The high incidence of dental caries in young children has highlighted the need for a more comprehensive approach to caries prevention in children. Caries risk assessment (CRA) is widely recognised as a foundation for clinical decision-making and disease management for individual patients, as well as allocating time and resources to those in the group who are most in need. It also notes that the course of action taken to prevent caries will alter a patient's caries risk status at an early stage. The approach takes into account past caries experience, sociodemographic, socioeconomic, oral hygiene, eating habits, oral bacteria, and saliva characteristics in patients. Various types of Caries Risk Assessment Tools that can be implemented in practice are Caries Questionnaire, Cariogram, Caries Assessment tool, Caries Management by Risk Assessment, Traffic Light Matrix, Caries Assessment and Risk Evaluation test.

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Introduction: In middle of the 3^rd wave, COVID19 is now gradually making agent host environment balance at the world level. COVID19 vaccine is also available for the prevention of diseases. The two vaccines which are available in India till July 2021, they are COVISHIELD and Covaxin. There are various news heard about the relation of the ABO blood group and COVID19 disease. However, no study has tried to the relation of various blood groups and adverse events following immunization (AEFI). Methods: This was a community-based cross-sectional study. It was conducted online mode with the use of Google Forms. Study participants were Indian citizens and who took either Covishield or Covaxin as COVID19 vaccination. The pretested form was used, which consisted of various information regarding blood group of individual, vaccine, type of vaccine, doses of vaccine, side effects postvaccination, what is/are side effects and other information like do you have disease COVID19. Results: A total of 893 participated in the study, but out of them, 731 participants took vaccine either one or two doses. Most of the participants, 597 (87%), were from urban areas. The postCOVID19 vaccine AEFI prevalence was 69.7%. The association between ABO and Rh blood group and AEFI was not statistically significant. However, Covaxin has lesser side effects compared to COVISHIELD. Even a small group of COVID19 disease also had no association with ABO or Rh blood group. Conclusion: The side effects following the COVID19 vaccine are quite common. Majority were mild AEFI. There is no statistical association with blood group and postCOVID19 AEFI.

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Introduction: Dental Anxiety (DA) can have a serious impact on daily life and is a significant barrier for seeking and receiving dental care. Hence, our aim is to develop new scale for the assessment of DA in children between 4 and 7 years. Methodology: Visual analouge scale(VAS) and Dave's hand gesture scales were laminated on A2 size paper, which was shown to 60 participants before the procedure, immediately after the procedure and ½ h postprocedure and the participants were asked to show the score on the laminated sheet without the presence of any of the parent/guardian. Result: Descriptive analysis of all the explanatory and outcome parameters was performed. Friedman's test was used to compare the mean anxiety rating scores of both rating scales. Pearson correlation test was accustomed to correlate the anxiety rating scores. Chi-square test was used to compare the preference/liking of the different anxiety rating scales. The level of significance was set at P < 0.05. The results were statistically significant the new scale was in accordance with VAS. Conclusion: Dave's hand gesture scale is a reliable and valid measure of child's DA.

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Context: Mental wellbeing is of utmost importance in the 21^st century but the coronavirus pandemic and simultaneous lockdown have brought uncertainty, fear among other issues disturbing the normal equilibrium and leading to disharmony in the mental wellbeing of university-going students. Aim: Find out prevalence and risk factors of anxiety disorder among undergraduate medical students of sbks medical institute and research center because of lockdown. Materials and Methods: It was a cross-sectional study. Participants were sent a preformed questionnaire that included a GAD-7 scale along with risk factors and socio-demographic questions via college social media groups. Simple random sampling method was used to select students. Results: Out of the 301 responses analysed, results showed 11.63% were screened to be experiencing severe anxiety, 19.27% moderate anxiety, 29.57% mild anxiety. Disturbance in academic study schedule (odds ratio [OR] = 8.461, 95% confidence interval [CI] (4.159,17.212), P < 0.001), inability of the participants to go outside as a routine (OR = 2.837, 95% CI (1.701,4.734), P < 0.001), inability to perform extracurricular activities (OR = 2.017, 95% CI (1.223, 3.328), P = 0.006) and the lack of offline/On-campus experience were significant factors leading to increased anxiety for the students (OR = 4.185, 95% CI (2.494, 7.022), P < 0.001). Conclusions: 30.90% of the participants tested positive for anxiety disorder and disturbance in academic study schedule, lack of offline/on-campus experience, and inability to perform extracurricular activities were significant factors affecting anxiety levels of students.

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Uterine fibroids (UFs) are common in women during their reproductive age. A 40-year-old married woman was diagnosed with UF and underwent conventional treatment in March 2019. Her symptoms began with dysmenorrhea associated with bloating of the abdomen. Initially, she visited a private hospital, underwent ultrasonogram (USG) of the pelvis in a private diagnostic center, and the report suggests the presence of bulky uterus with fibroid and features of adenomyosis. Her physician advised to undergo a surgery, but she refused and thus visited our hospital. The patient underwent yoga and naturopathy intervention for the period of 11 days. The results of the study showed a reduction in the UF size from 27 mm × 22 mm to 22 mm × 18 mm in the 11 days of yoga and naturopathy intervention. Although the results are encouraging, it may vary because of a single case study. Hence, further well-planned clinical studies are suggested with a large sample size to validate our results.

