Physical rehabilitation in Brazilian pediatric intensive care units: a multicenter point prevalence study / Reabilitação física em unidades de terapia intensiva pediátrica brasileiras: um estudo multicêntrico de prevalência pontual

ABSTRACT Objective: To determine the prevalence and factors associated with the physical rehabilitation of critically ill children in Brazilian pediatric intensive care units. Methods: A 2-day, cross-sectional, multicenter point prevalence study comprising 27 pediatric intensive care units (out of 738) was conducted in Brazil in April and June 2019. This Brazilian study was part of a large multinational study called Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). The primary outcome was the prevalence of mobility provided by physical therapy or occupational therapy. Clinical data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥ 72 hours. Results: Children under the age of 3 years comprised 68% of the patient population. The prevalence of therapist-provided mobility was 74%, or 277 out of the 375 patient-days. Out-of-bed mobility was most positively associated with family presence (adjusted odds ratios 3.31;95%CI 1.70 - 6.43) and most negatively associated with arterial lines (adjusted odds ratios 0.16; 95%CI 0.05 - 0.57). Barriers to mobilization were reported on 27% of patient-days, the most common being lack of physician order (n = 18). Potential safety events occurred in 3% of all mobilization events. Conclusion: Therapist-provided mobility in Brazilian pediatric intensive care units is frequent. Family presence was high and positively associated with out-of-bed mobility. The presence of physiotherapists 24 hours a day in Brazilian pediatric intensive care units may have a substantial impact on the mobilization of critically ill children.

RESUMO Objetivo: Determinar a prevalência e os fatores associados à reabilitação física de crianças em estado grave em unidades de terapia intensiva pediátrica brasileiras. Métodos: Realizou-se um estudo de prevalência pontual multicêntrico, transversal, de 2 dias, abrangendo 27 unidades de terapia intensiva pediátrica (do total de 738) no Brasil em abril e junho de 2019. Este estudo brasileiro fez parte de um grande estudo multinacional chamado Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU). O desfecho primário foi a prevalência de mobilidade proporcionada pela fisioterapia ou pela terapia ocupacional. Foram coletados prospectivamente dados clínicos sobre a mobilidade do paciente, possíveis eventos de segurança de mobilidade e barreiras de mobilização em pacientes admitidos por ≥ 72 horas. Resultados: As crianças com idade inferior a 3 anos eram 68% da população de pacientes. A prevalência de mobilidade fornecida pelo terapeuta foi de 74%, ou 277 dos 375 pacientes-dia. A mobilidade para fora do leito foi mais positivamente associada à presença de familiares (razão de chance ajustada de 3,31; IC95% 1,70 - 6,43) e mais negativamente associada às linhas arteriais (razão de chance ajustada de 0,16; IC95% 0,05 - 0,57). Foram relatadas barreiras à mobilização em 27% dos pacientes-dia, sendo a mais comum a falta de prescrição médica (n = 18). Registaram-se eventuais eventos de segurança em 3% de todos os eventos de mobilização. Conclusão: A mobilidade proporcionada pelo terapeuta nas unidades de terapia intensiva pediátrica brasileiras é frequente. A presença de familiares foi alta e positivamente associada à mobilidade para fora do leito. A presença de fisioterapeutas 24 horas por dia nas unidades de terapia intensiva pediátrica brasileiras pode exercer papel importante na mobilização de crianças em estado grave.

AN ANALYSIS OF TAMIL YOUTUBE VIDEOS ON DENTAL CARIES

The most ubiquitous social media site, YouTube, is frequently utilized to obtain information about oral and dental health. However, there is still an issue with the standard of online health information. We conducted a study to analyse the quality and professionalism of YouTube videos in Tamil language related to dental caries. The objective was to identify the number of useful videos and hoaxes available online. The videos were analysed using Global Quality Scale (GQS) and modified DISCERN questionnaire. In order to provide trustworthy information to the public, the research emphasises the need for dental professionals and healthcare organisations to be aware of the content available online.

