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Objective: To evaluate and compare the effect of variation in storage temperatures and duration on a tensile load at failure of elastomeric modules. Methods: In total, 140 modules were used in the study, 20 of which were tested on day 0 as received from a company using a Universal testing machine for baseline estimation of tensile load at failure. The rest 120 modules were divided into 6 groups. Groups I, II, and III modules were stored at low (T1 = 1–5°C), moderate (T2 = 20–25°C) and high (T3 = 35–40°C) temperatures, respectively, for 6 months. Groups IV, V and VI modules were stored at temperatures T1, T2 and T3 for 1 year, respectively, and were tested for tensile load at failure. Results: The tensile load at failure for the control group was 21.588 ± 1.082 N and for 6?month interval at temperatures T1, T2 and T3 was 18.818 N ± 1.121 N, 17.841 N ± 1.334 N and 17.149 N ± 1.074 N, respectively, and for 1 year, it was 17.205 N ± 1.043 N, 16.836 N ± 0.487 N and 14.788 N ± 0.781 N, respectively. The tensile load at failure decreased significantly from 6 months to 1 year among each temperature group. Conclusions: Maximum force degradation was seen in modules at high temperature followed by medium temperature and low temperature at both 6 months and 1 year intervals, and tensile load at failure decreased significantly from 6 months to 1 year storage duration. These results conclude that the temperature and duration at which the samples were exposed during storage produce a significant change in the forces exerted by the modules.
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To gain insights on the diverse practice patterns and treatment pathways for prostate cancer (PC) in India, the Urological Cancer Foundation convened the first Indian survey to discuss all aspects of PC, with the objective of guiding clinicians on optimizing management in PC. A modified Delphi method was used, wherein a multidisciplinary panel of oncologists treating PC across India developed a questionnaire related to screening, diagnosis and management of early, locally advanced and metastatic PC and participated in a web朾ased survey (WBS) (n = 62). An expert committee meeting (CM) (n = 48, subset from WBS) reviewed the ambiguous questions for better comprehension and reanalyzed the evidence to establish a revote for specific questions. The threshold for strong agreement and agreement was ?90% and ?75% agreement, respectively. Sixty?two questions were answered in the WBS; in the CM 31 questions were revoted and 4 questions were added. The panelists selected answers based on their best opinion and closest to their practice strategy, not considering financial constraints and access challenges. Of the 66 questions, strong agreement was reached for 17 questions and agreement was achieved for 22 questions. There were heterogeneous responses for 27 questions indicative of variegated management approaches. This is one of the first Indian survey, documenting the diverse clinical practice patterns in the management of PC in India. It aims to provide guidance in the face of technological advances, resource constraints and sparse high?level evidence.
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Background: Of all the cancers in women, about 10% manifest in the reproductive age group. These can be broadly classified as gynaecological cancers and non-gynaecological cancers; Among the non-gynaecological cancers besides haematological cancer, breast, thyroid, colon, bone and CNS are seen rarely. Clinical acumen in diagnosis and management of these rare cancers that appear during pregnancy or before pregnancy are difficult due to insufficient guidelines and rarity of the conditions.Methods: A retrospective analysis of rare cancers during a period of 10 years in this hospital was performed. Data concerning the gestational age at delivery, birth weight, mode of delivery and complications and the management of the cancers during the pregnancy were collected.Results: Among the 41 women with these rare non-gynecological, non-hematological cancers, 13 pregnancies were in women with prior history of cancers and 28 pregnancies were with current history of cancer. Majority of these cases with prior history were thyroid cancers who had uneventful pregnancies and delivered normally. Among pregnancies with current history of cancer, breast, CNS, GIT, and head and neck were the cancers with 5-6 cancers in each category. About 50% of these cancers were delivered early between 31-35 weeks to facilitate optimal treatment. Cancers with guarded prognosis diagnosed before 20 weeks had a termination of pregnancy.Conclusions: Cancers during pregnancies are rare and their care must be individualized.
