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Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults.Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.
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Cholecystectomy is currently a frequent performed operation. The presence of gallstones within either the gallbladder or biliary tree is associated with the bacterial colonization of the bile. Acute cholangitis spans a continuous clinical spectrum and can progress from a local biliary infection to advanced disease with sepsis and multiple organ dysfunction syndrome. Therefore, it is important to know the microbiological flora of the gallbladder before prophylactic antibiotics are given. Aim and objectives: 1.To evaluate the bacteriological profile of bile in patients undergoing cholecystectomy. 2. To determine the appropriate antibiotics for prophylaxis in cholecystectomy patients based on the bacteriological profile of bile in our study. Methods: The study was a prospective study carried out in Guru Nanak Dev Hospital, Amritsar. A total of 100 patients undergone cholecystectomy who met the inclusion criteria were included in the study. Bile was aspirated from all patients, this collected bile from gallbladder was transported to the Microbiology Department in 5cc sterile syringe. The specimen was evaluated to find out whether it is sterile or has any bacteria present. Sensitivity of isolated organisms was done against antibiotics. Results: 25 patients showed positive bile culture (25%), whereas bile was sterile in 75 patients (75%). E.Coli was the most common isolated bacteria (60%) followed by Enterococcus (20%), Staph Aureus (8%), Salmonella (8%) and Pseudomonas (4%). Postoperative wound infection was more common (20%) in group of patients with isolated organisms from bile. Conclusion: 25% of bile samples were culture positive. E coli was the most common aerobic bacteria to be isolated from the bile culture . E. coli, salmonella and pseudomonas were most sensitive to piperacillin + tazobactum and imipenum (100%). E. coli also showed sensitivity to amikacin and gentamicin (73.33% each). Enterococcus was most sensitive to linezolid and ampicillin + salbactum (100%) followed by gentamicin and amoxicillin + clavulanate (80% each). Staphylococcus was most sensitive to linezolid (100%). Antimicrobial susceptibility of potential causative organisms and the local susceptibility pattern must be taken into consideration when prescribing drugs to patients with biliary disease.
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Background: Mild Cognitive Impairment (MCI) a transitional stage between normal aging and dementia has been observed more in people with diabetes when compared with general population. The risk factors for MCI in type 2 diabetes mellitus (T2DM) have been defined in elderly patients and aging may itself contribute to declining in cognitive functions. As the large number people with T2DM are under 60years, the prevalence of MCI and factors contributing to it are not much studied. So, this study aimed to find out the factors contributing to MCI in non-elderly T2DM patients.Methods: In this cross-sectional study, 257 patients with T2DM underwent cognitive assessment by Montreal cognitive assessment test and the cognitive levels were correlated with their glycosylated hemoglobin, lipid profile, and highly sensitive C-reactive protein (hsCRP).Results: The prevalence of mild cognitive impairment (MCI) was 64.2%. MCI significantly correlated with duration of diabetes, socioeconomic status, HbA1c, serum triglycerides, low-density lipoprotein, very low-density lipoprotein and hsCRP levels. The factors that were statistically insignificant were body mass index and high-density lipoprotein levels.Conclusions: Cognitive impairment is seen even in non-elderly T2DM patients. It should be considered along with the other complications of diabetes and individuals with T2DM should be screened for cognitive impairment to prevent progression to dementia.
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Background: Congenital hereditary endothelial dystrophy (CHED) is an autosomal recessive disorder characterized by bilateral, symmetrical, noninflammatory corneal clouding (edema) present at birth or shortly thereafter. This study reports on an unusual delayed presentation of CHED with compound heterozygous SLC4A11 mutations. Materials and Methods: A 45‑year‑old female, presenting with bilateral decreased vision since childhood that deteriorated in the last 5 years, was evaluated to rule out trauma, viral illness, chemical injury, glaucoma, and corneal endothelial dystrophies. Tear sample was sent for herpes simplex viral (HSV) antigen testing. Genomic DNA from peripheral blood was screened for mutations in all exons of SLC4A11 by direct sequencing. Full‑thickness penetrating keratoplasty was done and corneal button was sent for histopathological examination. Results: Slit‑lamp findings revealed bilateral diffuse corneal edema and left eye spheroidal degeneration with scarring. Increased corneal thickness (762 μm and 854 μm in the right and left eyes, respectively), normal intraocular pressure (12 mmHg and 16 mmHg in the right and left eyes, respectively), inconclusive confocal scan, and specular microscopy, near normal tear film parameters, were the other clinical features. HSV‑polymerase chain reaction was negative. Histopathological examination revealed markedly thickened Descemet’s membrane with subepithelial spheroidal degeneration. SLC4A11 screening showed a novel variant p.Ser415Asn, reported mutation p.Cys386Arg and two polymorphisms, all in the heterozygous state and not identified in 100 controls. Conclusions: The study shows, for the first time, compound heterozygous SLC4A11 mutations impair protein function leading to delayed onset of the disease.
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Background: Asthma is a common problem all around the world with variable prevalence ranging from 1%–18% in different age and geographical distribution. There are proximately 300 million affected individuals. There are growing prevalence and morbidity, due to asthma associated with pregnancy. The course of asthma in pregnancy is unpredictable. Methods: 2400 consecutive pregnant women attending the antenatal clinic of S.P. Medical College and AG of Hospitals, Bikaner, were screened using asthma questionnaire translated in Hindi based on the questionnaire developed for International Union against Tuberculosis and Lung Disease. 52 patients diagnosed as asthma were subjected for PFT and classified according to clinical severity as per GINA guidelines, 2006. All subjects were followed till delivery and postpartum charts reviewed to see neonate and maternal outcome. Results: The prevalence of asthma during pregnancy was 2.1%, among them, 25 (48.1%) were categorized as having intermittent asthma, 6 (11.5%) with mild persistent asthma, 10 (19.2%) with moderate persistent asthma and 11 (21.2%) having severe persistent asthma. During the course of pregnancy, 36% had no change in the symptomatology, while (32.5%) experienced improvement and (32.5%) of worsening of asthma. 22 (42.31%) women were newly diagnosed during our study. There was no significant adverse maternal and fetal outcome in asthmatic group compared to control. Conclusions: Asthma is an under diagnosed and under treated disorder, especially during pregnancy and overall morbidity of asthma among women & neonates does not change during pregnancy.