Export selected to
Reference Manager
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
January-June 2018
Volume 9 | Issue 1
Page Nos. 1-104

Online since Monday, January 29, 2018

Accessed 4,353 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF

EPub access policy
Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
View as eBookView issue as eBook
Author Institution MappingAuthor Institution Mapping
Access StatisticsIssue statistics
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list

Rediscovering the drug discovery with natural products as therapeutic tools Highly accessed article p. 1
Arun H S. Kumar
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Tea polyphenols and prevention of epigenetic aberrations in cancer p. 2
Arundhati Bag, Niladri Bag
Tea polyphenols are secondary metabolites of tea plants and are well known for beneficial health effects. They can protect from a variety of illnesses including cancers. Tea polyphenols can prevent cancer by modulating epigenetic aberrations taking place in DNA methylation, histone modifications, and micro-RNAs. By altering these epimutations, they regulate chromatin dynamics and expression of genes those induce or suppress cancer formation. However, majority of the studies in existing literature are carried out for green tea polyphenols rather than black tea polyphenols despite the fact that black tea is the most commonly consumed form of tea (78%) followed by green tea (20%) and other forms of tea. Research findings indicate that tea polyphenols may be potential source from which drugs with less side effects and affordable price can be developed.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

DNA damage protecting activity and antioxidant potential of Launaea taraxacifolia leaves extract p. 6
Michael Buenor Adinortey, Charles Ansah, Alexander Weremfo, Cynthia Ayefoumi Adinortey, Genevieve Etornam Adukpo, Elvis Ofori Ameyaw, Alexander Kwadwo Nyarko
Background: The leaf extract of Launaea taraxacifolia commonly known as African Lettuce is used locally to treat dyslipidemia and liver diseases, which are associated with oxidative stress. Methanol extract from L. taraxacifolia leaves was tested for its antioxidant activity and its ability to protect DNA from oxidative damage. Materials and Methods: In vitro antioxidant potential of the leaf extract was evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH), nitric oxide (NO), and hydroxyl (OH) radical scavenging assays. Ferric reducing power, total antioxidant capacity (TAC), metal chelating, and anti-lipid peroxidation ability of the extract were also examined using gallic acid, ascorbic acid, citric acid, and ethylenediaminetetraacetic acid as standards. Results: L. taraxacifolia leaves extract showed antioxidant activity with IC50values of 16.18 μg/ml (DPPH), 123.3 μg/ml (NO), 128.2 μg/ml (OH radical), 97.94 μg/ml (metal chelating), 80.28 μg/ml (TAC), and 23 μg/ml (anti-lipid peroxidation activity). L. taraxacifolia leaves extract exhibited a strong capability for DNA damage protection at 20 mg/ml concentration. Conclusion: These findings suggest that the methanolic leaf extract of L. taraxacifolia could be used as a natural antioxidant and also as a preventive therapy against diseases such as arteriosclerosis associated with DNA damage.
[ABSTRACT]  [HTML Full text]  [PDF]  [Sword Plugin for Repository]Beta

Perception of patient safety culture among health-care providers in a Tertiary Care Hospital, South India p. 14
Adhisakthi Rajalatchumi, Thanjavur S Ravikumar, Kaliaperumal Muruganandham, Mahalakshmy Thulasingam, Kalaiselvi Selvaraj, Mahendra M Reddy, Balachander Jayaraman
Introduction: Patient safety is a global concern and is the most important domains of health-care quality. Medical error is a major patient safety concern, causing increase in health-care cost due to mortality, morbidity, or prolonged hospital stay. Aim: The aim of the study was to assess the perceptions on patient safety culture among health-care providers (HCPs) at a public sector tertiary care hospital in South India. Settings and Design: A hospital-based cross-sectional study was conducted 1 year after patient safety initiatives were implemented. Materials and Methods: Participants were selected through proportionate stratified random sampling. The Hospital Survey on Patient Safety Culture was used to assess perception of patient safety culture. Responses were collected on a Likert scale and were categorized into four types as negative, neutral, positive response, and nonresponse. Statistical Analysis Used: The data were entered in EpiData Version 3.1 and analyzed using SPSS Version 17. “Composite positive response rate” for the various dimensions was calculated. Results: The overall response rate in the study was 91.6%. Average composite positive response rate was 58%, and it varied among different cadres of HCPs ranged from 53% to 61%. The dimensions “teamwork within the unit,” “organizational learning and continuous improvement,” and “supervisor or officer-in-charge expectations” showed highest positive responses (80.1%, 77.8%, and 71.5%, respectively). Conclusions: This survey conducted after implementation of patient safety drive showed that, in many dimensions, the patient safety culture has taken roots. The dimensions such as “hand-off and transitions,” “frequency of events reporting,” and “communication openness” had scope for further improvement.