A comparative study of two mouthrinses on plaque and gingivitis in school children in the age group of 13-16 years in Bangalore city.

Research and clinical evidence indicate that most forms of plaque associated periodontal disease start as inflammatory lesions of the gingiva which if left untreated, may progress and eventually involve and compromise the entire periodontal attachment apparatus of the affected teeth. A study was conducted to assess the effect of a mouthrinse containing chlorhexidine and sodium fluoride on plaque accumulation and gingivitis in comparison with a chlorhexidine mouthrinse alone in a group of school children aged 13-16 years in Bangalore city. This combination along with the well established effect of fluoride in the prevention of caries presents an important contribution to dental public health. The results suggest that the chlorhexidine-sodium fluoride mouthrinse potentially possesses a significant effect on inhibition of plaque accumulation and gingivitis. This combination along with the well-established effect of fluoride in the prevention of caries, presents an important contribution to dental public health.

Comparison of simultaneous estimation of cardiac output by four techniques in patients undergoing off-pump coronary artery bypass surgery--a prospective observational study.

We prospectively compared four techniques of cardiac output measurement: bolus thermodilution cardiac output (TDCO), continuous cardiac output (CCO), pulse contour cardiac output (PiCCO), and Flowtrac (FCCO), simultaneously in fifteen patients undergoing off-pump coronary artery bypass grafting (OPCAB). All the patients received pulmonary artery catheter (capable of measuring both bolus thermodilution cardiac output and CCO), PiCCO arterial cannula in the left and FCCO in the right femoral artery. Cardiac indices (CI) were obtained every fifteen minutes by using all the four techniques. TDCO was treated as 'control' and the rest were treated as 'test' values. Interchangeability of techniques with TDCO was assessed by Bland and Altman plotting and mountain plot. Four hundred and thirty eight sets of data were obtained from fifteen patients. The values of cardiac output varied between 1 to 6.9 L/min. We found that the values of all the techniques were interchangeable. At certain times, the values of CI measured by both PiCCO and FCCO appeared erratic. The values of CI measured simultaneously appeared in the following descending order of accuracy; TDCO>CCO>FCCO>PiCCO (the % times TDCO correlated with CCO, FCCO, PiCCO was 93, 86 and 80 respectively). The bias and precision (in L/min) for CCO were 0.03, 0.06, PiCCO 0.13, 0.1 and flowtrac 0.15, 0.04 respectively suggesting interchangeability. We conclude that the cardiac output measured by CCO technique and the pulse contour as measured by PiCCO and FCCO were interchangeable with TDCO more than 80% of the times.

Conscious off-pump coronary artery bypass surgery.

BACKGROUND: Cardiothoracic surgery has been previously performed successfully under thoracic epidural anesthesia alone. Between October 2001 and December 2003, we performed 123 conscious off-pump coronary artery bypass surgeries using epidural anesthesia as the sole anesthetic. This technique is an alternative to cardiothoracic surgery performed under general anesthesia. Certain modifications in the technique facilitate the process. METHODS AND RESULTS: There were 24 female patients and 99 male patients with mean age of 58.6 +/- 6.2 years; 12 patients underwent repeat coronary artery bypass surgery. All the patients underwent epidural catheterization on the evening before surgery. Out of the 123 patients scheduled for coronary artery bypass graft surgery, 120 underwent off-pump coronary artery bypass graft surgery successfully; 4 patients underwent off-pump surgery via left thoracotomy and the rest through mid sternotomy. These patients received 295 grafts in all (single graft in 26 patients, double in 42 patients, triple in 35 patients, and quadruple in 20 patients). Three patients required conversion to general anesthesia and one to cardiopulmonary bypass. There was no mortality in the group. CONCLUSIONS: Our experience suggests that by modifying the surgical techniques, we can accomplish conscious coronary artery bypass surgery.

An echocardiographic study of net atrioventricular compliance in juvenile and adult mitral stenosis.

BACKGROUND: Left atrial compliance is an important determinant of symptoms in mitral stenosis. About one-third of patients with mitral stenosis have reduced left ventricular compliance. We measured the net atrioventricular compliance in rheumatic mitral stenosis patients noninvasively and analyzed if there were any clinical, electrocardiographic, roentgenographic or echocardiographic correlates of net atrioventricular compliance. METHODS AND RESULTS: Seventy-six patients with mitral stenosis were analyzed and as many normal subjects were taken as control group. Patients were divided into two groups--those 20 years and below were grouped as juvenile mitral stenosis and those above 20 years as adult mitral stenosis patients. The net atrioventricular compliance in patients with mitral stenosis was significantly impaired compared to normal population. Mean compliance in juvenile group was 4.66+/-2.18 ml/mmHg (range 2.17-9.6) and in adult group it was 4.79+/-1.99 ml/mmHg (range 2.04-8.9) (p = ns). There was no difference in net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. Mitral valve area showed an independent positive correlation with net atrioventricular compliance. CONCLUSIONS: The net atrioventricular compliance was significantly reduced in patients with rheumatic mitral stenosis; however, there was essentially no difference in the net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. The net atrioventricular compliance may not be responsible for the more severe symptoms observed in juvenile mitral stenosis.

Incidence of ocular myiasis due to infection with the larva of oestrus ovis (Oestridae Diptera).

The present paper is the result of the study of frequent occurrences of ocular myiasis due to the infection by the insect larva in 14 patients. The collected larvae were identified as first stage larva of oestrus ovis. The results of the examinations of the infected eyes show swollen conjunctiva, redness and watering of the eyes. These symptoms may be mistaken for mucopurulent conjunctivitis. The above results are discussed with earlier literature.