Rasmussen’s Encephalitis

Introduction: Rasmussen’s encephalitis (RE) is an inflammatory encephalopathy characterized by progressive refractory focal seizures, cognitive deterioration and focal neurological deficit that occur with gradual atrophy of one brain hemisphere. Case presentation: We report a case of an 18-year-old male with a history of abnormal body movements involving the right half of the body without loss of consciousness for the last 15 years. Noncontrast computed tomography (NCCT) head and magnetic resonance imaging (MRI) revealed hemiatrophy of the left cerebral hemisphere. Conclusion: RE is a rare disease; hence, diagnosing and managing such patients may be challenging. Our aim is to draw attention of the treating physicians towards this disease with the help of this case report.

Scrub Typhus and Myocarditis: A Rare Complication

Scrub typhus, also called bush typhus, is a zoonotic disease a Gram-negative bacterium. Its presentation may range from nonspecific febrile illness to severe disease, with cardiovascular, renal, hepatic and neurological involvement. Myocarditis is one of the rare complications of scrub typhus. Hence, we are reporting a case of a 50-year-old male, farmer by occupation, presenting to us in multiorgan dysfunction syndrome who developed myocarditis during second week of his illness.

A cross-sectional cariogram-based comparison of caries risk profile in children with various levels of intellectual disability

Aim: To compare the caries risk profile in children with mild, moderate, and severe intellectual disability (ID) using cariogram. Materials and Methods: A cross-sectional study was conducted to compare caries risk profile using cariogram among 150 children aged 6–18 years, with various levels of ID (50 each in Mild ID, Moderate ID, and Severe ID groups), attending special schools in Bengaluru city. The risk assessment consisted of: a questionnaire, an interview, estimation of oral hygiene, saliva sampling, microbial evaluation and clinical examination. Statistical analysis of the results obtained was performed using Chi-square/Fischer's exact test, Kruskal–Wallis test and Mann–Whitney test. Results: The overall comparison showed significant differences between the groups across all parameters except diet (P = 0.131), fluoride exposure (P = 1), salivary flow rate (P = 0.3), and buffer capacity (P = 1). Caries risk was high among children with severe intellectually disability while the actual chance to avoid caries was found to be high in the Mild ID group. Bacteria was one of the dominant caries risk sectors followed by susceptibility, circumstances, and diet. Conclusion: Cariogram can be used as an effective tool in assessing caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive measures can be implemented to overcome the caries risk.

Comparison of ambulatory blood pressure monitoring and self-blood pressure monitoring for diagnosing white coat hypertension amongst pregnant women

Background: White coat hypertension (WCH) is a common and well recognized phenomenon. It is also very prevalent amongst pregnant women and is often diagnosed as chronic/ gestational hypertension leading to unnecessary medications during pregnancy. ABPM is the gold standard for diagnosis of WCH. SBPM is an easy effective and reliable method to measure blood pressure but its efficacy needs to be tested and compared with ABPM in cases of WCH. It is important to compare the two methods in assessing WCH so SBPM can be utilized in cases of WCH, if found useful and efficacious.Methods: All pregnant women who presented to the ANC were screened for hypertension. Those who were diagnosed to be hypertensive in antenatal clinic and these patients were then admitted for ambulatory blood pressure monitoring (ABPM) for 24 hours and SBPM on 6 hourly bases for 5 days.Results: The ABPM and SBPB readings were noted, tabulated and compared. It was found that the prevalence of ‘WCH’ in this study using ABPM and SBPM were 47.368% (27/54) and 45.614% (26/54) respectively.Conclusions: The results in diagnosing WCH using ABPM and SBPM were comparable.

