Imaging in Covid-19 associated mucormycosis: a case series

Introduction: Mucormycosis is a very rare saprophy?c, opportunis?c fungal infec?on with high morbidity and mortality. With the Covid-19 pandemic, there is a sudden increase in the incidence of this disease due to causes not clearly known. Methods: Retrospec?ve clinic-radiological analysis of a series of seven microbiologically confirmed cases of Covid19 associated mucormycosis (CAM) treated at our ter?ary care center in 2021 was done. Results: All pa?ents were middle-aged with a mean age of 47 years. All pa?ents had poor glycemic control. Three pa?ents were on oxygen support and were given steroids during Covid-19 treatment. Symptoms were facial pain, swelling, headache, eyelid swelling, and nasal block. All pa?ents underwent contrast MRI to study the extent of ?ssue involvement. MRI helped in complete surgical debridement with minimal deformity. Conclusion: Judicious use of immunosuppressants and strict glycemic control vital during covid-19 treatment. Contrast MRI is the inves?ga?on of choice to iden?fy the extent of involvement in surgical planning.

A short-term chick embryo in vivo xenograft model to study retinoblastoma cancer stem cells

Purpose: Cancer stem cells (CSCs) reported in various tumors play a crucial role in tumorigenesis and metastasis of retinoblastoma (Rb). Following the efforts to reduce, replace, and refine the use of mammalian models, we aimed to establish a short?term xenograft for Rb to evaluate the CSC properties of CD133? Rb Y79 cells, using the well?established chick embryo chorioallantoic membrane (CE?CAM) assay. Methods: Y79 cells were cultured, labeled with two different dyes (CM?Dil Y79 and enhanced green fluorescent protein (eGFP)) and sorted for CD133? and CD133 + subsets. Two million cells from each of the labeled groups were transplanted onto the abraded CAM on embryonic day 7 (E7). On E14, the tumor nodule formation on CAM and spontaneous metastasis to the embryos were evaluated by confocal microscopy, in vivo imaging, and histology. Results: Y79 cells formed pink–white raised perivascular nodules with feeder vessels on the CAM with both the types of labeled CD133? cells. CD133? cells, when compared to CD133 + cells, demonstrated significantly larger tumor volume (40.45 ± 7.744 mm3 vs 3.478 ± 0.69 mm3, P = 0.0014) and higher fluorescence intensity (CM?Dil: AUF = 6.37 × 107 ± 7.7 × 106 vs 1.08 × 107 ± 1.6 × 106; P < 0.0001; eGFP: AUF = 13.94 × 104 ± 2.54 × 104 vs AUF = 1.39 × 104 ± 0.4 × 104; P = 0.0003). The metastatic potential of CD133? cells was also observed to be higher as noted by in vivo imaging and histopathology. Conclusion: This study highlights that CE?CAM is a feasible alternative nonmammalian model for evaluating tumorigenicity and metastatic potential of Y79 CSCs. Increased tumorigenicity and metastatic potential of CD133? subset of tumor cells substantiate their CSC properties

Percutaneous coronary intervention in unprotected left main coronary artery stenosis: Mid-term outcomes of a single-center observational study

