits were subjected to extraction process in the presence of aqueous solvents. Lyophilized extract was added in proportions of 0, 0.5, 1.0, 1.5, and 2.0 dry wt/wt % into polymer of self-cure PMMA denture base resin. Based on cranberry inclusion, the study comprised one control (0%) and four test groups (0.5%–2%) with total of 100 samples. A three-point bending test for flexural strength was done for fifty study samples (n = 10). Surface of fractured samples was analyzed using a scanning electron microscope (SEM). Microhardness was determined using Vickers hardness test. Statistical Analysis Used: One-way statistical ANOVA test was done to find the difference between groups, followed by Tukey’s post hoc test for multiple pairwise comparison. Results: Flexural strength ranged from 66.80 to 69.28 MPa, and a statistically insignificant difference was observed between groups (P > 0.05). SEM evaluation showed uniformly dispersed strands of cranberry extract in PMMA matrix. With higher concentration, less voids were seen. Vickers microhardness value significantly decreased from 15.96 in the control group to 14.57 with 2% cranberry addition (P < 0.05). Conclusion: Incorporation of cranberry extract into self-cure PMMA denture base resin, up to 2 dry wt %, did not decline the flexural strength. However, there was a significant decrease in Vickers microhardness values when compared against the control group (0% cranberry inclusion).

H syndrome is a rare autosomal recessive genodermatosis characterized by cutaneous manifestations and other systemic involvement. It presents with features like hyperpigmentation, hypertrichosis, hepatosplenomegaly, hearing loss, hallux valgus, hyperglycemia, low height, hypogonadism, and heart anomalies. Without a high index of suspicion, it is often misdiagnosed with other sclerodermatous cutaneous disorders. This case report highlights the clinical variability of H syndrome. An 8-year-old female child presented with hyperpigmented, hypertrichotic indurated patches with hyperglycemia and short stature. Histopathology showed dense lymphohistiocytic infiltrate and fibrosis in the dermis and subcutaneous tissue. The patient lacked features like heart anomalies, hearing loss, and hallux valgus, suggesting forme fruste presentation of H syndrome. An overlap between features of H syndrome and PHID syndrome is also suspected because of atypical presentation.

Objective: To determine the factors, if any, that are associated with the efficacy of “off-label therapies” (OLTs) for multiple sclerosis (MS). Methods: Consecutive patients (N = 174) with relapsing–remitting MS (RRMS) or secondary progressive MS (SPMS) with relapses, on OLTs with a generic formulation of azathioprine, mycophenolate mofetil, or rituximab biosimilar for ≥2 years were included. Annualized relapse rate (ARR) and expanded disability status score (EDSS) 1 year before and ≥2 years after starting OLTs were recorded. Optical coherence tomography (OCT) was done at baseline and at the end of the study. Results: During a median period of 4.1 years (2.4–24), ARR reduced in all (P < 0.0001) and EDSS improved in RRMS (P < 0.0001) patients but not in SPMS (P < 0.31) patients. Good responders were those who had RRMS (P = 0.001, odds ratio [OR] 0.04, 95% confidence interval [CI] 0.01–0.15), female gender (P 0.008, OR 6.67, 95% CI 1.7–26.8), and had early access to OLT (P = 0.006, OR 1.2, 95% CI 1.05–1.40). Baseline peripapillary retinal nerve fiber layer thickness identified the risk of conversion to SPMS (P < 0.01, OR 1.03; 95% CI 1.01–1.06). Conclusions: This limited prospective study suggests that early identification of patients who could potentially respond to unconventional but accessible therapies may be valuable in the treatment of MS, particularly in resource-poor regions.

The indoor radon and thoron measurements were carried out at Sri Renga Narayana Puram village, Tirunelveli district, Tamil Nadu, which is located nearer to the Nuclear Power Plant, Kudankulam. The survey was performed using a single-entry pin-hole dosimeter with a solid-state nuclear track detector for a period of 90 days. In the present study, the radon and thoron levels have been measured initially for 10 residences using LR-115 Type II films as a detector. The dose assessment due to radon and thoron is calculated. The effective dose of radon and thoron in the corresponding residences has been found to vary from 0.516 to 0.660 mSvy−1 and 0.010 to 0.144 mSvy−1. The total effective dose due to radon and thoron has been calculated which found to vary from 0.545 to 0.791 mSvy−1 with an average value of 0.655 mSvy−1.

IntroductionVarious studies have suggested use of socket grafting materials after dental extraction for socket preservation. However, there is no single material that has been accepted as standard for preserving the socket. The purpose of this systematic review was to analyze the evidence for the use of biphasic calcium phosphate for socket regeneration. Materials and MethodsThe team conducted a systematic literature search in accordance with the protocol registered at PROSPERO. PubMed, OVID, and EMBASE databases were used in the search. The articles were then screened using RAYYAN open-source software for the synthesis of evidence. ResultsOf the 240 articles found in the search, two studies could be included in the review. ConclusionBiphasic calcium phosphate (60% hydroxyapatite, HA and 40% beta-tricalcium phosphate, β-TCP) has a significant effect in the socket preservation and quality of bone regeneration.

The majority of species previously categorized as Bacteroides have been reassigned into new genera. Bacteroides levii (Holdeman, Cato, and Mooretaxonomic)’s status has remained uncertain. This species shares a high degree of similarity with members of the genus Porphyromonas based on biochemical, chemical, and comparative 16s rRNA sequence analysis. As a result, Bacteroides levii (Holdeman, Cato, and Moore) was reclassified as Porphyromonas levii comb. now under the genus Porphyromonas.

