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   2014| January-June  | Volume 5 | Issue 1  
    Online since February 18, 2014

 
 
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REVIEW ARTICLES
Acute respiratory infections among under-5 children in India: A situational analysis
Kalaiselvi Selvaraj, Palanivel Chinnakali, Anindo Majumdar, Iswarya Santhana Krishnan
January-June 2014, 5(1):15-20
DOI:10.4103/0976-9668.127275  PMID:24678190
Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Emergence of newer pathogenic organisms, reemergence of disease previously controlled, wide spread antibiotic resistance, and suboptimal immunization coverage even after many innovative efforts are major factors responsible for high incidence of ARI. Drastic reduction in the burden of ARI by low-cost interventions such as hand washing, breast feeding, availability of rapid and feasible array of diagnostics, and introduction of pentavalent vaccine under National Immunization Schedule which are ongoing are necessary for reduction of ARI.
  12,922 1,214 17
Chemoprevention of oral cancer: Green tea experience
Vijayalakshmi Ramshankar, Arvind Krishnamurthy
January-June 2014, 5(1):3-7
DOI:10.4103/0976-9668.127272  PMID:24678188
Oral cancer has a well characterized progression from premalignant oral epithelial changes to invasive cancer, making oral squamous cell carcinoma an optimal disease for chemoprevention interventions prior to malignant transformation. The primary goal of chemoprevention here is to reverse, suppress, or inhibit the progression of premalignant lesions to cancer. Due to the extended duration of oral pathogenesis, its chemoprevention using natural products has been found promising due to their decreased dose and limited toxicity profiles. This review discusses with an emphasis on the clinical trials using green tea extract (GTE) in chemoprevention of oral premalignant lesions along with use of GTE as a chemopreventive agent in various other cancers as well. It is worthwhile to include green tea extract in an oral screening program for evaluating the premalignant lesions comparing the results between the treated and untreated group. Given the wide acceptance of green tea, its benefits may help in effective chemoprevention oral cancer.
  4,461 971 12
ORIGINAL ARTICLES
Impact of iron deficiency anemia on cell-mediated and humoral immunity in children: A case control study
Indranil Das, Kaushik Saha, Debanjan Mukhopadhyay, Shreosee Roy, Gargi Raychaudhuri, Mitali Chatterjee, Pradip Kumar Mitra
January-June 2014, 5(1):158-163
DOI:10.4103/0976-9668.127317  PMID:24678217
Objective: The precise role of iron in immune regulation especially in children vulnerable to iron deficiency is not fully known. Hence, this study was conducted to evaluate the effects of iron deficiency anemia (IDA) and its treatment with oral iron supplementation on cell-mediated immunity (CMI) and humoral immunity (HMI) in children. Materials and Methods: A total of 40 children (<15 years) with IDA and 40 age-matched healthy children after satisfying the inclusion criteria were enrolled for this case-control study. Flow cytometric evaluation of absolute and relative numbers of cluster of differentiation 4 (CD4) and CD8 (cluster of differentiation 8) lymphocyte subgroups was carried out to assess the CMI and serum Immunoglobulin G (IgG), Immunoglobulin A (IgA), Immunoglobulin M (IgM) were measured to assess the HMI at baseline and 3 months post oral iron supplementation. Results: Significantly lower levels (P < 0.05) of CD4+ T-cells and decreased CD4:CD8 ratios were observed in the iron deficient children. Iron supplementation significantly improved the CD4+ cell counts and CD4:CD8 ratios. However, immunoglobulin levels weren't different between the two groups. Conclusions: Although IDA did not influence HMI, it significantly impaired CMI, which was improved following iron supplementation for 3 months.
  4,387 809 16
REVIEW ARTICLES
Botulinum toxin: The Midas touch
PS Shilpa, Rachna Kaul, Nishat Sultana, Suraksha Bhat
January-June 2014, 5(1):8-14
DOI:10.4103/0976-9668.127274  PMID:24678189
Botulinum Toxin (BT) is a natural molecule produced during growth and autolysis of bacterium called Clostridium botulinum. Use of BT for cosmetic purposes has gained popularity over past two decades, and recently, other therapeutic uses of BT has been extensively studied. BT is considered as a minimally invasive agent that can be used in the treatment of various orofacial disorders and improving the quality of life in such patients. The objective of this article is to review the nature, mechanism of action of BT, and its application in various head and neck diseases.
  4,393 766 4
ORIGINAL ARTICLES
Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India
Ganesh S Kumar, Gautam Roy, L Subitha, Swaroop Kumar Sahu
January-June 2014, 5(1):59-62
DOI:10.4103/0976-9668.127289  PMID:24678199
Background: Bronchial asthma is an important public health problem at the global level. There is paucity of studies on bronchial asthma among school children in Urban India. Objective: To assess the prevalence and associated factors of bronchial asthma among school children. Materials and Methods: A cross-sectional study was conducted among 263 children studying in the 8 th , 9 th , and 10 th standard using the modified International Study on Allergy and Asthma in Childhood questionnaire in Urban Puducherry. Data on associated factors that include family history of asthma, type of fuel used for cooking, placement of kitchen in the house, number of windows in sleeping room, pet animals, smoking among family members, birth order, and smoke outlet were collected. Data were analyzed by univariate analysis and expressed in proportion or percentages. Results: Prevalence of ever bronchial asthma was found to be 5.3%, of which 4.2% had current episode of asthma during the last 1-year period. About 72.7% of the current asthmatics had cold or rhinitis and 54.5% each had itching or rashes and nocturnal dry cough. Prevalence is more among the 12-13 years age group (6.5%) compared to the 14-16 years age group (3.6%). Boys (5.4%) and girls (5.2%) had comparable prevalence rates. The prevalence was significantly more among those with a family history of asthma, having smoking habits in any of the family members, and the absence of smoke outlet in the house (P < 0.05). Conclusion: Bronchial asthma is an important health problem among children in urban Puducherry. Intervention on exposure to passive smoking and provision of smoke outlets may help to reduce the burden of disease at the community level.
  3,913 577 2
Utilization of maternal health-care services by tribal women in Kerala
Jinu Annie Jose, Sonali Sarkar, S Ganesh Kumar, Sitanshu Sekhar Kar
January-June 2014, 5(1):144-147
DOI:10.4103/0976-9668.127314  PMID:24678214
Background: The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. Aim: This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. Settings and Design: This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Materials and Methods: Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Statistical Analysis Used: Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. Results: The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Conclusions: Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.
  3,761 665 4
Estimation of serum and salivary immunoglobulin G and immunoglobulin A in oral pre-cancer: A study in oral submucous fibrosis and oral lichen planus
VC Divya, S Sathasivasubramanian
January-June 2014, 5(1):90-94
DOI:10.4103/0976-9668.127294  PMID:24678204
Aim: Oral submucous fibrosis (OSMF) and oral lichen planus (OLP) are two frequently reported, potentially malignant disorders with multifactorial etiologies and ambiguous pathogenesis. An immunological pathogenesis has been hypothesized as a causative factor for both. The present study aims to evaluate the role of serum and salivary immunoglobulin G (IgG) and immunoglobulin A (IgA) in both these conditions, by their quantitative estimation. Materials and Methods: Saliva and serum samples were collected from 30 patients, clinically diagnosed and histopathologically confirmed with OSMF, 30 with OLP and 30 age and sex matched controls. The levels of IgG and IgA were estimated by nephelometry. Results: The mean values of serum IgG were marginally higher in both OSMF and OLP groups compared to the controls but this difference was not significant and the mean values of serum immunoglobulin A were marginally decreased in both the study groups compared to the controls but this difference was also not significant. Inconclusively low levels of salivary IgG and IgA were obtained in the three groups. Conclusion: The present study suggests an insignificant association of these immunoglobulins in the pathogenesis of both these diseases.
