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ABSTRACT Objective: The present study was conducted to investigate the effects of leukocyte-platelet-rich fibrin (L-PRF) on the rate of maxillary canine retraction for a period of 5 months. Methods: A split-mouth study was conducted on 16 subjects (9 males and 7 females; age range 17-25 years; mean age, 21.85±2.45 years) who required therapeutic extraction of bilateral maxillary first premolars. After the initial leveling and alignment, L-PRF plugs were placed in a randomly selected extraction socket (Experimental Group), and the other side served as a control (Control Group). Canine retraction was carried out by the activation of nickel-titanium (NiTi) closed-coil springs delivering 150 g of force. The rates of canine movement, canine rotation, tipping, root resorption, and molar movement were assessed at monthly intervals for five months (T0-T5). Pain, swelling and discomfort accompanying the procedure were assessed using a Likert scale. Results: The study revealed a significant increase in the rate of canine movement on the experimental side in the first two months, and significant molar anchorage loss was observed only in the first month for control side. There were no statistically significant differences between the groups regarding canine rotation, tipping, probing depth, root resorption, and pain perception. Conclusions: The use of L-PRF plugs in extraction sockets considerably enhanced the rate of canine movement only in the first two months, and long-term efficacy was not observed in this study.
RESUMO Objetivo: O presente estudo foi realizado para investigar os efeitos da fibrina rica em leucócitos e plaquetas (L-PRF) na taxa de retração do canino superior, durante um período de cinco meses. Métodos: Um estudo de boca dividida foi realizado em 16 indivíduos (9 homens e 7 mulheres; faixa etária de 17 a 25 anos; idade média de 21,85 ± 2,45 anos) que precisavam de extração terapêutica dos primeiros pré-molares superiores de ambos os lados. Após o nivelamento e o alinhamento iniciais, os plugs de L-PRF foram colocados em um alvéolo pós-extração, selecionado aleatoriamente (Grupo Experimental), e o outro lado serviu como controle (Grupo Controle). A retração do canino foi realizada pela ativação de molas fechadas de níquel-titânio (NiTi) com 150 g de força. As taxas de movimentação do canino, rotação, inclinação e reabsorção radicular do canino e movimentação do molar foram avaliadas em intervalos mensais durante cinco meses (T0-T5). A dor, o inchaço e o desconforto após o procedimento foram avaliados por meio de uma escala de Likert. Resultados: O estudo revelou um aumento significativo na taxa de movimentação do canino no lado experimental nos dois primeiros meses, e uma perda significativa de ancoragem do molar foi observada apenas no primeiro mês no lado controle. Não houve diferenças estatisticamente significativas entre os grupos, com relação à percepção da dor e rotação, inclinação, profundidade de sondagem e reabsorção radicular do canino. Conclusões: O uso de plugs de L-PRF em alvéolos pós-extração aumentou consideravelmente a taxa de movimentação do canino apenas nos dois primeiros meses, não sendo observada uma eficácia em longo prazo.
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Background: The biceps brachii is an important muscle of anterior compartment of arm. It shows frequent anatomic variability due to presence of supernumerary heads. Knowledge of the existence of the third head of biceps brachii is important for surgeons. Keeping this in mind a study was planned to see the incidence of additional head of biceps brachii in sample Indian population and to compare it with other racial groups.Methods: The study was carried out on 30 cadaveric upper limbs. The upper limbs were dissected and studied for the presence of additional head of biceps brachii. The attachment and nerve supply of the additional head was carefully observed, recorded and documented.Results: Out of 30 limbs which were dissected, additional head of biceps brachii was found only in two limbs. In both the cases the additional head was present only on the right side and arose from the anterior surface of humerus, superomedial to the origin of brachialis. The additional head fused with the common bulk of the muscle and was inserted into the radial tuberosity and bicipital aponeurosis. The extra heads of biceps brachii muscle received branches from musculocutaneous nerve.Conclusions: Biceps brachii is one of the commonest muscles showing variations. The additional head is not only of academic importance, but its knowledge also helps clinicians in managing fractures of humerus and nerve entrapment.