This article’s goal is to describe a case of oral contraceptives-related drug-induced gingival hypertrophy that was treated with nonsurgical and surgical periodontal therapy. The most prevalent negative side effect of systemic medicine on the periodontal tissues continues to be drug-induced gingival overgrowth. Specific regulatory molecules known as hormones control a variety of bodily processes. Gingival hypertrophies are sometimes linked to oral contraceptives that contain oestrogen and/or progesterone. A 32-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the maxillary right quadrant region for a period of two months. The medical history documented the use of contraceptives for three months, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. Intraoral examination revealed that there was unilateral, generalized, diffuse gingival enlargement with pseudo pockets. Patient was diagnosed with gingival fibromatosis a based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful. Women who use oral contraceptives are a “risk group” for periodontal infections. On oral contraceptives, not every female reacts the same way. In periodontal therapy, plaque management is the most crucial step. Patient compliance is another element that affects a therapy’s response. The patient demonstrated appropriate oral hygiene practices and adhered to home care guidelines adequately.

The purest and unrestricted source of stem cells is the enamel of the teeth. Dental stem cells (DSCs), which are simple to get, quick to use, and reasonably priced, have the potential to be used in a variety of promising therapeutic applications. Due to their capacity for self-renewal, they are employed to treat significant flaws brought about by diseases, injuries, or surgical procedures. However, they are constrained by moral and ethical issues, as well as challenges with isolation, culturing, and implantation. DSCs are used in the rebuilding of orofacial structures because they retain the ability to differentiate into neurogenic, adipogenic, and odontogenic components. Before stem cell implantation, scaffolding that has been treated with growth hormones and bone morphogenic proteins is crucial. A self-administered questionnaire was used for a cross-sectional study (n = 200) that collected data on demographics, knowledge of stem cells, and attitude statements. Statistical Package for Social Software version 20.0 was used to analyze the data. This study seeks to learn more about professional groups’ perceptions of stem cell research in Tamil Nadu and their knowledge and awareness of DSCs.

Multiple evanescent white dot syndrome (MEWDS) is a rare form of posterior uveitis characterized by involvement in the posterior pole and mid-periphery. A viral etiology that provokes an immune-mediated response has been hypothesized to be the inciting factor of the pathology. Recently, there has been an increase in the literature regarding new-onset uveitis and reactivation of previously diagnosed cases of uveitis following COVID-19 vaccinations. The COVID-19 vaccination has been speculated to trigger an immunomodulatory shift in recipients, resulting in an autoimmune event. MEWDS following COVID-19 vaccination was reported in 31 patients. It was most commonly observed following the first dose, affecting 15 patients, and least commonly after the booster dose, in only one patient. MEWDS-like disease following anti-SARS-CoV-2 vaccinations was reported the most in 16 cases after the Pfizer–BioNTech vaccination (BNT162b2 mRNA). Most of these cases had Primary MEWDS without any previous history of a similar event in the past.

Aim: Continuous chelation is a novel irrigation regimen popular as a single solution for irrigation of the root canal system during root canal therapy, especially for the removal of the smear layer. This study aimed to compare the effectiveness of three different irrigation activation systems in removing the smear layer from the apical third in single-rooted mandibular premolars using a scanning electron microscope (SEM). Methods: Fifty-six extracted single-rooted mandibular premolars were decoronated, and canals prepared till #30/0.09, with Chloroquick (3% NaOCl + 9% HEBP) as the working solution. Teeth were randomly divided into four groups based on the final irrigant activation protocol; Group A - (control group) conventional syringe irrigation with a 30-gauge single-side vented needle. Group B - (passive ultrasonic irrigation method) passive ultrasonic irrigation (PUI) with #20-Irrisafe ultrasonic files activated for 1 min. Group C - (sonic activation) EndoActivator system using the yellow tip (#20/0.04) activated for 1 min. Group D - Tornado Disinfection Kit using GF-brush for 20–30 s as per manufacturer's instructions. The canals were dried, samples were hemi-sectioned, and the amount of remaining smear layer was scored according to the Tabrizizadeh criteria (2015) with SEM images at ×2500 by two blinded operators. The collected data were analyzed statistically using the Chi-square test (P < 0.05). Results: The results showed statistically significant differences in terms of smear removal among the groups (P < 0.05) with the Gentlefile group performing better, followed by PUI, EndoActivator, and the conventional group. Conclusion: Within the limitations of the study, continuous chelation with Gentlefile activation could be a viable and efficient protocol for the removal of the smear layer from the apical third of root canals.

Purpose: This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography. Methods: This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts' reliability (“calibration”) and resolution (“boldness”) and were compared between local (Indian) and external (non-Indian) experts. Results: Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups (P = 0.40). Conclusion: Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, 'What will be the three top public health priorities in India to support family resilience in the 21st century?' as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master's in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable.

Simulation-based training is an acceptable method in medical sciences. The available simulators and the conduct of simulation require both simulators and infrastructural requirements. This narrative review highlights the potential of digital tools for team-based simulation exercises in low-resource settings. This review presents a comprehensive list of affordable digital tools for scenario planning, scenario design, and assessment. It covers various applications and platforms, providing detailed insights into their features, types, and accessibility. Different low-cost digital tools are available, from generative artificial intelligence for scenario planning to online repositories of simulation cases, browser-based assessment designers, and simulation games. These digital tools can make simulation accessible, transforming it into an immersive learning experience to enhance understanding and skill acquisition.

