A Way Forward for A Greener Future – Sustainability in Oral Health Care

Oral health professionals promote universal oral health for diseases that are primarily preventable and/or treated in their early stages. The delivery of oral health care, whether through therapeutic interventions, pre-ventive care, or long-term maintenance, causes pollutants and has a significant carbon footprint. Oral health practitioners share a moral obligation to society to offer optimal oral health services, ensure patient safety, and decrease their environmental impact. To ensure the long-term viability of oral healthcare services, all or-ganisations should recognise the critical need to work together to develop knowledge, identify remedial pos-sibilities, and exchange best practices that are environmentally friendly.

Diagnostic accuracy of saliva as a specimen for detection of SARS-CoV-2 by RT-PCR

Context: COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an emerging pandemic that is rapidly spreading with more than 114 million confirmed cases and 2.5 million deaths by far. Nasopharyngeal swab (NPS) in VTM has been used as the gold standard respiratory specimen for SARS-CoV-2 reverse-transcriptase real-time PCR (rRT-PCR) tests. But now the virus can also be detected in other clinical specimens like bronchoalveolar lavage, sputum, saliva, throat swab, blood, and stool specimens. Aims: The aim of this study was to determine the diagnostic potential of saliva as a sample in comparison to NPS for detection of SARS-CoV-2 by rRT-PCR. Settings and Design: A cross-sectional study was conducted among 256 paired samples (NPS and Saliva) received in the Department of Microbiology, SMS Medical College, Jaipur over a period of 2 months Methods and Material: NPS from individuals were collected in a sterile tube containing Viral Transport Medium™. Before swab collection, whole saliva was collected by spitting from the suspected patient into a sterile container. Both were stored at room temperature and transferred to the diagnostic laboratory within four hours of collection where extraction was done using Perkin Elmer chemagic extractor and rRT- PCR was performed using NIV, Pune mastermix. Results: Sensitivity, specificity, PPV, and NPV of RT-PCR for the diagnosis of COVID-19 in saliva were 84.26%, 100%, 100%, and 54.05%, respectively. The accuracy of detection of COVID-19 by saliva samples compared to the routinely used NPS samples (considered as the standard reference) for RT PCR was 86.72%. Conclusions: Our results show that saliva as a reliable sample type for SARS-CoV-2 detection.

Assessment of Infant and Young Child Feeding Practices among Mothers of Paniya Tribal Children Aged 0–23 Months in Gudalur Block, Nilgiris District

Optimal infant and young child feeding practices(IYCFPs), despite being emphasized since 2003, are yet to be met in India. This study assessed these practices and their association with various factors among mothers of children aged 0–23 months in Paniya tribes in Nilgiris, Tamil Nadu. About 89.1% of the infants below six months were timely breastfed and 77.9% of them were exclusively breastfed, respectively. Complementary food was introduced to 25% of infants aged six to eight months. About 27.8% of them received a diverse diet. About 91.7% of them were fed egg and/or flesh food and 37% of them were fed vegetables and fruits. Illiterate mothers and mothers who had a vaginal delivery fed the infant optimally. The adherence to these practices was found to decrease gradually with an increase in the infant’s age. The prevalence of IYCFP is higher in the study population compared to the corresponding indicators for the district according to the National Family Health Survey‑5.

Endoscopic Foreign Body Retrieval From The Upper Gastrointestinal Tract - A Five Year Experience

Most of the ingested foreign bodies are likely to pass without an intervention. But a few necessitate endoscopy while less than 1% require surgical intervention. Out of total 25 patients treated at our centre, 19 had impaction of foreign body in upper gastrointestinal tract with lower oesophagus being most common site of impaction followed by G–E junction & upper oesophagus. Management of foreign body relies on various factors as size, type, location of foreign body in GIT. foreign bodies impacted in oesophagus require early intervention in view of high rate of complications associated with it. Success rate of approximately 94% is documented in literature and endoscopic removal of foreign body is possible in almost all cases without significant complications.

Correlation between abdominal muscle strength and pulmonary function in subjects with low back pain

Introduction: The diaphragm is man's main respiratory muscle. The role of the abdominal muscles is seen in both quiet and forceful breathing. Abdominal muscle function could be affected in subjects with back pain. Few studies are done about the relation between expiratory muscle strength and pulmonary function. So the aim of this study was to evaluate the correlation of abdominal muscle strength with pulmonary function in patients with low back pain. Materials and methods: Sixty subjects with low back pain were included in the study. Subjects with history of acute or chronic respiratory disorders were excluded. Abdominal muscle strength was measured by curl up test and FEV1/FVC and peak expiratory flow rate (PEFR) was measured to assess pulmonary functional. Results: Using Spearman test for correlation between abdominal muscle strength and FEV1/FVC (r= - 0.27, p=0.03), and between abdominal muscle strength and PEFR (r=0.34, p=0.007) was seen. Conclusion: There was a weak correlation between abdominal muscle strength and pulmonary function in subjects of low back pain.

