Pulmonary Capillary Hemangiomatosis without Pulmonary Arterial Hypertension Mimicking Interstitial Lung Disease

Pulmonary capillary hemangiomatosis (PCH) is a rare disease usually associated with pulmonary hypertension which is classified in group I as per the World Health Organization (WHO) classification of pulmonary arterial hypertension (PAH). It is commonly presented as effort intolerance and hypoxia. Pulmonary capillary hemangiomatosis can present with ground-glass opacity on chest radiograph which can mimic interstitial lung disease. We need to consider PCH also in the differential diagnosis of interstitial shadows with these clinical presentations and should consider diagnostic evaluation for the same in case of unsatisfactory clinic-radiological response to treatment. We describe a case presented and treated as interstitial lung disease, which turned out to be PCH on lung biopsy. Interestingly, the case was not associated with any evidence of PAH.

Prevalence of gingival recession and associated etiological factors among the school children

Objective: The objective of this study is to assess the prevalence of gingival recession (GR) and associated etiological factors among school children. Methodology: The study sample consisted of 2095 children from the Nellore region divided into three groups of age ranges from primary dentition (<7 years), mixed dentition (7–12 years), and permanent dentition (>12 years) respectively, attending the department of pediatric and preventive dentistry and the school dental health programs organized by the department. The clinical examination involved measuring GR using William's periodontal probe and evaluating associated etiological factors. Data were statistically analyzed using the Chi-square test. Results: The GR among the study population was 7.9% (n = 165). Among them, males were 46% and females were 54% (P > 0.05). The GR was more in children in the 7–12 years age group (75%), followed by <7 years (21%) and >12 years (4%) age groups. The associated factors include malocclusion (69%), deleterious habits (5%), and anomalies (26%). Anomalies showed an association with GR (P < 0.05) compared to malocclusion and deleteriousness habits (P > 0.05). Conclusion: The prevalence of GR is 7.9%, and GR is more prevalent in males and the 7–12 years age group. GR is associated with transient malocclusion, deleterious habits, and anomalies.

Decoding 揼uitar pick sign� in COVID-19朼ssociated mucormycosis: A case series

揋uitar pick sign,� also referred to as posterior globe tenting, is a radiological surrogate marker of tense orbit and profound vision loss. It is seen commonly in traumatic retrobulbar hemorrhage and carotico-cavernous fistula and less frequently in orbital cellulitis, subperiosteal abscess, and invasive fungal infections. We report a case series of Coronavirus disease-19朼ssociated rhino-orbito-cerebral mucormycosis with guitar pick sign, of which none survived, and discuss the causative pathomechanisms, severity grade, and the clinical relevance of this unique radiological finding.

A novel report of dental development pattern in a 3-year-old girl with three congenitally missing primary canines A review of the literature and a case study

Dentists may encounter patients with numerical dental anomalies in clinical practice and understanding of these conditions would allow early detection as well as intervention. The absence of one or more teeth congenitally is referred as hypodontia. This dental anomaly is rarely reported in primary dentition and the most commonly affected teeth in the primary dentition are mandibular lateral incisors and primary canines are remarkably very rare and this entity has not been often reported. This case study was aimed to report a 3-year-old Indian girl with the absence of three canines primary dentition and also evaluate the overall dental development pattern of developing permanent teeth. Furthermore, a new finding for pediatric dentists that the development of permanent canines in case of missing primary canines.

The effect of multisensory-adapted dental environment on children's behavior toward dental treatment A systematic review

Objective: The objective was to assess the effectiveness of multisensory-adapted environment on children's behavior toward dental treatment, specifically in special need children. Materials and Methods: The main health databases were selected such as SCOPUS, Medline, CINAHL, and Dentistry and Oral Sciences. A set of keywords was defined to identify the relevant article were (i.e., Snoezelen OR Multisensory OR sensory-adapted and Dentistry OR Oral). The articles were selected and extracted by two reviewers based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and some predetermined exclusion criteria. Furthermore, the risk of bias assessment was done. Results: A total of 317 papers were selected at the first phase from SCOPUS (97 papers), Medline (108 papers), CINAHL (110 papers), and Dentistry and Oral Sciences (2 papers). After applying the inclusion and exclusion criteria and duplicated papers were removed, only four eligible papers were selected for final synthesis. Conclusions: Multisensory-adapted dental environment effectively improves oral health behavior among special needs children in terms of physiological changes, behaviors, pain, and sensory discomfort. Thus, the clinician may introduce this approach in their clinical settings.

