Risk factors and prevalence of cervical squamous intraepithelial lesions among women in South India: A community?based cross?sectional study

Background: Cervical cancer in India accounts for one-fifth of the global burden. Well-defined precancerous stages help early detection of the disease. Apart from human papillomavirus, the risk factors include age, education, occupation, early age at marriage and first delivery, abortions, and multiple sexual partners. Prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among women by Pap smear screening in south India were analyzed through a cross-sectional study. Methods: Women from rural and urban area were motivated by local accredited social health activists to attend pre-fixed Pap smear clinics in government hospitals. Pap smears collected in these clinics were taken to the Regional Cancer Centre, Thiruvananthapuram, processed, and cytology reports were prepared. Multiple logistic regression analysis was used to identify risk factors for SIL and high-grade SIL (HSIL). Results: The number of SIL was 67 out of 10,580 and HSIL was 39. Having higher education (Odds Ratio, OR:0.05(95% Confidence Interval, CI: 0.01-0.2), being married but living single (OR : 5.3, 95%CI:2.4-11.5), Having >2 abortions (OR:21, 95% CI:4.5-24), having younger age at delivery (OR : 0.1, 95% CI:0.01-0.3) and having unhealthy cervix (OR: 16.4, 95% CI:6.2-42.7) were the factors found to be the associated risk factors in multiple regression analysis. Conclusion: Pap smear screening can be focused on women with risk factors such as low education, married but living single, having >2 abortions, younger age at delivery, and unhealthy cervix on per speculum examination.

Assessment of nutritional status of children aged 34-92 months using various nutritional status indices and validity of age independent indices

Background: Even though there are many programs run by Government to tackle the problem of malnutrition in India, problem of malnutrition is still there. Malnutrition leads to infections and even can lead to death of child in severe cases. The mortality rate is very high compared to other countries. The objective of the study to study validity of age independent various nutritional status indices in comparison to gold standard of weight for ageMethods: Present study was institution based cross sectional study carried out at SDA high school, from January 2019 to July 2019 among 58 school children aged 34-92 months of age. Anthropometric measurements like weight, height, head circumference, chest circumference, mid arm circumference were recorded as per the standard guidelines. Weight for height, weight of age, Kanawati Index, Jeliffe's ratio, Rao index, and Dugdales index was calculated. Gold standard used was weight for age. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for these indices.Results: Majority of the children belonged to 48-60 months and 61-72 months i.e. 29.3% each. Males were more than females. Prevalence of malnutrition was 60.3%, 48.3%, 51.7%, 91.4%, and 56.8% based on weight for age, Kanawati index, Rao index, Jeliffe's ratio and Dugdale's index respectively. Dugdale's index was found to have high sensitivity (85.7%) and specificity (86.9%) compared to all other indices.Conclusions: Among age independent indices of nutritional status available, Dugdales index can be used as it has been found that it has remarkably higher sensitivity and specificity compared to other age independent indices of nutritional status.

Study of common aeroallergens in children with wheeze: a hospital based cross sectional study

Background: Prevention of diseases of the allergic origin depends upon the early identification of aeroallergens. Vaccine for allergy may not be required in all cases. but when treatment is not successful, then there is requirement of the vaccine. Objective of study allergens responsible for inducing recurrent wheezingMethods: A cross sectional observation study was carried out at Departmetn of Pediatric, Shadan Institue of Medical Sciences, Peerancheru, Hyderabad, Telangana, India from June 2017 to June 2018 among 100 children with recurrent (4 or more episodes of wheezing in past one year) ages between 2 yrs to 10 yrs. Using the guidelines for skin prick test as per the European committee, the skin prick test was carried out. Insulin syringe was used for the intradermal test. It is done using standardized allergen extracts (Creative Diagnostic Medicare pvt ltd) were done for our cases.Results: Out of 100 children studied, 67 children were found to be sensitive to at least one of the aeroallergen and 33 children were found to be negative for all the aeroallergens. A statistically significant correlation is seen between the age groups and sensitivity (p value 0.025). Out of 67 children with a positive skin prick test, 66 children showed the sensitivity to indoor allergens. The association between the indoor allergens and the wheezing is statistically significant (P value <0.0001)Conclusion: In children the sensitivity to indoor allergens is more prevalent than sensitivity to outdoor allergens. Sensitivity to pollen was found in older children more than 5 years of age.

