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Backgrond: Dyspnea is one of the main complain of the COPD patients. In the general setting it is treated by medical and physiotherapeutic intervention. Incentive Spirometry and Resistive Inspiratory Devices are 2 main treatment approaches in physiotherapy. Objective: The objective of this study is to compare the efficacy of Incentive Spirometry and Resistive Inspiratory Devices on ventilatory muscle strength in COPD patients with mild to moderate dyspnea. Method: 30 COPD patients with mild to moderate dyspnea were randomly assigned to Incentive Spirometry group (Group A) and Resistive Inspiratory Device group (Group B). The duration of protocol was 4 weeks and both the groups received 2 sessions per day. Pre-treatment RPE and IC are compared with post-treatment data i.e, at the end of 4 weeks. Analysis was based on the ICS and Borg’s RPE scale. Results: The test showed significant improvement (p<0.05) in both ICS and RPE score. Using unpaired t-test mean improvement in group A and B was 566.06 ml and 695.2 ml respectively, t =1.049 (p=0.303) for ICS and using Mann-Whitney ‘U’ test median in group A and B was 2.5, U = 106 (p=0.782) for RPE score, since p>0.05 the comparison showed difference as not significant. This result showed that there is no significant difference between the 2 groups. Interpretation & Conclusion: It is concluded that there is no significant difference between the 2 groups. Both the interventions (Incentive Spirometer and Resistive Inspiratory Device) are equally effective, both in improving ventilatory muscle strength and reducing the perception of dyspnea in COPD patients with mild to moderate dyspnea.

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A patient having dental and skeletal fluorosis with neurological complication in form of cervical myelopathy is presented.

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If the teeth are lost despite all efforts to save them, a re-establishment should be made in such a manner as to function efficiently and comfortably in harmony with the muscles of the stomatognathic system and the temporomandibular joints. Neutral zone technique is long being used for the management of severely resorbed mandibular ridges. The success of any prosthesis depends on the proper position of the artificial teeth within the neutral zone A 62 year old female patient reported in the department of prosthethic dentistry, K. M. Shah Dental college & Hospital with a chief complaint of missing teeth and wanted replacement of the same. Neutral zone technique recording with tissue conditioner was planned for the lower denture which was recorded after verification of the maxillo-mandibular relationship. The follow up resulted more comfortable and more stable and retentive because the denture were not interfering with or displaced by the functions of the lips, cheeks and tongues.

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Evidence based dentistry and medicine is increasingly attracting worldwide attention in public policy, resulting in the mass production of evidence based clinical guidelines. It is one of the recent evolutionin the dental practice in India EBD aids in clinical decision making in all fields of medicine, including primary care. With a lack of awareness of relevant research, and awareness about EBD, a substantial part of clinical practice in dentistry relies on practitioners personal experience, resulting in large variations in practice between healthcare workers. Thus the aim of this study was to assess the awareness of dentists of Vadodara city towards EBD and the need of training programs in Vadodara city for the same. This was an observational questionnaire survey on awareness of dentists towards EBD and the need of training programs for the same. The list of dentists practicing in Vadodara city was obtained from IDA Vadodara branch. 87 dentists were included in the study. A validated questionnaire was sent to these dentists across Vadodara city.The dentists were evaluated according to experience and qualification. Out of 80 participants there were 16 dentists who had heard about evidence based dentistry, had an experience of less than 10 years while 17 out of 28 dentists who were experienced more than 10 years had heard about the same. (p=0.16) .Participants believed that EBD is beneficial for current era of dentistry and there is need of training programs for the same. The knowledge of EBD is less amongst the practitioners in the city of Vadodara and there is need of training programs for evidence based dentistry.

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Background: Acute respiratory failure is the most common type of organ failure encountered in intensive care unit. PaO₂/FiO₂ < 300 is diagnostic for acute lung injury, which is measured by arterial blood gas analysis. In our study we aimed to find suitable clinical surrogates of PaO₂/FiO₂ (P/F). Materials and Methods: This cross sectional study was conducted in intensive care unit of a 1000 bedded hospital. All patients with clinical diagnosis of acute respiratory failure were included in the study. For each patient PaO₂ was recorded by obtaining arterial blood gas. Each time P/F ratio was correlated with corresponding clinical signs like single breath count, heart rate, systolic blood pressure, cyanosis, use of accessory muscle etc. Results: Correlation was found between single breath count, heart rate and P/F ratio.

