Comparision of Cardiac Output Measured by Transthoracic Echocardiography with Continuous Cardiac Output Measured by Pressure Recording Analytical Method

Background: Low cardiac output is a common complication following cardiac surgery and it is associated with higher mortality in the pediatric population. A gold standard method for cardiac output (CO) monitoring in the pediatric population is lacking. The present study was conducted to validate cardiac output and cardiac index measured by transthoracic echocardiography and Pressure recording analytical method, a continuous pulse contour method, MostCare Up in postoperative pediatric cardiac surgical patients. Materials and Methods: This was a prospective observational clinical study conducted at a tertiary care hospital. A total of 23 pediatric patients weighed between 2 and 20 kg who had undergone elective cardiac surgery were included in the study. Results: Spearman抯 correlation coefficient of CO between transthoracic echocardiography (TTE) and Pressure Recording Analytical Method (PRAM) showed of positive correlation (r = 0.69, 95% Confidence interval 0.59?0.77, P < 0.0001) Linear regression equations for CO between TTE and PRAM were y = 0.55 + 0.88x (R2 = 0.46, P < 0.0001). (y = PRAM, x = TTE), respectively. Bland? Altman plot for CO between TTE and PRAM showed a bias of ?0.397 with limits of the agreement being ?2.01 to 1.22. Polar plot analysis showed an angular bias of 6.55� with radial limits of the agreement being ?21.46 to 34.58 for CO and angular bias of 6.22� with radial limits of the agreement being ?22.4 to 34.84 for CI. Conclusion: PRAM has shown good trending ability for cardiac output. However, values measured by PRAM are not interchangeable with the values measured by transthoracic echocardiography.

Efficacy and Diagnostic Accuracy of Centrifuged Liquid-Based Cytology over Conventional Oral Exfoliative Cytology in Normal Oral Mucosa and Oral Squamous Cell Carcinoma: Comparative Study

Background: The five-year survival rate of oral cancer remains 50% or less despite the treatment advances. An effective screen- ing test is necessary for early detection of oral cancer. Aim: To assess the efficacy and diagnostic accuracy of centrifuged liquid-based cytology in comparison to conventional exfolia- tive cytology in normal oral mucosa and oral squamous cell carcinoma. Materials & Methods: The study population comprised of 40 individuals, equally divided into two groups: healthy individuals and previous histopathologically proven oral squamous cell carcinoma cases. Exfoliative cytology was done and the samples were processed by conventional cytology as well as by centrifuged liquid-based cytology and stained with Papanicolaou stain. Seven cytological parameters were analysed to assess the quality of slides prepared. A cytological diagnosis of the case group was also made and was compared with histopathological diagnosis to evaluate the diagnostic accuracy. Results: The present study revealed statistically significant superior results in all the cytological parameters evaluated by centri- fuged liquid-based cytology compared to conventional exfoliative cytology (P ?0.05). There was an ‘almost perfect agreement’ found between centrifuged liquid-based cytology diagnosis and histopathology (k=0.89) while only a ‘substantial agreement’ was found between conventional exfoliative cytology with histopathology (k=0.79). Conclusion: The present study summarizes that centrifuged liquid based cytology is more effective than conventional oral exfoliative cytology in screening oral cancer. Further studies with larger sample size in different oral lesions are necessary to validate the use of this cytology technique.

Spontaneous Urinary Bladder Perforation As A Cause Of Recurrent, Progressive Ascites With Multiorgan Dysfunction Syndrome

Spontaneous rupture of the urinary bladder wall is a rare complication that may lead to intraperitoneal accumulation of urine and is mistaken for ascites from other causes. This often leads to repeated and inconclusive diagnostic tests. Here, we report the case of a 60-year-old female, with a past history of cervical cancer, who presented with recurrent episodes of pain abdomen and breathlessness over 1 year period. She was hospitalized multiple times and found to have ascites. Ultrasound and computed tomography scan of the abdomen along with an ascitic fluid analysis were done at each admission, which were inconclusive as to the cause of the ascites. A diagnostic laparoscopy to rule out peritoneal metastases showed perforation of the urinary bladder wall with intraperitoneal urine leakage. Bladder wall repair was done the following which the patient recovered uneventfully.

The Radix Entomolaris : A Rare Entity In Endodontics.

Mandibular molars can have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of one Mandibular molar with a radix entomolaris or paramolaris, both of which are rare macrostructures in the Caucasian population. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described. Avoiding procedural errors during endodontic therapy demand an adapted clinical approach to diagnosis and root canal treatment.

The Use of Catlan's Appliance For Repaid Correction of Pseudo Class III Malocclusion.

In this case report, the use of a cemented lower anterior inclined bite plane (Catlan’s appliance) for the correction of a pseudo Class III malocclusion is shown in a growing child. The differential diagnosis of pseudo malocclusion and the advantages and disadvantages of the use of Catlan’s appliance are discussed.

Time Course of The Passage of An Ingested Brass Wire Separator Through The Gastrointestinal Tract.

Fixed Orthodontic Treatment involves the use of applinces with many metallic components. Some times appliance parts may go missing between appointments instead of and may be noticed during recall appointments. Ingestion of this parts is rare but if it happens it may be life threatening. Herewith a case of ingestion of metallic brass wire ligature and timely intervention is discussed.

The Use of 0.018" Special Plus Wire For Fabricating "Z-Springs" For Correction of Anterior Cross Bites.

Double helical cantilever springs of “Z-springs” are frequently used to correct one or two teeth anterior cross bites. Different wire sizes of round stainless steel wires have been suggested by various authors for the fabrication of these springs. The 0.018” Special Plus Australian wire is an excellent choice for the fabrication of the “Z-spring” because of it’s hardness and resilience. This case report shows the rapid resolution of a single tooth anterior cross bite of an upper central incisor using an appliance that incorporates such a “Z -spring”.

Neuroprotective effect of spiradoline and naloxone in focal cerebral ischemia: Promising behavioral and biochemical changes in Wistar rats.

Brain ischemia modulates endogenous opioids production and the expression of opioid receptors. The present investigations aim to determine the neuroprotective effect of Spiradoline and Naloxone, administered intraperitoneally, against carotid artery occlusion induced cerebral ischemia in adult male Wistar rats. The ischemic assessment was carried out by evaluation of behavioral (cognitive and sensorimotor), and biochemical (antioxidants, acetylcholinesterase, brain swelling and hemispheric water content) parameters. The groups included sham-operated control, vehicle control, spiradoline-treated and naloxone-treated rats. Carotid artery occlusion induced behavioral impairment as per 8-arm radial maze, elevated plus maze, sensorimotor deficits, free radical production and biochemical changes. The results revealed that spiradoline significantly (p<0.05) antagonized the cognitive and sensorimotor deficits, indicated by reduced working memory errors, increased transfer latency time, and neurologic scores on 24 h and day 7 after ischemia, while naloxone produced transient improvement. The drugs significantly (p<0.05) restored the levels of antioxidants, and acetylcholinesterase on day 7. The brain edema development was significantly antagonized by spiradoline while naloxone showed lesser improvement. The results implied that the opioid agonist spiradoline has better efficacy than opioid antagonist naloxone for brain stroke therapy at tested doses, and spiradoline may be used in future combination therapies as a neuroprotective drug.