Long?Term Performance of Untreated Fresh Autologous Pericardium as a Valve Substitute in Pulmonary Position

Background:Pulmonary regurgitation is imminent after transannular patch (TAP). We analyze the long?term performance of untreated autologous pericardium (UAP) as valve substitute at pulmonary position in patients requiring TAP. Material and Methods: This cross?sectional study include patients operated between 2007 and 2012 (n = 92). A sample of 19 patients was selected for this study which had a follow?up of more than 3 years. This includes patients with no TAP (n = 4) and with TAP and valve substitute, a monocusp (n = 11) or a tricuspid valve (n = 4) at neopulmonary annulus. Patients underwent echocardiography for assessment of right ventricle function and 18 fluoro?deoxyglucose PET CT scan for measurements of valve substitute at neopulmonary annulus. The target to blood ratio (TBR) of uptake of glucose by monocusp was measured at the cooptation edge of the neopulmonary valve. Results: The median age of the patients is 14 (9 – 37). RV function is preserved (TAPSE 18.9 (10.6 – 22.8)) at a mean follow?up of 4 years (3?9). The measurements of monocusp shows a shrinkage in height of the cusp by 35.5% (70% – 1.0%) and length by 7% (?44% ? +104%). There was less shrinkage observed in patients below 15 years of age. The TBR of monocusp was 0.945 (0.17 – 3.35) with a strong correlation between the TBR values of aortic valve leaflet and monocusp leaflet of same patient. Conclusion: The UAP is functional and successful as a valve substitute at neo pulmonary annulus at long?term follow?up. It has resisted calcification and has shown uptake of glucose in physiological limits.

Effect of waterlogging on physiological traits and yield in black gram (Vigna mungo L.) in field condition

Waterlogging is an important abiotic factor affecting crop productivity worldwide. Black gram (Vigna mungo L.) is very sensitive to waterlogged conditions. A field experiment was conducted in randomized complete block design to evaluate three black gram genotypes for waterlogging tolerance. Stress was imposed by maintaining the water level above the soil surface for 10 days after 30 days of sowing. Different physiological parameters including chlorophyll (Chl), chlorophyll fluorescence, normalized difference vegetation index (NDVI), sugars, along with the yield per plant and thousand grain weight (TW) were recorded in control and stressed plants. Results showed that NDVI, Chl, chlorophyll fluorescence, sugars, seed yield and TW reduced significantly during stress. Stress susceptibility index (SSI) for grain yield varied from 0.32 to 2.38. Linear correlation study showed that SSI was negatively correlated with NDVI (0.43),Chl (0.68) and TW (0.42) and grain yield (0.96). NDVI and sugars were correlated to TW under stress. IC530491 and IC559933 (SSI < 0.5) were waterlogging tolerant under field conditions. The study concluded that identified black gram lines may be utilized as trait donors in breeding program.

Synergistic effects of methyl 2-cyano-3,11-dioxo-18beta-olean-1,-12-dien-30-oate and erlotinib on erlotinib-resistant non-small cell lung cancer cells / 药物分析学报

Non-small cell lung cancer (NSCLC) is often characterized by an underlying mutation in the epidermal growth factor receptor (EGFR),contributing to aggressive metastatic disease.Methyl 2-cyano-3,11-dioxo-18beta-olean-1,12-dien-30-oate (CDODA-Me),a glycyrrhetinic acid derivative,reportedly improves the therapeutic response to erlotinib (ERL),an EGFR tyrosine kinase inhibitor.In the present study,we performed a series of studies to demonstrate the efficacy of CDODA-Me (2 μM) in sensitizing HCC827R(ERL-resistant) cells to ERL.Herein,we first established the selectivity of ERL-induced drug resistance in the HCC827R cells,which was sensitized when ERL was combined with CDODA-Me (2 μ.M),shifting the IC5o from 23.48 μM to 5.46 μM.Subsequently,whole transcriptomic microarray expression data demonstrated that the combination of ERL + CDODA-Me elicited 210 downregulated genes (0.44％ of the whole transcriptome (WT)) and 174 upregulated genes (0.36％ of the WT),of which approximately 80％were unique to the ERL + CDODA-Me group.Synergistic effects centered on losses to cell cycle pro-gression transcripts,a reduction of minichromosome maintenance complex components (MCM2-7),all key components of the Cdc45·MCM2-7GINS (CMG) complex,and replicative helicases;these effects were tantamount to the upregulation of processes associated with the nuclear factor erythroid 2 like 2 translational response to oxidative stress,including sulfiredoxin 1,heme oxygenase 1,and stress-induced growth inhibitor 1.Collectively,these findings indicate that the synergistic therapeutic effects of ERL +CDODA-Me on resistant NSCLC cells are mediated via the inhibition of mitosis and induction of oxidative stress.

