Therapeutic Potential of Apium graveolens on the Reproductive System of Cadmium Treated Male Rats.

Cadmium (Cd) is a well - known environmental toxin that is naturally present in air, water and soil. The reproductive system is most vulnerable to oxidative damage and therefore most affected by Cd. Zinc (Zn) is an essential antioxidant and a chelating agent that is capable of protecting the testis from Cd induced toxicity. Apium graveolens commonly known as Celery is a herbal plant rich in antioxidants and it improves various sperm parameters. MethodsMale Wistar albino rats were randomly divided into 7 groups. Control received 0.5 % Carboxy-Methyl Cellulose (CMC) in distilled water; the experimental groups namely Cd received 10 mg / Kg body weight of CdCl2; Cd + Zn received 10 mg / Kg bodyweight of CdCl2 + 40 mg / Kg body weight of ZnCl2; Cd + AG 200 received 10 mg/Kg bodyweight of CdCl2 + 200 mg / Kg body weight of Apium graveolens; Cd + AG400 received 10 mg/Kg body weight of CdCl2 + 400 mg / Kg body weight of Apium graveolens; Cd + AG 200 + Zn received 10 mg / Kg bodyweight of CdCl2 + 200 mg / Kg body weight of Apium graveolens + 40 mg / Kg body weight of ZnCl2; Cd + AG 400 + Zn received 10 mg / Kg bodyweight of CdCl2 + 400 mg/Kg body weight of Apium graveolens + 40 mg / Kg body weight of ZnCl2 all in 0.5% CMC. Hydroalcoholic extract of Apium graveolens was used in this experiment. The experiment was conducted for a duration of 56 days. Histopathology, sperm analysis, lipid peroxidation and hormone assays were performed. The therapeutic potential of Apium graveolens at two doses (200 and 400 mg / Kg body weight) with and without Zn supplementation was evaluated in this experiment. ResultsRats treated with Cd showed severe testicular damages. Zn offered protection from the damages done by cadmium. The hydroalcoholic extract of Apium graveolens at doses of 200 mg / Kg body weight showed better protective effect than 400 mg / Kg body weight and the protecting nature was enhanced by zinc supplementation.

Factors predicting difficulty of thyroidectomy preoperatively

Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care. Materials and methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied. Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive antithyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomy Conclusion: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, and positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

The role of hyperbilirubinemia as a marker of gangrenous/ perforated appendicitis

Background: Acute appendicitis is the most common cause of acute abdomen in young adults requiring Emergency Surgery. Diagnosing Acute Appendicitis clinically still remains a common surgical problem. Objectives: To study the Incidence of Hyperbilirubinemia in cases of Acute appendicitis and its Complications (Gangrenous/ Perforated), to compare other variables such as age, symptoms, clinical profile, total leukocyte count, Alvarado’s score and USG in a similar role. Materials and methods: All patients presenting with Right Iliac Fossa pain of abdomen who were admitted in the Emergency ward were evaluated by Detailed History and Examination and complete Hemogram, Liver function Test, Seropositivity for Hbs Ag, Alvarado's scoring system and USG. Confirmed cases were operated and clinical diagnosis was confirmed Per-operatively and post operatively by Histopathological Examination. Final HPE was considered as a gold standard for diagnosing and categorising patients as having Normal Appendix, Acute appendicitis and Acute appendicitis with Perforation/ Gangrene. During the study period, out of 249 cases operated, 246 cases were taken for study purpose. Rest of the three cases met the exclusion criteria. Two cases were HbsAg +ve and one case was Acute appendicitis associated with Cholelithisis hence, excluded from the study. Results: Within the 204 cases of Acute suppurative appendicitis, 35 cases had Hyperbilirubinemia (17.16%). Among 42 cases of Gangrenous/ Perforated Appendix, 36 cases had Hyperbilirubinemia (85.71%). Hyperbilirubinemia was most commonly associated with Gangrenous/ Perforated Appendix followed by Acute suppurative appendicitis. Here the cut off value for Hyperbilirubinmia was 1.15 mg and it was supported by statistical analysis. Conclusion: Total serum bilirubin appears to be a new promising marker for diagnosing Gangrenous/ Perforated Appendicitis. Patients with clinical signs and symptoms of Acute appendicitis with raised serum bilirubin should be considered as having high predictive potential for Appendicular gangrene/ Vijayalakshmi S, Jothi Ramalingam S. The role of hyperbilirubinemia as a marker of gangrenous/ perforated appendicitis. IAIM, 2019; 6(6): 100-105. Page 101 Perforation. Serum Bilirubin is an important adjunct in diagnosing the presence of Gangrenous/ Perforated Appendicitis along with other diagnostic aids. Therefore Hyberbilirubinemia may considered as a marker for Gangrenous/ Perforated appendix.

