Clinical evaluation of bioactive resin-modified glass ionomer and giomer in restoring primary molars A randomized, parallel-group, and split-mouth controlled clinical study

Aim: This study aims to evaluate and compare the clinical performance of two restorative materials – bioactive resin-modified glass ionomer (ACTIVA BioACTIVE restorative) and giomer hybrid composite (Beautifil Flow Plus) in restoring class I carious primary molars. Materials and Methods: The split-mouth randomized controlled study was conducted on 100 primary molars from 50 children (28 – males, 22 – females) from 50 children in age range of 5-9 years (Mean-7.29±1.34) with at least two occlusal carious lesions on either maxillary or mandibular primary molars. Each child had both the control and the experimental teeth restored with respective restorative materials, Group I (Control, n = 50) ? Giomer, Group II (Experimental, n = 50) ? Bioactive resin-modified glass ionomer. The restorations were evaluated by two independent investigators using modified United State Public Health Service criteria at immediate postoperative, 6 months, and 12 months. The Chi-square test was used for the statistical analysis after collecting the data. Results: At the 12-month follow-up, 33 children (66 teeth) reported with an attrition rate of 33%. The color match between the groups was not statistically significant at all intervals. The marginal discoloration, marginal integrity, anatomic form, and retention had no significant difference at 6 months. But at 12 months, there was a statistically significant difference between the groups with p value of 0.04,<0.001,<0.02 and <0.001 respectively. respectively. At 12 months, there was no postoperative sensitivity in both groups. Conclusion: Bioactive resin-modified glass ionomer with enhanced properties can be used as an effective restorative material, especially in children with excessive salivation.

Correlation of Vitamin D Levels with COVID-19 Severity and Outcome

Background and aims: Low vitamin D levels have been associated with an increase in inflammatory cytokines and a significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in coronavirus disease 2019 (COVID-19). These conditions are reported to carry a higher mortality in COVID-19. So, we conducted a study to prove the correlation of vitamin D levels with COVID-19 infection and severity. Material and methods: The present study was conducted at RNT Medical College, Udaipur, Rajasthan. This study was done over a period of 2 months after getting approval from Institutional Ethics Committee. Written and informed consent was obtained from patients. In this study, 81 patients admitted in COVID wards and ICU, with COVID reverse transcriptase-polymerase chain reaction (RT-PCR) positive reports were included. Results: Out of a total 81 patients, 37 (45.7%) were in the 41-60 years age group, 29 (35.8%) were more than 60 years of age and 15 (18.5%) were less than 40 years of age. Seventeen patients had severe vitamin D deficiency, 27 patients had moderate vitamin D deficiency, 20 patients had mild vitamin D deficiency and 17 patients had normal vitamin D level. Out of 17 patients who had severe vitamin D deficiency, 11 (64.7%) patients required invasive mechanical ventilation and out of these 17 patients, 13 (76.47%) patients died. Out of 17 patients who had normal level of vitamin D, 16 (94.1%) maintained SpO2 at room air and only 1 patient required invasive mechanical ventilation. As the level of vitamin D increased from severely low to normal level, requirement of high oxygen support decreased and SpO2 at room air increased. Mean of vitamin D among the patients who died was 10.4963 while mean of vitamin D level among patients who survived and were discharged was 27.2362. All 17 patients who had normal level of vitamin D were discharged from the hospital. Mean of serum ferritin and mean of interleukin (IL)-6 was high in patients who died and low in patients who were discharged. Conclusions: Vitamin D level plays an important role in COVID-19 disease. Vitamin D have significant role in protection from severe form of disease.

A Prospective Observational Study of Spectrum of Tropical Infections in Pregnancy in a Tertiary Care Hospital in Mumbai, Maharashtra

