Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial

Background@#In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. @*Methods@#A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. @*Results@#The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. @*Conclusions@#The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

Sunlight Exposure vs Oral Vitamin D Supplementation for Prevention of Vitamin D Deficiency in Infancy: ARandomized Controlled Trial

Objective: To compare the efficacy of sunlight exposure and oral vitamin D3 supplementation to achieve vitamin D sufficiency in infants at 6 months of age. Design: Open-label randomized controlled trial. Setting: Public hospital in Northern India (28.7°N). Participant: Breastfed infants at 6-8 weeks of age. Intervention: Randomized to receive sunlight exposure (40% body surface area for a minimum of 30 minutes/week) or oral vitamin D3 supplementation (400 IU/day) till 6 months of age. Outcome: Primary - proportion of infants having vitamin D sufficiency (>20 ng/mL). Secondary - proportion of infants developing vitamin D deficiency (<12ng/mL) and rickets in both the groups at 6 months of age. Results: Eighty (40 in each group) infants with mean (SD) age 47.8 (4.5) days were enrolled. The proportion of infants with vitamin D sufficiency increased after intervention in the vitamin D group from 10.8% to 35.1% (P=0.01) but remained the same in sunlight group (13.9%) and was significant on comparison between both groups (P=0.037). The mean (SD) compliance rate was 72.9 (3.4)% and 59.7 (23.6)% in the vitamin D and sunlight group, respectively (P=0.01). The geometric mean (95% CI) serum 25(OH) D levels in the vitamin D and sunlight group were 16.23 (13.58-19.40) and 11.89 (9.93-14.23) ng/mL, respectively; (P=0.02), after adjusting baseline serum 25(OH)D with a geometric mean ratio of 1.36 (1.06-1.76). Two infants in sunlight group developed rickets. Conclusion: Oral vitamin D3 supplementation is more efficacious than sunlight in achieving vitamin D sufficiency in breastfed infants during the first 6 months of life due to better compliance.

Esophageal varices presenting as lower GI bleed in an infant: a rare presentation

GI Bleeding is a common problem encountered in the emergency department and in the primary care settings. Lower GI Bleeding is relatively rare as compared to upper GI bleeding. Common causes of lower GI Bleeding are Polyp (32.5%), chronic nonspecific colitis (20.7%), lymphoid nodular hyperplasia (20%), Proctitis (18.2%), Solitary rectal ulcer (10%), Inflammatory bowel disease (6.5%).Among the various causes of lower GI Bleeding, esophageal varices is a rare cause. One such case presented to us with lower GI bleeding, on further evaluation was found to having esophageal varices due to portal hypertension. Child improved after conservative and definitive management.

Impact of Using Different Growth References on Interpretation of Anthropometric Parameters of Children Aged 8-15 Years

Objective: To compare the effect of the application of threegrowth references (Agarwal, 1992; Indian Academy ofPaediatrics (IAP), 2015; and World Health Organisation (WHO),2007) on interpretation of anthropometric parameters inschoolchildren.Setting: Cross-sectional school-based study.Participants: Children 8-15 years studying in one governmentschool and one private school of Delhi.Procedure: The age- and gender-specific standard deviationscores of height-for-age and BMI-for-age were estimated foreach student enrolled, using the three growth referencesindependently.Main outcome measure: The proportion of children withshort stature, thinness and overweight/ obesity determined byeach growth reference were compared.Results: A total of 1237 students participated in the study. Asignificantly higher proportion of children (both sexes) wereclassified to have short stature using WHO 2007 reference(8.8%) as compared to the Agarwal (3.3%) charts and IAP, 2015references (3.6%). The combined prevalence of overweight andobesity was highest (34.8%) by the IAP, 2015 reference asagainst 32% by Agarwal charts and 29.1% by WHO, 2007reference. Good agreement existed between the IAP, 2015reference and Agarwal charts in classifying subjects intodifferent BMI categories (Kappa=0.82) and short stature(Kappa=0.99).Conclusions: In view of differences noted, use of nationalpopulation derived reference data is suggested to correctlydefine growth trajectories in children.

