Assessment of Efficiency of Bioactive Glass, Self-Assembling Peptide, and Ozone Remineralising Agents on Artificial Carious Lesion

ABSTRACT Objective: To assess the efficacy of bioactive glass, self-assembling peptide, and ozone-remineralizing agents on the artificial carious lesion. Material and Methods: On the extracted 60 premolar teeth, an artificial carious lesion/demineralization was created. Later, the remineralization of demineralized teeth was done with respective remineralizing agents (Group A: Calcium sodium phosphosilicate (bioactive glass), Group B: Self-assembling peptide, Group C: Ozone remineralizing agents and Group D (Control): De ionized water. The degree of demineralization and remineralization were evaluated using the Vickers Hardness Number. Results: There was a decrease in microhardness from baseline to demineralization in all the groups, and this reduction was found to be statistically considerable. After the remineralization of demineralized samples with respective remineralizing agents, there was an increase in microhardness of 312.38, 276.67, and 254.42 in groups A, B, and C, respectively. In contrast, in Group D, there were no changes. Conclusion: Bioactive glass and self-assembling peptides had higher remineralizing capacities, which can be used to treat early carious lesions.

A rare optineurin mutation in an Indian family with coexistence of JOAG and PCG

Purpose: This study focused on the genetic screening of Myocilin (MYOC), Cytochrome P450 family 1 subfamily B member 1 (CYP1B1), Optineurin (OPTN), and SIX homeobox 6 (SIX6) genes in a family with coexistence of primary congenital glaucoma (PCG) and juvenile open?angle glaucoma (JOAG). Methods: Sanger sequencing was used to examine the coding region of all four genes. Six different online available algorithms were used for the pathogenicity prediction of missense variant. Structural analysis was done using Garnier–Osguthorpe–Robson (GOR), PyMol, ChimeraX, and Molecular Dynamic (MD) Simulations (using Graphics Processing Unit (GPU)?enabled Desmond module of Schrödinger). Results: There were a total of three sequence variants within the family. All seven algorithms determined that a single mutation, G538E, in the OPTN gene is pathogenic. The loops connecting the strands became more flexible, as predicted structurally and functionally by pathogenic mutations. Mutations create perturbations and conformational rearrangements in proteins, hence impairing their functioning. Conclusion: In this study, we describe a North Indian family in which members were having JOAG and PCG due to a rare homozygous/ heterozygous mutation in OPTN. The coexistence of two types of glaucoma within a single pedigree suggests that certain OPTN mutations may be responsible for the onset of different glaucoma phenotypes.

New cost-effective human leukocyte antigen testing algorithm for screening of human leukocyte antigen-matched related donor in thalassemia major patient pretransplant workup: A single-center study from resource-constrained settings

Introduction: India has a huge disease burden of thalassemia major with an estimated 40 million carriers and over a million thalassemia major patients. Very few patients are optimally treated, and the standard of care “hematopoietic stem cell transplant” (HSCT) is out of reach for most patients and their families. The cost of HSCT is significant, and a substantial proportion of it goes to human leukocyte antigen (HLA) testing of family members (HLA screening) in hope of getting a matched related donor (MRD) for HSCT. The aim of this study was to establish that a new proposed testing algorithm of HLA typing would be more cost-effective as compared to the conventional HLA screening within MRD families for possible HSCT. Material and Methods: Buccal swab samples of 177 thalassemia patients and their prospective family donors (232) were collected. Using a new HLA testing algorithm, samples were tested for HLA typing in a sequential manner (first HLA-B, then HLA-A, and finally HLA-DR) using the sequence-specific oligonucleotide probe method on the Luminex platform. Results: The new sequential HLA-A, HLA-B, and HLA-DRB1 testing algorithm showed a 49.1% reduction in cost compared to the conventional HLA testing algorithm. Furthermore, 40 patients (22.59%) were found to have HLA-MRD within the family among other samples that were tested. Conclusion: The new HLA testing algorithm proposed in the present study for identifying MRD for HSCT resulted in a substantial reduction in the cost of HSCT workup.