Background and aims: Pregnancy is associated with several hormonal and mechanical changes in the body. The tropical infections that most commonly affect pregnant females are malaria, dengue, leptospirosis and typhoid. These tropical infections cause many medical complications in pregnancy by causing anemia, thrombocytopenia, bleeding and inflammatory reactions. Therefore, we conducted a study to evaluate the clinical presentation, complications and outcome of tropical infections in pregnancy. Material and methods: The present study was conducted at a tertiary care hospital in Mumbai, Maharashtra over a period of 1½ year (January 2018 to June 2019) after getting approval from Institutional Ethics Committee. In this study, 250 pregnant patients admitted in medicine ward, obstetrics and gynecology ward, and ICU with symptoms and signs of tropical infections and age more than 18 years, who gave written informed consent, were included. Results: The most common age group amongst the study population was 20 to 24 years (41.6%), followed by 25 to 29 years (40%) and 30 to 35 years (18.4%). Most of the study population had gestational age of 1 to 12 weeks (61.6%), followed by 13 to 28 weeks (31.6%) and more than 28 weeks (6.8%). Most of the study population had parity 2 (46.8%), followed by parity 1 (43.2%), parity 3 (6.8%) and parity 4 (3.2%). The most common clinical features amongst the study population was fever (62%), followed by headache (32.8%), nausea (30.8%), pain in abdomen (26.4%) and petechiae (26%). The most common infections amongst the study population were malaria (11.2%), dengue (8%), leptospirosis (6%) and enteric fever (5.2%). The most common medical complications were bleeding due to thrombocytopenia (TCP) (6.8%), followed by serositis (5.2%), ARDS (4.4%), meningitis (2.8%), subconjunctival hemorrhage (2.8%) and encephalitis (1.4%). Complicated infections were seen in 30% of the study population. Conclusion: All pregnant women must be evaluated at primary care centers properly in their antenatal visits for their parity status and any associated risk factors and diseases. By doing this, we can reduce many tropical infections, complications and maternal mortality in early stage of pregnancy.

Fracture Clavicle: Is Surgical Fixation a Better Treatment?

Background: Fractures of clavicle represent approximately 3–12% of all fractures treated by orthopedic surgeons. There hasbeen a debate over the years for the best treatment of midshaft clavicle fractures. Our study is intended to find both conceptualand practical guidance for precision treatment with an expectant favorable functional result.Materials and Methods: Out of 50 patients of clavicle fractures, 25 were treated conservatively and 25 were treated operativelyby locking plate fixation. Outcomes were assessed using the disabilities of the arm, shoulder and hand (DASH) score forfunctional assessment.Results: Functional and anatomical outcomes were found to be better in patients treated operatively with better DASH scorescompared to patients treated with clavicle brace and sling.Conclusion: Surgical fixation of fracture clavicle gives better functional outcomes and shorter time for union with betteranatomical reduction than non-operative treatment. Hence, we recommend surgical fixation with a locking plate is the standardof treatment in these fractures.

Treatment of Distal End Radius Fractures - By Various Modalities

Introduction: Fractures of the distal end radius represent approximately 16% of all fractures treated by orthopedic surgeons.Our study is intended to find both conceptual and practical guidance for precision treatment with an expectant favorable result.Materials and Methods: Atotal of 50 patients of distal end radius fractures were treated with cast immobilization, percutaneouspinning, external fixation, and volar locking plate fixation. Fernandez classification was used. Functional outcomes wereassessed using Demerit Point System of Gartland and Werley (modified). The anatomical evaluation was done by Lindstromcriteria (modified).Results: Functional outcomes depend on patient’s age, fracture anatomy, displacement, reducibility, stability, and articularincongruity of fractures. They are related more to the anatomical reduction than to the method of immobilization. Volar lockingplate is a safe and effective treatment for unstable and metaphyseal comminuted fractures.Conclusion: According to Fernandez classification, Type I fractures were the most common. The volar locking compressionplate fixation gives excellent functional and anatomical results than other modalities of treatment. Hence, we recommend volarlocking plate fixation is the best modality of treatment among others.

Immunomodulatory Activity Of Chaturthamalaka Rasayana: An Experimental Evaluation

Triphala, a simple combination of Amalaki, Haritaki and Bibhitaki, have proven antioxidant and immunomodulatory activities. But, work on Chaturthamalaka Rasayana, containing Triphala, under four alternate combinations, was not found reported yet. For this, a study was conducted to evaluate the effect of different four combinations under Chaturthamalaka Rasayana on leucocytes and immunoglobulin with special reference to immunomodulatory activity in albino wistar rat model. Four combinations of test drugs were prepared as per classical textual guidelines mentioned in Charaka Samhita. 36 wistar strain albino rats were used in the study. Immunosuppression done by Cyclophosphamide which induced neutropenia. Total leucocyte count (TLC) (cells/mm3), % Neutrophil count and Serum immunoglobulin level (in ZST units) were parameters used to evaluate. All the data were collected and analysed using paired‘t’ test and one way ANOVA test, followed by Dunnett’s multiple comparison ‘t’ test. All the test formulations showed much better effect in comparison with the improvement noted in control group, as a cytoprotective agent. However, with respect to immunostimulation, the control group showed better effect in comparison to the test formulation. Chaturthamalaka Rasayana possesses significant cytoprotective activity and moderate immunostimulant activity. Among the four combinations, all test samples were found effective in immunosuppressive rats. Test sample IV containing Amalaki, Haritaki and Bibhitaki found more potent than or as similar as response in comparison of standard group (Levamisole). Chaturthamalaka Rasayana might be consider as a cost effective and adulteration free alternative formulation over used of costly Chyavanaprasha Avaleha.