  3,920 482 1
CASE REPORTS
Dens invagination: A review of literature and report of two cases
Seema Thakur, Narbir S Thakur, Manmohan Bramta, Mohit Gupta
January-June 2014, 5(1):218-221
DOI:10.4103/0976-9668.127341  PMID:24678234
Dens invaginatus occurs as a result of the invagination of the enamel organ. These cases may present difficulties with respect to its diagnosis and treatment because of canal morphology. It frequently leads to caries, pulpal, and periodontal involvement with necrosis and loss of attachment. The knowledge of classification and anatomical variations of teeth with dens invaginatus are of great importance for correct treatment. This article presents two case reports of two different types of dens invaginatus along with profound review of the literature regarding etiology, epidemiology, and histology. It discusses clinical appearance and diagnosis, and it provides guidelines for decision-making and treatment of invaginated teeth.
  3,529 630 4
External cervical resorption case report and a brief review of literature
Nizar Ahmed, Gopalakrishnan Bejoy Mony, Harinath Parthasarthy
January-June 2014, 5(1):210-214
DOI:10.4103/0976-9668.127336  PMID:24678232
External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action; it usually begins on the cervical region of the root surface of the teeth. The etiology, predisposing factors, diagnosis, and management of ECR have been reviewed here. Effective management and appropriate treatment can only be carried out if the true nature and exact location of the ECR lesion are known. This paper reports on the management of a case of external cervical root resorption (ECRR), which involved root canal treatment and removal of the resorbing area of the affected tooth as well as filling the resorbed area with mineral trioxide aggregate (MTA) and resin-modified glass ionomer filling material (RMGIC). The defect was filled with bone graft material and guided tissue regeneration (GTR) membrane. This case highlights the importance of using MTA and successful management of cervical resorption with a stable uneventful clinical recovery.
  3,340 635 7
ORIGINAL ARTICLES
Anomalies in primary dentition: Their distribution and correlation with permanent dentition
Santanu Mukhopadhyay, Sanjib Mitra
January-June 2014, 5(1):139-143
DOI:10.4103/0976-9668.127313  PMID:24678213
Background: Anomalies in primary dentition are often found to be associated with anomalies in permanent dentition. Aims: This study was performed to evaluate the prevalence of supernumerary teeth, hypodontia, double teeth, and talon cusp in the primary dentition, and their effect on succedaneous permanent teeth. Materials and Methods: In this prospective cross-sectional study, we clinically investigated 2757 Bengali speaking nursery children (1474 girls and 1283 boys), of age four to six years, at their respective schools, and the presence of supernumerary teeth, hypodontia, double teeth, and talon cusp in the primary dentition were recorded. Children with anomalous primary teeth were further subjected to periapical and panoramic radiographic examination, to determine the status of the underlying permanent teeth. Results: The total prevalence of all anomalies in this study was 1.8%. A total of 38 children (21 girls and 17 boys) had anomalies. The prevalence of anomalies was as follows: Supernumerary teeth (0.4%), hypodontia (0.5%), double teeth (0.4%), and talon cusp (0.07%), in both sexes combined. Radiographic examination showed 50% of the patients (19 children) had anomalies in the permanent dentition. Conclusions: Anomalies in primary dentition exhibited a correlation with anomalies in permanent dentition.
  3,446 483 1
Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students
Saniya Setia, Parampreet Pannu, Ramandeep Singh Gambhir, Virat Galhotra, Pooja Ahluwalia, Anjali Sofat
January-June 2014, 5(1):67-72
DOI:10.4103/0976-9668.127291  PMID:24678201
Objective: The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. Materials and Methods: A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. Results: The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. Conclusion: A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.
  3,025 589 6
CASE REPORTS
A rare case of Kartagener's syndrome
Sudipta Pandit, Sabyasachi Choudhury, Anirban Das, Sumitra Basuthakur, Sibes Kumar Das
January-June 2014, 5(1):175-177
DOI:10.4103/0976-9668.127321  PMID:24678221
A young boy presented with cough and intermittent breathlessness for 3 months. He used to suffer from frequent cough and cold since childhood. Clinical examination revealed bilateral coarse basal crepitations and rhonchi. His apex beat was on right 5 th intercostal space in mid-clavicular line. Investigation revealed situs inversus, bi-lateral bronchiectasis, and chronic sinusitis. His semen analysis revealed the complete absence of sperm. The Saccharin test revealed impaired nasal ciliary movement. Considering all the finding, he was diagnosed as a case of Kartagener's syndrome. We are reporting this case because of its rarity and rare presence of aspermia in Kartagener's syndrome.
  3,238 279 2
ORIGINAL ARTICLES
Correlation of oral health status of socially handicapped children with their oral heath knowledge, attitude, and practices from India
Raghavendra Shanbhog, Veena Raju, Bhojraj Nandlal
January-June 2014, 5(1):101-107
DOI:10.4103/0976-9668.127297  PMID:24678206
Background: Information on oral health knowledge and practice in orphanage house children is essential for healthcare policy makers to promote oral health resources and address oral health needs of this unprivileged group of society. Objectives: To assess the source of information, level of knowledge, attitude, and practice toward oral hygiene and oral health among socially handicapped children from city of Mysore, Karnataka state, India. Materials and Methods: A cross-sectional survey was conducted among 488 children of 12-14 years of age living in five different orphanage houses of Mysore district. Data regarding knowledge and practice were collected through structured questionnaire and oral health status by type III clinical oral examinations by two trained examiners. Decayed, Missing, Filled, Teeth (DMFT) and OH I-S was then correlated with the above information. Spearman's correlation test was used to measure the correlation. Results: The final data analysis included 488 children, of which 216 (44.26%) were boys and 272 (55.74%) were girls. A total of 88.5% children showed one or more decayed teeth in their oral cavity, with an overall mean DMFT of 3.55. Among DMF, component D showed maximum value with mean 3.42, followed by components F and M. Correlation between source of information, knowledge, and attitude for oral health to oral hygiene index (OHI-S; P < 0.05) and gingival index (P < 0.001) showed highly significant negative values. Correlation between oral hygiene practice to OHI-S, DMFT, and gingival index (P < 0.001) showed highly significant (P < 0.001) negative values. Conclusions: Although children of orphanage have positive attitude toward oral health, knowledge and practice among children are still below the satisfactory level. The children did not receive appropriate information or, if informed, were not re-evaluated or reinforced for its practical application by the concerned authority. The findings of this study suggest that awareness on the importance of oral health needs to be enhanced among the orphanage children of Mysore.
  3,110 382 2
Palatoscopy: An adjunct to forensic odontology: A comparative study among five different populations of India
Amit Byatnal, Aditi Byatnal, A Ravi Kiran, Y Samata, Yadavalli Guruprasad, Neethu Telagi
January-June 2014, 5(1):52-55
DOI:10.4103/0976-9668.127287  PMID:24678197
Objectives: This study was conducted to analyze and identify differences in the palatal rugae patterns and to identify gender wise changes in the palatal rugae shapes in populations of five different states of India. Study Design: Study was conducted in five different Indian states. 500 sample subjects from Andhra Pradesh, Tamil Nadu, Karnataka, Madhya Pradesh and Maharashtra were included. Rugae patterns with predominant shapes were analyzed and categorized according to different states and both genders, data was statistically analyzed using SPSS software 15.0 and the results were obtained by Chi-square analysis. Results: "Wavy" type of palatal rugae pattern is the most predominant variant in five different study groups in both the genders. Conclusion: This study could identify variations in distribution of various palatal rugae pattern in five different states and confirmed the "wavy" type of palatal rugae patterns to be the most predominant variant in five different study groups.
  2,977 398 3
CASE REPORTS
Laparoscopic appendectomy for mucocele of the appendix
Manish Kumar Singh, Mani Kant Kumar, Ramanuj Singh
January-June 2014, 5(1):204-206
DOI:10.4103/0976-9668.127332  PMID:24678230
Mucocele of the appendix is an aseptic dilatation secondary to obstruction. The preoperative clinical diagnosis of appendiceal mucoceles can therefore be difficult because of this lack of clinical symptomotology. Surgical excision is the treatment of choice in benign mucocele. We report a case presenting to the surgeons where initial clinical findings and investigations suggested a cyst in the right adnexa. Diagnostic laparoscopy revealed mucocele of the appendix and laparoscopic appendicectomy was done.
