European Journal of Molecular & Clinical Medicine

Aim: To study the clinico-etiologic profile of the critically ill geriatric patients admitted to the MICU.
Materials and Methods: The present prospective observational study was conducted on 100 patients of age 60 years and above with dysfunction of at least two organ systems, admitted in medical intensive care unit of Dr DY Patil Medical College Hospital and Research Centre, Pimpri, Pune during the period from OCTOBER 2020– SEPTEMBER 2022. When determining the severity of a critical disease, the SOFA score system is utilized, and this evaluation takes place both upon admission and after 48 hours have passed.
Results: Majority of the male and female patients were in the age group 60-69 years followed by 70-79 years and >80 years. The mean TLC is 18069.0 (SD ±9690.35441), mean CRP is 39.76176 (SD ±7.00), mean ESR is 20.82028 (SD ±11.00) and the mean urea is 45.70459(SD ±20.00). The mean direct bilirubin is 3.11292±5.22386, mean ALT is 218.0900±364.13262, mean AST is 185.7400±336.44123, mean ALP is 167.5500±101.13980, mean INR is 1.6261±0.63524 and the mean APTT is 33.9960±9.44580. Majority of the patients were having myocardial infarction (23%) followed by Cirrhosis Liver (18%), chronic kidney disease (17%), Pneumonia (12%), Ischemic Stroke (10%), Hemorrhagic Stroke (6%) and 3% in Bacterial Meningitis & Pyelonephritis. The mean SOFA score at admission and 48 hours were 5.73 ±3.36 and 6.2 ± 4.06 respectively. The mean value of Delta SOFA score was 0.47±3.00.

Aim: The aim of the present study was to determine the clinical presentation and document the etiological factors in patients with ocular motor nerve palsy involving 6th cranial nerve.
Methods: The cross-sectional study was conducted at a tertiary care center in western India from September 2020 to October 2022 and33 consecutive patients presenting with cranial nerves were included in study from wards and opd in a tertiary care center and sample size was calculated according to win pepi method.
Results: The Mean±SD age of the patients were 50±15.7 years and the range were 11-78 years. Majority of the patients were males (51.5%), followed by females (48.5%). Left side was affected among 51.5%, while 48.5% had their right side affected. RTA was the most common in 6^th nerve and hypertension (16%) were found as majority among the sixth nerve palsies. Majority of the patients had a visual acuity of 6/9 (15.2%) and 6/24p (12.1%).
Conclusion: Abducens was the most commonly involved nerve while trauma was most common etiology in our study. The most common cause for cranial nerve palsy was vascular i.e diabetes and hypertension. Therefore, early diagnosis and proper management of these systemic diseases can prevent ocular motor nerve palsies and its complications. Our study evaluated ptosis, diplopia, visual impairment, complete ophthalmoplegia, ocular deviation as some of the most common causes for ocular motor nerve palsies.

Background: Acute renal failure (ARF) is a generic term for an abrupt and sustained decrease in renal function resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products. To determine the cause, prognosis and outcome in patients of Acute Kidney Injury (AKI) admitted in a tertiary care hospital.
Materials and Methods: A Hospital based Prospective study was conducted in Department of Medicine, NRI Medical College for a 1 year period (From Septembet 2021 to Aug 2022). Universal Sampling Technique was used for selection of study subjects. All the patients coming to medicine department during the study period and fulfilling the xiii inclusion criteria were taken for study after taking prior informed consent. Final sample size was 138 subjects of Acute Kidney Injury of varied etiology.
Results: Mean of study subjects was 48.9 years (range from 19-87 years) with M:F ratio of 4.75:1. Most common etiology for AKI was Sepsis (14.5%) and Malaria infection (14.5%) followed by Dengue, AGI and Leptospirosis (11.6% each). Multi organ dysfunction (14.5%) was observed in patients of Sepsis and Lepto. Out of total patients, 92 (66.7% %) had stage II AKI, while 46 (33.3 %) had stage III AKI according to AKIN staging.A total of 11.6% patients were on dialysis. Two out of 46 patients of AKI stage III (8.7%) and one patient out of 92 (2.2%) belonging to AKI stage II died during the study.
Conclusion: AKI was observed at a relatively younger age in present study with male preponderance. Most common etiologies were Sepsis and Malaria. Most of the patient of Sepsis, MODS and Leptospirosis were having stage III AKI. Overall mortality observed was 4.34%.