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Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout theworld. The evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance toother non-β-lactams including vancomycin has only amplified the crisis. This paper presents data on the prevalence of MRSAand resistance pattern to other antibiotics on the selected specimen from burn patients.Materials and Methods: This is a prospective study conducted in the burn unit of Shyam Shah Medical College and SanjayGandhi Memorial Hospital, Rewa (M.P.), from June 2018 to May 2019, where all patients with flame and scald burns wereincluded in the study who had up to a second degree or partial-thickness burns.Results: A total of 558 patients were admitted in the burn unit throu`ghout the year, the age ranged from 2 months to 85 years.About 56.10% were females and 43.90% were males. Pseudomonas aeruginosa (37.5%) was the most common isolatefollowed by S. aureus (18.75%). The prevalence of MRSA was 57.14% but all the MRSA isolates showed 100% sensitivity tovancomycin and linezolid closely followed by piperacillin and tazobactam combination. The prevalence of methicillin resistanceoverall among S. aureus and Staphylococcus epidermidis was found to be 51.72%.Conclusion: MRSA is prevalent among the burn wounds but is 100% sensitive to vancomycin and linezolid. To ensure earlyand appropriate therapy, routine microbiological surveillance and a regular update of their antimicrobial susceptibility patterncould help in the prevention of development of multidrug resistance.
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Introduction: Chest trauma is one of the most serious injuries of the chest and also a common cause of significant disabilityand mortality. Chest trauma is the leading cause of death from physical trauma after head and spinal cord injury. Thoracicinjuries are primary or a contributing cause of about one-fourth of all trauma-related deaths. Traumatic chest injuries are onthe rise mainly due to increased frequency of road traffic accidents (RTAs) and rise in community disharmony. Chest injuriesare one of the common causes of major mortality and morbidity. The management of traumatic chest injuries depends on theseverity of injury, patient accessibility to nearby hospital, and availability of resources at tertiary care center.Materials and Methods: It is a prospective study of a total of 134 patients presenting to the emergency department with chest injuriesof varying severity in Sanjay Gandhi Memorial Hospital from 1 June 2018, to 31 May 2019 had been carried out. Data collectedregarding common injury modes, age and gender distribution, pre-hospitalization practices, clinical presentations, associated injuries,severity of injuries, and management options from the hospital record section and these data were analyzed with descriptive statistics.Results: Chest trauma is most common in males in their thirties with mean age of presentation 33.47 years. The most commonmode of injury was RTA 69.4%, followed by fall from height 14.9% and assault 11.1%. Pain in chest (53%) was the most commonsymptom of blunt trauma chest in the patients of our study sample followed by dyspnea (31%) and asymptomatic (9%). Clinicalsign was tenderness over chest. About 61.2% of patients found with collection in pleural cavity, in which hemothorax (23.9%)was the most common collection followed by pneumothorax (22.4%) and hemopneumothorax (15.7%).Conclusions: Chest injury is seen commonly in RTA patients. Most of the patients of chest injury had soft tissue trauma overchest in the form of abrasions and majority of these patients can be managed by symptomatic care and simple life-savingintervention, i.e. intercostal drainage. With increased RTAs, it is needed to have public awareness regarding road safetymeasures and educating them about the first aid measures for trauma patients.
