Sequelae of carbide-related thermo-chemical injury: A retrospective analysis

Purpose: To describe the outcomes of eyes with calcium carbide (CaC2)?related thermo?chemical injury. Methods: This study included 28 eyes of 23 patients who presented with calcium carbide?related ocular burns. Only patients with more than three months of follow?up were included. Group A included 16 eyes with Dua抯 Grade I朓II burns, while Group B included 12 eyes with Grade IV朧I burns. Electronic medical records were reviewed to provide data on the etiology of burn, presenting clinical signs and visual acuity, sequelae, and surgical interventions performed, both in the acute and chronic phases. Results: The overall mean age was 28.48 � 11.8 years. Fifteen patients were injured while using carbide to create an explosion to scare away animals on farms. The median presenting BCVA (best?corrected visual acuity) in Group A (20/160) was significantly better than in Group B [(20/2000) (P = 0.002)]. Five eyes in Group A and one eye in Group B underwent medical management. There was no difference in the duration of follow?up for both groups (P = 0.24). The median final BCVA in Group A (20/32) was significantly better than in Group B [(20/200) (P = 0.02)]. Two eyes in Group A and nine eyes in Group B developed LSCD. Two eyes in Group B were phthisical at the last visit. Conclusion: Calcium carbide?related ocular injuries can result in significant visual morbidity in young adults. Early presentation and management may improve outcomes. Prevention of these injuries by increasing awareness and increasing advocacy efforts is necessary.

Demographic profile and clinical characteristics of patients presenting with acute ocular burns

Purpose: To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods: This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results: Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work?place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV?VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV?VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion: The findings clearly delineate the at?risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data?driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB

Aqueous-deficient dry eye disease: Preferred practice pattern guidelines on clinical approach, diagnosis, and management

Dry eye disease (DED) is a broad term that includes a diverse group of clinical disorders. Aqueous-deficient dry eye (ADDE), a subtype of DED, is characterized by decreased tear production by the lacrimal gland. It can be seen in up to one-third of individuals with DED and can be comorbid with a systemic autoimmune process or occur secondary to an environmental insult. Since ADDE can be a source of long-term suffering and severe visual impairment, early identification and adequate treatment are imperative. Multiple etiologies can underlie ADDE, and it is critical to identify the underlying cause to not only improve the ocular health but also to improve the overall quality of life and well-being of affected individuals. This review discusses the various etiologies of ADDE, highlights a pathophysiology-based approach for evaluating underlying contributors, outlines various diagnostic tests, and reviews treatment options. We present the current standards and discuss ongoing research in this field. Through this review, we propose a treatment algorithm that would be useful for an ophthalmologist in diagnosing and managing individuals with ADDE.

Optimization and evaluation of tear protein elution from Schirmer’s strips in dry eye disease

Purpose: Extraction of tear protein from Schirmer’s strip is a prerequisite for the proper identification and screening of biomarkers in dry eye disease. The study compares different methods of extraction of tear proteins from the Schirmer’s strip. Methods: Reflex tear was collected from healthy controls (HC; n = 12), Stevens–Johnson syndrome (SJS; n = 3) and dry eye disease (DED; n = 3) patients using capillary tube. This tear was used to measure the volume absorbed by Schirmer’s strip per microliter. Different buffers (6) were used to compare the protein yield from the Schirmer’s strip in four different conditions. The tear proteins extracted using the highest protein yield buffer were analyzed by mass spectrometry. Results: A linear relationship between the tear volume and wetting length was observed (r = 0.0.997, n = 6). The highest yield was observed after incubation of the Schirmer’s strip in 100 mM ammonium bicarbonate (ABC) with 0.25% Nonidet P?40(NP?40) at 4°C for an hour (P < 0.00005). The in?solution digestion of tear eluted in the above condition 100 Mm ABC + 0.25% NP?40 with one?hour incubation yielded a total of 2119 proteins in HC, SJS, and DED. The unique protein observed in SJS and DED was 0.6% and 17.9%, respectively. The significantly expressed proteins are associated with innate immune response, proteolysis, wound healing, and defense response. Conclusion: A method for extraction of protein from Schirmer’s strip was optimized for increase in protein yield from the tear sample. SJS and DED tear samples have unique protein signature. The study will aid in better design of tear protein?based experimental study.

