Periodontitis is a multifactorial disease. Traditional methods like toothbrushing and manual scaling and root planing are the treatment of choice. However, these methods are time-consuming and not fully effective. To restore periodontal health systemic antibacterials are used as adjuncts, but due to side effect and inability to reach target areas, other alternative methods were devised. Various handicaps of systemic drugs such as side effects, resistance, and growth of opportunistic infection, local drug delivery agents (LDD) in periodontology have gained acceptance and popularity. Haldi/turmeric has been used in our country since time immemorial. It has vast array of therapeutic uses. This review attempts to shed light on the efficacy of curcumin as LDD agent in periodontal infections.

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Background: Metabolic bone disease (MBD), including osteomalacia, osteopenia, and osteoporosis, is common in patients with inflammatory bowel disease (IBD) and is considered to be an extraintestinal manifestation. There is a paucity of reports on MBD in patients with IBDs from India. We aimed to investigate the prevalence of MBD in adult patients with ulcerative colitis (UC). Materials and Methods: In this single–center, hospital–based, cross-sectional observational study, 161 consecutive patients of UC, between 18 and 70 years of age, were assessed for MBD with blood investigation (corrected serum calcium, phosphorus, alkaline phosphatase, serum 25-hydroxy Vitamin D₃, and parathyroid hormone levels) and dual-energy X-ray absorptiometry (DEXA). Results: Out of 161 UC patients, 74 (46.0%) had Vitamin D deficiency. Osteopenia and osteoporosis of the neck of the femur on DEXA were seen in 39.7% and 11.2% of the patients, respectively. Osteopenia and osteoporosis of the lumbar spine on DEXA were seen in 33.5% and 15.5% of the patients, respectively. Conclusion: MBD is common in UC.

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Background: There are increasing concerns about the adverse effects of highly active antiretroviral therapy (HAART) on lipid profiles. Limited studies reported the adverse effects of HAART on lipid profiles from the Indian subcontinent. Methods: This observational study was conducted at a tertiary care hospital in North Western India. The objective of the study was to find out the adverse effects on lipid profiles after HAART initiation in newly diagnosed HIV-infected children of immune stage III and IV in the 18 months to 16 year age group. These 43 children were evaluated every 3 months for lipid profile for 1 year. Results: There was a nonsignificant increase in total lipid and phospholipid levels and a statistically significant increase in triglycerides (TGs), cholesterol, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) levels after initiation of HAART therapy and a statistically significant decline in high-density lipoprotein (HDL) level after initiation of HAART therapy in immune phase III. The mean level of total lipid profile, phospholipids, cholesterol, HDL, LDL, VLDL, and TGs before starting of treatment was 474 mg/dl, 147 mg/dl, 126.8 mg/dl, 44.7 mg/dl, 94.3 mg/dl, 22.9 mg/dl, and110 mg/dl in immune stage IV, respectively. After starting treatment, the mean level of total lipid profile, phospholipids, cholesterol, HDL, LDL, VLDL, and TGs was 495.7 mg/dl, 164 mg/dl, 146.5 mg/dl, 38.9 mg/dl, 108.5 mg/dl, 28.9 mg/dl, and 127.3 mg/dl in immune stage IV, respectively. There was a statistically significant increase in total lipid, TG, phospholipid, cholesterol, LDL, and VLDL levels. There was a statistically significant decline in HDL level after initiation of HAART therapy in immune stage IV. Conclusions: We concluded that there was a significant alteration in lipid profile in HIV-infected children of immune stage III and IV with HAART.

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Background: Pregnancy which is not terminated within the boundaries of legal definition in India is called an unsafe abortion. Objective: To observe the proportion of unsafe abortions among total abortions in 15–49-year-old ever married women across India between 1990 and 2020. Materials and Methods: A comprehensive search was conducted in National Library of Medicine's PubMed database, IndMED, TRIP, Web of Science, and Google Scholar for articles published between January 1, 1990, and February 29, 2020. A combination of medical subject headings and free text word like abortion, induced, unsafe, women 15–49 years, prevalence, and India were used. Each article was assessed for quality using Joanna Briggs Institute Critical Appraisal Tool. The proportion of subjects classified as having unsafe abortion was the outcome of meta-analysis. Analysis was done using Comprehensive Meta-Analysis version 2.2. All pooled estimates were calculated using DerSimonian–Laird random-effects model and reported as a proportion with 95% confidence intervals. Results: The pooled estimate of the mean prevalence of unsafe abortion in India was 37.56% (confidence interval: 20.68–54.44). There was a significant heterogeneity between the studies (I² = 99.98% and Cochran's Q = 113538.65, df = 18, P < 0.001). Conclusion: Even after several amendments in Medical Termination of Pregnancy Act 1971 till 2020, unsafe abortions are highly prevalent in entire India, irrespective of high-performance or low-performance states. In urban India, the prevalence of unsafe abortions is comparatively higher than rural areas.

