Investigation on the performance evaluation of vertical subsurface flow constructed wetland for the treatment of rural wastewater.

In a rural country like India, low cost and decentralized treatment units like the vertical subsurface flow constructed wetland (VSSF CW) can be reflected as a novel wastewater system. In this concern, a pilot-scale VSSF CW unit of size 0.92 m × 0.92 m × 0.85 m bed planted with Typha latifolia and Phragmites australis was operated for a 12-month duration to treat simulated rural wastewater. During the operation, a constant head arrangement was made to maintain a continuous flow to achieve 5 different Hydraulic Retention Times (HRTs) of 2, 4, 6, 8 and 10 days in each season, such as winter, summer and rainy, to investigate the performance of the unit under different retention times. The reactor showed optimum removal efficiency at 6 days HRT at 12.5 cm/day Hydraulic Loading Rate (HLR) for organic matter removal. Both macrophytes and the microbial biomass of filter media effectively treated the rural wastewater. Average removal efficiency of the reactor during the entire study was 64.73%-88.80% for Chemical Oxygen Demand, 74.96%-95.34% for Biochemical Oxygen Demand, 40.13%-79.45% for Ammonia Nitrogen, 25.36%-65.65% for Total Kjeldahl Nitrogen, 22.86%-58.48% for Phosphate phosphorus, 23.50%-55.45% for Total phosphorous, 74.91%-98.59% for Faecal Coliforms and 71.14%-95.31% for Total Coliforms respectively. Two-way ANOVA followed by post-hoc Tukey's test showed that HRT had a significant impact on removal efficiency but not the season. Overall performance of the unit was good and study suggested that VSSF CW can be a smart alternative technology to treat rural wastewater before final disposal.

Pharmacognosy, phytochemistry, and molecular studies of an important medicinal herb Achillea millefolium L.

Background: Achillea millefolium L. is traditionally important medicinal herb used for the treatment of various ailments from the centuries. Recent studies showed its biological activities on hay fever, hepato-biliary disorders, and as appetite enhancing drug. It is also reported to be used for the treatments of skin inflammations, wounds, cuts, and abrasions. Aim: To investigate preliminary pharmacognostical, phytochemical, and molecular parameters of aerial parts of the drug. Materials and methods: A. millefolium was identified and collected from the Himalaya region. The material is properly dried, macro-and microscopic evaluation, phytochemical and molecular studies as per the standard quality control and WHO guidelines. Results: The leaves are pinnately lobed, inflorescence compound corymbose. Nonglandular trichomes are uni-seriate, multicellular, and smooth walled; glandular trichomes are bicellular, present throughout the aerial parts. The endodermis is evident in the stem and leaf mesophyll is equifacial. The partial genome sequence analysis showed similarity toward studied species, which can clearly distinguish it from other species of the genus Achillea. The best chromatographic separation was observed with ascentis express C18, 2.7 µm, 100 mm × 4.6 mm. The flavonoids and phenolic acids have shown maximum absorbance at 330 nm. The system suitability parameters such as theoretical plate, tailing factor, and resolution met the acceptance criteria with United States pharmacopeia (USP). Conclusion: The findings of this study will be helpful for the precise identification of the raw drug of A. millefolium from its closely allied species.

Studies on theileriosis in goats from Karnataka, South India.

A study was conducted to determine the prevalence of theileriosis in goats from southern districts of Karnataka. Out of 47 goat blood samples examined by microscopy, 68.08% (32/47) were positive for Theileria spp. The parasitemia ranged from 1.0 to 1.8 and 0.1-0.9% in clinical and carrier animals respectively. Out of 325 ticks collected from goats, 92.6 (301) and 7.38 (24)% of the ticks were found to be Haemaphysalis and Rhipicephalus respectively. Hemaphysalis kutchensis (90.15%) was found to be the predominant species followed by R. haemaphysaloides (6.7%), H. intermedia (1.84%), H. bispinosa (0.61%) and R. sanguineus (0.61%). The present study indicated that caprine theileriosis is an endemic disease in Karnataka and suggested that Haemaphysalis and Rhipicephalus ticks may play a role in transmission of the disease.

Structural and functional characterization of a novel immunomodulatory glycoprotein isolated from ajowan (Trachyspermum ammi L.).

Ajowan (Trachyspermum ammi L.) spice has been used in food preparations and also as a traditional medicine in Ayurveda. Although a number of pharmacological activities have been attributed to ajowan, its role in immunomodulation is not known. The main objective of the present study is to examine the macromolecular immunomodulatory components. Macrophage activation was studied by nitric oxide (NO) release, phagocytosis and secretion of pro-inflammatory cytokines as the markers. Ethanol precipitate (fractional) of ajowan aqueous extract was subjected to conventional chromatography (Q Sepharose followed by Bio-Gel P-100). One of the proteins (30.7 kDa; ajowan glycoprotein or Agp) showed effective mitogenic activity towards splenocytes. Agp is a O-linked glycoprotein with the glycans contributing to one-third of the molecular mass. It has a high content of glutamic acid, serine, aspartic acid and proline whereas galactose (45.7%), arabinose (34.5%), glucose (7%), mannose (5%) and xylose (4%) are the constituent sugars. Secondary structure analysis indicated that Agp contains 79% α-helices and 21% random coil. Internal sequencing of the tryptic peptides did not show homology with the existing proteins in the database (BLAST). Agp at 1 µg/mL induced proliferation of B-cell enriched murine splenocytes and activated macrophages in releasing NO and promoted phagocytosis (p < 0.01). RAW 264.7 cells produced pro-inflammatory cytokines (IL-12, TNF-α and IFN-γ) at 1 µg/mL Agp (p < 0.01). Deproteinized Agp (dpAgp) failed to elicit activation of murine immune cells, whereas deglycosylated Agp (20 kDa; dgAgp) showed compromised efficiency. This is the first report of an immunomodulatory protein from ajowan.

