Background: Knee Osteoarthritis is the most prevalent degenerative joint disease. The treatments of patient with knee osteoarthritis focused on pain reduction, improve joint motion, enhancement of muscle strength and endurance. However, little attention was given to hamstring flexibility training. It is believed that hamstring flexibility plays an important role in functional performance of patient with knee osteoarthritis. Aim: The present study was aimed to find out the correlation between hamstring flexibility and functional performance in patient with knee Osteoarthritis. Materials and Methods: Thirty-five patients with knee osteoarthritis matched with the inclusion criteria were included in the study. Active Knee Extension Test (AKET) was used to evaluate the hamstring tightness. Functional performance of participants was assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Pearson's product moment correlation was used to determine the relationship between hamstring flexibility and functional performance of patients with knee osteoarthritis. Results: A statistically significant positive correlation between hamstring flexibility and total WOMAC score (+0.467, p = 0.005). The component of WOMAC was also analysed separately pain (+0.369, p = 0.029), physical function (+0.418, p = 0.012) and (+0.273, p = 0.113). The results of the present study shows that decreased in hamstring flexibility in patient with knee osteoarthritis causes significant reduction in physical functional and pain. Conclusion: The results states that decreased in hamstring flexibility in patient with osteoarthritis causes functional limitation. Therefore, it is essential to suggest flexibility exercises for knee osteoarthritis patients during physical therapy.

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Background: The pharmacists can contribute to positive therapeutic outcomes by educating patients for rational use of medications. A chronic obstructive pulmonary disease (COPD) is one the most prevalent chronic respiratory diseases which requires continuous medication therapy. The clinical pharmacist can play an effective role through providing patient counselling to improve medication adherence and therapeutic outcomes. Aims and Objectives: The present study aims to assess the baseline levels of knowledge, attitude and practice of COPD patients and to study the impact of patient counselling on level of knowledge, attitude and practice with COPD patients. Materials and Methods: A total 90 patients (45 in the test group and 45 in control group) were enrolled in the study. A validated Knowledge, Attitude and Practice (KAP) Questionnaire was administered to both test and control group of patients at base line and at follow up (after 15 days) to assess the awareness regarding disease management. Patients in test group received counselling at visit and information leaflets were given. The control group of patients did not receive such counselling and information leaflets. Results: At the end of study the KAP scores of test group patients improved significantly (P<0.05), whereas no significant changes were observed in control group patients. We did not observed significant improvement in practice outcomes. However, patients counselling by a pharmacist improved overall KAP score. Conclusion: We conclude that pharmacist counselling may have an impact in improving the perception about disease and lifestyle change and thereby improving the Quality of life (QOL) of COPD patients.

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Objectives: To evaluate the percentage of interest in receiving orthodontic treatment and factors of positive perception in order of importance for thinking of receiving orthodontic treatment and negative barriers in order of importance for thinking of not receiving orthodontic treatment yet, amongst dental professionals according to age and sex. Methodology: participants included 425 dental professionals divided into five groups i.e. 21-30....61-70. After taking necessary permissions and informed concert, participant information sheet and questionnaire wereprovided to them through Google forms. All the filled questionnaires were then statistically analysed to conclude results. Results: Rate of positive perception towards orthodontic treatment was 57.9% amongst dental professionals. Malaligned teeth and Unesthetic were the first chief complaint of the partakers in their second, third and fourth decade; spacing was highly prevalent among fifth and sixth decade of their chronologic age , time and treatment fees were the reasons why patients not received orthodontic treatment yet in their 20s, 30s and 40s while periodontal complications and difficulties in chewing were the barriers in their 50s and 60s. Conclusion: Middle and old aged patients require precise understanding regarding the possibilities, advances and limitations of different orthodontic treatment modalities.

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Background: Nurses, as well as other health workers, have an important role to play toward preventing hospital-acquired infections (HAIs) among the patients and themselves. The most important and basic techniques in the prevention and control of infection transmission are hand washing. Objectives: The study was aimed to investigate measures utilized by health-care professionals, in the prevention and control of nosocomial infections in the selected health facility. Materials and Methods: A descriptive questionnaire was designed and used to identify and describe the measures and role of health-care professionals in the prevention and control of HAI in the Federal Medical Centre, Yenagoa. One hundred and fifteen nurses were selected at random among the health facilities to partake in the survey. Results: Respondents had good knowledge on the transmission and prevention of HAIs and that universal precaution must be employed in all aspects of patient care. All nurses strongly agreed that gloves do not transmit pathogens that cause HAIs and 88.7% of the respondents strongly disagreed that over diluted solutions are effective in decontamination as long as instruments are soaked for long periods, nurses that participated in the survey demonstrates a very good attitude towards the prevention of nosocomial infections. Some showed that personal protective equipment reduced their efficiency during procedures. Conclusion: Nosocomial infections complicate patient care and prolong the stay of patients in hospitals. The provision of safe care through the acquired knowledge and demonstration of a positive attitude will promote the preventive measures and subsequent incidence of HAIs.

