Effect of pupil dilation on biometric iris recognition systems for personal authentication

Purpose: To study the effect of pupil dilation on a biometric iris recognition (BIR) system for personal authentication and identification. Methods: A prospective, non?randomized, single?center cohort study was conducted on patients who reported for a routine eye check?up from November 2017 to November 2019 (2 years). An iris scanning device “IRITECH?MK2120U” was used to initially enroll the undilated eyes. Baseline scans were taken after matching with the enrolled database. All eyes were topically dilated and matched again with the enrolled database. The Hamming distance (a measure of disagreement between two iris codes) and recognition status were recorded from the device output, and eyes were evaluated by slit?lamp ophthalmoscopy with special emphasis on pupil shape, size, and texture. Results: All 321 enrolled eyes matched after topical dilation. The pupil size had a significant effect on Hamming distance with a P value <0.05. There were no false matches. A correct recognition rate of 100% was obtained after dilation. No loss of iris texture or pupil shape was observed after dilation. Conclusion: A BIR system is a reliable method for identification and personal authentication after pupil dilation. Topically dilated pupils are not a cause for non?recognition of iris scans.

Organic osmolyte betaine mitigates the deleterious effects of Diclofenac in vivo in wistar albino rats

Abstract Diclofenac sodium (DF) is a non-steroidal anti-inflammatory drug (NSAID) that possesses antipyretic, analgesic, antinociceptive and anti-inflammatory activities. Like other NSAIDs, DF is known to be associated with renal, cardiovascular, and gastrointestinal complications. The present study was carried out to evaluate the adverse effects of DF in vivo in wistar albino rats and to assess if oral administration of the organic osmolyte betaine mitigates the adverse effect of DF. Eighteen male Wistar rats were divided into three groups, one group of animals was fed orally with 20 mg/kg of DF once/day, and the other group received a combination of 20 mg/kg of DF and 30 mg/kg of betaine, once/day. Apart from the hematological and biochemical parameters, histopathological changes in the liver, lungs, brain, heart and kidney were also investigated. Histopathological alterations that were found in the liver, kidney, and lungs of DF-treated animals were found to be minimal or absent in DF + betaine-treated animals, as compared to untreated control. The results showed that betaine mitigates the adverse effects associated with DF treatment.

Ovarian volume is more closely related to the different manifestations of polycystic ovary syndrome than follicle number per ovary / 대한생식의학회지

Objective@#Polycystic ovary (PCO), a diagnostic component of polycystic ovary syndrome (PCOS), requires either an ovarian volume (OV) criterion or a follicle number per ovary (FNPO) criterion. This study investigated the association of OV and FNPO criteria with various manifestations of PCOS. @*Methods@#This cross-sectional study was conducted at a university hospital among 100 patients newly diagnosed with PCOS (according to the revised Rotterdam criteria). Fasting blood samples were collected to measure glucose, total testosterone (TT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), lipid, insulin, and hemoglobin A1c levels. An oral glucose tolerance test was performed. Transabdominal or transvaginal ultrasound of the ovaries was done, depending on patients’ marital status. All investigations were conducted in the follicular phase of the menstrual cycle. OV >10 mL and/or FNPO ≥12 indicated PCO. A homeostasis model assessment of insulin resistance (IR) value ≥2.6 indicated IR, and metabolic syndrome (MS) was defined according to the international harmonization criteria. @*Results@#Seventy-six participants fulfilled the OV criterion, 70 fulfilled the FNPO criterion, and 89 overall had PCO. Both maximum OV and mean OV had a significant correlation with TT levels (r=0.239, p=0.017 and r=0.280, p=0.005, respectively) and the LH/FSH ratio (r=0.212, p=0.034 and r=0.200, p=0.047, respectively). Mean OV also had a significant correlation with fasting insulin levels (r=0.210, p=0.036). Multivariate binary logistic regression analysis showed that IR (odds ratio [OR], 9.429; 95% confidence interval [CI], 1.701 to 52.271; p=0.010) and MS (OR, 7.952; 95% CI, 1.821 to 34.731; p=0.006) had significant predictive associations with OV alone, even after adjustment for age and body mass index. @*Conclusion@#OV may be more closely related to the androgenic and metabolic characteristics of PCOS than FNPO.