Unraveling Prostaglandin and NLRP3 Inflammasomemediated Pathways of Primary Dysmenorrhea and the Role of Mefenamic Acid and Its Combinations

Painful menstrual cramps during or around the time of the monthly cycle are known as dysmenorrhea. The estimated global prevalence in women of reproductive age ranges from 45% to 95%. It has a significant negative impact on regular activities and productivity at work. However, despite the severe consequences on quality of life, primary dysmenorrhea (PD) is underdiagnosed. Dysmenorrhea has complex pathogenesis. It involves the release of prostaglandins and activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and also includes the involvement of other mediators such as bradykinin, histamine and acetylcholine. Even though nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most common type of pain medication, the question of which one should be the most preferred is still open to debate. The current review examines the existing evidence for the pathogenesis of PD and makes evidence based and clinical experience based recommendations for the use of mefenamic acid and its combination in the treatment of dysmenorrhea. Mefenamic acid alleviates PD by inhibiting endometrial prostaglandin formation, restoring normal uterine activity, and reducing the inflammatory response by inhibiting the NLRP3 inflammasome and reducing the release of cytokines such as interleukin (IL)-1?. It is also known to have bradykinin antagonist activity. Dicyclomine has a dual action of blocking the muscarinic action of acetylcholine in postganglionic parasympathetic effect or regions and acting directly on uterine smooth muscle by blocking bradykinin and histamine receptors to relieve spasms. According to the experts, mefenamic acid and dicyclomine act synergistically by acting on the different pathways of dysmenorrhea by blocking multifactorial agents attributed to the cause of dysmenorrhea. Hence, the combination of mefenamic acid and dicyclomine should be the preferred treatment option for dysmenorrhea.

Cortical Reorganization Following Psychoeducational Counselling and Residual Inhibition Therapy (RIT) in Individuals with Tinnitus

Abstract Introduction Psychoeducational counselling and residual inhibition therapy (RIT) are traditional approaches used in many clinics to manage tinnitus. However, neurophysiological studies to evaluate posttreatment perceptual and functional cortical changes in humans are scarce. Objectives The present study aims to explore whether cortical auditory-evoked potentials (CAEPs; N1 and P3) reflect the effect of modified RIT and psychoeducational counselling, and whether there is a correlation between the behavioral and electrophysiological measures. Methods Ten participants with continuous and bothersome tinnitus underwent a session of psychoeducational counselling and modified RIT. Perceptual measures and CAEPs were recorded pre- and posttreatment. Further, the posttreatment measures were compared with age and gender-matched historical control groups. Results Subjectively, 80% of the participants reported a reduction in the loudness of their tinnitus. Objectively, there wasasignificant reductioninthe posttreatment amplitude of N1 and P3, with no alterations in latency. There was no correlation between the perceived difference in tinnitus loudness and the difference in P3 amplitude (at Pz). Conclusion The perceptual and functional (as evidenced by sensory, N1, and cognitive, P3 reduction) changes after a single session of RIT and psychoeducational counselling are suggestive of plastic changes at the cortical level. The current study serves as preliminary evidence that event-related potentials (ERPs) can be used to quantify the physiological changes that occur after the intervention for tinnitus.

Knowledge, attitude, and practice towards obesity among the general public in community settings of Tirupati: a cross-sectional study

Background: Obesity and overweight are strongly linked to developing diabetes, hypertension, myocardial infarction, stroke, and endocrine disorders. Knowledge, attitude, and practicesof the public are crucial in limiting the burden of obesity in the Indian community. The current study aims to assess the KAP of obesity among the general public of India. Methods: A community-based cross-sectional survey was conducted in the rural and urban areas of Tirupati city. Adults aged 18 years or above who are willing to participate, were included. A total of 300 subjects were enrolled and data was collected by using a pre-validated questionnaire. Variables like weight, height and KAP scores were obtained. Chi-square tests were used to associate demographics with good KAP towards obesity.Results: The findings show that more than half of the participants have good knowledge, and a positive attitude, but the practices are not optimal in dealing with obesity and management. Participants’ ages more than 40 years, presence of comorbidity, risk factors, and social habits are significantly associated with obesity and overweight. Obese are having goodknowledge but normal-weight people are significantly associated with a positive attitude. Participants of normal weight, no risk factor, and no habits were significantly associated with rational practices.Conclusions: The study concludes that the participants had good knowledge and attitude toward obesity but the participants failed to practice controlling and preventing obesity. However, more efforts are required in creating awareness and educating the general population regarding physical activity, diet, and lifestyle in preventing obesity and its associated complications.