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Background: The 1986 report of Dinesh Mohan stated India with approximately 500,000 amputees with almost 23,500 expected to be added annually. Since the year 2013, ALIMCO-Government of India Undertaking along with “Rehabs” clinic conducted the assessment, fabrication, and fitting of prostheses to the amputees of Gujarat. The main objective was to analyze the prevalence and details of lower limb amputees in central Gujarat during the last 7 years. Study Design: This was a retrospective analysis. Methods: Several camps were conducted in central Gujarat between the years 2013 and 2019. This study analyzes records of lower limb amputations (LLAs) for number, age, gender, site, causes, etc., Results: One hundred and fifteen camps were conducted. Amongst LLAs between the years 2013-2019, number of trans tibial amputations ranged between 57% -69% and trans-femoral 21 - 32 % only 10% having bilateral amputations &others. Males outnumbered females. Major cause trauma ranged 77.93% - 87.23%, congenital causes ranged between 1.37 and 2.26%. Age of amputees was between 7 years and 86 years with majority in the range of 21–60 years. Conclusion: This study reports on prevalence of LLAs in central Gujarat, males outnumber females, with major cause being trauma, number of amputees <21 and >60 years of age were small.

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Mandibular canine impaction is less frequently encountered in orthodontic practice compared to maxillary canine impaction and poses a challenge to orthodontic treatment. A very rare incidental finding of an impacted mandibular canine having bifid roots is reported in this article. The case report highlights the key points to be kept in mind to diagnose the presence of bifid roots and canals. It also discusses how the finding of an impacted mandibular canine with bifid roots can influence orthodontic treatment planning. Since the diagnosis and the evaluation of the number of roots and canals are key to the success of root canal treatment, endodontic implications have been highlighted as well.

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Oral submucous fibrosis (OSMF), and recently termed areca nut-induced oral fibrosis, is a debilitating disorder that hampers oral health and systemic health of patients. The management for this disorder involves a wide variety of modalities, including palliative, medicinal, and surgical. Regardless of tremendous research published in the literature, the management of OSMF has remained controversial due to the complexity of the disorder. Accordingly, this article aims to enlighten the clinicians with a comprehensive review of the current situation of the disorder and discuss the available medicinal treatment modalities for OSMF.

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Similar to “Agnivesha tantra” (popularly known as “Charaka samhita”), “Maharshi Bhela” has composed an Ayurvedic treatise known as “Bhela samhita.” Bhela samhita consists of 8 sections (sthana) and 120 chapters (adhyaya). “Indriya sthana” is one of the eight sections of “Bhela samhita” and it comprises 12 chapters. “Bhela Indriya sthana” deals with estimating life span and various prognostic aspects. “Mumurshurindriyam” is the third chapter of “Bhela indriya sthana.” The word “mumurshu” denotes a dying person and the chapter “mumurshurindriyam” contains the description of various signs and symptoms seen in the patients with terminal illness or end-of-life stages. Although previous works have explored “Charaka indriya sthana,” studies on “Bhela indriya sthana” are lacking. The present work is aimed to explore the contents of “Mumurshurindriyam” (third chapter) of “Bhela indriya sthana.” “Murmushurindriyam” chapter contains the description of conditions which are commonly seen during end-of-life stages. Various concepts/conditions such as end-of-life dreams and visions, deathbed communications, near death experiences, out-of-body experiences, visual hallucinations, delusions, dementia, delirium, organic psychosis, central auditory perception disorder, age-related hearing loss, late life psychosis, lower gastrointestinal bleeding, colon cancer, inflammatory bowel disease, end-stage renal disease, chronic kidney disease, diabetic ketoacidosis, central diabetes insipidus, spontaneous rupture of urinary bladder, myiasis, and medical etiquette are documented in this chapter by “Maharshi Bhela.” “Maharshi Bhela” has provided a list of signs and symptoms or clinical features in this chapter based on which questionnaire or screening methods can be developed, which can be used in prognostic research. Further research is required to substantiate the claims made in this chapter. The present study paves the path for future research directions.

