Introduction: Physiological stress among medical and engineering students is common as compared to other professional courses. Increased stress levels result in an increased prevalence of psychological problems such as depression, anxiety, drug abuse, and suicide ideation. This study aimed to assess and compare the level of depression, anxiety, and stress among medical and engineering students in North-East India. Materials and Methods: This institution-based epidemiological study was conducted among undergraduate students in engineering and medical college (310 students from each college) of North-East India from January 2017 to December 2017. Participants were interviewed with Depression, Anxiety, and Stress Scale-42 scale to assess the different grades of stress, anxiety, and depression. Data were entered and analyzed by the Statistical Package for the Social Sciences software version 16.0, and P < 0.05 was considered as statistically significant. Results: Greater mean scores among medical students indicated that they had more depression, anxiety, and stress in comparison to engineering students (P < 0.05). Gender, education, socioeconomic status, permanent residence, satisfaction with academic performances, smoking, and alcohol intake were found to be significantly associated with depression, anxiety, and stress in students from both courses (P < 0.05). Conclusions: A vast majority of the students were suffering from mild to very severe grades of depression, anxiety, and stress which is a matter of concern. Early interventions are needed to reduce the development of this depression, anxiety, and stress among professional students in today's date.

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Introduction: Role of tulsi in periodontal disease is a polymicrobial infection primarily caused by periodontal pathogens existing within the subgingival plaque. The conventional method of lowering the bacterial load in the periodontal pocket constitutes scaling and root planning, but to prevent recolonization the use of adjunctive methods has been advocated. Tulsi (Ocimum sanctum) is being widely used in dentistry in the form of mouthwashes, dentifrice, gels, and oral irrigants. Objective: The objective behind writing this article was to assess the relevance of and effectiveness of Tulsi (O. sanctum) in the treatment of periodontal disease. Data Source: Internet database Medline/PubMed search for word “Tulsi” resulted in 1000 articles. Review Methods: Articles with Medline/PubMed were only considered in writing this review. The result showed that Tulsi has been widely used as a mouthwash, dentifrice, and oral irrigant in the field of periodontics. Conclusions: Although highly effective, the use of Tulsi has not been popularized in today's day and age and needs to be done the same.

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Professionalism is applied to any field which requires a specialized body of knowledge and skill and the highest standards of conduct directed at the general benefit of the society. The principles of bioethics have always been the key component in the practice of medical profession. The authors highlight the various aspects of professionalism and characteristics of a professional. Principles of bioethics have been the key component in the practice of medical profession. The authors discuss the various ethical dilemmas which could arise in the practice of medical profession where the principles of bioethics could be applied to ensure quality assurance of health-care services. In addition, the need for teaching professionalism and bioethics, as a part of the medical curriculum, had been insisted.

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Background: The purpose of the present study aimed to assess the level of anxiety and factors influencing anxiety among orthopedic surgical patients admitted to a secondary care center in India. Methods: The study was conducted for a period of 3 months. A quantitative approach with a descriptive design was used. Simple random sampling was used to select 46 orthopedic inpatients. Demographic and clinical data were collected using a self-developed pro forma. State-Trait Anxiety Inventory form Y-1 was used to assess anxiety, and factors influencing anxiety were assessed by a self-developed questionnaire. Results: Out of 46 participants, 60.90% have low anxiety, 15.20% have moderate, and 23.90% have severe anxiety. Regarding factors influencing anxiety, 78.30% have fear about postoperative pain; 60.90% have fear about surgery; 58.70% have fear about anesthesia, the outcome of surgery, and economic issues; and 52.20% have fear of dependency and postponement of surgery. Some other factors are fear of complications and lack of sleep during night 45.70%, fear about family issues 37%, fear of postoperative nausea 34.80%, fear of death 23.90%, fear about the structure of the ward 17.40%, and fear due to lack of preoperative instructions 13%. Conclusions: Anxiety is common among patients waiting for orthopedic surgery. It is important to identify the factors influencing anxiety as a routine nursing care to reduce anxiety level.

