Formulation and assessment of biological properties of garcinia indica fruit extract mouthrinse as an adjunct to oral hygiene regimen: an in vitro analysis

Abstract The prevalence of gingivitis is substantial within the general population, necessitating rigorous oral hygiene maintenance. Objective This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. Methodology The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. Results Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). Conclusion This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.

The Effect of Integrated Nutrient Management on Various Growth Parameters of Cluster Bean (Cyamopsis tetragonoloba L.)

The present investigation entitled “The effect of integrated nutrient management on various growth parameters of cluster bean (Cyamopsis tetragonoloba L.)” was carried out at Horticultural Research Centre of Sardar Vallabhbhai Patel University of Agriculture & Technology, Meerut – 250110 during 2022-23. In this study integrated nutrient management (INM), farmyard manure (FYM), vermicompost and phosphate solubilizing bacteria (PSB) were used with different combinations. The entitled experiment was conducted in Randomized Block Design (RBD) with three replications. Application of INM dose @ 75% RDF + Vermicompost (1.5 t ha-1) + Rhizobium (2 kg ha-1) + PSB (1 kg ha-1) was found to be the most effective in terms of growth parameters viz., plant height (89.90 cm), number of branches plant-1(9.73), number of clusters plant-1(27.83) and number of leaves plant-1(37.98). Therefore, it can be suggested that a dose of 75% RDF + Vermicompost (1.5 t ha-1) + Rhizobium (2kg ha-1) + PSB (1 kg ha-1) suitable for the commercial cultivation of vegetable cluster bean in the Western Plane Zone of Uttar Pradesh.

Improving Yield of Tomatoes Grown in Greenhouses Using IoT Based Nutrient Management System

Nutrient management, fertigation scheduling, IoT, sensors, tomatoAims: This paper discuss, a study conducted to evaluate the developed automated IoT based fertigation control system for greenhouse for tomato (Solanum lycopersicum L.) crop.Study Design: Different nutrient and irrigation water levels were used to evaluate developed system using three replications in a factorial randomized block design (RBD).Methodology: An automated fertigation scheduling system was implemented in a greenhouse with soil moisture sensors at three depths (15, 30, and 45 cm) within the tomato root zone. R2, RMSE, NSE and MAE values were used to establish the correlation between sensor values and actual soil moisture. Tomato crop biometric parameters were collected and analyzed to evaluate the system's performance.Results: The results indicated strong correlation between sensor and observed soil moisture with R2 (0.8642 to 0.9528), RMSE (1.0786 to 1.8328), NSE (0.8438 to 0.9463), and MAE (0.9729 to 1.7043) values. Highest plant height (255 cm), girth (2.29 cm), number of leaves (21), number of flowers (23.1), fruit length (8.05 cm), fruit weight (110 g), yield/plant (2.75 kg), yield (68.77 t/ha) and sugar (5.1°Brix) were observed with drip irrigation at the rate of 100% ETc and 100% recommended dose of fertilizer (RDF), while minimum values of these parameters were noted in the control treatment.Conclusion: Using sensor-based drip irrigation at 100% ETc and 100% RDF led to a 62.92% increase in tomato yield and water saving of 14.84% compared to the control treatment. For tomato crop, the system required 2.27 l/plant/day water at 100% ETc. The developed automated fertigation system found suitable for greenhouse vegetable crops with the use of sensor based drip irrigation at 100% ETc and 100% RDF.

Pleomorphic Adenoma of the Hard Palate: A Multidisciplinary Approach

Pleomorphic adenoma is the most common salivary gland tumor accounting for 80% of all major salivary gland tumors. It is a benign salivary gland neoplasm that constitutes 3% to 10% of the neoplasms in the head and neck region.1 Salivary gland neoplasms represents less than 1% of all tumors. This article is being showcased as a special case due to the fact it was done at a Taluk Hospital and also because ENT and oromaxillofacial surgeons were involved during the surgery.

