Post-COVID-19 sequelae in lungs: retrospective computed tomography analysis in selected tertiary care hospitals of Mangalore.

Purpose: The radiological features of COVID-19 during the active disease process are well established, but the radio-logical features in the convalescent and post-recovery period of the disease are still unclear. The objectives of this study are to document and assess the proportion of the residual changes in lung post COVID-19 infection and to look for evidence and the proportion of fibrosis post COVID-19 infection on high-resolution computed tomography (HRCT). Material and methods: HRCT thorax of COVID-positive cases done during the disease process and in the recovery/post recovery phase were included in the study. Sample Size: 75. Categorical data are represented in the form of frequencies and proportions. The c2 test was used as a test of significance for qualitative data. Continuous data are represented as mean and standard deviation. A p-value (probability that the result is true) of < 0.05 was considered as statistically significant after assuming all the rules of statistical tests. Results: Initial computed tomography (CT) findings mainly included ground glass opacity (GGO) (93.3%), inter-lobular septal thickening (66.7%), consolidation (52.0%), and fibrotic bands (8.0%). Ninety-two per cent of the CT scans demonstrated some pulmonary change in the follow-up CT. This was mostly in the form of GGO (58%). Approximately 17% of cases showed fibrotic changes in the follow-up CT. Conclusions: Post-COVID lung sequelae can be present in a significant number of patients. This are mostly seen in patients with severe initial disease and in older patients. Statistically significant post-COVID sequelae changes include GGO, fibrotic bands, and bronchiectasis.

Cross-Cultural Adaptation and Validation of the Hindi Version of EuroQol (EQ-5D-3L) Health Questionnaire in Patients With Chronic Low Back Pain.

OBJECTIVE: The present study is an attempt to validate the Hindi version of the EuroQoL (EQ-5D-3L) questionnaire for patients with chronic low back pain (CLBP). DESIGN: Prospective clinical study. SETTING: The study was conducted on an outpatient basis with the subjects being followed via online platform on day 3. SUBJECT: Native Indian patients above 18 years of age having CLBP who could speak and read Hindi were enrolled in the study. METHODS: This study is a cross-sectional study on 132 patients presenting with CLBP. Hi-SF-36 was used as a reference scale. Pain was evaluated using the numeric rating scale. Psychometric properties including internal consistency, test-retest reliability on day 3 and convergent validity were evaluated. Confirmation factor analysis was carried out in order to establish the relationship between the five dimensions of Hi-EQ-5D-3L and the eight domains of Hi-SF-36. RESULTS: The Cronbach alpha of 0.984 for index value and 0.944 for visual analog scale confirmed internal consistency of the Hi-EQ-5D. Intraclass correlation coefficient was found to be excellent for EQ index value (0.969, 95% CI: 0.954-0.979) and very good for visual analog scale (0.894, 95% CI: 0.844-0.928). Spearman rho correlation coefficients for the index value correlated strongly with all domains except role emotion ( r =0.181 on day 0 and r =0.239 on day 3). A good relationship between Hi-SF-36 and Hi-EQ-5D-3L was confirmed through factor analysis. CONCLUSION: The Hindi version of the EQ-5D-3L demonstrated comprehensibility, reliability and proved to be a valid instrument for the evaluation of health-related quality of life in CLBP patients.

Long umbilical cord and its mysterious demeanour: A case report.

True knots in the umbilical cord are rare, affecting approximately 1% of all pregnancies. The diagnosis may be missed antenatally during routine ultrasonography. Many known predisposing factors are associated with true knotting. In the majority of cases, it has no bearing on foetal outcome, but may rarely be linked to intra-uterine foetal death.

Cold kit for Rhenium-188 microspheres based selective intra-arterial therapy (SIRT): Preparation, characterization and feasibility study.

