Klüver-Bucy Syndrome Following Traumatic Brain Injury: A Systematic Synthesis and Review of Pharmacological Treatment From Cases in Adolescents and Adults.

Klüver-Bucy syndrome (KBS) is a rare clinical presentation following traumatic brain injury (TBI). Symptoms include visual agnosia, placidity, hyperorality, sexual hyperactivity, changes in dietary behavior, and hypermetamorphosis. The purpose of this article was to identify and synthesize the available evidence from case reports and case series on the treatment profile of KBS among adolescents and adults after TBI. Four bibliographic databases (MEDLINE OVID, EMBASE, PsycINFO, and SCOPUS) were searched for relevant literature. No date or language restrictions were applied. All case reports containing original data on KBS following TBI among adolescents and adults were included. Articles were evaluated, and data were extracted according to predefined criteria. The literature search identified 24 case reports of KBS post-TBI published between 1968 and 2017. Most case subjects were male (70.1%), and the mean age at injury was 25.1 years (range, 13-67 years). Injury to one or both temporal lobes occurred in most cases. Inappropriate sexual hyperactivity was the most common KBS symptom, followed by a change in dietary behavior and hyperorality. Visual agnosia was the least reported. In 50% of cases, the patient fully recovered from KBS. One-half of all participants described pharmacological management; the most common medication prescribed was carbamazepine. Overall, there was a lack of data available on pharmacotherapy initiation and duration. The complex presentation of KBS presents challenges in terms of treatment options. Although overall individuals who were prescribed carbamazepine had positive outcomes, given the reliance on case reports, it is difficult to make a definitive recommendation to guide clinical practice.

Modified Whale's tail technique for the management of bone-defect in anterior teeth.

The purpose of this case report is to describe the efficacy of a modified Whale's tail technique to achieve primary closure and thereby aid in regeneration of an interdental osseous defect between maxillary central incisors complicated by an aberrant frenal attachment. A healthy 32-year-old female patient reported with the complaint of spacing between her upper front teeth. Clinical examination revealed an aberrant frenum extending into the interdental papilla in relation to the central incisors. There was a 6 mm periodontal pocket in relation to the mesiopalatal aspect of maxillary left central incisor. Intraoral periapical radiograph showed vertical bone loss in relation to mesial aspect of maxillary left central incisor. A modified Whale's tail flap was employed to access the area. The defect was filled with an alloplastic graft. Six months postoperative review showed complete elimination of the pocket along with radiographic bone fill of the defect.

Rate and Risk of All Cause Mortality among People with Known Hypertension in a Rural Community of Southern Kerala, India: The Results from the Prolife Cohort.

BACKGROUND: Hypertension is one of the most important determinants of death due to vascular damage and is fast emerging as a high burden disease in India. However, its documentation is poor in the country. This study aims to estimate the rate and the causal pattern of mortality in a cohort of people with high blood pressure as compared to normotensives. METHODS: The study setting is Varkkala, a rural village in southern Kerala, India, and the study design was that of a prospective cohort. A total of 77,881 participants of age 20 years and above were considered for analysis. The rate and risk of all cause mortality (death due to any cause) among hypertensives were quantified and compared against the normotensives. The causes of death were also analyzedin both the groups. Cox proportional hazard models were created to estimate the hazard ratios of death among hypertensives adjusted for sociodemographic factors, behaviors, and comorbidities. RESULTS: The incidence proportion of deaths in the study was 4.28% during the follow-up period of 6 years. The relative risk of mortality was 3.13 (CI: 2.91-3.37) in the high BP group. The age-adjusted hazard ratio of all cause mortality for the high BP group was 2.96 (2.56-3.42). Coronary artery disease was the major cause of death among the subjects with high BP. CONCLUSIONS: The study revealed high prevalence of hypertension in the study population. A person with hypertension is at three times higher risk of death due to any cause compared to a normotensive individual even after adjustment for age.

A study on container breeding mosquitoes with special reference to Aedes (Stegomyia) aegypti and Aedes albopictus in Thiruvananthapuram district, India.

