Numbness Following Total Knee Arthroplasty: Role of Incision Length And Position -A Randomized Study

Background@#One of the symptoms annoying patients after total knee replacement (TKR) is numbness around the operative scar. Some studies have shown that altering the incision in terms of placement or length may decrease the incidence of numbness. It still remains unknown whether numbness affects patient-reported outcomes. @*Methods@#We conducted a randomized study to compare a short-length incision (n = 50) and a lateral exit incision (n = 50) with a standard midline TKR incision (n = 50) in terms of the incidence of numbness and its progress over 1 year of follow-up. Our secondary objective was to look at the involved zone, area of numbness, and secondary symptoms. We also looked at patient-reported outcome in terms of satisfaction in all groups using a visual analog scale and Forgotten Joint Score. @*Results@#At 3 months postoperatively, the incidence of numbness was least in the lateral exit group: 46.2% as compared to midline (62%) and short (58.3%), but the difference was not significant (p = 0.07). At 6 months, the short incision group had a significantly lower incidence (8%) of residual numbness as compared to 30% in the other two groups (p = 0.003). At 1 year, most patients recovered sensation loss and had similar function. @*Conclusions@#Placement or length of an incision did not significantly affect the incidence of numbness; however, the short incision led to early recovery of numbness. At 1 year of follow-up, most patients did not complain of loss of sensation and had similar functional outcome.

Effect of COVID-19 Lockdown on Lifestyle Habits and Self-Care Practices of Diabetic and Hypertensive Patients in Rural Shimla and Udaipur – Findings from the HealthRise India program

Background: COVID-19 pandemic has increased the risk of mortality among patients with noncommunicable diseases. Maintaining a good metabolic control, lifestyle modification along with improved self?care practices are not only associated with less severe COVID?19 infections but also with a high recovery rate. Objectives: This research article explores the changes in lifestyle habits, self-care practices, and metabolic control among patients enrolled in the HealthRise program. The study compares behavioral changes, before COVID-19 pandemic and during COVID-19 pandemic, between intervention and control arms in Shimla and Udaipur. Methods: A quasi-experimental study design was employed for program implementation in select villages of Shimla district, and Udaipur district. A total of 459 patients from Shimla and 309 patients from Udaipur with diabetes mellitus or hypertension or with both were enrolled and followed for 1 year. Results: Metabolic control in Shimla intervention arm was 2.6 times higher than in control arm (P = 0.001) before COVID?19 pandemic. During COVID?19 pandemic, Odds of metabolic control in Shimla intervention was 1.5 times higher when compared with control arm (P = 0.03). In Udaipur, metabolic control before COVID-19 pandemic was comparable between control and intervention arms. During the pandemic, metabolic control in intervention arm of Udaipur was 5 times higher when compared to the control arm ((P = 0.001). Conclusion: Participants exposed to support, appreciate, learn, and transfer-community life competence process (SALT-CLCP) intervention maintained metabolic control during the COVID-19 pandemic with improved behavioral and self-care practices. Community-based interventions such as SALT-CLCP method bring ownership and empower community in achieving the better health outcomes.

Assessing consequences of untreated dental caries using pufa/PUFA index among 6–12 years old schoolchildren in a rural population of Kerala