Perceived Awareness of Clozapine associated with Socio- Demographic status, clinical, and side effect profile among patients from Mental Health Hospital, Taif, Saudi Arabia

Background: The main objective was to investigate the Socio-demographic, clinical, and side effect profile of patients on clozapine from Mental Health Hospital, Taif, Saudi Arabia. This article reports on an observational study. Clozapine is a second-generation atypical antipsychotic used as the drug of choice for the treatment resistant psychosis. It is supposed to be a baseline study from which we will get and understand rate of clinical, and side effect profile of the clozapine taking patients. Physicians, particularly psychiatrists are not only ignoring but also not aware, alert, so they always need to be watchful to the fatality of the drug, and take appropriate therapeutic measures. The aim was to study the socio-demographic status, clinical profile, comorbidity, side effects and outcome of patients treated with clozapine. Methodology: We reviewed all the indoor psychiatric patients of Mental Health Hospital, Taif, Saudi Arabia, from the period of one year between January 2021 to January 2022 (N=29). Our study design focused on prospective and observational studies. Descriptive statistical analysis was explored, and presented as frequencies, and percentages. We also determined crude rates for all adverse outcomes of clozapine. Results: We did a nearly mean follow-up of one year. The majority of patients were male (n=26; 89.65%), with a maximum being unmarried (n=16; 55.17%). Most patients belong to nuclear families due to cultural restrictions in this country (n=23; 79.31%). Among the literacy rate illiterate were (n=2; 6.89%, and unemployed (n=23; 79.31%). Among the study populations, the majority of respondents were found to have treatment-resistant schizophrenia (n=18; 62.06%), and around 79.31% of patients took more than two antipsychotics in adequate doses. Among side effect profiles most of the patients suffered hyper-salivation (n=19; 65.51%), sedation (n=12; 41.37%), and rarely suffered from agranulocytosis. Conclusion: Socio-demographic, clinical, and side effect profiles were the significant indicators of clozapine. Clozapine has been used for treatment-resistant psychosis, but due to fatal side effect profile we used it cautiously. In our study, we found that myocarditis, hematemesis, and leukocytosis, and neutropenia are fatal side effects of clozapine. We also found hyponatremia-induced seizure. The prevalence of blood dyscrasias in our study is rarely seen. Hyper-salivation is the most common side effect reported. Majority of the patients in our study were male, and treatment resistant Schizophrenia was the most common diagnosis. Myocarditis is life-threatening side effect seen in our study

Factitious Disorder - Patient Pretending To Long Stay At Hospital

Factitious disorder (FD) is a psychiatric disorder where patients intentionally create false physical or psychological symptoms or exaggerate the already existing ones consciously in the absence of clear external motive. Patients feigned for the sole purpose of assuming the patient's role and to stay lifelong at hospital. Here we present a case of 61 years old Saudi patient presenting with so many various complaints and wasting valuable time and resources of doctors and wants potentially long hospital stays, which affects both the patient and the healthcare system.

Recidivism Rate among Patients discharged from long care unit in forensic psychiatry program at Mental Health Hospital, Taif, Saudi Arabia

Background: This article reports on an observational study of rate and violent recidivism after discharge from a Long-Term Forensic care unit, in mental Health Hospital, Taif, Saudi Arabia. It is an attempt to examine current state of the service provided and its outcomes. It is supposed to be a base line study on which further efforts are to be directed to understanding the risk factors, effective rehabilitation programs and the necessary community-based follow up strategies that would lead to the best outcome possible towards maximizing the benefits of long-term psychiatric care hospitalization on criminal behaviour. Methodology: We reviewed all psychiatric patients who were admitted to, then discharged from the chronic forensic rehabilitation ward from Mental Health Hospital, Taif, Saudi Arabia, between 2005 and 2020 (N=66). Our study focused exclusively on observational studies. We counted number of times of reconviction after the first Mental Health Hospital admission, and also counted for the number of readmissions. Descriptive statistical analysis was explored and presented as frequencies and percentages. We determined crude rates for all adverse outcomes. Results: We did nearly mean follow up of 15 years, 15.15 percent patients died after discharge with average age of death of 31-40 years, 68.18 percent were hospitalized due to relapse of illness and 16.66 percent violently offended after discharge associated with violent crime. The association between psychiatric diagnosis and outcome varied such as substance use disorder as a primary diagnosis was associated with highest risk of mortality and re-hospitalization, on which personality disorder was linked with the highest risk of violent offending. Furthermore, comorbid substance use disorder typically increased risk of adverse outcomes. Conclusion: Long term unit, although might mitigate the risk of high risk patient group. However, that is not enough and they still in a way or another, and for reasons to be looked at and investigated, pose risk to the public safety

