In vitro and in vivo anticancer potential and molecular targets of the new colchicine analog IIIM-067 / 中西医结合学报

OBJECTIVE@#The current study evaluated various new colchicine analogs for their anticancer activity and to study the primary mechanism of apoptosis and in vivo antitumor activity of the analogs with selective anticancer properties and minimal toxicity to normal cells.@*METHODS@#Sulforhodamine B (SRB) assay was used to screen various colchicine analogs for their in vitro cytotoxicity. The effect of N-[(7S)-1,2,3-trimethoxy-9-oxo-10-(pyrrolidine-1-yl)5,6,7,9-tetrahydrobenzo[a] heptalene-7-yl] acetamide (IIIM-067) on clonogenicity, apoptotic induction, and invasiveness of A549 cells was determined using a clonogenic assay, scratch assay, and staining with 4',6-diamidino-2-phenylindole (DAPI) and annexin V/propidium iodide. Mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) levels were observed using fluorescence microscopy. Western blot analysis was used to quantify expression of proteins involved in apoptosis, cell cycle, and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling. Pharmacokinetic and in vivo efficacy studies against Ehrlich ascites carcinoma (EAC) and Ehrlich solid tumor models were conducted using Swiss albino mice.@*RESULTS@#IIIM-067 showed potent cytotoxicity and better selectivity than all other colchicine analogs screened in this study. The selective activity of IIIM-067 toward A549 cells was higher among other cancer cell lines, with a selectivity index (SI) value of 2.28. IIIM-067 demonstrated concentration- and time-dependent cytotoxicity against A549 cells with half-maximal inhibitory concentration values of 0.207, 0.150 and 0.106 μmol/L at 24, 48 and 72 h, respectively. It also had reduced toxicity to normal cells (SI > 1) than the parent compound colchicine (SI = 1). IIIM-067 reduced the clonogenic ability of A549 cells in a dose-dependent manner. IIIM-067 enhanced ROS production from 24.6% at 0.05 μmol/L to 82.1% at 0.4 μmol/L and substantially decreased the MMP (100% in control to 5.6% at 0.4 μmol/L). The annexin V-FITC assay demonstrated 78% apoptosis at 0.4 μmol/L. IIIM-067 significantly (P < 0.5) induced the expression of various intrinsic apoptotic pathway proteins, and it differentially regulated the PI3K/AKT/mTOR signaling pathway. Furthermore, IIIM-067 exhibited remarkable in vivo anticancer activity against the murine EAC model, with tumor growth inhibition (TGI) of 67.0% at a dose of 6 mg/kg (i.p.) and a reduced mortality compared to colchicine. IIIM-067 also effectively inhibited the tumor growth in the murine solid tumor model with TGI rates of 48.10%, 55.68% and 44.00% at doses of 5 mg/kg (i.p.), 6 mg/kg (i.p.) and 7 mg/kg (p.o.), respectively.@*CONCLUSION@#IIIM-067 exhibited significant anticancer activity with reduced toxicity both in vitro and in vivo and is a promising anticancer candidate. However, further studies are required in clinical settings to fully understand its potential.

Aberrant Expression of CD19 in Early T-cell Precursor Lymphoblastic Leukemia-A Diagnostic Challenge

A systematic approach is required to diagnose acute leukemia. Most of the cases are satisfactorily diagnosed and categorized into subtypes. However, a few cases pose diagnostic dilemma secondary to immunophenotypic aberrancies which are defined as antigens that are normally restricted to a different lineage and expressed by a neoplastic population while absent from its normal non neoplastic counterpart. We report a rare case of Early T-cell PrecursorLymphoblastic Leukemia with aberrant expression of CD19. A 7-year-old boy referred to our hospital with his cervical lymph node biopsy reported as lymphoproliferative disorder. The patient was COVID-19 positive. Chest X-ray showed mild right sided pleuraleffusion with huge mediastinal mass. Flow cytometry on peripheral blood used to establish the diagnosis. The case is reported to improve knowledge regarding aberrant expression of markers. Hematopathology teams should be aware of this phenomenon so that appropriate workup can be done to reach correct diagnosis.