Role of Nurse Leadership to Evaluate the Current Status of Nurses with a View to Invest in Nursing to Secure Global Health An Exploratory Approach

There is an opportunity for nurses to better explain what we do, to break the myths around nursing and to advocate for investment in the profession. This study endeavoured to explore the role of nurse leadership to invest in nursing to secure global health and to identify role of nurse leaders according to their demographic variables. An exploratory sequential mixed method re- search design was selected in this study. Through purposeful sampling, the researcher selected 60 nurse administrators. Data was collected from the nurse administrators in the form of an electronic survey and virtual face-to- face semi structured interview method after obtaining a formal permission. The data collected from them was utilised only for the purpose of the study and was kept confidential. The final analysis summarised the findings that emerged from both quantitative and qualitative data. In the present study there were 50 (83.3%) females and 10 males (16.7 %) and them had nurse administrators 52(86.6%) of experience. The results covered the issues like current status of nurses, ways and benefits to invest in nursing for global health and the role of nurse leaders in investing in nursing for global Health. Nurses are the head honchos and lifeline of health-care organisations but still lack recognition. Concern on this has been expressed by many, but till date no strong visible implementation of laws and policies are seen. Nurses need to take initiation and leadership at higher levels to bring change in the existing scenario and implement the recommendations regarding basic pay and maximum working hours per week..

UTI among patients attending IPD and its relation with preterm labor in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur

Background: Urinary tract infections (UTIs) now have become a severe public health problem because of the morbidity and treatment cost. UTI can be occur in all age groups, but women are more prone to develop UTI in comparison to men, due to several factors like short urethra, absence of prostatic secretions, pregnancy and easy infection in the urinary tract with fecal flora.Material & Methods:This study was a retrospective cross-sectional study which was conducted at the department of Obstetrics and Gynaecology, Bangabandhu Sheikh Muzib medical college hospital, Faridpur, Bangladesh. The study was conducted during the period of January 2021- January 2022. The total sample size for this study was 197.Results:Most of the respondents 87(44.2%) were aged between 25-29 years and followed by 16(8.1%) were aged 20-24 years, 81(41.1%) were 30-34 years and 13(6.6%) were aged >34 years. According to gravida, 4th gravida were 65(33.0%), 3rd gravida 37(18.8%), 2nd gravida 62(31.5%) and 1st gravida were 33(16.8%). The most common isolated organism was E. coli which was found in 135(68.5%) cases and followed by S. Aureus in 21(10.7%), Coagulase negative staph in 20(10.2%), Klebsiella in 9(4.6%) and GBS in 12(6.1%) cases. Majority of the patients 192(97%) had no complications onwards and only 5(3%) case was found with pyelonephritis.Conclusion: UTI in pregnancy has a major influence on pregnancy outcome. The unsolicited miseries of the pregnant mothers and their progenies might easily be legitimate by early diagnosis and treatment of UTI during pregnancy.

Esthetic management of a patient with cleft lip and palate

Esthetic rehabilitation of cleft lip and palate patients presents a myriad of challenges and requires interdisciplinary coordination. In the present case report, a 22-year-old male patient with a cleft palate and alveolus was treated. Comprehensive multidisciplinary treatment planning and management, along with a clinician-friendly process of smile designing and of creating mock-ups using digital technology, helped overcome the esthetic challenges faced in this case.

Interplay of Vitamin D and CYP3A4 Polymorphisms in Endocrine Disorders and Cancer

Vitamin D has received considerable optimistic attention as a potentially important factor in many pathological states over the past few decades. However, the proportion of the active form of vitamin D metabolites responsible for biological activity is highly questionable in disease states due to flexible alterations in the enzymes responsible for their metabolism. For instance, CYP3A4 plays a crucial role in the biotransformation of vitamin D and other drug substances. Food-drug and/or drug-drug interactions, the disease state, genetic polymorphism, age, sex, diet, and environmental factors all influence CYP3A4 activity. Genetic polymorphisms in CYP450-encoding genes have received considerable attention in the past few decades due to their extensive impact on the pharmacokinetic and dynamic properties of drugs and endogenous substances. In this review, we focused on CYP3A4 polymorphisms and their interplay with vitamin D metabolism and summarized the role of vitamin D in calcium homeostasis, bone diseases, diabetes, cancer, other diseases, and drug substances. We also reviewed clinical observations pertaining to CYP3A4 polymorphisms among the aforementioned disease conditions. In addition, we highlighted the future perspectives of studying the pharmacogenetics of CYP3A4, which may have potential clinical significance for developing novel diagnostic genetic markers that will ascertain disease risk and progression.

