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Background@#The influence of smoking on nonsyndromic clefts has been a topic of research for many years. However, few studies have investigated the effect of smoking on causing clefts in different gene pools. @*Methods@#A meta-analysis was conducted of case-control studies related to smoking. Keywords such as “clefts,” “cleft lip,” “cleft palate,” “orofacial cleft,” and “smoking” were used to search the MEDLINE, Embase, and Cochrane databases. @*Results@#In total, 51 articles were reviewed. The RevMan software was utilized for the analysis, and the Mantel-Haenszel method was employed to pool the odds ratios (ORs) and 95% confidence intervals. Although the overall OR, a measure of the association between exposure and outcome, was higher for smokers than for non-smokers, this association was significantly stronger in individuals from Asia and South America (1.73), and lowest in Europe (1.31). Among active and passive smokers in Asia, the OR was approximately 0.93, indicating an equivalent impact from both types of smoking. @*Conclusion@#This analysis indirectly suggests that restriction measures targeting both active and passive smoking are crucial in Asia.
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Objective: To describe the findings of short Hammersmith Neonatal Neurologic examination (HNNE) in preterm small for gestational age (SGA) and appropriate for gestational age (AGA) infants at term equivalent age (TEA) and to correlate it with the global score of Hammersmith Infant Neurologic Examination (HINE) performed at 4-6 months of corrected age. Methods: This prospective cohort study was conducted at the high risk follow-up clinic of our center. 52 preterm infants born <35 weeks gestation were examined using HNNE at TEA and followedup till 4-6 months of corrected age to estimate HINE. Results: 20 infants (38.5%) had warning signs and 9 (17.3%) had abnormal signs on short HNNE. 12 (37.5%) AGA infants and 6 (30%) SGA infants had global score <65 at mean corrected age (SD) of 4.3 (0.7) weeks and 4.5 (0.8) weeks, respectively. Very preterm, birth weight <1000 g and SGA was significantly associated with global scores <65. Conclusion: Early identification of warning signs among SGA infants using Short HNNE screening at TEA can be useful to initiate early intervention. There was no statistically significant difference in global scores by HINE among AGA and SGA infants in early infancy.
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Introduction: Healthy initiation of life is essential in establishing the foundations of a healthy nation. Traditional care practices at home and in the community inevitably affect maternal and young infant health. The objective is to study young infant nurturing practices and factors influencing these practices in rural Agra. Material and Methods: This is a community-based cross-sectional study that was conducted in rural Agra, using a multi-stage random sampling method. A total of 240 mothers were interviewed using a structured questionnaire. Results: The study results showed that 65.0% of the mothers were following either satisfactory (58.3%) or good (6.7%) nurturing practices. Of the three components of nurturing, the majority (61.6%) of mothers had satisfactory (46.6%) or good (15%) breastfeeding practices, most (86.6%) were giving satisfactory (56.6%) or good (30%) thermal care and only 53.33% were following satisfactory (42.2%) or good (10.8%) hygiene practice. The practice regarding newborn care was found to have a significant association with the place of birth, type of delivery and educational status of the mothers and fathers. Conclusion: This study outcome shows the need for a better awareness and educational outreach program coupled with an effective health-care delivery system to improve young infant nurturing practices in achieving better health.
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Introduction:Cardiac venous system is an important system for various cardiac interventional procedures such as cardiac catheterization. Various veins like right marginal vein, small cardiac vein (SCV), posterior vein of the left ventricle, left marginal vein, oblique vein of Marshall drain into coronary sinus. While anterior cardiac veins drain right ventricular wall directly into right atrium. Materials and Methods: An observational cross‑sectional study was conducted on thirty cadaveric hearts during a 2‑year period in Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Anatomy Department. The length, diameter of SCV, left marginal vein, posterior vein of the left ventricle, right marginal vein, and oblique vein of Marshall were taken. Results: The study reveals the length of SCV as 28.12 ± 22.87 mm. The length of right marginal vein and posterior vein of the left ventricle is having a significant correlation with age. The length of oblique vein of Marshall is lower in males as compared to females. A number of ACVs were significantly related to weight of cadaver in males. Conclusions: The present study provides data of cardiac veins for various cardiac interventional procedures.
