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   Table of Contents - Current issue
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January-June 2021
Volume 12 | Issue 1
Page Nos. 1-127

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EDITORIAL  

Publication paradigm among academics in dental sciences and pseudo perceptions of journal quality matrix: A re-look into medical council of India, dental council of India, and university grants commission publication guidelines Highly accessed article p. 1
Vinod Kumar, Shobha Fernandez, Divya Sharma, Arun H S. Kumar
DOI:10.4103/0976-9668.307845  
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ORIGINAL ARTICLES Top

Diagnostic utility of cell block technique as an adjunct to cytological smears in evaluation of thyroid aspirates on fine needle aspiration cytology p. 6
Usha Kiran Raina, Jyotsna Suri, Subash Bhardwaj, Bhavna Sahni
DOI:10.4103/jnsbm.JNSBM_118_20  
Background: Direct smears and cell blocks prepared from residual tissue fluids complement each other for establishing a conclusive cytopathologic diagnosis in thyroid lesions. Aim of the Study: Evaluation of the diagnostic utility of fine-needle aspiration cytology (FNAC) alone and in combination with cell blocks in the diagnosis of thyroid lesions. Materials and Methods: A hospital-based prospective longitudinal study was conducted in which 100 thyroid smears were categorized as neoplastic, nonneoplastic and inadequate using FNAC and cell block technique. All specimens were classified using point scoring system modified by Mair et al. Direct smears were compared with cell-block specimens on variables of cellularity, background blood and clot, cellular degeneration and retention of appropriate architecture using Fisher's exact and unpaired t-test. Results: Sixty-two percent of cell block specimens showed a moderate amount of background material (P = 0.01), display of excellent architecture was also significantly more in cell block (20%) technique than direct smears (9%), and degree of cellular degeneration was minimal in significantly more cell blocks (26%) than direct smears (12%), thereby making diagnosis easy as opposed to FNAC which yielded more cellular material than cell blocks (P = 0.02). Four cases showing hemorrhagic material on direct smears were diagnosed on cell block as one case each of colloid goiter and chronic lymphocytic thyroiditis and two cases of adenomatous goiter and two cases showing hemorrhagic material on cell block were diagnosed with chronic lymphocytic thyroiditis on direct smears. Conclusion: FNAC and cell block complement each other and combining both techniques improves the diagnostic yield and facilitates accurate diagnosis. It is advisable to perform cell-block for each case of FNAC of thyroid lesions.
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Comparative analysis of diagnostic methods used for assessing incidence of malaria in two regions from South India p. 12
G Mukthayakka, Annapurna G Sajjan, Ragini Ananth Kashid
DOI:10.4103/jnsbm.JNSBM_134_20  
Background: Malaria is a vector-borne disease of major public health concern in several tropical and subtropical countries. Five different Plasmodium species are known to cause malaria. For optimal public health measures, region-specific prevalence of Plasmodium species should be identified by optimal diagnostic methods available. In this study, we have detected the malaria incidence rates in two regions of South India and compared the merit of three different diagnostic methods available for detection of malaria. Materials and Methods: Six hundred blood samples from febrile symptomatic patients were screened for malaria from Bengaluru and Vijayapura regions of Karnataka, India, by microscopy, rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR) methods. Results: The incidence rate of malaria in Vijayapura and Bengaluru was 8.6% (26/300) and 7% (21/300), respectively. The rate of malaria infection by Plasmodium vivax was higher in Bengaluru (80.9%) compared to Vijayapura (69%), whereas the rate of Plasmodium falciparum infection was higher in Vijayapura (23%) compared to Bengaluru (14.2%). The mixed infection rate was slightly higher from Vijayapura region. One isolate detected as P. falciparum by microscopy and RDT method was identified as mixed infection by PCR. Three and two isolates which were negative by microscopy and RDT methods, respectively, tested positive by PCR, whereas eight isolates identified as P. vivax by RDT method were negative by PCR and microscopy methods. The sensitivity and specificity of microscopy-based detection method were 93% and 100%, respectively, whereas the sensitivity and specificity of RDT method were observed to be 95% and 75%, respectively. Detection of Plasmodium species by PCR was highly sensitive and specific compared to microscopy or RDT method. Conclusion: The incidence of malaria infection in these regions is moderate. Malaria infection in these regions was caused predominantly by P. vivax. Accuracy of the malaria detection was superior by PCR method compared to conventional methods tested.
