Comparison of Pre- and Posttreatment Airway Volume in Patients with Temporomandibular Joint Disorders Treated with Ultra-Low Frequency Transcutaneous Electrical Nerve Stimulation Using Cone Beam Computed Tomography

Abstract Introduction Temporomandibular joint disorders (TMD) present with a multitude of symptoms that can range from headaches to shoulder pain. Patients frequently present with pain in the ear, dizziness, and vertigo. It is noted that some patients who report TMDs also have a history of sleep disturbances, which is noted in cone beam computed tomography (CBCT) as a reduction in the oropharyngeal airway volume. Objective To evaluate the airway volume in pre- and posttreatment of TMD with the use of neuromuscular orthotics made with ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS). Methods A total of 15 patients were evaluated for TMDs using the related criteria. Those included were treated with ULF-TENS with evaluation of the airway volume both pre- and posttreatment using CBCT and the Dolphin 3D volume analysis software. Results While the symptoms were shown to be significantly reduced in patients who were treated with this particular modality, the airway volume varied in those who reported a reduction after a period of 3 months and those that reported after a period of 6 months. Conclusion Posttreatment evaluation of the airway should be done after a period of 6 months for a more objective evaluation. A multidisciplinary evaluation of the patient is required in such cases.

Etiology of graft dysfunction in renal transplant recipients

Background: Kidney transplantation is the preferred mode of renal replacement therapy for the endstage renal disease, with dramatic improvements in patient and graft survival over the last 50 years. In the modern era of immunosuppression, 1-year patient survival is close to 98%, and 1-year allograft survival rates have improved to 90% for deceased donor kidney transplants and 95 % for living donor kidney transplants with some inter-center variability. The aim of the study: To elucidate the etiology of graft dysfunction among renal transplant recipients. Materials and methods: A retrospective study was conducted among 155 patients who underwent both cadavers and live donor transplant from October 2009 to March 2011 at a tertiary care center in Chennai, South India. All the transplant recipients were regularly followed with serum urea and creatinine, urine routine, calcineurin inhibitor drug levels in the serum, USG Abdomen, urine culture depending on the graft status. Graft dysfunction defined by a rise in the creatinine more than 25% or 0.3 to 0.5 mg per dl from the baseline. Those who developed graft dysfunction were presented for graft biopsy and managed based on the report accordingly. S. Thirumavalavan, Krishna Kumar, S. A. K. Noor Mohamed, R Vijaya Kumar. Etiology of graft dysfunction in renal transplant recipients. IAIM, 2019; 6(3): 313-318. Page 314 Results: Among the 155 transplant recipient patients, 66 (44%) patients developed graft dysfunction and underwent renal biopsy. The graft dysfunction was due to chronic allograft dysfunction (interstitial fibrosis and tubular atrophy) in 24 (15.4%) patients, acute cellular rejection in 13 (8.4%) patients, acute antibody-mediated rejection in 2 (1.3%) patients, acute tubular necrosis in 9 (5.8%) patients, calcineurin toxicity in 6 (3.9%) patients, thrombotic microangiopathy in 6 (3.9%) patients, IgA nephropathy in 3 (1.9%) patients and transplant renal artery stenosis in 1(0.6%) patient. Conclusion: Among the various causes, acute cellular, acute antibody rejection and chronic allograft nephropathy holds nearly 25% of the incidence of graft dysfunction. It indicates appropriate immunological evaluation, appropriate immunosuppression, use of induction agents in high-risk patients and protocol renal biopsy to identify early rejection in high-risk patient and appropriate early intervention is important to improve long-term term graft and patient survival.

Sonographic Evaluation of Spectrum of Breast Diseases-A Study in a Tertiary Care Hospital of Southern Tamil Nadu

Background:Breast carcinoma has become one of the leading causes of death among women. Early clinical detection of breast carcinoma through screening has led to the detection of the tumor at a relatively earlier clinical stage, which definitely reduced the mortality. Breast ultrasonography (US) has gained widespread acceptance as a diagnostic tool for the evaluation of human breast disease and the ultrasound guided fine needle aspiration biopsy (FNAB) as the preferred method of tissue sampling. The present study aims to observe the diagnostic accuracy of US, in the assessment of breast masses compared to pathologic findings. Methods: This analytical, retrospective study was conducted on 246 patients that were referred for US scan in a tertiary care hospital of southern Tamilnadu, between January to December 2017. 110 breast masses from 246 patients were evaluated with US & US guided FNAB. BI-RADS US criteria combined with pathological findings were correlated in differentiation between benign and malignant masses. Sensitivity, Specificity & Accuracy were derived for US. Results:In our study the Sensitivity, Specificity, Positive predictive value (PPV) & Negative predictive value (NPV) of US, in detecting malignant breast nodule, was found to be 94%, 97.67%, 98.43% and 91.30% respectively. The overall accuracy of US in detection of benign & malignant breast nodule was found to be 95.45%. Conclusions: BI-RADS criteria combined with US guided FNAB, well correlated with pathological findings, increases the rate of detection of Breast cancer and reduces the number of unnecessary surgical & radiological procedures and the overall cost of medical care

Sonographic Evaluation of Acute Appendicitis -A Study at a Tertiary Care Hospital of Tribal, Hilly, Wayanad in Kerala.

