Depression is a state of sadness, hopelessness, and discouragement. Various studies have been conducted to uncover the etiological factors involved in depression. Serum folic acid is one such factor. Many researchers have reported an inverse association between serum folic acid and depression. We did an extensive computerized database searches on PubMed, Medline, and EBSCO and found that low serum folic acid are associated with depression, not only in adults, but also in elderly and diabetic patients. Further augmentation of folic acid with antidepressant treatment also improves the treatment outcome in depressed patients. Hence, considering the high benefits to the adverse effects ratio of serum folic acid, its supplementation should be done in "at risk" population whenever possible.

Background: Menopause increases stress level among females and this may be a contributing factor in developing metabolic syndrome. Objectives: The objective of this study is to study the effects of progressive muscle relaxation on cardiorespiratory efficiency and autonomic functions in over weight and obese working stressed postmenopausal females. Materials and Methods: A total of 30 postmenopausal overweight or obese (body mass index [BMI]: 24.97 ± 1.28) females belonging to the age group 50-55 years were included. Stress level in the subjects was assessed according to the presumptive life event stress scale. The perceived stress scale (PSS) of Sheldon Cohen was used for measuring the perception of stress. Fasting blood samples were collected to exclude diabetic subjects and analyze lipid profile. BMI and waist/hip ratio were calculated. Resting pulse rate and blood pressure, respiratory rate were measured. VO ₂ max, physical fitness index, breath holding time and 40 mm endurance test time were calculated for estimation of cardiopulmonary efficiency. Autonomic function tests were carried. Subjects were given progressive muscle relaxation training for 3 months and all parameters were reevaluated. Data was analyzed using SPSS version 16 (SPSS Inc., Chicago, USA). Results: PSS in pre-training session was 26.16 ± 1.7 and in post-training session was 14.33 ± 2.01 and the difference was statistically significant. There was a significant decrease in pulse rate, blood pressure, BMI, waist/hip ratio, cholesterol, low-density lipoprotein following preventive medicine residency training. Results of autonomic function tests and cardiopulmonary efficiency test improved significantly following relaxation training. Conclusions: Increased stress levels may increase BMI and waist/hip ratio, dyslipidemia and lead to autonomic dysfunctions and increase incidence of cardiovascular disease in postmenopausal females. Lifestyle modification with relaxation exercises decreases stress levels and improves autonomic functions, cardiopulmonary efficiency, and lipid profile.

Background: An increase in the incidence of infections caused by community-associated-methicillin resistant Staphylococcus aureus (MRSA) has been reported. Hence, the knowledge of resistance pattern of these isolates is a precondition for alleviating emerging antibiotic resistance and devising better treatment strategies Aim: To find out the prevalence of community-acquired methicillin-resistant staphylococcal strains from nasal carriers. Materials and Methods: A total of 352 nasal swabs collected during routine health checkup were analyzed. Results: Of the 58 (16%) staphylococci isolated, 32 (55%) were S. aureus and 26 (45%) were coagulase-negative staphylococci (CoNS). Methicillin resistance was observed in 7 (22%) of staphylococci aureus and 11 (42%) of CoNS. "D test" was positive in 1 (14%) MRSA, 2 (8%) methicillin-susceptible S. aureus and 2 (8%) methicillin resistant-CoNS. Conclusion: Effective implementation of the antibiotic policy along with measures like hand wash, isolation of patients will reduce the incidence of resistance.

