Community awareness and risk of rabies associated with exposure to animals in India

Background: Rabies is a fatal but preventable disease. Around the world, awareness studies about rabies have been widely used to understand the disease and in its preventive measures. Objectives: The present study was conducted to assess the awareness of rabies as a disease, its transmission, and prevention among the general population and also to assess the perceived health risks associated with exposure to animals. Methods: A cross-sectional study was undertaken across seven representative states in India between July and November 2017. Multistage sampling methodology was followed to select 1012 households as the primary sampling unit, and one adult responsible respondent from each household was interviewed as study participants. Results: Six hundred and eleven (60.4%) participants had heard of rabies. Only 0.2% had extensive knowledge of rabies. Majority (440, 72.0%) of the participants considered rabies as a fatal disease; 77.3% opined that risk of rabies from dogs was high compared to 41.6% who believed that there was little or no risk of rabies from cats. Only 37 (3.7%) participants were aware about preexposure prophylaxis. Conclusion: The awareness on rabies and its prevention in the study population was not satisfactory.

Cavernous haemangioma of spleen: a rare case report.

Tumours of the spleen are as such rare. Of these rare tumours, haemangioma is the most commonly encountered benign tumour with fewer than 100 cases reported. It is either an incidental finding or presents as splenic enlargement or with complications. Preoperative investigations are often inconclusive and may not distinguish between haemangioma and metastases. We report a case of 40 years female with cavernous haemangioma of spleen presenting as massive splenomegaly. Splenic haemangioma presenting as massive splenomegaly is extremely rare and deserves a mention.

Effect of glycemic status on peripheral nerve conduction in lower limbs in type 2 diabetes mellitus patients.

Background: Diabetes mellitus (DM) is one of the most common chronic diseases globally. Diabetic neuropathy is the most common & troublesome complication. But exact pathogenesis is not yet known. Comparatively there are few studies showing relation between glycemic status & diabetic neuropathy. Hence present study was conducted, which was aimed to assess the same in lower limbs in type 2 DM. Methods: 60 type 2 diabetes mellitus male patients were selected from diabetic OPD. 30 were having glycated hemoglobin (HbA1c) 6%-9% (group B), 30 were having HbA1c > 9% (group C). They were compared with age and sex matched 30 normal healthy controls (group A). Conduction velocity and amplitude of bilateral sural sensory nerve action potential (SNAP) and peroneal compound muscle action potential (CMAP) were recorded. Glycated hemoglobin was measured using ion exchange resin method. Results: Group B and group C had significantly lesser means of conduction velocity and amplitude of sural SNAP (p<0.001) and peroneal CMAP (p<0.05) as compared to group A. Hb A1c had statistically significant negative correlation with conduction velocity and amplitude of sural SNAP (p<0.001) as well as peroneal CMAP (p<0.001). Conclusions: This study shows that diabetic patients with higher blood glucose levels are at increased risk of diabetic neuropathy. Diabetic neuropathy in lower limbs worsens with increasing blood glucose levels. Hence stringent action has to be taken at an early stage to control blood glucose levels. Also, patients should be encouraged for regular follow up and strict glycemic control.

Coexistence of breast hemangioma with fibroadenoma: a rare case report.

Vascular tumors of the breast are uncommon and include angiosarcomas and hemangiomas. Angiosarcomas are more common and benign hemangiomas are rare. We report a case of 16 years old female patient with hemangioma of breast coexisting with very commonly occurring breast fibroadenoma. The rarity of literature on breast hemangioma especially coexistent with fibroadenoma, and its importance in differentiation from the more common malignant counterpart, the angiosarcomas deserves mention.

Non Surgical Management of Self Inflicting Gingival Injury In Schizophrenic Patient.

Schizophrenia is a brain disorder that affects the way a person acts and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with the reality. Some of the most common early warning signs of schizophrenia includes extreme reaction to criticism, deterioration of personal hygiene, depression, odd or irrelevant statement etc. A 24-year old female patient with similar features came to the department with the chief complaint of bleeding and receding gums; upon examination it was found that gingival mucosa in relation to maxillary right canine to first molar was lacerated. Detailed history of the patient showed that she was suffering from schizophrenia and was undergoing treatment for the same; she deliberately brushed hard on the respective region causing recession and laceration. Following diagnosis, non surgical management of the lesion was done including scaling and root planning. Four weeks after treatment, the patient was reviewed and in the follow up it was observed that the gingival lesion had resolved

The Role of Magnification In Endodontics.

