Regeneration of a large bony lesion with advanced-platelet rich fibrin: case report / Regeneración de una lesión ósea de gran tamaño con fibrina rica en plaquetas: reporte de caso

Introduction: This case report analyzes the regeneration potential of advanced-platelet rich fibrin (A-PRF) in large bony lesions. Advanced-platelet rich fibrin provides various growth factors which aids in faster healing. Materials and Methods: Patient presented with peri-apical radiolucency. CBCT showed bony radiolucency in teeth 31, 32, 41, 42. A full mouth mucoperiosteal flap was raised and a cyst lining was enucleated. Apicoectomy was done with respect to 31, 32, 41, 42 along with and retrograde with a preparation of APRF clots were placed in the bony cavity. Results: Post-op CBCT at 6 months showed a significant difference in size and bone density of the lesion. Conclusions: Advanced-platelet rich fibrin has shown promising results in reducing the size of bony defect and periapical lesion in this case.

Introducción: Este caso clínico demuestra el potencial de regeneración de la fibrina rica en plaquetas avanzada (A-PRF) en lesiones óseas de gran tamaño. La fibrina rica en plaquetas avanzada proporciona varios factores de crecimiento que ayudan a una curación más rápida. Materiales y Métodos: El paciente se presentó con radiolucencia periapical. Tomografía computarizada de haz cónico mostró radiolucencia ósea en los dientes 31, 32, 41, 42. Se levantó un colgajo mucoperióstico de boca completa y se enucleó el revestimiento del quiste. Se realizó apicectomía con respecto a 31, 32, 41, 42, y se colocó una preparación de APRF se colocaron coágulos en la cavidad ósea. Resultados: La tomografía computarizada de haz cónico postoperatorio a los 6 meses mostró una diferencia significativa en el tamaño y la densidad ósea de la lesión. Conclusión: La fibrina rica en plaquetas avanzada ha mostrado resultados prometedores en la reducción del tamaño del defecto óseo y la lesión periapical en este caso.

Prevalence and Determinants of Early Childhood Caries among Children Enrolled in Anganwadi Centres in Bhilai of Central India: A Cross-Sectional Study

Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child’s overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross?sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in ‘dmft’ using the WHO oral health assessment form for children 2013. The mothers’ knowledge, attitude, and practice were determined by a professionally administered 10?item pre?tested short questionnaire with Cronbach’s alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school?educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non?assisted (17.8%) (P = 0.044). Conclusion: Although mothers’ knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres.

Always, better and control - vital, essential, desirable matrix analysis of the drug store of a tertiary care teaching hospital of North India

Background: Substantial improvement can be brought about in the hospital inventory and drug expenditure by inventory control techniques. These include ABC (always, better and control), VED (vital, essential and desirable) and ABC-VED matrix analysis. The objective of the study was to categorize the drugs based on cost and criticality and identify those which require stringent managerial control.Methods: ABC analysis according to drug expenditure, VED analysis according to criticality of the drugs,  ABC-VED matrix analysis to classify drugs into category I, II and III was done for drug store of a tertiary care teaching hospital of North India for the period of April, 2018 to March, 2019.Results: The total number of the drug items used by the drug store was 315. The total drug expenditure was Rs. 9,61,29,859. By ABC analysis, it was found that 15.24%, 22.54% and 62.22% items belonged to A, B and C category respectively, accounting for 70%, 20% and 10% of Annual Drug Expenditure (ADE). VED analysis showed that 31.11%, 60.32% and 8.57% were V, E, and D category items respectively, accounting for 30.44%, 57.12% and 12.44% of ADE. By ABC-VED matrix analysis, 42.86%, 52.38% and 4.76% items were category I, II and III items respectively, accounting for 78.91%, 20.15% and 0.94% of ADE.Conclusions: The study depicted the items belonging to category I which requires top managerial control, also the items belonging to categories II and III which require control by middle and lower managerial level respectively.

