Effectiveness of Molecular?Targeted Chemotherapy in Ameloblastomas: A Systematic Review

Ameloblastoma is a benign, locally aggressive neoplasm that needs extensive surgical resection. The goal of this article is to obtain an in?depth review of benign ameloblastomas to determine the available level of evidence and the possible benefit of targeted therapeutics for the treatment of ameloblastoma and BRAF V600E mutation in ameloblastoma. An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE, EBSCO, and Web of Science for eligible studies published between 1975 and 2021. The systematic review is registered with INPLASY (INPLASY202260018). The review included 2 case series and 17 case reports. The histopathological type, anatomic location, expression of BRAF mutation, additional mutations, and molecular?targeted therapies of the 19 reviewed articles were summarized and tabulated. Interestingly, the majority of the primary site of ameloblastoma was located in the mandible (80.9%) compared to the maxilla (17%). The tumour size was reported in nine of the included studies. Most of the included studies in the review exhibited ameloblastoma with BRAF V600E mutations and responded to molecular?targeted therapies. Molecular therapies employing BRAF and/or MEK inhibitors in ameloblastoma with BRAF V600E mutations proved to be an appropriate treatment based on the limited available evidence. It is essential further to deepen our understanding at th

Validity of Pneumonia Severity Score in Predicting Mortality of Pediatric Patients in a Tertiary Care Hospital

Background: Pneumonia is estimated to kill 410,000 children in India every year. In India, recent estimates in under-fivessuggest that 13% of deaths and 24% of the National Burden of Disease is due to pneumonia.Very few studies have evaluatedthe predictors of mortality in children with pneumonia in developing countries.Hence, this study was planned to study predictorsof mortality in children aged 1–59 months based on pneumonia severity score (PSS) in hospitalized patients with severepneumonia.Objective: The objective of this study is to assess the factors (clinical and investigational) contributing to the mortality in patientsbased on PSS in hospitalized patients diagnosed with severe pneumonia.Materials and Methods: The present observational longitudinal study was carried out in a tertiary care PICU in a Govt. NSCBMedical College, Jabalpur for of 1 years (Ian 2019–December 2019). Children diagnosed as severe pneumonia of either sexbetween age group 1–59 months admitted in a hospital were enrolled in the study. Demographic data, clinical details, andlaboratory parameters of the enrolled cases were recorded in a predesigned pretested pro forma. PSS was calculated andcorrelated with the outcome of the patients enrolled and followed up till discharge or death.Results: Mortality was observed in 11 cases, and of them, 4 (36.4%) were males and 7 (63.6%) patients were females. This studyshowed that among clinical parameters pulse rate and SpO2 were significantly raised (63.6%) and saturation was significantly<90 (72.7%) in children who succumbed to death (P < 0.05). This study observed a statistically highly significant associationof PSS with the outcome of children (P < 0.01).

Drotaverine hydrochloride versus valethamate bromide for cervical dilatation in labour: a comparative study

Background: Labor is the most perilous journey a woman has to undertake. Painless and short labor is desired by every woman and is a constant aim for obstetrician. Objective of this study was to compare the efficacy of drotaverine hydrochloride with valethamate bromide for cervical dilatation in labor in primigravida.Methods: The present study was conducted in the department of obstetrics and gynecology, S. P. Medical College and Associated Group of Hospitals, Bikaner, Rajasthan from 1st August 2018 to 31st July 2019 over a period of 1 year. Total of 300 patients were included in the study with 150 patients in each of the two groups. In this study the effects of Drotaverine hydrochloride (Group A) and Valethamate bromide (Group B) on cervical dilatation were compared.Results: In our study, the mean drug delivery interval was 101.58±78.06 mins in Group A and 134.24±94.12 mins in Group B. The mean number of doses of drug required was 1.27±0.55 in Group A and 4.17±1.62 in Group B.  The difference was statistically highly significant (p <0.001).Conclusions: Drotaverine hydrochloride is found to be better than valethamate bromide in shortening the duration of active phase of labor in primigravidae. Drotaverine was found to be a better drug, hence, can be used to reduce the agony of the laboring woman without any significant side effects on the mother or the fetus.

