COVID-19 Pandemic and the Role of Control Room in the Tertiary Care Hospital

COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.

Clinico-epidemiological Trends of Leprosy in 21st Century and During COVID-19 Pandemic

Leprosy is the oldest disease affecting humankind since ancient times. Despite MDT’s availability for disease curability, vast pockets of multi-bacillary (MB) cases persist in the community. We conducted this study to know the clinico-epidemiological trends of leprosy over four years and five months in this era of the COVID-19 pandemic (C19P). A total of 90 cases were registered; 59 (65.5%) were males, and 31 (34.5%) were females. The majority (69%) of cases were in the 15-45 age groups. Childhood leprosy was detected in 3(3.3%) cases. A history of contact with leprosy patients could be established in 16 (17.8%) cases. The cases comprised 54.5% local inhabitants and 45.5% were migrants. The MB cases 77 out of 90 (85.6%) were in higher proportion than pauci-bacillary (PB) cases. In the clinical spectrum, BL leprosy was most common in 39% of cases, followed by LL and BT leprosy. Thirty-seven (41%) patients were suffering from lepra reactions (LR), and out of them, 59.4% had type 2 reactions (T2R), and the rest had type 1 reactions (T1R). Disabilities were found in a total of 56 (62.2%) cases, and grade 2 disabilities (G2D) were recorded in 25 (44.6%) patients. Ulnar nerve (UN) was most commonly affected nerve in 64.4% of cases, followed by lateral peroneal (LPN) and posterior tibial nerve (PTN). We observed the impact of Covid 19 infection peak C19P in two ways; firstly, during the C19P peak in 2020, there was a drastic fall in total registered cases (TRC) to 4/year against 22/year in pre-C19P with a relative increase in LRs and disabilities. In post-C19P peak periods, not only was there a marked rise in TRC (20/5 months), but LR (50%) and disabilities (75%) also showed a significant rise. A high proportion of MB cases, LRs and disability rates indicate the need for population-based studies and subsequent public health measures for early diagnosis and treatment. Further large sample-sized, in-depth studies can tell the exact impact of C19P on leprosy.

Dengue Serotype Prevalence and Laboratory Profile Correlation in a Tertiary Care Hospital in Gandhinagar

Background: Dengue fever and dengue haemorrhagic fever currently rank highly among the newly emerging infectious diseases and are the most important arboviral disease worldwide. Dengue virus can be distinguished by both serological and molecular methods. This study was aimed at analysing the prevalence and laboratory dynamics of the four dengue serotypes in tertiary care patients attending GMERS Medical College Gandhinagar. Material & methods: This study was an observational retrospective study. A total 105 samples were tested for Dengue serotyping by RT-PCR. Results: Among positive patients Dengue virus serotype-2 was the most common serotype 94 (89%) followed by DENV3 7(6%) and DENV4 2(2%). Co-infection with DENV 2/4 was 2(2%). A higher prevalence of dengue haemorrhagic fever was noted in serotype 2 compared to serotypes 3, 4, and coinfection. Thrombocytopenia was present in all serotypes of infection. There was a significant difference in the disturbance of liver function in DENV2, as compared to others serotype. Dengue serotype 2 was very common in rural areas, while dengue serotype 3 was seen in the urban Gandhinagar zone. Discussion: Dengue is the most extensively spread mosquito-borne disease. As per previous studies most common prevalent and severity of serotype wasDENV2, however in our study we were able to identify DENV3, DENV4 and confection with serotypes (DENV2 & DENV4).

Prevalence of Hepatitis B and Hepatitis C Infection among Patients Undergoing Dialysis

Background: Hepatitis B and C virus infection is a leading cause of mortality and morbidity among patients who are on haemodialysis. This study is conducted to investigate prevalence of Hepatitis C infection in patient who undergoes haemodialysis Material & methods: A retrospective study was carried out from September 2020 to September 2021 in General hospital Gandhinagar with the use of ELISA kit by detecting anti-HCV antibody and Hepatitis B surface antigen from serum sample. A total of 100 samples were collected from haemodialysis unit in General hospital Gandhinagar. Observation: Out of 100 patients, 9% were positive for hepatitis B and 14% were positive for hepatitis C. Among these two cases were coinfected with hepatitis B as well as C. Conclusion: The risk of hepatitis infection is more associated with patients with chronic renal failure due to high frequency of transfusion of blood and blood products and extracorporeal circulation during haemodialysis. For prevention of spread of hepatitis infection among patients with haemodialysis, dialysis unit must use proper universal precautions, has to properly maintain the machines of dialysis, and also has to follow proper disposal of material used in the unit.

