Development of the India COVID-19 vaccine tracker

COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Since then, efforts were initiated to develop safe and effective vaccines. Till date, 11 vaccines have been included in the WHO’s emergency use list. The emergence and spread of variant strains of SARS-CoV-2 has altered the disease transmission dynamics, thus creating a need for continuously monitoring the real-world effectiveness of various vaccines and assessing their overall impact on disease control. To achieve this goal, the Indian Council of Medical Research (ICMR) along with the Ministry of Health and Family Welfare, Government of India, took the lead to develop the India COVID-19 Vaccination Tracker by synergizing three different public health databases: National COVID-19 testing database, CoWIN vaccination database and the COVID-19 India portal. A Vaccine Data Analytics Committee (VDAC) was constituted to advise on various modalities of the proposed tracker. The VDAC reviewed the data related to COVID-19 testing, vaccination and patient outcomes available in the three databases and selected relevant data points for inclusion in the tracker, following which databases were integrated, using common identifiers, wherever feasible. Multiple data filters were applied to retrieve information of all individuals ?18 yr who died after the acquisition of COVID-19 infection with or without vaccination, irrespective of the time between vaccination and test positivity. Vaccine effectiveness (VE) against the reduction of mortality and hospitalizations was initially assessed. As compared to the hospitalization data, mortality reporting was found to be much better in terms of correctness and completeness. Therefore, hospitalization data were not considered for analysis and presentation in the vaccine tracker. The vaccine tracker thus depicts VE against mortality, calculated by a cohort approach using person-time analysis. Incidence of COVID-19 deaths among one- and two-dose vaccine recipients was compared with that among unvaccinated groups, to estimate the rate ratios (RRs). VE was estimated as 96.6 and 97.5 per cent, with one and two doses of the vaccines, respectively, during the period of reporting. The India COVID-19 Vaccination Tracker was officially launched on September 9, 2021. The high VE against mortality, as demonstrated by the tracker, has helped aid in allaying vaccine hesitancy, augmenting and maintaining the momentum of India’s COVID-19 vaccination drive

Ocular sequelae in severe COVID-19 recovered patients of second wave

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID?19 during the second wave of the pandemic in North India. Methods: In this observational cross?sectional study, 70 eyes of 35 patients who recovered from severe COVID?19 during the second wave underwent detailed ophthalmic evaluation 4–6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell?inner plexiform layer (GC?IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID?19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature

A Case Control Study of Risk Assessment of Diabetes and Nephropathy with eNOS (T786C and 27bp VNTR) Gene Polymorphisms

Objectives: To determine the association of eNOS (T786C and 27bp VNTR) gene polymorphism with the risk of type II diabetes mellitus and diabetic nephropathy in North India. Methods: The prospective case control study was conducted over a period of 18 months. A total of 100 patients of Type 2 Diabetes Mellitus (A1: 50 cases without Diabetic nephropathy-DN and 50 cases with DN) aged 18-75 years and 50 healthy adults as control (Group B) were included. The endothelial nitric oxide gene variant (T786C and 27bp VNTR) genotypes and alleles were studied. Odds ratio with 95% CI was calculated for genotype and alleles for the occurrence of diabetes and DN. p value of less than 0.05 was considered as significant. Results: With Bb as reference(27bp VNTR), the odds ratio for Ab in the three groups (A1,A2,B) was 2.243, 1.545 and 0.746 respectively; and for Aa was 3.043, 3.058 and 1.878 respectively; with TT as reference (T786C), it was 1.573, 1.55 and 1.055 respectively for TC; and for CC it was 2.121, 2.063 and 2.348 respectively. The OR was comparable among the study groups and control for all genotypes and alleles (p>0.05). Conclusion: In conclusion, there was a trend towards higher predilection of DN with aa genotype and a allele in 27 VNTR, CC genotype and C allele of -786T>C polymorphism however it was not found to be statistically significant. Future large sample studies are required to account for the ethnic variation for a clearer association of the genes and their associated risk with Diabetes and its complications.