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Study of correlation of the number of languages spoken with intelligence among young Indian adults p. 17
Divya Subramanian, Prasanna Mithra, K Bhagyalakshmi, Ganaraja Bolumbu
DOI:10.4103/jnsbm.JNSBM_85_20  
Background: Intelligence is the ability to learn and adapt rapidly and is highly variable among individuals. The existence of language can be attributed to the brain and its capability to learn. Language, therefore, must be learnable by children. Very few studies correlate the language skills and the intelligence level of the person. Aim of the Study: The aim of this study was to correlated languages known and intelligence. We hypothesized that the mental circuitry responsible for linguistic skills must be more refined among those who know more languages. Materials and Methods: A correlational questionnaire-based study was conducted on 205 subjects of the age group of 19–22 years, who were required to fill in a case study form and take an IQ test (Cattell's Culture Fair Intelligence Test). The number of languages known among the 205 participants ranged from 1 to 6. Intergroup comparison was made using Pearson Correlation, Kruskal–Walli's test, and Mann–Whitney U-test. Results: When the Pearson Correlation was used, we did not find a statistically significant difference among the groups. No correlation between the number of languages known and the IQ of a person was evident (The Pearson Correlation Coefficient-0.029 and P = 0.677). The IQ in those who knew two or more languages were higher, while it was highest in those who knew four languages (P < 0.001). Conclusion: From the results, we could conclude that there is no direct correlation between the languages known by a person and the IQ. However, their comprehension capability may be better.
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Underlying diseases and in-hospital mortality of acute respiratory failure patients: Indonesian prospective cohort study p. 22
Menaldi Rasmin, Mia Elhidsi, Prasenohadi , Wiendo Syah Putra Yahya, Yusup Subagio Sutanto, Ana Rima Setijadi, Ngakan Putu Parsama Putra, Ungky agus Setyawan, Oea Khairsyaf, Russilawati , Deddy Herman, Mulyadi , Teuku Zulfikar, Dewi Behtri Yanifitri
DOI:10.4103/jnsbm.JNSBM_127_20  
Background: Epidemiologic data of acute respiratory failure (ARF) are limited. This study aims to investigate the underlying diseases and in-hospital mortality of patients with ARF in Indonesia. Materials and Methods: An observational prospective cohort study involving patients with ARF in six hospitals was conducted. Data were collected between January and December 2017. Data on the type of ARF, quick sepsis-related organ failure assessment (qSOFA) score, underlying diseases, and in-hospital mortality were documented. Proportions were compared using Chi-square or Fisher exact tests. Multivariable regression models with variable selection based on a stepwise backward elimination were run to analyze the risk factors for in-hospital mortality. Results: A total of 412 patients (median age: 56-years-old) were included. Most of the subjects were male (66.9%), hypoxemic (55.3%), and acute onset (86.4%). The most commonly encountered underlying diseases were pneumonia (58.7%), chronic obstructive pulmonary disease (25.5%), lung tuberculosis (25.2%), lung cancer (16.5%), noncystic fibrosis bronchiectasis (11.9%), congestive heart failure (10.2%), and chronic kidney disease (CKD) (3.2%). There were 65% of patients received only oxygen therapy, invasive mechanical ventilation was utilized for 30.8% of patients, and 4.1% of patients underwent noninvasive mechanical ventilation. There were 201 (48.79%) in-hospital mortality cases. The risk factors of in-hospital mortality were qSOFA ≥2 (odds ratio [OR]: 2.420, 95% confidence interval [CI] 1.599–3.662; P = 0.000) and CKD (OR: 3.871, 95% CI 1.024–14.631; P = 0.046). Conclusions: Most of the underlying diseases of ARF in Indonesia are communicable diseases. Patients with qSOFA ≥2 and CKD have a higher risk of death during hospitality.
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Assessment of depression in HIV-positive patients attending antiretroviral treatment center of a tertiary care institute in Eastern India: A hospital-based cross-sectional study p. 27
Sudipta Kumar Sinha, Mithilesh Kumar, Surendra Singh, Vivek Kashyap
DOI:10.4103/jnsbm.JNSBM_89_20  
Context: Neurological ailments have complex relation with HIV/AIDS. Depression in seropositive patients directly affects treatment outcome. Aims: This study aims to determine the prevalence of depression/depressive symptoms in HIV/AIDS patients attending antiretroviral treatment center and ascertain the underlying factors that have bearing on depression. Settings and Design: This was a cross-sectional study conducted among HIV seropositive patients attending ART center of the largest public health hospital in Jharkhand. Subjects and Methods: Between April 2018 and March 2019, 250 adult subjects were consecutively recruited and interviewed. Depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), with a positive depression screen defined as PHQ-9 score ≥10. Statistical Analysis Used: Chi-square was used to assess association. Factors found significant underwent multivariable logistic regression analysis. Results: The overall prevalence of depressive symptoms was 18.8% (95% Confidence Interval (CI) [95% CI]: 14.2, 24.2). Multivariable logistic regression analysis identified history of weight loss (Adjusted odds ratio [aOR] 6.17, 95% CI: 2.0, 19.08; P = 0.002), presently suffering from tuberculosis (aOR 5.65, 95% CI: 1.47, 21.74; P = 0.012), bad relationship with family members (aOR 6.85, 95% CI: 1.49, 31.53, P = 0.013) as correlates of depressive symptoms. Conclusions: The present study found depressive symptoms among adults with seropositive status, attending the ART center. HIV seropositive patients with known comorbidities, for example, with a history of weight loss, presently suffering from tuberculosis and with stressed relation within the family were prone to depressive symptoms.
