Musculoskeletal disorders cause a significant amount of disability globally and are comprised degenerative, inflammatory, autoimmune and traumatic disorders of the bones, joints, muscles and connective tissues. nonsteroidal anti-inflammatory drugs, cortisone, physio, and surgery are traditional treatments that only alleviate symptoms. The management of orthopedic and rheumatologic diseases has greatly improved with recently developed therapeutic biological and the advent of regenerative medicine. Certain biologic therapies, such as tumor necrosis factor inhibitors, interleukin growth factors, and monoclonal antibodies, have proved to be effective in autoimmune inflammatory diseases, including rheumatoid arthritis and ankylosing spondylitis. Tissue repair and cartilage regenerative therapies are being explored, including platelet-rich plasma, bone marrow aspirate concentrate, mesenchymal stem cells, and gene-based therapies. While results so far are promising, issues regarding cost, access, standardization, and safety are still to be addressed. In this short communication, the shift from traditional therapies to biological and regenerative therapies is noted, and their future promise in the field of musculoskeletal medicine is discussed.
Background: Child abuse is a widespread and serious issue that affects children of all ages and backgrounds, cutting across regions, communities, and socioeconomic groups. It encompasses various forms of harm-including physical, emotional, and sexual abuse, as well as neglect and exploitation-often occurring in places where children should feel safe, such as homes, schools, and care institutions. Aim: The aim is to assess the effectiveness of educational intervention on good touch and bad touch. Methodology: A quantitative, preexperimental one-group pretest–posttest research design was employed. A total of 60 school students, aged 6–9 years, were selected using a convenience sampling technique. Knowledge levels were assessed using a self-structured questionnaire administered before and after the intervention. Data were analyzed using descriptive and inferential statistics. Results: In the pretest, 90% of participants demonstrated average knowledge, whereas 10% showed poor knowledge. Following the intervention, 86.7% of the children achieved good knowledge scores, and 13.3% remained at an average level. The mean posttest score (12.47 ± 1.05) was significantly higher than the mean pretest score (7.60 ± 1.42), with a t -value of 22.02 and P < 0.001, indicating a statistically significant improvement. Conclusion: The findings confirm that educational intervention programs are highly effective in enhancing young children’s understanding of good and bad touch. Incorporating such interventions into school curricula is strongly recommended to promote early awareness and personal safety.
The main type of inflammatory odontogenic cysts that occur after pulpal necrosis is the radicular cyst. The condition remains symptom-free most of the time, but palatal swellings appear when the tissues become infected or enlarge. Treatment of this large radicular cyst in the maxillary anterior region requires a multidisciplinary approach between endodontic and surgical methods that includes mineral trioxide aggregate (MTA) and titanium-prepared platelet-rich fibrin (T-PRF), as described in this case report. This case report presents painless swelling related to teeth 11–13, with a clearly marked periapical radiolucency that appeared on the radiographic examination. The patient received root canal treatment for the affected teeth before undergoing surgical cyst removal and apicoectomy treatment for tooth number 12. Histopathology confirmed a radicular cyst. The patient showed steady progress in bone regeneration without any signs of recurrence during the 1-, 3-, 6-, and 12-month follow-up assessments. This report highlights the treatment of large radicular cysts results through a combined endodontic surgical procedure with regenerative therapy, which uses MTA and T-PRF for predictable healing. This case presents a unique clinically integrated treatment modality that offers a predictable management for extensively large periapical lesions, particularly in an esthetically concerned region. Cone-beam computed tomography functions as an essential tool that helps assess surgical results and track patient recovery over time.
Background: Reliance on office-based blood pressure measurement (OBPM) may lead to misclassification of true blood pressure (BP) status. Ambulatory BP Monitoring (ABPM) offers a more accurate assessment of 24-h BP variations. This study compared office and ambulatory BP values and estimated the prevalence of different phenotypes of hypertension based on ABPM among adults. Methods: A community-based cross-sectional study was conducted for a period of 1 year and 6 months among 250 adults aged ≥30 years selected through multistage sampling-Probability Proportional to Size Sampling in Stage 1 and Systematic Random Sampling in Stage 2. Sociodemographic, lifestyle, and clinical details were collected. The study subjects were first checked for their BP by OBPM and then connected to the ABPM. Analyses were performed using SPSS version 26 with paired t -test, correlation, and Chi-square. Results: Mean office systolic BP (SBP) (135.34 ± 16.83 mmHg) was lower than mean 24 h SBP (140.72 ± 66.21 mmHg). ABPM revealed 45.2% as normotensives, 38% persistent hypertension, 8.4% masked hypertension, 6% white-coat hypertension (WCH), and 2.4% isolated systolic hypertension. High SBP and diastolic BP (DBP) load (>50%) were observed in 60.4% and 58%, respectively. Sociodemographic factors (age, education, occupation, and marital status) and lifestyle behaviors (coffee intake, sleep quality, screen use, physical activity, and body mass index) were significantly associated with BP phenotype. Correlation analysis showed a negligible relation between sleep quality and nighttime SBP ( r = 0.051) and DBP ( r = 0.113). Conclusion: A substantial proportion of participants showed discordance between office and ambulatory BP readings, emphasizing ABPM’s value in detecting masked and WCH and quantifying BP load. Incorporating ABPM in community hypertension screening could reduce misclassification and improve management.