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Background: Proprioceptive Neuromuscular Facilitation (PNF) A wide range of treatment techniques and approaches from different philosophical backgrounds are utilized in Neurological Rehabilitation The aim of this study is to evaluate the effectiveness of proprioceptive neuromuscular facilitation technique and conventional therapy in treating the patients with Cervical Spondylosis by improving the pain and range of motion of neck. Subjects and methods: 40 cervical Spondylosis patients of both the sexes selected on the basis of inclusion and exclusion criteria were included in the study and randomly divided into two groups A and B each of 20 persons. Group A consisting of 10 males and 10 females received PNF (Hold –relax and Contract relax) exercise for 4 weeks, 5 days/ week once in a day and Group B consisting of 11males and 9 females received conventional therapy for 4 weeks, 5 days/ week once in a day. Variables are measured pre intervention and post intervention after 4 weeks. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used, Range of motion is measured. Result: Group A shows more significant improvement in all variables (Pain, ROM) in cervical spondylosis subjects than Group B. Conclusion: Analysis of the results confirmed that both PNF and conventional therapy had a statistically significant impact on reducing pain and improving the range of motion of neck in subjects suffering from spondylosis, but PNF method proved to be more effective than conventional therapy and McGill score of PNF applied group were more significant.
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Background: Anatomy provides a platform of knowledge indispensable to all the branches of medicine. Students have to learn many new concepts and tongue-twisting terminologies, making this subject difficult to comprehend. It has been seen that a range of innovative, proactive, simple, hands-on approach strategies can achieve maximum student engagement and help them learn. Aim is to take students from the traditional view of anatomy as a subject that require surface learning (rote learning, memorization) to one that can lead to deep learning through understanding. Keeping all this in mind a study was planned to develop an innovative method of teaching anatomy to 1st year MBBS students.Methods: The diagrams of sagittal and horizontal sections of the brain were selected, marked and cut into jigsaw pieces. Students were given an incomplete jigsaw puzzle and a set of questions. The answer to these questions helped them complete the puzzle. Perception of students who consented to participate in the study was noted.Results: Out of 98 students who participated in the study 61.2% wanted to participate in similar activities in future in anatomy and 57.1% felt that it helped them in understanding the topic. For 52.1% it was a useful self-learning tool and for another 48.9% students solving the puzzle was a challenging experience.Conclusions: Jigsaw puzzle is an efficient way for students to become engaged in their learning. It maximizes interaction and establishes an atmosphere of co-operation and respect for other students and improves learning.
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Background: Inappropriate self-medication is a cause of concern as it can result in wasteful expenditure, prolonged suffering, drug dependence, resistance and increase in morbidity. Self medication assumes significance among medical students as they have knowledge about ailments and medicines. The aim of the study was to assess the knowledge, attitude and practice of self-medication among undergraduate medical students.Methods: The present study was conducted in December 2017 among second professional undergraduate medical students in the Department of Pharmacology and Therapeutics, GMC Jammu after obtaining approval from the Institutional Ethics Committee of GMC, Jammu. A total of 123 students who took self-medication during last six months were included and given a questionnaire that included open and close ended questions about self-medication. Data was analysed using Microsoft Excel and presented as number and percentages.Results: Total of 123 second professional undergraduate MBBS students were analysed. 72 (58.53%) were males and 51 (41.46%) were females. 96 (78%) students practised self-medication. Allopathic drugs were most commonly used for self medication (93.5%), followed by Ayurvedic drugs. Fever and headache were common ailments treated with self medication. Common class of drugs used for self medication were antipyretics (66.6%), antibiotics (42.2%). Adverse drug reactions were perceived as the most common disadvantage of self medication. Analysis of source of information revealed that old prescriptions (33%), internet (18%) were the main sources of information. Regarding prevention of self medication, many students perceived that enhancing awareness was the most effective solution (72.3%) followed by stoppage of supply of medicines without prescription(39.8%).Conclusions: Self medication is practised by a majority of students. As responsible self medication is now increasingly being considered as a component of self-care, there is need for review of educational programs especially teaching of rational and judicious use of medicines to the undergraduate medical students.
