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Forensic Odontology deals with the presentation of dental evidence in a court of law. An academic exploration revealed instances of technical challenges within the field. This study endeavours to delve into the spheres where these challenges occur, with the core objective of enhancing the quality of practice. An integrative literature review was conducted using the online platforms SCOPUS and Web of Science. Based on the selection criteria, 29 pertinent papers dated 2000-2023 were included. Quantitative analysis of the categories of selected articles was performed using Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, USA). Technical concerns were reported in all facets of Forensic Odontology with the general role of expert witnesses being reported the most (n=8; 27.58%). Within the different facets of the field, age estimation was the most prominent area of concern (n=8; 27.58%) and child abuse and neglect (n=1; 3.57%) represented the least reported category. Findings indicate that there is a need to prioritize avenues to enhance the quality of practice in the general role of expert witnesses and the specific area of dental age estimation. To this end, increased support for researchers must be provided to help validate methodologies. It is advisable to institute mandatory formal training and proficiency testing within the field. Inadequate knowledge of dentists regarding child abuse and neglect has been noted, demonstrating the need for more dedicated quality training. Recommendations for Forensic Odontologists have been curated combining this study's results and the codes of ethics of various forensic organisations
A Odontologia Legal trata da apresentação de provas odontológicas em juízo. Uma exploração acadêmica revelou exemplos de desafios técnicos na área. Este estudo procura aprofundar as esferas onde estes desafios ocorrem, com o objetivo central de melhorar a qualidade da prática. Foi realizada uma revisão integrativa da literatura utilizando as plataformas online SCOPUS e Web of Science. Com base nos critérios de seleção, foram incluídos 29 artigos pertinentes datados de 2000-2023. A análise quantitativa das categorias dos artigos selecionados foi realizada no Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, EUA). Preocupações técnicas foram relatadas em todas as áreas da Odontologia Legal, sendo o papel geral dos peritos o mais relatado (n=8; 27,58%). Dentro das diferentes áreas de atuação, a estimativa da idade foi a área de preocupação mais proeminente (n=8; 27,58%), e o abuso infantil e a negligência (n=1; 3,57%) representaram a categoria menos relatada. Os resultados indicam que há uma necessidade de priorizar caminhos para melhorar a qualidade da prática no papel geral dos peritos e na área específica da estimativa da idade dental. Para este efeito, deve ser prestado maior apoio aos investigadores para ajudar a validar metodologias. É aconselhável instituir treinamento formal obrigatório e testes de proficiência na área. Foi observado um conhecimento inadequado dos dentistas sobre abuso e negligência infantil, demonstrando a necessidade de uma formação mais dedicada e de qualidade. As recomendações para Dentistas Forenses foram selecionadas combinando os resultados deste estudo e os códigos de ética de várias organizações forenses.
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Objective: To describe the characteristics of gonadotropin-dependent precocious puberty (GDPP) in Indian children. Methods: Clinical profiles of GDPP (n=78, 61 females) and premature thelarche (n=12) from a single center in Western India were retrospectively studied. Results: Pubertal onset was earlier in boys than girls (29 vs 75 months, respectively; P=0.008). The basal luteinizing hormone (LH) was ?0.3 mIU/mL, except 18% of GDPP girls. At 60 minutes after GnRHa-stimulation, all patients (except one girl) had LH ?5 mIU/mL. The GnRHa-stimulated LH/FSH ratio was ?0.34 at 60 minutes in girls with GDPP unlike premature thelarche. Only one girl had an allergic reaction to long-acting GnRH agonist. Among GnRH agonist-treated girls (n=24), the predicted final adult height was -1.67±1.5 SDS, whereas the attained final height was -0.25±1.48 SDS. Conclusion: We establish the safety and efficacy of long acting GnRH agonist therapy in Indian children with GDPP. The 60-minute stimulated serum LH/FSH of ?0.34 differentiated GDPP from premature thelarche.
