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The article is a case report on the management of acute periapical abscess associated with maxillary left first premolar by conventional root canal treatment and incision drainage. Radiographic examination on follow up showed healing of the endodontic lesion. Clinical evaluation also revealed no pain and sensitivity in relation to the upper left first premolar. Early diagnosis and proper management of the endodontic lesion led to successful resolution of this infection.

A common entity in Western societies, gallstones are found in approximately 15% of adults. CBD stones have been noted in 10–15% of patients with cholelithiasis, and this incidence increases with age. Such patients present with biliary colic, bile duct obstruction, bilirubinuria (or tea-colored urine), pruritus, acholic stools, jaundice. Various diagnostic modalities used were ultrasonography, CT scan, MRCP. The treatment options available were ERCP and surgical biliary drainage. Here we have studied various modes of presentation of CBD calculi, identied various treatment options available for the disease and determine its outcomes, determined the effectiveness of our surgical treatment by studying recurrence or various complications and identied the treatment modality associated with the least hospital stay

The process of 3 Dimensional (3D) printing is used to create a 3D object with the help of a computer aided design (CAD) model, by successive addition of material layer by layer thus it is also known as additive manufacturing. During 1990’s, the technique of 3D printing was only applied for the manufacture of aesthetic or functional prototypes and was suitably named as rapid prototyping. The following descriptive review presents with an overview about contemporary 3D printing technologies and their use in various specialties of dentistry and largely focusing on the applications of this technology in the endodontics.

Incidence of new cases of a severe form of unchecked primary hyperparathyroidism is decreasing day by day. Here, we report the case of a 40-year-old female patient of primary hyperparathyroidism with a maiden visit to the hospital with multiple osteolytic lesions and multiple pathological fractures. The diagnosis was installed and managed accordingly.

Background: India represents 3% related to the global malaria problem. Early diagnosis and treatment that are complete alongside preventive measures are modalities essential to managing the situation. Rapid diagnostic tests (RDTs) and polymerase chain reaction (PCR) that are malaria that is real-time be used to obtain an exceedingly really very early diagnosis in acutely febrile customers. Aims and Objectives: This study aims to gauge the effectiveness of RDT bloodstream that is utilized entire from clients clinically suspected of malaria and compare it with real-time PCR. Materials and Methods: The cross-sectional study is observationally done and made up of 158 patients admitted to Index Hospital, Indore, having a serious illness that is febrile and medical suspicion of malaria. RDT for malaria antigen and PCR that are real-time done in the bloodstream that is whole examples depending on kit guidelines. Results: There exists a difference that is significant the nice and examples which are negative by both techniques. Fast P = test is diagnostic PCR that is real-time RDT has been good in 62 (44%) clients, whereas, real-time PCR detected the parasite in 136 (91%) customers. RDT was in reality negative for malaria antigen in 16 (12.8%) consumers, in whom RT-PCR was good. RDT failed to identify Plasmodium falciparum antigen in RT-PCR samples that can be good. RT-PCR indicates basic greater sensitiveness (82.4–95% CI 79.2–84.5%) in diagnosing malaria set alongside the quick test is an antigen. The sensitiveness of RT-PCR in detecting P. falciparum had been also high (74.2%, 95% CI 71.4–77.2). This has greater specificity than RDT in detecting P. falciparum disease (91.3%, 95% CI 89.4–95.4) in detecting P. falciparum than RDT. Conclusion: RT-PCR has better efficacy to look for the presence of malaria parasites in acutely clients being febrile remain undiscovered by RDT. Therefore, it might be helpful for the verification of diagnoses and studies which are epidemiological.