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Clinico-epidemiological profile of pediatric rheumatology disorders in Eastern India p. 19
Pratap Kumar Patra, Manish Kumar
Background: Data on rheumatological disorders in children from developing countries like India are scarce. Hence, this study aimed to understand the clinical and epidemiological profile of rheumatological disorders in children as this can help organize comprehensive evidence-based health care services. Methodology: A retrospective hospital-based study was designed in pediatric rheumatology clinic of the All India Institute of Medical Sciences, Patna, India, from January 2015 to December 2016. Clinical and laboratory findings and response to therapy of all children with rheumatological disorders were evaluated. Results: A total of 60 children with various rheumatological disorders were included in the study. Juvenile idiopathic arthritis (JIA) was the most common pediatric rheumatology disorder observed, and polyarticular JIA was the predominate subtype observed in our patients. The mean age of disease onset was 9.1 ± 3.6 years (age range: 1–16 years). Methotrexate was the most common disease modifying antirheumatic drug used. None of the children received newer biological agents due to financial constraints. The use of alternative medicine was observed in 10% of cases. Conclusion: The clinical and epidemiological profile of children with rheumatological disorders in our patient group was different from the European countries and Western world. There is a need for introspecting the lack of using biological agents and its potential impact in managing JIA in our patient group.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Analgesic properties of Nigella Sativa and Eucheuma Cottonii extracts p. 23
Amira Zakaria, Mohammad Rohani Jais, Reezal Ishak
Background: This study investigates the analgesic properties of the aqueous extracts of Nigella sativa and Eucheuma cottonii in mice. The analgesic properties of both extracts were evaluated in an experimental model of acetic acid-induced writhing test. Materials and Methods: The mice were divided into four different groups and received the test extracts and the standard drug (aspirin) for 14 days via force-feeding. On day 15, the mice were injected with 5% acetic acid, and the number of abdominal constriction and elongation of hind limb (writhes) were counted for 20 min. Results: The numbers of writhes were counted starting after 5 min of the acetic acid injection. The N. sativa extracts significantly reduced the number of writhes as compared to the control group. Both of the extracts revealed a comparable result as referred to the aspirin effects in the mice. Conclusions: These findings indicate that N. sativa and E. cottonii may possess protective active constituent that is effective in reducing the sensation of pain in mice.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Assessment of quality of prescription writing among dental and medical students and practitioners in Kerala p. 27
Naveen Jacob Varghese, Venkitachalam Ramanarayanan, Chandrashekar Janakiram, Joe Joseph
Background: The medical prescription is a valid and legal document. Prescriptions can also be used as a measure of the quality of medical education, observance of the laws and regulations, and sociocultural beliefs. Aims: To assess the quality of prescription written by dental and medical students and practitioners. Settings and Design: A cross-sectional study was conducted in three dental and two medical colleges in Kerala covering 345 participants (dental - 235 and medical - 110). Materials and Methods: Simulation exercise was conducted for drafting a model prescription based on a given clinical condition. The variables were identified based on the model prescription format by the Medical Council of India and were classified into four domains. Points were assigned for each variable. Statistical Analysis Used: Analysis was performed using descriptive statistics and Mann–Whitney U-test. Results and Conclusion: The total scores were found to be higher among dental fraternity (10.93 ± 2.88) to medical (10.81 ± 2.55). The medical house surgeons and postgraduates fared better in the doctor identification domain. Among the dental professionals, there was a significant difference among the undergraduates (mean score = 1.91) and postgraduates (mean score = 1.60) in the doctor identification domain. However, among the medical professionals, in the patient identification domain, house surgeons had a significantly higher score compared to postgraduates. There were no significant differences in quality of prescription writing among medical and dental professionals.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Evaluation of clinical and magnetic resonance imaging profile of pituitary macroadenoma: A prospective study p. 34
