Women’s Literacy a Major Predictor of Population Size: Findings from National Family Health Survey-5

Background: The global population continues to rise at different rates in different parts of the world. While some countries are seeing a fast population increase, others are experiencing population loss. Significant ramifications of such changes in the global population distribution would be felt, as they are critical for meeting the Sustainable Development Goals (SDGs), or we might say that rapid population expansion poses obstacles to sustainable development. Estimating the population size and composition by age, sex, and other demographic parameters is crucial for analyzing the country’s future influence on poverty, sustainability, and development. This study tries to look at these parameters covered by the National Family Health Survey- 5 (NFHS 5) to see how accurate and trustworthy the predictors of district population size are. Methodology: The study assessed the predictors of the population size of any district. It was conducted using the secondary data of phase 1 of NFHS-5. The outcome variable is the population of each district. Household profiles, literacy among women, their marriage and fertility, contraceptive usage, and unmet need for family planning were considered to assess their potential as a predictor of the district’s population size. Principal component analysis (PCA) was conducted to identify the predictors. Result: PCA was conducted on 18 variables, resulting in 7 principal components. Cumulatively, these components explained 77.6% of the total variation in data. On multiple linear regression, four principal components were found significant and these were related to women’s literacy, contraceptive usage, early pregnancy, the marriage of fewer than 18 years, and those using health insurance. Conclusion: Thus, women’s literacy plays a pivotal role in determining a region’s population size.

Comparative evaluation of outcomes of novel approach of subconjunctival Mitomycin C (MMC) injection at the end of trabeculectomy versus intraTenon injection of MMC prior to the initial conjunctival incision – A pilot study

Purpose: To describe a novel approach of subconjunctival injection of mitomycin C (MMC) at the end of trabeculectomy and compare it with intraTenon MMC injection. Methods: This pilot study included 40 eyes of 40 patients with uncontrolled primary and secondary glaucoma. Patients below18 years and failed trabeculectomy were excluded. Patients were randomly allocated into groups A and B (20 patients each). Group A patients received subconjunctival MMC injection in the superonasal quadrant at the end of standard trabeculectomy. Group B received an intraTenon MMC injection before the initial conjunctival incision. Outcome measures included intra?ocular pressure (IOP) reduction, bleb morphology, and complication rates. The complete success was defined as an IOP of ?21 mmHg without antiglaucoma drugs. Results: The mean preoperative IOP of 46.00 ± 11.2 mmHg in group A and 43.05 ± 10.3 mmHg in group B reduced to 12.00 ± 2.41 mmHg (P ? 0.001) in group A and 13.65 ± 2.76 mmHg in group B (P ? 0.001) at last follow?up. Complete success was 95% and 75% in groups A and B, respectively, 19 months after surgery. Avascular microcystic blebs (70% of group A and 45% of group B) were more common than avascular white blebs (15% in group A and 35% in group B). No intraoperative complications were seen. Postoperative wound leak, hypotony, choroidal detachment, or endophthalmitis were not encountered in any group. Conclusion: A novel approach of subconjunctival MMC application during trabeculectomy is reported. Both approaches appear to be highly effective in reducing IOP in primary and secondary glaucoma with similar safety profiles and bleb morphology. Subconjunctival MMC yielded a greater success rate (95%) compared to the intraTenon MMC group (75%)

Isolation and therapeutic efficacy of enteropathogenic E. coli phage cocktail against colibacillosis in neonatal goats

Phage based therapeutics have shown promising results against the infections caused by the drug resistant bacteria. To combat the problem of antibiotic resistance posed by diarrhoeagenic E. coli, here, we identified and characterized 38 E. coli phages which were isolated from 70 solid sources (goat-faeces and soil). The in vitro lytic range of phage isolates (n=38) against 439 isolates of E. coli was found between 16 and 53%. Three phage isolates with highest host range showed lytic efficacy against 53, 48 and 46% of E. coli isolates, respectively. A preparation with above three phages was developed, and the phages of the preparation were found stable at wide range of temperature, pH and chloroform treatment. Endotoxin content of the preparation was found below the threshold level and it also passed safety and sterility tests. a total of 40 diarrheic goat kids were administered orally with the therapeutic phage preparation for two days twice daily. Total 21 diarrheic goat-kids were successfully treated using the therapeutic phage preparation, whereas 19 kids could not be treated (success rate: 52.5%; 21/40). The results of the current study provide insight for using lytic bacteriophages for therapeutic interventions against drug resistant E. coli responsible for colibacillosis in neonatal goat kids