A comparative study of peak expiratory flow rate among healthy working women and housewives of Ahmedabad

Background: The growth of population, industry, number of vehicles and improper implementation of stringent emission standard makes the problem of air pollution worse. Automobile exhaust consists of particulate matter and gases which cause injury to the terminal bronchioles and decrease in the pulmonary compliance and vital capacity and PEFR. Aim: The present study aimed at assessing the Peak expiratory flow rate (PEFR) in healthy working women in the Ahmedabad compared to healthy housewives of same age to see the effect of short duration daily exposure of traffic air pollutants on PEFR. Materials and methods: An observational study was conducted in the community of Ahmedabad with 30 females between the ages of 30-40 years, divided into 2 groups. Group 1 comprised of 15 healthy housewives and Group 2 comprised of 15 healthy working women. Peak expiratory flow rate (PEFR) using a Wrights peak flow meter was measured in liter per minute. Three such readings were taken in standing posture. The highest of the three values obtained was treated as the peak expiratory flow rate. Results: The mean PEFR of the housewives and working women was 304±60.80litres/min and 285.33±45.01 litres/min respectively. There was no statistically significant difference between the two groups of the study (p=0.208, z= -1.259). Conclusion: There is no difference between the Peak Expiratory Flow Rate between healthy housewives and working women in Ahmedabad.

Effect of transcutaneous electrical Nerve stimulation on pain in subjects with primary dysmenorrhea

Background: Low back pain and pelvic pain are most common symptoms of Primary dysmenorrhea. Most commonly used treatments are pharmacological drugs. TENS has been found to be effective for primary dysmenorrhea according to Parisa P. Transcutaneous Electrical Nerve Stimulation (TENS) can be given in pre-menstrual days or during menstrual cycle and in both phases TENS has been shown to be effective. So this study was done to see and compare the effect of TENS in primary dysmenorrhea in both phases. Aim: The present study aimed at assessing effect of Transcutaneous Electrical Nerve Stimulation on Pain in Subjects with Primary Dysmenorrhea. Materials and methods: A quasi-experimental study was conducted in community of Ahmadabad. Non athletic females between 18-25 years of age, diagnosed with primary dysmenorrhea with regular menstrual cycle and no other medical conditions were included in this study. 30 subjects included by convenience sampling were randomly divided in 2 groups. Both groups were given 20 minutes of TENS, to back over para spinal region (L5-S1) at 100 Hz frequency with 80 µs at comfortable intensity, once daily for 3 days. One of 2 groups was treated on three premenstrual days and other group was treated at same dose during initial three days of menstrual cycle. Outcome measure used was visual analogue scale. Level of significance was kept at 5%. Results: Wilcoxon test was used to compare mean preVAS, 5.36±1.652 and postVAS, 2.85±1.711, in group A (W/z= -3.413, p= 0.001). Wilcoxon test was used to compare mean preVAS 4.61±1.187 and postVAS 2.77±1.102, in group B (W/z= -3.408, p= 0.001). Mean difference between group A and B was 2.17± 0.87.Applying Mann-Whitney U Test (U= 63.500, p=0.042) showed significant difference between groups. Patel V, Sheth M, Vyas N. Effect of transcutaneous electrical Nerve stimulation on pain in subjects with primary dysmenorrhea. IAIM, 2016; 3(6): 1-5. Page 2 Conclusion: Use of TENS for 3 days before or during menstrual cycle is effective in reducing pain. However use of TENS in premenstrual phase is more effective for reducing pain.

Recent advances in chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) was largely considered to be a disease of slow progression, standard treatment with Chlorambucil and having almost similar prognosis. With the introduction of molecular methods for understanding the disease pathophysiology in CLL there has been a remarkable change in the approach towards the disease. The variation in B-cell receptor response and immunoglobulin heavy chain variable region (IGHV) mutation, genetic aberration and defect in apoptosis and proliferation has had an impact on therapy initiation and prognosis. Early diagnosis of molecular variant is therefore necessary in CLL.

Ramipril vs captopril in mild to moderate hypertension.

Ramipril 5 mg once daily was compared to Captopril 50 mg twice daily in a randomised, double-blind, parallel group study in 60 patients with a diastolic blood pressure between 95 to 120 mmHg over a period of 2 months. Both drugs in the dose regimen used in this study exerted a similar anti-hypertensive effect at the end of 2 months of treatment resulting in a fall of supine diastolic blood pressure with Ramipril = 19.27 +/- 3.34 mmHg and Captopril = 19.15 +/- 2.63, in patients receiving the drugs without the diuretic. The mean fall in supine diastolic blood pressure 4 hours after the first dose of Ramipril was 6.5 mmHg and Captopril 8 mmHg. None of the patients developed first dose hypotension or orthostatic hypotension and there was no significant alteration of the heart rate in either group. The serum K+ levels remained unchanged in both groups of patients. Both drugs were well tolerated and there were no adverse effects observed on the liver, kidney, blood sugar or haemopoietic system. Based on the results of this study, it can be concluded that the antihypertensive efficacy of 5 mg ramipril in a once daily dose is equivalent to 50 mg captopril given twice daily. However an appreciably greater number of patients reported improvement in the "quality of life' parameters with ramipril as compared to captopril. Thus for the routine treatment of mild to moderate arterial hypertension, ramipril offers reliable antihypertensive efficacy in a once daily dose, thereby helping to improve patient compliance and making the treatment more economical.

Novel tertiary structures and stereospecificities of periplasmic binding proteins involved in active transport and chemotaxis.

Binding proteins, which are located in the periplasmic space of Gram-negative bacteria, are essential components of osmotic shock-sensitive active transport systems and Chemotaxis. Described briefly herein are the high resolution molecular structures of four binding proteins specific for (i) L-arabinose, (ii) sulphate, (iii) D-galactose, and (iv) leucine, isoleucine or valine which we have recently determined. The first three proteins contained bound substrates. Several novel substrate binding properties of the arabinose- and sulphatebinding proteins as revealed by structure refinement at 1·7 Å resolution are also presented. These results have profound significance in understanding both protein structures and substrate-protein interactions.