Small but viscious: the subclavius posticus muscle / Pequeño pero vicioso: el músculo subclavius posticus

SUMMARY: Accessory muscles of the neck are rare and are of clinical significance when present. During routine dissection of head and neck, two accessory muscles were found in the neck region of two cadavers, both male, one on the right and the other on the left. Both muscles took origin from the superior margin of the scapula and the insertion of the first muscle was to the clavicle, merging with subclavius and the second muscle got inserted to the first rib near the costochondral junction. This paper highlights the clinical significance and embryological aspects of such accessory muscles in the neck region.

RESUMEN: Los músculos accesorios del cuello son infrecuentes y tienen importancia clínica cuando están presentes. Durante la disección de rutina de la cabeza y el cuello, se encontraron dos músculos accesorios en la región del cuello de dos cadáveres, ambos de sexo masculino, uno a la derecha y otro a la izquierda. Ambos músculos se originaban en el margen superior de la escápula y la inserción del primer músculo se extendía a la clavícula, fusionándose con el músculo subclavio. El segundo músculo se insertó en la primera costilla cerca de la unión costocondral. Este artículo destaca la importancia clínica y los aspectos embriológicos de dichos músculos accesorios en la región del cuello.

Current realities of dental graduates about dental profession: Cross- sectional study future prospects of dental graduates

Purpose: Dentistry is specialized branch for head and neck region. In this field exponential growth in technology has taken place in the last few decades. At the same time dental graduates also increased. As the patient to doctor ratio has increased, it helped in offering services to the needy, but on the flip side, many qualified dentists are shifting careers due to multiple reasons. This study was conducted to know the awareness of dental graduates on their future prospects in pursuing the dental career. Materials and methods: A cross-sectional questionnaire survey was conducted among junior residents who attended the dental conference using a structured questionnaire. Questions are prepared in a customized form which elicits, knowledge and awareness of dental graduates on their future prospects among junior residents. Results: A total of 210 dental graduates/ junior residents participated in the study. Among them, nearly half of the sample, i.e. 42.4% of dental graduates are satisfied only 50% in pursuing dentistry. Most of the participants, i.e., 63.8% are willing to change the profession, while remaining one-third of the sample, i.e., 36.7% are willing to work in government sector. Only a few graduates, i.e. 22.4% of them were interested in teaching or academics. Conclusion: Even though most of the dental graduates were happy in pursuing dentistry, but most of them were willing to change the career option because of a stressful job timing with no expected fruitful returns in terms of income. This problem is also escalating because of fewer job opportunities.

Dietary intake of persons with depressive and psychotic disorders in Singapore

INTRODUCTION@#Nutritional psychiatry is an emerging field of study that investigates the role of diet and nutrition in mental health. Studies conducted in the general population have linked depressive symptoms with poor dietary patterns. The aim of this study was to characterise the dietary intake and analyse the dietary pattern using the Dietary Approach to Stop Hypertension (DASH) in a sample of psychiatric patients in a multiethnic Asian nation.@*METHODS@#Participants were recruited from an outpatient clinic and an inpatient unit at the Institute of Mental Health in Singapore. Self-reported dietary habits of a sample of psychiatric patients (N=380) were analysed using DASH. To examine the variables associated with DASH scores, a linear regression was conducted with the full sample and sociodemographic variables.@*RESULTS@#Persons with depressive disorders had a mean DASH score of 21.3 (±4.2), while persons with psychotic disorders had a mean DASH score of 21.2 (±4.9). Respondents who were older (B=1.94, 95% confidence interval [CI] 0.91-2.96, @*CONCLUSION@#Dietary patterns of persons with mental disorders were characterised. A host of sociodemographic factors, and not diagnosis of mental disorders, influenced the dietary quality of people with depressive and psychotic disorders. Clinicians treating psychiatric patients need to be aware of the nuanced reasons behind poor dietary choices and provide targeted psychoeducation to specific subgroups within the patient population.

