Thermal expansion and corrosion resistance of cobalt-chromium alloys fabricated by contemporary manufacturing processes: an in vitro study / Expansión térmica y resistencia a la corrosión de aleaciones de cobalto-cromo fabricadas mediante procesos de abricación contemporáneos: un estudio in vitro

In Purpose: The fabrication technique can influence the mechanical properties of Cobalt-Chromium (Co-Cr) dental alloys. Hence, the present study aims to determine the corrosion resistance and thermal expansion of alloys manufactured using three contemporary techniques. Material and Methods: A total of nine specimens of Co-Cr alloy were prepared according to ISO 22674 by each one of the three manufacturing processes (three in each process); conventional casting, direct metal laser sintering (DMLS) and milling (MIL). All these specimens were tested for coefficient of thermal expansion and corrosion resistance. The data was tabulated and analyzed statistically. Results: The difference in the thermal expansion of alloys fabricated using three techniques was non-significant at almost all the temperatures from 50 ºC to 950 ºC (p>0.05), except 450 ºC and 600 °C. The polarization resistance of specimens manufactured using the conventional method was more compared to DMLS and MIL at pH 5 (Conventional>MIL>DMLS) (p<0.001). Conclusion: The thermal expansion behavior of alloys manufactured using the three selected techniques were similar, whereas, at acidic pH, the corrosion resistance of conventional and MIL were better than the DMLS.

Antecedentes: La técnica de fabricación puede influir en las propiedades mecánicas de las aleaciones dentales de cobalto-cromo (Co-Cr). Por lo tanto, el presente estudio tiene como objetivo determinar la resistencia a la corrosión y la expansión térmica de aleaciones fabricadas con tres técnicas contemporáneas. Material y Métodos: Se prepararon un total de nueve probetas de aleación de Co-Cr según ISO 22674 por cada uno de los tres procesos de fabricación (tres en cada proceso); fundición convencional, sinterización directa de metal por láser (DMLS) y fresado (MIL). Todos estos especímenes fueron probados para determinar el coeficiente de expansión térmica y la resistencia a la corrosión. Los datos fueron tabulados y analizados estadísticamente. Resultados: La diferencia en la dilatación térmica de las aleaciones fabricadas con las tres técnicas no fue significativa en casi todas las temperaturas desde 50ºC hasta 950ºC (p>0,05), excepto 450ºC y 600ºC. La resistencia a la polarización de las muestras fabricadas con el método convencional fue mayor en comparación con DMLS y MIL a pH 5 (Convencional>MIL>DMLS) (p<0, 0 01). Conclusión: El comportamiento de expansión térmica de las aleaciones fabricadas con las tres técnicas seleccionadas fue similar, mientras que, a pH ácido, la resistencia a la corrosión de la convencional y la MIL fue mejor que la de la DMLS.

Role of Jaloukavacharana in Management of Raktharshas (Thrombosed Hemorrhoids)

Arsha's is one among the Astamahagada, and a commonest ano-rectal disease with a wide range of symptoms. It affects all economic groups of the population. In Ayurveda, Arsha's is a growth of Mamsa with obstructs the anal opening. Anatomically anal canal is 51/2 Angula's length. A faulty lifestyle and dietary habits along with occupational and physical stress triggers the pathology of Arsha's. Doshic involvement includes Rakta along with Mamsa dhatu at Rakthavaha Dahmanis of Guda, which forms as Mamsa Ankura. Acharya Susrutha mentioned 4 curative measures for the treatment, they are Bhesaja, Kshara karma, Agni karma, Shastra karma. Hemorrhoids are dilated rectal veins. Thrombosed piles occur where there is high venous pressure, which is associated with severe pain, which hampers their daily routine, thereby they avoid defecation which leads to hardening of stool, constipation and rectal bleeding. The treatment includes the surgical excision of the thrombosed pile mass. A case study of thrombosed pile treated with Jaloukavacharana (leech therapy) has been recorded which has reduced the mass, pain, bleeding per rectum

