Safety and efficacy of ayush rasayana A and B in improving functionality of the elderly – A single-arm multicenter study

Background: As per Ayurvedic classics, Ras?yana is a term used for unique therapeutic measures intended to improve cognition, memory, physical strength and delay the degenerative processes. Ayush Rasayana A & B are developed from extracts of herbs pertaining rasayana property. Aims & Objectives: To assess the safety and effectiveness of ‘Ayush Rasayana A and B’ in improving physical endurance, quality of life and cognition of elderly. Materials and Methods: This is an open label, single arm, multi-centre study among 256 apparently healthy elderly between 60?75 years. Ayush Rasayan A was given for 6 days and Ayush Rayana B for 180 days. The effect of the trial drug was seen on functional capacity, quality of life and cognitive function and, safety of the intervention was assessed through haematological and biochemical tests, clinical examination and incidence of adverse events. Results: Significant improvement in 6 minute walk test and HMSE score was observed at 187th as compared to baseline (p<0.0001). Quality of life of the participants especially in domains of physical health, social relationship and environment also improved at the end of intervention period (p<0.0001). The haematological and bio-chemical parameters showed no significant changes as compared to baseline and no adverse events were observed during the study. Conclusion: Ayush Rasayana A and Ayush Rasayana B, both were well tolerated by all the participants. This ayurvedic intervention can be safely given to apparently healthy elderly to improve their functionality, quality of life and cognition. However, a randomized controlled trial is warranted to substantiate the efficacy of this drug.

Alveolar Bone Grafting - A Summary of History and Current Literature on the Technique

Cleft lip and palate is a common condition affecting thousands of children in India and overseas. With an incidence of 1 in 800 live births, these cleft lip and cleft palate patients face numerous aesthetic as well as functional challenges. The condition goes untreated in many scenarios, or patients do not receive adequate treatment due to various reasons like lack of awareness, lack of specialist dentists etc. leading to permanent facial deformity with significant deterioration of quality of life. There have been many changes in the management of alveolar cleft in the past 100 years. Documentation of the first cleft lip repairs dates back to 400 BC, and was performed by Hippocrates, while the first cleft velum repair was done for the first time by a French dentist, Monnier, in 1764. The treatment protocol for the same has been upgraded with time, with better understanding of the anatomy and pathophysiology of the condition, and for better results to the patients. Alveolar bone grafting (ABG) is now becoming an integral part of managing cleft patients. There still isn’t a fixed and widely accepted protocol for ABG in the management of cleft patients, but there are various opinions of researchers around the world regarding the indications of bone grafting, the type of grafting (primary or secondary) to be employed, timing of grafting, the source of bone graft and use of various bone graft substitutes in the procedure. An increasing value of multidisciplinary approach, including maxillofacial surgeons and orthodontists, towards managing such patients, is helping improve the outcome of such patients, and hence easing the overall treatment duration for the patient and relatives. Hence, through this article, we aim to shed some light over the evolvement and current place of alveolar bone grafting in treating cleft lip and palate patients. The anatomy of involved parts, types and indications of ABG, clinical evidences on the timing of the surgery, future evaluation, results and complications, and orthodontic treatment have been mentioned in this article.

Establishment of Cephalometric Norms for UCLP Cases from Central India Population Falling Under Goslon 1 and 2 Based on Burstone Analysis.

This study was done as there is a need to evaluate separate hard and soft tissue parameters for UCLP as we cannot compare the deformity with normal. A study by Abhilasha Yadav has defined the Burstone norms for class I subjects in Central India as compared to Caucasians. The objective is to derive norms for UCLP itself as the pattern of growth and development of bone, muscle is not normal that can be compared with any population and needs to treated, based on specific norms.METHODS75 cases of UCLP from Central India, with an age range of 18-25 yrs. were selected for the study. The COGS analysis values for Central Indian UCLP cases (falling under GOSLON 1 and 2) was established and compared with class I Caucasians and class I Central Indian subjects. The cephalograms were traced, analysed and interpreted using the landmarks and values established in Burstone analysis (cephalometric analysis for orthognathic surgery). The mean, standard deviation and Z values were calculated to compare the values between three groups.RESULTSThe Central Indian UCLP cases demonstrated decreased anterior cranial base length, upper third height of face, decreased anteroposterior maxillary length, decreased upper and lower incisor height as well as molar height, retroclined upper anterior, significantly decreased facial convexity, nasolabial angle and reduced maxillary prognathism while mandible showed prognathism.CONCLUSIONSThe study reported significant differences in certain cephalometric parameters of UCLP cases from central India population with that of Caucasian and class I central Indian population. The results obtained for central India’s UCLP cases can be used as cephalometric norms for planning orthognathic surgery specifically for cleft cases.