A comprehensive study on the effect of injection methylprednisolone in post mastectomy seroma

Background: Seroma formation is a common problem after mastectomy. The incidence varies between 30% to 92%. It is often an ongoing problem after removal of the suction drain, and repeated skin puncture is necessary to remove the seroma. In addition to many ambulatory visits this also leads to an increased risk of infection, and the adjuvant treatment can be delayed for several weeks. Different procedures have been tried to avoid seroma formation. Among these are for examples: immobilisation of the arm and shoulder after mastectomy, different drain regimens, closing of the dead space of the cavity, different chemical substances as thrombin, tranexamacid and fibrin. None of these results has been successful. Seroma formation is most likely the result of the inflammatory response due to wound healing. In the seroma fluid several factors have been detected that support this assumption. These factors are: high levels of IgG, leucocytes, granulocytes, proteinases, proteinases inhibitors, different kinds of cytokines (tPA, uPA,, uPAR, PAI-1, PAI-2, IL-6 og IL-1). On the basis of this, an inhibition of the inflammatory response might result in a decrease of seroma formation, and perhaps improve quality of life after mastectomy. Steroids inhibit the inflammatory response for example by inhibition of the cytokine function. It has been shown that a high single dose of steroid infusion (30 mg/kg solu-medrol) inhibits the normal IL 6 response after colon resection. Newer studies have shown that even at a lower dose the inflammatory response is inhibited. In several studies of head and neck surgery the oedema in surgical area is reduced after a single dose of 125 mg solumedrol. It is precisely this effect of reduced fluid formation we want to obtain in our study. We have therefore chosen to use a single dose of 125 mg of solumedrol in this study. Even at the largest single dose of glucocorticoids there have not been seen any increasing in surgical complications. S Vijayalakshmi. A comprehensive study on the effect of injection methylprednisolone in post mastectomy seroma. IAIM, 2018; 5(2): 43-47. Page 44 Aim: The aim of this study was to study the effect of injection methylprednisolone in post mastectomy seroma in patients coming to Govt. Villupuram Hospital. Materials and methods: This was a prospective study consisting of 20 patients diagnosed as carcinoma breast who underwent modified radical mastectomy in our institution. With all aseptic precautions, 125 mg methylprednisolone sodium succinate intravenously as a single bolus before the start of surgery in patients undergoing modified radical mastectomy in case group. Results: Most common age group was 41-50 years of age. In 2 cases seroma aspiration was present. Conclusion: Since Seroma formation is the most common complication of Mastectomy and among the methods used to reduce its incidence, steroid administration seems to be the most cost effective and shows promising results. Its routine use in every case is recommended under good antibiotic cover and wound care.

A comprehensive study on effect of recombinant human epidermal growth factor gel in diabetic foot ulcer

Background: Ulcer healing in the diabetic patients is challenging due to a prolonged inflammatory response, extracellular matrix degradation irregularities, and increased bacteria presence. Recombinant human epidermal growth factor (REGEN-D 150), which was cloned and over expressed in E. coli, has shown enhanced healing of chronic diabetic foot ulcers (DFU) by significantly reducing the duration of healing in addition to providing excellent quality of wound healing and reepithelization. Aim: To compare the efficacy and safety of collagen granule dressings and conventional dressing in deep wounds in terms of reduced healing time, number of dressing, healing quality and complications. Materials and methods: Thirty patients with foot ulcer were evaluated. A recombinant human Epidermal growth factor gel or conventional dressings were applied, and the patients were followed as per standard post-application treatment protocol. Patients underwent dressing changes every day until wound healing or for maximum period of 12 weeks. Changes in wound size were recorded when the dressing was removed; and at 4 and 12 weeks. Results: Common age groups were 41-50 and 51-60 years of age. Complete healing was present in 12 cases. Conclusion: There was statistically significant difference between the results of Recombinant human epidermal growth factor gel and saline dressings as collagen dressings had better healing response rate as compared to placebo when given along with standard treatment of diabetic foot ulcer.