Awareness about vulvovaginal aesthetics procedures among medical students and health professionals in saudi arabia

Abstract Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value<0.05. Results There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. Themajority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. Conclusion The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

Myths and misperceptions in pacemaker patients: a quasi experimental study to assess effect of an educational intervention

Background@#Misconceptions regarding activities after pacemaker implantation can result in restrictions in daily life. This study aims at measuring the correction of misconceptions following an educational intervention utilizing a picture based brochure and personal counseling. @*Methods@#One hundred and twenty-eight patients were enrolled in a quasi experimental study on the day after pacemaker implantation. Patients’ perceptions about safety of various daily activities, medical procedures, and usage of appliances, in the presence of pacemaker was assessed using a questionnaire before and ten days after an educational intervention using a pictorial brochure. The number of correct responses before and after the intervention was compared to assess the change in patients’ perception. @*Results@#A total of 128 patients were interviewed at baseline, of which 115 followed-up at 10 days. Mean age of patients was 60.31 ± 12.81 years. In total, 76 (59.4%) were male and 61(47.7%) were illiterate. Mean correct responses increased from 64.47 ± 29.48% to 92.29 ± 14.42% (p < 0.001). Percent of questions answered correctly improved in all three categories after the intervention. Correct answers increased from 74.57 ± 24.94% to 95.65 ± 11.48% (p  < 0.001) for routine daily activities, 51.09 ± 33.9% to 84.78 ± 20.86% (p < 0.001) for medical procedures and 64.03 ± 37.36% to 92.57 ± 18.79% (p  < 0.001) for domestic appliance usage. @*Conclusion@#Misconception that can adversely affect pacemaker patient’s quality of life can be corrected by counseling with pictorial based brochures regardless of the patient’s baseline knowledge or education.

Myths and misperceptions in pacemaker patients: a quasi experimental study to assess effect of an educational intervention

Background@#Misconceptions regarding activities after pacemaker implantation can result in restrictions in daily life. This study aims at measuring the correction of misconceptions following an educational intervention utilizing a picture based brochure and personal counseling. @*Methods@#One hundred and twenty-eight patients were enrolled in a quasi experimental study on the day after pacemaker implantation. Patients’ perceptions about safety of various daily activities, medical procedures, and usage of appliances, in the presence of pacemaker was assessed using a questionnaire before and ten days after an educational intervention using a pictorial brochure. The number of correct responses before and after the intervention was compared to assess the change in patients’ perception. @*Results@#A total of 128 patients were interviewed at baseline, of which 115 followed-up at 10 days. Mean age of patients was 60.31 ± 12.81 years. In total, 76 (59.4%) were male and 61(47.7%) were illiterate. Mean correct responses increased from 64.47 ± 29.48% to 92.29 ± 14.42% (p < 0.001). Percent of questions answered correctly improved in all three categories after the intervention. Correct answers increased from 74.57 ± 24.94% to 95.65 ± 11.48% (p  < 0.001) for routine daily activities, 51.09 ± 33.9% to 84.78 ± 20.86% (p < 0.001) for medical procedures and 64.03 ± 37.36% to 92.57 ± 18.79% (p  < 0.001) for domestic appliance usage. @*Conclusion@#Misconception that can adversely affect pacemaker patient’s quality of life can be corrected by counseling with pictorial based brochures regardless of the patient’s baseline knowledge or education.

Intravenous ferric carboxymaltose for anaemia in pregnancy

Background: Anaemia in pregnancy is associated with unfavourable consequences both for the mother and the fetus and is a major cause of maternal and perinatal mortality and morbidity.Methods: The study was conducted over a period of one year in which 100 pregnant females who met the inclusion criteria were administered ferric carboxymaltose (FCM) preparation.Results: There was significant rise in mean haemoglobin and serum ferritin after transfusion of ferric maltose in the patients with very less adverse effects.Conclusions: FCM, because of its high efficacy and safety can revolutionize the management of iron deficiency anaemia (IDA) in pregnancy.