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Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male?to?female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time
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Background: BCR?ABL mutation on the Philadelphia chromosome is the key driver of chronic myeloid leukemia (CML) pathogenesis. However, there are certain cases of myeloproliferative neoplasms (MPN) wherein no inherent driver mutation is detected resulting in clinical phenotype. It is important to identify key genes and pathways in driving the disease. The aim of the study was to use a gene-based omics approach to molecularly characterize these mutation-positive and negative cases to further strengthen diagnostics and precision medicine. Methods: A microarray profiling was done on CD34 positive cells isolated from two BCR?ABL positive and five BCR?ABL negative samples. JAK2V617F mutation testing was also done to rule out the presence of any other mutation in the latter group. The fold change cut-off was taken as �5 with p?0.5 for significant genes. The gene network and pathway analysis were done using DAVID and STRING software. Results: The genes upregulated in BCR?ABL negative samples were shown to be involved in immune regulation, signal transduction and T- and B-cell signalling. The protein-protein interaction network of upregulated genes in these samples were enriched for various immunomodulatory genes such as HLADP, HLADQ , IL7R, CCR7, CD3 subtypes. These genes further formed a network with signal transduction genes such as LCK, FYN, RAG1, DOCK1, AKT3, SMAD3, LEF1. Conclusion: The results suggested a modulation of immune response genes and its subsequent effect on oncogenic signalling in BCR?ABL negative samples as compared to BCR?ABL positive samples. The protein network analysis was enriched for genes involved in Src, TGF-beta and PI3K-AKT pathway contributing to the proliferation of neoplastic clone.
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Objective: Otomycosis is a common fungal ear infection in tropical and subtropical regions worldwide. This study aimed to perform mycological analysis on fungal debris from the external auditory canals of the patients to study the most common clinical presentation and fungal species distribution in otomycosis. Materials and Methods: Patients who met the inclusion criteria for this cross-sectional study were included and evaluated after providing written informed consent. After obtaining a thorough medical history, ear swabs for culture, sensitivity, and potassium hydroxide were provided. Patients with positive culture results were studied between September 2019 and March 2021. Results: Among 103 cases observed for 18 months in the Department of ENT, Rajarajeswari Medical College, and Hospital, Bengaluru, India, we found that males (56.31%) were more affected than females (43.68%). Itching (67.96%) was the most primary and common symptom that was observed, followed by pain (20.38%), and the most common predisposing factor was the usage of earbuds (26.21%) followed by water in the ear (23.3%) and oil in the ear (16.50%). Unilateral infection was most common (96%), and the left ear was most affected (64.07%). Aspergillus niger was the most common fungal isolate (60.19%), and otomycosis was very common in postmonsoon (October–December) (58.25%). Conclusion: The most frequent fungal isolates in otomycosis are from the Aspergillus and Candida species. The left ear was typically affected by otomycosis, which frequently had a unilateral predominance. The most common clinical symptoms were itching and pain.
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Takra is the very common food item of Indians and used as a liquid food item from Vedic period. In Ayurveda their qualities, types, indications are mentioned. It is very important “Anupanhisa” of many ayurvedic formulations. Also, it is used both as food and medicine or Pathya in various disorders because of lots of medical properties. Takra is fundamentally a milk product prepared by fermentation process. In Ayurveda the usefulness of Takra is mentioned in many topics like Arsha, Grahani, Udara etc. along with this also mentioned the Takra in the disturbed condition of Agni. Due to advancement of biotechnology, microbiology and pharmaceutical sciences, numbers of pharmaceutical products are prepared which having same role as Takra in diarrhea, steatorrhea, IBS(irritable bowel syndrome), IBD(Infiammatory Bowel Disease), CD(Crohn's disease) and various intestinal diseases. Takra is natural probiotic diet because of friendly bacteria lactobacillus acidophilus for the intestine and the body are found abundance in these remedies. This article signifies that the role of Takra in widespread intestinal disorders as probiotics.
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Purpose: To report a new entity called “toxic non?inflammatory fungal keratitis.” Methods: Eyes manifesting infective keratitis with a history of prior administration of topical steroids were included in the study. The details pertaining to the type of injury, duration of injury, and primary treatment for corneal trauma were meticulously documented. The corneal tissues were scraped from the patients and were analyzed for fungal filaments by using a 10% KOH mount under a compound microscope. Moreover, these scraped materials were plated on blood agar and Sabouraud dextrose agar plates. Results: The corneal ulcers displayed a disproportionately reduced intensity of pain and improved visual acuity. Further, 10% KOH revealed profuse fungal filaments with few inflammatory cells in all the patients. The anterior chamber cells and flare were either reduced or entirely absent. There was no evidence of lid edema and surrounding corneal edema in any of the patients. The mean healing period was 28.8 days (standard deviation (SD): 10.05). The KOH mount revealed the presence of confluent fungal hyphae with a few inflammatory cell infiltrates. The Aspergillus species and Fusarium species were found in 47% and 40% of the cases, respectively. Conclusion: Toxic non?inflammatory fungal keratitis following steroid therapy needs to be considered in fungal ulcers with disproportionately less pain and good visual acuity. The fungal ulcers with altered clinical signs of classical inflammation need to be assessed for topical steroid misuse.