MBL PRODUCING P.PENNERI - A MAJOR THREAT TO THE HOSPITAL

Introduction: Proteus spp. has been the signi?cant cause of wound infections as they commonly colonize the wound. Simultaneously multiple drug resistance mechanisms also pose a therapeutic challenge. P.penneri is commonly misidenti?ed as P.mirabilis which is multidrug resistant. The current study was Aim and objectives: conducted to determine the prevalence of MBLs in P.penneri among wound infections at a tertiary care hospital from Western Maharashtra. Specimens collected from wounds of OPD and IPD patients were examined by standard Material and Methods: bacteriological methods. All Proteus isolates were subjected to Antimicrobial susceptibility and MBL production test as per CLSI guidelines. Total 1826 wound samples were screened over the period of May 2017 to July 2018. Overall Results: prevalence of Proteus spp. was 7.12%, P.mirabilis being the commonest. Among all isolates 53.68% and 37.04% of P.mirabilis and P.vulgaris were ESBL producers, respectively. The rate for MBL production was 11.58% and 0% for P.mirabilis and P.vulgaris, respectively. On the contrary 75% of P.penneri isolates were ESBL producers and 12.5% were MBL producers. Discussion and conclusion: Emergence of ESBL and MBL producers is of special concern as Proteus spp. is intrinsically resistant to tigecycline and colistin. Identi?cation of P.penneri from clinical specimens is necessary, due to its multidrug resistance which makes clinical treatment extremely dif?cult. This will limit its control and eradication especially from wound infections as they are common colonizers. Therefore isolation of such beta lactamases producing P.penneri shall be considered as an alarming sign to control the spread of this superbug.

Comparison of Lumbar Transforaminal Epidural Dexamethasone and Triamcinolone for Lumbar Radiculopathy

Epidural blockade is becoming one of the most useful and versatile procedures in modern anaesthesiology. What is unique is its application to clinical practice, as it can be placed virtually at any spinal level of vertebral column that allows considerable flexibility. Epidural steroid injections through lumbar transforaminal route to treat pain in lower back where radiculopathy is also associated with, are used widely. It has been reported that these procedures in lumber spine are effective clinically for improved physical function in patients as well as relief of pain of short- and long-term duration. We wanted to determine as to whether there is a difference in the efficacy between nonparticulate (e.g. dexamethasone phosphate) and particulate (e.g. triamcinolone acetate) steroids in Lumbar Epidural via transforaminal approach for acute radicular pain in lumber region and adverse effects of the drugs if any. METHODS66 patients, 33 in each group, with dexamethasone phosphate 8 mg or triamcinolone acetate 40 mg for lumbar transforaminal approach epidural steroid injection, were randomized. Observation was done through visual analog scale, short McGill pain questionnaire, revised Oswestry Disability Index before intervention and a month later. RESULTSA difference which was significant statistically in the visual analog score (2.85 ± 0.83 in group T, 5.76 ± 0.75 in group Dx), McGill Pain Questionnaire (3.73 ± 1.15 in group T, 6.55 ± 0.51 in group Dx) and Oswestry Disability Index (18.67 ± 7.13 in group T, 35.83 ± 5.10 in group Dx ) was found in both but was more in triamcinolone group. CONCLUSIONSEfficacy is more in particulate (triamcinolone) than non-particulate (dexamethasone) in epidural injection through lumbar transforaminal with no drug related complication, performed for radiculopathy in lumbar region.

Effectiveness of Transverse Abdominis Plane Block as a Method of Regional Anaesthesia in Unilateral Inguinal Hernia Repair