Demographic and Clinical Profile of Patients Presenting with COVID-19-Associated Rhino-orbito-cerebral Mucormycosis at a Tertiary Care Center

Objectives?Individuals affected with rhino-orbito-cerebral mucormycosis (ROCM) associated with coronavirus disease 2019 (COVID-19) increased enormously in northern India during the second wave of the novel coronavirus disease. This study determined the demographic and clinical profile including the risk factors in patients presenting to a tertiary care hospital in northern India. Materials and Methods?This is a descriptive study involving patients admitted with COVID-19-associated ROCM and were managed from May 2021 to 20th July 2021. Statistical Analysis?The data was analyzed using SPSS (IBM SPSS Statistics 20, SPSS Inc., Chicago, Illinois, United States) software and Microsoft Excel (Version 16.49). The chi-squared and Fisher's exact tests were used to compare various outcomes. A p-value of less than or equal to 0.05 was considered to be statistically significant. Results?One hundred and seventeen (117) patients (males: 70 [59.8%], females:47 [40.2%]) with the average age of 51.85?±?12.80 years presented with orbital involvement. Diabetes mellitus was noted in 100 (86.2%) patients. Of the available data from the records, oxygen supplementation for the management of COVID-19 was received by 37/108 (34.3%) patients for a median average duration of 11 days. Forty-eight patients of one-hundred-seventeen (60%) patients were treated with corticosteroids with a median duration of steroid administration being 10 days. The duration between onset of symptoms related to mucormycosis and diagnosis of COVID-19 was 0 to 75 days for 48 patients. Intravenous amphotericin B was administered in all cases. External sinonasal debridement was performed in 90 of 114 (78.9%) patients, retrobulbar amphotericin B injection was administered in 56 of 117 (47.9%), and orbital exenteration was performed in 17 of 117 (14.5%) of cases. Conclusion?Administration of corticosteroids and diabetes mellitus seem to be the major underlying causes for the development of COVID-19-associated ROCM. Prompt diagnosis and multidisciplinary management approach are essential for a reduction in mortality.

Lung ultrasonography as a tool to guide perioperative atelectasis treatment bundle in head and neck cancer patients undergoing free flap reconstructive surgeries: a preliminary observational study / Ultrassonografia pulmonar como ferramenta para orientar o tratamento perioperatório de atelectasia em pacientes com câncer de cabeça e pescoço submetidos a cirurgia reconstrutiva com retalho livre: um estudo observacional preliminar

Abstract Introduction: General anesthesia causes pulmonary atelectasis within few minutes of induction. This can have significant impact on postoperative outcome of cancer patients undergoing prolonged reconstructive surgeries. Objective: The purpose of this study was to evaluate the impact of sonographically detected perioperative atelectasis on the need for postoperative oxygen supplementation, bronchodilator therapy and assisted chest physiotherapy in patients undergoing free flap surgeries for head and neck carcinoma. Methods: Twenty eight head and neck cancer patients underwent bilateral pulmonary ultrasonographic assessments before and after lung surgery. Lung ultrasound scores, serum lactate, and PaO2/FiO2 ratio were measured both at the beginning and at end of the surgery. Patients were scanned in the supine position and the number of single and confluent B lines was noted. These values were correlated with the need for oxygen therapy, requirement of bronchodilators and total weaning time to predict the postoperative outcome. Other factors affecting weaning were also studied. Results: Among twenty eight patients, seven had mean lung ultrasound score of ≥10.5 which correlated with prolonged weaning time (144.56±33.5min vs. 66.7±15.7min; p = 0.005). The change in lung ultrasound score significantly correlated with change in PaO2/FiO2 ratio (r = −0.56, p = 0.03). Elevated total leukocyte count >8200 ΜL and serum lactate >2.1 mmoL/L also predicted prolonged postoperative mechanical ventilation. Conclusion: This preliminary study detected significant levels of perioperative atelectasis using point of care lung ultrasonography in head and neck cancer patients undergoing long duration surgical reconstructions. Higher lung ultrasound scores highlighted the need for frequent bronchodilator nebulizations as well as assisted chest physiotherapy and were associated with delayed weaning. We propose more frequent point of care lung ultrasonographic evaluations and use of recruitment maneuvers to reduce the impact of perioperative pulmonary atelectasis.