Objective: The C-shaped root canal is a unique root morphology that is mostly present in mandibular second permanent molars. C-shaped root canal networks may make endodontic procedures more difficult due to their structure's complexity. For accurate diagnosis and successful treatment, a complete grasp of root canal morphology is required. This survey aims to summarize current knowledge, attitude and practice based survey on the incidence of c shaped canals in the mandibular molars among undergraduate students.
Materials and methods: The online survey was conducted among 100 participants among dental practitioners on google forms. The survey was done in January 2021. The Questionnaire consisting of 25 questions were framed based on the incidence of c shaped canals in the mandibular molars and circulated. Responses from the participants were collected and exported to SPSS software. The results were acquired and statistically analysed using SPSS software. The results were represented as pie charts and bar graphs.
Results: The association between participants with different years of study was analysed and found that the majority of first year and second year participants agreed that c shaped canals often have conical or square configuration than others. The association is statistically significant. Chi square analysis value (p - value) = 0.025(p<0.05 is statistically significant).
Conclusion:  From this, it can be concluded that undergraduate students had a moderate amount of awareness about C shape canals. As a result, more awareness has to be created in the UG curriculum regarding the various aberrant root canal morphologies

Understanding the etiology and pathogenesis of periodontal diseases and their chronic, inflammatory and infectious nature necessitates recognizing the possibility that these infections may have effects somewhere in the body. The concept that oral diseases and systemic diseases influence each other goes back to the theory of “focal infection”. In 1891, Miller published his theory regarding focal infection in which he indicated that microorganisms and their products are able to access parts of the body that are adjacent to or distant from the mouth. The proponents of this concept assume that microorganisms present in dental plaque and their metabolic products may enter the bloodstream, thereby causing many systemic diseases and sometimes resulting in degenerative conditions. Associations have been reported between periodontal disease and cardiovascular disease (CVD), stroke, diabetes, preterm low birth-weight babies, respiratory infections and rheumatoid arthritis (RA).

Introduction: Erythroderma is an intense exfoliative disease with generalized redness appearing all over the skin. Even when managed well, it is capable of causing many deaths. As a result a proper etiopathology of the disease has to be properly established to facilitate a timely and appropriate treatment.
Materials and methods: 203 patients who were clinically diagnosed for erythroderma were included in this study. Detailed demographic data, the time of onset, a history if any cutaneous diseases and the medications, comorbities, history of weight loss, history of pruritis, ungueal alterations, palmo-plantar keratoderma, ectropion was taken.
Results: 55.17% of the patients were males and 44.83% were females. The most common age group was 30- 50 years. The most common cause was psoriasis in nearly 50%, followed by drug reactions in 26.6% and idiopathic causes in 4.93%.
Conclusion: In our study, a large number of patients with erythroderma had psoriasis, proving that condition to be the most common cause, followed by drug reactions and idiopathic reasons.

Background:The present study is a Clinical Profile and Management of Incisional
Hernia in a Rural Tertiary Care Hospital done at Kamineni Institute of Medical
Sciences, Narketpally, from October 2015 to September 2017.
Materials and Methods: Forty cases of incisional hernia which were admitted in
Kamineni Institute of Medical Sciences were studied. The statistical data and analysis of
the cases studied during this period are presented in this study.
Results: It is more common in females than in males with a ratio of 4.71:1. Incidence of
incisional hernia was highest in the age group ranging from 40- 60 years. Most of the
patients presented with swelling (82.5%) and swelling with pain (12.5%). Incisional
hernia was more common in patients with previous history of gynecological operations
(52.5%). The incisional hernia was more common in the infra-umbilical region (52.5%).
In majority of patients (95%) the incisional hernia occurred within 3 years of previous
operation. The size of the hernial defect less than 40sq.cms was found in 22 patients
(55%).33 patients (70%) underwent mesh repair (30 Onlay and 3 sublay repairs), which
had good outcome and minimal post operative complications whwn compared to
anatomical repair. Post-operative complications included wound infection in 5 patients
(12.5%) followed by seroma in 3 patients (7.5%) and no complications in 31 patients.
There was only one recurrence constituting for 2.5% of total forty cases reported, and
there was zero mortality in the study.
Conclusion: Wound infection following previous surgery was the most important risk
factor associated with incisional hernia. The other risk factors were obesity and COPD.
Polypropylene mesh repair is superior to anatomical repair as it has less recurrence.