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Introduction: Due to contrasting evidence for and against the age-based formulas for calculation of correct size of endotracheal tube (ETT) in children, this prospective observational study aimed at comparison of ultrasonography (USG) and age-based formula for calculation of correct ETT size in children <6 years of age. Materials and Methods: Following a sample size calculation of 63 children, children of <6 years of age were recruited. Age-based formula (Cole's formula) was used for predicting ETT size. Cricoid diameter was measured using USG, and USG ETT was selected. Correct tube used for the patient was confirmed by air leak test. Agreement for correct size ETT with USG and age-based method was assessed using kappa value for intraclass correlation (ICC). Subgroup analysis was carried out for age, sex, and weight. Results: Sixty-six children with a mean age of 27.9 months were recruited. USG method was found to be correct in 44 patients (67%), whereas age-based method selected the correct tracheal tube size in 32% (21) of patients (P < 0.001). Agreement of ultrasound-based method with the correct size tube was 0.902, while the same for age-based formula method and correct ETT was 0.835 proving the superiority of the USG. On subgroup analysis, ultrasound-based tube selection was accurate in children <1 year. Conclusions: With ICC of 0.902, ultrasound can be a useful tool for selecting pediatric ETT size as compared to age-based formula. This finding is significant, especially in children under the age of 1 year.

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Methotrexate (MTX) is one of the most common systemic immunosuppressive agents prescribed in dermatology. MTX toxicity targets skin, gastrointestinal mucosa, kidney, liver, and bone marrow. Toxic effects of MTX presenting as hepatic, renal, pulmonary, and bone marrow disorders occur less frequently than the minor effects but may be life-threatening. Characteristic signs and symptoms of acute MTX toxicity are based on extent and severity of organ involvement. Here, we report a 55-year-old married male, known case of chronic plaque-type psoriasis presenting with reaction to single dose of tablet MTX 7.5 mg as advised by the dermatologist for his disease. On history and clinical examination, diagnosis of idiosyncratic reaction to single dose of tablet MTX 7.5 mg was made.

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Objectives: Atlas and axis vertebrae have unique anatomical features compared to the rest of the cervical vertebrae. Variations of superior articular facet of the atlas have been extensively described. However, only limited studies describe the variations of the inferior articular facet. The aim of the present study is to explore the variations in the shape, size, and symmetry of the inferior articular facet of the atlas. Materials and Methods: The study was conducted on 110 dried adult atlas vertebrae. Shape, size, and the number of the inferior articular facets on each atlas were recorded. Results: Different shapes observed include round (36.36%), pear or drop shaped (35.09%), oval (21.36%), rectangular (3.6%), and triangular (3.0%). Nearly 87.73% facets were flat, whereas 12.27% were concave. In 43.64% of cases, the shape of the inferior articular facet was found to be different on the two sides of the same vertebra. Conclusions: Although not many authors have described the shape of the inferior articular facet, its dimensions have been given by many of them. These dimensions could be helpful while planning and designing implants, etc.

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Background: Foundation course (FC) program was introduced recently by the Medical Council of India for the 1^st-year of MBBS students in India to serve as a bridge into the MBBS program as well as to orient the students to various aspects of the medical college environment. Aim: The aim of the study was to analyze the feedback on FC by the 1^st-year MBBS students. Materials and Methods: The study was conducted at the Pt. B. D. Sharma PGIMS, Rohtak, during August 1–31, 2019, involving 242 1^st-year MBBS students. At the end of each day of the program, the students received a multiple-choice questionnaire along with a feedback form. Further, at the end of the 1-month of the FC program, the students received a final feedback form reflecting upon various aspects of the FC. Results: Majority of the students felt that the FC was well organized and helpful in gaining knowledge and information. Basic life support was the “most preferred” skill session (68.5%), followed by a session on immunization clinic (31.6%). Students felt that the training sessions organized under the six modules of the FC were able to impart ample information on respective topics and were considered helpful to a great extent for majority of the students. Fifty-eight percent of the students felt content overload and rushed pace of content delivery did not help in learning. Other hindering factors recognized by students included excessive use of technical/medical terminology, audio–visual disturbances, and spread out locations for small group activities. Conclusions: High levels of satisfaction with the FC in general and in terms of content and organization were observed. Shortcomings recognized through feedback will help us to improve.

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Cranial nerve palsy is a known but rare complication of spinal anesthesia. Upper cranial nerves are more commonly involved following spinal anesthesia. Reports of the lower cranial nerve, especially branches of vagus nerve involvement leading to unilateral or even bilateral vocal cord palsy are sparse. Here, we report a case series of patients who presented with vocal cord palsy following spinal anesthesia.