Aorto-Occlusive Disease Causing Pregnancy Complications: A Serendipitous Diagnosis

Takayasu arteritis or pulse-less disease is known to present in myriad forms. Here, we report the case of a 22-year-old young pregnant female who presented to us with pregnancy complications was finally diagnosed to have Takayasu Arteritis but not before her disease course took a lot of diagnostic turns. It highlights the fact that the disease is very variable in its presentation. The other unique presentations reported in literature along with a brief review of the treatment options are also given

Management Of Rhinosporidiosis In Our Experience

Background: Rhinosporidiosis is a chronic granulomatous disease caused by aquatic parasite Rhinosporidium seeberi belonging to group of fish parasite Mesomycetozoa. It commonly affects nose and nasopharynx. It is one of the endemic disease is in India. Materials and Methods: This is a prospective study of distribution pattern and management of 12 cases of rhinosporidiosis in our institute(GIMSR)from the region of Visakhapatnam, Vizianagaram and Srikakulam districts of Andhra Pradesh, India. This is also to study the pattern of involvement according to age, sex, site, laterality, and their management. It emphasizes the importance of excision under local anaesthesia once the stalk of the lesion is identified. Results: Our study of 12 patients were shown slightly male preponderance, around the age of 11–20 years, with a clear cut history of having a bath in contaminated pools and rivers . Nasal obstruction & epistaxis are the predominant symptoms. The majority of cases had been excised endoscopically under local anaesthesia with less bleeding and minimal recurrence rate. It also reveals the importance of general anesthesia when the lesions involving posterior aspect of nasal cavity, nasopharynx to prevent aspiration in to lungs and in children who don’t cooperate for local anaesthesia. Conclusion: Endoscopic identification of stalk is mandatory before excising the lesion under local anaesthesia. The bleeding is less when excision done with diathermy cautery.

Clinical profile of dengue fever in children presented at a tertiary care hospital

Background: Dengue fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, and arthralgia, rash, leucopenia, and lymphadenopathy. Dengue hemorrhagic fever and dengue shock syndrome are a severe, often fatal febrile disease caused by 1 of 4 dengue virus. It is characterized by increased capillary permeability, abnormalities of hemostasis and protein-losing shock syndrome. The aim of this study was to assess the clinical profile, complications and outcome of dengue infection in children.Methods: All children attending the hospital with symptoms and signs suggestive of dengue fever were tested for NS1 antigen and IgM/ IgG dengue antibody serology (depending on the day of fever) by enzyme-linked immunosorbent assay (ELISA) technique.Results: Of the 174-dengue serology positive children, fever was the most common major symptom (97.7%) followed by vomiting (85.6%), loss of appetite (81.6%), abdominal pain (77%), body pain/leg pain (62.6%). Severe dengue as per WHO criteria was seen in 29 (16.7%) children. Thrombocytopenia (platelet count less 1,00,000) was observed in 82 children (47%), Platelet count less than 20,000 in 8 children (4.5%). Dengue shock syndrome was seen it 26 children (15%). Mortality was nil.Conclusions: In children, if symptoms like fever, vomiting, loss of appetite, abdominal pain and body pain are present, a strong possibility of dengue fever is present especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

Study of knowledge, attitude and practice of self medication among health care workers at MC Gann Teaching District hospital of Shivamogga, India

