Every student has different learning style and if the method of information delivered conforms to their learning habits, they learn better. To get best out of a student, facilitator needs to understand the student’s learning modalities and ‘tailor instruction’ in such a way that students appreciate and follow it to learning. In this regard a study was designed to analyze the learning style distribution among 1st year MBBS students. A cross sectional questionnaire based study was conducted among 1st year MBBS students (n=152) using validated VARK questionnaire (version 7.8).The questionnaire consists of 16 questions with 4 options, each of which corresponds to a particular sensory modality preference (visual, aural, read/write and kinesthetic). The responses in the questionnaires were assessed according to the keys provided in VARK guide. Demographic details were collected. Preferred learning styles were expressed as frequency and percentage. The response rate was 86.18% (131 students out of 152). Of these 71 (54.2%) were female and 60 (48.8%) were males. All the students preferred more than one sensory modality with 98% quad modal (n=129, M/F=59/70) and near 1% each in tri modal (n=1, M/F=1/0) and bimodal (n=1, M/F=0/1) learning preference. Knowing student’s preferred learning modes; one can focus on developing strategies that are tailored for individuals. All the students in the present study showed multimodal learning styles which points towards the fact that they prefer information to arrive in a variety of modes. Lectures being the major proportion of teaching learning process in 1st MBBS curriculum, one need to adopt active learning strategies and process during lectures which will cater to the needs of all types of learners.

Objectives: To measure the degree of attenuation of fasciculations and the degree of reduction in post-operative myalgia caused by Succinylcholine in patients pretreated with Magnesium Sulphate during the induction of general anaesthesia. Methods: This observational study was conducted from June 2016 to June 2019 in the Department of Anesthesiology in Government Medical College Srinagar, on patients who were candidates for surgery under general anaesthesia. Patients were selected and divided into two equal groups of cases and controls using block randomization. The cases received magnesium sulphate, while the controls received normal saline. SPSS 18 was used for statistical analysis. Results: Of the 100 subjects in the study, 57(57%) were men and 43(43%) were women (p=1.0). The mean age of the two groups were 35.55±13.56 years and 32.80±13.37 years (p=0.85). The incidence of fasciculations was 06(12%) patients in group M and 43(86%) patients in group S. The incidence of fasciculations between two groups was highly significant (p = 0.001). Postoperative myalgia was present in 9 (18%) patients of Group M and 38 (76%) patients in Group S experienced myalgia in postoperative period. The results were highly significant between two groups (p = 0.001). Conclusions: Magnesium sulphate can prevent and reduce the degree of fasciculation and postoperative myalgia after anaesthesia. Therefore it can be used to prevent fasciculation and postoperative myalgia

The study was done to determine the levels of changes in haematological parameters in patients with asthma in Southeast, Nigeria. A total of 200 subjects were recruited for the study comprising 100 subjects each for Patients with asthma (50 subjects were Males, 50 were Females) and 100 subjects for apparently healthy subjects (Control) (50 subjects were Males, 50 were Females) drawn from a tertiary health institution. About 3ml of venous blood was aseptically collected from the antecubital vein of each subject by standard technique and was dispensed into an EDTA bottle for haematological parameters determination. The haematological parameters were determined using Mindray BC-5300. The results were expressed as mean± standard deviation. The data were analysed with the statistical package for social science (SPSS) version 21 using t-test, ANOVA and the level of significance was set at P<0.05. The study showed increase (P<0.05) in WBC( 9.63±4.51 X109/L , 4.88±0.19 X109/L, P=0.047), decrease (P<0.05) in MCV (85.26±4.20fl, 90.01±0.05fl, P=0.035) , MCH (27.54±1.09 pg, 30.00±0.17pg, P=0.001), MCHC (325.20±4.97g/l, 333.34±0.07 g/l, P=0.006) and no significant difference (P>0.05) in Neutrophils (70.02±9.44%, 66.40±3.56%,P=0.446), Lymphocytes(28.38±10.20%,31.39±3.88%,P=0.554),Monocytes(1.50±0.50%,1.70±0.45%,P=0.524),Eosinophils 0.53±0.23%,0.51±0.45%, P= 0.959), Red blood cell (4.82±0.39 X1012/L, 5.04±0.51 X1012/L, P=0.435), Haemoglobin (13.78±1.36g/dl,15.13±1.52g/dl,P=0.175), Packed cell volume (41.60±3.78%,45.40±4.56%,P=0.189) and Platelets(255.40±58.16X109/L, 222.00±37.01X109/L, P=) of patients with asthma relative to control. The results showed decrease (P<0.05) in Neutrophils (60.50±3.54%, 76.37±4.56%,P= 0.026), Monocytes (1.00±0.01%,1.83±0.29%,P=0.030), increase (P<0.05) in Lymphocytes (38.50±2.12%,21.63±5.92%, P=0.034), MCH (28.60±0.28pg, 26.83±0.65pg, P=0.040), and no significant difference (P>0.05) in WBC (7.76±3.05, 10.86±5.51, P=0.533), Eosinophils (1.09±0.29%,0.1

