Laboratory derangements and clinical picture of Covid-19 in pediatric age group: A retrospective study

Aim: To assess the clinical presenta?on and laboratory derangements of pediatric covid-19 pa?ents admi?ed to the ter?ary care hospital. Methodology: The present retrospec?ve study was started a?er the approval of the Ins?tu?onal Ethics Commi?ee. Clinical (Sp02, final diagnosis and outcome) and biochemical parameters (Complete Blood Count, Liver Func?on Test, Renal Func?on Test, Lactate De-Hydrogenase, D-dimer, C-Reac?ve Protein, and Serum ferri?n) of pediatric covid-19 pa?ents were collected from Central Laboratory and Medical Record Department of our ins?tu?on. Pa?ent names were anonymized and data were analyzed. The results are expressed in percentages. Results: A total of 16 pediatric covid-19 pa?ent details were iden?fied and collected who were admi?ed during our study period. Out of 16 pa?ents, 09 (56.2%) were female and the remaining 07 (43.7%) were male. Out of 16, 05 pa?ents had mild covid, 07 were moderate and the remaining 04 suffered from severe covid-19 infec?on. The mean values of oxygen satura?on, LDH, D-dimer, CRP, and Ferri?n were 88%, 249.4U/L, 1140.9 ng/ml, 16.17 mg/dl, and 61.7 µg/L respec?vely. Mean values of 17.9 mg/dl and 0.4 mg/dl were recorded for blood urea and S.crea?nine. Regarding liver func?on tests, mean values of 1.7mg/dl, 0.2mg/dl, 1.5mg/dl, 82.4 U/L, 55 U/L, 135.6 U/L respec?vely noted for total bilirubin, direct, indirect, SGOT, SGPT and ALP. Regarding pa?ent outcomes, all the pa?ents were covered and discharged from the hospital. Conclusion: The present study has found an increase in laboratory mean values of liver func?on tests but the mean values of C-Reac?ve protein, LDH, and d-dimer which are the acute inflammatory markers are highly disrupted compared to normal ranges.

Effect of SKB-Gutbiotic on acetic acid induced ulcerative colitis in male Wistar rats

Inflammatory bowel disease (IBD) is a chronic intestinal inflammation gaining increasing attention as it affects considerable number of humans. IBD is reported as ulcerative colitis (UC) and Crohn's disease (CD) Conventional therapies currently available are not satisfactory. Therefore, here, we investigated the effect of SKB-Gutbiotic on acetic acid induced ulcerative coltis (UC) in male Wistar rats. Male Wistar rats, 200-250 g were divided into six groups as follows: Gr. I (control) received 10 mL/kg of distilled water for 21 consecutive days. Gr. II received 2 mL of 4% acetic acid solution once intra rectally for induction of colitis. Gr. III received 2 mg/kg prednisolone as standard control. Groups IV, V & VI were treated with SKB-Gutbiotic @2×109, 20×109 and 50×109 Cfu/kg, respectively. All the animals from each group were sacrificed 24 h after the induction of colitis. Disease activity index, macroscopical damage, hematological parameters, level of superoxide dismutase (SOD), myeloperoxidase (MPO), reduced glutathione (GSH) and histopathological alterations were evaluated. Acetic acid-induced colitis significantly caused alteration in disease activity index, macroscopical damage, MPO and GSH levels (P <0.05) as compared to control group. SKB-Gutbiotic (20×109 and 50×109 Cfu/kg) administration significantly decreased disease activity index, MPO, SOD, increased GSH levels (P <0.05) as compared to colitis rats. In conclusion, SKB-Gutbiotic (20×109 and 50×109 Cfu/kg) significantly showed protective effects against acetic acid-induced colitis as a consequence of its anti-inflammatory and antioxidative properties.

