European Journal of Molecular & Clinical Medicine

Background: Cholangiocarcinoma, including intra-and extrahepatic cholangiocarcinoma,
is a rare but highly lethal cancer. Despite effort in finding the risk factors of
cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown.There are
considerable geographic and demographic variations in the incidence of
cholangiocarcinoma. Although it comprises only 10-15% of hepatobiliary neoplasms, its
incidence is increasing. There are several established risk factors for CC and few are
modifiable which will help in reducing the incidence.
Aims and Objectives: To study the Prevalence and risk factors of cholangiocarcinoma at
GMC Budaun.
Material and Methods: All types of cholangiocarcinoma cases above age of 40 years
admitted to Department of Surgery, GMC Budaun U.P., were studied for risk factors over a
period of two years.
Results: An incidence of cholangiocarcinoma was 0.032% in present study. Peak incidence
of cholangiocarcinoma was 4th to 6th decade of life with mean age of 61.92 years. out of
26 patients 13 patients (50%) were smoker and in those 13 patients 12 (92%) were smoking
for more than 10 years and 13 patients (100%) were smoking more than 10 cigarettes or
bidi per day. 18 patients were using chulha (69%) for cooking meals with coal as a primary
fuel.
Conclusion: In conclusion, we found associations with PSC, smoking and alcohol
consumption; however, further studies are needed to establish the risk factors in our
country Long term exposure to pesticides in patients, who are chronic smoker and exposed
to smoke from chulha are at higher risk of developing CCA than others in this socioeconomic
scenario.

: A pleasant smile not only increases the face value but is also important for improving the quality of life of a person in a variety of spheres. Facial appearance has a long lasting implication on an individual. An unacceptable dental appearance has often been associated with a negative effect on self-image, career advancement and peer-group acceptance. The third most frequent oral disorders, alongside tooth decay and periodontal disease, are dental malocclusions. To confer a treatment plan and to work out on the treatment needs of a community group, it is obligatory to know the trends of occurrence of various malocclusions. With this background the study was planned to determine the prevalence and various preventive and treatment procedures of malocclusion in Aurangabad district of Maharashtra. Methods: A community based cross-sectional study was conducted among 2151 subjects in Aurangabad district, being the capital of Marathwada region by Rural Health Training Center, Paithan under Govt. Medical College, Aurangabad. The standard pro-forma was designed and house to house survey was conducted over a period of 3 months i.e. from June to August 2021. Mouth mirrors, caries explorers and periodontal probes were used for oral examination with proper aseptic precautions. All the findings were recorded in the data sheet after thorough examination. Descriptive statistics and chi-square test were applied using SPSS-17 version. Results: In the present study, prevalence of malocclusion was found to be 28.4%. Epidemiological studies on malocclusion not only help in orthodontic treatment needs and evaluation of dental health services but also offer a valid research tool for assessing distinct environmental and genetic factors in the aetiology of malocclusion. Conclusion: Drastic efforts are being taken by developing countries like India to eradicate many medical and dental diseases. Extensive multi centric studies are required to obtain a countrywide representative data.

: Overall health status of an individual is greatly influenced by the oral cavity. Periodontal disease (PDD) and dental caries are the biggest threats to oral health among the various oral diseases. Despite increasing awareness and improvement in oral health, the global epidemiological data suggests that a worldwide prevalence of periodontal disease is 11.2%. It is a complex chronic disease which can lead to chronic inflammation, destruction of tooth supporting structures, and tooth loss in adults. With this background the study was planned to determine the prevalence of periodontal disease and perceptions towards oral health among the community in Aurangabad district of Maharashtra. Methods: A community based cross-sectional study was conducted among 2151 subjects in Aurangabad district, being the capital of Marathwada region by Rural Health Training Center, Paithan under Govt. Medical College, Aurangabad. The standard pro-forma was designed and house to house survey was conducted over a period of 3 months i.e. from June to August 2021. Mouth mirrors, caries explorers and periodontal probes were used for oral examination with proper aseptic precautions. All the findings were recorded in the data sheet and descriptive statistics and chi-square test were applied using SPSS-17 version. Results: Prevalence of periodontal disease in the present study was found to be 31.06%. It was observed that various factors act as predicators for periodontal disease. Conclusion: For reducing the disease Burdon and its impact on the community, school and community based oral health awareness programs should be implemented.

