Study of bone turnover markers, procollagen type 1 N-terminal propeptide and osteocalcin in healthy and type 2 diabetes mellitus postmenopausal women

Background: Individuals with diabetes mellitus are at increased risk of metabolic bone disease due to decrease in bone strength and quality. Several bone turnover markers like serum procollagen type I N propeptide (P1NP) and serum osteocalcin are powerful tools for studying osteoporosis and fracture risk across population to provide diagnostic and prognostic information of bone health. The aim of this study was to recognize possible correlation of levels of serum P1NP and osteocalcin in type-2 diabetic (T2DM) postmenopausal women as compared to healthy postmenopausal women.Methods: The study included 100 proven cases of type-2 diabetic postmenopausal women with age matched healthy postmenopausal women as controls. P1NP, osteocalcin, and other relevant parameters were measured. Differences between diabetics and controls were analyzed.Results: The body mass index was higher in diabetic group as compared to controls. The HbA1c% was (6.94±1.43) in diabetic group and (5.57±1.21) in non-diabetics. Low serum level of 25 (OH) D was observed both in diabetic and non-diabetic groups but significantly lower in T2DM. Procollagen type 1 N propeptide was lower in diabetic group (37.59±17.20 ng/mL) as compared to non-diabetic (52.14±24.82 ng/mL). Osteocalcin was lower (15.64±8.06 ng/ml) as compared to non-diabetic group (21.85±9.12 ng/ml). Lower osteocalcin and P1NP levels found in this study suggests slower bone metabolism with reduced bone formation in postmenopausal diabetics.Conclusions: Serum procollagen type 1 N propeptide and osteocalcin in postmenopausal diabetic women were lower as compared to non-diabetic group.

Dengue Encephalitis - A Diagnostic Dilemma

Introduction: Dengue is most important arthropod-borneviral disease worldwide, with approximately 390 millioninfection occurung per year, of which approximately 96 milliocause sign of disease. Dengue virus is single stranded RNAvirus belonging to flaviviridae family having four serotypes.Case report: We are thus reporting a case of Dengue feverwhich presented as encephalitis. Very few cases of dengueencephalitis has been reported worldwide and the literatureavailable on the illness is limited.Conclusion: Dengue is classically thought to be a nonneurotropic virus. Most common dengue serotype causingneurological complication are DEN 2 and DEN 3. Neurologicalcomplication are rare in dengue.

Prevalence of Developmental Anomalies of Teeth in a Group of Indian Children A Cross Sectional.

Introduction: Developmental anomalies of the tooth areroutinely encountered by paediatric dental professionalsand may present with esthetic and or functional problems.The reported literature has shown a wide variation in theprevalence of these conditions across the globe. Study aimedto assess the prevalence of various developmental anomaliesof tooth in a sample of Indian paediatric populationMaterial and Methods: A total of 3000 children in the agegroup of 6 to 13 years visiting the OPD of pedodontics andpreventive dentistry of BIDSH, Patna were examined clinicalyand radiologicaly when required and the data was tabulated.Descriptive statistics methods were used using SPSS.Results: Prevalence of dental anomalies was 4.86%.in thestudy population and Enamel hypoplasia, hypodontia andtalon's cusp were the most frequently encountered anomalies.The presence of developmental anomalies was a statisticalysignificant finding.Conclusion: Early detection of developmental anomaliesmay prevent future complications and eliminate the need forcomplex therapeutic intervention.

Awareness Regarding Practices Related to Infection Control among Dental Students in Patna City

Introduction: Cross infection control practice is essential toprotect both the patient and the dentist from blood and salivaborne infectious agents, including hepatitis B, C and HIV bydirect contact with contaminated instruments, fabrics and alsoby aerosols. Study aimed to assess the awareness regardingpractices related to infection control among dental student inPatna city.Material and Methods: This was a cross sectional studywhich was carried out in one of the dental teaching institutionsin Patna City. The subjects comprised of 180 dental students.The study subjects were third year; final year and Internstudents which were selected using convenience samplingtechnique. Their knowledge pertaining to infection controlpractices were assessed using a pretested self administeredquestionnaire. The questionnaire collected information onsocio demographic characteristics, and knowledge regardinginfection control practices. Data were analyzed using SPSSsoftware v20. Frequency distribution analysis and Chi sq testswere performed. p value<0.05 was considered statisticallysignificant.Results: The dental student had adequate knowledgeregarding personal protective measures and cross infectioncontrol but improvement was needed in areas of biomedicalwaste handling and disposal.Conclusion: A dental surgeon must take adequate protectionto prevent spread of harmful disease to self and other patients.Consequently inter-appointment disinfection of clinic surfacesis required to reduce the cross infection hazard.

