Assessment of the anterior and caudal extent of inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of submandibular fossa using computed tomography.

BACKGROUND: A well-versed knowledge of the precise location of various anatomical landmarks is necessary to avoid complications during surgery. The study was conducted for the assessment of the anterior and caudal extent of the inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of the submandibular fossa using computed tomography (CT). MATERIALS AND METHODS: One hundred CT scans were randomly selected for this study accounting for 200 hemimandibles. Both axial and coronal images were obtained and evaluated concurrently. Results were subjected to statistical analysis for correct inferences. RESULTS: A total of 200 hemimandibles (n = 200) from 100 patients with a mean age was 23.89 ± 1.75 years ranging from 21 to 33 years were evaluated. The mean length of the anterior loop was 0.95 mm for all of the observation combined and measurement range from 0 to 5.1 mm. The total frequency of type I, type II, and type III of mental nerve was found as 71%, 4.5%, and 24.5%, respectively. At the level of the first molar, the mean distance from the center of the inferior alveolar canal to the external surface of the buccal cortex (Q) was 5.44 ± 1.38 mm ranging from 2.4 to 10.4 mm. Furthermore, there was no statistically significant difference in MF-IMB (mental foramen to the inferior border of mandible) between the right and left sides of the mandible. (P = 0.87). CONCLUSION: Our study demonstrates that analyzing CT scans using the methods described in this study can be a useful tool in avoiding the iatrogenic injuries to inferior alveolar nerve and arteries during various maxillofacial surgical procedures.

Characteristics and outcomes of women initiating ART during pregnancy versus breastfeeding in Option B+ in Malawi.

BACKGROUND: Malawi adopted the PMTCT strategy 'Option B+' in 2011, providing life-long ART for all HIV-infected pregnant and breastfeeding women. We explored differences in characteristics and outcomes of women initiating ART during pregnancy versus breastfeeding. METHODS: We conducted a retrospective cohort analysis of women in Zomba District, southern Malawi, from January 2012- September 2013. Data were extracted from the Zomba District Observational Cohort Study, a surveillance project collecting data from standardized Ministry of Health ART monitoring tools. RESULTS: 1986 (67.2 %) women initiated ART during pregnancy and 969 (32.8 %) during breastfeeding. Women initiating ART in breastfeeding were more likely to be > 30 years (aOR = 1.33, 95 % CI1.11-1.59, p = 0.003) and have WHO Stage 3/4 (aOR = 2.74, 95 % CI1.94-3.87, p < 0.001). Eighteen (0.6 %) deaths occurred and 942 (31.9 %) women defaulted ART. 'Early' death (< 30 days) occurred in 3 (0.1 %) women and 449 (16.4 %) women defaulted early. Death/default < 30 days was more likely among women initiating ART during pregnancy (aOR 1.62, 95 % CI1.28-2.05, p < 0.001) or < 30 years old (aOR 1.27, 95 % CI 1.02-1.57, p = 0.03) and was less likely among those with WHO Stage 3/4 (aOR 0.30, 95 % CI 0.15-0.60, p < 0.001). Using Kaplan-Meier estimators to investigate time to death/default, we showed a sharp drop in death/default-free survival probability at time zero, yet survival probability decreased in a nearly linear manner after this initial period of high default. Women under 30 years had increased rates of death/default over time (log rank test: p < 0.001), however no significant differences were observed in death/default over time associated with timing of ART initiation, documented clinical stage at initiation, health clinic size or adherence rates. CONCLUSIONS: Many women in Malawi started ART during breastfeeding within Option B+ and were older and had more advanced WHO Clinical Staging. This represents a missed PMTCT opportunity to initiate treatment early in pregnancy. Early defaulting is identified as a challenge within Option B+, and was more likely among younger women and those initiating ART in pregnancy. Targeted research to understand factors associated with uptake of ART during pregnancy and retention in care could improve the efficacy of Option B+ in Malawi.

Evaluation of body growth and immunity-related differentially expressed genes through deep RNA sequencing in the piglets of Jeju native pig and Berkshire.