  2,975 297 3
Giant cemento-ossifying fibroma of the mandible
Raghavendra Mahadev Naik, Yadavalli Guruprasad, D Sujatha, Shubha Gurudath, Anuradha Pai, KV Suresh
January-June 2014, 5(1):190-194
DOI:10.4103/0976-9668.127326  PMID:24678226
Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.
  2,984 285 1
ORIGINAL ARTICLES
Docking studies for screening anticancer compounds of Azadirachta indica using Saccharomyces cerevisiae as model system
M Krishnamoorthy, Reena Balakrishnan
January-June 2014, 5(1):108-111
DOI:10.4103/0976-9668.127298  PMID:24678207
Introduction :Plants have a long history of use in the treatment of cancer. Plant-derived compounds have played an important role in the development of several clinically useful anticancer agents. In the recent years, more emphasis has been placed on identifying plant-derived compounds that can be used as an effective treatment for life-threatening diseases such as cancer. Cancer is a disease where there is abnormal cell proliferation. The proliferation of the cancer cells are restrained by cdk/cyclin complexes, which control the normal process of cell cycle. Materials and Method : The current study involves the investigation of the anticancer property of the chemical compounds present in the leaves of Azadirachta indica by performing docking studies with the cell cycle control protein using Arguslab. Result : The compounds were docked with the cdk1 protein to identify suitable inhibitors against the protein function. Conclusion : The study were conducted on yeast Cdk protein, because these proteins showed homology with the human Cdks
  2,739 523 -
CASE REPORTS
Unilateral multiple variations of renal, phrenic, suprarenal, inferior mesenteric and gonadal arteries
Kosuri Kalyan Chakravarthi
January-June 2014, 5(1):173-175
DOI:10.4103/0976-9668.127320  PMID:24678220
Knowledge of the branching pattern of the abdominal aorta is clinically important for any abdominal surgeon operating on parts of the gut or neighboring structures.Variations of these vessels may influences urological, renal transplantation and laparoscopic surgeries. We present an unreported case of multiple variations of branching pattern of abdominal aorta. It includes double renal arteries for left kidney, a common trunk with right and left phrenic, right and left superior suprarenal and left middle supra renal arteries, and a common trunk originate 2.5 cm above the bifurcation of abdominal aorta gave off inferior mesenteric, accessory renal artery to the left kidney and left testicular arteries in the middle-aged normal male cadaver. The embryogenesis of such multiple variations of branches of abdominal aorta is not clear, but the anatomic consequences may have important clinical implications. Knowledge of these variations is important for urologists, radiologists and surgeons in general.
  2,994 263 1
ORIGINAL ARTICLES
Detection of species diversity in oral candida colonization and anti-fungal susceptibility among non-oral habit adult diabetic patients
Jeyanthi Premkumar, Pratibha Ramani, Thiruvengadam Chandrasekar, Anuja Natesan, Priya Premkumar
January-June 2014, 5(1):148-154
DOI:10.4103/0976-9668.127315  PMID:24678215
Background and Objectives: Patients with diabetes mellitus are prone to secondary infections. In this study we aim to determine the prevalence of one such secondary infection (oral Candida colonization) and evaluate the influence of local and systemic factors on the oral candidal colonization in patients with diabetes mellitus. Materials and Methods: Forty non-insulin-dependent diabetic patients and 40 healthy individuals were included in this study. Samples were collected by using the oral rinse method. The candidal species were isolated and identified through phenotypic methods. An in vitro antifungal susceptibility profile was evaluated. Glycemic control, as determined by the glycosylated hemoglobin concentrations (HbA 1c ) of the study subjects, was correlated with the candidal colonization. Results: Patients with diabetes showed a significantly higher prevalence of candidal colonization. The rate of carriage and density (P = 0.001) was higher. Candida albicans was the most predominantly isolated species, however, C. dubliniensis, C. tropicalis, and C. parapsilosis were also observed. Variable resistance toward the antifungal drugs (amphotericin B and fluconazole) was observed in the Candida isolated from diabetics, but not from healthy patients. Interestingly, a positive correlation was observed between glycemic control and candidal colonization. Conclusion: Diabetic patients had a higher candidal carriage rate, with a variety of candidal strains, which significantly varied in their resistance to routinely used anti-fungal agents. Interestingly the higher oral candidal colonization in diabetic patients is related to local and systemic factors, independent of their oral habits.
  2,714 529 12
CASE REPORTS
Oral rhabdomyosarcoma-embryonal subtype in an adult: A rarity
A. Sri Kennath J Arul, Sonika Verma, A. Sri Sennath Arul, Rashmika Verma
January-June 2014, 5(1):222-225
DOI:10.4103/0976-9668.127347  PMID:24678235
Rhabdomyosarcoma is a malignant tumor composed of neoplastic mesenchymal cells, with varying degrees of striated muscle cell differentiation. With most cases occurring in children younger than 10 years, it is remarkably rare in adults. Further in adults, the typical pediatric rhabdomyosarcoma variants (embryonal and alveolar sub-types) occur less frequently and exhibit predilection for viscera followed by the head and neck region. A rare case of embryonal rhabdomyosarcoma arising from the buccal mucosa in a 36-year old male patient is herewith reported. Recognition of the correct diagnosis and histological sub-type is of critical importance in the therapy of this disease, since the treatment is not uniform in the literature because of the rarity of this neoplasm in the adult population.
  2,935 270 4
ORIGINAL ARTICLES
Elucidating the specificity of non-heparin-based conformational activators of antithrombin for factor Xa inhibition
Qudsia Rashid, Mohammad Abid, Mohamad Aman Jairajpuri
January-June 2014, 5(1):36-42
DOI:10.4103/0976-9668.127282  PMID:24678194
Introduction: Antithrombin, the principal inhibitor of coagulation proteases, requires allosteric activation by its physiological cofactor, heparin or heparin sulfate to achieve physiologically permissible rates. This forms the basis of heparin's use as a clinical anticoagulant. However, heparin therapy is beset with severe complications, giving rise to the need to search new non-heparin activators of antithrombin, devoid of these complications and with favorable safety profiles. Materials and Methods: We chose some representative organic compounds that have been shown to be involved in coagulation modulation by affecting antithrombin and applied a blind docking protocol to find the binding energy and interactions of the modified (sulfated) versus unmodified organic scaffolds. Results and Conclusion: Increased sulfation plays a key role in shifting the specificity of organic compounds like quercetin, diosmin, rutin, mangiferin, isomangostin, Trapezifolixanthone and benzofuran towards the heparin binding site (HBS). However, in hesperetin and tetrahydroisoquinoline, sulfation shifts the specificity away from HBS. We have further tried to elucidate changes in the binding affinity of quercetin on account of gradual increase in the number of hydroxyl groups being substituted by sulfate groups. The results show gradual increase in binding energy with increase in sulfation. A theoretical screening approach is an ideal mechanism to predict lead molecules as activators of antithrombin and in determining the specificity for antithrombin.