CYTOMORPHOLOGY PATTERN ON FNAC AND AFB POSITIVITY IN CASES OF TUBERCULAR LYMPHADENITIS IN A TERTIARY CARE CENTRE OF CENTRAL INDIA

Background- One of the most typical diagnoses at OPDs in a developing nation like India is tuberculous lymphadenitis. Anti-tubercular therapy, however, cannot be started based solely on clinical suspicion. Along with culture, cytomorphology with acid fast staining is an effective tool for diagnosing these cases. The purpose of the study was to examine the usefulness, limits, and relationships between Ziehl-Neelsen staining in tuberculous lymphadenitis and various cytomorphological presentations using fine needle aspiration cytology. At a tertiary care facility, the study was Materials and Methods- carried out over the course of a year with a total of 146 cases. Patients who had lymphadenopathy that was clinically suspected were chosen. There were 36.3% cases of tuberculous Resultlymphadenitis out of which 66.04% cases were overall AFB positive. The most frequent cytological finding was epithelioid cell granulomas with lymphocytes, and cases with granulomas and necrosis had the highest levels of AFB positivity. Most patients first showed up in their third or fourth decade of life. Solitary lymphadenopathy, as opposed to matted lymph nodes as reported by others, was the most frequent presentation and the cervical area was the most frequently involved site. Fine needle as Conclusion- piration cytology is a highly sensitive method for diagnosing tuberculous lymphadenitis that is inexpensive, safe, and dependable. By adding acid fast staining and culture procedures to cytomorphology, the diagnostic index can be raised even higher. However, FNAC combined with methods like ELISA and PCR would improve the current landscape of diagnostic and therapeutic options.

Impact of color vision deficiency on the quality of life in a sample of Indian population: Application of the CVD-QoL tool

Purpose: To investigate the quality of life (QoL) in a sample of color vision deficit (CVD) patients in India and how color vision deficiency affects them psychologically, economically, and in productivity related to their work and occupation. Methods: A descriptive and case–control study design using a questionnaire was conducted on N = 120 participants, of whom 60 were patients of CVD (52 male and eight female) who visited two eye facilities in Hyderabad between 2020 and 2021 and 60 were age?matched normal color vision participants who served as controls. We validated English–Telugu adapted version of CVD?QoL, developed by Barry et al. in 2017 (CB?QoL). The CVD?QoL consists of 27 Likert?scale items with factors (lifestyle, emotions, and work). Color vision was assessed using the Ishihara and Cambridge Mollen color vision tests. A six?point Likert scale was used, with lower scores indicating poor QoL (from 1 = severe issue to 6 = no problem). Results: The CVD?QoL questionnaire’s reliability and internal consistency were measured, including Cronbach’s ? (? =0.70–0.90). There was no significance between the group in age (t = ?1.2, P = 0.67) whereas the Ishihara colour vision test, scores showed a significant difference (t = 4.50, P < 0.001). The QoL scores showed a significant difference towards lifestyle, emotions and work (P = 0.001). The CVD group had a poorer QoL score than the normal color vision group odds ratio [OR] =0.31, 95% confidence interval [CI], (P = 0.002, CI = 0.14–0.65, Z = 3.0) . In this analysis, a low CI indicated that the OR was more precise. Conclusion: Color vision deficiency affects Indians’ QoL, according to this study. The mean scores of lifestyle, emotions, and work were lower than the UK sample. Since CVD is underreported and possibly affects developing countries more, advocacy for a new health care plan on CVD is essential. Increasing public understanding and awareness could also help diagnosing the CVD population

Role of swept-source anterior segment optical coherence tomography in imaging pediatric cataract

Purpose: To determine the morphology of pediatric cataracts and assess the status of the anterior and posterior capsules preoperatively on swept?source anterior segment optical coherence tomography (ASOCT) and compare the findings to those of intraoperative examination. Secondly, we aimed to obtain biometric measurements on ASOCT and compare them to those obtained on A?scan/optical methods. Methods: This was a prospective and observational study carried out at a tertiary care referral institute. ASOCT scans for anterior segment were obtained preoperatively for all patients, aged <8 years, scheduled for paediatric cataract surgery. The morphology of the lens and capsule and biometry were performed on ASOCT and the same were assessed intraoperatively. The main outcome measures were comparison of ASOCT findings to intraoperative findings. Results: The study included 33 eyes of 29 patients (range 3 months–8 years). The morphological characterization of cataract on ASOCT was accurate in 31/33 (94%) cases. ASOCT accurately identified fibrosis and rupture of the anterior and posterior capsules in 32/33 (97%) cases each. In 30% of eyes, ASOCT gave additional information preoperatively compared to the slit lamp. Intraclass correlation coefficient (ICC) calculation revealed a good agreement between the keratometry values obtained on ASOCT and those obtained preoperatively with a handheld/optical keratometer (ICC = 0.86, P = 0.001). Conclusion: ASOCT is a valuable tool that could provide complete preoperative information of the lens and capsule in pediatric cataract cases. In children as young as 3 months of age, intraoperative risks and surprises could be diminished. The keratometric readings are highly dependent on patient cooperation but show good agreement with the handheld/optical keratometer readings.