Selective-intra-arterial radionuclide therapy (SIRT) using radiolabeled microspheres are being widely employed for the delivery of therapeutic radioisotope to liver cancers by exploiting the dual blood supply to liver. It delivers the therapeutic radiations to tumor and spares the healthy liver. Several radiolabeled microspheres formulations, labelled with 90Y, are commercially available. However, high-cost leads to unaffordability for several patients. 188Re-based therapy seems affordable due to commercial availability of 188W/188Re generator that have long shelf-life of more than 6 months. To provide affordable solution, the microsphere cold kit with quick and facile methodology for 188Re radiolabeling has been developed. The microsphere cold kit has been characterized for their physicochemical properties. The Quality Control (QC) tests were also performed for clinical application. The feasibility studies were performed to study distribution and retention of 188Re microspheres in tumor. The results demonstrated that the developed cold kit enables facile and quick radiolabeling with 188Re. 188Re microspheres showed good retention in tumor and found suitable for SIRT.

Combination of behavioral therapy and varenicline for smoking cessation: Time to beat nicotine.

India is the second largest tobacco consumer and the third largest tobacco producer in the world. The current trends of tobacco use in India includes 1 million deaths per year, and the problem is worsening, and also, tobacco use will cause 13% of deaths in India by 2022. To control this number, it is an alarming situation to work on the main etiology. Smoking cessation programs are considered very useful in helping tobacco users to quit, as it is a very difficult addiction to break and effective approaches are required. So, authors reported a case of 61-year-old male patient who was a chronic smoker and used to smoke 20-25 cigarettes per day. He started noticing the ill effects of tobacco in the body, so he finally decided to seek help from doctor. His habit reduced to half in few days, and finally he completely quitted smoking with the help of behavioral therapy and pharmacotherapy.

Lessons learned from an audit of 1250 anal fistula patients operated at a single center: A retrospective review.

BACKGROUND: A complex anal fistula is a challenging disease to manage. AIM: To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center. METHODS: Anal fistulas operated on by a single surgeon over 14 years were analyzed. Preoperative magnetic resonance imaging was done in all patients. Four procedures were performed: fistulotomy; two novel sphincter-saving procedures, proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts (PERFACT) and transanal opening of intersphincteric space (TROPIS), and anal fistula plug. PERFACT was initiated before TROPIS. As per the institutional GFRI algorithm, fistulotomy was done in simple fistulas, and TROPIS was done in complex fistulas. Fistulas with associated abscesses were treated by definitive surgery. Incontinence was evaluated objectively by Vaizey incontinence scores. RESULTS: A total of 1351 anal fistula operations were performed in 1250 patients. The overall fistula healing rate was 19.4% in anal fistula plug (n = 56), 50.3% in PERFACT (n = 175), 86% in TROPIS (n = 408), and 98.6% in fistulotomy (n = 611) patients. Continence did not change significantly after surgery in any group. As per the new algorithm, 1019 patients were operated with either the fistulotomy or TROPIS procedure. The overall success rate was 93.5% in those patients. In a subgroup analysis, the overall healing rate in supralevator, horseshoe, and fistulas with an associated abscess was 82%, 85.8%, and 90.6%, respectively. The 90.6% healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess (94.5%, P = 0.057, not significant). CONCLUSION: Fistulotomy had a high 98.6% healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously. The sphincter-sparing procedure, TROPIS, was safe, with a satisfactory 86% healing rate for complex fistulas. This is the largest anal fistula series to date.

Diagnosis of anorectal tuberculosis by polymerase chain reaction, GeneXpert and histopathology in 1336 samples in 776 anal fistula patients.