Context: Dental caries is the most common dental disease of childhood. India with a population of more than 135 crores accounts for a high proportion of dental morbidity. Poor oral health has a significant impact on quality of life, especially in rural areas. The consequences of untreated dental caries include pain, abscess, and space infections which may lead to loss of function and school hours. These consequences are of utmost important while planning a community dental care program. Aims: To assess the prevalence of dental caries, caries experience, and severity of dental caries among 6–12 years old schoolchildren in the rural areas of Kollam District, Kerala State. Settings and Design: A community school-based, descriptive, cross-sectional study in the rural areas of Kollam District. Materials and Methods: A cross-sectional study was carried among 2194 schoolchildren in the rural areas of Kollam District in the age group of 6–12 years. Children from eight randomly selected schools were examined for pufa/PUFA and dmf/DMF indices. Statistical Analysis Used: SPSS version 17.0, Mann-Whitney, t-test, KruskalWallis test. P < 0.05 was considered statistically significant. Results and Conclusions: Overall caries prevalence among the total population was found to be 74%. The prevalence of caries in the deciduous dentition was 61% and a mean decayed, missing, filled teeth value of 2.74 ± 3.200 and for the permanent dentition the caries prevalence of 26.8% and a mean Decayed, Missing, Filled Teeth of 0.66 ± 1.360 were observed. The prevalence of untreated dental caries (pufa/PUFA) was 40.8%. The pufa prevalence in deciduous dentition was 38.3% with a mean pufa of 0.99 ± 1.679. Moreover, the PUFA prevalence in permanent dentition was 4.1% with a mean PUFA of 0.06 ± 0.349. The highest prevalence of untreated dental caries (pufa/PUFA) was found in the 7 years' age group (52%) and the lowest in 12 years' age group (22.4%).

Does Risk Mitigation Reduce 90-Day Complications in Patients Undergoing Total Knee Arthroplasty?: A Cohort Study

Background@#With ever-increasing demand for total knee arthroplasty (TKA), most healthcare systems around the world are concerned about its socioeconomic burden. Most centers have universally adopted well-defined clinical care pathways to minimize adverse outcomes, maximize volume, and limit costs. However, there are no prospective comparative trials reporting benefits of these risk mitigation (RM) strategies. @*Methods@#This is a prospective cohort study comparing post-TKA 90-day complications between patients undergoing RM before surgery and those following a standard protocol (SP). In the RM group, we used a 20-point checklist to screen for modifiable risk factors and evaluate the need for optimizing non-modifiable comorbidities. Only when optimization goals were achieved, patients were offered TKA. @*Results@#TKA was performed in 811 patients in the SP group and in 829 in the RM group, 40% of which were simultaneous bilateral TKA. In both groups, hypertension was the most prevalent comorbidity (48%), followed by diabetes (20%). A total of 43 (5.3%) procedure-related complications were seen over the 90-day postoperative period in the SP group, which was significantly greater than 26 (3.1%) seen in the RM group (p = 0.039). The commonest complication was pulmonary thromboembolic, 6 in each group. Blood transfusion rate was higher in the SP group (6%) than in the RM group (< 1%). @*Conclusions@#Screening and RM can reduce 90-day complications in patients undergoing TKA.

Early Outcomes of Medial Pivot Total Knee Arthroplasty Compared to Posterior-Stabilized Design: A Randomized Controlled Trial

Background@#The indications for total knee arthroplasty (TKA) have been expanded to include younger, demanding patients. Some TKA patients expect a return to high-performance activities to restore optimum quality of life. The concept of the medial pivot (MP) TKA is that more natural knee kinematics can be achieved by altering the bearing design. In the present study, we compared the early outcomes of MP TKA with posterior-stabilized (PS) TKA in terms of patient-reported outcomes, function, and performance. @*Methods@#This randomized study was performed in a high volume joint replacement facility of a tertiary care military hospital. We enrolled 40 patients each in the MP group and PS group and assessed knee flexion, patient-reported outcome (new Knee Society Score [new KSS]), patient performance (Delaware Osteoarthritis Profile Score [DOPS]), and function (Forgotten Joint Score [FJS]) at 2 years after surgery. @*Results@#Compared to PS group patients, MP group patients had similar patient-reported outcomes assessed by new KSS (satisfaction, expectation, and activity scales) and FJS. MP knee patients had better performance in the timed up and go test (p < 0.026) and self-paced walk test (p < 0.002) of DOPS. The gain in knee flexion (9.3° ± 14°) compared to baseline was significantly greater in the PS group (p < 0.013). @*Conclusions@#When assessed by DOPS, getting up from chair and walking speed were significantly better in MP knee patients than in PS knee patients. However, considering the predictable rollback ensured by cam and post, the PS knee produced better knee flexion. Despite these results, patients were equally satisfied with the two designs.

