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@#Introduction: COVID-19 pandemic has impacted the livelihood of Malaysians and gardening activities have contributed positively to the diet quality. This study aimed to determine the factors associated with diet quality among adults in AU2 Keramat, Kuala Lumpur. Methods: The cross-sectional study involved adults aged 18 to 59 via convenience sampling. The socio-demographic, physical activity level and involvement status in gardening were obtained through a questionnaire, while food intake was from a single-day 24-hour diet recall. The diet quality was determined through Malaysian Healthy Eating Index (MHEI) and dietary misreporting was calculated using the Goldberg cut-off method. Results: A total of 117 respondents (65.8% females, 35.2% males) with a mean age of 40.98 were involved in this study. Findings showed that most respondents did not engage in gardening activities (72.6%) and the prevalence of poor diet quality in this study was 89.7%, with a mean score of 44.51. The older respondents (r= 0.20, p= 0.034) and community gardeners (t= -2.63, p= 0.011) had a significantly higher diet quality but not home gardeners (t= 0.12, p= 0.902). The respondents involved in gardening activity also had a significantly higher fruit serving intake, Mann-Whitney U= 1045.00, p= 0.036) and lower total fat intake (t= 2.27, p= 0.025). Conclusion: The diet quality of the respondents remains poor but community gardeners had significantly higher diet quality and fruit intake while lower total fat intake. Interventions need to be developed to address the persistent poor diet quality of adults in the community.
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Buccolingual position of teeth could affect the prevalence of alveolar bone defects. Presence of alveolar defects may have a deleterious effect on orthodontic treatment. The aim was to assess the prevalence and extent of dehiscence and fenestration in Class I hyperdivergent subjects and correlate it with buccolingual inclinations(BL) of maxillary first molar teeth. Methods: This retrospective study involved 80 CBCTs of class I hyperdivergent subjects divided into two groups - group A (n=33) buccolingual inclination >9º and group B (n=47) buccolingual inclination <9º. Prevalence and extent of alveolar bone dehiscence and fenestrations were measured in CBCTs using OSIRIX Lite software. Descriptive statistics, Mann Whitney U test and Spearman correlation were done for evaluating intergroup differences and correlation with Buccolingual inclination. Results: Overall prevalence of dehiscence and fenestration in maxillary first molars was 60.95% and 5% respectively. In the buccal alveolar bone, prevalence of dehiscence was highest in group A (84.6%) for 16 and in the lingual alveolar bone prevalence of dehiscence was highest in group B (71.4%) for 26 . On intergroup comparison, the extent of lingual alveolar bone dehiscence (26) in group B was significantly higher (p value <0.05) than in group A. No significant correlation between the extent of dehiscence and fenestration with buccolingual inclination of molar teeth was noted. Conclusion: Molar teeth with BL inclinations of more than 9º had higher prevalence of dehiscence on the buccal side and molar teeth with BL inclinations less than 9 degrees had more dehiscence on the lingual side. But no significant correlation of BL inclination with prevalence and extent of dehiscence and fenestration was noted
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Humans , Male , Female , Adolescent , Adult , Maxillary Diseases/epidemiology , Alveolar Bone Loss/epidemiology , Malocclusion, Angle Class I/epidemiology , Molar/abnormalities , Maxillary Diseases/diagnostic imaging , Prevalence , Retrospective Studies , Alveolar Bone Loss/diagnostic imaging , Cone-Beam Computed Tomography , Malocclusion, Angle Class I/diagnostic imagingABSTRACT
Objective: We present outcome data on hematopoietic stem cell transplantation (HSCT) in children with inborn errors of metabolism (IEM). Methods: We retrospectively analyzed data on children up to 18 years of age, diagnosed with IEM, who underwent HSCT between January, 2002 and December, 2020. Results: 24 children, (mucopolysaccharidosis – 13, Gaucher disease – 4, X-linked adrenoleukodystrophy – 4, metachromatic leukodystrophy – 2, Krabbe disease – 1) were included. Donors were matched family donors in 24%, matched unrelated donors in 34%, and haploidentical fathers in 42% of the transplants, with engraftment in 91% of children. Overall survival was 72% (55-100%) with a median followup of 76.5 (10-120 ) months, and progression-free survival of 68% (MPS-76%, X-ALD - 60%, Gaucher disease – 50%, and 100% in MLD and Krabbe disease). Conclusion: HSCT is an available curative option, and early age at HSCT prevents end-organ damage.