Prevalence of white coat hypertension amongst pregnant women admitted with high BP recordings in ante-natal clinic

Background: White coat hypertension (WCH) is a common and well recognized phenomenon with significant prevalence amongst all age groups. This is also quite prevalent in the pregnant women with an intermediate long term prognosis between hypertensive and normo-tensive individuals. It is important to assess the true prevalence WCH in pregnant women and to prevent unnecessary medications to them during pregnancy but at the same time to keep a timely follow up and a watchful eye on these patients to identify complications at the earliest. Study was conducted at a peripheral secondary level hospital with a small obstetrics and gynecology OPD and ward. 54 patients were diagnosed to be hypertensive in Antenatal Clinic.Methods: All pregnant women who presented to the ANC were screened for hypertension. Those who were diagnosed to be hypertensive in antenatal clinic and these patients were then admitted for Ambulatory Blood Pressure Monitoring (ABPM) for 24 hours.Results: The ABPM tracings were checked and tabulated to arrive at the final diagnosis after 24 hrs. The prevalence of ‘WCH’ in this study was 48.15% as 26/54 patients were found to have their average BP < 140/90 mmHg after measurement by ABPM over 24 hours so they were diagnosed as ‘White Coat Hypertension’ patients.Conclusions: Many women who come to ANC in the early pregnancy are diagnosed to have hypertension. WCH is a well known phenomenon in pregnancy. WCH must be ruled out prior to starting these patients on anti-hypertensive medications.

Current applications of proteomics: a key and novel approach

Proteomics represented vital applications of technologies in the identification and quantification of high to moderate proteins (cellular signalling networks) found in biological matrix such as tissues, cells and fluids. Proteomics based technical knowledge is applied and verified in several preclinical research settings such as invention of diagnostic markers for specific disease and have shown to be increased in clinical applications. Extensive studies on proteomics resulted in detection of biomarkers that have been highly advanced in using diseases for cancer, lungs, cardiovascular, renal and neuro-regenerative and Parkinson's disease by introducing human origins for biocompatibility such as urine and serum. Advancement in the proteomic methods is conferring candidate right direction for clinical usage. In this review, recent developments and widely used proteomics approaches such as Mass Spectrometry (MS), Microarray chips are elaborately addressed and also focused merits and demerits of commonly used advanced approaches such as Selected Reaction Monitoring (SRM), Parallel Reaction Monitoring (PRM) and Data Independent Acquisition (DIA) and other used proteomics and that roles, in order to aid clinicians, were also discussed in the light of biomedical applications.

Comparative Study between Saliva and Serum in Diabetic Patients

Introduction: Diabetes mellitus is a common chronicmetabolic disorder which affects millions of people. Theprevalence of diabetes for all age groups worldwide wasestimated to be 2.8% in 2000 and may reach 4.4% by 2030.The objective of my study was to evaluate and comparethesalivary and serum glucose levels in diabetes mellitusindividuals.Material and methods: Study included 200 subjects, out ofthese 100 subjects were of diagnosed diabetes & 100 nondiabetic subjects were as controls group. 2ml of patient’s intravenous blood was obtained from the median cephalic veinof the forearm, by using 5 ml disposable syringe. The bloodsample was transferred in a fluoride tube.Results: Glucose was present in saliva of both diabetic andnon diabetic subjects. Glucose level was increased in diabeticpatients.Conclusion: Concentration of glucose in saliva increases withthe increase in serum glucose concentration. A significantcorrelation was seen between salivary and serum glucose levelin diabetic as well as non diabetic subjects.

A Cross Sectional Study of Association between Edentulism and Depression in Varanasi Population

This study was conducted to estimate the depression label; due to edentulism and measure the treatment outcome. Methods: A questionnaire were distributed to 96 edentulous participants undergoing routine prosthetic care in Department of Dentistry, Heritage Institute of Medical Sciences Varanasi and Various private clinics in Varanasi district. Results: Among Ninety six people who completed the questionnaire, 56 stated that they had experienced difficulties in accepting the loss of their teeth. In comparison with people who had no difficulties in accepting the situation, these people were feel less confident about themselves, more likely to feel inhibited in carrying out everyday activities. Conclusion: The label of depression of majority of participants were minimal only few participants showed marked or severe depression.