Introduction: After clubfoot, the most common congenital deformity is cleft lip with or without palate. Over the years, various treatment modalities and protocols have been formulated for these patients so as to achieve a satisfactory outcome. McNeil (1950) and Burstone (1958) were the pioneers of presurgical infant orthopedics; many researchers enhanced their notion by changing the basic design of the device of the appliance. It was Matsuo et al . (1989) who described the moldability and plasticity of neonatal nasal cartilage within 2 weeks of an infant’s life. Grayson et al . (1990, 1999) suggested a new technique of presurgical nasoalveolar molding for approximating the alveolar segments to reduce nasal deformity using Matsuo’s concept. This procedure has sparked a lot of attention and is now being utilized as an alternative to standard techniques of treating infants with cleft malformations. The anatomies and treatment objectives differed between unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) cases. As a result, using a single procedure for all sorts of cleft instances would be inappropriate. Hence, it is necessary to classify children with UCLP and BCLP in order to personalize the presurgical intervention orthopedics (PSIO) operation and reap the benefits mentioned. The purpose of this study is to propose a revised classification method for infants with BCLP in order to support PSIO. Aim and Objective: To develop a new classification system for the infants with Bilateral Cleft Lip and Palate to be treated with Presurgical infant orthopedics with an objective to assist in alveolar and nasal molding with judicious selection of the cases for the PSIO to avail the documented advantages of PSIO. Methodology: Post lip and patalal repair cast of the infants with BCLP treated with PSIO were assessed for the growth of maxilla from the records under Smile Train. They were assessed for the length of alveolar segment, cleft defect size, AP and transverse dimensions. Amongst the wide variety of the anatomical variation total 8 types were finalized and accordingly biomechanics is suggested. Result: (a) Easy to understand and implementation. (b) To provide information about variations in BCLP cases. (c) To ease the selection of appropriate treatment modality. Conclusion: This study introduces a novel classification system for infants with cleft lip and palate, emphasizing the importance of tailored interventions for BCLP cases. The results underscore the practical benefits of the classification system, offering a valuable tool for clinicians to optimize PSIO procedures and enhance outcomes in cleft lip and palate management.
The Protection of Children from Sexual Offences (POCSO) Act, 2012, is a landmark gender-neutral legislation intended to protect persons below 18 years from sexual crimes. However, its rigid definitions and mandatory reporting provisions have created operational conflicts with other laws, particularly the Medical Termination of Pregnancy Act, and have raised concerns about minors’ autonomy, privacy, and access to health care. This paper critically analyses the doctrinal inconsistencies between POCSO and related laws through recent judicial interpretations, highlighting areas of overlap and contradiction. It draws on recent judicial interpretations, including Dr Nikhil Datar and Ors v State of Maharashtra (2025) and X v Principal Secretary, NCT Delhi (2022). It highlights areas of overcriminalization, police overreach, and lack of harmonization with related statutes, and proposes targeted reforms to align child protection objectives with constitutional rights. The paper concludes with targeted policy recommendations for legislators, judiciary, and implementing agencies.
Background: Caudal epidural block is a popular regional anesthesia method in children, particularly infraumbilical and lower extremity surgeries. Even though bupivacaine alone is effective in analgesia, it has a rather short duration of action, which restricts its application. α2-adrenergic agonist such as clonidine has been adjuvant in the case of prolonging analgesia and enhancing block. Materials and Methods: It was a prospective, randomized, and controlled study of 60 pediatric patients (1–10 years old) undergoing elective surgeries on limbs and abdomen (American Society of Anesthesiologists I–II). Randomly selected patients (two groups: Group B: 30 patients and Group BC: 30 patients) were treated with bupivacaine (0.25% 1 mL/kg) and clonidine (1 µg/kg) by adding them to either group. Measurements of parameters included length of analgesia after operation, quality of analgesia (observational pain score), hemodynamic variables, and side effects. Results: Group BC (9.8 ± 2.1 h) had significantly more time than Group B (4.5 ± 1.3 h) of postoperative analgesia ( P < 0.001). Group BC always had lower pain scores and rescue analgesic requirements were less. The hemodynamic parameters were stable between the groups and mild sedation was seen in 20% of Group BC patients which was medically tolerable. None of the significant negative events (respiratory depression, bradycardia, and hypotension) were reported. Conclusion: Caudal addition of clonidine to bupivacaine did not have significant adverse effects and increased the duration and quality of analgesia in pediatric lower limb and abdominal operations.