STEPPING TOWARDS NON-SURGICAL MANAGEMENT: STUDY IN A TERTIARY CARE CENTRE IN A DEVELOPING NATION

Objective: To assess the emerging trend of Non-operative Management and image guided interventions over surgery in a tertiary care hospital in a developing nation. Data regarding patients who underwe Methods: nt Non-Operative Interventions (NOI) or Non-Operative Management (NOM) in VMMC and Safdarjung hospital, New Delhi, India over past 3 years was collected retrospectively from hospital database. Max diameter of liver abscess mana Results: ged nonoperatively ranged from 3.5 to 14 cm. Mean diameter was 7.15 +/- 3.20 cm. Mean volume of the abscess was 538 ml. 43.33% of the abscesses were ruptured. 73.33% of the patients underwent pigtail insertion and the rest underwent ultrasound guided aspiration. 12 patients underwent PTBD in the center over past 3 years. All the patients had malignant etiology of some sort. 75% patients had carcinoma of Gall bladder, and the rest had biliary stricture of malignant nature. Conclusion: NOIs have revolutionized management of several entities for which surgery was sole resort until few decades back. However, these facilities come with their own set of limitations. There is a paucity in literature in the developing world regarding outcome of NOI

A Rare Case of an Intratonsillar Abscess

The case describes the anatomy and pathophysiology of the palatine tonsils and the development of intratonsillar abscess. The abscess can be caused by a suppurative focus that arises in acute tonsillitis when outward drainage is prevented, leading to pus accumulation in the tonsillar tissue. Dehydration or a history of peritonsillar abscess can also lead to intratonsillar abscess. The condition can be mistaken for tonsillolith or malignancy, such as lymphoma. A computed tomography (CT) scan is recommended for diagnosis, showing a low-density and ring enhancement. Aspiration using a large bore needle is the preferred mode of treatment, but if repeated aspirations fail, tonsillectomy may be necessary. Intratonsillar abscess is rare and so far only 29 cases have been reported.1 The differential diagnoses include lymphoma, which usually presents as unilateral enlargement of the tonsil, tonsillolith due to its appearance and peritonsillar abscess again due to the unilateral enlargement of the tonsil. This case is different as compared to other reported cases we did not do a CT scan as recommended by most of the studies (cost being a concern). Also, in this case, we resorted to surgery as the main modality unlike other cases wherein the surgeons opted to do an aspiration of the pus mainly keeping the intraoperative complications in mind.

STABILITY TOLERANCE OF SUNFLOWER OIL -IN-WATER EMULSION EMULSIFIED BY SOYA LECITHIN FOR FOOD GRADE ACIDS

Oil-in-water emulsion has promised values in food, pharmaceutical, drug, cosmetic and allied industries. The stable emulsion with long shelf life increases its utility. Many avouring agents are used to increase shelf life as preservative or commercial value. Food grade acids are used to in the emulsion preparation which enhances the taste or avour. The present study focuses the usage of acetic acid, phosphoric acid and oxalic acid. The emulsions for different acids are prepared ranging concentration from 0.001 to 0.003M using lecithin as emulsier and sunower oil. Experiments were done to study organoleptic properties with respect to basicity and dissociation constant values. The colour of the primary emulsion was creamy white and sustainable for acetic acid emulsion to 28 day at experimental temperature 10, 25 and 40 0C. Oxalic acid is recorded a low pH value 1.88 for 0.003 M emulsion solution in compare with acetic acid (3.63) and phosphoric acid (2.32).The relative conductance measurement for oxalic acid shows a very high value 5.6mS to acetic acid 0.257mS and phosphoric acid 0.247 mS. The rst dissociation constant value 5.6x10-2 of oxalic acid is larger relatively compare to phosphoric acid 7.5 x 10-3 and acetic acid 1.8 x10-5. Basicity of acids increases from acetic acid (mono basic), oxalic acid (dibasic) to phosphoric acid (tri-basic).These results strongly supports that basicity and dissociation constant values of acids conspicuously inuence the stability of the emulsion. Higher value of dissociation constant value and basicity, lower the stability of the emulsion.

Prevalence of Non-Alcoholic Fatty Liver Disease and Its Correlation with Coronary Risk Factors in Patients with Type 2 DM