Congenital diaphragmatic hernias occur in 1 in 3500 live births. Among the congenital diaphragmatic hernias, morgagni hernias are the rarest accounting for 2-3% of all diaphragmatic hernias. They occur through a congenital defect in the anterior part of the diaphragm just behind the sternum. In most cases the defect in the diaphragm is small and the patient may remain asymptomatic. The occurrence of obstruction or strangulation in these hernias is a rare occurrence. We report a rare case of right sided Morgagni hernia in a 14 years old boy who presented with features of subacute intestinal obstruction. Chest X-ray showed a large right sided diaphragmatic hernia with stomach and bowel loops compressing the right lung. A contrast enhanced computed tomography (CT) scan indicated large right sided diaphragmatic hernia containing gastric volvulus with twisted small bowel loops causing right lung collapse, and congenital anomalies of the right kidney and liver. The patient underwent exploratory laparotomy with an upper midline incision with reduction of hernia and primary repair of the diaphragmatic defect found in the anterior aspect of right diaphragm without placement of a mesh. An ICD was placed in right thoracic cavity to allow the lung to expand. Due to inadequate lung expansion a second ICD was placed in the right third intercostal space on the 9th post-operative day and removed on the 18th post-operative day. Patient was discharged with a single ICD on 20th post-operative day which was removed on first follow up. Patient was asymptomatic and recovered well subsequently.

Background: Abdominal tuberculosis is found worldwide although prevalence rates are still highest in the developing countries. The sites of involvement of abdominal tuberculosis are peritoneum, lymph nodes, intestine and solid viscera. The objectives of this study were to describe the clinical profile of patients with abdominal tuberculosis, to review the use of diagnostic modalities, both non-invasive and invasive and to study the outcome of management of abdominal tuberculosis.Methods: This is an observational retrospective study of 30 patients with diagnosis of abdominal tuberculosis treated at university linked teaching hospital of South Gujarat from August 2015 to November 2017.Results: In our study, disease was found almost equally prevalent in both rural and urban areas affecting mostly lower socio-economical class. The mean age was 34 years (range from 13 to 62); male and female ratio was 2.33:1; the mean hospital stay was 09 days (range from 5 to 48 days). Abdominal pain was present in almost all cases, having chronic pain in 21 patients and acute in 9 patients. There were 05 (16.7%) patients found to be HIV positive in this study. There was mortality of 02 patients post operatively due to sepsis in those patients operated in emergency with peritonitis.Conclusions: Abdominal tuberculosis is prevalent in lower socioeconomic class patients and affects younger male patients more commonly. Most commonly intestinal and mesenteric disease presented with chronic abdominal pain and constitutional symptoms of tuberculosis.

Background: The main purpose of this study is to provide an overview of demography, neurological level of injury, completeness of injury, incidence, prevalence, delay in the presentation of spinal injury patients to the specialized spinal trauma units, injury mechanisms as well as lethality and causes of death associated with traumatic cervical spinal cord injuries and to suggest steps to improve the quality of care of the cervical spinal trauma patients in the Indian setup. Hence, the main objective of the study is to observe the socio demographic profile, injury pattern, mechanisms, lethality and causes of death associated with cervical spinal cord injuries Methods: This is a retrospective Study of 70 cases of colorectal carcinoma analysing incidence, clinicopathological features and outcome after different therapies including surgery, radiotherapy and chemotherapy. Results: Mean age of our sample is 35 ± 15 years, There were 11 females (14.66%) and 64 males (85.33%), Education and socio-economic status 70% of the sample belonged to the most vulnerable lower socio-economic group. Majority 45 (60%) had fall from height and RTA 30(40%) as the cause of injury. Only 53 (70.66%) received ambulance for transport, leading to a delay in admission in 22 (29.33%) cases. Most of the injured presented with neurologically incomplete picture 65 (61.33%), ratio of incomplete and complete injuries being 6.5:1. 43 (57.33%) cases was of cervical segments 5 and 6. out of 75 patient 60(80%) patient managed conservatively and 15(20%) were operated. 27(36%) patients were improved, 14(18.6%) were died and 34 (45.3%) not-improved by treatment given to all 75 patient. Mortality-13.33% in operated patients and 20% in conservatively managed patients. Mortality was 40% in complete neurological injury and 10% in incomplete injury. Mortality was highest in C4 level injury 27% and lowest 0% in C7 injury. Conclusions: out of total 75 patients- 27(36%) patients were improved, 14(18.6%) were died and 34 (45.3%) not-improved by treatment. Mortality was 40% in complete neurological injury and 10% in incomplete injury. This study evaluated the demographic variables of cervical spine injury for better understanding of impact that it has and further for better allocation of our health resources, distribution and planning.

