Myocardial strain analysis by 4D-speckle tracking echocardiography for prediction of coronary artery disease severity in patients with stable angina pectoris

Objective: We sought to evaluate the myocardial strain by four-dimensional speckle-tracking echocardiography (4D-STE) in patients with stable angina pectoris (SAP) to determine the severity of coronary artery disease (CAD) based on the Gensini score. Methods: The present study comprised of 150 patients with SAP. Patients with history of SAP, normal left ventricular ejection fraction, and without regional wall motion abnormalities (RWMA) were scheduled for elective coronary angiography. Based on Gensini score, there were two groups: non-critical stenosis group [Gensini score (0e19), n ¼ 117] and critical stenosis group [Gensini score 20, n ¼ 33]. Correlation between Gensini score and 4D-STE strain parameters were investigated. Results: Out of 150 patients, critical stenosis group had significantly depressed values of all 4D-STE strain parameters than non-critical stenosis group (p < 0.001), except global radial strain (GRS) parameter. Significant positive correlation was found between Gensini score and 4D global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) with Spearman's correlation coefficient (r) as 0.626, 0.548, and 0.631, respectively (p < 0.001), whereas significant negative correlation was found between Gensini score and GRS (r ¼ 0.433, p < 0.001). A 4D GLS value of 17 had 84.9% sensitivity and 97.4% specificity, GAS 31 (90.9% sensitivity, 78.6% specificity), GCS 17 (69.7% sensitivity, 92.3% specificity), and GRS <47 (sensitivity 72.7%, specificity 76.1%) to detect critical CAD described by Gensini score 20. Conclusion: The 4D-STE can aid in the assessment of severe CAD stenosis with good sensitivity and specificity in the patients with SAP without RWMA on traditional echocardiography.

A rare case of sirenomelia

Sirenomelia also called mermaid syndrome is a congenital, rare, lethal, multisystemic human malformation of unknown etiology. The characteristic feature of sirenomelia is the fusion of the lower limbs, resulting in the appearance of a mermaid’s tail, and thus the name “mermaid syndrome.” This condition is also characterized by various severe urogenital abnormalities and the presence of a singular umbilical cord blood vessel, and it is more common in infants of diabetic mothers and in monozygotic twins. The incidence is around 1 in 60,000–70,000 pregnancies. The majority of affected fetuses are stillborn, whereas the rest of the live-born die in the early neonatal period due to complications of the gastrointestinal and urogenital systems. We are reporting a case of sirenomelia in a neonate born to an unregistered multipara mother. The baby had perinatal asphyxia, sirenomelia, dextrocardia, low set ears, lymphatic malformation, bilateral renal agenesis, absent external genitalia and anus, single umbilical artery, and congenital corneal clouding. There was no antenatal ultrasonography done and the baby died at 6 h of life.

STUDY OF FUNCTIONAL OUTCOME IN DISPLACED BIMALLEOLAR FRACTURE TREATED WITH FIBULAR PLATING FOR LATERAL MALLEOLUS AND PINNING OR SCREW FOR MEDIAL MALLEOLUS

Fractures of the ankle joint are among the commonest fractures in adults, with an incidence of up to 174 cases per 100 000 persons per year1. A study was conducted to learn the functional outcome of displaced bimalleolar fracture treated with ?bular plating for lateral malleolus and pinning or screw for medial malleolus. For a good long-term functional outcome to be achieved, reliable early evaluation is crucial so that it can be determined whether the problem is a distortion (sprain), ligament rupture, bony ligament avulsion, or fracture of the talocrural joint. The proper treatment is chosen on the basis of the mechanism of the accident and the correct classi?cation of the injury and accompanying soft-tissue damage. The goal of treatment is to enable the patient to put his or her full weight on the joint once again without pain and to prevent permanent damage2. In this study, a total of 25 patients were included. Detailed history and clinical ?ndings are con?rmed and noted. After surgery patients followed on at 1 month, 3 months & 6 months, and thereafter yearly for their radiological and functional outcome

Maternal and fetal factors associated with non detection of fetal growth restriction at term: a retrospective study