Callus Induction, Proliferation, Enhanced Secondary Metabolites Production and Antioxidants Activity of Salvia moorcroftiana L. as Influenced by Combinations of Auxin, Cytokinin and Melatonin

Abstract: Tissue culture technique is one of the best methods to reproduce salvia plant Therefore, the aim of this research was to enhance the in-vitro callus proliferation and production of secondary metabolites of S. moorcroftiana using different combinations of auxin, cytokinin and melatonin. Initially, callus induction was optimized using indole acetic acid (IAA), 2, 4-dichlorophenoxy acetic acid (2,4-D), and naphthalene acetic acid (NAA) applied at different concentrations in combination with 1 mg L-1 of 6-benzylaminopurine (BAP). The results indicates that earliest days to callus induction (14.67 days) was occurred in the media fortified with 2, 4-D+BAP (2.0+1.0 mgL-1). Whereas the highest callus initiation (100%) was induced on MS medium incorporated with 2,4-D+BAP (1+1mgL-1). Furthermore, maximum fresh weight was obtained when 2,4- D + BAP at the rate of (1+ 1mg L-1) was incorporated and dry weight was attained when 2,4- D + BAP at the rate of (2+1 mg L-1) was added to MS media. The maximum fresh and dry weight was obtained when melatonin at rate of 1.5 mg L-1 was supplemented with MS media including 2,4-D + BAP (1+1mg L-1), moreover the maximum DPPH scavenging activity, total phenolic and flavonoid content was noted when supplemented with melatonin at rate of 1.5 mg L-1. In conclusion, among various concentrations of plant growth regulators, 2,4- D + BAP at the rate of (1+ 1mg L-1) along with 1.5 g L-1 melatonin was the best for callus growth and production of secondary metabolites of S. moorcroftiana.

Knowledge, attitude and practices (KAP) towards anaemia among female university students in Malaysia: A cross-sectional survey

@#Introduction: Anaemia is a common health problem in Malaysia, most common being iron deficiency anaemia (IDA). This study aimed to assess knowledge, attitude, practices (KAP), and health-seeking behaviour (HSB) towards anaemia among undergraduate female students. Methods: A cross-sectional study was conducted among 180 female university students from a medical university in Malaysia. Data were collected using an online questionnaire comprising KAP and HSB. SPSS version 25.0 was used for statistical analysis. Results: Most participants (60%) had an appropriate level of knowledge about anaemia. A positive attitude was shown with adequate awareness of anaemia. A total of 55.5% of participants reported having good health practices. However, 52.9% of the participants consumed less iron-rich foods and 81.7% reported skipping meals. The overall observed healthseeking behaviour was good. A statistically significant relationship was found between knowledge with attitude (p=0.003) and practice (p=0.005). This study observed that the study population had poor nutritional status, long menstrual duration, and vegetarianism. Moreover, infrequent consumption of vitamin C-rich fruits and low iron-folate supplementation were also observed. Conclusion: A good level of knowledge on IDA among students was noted. However, most of the students showed a lack of positive attitude and good practices towards preventing anaemia. University students are prone to IDA due to a lack of KAP, which can significantly affect health-seeking behaviour. This issue should not be neglected; therefore, implementing intervention programmes to educate students on the preventive measures against the risk factors of IDA is recommended.

Cytokine storm secondary to coronavirus disease-19 pneumonia in a preterm pregnancy: A management and bioethical dilemma / Philippine Journal of Obstetrics and Gynecology

@#A 27‑year‑old primigravida at 26 weeks’ age of gestation presented with difficulty of breathing, nonproductive cough, and generalized body malaise. Coronavirus disease‑19 (COVID‑19) infection was confirmed by a positive reverse transcription‑polymerase chain reaction. She was diagnosed with severe COVID‑19 pneumonia with progressive oxygen desaturation requiring intubation and intensive care unit admission. The management and bioethical dilemma involved the use of investigational therapeutic interventions for compassionate use, with unknown effects to the fetus, namely remdesivir, tocilizumab, dexamethasone, and hemoperfusion to manage the cytokine storm and prolong pregnancy or to terminate the pregnancy hoping that it might improve the deteriorating condition of the patient. A multidisciplinary approach and family conference to solve the dilemma resulted in a successful outcome.

