Where Did It Go? A Case Report of Accidental Tooth Ingestion during a Simple Tooth Extraction.

Ingestion of foreign bodies accidentally can be seen commonly in emergencies usually in children, elderly, mentally impaired, or alcoholic individuals. Ingestion of a foreign body is more common than aspiration of a foreign body. Aspiration represents a serious medical situation whereas ingestion of a tooth is a less serious situation as the tooth will be egested due to peristaltic movements of the gastrointestinal tract. Here is a case report of tooth ingestion during a simple dental extraction which could have turned into a serious medical situation, had the patient aspirated the tooth.

Effect of electron‑beam irradiation on antimicrobial, antibiofilm activity, and cytotoxicity of mouth rinses.

Background: Oral health diseases are common in all regions of the world. Mouth rinses are widely used generally by population as a port of daily oral care regimen. In addition to antimicrobial activity, mouth rinses possess certain cytotoxic effects. Electron‑beam (E‑beam) radiation is a form of ionizing energy known to induce structural, physical, and chemical changes in irradiated products. In this study, the modulatory effects of E‑beam in irradiated mouth rinses were evaluated for its biological activities. Materials and Methods: The antimicrobial activities of nonirradiated and irradiated mouth rinses were evaluated for its antimicrobial and antibiofilm activities against oral pathogens, Enterococcus faecalis, Streptococcus mutans, Staphylococcus aureus, and Candida albicans. The antimicrobial activity was evaluated by disc diffusion method and antibiofilm activity was evaluated by O’Toole method. The cytotoxicity was evaluated against human gingival fibroblast (HGF) cells by 3‑(4, 5 Dimethythiazol‑yl)‑2,5‑Diphenyl‑tetrazolium bromide assay. Results: Colgate Plax (CP) exhibited the antimicrobial activity against the tested pathogens, and a significant (P < 0.05) increase was observed against S. aureus at 750 Gy irradiation. Further, CP significantly (P < 0.05) suppressed S. mutans, S. aureus, and C. albicans biofilm. Listerine (LS) inhibited S. mutans and C. albicans biofilm. Whereas irradiated CP and LS significantly (P < 0.05) suppressed the biofilm formed by oral pathogens. The suppression of biofilm by irradiated mouth rinses was dose‑ and species‑dependent. There was no significant (P > 0.05) difference in the cytotoxicity of irradiated and nonirradiated mouth rinses on HGF cells. However, an increased percentage viability of HGF cells was observed by mouth rinses irradiated at 750 Gy. Conclusion: The E‑beam irradiation enhanced the antibiofilm activity of mouth rinses without modifying the cytotoxicity.

A study of cardiac dysfunction in cirrhotics.

Background: The heart and liver are organs that are closely related in both health and disease. Due to the limited number of human studies, the management of cirrhotic cardiomyopathy remains largely empirical. Material and methods: 30 Patients included in the study were recruited from the Department of Medical Gastroenterology, Narayana Medical College Hospital, Nellore. Consecutive patients diagnosed to have cirrhosis of nonalcoholic etiology formed the study group. The parameters that were assessed in echocardiography are E/A ratio, end diastolic volume (EDV), end systolic volume (ESV), ejection fraction. QTc interval more than 440 msec and E/A ratio less than 1 were considered diagnostic of cirrhotic cardiomyopathy in this study. Results: In 9 cases, cirrhosis was due to hepatic B viral infection, 4 due to due to hepatities C and in 17 patients it was cryptogenic. Of the 30 cases included in the study. Results: In 9 cases, cirrhosis was due to hepatic B viral infection, 4 due to hepatitis C and in 17 patients it was cryptogenic. Of the 30 cases included in the study, 7 cases (23.3%) had Class A CTP. 16 cases (53.3%) had Class B CTP, 7 cases had Class C CTP. Of the 30 patients included in this study, 21 patients had end diastolic volume above 90. 2 patients had end systolic volume above 38. 29 patients had ejection fraction above 60%. Out of the 30 cases, 23 showed features of cirrhotic cardiomyopathy. 7 patients had CTP Class A. 16 patients had CTP Class B.7 patients had CTP Class C. 12 patients with cirrhotic cardiomyopathy had CTP Class B. 7 patients with cirrhotic cardiomyopathy had CTP Class C. 3 patients with CTP Class A and 4 patients with CTP Class B did not have cirrhotic cardiomyopathy. The QTc was prolonged in 16 (53.3%) of patients in this study. 29 cases had ejection fraction above 60. Of the 23 cases that had cirrhotic cardiomyopathy 21 cases had ascites. 27 of the 30 cases had varices. 70.0% of the cases had end diastolic volume above 90. 76.2% of the cases with EDV above 90 had E/A ratio below 1. Conclusion: Cirrhotic patients with non alcoholic etiology do have evidence of cirrhotic cardiomyopathy. The presence of cirrhotic cardiomyopathy was independent of the etiology. Some degree of diastolic dysfunction is seen in most of the cirrhotics. Prolongation of QTc interval correlates with severity of cirrhosis. Ventricular end diastolic volume, end systolic volume and ejection fraction do not correlate with severity of cirrhosis.