Shoulder disorders are the most common complaint in general population and have an unfavorable outcome in many patients. Shoulder pain is the third most common cause of musculoskeletal consultation in primary care. Degenerative rotator cuff tear is the characteristic cause of shoulder pain and most often involves the supraspinatus tendon (SSP tendon). These tears can cause the significant impact on patient’s life, marking the functional impairment of shoulder joints. Plain radiography, ultrasonography, MRI, are the imaging modalities used for the assessment of rotator cuff-related pathologies. Ultrasonography of shoulder is accepted as the investigation of choice for rotator cuff abnormality mainly because it is non-invasive, cost effective, time consuming and well tolerated imaging modality that uses high frequency transducers to diagnose rotator cuff tears.This research deals with the study of prevalence of asymptomatic rotator cuff tears and their correlation with respect to age, sex, hand dominance and diabetes mellitus.

Background and Aim: Post operative bleeding is very common post operative complication seen in extraction cases. Anti coagulant therapies are employed to manage several clinical conditions. Patients those who are already on anti coagulant therapy, can show different patterns of post extraction hemorrhage. Anti coagulant makes blood flow via veins more easily. So, blood will be less likely to make a dangerous blood clot (like thrombosis or embolism). The sole endeavor of present study was to evaluate the correlation of post extraction hemorrhage and anti coagulant therapies in younger population. This study was retrospectively performed to assess the related prevalence also in the studied population. Materials & Methods: Patients case history, follow up case sheet and discharge summaries were explored. Younger age group patients those had undergone single tooth atraumatic extraction for different reasons, were selected for study. Patients who reported to be on anticoagulant therapy for more than one year, were studied in group one. Patients who reported to be on anticoagulant therapy for six to twelve months, were segregated in group two. Patients who reported to be on anticoagulant therapy for less than six months, were studied in group three. Patients not receiving this therapy were served as control group or group four. Post operative bleeding was studied under five categories in each group. These were mild, moderate, severe, uncategorized and no bleeding. Statistical Analysis and Results: Statistical analysis was done by statistical software Statistical Package for the Social Sciences (SPSS). P ≤ 0.05 was considered as statistically significant. Total 84 male and 36 female patients were studied in this study. Therefore, majority of the studied patients were male. In group I, 9 out of 30 patients had no bleeding. However, 8 patients showed severe post operative bleeding. 5 patients showed only mild bleeding. In this group (group I), P value was significant for all five severities of bleeding. In group IV, 23 patients had no post operative bleeding. Nevertheless, only 1 patient showed severe post operative bleeding. Only 1 patient showed mild bleeding. In this group (group IV), P value was significant for patients with no post operative bleeding (0.03). Conclusion: Within the limitations of the study, authors concluded that anti coagulant therapies are significantly affecting post operative bleeding in extraction cases. The relative severity and prevalence of bleeding are also exaggerated by time period of anti coagulant therapy. Patients those who were on anti coagulant therapy for more than one year, showed maximum prevalence and severity of bleeding.

OBJECTIVE: To study the prevalence and association of psychosocial concomitants with
dental fear and anxiety (DFA) in children aged 3-18 years in Lucknow, Uttar Pradesh.
STUDY DESIGN: This observational study was conducted among children aged 3-18years
who visited the Department of Pedodontics and Preventive Dentistry at Babu Banarasi Das
College of Dental Sciences, Lucknow. A clearance for the study was obtained by the
Institutional Research Committee. DFA levels for prevalence were assessed using Children
Fear Survey Schedule-Dental Subscale (CFSS-DS). Psychosocial concomitants were recorded
with the help of semi structured designed questionnaires separately for patients and parents by
the psychologist. It dealt with socioeconomic factors, family situation, medical and
psychosocial history, child’s daily life, adjustments and interactions. Parent’s questionnaire
included the reason for visit, awareness about milk teeth, brushing schedule, family living
style (nuclear or joint, number of children, education and occupation of parents). Obtained
answers from the questionnaire were graded using the semantic scale and some with the
dichotomized answers (yes or no).