BACKGROUND: The association of tuberculosis (TB) with anal fistulas can make its treatment quite difficult. The main challenge is timely detection of TB in anal fistulas and its proper management. There is little data available on diagnosis and management of TB in anal fistulas. AIM: To detect TB in fistula-in-ano patients were analyzed in different methods utilized. METHODS: A retrospective analysis of different methods, polymerase chain-reaction (PCR), GeneXpert and histopathology (HPE), utilized to detect tuberculosis in fistula-in-ano patients, treated between 2014-2020, was performed. The sampling was done for tissue (fistula tract lining) and pus (when available). The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were studied. RESULTS: In 1336 samples (776 patients) tested, TB was detected in 133 samples (122 patients). TB was detected in 52/703 (7.4%) samples tested by PCR-tissue, in 77/331 (23.2%) samples tested by PCR-pus, 3/197 (1.5%) samples tested with HPE-tissue and 1/105 (0.9%) samples tested by GeneXpert. To detect TB, PCR-tissue was significantly better than HPE-tissue (52/703 vs 3/197 respectively) (P = 0.0012, significant, Fisher's exact test) and PCR-pus was significantly better than PCR-tissue (77/331 vs 52/703 respectively) (P < 0.00001, significant, Fisher's exact test). TB fistulas were more complex than non-tuberculous fistulas [78/113 (69%) vs 278/727 (44.3%) respectively] (P < 0.00001, significant, Fisher's exact test) but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups [90/102 (88.2%) vs 518/556 (93.2%) respectively] (P = 0.10, not significant, Fisher's exact test). CONCLUSION: This is the largest study of anorectal TB to be published. The detection of TB by polymerase chain-reaction was significantly higher than by histopathology and GeneXpert. Amongst polymerase chain-reaction, pus had a higher detection rate than tissue. TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups.

Validation of Hindi (Indian) version of the child perceptions questionnaire (CPQ11-14) among 11-14 year old School Children.

CONTEXT: Oral health is a fundamental aspect of general health which significantly affects quality of life (QoL) of an individual. Oral health-related QoL is a multidimensional concept determined by race, education, culture, and experiences related to oral diseases. AIM: This study aims to evaluate the Hindi (Indian) version of the child perceptions questionnaire (CPQ11-14) among 11-14-year-old school children in Rohtak City, Haryana, India. MATERIALS AND METHODS: A cross-sectional study was carried out among 586 children in Rohtak city, Haryana, India, to find out the translation and cross-cultural adaptation of CPQ11-14. The original version of CPQ11-14was translated to Hindi language, and the dental caries experience was measured by caries assessment spectrum and treatment index. STATISTICAL ANALYSIS: The data were entered into Microsoft Excel and analyzed using SPSS 18. Reliability was assessed in 2 ways: internal consistency reliability and test-retest reliability. The level of significance was set at 0.05. RESULTS: Construct validity was confirmed demonstrating statistically significant associations between total CPQ11-14 score and global ratings of oral health (P = 0.00) and overall well-being (P = 0.00). Mean CPQ11-14scores (20.30 ± 10.91) including all the domain scores were higher among children without dental caries when compared to children with dental caries (19.79 ± 9.88) and the instrument was not able to discriminate between two clinical groups significantly (P = 0.08). CONCLUSION: The Hindi version of the CPQ11-14 questionnaire is a reliable instrument having good reliability, good construct, and convergent validity but lacks discriminant validity. Shorter forms of CPQ11-14may be more useful when compared to original construct.

Functionalized magnetic nanomaterials for rapid and effective adsorptive removal of fluoroquinolones: Comprehensive experimental cum computational investigations.

Alarming growth of pharmaceutical residues in aquatic environment has elevated concerns about their potential impact on human health. Taking cognizance of this, the present study is focussed on the coating of cobalt ferrite nanoparticles with different functionalities and to use them as adsorbents for pharmaceutical waste. The thickness of the coating was analysed using Small angle X-ray scattering technique. Thorough study of the isotherms and kinetics were performed suggesting monolayer adsorption and pseudo kinetic order model, respectively. To get an insight of the interactions liable for adsorption of fluoroquinolones over the functionalized magnetic nanoparticles computational studies were undertaken. The results demonstrated substantial evidence proposing remarkable potential of these nanostructures as adsorbents for different pollutants with an additional advantage of stability and facile recoverability with a view to treat wastewater.

Assessment of Dental Caries Spectrum among 11 to 14-Year-Old School Going Children in India.

