Background: Multi-drug resistant tuberculosis has become major public health problem and obstacle to effective control of tuberculosis. Objectives was to study the socio-demographic profile of multi- drug resistant tuberculosis patients and its association with severity of ADR (adverse drug reactions) in DOTS plus centre at tertiary hospital in Himachal Pradesh.Methods: It was a prospective observational study carried out from November 2012 to October 2013 on multi-drug resistant tuberculosis (MDR-TB) patients after approved from Institutional Ethics Committee.Results: Out of 104 patients the mean age of patients was 39.9 ±14.26 years. Majority of the patients were in the economically productive age groups. Multi-drug resistant tuberculosis was more in male (76%) than female (24%) and 96% of patients were belonged to rural area. The educational status of the MDR-TB shows 24% patients were illiterate. 63.46% MDR-TB patients were underweight (BMI<18.5%) according to WHO guidelines for obesity. Severity of ADR assessed by Hart wig and Siegel’s scale showed 21% patients experienced mild ADRs, 49% patients had moderate and 17% patients had severe ADRs. Severity of ADR is seen more in male, economically productive age group, subjects on vegetarian diet, patients who were underweight (BMI<18.5%) and with lower educational status.Conclusions: MDR-TB is a rapidly increasing health problem with major socio-economic and individual consequences. Multi-drug resistant tuberculosis mainly affects middle age that is in the economically productive age group which hampers the social and economic development of individual, society and nation.

Neck dissection (ND) is a surgical procedure performed in treating head and neck cancer patients with or without cervical nodal neck metastasis. The aim of neck dissection is to achieve loco-regional control thus optimizing the cancer cure rate. Various complications may potentially occur following this surgery. Previous studies done have documented the complication rate following neck dissection surgery to range between 5% to 15%. Most of the complications are inevitable and various efforts have been made to try and reduce complications by modifying the aggressive surgical procedure. The objective of this study is to report the various complications, its rate in various neck dissection procedures, their management and to seek improved patient care and outcome. : A systematic review of 73 patients who underwent neck dissection for various head and neck cancers from August 2017 to July 2020. These patients were studied for post-operative complications and their management.Out of 73 patients, Vascular injury observed in the current study was internal jugular vein (IJV) and was seen in 22.7%) cases and was repaired intraoperatively. Throracic duct injury was identified in 3(4.1%) and it was identified and ligated intraoperatively. Immediate post-operative complication being hemorrhage was seen among 2 cases, both the cases were re-opened. Marginal mandibular nerve and spinal accessory nerve injury was observed in 3 cases and they both came under the delayed type of complications.: A careful preoperative assessment, meticulous surgical technique, high quality postoperative care and appropriate rehabilitation are the cornerstone of preventing and managing complications.

Autoimmune disorders represent a cluster of diseases related to dysregulation of the immune system or misrecognition of self from non-self. Rheumatoid arthritis (RA) is a chronic inflammatory condition involving the joints. It is one of the most common forms of inflammatory arthritis reported globally. The incidence rate of RA is found to be the highest among middle-aged women. There happens to be a close relationship between RA and dental health. The inflammatory processes triggered by microbes and other endogenous factors affects the bone health resulting in the resorption of bones. This condition is observed in aggressive and chronic periodontitis. The main objective of the present literature review was to evaluate the association of rheumatoid arthritis with dental health such as gingivitis, tooth loss and periodontitis. Furthermore, the present literature review throws light on the common markers which might be associated with both the disease conditions. The current review identified novel markers that were associated with rheumatoid arthritis which were implicated in dental health also. Hence management of rheumatoid arthritis might as well reduce the damage caused by bone resorption and could aid in the prevention of premature tooth loss.

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