Until recently, endodontic therapy was performed using tactile sensitivity, and the only way to see inside the root canal system was to take a radiograph. Performing endodontic therapy entailed ‘‘working blind,’’ that is, most of the effort was taken using only tactile skills with minimum visual information available. Before the introduction of magnification devices the presence of a problem (a ledge, a perforation, a blockage, a broken instrument) was only ‘‘felt,’’ and the clinical management of the problem was never predictable and depended on happenstance. With the recent advances of magnification devices with increased magnification and illumination there is improved technical accuracy and performance. It also allows the dentist to sit in an upright, neutral, and balanced posture, and has proven to be of great value in aiding documentation. This article highlights the role of magnification, types of magnification devices and their clinical application in endodontics.

Trimethoprim-sulfamethoxazole induced toxic epidermal necrolysis: a case report.

Toxic epidermal necrolysis (TEN) is a rare but serious dermatological disorder commonly caused as an idiosyncratic reaction to drugs and the most common drugs implicated are antibiotics, anticonvulsants and non-steroidal anti-inflammatory drugs. Here, we report a case of trimethoprim-sulfamethoxazole induced TEN in a 26 years old female.

Aspirin induced fixed drug eruptions: a case report.

Fixed drug eruptions are common cutaneous adverse drug reactions, commonly caused by anticonvulsants, antibiotics and analgesics. Here, we report a case of a 27-year-old male of fixed drug eruptions due to Aspirin which was used in treatment of headache.

Interfollicular Hodgkin's Lymphoma - A Diagnostic Dilemma.

Interfollicular Hodgkin's lymphoma represents an unusual pattern of focal involvement of interfollicular zones by Hodgkin's lymphoma along with florid reactive follicular hyperplasia. It is often mistakenly diagnosed as a reactive change. We report a case of a 36 years old male with persistent lymphadenitis for three years, who was finally diagnosed as Interfollicular Hodgkin's lymphoma after being incorrectly diagnosed as reactive lymphadenitis. This case is reported in view of the unusual pattern of Hodgkin's lymphoma as well as its misdiagnosis as a benign lesion.

Placental morphometry in relation to birth weight of full term newborn babies.

Background: In obstetrics the relationship of birth weight and the perinatal outcome has long been appreciated, however an often neglected parameter is the placental changes. Placenta is a vital organ for maintaining pregnancy and promoting normal foetal development. Foetal outcome is adversely influenced by pathological changes observed in placenta. Objectives: To assess the morphology of placenta in normal and low birth weight babies. To correlate the morphometric analysis with birth weight between the two groups. Study design: Cross-sectional descriptive study. Study setting: Department of Anatomy, Chalmeda Anandrao Institute of Medical Sciences, Karimnagar, Andhra Pradesh from January to June 2011. Methods: Total 374 human placentae from uncomplicated pregnancies were studied for the morphology and compared between low birth weight babies and normal weight babies. Results: The morphometric parameters of placenta like, weight, volume were significantly lower in low birth weight group compared to normal group. Placental weight and placental volume had significant correlation with the birth weight of new born. Conclusion: The placental weight increased according to the birth weight. Placental parameters and its ratio to birth weight were significantly associated with some adverse pregnancy outcomes.

Delayed inflammation associated with retained perfluorocarbon liquid.

A 55-year-old woman, with history of cataract surgery 1 year back, presented with features of ocular inflammation for last 3 months. She had no history of any other intraocular surgery. On examination, anterior segment showed frothy material in the inferior angle with moderate anterior chamber reaction (cells+/flare+) and sulcus intraocular lens with large posterior capsule rent. Fundoscopy showed multiple, small to medium-sized transparent bubbles of perfluorocarbon liquid (PFCL) with membranes in the vitreous cavity. Ultrasonography confirmed the presence of PFCL in the vitreous cavity. Pars plana vitrectomy with anterior chamber wash was done which led to good visual recovery. To conclude, retained PFCL can cause late onset fibrinous inflammation after a quiescent period but surgical intervention may lead to good visual outcome.

