ANALYSIS AND COMPARATIVE STUDY OF TOPICAL CONSERVATIVEMEDICATION VERSUS OPERATIVE MANAGEMENT IN PATIENTS OFANAL FISSURE

Introduction:Anal fissures or anal ulcers are considered one of the commonest causes of severe analpain. Surgical techniques like manual anal(lords) dilatation or lateral internalsphincterotomy, effectively heal most fissures within a few weeks, but mayresult in permanently impaired anal continence. This has led to the research foralternative non-surgical treatmentAIMS AND OBJECTIVES:The present study comprises the comparative study of 2% Diltiazem gel,0.2% Glyceryl Nitrate,2%lignocaine jelly application and need of surgical intervention in the treatment of chronic fissure inano.MATERIALS AND METHODS: This is a prospective study of fissure in ano during the period from September 2020 to September2021 in Sheth Lallubhai Gordhandas Municipal General Hospital, Ahmedabad. Clinical Data ofadmitted patient were collected by their detail history after stabilizing the patient, clinicalexamination with appropriate investigations.OBSERVATION AND DISCUSSION:Anal fissure is a very common problem across the world. It causes considerablemorbidity and adversely affects the quality of life. Therefore appropriate treatment ismandatory.In this study the commonest age group affected was 31-40 years agegroup (40%) and least affected were 51-60 years age groupThe incidence of fissure in males was slightly greater than females with MaleFemale ratio being 2.2: 1 in our study.CONCLUSION:Propper clinical examination and appropriate investigations helps in management of patient eitheroperative or non-operative which leads successful treatment in these patients.

Seroprevalence of Lymes disease in the Nagarahole and Bandipur forest areas of South India

Purpose: The aim of this study was to determine the seroprevalence of Lymes disease in a population at risk in south India. Methods: Prospective ongoing study and included screening of forest workers and staff of Nagarahole and Bandipur forest ranges in South India for Lymes disease. Screening included a detailed questionnaire for Lymes disease, complete ocular and systemic examination by an ophthalmologist and infectious disease specialist and blood collection. ELISA for IgM and IgG antibodies for Borrelia burgdorferi were performed on the collected sera samples. Western blot confirmation was done on the seropositive samples. Ticks were also collected from these forest areas for future studies to detect if they harbor B. burgdorferi. Results: Seroprevalence of 19.9% was noted by ELISA. Western blot confirmation was seen in 15.6% of the seropositive samples. There was significant correlation between seropositivity and exposure to tick bites (P = 0.023). Conclusion: There is a high seroprevalence of infection with B. burgdorferi in the forest areas of Nagarahole and Bandipur ranges in south India.

Potential increase in photosynthetic response of taro (Colocasia esculenta L.) to photon flux density and elevated CO2

Aim: The present study was undertaken to study the net photosynthetic rate (Pn), stomatal conductance (gs) and intercellular CO2 (Ci) in five eddoe and four dasheen type taro genotypes under ambient and elevated CO2 , and subjected to different photon flux densities. Methodology: The critical evaluation of Pn was assessed at different photosynthetic photon flux densities (PPFDs) viz., 200, 400, 600, 800, 1000, 1200 and 1500 µmol m-2 hr-1 under ambient CO2 (400 ppm) and at saturation PPFD (1500 µmol m-2 hr-1) at short-term (ten min) exposure of leaves to elevated CO2 (eCO2; 600, 800 and 1000 ppm) at 30oC using portable photosynthesis system LI-6400, LICOR, USA in a controlled-climate cuvette system. Results: The Pn in the leaves of nine taro genotypes persistently augmented upon short-term (10 min) exposure to eCO2 concentrations which ranged between 400 ppm and 1000 ppm. Taro genotypes exhibited 61.80 – 113.3% hike in Pn at eCO2 (1000 ppm) as compared to ambient CO2 (400 ppm). However, the per cent increase in Pn at eCO2 for every 200 ppm between 400 to1000 ppm significantly declined (4.4-18.4%) at 1000 ppm CO2. The differences in gs were statistically significant across taro genotypes (P>0.001) and CO2 concentrations (P>0.001). Further, the Ci was also found to increase constantly at eCO2 concentrations (400 ppm to 1000 ppm). However, there was significant reduction (16.2 - 31.3%) in Ci for every 200 ppm between 400-1000 ppm. Interpretation: Results of the study revealed that the genotypes Muktakeshi, Sree Pallavi and Telia are promising in the context of climate change as they significantly responded to eCO2 concentrations. Response mechanism to eCO2 need to be elucidated.