Kamini Gupta, Shivam Sahni, Kavita Saggar, Gaurav Vashisht
Background: Pituitary macroadenoma is a common tumor of middle-aged people. Magnetic resonance imaging (MRI) is the investigation of choice for its evaluation. Various parameters regarding the extent, consistency, and contrast uptake can be studied and a noninvasive diagnosis is possible. Aims and Objectives: To study the MRI features and extent of pituitary macroadenomas. Materials and Methods: We studied clinical and MRI features of 33 patients of all age groups and both sexes with pituitary macroadenomas who presented to Dayanand Medical College and Hospital, Ludhiana from January 2014 to June 2015. MRI was carried out on MAGNETOM Avanto 18 Channel 1.5 Tesla Machine by Seimens India Ltd. The dedicated sellar protocol consisted of sagittal and coronal T1-weighted image (TI-WI) and T2-WI without intravenous contrast using thin slices (3 mm) and a field of view of <200 mm. Results: On analysis of the 33 cases, we observed that patients of pituitary macroadenoma showed an almost equal sex incidence and average age group of 50–60 years. The common presenting complaints were headache and decreased vision. Superior and inferior extent of the lesion was beyond the defined boundaries of sella in most cases, but the lateral extent was limited, resulting in characteristic “snowman-like” appearance. The imaging characteristics showed solid to predominantly solid consistency, appearing mostly heterogeneously hyperintense on T2-WI, and hypo to isointense on T1-WI with intense postcontrast enhancement. Hemorrhage is less common. Pituitary apoplexy is rare and can result in spontaneous resolution. Conclusions: We conclude that the knowledge of clinical and imaging profile of pituitary macroadenoma can help the radiologists to diagnose these sellar lesions, and hence their therapeutic approach can be defined timely.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

The use of thromboelastography to measure the influence inclusion of a local anesthetic agent has on the mechanical and kinetic properties of fibrin p. 39
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P. Clover
Context: Delivery of slow-release local anesthesia has considerable potential for postoperative analgesia. Fibrin gel has shown huge potential for drug delivery, but has not been fully investigated for the delivery of local anesthetics nor has whether incorporation of anesthetic drugs into fibrin alters its mechanical properties. Aims: This study aimed to evaluate the effects of bupivacaine inclusion on the mechanical and kinetic properties of fibrin as measured by thromboelastography (TEG). Materials and Methods: Serial dilutions of fibrinogen with thrombin were tested with TEG to identify the optimal concentrations to give reproducible results. Following this, fibrinogen samples diluted with bupivacaine 0.5% in place of normal saline (also 1:20 dilution) were added to thrombin to assess what influence this had on clot strength and kinetics as measured by TEG values (with R, K, and α angle relating to clot kinetics and MA and G (or shear elastic modulus strength) relating to clot strength). Results: The mean values yielded for R were higher and lower for α angle, suggesting that the inclusion of bupivacaine produced a fibrin clot at a slower rate. The values for MA and G were both lower when bupivacaine was included, suggesting inclusion of the local anaesthetic also resulted in a fibrin clot of inferior strength. These results were not statistically significant. Conclusion: Although TEG failed to consistently measure these properties, the results suggest that inclusion of local anesthetic affects the clotting process of fibrin, potentially interfering with its ability to function as a sealant, adhesive, or hemostat.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Chest X-ray findings comparison between multi-drug-resistant tuberculosis and drug-sensitive tuberculosis p. 42
Aziza Ghanie Icksan, Martin Raja Sonang Napitupulu, Mohamad Arifin Nawas, Fariz Nurwidya
