Microsurgery, this terminology itself is self-explanatory, where a surgical procedure is performed making use of the magnification obtained by an operating microscope. The instruments like a microscope which provides the magnification is made use of, in the fields of medicine since decades. Now the use of such magnification systems is a very popular practice in dentistry as well. Before adopting visual magnification systems such as microscopes and successfully applying it in the dental procedures, it is mandatory to understand the principles and the physics of such instruments. Microsurgery in dentistry has more advantages in terms of efficiency, improved ergonomics, minimally invasiveness and less fatigue. This review paper, highlights about the various magnification systems, its principles and the application of microsurgery in various fields of dentistry.

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Introduction: Historically our culture has traditionally viewed even the normal menustral cycle as an aberration, ostracizing the reproductive aged women. Aristotle quoted Hippocrates writings by describing the process of heavy uterine bleeding as "In quantity, bleeding in excessive, saith Hippocrates, when they flow about eighteenth ounces". Aims and Objective: To study the various aetiopathological factors responsible for AUB in women ages 20-55 years, and to correlate the clinical presentation with ultrasonography, hysteroscopy, laparoscopy and histopathological finding. Sample: In this study, 140 cases of 15-55 years of age group were randomly selected after the exclusion criteria who were willing to get admitted as well as prepared for follow-up. Inclusion Criteria: The cases of abnormal uterine bleeding, attending the gynecology OPD with complaints of menorrhagia, metrorrhagia, polymenorrhoea, and polymenorrhagia in the age group 20-55 years, were selected. Exclusion Criteria: Pregnant patients and patients below 20 years and above 55 years are excluded from the study. Conclusion: It is seen that incidence of AUB is more common in 5 ^th decade of life and in multiparous women. Menorrhagia is the most common bleeding pattern followed by metrorrhagia. Histopathological examination of the endometrium revealed that whatever may be the pathology, proliferative endometrium is the most common pattern.

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Purpose: Awareness of varied aspects of diabetes mellitus (DM) is essential for the prevention, management and control of the disease. Aim: The aim was to assess the level of understanding of DM among patients and their bystanders attending the ophthalmology out-patient department of a Tertiary Care Hospital in North Kerala. Design: Cross-sectional study based on a questionnaire survey. Materials and Methods: The cases were selected by convenient sampling. The questionnaire covered demographic characteristics, general knowledge on DM, its causes, management, and prevention. Results: The study included 40 cases of DM and 50 bystanders. The median age was 49.78 years (range: 19-78). About 32% of the bystanders were diabetic. 29 subjects led a sedentary life. More than one family member was affected among 52.22%. Despite general awareness, only 38.70% knew about the hidden complications of the disease. The source of information was the treating physician in 47.11%. Knowledge about visible complications was better. Awareness about management options and preventive strategies was poor. Duration of the disease, family history and being an accompanying person had correlation with the awareness among the group. Conclusion: The majority of patients and bystanders had poor knowledge on the related health aspects of DM.

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Background: Epilepsy, a chronic noncommunicable disease is recognized as a major public health concern. Stigma is an important factor that has a negative influence on people with epilepsy (PWE) and their families. The burden for people with epilepsy and their families is greatest in poor countries. Aims: The aim of this study is to elicit the lived experiences of individuals who had experienced burden of stigma while they live and care for patients with epilepsy. Settings and Design: The participants in this study are relatives who are the caregivers of patients with epilepsy who visited the mental health unit of a tertiary health center in Southwest Nigeria. Materials and Methods: Sociodemographic data of participants were collected in addition to recorded significant statements following extensive interactions held with the participants. Thematic analyses of varying experiences of participants, as recorded, were done using the phenomenological method of Colazzi. Results: Nineteen participants were engaged in the study with 12 (63.2%) of them being females and half of the females being mothers. Child and spouse of patients of epilepsy were least likely as care givers. The mean age of participants was 38.3 years and mean duration of patients' illness was 5.6 years. Four major themes including prejudice, fear, shame, and social isolation were the most recurring of the -33 significant statements recorded from the participants. Conclusions: It is pertinent to have enhanced and sustained self-efficacy with great empathy toward the patients and their family members.

