Uraga/Sarpa/Bhujaga grahonmada (UG) is one among the 18 types of bhootonmada. Bhootonmada denotes a category of psychiatric/neuropsychiatric conditions assumed to be caused by affliction of evil spirits (bhuta/graha). Till date, no studies have been conducted on UG and it is unexplored. The present study is focused on the better understanding of UG and its clinical applicability. UG is characterized by features of Krodhanam (aggressiveness/impulsivity), Nishwasantam (hyperventilation/anxiety/phobia), Bhramantam (agitation/restlessness/hyperactivity), Trasyantam (startle response/hyperekplexia/anxiety/phobia), Raktaaksha (red eyes/Kayser–Fleischer rings), Stabdha drishtim (prolonged staring/abnormal eye movements), Jihwa lolayantam/Srikkinyau lihaan (facial tics), Sarpavat prasarati/Adhomukha shaayinam (athetosis/chorea/motor tics/opisthotonus), Chalam/Vakra gamanam (gait abnormalities), Ksheera, ghrita, guda, and madhu priyam (craving for sweets), Snaana maalya priyam (obsessive-compulsive features), Gaatraani kampayantam (tremors/motor tics/seizures), Dantai khaadantam (self-injurious behaviors/oromandibular dystonia/bruxism), Nidraalu (hypersomnia/excessive daytime sleepiness), etc.. The clinical picture of UG shows similarity with various “extrapyramidal movement disorders” and also with “Tourette syndrome-plus.”

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Hypertension (HTN) has become a common chronic medical condition which affects ≥20% of adult population worldwide. HTN is assumed to be a major contributing factor for increasing complication of metabolic syndrome by adding one or more comorbidities such as heart disease, stroke, chronic renal failure, myocardial infarction, blindness, and dementia. HTN is also considered as a lifestyle disorder, and there are mainly two types of HTN, namely primary and secondary. Primary HTN is about 90%–95% of all cases of HTN and it is defined as high blood pressure due to genetic factors and nonspecific lifestyle, while secondary HTN is due to an identifiable cause such as Cushing's syndrome, obesity, and glucose intolerance. However, the exact cause and pathophysiology of HTN is still not clear. On the other hand, human body acts as a host and around 100 trillion bacteria are present in the body which is 10 times more than the number of cells in the human body. Many studies have published the role of microbiome in health and disease. Recent findings have shed light on the important role of microbiota in HTN and its treatment with probiotics (beneficial microbiota to host). Considering this, here, we have summarized and focused on possible interplays between the HTN microbiota, pharmacotherapeutic use of probiotics in HTN, and prospects to increase the degree of therapeutic personalization.

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Pulmonary blastoma (PB) is a very rare primary lung neoplasm. Morphologically, they mimic fetal lung tissue before 4 months gestation. As monophasic variety is extremely rare, we have reported here a case of monophasic PB in a young adult patient who came with cough and hemoptysis for 4 months. On computed tomography scan of the chest, findings showed left upper lobe mass with few specks of calcification within the lesion. The patient underwent left upper lobectomy. The diagnosis was confirmed through histopathological examination with immunohistochemical evaluation. Because of its extreme rarity, we report this case with special interest to help and improve in faster diagnosis and management of the patients diagnosed with PB in future.

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BACKGROUND: Vitamin B12 (B12) deficiency, by virtue of causing hyperhomocysteinemia (HHC), may be implicated as an acquired risk factor of ischemic stroke (IS), which is also easily modifiable. There is a scarcity of data from India regarding the prevalence of B12 deficiency in IS patients. OBJECTIVES: The objective of this study is to explore the relationship between B12 and folate deficiency, HHC, and IS. DESIGN: The study was a case–control study. MATERIALS AND METHODS: Eighty cases of IS were compared with equal number of age- and sex-matched controls. Plasma total homocysteine (tHcy) level, serum B12, and folate levels were analyzed as continuous data (Student's t-test) as well as categorical data (Chi-square test). Odds ratio (OR) for the occurrence of IS was calculated for each variable. Correlation of tHcy with serum B12 and folate was studied using Pearson's coefficient. RESULTS: Mean homocysteine was higher in cases compared to controls (20.49 ± 12.64 vs. 13.09 ± 6.96 μmol/L, P < 0.001, while B12 (282.46 ± 161.52 vs. 480 ± 248.92 pg/ml, P < 0.001) and folate (10.49 ± 6.86 vs. 17.00 ± 5.52 ng/ml, P < 0.001) were lower. Both HHC (OR 4.48, 95% confidence interval: 1.99–10.07, P + 0.0003) and B12 deficiency emerged as significant risk factors for occurrence of IS. Negative correlation of homocysteine with B12 (r = 0.457, P < 0.0001) and folate (r = 0.337, P = 0.0001) was observed. CONCLUSIONS: HHC appears to be an important risk factor for IS in Indian population. B12 deficiency is a major acquired cause for the same while folate deficiency is relatively rare.

