bluuebunny/crossref_metadata_2025 huggingface dataset:
MICROVASCULAR AND MACROVASCULAR DISEASES IN DIABETIC NEPHROPATHY
Authors: Chauhan Dr.Nitin , Sinsinwar Dr. Fateh Singh
Published: March 2020

Introduction:  Diabetes mellitus (DM) can be described as a metabolic disorder which is characterized by hyperglycemia which develops as a consequence of defects in insulin secretion or its action, or both. Diabetes is strongly associated with microvascular and macrovascular diseases and its complications, which includes nephropathy, retinopathy, microvascular neuropathy and ischemic heart disease, peripheral vascular disease, and macrovascular cerebrovascular disease which results in organ and tissue damage in about one third to one half of people with diabetes. The early manifestation of DN is microalbuminuria, which eventually progresses to overt albuminuria that is increased albumin levels in the urine, which indicates more severe renal dysfunction, and ultimately leading to renal failure.

Material and Methods: Patients were screened and clinically diagnosed accor­ding to World Health Organization (WHO) criteria. Demographic characteristics of the patients were taken, height and weight were recorded, and body mass index (BMI) was calculated in metrics units. Blood investigations were carried out like blood glucose, HbA1C, cholesterol, Triglycerides (TG), serum creatinine, creatinine clearance, and24-hour uri­nary protein were investigated for each patient. Glomerular filtration rate (GFR) was calcu­lated. Rate of change of GFR was calculated. Duration of follow-up, age at onset of diabetes, duration of complications, and time for doubling of serum creatinine were recorded and calculated.

Results: A total of 50 patients were included in the study who were diagnosed as DN by the physician. Mean age of the patients with DN was observed as 64.24 ± 13.68. There were 31 (62%) male and 19 (38%) and female. Mean duration of nephro­pathy was 7.2 ± 2.9 years. Family history of DN was shown in 5 (10%). Diabetic complications were recorded and tabulated. Retinopathy was observed in 23 (46%) of the cases, Coronary artery disease in 28 (56%), Angina in 22 (44%), stroke in 6(12%), Diabetic foot in 4 (8%), Hypertension in 43 (86%), blindness in 3 (6%) and end stage renal disease was observed in 12 (24%) of the cases. There were 2 (4%) deaths. The mean time to onset of diabetic com­plications from the diagnosis of diabetes in present study was 9.6 ± 2.9 (Mean± SD) years for coronary artery disease, 15.3 ± 7.3 years, for retinopathy, 11.3 ± 3.4 years for neuropathy, and 6.3 ± 2.9 years for diabetic foot. Patients those who were diagnosed >20 years, end stage renal disease was observed in them. The mean proteinuria was 2.34 ± 1.88 gm/L. Protein excretion < 0.5 was found in 15 (30%) patients, mean HbA1C was 9.7 ± 1.5(Mean± SD).

Conclusion: Age, male gender, duration of diabetes, baseline HbA1C, blood pressure, and renal function are risk factors for diabetic complications and nephropathy.

Keywords: microvascular, diabetes mellitus, diabetic nephropathy
PROPOFOL-FENTANYL FOR TRACHEAL INTUBATION IN CHILDREN WITHOUT NEUROMUSCULAR BLOCK
Authors: Gupta Dr. Anil Kumar , Agrawal Dr. Pawan Kumar
Published: March 2020

INTRODUCTION:  In paediatric anaesthesia tracheal intubation without prior administration of muscle relaxants is well-established practice. Depolarizing muscle relaxant such as suxamethonium is also used in induction but it may be associated with side effects such as postoperative myalgia, prolonged paralysis, and increase in intraocular pressure and hyperkalaemia.

MATERIAL AND METHODS:A total of 60 children were included in the study, of both sex, aged between 2 and 12 years. Patients were randomised in to two groups: Group 1: Inj. Fentanyland Inj. Propofoland group 2 : Inj. Propofol  and Inj. suxamethonium.The quality of intubation was graded by the consultant using the scoring system devised by Helbo-Hansen Raulo and Trap-Anderson.

RESULTS: A total of 60 patients were included in the study and were randomised in to two groups of 30 each.In group 1 mean age was 8.24±2.65 and in group 2 it was 7.96±2.77. Weight in group 1 was 21.58±6.22 and in group 2 was 22.87±5.59. There were 18 male and 12 female in group 1, while in group 2 there were 19 male and 11 female. No statistically significance e=was observedin both the group.Acceptable intubating conditions were observed in 29 (97%) out of 30 patients in group 1, whereas all (100%) patients in group S had excellent intubating conditions.

CONCLUSION: Tracheal intubation can be accomplished using a combination of Fentanyl Propofol combination and suxamethonium (muscle relaxant) can be avoided. When neuromuscular blocking drugs are contraindicated this method can be used.
STUDY OF CONGENITAL FETAL ANOMALIES WITH THE HELP OF SONOGRAPHIC EVALUATION
Authors: Kumar Dr. Ajit , Nayak Dr. Pradeep Kumar
Published: March 2020

Information regarding specific anatomic anomalies affords the physician the opportunity to offer the patient sophisticated prenatal procedures, such as fetal surgery or selective fetal reduction in multiple gestations. Likewise, prenatal knowledge about genetic, physiologic, and/or anatomic abnormalities enables the physician to tailor or manage the timing and mode of delivery for optimal maternal and fetal outcomes. Prenatal diagnosis also allows the neonatal and paediatric specialists to be adequately prepared for a potentially ill neonate at delivery. Recent progress in the fields of maternal fetal medicine, radiology, and genetics has resulted in great advances in prenatal diagnosis. Ultrasonography is the initial modality for evaluation of pregnant patient because of its widespread availability and reasonable cost, with other modalities used only if Ultrasonography results are non diagnostic. Hence based on above data the present study was planned Study of Congenital Fetal anomalies with the Help of Sonographic Evaluation.

