Comparative Evaluation of Presence of Butterfly Effect in Transverse Sections of Incisors, Canines and Premolars – An In-Vitro Study

Aim To compare the occurrence of the butterfly effect in the roots of incisors, canines and premolars. Materials and methodology A total of 30 extracted teeth were selected (incisors, canines and premolars of 10 each) and embedded in the clear acrylic and then sectioned into six thin sections of 1-mm thickness and are observed under light microscope at 5× magnification. Scoring was given on the presence or absence of the butterfly effect. Results 80% of the incisor and canine groups showed the presence of butterfly effect, whereas it is 70% in case of premolar group. Conclusion No significance difference in presence of butterfly effect in incisors, canines and premolars, with very slight predominance in incisors and canines. If present, this was uniform all along the root.

Bilateral Mandibular Centrals with Rare Type IV Canals

The aim of this study was to report the endodontic management of maxillary incisors having two canals with rare type IV vertucci canal configuration. Internal morphology of root canals is variable and often complex. Therefore, to achieve a technically satisfactory endodontic outcome, the clinician must have an adequate knowledge of the internal canal morphology and its variations to debride and obturate the root canal system thoroughly. This case report describes the successful endodontic treatment of both the mandibular central incisors having two-root canals in same individual.

Comparative Evaluation of the Bleaching Efficacy of 16% Carbamide Peroxide and 30% Hydrogen Peroxide – An In-vitro Study

Aim To evaluate the bleaching efficacy of 16% carbamide peroxide, 30%hydrogen peroxide for intracoronal bleaching of root filled discoloured tooth. Methodology Extracted teeth were artificially stained using human blood then centrifuged under 3,200 rpm speed for 30 min thrice daily for a period of 2 days to enhance penetration of the haemolysed red blood cells into the dentinal tubules. The precipitate was removed, and the teeth were immersed in the remaining haemoglobin-rich haemolysate for further 2 days, centrifuging it thrice daily for 30 min. The resultant discoloured teeth were then washed in distilled water. Root canal treatment was performed. After obturation, a 2-mm intermediate base of Intermediate restorative material IRM was placed to 1-mm apical to the cementoenamel junction. Teeth were divided into three groups with 10 teeth per group. Intracoronal bleaching was performed using either 35% carbamide peroxide gel (group CP) in one group, 35% hydrogen peroxide gel (group HP) in another group and distilled water in the control group as the third group. The bleaching agents were replaced after 5 days. The shade of the teeth was evaluated at day 0, 5 and 10 using VITA Zahnfabrik, Bad Sa¨ckingen, Germany) shade guide. The results were analysed using Kruskal–Wallis one-way analysis of variance and Mann–Whitney U-test. Results When superoxol and control group are compared, there shows a clear difference of significance between these two materials. But when superoxol and carbamide peroxide are compared, there is no difference of significance. Both superoxol and carbamide peroxide showed same results. Both are effective bleaching agents. Conclusion In our study we noticed that 16% carbamide peroxide and 30% hydrogen peroxide are equally effective in the treatment of intracoronal bleaching which we observed in a 5,10,15 days of regular intervals.

Lasers in Operative Dentistry-A Review

Laser equipment represents surely one of the most captivating technologies in the practice of dental medicine. Over the last two decades, numerousscientific publications have emerged in literature, concerning laser equipments and their applications in the field of dental medicine. Presently, in accordancewith their specific wavelength, laser equipments are available on a large scale. This material reviews the most common, most current newly emerged applications of laser in dental medicine. The applications of laser therapy are presented on soft as well as hard tissues. Although laser cannot fully replace all the conventional techniques of dental medicine, the progress is obvious, and laser is expected to become an essential component of conservatory dental medicine.

Prevalence of neonatal candidemia in a tertiary care institution in Hyderabad, South India.

