Nationwide surveillance for S-Metoprololtreatment effect on blood pressure control against sympathetic overdrive in Indian patients with hypertension (PROTECT)

Background:Patients with hypertension in India been reported with high heart rate owing to sympathetic overdrive (SO). Beta-blockers provides several positive effects to reduce SO in patients with hypertension. The aim of present survey studywasto understand current real-world prevalence of SO in Indian patients with hypertension and usage of beta-blocker therapy in them.Methods:A cross sectional, observational, questionnaire-based survey conducted across India between June 2020 to October 2020. A specially designed validated questionnaire was shared with 157 registered health care practitioners (HCP),their anonymous inputs were captured and analysed in qualitative manner. Categorical data was summarized by number (n) and percentage (%). Results:Total 157 HCP participated and completed the survey. Around 53% of HCP observed that patients with average heart rate above 75 beats/min were associated with negative prognosis. Around 43% of HCP reported that raised heart rate is associated with advancedage and increased body mass index (BMI). Two-third of HCP reported that tachycardia is associated with stage-2 hypertension and marked by restlessness and anxiety which is suggestive of SO. Over 70% HCP agreed that the HR below 75 beats/min is associated with good prognosis. Around 89% HCP reported beta-blockers as the drug of choice in patients with augmented SO. S-Metoprololwas reported to bethemost preferred beta-blocker agent and was recommended by 76% HCP in patients with hypertension and coexisting SO.Conclusions:SO been reported prevalent conditionin Indian patients with hypertension which likely worsensthe prognosis in these patients. Beta-blockers reported to be the preferred choice of anti-hypertensive and S-Metoprololseem to be themost preferred agent amongst the available beta-blockers against SO in patients with hypertension in India.

Assessment of Maximum Bite Force in Oral Submucous Fibrosis Patients: A Preliminary Study

Abstract Objective: To determine the maximum bite force (MBF) in oral submucous fibrosis (OSMF) patients and to compare them with that of healthy subjects. Material and Methods: Twenty patients who were clinically confirmed, as OSMF and 20 healthy controls matched for age, gender, and number of intact functional teeth were included in this study. For each subject, age, gender, weight, height and body mass index (BMI) were recorded. The MBF registration was carried out by the two evaluators, who were previously calibrated. Bite force was measured in the first molar region using a force transducer occlusal force meter for each subject seated at the upright position, with Frankfort's plane nearly parallel to the floor, and no head support. The Student's independent t-test was used to determine the statistical significance in relation to mean height, weight, BMI and the presence of number of intact teeth and MBF between the healthy subjects and OSMF individuals. A comparison of grades of OSMF with all variables was carried out by one-way ANOVA test. Results: No significant difference was found in mean age, mean height, weight, BMI and the presence of the number of intact teeth between healthy individuals and OSMF patients. The mean MBF in healthy subjects was 628.23 ± 24.39 N and 635.47 ± 31.22 N in OSMF patients. Even though the healthy subjects reported a higher MBF than OSMF patients did, the difference was statistically non-significant. With regards to sides, no significant difference was observed in mean MBF in healthy subjects and OSMF patients on the right (p=0.7818) and left side (p=0.6154). Conclusion: The healthy subjects reported higher MBF values than OSMF patients did and the difference was statistically non-significant.

Seasonal abundance & role of predominant Japanese encephalitis vectors Culex tritaeniorhynchus & Cx. gelidus Theobald in Cuddalore district, Tamil Nadu.

