Objective: This study aimed to clinically evaluate the efficacy of coronally repositioned flap in the treatment of isolated Miller’s class I and II gingival recession. Materials and Methods: Twelve patients with Miller’s class I and class II recession were selected. Patients were randomly divided into two groups: Group A (control group): coronally repositioned flap and Group B (test group): coronally repositioned flap with bioabsorbable collagen membrane. Clinical evaluation parameters such as probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (WKT), gingival biotype (thickness), recession width (RW), and recession depth (RD) were recorded at baseline and at 1, 3, and 6 months post-operatively using an acrylic stent. Results: A significant gain in CAL (−0.6, −0.78, and −0.60 mm) and WKT (0.25, 0.48, and 0.83 mm) was observed in both the groups from baseline to 1, 3, and 6 months, respectively. However, the gain was more in the test group than the control group. Similarly, a significant decrease in mean RD and RW was more in the test group when compared with the control group (significant P-value <0.001) 6 months post-operatively. Also, no statistically significant change was found in the two groups in terms of PD and gingival tissue at 6 months. Conclusion: The results of this study suggest that collagen can improve the clinical outcomes of the coronally repositioned flap operation in the therapy of localized recession defects.

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Background: The telemedicine-based approach facilitates remote health and social care for maintaining autonomy, thereby improving quality of life for geriatric patients with associated morbidities. Thus, the present study focusses on various challenges encountered during the use of technology-based model for geriatric care in urban as well as rural settings. Materials and Methods: The present operational research-based study was conducted on 2531 elderly individuals from rural and urban settings. The HUB and spoke model have been developed using cloud-based teleconsulting as well as mobile-based teleconsulting approaches which were setup up in rural and urban areas in India and Sweden for teleconsulting of elderly population. The rural and urban elderly population were screened using the telemedicine-based model. Feedbacks were taken from elderly subjects in both rural and urban settings to assess various challenges encountered during the use of technology-based model for geriatric careResults: Of 2531 elderly individuals, 701 (27.7%) individuals belonged to the urban population, while 1830 (72.3%) individuals belonged to the rural population who were examined with the help of model developed using telemedicine technology. Majority of persons screened were in the age group of 60–69 years with mean age 69.7 ± 7.90 years. Some of the challenges faced implementation of this tele-geriatrics model includes non-availability of accurate patient history, limitations over clinical examination, etc. have been highlighted working upon which would further improve this model. Conclusion: This teleconsultation-based model developed through this study provides practical evidence for its use in treating elderly population and associated challenges thereby improving their quality of life.

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Background: Novel corona-virus disease (COVID-19) has rapidly spread worldwide since its origin in late 2019 in the Wuhan province of China. Knowledge about the disease or lack thereof determines the success of containment of the virus. Individuals with chronic noncommunicable diseases are at a higher risk of complications of COVID-19. Materials and Methods: This cross-sectional survey was conducted to assess the knowledge, attitude, and practices of patients and the people accompanying the patients visiting the Endocrinology out patient department of a tertiary care hospital in south India. A questionnaire that included questions pertaining to knowledge, attitude, and practices regarding COVID-19 was administered. The COVID-19 knowledge questionnaire had 12 questions: four regarding clinical presentations, three regarding transmission routes, and five regarding the prevention and control of COVID-19. Results: Data of 268 individuals were analyzed. The mean knowledge score was 8.43 out of 12. Education was the significant factor that determined knowledge score. The majority agreed that COVID-19 will be controlled (69%) and were hopeful about India winning the battle against COVID-19 (70.5%), 82.1% were avoiding crowded places, and 77.6% were wearing a mask when leaving the house. Caregivers had better knowledge scores as compared with patients. Conclusions: The majority of the individuals attending the Endocrinology clinic had good knowledge about COVID-19. The level of education played an important role in determining the level of knowledge.

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Introduction: Benefits of yoga for a healthy life and stress management are proven; yoga was introduced into the new medical curriculum (competency-based medical education) from 2019 batch. This study was conducted to compare the attitudinal change of medical students and to identify the barriers of yoga practice among those with yoga in curriculum to those without. Materials and Methods: Using a cross-sectional study design, a total of 300 students (150 each from sixth [traditional] and fourth semesters [new curriculum]) were contacted. A self-administered researcher-made questionnaire (Google form) was sent to those who consented. Data were analyzed using SPSS version 20.0. Results: In this comparative study, among fourth and sixth semester students, it was found that 43.4% of the fourth, whereas 53.7% of the sixth semester students, knew about the benefits of yoga (P = 0.040). On comparing their attitude, “it was considered to be purely a weight loss program” by 17.9% of the fourth and 8.8% of the sixth semester students, respectively (P = 0.017). 94.5% students of the fourth semester, whereas 87.1% of the sixth semester, believed that yoga helped in improving immunity (P = 0.023). The barriers for practicing yoga cited were a lack of interest (37.1% by fourth semester, whereas 40% by sixth semester) and a lack of time (33% in fourth semester and 30.5% in sixth semester). Conclusion: The study helped reveal that the integration of yoga into the medical curriculum had brought an attitudinal change in them, but had not influenced their practices. The identified barriers will help implementing yogic lifestyle education programs, increasing its acceptance among medical students.