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OBJECTIVE: The objective is to assess the level of knowledge and practices regarding birth preparedness and complication readiness (BP and CR) among pregnant women. MATERIALS AND METHODS: The study was carried out in 2400-bedded tertiary care teaching hospital, Belagavi, over a period of 3 months from September to November 2017. A total of 384 pregnant women attending the antenatal clinic at the tertiary care teaching hospital were included in the study by purposive sampling. A descriptive approach was adopted, including collection of information from the pregnant women through a pretested and structured interview questionnaire and the data were analyzed using descriptive and inferential statistics. RESULTS: In this study among 384 pregnant women, there were 233 (60.7%) of respondents primigravida, nearly half of the pregnant women, i.e., 191 (49.7%) were between the age of 15 and 20 years, the majority of the women, i.e., 272 (70.8%) had visited the antenatal clinic around 5–10 times. Two hundred and forty-five (63.8%) of the respondents had their secondary education, the majority of women 278 (72.4%) belonged to rural area. In the level of knowledge about BP and CR, majority of the respondents, i.e., 296 (77.1%) had moderate level of knowledge and 66 (17.2%) women had poor level of knowledge and only 22 of the women (5.7%) had good level of knowledge. In the level of practice about BP and CR, there were 291 (75.8%) had a thorough awareness about the practices and <25%, i.e., 93 of the respondents (24.2%) had moderate level of knowledge regarding the practice. CONCLUSION: The present study concluded that three-fourth pregnant women attending antenatal clinic in a tertiary care teaching hospital had average knowledge regarding BP and CR was found to be average (77.1%), whereas in practice, three-fourth of them had good practice (75.8%). Hence, there is a need to retrain health-care workers about BP and CR to educate women in early pregnancy.

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INTRODUCTION: Laryngoscopy and intubation lead to mechanical and chemical stimuli, resulting in hypertension and tachycardia. The pneumoperitineum and CO₂ insufflation with positional changes result in significant hemodynamic and respiratory changes. These sudden changes may lead to myocardial ischemia, pulmonary edema, and cerebral hemorrhage. Many modalities such as propofol infusion, beta-blocker, high-dose opioid, benzodiazepine, and vasodilators have been tried to obtund these changes. Dexmedetomidine is highly selective alpha-2 agonist, has been effective in attenuating sympathomimetic response during laryngoscopy, intubation as well as during laparoscopic surgeries. OBJECTIVE: In a randomized, prospective, double-blind, control study, we evaluate the safety and efficacy of single bolus intravenous dose followed by infusion of dexmedetomidine as compared to control group of normal saline in attenuating response to laryngoscopy, intubation, and pneumoperitoneum in laparoscopic surgeries. MATERIALS AND METHODS: A total of 60 patients of either sex aged 18–65 years scheduled for elective laparoscopic surgeries were randomly allocated in one of the two groups of thirty patients each. Group D received injection dexmedetomidine with loading dose 1 mcg/kg before induction over 10 min followed by maintenance dose of 0.2 mcg/kg/h. Group S serve as control group received normal saline in the same dose. RESULTS: It was observed that heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were significantly less after intubation and throughout the period of pneumoperitoneum. CONCLUSION: Dexmedetomidine is efficacious in attenuating the hemodynamic response to laryngoscopy, intubation, and pneumoperitoneum.

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BACKGROUND: Sugar-sweetened beverages (SSBs) are commonly used. The objective of this study was to analyze the quantity and quality of published literature on SSBs and present the results in a bibliometric format. METHODOLOGY: Scopus database was used to retrieve documents from 2000 to 2015. Annual growth of publications, collaborations, geographic distribution, visualization and mapping of collaboration, author analysis, and top-cited articles will be presented and discussed. RESULTS: The total number of worldwide publications on SSBs was 3345, published in 27 subject areas. More than half (58.30%) of the SSB publications were within the area of medicine. The number of publications gradually increased until 2013 followed by a steady state. The median of number of citations was 3 (0–14) per document. The annual growth rate of publications on SSBs dropped from 15.22 in 2001 to 1.00 in 2016. The total number of authors was 13,813, with a mean of 3.72 ± 0.72 authors per document. Most documents (2942, 87.95%) were multi-authored publications. The USA was the most productive country (1062; 31.75%) followed by the United Kingdom (234; 7%) and Brazil (171, 5.11%). Harvard University was the leading institution with 112 publications. The most commonly preferred journal for publishing was “Public Health Nutrition” with 81 publications. Half of the top ten preferred journals were in the field of nutrition. CONCLUSION: Bibliometric analysis of literature on SSBs is one method to enrich literature and encourage health policymakers and nutrition specialists to take the case of SSBs one step further to limit the consumption of SSBs.