Resumo Introdução: A anestesia geral causa atelectasia pulmonar poucos minutos após sua indução. Isso pode ter um impacto significativo no resultado pós-operatório de pacientes com câncer submetidos a cirurgias reconstrutivas prolongadas. Objetivo: Avaliar o impacto das atelectasias perioperatórias detectadas por ultrassonografia na necessidade de suplementação pós-operatória de oxigênio, terapia broncodilatadora e fisioterapia respiratória assistida em pacientes com carcinoma de cabeça e pescoço submetidos a cirurgias com uso de retalho livre. Método: Foram submetidos a avaliações ultrassonográficas pulmonares bilaterais antes e após a cirurgia 28 pacientes com câncer de cabeça e pescoço. Os escores de ultrassonografia pulmonar, lactato sérico, razão PaO2/FiO2 foram medidos no início e no fim da cirurgia. Os pacientes foram avaliados na posição supina e o número de linhas B confluentes e únicas foi observado. Esses valores foram correlacionados com a necessidade de oxigenoterapia, necessidade de broncodilatadores e tempo total de desmame para predizer o resultado pós-operatório. Outros fatores que afetam o desmame também foram estudados. Resultados: Entre os 28 pacientes, sete apresentaram escore médio de ultrassonografia pulmonar ≥ 10,5, que se correlacionou com o tempo de desmame prolongado (144,56 ± 33,5 minutos vs. 66,7 ± 15,7 minutos; p = 0,005). A mudança no escore de ultrassonografia pulmonar correlacionou-se significantemente com a mudança na razão PaO2/FiO2 (r = −0,56, p = 0,03). A contagem total elevada de leucócitos > 8200 uLe o nível de lactato sérico >2,1 mmoL/L também previram ventilação mecânica pós-operatória prolongada. Conclusão: Este estudo preliminar detectou um nível significante de atelectasia perioperatória com ultrassonografia pulmonar no local de atendimento em pacientes com câncer de cabeça e pescoço submetidos a reconstruções cirúrgicas de longa duração. Escores mais altos de ultrassonografia pulmonar enfatizaram a necessidade de nebulizações broncodilatadoras frequentes e fisioterapia respiratória assistida e foram associados a desmame tardio. Propomos avaliações ultrassonográficas pulmonares mais frequentes no local de atendimento e o uso de manobras de recrutamento para reduzir o impacto das atelectasias pulmonares perioperatórias.

Estimation of bioactive potential of culturable bacterial endophytes from Coleus

Endophytic microflora is source of several bioactive compounds. Endophytes isolated from Coleus species are yet to be fully explored for their bioactive potential. In this study, bacterial endophytes were isolated from three different species of Coleus. Isolated endophytes were characterized by using Gram staining and by sequencing 16S rRNA region. Further, solvents with different polarities were used to prepare extracts which were used for assessment of different bio-activities including in vitro cytotoxicity, anti-microbial and anti-oxidant activities. Also, the pure endophytic bacterial cultures were evaluated for their antiphytopathogen potential as well as indole-3-acetic acid (IAA) and protease production. Advanced studies on the endophytes with promising activities may lead to the isolation of novel natural products for drugs as well as in industrial and agricultural applications.

