Background: With the advancement in medical facilities and sudden drop in mortality rate, the elderly are the most rapidly growing population group in the world. On contrary in industrialized societies, blood pressure increases with age, and blood pressure at one age is directly related to blood pressure at an earlier age. Blood pressure is also related to weight, weight change, and maturation. This study is to correlate the association of growth and maturation with blood pressure and the evidence for blood pressure "tracking" with age. Additional longitudinal studies are required to determine if blood pressures before puberty are related to blood pressures of sexually mature young adults. Materials and method: Prospective randomized sampling was done to include all the patients who came for the dental treatment and their systolic and diastolic blood pressure were recorded. Patients were then divided in 5 groups: group A (21 -30), group B (31 -40), group C (41- 50), group C (51 -60) and group D (61 -70) years of age. Patients who had gestational hypertension, patients already diagnosed with hypertension and on medication for same were excluded. All the five groups consisted of 20 patients each. Results: A total of 100 patients were evaluated pressure within 5 five groups for systolic and diastolic blood pressure. Over all mean blood pressure of 100 patients were 128/86 mmhg whereas among Group A, B, C, D, E and F mean blood pressure was 118/78, 122/84, 133/88, 130/84 and 138/94 mmhg. Results shows low mean blood pressure among Group A (age group of 21-30) patients that is 118/78mmhg and highest among group F (age group of 61- 70) that is 138/94 mmhg. Conclusion: With the advancement of age blood pressure also raises up which can be alarming for other progressive systemic diseases. One should have regular check-up, changes in diet and behaviour life style as age advances.

Laser is an acronym for light Amplification by Stimulated Emission of Radiation. Several decades ago, the laser was considered like a death ray, the ultimate weapon of destruction, something you would only find in a science fiction story. Then, lasers were developed and actually used, among other places, in light shows. The beam sparkled; it showed pure, vibrant and intense colors. Today the laser is used in the scanners at the grocery store, in compact disc players, as a pointer for lectures and above all in the medical and dental field. The perception of lasers has moved from the comical death ray to the more useful ray for development of health sciences

Squamous cell carcinoma (SCC) is the most frequently encountered malignancy by head and neck surgeons. There are certain variants of SCC that are classified as individual tumours by the World Health Organization (WHO).The histopathologic picture of these malignant tumours guides the surgeon in evaluating the prognosis. These variants require special attention owing to fact that there’s gross difference in their presentation and management. Ackerman’s tumour is the most commonly encountered variant. A case of Ackerman’s tumour involving the hard palate and lower labial mucosa is discussed

Backgroud: Aspirin is the generic name of Acetylsalicylic acid (ASA). It is an analgesic, antipyretic, anti-inflammatory. It also has an antiplatelet action and therefore this drug is used in the prevention and treatment of thromboembolic diseases. In order to avoid the excessive bleeding and to be on the safer side, dentists have traditionally advised their patients to stop taking aspirin before extraction of teeth although this surgical procedure can be done without cessation of aspirin intake and if the clinician wishes to stop the aspirin therapy, it should not exceed more than 3 days prior to the dental procedure. Objective: The purpose of the present study was to assess the time required for hemostasis if the low dose (150 mg once daily) aspirin therapy discontinued 3 days prior to dental extraction. Methodology: A cross sectional study was conducted which comprised of 40 subjects who took low dose of aspirin (150 mg) once daily. The blood pressure of all the subjects was recorded preoperatively. The extractions were done atraumatically under local anesthesia using 2% lidocaine with 1:100,000 epinephrine. The postoperative bleeding was controlled by the pressure pack. Result: Among 40 patients, the postoperative hemostatic time of 82.5% subjects was less than or equal to 10 minutes while that of 17.5 % was more than 10 minutes. The bleeding was successfully managed by the pressure pack. Conclusion: Reviewing most of the dental and medical literatures, it can be concluded that there is absolutely no need to discontinue aspirin therapy for any ambulatory dental procedure, and even if the practitioner wishes to discontinue, it should not be for more than 3 days. This is also stated in the guidelines of the American Heart Association. Therefore, it can be assumed that the dental extraction can be done without long cessation of low dose aspirin and avoiding the life threatening issues.

