Lc-Ms/Ms Study Of The Trace Level Impurities Of Irbesartan An Angiotensin Ii Receptor Antagonist Molecule To Its Origin Through Nms2 Technique

Objective: The mass characterization of five trace level related impurities of Irbesartan was performed through the “nMS2” technique of triple quadrupole mass spectrometer and also to Correlated to the impurity origin. Methods: A simple and effective patented process was applied to get the impurity profile, and mass characterization was performed through the “nMS2” technique of triple quadrupole mass spectrometer analyser. Results: The simple production scan in differential collision energies is coined as “nMS2” technique of the triple quadrupole analyzer. The molecular ion fragmentation occurs with multiple collision energies and provides meaningful MSMS fragments for characterizing five trace level impurities less than 0.5% of angiotensin II receptor antagonist-Irbesartan. The origin of the impurity formation in the synthetic process was successfully related to the Spiro ketones. Conclusion: The results obtained in this research clearly indicates the approach of “nMS2” technique was very useful in the identification and structural prediction of trace level related impurities of Irbesrtan.

Mitochondrial DNA content of peripheral blood mononuclear cells in ART untreated & stavudine/zidovudine treated HIV-1-infected patients

Background & objectives: Nucleoside reverse transcriptase inhibitors (NRTIs) are known to cause mitochondrial toxicity. This study was done to estimate mitochondrial DNA (mtDNA) content of peripheral blood mononuclear cells (PBMCs) among human immunodeficiency virus (HIV) infected, NRTI treated and antiretroviral therapy (ART)-naïve patients and evaluate the utility of mtDNA content as a biomarker of mitochondrial toxicity. Methods: mtDNA content in PBMCs of 57 HIV-infected ART untreated and 30 ART treated with stavudine (d4T) or zidovudine (AZT) containing regimen were compared against 24 low-risk healthy controls (LoRHC). Results: There was a significant (P=0.01) reduction in mtDNA content among HIV-infected (104; 80-135) compared to LoRHC (127; 110-167), and it was the same in both the treated (104.8; 88-130) and untreated patients (104.7; 78-142). mtDNA significantly (P=0.014) declined in ART treated patients symptomatic for toxicity (97; 74-111) than the asymptomatic patients (128; 103- 153). Interpretation & conclusions: mtDNA depletion in PBMCs was evident among HIV-infected individuals on ART. Moreover, as mtDNA content was reduced among the patients symptomatic for toxicity than the asymptomatic in both the HIV-infected groups, the current study supports mtDNA content of PBMCs to serve as a biomarker of mitochondrial dysfunction induced by NRTI and HIV. Longitudinal studies with a large sample need to be done to confirm these findings.

Root Surface Biomodification: Current Status and a Literature Review on Available Agents for Periodontal Regeneration.

Background: A critical step in periodontal regenerative therapy is to alter the periodontitis affected root surface to make it a hospitable substrate, to support and encourage migration, attachment, proliferation and proper phenotypic expression of periodontal connective tissue progenitor cells. So the Concept of Biochemical modification or alteration of the root surface has emerged as a potential therapeutic approach to the reconstruction of the periodontal unit. Aim: To review various agents used for root biomodification and update on the current status of root biomodification in periodontal regenerative therapy. Materials and Methods: Google Scholar database is searched using keyword “Root Biomodfication”and the studies with experimental design either In Vivo or In vitro were included in the search whereas Narrative reviews or Non – Systematic reviews were excluded. These studies were reviewed together to update the various agents used for root biomodification and their current status in Periodontal regenerative therapy. Result: Only the representative studies of the agents used were included in this studies including 2 systematic review, 1 literature review and 1 world workshop report. Conclusion: The present status suggests that root biomodification does not have any added advantage in periodontal regeneration. Large Size randomized clinical trials are necessary to give an definite conclusion.

Guided Tissue Regeneration Based Treatment of Root Coverage using Placental Membrane Allograft: A Case Report.