Acute Kidney Injury Masquerading as Acute Pancreatitis - Role of Serum Amylase and Lipase in Patients with Blunt Abdominal Trauma

Blunt trauma to abdomen is one of the common causes for morbidity and mortality. In blunt abdominal trauma, there may be trauma to the pancreas, tear of bowel and hollow viscous, which can result in elevated levels of serum amylase and lipase. Serum amylase and mainly serum lipase are diagnostic markers for pancreatitis according to some literature. We report a young male, who presented with complaints of acute abdominal pain, constipation and vomiting after blunt abdominal trauma with elevated serum amylase and lipase levels with normal pancreas. Initial assessment of intra-abdominal pathology due to blunt abdominal trauma is often challenging as many injuries may not manifest during the treatment period. The manifestations may vary from being simply asymptomatic to life threatening injuries due to unavailability of accurate information about the nature of trauma. Hence, accurate diagnosis becomes very important in the management. Injury to the pancreas is not common and can result from direct penetration or through the transmission of blunt force to the retroperitoneum. Some studies report an incidence of 0.2 % cases for blunt trauma up to 1.1 % cases for penetrating trauma.1 The role of ultrasonography (USG) and Computed Tomography (CT) in management of Blunt abdominal trauma is well established. But the role of laboratory tests in the evaluation of these patients is controversial.2 In cases of Blunt trauma to abdomen, lot of causes found to cause serum amylase and serum lipase levels tend to raise. Some of these causes can be pancreatic, rupture of hollow viscus or bowel, facial and brain injury.3 It has also been found that reduced clearance of lipase can be caused by renal impairment. Thus non‐pathological raise in level of pancreatic enzymes, and other miscellaneous causes such as diabetes mellitus, drugs and infections shall be included as alternative pancreatic diagnoses.3

Sub Clinical Disease Presenting with Serious Clinical Manifestations - Blame Thyroid.

Graves' disease is responsible for 60 to 80% cases of thyrotoxicosis and characteristically presents between the ages of 20 and 50 years.Both environmental and genetic factors lead to the development of Grave’s Disease.(1) Hyperthyroidism seen in grave’s disease is caused by thyroid-stimulating immunoglobulins (TSI) that are synthesized in the thyroid gland, bone marrow and lymph nodes, and detected by direct bioassays or TSH-binding inhibiting immunoglobulin (TBII) assays. Thyroid peroxidase (TPO) antibodies are found in about 80% of cases suggestive of Grave’s Disease.(1) Grave Disease is known to have multiple serious complications like Hypokalemia, Thrombocytopenia, heart rhythm abnormalities, brittle bone and thyroid storm(1,2). Hypokalemia in Grave’s Disease is a rare life-threatening complication seen, mostly in young males, often presents acute onset paraparesis. Paralytic symptoms usually occur after heavy exercise or carbohydrates rich meal.(3)This case report highlights about a young man who presented with quadriparesis, later on investigation diagnosed as hypokalemia due to subclinical grave’s disease.Clinically silent Grave’s Disease presenting with neurological quadriparesis is diagnostic challenge. Neurological paresis rapidly resolves with correction of hypokalemia. This report discusses the case of young man who presented with acute onset quadriparesis without any clue, came out as hypokalemic due to subclinical grave’s disease.

Correlation of ECG Changes with Coronary Angiographic Findings in Patients of Coronary Artery Disease.