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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: The prevalence of obesity is increasing in developing countries like India. This will place a great burden on the health infrastructure of the country. Early identification and intervention are the keys to managing this important problem. Since Asians tend to have more visceral body fat for any given body mass index (BMI), lower cut-off values have been suggested for different anthropometric parameters. Studies determining the correlation of Sagittal abdominal diameter (SAD) and SAD-height ratio (SADHtR) with total visceral fat volumes measured by computed tomography (CT) scan abdomen quantification are limited in the South Indian population. Aims and Objectives: This study was conducted with the objectives of measuring BMI, SAD, SADHtR, and comparing the correlation of the measured anthropometric parameters with visceral and subcutaneous abdominal fat volumes measured using CT scan abdomen in both the genders in South Indian population. Materials and Methods: This analytical cross-sectional study was done in a hospital setting with a sample size of 566 (276 men and 290 women-aged 30–70 years). Weight, height, and BMI were measured. SAD was measured electronically from a CT image at the L4–L5 level. SADHtR was derived. Total abdominal fat volumes, subcutaneous abdominal fat volumes, and visceral abdominal fat volumes were measured in cm3 from the dome of the liver to the pubic symphysis using software for CT-based quantification of fat volumes between ?190 and ?30 Hounsfield units threshold limits. The data were tabulated and analyzed to compare mean values between men and women and to find the correlation between the anthropometric parameters and visceral fat volume using Pearson’s correlation test. Results: The difference in mean values of BMI, SAD, and SADHtR between the sexes was statistically significant. SAD showed the highest correlation with visceral fat volume in both genders. BMI showed a higher correlation with subcutaneous adipose tissue volume than with visceral adipose tissue volume. Conclusion: Both SAD and SADHtR can be used as simple and reproducible anthropometric tools to identify the presence of increased visceral fat volume in both genders in our population.
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The physicians around the world would have come across the patients complaining of a particular symptom arising in a particular time of the day or night, or similar complaints recurring around the same months for the past few years, in their clinical practice. The classical texts of Ayurveda have described Kala as a factor influencing pathogenesis, diagnosis and treatment of a disease. The term “Kala” indicates Rogi avastha as well as the time. Though the texts have given the details of various seasons along with the changes that the Doshas undergo in each of them and the regimens to follow respectively, the description of Dosha avasthas with respect to day and night is very limited. Acharya Sushruta, the father of surgery has given a key insight on this principle. Ayurvedic diagnosis and treatments cannot be standardized in a very broad scale but rather its approach should be target- specific, for which we need deeper analysis for the principles. For achieving this, a Guna based analysis of every aspect of the protocol is to be followed while diagnosing and treating the patient (Guna Pratyaneeka pareeksha and Chikitsa), a process which unearths the hidden secrets of Ayurveda. This article deals the concept of Kala pareeksha in terms of day, night and a season from the basis of Gunas rather than the basis of Doshas with respect to the references from mainly Sushruta Samhita and Ashtanga Hrudaya in a way showing the actual beauty of the ever-puzzling science we are striving to practice.
