Introduction: Chronic obstructive pulmonary disease (COPD) is an obstructive lung disease. It occurs due to increased activity of oxidants combined with reduced activity of antioxidants. It is currently the 4th leading cause of death worldwide, projected to be 3rd by 2020. It has been proven that individual who develops COPD, gradually develops reduction in the strength of the peripheral muscles that will lead to further decrement in the physical activity and impaired mobility. These events gradually develop a vicious cycle. In the recent years we have developed many tools to evaluate or quantify the impaired physical activity which will help us to take certain measures to limit these and to improve the overall physical and mental health. There are various exercise performance test available to assume the physical activity impairment in COPD patients, like 6 minute walk test, incremental workload test, but lacunae with these test is that they require skilled personnel and various equipments. So, due to these reasons these tests could not be performed in many of the centers, to overcome these lacunae a simple test has been derived, i.e. sit to stand (STS) test. The advantage with this test is that it is easier to perform and does not require huge space and personnel. Aim and objectives: The goal of our study is to assess: • Exercise capacity in COPD patients • Correlation of STS test with severity of disease (COPD) Methods: Consecutives, stable COPD patients were examined in outpatient department of Chest and Tuberculosis (TB), a tertiary care hospital (Rohilkhand Medical College) during a period of 6 months (March–August 2017). The diagnosis and severity of COPD were assessed by spirometry and the global initiative for chronic obstructive lung disease (GOLD) guidelines. STS test was executed according to a standardised protocol. Patient was asked to sit without any assistance and to stand completely straight. Patient was asked to perform as many repetitions as feasible in 30 seconds. During the tests performed, the severity of dyspnea (modified Borg scale), oxygen saturation, heart rate were measured. Statistical analysis was done using EpiInfo version 7.2. Results: Total 46 stable COPD patients (mean age 59.69±11.77 years, mean forced expiratory volume (FEV₁) 40.02% ± 19.41%) were analyzed. During STS test, there was rise in heart rate, fall in oxygen saturation, and increase in dyspnea score which was statistically significant (p < 0.05). Mean repetitions in GOLD I and II COPD patients was 11, in GOLD III and IV COPD patients was 9.7886 in 30 seconds STS test (number of repetitions) was significantly correlated with FEV₁ (p < 0.05).

Introduction: Lack of healthy sustenance is one of the real general well-being concerns influencing a critical number of school youngsters affecting their well-being, development and improvement, and school scholarly execution. Malnutrition is the biggest medical issue of youngsters in creating nations. Roughly, 60 million children are underweight in India and youngster malnutrition is in charge of 22% of the nation's weight of sickness. One in each three malnourished youngsters on the planet lives in India. So, this epidemiological study is conducted among schoolchildren of Bareilly district. Aims and objectives: To estimate the prevalence and risk factors of malnutrition among school-going children of provincial region of Bareilly locale, Uttar Pradesh, India. Materials and methods: A cross-sectional study was conducted in Bareilly district, using multistage sampling technique. Pretested and prevalidated schedule is used for data collection, which was then compiled and analyzed using EpiInfo software version 7.2. Results: Totally, 150 children from primary schools of rural area were examined for malnutrition. Overall prevalence of malnutrition was 35.4%; among them severe thinness, thinness, overweight, and obesity were reported as 6, 14, 10.7, and 4.7%, respectively, whereas in majority of students, nutritional status was found normal, i.e., 64.6%. Conclusion: Health education should be used as a vehicle for promotion of healthy practices and healthy attitudes among children. Parents should be encouraged for healthy eating practices.

Introduction: Adolescents aged between 10 and 19 years constitute 18% of the world population, i.e., about 1.2 billion. About 88% of them live in developing world. India has the largest (243 million) number of adolescents comprising one-fourth of the country's population. Adolescent health and nutrition status has an intergenerational effect; hence, it is one of the important stages of the life cycle in terms of health interventions. Injuries and communicable diseases are prevalent among adolescents in 10 to 14 years age group; outcome of sexual behaviors and mental health problems become significant among adolescents in the 15 to 19 years age group. Aims and Objectives: To assess the awareness of adolescent- friendly health services (AFHS) among adolescents in the rural areas of Bareilly district, Uttar Pradesh. Materials and methods: A cross-sectional study was conducted in the rural areas of Bareilly district using multistage sampling technique. Pretested and prevalidated schedule was used for data collection and the data were compiled and analyzed using Epi-Info software version 7.2. Results: A total of 102 adolescents aged 10 to 19 years from rural areas of Bareilly district were interviewed on awareness regarding treatment offered in AFHS in districts. Out of the total, 60.8% were not aware regarding AFHS, 63.7% were not aware regarding the places of AFHS clinics; 45.1% were not aware regarding the treatment of menstrual problems. None were aware regarding treatment of sexually transmitted disease. Of the total, 98% were not aware about pregnancy care and prevention; 55.9% were not aware regarding the services available at different levels; 54.9% were not aware regarding the official person designated in AFHS. No significant statistical association was found between the gender of people and awareness about the places of AFHS clinics. Significant statistical association was found between the marital status of people and awareness about the places of AFHS clinics. Conclusion: Emphasis must be laid to create awareness among people regarding AFHS. To strengthen the adolescent health services, the current situation demands a single comprehensive program under one ministry which will cover outreach activities as well as clinic-based services.