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Intraoral angiolipoma (AL) is a rare clinical and histological variant of lipoma consisting of predominantly proliferating vascular channels interspersed with mature fat cells. The exact etiopathogenesis of this neoplasm still has to be established, and it clinically presents intraorally as a well-circumscribed, asymptomatic, or tender submucosal nodular mass that requires complete surgical excision. This report describes a rare case of AL located in the upper lip of a 65-year-old male patient and also focuses on its clinical and histological characteristic features for accurate diagnosis and better management.

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Anomaly (Greek, anomalos; irregular) is a deviation from what is regarded as normal, standard, or expected. Disturbance of the epithelium along with mesenchymal interactions markedly alters the normal sequence of odontogenesis, which represents as developmental anomaly of teeth. This is dependent on the developmental stage during which the alteration takes place. Various anomalies could take place, e.g., alteration of number, structure, size, and/or shape. More than 300 genes have been identified in literature that are expressed in teeth responsible for odontogenesis. Defects in any of these genes result in the alteration of the development of tooth. Understanding the etiology of each dental anomaly helps not only in identification but also assists in determining the course of the treatment.

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Metronidazole (MTZ) is a potent drug used against protozoa such as Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, and Balantidium coli, anaerobic bacteria, amebic liver abscess, bacterial meningitis, infection of the bone, and infectious disorder of the joint. Common side effects of MTZ include mild abdominal pain, headache, nausea, and persistent metallic taste, while other serious and rare side effects include pseudomembranous colitis, seizures, encephalopathy, and peripheral neuropathy. A case of MTZ-induced peripheral neuropathy has been included in this article. A patient was prescribed MTZ for liver abscess for 4 weeks; the patient developed peripheral neuropathy in 15 days; immediately, he reached the hospital and MTZ was withdrawn. He has then been prescribed pregabalin to treat peripheral neuropathy. The patient improved in 4 days on this treatment and was discharged from the hospital. This study concludes that MTZ has a rare side effect of peripheral neuropathy.

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Cannabis sativa L is a useful plant as it presents many interesting properties due to its rich metabolic profile such as anti-biofilm and bactericidal action. The metabolite of C. sativa (Cannabinoid) is very potent in treating infectious diseases of bacterial origin. This antibacterial activity is mainly due to the presence of several Cannabinoids like Tetrahydrocannabinol (Δ-8-THC), cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC). Various studies done in the past have proved that the cannabinoids are active against various Gram-positive and Gram-negative bacteria but there are no published literature related to the effect of cannabinoids on the formation of biofilm. Hence, the present review was conducted with an aim to explore the antibacterial effectiveness of cannabinoid and also its effect on the formation of biofilm.

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A 65-year-old male individual presented to an electronic urban primary health center with complaints of impaired hearing in the left ear, loss of sensations on the left side of the face, loss of sensation of taste of the left side of the tongue, and tingling and numbness of the left side of the face for 2 months. He had a history of diabetes for 8 years and hypertension for 5 years and on regular medication. The patient was completely evaluated by the medical officer and referred to a general medicine doctor for teleconsultation. The general medicine specialist had clinical evaluation, and after detailed discussion with the medical officer, he was referred to a neurosurgeon for further evaluation and management to Guntur Medical College. He had evaluated the client and recommended magnetic resonance imaging scans, and imaging revealed an extra-axial cerebellopontine angle solid mass lesion of size 3 cm × 2 cm with cystic component, arising from the left internal auditory canal causing mass effect on the middle cerebellar peduncle, suggestive of left acoustic neuroma without mass effect. He had specialized radiation therapy of 30 fractions of 25 gray in 5 cycles from July 20 to August 5, 2019, currently on regular medication for diabetes and hypertension and Vitamin B₁₂ supplements, and follow-up scheduled in July 2020.

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The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to overwhelm the health care delivery system of the affected nations. It was indeed challenging that the daily caseload in these nations was so high that the whole health system was outstretched and still hundreds of people kept losing their lives to the infection. In-fact, the nations were not left with any other option than to impose a strict lockdown with a primary intention to give some time for the health system to prepare themselves. In order to ensure that the disease is effectively contained, it is important to reconfigure the entire response of the health sector to the disease so that we can prevent the overwhelming of the health care system. In conclusion, the effective containment of the COVID-19 pandemic will essentially require the complete reconfiguration of the response of the health sector and capacity building activities. In-fact, all the nations should prepare themselves for the worst scenario and be ready to deal with the sudden upsurge in the number of cases

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