The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1-54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55-114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis.

Introduction. Mature cystic teratoma is the benign tumor of the ovary. CA19-9 levels, although a marker of pancreatic malignancy, have been found to be raised in large ovarian mature cystic teratomas. Case Report. We report a case of a young female who had unusually high levels of CA19-9 in the blood associated with large ovarian mature cystic teratoma. The levels returned to normal 12 weeks after cystectomy was performed. Conclusion. This case highlights the fact that although raised tumor marker may be associated with a benign pathology thorough evaluation to rule out malignancy still must be done.

Background and objectives Pneumonia is the most common cause of death in children under five years of age. Epidemiological factors and the disease burden differ in developing and industrialized countries. The present study is a cross sectional observational study, carried out from August 2018 to August 2020 in Hindu Rao Hospital, to assess the prevalence of congenital heart disease (CHD) in patients with pneumonia in children up to 5 years. The main objectives of the study were to study the prevalence of congestive cardiac failure (CCF) in pneumonia with and without congenital heart disease. Material and methods Patients under 5 years of age, presenting with pneumonia during August 2018 to July 2020 were enrolled for study. The bio-data of each patient was documented each patient was clinically evaluated thoroughly and findings noted. Pneumonia was diagnosed on typical history, physical findings, blood investigations and chest radiographic finding of pneumonia infiltrates in either one or both lung fields. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography, done by the cardiologist. Any congenital heart disease so found was noted. The type and size of the defects was documented. The ventricular septal defects were classified based on the site and size. The size of the patient ductus arteriosus was also determined. These measurements were taken to evaluate the impact of defect size on pneumonia. CCF was diagnosed when the patient fulfilled the clinical diagnostic criteria of heart failure. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography for diagnosis of any congenital heart disease. Results Mean age of the children with pneumonia was 9.94 months with 77.5% of the cases below 1 year of age. Male predominance was seen with 56.3% males to 43.8% females. Prevalence of congenital heart disease among cases of pneumonia was 12.5% while that of congestive heart failure was 27.5%. Most common CHD observed was VSD (14 cases; 8.8%) followed by PDA, ASD and TGA (4; 2.5% and 3; 1.9% and 1; 0.6% cases respectively). A significant association was observed between presence of congenital heart disease and development of CCF. Conclusion Our study demonstrates that most patients with pneumonia or recurrent pneumonia are likely to have an underlying illness at the time of pneumonia. Recurrent ALRTI often occurred in children with history of congenital heart diseases (CHD) and is also associated with Congestive Cardiac Failure. Children with CHD are more vulnerable to recurrent respiratory tract infection.

Background: In 2015, RNTCP covered a population of 1.28 billion. A total of 9132,306 TB suspects were examined by sputum smear microscopy and 14, 23, 181 cases were registered for treatment. Most peripheral unit under the RNTCP network is the designated microscopy centre (DMC) which serves a population of around 100,000 (50,000 in tribal and hilly areas). Treatment compliance and patients satisfaction is important concern for quality service success of RNTCP. Objectives of this study were to assess the treatment compliance and patient’s satisfaction regarding directly observed treatment short course chemotherapy (DOTS).Methods: It was an observational study conducted among DMCs of Kanpur district. Multistage random sampling technique was used for selection of DMC in both rural and urban area. 300 subjects interviewed in this study.Results: Most of the study subjects (87%) were satisfied with the services provided at the DMC. Compliant status was better in rural DMC (94.50%). Non-compliance was more in urban DMC (18.4%). Majority of the study subjects (67%) were satisfied due to availability of free medicines at the centres. Difficulty to come on alternate days was the most common reason for dissatisfaction among study subjects (43.6%) followed by wastage of time (23.1%).Conclusions: About 13 percent patient was not satisfied with DMC services. Among urban DMCs 18.4 percent patient were not compliant where it was 5.5 percent among rural DMCs. About 22.0 percent patient was unaware about duration of treatment. Whereas important reason for dissatisfaction with service was ‘difficulty to come on alternate day’.

A 55-year-old (para 3 living 3) postmenopausal female (menopause attained 10 years back) presented to the out-patient gynaecology clinic with the chief complaints of a long standing, painless yet gradually increasing in size, abdominal lump along with heaviness in abdomen for last two years and significant weight loss (almost 50%) over the past one year. There was history of loss of appetite and constipation. No significant risk factors for malignancy could be elicited from her past medical history or family history.General physical examination was unremarkable except for mild pallor and low (15) BMI. There was an abdomino-pelvic mass corresponding to 30 weeks size gravid uterus, occupying all quadrants of abdomen. It was a non-tender, variegate consistency lump with restricted mobility. Pelvic examination confirmed the same mass felt through the anterior and left fornix and a retroverted atrophic uterus was felt separately from the mass. Movements of the mass could not be transmitted to the cervix and the pouch of Douglas appeared free.