Background: Acute appendicitis (AA) is one of the most frequent causes of an acute abdomen requiring emergency surgery. Classically, the clinical findings consist of periumbilical pain migrating to the right lower quadrant, accompanied by fever and leukocytosis. However, the classic signs are not always present, and symptoms can be nonspecific and overlap with other causes of abdominal pain. While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Among imaging methods, Ultrasound (US) is a valuable tool, which is widely available, can be performed at the bedside, does not use ionizing radiation, is relatively inexpensive, and may show evidence of other causes of abdominal pain. Methods: We evaluated the role of ultrasound in the diagnosis of AA, at a tertiary care hospital of tribal, hilly, Wayanad in Kerala, involving 224 patients from Jan 2015 to July 2016. Ultrasound findings were finally compared with surgical / pathological report of appendices removed at surgery. Results: The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of ultrasound in diagnosis of AA, in our study were found to be 99.2 %, 76.7 %, 87.2% , 98.5% and 90.6 % respectively. Conclusion: Although the sensitivity, specificity, and accuracy of sonography vary greatly in studies evaluating the imaging diagnosis of acute appendicitis, it should be the first imaging modality when there is clinical concern for acute appendicitis.

Molecular dynamics of amorphous pharmaceutical fenofibrate studied by broadband dielectric spectroscopy$ / 药物分析学报

Fenofibrate is mainly used to reduce cholesterol level in patients at risk of cardiovascular disease. Thermal transition study with the help of differential scanning calorimetry (DSC) shows that the aforesaid active pharmaceutical ingredient (API) is a good glass former. Based on our DSC study, the molecular dynamics of this API has been carried out by broadband dielectric spectroscopy (BDS) covering wide temperature and frequency ranges. Dielectric measurements of amorphous fenofibrate were per-formed after its vitrification by fast cooling from a few degrees above the melting point (Tm ? 354.11 K) to deep glassy state. The sample does not show any crystallization tendency during cooling and reaches the glassy state. The temperature dependence of the structural relaxation has been fitted by single Vogel–Fulcher–Tamman (VFT) equation. From VFT fit, glass transition temperature (Tg) was estimated as 250.56 K and fragility (m) was determined as 94.02. This drug is classified as a fragile glass former. Deviations of experimental data from Kohlrausch–Williams–Watts (KWW) fits on high-frequency flank of α-peak indicate the presence of an excess wing in fenofibrate. Based on Ngai's coupling model, we identified the excess wing as true Johari–Goldstein (JG) process. Below the glass transition temperature one can clearly see a secondary relaxation (γ) with an activation energy of 32.67 kJ/mol.

Plant growth promoting capability and genetic diversity of bacteria isolated from mud volcano and lime cave of Andaman and Nicobar Islands

Twenty four bacterial strains from four different regions of mud volcano and lime cave were isolated to estimate their diversity, plant growth promoting and biocontrol activities to use them as inoculant strains in the fields. An excellent antagonistic effect against four plant pathogens and plant growth promoting properties such as IAA production, HCN production, phosphate solubilization, siderophore production, starch hydrolysis and hydrolytic enzymes syntheses were identified in OM5 (Pantoea agglomerans) and EM9 (Exiguobacterium sp.) of 24 studied isolates. Seeds (Chili and tomato) inoculation with plant growth promoting strains resulted in increased percentage of seedling emergence, root length and plant weight. Results indicated that co-inoculation gave a more pronounced effects on seedling emergence, secondary root numbers, primary root length and stem length, while inoculation by alone isolate showed a lower effect. Our results suggest that the mixed inocula of OM5 and EM9 strains as biofertilizers could significantly increase the production of food crops in Andaman archipelago by means of sustainable and organic agricultural system.

Basic Resuscitation in Dental Office: A Review.

Medical emergencies are little understood by most dental surgeons. Medical emergencies can occur in dental clinics. Hence, there is a signifi cant need for increased awareness among dental professionals in the fi eld of emergency medicine. Every dental professional should be trained in emergencies occurring which have life-threatening potential and should be able to tackle life-threatening emergency anywhere in any situation. Dental professionals should be aware of protocols for initial stabilization of the patient in the dental offi ce at time of risk. Every patient expects his dentist to be familiar with emergency interventions which include basic life support, advanced life support and specifi c drugs to be administered in emergencies. Th is is a widely discussed topic with poor understanding among dental practitioners. Emergency can occur in any dental offi ce without any warnings. Further, it has been noted in recent times there is an increase in a number of medicolegal cases due to rise in a number of death in the dental chair. Th is review article aims at briefi ng the basic protocols required to manage the medical emergency having life-threatening potential occurring in the dental offi ce or elsewhere.

The role of optometrists in India: An integral part of an eye health team.

