Assessment of Mental Wellness Amongst the Faculty and Students of an Educational Institute in the State of Himachal Pradesh, India — Post Lockdown during COVID-19

Background: The COVID-19 pandemic had a significant effect on the mental health of human beingsworld wide. There is a lack of information pertaining to the mental wellness of students and faculty in dental institutions in India. This study aimed to assess the overall mental well being of students and faculty of dental institution after return to normalcy post-lockdown period during COVID-19. Material & Methods: A self reporting online questionnaire was designed by the authors after speaking with various therapists and mental health coaches. This questionnaire was anonymously filled out by 492 participants which included under graduate students, post graduate students, academic staff, paramedical and clerical staff in a dental institution. Results: Majority of the subjects felt the need for counseling in their work place (53.4%). A greater number felt they were getting insufficient sleep (48.3%) and (31.5%) of the participants experienced depression and anxiety which further affected their emotional well being and their day to day activities. One-fifth (16.8%) of the participants perceived that mental health affected their relationships and 20.1% observed that physical health restricted their day to day activities. Mental wellness of females was significantly more affected than males. Additionally marital status also influenced the mental wellness of the subjects. Conclusion: Literary evidence suggests that mental wellness is not given enough importance in our country in general. This study only proved the ramifications of COVID-19 on mental wellness and suggested the provision of counselling which could’ve protected the participants from slipping into a negative frame of mind.

Extraskeletal mesenchymal chondrosarcoma of the abdomen: A rare clinical presentation

Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare malignant soft tissue tumor of chondroprogenitor cell origin. Originally, it was restricted to the bone only but that is no longer the case. Recent literature reports that 20–33% of these tumors occur at the extraskeletal sites. We report one such case, in which the tumor involved the anterior abdominal wall muscles and also had a large intra-abdominal mass that covered a large part of the peritoneal cavity. The clinical features and computed tomography findings suggested the diagnosis of a malignant desmoid tumor with intra-abdominal extension; however, the histopathological examination and the immunohistochemistry proved the tumor to be EMCS. The case is reported due to the dilemma in diagnosis, its rarity, large size, parietal, and intra-abdominal extension with multiple site involvement.

Pouch of sorrow: Undiagnosed isthmocele – presenting as secondary infertility of 11 years in a middle age female

In the past decade, the rate of cesarean sections has doubled leading to the more frequent occurrence of cesarean-related complications. Cesarean scar site diverticulum or isthmocele is one such complication that is defined as an outpouching of the anterior uterine wall at the cesarean scar site in continuity with the endometrial cavity, creating a wedge-shaped defect of variable depth. We report a case of a middle-aged female with secondary infertility for the last 11 years with one live issue 12 years back through a cesarean section at term. She had undergone an array of investigations for infertility for the past 5 years. She was diagnosed as having an isthmocele and managed with surgical repair of the defect at our hospital with subsequent assisted conception 8-month post-surgical repair. The importance of diagnosing a cesarean scar diverticulum cannot be understated not only because it is a surgically treatable cause of infertility but also because if such patients conceive, they may land in uterine rupture, placenta accreta, or scar ectopic pregnancy which can complicate into life-threatening situations.

BI-RADS 3 lesions in North Indian population: Their outcome and how to proceed for follow-up

Background: Breast Imaging Reporting and Data System (BI?RADS) classification for breast lesions was proposed for uniformity in categorizing breast lesions. While BI?RADS 1, 2 and 4–6 categories are straightforward, BI?RADS 3 is an intermediate category lesion with significantly different meanings and findings for mammography, ultrasound, and magnetic resonance imaging and is diagnostically challenging. Our study aims to determine the frequency and the malignancy rate of BI?RADS category 3 lesions detected on ultrasound breast and digital X?ray mammography by doing follow?ups at 6, 12, and 24 months of imaging. Materials and Methods: This ambispective study was conducted in the Department of Radiodiagnosis, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, from October 2020 to October 2022, which included 55 patients referred for digital X?ray and breast ultrasound. All BI?RADS category 3 in the initial sonomammography and digital X?ray mammography were included in the study and were followed up for final diagnosis and outcome either by pathological analysis or follow?up using sonomammography and digital X?ray mammography for a maximum of 24 months. Results: Fifty?five patients were categorized into the benign or malignant category from the results of tissue diagnosis or via follow?up. Fifty?four patients (98.18%) showed benign lesions, and one (1.82%) got malignant lesions. In the majority, 31 (56.36%) patients, the mean follow?up time was 6 months, followed by 12 months 10 (18.18%). Follow?up was 24 months in only 1 out of 55 patients (1.82%). The mean value of time to follow?up (months) of study subjects was 6 ± 4.6 with a median (25th–75th percentile) of 6. Conclusion: Short?term interval follow?up in BI?RADS category: three patients are enough to detect early breast malignancy, and this will avoid unnecessary tissue diagnosis (invasive procedure) in benign lesions. In our study, the malignancy yield in the follow?up of BI?RADS 3 was 1.82% (<2%).