The Transverses Abdominis Plane (TAP) block is a relatively new regional technique which is often used for sensory blockade of the lower abdominal wall mainly for post-operative pain relief. It causes sensory blockade mainly because of injection of local anaesthetic between the internal oblique and the transverse abdominis muscle. TAP block was performed using a blind landmark technique in the lumbar petit triangle. Nowadays USG guided TAP block is being performed in many centers. TAP block is known to improve postoperative pain, reduce the opioid demand, and also reduce the time to rescue analgesia in patients undergoing lower abdominal surgeries. In our study, we have used TAP block as a main anaesthetic technique in patients posted for unilateral inguinal hernia repair under elective conditions. TAP Block in this study was given with 0.5 % bupivacaine. Duration of anaesthesia / analgesia, effectiveness of block, period of block, cardiac stability and haemodynamic stability were studied. METHODSA prospective observational study was conducted on 30 randomly selected individuals posted for elective inguinal hernia repair who belonged to American Society of Anaesthesiologists classification 1 and 2; age group between 20 and 70 years; satisfying all inclusion and exclusion criteria. All the patients received 0.5 % bupivacaine for TAP block, dose not more than 2.5 mg / Kg body weight. RESULTSWe have found that TAP block gives good anaesthesia for patients posted for inguinal hernia repair with good haemodynamic stability. With inj. Bupivacaine 0.5 % having an onset of anaesthesia at about 7.45 + / - 2.32 minutes (p value < 0.001). The block was complete and effectively elevated nociceptive stimuli. The block lasted till the end of surgery in all cases, with no complications. CONCLUSIONSTAP block other than being the main anaesthetic technique for lower abdominal surgery, also provides good post-operative analgesia with minimal post-operative analgesic requirement with less haemodynamic variations.

Comparative Evaluation of Baska Mask and LMA Supreme in Patients Undergoing Short Surgical Procedures Under General Anaesthesia.

Supraglottic airway devices (SAD) are used for airway management in patients undergoing general anaesthesia, averting the need of tracheal intubation. Laryngeal mask airway is easy to insert and can be inserted by paramedics also in case of emergency. Here we primarily compared the efficacy of Baska Mask and LMA supreme in terms of ease of insertion. The secondary outcome was assessment of oropharyngeal seal pressure and post op laryngopharyngeal complications. MethodsA sample size of 30 was calculated in each group. Patients were divided into 2 groups, Group B and Group S. After giving premedication, Anaesthesia was induced with propofol 3 mg/Kg and anaesthetic depth will be deepened with 2% sevoflurane in oxygen using bag mask ventilation. An appropriately sized prior lubricated Baska mask and LMA supreme was inserted in Group B and Group S, respectively and ease of insertion was assessed. ResultsThe BM was successfully inserted in 23 patients (76.6%) in the first attempt and LMA supreme was successfully inserted in 29 patients (96.6%) in the first attempt. The difference was found to be statistically significant (P= 0.028). BM created a significantly higher oropharyngeal seal pressure than the LMA supreme group (P < 0.001). No significant difference in postoperative laryngopharyngeal complications was observed. ConclusionsFrom the present study, it is concluded that LMA supreme is easier to insert than BM. The BM creates higher oropharyngeal seal pressure and thus provides a better airway seal than the LMA supreme. The incidence of postoperative laryngopharyngeal complications is similar in both the groups.

Attitudes of Indian Dental Professionals towards Information Technology - A Cross Sectional Study

There have been substantial advances in the field of information technology (IT) which has led to the development of computer networks which allow access to an enormous amount of data. In 1971, computer was first introduced in dentistry and since then it has positively impacted the dental students’ attitudes and perceptions towards information technology. METHODSA pretested, structured, multisection electronic survey (e-survey) form was used which was prepared using Google Forms. The questionnaire was distributed among a group of people by forwarding and posting of Google survey form link through WhatsApp groups, sending an invitation via e-mail, and distribution of printed questionnaires to health professionals to participate in the study. Data was automatically collected in Google Drive. Necessary statistical analysis was performed using the statistical software package SPSS (Chicago, IL, USA) version 22.0 for MS Windows & P < 0.05. RESULTSThe response rate was higher among females than males i.e. 57% and 43% for females and males respectively. Among participants, students were highest in number (35%) followed by academicians (30%), self-employed (26%) and lowest was associate health professionals (9%). When asked about making computer training a part of the undergraduate curriculum, a majority (84%) of respondents suggested ‘Yes’, few (12%) suggested ‘No’ and only ‘very few’ (4%) were uncertain. CONCLUSIONSResults of this study highlighted the fact that there was easy access to a computer and internet among dental health professionals in India. Many potential applications of information technology in dentistry depend on the familiarity of the health professional to computers and advancing technology.