Background: Imaging has a big role in tuberculosis (TB) diagnosis and chest X-ray is preferable because it is available in primary health care and can point out the location, area, and morphology of lesions, such as cavity, consolidation, pleural effusions, and fibrosis. We aimed to compare the chest X-ray findings in multi-drug resistant TB (MDR-TB) and in drug-sensitive TB (DS-TB) cases. Methods: This is a retrospective cross-sectional study which compares chest X-ray findings of two groups of patients, involving 183 DS-TB patients and 183 MDR-TB patients. Radiologic findings that we analyzed were infiltrate, consolidation, cavity, ground glass opacity, fibrosis, bronchiectasis, calcification, node, atelectasis, bullae, emphysema, and other nonlung parenchymal findings. Results: MDR-TB group have 177 (96%) patients with large lesions, 6 (4%) with medium lesions, and no small lesions. DS-TB group have 55 (30%) patients with small lesions, 78 (43%) with medium lesions, and 50 (27%) with large lesions. Active TB lesions in the forms of infiltrate and ground-glass opacity were more dominant in DS-TB group, whereas consolidation, cavity, fibrosis, bronchiectasis, calcification, node, atelectasis, bullae, emphysema, and other nonlung parenchymal findings, were more dominant in MDR-TB. Conclusions: There were significant differences in chest X-ray findings between MDR-TB and DS-TB in terms of lesion size and morphology. Recognition of chest X-ray findings could help the physician to differentiate patient with suspected MDR-TB.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

In vitro H+/K+-ATPase Inhibition, Antiradical effects of a flavonoid-rich fraction of Dissotis rotundifolia, and In silico PASS Prediction of its isolated compounds p. 47
Michael Buenor Adinortey, Charles Ansah, Cynthia Ayefoumi Adinortey, Justine McGiboney, Alexander Nyarko
Background: Dissotis rotundifolia, commonly referred to as pink lady, has several medicinal uses including peptic ulcer. This study investigated the inhibitory effects of D. rotundifolia extract on H+/K+-ATPase and also assessed its antiradical activity. In silico study of some isolated compounds of this plant was also carried out to affirm the suspected binding properties of extract to H+/K+-ATPase enzyme. Materials and Methods: D. rotundifolia whole plant extract was obtained after extraction process and then assessed for its ability to scavenge free radicals in four in vitro test models. Its ability to inhibit the activity of H+/K+-ATPase enzyme was also evaluated. Molecular docking was carried out on phytoconstituents, namely, vitexin, isovitexin, orientin, and isoorientin reported to be present in the whole plant extract. Results: Data obtained indicated that D. rotundifolia extract (DRE) exhibits strong antioxidant activity. DRE also showed inhibitory effects on H+/K+-ATPase enzyme activity. Docking studies affirmed the in vitro binding effect of the extract to H+/K+-ATPase. Conclusion: These findings suggest that the plant extract possess antioxidant and antipeptic ulcer activity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Assessment of Vitamin D in rheumatoid arthritis and its correlation with disease activity Highly accessed article p. 54
Narendra Meena, Sumit Pal Singh Chawla, Ravinder Garg, Anil Batta, Sarabjot Kaur
Background: Vitamin D is believed to have an immunomodulatory and anti-inflammatory action, and its deficiency has been linked with several autoimmune disorders, including rheumatoid arthritis (RA). The relationship between the severity of RA and serum levels of Vitamin D is a subject of immense interest and therapeutic implications. Materials and Methods: This was a prospective, comparative study conducted on 100 participants, 50 cases of RA and 50 healthy controls, all in the age group of 18–75 years. Serum Vitamin D levels were measured and compared in cases and controls. Vitamin D levels in RA patients were also assessed in different stages of disease activity to assess the correlation between the two. Results: Eighty-four percent patients of RA were Vitamin D deficient versus only 34% of controls. The serum Vitamin D levels were also significantly lower in the RA patients (mean value of 21.05 ± 10.02 ng/ml), as compared to the controls (mean value of 32.87 ± 14.16 ng/ml). There was a significant inverse correlation between serum Vitamin D levels and RA disease activity. The mean serum Vitamin D levels were 35.28 ± 9.0 ng/ml, 33.80 ± 4.1 ng/ml, 22.47 ± 6.18 ng/ml, and 14.21 ± 6.97 ng/ml in the remission, low disease activity, moderate disease activity, and high disease activity groups, respectively. Conclusions: Vitamin D deficiency is more common in RA patients and may be one of the causes leading to development or worsening of the disease.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Incidence and pattern of mandible fractures in the Madinah Region: A retrospective study p. 59
Mahmood Samman, Syed Waheed Ahmed, Hassan Beshir, Turki Almohammadi, Santosh R Patil