Evaluation of Serum and Gingival Crevicular Fluid Levels of Vitamin D Binding Protein in Subjects with Clinically Healthy Periodontium and Chronic Periodontitis: A Clinico Bio-Chemical Study

Background: Advances in oral and periodontal disease diagnostic research are moving towards methods wherein periodontal risk can be identified and quantified by objective measures such as bio?markers. Given the roles of vitamin D binding protein (DBP) in modulating the immune response and in the transport of vitamin D, it is hypothesised that quantitative changes of vitamin DBP are associated with periodontal disease. Aim: The aim of the current study is to measure DBP levels in serum and gingival crevicular fluid (GCF) of patients with generalised chronic periodontitis, in comparison to healthy controls. Materials and Methods: The present cross?sectional clinico?bio?chemical study includes 30 systemically healthy subjects with 15 periodontally healthy and 15 chronic periodontitis subjects who were recruited from the out?patient Department of Periodontics. GCF and blood samples were collected from all the patients. DBP estimation was performed in both the samples using a commercially available ELISA kit. Results: Serum and GCF DBP levels in chronic periodontitis subjects were significantly higher when compared to the periodontally healthy group. There were no significant correlations found among serum and GCF DBP levels with gender and increasing age in both the groups. An increase in disease severity measured by the increase in probing pocket depth and clinical attachment loss did not show correlation with the GCF and serum DBP levels in the chronic periodontitis group. Conclusion: Based on the findings of the present study, increased serum and GCF DBP levels in chronic periodontitis seem to be a probable marker for identifying ongoing periodontal destruction.

​Comparison of Block Characteristics and Hemodynamic Effects of Low Doses of Clonidine and Dexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine for Spinal Anesthesia in Patients Undergoing Lower-limb Surgeries

Background: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and post-operativeanalgesia. Among them, clonidine and dexmedetomidine are two α2-agonists which can be used as neuraxial adjuvants.Dexmedetomidine, a highly selective α2- adrenergic agonist, is a newer neuraxial adjuvant gaining popularity.Objectives: The objective of the study was to compare sensory and motor block characteristics, hemodynamic effects and sideeffects of low doses of clonidine or dexmedetomidine as an adjuvant to 12.5 mg hyperbaric bupivacaine in spinal anesthesiain lower-limb surgeries.Materials and Methods: A total of 90 patients of American Society of Anesthesiology I and II posted for lower-limbsurgeries were randomly allocated into three groups of 30 each. Group B received plain 12.5 mg of hyperbaric bupivacainediluted to 3 ml with normal saline. Group C received 30 mcg clonidine added to 12.5 mg hyperbaric bupivacaine anddiluted to 3 ml. Group D received 3 mcg dexmedetomidine added to 12.5 mg hyperbaric bupivacaine and diluted to 3 mlwith normal saline.Results: Patients in Group D and Group C had a significantly shorter onset time of sensory and motor block and significantlylonger duration of sensory and motor block compared to bupivacaine group. The mean time for sensory regression to S1 segmentwas 301.90 ± 31.96 min in Group D, 283.23 ± 13.59 min in Group C, and 181.70 ± 18.55 min in Group B (B vs. D and B vs. C,P < 0.001). There was a statistically significant difference in the two segment regression of sensory block in Group D (140.32± 17.6 min) when compared to Group C (124.5 ± 16.10 min) and Group B (92.13 ± 11.45 min). The regression of motor blockto Bromage 0 was 262 ± 24.40 min in Group D, 261 ± 24.19 min in Group C, and 164.40 ± 15.26 min in Group B (B vs. D andB vs. C, P < 0.0001). The onset and regression times were comparable between Groups D and C. Time for the first request ofrescue analgesia was nearly equal in Groups D and C and prolonged compared to Group B. Patients were hemodynamicallystable in all the groups.Conclusion: Dexmedetomidine and clonidine have a similar onset of sensory and motor block, prolonged duration of analgesia.Dexmedetomidine provides better analgesia than clonidine