Curcumin encapsulated dual cross linked sodium alginate/montmorillonite polymeric composite beads for controlled drug delivery / 药物分析学报

The aim of the present work is fabrication of dual cross linked sodium alginate(SA)/montmorillonite(MMT)microbeads as a potential drug vehicle for extended release of curcumin(CUR).The microbeads were prepared using in situ ion-exchange followed by simple ionotropic gelation technique.The developed beads were characterized by Fourier transform infrared spectroscopy(FTIR),differential scanning calorimetry(DSC),thermogravimetric analysis(TGA),X-ray diffraction(X-RD)and scanning electron microscopy(SEM).The effect of MMT on encapsulation efficiency of CUR and intercalation ki-netics was investigated.Dynamic swelling study and in vitro release study were investigated in simu-lated intestinal fluid(pH 7.4)and simulated gastric fluid(pH 1.2)at 37℃.Results suggested that both the swelling and in vitro release studies were influenced by the pH of test media,which might be suitable for intestinal drug delivery.The release mechanism was analyzed by fitting the release data into Korsmeyer-Peppas equation.

Fish community structure as an indicator of the ecological significance: A study from Ulhas River Estuary, Western coast of India

Aim: The present study was aimed to analyze the ecological significance of Ulhas River estuary of the western coast of India using the taxonomic, functional and conservation aspects, and also to record an updated data base on the estuarine community structure.Methodology: Ichthyo faunal diversity was assessed by experimental fishing conducted at 3 selected stations using single day dolnets of code end mesh size of 10mm, from September 2017 to August 2018. The diversity of fish species was recorded considering the most relevant taxonomic classification data and further supplemented by the information pertaining to ecological roles played by the individual species (using guild approach) and the IUCN- conservation status. Results: There were 105 species, belonging to 4 classes, 19 orders, 44 families and 75 genera, recorded from Ulhas River Estuary. The class: Actinopterygii was the most diverse taxa, (including 12 orders, 32 families and 55 genera) among the total ichthyofauna reported. Order Perciformes was the most representative order of the class (40 species, 31 genera and 17 families), followed by Decapoda (21species, 8 genera and 6 families). Based on the estuarine usefunctional guild categorization, 51.42 % of the species were marine migrants, followed by amphidromous species (21.9%). Zoobenthivores (29.41%) was found to be the most dominant feeding guild followed by omnivores (19.6%). Based on the IUCN Red List, 53.33% of the fish species observed from Ulhas River Estuary were categorized as “Not Evaluated”, and 7% were “Data Deficient”, signifying the lack of information on biological aspects of the species along Indian waters. Tenualosa toli marked its presence under threatened category (Vulnerable) from Ulhas River Estuary. Interpretation: The abundance of marine migrants as well as the amphidromous species in the estuary signifies the use of this ecosystem for the nursery function of commercially important marine fisheries resources. Increased proportion of “Not Evaluated” and “Data Deficient” categories in the context of high level of anthropogenic stress demands for more updated documentation of the biodiversity and periodic changes in its ecological structure for formulating and implementing effective ecosystem-based management programs for such sensitive estuarine ecosystems.

Study of Anatomical Variations of Number of Pulmonary Veins and its Clinical Significance

Introduction: The pulmonary veins play an important rolein the pulmonary circulation by receiving oxygenated bloodfrom the Lungs and delivering it to the left atrium. Pulmonaryvein anatomy piqued curiosity of researchers off late afterthe discovery of its role in genesis of atrial arrhythmias andincreased incidence of pulmonary hypertension in COPD.The congenital variations in number of pulmonary veinsand their drainage patterns, encompass a wide spectrum ofanomalies and are not uncommon in general population. Theaim of the study was to observe the variations in the numberof pulmonary veins and pulmonary ostia.Material and Methods: The present study was done on 25formalin fixed hearts aged 18-70 years, obtained from thedepartment of anatomy, Sri Padmavathi Medical college forwomen, Tirupathi. These hearts were observed for the numberof pulmonary veins, their drainage into left atrium, variationsin pulmonary ostia on right and left sides and were comparedwith previous studies.Results: Out of the 25 specimens studied, 23 hearts (92%)had normal pattern of four pulmonary veins, two from eachlung extending to the left atrium and opening into it via twoseparate pulmonary ostia, on either side. In 2 (8%) out of 25specimens, variations in the number of pulmonary veins andthe pulmonary ostia were observed.Conclusion: The awareness of the variant anatomy ofpulmonary veins and their drainage is of paramountimportance to Radiologists, Electrophysiologist and Cardiothoracic surgeons while performing surgical procedures onHeart.