No reflow phenomenon in CAD patients after percutaneous coronary intervention: A prospective hospital based observational study

The present study assessed incidence, risk factors, in-hospital and short-term outcomes associated with no-reflow in patients undergoing percutaneous coronary intervention (PCI) in STEMI, NSTEMI, unstable angina and stable angina. Out of 449 patients, 42 (9.3%) developed no-reflow. Hypertension, dyslipidemia, obesity and smoking were significant risk factors. There was significant association of no-reflow with left main disease, multiple stents, target lesion length_x0001_ 20 mm and higher thrombus grade. Interestingly, 93 patients (23.4%) of normal flow had myocardial perfusion grade (MPG) of 0/1 with mortality in 9 (10%) patients. No-reflow is associated with poor in-hospital and short-term outcomes with higher incidence of death, cardiogenic shock, heart failure and MACE. Knowledge of risk factors of no-reflow portends a more meticulous approach to improve final outcomes. MPG could be better predictor of outcomes in these patients.

Detection and Comparision of Cytopathological Changes in Smokers and Non-Smokers: A Comparative Study

Background: Oral cancer is one of the sixth most common cancers in the world. Oral exfoliative cytology is one of the popular screening tool for oral cancer. Use of tobacco in any form are documented as the most common cause as initiators for dysplastic changes in oral mucosa. The purpose of the study was to detect the cytological changes in buccal mucosa, tongue and palate among non-smokers & smokers. Material & Methods: Smears sample were collected according to site (buccal mucosa, tongue & palate) from 100 subjects among smokers & non-smokers. Smears were then stained using Papanicolaou staining technique. Results: Among the smokers and non-smokers the results were statistically significant. Conclusion: Recent advances in the clinical visualization and detection of the oral mucosa have made the viability of cytological procedures more specific and sensitive. Contact endoscopy and use of autofluorescence devices are the forerunners in this group. The fluorescence characteristics of tissues depend upon their biochemical composition and histomorphological architecture, both of which undergo a change during malignant transformation. These changes are detectable as an alteration in the fluorescence spectral profile of the tissues21. Due to low feasibilities of such devices the benchmark of diagnosis will be microscopic tissue examination. Hence cytological smears will always be highly specific, sensitive, easy to use and reproducible procedures in routine screening of population for potentially and malignant conditions of the oral cavity.

Antimicrobial Utilization Study in a Neurology Setting

Background : Measuring antimicrobial consumption is necessary to understand the volume and patterns of use, to design appropriate interventions to reduce and rationalize its use. Materials and Methods : The antimicrobial consumption in Neurology ICU and IPD were measured over a 5-year period using WHO Defined Daily Dose (DDD) methodology. Results : There was an increasing trend in Antimicrobial Consumption (AMC) from 125.7 to 155.5 DDDs/100 days over 5 years with highest consumption in 2017-2018 (190.7 DDDs). The consumption of Watch group of antibiotics was higher than access group antibiotics both in ICU and IPD and constituted more than 75% of total antibiotic consumption. Conclusions : The initiation of empiric therapy though may be necessary depending on the patients condition, however, duration of antibiotic therapy and reducing usage of prophylactic antibiotics for aspiration pneumonia and reducing consumption of Watch group of antibiotics were identified as stewardship opportunities. Feedback on AMC data and persuasive educational interventions to rationalize and reduce antimicrobial use are required.

Evaluation of variable p16 immunostaining patterns, Ki-67 indices and HPV status in cervical SILs and squamous cell carcinomas: An institutional experience

Objective: The present study evaluates the immunoexpression of p16 and Ki-67 in cervical squamous intraepithelial lesion (SIL) and carcinomas and correlates their expression with clinicopathological features and HPV-DNA status. Material and Methods: A total 36 included cases of SIL and squamous cell carcinoma (SCC) were subjected to p16 and Ki-67 immunostaining. p16 staining was evaluated depending on grading, distribution, localization pattern, intensity and IHC score. Ki-67 expression was graded based on percentage of positive cells. Results: Incidence of HSIL and SCC cases was found to be significantly increased with parity > 5. p16 grade III diffuse nucleocytoplasmic immunostaining was observed in 62.5% LSIL, 80% HSIL and 87% SCC cases. Significant association of p16 staining intensity, IHC score and Ki-67 indices was noted with increasing grades of SILs and carcinomas. Conclusion: Our experience indicates that a combination of p16 and Ki-67 immunostaining may be useful to determine the severity of dysplastic change.

