SPARK: SKILL BASED PERFORMANCE ASSESSMENT & RESEARCH BASED KNOWLEDGE- APPROACH FOR IMPROVING QUALITY OF HIGHER EDUCATION IN INDIA

There has to be an immediate adjustment in the process used to evaluate students at higher education institutions. In the majority of institutions, evaluation of students is still done at the conclusion of the academic year using a single standardised exam. Students are evaluated on the basis of this single test for their subject knowledge and conceptual clarity, and they are then given a mark sheet and certificate to use when applying for jobs. The Ratta method was given more weight in the Indian examination system, which is a fundamental aw that requires immediate remedy. Since complete educational objectives like comprehension, critical and independent thinking, creativity, problem-solving ability, reflective thinking, skill development, and application of information in real life are overlooked, the memorising of content takes precedence. Numerous educational committees have drawn attention to this flaw. Examinees' anxiety and fear are further exacerbated by the "Ratta system," and occasionally this anxiety results in the usage of unfair test practises. Cramming is encouraged as a way to gain better grades across the Indian examination system, which leads to a pressured environment. This paper focuses on the application of such an assessment approach of student which is free from rote memorization and emphasises conceptual understanding, skill development and knowledge gained through search and analysis.

Extra-pulmonary Manifestations of COVID-19 in Western India

Background: SARS-CoV-2 is well known disorder to affect respiratory system, although it can also influence several extrapulmonary organs through variety of pathological mechanism. In this study, we aimed to discuss the prevalence of atypical and/or extrapulmonary manifestations in COVID-19, therefor action for early isolation and diagnosis can be initiated to prevent spread of infection. Methods: This retrospective observational study included 4200 admitted COVID-19 patients. The patient’s data concerning medical history, clinical symptoms at presentation and during course of hospitalization, laboratory and radiological diagnosis and underlying chronic medical illness were extracted from their medical records. Data of extrapulmonary and/or atypical presentations of COVID-19 were compiled and tabulated to know prevalence of these manifestations. Results: In this study, 1260 patients (30%) had symptomatic presentation. Major extrapulmonary clinical manifestation includes fatigue in 72.22% patients, impaired sense of taste (ageusia) in 58.73%, loss of appetite in 52.78%, impaired sense of smell (anosmia) in 46.83%, palpitation in 33.33%, headache in 33.17%, nausea/vomiting in 31.43%, diarrhoea in 25.40% patients. Among symptomatic COVID-19 patients, 95.56% patients had sinus tachycardia, 38.49% had lymphocytopenia, 36.83% had hepatitis, 35.48% had leukopenia, 27.83% had gastroenteritis, 22.22% had sepsis, 20.87% had proteinuria, 17.30% had coronary artery disease and 16.34% had acute kidney injury in decreasing order. Prevalence of coagulation defect associated disorder were found to be deep venous thrombosis in 15.56% patients, acute coronary syndrome in 7.78%, brain infarct in 6.35%, pulmonary artery thrombosis in 3.25% and SMA thrombosis in 0.32% of symptomatic patients. Conclusion: Patients of SARS-CoV-2 had widespread organ-specific manifestations with involvement of almost all organ system of body. Clinicians must have knowledge of these extrapulmonary symptoms or atypical presentation of COVID-19 as it assists in early diagnosis, isolation of suspected patients and limit the transmission of infection in the hospital settings.

Clinical evaluation of hydrophobic and hydrophilic pit and fissure sealants among 7-10 year old school children: a split mouth study design / Avaliação clínica de fóssulas e físsuras com selantes hidrofóbicos e hidrofílicos entre crianças de 7 a 10 anos de idade: estudo intervencional