Primary pelvic hydatid cyst: a rare case report

 Primary pelvic hydatid cyst disease is a zoonotic parasitic disease most frequently caused by Echinococcus granulosus or Echinococcus multilocularis. Primary pelvic hydatid cyst is a rare entity. A 39-year-old, para 3 living 3 presented to casualty with acute pain abdomen and a suprapubic mass. Patient gave history of acute lower abdominal pain since 4 days associated with vomiting. On examination, a palpable mass around 18 weeks size, firm to hard in consistency with ill-defined margins and restricted mobility and suprapubic tenderness. Lower limit could not be reached, extending from right iliac fossa to midline. Per vaginum findings suggestive of mass deviated to right side with fullness in right fornix. No cervical motion tenderness. The pre-operative tumor marker levels were as follows: CA125=12.44 U/mL (normal=0-35), CEA=0.09 ng/mL (normal=0-2.5). CA19.9=16.79 U/mL (normal=1.2-30). Erythrocyte sedimentation rate (ESR) was found to be 82 mm in the first hour. Transabdominal ultrasound suggestive of adnexal mass? ovarian with moderate ascites. Urinary bladder seen separately. Contrast enhanced computed topography (CECT) suggestive of complicated right para-ovarian /ovarian cystic mass like cystadenoma. Exploratory laparotomy was done and specimen (uterus, cervix, omental biopsy and peritoneal washings) was sent for Histopathological report. Histopathological examination of the haematoxylin and eosin-stained section revealed ruptured brood capsule releasing daughter cyst. Post-operative period was uneventful. Patient received full course of anti-helminthic treatment.

Efficacy of Topical Heparin in Prevention of Superficial Thrombophlebitis before Peripheral Venous Cannulation.

Thrombophlebitis can be very commonly associated with peripheral venous cannulation. Many a times, thrombophlebitis may go undiagnosed. With serious complications and uncertainty of the treatment, it is always better to prevent its development. Prophylactic topical heparin application can significantly reduce the incidence of thrombophlebitis and also the complications related like deep venous thrombosis and pulmonary embolism which increase the hospital stay. Thus, this study was conducted to evaluate the efficacy of topical heparin in prevention of development of superficial thrombophlebitis.METHODS150 patients in the age group of 20 - 60 years, were randomly allocated to group H (Heparin), group C (Control), with 75 patients in each group. Group C received placebo (normal saline) and group H received topical heparin QPS before the insertion of the cannula on the dorsum of the upper limb and were observed at an interval of 8 hours until 72 hours using Visual Infusion Phlebitis Scale.RESULTSAt the end of 72 hours, score of 0, I, II, and III was observed in 5.33%, 44.00%, 29.33% and 21.33% patients, respectively, in Group C; whereas score of 0, I, and II was observed in 60%, 25.33%, and 14.67% patients, respectively in Group H (P = 0.0001). In Group C, score up to III was observed, whereas maximum score was II in Group H and that too at 72 h in only 14.67% of patients which proves the efficacy of topical QPS of heparin [Table 2].CONCLUSIONSProphylactic topical application of QPS heparin was effective in preventing development of superficial thrombophlebitis.

Ectopic ovarian pregnancy following in vitro fertilization: case report

Ovarian pregnancy is a rare form of extrauterine ectopic pregnancy. Risk factors such as reproductive treatments and infertility have been identified in recent studies. In this article, we present a case of ovarian ectopic pregnancy occurring following in vitro fertilization treatment and a fresh embryo transfer. The diagnosis of ovarian pregnancy was made during transvaginal sonography performed due to suspected ectopic pregnancy. Ovarian ectopic pregnancy is a rare clinical phenomenon. Late diagnosis and lack of appropriate intervention may have catastrophic results. Several mechanisms and risk factors are proposed, and their acknowledgment may improve early diagnosis and prevention of complications.

Bakri postpartum balloon: an obstetrician’s armamentarium in managing post-partum haemorrhage

Background: Post-partum haemorrhage (PPH), an obstetric emergency that can complicate vaginal or cesarean deliveries and associated with serious complications. Guidelines for the management of PPH involve a stepwise escalation of pharmacological and eventual surgical approaches. In women who do not respond to uterotonics or medical treatment, a variety of procedures, such as arterial embolization, surgical ligation of the uterine arteries or obstetric hysterectomy, may be used. The Bakri balloon is an intrauterine device indicated to reduce or control PPH temporarily when conservative treatment is warranted. Here, we are presenting case series of primary atonic PPH and which were managed by Bakri Balloon Tamponade (BBT).Methods: This case series included five women with PPH managed by Bakri balloon as a conservative therapeutic option.Results: All five women were in age group between 23 years to 34 years. The causes of PPH were uterine atony, retained placenta and central placenta previa. The Bakri balloon was successful in controlling hemorrhage in all women (five of five) who did not respond to medical uterotonic treatment.Conclusions: Bakri balloon is a simple, easy to use and effective method for conservative management of acute PPH. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures.