Coronary Artery Disease (CAD) is the most common type of heart disease. Assessment of coronary artery disease (CAD) is the starting point of determination of prognosis of patients presenting with clinical symptoms. ECG reflects the physiology of the myocardium during ischemia, while Coronary Angiography identifies vessel anatomy. In the present study, we aimed to correlate ECG changes with coronary angiographic findings along with prediction of number of vessels involved in patients of coronary artery disease. This study also intended to determine sensitivity and specificity of ECG for diagnosis of coronary artery disease using CAG as gold standard. MethodsThis cross-sectional study was carried out for a period of 2 years at Acharya Vinobha Bhave Rural Hospital, a tertiary rural health institute. 200 patients above 18 years of age who presented with or without symptoms and were willing for ECG and Angiography were included in study. Patients with valvular and congenital heart disease were excluded. Patients were divided into groups according to ECG changes and correlated with coronary angiography findings. ResultsIn the present study, the sensitivity and specificity of ECG to diagnose myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 87.50% to 96.63% and 91.30% to 95.45%, respectively. Diagnostic accuracy of ECG to detect myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 89.36% to 96.40%. ConclusionsECG is used as reliable tool for the diagnosis of coronary artery disease due to its high sensitivity and specificity, though CAG is the Gold Standard method for the diagnosis of CAD.

Pseudocyst of Pancreas, Rare Crisis in Sickle Cell Disease.

Sickle cell syndrome is an inherited autosomal recessive disease which results in the production of abnormal haemoglobin S due to a point mutation in the beta globin gene that changes the sixth amino acid from glutamic acid to valine (α2β2 6 Glu→Val).[1] These deformed RBCs cause vaso-occlusion, tissue ischemia, and infarction leading to clinical manifestations. About 10% of sickle cell patients present with acute abdominal pain, which may be due to acute cholecystitis, acute pancreatitis (rare), peptic ulcer disease, constipation due to opioids, hepatic and splenic sequestration, urinary tract infections and ischaemic bowel.[2,3,4]On literature search, not a single case of pseudo pancreatic cyst as a complication of sickle cell disease has been reported. We present a rare case of vaso-occlusive crisis in a 40 year old male patient with sickle cell anaemia leading to acute ischemic pancreatitis which may not be identified at initial stages as he was treated with fluids for sickle cell crisis similar to acute pancreatitis later on diagnosed as pseudo cyst pancreas.Pancreatic pseudocyst in a sickle cell disease is commonly misdiagnosed as sickle cell crisis hence causing difficulty in establishing the diagnosis, especially if abdominal pain is the presenting complaint. We present a case of 40-year-old non-alcoholic male having complaints of pain abdomen, misdiagnosed as peptic ulcer disease turned out to be pseudocyst of pancreas on ultrasonography of abdomen.

Impact of early intervention of speech and language therapy among hearing impaired child

Background: Hearing impairment is a factor that directly compromises the individual’s language which can affect emotional and academic defects by delayed development of communicative ability. This can vary according to the type and degree of hearing loss. Speech therapy intervention is important, along with the use of sound amplification devices, so that the child may have a chance to develop speech, consequently learning and re-habilitation to the society. Aims of the present study was performed to assess the effectiveness of early intervention of speech and language therapy after use of hearing aids to hearing impaired children on their syntactic and lexical development.Methods: This quasi-experimental study conducted on 100 children having different degree of hearing loss at department of Neurology and department of ENT, King George’s Medical University, Lucknow, Uttar Pradesh. After collecting socio-demographic data of subjects by observation, completion of questionnaires, and speech recording by audiologist; Speech and language therapy provide by audiologist for six month after providing hearing aids and improvement in their syntactic and lexical development recorded.Results: There is significant improvement in verbal response from 14% before therapy to 81% after therapy and non-verbal response before therapy was 86% and after therapy was 19%. Before giving speech and language therapy to subjects pointing score was 24%, sign language was 10% and words response was 0% which increases after therapy were 1%, 2% and 39% respectively. Early identified/intervened hearing-impaired children had a notable positive difference in all assessed lingual gains.Conclusions: This is study results definitely point to positive effects of intensive and continuous application of speech and language therapy to syntactic and lexical development of hearing impaired children.

Application of Total Quality Management to Ensure Food Quality in Food Industry

Total Quality Management (TQM) is a managerial and managemental approach of an organization focused on quality, based on participation of all of its members and while aiming at long term benefits to the organization and consumers health. It is focused on continuous improvement of all processes approached with combined fundamental management techniques and specialized tools under quality systems. TQM is a process of managing the whole organization so that it progress in all the dimensions of products and services that are important to the consumers. It roots from the belief that mistake can be avoided or mininimised and defects can be prevented, with sole objective being the continuous process improvement. The introduction of Hazard Analysis Critical Control Point (HACCP) has signaled a shift in emphasis from resource intensive end product inspection and testing to preventive control of hazards at all the stages of food supply chain. It also identifies and controls hazards that are fundamentals for food safety. The integrated approach to implementation of ISO standards and HACCP concept is vital for management of quality and safety of dairy products hence safeguarding the customer’s requirements, ensuring that certified products conform to minimum standards set internationally. These standards ensure and enhance transparency in the development of food quality and safety procedures, thus helping to upgrade and update food safety systems. ISO laid down guidelines, codes, specifications and requirements to evolve effective TQM system.