Concurrent chemoradiation in head and neck cancers with weekly cisplatin: analysing toxicities

Background: Head and neck cancers constitute 6% of cancers worldwide. The management requires a multidisciplinary approach. Concomitant chemoradiotherapy with cisplatin is the standard approach for locally advanced head and neck cancers. The most commonly used regime uses three weekly cisplatin which is more toxic. Low-dose once-a-week cisplatin is substituted because of perceived lower toxicity and convenience.  Methods: Squamous cell carcinoma of stage III, IVA and IVB of oropharynx, hypopharynx and larynx were studied for one year. 82 patients were studied. Total dose of radiation was 66Gy/33#/6 ½ weeks from Monday to Friday with inj. Cisplatin 40mg/m2 i.v. infusion weekly.Results: 88% of patients were able to complete five or more weekly chemotherapy cycles with cumulative dose of 200mg/m2. Grade 2 and 3 acute toxicities were seen in weekly cisplatin arm but were conservatively managed.Conclusions: Weekly cisplatin can be used with concurrent radiotherapy as the acute toxicities are manageable and is well tolerated.

Seasonal Variation in Serum 25-hydroxy Vitamin D and its Association with Clinical Morbidity in Healthy Infants from Northern India

Objective: To evaluate the seasonal change in serum 25-hydroxyvitamin D (25-OHD) level inhealthy infants and to relate it to common childhood morbidities. Methods: 72 healthybreastfed infants residing in Delhi were enrolled at the end of summer and followed till the endof winter [mean (SD) duration 200 (10) d]. Serum 25-OHD was estimated at baseline andfollow-up. Infants were monitored for common childhood diseases. Results: Mean (SD)serum 25-OHD level was lower at the end of winter (20.7 (8.02) ng/mL) than summer (22.9(8.70) ng/mL) [mean difference (95% CI) –2.14 ng/mL (–3.36, –1.06), P<0.001). Theseasonal distribution of children according to vitamin D status in summer and winter -Deficient(15.3%, 12.5%), Insufficient (19.4%, 30.6%) and Sufficient(65.3%, 56.9%),respectively was comparable P=0.17). The morbidity profile remained unaffected by changein vitamin D status from summer to winter. Conclusions: Seasonal changes in vitamin Dlevels do not have significant clinical effect or effect on overall vitamin D status in apparentlyhealthy infants from North India. This may have implications for results of population surveysfor vitamin D status, irrespective of the season when they are conducted.

Evaluation of the analgesic activity of the water soluble extract of stem of Tinospora cordifolia in experimentally induced pain in albino rats

Background: Pain and pyrexia are the warning signals, primarily protective in nature, that cause discomfort and suffering and may even be unbearable and incapacitating. The modern drugs (like opioids, NSAIDs, corticosteroids) currently used for the management of pain, fever and inflammatory conditions, present with many known adverse effects. Tinospora cordifolia known as Giloe, widely used in folk medicine due to its property to cure a number of diseases. Hence the present study was undertaken to explore the analgesic activity of water-soluble extract of stem of T. cordifolia in albino rats in experimentally induced pain.Methods: Present study was done in the department of pharmacology, albino rats were used to study the analgesic activity of T. cordifolia aqueous extract at the dose of 1.25g/kg,2.5g/kg and 5g/kg p.o. Various methods like Eddy’s hot plate, tail flick test and acetic acid induced writhing were used for the anti- nociceptive study.Results: In Eddy’s hot plate and tail flick test an increase in reaction time was observed with peak effect at 90min. Results were similar to the standard drug Tramadol in acetic acid induced writhing increase in time of onset, decrease in number and duration of writhing was observed.Conclusions: Aqueous extract of T. cordifolia was effective in all the three models of pain suggesting its possible action by central and peripheral mechanisms. Activity of T. cordifolia can be attributed to various phytoconstituents viz. protoberberine alkaloids, terpenoids, glycosides and polysaccharides. It can be developed as potent analgesic agent in future.