The present study was planned in Department of Radio- Diagnosis, Katihar Medical College and Hospital, Katihar, Bihar, India. All pregnant females of second trimester who are referred from obstetrics and gynaecology department and thus sent to department of Radio diagnosis for antenatal Sonographic examination. A complete antenatal ultrasound examination of pregnant women included in the study will be done using gray scale & colour duplex examination.

Obstetric ultrasonography has become an important part of routine antenatal care. Routine anomaly screening improves perinatal outcome directly through termination of pregnancy for certain anomalies. Congenital fetal anomalies are one of the most threatening complications which are prevalent in the society associated with severe morbidity and mortality in the new born fetus or neonates. Ultrasound is the best possible non-invasive technique available to detect any congenital anomalies in pregnant women which will help to identify the severity of the disease, its outcome leading to pregnancy termination or gives an opportunity for fetal therapy or better neonatal care.

Keywords: Congenital Fetal anomalies, Sonography, etc.
ROLE OF ORAL ANTIBIOTICS IN ELECTIVE COLORECTAL SURGERY
Authors: Churi Dr. Amit Ramesh
Published: March 2020

Introduction:  Surgical site infection (SSI) is a major burden for patients who are posted for elective colorectal surgery, also there is significant increase to the cost of health care.it is a major cause of morbidity after surgery and is associated with increased hospital stay, readmissions, costs, and sometimes mortality. Surgical site infections are very high in colorectal surgery and are estimated to vary from 15% to 30% of patients undergoing colorectal surgery. For colorectal surgeries, orally administered antibiotics can be used in addition to the intravenous antibiotic prophylaxis.

Material and Methods: A total of 46 patients were included in the study who were posted for elective colorectal surgery. Patients who start with the 3-day intervention period but for whom surgery is cancelled or postponed for more than 7 days, will not be evaluable for analysis. After enrolment, patients were randomly assigned to one of two treatment arms in a 1:1 ratio. Patients were blinded into two groups, group 1 (medication group) and group 2 (placebo group). Patients are instructed to take the medication four times daily, during the last 3 days prior to surgery. 

Results: There were 16 (69.6%) male and 7 (30.4%) in medication group while in placebo group male were15 (65.2%) and female were 8 (34.8%). Mean age in medication group was 46.2 ±15.24 and in placebo group was 48.2 ± 14.55. BMI (Body mass index) in medication group was 29.44 ± 3.74 and in placebo group was 28.76 ± 2.96. Operative time in group medication was 6.4±2.12 and in placebo group was 6.23 ± 1.96. This was not significant. Surgical site infection (SSI) in medication group was 3(13%) and in placebo group was 8(39%). Mean Hospital stay (days) in medication group was 13.11± 2.45 and in placebo group was 16.2±3.87, this was statistically significant. No. of antibiotics required postoperatively in medication group was .2± 1.4 and in placebo group was 6.4±2.4.

Conclusion: Administration of oral antibiotics 3 days prior to colorectal surgery can significantly reduce the surgical site infection and mean hospital stay thereby reducing the morbidity.

Keywords: antibiotics, colorectal surgery, SSI, MBP and BMI
HEALTH CARE ASSOCIATED URINARY TRACT INFECTIONS IN DEPARTMENT OF MEDICINE
Authors: Sinsinwar Dr. Fateh Singh , Chauhan Dr. Nitin
Published: March 2020

Introduction:  Health care associated infections (HCAIs) or hospital acquired infections (HAIs) are infections that occur during hospitalization but they are neither present nor incubating before hospital admission. Health care–associated urinary tract infection (UTI) is an important cause of morbidity and increased health care costs in hospitals. Rapid advances in medical field, injudicious use of antibiotics and better adaptation of organisms to the hospital environment contribute to increase in HAIs. There are additional patient safety concerns associated with urinary catheter insertion, like patient discomfort, activity restriction, discharge delays, and the potential development of a reservoir of multidrug-resistant organisms that can be spread to other patient. 

Material and Methods: Patients admitted in wards of medicine department were included in the present study. Patients who were admitted for at least for past 48 hours, or readmitted in less than 14 days after their discharge from hospital. Sociodemographic data from all the included patients was collected from medical records. Clinical history was obtained from all the patients. Signs of HAI were observed and recorded. Bacteremia was defined as presence of bacteria in the blood confirmed by at least one positive blood culture.

Results: A total of 238 patients were included in the study who were admitted in the medicine wards. Out of 238 patients included in the study, 31 (13.02%) presented one or several signs suggestive of HAI and they received microbiological tests. 20 (8.40%) cases were confirmed or potential HAI. Of the 238 patients 109 (54.20%) were male and 129 (45.79%) were female. 31 patients were diagnosed as HAI patients of which 14 (45.16%) were male and 17 (54.83%) were female. Mean age of HAI patients was 54.21 ± 17.41while total mean of age was 46.52 ± 16.74. Mean age of male with HAI 52.41 ± 19.53 and female was 53.46 ± 16.77. Of the total 7 culture positive patients with HAI   Escherichia coli was isolated in 3 cases, Klebsiella pneumonia in 2 caesa, Pseudomonas aeruginosa and Staphylococcus aureus were isolated in 1 cases each. Conclusion: Prevalence of HAI in Urinary tract infection was 13.02% in this study. Preventive measures, periodic active surveillance over a longer period is required to reduce the rate of healthcare associated UTI.