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Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax
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Oral health influences general well-being and quality of life. Oral diseases can be debilitating and are amajor heath concern worldwide. Medicinal plants have been used for thousands of years for treatinghuman diseases. Considering the emergence of multi-drug resistant pathogens and financial difficultiesin developing countries, there is an urgent need for developing new antimicrobial compounds which aresafe, efficient and cost effective. Liquorice also known as yashtimadhu, sweetwood or mulhatti is onesuch herbal remedy which has shown to have immense potential in treatment of orofacial diseases.Liquorice is rich in secondary metabolites which are used in cosmetics, foods, traditional and modernmedicine. It has well known properties such as antiviral, glucocorticoid, anti-inflammatory, antioxidant,anti-ulcerative, anti-carcinogenic and many more. Liquorice extracts and liquorice bioactive ingredientssuch as glabridin, licoricidin, licorisoflavan A, licochalcone A, and glycyrrhizin have shown beneficialeffects in preventing and treating oral diseases. This paper reviews the effects of liquorice and its constituents on oral diseases such as dental caries, periodontitis, gingivitis, candidiasis, recurrent aphthousulcer and oral cancer and its use as a root canal medicament and summarizes the results of clinical trialsthat investigated the potential beneficial effects of liquorice and its constituents as a prevention andtreatment modality in oral diseases. Clinical trials, case reports and review of literature evaluating theeffect of liquorice on oral microorganisms and oral diseases are included. Literature pertaining to theeffects of liquorice on systemic diseases have been excluded from this review of literature.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Introduction: Burn injury causes a considerable amount of disability, prolonged hospital stay, and burden on the public healthsector. Main requirement in burn wound management is an economical, easy to apply, readily available dressing, or method ofcoverage that will provide good pain relief, protect the wound from infection, promote healing, prevent heat and fluid loss, beelastic, non-antigenic, and adhere well to the wound while waiting for spontaneous epithelialization of superficial partial thicknessburns. The sterilized paraffin gauze dressing is non-adherent and non-allergenic and helps in speedy recovery of burn wounds.Materials and Methods: A prospective study of 90 patients with partial thickness burns who were salvageable (≤40% bodysurface area), admitted to Burn unit of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital,Rewa from June 1, 2017, to May 31, 2018. The autoclaved liquid paraffin gauze was applied over burn wound. Patients wereassessed on the basis of subsidence of pain, time of epithelialization if occurred after liquid paraffin gauze dressing. Patients’blood investigations were noted and the assessment of the effect of hemoglobin (anemia) and platelet counts in burn woundhealing in terms of mean epithelialization time were done.Results: Mean epithelialization time was 16 days. In 25% of cases epithelialization developed in 10–12 days. Post-burn painsubsided in 4–6 days in maximum in 54.44% cases. Mild and moderate anemia had no significant effect on wound healingtime (mean epithelialization time). Patient with less than normal platelet counts (<1.5 lakh/cumm) had more epithelializationtime and with normal platelet count had less epithelialization time. 15 patients developed complications and most commoncomplication was hyper granulation (11.11%).Conclusion: Burn wounds pose a great burden on health-care infrastructure and burn units. We can conclude that liquid paraffingauze dressing has good patient acceptability and less painful, it is easily available and relatively less expensive. In developingand resource-poor countries, most of the patients are from the rural background so these patients will need a dressing that isrelatively less expensive and easily available such as liquid paraffin gauze dressing.
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Introduction: Anal fissure was first described by Recamier in 1829. It is a linear ulcer in the anoderm. Anal fissures are most commonly seen in young adults and have a slight female preponderance. Although a relatively minor entity, the morbidity in the general population is very large. Our knowledge of the pathophysiology and management of anal fissure has rapidly progressed over the past 15 years. All methods of treatment aim to reduce the anal sphincter spasm and aid in pain relief and healing of fissure. Aim: The main aim of this study is to compare the efficacy of topical 2% Diltiazem ointment and lateral internal sphincterotomy (LIS) in the management of chronic fissure in ano. Materials and Methods: This is a prospective study of 70 patients with chronic fissure in ano. A number of 35 patients were treated with diltiazem (2%) topical ointment and 35 patients were treated with LIS. The effectiveness of both treatment modalities was assessed on 2, 4, and 6 weeks follow-up. Result: Healing of fissure was complete in 24 (68.7%) patients of topical diltiazem group and 33 (94.28%) patients of LIS group after 6 weeks of treatment. A maximum number of patients (97.14%) achieved symptomatic relief who underwent LIS at 4 weeks follow-up. Patients who underwent LIS had an immediate pain relief when compared to those who were treated with topical diltiazem 2% ointment. Both topical diltiazem 2% ointment and LIS were equally effective in reducing bleeding per rectum in patients with chronic fissure in ano. Conclusion: Time taken for fissure healing in topical diltiazem group is long in comparison to LIS group. Surgical treatment with LIS is the treatment of choice in chronic fissure in ano.