Experience with Holter monitoring for evaluation of infant arrhythmia

Background: Arrhythmia is defined as abnormal heart rates. Sometimes they are intermittent and difficult to diagnose on routine ECG. Neonatologist and Pediatrician needs to rapidly establish accurate diagnosis and management for infants suspected to have arrhythmia. Hence Holter monitoring of the infants presenting with symptoms suggestive of arrhythmia is necessary as it provides a continuous record of heart's electrical activity. The aim of this paper is to find out the role of continuous ambulatory electrocardiographic monitoring in daily clinical practice of Pediatrics.Methods: All infants including neonates, either inborn or brought to the paediatric emergency with risk factors, between January 2016 to January 2018, were included in this prospectively study. Evaluation including chest X-ray, standard 12-lead electrocardiography, 24 hours continuous ECG monitoring using Mortara holter, echocardiography, biochemical and haematological analysis.Results: A total of 73 babies were enrolled in present study. In this study arrhythmia was found in 29 (39.72%) new-borns. The most common arrhythmia observed was supraventricular tachycardia (SVT) (41.3%). Other arrhythmia observed were ventricular tachycardia (VT), AV block (34.4%), atria premature beats (3.4%) and ventricular premature beats (6.89%), tachy-bradyarrhythmia (3.4%) and junctional rhythm (3.4%). Of 29 arrhythmia patients four were diagnosed solely by Holter monitoring. None of the babies had long QT syndrome on Holter monitoring.Conclusions: Cardiac arrhythmias are important causes of infant morbidity, and mortality if undiagnosed and untreated. It is important for the neonatologist and paediatrician to be aware of these of arrhythmias and the various diagnostic modalities available for them. A Holter electrocardiogram may be of value in identification of these transient arrhythmic events.

A case of potentially lethal vascular variation in association with palmaris profundus muscle / 대한해부학회지

Arterial variations in upper limbs are often reported commonly. Superficial arterial variations accounting for 4.2% of all arterial variations are hazardous during any invasive procedures of the upper limb, from routine intravenous injections to surgeries. Arterial variations are usually associated with inverted or absent palmaris longus. Palmaris profundus, a rare anomalous variation of palmaris longus has been reported in carpal tunnel syndrome as its tendon was associated with median nerve in the carpal tunnel. The authors reported a unique variation in the upper limb arterial pattern—the presence of bilateral superficial brachioulnar artery associated with unilateral palmaris profundus muscle and an abnormal radicle of musculocutaneous nerve to the median nerve in the left side.

Study Of Morphology Of Fissures Of Lung In Central Karnataka Region

The adult human lungs are two in number, the right & left lungs which are concerned with the aeration andexchange of gases. The right lung is comparatively larger & heavier and has 2 fissures oblique fissure & horizontalfissure & has 3 lobes in it. The left lung is longer & has only 1 fissure in it with 2 lobes.The present study was done on adult lungs in the Dept. of Anatomy SUIMS & R.C. Shimoga where only the obliquefissure was seen and horizontal fissure were missing in 7 out of 40 right lungs studied. Incomplete horizontalfissures were in 3 right lungs out of 40. Accessory fissure was seen in 1 specimen of right lung. Accessory fissureswere seen in 3 out of 40 left lungs studied. The presence of normal fissures in lung will help in proper expansionof lungs & also helps in localising the lesions to specific areas in the lungs. Incidence of absence of fissures inlungs varies from one geographical region to other region and is variable with the samples collected by differentworkers for the study.The incomplete fissures when present give a atypical appearance of the pleural effusion and may also alter theusual patterns of collapse of the lungs. The knowledge of such absence or incomplete fissures in lungs is helpfulfor anatomists, radiologists and surgeons operating on lungs during lobar resections of the lung

Antimicrobial And Phytochemical Evaluation Of Cissus Quadrangularis L.