BACKGROUND & OBJECTIVES: The district of Thiruvananthapuram reports the maximum number of cases of dengue in the state of Kerala. To determine the larval diversity, density and breeding site preferences of Aedes mosquitoes, during pre-monsoon and monsoon periods in urban and rural areas of Thiruvananthapuram district. METHODS: Based on the daily reports of dengue cases, 70 clusters were identified in Thiruvananthapuram district. A cross-sectional larval survey was done in the domestic and peri-domestic areas of 1750 houses, using the WHO standard techniques. The larval indices were calculated, and the larvae were identified by using taxonomic keys. Urban and rural differences and the variations during pre-monsoon and monsoon seasons were also studied. RESULTS: In the surveyed houses, 15% had mosquito breeding, with 88% having Aedes larvae. The house index, container index and the breteau index were 13.08, 13.28 and 16.57%, respectively. About 86% of the clusters were found positive for Aedes albopictus and 11% for Ae. aegypti. Aedes albopictus was distributed almost equally in rural and urban clusters, whereas the distribution of Ae. aegypti was significantly higher in urban areas (p = 0.03). The most common water holding containers found (outdoor) were of plastic, followed by coconut shells. The breeding preference ratio was highest for tyres. Significantly lesser positivity was found for containers during monsoon period when compared to pre-monsoon period. CONCLUSION: The geographical distribution of Ae. albopictus is significantly high in peri-domestic areas and, therefore, its epidemiological role in the widespread disease occurrence needs to be studied. The discarded tyres being the most preferred breeding sites, where IEC activities will help in source reduction.

Gender Difference in Blood pressure, Blood Sugar, and Cholesterol in Young Adults with Comparable Routine Physical Exertion.

CONTEXT: Gender differences in the risk of developing non-communicable diseases (NCD) are a matter of debate. The susceptibility of a woman to NCD should be evaluated taking into consideration the social factors that limit the physical activity among women. It will be interesting to note what will happen if women are allowed to take part in physical exercise to the extent of men. AIMS: To find out the gender difference in the pattern of the clinical and biochemical indices related to NCD in young adults with comparable daily physical activity. SETTINGS AND DESIGN: This is an institution-based cross-sectional study and the setting was Lekshmibhai National College for Physical Education (LNCPE), Thiruvananthapuram, Kerala, India. MATERIALS AND METHODS: The study participants were students who were regularly involved in more than three hours of physical exercise daily at least for the previous one year. The information on socio-demography, anthropometry, and blood pressure was recorded. Blood samples were taken for laboratory examination. RESULTS: Out of 150 students registered, 126 (84%) in the age group of 17 to 25 years who fulfilled the eligibility criteria were studied. Fifty-five (43.7%) of them were women. Systolic blood pressure, fasting blood sugar, and low-density lipoprotein were found significantly lower in women. No significant difference was noted in the case of diastolic blood pressure and total cholesterol. CONCLUSION: Gender differences exist for NCD risk factors among young adults with comparable physical activity and physical exertion seems to be more protective for females.

Assessment of thickness of palatal mucosal donor site and its association with age and gender.

AIM: The purpose of the study is to determine the thickness of the palatal mucosa by a direct clinical method, and the association of age and gender with the thickness of the palatal mucosa. MATERIALS AND METHODS: Forty systemically and periodontally healthy Indian subjects participated in the study. The subjects were categorized according to age and gender. The thickness of the palatal mucosa was assessed by bone sounding. Acrylic stents provided 15 consistent locations for the measurement, defined according to the gingival margin and mid-palatal line. RESULTS: The mean thickness of palatal mucosa was 2.48΁0.03 mm, ranging between 2.07 and 3.00 mm, among the participants. The younger age group had significantly thinner mucosa than the older age group. Females had thinner palatal mucosa than males, but not statistically significant. CONCLUSION: The palatal area from the distal line angle of the canine to the mesial line angle of the palatal root of the first molar provides sufficient donor tissue for grafting procedures. Factors such as body weight and genetic factors need to be further investigated. As the dimension of the soft tissue graft is an important factor influencing the success of the treatment procedure the assessment of the dimension is relevant to clinical periodontics.