Vertebral Endplate Changes Correlate with Presence of Cartilaginous Endplate in the Herniated Disc Tissue: Factor Predicting Failure of Conservative Treatment

Methods@#Fifty-one discs were obtained from patients undergoing surgery for herniated disc. Their ages ranged from 19-65 years, and 31/51 were male. Pre-surgical T1 and T2 weighted lumbar-spine MRIs were analyzed to observe Pfirrmann grade, VEP defects, herniation type, Modic changes, and high-intensity zones (HIZ) at the affected level. Five-micron thick sections were stained with hematoxylin and eosin, Alcian blue periodic acid–Schiff stain; examined for histological degeneration scores (HDS; 0–15), inflammation (0 [absence]–3 [severe]), and presence of cartilaginous endplate (CEP). Three-micron thick sections were stained with protein-gene-product 9.5 and expression was counted/mm2. Data was analyzed, and p<0.05 was considered to indicate statistical significance. @*Results@#VEP defects, Modic changes, and HIZ were respectively observed in 30/51, 16/51, and 6/51 of the samples. CEP was observed in 26/51 samples and in 23/51 with endplate defects. Discs with adjacent VEP defects showed increased HDS (p<0.001) and inflammation (p<0.001). Discs with adjacent Modic changes also revealed increased HDS (p=0.01). Histological sections with CEP showed increased HDS (p<0.001) and inflammation (p<0.001), and nerve density was significantly positively correlated with HDS (r=0.27, p=0.02). @*Conclusions@#VEP changes can modulate degeneration and inflammation of herniated discs. Presence of these changes is highly predictive of the occurrence of CEP in herniated discs, which leads to slow resorption and persistent clinical symptoms.

Multienzyme and Antibacterial Potential of Bacteria Isolated from gut of Asian Honey Bee (Apis cerana Indica), Lahore Using Culture Dependent Method

Abstract The bacteria residing in the gut of honey bees (HB) has demonstrated a significant role in protecting bees against various pathogens, production of honey and wax. However, no information exists about the antibacterial potential of bacterial isolates from gut of Asian HB, Apis cerana Indica F. (Hymenoptera: Apidae), against human pathogens. This study aims to investigate the antibacterial and multienzyme potential of aerobic bacteria from A. cerana gut using culture dependent approach. A total of 12 HB gut bacteria were characterized morphologically and biochemically. These strains were further screened for their antimicrobial activity against pathogenic human microorganisms Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Bacillus licheniformis and Bacillus subtilis using cross streak (primary screening) and agar well diffusion methods (secondary screening). Preliminary characterization of cell-free supernatant (CFS) of two promising isolates was performed by measuring lactic acid concentrations, enzymatic digestion of antimicrobial compounds, stability over a range of temperature, pH and amplification of spaS (subtilin) and spoA (subtilosin) genes. In primary screening, among 12 HB isolates, eight strains showed statistically significant highest zones of inhibition (p≤0.05) against E. coli, K. pneumoniae and P. aeruginosa. 16S rRNA sequencing revealed that these isolates belong to Bacillus genus, identified as B. tequilensis, B. pumilus, B. xiamenensis, B. subtilis, B. amyloliquefaciens, B. safensis, B. licheniformis, B. altitudinis (Accession numbers: MT186230-MT186237). Secondary screening revealed that among eight isolates, B. subtilis and B. amyloliquefaciens showed statistically significantly strong inhibition (p≤0.05) against all tested pathogens. Antibiotic susceptibility testing revealed that both isolates were resistant to antibiotics and possesses proteolytic, lipolytic and cellulolytic activities. The nature of the compound causing inhibitory activity was found to be proteinaceous and showed stability over a wide range of temperature as well as pH. PCR study confirmed the presence of bacteriocins by successful amplification of important antimicrobial peptide biosynthesis genes spaS and spoA. These results suggest that the HB gut is a home to bacteria that possess antimicrobial activity and important enzymes with antimicrobial potential. To our knowledge, this is the first report demonstrating the antimicrobial potential of bacteria isolated from gut of HB (A. cerana) against human pathogens.