Comparative Evaluation of Duration of Extraction Space Closure and Degree of Root Resorption with Conventional and Self-Ligation Brackets

Introduction: Determination of difference between conventional and passive self?ligating brackets (SLBs) in respect of extraction space closure, patient perception and root resorption. Material and Methods: Eighty patients were divided into four groups of 20 each with age?sex?matched control using a simple randomisation technique and allocation concealment with a closed opaque envelope method. Group 1 consisted of conventional brackets with Connecticut New Archwire (CNA) wire mushroom loop, group 2 consisted of conventional brackets with TAD (AbsoAnchor, Korea) supported retraction, group 3 consisted of passive SLB with CNA archwires (Libral Traders, India) mushroom loop and group 4 consisted of passive SLB brackets with TAD (AbsoAnchor, Korea) supported retraction. The rate of retraction, root resorption and patient satisfaction were assessed. All conventional brackets (Orthox, USA) and passive SLBs (CaptainOrtho, India) had 0.018 Roth prescriptions with a slot size of 0.018 × 0.025. Results: Retraction was the fastest in group 2 with a mean of 1.266 ± 0.14 mm/4 week and a duration of 23.40 weeks. Similarly, group 4 showed the most sluggish movement with a mean of 1.182 ± 0.80 mm/4 weeks with a total duration of 25 weeks; howeverdifferencesce among groups were not statistically significant (P = 0.470). Conclusion: SLBs have advantage of better patient comfort, less pain and reduced chairside time. Though the present study found increased treatment duration with SLB along with friction mechanics, refuting the previous claims of reduced friction with SLBs, however, the difference was not statistically significant and results have to be extrapolated with caution and experience considering other advantages of SLBs.

Inter-laboratory testing as a strategy for external quality assessment for qualitative detection of SARS-CoV-2 by real-time RT-PCR testing in India

To implement the strategy of test, track and treat to tackle the ongoing COVID-19 pandemic, the number of real-time RT-PCR–based testing laboratories was increased for diagnosis of SARS-CoV-2 in the country. To ensure reliability of the laboratory results, the Indian Council of Medical Research initiated external quality assessment (EQA) by deploying inter-laboratory quality control (ILQC) activity for these laboratories by nominating 34 quality control (QC) laboratories. This report presents the results of this activity for a period of September 2020 till November 2020. A total of 597 laboratories participated in this activity and 86 per cent of these scored ?90 per cent concordance with QC laboratories. This ILQC activity showcased India’s preparedness in quality diagnosis of SARS-CoV-2.

Effects of maxillary expansion on hearing and voice function in non-cleft lip palate and cleft lip palate patients with transverse maxillary deficiency: a multicentric randomized controlled trial / Efeitos da expansão maxilar na função auditiva e vocal em pacientes sem fissura labiopalatina e com fissura labiopalatina e deficiência maxilar transversa: um estudo controlado multicêntrico e randomizado

Abstract Introduction The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. Objective This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency Methods 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. Results Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0-T1, T1-T2, T0-T2, and T0-T3 observation periods (p < 0.05). The significant increase was observed in right middle ear volumes during the T0-T1, T0-T2 and T0-T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p < 0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods. Conclusion Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.