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Overdosing on medications can be unintentional or deliberate. Acetaminophen (APAP) is a widely used over-the-counter analgesic and antipyretic drug. APAP overdose can induce spleen and cardiotoxicity apart from hepatotoxicity. Bonduc nut is well-known for its medicinal and therapeutic properties. More scientific data is necessary to be therapeutically relevant. This study examined the effects of Bonduc nut extract (BNE) on APAP-induced spleen and cardiotoxicity in Wistar albino rats. The rats were divided into five groups of six rats each. In vitro assays were carried out to analyze antioxidant activity and free radical scavenging activity in aqueous, ethanol, and methanol solvents in Bonduc nut powder. Total phenolic content, DPPH, catalase, and peroxidase activity were used to test antioxidant activity. The rats were euthanized after the study period to examine antioxidant parameters such as superoxide dismutase, catalase, reduced glutathione, and glutathione peroxidase, as well as lipid peroxidation and histopathology of the spleen and heart tissues. Results suggest that compared to other solvents aqueous has better Invitro antioxidant ability and the same extract significantly increased the antioxidant and reduced lipid peroxidation followed by restoring the tissue morphology in APAP-induced spleen and cardiotoxicity. The outcome of the study revealed that aqueous BNE has a significant protective efficacy against APAP-induced spleen and cardiotoxicity in Wistar albino rats.
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Background: World Health Organization (WHO) declared Coronavirus disease of 2019 (COVID-19) as a pandemic in March 2020. The disease showed a wide range of severity ranging from being asymptomatic to causing high mortality. Various laboratory parameters were investigated, which could be used as biomarkers to determine the severity of the disease. The objective of the present study was to analyze hematological, coagulation, and immunological markers in mild, moderate, severe, and critical cases of COVID-19 patients and their relation to the outcome. Materials and methods: A retrospective observational study of 1,000 COVID-19-positive hospitalized patients was conducted. Cases were classified into mild, moderate, severe, and critical groups using WHO guidelines. Along with demographic data, hematological, coagulation, and inflammatory parameters were analyzed and correlated with severity and survival. Result: Out of the total 1,000 cases, there were 510 cases in mild, 232 in moderate, 201 in severe, and 57 in the critical category. Increase in total white blood cell count, absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and inflammatory parameters like C-reactive protein (CRP), serum ferritin, lactate dehydrogenase (LDH), interleukin-6 (IL-6), and decrease in absolute lymphocyte count (ALC) showed significant difference with disease severity and survival. Conclusion: These are important biomarkers to predict the prognosis and outcome of COVID-19 patients. As these markers are easily available, they could be used to categorize the patients at an early stage for optimum management.
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Purpose: To develop a viable in vivo chorioallantoic membrane (CAM) model to study the growth and invasion of patient?derived retinoblastoma (RB) and choroidal melanoma (CM) xenografts (PDXs). The study utilizes primary tumor samples instead of cancer cell lines, which provides a more authentic representation of tumors due to conserved morphology and heterogeneity. Methods: Fertilized chicken eggs were procured, windowed, and their CAM layers were dropped. On embryonic development day (EDD) 10, freshly cut patient?derived CM and RB tumors were implanted on the CAM layer and the setup was incubated for 7 days. The tumor?embedded CAM layer was harvested on EDD 17, and the extracted tumor samples were subjected to hematoxylin and eosin staining and immunohistochemical analysis to evaluate the extent of tumor invasion. Results: Significant changes in the vascularity around the RB and CM PDXs were observed, indicating an angiogenic environment. The cross?sectional histological view of the tumor implant site revealed the invasion of both the tumors into the CAM mesoderm. Invasion of CM into CAM mesoderm was visualized in the form of pigmented nodules, and that of RB was indicated by synaptophysin and Ki?67 positivity in Immunohistochemistry (IHC). Conclusion: The CAM xenograft model was successfully able to support the growth of CM and RB PDXs and their invasion in CAM, thus presenting as a feasible alternative to mammalian models for studying tumorigenicity and invasiveness of ocular tumors. Moreover, this model can further be utilized to develop personalized medicine by inoculating patient?specific tumors for preclinical drug screening.
