Comparison of Sealing Ability of MTA and Retroplast as Root End Filling Materials Evaluated Under a Stereomicroscope Using Rhodamine B Dye: An In vitro Study

Aim: The aim of the study was to compare the sealing ability of Mineral Trioxide Aggregate (MTA) and Retroplast as root end filling materials using the Rhodamine B dye penetration method in vitro. Methodology: Forty freshly extracted human single?rooted teeth were randomly divided into two groups of 20 teeth each, and standard root?end cavities were prepared in all teeth. The cavities were filled with MTA and Retroplast in groups 1 and 2, respectively. The specimens were then stored in 1% Rhodamine B dye for a week, following which the dye penetration with all samples was analysed under a stereomicroscope and scored according to Tronstad’s criteria. The observations were compared with Chi square test at a 0.220 level of significance. Results: 5% of the samples in both the groups showed no significant leakage. The leakage was deeper with the Retroplast group than with the MTA group; however, there was no statistically significant difference between the two groups. Conclusion: Both MTA and Retroplast are similar in their sealing potential as root?end cavity fillings with Retroplast reporting slightly deeper microleakage than MTA within the limits of the present study.

Comparative in vitro Activities of Different Antibiotics against Clinical Isolates of Gram-negative Bacilli

Objective: The local anti-microbial susceptibility profile plays a very critical role in guiding clinicians to choose the appropriate empiric therapies. This study was conducted to assess the pathogen characteristics and the in vitro susceptibility of different Gram negative isolates to commonly used antibiotics in our hospital settings. Methods: A total of 110 Gram negative isolates were included in the study. A retrospective, observational analysis of antibiogram data was performed for four antimicrobial agents including CSE-1034 (ceftriaxone-sulbactam-EDTA), piperacillin-tazobactam (pip-taz), cefoperazone-sulbactam and meropenem. Results:Of the 200 clinical specimens analysed, Gram negative isolates obtained from 110 samples were included in the final analysis.The most common Gram negative isolates were Klebsiellaspecies(35.5%), E. coli (33.6%) and P. aeruginosa(21.8%). The overall susceptibility was highest to CSE-1034 (100%) followed by meropenem (66.4%), cefoperazone-sulbactam (56.4%) and pip-taz (45.5%).The MIC90range of CSE-1034 for Enterobacteriaceae was ≤0.5-≤4μg/ml and ≤2μg/ml for susceptible P. aeruginosaisolates. The MIC90of meropenem for 94.4% of meropenem-susceptible Enterobacteriaceaestrains was <0.25μg/ml and 64.3% of P. aeruginosawere having MIC ≤0.25μg/ml. The MIC90of pip-taz for82.5% of the pip-taz susceptible Enterobacteriaceaestrains was 4μg/ml and 63.6% of P. aeruginosa was ≤8.0μg/ml. The MIC90of cefoperazone-sulbactam susceptible strains were between ≤8 to ≤16μg/ml and 45.8% isolates of susceptible P. aeruginosa werehaving MIC between ≤8 to ≤16μg/ml. Conclusions: Overall, this in vitro surveillance study suggests that CSE-1034 can be considered an important therapeutic option for the treatment of various multi drug resistant Gram-negative bacterial infections and avert the threat of resistance to last resort antibiotics including carbapenems

Osmf: Long Term Study Of Treated Patients

Background and Objective: Oral Submucous fibrosis (OSMF) is a chronic debilitating disease and a well recognized premalignant condition of oral cavity. The exact pathogenesis is not well established but the cause is believed to be multifactorial. The most commonly used treatment regimen is combination of Hydrocortisone acetate or Triamcinolone Acetonide with hyaluronidase and recently oral Pentoxifylline, but studies of its long term effect are lacking. The present study was therefore conducted to evaluate the long term effectiveness of afore said drugs. Material & methods: In the present study 60 previously treated patients of OSMF were registered. Out of which 34 patients had received Inj. Hydrocortisone acetate (1.5ml) mixed with Hyaluronidase (1500 I.U.) at weekly interval for 22 weeks, 15 patients had received Inj. Triamcinolone Acetonide (10mg/ml) mixed with Hyaluronidase (1500 I.U.) at biweekly interval for 22 weeks and 11 patients were given Tab Pentoxifylline (Trental) 400mg three times daily for a period of 7 months. Long term outcome was evaluated on the basis of symptom score and sign score. Results: There was statistically significant improvement between long term follow up score and immediate Post-treatment symptom score ( p value < 0.05 ) Interpretation and Conclusion: It was concluded that the improvement in symptoms and signs following treatment increased further or maintained in long term follow up

Mean reticulocyte volume enhances the utility of red cell mean sphered cell volume in differentiating peripheral blood spherocytes of hereditary spherocytosis from other causes.

