Study of Branching Pattern of External Carotid Artery

Background: Anatomical information of vasculature is of need for the surgeons and radiologists. Carotid artery and its branches supply most of head, neck, and brain. Injuries to the external carotid artery and its branches is often complex and results in high mortality. Knowledge of types and frequencies of vascular variations of external carotid artery is of help for invasive diagnostic and interventional procedures. Materials and methods: 50 external carotid arteries were dissected to study the branching pattern of external carotid artery. Results: Conventional branching pattern was seen in 58% specimens. Superior thyroid artery originated from common carotid artery in 12% specimens. Linguofacial trunk was observed in 16%. Occipital artery and ascending pharyngeal artery rose from a single trunk in 12%. Origin of facial artery from maxillary artery was observed in one specimen. Conclusion: Study of variations in the branching pattern of the external carotid artery adds to the existing anatomical knowledge. Variations in the branching pattern is of definite help for interventional radiologists, vascular, craniofacial and neck surgeons.

Clinical and mycological profile of fungal keratitis from North and North-East India

Purpose: To study the clinical presentation, mycological profile, and risk factors of fungal keratitis (FK) cases presenting at two tertiary?care centers, one each at North (Chandigarh) and Northeast (Assam) India, and to compare the spectrum of fungi recovered from the clinical and environmental samples at both locations. Methods: All patients with suspected FK were enrolled from both the centers between January 2018 and December 2019. Corneal samples were collected and processed as per standard laboratory protocols. Demographic details and clinical and mycological profiles were noted in all patients. Environmental sampling from the soil, air, and the vegetative matter was performed from both locations and neighboring districts. Results: Of the 475 suspected cases, 337 (71%) were diagnosed as FK (median age: 50 years; 77.2% males). The presence of diabetes, hypertension, blurred vision, and corneal discoloration was significantly higher in patients with FK compared to those without FK. Aspergillus sp. (52.1%) and Fusarium sp. (47.61%) were the predominant etiological agents isolated from cases in North and Northeast India, respectively. FK due to melanized fungi was associated with diabetes, trauma with animal tail, and corneal discoloration. A similar spectrum of fungi was seen in environmental and clinical samples in both the regions. Conclusion: The difference in etiological agents of FK and environmental fungal isolates in North and Northeast India highlights the need to identify the ecological niche of potential fungal pathogens. Prospective, multicenter studies, systematic environmental sampling, and the evaluation of the differences in causative agents and clinical presentation of FK from different parts of the country can substantially improve our understanding of its region?specific clinico?epidemiological profile.

LDBio Aspergillus immunochromatographic test lateral flow assay for IgG/IgM antibody detection in chronic pulmonary aspergillosis: Single-centre evaluation and meta-analysis

Purpose: Chronic pulmonary aspergillosis (CPA) is an infection of the lung usually caused by Aspergillus fumigatus in patients with pre-existing pulmonary diseases. Its diagnosis hinges on demonstrating IgG antibodies against A. fumigatus. Herein, we evaluated the performance of a newly introduced point of care test (POCT) kit, the LDBio Aspergillus IgG/IgM lateral flow assay (LFA) in India with the standard ImmunoCAP kit for diagnosing CPA. Methods: A total of 60 serum samples (30 CPA cases and 30 controls) were evaluated by the Aspergillus immunochromatographic test (ICT) IgG/IgM LFA. Fluorescent-enzyme immunoassay was used to determine specific A. fumigatus-IgG concentrations (positive >27 mgA/L). Further, a systematic review and meta-analysis of studies (up to August 26, 2021) reporting the performance of LDBio ICT for the diagnosis of CPA was performed. Result: A sensitivity of 86.7%, specificity of 90%, negative predictive value of 87.1%, positive predictive value of 89.7%, negative likelihood ratio of 0.15, positive likelihood ratio of 8.67, and was observed for the LDBio IC. There was good agreement between LDBio ICT and ImmunoCAP (88.3%) with a Cohen's Kappa score of 0.77. Our systematic review identified four studies and the pooled sensitivity of 90%, specificity of 91%, area under the curve of 0.94 and diagnostic odds ratio of 57.2, for CPA diagnosis by LDBio ICT. Conclusion: Aspergillus LDBio ICT assay exhibits good sensitivity and can be used to screen CPA cases

