Sex Determination in Kerala Population Using Morphometric Analysis of Orbital and Mandibular Height: An Institutional Based Study

Introduction: Measurement of orbital space and height of the mandible are used as tools for estimation of sex, which can be done by using different radiographic techniques like CT, MRI, frontal and lateral skull view, which gives superior accuracy and reproducibility. Aims: To determine the sex of the individual using orbital and mandibular height. Materials and Methods: A cross sectional retrospective study was conducted using a study group consisting of 100 lateral cephalograms both male and female of 18-30 years of age. Lateral cephalograms available in orthodontics department ar- chives were used. In the lateral cephalogram height of orbit was measured by marking the points at supra orbital and infra orbital margin & height of mandible was measured by marking the points at condylion superior (the most superior point on the mandibular condyle) and gonion with the help of GIMPS (GNU Image Manipulation Program) software. The data obtained were analyzed by descriptive statistics, discriminant function analysis using Wilk’s Lambda test. Results: Discriminant function analysis was used to describe the data with appropriate method of presentation. Descriptive statistics showed that mandibular height was statistically significant between males and females. However, the orbital height difference was not statistically significant. Conclusion: Mandibular height can be used in sex determination, which can be utilized as an adjunct in forensic identification

Perception regarding child gender preferences among mothers in Dakshina Kannada district: A mixed methods study

Background: A reflection on the census 2011 data tells us that gender preference has only been on the rise these past years. Objective: To assess perception regarding gender preference among mothers in Dakshina Kannada district. Materials & Methods: 2 tertiary care centres attached with medical college were selected in Dakshina Kannada district. Quantitative variables were collected using a questionnaire and qualitative component was done through focused group discussion. Results: Child preference was seen among 32.2% of the subjects. Preference for Male child if the first child was a girl was significantly associated with lower education and low income (p<0.05). Conclusion: Son preference is still existent in the society but not universally. It is more so when the first born is a female child.

Estimation of serum lactate dehydrogenase in smokeless tobacco consumers.

Statement of Problem: Salivary and serum lactate dehydrogenase (LDH) levels have been correlated with potentially malignant lesions. Salivary LDH levels require special testing and can be expensive. The need for a simple and cost‑effective analysis tool is essential to detect the oral malignant lesions to benefit rural populations. Aim: The aim of this study is to estimate the serum LDH in patients with oral lesions due to the consumption of smokeless tobacco. Materials and Methods: Thirty‑five patients with lesions were selected for this study while twenty patients served as a control. Levels of serum LDH were assessed. Age‑ and sex‑matched controls (n = 10) with no smokeless consumption habit and with the habit but without lesion (n = 10) also had their blood drawn to assess the basal level of LDH. The results were then analyzed through the two‑tailed t‑test and Chi‑square analysis using the SPSS statistics software. Results: The mean LDH value of patients with habit and lesion is 446.8 U/L; the mean LDH value for patients with habit but without the presence of a lesion is 421.2 U/L, and the mean LDH value for patients without a habit or lesion is 269.4 U/L. The patients having the habit of using smokeless tobacco had higher LDH values compared to the other two groups, and it is found to be statistically significant (p < 0.05). Conclusion: Serum LDH values increased in patients with the habit of chewing smokeless tobacco.

Continuous Professional Development: Faculty Views On Need, Impact And Barriers.