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Background and Aims: Intelligence is an abstract ability which is easily identifiable and recognizable but interestingly very hard to define. The study of intelligence is a dynamic field which is continuously evolving and expanding. The idea of multiple intelligence includes both interpersonal (to understand other individuals' emotions and intensions) and intrapersonal (to understand one's own emotions) intelligence. The present study was performed to assess the intelligence quotient (IQ), emotional quotient (EQ), social intelligence (SI), and resilience level of subjects and to assess the effect of music on different types of intelligence. Materials and Methods: The present study was conducted on 100 college-going students chosen randomly. The study was carried out in two phases. In the first phase, baseline parameters of IQ, EQ, SI, and resilience level were assessed. They were asked to listen to receptive music for 1 month and to maintain the record of the same. In the second phase, the effect of music was studied on parameters. Results: Significant correlation was found between IQ, EQ, SI, and resilience scores. Correlation and paired t-test values of each parameter analyzed between baseline and post music intervention levels exhibited significant difference. Comparison of mean values of parameters in males and females studied at baseline level and post music intervention level also exhibited statistical differences at different levels of significance. Conclusion: Music improves cognitive abilities in both males and females with more effect on IQ in males and SI in females.

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Background: Vaginal bleeding in early pregnancy is a common complaint of pregnant women and its incidence has been reported as 16% to 25%. About half of the patients with vaginal bleeding will abort and remaining poor pregnancy outcomes such as preterm delivery, preterm premature rupture of membranes (PPROM), and intrauterine fetal growth restriction can occur. Aims and Objectives: To study the association of vaginal bleeding in early pregnancy as a useful indicator of pregnancies at risk and to determine the associated perinatal outcome and pregnancy complications. Materials and Methods: A 1-year retrospective study was conducted on a total of 360 patients, comprising 120 women with early pregnancy bleeding and 240 women without bleeding. Pregnancy complications and perinatal outcomes were compared between these two groups of pregnant patients. Results: Out of 120 cases with early pregnancy bleeding, 52.88% aborted, and 47.12% continued their pregnancy beyond 20 weeks. Among those cases that reached beyond 20-week gestation, 48.98% of women delivered prematurely (<37 weeks) and 51.02% delivered at term. Women with vaginal bleeding had onset of preterm labor in 32.65%, antepartum hemorrhage in 18.37%, placenta previa in 8.16%, and low birth weight babies in 53.06% of cases. In contrast, cases without vaginal bleeding in early pregnancy had preterm labor in 2.92%, antepartum hemorrhage in 1.67%, placenta previa in 0.42%, and low birth weight babies in 10.83% of cases. Conclusion: Bleeding in early pregnancy increases the risk of pregnancy complications such as preterm delivery, abortion, antepartum hemorrhage, placenta previa, PPROM, fetal growth restriction, and low birth weight in neonates. Therefore, it is a useful indicator of pregnancy complications and adverse outcomes.

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Background: Teenage pregnancy is one of the determinants of high maternal morbidity and mortality. Assam is known for its highest contribution of maternal death in India. In Assam, around 31% of teenage girls get married before the age of 18, and around 12% teenage girls become mothers before they turn out to be 18 years. Objectives: The objective of this study is to know the maternal and fetal outcomes of teenage pregnancy and its determinants in a tertiary care setting in Assam. Materials and Methods: A cross-sectional study was conducted among 118 teenage mothers admitted to Jorhat Medical College and Hospital from June to August 2019. Required data on sociodemographic characteristics of the mother, antenatal, intranatal, and postnatal histories, and maternal and fetal outcomes of the pregnancy, were collected in predesigned and pretested schedule. Data analysis was done using Microsoft Excel software. Ethical approval was obtained from the Institutional Ethics Committee. Results: Among the 118 teenage mothers which constitute 14.6% of total deliveries conducted during the study period, 61% were anemic during pregnancy and 75.42% of teenagers had term delivery while 19.49% had either preterm or postterm deliveries. Cesarean section was done for 50.85% of pregnancies and 45.77% of teenage mothers had complications such as eclampsia, prolonged labor, cephalopelvic disproportion, and premature rupture of membrane during labor. About 42.73% of the newborns were found to be low birth weight babies. A statistically significant association was found between determinants such as lower socioeconomic class, younger age at marriage, less education of mothers, lack of knowledge about contraceptives, and teenage pregnancy. Conclusion: Our study findings indicated a high percentage of teenage pregnancy and increased complications among teenage mothers and newborns.