Background: Fetal growth restriction (FGR) is one of the major factors of perinatal morbidity and mortality. Aim was to study the maternal and fetal risk factors associated with non- detection of fetal growth restriction.Methods: A retrospective analysis was done at a tertiary care hospital. 280 term newborn cases weighing <2.5 kg were selected and they were divided into two groups, Group I- FGR detected cases by ultrasound, and group II- FGR non detected cases. Data was collected from the labour room registers.Results: Incidence of FGR found to be 6.8%.The maternal biological factors found to be significantly associated with fetal growth restriction were gestational hypertension, chronic hypertension and anemia. Fewer ANC visits was associated with non-detection of FGR cases. Detection of FGR cases were more if the birth weight found to be <2 kg when compared to non detection of FGR cases.Conclusions: Anaemia and fewer ante natal visits were associated with non detection of FGR at term when compared with antenatally detected FGR patients.

Swallowed dentures in thoracic oesophagus

Oesophagus is the second most (46.8%) common site of impaction of foreign body in the gastro-intestinal tract. Dentures constitute the 3rd most common (2.4%) foreign body in oesophagus of adults, following meat bone (76.1%) and coin (3.6%).In our Institute, impacted dentures in esophageal are referred to our department after a failed endoscopic venture at removal by ENT surgeons. Extraction in such a situation calls for judicial planning and careful timing of the procedure to achieve satisfactory results. The present study was done on 11 cases of thoracic oesophageal dentures which were removed surgically in the Department of CTVS Medical College and Hospital, Kolkata over 2 years of period. Between 1st October 2017 to 30st September 2019, 11 dentures were extracted from thoracic oesophagus via right postero-lateral thoracotomy approach. The defect in the oesophagus after denture removal was primarily closed; with reinforcement using intercostals muscle pedicled flap. A defunctioning cervical oesophagostomy and a feeding jejunostomy (FJ) were done in all cases. Surgical leaks were noted in 5 cases, of which 1 lady had fulminant mediastinitis before she died. Pneumonia was observed in 4 cases, superficial surgical wound infection in 2 cases, blocked FJ tube in 1 case and leakage following closure of cervical oesophagostomy in 3 cases. Thoracic esophageal dentures are serious surgical entities which need early diagnosis and management. Pre-operative optimization is very important for avoiding surgical leakage.

Different types of mucormycosis: case series

Mucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species causing Mucormycosis is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per 1000 000 inhabitants per year. Clinical diagnosis of mucormycosis is difficult, and is often made at a late stage of the disease or post-mortem. We present here a series of five cases of different types of mucormycosis that were reported in our hospital till date. Of which three patients had good recovery and other two had a fatal outcome. Treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection or debridement as part of source control-and appropriate anti-fungal therapy. Liposomal amphotericin B is the drug of choice for this condition. The overall rate of mortality of mucormycosis is approximately 40%.

Outcomes of pleural decortication in a tertiary care hospital of Telangana state

Background: The objective of the study was to study the clinical profile, incidence of postoperative complications in patients undergoing pleural decortication.Methods: The subjects for the study were selected from the cases admitted in a single unit of Department of Cardiothoracic Surgery, Nizam’s Institute of Medical Sciences, Hyderabad during the period of 2016 to 2018 and due ethics committee approval was taken.  Collection of data is done from the database including admission record, ICU charts, discharge records and follow-up records. 50 patients underwent surgery. Outcomes and complications were analyzed for 3 years duration.Results: 50 patients were included in this study with different aetiologies that required pleural decortication. The average age of patients in our study was 34 years. Most patients in our study were male (80%) and had history of infection with tuberculosis (42%) and pyogenic (28%) infection. A few patients had history of trauma (12%). Most of the patients suffered from cough (88%), dyspnoea (74%), fever (82%) and haemoptysis (22%). The common postoperative complications we encountered were pleural air leak (37.5%) bleeding (25%) infection (25%) and recurrence (2%). Overall morbidity from pleural decortication was seen in 16 patients, and there was no mortality.Conclusions: The most common reason for pleural decortication is still empyema thoracis secondary to infection in the developing countries. Tuberculosis is still the most common cause leading to fibrothorax requiring pleural decortication followed closely by pyogenic lung infections and trauma.