The present investigation involves antimicrobial and phytochemical evaluation of Cissus quadrangularis L. The antibacterial activity of Cissus quadrangularis was performed using disk diffusion method. The Results of study proved prompt efficacy of herbal extract against S. aureus and E. coli. The concentration dependent antibacterial activity of extract was observed against both organisms. Study also involves phytochemical investigation of herbal extract using HPTLC, IR and UV-Visible spectrophotometer. The result of study indicated that the methanolic extract possessed most potent antibacterial activity as compared to other extract. The antibacterial activity increases with the concentration and results indicated that the diameters of zone inhibition of the extract were comparable with the standard drug. The antimicrobial potential of plant extract may be attributed to the presence of specific phytoconstituents.

Parent's Knowledge, Attitude and Practice on Prevention of Early Childhood Caries in Al jouf Province, Saudi Arabia

Objective: To measure the knowledge, attitude, and preventive practices of parents in regards to their understanding of early childhood caries (ECC) in Al jouf province, Saudi Arabia (KSA). Material and Methods: A cross-sectional oral health survey was conducted among 228 parents, who were selected by stratified cluster sampling. A questionnaire consisting of 10 questions in each domain addressing knowledge, attitude, and preventive practice for ECC was applied. Scoring in the knowledge field included Yes/No/Don't know, while the attitude and practice domains used a 5-point Likert scale. Results: The mean values for knowledge of the respondents was 'Yes' (106.1 ±46.12), 'No' (63.5 ±50.95), and 'Don't know' (58.4 ±23.21); the p-value was p>0.05. The mean values for attitudes of the parents were strongly disagree (49.8 ±33.51), disagree (28 ±15.63), cannot say (47.4 ±20.33), agree (69.4 ±26.57), and strongly agree (33.4 ±30.48); the p-value was p<0.05. The mean values for preventive practices were strongly disagree (23.3 ±25.15), disagree (27.6 ±28.29), cannot say (38.9 ±31.8), agree (84.9 ±28.07), and stronglyagree (53.3 ±38.73); the p-value was <0.05. Conclusion: The parents did not have adequate knowledge of ECC but did have a good attitude and practice towards its prevention.

Undescended cecum with accessory right colic artery: a rare case report / 대한해부학회지

Midgut malrotation and incomplete rotation are common causes of neonatal intestinal obstruction. At end of 10 week of intrauterine life, cecum will be placed in subhepatic region temporarily and descends to right lower quadrant by eleventh week. Arrest of cecum in subhepatic region or undescended cecum is a rare congenital anomaly of mid gut. Usually, it remains asymptomatic and is diagnosed incidentally. If any pathology occurs in anomalous part, like appendicitis then the diagnosis and treatment will be challenging in all age groups. Variation in blood supply have also been reported with anomalies leading to iatrogenic injuries during colonoscopy and surgeries. Lack of knowledge of these rare variations may lead to delayed diagnosis of appendicitis leading to perforation and surgical emergencies. In the present case, we describe an undescended cecum and its associated variation in branching pattern of superior mesenteric artery.

Study of profile of cardiac dysfunction in HIV infected children

Background: There are very few published studies of heart disease in HIV infected children. The incidence of cardiovascular disease reported among HIV infected children ranges from 72% to 90%. Cardiac disease was primary cause of death in 25% of HIV Positive patients. Studies carried out in Indian subcontinent have demonstrated the presence of systolic and diastolic dysfunction on 2D Echo in HIV infected patients. Objectives: To determine the prevalence, and describe the type of heart disease among children with HIV attending an ART centre in Gandhi hospital and centre of excellence Niloufer hospital in collaboration Department of Cardiology, Gandhi Hospital. Materials and methods: 100 HIV infected children in age group of 1-18 years attending an ART centre in Gandhi hospital and centre of excellence Niloufer hospital from December 2011 to August 2013 were evaluated clinically, and investigated by chest X-ray, electrocardiography and 2D-echo. Results: Heart abnormalities were detected in 48 children (43 by 2D-echo, 4 by ECG, 1 by chest Xray). The abnormalities included left ventricular systolic dysfunction (16%), left ventricular dilation (8%), left ventricular hypertrophy (11%), Pulmonary artery hypertension (11%), tricuspid regurgitation (14%) pulmonary regurgitation (4%), mitral regurgitation (4%), sinus tachycardia (4%), cardiomegaly on chest X-ray 1 of total 100 children taken for study. Conclusions: Heart abnormalities were common especially in HIV infected children. Clinical examination, chest radiograph and ECG may pick up manifest cardiac disease. Sub-clinical manifestations such as left ventricular dilatation hypertrophy and decrease systolic dysfunction can be detected only by echo cardiography. Annual echography and ECG examination is recommended to evaluate the progression of cardiac disease and treat the same before it become irreversible in HIV infected children.