Background: Percutaneous coronary intervention (PCI) is an appropriate alternative to coronary artery bypass grafting (CABG) for revascularization of unprotected left main coronary artery (ULMCA) disease in patients with low-toeintermediate anatomic complexity or when the patient refuses CABG even after adequate counselling by heart team. We assessed the safety, in-hospital and mid-term outcomes of ULMCA stenting with drug-eluting stents (DES) in Indian patients. Methods: Our study was a retrospective analysis of patients who had undergone ULMCA PCI at a tertiary center, between March 2011 and February 2020. Clinical characteristics, procedural data, and follow-up data were analyzed. The primary outcome was a composite of major adverse cardiovascular and cerebrovascular events (MACCE) during the hospital stay and at follow-up. The median follow-up was 2.8 years (interquartile range: 1.5e4.1 years). Results: 661 patients (mean age, 63.5 ± 10.9 years) had undergone ULMCA PCI. The mean SYNTAX score was 27.9 ± 10.4 and the mean LVEF was 58.0 ± 11.1%. 3-vessel disease and distal lesions were noted in 54% and 70.6% patients, respectively. The incidence of in-hospital MACCE was 1.8% and the MACCE during follow-up was 11.5% (including 48 [8.4%] cardiac deaths). The overall survival rates after one, three, five, and nine years were 94%, 88%, 84%, and 82%, respectively. The multivariate analysis revealed that age >65 years and high SYNTAX scores were independent predictors of mid to long-term mortality. Conclusion: ULMCA PCI with DES is safe and has acceptable in-hospital and mid-term outcomes among patients with low-toeintermediate SYNTAX score

Therapeutic efficacy of low-dose steroid combined with hyaluronidase in ultrasonography-guided intra-articular injections into the shoulder for adhesive capsulitis

Purpose@#The purpose of this study was to compare the efficacy of low-dose steroid, highdose steroid, and low-dose steroid combined with hyaluronidase with respect to intra-articular injection therapy for adhesive capsulitis (AC) of the shoulder. @*Methods@#Thirty patients with primary AC in the initial stage were randomly assigned into three groups to receive ultrasound-guided intra-articular injections with 20 mg of triamcinolone acetonide (group A, n=10), 40 mg of triamcinolone acetonide (group B, n=10) and 20 mg of triamcinolone acetonide combined with hyaluronidase (group C, n=10). The outcome measures included a visual analogue scale (VAS), the Shoulder Disability Questionnaire (SDQ), abduction and external rotation range of motion, and intra-sheath fluid (ISF) before treatment and at 2, 4, 8, and 16 weeks after treatment. @*Results@#Among the 30 patients, one participant in group B dropped out; therefore, a total of 29 patients completed this study and were successfully injected. After the injection, the VAS, SDQ, range of flexion and external rotation, and ISF improved in all groups compared with the preinjection status, regardless of treatment or time point. In the comparison between groups, the SDQ and ISF showed significantly greater improvements in groups B and C than in group A. @*Conclusion@#The therapeutic efficacy of combined low-dose corticosteroid and hyaluronidase is superior to that of low-dose corticosteroid and equivalent to that of high-dose corticosteroid in early AC.

Improvement in awareness levels and periodontal health among patients undergoing fixed orthodontic appliance therapy with established gingivitis and periodontal health maintenance program: a questionnaire based study / Mejora de los niveles de conciencia y salud periodontal entre pacientes sometidos a terapia con aparatos de ortodoncia fijos con gingivitis establecida y programa de mantenimiento de la salud periodontal: un estudio basado en cuestionarios

Objetive: Home oral care practices in patients undergoing orthodontic therapy are often ineffective in maintaining optimal plaque control. The aim of the present study was to assess the effectiveness of periodontal maintenance program in subjects with established gingivitis undergoing fixed orthodontic appliance therapy for one year. Material and Methods: Forty patients undergoing fixed orthodontic appliance therapy with established chronic gingivitis were recruited for the study. As a part of a periodontal maintenance program, a pre-validated structured questionnaire evaluating oral hygiene and periodontal health was administered at the baseline as well as at the end of the study. At the baseline Gingival Bleeding Index, Gingival Index, and Bonded Bracket Plaque Index scores were recorded, Scaling and polishing procedure was performed followed by a customised Oral Hygiene Advice (OHA) session was conducted for all the study subjects. Clinical indices were assessed and OHA was conducted at the 3rd, 6th, 9th, and 12th months of orthodontic treatment visits. Results: There was significant improvement in the clinical indices and awareness regarding oral hygiene and periodontal health level in the patients at the end of the 12th month. Conclusion: The periodontal maintenance program appeared to be effective in improving the periodontal health and awareness health awareness level about oral hygiene among patients undergoing fixed orthodontic therapy at the end of 12 months in our study population.