Hysteroscopy in evaluation of intrauterine causes of abnormal uterine bleeding

Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause.Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected intrauterine abnormality in 59% cases. Most common being hyperplastic endometrium in 52 patients (26%) followed by polyp (20%). 14 (7%) had sub mucous fibroid, 8 (4%) had atrophic endometrium and 2 (1%) had intrauterine adhesions.Conclusion: Hysteroscopy provides a simple & easy method for visualization of the cervical canal & uterine cavity for the evaluation of AUB. Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.

Risk factors associated with ectopic pregnancy in our sociodemographic setup

Background: Ectopic pregnancy (EP) is assuming greater importance because of its increasing incidence and its impact on woman’s fertility.Aim: To assess the frequency and to determine an association between the studied risk factors and ectopic pregnancy.Methods: A retrospective study was conducted for the role of several risk factors in the occurrence of EP in department of obstetrics and Gynaecology, SMGS Hospital. A total of 110 cases and 110 controls were compared for socio demographic characteristics, cigarette smoking, obstetrical and gynaecological history, PID, past exposure to Chlamydia, surgical histories, the presence of assisted conception and contraceptive usage.Results: The main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11), history of infertility (p=0.001), abortions (p=0.01) and a history of prior ectopic pregnancy (OR=8.549). Other risk factors found to be associated with an increased risk for ectopic pregnancy were Pelvic inflammatory disease (PID)/Chlamydia infection (OR=5.63), endometriosis (5.40), induced conception cycle (OR=3.063), intrauterine device usage (OR=3.55), prior caesarean section (OR=2.83) and appendectomy (OR=2.25). On the contrary, barrier methods (OR=0.28) and oral contraceptive use (OR=0.28) were protective from ectopic pregnancy.Conclusion: Pelvic infection particularly TB was found to be a major etiological factor for EP in our setup. Furthermore, other factors found to be associated with ectopic pregnancy, such as prior ectopic pregnancy and infertility history may be the result of a previous pelvic infection that caused tubal sequele. Thus, these factors are potential targets for intervention and modification. Further, patients with previous abortions, pelvic surgeries, induced conception cycle and intrauterine contraceptive device (IUCD) users should be counselled about the possible risk when they conceive.

Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.

Pharmacological evaluation of Rhazya stricta root extract / Evaluación farmacológica del extracto de raíz de Rhazya stricta

The present study aimed to screen the Rhazya stricta Decne root for its antihyperglycemic and antioxidants potential through invitro assays along with phytochemical and elemental analyses. The crude extract was prepared through maceration and fractionated using solvent-solvent extraction technique. The spectroscopic studies indicated the presence of various phytochemical classes in the extract and its fractions. The antioxidant assays showed notable results along with a good concentration of phenolic and flavonoid contents. Enzyme inhibition assays demonstrated glucose-lowering effects by inhibiting the enzyme activity which could reduce post-prandial blood glucose level. The Dipeptidyl peptidase-IV (DPP-IV) inhibition assay results showed the novel DPP-IV inhibition activity of the plant extract and all fractions showed noteworthy enzyme inhibition and antihyperglycemic activity. Conclusively, the Rhazya stricta root extract displayed its antioxidant and antihyperglycemic potential due to the presence of various classes of phytochemicals and micro-nutrients.

El presente estudio tuvo como objetivo examinar la raíz de Rhazya stricta Decne por su potencial antihiperglicémico y antioxidante a través de ensayos in vitro junto con análisis fitoquímicos y elementales. El extracto crudo se preparó por maceración y se fraccionó usando una técnica de extracción solvente-solvente. Los estudios espectroscópicos indicaron la presencia de varias clases fitoquímicas en el extracto y sus fracciones. Los ensayos antioxidantes mostraron resultados notables junto con una importante concentración de contenido fenólico y flavonoide. Los ensayos de inhibición enzimática demostraron efectos reductores de la glucosa al inhibir la actividad enzimática que podría reducir el nivel de glucosa posprandial en sangre. Los resultados del ensayo de inhibición de Dipeptidyl peptidase-IV (DPP-IV) mostraron la nueva actividad de inhibición de DPP-IV del extracto de la planta y todas las fracciones mostraron una notable inhibición enzimática y actividad antihiperglicémica. En conclusión, el extracto de raíz de Rhazya stricta Decne mostró su potencial antioxidante y antihiperglicémico debido a la presencia de varias clases de fitoquímicos y micronutrientes.