Surgical Management of Long Bone Fracture of Lower Limb in Pediatric by Titanium Elastic Nails.

Background: Skeletal trauma accounts for 10-15% of all childhood injuries. The increasing incidence of fractures in children mainly attributed to increased road traffi c accidents and sports participation. Materials and Methods: The study was conducted from October 2012 to April 2015 at Terna Medical College, Navi Mumbai. A 28 pediatric patients (20 male and 8 female), who came to emergency department with long bone fractures subsequently, underwent surgical fi xation of long bones by titanium elastic nailing (TENS) were included in this prospective study. Results: Road traffi c accident was the main mode of injuries. The most common long bone fracture was femur 40% and 60% tibia fracture. Pattern of fracture 33.3% transverse, 13.3% commiunited, 20% oblique, 26.7% spira, 6.7% segmental. The level of fracture 80% middle third. The time interval between trauma and surgery was average 3.65 days. Average duration in 50.20 min. Average duration of immobilization is 7.2 weeks. Duration of stay in hospital was 10.25 days. Time of union is 10.35 weeks. Time of weight bearing in the present study is 11.8 weeks. Follow-up done for period of 24 weeks. According to Flynn’s criteria, 89% of patients were excellent and 11% satisfi ed; no patients reported their outcome as not satisfi ed. Conclusion: TENS is the method of choice for the management of long bone fractures in children, because its elastic mobility promoting rapid union at fractures site, stability ideal for early mobilization. It gives lower complication rate, good outcome. It allows an early functional and cast-free follow-up, quick pain reduction compared plating technique including a minimally invasive technique. A less time-consuming procedure and easier metal work removal, cosmetically a small scar. Our study results provide new evidence that expands the inclusion criteria for this treatment and shows that TENS can be successfully used regardless of fracture location and fracture pattern.

Cyanobacteria, Lyngbya aestuarii and Aphanothece bullosa as antifungal and antileishmanial drug resources

To investigate two cyanobacteria isolated from different origins i.e. Lyngbya aestuarii(L. aestuarii) from brackish water and Aphanothece bullosa (A. bullosa) from fresh water paddy fields for antifungal and antileishmanila activity taking Candida albicans and Leishmaniadonovain as targets. Methods: Biomass of L. aestuarii and A. bullosa were harvested after 40 and 60 d respectively and lyophilized twice in methanol (100%) and redissolved in methanol (5%) for bioassay. Antifungal bioassay was done by agar well diffusion method while antileishmanial, by counting cell numbers and flageller motility observation of promastigotes and amastigotes fromL. donovani . Fluconazole and 5% methanol were used as control. Results: Both the cyanobacteria were found to be potent source of antifungal activity keeping fluconazole as positive control, however, methanolic crude extract (15 mg/mL) of A. bullosa was found more potent (larger inhibition zone) over that of methanolic crude extract of L. aestuarii. Similarly antileishmanial activity of crude extract (24.0 mg/mL) of A. bullosa was superior over that of methanolic crude extract of L. aestuarii (25.6 mg/mL). Conclusions: Antifungal and antileishmanial drugs are still limited in the market. Screening of microbes possessing antifungal and antileishmanial activity drug is of prime importance. Cyanobacteria are little explored in this context because most of the drugs in human therapy are derived from microorganisms, mainly bacterial, fungal and actinomycetes. Thus in the present study two cyanobacterial strains from different origins showed potent source of antifungal and antileishmanial biomolecules.