Background: Atrial septal defect (ASD) is one of the most common congenital heart diseases, with an incidence of 1.6 per thousand live births. In adults, it is 3rd most common congenital heart disease. Timely intervention in ASD prevents long-term complications such as pulmonary hypertension, atrial arrhythmias, and congestive heart failure, and it also improves the quality of life of the patients. Both the treatment options, namely surgical and percutaneous device closure, are safe and effective, with the percutaneous approach being at an advantage of avoiding the need of sternotomy and cardiopulmonary bypass and having a better edge in preservation of RV systolic and diastolic function. Aims and Objectives: To study changes in right atrial and ventricular dimensions with functions pre and post device closure & to compare the biventricular dimensions with functions pre- and post-op, at 1, 3 and 6 months. Materials and Methods: We performed a single center prospective cohort study in patients undergoing transcatheter device closure of ASD to study the improvement in structural and functional changes in heart with the help of two-dimensional Echocardiography. Result: We found noticeable improvement in left atrial reservoir and contraction function and also resolution of Right Atrium (RA) and Right Ventricle (RV) functional abnormalities, and favorable changes in pulmonary arterial pressure and paradoxical septal motion. Conclusion: These changes can be the forerunner of improvement in overall cardiac function and quality of life for the patient.
The globalization of education, including medical education, is a 21 st -century need that requires significant transformations to meet the global standards. The 2010 Lancet Commission provided a model for health professional education. It supports “competency-based, interprofessional, and system-oriented learning,” matching local needs. In India, the National Education Policy (NEP) 2020 outlines a broad “vision” for higher education. It stresses “flexibility, multidisciplinary learning, critical thinking, innovation, and technology integration.” A year before, “competency-based medical education” (CBME) was introduced by the “National Medical Commission” in 2019. It features “outcome-driven curricula, early clinical exposure, and ethical communication skills.” This approach reflects principles laid down by the Lancet. Both frameworks aim for “globalization, holistic education, and transformative learning,” but they differ in their targets. The Lancet Commission specifically addresses medical education, giving clear structural and assessment reforms, whereas the NEP 2020 provides a general framework for national higher education. To close this gap, India needs to incorporate Lancet reforms into its medical education system, improve accreditation processes, and evaluate the implementation of CBME. By aligning the NEP 2020’s flexible, student-focused vision with competency-driven, transformative strategies, India can become a “Vishwaguru” in medical education. The transformative potential envisioned by both the Lancet Commission and the NEP 2020 can be realized by “systematic implementation of institutional reforms, collaborative work across professions, and performance-based evaluations.”
Iatrogenic perforations are serious problems in endodontics because they create a connection to the periodontal space, which can significantly impact treatment results and prognosis. This case report shows that Mineral Trioxide Aggregate (MTA) is an effective solution for treating iatrogenic perforations in the area of the mandibular second premolar. A 48-year-old woman was referred for treatment after an accidental perforation occurred in her right mandibular second premolar, near the alveolar crest. Radiographic and clinical assessment revealed that the perforation extended into the periodontal space. A rubber dam was used to isolate the area during the ProRoot MTA treatment for the perforation. The treatment plan included disinfection of the tooth and the concerned site of perforation, sealing of the defect with MTA, root canal treatment, followed by placement of composite restoration. Throughout the follow-up period, the patient reported no symptoms, indicating that the treatment was successful. MTA is biocompatible, has sealing properties, and promotes tissue regeneration. In the present case, early diagnosis, early management, and proper material selection were responsible for the success. This case highlights the importance of following protocols in endodontic treatment to effectively manage such complications. MTA is a reliable material for repairing root perforations, mainly in challenging clinical scenarios.