A case of intramural esophageal dissection in a patient with esophageal web.

A 50 year female presented with dysphagia for 2 months and she denied pain during swallowing, retrosternal pain, drooling of saliva, nasal regurgitation, cough, breathlessness, hoarseness of voice abdominal pain, vomiting, loss of weight or loss of appetite. Upper gastrointestinal (UGI) endoscopy revealed a web at 17 cm from incisors. Post endoscopy patient developed pain over the upper abdomen which worsened during swallowing and breathing. Because of rapid development of these symptoms we suspected esophageal perforation/dissection. Complete blood picture suggestive of neutrophilic leukocytosis and other parameters were normal. Thin barium study showed pseudo lumen in esophagus and confirmed the diagnosis of esophageal web with esophageal dissection. Patient was treated conservatively with nil per oral and parenteral fluids and antibiotics. Web was dilated after 2 weeks with Salivary-Gilliard dilators and procedure was uneventful and oral feeding was initiated.

Growth and Productivity of Speciality Corn as Influenced by Different Levels of Nitrogen Under Pongamia Plantations.

A field experiment was conducted during kharif 2011 at the Student’s Farm, College of Agriculture, Rajendranagar, Hyderabad on red sandy loam soils to study the effect of nitrogen management in speciality corn under Pongamia + maize agri-silvi system. All the growth and yield attributes such as plant height, dry matter production, leaf area index, cob length, cob girth, number of cobs plant-1, number of rows cob-1, number of kernals cob-1 and 100 kernel weight were found maximum at 120 kg N ha-1 than at the remaining nitrogen levels. Whereas, cob weight (with husk) was found maximum at 120 kg ha-1 but was on par with 90 kg N ha-1. Similarly cob yield (with husk), green fodder/stover yield, harvest index, kernel yield of popcorn and shelling percentage of popcorn were found significantly higher at 120 kg N ha-1 than the other two lower doses of nitrogen. The different types of corn were found significantly different from each other regarding growth parameters such as plant height, days to 50 per cent silking and days to maturity. Regarding the effect on yield attributes and yield, all the three types of corn were found significantly different from each other in cob length, cob girth, cob weight (with husk), green cob yield as well as green fodder/stover yield.

Growth pattern of low birth weight babies in the first year of life.

OBJECTIVE: The growth pattern of low birth weight (LBW) babies was studied prospectively in our hospital from September 1995 to august 1996. METHOD: Every baby <1.5 kg birth weight (B.Wt), every 2nd baby between 1.5 to 2 kg, every 6th baby between 2 to 2.5 kg and 120 term appropriate for gestation (AGA) babies ( as controls) were included in the study. Severe birth asphyxia, multiple gestation, major malformations or severe birth trauma formed exclusion criteria. Weight, length and head circumference were measured in all babies at birth and at 2 monthly intervals till 1 year of age. All babies completing 1 year follow-up were included for final analysis. Growth distance curves were constructed separately for each parameter for the six categories based on birth weight (Groups I-VI) and on gestational age (Divisions A-F). Comparison was made between the LBW babies and the controls for growth pattern among the babies who completed 1 year follow up (total of 220 babies). RESULT: The growth pattern for weight and length showed good catch up growth in babies >1.25 kg B.Wt. and >30 weeks gestation, reaching almost the same level as controls by 1 year of age. Babies with B.Wt <1.25 kg and <30 weeks gestation showed late and poor catch up growth, with considerable lag persisting at 1 year of age. Head circumference increased rapidly in all babies, with maximal growth rate initially followed by a steady decline. All babies showed catch up growth, although those <1.25 kg and <30 weeks gestation still lagged behind even at 1 year. CONCLUSION: It was seen that the smallest and least mature babies had late and poor catch up growth. Recognition of the factors influencing catch up growth and adequate measures to improve growth (like attention to feeding practices) may improve the overall outcome of these babies.

