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Introduction: Pleomorphic adenoma, the most common benign mixed salivary gland tumor which accounts for 70-80%, is a biphasic tumor with dual origin from epithelial and myoepithelial elements. It shows a malignant transformation rate of 6%. Microscopically, pleomorphic adenoma characteristically displays vast morphologic diversity. This present study is done to analyze prevalence rates and histomorphological variations to better elucidate the pattern of occurrence, diagnosis and treat- ment plan of pleomorphic adenoma. Materials and Methods: This are a retrospective study which was conducted in a private institution, Chennai. Based on the proportion of parenchymal and stromal tumor components, the cases were classified into four subtypes as proposed by Foote and Frazell. Morphological patterns, cellular patterns, capsular alterations and Stromal components were analyzed and statisti- cally evaluated. Results: Our analysis showed an overall 0.87% of pleomorphic adenoma cases being reported were associated with minor salivary glands followed buccal mucosa and palate. All the reported cases showed Type II pattern with histological cellular pat- tern of spindle cells and ductal morphological pattern. Conclusion: We observed the great diversity of morphological aspects of the stroma in pleomorphic adenoma, in which many cases showed variation in morphology and cellularity associated with tumor location.
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Introduction: Aspergillus fumigatus is the most prevalent fungal pathogen reported to cause diseases such as aspergilloma or aspergillosis in humans. Aspergillomas are commonly seen in a poorly drained and avascular cavitary space. Paranasal sinuses are most commonly involved, especially maxillary sinus. In the past two decades, the incidence of aspergillosis has increased substantially. Aims: To evaluate cases reported as aspergilloma of the maxillary sinus and to determine the percentage of cases involving aspergilloma of the maxillary sinus in healthy individuals. Materials and Methods: After the final full-text review,16 articles were included in this systematic review. Data extracted from these full-text articles was reviewed. Results: 83 % of cases had a history of dental procedures, with 42 % of those being due to infection from previous extraction sockets and 41 % due to root canal therapy (RCT). About 43% of the patients were immunocompromised, while 56% were healthy without any predisposing conditions. Conclusion: Aspergillus fungal infections of the paranasal sinuses are common and can occur in apparently healthy as well as immunocompromised individuals. Aspergilloma is the most common fungal infection involving the maxillary sinus with iatrogenic-dentogenic factors being predominant for initiation and progression of the infection. About 43% of the patients in this review were immunocompromised patients whereas 56% of the patients were healthy without any known predisposing condi- tions. The progression and prognosis of this disease depends on the location and immunologic status of the patient. So, it is very important for dentists to be cautious while performing any dental procedures so as not to initiate any iatrogenic infections.
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Introduction: General dental practitioners (GDPs) play an important role in screening and early detection of oral potentially malignant disorders (OPMD) and oral cancer. Aim: This survey aims to assess the knowledge and awareness of general dental practitioners about chairside diagnostic techniques for screening of inflammatory oral lesions, potentially malignant lesions and oral cancer. Materials and Methods: GDPs (n=125) were surveyed about their knowledge about chairside diagnostic techniques for early detection and screening of suspicious oral lesions. The interview was based on a pre-structured questionnaire containing 14 closed ended questions. Chi square test was used for evaluating the association of survey parameters. Result: 95.2% of dentists do diagnosis and management of suspicious oral lesions along with chief complaints. There is a strong association between the educational status of GDPs and their method for management of suspicious oral lesions (p=0.002). 84.5% of the postgraduate GDPs are aware of chemiluminescence methods than graduate level GDPs (p =0.0009). Majority of the graduate GDPs are unaware of VELScope(p=0.0009). Usage of all non-invasive techniques was found to be less among graduate GDPs (p=0.002). Conclusion: The overall awareness of the dentists involved in the study were good and postgraduate GDPs are more aware and practically ahead about the non-invasive diagnostic techniques than graduate GDPs.
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BACKGROUND: Congenital heart disease is an abnormality of anatomical structure of the heart that is of paramount importance. The incidence is approximately 8 per 1000 live births. CHD not only contributes to signi?cant mortality and morbidity but also causes tremendous psychological stress and economical burden to whole family. OBJECTIVE: To study the pattern and clinical pro?le of congenital heart diseases in a tertiary care hospital and to aid for early stdetection and quick referral of children with congenital heart disease In this study, done between January 1 2020 to RESULTS: june 31st 2021, 54 children with con?rmed congenital heart disease were observed. ACHD was the most common type of CHD and of them, VSD was the most common type, followed by ASD. Based on sex distribution, 31 were male (55.5%) and 23 were female (44.5%), with a male: female ratio of 1.25:1. Most children belonged in the age group 6m – 1year (46.2%) followed by (42.5%) in 30days – 6months age. The common clinical presentation observed in this study was breathlessness. The common complication observed in the current study was heart failure followed by malnourishment and recurrent LRTI.