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Purpose: India has the largest population of youth in the world, thereby making them important contributors to the “India of Tomorrow”. Over 80% of knowledge gained is by the visual sense, thereby making school screening programs a necessity in our country. Data from the pre?COVID era, that is, 2017–18 was collected from close to 19,000 children in Gurugram, Haryana, a tier two city in National Capital Region, India. A similar prospective observational study is planned post COVID?19 (2022–23) for further analysis to depict the impact of COVID?19 in these areas. Methods: The program They See, They Learn was set at government schools in the area of operations (district of Gurgaon, Haryana), where the children and their families were unable to afford eye care services. All children who were screened underwent a comprehensive eye examination at the school premises itself. Results: A total of 18,939 students were screened over a period of 18 months, covering a total of 39 schools in the Gurugram belt, in the first phase of the program. Eleven point eight percent (n = 2254) of all school students had some form of refractive error. Girl students were found to have a higher refractive error rate (13.3%) compared to boy students (10.1%) across the schools screened. Myopia was the most common type of refractive error. Conclusion: School students require perfect vision or else they can be discouraged and may become a major burden to the economy of any developing nation. A school screening program aiming at populations that cannot afford such basic needs like spectacles is a must in all zones of the country
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Diclofenac medication has been extensively used for anti-inflammatory, anti-pyretic, and analgesic actions. Its abiding usage and overdose have induced toxicity and harmful effects on the liver, kidney, and gastrointestinal tract. The research aims to scrutinize the protective effect of Madhuca longifolia seed oil against diclofenac-induced toxicity in female Wistar albino rats. A period of 10 days of study was aimed at 7 groups; Group 1 was assigned as normal control. Group 2 has been administered diclofenac (50 mg/kg b.w. /day, i.p.) only on the last two days of each study period. Group 3 and Group 4 have been pre-treated with 1 mL, and 2 mL of Madhuca longifolia seed oil, respectively, and diclofenac was induced as per Group 2. Group 5 was treated with the standard drug silymarin and diclofenac. Group 6 and Group 7 were given 1 mL and 2 mL of Madhuca longifolia seed oil alone. After the study period, parameters like liver enzyme markers, renal enzyme markers, and antioxidants were measured, and tissue samples were analyzed for histopathological changes. The results proved that pre-treatment of 1 mL of Madhuca longifolia seed oil has efficacy against diclofenac-induced toxicity.
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Diclofenac medication has been extensively used for anti-inflammatory, anti-pyretic, and analgesic actions. Its abiding usage and overdose have induced toxicity and harmful effects on the liver, kidney, and gastrointestinal tract. The research aims to scrutinize the protective effect of Madhuca longifolia seed oil against diclofenac-induced toxicity in female Wistar albino rats. A period of 10 days of study was aimed at 7 groups; Group 1 was assigned as normal control. Group 2 has been administered diclofenac (50 mg/kg b.w. /day, i.p.) only on the last two days of each study period. Group 3 and Group 4 have been pre-treated with 1 mL, and 2 mL of Madhuca longifolia seed oil, respectively, and diclofenac was induced as per Group 2. Group 5 was treated with the standard drug silymarin and diclofenac. Group 6 and Group 7 were given 1 mL and 2 mL of Madhuca longifolia seed oil alone. After the study period, parameters like liver enzyme markers, renal enzyme markers, and antioxidants were measured, and tissue samples were analyzed for histopathological changes. The results proved that pre-treatment of 1 mL of Madhuca longifolia seed oil has efficacy against diclofenac-induced toxicity.
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India after attainment of independence, granted the right to franchise to all her adult population irrespective of caste, creed, religion and sex. No country can progress if the ?fty percent of its population remains alienated from political activities and vis-a-vis con?ned themselves to the household drudgery and kitchen. It is true that reservation for women in Panchayat Raj Institutions (PRIs) have opened up huge vistas for their empowerment. The political scenario is changing at grass root level i.e., panchayati raj institutions having 33 per cent of women reservation which will increase up to 50 percent in future in the country. The present study was an effort to assess the role of Panchayats in participation as well as empowerment of women and also suggest some effective measures to achieve that goal. The present study reveals that some of the southern and western states are far more advanced than the northern and some of the eastern states. Bihar, otherwise not so impressive on other parameters, has provided for 50% reservation for women in PRIs and has given a huge impetus to their empowerment
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Schwannomas exhibit histopathological variation that leads to diagnostic dilemmas, although less frequent in the oral cavity. We describe a case with unique histopathology and no relevant clinical history that adds to the breadth of literature on the diversity presented by Schwannoma. A 60-year-old female patient presented with a small dome-shaped, asymptomatic swelling on the alveolar ridge 6 years in duration. Histopathologically, it showed rich cellular pathology with a unique arrangement of tumor cells forming irregular rosettes. Each rosette presented with a central core of fibrincollagenous material and the tumor cells were arranged on the periphery, exhibiting epithelioid change with evidence of mild cellular and nuclear pleomorphism. On immunohistochemical evaluation, the cells were strongly and diffusely positive for S-100 and negative for Ki-67. A diagnosis of benign Schwannoma with a rosette-like arrangement with epithelioid change was made. The case report emphasizes the risk of misdiagnosis and the importance of awareness regarding rare histopathological variants of Schwannoma.