Self-esteem and Suicidal Ideation in Pakistani Undergraduates / Autoestima e ideación suicida en estudiantes universitarios paquistaníes

Abstract The main purpose of the study was to assess the relationship between self-esteem and suicidal ideation in Pakistani undergraduates (N = 600). Participants' ages ranged from 17 to 25 years (M =20.26, SD = 1.6) with 50% males and 50% females. A Structural Equation Modeling approach was used to analyse the data. All fit indices were examined on measurement level. Relationships between three latent variables: positive self-esteem, negative self-esteem, and suicidal ideation were assessed on structural level. Results revealed that students with negative self-esteem were more prone towards suicidal ideation (β = .15, p < .001). Moreover, those students who were having positive self-esteem were less likely indicating suicide ideation which suggested that positive self-esteem is a protective factor against suicidal ideation (β = -.10, p < .05) among undergraduates.

Resumen El objetivo principal del estudio fue evaluar la relación entre la autoestima y la ideación suicida en estudiantes universitarios paquistaníes (N = 600). Las edades de los participantes variaron de 17 a 25 años (M = 20.26, SD = 1.6) con un 50% de hombres y un 50% de mujeres. Se utilizó un enfoque de modelado de ecuaciones estructurales para analizar los datos. Todos los índices de ajuste se examinaron a nivel de medición. Se evaluaron a nivel estructural las relaciones entre tres variables latentes: autoestima positiva, autoestima negativa e ideación suicida. Los resultados revelaron que los estudiantes con autoestima negativa eran más propensos a la ideación suicida (β = .15, p < .001). Además, los estudiantes que tenían una autoestima positiva tenían menos probabilidades de indicar una ideación suicida, lo que sugirió que la autoestima positiva es un factor protector contra la ideación suicida (β = -.10, p < .05) entre los estudiantes de pregrado.

Optimizing factors for the efficient expression and purification of spao and lamb from Salmonella typhi

We optimized the expression and purification of outer membrane proteins SpaO and LamB from Salmonella typhi. We investigated various factors in the expression and purification processes, including the use of isopropyl ß-d-1 thiogalactopyranoside (IPTG), imidazole, and urea. First, PCR amplification was carried out on SpaO and LamB genes. The genes were then cloned in pTZ57R/T, and then expressed in pET28a vector and transformed into Escherichia coli BL21 (DE3). Gene insertion was confirmed by enzymatic digestion with NdeI and XhoI. Inclusion bodies expressing recombinant SpaO and LamB were induced with 200 and 400 µL 0.5 mM IPTG, respectively. The formed protein inclusion bodies were then isolated from the pellet and solubilized in IB buffer containing 8 M urea for SpaO and 6 M urea for LamB. Proteins were refolded by dialysis in 3M urea. Purified proteins with nickel-nitrilotriacetic acid affinity chromatography and eluted with buffer containing 250 mM imidazole for SpaO and 150 mM imidazole for LamB. The protein expression profiles were analyzed by SDS-PAGE, which identified the 33 and 49 kDa bands corresponding to rSpaO and rLamB. Western blotting Purification was carried out by nickel affinity resin with 250 mM and 150 mM imidazole for rSpaO and rLamB and refolded through stepwise dialysis with anti-His tag antibodies confirmed their expression. These optimized methods can be used to generate recombinant proteins for the development of future vaccines.