Stethoscopes: a potential source of hospital acquired infection

Background: Nosocomial infection has been recognized for over a century as both a critical problem affecting the quality of health care and a leading cause of morbidity, mortality and increased health care cost. Stethoscopes because of their universal use by medical professional, can be a potential source of nosocomial infections. The study was conducted to determine the bacterial contamination of stethoscopes used by health care staff as well as the practices used for cleaning them.Methods: A structured questionnaire was administered to health workers and the surface of the diaphragm of their stethoscopes swabbed for bacteriological analysis using standard techniques.Results: Of the 65 stethoscopes sampled, 33(50.8%) showed bacterial growth. All the bacterial isolates were found to be gram positive organism. The isolates were Micrococcus spp. (35.8%), Coagulase negative staphylococcus (CONS) (30.8%), Bacillus spp. (15.4%), Staphylococcus aureus (10.3%) and Diphtheroids (7.7%).Conclusions: Further research is needed to solve the question whether stethoscope contamination actually results in infection in the patient. However strict adherence to disinfection practices by health workers can minimize cross-contamination and ensure patient safety in hospital environments.

Prevalence of obesity among adults in Ras Al Khaimah, United Arab Emirates

Background: There is an increasing prevalence of obesity globally which is associated with Non Communicable Diseases. As this trend continues even in UAE we decided to focus on determining the prevalence of obesity among adults in Ras Al Khaimah (RAK), UAE.Methods: This was a retrospective observational study done in adults between the age group of 18 to 77 years using convenience sampling technique in 544 subjects. Anthropometric, bio chemical, clinical and demographic data was collected by direct interview for four consecutive years, i.e. from 2013 to 2016. Body Mass Index (BMI) was analyzed to classify individuals as overweight (BMI 25.0-29.9kg/m²), Obese grade I (BMI 30.0-34.9kg/m²), Obese grade II (BMI 35.0-39.9kg/m²) and obese grade III (BMI > 40.0kg/m²).Results: Data was obtained from 544 subjects and considered for analysis. Our results showed that the mean age of the study population was 39.29±13.43 years, the mean weight was 75.35±15.65 kilograms and the mean BMI was 27.62±5.43kg/m2. A total of 67.6% of the study population was either overweight or obese. The prevalence of overweight is 36.2% followed by obesity prevalence of 31.4% of which 22.8% were categorized as Grade I obese, 5.5% Grade II obese and 3.1% Grade III obese. We found that higher proportions of males were in overweight and obese category compared to females.Conclusions: The results derived from our study shows that obesity and overweight are widespread among Ras al khaimah population with the obesity prevalence of 31.4%. Hence, policy makers should focus on preparing national nutritional strategies and implement protocols to overcome this burden by giving practical solutions.

Microbiological analysis of packaged drinking water sold in Chennai.

Background: Adequate supply of fresh and clean drinking water is a basic need for all human beings. In terms of public and environmental health, it is essential that water sources be free of pathogenic bacteria and safe to drink. Continuous increase in the sale and indiscriminate consumption of packaged drinking water is of public health significance. In order to safeguard public health it is essential that the available packaged water is of the highest quality. Aims & Objective: The current study was designed to assess the microbial quality of sachet and bottled drinking water sold in retail outlets in Chennai. Materials and Methods: In the present study, fifty one samples including 36 sachet and 15 bottled drinking water samples were analyzed for the presence of bacterial indicators of water quality. Total and faecal coliform count, total viable plate count and culture were performed to determine the identities of the isolates. Results: Of the 36 sachet water samples analysed, 33.3% failed to meet the WHO drinking water standard of zero coliform per 100 ml making them unsuitable for human consumption whereas all the 15 bottled water samples are of better quality. Faecal coliforms were not isolated from any of the sachet or bottled drinking water. The bacteria that were isolated from water samples included Klebsiella pneumonia, Enterobacter aerogenes, Citrobacter freundii, Pseudomonas spp., Acinetobacter spp., Staphylococcus aureus, Coagulase negative Staphylococci, Micrococcus spp. and Bacillus spp. Conclusion: The bottled water samples analyzed are of better microbiological quality when compared to that of the local brands of sachet water samples. The findings therefore suggests that these sachet water are not fit for human consumption and are hazardous to health. Hence there is a need for strict and routine monitoring of the packaged drinking water with the view of raising their standards.