Objetivo: Las prácticas de cuidado bucal en el hogar en pacientes sometidos a terapia de ortodoncia suelen ser ineficaces para mantener un control óptimo de la placa. El objetivo del presente estudio fue evaluar la efectividad del programa de mantenimiento periodontal en sujetos con gingivitis establecida sometidos a terapia con aparatos de ortodoncia fijos durante un año. Material y Métodos: Se reclutó para el estudio a 40 pacientes sometidos a terapia con aparatos de ortodoncia fijos y con gingivitis crónica establecida. Como parte de un programa de mantenimiento periodontal, se administró un cuestionario estructurado pre-validado que evaluaba la higiene bucal y la salud periodontal al inicio y al final del estudio. En la línea de base, se registraron las puntuaciones del índice de sangrado gingival, el índice gingival y el índice de placa de soporte adherido, se realizó el procedimiento de raspado y pulido seguido de una sesión personalizada de consejos de higiene oral (CHO) para todos los sujetos del estudio. Se evaluaron los índices clínicos y se llevó a cabo la CHO a los 3, 6, 9 y 12 meses durante las visitas de tratamiento de ortodoncia. Resultados: Hubo una mejora significativa en los índices clínicos y la conciencia sobre la higiene oral y el nivel de salud periodontal en los pacientes al final del 12º mes. Conclusión: El programa de mantenimiento periodontal pareció ser eficaz para mejorar la salud periodontal y el nivel de conciencia de la salud sobre la higiene bucal entre los pacientes sometidos a terapia de ortodoncia fija al final de los 12 meses en nuestra población de estudio.

Antifungal Activity of Selenium Nanoparticles Extracted from Capparis decidua Fruit against Candida albicans.

Nanotechnology has introduced nanoparticulate form of selenium for a wide variety of applications. Nanoparticles can be used in medicine due to their increased interaction with microbes and also because it has fewer side effects than the drugs. Selenium nanoparticles have unique biomedical applications ranging from antioxidant activity to anticancer activity. It is distinct with its high biological activity and low toxicity and cytotoxic property. Capparis decidua also called as karira belonging to Capparaceae family is a xerophytic small branched shrub found in Africa, Middle East and South Asia. Its fruit is used for preparing curry and pickles in the western parts of India. In our study, the selenium nanoparticles were extracted from its fruit. Candida albicans is pathogenic yeast in the oral cavity, gastrointestinal tract and the urogenital tract affecting the immunocompromised patients and causes various types of infections. It has gained resistance to present antifungals and new formulations are needed to be discovered. MethodsPlant extract was prepared from Capparis decidua fruit powder and filtered using Whatman No. 1 filter paper. It was kept in magnetic stirrer for nanoparticle synthesis. Colour change was observed which indicates the synthesis of nanoparticles. UV visible spectroscopy was taken in proper intervals. The nanoparticles synthesized were purified by centrifugation technique and checked for its antifungal activity. Antifungal activity of the prepared nanoparticles against Candida albicans was determined by using agar well diffusion assay method or agar disc diffusion method. The zone of inhibition formed around the disc indicates the sensitivity of the fungi to the plant extract. The inhibition zone diameter was measured using a ruler and compared with the inhibition zone formed by the positive control drug which was done in parallel. ResultsAntifungal activity was showed by an inhibition zone which was characterized by a clear zone around the wells. The diameter of the inhibition zone formed for 50 mL of the plant extract was 20.33 mm ± 0.47, for 100 mL of the plant extract was 28.33 mm ± 0.47, for 150 mL of the plant extract was 30.33 mm ± 0.47 and for the positive control drug was 34.33 mm ± 0.47. ConclusionsThe diameter of the inhibition zones was compared with the positive control drug. Selenium nanoparticles extracted from Capparis decidua fruit showed high activity against Candida albicans. Further in vivo research can be done for the same and it may represent an alternative for treating fungal infections.