Pirfenidone Induced Photosensitivity Reaction in a Patient with Idiopathic Pulmonary Fibrosis.

Drug-induced photosensitivity refers to the development of cutaneous disease as a result of combined effects of a chemical and light. Photosensitivity reactions may result from systemic medications and topically applied compounds. Pirfenidone is known to cause photosensitivity reactions, rash, pruritus and dry skin at high doses. However, similar adverse reactions with low doses of Pirfenidone have not been reported. We report a case of photosensitivity reaction induced by low- dose Pirfenidone in a patient with idiopathic pulmonary fibrosis (IPF).

Interhemispheric Variation of Sylvian Fissure: A Cadaveric Brain Study.

Introduction: Language areas of brain show a beautiful anatomico-functional correlation. It has been often assumed that the interhemispheric asymmetry of Sylvian fissure and perisylvian cortex is the basis of hemispheric dominance for language.The lateral sulcus is one of the earliest-developing sulci of the human brain. Materials And Methods: 60 formalin fixed cadaveric brains irrespective of sexes were studied in the department of Anatomy. The total length of sylvian fissure on the superolateral surface till the posterior sylvian point was noted bilaterally. Among the other measurements taken were the lengths of anterior ascending, anterior horizontal and posterior limb of lateral sulcus till posterior sylvian point on the right and left cerebral hemispheres. Observation and Results: The mean of the total length of the lateral sulcus on the left side is 8.48 which is larger than the right side which is 8.39.The mean of the anterior horizontal rami on right side (1.97) is greater than left side (1.96). On the other hand the mean value of left anterior ascending ramus 2.41 is greater than the mean value of right anterior ascending ramus 2.37. The mean value of posterior limb of sylvian sulcus is also greater on the left side i.e. 6.43 than on the right side i.e.6.23.All measurements are in cms. Conclusion: The Sylvian fissure in this study is longer on the left side than the right which has been proved in previous studies.To correlate this structural asymmetry with the functional localization of speech and language calls for further studies.

Cervical and vaginal agenesis report.

Cervical agenesis is a very rare condition often associated with atresia of vagina. Clinical diagnosis is usually difficult before surgery. Transverse vaginal septum or vaginal agenesis is also a rare condition that results from incomplete fusion between vaginal components of the mullerian ducts and urogenital sinus. Here we presented case of 16 years old girl who presented with primary amenorrhea and cyclical lower abdominal pain for 6 months. Abdomino-pelvic scan showed hematometra with bilateral hematosalpinx with mild free fluid in pouch of Douglas with collapsed vagina and cervix. MRI pelvis confirmed USG findings giving differential diagnosis of high vaginal septum or cervical agenesis. She was operated for cervical recanalization and vaginosplasty.

Couvelaire uterus – A case report.

“Couvelaire uterus” or “Utero-placental apoplexy” is a rare complication of severe forms of placental abruption. It occurs when vascular damage within the placenta causes hemorrhage that progresses to and infiltrates the wall of the uterus. We presented here rare case of 23 years old female with Couvelaire uterus.

Study of Morphology of Uterus Using Ultrasound Scan.