Cephalometric evaluation of the cervical spine posture following fixed functional therapy with Forsus™ appliance

Background: To investigate whether fixed functional therapy for mandibular advancement with the Forsus™ appliance would produce any changes in the cervical spine posture. Materials and Methods: This prospective clinical exploratory study was conducted on 12 patients (six females and six males) with a mean age of 15 ± 1.3 years, having mandibular retrusion, Class II malocclusion, who were treated with the Forsus™ appliance. Lateral cephalogram was taken twice, once at the baseline (T1) before the commencement of the treatment and once following termination of fixed functional treatment (T2). Eleven measurements representing the vertical and the sagittal craniofacial proportions, and the head posture, were taken into account. Data were analyzed using SPSS version 22. The variations between before and after treatment measurements were collated using paired t-test. P < 0.05 was considered statistically significant. Results: No significant differences were noticed in the angle linking the horizontal lines of the head and the superior crest of the spinal column before and after the treatment, with P = 0.73. The cervical curvature angle also failed to show any significant difference with P = 0.14. Conclusion: Fixed functional therapy with the Forsus™ device resulted in dentoalveolar and soft tissue alterations alone but did not alter the cervical spine posture.

Tylophora hirsuta L. leaf extract attenuates alloxan-induced diabetes in mice by suppressing oxidative stress and α-Amylase

Objective: To evaluate the antidiabetic potential of leaf extracts of Tylophora hirsuta (T. hirsuta). Methods: The methanolic and ethyl acetate extracts of T. hirsuta leaves were analyzed by high pressure liquid chromatography. In vitro antioxidant activity was determined by ferric ion reduction, 1, 1-diphenyl-2-picrylhydrazyl, and hydrogen peroxide scavenging methods. In vitro alpha amylase (α-Amylase) inhibitory activity of the plant extracts was assessed. In vivo antidiabetic potential was determined in alloxan-induced diabetic mice to assess glycated hemoglobin (HbA1c), oral glucose tolerance, serum amylase, lipid profile, fasting blood glucose, and body weight. Histopathological lesions of the pancreas, liver and kidney were observed. Oxidative stress biomarkers such as superoxide dismutase, catalase and peroxidase were also determined. Results: Quercetin, chlorogenic acid, p-coumaric acid, and m-coumaric acid were found in the plant extracts. The methanolic plant extract exhibited higher in vitro antioxidant activities than the ethyl acetate extract. Moreover, methanolic plant extract exhibited (83.90±1.56)% α-Amylase inhibitory activity at 3.2 mg/ mL concentration. Animal study showed that the methanolic extract of T. hirsuta improved the levels of fasting blood glucose, HbA1c, serum α-Amylase, lipid profile, liver function biomarkers, and kidney functions of diabetic mice. Moreover, the methanolic extract ameliorated diabetes-related oxidative stress by increasing superoxide dismutase and catalase activities and decreasing peroxidase and malondialdehyde levels. Histopathological examination showed that the plant extract had improved the integrity of pancreatic islets of Langerhans and reduced the pathological lesions in the liver and kidney of diabetic mice. Conclusions: The methanolic extract of T. hirsuta exhibits pronounced antidiabetic activity in mice through reduction of oxidative stress. The plant extract has several natural antioxidants such as phenolic acids. T. hirsuta extract could serve as a nutraceutical for managing diabetes mellitus.

Tylophora hirsuta L. leaf extract attenuates alloxan-induced diabetes in mice by suppressing oxidative stress and α-Amylase

