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We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.
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Nasal Polyposis (NP) is not simply mucosa oedema, but rather grape shaped, smooth, soft, freely mobile mucosal swellings that are often visible on anterior rhinoscopy. Polyps arise from the lateral wall of nose. NP may be present without clinically significant sinus disease and vice versa. In Ayurveda, polyposis can be understood with Nasa Arsha. Modern management includes antibiotic, systemic and topical corticosteroids, decongestants and surgery. And lot of chances for recurrence after surgery especially in Ethmoidal polyps. In Ayurveda, various treatment modalities have been proposed for the treatment of Arsha as Shastra karma (operative procedure), Kshara karma (applying some alkaline drugs), Agni karma (cauterization) and Bhaishaja (conservative/medical treatment). The reported case revealed that B/L ethmoidal polyps are high recurrence rate after surgery and can be managed with Ayurvedic medicine to give sustained relief from symptoms.
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A cross-sectional study was conducted to predict time in therapeutic range (TTR) using clinical history, examination, and socioeconomic data. Study included warfarin-receiving patients from outpatient-clinic. In 203 patients studied, mean warfarin start-dose was 2.55 mg/day and maintenance-dose/week was 30.79 mg. Body mass index (BMI) (p ¼ 0.03), warfarin maintenance dose/day (p ¼ 0.02), and comorbidity presence (p ¼ 0.04) were significantly associated with TTR. Occupation (p ¼ 0.53), income (p ¼ 0.83), education (p ¼ 0.55), and socioeconomic score (p ¼ 0.73) showed non-significant association with TTR. A TTR predicting nomogram was built from clinical history and examination findings.
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BACKGROUND Hand sanitizer (HS) has been increasingly used during the Covid-19 pandemic. We compared the telephonic calls received by the National Poisons Information Centre (NPIC), New Delhi, India, related to its unsafe exposure and inappropriate use during the lockdown and prelockdown periods. METHODS We analysed and compared telephonic call records of 3 months of pre-lockdown and 3 months of the lockdown and HS-related calls in different age groups and zones during these periods. RESULTS The centre received 4000 calls; of these 1583 (40%) were related to household products of which only 63 (4%) were related to HS. There was an 8-fold increase in the number of calls received at the NPIC during the lockdown compared to the pre-lockdown period seeking medical attention following unsafe exposure or inappropriate use of HS. More calls were received from the south and north zones and, in the majority of these cases, HS was ingested accidentally. In some cases, HS was ingested intentionally for suicide during the lockdown. CONCLUSIONS Our study shows that unsafe exposure of HS is common under conditions of stress as seen during the lockdown period of the Covid-19 pandemic. It should be kept out of reach of small children. Further, providing psychological help and counselling to older age groups under conditions of stress are important issues of concern.
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Introduction: Developmental anomalies of the tooth areroutinely encountered by paediatric dental professionalsand may present with esthetic and or functional problems.The reported literature has shown a wide variation in theprevalence of these conditions across the globe. Study aimedto assess the prevalence of various developmental anomaliesof tooth in a sample of Indian paediatric populationMaterial and Methods: A total of 3000 children in the agegroup of 6 to 13 years visiting the OPD of pedodontics andpreventive dentistry of BIDSH, Patna were examined clinicalyand radiologicaly when required and the data was tabulated.Descriptive statistics methods were used using SPSS.Results: Prevalence of dental anomalies was 4.86%.in thestudy population and Enamel hypoplasia, hypodontia andtalon's cusp were the most frequently encountered anomalies.The presence of developmental anomalies was a statisticalysignificant finding.Conclusion: Early detection of developmental anomaliesmay prevent future complications and eliminate the need forcomplex therapeutic intervention.
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Introduction: Cross infection control practice is essential toprotect both the patient and the dentist from blood and salivaborne infectious agents, including hepatitis B, C and HIV bydirect contact with contaminated instruments, fabrics and alsoby aerosols. Study aimed to assess the awareness regardingpractices related to infection control among dental student inPatna city.Material and Methods: This was a cross sectional studywhich was carried out in one of the dental teaching institutionsin Patna City. The subjects comprised of 180 dental students.The study subjects were third year; final year and Internstudents which were selected using convenience samplingtechnique. Their knowledge pertaining to infection controlpractices were assessed using a pretested self administeredquestionnaire. The questionnaire collected information onsocio demographic characteristics, and knowledge regardinginfection control practices. Data were analyzed using SPSSsoftware v20. Frequency distribution analysis and Chi sq testswere performed. p value<0.05 was considered statisticallysignificant.Results: The dental student had adequate knowledgeregarding personal protective measures and cross infectioncontrol but improvement was needed in areas of biomedicalwaste handling and disposal.Conclusion: A dental surgeon must take adequate protectionto prevent spread of harmful disease to self and other patients.Consequently inter-appointment disinfection of clinic surfacesis required to reduce the cross infection hazard.