Purpose: To report the uveitic manifestations of patients with systemic lupus erythematosus (SLE). Methods: This was a retrospective analysis of all SLE cases with ocular manifestations seen by a single ophthalmologist between 2015 and December 2021. Results: In total, seven patients with a median age of 40 (range 18–50) years were included in the study. Female (85.7%) predominance was noted. Ocular findings were bilateral in 71% (five patients) of cases. Majority (10 eyes, 83%) of the patients had retinal vasculitis as the common finding. Antinuclear antibodies were positive in all the patients. The vision improved in two (16.6%) eyes, was stable in eight (66%) eyes, and worsened in one (8%) eye. All the patients were treated with oral steroids along with immunosuppressive agents. Conclusion: Though SLE is rare cause of uveitis, it can be associated with significant ocular morbidity. Hence, early diagnosis and treatment can salvage vision in many cases.

Aim: The aim of the study was to correlate axial length (AL) and anterior chamber depth (ACD) with stature. Materials and Methods: The study was conducted among 100 patients attending the ophthalmology outpatient department, including both males and females aged between 20 and 40 years, with clear media and without any systemic or ocular pathology. The first comprehensive ophthalmic examination was done on each subject, including vision assessment, refraction, slit lamp examination, and fundus examination. Then subjects were enrolled in this cross-sectional and purposive study depending on the inclusion and exclusion criteria and were divided into four groups depending on their heights (in cm). Data analysis was performed using SPSS to correlate AL and ACD with stature in young adults in tertiary care hospitals. Results: Although the mean values of the height group 179–189 cm are found to be higher, the P value was found to be insignificant (P = 0.343). There was a positive correlation with P being 0.019 and 0.001 in height groups 159–169 and 169–179 cm, respectively, indicating that there is statistical significance in these groups with the ALs. The correlation was significant with P = 0.026 in the group 159–169 cm. Therefore, the height group 159–169 cm has statistical significance with ACD. Conclusion: In the present study, we found that there was a statistical correlation between the stature of an individual with their ALs and the anterior chamber of the eyeball. We found that taller young adults tend to have longer AL and ACD.

Background: The number of dengue cases reported to WHO increased over 8-fold over the last two decades, from 505,430 cases in 2000, to over 2.4 million in 2010, and 5.2 million in 2019. The disease is now endemic in more than 128 countries with Asia representing ~70% of the global burden of disease. The transmission of dengue is dependent on various environmental factors and socio-demographic and economic factors. This study aimed to describe the climatic factors and vector Indices in the occurrence of dengue fever cases in Northern Kerala. Objectives: 1) To describe the epidemiological factors for occurrence of dengue cases in Northern Kerala. 2) Serological typing of Dengue confirmed cases admitted in a tertiary care Centre in Northern Kerala. Methodology: Data of dengue fever cases admitted to a tertiary care centre in Northern Kerala for a period of one year were collected from Regional Prevention of Epidemics and Infectious Diseases Cell (R-PEID CELL). Vector indices data obtained from District vector control unit. Serology details were collected from Microbiology lab of the tertiary centre and Regional Virus Research and Diagnostic Laboratory (RVRDL). Geographical mapping and analysis of occurrence of dengue cases with rainfall done. Results: Total 518 cases were admitted to the tertiary centre during January 23-October 23. 68% Male and 32% female.77.7% Cases were reported from Kozhikode district.25 % cases were belonging to age group 20-29. Admission of cases were more during October followed by August. Serological typing of sub sample showed DEN2 as the predominant serotype. DEN1 and DEN3 serotypes were also identified. Conclusion: There is increased case transmission occurred during rainy season i.e. in North East and South West Monsoon which is in accordance with district vector indices data. DEN2 was the predominant serotype followed by DEN1.

Background: In the clinical practice, one of the most common suspicious lesions that may be potentially malignant is oral leukoplakia. Globally, the rate at which it turns malignant varies. This study examines the levels of markers CD138 and 43 in oral leukoplakia. Materials and Methods: Twenty archival blocks of confirmed epithelial dysplasia were taken from the Department of Oral Pathology. These were processed for the identification of markers CD138 and 43 through Immuno Histo Chemistry (IHC). The blocks were divided equally for both the markers. Results: There was a noticeable difference in staining intensity between dysplastic tissue and nondysplastic epithelium. However, CD138 expression was low or weak in dysplastic epithelium. CD43 expression was negative in all nonhematopoietic tissues. Conclusion: Genes that are cancer associated have been found to have incredibly different impacts in numerous tissues during the multistep process of oral carcinogenesis. In tissues undergoing dysplastic changes, CD138 expression was shown to be decreased, which could point out the malignant changes initiated in the epithelium of the oral tissues.

Background: Menstrual hygiene practices are consequently a significant public health issue. However, menstrual practices are still tainted by taboos and other sociocultural constraints, which adversely affect health since adolescent females are unaware of the scientific facts regarding menstrual hygiene practices. Objective: To determine knowledge, attitude, practice regarding menstrual hygiene among adolescent school girls in a government higher secondary school, Thrissur, Kerala Methodology: A cross sectional study was conducted among students of 8th standard to 12th standard in a government higher secondary school Thrissur. The data was collected after obtaining permission from head of the institution and verbal consent from the participants. Results: The study was conducted among 237 adolescent girls studying from 8th to 12th standard in a government school in Thrissur. Out of the total study participants 96 % have high knowledge about menstrual hygiene and the rest have moderate knowledge. 77.6% students use sanitary pads as adsorbing material, 15.6 % use cloth and only 6.8 % use menstrual cup. But 62 % have the opinion that menstrual cup is better than pads. 49% of the students believe that menstrual blood is impure and 50 % of students believe that normal routine activities cannot be done during menstruation. Most of the participants (92 %) adopt burning as the method of disposal while 4.2 % were practicing flushing of the pads. 61.2 % students liked to share doubt with mother and 30 % like to share with friends. Conclusion: Majority of the students have good knowledge about menstrual hygiene, but the scientific knowledge about menstruation is lacking behind.