Background & objectives: Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia. The first major JE outbreak occurred in 1978 and since 1981 several outbreaks had been reported in the Cuddalore district (erstwhile South Arcot), Tamil Nadu, India. Entomological monitoring was carried out during January 2010 - March 2013, to determine the seasonal abundance and transmission dynamics of the vectors of JE virus, with emphasis on the role of Culex tritaeniorhynchus and Cx. gelidus. Methods: Mosquito collections were carried out fortnightly during dusk hours in three villages viz. Soundara Solapuram, Pennadam, Erappavur of Cuddalore district. Mosquitoes were collected during dusk for a period of one hour in and around the cattle sheds using oral aspirator and torch light. The collected mosquitoes were later identified and pooled to detect JE virus (JEV) infection by enzyme linked immunosorbent assay (ELISA). Results: A total of 46,343 mosquitoes comprising of 25 species and six genera were collected. Species composition included viz, Cx. tritaeniorhynchus (46.26%), Cx. gelidus (43.12%) and other species (10.62%). A total of 17,678 specimens (403 pools) of Cx. gelidus and 14,358 specimens (309 pools) of Cx. tritaeniorhynchus were tested, of which 12 pools of Cx. gelidus and 14 pools of Cx. tritaeniorhynchus were positive for JE virus antigen. The climatic factors were negatively correlated with minimum infection rate (MIR) for both the species, except mean temperature (P<0.05) for Cx. gelidus. Interpretation & conclusions: High abundance of Cx. tritaeniorhynchus and Cx. gelidus was observed compared to other mosquito species in the study area. Detection of JEV antigen in the two species confirmed the maintenance of virus. Appropriate vector control measures need to be taken to reduce the vector abundance.

Complex odontoma: report of two unusual cases

Odontomas are the most common benign, slow-growing and nonaggressive odontogenic tumors of the jaws. They are usually clinically asymptomatic and are diagnosed on routine radiological examination in the second decade of life. The eruption and infection of odontomas are uncommon and very few cases are reported in the literature. This paper reports two cases of complex odontomas with such unusual features.

Ectodermal dysplasia : report of a rare case.

Ectodermal Dysplasia (ED) is a hereditary congenital disorder of ectodermal origin. It is characterized by lack of sweat glands, (hypohydrosis), Alopecia (Hypotrichosis), defective palms and soles (Palmoplantar hyper keratosis) and oral presentation of partial absence of teeth, (hypodontia) or complete absence of teeth (anodontia). Hypodontia of primary and permanent dentition is one of the most frequently occurring oral symptoms in ectodermal Dysplasia. We report an unusual case of ectodermal dysplasia effecting soles and palms along with oral manifestations.

Evaluation of clinical efficacy fluconazole mouthrinse for treatment of oral candidiasis.

Background: Oral Candidiasis is associated with multiple local and systemic factors. Morbidity and death in high risk patients may be prevented by recognition and adequate management.Flluconazole in a systemic antifungal medication that demonstrate clinical advantage in rinsing before swallowing. The purpose of present study was to evaluate the clinical efficacy of fluconazole aqueous mouth rinses to treat oral candidiasis.AIM: To evaluate the clinical efficacy of fluconazole mouth rinse for treatment of oral candiadiasis. Objectives: 1) To verify the mycological cure achieved by the drug supported clinical and candida culture.2) To determine the side effects associated with drug. Material and Methods - This study group consists of 30 patients who were clinically diagnosed as oral candidiasis and the subjects used 5 ml fluconazole ( 2mg/ml ) mouth rinse 3 times per day rinsing a minimum of 2 minutes and spitting it. The clinical out come and possible adverse effect were assessed after two weeks of treatment.Results: Follow –up done for the 30 patients. Complete systematic and clinical relief was noted in 86.66% and mycological cure in 73.3% of the patients. No side effects were reported. Conclusion: The use of fluconazole mouth rinses appears to be well tolerated and it is helpful in the treatment of oral Candidiasis effectively.

Florid cemento-osseous dysplasia: Review and report of two cases.

Only three Indian patients of florid cemento-osseous dysplasia have been reported (less than 2%), according to the review of recent literature (2003). This makes the occurrence of FCOD a relatively rare phenomenon. The age group may vary from 19-76 years and typically presents in the fourth and fifth decade. In most of the cases, patients do not have family history of the disease. We report two cases showing classic radiologic features. The diagnosis of our cases were made radiographically.

In vitro interaction of bleomycin with collagen--equilibrium dialysis technique.

In an earlier communication, we have presented the results of our study on in vitro interaction of bleomycin with collagens of sepia, fish and rat skins using spectrophotometry. Since the spectrophotometric method does not involve physical separation of the bound and unbound portion of the drug, it was considered worthwhile to test the validity of the use of spectral data by equilibrium dialysis. In the present communication, the values of binding between bleomycin and soluble collagens representing vertebrate, lower vertebrate and invertebrate determined independently at pH 7.4 and 3.0 are presented.