Penile strangulation by a metal ring

Penile strangulation due to the metallic ring is an uncommon clinical entity that requires urgent attention to prevent irreversible nerve damage, and if neglected gangrene of the penis. Various methods have been described in the literature for removing constricting foreign bodies, but there is no consensus regarding an acceptable technique. We report the case of a 51-year-old man with a history of a metal ring used for sexual pleasure lodged over the shaft of his penis with an inability to remove the same.

Effect of Kangaroo Mother Care on Cerebral Hemodynamics in Preterm Neonates Assessed by Transcranial Doppler Sonography in Middle Cerebral Artery

Objective: To study the effect of KMC in premature newborns on cerebral hemodynamics in the middle cerebral artery (MCA) using transcranial doppler sonography. Methods: In this descriptive study, 40 clinically stable preterm neonates admitted to the neonatal intensive care unit of our institute and undergoing Kangaroo mother care (KMC) were enrolled. Physiological and cerebral blood flow parameters of MCA were obtained by using transcranial doppler sonography at baseline, at 60 minutes of KMC, and after 60 minutes of stopping KMC. Results: Of the 40 enrolled neonates (24 males), the mean (SD) birth weight, gestation age, and postnatal age were 1698.25 (495.44) g, 33.00 (1.67) wk, and 6.80 (4.51) days, respectively. The mean (SD) cerebral blood flow velocities increased (peak systolic velocity (PSV), P=0.03; end diastolic velocity, P<0.001; mean velocity, P<0.001) and doppler indices decreased (resistive index, P=0.001; pulsatility index, P<0.001) significantly; whereas, heart rate (P<0.001) decreased but SpO2 (P=0.001) and mean blood pressure (P=0.003) increased significantly at 60 minutes of KMC as compared to baseline. Sixty minutes after stopping KMC, all parameters (except PSV) were higher than baseline, indicating post KMC effect. Conclusion: KMC improves cerebral hemodynamics in clinically stable preterm neonates.

Prevalence of oromucosal lesions in relation to tobacco habit among a Western Maharashtra population

OBJECTIVES: This study was conducted to determine the number and types of oromucosal lesions (OMLs) in relation to tobacco habits in patients who attended the outpatient department. METHODOLOGY: A total of 1730 patients visiting the Department of Oral Medicine and Radiology were interviewed and screened for tobacco habits (smoking and smokeless). Clinical oral examination was conducted with diagnostic instruments using the Color Atlas of Common Oral Diseases as a guide for diagnosis. When clinical features were not diagnostic, a biopsy was done. RESULTS: Of the 1730 outpatients, 975 (56.3% ) individuals used tobacco in one or other forms and 687 (70.4%) of these had OMLs. CONCLUSION: The results of this study provide important information on the prevalence of OMLs in patients seeking dental care. This provides baseline data for future studies on the prevalence of oral lesions in the general population.

Cost Effective Pilot-scale Ajmalicine Production by Catharanthus roseus Cell Suspension Cultures in a 100 Lit Bioreactor

Aims: The cosmic production of biomass and bioactive compounds at pilot scale with minimum production costs is an important task to achieve feasible production process of corresponding secondary metabolites at a commercial level. Materials and Methods: The cell suspension cultures of Catharanthus roseus in MS medium supplemented with 2, 4-dichlorophenoxyacetic acid (9.05 µM), kinetin (4.52 µM) were scaled up in a pilot plant bioreactor (100 lit). The cost of production was reduced by addition of substitute carbon source in a basal medium which hardly costs 30% in the medium. Preliminary studies were performed in the 7-lit bioreactor. A 100 lit stainless steel bioreactor equipped with helical impeller top mounted was used for scale-up of C. roseus suspension cultures and ajmalicine production. Results: The culture medium reduced the cost by 36% by addition of commercial grade sugar whereas medium consist of tissue culture grade sucrose costs 53 USD per 100 lit. The suspension cultures were cultivated in a 100 lit bioreactor containing MS medium fortified with cost-effective carbon source produced ajmalicine 73.18 mg/l DW and achieved 36 kg of fresh biomass on day 20. Conclusion: The results of the present finding demonstrated the feasible and cost-effective production process of ajmalicine at pilot scale.