Pheochromocytomas are catecholamine-secreting tumours arising mostly from the adrenal medulla. With the advancement in surgical and anaesthetic techniques, the incidence of severe morbidity and mortality associated with surgery is low. However, concurrent coronary artery disease and pheochromocytoma continue to be a challenge due to the risk of adverse cardiovascular events. We describe the successful management of pheochromocytoma excision in a patient with coronary artery disease.

Introduction: Sexual offense has been defined as sexual contact with another person (including touching of the sexual organs of another) or touching of another person with one's sexual organs without that person's consent. Adverse childhood experiences could lead to health problems, behavioral problems, and psychosocial problems like crimes. Aims: The aim is to study adverse childhood experiences and psychopathology of imprisoned sexual offenders. Materials and Methods: A sample of 48 sexual offenders from a central prison and after taking informed consent, a semi-structured intake pro forma was used, followed by that adverse childhood experiences–international questionnaire, Mini-international neuropsychiatric interview-7.0.2 were applied. Results: It was found that the majority of the offenders had experienced adversities in their childhood, the most common being community violence and physical abuse, emotional neglect. Half of the participants had antisocial personality disorder. A statistically significant relationship was found between adverse childhood experiences score and number of offenses committed (P = 0.002). Conclusion: It can be concluded that the presence of adverse childhood experiences could affect physical, mental health in adulthood, and increase crimes.

Aim: This study aims to examine the characteristics of endodontic clinical trials registered in the ClinicalTrials.gov database. Methods: The ClinicalTrials.gov website was searched for endodontic clinical trials that were registered between 2000 and 2022. The search term used was “endodontics.” As a result of the search strategy, 613 trials were identified. Out of which, 500 clinical trials met our inclusion criteria. For each clinical trial, information was extracted including the year of registration, location of the trial, type of trial, study design (allocation, intervention model, and masking) estimated enrollment, participants' age, health condition/problems studied, intervention/treatment, the status of the trial, study results, phase of the trial, and source of funding. Fisher's exact test was applied to identify the characteristics of clinical trials associated with funding. Results: The number of registered clinical trials gradually increased from 2000 to 2022. Out of 500 clinical trials, 456 were interventional, and 44 were observational. Only 18 clinical trials had secured funding. The majority of interventional trials (90.8%) are randomized, and the most common interventional model was parallel assignment (88.4%). It was observed that irreversible pulpitis was the most common condition studied (32.2%). Nonsurgical endodontic therapy was the most common intervention used in the trials (42.2%). Conclusion: The study provided an overview of endodontic clinical trials that were registered in the ClinicalTrials.gov. The findings showed that registered endodontic clinical trials have increased rapidly since 2000. The vast majority of trials took place in Africa. The majority of endodontic clinical trials followed rigorous methods in terms of allocation, intervention model, and masking. However, only a small portion of trials had secured funding. The findings also indicate the need for trial results to be made publicly available to enhance evidence-based practice in endodontics.

Introduction: There are few scores for mortality prediction in acute respiratory distress syndrome (ARDS) incorporating comprehensive ventilatory, acute physiological, organ dysfunction, oxygenation, and nutritional parameters. This study aims to determine the risk factors of ARDS mortality from the above-mentioned parameters at 48 h of invasive mechanical ventilation (IMV), which are feasible across most intensive care unit settings. Methods: Prospective, observational, single-center study with 150 patients with ARDS defined by Berlin definition, receiving IMV with lung protective strategy. Results: Our study had a mortality of 41.3% (62/150). We developed a 9-point novel prediction score, the driving pressure oxygenation and nutritional evaluation (DRONE) score comprising of driving pressure (DP), oxygenation accessed by the ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) ratio and nutritional evaluation using the modified nutrition risk in the critically ill (mNUTRIC) score. Each component of the DRONE score with the cutoff value to predict mortality was assigned a particular score (the lowest DP within 48 h in a patient being always ≥15 cmH2O a score of 2, the highest achievable PaO2/FiO2 4 was highly associated with mortality (P < 0.001, hazard ratio 5.43, 95% confidence interval [2.94–10.047]). Internal validation was done by bootstrap analysis. The clinical utility of the DRONE score ≥4 was assessed by Kaplan–Meier curve which showed significance. Conclusions: The DRONE score ≥4 could be a reliable predictor of mortality at 48 h in ARDS patients receiving IMV.

Background: Hepcidin is a 25 amino acid peptide expressed in the liver. Discovered as late as 2002, hepcidin is a master regulator of iron metabolism and is sensitive to inflammation. Chronic periodontitis, being an inflammatory condition, affects levels of hepcidin. There exists a linear correlation between chronic generalized periodontitis (CGP) and cardiovascular disease (CVD). Objective: To assess and compare serum hepcidin between Group I (Control Group—CGP without CVD) and Group II (Case Group—CGP with CVD). Methods: Blood samples of 20 patients from Group I and 20 patients from Group II were collected and centrifuged to separate serum samples. ELISA kit was used for the estimation of serum hepcidin levels. The statistical analysis was done using G-Power version 3.1 software. Results: The serum hepcidin levels in Group I and Group II were found to be insignificant (P = 0.742679, P < .05). Conclusion: Serum hepcidin levels were higher in Group I when compared with Group II. We can conclude that there is an increase in the hepcidin levels due to inflammatory conditions. However, using hepcidin as a biomarker in CVD needs further examination using a larger sample size with long-term observations.