Acinic cell carcinoma of the posterior buccal mucosa: A rare case report

Acinic cell carcinoma (ACC) is a low-grade malignant salivary gland neoplasm that comprises approximately 17% of primary salivary gland malignancies or about 6% of all salivary gland neoplasms. The most common intraoral sites are the buccal mucosa, lips, and palate. The diagnosis of ACC frequently presents difficulties, owing to its great radiological and cytological similarity with benign tumors and with normal acinar component of the salivary gland, respectively. The management of ACC consists of complete surgical excision. Here, we report a case of ACC on the left retromolar trigone, a rare location in a 44-year-old female

Morphological And Morphometric Study Of Nutrient Foramina Of Femur In South Indian Population

Background: The knowledge of variations in the position of nutrient foramina and hence nutrient arteries isimportant for orthopedicians and radiologists for various procedures.Introduction: The major blood supply to long bones occurs through the nutrient arteries, which enter through theforamina called nutrient foramina. The blood supply from nutrient artery is essential during the growing period,also during the early phases of ossification, and in procedures such as bone grafts, transplant techniques inorthopaedics. The present study analyzed the position and number of nutrient foramina in the diaphysis of fiftyadult femora.Aim: to determine the number, direction, position of nutrient foramen and whether the nutrient foramina obeythe general rule that is, directed away from the growing end of the boneMaterials and Method: The present study has been undertaken in Fifty dry adult femora of South Indian origin inthe Department of Anatomy, M.S Ramaiah Medical College, Bangalore. The number, directions, position of nutrientforamen in femur were measured with a digital Vernier caliper. The data were tabulated as mean + SD andstatistically compared between the right and left sides.Results: A total of 75 foramina were examined in the 50 bones. 40 in Right sided femur and 35 in left sided femur.46% bones had single foramina and 52% bones had double foramina. Foramen was absent in 2% bones. Allnutrient foramina in the femur were directed proximally, away from the growing end. 16% of the foramina werelocated in the proximal third of the bone and the rest 84% were located in the middle third of the bone. There wasno significant difference in location of foramina between right and left sided bones.Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpfulin interpretation of radiological images and for orthopedic procedures. Precise knowledge of usual and anomalousposition of nutrient foramina and hence the nutrient artery may help the orthopaedician for the internal fixationat appropriate place in the long bone. The location of nutrient foramen is important for bone grafts, tumourresections, in traumas, congenital pseudoarthrosis and more recently in microsurgical vascularised bonetransplantation

Different Changes In Electrocardiogram In Cases Of Acute Cerebrovascular Accidents

INTRODUCTION:Stroke is dened as a "neurological decit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours"[1] .CVA can be classied into two major categories- ischemic and hemorrhagic strokes.[2] About 87% are ischemic strokes and the rest being hemorrhagic in origin. studies have demonstrated the fact that primary neurologic abnormalities may produce ECG changes without any myocardial lesion. ECG changes affecting T waves, U wave,ST segment, QT interval and arrhythmias have been reported. These changes may resemble those of myocardial ischemia and myocardial infarction, leading to misinterpretation and delay in operative management of sub arachanoid hemorrhage[3]. There are evidences suggesting, that patients who had ECG changes following CVA had poor prognosis compared to who don't have changes in ECG. Approximately 2-6% of all CVA patients die from cardiac causes in rst 3 months after ischemic stroke[4].