Background: Healthcare workers gain adequate knowledge related to medications used in treating illness from their work experiences which influences self medication practices.Methods: The present study was conducted in N=150 healthcare workers, divided into 2 groups with group I (nursing staff) and group II (paramedical staff) with 75 participants in each group. Data related to self medication was obtained from a pretested validated semi structured questionnaire either in Kannada or English. The responses were compared between each group with chi square test. P value ?0.05 was considered significant. All statistical analysis was conducted with SPSS 16.Results: The mean age (mean±SD) of the participants in group I and group II is 31.79±8.309 and 34.15 (±8.168) respectively with p =0.081. The prevalence of self medication was 100% in both the groups. Both the groups knowledge related to the definition of self medication was similar (group I 63 (84.0%) and group II 62 (82.7%) p = 0.900). Group I believes that self medication is entirely safe compared to group II which was statistically significant (group I 66 (88.7%) and group II 46 (61.3%) p=0.029). Most common drugs used for self medication was NSAIDS (non steroidal anti-inflammatory drugs) in both the groups being 75 (100%). Antibiotics was used by 26 (2.66%) in group I and 14 (18.66%) in group II.Conclusions: Self medication practice is highly prevalent in the healthcare workers, who also influence the other populations to practice self medication. Practicing responsible self medication is more appreciable.

An alternative approach with a low dose and prolonged chemotherapy for palliative treatment of locally advanced, metastatic or recurrent squamous cell head and neck cancer

Background: It is expected that about 65,000 new patients will be diagnosed with head and neck cancer in 2017 in the United States. Patients with recurrent or advanced or metastatic head and neck do not have good survival due to aggressive and recurrent nature of this cancer. Moreover, cumulative and residual toxicities from previous and ongoing treatments significantly impede quality of remaining part of their life. Currently available chemotherapeutic regimens for this group are derived from the treatments used for the potentially curable disease. These regimens and associated toxicity are obviously not the best matches for the treatment with palliative intent. We here present a retrospective study where we used dose-adjusted chemotherapy specifically for palliative treatment this sub-group of head and neck cancer patients. Methods: Study population was identified from the University of Florida, and IRB approval was obtained. We used currently available and approved chemotherapeutic agents (including Taxols, Platins, 5-Fluorouracil and Epidermal Growth Factor Receptor inhibitors) for treatment of head and neck cancer but dose-adjusted at approximate 50% dose of currently recommended doses. We then gave personalized doses for a prolonged period by titrating doses based on response and tolerability of each patient. Data was collected for treatment, response, side effects, and outcomes. KM analysis was performed for survival data. Results: Total of 32 patients were included in this study with a median age of 65.2 years and a median follow-up of 10.1 months. 62.5% (n = 20) had locally advanced disease and rest had metastatic disease. 37.5% (n = 12) had new disease while rest had recurrent cancer. Of 32 patients, 14 patients received TPF based while 18 patients received PFE based chemotherapy. Total of 270 chemotherapy cycles were delivered among these 32 patients. They received a median of 9 cycles (range 3­14) over a median of 6.2 months (range 1.8­21.1). With this treatment approach, we noted median progression-free survival of 14.0 months and median overall survival of 15.7 months. Notable grade 3 toxicities were generalized fatigue in 12.5% (n = 4), nausea/vomiting in 6.3% (n = 2), diarrhea in in 6.3% (n = 2), mouth soreness in 6.3% (n = 2), rash in 3.1% (n = 1), neutropenia in 18% (n = 6) and anemia in 15.6% (n = 5) while notable grade 4 toxicities were neutropenia and anaphylaxis in 3.1% (n = 1) patient each (AU)

Postoperative rate induced left bundle branch block after craniotomy

Rate induced left bundle branch block [LBBB] is a rare peri-operative phenomenon. We encountered rate related LBBB in a 72 year old patient who had undergone a craniotomy. Acute coronary event was ruled out by doing serial troponin-I levels and absence of new onset regional wall motion abnormalities on echocardiogram. The electrocardiographic changes reverted to normal after controlling the rate with beta blockers. Further cardiac evaluation was advised but the patient and family opted for a conservative medical management considering his age and co-morbidities

Antihyperlipidemic activity of chickpea sprouts supplementation in ovariectomy‑induced dyslipidemia in rats.