Evaluation of Dehydroepiandrosterone Supplementation on Diminished Ovarian Reserve: A Randomized, Double-Blinded, Placebo-Controlled Study.

INTRODUCTION: We conducted a randomized, double-blinded, placebo-controlled study, to evaluate the effect of dehydroepiandrosterone (DHEA), on diminished ovarian reserve (DOR). MATERIALS AND METHODS: Twenty patients with DOR received DHEA (oral 25 mg three times a day). Post-supplementation 12 weeks, D2/3 age-specific follicle-stimulating hormone (FSH), anti-mullerian hormone (AMH) levels, and antral follicle count (AFC), were repeated to evaluate response. Spontaneous pregnancy rates and regularization of menstrual cycles were also studied as secondary outcome. RESULTS: Predominant risk factors were age >35 years (28 %) and poor responders to ovarian stimulation (23 %). There was significant improvement of AMH levels (1.15 ± 1.49 vs. 1.53 ± 1.62) found before and after supplementation in the DHEA group. When the AMH values between DHEA and placebo group were compared, pre- and post-supplementation, no significant difference was found. There was decrease in FSH levels and increase in AFC value post-supplementation in both DHEA and placebo groups which was not statically significant. DHEA supplementation benefited clinically, as evidenced by the improvement in the menstrual abnormality spontaneous conception in two cases each. CONCLUSIONS: A significant improvement in AMH levels pre- and post-supplementation of DHEA was noted. The same was not seen for FSH and AFC values.

A randomized, open-label, standard controlled, parallel group study of efficacy and safety of baclofen, and chlordiazepoxide in uncomplicated alcohol withdrawal syndrome.

BACKGROUND: Alcohol withdrawal syndrome (AWS) is a distressing condition, generally controlled by benzodiazepines (BZD's). Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has also shown promising results in controlling AWS. As there are few studies comparing the efficacy and tolerability of chlordiazepoxide with baclofen, the present study was taken up. The objective of this study was to compare efficacy and tolerability of baclofen with chlordiazepoxide in uncomplicated AWS. METHODS: Sixty subjects with uncomplicated AWS were randomized into two groups of 30 each, to receive baclofen (30 mg) or chlordiazepoxide (75 mg) in decremented fixed dose regime for 9 days. Clinical efficacy was assessed by Clinical Institute Withdrawal Assessment for Alcohol-Revised Scale (CIWA-Ar) and tolerability by the nature and severity of adverse events. Lorazepam was used as rescue medication. Secondary efficacy parameters were Clinical Global Impression scores, symptom-free days, and subject satisfaction as assessed by visual analog scale. This study was registered with Clinical Trial Registry-India (CTRI/2013/04/003588), also subsequently registered with WHO's ICTRP clinical trial portal. RESULTS: Both baclofen and chlordiazepoxide showed a consistent reduction in the total CIWA-Ar scores. However, chlordiazepoxide showed a faster and a more effective control of anxiety and agitation requiring lesser lorazepam supplementation, and also showed a better subject satisfaction compared to baclofen. Both the drugs showed good tolerability with mild self-limiting adverse events. CONCLUSION: The present study demonstrates that baclofen is not as good as chlordiazepoxide in the treatment of uncomplicated AWS. However, baclofen might be considered as an alternative.

A Study of Medication Compliance in Geriatric Patients with Chronic Illnesses at a Tertiary Care Hospital.

INTRODUCTION: Geriatric population is more prone for various chronic and recurrent illnesses like diabetes mellitus, hypertension, IHD, arthritic, neurodegenerative, gastrointestinal, ocular, genitourinary, respiratory disorders etc., which may require chronic medication with multiple drugs. Poor compliance in this age group accounts for medication wastage with increased cost of healthcare and substantial worsening of the disease with disability or death. Most of the human and economic costs associated with non adherence can be avoided by improving medication adherence. AIM: To assess the level of medication compliance in elderly patients with chronic illnesses and to analyse the factors influencing medication compliance. MATERIALS AND METHODS: The study subjects were assessed by using twenty item structured questionnaires as per modified Morisky Medication Adherence Scale (MMAS). RESULTS: A total of 251 subjects of geriatric age group with chronic illnesses were assessed for the level of compliance for long term medications. The average number of medications 2.96±1.42 per subject and most of the subjects were receiving FDCs. The compliance level was assessed by way of interview using a twenty item structured pretested questionnaire as per modified MMAS. The level of compliance was good in 45.41%, moderate in 35.45% and poor in 19.12% of the study subjects. CONCLUSION: The level of compliance positively correlated with the educational status of the study subjects and their awareness about the diseases and prescribed medications. The overall level of compliance was higher in subjects living with spouse or families, subjects without any functional impairment, subjects who were regular for the follow-up visits and also in subjects who did not experience any adverse events.