Keywords: UTI, HAI, Health care associated infections, Catheter-associated UTI
PREVALENCE OF DENTAL FLUOROSIS AMONG 6–14-YEAR-OLD SCHOOL CHILDREN OF BALIDIH INDUSTRIAL AREA OF BOKARO DISTRICT, JHARKHAND STATE, INDIA − A RETROSPECTIVE STUDY
Authors: Narayan Dr Jay Prakash , Jha Dr Ritu , Kumari Dr Nisha
Published: March 2020

Dental fluorosis is a cosmetic condition that affects the teeth. It’s caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. The present study seeks to investigate the prevalence of dental fluorosis among children in Balidih, Jharkhand, india. The study was a retrospective collection of data to evaluate the prevalence of dental fluorosis among 2495 children attending the Free Dental Camp under Indian Dental Association, Bokaro from 2015 to 2018, aged between six to fourteen years. Test of association was done using Pearson’s Chi Square test and Cramer’s V. The results showed that the prevalence of fluorosis was 14.54% in the observed population. There was no correlation of dental fluorosis found with particular sex. The present study gives an insight into the prevalence of dental fluorosis among school going children of Balidih, Jharkhand, India.
EVALUATION OF OCCURRENCE OF HYPERDONTIA IN NON-SYNDROMIC POPULATION FROM BIHAR REGION
Authors: Kumari Dr. Minti , Kumari Dr. Madhuri , Rai Dr Anurag , Kumar Dr. Navin
Published: March 2020

It is evident that hyperdontia is more common in the permanent dentition than in the primary. There is a considerable difference between males and females in the prevalence of these teeth in permanent dentition; hyperdontia is twice as common in males as in females. However, this approximation varies in terms of location, other associating syndromes that may be present, and the ethnicity of the individual. In terms of ethnicity, it can be seen that hyperdontia is in fact less common in Caucasian than in Asian populations. There is evidence to show that an individual is more likely to have hyperdontia if other members of their family also have the condition. Hence the present study was planned for evaluation of occurrence of hyperdontia in non-syndromic  population from Bihar Region.

The present study was planned in Public Health Dentistry, Patna Dental College and Hospital, Patna, Bihar. Total 195 patients referred to Department of Dentistry were evaluated in the present study. Panoramic radiographs and clinical records of patients above the age of 18 years and without any syndromic features were selected for the study.  All the radiographs were examined for the presence of supernumerary teeth, their location, morphology, and number. Morphologically, teeth were classified as conical, tuberculate, supplemental, and odontoma.

Early diagnosis of dental anomalies can prevent some esthetic, orthodontic, and periodontal problems, and knowledge of the prevalence and distribution of the anomalies may help clinicians to the detection of these anomalies at early stages. Our study evaluated the prevalence of selected dental anomalies; future studies should investigate the prevalence of dental anomalies of all types.

Keywords: Hyperdontia, non-syndromic, panoramic radiograph, supernumerary teeth, etc.
EVALUATION OF SPECTROPHOTOMETER ANALYSIS OF BULK-FILL COMPOSITES IN VARIOUS DAILY USED BEVERAGES
Authors: Maitin Dr. Shipra Nangalia , Maitin Dr. Nitin , Priyank Dr. Harsh , Raj Dr. Swati
Published: March 2020

The visible color alterations in esthetic materials can also be ascribed to the proprietary differences in chemistry that may affect the polymerization, water sorption, and consequently the color stability of the material. In addition, the obvious effect of colorants in beverages and foods leads to extrinsic discoloration of composites. Thus, for suitable performance, longevity and good clinical success of esthetic restorations, the material of choice should present adequate inherent characteristics. The discoloration of tooth-colored, resin-based materials may be caused by intrinsic or extrinsic factors. Visual or instrumental techniques can be used to evaluate discoloration. The use of instrumental methods like spectrophotometers and colorimeters to quantify tooth color could potentially eliminate the subjective aspects of color assessment. Hence based on above findings the present study was planned for evaluation of spectrophotometer analysis of bulk-fill composites on various daily used beverages.

The present study was planned in Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar. The color of composite resins can be determined by varying methods, including visual assessment and instrumental measurement by a spectrophotometer.

According to the Spectrophotometer results of this study, material tested became changes in color after immersion in the beverages. The data generated from the present study concludes that all the beverages used in this study changes in color in the material tested. Coca-Cola causes more color changes than other beverages in the material tested. The total changes of color after 1, and 7 days of composite immersion in coca cola were higher than the clinically acceptable threshold, and they are comparable to the color changes observed with coffee, tea, orange juice and beer, which are known as strong staining agents.

Keywords: Spectrophotometer Analysis, Bulk-Fill Composites, Beverages, esthetic materials, color change, etc.
CLINICAL OUTCOMES OF SURGICAL APPROACHES IN THE FRACTURES OF THE FRONTAL SINUS
Authors: Rai Dr. Shweta , Kumari Dr. Minti , Rai Dr. Anurag , Kumar Dr. Kunal , Kumar Dr. Tanoj
Published: March 2020

Frontal sinus fractures occur from trauma to the part of the frontal bone that overlies the sinus, often from motor vehicle accidents and falls. The hallmarks of a frontal sinus fracture are a frontal depression in the anterior table of the bone. Additionally, clear fluid leaking from the nose may indicate that fractures to the posterior table have torn into the dura mater, creating a cerebrospinal fluid leak.