Introdução: O estudo foi realizado para comparar a eficácia da retenção hidrofóbica e hidrofílica de selante de fóssulas e fissuras entre crianças de 7 a 10 anos de idade escolar. Material e métodos: O presente estudo randomizado de boca dividida foi realizado nas superfícies oclusais dos primeiros molares inferiores permanentes para comparação e avaliação da retenção junto com outras variáveis de resultado, como a cor, descoloração marginal, adaptação marginal, forma anatômica, sensibilidade pós-operatória, formação de cárie e rugosidade de superfícia de selantes hidrofóbicos e hidrofílicos de fóssulas e fissuras no 3º e 6º mês de aplicação. Os dados foram analisados usando o software SPSS e os resultados foram obtidos. Resultados: No presente estudo, entre as 50 restaurações com selantes hidrofóbico de fóssulas e fissuras (Grupo I), 48 (96%) das restaurações ficaram retidas no final do terceiro mês e 45 (90%) ficaram retidas no final do sexto mês. Entre as 50 restaurações nos selantes de fóssulas e fissuras hidrofílicas (Grupo II), 49 (98%) restaurações ficaram retidas no final do terceiro mês e 46 (92%) no final do sexto mês ficaram retidas. Não houve diferença significativa no número de restaurações totalmente retidas ao final de seis meses (p = 1,00) entre os dois grupos. A avaliação de todas as outras variáveis entre as duas intervenções mostrou que a diferença não foi estatisticamente significativa. Conclusão: O estudo concluiu que o selante de fóssulas e fissuras hidrofílico era semelhante ao selante de fóssulas e fissuras hidrofóbicas em termos de retenção, combinação de cor, descoloração marginal, adaptação marginal, forma anatômica e rugosidade de superfície. (AU)

Introduction: The study was done to compare the effectiveness of hydrophobic and hydrophilic pit and fissure sealant retention among 7-10 year old school children. Material and Methods: The present split mouth randomized trial was conducted on the occlusal surfaces of permanent first mandibular molars to compare and assess the retention along with other outcome variables like colour match, marginal discolouration, marginal adaptation, anatomic form, post-operative sensitivity, caries formation and surface roughness properties of Hydrophobic and Hydrophilic pit and fissure sealants at 3rdand 6th month. The data was compiled and analyzed using SPSS software and results were generated. Results: In the present study among the 50 restorations in the hydrophobic pit and fissure sealants (Group I), 48 (96%) restorations were retained at the end of third month and 45(90%) were retained at the end of sixth month. Among the 50 restorations in the hydrophilic pit and fissure sealants (Group II), 49(98%) restorations were retained at the end of third month, and 46(92%) at the end of sixth month were retained. There was no significant difference in the number of completely retained restorations at the end of six months (p = 1.00) among both the groups. The assessment of all the other outcome variables between both the interventions showed that the difference was not statistically significant. Conclusion: The study concluded that the hydrophilic pit and fissure sealant was similar to the hydrophobic pit and fissure sealant in terms of retention, colour match, marginal discolouration, marginal adaptation, anatomic form and surface roughness properties with (AU)

Characterisation of Escherichia coli Recovered from Wild Animals Kept at Bikaner Zoo for Their Antibiotic Resistance

In the present study, a total of 41 E. coliisolates obtained from Boselaphus tragocamelus (5), Antelope cervicapra(18) and Gazella gazelle (18) maintained at Bikaner (Rajasthan) zoo were subjected to antibiogram determination against 15 antibiotics belonging to four different classes and were also genotyped for detecting presence of blaTEM,sul-2, strA and aadAgenes. Antibiogram study revealed highest efficacy of ciprofloxacin (90.2%) followed by nalidixic acid (75.6%) and chloramphenicol (68.4%) and high resistance to β lactam, Sulfamethoxazole and Aminoglycoside antibiotics. The overall presence of blaTEM, sul-2, strA and aadA genes was detected in 95.12%, 80.48%, 60.97% and 87.8% in isolates.

Retroperitoneal lymphangiectasia: a great clinical masquerade

Retroperitoneal lymphangiectasia is a very rare lymphatic disorder characterized by abnormal proliferation of lymphatics. We present series of 3 cases of retroperitoneal lymphangiectasia which are diagnosed in our institute with the help of Ultrasonography (USG), Computed Tomography (CT) and Magnetic resonance imaging (MRI) of abdomen and pelvis with unusual clinical presentation. We include clinical features and imaging findings of this disorder with its pathogenesis and diagnosis. Two of the cases were clinically masquerading as hernia and one case was mimicking varicocele. Thorough clinical examination and USG, colour Doppler, CT and MRI are extremely helpful imaging investigation that aid in differentiating these lesions from hernia/ varicocele and the cross sectional imaging like CT and MRI can  depict the anatomical extent of the disease.