Knowledge and Awareness of Role of Endodontics in Forensic Odontology- A Questionnaire Based Survey among Postgraduate Students

The unique nature of human teeth has always been a special aid in personal identification throughout history.[1] Forensic odontology is a branch of dentistry that deals with the application of dental knowledge to those criminal and civil laws that are enforced by the investigative agencies in a criminal justice system.[2] Dental tissues are the strongest tissues in the human body and therefore their characteristics remain unchanged even in extreme environment and can survive long periods in conditions like burial under soil, fire and exposure to any biological agents in the environment.[3] Therefore, the importance of teeth in forensics is profoundly increasing. Endodontics in particular plays a pivotal role in forensic investigation by providing adequate knowledge of root canal anatomy, periapical radiographs, dental restorations, which favour comparison and personal identification of a deceased person.[1]We wanted to evaluate the knowledge and awareness of the role of endodontics in forensic odontology among postgraduate students enrolled in the specialty of Conservative Dentistry and Endodontics.METHODSA standardized web-based questionnaire survey was conducted in a group of post graduate students n=306 (endodontists) in which 20 questions related to the role of endodontics in forensic odontology were included. The responses were recorded, and the data was analyzed using statistical analysis. Based on the responses obtained, data was analysed, and the frequencies and percentages were calculated.RESULTSThe results of the present survey revealed that 6% of total participants had good awareness (>16 Qs), 62% of total participants showed moderate awareness (10-16 Qs) and 32% of total participants had poor awareness (<10 Qs)CONCLUSIONSThis survey was conducted to assess the knowledge and awareness on practical usefulness of endodontics in forensic odontology. By considering the present expansion in field of forensic odontology, endodontists should be knowledgeable of the role and importance of their specialization in personal identification.

Post-operative analgesia of 2% lignocaine with or without magnesium sulfate for inferior alveolar nerve block in symptomatic mandibular molars - a randomized double blind controlled clinical trial

Background@#Single inferior alveolar nerve block is ineffective in achieving adequate pulpal anesthesia in 30-80% of patients due to anatomical variations, local tissue pH, central sensitization, and several factors. Various supplementary techniques and combination of adjuvants with lignocaine are used to overcome these failures. Magnesium sulfate (MgSO4), one such adjuvant, acts at the N-methyl-D-aspartate glutamate receptor resulting in effective anesthesia. The aim of this prospective, randomized, double-blind, clinical controlled trial was to evaluate the onset, anesthetic efficacy, duration and post-operative analgesia of 2% lignocaine with and without the addition of MgSO4 in patients with symptomatic irreversible pulpitis and apical periodontitis. @*Methods@#Fourty-two patients were randomly divided into three groups: 2% lignocaine (group 1) and 2% lignocaine with MgSO4 (75 mg) and (150 mg) in groups 2 and 3, respectively. Pre-operative vitals and Heft Parker–Visual Analogue Scale (HP-VAS) pain scores were recorded. The onset of anesthesia, anesthetic efficacy, and duration of anesthesia were evaluated post administration of the local anesthetic solution. The post-operative analgesia was examined at intervals of 2, 6, 12, 24, and 48 h. @*Results@#Administration of 150 mg MgSO4 hastens the onset of anesthesia (1.29 min) and produces better anesthetic efficacy (3.29 HP-VAS) compared to group 2 (2.07 min and 9.14 HP-VAS) and group 1 (3.29 min and 35.79 HP-VAS), respectively. The duration of anesthesia was significantly higher in group 3 (247.07 min) compared to that of groups 2 and 1 (190 min and 110.21 min) with P < 0.05. @*Conclusion@#Combining 75 mg or 150 mg of MgSO4 with lignocaine is more effective than 2% lignocaine and 75 mg of MgSO4 is adequate for endodontic procedures.

Identification of mitochondrial DNA profiling (COX - 2) in ovarian cancer patients - A population-based study in South India

Objectives: Ovarian cancer (OC) is a most dangerous gynecological cancer affecting women aged mostly in 50s and above due to its poor prognosis. mtDNA has been emerging as a prime hotspot candidate for the progression of OC. Thus, the objective of the present study was to investigate polymorphisms in COX - 2 gene in mtDNA by using PCR RFLP.Methods: In the present study, detailed questionnaire and consent forms have been obtained from the OC patients and the age - matched controls. Blood samples from OC patients (n = 72) were collected from oncological clinics, and by population-based survey in South India. Control subjects (n=72) who had no history of tumors were selected and they were matched for age, sex and race. Peripheral blood was collected to detect polymorphism in the COX - 2 gene using PCR - RFLP.Result: In the present study, we found that OC patients with COX - 2 CC homozygous genotype showed higher risk for OC progression, whereas, the GG genotype in controls revealed its protection against the OC risk.Conclusion: In conclusion, our results suggests that, COX - 2 CC genotype may contribute to the development of OC pathogenesis. Though genetic polymorphism investigation was very limited to modulate the OC risks, the outcome of this study may help in future genotypic analysis. Thus, in future more genetic studies are warranted to prove that genotypic variation, mutations in COX - 2 would be a prime factor in Ovarian Carcinogenesis, and it can be used as candidate biomarker in treatment strategies.