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Background: Histopathology is the gold standard of diagnosiswith a limited role of Immunohistochemistry. The present studywas Conducted to study the Eccrine skin Adnexal tumors withreference to their Anatomical location, age, sex of theindividuals affected to determine their incidence and correlatethem with other simulating studies.Material & Method: A total of 106 specimens of skin Adnexaltumors were received in the department of pathology fromdepartment of Dermatology, surgery and other specialties fromJune 2002 to May 2012. Histopathological Examination wasdone on routine Hematoxylin and Eosin stained tissuesections. Special stains like PAS and recticulin was donewhere required.Results: There were 21 males and 25 female patientsconstituting a ratio of 0.84 :1. The age range of these tumorswas 31-40 years with a mean age range of 43.73 years. In thepresent study 46/106 (43.39%) cases of SAT’s were of eccrinedifferentiation. Eccrine Acrospiroma was the most CommonBenign Skin adnexal tumor of Eccrine differentiationconstituting 25 out of 46 cases (54.34%) and Eccrine poromawas the least common benign Eccrine SAT. Out of 6 cases ofMalignant Eccrine skin Adnexal tumors 3/46 were of malignanteccrine acrospiroma and eccrine ductal carcinomarespectively.Conclusion: We concluded that the pattern and biologicalbehaviour of the tumors cannot be determined until thebiopsies are submitted for HPE so histopathology is mandatoryfor diagnosis SAT and to know their potential biologicalbehaviour for further management.
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Background: The management of PROM has often been adilemma in obstetrics. This study is aimed to assess the safetyand efficacy of misoprostol administered vaginally for inductionof labour in patient with PROM with poor Bishop’s Score.Materials & Methods: A randomised observational study doneon 90 Patients of PROM admitted in labour room of MahilaChikitsalaya, SMS Medical College, Jaipur as per inclusion andexclusion criteria. Augmentation with oxytocin was done inpatients with favourable bishop score (>5) with mild uterinecontraction or patients with poor bishops score (<5) even after3 doses of misoprostol. If leaking of more than 24 hours andunfavourable cervix (bishop <5) or any evidence of foetaldistress then further management was at the discretion ofattending obstetrician.Results: Our study showed that the mean induction deliveryinterval was 7.67±4.86hours & 78 patients (86.7%) deliveredwithin 12 hours after induction in patient of PROM. Apgar scoreof new born babies at 1 min in majority was 8 – 10 min.(81.1%) and at 5 min in majority was 8-10 (98.9%).Conclusion: Misoprostol maximum of 75µg is an effectivemethod of improving the inducibility score and induction oflabour in properly selected cases. Misoprostol in above dosesis without any untoward effect on maternal and foetal outcomeand hence, safe.
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Background: Obesity is associated with an increased risk of atherosclerosis, which can be mediated by an increase in angiogenesis and inflammation. The objective of the present study was to explore the relationship between BMI and levels of VEGF, a circulating biomarker of angiogenesis.Methods: 225 healthy volunteers in the age group of >18 years formed the subjects of the study. Individuals with any acute or chronic illness including history of HT, DM, and smoking, alcohol or drug abuse or on any long term medication were excluded from the study. Anthropometric measurements were taken, and BMI calculated. Blood samples were taken, and serum levels of VEGF were estimated using commercially available ELISA kits. Student’s ‘t’ test was done for comparison and correlation was assessed using Pearson’s method.Results: A statistically significant difference in the levels of VEGF was found in subjects with BMI < 25 kg/m2 as compared to subjects with BMI > 25 kg/m2 (p<0.001). A significant positive correlation was found between the levels of VEGF and BMI in both males and female subjects of the study group (r=0.68 and 0.73 respectively).Conclusions: The positive correlation of levels of VEGF with BMI in the healthy subjects of the study group may be related to the expansion of adipose tissue and to the concomitant formation of new vessels to support tissue deposition. These factors may predispose an individual to an increased risk of atherosclerotic damage later in life. VEGF may therefore, have a potential as a biomarker for the prediction of cardiovascular risk and estimation may allow intervening with lifestyle modifications and nutritional changes before the disease is manifested and pharmacotherapy is required.