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Purpose@#The practice of feedback is influenced by the characteristics of students, teachers, and the clinical environment. Most studies on feedback have been conducted in Western settings with different sociocultural backgrounds to Indonesia. This study explores feedback in Indonesian clinical clerkship using a sociocultural lens and aims to provide an exemplar of adaptive practice relevant to non-Western settings. @*Methods@#This qualitative study was conducted using an interpretive phenomenology approach. Data were collected through focus groups with students and teachers and interviews with program coordinators. Data were transcribed verbatim and grouped according to data sources, coded, and analyzed thematically. @*Results@#Themes identified from the focus group discussions and interviews were categorized as student, teacher, and environmental factors. Student factors include dependence on feedback, tendencies to use a group approach, difficulties recognizing social rules, a perceived lack of resilience, and tendencies to doubt praise. Factors related to teachers include a high level of expertise, being extremely busy, having a strong commitment, and being unsure of students’ acceptance of feedback. Clinical environment factors influence interactions between teachers and learners and include high power distance and collectivistic values. A safe environment is needed to ensure effective feedback interactions. @*Conclusion@#High power distance, collectivism, and generational characteristics of students likely impact feedback practice in clinical settings. Designing a safe environment is essential for effective feedback practice.
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Background: F.Benghalensis is known to have medicinal effect and is beneficial in treating mouth ulcers. A.Indicais rich in antioxidants and helps to boost the immune response in gum and tissues of the mouth. Neem offers a good remedy for curing mouth ulcers, tooth decay and acts as a pain reliever.M.Piperita contains antimicrobial and anti- inflammatory properties that promote oral hygiene. Aim: To prepare a mouth wash formulation containing F.benghalensis, A.indica, M.piperita. To determine the cytotoxic and antimicrobial effects of mouthwash formulation containing F.benghalensis, A.indica, M.piperita. Materials and Methods: In the present study, preparation of herbal mouthwash formulation was carried out initially and then the cytoxicity and antimicrobial activity of the mouthwash was assessed. The antimicrobial activity of the mouthwash formula- tion was carried out using agar well diffusion method. Different concentrations of mouthwash were tested against Streptococ- cus mutans, E.faecalis, lactobacillus and Candida albicans. The cytoxicity activity of the mouthwash was assessed using brine shrimp lethality assay method. Results: The cytotoxic activity was found to be better at low concentration. 8 nauplii survived at 5 ?L, 10 ?L, 20 ?L after 24 hours. The antimicrobial activity of the mouthwash formulation showed that the mouthwash formulation had the highest zone of inhibition seen in 100 ?L concentration on C.albicans almost similar to the control antibiotic in comparison to the oral pathogens. Discussion: Ficus benghalensis, Azadirachta indica & Mentha piperita extracts have many medicinal properties. Our study has evaluated the combination of these three extracts in a mouthwash formulation and has found positive results. Conclusion: The mouth wash formulation had better antimicrobial activity and exhibited less cytotoxicity at lower concentrations.
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Headache during pregnancy is a common complaint in the emergency room. In pregnancy, pituitary disorders include both hormone active and hormone inactive tumors. Apoplexy may be the first clinical presentation of an underlying pituitary tumor. Red flag signs of presenting symptoms, to be assessed for identifying life-threatening etiology. Various pathophysiological mechanisms have been passed for pituitary apoplexy in pregnancy. Magnetic resonance imaging of the brain is the gold standard investigation. The mainstay of management is the initiation of steroids. Transnasal transsphenoidal removal of the tumor is the definitive treatment that requires a multidisciplinary approach. The indications of surgery are the presence of symptoms due to compression and endocrine abnormalities; however, gestational period should be taken into consideration. We report a case of headache in antenatal women who presented to our emergency room diagnosed with pituitary apoplexy managed with steroids and early surgery, and discharged with good clinical outcome. We recommend a methodical approach to common symptoms that assist in diagnosing forgotten etiology.