Objective: The purpose of this study was to determine the current trends in usage, handling and dispensation of endodontic files by the dental practitioners of Karachi. Methodology: In this cross sectional study, two hundred and seventy survey performas were distributed to the dental teaching institutes and private dental clinics of Karachi. Survey participants were questioned about the preferred type of endodontic therapy, file system, method of dispensation of files, method of disinfection or sterilization of used files, criteria to discard used endodontic files and the preferred method of removal of debris from used files. SPSS version 21 was used for the calculation of frequency and percentage for statistical analysis. Results: Total two hundred and seventy survey forms were distributed out of which 200 were received with total response rate of 70.07%. 45.5% of dental practitioners perform manual root canal where as 19.5% prefer rotary endodontics. 82.25% respondents preferred to use Protaper files for rotary endodontics. 69.5% of the participants dipped the files in hydrogen peroxide while 20% kept their files in sodium hypochlorite while performing endodontic therapy. Autoclaving of the used files was found to be most common method amongst 87.5% of the participants and 80% of the respondents discard the files on first sign of deformation. 53% of the respondents dipped files in hydrogen peroxide to remove debris after usage.

Background and objectives: Carcinoma prostate is becoming an increasingly significant international health problem. Perineural tumour growth is associated with adverse prognostic features and a poor outcome; hence is a necessary component in histopathological reporting of malignancy. For accurate detection of perineural cancer spread, immunohistochemistry (IHC) with S100 was performed along with haematoxylin and eosin (H&E) stain. This study attempts to correlate the clinic-pathological prognostic factors with PNI, in a regional scenario. Methods: A retrospective study was conducted at a tertiary care hospital over a period of one year. Specimens were trurcut biopsy, TURP chips and prostatectomy specimen, sent in 10% formalin. Paraffin embedded blocks was stained with H&E and representative sections with S100. Relationship of tumor with nerve was established and graded accordingly as: Category 0: nerves without immediate tumor-cell-contact. All nerves being fully surrounded by tumor (classical perineural invasion) were categorized group 3. Two further categories discriminated between nerves that were touched either by carcinoma cells below 50% of the circumference (category 1) or above 50% as category 2. Results: Out of 30 cases of prostatic adenocarcinoma, majority of specimens were needle biopsies (47%). The age of presentation were 55-84years with mean age being 68.93 years. Pretreatment and posttreatment PSA levels were assessed. Most common presentation was bladder outlet obstruction (57%) and treatment given was radical Prostatectomy (44%). Perineural invasion (PNI) was seen in 66.7% of cases and correlated positively with Gleason’s score, pT categories, %PSA. Perineural spread noted in 73.3% cases and negatively correlated with Grade group.

