Identification of various Candida species isolated from patients with vulvovaginal candidiasis attending a tertiary care hospital in North India

Background: Vulvovaginal Candidiasis (VVC) is a condition diagnosed in a large proportion of women presenting with complaints of abnormal vaginal discharge. The risk of VVC is high in women with diabetes mellitus, pregnancy, using oral contraceptives or broad-spectrum antibiotics and those having Human Immunodeficiency Virus infection.Objective of the present study was to identify the various species of Candida isolated from patients with Vulvovaginal Candidiasis.Methods: A cross-sectional study was done from January to June 2018. A total of 69 clinically suspected VVC cases were included in the study whose high vaginal swabs were collected and subjected to direct microscopy and cultured on Sabouraud Dextrose Agar (SDA). Creamy white pigmented colonies on SDA were confirmed as Candida by doing Gram抯 staining. Speciation of positive cultures was confirmed by conventional methods like Corn Meal agar culture, Germ tube test (GTT), Candida CHROM Agar Medium (CAM), sugar assimilation and fermentation test.Results: Out of 69 clinically suspected VVC cases included in the study, only 14 cultures were positive for Candida species. All the 14 isolates were found to be Non-albicans Candida (NAC). Most common species isolated were Candida glabrata 7(50%), followed by Candida tropicalis 3(21.4%), Candida lusitaniae 3(21.4%), and Candida parapsilosis 1 (7.1%).Conclusions: Candida albicans was known to be the most common causative agent of VVC as it was isolated in 90% cases. However, this study showed that all isolates from VVC were Non-albicans Candida. Therefore, species identification should be done in all microbiology laboratories for accurate diagnosis of VVC.

Comparative evaluation of the effect of various irrigants and dry canal on electronic apex locators in locating simulated root perforations: an in vitro study / Avaliação comparativa do efeito de vários irrigantes e canal seco em localizadores apicais eletrônicos na localização de perfurações radiculares simuladas: um estudo in vitro

Objective: this study aimed to evaluate the effects of irrigants and dry canal on the accuracy of electronic apex locator (EAL) in locating simulated root perforations. Material and methods: twenty singlerooted, mandibular premolars were decoronated at CEJ, and the contents were removed with a barbed broach. The canals were instrumented up to a size of 15 K-file. The roots were artificially perforated at 4 mm from the anatomic apex. The actual length (AL) up to the perforation site was determined. The electronic length (EL) of perforations was obtained by Root ZX mini and iRoot in the dry canal and in the presence of 5.2% NaOCl, SmearOff, and 0.9% sodium chloride using a size 20 K-file. The differences between the EL and AL of the perforations were calculated. Statistical analyses using Friedman and Wilcoxon signed-rank tests were used to analyse the data with the level of significance set at p <0.05. Results: there were significant differences in different canal conditions with both Root ZX mini and i Root. Measurements in dry canals were significantly longer for both apex locators (p <0.05). Measurements with NaOCl were significantly shorter for both apex locators (p < 0.05). Both apex locators produced significantly accurate values for Saline and Smear OFF (p < 0.05). Conclusions: in this study, both Root ZX mini and i Root were affected by different canal conditions. The most accurate measurements were seen in the presence of saline and SmearOFF. (AU)

Objetivo: este estudo teve como objetivo avaliar os efeitos de irrigantes e canal seco na precisão do localizador apical eletrônico (EAL) em localizar perfurações radiculares simuladas. Material e métodos: vinte pré-molares inferiores unirradiculares tiveram suas coroas removidas na altura da JEC e o tecido pulpar removido com um extirpa nervos. Os canais foram instrumentados até a largura de uma lima k 15. As raízes foram perfuradas artificialmente a 4 mm do ápice anatômico. O comprimento real (AL) até o local da perfuração foi determinado. O comprimento eletrônico (EL) das perfurações foi obtido pelo Root ZX mini e iRoot no canal seco e na presença de 5,2% de NaOCl, SmearOff e 0,9% de cloreto de sódio usando uma lima K tamanho 20. As diferenças entre o EL e o AL das perfurações foram calculadas. Análises estatísticas, utilizando os testes de sinais por postos de Friedman e Wilcoxon, foram realizadas para analisar os dados com o nível de significância estabelecido em p < 0,05. Resultados: houve diferenças significativas nas diferentes condições do canal, tanto no Root ZX mini quanto no i Root. As medidas em canais secos foram significativamente maiores nos dois localizadores apicais (p < 0,05). As medidas com NaOCl foram significativamente mais curtas para os dois localizadores apicais (p<0,05). Ambos os localizadores apicais produziram valores significativamente precisos para Saline e Smear OFF (p < 0,05). Conclusões: neste estudo, tanto o Root ZX mini quanto o i Root foram afetados por diferentes condições do canal. As medidas mais precisa foram observadas na presença de soro fisiológico e SmearOFF. (AU)

Analysis of chickpea gene co-expression networks and pathways during heavy metal stress

