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Background: Total knee replacement is one of the common orthopaedic procedures performed worldwide. Blood transfusion is one of the major requirements in TKR procedure due to the amount of blood loss during and after the procedure. We carried out a prospective study to determine the efficacy of tranexamic acid in controlling blood loss during TKR procedure. Methods: Study was conducted at a tertiary care centre, involving cases operated by a single surgeon. Study included 140 patients undergoing primary TKR for advance degenerative disease of knee and were divided into two groups of 70 each, one group that received tranexamic acid before surgery and another group that did not receive tranexamic acid before surgery. Patient with allergy to the drug, hepato/renal dysfunction, DVT, abnormal PT and INR were not included. Tranexamic acid was given intravenously as well as intra-articular. Results: Pre-operative haemoglobin ranged from 10.2 gm% to 14.4 gm% in the group getting tranexamic acid and from 10% to 14 % in the group not getting tranexamic acid. Post operatively haemoglobin varied from 8.4 gm% to 12.8 gm% in Group 1 and from 7.8 gm% to 12 gm% in Group 2. Difference of mean post-operative Hb (p=0.0045) and PCV (p=0.0024) in two groups was statistically significant. Conclusions: We concluded that administration of tranexamic acid reduces the blood loss as well as need of blood transfusion in a patient undergoing total knee replacement.
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Mucoadhesion is one of the most extensively studied methods for the administration of medication for faster onset of action with enhanced bioavailability. Present investigation was concerned with the development and characterization of controlled release muco-adhesive drug delivery system for the drug Tramadol Hydrochloride (TRD) to extend the duration of analgesia for patients suffering from acute to chronic pain. Formulations were made using the solvent casting technique, incorporating natural polymers like Guar Gum, Xanthum Gum and Chitosan in conjunction with HPMC (hydroxy propyl methyl cellulose) to modify the drug release. The compatibility of film components were validated by Fourier Transform Infra- Red (FTIR) spectroscopy and subjected to physico-chemical evaluation parameters and ex-vivo drug diffusion study. Optimized formulation was tested for analgesic efficacy in vivo to determine extent of their suitability in therapeutic use. All the prepared formulations exhibited superior pharmaceutical qualities with respect to drug content, folding endurance, swelling index and mucoadhesion time. In ex-vivo drug diffusion study, all the films displayed a controlled release lasting longer than eight hours. Formulations containing Chitosan in combination with HPMC (F6) showed better controlled drug release over other combinations. The formulation F6 bring out remarkable in vivo analgesic efficacy with 58.10 % analgesia in contrast to the standard (61.16%). It was deduced that Tramadol hydrochloride mucoadhesive films were found to be an effective treatment for moderate to severe pain with a quick onset and a lengthy half-life.
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Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%–80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. Methods: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. Results: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart’s operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.3610.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart’s operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. Conclusions: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD. Level of evidence: III.
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Background/Aims@#It is a common belief that constipated patients have hard feces that contributes to the difficulties defecating. To the best of our knowledge, no studies had been published on controlled evacuation of simulated feces with different consistencies. @*Methods@#Twelve normal subjects were recruited for studies with the simulated feces device “Fecobionics” of different consistency (silicone shore 0A-40A corresponding to Bristol stool form scale types 2-4). The subjects filled out questionnaires and had the balloon expulsion test and anorectal manometry done for reference. The Fecobionics probes were inserted in rectum in random order with +20 minutes between insertions. The bag was filled to urge-to-defecate and evacuations took place in privacy. Non-parametric statistics with median and quartiles are provided. @*Results@#One subject was excluded due to technical issues, and another had abnormal anorectal manometry–balloon expulsion test. The 4 females/6 males subjects were aged 23 (range 20-48) years. Most differences were observed between the 0A and 10A probe (duration, maximum bag pressure, duration x maximum bag pressure, and relaxation of the front pressure and the bend angle during evacuation), eg, the duration was 9 (8-12) seconds at 0A and 18 (12-21) seconds at 10A (P < 0.05), and maximum bag pressure was 107 (96-116) cmH 2 O at 0A and 140 (117-162) cmH 2 O at 10A (P < 0.05). The bend angle before evacuation differed between the probes whereas only the 10A differed from 40A during defecation. The 10A was harder to evacuate than the 0A probe. Except for the bend angles, no further significant change was observed from 10A to 40A. @*Conclusion@#Fecal consistency affects defecatory parameters.