Total 20 cases of the patients undergoing the surgery for frontal sinus injuries were evaluated in the present study was planned in Department of Oral & Maxillofacial Surgery, Buddha Institute of Dental Sciences & Hospital. The patients were divided in two groups. Group A includes the 10 cases in which care was taken in first 10 days. Group B includes the 10 cases in which care was taken after 10 days.

The data generated from the present study concludes that fractures of the frontal sinuses are more and more frequent and serious. They involve the vital, functional and aesthetic prognosis of patients, and must therefore require a safe method of management with ways of starting allowing both good security and better exposure.

Keywords: Craniofacial Trauma, Frontal Sinus Surgery, Cranialization, Exclusion of Sinus, etc.
EVALUATION OF THE STATURE HEIGHT IN THE MAHARASHTRA POPULATION BY USING ARM SPAN USING REGRESSION EQUATION
Authors: Gawande Dr. N. B. , Tank Dr. Ashok
Published: March 2020

Measurement of body size such as height and weight are required for assessment of growth and nutritional status of person, determination of basic energy requirements, standardization of measures for physical capacity, for adjusting drug dosage and for identifying an unknown cadaver. However, in some situations it is not possible to measure the stature of a person because of deformities of the limbs, in person who have undergone amputations or in unknown cadavers where lower limb (s) and / or trunk is mutated / absent. In such cases, stature has to be estimated using other body parameters. These estimations are also of prime importance in predicting the age-related loss in stature, identifying individuals with disproportionate growth abnormalities, skeletal dysplasia, medico-legal cases or height loss during surgical procedures on the spine. These measurements also have found application in normalizing pulmonary function in scoliosis. Hence based on these findings the present study was planned for evaluation of the stature height in the Maharashtra population by using arm span using regression equation.

The present study was planned in Department of Forensic Medicine, Dr. Panjabrao Alias Bhausaheb Deshmukh Memorial Medical College, Shivaji Nagar, Amravati. The total 50 cases of the age group from 20 - 45 years were enrolled in the present study. This age group was chosen because the growth of an individual ceases by this age and there is no age related loss in body height at this age.

Arm span measurement can serve as one of the most reliable body parameter to determine stature of an individual. It is useful in determining related loss in stature and in identifying individuals with disproportionate growth abnormalities. The data generated from the present study concludes that arm-span and hand length can be used in estimation of the height of both males and females. The regression equations so derived can be used in cadavers or an amputee with fairly accurate results. This can be helpful in medico- legal cases as well as in study of anthropology.

Keywords: Stature Height, Arm Span, Maharashtra Population, etc.
UTILIZATION OF MARKET ORGANIC WASTE INTO ANIMAL FEED PELLETS
Authors: Wahyuni Endang Uji , Widyastuti Arni , . Tugiyo , Rajiani Ismi
Published: March 2020

Background: Rubbish is still often treated as something that is of no use. Rubbish can provide benefits to humans. Several types of vegetable waste from the market can be used as animal feed. This study aims to get a solution to overcome the buildup of organic waste in market by creating into a pellet and find out if the animal likes the organic waste pellets.

Methods: This type of research is experimental, which is a research method that uses a quantitative approach, doing three controlling activities, manipulating activities, and observation. In this study, researchers took the three types of organic waste most widely produced in the market, namely mustard, bean sprouts and spinach, were treated as pellets and were examined for their nutrient content and moisture content and were tested on experimental animals.

Result: From the observations it can be seen that the pellets favored by the test animals are pellets from bean sprouts with the most pellets being eaten every day. Moreover, the most disliked by the test animals are pellets from mustard greens, this is possible because the bean sprouts pellets smell of caramel and hollow texture, while mustard pellets smell like salted fish.

Conclusion: Organic waste should be collected and made into pellets so that it can be of economic value. In making mustard pellets, it should not be in a pure state but made into a mixture so that it is preferred by animals.

Keyword: Organic waste, pellet, animal food
A PROSPECTIVE STUDY ON TRANSVAGINAL DOPPLER SONOGRAPHY OF ENDOMETRIUM IN WOMEN WITH POSTMENOPAUSAL BLEEDING.
Authors: Choudhary Dr. Richa , Sinha Dr. Rishikant
Published: March 2020

Objectives: This present study was to evaluate the clinical profile and Transvaginal Doppler Sonography findings of endomterium in women with postmenopausal bleeding.

Methods: Detail history, clinical examinations and relevant investigations were performed to all cases of PMB. BMI was calculated. Transvaginal sonography of the uterus and Doppler analysis of the blood flow were performed using vaginal probe at 5-7.5 megahertz. Endometrial thicknesses as well as other pathologies in the cavity were noted. Resistive index was calculated.

Results: Data was analyzed by using SPSS version 26 software. One sample statistical methods was used. Mean ± standard deviation was observed. P-value was taken equal to less than 0.05 for significant differences.

Conclusions: Highest prevalence of PMB was seen in women with age greater than 50 years. Most of the cases had BMI 20-25 kg/m2. Most of the benign and malignant cases had parity status P3-P4 and P1-P2 respectively. Endometrial thickness of malignant PMB cases was significantly greater than benign PMB cases. Resistive index of malignant PMB women was significantly lower than benign PMB women. Hence, promotion of healthy lifestyles and contraceptives in early reproductive life and awareness for the need of early screening should be recommended to reduce the prevalence of PMB. And early diagnosis and management of post menopausal bleeding are needed for prevention from malignancy.