Background: Management of axilla in early breast cancer is controversial with options being sentinel lymph node biopsy (SLNB), axillary sampling and axillary dissection. In our study we explored the possibilities of 5-node sampling as an alternative or adjunct to SLNB in early invasive breast cancer. Methods: We did an observational study of the 45 patients, who underwent modified radical mastectomy and compared the initial 5-nodes pathology with standard axillary dissection in the excised breast tissue specimen. Results: Out of 45 patients, first 5-nodes were found positive in 25 cases. In 8 cases only initial 5-nodes were involved. Sensitivity improved with increasing number of nodes examined in 5-node biopsy, approaching 100% with 5 nodes examined. In all pathological negative axilla, 5-node pathology was also negative. Conclusions: Five node sampling of axilla has a comparable sensitivity and false negative rate as SLNB. It fairly represents axillary nodal status and could be a good adjunct to SLNB for further increasing accuracy of later. It can also be an alternative to SLNB in situation where lack of feasibility to perform it as in many developing countries. We also recommend further study directly comparing five-node sampling and SLNB in future.

Aberrations in the root canal anatomy are a commonly occurring phenomenon. A thorough knowledge of the basic root canal anatomy and its variations is necessary for successful completion of the endodontic treatment. The maxillary molars has fascinated researchers and clinicians for a variety of reasons. Endodontically, these are the most misunderstood teeth, and presents a variety of considerations for the treating practitioner. This case report presents the endodontic management of a maxillary first molar with five roots and five canals and another case of maxillary third molar with four canals. The clinical detection of the five canals was made using loupes and confirmed using computed tomography (CT) scanning. This report serves to remind clinicians that such anatomical variations should be taken into account during endodontic treatment of the maxillary molars.

Diagnosis of vertical root fracture in an endodontically treated tooth presents with various difficulties. The diagnosis of such a fracture is a challenge to the clinician since it is based on subjective parameters. There are, however, many specific clinical and radiographical signs which, when present, can alert clinicians to the existence of such a fracture. Various methods to clinically diagnose vertical root fracture include conventional methods such as illumination, periodontal probing, staining, direct visual examination and newer techniques such as cone beam computed tomography, optical coherence tomography. The management of a vertical root fracture has always been considered a difficult task for the endodontist. This article provides an insight into the various methods of diagnosis and treatment strategies for the vertical root fracture.

The last decade has been witness to phenomenal growth in endodontic technology. The introduction of these new technologies has resulted in endodontics becoming easier, faster and most importantly, better. NiTi alloys overall are softer than stainless steel, are not heat treatable, have a low modulus of elasticity (about one fourth to one fifth that ofstainless steel) but a greater strength, are tougher and more resilient, andshow shape memory and superelasticity. The latter two properties arethe main reasons why NiTi alloys have succeeded in endodontics. Thepurpose of this article is to review the design features of different rotary instruments used for pulp space preparation. Important mechanical features include thevariability of taper, rake angle, cross-sectional geometry, tip configuration, design of blades, helical angle and pitch. These design features influence flexibility, cutting efficiency and safety. In this review, design features of commonlyused NiTi rotary systems are summarized.