A Case Of Cerebral Sinus Venous Thrombosis Resulting In Mortality In Pregnant Woman: Late Diagnosis

Cerebral venous sinus thrombosis (CVST) is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis and papilledema. We report a case of CVST in a 30-year-old female that presented with headache, diminution of vision, swelling and pain in both eyes and bilateral restricted extraocular movements. She expired after 3 days of treatment as she was diagnosed late. Due to its diverse and varied clinical presentation, CVST should be considered as differential in almost any brain syndrome.

Clinical presentation of vernal keratoconjunctivitis in an immunocompromised patient: a case report

Vernal keratoconjunctivitis(VKC)is a chronic bilateral inflammation of the conjunctiva, commonly associated with a personal or family history of atopy. It is characterized by severe itching, foreign body sensation, thick ropy discharge, photophobia and conjunctival injection. VKC has palpebral, limbal and mixed forms. The classical conjunctival sign in palpebral VKC is the presence of giant papillae, which are predominantly seen on the superior tarsal conjunctiva. The limbal form occurs in dark skinned individuals and the papillae tend to occur at the limbus and have a thick gelatinous appearance. Clinical findings and laboratory investigations support the presence of IgE mediated type1 hypersensitivity reaction. Involvement of CD4 T helper (Th2) driven type IV hypersensitivity has also been confirmed. There has been an increase in the prevalence of allergic disorders in recent years and exaggerated manifestations of these diseases have been recognized in patients living with Human immunodeficiency virus

Severe Ocular Surface abnormalities in a child and Ectodermal Dysplasia: A Case Report.

Ectodermal Dysplasia is a disorder that occurs due to abnormal development of at least two major ectodermal derivatives in the developing embryo. Author report the case of a 10 year old male child who was referred to our department with complaints of absent sweating, foreign body sensation and watering in both eyes for past few months. The family history could be traced to four generations and there was an observed trend of increase in severity of signs and symptoms occurring at younger age.  The purpose of this case report is to create awareness in the Ophthalmic community about the diagnosis and clinical manifestations of the disorder. This case highlights the role of multidisciplinary approach for management of systemic disease, genetic evolution of affected individual and carriers and genetic counseling.

Study of perceived stress and stressors among undergraduate medical students

Background: Recently there is growing concern about stress during undergraduate’s medical training. Undue stress may cause adverse health consequences and lowered academic performance. Objective of the study was to know perceived level of stress and its causes among undergraduate medical students.Methods: A cross sectional survey, using self-structured questionnaire, was conducted among 65 third year medical students. Questionnaires were related to socio-demographic profile, perceived stress scale [PSS] and 32 item list of stressors (grouped as health related, academic and psycho-social). Student’s responses were recorded on five point Likert scale.Results: Mean PSS score was 25.53±5.55 and was significantly higher for females. Psycho-social stressors occurred most frequently, followed by the academic causes.Conclusions: Medical undergraduates face high level of stress and the causes may be varied. They need more interaction, counselling and support from faculty to relieve their stress.

A Cross-Sectional Study to Assess the Effect of Epidemiological Determinants on Prevalence of Anaemia among the Adolescent and Reproductive Age Females Residing at Rural Bikaner

Introduction: Nutritional anaemia is a worldwide problem, withthe highest prevalence in developing countries. In India, 20-40% of maternal deaths are due to anaemia. 55 % of Indianadolescent girls are anaemic and the prevalence of anaemia inwomen of reproductive age is 53.1% and 56% of adolescentgirls and 46.8 % of the women aged 15-49 years are anaemicin Rajasthan and the prevalence was slightly higher in ruralthan urban areas.Objective: To study association between epidemiologicaldeterminants and anaemia prevalence among 10-49 year agegroup females of rural Bikaner.Methodology: Community based cross-sectional study, A totalof 600 women were selected for study by systematic randomsampling. Inclusion criteria included informed verbal consentand no critical or chronic illness.Results: Most (92.50%) of the study population was anaemic.Mean haemoglobin value among anaemic and non-anaemicfemales was 8.65±1.23 g/dl & 11.24±1.21 g/dl respectively.About 2/3rd (69.55%) of the anaemic study population hadmoderate anaemia. Only 2.50 % of the anaemic studypopulation had severe anaemia.Conclusion: Anaemia is a major public health problem amongadolescent and reproductive age females in rural area and agegroups, type of family, age at marriage, age at first child,pattern of menstrual cycle, medical history of study populationand signs and symptoms were associated with anaemia inadolescent and reproductive age females.