Evaluation of pharmacovigilance concepts among healthcare professionals in Davangere, Karnataka, India

Background: Adverse drug reactions are one of the leading causes of morbidity and mortality worldwide. Timely detection and reporting of adverse drug events through pharmacovigilance is the best tool we have to prevent adverse drug reaction. One of the major reasons for underutilization of pharmacovigilance in India is deficit in awareness, attitude and practice of pharmacovigilance. The objective of this study was to assess these parameters among healthcare professionals in our hospital.Methods: 200 health care professionals (post graduate students, undergraduate students, interns and nurses) took part in the study. A pre-designed questionnaire structured to obtain information on pharmacovigilance was used for evaluation. Questionnaire also enquired on factors that deter respondents from reporting.Results: Among undergraduates, the satisfactory responses for knowledge, awareness and practice of pharmacovigilance were 12%, 72% and 42% respectively and for postgraduates it was 52%, 48% and 26% respectively. For interns it was 4%, 38% and 8 % respectively and nurses 8%, 18% and 26% respectively. Only 1% of undergraduates and 14% of postgraduates showed satisfactory responses to all three categories evaluated. Undergraduate students had a significantly higher awareness scores among the categories (p<0.05). When it comes to knowledge and practice there was not much differences between groups. Lack of time to report was the most cited factor across all categories discouraging reporting.Conclusions: Results are encouraging among undergraduate students, but not significantly better than postgraduates. The poor performance among interns and nurses is due to lack of awareness. A strong basic foundation course regarding pharmacovigilance in academics will help in effective implementation of pharmacovigilance.

Migrainous vertigo (Migraine-associated dizziness) in adults - clinical and audiological profiles in patients suffering from chronic recurrent vertigo and headache: An original research

Half of patients who suffer from Migraine also concurrently suffer from vertigo. Migrainous vertigo is emerging as a distinct entity related to Common migraine but having a number of distinctive clinical features. This study aims to highlight the novel clinical and audiological features of Migrainous vertigo. Methods: In this study 53 patients who suffer from Migrainous vertigo were analyzed. Results: It was found the most clinical features of Migrainous vertigo parallel Common migraine like Long history of headache typically 4.3 years, episodes lasting few hours, absence of Aura, female preponderance, sleep relief and phonophobia. Conclusion: Audiological features of Migrainous vertigo are a distinctive 5 to 10 dB decrease in Air-conduction curves in frequencies 2,000 to 4000Hz, during an attack of Migrainous vertigo is found in 63% of cases.

Management of Osteoporosis in Post-Menopausal Women With History of Fragility Fracture

@#Sleep disturbance is common in the elderly and is frequently undiagnosed. It has been estimated that 75 percent of adults >65 years of age has sleep disturbance and 30 percent of them has insomnia. The classification of insomnia has less significance in the older adults as the subtypes demonstrate significant overlap and usually treatment of the underlying disorder does not solve the problem or cure it. The elderly has multiple comorbidities and poly pharmacy with a myriad of cause for insomnia. A comprehensive medical and psychiatric history together with a complete physical examination and mental state examination should be done in the evaluation of the older patient. Behavioural therapy with sleep hygiene education should be the initial treatment together with the treatment of the contributing physical and psychiatric conditions. Referral to an expert for cognitive behavioural therapy or multicomponent therapy may be necessary if the initial therapy failed to produce any improvement. If medications are needed it can be combined with behavioural therapy. Medication used should be the lowest effective dose and prescribed for shortterm use of not more than four weeks. Medications used need to be discontinued gradually and one needs to be mindful of rebound insomnia upon withdrawal. Whenever possible, it will be ideal to avoid benzodiazepines and other sedative hypnotics as first choice for insomnia. Over the counter sleep aids which usually contain antihistamines may not be good choices as they carry significant risk of adverse events and drug interactions. Currently the safest medications for use in the elderly includes the Z-drugs (zolpidem, zopiclone), melatonin and low dose tricyclic antidepressant Doxepin.