  2,802 399 3
Effect of moisture, saliva, and blood contamination on the shear bond strength of brackets bonded with a conventional bonding system and self-etched bonding system
Mandava Prasad, Shamil Mohamed, Krishna Nayak, Sharath Kumar Shetty, Ashok Kumar Talapaneni
January-June 2014, 5(1):123-129
DOI:10.4103/0976-9668.127305  PMID:24678210
Background: The success of bonding brackets to enamel with resin bonding systems is negatively affected by contamination with oral fluids such as blood and saliva. The new self-etch primer systems combine conditioning and priming agents into a single application, making the procedure more cost effective. Objective: The purpose of the study was to investigate the effect of moisture, saliva and blood contamination on shear bond strength of orthodontic brackets bonded with conventional bonding system and self-etch bonding system. Materials and Methods: Each system was examined under four enamel surface conditions (dry, water, saliva, and blood), and 80 human teeth were divided into two groups with four subgroups each of 10 according to enamel surface condition. Group 1 used conventional bonding system and Group 2 used self-etched bonding system. Subgroups 1a and 2a under dry enamel surface conditions; Subgroups 1b and 2b under moist enamel surface condition; Subgroups 3a and 3b under saliva enamel surface condition and Subgroup 4a and 4b under blood enamel surface condition. Brackets were bonded, and all the samples were then submitted to a shear bond test with a universal testing machine with a cross head speed of 1mm/sec. Results: The results showed that the contamination reduced the shear bond strength of all groups. In self-etch bonding system water and saliva had significantly higher bond strength when compared to other groups. Conclusion: It was concluded that the blood contamination showed lowest bond strength from both bonding systems. Self-etch bonding system resulted in higher bond strength than conventional bonding system under all conditions except the dry enamel surface.
  2,790 401 8
Enhancement of Hippocampal CA3 Neuronal Dendritic Arborization by Glycyrrhiza glabra root extract Treatment in Wistar Albino Rats
Kosuri Kalyan Chakravarthi, Ramakrishna Avadhani
January-June 2014, 5(1):25-29
DOI:10.4103/0976-9668.127279  PMID:24678192
Background: In the traditional system of medicine, the roots and rhizomes of Glycyrrhiza glabra (Gg) (family: Leguminosae) have been in clinical use for centuries. Aim: In the present study, we investigated the role of aqueous extract of root of Gg treatment on the dendritic morphology of hippocampal Cornu Ammonis area three (CA3) neurons, one of the regions concerned with learning and memory, in 1- month- old male Wistar albino rats. Materials and Methods: The aqueous extract of root of Gg was administered orally in four doses (75, 150, 225 and 300 mg/kg) for 4 weeks. After the treatment period, all experimental animals were subjected to spatial learning (Morris water maze, Hebb-William's maze and elevated plus maze) tests. At the end of the spatial memory tests, the rats were deeply anesthetized with Pentobarbitone and killed their brains were removed rapidly and fixed in rapid Golgi fixative. Hippocampal CA3 neurons were traced using camera lucida, and dendritic arborization and intersections were quantified. These data were compared to those of age-matched control rats. Results: The aqueous root extract of Gg in the dose of 150 and 225 mg/kg/p.o showed a significant (P < 0.01) enhancement of dendritic arborization (dendritic branching points) and dendritic intersections along the length of both apical and basal dendrites in hippocampal (CA3) pyramidal neurons is comparable to control. Conclusion: Based on our results obtained, we conclude that constituents present in aqueous root extract of Gg have neuronal dendritic growth stimulating properties.
  2,864 296 2
CASE REPORTS
Management of palato radicular groove in a maxillary lateral incisor
KV Kishan, Vani Hegde, KC Ponnappa, TN Girish, MC Ponappa
January-June 2014, 5(1):178-181
DOI:10.4103/0976-9668.127322  PMID:24678222
This study is to report the rare localization of a radicular groove on the palatal aspect of the maxillary lateral incisor and to discuss the pathology and management of the concomitant endo-periodontal defect. Unilateral palato-radicular groove was located on the Maxillary right lateral incisor of an 18-year-old female patient. The groove was associated with deep local periodontal pocket resulting in pulp necrosis and the formation of a large periapical lesion. A collaborative management was carried out using a combination of endodontic therapy, surgical enucleation, odontoplasty, and periodontal regenerative procedure resulting the successful healing of the periapical lesion.
  2,677 462 8
Low grade endometrial stromal sarcoma in a premenopausal woman
Sujata Jetley, Safia Rana, Zeeba S Jairajpuri
January-June 2014, 5(1):214-217
DOI:10.4103/0976-9668.127339  PMID:24678233
Endometrial stromal sarcoma are rare malignant tumors of the uterus and has been described as the second most common malignant uterine mesenchymal tumor. The diagnosis is confirmed on hysterectomy for a presumed benign disease. In the latest World Health Organization (WHO) classification (2003), the term endometrial stromal tumor is applied to neoplasms typically composed of cells that morphologically resemble endometrial stromal cells of the nonneoplastic proliferative phase endometrium. The WHO recognizes three categories of endometrial stromal tumors: Endometrial stromal nodule, low-grade endometrial stromal sarcomas (LGESS), and undifferentiated endometrial sarcoma. We report here an interesting case of a 39-year-old female who presented with irregular bleeding per vaginum and urinary retention with a clinical impression of a leiomyomatous polyp, which on histological examination showed a LGESS.
  2,653 309 -
ORIGINAL ARTICLES
Study of extended spectrum β-lactamase producing Enterobacteriaceae and antibiotic coresistance in a tertiary care teaching hospital
Nema Shashwati, Tripathi Kiran, AG Dhanvijay
January-June 2014, 5(1):30-35
DOI:10.4103/0976-9668.127280  PMID:24678193
Aims: To study the prevalence of extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae and coresistance to other commonly used antibiotics from the Bhopal region of Central India. Settings and Design: A prospective study was conducted from September 2011 to August 2012 in Microbiology Department of our tertiary health care center. Materials and Methods: A total of 1044 Enterobacteriaceae isolates were recovered from various specimens. ESBL production was detected by using Clinical Laboratory Standard Institute (CLSI) that described the phenotypic confirmatory test along with routine antibiotic susceptibility testing. Statistical Analysis: Two-tailed Z-test. Results: Escherichia coli was the most common isolate (65.32%). ESBL production was confirmed in 504 (48.27%) isolates. The isolates of E. coli (50.14%) were the most common ESBL producers. Maximum ESBL isolates were obtained from urine samples (52.28%) and male patients (52.54%). Sensitivity to imipenem was 100% followed by piperacillin-tazobactam (89.28%), meropenem (87.5%), and amikacin (83.92%). Significant resistance was detected against trimethoprim-sulfomethoxazole, fluoroquinolones, and gentamicin. Conclusion: This is the only study conducted from Central India and shows high prevalence of ESBL production among Enterobacteriaceae. Imipenem seems to be more sensitive than meropenem. Piperacillin-tazobactam combination was found to be the best among the β-lactam-β-lactamase inhibitor combinations. Prevalence of ESBL producers were more in males than females.
  2,468 459 5
Insights from computational analysis of full-length β-ketoacyl-[ACP] synthase-II cDNA isolated from American and African oil palms
Subhash J Bhore, Thye S Cha, Kassim Amelia, Farida H Shah
January-June 2014, 5(1):73-81
DOI:10.4103/0976-9668.127292  PMID:24678202
Background: Palm oil derived from fruits (mesocarp) of African oil palm (Elaeis guineensis Jacq. Tenera) and American oil palm (E. oleifera) is important for food industry. Due to high yield, Elaeis guineensis (Tenera) is cultivated on commercial scale, though its oil contains high (~54%) level of saturated fatty acids. The rate-limiting activity of beta-ketoacyl-[ACP] synthase-II (KAS-II) is considered mainly responsible for the high (44%) level of palmitic acid (C 16:0 ) in the oil obtained from E. guineensis. Objective: The objective of this study was to annotate KAS-II cDNA isolated from American and African oil palms. Materials and Methods: The full-length E. oleifera KAS-II (EoKAS-II) cDNA clone was isolated using random method of gene isolation. Whereas, the E. guineensis KAS-II (EgTKAS-II) cDNA was isolated using reverse transcriptase polymerase chain reaction (RT-PCR) technique; and missing ends were obtained by employing 5'and 3' RACE technique. Results: The results show that EoKAS-II and EgTKAS-II open reading frames (ORFs) are of 1689 and 1721 bp in length, respectively. Further analysis of the both EoKAS-II and EgTKAS-II predicted protein illustrates that they contains conserved domains for 'KAS-I and II', 'elongating' condensing enzymes, 'condensing enzymes super-family', and '3-oxoacyl-[ACP] synthase II'. The predicted protein sequences shows 95% similarity with each other. Consecutively, the three active sites (Cys, His, and His) were identified in both proteins. However, difference in positions of two active Histidine (His) residues was noticed. Conclusion: These insights may serve as the foundation in understanding the variable activity of KAS-II in American and African oil palms; and cDNA clones could be useful in the genetic engineering of oil palms.