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Purpose: To investigate the rate of secondary glaucoma after intravitreal (IV) dexamethasone implant (ozurdex) 0.7 mg injection in a retinal disorder over a clinical treatment period of 2 years in a tertiary eye care center. Methods: Retrospective study based on the records of patients receiving IV ozurdex 0.7 mg implant for T/t of cystoid macular edema (CME), diabetic macular edema (DME), macular edema due to central retinal vein occlusion/branch retinal vein occlusion (CRVO/BRVO), and choroidal neovascular membrane (CNVM) at a tertiary eye care hospital for 2 years with 6 months of follow?up. The post?T/t intraocular pressure (IOP) and antiglaucoma medication (AGM) required was recorded at day 1, 1 week, 1, 2, 3, 4, and 6 months and analyzed for secondary IOP spike or ocular hypertension defined as IOP >21 mmHg at any point in time. The patients with pre?existing glaucoma and lost to follow?up were excluded. Results: A total of 102 eyes of 80 patients were included in the study. The mean baseline IOP was 14.40 + 2.97 mmHg, post?injection was 15.01 + 3.22 mmHg at day 1, 15.15 + 3.28 mmHg at 1 week, 15.96 + 3.62 mmHg at 1 month, 16.26 + 3.95 mmHg at 2 months, 15.41 + 3.33 mmHg at 3 months, 15.38 + 3.28 mmHg at 4 months, and 14.27 + 2.69 mmHg at 6 months. No significant difference was seen from baseline IOP at day 1 (P = 0.163), 1 week (P = 0.086), and 6 months (P = 0.748). Statistically significant difference was seen at 1 month (P = 0.0009), 2 months (P = 0.0001), 3 months (P = 0.023), and 4 months (P = 0.026). The mean IOP peak at 2 months recovered to baseline by 6 months subgroup IOP trend shows a similar variation and the results are consistent with the studies in the literature. About 19/102 (18.62%) eyes showed an IOP spike post?T/t. The maximum was seen at 2 months; 16 eyes showed a rise in the range 22–25 mmHg; 8 in the range 26–30 mmHg; and 1 eye had 34 mmHg and required multiple AGM—no surgical intervention was needed. Conclusion: A secondary IOP spike post?IV ozurdex 0.7 mg seen in 18.62% of the cases require AGM. The IOP monitoring should be meticulously performed for the variations and secondary IOP spike management to prevent irreversible damage to the optic nerve and visual field
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Background: Mesh repair has been one of the most popular methods of hernia repair with the lowest recurrence rates as compared to other tissue repairs. With increasing incidence of incisional hernia which is only 2nd to inguinal hernia in incidence, number of surgeries performed for incisional hernia has increased considerably. The mesh fixation has traditionally been done with Polypropylene which are non-absorbable sutures. This study aims to compare the group of patients in which polyglactin-910 was used with patients in which polypropylene was used. Methods: The study is a prospective study conducted over a period of 4 years at the largest tertiary care hospital of Western India. 400 patients were included from which 256 patients had inguinal hernia and the rest 144 had ventral incisional hernias. Two groups were framed from these 400 patients – one in which polyglactin-910 was used (120 patients) and the other in which polypropylene (280 patients) was used. All the patients were followed up for at least 1 year and the complications were compared. Result: Out of 400 patients in 120 patients mesh repair was done with polglactin-910 and rest with poplypropylene, and study was conducted over a period of 4years with results showing incidence of pain 23% with poplypropylene against relatively low incidence with polyglactin-910 of 12%. Another observation was that incidence of sinus formation was 13% with polypropylene and only 0.8% with polyglactin-910. Conclusion: The study concluded that the association of pain and sinus formation was higher with polypropylene
