Case-based Learning in Microbiology: Observations from a North West Indian Medical College.

BACKGROUND: Microbiology is usually taught by conventional lectures, and its retention and application is observed to be poor among medical graduates/practitioners. AIM AND OBJECTIVES: Introduction of case-based learning (CBL) in microbiology for second-year professional MBBS students. MATERIALS AND METHODS: Students were divided into two groups of fifty each. Four clinical cases were used for CBL. One group had two CBL sessions whereas the other had didactic lectures (DLs) and then the groups were crossed over. Case scenario handouts were given to students a week before the session, and smaller groups were formed for discussions and presentations in CBL sessions. Posttest, in multiple choice questions format, was conducted in two phases: First, immediately after the completion of the four CBL and DL sessions, and second, 6 weeks after the first posttest. Student and faculty feedback was taken about CBL sessions. RESULTS: Hundred MBBS students of the fourth semester voluntarily participated in the CBL study. The CBL scores were significantly higher than DL session scores (P = 0.015). This difference was more marked in scoring done after 6 weeks of session completion (P < 0.001). Student reported satisfaction in being taught by CBL method in 5-point Likert scale feedback form. Faculty feedback was positive for CBL. CONCLUSIONS: CBL helped in retention of knowledge and its application better than DL in our observation. More sessions on commonly encountered case scenarios will be useful for students in recalling basic science knowledge in their later years as practitioners.

Cleidocranial dysplasia syndrome (CCD) with an unusual finding in a young patient.

Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, presents with a wide range of variability. Dentists are often the first to encounter patients with CCD, some of whom do not show typical manifestations. Since it has similar features to other pathologies, CCD is misdiagnosed as other conditions. A 10-year-old boy suffering from CCD was misdiagnosed as having rickets and was referred for non-eruption of a few permanent teeth along with an unaesthetic facial appearance. Clinically and radiologically, a diagnosis of CCD was made. Currently, management of this patient's orofacial manifestations is underway.

Hepatitis B virus seroprevalence and its correlation with CD4 cells and liver enzymes among human immunodeficiency virus positive individuals at a tertiary care hospital in North-West India.

BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are global health concerns. Due to shared routes of transmission, co-infection is common. Their co-existence can cause severe liver complications and immunological impairment in infected individuals. AIM: To find the prevalence of HBV co-infection in HIV patients and to assess the pattern of liver enzymes and CD4 T-cell counts in HIV monoinfected and HIV/HBV co-infected patients. MATERIALS AND METHODS: A total of 342 consecutive confirmed HIV positive treatment naïve patients were tested for hepatitis B surface antigen (HBsAg). Clinical staging was done according to Centers for Disease Control and Prevention classification guidelines. Liver function tests were performed by an autoanalyser. CD4 T-cells were estimated by FACS Calibur. RESULTS: Hepatitis B virus co-infection was detected in 8.7% of HIV positive patients as compared to 1.42% in the HIV negative control group (P < 0.05). Majority of the HIV monoinfected and co-infected patients were below 38 years. HBsAg positivity was higher in males (9.4%) and the route of transmission was heterosexual. Categorical data revealed significantly higher proportion of alanine aminotransferase and aspartate aminotransferase (AST) in the co-infected patients compared to the monoinfected patients (P < 0.05). The HIV/HBV co-infected patients had significantly lower CD4 T-cell counts (P = 0.03) and significantly higher AST, alkaline phosphatase and serum bilirubin values (P = 0.023, P = 0.029, P = 0.009 respectively) than the monoinfected group. Males had 1.33 times higher risk than females for co-infection (odds ratio = 1.33; 95% confidence interval 0.57-3.10). CONCLUSION: The prevalence of co-infection was high. Raised levels of liver enzymes and lowered CD4 counts were seen in co-infected patients. These findings underscore the importance of HBV screening of all HIV positive individuals before initiating antiretroviral treatment.

True generalized microdontia and hypodontia with spondyloepiphyseal dysplasia.

Spondyloepiphyseal dysplasia (SED) is a descriptive term used for group of inherited disorders of bone growth resulting in short stature, skeletal abnormalities, and problems with hearing and vision. SED have three major forms, SED congenital, pseudoachondroplastic SED, and SED tarda. SED tarda is milder than SED congenita. True generalized microdontia is a rare condition in which all the teeth are abnormally small. This is a report of a rare case having SED with generalized microdontia in a 26-year-old patient.