Comparative evaluation of low-level laser therapy and ultrasound heat therapy in reducing temporomandibular joint disorder pain

BACKGROUND: Pain, limitations in opening, asymmetrical jaw movements, and temporomandibular joint (TMJ) sounds are the most common findings in temporomandibular joint disorders (TMDs), which causes excruciating pain, inflammation of the surrounding muscles, posterior fibers, and synovial fluid. This study aimed to evaluate and compare the effects of ultrasound heat therapy and low-level laser therapy (LLLT) in reducing TMD-related pain. METHODS: This prospective study included 42 patients (age range, 25–45 years), who were divided into two groups of 21 patients each. All patients were prescribed a non-steroidal anti-inflammatory drug (NSAID) twice a day for 5 days for temporary relief of pain prior to the commencement of treatment. Patients were kept on a soft diet and asked to restrict mouth opening during the same period. Fifteen sessions of LLLT (Group A) or ultrasound therapy (Group B) were administered to the affected side. RESULTS: Post-therapy, the mean visual analog scale score for group A and group B was 4.81 (2.01) and 6.19 (1.20), respectively; the difference was statistically significant and favoring the LLLT group. Similarly, the mean mouth opening for group A and group B was 3.99 (0.40) and 3.65 (0.41), respectively; the difference was statistically significant and favoring the LLLT group. CONCLUSION: Our study recommends LLLT for treating TMD-related pain with no underlying bony pathology.

Outcomes of Fast-Track Multidisciplinary Care of Hip Fractures in Veterans: A Geriatric Hip Fracture Program Report

BACKGROUND: Hip fractures are a significant cause of morbidity and mortality in the elderly. Fast-track multidisciplinary co-management of these patients, rapid preoperative optimization, early surgery, and expeditious rehabilitation may minimize morbidity and mortality. In this study, we evaluated outcomes of fixation of hip fractures in the elderly patients managed by Geriatric Hip Fracture Program at a military hospital in India. METHODS: A total of 114 patients above 60 years of age with hip fractures were enrolled. They were comanaged by a team of specialists and fast-tracked to surgery. Independent ambulation with support of a walker was achieved before discharge to home. Patients were followed up for 1 year. RESULTS: The average age of the 114 patients was 77 years; 24 patients were octogenarian. Eighty-four percent of injuries were due to a domestic fall. Hypertension (41%) and diabetes (22%) were the most common comorbidities. All patients were optimized before surgery. The average delay from injury to admission was 1.7 days (range, 0 to 14 days) and that from admission to surgery was 1.8 days (range, 0 to 19 days). Hence, the average time from injury to surgery was 3.5 days. The length of stay in hospital was, as per rehabilitative milestones achieved, 2 to 5 days in 40% of the patients and 6 to 15 days in 60% of the patients. At 1 year after surgery, 95 patients were independently ambulant (56 patients with support and 39 patients without support). Twenty-three percent of the patients had postoperative complications and eight patients died (7.7%) at 1-year follow-up; 11 patients were lost to follow-up. CONCLUSIONS: Elderly hip fracture has a high risk of mortality (14%–58%). Thus, expeditious surgery within 24 hours of admission has been advocated in the Western literature to minimize mortality. Mortality rate at 1 year after surgery remains at 10% to 24%. In our study, even with aggressive co-management, the average delay to hip fracture fixation was more than 3 days; however, the 1-year mortality was relatively low (7.7%). This indicates the importance of preoperative optimization and postoperative rehabilitation for independent ambulation and mortality reduction in the elderly population.