  2,618 267 -
Clinico-immunological profile and their correlation with severity of atopic dermatitis in Eastern Indian children
Mani Kant Kumar, Punit Kumar Singh, Pankaj Kumar Patel
January-June 2014, 5(1):95-100
DOI:10.4103/0976-9668.127296  PMID:24678205
Objective: To study the clinical features, absolute eosinophil count, and total immunoglobulin E (IgE) level and their association with severity of atopic dermatitis in Eastern Indian children (Bihar). Design: Prospective hospital-based study. Settings: Pediatrics out-patient Department (OPD) and Dermatology OPD of a Tertiary Care Teaching Hospital located in Rohtas District of Bihar. The study was carried out over a period of 2 years during January 2010 to December 2011. Participants: One hundred and thirty two children aged 0 month to 15 years were diagnosed with atopic dermatitis. Main Outcome: Demographic profile, common clinical features, absolute eosinophil count, and total IgE level and their correlation with severity of atopic dermatitis in Eastern Indian children. Results: Out of a total 1829 pediatric patients aged 0 month to 15 years with some pediatric dermatoses, 132 (7.21%) had atopic dermatitis. Of 132 patients, 57 (43.2%) were boys and 75 (56.8%) were girls, with a male to female ratio 1:1.3. Of these 29 were infants and 103 were children. Two (62.1%) patients belonged to rural area whereas 50 (37.9%) belonged to urban area. Personal history, family history (up to third degree relatives), and both personal and family history of atopy were present in 43.18%, 33.34%, and 12.1% of the subjects respectively. Majority (89.4%) of patients had onset before 5 years of age. In infantile Atopic dermatitis (AD), mean age ± SD at onset was 5.2 months ± 3.01 months. In infantile group, 8 (27.6%) had mild, 14 (48.3%) moderate, and 7 (24.1%) had severe atopic dermatitis. Infantile AD had statistically significant higher SCORing Atopic Dermatitis (SCORAD) index score in all three grades of severity of the disease. One hundred and three patients had childhood AD, out of which 40 (38.8%) were boys and 63 (61.2%) were girls, with a male to female ratio 1:1.57. In childhood AD, mean age ± SD at onset of the disease was 3.47 years ± 3.02 years. Sixty three (61.1%) belonged to rural area whereas 40 (38.9%) were from urban area. One hundred and thirty (98%) patients presented with itching. Ninety two (69.7%) patients had high absolute eosinophils count (AEC) with mean ± SD of 1004.1 ± 596.2 (range 325-2510). Eighty seven (65.9%) patients had increased total serum immunoglobulin E (TsIgE) with mean ± SD value of 1127.11 IU/ml ± 731.69 IU/ml (range: 125-2680 IU/ml). Conclusion: Epidemiological data on atopic dermatitis in India are mainly hospital-based, true-point prevalence in community is still scanty . Although the prevalence of AD is considered to be increasing, it still remains low in comparison to developed countries. In Indian children, the disease is relatively milder than children of developed countries. This study identified that both AEC and TsIgE increased significantly in about 66% patient and directly correlated with the severity of the AD.
  2,483 351 4
EDITORIAL
Anatomy and physiology of peer review process, can it be unbiased?
Arun H.S Kumar
January-June 2014, 5(1):1-2
DOI:10.4103/0976-9668.127269  PMID:24678187
  2,272 429 -
CASE REPORTS
Dexmedetomidine induced catecholamine suppression in pheochromocytoma
Sanjeev Singh, Arti Singh
January-June 2014, 5(1):182-183
DOI:10.4103/0976-9668.127323  PMID:24678223
Pheochromocytoma is a neuroendocrine tumour of chromaffin cells, though rare but a known cause of paroxysmal hypertension with a triad of headache, diaphoresis and palpitation. The biochemical diagnosis of pheochromocytoma is based on estimation of plasma nor-adrenaline, adrenaline and their metabolites in plasma or urine. Clonidine suppression test is performed to differentiate the raised catecholamine level due to pheochromocytoma or other than heochromocytoma especially in cases where plasma nor-adrenaline levels are less than 2000 pg/ml. Clonidine is stated to be unable to suppress catecholamine level in cases of pheochromocytoma, therefore we tested the other α2-agonist Dexmedetomidine intravenous in a case of Pheochromocytoma with remarkably raised nor- adrenaline (25,183 pg/ml) and found 49.42% suppression.
  2,221 434 4
ORIGINAL ARTICLES
Decadorial of a burn center in Central India
Jayanta Bain, Shyam Lal, Vijay Singh Baghel, Vinod Yedalwar, Rachna Gupta, Anil Kumar Singh
January-June 2014, 5(1):116-122
DOI:10.4103/0976-9668.127303  PMID:24678209
Introduction: Burn injuries are a serious public health problem. In our study we have identified different epidemiological factors based on 10 years of our experience at a burn unit in central India and recommend some strategies to prevent burn injuries. Materials and Methods: This is a retrospective analysis (2001-2010) of database from burn unit of S.S. Medical College, Rewa, India. Results: 2499 patients with burn injury were analysed. 66.8% and 38.2% patients were females and males respectively, with a median age of 25 years. Flame (80.1%) was most common cause, home (96%) was most common place, traditional Indian stove (28.8%), kerosene lamp (26.7%), hot liquid (12.2%) and kerosene stove (10.4%) were common causes. Median Total Body Surface Area (TBSA) burn was 40.0%; females had significantly greater (P < 0.001) burn than males (median 50% vs 26.0%). High mortality (40.3%) seen; female sex (OR 3.22, 95% CI 2.65-3.92); young age (15-29 year) (OR 3.48, 95% CI 2.45-4.94); flame burn (OR 12.9, 95% CI 1.69-98.32); suicidal burn OR 6.82 95%CI 4.44-10.48) and TBSA > 76% (OR 3099, 95%CI 1302-7380) were significant risk factors for death. Median hospital stays was 8 days; shorter hospital stays seen among TBSA burn > 76% (2 days), suicidal intent (4 days), and those who expired (4 days). Septicemia (45.8%) and burn shock (41%) were the major cause for death. Conclusions: Cooking and lighting equipments are major cause of burn injury among females and young age group. Equipment modification to improve safety features and public awareness programs are necessary to reduce burn incidents.
  2,350 239 3
CASE REPORTS
Oral myiasis involving palatal mucosa of a young female
Suresh Yadav, Shallu Tyagi, Prince Kumar, Naveen Puri
January-June 2014, 5(1):194-197
DOI:10.4103/0976-9668.127327  PMID:24678227
In literal terms myiasis is the invasion of the tissues and organs of human beings by fly larvae. This phenomenon is well documented in the skin, especially among animals and people in developed and developing countries. When the tissues of oral cavity are invaded by the parasitic larvae of flies, the condition is called as oral myiasis. With the paper we are presenting a case of 19-year-old female suffering from oral myiasis of upper lip and palate. The treatment consisted of manual removal of the larvae, surgical debridement of the wound and oral therapy with doxycycline used as a locally acting drug for faster and better recovery.