Tetralogy of Fallot- Not an Innocuous Abnormality in Adult.

Among cyanotic congenital heart disease, Fallot’s tetralogy most commonly presents in childhood and rarely goes beyond second decade as death is inevitable without surgical correction of the abnormality. Here we report about unusual course of an uncorrected tetralogy, in which patient reach adulthood and presented only with seizure later found to have brain abscess.Fallot’s tetralogy (TOF) accounts for 10% of cyanotic congenital heart disease, which has combinations of a) ventricular septal defect, b) overriding aorta, c) right ventricular hypertrophy, and d) right ventricular outflow tract obstruction.[1] Although known complication, cerebral abscess has been reported in patients with CHD mostly at the age of 4–7 years, only rarely in adults as their survival is minimal without surgical interventions.[2] In this case, a 49 year old female who presented with a cerebral abscess later diagnosed as TOF on 2 D echocardiography.

Study of evaluation and correlation of calcium and phosphorus in chronic kidney disease with reference to parathyroid hormone

Background: Recent guidelines for bone metabolism and disease in CKD recommend that, the target levels for calcium (Ca), phosphorus (P), calcium x phosphorus product(Ca × P) and parathyroid hormone (PTH) levels should be maintained at 8.8-10.2 mg/dl, 2.1-5.6 mg/dl, < 57.1mg2/dl2 and 8.7-79.6 pg/ml, respectively in patients of CKD.Methods: This was an observational study done in 70 patients, presenting in outpatient and inpatient department of tertiary care multi-specialty teaching hospital. Study was carried out at Dhiraj Hospital, Vadodara, Gujarat, in interval of one and half year.The study was investigation based, in the age group of 18 years and above who presented with chronic kidney disease. Serum Ca and serum P levels were measured by Fully Automated Colorimetry and Parathyroid hormone was measured by FLIA-fluoroscence linked immunoassay.Results: Among the 70 patients of chronic kidney disease, 55.7% showed abnormal calcium levels, 41.4% showed abnormal phosphorus levels,72.9% showed abnormal PTH levels,11.4% showed abnormal Ca x P levels.Conclusions: The correlation between the phosphorus and PTH was linear and statistically significant. But the correlation between calcium and PTH was statistically insignificant and between Ca x P and PTH was very weak and statistically insignificant in CKD patients.

Study of Myocardial Performance Index in Prediabetes and Its Correlation with Other Cardiovascular Risk Factors.

Myocardial performance index (MPI)/Tei index measures the LV systolic and LV diastolic function. Several studies have proved its reliability in evaluating the LV systolic and diastolic performance, with clear benefit over other old indices. It is also helpful in determining the prognosis of heart diseases, especially coronary artery disease. Diabetes affects the heart in several ways. The prevalence of coronary artery disease in a patient with diabetes is well known. The cardiac status in prediabetes is not studied extensively. Hence this study was undertaken to assess the myocardial function in prediabetes using MPI. We wanted to assess myocardial performance index (MPI) in prediabetes and correlate myocardial performance index with cardiovascular risk factors like waist hip ratio (WHR), fasting lipid profile (FLP) and body mass index (BMI).METHODSIn this cross sectional study 200 prediabetics were enrolled as cases and 100 age and sex matched subjects were enrolled as controls. Thorough history, physical examination, biochemical investigations like FBS, PMBS, FLP and Echocardiography for myocardial performance index were done.RESULTSBody mass index (BMI), waist to hip ratio (WHR), total cholesterol, triglycerides, low density lipoprotein (LDL) and very low-density lipoprotein (VLDL) were significantly higher in prediabetes and high-density lipoprotein (HDL) were significantly lower in prediabetes in comparison to controls (p=0.0001). Out of 200 prediabetic subjects, 23 (11.5%) had abnormal MPI which was statistically significant in comparison with controls (p=0.037) There was no correlation of abnormal myocardial performance index with cardiovascular risk factors like BMI, WHR and fasting lipid profile (FLP).CONCLUSIONSPrediabetes had abnormal MPI in comparison to controls. However, no correlation was found between cardiovascular risk factors and MPI.

Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report

Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.

High-Sensitivity C-Reactive Protein in Metabolic Healthy Obesity (MHO)..

Metabolically Healthy Obesity/Metabolic Healthy Obesity (MHO) is a paradox in scientific medical literature and discussion is still on regarding the safety status of MHO phenotype. It is an obesity phenotype where the subjects have BMI more than or equal to 30 Kg/m2 but are devoid of conventional metabolic complications such deranged lipid profile, altered glucose tolerance, or metabolic syndrome as they have less adverse inflammatory profile, low visceral fat, less disturbed insulin signalling, and lipid metabolism. But recently studies are coming up with robust evidence that MHO is not a benign condition. It may lead to metabolic syndrome in future and it is also associated with cardiometabolic risks.METHODSThis cross-sectional study was done in a tertiary care hospital conducted for a period of two years from October 2017 to October 2019. After obtaining institutional ethical clearance, this cross-sectional study was conducted on 120 MHO subjects, 120 metabolic syndrome (MS) and 120 Metabolic Healthy Non-Obese (MHNO) subjects. Anthropometric data was obtained, and hs-CRP was estimated and compared with MS and MHNO group. The data was analysed using appropriate statistical significance tests.RESULTSIn one-way Analysis of Variance (ANOVA), anthropometric determinants and metabolic variables differed significantly across the groups (p<0.0001). The mean hs-CRP in MHO was; 4.45 ± 1.46 and in the control group it was 1.84 ± 0.77 (p<0.0001). Using Pearson’s correlation coefficient, significant positive correlation was found between hs-CRP with other anthropometric and metabolic parameters. In multiple regression analysis, Body Mass Index (BMI), Waist Circumference (WC), were significantly associated with elevated hs-CRP. Adjusted odd’s (AOR) of abnormal hs-CRP in MHO was 1.9 times that of MHNO subjects.CONCLUSIONSMHO phenotype is associated with increased hs-CRP levels as compared to MHNO phenotype suggesting that obesity even if associated with a healthy metabolic profile, still harbour subclinical inflammation. So, subjects with MHO should be targeted for appropriate preventive strategies in the form of health education, lifestyle alterations to avoid future cardiovascular morbidities. MHO phenotype with evidence of subclinical vascular inflammation should not be considered a benign condition.

Histopathological Spectrum of Cysticercosis and thir Demographic Study in Tertiary Care Hospital at N.M.C.H., Patna, Bihar

Introduction: Cysticercosis is a systemic manifestationcaused by dissemination of larval form of Tacnia solium, alsocalled as pork tape worm, is a major public health problem indeveloping countries. The aim of present study was undertakento evaluate the histopathological spectrum of cysticercosiswith their demographic pattern in our tertiary care hospital.Material and methods: A total of 3055 patients of differentage, sex and religions with nodular swelling in different partsof their body were attending in different OPD. From all thepatients, a total of 3055 specimens were received in ourdepartment for histopathological evaluation.Results: Out of 3055 specimen received for biopsy, 8 (0.26%)cases were diagnosed as cysticercosis. Out of which 50%cases (4 cases) were of less than 20 years of age group and62.5% cases were female patients. The disease was found inboth religions Hindus and Muslims (87.5% in Hindus)Conclusion: Even fine needle aspiration cytology (FNAC)has very limited value in diagnosis of cysticercercosis inmost of the cases and could not be recommended due topoor diagnostic value and in cases of neurocysticercosis aswell as ocular or orbital cysticercosis, FNAC could not beattempted due to risky procedure with very limited diagnosticvalue, although serological tests are done for the seriouscomplications of cysticercosis,but the final diagnosis isHistopathological study which is justified and the ultimatediagnostic technique for correct diagnosis.

Acute Emamectin Benzoate Poisoning- A Fatal Case Report.

Emamectin benzoate is a broad-spectrum insecticide for vegetables having wide margin of safety as reported in animal studies, due to its low gamma-aminobutyric acid receptor affinities and very poor penetration to the blood-brain barrier. Not a single case has been reported about fatal human exposure in India. This case highlights about 40-year-old man who succumbed in intensive care unit even after all supportive treatment as well as with Flumazenil and Lipid emulsion. Emamectin benzoate is a semisynthetic avermectin, a class of natural fermentation products of Streptomyces avermitilis (soil microorganism).