Accuracy of two face-bow/semi-adjustable articulator systems in transferring the maxillary occlusal cant.

Context: The precision of an arbitrary face-bow in accurately transferring the orientation of the maxillary cast to the articulator has been questioned because the maxillary cast is mounted in relation to arbitrary measurements and anatomic landmarks that vary among individuals. Aim: This study was intended to evaluate the sagittal inclination of mounted maxillary casts on two semi-adjustable articulator/face-bow systems in comparison to the occlusal cant on lateral cephalograms. Materials and Methods: Maxillary casts were mounted on the Hanau and Girrbach semi-adjustable articulators following face-bow transfer with their respective face-bows. The sagittal inclination of these casts was measured in relation to the fixed horizontal reference plane using physical measurements. Occlusal cant was measured on lateral cephalograms. SPSS software (version 11.0, Chicago, IL, USA) was used for statistical analysis. Repeated measures analysis of variance and Tukey's tests were used to evaluate the results (P < 0.05). Results: Comparison of the occlusal cant on the articulators and cephalogram revealed statistically significant differences. Occlusal plane was steeper on Girrbach Artex articulator in comparison to the Hanau articulator. Conclusion: Within the limitations of this study, it was found that the sagittal inclination of the mounted maxillary cast achieved with Hanau articulator was closer to the cephalometric occlusal cant as compared to that of the Girrbach articulator. Among the two articulators and face-bow systems, the steepness of sagittal inclination was greater on Girrbach semi-adjustable articulator. Different face-bow/articulator systems could result in different orientation of the maxillary cast, resulting in variation in stability, cuspal inclines and cuspal heights.

Nasopalpebral lipoma coloboma syndrome.

Nasopalpebral lipoma–coloboma syndrome is characterized by nasopalpebral lipoma and eyelid coloboma. We report a case of a 16-year-old Indian girl who reported to us with this rare syndrome. Computed tomography scan showed a significantly hypodense lesion on the right side of nose which was confirmed to be a lipoma on histopathological examination. This condition should be included in differential diagnosis of conditions with congenital eyelid coloboma.

Screening & profiling of quorum sensing signal molecules in Pseudomonas aeruginosa isolates from catheterized urinary tract infection patients.

Background & objectives: Catheter associated urinary tract infections are the second most common nosocomial infections and Pseudomonas aeruginosa is the third most common organism responsible for these infections. In this study P. aeruginosa isolates from catheterized urinary tract infection patients were screened and profiled for the presence of different type of quorum sensing (QS) signal molecules. Methods: Screening and quantitation of AHLs was done by using cross feeding assay and by determining β-galactosidase activity respectively using Escherichia coli MG4 as reporter strain. Further, AHL profiles were determined by separating AHLs on TLC coupled with their detection using Chromobacterium violaceum CV026 and Agrobacterium tumifaciens A136 biosensor strains. Results: All uroisolates from catheterized patients having urinary tract infections were found to be producers of QS signal molecules. There were differences in amounts and type of AHL produced amongst uroisolates of P. aeruginosa. Several AHLs belonging to C4-HSL, C6-HSL, oxo-C6-HSL, C8-HSL, C10-HSL and C12-HSL were determined in these strains. Interpretation & conclusions: Simultaneous use of more than one reporter strain and assay method proved useful in determining the AHLs profile in uroisolates of P. aeruginosa. Observed differences in the amounts and types of AHLs may reflect differences in virulence potential of P. aeruginosa to cause UTIs which can be further confirmed by employing animal model system. The present study speculates that production of QS signal molecules may act as a new virulence marker of P. aeruginosa responsible for causing catheter associated UTIs and can be considered as futuristic potential drug targets towards treatment of UTIs.