India has a proud tradition of blindness prevention, being the first country in the world to implement a blindness control programme which focused on a model to address blinding eye disease. However, with 133 million people blind or vision impaired due to the lack of an eye examination and provision of an appropriate pair of spectacles, it is imperative to establish a cadre of eye care professionals to work in conjunction with ophthalmologists to deliver comprehensive eye care. The integration of highly educated four year trained optometrists into primary health services is a practical means of correcting refractive error and detecting ocular disease, enabling co-managed care between ophthalmologists and optometrists. At present, the training of optometrists varies from two year trained ophthalmic assistants/optometrists or refractionists to four year degree trained optometrists. The profession of optometry in India is not regulated, integrated into the health care system or recognised by the majority of people in India as provider of comprehensive eye care services. In the last two years, the profession of optometry in India is beginning to take the necessary steps to gain recognition and regulation to become an independent primary health care profession. The formation of the Indian Optometry Federation as the single peak body of optometry in India and the soon to be established Optometry Council of India are key organisations working towards the development and regulation of optometry.

Sensitivity of last larval stadium of Chrysomya megacephala (Fabricius) to anti-allatin ageratochromene Precocene II.

Treatment of early and late third instar larvae of economically important insect C. megacephala with the ageratochromene precocene II resulted into precocious metamorphosis. The other effects included mortality, production of pupal-adult mosaics, reduction in percentage of adult emergence and formation of non-viable deformed adults that died after a few hours of emergence. The application of precocene II adversely hampered the normal growth, development and metamorphosis of the insect and the results show that precocene II has vast potential for excellent control of this insect of medico-veterinary importance and can be used in insect pest management programs.

Endodontic treatment in primary molars with taurodontism.

Dental morphological traits are of particular importance in the study of phylogenetic relationships and population affinities. One of the most important abnormalities in tooth morphology is Taurodontism. Taurodontism can be defined as a change in tooth shape caused by the failure of Hertwig’s epithelial sheath diaphragm to invaginate at the proper horizontal level. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cementoenamel junction are the characteristic features. Although permanent molar teeth are most commonly affected, this change is very rarely seen in primary dentition. Taurodontism has a very low incidence in primary dentition and very few cases have been reported in the literature. Endodontic treatment of a taurodont tooth is challenging, because it requires special care in handling and identifying the canal obliteration and configuration and the potential for additional root canal systems. This paper highlights a case report of taurodontism in primary molars of a five year old male child with endodontic treatment.

The relationship of salivary immunoglobulin-A with dental caries and oral hygiene status in Down’s syndrome children.

A positive correlation between salivary IgA antibody levels to Streptococcus mutans and caries resistance in adults has been reported in literature. Such a correlation is also observed in Down’s syndrome population but lacks sufficient data support. The present study was conducted to assess the relationship of salivary IgA with dental caries and oral hygiene status in Down’s syndrome (DS) children compared to control group of normal subjects (NS) of school children of Chidambaram. The study population consisted of 80 subjects aged 8-14 years who were divided into four groups: Group 1 – DS subjects with DMFS= 0, Group 2 - NS with DMFS=0, Group 3 - DS subjects with DMFS= 3 and above and Group 4- NS with DMFS= 3 and above.Clinical examination was done and the study population was examined for the assessment of dental caries status (WHO 1987) and oral hygiene status (OHI -S Index). Unstimulated total saliva samples were collected and s-IgA concentration was evaluated by ELISA. Scheffe test (Intergroup comparison) and Pearson test (correlation analysis) were used to analyze the data. In DS subjects, a negative correlation of s-IgA with DMFS and OHI-S scores was found; the s-IgA levels were significantly higher, prevalence of dental caries was very low and oral hygiene status was not properly maintained when compared to the normal subjects. In the control group, a positive correlation of s-IgA with DMFS and OHI-S scores was found.

Neonatal Kawasaki disease.

The authors report a case of Kawasaki disease that manifested in a newborn and presented at the age of 6 weeks of age with coronary artery aneurysms.

Effect of precocene on development of ovarian follicles in flesh fly, Sarcophaga ruficornis F.

Administration of precocene II (6,7-dimethoxy-2, 2-dimethyl chromene) to freshly emerged virgin female flies of S. ruficornis adversely affected the development and differentiation of ovarian follicles leading to a number of morphological abnormalities. Precocene treatment resulted into suppression of development of egg chamber, differentiation of follicular epithelium, degeneration of nurse cells, growth of oocyte and uptake of yolk granules by oocytes. The results suggest that precocene induced effects are due to deficiency of juvenile hormone.

Heterochrony in cotton bollworm, Earias vitella (Fb) following ethoxyprecocene administration.

Administration of a synthetic precocene analogue, 7-ethoxy-6-methoxy-2,2-dimethyl chromene to fourth and last instar larvae of E. vitella results into heterochrony, viz. prothetely and metathetely. These disturbances are due to interference with the endocrine system and application of juvenile hormone to treated larvae abolishes the effect of ethoxyprecocene.