Smile makeover by veneers ­ case report / Sonrisa mejorada por carillas dentales - reporte de un caso

Ceramic veneers have evolved in the last few years as an aesthetic restoration in the field of aesthetic dentistry. It is a conservative option as compared to full coverage crowns for improving the patients smile. Ceramic veneers are widely used for smile designing in patients with fluorosis, midline diastema, hypoplastic teeth, and peg shape laterals. Clinical relevance: This article highlights the smile designing of a young patient with fluorosis using ceramic veneers, which not only improves the smile of the patient but has positive psychological benefits.

Las carillas de cerámica han evolucionado en los últimos años como una restauración estética en el campo de la odontología estética. Es una opción conservadora para mejorar la sonrisa de los pacientes en comparación con las coronas de cobertura total. Las carillas de cerámica se usan ampliamente para el diseño de sonrisas en pacientes con f luorosis, diastema de la línea media, dientes hipoplásicos, o laterales en forma de clavija. Relevancia clínica: este artículo destaca el diseño de la sonrisa en un paciente joven con f luorosis utilizando carillas de cerámica, que no solo mejora la sonrisa del paciente sino que entrega beneficios psicológicos.

Performance and Carcass Traits of Broiler Chickens Reared on LEDs vis-a-vis CFL as a Growth Promotor

The present study was conducted to compare the performance of broiler reared under two different light sources and three different light colours. For this purpose, 120, two-week-old IBL-80 (Indian Broiler Ludhiana-80) broiler chicks were randomly distributed in four different treatment groups viz. TLEDB-G (first 2 wks, blue LED then switched to green LED for the next 2 wks), TLEDG-B (first 2 wks, green LED then switch to blue LED for the next 2 wks), TLEDW (White LED) and TCFL (CFL light; Control) with 3 replications and 10 birds in each experimental unit was applied. The effects of different lights on performance (BW, BWG and FCR), carcass traits and its economic impact on broiler chickens were investigated in the present study. The results show that performance and carcass traits of broiler birds of blue-green and green blue LED light group was at par to that of CFL group whereas benefit cost ratio of birds of TLEDB-G (1.13) was found highest among different treatment groups. Therefore, use of a combination of monochromatic Blue-Green or Green-Blue LED light could be a better alternative source of light than CFL light in terms of birds’ performance, economics and energy saving

Modified Stoppa Approach for Acetabulum Fracture: A Review / Técnica de Stoppa modificada para fratura de acetábulo: uma revisão

Abstract Fracture acetabulum is a grave injury and a challenge for orthopedic surgeons. Anterior and posterior approaches have been described for fixation of acetabulum fractures. The modified Stoppa approach is considered an alternate to anterior approach, which provides access to pelvis from inside the cavity. The purpose of this article is to review the available literature on use of the modified Stoppa approach in acetabulum fractures. The available data suggest that modified Stoppa approach is useful in anterior acetabulum fractures and some posterior acetabulum fractures, especially where buttressing of medial wall is required.

Resumo Fraturas acetabulares são lesões graves e desafiadoras para cirurgiões ortopédicos. As abordagens anterior e posterior foram descritas para a fixação dessas fraturas. A técnica de Stoppa modificada é considerada uma alternativa à abordagemanterior, que fornece acesso à pelve pelo interior da cavidade. O objetivo do presente artigo é revisar a literatura disponível sobre o uso da abordagem de Stoppa modificada em fraturas de acetábulo. Os dados disponíveis sugeremque a abordagemde Stoppamodificada é útil em fraturas anteriores de acetábulo e em algumas fraturas posteriores, especialmente aquelas nas quais o reforço da parede medial se faz necessário.