Outcomes following transaortic septal myectomy in hypertrophic cardiomyopathy

Background: The objective of the study was to evaluate effect of myectomy and its impact on survival for a period of one year and to identify the co-morbid conditions that would increase the risk of surgery.Methods: The study was conducted on the patients admitted in a single unit of department of cardiothoracic surgery, NIMS, Hyderabad during the period of 2014 to 2018. The study was a retrospective observational study. 21 patients were enrolled in the study after approval from institute ethics committee. All the patients between 7 to 70 years who underwent septal myectomy were included in the study.Results: Out of the 21 patients underwent modified Morrows myectomy 16 (76.2%) were male and 5 (23.8%) were female. The most common presenting symptom was dyspnea (81%), followed chest pain (76%), palpitations (62%) and syncope (38%). 5 (24%) patients had a family history of sudden cardiac death. Preoperative beta blockers were used by 15 (72%) patients. 11 patients had severe mitral regurgitation, out of which 8 patients underwent valve replacement and 3 underwent mitral valve repair. The mean preoperative left ventricular outflow tract obstruction gradient was 86.86 and the mean postoperative gradient was 23.47. 3 patients had implantable cardioverter defibrillator insertions. All patients had symptom relief.Conclusions: Surgical treatment of hypertrophic cardiomyopathy through transaortic septal myectomy is safe and effective method to relieve left ventricular outflow tract obstruction. Mitral valve replacement can be done for cases with structural defect of mitral valve. Early detection and intervention in patients with family history of sudden cardiac death would reduce the risk of death and ensure long term survival.

Clinical Profile of Critical Pertussis in Children at a Pediatric Intensive Care Unit in Northern India

Objective: To delineate the clinical profile, complications, intensive care needs, andpredictors of mortality in children with critical pertussis. Methods: Retrospective analysis ofcase records of children in the pediatric intensive care unit of a tertiary-care hospital, with adiagnosis of critical pertussis over 3 years. Diagnostic criteria included CDC case definitionand confirmation by polymerase chain reaction (PCR), when available. Survivors and non-survivors were compared to identify predictors of mortality. Results: 36 records wereanalysed, most cases were infants (31, 86.1%). 10 (27.7%) were (below 6 weeks of age). Inthe rest, 16 (61.5%) were partially immunized or unimmunized against pertussis. Rapidbreathing (88.9%), paroxysmal cough (86.1%) and apnea (41.7%) were common presentingcomplaints. Hypoxemia (97.2%), hyperleukocytosis (61.1%) and encephalopathy (52.8%)were common complications. Intensive care needs were mechanical ventilation in 11(30.6%), vasoactive support in 7 (19.4%) and exchange transfusion in 3 (8.3%). Femalegender, apnea, hyperleukocytosis, encephalopathy, need for vasoactive support, andmechanical ventilation predicted mortality. Conclusion: Pertussis demands attention due toits varied presentation, increased complications and higher mortality.

Omega 3 Fatty Acids and COVID-19:A Comprehensive Review / 감염과화학요법

The rapid international spread of severe acute respiratory syndrome coronavirus 2 responsible for coronavirus disease 2019 (COVID-19) has posed a global health emergency in 2020. It has affected over 52 million people and led to over 1.29 million deaths worldwide, as of November 13th, 2020. Patients diagnosed with COVID-19 present with symptoms ranging from none to severe and include fever, shortness of breath, dry cough, anosmia, and gastrointestinal abnormalities. Severe complications are largely due to overdrive of the host immune system leading to “cytokine storm”. This results in disseminated intravascular coagulation, acute respiratory distress syndrome, multiple organ dysfunction syndrome, and death. Due to its highly infectious nature and concerning mortality rate, every effort has been focused on prevention and creating new medications or repurposing old treatment options to ameliorate the suffering of COVID-19 patients including the immune dysregulation. Omega-3 fatty acids are known to be incorporated throughout the body into the bi-phospholipid layer of the cell membrane leading to the production of less pro-inflammatory mediators compared to other fatty acids that are more prevalent in the Western diet. In this article, the benefits of omega-3 fatty acids, especially eicosapentaenoic acid and docosahexaenoic acid, including their anti-inflammatory, immunomodulating, and possible antiviral effects have been discussed.