GOLD Strategy Update 2023: Rationale and Clinical Implications in Indian Perspective

Chronic obstructive lung disease (COPD) is a major contributor to global disease burden with a huge socioeconomic impact. Global initiative for chronic obstructive lung disease (GOLD) strategy update 2023 is a step forward in the direction of evidence-based practice. Key topics like taxonomic classification, ABE grouping, single inhaler triple therapy, correct use of inhalers, etc. would have a positive impact on documentation and prescription practices in COPD management. The tobacco consumption habits are peculiar in India. There is a variation in prevalence estimates across diverse cultures. Non-smoking risk factors are important in Indian subcontinent especially in female and younger populations. We discuss the rationale of latest GOLD strategy update, its implications, and challenges in the management of COPD in Indian context.

A review of the SARS-CoV-2 viral genome mutation and its effects

The pandemic-starting SARS-CoV-2 novel coronavirus was found in Wuhan, China. WHO declared this pandemic, which began in late 2019, in March 2020. Experts say this was the first SARS-CoV-2 outbreak. It was the first of many. This virus constantly mutates in response to its replication environment, causing waves, the deadliest of which was the delta variant-caused second wave, which killed millions worldwide. This review examines viral genome alterations and their global effects. We used references from previous research articles on this or similar issues to make our review more data-driven. We found that the virus’ mutation has caused major health problems in humans, including deaths. The viruses changed genome, proteins, local food, sanitation, immunity, and milieu may be involved. We also found that while some of the impacted variations are milder and less contagious, some have had record-breaking peaks and significant death rates in a short time. This analysis examines COVID-19’s impact on diabetes, cardiovascular disease, asthma, aging, and community hygiene. SARS-CoV-2 increases stress and blood glucose in diabetics. Clinical investigations have linked COVID-19 to cardiovascular disease, although the mechanism is uncertain. Asthmatics are more vulnerable to respiratory infections. Its effects change as one age. Cleanliness campaigns are needed to put an end to the epidemic.

BIOMEDICAL WASTE MANAGEMENT TRAINING: AN EFFICIENT TOOL?

Introduction: This is an interventional study since an in-service training to nursing staff has been given, performed in order to assess whether training has a significant impact on knowledge on BMWM. BMWM has become a significant concern for both the medical and general community. Effective management of biomedical waste is not only a legal necessity but also a social responsibility. Objective: To assess the impact of in-service training on the knowledge among the nursing staff working in pre-identified patient care areas of a tertiary healthcare organization in North India. The study was Methods: conducted from April 2017 to April 2018. It was an interventional study. Study sample consists of the Nursing staff working in the Pre identified patient care areas of the institute who are dealing with BMW generation. The study was conducted by using a questionnaire. The data thus obtained was tabulated and interpretation was done by using SPSS 23 software. Results: It included 200 Nursing staff. Majority of study participants belongs to 21 -30 years (61%) age group. More than two third of study participants working in hospital from 1 to 5 years. The result indicated that there was a significant increment in the knowledge score from the pre-assessment to the post-assessment. The mean difference between two was found to be significant (2.3+- 0.41 v/s 2.80+-0.39, P value <0.001). the use of a training model could improve knowledge of regulated biome Conclusion: dical waste management among the staff. Such an improvement could translate into improved performance. The importance of training regarding biomedical waste management cannot be overemphasized, lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste disposal

Predictors of Practice of breast self-examination among women in District Ambala (Haryana)

Background: Breast cancer is the most common cancer among women and its early detection is critical to improve survival. Breast self-examination is a cheap, basic and non-intellectual method to detect breast cancer. Aims and objectives: 1To determine the knowledge, attitude and practices regarding breast self-examination2. To explain the various factors which affect the practice of BSE Material and Methods: The present study was carried out among 300 women residing in rural and urban areas of district Ambala using a self-designed pretested semi-structured questionnaire. Results: In this study 127 (42.3%) of the participants had heard of BSE and 107 (35.7%) of the participants knew how to perform BSE. Overall, 47.7%, 30.3%, and 22% of the study participants had poor (<50%), medium (50–75%), and good knowledge (>75) on BSE, respectively. Educational qualification, knowing the three positions to perform BSE, knowing how often should BSE be done, taught how to do BSE, BSE is a useful tool to detect breast cancer were seen to be significantly associated with practice of BSE. Conclusion: This study elucidates that the knowledge as well as practice of BSE was significantly low in the population. This study provides insights into the various factors which affect the practice of BSE