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Introduction: Work-related musculoskeletal disorders (MSDs) are very common in dental professionals. Dentists spend their workdays in an awkward, static position, performing extremely precise procedures. However, maintaining a steady hand and posture comes at the cost of pain in various body parts of the dentist. Occasional pain from irregular stances or positions is to be expected while the dentists are performing static work. Irrespective of whether dentists work in an institutionalized setup or a private setup, they all are at risk. Hence, this study aims to identify their common musculoskeletal problems. Objectives: To identify various musculoskeletal problems of dental surgeons. Materials and Methods: A cross-sectional study carried out in Navi Mumbai and Mumbai, Maharashtra, India among 250 dental surgeons. A questionnaire was developed to incorporate basic information on job profiles and musculoskeletal issues. The data collected were analyzed using an appropriate statistical analysis method. Results: Our study found that the most commonly affected area among male subjects was the neck in institutional practitioners and the lower back in private practitioners. In females, the neck was the maximum area of pain followed by the wrist and hand in institutional as well as private practitioners. This investigation of this study revealed that almost all the participants reported musculoskeletal pain. Conclusion: The study showed that there was a significant association between the work posture, lifestyle, environmental factors, and MSDs.

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Tubular apocrine adenoma, the apocrine variant of papillary tubulopapillary hidradenoma is a rare well-circumscribed, intradermal benign tumor, with tubular structures showing apocrine differentiation. We present a 40 year female with swelling on the scalp of one year duration measuring 3 x 3.5 x 2 cm. On gross examination, a 2 x 2 x 1.5 cm grayish white mass was seen. H and E stained sections from the tumor mass revealed tubules of various sizes lined by two layers of cells, an outer cuboidal and inner columnar. Some of the tubules showed intraluminal papillary projections without a fibrovascular core. Diagnosis of tubular apocrine adenoma was made. Tubular apocrine adenoma is an unusual entity which may be mistaken for other adnexal tumors both clinically and cytologically. Histopathologic examination is essential for diagnosis.

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Context: In patients with anticipated difficult airway, it is difficult to align the oropharyngolaryngeal axis to facilitate intubation by conventional laryngoscopy, which leads to failed intubation. The TruView EVO ₂ laryngoscope is a device with a unique blade that provides an optical view "around the corner." The blade is a modified laryngoscope blade incorporating an unmagnified optic side port with anterior fraction of 42΀ in the line of sight allowing indirect tracheal intubation. Aim: The aim of the study was to compare TrueView blade with Macintosh blade with respect to the (view of the glottis by (Cormack-Lehane grading); Time for tracheal Intubation, Attempts required for intubation, maneuvers to optimize the laryngeal view and success rate of intubation); Settings and Design: It was a prospective, randomized controlled single blind clinical study. Materials and Methods: Seventy ASA grade I and II, Mallampatti Grading (MPG), III and IV patients posted for elective surgery with restricted neck mobility such as post-burn contracture neck, cervical spine surgeries divided into Group 1-35 patients (Trueview) and Group 2-35 patients (Macintosh). All intubation was done by an expert anesthesiologist. Statistical Analysis: Tests used were Mann-Whitney U test, two independent sample t-tests, Chi-square test, and Fischer's exact t-test. Results: Cormack-Lehane Grade I was seen in 62.85% and O in Group 1 and Group 2, respectively. Grade II was seen in 37.14% and 28.57% in Group 1 and Group 2, respectively, and Grade III in 0 and 71.42% in Groups 1 and 2, respectively, which was statistically significant. Thus EVO ₂ improved the view of glottis by 2 Grades. Both the techniques were comparable as far as time is concerned. A 94.2% patients in Group 1 intubated in 1 ^st attempt, 5% needed 2 ^nd attempt, whereas in Group 2 72.7% patients were intubated in 1 ^st attempt and 27.2% in 2 ^nd attempt. Maneuver BURP required more with conventional laryngoscopy. Success rate in Group 1 was 100% and in Group 2 it was 94.2%. Conclusion: The use of TrueView in patients with anticipated difficult airway considerably improved the view of glottis. With adequate experience, the number of attempts may be reduced and maneuver required for securing airway successfully could be optimized.

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A pheochromocytoma is a highly vascular neuroendocrine tumor of the medulla of the adrenal glands, originating from the chromaffin cells or extra-adrenal chromaffin tissue and secreting an excessive amount of catecholamines. Medical management of this tumor includes correction of hypertension and arrhythmias, and assessment of end organ damage. This can be achieved by alpha-receptor blockade and beta-receptor blockade, calcium channel blockers (CCBs),   alpha-methyl-tyrosine, etc. Surgical excision of the tumor, either open laparotomy or laparoscopy, is the definitive management. A laparoscopic approach offers several advantages compared with an open laparotomy such as decreasing fluid shifts that may accompany an open procedure, potentially decreasing the surgical stress imposed on the patient, decreasing the need for postoperative analgesia, shortening postoperative convalescence including an intensive care unit stay, and decreasing the overall hospital stay. A 11-year-old male patient with left adrenal mass  measuring 2.9 cm × 3.9 cm × 4.7 cm on alpha-blocker and beta-blocker for laparoscopic adrenalectomy was successfully managed perioperatively.

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