Purpose: To assess the quality of life and contrast sensitivity (CS) pre- and post-laser assisted in situ keratomileusis (LASIK) among subjects with low, moderate and high myopia. Materials: A total of 95 ubjects undergoing myopic LASIK during the study period from 2018 to 2019 among different grades of myopia were included. It was a prospective, non-randomised study. Quality of life was measured by NEI-RQL 42 (national eye institute refractive error quality of life) questionnaire. The Pelli-Robson chart measured contrast sensitivity and the visual outcomes before LASIK and at one week, one month and six months after LASIK. Results: One hundred and ninety eyes of 95 subjects were included in the study. Out of these, 93.5% of low myopia (n = 29/31), 85.7% of moderate myopia (n = 36/42) and 72.7% of high myopia (n = 16/22) improved to 6/6 at six month follow up. All 13 subscales of the NEI-RQL 42 questionnaire observed an increasing trend except glare (GL) which showed a decreasing trend over time, and the results were statistically significant at a 5% level. Concerning contrast sensitivity, low myopias had a better postoperative CS when compared to high myopia, and this finding was statistically significant (P = 0.012). Conclusion: Despite being a safe and effective procedure of refractive correction, LASIK has its setbacks, especially when compared with the quality of vision, and this can be minimized by careful preoperative assessment and in-depth patient counseling by the treating physicians.

Purpose: To study the clinical outcomes, time span of healing of various ocular surface disorders with amniotic membrane graft. Methods: A total of 41 patients, presenting to cornea clinic were included in the study and divided into five groups depending on the type of diagnosis: Group 1, with either >2 weeks of Persistent epithelial defect following cataract/retinal/glaucoma surgeries or Shield ulcers, Group 2 with >4 weeks of Non healing corneal ulcers, Group 3 with chemical injuries, Group 4 with Epithelial defects following keratoplasty, and Group 5 is the miscellaneous group. Results: The mean age of the study subjects was 50.0 years. Overall mean duration between clinical presentation and AMT was 23.59 (30.7) days, a median 16 days (IQR; 2-26 days). Failure rate was high in Group 5 (n = 3: 30.0%) and Group 2 (n = 3: 27.3%). Time taken for epithelial closure was slower in groups 1 and 5 patients. The average time taken for reabsorption of AMG was 14.98 days. The complications included repeat AMG was in four eyes (9.75%), and graft displacement was noted in four eyes (9.75%) required resuturing, three eyes required TPK (7.31%), and one eye underwent evisceration (2.43%) following severe corneal melt secondary to neurotropic ulcer. The mean log MAR visual acuity improved from 1.52 to 1.26 at the 3 months. Conclusion: Understanding on timespan for healing of ocular surface disorders with AMG is needed to assess the prognosis of the disease, preoperative counselling for repeat procedures, and the compliance with regard to follow up.

Corneal blindness (CB) is one of the leading causes of blindness in India and globally, affecting around 8 million population worldwide. Many of these corneal blind patients may be visually rehabilitated by corneal transplantation (CT). Eye banking plays a crucial role in facilitating CT and ocular research. Many countries have adopted regulatory frameworks, quality assurance programs, and technological advancements to enhance the efficacy and safety of CT. Various infrastructural and organizational frameworks of eye banks (EBs) in India, according to the Eye Bank Association of India (EBAI), aid in establishing guidelines and standards for EB practices. Initiatives such as the National Programme for Control of Blindness (NPCB) have significantly contributed to eye donation rates and improved access to donor corneas. This review article discusses the established eye banking networks in countries such as India, the United States (USA), and Europe, where dedicated EB organizations work collaboratively to ensure efficient procurement, processing, and distribution of corneal tissue. It also highlights specific strategies employed in India and global countries to address EBs' challenges. These challenges include the shortage of donor corneas, improving donor screening and tissue processing techniques, ensuring timely distribution of corneal tissue, and maintaining high-quality standards. Interestingly, the comparative analysis between India and other developed countries highlights the similarities and differences in eye banking strategies. By understanding the strategies employed by different regions, EBs can learn from each other's experiences and work toward achieving optimal outcomes in CT and ocular research worldwide. It underscores the importance of knowledge sharing and collaborative efforts in addressing common challenges and implementing best practices in eye banking.

Objective: To investigate the cardioprotective effect of beta-glucan against isoproterenol-induced cardiotoxicity in rats, and elucidate the underlying mechanism. Methods: Rats were orally pretreated with beta-glucan (40 mg/kg body weight) for 30 d, and isoproterenol (20 mg/100 g body weight) was administered on days 31 and 32. The effects of beta-glucan on markers of cardiac injury, hemodynamic changes, production of proinflammatory cytokines, and the corresponding mRNA expressions were evaluated. In addition, histological analysis was performed. Results: Pretreatment with beta-glucan prevented isoproterenol-induced cardiac injury by preserving the structural and functional integrity of the plasma membrane and attenuating the production of proinflammatory cytokines (NF-κB, TNF-α, IL-6, IL-Ιβ, and IFN-γ) in the heart. Moreover, beta-glucan significantly downregulated the mRNA expression of ACE, AT1R, TNF-α, IL-6, NF-κB, caspase-3, TLR-4, and Bax, and upregulated Bcl-2 in the heart. At the same time, pretreatment with beta-glucan alleviated myocardial damage as reflected in a reduction in myonecrosis, edema, and erythrocyte extravasation with almost imperceptible inflammation. Conclusions: Beta-glucan can protect against isoproterenol-induced cardiotoxicity by attenuating cardiac inflammation and apoptosis and regulating the ACE-AT1R axis, thereby preventing cardiac remodeling.