Assessment of Extra Dural Hematoma – Factors affecting morbidity, mortality and outcome

Background: Extradural hematomas occur in approximately 2% of all patients of head injuries and 5- 15% of fatal head injuries. EDH is considered to be one of the most serious conditions of head injury requiring immediate diagnosis and surgical intervention. Aim and Objectives: The purpose of this study was to evaluate the clinical presentation of patients with extradural hematoma and to decide upon the mode of management and to study the results of the management and the outcome and the factors affecting morbidity and mortality. Materials and Methods: Patients with EDH admitted in Neurosurgery Department, King George Hospital Andhra Medical College, Visakhapatnam were studied. Study period was one year July 2018 to June 2019. The sample size of the study was 106 patients who fulfill the inclusion and exclusion criteria. All the patients with head injury, diagnosed to have EDH on CT scan were included in the study. The management includes conservative measures and/or surgical intervention. The patients’ outcome was assessed during the hospital stay, at discharge and followed up to 6 months after discharge. The various factors were analyzed which are likely to affect the outcome. Results: Temporo-parietal and temporal region was the most common location of EDH. The most significant factors which influences outcome are - time of surgical intervention, older age group, low GCS and associated injuries on CT scans like contusions and other injuries. The patients were followed after 1, 3 and 6 months. P Prahaladu, M V Vijaya Sekhar, K Satyavara Prasad, Hemal Chheda. Assessment of Extra Dural Hematoma - Factors affecting morbidity, mortality and outcome. IAIM, 2019; 6(9): 102-107. Page 103 Conclusion: From this study, it was observed that neurological status of patient at the time of presentation, time of surgical intervention, associated injuries on CT scan and the volumetric details of EDH are the most important factors in management and outcome of EDH.

Factors affecting outcomes in compound depressed frontal bone fractures: Institutional study

xIntroduction: Compound depressed frontal bone fractures exhibits some peculiarities such as frequent involvement of frontal sinus and olfactory nerve and tract, which lie on the floor of the anterior cranial fossa. The primary aim of our study is analyzing factors influencing the outcomes in compound depressed fractures of frontal bone .This will help in improving outcomes and management of compound depressed frontal bone fracture. Material and methods: Study was conducted at tertiary care institute by collecting data of 40 patients operated surgically from August 2018 to July 2019. The study included patients who were diagnosed with compound depressed frontal bone fracture and underwent surgical management at our institute. Follow-up was performed at least 3 months after the trauma. The variables evaluated were mortality, GOS, occurrence of rhinorrhea, meningitis, late post-traumatic epilepsy and smell disturbances. Results: Most of our patient with GCS 13-15 was discharged with good clinical outcome and no complication on follow-up. Patient with low GCS and delayed presentation are at risk and adds up morbidity and mortality. Conclusion: Early surgical intervention in patients with GCS 13-15 is associated with good outcomes and low complication rate associated with meningitis or CSF leak.

Screening Of Wound Healing Activity Of Madayantika (lawsonia Inermis Linn.) In Albino Wistar Rats

Madayantika (Lawsonia inermis Linn.) is a miracle medicinal plant used in the treatment of various skin diseases especially in wound healing activity in the Indian system of medicine. Aim and Objective: The objective of the study presented in this article was to evaluate the wound healing potential of aqueous extract. The models usually used for evaluation of wound healing activity are Excision wound model, Incision Wound Model and Dead Space model. Among those excisions wound model is selected for the study. Healthy wistar strain Albino rats of either sex weighing 150-200gm were used for the study. Animals are acclimatized in a laboratory and then it were anaesthetized and then dorsal surface of rats were shaved to about an area of 500mm2 and then it was cut carefully with sterilized forceps and left undressed for open environment, then extracts of test drugs, Scaffolds containing aqueous extract and standard drug were applied and then observed and noted. Results: The extract of Madayantika (Lawsonia inermis Linn.) treated wounds were found to epithelize faster and rate of wound contraction was significantly (p<0.0001) increased as compared to control group (p< 0.01). The extract treated animals showed from 502 �364 to 25.1�252 reduction in wound area when compared with control groups from 502� 0.538 to 40.71� 0.166. Conclusion: Madayantika (Lawsonia inermis Linn.) possess significant wound healing effect which may beneficial in treating wounds. This drug showed extremely significant results in wound healing activity.

