Background: Spontaneous bacterial peritonitis (SBP) is a common and fatal complication occurring in cirrhotic patients with ascites. It is defined as infected ascites in the absence of any recognisable secondary cause of infection. This study was undertaken to find out the rate of occurrence of SBP in patients of cirrhosis with ascites,to find out relative frequency of variants of ascitic fluid infection, to study clinical presentation and laboratory profile and to determine relationship between MELD score and the occurrence of SBP.Methods & Materials: This hospital based cross-sectional study was carried out in a tertiary care hospital in Nagpur after taking approval from Institute's Ethics Committee. 100 patients of cirrhosis with ascites irrespective of age and gender were enrolled after taking their written informed consent.. 20 ml of ascitic fluid was aspirated in heparinised disposable syringe; out of it 10 ml was immediately inoculated into blood culture bottle at bedside and sent for bacterial culture along with the remaining 10 ml for routine biochemical and cytological examination.Results: Majority of the patients were between 40-49 years of age, mean age of patients diagnosed as SBP was 42.51 years. Out of total 42 cases of SBP, classical SBP was present in 16(38.09%), Culture negative neutrocytic ascites in 14 (33.33%) , Bacterascites in 12 (28.57%) patients with SBP. Escherichia.coli was the most frequently cultured organism isolated in 15 cases (53.570%), followed by pseudomonas in 9 (32.14%), Klebsiella pnuemoniae in 3(10.71%) cases . The common mode of presentation of SBP was abdominal tenderness(65.38%) followed by hepatic encephalopathy(58.82%) associated with abdominal pain(50%) and fever (46.66%) , distention of abdomen (44.30%) hematemesis and malena(45%). Hyponatremia with a serum was found to be associated with severe complications. In (52.63%) patients of SBP ascitic fluid protein was less than 1 mg/dl . MELD score was found to be a reliable index of disease severity .Conclusion: SBP is a fatal complication of cirrhosis with ascites. It has heterogenous clinical presentation. Ascitic fluid should be analysed routinely in all cases of cirrhosis with ascites for the early detection of SBP.

Introduction: Varicella zoster virus is a highly infectious a-herpesvirus, pathogenic only to humans. The primary infection of varicella zoster virus causes chickenpox, which is contagious and primarily infects children and adolescents in India. Following the primary infection, the virus remains dormant in sensory root ganglia. Activation of the dormant virus in later stages of life causes herpes zoster infection which may vary from subclinical infection to typical zoster, scattered vesicles, zoster sine herpete or disseminated zoster, which depends on the individual's immune status. Case report: In this case series, we present two patients with herpes zoster involving the mandibular branch of the trigeminal nerve. Cytology revealed characteristic features of the infection including nuclear moulding, multinucleated giant cells and ballooning degeneration. Conclusion: More recently, patients presenting with herpes zoster have been reported to have sub-clinical Covid-19 infection, suggesting a possibility that herpes zoster might be an indicator for latent Covid-19. Timely detection and treatment of this infection can reduce the risk of post herpetic neuralgia.

Teeth are biological markers of maturity, and their eruption into the oral cavity is an essential milestone in an individual's life. Multiple factors have been considered to play a role in the pattern of tooth eruption, including dental caries, fluorides and congenital conditions such as Down's syndrome. The aim of the paper was to determine the time of eruption of permanent teeth amongst children aged between five and ten years, visiting the Dental College in Mangalore. A survey was conducted among children aged between 5 to 10 years visiting A.B. Shetty Memorial Institute of Dental Sciences Deralakatte, Mangalore. Each child included in the study was screened by clinical examination for the erupted and erupting permanent teeth. A parent/guardian accompanying a child was interviewed and their data were recorded. The study revealed that the first tooth to erupt was the left mandibular first molar, with a mean age of eruption at 6.4 years. A slight early eruption of teeth was noticed in the left side of the jaw compared to the right side in the present study. The first permanent tooth to erupt in the oral cavity is the left mandibular first molar and there is a slight delay in the eruption of the maxillary lateral incisor in the study population.

Odontogenic keratocyst (OKC), in the last decade sceptically referred to as keratocystic odontogenic tumor (KCOT), is known for its subclinical extensive growth potential and significant rate of recurrences. Odontogenic keratocyst, being the third most common cystic lesion (10-20%) of the maxillofacial region, is often recognized as a sporadic lesion and is well-documented in the literature. Multiple presentation of these cysts over a lifetime is relatively uncommon and is usually seen in conjunction with nevoid basal cell carcinoma syndrome (NBCC), orofacial digital syndrome, Noonan syndrome, Ehlers-Danlos syndrome, Simpson-Golabi-Behmel syndrome, or other syndromes. The 'two-hit' hypothesis postulated by Knudson best explains this anomaly, wherein multiple OKCs associated with the syndromes arise as a consequence of the allelic loss in the patched (PTCH) gene, mapped to the long arm of chromosome 9q22.3-q31. A partial expression of the gene may result in multiple OKCs (5%) without any related syndromes. Though concurrent occurrence of non-syndromic multiple OKCs is a rare phenomenon, a handful of cases have been documented over the past few years. Adding to this, we report a case of multiple OKCs occurring synchronously and bilaterally in all 4 quadrants in non-syndromic, otherwise healthy persons, which could indicate a shift in trend.