The debate of early vs late tracheostomy is far from settled. This study reveals that early tracheotomy is associated with higher tracheotomy rates and better outcomes, including more ventilator-free days, shorter intensive care unit (ICU) stays, less sedation, ventilator-induced pneumonia, and reduced long-term mortality compared with late tracheostomy.

Introduction: Cholesteatoma is traditionally diagnosed by otoscopic examination and treated by surgery. Imaging in an uncomplicated case remains a controversy. This study was planned to correlate preoperative high-resolution computed tomography (HRCT) and intraoperative findings in patients with squamous chronic otitis media and to investigate the usefulness of a preoperative HRCT scan in depicting the status of middle ear structures in the presence of a cholesteatoma. Materials and methods: (a) To compare the preoperative HRCT temporal bone and surgical findings in patients with squamosal chronic otitis media; (b) To evaluate the role of HRCT temporal bone in the assessment of squamosal chronic otitis media. A prospective observational study was conducted between September 2015 and August 2017 in the Department of Otorhinolaryngology, Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi. Total seventy diagnosed cases of squamous chronic otitis media were included, and their preoperative HRCT temporal bone findings and intraoperative findings were correlated. Results: The sensitivity, specificity, and positive and negative predictive values of HRCT were 73%, 97%, 80%, and 95% respectively, for determining the presence of lateral semicircular canal dehiscence 75%, 93%, 86%, and 88% respectively, for determining the presence of facial canal dehiscence; 84%, 71%, 87%, and 75% respectively, for determining the presence of scutal erosion; 91%,90%,62%,98% respectively for presence of tegmen erosion; 100%, 96%, 50%, and 100% respectively, for detecting the presence of dural plate defects. Conclusion: The decision for surgical intervention should not be entirely based on the radiological interpretation. The operating surgeon should be well prepared to encounter conditions which are not reported by the radiologist preoperatively and modify the operating strategy accordingly. The HRCT scan acts a good preoperative imaging modality for the otologist to predict disease and to explain the possible outcomes to the patient.

Introduction: We are moving from millennium development goals to sustainable development goals, having universal health care as a key. To achieve universal health care, we need morbidity patterns and data in order to plan for the fulfilment of the health care needs of the community effectively. Objectives: • To assess the morbidity patterns of patients attending the outpatient department (OPD) at the urban health and training center (UHTC) • To determine the antenatal care (ANC) of cases attending the OPD on a monthly basis at the UHTC. Materials and methods: The information was collected from the OPD registers of the UHTC. The data were taken for a 12-month duration from January 1, 2015 to December 31, 2015. We collected the information of all the patients, even those who visited the center for collecting medicines or for reviewing of the disease conditions and treatments. There were no exclusion criteria adopted to exclude the patients and his/her diseaserelated information. All the patients who visited the UHTC during a 1-year period were included in this study. Results: A total of 8,115 patients, including new, old, and review patients, attended the OPD of the UHTC during the 1-year period. Out of total, 2,524 were males, 5,591 females, 1,273 under 5 children, 157 ANC women, and 68 elderly. Conclusion: The overall performance of the UHTC was assessed regularly based on the records of both the old and the new patients including children, ANC women, and the elderly.

Aim: The aim of this study is to evaluate the dental anxiety expressed by patients undergoing endodontic treatment with respect to some social and dental parameters. Materials and methods: A questionnaire comprising of 25 questions was given to 1,000 patients, 500 males and 500 females, in order to assess their fear of different phases of endodontic therapy. Questions were asked before, during, and after completion of root canal treatment. Results: It was observed that females reported greater anxiety concerning root canal therapy than males. Older subjects reported less anxiety than younger subjects. Local anesthetic injection was ranked as the most unpleasant or anxiety-arousing aspect of root canal therapy. Conclusion: High-anxiety subjects reported feeling more apprehension upon hearing or reading stories concerning root canal treatment than low-anxiety subjects. Nearly everyone indicated that they would agree to future root canal therapy to save a tooth.