Background: Left ventricular (LV) thrombus is a complication of acute Myocardial Infarction (MI) and is associated with systemic thromboembolism. Although standard trans-thoracic echocardiogram (TTE) is commonly used for screening, it is limited by low sensitivity for detection of LV thrombus. Magnetic resonance imaging has a high yield in detection of these thrombi. Objective: To determine rate of detection of left ventricular thrombi on magnetic resonance cardiac viability studies. Design: Retrospective, observational. Setting: Department of Radiology at a Hospital in Dhahran from April 2013 to April 2018. Patients and Methods: All recently reperfused ST Segment Elevation MI (STEMI) patients who were referred for MR cardiac viability studies with negative TTE (for LV thrombi) were evaluated. Patients with limited or incomplete studies, previously known MI or cardiac surgeries, and those contraindicated to MRI were excluded. An area of low signal intensity with no late gadolinium enhancement (LGE) was defined as thrombus on MR imaging, and two radiologists made consensus reporting for the diagnoses. Patients with anterior or non-anterior wall MI were documented, and their ejection fractions were recorded. The percentage estimation for positive LV thrombi cases was made. Any complications (like stroke or death) that occurred within one year of diagnoses were documented. A Chi-square and t-test determined the association. Main Outcome Measures: Detection of LV thrombi. Sample size: 125 patients. Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (<40%). Three out of 11 patients with LV thrombi developed complications versus 3 out of 114 without LV thrombi. Conclusion: Cardiac MR viability studies can detect LV thrombi in recently reperfused echo-negative STEMI patients. Limitations: Retrospective, small sample, single center, use of non-contrast echocardiography

Objectives: To highlight spectrum of findings on Magnetic Resonance Cholangiopancreatography (MRCP) in patients with acute cholecystitis. To determine length of hospital stay in operated cases. Method: This retrospective observational study was conducted in Radiology department at our hospital in Dhahran, from August 2016-2018. All patients who presented with acute cholecystitis, obstructive liver pattern or deranged liver tests, and underwent MRCP (on a 1.5 Tesla scanner) were evaluated. Patients with chronic cholecystitis, previous hepatobiliary surgery, pregnant patients and those contraindicated to MRI were excluded. Patterns of MRCP findings were categorized as: (i) acute cholecystitis with normal CBD, (ii) acute cholecystitis with dilated CBD and cause identifiable, (iii) acute cholecystitis with dilated CBD and cause not identifiable. Any associated biliary ductal variants or anomalies (e.g., pancreas divisum, choledochal cyst, low insertion of CBD) were also documented. Operated cases were followed to determine length of hospital stay after open or laparoscopic procedures. Chi-square and t-test were used to determine association. Results: Of the 104 patients, majority (60%) were females. The mean age was 43 years. Two-thirds of patients were having normal CBDs (68.3%), while nearly one-third (31.7%) had dilated CBDs, and half of these (16.4%) showed an identifiable cause of obstruction. Thirteen patients (12.5%) had associated anomalies. The length of hospital stay was seen significantly less in laparoscopic than with open cholecystectomies (p=.0005). Conclusion: Magnetic resonance cholangiopancreatography is helpful to identify causes and anomalies in patients with acute cholecystitis patients having deranged or obstructive liver function.

Thyroid hormone is very important for optimal functions of the body including the cardiovascular system. Hypothyroidism has significant adverse effects on the functions of the cardiovascular system. Overt and subclinical hypothyroidism is associated with increased risk of cardiovascular-related mortality and morbidity. Methods: This prospective cross-sectional study was done in the Department of General Medicine, Govt. Medical College, Mahaboobnagar. A total was n=47 with n=15 males and n=32 females were included based on inclusion and exclusion criteria. The patients with clinical symptoms of hypothyroidism were diagnosed and confirmed by chemiluminescence immunoassay (CLIA) method for TSH, FT4 and FT3 levels other investigations were CXR, ECG, and 2D echo. Results: Out of total n=47 patients there were n=15 male and n=32 females. The total number of cases with hypothyroidism in the male group were n=15 out of which n=6 showed cardiovascular involvement and n=9 did not show cardiovascular involvement. Bradycardia was found in n=2 male and n=9 females and decreased in heart sounds was found in n=6 male and n=7 females. Echo findings were Diastolic dysfunction was found in n=10 female and mild diastolic dysfunctions were found in n=6 female. One case each of IVS thickness and pericardial effusion was found in n=5 males and n=11 females. Conclusion: Hypothyroid patients can present with different symptoms which may be sometimes non-specific. High suspicion is the key for early diagnosis of hypothyroidism. The appearance of cardiovascular symptoms depends on the duration of hypothyroidism. Treatment with appropriate doses of L-thyroxine depending on the levels of TSH and proper patient compliance to the treatment will generally ensure the reversal of the cardiac abnormalities