Background: Type 2 diabetics appear to be at greater risk of Non-alcoholic Fatty Liver Disease (NAFLD) and certainly of fibrosis and cirrhosis development. Type 2 diabetes and NAFLD are more common than previously thought, especially in India. To find out if there is a connection between NAFLD and Cardiovascular Disease (CVD) in a large group of type 2 diabetics, the current study was designed. Aim: 1) To study the prevalence of NAFLD by USG in patients with type 2 diabetes mellitus. 2) To correlate NAFLD with coronary artery disease and coronary risk factors in patients with type 2 diabetes mellitus. Methods: This was an observational, cross-sectional, open-labeled, single-centric, parallel-design study conducted in the department of general medicine of a tertiary care hospital among patients with type 2 Diabetes Mellitus (DM). Results: Among the 120 patients that took part in the study, there were 69 NAFLD patients and 51 non-NAFLD patients. Individuals with NAFLD had a significantly longer mean diabetes duration. In the NAFLD group, the prevalence of hypertension, obesity, visceral obesity, and metabolic syndrome was greater. The NAFLD group had much worse glycemic control. Sr. HDL and Sr. Triglyceride levels were found to be greater in the NAFLD group, whereas Sr. LDL levels were found to be higher in the non-NAFLD group, and Total cholesterol levels were practically comparable in both groups. ALT and AST values were higher in NAFLD patients than in non-NAFLD patients. Conclusion: The prevalence of NAFLD increases dramatically in the presence of type 2 diabetes, with the majority of patients affected in the fourth decade of life. Obesity, hypertension, and dyslipidemia were considerably more prevalent with NAFLD compared to subjects without NAFLD.

A study on seroconversion following first & second doses of ChAdOx1nCoV-19 vaccine in central Kerala

Background & objectives: Vaccination against COVID-19 induces spike protein-binding IgG antibodies, a robust correlate of protection against COVID-19. This study was undertaken to assess the humoral response after completion of both the doses of ChAdOx1 nCoV vaccine in healthcare workers (HCWs) at a tertiary care health centre in India. Methods: A cross-sectional COVID-19 vaccine-induced antibody study was conducted among HCWs. IgG antibodies against spike protein were measured at least 28 days after the first dose and the second dose of vaccination in both SARS CoV-2 naïve and recovered HCWs. Mean and median antibody titre following each dose of vaccine and its association with age, gender, co-morbidities and factors such as exercise, stress and sleep deprivation were also explored. Results: Among the 200 vaccine recipients, 91.5 per cent showed seroconversion after the first dose and 99.5 per cent after the second dose. The mean titre after the second dose was significantly higher when compared to the first dose (12.68±4.17 vs. 9.83±6.3, P=0.001). More than half (54%) had high antibody titre ?12 S/Co (Signal/cut-off). Previous COVID-19 infection was the single most important factor influencing antibody production, where the mean titre just after a single dose [mean-17.81±5.94, median-20.5 (interquartile range [IQR]-3.7)] surpassed the titre after the second dose in SARS CoV-2 naïve individuals [mean-12.29±4.00, median-12.8 (IQR-3.7), P=0.001]. Furthermore, 28 per cent of vaccinees showed a reduction in titre after the second dose. The mean fall in titre was 2.25±1.40 and was more pronounced in males, the younger age group and those with previous COVID-19 infection. Interpretation & conclusions: ChAdOx1 nCov-19 vaccine after two doses elicited an excellent immune response. However, greater immunogenicity after the first dose was seen among those with previous COVID-19 infection, even surpassing the titre achieved by the second dose of vaccine in SARS CoV-2 naïve recipients. A fall in antibody titre after the second dose is a matter of concern and requires further studies.

Rifampicin-induced thrombocytopenia in a patient of disseminated tuberculosis

Thrombocytopenia may be associated with a variety of conditions and risks depending on its severity, ranging from mild epistaxis to life-threatening bleeding. Many drugs or herbal remedies can cause thrombocytopenia by either inhibiting platelet production and/or enhancing their destruction from the peripheral blood-mediated through an immunological mechanism implicating drug-dependent antibodies. Drugs are a common cause of acute immune-mediated thrombocytopenia in adults, the drug etiology is often initially unrecognized. Most cases of drug-induced thrombocytopenia are caused by drug-dependent antibodies that are specific for the drug structure and bind tightly to platelets by their Fab regions but only in the presence of the drug. Thrombocytopenia is an uncommon but life-threatening complication of certain antitubercular drugs. The discovery of isolated thrombocytopenia in a patient taking several medications presents a challenging clinical problem. We report a case of a young immunocompetent female who presented with disseminated tuberculosis and was found to have rifampicin-induced thrombocytopenia

Outcome of Patients with Sepsis Admitted in Intensive Care Unit of a Tertiary Care Hospital in India

Introduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The rapid progression of sepsis requires correspondingly swift adjustments in therapy, and accurate identification of disease severity is therefore vitally important for predicting prognosis, treatment, preventing complications, reducing complication and mortality. With this background, the present research is aimed to study the relation of serum procalcitonin levels in cases with sepsis, to calculate APACHE II scores and to correlate the levels of serum PCT levels with APACHE II Score with the outcome. Methodology: This was a prospective observational non interventional cohort study was conducted in the Clinic of Intensive Care unit of a tertiary care hospital and medical college in western India from May 2020 to December 2020. Results: A total of 75 patients, admitted to the ICU with the diagnosis of sepsis, were included in this prospective observational study. Of them 47 (62.7%) were males and highest cases were aged between 60 to 69 years. Of the total 75 patients, 47 (62.7%) patients were survivors. Age, gender and involvement of system were not associated with mortality while lower APACHE II score and presence of co-morbidities were significantly associated with mortality. Conclusion: From this study we conclude that the lower APCHE II score and presence of co-morbidity significantly increases the mortality in ICU patients admitted with sepsis

Case for investment in tobacco cessation: a population-based analysis in low- and middle-income countries / Argumentos a favor de la inversión en iniciativas para el abandono del tabaco: un análisis basado en la población en países de ingreso bajo y mediano / Análise de viabilidade de investimento na cessação do tabagismo: um estudo populacional em países de baixa e média renda

ABSTRACT This study aimed to estimate the return on investments of three population-level tobacco cessation strategies and three pharmacological interventions. The analysis included 124 low- and middle-income countries, and assumed a 10-year investment period (2021-2030). The results indicate that all six cessation programmes could help about 152 million tobacco users quit and save 2.7 million lives during 2021-2030. If quitters were followed until 65 years of age, 16 million lives could be saved from quitting. The combined investment cost was estimated at 1.68 United States dollars (US$) per capita a year, or US$ 115 billion over the period 2021-2030, with Caribbean countries showing the lowest investment cost at US$ 0.50 per capita a year. Return on investments was estimated at 0.79 (at the end of 2030) and 7.50 if benefits were assessed by the time quitters reach the age of 65 years. Disaggregated results by country income level and region also showed a return on investments less than 1.0 in the short term and greater than 1.0 in the medium-to-long term. In all countries, population-level interventions were less expensive and yielded a return on investments greater than 1.0 in the short and long term, with investment cost estimated at US$ 0.21 per capita a year, or US$ 14.3 billion over 2021-2030. Pharmacological interventions were more expensive and became cost beneficial over a longer time. These results are likely conservative and provide support for a phased approach implementing population-level strategies first, where most countries would reach break-even before 2030.

RESUMEN Este estudio tenía como objetivo estimar el rendimiento de la inversión de tres estrategias para el abandono del tabaco dirigidas a la población y de tres intervenciones farmacológicas. El análisis incluyó a 124 países de ingreso bajo y mediano y consideró que el período de inversión era de 10 años (2021-2030). Los resultados muestran que los seis programas sobre el abandono del tabaco podrían ayudar a unos 152 millones de personas a dejar el tabaco y salvar 2,7 millones de vidas en el período 2021-2030. Si se siguiera a las personas que dejan el tabaco hasta que cumpliesen 65 años, el número de vidas que se podrían salvar sería de 16 millones. Se estimó que el costo combinado de la inversión era de 1,68 dólares estadounidenses (US$) per cápita al año, o US$ 115 billones durante el período 2021-2030, y que el costo de inversión más bajo se encontraba en los países del Caribe (US$ 0,50 per cápita al año). Se estimó que el rendimiento de la inversión era de 0,79 (a finales de 2030) y de 7,50 si se tenían en cuenta los beneficios que obtienen las personas que dejan el tabaco hasta que alcanzan los 65 años. Los resultados desglosados por nivel de ingresos de los países y región también mostraron que el rendimiento de la inversión era inferior a 1,0 a corto plazo y superior a 1,0 de mediano a largo plazo. En todos los países, las intervenciones dirigidas a la población fueron menos costosas y produjeron un rendimiento de la inversión superior a 1,0 a corto y largo plazo, con un costo de las inversiones estimado en US$ 0,21 per cápita al año, o US$ 14,3 billones durante el período 2021-2030. Las intervenciones farmacológicas fueron más costosas y solo fueron generaron beneficios en función de los costos a más largo plazo. Probablemente son unos resultados prudentes, pero sirven de base para adoptar un enfoque gradual en la aplicación de estrategias dirigidas a la población primero donde la mayoría de los países alcanzarían el punto de equilibrio antes del 2030.