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Purpose@#The coronavirus disease 2019 (COVID-19) pandemic has adversely impacted medical education worldwide. However, its impact on the postgraduate medical thesis and dissertation work is still not evaluated. Through this study, we planned to find out the problems brought by the pandemic and likely alternatives and possible solutions to thrust the academic competence of postgraduate students. @*Methods@#After obtaining institutional ethics committee approval, we sent a 13-item questionnaire to postgraduate medical students in India via various social media online platforms. Data on the impact of the COVID-19 pandemic on thesis work and alternatives/solutions to improve the research competence were collected on a Likert scale and analyzed. @*Results@#We received a total of 398 responses out of which 377 entries were included for final analysis. The majority of participants (88%) reportedly had an adverse impact on the thesis work and out of 25% of the participants who recently submitted their around 45% had to do so without achieving the estimated sample size. The 6-month departmental review for thesis progress was seen in merely 28% of participants. Possible alternatives suggested were the maintenance of log books, task-based assessment of research methodology, departmental audits, and systematic reviews. Solutions suggested for improving the research competence of students were a compulsory research methodology curriculum, a biostatistics department in each institution, permission to conduct thesis work beyond submission time, exclusive time for research work, and financial incentives. @*Conclusion@#Modification in the research aspect of the current postgraduate medical education is the need of the hour and the pandemic has enlightened us regarding the current weaknesses.
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Introduction:Heart failure is a major public health issue with a prevalence of about 26 million people worldwide.Reduced nitric oxide availability,lower soluble guanylate cyclase(sGC)activity,and decreased cyclic guanosine monophosphate(cGMP)production are the causes of HF's development.Vericiguat prescribed under the brand name Verquvo was approved by U.S.Food and Drug Administration(FDA)in January 2021.It is a novel agent and the first sGC stimulator which helps to treat patients suffering from heart failure with reduced ejection fraction(HFrEF).Objective:The mechanism of action(cGMP pathway)of vericiguat,its clinical trials,its use in the treatment of heart failure,and its possible future aspects in therapeutic recommendations are all covered in this review.It will also raise awareness amongst healthcare professionals about the pharmacokinetic and pharmacodynamic parameters,dosing,administration,and drug-related problems of this new drug.Methods:Various databases for drug review were used in this review like PubMed,Medline,Google scholar,Drug bank,U.S.FDA,Medscape,and European society of cardiology guidelines.A total of 58 articles were screened out of which 39 articles were included in this review.Results:This review discusses vericiguat's mechanism of action(cGMP pathway),clinical studies,application in the treatment of heart failure,and potential future considerations in therapeutic recommendations.It will also educate healthcare professionals about the new drug's pharmacokinetics and pharmacodynamics,dose,adminis-tration,and drug-related problems.Conclusion:After hospitalization for HFrEF,the 5-year survival rate is just 25％,and disease morbidity and death are still significant.As adjunctive therapy for individuals with heart failure and a low ejection fraction,vericiguat has a moderate level of effectiveness.Vericiguat's efficacy as an adjunct therapy to different drugs used to cure HF has to be further investigated.Vericiguat's safety and dosage in patients who have severe renal or hepatic illness need to be studied further.
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ABSTRACT Parasitic infections rarely involve the oral and maxillofacial regions and pose a diagnostic challenge when they do. Hydatid cysts are parasitic cysts caused by Echinococcus granulosus. Intraosseous involvement is observed in 3% of cases, of which only 2-6% are in the maxillofacial region. A scientific literature search revealed only seven cases involving the mandible. We report a rare case in a 16-year-old female patient who presented with facial asymmetry and well-defined radiolucency of the ramus. Our findings will help in understanding the diagnostic issues caused by non-specific presentation and difficulties in suspecting such a rare diagnosis as echinococcosis of the oral or maxillofacial region. A thorough systemic investigation is essential as 20-30% of these cases show multiorgan involvement.