A Review on Evolution and Controversies Regarding Surgical Methods and Timing of Palatoplasty in UCLP Cases

To establish speech, growth and development of maxillofacial region and hearing etc. towards normal is the aim of every professional working for cleft care. With a quest to attain and normalize the growth and development in CLP since ages, researchers and workers have invented and still inventing newer technique to treat them. The procedure of surgeries has evolved over a period of time. Controversies concerning speech and maxillofacial growth have challenged many surgeons who have come up with different views in surgical methods. Studies suggest that the palate repair is the main cause of the maxilla and growth disturbance that later is responsible for speech impairment due to fibrous tissue in anterior palate and constricted tissue in uvula due to repair. Many authors have noted that delayed hard palate repair has more positive effects on maxillary growth than that of early hard palate repair, but studies have also proved that late palate repair impair the speech with due respect. This unsolved controversy whether to opt for late/ early palatoplasty w.r.t to the improvement in speech is still unsolved controversy. The purpose of this article is to review the history of cleft palate surgery, its evolution, various surgical methods and optimal timing of cleft palate repair.

ICSI outcome in surgically retrieved sperm compared with ejaculated sperm control

Background: Globally, the prevalence of infertility is around 10% of the total population. 30% of these have male factor infertility. Azoospermia is found in 1% of men, in 20% of which, the etiology is a bilateral obstruction of the male genital tract while others have non obstructive azoospermia. In azoospermic men sperms are microsurgically retrieved from epididymis and testes by TESA and PESA respectively. The aim of this study was to evaluate the outcomes of intracytoplasmic sperm injection ICSI using surgically retrieved sperm of azoospermic men either obstructive or nonobstructive and to compare it with ejaculated sperms in men having severe oligospermia.Methods: This was retrospective cohort study conducted based on the data collected from our reproductive endocrinology and infertility unit, 126 ICSI cycles performed during the period of 5 years were taken and divided into two groups, one with patients having ejaculated sperms with oligospermia and other group with patients who had surgically retrieved normal sperms due to azoospermia. Outcome of these ICSI cycles included fertilization, cleavage, biochemical and clinical pregnancy was assessed.Results: In present study it was found that ICSI outcome was comparable in both the groups with ejaculated sperm and surgically retrieved sperm as fertilization rate (72% vs 65%), Implantation Rate (58 vs 51%), clinical pregnancy rate (CPR) (51% vs 44.82%) observed with ejaculated or retrieved sperm group respectively showed no statistical difference.Conclusions: Present study shows that minimally invasive techniques of PESA and TESA can be successfully performed to retrieve sperm for ICSI in the treatment of azoospermic men which gives them the chance to father their biological child. The result of this study indicates that treatment outcomes of PESA/TESA-ICSI cycles compare favourably with that of ICSI using ejaculated sperm.

Antimicrobial effect of platelet‑rich plasma and platelet‑rich fibrin.

Context: Platelet concentrates have been extensively used in a variety of medical fields to promote soft‑ and hard‑tissue regeneration. The significance behind their use lies in the abundance of growth factors (GFs) in platelets α‑granules that promote wound healing. Other than releasing a pool of GFs upon activation, platelets also have many features that indicate their role in the anti‑infective host defense. Aim: The aim of this study is to evaluate the antimicrobial activities of platelet‑rich plasma (PRP) and platelet‑rich fibrin (PRF) against periodontal disease‑associated bacteria. Subjects and Methods: Blood samples were obtained from ten adult male patients. PRP and PRF were procured using centrifugation. The antimicrobial activity of PRP and PRF was evaluated by microbial culturing using bacterial strains of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Results: P. gingivalis and A. actinomycetemcomitans were inhibited by PRP but not by PRF. Conclusions: PRP is a potentially useful substance in the fight against periodontal pathogens. This might represent a valuable property in adjunct to the enhancement of tissue regeneration.

Different anthropometric adiposity measures and their association with cardiovascular disease risk factors in middle aged women.

A cross sectional study of 136 women age group40-55 years was conducted to study which anthropometric measure had the strongest association with cardiovascular disease risk factors in middle aged women. In accordance with their BMI measurement subjects were divided into three groups namely:Normal weight (Group1) BMI 18.5-24.9 kg/m2, Overweight (Group2) – 25 kg/m2 – 29.9 kg/m2, Obese (Group3) – BMI > 30 kg/ m2. Each group was further divided into premenopausal and postmenopausal women BMI, WHR, WHtR, SBP, DBP were recorded. TG, TC, HDL and FBS values were estimated. Results showed that both pre and post menopausal middle aged obese women with higher BMI, WHR and WHtR have more chances of having cardiovascular diseases. BMI, WHR and WHtR are theeasy and practical methods to diagnose obesity and together can be used as simple measures to predict cardiovascular risk factors in middle aged women.