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Purpose@#The aim of this review was to systematically analyze the available literature on the correlation between the gray values (GVs) of cone-beam computed tomography (CBCT) and the Hounsfield units (HUs) of computed tomography (CT) for assessing bone mineral density. @*Materials and Methods@#A literature search was carried out in PubMed, Cochrane Library, Google Scholar, Scopus, and LILACS for studies published through September 2021. In vitro, in vivo, and animal studies that analyzed the correlations GVs of CBCT and HUs of CT were included in this review. The review was prepared according to the PRISMA checklist for systematic reviews, and the risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A quantitative analysis was performed using a fixed-effects model. @*Results@#The literature search identified a total of 5,955 studies, of which 14 studies were included for the qualitative analysis and 2 studies for the quantitative analysis. A positive correlation was observed between the GVs of CBCT and HUs of CT. Out of the 14 studies, 100% had low risks of bias for the domains of patient selection, index test, and reference standards, while 95% of studies had a low risk of bias for the domain of flow and timing. The fixed-effects meta-analysis performed for Pearson correlation coefficients between CBCT and CT showed a moderate positive correlation (r=0.669; 95% CI, 0.388 to 0.836; P<0.05). @*Conclusion@#The available evidence showed a positive correlation between the GVs of CBCT and HUs of CT.
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Introduction: Formulating an oral health status which will include oral hygiene index (OHI) exclusively for children, deft index, and the incidence of white spot lesions (WSL) will make it easier for the examiner to assess the current oral health status of a child and help in planning preventive strategies. This index will provide a comprehensive yet quick way to assess the oral health status of children as it includes past caries experience, present oral hygiene status, and future prediction of caries. Materials and Methods: Two hundred children (100 male, 100 female) aged 3–5 years (primary dentition) were included in this study. OHI, recorded index tooth wise and segment wise, deft index, and the WSLs classification were recorded in all the children. Receiver operating characteristics (ROC) curve was used to evaluate the accuracy of recording OHI in children index tooth wise and segment wise. Results: All the three indices were recorded for the 200 subjects, and based on the area under the curve of receiver operating characteristics, it was found that the OHI for primary dentition can be recorded tooth wise or segment wise. Index teeth chosen for primary dentition were labial surfaces of 54, 61, and 64, lingual surfaces of 82, 75, and 85. Conclusion: It includes the past caries experience, present hygiene status, and the future prediction of caries, making it a wholesome index. This cumulative index can be widely used in studies of epidemiology and ensure quicker evaluation during dental health programs in public school systems.
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Purpose@#To assess the effect of combination probiotic Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 in outpatient management of acute watery diarrhea in children. @*Methods@#A randomized double-blind placebo-controlled study was conducted in 180 participants aged six months to five years with acute mild to moderate diarrhea. All were enrolled from six centers across India and centrally randomized to receive S. boulardii CNCM-I 3799 and B. subtilis CU-1 or a placebo along with oral rehydration salts and zinc supplementation. Each participant was followed up for three months to assess recurrence of diarrhea. @*Results@#The mean duration of diarrhea in the probiotic and placebo groups were 54.16 hours and 59.48 hours, respectively. The difference in the duration of diarrhea in those administered with probiotic or placebo within 24 hours of diarrhea onset was 25.21 hours. Furthermore, the difference in duration of diarrhea was 13.84 hours (p <0.05) for participants who were administered with probiotics within 48 hours. There were no significant differences in the stool frequencies between the two arms. After three months, 15% in the probiotic group and 18.5% in the placebo group reported episodes of diarrhea. The mean duration of diarrhea was considerably lower in the probiotic group, 31.02 hours versus 48 hours in placebo (p =0.017). @*Conclusion@#S. boulardii CNCM-I 3799 and B. subtilis CU-1 combination was effective in reducing the duration of diarrhea when administered within 48 hours of diarrhea onset. Similarly, it reduced recurrence of diarrhea and its intensity in the subsequent three months.