Background: The genetic diseases that are known to be accompanied with congenital malformations are often not well understood and has an element of surprise attached to it unless proved otherwise as seen in some familial cases. The raw emotions that run in the family of having a new guest, comes to a sudden halt. As the stakes are high and such cases should always be diagnosed as soon as possible a sincere attempt is being made in this study to understand the pre-natal diagnosis using the USG. Methods: Nine hundred twenty one patients records of scanning were observed out of which thirty patients who were diagnosed to have some malformations in USG scanning are reported. This study is done in the Department of OBG, Srinivas Institute of Medical Sciences, Mangalore. Results: Out of the observed 921 patients thirty was observed to have congenital anomalies. Conclusion: USG is able to detect the anomaly and is the gold standard for screening the patients

Vast number of the females in this part of the population suffers from the thyroid illness and majority of them comes to the hospital after suffering from the same illness for a long time. They will not know before the parameters of the blood are out of proportions. This study puts in an effort to find the base proportions of the USG gland in normal female patients and tries to establish a normal paremeters of the thyroid gland. Many cadaver based study are there but not even a single female dedicated USG based morphometric analysis is not found in the open access journals

Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year. An intention to quit is an important preliminary step for the behavioral change and it is highly associated with attempting to quit and with quitting. Therefore, this study examines the predictors of intention to quit and previous quitting attempts in Bahrain. Aim: To improve the overall quality of smoking cessation services in Bahrain. Objectives: 1) To study the prevalence of intention to quit smoking among adult smokers attending primary health care in Bahrain. 2) To explore predictors of an intention to quit and predictors of previous quitting attempts among adult smokers in Bahrain. Study design: Cross-sectional study. Settings: Data was collected from two primary care health centers in each health region in Kingdom of Bahrain using validated questionnaire. Participants 502 adult smokers aged ≥18 years, who were attending primary care within 10 days period in February 2018 (1st – 14th February), were included. Data was analyzed by using SPSS version 23.0. Results: We found that more than half of the smoker population (51.4%) are seriously thinking of quitting smoking in the next 12 months., while (70.9%) of them had previous quitting smoking attempts. Predictors noted to be significant in this study, include being a male, married, lower level of education, having shortness of breath and gastrointestinal symptoms. Conclusion: Results indicate high intention to quit smoking rate and along with the significant predictors found in this study, there is a great need to develop preventive and therapeutic interventions addressing these predictors to ensure higher rate of success and support the current tobacco smoking cessation services according to what predictors showed.

Background: Foreign bodies within the bladder pose a challenging urologic problem as a result of their diversity, varied presentation and tailored management. Examples of foreign bodies that have been removed from the urinary bladder include electric wires, glass ampoules, sticks, ball point pens, pencils, safety-pins, hairclips, magnetic balls, intrauterine contraceptive devices (IUCD), gauze pieces, pelvic drains and batteries. Methods: We carried out a retrospective review of patients who were found to have intravesical foreign bodies intraoperatively between January 2017 and December 2018 in Abuja, Nigeria. Results: Five patients were found to have intravesical foreign bodies. There were 4 female and a male patient. The mean age at the time of presentation was 51 years. The aetiology was iatrogenic in all but one patient. There was varied mode of presentation. Plain radiographs and abdominopelvic ultrasonography were useful in diagnosis. Endoscopic removal of the foreign body was successful in 3 patients whilst one patient had a suprapubic cystostomy and another suprapubic cystolithotomy. Conclusion: Our review highlights the importance of educating health care workers on the need to ensure catheters, stents, abdominal drains are removed following their stipulated time of use. Awareness of this rare entity as an important possible differential diagnosis in patient presenting with urologic symptoms is also important.

