“Oxygen Pheriwala: ” An Innovative Model for SARS-CoV-2 Screening in Resource-Limited Settings

The second wave of SARS?CoV?2 infection came as a hypoxic emergency and situation became worse in rural India, where undiagnosed COVID-19 patients died without any diagnosis or intervention. The primary aim of this innovative model was the early diagnosis of suspected SARS?CoV?2 cases, providing empirical treatment and timely referral to appropriate COVID care facilities. Fever was measured with infrared thermometer and oxygen saturation level with pulse oximeter. A total of 8203 people were screened, of which 274 persons were febrile and 69 (25%) were hypoxic too. Sixty?four out of 69 (93%) patients turned COVID?19 positive on reverse transcription?polymerase chain reaction. At the end of 3 weeks, 48/64 (75%) patients were successfully discharged. This model can be easily implemented in resource?limited regions to identify and prioritize the patients not only in this pandemic but also in outbreak of other communicable diseases.

Hydrocephalus, Ankylosis and Brachygnathism in an Non-descript Indigenous Calf: A Case Report

The present finding of a case reports revealed successful management of per-vaginal delivery of an indigenous male calf with multiple congenital anomalies like hydrocephalus, ankylosis and brachygnathism.

Antibacterial efficacy of Carica papaya leaf extract, probiotics, kidodent, and placebo mouthwashes in reduction of salivary Streptococcus mutans A double-blinded parallel designed randomized controlled trial

Aim: To compare the antibacterial efficacy of Kidodent, Probiotics, and Carica papaya Leaf extract mouthwashes in reducing Streptococcus mutans count in 8–12 years' old school children. Methodology: Sixty children of age group of 8–12 years were nominated and grouped as Group A (Kidodent mouthwash), Group B (probiotics mouthwash) Group C (C. papaya leaf extract mouthwash), and Group D (distilled water placebo). Probiotics sachets (Prebact) of about 1 g were diluted in 10 ml of water and given as mouthwash. C. papaya leaf extract was obtained by Soxhlet extraction using ethanol as a solvent. Participants were asked to rinse with mouthwashes for 30 s once daily for up to 15 days. Saliva samples were collected and inoculated using Salivarius Mitis and Agar Agar Type I at 38°C for 24 h and incubated, later colony-forming units per milliliter were determined by serial dilution and calculated using colony counter manually. Statistical Analysis: Data were statistically analyzed using the one-way ANOVA and t-test using the SPSS V.20 software. Results: Probiotics and C. papaya leaf extract mouthwashes were equally effective as Kidodent in reducing S. mutans count in saliva. Conclusion: Probiotics and C. papaya leaf extract mouthwashes manifested potential efficacy in reduction of S. mutans.

Advancements in molecular marker technologies and their applications in diversity studies

Crop improvement is a continuous effort, since some 10,000 years ago when primitive man made the transitionfrom hunting and foraging to domestication and crop cultivation. Since then, man-made interventions havechanged the entire scenario of crop evolution, by means of genetic alterations of plants and animals made tosatisfy man’s needs. The process of domestication has led to dramatic changes in their appearance, quality andproductivity that have contributed substantially to global food security. The tremendous decline in cultivableland, freshwater, and increasing risk of biotic and abiotic stress demand immediate attention on cropimprovement to cope with the higher demand of *40% of the food by 2020. Therefore, plant genetic variationplays a key role in plant breeding for its improvement. Most of the genetic variations useful for cropimprovement have been deposited and maintained in seed gene banks across the world; they need to be broughtinto the mainstream of breeding lines. Recent advances and progress made in molecular markers have beensubstantial tools for deeper insights of genetics, and greatly complemented breeding strategies. Integration of thenext-generation sequencing (NGS) technologies with precise phenotyping, association mapping, proteome andmetabolome studies has increased the chances of finding candidate genes and their allelic variants controlling atrait of interest. Further, these functional markers (FMMs), genotype-by-sequencing and association mappingmethodologies have opened new avenues for identification of novel genetic resources (lines) that can facilitateaccelerated crop breeding programs for increased yield, high nutritional quality, and tolerance to a variety ofabiotic and biotic stresses. The details of popular molecular markers, advancement in the technologies andstrategies for crop diversity studies and their application in crop breeding programs are presented here.

Schneiderian membrane and its significance in Oral Implants

Schneiderian membrane and its significance in Oral Implants

A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females.  The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.

