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Further improvement in the delivery of clinical teaching preferably by using wide variety of teaching-learning activities can be taken into account through students' feedback on their learning experience.

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This paper describes a method used for the fabrication of a two-piece denture obturator for a patient who had surgical removal of the premaxilla due to squamous cell carcinoma. The patient had been wearing a two-piece obturator but encountered difficulty in inserting the prosthesis. In this case report, a lock-and-key mechanism was used to easily assemble the two-piece prosthesis intraorally. A keyhole was designed on the obturator to act as the lock while the denture was used as the key that fitted into the keyhole. This mechanism facilitated insertion and provided retention for the prosthesis. Heat-cured resilient acrylic material (Molloplast B®), which was used to fabricate the obturator, was a nonirritant, nontoxic, tissue-compatible material. It also did not contain plasticizers, therefore eliminating the problems associated with leaching out of plasticizers. The use of this flexible and resilient material allowed the obturator to engage in the undercuts without causing trauma and irritation to the soft tissues in the region of the defect. To conclude, the “lock-and-key” mechanism used in the fabrication of the two-piece denture obturator provided the patient with a lightweight, comfortable, and user-friendly form of prostheses.

Background: Acinetobacter baumannii has evolved as a common Multi Drug Resistant (MDR) microbe. This study was conducted to find the profile of antimicrobial resistance and mortality and their associated factors in A. baumannii infection of lower respiratory tract. Materials and Methods: This was a record based cross sectional study done in a tertiary care teaching hospital in Kerala. Records of all the 63, A. baumannii lower respiratory infection in 2017, were retrieved and analyzed. MDR was defined as resistance to at least one agent of three or more antimicrobial classes. Proportion of MDR, carbapenam resistance and resistance to other major antimicrobials were calculated. Determinants of carbapenam resistance and its associated antimicrobial resistance were explored. Proportion of mortality and the associated factors were explored. Student's t-test, chi-square test or fisher exact test were used appropriately. Results: Proportions of MDR and carbapenam resistance were 85.7% and 41.3% respectively. Highest proportion (90.5%) was resistant to piperazillin-tazobactam. Carbapenam resistance was associated with MDR (p-value<0.05). Mean duration of mechanical ventilation and intensive care unit (ICU) stay prior and after the infection were longer for patients with carbapenam resistant strains (p-value<0.05). Mortality rate was 74.6% (95% CI: 63.9% to 85.3%). Older age and ICU stay prior to infection were associated with mortality (p-value<0.05). Conclusions: Rates of antimicrobial resistance in Acinetobacter baumannii and the mortality were high in the setting, comparable to reports from other parts of India. The drug resistance increases hospital care burden. There is an urgent need to implement stringent infection control measures.