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Background: Xerostomia, one of the most major side effects of radiotherapy in patients with oropharyngeal cancer, has a compromising effect on the quality of life. The aim of this study was to evaluate the effect of 635nm low-level laser on salivary flow rate and quality of life (QoL) in post-radiotherapy oropharyngeal cancer patients. Methods: A prospective study was conducted on patients (n=34) with persistent post-radiotherapy xerostomia received low level laser therapy (LLLT) (635nm) on the three major salivary glands twice a week for 12 weeks. For each point, dose was 18.75 J/cm2, irradiation time was 15 s, energy was 1.5 J. Energy for each session was 33 J and laser tip diameter was 0.08cm2. Extra oral points were marked over the parotid gland (6 points), submandibular (3points) and sublingual gland (2 points). Unstimulated and stimulated salivary flow rate (SFR) and quality of life (QoL) using University of Washington (UW) QoL questionnaire were assessed. Unstimulated SFR and QOL scores were normally distributed and hence paired t-test was used. A p-value ≤0.05 was considered as statistically significant. Results: The mean unstimulated SFR was significantly increased by 0.16 units after LLLT (p=0.001). Similarly, the median stimulated SFR significantly increased by 0.45 units post LLLT respectively (p=0.001). The mean QoL was significantly increased by 591.32 units after LLLT (p≤0.05). Conclusion: Low level laser therapy (LLLT) demonstrates to be effective in increasing salivary flow rate and the QoL scores hence mitigating salivary hypofunction and improving overall quality of life of patients. Keywords: Low-Level Laser Therapy; Xerostomia.

ABSTRACT Objective: This study aimed to determine the burden of oral health parameters such as dental caries, dental plaque, gingivitis, periodontitis, mouth opening, and dental fluorosis among children and early adolescents belonging to upper and lower-middle-class private schools of Karachi. Methods: A cross-sectional study with 550 study subjects was conducted among schools to assess dental caries, the presence of dental plaque, gingivitis, dental fluorosis, and mouth opening. The sample was selected through a nonprobability sampling technique. The inclusion criteria were male and female students from class 6 to class 10, students present on the day of the examination, and students given verbal consent for the study; the exclusion criteria included students with dental anomalies such as amelogenesis imperfecta, dentinogenesis imperfecta, supernumerary teeth, congenitally absent teeth or teeth missing due to fracture or trauma. An open epi was used to calculate the sample size. The study was performed in private schools belonging to various localities near Ziaud-din University. Dental examination was carried out using a disposable dental examination kit. SPSS version 20 was used for data analysis, and the nonparametric Mann-Whitney test was used to analyse the variables. Results: The mean age of the study sample is 12.96 ± 2.30, the mean DMFT (Decayed missing and filled tooth) score is 1.07 ± 2.04, the mean plaque score is 0.38 ± 0.90, and the gingival index is 0.21 ± 0.79, the mean mouth opening is 36.16±8.65. The gender-wise distribution of oral health parameters presented the statistically significant difference in mean mouth opening among male and female study subjects p

Persistent Müllerian Duct syndrome is a rare male disorder of sexual development. The phenotypically and genotypically male patient presents with female internal organs (i.e., uterus, cervix, fallopian tubes and upper part of vagina) due to deficiency of anti-mullerian hormone or insensitivity of tissues to Anti Mullerian Hormone. We present a 19 year old male who came with complaint of right iliac fossa pain. He was investigated for acute appendicitis and on imaging, he was diagnosed to have bilateral cryptorchidism with rudimentary uterus. Computed tomography followed by pelvic ultrasonography was done which indicated two testes in abdomen and a soft tissue density structure, identified as a rudimentary uterus located posterior to the urinary bladder. CT scan findings were further confirmed by magnetic resonance imaging pelvis. A trial of stepwise orchidopexy followed by orchidectomy with removal of rudimentary uterus was performed laparoscopically. ---Continue

Introduction The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities.Methods Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020–October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting.Results Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30–60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6–7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03).Conclusion Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.

Background: Human immunodeficiency virus (HIV) seems to be a major public health challenge for all over the world, especially in developing countries such as India. Objective: The objective of the study was to study the sociodemographic profile of people living with HIV/acquired immune deficiency syndrome (AIDS) attending a standalone Integrated Counseling and Testing Centre (ICTC) at Jawaharlal Nehru Medical College and Hospital Aligarh in Uttar Pradesh. Materials and Methods: A record-based study was carried out among the HIV-positive patients who were attending the ICTC at Jawaharlal Nehru Medical college, AMU, Aligarh. Results: Prevalence of HIV infection was found to be 5.04% in and around Aligarh region. Males were more commonly affected than females with a ratio of 1.6:1. Majority of HIV-positive patients (35.82%) belonged to 25–34 years of age group. Most common clinical presentation was fever (46.9%) among HIV-positive patients, followed by weight loss (36.88%) and diarrhea (32.55%). Sexual transmission (61.19%) was the most common route of HIV transmission seen in our study. Most of the patients had a baseline CD4 count level below 200/μl. Conclusion: Majority of HIV/AIDS study subjects were from the economically productive age group. Education level, occupation, socioeconomic status, and marital status were found to be statistically associated. Practice of heterosexuality is the most common mode of transmission. Most of the patients reported at an early phase of disease.