  2,301 258 1
ORIGINAL ARTICLES
Outcome of forceps delivery in a teaching hospital: A 2 year experience
Lopamudra B John, S Nischintha, Seetesh Ghose
January-June 2014, 5(1):155-157
DOI:10.4103/0976-9668.127316  PMID:24678216
Introduction: The art of forceps delivery though existing for centuries has earned a disreputation due to the possibility of poor maternal and fetal outcome. However, its safe use can reduce the rising cesarean section rates in the present times. This study is to see the outcome of its use in a teaching hospital over a 2 year period. Materials and Methods: In this retrospective observational study, 120 cases of forceps delivery were studied for maternal outcome such as injuries, postpartum hemorrhage, and fetal outcome such as Apgar score at birth, neonatal intensive care unit admissions, injury, and mortality. Results: The most common indication was fetal distress (47.5%). A total of 15 cases (12.5%) of maternal injuries occurred, with 2 uterine ruptures one of which was in a previous lower segment caesarean section case, 4 complete perineal tears and 9 minor cervical and vaginal lacerations. A total of 12 babies (10%) had poor Apgar scores who recovered after resuscitation and one out of them died, which was a case of multiple instrumentation. Conclusion: Forceps is a reasonable option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument are required to prevent undue risk to mother and fetus.
  2,178 367 1
Immediate implants in anterior maxillary arch
K Anitha, S Senthil Kumar, M. R. Ramesh Babu, Ramesh Candamourty, Thirumurugan
January-June 2014, 5(1):82-89
DOI:10.4103/0976-9668.127293  PMID:24678203
Aim: The aim of the study was to evaluate the osseo-integration and soft tissue status of the endosseous implants placed in immediate extraction socket. Methodology: Seven patients (4 males and 3 females) aged 20-30 years were selected for the study. Nine implants were placed in seven patients in the maxillary arch. All the patients were clinically αnd thoroughly examined. Under local anesthesia, the indicated tooth was extracted. The extracted socket was prepared using standard drills with palatal wall as guide. The longest and widest implants were placed (Hi-Tec Implants). All implants showed good primary stability. The implants used in the study were tapered design endosseous implants with Threaded implants (TI) unit plasma-sprayed surface. Surgical re-entry (secondary surgery) was performed to remove the healing cap after 6 months for supra crestal fabrication. All patients were reviewed periodically at 3 rd and 6 th month interval and the following clinical parameters including modified plaque index (mPlI), modified bleeding index (mBI), probing depth (PD), attachment level (AL), and distance between the implant shoulder and mucosal margin (DIM), distance between the implant shoulder and first bone-implant contact, and Clinical Mobility Index were recorded. The results were computed and subjected to statistical evaluation. Results: The mPlI, mBI, PD, AL, and DIM were evaluated around the implants at baseline, 3 rd and 6 th month intervals and analyzed statistically by Friedman T-test. The results of the above were shown to be statistically non-significant. The distance between the implant shoulder and first bone implant contact was evaluated around the implants at base line, 3 rd and 6 th month intervals. The results proved to be statistically significant (0.01) implying that there was a bone apposition around the implants. Conclusion: During the course of the study, soft tissue status around implants was found to be healthy. Osseointegration as assessed by clinical and radiographic findings was found to be sound.
  2,120 409 1
CASE REPORTS
Spontaneous pneumomediastinum with pneumopericardium, surgical emphysema, pneumothorax, and epidural pneumotosis: A rare association
Amandeep Singh, Haramritpal Kaur, Gurbax Singh, Simmi Aggarwal
January-June 2014, 5(1):201-204
DOI:10.4103/0976-9668.127330  PMID:24678229
Pneumomediastinum is usually associated with subcutaneous emphysema and pneumopericardium, but rarely associated with pneumothorax and epidural pneumotosis. We report extremely rare simultaneous occurrence of self-limiting pneumomediastinum, pneumopericardium, surgical emphysema, pneumothorax, and epidural pneumotosis in an 18-year-old gentleman in the absence of identifiable cause.
  2,206 287 7
ORIGINAL ARTICLES
Dentin hypersensitivity following tooth preparation: A clinical study in the spectrum of gender
Kusum Yadav, Anjali Sofat, Ramandeep Singh Gambhir, Virat Galhotra
January-June 2014, 5(1):21-24
DOI:10.4103/0976-9668.127277  PMID:24678191
Objective: The objective of this study was to estimate and compare the incidence of dentin hypersensitivity among men and women in an adult population who required replacement of missing tooth/teeth with a fixed partial prosthesis (FPD). Materials and Methods: The study population included 124 subjects (62 men and 62 women), who visited the out-patient department in need of FPD for replacement of missing teeth. After conducting routine examinations, each abutment tooth received two stimuli: Tactile and thermal to assess the sensitivity. The measurement of sensitivity was carried out by using a 10 cm visual analog scale before preparation and after preparation. The results were analyzed statistically using the Mann-Whitney U test. Results: The results showed that women reported more dentin hypersensitivity than men before and after tooth preparation. Conclusion: The results of the present study demonstrated that women reported more dentin hypersensitivity than men before and after tooth preparation. More studies are needed to explore this nature on gender basis.
  2,045 417 4
CASE REPORTS
Stress fracture of ulna due to excessive push-ups
Sanjay Meena, Devarshi Rastogi, Bipin Solanki, Buddhadev Chowdhury
January-June 2014, 5(1):225-227
DOI:10.4103/0976-9668.127349  PMID:24678236
Stress fractures are most common in the weight-bearing bones of the lower extremities and spine, but are rarely found in non-weight-bearing bones of the body. Stress fracture of the ulna is extremely rare. We report a case of complete stress fracture of ulna caused due to excessive push ups in a young athlete. Conservative management was successful in healing of fracture and returning this patient back to his previous activity level. Physician should have high index of suspicion, whenever they encounter a young athlete complaining of forearm pain.
  2,187 256 2
LETTER TO EDITOR
Study of life expectancy in urban Pondicherry
Sonali Sarkar, AM Veerakumar, Umakant Shidam
January-June 2014, 5(1):228-229
DOI:10.4103/0976-9668.127350  PMID:24678237
  2,104 270 -
ORIGINAL ARTICLES
Enamel hypoplasia of primary canine: Its prevalence and degree of expression
Santanu Mukhopadhyay, Pinaki Roy, Bibek Mandal, Chiranjit Ghosh, Bidyut Chakraborty
January-June 2014, 5(1):43-46
DOI:10.4103/0976-9668.127283  PMID:24678195
Background: Enamel hypoplasia is a unique lesion showing wide variations in prevalence among populations. The present study aimed to evaluate frequency and degree of expression of enamel hypoplasia of primary canine in populations living in the eastern part of India. Materials and Methods: A prospective cross sectional study was performed in randomly selected 3539 school children. Labial surfaces of all primary canines were examined. The frequency and degree of expression of enamel hypoplasia between different ethnic groups were recorded. Based on the location of the defect on the tooth surfaces, the lesions were divided as prenatal, perinatal, and postnatal according to stage of mineralization. Statistical analysis was carried out using Chi square test. Results: The overall prevalence of primary canine hypoplasia was 10.3%. The mandibular primary canines were significantly (P = 0.03) more frequently affected than maxillary canines among different ethnic groups. The side difference among populations was not significant (P = 0.96) statistically. In 8.5% Bengali population, 7% Rajbangsi population, and 9.4% in other group of population, the defect occurred prenatally. Most of the defects, 64.7% in Bengali, 66.1% in Rajbangsi, and 58.8% in others occurred during perinatal stage of mineralization. The defect occurred postnatally in 26.8%, 26.7%, and 31.8% in Bengali, Rajbangsi, and in other group of population respectively. Conclusion: The overall prevalence of primary canine hypoplasia was 10.3%. The mandibular primary canines were more frequently affected (P = 0.03) than their maxillary counterparts among populations. Most of the defects correspond to perinatal stage of mineralization.