A Phantom-based Investigation Into the Influence of Low Tube Potential and Matrix Size on Radiation Dose and Image Quality for a 128 Slice Abdominopelvic Ct Protocol

@#Introduction: Reducing radiation dose for CT examinations has been accompanied by an increase in image noise. Studies have highlighted the application of a higher matrix size for improving image quality when assessing the lungs. This study aims to evaluate the influence of a low kVp and higher matrix size on radiation dose and image quality for abdominopelvic CT. Methods: This experiment was done on a 32 cm body phantom and scanned using a 128 slice CT scanner. The study utilised various combinations of kVp settings (140, 120, 100, 80 & 70) and matrix sizes (1024, 768 & 512). The image obtained was analysed objectively and subjectively. For objective analysis, we calculated SNR, and CNR. For subjective analysis, two radiologists evaluated the image in a 3-point scoring scale. Results: The study reported an increase in SNR (0.8%) and CNR (46%) at 120 kVp when increasing the matrix size from 512 x 512 to 768 x 768. Similarly, there was an increase of 14.5 % and 56.4 % in CNR and SNR using 1024 matrix size. The DLP was reduced by 4.5%, 50% and 70.6 % using 100, 80 and 70 kVp respectively. However, there was no change in DLP with higher matrix sizes. Conclusion: The study reported a combination of 100 kVp and 768 matrix size resulted in an almost similar (↓0.9 %) SNR and improved CNR (↑46.4 %) compared to 120 kVp and 512 matrix size. Qualitative analysis also showed a similar image quality with decreased radiation dose for abdominopelvic CT.

The future of precision medicine in opioid use disorder: inclusion of patient-important outcomes in clinical trials

Opioid use has reached an epidemic proportion in Canada and the United States that is mostly attributed to excess availability of prescribed opioids for pain. This excess in opioid use led to an increase in the prevalence of opioid use disorder (OUD) requiring treatment. The most common treatment recommendations include medication-assisted treatment (MAT) combined with psychosocial interventions. Clinical trials investigating the effectiveness of MAT, however, have a limited focus on effectiveness measures that overlook patient-important outcomes. Despite MAT, patients with OUD continue to suffer negative consequences of opioid use. Patient goals and personalized medicine are overlooked in clinical trials and guidelines, thus missing an opportunity to improve prognosis of OUD by considering precision medicine in addiction trials. In this mixed-methods study, patients with OUD receiving MAT (n=2,031, mean age 39.1 years [SD 10.7], 44% female) were interviewed to identify patient goals for MAT. The most frequently reported patient-important outcomes were to stop treatment (39%) and to avoid all drugs (25%). These results are inconsistent with treatment recommendations and trial outcome measures. We discuss theses inconsistencies and make recommendations to incorporate these outcomes to achieve patient-centered and personalized treatment strategies.

Disc battery in the pediatric oesophagus

The wide usage of disc batteries in toys, in the late seventies presented a new problem. In the form of accidental lodgements in the pediatric aerodigestive tract. The physico-chemical nature of the disc battery necessitates an early removal, so as to avoid a fatal outcome if missed and retained for a long duration. Management of one such case is reported with radiographic documentation.

Breus’ mole/chorangiosis/chorangioma of the placenta: a dilemma with a rare fetal outcome report