Omega 3 Fatty Acids and COVID-19:A Comprehensive Review / 감염과화학요법

The rapid international spread of severe acute respiratory syndrome coronavirus 2 responsible for coronavirus disease 2019 (COVID-19) has posed a global health emergency in 2020. It has affected over 52 million people and led to over 1.29 million deaths worldwide, as of November 13th, 2020. Patients diagnosed with COVID-19 present with symptoms ranging from none to severe and include fever, shortness of breath, dry cough, anosmia, and gastrointestinal abnormalities. Severe complications are largely due to overdrive of the host immune system leading to “cytokine storm”. This results in disseminated intravascular coagulation, acute respiratory distress syndrome, multiple organ dysfunction syndrome, and death. Due to its highly infectious nature and concerning mortality rate, every effort has been focused on prevention and creating new medications or repurposing old treatment options to ameliorate the suffering of COVID-19 patients including the immune dysregulation. Omega-3 fatty acids are known to be incorporated throughout the body into the bi-phospholipid layer of the cell membrane leading to the production of less pro-inflammatory mediators compared to other fatty acids that are more prevalent in the Western diet. In this article, the benefits of omega-3 fatty acids, especially eicosapentaenoic acid and docosahexaenoic acid, including their anti-inflammatory, immunomodulating, and possible antiviral effects have been discussed.

Effectiveness of adolescent health education among secondary and senior secondary school girls in rural Bangalore

Background: Adolescence is a phase of transition from childhood to adulthood. It is during this period that the adolescents acquire sexual and reproductive maturity. Health education given to adolescent girls helps build their knowledge, motivates them to improve and maintain their health, prevent diseases and reduce risky behaviors among them hence the study was done to assess the effectiveness of health education among rural adolescent girls.Methods: An educational interventional study was carried out among adolescent girls in one secondary and one senior secondary school in Hoskote, rural Bangalore. Initial survey was done to assess the baseline knowledge regarding adolescent health issues using semi structured, self-administered questionnaire. Health educational sessions were conducted using audio-visual aids such as slide presentations, charts, posters and handouts. The education was followed by an interactive session with the students to clarify doubts and the impact of intervention was assessed.Results: The study comprised of 150 students (75 secondary and 75 senior secondary school girls). It was found that overall general knowledge regarding adolescent changes, menstruation and menstrual hygiene, pregnancy, contraception and sexually transmitted infections including HIV/AIDS was poor among the study participants. Following educational session statistically significant improvement was observed among the students as detected by improved correct response rates.Conclusions: Study successfully proved that adolescent health education was effective in improving the knowledge among adolescent girls in rural area.

Effectiveness of daily directly observed treatment, short-course regimen among patients registered for treatment at an urban primary health center in Bengaluru

Tuberculosis (TB) is a major public health problem in India with high morbidity and mortality. As per the World Health Organization guidelines, the Revised National Tuberculosis Control Program introduced daily directly observed treatment, short-course (DOTS) regimen with a fixed-dose combination with weight bands. This study was undertaken to compare the effectiveness of daily DOTS regimen with intermittent regimen and to assess the proportion of adverse drug reactions in both groups. Materials and Methods: A descriptive study was conducted at a peripheral health institute under one of the TB Units in South Bengaluru. Participants registered for treatment during the third and fourth quarter of 2017 were selected using continuous sampling. Data were collected by case record analysis, structured interviews, and telephonic follow-up. Results: The study included 81 participants, with the mean age of 40 ± 16.1 years. Majority of the study participants 55 (67.9%) were male, and majority (38 [46.9%]) belonged to the upper-lower class. Forty-two (51.8%) of the study participants were on intermittent regimen, and 39 (48.1%) were on daily DOTS regimen. There was 100% sputum conversion at the end of treatment under both treatment regimens. A total of 36 (85.7%) participants under intermittent regimen and nine (23%) under daily regimen developed one or the other adverse drug reactions. The treatment success for participants under intermittent regimen was 38 (90.47%) and that for daily regimen was 35 (89.74%). However, there was no statistically significant difference between the two groups. Conclusion: Both daily and intermittent DOTS regimens are equally effective in TB treatment, but adverse drug reactions were more common with the intermittent regimen.