Knowledge, attitude and practice of dental caries and periodontal disease prevention among primary school teachers in Belgaum City, India

Objective: To evaluate the knowledge, attitude and practice of dental caries and periodontal disease prevention among primary school teachers in Belgaum city and to identify teacher's level of knowledge of health Information and utilization of the services of the school teachers in promotion of dental health and prevention of dental diseases. Methods: A cross-sectional questionnaire based survey was conducted among 150 primary school teacher from 175 primary school of Belgaum city, Karnataka, India. The questionnaire comprised six questions on knowledge, six questions on practice, and three questions on attitude regarding dental caries and periodontal disease prevention. Each question was followed by four choices. Chi square test was applied by using the statistical package for the social sciences (SPSS) software (version 11.0). Results: The female subjects had better knowledge and practices as compared to their male counterparts. Also the younger subjects had better knowledge and practices as compared to the older subjects. The teachers were more aware and they knew that tooth decay was due to chocolate and carbohydrate sticky food and also they knew the tooth loss in adults was due to decayed teeth and periodontal diseases. Conclusion: They had good knowledge and preventive attitude towards prevention of dental diseases but a few but important deficiencies in the of knowledge, attitude and practice about prevention of dental diseases have been identified for which recommendations are suggested.

Objetivo: Avaliar o conhecimento, atitudes e práticas frente à cárie dentária e prevenção da doença periodontal entre professores da escola primária na cidade Belgaum e identificar o nível de conhecimento desse profissional sobre as informações de saúde e utilização dos serviços da escola na promoção de saúde bucal e prevenção de doenças dentárias. Método: Um inquérito transversal utilizando como instrumento um questionário foi realizada entre os 150 professores do ensino básico de 175 escolas primárias da cidade Belgaum, Karnataka, na Índia. O questionário foi composto por seis questões sobre o conhecimento, seis perguntas sobre a prática, e três perguntas sobre a atitude em relação a cárie dentária e prevenção da doença periodontal. Cada pergunta continha quatro opções. O teste do Qui-quadrado foi aplicado usando o software SPSS (versão 11.0). Resultados: As professoras tinham um melhor conhecimento e práticas, em comparação com os professores. Também os sujeitos mais jovens tiveram um melhor conhecimento e práticas, em comparação com os indivíduos mais velhos. Os professores eram mais conscientes e sabiam que a cárie dentária devia-se à ingestão de chocolate e carboidratos de consistência pegajosa e também sabiam que a perda dentária em adultos devia-se a dentes cariados e doença periodontal. Conclusão: Os professores possuíam bom conhecimento e atitudes preventivas em relação à prevenção das doenças bucais, porém poucas mas importantes deficiências no domínio do conhecimento, atitude e prática sobre a prevenção de doenças dentárias foram identificadas sendo sugeridas recomendações.

Application of Botulinum toxin Type A: An arsenal in dentistry.

An extremely effective way of preventing damage to and enhancing treatment of dental hard tissues and restorations would be to ''de-programme'' the muscles responsible for excessive destructive forces and other gnathological-related diseases. The new paradigm is the intramuscular injection of Botulinum toxin type A (BOTOX) into the affected muscles. It is a natural protein produced by anaerobic bacterium, Clostridium botulinum. The toxin inhibits the release of acetylcholine (ACH), a neurotransmitter responsible for the activation of muscle contraction and glandular secretion, and its administration results in reduction of tone in the injected muscle. There are seven distinct serotypes of Botulinum toxin, viz., A, B, C, D, E, F, and G, which differ in their potency, duration of action, and cellular target sites. This paper describes the different applications of BOTOX in dentistry.

Cárie Dentária em Pré-Escolares: um Estudo em Áreas Cobertas pela Estratégia Saúde da Família do Recife, PE, Brasil / Dental Caries in Preschoolers: A Study in Areas Assisted by the Family Health Strategy of the city of Recife, PE, Brazil