Four percent formalin application for the management of radiation proctitis in carcinoma cervix patients: An effective, safe, and economical practice

Context: Radiotherapy is a very effective treatment modality for pelvic malignancies such as carcinoma of the cervix. However, it is quite common for chronic radiation proctitis (CRP) to manifest after radical radiotherapy. CRP is a source of significant morbidity, and there is a lack of effective treatment modalities. There also exists a general lack of guidelines on management of CRP. Aims: To assess the benefit from 4% formalin application for the treatment of Grade >2 CRP among patients previously treated with radical radiotherapy for cervical carcinoma. Settings and Design: This retrospective descriptive study involved 29 eligible patients who were treated from November 2010 - November 2015 for CRP with 4% formalin application. Materials and Methods: Of the 1864 patients of carcinoma cervix treated during the said patients, 29 patients fulfilled the eligibility criteria. Eligible patients were invited telephonically for follow-up and were assessed for response and complications of the procedure. Results: The treatment of hemorrhagic radiation proctitis with local formalin instillation is effective, well tolerated and safe procedure. The procedure is inexpensive, technically simple and can be done on an outpatient basis. 62% patients had complete freedom from rectal bleed, while 34.5% patients had partial benefit. Only one patient required diversion colostomy for persistent bleeding.

Intraperitoneal nebulization versus intraperitoneal instillation of ropivacaine for postoperative pain management following laparoscopic donor nephrectomy / 대한마취과학회지

BACKGROUND: Laparoscopic donor nephrectomy is considered less painful than open nephrectomy but is still associated with significant postoperative pain. Studies reported that intraperitoneal instillation of local anesthetics provides uncertain pain relief after laparoscopic surgery. This randomized, double-blind study evaluated the effect of intraperitoneal nebulization of ropivacaine on postoperative pain relief after laparoscopic donor nephrectomy. METHODS: Sixty patients undergoing elective laparoscopic donor nephrectomy were randomly assigned to receive either an instillation of 20 ml 0.5% ropivacaine after the induction of pneumoperitoneum or nebulization of 5 ml 1% ropivacaine before and after surgery. The primary outcome was the degree of pain relief (static and dynamic) after surgery. The secondary outcomes were postoperative fentanyl consumption, incidence of shoulder pain, unassisted walking and postoperative nausea and vomiting (PONV). Data were collected in the postanesthesia care unit (PACU) and at 6, 24, and 48 h after surgery. RESULTS: Compared to patients in the instillation group, those in the nebulization group showed significant reductions in postoperative pain and fentanyl consumption, and none complained of significant shoulder pain (visual analog scale score ≥ 30 mm). Within 20 h of surgery, 13.3% of patients in the instillation group and 93.3% in the nebulization group started unassisted walking (absolute risk reduction, 38%; P = 0.001). In the nebulization group, PONV was significantly reduced in the PACU and at 6 h. CONCLUSIONS: Intraperitoneal nebulization of ropivacaine reduced postoperative pain, fentanyl consumption, referred shoulder pain, and PONV while enabling earlier mobility without any difference in the length of hospital stay.

Intraperitoneal nebulization versus intraperitoneal instillation of ropivacaine for postoperative pain management following laparoscopic donor nephrectomy / 대한마취과학회지

BACKGROUND@#Laparoscopic donor nephrectomy is considered less painful than open nephrectomy but is still associated with significant postoperative pain. Studies reported that intraperitoneal instillation of local anesthetics provides uncertain pain relief after laparoscopic surgery. This randomized, double-blind study evaluated the effect of intraperitoneal nebulization of ropivacaine on postoperative pain relief after laparoscopic donor nephrectomy.@*METHODS@#Sixty patients undergoing elective laparoscopic donor nephrectomy were randomly assigned to receive either an instillation of 20 ml 0.5% ropivacaine after the induction of pneumoperitoneum or nebulization of 5 ml 1% ropivacaine before and after surgery. The primary outcome was the degree of pain relief (static and dynamic) after surgery. The secondary outcomes were postoperative fentanyl consumption, incidence of shoulder pain, unassisted walking and postoperative nausea and vomiting (PONV). Data were collected in the postanesthesia care unit (PACU) and at 6, 24, and 48 h after surgery.@*RESULTS@#Compared to patients in the instillation group, those in the nebulization group showed significant reductions in postoperative pain and fentanyl consumption, and none complained of significant shoulder pain (visual analog scale score ≥ 30 mm). Within 20 h of surgery, 13.3% of patients in the instillation group and 93.3% in the nebulization group started unassisted walking (absolute risk reduction, 38%; P = 0.001). In the nebulization group, PONV was significantly reduced in the PACU and at 6 h.@*CONCLUSIONS@#Intraperitoneal nebulization of ropivacaine reduced postoperative pain, fentanyl consumption, referred shoulder pain, and PONV while enabling earlier mobility without any difference in the length of hospital stay.