Reference centile charts of first-trimester aneuploidy screening & Doppler parameters for Indian population

Background & objectives: The risk estimation for foetal aneuploidies in the first trimester of pregnancy uses reference curves based on western data. The objective of this study was to construct the reference curves of first-trimester foetal aneuploidy screening parameters for the Indian women. Methods: Cross-sectional data were obtained from 1204 singleton pregnancies between the crown-rump length (CRL) of 40-84 mm. Linear regression models were constructed; the mean, median and standard deviation were derived as a function of CRL. Results: The mean value of CRL was 61.3 mm. The regression analysis showed a significant correlation between all variables and CRL (P< 0.001). There was a positive correlation of CRL with nuchal translucency (NT) (y=0.010x+0.629, R2=0.116) and pregnancy-associated plasma protein-A (PAPP-A) (y=0.107x?1.079, R2=0.173), whereas inverse correlation was seen with free ?-human chorionic gonadotropin (?-hCG) (y=?0.409x+75.025, R2=0.018) and Doppler parameters pulsatility index (PI) (y=?0.008x+1.924 R2=0.053). The centile charts of NT, PAPP-A, free ?-hCG and uterine artery (Ut A) Doppler PI were constructed. Interpretation & conclusions: The reference centile charts of first trimester aneuploidy screening along with Doppler parameters were derived in Indian pregnant women. These centile charts may be used as a reference for clinical use in Indian population.

Review of research designs and statistical methods employed in dental postgraduate dissertations.

Context: There is a need to evaluate the quality of postgraduate dissertations of dentistry submitted to university in the light of the international standards of reporting. Aims: We conducted the review with an objective to document the use of sampling methods, measurement standardization, blinding, methods to eliminate bias, appropriate use of statistical tests, appropriate use of data presentation in postgraduate dental research and suggest and recommend modifications. Settings and Design: The public access database of the dissertations from Rajiv Gandhi University of Health Sciences was reviewed. Subjects and Methods: Three hundred and thirty‑three eligible dissertations underwent preliminary evaluation followed by detailed evaluation of 10% of randomly selected dissertations. The dissertations were assessed based on international reporting guidelines such as strengthening the reporting of observational studies in epidemiology (STROBE), consolidated standards of reporting trials (CONSORT), and other scholarly resources. Statistical Analysis Used: The data were compiled using MS Excel and SPSS 10.0. Numbers and percentages were used for describing the data. Results: The “in vitro” studies were the most common type of research (39%), followed by observational (32%) and experimental studies (29%). The disciplines conservative dentistry (92%) and prosthodontics (75%) reported high numbers of in vitro research. Disciplines oral surgery (80%) and periodontics (67%) had conducted experimental studies as a major share of their research. Lacunae in the studies included observational studies not following random sampling (70%), experimental studies not following random allocation (75%), not mentioning about blinding, confounding variables and calibrations in measurements, misrepresenting the data by inappropriate data presentation, errors in reporting probability values and not reporting confidence intervals. Few studies showed grossly inappropriate choice of statistical tests and many studies needed additional tests. Conclusions: Overall observations indicated the need to comply with standard guidelines of reporting research.

Significance of Epstein-Barr virus (HHV-4) and CMV (HHV-5) infection among subtype-C human immunodeficiency virus-infected individuals.