Head-and-neck cancer patients beyond 2 years of disease control: Preliminary analysis of intensity-modulated radiotherapy late-effect assessment scale

Over a decade of intensity-modulated radiotherapy (IMRT) improved the toxicity profile among head-and-neck cancer patients and also improved the quality of life (QOL). Several parameters' few subjective and few objectives have documented various aspects related to QOL. Patients surviving beyond a certain period will have few unattended concern. A single questionnaire-based evaluation might answer few untouched issues. This brief communication formulated such an indigenous single-institution scale named IMRT late-effect assessment scale (ILEA). The preliminary analysis identified concerns related to dryness of mouth, swallowing habit change, and fear of disease recurrence. Future large-scale prospective evaluation is needed

The Effects of Calcium and Vitamin D Supplementation on Blood Glucose and Markers of Inflammation in Non Diabetic Adults

Introduction: Type 2 Diabetes mellitus is associated with considerable morbidity and mortality and its prevalence has been increasing globally. Present study was undertaken to see the effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in non-diabetic adults. Aim of the study: To compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in non-diabetic adults. Material and methods: 120 non-diabetic patients fulfilling the inclusion and exclusion criteria coming to OPD/wards of MGUMST, Jaipur were recruited. They were subjected to two study groups with two treatment arms, one group with normal fasting blood glucose and other group with impaired fasting blood glucose. Results: The effects of calcium and vitamin D supplementation on fasting blood sugar and CRP were statistically significant in impaired fasting blood glucose group. Conclusion: Supplementation with vitamin D and calcium improves blood glucose and markers of inflammation.

Extensive Ischemic Stroke Following Scorpion Sting In A Young During Hospital Stay In A Tertiary Care Hospital: A Rare Case Report

Complication following scorpion sting are common in India and can be fatal. Stroke following scorpion sting is a rare complication and can occur by various mechanisms such as autonomic storm, hypertension, hypotension, toxic myocarditis, disseminated intravascular coagulation, venom induced vasculitis. We present a rare case of multiple brain infarcts following scorpion sting which has rarely been reported in medical literature. In our case non-contrast CT head showed multiple infarcts involving bilateral cerebellar hemisphere, bilateral occipital lobes, medulla and Pons on right side, right temporal lobe, and right thalamus, left parietal lobe. He was investigated for other possible cause of stroke in young without positive results such as cardiac, hematological, rheumatological workup. In view of normal CT cerebral angiography and lack of other cause of stroke in young and the temporal relation and progression of events we concluded that stroke in this patient is likely as result of severe vasospasm due to autonomic storm resulting in low flow infarct. Close observation of the patient for a period of hospital stay is required. During this period an hourly check of the patient should be done as assessing the level of consciousness, pulse rate and rhythm, blood pressure, respiratory rate and new symptoms or signs such as focal neurological deficits.

Correlation between association of hypothyroidism and cardiovascular risk indices

Background: Association of hypothyroidism and cardiovascular diseases are important in development of Atherosclerosis. Hypothyroidism and sub clinical hypothyroidism reported highly risk factors due to lipid levels dearranged. Present study to demonstre of correlation of hypothyroidism and cardiovascular disease.Methods: The present study has carried out in the department of medicine and Biochemistry SRG Hospital and associated hospital, Jhalawar Medical College Jhalawar (Raj.) Total 100 Hypothyroidism cases and 100 euthyroidism subject were included in the study Information regarding clinical history were recorded in self Constructed present questionnaires Patients were examined and estimated TSH, T3, T4 total Cholesterol, LDLc, HDCc, TG data were analyzed by SPPS version 20.0.Results: Present study demonstrated increased levels of total cholesterol, LDH, VLDLC and TG and decreased level of HDLC and increased TSH level and decreased T3 and T4 Level in hypothyroidism cases when compared with euthyroid cases It was found significant.Conclusions: In present study hypothyroidism and hormone Level (TSH, T3, T4) and lipid level dearranged values are associated with development cardiovascular disease atherosclerosis.

Turner syndrome with pseudohypoparathyroidism: A case report / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;">The association of Pseudohypoparathyroidism (PHP) with Turner syndrome is very rare and only a single case has been reported so far. Both manifest with short stature and lack of secondary sexual characteristics along with other stigmata similar to each other, creating a diagnostic dilemma.<br />We describe a case of a 15-year-old Asian Indian female who presented with short stature and delayed puberty with overlapping phenotype of PHP and Turner syndrome. The diagnosis of Turner syndrome was made easily on the basis of typical history, clinical features and karyotype but the diagnosis of PHP was suspected only after radiological and biochemical investigations. The association of Turner syndrome with PHP can be easily missed due to similar phenotypes and subtle manifestations.</p>