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CONTEXT AND AIM: AIDS is an acronym for acquired immunodeficiency syndrome caused by a retrovirus known as human immunodeficiency virus (HIV) which breaks down the body's immune system, leaving the patient vulnerable to a host of life-threatening opportunistic infections, neurological disorders, or unusual malignancies. According to estimates by the WHO and UNAIDS, 35 million people were living with HIV globally at the end of the year 2013. The first AIDS case in India was detected in the year 1986. Seldom studies have been conducted correlating CD4 cell counts and complete blood picture including platelet counts in HIV infected and AIDS patients in the Indian population. The present study was carried-out with the same intent to evaluate the CD4 cell counts and complete blood picture in the HIV infected and AIDS patients and correlate them with the sero-negative controls. MATERIALS AND METHODS: The present study was a cross-sectional, hospital-based study on patients that were divided into three groups: Group A consisting of 500 patients who were healthy controls without any systemic illness, Group B consisting of 500 patients who were diagnosed as HIV infected, and Group C consisting of 500 patients diagnosed as AIDS patients depending on their CD4 cell counts. Evaluation of complete blood picture was done using Sysmex XP 100, a fully automated analyzer, while CD4 cell counts were evaluated using Partec Cyflow Cell Counter. STATISTICAL ANALYSIS USED: The data was analyzed using SPSS version 15.0 (SPSS Inc., Chicago, IL, USA). Comparison of the said parameters was done using Analysis of Variance (ANOVA) and post-hoc Games-Howell test. P-value of <0.05 was considered statistically significant. RESULTS: The results were found to be statistically significant with P < 0.001 for hemoglobin (Hb), white blood cell (WBC) counts, and platelet counts in the HIV-infected and AIDS patients when compared with the seronegative controls. CONCLUSION: Hb, WBC counts, and platelet counts were significantly altered in the HIV-infected and AIDS patients when compared with the seronegative controls.

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AIMS AND OBJECTIVES: The aims and objectives of this study is to assess the role of fundus fluorescein angiography (FFA) in classification and diagnosis of macular diseases. SETTING AND DESIGN: This was an 1-year hospital-based study conducted at KLES, Dr. Prabhakar Kore Hospital, Belagavi, Karnataka. METHODOLOGY: The present study was conducted in the Department of Ophthalmology, KLES, Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, on 66 participants from January 1^st, 2016 to December 31^st, 2016. METHODS: An 1-year hospital-based study was conducted on 66 patients who attended the outpatient department. A detailed history was obtained from all the patients and a thorough ocular and systemic examination were done. All the patients were examined by conventional methods of ophthalmoscopy (direct, indirect, and slit lamp examination with +90 D lens) followed by FFA. The clinical ophthalmoscopy and fluorescein angiography findings were analyzed and categorized. RESULTS: Sixty-six participants were analyzed and sub-divided into categories of age-related macular degeneration (ARMD), diabetic maculopathy, vascular occlusive disorders, Central Serous Chorioretinopathy (CSCR), inflammatory causes, macular dystrophy, and macular hole. FFA confirmed the diagnosis in 62% of the cases and altered the diagnosis in 38% of cases. It also classified the lesions in 64% of cases. CONCLUSION: FFA has played a major role in diagnosing wet ARMD. It was of immense value in diagnosis and classification of diabetic maculopathy cases. It is a superior diagnostic modality in differentiating macular edema from macular ischemia in vascular disorders. It provides definitive diagnosis in CSCR by detecting the exact site of leakage. It is of immense value in the diagnosis of macular edema in inflammatory diseases. FFA played an important role in the diagnosis of macular dystrophy and macular hole cases.