Purpose: Opportunistic viral infections are one of the major causes of morbidity and mortality in HIV infection and their molecular detection in the whole blood could be a useful diagnostic tool. Objective: The frequency of opportunistic DNA virus infections among HIV-1-infected individuals using multiplex real-time PCR assays was studied. Materials and Methods: The subjects were in two groups; group 1: Having CD4 counts <100 cells/μl (n = 118) and the group 2: counts >350 cells/μl (n = 173). Individuals were classified by WHO clinical staging system. Samples from 70 healthy individuals were tested as controls. In-house qualitative multiplex real-time PCR was standardised and whole blood samples from 291 were tested, followed by quantitative real-time PCR for positives. In a proportion of samples genotypes of Epstein-Barr virus (EBV) and CMV were determined. Results: The two major viral infections observed were EBV and CMV. The univariate analysis of CMV load showed significant association with cryptococcal meningitis, oral hairy leukoplakia (OHL), CMV retinitis, CD4 counts and WHO staging (P < 0.05) while the multivariate analysis showed an association with OHL (P = 0.02) and WHO staging (P = 0.05). Univariate analysis showed an association of EBV load with CD4 counts and WHO staging (P < 0.05) and multivariate analysis had association only with CD4 counts. The CMV load was significantly associated with elevated SGPT and SGOT level (P < 0.05) while the EBV had only with SGOT. Conclusion: This study showed an association of EBV and CMV load with CD4+ T cell counts, WHO staging and elevated liver enzymes. These viral infections can accelerate HIV disease and multiplex real-time PCR can be used for the early detection. Genotype 1 and 2 of EBV and genotype gB1 and gB2 of CMV were the prevalent in the HIV-1 subtype C-infected south Indians.

A Follow-Up Study on Survival Trend of AIDS Patients Reported at ART Center in Delhi & Variation According to Age, Sex, Stages & Mode of Transmissions.

Incubation period of HIV to AIDS is a vital tool that plays an important role in estimating the longevity or survivability of the HIV infected patients. However, death of AIDS patients when considered as end point becomes meaningful while finding the actual survivability of an individual. The present study is focused in analyzing the data on 343 AIDS patients who were recommended to undergo treatment in the ART centre followed up for a period of 6 years. The study included a cohesive treatment of censored observations based on lost to follow-up, deaths, recovered and alive cases till the end of study as well as uncensored observations. On the basis of diagnosed AIDS cases, the estimates of survivability under various conditions have been obtained. This paper also incorporates the trend of survivability for the reported AIDS patients with respect to age, sex, stages and mode of transmission across these 6 years. Kaplan Meier estimation method and Cox proportional hazard model were applied to determine the effect of various covariates that may be responsible for the death of the AIDS patients, survival pattern.

Implementation of stress coping skills programme in dental students’ curriculum to improve the validity of their assessment.

The key dictum to build reliability (and validity) for any assessment is to have multiple tests on multiple content areas by multiple examiners using multiple tools in multiple settings. Moreover, stress coping skills will have positive impact on all the domains which in turn give a boost to positive tendencies, viz., increasing their attentiveness in class, concentration, and learning and thereby reduce the altered performance due to stress. As a result, the CIV (noise in the assessment) is reduced and hence the validity of assessment is improved. Psychologist and Psychometricians are to be appointed in every institute.

Impact of gibberish meditation on students learning in a dental school.

Background: Gibberish meditational technique claims to reduce the stress and decrease unnecessary thought currents helping the practitioner to be relaxed and attentive. Aims & Objective: The aim of the present study was to know the effect of this technique, just prior to a learning session, on the student’s academic performance, perception and pulse rate. Material and Methods: 87 dental students were divided into two groups by systematic allocation. One group practiced Gibberish meditation technique and the other was control group. Both groups attended a one hour lecture as a part of their regular lecture series. Results: Results did not show any significant difference between the groups in academic performance, although meditation group scored higher. Significant number of students in gibberish group reported to be more attentive, comfortable, relaxed and had better memory and had significant reduction in mean pulse rate. Students expressed a feeling of relaxation and of having a fun filled learning atmosphere after meditation. Conclusion: This simple and easy technique of meditation could be adopted to enhance student learning.

Olfactory tract transection reveals robust tissue-level plasticity by cellular numbers and neurotrophic factor expression in olfactory bulb.

Nervous system lesions are characterized by the loss of neuronal numbers and types. The neurotrophic factor levels in an injured tissue reflect their potential for regeneration. This hypothesis was investigated in olfactory bulb (OB), where olfactory tract was surgically transected disrupting neuronal migration and turnover. The effects were followed with quantification of mitral cells and three neurotrophic factors mRNA levels for 6 weeks. The neuronal numbers decreased by 3rd- and 4th-week in transected OBs followed by their restoration, comparable with that of controls at 5th- and 6th-week. The endogenous levels of three neurotrophic factors – (brain derived neurotrophic factor, insulin growth factor-1 and fibroblast growth factor-2) using qPCR showed increase at 2nd-week by 136-, 8- and 2-fold respectively. Also, there was a significant increase in specific neurotrophic factors at 5th-week and 6th-weeks. The results propose a temporal link between deployment of neurotrophic factors and the plausible restorative events for mitral cell numbers in OB.