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Delusional misidentification syndromes (DMS), which includes the Capgras, Fregoli, Inter metamorphosis and Syndrome of Subjective doubles gain curiosity due to the bizarreness in their symptomatology. However they are diagnosed as some form of Schizophrenia and related psychosis and treated accordingly. An issue that remains unresolved is whether DMS (either in its pure form or as embedded symptoms of other diagnoses) can be accommodated in the present Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV TR). As we await the DSM – V, it is still not clear as where do we diagnose patients with monothematic bizarre delusions due to lack of proper guidelines in DSM IV TR. Here we present two cases with Capgras Delusions and express our concern regarding the short comings of current Diagnostic system

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Monoclonal antibodies (mAbs) have found several therapeutic applications. By Far, the most promising utilization of mAbs has been use of these agents in cancer therapeutics. The major reason for this is the ability of mAbs to selectively home-in on cancer cells opening up avenues for targeted therapy. The importance of mAbs for therapeutics can be recognized from the fact that more than 40 mAbs have been approved by the FDA till date for application in several disease modalities. Production of mAbs has also radical changes from the conventional methods till date. In relation to cancer, bevacizumab, trastuzumab and cetuximab may be considered as breakthroughs, significantly improving the therapeutic armamentarium against various types of cancers. This review focuses upon the current global status of mAbs in clinical studies with a convergence on different mechanisms of actions governing their therapeutic activity.

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Aims: This study is aimed to investigate the protective effects of Pomegranate fruit extract on ECG, biochemical and histoarchitectural changes in isoproterenol (ISO) induced myocardial infarction in rats. Materials and Methods: Male albino rats were treated with Pomegranate fruit extracts (100 mg/kg/day, p.o) for a period of 30 days. ISO (200 mg/kg, s.c) was injected to rats on 29^th and 30^th day at an interval of 24 h to produce myocardial infarction. On day 31^st electrocardiographic, biochemical, histoarchitectural and apoptotic changes were monitored from control and experimental groups. Results: ISO injected rats showed a significant alteration in ECG pattern. The levels of cardiac and inflammatory markers such as Lactate dehydrogenase and creatine phosphokinase-MB were significantly increased. A significant alteration in lipid peroxidation and biomarkers of oxidative stress (GSH, SOD and CAT) were observed. In addition, it also showed significant alteration in collagen content (Masson's Trichrome staining) and glycogen content (Periodic acid Schiff's staining) of the heart. Treatment with Pomegranate fruit extract (PGFE) significantly reduced ISO induced alteration in ECG, biochemical and histoarchitectural changes. Conclusions: In conclusion the present study showed that treatment of PGFE significantly attenuates myocardial infarction induced by isoproterenol.

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Herewith reporting a rare case of gingival plasma cell granuloma in a 50 year old woman who presented with upper gingival polypoidal growth. The histopathological examination revealed a mass composed of parakeratinised thin epithelium with proliferating rete ridges. The connective tissue is hypercellular and shows dense inflammatory infiltrate primarily composed of plasma cells and lymphocytes. Focal budding capillaries are also seen in the stroma confirming a diagnosis of plasma cell granuloma.

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Introduction: Health of mother and children is an asset to the family, society and community. The contribution of institutional delivery in achieving the optimal health of a mother and a child is beyond doubt. The present study was conducted with the objective to know the status of institutional delivery in a block of Vadodara district of western India. Methods: A cross sectional study was conducted during December 2011 to October 2012. The study participants were mother, who had delivered their live baby during 1^st April 2010 to 31^st March 2011 and living in Vadodara Block. One per cent of the total live births during that duration were selected as the study participants. Samples represent both urban and rural areas of Vadodara Block. The systemic stratified random sampling method was used for selection of participants. Results: Majority 327 (90.6%) of the delivery was institutional. Among institutional delivery, 173 (47.9%) participants went to public health institution and 154 (42.7%) went to private health institution. The reasons for home delivery (9.4%) were dissatisfaction from the institution (hospital) 19 (56%), economic constrain 11(32%) and distance factor 4(12%). Conclusion: Almost 90% of study participants delivered baby at institution. It is a positive trend observed in the achievement of government target to 100% institution deliveries. The home deliveries are still prevalent in illiterate and schedule caste and schedule tribe population.

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Consumption of tobacco products is increasing globally. Tobacco kills nearly 6 million people each year, unless urgent action is taken, the annual death toll could rise to more than 8 million by 2030. Smoking cessation provides immediate and lasting benefits to public health as well as result in decrease incidence and mortality from cancer. Tobacco comes in different forms and all contain nicotine, the addictive substance. Pharmacological agents have been used successfully in the cessation of smoking; include nicotine replacement therapies and nicotine medications.These interventions are designed to reduce cravings for tobacco and relieve the withdrawal symptoms while trying to quit. This article reviews background of tobacco cessation programmes for public as well as health professionals to create nicotine free environment.

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