Study of impact of transcendental meditation on reaction time and cardiovascular parameters in young healthy volunteers

Background: Transcendental meditation technique is purported to help treat high blood pressure, chronic pain, insomnia, and many other physical ailments. The present study was conducted to evaluate the impact of transcendental meditation on reaction time and cardiovascular parameters in young healthy volunteers.Methods: In this single centre, randomized, controlled study, 120 1st year M.B.B.S and OTPT students were recruited and put into two groups [control (60), experiment (60)]. Simple Auditory Reaction Time (ART) and Visual Reaction Time (VRT), along with Heart Rate (HR) and Blood Pressure (BP), of all subjects were recorded and compared. The experimental group participated in 16 weeks of TM programme and performed TM twice in a day, for 20 minutes, sitting comfortably with eyes closed and chanting OM. Control group were only made to sit with eyes closed during the same time. Keeping all the variables constant, all the parameters were measured again after 16 weeks.Results: There was significant reduction in all parameters (ART, VRT, HR, systolic BP and diastolic BP) in experimental group after 16 weeks of TM as compared to control group. ART was significantly shorter than VRT in both experimental and control groups and this difference was maintained after the intervention also.Conclusions: Transcendental meditation is an effective technique for reducing cardiovascular risk and can be prescribed to pre-hypertensive and hypertensive patients for stress reduction, along with medications for better results.

A study comparing non-gestational diabetes mellitus and gestational diabetes mellitus in antenatal patients in a tertiary care center

Background: Gestational diabetes mellitus is defined as any glucose intolerance with the onset or first recognition during pregnancy. Objectives of this study were to diagnose cases of GDM by screening with DIPSI criteria at less than 28 weeks. And observation and comparison of maternal and perinatal outcome in women diagnosed of GDM in less than 20 weeks and at 24-28 weeks.Methods: This was the prospective analytical study conducted in the department of obstetrics and gynecology for one year in Muzaffarnagar medical college and Hospital. After history taking, clinical and obstetrics examination 1503 antenatal patients of less than 28 weeks were enrolled underwent screening with DIPSI criteria. Out of which 80 patients with abnormal OGTT of gestational age less than 20 weeks and 69 patients with abnormal OGTT of gestational age 24 -28 weeks.Results: In early diagnosed GDM group alive and healthy babies were slightly lower as compared with late diagnosed GDM group.Conclusions: The diagnosis of GDM gives us an opportunity in identifying individuals who will be benefitted by early therapeutic intervention with diet, exercise, and normalizing the weight to delay or prevent the onset of the disease.

Prescribing pattern of antibiotics among postoperative patients admitted in gynaecology and obstetrics department of tertiary care hospital in Northern India

Background: The objective of the study was to study the prescribing pattern of the antibiotics in postoperative patients admitted in gynaecology and obstetrics.Methods: Current prospective observational study was conducted in the department of pharmacology, Government Medical College, Kathua in collaboration with department of gynaecology and obstetrics for a period of six months duration from 1st May 2019 to 31st October 2019. The case sheets of all post operated patients above eighteen years of age admitted were studied and analyzed.Results: Total of 1807 case sheets were analyzed and showed that 4245 antibiotics were prescribed with an average of 2.3 antibiotics prescribed. Oral cefuroxime (17.3%) was maximally prescribed in patients who delivered normal presentation with episiotomy and injection ceftriaxone along with tinidazole and gentamycin were prescribed (58.4%) where caesarean section was done. While injection ceftriaxone and sulbactum along with tinidazole and gentamycin (17.09%) was prescribed in patients who were operated for gynaecological diseases. Maximum (80%) of the antibiotics were prescribed under brand name.Conclusions: Cephalosporin’s are commonly prescribed antibiotic and in eighty percent brand names were prescribed. Results underscore that antibiotic in generic name should be encouraged.

Obstetrics outcome in pregnant women with cardiac disease in tertiary care center, Dehradun, India