Mortality and survival benefits in people living with human immunodeficiency virus initiated newly with Antiretroviral therapy irrespective of CD4 count

Background: HIV is a global pandemic with estimated 37.9 million people living with HIV(PLHIV) worldwide in which 23.3 million (62%) PLHIV take antiretroviral therapy (ART). In 2018 UNAIDS estimated 7,70,000 people died from AIDS related illness globally. India has around 21,40,000 PLHIV and 69,110 AIDS-related deaths in 2017 according to NACO report. This study aims to know the mortality and survival benefits in PLHIV newly initiated on ART as per test and treat policy.Methods: A prospective observational cohort study was conducted from June 2017 to June 2018, involving 100 ART-na飗e PLHIV attending this ART Centre at Hospitals attached to BMCRI, Bangalore, India. Survival analysis was done by Kaplan Meier estimates. Spectrum of opportunistic infections and their role in cause of mortality was studied.Results: The overall survival rate was 92% at 6 months and 91% at one year after ART initiation. The mortality rate at the end of one year was 9%, out of which Pulmonary Tuberculosis is the most common cause of mortality. There was a significant increase in the CD4 count during follow up, the mean increase in the CD4 T-cell count at the end of 6 months and 12 months was 157 cells and 286 cells per cubic millimeter respectively above the baseline value.Conclusions: In this study early initiation of ART is found to be beneficial in clinical and immunological recovery with increase in CD4 counts and reduction in opportunistic infections in PLHIV. Pulmonary Tuberculosis remains the grave risk factor for mortality among PLHIV/AIDS patients on ART.

Intussusception associated with celiac disease in a child: case report and review of literature

Intussusception and celiac disease both are common in children.' Intussusception has been rarely associated with celiac disease in children, which mostly involved small bowel, are transient without classical symptoms, reduced spontaneously and rarely needs intervention. Authors are reporting a 2-year girl who presented initially as gastroenteritis and later on intestinal obstruction and on investigation revealed ileo-ileal intussusception which resolved spontaneously during laparotomy preparation. The patient had growth retardation and microcytic hypochromic anemia and on further evaluation diagnosed with celiac disease. This case report highlights the need of celiac testing in children with intussusception, and such intussusception resolved spontaneously with gluten free diet and rarely needs any active intervention, thus preventing from undue nonsurgical or surgical interventions for intussusception.

comparative study of dissolution profile of drug by enhancing aqueous solubility through Kneading method

Solid dispersions (SDs) are resulted by dispersion of drug in biologically inert matrix. They can be used to increase the solubility of a drug with low aqueous solubility, thereby improving its oral bioavailability. Higher drug dissolution rates from a SD can be facilitated by optimizing the wetting characteristics of the compound surface, as well as increasing the interfacial area available for drug dissolution. Although the latter can be easily accomplished by, for example: decreasing the particle size of the drug powder but micronized powders may result in further complications as they occasionally tend to agglomerate. A more preferable solution would be to introduce the drug in the form of a molecular dispersion. The aim of present study was to enhance the dissolution rate of diclofenac a practically less water-soluble drug. The same was done by preparation of solid dispersions of the drug employing different ratios of established polymers. This was done by using polymers namely; hydrophilic polymer β-cyclodextrins, PVP and PEG. The kneading method was used to prepare solid dispersions in various ratios with polymer. The dissolution data was studied for all the three formulations. The data obtained was compared with that of physical mixtures containing drug, polymer and lactose in the same ratio as that of solid dispersions. The dissolution data showed that best release was obtained in formulation f1 containing beta –cyclodextrins, PVP and PEG as polymer. The comparative data showed 98% release at approximately 4 hours with polymer β –cyclodextrins, whereas, 90% and 88% release were obtained using PEG and PVP respectively in the same time frame.