Resumo Introdução A associação entre o tratamento da deficiência maxilar transversa e a recuperação das funções auditivas e vocais ganhou atenção nos últimos anos. Objetivo Avaliar os efeitos da expansão rápida da maxila na função auditiva e vocal em crianças sem fissura labiopalatina e com fissura labiopalatina bilateral com deficiência maxilar transversa. Método Foram recrutados para este estudo 53 pacientes (26 sem fissura e 27 com fissura labiopalatina bilateral; média de 11,1 ± 1,8 anos) que necessitam de expansão rápida da maxila para correção de arcos maxilares estreitos. Oito subgrupos foram estabelecidos com base no grau de perda auditiva. Registros audiométricos e timpanométricos de tons puros foram obtidos para cada indivíduo em quatro períodos. Os primeiros registros foram obtidos antes da expansão rápida da maxila (T0), o segundo após a expansão (T1) (média de 0,8 meses), o terceiro após três meses (T2) (média de 3 meses) e o quarto no fim do período de retenção (T3) (média de 6 meses). Anova e o teste post-hoc de Tukey HSD foram usados para análise dos dados. Além disso, a análise da voz foi feita com um programa PRAAT atualizado em um laboratório de fala computadorizadaem T0 e T2. Foi usado um teste t de amostras pareadas para comparação dos valores médios dos parâmetros de voz em T0 e T2 nos dois grupos. Resultados O tratamento com expansão rápida da maxila produziu um aumento significativo nos níveis auditivos e nos volumes da orelha média de todos os pacientes sem fissura e pacientes com fissura labiopalatina bilateral e níveis auditivos normais e com perda auditiva condutiva leve, durante os períodos de observação T0-T1, T1-T2, T0-T2 e T0-T3 (p < 0,05). Aumento significativo foi observado nos volumes da orelha média direita durante os períodos T0-T1, T0-T2 e T0-T3 em pacientes sem fissura e com perda auditiva moderada. Para a análise de voz, diferenças significantes foram observadas apenas entre a frequência fundamental média T0 e T2 (F0) e a porcentagem de jitter (p < 0,05) no grupo sem fissura. No grupo com fissura, não foram observadas diferenças significantes para nenhum parâmetro de voz entre os períodos T0 e T2. Conclusão A correção da anatomia palatal pela expansão rápida da maxila tem um efeito benéfico tanto na melhoria da audição quanto na função normal da orelha média em pacientes sem fissura e com fissura labiopalatina bilateral. Da mesma forma, a expansão rápida da maxila influencia significativamente a qualidade da voz em pacientes sem fissura, sem efeito significativo em pacientes com fissura labiopalatina bilateral.

Winged nance palatal arch An adjunct to tooth movement

Anchorage control during the correction of severely crowded dentitions has always been a source of concern during orthodontic therapy. The Nance palatal arch (NPA) has, in the past, been widely used for reinforcing anchorage in such cases. Modifications of the NPA have been reported for use as a fixed functional appliance or for molar distalization. Herein, a simple, effective modification of the conventional NPA is introduced incorporating two power arms, which can be used for unravelling of anterior crowding at the same time effectively augmenting molar anchorage.

Endodontic–orthodontic Interrelationships: A Clinician’s Guide

The multidisciplinary approach to the management of clinical situations holds the utmost importance for the success of dental treatment. Endodontic involvement of cases undergoing orthodontic treatment is not uncommon. Similarly, orthodontic treatment of already endodontically treated teeth also poses challenges to the clinicians. This article discusses in brief such endodontic–orthodontic interrelationships and the guidelines for managing complex cases where both these streams of dentistry are involved.

Comparative Evaluation of Fluoride Release From Two Different Glass Ionomer Cement and a Novel Alkasite Restorative Material - An in Vitro Study

Abstract Objective: To compare the fluoride release from Conventional Glass Ionomer Cement (GIC), Resin Modified GIC (RMGIC), and Cention N Alkasite Material. Material and Methods: Forty- five disc-shaped specimens of three different restorative materials (Conventional GIC, RMGIC, and Alkasite material) were made and divided into 3 groups (n=15). Fluoride release was evaluated at the end of Day 1, 7, 14, and Day 28 using fluoride ion-selective electrode. Intergroup and Intra-group analysis was done using One-way ANOVA with a Post-hoc test. A p-value of <0.05 was considered statistically significant. Results: Cention showed more fluoride release (in parts per million) than GIC and RMGIC at increased time duration. However, at the end of day 1, there was lesser fluoride release with Cention, as compared with the other groups. Conclusion: The new Alkasite restorative material showed promising results in terms of fluoride release and is better than GIC and RMGIC at increased time duration.

Dynamics of Selected Trace Minerals during Estrus Induction in Anestrus Sahiwal Cattle

The present study evaluated the effect of circulatory trace mineral profiles on fertility response during estrus induction by progesterone based therapy in acyclic Sahiwal cattle. Sahiwal cows and post-pubertal heifers (n=25 each) with true anestrus condition (acyclicity confirmed ultrasonographically) were subjected to CIDR-based protocol (intravaginal CIDR application for 7 days, 500 IU eCG at CIDR removal, followed by estrus observation and AI). In heifers, additionally an injection of 5.0 mg estradiol valerate at CIDR insertion was given. Blood samples on days 0 (before CIDR application), 3, 5, 7 and 9 were collected. Almost similar estrus induction (68% vs. 64%) and subsequent conception rates (41.2% vs. 50%) during the first induced estrus were recorded in cows and heifers, respectively. During the course of treatment, significant (P<0.05) variation in plasma copper and zinc concentrations was recorded both in cows and heifers. Contrarily, manganese concentrations varied significantly (P<0.05) in cows only. However, iron profiles remained uniform during the course of treatment. Significantly (P<0.05) higher pre-treatment plasma concentrations of copper, zinc and manganese was recorded in those cows and heifers in which estrus was induced, compared to those in which estrus induction failed to occur. No significant difference (P>0.05) was recorded for iron concentration vis-à-vis estrus induction response. Hence, it is indicated that circulatory copper, zinc and manganese profiles influence the reproductives energy in acyclic animals and their suboptimal profiles may reduce the efficacy of estrus induction protocols in Sahiwal cattle.