Objeti vo: Analisar o padrão de distribuição da cárie dentáriaem pré-escolares residentes em áreas assisti das pela EstratégiaSaúde da Família do Recife, Pernambuco, em dois distritossanitários e, estabelecer comparações.Método: Um inquérito epidemiológico de cárie dentária foiconduzido no ano de 2006 em 2020 crianças de 18-36 meses e5 anos de idade cadastradas nas unidades de saúde da famílianos Distritos Sanitários II e IV, Recife/PE. Uti lizou-se o índiceceo-d, segundo padronizações da Organização Mundial deSaúde e do Ministério da Saúde. A amostra foi probabilísti capor conglomerados (famílias) em um estágio. Calculou-sedistribuição de freqüência, testes de comparação de médias(t-Student e ANOVA), de proporções (Qui-quadrado) comnível de signifi cância de 5,0% e fatores de ponderação pararepresentati vidade da amostra. As análises foram produzidaspor distrito e microrregiões.Resultados: Nos dois Distritos as prevalências e médias ceo-dforam elevadas, sendo de 29,7% no total de crianças de 18-36meses e 63,8% aos 5 anos. Entre os Distritos o ceo-d variou de0,99 a 1,15 (18-36 meses) e 3,01 a 3,65 (5 anos). Contudo, asrazões de prevalência não apresentaram diferenças signifi cantesentre distritos e idades. Entre microrregiões, as diferençasna prevalência e severidade ocorreram apenas na idade de 5anos.Conclusão: Os indicadores de cárie uti lizados informama existência de nichos infanti s com piores situações desaúde bucal em áreas pobres de aparente homogeneidadesocioeconômica devendo-se assim reorientar as intervençõescoleti vas e individuais em áreas/microáreas, onde esses índicessão mais elevados...

Objecti ve: To analyze comparati vely the distributi on patt ernof dental caries in preschoolers living in areas assisted by theFamily Health Strategy of the city of Recife, PE, in two sanitarydistricts.Method: An epidemiological survey of dental caries wasconducted in 2006 in 2,020 children aged 18-36 months and5 years enrolled in the Family Health Centers of the SanitaryDistricts II and IV of the city of Recife, PE. The dmft index wasused as recommended by the World Health Organizati onand the Brazilian Ministry of Health. A probabilisti c sampleby conglomerates (families) was used in one stage. It wascalculated frequency distributi on, tests for comparison of themeans (Student’s t-test and ANOVA) and proporti ons (chisquare)with 5.0% signifi cance level, and ponderati on factorsfor sample representati veness. The analyses were produced bydistrict and by microregions.Results: In both districts, the prevalence and dmft means werehigh, being 29.7% among children aged 18-36 months and63.8% among those aged 5 years. Comparing the districts, thedmft ranged from 0.99 to 1.15 (18-36 months) and from 3.01to 3.65 (5 years). However, the prevalence rati os did not showsignifi cant diff erences between districts or ages. Comparing themicroregions, the diff erences in caries prevalence and severityoccurred only at the age of 5.Conclusion: The caries indicators used in this study revealedthe existence of niches of children with worse oral healthconditi ons in poor areas with apparent socioeconomichomogeneity, suggesti ng a reorientati on of collecti ve andindividual interventi ons in areas/microareas in which higherindices are observed...

Perioperative anesthetic management of patients with hypertrophic cardiomyopathy for noncardiac surgery: A case series.

Hypertrophic cardiomyopathy with or without left ventricular outflow tract obstruction is characterized by asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left ventricular outflow tract. Because Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease, it may present to the anesthesiologist more often than anticipated, sometimes in undiagnosed form during routine preoperative visit. Surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. Therefore, a complete understanding of the pathophysiology, hemodynamic changes and anesthetic implications is needed for successful perioperative outcome. We hereby describe the perioperative management of three patients with Hypertrophic cardiomyopathy for different surgical procedures.

Anti-allergic, anti-inflammatory and anti-lipidperoxidant effects of Cassia occidentalis Linn.

Cassia occidentalis Linn. mast cell degranulation at a dose of 250 mg/kg, showed dose dependent stabilizing activity towards human RBC, with is widely used in traditional medicine of India to treat a number of clinical conditions including allergy and inflammatory manifestations. In the present study anti-allergic, anti-inflammatory and anti-oxidant properties of C. occidentalis whole plant ethanolic extract (CO) was investigated. Effects of CO on rat mast cell degranulation inhibition and human red blood cell (HRBC) membrane stabilization were studied in vitro following standard methods. The anti lipidperoxidant effects of CO were also studied in vitro. Effect of CO on carrageenan-induced mouse paw oedema inhibition was also assessed. CO significantly decreased maximum protection of 80.8% at 15 μg/ml. The extract also caused significant reduction in malondialdehyde (MDA) levels of murine hepatic microsomes at 100 μg/ml (56%) and significantly reduced carrageenan induced inflammation in mice at a dose of 250 mg/kg. Results of the present study indicated that CO inhibited mast cell degranulation, stabilized HRBC membrane thereby alleviating immediate hypersensitivity besides showing anti oxidant activity.

