Scrub typhus in urban areas of Wardha district in central India

Background & objectives: Scrub typhus caused by Orientia tsutsugamushi presents as acute undifferentiated fever and can be confused with other infectious causes of fever. We studied scrub typhus as part of a study on hospital-based surveillance of zoonotic and vector-borne zoonotic diseases at a tertiary care hospital located in the Wardha district, Maharashtra, India. We report here descriptive epidemiology and climatic factors affecting scrub typhus. Methods: Patients of any age and sex with fever of ?5 days were enrolled for this study. Data on sociodemographic variables were collected by personal interviews. Blood samples were tested by IgM ELISA to diagnose scrub typhus. Confirmation of scrub typhus was done by indirect immunofluorescence assay for IgM (IgM IFA). The climatic determinants were determined using time-series Poisson regression analysis. Results: It was found that 15.9 per cent of the study participants were positive for scrub typhus by IgM ELISA and IgM IFA, both. Positivity was maximum (23.0%) in 41-60 yr of age and more females were affected than males (16.6 vs. 15.5%). Farmworkers were affected more (23.6%) than non-farm workers (12.9%). The disease positivity was found to be high in monsoon and post-monsoon seasons (22.9 and 19.4%) than in summer and winter. Interpretation & conclusions: There were three hot spots of scrub typhus in urban areas of Wardha district. Rainfall and relative humidity in the previous month were the significant determinants of the disease

Chuckling Smile: Ceramic Veneer.

Smiling is not a simple option in those patients who have a severe aesthetic deformity. Many definitions of aesthetics were introduced in dentistry but according to Young, beauty, harmony, naturalness and individuality are the major qualities of aesthetics. The dentist must visualize aesthetics in relation to the patient and then translate that visualization into an acceptable aesthetic result. The success of his efforts depends upon his artistic ability, his powers of observation and experience. Many treatment options are available to achieve aesthetics in compromised anterior teeth but in recent era with the introduction of advanced material (new ceramic and composite materials) has increased the demand of conservative treatment options. Porcelain laminate Veneers (PLVs) were introduced in the 1980s as an alternative to full-coverage crowns. The present case report describes the treatment of fracture & diastema in the anterior dentition with thin ceramic veneers, to restore esthetics and function.

Cardiac hemodynamic profile and its correlates by Impedance plethysmography in normal individuals of Central India.

Evaluation of hemodynamic profile by impedance plethysmography (IPG) provides functional expression of cardiovascular performance with efficacy of treatment. Objective of this study was to establish normative hemodynamic parameters by IPG. In this cross-sectional study hemodynamic parameters including cardiac output (CO), Stroke volume (SV), left ventricular ejection time (LVET), impedance (Zo) Cardiac index (CI) and Stroke index (SI) of 50 normal individuals in mean age 38.9±15.2 years were evaluated. Mean CO and CI were 4.9±0.8L/min and 3.3±0.7 L/min/m2 respectively. A negative linear co-relation of CI with increasing age and body fat mass was observed. Mean LVET was 336±33ms with a significant positive linear correlation (r = 0.46) with advancing age and body fat mass while a negative linear correlation with BSA. To conclude preliminary normative data of cardiac parameters using IPG, in subjects of central India of different age groups has been presented.

Endodontic and Esthetic Management of Hypolplastic Turner’s Teeth with Severely Dilacerated Roots.

Dilaceration refer to an angulation or sharp bend or curve in the root or crown of formed tooth. It is usually occur due to trauma that lead to white or yellow brown discoloration, crown dilaceration, root dilacerations, crown duplication, root duplication, odontoma like malformation etc. This paper elaborated a useful clinical considerations for diagnosis and treatment planning of a severely dilacerated root of malformed tooth having turner’s hypoplasia.

Biological Post: A Reconstructive Approach to Achieve Aesthetics.

Traumatic injuries lead to fracture of anterior teeth, frequently occurs in dentistry and the prevalence rate of fractured anterior teeth, as a result of traumatic injuries, occurs 8.1 in 1000. The fracture of a tooth is itself a traumatic incident for young patients which leads to functional, aesthetic, psychological problems and reduces patient's quality of life. Various materials are available to restore these types of traumatic injuries, but till date there is no material that has been proved to be as effective as natural structure considering mechanical and biological properties. This case report represents the management of traumatized fractured mandibular anterior teeth with biological posts and coronal restorations with composite.

Usefulness of blink reflex in hypothyroid patients with or without polyneuropathy :a case control study.

Central nervous system (CNS) dysfunction is an important consequence of thyroid deficiency. Cranial nerves are frequently affected in hypothyroid process. On routine nerve conduction studies, symptomatic peripheral and cranial neuropathy can be detected, however, diagnosing subclinical cranial neuropathy pose the major problem. Blink reflex (BR), has been shown to be an effective method for revealing subclinical involvement of cranial nerves in generalized neuropathies. The present study was undertaken to evaluate the efficacy of BR as a method for early diagnosis of subclinical cranial neuropathy in hypothyroid patients with or without overt peripheral polyneuropathy. A case control study was conducted on 150 subjects aged 18 years and above (100 controls, 50 cases). A routine nerve conduction study and BR evaluation was done in all the subjects. We found abnormal BR response in 50% of hypothyroid patients studied. In hypothyroid patient without polyneuropathy R1 latency was significantly prolonged (P<0.05 Vs control).Ipsilateral and contralateral R2 latencies were significantly prolonged in hypothyroid cases with or without polyneuropathy on bilateral stimulation. Magnitude of prolongation was greater in with polyneuropathy group. In conclusion, study suggests that BR is a useful non-invasive method for the detection of clinically silent cranial nerve compromise in hypothyroid patients.