Clinicolaboratory profile and outcome of dengue fever cases in peak season of an academic year among pediatric population admitted to teaching hospital, Bangalore, Karnataka, India

Background: Dengue is a vector borne diseases with varied clinical manifestations, a major concern to public health globally. This study was done to describe the salient clinical as well as haematological profile of serologically confirmed cases of dengue fever and outcome in admitted cases.Methods: This was a prospective study conducted at major Government teaching Hospitals in Bangalore from July 2019 to December 2019. Total 164 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire format. Haematological parameters on admission, duration of stay and outcomes were analysed. The outcomes of the cases were mentioned as improved and death.Results: In this study commonly affected age band was adolescents group (36.6%) without any sex predilection. Maximum number of dengue cases were presented with warning signs (87.5%), 14 (8.69%) cases without warning signs and 6 (3.72%) with severe dengue. Fever was the most common symptom (100%), followed by vomiting (58%) and abdominal pain (38.5%). NS1 antigen positive cases (61.5%). Severe Leukopenia was present in 57% of cases and Thrombocytopenia in all admitted patients (100%). Most of the cases were treated with antipyretics, oral fluids (46%) and IV fluids (53%), only single case received platelet transfusion. Duration of stay was more in severe dengue cases. Mortality of our study was 1.8%.Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case. Both clinical, haematological parameters should be monitored for better outcome.

In vitro antiproliferative effect of aqueous extract of Solanum macranthum fruits on MDA-MB-231 tripple negative breast cancer cell line

The current investigation was focused on the assessment of antiproliferative effects of the Solanum macranthumaqueous fruits extract against the human breast cancer cell line MDA-MB-231 in vitro. Phytochemical analysisof the S. macranthum aqueous fruits extract was performed and the phytoconstituents found positive foralkaloids, phenols, and saponins. Quantitative analysis of the total alkaloid and phenol was determined usinggravimetric analysis and folins-phenols reagent method, respectively. The total alkaloid present was estimatedto be 7.58% and total phenol of 158.774 mg/Gallic Acid Equivalent. The cytotoxicity of S. macranthumaqueous fruits extract was screened using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide(MTT) assay and camptothecin was used as standard reference drug. At the concentration of 500 µg/ml, theaqueous extract potentially inhibited the growth of the MDA-MB-231 cell line in vitro reaching 19%, and theIC50 value was calculated to be 525.59 μg/ml. Thus, indicating that aqueous extract of the S. macranthum fruitspossess potential anticancer property.

A study to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs

Background: Early childhood caries (ECC) is a specific form of rampant caries that initially affects the primary maxillary anterior teeth of infants and children.' According to American Academy of Pediatric Dentistry (AAPD) 2011, early childhood caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a child under the age of six. The objective of this study was to assess the association between early childhood caries and relationship of Streptococcus mutans in saliva of mother, child and sibling pairs.Methods: Group 1 consists of fifty children with early childhood caries along with their mothers and siblings with the child age between 15 months to 5 years and sibling's age between 4 years to 10 years, whereas group 2 consists of fifty caries free children along with their mothers and siblings. For both groups, saliva samples were taken from the child, mother and sibling pairs to estimate the Streptococcus mutans count and to determine pH of saliva in these children. DMFT scores, debris scores checked for child, mother and sibling pairs.Results: Streptococcus mutans count was significantly high in group 1 than that of the group 2. Mothers were more co related to the children in the acquisition of Streptococcus mutans than the siblings. Increased no of meals of the child, pacifier use, low socio-economic status and low maternal education showed significant high correlation with caries prevalence. Low pH score was also significantly correlated with the increase in caries rate.Conclusions: Maternal factors such as high DMFT scores, low education levels, prolonged bottle-feeding with sweetened milk, pacifier use are strong risk indicators for identifying high caries-susceptible children.