A link between long non-coding RNA (lncRNA) and thalassaemia: A review

@#The long non-coding RNAs (lncRNAs) are the most prevalent and functionally diverse member of the non-coding RNA (ncRNA). The lncRNA has previously been considered to be a form of transcriptional “noise” but recent studies have found that the lncRNA to be associated with various disease conditions. It has also been found to play important roles in various physiological processes such as haemopoiesis, where lncRNA is reported to act as a fine-tuner of this very important process. To date, the effects of dysregulated lncRNA in thalassaemia has not been fully explored. This review article focuses on the possible roles of dysregulated lncRNAs in the pathogenesis of thalassaemia.

Evaluation of GeneXpert MTB/RIF assay for detection of pulmonary tuberculosis on sputum samples

Objective: To analyse the diagnostic performance of MTB/RIF assay for the diagnosis of pulmonary tuberculosis and detection of rifampicin resistance using sputum samples

Study Design: Observational cross-sectional study

Place and Duration of Study: Provincial TB Reference Laboratory [PTRL], Hayatabad Medical Complex, Peshawar, Pakistan, from January to October 2015

Methodology: A total of 268 participants were consecutively enrolled in the study after meeting the inclusion criteria. Their sputum samples were collected and processed by N-acetyl-L-cysteine-sodium hydroxide [NALC-NaOH] method and GeneXpert MTB/RIF assay

Results: This study determined the overall sensitivity and specificity of MTB/RIF assay, it was 92.4% [86/93] and 97.1% [138/142], respectively. The sensitivity was 98.4% [60/61] in culture proven smear positive samples, whilst sensitivity in culture proven smear negative samples was 93.7% [30/32], using culture as reference standard

Conclusion: GeneXpert MTB/RIF assay could greatly improve early diagnosis of PTB in smear negative cases as well as multidrug resistant tuberculosis

Microwave assisted extraction of phytochemicals an efficient and modern approach for botanicals and pharmaceuticals

The final quality of pharmaceutically active herbal preparation is significantly contributed by extraction procedures. Hence in the last decade Microwave assisted extraction [MAE] has been introduced. This is an efficient and modern tool with multiple benefits as compared to the traditional methods of extraction. The benefits are in terms of reduction in cost, time of extraction, amount of solvent used, energy consumptions and low CO2 emission. Therefore present study was planned to give brief overview on applications of microwave assisted extraction of natural products. It is also discussed that how the various parameters of microwave assisted extraction like nature of the solvent, temperature, particle size, power level of microwaves and time of irradiation influences the extract yields of plant parts. This review also emphasizes the application of MAE for increased production of phyto-medicines, sweeteners, spices and all other commercial products related to botanicals

Cleidocranial Dysplasia - A Rare Case Report

Cleidocranial dysplasia is an autosomal dominant heritable disorder caused by mutation in the gene encoding transcription factor Core Binding Factor Subunit Alpha 1 (CBFA1) or Runt related transcription factor 2 (RUNX2). It is characterized by aplasia or hypoplasia of the clavicles, characteristic craniofacial malformations, and the presence of numerous supernumerary and unerupted teeth. A 37 year old male with cleidocranial dysplasia is described in this article with cyst associated with impacted teeth as the first presentation.

Assessment of Changes in Paraclinical Indexes Due to Intermaxillary Fixation: A Prospective Clinical Study