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Purpose@#To assess the effect of combination probiotic Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 in outpatient management of acute watery diarrhea in children. @*Methods@#A randomized double-blind placebo-controlled study was conducted in 180 participants aged six months to five years with acute mild to moderate diarrhea. All were enrolled from six centers across India and centrally randomized to receive S. boulardii CNCM-I 3799 and B. subtilis CU-1 or a placebo along with oral rehydration salts and zinc supplementation. Each participant was followed up for three months to assess recurrence of diarrhea. @*Results@#The mean duration of diarrhea in the probiotic and placebo groups were 54.16 hours and 59.48 hours, respectively. The difference in the duration of diarrhea in those administered with probiotic or placebo within 24 hours of diarrhea onset was 25.21 hours. Furthermore, the difference in duration of diarrhea was 13.84 hours (p <0.05) for participants who were administered with probiotics within 48 hours. There were no significant differences in the stool frequencies between the two arms. After three months, 15% in the probiotic group and 18.5% in the placebo group reported episodes of diarrhea. The mean duration of diarrhea was considerably lower in the probiotic group, 31.02 hours versus 48 hours in placebo (p =0.017). @*Conclusion@#S. boulardii CNCM-I 3799 and B. subtilis CU-1 combination was effective in reducing the duration of diarrhea when administered within 48 hours of diarrhea onset. Similarly, it reduced recurrence of diarrhea and its intensity in the subsequent three months.
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The indigenous systems of medicine in India are Ayurveda, Siddha and Unani which is practisedfrom ancient times. India and China are the two major countries having 40 per cent of the global diversity and are known as the house of medicinal plants. Most of the medicinal plants are gathered from the forest areas to meet the demand of the medicinal profession, which becomes exhaustible if overused and sustainable when used with care and wisdom. Hence, it is important to take efforts to grow them as commercial crops. Several theoretical concepts to measure empowerment of farmers have been identified and proposed worldwide, very few studies have been conducted to measure their empowerment. This paper presents the Perceived Social Empowerment status of medicinal plant growers
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Seventy two cattle with bacterial pneumonia and twelve healthy cattle were studied in detail for haemato-biochemical examination, radiography and tracheobronchoscopy. Haematobiochemical examination revealed leukocytosis with neutrophilia. Radiographic examination showed increased pulmonary infiltration. Tracheobronchoscopic examination of affected animals revealed inflammation, haemorrhage, mucus to mucopurulent exudates in nasal cavity, trachea, bronchi and bronchioles. Bronchoalveolar lavage (BAL) collected through endoscope was subjected to cytology and cultural examination. Cytology of the affected animals showed increased total cell counts and predominant neutrophils. Pasteurella multocida, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli were isolated from BAL and confirmed with PCR studies
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Introduction: Difficulties to find the ideal donor site with perfect matching tissues have always made the reconstruction of facial complex defect a tough problem for surgeons. The main aim of reconstruction is to restore facial contour (esthetics) and function (mastication, deglutition, and speech). Aim: The aim of the study was to analyze the versatility of forehead flap in maxillofacial/nasal and intraoral defects. Materials and Methods: This retrospective study was conducted to analyze the versatility of forehead flap in maxillofacial/nasal and intraoral defects. A total of 25 consecutive patients, of either sex, who required soft tissue reconstruction of the maxillofacial region, including oral cavity and nasal defects due to tumor ablative surgery. Follow-up was done for up to 4 months – 1 year and on every follow-up visit, patients were questioned about the degree of satisfaction, with mouth opening, swallowing, and donor site esthetics. Cosmetic deformity judged subjectively. Results: Of 25 patients, 17 patients were males, 12 patients were above 60 years. Maximum number of site of tumor involvement was noted in cheek 9 patients (36%) and in lower lip 5 patients (20%). About 44% patient had stage 2 tumors and 28% had stage 3 tumors. About 18 patient had adjuvant radiation, 1 patients had chemo RT, and 6 patients had no adjuvant treatment. About 16% of patients had a complication of altered forehead sensation. Conclusion: Forehead flap is a reliable technique for the reconstruction of maxillofacial region defects. It is easy to rise and can provide coverage for wide defects as far as the para mandibular and submandibular regions. Moreover, it does not require patient repositioning.
