The passive case-finding approach of Revised National Tuberculosis (TB) Control Programme in India strongly affects the health-seeking behavior of TB patients, the timing of help seeking as well as the subsequent delays associated with the same. Studies carried out in different parts of India reveal a host of several factors for delay in seeking help and the reasons for not seeking help at all. Important reasons for delayed health-seeking behavior include financial constraint, symptoms are not severe (as perceived by the patients), work pressure, lack of awareness, first consulted nonpublic sector, inaccessibility to health facility, home remedy, social stigma, self-medication, transport problem, and dissatisfaction with health facility. Similarly, the median patient delay ranged from 7 to 56 days as reported by various studies. Health-seeking behavior and related delays are of utmost importance in TB care from two important perspectives; first, TB requires timely treatment, and second, it requires protracted treatment. Required level of knowledge and a positive health behavior helps the patients in taking timely help from an appropriate health facility. Moreover, timely help-seeking prevents further spread of the disease and helps in establishing a TB-free society.

Psoriasis is a common inflammatory skin disorder characterized by itchy erythematous papules and plaques topped with silvery white scales. It has a chronic relapsing course and is associated with significant morbidity and reduction in the quality of life. Therapy of psoriasis is challenging. Topical therapy forms the first line of treatment for stable plaque psoriasis affecting a limited body surface area and in extensive disease systemic agents are indicated. All these drugs have inherent side effects, and none bring prolonged remission of the disease. The other therapeutic modality for psoriasis is phototherapy, but it is delivered through a specialized machine which can be available only at referral centers. Biologics have revolutionized the management of psoriasis as they can bring a remission of disease up to several years. Although limited availability and high cost prohibit their regular usage, Indian dermatologists are rapidly adopting biologics in the treatment of psoriasis.

Intermittent hypoxia (IH) is a hallmark manifestation of recurrent apneas, which is a major clinical problem in infants born preterm. Carotid body (CB) chemoreflex and catecholamine (CA) secretion from adrenal medullary chromaffin cells (AMCs) are two major mechanisms contributing to the maintenance of cardiorespiratory homeostasis during hypoxia. The purpose of this article is to highlight recent studies showing how neonates experiencing IH affect the CB and AMC function and their consequences in adult life. To simulate apneas, rat pups were treated with IH consisting of alternating cycles of hypoxia (1.5% O₂) for 15 s and room air for 5 min, 8 h/day from ages P0–P10. Rats treated neonatal IH displayed augmented CB response to hypoxia and augmented CA secretion from AMC. Rats treated for 10 days of IH in the neonatal period were allowed to grow into adulthood. Remarkably, the effects of neonatal IH on CB and AMC persisted in the adulthood. Moreover, adult rats that were exposed to IH in neonatal period exhibited hypertension, increased incidence apnea. Analysis of the underlying molecular mechanisms revealed re-programming of the redox state by epigenetic mechanisms involving suppression of transcription of antioxidant enzyme genes by DNA hypermethylation. DNA hypomethylating agents might offer a novel therapeutic intervention to prevent early onset of cardiorespiratory morbidities caused by neonatal IH.

Aims: We have seen middle-aged and elderly patients with lower urinary tract symptoms (LUTS) or retention of urine in our hospital. Digital rectal examination (DRE) and prostate-specific antigen (PSA) were done for workup. Prostate biopsy (PB) was done whenever indicated. We wanted analysis of PB in our rural setup. Materials and Methods: The study period includes from January 2008 to May 2012 and January 2015 to May 2016. Any patient aged 45 years or more presenting with LUTS or retention of urine was included in the study. PSA and DRE were done in all patients. Inclusion criteria were abnormal DRE or PSA ≥4 ng/ml. Exclusion criteria were immunocompromised status, coagulopathy, urinary tract infection, acute prostatitis or abscess, uncontrolled diabetes mellitus, or previous biopsy. Histopathology report was noted. Statistical Analysis: No special software was used. Author used his arithmetical skill learned in school days to do analysis. Results: One hundred and thirty-four patients were included in the study. Average age was 69 years. PSA ranged from 1 to 1700, average being 65.3 ng/ml. Prostate cancers (PCs) was found in 65 cases. Adenocarcinoma of prostate was found in 54 cases, average PSA being 110.8 ng/ml. Small cell PC (SCPC) found in 11 cases, average PSA being 55 ng/ml. Prostatic intraepithelial neoplasia was found in six cases, average PSA being 18.8 ng/ml. Conclusion: PC is not uncommon in India. Patients present in advanced stages and with high PSA values. Transrectal ultrasound-guided 12-core systematic PB is the standard to confirm diagnosis of PC. Incidence of SCPC is high in our series. They presented with high PSA values. This need further study.

Objective: The aim of this study was to investigate the prevalence of tetracycline-resistant Aeromonas hydrophila isolated from clinical sources in Iraq, using polymerase chain reaction (PCR) technique. Materials and Methods: A total of 822 samples were collected from patients suffering from diarrhea. Isolates were identified using biochemical tests, Vitek 2 system, and 16S rRNA specific primer. PCR was used to detect tetracycline-resistant isolates. Results: Out of the 822 clinical samples collected, 13 Aeromonas spp. isolates (1.58%) were recovered, out of which eight isolates (61.53%) were identified as A. hydrophila. Results found that all tetracycline-resistant isolates carried at least one of the tet genes examined. Among efflux genes, tet (A) was most commonly observed in isolates, followed by efflux tet gene (tet B and C) and ribosomal protection protein (tet O). However, efflux genes tet (D and G) were not detected in any of the isolates. Conclusions: The prevalence of tet O chromosomal protection protein among A. hydrophila isolates was first recorded in Iraq and in many other neighboring countries.