Background: One of the treatment modalities of mandibular and midface fracture is closed reduction with the use of intermaxillary fixation (IMF), in which the fractured segments are immobilized adjacent to each other and this procedure results in the reunion of the separated segments. It has been shown that there is a direct relation between nutrition and the healing process of the body therefore treatment with IMF could possibly affect the healing process. In this study, we evaluated the effects of IMF on paraclinical factors like protein profile and lipid profile which are markers for malnutrition condition, so further thoughts can be given to prevent malnutrition by using different supplements. Methods:30 Patients having mandibular fracture which needed closed treatment was selected for this study. All patients were treated with a 4 weeks period of IMF. Lipid profile factors [total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG)] and protein profile factors [hemoglobin (Hb), albumin (Alb)] were measured before the start of IMF and after the 4 weeks period of IMF. Results: there occur decrease in the level of Alb and the reduction was statistically significant. There occur slight increase in Hb level at the end of treatment however the result was statistically insignificant. also there occur decrease in the level of TC, HDL, LDL and TG after the treatment but the result was statistically insignificant. Conclusion: it was concluded that treatment with IMF can result in malnutrition conditions although not severe. so when close reduction techniques are used as the treatment plan in maxillofacial region, a supplemental nutrition planning is very thoughtful thing to do.

Insertion/deletion polymorphism of ACE gene in females with peripartum cardiomyopathy: A case-control study

Background The role of polymorphism of Angiotensin converting enzyme (ACE) gene and ACE activity in etiopathogenesis, prognosis, and many other clinical parameters in the various form of the cardiovascular disease has been established to some degree of certainty. The pathophysiology of Peripartum cardiomyopathy (PPCM) remains an area of active research. The main aim of our study was to see pattern of ACE- Insertion/Deletion (I/D) allele in PPCM and its implications on left ventricular performance indices. Methods This single-center case-control study included 45 cases and 70 controls. The diagnosis of PPCM was established clinically and echocardiographically. ACE genotyping was done by polymerase chain reaction (PCR) method in all subjects. Results The II, ID, and DD genotype was present in 16, 18 and 11 of subjects with PPCM and 48, 19 and 3 of controls respectively. The odds ratio for ACE-II genotype in cases vs. controls was 0.253 (95% CI = 0.114–0.558; p = 0.007), for that of II genotype was 1.93 (95% CI = 0.86–4.3; p = 0.107) and for DD genotype was 7.225 (95% CI; 1.88–27.6; p = 0.0039). Overall frequency of D allele in cases was significantly higher than controls (odds = 4.25; 95% CI = 2.01–6.7; p = 0.0001). Moreover, ejection fraction, left ventricular volume and linear dimensions were worse in patients with DD genotype. Conclusion ACE DD genotype and overall frequency of D allele is significantly higher in patients with PPCM. Also, the presence of DD genotype is associated with worse systolic performance indices measured echocardiographically.

Epidemic of kala pathar [paraphenylene diamine] poisoning: an emerging threat in Southern Punjab

Objective: To assess cases of the spectrum of Kala Pathar poisoning in all age groups. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital [CMH] Bahawalpur and Bahawal Victoria Hospital [BVH], Bahawalpur, from January 2016 to April 2017

Methodology: All the cases of Kala Pathar [Paraphenylene diamine [PPD]] poisoning, admitted and treated at the study places during said period were included in the study. The assessed variable included gender, age, education status, socioeconomic status, reason of poisoning and mortality. Chi-square was applied for qualitative variables with p-value less than 0.05 was considered significant

Results: A total of 1,258 cases of PPD poisoning were included in the study; 814 [64.7%] females and 444 [35.3%] males. Their age ranged from 5 - 63 years, with median age 21 [IQR 4]. Sixty-six [5.2%] were children and the rest 1,192 [94.8%] were adults. In adults 1,125 [94.37%] cases of PPD poisoning were suicidal and 62 [5.20%] accidental cases; only 5 [0.42%] adults were intentionally poisoned. On the other hand, only one child took it with suicidal intent, 54 [81.81%] ingested it accidentally and 11 [16.66%] children were given poison deliberately with the intent to murder. The overall mortality was 24.08% - 22.81% in adults, and 46.96% in children

Conclusion: Kala Pathar [PPD] is a lethal substance when ingested. PPD poisoning is not limited to adults; many cases of pediatric poisoning are also being reported in Southern Punjab. Mortality due to Kala Pathar is high. Tracheostomy should be done immediately in all such cases; and high intensive multidisciplinary approach is required

Ameliorative effect of hydro-methanolic extract from roots of Rauwolfia serpentina on some biochemical parameters of type 1 diabetic mice