A Comprehensive Review On Adulteration Of Raw Materials Used In Asu Drug Manufacturing

Ayurveda is a system of Indian traditional form of alternative medicine. In 20th and 21th century due to side effects of synthetic drugs, there is an increasing interesting ASU medicine. At present the adulteration of the herbal drugs is the burning problem in ASU herbal industry and it has caused a major problem in the research on commercial natural products. The deforestation and extinction of many species and incorrect identification of many plants has resulted in adulteration and substitution of raw drugs. The future development of analysis of herbs is largely depended upon reliable methodologies for correct identification, standardization and quality assurance of Ayurvedic drugs. In India normally the contamination/adulteration in food/crude drugs is done either for financial gain or due to carelessness and lack in proper hygienic condition of processing, storing, transportation and marketing. Medicinal plants constitute an effective source of traditional and modern medicine. Adulteration is considered as an intentional addition of foreign substances to increase the weight of the product or to decrease its cost. It may be due to- Confusion in vernacular names, Lack of knowledge about authentic plants, Non availability, Similarity in morphology, activity, aroma, Careless collection and other unknown reasons. This article throws a light on adulteration, types, common market adulterants in ASU medicines and prescribed Prevention methods.

Heerfordt's syndrome presenting with recurrent facial nerve palsy, case report and 10-year literature review

Heerfordt's syndrome is defined as a combination of facial palsy, parotid swelling, uveitis and fever in sarcoidosis cases. Heerfordt's syndrome as a cause of facial palsy is very rare. We report a case of alternating facial nerve palsy in a 52-year-old female initially treated for Bell's palsy. The patient was referred to the All India Institute of Medical Sciences, Bhubaneswar, India, in January 2013 for clinical evaluation. She was found to have a parotid swelling and anterior intermediate uveitis. A pathoradiological evaluation suggested sarcoidosis and a final diagnosis of Heerfordt's syndrome was made. Steroid treatment was initiated which led to an improvement in the facial palsy and uveitis as well as the disappearance of the parotid swelling with a corresponding decrease in angiotensin-converting enzyme levels. An English literature review was carried out to analyse the varied presentation of this syndrome. The analysis focused on presenting symptoms, biochemical markers and radiological findings of Heerfordt's syndrome cases

Topical amiloride delays healing of deep thermal wounds in albino rabbits.

The present investigation was undertaken to explore the ulcer healing properties of three dosage schedules of different strengths of topically administered amiloride solution in thermally produced skin ulcers on the side of the midline on the back of the rabbits. Four circular thermal burns about 4.0 cm in diameter (two on either side of the midline) were made 4.0 cm apart on the pre shaved back of each anaesthetized (with thiopentone sod., 45 mg/kg, ip) rabbit with a heated template, applied for 30 sec. Three days later under anaesthesia, the burns were excised removing epidermis, dermis and subcutaneous tissue. The animals were randomly divided into various groups. Ulcers on one side of the midline were treated with normal saline and served as control, whereas those on the other side were treated with amiloride solutions. Each ulcer was observed for its size, slough formation and any sign of irritation on alternate days until healing was complete. Healing of ulcers were significantly delay in comparison to control group with all the strength of amiloride (0.02%, 0.5% and 1%) in all the dosage schedule (o.d., b.i.d. and q.i.d.) in terms of days required for complete healing (except with b.i.d. dosage schedule of 0.5% &q.i.d. dosage schedule of 1% amiloride solution), ulcer size and area under the size time curve (except with b.i.d. &q.i.d. dosage schedule of 1% amiloride solution). Thus, it is concluded that unlike mechanical ulcers topical amiloride delays wound repair in deep burn lesions.

Topical amiloride delays healing of deep thermal wounds in albino rabbits.