An Unusual Occurrence Of Two Palatal Canals In Maxillary First Molar - A Case Report.

The endodontist should have a detailed and thorough knowledge of root canal anatomy to effectively perform endodontic treatment, negligence to which might lead to endodontic failures. Maxillary first molars show considerable variation in root canal anatomy with respect to number of roots and number of canals. Literature states that canal variations can reach up to 33% in maxillary first molars. There is an overall low prevalence (<2%) of anatomic variations in the palatal canal of maxillary molars among different populations. This case report deals with one such palatal canal variations in maxillary first molar with 4 canals: 2 separate palatal canals, mesiobuccal and distobuccal canal and its management.. Clinician awareness on careful assessment of extra palatal canal in maxillary molar teeth using conventional radiograph has been reinforced in this case report to achieve long term success in endodontic treatment.

Evaluation of matrix metalloproteinase and cysteine cathepsin activity in dentin hybrid layer by gelatin zymography.

Aim: The aim of this study was to comparatively assess the gelatinolytic activity of matrix metalloproteinases(MMPs) and Cysteine Cathepsins (CCs) in the adhesive interface using etch and rinse adhesive at different time intervals using zymographic technique. Methodology: Twenty freshly extracted non-carious human third molars were used in this study. Occlusal surfaces were ground flat and 1mm thick horizontal dentin slabs were obtained from each tooth using a diamond disc. The dentin surface was polished with 600-grit silicon-carbide paper. Five out of 20 samples were directly pulverized. In the remaining fifteen samples, the dentin was etched and adhesive was applied and light cured according to the manufacturer’s instructions. A 1mm thick flowable composite was build up and light cured. Bonded specimens were cut vertically into 3 to 4 dentin slabs by means of diamond disc to expose the adhesive/ dentin interfaces. These were then ground down to 500 μm thick resin-dentin interface using a hard tissue microtome. These sections were then pulverised into powder. Following this, every five samples were subjected to zymographic analysis after 1 day, 7 days and 21 days. Results: Zymograms showed clear, thicker bands on all three isoforms in the etched samples compared to control samples at 1st and 7th day intervals and became inactive at 21st day for all three isoforms. MMP 9 activity was relatively higher when compared to CCs and MMP 2. Conclusion: Etch and rinse adhesive activated MMPs and CCs within the hybrid layer that remained active till 7th day and no gelatinolytic activity was found on 21st day and MMPs are more active compared to CCs and MMP-2.

Evaluation of microshear bond strength and nanoleakage of etch‑and‑rinse and self‑etch adhesives to dentin pretreated with silver diamine fluoride/potassium iodide: An in vitro study.

Aims: The aim of this in vitro study was to comparatively evaluate the microshear bond strength (MSBS) of etch‑and‑rinse and self‑etch (ER and SE) bonding systems to dentin pretreated with silver diamine fluoride/potassium iodide (SDF/KI) and nanoleakage at the resin‑dentin interface using transmission electron microscope (TEM). Subjects and Methods: Seventy‑two dentin slabs of 3 mm thickness were prepared from extracted human permanent third molars and divided into four groups (n = 18) based on the dentin surface treatment as follows: (1) ER adhesive bonding without dentin pretreatment; (2) SDF/KI pretreatment of dentin followed by ER adhesive bonding; (3) SE adhesive bonding without dentin pretreatment; and (4) SDF/KI pretreatment of dentin followed by SE adhesive bonding. Resin composite was built on the dentin slabs to a height of 4 mm incrementally, and dentin‑composite beams of approximately 1 mm2 cross‑sectional area were prepared. The beams were subjected to MSBS analysis, and the fractured surface was observed under scanning electron microscope to determine the mode of failure. The resin‑dentin interface was examined under TEM for evaluation of nanoleakage. Statistical Analysis Used: One‑way ANOVA followed by Tukey’s post hoc multiple comparison tests. Results: Pretreatment of dentin with SDF/KI increased the MSBS of ER and SE adhesives, though not statistically significant, except between Groups 2 and 3. In all the groups, the predominant mode of failure was adhesive followed by cohesive in resin, mixed and cohesive in dentin. TEM examination of resin‑dentin interface showed that pretreatment with 38% SDF/KI reduced nanoleakage regardless of the type of bonding system used. Conclusions: Pretreatment of dentin with SDF/KI minimized nanoleakage at the resin‑dentin interface without adversely affecting the bond strength of resin composite to dentin.