A left ventricular aneurysm (LVA) is a localized dyskinetic area of infarcted myocardium that bulges in systole and diastole. It is a well studied structural complication seen post myocardial infarction although decreasing in incidence due to major improvements in reperfusion therapy. Persistent ST elevation is the most widely reported electrocardiographic manifestation of left ventricular aneurysms. LVA may be evident on chest x-ray, as observed in this case. Diagnosis is non invasively confirmed using echocardiography. Complications of LVA include congestive heart failure, ventricular arrhythmias and rupture that can lead to sudden cardiac death. Surgical treatment is usually effective and followed by a marked improvement in function but is burdened with a heavy post operative mortality. We report the case of a 55-year-old man, with a history of myocardial infarction presenting with a large left ventricular aneurysm.

Introduction: Pemphigus vulgaris is an rare Autoimmune blistering disease. The common cause of death in Pemphigus is septicemia which is secondary to cutaneous bacterial infection. Aim: The aim of this study is to find out bacteriological profile and its antimicrobial susceptibility pattern in patients with Pemphigus vulgaris attending tertiary care hospital, Jamnagar. Materials and Methods: The present study was conducted using the 198 skin swab culture and sensitivity reports collected retrospectively in department of Microbiology Shri M.P.Shah Medical College, Jamnagar from July - 2018 to July – 2019. Results: During the study 198 culture Reports were analysed. Out of this 91(45%) were culture Positive. Staphylococcus aureus (65.93%) was the most common organism isolated Followed by the Pseudomonas aeruginosa (17.58%), Klebsiella (8.79%). Other isolates include species of CONS, Escherichia coli, Enterobacter and Acinetobacter (7.69%). Out of this High sensitivity rate were observed against linezolid in gram positive cocci and against Imipenem and Piperacilin/ tazobactum in gram Negative bacilli. Conclusion: Secondary Cuteneous bacterial infection in pemphigus vulgaris is fatal. The Most common Organism is Staphylococcus aureus followed by Pseudomonas aeruginosa, Klebsiella and species of E.coli, acenatobacter and enterobacter showing high resistant to routine antibiotics.

Aim: The aim of this study is to compare the Solubility of Endosequence root repair material fast set putty and Mineral Trioxide Aggregate Angelus (MTA-Angelus). Methods and Material: Solubility was determined by preparing stainless steel ring molds which were filled with cements corresponding to two groups (n = 5). Samples were transferred to bottles containing 10 ml of distilled water and stored at 37°C for 1, 7, and 21 days. Solubility was measured as the difference between the initial weight and the weight at the end of each storage period. Results were analyzed using Mann Whitney U test and Wilcoxon signed rank sum test. Results: The results showed weight loss with time for both materials. The solubility of ERRM and MTA on 21 days was more compared to its solubility after 1 and 7 days. Conclusions: There was no significant difference in solubility between endosequence root repair material and mineral trioxide aggregate.

How to respond to pleural thickening on a chest X-ray or CT? Benign pathology or potentially serious subclinical cancer? The differential diagnosis is wide. Only the pathological examination can decide.

Introduction: Most common mode of communication between medical professionals is by visits, telephone and mobile phone calls, meetings of doctors, and WhatsApp usage. WhatsApp has group communication and makes sending of images and videos on same group its usage most effective. Material and Methods: We did a 3 months prospective study in our Surgical Gastroenterology unit (of 15 professionals) using English and Hindi language and compared WhatsApp communication with communication by by telephone mobile phone. Results: Of the total 3462messages delivered 3219 (92.7%) were of patient care only. There were 71 (2.05%) messages related to administrative details, 5.4%(188) messages relates to teaching and academic. Multimedia messages were 145 (4.2%). Time taken to reply a message in routine working hours was found to be of 8 seconds to 25 minutes. Messages done by land line or mobile phone call systems were 184 and the time spend on each was approx 2 to 17 minutes. It was a common opinion of all members was that it’s a very useful tool, it saved time compared to the traditional methods of calling and replying. Conclusion: WhatsApp is a free of cost, easily available and a very reliable mode of use for medical practitioners. It is a development over the traditional telephone or call on mobile phone.