This study was carried out with the objective to investigate the differentially expressed genes (DEGs) between Jeju native pig (JNP) and Berkshire piglets. The RNA-Seq technique was used to investigate the transcriptomes in the fat, liver and longissimus dorsi muscle from these two breeds. Paired-end reads of the sequences that passed the quality filters were aligned to the Sus scrofa genome using tophat2 (v2.0.2). In this study, 65% of muscle, 20% of fat and 54% of liver genes showed higher expression in the piglets of JNP than in Berkshire. Gene Ontology and signaling pathways showed that immune response and lipid metabolisms were commonly enriched pathways in all three tissues. It was found that the genes pertaining to body growth and immune system are significantly (P < 0.01) more highly expressed in Berkshire piglets. DEGs explored between the piglets of the two breeds might influence the identification of the genetic markers for further breed improvement programs. Our findings provide a new perspective for understanding and identifying candidate genes that are involved in various biological functions. Moreover, transcriptome analysis makes it easier to understand the differences between genetic mechanisms of breeds.

Histopathological and immunohistochemical diagnosis of infectious bursal disease in poultry birds.

AIM: The aim of the present study was to diagnose infectious bursal disease (IBD) using gross, histopathological, and immunopathological approaches and to compare efficacy of immunohistochemical techniques with conventional diagnostic techniques. MATERIALS AND METHODS: A total of 33 samples were collected from the six different poultry farms from Ludhiana and the nearby districts. Upon gross analysis of the necropsied birds, the relevant tissue samples such as bursa, kidney, junction of proventriculus and gizzard, heart, and muscles were then processed for histopathological and immunohistochemical studies. RESULTS: Varied macroscopic changes were noted in bursa, characterized as swollen, hemorrhages to atrophy in size. Nonetheless, hemorrhages over thigh muscles were rarely seen. Histologically, the bursa showed prominent fibrotic and atrophic changes. Rarefaction of bursal follicles with intermittent infiltration of lympho-mononuclear cells with chronic cystic changes was additional changes, considered to be paramount for IBD. Expression and localization of IBD specific viral antigens were noticed mainly intracellular to the rarefied areas of bursal follicle section(s), in conjunction to inner lining of the cystic cavities of affected follicles. In addition, the junction of proventriculus and gizzard, the heart muscle, respiratory ciliated epithelium, and proventriculus also revealed positive expression to IBD virus (IBDV) antigen. Advanced immunopathological techniques, i.e., immunofluorescence further testified the evidence of antigen as positive green signal within affected follicles. Further consideration to the reliability of various techniques employed, positive correlation (r=0.64623) was emerged out with conventional pathological scoring. CONCLUSION: It is concluded that the bursa acts as an organ of choice for demonstrating IBDV antigen for specific diagnosis of disease using immunohistochemistry (IHC), and IHC staining is a precise, specific, rapid, and reliable method to demonstrate the IBDV antigen in the altered tissues due to IBDV infection.

Closure of Anterior Palatal Fistula by Tongue Flap: A Prospective Study.

AIM: To check the efficacy of dorsal tongue flap in closure of anterior palatal fistula without using any fixation devices. MATERIAL AND METHOD: It is a prospective study in which 20 patients of anterior palatal fistula, larger than 5 mm, attending the outpatient department of oral and maxillofacial surgery, Genesis Institute of Dental Sciences and Research, Ferozpur over a period of 5 years (from November 2005 to January 2011) were included. The surgical treatment was divided into 2 stages-raising of the flap on the tongue and transfer of the flap from the dorsum of the tongue to fistula site and then separation of flap and its adjustment at the site of defect after an interval of 3 weeks minimum. Follow-up was done for 3 and 6 months. RESULT: Successful closure was achieved in 90 % of the cases. 80 % patients experienced decrease in hypernasality. In none of the cases decrease in size of tongue, loss or change in taste sensation, difficulty in speech, difficulty in swallowing or bulkiness of flap was observed. CONCLUSION: The results obtained during the course of this study strongly support the method used to close the anterior palatal fistula. It is concluded that the dorsal tongue flap is the highly successful method without the need of additional fixation devices in closure of anterior palatal fistula.

Primary leiomyosarcoma of the maxilla: An investigative loom-report of a challenging case and review of literature.

Leiomyosarcoma (LMS) is a malignant neoplasm composed of cells showing distinct smooth muscle features. Majority of the tumors are located in the retroperitoneum, including the pelvis and the uterus but are rare in the oral and pharyngeal region. Intraorally, they are present as painless, lobulated, fixed masses of the submucosal tissues in middle-aged or older individuals. Lesions are usually slow growing and are less than 2 cm in diameter at the time of diagnosis. Here we report the clinico-pathological findings of a case of primary LMS of the maxilla in 63-year-old male patient with an emphasis on the judicious use of ancillary diagnostic modalities to arrive at a definitive diagnosis.