Evaluation of Efficacy of Virgin Coconut Oil in Maintaining Hygiene in Orthodontics Patients

Background: Fixed orthodontic appliances are considered to jeopardize dental health due to the accumulation of oral microorganisms that may cause enamel demineralization. Oil pulling involves the use of edible vegetable oils as oral antibacterial agents. It is a practice of swishing oil in the mouth for oral and systemic health benefits. Aims and Objectives: To assess the effect of oil pulling therapy with virgin coconut oil on Streptococcus mutans count in patients undergoing orthodontic treatment. Methods: A total of thirty subjects were included in the study. They were divided in to 2 groups. Group A subjects were asked to swish coconut oil and Group B normal saline for a week. Streptococcus mutans colony forming units were estimated and compared. Results: A statistically significant reduction in S. mutans CFU was seen with Group A after oil pulling with coconut oil when compared to saline group (P = 0.0003. Conclusion: Edible oil-pulling therapy is natural, safe and has no side effects. Hence, it can be considered as a preventive therapy at home to maintain oral hygiene

A morphometric study of mandibular foramen in dry adult human mandibles of indian population in telangana state

Background: Mandibular foramen is an irregular foramen located just above the centre of the medial surface ofthe ramus of the mandible. Mandibular foramen is leading to mandibular canal through which inferior nerveand vessels will transmit and supply the teeth of lower jaw.The Mandibular foramen is an important anatomical landmark for the inferior nerve blocks, mandibularosteotomies and implant treatment. The inferior nerve block is the commonest local anaesthetic techniquewhich is used for anaesthetizing lower jaw in various surgical and dental procedures on mandible andmandibular teeth such as removal of impaction, reduction of fractures and tooth extraction. Inferior alveolarnerve block failure is not uncommon and it occurs even with experienced hands due to variations in position ofmandibular foramen.A thorough knowledge of anatomy of mandibular foramen is very essential hence aim of this study was todetermine the exact position of mandibular foramen by studying dry adult human mandibles of telanganapopulation.Material and methods: The present study was conducted using 60 dry adult human mandibles obtained fromanatomy department of Shadan institute of medical sciences,Hyderabad and VRK womens medicalcollege,Hyderabad. The data was tabulated and statistically analysed.Result: The mean distance of mandibular foramen to anterior border of ramus (MF-AB)was16.67±2.73mm(R)and16.56±2.52mm(L),to posterior border of ramus(MF-PB) was 12.67±2.37mm(R) and 13.03±2.43mm(L),to mandibularnotch (MF-MN) 21.04±2.95mm(R) and 20.24±2.94mm(L),to angle of mandible was 23.005±3.92mm(R) and22.36±3.89mm,base of mandible or inferior border (MF-MB) was 24.38±3.86mm(R) and 24.42±4.44mm(L), tip ofcoronoid process (MF-CrT) 35.68±3.25mm(R) and 35.19±3.47mm (L).Conclusion: The present study gives a fair knowledge of the position of mandibular foramen and provides usefulinformation for successful local anaesthesia ( inferior nerve block),to the maxillofacial surgeons,radiologistsand oncologists performing operations on the mandible to prevent complications and misinterpretations

Incidence and Outcomes of Community Acquired Pneumonia in Patients with Chronic Obstructive Pulmonary Disease at King Abdulaziz Medical City, Riyadh

Aims: The aim of the study was to estimate the incidence of Community-acquired pneumonia (CAP) among patients with chronic obstructive pulmonary disease (COPD).Study Design: A retrospective cohort study.Place and Duration of Study: King Abdulaziz Medical City in Riyadh between January 2016 to March 2018.Methodology:From the medical file, we identified patients with COPD diagnosis who admitted to the hospital. Then we identified the patient who develop CAP after the diagnosis date of the COPD. Other variables such as demographic factors, clinical outcome, comorbidity disease, length of stay in the hospital, and mortality were identified for each patient using their electronic medical file.Results:Out of363 COPD patients, 122 (33%) had developed CAP after the date of COPD diagnosis. Based on patient characteristics, the mean age of them was 75.39 years SD was 9.76 and 65% of the patients were female. The available evidence indicates that the mortality rate was n=22 (18.0%). Among those patient, 33 patients were admitted to ICU (27.0%) the rest of patients either wards n= 59 (48.4%) or both n=28 (23.0%). Among our study population, 97.4% had hypertension, 88.6% of the patients had diabetes, and 28.9% had renal failure. Majority of the study population have been placed on non-invasive ventilation n=94 (77.0%).Conclusion:This study has been shown that COPD patients had increased risk of CAP. Patients who have multiple comorbidity diseases and got CAP withCOPD have a higher risk of morbidities and mortality rate, especially elderly patients.Mention the design of the study here.