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SUMMARY OBJECTIVE: Endogenous melatonin is produced from tryptophan which is an essential amino acid. Besides its role in the regulation of sleep patterns, melatonin has anti-inflammatory effects. In this case-control study, we aimed to compare tryptophan and melatonin levels and their relationship with the inflammatory response, specifically serum interleukin-1, interleukin-6, and c-reactive protein levels following major abdominal surgery in patients with food restriction and who receive parenteral nutritional therapy. METHODS: We enrolled 40 patients between the ages of 18 and 65 years in the study. We collected blood and urine samples 48 h before the operation and on postoperative days 1, 3, and 5. RESULTS AND CONCLUSION: The tryptophan levels in the experimental group were higher than in the control group but failed to reach any statistical difference. Melatonin levels were increased in both groups following the surgery compared with preoperative levels. The increase in the experimental group was statistically different 3 days after the surgery. The difference in the level of interleukin-1 between the control and the experimental groups was greatest on postoperative day 3. On postoperative day 3, the interleukin-6 level in the treatment group was slightly higher than in the control group. We did not find any difference in the levels of c-reactive protein between the groups. As a result, the levels of tryptophan and melatonin were increased in the parenteral nutrition group, irrespective of the postoperative inflammatory response.
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ABSTRACT Introduction: Proximal femoral nailing for intertrochanteric femur fracture is sometimes a challenging procedure without a traction table, especially if complicated fracture pattern. We aimed to overcome this difficulty with the hook. Materials and Methods: A retrospective study of 60 patients. 28 of the patients reduction was necessitated with a hook (group 1). The other patients did not need to use this technique (group 2, n=32). The collo-diaphyseal angle, lag screw placement, and tip-apex distance were measured using radiographs. Results: There were statistically significant differences between the two groups regarding the Garden Alignment Index, postoperative collo-diaphyseal angle measurements, and tip-apex distance. The Garden Alignment Index was found as 163.92 degrees (dg.) In the frontal plane in group 1, and 154.78 dg in group 2, respectively. In group 1, the tip-apex distance was 16.05 cm, whereas it was 25.32 cm in group 2. The collo-diaphyseal angle was 133.1º in group 1, and 128.65º in group 2. Conclusions: The hook-assisted reduction is beneficial when operating without a traction table; however, it can also be a part of the surgeons' equipment even when operating on a traction table. When difficulties in obtaining an ideal anatomical reduction in displaced intertrochanteric femoral fractures, we suggest using the hook-assisted reduction technique. Level of Evidence III; Case-control Study.
RESUMO Introdução: Frequentemente, a fixação do fêmur proximal para fratura intertrocantérica do fêmur sem uma mesa de tração é um procedimento desafiador, especialmente se o padrão da fratura for complicado. O objetivo foi superar essa dificuldade utilizando um gancho. Materiais e métodos: Trata-se de um estudo retrospectivo de 60 pacientes. Em 28 desses, a redução foi necessária com um gancho (grupo 1). Os outros pacientes não precisaram usar essa técnica (grupo 2, n=32). O ângulo colo-diafisário, a colocação do parafuso lag e a distância ponta-ápice foram medidos por meio de radiografias. Resultados: Houve diferenças estatisticamente significativas entre os dois grupos com relação ao Índice de Alinhamento de Garden, às medidas do ângulo colo-diafisário pós--operatório e à distância ponta-ápice. O índice de alinhamento de Garden foi de 163,92 graus (dg.) No plano frontal no grupo 1 e 154,78 dg no grupo 2, respectivamente. No grupo 1, a distância ponta-ápice foi de 16,05 cm, enquanto no grupo 2 foi de 25,32 cm. O ângulo colo-diafisário foi de 133,1 graus no grupo 1 e 128,65 graus no grupo 2. Conclusão: A redução assistida por gancho é benéfica quando se opera sem uma mesa de tração; no entanto, ela também pode fazer parte do equipamento do cirurgião mesmo quando se opera em uma mesa de tração. Quando houver dificuldades em obter uma redução anatômica ideal em fraturas femorais intertrocantéricas deslocadas, sugerimos o uso da técnica de redução assistida por gancho. Nível de Evidência III; Estudo de Caso-controle.