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OBJECTIVES: The aim of this study was to sonographically measure and compare the pronator quadratus muscle thickness (PQMT) in apparently healthy volunteers between two occupational groups and to assess the influence of hand dominance on the PQMT. METHODS: A total of 180 apparently healthy volunteers were enrolled in the study. The volunteers were grouped into repetitive (90) and nonrepetitive (90) workgroups. They were scanned with a B-mode ultrasound machine and linear transducer. RESULTS: The mean PQMT was significantly higher (P < 0.05) in the repetitive workgroup than in nonrepetitive workgroups. Similarly, a significant difference in mean PQMT was observed between dominant and nondominant hands in the repetitive workgroups (P < 0.05). CONCLUSION: The mean PQMT among repetitive workgroup is significantly higher when compared with nonrepetitive workgroups in the study area.

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BACKGROUND: Embryo transfer (ET) is a critical step in in vitro fertilization (IVF). Selecting the day of transfer for achieving the desired outcomes has been a great challenge. AIMS AND OBJECTIVES: The aim of this study was to compare the pregnancy rates of day 3 and day 5 ET in assisted conception. MATERIALS AND METHODS: This is a longitudinal prospective study of 122 eligible patients that underwent assisted reproduction program in our facility. All patients had controlled ovarian hyperstimulation using antagonist protocol. Patients with four or more zygotes were randomly allocated on day 1 to either day 3 or 5 transfers (58 vs. 64 patients). Fertilization was achieved through conventional IVF. Zygotes were kept in a single-step medium (Global total ^®) for day 3 and 5 transfers, respectively. The morphologically best two or three embryos or blastocysts were chosen for transfer in both groups. RESULTS: The overall clinical pregnancy and live birth rates for both groups were 40.2% and 33.6%. There was no statistically significant difference between day 3 and day 5 transfer regarding clinical pregnancy rates (36.2% vs. 43.8% [P = 0.51]), live birth rates (27.6% vs. 9.1% [P = 1.0]), twinning rates (18.8% vs. 20% [P = 1.0]), and rates of early pregnancy loss (8.6% versus 4.7% P = [0.2]). CONCLUSION: In this study, the clinical outcomes of blastocyst transfer are similar to day 3 ET. This underscores the need for patient selection for the choice of days of ET. Further controlled randomized prospective studies with larger sample sizes are recommended.

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BACKGROUND: Invasive infections from Staphylococcus aureus are increasingly being encountered in healthy children. Nasal colonization of S. aureus is associated with increased risk for acquiring invasive disease. The objective of this study was to determine the prevalence and risk factors for S. aureus nasal colonization among a healthy pediatric population and to determine antibiotic susceptibilities of the S. aureus isolates. MATERIALS AND METHODS: Using a cross-sectional study design, a total of 468 children of age group 5–16 years from 15 different schools of urban Belgaum (Belagavi) located under Ramnagar Urban Health Centre of KLE University's Jawaharlal Nehru Medical College, India, were screened for S. aureus colonization. Information on selected risk factors for nasal colonization of S. aureus was obtained through a questionnaire. Samples were obtained from the anterior nares and processed. S. aureus isolates were confirmed by growth on selective media and coagulase testing. Disc diffusion antibiotic susceptibility tests were performed according to the Clinical and Laboratory Standard Institute guidelines. RESULTS: Of the 468 children included in the study, S. aureus was isolated from the anterior nares in 142 (30.3%) children. S. aureus isolates exhibited resistance to multiple classes of antibiotics including co-trimoxazole resistance (19.7%), ciprofloxacin (47.9%), erythromycin resistance (33.1%), clindamycin resistance (4.9%), amoxiclav (1.4%), and linezolid (4.9%). CONCLUSION: Children in India have a high rate of nasal colonization of S. aureus. The high rate of resistance to many classes of antibiotics among S. aureus strains is of great concern warranting continued surveillance and antimicrobial stewardship.

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INTRODUCTION: There are innumerable things we use in our household on day-to-day basis. Many things that we use at home from cleaning products to cosmetics are toxic when we are not careful about them. OBJECTIVES: The study is carried out to assess and to compare the awareness and attitude of medical and nonmedical students toward household poisons and to bring awareness among the students and general public about household poisons. MATERIALS AND METHODS: A questionnaire containing 40 questions were given to the study category of students (300 students, 150 medical and 150 nonmedical), tabulated, and analyzed using SPSS 17. RESULTS: Eighty-five percent medical students and 34.7% nonmedical students are aware of the hazards caused by household poisons. Even though an awareness should be created to bring about further change in their attitude toward household poisons especially among the nonmedical students. CONCLUSION: In the present study, 84% medical students and 83% nonmedical students said that awareness about household poisons should be added in the academic curriculum. This will provide a pathway for health education to broaden a change of attitude toward household poisons.