KDIGO Classification in Predicting the Outcomes of Acute Kidney Injury in Patients in Intensive Care Units of a Tertiary Care Centre

Background: Acute kidney injury (AKI) is a common occurrence in intensive care units. Mortality is more for patients with AKI than those without AKI. KDIGO classification system is a recent tool to stage AKI. Outcomes of AKI depend on stage of the disease, underlying aetiologies and interventions. Objectives were to study the ability of KDIGO classification in predicting the outcomes of acute kidney injury in patients admitted to the intensive care units of a tertiary care centre, to predict the mortality among acute kidney injury patients admitted for intensive care and to study the clinical and etiological profile of acute kidney injury in such patients. Materials and methods: 153 subjects from Medical ICUs admitted with AKI were included. The period of study was from 1st January 2016 to 31st December 2016. After getting proper consent, details were taken in proforma. Patients coming under exclusion criteria were excluded. Data of 153 patients entered in excel sheet and with various statistical tools the data were analysed. Results: Globally subjects with AKI in ICU, the mortality is about 40 to 60%. Duration of ICU stay among Stage III patients were comparatively longer than those in stage II and stage I (p<0.05). Patients undergoing RRT hold higher mortality. AKI patients who need HD or PD as Renal replacement had comparatively higher rates of mortality than those doesn't require RRT (p<0.05). There was no significant association between age of the patients and mortality (P>0.05). There was no significant association between mortality and gender. Binary logistic regression model for mortality was performed to predict the independent risk factors of mortality. The regression analysis revealed Sreenath S, Santhosh Kumar T.S., Retheesh kumar. KDIGO Classification in Predicting the Outcomes of Acute Kidney Injury in Patients in Intensive Care Units of a Tertiary Care Centre. IAIM, 2018; 5(8): 30-40. Page 31 that staging according to KDIGO, sepsis, hypertension and diabetes has independent predictability in mortality. Conclusion: We concluded that higher the stage of AKI, the higher will be the mortality and also staging can predict mortality. So staging AKI patients with KDIGO classification holds statistical significance

Is long term storage of cryopreserved stem cells for hematopoietic stem cell transplantation a worthwhile exercise in developing countries?

BACKGROUND: Stem cell units (SCUs) that are cryopreserved prior to both autologous and allogeneic hematopoietic stem cell transplants (for donor lymphocyte infusion) remain unused or partially used several times, and become an increased burden to blood banks/SCU repositories. Because of the scarcity of data regarding the duration for which the storage is useful, there is no general consensus regarding disposal of SCUs. METHODS: We conducted a retrospective audit of SCU utilization in 435 patients who planned to undergo either autologous stem cell transplantation (auto-SCT) (N=239) or allogeneic stem cell transplantation (allo-SCT) (N=196) at a tertiary cancer care center between November 2007 to January 2015. RESULTS: Our cohort consisted of 1,728 SCUs stored for conducting auto-SCT and 729 SCUs stored for conducting donor lymphocyte infusions (DLIs) after allo-SCT. Stem cells were not infused in 12.5% of patients who had planned to undergo auto-SCT, and 80% of patients who underwent allo-SCT never received DLI. Forty-one percent of SCUs intended for use in auto-SCT remained unutilized, with a second auto-SCT being performed only in 4 patients. Ninety-four percent of SCUs intended for carrying out DLIs remained unused, with only minimal usage observed one year after undergoing allo-SCT. CONCLUSION: The duration of storage of unused SCUs needs to be debated upon, so that a consensus can be reached regarding the ethical disposal of SCU.