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Judgment of pragmatic abilities: A story-based assessment in adolescents p. 35
Malavika Anakkathil Anil, Esmin Thayana, Jayashree S Bhat
DOI:10.4103/jnsbm.JNSBM_114_20  
Background: Adolescents start to understand nonliteral language and begin to use language to maintain social bonds in varying social contexts. Aim: This study aims to profile pragmatic judgment abilities in typically developing adolescents. Materials and Methods: The present study was conducted on 120 typically developing adolescents across the age range of 10–16 years. The formulated story consisted of 29 multiple-choice judgment questions to assess an adolescent's ability to judge the use of pragmatics skills by different characters in the story. Results: There was a statistically significant difference between the groups determined by the one-way analysis of variance (F [5114] =4.83, P = 0.00). Conclusion: With increasing grades, adolescents spend a reasonable time socializing with peers and others, promoting the development of pragmatic skills. As children and adolescents grow, perceptions of others improve, along with their ability to identify the complexity of contentious topics and differing points of view.
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Effectiveness and safety of topical combination of tropicamide 0.8% (w/v) and phenylephrine hydrochloride 5% (w/v) among the successful postdacryocystorhinostomy cases p. 43
Suvendu Das, Somnath Maity, Tanmoy Kanti Goswami
DOI:10.4103/jnsbm.JNSBM_94_20  
Background: Mydriatics are essentially used in routine ophthalmoscopic examinations and before various eye surgeries. Because pupil is under the control of autonomic nervous system, a combination of parasympatholytic drug (tropicamide) and sympathomimetic agent (phenylephrine) causes greater pupillary dilatation. In postdacryocystorhinostomy (DCR) patients, the nasolacrimal passage becomes wider and shortened, so the chances of absorption of topical drugs as well as the diminished local effects such as mydriasis are higher than normal. Hence, there are more chances of systemic adverse reactions. Materials and Methods: Data were collected and compared between fifty patients with unilateral nasolacrimal duct obstruction scheduled for DCR. Normal eye served as the control group, whereas affected post-DCR eye was considered the study group. Local (mydriasis) and systemic effects of the combination drop of tropicamide 0.8% (w/v) and phenylephrine 5% (w/v) were assessed. Results: Mydriasis was lesser in the post-DCR eyes (P < 0.001 for both vertical and horizontal papillary diameters). There were no statistically significant changes in systemic vital parameters when measured before and after the application of the combination drop in both the groups. Conclusions: The combination of tropicamide and phenylephrine can be safely used in post-DCR eyes as mydriatics, although mydriasis is lesser due to rapid drainage.
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Assessment of the level of knowledge of first aid and basic life support among the police workforce in a coastal area in Southern India p. 47
Gowry Reddy, Gabrielaa Kothakulangara, Rekha Thapar, Ramesh Holla, Nithin Kumar
DOI:10.4103/jnsbm.JNSBM_122_20  
Background: First aid and basic life support (BLS) are the basic principles that have significant importance in the revival of victims on site. Although the epidemiology of injuries has been well studied in many developed countries, there are a fewer number of such similar studies among the police workforce in developing countries, such as India. Objective: The objective was to assess the level of understanding about first aid and BLS measures among the police workforce in a coastal city of Southern India. Materials and Methods: This descriptive cross-sectional study was conducted at police stations and traffic police stations in a coastal city of South India with a sample size of 196. A pretested semi-structured questionnaire assessed a plethora of parameters, such as choking and seizures. Data were analyzed using SPSS version 16.0 (IBM SPSS Inc Chicago, SPSS Inc) and results were obtained. Consent from the study participants was obtained before commencement. Results: About 87.3% of the study participants who received training markedly scored <10, which is graded as a poor outcome, whereas 12.7% who have received training scored adequate. Among the untrained personnel, 86.4% scored <10, whereas the remaining 13.6% have adequately scored due to external or general knowledge without undertaking specific prior training. Conclusion: A majority of the police personnel who have received training should undergo frequent training to enhance their skills, which are currently below the baseline. Those who have not received training should also obtain proper training to improve their efficiency in emergency management.