Objective: To explore the therapeutic efficacy of L-carvone from Mentha spicataL. leaf extracts against isoproterenol-induced cardiac hypertrophy in rats. Methods: Isoproterenol (5 mg/kg) was injected intraperitoneally into rats for one month to induce cardiac hypertrophy. L-carvone (25 and 100 mg/kg) was administered orally to treat cardiac hypertrophy. The cardioprotective activity of L-carvone was evaluated by electrocardiogram, histopathological analysis as well as determination of biochemical parameters and enzymatic markers. Results: L-carvone from Mentha spicata L. at 25 and 100 mg/kg ameliorated isoproterenol-induced cardiac hypertrophy, as evidenced by reduced QRS interval on electrocardiogram, and decreased heart weight and heart index. In addition, both doses of L-carvone markedly lowered the levels of glucose, total protein, low-density lipoprotein cholesterol, aspartate transaminase, alanine transaminase, lactate dehydrogenase, creatine kinase MB, troponin-I, N-terminal pro-B type natriuretic peptide and triglycerides while increasing high-density lipoprotein cholesterol and lipase level (P

Complete edentulism is one of the most common problems encountered by geriatric individuals. With advanced aging, despite attempts made to retain natural dentition, loss of entire teeth is yet observed. For precise denture fabrication, a digital sensor device was used during the making procedure. The use of sensor device aided in better appreciation and more retentiveness of denture.

Introduction: “Burnout syndrome (BS)” is a work-associated condition which is frequently observed in medical professionals, especially students. Extra-curricular activities (ECAs) are one of the coping techniques that students employ to deal with stress and exhaustion. Goal: The study's goal is to evaluate dental students' levels of burnout and how it correlates with their participation in ECAs. Materials and Procedures: In South India, a dentistry school conducted a cross-sectional questionnaire research with its students. Both the regular and supplemental batches of students from the first year through the fifth year (internship) were included. The “Maslach Burnout Inventory Student Survey”, which has 15 items in three areas—”Emotional Fatigue (EE), Cynicism (CY), & Professional Efficacy (PE)”—was used to assess burnout. A 5-point Likert scale was used to grade each response. Poisson log linear model and the Mann–Whitney U test were employed. The threshold for statistical significance was 5 out of 100. Results: Four hundred participants were finalized after the criteria. Over 80% of the participants were women students as in accordance with the routine proportion of the dental students. The participants' average age was 22.1 ± 12 years. Burnout was seen in nearly 20% of subjects. Significant variation was seen for all the three domains of the burnout when they were compared against the ECA (P = 0.019(EE), 0.003(CY), and 0.005(PE)). Conclusion: It is safe to say that among the participants, burnout is a common occurrence. There is a need for early detection of burnout in dental students and prompt, efficient management.

Background: Assessment drives learning is a well-known adage. If the assessment is subjective, it can under/overestimate the student's performance and thus impair the learning process. Rubrics help standardize the assessment by giving guidelines to both the assessor and the student and minimize subjectivity. Methodology: A mixed method design was employed to identify the inter- and intra-rater reliability of assessing narrative reports and explore the faculty perceptions on using rubrics for the assessment of narrative reports. Results: The inter-rater reliability scores were 0.08 without the use of rubrics and 0.93 with the use of rubrics demonstrating a statistically significant-excellent reliability when rubrics were used. The intra- and inter-examiner mean total assessment scores showed a statistically significant variation when rubrics were not used while the variation was reduced with the use of rubric. The two examiners who were part of the study welcomed the use of rubrics for assessment. They concurred that rubrics gave the assessor the schema and minimized the subjectivity of the assessment. Although the time taken for assessment was initially longer with a rubric scale, subsequently, the time taken was reduced. The assessors felt that they were now in a position to give richer constructive feedback to students. They felt that the students should also know the rubric scale beforehand so that it sets the expectations and helps the student to set self-determined learning goals. Conclusion: The use of rubrics improves inter- and intra-rater reliability of assessment scores. It gives a direction to the examiners and helps categorizing the student performance with minimal subjectivity.

Impacted tooth is often a common problem in dentistry. Maxillary canines are seen impacted most commonly in patients undergoing orthodontic treatment without reaching the line of occlusion. These impactions are commonly due to physical obstructions and the difference in the direction of movement of the tooth. Canines are the cornerstones for esthetic smile and functional occlusion. Hence, surgical exposure of these impacted canines, guiding them toward the line of occlusion, plays a very important role in the maintenance of the health of periodontium. A series of cases are discussed on various techniques that can be used in guiding the direction or altering the direction of impacted canines to bring them into a proper occlusion without disturbing the health of periodontium.

