The predictable success of dental implants has revolutionised dentistry in many ways. Clinicians are becoming more vigilant in planning teeth extraction than ever before. This has led to the routine use of the concept of the socket preservation after tooth extraction and before the placement of dental implant. This routine use of collagen membrane use for socket preservation has uncovered a new situation of the exposed collagen membrane left intentionally or unintentionally which has to be dealt with frequently. The management of such exposed collagen membrane becomes vital for the success of socket seal surgery. This case report emphasises on the management of exposed collagen membrane after socket seal surgery and before placement of dental implant.

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Autism spectrum disorder (ASD) may affect all spheres of a child's life. Indeed, parents and siblings also live with emotional instabilities in the family. The experience of parents with ASD child can be distressing since they need to make more adjustments to the demanding need to cope with their life situations. Perhaps, their life is drastically exaggerated with their complexities of life. Particularly, their social life is radically affected. The presence of pervasive and severe deficits in children with ASD isolates these parents from their social life; demanding adjustments to their social environment of parents in their life situations shove them into distress and unstable emotions. Finally, they culminate being shattered in their interpersonal relationship, their family and social life. Indeed, these aspects of distress mask social intelligence of these parents, thus narrow down their focus more on the treatment rather than holistic management of their child. Thus, the management of ASD with these parents of the deficit children to reach their fullest abilities remains doubtful. Therefore, the objectives of this study are as follows: (a) to examine the impact of emotionality on social intelligence of parents blessed with autistic child, (b) to develop awareness regarding social intelligence and its significance among these parents, (c) to propose a new model stabilising emotionality of these parents through developing social adaption skills and (d) to suggest a new model as a guide in the current intervention regimens to ensure the emotional well-being and better social adoption. This study is made based on the keenly examined past evidence with the correlation of emotionality and its impact on social intelligence of the parents with ASD children. The results reveal that the social intelligence is perceived as lowered evidenced by poor social adjustment reflected in social isolation observed in the parents of children with ASD. A new model proposed for stabilising and developing awareness of social intelligence among the parents of ASD children. Integrating this model with the existing treatment paradigm has been suggested to attain the better result. The conclusion is drawn in this study by analysing the fact that considerable improvement in the diagnosed child may not amend the parent and family distress and drastically affect social intelligence. Indeed, the intervention can be more promising with the healthy personality of parents, where their multiple aspects of intelligence are not affected. The new proposed model of intervention can pave the way for further research in this regard.

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Foreign bodies may be ingested after being inserted into an oral cavity or deposited in the body by traumatic or iatrogenic injury. Accidentally left out foreign materials are common complications of dental procedures including apical deposition of endodontic materials, sub-mucosal amalgam pieces, graphite tattoos and traumatically introduced dental materials and instruments. Once a foreign material is left behind within a soft and/or hard tissue, it promotes local inflammation and infection that may cause pain and/or destruction within the surrounding tissues. This article presents a case of retrieval of iatrogenically broken periosteal elevator trapped in the maxillary sinus.

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Background: The acute physiology score is determined from the most deranged (worst) physiologic value, for example, the lowest blood pressure or the highest respiratory rate, during the initial 24 h after Intensive Care Unit (ICU) admission. The aim of present study is to apply Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system to surgical patients who have been critically ill preoperatively requiring elective surgical intervention or who underwent extensive elective surgery thereby requiring post-operative critical care monitoring and treatment in the post-operative ward or ICU or surgical ward. Materials and Methods: This prospective study was carried out on critically ill surgical patients from August 2012 to December 2013 in M. G. Hospital, Department of Surgery attached to Dr. S.N. Medical College and Associated Group of Hospitals, Jodhpur. The APACHE II score in the first 24 h of admission or operation and expected risks of death was calculated. Results: This study observed that 67.74% recovered male and 81.58% female and mortality rate increase when APACHE II score of patients increases. From the 100 patients enrolled the mean age was 47.38 ± 18.37 the overall median APACHE II score for all critically ill surgical patient was 9 with a range of 2–44 (minimum 2 and maximum 44). There was a significant difference between the APACHE II score of survivors and non-survivors. Conclusion: This scoring still provides a basic idea and uniform comparison of critical patients, thus help in research activities database validation. Few pitfalls related in the present study could have been avoided had there been large number of cases and more so of specific procedure-related patients necessitating critical care.

