Maxillofacial Fractures in Pondicherry, India: An Eight?Year Single Centre Retrospective Study

Background: The purpose of the present study was to analyze the etiology, incidence, pattern, and treatment modalities of patients with maxillofacial fractures treated at the Department of Dentistry of a medical college in Pondicherry during the period between June 2011 and June 2019. Materials and Methods: A retrospective epidemiological study of 277 patients treated for maxillofacial fractures between June 2011 and June 2019 was performed. Data regarding age, gender, etiology, site of the fracture, time of injury, presence of associated injuries, treatment modalities, and complications were recorded. Results: A total of 491 maxillofacial fractures were seen in 277 patients. These were 261 males (94.2%) and 16 females (5.8%) with a male to female ratio of 16.3:1. Most of the patients 79.8% were in the age group of 11 to 40 years. Most common cause of injury was Road Traffic Collisions (RTCs; 62.1%), followed by fall (20.2%), assault (14.4%) and others (3.3%). Fractures of the mandible (52.3%) and zygomatic complex (18.9%) were the most common maxillofacial fractures reported in our study. 196 patients sustained associated injuries with a prevalence of soft tissue injury (61.2%). Majority of fractures were treated with open reduction and internal fixation (ORIF; 71.9%) of patients followed by closed reduction (17.7%) and observation only (10.4%). Postoperative complications were presented in 16.8% of the patients in the study. Conclusion: RTC is the commonest cause of maxillofacial injury with a male predominance in our study. Mandibular and zygomatic complex fractures were the most common. ORIF remains the preferred method of treatment.

Biodecolorization of azo dye mixture (Remazol Brilliant Violet 5R and Reactive Red 120) by indigenous bacterial consortium isolated from dye contaminated soil

Aims@#The present study investigated the biodegradation and removal of dye mixture (Remazol Brilliant Violet 5R and Reactive Red 120) using a new bacterial consortium isolated from dye-contaminated soil.@*Methodology and results@#Among the total 15 isolates screened, the two most efficient bacterial species (SS07 and SS09) were selected and identified as Enterobacter cloacae (MT573884) and Achromobacter pulmonis (MT573885). The removal efficiency of dye mixture by E. cloacae and A. pulmonis at an initial concentration of 100 mg/L was 82.78 and 84.96%, discretely. The bacterial consortium was developed using selected isolates and the optimum conditions for removing dyes were investigated. The maximum decolorization efficiency was achieved at pH 7; 35 °C; dye concentration, 100 mg/L; and initial inoculum concentration, 0.5 mL with mannitol and ammonium sulfate as carbon and nitrogen sources. The maximum removal efficiency of 91.3 ± 3.35% was achieved at the optimal conditions after 72 h of incubation.@*Conclusion, significance and impact of study@#Decolorization of azo dyestuff by the developed microbial consortia conforms to the zero-order reaction kinetics model. Consortia of E. cloacae and A. pulmonis was established as an effective decolorizer for the Remazol Brilliant violet 5R and Reactive Red 120 dye mixture with >90% color removal.

A study on haloperidol and risperidone induced metabolic derangements in patients with newly diagnosed schizophrenia

Background: The occurrence of metabolic abnormalities in schizophrenic patients has been increased with the rampant use of second-generation antipsychotics. The aim and objective of this study is to compare the metabolic derangements induced by a typical antipsychotic: haloperidol and an atypical antipsychotic, risperidone in patients with newly diagnosed schizophrenia in a tertiary care hospital.Methods: Out of 60 newly diagnosed schizophrenic patients, 30 patients received tablet haloperidol and the remaining 30 patients received tablet risperidone orally. The anthropometric measurements like height, weight, waist circumference was measured and blood investigations like fasting blood glucose level and fasting lipid profile were taken at baseline and at the end of 3 and 6 months of drug therapy. The metabolic derangements induced by the two antipsychotics were compared and analyzed at end of 3rd and 6th month using SPSS software version 16.Results: At the end of 6th month statistically significant differences (p<0.05) were observed in weight, waist circumference, fasting blood sugar, fasting triglyceride and high-density lipoprotein level between the haloperidol and risperidone group on following the International Diabetic Federation (IDF) criteria of metabolic syndrome. Risperidone caused metabolic abnormalities in 13.3%, 4 patients whereas none of the patients in haloperidol group developed metabolic syndrome.Conclusions: Hence it is concluded that the atypical antipsychotic risperidone has been associated with an increased risk of causing metabolic abnormalities than the typical antipsychotic haloperidol. Regular and periodic monitoring of the anthropometric and metabolic parameters in schizophrenic patients on antipsychotics especially the atypical antipsychotics is mandatory to prevent further complications.