Background: Incidence of heart disease in pregnancy is about 1%. Pregnant patient with cardiac disease can present with lot of challenges for the obstetrician, paediatrician and the cardiologist. With improvement in diagnostic, medical, surgical management, more patient with cardiac diseases especially congenital are able to reach reproductive age. Therefore, still a cardiac disease remains a significant cause of maternal death. Maternal and fetal prognosis both is affected by the care given and the skills used in the treatment of the individual patient. Hospital has resulted in majority of cardiac disease patient being managed in a tertiary care center and this provide an opportunity to report on clinical experiences of pregnancy with cardiac disease, their management and obstetrical outcomes.Methods: This was a retrospective study, with all the patients detailed demographic information, diagnosis, course in the hospital, management, maternal and fetal outcome was obtained from the medical records and files.Results: Incidence of cardiac disease was found to be 0.7%, 47% of pregnant women fell in age group of 26-30 years, 38.2% were primigravida, only 23.53% were booked, and half of them belonged to NYHA II class. 73.5% had Rheumatic heart disease and the most common obstetrics complications were preterm labor and anemia. LSCS was done in 29.4% cases and 38.2% of the newborns were premature.Conclusions: Prematurity anaemia, IUGR, are the common obstetrical complication in pregnant patient with cardiac disease which can be taken care with increased awareness and pre-conceptional counselling especially in patient with congenital heart disease. For optimization of maternal and neonatal outcomes in these patients, dedicated team of obstetrician, fetal medicine specialist, pediatricians, cardiologist and anesthesiologist is the prime requirement.

Anatomical And Embryological Study Of Renal Hilum

Introduction: As per standard text, the anteroposterior topographical arrangement of renal hilar structures are:vein-artery-renal pelvis. However, hilar variations are very common. Aim: The present study intends to increaseawareness of possible variations in the hilar anatomy as they are of immense importance in invasive renalinterventions.Materials and methods: A careful dissection of 51 embalmed cadaveric kidneys was carried out for the propervisualization of renal hilar structures and their relations were clearly defined.Observations and Results: Enormous renal hilar variation was observed. We classified these renal variations in8 different patterns. Normal hilar arrangement was seen in 25.5% kidneys and in 74.5% cases this arrangementis disturbed. 43.1% kidneys demonstrated presence of retropelvic structures. Anterior and posterior tributariesof renal vein were displayed in 9.8% of casesConclusion: Knowledge of the pattern of renal hilar structures is of great importance in the interventionalradiological & laparoscopic renal surgeries thereby reducing the risk of vascular complications.

Probiotics-A complete oral healthcare package / 中西医结合学报

Probiotics are living bacterial cells that have significant therapeutic potential for treating human infectious diseases. There is a huge market for probiotics in the pharmaceutical sector. They have been frequently used to treat the gastrointestinal diseases and improve gut immunity. In this review, the strains currently in use for manufacturing oral probiotic formulations are discussed. The review further recommends the use of probiotics for the control of various oral health disorders, like dental caries, periodontitis, gingivitis, halitosis, burning mouth syndrome, and oral cancer. Finally, this review also explores the use of various commercial probiotic products in maintaining oral health, their market values, and government acts and regulations that are relevant to the production and marketing of probiotics. Probiotics have tremendous therapeutic potential and more in-depth research must be done on these beneficial bacteria to make them one of the leading drugs in treating oral disorders.

Effect Of Ageing And Osteoarthritis Of Knee Over Temporospastial Parameters Of Gait: A Systemic Review

Background: Health care provision is facing significant burden due to osteoarthritis, which is the most common condition affecting synovial joints. Osteoarthritis of the knee causes substantial pain and disability, especially in the elderly. Purpose of the study: Our objective is to incorporate the effect of ageing and osteoarthritis of knee over temporo-spatial parameters of gait, based on a systematic review of the evidence from various articles. Method: Systemic literature search using PubMed, CINAHL, EBSCO and Willes library databases done. Articles following criteria of OA knee, gait analysis and ageing were selected. Result: Among the 272 articles identified by the literature search, 59 articles reporting one of filter criteria were selected. Three additional articles were found by manual search. After reviewing the full-texts, another 29 reports were excluded because preselected 3D kinematic data were not available. Thus, the final analysis included 30 full-length reports (19 knee OA studies, 11 OA studies including ageing individuals) studying 781 knee OA patients (weighted mean age = 64.4 years, 59% females, weighted mean BMI = 29.0 kg/m2) and 343 ageing OA patients (weighted mean age = 78.1 years, 68% females, weighted mean BMI = 27.3 kg/m2) Conclusion: Gait analysis as a noninvasive aid to clinical assessment could become an important clinical method of functional assessment in knee OA as well as arthritic changes taking place due to age. However, on the basis of the present systematic literature search, the available data concerning validity and reliability are clearly insufficient to consider kinematic parameters as quantifiable outcome measures in OA. Summary and implications: Our study finding suggests presence of altered gait parameters because of osteoarthritis of knee as well as ageing, which was supported by result of having higher grading of affection in relatively younger individual have shown less affection because of high functionality level, while in compare to that older individuals less arthritic changes have also shown more impairment in functionality because of low occupational needs.