Background: Candida species are known to be the most common fungal pathogens isolated from blood cultures of neonates. Recent reports from our country indicates trend towards an increasing prevalence of non-albicans candidemia. Candida species possess a number of virulence factors which enable them to cause hematogenously disseminated infections in susceptible hosts with increased morbidity and mortality. Objective of current study was to know the prevalence of nonalbicans candidemia in neonates and their antifungal susceptibility pattern. Methods: Blood samples from suspected cases of neonatal septicaemia were subjected to culture, incubated for 7 days and subcultures performed. Culture yielding pure growth of Candida were included for the study and identified by standard methodology. Antifungal susceptibility was performed. Results: A total of 255/500 (51%) cases were blood culture positive. Pure growth of Candida species was isolated from 52/255 (20.39%) cases. A total of 52 Candida isolates were obtained over a period of one year accounting for 20.39% of all neonatal septicemia cases. Among 52 isolates, 14/52 (26.92%) were Candida albicans, followed by C. tropicalis 19/52 (36.53%), C. glabrata 10/52 (19.23%), C. parapsilosis 4/52 (7.69%), C. guillermondii 2/52 (3.84%) and C. krusei 1/52 (1.92%). C. tropicalis, the most common species isolated, was 91 per cent susceptible to fluconazole, whereas C. parapsilosis and C. glabrata showed lower sensitivity rates of 67.8% and 62.5% respectively. Conclusion: In this study non albicans candida was the common isolate & they showed decreased resistance to Fluconazole. In neonatal septicemia speciation& antifungal susceptibility may help in management.

Seroprevalence of dengue virus in a tertiary care hospital, Andhra Pradesh, South India.

Background: Dengue fever and Dengue Haemorrhagic fever (DF/DHF) is an acute viral disease caused by Dengue virus. The infection is transmitted by the bite of an infected female mosquito- Aedes aegypti. The Dengue virus causes significant morbidity and mortality in many parts of the world, including India, where it was first isolated in Calcutta, West Bengal during 1945. This study was conducted to know the seroprevalence of Dengue virus in a tertiary care hospital, Hyderabad Methods: Blood for serological studies are carefully collected taking due universal precautions from suspected DF/DHF cases (a) as soon as possible after hospital admission or attendance. All the patients were screened for anti-Dengue IgG and IgM antibodies By Enzyme Immunoassay. The study period was 18 months from 2012. Results: From a total of 1327serum samples tested were screened for Dengue IgM and IgG among which 706(53.2%) were positive. 125(17.7%) were only IgM positive and 198(28.05%) of the tested samples showed only IgG positive. 383(54.25%) of the tested samples revealed positive for both IgM and IgG antibodies. Conclusion: Surveillance is prerequisite for monitoring the dengue situation in the area and should be carried out regularly for early detection of an impending outbreak and to initiate timely preventive and control measures.

To evaluate the prevalence of female genital tuberculosis in Hyderabad.

Background: Tuberculosis (TB) is an increasing public health concern worldwide. It is one of the most important causes of infectious morbidity and mortality. Genital TB is one form of extra pulmonary TB and is not uncommon, particularly in communities where pulmonary TB is prevalent. The objective of the study was to evaluate the prevalence of female genital tuberculosis in Hyderabad and its presentational symptoms and methods of diagnosis. Methods: A total of 1102 cases of suspected genital TB who had been registered and treated in the AIMSR and few selected government urban health post and private hospitals and clinics in different zones of Hyderabad, from 2012 January to 2013 March were retrospectively and prospectively studied. From this group, 23 women were diagnosed as having genital TB based on the standard pathological and microbiological criteria of tissue specimens. Results: Out of 23 cases diagnosed as having genital tuberculosis, 3 patients (13.04 %) presented with abdominal or pelvic pain. In 17cases (73.91%) tuberculosis was diagnosed during studies performed to evaluate the cause of their infertility, and the most common diagnostic procedure was endometrial curettage. Remaining 3 cases (13.05 %) have past, present or contact history of tuberculosis. Female genital TB accounted for 2.08 % of all tuberculosis patients in this study. Conclusions: This study indicates the presence of a strong relationship between genital TB and infertility; therefore genital TB would be more frequently diagnosed if this possibility was considered in the evaluation of every infertile patient in areas where tuberculosis is endemic.