Recent innovations and scientific inventions have been applied successfully in teaching and learning. It is always known that for a newer approach to be implemented successfully there are always hurdles. At this moment it is also understood that people will not accept the changes until they are familiar with the technologies. It is always known that the eyes see only those things that are well familiarized. Even if it is universally accepted there may be hurdles that have to be passed successfully by each and every individual. This article examines the faculty and the student’s attitude towards the E-Learning programme

Most of the cases of Urinary tract infections land up first in a general practitioners office as the signs and symptoms are very plethoric. Urinary tract infections (UTIs) results in patient morbidity. The effectiveness of antimicrobial treatment in reducing UTI s is well established. But Studies have demonstrated wide variation in utilization of antimicrobial treatment, including inappropriate selection of agents, improper timing of administration, and excessive duration of treatment. The purpose of this study is to evaluate and establish an antibiotic protocol for UTI’s in our hospital setting. We would be performing a culture analysis of urine to identify the presence of infection in the renal unit, which will guide us for antibiotic usage. Hence, we are trying to establish an antibiotic protocol for UTI without compromising on treatment, and to avoid excessive duration of antibiotic treatment

The Roleplay is becoming more popular to support learning process of students in professional colleges by asking students to prepare before lectures and actively engaging students during lectures. One of the main reasons is the compartmentalised manner in which they are taught by each clinical department at different time, without any knowledge of what is taught by the other departments. Classroom time is spent in discussion, clarification, exercises, or other learning activities to enhance application of knowledge. This study puts in a sincere effort to find the answer of which method is better

Diabetes is a metabolic disorder and long standing diabetic patients are prone to get neuropathy. The pain I the neuropathy is unbearable and cannot be treated by cox inhibitors. Pregabalin is a structural similar drug of the inhibitory neurotransmitter γ-amino butyric acid but it is not functionally the same. It binds to the α-2-δ subunit of voltage-gated calcium channels reducing the release of several excitatory neurotransmitters and blocking the development of hyprealgesia and central sensitization. This study puts in a effort to find the efficacy of this drug in controlling the diabetic neuropathy pain

Tumors of the round ligament are rare and exceptional; leomyomas are the most common tumor. We report in our case the case of an inguinal woman with a left inguinal mass previously explored by todensitometry and magnetic resonance imaging which was found to be related to a leiomyoma of the round ligament. The patient had an excision of the tumor mass with simple follow-ups. The anatomo-pathological data confirmed the diagnosis.

Introduction: Ectodermal dysplasia (ED) is a rare hereditary disorder involving two or more of the ectodermal structures. Palmoplantar keratoderma is a characteristic feature of hidrotic forms of ED. We report a case of Hypohidrotic ectodermal dysplasia associated with palmoplantar keratoderma. Case Report: A 4-year-old girl presents a chronic palmo-plantar dermatosis that started three years ago. The interrogation finds a history of hospital admission in the 2nd month of life for an unexplained fever. The dermatological examination finds a limited, diffuse erythematous palmo-plantar hyperkeratosis, associated with diffuse alopecia with light-colored brittle and slow-growing hair. The findings also include hypotrichosis and onychodystrophy. The rest of the examination revealed a facial dysmorphism with a light prominent forehead, flattened bridge of the nose, sunken eyes with periorbital hyperpigmentation and photophobia. Other abnormalities include a hypodontia with small teeth. Discussion: Our observation suggests a hypohidrotic ectodermal dysplasia. It is a genetic disease most often hereditary. The X-linked form or Christ Siemens Touraine syndrome is the most frequently encountered form. A male predominance is noted. Clinically it is characterized by the presence of all or several of the four typical clinical signs of the disease: Anhidrosis or hypohidrosis, dental hyoplasia, hypotrichosis, facial dysmorphism. Palmoplantar keratoderma is rarely associated as it is the case in our patient. The genetic study reveals abnormalities that can be found in the X chromosome for the X-linked forms, and at the level of the chromosomes 2q11-13 or 1q42 for the autosomal forms. Conclusion: Our observation illustrates the frequent diagnosis delay in this disease. It also emphasizes the importance of a detailed somatic examination in front of any palmoplantar keratoderma presented in children.

A study of Microangiopathic and cardiovascular complications in 106 diabetic patients admitted to the department of medicine of Diwaniyah Teaching Hospital showed 39 patients had diabetic retinopathy and 20 patients had ad/or nephropathy, 59 patients had absent ankle jerk, 15 patients had postural hypotension, 6 patients had absent vibration sense, 7 patients had abnormal pin prick sensation, 11 patients had abnormal ECG.