Background: Hypoglycemic emergencies are potentially life-threatening complication of diabetes management that predisposes the patients to higher risk of disability and premature death. As the impetus for the prevention of diabetes-related hypoglycemic endpoints grows, emphasis should also be focused on patients' knowledge of symptoms, causes, and self-management practices for hypoglycemia. Aim: The study was aimed at describing the knowledge of symptoms, causes, and self-management practices for hypoglycemia among ambulatory type 2 diabetic patients in Eastern Nigeria. Materials and Methods: A cross-sectional descriptive study was carried out on 145 type 2 diabetic Nigerians at a primary care clinic in Eastern Nigeria. Data on knowledge of symptoms, causes, and self-management practices for hypoglycemia were collected using pretested, structured, and researcher-administered questionnaire. Results: The age of the type 2 diabetic patients ranged from 32 to 78 years with mean age of 44 ± 10.2 years. There were 59 (40.7%) male and 86 (59.3%) female. Thirty-six (24.8%), 22.8%, and 29.0% had adequate knowledge of symptoms, causes, and self-management practices for hypoglycemia with the most common symptom, cause, and self-management practice being dizziness (69.7%), overdose of antidiabetic medications (91.0%), and taking drink containing glucose (67.6%), respectively. Educational level was significantly associated with adequate knowledge of symptoms (P = 0.039), causes (P = 0.02), and self-management practices (P = 0.016) for hypoglycemia. Conclusion: Knowledge of causes, symptoms, and self-management practices for hypoglycemia was inadequate. The most common symptom, cause, and self-management practice for hypoglycemia were dizziness, overdose of medications, and taking of drink containing glucose, respectively. Adequate knowledge of causes, symptoms, and self-management practices for hypoglycemia was associated with educational level. There is a need for hypoglycemic-oriented diabetes education, especially in resource-poor environment.

Introduction: Liver is termed as Yakrut in ayurvedic classical literature, is one of the major organs for maintaining homeostasis, and is involved more or less with all the biochemical pathways in the body. Arogyavardhini Rasa (AVR) is one of the widely practicing ayurvedic herbo-mineral formulations in liver disorders. It has been used for the management of diverse types of Jvara (fever), Kushtha (skin disorders), Medoroga (altered lipid profiles associated with obesity), and other Yakrit vikara (liver disorders). In this study, AVR was prepared as per the 13^th-century classical text Rasaratna Samuchaya. On the other hand, heavy metals causing toxicity, especially mercury present in this formulation, are an issue of concern. Aim of the Study: Hepatoprotective effects of formulation were evaluated by paracetamol (PCM)-induced liver damage in rats to substantiate the role of metal mineral in the classical AVR formulation. Materials and Methods: Effects of formulation were assessed on serum and liver tissue biochemical parameters and histopathological studies. Results: PCM produced significantly impaired the liver and kidney functions as assessed through an increase in liver and kidney marker enzymes. Arogyavardhini-treated group significantly (P = 0.05) prevented this hepatotoxicity and strongly supported by histopathological examinations that revealed AVR shows the protection of liver tissue from PCM-induced hepatotoxicity. Conclusion: The observation of the present study has stalwartly supported the hepatoprotective action of AVR against PCM-induced hepatotoxicity in rats.

Background: Influenza disease is one of the oldest medical problems, which is known to cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students' knowledge, attitudes, and practices are critical to save patients' life. Aims: To assess knowledge and attitude regarding swine flu among dental house surgeons in Belagavi city. Settings and Design: This was a cross-sectional questionnaire study conducted among dental surgeons of Belagavi city. Subjects and Methods: One hundred thirty-three participants were recruited in a convenient sampling cross-sectional survey. Pretested, self-reported questionnaire was used and results were analyzed applying fitting statistical tests. Statistical Analysis Used: Reliability of the questionnaire was checked using Cronbach's alpha which was found to be 78.4. Data were analyzed using SPSS 18.0 software. Results: From the present study, it was seen that the participants do not have adequate knowledge regarding swine flu influenza. Conclusions: We concluded that dental house surgeons do not have sufficient knowledge about swine flu. It seems that traditional educational models are not efficient and government with other nongovernmental organizations should emphasize to advocate motivational education methods including health belief model and motivational interview at undergraduate levels. Younger students and dentists may have less motivation to change their attitude and behavior so that we can focus our interventions on these groups.

Background: If the impression thickness is uniform, stock trays can also give a better result when compared to custom trays. Purpose: This study aimed to obtain a uniform thickness impression with a modified putty-wash two-step technique. Materials and Methods: A chairside method of putty-wash two-step impression in a stock tray was made utilizing a wax spacer. Results: A uniform thickness impression was obtained in stock tray in quick time. Conclusion: The current article has given the options of using wax as spacer for making putty wash two step impressions for the fabrication of tooth-supported fixed restorations. Further research is required to find whether there is any dimensional inaccuracy caused in restorations due to usage of wax as a spacer.

We obtained responses from 69 medical and 65 pharmacy students who had cardiovascular (CVS) physiology taught in the previous academic year. A real-time response exercise using an online game-based learning platform (Kahoot!) (https://getkahoot.com/) was conducted during a lecture class using true/false questions that cover certain core aspects of CVS physiology. Comments will be made on some of the common, incomplete understanding of CVS conceptual mechanisms. Some follow-up thoughts on our role as physiology educators in fine-tuning our teaching as we encounter persistent mistakes among our students' learning physiology.