Antimicrobial and Antioxidant activity of leaf and flower extract of Caesalpinia pulcherrima, Delonix regia and Peltaphorum ferrugineum.

The present study was undertaken to determine antimicrobial and antioxidant activities of leaf and flower extracts of Caesalpinia pulcherrima, Delonix regia and Peltaphorum ferrugineum. Antimicrobial activity was tested against Staphylococcus aureus, Salmonella typhi, Candida albicans and Cryptococcus neoformans by Agar well diffusion assay. Antioxidant activity was determined by DPPH free radical scavenging assay, ABTS free radical scavenging assay, Ferric reducing assay and Total antioxidant capacity determination. Total phenolic content of extracts was estimated by Folin-Ciocalteau Reagent method. S. typhi and C. neoformans were susceptible to extracts to greater extent than S. aureus and C. albicans among bacteria and fungi respectively. Except C. pulcherrima extract, the leaf extracts were more effective in inhibiting bacteria than flower extracts. Leaf extracts have shown high antifungal activity than flower extracts. The extracts have shown dose dependent scavenging of DPPH and ABTS radicals. Scavenging of ABTS radicals was more efficient than that of DPPH radicals as revealed by low IC50 values. All leaf extracts except C. pulcherrima displayed stronger scavenging activities than flower extracts. Similar results were observed in ferric reducing assay and total antioxidant capacity determination. Total phenolic content was found to be higher in leaf extracts (except C. pulcherrima) than flower extracts. A correlation has been observed between phenolic content of leaf and flower extracts and the antioxidant activity. A marked antimicrobial and antioxidant activity of leaf and flower extracts was observed which may be attributed to the presence of phenolic compounds and other phytochemicals. The plants can be used to control infectious diseases and oxidative damage.

Non invasive and surgical measurement of length of soft tissue from the tip of interdental papilla to the alveolar crest

Various methods, including clinical and radiographic techniques, can be used to assess periodontal regeneration in interproximal areas. The goal of the present study was Periodontal regeneration; to compare the papilla length relative to the alveolar bone crest measured by clinical, intrasurgical, Radiographic bone length; and radiographic techniques. Bone probing length; Materials and The study sample included 250 interproximal papillae in 68 patients with Actual papilla length generalized chronic periodontitis. The papilla length from the alveolar bone crest was measured clinically [as the actual papilla length, APL], intrasurgically [as the bone probing length, BPL], and radiographically [as the radiographic bone length, RBL]. Measurements were standardized by using acrylic resin stents, XCP rinn, a paralleling technique, and/or a radiographic grid. The mean [+/- standard deviation] for RBL was 4.9 +/- 0.8 mm, BPL was 5.1 +/- 0.6 mm, and APL was 5.1 +- 0.6 mm. Correlations between RBL and APL and between BPL and APL were 0.918 and 0.943, respectively [both P < 0.01]. If the clinical recordings are appropriately standardized, then noninvasive radio-graphic methods can be used to evaluate the papilla length with good accuracy

Oral health-related KAP among 11- to 12-year-old school children in a government-aided missionary school of Bangalore city.

BACKGROUND: To organize community-oriented oral health promotion programs systematic analysis of the oral health situation would be needed, including information on oral health knowledge, attitudes, and practices (KAP). AIM: The aim of this study was to assess knowledge, attitude, and practice (KAP) toward oral health among 11 to 12-year-old school children in a government-aided missionary school of Bangalore city. MATERIALS AND METHODS: The study group comprised of 212 children (Male: 108; Female; 104) who were in the age group of 11-12 years studying in a government-aided missionary school of Bangalore city. Data on oral health KAP were collected by means of a self-administered questionnaire. Statistical significance was determined by Chi-square test. RESULTS: This survey found that only 38.5% of the children brush their teeth two or more times a day. Pain and discomfort from teeth (35.1%) were common while dental visits were infrequent. Fear of the dentist was the main cause of irregular visit in 46.1% of study participants. High proportion of study participants reported having hidden sugar at least once a day: soft drinks (32.1%), milk with sugar (65.9%), and tea with sugar (56.1%). It was found that 5.4% and 3.9% of study participants smoke and chew tobacco, respectively. CONCLUSION: Results of this study suggest that oral health KAP of study participants are poor and needs to be improved. Systematic community-oriented oral health promotion programs are needed to improve oral health KAP of school children.