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Background: The stability of the rubber dam (RD) basically depends on the selection of a properly fitting clamp corresponding to the tooth. There are significant differences in tooth size between various races. This implies that the commercially available RD clamps may fit well to teeth of one population but not to another. Aim: The aim of this study was to obtain standard measure of mesiodistal widths at the cervical level of primary second molars in Gujarat children and to compare them with commercial RD clamps commonly used in paediatric dentistry. Materials and Methods: A total of sixty children were selected on the basis of selection criteria. The mesiodistal widths of primary second molars were measured at the clinical cervical level for buccal and lingual sides, respectively, by a digital Vernier caliper. It was compared with mesiodistal with of RD clamps no. #14A, #7 and #13A/12A. Statistical tests independent sample t-test and single sample t-test were applied. Results: All clamps width show significant difference either buccal or lingual side with their respected teeth (P < 0.05). #14A and #7 clamp show <1 mm discrepancy for mandibular second molar while for maxillary second molar discrepancy were more than 1 mm. #13A/#12A show large discrepancy for mandibular second molar. Conclusion: Cervical mesiodistal dimensions of primary mandibular molars were generally larger than those of primary maxillary molars. #14A and #7 can relatively fit to primary mandibular second molar and #13A/#12A for primary maxillary second molar.

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Background: The gingival biotype is the width of the gingiva in the faciopalatal dimension. It is a feature of the periodontium that is susceptible to change when exposed to physical, chemical or bacterial injury or as a result of surgical or orthodontic treatment. Aim and Objective: The objective of the study undertaken was to assess the adaptation of gingival biotype following prosthetic rehabilitation. Materials and Methods: Forty individuals between 20 and 40 years with healthy periodontium and full complement of teeth with absence of clinical attachment loss or systemic disease were selected for the study. The individuals were restored with a full-coverage porcelain fused to metal with a subgingival margin on root canal-treated teeth with no gingival recession. The gingival biotype of the tooth with the restoration was evaluated in terms of thickness with the help of transparency of the probe method. Twenty individuals were selected with thick biotype and rest with thin biotype. Follow-up was done after 6 months, and the gingival biotype and gingival recession were re-evaluated. Results: It was observed that out of the twenty individuals with thick biotype, eight underwent transformation to thin biotype. Furthermore, thin gingival biotype was more prone to gingival recession as five individuals were found to have gingival recession. Conclusion: Within the limitations of the current study, it was observed that gingival biotype may undergo transformation in response to prosthetic rehabilitation from thick to a thin gingival biotype progressively over a period of time. Hence, supragingival margins should be placed wherever possible. In addition, the thin gingival biotype has a higher susceptibility towards gingival recession.

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Introduction: Pharmacovigilance (PV) plays an important role in generating adverse drug reaction (ADR) data. However, the practice of PV is still very low among health-care professionals due to lack of knowledge and awareness. Internship is the phase when medical graduates work for the first time under supervision of the seniors. At present, we have little knowledge about awareness of PV among interns in India. Hence, this study was planned to assess the level of knowledge awareness and practice of PV among interns and subsequent change in these after PV training session. Materials and Methods: A cross-sectional descriptive questionnaire-based study was conducted among interns of a tertiary health care and teaching institute. Participants were given descriptive questionnaire; they completed the questionnaire before and after undergoing training program in PV. The impact of the effectiveness of educational intervention among interns was evaluated by Chi-square test. Results: Out of 150 participants, 120 interns completely filled the questionnaires before and after the educational intervention. Educational program on PV was found to increase knowledge and positive attitudes towards various aspects of PV. Conclusion: Training program on PV may help increase the knowledge as well as awareness about principles and techniques of PV, which will increase the credibility of health care in the country.

