The margin is one of the components of the cast restoration most susceptible to failure, both biologically and mechanically. Obtaining a good marginal seal is one of the most important factor in determining the long term success of cast restorations. The purpose of the study was to comparative evaluate the casting accuracy by axial coverage of the die spacer 1.00 mm short from the finish line and complete axial coverage of the die spacer. Irrespective of the method of the die spacer application, all the castings showed deficiency in the marginal fit. Efforts were made to select and utilize standard method. The enhancement of marginal fit with incomplete axial die spacer coverage by providing an area of close adaptation near the marginal area, thereby improving the marginal seal and thus reducing the dissolution of cementing media is of great clinical significance. Increased casting accuracy with die spacer application short by 1.00 mm from finish line could be due to the reason that unpainted area will ensure an area of close adaptation at the margin. From this study, it is clear that the die spacer application short by 1.00 mm from finish line gives better marginal adaptation to castings when compared to full length die spacer application

Down syndrome (DS) is a common chromosomal anomaly. Congenital heart disease (CHD) is main prognostic factor contributing to a favourable or unfavourable outcome in these patients. To study the patterns of congenital heart diseases in children with Down syndrome. Hospital based descriptive type of observational study of 70 patients conducted at SPMCHI, Jaipur from April 2012 to Sept 2013. There were 70 DS children; 46 (65.71%) male and 24 (34.29%) female. Congenital heart disease was detected in 47 (67.14%) DS children. Out of those, 95.74% were detected as acyanotic heart disease and 4.26% were cyanotic heart disease. Total 73 congenital heart defects were detected in 47 DS children with CHD. In these children, 46.81% have single defect, 31.91 % have 2 defects and 21.28 % have multiple defects. In total congenital heart defects ASD (41.10%) was the commonest congenital heart defect followed by PDA (21.92%) and VSD (15.07%). It is imperative to know about presence of congenital heart disease in Down syndrome children. Contrary to result of most of other workers who observed atrioventricular septal defect was commonest defect. In present study ASD, PDA and VSD were the commonest CHD in order of frequency

The study conducted was to evaluate the quality of oral pediatric antimalarials drugs found in the formal and informal sectors of the city of Douala: particular case of syrups and suspensions of quinine and some powders for oral suspension of artemether-luméfantrine. An analytical study was made on 100 samples selected at random sanitary formations, whole salers distributors and markets of illicit distribution found in the various districts of the city of Douala at which the takings were made. The labeling, the visual aspect, the pharmaco-technical parameters (pH, density, volume) and physic chemical parameters (identification, dosage and stability of actives ingredients) of the different samples were estimated. The results of the analyzes showed an global rate of non-compliance of 77%, the informal sector was the most represented with 92% of its samples non-compliant as compared to 62% in the formal sector. The pharmaco-technical non-compliance concerns the pH with 30%, then the density with 46.7% and the volume 46.7%. The physico-chemical non-compliance concerns the identification of the active substance with 2% and the dosage of active substances with 77%. As regard the stability of the reconstituted suspensions, the pH was stable during 14 days after the reconstitution whereas 22.7% of samples saw their concentration of artemether reduce more than 10% and 41.4% of samples for the lumefantrine. In view of all this, the WHO recommends instead the use of dispersible compressed forms for the treatment of simple malaria in children

Chronic kidney disease (CKD) patients have higher HOMA-IR index compared to otherwise healthy metabolic syndrome controls. The aim of this work was to compare the biochemical profile, symptoms and signs of Metabolic Syndrome (MS), between chronic kidney disease patients and non-chronic kidney disease metabolic syndrome subjects, using the World Health Organization criteria. it is a case-control study. Among the CKD patients, 20 patients fulfilling the criteria for metabolic syndrome were included in the study and compared with the age, sex matched otherwise healthy metabolic syndrome subjects. Individuals aged >18 yrs and above were included in the study. Fasting glucose, anthropometric measurements, lipid estimations, and biochemical parameters were done in all the participants, who fulfilled the WHO criteria of metabolic syndrome. All the cases belonged to stages 3 & 4 of CKD. Presence of symptoms among cases were due to their CKD condition, waist hip ratio (W/H) ratio is significantly higher in cases than controls (P<0.05). Both systolic as well as diastolic blood pressure is higher in cases (M 142±19.6, F141 ± 11.3).There was significant difference in the HDL and LDL level among cases and controls HDL level being higher in females among cases(F 46.5±8.31) , whereas LDL level was higher in females among controls (F111.3±55.9). Fasting insulin level was significantly lower among cases in both females and males (Case; M 42.6±8.3, F32.04+14.4; Controls; M56.5±6.6, F 57.5±9.4) similarly HOMA-IR values were significantly lower in cases than controls (Case M7.9±0.86, F7.4±3.7, Controls M13.4±3.5 F12.1±3.4).None of the comparative studies, between CKD and otherwise healthy metabolic syndrome cases have reported higher HOMA-IR levels in controls than CKD patients. HSCrp level was higher in cases than controls (case M 9.3±9.6 F5.9±7.2; Controls M2.5±3.2, F1.9±2.4). Sodium and Potassium levels were significantly higher in cases than controls. Calcium levels were higher in controls than cases, alkaline phosphatase is significantly higher in cases than controls. Though both the cases and controls, are insulin resistant, there is significant difference between HOMA –IR index among cases and controls, HOMA-IR value is higher among controls than CKD patients.