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ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1-4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried's frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients.
RESUMO Introdução: Fragilidade e sua associação com DRC foram estabelecidas anteriormente. O presente estudo aprofundou esta associação, estudando distribuição da fragilidade entre grupos definidos por diferentes estágios da doença. Também identificou déficits de saúde associados e explorou sua associação com taxa de filtração glomerular estimada (TFGe) e relação albumina/creatinina urinária (RAC). Métodos: Realizou-se uma pesquisa transversal em 90 pacientes com DRC Estágios 1-4 não dependentes de diálise, recrutados em três grupos estratificados de 30 participantes cada, conforme estágio da doença. Avaliou-se fragilidade usando os critérios de fragilidade de Fried e registraram-se os déficits de saúde associados usando uma lista pré-determinada. A depressão foi verificada utilizando a escala de depressão de 4 pontos. Resultados: 21,1% dos participantes eram frágeis e 43,3% eram pré-frágeis. A proporção de fragilidade nos grupos de DRC A (Estágios 1 e 2), B (Estágio 3a), e C (Estágios 3b e 4) foi de 10%, 13,3%, 40% respectivamente. A associação de déficits de saúde, incluindo comorbidades, parâmetros físicos, estado mental, atividades diárias etc. com RAC, TFGe e estágios da DRC não foi estatisticamente significativa. Cerca de um em cada dois participantes frágeis estava depressivo comparados com 14% entre não frágeis. Conclusão: A distribuição enviesada de 21% dos indivíduos frágeis identificados em nosso estudo indica associação entre fragilidade e doença renal progressiva. Indivíduos frágeis apresentaram menor TFGe, maior RAC, eram mais propensos a depressão, tinham maior índice de déficits de saúde e desempenho inferior no Índice de Atividades da Vida Diária de Barthel e WHOQOL. A identificação precoce da depressão melhoraria o atendimento desses pacientes.
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Aim: To determine physicochemical properties and age of rice by non-destructive technique.Place and Duration of Study: Study was conducted at Division of Food Science and Postharvest Technology, Indian Agricultural Research Institute, New Delhi during 2020 to 2021. Methodology: Rice were kept for accelerated aging at 42.6°C temperature & 71% RH for a duration of 30 days. Changes in four physicochemical properties namely amylose content, volume expansion ratio (VER), water absorption ratio (WAR), and kernel elongation ratio (KER) were evaluated destructively (by spectrophotometer and cooking method) and non-destructively (by spectroradiometer) at every alternate day, during 30 days storage.Results: The physicochemical parameters of rice showed a good correlation with spectral signatures. Subsequently, Principal component Analysis (PCA), Partial Least Square Regression (PLSR), and Multiple Linear Regression (MLR) were used to model the physicochemical changes occurring during the process of accelerated aging using spectral reflectance values. Based on values of Coefficient of determination (R²) and Root mean square error (RMSE) accuracy of models was determined. Predictions with the MLR model resulted in a coefficient of determination (R2) of 0.82, 0.87, 0.9,7, 0.83 and 0.82 with root mean square error (RMSE) of 0.18, 0.13, 0.21, 0.124 and 4.2 for amylose content, VER, WAR, KER, and ageing process respectively for calibration.Conclusion: The study demonstrated the potential of NIRS in non-destructively predicting the physiochemical parameters of rice.