Background: Phytoestrogens are increasingly becoming popular as alternatives for hormone replacement therapy in postmenopausal condition. Objective: In this study, the antihyperlipidemic effect of chickpea (Cicer arientum) sprouts was evaluated in ovariectomy‑induced dyslipidemia in rat model in comparison with standard antihyperlipidemic agent atorvastatin. Materials and Methods: A total of 24 female adult Wistar rats were divided into four groups that is, Group I ‑ Control; Group II ‑ Ovariectomized (OVX) rats; Group III ‑ OVX + germinated chickpea sprouts (20% in diet) and Group IV OVX + atorvastatin (1.2 mg/kg b.wt, p.o.). Body and organ weights, serum, and liver lipid profile were assessed at the end of 8 weeks. Results: The results indicated that ovariectomy significantly (P < 0.05) increased total cholesterol, nonhigh‑density lipoprotein cholesterol and triglycerides (TGs) in serum and liver. The total lipid and phospholipid content in liver were also significantly (P < 0.05) increased. The weights of uterus and heart were significantly (P < 0.05) decreased. Dietary supplementation with germinated chickpea normalized the lipid profile in serum and liver. Further, high‑density lipoprotein (HDL) cholesterol, body weight, uterine, heart, and spleen weights were significantly (P < 0.05) increased. Atorvastatin administration showed similarly normalized lipid profile, but showed no improvement on decreased uterus and heart weights. Histopathological examination revealed fatty changes in liver, uterine atrophy, and subintimal fat accumulation in aorta in OVX group. The changes were mild in chickpea group with no improvement in statin group. Conclusions: Germinated seeds of chickpea showed significant antihyperlipidemic activity, which was comparable to atorvastatin. Further, germinated chickpea improved organ weights and helped in the reversal of histopathological changes suggesting its usefulness in postmenopausal condition.

Effect of Argemone mexicana (L.) against lithium-pilocarpine induced status epilepticus and oxidative stress in wistar rats.

Argemone mexicana (L.) has a role in the treatment of epileptic disorders in Indian traditional system of medicine. We studied its effect on induced status epilepticus (SE) and oxidative stress in rats. SE was induced in male albino rats by administration of pilocarpine (30 mg/kg, ip) 24 h after injection of lithium chloride (3 mEq/kg, ip). Different doses of the ethanol extract of A. mexicana were administered orally 1 h before the injection of pilocarpine. The severity of SE was observed and recorded every 15 min for 90 min and thereafter at every 30 min for another 90 min, using the Racine scoring system. In vivo lipid peroxidation of rat brain tissue was measured utilizing thiobarbiturate-reactive substances. Both in vitro free radical nitric oxide and 2,2-diphenyl-1-picryl hydrazyl scavenging activities of the extract were also determined. The SE severity was significantly reduced following oral administration of the extract at 250, 500 and 1000 mg/kg doses. None of the animals from groups 3 to 5 (with A. mexicana extract) have exhibited forelimb clonus of stage 4 seizure. The extract also exhibited both in vivo and in vitro antioxidant activities.

Effect of Titanium dioxide nanoparticles on the flexural strength of polymethylmethacrylate: An in vitro study.