Keratoconjunctivitis caused by an unusual retained conjunctival foreign body: A frequently unrecognized entity.

Purpose: The purpose of this study is to describe a case series of keratoconjunctivitis caused by a retained bindi (dot) in six children who presented to a tertiary eye care facility in Southern India. Patients and Methods: Over a period of 11 years (January 2000 and January 2012), six children (all female, ranging in age from 6 months to 3 years) were diagnosed with ocular manifestations subsequent to a retained bindi. Results: All patients presented with redness, photophobia, extensive lacrimation, and blepharospasm. Two patients presented with mucopurulent conjunctivitis, three patients with suppurative keratitis and one patient presented with corneal epithelial defect. After removal of the foreign body the response to topical antibiotics was good in fi ve of six cases, whereas one patient required therapeutic keratoplasty. Conclusions: Young children presenting with unilateral keratitis and conjunctivitis should alert the clinician to the possibility of a retained foreign body in the eye.

“Platform switching”: Serendipity.

Implant dentistry is the latest developing field in terms of clinical techniques, research, material science and oral rehabilitation. Extensive work is being done to improve the designing of implants in order to achieve better esthetics and function. The main drawback with respect to implant restoration is achieving good osseointegration along with satisfactory stress distribution, which in turn will improve the prognosis of implant prosthesis by reducing the crestal bone loss. Many concepts have been developed with reference to surface coating of implants, surgical techniques for implant placement, immediate and delayed loading, platform switching concept, etc. This article has made an attempt to review the concept of platform switching was in fact revealed accidentally due to the nonavailability of the abutment appropriate to the size of the implant placed. A few aspect of platform switching, an upcoming idea to reduce crestal bone loss have been covered. The various methods used for locating and preparing the data were done through textbooks, Google search and related articles.

Alternative anterior esthetics: A case report.

Due to the rise over the years in patient emphasis on better esthetic outcomes, veneering the metal base of a restoration with composite resin or porcelain is widely used in dentistry. For the preservation of the opposing natural dentition and the potential for repair, the use of composite veneering materials has been suggested because of their resilience, low abrasive properties, and superior repair potential. Composites are not as popular as porcelain, but they are still widely used to cover metal because of low cost and because the laboratorial procedures are faster and simpler.

GC-MS analysis of bioactive constituents of rauwolfia densiflora (Wall) benth. ex HK.f.

Rauwolfia densiflora (Wall) Benth. ex HK.f known to the Kanikkars as “Paarisirunila” is one of the medicinally important plants belonging to the family Apocynaceae. Kanikkar tribes, inhabitants of Agasthiarmalai Biosphere Reserve, Western Ghats, Tamil Nadu, India use the paste prepared from the fresh leaves and flowers to treat rheumatic complaints. This study was carried out to analyse the active constituents present in the whole plant of said plant. Seven compounds were identified in the ethanol extract of Rauwolfia densiflora by Gas Chromatography - Mass Spectrometry (GC-MS) analysis.

Dimensional accuracy and detail reproduction of two hydrophilic vinyl polysiloxane impression materials tested under different conditions.

Background and Objectives: A limitation of vinyl polysiloxane (VPS) impression materials is hydrophobicity, and manufacturers have added surfactants and labeled these new products as "hydrophilic." The purpose of this investigation was to evaluate and compare the dimensional accuracy and surface detail reproduction of two hydrophilic VPS impression materials under dry, moist, and wet conditions. Materials and Methods: Ten impressions were made under dry, moist, and wet conditions respectively, with monophase, and regular body VPS impression material using a stainless steel metal die similar to that described in American Dental Association (ADA) specification 19, with lines scribed on it. Dimensional accuracy was measured by comparing the average length of the middle horizontal line in each impression to the same line on the metal die, by using a measuring microscope. The surface detail was evaluated. A one-way analysis of variance and Student t-test were used to compare mean dimensional changes (α = 0.05). Results: Conditions (dry, moist, and wet) did not cause significant adverse effects on the dimensional accuracy of either material. The mean dimensional changes were 0.00084% (+0.00041%) for monophase and 0.00119% (+0.00033%) for regular body. Monophase material was satisfactory in detail reproduction 100% of the time in dry conditions, 90% in moist, and only 20% in wet conditions. The regular body showed 100% satisfactory impressions in dry, 80% in moist, and 10% in wet conditions. With the additional smooth surface evaluation, only under dry conditions impressions with clinically acceptable surface quality were produced. Conclusions: Dimensional changes for both materials were well within ADA standards of minimal shrinkage value of 0.5%.