Ultrasound Evaluation of Thyroid Lesions

This study was done at Santhiram general hospital. 57 patients with thyroid swelling were examined with ultrasound and followed up with FNAC. Findings were analyzed which showed that 14 were cystic, 27 solid and 16 were mixed lesions; 93% of cystic lesions were benign (Table 2). Among solid lesions 83% were benign rest malignant. Among mixed lesions 87.75% benign and only 12.25% were malignant (Table 3). Ninty two per cent of goiter showed calicification papillary; carcinoma case showed calicification. Hypoechoic hallow showed 88% benign lesions and 12% of malignant lesions; hence US has a definete role in charecterising thyroid lesions. It is being cheap and readily available. The characterisation of perilesion halo is whether irregular or smooth which helps in differentiating benign and malignant nature of lesion. It helps in FNAC for exact localisation.

Effect of ethanolic extract of Coriandrum sativum L. on tacrine induced orofacial dyskinesia.

The effect of ethanolic extract of Coriandrum sativum L. seeds (100, 200 mg/kg) was studied on tacrine induced orofacial dyskinesia. Tacrine (2.5 mg/kg, i.p.) treated animals were observed for vacuous chewing movements (VCM), tongue protrusions (TP) and orofacial bursts (OB) for 1 h followed by observations for locomotor changes and cognitive dysfunction. Sub-chronic administration of Coriandrum sativum L. seed extract (E-CS) (100, 200 mg/kg, p.o., for 15 days significantly (P <0.05) decreased the tacrine induced VCM, TP and OB; and also significantly (P <0.05), increased locomotion and cognition compared to the tacrine treated group. Biochemical analysis revealed that tacrine administration significantly (P <0.05) decreased the levels of superoxide dismutase (SOD), Catalase (CAT), glutathione reductase (GSH) levels and also significantly (P <0.05) increased lipid peroxidation (LPO) as an index of oxidative stress, whereas sub-chronic administration of E-CS significantly (P <0.05) improved the antioxidant enzyme (i.e. SOD, CAT, and GSH) levels and also significantly (P <0.05) decreased lipid peroxidation (LPO). The results have demonstrated the protective role of ethanolic extract of Coriandrum sativum. L against tacrine induced orofacial dyskinesia.

Preclinical evaluation of Boswellia serrata for anxiolytic activity.

Background: Boswellia serrata (BS) has been described in the ancient Ayurvedic texts Sushruta Samhita and Charaka Samhita. It possesses anti-inflammatory, analgesic, anti-arthritic and antioxidant properties. It is found that BS helps in surging of GABA levels in mice brain. The aim of this study was to evaluate the possible anxiolytic activity of BS in Swiss albino mice by light and dark arena (LDA) and elevated plus maze (EPM) models. Methods: In this study, BS (50 mg/kg, 100 mg/kg and 200 mg/kg; p.o) was evaluated for anxiolytic action and compared with standard drug (diazepam) and control (normal saline) in mice by LDA and EPM models. In LDA, number of entries and time spent in light and dark boxes were noted for individual mouse. Similarly, number of entries and time spent in open and closed arms were recorded for EPM model. Results: One-way Analysis of Variance (ANOVA) followed by Dunnett’s post-hoc test was used to analyze the data. BS in a dose of 50 mg/kg has shown significant increase in time spent in light box (p<0.05) and decrease in time spent in dark box (p<0.05) when compared to control group in LDA model. Similarly, in EPM model 200 mg/kg of BS significantly increased time spent in open arm (p<0.001) and decrease in time spent in closed arm (p<0.001) when compared to control group. Conclusion: BS in dose of 50 mg/kg and 200 mg/kg has significant anxiolytic action in animal models.

