Public Health System's Preparedness to Address Polycystic Ovarian Syndrome: A Rapid Assessment Survey of Health-care Providers in India.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders largely affecting women of reproductive age group. OBJECTIVES: This study aimed to understand the Indian public health-care systems' preparedness in addressing PCOS. MATERIALS AND METHODS: A multicentric rapid assessment cross-sectional study was undertaken among 173 health-care providers serving across various public health-care facilities in India. This study was a component of a larger task force study that aimed to estimate the community-based prevalence of PCOS in India. Information on PCOS cases reported that knowledge about PCOS diagnosis, management practices, availability of diagnostic facilities, and drugs was explored. RESULTS: Irregular menstrual cycle was the most commonly reported PCOS symptom. Most of the health-care providers (HCPs) lacked correct knowledge about diagnostic criteria and investigation needed for the diagnosis of PCOS. Diagnostic facilities and drugs were inadequate. However, some facilities had access to investigations through public-private partnerships. Awareness programs on PCOS in the community were negligible, and PCOS cases were not documented. Training HCPs on PCOS along with the availability of specialists and strengthening diagnostic facilities were some major demands from the HCPs. CONCLUSION: Results suggest the need for training HCPs, strengthening infrastructure with good referral linkages, and adequate supply of drugs to help improve PCOS management at public health-care facilities in India. There is a need to develop national technical and operational guidelines to address PCOS using a multidisciplinary approach across all levels of care. Creating demand for services and advocating healthy lifestyles through community awareness can help early diagnosis and prevention of complications.

Arbuscular Mycorrhizal inoculants and its regulatory landscape.

One of the most prominent means for sustainable agriculture and ecosystem management are Arbuscular Mycorrhizal (AM) inoculants. These inoculants establish beneficial symbiotic relationships with land plant roots, offering a wide range of benefits, from enhanced nutrient absorption to improved resilience against environmental stressors. However, several currently available commercial AM inoculants face challenges such as inconsistency in field applications, ecological risks associated with non-native strains, and the absence of universal regulations. Currently, regulations for AM inoculants vary globally, with some regions leading efforts to standardize and ensure quality control. Proposed regulatory frameworks aim to establish parameters for composition, safety, and efficacy. Nevertheless, challenges persist in terms of scientific data, standardization, testing under real conditions, and the ecological impact of these inoculants. To address these challenges and unlock the full potential of AM inoculants, increased research funding, public-private partnerships, monitoring, awareness, and ecosystem impact studies are recommended. Future regulations have the potential to improve product quality, soil health, and crop productivity while reducing reliance on chemical inputs and benefiting the environment. However, addressing issues related to compliance, standardization, education, certification, monitoring, and cost is essential for realizing these benefits. Global harmonization and collaborative efforts are vital to maximize their impact on agriculture and ecosystem management, leading to healthier soils, increased crop yields, and a more sustainable agricultural industry.

Optimizing factors for large-scale production of Arbuscular Mycorrhizal Fungi consortia using root organ cultures.

Large-scale production of Arbuscular Mycorrhizal Fungi (AMF) consortia is a crucial stride in harnessing their potential for sustainable agriculture and plant growth enhancement. However, establishing optimal production conditions is challenging due to their obligate nature, variability, lack of standardized protocols, and limited understanding of their specific requirements. Previous attempts to standardize Root Organ Cultures (ROC) for AMF overlooked challenges related to viable inoculum production for field applications. This current investigation reported, for the first time, the optimization of various factors during large-scale production of AMF using ROC. By optimizing factors like gelling agents, media preparation, medium-to-inoculum ratios, incubation conditions, age, harvesting method and drying temperatures, we achieved significant yields of viable propagules. The standardized protocol outlined in this study will greatly influence commercial-scale AMF production. These standardized protocols are poised to contribute to larger-scale AMF production worldwide, with the potential to support sustainable agriculture and ecosystem management.

Postoperative clinical outcome between lateral retraction and eversion of patella following simultaneous bilateral total knee arthroplasty.

AIMS AND OBJECTIVE: Among the various exposure technique used in total knee arthroplasty (TKA); the midline medial parapatellar knee approach is most commonly performed; which require mobilisation of patella for adequate surgical exposure. In this study, we compare the effect of patellar eversion with lateral retraction in simultaneous bilateral TKA to find out difference in postoperative clinical outcome between the two patellar mobilisation techniques. METHODS: We enrolled 41 patients who underwent bilateral simultaneous TKR (82 knees) from Nov 2016 to Dec 2018. During surgery patellar eversion was done in one knee and lateral retraction was done in other knee selecting them randomly to reduce the bias. During the follow up period achieving unassisted active straight leg raise (SLR), 90 flexion and complications were recorded. Measurement of Oxford knee society score (OKSS), American knee society score (AKSS), Visual Analogue Scale (VAS) score, and quadriceps strength (measured by handheld dynamometer) was done daily up to one week, 1 month, 3 months, 6 months, and 1 year postoperatively. RESULTS: The time of achieving active SLR and 90∗ flexion postoperatively was quicker in the lateral retraction group with a statistically significant difference. VAS pain score at 1 week and 1 month along with quadriceps strength in 1-month had statistically significant favourable outcomes in the lateral retraction group. Throughout the follow up lateral retraction group had better Oxford and American knee score but the difference being statistically insignificant. No significant difference was found on the complication rate. CONCLUSION: In comparison to lateral retraction, patellar eversion has an adverse effect in early knee functional recovery after TKA; it delays achieving active SLR, 90∗ flexion and has unfavourable outcome in functional scores, quadriceps strength, and postoperative pain relief. However it has minimal effects on long term functional outcomes.