Hydatid disease (HD) is a zoonotic infection caused by larval stage of Echinococcus granulosus. It is a worldwide health problem causing significant socio-economic impact. This retrospective study included 19 patients diagnosed with HD at a university medical center between 2007 and 2019 in Western Region of Saudi Arabia. There were 68% (n=13) males and 32% (n=6) females (mean age 40 ± 17 years). The clinical presentations were variable and non-specific. The affected organs were as follows: liver (68%), lung (32%), soft tissue (11%), peritoneal nodule (5%), kidney (5%), and brain (5%). Multiple organ involvement and combined liver and lung were seen in 26% (n=5) and 16% (n=3) of the patients, respectively. The mean diameter of cyst was 8.98 ± 1.77 cm. Serology confirmatory test was positive in 95% (n=18) of the patients. Blood eosinophilia was noticed in 32% (n=6) of the patients. Histopathological and cytological features include laminated cyst wall, inner germinal layer and protoscolices. Management included cyst resection or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Re-aspiration) technique combined with anthelmintic drugs. The overall recurrence rate was 7.5% and 60% for surgery and PAIR, respectively. Overall mortality rate was 0%. In conclusion, considering that there is no pathognomonic clinical feature for HD, it may lead to confusion and delaying in diagnosis. Good history including exposure to dogs in the endemic areas, good imaging modalities and the proper use of serology might help for suspecting HD. The histopathological findings are valuable in confirming diagnosis of HD.

Background: Numerous restorations have been used in dentistry to substitute the lost natural tooth structure. In attempts to improve the mechanical properties of glass ionomer, a nano-zirconia reinforced glass ionomer was introduced. The aim of the study was to compare the impact of cyclic stresses on flexural strength of two aesthetics restorative materials. Materials and methods: A nano-hybrid composite resin and a nano-zirconia reinforced glass ionomer were used in this study. A total of 80 specimens, 40 for each restorative were fabricated. In each group, 10 specimens were assigned for each aging condition as following; control, thermo-cyclic stresses, mechanical-cyclic stresses and combined thermo-mechanical cyclic stresses. Then the specimens were submitted to 3-point loading test using the Universal Testing Machine. Results: In all test conditions, nano-hybrid composite resin showed statistically significant higher mean flexural strength than nano-zirconia reinforced glass ionomer (61.1MPa SD ±17.3, 24.2 MPa SD ± 9.9 P-value <0.001). The control condition showed the highest statistically significant mean flexural strength (59.4 MPa SD± 26.8, P-value<0.001), while the combined condition showed the lowest statistically significant mean of flexural strength (29.7 MPa, SD±15.9, P-value <0.001). Conclusions: Nano-hybrid composite showed superior performance than zirconia reinforced glass ionomer when subjected to cyclic stresses; either thermal, mechanical or combined.

Mycoplasma pneumoniae has been well established as a major cause of lower respiratory tract infections (LRTIs) accounting for 10-30% of all cases of community‑acquired pneumonia and is clinically indistinguishable from other infectious causes of pneumonia. The study aimed to investigate the occurrence of M. pneumoniae as the etiologic pathogen in LRTIs among children and to compare Polymerase Chain Reaction [PCR] and serology for the diagnosis of M. pneumoniae in community-acquired LRTIs in children. A total of 133 children aged between 6 months and 12 years with signs and symptoms of community-acquired LRTIs attending the Paediatrics OPD, emergency or admitted to the wards of a tertiary care hospital were prospectively enrolled into the study. M. pneumoniae in throat swab samples was detected by conventional PCR, and compared with serology and clinical signs and symptoms. Univariate analyses was conducted to determine the association of M. pneumoniae infection among different categories of patients. 31 out of 133 patients included in the study (23.3%) were positive for M. pneumoniae by any test. Among 31 patients, serology (IgM) was positive in 19 patients (61.2%) and PCR in 12 patients (38.7%); 2 patients were found to be positive by both methods. Fever, cough, hurried breathing and intercostal retraction were the clinical signs and symptoms significantly associated with LRTIs due to M. pneumoniae (P<0.05). A combination of clinical features, PCR and IgM for Mycoplasma pneumoniae is recommended depending upon the duration of illness for optimal diagnosis, timely initiation of therapy and to prevent overuse of macrolides.

