Introduction The skin is a mirror of the internal milieu of the body. As with other systemic disorders, many internal malignancies can be reflected in this mirror, provided we look carefully enough. Internal malignancies may lead to cutaneous manifestations in a number of ways. The tumor may invade the skin directly or do so by way of lymphatic or hematogenous dissemination, thereby giving rise to deposits in the skin (cutaneous metastases). As is evident from the foregoing, a knowledge of cutaneous manifestations in various internal malignancies can be extremely helpful in making a diagnosis, gauging the extent of the disease, assessing the progress and response to therapy of a neoplasm besides enabling one to prognosticate. Materials and methods The study comprised 225 cases with internal malignant disease of varying types and duration and involving different organs and organ systems, recorded over a period of 1 year and 8 months. A thorough history and examination with relevant laboratory investigations with skin biopsy were carried out where indicated. Results The patients studied comprised 130 males (58%) and 95 females (42%) with maximum number of patients in the age group of 61 years and above. Mucocutaneous manifestations were seen in 52 (23%) patients in the present study with a total of 73 skin lesions of various types. Specific skin lesions were seen in 11 patients, paraneoplastic skin syndromes/nonspecific skin lesions were seen in 27, genetic syndromes denoting increased susceptibility to cancer in 1 and skin lesions due to cancer therapy in 21 patients; 14 (8.6%) out of 163 patients given chemotherapy showed adverse effects of chemotherapy; 7 patients (7.1%) out of a total of 98 given radiotherapy showed features of radiodermatitis in the present work. How to cite this article Singh N. Cutaneous Manifestations in Internal Malignancy. Int J Adv Integ Med Sci 2017;2(4):161-168.

Introduction Refractive error is one of the important causes of impaired visual acuity in children. Aim To study the pattern of refractive errors in children of Bareilly city and determine its association with selected variables of age, sex, educational status, socioeconomic status, residing locality, family history, previous use of spectacles, amblyopia, and strabismus. Materials and methods A cross-sectional study was conducted on 521 children aged 5 to 15 years attending the ophthalmology outpatient department (OPD) of a teaching hospital of Bareilly. Visual status along with dry and cycloplegic refraction was carried out. Relevant data in relation to the selected variables were compiled. Statistical analysis of obtained results was carried out using the software Statistical Package for the Social Sciences (SPSS) version 22. Results The mean age of presentation of refractive error was 10.75 ± 2.96 years with a distinct male preponderance and with a male:female ratio of 1.33:1. Parental education background revealed fair literacy rate with 56.23% mothers and 69.28% fathers having intermediate qualification and above. Higher incidence of refractive error was noted in children with upper lower socioeconomic status (34.54%) and with those having positive family history (61.23%); 7.67% children were amblyopic and 7.10% children had coexisting strabismus. Most of the children (80.23%) gave no history of previous use of spectacles. Astigmatism was noted as the commonest refractive error in 45.09% followed by myopia (42.86%) and hypermetropia (12.05%). Conclusion The study provides an insight into the quantum, extent, and form of visual impairment prevalent in Bareilly district. It furnishes essential data for planning and evaluating preventive and curative services for visual impairment of children in this region. Clinical significance These data support the assumption that vision screening of achool children in developing countries would be very useful in early detection of correctable causes of poor vision, especially refractive errors and in preventingvisual complications. How to cite this article Mittal J, Rizvi Y, Jain R. Clinical Profile of Refractive Errors in School-going Children of Bareilly, Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(4):169-172.

Studies of nonmetric cranial variants have been a field of considerable interest to research workers, especially because of their racial and regional importance. Twenty-eight North Indian skulls of Uttar Pradesh, India, were studied for the posterior ethmoidal foramen absence, a cranial variant in the present study. Findings are discussed and compared with other global studies and are found to be of considerable regional and racial significance. How to cite this article Zaidi SHH. A Study of Posterior Ethmoidal Foramen Absence in North Indian Crania. Int J Adv Integ Med Sci 2017;2(4):173-174.