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Comparison of serum benzo(a)pyrene diol epoxide – protein adducts level between lretek cigarette smokers and nonsmokers and the related factors p. 52
Agus Dwi Susanto, Nofiarni Yusril, Jamal Zaini, Fariz Nuwidya
DOI:10.4103/jnsbm.JNSBM_100_20  
Background: Benzopyrene is a carcinogenic agent found in cigarette smoke. Benzo(a)pyrene diol epoxide (BPDE) is one of the benzopyrene metabolites. In this study, we investigated the level of serum BPDE in kretek cigarette smokers compared to non-smokers. Methods: A cross-sectional study which involved 32 “healthy” kretek cigarette smokers and 32 “healthy” nonsmokers were conducted. We collected the blood sample and the serum BPDE level was assayed using enzyme-linked immunosorbent assay kit. The BPDE serum level in kretek cigarette smokers was compared to the level in nonsmokers. Results: A total of 32 kretek smokers and 32 controls underwent an examination of the BPDE-protein adducts level. In the kretek smokers group, 59.4% were aged over 45 years and 56.3% have a high educational background, while in the control group, 87.5% were aged under 45 years and 75% have high educational backgrounds. The level of BPDE-protein adducts in the kretek smokers subject was 12.15 (8.87–33.55) ng/ml and the levels in the control group were 11.4 (3.87–13.27) ng/ml, P = 0.004. The factors which influence the levels BDPE-protein adducts in smokers cigarettes, as determined by multivariate analysis, were sucking pattern (P = 0.002) and the degree of addiction (P = 0.047). Conclusion: The serum BPDE-protein adducts level was higher in smokers compared to nonsmokers, and the sucking pattern and degree of addiction are the influencing factors.
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Atorvastatin enhanced the bioavailability of irinotecan by inhibition of permeability-glycoprotein in rats with colon cancer: In vivo and in vitro studies p. 57
Kiran Lyagala, Prasad Neerati
DOI:10.4103/jnsbm.JNSBM_191_19  
Background: Satins' combination with anticancer drugs is a potential combination in treating cancer, which also inhibits the permeability glycoprotein (P-gp) to reduce the development of drug resistance by altering the absorption kinetics. The objective of the present investigation was to study the effect of atorvastatin (ATS) and verapamil (VER) on the pharmacokinetics of irinotecan (IRT) by N-methyl N-nitroso-urea-induced cancer in rat colon and small intestine. Materials and Methods: An in vitro study using noneverted sac model was conducted to determine the effect of ATS on the functional status of intestinal P-gp in colon cancer-induced rats. IRT (75 μg/ml) with and without VER (200 μM) and ATR (30 μg/ml) were filled into the excised colon tissue. In in vivo study, VER (25 mg/kg, p.o.) and ATS (20 mg/kg, p.o.) were administered separately 2 h before IRT (80 mg/kg, p.o.) dosing in male Wistar rats. Serum samples were collected at 0.5, 1, 2, 4, 6, 8, 10, and 12 h time points from control and treated animals to determine IRT concentration. Results: An in vitro noneverted sac study indicated IRT to be a P-gp substrate, and the function of intestinal P-gp was significantly inhibited in the presence of VER and ATS. After oral TRT dosing, the mean area under the plasma concentration-time curve was found to be 1.406 ± 0.15, which was increased significantly, i.e., 2.376 ± 0.19 (P < 0.001) and 1.856 ± 0.07 (P < 0.01), when VER and ATS, respectively, were co-administered with IRT. Similarly, the mean maximum plasma concentration of IRT increased from 0.247 ± 0.02 μg/ml (IRT alone) to 0.390 ± 0.03 (P < 0.001) (with VER) to 0.321 ± 0.02 (P < 0.01) (with ATS). Conclusion: These results indicate the improved bioavailability of IRT by the P-gp inhibitory effect of ATS, and further investigation is needed to develop IRT oral formulation in combination with suitable P-gp inhibitors for the treatment of colon cancer.
