Twin pregnancy with one normal fetus and one complete mole.

Twin pregnancy with a complete mole and a coexisting healthy fetus is a rare condition. There is increased risk of developing severe complications and development of persistent trophoblastic disease. A 28 years old 2nd gravida, with 1 st vaginal delivery reported to the hospital at 20 weeks gestation as a case of dichorionic twin pregnancy. On routine USG, it showed a complete mole with a coexisting live fetus. The patient had features of anemia and severe preeclampsia. After explaining the risk to the patient and bystanders, they requested to terminate the pregnancy. She was induced for the same and delivered a normally appearing fetus. This was accompanied by evacuation of the mole. Diagnosis of complete mole was confirmed by histopathology. Twin pregnancy with acomplete mole and a coexisting healthy fetus is a rare condition. The decesion regarding management of this condition is difficult due to the various complications associated especially development of choriocarcinoma.

Incipient caries: an early intervention approach.

Dental caries is an irreversible microbial disease of the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth, which often leads to cavitation (Shafer-1993). Organic acids produced as a by-product of fermentable carbohydrate metabolism plays a key role in the disease. The caries process is a continuous, involving various cycles of demineralization and remineralization. Demineralization begins at the atomic level on the crystal surface in enamel or dentine and can continue to cavitation. However currently there are many treatment modalities to intervene this continuing process, to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non-cavitated or incipient carious lesion.

Metabolic Effect of FOS (Fructooligosaccharide) in Terms of Gut Incretin (GLP-1) Gut Microflora and Weight Reduction in Obese Adults.

In the recent years, obesity has increased beyond imagination. Appropriate dietary strategies which have the potential for weight loss demand patience and strong determination on part of the individual, however inclusion of functional foods like FOS that modulate gut hormones have a promising role in weight management. Methods: A randomized double-blind placebo-controlled trial was used as the study design wherein 65 obese adults were divided into experimental group (which was given 12 g of FOS) and a placebo group (which was fed with 12 g dextrose). The subjects were given the supplements daily for 12 week period. Their plasma samples were anlaysed for GLP-1 and microbial count in fecal samples were determined in terms of lactic acid bacteria, bifidobacteria and enteric pathogens. Hunger scores, dietary intake, and anthropometric parameters were assessed using standard techniques. Results: FOS supplementation resulted in improved plasma GLP-1 level by 17.0%. Significant improvement was observed in hunger score by 3.15% (p<0.05) along with reduction in dietary intake of energy (kcal) by 8%, carbohydrate (g) by 8%, protein (g) by 6% and fat (g) by 2%. Further, reductions were observed in total body weight (kg), BMI, % body fat and waist circumference (cm) levels by 4%, 1.06%, 4% and 1.66% respectively (p<0.001, p<0.001, p<0.001, p<0.05). The mean log counts of beneficial gut microbiota i.e. lactic acid bacteria and bifidobacteria increased significantly by 14 % and 10 % respectively along with 20% reduction in enteric pathogen. Conclusion: Daily intake of 12 gm FOS for 12 weeks helps in improving gut health and weight loss through increased satiety in obese individuals.

Smokeless tobacco use among patients with tuberculosis in Karnataka: The need for cessation services.

Background. India is home to the largest population of patients with tuberculosis and tobacco users in the world. Smokeless tobacco use exceeds smoking and is increasing. There is no study to date that reports smokeless tobacco use before and after the diagnosis and treatment of tuberculosis. We assessed smokeless tobacco use among former patients of tuberculosis in Karnataka, India. Methods. We conducted a community-based, crosssectional study among 202 men, who had been diagnosed and treated for tuberculosis (mean age 48 years), selected by multistage, random sampling. Using a semi-structured interview schedule, retrospective smoking and smokeless tobacco use were captured at eight time-points before and after the diagnosis and treatment of tuberculosis. Results. Most patients suspended tobacco use during treatment. A high 44% prevalence of smokeless tobacco use 6 months before diagnosis was reduced to just 8% during the intensive phase of treatment and climbed to 27% 6 months after treatment. The tobacco use relapse rate 6 months after completion of treatment was higher for smokeless tobacco use (52%, 95% CI 41%–62%) than for smoking (36%, 95% CI 26%–45%). We also found that many patients who were advised to quit smoking continued using smokeless tobacco after completion of treatment. Additionally, new smokeless tobacco use was documented. Of the 11 new exclusive smokeless tobacco users, 10 shifted from smoking to smokeless tobacco use as a form of harm reduction. Conclusion. Patients with tuberculosis are advised by their doctors, at the time of diagnosis, to quit smoking. Several patients shift from smoking to smokeless tobacco use, which needs to be addressed while providing tobacco cessation services.

Prevalence of depression among adolescents.

OBJECTIVE: To find out the prevalence and pattern of depression among adolescents. METHODS: Adolescents of age group from 13 to 19 belonging to school/college students and school dropouts were assessed using Beck's Depression Inventory (BDI) by a team consisting of a pediatrician, psychologist and PGDCCD (Post Graduate Diploma in Clinical Child Development) students. RESULTS: 11.2% of school dropouts had severe and extreme grades of depression as against 3% among school going and nil among college going adolescents.

Scholastic performance of adolescents.

OBJECTIVE: To find out the factors affecting scholastic performance of adolescents belonging to various groups and the determinants for poor scholastic performance. METHODS: 1892 adolescents of 13 to 19 years age group belonging to different category of schools were interviewed and assessed by a team consisting of pediatrician, psychologist and PG-DCCD* students using Teenage Screening Questionnaire--Trivandrum and Study Habit Rating Scale. Daily study pattern, Family environment, Education status of parents, Personal distractions, and Attitude towards studies were observed as factors affecting scholastic performance. RESULT: On multivariate analysis the predictor variables for poor scholastic performance were; lower studying daily lessons, poor concentration in studies, lower education status of father and unhappy family. CONCLUSION: It is feasible to identify determinants of scholstic performance and plan intervention strategies at school level.