A Study on Assessment of Clinical, Radiological Parameters in Women Suffering from PCOD

Background: PCOS patients who fail to respond to CC are considered as clomiphene resistant. Approximately 15%–40% of women with PCOS, it is very common. Obesity, insulin resistance, ( 50%–70% of females with PCOS) and hyperandrogenemia are some major factors which postulated for CC resistance. Methods: In this study 50 females were included on the basis of inclusion and exclusion criteria. The duration of study was over a period of 3 month. This study was conducted in the Department of Gynecology, K M Medical College & Hospital, Mathura Result: This result revealed that 56% cases had elevated LH, 36% had hypothyroidism followed by 16% hyperprolactinemia & 4% hypoprolactinemia. Conclusion: This study suggested that, Obesity and overweight are the most important modifiable risk factor which causes 70% of cases to prevent PCOS, weight reduction is one of the most important step.

Next-generation sequencing analysis reveals high bacterial diversity in wild venomous and non-venomous snakes from India

The oral cavities of snakes are replete with various types of bacterial flora. Culture-dependent studies suggest that some of the bacterial species are responsible for secondary bacterial infection associated with snakebite. A complete profile of the ophidian oral bacterial community has been unreported until now. Therefore, in the present study, we determined the complete bacterial compositions in the oral cavity of some snakes from India. Methods: Total DNA was isolated from oral swabs collected from three wild snake species (Indian Cobra, King Cobra and Indian Python). Next, the DNA was subjected to PCR amplification of microbial 16S rRNA gene using V3-region-specific primers. The amplicons were used for preparation of DNA libraries that were sequenced on an Illumina MiSeq platform. Results: The cluster-based taxonomy analysis revealed that Proteobacteria and Actinobacteria were the most predominant phyla present in the oral cavities of snakes. This result indicates that snakes show more similarities to birds than mammals as to their oral bacterial communities. Furthermore, our study reports all the unique and common bacterial species (total: 147) found among the oral microbes of snakes studied, while the majority of commonly abundant species were pathogens or opportunistic pathogens to humans. A wide difference in ophidian oral bacterial flora suggests variation by individual, species and geographical region. Conclusion: The present study would provide a foundation for further research on snakes to recognize the potential drugs/antibiotics for the different infectious diseases.(AU)

Antifreeze proteins enable plants to survive in freezing conditions.

Overwintering plants secrete antifreeze proteins (AFPs) to provide freezing tolerance. These proteins bind to and inhibit the growth of ice crystals that are formed in the apoplast during subzero temperatures. Antifreeze activity has been detected in more than 60 plants and AFPs have been purified from 15 of these, including gymnosperms, dicots and monocots. Biochemical characterization of plant antifreeze activity, as determined by the high ice recrystallization inhibition (IRI) activities and low thermal hysteresis (TH) of AFPs, showed that their main function is inhibition of ice crystal growth rather than the lowering of freezing temperatures. However, recent studies showed that antifreeze activity with higher TH also exists in plants. Calcium and hormones like ethylene and jasmonic acid have been shown to regulate plant antifreeze activity. Recent studies have shown that plant AFPs bind to both prism planes and basal planes of ice crystals by means of two flat ice binding sites. Plant AFPs have been postulated to evolve from the OsLRR-PSR gene nearly 36 million years ago. In this review, we present the current scenario of plant AFP research in order to understand the possible potential of plant AFPs in generation of freezing-tolerant crops.

Adverse Drug Reaction Monitoring in Psychiatry Outpatient Department of a Tertiary Care Teaching Hospital.

To study the pattern of adverse drug reactions (ADR) in patients attending psychiatry OPD of a tertiary care teaching hospital. Patients attending psychiatry OPD with ADRs due to drugs prescribed for various psychiatric illnesses over a period of 1year were included in the study. Adverse event history, medication history and other relevant details were entered in the PvPI format. Causality was assessed by WHOUMC criteria. A total of 103 ADRs were reported from 85 prescriptions with a female preponderance. Majority of ADRs (45.7%) were seen with antidepressants as they were the commonly prescribed drugs followed by antipsychotics (33.3%) and others by sedative hypnotics and anticonvulsants. ADRs like somnolence topped the list (21.9%) followed by weight gain (18.4%), akathesia (6.8%) and drug induced restless legs syndrome (RLS) (5.8%). The reported ADRs were assessed for causality and maximum (80.6%) belong to the "possible" category. Maximum ADRs were seen with antidepressants followed by antipsychotics. Sedation and weight gain were the most commonly occurring ADRs.