Comparison of Plasma Glucose, Serum Ferritin, HbA1c and Serum Nitric Oxide Levels between Diabetic and Non Diabetic Individuals: An Indian Scenario.

Aims: To estimate fasting plasma glucose (FPG), serum ferritin, HbA1c and serum nitric oxide levels in type 2 diabetes mellitus (DM) subjects and compare the values with non diabetic individuals and also to assess the correlation analysis between the biochemical parameters in type 2 DM subjects. Study Design: A case control study. Place and Duration of Study: Study was carried out from June 2012 to June 2013 in Bapuji Hospital and Chigateri General Hospital, Davangere, Karnataka, India. Methodology: A total of 87 subjects were included in the present study of which 56 type 2 Diabetes Mellitus patients and 31 control subjects. FPG, serum ferritin, HbA1c and serum nitric oxide were estimated in all subjects. Results: Intergroup comparison of biochemical parameters was done by unpaired “t” test and correlation between the parameters by Pearson’s coefficient analysis. The estimated mean levels (mean  SEM) of FPG, serum ferritin, HbA1c and serum nitric oxide in control group were 98.06±1.30, 84.6±6.61, 5.46±0.15 and 39.0±0.84 respectively. Similarly, in type 2 diabetic patients mean levels of 179.5±7.11, 457.9±53.7, 9.49±0.25, and 100.9±3.5 were obtained for respective parameters. Mean values of all parameters were found to be significantly increased In DM subjects (P=.001) when compared to control group. Moreover, Serum ferritin has shown significant positive correlation with HbA1c and serum nitric oxide in type 2 DM patients with ‘P’ value of .05. Conclusion: The present study suggests that iron over load is one of the major factors in the pathogenesis of type 2 DM. Decreasing iron stores may reduce the oxidative stress, improve the vascular endothelial dysfunction and also improves insulin sensitivity in type 2 DM subjects.

Spheniodal mucocele causing bilateral optic neuropathy and ophthalmoplegia.

Sphenoid sinus mucocele comprises only 2% of all paranasal sinus mucoceles. In literature, there is a case report on sphenoidal mucocele causing bilateral optic neuropathy, with unilateral partial recovery and cranial nerve palsy, but we did not come across any literature with bilateral optic neuropathy and ophthalmoplegia together caused by spheno-ethmoidal mucocele. We present such a rare case of spheno-ethmoidal mucocele causing bilateral optic neuropathy and unilateral sixth nerve palsy who had postsurgery, unilateral good vision recovery, and complete resolution of sixth nerve palsy.

Intravenous human umbilical cord blood improves elctrophysiological and metabolic properties in ISO induced myocardial necrosis in rats.

Rats treated with isoproterenol (ISO, 85 mg/kg, sc, twice at an interval of 24 h) showed a significant increase in heart rate, mean arterial blood pressure, pressure rate index, ST elevation on ECG, and a significant increase in the levels of cardiac marker enzymes- lactate dehydrogenase, and creatine kinase in serum and a significant reduction in superoxide dismutase, and catalase and increase in thiobarbituric acid reactive substance activity in heart tissue. Treatment with Human umbilical cord blood (hUCBC; 500 and 1000 µL, iv, via the tail vein; 2 h after the second dose of ISO) significantly restored back to normal levels and showed a lesser degree of cellular infiltration and infarct size in histopathological and planimetry studies respectively. Thus, hUCBC ameliorates cardiotoxic effects of isoproterenol and may be of value in the treatment of myocardial infarction.

Clinicopathological study of exfoliative dermatitis.

A clinicopathological study of exfoliative dermatitis involving 25 fresh cases was carried out. Males were predominantly affected with a peak incidence between 21-30 years. Pruritus, shivering, erythema and scaling were the common clinical manifestations. Psoriasis and eczema were the most common aetiological factors and the histopathological findings were correlating with the same.