Comparative Study of 3 Dimensional and Standard Miniplate in Management of Anterior Mandibular Fractures

Introduction: The aim of mandibular fracture treatment isto restore the pre-injury anatomic form and function, withparticular care to establish the occlusion. Of the varioustreatment modalities available, Champys miniplate fixation hasbecome the most widely used technique. The 3-dimensional(3D) plating for mandibular fracture treatment is relativelynew. This study was conducted to compare efficacy, stabilityand rigidity of 3-dimensional plates with that of 2mm titaniumminiplates in the surgical management of anterior mandibularfractures.Material and Methods: The study was conducted on 70patients with anterior mandbibular fractures (Symphysis andParasymphysis region). Patients were randomly divided intotwo groups, Group I (n=35) in which the patients underwentfixation by miniplates (2 nos) while in Group II (n=35), 3Dplates were used for fixation. The patients preoperative, intraoperative and post-operative clinical and radiological findingswere recorded in a proforma and were subjected to statisticalanalysis. Fisher’s Exact Test was used to compare the dataobtained from group I and group II patients.Results: Out of 70 patients, 77.14% corresponded to the agegroup of 15-30 years and 82.85% were males. Road trafficaccident (80) % was the leading cause of fracture. The timerequired to adapt and fix the miniplates was slightly more than3-D plates and results were statistically significant. Skeletaland occlusal stability was maintained in both group.Conclusion: There is no major difference in terms of treatmentoutcome in both systems, and both are equally effective inmandibular fracture treatment.

Histopathological spectrum of salivary gland lesions in Ajmer region, Rajasthan, India

Background: There is a wide spectrum of salivary gland lesions with morphological and clinical diversity which makes it a difficult task for histopathological interpretation. Tumours of salivary glands are uncommon accounting for 3-10% of the total tumors of head and neck region and less than one percent of all tumours. The aim of this study was to recognize various histomorphological patterns of salivary gland lesions, their frequency, age, gender and site wise distribution.Methods: This study was carried out from June 2015 to May 2018 in the department of Pathology, JLN Medical College and associated Group of Hospitals, Ajmer. Total 121 cases of salivary gland lesions were included. Specimens were processed and stained by Hematoxylin and Eosin stain followed by histopathological examination.Results: Out of total 121 cases, 43.8% were non-neoplastic and 56.2% were neoplastic. In non-neoplastic lesions predominant was chronic sialadenitis (50.9%) followed by mucocele (28.3%) which commonly seen in submandibular gland (47.17%). Among neoplastic cases, 79.4% were benign and 20.6% were malignant lesions. Neoplastic lesions commonly were seen in parotid (75%). Pleomorphic adenoma was the commonest benign tumour (81.4%). Mucoepidermoid carcinoma was the most common malignant salivary tumour. Benign tumours were common in third and fourth decades, whereas malignant tumours were more common in fifth and sixth decades. Male predominance was seen in overall salivary gland lesions.Conclusions: Histopathological examination is mandatory in the diagnosis of salivary gland lesions because of their wide spectrum of histomorphology.