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Metallo-beta-lactamase-producing multidrug-pesistant acinetobacter isolates in patients with ventilator-associated pneumonia p. 64
Harsha Virendra Patil, Shivaji T Mohite, Virendra Chandrashekhar Patil
DOI:10.4103/jnsbm.JNSBM_54_20  
Background: Acinetobacter, a nonfermenting Gram-negative coccobacilli, have emerged as significant pathogens causing multidrug-resistant (MDR) ventilator-associated pneumonia (VAP). Metallo-beta-lactamase (MBL)-producing Acinetobacter spp. have become an emerging therapeutic concern worldwide due to the MDR isolates. Aim and Objectives: Phenotypic detection of MBL producing MDR Acinetobacter isolates in patients with VAP and to study the antibiotic susceptibility pattern of MBL-producing isolates. Materials and Methods: This was a prospective observational and noninterventional study conducted on patients with VAP over a period of 2 years. This study was conducted at a tertiary care teaching hospital in the intensive care unit. A total of 164 MBL-producing MDR AB isolates were included in the study. MBL was detected by imipenem-EDTA double-disc synergy test (DDST), imipenem-EDTA combined disc synergy test (CDST-IPM), and MBL-E test. Results: A total of 188 samples were enrolled for the study, fulfilling the inclusion criteria of VAP. Total MDR Acinetobacter spp. isolates were 188 (76.42%) of them, 164 (87.23%) were MBL producing and 24 (12.76%) were nonMBL (P < 0.002). Total 11.17% and 88.83% MDR VAP due to Acinetobacter spp. were early-onset VAP and Late-onset VAP, respectively (P < 0.001). Late-onset VAP due to MDR Acinetobacter spp. was predominant in the present study caused by Acinetobacter spp. Of total 188 MDR Acinetobacter isolates, 156 (82.98%) were Acinetobacter baumannii, 15 (7.98%) were Acinetobacter iwoffii, 9 (4.79%) were Acinetobacter calcoacetiucs, 5 (2.66%) were Acinetobacter hemotyticus, and 3 (1.59%) were ABC complex, predominated by A. baumannii (P < 0.001). Of total 188 MDR Acinetobacter spp. 164 (87.23%) were putative MBL producing and 24 (12.67%) were nonMBL Acinetobacter spp. Of 164 MBL-producing isolates, 141 (85.98%) were detected by the DDST method, and 23 (14.02%) were DDST negative. Total 146 (89.02%) MDR Acinetobacter spp. were detected by a combined disc test-IMP test. A total of 152 (92%) MDR Acinetobacter spp. were detected by MBLe-Test. All MBL-producing MDR Acinetobacter spp. isolates (164) were resistant to piperacillin (PI), piperacillin + tazobactam (PIT), ciprofloxacin (CIP), ceftazidime (CAZ), cefepime (CPM), imipenem (IMP), and meropenem (MRP). The tigecycline (21.34%) resistance was significantly less compared to all other antibiotics. Conclusions: The present study highlighted the burden of MDR MBL producing Acinetobacter spp. in patients with VAP. About three-fourth of patients with VAP had MDR Acinetobacter spp. Eighty percent were MDR Acinetobacter spp. were MBL producers. MDR Acinetobacter isolates, including MBL producer, were significantly higher in late-onset VAP. The ability of phenotypic identification of Acinetobacter spp. for MBL producer among imipenem-EDTA double-disc synergy test (DDST), CDST-IPM and MBL-E Test were comparable. All MBL-producing MDR Acinetobacter spp. isolates were resistant to PI, Ciprofloxacin, CAZ, CPM, IMP, and MRP. The tigecycline resistance was significantly less (1/5th). The study of antibiotic sensitivity patterns and screening for MBL production among A. baumannii isolates is essential for controlling Acinetobacter infections. The judicious use of antimicrobial therapy and combined approaches of rotational antibiotic therapy is strongly suggested.
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Measuring Effects of Competing Swallowing-Cognitive Task on 100-ml Water Swallowing and Number Recognition: A Crossover Comparative Study in Healthy Young and Middle-Aged Adults p. 75
Thejaswi Dodderi, Lekshana Umesh, Shahana Hakkeem
DOI:10.4103/jnsbm.JNSBM_59_20  
Introduction: The 21st-century lifestyle has swallowing accompanied by competing cognitive activities (texting, reading, and television watching). The potential influence of competing cognitive tasks on swallowing and vice versa is not completely understood. Aim of the Study: This study examined the swallowing and cognitive abilities of healthy young and middle-aged adults in isolated condition and compared their performance with a competing swallow-cognitive dual task. Materials and Methods: Swallowing ability of thirty healthy young adults (20–40 years) and thirty healthy middle-aged adults (41–60 years) were measured by 100-ml thin liquids swallowing, and the cognitive ability was assessed by number recognition task. The two tasks performed in isolation and competing dual-task conditions were observed for changes in: (a) swallowing indices-volume/swallow, time/swallow, and swallow capacity; and (b) cognitive performance-reaction time. Results: Healthy young adults had better swallowing indices and faster number recognition compared to middle-aged adults, in isolated as well as dual-competing condition. Male participants 100-ml swallow capacity was higher, and their number recognition quicker than female participants. Multivariate Analysis of Variance with the main effect of age and gender suggested a statistically significant difference at P < 0.05 in isolated and competing-dual task conditions. Conclusion: Overall, the state of evidence suggests there exists a cumbersome influence of competing cognitive resources on swallowing performance and vice versa.