A conglomeration of preclinical models related to myocardial infarction

Cardiovascular diseases are the main source of death and morbidity in developed and developing nations. Animal models are required to propel our understanding of the pathogenesis, increase our knowledge, disease progress, and mechanism behind cardiovascular disorder, providing new approaches focused to improve the diagnostic and the treatment of these pathological conditions and additionally to test various therapeutic ways to deal with tissue regeneration and re-establish heart working following damage. A perfect model framework ought to be reasonable, effectively controlled, reproducible, and physiologically illustrative of human disease, show cardinal signs and pathology that resembles after the human ailment and ethically stable. The decision of selection of animal model should be considered precisely since it influences exploratory results and whether results of the research can be sensibly matched with the human. In this way, no specific technique splendidly reproduces the human disease, and relying upon the model, extra cost burden, resources, infrastructure and the necessity for technical hands, should also be kept under consideration. Here we have discussed and compiled various methods of inducing myocardial infarction in animals, basically by surgery, chemicals and through genetic modification, this may benefit the researchers in getting a complied data regarding various methods through which they can induce myocardial infarction in animals.

The current status of anti-GPCR drugs against different cancers / 药物分析学报

G protein coupled receptors (GPCRs) have emerged as the most potential target for a number of drug discovery programs ranging from control of blood pressure, diabetes, cure for genetic diseases to treatment of cancer. A panel of different ligands including hormones, peptides, ions and small molecules is responsible for activation of these receptors. Molecular genetics has identified key GPCRs, whose mutations or altered expressions are linked with tumorgenicity. In this review, we discussed recent advances regarding the involvement of GPCRs in the development of cancers and approaches to manipulating the mechanism behind GPCRs involved tumor growth and metastasis to treat different types of human cancer. This review provides an insight into the current scenario of GPCR-targeted therapy, progress to date and the challenges in the development of anticancer drugs.

FANCA Gene in Pakistani Fanconi Anemia Patients: Screening of Mutations in Exon 28 and Exon 29

Objective: This kind of study was conducted first time in Pakistan. Its objective was to ascertain the associated clinical features and analyze the FANCA exon 28 and exon 29 mutations in Pakistani Fanconi anemia (FA) patients. Methods: A total of 38 patients with Fanconi anemia were recruited presenting in the Armed forces institute of pathology (AFIP) Rawalpindi Pakistan. They were enrolled in this study on the basis of comprehensive clinical evaluation and positive Diepoxybutane (DEB)/Mitomycin C Chromosomal breakage test. Genomic DNA was extracted from peripheral blood of patients and age and gender-matched controls. Mutation analysis of FANCA gene was done by conventional Polymerase chain reaction (PCR) and DNA sequencing. Various online tools and software were used for analysis of the obtained data and identification of the sequence alterations in FANCA gene in exon 28 and exon 29 of FA patients. Results and Discussion: The current study on screening of FANCA mutational analysis in exon 28 and exon 29 revealed four novel mutations. These include three missense variants (p.F876L, p.L883H, and p.K921I) in exon 28 and a novel homozygous frameshift variant (p.S947FfsX950) in exon 29. In addition two new intronic variants were also found in this set of patients. Conclusion: The sequence variants identified in this study in 10 (26.31%) FA patients in two out of forty-three FANCA gene exons (i.e., exon 28 and exon 29) strongly emphasize the importance of large-scale molecular studies on FANCA gene in Pakistani population.

To Study the Characteristic of Occlusion of Primary Dentition in Pre School Children-An Epidemiological Study