Massive Subchorionic Thrombohematoma (MST) is a rare condition in which there is a massive collection of blood between the placental membranes and uterine wall separating the villous chorionic plate from villous chorion. It is relatively rare and is poorly understood. Many theories have been proposed to explain the etiology of Breus mole; some suggest it is a fetal haemorrhage, while others claim it has a maternal-origin thrombosis of placental vessels. A 30-year-old healthy Indian pregnant woman was presented at Max Hospital, Shalimar Bagh Delhi, India, during her second pregnancy with a complaint of fever. On routine level-2 ultrasonography (USG) done at 18.6 weeks of gestation showed thick placenta. No fetal tumours or any other anomalies were noted on that scan which was followed by a detailed scan which confirmed a solitary mass arising from fetal side 103x64x82 mm S/O chorioangioma. Serial growth and doppler USG were conducted to monitor placental function, tumor characteristics and future anatomy. The subject received steroids to enhance fetal lungs maturation at Week 30, iron/calcium supplements, Ecosprin tablets, and progesterone support. At 32.5 weeks, the subject developed deranged sugars followed by gestational hypertension at 34.1 weeks. Ultrasonography also showed fetal growth restriction with large chorioangioma. The subject underwent a successful elective caesarean section at 34.4 weeks. On placental examination, 10 cm large mass encasing ¾ of the placenta was identified as a large subchorionic hematoma/chorioangioma (800 g). This study concludes that early identification of a large chorangioma aids in consequent fetal surveillance, management of maternal symptoms, and delivery planning discussions even if the pathological diagnosis turns out to be Breus’ mole with underlying chorangiosis postnatally.

A Curious Case of Diffuse Systemic Sclerosis with Discoid Lupus Erythematosus-Like Lesions: Enigma of an Overlap

@#Overlap syndrome is a term used to describe a condition wherein a patient has features of more than one classic inflammatory rheumatic disease like systemic lupus erythematosus, polymyositis, scleroderma and rheumatoid arthritis. Individuals with an overlap syndrome may, but need not meet, complete diagnostic criteria for one or more than one classic rheumatic disease. Mixed connective tissue disease is a specific subset of overlap syndrome wherein patients have antibodies to the U1 small nuclear ribonuclear protein (anti- U1RNP) and clinical features like hand edema, synovitis, Raynaud phenomenon, acrosclerosis and biologically or histologically proven myositis. We came across an interesting case showing clinical features of both Systemic Sclerosis and Discoid Lupus erythematosus (DLE). On complete evaluation, a final diagnosis of Diffuse Systemic Sclerosis - DLE overlap was made on the basis of histopathopathological and serological findings. Patient was started accordingly on systemic and topical medications and responded well.

Isolation, identification and bioactive potential of bacterial endophytes from Coleus

Coleus (Lamiaceae) is a large and widespread genus comprising of species with diverse ethnobotanical uses. In the present study, bacterial endophytes were isolated from Coleus forskohlii and Coleus aromaticus. Endophytes are the microorganisms which reside within the plants without showing any harmful effect on its host. Diverse types of endophytes live symbiotically within almost all plants and in turn help the plant in a number of ways such as imparting resistance against biotic and abiotic stresses, producing compounds involved in attraction of pollinators, inducing the plant defense mechanisms, etc. The bacterial endophytes isolated in this study, were characterized by microscopic examination (using gram staining) and molecularly identified by sequencing the 16S rRNA. Extracts were prepared from endophytic biomass using solvents of different polarities (methanol, ethyl acetate and butanol) and were screened for their bioactive potential (in vitro cytotoxicity anti-microbial, and anti-oxidant activity). Scale-up of endophytes showing promising results is under process, which will help in isolation of pure compounds.

Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study / Efetividade do plasma rico em plaquetas no tratamento da dor em osteoartrite de joelho: estudo comparativo randômico e duplo-cego

Abstract Background: Intra-articular injections of platelet-rich plasma to treat symptoms of knee osteoarthritis have been successfully used in young patients. However in most of these studies the control and test knees were present in different patients thus incorporating a large amount of bias in the results. Therefore, the present study was designed in which patients with bilateral osteoarthritis knee were included and platelet-rich plasma was administered in one knee and normal saline in another knee of same patient. Methods: 20 patients aged 30-65 years with bilateral osteoarthritis knees (ASA class I and II) of either gender were included in the study. Patients were randomized to receive platelet-rich plasma and normal saline in one of the two knees. The primary outcome was VAS and WOMAC score at 6 months after procedure. The secondary outcome included changes in joint stiffness, physical function, any adverse effects noted during the course of study. Results: The baseline VAS score in platelet-rich plasma knee was 8.4 ± 0.88 which improved significantly to 4.85 ± 2.48 (p < 0.001) at 6 months as compared to normal saline knee (p = 0.017). The WOMAC pain score also improved from baseline (14.5 ± 1.3) to over 6 month 7.00 ± 4.24 (p < 0.001) in platelet-rich plasma knee while in the normal saline knee, no significant change occurred from baseline to six months (10.2 ± 1.2 to 10.05 ± 1.23). There was also significant decrease in stiffness and improvement of physical activity in the platelet-rich plasma knee as compared to normal saline knee. Conclusion: The present study showed significant decrease in pain and stiffness and improvement of physical functions of knee joint with intra-articular platelet-rich plasma injection as compared to normal saline.