This study was conducted to estimate the prevalence and distinguish kinds and related factors
of Mental Disorders among elderly people attending Geriatric Clinic, Baghdad, Iraq.
Methodology: A cross-sectional study conducted and a systematic random sampling technique
was used to select 320 elderly people. We collected data on basic demographics and associated
risk factors using a questionnaire filled through self-reported questionnaire. Mental disorders
(MDs) were defined according to Kessler Psychological Distress Scale (K10) with a cutoff score
of 20+. Accredited tools used by WHO were utilized to identify mental disorders kinds. Results:
The prevalence of MDs in the study sample was 24.4%. The prevalence of MDs types were:
Depression 16.6%, anxiety 12.8%, dementia 5.3%, substance abuse 2.5%, suicide thoughts
5.6%, and suicide attempts 2.5%. Logistic regression analysis was used to examine the
determinant factors of elderly MDs revealed the following significant factors: Aging, smokers,
living depends on others, loneliness and social isolation, visual impairment, economic state
deterioration, neglect and mishandling, and chronic diseases are the determinant factors of
elderly MDs. Conclusions: Mental disorders are wide spread among elderly people and
enhanced elderly mental health care services should be provided

To determine the prevalence of refractive errors among the type 2 diabetic population through a community-based study conducted in Lucknow.
Background of the study: Diabetes prevalence is on the increase rapidly the epidemic proportions during development as well as the world developed. Refractive error in the diabetic population is considered a leading cause of visual impairment.
Methods: A total of 437 patients (> 40 years old) with type 2 diabetes were examined via complete eye screening tests, including objective autorefraction. Spherical equivalent refractions of both eyes were reported. Data collected include age, gender, general medical information, and serum biochemistry.
Results: The mean refraction was −0.84 ± 2.59 D. Prevalence rates were determined for astigmatism (63.8%), hyperopia (1.4%) & myopia (0.2%). 34.6% of the patients were emmetropic. Age is an essential factor for all refractive errors. Correlation showed that every increase of one year of age and one percent of HbA1c is associated with 0.05 D (P = 0.003) and 0.14D (P = 0.04) shift in hyperopia, respectively.
Conclusions: This study provides epidemiological data on refractive errors in a North Indian diabetic population in Lucknow, India. The astigmatism prevalence is higher than the reported rates in the diabetic population compared to hyperopia and myopia. The second major finding was emmetropia.Refractive errors, Type 2 diabetes, Prevalence, Community-based stud

Introduction:The neonatal period comprising the first 4 weeks (28 days) of a child's life after birth is critical and dangerous events might occur. Structural, functional changes occur rapidly in this period. It is very important for mothers to be aware of the danger signs in neonates during this period. This study was done to find the prevalence of knowledge and awareness of danger signs among mothers of children aged less than 1 year.
Methods: A Community based cross-sectional study was carried out in United Arab Emirates from June 2020 to August 2020. Simple random sampling method was used and the sample size was calculated as 150. Mothers of children aged below 1 year were included in the study. A semi-structured pre-tested questionnaire was used in this study for interview purposes. Informed oral consent in common languages- English, Hindi, Tamil, Telugu, and Malayalam was obtained.
Results: The prevalence of good knowledge of danger signs among mothers of children aged less than 1 year in this study was found out to be 28.6%. 91.2% of the mothers have reported having sought medical care when any of the mentioned Danger signs occurred whereas 8.7% of them had opted to treat at home.
Conclusion:In spite of extensive coverage of maternal and child health services, the knowledge and awareness of the danger signs in neonates are fairly low in the mothers. Therefore more awareness and health education campaigns need to be implemented.