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Abstract Background: Postoperative nausea and vomiting is the second most common complaint in the postoperative period after pain. The incidence of postoperative nausea and vomiting was 60-80% in middle ear surgeries in the absence of antiemetic prophylaxis. Because of this high incidence of postoperative nausea and vomiting, we aimed to assess the effect of palonosetron-dexamethasone and ondansetron-dexamethasone combination for the prevention of postoperative nausea and vomiting in patients of middle ear surgery. Methods: Sixty-four patients, scheduled for middle ear surgery, were randomized into two groups to receive the palonosetron-dexamethasone and ondansetron-dexamethasone combination intravenously before induction of anesthesia. Anesthesia technique was standardized in all patients. Postoperatively, the incidences and severity of nausea and vomiting, the requirement of rescue antiemetic, side effects and patient satisfaction score were recorded. Results: Demographics were similar in the study groups. The incidence difference of nausea was statistically significant between groups O and P at a time interval of 2-6 hours only (p = 0.026). The incidence and severity of vomiting were not statistically significant between groups O and P during the whole study period. The overall incidence of postoperative nausea and vomiting (0-24 hours postoperatively) was 37.5% in group O and 9.4% in group P (p = 0.016). Absolute risk reduction with palonosetron-dexamethasone was 28%, the relative risk reduction was 75%, and the number-needed-to-treat was 4. The patient's satisfaction score was higher in group P than group O (p = 0.016). The frequency of rescue medication was more common in group O than in group P patients (p = 0.026). Conclusion: The combination of palonosetron-dexamethasone is superior to ondansetron-dexamethasone for the prevention of postoperative nausea and vomiting after middle ear surgeries.
Resumo Justificativa: Náusea e vômito no pós-operatório é a segunda queixa pós-operatória mais frequente após a dor. Sem profilaxia antiemética, a incidência de náusea e vômito no pós-operatório foi de 60−80% após cirurgia do ouvido médio. Dada a alta incidência relatada de náusea e vômito no pós-operatório, nosso objetivo foi avaliar o efeito da combinação de palonosetrona-dexametasona e ondansetrona-dexametasona na prevenção de náusea e vômito no pós-operatório em pacientes submetidos a cirurgia do ouvido médio. Método: Sessenta e quatro pacientes programados para cirurgia de ouvido médio foram aleatoriamente divididos em dois grupos. Um recebeu a combinação de palonosetrona-dexametasona (grupo P) e o outro ondansetrona-dexametasona (grupo O) por via intravenosa antes da indução anestésica. A técnica anestésica foi padronizada em todos os pacientes. No pós-operatório, foram registradas incidência e gravidade das náuseas e vômitos, necessidade de antiemético de resgate, efeitos colaterais e índice de satisfação dos pacientes. Resultados: As características demográficas foram semelhantes nos grupos estudados. A diferença na incidência de náusea foi estatisticamente significante entre os grupos O e P apenas no intervalo de tempo entre 2 e 6 horas (p = 0,026). A incidência e gravidade de vômito não foram estatisticamente significantes entre os grupos O e P durante todo o período do estudo. A incidência geral de náusea e vômito no pós-operatório (0−24 horas de pós-operatório) foi de 37,5% no grupo O e de 9,4% no grupo P (p = 0,016). A combinação palonosetrona-dexametasona associou-se com redução do risco absoluto de 28%, redução do risco relativo de 75%, e o número necessário para tratar foi 4. O escore de satisfação do paciente foi maior no grupo P (p = 0,016). A frequência da medicação de resgate foi mais comum no grupo O (p = 0,026). Conclusão: A combinação de palonosetrona-dexametasona é superior à ondansetrona-dexametasona na prevenção da náusea e vômito no pós-operatório após cirurgia de ouvido médio.