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Introduction: Major head and neck surgery involve dissections close to crucial structures such as nerves and vessels. For this reason, it is very important to use safe instruments for dissection and hemostasis. In a wide variety of surgical procedures, advanced vessel sealing devices are replacing traditional techniques for vessel ligation. Aim: Our study aimed to compare the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Methods: This prospective comparative study was conducted to compare the outcome of the bipolar vessel sealing system versus suture ligation in selective neck dissection in patients with oral cancer. Out of 40 patients enrolled in the study, 20 patients were in Group A (bipolar vessel sealing system) and 20 patients in Group B (Suture ligation). The outcome measures recorded were blood loss, operating time, duration of hospital stay, pre-operative blood transfusion, Fromme’s surgical field scale, post-operative pain, and drainage volume. Treatment protocol and follow-up protocol were followed and the results were statistically analyzed and discussed. Results: Out of 40 patients, 20 patients had bipolar vessel sealing system and 20 patients had suture ligation. In bipolar vessel sealing system of 20 patients, 12 patients were male and 8 patients were female, mean value of blood loss is 26.84 ± 22.34 ml, operating time is 48.56 ± 5.48 min, duration of hospital stay is 12.92 ± 1.28 days, mean value of post-operative pain in day 0 is 3.5 ± 1, day 1 is 3.1 ± 1, day 2 is 1.8 ± 0.5, and day 3 is 1.1 ± 0.5, and drainage volume (ml) in 24 h is 72.48 ± 28.46, 48 h is 24.57 ± 18.29, and 72 h is 7.24 ± 6.7. In suture ligation of 20 patients, 15 patients were male and 5 patients were female, mean value of blood loss is 39.28 ± 16.44 ml, operating time is 54.22 ± 4.14 min, duration of hospital stay is 13.87 ± 1.42 days, mean value of post-operative pain in day 0 is 4.01 ± 0.9, day 1 is 3.8 ± 1.1, day 2 is 2.4 ± 0.6, and day 3 is 1.6 ± 0.8, and drainage volume (ml) in 24 h is 98.28 ± 36.87, 48 h is 41.28 ± 21.24, and 72 h is 18.29 ± 9.45. Conclusion: Bipolar vessel sealing system is more efficacious in terms of reducing blood loss, operating time, and better surgical field than conventional suture ligation. Thus, bipolar vessel sealing system is more advantageous compared to the traditional techniques, from both a clinical and economic point of view.
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Introduction: The scalp is the most frequent site of occurrence of malignant tumors because this area is generally neglected bythe patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant.Aim: The aim of our study was to analyze the histological patterns and management options in malignant tumors of the scalp.Materials and Methods: This prospective study was conducted to analyze the histological pattern and management options inmalignant tumors of the scalp. Medical reports of patients diagnosed with the clinical diagnosis of scalp lesions were studied.H&E stained slides of the scalp lesions were retrieved and reviewed. Clinical and histopathological diagnoses were studiedfor each case to evaluate clinically misdiagnosed cases. Data so obtained were tabulated and were analyzed statistically, andresults were discussed.Results: Out of 25 cases, male patients were 13 (52%) and female patients were 12 (48%), age distribution ranges from 20 to80 years with <30 years 2 patients (8%), 31–40 years 4 patients (16%), 41–50 years 3 patients (12%), 51–60 years 9 patients(36%), >61 years 7 patients (28%), based on histological pattern squamous cell carcinoma is most common of 10 cases (40%),basal cell carcinoma 8 cases (32%), dermatofibrosarcoma 2 cases (8%), fibroxanthoma 1 case (4%), melanoma 2 cases (8%),and metastatic tumors 2 cases (8%) where the primary site is the lung in both the cases. Sixteen cases (64%) were managedby split skin graft, 7 cases (28%) by rotational/transpositional flap, and 2 cases (8%) by free flap.Conclusion: Although malignant scalp tumors are not common, when facing a patient with scalp lesions or lumps, physiciansshould be alert in detecting any suggestive new growth hidden in this hairy area to make an early diagnosis and perhaps todetect primary cancer in case of metastatic scalp tumors.