Pseudomonas putida is widely used as a biocontrol agent, however, mechanisms by which it initiates the plants’ defenseresponse remains obscure. To gain an insight into the molecular changes that occur in plants upon plant growth-promotingrhizobacteria colonization, root transcriptome analysis by using a microarray was performed in rice using P. putida RRF3 (arice rhizosphere isolate). Data analysis revealed a differential regulation of 61 transcripts (48 h post-treatment), of which,majority corresponded to defense response, cell wall modification and secondary metabolism. Seven genes encodingsalicylic acid (SA) responsive pathogenesis-related proteins were up-regulated significantly (fold change ranges from 1 to4), which suggests that RRF3 has a profound impact on a SA-mediated defense signaling mechanism in rice. Investigationsperformed at later stages of RRF3 colonization by real-time polymerase chain reaction and high-performance liquidchromatography (HPLC) analysis confirmed the above results, demonstrating RRF3 as a potent biocontrol agent. Further,the impact of RRF3 colonization on root exudation, in particular, exudation of SA was investigated by HPLC. However,analysis revealed RRF3 to have a negative impact on root exudation of SA. Overall, this study shows that P. putida RRF3immunizes the rice plants by re-organizing the root transcriptome to stimulate plant defense responses (‘priming’), andsimultaneously protects itself from the primed plants by altering the rhizosphere chemical constituents.

The concept of Clinical Supervision at workplace

Clinical supervision is a professional relationship and is much crucial and demanding at clinical workplaces. Effective clinical supervision provides direction to ethical practice in clinical setting which benefits the organization and clinician. This article outlines evidence-based real-world advices related to reflective practice, effective feedback and evaluation of supervision which are collected from various literatures that will empower health professionals to efficiently and effectively perform clinical supervision at workplaces.

Rapid chairside disinfection and surface alterations of gutta-percha cones with 1% Alexidine, 2% Chlorhexidine and 525% sodium hypochlorite against Enterococcus faecalis – An in vitro comparative study

Background: During endodontic intervention, major efforts are made to eliminate bacteria from the infected root canal system. Along these lines, keeping up the chain of asepsis is critical to anticipate sterile root canal system. Currently, gutta-percha (GP) is the most commonly used root canal core filling material. Objective: The purpose of this study was to compare the efficacy of 1% Alexidine, 2% Chlorhexidine, 5.25% Sodium Hypochlorite and saline against E.faecalis in disinfecting gutta-percha cones and to analyze the surface topography of gutta-percha cones after the rapid chemical disinfection procedure. Materials and methods: Gutta-percha cones were contaminated with E.faecalis and immersed in 1% ALX, 2% CHX, 5.25% NaOCl and 0.9% saline for 30 and 60 sec. The disinfected cones were immersed in test tubes and incubated at 37°C for 72 hours. Bacterial growth was evaluated by the presence of turbidity in the broth. Results were confirmed by sub culturing the bacterial colony. For topographical examination, the gutta-percha cones were analyzed under Scanning electron microscopy (SEM). Data was statistically analyzed using one way ANOVA. Swati Srivastava. Rapid chairside disinfection and surface alterations of gutta-percha cones with 1% Alexidine, 2% Chlorhexidine and 5.25% sodium hypochlorite against Enterococcus faecalis - An in vitro comparative study. IAIM, 2019; 6(10): 1-7. Page 2 Results: ALX and NaOCl did not show growth of the tested microorganism for any observed period. CHX completely eliminated E. faecalis after 60 sec. Saline showed no antimicrobial activity. The results of SEM showed some deposits after disinfection procedure by NaOCl and CHX test solutions used. Conclusion: ALX and NaOCl were found to be the most efficient disinfecting agent in eliminating E.faecalis at different time intervals tested. The topographical examination revealed that ALX and CHX left little residue than as compared to NaOCl after 1 minute.

Antibiofilm efficacy of 01% Octenidine, SmearOFF, 1% Alexidine and 525% Sodium Hypochlorite against E faecalis biofilm formed on tooth substrate

Context: The present study was aimed to explore new irrigating solutions, which would probably be as effective as sodium hypochlorite. Aims: The aim of this in vitro study was to evaluate the antibacterial effectiveness of 0.1% octenidine, SmearOFF, 1% alexidine and 5.25% sodium hypochlorite against E. faecalis biofilm formed on tooth substrate. Materials and methods: Eighty extracted human teeth were decoronated, biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis strain (ATCC 29212) to establish 3-week-old biofilm. At the end of the 3rd week all groups were treated for 10 minutes with 3 ml of test solutions. Samples exposed to 5.25% sodium hypochlorite (NaOCl) were used as control. All the samples were evaluated for E. faecalis growth and number of colony forming units. Statistical analysis was performed by using one-way analysis of variance (ANOVA) to measure the mean values. The intergroup comparison was done by Tukey HSD post hoc test (p<0.05). Results: Maximum inhibition was observed with 0.1% OCT (group 1) followed by NaOCl (group 4) and ALX (group 3). SmearOFF (group 2) showed the least inhibitory effect. NaOCl (group 4) and ALX (group 3) showed no statistically significant difference (p>0.05), whereas all the other inter‐ group differences were statistically significant (p<0.05). Conclusions: 0.1% OCT showed significantly higher antibiofilm effects. No significant differences Swati Srivastava. Antibiofilm efficacy of 0.1% Octenidine, SmearOFF, 1% Alexidine and 5.25% Sodium Hypochlorite against E. faecalis biofilm formed on tooth substrate. IAIM, 2019; 6(11): 1-8. Page 2 were observed between 1% ALX and 5.25% NaOCl. SmearOFF showed significantly lower antibiofilm effects (p<0.05)