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Introduction: Acute dyspnea is a common symptom in the emergency department (ED). Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in the ED. A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The standard approach to dyspnea often relies on radiologic and laboratory results, causing an excessive delay before adequate therapy is started. The use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile. Materials and Methods: This was a prospective study on 88 patients aged above 18 years who came with a complaint of acute dyspnea to emergency room of a tertiary care center in Mangalore, Karnataka, over a period of 1 year from September 2017 to September 2018. Results: The accuracy of PoCUS in diagnosing acute dyspneic patients was found to be 93.8% in our study. Conclusion: PoCUS is a great tool in all emergency settings to deliver a better care.

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Cariprazine is a partial agonist of dopamine and serotonin with high affinity for D3 receptor. There is excess endogenous dopamine both in schizophrenia and bipolar disorder. Cariprazine binds to D3/D2 receptor as antagonist and agonist in schizophrenia and bipolar depression, respectively. Thus, the dopamine pathway inhibited and stimulated in the respective cases. The United States Food and Drug Administration (USFDA) approval now covers the full-spectrum Bipolar I disorder, yet to hit the Indian market.

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Objectives: Anthropometry is a routine and simple procedure to assess the nutritional status of a child. We aimed to study the impact nutritional status has on the mortality and morbidity of children admitted in the pediatric intensive care unit (PICU) in a tertiary care hospital in Eastern India. Materials and Methods: We performed a prospective observational study to assess the relation between anthropometric measurements of children on admission in PICU and their outcomes in terms of mortality and morbidities (total stay in PICU, duration of mechanical ventilation, requirement of inotrope, delay in enteral nutrition, and total duration of enteral feeding). Results: Sixty children were included out of which 45 were under 5 years of age and 15 were more than 5 years of age. Children under 5 years with normal weight for age, weight for height, and mid-upper arm circumference had higher chances of survival. Similarly, in children >5 years of age, those with weight for age and body mass index for age in 25th–50th percentile had higher chances of survival. All these associations were statistically significant. On further analysis, these anthropometric measurements that affected mortality also influenced morbidities significantly. Conclusion: Children with inadequate nutritional status as assessed by anthropometry had statistically significant higher mortality and morbidity in the PICU. Thus nutritional status of a child on admission is an important factor to prognosticate the outcome of a child in PICU.

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This case report describes a case of ocular blast injury and its management. A 35-year-old male patient was referred to a tertiary hospital with a history of landmine blast injury. The right eye examination revealed full-thickness lacerated wound in the right upper eyelid and globe rupture. The left eye examination revealed a partial-thickness scleral tear, multiple foreign bodies in the cornea, foreign body embedded in the iris, and traumatic cataract. The evisceration of the right eye with scleral tear repair in the left eye was performed under general anesthesia. Multiple foreign bodies from the cornea and one embedded in the iris were removed from the left eye. At the final follow-up at 3 months, the right socket showed a good healing with an implant in place. The visual acuity in the left eye was 6/24 with foreign bodies in the deeper corneal stroma and traumatic cataract.

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Burkitt’s lymphoma (BL) is an aggressive and rapid neoplasm that is curable and highly sensitive to chemotherapy. It can affect any organ or part of the body, leading to several clinical presentations. Early diagnosis and treatment of BL are very important before landing life-threatening complications such as airway compromise and compression of vital structures such as the spinal cord. This is a case of a 10-year-old boy, who developed BL at the posterior part of the nasal cavity and nasopharynx. This case report aims to describe the rarity of the location, course of the pathology, clinical presentations, investigations, and treatment. As BL is an aggressive neoplasm and is considered a serious health problem, it needs timely diagnosis for prompt and appropriate treatment.

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Endodontic treatment success is obtained by thorough chemomechanical preparation and three dimensional obturation of the root canal system. Maxillary first premolar most commonly presents with two roots with two canals. The most common variation in maxillary first premolar is the presence of three canals and can be frequently missed leading to endodontic treatment failure. This case report describes two cases of endodontic management of maxillary first premolars with three canals. Additional canal was identified through exploration and multiple radiographs with mesial and distal eccentric shifts. Appropriate knowledge regarding the possible anatomic variations and good clinical skills are essential prerequisites for a successful endodontic treatment outcome. Missed canal and inadequate cleaning and shaping contributes to persistent pain, sensitivity leading to treatment failure.

