Spontaneous hemoperitoneum in pregnancy: report of two cases

The condition known as spontaneous hemoperitoneum in pregnancy (SHiP) is characterized by an accumulation of fluid in the abdominal cavity and a vague collection of symptoms. Specifically, intrauterine pregnancy increases the chance of death for both the mother and the fetus, making SHiP a potentially lethal illness when it coexists. Here, we discuss two cases of spontaneous hemoperitoneum in pregnancy that resulted from placenta accreta spectrum and endometriosis, and happened in the second and third trimesters, respectively.

Acinetobacter baumannii as an oro-dental pathogen: a red alert!!

Abstract Objectives This review highlights the existence and association of Acinetobacter baumannii with the oro-dental diseases, transforming this systemic pathogen into an oral pathogen. The review also hypothesizes possible reasons for the categorization of this pathogen as code blue due to its stealthy entry into the oral cavity. Methodology Study data were retrieved from various search engines reporting specifically on the association of A. baumannii in dental diseases and tray set-ups. Articles were also examined regarding obtained outcomes on A. baumannii biofilm formation, iron acquisitions, magnitude of antimicrobial resistance, and its role in the oral cancers. Results A. baumannii is associated with the oro-dental diseases and various virulence factors attribute for the establishment and progression of oro-mucosal infections. Its presence in the oral cavity is frequent in oral microbiomes, conditions of impaired host immunity, age related illnesses, and hospitalized individuals. Many sources also contribute for its prevalence in the dental health care environment and the presence of drug resistant traits is also observed. Its association with oral cancers and oral squamous cell carcinoma is also evident. Conclusions The review calls for awareness on the emergence of A. baumannii in dental clinics and for the need for educational programs to monitor and control the sudden outbreaks of such virulent and resistant traits in the dental health care settings.

A rare case of Guillain-Barré syndrome in pregnancy and its implications: a case report

Guillain barre syndrome (GBS) is a rare neurological disease in pregnancy. Incidence varies from 1.2 and 1.9 cases per 100,000 people annually. It carries high maternal risk and may complicate pregnancy. It usually presents as an acute ascending symmetrical polyneuropathy. It requires early diagnosis and multidisciplinary supportive care for its management.

A rare case of Guillain-Barré syndrome in pregnancy and its implications: a case report

Guillain barre syndrome (GBS) is a rare neurological disease in pregnancy. Incidence varies from 1.2 and 1.9 cases per 100,000 people annually. It carries high maternal risk and may complicate pregnancy. It usually presents as an acute ascending symmetrical polyneuropathy. It requires early diagnosis and multidisciplinary supportive care for its management.

Residual Effect of Integrated Nutrient Management in Kharif Maize (Zea mays L.) on Growth and Yield of Toria (Brassica campestris L. var. Toria) during Rabi Season in Odisha, India

A field experiment was carried out at Regional Research and Technology Transfer Station (OUAT), Semiliguda of Koraput district under Eastern Ghat High Land zone of Odisha in acidic soil during two consecutive rabi seasons of 2016-17 and 2017-18 to study the residual effect of integrated nutrient management in maize on succeeding toria crop. The experiment was laid out in randomized block design with three replications consisting of twelve treatments. The present investigation revealed that application of soil test based fertilizer with green leaf manure (cowpea), FYM @ 5 t ha-1 and biofertilizer (Azotobacter + Azospirillum + PSB @ 4 kg ha-1 each) to maize crop registered maximum residual effect thereby resulted significantly highest seed yield (6.3 q ha-1) and stover yield (11.1 q ha-1) of toria with a net monetary return of Rs. 7025 ha-1 and benefit cost ratio of 1.38.

Comparative Evaluation of Efficacy of Three Single File Retreatment Systems for Removal of Gutta Percha and Assessment of Root Canal Transportation - An In Vitro Study

Background: In comparison to multiple file systems, recent advancements in single file retreatment systems had reduced the working time and ease of operation for clinicians. Aim: To compare the efficacy of retreatment systems compared with hand instrumentation, by evaluating their removal efficacy, time required for retreatment and assessment of canal transportation. Methods and Material: Forty premolars were instrumented using ProTaper Gold gold files. Post instrumentation, scan was taken, obturated using warm vertical compaction technique, and stored in artificial saliva for three months and randomly divided into four groups for retreatment. Hand instrumentation (Hi), Neoniti (Nn), Mtwo R (Mt), WaveOne Gold (Wg). Post retreatment, scan was taken. Teeth were sectioned longitudinally and photographed under the stereomicroscope. Retreatment time was recorded, and canal transportation was calculated. Statistical Analysis: The results were analyzed using one?way analysis of variance (ANOVA) followed by Tukey’s post hoc test at 95% confidence level. Results: The retreatment time was significantly longer in the Hi group. Within the test groups, a significantly longer time has been taken by Wg (p < 0.05) compared to Mt and Nn. There was no difference in the canal transportation between the single file systems at 3 mm, 6 mm and 9 mm from the apex, there was statistically significant higher transportation for the Hi group at 9 mm from the apex (p < 0.05). Conclusions: All techniques were effective in removal of filling material with minimal canal transportation. Wg system was shown to increased time compared to Nn and Mt systems. Hi group was slowest with maximum canal transportation at 9 mm from the apex.

An undiagnosed case of cervical ectopic pregnancy: A case report

Cervical ectopic pregnancy very rarely presents in the second trimester. A 35-year-old female was diagnosed with a rare case of cervical pregnancy intraoperatively at 18 weeks as it was undetected prior. Emergency laparotomy was done as she started bleeding torrentially, and a hysterectomy was done as postpartum hemorrhage was noted. The patient recovered in 1 day and was discharged on day 10 without any postoperative surgical complications.

Lethologica in aging: An analytical study

Introduction: Lethologica is a phenomenon that is an early sign of aging. Lethologica refers to the inability to retrieve a specific word as a response to a visual, auditory, or tactile presentation. Need: Even though it is known that aging has a strong impact on cognitive language functions, it is not yet clear which aspect is most affected. Since naming is an important element of language functions, analysis of this aspect would aid in understanding the nature of deterioration of cognitive?linguistic functions with age. Aim: The aim is to analyze the impact of aging on naming abilities in neurotypical individuals. Methods: One hundred and fifty neurotypical individuals of 30 individuals from each group between 30 and 80 years of age, i.e., 31� years, 41� years, 51� years, 61� years, and 71� years participated in the study. A tool was developed in Malayalam language to assess confrontation naming, responsive naming, generative naming, and contextual naming. A score of 1 was given for each correct response. Results: As age advances, all the naming abilities deteriorated. The effect was most prominent in the generative naming task as it demands the most cognitive involvement. The neuronal areas governing these cognitive aspects mainly include the prefrontal cortical regions which are highly susceptible to the aging process. Responsive naming and contextual naming were least affected as it gained the advantage of crystallized intelligence. The age?related decline is more prominent after the age of 60 years. Conclusion: Naming skills, even though being a language element also have strong foundations within the cognitive domain. Hence, any age-related neurobiological alterations can impact naming functions.

An In Vitro Evaluation of the Remineralizing Efficacy of Two concentrations of Silica Doped Nanohydroxyapatite on Bleached Enamel

@#Introduction: Vital bleaching of teeth is associated with mineral loss and surface roughness leading to hypersensitivity. Aesthetic restorations are recommended after one week. Search is on for a suitable remineralizing material, which helps in instant adhesive bonding. Hence objective of the study is to evaluate the remineralizing efficacy of two concentrations of Silica doped Nanohydroxyapatite on bleached enamel. Methods: Enamel surfaces of 30 extracted human central incisors were divided into Part A: Unbleached enamel, Part B: Bleached enamel, Part C: Remineralized enamel. The samples were randomly divided into, Group 1: MI Paste Plus (Recaldent, USA), Group 2 and 3 for application of Dentin bonding agents (Tetric- n-bond, Ivoclar, Vivadent) mixed 0.2% and 0.8% Silica doped Nanohydroxyapatite (Sigma Aldrich, Bangalore, India). Post bleaching remineralizing agents were applied on part C. Surface roughness was evaluated with contact stylus profilometer and mineral content was evaluated with Energy dispersive X-Ray spectroscopy for three parts. Data were analysed using ANOVA and Post Hoc Tukey test with p ≤ 0.05. Results: Surface roughness values (Ra) were increased, and mineral loss (Ca:P) was observed after bleaching. After application of remineralizing agents, surface roughness was decreased with no significant value (p > 0.05) and a significant increase in mineral content of all three groups with a p < 0.05 was observed. Conclusion: Application of dentin bonding agent mixed with Silica doped Nanohydroxyapatite decreased surface roughness and improved remineralization of bleached enamel.

Effect of lifestyle intervention holistic approach on blood glucose levels, health-related quality of life and medical treatment cost in type 2 diabetes mellitus patients

Type 2 Diabetes Mellitus (T2DM) is a costly, lifestyle-related disorder, its management is very critical and challenging hence lifestyle intervention may a cornerstone in the reversal and management of T2DM. This study designed to assess the impact of lifestyle intervention holistic (LIH) Model on blood glucose levels (BGL), Health-Related Quality of Life (HRQOL), and medical treatment cost in T2DM patients. This prospective, quasi-experimental study was conducted among 224 T2DM patients in Delhi Diabetes Research Center (DDRC), New Delhi. The study participants were allocated into two groups-Lifestyle Intervention Counseling (LIC) group received lifestyle-based counseling through the LIH model while the Usual-care group received only standard treatment. Study outcomes were assessed at baseline, 3rd, 6th, and 12th month and data were analyzed through SPSS. Study results revealed that LIC participants had decreased in fasting blood glucose 0.26 mg dL-1(-4.37 to 4.89), blood glucose postprandial -70.16 mg dL-1(-85.15 to -55.16), HbA1C -2.82% (-5.26 to -0.37), medicine cost (p < 0.004), hospitalization cost (p < 0.011), and cost of surgery (p < 0.0005). A significant improvement also observed in HRQOL and adherence towards a holistic model in LIC group. The study concludes that lifestyle-based counseling and its adherence was cost-effective and significantly improves BGL, HRQoL, and medical treatment in T2DM patients.

Genetic alterations in Wnt family of genes and their putative association with head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) is the most frequent type of head and neck cancer that usually arises from the mucosal surfaces of several organs including nasal cavity, paranasal sinuses, oral cavity, tongue, pharynx, and larynx. The Wnt signaling pathway is a crucial mechanism for cellular maintenance and development. It regulates cell cycle progression, apoptosis, proliferation, migration, and differentiation. Dysregulation of this pathway correlates with oncogenesis in various tissues including breast, colon, pancreatic as well as head and neck cancers. The present study aims to assess the gene alterations in the Wnt family of genes so as to derive an association with HNSCC. Computational approaches have been utilized for the identification of gene alterations in the Wnt family of genes. Several databases such as cBioportal, STRING, and UALCAN were used for the purpose. The frequency of alteration was high in case of Wnt family member 11 (5%). Gene amplification, deep deletions, missense and truncating mutations were observed in HNSCC patients. There was a marked difference in the gene expression profile of WNT11 between grades as well as normal samples. The survival probability measured using the Kaplan-Meier curve also presented with a significant difference among male and female subjects experiencing a low/medium level expression. The female patients showed less survival probability when compared to the male subjects. This provides the prognostic significance of the WNT11 gene in HNSCC. Taken together, the present study provides clues on the possible association of WNT11 gene alterations with HNSCC, which has to be further validated using experimental approaches.

Genetic alterations in Wnt family of genes and their putative association with head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) is the most frequent type of head and neck cancer that usually arises from the mucosal surfaces of several organs including nasal cavity, paranasal sinuses, oral cavity, tongue, pharynx, and larynx. The Wnt signaling pathway is a crucial mechanism for cellular maintenance and development. It regulates cell cycle progression, apoptosis, proliferation, migration, and differentiation. Dysregulation of this pathway correlates with oncogenesis in various tissues including breast, colon, pancreatic as well as head and neck cancers. The present study aims to assess the gene alterations in the Wnt family of genes so as to derive an association with HNSCC. Computational approaches have been utilized for the identification of gene alterations in the Wnt family of genes. Several databases such as cBioportal, STRING, and UALCAN were used for the purpose. The frequency of alteration was high in case of Wnt family member 11 (5%). Gene amplification, deep deletions, missense and truncating mutations were observed in HNSCC patients. There was a marked difference in the gene expression profile of WNT11 between grades as well as normal samples. The survival probability measured using the Kaplan-Meier curve also presented with a significant difference among male and female subjects experiencing a low/medium level expression. The female patients showed less survival probability when compared to the male subjects. This provides the prognostic significance of the WNT11 gene in HNSCC. Taken together, the present study provides clues on the possible association of WNT11 gene alterations with HNSCC, which has to be further validated using experimental approaches.

Targeting the Secreted Aspartic Proteinase (SAP-1) Associated with Virulence in C. albicans by C. cassia Bio-compounds: A Computational Approach

Evaluation of the drug ligand interactions between the C. cassia bio-compounds with the SAP-1 in C. albicans to explore the inhibitory medicinal potential of C. cassia bio-compounds by a computational approach is performed in the present investigation. Antimicrobial assay was done using agar well diffusion method with the crude aqueous and ethanolic extracts of the dried barks of C. cassia against C. albicans. 2D & 3D structures of the active bio-compounds of C. cassia were optimized and the 3D structure of SAP-1 was retrieved from the PDB data bank. In-silico inhibitory potential of the selected C. cassia biocompounds against SAP-1 was done by Auto Dock 2.0 and was visualized with Accelrys discovery studio visualizing tool with the assessment of the molecular properties of the ligands against SAP-1 by molinspiration calculations and further assessment for their drug likeliness. In-vitro analysis showed a promising anti-fungal activity of C. cassia extracts against C. albicans. Cinnamoyl E-acetate and Eugenyl acetate seem to possess promising inhibitory effect to target SAP-1 with a least binding energy of –5.33 and -5.21 Kcal/mol with four hydrogen bonds respectively. Molinspiration assessments showed zero violations for all the C. cassia compounds with the TPSA scores of <140 Å towards the best oral bioavailability. The findings of the study emphasize that cinnamaldehyde, cinnamoyal acetate and eugenol from C. cassia seem to possess a promising inhibitory effect against SAP-1 of C. albicans suggesting the medicinal value of the spice against SAP-1

Frequency of Chromosomally Encoded gyrA and parC Genetic Determinants of Fluoroquinolone Resistance in A. baumannii

Fluoroquinolones are administered as routine drugs of choice for treating complicated urinary tract infections caused by multidrug resistant Acinetobacter baumannii strains. It is now a world-wide issue that gyr and par induced quinolone resistance as one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence of quinolone resistance and to characterize the gyrA and parC producing strains of A. baumannii. Genomic DNA from 50 fluoroquinolone resistant A. baumannii were screened for gyrA and parC by PCR for the genetic relatedness with fluoroquinolone resistance, with sequencing of the representative strains. All the strains were positive for gyrA(100%) and 82% (n=41)for parC. Presence of parC was observed in 56.09% (n=23) ciprofloxacin resistant A. baumannii with 43.90% (n=18) in levofloxacin resistant A baumannii. The findings of the present study showed the prevalence of fluoroquinolone resistance among A. baumannii in urinary tract infections and the frequency of gyrA and parC in inducing the resistance

Frequency of Adhesive Virulence Factor fimH among the Clinical Isolates of Acinetobacter baumannii in India

The objective of the study was to detect the presence of fimH geneamong the drug resistanst strains of Acinetobacter baumannii.fimH gene was found to be associated with a catch bond mechanism which led to better evolution of biofilm formation. Since there are not many studies done with this gene it would be a timely investigation and this study mainly aims in molecular characterizationof fimHgene among clinical isolates of A.baumannii. Semi quantitative bio adherent assay was done by the multidrug resistant strains of A.baumannii to find the formation of biofilm. The DNA was extracted with the help of kit and PCR was performed for amplification. Pearson correlation analysis was done to find the existing correlation between the fimHgene and MDR strains of A.baumanniiwith significant p-value of (<0.05). From the screened 73 genomes of MDR A.baumannii 6.8% showed positive amplicons for the fimH gene which were related to biofilm and porin formation (Fig. 1). Correlation of its existence was high in beta lactamase (100%), cephems (100%), folate (100%) resistant strains, followed by aminoglycosides (80%), carbapenems (60%) and fluoroquinolones (60%) and efflux pumps (20%). In Spite of various measures undertaken to prevent the disease, the prevalence of the pathogen is multiplying. The current study recorded the presence of fimHgene (6.8%) among the clinical isolates of A.baumannii. This gene can be used as a target to develop new drugs and vaccines to combat the menace of A.baumannii infection

An in silico Analysis of Protein Targeted by Glycyrrhizin in Common Dental Pathogens

Glycyrrhizin is a phytocompound which is derived from Glycyrrhiza glabra. It is used in treating the upper respiratory tract disease like cough, bronchitis, laryngitis, sore throat, etc. It has various medicinal uses in rheumatism, peptic ulcers, asthma, allergies, and inflammation. Glycyrrhizin has been reported to possess antibacterial, antiviral, antioxidant, anti inflammatory properties. In view of the above facts, the present in silicostudy was designed to demonstrate the molecular mechanism underlying the antimicrobial activity of glycyrrhizin against common dental pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Treponema denticola, Enterococcus faecalisandTannerella forsythia.The STITCH tool was used to identify the drug-protein interaction. The functional class of the protein was deduced using VICMPred, followed by the identification of epitopes on the virulence factors using BepiPred. Further, the subcellular location of the virulence factors were also studied using PSORTb software. The computational analysis performed identified several virulence factors viz., short chain dehydrogenase/reductase family oxidoreductase of Treponema denticola and D-mannonate oxidoreductase of Tannerella forsythiawhich were found to interact with glycyrrhizin. Interestingly, phosphopyruvate hydratase was found to be the protein present in all the five genera was shown to interact with glycyrrhizin. Thus the present study reveals the target proteins on the dental pathogens which were shown to interact with glycyrrhizin. Furthermore,experimental validation of the resultsare warranted to provide substantial details on the anti-microbial activity of glycyrrhizin against common dental pathogens

Deciphering the Genetic Aberrations in DNA Damage Response Genes and Their Possible Association with HNSCC

Head and neck squamous cell carcinoma (HNSCC) includes carcinomas in the oral cavity, pharynx and larynx. It is considered as the sixth most common form of cancer in the world. Severalstudies have confirmed that smoking and alcohol consumption are the major risk factors for HNSCC. DNA damage response genes play an important role in the maintenance of the genome. Defects in cell cycle checkpoint and DNA repair mechanisms, such asmutation or abnormalities, may lead to the wide spectrum of human diseases. The present study employs databases and computational tools to identify the genetic abnormalities associated with DNA damage related genes which might have a direct or indirect association with HNSCC. The demographic details of HNSCC patients was obtained from The Cancer Gene Atlas (TCGA, Firehose Legacy) dataset hosted by the cBioportal database. The oncoprint data analysis revealed the highest frequency of gene alteration in the ATR gene (15%), followed by ATM, BRCA2and CHEK2(5%). Other genes showed less than 5% alteration. The gene expression profile of ATRgene revealed its differential expression pattern in different grades of tumor relative to normal samples. The survival curve analysis using Kaplan-Meier method revealed that a high level expression of the ATR gene leads to poor survival rate in the female HNSCC patients when compared to males. Thus the present study has identified gross and single nucleotide variants in the ATRgene which could have a putative role in the development of tumor. Further experimental research is required to confirm this association

Effect of Two Different Mouth Rinses on S. mutans Counts in Subjects Undergoing Orthodontic Treatment – A Pilot Study

The study is thus aimed to assess and compare the efficacy of Herbostra oil pulling mouthwash with Chlorhexidinemouthwash in reducing plaque accumulation around orthodontic brackets. A total of 20 patients were considered in this study randomly assigned into Group I (experimental group -Herbostra oil pulling mouthwash) and Group II (reference group-0.2% Chlorhexidine mouthwash). The plaque index scores were recorded in each individual at baseline (pre) and after 3 weeks (post).Dental plaque samples were collected around the orthodontic brackets at the cervical region of maxillary upper molars and lower incisors bycotton swabbing method and evaluated for the presence of microflora. Paired sample t-test for Streptococcus mutanscount showed that statistically significant difference only within the group II (p=0.000) (Chlorhexidine group) and there was no significantdifference within the group I (p=0.103) (Herbostra group). Paired sample t-test for plaque index score shows statistically significant difference within the groups (0.000).Independent t test showed statistically significant difference in the levels ofStreptococcus mutanscount after 3 weeks between the two groups (p=0.000) with the mean values of (2.230±0.5056), (1.080±0.3458) in group I and group II respectively. From this study we concluded that, even though there was a reduction in plaque scores and S. mutanscount with Herbostra oil pulling mouthwash but it was not as effective as Chlorhexidine mouth rinse

Genetic Aberrations in Caspase Family of Genes and Their Possible Association with HNSCC

The cell suicide pathway of apoptosis is a necessary event in the life of multicellular organisms. It is involved in many biological processes ranging from development to the immune response. Over expression of interleukin-1β-converting enzyme (later renamed caspase-1) was shown to be sufficient to induce apoptosis in mammalian cells. The present study aims to assess the gene alterations in the Caspase family of cytochromes so as to derive an association with HNSCC. Earlier eleven genes were found in the human genome to encode 11 human caspases, caspase-1 to caspase-10 and caspase-14, which is now populated to 13, whereas 10 genes were found in the mouse genome to encode 10 murine caspases including caspase-1, 2, 3, 6, 7, 8, 9, 11, 12 and 14 Caspases share a number of features distinguishable from other proteases. The analysis follows an observational study design, employing several computational tools to identify and predict the possible outcomes of gene alterations identified in HNSCC patients. cBioportal server was used to identify the gene alterations which was further analyzed using tools such as PROVEAN, I-Mutant and gnomAD. Several reported polymorphic variants were also identified. The pathogenicity and protein stability of gene alterations documented in the present study were identified at standard biological conditions. Further experimental studies would provide concrete evidence on the association of the observed genetic abnormalities with HNSCC especially in individuals exposed to habitual carcinogens

Correlation between serum ferritin and gall stones

Background: The incidence of gall stones is in increasing trend. The old axiom that a typical gall stone sufferer is a fat, fertile, female of fifty, is only partially true, as the disease is found in women soon after their first delivery, in underweight and thin people. So, while searching for other parameters, iron deficiency was found to be a new parameter of interest in the aetiology of gall stones.7Methods: 50 cases of cholelithiasis and 40 cases of anaemia with low serum ferritin levels from September 2017 to August 2019 was studied. Serum iron was estimated by carbonyl metallo-immunoassay method. Serum cholesterol was estimated by the CHOD-POD Enzymatic method. Biliary cholesterol was estimated after extraction of biliary lipids from bile from the gallbladder specimen of the patients by the method of Folch et al which was followed by the procedure similar to the analysis of serum cholesterol by CHOD-POD enzymatic method. Fischer’s chi square exact test was used as statistical method.Results: It was observed that 70% of the group A study group with cholelithiasis had normal serum ferritin levels and 30% had low serum ferritin levels. It was observed that 95% had normal sonographic findings and 5% had cholelithiasis with normal ferritin levels in group B.Conclusions: In our study low serum ferritin levels with cholelithiasis was associated with raised bile cholesterol levels and so it can be concluded that low serum ferritin level is causing biliary stasis and hence leading to increase in the incidence of cholelithiasis.