Self-exfoliation of large submandibular stone-report of two cases.

Sialoliths are the most common diseases of the salivary glands. They may occur in any of the salivary gland ducts but are most common in Wharton's duct and the submandibular gland. This report presents clinical and radio graphical signs of two unusually large sialoliths which exfoliated by itself. There were painless swellings on the floor of the mouth in both cases. Radiographical examination revealed large irregular radioopaque mass superimposed right canine and premolar areas. Sialoliths were yellow in color and approximately 1.8 cm and 2.1 cm in size.

Carisolv as an endodontic irrigant in deciduous teeth: an SEM study.

AIM: Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. "The purpose of this study was to evaluate the efficacy of Carisolv , 1% sodium hypochlorite (NaOCl) gel, and 1% NaOCl solution as root canal irrigants in deciduous anterior teeth." MATERIALS AND METHODS: THIRTY-six extracted deciduous anterior teeth were used. Root canals were flooded with NaOCl solution in Group A, NaOCl gel in Group B and Carisolv in Group C and incubated for 30 min. Scanning electron microscope photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored. RESULTS: The results showed that regardless of irrigation regime, canals were consistently cleaner in the coronal and middle thirds than in the apical thirds. NaOCl solution, NaOCl gel, and Carisolv had comparable activity at coronal third and middle third of root canals. At the apical third, NaOCl solution cleaned canals better than NaOCl gel and Carisolv. Carisolv cleaned debris better than NaOCl gel at the apical third. CONCLUSION: Carisolv can be used as an adjunct to root canal preparation.

Cemento-ossifying fibroma.

The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of cemento-ossifying fibroma involving the left mandible is described in a 35 year old female patient. The clinical, radiographic and histological features as well as surgical findings are presented. The cemento-ossifying fibroma is a central neoplasm of bone as well as the periodontium which has caused considerable controversy because of the confusion regarding terminology and the criteria for its diagnosis.

A comparative analysis of root dentin transparency with known age.

OBJECTIVE: To correlate dimensions of root transparency and age, and to assess whether transparency is reliable for age estimation of unknown. MATERIALS AND METHODS: 50 freshly extracted single rooted permanent teeth from 50 different individuals (27 males and 23 females) were collected and their ground sections of 400 µm were stained with 1% methylene blue. The area of the translucent zone was measured by superimposing a transparent graph paper on the ground section under stereomicroscope. The length of the translucency was measured by using digital vernier caliper. RESULTS: A strong positive correlation between age and translucency of dentin was noted. The length rather than the area of the translucent zone correlated more with age. CONCLUSION: Translucency of the root dentin increases with age and it can be used as a reliable parameter for the age estimation.

Prevalence of HIV/AIDS and Prediction of Future Trends in North-west Region of India: A six-year ICTC-based Study.

BACKGROUND: The study was conducted to analyze previous six-year prevalence data of HIV infection in the Northwest region of India and predict future trends for a couple of years. OBJECTIVES: The study was conducted to aid SACS and NACO to plan and arrange resources for the future scenario. MATERIALS AND METHODS: All the attendees of ICTC, Jaipur, from January 2002 to December 2007 were included and variables like age, sex, marital status, occupation, place of residence, pattern of risk behavior and HIV serostatus were studied. As per the strategy and policy prescribed by NACO, tests (E/R/S) were performed on the serum samples. Data was collected; compiled and analyzed using standard statistical methods. Future trends of HIV-prevalence in north-west India were anticipated. RESULTS: The overall positivity rates among attendees of ICTC, were found to be 12.2% (386/3161), 11.8% (519/4381), 11.1% (649/5867), 13% (908/6983), 14% (1385/9911) and 17.34% (1756/10133) in the years 2002, 2003, 2004, 2005, 2006 and 2007 respectively. Future trends for the next couple of years depict further increase in prevalence without any plateau. CONCLUSION: Epidemiological studies should be carried out in various settings to understand the role and complex relations of innumerable behavioral, social and demographic factors, which will help, interrupt and control the transmission of HIV/ AIDS.