The Dalai Lama is the spiritual leader of the Tibetan Buddhism, has a close and unusual relation with the MIT and the US neuroscience for decades. Recent researches is discovering that MIT has a corrupt network of illegal human experimentation of artificial intelligence in poor countries to develop human robots with invasive neurotechnology such as brain nanobots. Buddhist monks has characteristics that make them ideal candidates for their transformation in cyborgs such as their resistance to high altitude, their knowledge about martial arts, mind self-control, their belief in reincarnation, non-existent sexual activity of the Buddhist monks, thus these characteristics explain the approach of USA neuroscience to the Buddhist monks to involve them in artificial intelligence projects and to turn them into cyborgs, slaves, without sex, without privacy, without freedom and to be sold as war machines. The Dalai Lama's promotion subliminal of emotional intelligence and his relation with MIT indicate that Dalai Lama is also part of this MIT's mafia of artificial intelligence. The Dalai Lama, rather than seeking Tibet independence, would really be seeking its slavery through mind control with brain nanobots and microchips

Osteomyelitis is an inflammatory disease which is heterogeneous in pathophysiology, clinical presentation and management. It occurs more commonly in the mandible than in the maxilla as the maxilla has a significant collateral blood flow, thin cortical bones which make it less prone to infection. Factors that predispose an individual to osteomyelitis of jaw is virulence of the microorganism, compromised vascular perfusion in the host bone at the local, regional or systemic level, and environment distressing host resistance or defense. Early diagnosis and management is of utmost importance so as to avoid the potentially serious consequences of the disease. We report an unusual case of maxillary osteomyelitis in a 33 year old female patient with poorly controlled diabetes and recurrent maxillary sinusitis

The objective of this study was to evaluate the effects of two different mean arterial blood pressure (MAP) targets in septic shock. Sepsis is a syndrome is caused by a dysregulated inflammatory response to bacterial infections. We carried out a prospective observational study enrolling patients admitted to the ICU with sepsis from 01/01/2017to 01/03/2018. Both the medical and surgical units of the ICU were included. This study was conducted at Apollo Health City, Critical Care Medicine, Hyderabad, India after obtaining permission from the hospital ethics committee. A total of 100 members were included in this study, had septic shock. These were divided in to two groups aiming at increasing mean arterial pressure from 65mmHg to 80mmHg in older patients. MAP at the end of resuscitation was 57.32 ± 13.69 mmHg (mean ± SD) and 78.45 ± 17.23 mmHg respectively, for low-MAP and high-MAP groups. The high-MAP group had a more positive fluid balance. MAP below 65 mm Hg was shown to be associated with highest mortality during the first 48 hours of septic shock. The longer the time spent below MAP 65 mmHg, the higher the risk of mortality, acute kidney and myocardial injury. The MAP target of around 75–85 mmHg may reduce the incidence of acute kidney injury (AKI) in patients with chronic hypertension. The perfusion pressure is highly heterogenous not only between different patient but also in the same patient between different organs and different periods of septic shock. Hence the MAP target needs to be individualized according to patient requirements

In the field of maxillofacial surgery, digital photographic documentation plays a crucial role in clinical practice. The main advantage of digital photography is the possibility of immediate reappraisal of the photographs for alignment, brightness, positioning, and other photographic settings, which aids in avoiding errors in addition to permitting the instant repetition of photographs if and when required. This paper gives an overview of the evolution from analog to digital in photography and highlights the significance of digital photography in orthognathic surgery

The oxidative stress results because of the disturbance in systemic equilibrium of the oxidants and antioxidants. However, when there is increase in the generation of the free radicals such as reactive oxygen and nitrogen species (ROS and RNS respectively), then there is a shift in this systemic equilibrium. Various environmental and lifestyle factors such as pollutants, alcohol consumption, smoking, poor diet and other adverse habits contribute towards the oxidative stress. Oxidative stress can affect systemically (the whole body) as well as locally (in oral soft tissues).Various recent literatures have shown that the oxidative stress and inflammation are predisposing factors for various chronic illnesses, like atherosclerosis, rheumatoid arthritis, diabetes and periodontitis

Targeted therapies are the drugs which are designed in order to interfere with the specific molecules necessary for the tumor growth and progression. The traditional cytotoxic chemotherapies mostly kill the rapidly dividing cells in the body by interfering with the cell division while causing the toxicity in normal cells also. This review article aims to highlight the most recent FDA-approved anticancer drugs eligible for targeted therapies. In addition, an early outline evaluation of the costs of the therapies was also taken in consideration. Moreover, further studies have been going on in order to plan treatment regimen for these drugs. On the basis of these fields, the oncologists will have new means to make treatment decisions for their patients in order to maximize benefit and minimize toxicity