Diabetes, is a metabolic disease, and is one of the most common endocrine disorders affecting almost 6% of the world’s population. This study intends to determine the prevalence of obesity and risk factors among type 2 diabetic patients, with the aimed of providing some possible measures to the finding in order to improve the level of health care rendered to the patients. This was a hospital-based retrospective study carried out at metabolic clinic of Department of Chemical-Pathology of Usman Danfodiyo University Teaching Hospital, Sokoto Nigeria, from 1st January 2018 to 31st December, 2018. Patients with clinical features of type 2 Diabetes, who were on follow up, were recruited. Data were extracted from the chemical pathology register, other clinical parameters extracted from the patients case folder, entry and validation was done using Microsoft excel version 13. The data were exported it into SPSS version 23.0 (Chicago IL) for windows; for statistical analysis. Numerical data were summarized using measures of central tendency with their respective measures of dispersions. Frequency and percentages were used to summarize categorical data. There where a total of 182 type 2 diabetes mellitus patients confirmed during the study period, the mean age of patients was 53.2, with SD± 16.9, and the age range of (21-87 years) respectively, the peak age incidence occurred within 60-69 decade of life which accounted for 27.5%. More than two-third of patients (n=116, 63.7%) were females. While (n=66, 36.3%) were males. More than half of the study participants (n= 148, 81.3%) were overweight or obese at diagnosis of type 2 diabetes. The study showed that BMI is strongly associated with risk of being diagnosed with overweight or obese, high prevalence of overweight or obesity was observed in female patients as compared to their males counterparts70.3%. Therefore, education on the complications of obesity and DM is very important to the diabetic patients.

Ovarian carcinomas represent sixth most common female cancers and fourth leading cause of death due to cancers in women. Surface epithelial tumors are commonest variety of ovarian tumors followed by germ cell tumors. Angiogenesis is critical factor in tumor growth and metastasis, because tumor proliferation is severely limited by nutrient supply to proliferating tumor cells. Hence tumorigenesis of malignant neoplasms is associated with extensive neovascularization. Many studies has established micro vessel density as an important prognostic factor in solid tumors, but there is paucity of literature regarding characteristics of tumor blood vessels in ovarian surface epithelial tumors Aims and objectives: To clarify the differences in angiogenesis between benign and malignant epithelial tumors. To assess the characteristics of tumor vessels with aid of immunohistochemistry. Material and methods: The study was done on 30 specimens received at Gandhi hospital during May 2017-July 2018. All oophorectomy specimens received at department of pathology after considering the exclusion criteria were included in the study. Routine investigations, ultrasound abdomen and pelvis, H and E staining, immunohistochemistry Smooth Muscle Actin was performed. Smooth Muscle Actin expression is classified as high, moderate, low with normal ovary as control. Results: Out of 30 cases, 15 are benign (50%), 3 borderline (10%) and 12 cases are malignant (40%).Youngest age at diagnosis was 29 years and oldest was at 65 years. Majority of the cases were diagnosed as serous tumors. Conclusion: Smooth muscle actin is highly expressed in benign cases, moderate in borderline and low in malignant cases. Malignant ovarian tumours statistically showed higher production of immature blood vessels along with paucity of smooth muscle support as compared to benign tumours. Therefore Mean MVD is higher and Smooth muscle actin expression is low in malignant tumors.