Association of first trimester serum level of placental growth factor (PlGF) and cervical length with onset of preterm labour

Background: Preterm labour (PTL) or premature labour is defined as one where labour starts before the 37th completed week.  The incidence of preterm birth is around 5-10% and it is the leading cause of perinatal morbidity and mortality. Diagnosis and treatment of PTL is challenging. However, owing to the availability of effective strategies for prevention of preterm birth, risk identification and early prediction is even more essential. This may provide opportunity for intervention and better obstetric care. Various biochemical markers were studied for prediction of preterm labour, but the sensitivity and specificity were found to be low. This study focuses on determining whether serum level of PlGF and ultrasound measure of cervical length at 10 – 14 weeks period of gestation can be used for early prediction of preterm labour.Methods: 296 antenatal women participated in this prospective observational study carried out from Dec 2015 to Sep 2017 at a tertiary care hospital. Serum level of PlGF was determined at 10-14 weeks. In the same sitting, cervical length was measured by transvaginal sonography. All these patients were followed up in antenatal OPD for monitoring the onset of preterm labour.Results: Incidence of preterm labour was 6.76 %. Maternal characteristics and obstetric factors were comparable in cases and controls. Serum PlGF level and cervical length values were lower in preterm labour group than term deliveries. But this result was not statistically significant.Conclusions: Lower levels of PlGF and cervical length were seen in preterm labour group, although it was not found to be statistically significant.

Evaluation Of Disaster Preparedness In Public & Pvt Tertiary Care Hospital In Delhi Ncr

Introduction: Disaster can strike any time and can cause severe catastrophe to us. It strikes with suddenness and fury and has a curious tendency of choosing the most inappropriate moment . While it is very difcult to prevent disasters, it is certainly possible to be prepared for facing and handling the disaster situation in a way that ensures minimum damage to life, limb and property. Hospitals are organization that remains full of people round the clock and any disaster affecting hospital can cause heavy damage to life. Disaster poses a unique challenge for every medical care facility in terms of infrastructure, capability, & preparedness. As every disaster presents extremely diverse & multi-dimensional problems, hospitals will require formulating their disaster response plans to adequately respond to each possible situation. Aim: To evaluate disaster preparedness of select Public & Pvt multispecialty hospital at Delhi NCR. Objectives: To study the disaster preparedness of the select Public & Pvt multispecialty hospital at Delhi NCR, by using checklist. Materials and Methods: Avalidated checklist with 25 parameters based on saint Luis Disaster Plan check list and NDMAguideline prepared for evaluating the disaster preparedness of select public & Pvt Hospital of Delhi NCR. In addition to the checklist, formal and informal discussions and interviews were carried out with the key functionaries to identify deciencies in the input, process and output. The saint Luis Disaster Plan check list along with NDMAguideline1 , used for the study to assess the State of preparedness of the Hospital has 25 broad parameters. They are as under: 1. Foundational Consideration 2. Surveillance 3. Identication of Authorized Personnel 4. Activation of The Plan 5. Alerting System 6. Response 7. Hospital Disaster Control Command Centre 8. Security 9. Communication System 10. Internal Trafc Flow and Control 11. External Trafc Flow and Control 12. Visitors 13. Media 14. Reception of Casualties and Victims 15. Hospital Evacuation 16. Relocation of Patients and Staff 17. Hospital out of Communication or Cut off from Resources 18. Equipment, Services, Facility and Laboratory Assessment 19. Pharmaceuticals 20. Post Disaster Recovery 21. Education and Training 22. Key Internal Personnel 23. Key External Personnel/Agencies 24. Incident Command System 25. Exercising The Disaster Planning Programme This checklist was circulated for different group of ofcials as relevant to the particular department or services for which they are responsible for and associated with. For examples, the questionnaire related to Security facilities were addressed to the Chief Security Ofcer and questionnaire related to the public relation concern was sent to the Public Relation Ofcer. The results were recorded in Disaster Plan evaluation check list in 'Yes', 'No' or 'Not Applicable' (N.A). Results: The ndings of the base-line evaluation based on checklist were used to identify the deciencies in the existing system of disaster preparedness and response through system analysis of inputs, process and outputs of both public and Pvt multispecialty hospital. Both hospitals have a large number of deciency to handle the victims. The systems are in place but need to reorganized and implementation to be done in strict manner. Conclusions:This study had the aim to evaluate the disaster preparedness of the Select Public & Pvt Hospital. A Disaster Plan should be prepared, circulated and implemented exercising Principles of Management of Planning , Organizing , Stafng , Leading , Controlling along with PDCA cycle approach(Plan, Do, Check and Act).