Prescribing pattern of ophthalmological medication in geriatric inpatients of a tertiary care hospital

Background: Older people are potentially at greater risk of medication error. Gaining insight into the prescribing pattern especially in eye diseases as they are a common problem in elderly, in order to identify prescribing related problems is the fundamental step in improving the quality of prescription and patient care.Methods: Prescriptions fulfilling inclusion criteria were collected from hospital Medical record department (MRD) and analyzed using the World Health Organization (WHO) core prescribing indicators for rationality of prescriptions.Results: Among 811 prescriptions analysed, 52.7% (428) were of male patients, those aged 60-70 years were 77.2% (626) and patients with only cataract constituted 77% (625). Prescriptions with oral antibiotics were 57.1% (334); topical antibiotics were 35.8% (429) and topical analgesics 46.2% (553). Out of 1182 FDCs noted, 59% (479) were found to be rational and 34.6% (281) were from Essential Medicines List 2014. Only 2% (61) drugs were prescribed using generic name while 64.06% (1606) of drugs were from the WHO Model List of Essential Medicines (April 2015). Average number of drugs per encounter was 3.7. Percentage of encounters with antibiotics was found to be 43.8% and no prescriptions with injections were noted.Conclusions: Although usage of antibiotics and topical drugs was conforming to WHO recommended standards, there is a need to improve prescription pattern by using generic names and drugs from Essential Drug List.

Large adnexal mass: is laparoscopic surgery a safe option?

Background: Laparoscopic surgery is regarded as the gold standard for management of adnexal tumours due to many advantages. Currently, the exact size of the adnexal tumour contraindicating laparoscopic management has not been clearly defined. Some studies suggest laparotomy for the treatment of adnexal tumours larger than 8 to 10 cm. Risk of malignancy increases with large cysts. Issues with operation of huge adnexal masses are limited surgical field, difficulty in inserting trocars and removing the specimen without rupture. This study aims to evaluate the feasibility and surgical outcomes of laparoscopic surgery for large adnexal masses.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, JSS Medical College, Mysuru.Results: 35 patients with large adnexal masses, which were thought to be benign, were subjected to laparoscopic surgery. Mean diameter of masses as per the pre-operative ultrasound measurements was 12.2cm (range: 10.1-20.4cm). The mean operative time was 51.15minutes, estimated blood loss was 85.4ml, duration of postoperative hospital stay was 2.8 days. Serous cystadenoma was the most common histopathological finding. However, one case of borderline tumour was found.Conclusions: The potential risk of malignancy is the most important limiting factor for laparoscopic management of large ovarian cysts. Therefore, it is necessary to establish risk profiles of patients with adnexal masses in order to benefit from minimally invasive surgery wherever possible. The current study supports laparoscopic management of large ovarian cysts as a technically feasible method if proper case selection is made.

An Osteological Study Of Arcuate Foramen In Atlas And Its Clinical Significance

Background: Atlas, first cervical vertebra bears sulcus over posterior arch for third part of vertebral artery.Sometimes an osseous bridge converts the sulcus into a foramen called as Arcuate foramen. It is commonlycalled as Kimmerle’s anomaly, also known as Ponticulus Posticus. It is the product of the complete or incompleteossification of the posterior atlanto-occipital membrane over the vertebral artery groove resulting in the formationof a foramen (Arcuate foramen) containing the vertebral artery and the posterior branch of the C-1 spinal nerve.This variation has been associated with vertebro-basilar insufficiency symptoms, various types of headaches,and acute hearing loss. The knowledge of this variant prevents complications during lateral mass screw fixation,posterior laminectomy and endovascular surgery.Aims: The aim of the present study was to analyze the percentage of incidence of arcuate foramen and to identifyits clinical significance.Materials and Methods: Hundred dried human atlas bones were used to study the presence of arcuate foramen inthe department of Anatomy at ESIC Medical College and PGIMSR, Rajajinagar, Bangalore.Results: We came across the presence of arcuate foramen in two out of hundred bones. In both the atlas bones,osseous bridge extending from posterior aspect of superior articular facet to the posterior arch of atlas on theleft side, forming arcuate foramen, posterior to foramen transversarium was observed.Conclusion: Arcuate foramen commonly called as Kimmerle’s anomaly where in a groove for vertebral artery isconverted into a foramen by ossification of the ligament. Awareness of osseous bridging is essential in performingcranio-cervical junction surgeries. It also serves as an anthropological data and also identifying the impact ofcomplete arcuate foramen on the signs and symptoms of vertebra-basilar insufficiency.