Study Of Mandibular Ramus As Predictor Of Sex

Background: Methods based on measurements and morphometry are accurate and can be used in determinationof sex. Even the bony remains like mandibular ramus can be used to predict the sex of the individual which willbe of help for forensic experts. Morphometry of mandibular ramus will also be of importance for anthropologists,anatomists and prosthetists.Materials and Methods: Coronoid height, maximum ramus breadth, minimum ramus breadth and maximumramus height was measured in 200 adult cadavers.Results: The coronoid height varied from 42.02 mm to 68.46 mm in males and it varied from 40.08 mm to 66.76mm in females. The maximum ramus breadth in male mandible varied from 28.84 mm to 42.28 mm and infemales it varied from 27.44 mm to 41.42 mm. The minimum ramus breadth in males varied from 21.92 mm to36.80 mm, in females it varied from 17 mm to 34.26 mm. The maximum ramus height in males varied from 47.76mm to 68.64 mm and in females it varied from 42.56 mm to 69.56 mm.Conclusion: All the parameters measured were higher in males than females. Comparison studies revealed thatthe South Indian parameters were lesser than Thais, Croatians and Africans.

Implementation of standardized patient program using local resources in Avalon School of Medicine

Introduction: the standardized Patient Program [SPP] is a standard educational training method which provides the preclinical students a better clinical foundation by linking the realm of clinical medicine to basic sciences. It incorporates a modern simulation technique and enhances the ability of the students wherein they can practice, apply and learn the basics of patient encounter. The main objective of this study was to analyze the implementation and efficiency of the SPP in Avalon University School of Medicine [AUSOM]

Methods: a quasi-experimental "before-and-after" study design was conducted among the 3rd Semester [MD3] medical students at AUSOM. 24 students voluntarily participated in the study. The effectiveness of the program was evaluated after comparing the summative examination scores before and after implementation of the SPP [graded in 100 points system]. Mean scores were calculated and a comparison of the change in scores was made, using a paired t-test in Stata [©Stata corp]

Results: the mean final summative clinical skills examination scores of the students before and after the introduction of the SPP were 78.46 +/- 6.62 [SEM: 1.35, range: 89-70] and 86.54 +/- 6.41 [SEM: 1.31, range: 98-65], respectively. There was a statistically significant increment [t=5.5058, p=0.0001] in the scores of the students after the introduction of the SPP

Conclusion: introduction and implementation of SPP at AUSOM at preclinical years increased the overall students' performance in clinical skills. It is necessary that medical schools implement SPP early in preclinical years to strengthen learning and inoculate necessary clinical skills in medical students

Drug Resistance in Malaria-in a nutshell.

One peek into the history of malaria, shows us that despite many attempts by mankind to counter the development and propagation of malaria, it has always risen back like a ‘phoenix from its ashes’. This has been possible by virtue of the singular ability of the malarial parasite to mutate and evade the actions of various anti-malarial drugs. The emergence of drug resistant malarial parasites by virtue of the various molecular mechanisms, has put the authorities under the cosh and forced the scientists to start generating newer and better anti-malarial drugs. In this review, we have dwelt upon the various molecular mechanisms which have allowed the malaria parasite to develop resistance, as it can serve to educate the scientists in their effort to generate newer anti-malarials.

A case of histoplasmosis in a patient with MDS/MPN-U

No abstract available.

Induction of Apoptosis in MCF-7 Cells by Methanolic Extract of Clitoria Ternatea L.

Aim: Investigation of apoptosis induction by methanolic extract of Clitoria ternatea L. flower against multiple cancer cell lines. Main Methods: In the present study cytotoxic activity of Clitoria ternatea L flower was determined using MTT cell viability assay. The induction of cell death/apoptosis was evaluated by light microscopy, DNA fragmentation and caspase-3 enzyme activation. Key Findings: The methanolic extract from C. ternatea (MECT) showed cytotoxic activity against several cancer cell lines. The most potent activity exhibited by MECT was against MCF-7 breast carcinoma cells with an IC50 value of 27.2 ± 2.6 μg/mL. Light microscopic evaluation clearly indicated the apoptotic morphology of MECT treated cells. Treatment of MCF-7 cells with various MECT concentrations resulted in growth inhibition and induction of apoptosis as indicated by DNA fragmentation and caspase-3 enzyme activation. Significance: The current report strongly suggests the pro-apoptotic properties of C. ternatea flowers. Our findings demonstrate that C. ternatea phyto-constituents may have beneficial applications in the field of anti-cancer drug discovery.

Assess the frequency and severity of adverse drug reactions due to errors in drug intake at a tertiary care hospital.