Key words: Postmenopausal Bleeding, Benign, Malignancy, Transvaginal Doppler Sonography.
The IMMUNOHISTOCHEMICAL EXPRESSION OF NOVEL B7-H6 IN ORAL SQUAMOUS CELL CARCINOMA AND CORRELATION WITH HISTOLOGICAL DIFFERENTIATION AND CLINICOPATHOLOGICAL PARAMETERS
Authors: Fauzia Taqia , Syed Serajuddaula , Baig Faraz Ahmed , Zakaria Maheen
Published: March 2020

B7-H6 is a new immune checkpoint molecule related to B7 family; however, little research has been performed to determine its expression among tumors. In this study, we investigated the immunohistochemical expression of B7-H6 protein in 141 biopsy proven oral squamous cell carcinoma tissues. The specimens were subjected for immunohistochemical analysis to evaluated B7-H6 expression and was graded according to the intensity of cytoplasm and membrane staining. The distribution of B7-H6 expression was also correlated with different clinicopathological parameters of oral squamous cell carcinoma.Overall, 69 out of 141 oral squamous cell carcinoma cases had shown the expression of B7-H6 protein, majority of which belongs to moderately differentiated histological grade. This accounts for strong statistical association of B7-H6 with oral squamous cell carcinoma (P-value=0.001). The distribution of B7-H6 was also observed across broad range of clinicopathological characteristics of disease, however only long term naswar consumers have shown significant statistical difference with B7-H6 expression. We thus conclude that, B7-H6 may represent a new marker for oral squamous cell carcinoma with potential to forecast biological aggressiveness of oral squamous cell carcinoma. Hence, B7-H6 may serve as an immune target for oral squamous cell carcinoma therapy, which needs to evaluated in future studies.
THE STUDY OF DETECTION OF DENGUE CASES BY NS1 ANTIGEN AND IGM ANTIBODY IN RIMS, ADILABAD, INDIA.
Authors: Zade Dr. Tanajee , Srinivas Dr. K. , Berad Dr. Akshay
Published: March 2020

Dengue fever is an acute febrile arboviral disease affecting tropical & subtropical regions of the world. Dengue infection produces a spectrum of clinical illness, ranging from an asymptomatic to its most severe form like dengue haemorrhagic fever and dengue shock syndrome. In view of high morbidity and mortality, it is imperative to have a rapid and sensitive laboratory assay for early detection of the dengue infection. The newer parameter NS1 antigen has gained a lot of interest for early diagnosis of the disease. Detection of non-structural antigen (NS1 Ag), IgM and IgG antibody may help in the early diagnosis. The present study was conducted in a RIMS Adilabad, tertiary care hospital & medical college in the Department of  General Medicine. A total of 100 serum samples were processed from suspected cases of dengue fever by using dengue test for detection of NS1 antigen and IgG antibodies. Platelet counts of all these cases were noted. . Of these 100 subjects 85 were serologically proved to have dengue illness, 57 patients were NS1 antigen positive, 28 patients were IgM antibody positive patients. As the NS1 antigen is detectable in blood from day one after onset of fever, its assay is an effective tool for early diagnosis of dengue infection so as to avoid complications.

Key words:  Dengue, NS1 Antigen, IgM antibody, Platelet
EFFECTIVENESS OF NON-SURGICAL PERIODONTAL THERAPY ON AMLODIPINE INDUCED GINGIVAL ENLARGEMENT: A CASE REPORT
Authors: Mona Dagar , Prerna Kataria
Published: March 2020

Gingival enlargement, [sometimes abbreviated to GO (gingival overgrowth)] is an increase in the size of the gingiva. It is a common feature of gingival disease. Gingival enlargement is a well known side-effect of drugs like anticonvulsants, calcium channel blockers and immunosuppressant. A case of amlodipine induced gingival enlargement was reported and after drug substitution when the patient was treated non-surgically (scaling and root planing), the enlargement subsides to a normal state which suggested the effectiveness of non-surgical periodontal therapy in the treatment of drug induced gingival enlargement.

Keywords: Anticonvulsants, Immunosuppressants, Calcium channel blockers, gingival enlargement
TO FIND OUT THE TOXICITY PROFILE OF TWICE WEEKLY CISPLATIN OVER CONVENTIONAL ONCE WEEKLY CISPLATIN BASED CRT IN LOCALLY ADVANCED CERVICAL CANCER.
Authors: Vardhan Ranveer , Rana Amit , Gupta Manoj , Seam Rajeev , Gupta Manish
Published: March 2020

Background: Carcinoma cervix ranks fourth most common malignancy (for both incidence & mortality) globally and third most common diagnosed malignancy in females (~16.5%) in India, (after breast & lip/oral cavity), with about 80% of the total burden occurring in developing countries  like India.

Methods: This Prospective comparative study was conducted in the Department of Radiotherapy and Oncology TCC, IGMC, Shimla, in patients suffering from

advanced carcinoma of cervix.

Results: Hematological toxicities were seen mainly in the study group as compared to the control group (28 patients in the study group vs. 22 patients in control group). The difference was not statistically significant (p = 0.214). Grade III toxicities were seen in 5 patients in study group and 4 patients in control group. Cutaneous toxicity of different grades was seen in all the patients in the study arm and of the patients in the control arm. There was no statistically significant difference between the two arms (p=0.8121).

Conclusion: Both (Study & control) groups are comparable in terms of toxicity and are equally well tolerated by the patients.