Updating a patient-level ART database covering remote health facilities in Zomba district, Malawi: lessons learned.

SETTING: A non-governmental organization, Dignitas International, working in partnership with the Ministry of Health in Malawi, adopted innovative, low-technology methods to collect, capture, and manage patient-level antiretroviral therapy (ART) data in a district database covering 26 remote low-resource facilities in Zomba District, Malawi. OBJECTIVE: To establish a longitudinal, observational database of routinely collected program data that could serve as a program monitoring and evaluation tool as well as a platform to conduct effective operational research. DESIGN: This article describes the processes developed for digital capture of paper-based ART clinical records at health facilities and updating them in a central electronic database. It documents and focuses on lessons learned during the implementation and review of processes. CONCLUSIONS: Data quality can only be ensured with regular review of, and compliance with, clearly delineated workflow protocols and adequate staffing and supervision. Through the implementation of this procedure, we expect to improve data quality, completeness, and use of routine ART clinical data in low-resource settings.

Acute superior vena cava obstruction due to tight pericardial closure following congenital defect repair.

The obstruction of the superior vena cava (SVC) of acute onset nature following surgery is a rare and serious condition. The tight closure of the pericardium over the heart during surgical procedures may cause external compression on the SVC. Echocardiography and Computed tomography (CT) scan aids in the diagnosis. Cutting open the pericardial stitches relieves the condition.

Prevalence and impact of gastrointestinal helminths on body weight gain in backyard chickens in subtropical and humid zone of Jammu, India.

Necropsy of gastrointestinal tract of 125 free-range chickens from a subtropical and humid zone of northwestern India revealed four nematode spp. (Ascaridia galli, Heterakis gallinarum, Capillaria spp. and Cheilospirura hamulosa) and four cestode spp. (Raillietina cesticillus, Raillietina echinobothrida, Raillietina tetragona and Amoebotaenia cuneata) The overall prevalence of the helminth parasites was 72.0%. Amongst various helminth species encountered in the region, A. galli emerged out as the most prevalent, followed by H. gallinarum, R. cesticillus and R. echinobothrida. The impact of helminthic infections on body weight gain in growing chickens was investigated. One hundred growing chickens, aged 40 days were randomly assigned to two groups (treated and untreated controls) of 50 birds each. The birds in treated group were given fenbendazole at 7.5 mg per kg body weight in drinking water, while the birds in other group served as untreated controls. At the end of the 90 days of the field trial, the mean body weight gain of untreated controls was 1232.2 ± 7.28 g (13.7 g/day) compared with 1617.6 ± 5.43 g (18.0 g/day) in the treated group. It was associated with a significantly (P < 0.05) higher mean worm burden (32.92 ± 6.12) in untreated controls than the treated group (2.46 ± 1.14). The prevalences of helminthic species and their impact on body weight gain in growing backyard chickens have been discussed.

Reasons for accepting or refusing HIV services among tuberculosis patients at a TB-HIV integration clinic in Malawi.

SETTING: In Malawi, human immunodeficiency virus (HIV) prevalence among newly registered tuberculosis (TB) patients is 60-70%. In 2008, an integrated TBHIV clinic was established at a central hospital in Zomba. Despite the integration of TB-HIV activities and improved HIV service uptake, unacceptably high proportions of HIV-positive TB patients are still not receiving antiretroviral therapy (ART). OBJECTIVE: To identify factors that motivate or discourage TB patients from accepting HIV services. DESIGN: Retrospective analysis of patients registered for TB treatment (not yet on ART) between April 2008 and March 2009; qualitative interviews of 99 patients on TB treatment. RESULTS: Of 1773 newly registered TB patients who were not already on ART at the time of TB registration, 86% accepted HIV testing and counselling. Among HIV-positive TB patients, 38% started ART during or after anti-tuberculosis treatment. Young adults aged 15- 24 years were least likely to initiate ART. Motivation for accepting ART during TB treatment included prospects of regaining good health and longer life, and counselling by health care providers. Barriers to ART uptake included not being offered ART, high CD4 count, drug stockouts and fear of drug toxicities/interactions. CONCLUSION: Several factors that undermine uptake of ART have been highlighted; targeted measures urgently need to be addressed by TB-HIV programmes to overcome these barriers.

Clinicopathological Studies on Vitamin D(3) Toxicity and Therapeutic Evaluation of Aloe vera in Rats.