Sujets)
Humains , Mâle , Femelle , Adulte , Jeune adulte , Dexaméthasone/administration et posologie , Ondansétron/administration et posologie , Vomissements et nausées postopératoires/prévention et contrôle , Palonosétron/administration et posologie , Méthode en double aveugle , Incidence , Études prospectives , Satisfaction des patients , Vomissements et nausées postopératoires/épidémiologie , Association de médicaments , Oreille moyenne/chirurgie , Adulte d'âge moyen , Antiémétiques/administration et posologieRésumé
Background: Aim of the study was to assess quality of life (QOL) of parents of epileptic child and its association with various factors like demographic, clinical, therapeutic and behavioral factors.Methods: Consenting parents of 160 epileptic children were enrolled after finishing child’s visit to the pediatrician. Parents were enquired on baseline demographic variables like age, gender, socio-economic status, parental education; clinical details like type of epilepsy, duration of seizure, seizure frequency and co-morbidity and therapeutic factors like treatment of epilepsy and adverse drug reactions. QOL was evaluated using QOLCE questionnaire and Childhood Illness-related Parenting Stress Inventory and analysed.Results: Out of 160 parents, 85% belong to 30-40 years of age and 62.5% were male. Deteriorated quality of life was reported by parents as mean score 63.46±7.69. QOL was significantly poor (p<0.05) in parents of younger child (<6 yrs), education status (upto primary school only), employment status of parent (unemployed) and lower socioeconomic status. Assessment of disease related parameters revealed that type of seizure, seizure frequency, duration and co-morbidity were factors significantly affecting quality of life of parents with lower QOL scores(p<0.05). QOL of parents of child with epilepsy undergoing polytherapy with multiple AEDs treatment, particle seizure control and having adverse drug reaction were associated with poor scores of health and well being (p<0.05). It was found that parents of epileptic child had deteriorated QOL score with respect to behaviour patterns irrespective to conditions of epilepsy due to constant stress and anxiety and poor state of mind.Conclusions: QOL of parents was compromised in Indian children with epilepsy. Demographic factors like age of child, parental education, socio-economic status and clinical factors like type of seizure, frequency & duration of seizure and co-morbid conditions significantly affect the QOL of parents. Significantly poor QOL scores was also due to therapeutic factors like treatment with polytherapy and adverse drug reactions with poor behavioral patterns which was observed in parents that should be taken care and should not be overlooked.
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Denture adhesives play a vital role in retention of complete dentures, wherever indicated. Dentists need to know about denture adhesives to be able to identify those patients who actually need them and to be able to educate them about the advantages, disadvantages and correct use of these products. The aim of the study was to evaluate the knowledge about denture adhesives among complete denture wearers indicated for use of denture adhesives visiting Dental Colleges in Western Maharashtra. METHODSThe study was conducted on 300 completely edentulous patients with conventional complete dentures indicated for use of denture adhesives. RESULTSPatients (n= 300) who were wearing ill - fitting complete dentures and required use of denture adhesives were selected, their response about knowledge was assessed by questionnaire survey and those who knew about it were instructed to demonstrate the application of denture adhesive to the intaglio surface of complete denture. 34.7% (n1= 104) of the total subjects (n= 300) had heard about denture adhesives. Out of these 104 subjects, 69.2% (n1= 72; CP= 24%) had used and 77.8% (n1= 81; CP= 27%) knew when to use denture adhesives. Out of 72 subjects who had used denture adhesive, only 30.5% (CP= 7.3%) could demonstrate the adequate technique to use denture adhesive. CONCLUSIONSKnowledge about use of denture adhesives for those who are in need per se has to be spread along with right technique of its use. The indication of its use, and correct technique/techniques of application, should be taught to the patients who demand the use of denture adhesives.
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Background: Urolithiasis is a burgeoning disease that results from pathological biomineralization. Daucuscarota L. is a widely consumed food crop with reported nephroprotective and diuretic activity. Its potential for Ashmari bhedan (destruction of stone/calculi) or treatment of urinary calculi has been exploredtraditionally. However, no scientific evidence is available to prove its antiurolithiatic efficacy. Moreover,establishing the antiurolithiatic effects of D. carota, an extensively consumed commodity with numeroushealth benefits, would provide a beneficial dietary measure for the prevention and cure of urolithiasis.Objective: The study aimed at investigating in vivo antiurolithiatic potential of hydroethanolic extract ofD. carota roots against calcium oxalate urolithiasis.Materials and methods: Ethylene glycol and ammonium chloride induced hyperoxaluria model of urolithiasis in male Wistar