Objectives: The objective of the study is to study the incidence and pattern of mandible fractures in the holy city of Madinah in the Kingdom of Saudi Arabia over a retrospective period of 3 years from 2013 (1434H) to 2016 (1436H) and to compare the results with those from other regions of Saudi Arabia and elsewhere. Materials and Methods: Relevant data of patients admitted to the King Fahad Hospital, Madinah with a fracture of the mandible during the study were collected from their medical records and radiographs. The age, gender, etiology, role of the patient, site, and number of fractures in the patients were evaluated. The data were analyzed by standard statistical methods. Results: A total of 197 patients with fracture of the mandible were admitted in the period of the study by the Oral Maxillofacial Surgery Department, King Fahad Hospital, Madinah. There were 165 male and 32 female patients. The ages ranged from 3 to 86 years with a mean of 24 years. A total of 260 fractures of Mandible were documented. The largest number (113) of patients was found in the age group between 16 and 30 years. Trauma caused by motor vehicle road traffic accidents (RTAs) was the main etiology of the fractures followed by falls and assault. The majority of the patients were in the role of vehicle drivers. The condylar anatomical site of mandible was most frequently affected and constituted the largest number (103) of fractures followed by the angle (51), parasymphysis (45), and then by the body (23) of the mandible. Dentoalveolar fractures were present in 22 cases. Very less number of coronoid fractures (7), followed by those of the ramus (5), and least number at the symphysis (4) of the mandible were found. Conclusion: RTA was the most common etiology for trauma and fracture of the mandible. The males outnumbered the female patients, the largest number of patients with trauma and mandible fracture was found in the age group between 16 and 30 years and frequency of condylar fractures was higher.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Gingival tissue response following placement of a light cure dressing and a non-eugenol dressing after periodontal flap procedure: A comparative clinical study p. 65
Ankita Kakar, Arundeep Kaur Lamba, Shruti Tandon, Farrukh Faraz, Abdul Ahad
Aim: The aim was to compare the gingival tissue response following placement of a light cure dressing (Barricaid®) and a non-eugenol periodontal dressing (Coe-Pak) after periodontal flap procedure. This was carried out by evaluating plaque deposition underneath both the dressings, healing response and the patient preference for each. Materials and Methods: A total of 12 patients with chronic generalized periodontitis requiring surgery in at least two different quadrants were enrolled for this split-mouth study. After periodontal flap surgery, Coe-Pak was placed in the quadrant assigned to Group I and Barricaid® was placed in the other quadrant assigned to Group II. Clinical parameters were recorded on day 7 and day 14. Patient comfort and pain levels were also evaluated by a questionnaire. Results: There were no statistically significant differences in wound healing and the clinical gingival parameters between two groups. The only significant difference was found in the plaque attached underneath the dressing, with Coe-Pak showing greater plaque accumulation than Barricaid®. Seventy five (75) % of the patients preferred Barricaid® over Coe-Pak, based on its appearance and taste. Conclusion: The non-eugenol dressing seemed to retain more plaque on its undersurface than light-cure dressing. However, this did not have much influence on the healing outcome and clinical gingival parameters, which were optimal and comparable in both groups. The greater number of patients showed a preference for light cure dressing, based on its superior esthetics and taste.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Periodontal flap surgery along with vestibular deepening with diode laser to increase attached gingiva in lower anterior teeth: A prospective clinical study p. 72
Ashu Bhardwaj, Zeba Jafri, Nishat Sultan, Madhuri Sawai, Anika Daing