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Immune-enhancing effect of bengkoang (Pachyrhizus erosus (l.) Urban) fiber fractions on mouse peritoneal macrophages, lymphocytes, and cytokines p. 84
Hanif Nasiatul Baroroh, Agung Endro Nugroho, Endang Lukitaningsih, Arief Nurrochmad
DOI:10.4103/jnsbm.JNSBM_53_20  
Background: This study was conducted to evaluate the immunomodulatory effects of bengkoang (Pachyrhizus erosus [L.] Urban) fiber extract (BFE) fraction on mouse peritoneal macrophages, lymphocytes, and cytokines. Materials and Methods: BFE was prepared by heat-extraction from the bengkoang fiber in distilled water at 121°C for 20 min. Fraction of BFE including BEF-A, BEF-B, BEF-D, and BEF-E were prepared by precipitation method with cold ethanol and potassium hydroxide. The phagocytic activity of macrophages was observed by a phagocytosis assay using mouse macrophages. The lymphocyte proliferation assay was performed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and measuring the absorbance at 550 nm. Also, the production of cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 was determined. Results: The BFE enhanced the phagocytic activity by increasing the phagocytic index and capacity of mouse peritoneal macrophages. The phagocytic capacity of mouse peritoneal macrophages was significantly increased after the treatment of BFE, BFE-B, and BFE-E compared with control. The fractions BFE-A, BFE-B, BFE-D, BFE-E, and pectin could stimulate phagocytic activity by increasing the phagocytic index. There were no significant differences after treatment with fiber fractions in enhancing lymphocyte proliferation, but pectin could stimulate the lymphocyte proliferation. Also, the fraction of BFE-A could enhance TNF-α and IL-10 production. After treatment with BFE-B, there were increases in TNF-α and IL-6 production but decreases in IL-10 production. The fraction of BFE-D could also stimulate TNF-α production, and BFE-E could reduce IL-10 production. Conclusion: The fiber fractions of bengkoang showed an immune-enhancing effect, stimulated both TNF-α and IL-6 production, and suppressed IL-10.
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Effectiveness of thoracic spine manipulation in conjunction with cranial base release technique on pain and range of motion in patients with mechanical neck pain Highly accessed article p. 93
Ramesh Chandra Patra, Biswajit Kanungo, Sumiya Nazir, Ancy Abraham
DOI:10.4103/jnsbm.JNSBM_60_20  
Background: Pain originates from the neck and may radiate to the shoulder or base of the cranium and is often aggravated by anxiety, depression, soft-tissue strain, occupational activities, and poor posture. In this study, we evaluated the efficiency of thoracic spine manipulation along with cranial base release technique to improve motion and alleviate pain in individuals suffering from mechanical neck pain. Materials and Methods: We recruited 60 individuals (male: 31 and female: 29) who were suffering from mechanical neck pain. The participants were randomly distributed into Groups A and B. Patients of Group A underwent conventional physiotherapy treatment, whereas patients of Group B patients underwent thoracic spine manipulation and cranial base release. Baseline range of motion and pain were evaluated before starting the treatment, and postintervention measures were obtained after the weeks of intervention. Results: All participants completed 2 weeks of treatment. Group A had shown better outcome in all the parameters than Group B. We observed that the pain and cervical range of motions of Group B patients were statistically significantly different from those of Group A patients (P < 0.05). Conclusions: Thoracic spine manipulation in conjunction with cranial base release technique is more effective in the management of pain and cervical range of motion compared to the conventional physiotherapy treatment.