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INTRODUCTION: Biofeedback therapy is essential for releasing the stress, gain awareness, and to control over psychophysiological processes. The current study deals with the impact of biofeedback therapy on drivers by comparing the performances of drivers on “Decision Time” (DT) test before and after the use of biofeedback therapy. METHODOLOGY: For this study, as a special case 40 drivers from special protection group were selected for administering the decision time (DT) from “Vienna Test System” before and after applying biofeedback therapy with respiratory training. RESULTS: The results of this study reveal the beneficial effects of biofeedback in reducing negative effects, thereby enhancing the behavioral performance of the drivers. CONCLUSIONS: Results obtained in this study recommend that biofeedback therapy training may be used as an adjunct to existing behavior modification and stress management programs of drivers adopted by the driver training institutes for enhancing driver's physical and psychological health.

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INTRODUCTION: Osteosarcoma is an aggressive primary bone malignancy characterized by osteoid formation. It typically affects long bones, rarely affecting the jaws. OS of the jaws accounts has an estimated incidence of 0.7 per million. Reports of gnathic osteosarcoma from sub-Saharan Africa are few and to the best of our knowledge there is none from Northwestern Nigeria. This study aims to present our experience with gnathic osteosarcoma in our center. MATERIALS AND METHODS: A review of the records of patients managed on account of histologically diagnosed gnathic osteosarcoma at the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, between March, 2010 and March, 2017 was done. Data were recorded and analyzed using IBM SPSS Statistics for Windows version 20 (Armonk, NY, USA: IBM Corp.). RESULTS: A total of 431 Oral and Maxillofacial lesions were biopsied during the study period, out of which 17 (3.9%) were histologically diagnosed as osteosarcoma. Majority of the patients presented with a chief complaint of jaw swelling 9 (52.9%). The most frequently encountered histological type was the osteoblastic type 9 (52.9%). High grade tumours constituted 10 (58.8%). The patients were followed up for varying periods and recurrences were observed in 3 cases. Five (29.4%) mortalities were recorded. CONCLUSION: Despite the rarity of gnathic osteosarcomas, they still pose a daunting challenge in Oral and Maxillofacial practice. Patients often present with complaints of facial swelling, bleeding or pain. Late presentation is common in our environment and multi-modal treatment plan is often preferable.

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Promotion is an academic reward system for university faculty. The word promotion these days comes with mixed feelings. With our rapidly escalating population and increase in the number of dental schools and availability of specialists, faculty positions are rapidly getting saturated. In the early days, career advancements and promotion were primarily based on time. According to the current promotion guidelines, career advancement depends on performance, namely, publications, research, participation in other administrative responsibilities, and clinical work. However, publications seem to have a greater impact on the decision to promote. The Dental Council of India has devised a point system to aid in decision to promote. Currently, we do not have a system of recruiting or promoting faculty under different tracks such as clinical teachers, researcher teachers, and tenure-track faculty as in American and British universities. All recruitments are for full-time jobs. The number of ranks is three, namely, lecturer, reader (equivalent to associate professor), and professor. There is a dire need for reforms in promotion policies. We need new policies to be framed so that teachers can engage in different aspects of scholarship defined by Boyer. This article looks at current deficiencies in promotion policy in dental schools in India and career advancement policies in American universities which can be used as a template for framing new guidelines in the Indian scenario.

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BACKGROUND: A cough is the major functional mechanism which is responsible for the clearance of secretions from the respiratory tract and serves as an important defense mechanism, and chest X-ray is the commonly indicated examination in this category of patients for possible diagnosis and treatment. AIMS: This study aimed at evaluating the spectrum of findings among patients presented with a chronic cough in the tropics. MATERIALS AND METHODS: A prospective study design was used to obtain data over a period of 3 months (March–May 2018). Adult patients aged 18 years and above who presented to the department with indication of chronic cough and plain posteroanterior chest radiographs with optimum diagnostic value were included in the study. All the radiographs were reported by a radiologist. The age, sex, coughing duration, lung changes, heart changes, and diagnosis were recorded. Data were analyzed using the SPSS software version 22.0. RESULTS: A total of fifty patients with a chronic cough were included in the study. The male-to-female ratio (M:F) was approximately 3:2. The mean age of the patients was 43.88 ± 19.24 years (range, 18–95 years). Forty-six (92.0%) patients were nonsmokers, while four (8%) were smokers. Radiographs of the twenty (40%) patients appeared normal, while thirty (60%) were abnormal, with lung opacities accounted for 34% and 26% for the right and left lungs, respectively. CONCLUSION: Chest X-ray in patients with a chronic cough nearly always causes detectable changes and lung opacity was the commonest lung change. These patterns corroborated with most studies that have been done.

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