RESUMO Este estudo teve como objetivo estimar o retorno dos investimentos de três estratégias de cessação do tabagismo no nível populacional e de três intervenções farmacológicas. A análise incluiu 124 países de baixa e média renda e presumiu um período de investimento de 10 anos (2021-2030). Os resultados indicam que todos os seis programas de cessação poderiam ajudar cerca de 152 milhões de usuários de tabaco a parar de fumar e salvar 2,7 milhões de vidas entre 2021 e 2030. Se houvesse acompanhamento até os 65 anos de idade daqueles que parassem de fumar, 16 milhões de vidas poderiam ser salvas. O custo de investimento combinado foi estimado em 1,68 dólares americanos (US$) per capita por ano, ou US$ 115 bilhões no período 2021-2030, com os países do Caribe apresentando o menor custo de investimento, a US$ 0,50 per capita por ano. O retorno dos investimentos foi estimado em 0,79 (no fim de 2030) e 7,50 se os benefícios fossem avaliados até o momento em que aqueles que pararam de fumar chegassem aos 65 anos de idade. Os resultados desagregados por nível de renda nacional e por região também mostraram um retorno dos investimentos inferior a 1,0 no curto prazo e superior a 1,0 no médio e longo prazos. Em todos os países, as intervenções no nível populacional foram menos caras e renderam um retorno dos investimentos superior a 1,0 no curto e longo prazos, com um custo de investimento estimado em US$ 0,21 per capita por ano, ou US$ 14,3 bilhões entre 2021 e 2030. As intervenções farmacológicas foram mais caras e tiveram um bom custo-benefício durante um período mais longo. Estes resultados são provavelmente conservadores e servem de apoio para uma abordagem em fases que implemente primeiramente estratégias no nível populacional, onde a maioria dos países atingiria o ponto de equilíbrio antes de 2030.

Clinical implications in orbital and pterional flap surgeries as well as radioimaging studies to determine topographical prevalence and characterization of meningo-orbital foramen in orbits of the Indian population / Implicaciones clínicas en cirugías de colgajo orbitario y pterional, así como estudios de radioimagen para determinar la prevalencia topográfica y la caracterización del foramen meningoorbitario en órbitas de la población india

SUMMARY: The pear-shaped bony orbit connects with intracranial cavity via foramina's and fissures. The Meningo-orbital Foramen (MOF) is usually present in greater wing of sphenoid close to lateral edge of Superior orbital fissure. It provides a route for an anastomosis between the orbital branch of the middle meningeal artery (MMA) and recurrent meningeal branch of Ophthalmic Artery (OA) and hence, risk of damage during surgeries can occur. To verify occurrence and location, with morphology of MOF in dry orbits and the impending clinical hazards in surgeries pertaining to the orbit, document and analysis it to determine a standardized guideline. The presence for MOF was studied in 446 dry orbits with its location from the supra orbital margin (SOM), front zygomatic suture (FZS), the lateral tubercle of Whitnall (WT)and the lateral end of superior orbital fissure (SOF) along with its patency, laterality and number of foramina's present. Nylon probes, long divider/pins, compass and Vernier callipers was used to check the patency and various parameters. The study noted the percentage prevalence of MOF as 69 % with communication with middle cranial fossa (MCF) being 76 % of 69 % and the average distance from SOM, FZS, WT and lateral end of SOF being 35.58 mm, 24.9 mm, 26.6 mm and 0.92 mm. On comparison with various population studies, certain similarities and differences with regards to different parameters were noted. Prevalence of MOF was mostly unilateral and showed multiple foramina, that can act as channels for arteries, a variant of MMA or OA, that supply orbital structures or tumour growths. Thus, awareness of this variation is of prime importance to ophthalmologists and neurosurgeons as well as interventional radiologists, in preventing haemorrhagic condition which could further raise the difficulties in operative procedures and surgical outcomes.