Impact of educational intervention in promoting knowledge attitude and practice for prevention of common childhood diseases among 9-11 year old school children in rural Bangalore

Background: Children are the most vulnerable and easily influence able part of society and thus when subjected to health education the knowledge they gain and the practices they develop are more likely to stay with them throughout their life hence the study was done to assess the impact of health education among school students.Methods: Educational intervention study was carried out in three primary schools in Hoskote, rural Bangalore among 9-11 years school children. Initial survey was done to assess the KAP levels in 9 to 11 years old school children regarding prevention of common childhood disease and intervention was done using an interactive story board to provide health education and impact of intervention was assessed.Results: The study comprised of 200 students (112 boys and 88 girls). It was found that overall general knowledge and attitude regarding prevention of common childhood diseases was poor among the study participants. Following educational sessions using interactive story board (edutainment) a significant improvement was observed in knowledge and attitude of the students as detected by improved correct response rates.Conclusions: Interactive story board was successful in providing educational intervention in 9 to 11 year old school children which may help to prevent common avoidable childhood diseases.

Sleep Quality, its determinants and its Association with Academic Performance among the Students of a Medical College in Kerala

Sleep deprivation may have grave health consequences; resulting in increased disease morbidity and mortality. Prevalence of poor sleep quality is higher among medical compared to non-medical students and the general population. Poor sleep quality affects the academic performance of medical students and also their work performance in the future when they become practitioners. Hence, in this background, the present study was conducted. Objectives: The objectives of the study were to find out the prevalence of poor sleep quality among medical students, its determinants and also its association with academic performance. Materials and Methods: This was a cross-sectional study conducted at a Medical College, Wayanad District, Kerala, between May and November 2018. All the undergraduate medical students of the college were the study subjects. Data were collected using a predesigned and pretested self-administered questionnaire, i.e., the Pittsburgh Sleep Quality Index. Completed responses were obtained from a total of 684 students. Results: 62.4% were found to have good sleep quality and 37.6% poor sleep quality. The prevalence of poor sleep quality was more among 17–19 years age group, males, married, Phase I MBBS students, NRI quota students, subjects belonging to religion “others,” urban origin students and day scholars. However, only phase of MBBS and place of origin were found to have a statistically significant association (P=<0.01 for both). The prevalence of poor sleep quality was more among those who had failed in the previous university exam/internal assessment or who had passed in pass class when compared to those who had secured distinction/I/II class. However, the association was not found to be statistically significant (P = 0.39). Conclusions: The prevalence of poor sleep quality among the study subjects was lower. There was a significant association of male sex and Phase I, MBBS with poor sleep quality. There was no significant association between sleep quality and academic performance.

