ABSTRACT
Background: Gestational age (GA) is a critical-factors in the decision making and predicting mortality and morbidities of neonates. In low resource settings where affordability and availability of first trimester scan is limited, assessment is often done by postnatal methods like expanded new Ballard score (ENBS) which are often clinical skill dependent and complex. Hence, there is a need of a simple and cost-effective method which can be readily adopted by frontline health care workers at periphery. One such method is assessment of foot length (FL). Methods: This prospective cross-sectional study was conducted in the level 3 NICU of Central India over a period of 18 months. Included neonates were assessed for GA by measuring FL by vernier calliper within 48 hours of birth and its validity was tested against ENBS as reference standard. Other anthropometric measurements like birth weight, head circumference and length were obtained within 48 hours of birth. Results: Total 700 neonates were included in the study. For, determining preterm newborn, the potential cut-off of FL of ?6.86 cm, with a sensitivity of 94.6% and specificity of 73.8%. The area under ROC (receiver operating characteristic) curve is 0.92. Conclusions: FL measurement is a cost-effective and time-saving simple intervention that can facilitate early identification of preterm newborns as well as help in initiating timely interventions and hence improving neonatal outcomes in resource-poor settings
ABSTRACT
Context: ?-thalassemia trait is usually diagnosed by raised hemoglobin A2 (HbA2). The presence of megaloblastic anemia can cause an increase in HbA2 and create a diagnostic dilemma. Here, we have analyzed the effect of vitamin B12 and folic acid supplementation on HbA2 and diagnosis of ?-thalassemia trait in cases of megaloblastic anemia with raised HbA2. Materials and Methods: Cases of megaloblastic anemia with raised HbA2 on high-performance liquid chromatography (HPLC) were supplemented with vitamin B12 and folic acid. Post-treatment evaluation was done after 2 months. Cases showing adequate hematological response were subjected to statistical analysis. Based on post-treatment HbA2 value, the cases were diagnosed as normal, borderline raised HbA2, or ?-thalassemia trait. Pre- and post-treatment values of red cell parameters and HbA2 were analyzed. Results: There was a significant decrease in HbA2 value after vitamin B12 and folic acid supplementation. The diagnosis was changed in 70.97% of the cases after treatment. The chance of inconclusive diagnosis was decreased from more than 50% to less than 10%. Pre-treatment mean corpuscular volume (MCV) and HbA2% showed a significant difference between the thalassemic and normal groups. Conclusions: Megaloblastic anemia can lead to false-positive diagnosis of ?-thalassemia trait on HPLC. Repeat HPLC should be done after adequate supplementation of vitamin B12 and folic acid in cases of megaloblastic anemia with raised HbA2. Red cell parameters are not helpful to suspect ?-thalassemia trait in presence of megaloblastic anemia. However, HbA2% on HPLC can be a useful parameter to suspect or exclude ?-thalassemia trait in cases of megaloblastic anemia.
ABSTRACT
Periodontitis is a prevalent infectious disease in which the accumulation of bacterial plaque leads to an inflammatory reaction and destruction of supporting tissues around the teeth. The optimal goal in periodontal treatment is to eliminate the infection and to recreate the lost structures of cementum, periodontal ligament (PDL), and the alveolar bone with the reestablishment of their functions. Achieving this regenerative aim, however, remains a major challenge for periodontists. In order to increase the predictability and the efficacy of regenerative periodontal therapies, treatment modalities have moved from the conventional guided tissue treatments to novel tissue engineering and stem cell–based treatments. This is achieved either by transplantation of cells from outside sources to the periodontal defects or by enhancing the recruitment of endogenous host cells present in the area, known as cell homing methods. Photobiomodulation (PBM) therapy is a term used for exposure of cells/ tissues to low-level laser light or light-emitting diodes (LEDs), which is absorbed by specific photoreceptors in cells and may cause alteration at a molecular level inside cells without any heat generation leading to biological changes in cell metabolism and function.
ABSTRACT
Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients’ need for pain control, destigmatization, and human immune-deficiency virus (HIV) transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor collaboration between dental and general health care sectors serving addicts. These interfere with an accurate picture of the situation. Moreover, lack of appropriate policies to improve access to dental services, lack of comprehensive knowledge of and interest among dental professionals in treating addicts, and low demand for non-emergency dental care affect provision of effective interventions. Management of drug addiction as a multi-organ disease requires a multidisciplinary approach. Health care programs usually lack oral health care elements. Published evidence on oral complications related to addiction emphasizes that regardless of these barriers, oral health care at various levels including education, prevention, and treatment should be integrated into general care services for addicts.
ABSTRACT
In Odisha, Kalahandi is one of the most exposed and vulnerable districts to malaria incidences due to its poor socioeconomic condition and extreme climate. The study aimed to explore the temporal characteristics of malaria incidences in Kalahandi and to identify its relationship with rainfall for the period from 2011 to 2018. Out of the total blood films examined, 8.84% were found positive in Kalahandi between 2011 and 2018. Plasmodium falciparum is the most dominant species accounted 88.3% of the total cases. Very high mean annual parasitic index (API) >15 is recorded throughout the study years. The highest incidences are recorded in the monsoon season followed by postmonsoon. The correlation value of the annual blood examination rate with P. falciparum, Plasmodium vivax, and API has shown a very high positive correlation. Rainfall shows a (+) correlation with malaria incidences in the cold (0.47) and hot seasons (0.01) and (−) correlation in the monsoon (−0.54) and postmonsoon season (−0.54).