Background of study: Soft tissue injuries include pain, weakness, numbness, and tingling sensations involving the muscles, ligaments and tendons. The etiological factors of these injuries can be professional, personal, environmental, and psychosocial. These disorders in musicians are designated as playing related soft tissue injuries. Aim of Study: To investigate the disability and severity of playing related soft tissue injuries among professional guitar players. Methodology The cross sectional survey was conducted from February 2017 to June 2018 after taking ethical approval from institutional ethical committee. The participants fulfilling the inclusion criteria were recruited through convenient sampling technique and informed consent was taken. A structured anonymous questionnaire and validated scales like Disability Arm Shoulder and Hand Scale (DASH), Neck Disability Index (NDI), Oswestry Disability Index (ODI) Oswestry Disability Index (ODI) were used for data collection. The results was assessed by using IBM SPSS Version 20.0. Results: In this study 98 participants were included constituting 50 (51 %) females and 48 (49 %) males. The highest prevalence site of pain was wrist 57% followed by back 26 %, shoulder 22 % and elbow 21 % while least pain was reported in neck 7 %. Likewise, When Compared with DASH score was more than to ODI and NDI score was lower with significant difference assessed at 95% confidence interval (p < 0.05) Conclusion: This study concludes severity of soft tissue injuries are more prone in guitar players. The common sites was in wrist, shoulder, back. Proper technique, postural education, warm up and cool down will benefit in reducing the risk of injuries.

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

The aim of this study was to assess the prevalence of missing permanent first molars in the South Indian population who reported for orthodontic treatment to a dental hospital. A total of 550 OPGs of patients who reported for orthodontic treatment to the hospital were assessed for missing permanent first molars.The data was retrieved from the extensive electronic database record of the hospital. Descriptive analysis was done to represent the data. Prevalence of missing permanent first molars was found to be 5.8%. A significant percentage of the orthodontic population have missing permanent first molars. A thorough clinical examination, from an orthodontic perspective will help formulate a better treatment plan.

Dental caries(DC) is one of the most prevalent oral diseases of health concern often affecting adolescents.Dental caries is a biofilm mediated,diet modulated, multifactorial, non communicable,dynamic disease resulting in net mineral loss of hard fissure of the oral cavity. It is determined by biological, physiological, behavioural and environmental factors of an individual. As a consequence a carious lesion is produced. People of all ages are affected by dental caries.Adolescents are individuals between 10-19 years old and proven to have a high caries experience. The aim of this study is to evaluate the incidence of Dental caries among 10-19 years old patients visiting Saveetha Dental college between june 2019-april 2020. A total of 5445 patients data was analysed from their case records and analysed for incidence among gender,correlation with age.It was found that out of 5445 patients,3021 patients(73%) were male and 2412 patients(25%) were female and 2 patients(2%) were transgenders.Patients of the age group of 13-19 years had more incidence and the age group of 14-15 year old had least incidence. Within the limitations of this study it can be concluded that male patients have more DC than female patients among the 10-19 years age group in an outpatient population of a Dental College.

Introduction:
The permanent first molar teeth are the most caries prone teeth in mixed dentition. Reasons for permanent molar teeth loss include poor prognosis, caries,orthodontic and periodontal reasons. This study was done with the aim to assess the common reasons for extraction of first permanent molars in children between 6-17 years of age.
Materials and methods:
A total of 89000 case sheets were reviewed and cross verified from June 2019 to March 2020. Data related to permanent molar extractions were retrieved by searching with Patient ID, age, gender ,tooth number and treatment relevant to the study. Data was tabulated in the excel sheet. Statistical analysis was done using Statistical Package for the Social Sciences software(version 9.0.3). Results were statistically analysed using association analysis.
Results:
Higher number of males (64.47%) had first permanent molar extractions when compared to females (35.53%). In males, dental caries with pulpitis (22.37%) was the most common reason for extraction of permanent molars. In females, root stumps(13.16%) was the most common reason for extraction of permanent molars. In both 8-12 years age group and 13-17 years age group, dental caries with pulpitis (34.21%) was the most common reason for extraction of permanent molars.
Conclusion:
Within the limitations of the current study, first permanent molars were commonly extracted among males and dental caries with pulpitis was the most common reason for extraction of first permanent molars.