Comparison of a conventional polymerase chain reaction with real-time polymerase chain reaction for the detection of neurotropic viruses in cerebrospinal fluid samples.

Purpose : To compare a conventional polymerase chain reaction (PCR) and real-time PCR for the detection of neurotropic DNA viruses. Materials and Methods : A total of 147 cerebrospinal fluid (CSF) samples was collected from patients attending a tertiary care hospital in South India for a period from 2005 to 2008. All these samples were tested using a conventional multiplex/uniplex PCR and a real-time multiplex/uniplex PCR. This technique was used to detect a large number of herpes viruses responsible for central nervous system infections, including HSV-1, HSV-2, VZV, CMV and EBV and the polyoma virus JCV. Results : Overall, in the entire set of samples, the real-time PCR yielded 88 (59.9%) positives and conventional PCR had six (4.1%) positives. Conclusion : Our results suggest that the real-time PCR assay was more sensitive compared with the conventional PCR. The advantage of real-time PCR is that it can be performed much faster than conventional PCR. Real-time PCR is less time-consuming, less labour-intensive and also reduces the chance of contamination as there is no post-amplification procedure. In the entire study population, the major viruses detected using real-time PCR were EBV (34%), HSV-2 (10.8%) and VZV (6.8%).

Comparative evaluation of BACTEC 460TB system and Lowenstein-Jensen medium for the isolation of M. tuberculosis from cerebrospinal fluid samples of tuberculous meningitis patients.

PURPOSE: To evaluate the role of the radiometric BACTEC 460TB system and the conventional Lowenstein-Jensen (LJ) medium for isolation of M. tuberculosis from cerebrospinal fluid (CSF) samples of tuberculous meningitis (TBM) patients. METHODS: CSF specimens (n=2325) from suspected TBM patients were processed for isolation of mycobacteria by inoculating BACTEC 12B medium and the LJ medium. The isolation of mycobacteria in both media was confirmed by microscopy and biochemical identification. Drug sensitivity testing for the anti-TB drugs was carried out by BACTEC radiometric method. RESULTS: Among the total 2325 CSF specimens processed by both methods, M. tuberculosis was isolated from 256 specimens. The isolation rates were 93% and 39% for the BACTEC system and LJ medium respectively. Both the media supported growth in 32% of the culture-positive specimens. BACTEC system alone yielded growth in 61% and LJ alone in 7%, of the culture-positive specimens. Among 205 isolates tested for drug susceptibility 81% were sensitive to all the drugs tested and 19% were resistant. CONCLUSIONS: The BACTEC 460TB system provides a highly sensitive and rapid tool for the isolation and drug susceptibility testing of M. tuberculosis, from CSF of TBM patients. Use of a solid medium in conjunction with the BACTEC 12B medium is essential for optimal recovery for M. tuberculosis from CSF specimens.

Effect of isopod parasite, Cymothoa indica on gobiid fish, Oxyurichthys microlepis from Parangipettai coastal waters (South-east coast of India).

The present study reported for the first time on the effect of isopod parasite, Cymothoa indica infestation on Oxyurichthys microlepis an ecologically important gobiid fish from Parangipettai coastal environment (South-east coast of India). The loss of weight in host fishes (male 20.47 and female 32.84%) were observed due to parasitism. The weight of uninfested female fish was found to be higher than that of infested one. The calus like thickening developed on the gill arch and gill filaments of host fish due to the persistent irritation caused by the appendages of the parasite. The reduction of gill surface area was observed due to the attachment of the parasites. The maximum reduction noticed in the first gill arch is mainly due to the heavy pressure exerted by the parasite. Details of gross lesions observed in the branchial chamber, buccal cavity and body surface was enumerated. Heavy infestations of parasitic juveniles have the potential to kill small fingerlings. The swimming capacity of the fish was also found to be affected.