Detection of Enterotoxin Genes (seg, seh and sei) in Staphylococcus aureus Milk Isolates from Cow with Subclinical Mastitis

Enterotoxigenic Staphylococcus aureus can be isolated from various sources and are responsible for food poisoning in addition to many suppurative infections. In the present study, from 82 physically normal milk samples from cattle subclinical mastitis 33(40.24%) were isolated to S. aureus. Out of these, 22 (66.66%) S. aureus isolates had either one or more enterotoxin genes. Both seg and sei enterotoxin genes were carried by 19 (57.5%) S.aureus isolates while only three (9.09%) isolates were positive for seh gene. This study showed the evidence of presence of enterotoxin genes seg, seh, and sei in S. aureus isolates from subclinical mastitis. The presence of these enterotoxigenic S. aureus strains in milk indicates potential public health concern

Effectiveness of musical toothbrush on oral debris and gingival bleeding among 6–10-year-old children: A randomized controlled trial

Context: Motivation serves to be an integral part of health promotion to children at the learning phase of their life. Aim: Evaluation of the effectiveness of musical toothbrush over regular toothbrush in the debris and gingival bleeding scores among children. Settings and Design: This was a single-blinded parallel, randomized controlled trial conducted among 6–10-year-old schoolchildren in Chennai. Methods: One hundred participants with allocation ratio of 1:1 were assigned to musical and regular toothbrush group by simple randomization. After baseline evaluation (T0) of Debris Index-Simplified (DI-S) and Gingival Bleeding Index (GBI), outcome variables were assessed for a period of 3 months (T1, T2, and T3). Statistical Analysis Used: Friedman test and Mann–Whitney statistical test were used to compare the outcome variables within and across the two groups. Results: Thirty-two boys and 68 girls (mean age: 8.53 years) participated in the study. Statistically significant difference was seen in DI-S score among musical toothbrush group (mean: 0.50 [T3] and GBI score: 8.18% [T3]) when compared to regular toothbrush group (mean: 1.59 [T3] and GBI score: 23.54 [T3]) at the end of the 3rd month. Conclusion: Although both the musical and regular toothbrushes effectively reduced the DI-S and GBI scores, former showed effective change among children when compared to the latter.

Resistance pattern of methicillin resistant Staphylococcus aureus among nasal isolates of HIV infected patients in a tertiary care hospital

Background: Patients infected with HIV have an increased risk of nasal Staphylococcus aureus carriage as well as consecutive staphylococcal infections and is a major reservoir for MRSA which is potential risk factors for community acquired MRSA. Knowing the Nasal carriage status of Staphylococcus aureus and their Antibiogram will be beneficial for effective management of these patients.Methods: Nasal swab sample were collected from all the participants and processed for culture and identification of Staphylococcus aureus and their antimicrobial sensitivity. All the Staphylococcus aureus isolates were tested for Methicillin resistance by Oxacillin screen agar test, cefoxitin disc diffusion test and further confirmed by mecA gene PCR.Results: In this study out of 220 HIV seropositive patients, 43.64% isolates were confirmed to be S. aureus, 18.75% MRSA and 81.25% were MSSA. Cefoxitin disc diffusion showed 100% specificity (95% CI; 97.05%-100.00%), 100% sensitivity (95% CI; 83.89-100.00%) and 100% accuracy (95% CI; 97.47% to 100.00%) while comparing with gold standard mecA gene PCR. Among the nasal carriers; males (60%) ware dominant on females (40%). 31-50 years age group was strongly associated with MRSA nasal carriage. None of the isolates were resistant against lenozolid, teicoplanin and vancomycin while ampicillin (75%), ciprofloxacin (62.5%), clindamycin (59.38%) and cotrimoxazole (53.13%) showed increased resistance against S. aureus nasal carriage.Conclusions: Resistance among HIV positive persons for all antibiotics showed statistically significant while compared to control group. Cefoxitin disc diffusion can be used as surrogate agent for mecA gene detection.

Rupture of sinus of valsalva – A 15 years single institutional retrospective review: Preoperative heart failure has an impact on post operative outcome?