RESUMEN: La órbita ósea en forma de pera se conecta con la cavidad intracraneal a través de forámenes y fisuras. El foramen meningoorbitario (MOF) suele estar presente en el ala mayor del esfenoides cerca del margen lateral de la fisura orbitaria superior. Proporciona una ruta para una anastomosis entre la rama orbitaria de la arteria meníngea media (MMA) y la rama meníngea recurrente de la arteria oftálmica (OA) y, por lo tanto, puede ocurrir riesgo de daño durante las cirugías. Para verificar la ocurrencia y ubicación, con la morfología de MOF en órbitas secas y los peligros clínicos inminentes en cirugías de la órbita, documentarlo y analizarlo para determinar una pauta estandarizada. Se estudió la presencia de MOF en 446 órbitas secas desde el margen supraorbitario (MOS), sutura cigomática frontal (FZS), el tubér- culo lateral de Whitnall (WT) y el extremo lateral de la fisura orbitaria superior (SOF) junto con su permeabilidad, lateralidad y número de forámenes presentes. Se utilizaron sondas de nailon, divisores / pasadores largos, brújula y calibradores Vernier para comprobar la permeabilidad. En el estudio se pudo observar que la prevalencia porcentual de MOF era del 69 %, siendo la comunica- ción con la fosa craneal media (MCF) del 76 % del 69 % y la distancia promedio desde SOM, FZS, WT y el extremo lateral de SOF era de 35,58 mm, 24,9 mm, 26,6 mm y 0,92 mm. En comparación con varios estudios de población, se observaron ciertas similitudes y diferencias con respecto a diferentes parámetros. La prevalencia de MOF fue mayoritariamente unilateral y mostró múltiples forámenes, que pueden actuar como canales para las arterias, una variante de MMA u OA, que irrigan estructuras orbitarias o crecimientos tumorales. Por lo tanto, la conciencia de esta variación es de primordial importancia para los oftalmólogos y neurocirujanos, así como para los radiólogos intervencionistas, en la prevención de una enfermedad hemorrágica que podría aumentar aún más las dificultades en los procedimientos y los resultados quirúrgicos.

Surgical emergencies, onco-surgeries and colorectal surgeries in COVID-19 pandemic: practical advice based on the global experience and at Dr. D. Y. Patil Medical College, Hospital and Research Centre

The existing coronavirus 2019 (COVID-19) pandemic is challenging healthcare systems at global level. We provide a practical strategy to reform pathways of emergency elective onco-surgery and colorectal surgery in the COVID- 19 pandemic. The novelists, from areas affected by the COVID-19, thought to outline the key-points to be conferred. Responsibilities were allotted, concerning specific characteristics of surgical emergencies, onco-surgery and colorectal surgery during the pandemic, including the administrative management of the catastrophe in India. The endorsements were collected and summarized. During the swift spread of COVID-19, it remains thoughtful to halt non-cancer procedures and prioritize surgical emergencies. Endoscopy, proctological procedures have to be completed selectively. With colorectal emergencies, a conservative approach is recommended. Detailed procedures should be followed when operating on COVID-19 patients, using committed personal protective equipment and adhering to specific rules, containing minimally invasive surgery. These guidelines summarize the strict instruction of entry/ exit into theatres and operating block as well as advice on performing procedures carefully to decrease risk of contracting the virus. It is likely that restructuring of health system is required, at central, state, and district levels. A description of the strategy adopted in Dr. D.Y. Patil Medical College Hospital, Kolhapur is provided. Evidence on the management of patients requiring surgery for surgical emergencies, onco-surgery and colorectal conditions during the COVID-19 pandemic is presently deficient. Healthcare professionals have succeeded with high volumes of surgical patients during the pandemic, could be useful to alleviate some risks and decrease exposure to other patients, public and healthcare staff.

Prevalence of Dental Caries and Treatment Needs among Adult Population of Mangalore Taluk - A Pilot Survey.

Dental caries remains the most common oral disease affecting a considerable proportion of people worldwide. It not only causes damage to the tooth, but is also responsible for several morbid conditions of the oral cavity and other systems of the body. Without treatment, caries can proceed and destroy the tooth leading to infection of dental pulp. We wanted to evaluate the prevalence of dental caries and treatment needs among adult rural population. METHODS619 participants aged 18 years and above from peripheral health centres were examined to determine the prevalence of caries and treatment needs. A pretested proforma was used for data collection. Collected data was analysed using Chi Square test. P<0.05 was considered as significant. RESULTSNo significant difference was found in the mean number of teeth affected by caries between the two age groups (<40 years & >40 years) (p= 0.352), between genders (p=0.704) and education levels (p=0.983). When treatment needs (TN) was considered, maximum 2 surface fillings were needed in both the age groups (<40 years 45.6% & >40 years 54.4%). Various treatment needs prevailed among participants of different education level. CONCLUSIONSOral health educative programs may change the attitude of an individual and population as a whole towards maintenance of oral health.