A study was conducted to examine the clinical signs, hematological, biochemical and histopathological changes in vitamin D(3) toxicity at a dose rate 2 mg/kg b.wt. of vitamin D(3) and to assess the protective effect of Aloe vera in vitamin D(3) toxicity. The clinical signs observed were anorexia, progressive weight loss, difficulty in movement and respiration, diarrhea, epistaxis, subnormal body temperature and nervous signs before death. Mortality was observed in treated rats between day 10 and day 19 of treatment. The gross postmortem changes observed were severe emaciation, white chalky deposits on epicardial surface of heart, pin point white deposits on cortical surface of kidneys with pale yellow discoloration and diffused white deposits on serosal surface of stomach and intestine with bloody ingesta in lumen. The hematological changes included non-significant increase in hemoglobin and total leukocyte count and significant increase in relative neutrophil count. The biochemical changes observed were significant increase in plasma concentration of calcium, phosphorus and blood urea nitrogen, whereas a significant decrease in the concentration of albumin and total plasma protein was observed. The histopathological lesions included calcification of various organs, viz., tongue, stomach, intestines, kidney, heart, aorta, larynx, trachea, lungs, spleen, choroid plexus arteries of brain and vas deferens. The Aloe vera juice (2.5% in drinking water) has no protective effect on vitamin D(3) toxicity (2 mg/kg b.wt.).

Efficacy of fenbendazole, levamisole and ivermectin against gastrointestinal nematodes in Jamunapari goats.

Efficacy of fenbendazole, levamisole and ivermectin was checked in comparison to untreated controls in twenty Jamunapari goats, naturally infected with gastrointestinal nematode parasites. Faecal examination at day 0 revealed an egg per gram of 930 ± 175.1, 1350 ± 421.1, 1060 ± 224.9 and 800 ± 279.7 in group A, B, C and D, respectively having five animals each. The results of larval culture examination revealed the presence of Haemonchus, Trichostrongylus, Oesophagostomum, Bunostomum and Strongyloides spp. in these animals. Faecal egg counts of the animals treated with fenbendazole (group A), levamisole (group B) and ivermectin (group C) were reduced by 23.66, 63.70 and 98.11%, respectively on day 14 post-treatment.

Chlorpyrifos chronic toxicity in broilers and effect of vitamin C.

An experiment was conducted to study chlorpyrifos chronic toxicity in broilers and the protective effect of vitamin C. Oral administration of 0.8 mg/kg body weight (bw) (1/50 LD50) chlorpyrifos (Radar(®)), produced mild diarrhea and gross lesions comprised of paleness, flaccid consistency and slightly enlargement of liver. Histopathologically, chlorpyrifos produced degenerative changes in various organs. Oral administration of 100 mg/kg bw vitamin C partially ameliorated the degenerative changes in kidney and heart. There was insignificant alteration in biochemical and haematological profiles. It is concluded that supplementation of vitamin C reduced the severity of lesions induced by chronic chlorpyrifos toxicity in broilers.

Pleomorphic adenoma of submandibular gland: An uncommon occurrence.

Pleomorphic adenoma (PA) is the most common tumor of the benign salivary gland neoplasms, and the most common gland to be involved is the parotid gland. Its occurrence in the submandibular or the sublingual gland is uncommon. We present a case of a histologically proven PA involving the submandiblular gland.

Female genital tuberculosis: early diagnosis by laparoscopy and endometrial polymerase chain reaction.

OBJECTIVE: To evaluate the efficacy of laparoscopic visual inspection vs. endometrial tuberculosis (TB) polymerase chain reaction (PCR) for an early diagnosis and management of female genital TB (GTB) in India. DESIGN: Observational case study. RESULTS: Both laparoscopy and endometrial (endo) TB-PCR were performed on 162 infertile women: 52 endo TB-PCR-positive patients were diagnosed as definite GTB, of whom 44 (84.6%) also showed laparoscopic findings suspicious of TB (Type I). Subgroup analysis showed a similar PCR positivity of 54.5% (24/44) in the strongly suspicious and 54.1% (20/37) in the mildly suspicious patients. Using the Bayesian approach, the maximum likelihood estimates of the sensitivity and specificity of laparoscopy in diagnosing GTB were 0.96 and 0.93 and those of a positive PCR were respectively 0.59 and 0.92. Of the 52 women who were TB-PCR positive, 16 (30.8%) conceived following treatment. CONCLUSIONS: Endo TB-PCR had high specificity to diagnose GTB, as did laparoscopy. Laparoscopy may therefore be avoided in TB-PCR-positive patients for diagnosis but may still be required to rule out GTB in PCR-negative cases.