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Background: Breast milk is a complete food for the newborn. Timely introduction of breast milk and exclusive breast feeding till 6 months of age of a newborn, with proper positioning and adequate attachment to mother’s breast is encouraged as Initiation of breast feeding within the first hour after birth, prevents the newborn from the risk of morbidity and mortality. An effective improvement in mother’s self efficacy and understanding on breast feeding will be useful in meeting the nutritional goals of the child. Aim of study was to assess the knowledge, perception and practice among the mothers on breast feeding and the factors influencing their practice and to determine probable association of ideal infant weight with exclusive breast feeding. Methods: Descriptive cross-sectional study among 390 mothers attending the Immunization Clinic of Kalinga Institute of Medical Sciences, Bhubaneswar. They were assessed if they breast fed infant by following the ideal positioning and proper attachment to breast and for their knowledge, perception and practices of breast feeding. Analysis was done using STATA-17. Results: Good knowledge, perception and practice of breast feeding was present among 88.2%, 83.5% and 69.8% mothers, respectively. Association between ideal weight of baby and proper breast feeding technique was found. Knowledge was more positively related to practice, than to perception. Conclusions: Children who have been exclusively breast fed, had the right weight for age. Mother and other family members must be aware of proper technique, adequacy and frequency of breast feeding for the best nourishment of the newborn.
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Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Extensive rhabdoid morphology in ACC has been described recently in very few cases. The proportion of rhabdoid morphology and the role of SMARCB1/ INI1 expression in these tumor cells to diagnose the specific variant is not described in the literature. We reviewed the clinicopathological features of nine cases of adrenocortical neoplasm. Out of which, three cases of ACC showed predominant rhabdoid morphology. Large discohesive cells with abundant cytoplasm containing eosinophilic inclusions, eccentric vesicular nucleus, and prominent nucleoli. INI1 immunostain was retained in all cases. We reported the rhabdoid variant of ACC, a novel entity, and its diagnostic approach from their histological mimickers. Identifying more cases of this entity will help to clearly understand the pathogenesis, biologic behaviour, and any specific molecular alterations in the future.
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Background: The prostate is a male reproductive accessory gland which gives rise to several pathological conditions. The present study aims to study the correlation of histopathology of prostatic diseases with the clinical profile of the patient coming to VSS Medical College (VSSMC), Burla for histopathological reporting of prostatic biopsies. Aim and Objectives: The objectives of this study were as follows: (1) To correlate serum prostate-specific antigen (PSA) level with various clinical and pathological lesions of the prostrate gland, in a Hospital-based sample of Western Odisha population. (2) As the male gender represents almost half of the entire population, to find out different clinicopathological lesions, percentage-wise, so as to know the frequency of occurrence of such lesions. Materials and Methods: Fifty-seven cases of prostatic diseases were recorded in the Department of Pathology, VSSMC, Burla for histopathological examination of prostatic tissue for 2 years from September 2017 to August 2019. All the samples were fixed in 5 ? sections with 10% neutral buffered formalin. Then Hematoxylin and Eosin stain (H and E stain) was used for staining. Appropriate clinical data comprising signs and symptoms, laboratory findings, and serum PSA levels were recorded. Results: The present study, in the beginning, consisted of 64 patients, out of which seven patients were excluded by exclusion criteria, and finally, 57 cases were analyzed. The most prevalent age group for all prostatic diseases was 61–70 years with a mean of 67 years. The majority of the cases (73.67%) were benign mostly benign prostatic hyperplasia (BPH). Prostatic intraepithelial neoplasia (PIN) was 12.29% and malignant cases (all adenocarcinoma) were also 12.29%. All patients showed prostatomegaly. About 50% of cases suggestive of malignancy by digital rectal examination (DRE) were confirmed to be carcinoma by histopathological study. Serum creatinine level was raised in 16.27% of benign and 21.42% of premalignant and malignant conditions. Serum PSA level below 4 ng/mL were all benign and above 10 ng/mL were majority malignant conditions. However, at level 4–10 ng/mL, BPH and PIN cases were overlapped with cases of carcinoma. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Serum PSA level <4 ng/mL is associated with benign conditions and more than 10 ng/mL is associated more with carcinomas. Although, investigations such as DRE and serum PSA estimation aid in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies.