Prevalence of Temporomandibular Disorders and its Correlation with Stress and Salivary Cortisol Levels among Students

ABSTRACT Objective: To evaluate the prevalence of temporomandibular disorders (TMD) in students and to evaluate if any relationship existed between the stress levels, salivary cortisol levels, and TMD. Material and Methods: A total of 348 students, 187 female, and 161 male students, participated in this cross-sectional study. Students were evaluated based on the Research Diagnostic Criteria for TMD. The stress levels were evaluated using the Perceived Stress Scale. The students were divided into the control and TMD groups. Salivary cortisol levels in the salivary samples were analyzed. Results: The prevalence rate of TMDs was 30.7% in the study population. Of the female students, 61% had TMD compared with 46% of male students. Muscle disorders were the most predominant disorder in 14.2% of the students with TMD. The TMD group showed significantly higher salivary cortisol and stress levels than the control group. The TMD group also showed a moderate positive correlation between cortisol and stress levels (p=0.01). Conclusion: The study showed a strong association between salivary cortisol levels, stress, and temporomandibular disorders. Salivary cortisol could be used as a prognostic biomarker for stress while assessing the severity of TMJ problems in stressed individuals.

Langerhans cell histiocytosis of liver

Langerhans cell histiocytosis (LCH) is a rare disorder of unknown etiology caused by proliferation of Langerhans cells. It can involve single organ system to multi organ systems and clinical presentation is variable depending on the organ involved and have different prognosis. LCH is common in children when compared to adults. Hepatic involvement in adults is relatively rare. Liver involvement has considerable impact on survival rates. Histopathology and immunohistochemistry provide the definitive diagnosis. Authors report a case of Langerhans cell histiocytosis in a young adult with hepatic involvement.

The Radix Entomolaris and Paramolaris: A Review and Case Reports with Clinical Implications

Normally, the permanent mandibular first molar has two roots, mesial and distal. However, mandibular molars may have anadditional root located either buccally (radix paramolaris) or lingually (radix entomolaris [RE]). Understanding of the presence ofan additional root and its root canal, anatomy is essential for successful treatment outcome. The aim of this paper is to reviewthe prevalence and morphology of RE and to present two cases of permanent mandibular first molars with an additional thirdroot (RE) in the Indian population. In this study, we did a clinical investigation of two cases; one case of successful endodonticmanagement of permanent mandibular first molar characterized as RE, whereas the second one is a presentation of a case ofsevere bone loss around permanent first molar with an additional third root. The presence of an additional third root in permanentmandibular first molars may affect the prognosis of the tooth if it is misdiagnosed. Thus, an accurate diagnosis and thoroughunderstanding of variation in root canal anatomy are essential for treatment success.

Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

Background: Critical part of transfusion is effective screening of TTI, to reduce the risk of transmission is as safe as possible. The present study has undertaken to focus on seroprevalence of TTIs among both voluntary and replacement donors and also to project epidemiological data of TTIs in this community.Methods: This is a retrospective study conducted from January 2014 to December 2018. All blood samples collected from donors were screened for HIV, HBV, HCV, Syphilis and malaria according to blood bank policy. Before drawing blood, donors were asked to fill pre structured Blood bank questionnaire and consent form.Results: In this present 5-year study, total number of blood donor population was 54937, among them voluntary donors were 33891 and replacement donors were 21046. Out of 33891 voluntary donors, 33486(98.8%) were males and remaining 405(1.19%) were females. All replacement donors (21046) were males. The seroprevalence of HBV was highest, 1.82% (1003/54937) followed by HCV 0.31% (175/54937) in all the donors. The seropositivity for HIV is 0.23% (129/54937), for syphilis 0.04% (24/54937) and for malaria 0.01% (6/54937).Conclusions: National blood transfusion policy should be strengthening the standards and quality of screening across the country. For blood screening, resources and appropriate screening assays must be available at all health centres.

Demonstrate observe assist perform versus video assisted teaching in teaching deep tendon reflexes to medical students: a comparative study

Background: Clinical examination of Deep tendon reflexes is a skilled technique that should be taught in an interesting way. Newer teaching learning methods like Video assisted teaching can be utilized  to facilitate self-directed and long term learning  and to cultivate enhanced interest in the study.Method: Among 120 students are divided into 6 groups.  Each group is divided into two batches of 10 members each. 6 batches are taught deep tendon reflexes separately by DOAP.  6 batches are taught deep tendon reflexes separately by video assisted teaching. At the end of teaching and 2 weeks later, each batch is  assessed by OSCE . Objective Structured Clinical Examination checklist marks are systematically entered in an excel sheet and was analysed using unpaired t-test .The perception to each teaching learning method was assessed by feedback Questionnaire using  Likert Scale.Results: On comparing between the effectiveness of video assisted teaching and clinical demonstration of the examination of deep tendon reflexes , students taught by video assisted teaching scored higher marks in the evaluation after two weeks, which was statistically significant. Regarding perception, students favoured both teaching methods for their effectiveness. For clarifying doubts, students favoured DOAP method. For reproducibility and better retaining of memory, students favoured video assisted teaching.Conclusion: Video assisted teaching was equally effective as DOAP in teaching deep tendon reflexes to medical students. For reproducibility and better retaining of memory, Video assisted teaching was perceived better as reflected in the better mean scores two weeks after the teaching sessions.