Maxillofacial Surgeon as Fact Witness for Medico-Legal Cases: Indian Scenario.

An Oral and Maxillofacial surgeon at any time during the practice will encounter medicolegal cases (MLC). There are lacunae in the knowledge and understanding of the correct method of dealing with such cases. Many of the practitioners are apprehensive and anxious as they have to interact with individuals and systems outside the normal realm of practice. In today's arena, it is of utmost importance to be aware of legal system and law of the land. An OMF surgeon needs to have thorough understanding in recording and maintenance of the details of all MLCs and presenting the same in the court. Professional guidelines for expert witness are often not well recognised as those relating to the clinical practice. Surgeon has an obligation to conduct him/herself to highest ethical standards. This article provides insight into the details of registration of MLC, examination and recording of injuries, collecting medico-legal evidences and writing a medico legal report. Also discusses the court proceedings and possible questions that may be faced by the surgeon in the court.

Immunomodulatory activity of purified arabinoxylans from finger millet (Eleusine coracana, v. Indaf 15) bran.

Biological activities of alkali extracted (Barium hydroxide: BE-480 kDa, Potassium hydroxide: KE1-1080 and KE2-40 kDa), purified arabinoxylans (AX) from the finger millet bran varying in their molecular weight, phenolic acid content, arabinose to xylose ratios were evaluated for their immune-stimulatory activities using murine lymphocytes and peritoneal exudate macrophages. All three purified AX displayed significant (p < 0.001) mitogenic activity and activation of macrophages including phagocytosis. Among these BE has shown higher enhancing lymphocyte proliferation (>2 fold) and macrophage phagocytosis than KE1 and KE2. The above results clearly documented that the immunostimulatory activity of arabinoxylans is directly proportional to the amount of ferulic acid content (0.11 mg/100 g), whereas molecular weight as well as arabinose/xylose ratio, did not have any bearing. Purified AX from the finger millet bran can be explored as a potent natural immunomodulator.

MRI as an essential diagnostic approach for trigeminal neuralgia.

Trigeminal neuralgia is a well recognised disorder frequently reported to the dentist. The diagnosis of trigeminal neuralgia is primarily based on history and clinical criteria. The clinical findings do not differentiate idiopathic trigeminal neuralgia from symptomatic trigeminal neuralgia. We describe a case of cliviopetrosal meningioma presenting as trigeminal neuralgia and discuss the importance of magnetic resonance imaging as an essential diagnostic approach when trigeminal neuralgia occurs concurrently with a brain tumour.

TMJ ANKYLOSIS: MANAGEMENT WITH RECONSTRUCTION AND INTERPOSITIONAL ARTHROPLASTY.

Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing. Trauma and Infections are usually responsible. If trauma occurs in young age, it leads to disturbance in growth & facial asymmetry. Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. Early mobilization, physiotherapy & strict follow up are essential to prevent postop adhesions. In our cases fascia lata was used as an interpositional grafting material. One case was treated by gap arthroplasty, second case by costochondral graft & third case was managed with titanium condylar prosthesis.

Articaine for surgical removal of impacted third molar; a comparison with lignocaine.

AIM: Articaine is an amide local anesthetic that differs from other agents of its group due to the presence of thiophene ring instead of a benzene ring. Some researchers claim that articaine is superior to lidocaine in its biologic profile. The aim of the study is to compare the efficacy of articaine with that of lidocaine which has proven efficacy. MATERIALS AND METHOD: This study was done on 50 subjects; 25 of them received 4 % articaine HCl with 1:100000 epinephrine and the next 25 received 2% lignocaine HCl with 1:100000 epinephrine. Time of injection, onset of anesthesia, amount of anesthetic injected were recorded. Efficacy was determined using visual analog scale. The values were statistically analyzed. RESULTS: The mean onset time of anesthesia in study group was 2.07 ± 0.22 and 2.18 ± 0.26 minutes in comparison group. A mean duration of 4.28 +0.78 hours was seen with articaine group and 3.51 + 0.45 hours with the lignocaine group. No statistical difference between the two groups with regard to pain experience. CONCLUSION: Articaine has similar efficacy as that of lignocaine with slightly longer duration and can be used as an alternative to lignocaine in third molar surgeries. CLINICAL SIGNIFICANCE: Increased availability of local anesthetics has improved interest in research about dental pain control. a quest for new methods of pain reduction is always justified. How to cite this article: R Shruthi, S N Kedarnath, S Mamatha N, Rajaram P, Dinesh B. Articaine For Surgical Removal of Impacted Third Molar; A Comparison With Lignocaine. J Int Oral Health 2013; 5(1):48-53.