Tenecteplase versus streptokinase thrombolytic therapy in patients with mitral prosthetic valve thrombosis

Objective Prosthetic valve thrombosis (PVT) is a dreadful complication of mechanical prosthetic valves. Thrombolytic therapy (TT) for PVT is an alternative to surgery and currently making a leading role. This study compares TT with tenecteplase (TNK) and streptokinase (SK) head to head in patients with mitral PVT. Methods In this single center, observational study, patients with mitral PVT diagnosed by clinical data, transthoracic echocardiography, transesophageal echocardiography, and fluoroscopy were included. After excluding patients with contraindications for thrombolysis, they were randomly assigned to receive either SK or TNK regimen. Patients were monitored for success or failure of TT and for any complications. Results Among 52 episodes (47 patients with 5 recurrences) of mechanical mitral PVT, 40 patients were thrombolyzed with SK and 12 patients were thrombolyzed with TNK. Baseline characteristics including demographic profile, clinical and echocardiographic features, and valve types were not statistically significant between the groups. Complete success rate was 77.5% in SK group and 75% in TNK group (p = 0.88). Partial success rate, failure rate, and major complications were not statistically significant between the two groups. Within 12 h of therapy, TNK showed complete success in 33.3% of patients compared to 15% in SK group (p-value <0.02). Minor bleeding was more common in TNK group. Conclusion Slow infusion of TNK is equally efficacious but more effective than SK in the management of mitral mechanical PVT. 75% to 77.5% of PVT patients completely recovered from TT and it should be the first line therapy where the immediate surgical options were remote.

A Study Of Palmaris Longus Muscle: Its Anatomic Variations With Embryological Significance And Clinical Importance

Background: In the present study, variations in the Palmaris longus and the clinical implications of these arediscussed.Aim: To study the variations in the Palmaris longus and to discuss the embryological basis, clinical and surgicalimplications of these variations.Materials and Methods: This study was conducted in Department of Anatomy of Hassan Institute of MedicalScience, Hassan, Dr B.R.Ambedkar Medical college, Bangalore and Sri Devaraj Urs Academy of Higher Educationand Research,Tamaka, Kolar. Thirty formalin fixed cadavers (60 upper limbs); 25 males & 5 female cadavers weredissected for the study and it was conducted over a period of three years, i.e., from 2011-2014. The cadavers withvisible trauma, pathology or prior surgeries were excluded from the study. Routine dissection of the upper limbwas carried out following the Cunnigham’s Manual of Practical Anatomy. During the dissection of the anteriorcompartment of forearm, the Palmaris longus muscle was identified & carefully dissected. At first, the origin wasconfirmed and then, it was traced towards its insertion. Any variations found were noted and photographed. Theresults were analysed and compared to previous studies.Results: Bilateral absence of palmaris longus was seen in one male cadaver and unilateral (right sided) absencein one female cadaver. Percentage of bilateral absence of palmaris longus is 3.3%. Total absence of palmarislongus is 5%. Right side absence is 3.3%, left side absence is 1.6%. Variations like split tendon of palmaris longuswas observed in a female cadaver on right side, bilateral split tendon with fleshy belly in a male cadaver,reversed belly of right side palmaris longus in a male cadaver .