Background: The anatomical variations of uterus particularly those concerning the body of uterus are well known in medical literature. Knowledge of these variations is important in reproductive periods of life, as well as in deciding the surgical procedures involving caesarean section delivery. However there are some exceptional variations in the body of uterus thatmay puzzle the obstetrician and gynaecologist dealingwith gynaecological patients. Normal development of the female reproductive tract requires a complex series of events. Failure of any part of this process can result in congenital anomaly. Careful sonography and an awareness of the sonographic findings of early pregnancy in anomalous uteri should improve the detection of these anomalies. Recognition of such anomalies will also allow differentiation of those patients requiring repeat dilatation and curettage from those requiring laparotomy, as in the presence of a blind uterine horn or ectopic gestation. 3D ultrasonography permits the obtaining of planar reformatted sections through the uterus, which allow precise evaluation of fundal indentation& length of the septum. AimThis studywas undertaken to assess themorphology of uterus and evaluate the anomalies. Materials: 1500 subjects within the age of 15-45 were assessed using ultrasound scan and the anomalies were analyzed. Results: 5-7% cases involving the variations ofmorphology of the uterus were reported in this study, that 3DUS has recently become the only mandatory step in the initial investigation. Conclusion:With timely and accurate diagnosis, appropriatemanagement is likely to provide the best possible outcome for all such patients.

Histomorphometric analysis of nuclear and cellular volumetric alterations in oral lichen planus, lichenoid lesions and normal oral mucosa using image analysis software.

Introduction: Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. Aims: To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. Materials and Methods: A retrospective study was done on 25 histologically diagnosed cases each of oral lichen planus, oral lichenoid lesions, and normal oral mucosa. Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Statistical Analysis: Analysis of variance test (ANOVA) and Tukey's post-hoc test. Results: The basal cells of oral lichen planus showed a significant increase in the mean nuclear and cellular areas, and in nuclear volume; there was a significant decrease in the nuclear-cytoplasmic ratio as compared to normal mucosa. The suprabasal cells showed a significant increase in nuclear and cellular areas, nuclear diameter, and nuclear and cellular volumes as compared to normal mucosa. The basal cells of oral lichenoid lesions showed significant difference in the mean cellular area and the mean nuclear-cytoplasmic ratio as compared to normal mucosa, whereas the suprabasal cells differed significantly from normal mucosa in the mean nuclear area and the nuclear and cellular volumes. Conclusions: Morphometry can differentiate lesions of oral lichen planus and oral lichenoid lesions from normal oral mucosa. Thus, morphometry may serve to discriminate between normal and premalignant lichen planus and lichenoid lesions. These lesions might have a high risk for malignant transformation and may behave in a similar manner with respect to malignant transformation.

Distribution of enteric bacteria in the sediments of Parangipettai and Cuddalore coast of India.

Distribution of major groups of enteric bacteria viz., Escherichia coli, Shigella spp., Salmonella spp., Vibrio parahaemolyticus and Vibrio cholerae was studied in the sediment samples collected from different depths of 5, 15, 25 and 35 m in Parangipettai and Cuddalore coast during March, 2009 to February, 2010. Among the bacterial population in Parangipettai, V. parahaemolyticus was found to be maximum with an occurrence of 55% followed by Shigella spp. (15%), V. cholerae (12%), Salmonella spp. (12%) and E. coli (6%). In Cuddalore, as an oddity, Vibrio cholerae emerged as dominant species with an incidence of 60% of the total. V. parahaemolyticus came next in the order with an incidence of 14%, followed by E.coli (11%), Shigella spp. (8%) and Salmonella spp. (7%). Similarly, monsoon and premonsoon seasons registered higher bacterial populations in both the regions. When the depth wise results were viewed, 5 and 15 m depths showed maximum (V. parahaemolyticus 3.7x 10 CFU g-1 in Parangipettai; V. cholera - 8.6x10 CFU g-1 in Cuddalore) bacterial population compared to subsequent depths. Cluster and MDS also showed distinct spatial and seasonal variations of bacterial populations in both the regions. Biota-Environment (BIO - ENV) method revealed the combinations of temperature, salinity and TOC as the best match influencing bacterial population.

Intraosseous fibrosarcoma of maxilla in an HIV patient

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the oral cavity and can cause local recurrences or metastasis. Fibrosarcomas account for 15% of all soft tissue sarcomas, which represent only 1% of all malignant tumors of the head and neck region. The clinical behavior of the fibrosarcoma is characterized by a high local recurrence rate, and low incidence of loco regional lymph node and/or distant hematogenous metastasis. The etiology for fibrosarcoma has no definite cause but is thought to occur from preexisting lesions or in previously irradiated areas of bone lesions. Immunosuppression associated with HIV infection and acquired immune deficiency syndrome [AIDS] has been consistently linked to various cancers, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive cervical cancer. Rare neoplasms like Hodgkin's disease, anal cancer, leukemia, basal cell carcinoma, and squamous cell carcinoma have also been demonstrated. This paper presents one such a rare incidence of an intraosseous fibrosarcoma occurring in an HIV-positive patient

Phytochemical constituent of aconitum species-A review.