Smart use of smart phones in severe TBI (Traumatic Brain Injury) – A miniature Tele therapy.

This is the era of Smart phones. Smart phones have revolutionised all the fields including the field of medicine. Absence of internet coverage in the remote rural areas which was a constraint and limitation for their use has also been overcome by the technological advancements in the yesteryears. Simultaneously the availability of CT and MRI scan has seen the light in the District Headquarters hospitals of North Coastal Andhra Pradesh. In trauma care, the ubiquitous concept of the “golden hour” suggests that the time between the occurrence of an accident and the receipt high quality, appropriate treatment is a critical factor in patient survival. Therefore, saving time from the moment of occurrence all the way through to the moment of appropriate treatment is critical. Introduction of various APPs in Smart phones has made transmission of visual images instant and easy from any remote corner of the world. This advancement in function, applied to the health care sector in India made an enormous difference in providing emergency specialist care services to the remote areas of India.

Cephalometric Comparison of Frankforts Horizontal Plane And Occlusal Plane With Variations In Ala- Tragus Line.

The glossary of prosthodontic terms defines occlusal plane as an average plane established by the incisal and occlusal surfaces of the teeth. Generally, it is not a plane but represents the planar mean of the curvature of these surfaces. Another definition defines it as the surface of wax occlusion rims contoured to guide in the arrangement of denture teeth. Ala-tragus line according to the glossary of prosthodontic terms is defined as a line running from the inferior border of the ala of the nose to some defined point on the tragus of the ear, usually considered to be the tip of the tragus. It is frequently used, with a third point on the opposing tragus, for the purpose of establishing the ala-tragus plane. Ideally, the ala-tragus plane is considered to be parallel to the occlusal plane. The occlusal plane is at an angle of approximately 10 degrees relative to the Frankfort horizontal plane, when viewed in midsagittal plane. No precise, scientific method exists for determining the level of the occlusal plane in edentulous patients. Several principles have been postulated for determining the occlusal plane. The use of ala-tragus line to orient the occlusal plane has been controversial. This controversy is primarily due to disagreement on the exact point of reference for this line.Therefore the main objective of this study was to find out a reference line most parallel to the natural occlusal plane so that this reference point on the tragus can be used to determine the occlusal plane during the fabrication of complete denture

Factors Affecting Trial Without Catheter for First Spontaneous Acute Urinary Retention / 대한배뇨장애요실금학회지

PURPOSE: To find the association of trial without catheter (TWOC) outcome for first spontaneous acute urinary retention (AUR) in benign prostatic obstruction with age, prior lower urinary tract symptoms (LUTS), retention volume at catheterization (RV), and size of prostate. METHODS: Our prospective observational analytical (interventional) study enrolled 77 cases of spontaneous AUR over 24 months. After clinical evaluation, digital rectal examination, and transabdominal ultrasonography, all patients were catheterized per urethra and their RV was recorded. TWOC was administered after 2 or 3 doses of 0.4 mg tamsulosin-oral absorption control system and after 48-72 hours had passed. A successful endpoint was defined as a maximum flow-rate, >5 mL/sec; voided volume, >100 mL; postvoid residue, <200 mL; and voiding within 6 hours of catheter removal. Data obtained from 58 patients were analyzed after excluding the cases lost to follow-up and secondary exclusion. Age, RV, duration of LUTS, and prostate volume on examination and ultrasonography (PUSG) were recorded and statistically analyzed. Prostate-specific antigen levels were obtained on follow-up and cases of cancer, as seen on transrectal ultrasound-guided biopsy, were secondarily excluded. RESULTS: The patients had a mean age of 65.89+/-8.67 years. Prior LUTS was seen in 35 patients (2.07+/-2.91 months). The mean PUSG and RV were 46.81+/-20.58 mL and 854.8+/-36.26 mL, respectively. Thirty patients underwent a successful TWOC; a mean age of 63.13+/-8.58 years (mean+/-standard deviation; unpaired t-test; P=0.0053) and a PUSG of < or =45 mL (Pearson chi-square test; P=0.0427) were significantly associated with a successful outcome. CONCLUSIONS: There is a significant association between TWOC outcome, age (P=0.0053), and PUSG (P=0.0427).