A study to investigate the prevalence of metabolic syndrome in Chronic Obstructive Pulmonary Disease patients from North India

Background: Worldwide, Chronic obstructive pulmonary disease (COPD) is the one of the leading cause of chronic morbidity and mortality. COPD is one of the diseases in which smoking is the common and important risk factor when it is associated with Metabolic syndrome (MetS). The individual components of MetS, i.e., obesity, dyslipidemia, fasting hyperglycaemia, and hypertension were independently associated with impairment of lung function too. The objective of this study is to find out the prevalence of metabolic syndrome among COPD patients.Methods: This was a cross-sectional study conducted in department of Respiratory Diseases and a total of 70 COPD patients were included in the study, which were enrolled for treatment from July 2016 to July 2017. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), 2015 guideline. International Diabetes Federation (IDF) guideline; (2005) was used in diagnosis of metabolic syndrome.Results: Seventy patients with COPD were enrolled during the study period. There were 45 males (64.2%) and 25(35.7%) females. Mean age of male patients was 58.67±9.87 years, while mean age of female patients was 57.23±10.4 years (35-87 years). Mean BMI of male was 24.33±6.64 kg/m2, while in case of female it was 30.07±6.95 kg/m2 and overall mean BMI of study population was 26.22±7.22 kg/m2. The mean   waist circumference of male was 86.91±13.31 cm while in female it was 87.18±14.51 cm. The Overall prevalence of metabolic syndrome was 31.34% and most common in GOLD stage-3 (47.06%), followed by stage-2 (40%), followed by stage-4 (25.71%) and 7.4 % in GOLD stage -1.Conclusions: The presence of metabolic syndrome is common in patients with COPD and, all COPD patients should be considered for screening for it.

Prevalence and clinical significance of microalbuminuria and hypoxemia in patients with chronic obstructive pulmonary disease

Background: Microalbuminuria is a sign of glomerular dysfunction in general and sign of tubulointerstitial disease to a lesser extent. Hypoxia induces endothelial cell to release a number of different vasoactive agents including endotheline-1, platelet derived growth factor (PDGF), nitric oxide; that causes endothelial injury and lead to microalbuminuria. This study was aimed to assess the prevalence of microalbuminuria in COPD patients and assess the Relationship of microalbuminuria with the disease severity in the forms of FEV1, PaO2, PaCO2, and BODE INDEX in COPD patients.Methods: Total 130 COPD patients were included in our cross sectional study. Total patients were divided into two groups, 1st group was COPD with microalbuminuria while 2nd group was COPD without microalbuminuria. Lung function test, 6 min walk distance, arterial blood pressure (BP), BODE index, arterial blood gases, fasting and post prandial plasma glucose and kidney function tests were measured. Screening for microalbuminuria was done by measuring urinary microalbumin in a random spot urine collection.Results: The prevalence of microalbuminuria was 29.23% in patients of COPD. As compared with COPD without microalbuminuria group, COPD with microalbuminuria group were more hypoxic (12% vs 74%, P=0.0001 ), more hypercapnic (22% vs 84%, p=0.00001) and most of the patients with grade III (16% vs 34%, p=0.00001) or grade IV (19% vs 47%, p=0.00001) severity (according to GOLD criteria).Conclusions: Patients with severe COPD with hypoxemia or hypercapnia were significantly associated with microalbuminuria.

Oral Cancer – Screening and Prevention

In the digital era of the 21st century, where computer and humans are working together in almost every fields.In this era, oral cancer and its morbidity with one of the highest mortality rates among all other malignancies isalso increasing day by day, hour by hour, and minute to minute.

A prospective study on the effects of Ayurvedic massage in post-stroke patients

Background: Few stroke patients have reported improvements after Ayurvedic massage. Unfortunately,there is a dearth of indexed literature to support the use of this in rehabilitation.Objectives: To objectively measure the differences between patients with stroke who received Ayurvedicmassage in addition to standard Physiotherapy (PT) versus those who received only standard PT.Materials and methods: The study was a prospective case control study, retrospectively analysed. Thesetting was a tertiary level hospital with neuro-rehabilitation unit. Fifty-two patients undergoing acuteinpatient rehabilitation were prospectively followed post stroke. They were self-selected one monthfrom the event for Ayurvedic massage with regular PT or PT alone. Twenty five received Ayurvedicmassage with PT and twenty seven received only PT. All participants completed treatment. Informationrelated to age, gender, National Institute of Health Stroke Scale result, number of co-morbidities, andwhether cases were deemed simple or complex were taken at baseline. All patients received 6 hours ofphysical therapy averaged over a week. Massage was delivered daily for a total of 10 sessions followed bysteam application.Results: Patients were categorized as simple or complicated stroke based on events prior to rehabilitation. Both simple and complicated patients who received Ayurvedic massage had lower MAS and needfor antispastic drugs, achieved standing with minimal assistance sooner, and had better locomotion atdischarge. All these differences were significant.Conclusion: Utilizing Ayurvedic massage in post stroke patients with flaccidity can promote fasterstanding with minimal assistance and lead to less need for antispastic drugs at discharge.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Recurrent decidual cast with membranous dysmenorrhea