Background: Chronic periodontitis in lower anterior teeth results in rapidly progressive gingival recession (GR), loss of alveolar bone, decreased vestibular depth (VD) with consequential tooth mobility, and tooth loss. Treatment option for such cases in this esthetically important area of the oral cavity includes extraction followed by implants for which sufficient bone height and mucogingival complex are a prerequisite. Henceforth, an attempt was made to prolong the life of lower anterior teeth and postpone the need for implants by the treatment of chronic periodontitis with periodontal flap surgery followed by vestibular deepening in single surgical procedure. Materials and Methods: In this clinical, prospective study, conventional periodontal flap surgery was done on 74 sites in lower anterior teeth in 16 patients with attachment loss >5 mm due to chronic periodontitis. Vestibular deepening with diode laser at (wavelength - 810 nm, output power: 0.5–7 W, continuous wave, contact mode) was done after suturing the flap. All the clinical parameters: GR, pocket depth (PD), clinical attachment loss (CAL), width of keratinized gingiva, width of attached gingiva, and VD were assessed preoperatively after Phase I therapy and 6 months postoperatively. Results: At all the 74 sites, there was highly significant gain in attached gingiva, keratinized gingiva, and VD (P ≤ 0.001). Highly significant reduction in PD (P ≤ 00.001), significant reduction in attachment loss (P ≤ 0.01) but no significant reduction in GR (P = 0.897) was observed. Conclusions: The combination of periodontal flap surgery with vestibular deepening with diode laser may be a suitable cost-effective treatment option to prolong the life of periodontally involved lower anterior teeth. The surgical technique can postpone the need for extraction of teeth along with all the intangible benefits of periodontal therapy.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Urinary cotinine level in indonesian children exposed to domestic cigarette smoke p. 77
Agus Dwi Susanto, Priska Duana Putri, Achmad Hudoyo, Feni Fitriani Taufik, Fariz Nurwidya, Sita Andarini
Background: Cotinine is a major metabolite of nicotine, and its urinary level is an indicator of exposure to cigarette smoke. The present study was aimed at identifying the urinary cotinine level in Indonesian children who were exposed and not exposed to domestic cigarette smoke. Methods: The study was a cross-sectional study in elementary school-aged children who had not smoked. The subjects were categorized into an exposed group and unexposed group based on their exposure status. Data were obtained from a questionnaire and random urinary samples measured using enzyme-linked immunosorbent assay. Results: There were a total of 128 subjects, including 64 children in the exposed group and 64 children in the unexposed group. The median level of cotinine in all subjects was 17.95 ng/ml (with a range of 0.1–158.3 ng/ml). The urinary cotinine level in the exposed group was higher than the unexposed group (median: 30.1 ng/ml vs. 8.45 ng/ml; P < 0.000). There was a correlation between urinary cotinine levels in children exposed to cigarette smoke and the number of cigarettes smoked by the smokers at home (P < 0.05). The optimal cut-off points of urinary cotinine levels in children, which was utilized to evaluate cigarette smoke exposure, was 17.95 ng/ml (81% sensitivity; 81% specificity; P < 0.000). Conclusion: The urinary cotinine level in children exposed to cigarette smoke is higher than children who are not exposed to domestic cigarette smoke. The urinary cotinine level can be used as a noninvasive marker to evaluate cigarette smoke exposure in children.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Preprocedural anxiety and pain perception following root surface debridement in chronic periodontitis patients p. 82
Vanaja Krishna Naik, Aruna Balasundaram, Devapriya Appukuttan, Deepavalli Arumuga Nainar, Michael Robert Milward, Dhayanand John Victor, Mohammed Junaid
Background: The aim of this study was to evaluate and compare preprocedural dental anxiety levels and postprocedural pain perception in chronic periodontitis patients during conventional-staged root surface debridement (RSD) and single-stage RSD. Materials and Methods: Thirty-seven adult generalized chronic periodontitis patients requiring RSD were recruited in this study. Preprocedural anxiety levels were assessed using a self-reported questionnaire and postprocedural pain perceptions were assessed using 0–10 cm visual analog scale. The subject population was divided into two groups: staged RSD (n = 18) and single-stage RSD (n = 19). Staged RSD patients visited four times as opposed to single-stage RSD patients. Data were subjected to Pearson Chi-square test, Mann–Whitney U-test, and Spearman's rank correlation. Results: There was no statistically significant difference in dental anxiety levels or pain perceptions in both the groups. Within Group 1, there was statistical significant difference in dental anxiety levels between visit 4 and visit 3 (P = 0.037) and pain perception between visit 3 and visit 1 (P = 0.005), visit 4 and visit 1 (P = 0.002), and visit 4 and visit 2 (0.04) was statistically significant. There was a positive correlation of anxiety questionnaire (Q1–Q4) to the pain score in Group 1 which was statistically significant and in single-stage RSD. Conclusion: Conventional quadrant-wise RSD tends to cognitively condition the anxiety experience thus influencing pain experience.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Unilateral transient watershed cerebral infarct in a 6-year-old girl with frequently relapsing nephrotic syndrome p. 90