Neuropathology of HIV/AIDS with an overview of the Indian scene.

Neurological manifestations of HIV infection and AIDS are being recognized with a frequency that parallels the increasing number of AIDS cases. Next to sub-Saharan Africa, India has the second largest burden of HIV related pathology, essentially caused by HIV-1 clade C in both the geographic locales, in contrast to USA and Europe. But the true prevalence of HIV related neuroinfections and pathology is not available due to inadequate medical facilities, social stigma and ignorance that lead to underdiagnosis. Neurotuberculosis, followed by cryptococcosis and toxoplasmosis in various combinations are the major neuropathologies reflecting the endemicity and manifesting clinically by reactivation of latent infection. Discordance in the clinical prevalence of various infections, when compared to pathological studies highlight similarities in clinical, radiological modalities of diagnosis and inherent problems in establishing definitive diagnosis. Viral infections appear to be relatively rare. Inspite of heavy burden of HIV/AIDS, HIV associated neoplasia is infrequent, including primary CNS lymphomas. HIV encephalitis and HIV associated dementia are considered infrequent, though systematic studies have just been initiated in various centres. Peripheral neuropathy characteristically manifests with vasculitic neuropathy while diffuse infiltrative lymphocytosis syndrome (DILS) involving nerves has not been reported from India. Spinal cord pathology including vacuolar myelopathy is rare, even in asymptomatic cases. Till now the AIDS cases in India were drug naive but a new cohort of cases following initiation of HAART therapy as a national policy is soon emerging, altering the biology and evolution of HIV/AIDS in India. Lacunae in the epidemiology, diagnosis and study of biology of HIV/AIDS are outlined for future research.

Structural and functional analysis of rice genome.

Rice is an excellent system for plant genomics as it represents a modest size genome of 430 Mb. It feeds more than half the population of the world. Draft sequences of the rice genome, derived by whole-genome shotgun approach at relatively low coverage (4-6 X), were published and the International Rice Genome Sequencing Project (IRGSP) declared high quality (>10 X), genetically anchored, phase 2 level sequence in 2002. In addition, phase 3 level finished sequence of chromosomes 1, 4 and 10 (out of 12 chromosomes of rice) has already been reported by scientists from IRGSP consortium. Various estimates of genes in rice place the number at >50,000. Already, over 28,000 full-length cDNAs have been sequenced, most of which map to genetically anchored genome sequence. Such information is very useful in revealing novel features of macro- and micro-level synteny of rice genome with other cereals. Microarray analysis is unraveling the identity of rice genes expressing in temporal and spatial manner and should help target candidate genes useful for improving traits of agronomic importance. Simultaneously, functional analysis of rice genome has been initiated by marker-based characterization of useful genes and employing functional knock-outs created by mutation or gene tagging. Integration of this enormous information is expected to catalyze tremendous activity on basic and applied aspects of rice genomics.

Infectious mononucleosis presenting as upper airway obstruction.

Upper airway obstruction though a common complication of infectious mononucleosis is rarely considered in differential diagnosis of stridor. We report a three-year-old child who had upper airway obstruction due to infectious mononucleosis, managed conservatively with oxygen, intravenous fluids and steroids.

Inhibitory role of Syzygium cumini on autacoid-induced inflammation in rats.

The ethanolic extract of Syzygium cumini bark has been reported to possess anti-inflammatory activity in our previous studies. The present study is an attempt to elucidate the anti-inflammatory activity of S. Cumini bark against inflammation induced by individual autacoid insult. Histamine (1 mg/ml), 5-HT (1 mg/ml), bradykinin (0.02 mg/ml) and PGE2 (0.001 mg/ml) were used as inflammogens. One of these agents (0.1 ml) was injected s.c. into the right hind paw of each rat. The ethanolic extract of S. cumini bark was tested at the doses of 100, 300 and 1000 mg/kg, p.o. The results indicated the anti-inflammatory activity of S. cumini bark in histamine, 5-HT and PGE2-induced rat paw oedema. However, there was no such significant inhibition of oedema volume observed in bradykinin-induced rat paw oedema at any dose level. Thus, it is concluded that S. cumini exhibits inhibitory role on inflammatory response to histamine, 5-HT and PGE2.