Fatigue and diabetes mellitus: a prospective study

Background: Fatigue is a common complaint among patients with diabetes mellitus (DM) that can undermine the daily functional activities of a person. The objectives of the study were to assess the fatigue in patients of newly diagnosed type 2 DM and to relate fatigue with blood glucose parameters (BGP) and glycemic control.Methods: A total 50 patients of type 2 DM, diagnosed as per American Diabetes Association 2011 criteria, were enrolled in the study group. Each subject was evaluated two times for fatigue using Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) scale. 1st assessment was at the time of enrollment and 2nd was done after achieving target control of type 2 DM. Values of Fasting blood glucose (FBG), postprandial blood glucose (PPBG), blood glucose variability (BGV) and glycosylated hemoglobin (HbA1c) were obtained for each subject at each assessment. Data collected was analyzed statistically.Results: Mean age of study group was 50.7±8.9 years with male to female ratio of 1.17:1. Mean values of MFSI-SF score at 1st and 2nd assessment were 14.10±17.97 and 4.64±14.06, respectively indicating a statistically significant improvement in fatigue (p<0.05) after achieving target control. Overall fatigue, general fatigue, emotional fatigue, and vigor score correlated significantly with glycemic control (HbA1c) with correlation coefficient (r) of 0.337, 0.351, 0 .339, and - 0.281, respectively (all p <0.05).Conclusions: Fatigue had a positive correlation with FBG, PPBG and BGV and HbA1c. A significant improvement in all the parameters of fatigue was noted after control of diabetic status.

Ketamine use in Refractory Depression and Neuropathic Pain - A Case Report

Introduction: Depression is a common psychiatric illness inthe elderly. It often co-exists with chronic neuropathic pain inold age group.Case report: We present a case report of an elderly patientwho was successfully treated with subanaesthetic intravenousinfusion for severe depression with suicidal intention andchronic neuropathic pain.Conclusion: Ketamine has been reported to be used indepression with suicidal features as well as refractory pain.Depression is a common psychiatric problem across the agegroups. It occurs due to neurochemical imbalance in the brainnamely dopamine, norepinephrine serotonin.

A Comparative Study of Fistulectomy Versus Fistulotomy with Marsupialisation for the Treatment of Low Fistula-In- Ano

Background: A fistula in ano is a pathway, lined by granulation tissue that joins deeply in the anal canal or rectum and superficially on the skin around the anus. A fistulectomy involves complete excision of the fistulous tract. Low anal fistulae have been mainly treated by fistulotomy with good results. However, Marsupialization of the fistulotomy wounds can reduce the healing time further. The purpose of this study was a randomized controlled trial that aimed to compare the fistulectomy to the fistulotomy with marsupialization in the management of simple anal fistula. Methods: This was an analytical type of study which was conducted at departments of surgery of TMMC & RC, Moradabad from September 2017 to September 2018. The patients included in the study were randomly divided into two groups. Group I included seventy patients (70) underwent for fistulectomy and group II consisted seventy patients (70) underwent for fistulotomy with marsupialisation. Results: The healing time was longer in group I (37.6 ± 11.9 day) in comparison to group II (29.8 ± 13.6 days) with a statistically significant p value (<0.05). The length hospital stay for both groups was 4.6 ± 1.4 days. Whereas, length hospital stay individually for group I and group II were 4.4 ± 1.1 days and 4.8 ± 1.7 days correspondingly with an insignificant p value (>0.05). There were significantly less postoperative pain as well as blood loss in group II patients of fistulotomy with marsupialisation in comparison of group I patients of fistulectomy. There was an insignificant difference in the extents of adverse effects of surgery on various aspects of group I and group II. Conclusion: Results of the present study suggested that there was a shorter duration of wound healing as well as less blood loss in patients of fistulotomy with marsupialisation in comparison of patients of fistulectomy. Therefore, fistulotomy with marsupialisation is recommended as a standard surgical procedure in the surgical treatment of low fistula-in-ano. However, studies on larger population and longer period of follow-up are warranted to establish fistulotomy with marsupialisation as standard surgical procedure for the treatment of low fistula-in-ano.