Prevalence of pulmonary tuberculosis in patients with diabetes mellitus and lower respiratory tract infection

Background: Pulmonary Tuberculosis (PTB) still remains a global public health problem. Diabetes Mellitus (DM), is a metabolic disorder characterized by hyperglycaemia. Diabetes along with poor glycaemic control leads to an immune compromised state. As prevalence of both TB and DM is increasing in India, this association of PTB and DM may prove a threat to TB control program. Aims and objectives of the study was to detect prevalence of pulmonary tuberculosis in patients with DM and Lower Respiratory Tract Infection (LRTI).Methods: Sputum specimen from consecutive 250 known diabetic adult patients with type 2 diabetes and clinical evidence of LRTI were processed for microscopy, solid culture and Xpert MTB/RIF assay. Clinical findings, duration of DM, regularity of treatment and recent fasting blood glucose level were noted.Results: TB was detected in 31(12.8%) patients. Microscopy, culture and Xpert assay were positive in 14(5.6%), 29(11.6%) and 24(9.5%) cases respectively. Culture detected seven cases more than Xpert assay. Two additional cases were detected by Xpert assay than culture. Rifampicin resistance was detected in seven (29.17%) cases by Xpert assay. TB detection rate was higher in patients with more than two weeks of cough (14.38%), history of tuberculosis (15.9%), hyperglycemia (13.9%) and significantly higher in those with irregular anti-diabetic treatment (35.7%).Conclusions: Irregular anti-diabetic treatment, hyperglycaemia and history of tuberculosis were strongly associated with pulmonary TB. Xpert assay should be used as the initial diagnostic test for detection of tuberculosis as well as rifampicin resistance in diabetic patients by TB control programme.

Sequestration and purification of essential enzyme from Pleurotus florida compost waste and its application studies

Spent oyster mushroom (Pleurotus florida) compost as tremendous source for isolation of industrial significantenzymes such as amylase, protease, and cellulase. This study was conducted to achieve efficient extraction oflignocellulolytic enzymes amylase (EC 3.2.1.1), cellulase (EC 3.2.1.4), and protease (EC 3.4.21.14) from spent oystermushroom (P. florida) compost waste. Optimal enzyme recovery was achieved when spent oyster mushroom compostwastes and concentrated by acetone precipitation. The purification was performed by column chromatography. Theenzymes such as cellulase, amylase, and protease released from oyster mushroom (P. florida) compost waste wereshowed activities of 15.78 U/ml, 3.42 U/ml, and 0.042 U/ml, respectively. These were utilized in various industrialand environmental applications such as starch processing in potato waste from food industry using amylase andbiotreatment of cotton waste using cellulase.

Prevalence of hyponatremia in pulmonary tuberculosis

Background: Tuberculosis is one of the most common infection in India and is associated with high mortality. India ranks 14th out of top 22 countries who are burdened with TB infections.Methods: It is a prospective study after getting the ethical committee clearance from the institute. The patients admitted to Chest and TB, Medicine Department of SLN medical college and Hospital, Koraput, Odisha from Jan 2019 to December 2019 with pulmonary tuberculosis were included in the study.Results: A total of 65 adult patients with active PTB were included in this study with age ranging from 15 to 69 years. The mean age of patients was 38.80 + 15.03 years. The total mean serum sodium levels among the subjects was 135.5+7.23. Among 65 patients, 26 (40%) patients had low sodium levels which was less than 135mmol/l out of which 21 (42%) were males and 5 (33%) were females. In all the groups of hyponatremias, majority were found to be males when compared to the females in their respective groups.Conclusions: Hence patients with PTB have to be evaluated for hyponatremia as early detection and treatment of underlying electrolyte abnormality can potentially reduce mortality and morbidity associated with tuberculosis and also can shorten the duration of hospitalization.