Background: We reviewed our experience with ruptured sinus of Valsalva aneurysms (RSOV) to determine a correlation with preexisting heart failure (HF) and coexisting cardiac lesions (aortic regurgitation [AR] and ventricular septal defect [VSD]) to postoperative left ventricular (LV) dysfunction and postoperative outcomes. Materials and Methods: Retrospective review of RSOV cases over 15 years showed that RSOV repair was done in 87 patients. We looked for patients who presented with HF and patients having AR and/or VSDs. Statistical analysis was done to see if the coexisting lesions and preoperative HF were associated with postoperative LV dysfunction. Chi-square test was used on contingency table for statistical analysis. Complications in the postoperative period and prolonged Intensive Care Unit stay were noted. Results: 17% (15/87) presented with HF. Fifty-two patients had moderate to severe AR and 50 patients had VSD. Seventeen patients had postoperative LV dysfunction. The correlation of preoperative HF and coexisting lesions with postoperative LV dysfunction was not statistically significant. Two patients underwent redo surgery for residual RSOV and AR. Two patients had arrhythmias. One patient had cerebrovascular accident. No mortality was seen in the study. Conclusion: Preoperative HF and the presence of VSD and/or AR have no statistical significant correlation with postoperative LV dysfunction. As the outcome of RSOV repair is good, all patients need to undergo early repair to avoid complications.

A Study Of Femoral Neck Anteversion Angle In Central Indian Population: A Guide For Orthopaedic Surgeries Including Hip Arthroplasty

Background: Femoral neck anteversion angle is the angle which measures the anterior rotation of the neck of thefemur around the shaft. Its variation in the various population groups is attributed to various factors such asheredity, diet, climatic factors and lifestyle. This angle is clinically significant for orthopedicians while doinghip arthroplasties and osteotomies where it is pertinent to restore the anatomy of proximal femur for stability ofthe hip joint.Context and purpose of the study: There is no baseline data of Femoral Neck Anteversion angle for Central Indianpopulation. The present study was aimed to fill this lacuna and to give the normal values of femoral neckanteversion angle for above specified population.Materials and methods: 152 dried femora were procured from department of anatomy consisting of 77 femora ofright side and 75 femora of left side. Anteversion angle is recorded using goniometer. Means were calculated andstatistically correlated for laterality using independent student‘t’ test. p value was thus obtained.Results: Mean anteversion angle of right side was found to be 19.03º ± 12.11º and that of the left side came outto be 18.62º ± 10.8º. Among 152 femora taken, 7 retroverted and 7 neutral verted femora were also found in thestudy.Conclusion: So much variation in the angle of anteversion along with the presence of retroversion (4.6%) andneutral version (4.6%) is a challenge for both implant designer companies as well as orthopedicians. Thus,present study acts as a guide for normal values and range of this clinically significant angle.

Effect of water stress on antioxidative enzymes and glycine betaine content in drought tolerant and drought susceptible cotton (Gossypium hirsutum L.) genotypes

Drought stress is one of the foremost abiotic stress, which causes a reduction in plant growth and yield. Therefore, present study was aimed to analyzed the activity of four antioxidant enzymes, including superoxide dismutase (SOD), peroxidase (POD), glutathione reductase (GR), esterase (EST), and osmolyte glycine betaine (GB) in leaf and root tissues of two cotton genotypes namely, G.cot-16 (drought tolerant) and GBHV-177 (drought susceptible) subjected to drought stresses by withholding of irrigation.A differential response was observed for antioxidant enzymes and GB network in cotton genotypes. GB content was significantly higher in leaf tissues as well as root tissues of G.cot-16 than GBHV-177. The activity of SOD significantly boosted in leaf and root tissues of both the genotype up to 20 days after stress (DAS) however, further it declined in the GBHV-177 with increasing severity of water deficit stress. Activities of GR and EST significantly enhanced in leaf and root tissues of G.cot-16 while drastically declined in the leaf and root tissues of GBHV-177 till 40 DAS under water stress condition. Moreover, POD activity was significantly increased in the leaf and root tissues of G.cot-16 up to 30 DAS then it was declined to 40 DAS, however in GBHV-177 markedly declined in the leaf and root tissues till 40 DAS under water deficit stress condition. It is concluded that during water stress leaf tissues of drought-tolerant genotype shows higher reactions of an antioxidative pathway to cope up drought stress. Thus, the existence of this variability in the cotton genotypes might be used by the breeder for improvement of cotton productivity under drought or water deficit stress condition.