OsNAC-like transcription factor involved in regulating seed-storage protein content at different stages of grain filling in rice under aerobic conditions

In this study, we show that NAC-like transcription factor (TF) has 90% sequence similarity with cDNA of the OsNac5 gene present in the NCBI database. Phylogenetic analysis of the NAC gene family was performed with inclusion of the highly diverse C-terminal sequences. We report that this gene is also found to be orthologous to Glycine max NAC8, NAC2, Triticum aestivum NAC6 and paralogous to OsNAC6. mRNA was purified from five recombinant inbred lines (RILs) and parents of rice at three different stages of grain filling under aerobic conditions, with grain protein content (GPC) spanning from 4 to 14%. TheNAC-like TF encoding a protein was found to be upregulated at the S2 stage in the leaf (3.9-fold) and panicle (1.84-fold) of parent HPR14 and in five RILs (1.9 to 4.51-fold in leaves and 0.47 to 3.2-fold in panicles). Expression analysis of the NAC-like TF encoding a protein for the rice gene was found to be upregulated at the S2 stage in the leaf and panicle of parental line HPR14 and RILs with high protein content.

Pharmaceutical Evaluation Of Chaturthamalaka Rasayana-an Ayurveda Compound

In Ayurveda, Rasayana is mentioned as a unique preventive as well as curative therapy to achieve healthy long life. The modern medical world is seeking for an alternative class of immunomodulatory drugs, which is nothing but the category of Rasayana. Among this Rasayana formulation, Chaturthamalaka Rasayana (CR) is the one that formulation, mentioned just after Chyavanprasha Avaleha in classical literature of Charaka Samhita. CR consists of four formulations. It is nothing but the simple permutation and combination of Amalaki (Emblica officinalis Gaertn.), Bibhitaki (Terminalia bellerica Roxb.) and Haritaki (Terminalia chebula Retz.) collectively called as Triphala. In present study, it was prepared according to the classical standard operative procedure (SOP) so as to evaluate a physicochemical and phytochemical profile of CR as per standard lab protocols, for all the four formulations under CR, along with the main three raw drugs which ensure the quality. This pharmaceutical analysis differentiates one compound from another by developing its identification markers. As the CR has not been yet studied before, it will be more helpful to evaluate the pharmaceutical screening of this four formulations as an initial step towards standardization. In the future, this study will be helpful to prepare the monograph of CR in the Ayurvedic formulary of India (AFI).

Evaluation of Pro-Inflammatory Markers (Neutrophil- Lymphocyte Ratio and Platelet-Lymphocyte Ratio) and Patient Characteristics in Obstructive Biliary Malignancies Undergoing Palliative Interventional Radiology Management with S.E.M.S (Self Expanding Metallic Stents)

Background: Cholangiocarcinoma and other malignant biliary tract diseases are common causes of obstructive jaundice in elderly patients. Despite advances in imaging these tumors are usually detected at a stage when the resection is no longer possible. In all such cases palliative Interventional Radiology Management with S.E.M.S (Self Expanding Metallic Stents) is one of the best possible palliative treatment options. Utility of pro-inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers for predicting various complications in these patients have been studied by very few researchers. We have conducted this study to find out whether raised NLR and PLR values can be used as prognostic factors in patients undergoing SEMS.Methods: This was a prospective study conducted in the department of interventional radiology of a medical college situated in a rural area. Patients who have undergone SEMS for palliative management of biliary tract cancers were included in this study on the basis of predefined inclusion and exclusion criteria. NLR and PLR were calculated from complete blood count. The analysis of complication rates (cholangitis, cholecystitis, pancreatitis or any other complication) and sepsis was done in relation to NLR and PLR ratio. Statistical analysis was done with Minitab version 17.Results: Out of 76 patients included in this study there were 50 males and 26 females with a M: F ratio of 1:0.52. The most common affected age group was found to be between 41-50 years (26.31%). The most common malignancy encountered was found to be Perihilar cholangiocarcinoma (including its subtypes) (34.21%) followed by distal cholangiocarcinoma (28.94%), intrahepatic cholangiocarcinoma (18.42%), Gall Bladder Carcinoma (13.15%) and Periampullary carcinoma (5.26%). NLR values of more than 3 and PLR values of more than 150 were associated with increased chances of complications and sepsis. Conclusions: Raised values of Neutrophil to Lymphocyte ratio (NLR) and Platelet to lymphocyte ratio (PLR) were found to be associated with increased chances of sepsis and other complications. However further randomized controlled trials are needed to validate prognostic ability of these ratios.