Attenuation of quorum sensing controlled virulence of Pseudomonas aeruginosa by cranberry.

Background & objectives: Emergence of antimicrobial resistance in Pseudomonas aeruginosa has led to the search for alternative agents for infections control. Natural products have been a good alternative to present antibiotics. The present study was undertaken to evaluate the effectiveness of cranberry in attenuation of virulence of P. aeruginosa in experimental urinary tract infection (UTI) in mouse model. Efforts were also directed to explore the action of cranberry towards virulence of P. aeruginosa through quorum sensing (QS) inhibition. Methods: Efficacy of cranberry was evaluated in an experimental UTI mouse model and on production of QS signals, alginate, pyochelin, haemolysin, phospholipase-C, cell-surface hydrophobicity, uroepithelial cell-adhesion assay and biofilm formation by already standardized methods. Results: Presence of cranberry showed significant decline in the production of QS signals, biofilm formation and virulence factors of P. aeruginosa in vitro (P<0.001). Further, cranberry was found to be useful in prevention of experimental UTI in mouse model as indicated by reduced renal bacterial colonization and kidney tissues destruction. Interpretation & conclusions: The findings of the present study indicated that cranberry inhibited QS and hence elaboration of virulence factors of P. aeruginosa. It also affected the adherence ability of this pathogen. This approach can lead to the discovery of new category of safe anti-bacterial drugs from dietary sources such as cranberry with reduced toxicity without the risk of antibiotic resistance.

Idiopathic central sleep apnoea an Indian case with polysomnographic findings.

Patients with idiopathic central sleep apnoea (ICSA) usually complain of poor quality sleep; yet many of them do not receive appropriate treatment because of poor recognition of ICSA by health professionals. We report the case of a patient with ICSA who was misdiagnosed and received treatment for seizures, depression or anxiety for a number of years and discuss the differential diagnosis and treatment options for ICSA.

Displaced Tibial Plateau Fractures: Is There A Role Of Conservative Treatment In The Present Scenario.

This retrospective case series includes 92 closed tibial plateau fractures treated by operative (66 patients) and conservative (26 patients) methods at our institution.The means and mean differences of grades of the objective variables of extensor lag and range of motion and articular step were better in the surgically treated patients (p value <0.05), while those of axial alignment and side to side instability did not show any statistical significance. An average articular step of more than 1.6 mm significantly deteriorated the functional outcome.Achieving articular congruity is the most important factor for the successful outcome of tibial plateau fractures. Operative treatment in the presence of adequate expertise and infrastructure gives satisfactory results. Type V and VI fractures are highly unstable fractures and need to be treated by more stable fixation in the form of dual plating and/or locked compression plating. The variables like extensor lag, range of motion and radiological articular step directly correlate with the functional outcome of tibial plateau fractures. The conservative treatment should only be accepted as last option in case of displaced tibial plateau fractures.

Evaluation of Neurophysiological Parameters: Autonomic Status and Acute Pain Perception in Migraneurs.

Introduction: Painful conditions are associated with autonomic dysfunction and altered pain perception. However, data regarding autonomic status in migraineurs is not conclusive and there are few studies regarding acute pain perception in these cases. Aims: This study was conducted to assess various neurophysiological parameters namely autonomic functions using the autonomic function tests and acute pain perception using the cold pressor test in migraneurs. Material and methods: 60 migraineurs and 30 age and gender matched control subjects were included in this study after screening for the exclusion criteria and following a written consent. Diagnosis of migraine was made according to the International Classification of Headache Disorders(ICHD) – 2 Criteria. In the pain free state of the subjects, autonomic function tests including basal heart rate variability, E:I ratio, 30:15 ratio, postural challenge test and sustained handgrip test were carried out together with the cold pressor test. Unpaired t-test was used for analysing the data. Result: Migraineurs showed a trend towards increased parasympathetic tone, as compared to the control subjects, though the p-values were not significant. The pain threshold was lower while the pain tolerance was significantly lower in migraineurs as compared to controls (p= 0.00).Conclusion: In our study we observed an increased vagal tone together with lower values of pain threshold and pain tolerance in migraineurs, indicating that certain neurophysiological parameters are affected in painful conditions like migraine.