INTRODUCTION: The quantification of dental caries is usually done by DMFT index but efforts are being made to find an alternative. Caries Assessment Spectrum and Treatment (CAST) is a recent, innovative caries assessment tool which can be used in epidemiological surveys. AIM: To assess dental caries using CAST index among 11-14-year-old school children in Rohtak city, Haryana, India. MATERIALS AND METHODS: A cross-sectional study was carried out among 11-14-year-old children in schools of Rohtak City using multi stage cluster sampling technique. Rohtak city was divided in to nine clusters. In the 2nd stage, one school was randomly selected from each cluster with lottery method. Finally from each selected school, every odd roll number child between age group 11-14 years, were enrolled to reach a sample of 586. Caries was recorded using the CAST index. Each child was clinically examined by a trained examiner using CAST index. Descriptive and inferential statistics were done and Chi-square test was used to find association between caries prevalence and gender. Mann-Whitney U test was used to find any difference of mean DMFT between different age groups. RESULTS: A total of 586 children were examined. Prevalence of dental caries was 28.6%. Highest caries was observed in lower right first molar and lower left first molar (13.8% and 11.6%) respectively. Pulpal involvement in lower molars was found more than the upper molars. CONCLUSION: CAST index presents a simple hierarchical structure of caries spectrum and is a promising index for epidemiological studies with complex quantifiability.

Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication.

INTRODUCTION: Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. AIM: To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. MATERIALS AND METHODS: A cross-sectional study was undertaken on a total of 84 children aged 2-12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. RESULTS: Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). CONCLUSION: Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy.

Nickel-doped cobalt ferrite nanoparticles: efficient catalysts for the reduction of nitroaromatic compounds and photo-oxidative degradation of toxic dyes.

This study deals with the exploration of NixCo1-xFe2O4 (x = 0.0, 0.2, 0.4, 0.6, 0.8, 1.0) ferrite nanoparticles as catalysts for reduction of 4-nitrophenol and photo-oxidative degradation of Rhodamine B. The ferrite samples with uniform size distribution were synthesized using the reverse micelle technique. The structural investigation was performed using powder X-ray diffraction, high-resolution transmission electron microscopy, energy dispersive X-ray and scanning tunneling microscopy. The spherical particles with ordered cubic spinel structure were found to have the crystallite size of 4-6 nm. Diffused UV-visible reflectance spectroscopy was employed to investigate the optical properties of the synthesized ferrite nanoparticles. The surface area calculated using BET method was found to be highest for Co0.4Ni0.6Fe2O4 (154.02 m(2) g(-1)). Co0.4Ni0.6Fe2O4 showed the best catalytic activity for reduction of 4-nitrophenol to 4-aminophenol in the presence of NaBH4 as reducing agent, whereas CoFe2O4 was found to be catalytically inactive. The reduction reaction followed pseudo-first order kinetics. The effect of varying the concentration of catalyst and NaBH4 on the reaction rates was also scrutinized. The photo-oxidative degradation of Rhodamine B, enhanced oxidation efficacy was observed with the introduction of Ni(2+) in to the cobalt ferrite lattice due to octahedral site preference of Ni(2+). Almost 99% degradation was achieved in 20 min using NiFe2O4 nanoparticles as catalyst.

Pseudocarcinomatous Hyperplasia of the Fallopian Tubes which was Associated with Female Genital Tract Tuberculosis, Histologically Mimicking Tubal Adenocarcinoma: A Diagnostic Challenge.

The benign proliferative and reactive processes of the fallopian tubes which are a result of female genital tract tuberculosis can mimick malignant neoplasms, both clinically and pathologically. 'Pseudocarcinomatous hyperplasia' is a term which is applied to the florid form of epithelial hyperplasia with atypical features, that mimicks tubal adenocarcinoma. It may be encountered in the tuberculous and the non tuberculous forms of chronic salphingitis. We are reporting a case of a 30 years old female who presented to our institute with complaints of vaginal discharge and fever. She underwent panhysterectomy for uterine fibroids. Both her fallopian tubes revealed features of florid atypical epithelial hyperplasia, along with widespread caseating granulomatas. Ziehl Neelsen (ZN) staining of the lesion for acid fast bacilli (AFB) was positive. A diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes which was associated with female genital tract tuberculosis, which histologically mimicked tubal adenocarcinoma was made, which posed a diagnostic dilemma.