Decidual cast is the entire sloughed endometrium that takes the form of the endometrial cavity. It causes membranous dysmenorrhea because the intact cast passes through an undiluted cervix. It may be associated with ectopic pregnancy, incomplete abortion, non-pregnant state with use of progesterone, Depot medroxyprogesterone acetate (DMPA), rarely with oral contraceptive pills. Authors are reporting a case of recurrent decidual caste formation with membranous dysmenorrhoea in 33 years old women P3L3 who was on norethisterone acetate treatment for a typical uterine bleed (AUB). She presented with heavy menstrual bleeding with severe dysmenorrhea in Gynae causality of ESI Basaidarapur medical college, Delhi. She expelled decidual caste and required therapeutic Dilation and Curettage (D and C) to control bleeding per vaginum. Her histopathology report showed marked decidua like change of the stroma but no villi suggestive of endometrial caste.

Off-pump coronary bypass grafting in a post-pneumonectomy patient: Challenges and management

Pulmonary complications are common in cardiac surgical patients. Limited respiratory reserves along with the pain associated with sternotomy add to the morbidity. Patients undergoing cardiac surgery who have had a pneumonectomy done before can be even more challenging to manage perioperatively due to a single-functioning lung. We present a case of a postpneumonectomy patient who underwent off-pump coronary artery bypass grafting. Perioperative optimization of lung function tests was stressed upon including the chest physiotherapy and early mobilization. Preoperative thoracic epidural catheter was inserted for postoperative pain and other proven benefits of thoracic epidural in coronary artery disease patients. We could conclude from our experience that proper optimization of lung function tests and meticulous pain management along with fast-tracking are keys to the management of such patients.

Study of Carpal Bone Ossification by Using Radiological Method for Age Estimation of Infant and Paediatric Group in North Indian Population

Background: Ossification of carpal bones forms the most significant aspect of development in clinical sciences and in medical jurisprudence. Important factors influencing the process of ossification include age, sex, heredity, the state of nourishment and particular geographical region may not be exactly similar to that in another area. The main purpose of this study is to evaluate the average age of appearance of the ossification centre of Indian population in comparison with western data. Materials & Methods: Present work was performed in 200 healthy individual of both sexes of which  date of birth proof was present .  X-ray of carpal bones were taken for presence or absence of centre of ossification of the individual carpal bones. Results: In the present study 102(51%)males  and 98 (49%) females  were taken who had accurate birth certificate indicating their age from  < 6 month to 12 year. Variation in the appearance of centre of ossification in carpal bones shows influence of race, climate, nutritional, and geographical factors. Conclusion: Ossification of carpal bones  in the population of North India occur 1-2 year later then  Europeans and  appearance of the ossification centre is earlier in females  than males .

Ultrasonographic Study on Size and Echotexture of Spleen in Normal and Diseased Adult Population in Kosi Region of Bihar

Background: The spleen is the largest organ in the reticuloendothelial system. A number of disorders are accompanied by altered spleen size, including infective, infestation, infiltrative, immunologic, and malignant conditions. Ultrasonography affords a useful noninvasive role in evaluating the spleen and used for best advantage, it can demonstrate the existence and composition of splenic masses, disruption of splenic texture or outline, progressive changes in masses and the size of the spleen. Materials & Methods: 166 subjects were selected from the Departments of Medicine, Surgery and Radiology, from a tertiary care teaching hospital and from the other clinics of Kosi region like Purnea, Araria and Madhepura districts during the period of June 2016 to May 2017. Results: The splenic length decreased at a slow rate up to the age of 50 years after which it decreased rapidly in both sexes. The splenic length was greater in males than in female in each age group. Mean splenic width in the first age group i.e. 21 30 years was 60.9 ± 8.4 mm, in the second age group i.e. 31 - 40 years was 56.4 ± 7.9 mm, in the third age group i.e. 41 – 50 years was 46.6 ± 4.3 mm, and in the fourth age group i.e. 51 – 60 years was observed to be 44.6 ± 8.0 mm. Conclusion: The ultrasonography affords a useful noninvasive role in evaluating the spleen, it can demonstrate existence and composition of splenic masses, disruption of splenic texture or outline; and also progressive changes in masses and size of spleen.