Keywords: Chemoradiotherapy, RT, Partial response, toxicity.
TO COMPARE THE TOXICITY PROFILE OF ACCELERATED RADIOTHERAPY (SIX FRACTIONS PER WEEK) WITH CONCOMITANT CHEMO-RADIOTHERAPY IN LOCALLY ADVANCED HEAD AND NECK CANCER
Authors: Kaushal Vikrant , Rana Amit , Gupta Manoj , Seam Rajeev , Gupta Manish
Published: March 2020

Background: Head and neck malignancies are common among males in India. The age adjusted incidence rate of head and neck cancer in India in males is 16.4/100,000 and in females it is 8.8/100,000.In All India Institute of Medical Science head and neck cancer represents 25% of all malignancies registered

Methods: This prospective randomized study was conducted in the Department of Radiation Therapy & Oncology, Regional Cancer Centre, IGMC, Shimla and patients were enrolled for a period of one year, from July 2012 to July 2013.It included all the eligible, previously untreated patients of squamous cell carcinoma of Head and Neck with histologically confirmed diagnosis and no evidence of distant metastasis. The sites included were oro-pharynx, hypo-pharynx and larynx with stages III, IV A and IV B.

Results: Grade 3 and grade 4 skin toxicities were higher in CRT arm but without statistically significant difference from that in ART arm. G3 & G4 mucositis was higher in the Concomitant CRT arm however the difference was not statistically significant. G2 and G3 Laryngeal Toxicities were higher in Concomitant CRT arm as compared to Accelerated arm but the difference was not statistically significant. G2 & G3 haematological toxicities were significantly (combined p value = 0.002) higher in the concomitant CRT arm (32.4%) as compared to Accelerated RT arm (2.9%). Only one patient in accelerated arm had any hematological toxicity.

Conclusion: Higher peak incidence of toxicities was seen in concomitant CRT arm as compared to accelerated arm.

Keywords: Toxocity, six fraction, chemoradiation, Local control
PREVALENCE OF HYPERTENSION AMONG PRE-ELDERLY PATIENTS ATTENDING PERIPHERAL HEALTH CENTRE OF TERTIARY CARE HOSPITAL OF INDIA
Authors: Sharma Dr. Munish Kumar , Gour Dr. Neeraj , Goel Dr N K , Sharma Dr. Deepak , Chaudhary Dr. Meenakshi , Chouksey Dr. Megha
Published: March 2020

Background: In this modern era, chronic noncommunicable diseases (NCDs) are a major global health challenge with numerous grave complications on the human body. Hypertension is the most common disorder which is being encountered in the outdoor patients

Method:  This cross sectional study was undertaken to provide the data on the prevalence of hypertension amongst patients who were aged 20 years and above (pre elderly) and who attended the Out Patients Department of the Rural Health & Training Centre of tertiary care hospital of Chandigarh city of India.

Results: Association of age with systolic blood pressure & diastolic pressure was found to be highly significant (P < 0.001). On the other hand association gender with systolic blood pressure & diastolic blood pressure was also found to be highly significant (P < 0.001). Logistic regression was also applied & it was found that age and male gender is a better predictor of diastolic hypertension but it was found to be non-significant (P > 0.05).

Conclusion: Hypertension was found to be highly prevalent among the outdoor patients of Rural Health & Training Centre of Chandigarh, India. This study warrants the need of an early detection of hypertension, which can be accomplished by a periodic screening of the people.

Key words: Hypertension; India.
DILEMMA OF THYROID NODULES AND THE TIME TESTED RATIFICATION OF USG WITH HISTOPATHOLOGY, IN A SHORT PROSPECTIVE STUDY OF THE LOCAL POPULATION.
Authors: Lodha Dr. Sambhav , Soni Dr. Viral , Mor Dr. Vandita , Kapadia Dr. Mahin , Pooja Dr.
Published: March 2020

Ultrasonography enjoys the intrinsic advantages of universal availability economy and non-invasive nature. It presents no radiation hazards and can be readily repeated. Ultrasonography can demonstrate normal thyroid anatomy and pathologic with remarkable clarity. The role of ultrasonography as an initial diagnostic modality for thyroid noduleswith high sensitivity and specificity as correlated with the pathological findings.

Keywords: Thyroid nodules, Ultrasonography.
ROLE OF VITAMIN B12 SUPPLEMENTATION IN METFORMIN INDUCED DIABETIC NEUROPATHY IN INDIAN PATIENTS. CAN SUPPLEMENTATION HELP?
Authors: Merchant Dr. Fatema. S. , Merchant Dr. Arwa. S.
Published: March 2020

Metformin is one of the most commonly used oral hypoglycemic drug amongst type II diabetes mellitus patients, particularly overweight with normal kidney functions. Literature reports an average of 10-30% of patients taking metformin for longer duration (more than 4 years) have shown some signs of vitamin B12 deficiency.

Thus the present study was planned to assess the development of peripheral neuropathy in metformin users due to Vitamin B12 deficiency and effect of its supplementation was assessed for improvement in terms of VPT (Vibration perception threshold) score assessed by Biothesiometer which is a simple, portable, reliable, non-invasive method to screen the peripheral neuropath

Unique about this study is, evaluating the effect of B12 supplementation on Indians patients. They being primarily vegetarian are at more risk to develop Vitamin B12 deficiency, so, metformin induced Cobalamin deficiency assumes greater risk in such patients in terms of development and progression of peripheral neuropathy.
STUDY OF CENTRAL STORE DEPARTMENT ACTIVITIES BY PROCESS FLOW MAPPING IN A TERTIARY CARE HOSPITAL
Authors: Bhatia Pallavi , Bhatia Kapil , Damania Binal , Patil Neelam
Published: March 2020

Introduction: Healthcare industry is witnessing sharp rise in price in almost all its products and services. Hospital’s inventory management has become increasingly important in the recent past. Organizations process mapping is composed of  activities involved in defining what an organizational entity does, who is responsible, to what standard  organization process should be completed, and how the success of an organizations process can be determined.