Context: Mean sphered cell volume (MSCV) and mean reticulocyte volume (MRV) are additional reticulocyte parameters generated while processing the blood samples on Beckman coulter LH 755 in the reticulocyte mode using the volume, conductivity and scatter technology. It has been observed that the difference between mean corpuscular volume (MCV) and MSCV is higher in the cases of hereditary spherocytosis (HS) and this difference is increasingly being utilized as a screening tool for spherocytes. In addition now there have been new observations that reticulocyte volume in cases of HS is less as compared to normal reticulocyte. Aims: Our aim was to test the usefulness of reticulocyte parameters like MSCV and MRV in distinguishing cases of HS and autoimmune hemolytic anemia (AIHA). Materials and Methods: This is a retrospective and partly prospective study where peripheral blood ethylenediaminetetraacetic acid samples from cases of HS (n = 57) and AIHA (n = 29) were processed on LH 755 in both the differential and the reticulocyte mode. The data generated were analyzed and compared with data from normal healthy donors (n = 46). Results: Using an algorithm of MCV — MSCV >10 and MRV — MSCV <25, a sensitivity of 84.2% and specifi city of 94.7% was observed in cases of HS. Conclusions: With the reticulocyte analysis, we may now have a simple and cheap additional tool for screening of HS.

A Missed Malignant Right Coronary Artery Anomaly Detected Post-Cardiac Event in an Adult Patient.

Aims: We present this case to raise awareness of this unusual presentation of a malignant anomalous right coronary artery arising from the left coronary cusp in a patient older than 50 years. We describe a useful imaging modality and discuss therapy. Presentation of the Case: We report a case of a 63-year-old male with an interarterial coursing right coronary artery arising from the left coronary cusp with a history of a mechanical aortic valve replacement. The patient presented to our emergency department after being resuscitated from a cardiac arrest and later had a normal coronary angiogram. High suspicion of his right coronary artery angulation, he underwent a computed tomography with angiogram that revealed his anomalous course and anatomy. Discussion: We discuss the importance of coronary artery anomaly detection in the young at risk population (athletics), pathophysiology, diagnostic modalities, and treatment recommendations. Surgical revascularization has been advocated in malignant coronary anomalies, however, the lack of large randomized clinical trials for patients older than 50- year-old left this topic controversial. Medical therapy augmented with implanted cardioverter defibrillator (ICD) was utilized in this case. Medical management could be considered in centers that don’t have surgical experience or in adult patients who are a poor surgical candidate because of other comorbidities or life expectancy. Conclusion: Computed tomography with angiogram seems to be the best noninvasive modality to delineate coronary course and anatomy. There is a need for randomized clinical trials to determine the best management of anomalies arising from opposite sinus with an interarterial course in adults >50-year-old.

Intravitreal anti-VEGF monotherapy for thick submacular hemorrhage of less than 1 week duration secondary to neovascular age-related macular degeneration.

Aim: To investigate the role of anti‑VEGF monotherapy in patients with thick submacular hemorrhage (SMH) of ≤1 week duration secondary to neovascular age‑related macular degeneration (N‑AMD). Materials and Methods: A retrospective chart review of 14 eyes of 14 patients presenting with acute decrease in central vision of ≤1 week duration secondary to a thick SMH measuring ≥ 2 MPS disk areas from N‑AMD was performed. Intravitreal injections of bevacizumab 1.25 mg (13 eyes) or ranibizumab 0.5 mg (1 eye) were given monthly until resolution of SMH and less frequently thereafter, based on treat-and-extend approach utilizing spectral domain optical coherence tomography (SDOCT). Patients with follow‑up of ≥6 months were included. Results: Patients presented after a median of 4 (range 1-7) days from the onset of SMH. Mean lesion size was 27.9 mm2 (range 5.47-100, median 15), with blood comprising 77-98% of the lesion. Presenting visual acuity (VA) ranged from 20/60 to hand motions (median 20/200). Patients received a mean of 11.4 (range 5-20) injections over 18.4 (range 7-50) months. SMH resolved in all eyes in a mean of 4.8 (range 2-8) months. At 6 months follow‑up, mean VA gain was −0.54 logMAR (range: −1.5 to +1, Snellen range 20/25‑20/400, median 20/100, P = 0.0037), with 11 gaining ≥0.2 logMAR. Mean change in VA from baseline at final follow‑up was −0.58 logMAR (range −1.6 to +1, Snellen range 20/30-20/400, median 20/60; P = 0.0022). Conclusion: A good anatomical and visual outcome can be accomplished in patients with thick SMH secondary to N‑AMD treated with anti‑VEGF monotherapy within 1 week.