  2,068 266 1
CASE REPORTS
Tuberculous brain abscess in an immunocompetent adolescent
Mohd K Ansari, Sanjeev Jha
January-June 2014, 5(1):170-172
DOI:10.4103/0976-9668.127319  PMID:24678219
Tuberculous brain abscess (TBA) is one of the rare forms of central nervous system tuberculosis. A case of tuberculous cerebellar abscess in a young immunocompetent adult male is being described. There was no clinical or radiological evidence of active tuberculosis elsewhere in the body. The diagnosis of tubercular abscess was confirmed by demonstration of acid fast bacilli in the abscess material aspirated via a burr hole. High index of suspicion and timely intervention is required to diagnose and treat this potential fatal but easily treatable condition.
  1,976 322 2
ORIGINAL ARTICLES
Frequency distribution of Hepatitis C virus in different geographical regions of Punjab: Retrospective study from a tertiary care centre in North India
Paramdeep Singh, Rupinderjeet Kaur, Amarpreet Kaur
January-June 2014, 5(1):56-58
DOI:10.4103/0976-9668.127288  PMID:24678198
Background and Aim: There is a scarcity of published information on epidemiology of Hepatitis C infection in India particularly in Punjab. We conducted a retrospective study to assess the frequency distribution, including demographic and geographical data of patients with Hepatitis C in different regions of Punjab. Materials and Methods: We retrospectively collected the clinical, demographic and geographical data of 516 patients with Hepatitis C admitted in our hospital from January 2010 to December 2010. Punjabi patients with positive anti-Hepatitis C virus (HCV)-enzyme linked immune sorbent assay test for the detection of anti-HCV antibodies were included. Results: There was predominantly rural distribution (67.3%) of patients with maximum cases from Ludhiana district (30.04%). Highest frequency of Hepatitis C infection was found in the middle aged (41-60 years) patients with male predominance. High proportions (44.8%) of the patients included in our study were incidentally detected with Hepatitis C infection on routine screening. Various associations of HCV infection with other diseases were also identified. Conclusions: Hepatitis C is an emerging disease in Punjab with a sizeable cluster of HCV infected asymptomatic persons who can act as a pool for its continuous transmission. The study helps us to predict the probable risk factors for Hepatitis C infection in Punjab. The need of the hour is to increase awareness about HCV among the public and practicing physicians.
  1,983 295 5
Serum zinc levels and its association with vitamin A levels among tuberculosis patients
Wahid Ali, Irfan Ahmad, Vinod Kumar Srivastava, Rajendra Prasad, Ram Avadh Singh Kushwaha, Mohd Saleem
January-June 2014, 5(1):130-134
DOI:10.4103/0976-9668.127310  PMID:24678211
Introduction: One-third of the total human population is infected with the Mycobacterium tuberculosis. This bacterium causes illness in up to 9 million people annually and is responsible for three deaths every minute world-wide. Objective: To determine the association of serum zinc level with vitamin A level in active pulmonary tuberculosis (TB) cases. Materials and Methods: It was a cross-sectional study of 208 active pulmonary TB patients aged 18-55 years. Blood samples were obtained from these patients to determine the serum zinc and serum retinol levels. Results: The mean age of the patients was 30.56 (±11.38) years ranging from 18 years to 55 years. More than half (54.3%) of the patients were males and 63% were married. Body mass index of the patients was 18.40 ± 3.10. The serum zinc and vitamin A levels among the patients were 9.60 (±0.86) μmol/l and 0.77 (±0.22) μmol/l respectively. However, haemoglobin, white blood cell, erythrocyte sedimentation rate, and serum albumin were 10.02 (±1.33) g/dl, 10076.01 (±1822.67) cell/mm3, 14.50 (±2.95) mm/h and 3.40 (±0.32) g/dl respectively. There was a strong correlation between serum zinc and vitamin A levels (r = 0.86, P < 0.01). Vitamin A levels were not significantly different among the different age groups; however, this was significantly (P = 0.001) higher in male (0.82 ± 0.23, 95% confidence interval [CI] =0.77-0.86) patients as compared to females (0.71 ± 0.20, 95% CI = 0.67-0.75). Conclusion: Zinc deficiency may indirectly influence the metabolism of Vitamin A via reduction of the levels of circulating proteins.
  1,910 313 5
Study of cognitive functions in newly diagnosed cases of subclinical and clinical hypothyroidism
Kirti Sharma, Joshil Kumar Behera, Sushma Sood, Rajesh Rajput, Satpal , Prashant Praveen
January-June 2014, 5(1):63-66
DOI:10.4103/0976-9668.127290  PMID:24678200
Introduction: Hypothyroidism is associated with significant neurocognitive deficits because hypothyroidism prevents the brain from adequately sustaining the energy consuming processes needed for neurotransmission, memory, and other higher brain functions. Hence, the study was done to assess the cognitive functions of newly diagnosed subclinical and clinical hypothyroid patients by evoked response potential P300. Materials and Methods: 75 patients each of newly diagnosed subclinical and clinical hypothyroid patients attending endocrinology clinic and 75 healthy age and sex matched euthyroid controls were considered for the study. P300 was recorded with Record Medicare System Polyrite, Chandigarh using auditory "oddball paradigm". The data was analyzed using ANOVA followed by post Tukey's test. Results: Newly diagnosed clinical hypothyroid patients showed a significant increase in P300 latency compared to control (P < 0.05) and subclinical cases (P < 0.01) while there was no significant difference between the P300 latency of subclinical cases and control group. Also, there was no significant difference in P300 amplitude among the three groups. Conclusion: P300 latency in case of newly diagnosed hypothyroid clinical cases is significantly increased compared to newly diagnosed subclinical cases and control.
  1,912 299 3
An assessment of etiological spectrum and injury characteristics among maxillofacial trauma patients of Government dental college and Research Institute, Bangalore
Yadavalli Guruprasad, OR Hemavathy, Girish Giraddi, Jayaprasad N Shetty
January-June 2014, 5(1):47-51
DOI:10.4103/0976-9668.127285  PMID:24678196
Background: Maxillofacial injuries pose a therapeutic challenge to trauma, maxillofacial and plastic surgeons practicing in developing countries. This was a retrospective study carried out to determine the incidence, etiology, injury characteristics of maxillofacial injuries reported at our centre. Patients and Methods: The data for this study were obtained from the medical records of 689 cases reported to our centre during the period from 2006-2009. Records of patients who were either treated in the emergency room as outpatients or the Department of Oral and Maxillofacial Surgery as inpatients were analyzed and were subjected to statistical analysis using statistical package for social sciences (SPSS) for Windows version 17.0. Data was summarized in form of proportions and frequency tables for categorical variables and was subjected to Chi-Square test. Results: Out of 689 patients, 75.9% were male and 24.1% were female. 42.5% of the patients were in the age group of 21 to 30 years. Road traffic accidents accounted for the majority (74.3%) of cases of maxillofacial trauma. Mandible was seen as the most commonly fractured bone (50.3%) and 53.8% head and neck injuries were most common among the associated injuries. Conclusion: Road traffic accidents were clearly the most prevalent etiological factor for maxillofacial trauma. Measures on prevention of road traffic crashes should be strongly emphasized in order to reduce the occurrence of these injuries.
  1,818 305 2
Incidence of nutrient canals in hypertensive patients: A radiographic study
Vinod R Kumar, Raghavendra Mahadev Naik, Rajesh T Singh, Yadavalli Guruprasad
January-June 2014, 5(1):164-169
DOI:10.4103/0976-9668.127318  PMID:24678218
Objectives: To determine if any correlation exists in the presence of nutrient canals in hypertensive patients and nonhypertensive patients, to compare the incidence of nutrient canals in different age groups, and also to compare the incidence of nutrient canals between dentulous and edentulous patients. Materials and Methods: This study was carried out on patients, who were divided into a control group comprising of healthy individuals, without history of hypertension and a study group of patients with the history of hypertension. The necessary information like age of the patient, presence or absence of hypertension, its duration, and blood pressure were recorded. An intraoral periapical radiograph of lower anterior region was made using bisecting angle technique and was interpreted. The presence or absence of nutrient canals, bone loss, and the levels of bone loss were recorded. The results so obtained were subjected to statistical analysis. Results: We found that the incidence of nutrient canals was statistically higher in the study group (55.2%) as compared to the control group (36.2%). The incidence of nutrient canals was also found to be increased with, the age till 60 years, amount of alveolar bone loss and in edentulous patients. Conclusion: Hypertension being one of the most commonly encountered medical problems in dental practice and many cases being undiagnosed, the presence of nutrient canal though not entirely indicative of hypertension, should increase the suspicion of the condition to be investigated further.