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Introduction: Prescription auditing is an important tool to assess the appropriateness of drug dispensing in any health-care setup. Aim: The aim of this study is to evaluate the prescriptions as per the World Health Organization (WHO) core indicators. Materials and Methods: The study is an observational study undertaken in the outpatient department of the rural health training center. About 310 prescriptions were analyzed for their completeness as per the WHO guidelines. Results: The auditing showed the distribution of gender as 62.90% in the male category and 37.09% in the female category. The age distribution of the prescription falls across the ages from 1 to 60 years with 64.51% in the under-five categories, 54.83% in the adolescent category, 17.74% in the middle age group, and 38.70% in the geriatric age group. The prescription indicators such as name and age of the patient, hospital id, dose of the drug, and duration of treatment were completely recorded in the out patient (OP) slip. The parameters like were near to completion such as history (98%), examination (99%), and signature with the name of the doctor (96.12%). Generic names of the drugs are entered in 89.67%, investigations were ordered in 63.87%, and follow-up was advised only in 54.19% of the prescriptions. Handwriting in capitals was only in 56.77% and the registration number of the doctor was entered only in 46.77% of the prescriptions. Conclusion: This study showed some pitfalls in the areas of prescribing indicators which have to be sorted out through proper training of the medical officers and interns posted in the health centers.

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Competency-based medical education (CBME) is the new buzzword in the context of the Indian postgraduate teaching. Entrustable professional activities (EPA) are a means by which competencies can be converted to clinical practice. The National Medical Council (NMC) has outlined the four basic skills expected from postgraduate students at the end of cytopathology training. In pathology, the College of American Pathologists Graduate Medical Education Committee has defined 19 EPA s for pathology postgraduate education. Out of these, 4 were for clinical pathology, 7 were for anatomic pathology, and 8 related to both of the above. However, both NMC and College of American Pathologists (CAP) have not further divided the EPAs and skills into smaller observable components observable practice activities (OPAs) so that the postgraduates can have clear-cut targets for their competency. Integration of the EPA to the pathology curriculum would be easier if separate OPAs are devised for postgraduates. We provide the proposed OPAs in cytopathology for postgraduate students based on multiple rounds of analysis by faculty from different institutions using a modified Delphi approach. This study is an example of a pilot project undertaken to implement OPAs in cytopathology laboratory by taking feedback from the stakeholders. This was followed by mapping these OPAs to their relevant competencies. These can be considered stepping stones for the final competency evaluation. To conclude, shortlisting the OPAs is the first step in integrating CBME into the existing pathology postgraduate teaching. The next step is to devise ways to evaluate them in an objective manner and provide feedback to the residents regarding their shortcomings.

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Background: The organ donation rate in India is much lower than the developed countries, which leads to long waiting for the recipient. Religious beliefs, misconceptions, and lack of awareness were a few of the reasons. The study was undertaken to assess the knowledge and attitude of undergraduate medical students regarding organ donation. Methodology: The study was conducted in a tertiary care center in eastern India from February to April 2019. A total of 285 undergraduate students were randomly selected and interviewed by using a pretested structured questionnaire. The data were entered and analyzed. Categorical data were presented as proportion or percentages. Results: Among the participants, 98.6% were aware of organ donation and television was the major source of knowledge for most of them. The participants were found to have a good knowledge regarding organ donation. However, their knowledge was poor regarding the legal framework. Despite knowledge, the attitude toward organ donation was poor among the students. Conclusion: Lack of complete knowledge among health-care providers and particularly doctors can affect the organ donation activity. In a country like India, where the organ donation rate is poor, health-care providers need to take initiative to encourage people. The subject of organ donation should be incorporated into the medical curriculum to improve the knowledge of medical students.

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Implantation of a permanent pacemaker (PPM) in a patient with venous anomalies can be quite difficult, especially in a patient with persistent left superior vena cava (PLSVC). Our patient was a 63-year-old female who presented with complaints of dizziness and an episode of syncope. Her electrocardiogram was suggestive of a complete heart block. We approached the right side of the heart through the right infraclavicular cephalic vein initially, as that is the preferred site in our hospital. We encountered difficulty negotiating the leads through the right side, which raised the possibility of PLSVC. We report the various steps we took while inserting the PPM in this case.

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