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In current scenario herbal formulations containing natural ingredients is more acceptable in public belief than chemical based synthetic formulations due to their safety and efficacy in reducing dental caries, pyorrhoea and preventing other dental and oral issues to which this generation is prone to. Clinically more effective and tolerable treatments should improve patient compliance with oral hygiene practices, further supporting medical professionals' efforts to avoid disease. Controlling the creation of dental plaque is the most efficient method of preventing the onset of dental disease. Microbes have an impact on its formation. Ayurveda recommends some daily use therapeutic procedures for the prevention and maintenance of oral health. These include: Pratisarana (gentle massage over tissue), Dant Dhavani (brushing), Jivha Lekhana (tongue scrapping) and Gandoosha (gargling) or oil pulling. The present study focused on preparation and validation of the classical formulation Trivargtrityadi yoga (TT yoga) which mentioned in Ashtang Sangraha by Acharya Vagbhata described in Dantadhawanacharya. It Contains Triphala, Trikatu, Trijatak and Kuth. These extracts have a variety of beneficial characteristics, including those that are anti-cancer, anti-fungal, and anti-ulcer, anti-caries, anti-bacterial and wound healing. The preparation of the formulation in accordance with traditional references and evaluation of its analytic and antibacterial properties are the objectives of this study.
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Objective: Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes (MT). Aim: To evaluate the effectiveness of CT compared to MT in dental plaque removal. Methods: Studies comparing the efficiency of CT and MT in dental plaque removal measured by Turesky Modification of Quigley-Hein Plaque Index (TMQHI), Quigley-Hein Plaque Index (QHI), or Silness Loe Plaque Index (SLPI) were identified in PubMed, Medline Web of Science, Google Scholar, and the CENTRAL. Results and effect sizes estimate are presented as mean difference, and subgroup analysis is presented separately for non?randomised interventional studies and randomised intervention studies. Risk of bias was assessed using the Cochrane risk of bias tool (ROBINS?I and ROB2 tool). Results: A total of 10 studies were included in the systematic review, whereas six out of 10 studies were included in the meta?analysis. Both CT and MT were effective in plaque reduction over time when compared individually using the TMQHI and SLPI scores. The overall pooled summary showed no difference in CT and MT’s dental plaque removal ability when measured using the TMQHI score. Similarly, there was no difference in CT and MT’s dental plaque removal ability when measured using the SLPI score. Conclusion: There is no significant difference in CT and MT’s plaque removal ability. Therefore, CT should only be recommended for children and individuals with a disability or manual dexterity.
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Introduction: Recent COVID‑19 pandemic is an unprecedented public health problem worldwide. Knowledge about the disease and adoption of COVID Appropriate Behavior (CAB) are of utmost importance in combating the pandemic. The study was conducted to assess and compare the knowledge, attitude, and practice and to determine different misconceptions and wrong practices related to the disease among urban and rural populations. Materials and Methods: A community‑based analytical study with cross‑sectional design was conducted from January 2021 to March 2021 among 144 adult residents from urban and rural West Bengal. Multistage sampling was adopted and a predesigned, pretested, semistructured schedule was used for interviewing study subjects. Results: Urban people were significantly more knowledgeable and more appropriate in attitude and practice than rural people (P < 0.05). The mean knowledge and attitude scores of urban population were significantly higher than the rural population across age groups, gender, occupation, and education (P < 0.05), whereas mean practice score was significantly higher across gender and occupation in the urban population compared to the rural population (P < 0.05). Many cultural and indigenous practices such as drinking warm water, using mouth wash, using home remedies were more common in urban areas and consumption of homeopathy medicines, lighting candles, making sound with utensils, blowing conch shells, and worshipping corona were observed more in rural areas. Conclusions: Wide gap exists in knowledge, attitude, and practice between urban and rural population and there were many wrong perceptions and practices surrounding COVID‑19 among both urban and rural population. Appropriate policy for improving knowledge, attitude, and CAB is the need of the hour.
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Bhaishajya Kalpana- the pharmaceutical science of Ayurveda mainly deals with the planning and preparation of medicines. As per Ayurveda, an ideal drug is that one which can process into different forms. Though Ayurveda claims that no material is incapable of being utilized as medicine, none of them can be employed in the form in which they are available because they are not appetizing or easily absorbed by the human system. In this modern era, society prefers medicines which are more palatable, available, less dose and with more shelf life. In this view, as per the need of time, there is a need to modify the classical formulations in order to improve its characters and to make more acceptable. In this present study, Tiladi churna, a pure herbal formulation having minimum ingredients and its granules were prepared in departmental pharmacy. Churna Kalpana is considered as an Upakalpana of Kalka Kalpana which is one among the basic Panchavidha Kashaya Kalpana mentioned in classical texts while Khanda Kalpana or granules are the preparations added after 20th century which have more palatability and acceptance. Here both Tiladi Churna and granules were then compared to determine the efficiency in terms of method, duration of preparation and also in terms of organoleptic and physical parameters