Objective: To evaluate the antidiabetic potential of leaf extracts of Tylophora hirsuta (T. hirsuta). Methods: The methanolic and ethyl acetate extracts of T. hirsuta leaves were analyzed by high pressure liquid chromatography. In vitro antioxidant activity was determined by ferric ion reduction, 1, 1-diphenyl-2-picrylhydrazyl, and hydrogen peroxide scavenging methods. In vitro alpha amylase (α-Amylase) inhibitory activity of the plant extracts was assessed. In vivo antidiabetic potential was determined in alloxan-induced diabetic mice to assess glycated hemoglobin (HbA1c), oral glucose tolerance, serum amylase, lipid profile, fasting blood glucose, and body weight. Histopathological lesions of the pancreas, liver and kidney were observed. Oxidative stress biomarkers such as superoxide dismutase, catalase and peroxidase were also determined. Results: Quercetin, chlorogenic acid, p-coumaric acid, and m-coumaric acid were found in the plant extracts. The methanolic plant extract exhibited higher in vitro antioxidant activities than the ethyl acetate extract. Moreover, methanolic plant extract exhibited (83.90±1.56)% α-Amylase inhibitory activity at 3.2 mg/ mL concentration. Animal study showed that the methanolic extract of T. hirsuta improved the levels of fasting blood glucose, HbA1c, serum α-Amylase, lipid profile, liver function biomarkers, and kidney functions of diabetic mice. Moreover, the methanolic extract ameliorated diabetes-related oxidative stress by increasing superoxide dismutase and catalase activities and decreasing peroxidase and malondialdehyde levels. Histopathological examination showed that the plant extract had improved the integrity of pancreatic islets of Langerhans and reduced the pathological lesions in the liver and kidney of diabetic mice. Conclusions: The methanolic extract of T. hirsuta exhibits pronounced antidiabetic activity in mice through reduction of oxidative stress. The plant extract has several natural antioxidants such as phenolic acids. T. hirsuta extract could serve as a nutraceutical for managing diabetes mellitus.

Screening of novel alkaloid inhibitors for vascular endothelial growth factor in cancer cells: an integrated computational approach

Vascular endothelial growth factor (VEGF) is expressed at elevated levels by most cancer cells, which can stimulate vascular endothelial cell growth, survival, proliferation as well as trigger angiogenesis modulated by VEGF and VEGFR (a tyrosine kinase receptor) signaling. The angiogenic effects of the VEGF family are thought to be primarily mediated through the interaction of VEGF with VEGFR-2. Targeting this signaling molecule and its receptor is a novel approach for blocking angiogenesis. In recent years virtual high throughput screening has emerged as a widely accepted powerful technique in the identification of novel and diverse leads. The high resolution X-ray structure of VEGF has paved the way to introduce new small molecular inhibitors by structure-based virtual screening. In this study using different alkaloid molecules as potential novel inhibitors of VEGF we proposed three alkaloid candidates for inhibiting VEGF and VEGFR mediated angiogenesis. As these three alkaloid compounds exhibited high scoring functions, which also highlights their high binding ability, it is evident that these alkaloids can be taken to further drug development pipelines for use as novel lead compounds to design new and effective drugs against cancer.

Screening of novel alkaloid inhibitors for vascular endothelial growth factor in cancer cells: an integrated computational approach

Vascular endothelial growth factor (VEGF) is expressed at elevated levels by most cancer cells, which can stimulate vascular endothelial cell growth, survival, proliferation as well as trigger angiogenesis modulated by VEGF and VEGFR (a tyrosine kinase receptor) signaling. The angiogenic effects of the VEGF family are thought to be primarily mediated through the interaction of VEGF with VEGFR-2. Targeting this signaling molecule and its receptor is a novel approach for blocking angiogenesis. In recent years virtual high throughput screening has emerged as a widely accepted powerful technique in the identification of novel and diverse leads. The high resolution X-ray structure of VEGF has paved the way to introduce new small molecular inhibitors by structure-based virtual screening. In this study using different alkaloid molecules as potential novel inhibitors of VEGF we proposed three alkaloid candidates for inhibiting VEGF and VEGFR mediated angiogenesis. As these three alkaloid compounds exhibited high scoring functions, which also highlights their high binding ability, it is evident that these alkaloids can be taken to further drug development pipelines for use as novel lead compounds to design new and effective drugs against cancer.