Evaluation of Knowledge and Skills of Home Based Newborn Care among Accredited Social Health Activists (ASHA).

Objective: We assessed the knowledge level and skills of trained ASHAs in providing home-based newborn care. Methods: 100 ASHA from two talukas of Anand district of Gujarat participated. Knowledge was assessed using a structured questionnaire while certain skills were assessed through direct observation on mannequins. Results: The mean (SD) knowledge score of the participants was 16.7(3.16) out of 34. The skills were satisfactory in 52%, 61%, 43%, and 68% of ASHA workers for temperature measurement, hand washing, weight measurement and skin-to-skin care, respectively. Large variability was observed in self–reported and field performance of ASHA workers. Conclusions: Knowledge and skills of Asha workers in this region were inadequate.

Association of pulmonary tuberculosis and dermatological conditions among patients of a rural medical college hospital.

Introduction. Pulmonary tuberculosis (PTB) affects a significant proportion of the population. There are many contributory aetiological factors common to tuberculosis (TB) and dermatological conditions. Aim. To study the spectrum of concurrent skin conditions in patients with PTB and to compare with patients having other diseases. Methods. All patients with PTB admitted to our Institute during the period of the study were included in the study. A comparable number of patients admitted in other departments constituted the control group. All patients were screened for skin diseases. Results. There were 498 patients in each group, matched for age and gender. There were 126 patients with skin conditions in the study group as against 60 patients in the control group. Pityriasis versicolor was the commonest skin condition in both the groups. Whereas acniform eruptions and pruritis were more common in the control group. Pityriasis versicolor, herpes zoster, erythema nodosum and leprosy were significantly more frequent among patients. Conclusion. There is a high frequency of concurrent skin diseases in patient with PTB that should be managed along with it.

Newborn Care Practices and Health Seeking Behavior in Urban Slums and Villages of Anand, Gujarat.

Health status of neonates in urban slums has not been studied in smaller towns. A questionnaire was administered to 154 families of 10 urban slums of Anand (population - 197351) and 160 families from 6 villages of Anand district. The socioeconomic and education status of the slum dwellers versus rural participants were significantly lower (P<0.001). Antenatal care (79.9 vs 94.4%, P<0.001), hospital delivery (82.5 vs 93.8%, P=0.002), neonatal follow-up (27.9 vs 78.8%, P<0.001), health seeking (56.5 vs 91.3%, P<0.001), essential newborn care and exclusive breastfeeding (6.5 vs 85.6%, P<0.001) were also lower in urban slums, as compared to villages, Care seeking was low in urban slums, Hindus and illiterate mothers. Health care and socioeconomic status of neonates in slums of smaller cities is poorer than in surrounding villages.

Unilateral segmental odontomaxillary hypoplasia: an unusual case report

Facial asymmetry is not an uncommon occurrence in day to day dental practice. It can be caused by various etiologic factors ranging from facial trauma to serious hereditary conditions. Here, we report a rare case of non-syndromic facial asymmetry in a young female, who was born with this condition but was not aware of the progression of asymmetry. No relevant family history was recognized. She was also deficient in both deciduous and permanent teeth in the corresponding region of maxilla. Hence, the cause of this asymmetry was believed to be a segmental odontomaxillary hypoplasia of left maxilla accompanied by agenesis of left maxillary premolars and molars and disuse atrophy of corresponding facial musculature. This report briefly discussed the comparative features of segmental odontomaxillary hypoplasia, hemimaxillofacial dysplasia, and segmental odontomaxillary dysplasia and justified the differences between segmental odontomaxillary hypoplasia and the other two conditions.

Non-syndromic hypohyperdontia of the permanent dentition with involvement of the mandibular anterior region: a rare occurrence / Hipo-hiperdontia não sindrômica da dentição permanente com envolvimento da região anterior mandibular: uma rara ocorrência

Objective: To present an uncommon case of numeric abnormalities in a non-syndromic patient.Discussion: Dental numeric abnormalities in development of the permanent dentition are quite common;however, combined occurrence of hypodontia and hyperdontia is a rare phenomenon, especiallyin a non-syndromic situation. This paper describes a 28-year-old non-syndromic man with missing mandibularlateral incisors and an erupted mandibular mesiodens. This is only the third case, to the best ofour knowledge, with the two anomalies manifesting in the anterior region of the mandible.