Progressive atrophy of retinal pigment epithelium after trypan-blue-assisted ILM peeling for macular hole surgery.

We report a case of progressive atrophy of the retinal pigment epithelium (RPE) after trypan-blue-assisted peeling of internal limiting membrane (ILM) for macular hole surgery. A 68-year-old Caucasian female underwent a 20-g pars plana vitrectomy for a chronic stage-3 macular hole. The ILM was stained with 0.06% trypan blue (VisionBlue™, DORC Netherlands) for 2 min after fluid air exchange. Dye was reapplied for another 2 min due to poor staining. The ILM was completely removed around the macular hole with forceps. RPE atrophy was noticed at the edge of the hole 1 month after surgery. It progressively increased in intensity and enlarged over 2 years. Her final visual acuity was counting fingers, significantly worse compared to her presenting visual acuity of 20/200. Progressive atrophy of RPE in our patient was most likely due to the toxicity of trypan blue. Reapplication of the dye may increase the likelihood of toxicity.

Screening for SAM in the Community: Is MUAC a ‘Simple Tool.

Anthropometric data from our survey of 1,879 children in Madhya Pradesh revealed low sensitivity (17.5%) and positive predictive value (30.4%) of Mid-Upper Arm Circumference (MUAC) at the recommended cut-off of 115 mm for identifying Severe Acute Malnutrition (SAM). This led us to question the reliability of MUAC as a screening tool to identify SAM at the community level, especially in the context of very high levels of stunting.

In-Vivo Antioxidant activity of ethanolic extract of Mentha pulegium leaf against CCl4 induced toxicity in rats

Objective: To evaluate the in-vivo antioxidant potential of ethanolic extract of Mentha Pulegium against CCl4 induced toxicity in rats. Methods: Animals were treated with plant extract for 7 days and then toxicity was induced with a single CCl4 intraperitoneal injection. Pre-treatment with 600 mg/kg (p.o.) of ethanolic extract of Mentha Pulegium improved the glutathione, SOD, catalase, and peroxidase levels significantly as compared to control group. Results: The present studies revealed that Mentha Pulegium has significant in-vivo antioxidant activity and can be used to protect tissue from oxidative stress. The result showed that the activities of glutathione, SOD, catalase and peroxidase in group treated with CCl4 declined significantly than that of normal group. Conclusion: Ethanolic extract of Mentha Pulegium in the dose of 600 mg/kg, p.o., has improved the glutathione, SOD, catalase, and peroxidase levels significantly, which were comparable with Liv 52. Based on this study we conclude that Ethanolic extract of MenthaPulegium possesses in vivo antioxidant activity and can be employed in protecting tissue from oxidative stress.

Pharmacological evaluation of anti-fertility activity of ethanolic extract of Jatropha gossypifolia leaf in female albino mice

Objective: Anti-fertility activity of ethanolic extract of Jatropha gossypifolia leaf in female albino mice. Methods: Jatropha gossypifolia leaf extract, when administered orally, altered the estrous cycle pattern in female mice, prolong the length of estrous cycle with significant increase in the duration of diestrus stage and reduced significantly the number of litters in albino mice. Treatment of mice with extract of 250 and 450 mg/kg body weight/day for 21 days caused a prolonged estrous cycle with significant increase in the duration of diestrus phase and elongation of estrus stage in treatment with higher dose (450 mg/kg body weight/day). Results: The analysis of the principal hormones involved in estrous cycle regulation showed that the plant extracts altered gonadrotrophin release (LH, FSH and prolactinn) and estradiol secretion. Conclusions:The results indicated the anti-fertility effect of Jatropha gossypifolia leaf extract in female albino mice.

Accidental isoniazid poisoning--a report.

Eight patients who had taken accidental overdose of Isoniazid were followed in relation to its clinical manifestations, EEG changes and management. All cases survived without any residual effect.

Pleomorphic lipoma of the tonsillar fossa--a case report.

Pleomorphic lipoma is a benign adipocytic tumor, commonly located in the shoulder and posterior neck region. The presence of bizarre, hyperchromatic stromal cells along with multinucleated giant cells often poses difficulty in diagnosis, especially when it arises at an unusual site like tonsillar fossa.