Background: Acute intestinal obstruction (AIO) is a common surgical emergency,
requiring urgent diagnosis and prompt treatment. The cause of bowel obstruction has
changed dramatically during the past century. Varying etiologic pattern has been noted
in developing nations as compared to the industrialized nations.
Materials and Methods: This was a prospective study comprising of all the 68 patients
admitted between August 2020 and August 2021 in the Department of General Surgery,
Govt Medical Collge & Hospital, Suryapet with a clinical diagnosis of AIO and
operated. The aim was to study the etiological pattern and other characteristics of AIO
and to look for any variation in the pattern in this region.
Results: Cases operated for AIO constituted 6.84% of all emergency surgeries. The
most common cause of AIO was complicated hernia (n=23, 33.82%) followed by
adhesions (n=14, 20.59%) and abdominal tuberculosis (n=10, 14.71%). The mean age of
presentation was 46.55 years ± 15.76 years and male to female ratio was 2:1. The most
common symptom was pain abdomen (n=63, 92.65%) while the most common sign was
tachycardia (n=66, 97.06%). The most common preceding surgery leading to AIO due
to adhesions was open appendicectomy and the most common complication was surgical
site infection (n=15, 19.12 %). There were 4 mortalities (5.88%).
Conclusion: Obstructed hernia, though the leading etiology for AIO in this study, has
lower incidence compared to similar studies, mostly due to improving socio-economic
status of people and better accessibility to health care in this region. Adhesions, has a
considerably high incidence, probably due to increased number of timely surgeries for
diseases that previously went untreated, such as surgeries for various intra-abdominal
malignancies. Tuberculosis is the third most common cause of AIO in this study and is
mainly attributed to increasing incidence of HIV and its coexistence with tuberculosis.

 Aim: The purpose of our research was to study various patterns as well as incidence of mandibular population amongst Indian population. Methodology: The medical records of 1842 patients with mandibular fractures treated
over a 3 years period were identified and analyzed supported age, sex, mechanism of trauma, seasonal variation, drug/alcohol abuse, number and anatomic location Results: 464 Patients who were in age range of 7 to 89 years participated in the study. The highest incidence (37.5%) of mandibular fractures was in the age group of 21–30 years. Most prominent cause for mandibular fracture was due to road traffic accidents which accounted for 68.8 % of all cases followed by free falls as well as assault cases. It was observed that parasymphyseal fracture was the most common site affected in mandible and the least affected was the angle of mandible. Mandibular angle
fractures were found mostly to be related to assault victims. Conclusion: The mechanism of injury correlates significantly with the anatomic location of fracture and knowledge of those associations should guide the surgeons for appropriate and timely management.

Statistically significant association of allele G and hetero A/G,
homozygous genotype G/G polymorphism rs1801394 MTRR gene with risk of autism
development was revealed. The presence of allele A and genotype A/A polymorphism of the
rs1801394 MTRR gene reduces the risk of autism. Identification of allele G increased the
risk of autism by 1.4 times compared to the presence of allele A (95% CI = 0.68-2.93, df=1).
The presence of the allele G of MTR A2756G polymorphism correlates with an increased
risk of autism.

External cervical resorption (ECR) is a type of external root resorption. ECR is relatively uncommon and the etiology is not very clear. Often misdiagnosed leading to improper management or tooth loss.Clinicallyit’s often asymptomatic unless pulpal or periodontal involvement begins. ECR is mostly noted in routine radiograph. Accurate assessment of the true nature and accessibility of ECR is important for its effective management

The main aim of this review article is to provide information about Dentin Hypersensitivity(DH). Dentin Hypersensitivity ,a common condition of the teeth, characterized by short sharp pain arising from exposed dentinal tubules in response to stimuli. The article reviews its clinical features, pathogenesis, mechanism, diagnosis, prevention and management. The diagnosis should be accurate and all the differential diagnosis should be omitted. Desensitization remains the major choice for dentin hypersensitivity. The basic principle of treatment of dentin hypersensitivity is to block the patent tubules or block pulpal nerve response.