West syndrome: clinic etiological profile, and response to treatment in Western India

Background: Information on the profile of infants with West syndrome in developing countries is limited. This study was done to determine clinico-etiological profile and clinical response of infantile spasms to various medications in children with west syndrome in a developing country.Methods: It was a retrospective cohort study from January 2017-january 2020 done in a tertiary care hospital in western India. Records of 39 children with west syndrome who visited this pediatric neurology division during study period were analysed. 6 were excluded in view of incomplete data. Detailed history, examination, investigations and medications given were noted. Follow up records were assessed to look for long term control of spasms, relapse rates after cessation, or progression to other seizure types.Results: Mean age at onset of infantile spasms was found to be 8.12 months (1 - 36 months).' Mean lag time to treatment was 5.35 months. Etiology was found in 69.7% children with perinatal causes being most common. With oral prednisolone, 54.5% had complete cessation of spasms, and with ACTH also 54.5% had complete spasm cessation. Favourable clinical response at 6 months follow up was found in 8 (47.05%) of the 17 children. Surprisingly, lag time (p=0.381) and symptomatic etiology (p=1.00) did not have any significant impact on outcome.Conclusions: This study highlights the developing country perspective of west syndrome. Increased lag time, different etiological profile and poor outcome are the challenges. High dose prednisolone is a good first line alternative treatment option in resource poor settings.

Psychopat hy Predicting Violent Criminal Behaviour among Adult Offenders / Psicopatía y predicción del comportamiento violento criminal en reclusos adultos

Abstract The aim of the present research was to examine the role of psychopathy in predicting violent offending within a sample of adult criminal inmates (N= 342) (M = 48.07, SD = 17.8) from the prisons of Khyber Pakhtunkhwa Pakistan (KPK). T-test and logistic regression was used to analyse the data. Logistic regression analysis revealed that a higher level of egocentricity and a higher level of antisocial behaviour predict a greater probability of committing violent offence. These findings provide important implications for future research in Pakistan, specifically concerning psychopathy as a risk factor for criminal and violent behaviour. The present findings will help to inform legal decisions as to whether inmates should be incarcerated as violent criminals or non-violent criminals. The conclusions of the present research are limited to incarcerated adult male offenders only; therefore, the present study remains unable to reflect the development of psychopathy in either females or the general population.

Resumen El objetivo de la presente investigación fue examinar el papel de la psicopatía en la predicción de delitos violentos dentro de una muestra de reclusos adultos (N = 342) de las prisiones de Khyber Pakhtunkhwa Pakistán (KPK). La prueba T y la regresión logística se utilizaron para analizar los datos. El análisis de regresión logística reveló que un mayor nivel de egocentricidad y un mayor nivel de comportamiento antisocial predicen una mayor probabilidad de cometer un delito violento. Estos hallazgos proporcionan importantes implicaciones para futuras investigaciones en Pakistán, específicamente sobre la psicopatía como factor de riesgo para el comportamiento criminal y violento. Los presentes hallazgos ayudarán a informar las decisiones legales sobre si los reclusos deben ser encarcelados como delincuentes violentos o criminales no violentos. Las conclusiones de la presente investigación se limitan a los delincuentes varones adultos encarcelados únicamente; por lo tanto, el presente estudio sigue siendo incapaz de reflejar el desarrollo de la psicopatía en mujeres o en la población general.

Clinicoepidemiological and laboratory profile of children with severe acute malnutrition admitted to a tertiary care centre

Background: Severe Acute Malnutrituon (SAM) is a form of malnutrition where there is an imminent threat of death to the child. The chances of complications are very high and in most case child requires hospitalization for stabilization and rehabiliatation. Objective of study the clinicoepidemiological and laboratory profile of children with severe acute malnutrition (SAM) admitted to a Nutritional Rehabilitation Centre (NRC) of our hospital.Methods: A retrospective chart review of admitted patients. Nutritional Rehabilitation centre (NRC) at GB Pant Hospital Government Medical College Srinagar over a one year period between June 2017 and June 2018.Results: Total of 187 patients of SAM was admitted in NRC during the study period. One hundred and eight (57.7%) were males and 79(42.3%) were females .Patients were equally among various districts. Infants (<12months) constituted the majority of admissions (54.5%). Marasmus was by far the commonest phenotype presenting as SAM (85.5%).Respiratory comorbidity was the commonest present in about' 41 (26.3%) followed by daiarrhea in' 32(20.5%). Delayed initiation of complimentary feeding was found in 75(40.1%) while early weaning was found in another 55 children (29.4%). Birth order more than three was present in 92 children (49%). Mother's literacy status had a direct bearing on the prevalence of SAM. Most of the children were from rural background (75%).Most belonged to low economic and income class as around 65.2% had a very meager' family income.Conclusions: SAM is more common in Infants and in children from rural background. It is highly associated with faulty feeding practices including lack of breast feeding and presence of mixed and faulty feeding. It is also associated with increasing birth order, low maternal education and low family income Pneumonia and diarrhea are leading comorbidities. Hypoglycemia and hypothermia are leading complications.' Marasmus is the commonest phenotype.