Study of cholesterol levels in patients with ischaemic stroke and their outcome

Background: Stroke is a major health problem in India. Stroke burden has been rising in India as compared to the developed countries. Recent studies have shown that high serum cholesterol is associated with clinically less severe ischaemic strokes and better outcome. Aim: The primary objective of the study was to compare the outcome of patients with ischaemic stroke to their cholesterol levels and to correlate the cholesterol levels to the stroke outcome. Materials and methods: This hospital based prospective follow-up study was conducted in 140 patients admitted with ischaemic stroke in the medical wards of Medical College hospital, Trivandrum. Patients were divided into 2 groups based on cholesterol levels as <160 mg/dl and >160 mg/dl. Their clinical severity at presentation was calculated by Scandinavian stroke scale (0=worst, 58=best) and outcome of these patients at the end of 1 year was measured by Modified Rankin scale (0=best, 6=worst).Serum cholesterol was measured using enzymatic method. Results: Mean age of 140 patients of at presentation was 63.4±11.9 years of which 53.5% (n=75) males, the mean Scandinavian stroke scale (SSS) being 28.3±12.5. The mean SSS score of high cholesterol group was 39.6 whereas 17 in the low cholesterol group (p<0.001). Similarly, the size of infarct in CT brain, outcome variables of modified Rankin scale and mortality were statistically significant between these groups (p<0.001). Bivariate correlation analysis showed that increased serum cholesterol level is associated with increased SSS score (positive correlation) with high statistical significance (p<0.001). Logistic regression adjustedwith other risk factors showed high cholesterol levels are associated with better outcome and decreased mortality, which is supported by Kaplan-Meier survival analysis. Sreenath S, Santhosh Kumar T.S., Parthiban, Jasen Joseph, Ratheesh Kumar V.R. Study of cholesterol levels in patients with ischaemic stroke and their outcome. IAIM, 2017; 4(10): 194-202. Page 195 Conclusion: Hypercholesterolemia is associated with clinically minor strokes and better outcome, whereas major strokes are commonly seen in patients in the low cholesterol group. Hence post stroke outcome is inversely related to serum cholesterol levels in ischaemic stroke patients.

Phosphorylation of Staphylococcus aureus protein-tyrosine kinase affects the function of glucokinase and biofilm formation

Background: When Staphylococcus aureus is grown in the presence of high concentration of external glucose, this sugar is phosphorylated by glucokinase [glkA] to form glucose-6-phosphate. This product subsequently enters into anabolic phase, which favors biofilm formation. The presence of ROK [repressor protein, open reading frame, sugar kinase] motif, phosphate-1 and -2 sites, and tyrosine kinase sites in glkA of S. aureus indicates that phosphorylation must regulate the glkA activity. The aim of the present study was to identify the effect of phosphorylation on the function of S. aureus glkA and biofilm formation

Methods: Pure glkA and protein-tyrosine kinase [BYK] of S. aureus ATCC 12600 were obtained by fractionating the cytosolic fractions of glkA1 and BYK-1 expressing recombinant clones through nickel metal chelate column. The pure glkA was used as a substrate for BYK and the phosphorylation of glkA was confirmed by treating with reagent A and resolving in SDS-PAGE, as well as staining with reagent A. The kinetic parameters of glkA and phosphorylated glkA were determined spectrophotometrically, and in silico tools were used for validation. S. aureus was grown in brain heart infusion broth, which was supplemented with glucose, and then biofilm units were calculated

Results: Fourfold elevated glkA activity was observed upon the phosphorylation by BYK. Protein-protein docking analysis revealed that glkA structure docked close to the adenosine triphosphate-binding site of BYK structure corroborating the kinetic results. Further, S. aureus grown in the presence of elevated glucose concentration exhibited an increase in the rate of biofilm formation

Conclusion: The elevated function of glkA is an essential requirement for increased biofilm units in S. aureus, a key pathogenic factor that helps its survival and spread the infection

Evaluation Of Clinical Outcome Of Patients With Mandibular Angle Fractures Treated By Rectangular Grid Miniplate