Effect of Sertraline on biomarker alterations in patients of multidrug resistant tuberculosis with depression: a prospective clinical trial

Background: Lipid profile parameters may be used as biomarker for depression. Sertraline belongs to selective serotonin reuptake inhibitors (SSRIs), the most commonly used group to treat the depression in multidrug resistant tuberculosis patients.Methods: A prospective clinical trial was carried out in department of Psychiatry and department of Tuberculosis and Respiratory disease G.S.V.M. Medical College, Kanpur. Diagnosed MDR TB patients were screened for depression applying Hamilton Depression Rating Scale (HDRS) and these patients were referred to Psychiatrist for diagnosis of depression. Total 25 diagnosed patients of MDR TB with mild to moderate depression were selected. HDRS Score and morning blood sample of 5ml were collected to analyze biomarker for depression before intervention. Same test was repeated in 18 patients who completed the study at day 30 and 120 after administering Sertraline (50mg). Data were compiled and analyzed using SPSS 20.0 and paired t - test.Results: The mean decrease in HDRS score from base line at day 30 and 120 of administering Sertraline were 6.22 (±1.26) and 2.72 (±0.67) which were significant (p?0.001). The mean increase in serum cholesterol at day 30 was 153.94 (±19.31) and at day 120 was 157.83 (±19.36) which were significant (p?0.001). Rest of Tg, HDLc, LDLc and VLDL cholesterole levels were not increased significantly.Conclusions: As the depression symptoms improved by sertraline. The biomarkers of depression were also increased (within the normal range) from baseline but significant increase was observed in serum cholesterol only.

Tuberculous Liver Abscess with Right Sided Pleural Effusion.

Tuberculosis is a rare cause of liver abscess even in countries where the tuberculosis is prevalent, liver may be involved as a part of miliary tuberculosis or as local tuberculosis. We present a case of tuberculous liver abscess in patient with smear positive pulmonary tuberculosis and right pleural effusion. A positive BACTEC culture and Polymerase chain reaction (PCR) for Acid Fast Bacilli (AFB) in the pus aspirated from abscess confirmed the diagnosis of tuberculous liver abscess.

Prehospital trauma care services in developing countries

Trauma is a leading cause of death and disability especially amongst young people. Prehospital trauma care service remains a dynamic field of medicine for care of trauma patients. The goal of prehospital emergency care system should be to match the needs of the patients to the available resources so that optimal, prompt and cost-effective care can be offered. For bridging the wide gap between the actual and expected level of care, the urgent need must be appreciated by the community, administration, medical professionals and very positive steps should be taken to meet the future challenges. The authors included a "snapshot" of current articles applicable to prehospital trauma care in developing countries. The current review aims to explore the concept of "golden hour" and objectives, controversies and existing status of prehospital trauma care service using the recent evidence based literature in developing countries

Wildervanck syndrome associated with cleft palate and short stature.

We report a case of Wildervanck syndrome exhibiting Klippel-Feil anomaly, Duane retraction syndrome and deafness. Since the first case was reported in 1952, there have been more reports describing this triad, either complete or incomplete. Our patient had the complete triad of the syndrome along with cleft palate and short stature. Also, a review of the literature regarding this syndrome is presented here.

Effect of gonadotropins on chromosome aneuploidy, chromosome mosaicism & sex ratio in mouse preimplantation embryos.

Background & objectives: There are potential risks of major birth defect in IVF (in vitro fertilization) pregnancy as well as IVF-ICSI (intra cytoplasmic sperm injection) pregnancies in comparison with naturally conceived human pregnancies. This increase risk could be due to either gonadotropins used for ovarian stimulation or in vitro culture conditions or multiple pregnancy or combinations of all the factors. The effects of gonadotropins on chromosome aneuploidy, chromosome mosaicism and sex ratio on mouse preimplantation embryos were evaluated through the use of fl uorescence in situ hybridization (FISH). Methods: The study material consisted of 111 preimplantation mouse embryos (2-16 cell stage) in control group and 405 preimplantation mouse embryos in gonadotropin stimulated group from genetically identical Swiss Albino young (6-8 wk) mouse kept in a similar environmental conditions. The study was designed to investigate effect of gonadotropins on chromosome aneuploidy, chromosome mosaicism and sex ratio through the use of FISH technique using chromosome X, Y and 19 probes. All blastomeres of embryos in both groups were assessed. Results: Interpretable FISH results were obtained in 66 embryos in control group and 128 embryos in gonadotropin stimulated group. There was no excess of chromosome aneuploidy (only one case of sex chromosome trisomy in study group; 19, 19, X, Y, Y) or chromosome mosaicism or deviations in sex ratio between the two groups. However, deviation (1.36 M: 1 F in control group & 1.25 M : 1 F in study group) was seen from expected sex ratio (1 M : 1 F) i.e., skewed sex ratio in both the groups. Interpretation & conclusions: Our results showed that gonadotropins used for ovarian stimulation had no effects in causing increase in chromosome X, Y, 19 aneuploidy and mosaicism and skewing of sex ratio in mouse model. A large scale study with more FISH probes on a larger sample size need to be done to confi rm the findings.