Accessory Head of Flexor Pollicis Longus Muscle and its Significance in Anterior Interosseous Nerve Syndrome: Case Report and Review / Cabeza Accesoria del Músculo Flexor Largo del Pulgar y su Significancia en el Síndrome del Nervio Interóseo Anterior: Reporte de Caso y Revisión

During the laboratory dissection of the fore arm, an accessory head of flexor pollicis longus muscle has been observed unilaterally in the right upper limb of a male cadaver. It took its origin from the under surface of flexor digitorum superficialis muscle just distal to the origin of this muscle from medial epicondyle. On further dissection we have noticed that, the accessory belly was running downwards to the medial aspect of the tendon of flexor pollicis longus muscle for its insertion. Its possible role in anterior interosseous syndrome is discussed in detail with a brief review.

Durante una disección en el laboratorio se encontró en el antebrazo derecho de un cadáver de sexo masculino una cabeza accesoria del músculo flexor largo del pulgar. Ésta se originaba de la superficie profunda del músculo flexor superficial de los dedos, inmediatamente distal al origen de este músculo en el epicónddilo medial. El vientre accesorio se dirigía hacia abajo medial al tendón del músculo flexor largo del pulgar hasta su inserción. Se discute detalladamente su posible rol en el síndrome interóseo anterior.

Effect of intracerebroventricular methotrexate on brain amines.

Intrathecal methotrexate in children with leukemia is known to cause seizures, dementia, leukoencephalopathy and cognitive dysfunction. To investigate the role of brain amines in cognitive dysfunction, male Wistar rats were given multiple intracerebroventricular injections of methotrexate. Our earlier studies in this regard revealed disruption of brain monoamines in hippocampus with severe cytotoxic effect on CA4 hippocampal neurons. Further extending this study, the levels of brain monoamines in frontal cortex, hypothalamus and brainstem were estimated by HPLC method and histopathological study of the frontal cortex. The concentration of all three-brain amine (norepinephrine, dopamine and serotonin) levels was reduced in 2 mg/kg dose of methotrexate in frontal cortex and brain stem. Hypothalamus did not show any significant change in brain monoamine levels. No structural changes in the frontal cortex neurons were observed. Disruption of brain monoamines has been proposed as a cause of brain dysfunction from this chemotherapy. The outcome of the study may have therapeutic implications in the management of childhood lymphoblastic leukemia.

Prevalence of Candida in the oral cavity of diabetic subjects.

OBJECTIVE: Estimation of prevalence of Candida in the oral cavity of diabetic and non-diabetic subjects. MATERIAL AND METHODS: One hundred and three subjects of diabetes mellitus (49 Type 1 diabetes mellitus and 54 Type 2 diabetes mellitus) and one hundred non-diabetic subjects (control) were studied. RESULTS: 41(83.67%) out of 49 Type 1 diabetes mellitus, 37(68.52%) out of 54 Type 2 diabetes mellitus and 27(27%) out of 100 in non-diabetic subjects were found to carry Candida in their oral cavity. Colony Forming Unit (CFU) of Candida in the oral cavity ranking in groups was Type 1 diabetes mellitus > Type 2 diabetes mellitus > non-diabetic subjects. CONCLUSION: Colonization and carriage of Candida in the oral cavity was found to be higher in diabetic subjects than in non-diabetic subjects. However anti-diabetic therapy and glycaemic control in diabetes were found to bear no relation with carriage of Candida in the oral cavity.

Anaesthetic management of splenectomy in Evan's syndrome during pregnancy with pregnancy induced hypertension.