Recurrent headache in indian adolescents.

Objective. To analyze the epidemiology and characteristics of primary recurrent headaches in Indian adolescents. Methods. This cross sectional study was conducted in three urban public schools. Adolescents of 9th to 12th grades were included and they were given a questionnaire in their classrooms in the presence of at least one of the authors, who assisted them in filling it. They were asked to provide responses based on most severe recurrent headache they had experienced rather than the more frequent one. Diagnosis was based upon the information contained in questionnaire, however, where it was inadequate, those subjects were approached telephonically. Statistical analysis was done with the help of SPSS v. 11.0. Descriptive analysis, Chi-Square test, Fisher’s Exact test, and independent sample‘t’ test were run. Results. We studied 2235 adolescents (boys: girls 1.6:1). 57.5% adolescents reported recurrent headaches in past one year. Migraine was the most prevalent (17.2%) headache followed by unspecified (14.9%) and tension type headache (11%). Family history of headache was more common in adolescents with headache (p < 0.001) compared to those without headache. Average age of headache onset was 11.33 yr (10.72 yr in girls vs. 11.75 years in boys; p < 0.001). 37.1% adolescents complained of progression of headache since its onset. A significantly higher proportion of girls suffered headache (p=0.018), particularly migraine, than boys. However, other characteristics of headache were not dependent upon gender. Headache was more prevalent in higher grades. Conclusion. Primary recurrent headaches are prevalent in Indian adolescents and migraine is comparatively the most prevalent type of headache. Female gender and increasing age is associated with higher chances to have headache, particularly migraine. It progresses in approximately one third of sufferers and aura increases the chances of worsening of headache.

Sleep patterns of urban school-going adolescents.

OBJECTIVE: To analyze the variance in sleep habits of adolescents of different high school Grades in urban India. DESIGN: Cross-sectional questionnaire-based study. SETTING: Community based school survey in an urban setting. SUBJECTS: School going adolescents from 9th to 12th Grades. METHODS: A total of 1,920 adolescents aged 12-18 years were included. The questionnaire contained questions related to sleep habits. Each question was explained to the participants and their responses were noted. Outcome parameters were total sleep time in a day, time to go to bed and wake up-time, sleep latency, nocturnal awakenings (duration, frequency per night and nights per week), wake-time after sleep onset, wake time after sleep offset, sleep efficiency, quality of sleep, daytime napping (duration and frequency), and sleepiness during the day. RESULTS: Mean age of the adolescents included in this study was 15.1 years and mean total sleep time was 7.8 hr/day. Adolescents of higher Grades had lesser total sleep time (9th=8 hours; 10th=7.7 hours; 11th=7.9 hours; 12th=7.6 hours; P=0.001), and more frequent nocturnal awakenings (9th=35.9%; 10th=44.7%; 11th=40.3%; 12th=28.3%; P=0.001). Daytime leg pain ( 9th=14.4%; 10th=18.4%; 11th=6.1%; 12th= 21.8%; P=0.01), daytime napping (9th=47.6%; 10th=50.4%; 11th=61.8%; 12th=69.8%; P=0.001), and daytime sleepiness (9th=37.2%; 10th=39.1%; 11th=39.7%; 12th=54.2%; P=0.001) increased progressively among higher Grades. Adolescents in higher Grades were more prone to not follow their weekly schedule on week-ends (P= 0.001). Sleep debt of approximately one hour per day was seen in all adolescents, and progressed with higher Grades. CONCLUSION: Adolescents of higher Grades had lesser sleep time, and frequent awakenings; suffered daytime leg pain, and felt sleepy during the day. These factors suggest increasing sleep deprivation among higher Graders.