Assessment of Tooth Movement with Piezocision and Its Periodontal Transversal Effects in Class II Malocclusion Patients: A Clinical Study

Background: There are considerable amount of population suffering from malocclusion. An increasing number of patients are demanding orthodontic treatment for improved esthetics and a better mastication system. The present study was conducted to assess tooth movement with piezocision and its periodontal transversal effects in class II malocclusion patients. Methods: The present study was conducted in the department of Orthodontics. It comprised of 120 patients with class II malocclusion. Before canine distalization and after the alignment and leveling phases, piezocision was performed on experimental side (Group I). Tooth mobility and gingival index was assessed on both sides. Results: In group I, there was 3.56± 1. 4 months and in group II there was 5.61± 1.2 months for distalization. There was 1.54± 1.3 mm and 0.80± 1.1 mm distalization in group I and group II. The difference was significant (P< 0.05). The mobility score was 1.2 and 1.4 before and after distalization in group I and 1.3 and 1.5 before and after distalization in group II. The difference was non- significant. Gingival index score was 1.4 and 1.3 before and after distalization in group I and 1.5 and 1.6 before and after distalization in group II. The difference was non- significant (P> 0.05). Conclusion: Piezocision-assisted distalization accelerates tooth movement, decreases the anchorage loss for posterior teeth, and does not induce any maxillary transversal change. This technique does not have any adverse effects on periodontal health.

A Prospective Randomized Study Comparing the Effects of Intravenous Bolus Doses of Ephedrine and Phenylephrine for the Maintenance of Blood Pressure in Caesarean Section Under Spinal Anaesthesia.

Background: In most of the obstetric patients undergoing caesarean section, spinal anaesthesia is the most accepted approach. It provides a rapid, intense, definite and better sensory and motor blockade. In spite of this, eighty per cent of patients experience hypotension after spinal anaesthesia. The use of vasopressors (Phenylephrine and Ephedrine) is the mainstay of treatment for hypotension. Methods: This is a prospective, randomized and comparative study conducted on 100 obstetric patients undergoing caesarean section in spinal anaesthesia. The patients were divided into two groups (group P and group E) each containing 50 members. When hypotension occurred in patients undergoing surgery, group P was given 40mcg of phenylephrine and group E received 6 mg bolus dose intravenously. The comparison in between the two groups was done by using Student’s t test. Results: Phenylephrine has proved to be better in raising as well as maintaining the arterial pressure after the block as compared to ephedrine. The administration of phenylephrine showed reduction in heart rate. Neonatal APGAR scores were comparable in both Phenylephrine and Ephedrine groups. Conclusion: Intravenous phenylephrine plays a major role in controlling the post-spinal anaesthesia hypotension, without jeopardizing the maternal physiology and foetal outcomes.

Surgical Correction of Asymmetric Mandibular Prognathism with Modifi ed Bilateral Sagittal Split Osteotomy Technique: A Clinical Study.

Introduction: An asymmetrical face consists of multitude of the minor asymmetrical component, the mandibular component being most common. The asymmetric mandibular prognathism (AMP) is one of the most common forms of asymmetry caused by genetic and epigenetic factors and environmental condition such as trauma, functional deviations due to dental interference. The present study was undertaken to assess the effi cacy of a modifi ed bilateral sagittal split osteotomy (BSSO) technique in correction of AMP. Purpose: The purpose of the study was to investigate the skeletal stability and changes of proximal segments position postoperatively following surgical correction of AMP with modifi ed BSSO technique and analyze the effect of such changes on the incidence of signs and symptoms of temporomandibular joint (TMJ) disorders. Materials and Methods: Patients with AMP were included in the study. All the patients underwent surgical correction by modifi ed BSSO technique. The patient clinical and cephalometric fi ndings (pre-operative, immediate post-operative, and 6 months postoperatively) were recorded in a proforma and subjected to statistical analysis. Results: A total of six (n = 6) participated in the study. Five out six patients had pre-existing TMJ problems. In lateral cephalogram, the mean mandibular setback of Point B was 7.75 mm. In frontal cephalogram, the mean mandibular deviation decreased 2.55 mm after surgery. Minimal relapse was noted 6 months post-operatively suggestive of good skeletal stability with minimal complications. Conclusions: The modifi ed BSSO technique was effective in the treatment of AMP.

Identification, synthesis and characterization of an unknown process related impurity in eslicarbazepine acetate active pharmaceutical ingredient by LC/ESI-IT/MS, 1H, 13C and 1H-1H COSY NMR / 药物分析学报

A new impurity was detected during high performance liquid chromatographic (HPLC) analysis of eslicarbazepine acetate active pharmaceutical ingredient. The structure of unknown impurity was postulated based on liquid chromatography mass spectrometry using electrospray ionization and ion trap analyzer (LC/ESI-IT/MS) analysis. Proposed structure of impurity was unambiguously confirmed by synthesis followed by characterization using 1H, 13C nuclear magnetic resonance spectrometry (NMR), 1H-1H correlation spectro-scopy (COSY) and infrared spectroscopy (IR). Based on the spectroscopic and spectrometric data, unknown impurity was characterized as 5-carbamoyl-10,11-dihydro-5H-dibenzo[b,f]azepin-10-yl propionate.