Gingival recession is defi ned as the apical migration of gingival margin to the cementoenamel junction. It results in root exposure which leads to clinical problems such as root surface hypersensitivity, root caries, cervical root abrasions, diffi cult plaque control, and diminished aesthetic/cosmetic appeal. Guided tissue regeneration based root coverage has emerged as a promising treatment modality. A variety of non-resorbable and bioresorbable membranes have been successfully used. Among resorbable membranes, collagen has been extensively studied. Recently, amnion membrane, the third generation membrane which is a placental derived tissue has been introduced. On the basis of the fi ndings of the present case report, it can be concluded that recently introduced amnion membrane (third generation membrane) are equally effi cacious in the treatment of gingival recession and use of this resorbable membranes with coronally advanced fl ap is a versatile treatment modality for root coverage of isolated buccal gingival recessions. Th e more gingival tissue thickness (gingival biotype) enhancement was observed with this membrane. Amnion membrane has certain additive advantages over the collagen membrane such as better handling properties and a thin diameter enabling it to mold according to the defect anatomy and root surfaces easily.

Socio demographic profile of oral cancer patients residing in Tamil Nadu - A hospital based study.

Introduction: In developing countries, a high proportion of patients with oral cancer are from lower socioeconomic classes. This high proportion is clearly associated with difficulties in accessing the health care system. Hence, the aim of this study is to assess the socio-demographic profile of oral cancer patients at Tamil Nadu, India. Objective: To determine the socio-demographic profile of study subjects. Materials and Methods: This study was a cross sectional study done at a cancer hospital in Chennai. The study population were subjects with oral cancer who reported for treatment. A pretested interviewer administered questionnaire was used to assess the socioeconomic status of oral cancer patients. Pareek's scale of classification was used for rural population and Kuppuswamy's classification was used in urban population to assess the socioeconomic status. Results: A total of 266 oral cancer patients aged 21-60 years and above comprised the study population. Most of the study subjects belonged to the lower socio economic classes. About 48.5% of rural subjects had agriculture as a source of occupation and 28.6% of urban subjects were unskilled labourers. In both rural and urban subjects, majority, 94.9% and 71.9% had family income below Rs 5000. The percentage of illiterates was high in both rural and urban class (i.e.) 55.8% and 21.9% respectively. The difference in the prevalence of oral cancer among different levels of literacy and occupation was found to be significant statistically. Conclusion: Identifying occupation, income and education specific disparities in tobacco use can provide a useful "signspot" indicating inequalities that need to be addressed by policy makers and broader community through allocation of resources.

Prevalence of permanent tooth loss among children and adults in a suburban area of Chennai.

Aim: To determine the prevalence of permanent tooth loss among children and adults in a suburban area of Chennai. Design: Cross sectional descriptive study. Study setting: The study was conducted in Tiruverkadu, a suburban area of Chennai. Materials and Methods: A house-to-house survey was done in Tiruverkadu. The study population consisted of 6, 12, 15 years children, 35-44 years, and 65-74 years adults. Type III dental examination was carried out. Cross tabulations and Chi-square statistics were computed. The level of significance was chosen as P<0.05. Results: Out of the total 679 subjects, 309 subjects had tooth loss. Females (47.9%) had greater tooth loss compared to males (42.9%). Tooth loss increased as age progressed. Subjects in the lower socio-economic status had greatest tooth loss. The mean tooth loss among the subjects was 2.7. Conclusion: This study indicates that tooth loss increases with age and differs for gender and socio-economic status. The prevalence of tooth loss among the subjects was found to be high in children as well as in adults. Therefore, dental professionals should utilize various measures available in preventive dentistry to minimize tooth loss.

Diagnostic efficacy of C4d immunostaining in the detection of the humoral component of renal allograft rejection and therapeutic implications.