Biofabrication and optimization of silver nanoparticles using Campsis sp. to explore their antimicrobial properties

Plant mediated green synthesis of silver nanoparticles (AgNPs) holds promising applications in the field of Biomedicine, Food packaging and Wound healing. In the present investigation, biofabrication of AgNPs was performed using the aqueous extracts of Campsis sp. (Family Bignoniaceae) leaves and flowers growing in the premises of Kirori Mal College, University of Delhi, Delhi. Optimization of AgNPs was performed to analyse the varying effect of pH (6.0, 8.0, 10.0) and silver salt concentration (2mM, 4Mm and 6Mm) in controlling the shape and size of AgNPs which in turn governs their further applications. Interestingly, change in colour of the reaction mixture from pale yellow to reddish brown indicated the formation of AgNPs. These AgNPs were further characterized by UV-Visible spectroscopy and showed peak in the range of 400-450 nm which confirmed the synthesis of silver nanoparticles. Dynamic light scattering and zeta potential analysis (DLS-Zeta) confirmed the size of AgNPs around 200-300 nm. A significant zone of inhibition was observed for both Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacterial strains which revealed the antimicrobial potential of Campsis sp. AgNPs. Therefore, Campsis AgNPs may provide a green, eco-sustainable alternate method for sustainable production of nanomaterials for biomedical applications. These AgNPs may also show tremendous applications in food packaging, wound healing and biomedical fields.

A CLINICOHAEMATOLOGICAL PROFILE OF ADVERSE TRANSFUSION REACTIONS AND ITS ASSOCIATION WITH BLOOD COMPONENTS

Different blood components are associated with various types of adverse transfusion reactions and are linked to several factors including the number, rate and volume of transfusions. The given study was conducted to study the relationship between various transfusion reactions and its causative factors. This study was a prospective study carried out over eighteen months on all patients who received a blood transfusion and blood components including various adverse reactions and events related to transfusion. These were correlated with tests for compatibility including general blood picture ,tests for haemolysis ,hematuria and haemoglobinuria, Coombs Test (Direct and Indirect), culture along with relevant clinical details of the patient. Out of a total of 31451 units of blood issued, 47 adverse transfusion reactions were noted with a maximum number in the age group of > 18 years (87.3%) with M: F being 1.6: 1 .0.24% of adverse transfusion reactions were by Packed red blood cell transfusion and mostly were immediate transfusion with a mean volume of 100 ml and mean time of 20 minutes. Febrile Non Hemolytic Transfusion Reaction (FNHTR) was the most common Adverse Transfusion Reaction (ATR)(0.128%) with 2 cases positive for Direct Coombs Test. A thorough serological and immunological examination and the addition of methods like buffy coat reduction and leucocyte filtration help in reducing the incidences of hemolytic transfusion reactions and transmitted infections and establishing a hemovigilance system help in the attainment of the goal of safe transfusion

Knowledge, Attitude, and Practice Regarding Mosquito-Borne Diseases among Migrant Laborers from a Migrant Settlement in Ponekkara, Ernakulam Kerala

Background: Mosquito?borne diseases (MBDs) such as Malaria, Dengue, Chikungunya, lymphatic filariasis, and Japanese Encephalitis are important public health problems in India. Ernakulam in Kerala being a hub of construction activities has a large influx of migrants from Odisha, West Bengal, Bihar, Assam, U. P., Jharkhand, T. N., and Karnataka. Hence, the objective of this study was to assess the knowledge, attitude, and practice related to MBDs and the associated factors among the migrant laborers from a migrant settlement in Ponekkara, Ernakulam Kerala. Materials and Methods: A cross?sectional study was done among 179 migrant laborers from a migrant settlement in Ponekkara, Kerala, from September 2021 to November 2021 using a pretested semi?structured questionnaire to collect information regarding socio?demographic details and their knowledge, attitude, and practice regarding mosquito borne diseases. After taking verbal consent, the questionnaire was administered by the investigator. Descriptive and univariate analysis was done using SPSS Version 20. Results: It was found that 58.4% of the migrant laborers had poor knowledge, 55.9% had poor attitude, and 61.5% of them had poor practice regarding MBDs. On univariate analysis, a statistically significant association was observed between attitude score and the level of education. Conclusion: The findings showed that migrant laborers had an overall poor knowledge, attitude, and practices regarding MBDs. Consequently, there is a need to plan an awareness program among the migrant settlements regarding MBDs.