The purpose of this retrospective radiographic study was to evaluate the position of mandibular third molars. This study was conducted at the Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. Patients who had reported with the complaint of pain and swelling in the lower third molar area were assessed and advised orthopantomograph (OPG) for their lower third molar. These were evaluated according to Pell and Gregory classification. Of the total 600 patients examined, 300 were males and 300 were females. Most of the patients were between 30 and 39 years of age (n = 250). It was observed that position I (n = 313) and class II (55% n = 324) were found to be the most common. How to cite this article Mohan S, Prajapati VK, Shahi A. Prevalence of Impacted Mandibular Third Molars in an East Indian Subpopulation: A Retrospective Radiographic Study. Int J Adv Integ Med Sci 2017;2(4):175-177.

Introduction Sensorineural hearing loss (SNHL) is an extremely common disorder, with a spectrum of effect ranging from an almost undetectable degree of disability to a profound alteration in the ability to function in society. The purpose of this study was to identify patients with SNHL and to establish an etiological diagnosis. Study design It was a prospective study. Materials and methods Patients with SNHL attending the Department of ENT at a tertiary referral center in the state of Uttarakhand were evaluated; 135 patients with audiologically proven SNHL were included in this study and were evaluated to make an etiological diagnosis. Results Sensorineural hearing loss was found predominantly in males with a mean age of 45.5 years. The maximum patients were in the age group of 26 to 45 years (54 patients; 40%). The maximum incidence of SNHL was found in office workers (49 patients; 36.3%). A total of 119 (88%) patients reported to have a progressive hearing loss while only 16 (12%) patients had a sudden onset of hearing loss; 69 (51%) cases had unilateral and 66 (49%) cases had bilateral hearing loss. The patients with moderate hearing loss (41–55 dB) were 33 (24.4%), while profound deafness (more than 90 dB) was seen in 31 (23%). A maximum of 66 (49%) patients were diagnosed as having a cochlear disease and retrocochlear disease was seen in 38 patients (28%) The most common etiology of SNHL was idiopathic while the second most common was presbycusis followed by noise-induced deafness and Meniere's disease. Conclusion It was found that the majority of the patients with SNHL were males belonging to younger age group and therefore, had a greater significance of early identification and rehabilitation. The main etiological diagnosis in our study was idiopathic followed by presbycusis. How to cite this article Bist SS, Varshney S, Gupta S, Bhagat S. Sensorineural Hearing Loss in Adults: Etiological Study. Int J Adv Integ Med Sci 2017;2(4):178-182.

Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of women in the reproductive age group, with a prevalence of 5 to 10% of the female population. Dyslipidemia, insulin resistance, and obesity are all potent cardiovascular risk factors that tend to cluster in women with PCOS. The Androgen Excess-PCOS Society consensus statement recommended a complete lipid profile, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), non-HDL-cholesterol (non-HDL-C), and triglycerides (TGs) in all subjects with PCOS for cardiovascular risk prevention. Aim The purpose of this study is to evaluate lipid levels in subjects with PCOS and to correlate with obesity. Materials and methods Study group comprised 142 women with PCOS and 65 healthy non-PCOS subjects. Body mass index (BMI), waist circumference, and lipids were measured in PCOS subjects and age-matched non-PCOS subjects. Statistical analysis All values are expressed as mean ± standard deviation (SD). The results obtained are analyzed statistically using unpaired t-test to evaluate the significance of difference between the mean values. Results The mean BMI, waist circumference, serum cholesterol, TGs, LDL-C, and non-HDL-C values significantly increased, whereas serum HDL-C significantly decreased in PCOS subjects when compared with non-PCOS subjects, and serum lipids correlated with obesity. Conclusion Dyslipidemia was observed in the present study and serum lipid levels correlated with obesity in women with PCOS. How to cite this article Priyanka M, Bhaskar MV, Madhulatha M, Kodumuri PK. Dyslipidemia in Women with Polycystic Ovary Syndrome in Khammam District, Telangana, India. Int J Adv Integ Med Sci 2017;2(4):183-187.