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Coronavirus disease-2019 (COVID-19) infection caused worldwide morbidity and mortality with complications and still, it is going on. After the Spanish flu, no other illness has obtained such a heavy toll on the human population such as the severe acute respiratory syndrome coronavirus 2. The most common symptoms of COVID-19 infection were fever, cough, dyspnea, expectoration, headache, myalgia, or fatigue and gastrointestinal symptoms. Complete blood count parameters with morphological findings can help a pathologist to alert the physician of future disease progression. Collective findings of various articles were noted down and crux of it was presented here. Lymphocytopenia, neutrophilia, eosinopenia were the common findings with morphological abnormality in lymphocytes and neutrophils in COVID-19 infection. To reach a definite conclusion regarding the specificity and the reliability of these viral cytopathic effects in the peripheral smear, more research is required in this field.

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Background: Pleural effusion refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly encountered medical problem caused by a variety of underlying pathological conditions. Collection of fluid in the pleural cavity has varied etiological factors. Because of the various etiologies that can cause pleural effusion, it often presents a diagnostic problem, even after extensive investigations. Materials and Methods: A prospective study was carried out with the aim was to arrive at the etiological diagnosis by analysis of history, clinical presentation, biochemical, radiological, cytological, and bacteriological methods. The inclusion criteria were total 100 patients of adult age and either sex were taken, with age >18 years, and chest X-ray showing evidence of pleural effusion. Already diagnosed with pleural effusion were excluded from the study. Diagnosis was made on clinical examination, radiological examination, and analysis of laboratory data. Results: A total of 106 patients were enrolled with a mean age of 42.8 years and standard deviation of ± 15.1, respectively. Out of 106, the maximum number of cases of pleural effusion were tuberculosis 59 (55.7%) among them more than three-fourth of them were affected on the right side and only 13 (12.2%) were affected on the left side. After tuberculosis, malignancy 17 (16.0%) and congestive heart failure 10 (9.4%) respectively. Most of the cases were affected on the right side 57 (53.7%), followed by 35 (33.1%) and only 14 (13.2%) were affected bilaterally. The most common presenting symptoms are 99 (93.3%) and had shortness of breath, 87 (86.0%). Among the plural effusion cases, majority 90 (84.9%) of them had diagnosed with thoracocentesis. Almost 89 (83.9%) exudative effusions are more common and only 17 (16.1%) transudative effusion. Conclusion: A maximum number of cases of pleural effusion were tuberculosis followed by malignancy. Thoracentesis and pleural fluid analysis were the most common diagnostic technique. Thoracoscopy was required in few cases which are difficult to diagnose cases.

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Catering a tooth colour restoration is the fundamental objective of chairside digital Dentistry in a single sitting with computer-aided design or computer-assisted manufacturing (CAD/CAM) technology, which has become a legitimate reality with the initiation of the CEREC workflow. Nowadays, CAD/CAM of dental restorations has become an ingrained fabrication process, especially for customized Zirconium restorations. In this case report, we will discuss the clinical use of chairside digital dentistry in grossly decayed primary canine treated by pulpectomy followed by CEREC workflow for the fabrication of customized Zirconia crown thus restoring the form, function, and occlusion.

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Background: Viral infection is the infection caused by a virus in the human body. The immune response to a virus infection is attacking the body’s own cells. This causes stress and inflammation of tissues in the body and damage to the cells. Polyarthritis is one of the most common complications caused by viral infection. Post viral polyarthritis mainly affects the large joint such as the knee, but can affect several joints such as ankle, wrist. The full recovery time is still not sure, some studies have shown that it usually takes six weeks or it can even last for months or years. Case Description: A 15-year-old male complains of fever with dry cough for 2 days followed by Multiple joint pain and soft tissue pain since 2 months. Swelling was also noticed in both wrist and knee for a week. For assessment outcome measures like VAS, MMT, ROM were taken prior to the treatment. Patient underwent a 4 weeks physiotherapy rehab program and showed marked improvement in the pain, range of motion, muscle strength and functional activities. Result: When the post-assessment was done, patient showed significant improvement in the pain relief, showed improvement in range of motion of the joints, increase in the muscle strength and noticeable improvement in functional capacity. Conclusion: This concluded that starting physiotherapy management in the sub-acute stage of the condition is effective in reducing pain increasing mobility and increasing the strength and endurance.

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