It has been established that smoking is a very different addiction to break. Many smokers persist in
tobacco use for several years and cycle through multiple periods of remission and relapse Smoking is not a
single event process and relapse is an ordinary component of this process. International guidelines have
greatly emphasized on relapse prevention. Very few studies examine the association between the number
of cigarettes smokers consume per month and their response to cues derived from peer and physiological
distress. This study aims to evaluate association between peer pressure and relapses during tobacco quit. A
retrospective study was conducted by reviewing 75,000 patient records of University hospital for a period
of nine months from June 2019 to March 2020. About 150 case reports containing information on tobacco
dependence and quit rate (in terms of number of relapses) were retrieved and analysed. Descriptive
statistics was done to present the sociodemographic details. Chi-square association was done to find the
association. Most of the participants (34%) were in the age group 29-38 years, followed by 49-59 years
(26%), 19-28 years (24%) and 39-49 years (16%). About 13.3%, 20%, 4%, 10% of 19-28 yrs, 29-38 yrs,
39-48 yrs and 49-59 yrs of patients respectively had peer pressure during their quitting process.About
11.3% 20%, 8.67 and 13.3% of patients in the age group 19-28 yrs, 29-38 yrs, 39-48 yrs and 49-59 yrs had
no relapses during the quitting process.No significant association between age and number of relapses
(p=0.746; not significant). Hence proving no influence of age on relapse during quitting process. About
28% of patients with peer pressure and 25.3% without peer pressure had no relapse during quitting.
However 19.3% and 27.3% with and without peer pressure had >1 number of relapses. during their
quitting process,No significant association of peer pressure in relapse (p=0.295, not significant). No
influence of peer pressure on relapse during the quitting process. Peer pressure is not much influencing the
number of relapses during the quitting process, however a watch over this factor to be taken in account
during cessation counselling

Dental injuries result in functional , esthetic and psychological disturbance accompanied by great concern.Traumatic dental injuries are due to the physical impact on a tooth and its surrounding tissues which may be direct or indirect trauma to the teeth may result either injury of pulp, with or without damage of crown or root displacement of the tooth from the socket. The most frequent causes of these injuries are falls, sport activities, bicycling, traffic accidents. A cross sectional retrospective study of, study population will 100 adult patients visiting Saveetha Dental College and Hospital with tooth fracture . Data was gathered and analyzed. The data was tabulated and Chi square analysis done using IBM SPSS software version 20. With the limited population and parameters of this study, there is a more prevalence of tooth fracture in male over females .The most common tooth involved in fracture is 21.Traumatic dental injuries are recognized as a public dental health problem worldwide.

Background: at a global level and among child bearing age women, the first leading disease burden cause is the depression. Nationally, scarce published data was related to the depression prevalence among pregnant especially with hyperemesis gravidarum women. Aim: to assess the depression extent among hyperemesis gravidarum pregnant Thi-Qarnian women. Methodology: A cross sectional, hospital based, analytical study was carried out in two teaching hospitals (Bent Al Huda and Al Habobi teaching hospitals) in from first week of September /2015 to end of July 2016. All attendants sufferer pregnant from HG to the obstetric outpatients included in this study. Based on previous Iraqi study (37.2%) for of depressive symptoms prevalence in pregnant women sample size had been calculated such prevalence rate with precision of 5%, confidence level of 95%, and added extra sample of 10%, to reach to 322. Beck depression inventory-II (Arabic version) (BDI –II score of > 20 depression was considered) had been used as a specialized questionnaire designed for the achieve the aim of the study. SPSS version 23 had been used for data analysis, P