A clinicopathologic study of skin appendageal tumors.

BACKGROUND: Appendageal skin tumors belong to a heterogenous group of tumors with specific histopathology. The aim of this study is to determine the pattern of appendageal tumors in skin biopsies done in our department. METHODS: This is a 3-year retrospective descriptive study of all patients who were diagnosed to have skin appendageal tumors in our department, and the diagnoses were confirmed by histopathology. The tumors were classified as eccrine, hair, sebaceous, and apocrine after a detailed examination of routine hematoxylin and eosin sections. RESULTS: The total number of cases in the study was 33-10 males and 23 females. Tumors with eccrine differentiation constituted the maximum, 17 cases (51.5%); followed by tumors with hair differentiation, 12 cases (36.36%); tumors with sebaceous differentiation, 2 cases (6.06%); and apocrine tumors, 2 cases (6.06%). Syringoma constituted the commonest eccrine tumor, 14 cases (42.42%); while trichoepithelioma was the commonest hair tumor, 9 cases (27.27%). The other eccrine tumors were eccrine spiradenoma, 2 cases (6.06%); and nodular hidradenoma, 1 (3.03%). The other hair tumors were pilar cyst, 2 (6.06%); and pilomatricoma, 1 (3.03%). The sebaceous tumors constituted 2 cases (6.06%) of nevus sebaceous. Syringocystadenoma papilliferum, 1 (3.03%); and cylindroma, 1 (3.03%), constituted the apocrine tumors. CONCLUSIONS: Appendageal skin tumors are relatively uncommon. Histopathology is mandatory for the diagnosis. No tumor showed malignant change in this study.

Hepatoprotective effect of Hibiscus hispidissimus Griffith, ethanolic extract in paracetamol and CCl4 induced hepatotoxicity in Wistar rats.

Hibiscus hispidissimus Griff. is used in tribal medicine of Kerala, the southern most state of India, to treat liver diseases. In the present study, the effect of the ethanolic extract of Hibiscus hispidissimus whole plant on paracetamol (PCM)-induced and carbon tetrachloride (CCl4)-induced liver damage in healthy Wistar albino rats was studied. The results showed that significant hepatoprotective effects were obtained against liver damage induced by PCM and CCl4 as evidenced by decreased levels of serum enzymes, glutamate oxaloacetate transaminase (SGOT), glutamate pyruvate transaminase (SGPT), serum alkaline phosphatase (SAKP), serum bilirubin (SB) and an almost normal histological architecture of the liver of the treated groups compared to the toxin controls. The extract also showed significant antilipid peroxidant effects in vitro, besides exhibiting significant activity in quenching 1, 1-diphenyl-2-picryl hydrazyl (DPPH) radical, indicating its potent antioxidant effects.

Pseudoxanthoma elasticum with cerebrovascular accident.

A 65-year-old male presented with right hemiparesis and skin lesions. On examination, the patient had multiple, discrete, skin-colored papules on the neck and upper chest with wrinkling of the skin. The lateral part of the trunk and medial aspect of both upper arms showed atrophic plaques. A computerized tomography scan of the head showed dilatation of the basilar artery with a frontoparietal infarct. Funduscopic examination showed characteristic angioid streaks. Skin biopsy of the papule and atrophic plaques showed epidermal atrophy, calcium deposits in the mid-dermis and basophilic clumped and fragmented elastic fibers in the mid- and lower dermis, all findings consistent with pseudoxanthoma elasticum. We are reporting here a case of pseudoxanthoma elasticum with cerebrovascular accident.

Primary mucocutaneous histoplasmosis presents as oral ulcer .

We are reporting a rare case of primary mucocutaneous histoplasmosis. A 47-year-old male with a part-time job of rearing pigeons presented with a non-healing oral ulcer with no associated systemic symptoms. Differential diagnosis of oral ulcerative lichen planus, squamous cell carcinoma and mucocutaneous leishmaniasis was considered. Histopathology showed multiple organisms with a peripheral halo, stained strongly with Gomori methenamine silver stain.