The management of idiopathic thrombocytopenic purpura (ITP) during pregnancy, especially with ongoing bleeding diathesis, has not been highlighted sufficiently in the literature. Aortocaval compression and reduction in uteroplacental circulation resulting in foetal hypoxia and acidosis, Mendelson's syndrome due to gravid uterus, trauma to airway with resultant haemorrhage and aspiration into lungs, compromised airway due to short neck, anasarca and heavy breast, limitation in using invasive monitoring and regional anaesthesia and uncontrolled bleeding leading to placental hypoperfusion and foetal hypoxia are some of the important risks. In the present case report, anaesthetic management for splenectomy during pregnancy complicated with pregnancy induced hypertension and bleeding diathesis secondary to ITP is described with reference to above risks.

Clitoria ternatea (Linn) root extract treatment during growth spurt period enhances learning and memory in rats.

Neonatal rat pups (7 days old) were intubated with either 50 mg/kg body weight or 100 mg/kg body weight of aqueous root extract of Clitoria ternatea (CTR) for 30 days. These rats were then subjected to open field, two compartment passive avoidance and spatial learning (T-Maze) tests (i) immediately after the treatment and (ii) 30 days after the treatment, along with age matched normal and saline control rats. Results showed no change in open field behaviour, but showed improved retention and spatial learning performance at both time points of behavioural tests, indicating the memory enhancing property of CTR which implicates a permanent change in the brain of CTR treated rats.

Effect of granulocyte macrophage colony stimulating factor on hepatitis-B vaccination in haemodialysis patients.

OBJECTIVES: Haemodialysis patients often fail to respond to hepatitis B vaccination. There are various agents that can be used as vaccine adjuvant in chronic renal failure patients on haemodialysis. In this study, the adjuvant effect of granulocyte macrophage colony stimulating factor (GMCSF) is compared with that of control subjects. METHODS: In this study, eight patients were started on 150 mcg of GMCSF subcutaneously 24 hours prior to intramuscular hepatitis B vaccination (20 mcg of genetically engineered vaccine at the same site). The antibody response to surface antigen (anti HBsAg) in these patients were compared with those of eight control subjects who received standard three doses of monthly 40 mcg of same hepatitis B vaccine. RESULTS: In the control study, only two patients developed significant antibody response to surface antigen whereas seven of eight patients in GMCSF group developed significant antibody titres (> 10 IU/L). The sero-protection rate was 87.5% in GMCSF group and 25% in control group. CONCLUSION: This study shows that GMCSF offers significantly better seroprotection against hepatitis B compared to standard dose of vaccination in patients with chronic renal failure on haemodialysis.

Prospective observational study of primary angioplasty of the infarct-related artery for acute myocardial infarction.

Primary angioplasty has been shown to reduce rates of in-hospital mortality, recurrent ischaemia and infarction. However, the role of primary stenting and abciximab is presently undergoing evaluation. This study attempted to examine the feasibility, safety and outcomes of primary angioplasty in the treatment of acute myocardial infarction. Data in 100 patients who underwent primary angioplasty for evolving acute myocardial infarction was prospectively analysed to assess the safety and efficacy of various modalities. Twenty patients were in Killip class III and above. Multivessel (2 or more vessels) disease was noted in more than 52 cases. Procedural success was 99 percent; 86 patients received primary stenting, majority of them had Kalam-Raju stent implantation. Adjunct treatment included abciximab infusion in 22 and intra-aortic balloon pump support in 12. Overall mortality rate was six percent with a mortality of 2.2 percent in non-cardiogenic shock patients. Recurrent ischaemic events were noted in five, three of them had successful reperfusion with repeat angioplasty. None of the patients had emergency coronary artery bypass surgery. It is concluded that primary angioplasty is safe and effective with high procedural success. Recurrent ischaemic events are low, possibly due to routine use of stenting and selective use of abciximab.

Clinical evaluation of new balloon mountable coil stent: in-hospital and follow-up results.