Resumo Justificativa e objetivos: Injeções intra-articulares de plasma rico em plaquetas têm sido usadas com sucesso para tratar os sintomas da osteoartrite de joelho em pacientes jovens. Porém, na maioria desses estudos, os joelhos de controle e teste estavam presentes em diferentes pacientes, o que incorporou uma grande quantidade de viés aos resultados. Portanto, o projeto do presente estudo incluiu pacientes com osteoartrite em ambos os joelhos, com a administração de plasma rico em plaquetas em um dos joelhos e de solução salina normal no outro joelho do mesmo paciente. Métodos: 20 pacientes, de ambos os sexos, com idades entre 30-65 anos e portadores de osteoartrite bilateral de joelho (classificação ASA I e II) foram incluídos no estudo. Os pacientes foram randomizados para receber plasma rico em plaquetas e solução salina normal em um dos dois joelhos. O desfecho primário foram os escores VAS e WOMAC seis meses após o procedimento. O desfecho secundário incluiu alterações na rigidez articular, função física e qualquere feito adverso observado durante o curso do estudo. Resultados: O escore VAS basal para o joelho que recebeu plasma rico em plaquetas foi 8,4 ± 0,88 e melhorou significativamente para 4,85 ± 2,48 (p < 0,001) após seis meses, comparado ao joelho que recebeu solução salina normal (p = 0,017). A intensidade da dor avaliada com o WOMAC também melhorou de 14,5 ± 1,3 na fase basal para 7,00 ± 4,24 após seis meses (p < 0,001) nos joelhos que receberam plasma rico em plaquetas, enquanto nenhuma mudança significativa ocorreu nos joelhos que receberam solução salina normal entre a fase basal e após seis meses (10,2 ± 1,2 a 10,05 ± 1,23). Além disso, houve uma diminuição significativa da rigidez e melhora da atividade física nos joelhos que receberam plasma rico em plaquetas, comparados aos joelhos que receberam salina normal. Conclusão: O presente estudo identificou uma diminuição significativa da dor e da rigidez e uma melhora das funções físicas da articulação do joelho com a injeção intra-articular de plasma rico em plaquetas, comparada à solução salina normal.

Clinical Practice of Palliative Care: Current Concepts and Future Perspectives

Pain is a distressing symptom having biological, psychological, and social consequences. A large number of cancer patients are in advanced stages of the disease and for these patients the only positive and realistic option is pain management and palliative care. These patients have complex needs that have to be taken care of in order to improve the quality of life of such patients and their family members. Surgical treatment along with chemotherapy and radiotherapy is the mainstay for the treatment of cancer, but these modalities also have limitations. The main aim behind palliative care is to allay the sufferings of a terminally ill patient by responding to pain using multimodal analgesia including opioids. According to WHO step ladder, other symptoms like breathlessness, fatigue, delirium etc., are also needed to be managed adequately along with psychosocial and spiritual support. Along with it patients and his family members should be well explained that palliative care is a multidimensional approach directed to the best possible care for that stage of their illness, which may not be curative in nature. There are multiple obstacles in the growth of palliative care in India. Nonetheless we have overcome many such hurdles and there has been a noticeable change regarding palliative care in the mindset of health care providers in the last 2 decades.

Effect of orthodontic forces on levels of enzymes in gingival crevicular fluid (GCF): A systematic review

Abstract Objective: Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement. Methods: Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search. Results: Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude. Conclusions: A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.