Platelet-rich fibrin: a boon in regenerative endodontics.

Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

Incidence and pattern of mandibular fractures in Rohilkhand region, Uttar Pradesh state, India: A retrospective study.

AIMS: To understand and evaluate the significance of various aetiological factors in determining the incidence and dictating the patterns of mandibular fractures in Rohilkhand region. METHODS: The patient records and radiographs for 144 patients treated for mandibular fractures were reviewed between the time periods from January 2012 to December 2013. Data on age, gender, aetiology, use of intoxicants, head injury, associated injuries, days of the week, anatomic site and multiple fractures within the mandible were recorded and assessed. RESULTS: Maximum incidence of fractures was observed among the individuals in 3rd decade (35.4%) followed by 2nd and 4th decades, which exhibited 32 and 30 cases (22.2% and 20.8%), respectively. Male to female ratio was biased (4:1) portraying a male predominance. Road traffic accidents (RTAs) were observed to be the predominant aetiological factor responsible accounting for 79.2% of the total injuries followed by assaults (11.8%) and falls (9%). Parasymphysis exhibited the highest incidence (32.63%) amongst the anatomic sites, followed by body (18.75%), angle (16.66%), condyle (15.27%), symphysis (12.50%), ramus (2.77%) and coronoid (1.38%). CONCLUSION: The study reveals that majority of affected patients were in the 2nd and 3rd decades. A definitive relationship existed between RTA and the incidence of mandibular fractures. The frequency further increased with consumption of social intoxicants. The most commonly fractured site was parasymphysis either isolated or associated with other fractures in the mandible.

Costochondral Graft as Interpositional material for TMJ Ankylosis in Children: A Clinical Study.

ABSTRACT: TMJ ankylosis is one of the most disruptive anomaly that affects the masticatory system. The inability to move the mandible has significant functional ramification, such as the inability to eat a normal diet. Additionally, speech is affected, making it difficult for some individuals to communicate and express themselves to others. As there are several biologic and anatomic similarities to the mandibular condyles, autogenous costochondral grafts have been considered to be the most acceptable tissue for temporomandibular joint reconstruction. In addition donor site complications are infrequent and regeneration of the rib usually occurs within a year post operatively in children. AIM: The aim of this study was to evaluate the function of costochondral grafts to replace the mandibular condyles and to assess the position, growth, overgrowth, function, success, failure and resorption of costochondral grafts. MATERIALS AND METHODS: Ten TMJ ankylosis patients were operated in the Department of Oral and Maxillofacial Surgery at Institute of Dental Sciences, Bareilly. Out of the 10 cases 6 were male patients and 4 female patients in age group of ≤14 years; of which 8 patients were of unilateral TMJ ankylosis and 2 were of bilateral TMJ ankylosis. All ten patients underwent interpositional gap arthroplasty with reconstruction of the condyle by costochondral graft. RESULTS: All patients with costochondral grafts had improved mandibular symmetry and growth with adequate mouth opening. CONCLUSION: This study indicates that using costochondral grafts to reconstruct TMJ ankylosis in children provides a good result.

Treatment of Mandibular Fractures Using Intermaxillary Fixation and Vacuum Forming Splints: A Comparative Study.

OBJECTIVE: The study was done to compare the clinical efficacy of vacuum formed splints and arch bar in treating minimally displaced mandibular fractures. METHOD: Forty patients were included in two groups. Group 1 was treated with custom made splints and group 2 with conventional arch bar. Patients were recalled on 3rd, 7th, 14th day and on the day of removal of the appliance. Periodontal status, stability of appliance and chair side time were evaluated. RESULTS: The mean chair side time taken by vacuum formed splint was 18.05 min and conventional arch bar fixation was 68.25 min. 8.3 % of patients with vacuum formed splints had poor oral hygiene in comparison with 25 % of patients with conventional arch bar. 70 % of patients with vacuum formed splints and 60 % of the patients with conventional arch bars were comfortable in mastication during treatment. CONCLUSION: Vacuum formed splints has better advantages over arch bar with respect to chair side time, periodontal health, patient's compliance of maintaining oral hygiene, mastication and speech. Vacuum formed splints avoid needle stick injuries. So, they can be used for intermaxillary fixation in minimally displaced mandibular fractures.

Efficacy of lignocaine with clonidine and adrenaline in minor oral surgical procedure.

Use of vasoconstrictors in local anaesthesia is well known. The study was done on 30 patients who underwent removal of bilateral impacted third molars. The aim of the study was to compare the efficacy of lignocaine with clonidine and lignocaine with adrenaline in respect to onset, duration of anaesthesia, and postoperative analgesia along with hemodynamic stability (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate in intraoral nerve block. The patients were randomly selected of both sexes (male and female) between the age group of 18-40 years. Patients received 2 mL of 2% lignocaine with adrenaline (12.5 µg/mL) on one side and 2 mL of 2% lignocaine with clonidine (15 µg/mL) on the other side at two different appointments. 2 millilitres of drug was administered in both the test group and the control group. Statistically there was significant decrease in intraoperative and postoperative systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate in the lignocaine with clonidine group. The efficacy of clonidine based on visual analog scale was similar to adrenaline. No significant operative complications were observed.