A Histomorphometric Evaluation Of Effects Of Sucralose Ingestion On Liver Of Albino Rats

Sucralose is a non-nutritive sweetener used in a broad range of foods and beverages. The aim of the study was to demonstrate any histomorphometric changes in liver after sucralose ingestion. Adose of 3g/kg/day of sucralose dissolved in distilled water were given for 30 days to experimental rats by oral gavage whereas Control rats received equal quantity of distilled water. Liver Pieces each having thickness 5mm were taken for paraffin sectioning. 80 slides of 5 micron thick tissue sections were made from each liver and stained with Hematoxylin and Eosin (H & E) which were subsequently evaluated for histomorphometric changes. No significant change in the size of hepatocytes and size of nuclei of hepatocytes were observed between slides of control and sucralose treated rat livers. Sinusoidal width was found to be significantly increased in experimental rat livers as compared to control which is indicative of hepatic damage. A food additive so commonly used as sucralose deserves further investigations.

Absent superior vena cava in tetralogy of fallot

Absent superior vena cava (SVC) is an asymptomatic congenital systemic venous anomaly which is rarely detected and compatible with normal life. Undiagnosed absent SVC may cause problems during cardiac catheterization or cardiac surgery. We present our surgical experience in a patient with tetralogy of Fallot who had undiagnosed absent SVC.

Assessment of Chronic Obstructive Pulmonary Disease among Smoker and Non-Smoker: A Hospital Based Prospective Study

Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is typically progressive and associated with an enhanced chronic inflammatory response in the airways and lung tissue to harmful particles or gases. The present study was conducted to assess the cases of COPD among smokers and non- smokers. Materials & Methods: The present study was conducted on 50 subjects of both genders. Subjects diagnosed based on history, clinical examination and spirometric criteria were included. Subjects were divided into 2 groups. Group I (25) were those who were habit of smoking since 20 years and group II who were non- smokers. Results: Age group 20-30 years had 3 subjects in group I and 4 subjects in group II, 30-40 years had 7 subjects in group I and 6 in group II, 40-50 years had 9 subjects in group I and 7 in group II and >50 years had 6 subjects in group I and 8 in group II. The difference was non- significant. In group I, 10 subjects were from urban and 18 were from rural area and 15 were from urban and 7 were from rural area in group II. The difference was non- significant. 12 subjects in group I and 20 in group II had history of occupational exposure, 10 in group I and 18 in group II history of environmental exposure and 6 in group I and 17 in group II history of bio mass fuel usage. The difference was significant. Conclusion: COPD is a common respiratory disease mostly associated with smokers. However, environmental factors, occupational factors also play an important among non- smokers.

The reliability of cephalometric measurements in oral and maxillofacial imaging: Cone beam computed tomography versus two‑dimensional digital cephalograms.

Context: This study compared digital two‑dimensional (2D) lateral cephalograms and cone‑beam computed tomography (CBCT) total and half‑skull images for the reliability of cephalometric measurements. Aims: (1) To compare the accuracy of cephalometric measurements and reproducibility between the digital and CBCT cephalograms in the Indian population. (2) To compare interobserver variability in landmark identification through their cephalometric measurements by comparing different imaging modalities (CBCT total skull, CBCT half‑skull, and conventional lateral cephalogram). (3) To further compare half‑skull with the total skull synthesized CBCT and digital cephalograms in the same regard. Materials and Methods: Thirty patients, who had consented with orthodontic treatment, participated in the study. Informed consent was obtained from the patient before the radiographic procedures. 2D digital lateral cephalograms and their corresponding CBCT scans were taken and imported in DICOM format to OnDemand 3D software. Twenty‑three landmarks were identified by 3 observers and 9 linear and 14 angular measurements were digitally traced. The values were sent for statistical analysis using ANOVA to check the interobserver reliability between the imaging modalities. Statistical Analysis Used: ANOVA, Student’s t‑test, and post hoc test were used for the statistical analysis. Results: The interobserver reliability was high between the modalities. CBCT total skull received an overall intraclass correlation coefficient (ICC) value of 0.76. The ICC value for the CBCT half‑skull was 0.79 and for the digital cephalograms it was 0.80. The reliability for CBCT total skull was marginally less when compared to the CBCT half‑skull and digital cephalograms, but more for the mid‑sagittal measurements. Digital cephalograms showed the most variation with measurements of the mandibular plane when compared to CBCT. Conclusions: CBCT has the potential to be used for cephalometrics, especially the half‑skull images, but further studies are required to prove whether CBCT total skull images can be used. 2D cephalometry, however, still does remain as the mainstay of orthodontic diagnosis and treatment planning and cannot be easily replaced by three‑dimensional cephalometry.