Performance of a shipwreck as an artificial fish habitat along Goa, west coast of India

Aim: The objective of the study was to test the hypothesis that submerged shipwrecks along the western coast of India can function as artificial fish habitats with trophic structure of fish assemblages similar to natural rocky reef habitats. Methodology: The fish assemblages on shipwreck and natural reefs were analysed from September 2013 to December 2016 using diver assisted underwater visual census (UVC). Data collected on fish assemblages were used to compare the fish trophic structure between shipwreck and natural reefs using diversity indices, permutational multivariate analysis of variance and similarity percentage analysis. Results: Fish abundance was two times greater on shipwreck than on natural reefs and the major trophic guilds on shipwreck were omnivores and carnivores. Multivariate analyses showed a distinct fish trophic structure on shipwreck from that of natural reefs and certain fish species differentiated the trophic structure of shipwreck from natural reefs. The high densities of Pomadasys furcatus, P. guoraca, Pempheris multiradiata, Lutjanus indicus, L. fulvus, Ostorhinchus compressus, Epinephelus coioides, E. erythrurus, Monodactylus argenteus and Heniochus singularis contributed significantly to the average dissimilarity for fish assemblages in shipwreck from natural reefs. This has helped to differentiate the fish communities on shipwreck from natural reefs. Interpretation: This study showed that shipwreck and natural reefs differ significantly in fish trophic structure. Fish species richness and abundance were significantly higher on shipwreck than natural reefs. Therefore, the Greater species richness, abundance and diversity of fish communities on shipwreck could be a result of unique, complex and heterogeneous habitat features existing within the wreck

Comparative evaluation of virtual reality distraction and counter-stimulation on dental anxiety and pain perception in children

BACKGROUND: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. METHODS: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7–11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. RESULTS: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. CONCLUSIONS: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.

Clinicl Study Of Inflammatory Bowel Disease With Reference To Crp, Esr, Albumin

Inflammatory bowel disease (IBD), which includes Crohn‘s disease and ulcerative colitis (UC), is a relapsing and remitting condition characterized by chronic inflammation at various sites in the GI tract, which results in diarrhea and abdominal pain. Aims of the Study The aim of the study the correlation of CRP, ESR, ALBUMIN in relation to the disease activity of IBD. Material & Methods Patients who come to the outpatient department of general medicine and gastroenterology as well as to the emergency department are taken up for the study. Results A total of 47 cases are studied, Out of 47 cases, 42 (89.36%) are ulcerative colitis 5 (10.63%) are crohn’s disease.

A Study on Predictive Value of Thrombocytopaenia in Cases of Malaria

Malaria is a major health problem in India. In cases of fever with thrombocytopenia, malaria should be on top of the differential diagnosis. This was a study of admitted patients in medical wards of Bhaskara Medical Colleges, Hyderabad who were diagnosed with malaria and they were assessed for thrombocytopenia using automated quantitative D3 analyser. The data were analysed using SPSS version 16.0. Viral haemorrhagic fevers can also be presented as fever with high haematocrit and leucopenia along with thrombocytopenia. In our study, the commonest cause of thrombocytopenia in malaria was vivax malaria.