Evidence-based National Vaccine Policy.

India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form.

Oxidative Stress in Cardiovascular Disease.

Over the last two decades, it has become increasingly clear that reactive oxygen species (ROS), including free radicals are involved in cardiovascular disease. In recent years, there has been a growing interest in the clinical implications of these oxidants. The ROS are common by-products of many oxidative biochemical and physiological processes. They can be released by xanthine oxidase, NAD(P)H oxidase, lipoxygenases, mitochondria, or the uncoupling of nitric oxide synthase in vascular cells. ROS mediate various signaling pathways that underlie vascular inflammation in atherogenesis. Various animal models of oxidative stress support that ROS have causal role in atherosclerosis and other cardiovascular diseases. They are too reactive to be tolerated in living tissue, and aerobic organisms use sophisticated defense system, both enzymatic and non-enzymatic for prevention of overload of free radicals. In a number of pathophysiological conditions, the delicate equilibrium between free-radical production and antioxidant capability can be altered in favor of the former, thus leading to oxidative stress and increased tissue injury. This review focuses on the biochemical evidences concerning involvement of ROS in several cardiovascular diseases, namely atherosclerosis, heart failure, hypertension and ischemia/reperfusion injury.

Post-BCG vaccination check based on serum IgG to culture filtrate antigens.

Since there are no reliable methods to demonstrate the effect of BCG vaccination in children, culture filtrates of BCG were evaluated for their specificity and sensitivity. BCG culture filtrate (BCG-CF), BCG sonicate and tuberculin were used as antigens and tested against serum, for the presence of IgG class of antibodies by ELISA and Western blot. Methodology: Children in the age-group of 1 to 10 years, were categorized as: (a) normal, and vaccinated, n=35; (b) normal, without a scar and with no evident history of vaccination, n=15; and (c) children with tuberculosis (meningitis, miliary and lymphadenitis) n=15. Results: The mean values of optical density (OD) in group (a), 4.0+0.08, were significantly high (P<0.001) to BCG-CF, compared to that of groups (b) (1.0+0.02) and (c) (1.4+0.03). The Western blot results revealed that a greater number of children (71%) in the vaccinated group reacted to low molecular weight proteins (10-30kDa) compared to other groups (unvaccinated: 17% and TB: 20%). The overall specificity, sensitivity, positive predictive value and negative predictive value of BCG-CF were higher in the vaccinated group. Conclusions: The results of the study suggest that the secreted antigens of BCG induce antibody formation, which are specific and are directed mostly towards the low molecular weight proteins. The presence of these antibodies could probably be exploited in an assay to distinguish children immunized by BCG from the unvaccinated and those having tuberculosis.

Effect of fish oil on mitochondrial respiration in isoproterenol induced myocardial infarction in rats.

Following isoproterenol treatment mitochondrial lipid peroxidation, phosphoslipase activity, lactate and calcium increased significantly, while activities of tricarboxylic acid cycle enzymes, enzymes of respiratory chain and ATP production showed decline. Oxidative phosphorylation was also affected on isoproterenol treatment with significant reduction in all the variables. Fish oil pretreatment in isoproterenol treated rats showed improved mitochondrial energy metabolism. The results suggest cardioprotective effect of fish oil.