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Introduction: The aim of mandibular fracture treatment isto restore the pre-injury anatomic form and function, withparticular care to establish the occlusion. Of the varioustreatment modalities available, Champys miniplate fixation hasbecome the most widely used technique. The 3-dimensional(3D) plating for mandibular fracture treatment is relativelynew. This study was conducted to compare efficacy, stabilityand rigidity of 3-dimensional plates with that of 2mm titaniumminiplates in the surgical management of anterior mandibularfractures.Material and Methods: The study was conducted on 70patients with anterior mandbibular fractures (Symphysis andParasymphysis region). Patients were randomly divided intotwo groups, Group I (n=35) in which the patients underwentfixation by miniplates (2 nos) while in Group II (n=35), 3Dplates were used for fixation. The patients preoperative, intraoperative and post-operative clinical and radiological findingswere recorded in a proforma and were subjected to statisticalanalysis. Fisher’s Exact Test was used to compare the dataobtained from group I and group II patients.Results: Out of 70 patients, 77.14% corresponded to the agegroup of 15-30 years and 82.85% were males. Road trafficaccident (80) % was the leading cause of fracture. The timerequired to adapt and fix the miniplates was slightly more than3-D plates and results were statistically significant. Skeletaland occlusal stability was maintained in both group.Conclusion: There is no major difference in terms of treatmentoutcome in both systems, and both are equally effective inmandibular fracture treatment.
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Bhasma occupy the highest attention and have got a very unique place because of their small doses, tastelessness, quick action, easy absorption and also their prolonged shelf life, wide range of therapeutic efficacy and better rejuvenating (Rasayana) effects. Metals and minerals are integral part of therapeutics in Ayurveda and Tamra is one of such metals which if properly processed and detoxified is useful in many diseases. But if not processed properly it shows many ill effects called Ashtmaha Dosha. In the present study Tamra Bhasma was prepared by using Tamra Patra. This study included procedures like Shodhana, Marana, Amrutikarana as per classical texts. 380gm of raw Tamra Patra were taken. Samanya and Vishesha Shodhana were done as per reference of Rasa Ratna Samuchya. After complete Shodhana, total 350gm Shudha Tamra was obtained. Loss in weight after Shodhana may be due to loss in impurities present in raw Tamra. Total 21 Puta were given in the electrical muffle furnace to prepare Tamra Bhasma. Specific temperature pattern was adopted for Puta in the electrical muffle furnace. Total 300gm of Tamra Bhasma was obtained. After each Puta there was significant loss in weight of Tamra may be due to loss in hardness and impurities. Marana was followed by Amrutikarana and net weight of Tamra Bhasma obtained was 330gm. 30gm weight gain may be due to the organic material used for the Amrutikarana process. Color of Bhasma became black after Amrutikarana.
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BACKGROUND:- New Delhi metallo-β-lactamase 1 (NDM-1) enzyme leads to multidrug resistance and has been detected from bacteria in many countries. The study was done To detect bacteria carrying blaNDM-1 gene from intensive care unit (ICU) patients and correlate the change with increasing duration of ICU stay. METHODS:- Blood and urine samples were collected from 140 patients thrice- 0-2 days, 3-7 days and 7 days of ICU admission. All bacterial isolates resistant to meropenem were evaluated for Metallo-β-lactamase (MBL) production. blaNDM-1 gene was detected using Real Time PCR from the MBLproducers. RESULT:- Overall, 458 samples (229 each) of blood and urine were collected and 75 gram negative bacteria were isolated. From these, 46.7% (35/75) strains were found to be carbapenem resistant and blaNDM-1 gene was detected in 17.3% (13/75). CONCLUSION:- High prevalence of bacteria carrying blaNDM-1 gene was seen in ICU patients increasing the burden on healthcare.
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Aims: The study aims to compare the efficacy of the anti-inflammatory effect of 0.1% dexamethasone sodium and 0.05%difluprednate eye drops after small incision cataract surgery (SICS).Study Design: A prospective, randomized, and clinical study was conducted on patients.Place and Duration of Study: This study was conducted in the Department of Ophthalmology, VCGS Government MedicalCollege, Srinagar, Uttarakhand, between December 2017 and November 2018.Materials and Methods: This study included two groups of 40 patients each (a total of 80 patients). 40 patients in GroupA wererandomly started on 0.1% dexamethasone eye drops postoperatively and another 40 patients in Group B were randomly started0.05% difluprednate eye drops postoperatively. Response to the therapy was recorded on day 1, 7, and 40 on the parametersof post-operative anterior chamber reaction and post-operative visual acuity, and the results were compared.Results: All results were correlated with final visual outcome, and post-operative flare, which showed 0.05% difluprednate, isclinically and statistically more effective in early post-operative period than 0.1% dexamethasone sodium to control inflammationin uneventful SICS.Conclusions: After the comparison of the data in both the groups, the patients started on 0.05% difluprednate eye dropspostoperatively showed better response to therapy (P < 0.0001) with respect to the parameters of best-corrected visual acuityand post-operative flare as compared to the patients started on 0.1% dexamethasone sodium eye drop therapy postoperatively,indicating that 0.05% difluprednate eye drops have a better anti-inflammatory effect.