Neuropathological studies of chickens following exposure to chlorpyrifos.

The objective of this study was to determine the putative neuropathological effects in young chickens after administration of a single dose of 55 mg/kg bw chlorpyrifos. The gross lesions of the nervous system comprised of congestions in the brain. Microscopic examination of brain showed mild congestion of cerebral blood vessels and mild perivascular cuffing of lymphomononuclear cells in the cerebral cortex and necrosis of the neurons. The interesting findings were the presence of cytoplasmic vacuolations of cerebral neurons and swelling of the endothelial cell of the cerebral capillaries. Cerebellum showed congestion and hemorrhages in the granular layer and necrosis of Purkinje cell. Sciatic nerve exhibited mild edema, swelling and degeneration of axons, and swelling of Schwann cells. There was a significant inhibition of plasma cholinesterase enzyme activity in chickens administered with chlorpyrifos compared to chickens of control group. The study revealed that administration of chlorpyrifos produces neuropathological lesions in chickens shortly after exposure.

Effects of dietary supplements of selenium, vitamin E or combinations of the two on antibody responses of broilers.

1. The effects of selenium and vitamin E supplementation on some immune parameters were investigated in broilers. 2. Broiler chicks were fed on maize-soybean diets with different concentrations of vitamin E (0-200 mg/kg) and selenium (0-0.2 mg/kg diet) either alone or in combinations from 1 to 42 d of age. 3. Chicks were immunised against Newcastle disease virus (NDV) vaccine at 21 d of age and haemagglutination inhibition (HI) titres were determined after 10 d. 4. Chicks receiving supplements of 200 mg vitamin E/kg and 0.2 mg selenium/kg produced significantly higher HI antibody titres. This was associated with an increased serum concentration of total immunoglobulins and circulatory immune complexes. 5. The chicks given 200 mg vitamin E/kg and 0.2 mg selenium/kg had significantly heavier spleen and bursa. 6. These results suggested that vitamin E and selenium have synergistic effects on immune responses.

A protective effect of vitamin E and selenium in ameliorating the immunotoxicity of malathion in chicks.

A study was conducted to determine whether a combination of vitamin E and selenium was able to counteract the immunosuppressive effects of chronic toxicity of malathion in chicks. The chicks were divided into three groups. The first group received malathion 10 mg/kg body weight; the second group received the same dose of malathion but was supplemented with vitamin E and selenium for 60 days; and the third group served as the control. The concentration of total immunoglobulins and circulatory immune complexes decreased following the administration of malathion, whereas the supplementation of the diet with vitamin E and selenium partially counteracted this effect. The histopathological changes in the bursa of Fabricius due to malathion were consistent with these findings. Supplementation with vitamin E and selenium partially ameliorated the degenerative changes in the bursa of Fabricius.

Effect of blood transfusion in combination with Dextran-40 and hypertonic saline solution on cardiopulmonary haemodynamics of endotoxin (lipopolysaccharide) shock in buffalo calves.

The intravenous (i.v.) infusion of lipopolysaccharide (LPS) of E. coli endotoxin in buffalo calves (n = 15) at 5 microg/kg bw per h for 3 h caused a significant (p<0.05) fall in plasma volume, blood volume, haematocrit haemoglobin, and systolic, diastolic and pulse pressure, mean arterial pressure and central venous pressure (CVP), with a marked rise in respiration. Treatment with a combination of i.v. infusion of 7.2% hypertonic saline solution, Plasmex-D-40 (Dextran-40) and blood successfully alleviated hypovolaemia, and raised systolic, diastolic and pulse pressure, mean arterial pressure and central venous pressure. The whole blood was collected from apparently healthy male buffalo calves 24 h prior to infusion and was transfused without cross-matching. No significant fall in haemoglobin, haematocrit and body temperature was observed after transfusion. All these values tended to remain near normal levels. However, this combination of treatment had no effect on high respiratory rate. A one-time blood transfusion did not evoke any cross-reaction and was helpful in raising haematocrit and haemoglobin close to pre-infusion values. The general symptoms of restlessness, respiratory distress, profuse salivation, violent movement of the ears, snoring, intermittent struggle, etc. were markedly reduced. All the treated animals became quiet and lay with eyes open and survived the 7 h of observation.