Internet Addiction and its determinants among the Students of a Medical College in Kerala

Internet has literally percolated every aspect of human life today including social communication, education, research, health seeking, banking, business, shopping, administration, and entertainment, so much so that we cannot imagine our lives without internet. However, internet can be misused and excess internet use can be pathological and addictive. Younger population and especially college students are more vulnerable to this addiction because of their psychosocial and environmental characteristics. This internet addiction can lead to various psychological, physical, as well as social problems. Hence, in this background, the present study was conducted to find out the prevalence of internet addiction among medical students and also its determinants. Methodology: This was a cross-sectional study done at DM Wayanad Institute of Medical Sciences, Wayanad District, Kerala, between January and June 2018. All the undergraduate medical students of the college were the study subjects. Data were collected using a predesigned and pretested self-administered questionnaire (Young’s internet addiction test). Completed responses were obtained from a total of 729 students. Results: 5.5% were found to have no internet addiction and 94.5% were found to have internet addiction. 60.8%, 31.3%, and 2.5% were found to have mild, moderate and severe internet addiction, respectively. The prevalence of internet addiction was more among males compared to females, Part II, final phase students compared to other phase students, management quota students compared to other quota students, Christians compared to other religions, urban origin students compared to rural origin, and day scholars compared to hostellites. However, only sex, phase of MBBS, and place of origin were found to have a statistically significant association (P= <0.01, 0.026 and 0.049 respectively). There was a weak negative correlation (r = −0.117) between the percentage of marks obtained in previous university examination and IA scores, and the correlation was found to be statistically significant (P= <0.01). Conclusions: The prevalence of internet addiction among the study subjects was significantly more compared to other studies. Sex, phase of MBBS, and place of origin were found to have a statistically significant association with internet addiction. There was a negative correlation between the degree of internet addiction and academic performance.

Palatal rhinosporidiosis: an unusual case report and review of the literature

Rhinosporidiosis is a chronic, granulomatous, mucocutaneous infection caused by Rhinosporidium seeberi . The infection is non-contagious and sporadic in humans. The site most commonly affected is the mucous membrane of the nose and nasopharynx, followed by the oropharynx, trachea, bronchi, ear, eye, and genitourinary tract. It can also spread to other areas through blood and lymph. Here, we report a case of rhinosporidiosis affecting the palate in a 60-year-old female patient.

Blistering mucocutaneous disease of oral cavity Pemphigus vulgaris 8 year study in Nalgonda population

Background: Autoimmune disorders are conditions in which autoantibodies are directed against a single organ or tissue resulting in localized tissue damage. Pemphigus includes a group of autoimmune blistering diseases of skin and mucous membranes characterized by intra dermal blisters and immunologically by finding of circulating immunoglobulin G antibody directed against the cell surface of keratinocytes. Objectives: To analyze age distribution of Pemphigus vulgaris, prevalence among males and females, predominant oral site and clinical presentation. Materials and methods: A retrospective study of 31 cases of Pemphigus vulgaris obtained over a period of 8 years from January 2008 to September 2015 in the Department of Oral Pathology, Kamineni Institute of Dental Sciences was designed. Clinical details of age, sex, intraoral distribution and oral presentation were noted. P Pavan, T Madhusudan Rao, Pavan G Kulkarni, SRK Nandan, Shyam Prasad Reddy, M Keerthi. Blistering mucocutaneous disease of oral cavity Pemphigus vulgaris – 8 year study in Nalgonda population. IAIM, 2017; 4(1): 58-63. Page 59 Results: Age distribution of Pemphigus vulgaris was 30 – 70 years with a mean age of 49.12 years. Mean age of presentation in males was 45.5 years and in females 46.76 years. Females are more commonly affected than males with a ratio of 2:1. Most commonly affected sites were buccal mucosa, lips and palate, tongue, floor of mouth and skin. Erosions and encrustations were the most common clinical presentation. Conclusion: Pemphigus vulgaris is a fatal disease if left untreated. The skin and the mucosa are majorly involved and oral mucosa is often affected first. The study elucidates the characterization of Pemphigus vulgaris so that early diagnosis can be made. As oral lesions precede, oral health care professionals can play a major role in early diagnosis and managing oral lesions.