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Background: Alcohol consumption by women of reproductive age group not only affects their health but can also cause multiple adverse birth outcomes. The objectives of the study were to assess the prevalence and pattern of alcohol consumption among women of reproductive age group in urban field practice areas of Sikkim Manipal Institute of Medical Sciences (SMIMS) by using a structured questionnaire and WHO tool, AUDIT (Alcohol Use Disorder Identification Test). Methods: The study was a cross sectional study. A total of 284 women of reproductive age group (15-49 years) were interviewed using a structured questionnaire and AUDIT. Results: The overall prevalence of alcohol consumption was 36.6%. Proportion of alcohol users was more among women of 25-34 years. Almost 95% of the women are current users (alcohol use in past 12 months). Beer was mostly preferred over other types of alcoholic beverages. Social customs (36.5%) and stress (25%) were the main reasons for consumption of alcohol. Based on AUDIT score, low risk drinking 68.6% was the predominant drinking pattern reported. However, one fourth of the women fall into hazardous pattern of drinking and 3 out of every 100 women had harmful and dependent pattern of drinking respectively. Conclusions: The present study highlights the prevalence of alcohol consumption among women of reproductive age group in urban field practice areas of SMIMS. Socio-cultural factors and stressful life plays an influential role in consumption of alcohol. Although low risk drinking is the predominant pattern of alcohol use, an alarming 31% of women consuming alcohol are at risk of developing alcohol related harm.
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Background- Whole pulp amputation followed by pulp space disinfection and ?lling with an arti?cial material causes loss of signi?cant amount of dentin leaving a non-vital and weakened tooth. Regenerative endodontics with its emerging ?eld of modern tissue engineering has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. [1] Introduction- PRF was recognized as the “second generation” of this family of biomaterials. [6] PRF being tested in pulp tissue engineering by different research groups showed mixed results. (7,8) Research studies have shown that the interactions between the cells and their niche are closely related to physicochemical properties of the scaffolding materials [9, 10]. As PRF is a fragile gel its physical character needs to be improved by cross linking and thereby more longer period of liberation of its growth factors and delayed disintegration in physiological system. Aims and Objectives- Aim of our study was to prepare a very economical and autologous biomaterial for pulp tissue engineering by crosslinking of PRF with tannic acid. Our objective was to detect cytotoxic effect of tannic acid in PRF. Methods and Materials- We followed Choukroun et al. protocol to prepare PRF samples from whole venous blood collected from donors. PRF samples were then cross-linked in freshly prepared TA solution in dapendish for 10 minutes at room temperature. Concentrations of TA 1 wt% was used for preparing samples. After crosslinking, the gels were washed with normal saline for 5 min. to ensure that all excess TA was removed. The viability of cells cultured on the scaffolds was assessed through MTT assay (EZcountTM MTT cell Assay Kit, HiMedia, Mumbai, India). Observations- Both MTT Assay and Phalloidine staining showed favourable results of no clear cytotoxic effects of C-PRF. Conclusion- Based on the results of the cell viability analysis it can be concluded that none of the tannic acid crosslinked PRF created any clear cytotoxicity in the MC3T3 cells. So, C-PRF can safely be used as scaffold for dental pulp or similar tissue engineering purposes
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Objectives: Micro and macrovasculopathy are common complications of undertreated or undiagnosed type 2 diabetes mellitus (T2DM) patients. One of the underlying factors of macrovasculopathy is arterial stiffness, which may lead to cardiovascular and cerebrovascular diseases. Understandably, diabetic micro and macrovasculopathy affect vital functions, which may affect the well-being of the individual. However, few studies have attempted to determine arterial stiffness, cardiac autonomic neuropathy (CAN) and lipid profile separately in South Asian population and examined its associations with T2DM. Moreover, there is a need to understand the mechanistic links among cardiovascular risk factors. This forms the basis of the present study. Materials and Methods: T2DM patients of 53–62 years and age- and gender-matched healthy control subjects were recruited in the cross-sectional and observational study (n = 30 each, eight women). Anthropometric measurements, physiological parameters such as resting heart rate, peripheral blood pressure (PBP), central blood pressure (CBP), augmentation index% (AIx%), brachial-ankle pulse wave velocity and lead II ECG for analysis of heart rate variability parameters were recorded after obtaining the consent of the study participants. The lipid profile and fasting blood glucose were also analysed. Results: Peripheral systolic blood pressure was significantly higher (P = 0.05) in T2DM patients. Dyslipidaemia was evident in T2DM patients. Atherogenic index of plasma (AIP) was also significantly higher in T2DM patients. Correlation analysis revealed a positive association between AIx% with PBP and CBP as well as between AIP index and central systolic blood pressure, serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. AIP index was found to be negatively associated with HF (nu). Serum TG, high-density lipoprotein cholesterol (HDL-C) levels and AIP index have emerged as significant independent predictors of T2DM vasculopathy by multiple regression analysis. Conclusion: In the present study, atherogenic dyslipidaemia was observed in T2DM patients in combination with increased serum levels of TG, VLDL-C and decreased serum levels of HDL-C. Moreover, AIP index, a predictor cardiovascular risk, was found to be significantly higher in T2DM patients. Dyslipidaemia was found to be associated with dysregulation of autonomic nervous system in those patients. A positive association between noninvasive, surrogate markers of arterial stiffness with PBP and CBP indicates that enhanced arterial stiffness may elevate systemic arterial pressure. Therefore, early screening of T2DM patients for the estimation of serum lipid profile, arterial stiffness and cardiac autonomic neuropathy may be performed to unravel diabetic vasculopathy.