The present investigation was undertaken to explore the ulcer healing properties of three dosage schedules of different strengths of topically administered amiloride solution in thermally produced skin ulcers on the side of the midline on the back of the rabbits. Four circular thermal burns about 4.0 cm in diameter (two on either side of the midline) were made 4.0 cm apart on the pre shaved back of each anaesthetized (with thiopentone sod., 45 mg/kg, ip) rabbit with a heated template, applied for 30 sec. Three days later under anaesthesia, the burns were excised removing epidermis, dermis and subcutaneous tissue. The animals were randomly divided into various groups. Ulcers on one side of the midline were treated with normal saline and served as control, whereas those on the other side were treated with amiloride solutions. Each ulcer was observed for its size, slough formation and any sign of irritation on alternate days until healing was complete. Healing of ulcers were significantly delay in comparison to control group with all the strength of amiloride (0.02%, 0.5% and 1%) in all the dosage schedule (o.d., b.i.d. and q.i.d.) in terms of days required for complete healing (except with b.i.d. dosage schedule of 0.5% &q.i.d. dosage schedule of 1% amiloride solution), ulcer size and area under the size time curve (except with b.i.d. &q.i.d. dosage schedule of 1% amiloride solution). Thus, it is concluded that unlike mechanical ulcers topical amiloride delays wound repair in deep burn lesions.

Methylenetetrahydrofolate reductase C677T variant in Indian children with craniosynostosis: Its role in the pathogenesis, risk of craniosynostosis.

BACKGROUND : 677C to T allele in the 5, 10‑methylenetetrahydrofolate reductase (MTHFR) gene has been implicated in the etiology of various syndromes and nonsyndromic diseases but till date no direct studies have been reported with craniosynostosis. OBJECTIVES: The aim was to study the family‑based association of MTHFR polymorphism in different categories of craniosynostosis patients. MATERIALS AND METHODS: This was a cross‑sectional study in which 30 patients classified as Apert syndrome, Pfeiffr syndrome and nonsyndromic craniosynostosis patients with their family were recruited. A sample of 3 ml intravenous blood was taken from patients and from their family members (father and mother) in ethylenediaminetetraacetic acid‑anticoagulated vacutainer for the purpose of the study. Genomic DNA was extracted from peripheral blood lymphocytes by phenol chloroform extraction method. Primers for MTHFR gene were designed. The polymerase chain reaction was carried out. After successful amplification, a small aliquot (5 µl) of the MTHFR reaction mixture was treated with 1 units of Hinf I restriction enzyme (NEB). Results were obtained and compiled. RESULTS: A total of 30 patients/participants with craniosynostosis of Indian descent and their parents formed the study group. The genotyping did not confirm an association between the MTHFR 677C to T polymorphism and between different categories of craniosynostosis. When comparing the offspring of mothers statistically significant differences were found. CONCLUSION: C667T polymorphism of the MTHFR gene is unlikely to play a role in the pathogenesis of craniosynostosis though maternal MTHFR C677T polymorphism may be a genetic risk factor.

300,000 IU or 600,000 IU of Oral Vitamin D3 for Treatment of Nutritional Rickets: A Randomized Controlled Trial.

Objective: To evaluate the non-inferiority of a lower therapeutic dose (300,000 IU) in comparison to standard dose (600,000) IU of Vitamin D for increasing serum 25(OH) D levels and achieving radiological recovery in nutritional rickets. Design: Randomized, open-labeled, controlled trial. Setting: Tertiary care hospital. Participants: 76 children (median age 12 mo) with clinical and radiologically confirmed rickets. Intervention: Oral vitamin D3 as 300,000 IU (Group 1; n=38) or 600,000 IU (Group 2; n=38) in a single day. Outcome variables: Primary: Serum 25(OH)D, 12 weeks after administration of vitamin D3; Secondary: Radiological healing and serum parathormone at 12 weeks; and clinical and biochemical adverse effects. Results: Serum 25(OH)D levels [geometric mean (95% CI)] increased significantly from baseline to 12 weeks after therapy in both the groups [Group 1: 7.58 (5.50–10.44) to 16.06 (12.71– 20.29) ng/mL, P<0.001]; Group 2: 6.57 (4.66–9.25) to 17.60 (13.71–22.60, P<0.001]. The adjusted ratio of geometric mean serum 25(OH)D levels at 12 weeks between the groups (taking baseline value as co-variate) was 0.91 (95% CI: 0.65–1.29). Radiological healing occurred in all children by 12 weeks. Both groups demonstrated significant (P<0.05) and comparable fall in the serum parathormone and alkaline phosphatase levels at 12 weeks. Relative change [ratio of geometric mean (95% CI)] in serum PTH and alkaline phosphatase, 12 weeks after therapy, were 0.98 (0.7–1.47) and 0.92 (0.72–1.19), respectively. The serum 25(OH)D levels were deficient (<20 ng/mL) in 63% (38/60) children after 12 weeks of intervention [Group 1: 20/32 (62.5%); Group 2: 18/28 (64.3%)]. No major clinical adverse effects were noticed in any of the children. Hypercalcemia was documented in 2 children at 4 weeks (1 in each Group) and 3 children at 12 weeks (1 in Group 1 and 2 in Group 2). None of the participants had hypercalciuria or hypervitaminosis D. Conclusion: A dose of 300,000 IU of vitamin D3 is comparable to 600,000 IU, administered orally, over a single day, for treating rickets in under-five children although there is an unacceptably high risk of hypercalcemia in both groups. None of the regime is effective in normalization of vitamin D status in majority of patients, 3 months after administering the therapeutic dose.