Background: Postural control along with balance constitutes the major characteristics of functional movement as well as stability. In case these parameters are assessed in different stance conditions, important details concerning the neuromuscular coordination and control mechanisms may be derived. Thus, multi-level heel and toe standing have been a promising technique for the diagnosis of balance performance in healthy individuals. Methodology: The study was conducted from September 2025 to October 2025. Participation in the study was open to all healthy subjects who could perform four progressive standing positions: Heel standing, toe standing, toe-raise standing, and tiptoe standing. Each position will last 10 s and the stability of the participants and their control over postural sway will be observed. The four stage balance test and Modified Star Excursion Balance Test were employed to evaluate balance and postural control. Results: It was shown that with an increased difficulty level of the stance, participants exhibited larger center of pressure displacement reflecting reduced stability and increased postural sway. The most challenging positions were tiptoe and heel-standing. The Toe raise and Toe standing positions in contrast, manifested better balance control and stability ( P < 0.05). Conclusion: It is the final resolution of the research that multi-level heel and toe standing tasks can assess the postural control and balance of the healthy subjects well. The outcomes imply that the corresponding multi-level standing tests can be accepted as useful devices for the purposes of balance assessment and balance training or rehabilitation programs design.
The Unique Identification Authority of India (UIDAI) oversees the Aadhaar program, considered the largest biometric ID system globally. Aadhaar is a 12-digit unique identification number that is obtained voluntarily by all residents of India. Aadhaar data consists of demographic information and biometric data (fingerprints, iris scans, and a photograph of the face). Aadhaar numbers have been issued to over 1.11 billion Indian residents. This article is a review of the challenges associated with privacy, legal frameworks, societal acceptance, and the implications of using Aadhaar data for potential benefits in forensic investigation and the assessment of Aadhaar for investigation in routine criminal and civil cases. This review has highlighted the advantages of using UIDAI data for the immediate identification of anonymous dead bodies and also individuals accused of criminal acts while addressing the ethical, medicolegal, and sociocultural issues.
A 46-year-old female with a history of recurrent complete maxillary denture fracture presented for treatment. Due to financial limitations, a metal mesh-reinforced denture was fabricated as a cost-effective alternative to implant-supported or cast metal prostheses. This case demonstrates a successful, affordable approach to enhancing the durability of a complete denture, offering a viable solution for patients with financial constraints seeking a more fracture-resistant prosthesis. Denture fracture results from the heat-cured acrylic resin’s inability to withstand high occlusal loads alone. Innovative materials and suitable methods can be used to overcome this issue. For these situations, metal mesh reinforcement in dentures offers a good and affordable option. The process of creating a metal mesh reinforced single maxillary denture, which is simpler to construct and more effective at withstanding the masticatory loads of mandibular teeth, is described in this case study.
Lipomas are benign growths arising from adipose tissue and constitute the most frequently encountered type of mesenchymal soft-tissue tumor. Although lipomas may develop in different parts of the body, they are most commonly found in the subcutaneous tissue of the trunk, neck, and extremities. Lipomas measuring more than 10 cm are termed “giant lipoma,” which are relatively uncommon, especially in regions such as the axilla. In these situations, ultrasonography, cytology, and computed tomography are commonly used to assess giant axillary masses. This report presents a rare case of a giant axillary lipoma in a 40–50-year-old man, manifesting as a slowly enlarging swelling in the right axilla, first observed when he was 14 years old. The lipoma showed significant growth in the past year and was associated with a small ulcer at the base. Surgical excision under general anesthesia was performed, and a histopathological examination confirmed the diagnosis. The patient had an uneventful postoperative recovery. Lipomas are rarely seen in the axilla, and when a large tumor presents in that region, the potential for malignancy, such as liposarcoma, must always be considered. A thorough clinical and imaging workup is essential to rule out malignancy before planning treatment. The preferred management of giant axillary lipomas is complete surgical excision, especially due to the presence of a well-defined pseudo-capsule. Giant axillary lipomas, although rare in clinical practice, and can be effectively treated with this careful surgical approach which minimizes the risk of recurrence and leads to excellent patient outcomes.
Pemphigus is an autoimmune illness that causes blisters on the mucosa. The disorder is distinguished by the development of autoantibodies against desmosomal glycoproteins. In pemphigus vulagaris oral lesions may be the first signs, so dentists should beknow with all clinical findings, diagnosis, and management. This reports a case of pemphigus vulgaris (PV) in a 53-year-old lady who had ulcers on her right and left buccal mucosa, tongue, and palate. Clinical examination and histology led us to the diagnosis of PV. If left undiagnosed or untreated, PV can be lethal. Early detection allows for more suitable treatment and a better prognosis.