The purpose of this study was to determine the feasibility, safety and efficacy of elective deployment of a new coil-stent (KR stent) in patients with coronary artery disease. KR stent deployment was attempted in 100 patients (135 lesions) enrolled prospectively at a single centre from December 1996 to March 1997. Ten, 15, 18, 24, and 32 mm long KR stents were manually crimped onto balloons and deployed in native coronary artery lesions. Majority of the patients had recent acute coronary syndromes (unstable angina 30% and post-myocardial infarction angina 56%). Diabetes was present in 34 percent of the patients. Fifty-six percent had single-vessel and 44 percent multi-vessel disease. In 38 percent, the lesions were located in proximal segments and 40 percent of lesions were long. KR stents were successfully deployed in 98 percent of patients. Mean minimal luminal diameter increased by 2.89 +/- 0.63 mm (from 0.57 +/- 0.38 mm before to 3.45 +/- 0.56 mm after the procedure). Mean percent diameter stenosis decreased from 83.33 +/- 10.84 percent before to 3.38 +/- 5.74 percent after the stent deployment. Mean reference vessel diameter was 3.45 +/- 0.56 mm. There were occasional technical complications including balloon rupture (1), stent migration (2) and distal embolisation of atheromatous material (1). One patient developed subacute stent thrombosis. There were no other major in-hospital cardiovascular events. At the end of six-month follow-up, there were no myocardial infarction or death. Six patients presented with recurrence of symptoms within six-months of the procedure, four of whom underwent target vessel revascularisation procedure. In conclusion, the in-hospital and six-month follow-up clinical results were highly encouraging with KR stent. Successful deployment rates were high despite unfavourable clinical and angiographic background. Low clinical events on follow-up will make it suitable for elective stenting.

Cystoscopic staging of carcinoma uterine cervix, revisited.

Of the 378 cases of stage 3 carcinoma uterine cervix, only 10 showed vesical invasion, while 19 of 24 cases of stage 4 disease had vesical invasion. Results of this procedure did not alter the management of the disease in any of these cases. From the whole series it was concluded that cysto-urethroscopy is an unnecessary, cost ineffective, invasive procedure which has no role in either diagnosis or in planning the definitive treatment of carcinoma uterine cervix.

Single unilateral ectopic bifid ureter with contralateral orthotopic quadrufid ureter--a rare combination.

This is a report a case with a unilateral single ectopic ureter associated with ipsilateral incomplete duplication of upper third of the ureter, contralateral quadrufid ureter and L3 hemivertebra. These findings provide further evidence of a generalised mesenchymal or epithelial defect, which would explain a defective ureteral bud and metanephric development, besides associated anomalies.

Energy cost of graded work loads & mechanical efficiency of sportsmen.

This study was undertaken to determine oxygen consumption at rest and constant graded work loads while exercising on a bicycle ergometer and to compute mechanical efficiency of sportsmen. Thirteen healthy, active, well trained young sportsmen from sports hostel, Sports Authority of India, Hyderabad, were selected and were requested to pedal the bicycle ergometer at 50 watts and 100 watts (300 and 600 kpm) work loads for 18-20 min. The energy cost of the activity at the respective work loads was measured by means of indirect, open circuit respiratory exchange method. The workouts resulted in the oxygen consumption of about 920.4 +/- 77.5 ml and 1475.2 +/- 101.7 ml at 300 and 600 kpm respectively. The gross or absolute mechanical efficiency (AME) were calculated at these work loads. The delta mechanical efficiency (DME) was also computed for the work increment from 300 to 600 kpm by using the amount of oxygen consumed at these work loads. The AME was about 23-24 per cent in both the loads while the DME was found to be 26 per cent. The relationship between anthropometry, resting metabolic rate (RMR), AME and DME was assessed. It was observed that both AME and DME values of these subjects were in the normal range of Swedish and Canadian active young men. These parameters can be used as indicators for assessing sports persons efficiency both in the active and lean periods.