Effect of Glass Fiber And Silane Treated Glass Fiber Reinforcement On Impact Strength Of Maxillary Complete Denture.

Background and objectives : The fracture of acrylic maxillary complete dentures is a commonly seen clinical problem which usually occurs due to heavy occlusal forces or accidental damage.The objectives of the study were to measure the impact strength of maxillary complete dentures fabricated with high impact acrylic resin and to evaluate the effect of woven E-glass fiber and silane treated glass fiber reinforcement on the impact strength of the Maxillary complete dentures. Methods :One commercially available heat cured acrylic resin (Trevalon HI) was selected. Preimpregnated woven E-glass fibers (Stick Net) and Silane treated glass fibers were used to reinforce ten maxillary complete dentures each. Ten unreinforced complete dentures served as the control group. The impact strength in Joules of the dentures were measured with a falling-weight impact test. Results : The mean impact strength of the control dentures was 75.22+/ - 10.392 J at crack initiation, and 84.62+/- 11.495 J at complete fracture. The mean impact strength of dentures reinforced with preimpregnated woven E-glass fibers was 165.91+/- 12.929 J at crack initiation, and 187.06+/- 17.972 J at complete fracture. The mean impact strength of dentures reinforced with silane treated glass fibers was 112.30+/- 8.709 J at crack initiation, and at complete fracture was 126.43 +/- 8.709 J. Interpretation and Conclusion :The impact strength of maxillary complete dentures fabricated with high impact acrylic resin increased significantly after reinforcement with preimpregnated woven Eglass fibers and silane treated glass fibers. The best improvement, however , was obtained by preimpregnated woven Eglass fibers.

Prosthetic Rehabilitation of Patient With Subtotal Maxillectomy And Orbital Exenteration.

Orbital exenteration presents a unique challenge to the maxillofacial prosthodontist. Prosthetic rehabilitation of the orbit is often complicated by the extent of resection, tissue response and the method of retention. Loss of an eye due to trauma or disease resulting in facial defect has a crippling effect on patients psychology. The placement of good prosthesis serves as a great psychological, social and cosmetic benefit in rehabilitation of the patient. The article discusses the prosthetic rehabilitation in an elderly male patient with orbital defect.

An evaluation of the mechanical properties of Type III and Type IV gypsum mixed with two disinfectant solutions.

Background and Objectives: This in-vitro study was conducted to evaluate the strength and properties of Type III and Type IV gypsum mixed with disinfectant solutions. Materials and Methods: Type III and Type IV gypsum were used for the study. Three different mixing solutions namely waterqueous solutions of 0.525% sodium hypochlorite and 2% glutaraldehyde were used. Gypsum materials were subjected to further modification by adding a mixture of 1.0% gum arabic and 0.132% calcium hydroxide before mixing with the disinfectant solutions, at two different liquid/powder (L/P) ratios for each. Both, the unmodified and the modified gypsum were tested for compressive and tensile strength after one hour and one week from the start of the mix. The crystalline configuration of the fracture fragments of the unmodified and modified set gypsum were studied under the scanning electron microscope. Results: The disinfectant solutions reduced the strength of both Type III and Type IV gypsum. Water showed higher-strength, which was followed by 0.525% sodium hypochlorite and 2% glutaraldehyde. The modified Type III and Type IV gypsum with reduced L/P ratio also showed strength values less than that of the control groups. Interpretation and Conclusion: Chemical disinfectants reduced the strength of gypsum when used as water substitutes. Gum Arabic and calcium hydroxide additives permitted lower L/P ratio, however, there was still excess water retained in the set gypsum that lowered the strength values of Type III and Type IV gypsum. Hence, further reduction of L/P ratio may increase the properties of the modified Type III and Type IV gypsum.