Resumo Objetivo: a aplicação da força ortodôntica libera múltiplas enzimas no fluído crevicular gengival (FCG), desencadeando a ativação, reabsorção, reversão, deposição de elementos ósseos e degradação da matriz extracelular. A presente revisão sistemática avaliou criticamente toda a evidência disponível sobre os níveis de enzimas durante a movimentação ortodôntica. Métodos: utilizando-se estratégias predeterminadas, foram realizadas buscas em bases de dados eletrônicas (PubMed, Scopus, Embase), sendo também feitas buscas manuais. Resultados: a busca inicial identificou 652 estudos e, com base nas diretrizes do PRISMA, foram selecionados 52 estudos. A avaliação qualitativa resultou na inclusão final de 48 estudos (13 estudos com moderada sensibilidade e 35 com alto nível de sensibilidade). Os desfechos primários foram o aumento significativo dos níveis no FCG das enzimas aspartato aminotransferase (AST), fosfatase alcalina (FA), metaloproteinases de matriz (MMPs), lactato desidrogenase (LDH), β-glucuronidase (βG), fosfatase ácido-resistente ao tartarato (TRAP), fosfatase ácida (FAC) e baixa regulação de catepsina B (Cb). Especificidade quanto ao local foi mostrada para FA, TRAP, AST, LDH e MMP9 com os níveis no lado de compressão aumentando mais rápido e em maiores quantidades, quando comparado ao lado de tensão. Os níveis de FA foram maiores no lado de tensão somente no período de contenção. Uma correlação positiva de LDH, FA e AST também foi observada à medida que a magnitude de força ortodôntica aumentou. Conclusões: há fortes evidências indicando que as variações nas enzimas (FA, AST, FAC, TRAP, LDH, MMPs, Cb) presentes no FCG estão associadas a diferentes magnitudes, estágios e locais de aplicação da força ortodôntica.

Chronic cholecystitis with follicular lymphoid hyperplasia: nomenclature and diagnostic dilemmas

Background: To revisit the nomenclature, prevalence, histogenesis and the diagnostic dilemmas in cases of cholecystitis with lymphoid hyperplasia received in a private laboratory in one-year duration.Methods: A total of 51 cases of cholecystectomy were examined histopathologically to identify and review all the cases with emphasis on cholecystitis with marked lymphoid infiltration.Results: Out of 51 cholecystectomy specimens, some rare entities were observed such as 4 cases (8%) of xanthomatous change, 2 cases (4%) of cholecystitis with follicular lymphoid hyperplasia and a case of hyalinizing cholecystitis.Conclusions: The literature on cholecystitis with marked lymphoid infiltrate (with or without follicle formation) was overlapping and thus confusing. The same has been simplified with review of literature.

A Comparative Analysis of Different Phenotypic Methods Used in \r\nDetection of Methicillin Resistant Staphylococcus Aureus\r\n

Introduction: In developing country like Bangladesh rheumaticfever is common diseases occur in children.Objective: In this study our main goal is to evaluate theincidence in rheumatic fever in age 5-15 age groupBangladesh.Method: This cross sectional study was done at differentprivate hospital in Khulna district from January 2016 to January2017 .where 100 patients data were recorded methodically in apreformed data sheet.Results: In the study 71% patients’ mother was illiterate andmost of them were house wife. Also, most of the patients facedserious heart damage.Conclusion: We can conclude that, overcrowding and lowattainment of education by mothers is responsible for incidenceof RF in children. Further study in needed for better outcome.

Organization and workflow management of central sterile supply department of a tertiary care hospital of Haryana

Background: Nosocomial infection cause significant health issues and economic loss to the patients as well as the health care facilities. To combat hospital acquired infections, hospitals need an effective method of disinfection and sterilization which can be taken care by the central sterile supply department (CSSD). The objective of establishing a CSSD is to make reliably sterilized articles available at the required time and place. Aim and objectives were to study the organization and workflow management of CSSD of a tertiary care institution.Methods: This observational study was carried out from February 2018 to April 2018. An observation checklist was used for the purpose of study after obtaining permission from appropriate authorities.Results: CSSD of the institution is centrally located within the hospital premises and has 11 staff members. Linen, cotton, dressings, instruments and trays are sterilized in the CSSD. Sterilization is done by steam sterilization and gas sterilization with a total of seven autoclaves and two ETO machines. Physical, chemical and biological indicators are regularly used during the process of sterilization.Conclusions: CSSD of the institution is contributing its part towards reduction of nosocomial infections. Quality of standards for sterilization and disinfection is maintained.