A Cross Sectional Study of Drug Utilization Pattern in Indoor Patients of Tertiary Care Teaching Hospitals in Central India

OBJECTIVE: To evaluate the pattern of drug utilization with special focus on the use of antimicrobials. METHODS: Single day hospital-wide point prevalence survey was conducted to assess drug utilization pattern.  Information regarding age, gender, occupation, income group, diagnosis, patient’s present/past medical history, treatment, any adverse drug reactions, and investigations were recorded in a proforma. Drug utilization pattern was evaluated using quality indicators of drug use recommended by WHO. RESULTS: A total of 77 patients were included, 62% male and 38% female. Maximum number of patients was admitted for infectious diseases (34%). Pantoprazole was most commonly prescribed drug & ceftriaxone was most commonly prescribed antibiotic. The average number of drugs prescribed per encounter was 4.87.  Oral route was the most preferred route. Percentage of drugs prescribed by generic name was 42.44%. Percentage of drugs prescribed from essential medical list was 49.33%. Multivitamins & non steroidal anti-inflammatory drugs (NSAIDS) were most commonly prescribed fixed dose combination in our study.  CONCLUSION: Majority of drugs were prescribed by oral route. Essential medical list and updated guidelines were available in the hospital. Poly-pharmacy, over use of proton-pump inhibitors & multivitamins was areas of concern. Prolonged and irrational use of antibiotics for surgical prophylaxis was noted in surgical indoor patients. There was underutilization of microbiological facilities.

Neonatal necrotizing fasciitis

Necrotizing fasciitis (NF) is an uncommon rapidly spreading infection of skin and subcutaneous tissue with systemic toxicity and fulminant course. The disease though relatively uncommon in pediatric and neonatal age group carries a high mortality unless diagnosed early and treated aggressively. Mono-microbial pseudomonas infection causing neonatal NF is a rarity and we, therefore, present one such neonate with fatal NF due to pseudomonas sepsis.

Study on physical properties of Ayurvedic nanocrystalline Tamra Bhasma by employing modern scientific tools

Background: Tamra Bhasma is derived from metallic copper that is recommended for different ailmentsof liver and spleen, dropsy, abdominal pain, heart disease, colitis, tumors, anemia, loss of appetite,tuberculosis, as well as eye problems.Objectives: The knowledge of crystallite size and active ingredients in Bhasma materials is limitedrestricting its use as nanomedicine in the modern era. Also, the 2015 Nobel prize in medicine hasmotivated many researchers towards traditional medicines. Therefore, the different chemical andphysical properties of prepared Tamra Bhasma has been studied by modern experimental tools (XRD,VSM, SEM, FTIR and PL spectrometer) and the preliminary testing of Tamra Bhasma nanoparticles wasexamined on bacteria.Materials and methods: Bhasma is prepared by metals and minerals using three step procedures e.g.Shodhana, Bhavana and Marana. In the present work, for the preparation of Tamra Bhasma, pulverizedcopper wire was used and prepared by the principle of Puta (incineration) in an Electrical Muffle Furnace(EMF).Results: X-ray diffraction analysis and scanning electron microscopy results revealed that the crystallitesize of Bhasma powder was less than 100 nm and nanocrystallites of aglomerated size in micrometer.Magnetometer measurement supports its medicinal value. Photoluminescence (PL) properties of nanocrystalline Bhasma powder was investigated in UV-NIR region and shows luminescence in visible region.The antimicrobial study of Tamra Bhasma shows effectiveness on bacteria and, may be useful to controlthe bacterial infection disease.Conclusion: Scientific data obtained using modern scientific tools and evidence would support in utilizing the ancient Indian wisdom of Ayurveda for the development of newer drugs as a modern nanomedicine and in other possible technological applications.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Dental Management Of A Patient With Down Syndrome: A Case Report And Review Of Literature

Down syndrome (DS) is the most common chromosomal abnormality which affects numerous organs, including the orofacial region. Patients with DS may not be cooperative during dental treatment, and in cases of complex treatment, it is necessary to use oral or inhaled sedation and/or general anesthesia, which represents safe and efficient treatment resources. This article reports a management of DS in a 7-year-old male patient who came to the Hospital of New Delhi with the chief complaint of pain in lower right back tooth region. Due to the uncooperative nature of the patient, dental treatment was done under general anesthesia in which multiple dental restoration and extraction were done.