Circumferential Fusion through All-Posterior Approach in Andersson Lesion

STUDY DESIGN: Retrospective case series. PURPOSE: To assess safety and efficacy of single stage, posterior stabilisation and anterior cage reconstruction through the transforaminal or lateral extra-cavitary route for Andersson lesions. OVERVIEW OF LITERATURE: Pseudoarthrosis in ankylosing spondylitis (Andersson lesion, AL) can cause progressive kyphosis and neurological deficit. Management involves early recognition and surgical stabilisation in patients with instability. However, the need and safety of anterior reconstruction of the vertebral body defect remains unclear. METHODS: Twenty consecutive patients with AL whom presented with instability back pain and or neurological deficit were managed by single stage posterior approach with long segment pedicle screw fixation and anterior vertebral reconstruction. Radiological evaluation included- the regional kyphotic angle, measurement of anterior defect in computed tomography (CT) scan and the spinal cord status in magnetic resonance imaging. Radiological outcomes were assessed for fusion and kyphosis correction. Functional outcomes were assessed with visual analogue scale (VAS), ankylosing spondylitis quality of life (ASQoL) and Oswestry disability index (ODI). RESULTS: The mean age of the patients was 50.1 years (male, 18; female, 2). The levels affected include thoracolumbar (n=12), lower thoracic (n=5) and lumbar (n=3) regions. The mean level of fixation was 6.2±2.4 vertebrae. The mean anterior column defect was 1.6±0.6 cm. The mean surgical duration, blood loss and hospital stay were 112 minutes, 452 mL and 6.2 days, respectively. The mean followup was 2.1 years. At final follow up, VAS for back pain improved from 8.2 to 2.4 while ODI improved from 62.7 to 18.5 (p <0.05) and ASQoL improved from 14.3±2.08 to 7.90±1.48 (p <0.05). All patients had achieved radiological union at a mean 7.2±4.6 months. The mean regional kyphotic angle was 27° preoperatively, 16.7° postoperatively and 18.1° at the final follow-up. CONCLUSIONS: Posterior stabilisation and anterior reconstruction with cage through an all-posterior approach is safe and can achieve good results in Andersson lesions.

Morphometry of Tricuspid Valve in Human Foetal Cadavers.

Introduction: Anatomy of tricuspid valve complex is highly sophisticated and is altered by various disease states. Anatomic and morphological studies on the tricuspid valve are comparatively less in adults and there were no studies on foetal tricuspid valve. Hence the present study was under taken. Materials and methods: Parameters of the tricuspid valve of heart were defined and measured individually by using paquimeter. The morphometric parameters of basal width and depth of three cusps, attachment lengths of leaflets, frontal and sagittal dimensions of atrioventricular orifice and atrial circumference of valve attachment were recorded. Results: All the parameters of tricuspid valve increased with gestational age and were statistically significant in males. The widths of all the three cusps were greater in male. The frontal and sagittal dimensions and tricuspid valve circumference were higher in female foetuses when compared to male foetuses. Tricuspid valve area is expressed as triangle only. Gestational age is negatively correlating with depth of posterior cusp while other parameters correlated positively as a whole as and in less than 30 weeks age group. In more than 30 weeks age group age has negative correlation with depth of anterior and posterior cusps; tricuspid valve circumference is negatively correlating with frontal and sagittal dimensions; frontal and sagittal dimensions positively correlated with age and tricuspid circumference. Conclusion:Understanding tricuspid valve morphology and morphometry has great clinical importance in the practice of cardiac surgery, especially in partial transfer of leaflets of tricuspid valve for mitral valve repairs and in severe cardiac malformations. The present study forms a database for right atrioventricular orifice dimensions in human fetuses of different gestational ages.

Study to assess the prevalence of human leukocyte antigen-A*3101 allele among Indian epileptic patients and its infl uence on safety and effi cacy of antiepileptic therapy.

Background: The objective was to study the prevalence of human leukocyte antigen (HLA)-A*3101 allele among epileptic patients and to assess the safety and effi cacy of antiepileptic therapy. Methods: 295 subjects were selected and divided into two groups, Group I had 192 epileptic patients and Group II had 103 normal healthy controls. After written informed consent, 30 ml of mouthwash sample was collected from each subject and DNA was extracted by standard salting-out technique and used for HLA-A*3101 genotyping by two-step nested allele-specifi c polymerase chain reaction amplifi cation and agarose gel electrophoresis. Results: In Group I, 12 (6.25%) of the 192 patients were tested positive for HLA-A*3101 allele and all were taking carbamazepine (CBZ). Among them, 56 (30%) subjects had developed less severe adverse effects such as headache and giddiness, skin rashes and memory disturbances, and HLA-A*3101 was present in 8 of them while 136 had no adverse effects in which 4 of them were tested positive for the allele. In Group II, 3 (2.9%) of the 103 healthy controls were tested positive for the allele. No difference was found in response to antiepileptic therapy between allele positive and negative patients. Conclusion: The present study had shown that HLA-A*3101 is prevalent in 6.25% of the Indian epileptic population under study. The presence of this allele has a signifi cant association with the development of mild cutaneous reactions like skin rashes. However, no difference was observed in allele positive patients in response to antiepileptic therapy in comparison with allele negative patients.