Nonmetric studies of cranium have been of great interest among research workers. The crania have different regional and racial characteristics. In the present study, 30 skulls from North Indian population of Uttar Pradesh were studied for the maxillary torus. Findings of this study have been compared with other global studies and it has been found to be significant. How to cite this article Gupta S, Prasad NK, Gupta A. Maxillary Torus in North Indian Crania in Rohilkhand Region, Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(4):188-189.

Introduction In humans, sacrum consists of five fused sacral vertebrae. Anatomically, this fusion provides strength and stability to the pelvis and transmits the weight of the body to the pelvic girdle through the sacroiliac joints. Lumbosacral transitional vertebrae (LSTVs) are congenital anomalies of the lumbosacral region, which include sacralization of fifth lumbar vertebra and lumbarization of first sacral vertebra. Low back pain is quite a common ailment affecting about 80% of the population in their lifetime. Lumbosacral transitional vertebra is one of the causes of low backache. Objective (1) Prevalence of sacralization of fifth lumbar bone. (2) Prevalence of various types of fusion. Materials and methods In the present study, 100 cadaveric spinal cords were examined in the Department of Anatomy, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India. Results In the present study of 100 adult cadaveric human sacra, 61 were male and 39 were female. Out of 100 sacral bones, 17 showed sacralization of fifth lumbar vertebrae and remaining 83 were normal vertebra. Out of 17 sacralized bones, 15 bones showed bilateral sacralization and only 2 bones showed unilateral sacralization. Conclusion Being a cause of low backache, knowledge of sacralization is of great importance for not only the orthopedician but also for radiologist and physiotherapist. Correct knowledge of presence of LSTV may help in correct treatment with appropriate rehabilitation. How to cite this article Garg S. A Cadaveric Study of Sacralization of Fifth Lumbar Vertebra. Int J Adv Integ Med Sci 2017;2(4):190-192.

Introduction Human rabies continues to be endemic in India. Rabies is a zoonotic disease transmitted by animal bites, mainly dogs. It is invariably fatal if proper treatment is not instituted promptly. One of the important factors associated with successful treatment is the knowledge of the nursing staff regarding the proper management of animal bites and rabies vaccination. Objectives To assess the awareness of the nursing students of Rohilkhand School of Nursing regarding animal bite wound management and pre- and postexposure prophylaxis of rabies. Materials and methods Study Area: Rohilkhand School of Nursing, Bareilly, Uttar Pradesh, India. Study Design: Cross-sectional study. Study Duration: January 2017 to February 2017. Study Population: Students of Rohilkhand School of Nursing, Bareilly, Uttar Pradesh, India. Sample Size: 100. Study Tool: Questionnaire was distributed to the nursing students for collecting the data. Results A total of 100 nursing students were studied, out of which 85% were females and 15% were males. It was observed that the majority of participants (80%) were aware regarding the immediate treatment of animal bite wound. Knowledge of the study participants regarding site of intramuscular (IM) vaccine administration in infants was found to be poor, i.e., only 31% of participants were aware regarding the correct site of IM vaccination in infants. It was also found that only 9% of participants were aware of the incurability of rabies after clinical onset, 72% were aware about the noncurable nature of rabies, and 72% were aware about the preventable nature of rabies. Knowledge of participants regarding rabies immunization showed that only 46% of participants were aware about the recommended regimen for IM vaccine administration for postexposure prophylaxis and 32% regarding the route of administration of antirabies vaccine (ARV) in pregnancy. About 94% of participants were aware about the tetanus toxoid (TT) vaccine administration postanimal bite. Conclusions and recommendations There is an apparent lack of knowledge among study participants regarding rabies and its immunization. Hence, there is a need for generating awareness regarding rabies and its immunization. The nursing students should be sensitized so that their knowledge can be converted into appropriate practices when they will be posted in hospitals as nursing staff. How to cite this article Panat S, Singh A, Joshi HS, Upadhyay D. A Cross-sectional Study on Awareness regarding Animal Bite Wound Management and Rabies Immunization among Students of a School of Nursing in a City of India. Int J Adv Integ Med Sci 2017;2(4):193-197.