Using smartphone video “selfies” to monitor change in toothbrushing behavior after a brief intervention: A pilot study.

Background: Attempts to refine toothbrushing (TB) technique, an ingrained habit in adults, can meet with some challenges. Recently, the role of proactive interference as a barrier to improving the learning of proper brushing has been proposed. This pilot feasibility study was designed to investigate TB behavior and to see how it changes after training. Smartphone video “selfies” (SPVSs) are increasingly being used in the medical field to assess, monitor, and determine the progression of diseases. Materials and Methods: We used SPVS to study TB skills in a small sample of volunteers. Over a period of 14 days, after a one‑time group training session, we observed TB behavior of volunteers using self‑captured SPVS. Results: Following the brief intervention, we observed an 8% of improvement in TB skills. Discussion: To the best of our knowledge, this is the first report using SPVS to study TB behavior. We demonstrated initial feasibility of using SPVS in the dental setting. We observed modest improvements in toothbrushing accuracy and quality, and we generated important experiences about the use of Selfies for TB monitoring and intervention, and some interesting insights about where in the toothbrushing is more or less effective. Conclusion: Further investigation using a larger sample size is needed to thoroughly assess the effectiveness of this approach to improve TB skills and better understand the role of proactive interference.

Comparison of hemodynamic responses to laryngoscopy and intubation with Truview PCDTM, McGrath® and Macintosh laryngoscope in patients undergoing coronary artery bypass grafting: A randomized prospective study.

Context: We hypothesized that reduced oropharyngolaryngeal stimulation with video laryngoscopes would attenuate hemodynamic response to laryngoscopy and intubation. Aim: Comparison of hemodynamic response to laryngoscopy and intubation with video laryngoscopes and Macintosh (MC) laryngoscope. Setting and Design: Superspecialty tertiary care public hospital; prospective, randomized control study. Methods: Sixty adult patients undergoing elective coronary artery bypass grafting (CABG) were randomly allocated to three groups of 20 each: MC, McGrath (MG), and Truview (TV). Hemodynamic parameters were serially recorded before and after intubation. Laryngoscopic grade, laryngoscopy, and tracheal intubation time, ST segment changes, and intra‑/post‑operative complications were also recorded and compared between groups. Statistical Analysis: SPSS version 17 was used, and appropriate tests applied. P < 0.05 was considered significant. Results: Heart rate and diastolic arterial pressure increased at 0 and 1 min of intubation in all the three groups (P < 0.05) while mean arterial pressure increased at 0 min in the MG and TV groups and at 1 min in all three groups (P < 0.05). A significant increase in systolic arterial pressure was only observed in TV group at 1 min (P < 0.05). These hemodynamic parameters returned to baseline by 3 min of intubation in all the groups. The intergroup comparisons of all hemodynamic parameters were not significant at any time of observation. Highest intubation difficulty score was observed with MC (2.16 ± 1.86) as compared with MG (0.55 ± 0.88) and TV (0.42 ± 0.83) groups (P = 0.003 and P = 0.001, respectively). However, duration of laryngoscopy and intubation was significantly less in MC (36.68 ± 16.15 s) as compared with MG (75.25 ± 30.94 s) and TV (60.47 ± 27.45 s) groups (P = 0.000 and 0.003, respectively). Conclusions: Video laryngoscopes did not demonstrate any advantage in terms of hemodynamic response in patients with normal airway undergoing CABG.