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Background: For understanding injuries in paediatric elbow and checking the degree of reduction after manipulation, various radiological criteria using anthropometric parameters are used. Since anthropometric parameters of Caucasians are different from European and Mongoloids, their parameters cannot be applied on our population. Hence, there is a need to characterise anthropometric parameters of elbow among children in the Indian population. Materials and Methods: The study population comprised all cases of injury to the elbow joint between 3 and 13 years of age reporting to the Department of Orthopaedics during the study. The X-rays films were preserved, and the angles and lines (as anthropometric parameters) were drawn on the radiographs. Results: Mean ± (standard deviation [SD]) for Baumann angle in children included in this study was 75° ± 4.70°. Mean ± (SD) of Baumann angle in males was 76° ± 4.44° and females was 74° ± 5.37°. Mean ± (SD) for lateral capitellohumeral angle in children from 3 to 13 years of age was 49 ± 5.75. Conclusions: As the values of normal side have been found to affect the functional and cosmetic outcome of the affected extremity, slight changes in values of our population in comparison to that of the Western population can significantly affect the outcome.

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Aim: Breast cancer is the most frequent cancer among women and the prognosis depends on the tumour biology and the treatment characteristics. Derived neutrophil-lymphocyte ratio (DNLR) a surrogate marker of cancer-associated inflammatory response is a cost-effective and simple prognostic parameter for breast cancer. There is a paucity of data regarding the prognostic significance of the DNLR in breast cancer in Indian subcontinent. The aim of the study is to investigate the prognostic role of DNLR in breast cancer in the Indian population. Materials and Methods: 497 patient data were evaluated retrospectively for evaluation of DNLR as a prognostic marker in non-metastatic breast cancer. With a median time to follow-up is 33.8 months (range: 9.6-64.7). A total number of the relapse were 115 and 36 deaths occurred. Results: The predicted 5-year relapse free and overall survival were 70% and 87.5% respectively. On multivariate analyses, factors significantly associated with high DNLR were duration of presentation >6 month, pre-menopausal status, higher T stage, high leucocyte count and the presence of hypoalbuminemia. There was a significant association between DNLR with RFS and OS with P < 0.05 and 0.003 respectively. Conclusion: This is the first study to investigate the prognostic role of DNLR in breast cancer in the Indian population. With combination with other prognostic markers, DNLR, a low-cost, reliable marker of inflammation may have potential utility in breast cancer prognosis.

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Aim: Glaucoma is defined as chronic, progressive optic neuropathy caused by a group of ocular conditions, which leads to damage of the optic nerve with loss of visual function. This study was conducted to find out the changes in corneal curvature, axial length and intraocular pressure. Materials and Methods: The present study was conducted in the Department of Ophthalmology, S P Medical College and Associated Group of Hospitals, Bikaner. A total of fifty cases of either age- and sex-matched controls were selected for this study. These cases were divided into two groups: Group A (sutureless trabeculectomy with mitomycin-C [MMC]) and Group B (sutureless trabeculectomy without MMC). Results: The mean post-operative intraocular pressure (IOP) was lowered in MMC-treated eyes when compared to control at 1½ months. The IOP reduction was greater in the MMC-treated eyes (13.25 mmHg at 1½ months) as compared to control Group B (16.9 mmHg at 1½ months). Comparing results with the present study, it was found that success rate in MMC-treated eyes was noted in 23 (92%) individuals, in which complete success was in 22 (88%) while qualified success in 1 (4%) and qualified failure in 2 (8%) with mean IOP of 13.2 mmHg at 1½ months, whereas in control group, success rate was noted in 19 (76%) individuals, in which complete success was in 18 (72%) and qualified success in 1 (4%), while qualified failure in 6 (24%) with mean IOP of 16.9 mmHg at 1½ months after operation. Conclusion: Results of this study are in favour of intraoperative application of MMC during filtration surgery, especially in cases with high-risk failure.

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Tracheopathia and tracheobronchopathia osteochondroplastica refer to idiopathic, non-malignant disease of large airways featured by sub-mucosal cartilaginous to osseous nodules overlying the cartilaginous rings, which may be focal or diffuse. We report two cases, one having tracheopathia osteochondroplastica and other having tracheobronchopathia osteochondroplastica. It is generally an overlooked diagnosis due to lack of familiarity among the clinicians. Our aim to present these cases is to avoid under-diagnosis/misdiagnosis whenever such a condition is encountered in daily practice.

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