Aim and objectives: This study focuses on basic components of supply chain process in the central store to make it more efficient in sales, distribution and storage of drugs.

Materials and methods:  Data was collected from central stores department for two months through process mapping; Quantitative and observational/ prospective design are used to identify the main supply issues and data analysis.

Results: The compliance was found to be 100 % in all the different processes like procurement process, internal quality checks, storage of drugs, ledger maintenance & documentation and maintenance of special drugs except GRN date which was 75.45%, storage of high risk medicine amounting to 81.82%.

Conclusion: Innovative design of supply chain has a significant impact on selection of and cooperation with excellent suppliers, improves supply chain efficiency, and encouragement of QM practices.

Keywords: Inventory management, Supply chain, Central stores department, Drugs
TO FIND OUT THE VARIATION OF SYMPATHETIC & PARASYMPATHETIC TESTS BETWEEN MALE & MENSTRUAL PHASE OF MENSTRUAL CYCLE IN FEMALE.
Authors: Solanki Dr. Hitesh Kumar , Yadav Dr. Omnath P , Gojiya Dr. Anita J
Published: March 2020

The hormonal fluctuations that occur during normal menstrual cycle has profound influence on autonomic functions. This influence on autonomic nervous system may affect cardiovagal control. The aim of the study is to find out the variation of Parasympathetic function tests during different phases of menstrual cycle in young healthy females.

The mean E:I ratio in Menstrual Phase of menstrual cycle in females is 1.34 ± 0.06.

The mean E:I ratio in males is 1.41 ± 0.12.

The mean Postural SBP in Menstrual Phase of menstrual cycle in females is 97.76 ± 5.13 mmHg. The mean Postural SBP in males is 103.24 ± 6.88 mmHg.

The study concludes that there was statistically significant heart rate variability during three phases of the menstrual cycle, as observed by the increased sympathetic discharge in the luteal phase compared to the increased parasympathetic discharge in the follicular phase. The results of our study have emphasized the complexity of the relationship between ovarian steroids and various hemodynamic regulatory systems.

Keywords: Sympathetic, Parasympathetic & Menstrual.
TO STUDY THE CORRELATION BETWEEN SONOGRAPHIC MODIFICATION OF CORMACK LEHANE SCORING WITH ACTUAL CL GRADING DURING DIRECT LARYNGOSCOPY
Authors: Koundal Dr. Vishal
Published: March 2020

Background: Airway assessment is an essential aspect of preanaesthetic assessment. Presently, prediction of difficult airway is based on clinical assessment of airway.

Methods:  Prospective Observational conducted at Department of Anesthesiology, Dr. RPGMC Kangra at Tanda, Himachal Pradesh.

Results:  It was observed that 44% patients (n=88) were in grade 2 followed by 27 % (n=54) in grade 1, grade 3 was observed in 24.5% patients (n=49) whereas Cormack Lehane grade 4 was seen in 4.5% patients (n=9)

Conclusion: The thyromental distance was more than 6.5 cm in the majority of patients (87.5%) while 12.5% had a thyromental distance less than 6.5 cm. There was a significant difference in Thyromental distance between different Cormack Lehane grades (P=0.001)

Keywords: Ultrasound, endotracheal intubation, direct laryngoscopy
A STUDY ON THE CORRELATION OF ADENOSINE DEAMINASE AND GLYCATED HAEMOGLOBIN IN THE PATIENTS OF TYPE 2 DIABETES MELLITUS.
Authors: Singh Supriya , Suri Arpita , Sinha Maheep , Fiza Bushra
Published: March 2020

Background & Objectives:  Adenosine modulates insulin action on various tissues and its concentration in tissues is affected by Adenosine Deaminase (ADA) levels. ADA is an enzyme involved in purine metabolism and is considered to be a marker of T cell activation. Immunological disturbances in type 2 diabetic individuals have an association with cell mediated responses and inappropriate T-lymphocyte function. Hence, the study was undertaken to determine the levels of Serum ADA activity in patients of type 2 DM and its correlation with parameters of glycemic profile such as Fasting blood sugar (FBS) and Glycated Haemoglobin.

Material and Methods- A total of 100 patients diagnosed for type 2 DM visiting the Outpatient Department of General Medicine and Endocrinology at Mahatma Gandhi Medical College & Hospital, Jaipur were enrolled for the study based on predefined inclusion and exclusion criteria. Blood samples were collected for all enrolled patients and analysed for the investigations like Serum BSF, HbA1c and Serum ADA.

Results- In the study, BSF, mean HbA1c and serum ADA level was significantly higher in diabetic group in comparison to control group (p=0.000). The diabetic group was subdivided on the basis of HbA1c levels, HbA1c ≤ 8% as good glycemic control and HbA1c > 8% as poor glycemic control. BSF, mean HbA1c and serum ADA levels were observed to be significantly higher in poor glycemic control group as compared to that of good glycemic control. A significant positive correlation between S. ADA and HbA1c activity was also seen (r= 0.388).

Conclusion- Increased ADA level can be used to determine the glycemic status in the patients of type 2 DM and serve as a marker for insulin resistance. Hence, by analysing ADA levels in diabetes, glycemic control and insulin resistance can be assessed. Raised ADA levels can be an early indicator of progressive diabetic change and help to take preventive measures for the development of diabetic complication and thereby improving the outcome of the disease.