Nickel titanium rotary shaping files fundamentally changed everything in endodontics; conceptually, procedurally and economically as well. NiTi rotary files made root canal therapy more accessible and kind of fun for dentists, and dental companies were loved for making files that cost four times more than stainless steel hand files but delivered a ten times improvement. The single file systems need no disinfecting, cleaning, sterilizing and organizing the NiTi files, provide optimal cutting efficiency along with better control of file breakage and thus increased patient safety and no risk for cross contamination.

Out of a total of 50 study-eligible patients, 15 patients were found to have synchronous breast cancer and gallbladder diseases. Fourteen such patients had breast cancer and cholelithiasis while 1 patient had breast cancer with gallbladder cancer. Amongst these 15 patients, 7 patients tested positive for chromosomal aberrations on karyotyping. Aberrations in these patients were seen on chromosomes 13 and 17 with 2 patients having deletion 13q, 2 having deletion 17q, and 2 having deletions on 17p while one patient had multiple deletions on chromosomes 13q and 17p. The patient with multiple aberrations on 13q and 17p had a grade III infiltrating ductal carcinoma (NOS) of the breast with adenocarcinoma of the gallbladder. On the basis of our study and its analysis, we conclude that synchronous breast and gallbladder lesions are common amongst females and the occurrence of one should warn the clinician to search for the other. Also, chromosomal aberrations are common amongst patients with synchronous diseases and since these abnormalities are in the germ line cells, genetic counselling should be offered to the first- and second-degree female relatives.

The Breast Conservative Therapy is the standard treatment for early - stage breast cancer in the western world . On the other hand, in India BCT is not preferred by the surgeons and patients (11 - 23% vs. >60 - 70%). Patients suffer from cancer, its treatments and the side - effects of treatment. The majority of them encounter breast cancer multiplicity of physical and psychological difficultie s after finishing cancer treatment. Without rehabilitation these difficulties may lead to functional limitations, disabilities, and mental issues. The breast cancer survival rate has increased, due to improvements in early diagnostic procedures and more ag gressive therapies. Because of increased survival rate need of rehabilitation has been increased. The study was conducted with the aim of being able to determine the need of rehabilitation in patients of breast cancer after MRM in alleviating the disabilit y also, to assess post MRM complication and t o assess the psychological impairment and quality of life of breast cancer survivors.it was observed that out of 90/122 (73.77%) individuals were scoring below 40 which was suggestive of poor quality of life als o, o ut of 122 patients 18 patients developed lymphedema. Amongst the 122 patients 54.97% wanted breast reconstruction & most of them belong to younger age group

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a new form of minimally invasive surgery which eliminates traditional skin incisions by accessing internal body cavities through natural orifices. In our experimental animal study, we compared the incidences intraperitoneal abscess formation , culture swab of peritoneal cavity positive for organism, intraperitoneal adhesion formation and mean adhesion score before and after lavaging the portal of entry of albino rat , i.e. transgastric and transvaginal. On vaginal route as a portal of entry into peritoneal cavity , on the 7th day , 66% rats developed abscesses , 88% rats had culture swab positive and 88% rats developed intraperitoneal adhesion (grade - 2) before any cleansing of vaginal cavity with antiseptic solution . Now after lavage with povidone iodine solution, only 11% developed abscesses , 22% were peritoneal swab culture positive and 33% had interbowel and parietal adhesion of (grade 0 - 1). On 21 st day , the complication observed was adhesion formation in pre lavage group of 66% incidence and 16% after vaginal lavage. The incidence of complications were reduced significantly after lavage with antiseptic solution as shown by p values (p

Additional teeth to the normal set of primary or permanent dentition are referred to supernumerary teeth. The supernumerary teeth that occurs distally to the third molar is called Distomolar. These teeth without in association with any syndrome are quite rare. There is no exact treatment protocol for the management of supernumerary teeth in literature. The routine use of radiographic images during examination is a valuable tool that helps to make the early diagnosis of these types of abnormalities. This case report presents 20 yr old male with unilateral upper left distomolar teeth.