Context: In the current scenario of renal transplantation, the role of immunological methods in the detection of C4d has emerged as a useful adjunct in the recognition of acute humoral rejection (AHR). Few reports of this nature are available from the Indian context although there are several from the Western literature. Aims: To study the humoral component of renal allograft rejection in patients presenting clinically with graft dysfunction by histopathological detection of polymorphs in the peritubular capillaries and the expression of C4d using immunological techniques, as well as the response of patients to appropriate antirejection therapy. Settings and Design: This study from a tertiary care center reemphasizes the importance of recognition of AHR as a cause of renal allograft dysfunction. Materials and Methods: Percutaneous renal biopsies were obtained from 40 postrenal transplant patients and evaluated for C4d using immunofluorescence and immunohistochemical methods. Statistical a0 nalysis used: SPSS software. Results: Positive expression of C4d was seen in a total of 19/40 cases (44.4%) indicating immunological evidence of AHR. Diffusely positive cases were treated with IV immunoglobulin therapy, plasmapheresis and Rituximab following which graft function was restored. Patients with minimal to focal positive expression of C4d responded well to pulse steroids and change in immunosuppressive therapy. Conclusions: C4d staining is a useful adjunct to routine histopathological methods in evaluating the humoral component of acute renal allograft dysfunction and helps in planning appropriate antirejection therapy with the goal of achieving long-term graft survival.

Caries prevalence and treatment needs of rural school children in Chidambaram Taluk, Tamil Nadu, South India.

OBJECTIVE: To obtain information on caries prevalence and treatment needs of children aged 5-10 years to plan appropriate dental care services in rural areas. MATERIALS AND METHODS: Children studying in all the primary schools (six schools) in the field practice area of the Rural Health Centre of the Faculty of Medicine, Annamalai University, Chidambaram, were surveyed. Each child was clinically examined in the schools by calibrated examiners. Dental caries was assessed using diagnostic criteria recommended by WHO (1997). The chi-square test and two-way analysis of variance were used for statistical analysis. RESULTS: Five hundred and eight 5-10 year-old school children (247 boys and 261 girls) were surveyed. Caries prevalence was 71.7 and 26.5% in primary and permanent dentition, respectively. The mean dmft and decayed missing filled tooth (DMFT) scores were 3.00 and 0.42 respectively. The mean dmft decreased with age ( P < 0.01) whereas the mean DMFT increased with age ( P < 0.001). Although the mean dmft scores were not statistically significant different for the two sexes, the mean DMFT score was found to be higher among girls than among boys ( P < 0.02). The entire dmft/DMFT value represented the 'decay' component only. There was a strong need for single surface restorations (60.6%). In the WHO index age (5-6 years), the caries prevalence was 70.2% (29.8% caries-free) with a mean dmft value of 3.54 +/- 3.71. CONCLUSION: Dental caries is a significant public health problem in this population. An extensive system to provide primary oral health care has to be developed in the rural areas of India.

Prevalence pattern of dental caries in the primary dentition among school children.

The purpose of the study was to assess the pattern of prevalence of dental caries in the primary dentition among 5 year old children. The area of study was urban Pondicherry and the study population consisted of 1009 school children of both sexes (527 boys and 482 girls). A simple random sampling method was used to select the schools. Dental caries was assessed by the Dentition status and Treatment Need (WHO 1997). Statistical analysis was done using the Proportion test. The prevalence of caries was 44.4% among the study population, being higher in the boys (P < 0.05); In Mandibular arch in both the sexes (boys P < 0.05, girls P < 0.01); in posterior teeth (both sex wise & arch wise). Comparison of caries among anterior teeth (Boys vs Girls) [corrected] and posterior teeth (upper vs. lower) revealed higher caries prevalence in Maxillary anterior teeth (P < 0.001) and Mandibular posterior teeth (P < 0.001). In both the sexes and arches, primary second molars showed higher caries prevalence.