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The spectrum of dental care is expanded across a wide approach including treatment measures involving the overall health care of the patient without the extensive use of conventional medicines. At times, diseases constrain their response to methodical therapeutic measures. In the course of relief, patients spend their fortune, and so, a need for excavating the root cause of a dental ailment is of utmost importance. Healing does not necessarily occur on the sole basis of medicines. Various other factors in addition to the regular measures play a vital role in the dental treatment modalities. Holistic dentistry is one such branch in which the dentist, practices to achieve comprehensive dental care by finding out the root etiological factor of the disease and initiating therapy accordingly. Understanding the importance of a healthy mind, body, and soul to successfully treat a patient with a dental ailment, ushering towards a better, successful, and efficient dental practice with utmost satisfaction on the patient's end. Holistic dentistry plays a key factor in unlocking the overall health care of the patient.

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Bhela samhita is an ancient Indian textbook of medicine composed by Maharshi Bhela. Indriya sthana is one among the eight sections of Bhela samhita, and it consists of 12 chapters deals with prognostic aspects. Pushpeeyam adhyaya is the 11^th chapter of Bhela indriya sthana which consists of 20 verses. Previous works have explored the prognostic potential of various chapters of Bhela indriya sthana. No studies have been conducted on “Pushpeeyam adhyaya” till date. The present study aims to explore the contents of “Pushpeeyam adhyaya” with the help of contemporary medical literature and principles of Freud's interpretation of dreams. Various databases have been searched to identify suitable studies (published in English language) by using appropriate key words. Various conditions such as visual perceptual distortions (erythropsia, photopsia, hyperchromatopsia, achromatopsia, metamorphopsia, etc.), Charles Bonnet syndrome, Anton-Babinski syndrome, retinal and vitreous detachments, end-of-life dreams and visions, hypnagogic visual hallucinations with sleep bruxism, temporal lobe epilepsy, occipital lobe seizures, pilomotor seizures, and psychiatric or neuropsychiatric conditions are documented in “Pushpeeyam adhyaya.” Various dreams such as bad, inauspicious, neutral, wish fulfilling, nightmares, day dreams, lucid dreams, bizarre or absurd dreams and dreams having animal figures, and colors along with their consequences (either death or survival) are documented in “Pushypeeyam adhyaya.” Analysis of dreams with the help of “Freud's interpretation of dreams” principles has revealed that the dreams documented in “Pushpeeyam adhyaya” seems to be rationale. Prognostic estimation based on odors emitted by patients (pushpeeyam) and analyzing dreams (swapna vignaana) of patients are having paramount importance (due to their cost-effectiveness, noninvasiveness, and feasibility) in resource-poor settings. Various hypotheses generated by the present work may pave the way for future research studies.

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Sushruta Samhita is an ancient Ayurvedic text deals mainly with surgical knowledge. Sushruta has documented Arishta Vignaana (prognostic knowledge) in the chapters 28 to 33 of Sutra Sthana. Avaaraneeya Adhyaya is the 33rd chapter of Sushruta Sutra Sthana. The term Avaraneeya denotes various untreatable conditions. Avaaraneeya Adhyaya consists of 26 verses that deal with the description of various poor prgnositc conditions or diseases. The contents of Avaaraneeya Adhyaya chapter are unique and require further exploration. No work has been conducted on Avaaraneeya Adhyaya chapter of Sushruta Sutra Sthana till date. The present study is aimed to evaluate the prognostic importance of the contents of Avaaraneeya Adhyaya chapter with the help of contemporary prognostic literature. Various databases have been searched to collect relevant data by using appropriate keywords. Clinical interpretation of the verses have revealed various fatal conditions with poor prognosis such as end of life stages, multiple chronic conditions and signs & symptoms of terminal illnesses. The contents of Avaaraneeya Adhyaya chapter of Sushruta Samhita Sutra Sthana seem to be having clinical and prognostic significance and clinical applicability. The present study provides inputs for future research works on Ayurvedic prognostic science.