The possible etiological factors found in the causation of protein energy malnutrition among young children are non feeding of colostrums, lack of exclusive breast feeding in first six month of life, late introduction of semi solid and solid foods, dilution of top milk accompanied by faulty complementary feeding practices by mother and exacerbated by ignorance in the family and the community of the basic dietary needs of the child, particularly during complementary feeding phase. It has been found that, nutrition education can positively effect changes in the attitudes and practices of mothers and is an extremely valuable tool in alleviating the malnutrition, which may occur as a result of improper feeding practices. Aim of the study is to study of infant feeding practices at a tertiary care centre in central India. Information was collected from interview with the parents and examination of under five years children was entered in a predesigned and pretested proforma of the study. In our study top milk was introduced by 20.6% of mothers below the 6 months of age. Majority of them recived top milk between 6-12 months of age (75%). This study revealed that only 21.8% children were receiving undiluted milk. 1/3 received half diluted (43.7%) and remaining was receiving (34.5%) 1/4 dilution. This dilution of milk was responsible for malnutrition in children

The important role of malnutrition in child death is that most nutritional deficiencies, including vitamin A and Zinc, impair immune function and other host defenses leading to a cycle of longer lasting and more severe infection and even worsening nutritional status. Thus inadequate intake, infection and poor nutritional status are intimately linked. Aim is to study the contact of TB and measles in malnourished children. Information was collected from interview with the parents and examination of under five years children was entered in a predesigned and pretested proforma of the study. History of contact of tuberculosis was present in 9.2% children. While measles in malnourished children is 31.1%, which has significance, precipitate of severe grade of malnutrition as compared to no history of measles

This prospective observational study was conducted in the Department of Pediatrics, Amaltas Institute of Medical Sciences, Dewas between March 2016 to August 2017. Patients were classified on the basis of detailed history, clinical examination, ECG record, chest x-ray, Weight-for-Height, age of diagnosis, follow up and other relevant investigations pertaining to the case. The correlation among the clinical examination, ECG & chest x-ray findings were studied. The predictive values of development of complications during the follow-up period by these 3 parameters were observed. Sex distribution, age of diagnosis, clinical examination, ECG, chest x-ray, weight for height, types of VSDs and development of complication on follow up of these patients were analyzed and classified accordingly. The complications of VSD are biventricular hypertrophy, congestive cardiac failure, Pulmonary hypertension, Eisenmenger Syndrome, aortic insufficiency, infective endocarditis& heart block (rare). In our study group 24/56 (42.8%) patients presented with biventricular hypertrophy & all of them were large sized VSDs. Out of25 large sized VSDs, 20 (35.7%) patients had congestive cardiac failure. 35 out of56 had pulmonary hypertension (62.5%), as evident by ECG (P pulmonale in lead II), clinical examination (palpable P2 & loud P2 on auscultation) & chest x-ray (enlarged Pulmonary Artery segment). 1 Patient out of 56 developed Eisenmenger Syndrome (1.7%). 1 Patient out of 56 developed infective endocarditis (1.7%). Prospective Observational Study. A detailed clinical history, clinic-radiological profile and ECG are very helpful in assessing severity and development of complications. Early diagnosis is required to aid the physician in referral of the patient to a specialized center for early surgery. Early diagnosis, proper referral as discussed above & management will help in preventing the associated complications, thereby reducing the mortality and morbidity in these children and improve their quality of life

Pericardial effusion is an extremely rare expression of hyperthyroidism. We report a case of a patient with Graves’ disease who developed a sanguineous pericardial effusion. Our patient had been hospitalized for retrosternal chest pain and dyspnea. She underwent pericardiocentesis resulting in 700 ml of blood. The pericardial fluid’s cytology and culture were negative. Besides, thyroid hormone markers were progressively normalized using antithyroid drugs .Thus the pericardial effusion resolved without recurrence.