Comparative analysis of two electronic apex locators in working length determination using stainless steel and nickel titanium hand files in permanent teeth with simulated apical root resorption – An in vitro study

Background: Exact estimation of root canal length is imperative for the achievement of root canal treatment. Working length (WL) has been defined as „„the distance from a coronal reference point to the point at which canal preparation and obturation should terminate‟‟. Aim: The aim of this study was to evaluate and compare the accuracy of two generations of apex locators in teeth with simulated apical root resorption using stainless steel and nickel titanium hand files. Materials and methods: Eighty single-rooted, maxillary anterior teeth were selected. The extracted teeth were soaked in 5% sodium hypochlorite for 6 hours and then in sterile 0.9% saline until use. An oblique cut of 45 degree was made from facial to palatal wall. Access cavities were prepared and the Haneen Al Otheem, Swati Srivastava, Shahad Alogayyel, Maymonah Abdurhman Alghadouni. Comparative analysis of two electronic apex locators in working length determination using stainless steel and nickel titanium hand files in permanent teeth with simulated apical root resorption - An in vitro study. IAIM, 2018; 5(5): 45-50. Page 46 Visual Working Length (VWL) was measured. The samples were then embedded in alginate and the electronic measurements were recorded using stainless steel and nickel titanium hand files. Statistical analysis was done by Analysis of variance (ANOVA) followed by Tukey HSD test were used for statistical analysis. Results: There was no statistically significant difference seen with DentaPort ZX and i-Root along with the use of stainless steel and NiTi hand files. Conclusion: In the present study, DentaPort ZX and i-Root apex locators showed similar efficacy in determining working length with the use of both stainless steel and NiTi hand files under present study conditions

Current and Future Perspectives for Dentin-pulp Tissue Engineering – An update

The ball has been set rolling with the isolation of dental pulp stem cells in 2000 for tissue engineering to generate dental pulp. The rationale lies in the possibility of further root development and reinforcement of dentinal walls by deposition of hard tissues which are usually a clinical problem of interest for dentists. In such scenarios, mechanical preparation of the root canal may further weaken the thin dentinal walls and increase the risk of tooth fracture. On the other hand, regenerative endodontic procedures (REPs) could be a better solution. Many exciting areas of endodontic research are emerging and contributing to an increasing momentum of activity in this discipline including regenerative procedures in permanent teeth. This review is an attempt to update on the current trends.

Universal access to medicines: evidence from Rajasthan, India

India has outlined its commitment to achieving universal health coverage and several states in India are rolling out strategies to support this aim. In 2011, Rajasthan implemented an ambitious universal access to medicines programme based on a centralized procurement and decentralized distribution model. In terms of the three dimensions of universal health coverage, the scheme has made significant positive strides within a short period of implementation. The key objectives of this paper are to assess the likely implications of providing universal access to essential medicines in Rajasthan, which has a population of 70 million. Primary field-level data were obtained from 112 public health-care facilities using multistage random sampling. National Sample Survey Organization data and health system data were also analysed. The per capita health expenditure during the pre-reform period was estimated to be `5.7 and is now close to `50. Availability of essential medicines was encouraging and utilization of public facilities had increased. With additional per capita annual investment of `43, the scheme has brought about several improvements in the delivery of essential services and increased utilization of public facilities in the state and, as a result, enhanced efficiency of the system. Although there was an attempt to convert the scheme into a targeted one with the change in government, strong resistance from the civil society resulted in such efforts being defeated and the universality of the scheme has been retained.

Irreversible Thyrotoxic Dilated Cardiomyopathy: Case Reports and Review of Literature.

Irreversible dilated cardiomyopathy due to thyrotoxicosis is a rare clinical entity. We report two cases, one who presented with congestive cardiac failure and other presented with severe left ventricular dysfunction and atrial fibrillation. Both cases were diagnosed as dilated cardiomyopathy with severe left ventricular dysfunction (ejection fraction <30%) due to thyrotoxicosis. Inspite of vigorous medical therapy, there was only symptomatic improvement. Restoration of euthyroid levels did not revert the cardiomyopathy but led to definite clinical improvement.