Present work seeks to investigate the biochemical parameters in terms of hypoglycemic and hypolipidemic effects of hydro-methanolic roots extract [HyMREt] of Rauwolfia serpentina in type 1 [alloxan induced] diabetic mice. Animals were divided into seven groups, four control groups, and three were test groups [HyMREt at 50, 100, and 150mg/kg]. Each treatment was repeated for 14 days regularly in all seven respective groups and afterwards the body weights, fasting blood glucose [FBG], insulin, and serum lipid levels were determined. Total body weights of diabetic mice treated with HyMREt extract were dose dependently [p

Assessment of knowledge regarding breast self-examination among college students [girls] of district Islamabad, Pakistan

Background: Among all female malignancies, breast cancer [BC] remains the commonest around the globe. Worldwide, more than one million new cases are diagnosed each year and more than 90,000 of them are from Pakistan. Current study was conducted to evaluate the knowledge regarding breast self-examination [BSE] among female students

Objectives: To determine knowledge of college girls regarding breast cancer and assess their knowledge, perception and practices regarding breast self-examination

Study design, settings and duration: Cross sectional study of 3 months duration was conducted among students of government girls colleges of Islamabad from October to December 2016

Subjects and Methods: Using simple random sampling, 05 girl's colleges were selected from Islamabad. From each college 160 students were selected at random. Informed written consent was obtained. A self-administrated questionnaire was used to gather information on knowledge regarding risk factors of breast cancer, breast self-examination, procedure to perform BSE, sources of information on BSE and when did last time perform BSE. Data was entered and analyzed by using Epi Info version 7.2

Results: Total 763 female students were enrolled. Response rate was 95%. Mean age of students was 20.6 +/- 2.8 years. All students were Muslims and unmarried. Eighty seven [11.4%] students had a family history of breast cancer. Five hundred fifty one [72%] students knew that family history is a risk factor for breast cancer. BSE is a procedure to pick up early cases of breast cancer was known to 345 [45%] students. Most common source of information was internet 331 [43%]. Regarding the process to perform BSE, 313 [41%] answered correctly. About 567 [74%] students agreed that BSE is necessary to perform as an early BC detection method. Positive family history of breast cancer was significantly associated with higher odds of knowing BSE as a method for early detection of breast cancer [O.R: 2.6, CI: 1.7-4.2, p <0.05]. However only 188 [25%] had ever done BSE. Positive family history of breast cancer was significantly associated with higher odds of having some kind of breast problem [OR: 2.7, CI: 1.2-6.11, p <0.05]

Conclusion: Knowledge about accurate way to perform BSE among female students of Islamabad is insufficient. As prevalence of this cancer is at rise in the country, therefore there is an urgent need for health education programs to focus on this important issue and take steps so as to enhance knowledge regarding importance and accurate method to perform BSE

mini-review of therapeutic potential of mangifera indica L.

Among known species of 69 Mangifera, Mangifera indica L. is a medicinal plant being used in tropical regions by indigenous people. It has been a main plant species being used in Ayurvedic as well as indigenous medical systems form 4000 years. Components of M. indica are recurrently used as a traditional medicine system to cure numerous ailments. Active constituents are present in stem bark, leaves, heartwood, roots and fruit and have antioxidant, anti-inflammatory, radioprotective, antitumor, immune-modulatory, anti-allergic, anti-diabetic, anti-bone resorption, mono-amine oxidase inhibiting, anti-viral, anti-fungal, anti-bacterial, anti-spasmodic, antidiarrheal, anti-malarial, antiparasitic as well as lipolytic properties. In spite of essential progress in phyto-chemical and medicinal analysis of M. indica, more efforts are needed to explore M. indica active components and their application in pharmaceutical industry. In this review, we focus on recent information about chemical constituents and pharmacological uses of M. indica

Audit of various otorhinolaryngological diseases in Shangla valley

Objective: To assess the prevalence of various ear, nose and throat diseases in Shangla valley. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Study was carried out in shangla. Duration of study was 3 months, from Jun 2014 to Aug 2014

Material and Methods: All the patients of any age group and both genders who reported with any ENT disorder and emergency were included in this study. Frequency and percentage of various ENT diseases among patients and emergency procedures performed were found