Background: Childhood is the mirror that reflects our future and habits that form part of our childhood are inculcated in our adulthood. Similarly the primary dentition lays down foundation stone for our permanent dentition and determines all the basic characteristics of permanent dentition. The objective of the study is to assess the occlusal characteristics of primary dentition in the age group of 3-5 years in school of Sriganganagar. All the basic parameters, terminal molar relationship, primary canine relationship, the degree of overbite and overjet (in millimeters) were considered in this study. Methods: The study was based on examination of the primary dentition of 600 preschool children aged 3-5 years old from Sriganganagar, India. The sample was selected from nursery school and the age of each child were obtained from school records. Healthy preschool children irrespective of socioeconomic status whose age was between 3-5 years were included in the study. Results: A total of 600 children who met the selection criteria were examined. In this sample size, 136 were of 3 year of age, 152 children were 4 year of age and 321 children were of 5 year of age respectively. Age wise distribution of primary molar relationship for Right side was 83.8% for flush terminal plan, 12.5 % was mesial step, 3.7 % distal step and on left side it was 84.6% for flush terminal plan, 11.8% was mesial step, 3.7% distal step and it was found to be significant however the age wise distribution of canine relationship, overbite and overjet was found to be insignificant. Conclusion: There is an increase in mesial step molar relationship with age, which is statistically highly significant. Distal step molar relationship was less prevalent and was not significant with age. However, the Class I canine relationship was the most prevalent type of deciduous canine relationship than the Class II canine relationship, though the changes in canine relationship with age were not statistically significant. In addition, the changes in overjet and overbite with age were not statistically significant. Also No case of anterior open bite (negative overlap) was observed. Probably larger scale of sample size may be required to assess the incidence of cases of negative overlap.

A comparative study of supraclavicular versus infraclavicular approach for central venous catheterization in neurosurgical patients

Background: Central venous cannulation is a commonly performed procedure in neurosurgical patients to maintain the hemodynamic stability in the intraoperative period. It is used for infusion of intravenous fluids, vasopressors central venous pressure monitoring and detection of air embolism. Subclavian vein is commonly performed as there are minimal effects of positioning on it. Supraclavicular approach to subclavian vein cannulation is not as frequently employed as the infraclavicular approach. The purpose of this study was to compare the supraclavicular approach versus the infraclavicular approach in terms of number of attempts, success rate of catheterization and complications associated with the procedure.Methods: About 150 patients undergoing various neurosurgical procedures were enrolled in the study. They were divided into two groups. 75 patients underwent right supraclavicular catheterization of subclavian vein while as 75 patients underwent right infraclavicular catheterisation of the subclavian vein. The number of attempts for cannulation, success or failure of catheterization and any complications associated with the procedure or in the postoperative period were noted in each group. The data was compared between the two groups by using Chi-square test and Student’s Independent Samples T-test.Results: The right supraclavicular vein was successfully cannulated in 90.66% while as the right infraclaviclar vein was successfully cannulated in 96% of the patients (p >0.05). Malpositioning of catheter (threaded in contralateral subclavian) was noted in 4 patients in Group S and ipsilateral internal jugular vein in 2 patients. Pneumothorax was encountered in 1 patient in the group S undergoing supraclavicular subclavian vein cannulations while as subclavian arterial puncture was seen in 4 patients who underwent infraclavicular arterial puncture.Conclusions: There was no difference in successive cannulations between right the supraclavicular and right infraclaviclar veins. The rate of complications between the two approaches was comparable.

A prospective randomized controlled trial comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation in neurosurgical patients

Background: Laryngoscopy is associated with a sympathetic response that results in a rapid increase in blood pressure and heart rate in these patients. The mechanisms underlying these hemodynamic changes are incompletely understood. They may be caused by a reflex sympathetic discharge due to stimulation of the upper respiratory tract. It has been observed that hemodynamic responses to tracheal intubation are associated with an increase in plasma catecholamine concentrations and are attenuated by β-adrenergic blockade. These hemodynamic changes may be undesirable particularly in neurosurgical patients. Aim of the study is the present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy and intubation in neurosurgical patients undergoing lumbar spine surgeries.Methods: A total of 60 patients of 18–65 years, American Society of Anaesthesiologists Class I/II of undergoing elective neurosurgical procedures were included in the study. The patients were divided into two groups of 30 patients each. Group D received dexmedetomidine and Group F received Fentanyl. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded preoperatively (baseline), at 5 and 8 minutes after infusion of study drug, before induction, 1 minute after induction, 2 minute after intubation, 5 minute after intubation, 10 minute after intubation  and 15 minute after intubation.Results: There was a better control of Heart rate, systolic blood pressure, diastolic blood pressure   and mean arterial pressure in Group D when compared to Group F during laryngoscopy and after intubation.Conclusions: The present study shows that dexmedetomidine suppresses hemodynamic responses effectively than fentanyl.