Aconitum species were used as the major component in the Chinese and Bhutanese herbal medicines. The species posses many phytochemical compounds which possess many of the pharmacological activities. Diterpene alkaloids were the main compound with the pharmacological activities such as analgesic and against inflammation. This alkaloid possesses certain toxic hydrolyzed bases which could be detoxified by the intervention of recent technologies. Apart from this, the plant possess many alkaloids, amide alkaloids, flavonoids, flavonol glycosides, diterpenoid and norditerpenoid compounds which possess medicinal values. The above mentioned compounds of potent importance were isolated and characterized by the chromatographic separation techniques and their structures were usually elucidated by the spectroscopic studies especially with Nuclear Magnetic Resonance techniques. These compounds were the central target of the medicinal chemist as they possess both medicinal and toxic nature. The measures to be taken in such a way that the medicinal compounds of the plant should be isolated and formulated without the toxic nature. This review encompasses the total phytochemical compounds that have been isolated from various species of the plant genus Aconitum.

Histopathologic changes in soft tissue associated with radiographically normal impacted third molars.

Background: The incidence of impacted or embedded third molars accounts for approximately 98%. Since 1948, there are studies reporting pathological changes in an asymptomatic dental follicle. Controversy still exists for removal of asmptomatic impacted teeth. Hence, this study was performed to histologically evaluate soft tissue pathosis in the pericoronal tissues of impacted third molars with pericoronal radiolucency measuring up to 2.5 mm on orthopantomographs. Materials and Methods: Forty-one asymptomatic impacted third molars with follicular space of up to 2.5 mm on radiographs were included. The disimpacted teeth and the follicular tissues were obtained for histological examination. Results: Age of the patients ranged from 14 to 25 years. Of 41 tissues evaluated, histopathological reports of 18 follicles were suggestive of dentigerous cyst, two follicles showed odontogenic keratocyst, one follicle each of calcifying epithelial odontogenic cyst, ameloblastoma-like proliferation, odontogenic myxoma and odontogenic fibroma. Conclusion: This study showed 58.5% of asymptomatic cases with definite pathological changes. Hence, thorough clinical and radiographic examination should be carried out for all impacted third molars and the dental follicular tissue should be submitted for histopathological evaluation.

Informed consent: a survey of general dental practitioners in Belgaum city.

The informed consent process allows the patient or legal guardian to participate in and retain autonomy over the medical service received. Obtaining informed consent may also decrease the practitioner’s liability from claims associated with miscommunication. The aim of this study was to assess knowledge and practices of general dental practitioners (GDPs) regarding informed consent. 118 GDPs in Belgaum city, Karnataka, India, were given questionnaires asking for information on their knowledge and practices related to informed consent. The questions covered general information, treatment-specific issues and the consent process. 80 responses were received out of which 44 were complete. 63.6% of GDPs reported that they obtained written consent. All of them reported that they obtained only general consent. 4 of them obtained written consent in the local language. 37 said they gave a detailed explanation of the procedure. 3 said they did not inform their patients on radiation exposure. Dentists should upgrade their knowledge regarding legal jurisprudence and legal medicine to avoid any litigation.

Primary taste discrimination in alloxan diabetic rats with restricted access to testant and water.

This study was conducted to assess the primary taste discrimination in 18 h water deprived control and alloxan diabetic rats for a period of 60 min duration by using two bottle choice paradigm. Different concentrations of sodium chloride, sucrose, urea and hydrochloric acid were used for salty, sweet, bitter and sour taste sensations respectively. Alloxan diabetic rats showed loss of discrimination for sucrose and urea solutions, increased sensitivity for low concentration of hydrochloric acid and no change in sodium chloride taste sensitivity.