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Background: Thyroid gland is an endocrine organ. The non-neoplastic and neoplastic conditions affecting the gland can manifest as the swelling of the gland with thyroid dysfunction. Based on cytology, the diseases can be categorized into non-neoplastic, benign neoplastic, and malignant neoplastic conditions and according to hormone status, the lesions of thyroid can be categorized in hypothyroid, euthyroid, or hyperthyroid condition. Aims and Objectives: Our study was done to find out the various cytomorphological spectrum of thyroid diseases and to record their common clinical presentation along with hormonal status in a tertiary care hospital in Northern Odisha. Materials and Methods: A total of 220 cases of thyroid disorder were taken for analysis over a period of 2 years. Patients demographic data, brief clinical features, finding on FNAC (cytomorphology), and thyroid function status were analyzed with appropriate statistical method. Results: The predominant age group affected was 21–40 years and total female to male patient ratio was 5.5:1. Most common presentations were heat intolerance (22.27%), cold intolerance (28.63%), and tachycardia (27.72%) apart from thyroid enlargement. Most common non-neoplastic lesion were multinodular and colloid goiter constituting 38.18% of total cases and most common neoplastic lesion was papillary carcinoma constituting 14.55% of total cases. Thyroid function test showed predominantly euthyroid states for all conditions. Conclusion: As the rest part of India, this part of Odisha also showed that thyroid disorders are more common in females and the most affected age group is 21–40 years. Multinodular and colloid goiter are the most common thyroid lesions. Most of the cases present with euthyroid state.
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Background: Normal human beings can appreciate color in all three of it’s attributes; Hue, intensity, and saturation. Human beings can perceive three primary colors, that is, red, green, and blue. Any defect in appreciation of colors is known as color vision deficiency (CVD). Complete inability to appreciate color is known as color blindness. The genes for red and green cone pigments are found in the q arm of the X chromosome. Hence, red and green CVD are inherited as X-linked recessive diseases. Blue CVD is autosomaly inherited. Blood groups are genetically inherited as well. Although it is a known fact that there is a preponderance of genetic diseases in subjects belonging to a specific blood group, no such study was available in Western Odisha as per our knowledge. This becomes more relevant as consanguineous marriages are a serious social problem in that part of Odisha. Aim and Objectives: Therefore, the study was undertaken to find out the prevalence of CVD among Medical students in Western Odisha and to find out it’s relation, if any, with ABO blood groups, as these two entities are genetically inherited. Record should be kept for future use, especially for counseling at the time of marriage and if necessary, to choose a subject for further study, where color detection does not play an important part. Materials and Methods: Prior permission was taken from the Institutional Ethics Committee to carry out this study. The study was carried out among the 1st–4th year medical students of V.S.S. Medical College and Hospital (n = 690) from August 2022 to October 2022. Ishihara test plates for color vision and agglutination method for ABO blood grouping were employed to get the prevalence of CVD and to get the percentage of subjects belonging to each blood group among those having CVD. The observations were noted carefully. Results: After careful screening, it was seen that 647 (93.76%) were normal, 42 (6.08%) had CVD, and 1 (0.14%) subject was completely color blind. All those affected were males. Distribution of blood group in CVD subjects showed 7 (16.27%) numbers belonging to blood group A, 22 (51.16%) belonging to blood group B, 1 (2.3%) belonging to blood group AB, and 12 (27.9%) belonging to blood group O. The only color blind student belonged to blood group B (2.3%). Conclusion: As medical students have to deal with colors throughout their career, the study helps the subjects to be aware of their condition early in their professional life. It also tried to find out the percentage distribution into ABO blood groups. A larger population should be included to get more accurate results.