rats was used for the study. Urine and serum parameters and, kidney histopathology was used to determine the antilithic efficacy of D. carota root extract.Results: D. carota extract significantly ameliorated abnormal urinary levels of calcium, oxalate, phosphate, magnesium, citrate, protein and uric acid in lithogenic rats. Serum BUN, creatinine and uric acidlevels; and calcium, phosphate and oxalate deposition in kidney tissue were also rendered normalfollowing D. carota treatment. D. carota extract also prevented oxidative stress mediated renal tissuedegeneration both prophylactically and curatively.Conclusion: This study suggests antiurolithiatic effect of D. carota roots, which can be attributed to itsanticrystallization property, ability to ameliorate urine and serum biochemistry and renal cellularity
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Introduction: Chronic abdominal pain which is difficult to diagnose initially not only encumbers the patient but it also affectstheir daily routine, leading to physical and psychological disability, here comes the role of diagnostic laparoscopy which provesto be beneficial aiding in diagnosing most of these cases. Hence, the aim was to evaluate the diagnostic value of laparoscopyin cases with chronic abdominal pain.Materials and Methods: This study was done in the Department of General Surgery at Indira Gandhi Institute of Medicalsciences, Patna, Bihar, from July 2019 to March 2020 in 40 patients. Prior Institutional Ethical Committee approval was alsoobtained for this study.Results: Out of 40 patients included in this study, maximum number of patients were females. Male-to-female ratio was 1:1.4.The maximum number of patients were in the age group of 21–40 years (60%). Maximum patients 45% (n = 18) had complaintof pain in the right lower quadrant of abdomen. The most common finding during diagnostic laparoscopy was found to bepathology in the appendix accounting for 27.5% of cases (11/40).Conclusion: Diagnostic laparoscopy is a safe and effective tool to establish the etiology of chronic abdominal pain and allowsfor appropriate interventions. It can serve as a time saving and cost-effective implement for these patients.
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India, the disaster preparedness has primarily been restricted to being response oriented that is mainlyconcentrated on the rescue operations. Insufficient community preparedness and lack of propercommunication leads to large scale causalities. The lack of proper communication is due to the fact thatthe relevant information among the community participants is not spread properly. One of the majorreasons for this is: the difference in the language of communication among the people and the language inwhich the information is officially shared. Due to this language gap it becomes very difficult for thenative people to understand the guidelines related to the disaster risks and disaster preparedness, therebymaking them more vulnerable to disaster risks. Five districts from Bihar have been identified for datacollection. The districts feature prominently from North to South on the map showing Multi HazardZones in Bihar issued by Bihar State Disaster Management Authority. Quantitative data analysis clearlyreflects that firstly, the official languages (English and Hindi) used by the government agencies forknowledge transfer are totally inadequate and secondly, translating the information in regional languageslike Magahi, Bhojpuri and Maithili considerably enhance the quality and the quantity of responses thatare generated during data collection. Community involvement can be promoted and made efficient onlywhen the regional languages are used as the desired media of communication.
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Background: Serious adverse drug reactions (ADRs) constitute a major limitation in clinical development of a drug thus necessitating close monitoring. Studies regarding the pattern of serious ADRs are limited in southern India. The present study was conducted in tertiary care hospital in Andhra Pradesh with an objective to evaluate the pattern of severe cutaneous and non-cutaneous ADRs in our hospital and to assess the causality, severity, and preventability of these reactions.Methods: A retrospective observational study was conducted over two years, from January 2016 till January 2018 in our ADR monitoring center. The pattern of serious adverse drug reactions, the nature of ADR, suspected drug, the outcome and preventability were analyzed using Modified Hartwig and Siegel scale, and modified Schumock and Thorton scale.Results: Out of 734 ADRs reported, 42 were serious, while 692 were non-serious. Out of 42, 22 were dermatological in origin while the others were acute kidney injury, acute psychosis, febrile neutropenia, gynecomastia, and lipodystrophy. According to WHO causality assessment scale, 27 were probable while 15 were possible. The majority were reported in the age group of 16 to 65 years with female (34) preponderance. The most common drug category responsible was antimicrobials, followed by antiretrovirals, anti-epileptics, and analgesics.Conclusions: Antimicrobial, anti-epileptics, and analgesics contributed to serious ADRs. Although non-cutaneous ADRs did not result in hospitalization, they caused social inhibition and mental stress in the patient.