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Gastroduodenal fistula (GDF) or double pylorus (DP), also called double-channel pylorus, is a rare condition seen in 0.001%–0.4% of upper gastrointestinal endoscopies. The condition is characterized by the presence of two openings from the gastric antrum to the duodenum, which may be congenital or acquired. Acquired DP is usually an uncommon complication of peptic ulcer that erodes and creates a fistula between the duodenal bulb and the prepyloric antrum. We report a case of elderly male patient who was evaluated for the complaints of upper gastrointestinal bleed and was found to have peptic ulcer disease with GDF.

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Aim: The study aimed at comparing the antimicrobial activity of mycelium and spore of Ganoderma lucidum on Prevotella intermedia isolated from subgingival plaque of chronic periodontitis patients. Settings and Design: Written informed consent was obtained from each subject enrolled in the study. The institutional ethics committee granted ethical clearance for the study. Materials and Methods: Twenty patients diagnosed with chronic periodontitis were included in the study. Using sterile curettes, pooled subgingival plaque samples were collected from the deepest sites of periodontal pockets. The collected samples were then transported in 1 mL of reduced transport fluid. The organisms were cultured and confirmed and were used for the minimum inhibitory concentration (MIC) procedure. Statistical Analysis: Mean of the MIC value obtained was calculated. Comparison between the antimicrobial activity of mycelium and spore against P. intermedia groups with respect to mean MIC value (in mcg/ml) was done by Mann–Whitney U test. Comparison of antimicrobial activity of mycelium and spores of G. lucidum against P. intermedia expressed by the MIC value at different concentrations was done by Chi-square test. Results: The mean MIC obtained for mycelium was 5.64 mcg/ml. The mean MIC obtained for spore was 3.62 mcg/ml. Results of the comparison of antimicrobial activity implied that the antimicrobial activity of mycelium and spore of G. lucidum was comparable. Conclusions: Both mycelium and spore of G. lucidum with its bioactivity could be used as an antimicrobial, in combination with conventional therapy in periodontal disease.

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Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm, characterized by a hematopoietic stem cell carrying BCR-ABLl fusion protein. Common sites of extramedullary deposits in CML are lymph nodes, bones, and central nervous system. We present a case of a 39-year-old male diagnosed case of CML who presented with extramedullary deposit in the right femur in spite of complete hematological remission and major molecular response on real-time quantitative reverse transcriptase polymerase chain reaction in the blood. Extramedullary deposit is almost always followed by hematological reemergence of disease and is considered as an early sign of disease in the bone marrow. Bone, lymph nodes, skin and soft tissues, and central nervous system are the common sites for extramedullary deposits in a case of CML. A thorough literature review revealed limited case reports on extramedullary deposits in a case of CML in major molecular response. Therefore, the possibility of being confronted with unusual signs and symptoms which could be indicative of extramedullary deposits should be kept in mind.

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Background: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) are viral infections that are transmitted through transfusion of unscreened blood products, needlestick injuries, and unprotected sex. This was a study to determine the prevalence of Hepatitis B and HIV infection among pregnant women accessing antenatal care. Materials and Methods: Two ml of venous blood was also collected into ethylenediaminetetraacetic acid bottles for hepatitis B surface antigen (HBsAg) and HIV test using a rapid diagnostic test kit following the standard algorithm of performing diagnosis. Results: Of the 250 participants examined for the presence of HBV and HIV among pregnant women attending the antenatal clinic in Calabar, 14 (5.6%) and 3 (1.2%) were positive for HBsAg and HIV. Participants aged 26–30 years had the highest prevalence of HBsAg 8 (7.0%) and participants aged 31–35 had the highest prevalence of HIV 1 (3.2%). The seroprevalence of HBsAg and HIV infection among pregnant women attending antenatal clinics by occupation shows that students had the highest infection rate of 3 (9%) and 2 (6%) for HBsAg and HIV. Of the 250 participants enrolled, the level of HIV and HBV awareness was 178 (71.2%) and 242 (96.8%), respectively. Conclusions: The study has revealed that the prevalence of HBV and HIV is on the increase among pregnant women, with a prevalence of 5.6% and 1.2%, respectively. General precautions need to be strictly adhered to in the hospital and particularly in blood transfusion and handling of sharps objects.

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