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“I Think I Can Remember” age-related changes in self-efficacy for short-term memory p. 97
Dasmine Fraclita DSouza, Gagan Bajaj, Vinitha Mary George, Sudhin Karuppali, Jayashree S Bhat
DOI:10.4103/jnsbm.JNSBM_32_20  
Introduction: Changes in metacognitive abilities due to aging, like self-efficacy, have received less attention in cognitive research. Short-term memory (STM) declines among aging adults are well known but the age-related trends of self-efficacy linked to the same have received less attention. The present research aimed at studying age-related trends in self-efficacy linked to STM among the young-aged, middle-aged, and old-aged adults. Materials and Methods: Participants performed face recall, name recall, object recall, face-name association, first-second name association, and face-object association tasks. The self-efficacy linked to these STM tasks was measured through a pre-task prediction question and a post-task judgment question. Descriptive statistics and two-way mixed model ANOVA with post hoc Bonferroni analysis were performed to assess age related changes in self-efficacy measures. Results: The findings revealed significant overestimation of performance, during pretask prediction, by old-aged adults and middle-aged adults. While the posttask judgment was recalibrated closer to the actual performance by participants of all age groups. Conclusion: The current research findings indicate that self-efficacy for STM follows an age related decline. Therefore, inclusion of self-efficacy measures in the assessment of STM would provide a valuable insight as it describes an individual's own awareness about their STM abilities, provides realistic feedback about one's STM performance and also aids clinicians in understanding the perception-performance dynamics among the aging adults.
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Anti-inflammatory potential of aqueous extract of Elsoltzia stachyodes on experimental models of inflammation in rats p. 103
Priyotosh Banerjee, Tarun Kumar, Sudhir Chandra Sarangi, Usham Dharmaraja Meetei, Akham Subhalakshmi Devi, Ritesh Kumar
DOI:10.4103/jnsbm.JNSBM_5_20  
Aim: Elsholtzia stachyodes is being used as a folk medicine to suppress the pain in various inflammation-related disorders in the North-eastern part of India. However, there is a lacking of evidence-based data on it. Hence, this study was conducted to evaluate the anti-inflammatory properties of an aqueous extract of Elsoltzia stachyodes (AEES) on experimental models of inflammation in rats. Materials and Methods: The qualitative phytochemical analysis tests were performed to check the presence of alkaloids, glycoside, flavonoids, saponin, tannin, and triterpenoids. Wistar (150–175 g) rats were used to evaluate anti-inflammatory property by carrageenan induced paw edema and cotton pellet-induced granulation tissue formation models. Indomethacin (10 mg/kg) and AEES were administered at doses of 50, 100, and 200 mg/kg in both the models. In case of carrageenan-induced paw edema model, the change in paw volume was estimated using plethysmometer. However, wounds weights of cotton pellet were measured in cotton pellet-induced granulation tissue formation model. Results were analyzed by one-way ANOVA. Results: The phytochemical analysis of AEES showed the presence of flavonoids, saponin, tannin, and triterpenoids. AEES showed a significant decrease in paw edema and weight of the cotton pellets in a dose-dependent manner in both the inflammatory models. Conclusion: The findings of the present study suggest that AEES exhibited significant anti-inflammatory activity and may have the potential of usefulness as an adjuvant therapy in inflammatory-related disorders.
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Urease activity in saliva and plaque as endogenous protection against dental caries in institutionalized blind children p. 109
Vinod Kumar, Anisha Nanda, K Harish Bhat, Pallavi Ashrit, Aleena Babu, MK Shakir
DOI:10.4103/jnsbm.JNSBM_90_20  
Background: Urease activity has been proposed to have a significant effect on dental caries, showing reduced caries activity with increased urease levels. Thus, the aim of the study was to evaluate the ureolytic activities of saliva and plaque in caries-active and caries-free institutionalized blind children. Materials and Methods: Fifty-two institutionalized blind children were divided into two equal groups using decayed, missing, and filled Teeth index as Group A – caries free and Group B – caries active. Urease activity was measured by collecting saliva and plaque samples from them. Children were refrained from any oral hygiene procedures during the 12 h preceding the sample collection. Urease enzyme activity was obtained by carrying out biochemical procedures. Mann–Whitney test was used to determine the statistical significance of the data. Results: In saliva, caries-free group had higher mean urease levels of 1.82 ± 0.497 as compared to caries-active group which had mean urease levels of 0.445 ± 0.304. In plaque, caries-active group had lower mean urease levels of 0.877 ± 0.942 as compared to caries-free group which had mean urease levels of 1.570 ± 0.918. The specific urease activity in saliva and plaque was significantly higher in individuals with low caries rates. Conclusion: Caries-free children had a higher ammonia generation activity by urease for both saliva and plaque samples than low caries-active children. High levels of alkali production in the oral environment were related to caries-free children.