Introduction Vermian fossa (VF) is also known as middle cerebellar fossa of Verga. It is present at lower part of internal occipital crest of occipital bone, over which inferior vermis of cerebellum lies. As very few studies are done on VF, so the present study was conducted. Objective To know the incidence, morphology, and morphometry of VF in adult dry human skulls. Materials and methods In the present study, 60 dry human skulls were examined for the presence or absence of VF, and shape and depth of VF. Morphometry of VF was done with digital Vernier caliper. Results In the present study, incidence of VF was 66.7% (in 40 skulls). Among observed VF (40), 32 (80%) were type I (triangular) and 8 (20%) were of type II (quadrangular) in shape, and 75% were shallow and 25% were deep. Average length of VF was 16.98 ± 4.3 mm, and width was 13.52 ± 2.25 mm. Conclusion In the present study, incidence of VF was quite higher than other studies but almost similar to other Indian studies. Although the sample size of the present study is less, this may provide some help to neurosurgeons, clinicians, and morphologist as the studies on VF are very less. How to cite this article Singh A, Gupta R. Morphological and Morphometric Study of Vermian Fossa. Int J Adv Integ Med Sci 2017;2(4):198-200.

Inadequate and inappropriate handling of health care waste may have serious public health consequences and a significant impact on the environment. The Ministry of Environment and Forests (MoEF) has notified the new Biomedical Waste Management rules (BMWM Rules, 2016) on March 28, 2016, under the Environment (protection) Act, 1986, to replace the earlier rules (1998) and the amendments thereof. These rules shall apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle biomedical waste in any form. Sufficient financial and trained human resources, proper monitoring and control of waste disposal are some challenges for the management of biomedical waste. Thus, appropriate management of health care waste is a crucial component of environmental health protection, and it should become an integral feature of health care services. If we want to protect our environment and health of the community, we must sensitize ourselves to this important issue not only in the interest of health managers but also in the interest of community. How to cite this article Singh H, Joshi HS, Singh A, Katyal R, Singh R. Biomedical Waste Management Rules, 2016: A Brief Review. Int J Adv Integ Med Sci 2017;2(4):201-204.

There is a rapid increase in the geriatric population. In our nation, more than 5% of males and 4 to 5% of females belong to geriatric group. Although the proportion of elderly people in our nation compared with developing countries is on the lower side, the absolute number is on the higher side as compared with the developed world. Growing is a natural process for every being, hence geriatric stage cannot be prevented. However, a handful of things can be done by the family members of the elderly in helping them to lead a normal life, which is their uttermost necessity to perform their daily routine activities with ease. The commonest problem the elderly face is joint pain and diminished mobility. All the aspects of health status, lifestyle, life satisfaction, mental state, or well-being together reflect the multidimensional aspect of lifestyle of an individual. Mental health problems with the geriatric age people remain neglected most of the time. There is a different presentation of tuberculosis in older people as compared with that observed in young adult patients. There should be a separate classification of tuberculosis treatment for elderly people. Hence, diagnosis has to be made at the earliest and treatment not delayed, which, in the current scenario has led to a rise in morbidity and mortality in the geriatric group. How to cite this article Gaffar, Khan S, Joshi HS, Ojha R, Upadhyay D. Health and Social Problems of Geriatric Age Group. Int J Adv Integ Med Sci 2017;2(4):205-207.

Oral leukoplakia (OL) is one of the most commonly seen potentially malignant disorders with varied clinical presentations. A wide variety of medical and surgical treatment modalities have been tried for its management with varying successes. Laser ablation of the lesion is considered as one of the treatment modalities. Conventional surgery may be followed by some side effects like scar formation, contraction, and contamination of surgical field. Using high-power laser has some advantages like less pain, swelling, bleeding, ability to decontaminate, thus preventing secondary infection. This article presents a case of leukoplakia in the right buccal mucosa, which was managed using a 6 W diode laser of 970 nm. The healing occurred uneventfully over a period of 1 month postoperatively with minimal patient discomfort. The case establishes the efficacy of diode laser in the management of OL. How to cite this article Gupta P, Thakur J, David CM. Excision of Oral Leukoplakia using 970 nm Diode Laser. Int J Adv Integ Med Sci 2017;2(4):208-211.