Antioxidant and antimicrobial activities of Bauhinia racemosa L. stem bark

The present study was carried out to evaluate the antioxidant and antimicrobial activities of a methanol extract of Bauhinia racemosa (MEBR) (Caesalpiniaceae) stem bark in various systems. 1,1-Diphenyl-2-picryl-hydrazyl (DPPH) radical, superoxide anion radical, nitric oxide radical, and hydroxyl radical scavenging assays were carried out to evaluate the antioxidant potential of the extract. The antioxidant activity of the methanol extract increased in a concentration-dependent manner. About 50, 100, 250, and 500 æg MEBR inhibited the peroxidation of a linoleic acid emulsion by 62.43, 67.21, 71.04, and 76.83 percent, respectively. Similarly, the effect of MEBR on reducing power increased in a concentration-dependent manner. In DPPH radical scavenging assays the IC50 value of the extract was 152.29 æg/ml. MEBR inhibited the nitric oxide radicals generated from sodium nitroprusside with an IC50 of 78.34 æg/ml, as opposed to 20.4 æg/ml for curcumin. Moreover, MEBR scavenged the superoxide generated by the PMS/NADH-NBT system. MEBR also inhibited the hydroxyl radical generated by Fenton's reaction, with an IC50 value of more than 1000 æg/ml, as compared to 5 æg/ml for catechin. The amounts of total phenolic compounds were also determined and 64.7 æg pyrocatechol phenol equivalents were detected in MEBR (1 mg). The antimicrobial activities of MEBR were determined by disc diffusion with five Gram-positive, four Gram-negative and four fungal species. MEBR showed broad-spectrum antimicrobial activity against all tested microorganisms. The results obtained in the present study indicate that MEBR can be a potential source of natural antioxidant and antimicrobial agents.

Prevalence of dental caries and treatment needs among school going children of Pondicherry, India.

Dental caries is an important Dental public Health problem. Its high morbidity potential has brought this disease into the focus of dental health professionals. The purpose of the study was to assess the prevalence of dental caries and treatment needs among 5 and 12 years old school children of urban Pondicherry. The study population consisted of 2022 school children of both the sexes, (1009, 5-year-old children) and (1013, 12-year-old children). A simple random sampling method was used to select the schools. Dental caries was assessed by Dentition Status and Treatment Needs described by WHO (1997). The prevalence of dental caries was 44.4% in 5 years age group with 47.4% for males (mean dmft = 1.91 +/- 2.64 S.D.) and 41.1% for females (mean dmft = 1.45 +/- 2.18 S.D.). In 12 years age group the prevalence of dental caries was 22.3% with 20.6% for males (mean DMFT = 0.40 +/- 0.94 S.D.) and 24.1% for females (mean DMFT = 0.55 +/- 1.15 S.D). Evaluation of treatment needs revealed that the greatest need was for one surface restorations followed by two or more surface restorations. It may be concluded that FDI/WHO Oral Health Goals for the year 2000 have been achieved for the ages 5-6 and 12 years in Pondicherry.

Spinal compression caused by multiple arachnoidal cyst.

A 14-year-old boy presented with subacute onset of paraparesis. The spinal compression was due to multiple giant sized spinal arachnoid cysts. Postoperatively the patient recovered completely.

Refresher training and continuing education for para-medical ophthalmic assistants.

This paper describes a refresher training and continuing education programme in clinical and community ophthalmology for para-medical ophthalmic assistants (PMOAs) conducted by the Lions Aravind Institute of Community Ophthalmology. The course participants included 60 PMOAs working either in district hospitals, primary health centres or mobile units from the districts in Maharashtra. Each training programme was spread over 43 hours in 4 days and included lectures, practical demonstrations, and hands-on training in the outpatient, inpatient, and operation theatre of the training institution. Participants were given exposure to outreach activities in an eye camp and a satellite eye centre resembling a district hospital. The PMOAs found the training to be useful and it was seen that areas like patient counselling, instrument and equipment maintenance, and assistance in the operation theatre for newer surgical procedures which were lacking in the basic training were fulfilled in this training programme. Regional Institutes of Ophthalmology, upgraded medical colleges, and other eye-care institutions which have facilities and manpower could organise similar refresher and continuing education programmes for PMOAs so that they could be utilised more efficiently in the blindness-control activities in the country.