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Background: Oral squamous cell carcinoma (OSCC) is the most predominant type of oral cancer which has a poor prognosis, with 5-year survival rates less than 50%. Clinical characteristics such as tumor position, TNM classification and method of treat- ment, as well as histological grades have all been studied as OSCC prognostic factors but evaluating the genetic expression is the evolving trend in early diagnosis. Aim: To compare the gene expression of TGF-?-1, GSK3, Pi3 kinase in OSCC and normal tissue samples and to correlate the expression levels of these molecules with the pathological grading and survival in OSCC patients. Also to understand the role of GSK3 in Pi3 kinase pathway and TGF-? signaling pathway in OSCC progression thereby attempting targeted therapy in OSCC patients. Materials and Methods: 10 OSCC samples as well as normal healthy samples were collected and RNA isolation was done us- ing RNA easy kit from Qiagen (Valencia, CA), and thensubjected to cDNA synthesis using Human TGF-?1, Human GSK3? and Human Pi3 kinase primers. Real time PCR was performed using gene specific primers at 40 cycles. The results were retrieved, tabulated and analyzed. Results: The current research results revealed that there were up regulation of mRNA expression in GSK3, TGF ?-1 and Pi3 kinase in OSCC patients than in healthy individuals. On comparison, Pi3 kinase showed highest mRNA expression levels than GSK3 and TGF ?-1. Conclusion: The expression of GSK3 and its role in activation of Pi3 kinase pathway plays a crucial role in progression of oral cancer and targeting GSK3?could be a novel and targeted approach for treating OSCC.
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A comprehensive analysis of volatile organic compounds (VOCs) from the exhaled breath sample is termed as breathomics. Breath samples are a complex mixture composed of a multitude of VOCs and other molecules. The analysis of total VOCs in exhaled breath provides a promising tool for the diagnosis of many diseases because it enables the observation of biochemical processes in the body in a non?invasive way. VOCs are produced in various physiological and pathophysiological conditions thus making it a potential biomarker for several diseases.
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It is essential to assess the corneal thickness in diabetes patient.Introduction: diabetes mellitus is a major cause of blindness throughout the worldDiabetic retinopathy is the most importance given on day to day basics studies especially for ophthalmologist studied indicators in eye. However, functional oddities have been recognised in cornea too like changes in central corneal thickness.Objectives: 1. To estimate the central corneal thickness (CCT) of type 2 diabetes mellitus patients without diabetic retinopathy age/sex matched normal people. 2. To measure central corneal thickness (CCT) of type 2 diabetes mellitus patient with diabetic retinopathy with age/ sex matched normal person.Methods: This is a hospital based case control study.Expected Results: The central corneal thickness is more in type 2 diabetes patients than non-diabetic individual.
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Sandhigat Vata is a Vata vyadhi of degenerative nature, and Basti is preferred line of treatment for all Vata vyadhi as mentioned by Acharya Charak. Matra Basti is a type of Anuvasan Basti which is used for many degenerative diseases. So for present study Matra Basti with Sahachar Tail was selected. Acharya Charaka has mentioned Sahachar Taila in the management of the Vat Vyadhi. Acharya Yogratnakar has mentioned Sahacharadi Kwath with Til Taila under the context of Vat Vyadhi. Here Sahacharadi Kwath with Til Taila was selected for Shaman Chikitsa. Aims and objectives: To evaluate and compare the effect of Sahacharadi Kwath with and without Matra Basti in the management of Janu Sandhigat Vata w.s.r to Osteo-arthritis. Material and methods: For present study 30 patients of Janu Sandhigat Vata were selected according to the classical signs and symptoms of Sandhigat Vata according to Ayurveda as well as modern science, were randomly divided into 2. Result: In Group A, total 15 patients were treated. Out of 15 patients 20.0% patients got marked improvement, 73.33% got moderate improvement while 6.67% patients got mild improvement. No patient got complete remission. In Group B, total 15 patients were treated. Out of them 6.67% patients got marked improvement, 40.0% patients got moderate improvement and 46.67% showed mild improvement. One patient remains unimproved. No patient got complete remission. Conclusion: It is concluded that Matra Basti along with Sahacharadi Kwath provided better result as compare to only Sahacharadi Kwath in the management of Janu Sandhigata Vata.