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Introduction: Surgical incisions are usually made with scalpel. Usage of scalpel usually results in skin bleeding which obscuresthe operating field resulting in wastage of operating time. Although diathermy is increasingly used for underlying tissue dissection,cutting, and hemostasis, its use for making skin incisions is not gaining favor.Aim: The aim of our study was to compare the value outcome of diathermy incisions versus scalpel incisions in abdominalsurgeries.Materials and Methods: This prospective comparative study was conducted to compare the outcome of diathermy incisionsversus scalpel incisions in oncological surgeries. Total of 80 patients who divided into Group A (scalpel incision) for 39 patientsand Group B (diathermy incision) for 41 patients. Treatment protocol and follow-up protocol were followed and the results werestatistically analyzed and discussed.Results: Out of 80 patients, 39 patients had scalpel incision and 41 patients had diathermy incision. In the scalpel group outof 39 patients, 21 patients were male and 18 patients were female, the mean duration of incision time in the scalpel group is116 sec, the mean value of incisional blood loss in the scalpel group is 1.9/ml, the mean operating time in the scalpel group is36.42 min, and the mean value of post-operative pain in day 1 is 6.42, day 2 is 5.18, and day 3 is 3.66. In the diathermy groupout of 41 patients, 26 patients were male and 15 patients were female, the mean duration of incision time in the diathermy groupis 88.52 sec, the mean value of incisional blood loss in the diathermy group is 1.4/ml, the mean operating time in the diathermygroup is 38.75 min, and the mean value of post-operative pain in day 1 is 5.12, day 2 is 3.88, and day is 2.01.Conclusion: The findings of the present study show that diathermy seems to provide some benefit with respect to post-operativewound pain, less incision time, and less incisional blood loss and has obvious safety advantages to the surgical team comparedwith scalpel.
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Abstract The safety and efficacy of elosulfase alfa were evaluated in a multicenter, open-label, phase 3b study in Australian Morquio A patients, consisting of a 49-week initial phase and an extension phase until elosulfase alfa was government funded. Thirteen patients (1-27 years) were enrolled. No new safety concerns were identified over 138 weeks. Most drug-related adverse events were mild or moderate in severity; none led to study discontinuation. After 49 weeks of treatment, median improvements from baseline were seen in the 6-minute walk test (+41.0 m), 3-minute stair climb test (+14.0 stairs/min), forced vital capacity (+16.4%), forced expiratory volume in 1 second (+14.1%), urine keratan sulfate (-7.1 µg/mg creatinine), and pain intensity. Growth, cardiac function, sleep, and quality of life results were mixed or stable. These results provide further evidence of the acceptable safety/tolerability profile of elosulfase alfa. The improvements in endurance, pulmonary function, and pain support findings from previous studies.
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Background: Tuberculosis is highly prevalent in developing countries like India and several strategies have been implemented by the World Health Organization and Government of India in order to minimize its burden. However, effectiveness of these strategies is best achieved when there is adequate awareness among the general population regarding the cause and spread of the disease. This study was carried out to evaluate the knowledge, attitude and practices regarding tuberculosis among general population.Methods: This cross sectional study was carried out among 500 adults visiting our tertiary care center as patients or attenders for a period of one year between April 2018 and March 2019. A structured interview schedule was used to collect information regarding the knowledge, attitude and practices regarding the cause, spread and management of tuberculosis infection.Results: About 73.6% of the study participants felt that tuberculosis was a genetic disorder, while only 12.4% of them were aware that the infection was transmitted through coughing, etc. Moreover, 18% of the participants believed that the medications for treating tuberculosis could be stopped without the supervision of the health care provider.Conclusions: This study has elicited the prevailing misconception regarding the cause, transmission, treatment and prevention of tuberculosis. It is important for policy makers and public health program implementation experts to develop health literacy campaigns to specifically create awareness among the population, so as to facilitate successful mitigation of the disease.