Results: A total of 2725 patients were included. The most common ENT disorder encountered was rhinosinusitis which was seen in 14.2% cases, followed by ear wax [impacted cerumen] in 13.4% and pharyngitis in 12.5% cases. Allergic rhinitis was seen in 10.4% cases, epistaxis in 7.4% and chronic suppurative otitis media in 6.4% cases. Among the emergency ENT procedures performed, anterior nasal packing was the commonest [done in 55 cases] followed by stitching of lacerations and foreign body removal from ear and nose

Conclusion: Ear, nose and throat diseases are very common in Shangla and their spectrum range from rhinosinusitis, impacted cerumen [ear wax] and pharyngitis to less common but potentially dangerous conditions like foreign body impaction in ear and nose

Comparison of chemical cautery versus topical vasoconstrictors in idiopathic pediatric anterior epistaxis

Objective: To compare efficacy of chemical cautery with silver nitrate along with fucidin ointment versus topical vasoconstrictor spray [xylometazoline 0.05%] and fucidin ointment application in idiopathic pediatric anterior epistaxis. Study Design: Randomized controlled trial. Place and Duration of Study: Study was carried out at Combined Military Hospital [CMH] Bahawalpur from Jan 2016 to Dec 2016

Material and Methods: Total 112 patients fulfilling the inclusion criteria were selected from Ear Nose Throat [ENT] outpatient department at CMH Bahawalpur. They were randomly divided into two groups of 56 cases in each group. Group A individuals were treated by cauterization with 75% silver nitrate followed by fucidic acid ointment. Group-B individuals were treated with topical vasoconstrictor spray [xylometazoline 0.05% twice a day for one week] along with fucidic acid ointment. Efficacy was determined in terms of control of epistaxis, whether the procedure was effective in controlling epistaxis or otherwise i.e. patient again developed bleeding from same side of nose and needed further treatment to control epistaxis. All the cases were followed up for two months after procedure to check their efficacy

Results: There were total 61 [54.46%] males and 51 [45.54%] females among the cases. Mean age of patients was 8.27 [+/- 2.34] years. Both the groups were comparable as regards the gender [p=0.817] and age [p=0.749]. Group-A were treated with silver nitrate cauterization followed by fucidic acid ointmnet application and group-B were treated by vasoconstrictor nasal spray along with fucidic acid ointment. In group A [silver nitrate cautery], 87.5% cases had no rebleed during two months follow up and in group-B, 67.8% children had no rebleed during two months follow up period [p=0.022]

Conclusion: Chemical cauterization with silver nitrate along with fucidic acid ointment application was found to be more effective as compared to xylometazoline nasal spray and fucidic Acid ointment application in treating idiopathic pediatric epistaxis

Reasons why people do not opt for crowning after root canal treatment

Teeth get weakened after endodontic treatment and these should ideally be crowned. However, few patients opt for crowns to preserve their teeth, whereas, many do not opt for crowning due to multiple reasons. The aim of this study was to explore how many patients take interest to preserve their teeth after endodontic treatment and to find out reasons for not opting for crowning. A data of 80 patients who had their root canal treatment done was collected during routine visit of various patients for dental treatment at 21 Military Dental Centre in Combine Military Hospital, Quetta. It was a questionnaire based cross sectional study. The collected data was analyzed to see frequency of patients who did or did not get their teeth crowned and possible reasons for not crowing after endodontic treatment. It was found that 36 % people had got their teeth crowned after endodontic treatment and 64% of patients did not opt for crowns. Majority of patients [29.4 %] who did not opt for crowns were found to be ignorant about the procedure, 19.6 % did not have time for their treatment, 15.7% were found to have financial limitation, non- availability of facility for treatment and lack of interest, whereas 3.9% did not opt for crowning due to previous bad experience. It was concluded that there is an absolute need for an educational campaign to create awareness among people to highlight importance of oral health and benefits of crowning of endodontically treated tooth for its longer survival. Government should make an effort to provide dental facility available to masses and introduce measures to provide affordable dental care