Orofacial infections of odontogenic origin have long plagued mankind. The discovery of the miracle drug
by fleming in the year 1928 and the routine use of penicillin after the landmark discovery of the powder
form of the antibiotic by florey and chain leading to significant change in the management of odontogenic
infection .The spread of infection is governed by factors such as impaired host defence, the virulence of
microorganism, functional abnormalities of the host and a lack of or delayed treatment. the microbiology
of odontogenic infections in diabetic and non-diabetic individuals has been found to be variable. Though
the effects of diabetes can affect infection severity , length of hospital stay, susceptibility to antibiotics
and outcome of treatment is unassured . Differentiation in antibiotics prescribed is also observed.The aim
of the study was to analyse the prevalence of the use of antibiotics among diabetic and non-diabetic
patients in a south indian dental university clinic . The list of all diabetics and non diabetics patients
treated for pain, dental infections , swelling were retrieved by reviewing 86000 patient records who have
visited the hospital during the study periods from june 2019 to march 2020 from the university
database.Data tabulation was carried out in Excel. The data was imported and transcribed in Statistical
Package for Social sciences version 16(SPSS,IBM corporation). Descriptive analysis was carried out.A
total of 9128 patients were included in the study based on treatment done of which 580 patients(6.3%) had
diabetes mellitus. Only 3.5 % of the male population and 2.8% of the female population has
diabetes.Amoxicillin 93.2% was found to be the most frequently prescribed antibiotics among nondiabetic
patients and diabetics patients 1.6% .A combination of metronidazole and amoxicillin was
prescribed to 0.5% of the whole study population .A combination clavulanic acid and
amoxicillin(augmentin )was prescribed to 4 % of the total diabetic study population and 0.4% of the nondiabetic
study population that is about.The relation between the diabetic status of a patient and the
antibiotic prescribed showed a significant statistical relationship in a Pearson's Chi square test with p value
of 0.001(p<0.005).The prescribing practises in dental offices can be improved by increasing awareness
among dental practitioners about the recommended guidelines for prescribing antibiotics . The most
commonly prescribed antibiotics among diabetic patients was Augmentin (4.08%) and for non diabetics it
was amoxicillin (93.25%). .

Dental erosion is a public health problem as it may affect various age groups and gender. It may lead to dentin hypersensitivity and eventually pulpal exposure if the erosion is severe and not treated which causes pain. Therefore, the study was done to find the association of gender with dental erosion. A retrospective study was conducted using University hospital patient records from July 2019 - March 2020. A total of 149 case sheets were reviewed. The data variables such as socio-demographic data, presence of dental erosion and number of teeth involved with dental erosion were retrieved and analyzed. Results were present with frequency distribution and chi-square test for association. Dental erosion was prevalent in males (64.4%) than females (35.6%). The age range of the patients included in the study was 21-80 years old out of which 21-40 years (14.8%), 41-60 years (57%) and 61-80 years (28.2%). Erosion in maxillary teeth involving 0-5 (85.8%) was the highest followed by 6-10 (14.1%) and erosion in mandibular teeth involving 0-5 (87.9%) was the highest followed by 6-10 (11.4%) and 11-15 (0.7%). There was no statistically significant association between gender, age with dental erosion in maxillary and mandibular teeth (p>0.05). Within the limitations of the study, it can be concluded that dental erosion was prevalent in males of early 60’s and there was no association between gender, age with dental erosion in maxillary and mandibular teeth.

Rubber dam was introduced by Dr.Barnum in the 1860 s, the main advantage of using rubber dams in endodontics include patient protection from medicaments, aspiration of endodontic instruments, tooth debris, and irrigating solutions. The aim of the study to determine the prevalence and frequency of rubber dam usage during endodontic procedures among dentists in the state of TamilNadu, India.A survey was conducted among 101 dentists in the state of Tamil Nadu, India by preparing a set of questions, and the answers were collected through an online survey method.In this survey, 82.2% feel comfortable to use a rubber dam,36.6% never use a rubber dam to pediatric patients,89% always use a rubber dam to adult patients,61.4% not using rubber dam for all cases of RCT,73.8% need to gain knowledge about rubber dams through training programs,23.8 % told patients discomfort was a reason for not using a rubber dam, 80.2% not using rubber dam while taking X- rays,45.5% take more than 5 mins for applying a rubber dam to patients,63.4% told it is easily available for clinical usage.The present survey shows there is a low prevalence of its usage during endodontic treatment. Greater emphasis should be placed on the advantages of using rubber dams in clinical dentistry at dental school and through continuing dental education for practitioners to update their knowledge