Isolated metastatic papillary thyroid carcinoma masquerading as parapharyngeal space paraganglioma

Isolated metastatic deposits of papillary thyroid carcinoma to the parapharyngeal space are rare. Herein, we describe the case of a young woman who presented with a right-sided oropharyngeal mass that was initially diagnosed as a parapharyngeal space paraganglioma. The patient opted for conservative treatment as she was asymptomatic and wished to avoid the risk of neurovascular morbidity associated with surgery. After 20 years, the patient sought treatment again for the oropharyngeal mass, which had progressively increased in size and was causing difficulty in swallowing. Repeat imaging of the affected area revealed that the mass had increased significantly in size; it also revealed the presence of a previously absent small lesion in the right lobe of the thyroid. Excision of the parapharyngeal space tumour and near-total thyroidectomy were performed; the excised specimens showed features of the follicular variant of papillary thyroid carcinoma. As papillary thyroid carcinoma that metastasises to the parapharyngeal space can masquerade as a paraganglioma, clinicians should bear in mind that an isolated metastatic deposit in the parapharyngeal space could be the first sign of occult papillary thyroid carcinoma.

Nephrogenic epistaxis

Metastatic renal cell carcinoma (RCC) in the nose and paranasal sinuses is very rare. We report an unusual case of metastatic RCC that presented as recurrent epistaxis ten years after curative nephrectomy. The purpose of this report is to draw the attention of clinicians to the possibility of metastatic RCC in patients with recurrent epistaxis and nasal mass. We also discuss treatment options and review the relevant literature.

Mutational identification of fibroblast growth factor receptor 1 and fibroblast growth factor receptor 2 genes in craniosynostosis in Indian population.

OBJECTIVE: The Objective of this study was to identify the association of mutation of fibroblast growth factor receptor 1 (FGFR1), FGFR2 genes with syndromic as well as non‑syndromic craniosynostosis in Indian population. MATERIALS AND METHODS: Retrospective analysis of our records from January 2008 to December 2012 was done. A total of 41 cases satisfying the inclusion criteria and 51 controls were taken for the study. A total volume of 3 ml blood from the patient as well as parents was taken. Deoxyribonucleic acid extracted using phenol chloroform extraction method followed by polymerase chain reaction‑restriction fragment length polymorphism method. RESULTS: There were 33 (80.4%) non‑syndromic cases of craniosynostosis while 8 (19.5%) were syndromic. Out of these 8 syndromic cases, 4 were Apert syndrome, 3 were Crouzon syndrome and 1 Pfeiffer syndrome. Phenotypically the most common non‑syndromic craniosynostosis was scaphocephaly (19, 57.7%) followed by plagiocephaly in (14, 42.3%). FGFR1 mutation (Pro252Arg) was seen in 1 (2.4%) case of non‑syndromic craniosynostosis while no association was noted either with FGFR1 or with FGFR2 mutation in syndromic cases. None of the control group showed any mutation. CONCLUSION: Our study proposed that FGFR1, FGFR2 mutation, which confers predisposition to craniosynostosis does not exist in Indian population when compared to the western world.