Context: To improve the flexural strength of polymethylmethacrylate (PMMA). Aim: To evaluate whether the incorporation of titanium dioxide nanoparticles in polymethylmethacrylate (PMMA) increases the flexural strength and to compare the different concentrations of titanium dioxide nanoparticles and its relation to flexural strength. Settings and Design: Study was conducted in Sri Ramachandra University utilizing 40 specimens manufactured from clear heat polymerizing acrylic resin. Materials and Methods: Forty specimens of clear heat polymerizing acrylic resin of dimensions 65 × 10 × 3 mm as per ISO 1,567 standardization were fabricated and were grouped into A (CONTROL) with no titanium dioxide (TiO2) nanoparticles, B with 0.5 gms of TiO2 nanoparticles, C with 1 gm of TiO2 nanoparticles and D with 2.5 gms of TiO2 nanoparticles added.The concentrations of titanium dioxide in each group were 1 wt%, 2 wt% and 5 wt%. Universal testing machine INSTRON was used to load at the center of the specimen with a cross head speed of 1.50 mm/min and a span length of 40.00 mm. Statistical Analysis Used: ANOVA and multiple comparisons are carried out using the independent t‑test. Results: The ANOVA result shows that there is a significant difference between the groups with respect to the mean flexural strength. Highest mean flexural strength is observed in Group D, while the lowest is seen in Group A. Independent t‑test revealed that there was a statistical significance between Group A and Group D (0.041) and between Group B and Group D (0.028). Conclusions: The results concluded that polymethylmethacrylate reinforced with different concentrations of titanium dioxide nanoparticles showed superior flexural strength than those of normal PMMA.

Left Ventricular Torsion Changes Post Kidney Transplantation

BACKGROUND: To quantify changes of left ventricular (LV) torsion in patients' pre and post kidney transplantation. METHODS: A prospective study was conducted on 48 patients who received kidney transplantation for end stage renal disease and without myocardial infarction. The rotation, twist and torsion of LV were studied pre and post kidney transplantation (6 months post transplantation) using velocity vector imaging by echocardiography. The data is expressed as mean +/- standard deviation and compared by paired t-test at the p < 0.05 significance level. RESULTS: Six months post kidney transplantation, left ventricular ejection fraction (from 40.33 +/- 11.42 to 61.00 +/- 13.68%), ratio of mitral early and late diastolic filling velocity (from 1.04 +/- 0.57 to 1.21 +/- 0.52), rotation of basal LV (from 4.48 +/- 2.66 to 5.65 +/- 2.64 degree), rotation of apical LV (from 4.27 +/- 3.08 to 5.50 +/- 4.25 degree), LV twist (8.75 +/- 4.45 to 11.14 +/- 5.25 degree) and torsion (from 1.06 +/- 0.54 to 1.33 +/- 0.61 degree/cm) were increased significantly (p < 0.05). Interventricular septum thickness (from 11.67 +/- 2.39 to 9.67 +/- 0.48 mm), left ventricular mass index (from 104.00 +/- 16.47 to 95.50 +/- 21.44 g/m2), systolic blood pressure (from 143.50 +/- 34.99 to 121.50 +/- 7.09 mmHg), serum blood urea nitrogen (from 42.40 +/- 7.98 to 30.43 +/- 13.85 mg/dL) and creatinine (from 4.53 +/- 1.96 to 2.73 +/- 2.57 mg/dL) were decreased significantly (p < 0.05). CONCLUSION: Kidney transplantation in end stage renal disease without myocardial infarction results in improvement in left ventricular structure, function and myocardial mechanics as detected by echocardiography and velocity vector imaging. Velocity vector imaging provided valuable information for detection and follow-up of cardiac abnormalities in patients with end stage renal disease.

Three component one pot synthesis of 5-Substituted 1-Aryl-2,3-diphenyl imidazoles: A novel class of promising antioxidants.

A novel series of structurally diverse 5-Substituted 1-Aryl-2,3-diphenyl imidazoles (2a-j) was synthesized by treatment of benzoin (1) with 4-hydroxy aniline, substituted benzaldehydes and NH4OAc in polyethylene glycol (PEG-400) under reflux condition in excellent yields. The newly synthesized compounds were characterized by spectral and elemental analysis and screened for their antioxidant properties by employing three in vitro assays like 2,2–diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay, 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid (ABTS) assay and iron reducing power assay. Ascorbic acid was used as a standard antioxidant and the comparative study with newly synthesized compounds was also done. Among the analogues compounds 2e, 2g and 2j bearing hydroxy and methoxy groups on 2-substituted phenyl moiety respectively showed predominant antioxidant activity.