Nutrition knowledge is one of the factors that affect nutritional status and nutritional habits of individuals, families, and societies. Nutrition knowledge is an important tool in assessing the nutritional status of an individual, group or community. Researchers have been trying to design and develop reliable and valid questionnaires that distinguish and measure nutrition knowledge and its impact on dietary behavior and diet-health awareness. Many studies have shown that nutrition knowledge can affect someone to follow dietary recommendations. The aim of this study was to assess the nutrition knowledge of Syrian university students and to find out if there was any relationship between anthropometric measurements, socioeconomic status, type of university and nutrition knowledge of the students. Nutritional knowledge was assessed using valid nutrition knowledge questionnaire, which covered six main sections. The questionnaire was designed for this study and was adapted from Parameter and Wardle. The number of students participated in the study was 998 students and were selected from four universities) in Syria. They were asked to complete the nutrition knowledge questionnaire under supervision of trained nutritionist. Anthropometric measurements were taken for all participants by trained professional. The results were statistically analyzed and P < 0.05 set to be significant. The total score of nutrition knowledge for all sections was 37.86 ± 0.26 (out of 110). Scores for nutrition knowledge was higher in females as compared with males (38.37 ± 0.35 and 37.29 ± 0.38, respectively). Students who enrolled in health related programs scored higher (41.23 ± 0.05) compared with those who were enrolled in nonhealth-related programs (36.86 ± 0.28). Students in private universities scored higher than students in public universities in total nutrition knowledge (TNK). Very good grade point average students scored the highest points in all sections. Surprisingly, students with body mass index (BMI) >30 had the highest points in TNK. Females had higher TNK score as compared with males. Furthermore, students enrolled in the private university and in health-related programs showed typically better TNK scores than those enrolled in public universities and in nonhealth-related programs. The highest TNK score based on BMI was found among students with BMI >30. The results support the likely value of including nutrition knowledge as a target for health education campaigns aimed at promoting healthy eating.

Introduction: The legacy of malnutrition especially among preschool children is a huge obstacle to overall national development. India is home to more than one-third of the world's under-nourished children. While there is global acceptance that body mass index (BMI) should be used for assessment of obesity/adiposity in children, there has not been a similar consensus regarding use of BMI for assessment of under-nutrition in children. Materials and Methods: The present study was a community-based cross-sectional study carried out in a primary health center between January and December 2011. Study population comprised of 697 children aged between 2 and 5 years. Weight (kg) and height (cm) measurements were taken on each subject, and BMI was computed. Nutritional status was evaluated using the Cole's age- and sex-specific cut-off points of BMI. One-way ANOVA (F-test) was performed to test for age differences in means of weight, height, and BMI using SPSS statistical package. Results: A total of 339 boys and 358 females were studied. Result showed that age-combined prevalence of under-nutrition (Grades I, II, and III combined) among boys and girls was 63.4% and 58.6% respectively with an overall prevalence of 61.7%. There were significant mean differences between ages among boys in weight (F = 4.160; P < 0.001) and height (F = 6.502; P < 0.001). However, no significant mean differences between ages for BMI (F = 1.098; P = 0.295). Similar findings were seen among girls where in significant differences were observed in weight (F = 3.125, P < 0.001) and height (F = 6.895; P < 0.001) but not with BMI (F = 1.091; P = 0.311). Conclusion: Our study provided evidence that these children were under acute and chronic nutritional stress in the form of thinness.

Aims and Objective: To establish whether the reported episode was a seizure, to determine the cause of seizure by identifying the risk factors, lab, radiological and electroencephalography (EEG) evaluation to determine any underlying structural abnormality and to decide whether anti-epileptics therapy is essential. Settings and Design: This was a descriptive study. Materials and Methods: (1) Source of data - All the patients with inclusion criteria attending to the medicine outpatient department (OPD)/wards. Sample size = 50 cases. (2) Study subjects - Inclusion criteria: All patients >15 years age group presenting in medicine OPD/wards with the first episode of seizure. Exclusion criteria: Seizures on treatment and head injury. Methods of Collection of Data: Each patient was subjected to the detailed evaluation including history, precipitating factors, and symptomatology recorded accordingly. History of hypertension, diabetes mellitus, tuberculosis (TB) was enquired into. Family history of epilepsy, TB was recorded. Complete clinical evaluation and thorough investigations-complete blood count, urine examination, blood urea nitrogen, random blood sugar, chest X-ray, computerized tomography (CT) scan and EEG were done for all patients in the inclusion criteria. Anti-epileptics were started if either CT/EEG was abnormal, rest of the patients were not given anti-epileptics. Follow-up was done for 6 months, and any recurrence of seizures was noted. The data collected from cases in the inclusion criteria were recorded in a Master chart. Data analysis was done using appropriate statistical tests and graphs. Results and Conclusions: Peak incidence of new onset seizure was second to third decade (25 cases; 50%), max cases <25 years, male: Female ratio of 2.12:1, duration of seizure <5 min (30 cases; 60%), evidence of TB = 6 cases (12%), alcohol intake = 5 cases (10%), developmental delay = 3 cases (6%), family history = 3 cases (6%), old cerebro-vascular accident = 2 cases (4%), neurological abnormalities (CT scan) =11 cases (22%), EEG abnormalities = 4 cases (8%), recurrence = 12 untreated cases (24%).

