Greetings from the Chettinad Health City Medical Journal team In this issue of our journal we have articles spanning epigenetics and Assisted Reproductive Technology, public health issues, pediatric orthopedics and gastroenterology.

Intestinal polyps are one of the common cause of Intussusception in children. Most of the polyps are located in the rectum. Sigmoid colon polyp causing recurrent Intussusception is a rare entity. We report a case of Sigmoid colon polyp causing recurrent Intussusception in a 4 year old girl. Patient underwent colonoscopy which revealed large pedunculated polyp of about 3cm in size. Standard Endoscopic snare polypectomy was done, using ERBE electrocautery. Biopsy was reported as Juvenile retention polyp.

A 31 year old patient was diagnosed to have a left atrial myxoma after he presented with exertional dyspnoea. Myxomas are the most common type of cardiac tumours and is often found in the left atrium.

The British epidemiologist David Barker, perusing the records of births and deaths in 1990, proposed the hypothesis about the influence of intra uterine nutrition on adult onset of diseases (Thrifty phenotype hypothesis).1 He proposed that poor fetal and early post natal nutrition imposes nutritional thrift on the developing fetus, leading to metabolic diseases like type 2 diabetes mellitus, cardiovascular diseases and hypertension in adult life. In natural conceptions, the embryo and the fetus are exposed only to the in-utero environment and the external factors which can cross the placental barrier. Whereas in assisted conceptions the gametes and embryo are exposed to in-vitro conditions too.

In April 1959, at the age of 25 years, I passed my MS in General Surgery. I was in Tamilnadu Government Service as an Assistant Surgeon. In those days, only one promotion was available to an Assistant Surgeon, i.e. to the grade of Civil Surgeon.

Incidence of heart failure is increasing worldwide. Heart failure is known to cause sleep disordered breathing (SDB) and SDB in the setting of heart failure is known to worsen heart failure, increase morbidity and mortality.

Noise being a major component of dynamic space, is one of the most invasive aspects of the urban environment. Excessive noise is displeasing to human, animal and environment. This study aims to review various articles which assesses the audiological status of the various people involved in different occupation who are exposed to such high noise.

Stenosing Tenovaginitis of the long thumb flexor is a rare lesion in children. Also, being commonly referred as ‘Congenital Trigger Thumb’, its congenital aetiology is controversial and so is the choice of definitive treatment of this condition. Two children who had flexion deformity of the thumb interphalangeal joint underwent surgical correction with excellent outcome and are being presented in this case report.