Background: Drug-related problems are an important cause of morbidity and mortality and a significant burden on healthcare resources. There are few studies to account for errors in drug intake leading to adverse drug reactions (ADRs). This study was pursued with the objective of determining the frequency and severity of the ADRs resulting from erroneous drug intake, the expenses incurred in treating the same. Methods: The study was a prospective, cross-sectional, observational study. The study subjects were patients with ADRs due to errors in drug intake and from selfmedication. All the information regarding the ADR were collected as per ADR reporting form issued by Central Drugs Standard Control Organization. Causality was assessed by both Naranjo and the WHO criteria for causality assessment. Direct cost of all the medications, hospital charges (admission, bed charges, consultations paid, treatment charges, investigations, and conveyance charges) were recorded to find the financial burden due to error in drug intake. Results: The study showed that nearly 30% of the ADRs were due to errors in drug intake and the major contributing factor is self-modification either by discontinuation or missed doses. Major drugs that are implicated in these ADRs were that of metformin and insulins among anti-diabetic drugs and amlodipine and atenolol among antihypertensives. These two groups contributed to 18 (62%) of the total 29 ADRs. Organ system commonly involved was central nervous system and that was followed by musculoskeletal system. The average direct cost incurred in the management of these ADRs was Rs. 5773 for non-serious adverse events (SAE’s) and Rs. 11,400 for SAE’s. Conclusion: Proper education about the importance of compliance and damaging consequences of self-modification of drug dosage in patients who are on treatment for chronic disorders like diabetes and hypertension will be an effective strategy to prevent many of these ADRs.

Assess the frequency and severity of adverse drug reactions due to errors in drug intake at a tertiary care hospital.

Background: Drug-related problems are an important cause of morbidity and mortality and a significant burden on healthcare resources. There are few studies to account for errors in drug intake leading to adverse drug reactions (ADRs). This study was pursued with the objective of determining the frequency and severity of the ADRs resulting from erroneous drug intake, the expenses incurred in treating the same. Methods: The study was a prospective, cross-sectional, observational study. The study subjects were patients with ADRs due to errors in drug intake and from selfmedication. All the information regarding the ADR were collected as per ADR reporting form issued by Central Drugs Standard Control Organization. Causality was assessed by both Naranjo and the WHO criteria for causality assessment. Direct cost of all the medications, hospital charges (admission, bed charges, consultations paid, treatment charges, investigations, and conveyance charges) were recorded to find the financial burden due to error in drug intake. Results: The study showed that nearly 30% of the ADRs were due to errors in drug intake and the major contributing factor is self-modification either by discontinuation or missed doses. Major drugs that are implicated in these ADRs were that of metformin and insulins among anti-diabetic drugs and amlodipine and atenolol among antihypertensives. These two groups contributed to 18 (62%) of the total 29 ADRs. Organ system commonly involved was central nervous system and that was followed by musculoskeletal system. The average direct cost incurred in the management of these ADRs was Rs. 5773 for non-serious adverse events (SAE’s) and Rs. 11,400 for SAE’s. Conclusion: Proper education about the importance of compliance and damaging consequences of self-modification of drug dosage in patients who are on treatment for chronic disorders like diabetes and hypertension will be an effective strategy to prevent many of these ADRs.

Assessment of attitude and practice toward post-exposure prophylaxis for HIV among healthcare workers at a tertiary care hospital.

Background: Prevention and control of AIDS are now a major problem as there is no vaccine or effective-curative treatment for this disease. Health care workers (HCWs) are at increased risk for HIV infection. There were inadequate studies about post-exposure prophylaxis (PEP) of HIV among HCWs in southern India. Hence, we are conducting this study to assess the attitude and practice of PEP toward HIV among HCWs. Methods: The cross-sectional study was done among HCWs (doctors, surgeons, nurses, and dentists). Pre-tested questionnaire was given and requested to fill it after explaining the purpose of the study. About 65% and above correct answers was considered as adequate response. Values expressed as mean, proportions and analyzed by SPSS version 17. Results: Overall 6 (66%) of the total 9 questions in attitude were answered satisfactorily, and thus can be said to have good attitude regarding PEP in HIV. Only 16 people (10%) of the participants had taken PEP regimen. Among those who took PEP, the responses for the questions about the time of initiation of regimen, completion of prescribed duration of therapy and checking of HIV status after completion of regimen were unsatisfactory. Among the professions, surgeons were exposed more compared to other professions. Conclusion: Overall attitude toward PEP was positive among all the HCWs. The practice of PEP was not satisfactory even after exposure to risks. Informing HCWs about completing treatment course and post-treatment testing is important to prevent HIV transmission. Awareness of PEP should be improved among health professionals, by regular training meetings and introducing the guidelines of the safe practices in the academic syllabus of all the professions.