Purpose: The purpose of this study is to study the patient's awareness of the proper method of eye drop (ED) opening and usage among patients attending the outpatient and specialty clinics of a tertiary eye care center in South India. Methods: A questionnaire-based cross-sectional survey was conducted among 514 patients attending outpatient departments of general units and specialty clinics by seven study coordinators. The questionnaire consists of 10 simple questions to assess the awareness of these patients on ED opening, usage methods, and from whom they received the information. Immediately, at the end of the questionnaire, all the patients participating in the survey were properly instructed on the right method of ED usage. In addition, they were inquired about the right mode of communication on the topic of interest. Results: Total number of participants included was 514. Mean age was (standard deviation) 50.58 (20.8) years; only 3.3% (17) were not informed about the proper usage of ED method by any of the staff or the counselors or doctors from the hospital, and 96.7% (497) were counseled for the proper method of ED usage. Among them, the information was properly explained to 82.7% (412) of the respondents by the counselors in each department; only 7.4% (37) were explained by the doctors. Most of them, 80.2% (412), preferred direct oral conversation methods of counseling on ED usage, 9.9% (51) preferred through posters, 7% (36) through video displays, and only 9% (10) through public address systems. Conclusion: A separate, precise ED counseling system is necessary for delivering proper instructions on ED usage and opening. The patient's education with eye-to-eye contact from the counselors is the patient's preferred route of obtaining information on ED usage.

Introduction: On 11 March, 2020, World Health Organisation (WHO) declared coronavirus disease 2019 (COVID- 19) a pandemic disease, and by 26 March, 2020, COVID-19 had spread to nearly 199 countries and homes worldwide. Cases substantially present with fever, dry cough and breathing difficulty. As a result of the pandemic, a number of cases visiting the hospital for non-COVID-19 diseases was drastically reduced and only emergencies were seen in our hospital. Inpatient admissions were also reduced and surgical procedures were reduced. The cost of ocular surgeries was escalated to adhere to the guidelines issued by authorities, for the safety of patients and staff. Majority of ocular surgeries are elective, and national programmes conducting cataract camps were completely stopped since cataract surgeries are elective. Objectives: To assess the knowledge, attitude and practice (KAP) of the patients visiting ophthalmology OPD towards COVID-19 and ocular surgery. Materials and Methods: A cross-sectional non-interventional questionnaire-based study was conducted among patients visiting ophthalmology OPD. Results: The study included 100 patients of which 54% were males and 46% were females. A total of 38% were above the age of 50 years and literates consisted of 60%. The main ocular symptom was defective vision (43%). Furthermore, 98% were aware of COVID-19. Internet/media (48%) was the major source of knowledge. In addition, 80% were aware of the cause and mode of spread, 40% were willing to undergo eye surgery and 75% agreed with government lockdown measures and were ready to take the vaccine to prevent COVID-19 infection. Conclusion: The study suggests that the population demonstrated decent knowledge, appropriate practice and a positive attitude towards COVID-19 at the time of its outbreak.

Context: The use of smartphone-based peek acuity application to test the visual acuity will improve the time efficacy, availability, and utility of subjective results collections for the healthcare providers. Aims: To assess and compare the VA by Smartphone visual acuity chart and LogMAR visual acuity chart and to determine the significance of the peek acuity chart over the LogMAR chart. Settings and Design: Prospective study. Methods and Material: We analysed 50 subjects with their approval and informed consent, evaluated their visual acuity using a LogMAR chart at three metres, and performed subjective refraction, silt lamp examination, and fundus examination. VA measures were taken with a smartphone software called Peek acuity and subjective refraction was done with a smartphone-based visual acuity program. The results were then compared between the two techniques. Sample Size: Convenient sampling. Statistical Analysis Used: The data were entered in MS excel and the results were calculated using statistical software SPSS, version 20. The results were expressed in the form of descriptive statistics like mean, standard deviation, graphs, frequency, and percentage was performed and inferential statistics like corelation and paired t-test were performed wherever necessary to compare unaided visual acuity, visual acuity with pinhole, and with glasses in both the eyes using smartphone-based PEEK visual acuity app and LogMAR visual acuity chart. If P

Background: Status dystonicus (SD) is a life-threatening movement disorder emergency characterized by increasingly frequent and severe episodes of generalized dystonia, requiring urgent hospital admission. The diverse clinico-etiological spectrum, high risk of recurrence, and residual disabilities complicate functional outcomes. Aim: We aim to describe the clinico-etiological spectrum, radiology, therapeutic options, and follow-up of patients with pre-status dystonicus (pre-SD) and SD. Methodology: A cross-sectional retrospective study was carried out in a tertiary care referral center. The clinical, laboratory, and radiology data of all patients aged less than 18 years with pre-SD and SD from January 2010 to December 2020 were collected. The Dystonia Severity Assessment Plan (DSAP) scale for grading severity and the modified Rankin Scale (mRS) for assessing outcome were used at the last follow-up visit. Results: Twenty-eight patients (male:female: 2.1:1) experiencing 33 episodes of acute dystonia exacerbation were identified. The median age at the onset of dystonia and SD presentation was 8.71 (range: 0.25–15.75) and 9.12 (range: 1–16.75) years, respectively. Four patients experienced more than one episode of SD. The etiological spectrum of SD includes metabolic (Wilson's disease—13, L-aromatic amino acid decarboxylase deficiency—one, and Gaucher's disease—one), genetic (neurodegeneration with brain iron accumulation—three and KMT2B and THAP 1 gene-related—one each), structural—three, post-encephalitic sequelae (PES)—four, and immune-mediated (anti-NMDA receptor encephalitis—one). Five patients had pre-SD (DSAP grade 3), and 23 patients had established SD (DSAP grade 4—17 and DSAP grade 5—six). The Rapid escalation of chelation therapy precipitated SD in 11 patients with Wilson's disease. Febrile illness or pneumonia precipitated SD in nine patients. Twenty-three episodes of SD required midazolam infusion in addition to anti-dystonic medications. The median duration of hospital stay was 10 days (range: 3–29). Twenty-three patients had resolution of SD but residual dystonia persisted, while two patients had no residual dystonia at follow-up. Three patients succumbed owing to refractory SD and its complications. Conclusion: Early identification of triggers, etiology, and appropriate management are essential to calm the dystonic storm.

