ABSTRACT
Injuries due to a lightning strike are uncommon presentations in the emergency department. Common injuries caused by lightning include burns, muscle pains, cardiac arrest, hearing loss, seizures, behavioral changes and ocular cataracts. We report a case of a 26-year-old primigravida with history of 3 months of amenorrhea who was struck by lightning as she was standing beside a tree. It left her unconscious, immediately after which she was taken to the emergency department of Maharana Bhupal Govt Hospital (MBGH Hospital), Udaipur, Rajasthan. Entry wound was from right ear and the exit wound was on abdomen. Examination confirmed linear first- and superficial second-degree burns. The electrocardiogram (ECG) showed deep and symmetrical T-wave inversion in precordial and lateral leads. There was an associated elevation of troponin T levels (peak: 432 ng/L), suggestive of myocarditis. On otoscopic examination, she was found to have rupture of tympanic membrane bilaterally. A transthoracic echocardiography revealed reduced ejection fraction of the left ventricle to 25% with global left ventricle hypokinesia, moderate mitral regurgitation and tricuspid regurgitation. This case aims to raise awareness among the healthcare providers regarding multiple organ involvement in lightning injury.
ABSTRACT
Injuries due to a lightning strike are uncommon presentations in the emergency department. Common injuries caused by lightning include burns, muscle pains, cardiac arrest, hearing loss, seizures, behavioral changes and ocular cataracts. We report a case of a 26-year-old primigravida with history of 3 months of amenorrhea who was struck by lightning as she was standing beside a tree. It left her unconscious, immediately after which she was taken to the emergency department of Maharana Bhupal Govt Hospital (MBGH Hospital), Udaipur, Rajasthan. Entry wound was from right ear and the exit wound was on abdomen. Examination confirmed linear first- and superficial second-degree burns. The electrocardiogram (ECG) showed deep and symmetrical T-wave inversion in precordial and lateral leads. There was an associated elevation of troponin T levels (peak: 432 ng/L), suggestive of myocarditis. On otoscopic examination, she was found to have rupture of tympanic membrane bilaterally. A transthoracic echocardiography revealed reduced ejection fraction of the left ventricle to 25% with global left ventricle hypokinesia, moderate mitral regurgitation and tricuspid regurgitation. This case aims to raise awareness among the healthcare providers regarding multiple organ involvement in lightning injury.
ABSTRACT
Scrub typhus, a rickettsial disease endemic in several parts of India, usually presents with acute symptoms. It is caused by small intracellular Gram-negative bacteria belonging to the Rickettsiaceae family. Optic neuritis and lateral rectus palsy may be associated with a range of autoimmune disorders, infectious diseases and raised intracranial tension. In this case, we report optic neuritis and lateral rectus palsy induced by Orientia tsutsugamushi. We report a case of a 23-year-old woman presenting with complaints of high-grade fever, vomiting and generalized swelling since 5 days. During this febrile period, on 4/10/2021, she complained of difficulty in vision and double vision. She was found to be positive for scrub typhus on 5/10/2021. Optic neuritis was diagnosed on the basis of ophthalmologic examination and magnetic resonance imaging (MRI) brain. Investigation was done to rule out autoimmune disorders (vasculitis and connective tissue diseases). Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests. Fever, eschar, history of tick exposure and supportive diagnostic tests usually lead to the diagnosis. This case aims to raise awareness among the healthcare providers for this type of association. Scrub typhus should be included in the differential diagnosis when a patient presents with fever with or without eschar and isolated or multiple cranial nerve palsy
ABSTRACT
Background: Overpopulation is a major problem in 21st century India. 2012 census shows birth rate of 20.97/1000 people and death rate of 7.48/1000 people. Fertility rate in 2019 was 2.28 children per women. Many states implemented 2 child norms. Purpose of study is to understand the number of children preferred.Methods: A Cross sectional study was done amongst 200 primigravida women who attended antenatal clinic at SMC, Shimoga. A predesigned and pretested standard Questionnaire was used to know the number of children preferred, KAP about birth spacing, contraceptive use and unsafe abortions using objective questions.Results: Most women preferred 2 child norms across most subclasses. Most Muslims (85.7%) preferred ?3 children. Though 100% were aware of family planning, only 46% chose to space their next pregnancy. 56.5% were in support of 2-child norm. Family pressure plays crucial role in 83.5% cases and 65.5% still opted sterilization as the first choice for contraception.Conclusions: India with high population density is staring at demographic disaster due to limited life resources. Right attitude towards birth spacing, contraceptive use, avoidance unwanted pregnancies and unsafe abortions is needed. Better female literacy, societal awareness and good medical facility at last mile is crucial. Male partner's involvement in every step is vital.