Cutaneous mucormycosis of scalp and eyelids in a child with type I diabetes mellitus.

Scalp mucormycosis in children is extremely rare. We present a case of pediatric scalp mucormycosis caused by Rhizopus oryzae in a 9-year-old diabetic girl who was successfully diagnosed and treated with amphotericin B deoxycholate and wound debridement. At 3 months follow up, the patient was stable although she had lost her vision.

A rare case of onychomycosis caused by Emericella quadrilineata (Aspergillus tetrazonus).

Onychomycosis is a common chronic nail disorder where dermatophytes are the predominant pathogens. However, non‑dermatophytic moulds like Aspergillus can also be implicated as the causative agents. Herein, we report a rare case of onychomycosis due to Emericella quadrilineata (Aspergillus tetrazonus) in an apparently immunocompetent host.

Evaluation of Antioxidant potential of Costus igneus in ethanol induced peroxidative damage in albino rats.

Improved antioxidant status helps to minimize the oxidative damage and thus can delay the risk of developing many chronic age related, free radical induced damage in diseases like diabetes, cancer, neurodegenerative diseases. We tried to evaluate the antioxidant potential of Costus igneus (CI) leaves in ethanol induced peroxidative damage in albino rats. Wistar albino rats of either sex were divided into four groups. Group I was control group and received normal saline, Group II received ethanol, Group III received test drug CI at 300 mg/kg and Group IV received CI at dose of 600 mg/kg. Study duration was 30 days. Antioxidants estimated at the end of 30 days. The levels of reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) significantly reduced and (malondialdehyde) MDA levels raised in ethanol treated group compared to control group. The levels of reduced glutathione, SOD and catalase enzyme recovered completely in a dose dependent manner. Results demonstrate CI significantly reversed the reduction of GSH, SOD and CAT and reduced significantly the levels of MDA, a biomarker of lipid peroxidation in a dose dependent manner, suggesting its ability to enhance the antioxidant defense to prevent alcohol induced oxidative stress injury.

Association of Malassezia species with dandruff.

Background & objectives: Malassezia species implicated with dandruff vary at different geographical locations. The present study was conducted to determine the spectrum and distribution of Malassezia species in dandruff patients and healthy individuals. Methods: Patients with dandruff from northern (Chandigarh) and southern (Manipal, Karnataka) parts of India (50 each) and healthy individuals (20) were included in the study. Dandruff severity was graded as mild, moderate and severe. Malassezia spp. isolated were quantified and identified by phenotypic characters and molecular methods including PCR-RFLP and DNA sequencing. Results: Number of Malassezia spp. retrieved was significantly higher (P<0.001) in dandruff cases (84%) as compared to healthy individuals (30%). Isolation of Malassezia spp. was significantly higher (P<0.01) in patients from southern India. In moderately severe cases M. restricta was single most predominant (37.8%) isolate from patients of northern part of India and M. furfur (46.4%) from patients of southern part of India. Malassezia density was significantly associated with the severity of dandruff (P<0.001). Interpretation & conclusions: Our results on a limited number of individuals show that Malassezia spp. associated with dandruff varies in different regions of the country and the density of yeasts increases with severity of disease.

An in vitro comparison of resistance to second and third order archwire activations of three different varieties of esthetic brackets.

Background: When ceramic brackets were introduced as an esthetic alternative to the stainless steel brackets, it was a step ahead in the use of esthetic appliances for orthodontic treatment. Although ceramic brackets had overcome the drawbacks of the initial polycarbonate brackets such as staining and bracket slot distortion, they posed an altogether different problem. This was on account of the physical properties of the ceramic material, namely brittleness. Purpose of the Study: The purpose of this study is to investigate the physical properties of three different varieties of esthetic brackets, i.e., “MXI” ceramic bracket, “Spirit MB” bracket (Ormco), a composite bracket with metal slot reinforcement and the third one fiber bracket, with silicious copolymer, Natura (Leone Co.). Aims and Objective of the Study: The objective of this study is to compare the torsional resistance of the brackets and resistance of brackets to second order archwire activations. Conclusion: The strength of the selected brackets was more than sufficient to withstand orthodontic load without any fracture or deformation.