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Objective: To study the association between routine childhood vaccination and the severity of COVID-19 among children. Methods: A cross-sectional study was undertaken among 141 children (aged ?15 years), tested positive for SARS-CoV-2 infection. Results: COVID-19 severity (combined moderate and severe) was significantly more in males (14.5%) than females (3.8%), and in those who did not receive first and second dose of MR vaccine (57.1%, and 40%, respectively) than who received (6.3%, and 6.1%, respectively). Disease severity was more in partially immunized children (16.7%) as compared to fully immunized children (7.0%). Conclusions: Children who did not receive both doses of MR vaccine had a severe infection when compared to those who were vaccinated.
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Though masks are the best shield against COVID?19, they can be a source of discomfort and ocular side effects. We discuss three cases of corneal injury due to mask use. Three patients, who were healthcare workers, presented with discomfort, photophobia, and pain in the eyes. While adjusting the mask, they had an ocular injury. There were multiple superficial linear abrasions in the eyes. They recovered with treatment. Though masks are imperative during the COVID?19 pandemic, it is important to be aware of a possible mask injury.
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Objective@#: Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. @*Methods@#: A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. @*Results@#: Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9–15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. @*Conclusion@#: Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.
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Purpose@#The objective of the study was to evaluate the type of conjunctival microbial flora in intensive care unit patients and their antimicrobial sensitivity pattern. @*Methods@#A total of 272 samples (conjunctival swabs) were taken from patients in various intensive care units and sent for culture and sensitivity. An ocular examination was done to look for lagophthalmos, conjunctival discharge, exposure keratitis, and corneal perforation. @*Results@#Majority (82.1%) of the samples showed at least one microbial isolate while 29 (10.7%) samples showed multiple microbial growth. The most common microbes were coagulase negative Staphylococcus spp. (41.5% of isolates), diphtheroids (11.0% of isolates), and Staphylococcus aureus (9.6% of isolates) which are the usual commensals of the ocular surface. Of the other microbes isolated, Pseudomonas aeruginosa (4.0%) was the most common. Eighty-four percent isolates of coagulase negative Staphylococcus sp., 81.8% isolates of diphtheroids and 100% isolates of Staphylococcus aureus were penicillin resistant. All isolates of Enterococcus fecalis were sensitive only to vancomycin. Two hundred and twenty eyes (80.9%) had varying degrees of lagophthalmos. Nineteen (7.0%) had severe corneal exposure changes leading to infectious corneal ulcer and perforation in all of them. @*Conclusions@#The isolates in patients of intensive care units were no different from the normal conjunctival flora though few pathogenic organisms such as Pseudomonas aeruginosa and Acinetobacter sp. were also isolated. Most of the isolates were penicillin resistant. This knowledge will help take appropriate prophylactic measures to contain ocular infections in the intensive care units.
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Purpose@#The objective of the study was to evaluate the type of conjunctival microbial flora in intensive care unit patients and their antimicrobial sensitivity pattern. @*Methods@#A total of 272 samples (conjunctival swabs) were taken from patients in various intensive care units and sent for culture and sensitivity. An ocular examination was done to look for lagophthalmos, conjunctival discharge, exposure keratitis, and corneal perforation. @*Results@#Majority (82.1%) of the samples showed at least one microbial isolate while 29 (10.7%) samples showed multiple microbial growth. The most common microbes were coagulase negative Staphylococcus spp. (41.5% of isolates), diphtheroids (11.0% of isolates), and Staphylococcus aureus (9.6% of isolates) which are the usual commensals of the ocular surface. Of the other microbes isolated, Pseudomonas aeruginosa (4.0%) was the most common. Eighty-four percent isolates of coagulase negative Staphylococcus sp., 81.8% isolates of diphtheroids and 100% isolates of Staphylococcus aureus were penicillin resistant. All isolates of Enterococcus fecalis were sensitive only to vancomycin. Two hundred and twenty eyes (80.9%) had varying degrees of lagophthalmos. Nineteen (7.0%) had severe corneal exposure changes leading to infectious corneal ulcer and perforation in all of them. @*Conclusions@#The isolates in patients of intensive care units were no different from the normal conjunctival flora though few pathogenic organisms such as Pseudomonas aeruginosa and Acinetobacter sp. were also isolated. Most of the isolates were penicillin resistant. This knowledge will help take appropriate prophylactic measures to contain ocular infections in the intensive care units.
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Objective@#: Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. @*Methods@#: A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. @*Results@#: Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9–15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. @*Conclusion@#: Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.