Full genome sequencing of the bluetongue virus-1 isolate MKD20/08/Ind from goat in India

ABSTRACT This communication reports full genome sequencing of the bluetongue virus-1 (BTV-1) isolate MKD20/08/Ind from goat in northern India. The total BTV-1 genome size was found to be 19,190 bp. A comparison study between the Indian isolate and other global isolates revealed that it belongs to the 'Eastern' BTV topotype. The full genome sequence of BTV-1 will provide vital information on its geographical origin and it will also be proved useful for comparing the Indian isolate with global isolates from other host species.

Dens evaginatus and dens invaginatus in a double tooth: A rare case report.

The presence of dens invaginatus (DI) and dens evaginatus (DE) on same tooth is a rare phenomenon. However, when these dental anomalies occur on a double tooth, it becomes an extremely rare phenomenon. The authors report a rare case of DI and DE on fused permanent maxillary central incisor with supernumerary tooth in a 40‑year‑old male. The present article also focuses on the differentiating fusion from gemination and also reviews preventive and management strategies for tooth with complex dental anatomy.

Non‑syndromic multiple talon cusps in siblings.

Talon’s cusp is an anomalous structure that projects palatally from the cingulum areas of maxillary or mandibular anterior teeth. This dental anomaly may pose several pathological, functional and esthetic problems. Talon cusps usually affect a single tooth, but may rarely affect an entire sextant. Such multiple talon cusps may not always occur in association with a syndrome. Furthermore, they may exhibit a genetic pattern of inheritance. This article emphasizes rare occurrence of such nonsyndromic multiple talon cusps in two siblings.

Genomic architecture of HIV-1 infection: Current status & challenges.

Studies on host genomics have revealed the existence of identifiable HIV-1 specific protective factors among infected individuals who remain naturally resistant viraemia controllers with little or no evidence of virus replication. These factors are broadly grouped into those that are immune associated (MHC, chemokines, cytokines, CTLs and others), linked to viral entry (chemokine co-receptors and ligands), act as post-entry restriction elements (TRIM5a, APOBEC3) and those associated with viral replication (cytokines and others). These features have been identified through multiple experimental approaches ranging from candidate gene approaches, genome wide association studies (GWAS), expression analysis in conjunction with functional assays in humans to primate based models. Several studies have highlighted the individual and population level gross differences both in the viral clade sequences as well as host determined genetic associations. This review collates current information on studies involving major histocompatibility complex (MHC) as well as non MHC genes in the context of HIV-1 infection and AIDS involving varied ethnic groups. Special focus of the review is on the genetic studies carried out on the Indian population. Further challenges with regard to therapeutic interventions based on current knowledge have been discussed along with discussion on documented cases of stem cell therapy and very early highly active antiretroviral therapy (HAART) interventions.

Paraneoplastic Syndromes In Patients With Oral Cancer.

Paraneoplastic syndromes (PNS) include a series of disorders that accompany benign and malignant tumors. PNS occurs in one to seven percent of all cancer patients, however the evidences seem to be increasing. PNS associated with head and neck cancer can be divided into six main groups : endocrine, cutaneous or dermatologic, hematologic, osteoarticular or rheumatologic, neurologic and ocular syndromes. PNS can precede, follow or be concurrent with the malignant tumours. The following review thus aims to highlight various aspects of different Paraneoplastic syndromes and how important is awareness of these conditions for clinicians dealing with cancer.

Hypoglossia Type 1A: Report of a case and review of literature with focus on clinical investigations.

Hypoglossia is a rare entity which is reported sporadically. Hypoglossia has often occurred in an association with limb anomalies and, therefore, these cases have been grouped together as hypoglossia-hypodactylia within oromandibular limb hypogenesis syndromes. The literature on this condition is reviewed, and a case of hypoglossia has also been presented. An investigative protocol to aid in the treatment planning of a patient with hypoglossia has also been suggested.