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Periodontitis is a prevalent infectious disease in which the accumulation of bacterial plaque leads to an inflammatory reaction and destruction of supporting tissues around the teeth. The optimal goal in periodontal treatment is to eliminate the infection and to recreate the lost structures of cementum, periodontal ligament (PDL), and the alveolar bone with the reestablishment of their functions. Achieving this regenerative aim, however, remains a major challenge for periodontists. In order to increase the predictability and the efficacy of regenerative periodontal therapies, treatment modalities have moved from the conventional guided tissue treatments to novel tissue engineering and stem cell–based treatments. This is achieved either by transplantation of cells from outside sources to the periodontal defects or by enhancing the recruitment of endogenous host cells present in the area, known as cell homing methods. Photobiomodulation (PBM) therapy is a term used for exposure of cells/ tissues to low-level laser light or light-emitting diodes (LEDs), which is absorbed by specific photoreceptors in cells and may cause alteration at a molecular level inside cells without any heat generation leading to biological changes in cell metabolism and function.
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Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients’ need for pain control, destigmatization, and human immune-deficiency virus (HIV) transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor collaboration between dental and general health care sectors serving addicts. These interfere with an accurate picture of the situation. Moreover, lack of appropriate policies to improve access to dental services, lack of comprehensive knowledge of and interest among dental professionals in treating addicts, and low demand for non-emergency dental care affect provision of effective interventions. Management of drug addiction as a multi-organ disease requires a multidisciplinary approach. Health care programs usually lack oral health care elements. Published evidence on oral complications related to addiction emphasizes that regardless of these barriers, oral health care at various levels including education, prevention, and treatment should be integrated into general care services for addicts.
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@#Aneurysms and pseudoaneurysm are commonly encountered with arteriovenous vascular access for haemodialysis. They are difficult complications to manage. Due to the limited number of vascular centers available, patients were unable to seek treatment until further complications arise. The technique of partial aneurysmectomy and primary repair was adopted as the method of repair in this study. A total of 20 cases underwent the surgery from 2019 to 2020. Among the 20 cases, one patient had two pseudoaneurysms at different location which requires her to undergo the procedure twice. The successful cannulation rate post repair was 70% whereas the overall complication rate was 35% which might be attributed to the small sample size. Overall, this study demonstrated that AVF aneurysm and pseudoaneurysm can be safely treated with this approach and can be done effectively in non-vascular centers by general surgeons.
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Objective@#COVID-19 has gravely affected patients with psychiatric conditions. Potential interactions may occur between psychotropic medications and medications used in treatment of COVID-19. This study aimed to compare the online databases in terms of the quality of drug-drug interaction related information available on them. @*Methods@#216 drug interactions which included fifty-four psychotropic medication interactions with four COVID-19 drugs across six databases were analyzed by four authors independently. The overall grading of the databases was done on Likert scale independently by the authors using the parameters of ease of understanding for consumers and professionals, level of completeness, discussion on level of evidence and the number of available drugs, congruity with other databases and the mean score was tabulated. @*Results@#Drugbank and Lexicomp had maximum discrepancy. The safety profile of Hydroxychloroquine was the best (eighteen moderate/severe psychotropic medication reactions) while Ritonavir has worst profile with thirty-nine medications. Drugbank had the highest SCOPE score (1.00) for completeness and covid19druginteractions.com had least (0.81). Overall, Liverpool© Drug Interaction Group and Lexicomp scored the highest (23/30 each) and were the best interaction checker software closely followed by Drugs.com (22/30). Medscape and WebMD were the poorest interaction checker databases. @*Conclusion@#There is significant variability in the available online databases. Liverpool © Drug Interaction Group and Lexicomp were the most reliable sources for healthcare workers whereas for patients, Drugs.com was the easiest to understand (as it segregates the needs of general consumers and professionals distinctly to explain the interaction).