A Study of Clinical Profile of Headache in Epilepsy Patients

Background: Headache is the most common symptom encountered in neurology outpatient department (OPD). One-fifth of patients in neurology clinics present with headache. Headache was long been found to be associated with epilepsy, especially migraine both chronic neurologic disorders share possible clinical interrelationships. Studying their association is necessary as identification of clinical subgroups vulnerable to develop to both disorders can be made possible in the future. Aims and Objectives: The objective of the study was to analyze the characteristic features of various types of headaches in epilepsy patients and their causal association. Materials and Methods: A total of 100 epilepsy patients with headache were recruited from the OPD of the neurology department in a tertiary care center and interviewed regarding the characteristic features of headache through a questionnaire. Results: Out of our study population, female outweighs the male (53, 47). Out of all, interictal was more prevalent (57%), followed by post-ictal (48%), pre-ictal (22%), and intra-ictal (0%) among epilepsy patients. Migraine was found to be the most common type of headache in all subgroups of headaches in epilepsy patients (pre-ictal – 77% of migraine, postictal – 81% of migraine, and interictal – 61% of migraine). Associated characters of headaches such as photophobia (42%) and their prevalence are also studied. Conclusions: Stronger association between migraine and headache is validated, and the strongest associated with migraine in postictal headache is highlighted (81%). This can strengthen the theories proposed so far such as the frequent triggering of headache by a seizure. Further research on common etiologic or pathophysiological processes to these associations can lead to a common therapeutic strategy and prevention of morbidity in patients.

Flap Reconstruction Options And Outcomes For Carcinoma Lip - Our Experience

Aim The aim of this study was to review and describe techniques for the reconstruction of defects after resection of lip squamous cell carcinoma with emphasis on cosmetic and functional outcome. Patients and Methods A review of techniques and selected case presentations using different flap designs for the reconstruction of perioral defects following resection of squamous cell carcinoma in 25 patients out of 128 cases of head and neck malignancies was performed in period of 2017-2018 in Regional Cancer Centre,Govt Coimbatore medical college hospital. The Abbe estlander ,Nasolabial flap,Karapandzic flaps5 deltopectoral ,PMMF flap were used for lip defects. Results All reconstructed patients had acceptable functional results and healed without complication. Seven tumors were located in upper lip, Eight tumors in lower lip and Ten tumors in the angle of mouth. The lip defects were easily closed with the Karapandzic flaps, Abbe estlander ,nasolabial ,deltopectoral flap, forehead flap. While cosmesis was acceptable in all cases, the commissure was the most difficult region to reconstruct with a esthetic appearance and functional outcome. There were no flap failures.Oral competence was noted to be better in Karapandzic flaps, Abbe estlander flap,Nasolabial flap than deltopectoral/ forehead flap. Conclusion The Karapandzic,nasolabial and Abbe estlander flaps provide a easy and useful method to reconstruct perioral defects following resection for oral cancer.

Development and Administration of Chronic Suppurative Otitis Media Questionnaire-12 (COMQ-12) and Chronic Otitis Media Outcome Test-15 (COMOT-15) in Kannada

Abstract Introduction It is essential to determine the quality of life among individuals with chronic suppurative otitis media (CSOM). However, there is limited literature on healthrelated quality of life measurements in Kannada-speaking individuals with CSOM. Objectives The present study attempted to translate and validate Chronic Suppurative Otitis Media Questionnaire-12 (COMQ-12) and Chronic Otitis Media Outcome Test- 15 (COMOT-15) in Kannada. Method The English questionnaires were translated and back-translated, and they were later verified for content validity. The developed questionnaires were then administered to 100 individuals with CSOM for further validation. Results The results of the study showed that the translated questionnaires have good internal consistency for measuring quality of life among individuals with CSOM. The study also showed that Kannada-speaking individuals with CSOM show significant impairment in their health-related quality of life measures. Conclusions The impairments weremore related to ear symptoms and psychological issues. However, test-retest reliability of the developed questionnaire and its further validation are essential. Thus, these questionnaires attempt to understand the problems of the individuals with CSOM from the patients' perspective and help clinicians provide the appropriate management.