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Background: Lung cancer is one of the leading causes of cancer related mortality accounting for 1.61million new cases per year with 1.38 million deaths annually worldwide. In NSCLC, concurrent Chemoradiotherapy is usually employed in stage IIIA and IIIB when performance status of the patients is reasonable and chemotherapy alone in stage IV, if the performance status of the patients is adequate. In SCLC, combination chemotherapy is given in limited stage disease as well as in extensive stage if the performance status of the patients is adequate. The objective is to study the chemotherapeutic treatment modalities in the treatment of lung carcinoma.Methods: The present cross-sectional prospective study was conducted in the Postgraduate Department of Medicine and Department of Pharmacology in collaboration with the Department of Oncology, Government Medical College, Jammu for a period of one year from November 2012 to October 2013. A total of 80 patients having histopathological documentation of lung cancer, registered under regional cancer centre (RCC) and referred from various departments of the institute and from other hospitals of the region were included in the study. The treatment for each patient was then decided on the basis of performance status, stage and clinical condition. The treatment modalities used were in the form of radiation therapy, surgery and chemotherapy. In the chemotherapy, the details regarding the type of chemotherapeutic regimen employed in particular type of lung cancer variant, their doses, number of cycles given and the duration for which these chemotherapeutic drugs were administered was noted down.Results: Out of 80 patients in the present study, 68 (85%) were males and 12 (15%) were females. Majority of the patients fall in the age group of 46 to 75 years (81.25%). Staging of the patients with non-small cell lung cancer showed that majority of the patients were in stage IV (31; 45.59%) of the disease. Eighteen (26.46%) patients were in stage III and 10 (14.71%) in stage II and 9 (13.24%) patients in stage I. In patients with small cell lung cancer, 4 (33.33%) patients were in limited stage and 8 (66.67%) patients. Various treatment modalities were employed with maximum number of patients receiving combined treatment (48.75%), followed by chemotherapy alone (22.25%) and radiotherapy alone (11.25%). Among patients who received combination therapy, various combinations of surgery, radiotherapy and chemotherapy were used but maximum number of patients i.e. 37 out of 39 (94.87%) used combination of chemotherapy and radiotherapy.Conclusions: Most of the patients presented in an advanced stage III and IV (75.9%) and the main treatment modality used in this study was combination therapy of chemotherapy and radiotherapy in (48.75%) followed by chemotherapy alone (22.25%). In the chemotherapy, cisplatin-based combination regimens were most commonly used regimens. Thus, more of such studies need to be done so as to make patients as well as the health professionals more aware of the risk factors and the effective treatment modalities associated with the disease.
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Keratin is a durable, fibrous protein which is mainly present in higher vertebrates (mammals, birds and reptiles) and humans epithelial cells. Food industry especially the meat market, slaughter house and wool industry produces million of tons of keratin containing biomass. These industries are constantly growing and the major producers include USA, Brazil and China, account for more than 40 million tons per year. These proteins constitute keratin by-products have from 15 to 18% nitrogen, 2-5% sulphur, 3.20% mineral elements and 1.27% fat and 90% of proteins. The organic waste rich in keratin can be utilized as a natural source using chemical and mechanical methods. The natural keratin obtained by biomass does not contain any harmful chemical and can be used directly to produce variety of cosmetics, creams, shampoos, hair conditioners and biomedical products. The natural protein is more compatible to use or apply on human skin and hairs. The monomeric units of natural keratin can penetrate in the skin and hair cuticle and able to nourish the skin without any side effects. In the present review various strategies for the purification and separation of keratin from the organic waste have been described and use of natural keratin in cosmetics and pharmaceutical industry has also been explored.
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Aims: HIV and AIDS is a major public health challenge and India alone accounts for 2.5 million of the Asian sub continent 2009 estimated 4.89 million people were living with HIV/AIDS. The oral manifestations are often among the first symptoms of HIV/AIDS and thus can be useful in early detection of the disease. Therefore it is professional and ethical responsibility of the dentist to provide treatment to such patients. Therefore, the present study was carried out to assess the knowledge and attitude of dentist and Dental auxiliary staff in a private Dental College. Study Design: Descriptive cross sectional study. Methods: A descriptive cross sectional study was carried out for one month among the dentists and dental auxiliary staff. Information, thus obtained from above questionnaire was entered in MS excel spreadsheet and the percentage was calculated. Results: Fifteen (30%) of the dentists had excellent knowledge regarding modes of transmission of HIV/AIDS while 18 (36%) of nurses had extremely poor knowledge. Thirty (60%) of the dentists had a positive attitude towards HIV/AIDS patients while 25 (50%) of the dental nursing staff and 9 (45%) of the Lab Technicians had negative attitudes towards them. Recommendation: Regular continuous medical examination of dental health workers is advised for the up gradation of their knowledge and building of strong positive attitudes towards HIV/AID patients.