Assessing decisional capacity for research participation in psychiatric patients and their relatives

A cross-sectional study among adult inpatients with non-organic psychiatric disorders, and among their key relatives, assessed their comprehension and recall of key information in consent forms. It also assessed their capacity to consent to participate in two hypothetical randomised controlled trials (RCTs) with different potential risks and burdens, using structured questionnaires and recorded interviews. Of the 24 participants (12 patient–key relative dyads), seven patients (58%) and three key relatives (25%) were clinically judged to lack the capacity to consent. Of the remaining 14 participants s, less than half the patients (2/5; 40%) or relatives (3/9; 33%) accurately recalled 50% of the key information on both trials. Among the eight participants (3 patients, 5 relatives) independently assessed on the MacArthur Competence Assessment Tool for Clinical Research, the proportions judged competent for each trial varied with the criteria for defining competence. No one fulfilled the stringent competence criteria for both trials. Routine assessments of the capacity of psychiatric research participants, and of relatives providing proxy consent, appear to be warranted. However, neither suboptimal understanding of consent forms, nor incompetence determined by the use of formal assessment tools, necessarily denote an incapacity to consent to research if detailed clinical assessments indicate otherwise. Research into incorporating participants’ health literacy and clinical status in formal assessments may help determine the optimal standards for defining competence.

Participation in randomised controlled trials: perspectives of psychiatric patients and key relatives

This study assessed the perspectives of adults who had acute nonorganic psychiatric disorders and were admitted in a private, not for- profit medical college hospital, and also of their key relatives, on randomised controlled trials (RCTs). Structured questionnaires and audio-recorded interviews were used for the purpose. We explored their willingness and motivation to participate in two hypothetical RCTs with different risks and burdens. The transcripts of the interviews were analysed using the principles of grounded theory and framework analysis. Of the 24 consenting participants (12 patient and key-relative dyads), the 20 who completed the interviews had largely positive attitudes towards research and RCTs. However, 50% of those interviewed declined to participate in either of the hypothetical RCTs. The refusal to participate seemed to be influenced by a lack of education; forgetfulness, which impeded the process of making informed decisions; unfavourable benefit–risk–burden ratios; practical difficulties; dependence on treating doctors and relatives for decision-making; and the wish to exercise one’s choice regarding treatment options. The factors that motivated the patients and relatives were trust in doctors and organisations, altruism, expectation of personal benefits and favourable risk–benefit ratios. These observations indicate that while the respondents in this study valued research, they were discerning about whether or not to participate in the trials; their decision-making was influenced by individualised assessments of risks and burdens and pragmatic considerations, rather than only by the benefits they would obtain.

Building Capacity of Indian Scientists to Conduct Systematic Reviews in Child Health: An ICMR Initiative.

Knowledge and training in evidence-based medicine is essential for informed clinical decision-making and treatment choices. Systematic reviews identify, appraise and synthesize research-based evidence and present it in accessible format. The Indian Council of Medical Research has promoted evidence-based medicine in India by establishing an Advanced Center for evidence based medicine that hosted the South Asian Cochrane Network and Center at the Christian Medical College, Vellore; procuring a national subscription to The Cochrane Library making it accessible to all Indian scientists; and establishing a Center for Advanced research on evidence-based child health at Post Graduate Institute of Medical Education and Research, Chandigarh. This article informs about a national level initiative by ICMR that aims to harness the translational potential of secondary research, by funding systematic reviews aligned to national health priorities selected through a national competitive process; and to provide training, mentoring, and quality assurance. A continuing scheme of funding high-quality systematic reviews on priority areas of Child Health may follow.

Elongated Odontoid Process of Axis Vertebra.

Introduction: Odontoid process is a bony projection of axis around which the atlas rotates. It measures 1 to 1.25 cms in length and projects upwards from the body of Axis. An elongated odontoid process may narrow the foramen magnum causing compressive neurological symptoms. It can cause cervical stiffness, serious restrictions of neck movement, and even a bone-derived torticollis. Observation: During routine osteology classes, we encountered an Axis vertebra with an elongated odontoid process. The measurements of the elongated odontoid process were taken using digital Vernier slide calipers. Conclusion: Elongated odontoid process can be mistaken for fracture of dens in radiological images; hence the knowledge of elongated odontoid process is useful for the radiologists, neurosurgeons and orthopaedicians for accurate diagnosis and treatment involving cranio-vertebral junctions.