Kapil Bhalla, Deepali Garg, Mahima Rajan, Jaya Shankar Kaushik, Geeta Gathwala
Nephrotic syndrome is a prothrombotic state with predisposition to venous sinus thrombosis and arterial vascular stroke. Watershed infarcts in junction of arterial territory develop in hypotensive hypovolemic state. These border zone infarcts are usually bilateral in the absence of unilateral arterial stenosis or microembolism. We report a 6-year-girl of frequently relapsing nephrotic syndrome who developed sudden onset hemiparesis with aphasia. Magnetic resonance (MR) imaging brain revealed unilateral watershed infarct in territory between the major cerebral arterial vessels with evidence of restricted diffusion and normal vessel anatomy on MR angiography. This could possibly reflect asymmetric variant of posterior reversible encephalopathy syndrome that resolved with remission on steroids.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of complicated crown fracture by reattachment using fiber post: Minimal intervention approach p. 93
Ambar W Raut, Vijay Mantri, Vaibhao I Shambharkar, Mitul Mishra
Anterior crown fractures are a common form of traumatic dental injuries that mainly affect the maxillary incisors, especially in children and adolescents. Complicated crown fractures although less common, pose a challenge to the clinician. The main objective while treating such cases is successful pain management and immediate restoration of function, esthetics and phonetics. Since the development of the adhesive dentistry, the patient's own fragment can be used to restore the fractured tooth. Reattachment of fractured tooth fragments offers a viable restorative alternative. The procedure provides good and long-lasting esthetics, because the original morphology, color, and surface texture are preserved. This article reports management of complicated crown fracture in a young adult and a middle-aged adult that were successfully treated by reattachment technique. The teeth were endodontically treated followed by esthetic reattachment of the fractured fragment using the glass fiber post. To improve the adhesion between fractured and remaining fragment, circumferential beveling and internal groove placement were done.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Hemisection as a conservative management of grossly carious permanent mandibular first molar p. 97
Shweta Sharma, Rajat Sharma, Abdul Ahad, Narinder Dev Gupta, Surendra Kumar Mishra
Hemisection of a molar denotes removal or separation of a root along with its accompanying part of crown. It is a suitable treatment option when the caries, resorption, perforation, or periodontal damage is restricted to one root while the other root is relatively healthy. Hemisection of the affected tooth helps to retain the tooth structure, surrounding alveolar bone, and may also facilitate the placement of fixed prosthesis. This case report describes the hemisection as a successful treatment method to save a grossly carious mandibular first molar with periodontal and periapical involvement. Hemisection and prosthetic rehabilitation yielded a satisfactory result. With careful treatment planning and precise surgical management, undesirable consequences of tooth loss were prevented.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Severe abdominal complaints after technical successful endovascular treatment of chronic splanchnic ischemia p. 100
Claire A. J I. Leenarts, Mark J F. Haagmans, Lee H Bouwman, Cornelis J. J M. Sikkink
Reperfusion syndrome (RS) after revascularization of an arterial occlusion of the lower leg is a well-known complication. RS after splanchnic revascularization, however, is an infrequent and less-known phenomenon. We present a patient with persisting abdominal complaints after revascularization of the celiac trunk and superior mesenteric artery suggesting reocclusion. Although computed tomography angiography showed patent splanchnic arteries, an impressive hyperperfusion state of liver and spleen was visualized. Complaints diminished steadily with conservative therapy, but RS can cause severe complications such as liver failure and multiple organ failure. Ignorance of RS might interfere with adequate treatment and can contribute to a high in-hospital mortality rate.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

“Thanatophobia”: Physician's perspective of dealing with patients with fear of death p. 103
Chandramouli Balasubramanian, Malathy Subramanian, Sarasa Balasubramanian, Amit Agrawal, Savitha Raveendran, Chandrasekaran Kaliaperumal
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta