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Background: There is no oncologic basis for the extirpation of the submandibular gland (SMG) in early oral squamous cell carcinomas (OSCC) unless the SMG is truly infiltrated by the tumor. The study aimed at assessing the true involvement of SMG in OSCC and to determine whether the gland extirpation in all cases is justified. Methods: This study prospectively evaluated the pathological involvement of SMG by OSCC in 281 patients, who were diagnosed with OSCC and underwent wide local excision of the primary tumor with simultaneous neck dissection. Results: Among 281 patients, 29 (10%) cases underwent bilateral neck dissection. A total of 310 SMG were evaluated. Involvement of SMG was seen in 5 (1.6%) cases. SMG metastases from Level Ib were seen in 3 (0.9%) of cases, whereas 0.6% showed direct SMG infiltration from the primary tumor. The advanced floor of mouth and lower alveolus cases had a higher tendency to infiltrate SMG. In none of the cases, bilateral or contralateral SMG was involved. Conclusion: The findings of this study show that the extirpation of SMG in all cases is truly irrational. Preserving the SMG is justified in early OSCC with no nodal metastasis. However, SMG preservation is case dependent and is an individual preference. Further studies are required to assess the locoregional control rate and salivary flow rate in postradiotherapy cases where SMG is preserved.
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Background: surgical site infections (SSIs) are recognized as a common surgical complication occurring in about 3% of all surgical procedures and in upto 20% of patients undergoing emergency intraabdominal procedures. Aims: To determine the incidence of SSIs in emergency laparotomies done for perforation peritonitis and the organisms involved and their sensitivity pattern in superficial SSI. The objective of the study was to determine the effect of planned intra operative intervention [antibiotic lavage with III generation cephalosporin e.g. ceftriaxone 1 gm and metronidazole 100 ml (5 mg per ml)] on superficial surgical site infection in emergency laparotomies done for perforation peritonitis.Methods: This prospective randomized case controlled study was carried out in P. G. Department of Surgery, S. R. N. Hospital associated with M. L. N. Medical College, Allahabad, from September 2018 to August 2019 after approval from the ethical committee and after obtaining written and informed consent either from patient or their guardian. Patients were divided into two groups viz. control group receiving the normal saline lavage and case group receiving the antibiotic lavage (III generation cephalosporins i.e., ceftriaxone (1 gm in 1000 ml NS) and metronidazole- 5 mg/ml (100 ml in 500 ml NS).Results: There is almost 50% incidence of SSI in emergency laparotomy done for perforation peritonitis. The most common organism involved in superficial SSI in present study was gut flora (E. coli) followed by normal skin colonizer (Staph. aureus).Conclusions: Intraperitoneal antibiotic lavage has a significant role in reducing the rate of SSI especially in gastroduodenal perforations.
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Background: Traumatic avulsion injury poses severe risk as the overlying protective covering is lost and the raw tissue is exposed to the environment. Avulsion injuries involving the scalp are even more complicated to treat because of significant cosmetic concern involved. Aim of the study was to find a better solution than the existing method, we conducted a prospective study involving 13 patients with isolated traumatic scalp avulsion injury.Methods: This prospective study was conducted in Motilal Nehru Medical College and associated Swaroop Rani Nehru Hospital, Prayagraj, after taking written and informed consents from the patients, between June 2017 and June 2019.These were divided into two groups (A and B) based on whether the underlying periosteum was intact or not.Results: Patients with intact periosteum (Group A) underwent primary thin thickness skin grafting within a few hours of their admission while the other group (Group B) was treated with a traditional conservative approach. We compared the results of both the groups and found that Group A patients not only had satisfactory graft uptake (≥85 TBSA) but also had significant decreased risk of infection, lesser hospital stay, overall decreased healthcare cost, better cosmoses and early return to routine activity.Conclusions: For the surgeon, this single step procedure is safe and technically easy. Thus this approach was found to be superior than the current traditional approach.
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Background: Dental erosion is a complex pathology of multifactorial etiology in which chemical, biological and behavioural factors influence the erosive process. The etiology has been related to the regular use of products with low endogenous pH and high acidity including liquid medicaments. Aim: To investigate the endogenous erosive potential of commonly used pediatric liquid medicaments. Methods: Endogenous pH and titratable acidity of eight commonly used pediatric liquid medicaments were measured using a digital pHmeter. 54 exfoliated or extracted primary and permanent teeth without any carious lesion, maintained in pediatric liquid medicaments were observed under SEM after 1 minute and 10 minutes of time intervals. Results: Most of the medicaments showed etched prism pattern on primary teeth and crater formation whereas etched prism pattern was seen on all permanent enamel surfaces. Conclusion: Evidence of dental erosion was observed on both primary and permanent enamel.
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Acetohydroxamic acid is a pharmaceutically active metal chelating agent which has various applications in the field of medicine. Current study focuses on the enzymatic synthesis of acetohydroxamic acid catalysed by thermophilic amidase from Bacillus smithii IIIMB2907. Bacterial cells were grown in 7 L fermenter for amidase production and effect of pH, temperature and substrate concentration for the biotransformation of acetamide to acetohydroxamic acid was studied. Batch reaction was also successfully optimized at bench scale with the recovery of ≈ 81% acetohydroxamic acid (purified).
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Torsion of an epiploic appendix is a little or difficult to diagnose initially is a rare surgical entity which is capable of mimicking different pathologies. Less than 200 cases of torsion of appendices epiploicae have been reported in literature. Till date, none in my knowledge has been in postpartum period. We report the first case in gynecological literature of a normal delivery being complicated by this rare entity. We present our experience in a 38-year-old pregnant female patient.
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Background: Non communicable diseases like obesity and diabetes are increasing worldwide, healthcare physicians are also not immune to this morbidity. The objective of this study is to find the prevalence of obesity and diabetes among healthcare physicians.Methods: The study was done at a tertiary care hospital in Pondicherry. All adult health care physicians of both sexes working in the hospital and giving informed consent to participate in the study were included. Pregnant physicians and those who are not willing to give written consent for participation in the study were excluded from the study. The study was done as a cross sectional study using a pretested standardized questionnaire. Age, sex, demographic data, height, weight, diet habits, family history of diabetes, exercise, medication in all the health care physicians were recorded and studied.Results: Of the total one hundred health care physicians, there were 50 male and 50 female physicians. Among the female physicians, there were 17 of age 41 to 50 years. There were 27 male and 34 female physicians with body mass index of 25 to 29.9. Six males and four females had diabetes mellitus. Six physicians were doing regular exercise. Four physicians were taking both oral anti hyperglycemic drugs and insulin.Conclusions: Doctors are aware and educated part of the society but there is high prevalence of obesity and diabetes mellitus among healthcare physicians. Doctor have to be motivated to take care of their health and to prevent lifestyle disease complication. Further regular screening for diabetes and obesity has to be done for doctors.
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Mastalgia or Breast pain, is a common symptom which women may experience at different time in their lives. Many women worry that pain in their breasts is caused by breast cancer. Breast cancer rarely causes breast pain, however a thorough history and clinical examination by clinician appreciates it. Methods: A descriptive study was carried out in department of general surgery, Govt. Medical College in Guru Nanak Dev Hospital, Amritsar. there is 500 cases of mastalgia collected in Guru Nanak Dev Hospital and diagnosis was made on basis of clinical history and local examination of both breasts. All the quadrants of the breast were examined. Treatment of each patient was done as per the diagnosis. Results: Among 500 Patients 449 patients had cyclical mastalgia were as 51 patients has non cyclical mastalgia. Conclusion: In our study 89.8% of the patients experienced cyclical mastalgia and 10.2% non cyclical mastalgia.
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Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of multimodal treatment approach in cases of stage 3 technically inoperable breast cancer. Its effect on clinical response was studied. Methods: This prospective study was carried out in department of general surgery, government Medical College, Amritsar, Punjab. Main part of multimodal approach is neoadjuvant chemotherapy, so in collaboration with department of radiotherapy, relevant data was collected. 25 cases of locally advanced breast carcinoma were studied. These patients were studied on treatment with FAC regimen (as neoadjuvant chemotherapy), then underwent surgical excision (MRM) followed by chemotherapy, radiotherapy and hormonal therapy wherever indicated, and response was assessed. Results: Initially assessment of lump was done after 3 cycle of chemotherapy. 2 patients (8%) have reduction <50%, 22 patients (88%) have reduction in size which ranges between 51- 75% of the initial, remaining 1 patient (4%) has reduction >75% of the initial. Thus making them operable therefore after this they all had undergone modified radical mastectomy. During follow up period no lump was detected clinically, ultrasonographically or radiologically. There was no any loco-regional recurrence in any case. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in down staging the tumor enabling definitive surgery with less morbidity.
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Background: Otitis Media or infection of Middle Ear is a broadterm that encompasses all the inflammation of the middle earwithout any specific etiology or pathogenesis. The presentstudy was conducted with the aim to determine the incidenceof dental caries amongst the subjects with middle ear infection.Materials and Methods: Controls were subjects who didn’thad dental caries of ear infection. Children with any othermedical condition were excluded from the study. Children withinfection of middle ear were categorized according to age andgender. Group I subjects were having middle ear infection andGroup II were controls. Centrifugation was done for 10 minsand the deposits obtained were used for culturing. All the datathus obtained was arranged in a tabulated form and analyzedusing SPSS software. Probability value of less than 0.05 wasconsidered as significant.Results: The mean age of the subjects was 10.67+/-3.62years. The mean colony forming units in Group I was 5.7+/-9.65 and in Group II was 1.6+/-2.78. There were 5 children inGroup I and 30 children in Group II with very good health ofteeth. Good oral health was seen amongst 5 subjects in GroupI and 20 subjects in Group II. Majority of subjects in Group I(40) had average oral health. There was a significant differencein the Groups amongst oral health amongst the groups.Conclusion: There was an increased risk of early childhoodcaries amongst children with middle ear infection.
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Abstract Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce "Know-Do gap" between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.