ABSTRACT
Introduction: Cone beam computed tomography (CBCT) has its wide range of uses in dentistry most commonly as an aid in preoperative planning of dental implant treatment. However, in order to determine the best application of CBCT in dentistry, it is necessary to analyze the accuracy of data obtained related to distance measurements. The present in-vitro study was undertaken to evaluate the accuracy of radiographic linear measurements on CBCT images by comparing them to direct measurements in human dry mandibles. Materials and methods: Ten human dentulous dry mandibles were selected for the study. Four anatomical sites (Site A, B, C, and D) with two anatomical reference points for each site were selected on dry mandibles for measurement. The reference points were made as 3 mm depressions on the mandible with Marathon micromotor hand piece and diamond bur. These depressions were filled by guttapercha. All the selected mandibles were scanned using Sorodex Cranex 3Dx CBCT Machine. After the CBCT scan was obtained, the direct measurements at each site were recorded using digital vernier calipers with an accuracy of 0.01mm. Results: Comparison of CBCT measurements with direct measurements at 4 anatomical sites revealed no statistical difference (p value >0.05). Correlation of CBCT measurements with direct measurements revealed strong correlation at site site A (0.965), site B (r=0.899), D (r=0.975) and moderate correlation at site C (r=0.571). Conclusion: According to present study, CBCT technique can be recommended for linear measurements in the mandible.
ABSTRACT
The purpose of this investigation was to develop fast dissolving tablets (FDTs) of Granisetron hydrochloride (GHCl) by vacuum drying technique using camphor as subliming agent together with croscarmellose sodium (CCS), crospovidone (CP), sodium starch glycolate (SSG) and plantago ovate (PO) as superdisintegrants. The prepared formulations were evaluated for pre-compressional and post-compressional parameters. The compatibility of drug with other ingredients was checked by FTIR studies, the results revealed that there was no interaction between dug and other excipients. The values of pre-compressional parameters were within prescribed limits and indicated good free flowing properties. In all the formulations the hardness test indicates good mechanical strength. Friability of all formulations was less than 1. Drug content was found to be high (≥ 100.44%) and uniform in all the formulations. The tablet thickness was found to be 3.11 – 3.34. The weight variation results revealed that average percentage deviation was less then ± 7.5 %, which provides good uniformity in all formulations. The disintegration time of the tablets found to be in the range of 18 to 44 sec. The formulations SBC4, SBP4, SBG4, and SBO4 50 % of drug released in 0.41, 0.48, 0.59 and 0.47 min, and 90 % of drug released in 2.01, 3.05, 4.01 and 2.51min. Stability study carried out as per ICH guidelines for three months and results revealed that upon storage disintegration time of tablets decreased significantly (p<0.05). The release of drug from the SBC4 and SBO4 formulations was quick when compared to other formulations. It was concluded that fast dissolving tablets with improved Granisetron hydrochloride dissolution could be prepared by sublimation of tablets containing suitable subliming agent.
ABSTRACT
Fast dissolving drug delivery systems offers a solution for those patients having difficulty in swallowing tablets/capsules etc. Granisetron hydrochloride was selected as the model drug. In the present study, an attempt had been made to prepare fast dissolving tablets of the drug using , plantago ovata mucilage and sodium starch glycolate as super disintegrants (2.5 to 10 % w/w) following by direct compression method. Formulations were evaluated for precompressional parameters such as angle of repose, carr’s compressibility index and hausner’s ratio. The tablets were evaluated for uniformity of weight, thickness, hardness, friability, drug content, wetting time, in-vitro dispersion time and in-vitro dissolution study. The prepared tablets were characterized by FTIR studies. No chemical interaction between drug and exciepients was confirmed by FTIR studies.