Interdisciplinary management of an impacted dilacerated maxillary central incisor

ABSTRACT Introduction: Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown and root, or in the root. Although not so common, impacted maxillary incisors exhibiting root dilaceration pose a diagnostic and treatment challenge to the clinician. Description: This case report describes the management of a horizontally impacted and dilacerated maxillary central incisor in a 12-year-old girl. Cone-beam computed tomographic scans were used to accurately localize the position of the dilacerated tooth, and to assess the extent of root formation and degree of dilaceration present in the root. Treatment included surgical exposure and orthodontic traction, followed by root canal treatment and apicoectomy. Results: Through a meticulously planned interdisciplinary approach, the impacted dilacerated central incisor was properly aligned and demonstrated good stability after the long-term follow-up. Conclusion: Taking into consideration the concerns and expectations of the patient, communicative feedback between the oral surgeon, orthodontist and endodontist helped achieving successful esthetic, structural and functional outcome in the present case.

RESUMO Introdução: as dilacerações dentárias são anomalias caracterizadas por desvio acentuado no eixo longitudinal de um dente. Elas podem ocorrer na coroa, entre a coroa e a raiz, ou na raiz. Apesar de não serem muito comuns, os incisivos superiores impactados apresentando dilaceração radicular representam um desafio para o clínico, quanto ao diagnóstico e tratamento. Descrição: o presente relato de caso descreve o tratamento de um incisivo central superior impactado horizontalmente e com dilaceração, em uma menina com 12 anos de idade. Tomografias computadorizadas de feixe cônico foram utilizadas para localizar com precisão a posição do dente dilacerado e avaliar o grau de formação e de dilaceração da raiz. O tratamento incluiu exposição cirúrgica e tração ortodôntica, seguida de tratamento do canal radicular e apicectomia. Resultados: por meio de uma abordagem interdisciplinar meticulosamente planejada, o incisivo central impactado com dilaceração foi devidamente alinhado e demonstrou boa estabilidade em acompanhamento de longo prazo. Conclusão: levando-se em consideração as preocupações e expectativas da paciente, a comunicação interativa adotada entre o cirurgião oral, ortodontista e o endodontista ajudou na obtenção de resultados estéticos, estruturais e funcionais satisfatórios no presente caso.

The use of evidence-based practices for the management of shoulder impingement syndrome among Indian physical therapists: a cross-sectional survey

ABSTRACT Background: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS). Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75%) believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2%) and dyskinesis, especially in women (24.2%). Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.

Our experience of management of sub trochanteric fractures of femur by proximal femoral nail.

Background: Sub trochanteric fractures of the femur remain some of the most challenging fractures. Most of the fractures result from trivial fall in the elderly; while in the younger age group, it's mainly due to road traffic accidents. Operative management is the preferred treatment. This study is intended to assess the outcome of the intramedullary fixation of sub trochanteric fractures with Proximal Femoral Nail (PFN). Methods: This study is a prospective, uncontrolled study of 40 cases of sub trochanteric fracture of femur admitted to a tertiary level hospital between August 2011 and November 2013; and treated with proximal femoral nails. Adults with recent sub trochanteric fracture of femur were included in this study; while patients less than eighteen years of age, pathologic fractures, periprosthetic fractures, and old neglected fractures were excluded from the study. Results: In our study of 40 cases, there were 28 male and 12 female patients with mean age of 51.43 years (range 22-87 years). Based on Seinsheimer’s classification, type IIIA fractures accounted for majority (32.5%) of the cases. majority of patients, i.e. 35% (n=14) showed union at 20 weeks after surgery. Cases were followed up and assessed according to the Harris hip scoring system (Modified). The outcome was good to excellent in 82.9% cases. Conclusions: From our study we conclude that PFN is a reliable minimally invasive implant for sub trochanteric fractures, with good to excellent functional outcome in the majority of cases.