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Background: Animal models had always served as integral part in introducing newer drugs for epilepsy. India has long tradition of using herbal medicines. Centella asiatica is an ingredient of various ayurvedic preparations to treat brain related disorders like insanity, memory loss and epilepsy. This research is done to find out the usefulness of Centella asiatica in epilepsy. Methods: Ethanolic extract of the plant is prepared using Soxhlet apparatus. Experimental seizure is induced in albino mice by maximal electroshock method. Resulting seizure goes through different phases. Duration of the phase of hind limb extension was the measured data. Clinically used anti epileptic drugs can abolish hind limb extension. Effect is compared to that of standard drug phenytoin. Four different doses of the plant extract; 100mg, 200mg, 500mg and 1000mg per kilogram bodyweight was given orally. Statistical analysis of data was done by one way ANOVA and Dunnett test.Results: Ethanolic extract of Centella asiatica exhibited statistically significant protection from maximal electroshock seizures. All given doses of the extract had p<0.05 when compared to control.Conclusions: Centella asiatica is potential source of anti-epileptic drug. Detailed phytochemical studies and animal experiments are recommended.
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Background: Anovulatory dysfunction is a commonly encountered problem which is responsible for about 40% of female infertility. One of the leading causes of female infertility is polycystic ovarian syndrome (PCOS). Clomiphene citrate has been the drug of choice in treating women with anovulatory infertility. However, in recent years, letrozole, an aromatase inhibitor, has emerged as alternative ovulation induction agent. Aim of this study was to compare efficacy of clomiphene citrate and letrozole as first line therapy for ovulation induction in polycystic ovarian syndrome.Methods: This study was a hospital based prospective comparative study done in MVJ MC and RH involving 100 females suffering from infertility due to anovulation. They were divided into 2 groups of 50 each. One group was given clomiphene citrate 50 mg while another group was given letrozole 2.5 mg from day 3 to day 7 of menstrual cycle. Ultrasonographic follicular monitoring was done and injection beta HCG 5000 IU was given once follicle reached optimum size (≥18 mm) and endometrial thickness was adequate (≥7 mm). Patients were advised for timed intercourse after 24-36 hours of HCG administration. Ovulation was detected by sonographic findings of follicular rupture done after 48 hours. Primary outcomes measured were number of growing follicles (≥18 mm), endometrial thickness, ovulation rate and pregnancy rate.Results: In our study there was significant difference in the outcomes of ovulation induction between letrozole group and clomiphene group. Women who received letrozole showed improved endometrial growth (8.44 mm versus 7.86 mm), ovulation rate (72% versus 56%) and pregnancy rate (22.2% versus 14.3%) than those who received clomiphene. However, variation in follicular growth was negligible between the two groups (1.28 versus 1.36).Conclusions: Letrozole is a superior alternative to clomiphene citrate for ovulation induction in cases of PCOS with anovulatory menstrual cycle, and can be considered as first-line therapy for ovulation induction in such women.
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A 40-year-old male presented in our surgery OPD with a history of left sided neck swelling since two months. There was no associated history of pain, fever or cough. General physical and systemic examination did not reveal any abnormality. Local examination revealed multiple cervical lymph nodes along the jugular chain, largest measuring 3 cms. His complete blood count and chest X-ray did not reveal any abnormality. FNAC was suggestive of sinus histiocytosis. Patient underwent excision of the lymph nodes under general anaesthesia. Since the submandibular gland also appeared involved on table, decision was taken to excise it as well. Histopathology report revealed multiple foci of dilatation of sinusoids with histiocytes showing engulfment of lymphocytes and plasma cells, thus consistent with Rosai Dorfman disease. The Submandibular Gland was normal. The Patient was managed conservatively. The postoperative recovery was uneventful and subsequent follow ups did not reveal any recurrence.Isolated painless cervical lymphadenopathy is a common presentation in a surgical OPD accounting for almost 12 - 15 % of all cases1. Most common differentials in these cases include infections, tuberculosis, lymphoma, and metastatic malignancies. We report a case of Rosai Dorfman disease presenting as isolated unilateral cervical lymphadenopathy in a young male. The diagnosis was made on cytology and later confirmed on histopathology of excision biopsy. The patient was managed conservatively and had an uneventful course.Rosai Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is a rare benign proliferative disorder of histiocytes, characterised in majority of cases by painless ipsilateral cervical lymph node enlargement and rarely as an extranodal disease2,3. In the setting of other conspicuous differentials, it often presents as a histopathological surprise. This disease often has a benign course and mostly resolves spontaneously. Our case emphasizes on the need for unbiased general approach in the management of cervical lymphadenopathy with the awareness of Rosai Dorfman as a differential diagnosis.