FANCA Gene in Pakistani Fanconi Anemia Patients: Screening of Mutations in Exon 28 and Exon 29

Objective: This kind of study was conducted first time in Pakistan. Its objective was to ascertain the associated clinical features and analyze the FANCA exon 28 and exon 29 mutations in Pakistani Fanconi anemia (FA) patients. Methods: A total of 38 patients with Fanconi anemia were recruited presenting in the Armed forces institute of pathology (AFIP) Rawalpindi Pakistan. They were enrolled in this study on the basis of comprehensive clinical evaluation and positive Diepoxybutane (DEB)/Mitomycin C Chromosomal breakage test. Genomic DNA was extracted from peripheral blood of patients and age and gender-matched controls. Mutation analysis of FANCA gene was done by conventional Polymerase chain reaction (PCR) and DNA sequencing. Various online tools and software were used for analysis of the obtained data and identification of the sequence alterations in FANCA gene in exon 28 and exon 29 of FA patients. Results and Discussion: The current study on screening of FANCA mutational analysis in exon 28 and exon 29 revealed four novel mutations. These include three missense variants (p.F876L, p.L883H, and p.K921I) in exon 28 and a novel homozygous frameshift variant (p.S947FfsX950) in exon 29. In addition two new intronic variants were also found in this set of patients. Conclusion: The sequence variants identified in this study in 10 (26.31%) FA patients in two out of forty-three FANCA gene exons (i.e., exon 28 and exon 29) strongly emphasize the importance of large-scale molecular studies on FANCA gene in Pakistani population.

Role of Angiotensin Converting Enzyme (ACE) Gene Polymorphism in Breast Cancer among North Indian Population

Background: The most common cause of cancer related death among women in the world is Breast cancer (BCa). Almost Every year, approximately 1,300,000 cases and 450,000 deaths are related with Carcinoma of Breast are reported worldwide. The incidence of invasive Carcinoma of Breast and mortality in American women in 2017 was 252,710 and 40,610 respectively as quoted by a study. According to latest survey conducted by the Indian Council of Medical Research (ICMR) in India, there were an estimated 150,000 new cases of Carcinoma of Breast in the year 2016. The rise in both Carcinoma of Breast incidence and mortality, therefore, necessitates an examination of risk factors associated with this disease. Molecular subtypes-based classification system characterized by the presence or absence of immunohistochemical expressions like Progesterone receptor (PR), Estrogen receptor (ER), and Human epidermal growth factor receptor 2 (HER2) may show certain limitations. The gene encoding ACE (Angiotensin Converting Enzyme,) in humans is located in the chromosome 17 (17q23), consisting of 26 exons and 25 introns and spanning 21 kb. ACE is a zinc dependent dipeptidyl carboxypeptidase which catalyzes conversion of inactive decapeptide Angiotensin I (Ang I) to active octapeptide Ang II . Ang II mediates physiological effects by binding to two subtypes of the receptors, AGTR1 and Angiotensin II receptor type II (AGTR2), which belongs to superfamily of G-protein-coupled receptors (GPCRs).So, keeping all these physiological effects in mind, this study was conducted to see the role of ACE gene in carcinoma of breast. Methods: From confirm and control cases 3.0 ml of venous blood from each study subject was collected in an EDTA vial. Genomic DNA was extracted by phenol-chloroform method. The genotyping was performed by using PCR (Polymerase Chain reaction), using gene-specific primers. The resulting PCR products were separated on 2% agarose gels using ethidium bromide stain and visualized under UV light. The clinicopathologic parameters of breast cancer patients were obtained from medical records. Results: Of the 10 patients, 3 (30%) had Deletion/deletion genotype DD, 6 (60%) had ID, and 1 (10%) had II genotypes. In control subjects, 2 (20%) had DD, 6 (60%) had ID, and 2 (20%) had II genotypes. Conclusion: The results showed no significant association of ACE gene polymorphism with breast cancer (p>0.05). There is a necessity to conduct large-scale studies with adequate methodological quality and larger sample size in order to come to a definitive conclusion.