Measurement is a fundamental aspect of research in the area of infant mortality. The National Population Policy, 2000 aims at a reduction of Infant mortality rate (IMR) to less than 30 by 2010. The estimates on infant and child mortality at the national level and for major states of India are provided by the sample registration system (SRS) annually. The National Family Health Survey (NFHS) also provides the estimates by mother's educational level, standard of living of the households as well as the other socio economic characteristics of the households. Thus, at the state level we have good information on these estimates. Estimates of IMR can be derived directly as well as indirectly. The direct estimates are usually based on the number of infant deaths reported during the last one year per 1000 live births. The civil registration system as well as the SRS adopts this technique for providing the estimates.

Introduction: The aim of this study was to document the morphological and topographical anatomy of the accessory infraorbital foramen (AIOF) in relation to the main infraorbital foramen (IOF), which is necessary in clinical situations that require regional nerve blocks. Materials and methods: A total of 72 dry Indian adult human skulls of unknown age and gender were studied. Presence and position were noted. In each skull, the position of AIOF on both sides was measured using a metal casing Vernier caliper, with the IOF as the reference point. The number of accessory foramen was also noted. Results: Accessory IOFs were seen only in 4.16% in our study and all seen were single in number. Half of those accessory foramen were present on medial and half were present on superomedial position as compared with the main IOF; 50% of present accessory foramens were located at a distance of lesser than 2 mm and 50% were located at a distance of more than 2 mm. The mean location of AIOF was 3.1 mm from main IOF. Conclusion: Knowledge of the anatomical characteristics of AIOF may have important implications on blocking the infraorbital nerve for surgical and local anesthetic planning. Information on the foramens obtained from this study may provide additional guidance to surgeons when introducing needles in anesthetic procedures. The surgeons must remember this during nerve block since injury to any branch can result in sensory loss and incomplete nerve block.

Introduction: Plexiform neurofibromas are benign tumors originating from subcutaneous or visceral peripheral nerves, which are usually associated with neurofibromatosis type I. Orbital neurofibromas are relatively rare and usually present with high infiltration into the periocular structures making the management extremely difficult. Purpose: To r eport a c ase o f p lexiform n eurofibroma w ith neurofibromatosis type I in a young boy managed satisfactorily with surgical excision. Materials and methods: A 14-year-old boy presenting with a soft, painless, nontender, gradually enlarging swelling of the left upper eyelid and adjacent temporal region and of 6 years duration was managed with complete surgical excision. Histopathological examination of excised mass confirmed the diagnosis of neurofibroma. Results: Satisfactory functional and cosmetic result was achieved following surgical excision of the subcutaneous fibromatous mass. A 1-year follow-up did not reveal any functional deficit or recurrence. Conclusion: Plexiform neurofibroma may present as an uncommon cause of periorbital swelling even in the absence of typical features of neurofibromatosis type I and can be surgically managed to achieve acceptable cosmetic and functional results.

The practice of quackery in dentistry is a threat as it challenges the trust of the patients and places the patients at unnecessary risks through their illegal practices. Most commonly, dental quacks are the self-styled experts, whose basic tools are very incompetent and also pretentious. This is a case report of a 12-year-old girl with anterior teeth fracture who fell prey to two such fraudulent dental practitioners over a period of 2 years.

Heterotopic pregnancy is defined as the rare presence of simultaneous pregnancies at two different sites of implantation, one intrauterine and the other extrauterine (ectopic). It is a life-threatening condition that can be easily missed if not noticed carefully. Here, we present a case report of heterotopic pregnancy diagnosed by ultrasonography in a patient. Once an intrauterine gestational sac is visualized, the radiologists are relieved and do not inspect the adnexa carefully even if ectopic pregnancy is clinically suspected. One should remember “Think ectopic. If intrauterine gestation is seen, think heterotopic.”

Foreign bodies in maxillary antrum, whatever their origin or nature, are unusual. Usually it presents as unilateral unexplained chronic rhinosinusitis and rarely as fistula over facial skin. The diagnosis is usually based on the history, proper examination, and radiological findings. Mostly foreign bodies are of dental origin, such as tooth roots, dental impression material, root-filling materials, dental implants, and burs. Foreign bodies in maxilla lodge during various procedures, but sometimes, there may be history of blast injuries and penetrating objects. We are reporting a special case of foreign body maxillary antrum that occurred during the road traffic accidents and was misdiagnosed and treated for a long time as osteomyelitis.