Missing teeth after maxillofacial trauma:a case report and management protocol

Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.

Missing teeth after maxillofacial trauma:a case report and management protocol

Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.

Does the morbidity management and disability prevention (MMDP) clinic serve the filarial lymphedema (FLE) patients’ preeminent expectation?

@#Advocacy and training on “Home care” for filarial lymphoedma (FLE) patients are provided through morbidity management and disability prevention (MMDP) clinic commonly known as filariasis clinic and clinical improvement is assessed by follow-up visits. While the physicians aim at reducing the recurrent ADL (coined as ADLA in 1997) episodes, the patients expect reduction in LE volume. The objective of the present study was to know whether the MMDP clinic serves the primary expectation of the FLE patients. LE patients who attended the clinic for at least four follow-up consultations and had LE volume measurements at three points of time during the one year period of observation were considered for analysis. Clinical assessment was done for LE grading and LE volume was measured by water displacement volumetry. Sixty-three patients who fulfilled the follow up criteria were included. It was observed that the median LE volume was 914ml (IQR 269 – 1935) at first visit of the observation period which reduced to 645ml (IQR 2151666) and 752ml (IQR 215 – 1720) at first and second follow-up visits respectively. Over all, in short span of one year, 21 of the 63 patients (33.3%) who visited MMDP clinic at least four times in a year were benefitted through the MMDP advocacy and the National filariasis control programme need to emphasise on the importance of follow up visits to FLE patients.

Enhanced efficacy of sequential administration of Albendazole for the clearance of Wuchereria bancrofti infection: Double blind RCT

Till today, there is no effective treatment protocol for the complete clearance of Wuchereria bancrofti (W.b) infection that causes secondary lymphoedema. In a double blind randomized control trial (RCT), 146 asymptomatic W. b infected individuals were randomly assigned to one of the four regimens for 12 days, DEC 300 mg + Doxycycline 100 mg coadministration or DEC 300 mg + Albendazole 400 mg co-administration or DEC 300 mg + Albendazole 400 mg sequential administration or control regimen DEC 300 mg and were followed up at 13, 26 and 52 weeks post-treatment for the clearance of infection. At intake, there was no significant variation in mf counts (F(3,137)=0.044; P=0.988) and antigen levels (F(3,137)=1.433; P=0.236) between the regimens. Primary outcome analysis showed that DEC + Albendazole sequential administration has an enhanced efficacy over DEC + Albendazole co-administration (80.6 Vs 64.7%), and this regimen is significantly different when compared to DEC + doxycycline co-administration and control (P<0.05), in clearing microfilaria in 13 weeks. Secondary outcome analysis showed that, all the trial regimens were comparable to control regimen in clearing antigen (F(3, 109)=0.405; P=0.750). Therefore, DEC + Albendazole sequential administration appears to be a better option for rapid clearance of W. b microfilariae in 13 weeks time. (Clinical trials.gov identifier – NCT02005653)

Kinetics and mechanisms of oxidation of some antioxidants with photochemically generated tert-butoxyl radicals.

Dietary antioxidants play an important role in the prevention of several chronic diseases including cardiovascular diseases, cancer, ageing and diabetes. In order to understand the mechanism of oxidation of antioxidants viz., gallic acid (GA), caffeic acid (CA), rosmarinic acid (RA) and chlorogenic acid (CGA), a systematic kinetic study of these antioxidants with photochemically generated tertiary butoxyl (t-BuO). radicals was carried out. The oxidation of antioxidants by t-BuO. radicals was followed spectrophotometrically by measuring the absorbance of GA (266 nm), CA (310 nm), RA (324 nm) and CGA (328 nm) at their respective lmax. The initial rates of oxidation of antioxidants were calculated from the plot of absorbance vs time and were found to increase with increase in [antioxidant], [t-BuOOH] and light intensity in all the cases. The quantum yields (f) were calculated from the initial rates of oxidation of antioxidant and the measured light intensity at 254 nm, the wavelength at which the tert-butyl hydroperoxide (t-BuOOH) was activated to radicals. The quantum yields were found to depend on [antioxidant] and [t-BuOOH], and were independent of light intensity. The order with respect to [antioxidant], [t-BuOOH] were found to be fractional whereas order with respect to intensity was one. The order of reactivity was found to be: CA > CGA > RA > GA. The products were identified by mass spectral data. On the basis of kinetic results and product analysis, probable mechanisms were suggested.

Is moderation of protease production an adaptation of well-defined anthropization in dermatophytes.

The protease activity of different isolates of dermatophytes representing different ecological groups namely geophilic, zoopahilic and anthropophilic, in their vegetative and sporulation growth phases were compared. Unlike their geophilic and zoophilic counterparts, all the isolates of anthropophilic dermatophytes viz. Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. violaceum and Epidermophyton floccosum recorded reduced protease activity during artificially induced sporulation phase in comparison to their vegetative growth phase. Even among the anthropophilic group, a classical moderation of protease activity was recorded in Trichyphyton rubrum which also correlates to its clinical manifestation. This enzyme moderation could also be an evolutionary adaptation of the anthropization of these species.

Kinetics of oxidation of adenosine by tert-butoxyl radicals: Protection and repair by chlorogenic acid.

The rates of oxidation of adenosine and chlorogenic acid by tert-butoxyl radicals (t-BuO-) were studied by measuring the absorbance of adenosine at 260 nm and chlorogenic acid at 328 nm spectrophotometrically. t-BuO- radicals were generated by the photolysis of tert-butyl hydroperoxide (t-BuOOH) in presence of tert-butyl alcohol to scavenge OH. radicals. The rates and the quantum yields() of oxidation of chlorogenic acid by t-BuO-radicals were determined in the absence and presence of varying concentrations of adenosine. An increase in the concentration of adenosine was found to decrease the rate of oxidation of chlorogenic acid, suggesting that adenosine and chlorogenic acid competed for t-BuO. radicals. From competition kinetics, the rate constant of chlorogenic acid reaction with t-BuO- was calculated to be 3.20 109 dm3 mol-1 s-1. The quantum yields (expt) were calculated from the experimentally determined rates of oxidation of chlorogenic acid under different experimental conditions. Assuming that chlorogenic acid acts as a scavenger of t-BuO- radicals only, the quantum yields (cal) were theoretically calculated. expt and cal values suggested that chlorogenic acid not only protected adenosine from t-BuO- radicals, but also repaired adenosine radicals, formed by the reaction of adenosine with t-BuO- radicals.

Biomanagement of paper mill sludge using an indegenous (Lampito mauritii) and two exotic (Eudrilus eugineae and Eisenia foetida) earthworms.

Paper mills have severe problem in disposing effluent or semisolid sludge despite repeated recycling. It requires treatment prior to disposal of sludge. In recent years biological treatment methods received much attention and considered as efficient low-cost treatment. One such method is vermiculture treatment. The present study was carried out to dispose the paper mill sludge biologically using 2 exotic species (Eudrilus eugineae and Eiseniafoetida) and an indigenous species (Lampito mauritii) of earthworm. The paper mill sludge in various concentration 25%,50% and 75% were subjected to vermitub treatment for a period of 60 days. During the period of study data were collected on reproductive strategies of earthworm and chemical analysis of wastes before and after treatment. Results obtained indicate that 25% concentration of sludge was ideal and of the three worms used Eiseniafoetida proved to be the best worm for biomanagement.