Mature benign cystic teratoma is a commonly encountered ovarian tumor, whereas the occurrence in the pouch of Douglas is relatively uncommon and the specific etiology remains unknown. The case report brings to fore a woman in her early twenties with lower abdominal pain suggestive of complex echogenic mass in pouch of Douglas on ultrasonography. The patient underwent laparoscopic excision of the mature cystic teratoma of the pouch of Douglas. Macroscopically, a 5.9 cm × 4.3 cm cystic tumor that emerged from the pouch of Douglas revealed that the mass was visibly detached from both the ovaries. From a microscopic perspective, the cyst was a fully developed cystic teratoma that did not originate in the ovaries. Postsurgery, 3-month follow-up showed full recovery of the patient with significant clinical improvement and USG pelvis revealed no recurrence at the primary site.
Background: Organophosphorus (OP) is reachable pesticide which has a high morbidity. There is limited information available on acute poisoning in the study area. Aim of the Study: To study the clinical profile, laboratory profile and outcome of organophosphorus poisoning at tertiary care hospital. Materials and Methods: A total of 100 individuals with organo-phosphorus poisoning were enrolled in this study and were categorized (mild, moderate, and severe poisoning groups) based on peradeniya organophosphorus poisoning (POP) score. Their serum cholinesterase (SChE) levels at the time of admission were sent and categorized into three groups. The POP score, SChE levels were analyzed to find their association with mortality, ventilator support, and duration of hospital stay. Results: Of 100 patients with organophosphorus (OP) poisoning, a majority of 36% subjects were aged between 21 and 30 years (66% males and 34% females), with a male-to-female ratio of 1.9:1. Chlorpyriphos (59%) was the most common type of poisoning followed by dimethoate (16%). A majority (46%) had mild, 38% had moderate, and 16% had severe poisoning. The overall mortality was 14%, mortality in patients requiring ventilator was 21.5% and the case fatality rates for were high in severe poisoning (62.5%). Conclusion: A higher POP score and a significant decrease in SCh-E levels were associated with increase in the duration of hospital stay, severity of poisoning, need of ventilator, and poor outcome.
A variety of reconstructive methods have been quoted in the literature for the reconstruction of defects created following excision of oral submucous fibrosis (OSMF). Nasolabial flap provided excellent function without compromising the aesthetics with little postoperative morbidity and good patient acceptance. This article details a modification of the nasolabial flap for reconstruction of extensive defects created by surgical excision of fibrous bands in OSMF in a 36 year old male patient with an interincisal distance of 10 mm. Nasolabial flap with fishtail modification was used to reconstruct the intraoral defect. Postoperative interincisal distance at the end of 6 months is 35 mm with an acceptable facial scar. Modified nasolabial flap can be used with minimal donor site morbidity to improve outcomes and to increase the distal extension to cover large defects.
Mucormycosis is a rare opportunistic fungal disease that progresses quickly, becomes spout and ultimately lethal. This condition is predisposed to by the patient’s poor systemic health. It begins after the inhalation of the fungal spores. The rhinomaxillary type invades the nasal mucosa and the paranasal sinus involvement is also present. This can be fatal if it extends into the orbital region and intracranium. Hence, early diagnosis and intervention are important for better prognosis. The aim of the current paper is to report a case series presenting radiographic features of rhinomaxillary mucormycosis using cone-beam computed tomography.
Purpose: To evaluate bilateral symmetry in permanent tooth development using Nolla’s staging method and to examine the impact of primary tooth status, age, and gender. Materials and Methods: A retrospective analysis was conducted on panoramic radiographs of 210 children aged 6–12 years. Each permanent tooth (excluding third molars) was assessed bilaterally using Nolla’s 10-stage classification. Symmetry was measured as the absolute difference in stage between contralateral teeth. Subgroups were formed based on primary tooth status (present, absent, and retained), radiographic signs suggestive of infection, age group (6–8 years vs. 9–12 years), and gender using appropriate nonparametric tests (Wilcoxon signed-rank test for paired comparisons and Mann–Whitney U -test) for subgroup analysis. Interexaminer reliability was assessed using Cohen’s kappa. Results: Overall, high bilateral symmetry was observed, with mean stage differences typically <0.3. Premolars and canines showed the highest rates of ≥1-stage difference in >20% of cases. However, no statistically significant differences were observed between contralateral tooth pairs after adjustment for multiple comparisons. Increased asymmetry was observed in association with retained, absent, or infected primary teeth, as well as among males and younger children ( P < 0.05). Interexaminer reliability was high (κ = 0.82–0.91). Conclusion: Symmetry in permanent tooth development is generally maintained, but can be altered by primary tooth conditions, age, and gender. Recognition of such variability is important for timely pediatric, orthodontic, and forensic applications.