Congenital pulmonary airway malformation with mucoepidermoid carcinoma: A case report and review of literature.

Congenital cystic adenomatoid malformations (CCAM) are rare developmental anomalies of the lung characterized by cysts of varying sizes and/or adenomatoid proliferation. Type I CCAM, the most frequent subtype, is associated with an increased incidence of malignant transformation, principally bronchioloalveolar carcinoma, with a reported incidence of around 1%. We report the first case of mucoepidermoid carcinoma arising in a type 1 CCAM.

A study of cardiac autonomic control and pulmonary functions in different phases of menstrual cycle.

Introduction: Menstrual cycle is a physiological cyclical occurrence in women. This is associated with variations in metabolism and associated endocrine fluctuations. Among other things, the cardio respiratory changes too have been observed. In the present study, we investigated the autonomic control of heart, and concurrent changes in the respiratory system. Material and methods: Forty seven normally menstruating women were recruited from a group of 80 subjects reported for this study voluntarily. ECG was recorded from limb lead II time domain and frequency domain analysis of Heart rate Variability (HRV) was done. Their respiratory parameters namely PEFR, FEV1 were determined. Results: The results of this study were analysed by applying Wilcoxon’s signed rank sum test. In Time domain analysis RMSSD (36.91±2.73, p<0.05) showed significant decrease during ovulation, while other parameters did not show significant variation among the three phases. Frequency domain analysis yielded results to suggest that there is increased variability during Ovulatory and Luteal phase (p<0.05). PEFR and FEV1 increased in luteal phase (p<0.05).Conclusions: The results of our study reiterated the findings of reports of previous studies on the heart rate variability suggesting that the HRV was more during ovulatory and luteal phase. This is suggestive of the role of Progesterone on the HRV. Similarly the respiratory parameters too showed an increased PEFR and FEV1 suggesting a decreased airway resistance, while other parameters remained unchanged.

Influence of Tongue In Complete Denture Retention And Stability.

It is very difficult to relate the anatomical sciences to clinical dentistry, but there is an ever growing need to do so. Especially in fabrication of complete denture, it is important to understand the anatomy, size, position and classification of the tongue and surrounding musculature without which it impossible to achieve proper retention and stability of the complete denture. This paper tries to discuss the various factors that influence the retention and stability and ways to overcome those difficulties

Effect of An Adhesion Booster on The Bond Strength of New And Recycled Bracket.

This Study was undertaken to study if adhesion boosters could improve bond strengths of new and recycled orthodontic brackets. Materials and Methods: The sample consisted of one hundred freshly extracted non carious human premolars extracted for orthodontic purpose were divided into four Groups Group-I: New Brackets bonded with no mix adhesive. Group-II: New brackets bonded with no mix adhesive and all bond-2 (an adhesion booster). Group-III: Recycled brackets with no mix adhesive. Group-IV: Recycled brackets with no mix adhesive and all bond-2. Shear bond strength was tested using a Universal Testing Machine (Instron Corp, Figure-4) Results:The mean bond strength of different groups are Group I-10.4470Mpa, Group II- 14.2465Mpa, Group III- 6.5395Mpa, Group IV-10.2220Mpa. Discussion:There was a significant increase in bond strengths in the groups bonded with all bond-2 compared to groups without all bond-2. The mean bond strength of recycled brackets without all Bond-2 (6.5395 MPa) was significantly lower than the mean bond strength of recycled brackets with all bond-2 (10.22 MPa at P<0.05 level P=0.49635). Conclusion: In order to increase bond strength of recycled brackets, all bond-2 can be used. As the bond strength of recycled brackets with All bond-2 is close to that of new brackets without adhesion boosters, bonding all bond-2 on recycled brackets is as good as bonding new brackets.