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The mother's womb is a favorable environment for fetal growth and development. The extrauterine environment is traumatic to tiny and premature infants for survival, and the environment in neonatal intensive care unit (NICU) does not support the optimal brain growth and development of a premature infant. The survived premature and low birth infants are at risk to develop lifetime disabilities and impaired neurodevelopment outcomes. The aim of the review was to highlight the component of early neurodevelopmental supportive care used in NICU to enhance the neurodevelopment of preterm and low birth weight. The researcher used electronic databases – PubMed, MEDLINE, CINAHL, and Google Scholar electronic databases for searching the literature. Poor developmental outcome impacts directly on the long-term development and functionality during infancy, childhood, and adulthood. The early neurodevelopmental supportive care in NICU and in early infancy period could improve the neurodevelopmental outcome. Neurodevelopmental supportive care is an approach that uses a wide variety of medical and nursing interventions that focus to decrease the stress of preterm neonates in NICUs and support optimum neuronal growth as well neurobehavioral development of an infant. Nurturing a child by understanding their needs and responding sensitively helps to protect developing brains from undue stress and support optimal cognitive and behavioral development.

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Context: Diabetes mellitus (DM) is one of the noncommunicable diseases with an increased worldwide prevalence which differs from country to country. Hypertension and obesity may coexist in diabetes, thus enhancing complications and morbidities. Aim: The study determined the prevalence of hypertension, overweight, and obesity in type 2 DM patients attending a tertiary health care facility in Enugu, Nigeria. Setting and Design: A total of 296 type 2 DM patients attending the diabetes clinic at Enugu State University Teaching Hospital, Parklane, Enugu, were recruited for this study. Subjects and Methods: Blood pressure, weight, height, waist and hip circumferences were measured according to standard methods, waist to hip ratio and body mass index (BMI) were calculated. 3 ml of fasting blood sample was collected for blood glucose analysis. Statistical significance was considered at P < 0.05. Results: Of the 296 patients, 176 (59.5%) were female, whereas 120 (40.5%) were male. BMI was significantly higher in females when compared with the males (P = 0.002). The prevalence of hypertension was 36.8%, 35.2% in females and 39.2% in males. 26.7% were obese (30.1% females and 21.7% males) while 43.9% were overweight (42.6% females and 45.8% males). The prevalence rates of hypertension, overweight, and obesity were high in patients aged 56 years and above. Overweight and obese hypertensive patients had the prevalence rates of 45.9% and 40.4%, respectively. Conclusion: Hypertension and overweight or obesity persist in type 2 diabetic patients. The high prevalence of hypertensive overweight/obese diabetes patients calls for stringent measures through lifestyle modifications such as weight reduction, physical activity and dietary intake.

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Background: Senna alata belongs to the Senna family and is known to contain several bioactive constituents that contribute to its therapeutic properties. A variety of medicinal and pharmacological effects have been reported, including antidiabetic, antiasthma, anthelmintic, and antiplasmodium infection effects. Objectives: The goal of the study was to determine whether the extract of S. alata can reduce blood sugar levels in streptozotocin (STZ)-induced diabetic mice. Materials and Methods: S. alata leaves were collected from the Department of Botany, University of Nigeria Nsukka, Nigeria, authenticated, and validated. Phytochemical screening was conducted. Specifically, leaf blades were extracted in 70% ethanol for 3 min, transferred to 500 ml of water for 5 min, then cut into small pieces, and then inoculated onto malt extract agar, and local rice was used to inoculate the fermentation medium. 25 male albino mice of 30–35 g weight, average weight of 30–35 g were used in the study. Streptozotocin (STZ; 65 mg/kg) was injected intravenously to induce type 2 diabetes. Results: The crude extract significantly (P < 0.05) reduced the fasting blood glucose levels in STZ-induced diabetic mice. The two doses (250 and 500 mg/kg) of the ethanol extract and metformin 500 mg/kg caused a significant (P < 0.05) reduction in the fasting blood glucose levels from 0 h to the 10^th h of treatment. The extract displayed a dose-related reduction in blood sugar level concerning time. The highest reduction rate was found in 500 mg/kg 409.66 ± 1.92. The fasting blood glucose reduction was dose-dependent. The highest reduction rate was found in 500 mg/kg 80.00 ± 4.00 (80.47%) being the highest dose so far. There was a reduction in the bodyweight of the animals induced with STZ. Conclusion: The endophytic extract of S. alata displayed useful pharmacological properties and can be used to manage diabetes and its complications.

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A patient with nonhuman papillomavirus (HPV)-related head-and-neck cancers is at an increased risk of developing second primary malignancies. We present a case of non-HPV-related squamous cell carcinoma (SCC) of the left lower alveolus who presented with locoregional recurrence in the left upper lip 3 years after initial treatment with chemoradiotherapy along with a synchronous Epidermal growth factor receptor(EGFR)mutated lung adenocarcinoma. Comprehensive genomic profiling will guide diagnosis and therapy in these cases. Registry of synchronous tumors would help design protocols for better management.

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Dementia is one of the most common neurological manifestations. While degenerative dementia is the commonest form of dementia, various metabolic, toxic, infective, and inflammatory diseases can also present with dementia. It is the course of the disease, speed of the progression, and the presence of associated features which often give clue to the diagnosis of nondegenerative dementias. Here, we report a case of rapidly progressive dementia in a middle-aged male patient and discuss the various differential diagnoses.

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