Study of Anatomical Variations of Number of Pulmonary Veins and its Clinical Significance

Introduction: The pulmonary veins play an important rolein the pulmonary circulation by receiving oxygenated bloodfrom the Lungs and delivering it to the left atrium. Pulmonaryvein anatomy piqued curiosity of researchers off late afterthe discovery of its role in genesis of atrial arrhythmias andincreased incidence of pulmonary hypertension in COPD.The congenital variations in number of pulmonary veinsand their drainage patterns, encompass a wide spectrum ofanomalies and are not uncommon in general population. Theaim of the study was to observe the variations in the numberof pulmonary veins and pulmonary ostia.Material and Methods: The present study was done on 25formalin fixed hearts aged 18-70 years, obtained from thedepartment of anatomy, Sri Padmavathi Medical college forwomen, Tirupathi. These hearts were observed for the numberof pulmonary veins, their drainage into left atrium, variationsin pulmonary ostia on right and left sides and were comparedwith previous studies.Results: Out of the 25 specimens studied, 23 hearts (92%)had normal pattern of four pulmonary veins, two from eachlung extending to the left atrium and opening into it via twoseparate pulmonary ostia, on either side. In 2 (8%) out of 25specimens, variations in the number of pulmonary veins andthe pulmonary ostia were observed.Conclusion: The awareness of the variant anatomy ofpulmonary veins and their drainage is of paramountimportance to Radiologists, Electrophysiologist and Cardiothoracic surgeons while performing surgical procedures onHeart.

Vaginal Leiomyoma- A Diagnostic Dilemma.

Vaginal leiomyomas are uncommon masses located on the anterior wall of vagina and rarely lateral wall and vulval region. Only 250 and 300 cases have been reported worldwide. These are benign smooth muscle lesions, usually single and mostly without symptoms. The cause is unknown. Histologically, they resemble leiomyoma elsewhere. They originate from smooth muscle cells of vagina, local arterial musculature, or bladder or urethra smooth muscles. These are oestrogen dependent lesions like uterine leiomyomas. They rarely become malignant. Pressure symptoms include discharge per vaginum or bleeding, dyspareunia, or retention of urine. Lesion has to be excised in the symptomatic patient. Recurrence is rare.

Effect of Donepezil and Vitamin B12Supplement on Serum Thyroid Profile in Alzheimer’s Disease

Aims: The aim of this study was to investigate thyroid status in Alzheimer’s Disease (AD) patients and its response to donepezil and vitamin B12supplement therapy for 6 months.Design:Case-Control Observational study.Place and Duration:Department of Biochemistry, GGMC & Sir J. J. Group of Hospitals, Mumbai, India between March 2017 and July 2019.Methodology:Case-Control study comprised of 71 AD patients and 70 healthy controls above 60 years of age. Blood serum samples were analyzed forthyroid hormones levels by the chemiluminescence method. AD patients weretreated with donepezil (5mg/day) and vitamin B12supplement (1.5mg/day) and thyroid profile was observed at intervals of 3 and 6 months. Statistical evaluationwas done by using IMB SPSS statistics version 25.Results:Serum levels of thyroid hormones were low in euthyroidAD patients when compared with controls at the baseline level [T3 (120.64 ± 20.64 vs127.8 ± 17.29), T4 (7.71 ± 2.34 vs 7.54 ± 1.85), FT3 (1.2 ± 0.13 vs 2.26 ± 0.63) and FT4 (0.79 ± 0.08 vs 1.29 ± 0.27)]except TSH which was increased in AD [TSH (2.71 ± 1.19 vs 2.34 ± 0.65)]. During follow-ups at 3 and 6 months, there was a slight decrease in TSH levels in response to the therapy.Conclusion: The AD patients were euthyroid with low T3, FT3 and FT4 serum levels and high TSH serum levels. Thyroid hormones might play a role as markers for disease progression. Donepezil and vitamin B12therapy could not benefit restorethe normal thyroid functioning in a period of 6 months. Further longitudinal research with larger cohort might help in elucidating thyroid dysfunction in AD and develop novel therapeutic strategies.