Bilateral Pseudomonas keratitis without predisposing factors.

Bilateral keratitis usually occurs in predisposed individuals such as contact lens wearers, those suffering from malnutrition and immunodeficiency or patients undergoing bilateral refractive corneal surgery. We report a 30-year-old man without any obvious predisposing factors who presented with complaints of pain and decreased vision in both eyes. Examination revealed corneal ulcers in both eyes, which on microbiological culture grew Pseudomonas aeruginosa. The patient underwent a therapeutic keratoplasty in the right eye while the left eye was managed medically. Bilateral Pseudomonas keratitis can develop in the absence of any obvious predisposing factors.

Trends of head and neck cancers in urban and rural India.

BACKGROUND: The sub-site predilection of head and neck squamous cell carcinoma (HNSCC) reflects the risk profile of a community and there are suggestions that these are changing over time. OBJECTIVE: To determine the change in head and neck cancer in rural and urban populations in India. METHODS: Cancer registry data of an urban and a rural population were reviewed over a period of 13 and 11 years, respectively. Age adjusted rates (AAR) and age specific incidence rates were used for data analysis. RESULTS: Oral cancers formed the majority of the head and neck cancers with a predilection for tongue, except in rural males, in whom the pharynx was the predominant sub-site. Overall there was a reduction in the incidence of HNSCC, which was more pronounced in urban females and rural males (p< .001). Among the sub-sites, oral cavity cancers showed a decreasing trend in urban females (p< .01) and rural males (p< .01). However, the trend was towards increase of incidence of tongue cancers. Pharyngeal cancer showed reduction in urban females (p< .01), whereas it increased in rural females. The recent increase in incidence of young adults with HNSCC reported in developed countries was not observed. CONCLUSIONS: Overall, incidence of HNSCC is reducing. This may be attributed to the decreased prevalence of tobacco use.The increase in incidence of tongue cancer may suggest factors other than tobacco and alcohol in its genesis.

A Cohort Study to Address the Natural History of HPV and Cervical Dysplasia in Trivandrum, South India: Methodological Issues and Initial Results.

Epidemiological studies, especially cohort studies have many limitations in countries like India. The present population based molecular epidemiolohgical cohort study was planned to address the prevalence, risk factors and natural history of uterine cervical HPV infection in women in an area of suburban dwellings in South India. Epidemiological data, blood samples and cervical scrape smears were collected from women after obtaining an informed consent. A compliance rate of 38% for the first round of screening was noted. More than 70% of women demonstrated evidence of inflammation in their smears.

Prevalence, awareness, treatment and control of hypertension in an elderly community-based sample in Kerala, India.

BACKGROUND: Hypertension is one of the most important causes of cardiovascular morbidity and mortality in the elderly. With the increase in the number of elderly in India, hypertension is likely to emerge as an important public health problem. METHODS: We performed a cross-sectional survey of a random sample of 357 community-dwelling elderly individuals (191 women, 166 men; mean age 70 years) in Kerala. We measured blood pressure on all study participants using a standardized technique to assess the prevalence of hypertension. We compared the variations in prevalence, awareness, treatment and control of hypertension according to age, sex and place of residence of the subjects, and examined the socio-demographic correlates of hypertension using sex-specific multiple logistic regression. RESULTS: The overall prevalence of hypertension in our sample was 51.8% (95% CI: 46.8%-56.8%), which did not vary with sex but increased with age. Fewer than half of the hypertensive subjects were aware of their condition or were on treatment, and only a quarter of the treated hypertensives achieved adequate control of blood pressure. Rural elderly subjects were especially less likely to be aware of, and on treatment for hypertension. Smoking status and rural residence (in men) and marital status (in women) were important correlates of hypertension. CONCLUSIONS: Our findings emphasize the public health importance of hypertension in the elderly in Kerala at present, and point to a likely increase in burden of this problem in India in the near future. A National Hypertension Programme, targeted to meet the imminent public health challenge posed by hypertension seems warranted.