Screening of bone mineral density by densitometer and correlation with serum calcium and vitamin D levels to detect early osteoporotic changes in postmenopausal women in slum areas of Raipur and Kalupur of Ahmedabad.

Background: Osteoporosis is a rising health difficulty, which is renowned in both developed and developing countries. It is linked with considerable morbidity and socio-economic burden worldwide. Various factors are responsible for osteoporosis such as race, family history, body weight, estrogen deficiency (menopause), low calcium intake, and many others. The present study was aimed to early prediction and evaluates the prevalence of osteoporosis in postmenopausal women of slum area of Ahmedabad (Raipur and Kalupur). Methods: The prospective, single-center study included 230 postmenopausal women. Baseline demographic characteristics were recorded using standard pre-designed case record form. Eligible patients according to inclusion and exclusion criteria were underwent for dual-energy X-ray absorptiometry (DEXA) scan to measure bone mass density at the lumbar spine, femoral neck, and hip bone. Laboratory investigations such as serum calcium and serum vitamin D were performed according to standard procedure. Prediction for early detection of osteopenia and osteoporosis was evaluated based on T-score (DEXA scan). Results: The overall prevalence of osteopenia and osteoporosis were found 28.69% and 44.34%, respectively. Prevalence of osteoporosis was found higher (50.72%) in study population belongs to age between 51 and 60 years, whereas the prevalence of osteopenia was higher (38.53%) in age group (41-50). In further, normal body mass index was associated with the higher prevalence of osteopenia and osteoporosis. The calcium deficiency, vitamin D deficiency, family history of osteoporosis were found major risk factor associated with osteopenia and osteoporosis (p<0.05). T-score was much lower at femoral neck site (−3.29±0.47) and lumbar spine site (−3.15±0.50) when compared with hip bone (−2.40±0.68). Conclusions: The present study found moderately higher prevalence of osteopenia and osteoporosis among the postmenopausal women from slum area of Ahmedabad. Results revealed that the early measurement of bone mineral density will not only help for early detection, but it will also help for the prevention of osteoporosis.

Effect of dual task activity on reaction time in males and females.

The present study was designed to compare the auditory and visual reaction time on an Audiovisual Reaction Time Machine with the concomitant use of mobile phones in 52 women and 30 men in the age group of 18- 40 years. Males showed significantly (p<0.05) shorter reaction times, both auditory and visual, than females both during single task and multi task performance. But the percentage increase from their respective baseline auditory reaction times, was more in men than women during multitasking, in hand held (24.38% & 18.70% respectively) and hands free modes (36.40% & 18.40% respectively) of the use of cell phone. VRT increased non significantly during multitasking in both the groups. However, the multitasking per se has detrimental effect on the reaction times in both the groups studied. Hence, it should best be avoided in crucial and high attention demanding tasks like driving.

Palatogingival Groove - Cause of Root - Canal Failure - A Case Report.

Morphological defects occurring in dental structure can be sometimes predisposing factors for the onset of inflammatory processes in the periodontal and/or pulpal tissues. Palatogingival groove is one such defect, most frequently found on the lingual surface of maxillary laterals. They are easily overlooked as aetiologic factors, as these grooves are covered by periodontal tissues. This case report discusses successful management of a root-canal treated maxillary lateral incisor with an associated radicular lingual groove having persisting inflammatory condition. The management included a combination of endodontic therapy and periodontal regenerative techniques.

Use of hair root sheath for barr body determination.

Determination of sex is useful in Forensic Medicine. Barr bodies can be seen hair root sheath cells. The presence of barr bodies indicates that sex of the person is female. They are inactive X chromosome. The Barr bodies are also known as sex chromatin. Hair can present in the crime scene. Hair is trace evidence. The stain used was aceto-orcein. The percentage of barr bodies was found to be 28-49 %. The study was carried out for eight months and it was found that barr bodies persisted for eight months. It can be present anywhere at the crime scene. Hair of the accused can be present in hands of victim due to cadaveric spasm. Hair of victim can be found on the clothes of the accused. There is average fall in percentage of barr bodies with the passage of time due to the start of decomposition changes in the root sheath cells.