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Purpose: The aim of this study was to estimate the prevalence and causes of visual impairment (VI) and blindness and diabetic retinopathy (DR) in Siwan district, Bihar. Methods: A population-based cross-sectional study was done from January to March 2016 using the Rapid Assessment of Avoidable Blindness 6 (RAAB 6, incorporating DR module) methodology. All individuals aged ?50 years were examined in 57 randomly selected clusters within the district. Results: A total of 3476 individuals were enumerated and 3189 (92%) completed examination. The overall prevalence of blindness and severe VI was 2.2% (95% confidence interval (CI): 1.6–2.8) and 3.4% (95% CI: 2.6–4.3), respectively. Untreated cataract was the leading cause of blindness (73%) and severe VI (93%). The cataract surgical coverage (CSC) at <3/60 was 71.5% for eyes and 89.3% for persons in this sample and the CSC was similar between the genders. Refractive error (71%) was the primary cause of early VI. The overall prevalence of known and newly diagnosed diabetes was 6.3% (95% CI, 5.4–7.2%). Prevalence of any DR, maculopathy, and sight-threatening DR was 15, 12.4, and 6%, respectively. Conclusion: To conclude, as compared to previous reports, the prevalence of blindness and DR in Siwan district of Bihar was found to be lower and the CSC was higher. However, the problem of avoidable blindness remains a major problem in this region.
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Besides the fundamental components of the chromatin, DNA and octameric histone, the non-histone chromatinproteins and non-coding RNA play a critical role in the organization of functional chromatin domains. Thenon-histone chromatin proteins therefore regulate the transcriptional outcome in both physiological andpathophysiological state as well. They also help to maintain the epigenetic state of the genome indirectly.Several transcription factors and histone interacting factors also contribute in the maintenance of the epigeneticstates, especially acetylation by the induction of autoacetylation ability of p300/CBP. Alterations of KATactivity have been found to be causally related to disease manifestation, and thus could be potential therapeutictarget.
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Background@#Catheter-related bladder discomfort (CRBD) is a frequent complaint after awakening from anesthesia in patients receiving perioperative bladder catheterization. Overactive bladder (OAB) and CRBD show similar symptoms; thus, drugs used for the management of OAB influence symptoms of CRBD. Trospium chloride has been found effective in managing resistant cases of OAB. We evaluated the efficacy of oral trospium on CRBD in the postoperative period. @*Methods@#Sixty-four male and female adult patients, with planned spinal surgery and requiring urinary bladder catheterization, were randomly divided into two groups of 32 each. Group T patients received 60 mg extended-release oral trospium (extended-release) 1 h before induction of anesthesia and Group C patients received a similar-looking placebo. The anesthetic technique was identical in both groups. The CRBD score was evaluated in the postoperative ward using a 4-point scale (1 = no discomfort, 2 = mild, 3 = moderate, 4 = severe). Readings were recorded on arrival (0 h), and 1 h, 2 h, and 6 h postoperatively. All patients received fentanyl for postoperative pain relief. @*Results@#The incidence of CRBD was significantly higher in group C than in group T at 0 h (66% vs 22%, P=0.001) and 1 h postoperatively (72% vs 28%, P=0.001). The incidence of moderate to severe CRBD was higher in group C at postoperative 2 h (82% vs 14%, P=0.004). There was no significant difference in postoperative fentanyl requirements. @*Conclusions@#Pretreatment with 60 mg ER trospium reduced the incidence and severity of CRBD in the early postoperative period.
Résumé
Background: The mobile phone is viewed as an important communication tool and is an integral part of the human society in the present era. Medical students use smart phones for note taking, imaging, web browsing, text books, question banks etc. Excessive mobile phone use has been found to be associated with health problems such as impaired concentration, headache, fatigue, thermal sensations in and around ear, stress, sleep disturbances and frustration. Objective was to explore the mobile phone usage pattern and its health effects among medical students.Methods: An observational study was conducted among medical students of Belagavi. The calculated sample size was 277 after taking the prevalence of mobile phone usage pattern of 76.4%. The questionnaire consists of socio-demographic characteristics, pattern of mobile phone usage like mode of use, time of maximum use etc. and the health effect variables like headache, restlessness, neck pain, painful fingers etc. Statistical analysis was done using MS-Excel 2007 and SPSS v 22, proportion and chi-square test was applied and p<0.05 was considered significant.Results: 98.19% were using smart phone and 85.56% were having single phone. Maximum were using for 2-4 years (42.60%). Internet was used for academic purpose in 89.89%. Majority of them experienced eyes symptoms (55.23%) followed by sleep deprivation (46.21%) and headache (42.60%).Conclusions: Even though mobile phone has positive role in our daily lives, its overuse leads to negative impact on health, sleep, and academic performance of students.