All clinicians face the common problems in making complete denture prosthesis for patients exhibiting high degree of bone resorption. Though resorption can be prevented to an extent but sooner or later it comes back to haunt the clinician. The result is a dis-satisfied patient with a loose prosthesis ready for a new one. The real problem lies in the capturing the oral tissues and using them for creating retention and stability in the prosthesis. Though ultimate success also depends on many other factors such as the occlusal scheme used and patient adaptability yet the most important step still remains the impression technique employed. A few impression techniques are suggested for increasing the success rates in such patients.

Context: One percent of the population in India is homeless (destitutes) which include beggars, commercial sex workers, homeless mentally ill, elderly women with dependent children, street children, and persons with disability. Psychiatric disorders are generally seen to be common among homeless individuals. The data are limited regarding psychiatric morbidity and its prevalence in this populace in Indian context. Aim: The aim was to study the prevalence of psychiatric morbidity among the inmates of a center for destitutes. Settings and Design: Cross-sectional study. Materials and Methods: The study included all the residents (n = 50) of a center of destitutes. Psychiatric evaluation was done by qualified practicing psychiatrist. Brief Psychiatric Rating Scale and Global Assessment of Functioning instruments were used to assess the severity of psychiatric symptoms and general functioning of the individuals with mental disorders. Statistical Analysis Used: SPSS version 13 was used for statistical analysis. Results: All residents (n = 50) of center of destitutes were evaluated for psychiatric co-morbidity. 42 (84%) inmates were suffering from psychiatric disorders. Most common psychiatric disorder among them was psychotic disorders in 19 (38%), followed by affective disorders, mainly depression in 16 (32%), somatoform disorders in 5 (10%), and anxiety disorders in 2 (4%). No significant gender differences were noted (P = 0.335). Substance abuse was present in 22 (44%) of the inmates. A significant negative correlation between psychiatric symptoms and functioning of the subject was seen, (P < 0.001). Conclusion: Psychiatric disorders and in particular substance abuse, are common among the homeless people who stay in the center of destitutes. Psychiatric disorders are likely to be the cause significant functional impairment.

Orbital cavernous haemangiomas are most frequent intra-conal, intra-orbital primary tumor in adults. They represent 4% of all orbit tumors and 9-13% of all intracranial cavernous haemangiomas. Forty-two-year-old female came with complaints of protrusion of right eye (RE) since 3 months associated with diminution of vision, headache, and eye ache. Absolute proptometry was 28 mm OD and 20 mm OS. 2 mm of the inferior scleral show was seen in RE. Axial computed tomography (CT) showed unilaterally, moderately enhancing, homogeneous, smooth-contoured mass. The patient underwent right lateral orbitotomy with mass excision under general anesthesia. The histopathological evaluation proved it to be a cavernous haemangioma. We report a case of intra-orbital, intra-conal cavernous hemangioma occurring in a 42-year-old female presenting with proptosis. The tumor was diagnosed on CT and was removed using lateral orbitotomy approach. Patient had significant improvement in symptoms with the mild deterioration of vision.

Various maxillofacial prostheses are made from materials used in dentistry. The treatment of the patient who loses one or both eyes is a challenging task for the clinician. A multidisciplinary approach is required to fulfill the needs and expectations of an anophthalmic patient. Dentists are now playing a major role in this regard as they are more familiar with the materials used for artificial eyes. Ocular prosthesis is an artifi cial replacement of the eye. The article describes the overall management and treatment of an anophthalmic patient, followed by a procedure for an easy fabrication of a custom-fi tocular prosthesis.