Occupational dermatoses in beedi rollers.

A total of 91 beedi workers were analyzed for the pattern of cutaneous lesions. Period of rolling beedi ranged from 2 months to 40 years. Dermatological findings included; callosities seen in 51 (56.04%) of workers on fingers and feet, nail changes in 22 (24.18%) like pigmentation, paronychia, dystrophy which were more prominent on the right index finger, fungal infections in 15 and eczemas in 29. Callosities and localised nail changes can be considered to be occupational marks in beedi rollers correlated to use of scissors for cutting leaves and use of gum and artificial metallic nails for rolling beedis.

Postasphyxial encephalopathy in preterm neonates.

OBJECTIVE: Perinatal asphyxia is an important determinant of infant neurological outcome. There are very few studies looking exclusively at postasphyxial encephalopathy in preterm neonates. METHODS: We studied the neurologic and sonographic abnormalities in 40 preterm babies with severe birth asphyxia during their hospital stay and till 3 months corrected age. RESULT: 87.5 % of the asphyxiated preterm babies had neonatal neurologic abnormality, compared to only 17% of the control babies (p<0.0001). Generalised hypotonia and reduced activity were the commonest abnormalities (observed in 85% of asphyxiated babies) while depressed sensorium (60%) and seizures (35%) were seen in more severe cases. White matter disease (WMD-including periventricular flare, cerebral edema and periventricular leucomalacia) was significantly more frequent in the study cases (34.5% in study cases vs 7.5% in controls, p<0.0001) as was grade 3/4 intraventricular hemorrhage(IVH) (25% in study cases vs 2.5% in controls, p<0.0001). There was 11 fold higher mortality among the asphyxiated babies (23 deaths in study cases vs 2 in controls, p<0.0001). CONCLUSION: The survivors had a significantly higher incidence of both mild and severe neurological abnormalities at corrected age of 3 months among the asphyxiated babies. There was a good correlation between the severity of the neonatal encephalopathy as well as the sonographic findings and the outcome.

Aniptodera indica, a new species of mangrove inhabiting ascomycete from west coast of India.

On decomposing mangrove leaves and woods collected from west coast of India, a new species of Aniptodera was encountered. Aniptodera indica sp. nov. differs from other members of the genus, as the ascospores possess single polar appendage. This new species is described, illustrated and compared with closely resembling species: Aniptodera chesapeakensis and A. juncicola.

Surgery for ossification of the posterior longitudinal ligament of the cervical spine.

The authors present their surgical experience with fifty seven cases of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, operated between January 1992 and January 1999. Continuous OPLL was seen in the majority of patients (40/57). Posterior decompressive surgery was performed in 18 patients, a median corpectomy and excision of the OPLL in 28 and anterior segmental decompression in 11 patients. One patient had a transient weakness of muscles supplied by the C5 myotome following a C4-C5 corpectomy. 84.2% of the patients showed improvement by at least one grade at the time of discharge. 92.8% of patients who underwent a corpectomy improved in the immediate post-operative period as compared to 90.9% of those who underwent an anterior segmental decompression and 83.3% of those who underwent a posterior decompressive procedure. 97.7% of the 44 patients followed-up between one and five years showed neurological improvement. Thirty-two patients (72.7 %) had regained normal or near normal neurological function and returned to their jobs. Good results were obtained when the surgical approach and the procedure adopted were individualised.