Purpose: To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India. Methods: A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted. Results: A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% (n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet's stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment. Conclusion: Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.

Purpose: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects. Methods: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi-square test was used for statistical analysis. Results: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2). Conclusion: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.

Purpose: The aim of this study was to determine the predisposing risk factors, clinical characteristics, microbiological profile, and visual and functional treatment outcome of microbial keratitis including viral keratitis in children. Methods: A prospective study was carried out in a tertiary care institute over a period of 18 months on 73 pediatric patients. Data collected was analyzed for demographics of the patient population, causative organisms, and management outcome in terms of visual and functional outcome. Results: Patients in the age group from 1 month to 16 years were included, with a mean age of 10.81 years. Trauma was the commonest risk factor (40.9%), with unidentified foreign body fall being the most common (32.3%). No predisposing factors were identified in 50% of cases. Also, 36.8% of eyes were culture positive, with bacterial isolates in 17.9% and fungus in 82.1%. Moreover, 7.1% eyes were culture positive for Streptococcus pneumoniae and Pseudomonas aeruginosa each. Fusarium species (67.8%) was the commonest fungal pathogen, followed by Aspergillus species (10.7%). Also, 11.8% were clinically diagnosed as viral keratitis. No growth was found in 63.2% of patients. Treatment with broad-spectrum antibiotics/antifungals was administered in all cases. At the final follow-up, 87.8% achieved a best corrected visual acuity (BCVA) of 6/12 or better. Therapeutic penetrating keratoplasty (TPK) was required by 2.6% of eyes. Conclusion: Trauma was the major cause for pediatric keratitis. Majority of the eyes responded well to medical treatment, with only two eyes needing TPK. Early diagnosis and prompt management helped majority of the eyes to achieve a good visual acuity after the resolution of keratitis.

Background: Around the world, the number of people with diabetes is rising at an alarming rate, and experts have been using ancient drugs that are mostly made from plants as treatments.This study aimed to see if Borassus flabellifer L. palm sprout ethanolic extracts could help treat diabetes in rats made diabetic by streptozotocin (STZ). Methods: STZ (45 mg/kg bw) was injected once into the peritoneum of male albino Wistar rats. This caused them to get diabetes. For 60 days, intragastric intubation was used to give diabetic rats B. flabellifer palm sprout ethanolic extracts (400 mg/kg bw) and glibenclamide (1 mg/kg bw). Results: As a result, the rats lost a lot of weight, their blood sugar and glycosylated hemoglobin levels went up, and their total hemoglobin (Hb) levels went down. Furthermore, glucose-6-phosphatase and fructose-1,6-bis phosphatase were higher in rats made diabetic by STZ, while hexokinase and glycogen levels were lower. When diabetic rats were given ethanolic extracts of B. flabellifer palm sprouts and glibenclamide, their blood glucose and glycosylated Hb levels went down very well, and their Hb levels went up. Changes in how enzymes that break down carbohydrates and liver glycogen work were greatly improved. Conclusion: The results of the ethanolic extracts of B. flabellifer palm sprouts were similar to those of the standard drug glibenclamide. The results of this study back up the traditional use of plant extracts to treat diabetes.

A 37-year-old lady, when being evaluated in gynecology for pain in the abdomen, was found to have a pelvic mass suspicious of ovarian cancer with markers negative. There was an ovarian vein thrombosis extending to the right atrium in the contrast-enhanced computed tomography scan. A fluorodeoxyglucose positron emission tomography-computed tomography ruled out any other lesions. The patient underwent surgery under general anesthesia with transesophageal echocardiography to monitor the atrial thrombus. Intraoperatively, a retroperitoneal mass is seen arising from the right adnexal region of the uterus extending to the lumbar area. After the hysterectomy, bilateral salpingo-oophorectomy, tumor resection, and baring and looping of the retroperitoneal vessels, a sternotomy was done, and she was put on cardiopulmonary bypass. The tumor thrombus had two limbs both arising from the mass, one through the ovarian and the second through the iliac veins and joining together inside the inferior vena cava (IVC). With the excision of the ovarian vein at its junction, atrial incision, and incisions over the iliac veins and IVC, the thrombus was removed completely in a single sitting. Final histopathology revealed intravenous leiomyomatosis and no malignancy. We report this case as a rare disease, with both ovarian and iliac thrombus being a further rarity and a multidepartment joint effort with a successful outcome.

The present study aimed to evaluate the peri-implant tissue response and marginal bone levels of immediately loaded narrow diameter dental implants. In this study, 10 patients with single maxillary anterior edentulous space were included. Implants were placed and immediate provisional crown was given without any centric or eccentric contacts. After three months, a definitive restoration was placed. All the clinical and radiographical parameters were evaluated.

To report a unique case of spontaneous resolution of momentary, non-inflammatory phakic intraocular lens implantation (pIOL) deposits, in a 24-year-old female underwent phakic IOL implantation in both eyes for high myopia. Surprisingly, multiple, whitish, refractile, non-inflammatory deposits were noted in the immediate postoperative period on the posterior surface of the pIOL in the right eye. A quick recap of surgical steps identified the rationale for the lens deposits, circumventing similar incident in the fellow eye.