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Background: Laparoscopic surgery has now become an accepted method of minimal invasion of human anatomy but the dreaded problem of port site complications especially the chronic sinuses has rejuvenated the proponents of open techniques. The scope of laparoscopy widened from diagnostic purposes to resecting large tumors in almost all the systems of the body. As the time progressed, the problems associated with use of long instruments and dexterity of movements started creeping in. The vision, which was analogue, to start with, became 3D digital and with the introduction of robotic arm, the problem of dexterity was addressed to some extent. One thing that persisted right through so much of technical development was the problem of infection and sinuses and the enormity of this issue can be gauged by its evergrowing number. Methods: Although minimal invasive surgery is here to stay for all intent and purposes, we have decided to study 50 cases of chronic port site sinuses treated and followed up for 5 years in various wards of department of surgery in Guru Nanak Dev Hospital, Amritsar. In this study the authors present their experience and rationale regarding various factors like age and sex distribution, site of infection, results of microscopy and culture/sensitivity, treatment given (both surgical and non surgical), response time and prognosis. Results: In the cases where there was discharge culture of the pus yielded skin and soft tissue infections like staphylococcus, streptococcus, pseudomonas, E. coli and klebsiella. Out of 50, 20 cases were treated by appropriate antibiotics after culture sensitivity and quinolones.Conclusion: From the above discussion and flow chart, it can be safely concluded that atypical mycobacteria and some of the anaerobes remain the main offending agents.
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Pyrazinamide is one of the first line drugs used for the treatment of tuberculosis. Hepatotoxicity and hyperuricaemia are important and common untoward effects seen after administration of pyrazinamide. The drug inhibits elimination of urates resulting in hyperuricaemia, the presenting features of which are arthralgia, arthritis or even gout. A-case of bilateral leg cramps due to hyperuricaemia following pyrazinamide therapy is reported here.
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Adult , Antitubercular Agents/adverse effects , Humans , Hyperuricemia/chemically induced , Male , Muscle Cramp/chemically induced , Pyrazinamide/adverse effectsABSTRACT
Radiation is a well established therapeutic modality for the treatment of solid tumors. By merging molecular biological approaches with radiation biology, a significant number of signaling events elicited by ionizing radiation have been delineated. These signaling pathways include events leading to cell cycle arrest, apoptosis or cell survival. There are two major signaling events that affect radiation response. One is the intrinsic/constitutive pro-survival signaling event that is present in proliferating tumor cells while the other is "induced pro-survival event" in response to radiation, both of these events confer resistance to the killing effects of radiation. In this review, signaling pathways that lead to either apoptosis or survival of cells following ionizing radiation are discussed in detail. In addition, mechanisms of action for gene/drug based inhibitors that modulate the expression and function of various genes and gene products involved in pro-survival signaling pathways are described. Further, novel strategies to abrogate the "induced radiation resistance" leading to enhanced therapeutic efficacy of ionizing radiation have been proposed. These novel strategies include the use of radio-gene therapy, low dose fractionated radiation therapy as a chemopotentiator and therapeutic utility of high radiation dose induced bystander effect. The complete understanding of the molecular pathways leading to apoptosis/survival of cells following ionizing radiation will help in tailoring more effective novel strategies and treatment modalities for complete eradication of cancer.