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Correlations of oral bacterial urea catabolism with caries experience in normal-weight children and underweight children p. 113
Vinod Kumar, Aleena Babu, K Harish Bhat, Pallavi Ashrit, Anisha Nanda, MK Shakir
DOI:10.4103/jnsbm.JNSBM_91_20  
Background: Alkali generation by oral bacteria plays a key role in plaque pH homeostasis and may be inhibitory to the initiation and progression of dental caries. A substantial body of evidence is beginning to accumulate, which indicates that the modulation of the Alkali generating potential of dental biofilms may be a promising strategy for caries control. Aim: The aim of the study was to determine the capacity of oral samples to produce ammonia from urea and its relation to caries experience in normal-weight children and underweight children. Materials and Methods: Urease activity was measured in the saliva and plaque of 25 caries-active (CA) individuals who have normal weight and 25 CA individuals who are underweight. Urease activity was obtained from the ammonia produced by the incubation of plaque and salivary samples in urea. Independent sample t-test and Pearson's correlation were used to compare the differences and to correlate the urease levels and caries experience between groups. Results: The results showed that the mean urease levels in saliva were higher in All are positive value-1.2192±1.012 as compared to that of underweight children-0.78-0.676. The mean urease levels in plaque were lower in normal-weight children-0.1120-0.12206 as compared to that of underweight children-0.4824-0.5215. Conclusion: In underweight children, the caries activity was higher along with increased urease activity in saliva and lower urease activity in plaque, whereas in normal-weight children, the caries activity was lower with increased urease activity in saliva and lower urease activity in plaque.
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Diagnostic predictors of active tuberculosis infection in diabetic patients with latent tuberculosis: A review on cathelicidin and 1,25-dihydroxyvitamin D3 p. 117
Yunita Arliny, Faisal Yunus, Erlina Burhan, Sita Andarini, Sri Widia A Jusman, Em Yunir, Aria Kekalih, Arto Yuwono Soeroton, Fariz Nurwidya
DOI:10.4103/jnsbm.JNSBM_26_20  
Background: Diabetes Mellitus has been identified as one of factors causing increased risks of latent TB infection. The roles of cathelicidin LL-37, 1.25(OH)2D3 as well as their correlation with specific IFN-γ in latent TB has not been extensively identified. Aims and Objectives: Our study was aimed to identify proportion of latent TB infection in patients with DM and to identify the role of cathelicidin, 1.25(OH)2D3, vitamin D and other clinical factors as predictors for active TB infection in diabetic patients with latent TB. Methods: Our study was conducted in 2 stages. The first-stage study was a cross-sectional study to identify the proportion of latent TB infection in patients with DM without any history of TB, which was continued with a case-control study to identify the roles of predictive biomarkers (cathelicidin LL-37, 25(OH)D3, 1.25(OH)2D3 and IFN-γ) as well as clinical predictive factors for active TB infection in diabetic patients with latent TB. Results: Out of 242 diabetic patients without any history of TB who underwent screening test for latent TB, there were 78 (33.2%) subjects with a diagnosis of latent TB and 1 subject was diagnosed with active TB. There was significant association on the level of cathelicidin LL-37 in DM patient with latent TB, active TB and without TB infection (23.49 ng/mL vs. 49.6 ng/mL vs. 10.46 ng/mL, P < 0,005). Almost all of subjects with DM showed low levels of vitamin D, most in subject with active TB (97%). There was no significant association between 1.25(OH)2D3 and 25(OH)D3 in DM patients with latent TB, active TB and without TB infection. There was a significant association on the levels of IFN-γ ((TB1 1.4 IU/mL vs. 0.03 IU/mL P < 0.005; TB2 1.4 IU/mL vs. 0.04 IU/mL P < 0.005) in DM subjects with latent TB and those without TB infection; however, no significant association was found in DM subjects with latent TB and active TB. History of smoking, HbA1C > 9.5% and cathelicidin LL-37 levels of > 30 ng/mL were predictors for latent TB into active TB in DM patients. Conclusion: Cathelicidin LL-37 can serve as a biomarker of latent TB progressiveness in patients with DM.
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CASE REPORT Top

Laser excision of intraoral capillary hemangioma p. 124
Sangeetha Subramanian, Purva Dalmia, Prakash Ponnudurai Samuel Gnana, Devapriya Appukuttan
DOI:10.4103/jnsbm.JNSBM_81_20  
Hemangiomas are benign tumors of the blood vessel origin. They appear as raised or flat reddish-blue lesions and are generally solitary, affecting women in younger age groups. The tumor may be slowly progressive, involving extensive portions of the superficial and deep blood vessels, and affect function, depending on the location. They are mostly common in the head and neck region but rarely in the oral cavity. This case report presents a case of capillary hemangioma in the labial mucosa of a female patient, which was diagnosed by histopathology after laser excision.
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