Objetivo: Apresentar um caso incomum de anomalias numéricas num caso de paciente não sindrômico. Discussão:Anomalias dentárias numéricas no desenvolvimento da dentição permanente são comuns; entretanto, a ocorrênciacombinada de hipo e hiperdontia é um fenômeno raro, especialmente em situações não sindrômicas. Este artigo descreve o caso de um paciente masculino não sindrômico apresentando ausência de incisivos laterais mandibularese um mesiodens mandibular erupcionado. Esse é o único caso, pelo melhor de nosso conhecimento, com as duasanomalias manifestando-se simultaneamente na região anterior da mandíbula.

Prepubertal testicular tumors: Our 10 years experience.

Background: Testicular tumors in the pediatric population are distinct from those of the adults. In contrast to the prevalence data reported in tumor registries, several studies have shown that a majority of the prepubertal testis tumors are benign. We retrospectively analyzed a series of prepubertal testicular tumors. Materials and Methods: A retrospective review of all testicular tumors at our institution was done from Jan 1999 to Dec 2008. Data relating to presentation, evaluation, and management were collected. Results: A total of 22 children with prepubertal testicular tumors were identified. The mean age at presentation was 4.6 years. Mature teratoma, epidermoid cysts, immature teratoma, and yolk sac tumor accounted for 49.94%, 13.62%, 9.08%, and 18.16%, respectively. All surgeries were successful with respect to cancer control and testicular preservation. Conclusions: Benign tumors formed the majority (72.64%) of the tumors that were encountered, with yolk sac tumors (18.16%) being a minority. Testicular preserving surgery appears to be a feasible option for benign tumors and is safe and efficacious in long-term follow-up.

retrospective study of two-port appendectomy and its comparison with open appendectomy and three-port appendectomy

To establish the efficacy of two-port appendectomy as an alternative to standard laparoscopic and open appendectomy in the management of acute appendicitis. Of the 151 patients included in the study, 47 patients were in the open group, 61 in two-port and 43 patients were included in the three-port group. Only patients with uncomplicated acute appendicitis were included in the study. Patients with complicated appendicitis like perforated appendix, appendicular lump and appendicular abscess were excluded from the study. Patients converted to open procedure after initial diagnosis and patients with other pathology in addition to appendicitis were also excluded. Patients with recurrent appendicitis and chronic appendicitis were excluded. The total number of excluded cases was 50. Data were compared with cases of open and three-port appendectomy. The mean operative time was 43.94, 35.74, and 59.65 min [SD: 18.91, 11.06, 19.29] for open, two-port, and three-port appendectomy groups respectively. Mean length of stay in days was 3.02, 1.93, and 2.26 [SD: 1.27, 1.04, 1.09] for open, two-port, and three-port appendectomy groups respectively. Surgical site infection was significantly lower [P = 0.03] in laparoscopy group as compared to that in open appendectomy group. Seven patients [4.63%] developed surgical site infection, 5 [10.63%] in the open and 2 [1.92%] in the laparoscopy group. Surgical site infection was 1.63% and 2.32% in two-port and three-port appendectomy groups respectively. For uncomplicated appendicitis, the two-port appendectomy technique significantly reduces operative time as well as length of hospital stay. It also reduces surgical site infection as compared to open appendectomy group

Tuberculous ulcer of tongue with oral complications of oral antituberculosis therapy.

Tuberculosis (TB) is an infectious disease affecting humans of all ages in all parts of the world. The dentist plays an important role in the identification and control of this condition by early recognition of oral lesions that may precede the detection of the pulmonary form. Occurrence of increased incidence of mycobacterial infections as a part of the spectrum of AIDS only emphasizes the importance of early diagnosis. A case of a tuberculous ulcer on the tongue along with oral ulcerations, which occurred as a consequence of oral antituberculosis therapy (ATT), is presented. Such complications have rarely been reported in the literature and the management of these is described herein. The tuberculous ulcer healed uneventfully in five weeks after institution of ATT and the other ATT-induced ulcers healed after a week of topical anesthetic application. The clinical presentations, differential diagnoses to be considered, and management of such oral manifestations is discussed. The occupational risk posed by TB to the dentist and appropriate precautions to be observed have been highlighted.