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Animals , Apoptosis/genetics , Humans , Models, Biological , Neoplasms/genetics , Signal Transduction/geneticsABSTRACT
The present study was conducted to assess and compare the cognitive and psychomotor effects of fexofenadine, a newer second generation antihistamine with cetirizine, diphenhydramine and placebo in 10 healthy adult volunteers in a double blind, randomized cross over study. Following single dose of each drug, the volunteers were subjected to perform a series of tests of cognitive and psychomotor performance at 1, 3 and 6 hours post dose. The test battery consisted of both subjective and objective tests which were further grouped into instrumental and non-instrumental. Instrumental tests included – Simple reaction time (SRT), Multiple Choice ReactionTime Task (MCRT) and Critical Flicker Fusion frequency threshold (CFFT). The tests used in the non instrumental group were- Stanford Sleepiness Scale (SSS), Digit Cancellation Task (DCT), Digit Symbol Substitution Task (DSST) and mental arithmetic tests. Fexofenadine at doses of 120 mg was not significantly different from placebo in any of the tests used. However, as expected for a verum, all the measures were significantly disrupted by diphenhydramine 25 mg upto 6 hours post dose. Cetirizine 10 mg has produced significant subjective somnolence at 3 & 6 hours post dose but without any impairment of objective tests. These results allow the conclusion that fexofenadine at its recommended therapeutic dose of 120 mg is free from impairment effects on aspects of psychomotor function and hence can be used safely. Cetirizine is mildly sedating though it did not impair any of the objective psychometric tests.
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Photodynamic therapy (PDT) using a photosensitizer, such as haematoporphyrin derivative (HpD), in conjunction with visible light is a promising new modality to treat localized cancer. Cell death caused by PDT (through the generation of reactive oxygen species) can occur either by apoptosis (interphase death or as a secondary event following mitosis) and/or necrosis depending on the cell type, concentration and intracellular localization of the sensitizer, and the light dose. Since, apoptosis induced by PDT treatment plays an important role in determining the photodynamic efficacy, in the present work we have investigated the role of apoptotic cell death in relation to the observed differences in sensitivity to HpD-PDT between a human glioma cell line (BMG-1) carrying wild-type tumour suppressor gene p53 and a human squamous carcinoma cell line (4451) with mutated p53. HpD (photosan-3; PS-3) -PDT induced apoptosis was studied by: [A] flow-cytometric analysis of DNA content (sub G0/G1 population); [B] phosphatidylserine externalization (Annexin-V +ve cells); [C] cell size and cytoskeleton reorganization (light-scatter analysis); and [D] fluorescence microscopy (morphological features). PS-3-PDT induced a significantly higher level of apoptosis in BMG-1 cells as compared to 4451 cells. This was dependent on the concentration of PS-3 as well as post-irradiation time in both the cell lines. At 2.5 microg/ml of PS-3 the fraction of BMG-1 cells undergoing apoptosis (60%) was nearly 6 folds higher than 4451 cells (10%). In BMG-1 cells the induction of apoptosis increased with PS-3 concentration up to 5 microg/ml (>80%). However, a decrease was observed at a concentration of 10 microg/ml, possibly due to a shift in the mode of cell death from apoptosis to necrosis. In 4451 cells, on the other hand, the increase in apoptosis could be observed even up to 10 microg/ml of PS-3 (60%). Present results show that the higher sensitivity to PS-3-PDT in glioma cells arise on account of a higher level of apoptosis and suggest that induction of apoptosis is an important determinant of photodynamic sensitivity in certain cell types.
Subject(s)
Apoptosis , Cell Line, Tumor , Humans , Phosphatidylserines/metabolism , PhotochemotherapyABSTRACT
We report a case of penicillium keratitis in vernal shield ulcer in the absence of corticosteroid use. This report illustrates super-added infection in vernal shield ulcer by an organism which is otherwise innocuous and forms a part of the normal ocular flora.