patients who underwent frenectomy/ frenotomy for high frenal attachment in a dental hospital from June 2019 to March 2020. No gender or age restrictions were. 99 patients were included in the study. Digital case sheets were reviewed and the following data including the details like patients gender, age, site of high frenal attachment, reason for frenectomy were extracted, tabulated and analysed statistically with Chi square test using SPSS version 20. Among those 99 frenectomy cases. The males were ( 43.4%) and females were (56.6%). The prevalence of frenectomy was more in female gender as compared to male gender. The common reason behind frenectomy was spacing (61.6%) and the more common site of high frenal attachment was S2 (Maxillary anterior sextant) (55.5%) compared to S5 (Mandibular anterior sextant). There was a significant difference in the reasons for frenectomy between site(p < 0.05 )and sites underwent frenectomy and age of the patient(p < 0.05).No significant difference in the reasons for frenectomy between males and females (p > 0.05). From the study it can be concluded that the common reason for frenectomy is diastema and the reasons for frenectomy is influenced by the site of high frenal attachment and the age of the patients.

Pregnancy has some physiological changes which complicate the process of diagnosis and treatment. Over 200 million people suffer from anaemia especially among women of reproductive age. Anaemia is a major health problem among pregnant and non-pregnant women. Anaemia during pregnancy is considered as a public health problem especially in developing countries. The World Health Organization (WHO) defined anaemia during pregnancy as a haemoglobin concentration of less than 11g/dl. In severe anaemia, the haemoglobin level is 6g/dl. Anaemia threatens both mother and foetus. The causes may be multifactorial, such as nutrient deficiency, parasitic infections or chronic infections. It may also be due to acute blood loss. It may also depend on geographical location and economic status. The effects of anaemia on mothers are tiredness, weakness, dizziness and affects the immune system. In children, it may cause preterm delivery, low birth weight. On both the mother and the fetus it can cause mortality and morbidity. Intake of balanced diet and awareness programmes on anaemia is a measure to prevent anaemia. This study is to evaluate the awareness and prevalence of anaemia among pregnant women. A cross-sectional survey was conducted containing a set of self-developed questionnaires. The data was collected and analysed using SPSS software. The results are analysed and tabulated. The result was gained as follows, 25% of the participated population‟s haemoglobin level is less than 11, 75.89% of the population participated are aware that anaemia can affect pregnant women, 66.07% of the population agree that haemoglobin level less than 11 can cause anaemia. From the study, it is obvious that there is an awareness between the effects of anaemia during pregnancy.

Background:
Psychiatric disorders in Saudi Arabia, mainly depression are estimated to have high prevalence. More than 6 decades ago, the World Health Organization (WHO) defined health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” Bircher, 2005 defined health as “a dynamic state of well-being characterized by a physical and mental potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility”. Health has been defined by various authors, who have always emphasized its mental component.In recent years, there has been a sharp increase in the number of older persons worldwide. Globally, more than 350 million people of all ages suffer from depression. Elderly persons are more vulnerable to depression. By the year 2020 depression would be the second major cause of disability adjusted life years lost, as reported by the World Health Organization. depressive symptoms are common among older people and are associated with disability, morbidity and mortality. Depression is a mental illness which causes persistent low mood, a sense of despair, and has multiple risk factors.
 Aim of the study: To assessment the determinant and prevalence of depression among elderly attendees in primary health Care center in Makkah Al-Mukarramah.
Methods:Methods: A cross-sectional study was conducted among elderly patients attending to clinic in PHC at Makkah, Saudi Arabia, during the October to December, 2019, validated questionnaires concerning demographic data and knowledge scores on depression among elderly. Our total participants were (400). Results:show that the Family history of depression (70.0%) is the most common clinical variables also show that of the(45.0%) participants have negative depression , (23.0%) have moderate depression,  and the data ranged from(0to 16)by mean+ SD (7.254+2.88).
Conclusion:Depression is associated with a deficiency in the cognitive state, with familial partner risk being an influential factor that may be preventable. Depression constitutes a health problem among Saudi geriatrics in in Makkah Al-Mukarramah, especially among elderly, those having history of chronic diseases and those having sensory impairment. These results provide insight for all health care workers caring for the elderly, researchers in the field of Geriatrics, and health educators into the particular care needs of elderly patients in Makkah, KSA.