Background& Objective:Ever changing dynamic field of science, technology and health care had made it essential for a health care professional to keep abreast of the latest development. Continuous Professional Development (CPD) can be considered as a process in which individual practitioners identify their own learning needs, makes plan to meet those objectives and finally evaluates the effectiveness of the plan .Perceived barriers to CPD vary significantly by individual’s personal characteristics, job position, and organizational factors. Present study was done to explore the faculty views of CPD in terms of its need, methods, impact and barriers. Objectives: 1.To assess the perceptions of healthcare faculty about Continuous Professional Development 2.To identify the barriers perceived by health care faculty for Continuous Professional Development.Methodology:A Cross Sectional study was conducted among 32 faculty,enrolled for Foundation for Advancement in International Medical Education and Research (FAIMER) Fellowship programme at one of the regional institutes of India. A self- administered structured and modified questionnaire was given to participants as a part of Mentoring and Learning (ML) web sessions through ‘Survey Monkey”.Results:In the study, 16 (50%) out of 32 faculty members participated, where majority of participants considered attending conferences, reading journals and E-learning Modules as a CPD activity undertaken in the past one year . Nearly all participants agreed that CPD can make positive change in terms of diagnostic and treatment practices (81.25%), knowledge acquisition (100%) as well as attitude (93.75%) towards patients. Availability of study leave (56.25%) and work-life balance (75%) were significant barriers to participation. Participants strongly believed that CPD helps to recognize knowledge gaps, promoted self-reflection and focused endeavours.Conclusion:Present study reported good knowledge, favourable attitudes and practices towards Continuous Professional Development activities among health care faculty members. The study also revealed combination of responses among faculty about their own CPD activities.

Biochemical evaluation in human saliva with special reference to ovulation detection.

Aim : The aim of the present study was to investigate the level of salivary sialic acids and glycosaminoglycans with reference to salivary hormones during the normal menstrual cycle. Settings and Design: Fifty women volunteers were selected for the present study. Materials and Methods : Saliva was collected from 50 women and ovulation was detected in women with normal menstrual cycles through basal body temperature (BBT), ultrasound and salivary ferning. Samples were divided into five categories, as prepubertal (6-9 years), pre-ovulatory phase (6-12 days), ovulatory phase (13-14 days), postovulatory phase (15-26 days) and menopause (above 45 years). Each sample was subjected to evaluation of the sialic acids and glycosaminoglycans along with salivary hormones. Results : The result revealed that the ovulatory phase has increased sialic acid and glycosaminoglycans during the menstrual cycle when compared with that of the other phases. Consequently, an increased level of hormones such as luteinizing hormone and estrogen during the ovulatory period when compared to that of the pre-ovulatory and postovulatory periods appeared to be noteworthy. Statistically, analysis was performed using one way-ANOVA (LSD; post hoc method) to determine the significance as P < 0.001, 0.01, 0.05 in between the reproductive phases of the menstrual cycle. Conclusion : This study concluded that saliva-specific carbohydrates in the ovulatory saliva make the possibility to develop a biomarker for detection of ovulation by non-invasive methods.

Macrophage activation syndrome: experience from a tertiary referral centre.

Over a period of 3 years, 13 patients with Macrophage Activation Syndrome were seen. Most had underlying connective tissue disease or malignancy. High-grade fever, cytopenia and elevated transaminases were the common presenting manifestations. Elevated LDH and ferritin were characteristic. Due to low index of suspicion the diagnosis was delayed in majority of cases. Five of the 13 expired. Macrophage Activation Syndrome is associated with a high mortality and should be considered in the differential diagnosis of unexplained pancytopenia in-patients with connective tissue disease and malignancy.

Polyglandular autoimmune syndrome-type I.

Polyglandular autoimmune syndrome type I is a rare disorder characterized by mucocutaneous candidiasis (MC), hypoparathyroidism (HP) and adrenal insufficiency , requiring regular follow up as the components of the syndrome appear at different age groups. We report a six and half year boy having this syndrome and presenting with MC, HP and ectodermal dystrophy.

Study of histamine wheal suppression by dexamethasone with and without iontophoresis.

BACKGROUND: Iontophoresis increases the penetration of drugs into the skin by electric current. The ability of topical steroids to reduce the size of the histamine wheal was used to assess the efficacy of topical dexamethasone delivered with and without iontophoresis. AIM: To determine the wheal suppressing ability of dexamethasone delivered with and without iontophoresis. METHODS: A template with three squares of 3x3 cm was placed on both forearms of 20 volunteers and the edges marked. A gauze piece soaked in 2 ml of dexamethasone solution was placed on the flexor aspect of the left forearm and the electrode, an aluminum foil was placed on it and connected to the negative pole (since dexamethasone is negatively charged). An electric current was passed for 15 minutes. Similarly, on the right forearm, a dexamethasone soaked gauze piece was placed without iontophoresis. Histamine wheal suppression was assessed at the end of 30 min, 1 hr and 2 hrs, on both sides. Statistical analysis was done using an independent t-test. RESULTS: There was a statistically significant difference in wheal suppression at 30 min (p=0.006) on the left hand where iontophoresis was used. CONCLUSION: Our experiment showed that topical dexamethasone with iontophoresis has the maximum effect at the end of 30 minutes and is more effective than dexamethasone without iontophoresis.