The occurrence of combined injury involving both extrusion and lower lip injury is extremely rare. A simple review of the medical literature shows that no article up to this date has reported the prevalence of the both the injuries in mandible. And an ideal treatment of this type of dental trauma is not well established. Hence, our objective is to relate several challenges that the professional might have to deal with. In this case report, extruded 41 was replanted after 6 h and lower lip tear crossing vermilion border and extending 2 mm involving skin. The repositioned extruded teeth did not demonstrate ankylosis, lower lip healed with minimum scar. Proper treatment planning and follow-up care can lead to a successful outcome.

Desmoplastic fibroblastoma is an uncommon fibrous soft tissue tumor. Only a few cases have been reported in the literature till date. These slow growing, painless mass is most commonly seen in the upper extremities, but rarely in the head and neck region. This article presents a case report of a 45-year-old female who presented with a similar soft tissue mass in the oral cavity. The mass was excised and sent for histopathological evaluation, which confirmed the diagnosis as desmoplastic fibroblastoma.

Breast cancer is very rare in men. It accounts for 0.2% of all cancers and 1% of all breast cancers. The occurrence of occult breast cancer that present as axillary metastasis as the first manifestation is even rarer in men. We are hereby presenting an extremely rare case of a septuagenarian male patient who presented with occult breast cancer and axillary lymph node metastasis.

Failure to detect pregnancy in the emergency situations can have important consequences. These include missing of ectopic pregnancy (the leading cause of first-trimester pregnancy-related maternal death), administration of medications contraindicated in pregnancy, fetal radiation exposure, and medico legal problems. This in turn has led to the dictum to check for pregnancy in all women of child-bearing age group. Urine pregnancy (human chorionic gonadotropin [hCG]) test is the commonly used test to rule out pregnancy and has been reported by Griffey et al. in their study to achieve 100% sensitivity and 99.2% specificity in a clinical setting, resulting in a positive predictive value of 98.3% and a negative predictive value of nearly 100%. However, the sensitivity is influenced not only by the quantity of β hCG but on its variants that vary with different weeks of pregnancy. β hCG is present in several variant forms that change in their concentrations at different stages of pregnancy. In spite of its high sensitivity, in the presence of molar pregnancy that is associated with very high levels of β hCG it fails to detect the antigen (β hCG). This is explained by the phenomenon known as "high-dose hook effect" which further leads to delay in diagnosis and treatment. This can be overcome by dilution of the sample. In such cases, diagnosis will be made by serum β hCG and ultrasound (USG). Here, we present a case of gravida 2 para 1 living 1 with 2΍ months amenorrhea with bleeding p/v and pain abdomen of 20 days duration whose urine β hCG was repeatedly negative and diagnosis was made by serum β hCG and USG.

Deep vein thrombosis (DVT) of iliac and femoral veins is a common condition in our clinical practice. Spontaneous retroperitoneal hematoma (SRH) is a relatively rare condition. The occurrence of both DVT and SRH concomitantly is very rare. Many of the times the exact pathology leading to SRH with DVT is unknown. Both conditions being fatal in nature, the management remains very challenging. Here we report a similar case with review of the literature.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in about 2% of the population and, in most cases, incidentally being discovered during autopsy, laparotomy, or barium studies. Hemorrhage, obstruction, and inflammation are the complications that can occur in a Meckel's diverticulum. Perforation in a Meckel's diverticulum can occur in the presence of ectopic mucosa which is rare, but perforation following blunt abdominal injury is very rare and only few cases have been reported so far. We report a case of perforation of Meckel's diverticulum in an 8-year-old boy following a blunt abdominal trauma due to fall from a bicycle.

Spinal intramedullary tuberculoma is a rare cause of paraparesis. Clinical presentation is often nondistinctive in the absence of systemic tuberculosis. Magnetic resonance imaging reveals intramedullary granuloma with relatively distinct pattern with peripheral gadolinium enhancement resembling "target sign." Histolopathological evaluation is essential to differentiate it from other intramedullary lesions to offer curative treatment augmented by surgical excision. Early surgical intervention combined with anti-tubercular drugs yields good prognosis.