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Humanos , Masculino , Femenino , Estudiantes de Odontología , Conocimientos, Actitudes y Práctica en Salud , Eliminación de Residuos Sanitarios , Residuos Dentales , Administración de Residuos , Estudios Transversales/métodos , Encuestas y Cuestionarios , Estadísticas no Paramétricas , India/epidemiologíaRESUMEN
Background: The mandibular foramen, is the emerging point of the neurovascular bundle which makes it fundamental for performing anaesthetic techniques for desensitization of the mandible in oral surgery interventions. The knowledge of position of mandibular foramen is neccessary while anaesthetizing palate during periodontal procedures, tooth extractions and maxillofacial surgeries. Objective: The present study was carried out to identify the position and location of mandibular foramen in relation to the angle of mandible (gonial angle) in adult human mandibles of Indian origin . Materials and Methods: The study was conducted on 300 adult human dry skulls of Indian Population. Angle of mandible, Distance of mandibular foramen from angle of mandible and Angle of mandibular foramen with the base of mandible were measured. Measurements were done with Steel measuring tape and Mylometer. The data was Statistically analysed. Results and Conclusion: The Mean value of the angle of mandible (Gonial Angle) was 121.870 ± 6.220. The Mean value of the distance of mandibular foramen from angle of mandible was 22.78± 4.05 mm. The angle of mandibular foramen was Mean ± standard deviation of 82.240± 6.870. The morphometric correlation of the parameters analyzed in the mandibles showed a statistically significant Pearson correlation. Regression line was also derived.
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The present research article reveals the pharmacognostic study of Trigonella foenum graecum. Standardization in medicinal plants is complicated by the complex chemical makeup of plants and the difficulty in obtaining the pure materials needed to compare and measure the amounts of any one particular compound in a plant mixture. In this, study standardization parameters are performed to ensure the quality, safety and efficacy of given herbal drug according to Indian Ayurveda pharmacopoeia.
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A modified simple, selective, rapid, precise reversed phase high performance liquid chromatography method has been developed and validated for the simultaneous estimation of ketorolac and sparfloxacin. The separation was made in a Hypersil-Keystone C-18 column using a methanol: water (60:40, v/v) (pH 3.1) as mobile phase at 308 nm. The mobile-phase flow rate and the sample volume injected were 0.9 ml/min and 20 μl, respectively. Retention time of sparfloxacin and ketorolac was found to be 3.181 and 4.473 minutes respectively. The correlation coefficient of both drugs was found to be 0.999. The accuracy of ketorolac was found to be 99.82% - 100.55% whereas for sparfloxacin, it was 99.76% - 99.89%. Over all % RSD was found to be less than 2%. The method was validated according to ICH guidelines with respect to linearity, accuracy, precision, robustness, specificity, etc. The developed method can be used for routine analysis of ketorolac and sparfloxacin in their pharmaceutical dosage forms.
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Immunomodulatory effect of ethanolic extract (50%) of M. oleifera leaves (MOE) has been studied in normal and immunosuppressed mice models. Different doses of MOE i.e. 125, 250 and 500 mg/kg body weight of mice were administered orally for 15 days. Cyclophosphamide at a dose of 30 mg / kg body weight was administered orally for the next 3 days. On day 16 and 19, hematological parameters like white blood cell (WBC) count, red blood cell (RBC) count, haemoglobin level (Hb), percent neutrophils and organ weight were recorded. Effect of MOE on phagocytic activity of mice macrophages was determined by carbon clearance test. MOE showed significant dose dependent increase in WBC, percent neutrophils, weight of thymus and spleen along with phagocytic index in normal and immunosuppressed mice. The results indicate that MOE significantly reduced cyclophosphamide induced immunosuppression by stimulating both cellular and humoral immunity.
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The latex agglutination test (KAtex), direct agglutination test (DAT), and the rK39 immuno-chromatographic strip test (dipstick test) were evaluated for their role in the diagnosis and prognosis of visceral leishmaniasis (kala-azar) in India. Sera and urine samples from 455 subjects—150 confirmed visceral leishmaniasis cases, 160 endemic controls, 100 non-endemic controls, and 45 other febrile diseases—were included in the study. The sensitivity of the KAtex, DAT, and rK39 strip test was 87% [95% confidence interval (CI) 80-96], 93.3% (95% CI 88-100), and 98% (95% CI 93-100) respectively. The specificity of these tests was 98% (95% CI 93-100), 93% (95% CI 87-100), and 89% (95% CI 82-97) for the KAtex, DAT, and rK39 strip test respectively. Fifty cases were followed up and subjected to the KAtex, DAT, and rK39 strip test after 30 days of successful treatment. The DAT and rK39 strip test showed positive results in all the 50 cases whereas the KAtex showed no positive reaction in any case. Based on the results, it is concluded that the sensitivity and specificity of the DAT and rK39 strip test are comparable but the greater convenience of use of the strip test makes it a better tool for the diagnosis of visceral leishmaniasis in the peripheral areas of endemic regions whereas the sensitivity of the KAtex needs to be improved to promote its use as a first-line diagnostic test in the field-setting. It may be used for the prognosis of the disease as antigen becomes undetectable in urine after 30 days of the completion of the treatment. Alternatively, it can be used as an adjunct with rK39 for sero-epidemiological surveys.