Aim of the study: This study was conducted to evaluate the efficacy of rectangular grid 3-d miniplates in the treatment of mandibular angle fractures.Methods: The study included 10 patients with mandibular angle fractures. A 2mm X 4hole titanium rectangular grid Miniplate was used to fix the fracture. Intraoral approach for fracture reduction and Transbuccal approach were used for plate fixation. Patients were evaluated for Fracture stability, Occlusion, Mouth opening, Complications like infection, plate loosening, plate fracture, malunion on 7th post operative day, 1st month, and 3rd month postoperatively.Results:Only one patient had mild occlusal derangement at end of the follow-up period of 3 months. One patient developed post-operative infection on the 7th post-operative day which resolved on antibiotic therapy. No cases of hardware failure were reported. All the patients had adequate mouth opening at the end of follow-up period.Conclusion: The rectangular grid miniplates used in this study were stable for the treatment of simple mandibular angle fractures with sufficient interfragmentary contact. The patients also had minimal complications. The armamentarium needed and cost of the hardware is also low. Further clinical studies with larger sample size are required to arrive at a more comprehensive conclusion about these plates.

novel single-stage procedure for increasing the width of attached gingival and eliminating the aberrant frenal attachment

Common treatment for buccal gingival recession caused by an aberrant frenal attachment includes elimination of the frenum and treatment of the gingival recession by soft tissue graft to increase the width of the attached gingiva that in turn results in root coverage. Keratinised gingival, if present in adequate amount, maintains the gingival health by protecting the marginal gingiva. This not only considers the desires of the patient but also explores the potential regenerative capacity of the tissues. This report describes a novel single-stage procedure for increasing the width of the attached gingiva and eliminating the aberrant frenal attachment

In silico profiling of miRNAs and their target polymorphisms in leukemia associated genes

Single Nucleotide Polymorphisms [SNPs] within microRNA [miRNA] encoding regions of the genome are a large potential source for biologically relevant variation. SNPs along with miRNA act as a powerful tool to study the biology of a disease and also have the potential in monitoring disease prognosis and diagnosis. Therefore, evaluating the functional role of target mRNA will be a major challenge of future studies in the field of cancer biomarker research in leukemia. To assess, whether miRNA target SNPs are implicated in leukemia associated genes, we conducted an in silico approach along with the availability of publicly available web based tools for miRNA prediction and comprehensive genomic databases of SNPs. In this in-depth report, we attempted to use two computational approaches: prediction of miRNA in leukemia associated genes, and identifying the functional role of mRNAs targeted by miRNA. Our results from this study suggest that the application of in silico algorithms miRdSNP, PupaSuite and UTRScan analyses might provide an alternative approach to select target untranslated region [UTR] SNPs and understand the effect of SNPs on the functional attributes or molecular phenotype of a protein

Oral lichenoid lesions: Clinico-pathological mimicry and its diagnostic implications.

Oral cavity is commonly affected by number of lichenoid lesions, whose clinical and histopathologic features overlap due to the presence of inflammatory cells in connective tissue. Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. The literature discussed in the article is an attempt to segregate individual lichenoid lesions by defining clinical and histopathologic variations among each other, which avoids the diagnostic problem.

Invivo Antidiabetic evaluation of Neem leaf extract in alloxan induced rats.

Azadirachta indica has been used medicinally throughout history by many different cultures. Many compounds have been found in the exudates of the, Azadirachta indica plant that have been used medically by humans. We have examined the pharmacological hypoglycemic action of Azadirachta indica in diabetic rats. After treatment for 24 hrs, Azadirachta indica 250mg/kg (single dose study) reduced glucose (18%), cholesterol (15%), triglycerides (32%), urea (13%), creatinine (23%), and lipids (15%). Multiple dose study for 15days also reduced creatinine, urea, lipids, triglycerides and glucose. In a glucose tolerance test in diabetic rats with neem extract 250 mg/kg demonstrated glucose levels were significantly less compared to the control group. , Azadirachta indica significantly reduce glucose levels at 15th day in diabetic rats. Azadirachta indica serves as an important alternative source in the management of diabetes mellitus involved in reducing increased blood glucose during diabetes which should be examined further by oral hypoglycemic therapy.