Result of Probing for Congenital Nasolacrimal Duct Obstruction in Children Less than 1 Year Versus Children Greater than 1 Year

Congenital obstruction of nasolacrimal duct is a very common cause of epiphora in new born children.Controversy exists regarding the natural course and management of children with congenital nasolacrimalduct obstruction. The present study was undertaken on 80 children of congenital nasolacrimal duct obstructionwith no previous intervention. They were divided into two groups of 40 each. Group 1 had children aged lessthan 1 year and Group 2 comprised of children older than 1 year. Probing was done under general anesthesia.The mean age of the patients in Group 1was 8.35±2.65 months and that of the children in Group 2 was27.5±11.98 months. The overall success rate of probing was 78.75%. Success rates in Group 1 and Group2 were 85% and 72.5%, respectively. The difference between the two groups was statistically insignificant.However, there was a significant difference in the success rate of probing depending on the type of obstruction(p<0.05). Membranous obstruction of NLD was associated with increased success rates of probing ascompared to firm obstruction of NLD (p=0.001230, Yates corrected Chi square =0.0009578). Probing is asafe option of treating congenital nasolacrimal duct obstruction. Probing is beneficial in older children althoughthe success rate of probing tends to decline with increasing age. Firm anatomical obstruction in nasolacrimalduct is associated with a decline in the success rate of probing.

Prevalence of Early Loss of Primary Molars among Children Aged 5-10 Years in Darbhanga Town: A Cross- Sectional Study

The present study was designed to determine the prevalence of premature loss of primary molars in 5-10 year children in Darbhanga town. Methods: This is an observational, cross-sectional study that include 100 children of aged 5-10 year (50 male & 50 female child). The examination was done under sufficient artificial light. Data including patient age and missing teeth were collected. Results: The result showed that 46% had early loss of primary molar teeth with boys showing an increased prevalence rate (60.8%) as compared to female (39.1%). Also, mandibular arch are more commonly affected. Conclusion: The prevalence rate of premature loss of primary teeth was found to high. Educational and preventive programs must be implemented in order to maintain healthy primary dentition which eventually prevents the disturbances in normal occlusion.

Gestational diabetes mellitus, Vitamin D status and fetomaternal outcome

Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin.

Knowledge, Attitude, Practice towards Breast Cancer and Breast Self-examination among Female Undergraduate Students in Karachi, Pakistan

Aims: The study was aimed at investigating knowledge, attitude and practice towards breast cancer and breast self-examination among female undergraduate students in Karachi, Pakistan.Study Design:Cross Sectional study.Place and Duration of Study:This study was conducted for a period of four months in different universities of Karachi, Pakistan. Methodology:The study was done using a self-administered questionnaire. A total of 381 undergraduate students of medical and non-medical universities were included. Results:The mean age of participants was 20.45 ±3.67 years.97% of the candidates had heard about breast cancer out ofwhich only 65.4% were aware about its high prevalence rate in Karachi, Pakistan. A good proportion of candidates i.e. 78% of participants had good knowledge of breast self examination out of which only 43.8% knew how to perform it but just 24.9 % actuallyperformed it.20.5% of female population had made arrangements for breast screening once in their lifetime however many of the candidates (39.1%) never experienced any symptoms of breast pathology thus never felt the need to screen themselves.Various signs and symptoms were considered as indications of breast cancer though lump as a sign was answered the most by 76.1% students. Out of the several risk factors of breast cancer 70.9% of candidates responded as family history the most common risk factor and early menstruation as a risk factor was 22.8% (the least). 44.4% of the aware candidates stated that they acquired this knowledge from social media. 21.5% had a positive family history. Mammography as a diagnostic modality was considered the most helpful by 61.4% population.Conclusion:Thestudy points out to the sufficient knowledge and attitude of breast cancer among female undergraduates in Karachi, Pakistan. However, they lacked the practice towards breast self examination. We expect that our results may provide useful data that could be used by the department of health in Karachi, Pakistan to formulate their health programs to increase the knowledge, attitude and practice towards breast cancer and breast self-examination