Green Synthesis of AgNPs Stabilized with biowaste and their antimicrobial activities

In the present study, rapid reduction and stabilization of Ag+ ions with different NaOH molar concentration (0.5 mM, 1.0 mM and 1.5 mM) has been carried out in the aqueous solution of silver nitrate by the bio waste peel extract of P.granatum. Generally, chemical methods used for the synthesis of AgNPs are quite toxic, flammable and have adverse effect in medical application but green synthesis is a better option due to eco-friendliness, non-toxicity and safe for human. Stable AgNPs were synthesized by treating 90 mL aqueous solution of 2 mM AgNO3 with the 5 mL plant peels extract (0.4% w/v) at different NaOH concentration (5 mL). The synthesized AgNPs were characterized by UV-Vis spectroscopy, TEM and SEM. Further, antimicrobial activities of AgNPs were performed on Gram positive i.e. Staphylococcus aureus, Bacillus subtilius and Gram negative i.e. E. coli, Pseudomonas aeruginosa bacteria. The AgNPs synthesized at 1.5 mM NaOH concentration had shown maximum zone of inhibition (ZOI) i.e. 49 ± 0.64 in E. coli, whereas Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilius had shown 40 ± 0.29 mm, 28 ± 0.13 and 42 ± 0.49 mm ZOI respectively. The MIC value of 30 g/mL observed for E. coli Whereas, Staphylococcus aureus, Bacillus subtilius and Pseudomonas aeruginosa had shown 45 µg/mL, 38 µg/mL, 35 µg/mL respectively. The study revealed that AgNPs had shown significant antimicrobial activity as compared to Streptomycin.

A study on body mass index and its correlation with type 2 diabetes.

Obesity and increases in body weight are among the most important risk factors for type 2 diabetes mellitus. Obesity contributes to the development of type 2 diabetes mellitus. Body mass index is also known as obesity index. Body mass index is a strong and independent risk factor for being diagnosed in cases of type 2 diabetes mellitus. There is a high risk of type 2 diabetes in those who have a higher body mass index. The present study has been done with the objective of finding correlation between BMI and type 2 diabetes.

Malaria Diagnostic Tests: Microscopy And Rapid Diagnostic Test (RDT) Revisited.

In the prevention and control of malaria, Prompt and accurate diagnosis is the key to effective disease management. Giemsa microscopy and rapid diagnostic tests (RDTs) are the diagnostic tests each with characteristic strengths and limitations is the best way for accurate diagnosis has a key role for malaria control successfully. Reduction in morbidity and drug resistance intensity of malaria require a parasite based diagnostic methods. A parallel commitment is needed in production of antimalarial drug or malaria vaccine along with improvement in diagnostic tests and their availability to people in endemic areas.endemic areas.

Colposcopy: A new ray in the diagnosis of oral lesions.

Oral squamous cell carcinoma is the most common cancer of the oral cavity. The survival rates for oral cancer patients will significantly be improved provided lesions are detected and treated at the infancy stage. Early diagnosis is therefore of paramount importance. Histopathological examination is considered as the gold standard in diagnosing oral lesions. Therefore, the selection for a biopsy site is highly significant. In this article, we present a current review of the colposcope and oral application of the colposcopy technique and its use as an adjunct in the early diagnosis of premalignant and malignant lesions of the oral mucosa. We stress upon the fact that colposcopy (direct oral microscopy) of oral mucosal lesions helps in selecting more representative sites for biopsy than routine clinical examination alone. Because of its precision, versatility, ease of use, and being a non-invasive technique, colposcopy might prove to be a useful step toward continuing to learn and improve the care for our patients.

Prevalence of multidrug-resistant tuberculosis among Category II pulmonary tuberculosis patients.

Background & objectives: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. The most important risk factor for the development of MDR-TB is previous anti-tuberculosis therapy. Category II pulmonary TB includes those patients who had failed previous TB treatment, relapsed after treatment, or defaulted during previous treatment. We carried out this study to ascertain the prevalence of MDR-TB among category II pulmonary TB patients. Methods: This was a cross-sectional, descriptive study involving category II pulmonary TB patients diagnosed between 2005 and 2008. All sputum-positive category II TB cases were subjected to mycobacterial culture and drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 196 cases of sputum-positive category II pulmonary tuberculosis patients were included. Of these, 40 patients (20.4%) had MDR-TB. The mean age of MDR-TB patients was 33.25 ± 12.04 yr; 9 patients (22.5%) were female. Thirty six patients showed resistance to rifampicin and isoniazid; while 4 patients showed resistance to rifampicin, isoniazid and streptomycin. The prevalence of MDR-TB among category-II pulmonary tuberculosis patients was 20.4 per cent. Interpretation & conclusions : The prevalence of MDR-TB in category II TB patients was significant. However, nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. We stress the importance of continuous monitoring of drug resistance trends, in order to assess the efficacy of current interventions and their impact on the TB epidemic.

Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis.

Background & objectives: The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naïve patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Methods: This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 ± 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent. Interpretation & conclusions: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases.

A study of TB-associated immune reconstitution inflammatory syndrome using the consensus case-definition.

Background & objectives: A considerable proportion of patients with HIV associated tuberculosis (TB) started on highly active antiretroviral therapy (HAART) develop immune reconstitution inflammatory syndrome (IRIS), which is difficult to diagnose in a resource-limited setting. In view of the recently proposed consensus case-definitions for TB-IRIS for use in resource-limited settings we undertook this study to describe the incidence and risk factors of TB associated IRIS in a tertiary care hospital and research centre in north India. Methods: Retrospective analysis of antiretroviral treatment (ART) naïve adults started on highly active ART (HAART) from June 2006 to September 2008 was done. Results: Of the 627 patients studied, 237 (38%) had TB at the initiation of HAART. In total, 18 (7.5%) of 237 patients with TB at baseline had paradoxical TB-associated IRIS, and 12 (3%) of 390 patients without TB at baseline developed ART-associated TB. Most IRIS events occurred during the initial 30 days of HAART. Two patients developed TB-associated IRIS after 90 days of HAART. Using univariate analysis, low CD4+ cell count at baseline [64 (28-89) vs. 95 (52-150); P=0.009] and early initiation of HAART [33 (24-41) vs. 48 (35-61) days; P<0.001] were significantly associated with paradoxical TB-associated IRIS. No identifiable risk factors were associated with the development of ART-associated TB. Interpretation & conclusions: A considerable proportion of patients on HAART develop TB-associated IRIS. The consensus case-definition is a useful tool in resource-limited settings for the diagnosis of TB-associated IRIS.

EDTA enhances lead uptake and facilitates phytoremediation by vetiver grass.

Vetiver grass (Vetiveria zizanioides) has strong and dense root system and is a potential phytoremediator plant since it can tolerate a wide range of climatic conditions and grow well in soils contaminated with heavy metals. Soil was artificially contaminated by lead (20 mgl(-1)) during field trials. Four concentration of EDTA (Ethylene diamine tetra acetic acid-disodium salt) solution i.e. 0, 3, 5 and 10 mmol kg(-1) were added to soil prior to harvesting, to study the influence of EDTA solution on phytostabilization by vetiver grass. Results showed that the concentration of lead in roots of vetiver is significantly increased after EDTA solution (5 mmol kg(-1)) application. However, high concentration of EDTA (10 mmol kg(-1)) does not show such significant increase. The toxicity of highly contaminating metal did not affect the growth of vetiver grass significantly but a slight decrease in parameters studied was noticed. No stress symptoms were observed in vetiver plants. Results of present study reveal that vetiver could be considered as a potential phytoremediator for lead contamninated site.

Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

BACKGROUND: Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. AIMS: The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. MATERIALS AND METHODS: A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. RESULTS: A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. CONCLUSIONS: Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

Case detection rate targets under DOTS: the Indian experience.

The DOTS programme in India has been recognized as the fastest growing programme in the world. It currently covers more than 1 billion people (90% of the population). In spite of this rapid expansion, the programme has consistently achieved the global target of 85% cure rates. However, improvement in case detection rates has been slow, and the global target of 70% has been achieved only in the last few quarters. Public-private partnerships were initiated at the national and local level with the non-health public sector, corporate sector and non-governmental organizations, private practitioners and medical colleges. The partnerships have significantly contributed to the case detection rates in the country, especially the medical colleges, which have contributed up to 5%-15%. Some areas achieved case detection rates well above 70%. There is a need to forge new initiatives, strengthen existing partnerships and make special efforts to access the poorer, vulnerable and hard-to-reach sections of society more effectively. This would not only increase the numbers of cases but also serve the overarching objective of equity. Disaggregated targets should be set, with much higher ones for selected areas, sectors and institutions.