Molecular Characterization of Diarrhoegenic Escherichia coli Isolated from Neonatal Goat-Kids

Faecal samples (n=300) from diarrhoeic neonatal goat-kids of different livestock sheds of ICAR-CIRG, Makhdoom, and field goat-kids of Mathura, UP were aseptically collected, and used for E. coli isolation. On the basis of cultural, morphological, biochemical and molecular characteristics, a total of 193 E. coli isolates were identified from 300 fecal samples. Out of 140 E. coli isolates, only 90 isolates could be serotyped at National Salmonella and Escherichia Centre, Central Research Institute, Kasauli, and the most common serogroups responsible for neonatal diarrhoea were found as O88 (n=11), O22 (n=10), O11 (n=8) and O83 (n=7). Congo red dye agar test was done to determine invasiveness of the isolates, and 77.20% (149/193)E. coli isolates showed Congo red binding activity. Identification of shiga toxin producing E. coli (STEC) was done by PCR amplification of its stx-1 gene, and 5.69% (11/193) isolates were identified as STEC. Pathotype specific primers were used to amplify bundle forming pilus (bfpA) gene of enteropathogenic E. coli (EPEC), and 35.23% (68/193) isolates were identified as EPEC. A multiplex PCR was performed to detect labile toxin producing enterotoxigenic E. coli (ETEC-lt), stable toxin producing enterotoxigenic E. coli (ETEC-st) and enteroinvasive E. coli (EIEC), and 24.35% (47/193), 2.59% (5/193) and 2.07% (4/193) isolates were determined as ETEC-st, ETEC-lt and EIEC, respectively. EPEC and ETEC-st were found as the most prevalent pathotypes associated with neonatal diarrhoea in goat-kids whereas; O88 and O22 were observed as the most common serogroups in causing diarrhoea in the neonatal goat-kids.

​Assessment For Performance Of Middlebrook 7h9 With Oleic-Albumin-Dextrose-Catalase Culture Media For Isolation Of Mycobacterium Tuberculosis In Ziehl–Neelsen Smear-Positive Sputum Samples In Clinically Suspected Cases Of Tuberculosis

Introduction: Pulmonary tuberculosis (TB) is a second foremost cause of death from a communicable disease, after the HIV.Being communicable should be diagnosed at the earliest. Smear examination is preliminary step for the confirm diagnosis, butculture is still a gold standard method.Materials and Methods: The present study was carried out in the Department of Microbiology on a total of 600 smear sputumsamples from clinically suspected cases of pulmonary TB attending the outpatient and inpatient departments of MMIMSR,Mullana, Ambala, from December 2016 to June 2018. Specimens were subjected to ZN and LED staining before and afterdecontamination. After microscopy, specimens were subjected to culture on LJ and Middlebrook 7H9.Results: Mycobacterium tuberculosis was isolated in 23.33% of samples. 110 (78.57%) were detected by microscopy (ZN andLED), respectively. ZN smear positivity before and after decontamination was maximum in mucopurulent 78% and 76.63% andLED 73.63% and 72.03%. Culture positivity on Middlebrook 7H9 was 100% while 87.85% on LJ media. The rate of contaminationwas 5% and 7% on Middlebrook 7H9 and LJ media, respectively.Conclusions: Middlebrook media was superior to the conventional LJ medium in being rapid, easy to use and interpret, andsignificantly low time-to-growth detection and had lesser contamination rate because the liquid media contains growth supplementoleic-albumin–dextrose-catalase, provides additional nutrition.