Pseudomembranous Colitis: Do We Need A Screening.

In the last few decades, increasing use of antibiotics has dramatically increased incidences of antibiotic associated diarrhea. An unopposed homing of Clostridium difficile in ICU and wards put forward new challenges for physicians. Development of diarrhea during or just after hospital stay especially in old patients is a typical clinical presentation of C. difficile diarrhea. Cytotoxin assay from tissue culture is a gold standard diagnostic test but its poor availability, high cost, time bound results and rapidly development of life-threatening complications made us to think of a screening test. Demonstration of pathognomonic summit lesions and pseudomembrane with colonoscopy or sigmoidoscopy is relatively inexpensive, easily available and diagnosis is prompt. Our experience in few patients with colonoscopy makes us to recommend it as a screening test for all clinically suspected patients. Till today, it is refuted as first-line investigation because of good number of false negative results but demonstration of pathognomonic lesions even in few patients saves the life with minimal expenditure and least time wastage before initiation of definitive treatment.

Pharmacognostic evaluation of Nyctanthes arbortristis bark

Objective: To study detailed Pharmacognosy of the bark of Nyctanthes arbortristis Linn (Oleaceae), an important plant in Indian system of medicine. Methods: the macroscopy, microscopy, physicochemical analysis, preliminary phytochemical testing of powder of the plant bark and other WHO recommended methods for the standardization was done. Results: Trunk bark consists of two distinct regions i.e. outer bark and inner bark. Outer bark consists of broad periderm of a wide phellem and inner phelloderm regions. Inner bark is broader than the outer part and it includes all the secondary phloem tissues. It can be distinguished into 2 zones viz. collapsed secondary phloem and non-collapsed secondary phloem regions. Collapsed secondary phloem region consist of thick blocks of phloem sclereids and radially oblique dark streaks of crushed sieve tubes and dilated axial parenchyma cells. Non-collapsed secondary phloem region is the conducting part of the phloem where the sieve elements are intact. It consists of intact sieve tube members, companion cells, axial parenchyma cells and narrow undilated ray. Calcium oxalate crystals are abundant in collapsed phloem region. Conclusions: it can be concluded that the pharmacognostic profile of N. arbortristis bark is helpful in developing standards for quality, purity and sample identification.

Fatal Delftia acidovorans infection in an immunocompetent patient with empyema

Delftia acidovorans (earlier known as Comamonas acidovorans) is an aerobic, non-fermentative, Gram negative rod, classified in the Pseudomonas rRNA homology Group III. Reports of isolation of the organism from serious infections like central venous catheter associated bacteremia, corneal ulcers, otitis media exist. The microbiologists can identify this organism based on an orange indole reaction. This reaction demonstrates the organism's ability to produce anthranilic acid from tryptophan on addition of Kovac's reagent; which gives the media its characteristic“pumpkin orange” colour. Here we report the isolation of this organism from the Endotracheal tube aspirate of a 4 year old child. With the increasing use of invasive devices, it has become important to recognize these non fermentative gram negative bacilli as emerging source of infection even in immunocompetent individuals.

Chloroquine delivery to erythrocytes in Plasmodium berghei-infected mice using antibody-bearing liposomes as drug vehicles.

Suitability of anti-erythrocyte F(ab')2-bearing liposomes as vehicles for chloroquine in the treatment of chloroquine resistant Plasmodium berghei infections in mice has been examined. Free chloroquine or chloroquine encapsulated in antibody-free liposomes failed to show much effect on the resistant infections, but the same doses of this drug after being encapsulated in antibody-bearing liposomes exhibited a significant inhibitory effect on this infection. These results indicate that chloroquine delivery in antibody targeted liposomes may help in the successful treatment of the chloroquine resistant malarial infections.