Achieving asepsis of banana leaves for the management of toxic epidermal necrolysis.

BACKGROUND: Banana leaf is used in many centers in India during the care of patients with toxic epidermal necrolysis (TEN) and other extensive blistering disorders. Sepsis is an important cause of death in TEN patients and use of banana leaf may be a source of such infection. AIMS: We conducted this study to detect the bacterial flora of the banana leaf and to examine various methods of rendering the leaf aseptic. METHODS: Five pieces of banana leaf, 2 x 2 cm in size, were cultured separately in blood agar as follows: One piece was heated over a flame and one was soaked in boiling water and one was autoclaved. Methylated spirit was applied over one piece and ignited. One piece was placed on the media, 'as is.' The Petri dishes were incubated examined after 48 h. RESULTS: All the pieces except the autoclaved specimen of the leaf grew coagulase-negative staphylococci (CONS) when aseptic precautions were not maintained and aerobic spore bearers when all aseptic measures were subsequently instituted during the procedure. CONCLUSION: We recommend measures to prevent possible transmission of bacterial infection by the leaf. Autoclaved and aseptically handled banana leaves may be used to reduce chance of infection in the treatment of TEN.

Cardioprotective effect of mangiferin on isoproterenol induced myocardial infarction in rats.

Isoproterenol (ISPH) induced myocardial infarction was confirmed by disturbances in serum and heart tissue marker enzymes such as lactate dehydrogenase (LDH), creatine phospho kinase (CPK), aspartate transaminase (AST) and alanine transaminase (ALT), increased level of lipid peroxidation and histopathological changes in the heart of ISPH administered rats. Pretreatment with mangiferin (10 mg/100 g body weight) for 28 days was found to ameliorate the effect of ISPH-induced pathological changes, reduced the lipid peroxide formation and retained the myocardial marker enzyme activities at near normal level. The above results indicate the cardioprotective effect of mangiferin against ISPH-induced myocardial infarction in rats.

Fibrochondrogenesis.

Fibrochondrogenesis is a rare lethal short-limb skeletal dysplasia. Till now only fifteen cases have been reported since Lazzaroni-Fossati first described it in 1978. Hence reported a case of fibrochondrogenesis in a child born to a consanguineously married couple with characteristic physical and radiological features and discuss the incidence, inheritance, ultrasonographic, clinical, radiological and pathological characteristics of this disorder.

Cardiac dysfunction in HIV infected children: a pilot study.

Twenty six perinatally acquired HAART naive HIV positive children asymptomatic for cardiac disease in age group of 1-9 years were evaluated for cardiac abnormalities by echocardiography. All children were classified according to the revised CDC classification for HIV infection in children. 20 (76.9 percent) patients had evidence of cardiac abnormalities on echocardiography. 18 (69.2 percent) patients in category B had statistically significant abnormal echocardiographic finding . The commonest echocardiographic abnormalities seen were left ventricular dilatation in 10 (38.5 percent) and left ventricular hypertrophy in 10 (38.5 percent) patients. Echocardiographic abnormalities are present even in HIV-infected children who are asymptomatic for cardiac dysfunction.

Laparoscopic Management of Splenic Pseudocyst

Splenic cysts are rare entities. They are either true cysts or pseudocysts. Former is thought to be congenital or parasitic while the latter are considered post-traumatic. Developments in imaging and operative surgery have led to significant changes in the management of these cysts. We present a case of young male with a large splenic pseudocyst who was managed successfully by minimally invasive surgical approach. Pertinent literature is reviewed briefly.