Comparison of postoperative analgesia with 0.8 mg and 1.6 mg intrathecal nalbuphine; a randomized controlled trial

Background and Objectives: Intrathecal opioids provide an easy and efficient method of prolonging postoperative analgesia due to its action on the spinal opioid receptors. Nalbuphine is a mixed opioid agonist - antagonist which has better side effect profile than morphine. It is easily available in India without a need for narcotics license. The optimal dose of nalbuphine as an adjuvant to intrathecal bupivacaine is not known, as the availability of other narcotics, e.g. fentanyl, sufentanyl etc., in the West has diminished the need to use, and thus to research partial opioids like nalbuphine. The aim of our study was to compare the duration of postoperative analgesia with 0.8 mg and 1.6 mg of nalbuphine when used as an additive with 0.5% hyperbaric bupivacaine in patients undergoing lower abdominal and lower limb surgeries

Methodology: 66 patients undergoing various lower abdominal and lower limb surgeries were randomized into 2 groups and received either 0.8 mg or 1.6 mg intrathecal nalbuphine with 3.2 ml of 0.5% hyperbaric bupivacaine. The duration of postoperative analgesia, hemodynamic stability and incidence of adverse effects were noted

Results: The mean duration of postoperative analgesia in 0.8 mg and 1.6 mg group were 247 +/- 12 and 239 +/- 10 min respectively [p = 0.007]. The incidence of bradycardia was more in 1.6 mg group but did not reach statistical significance. The inability of the higher dose to achieve longer analgesia might be due to a ceiling effect and anti-analgesic actions of nalbuphine

Conclusion: A dose of 0.8mg of nalbuphine as an intrathecal adjuvant seems to be optimal for providing prolonged post operative analgesia with minimal side effects

An Overview of Fluoroquinolones.

The fluoroquinolones are broad-spectrum bactericidal agents inhibiting DNA synthesis. They are active against gram positive and gram negative organisms like P. aeruginosa, Mycoplasma, Chlamydia, Staphylococci and a few of the Streptococci. They are useful in the treatment of pneumonia, urinary tract infections, bacterial diarrhea, and skin and soft tissue infections. The use of quinolones began with its first generation that consisted of nalidixic acid. From that time, a large number of newer fluoroquinolones having a variety of structures and a broader spectrum of activity have been developed forming the five generations. The more number of fluoroquinolones developed and its widespread usage is attributed to its high bioavailability and tissue penetration. Moreover, the development of resistance to the most commonly used antibiotics has led to the need for alternatives. The various derivatives of fluoroquinolone have varying levels of activity depending on the various groups attached at different positions. Generating a derivative with increased activity will help to reduce the Minimum Inhibitory Concentration (MIC), thereby reducing the possibility of developing resistance to it. This paper gives an overview of fluoroquinolones, their mechanism of action, their uses, resistance development and their adverse effects.

Intra-Aneurysmal Glue Embolisation of a Giant Pulmonary Artery Pseudoaneurysm after Left Upper Lobe Lobectomy: Case Report

We report a case of pseudoaneurysm of the anterior ascending branch of the left pulmonary artery, following a left upper lobectomy for pulmonary aspergillosis, for which we have done an endovascular treatment. This is the first case where complete pseudoaneurysm occlusion was accomplished after a transcatheter intra-aneurysmal N-butyl 2-cyanoacrylate (glue) injection.

Evaluation studies of antimicrobial activity on the leaf extracts of Achyranthes aspera Linn

Disc diffusion method was employed to determine the effect of methanol, acetone and chloroform extracts of the dried leaves of Achyranthes aspera against Staphylococcus aureus, Streptococcus fecalis, Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. The chloroform extract shown to exhibit maximum potency against E. coli and Pseudomonas aeruginosa. Methanol extract showed moderate potency against E. coli and Candida species. Acetone extract was less effective against most of the species used except Streptococcus fecalis. Among all the extracts tested, none of the extract was found to be effective against gram positive S. aureus and gram negative Proteus vulgaris