  1,847 267 1
Out of pocket expenditure among the households of a rural area in Puducherry, South India
R Archana, Sitanshu Sekhar Kar, KC Premarajan, Subitha Lakshminarayanan
January-June 2014, 5(1):135-138
DOI:10.4103/0976-9668.127312  PMID:24678212
Background: As a measure to reduce the out of pocket health spending in our country, the high level expert group on Universal Health Coverage recommends a National Health Package free of cost to all. Whether availability of services free of cost, will reduce out of pocket expenditure? Aim: To assess this, we studied the out of pocket health spending among the households of a Ramanathpuram, a village in Puducherry, where surplus health services are available free of cost. Settings and Design: An exploratory study was conducted in by 200 purposively selected households of Ramanathpuram, during the months of March-April 2012. Materials and Methods: Information was sought on socio-demographic details (age, gender, and income), expenditure incurred during OPD visits, follow up for chronic diseases, and hospitalization using a pretested questionnaire. Recall periods of 1 and 3 months were considered for OPD visits and hospitalizations, respectively. Results: Of the total 935 individuals from the 200 households included, 51.3% (480) were men and 455 (48.7%) were women. A total of 231 visits to health care facilities were recorded from 143 (71.5%) households, of which 153 (66.2%) were for acute illness and 68 (29.4%) for follow up of chronic diseases and 10 (4.3%) for hospitalization. The mean per visit expenditure for acute illness, chronic diseases, and hospitalization were INR72.7 ± 143.6, 135.7 ± 196.2, and 1340 ± 1192.9, respectively. Government facilities were availed for 175 (75.7%) visits. Majority of those who incurred health expenditure for acute illness (80.4%) and utilized the private sector for acute illness (78.4%) were from higher socioeconomic class (P = 0.001). Conclusion: Majority (58.1%) of the households did not incur health care expenditure. Public health care facilities were preferred (75.5%) for seeking care. Availability of services free of cost reduces out of pocket expenditure among non-hospitalized cases.
  1,784 322 1
CASE REPORTS
Delivery after augmentation cystoplasty: Implications and precautions
Deepa Kapoor, Saurabh Sudhir Chipde, Shalini Agrawal, Surabhi Chipde, Rakesh Kapoor
January-June 2014, 5(1):206-209
DOI:10.4103/0976-9668.127334  PMID:24678231
A young female with history of genitourinary tuberculosis with solitary functioning kidney became pregnant 1 year after augmentation cystoplasty (AC) with ureteric reimplantation. Throughout pregnancy she had two episode of febrile urinary tract infection. Her renal function remained normal. She was planned for cesarian section due to obstetric indications. Despite altered pelvic anatomy, we successfully did the lower segment cesarian section. We reviewed the literature regarding pregnancy in patients with AC to find that what the treating Urologist and Gynecologist should know about these rare cases. Various complications which should be anticipated and measures to prevent them are also discussed.
  1,857 244 3
ORIGINAL ARTICLES
Immunohistochemical analysis of factors related to apoptosis and cellular proliferation in relation to inflammation in dentigerous and odontogenic keratocyst
Gadiputi Sreedhar, M Vijaya Raju, Kiran Kumar Metta, SM Manjunath, Sujan Shetty, Rakesh Kumar Agarwal
January-June 2014, 5(1):112-115
DOI:10.4103/0976-9668.127300  PMID:24678208
Background: The effect of inflammation on pathogenesis and biological behavior of odontogenic keratocyst (OKC) and dentigerous cyst (DC) is not completely understood. Hence, we aimed to analyze the effect of inflammation on biological behavior of OKC and DC using a proliferative and anti-apoptotic marker, i.e., proliferative cellular nuclear antigen (PCNA) and Bcl-2, respectively. Materials and Methods: Immunohistochemical staining was performed using anti-PCNA and Bcl-2 antibody in 10 cases each of classical OKC, inflamed OKC and classical DC and inflamed DC. Results: Inflamed OKC and DC showed a significant increase in PCNA expression and decrease in Bcl-2 expression when compared with non-inflamed cyst. Correlation between inflammation and proliferative and anti-apoptotic activity was found to be statistically non-significant. Conclusion: Inflammation is responsible for change in behavior of neoplastic epithelium of OKC and hence should be treated meticulously, whereas in DC it is responsible for changes in the epithelial lining.
  1,728 357 4
CASE REPORTS
Lymphocutaneous nocardiosis caused by Nocardia otitidiscaviarum: A case report and review of literature
Praveen R Shahapur, BV Peerapur, RP Shahapur, RM Honnutagi, MS Biradar
January-June 2014, 5(1):197-201
DOI:10.4103/0976-9668.127328  PMID:24678228
Nocardia otitidiscaviarum is a rare clinical isolate of primary cutaneous infections. This report describes a case of lymphocutaneous nocardiosis caused by N. otitidiscaviarum. Analysis of 16S ribosomal RNA gene of the isolate and the type strain of N. otitidiscaviarum DSM 43242 showed 100% similarity. The partial gene sequence of 1439 bp was submitted to GenBank. (EU031786). The isolate was susceptible only to amikacin, minocycline, linezolid and resistant to remaining other routine anti-nocardial drugs. The patient was free of nocardiosis after 12 weeks of treatment with amikacin and linezolid. We reviewed four other cases of lymphocutaneous nocardiosis caused by N. otitidiscaviarum.
  1,831 249 3
Metachronous multifocal myxoid liposarcoma involving the gastrointestinal tract. Management and literature review
Nikolaos S Salemis, Charalambos Seretis, Fotios Seretis, Charalambos Christofyllakis, Georgios Karalis
January-June 2014, 5(1):186-190
DOI:10.4103/0976-9668.127325  PMID:24678225
Multifocal soft tissue sarcoma is a rare clinical entity occurring in 1% of patients with extremity soft tissue sarcoma and in 4.5% of patients with liposarcoma. Multifocal disease may arise either synchronously or metachronously and has been associated with poor prognosis. Herein, we have described a rare case of metachronous multifocal myxoid liposarcoma involving the gastrointestinal tract that developed 14 months after the resection of a myxoid buttock liposarcoma. Diagnostic evaluation and management of the patient are discussed along with a review of the relevant literature. We conclude that multifocal myxoid liposarcoma is a rare clinical entity that usually represents metastatic disease with poor prognosis. A thorough imaging and careful physical examination are essential in the preoperative evaluation and postoperative follow-up of patients with myxoid extremity liposarcomas, as these tumors are known to have a tendency to spread toward extrapulmonary sites, frequently without pulmonary metastases.
  1,859 214 2
Primary tubercular mastitis masquerading as malignancy
S Prathima, R Kalyani, S Parimala
January-June 2014, 5(1):184-186
DOI:10.4103/0976-9668.127324  PMID:24678224
The significance of primary tubercular mastitis is due to rare occurrence and often overlooked and misdiagnosed as pyogenic breast abscess or malignancy. Despite the high incidence of tuberculosis in India, reports of breast tuberculosis among the total number of mammary conditions varies between 0.64% and 3.59%. We report a case of a 35-year-old lady with breast lump of 3 months duration, which simulated malignancy on clinical examination but fine needle aspiration cytology revealed granulomatous mastitis secondary to tuberculosis. High level of suspicion and simple fine needle aspiration procedure with micro-biological tests will clinch the final diagnosis.
  1,684 234 1
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