Keywords- Diabetes Mellitus, Adenosine Deaminase, Glycated haemoglobin
STANDARDIZATION OF HYDROPONIC AND WILD GROWING TEUCRIUM POLIUM L. BY HPLC
Authors: M Galstyan H. , H Dumanyan K. , O Tsaturyan A. , H Gukasyan N. , A Engibaryan A. , B Chichoyan N.
Published: March 2020

It was approved that flavonoids (luteoline, apigenin) and phenylpropanoid glycosides verbascoside best separation was implemented by using UM detector and isocratic isolation regime.

Depending on the growing conditions main influencing substance quantities fluctuate: in the wild growing plants were synthesized nearly 2 times more than in hydroponic growing plants. For the study were obtained 500 alcoholic extracts from hydroponic and wild growing T. polium. The studied samples before analysis were developed three-chloral-acetic-acid anhydride and centrifuged by 10 minutes 12000 rev/m speeds. The solution volume of each injected analysis was 10 mkl. Then some amount of standard verbascoside, luteolin and apigenin samples were solved in 1ml ethyl alcohol and were filled into the special test tubes for analysis. By T. polium chloroform-methanol and tower chromatography water fractions teupolizoid, verbascoside and poliumozid phenylpropanoid glycosides were separated which Rf were equal to 0.25, 0.5, 0.37 in our researches in the past. These compounds composition was proved by complex spectroscopic methods. They had close structure to each other and verbascoside enclosed peaks in HPLC were supposed that belong to poliumozid and teupoliozid and also was brought the above mentioned compounds quantities by calculating chromatography data.

Keywords: Teucrium polium L., wild and hydroponic, HPLC, standardization, verbascoside, apigenine, luteolin.
NANO-ENGINEERED IRRIGATING SOLUTIONS AND LASERS – AN ANTIBACTERIAL STUDY AGAINST ENTEROCOCCUS FAECALIS
Authors: Sundaresan Balagopal , James Vandana , Sebatni Anisha , M Nazrin , Hemasathya Bahavathi Ananthan , Chandrasekaran Charanya , Senthilnathan Natarajan
Published: March 2020

BACKGROUND:

Enterococcus faecalis (E. faecalis) is the most commonly detected micro-organism in asymptomatic and persistent endodontic infections. Thorough disinfection of the root canal is more important than proper shaping for a successful endodontic treatment. This study is an attempt to implement nanoparticles which have proven anti-bacterial efficacy as irrigating solutions against E. faecalis.

AIM:

To compare and evaluate the anti-bacterial efficacy of 5% sodium hypochlorite (NaOCl), 0.2% chitosan nanoparticles solution (ChNP) and 0.01% silver nanoparticles solution (AgNP) against E.faecalis with and without diode laser activation.

MATERIALS AND METHODS:

70 single rooted mandibular premolars were included in this study. Access opening, working length determination and biomechanical preparation were standardized. Samples were embedded in putty material inside an eppendorf tube to simulate periodontal ligament and autoclaved followed by inoculation of  E.faecalis (MTCC 439) and incubated at 37℃ for 7 days. The samples were divided into 7 groups (10 samples in each group). Group 1- No treatment (Negative control), group 2 - 5% NaOCl without activation (Positive control), group 3 - 5% NaOCl with diode laser activation, group 4-  0.01% AgNP without activation, group 5- 0.01% AgNP with diode laser activation, group 6- 0.2% ChNP without activation and group 7- 0.2% ChNP with diode laser activation. A final rinse of the respective irrigants and activation were performed, followed by counting the colony forming units.  Statistical analysis used were one-way analysis of variance (ANOVA) followed by Tukey’s post-hoc tests. Results showed that diode laser in combination with 5% NaOCl and 0.2% ChNP had significant effects in the reduction of microbial colony counts of E. faecalis in comparison to other experimental groups.

 Keywords: Nanoparticles, Irrigation, LASER, Enterococcus faecalis
LEMON SCORE: A TOOL TO PREDICT DIFFICULT AIRWAY IN ED IN INDIAN SETTING.
Authors: Tripathi Sumalya , Shinde Dr V.S , Shaikh Zahid Parvez
Published: March 2020

Background: Airway management is a critical need in many acutely ill and injured patients. Inadequate delivery of oxygen to brain and other vital structures is the quickest killer. Emergency airway management is the major key for successful resuscitation in ED. Emergency medicine is an emerging branch in India at present and no research study has been conducted to evaluate difficult airway prediction score. Hence this study aimed to find the use of LEMON score as a tool to predict difficult airway in our ED.

Methods: All the patients requiring invasive mechanical ventilation with age >12 years, not admitted outside and admitted to the emergency medicine department from July 2017 to September 2019 were included in our study.  A total of 67 patients required invasive ventilation and were assessed by LEMON score for difficult intubation. This score is related to number of attempts required and Cormack lehane class of laryngoscopic view while intubation.

Results: In the “LOOK EXTERNALLY” the most common finding was edentulous mouth with occurrence of 26.87%. In ‘EVALUATE’ component the most common difficulty was 2-3-2. In MALLAMPATI CLASS 56.71% were class I, 39.39% were class II. In OBSTRUCTION component of LEMON, 98.51% had no obstruction. In NECK MOBILITY component we found that 85.1% subjects had mobile neck and only 15.15% subjects had restricted neck mobility. We observed that the LEMON score is 60% sensitive and 96.15% specific to predict difficult airway. The positive predictive value was 83.33%.

Conclusion: This tool can reduce the chance of unexpectedly encountering difficult airway.