Objectives: This study was conducted to compare the disease severity of COVID-19 in pregnant and nonpregnant females of reproductive age group and to evaluate the effect of COVID-19 on neonatal outcome. Materials and Methods: The present prospective observational study was conducted at a tertiary care center in northern India over a period of 6 months. Females of reproductive age group (15–44 years) that were admitted in COVID isolation ward with reverse transcription–polymerase chain reaction-positive COVID-19 disease were included in the study and followed till discharge. Results: Among the 60 females of reproductive age group, 41.67% (25) were pregnant and 58.34% (35) were nonpregnant. The median duration of hospitalization among pregnant and nonpregnant females was 9 and 8.5 days, respectively. The severity of infection among pregnant and nonpregnant females was as follows: asymptomatic + mild disease 96% (24) and 77.14% (27) and moderate + severe disease 4% (1) and 22.86% (8), respectively. There were no maternal mortalities. Forty percent (10) of pregnant females had lower segment cesarean section (LSCS) and 32% (8) had normal vaginal delivery. There were 8 preterm, 6 full-term, 3 early-term, and 1 late-term deliveries. Twelve newborns had normal birth weight, 4 were low birth weight (LBW), 1 was very LBW, and 2 intrauterine deaths IUD were reported. No case of neonatal death or neonatal asphyxia was reported. Conclusion: In comparison to nonpregnant women with COVID-19 pneumonia, the infected pregnant females had mild or no respiratory symptoms, and none developed severe respiratory compromise or required intensive care. Preterm delivery, LSCS, and LBW were common in COVID-19-infected females.

Purpose: Early diagnosis of extrapulmonary tuberculosis (TB) with simultaneous detection of rifampicin (RIF) resistance (RR) directly from the sample is a revolution brought by GeneXpert Mycobacterium TB (MTB/RIF) assay. Line probe assay (LPA) is not recommended for extrapulmonary/nonsputum specimens; GeneXpert MTB/RIF provides a diagnostic option for these. Hence, the following study aimed to evaluate the performance of GeneXpert MTB/RIF assay in nonsputum samples. Materials and Methods: A total number of 642 extrapulmonary and nonsputum respiratory samples were subjected to Ziehl–Neelsen (ZN) staining technique, fluorescent microscopy (FM), and GeneXpert MTB/RIF Assay. All samples were cultured on a solid Lowenstein–Jensen (LJ) medium and culture-positive samples were subjected to GenoType MTBDRplus LPA and drug susceptibility testing by 1% proportion method on a solid LJ medium. Results: GeneXpert MTB/RIF assay detected MTB in 25.9% (166/642) of the samples. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ZN staining technique and FM were 21.52%, 99.35%, 91.89%, and 78.77% and 27.22%, 99.78%, 97.73%, and 80.07%, respectively. Sensitivity, specificity, PPV, and NPV of GeneXpert MTB/RIF in the detection of MTB were 93.75%, 96.53%, 90.36%, and 97.80%, and RIF RR was 92.0%, 97.74%, 88.46%, and 98.48%, respectively. LPA performed on positive culture growth showed 100% sensitivity and specificity in the detection of RIF and isoniazid resistance. Conclusion: GeneXpert MTB/RIF showed high sensitivity and specificity in detecting MTB and simultaneous RIF RR among the nonsputum samples which had a good concordance to LPA. It provides a judicious option for early detection of multidrug-resistant TB in extrapulmonary and nonsputum respiratory samples.

Abstract Background For the treatment of hypothyroidism, patients are usually placed on lifelong levothyroxine replacement therapy. Achieving clinical and biochemical euthyroid status is sometimes difficult because of several factors, including poor compliance or poor absorption of levothyroxine in the gut mucosa. Case presentation We present the case of a 45-year-old South Asian female with hypothyroidism on lifelong levothyroxine replacement. However, on her multiple follow-up visits over the past 2 years, it was noted that her thyrotropin level was never controlled and was not in range. A thorough history was unyielding in terms of compliance regarding levothyroxine medication and use of over-the-counter pills or mineral supplements that may interfere with the absorption of levothyroxine. Hence, we performed levothyroxine absorption test to rule out any malabsorption as well as document pseudo-malabsorption favoring drug nonadherence. Levothyroxine absorption test resulted in more than 56% absorption of levothyroxine; therefore, the patient was put on weekly directly observed treatment strategy resulting in normalization of thyrotropin levels on successive follow-ups. Conclusion Directly observed treatment to replace levothyroxine once a week can be used as an alternative by health care professionals in patients in whom compliance to daily levothyroxine is the hidden cause of persistently raised thyrotropin. This strategy can reduce undue health burden on the patient and improve adherence to self-medication under confident supervision of the treating physician.

Abstract Background Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. Methods Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. Results CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. Conclusions Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.

Background and Objectives: There are conflicting views regarding face mask guidelines amongst healthcare staff to prevent transmission of coronavirus disease 2019 (COVID-19), influenza and other respiratory viral infections (RVIs). We conducted a thorough meta-analysis to statistically compare mask use versus no mask use efficacy for RVIs in healthcare settings. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used for selecting researches published between 2003 and June 2022 from different databases, including Publisher Medline (PubMed), Web of Science, etc.; 6 studies qualified for inclusion. Data was pooled from in vivo randomized control, case-control and observational studies dealing with the relationship between face mask use and no use by patients or health personnel and RVI prevention in healthcare setups. Results: The fixed and random-effects model was carried out to determine pooled odds ratios (ORs) and their respective 95 percent confidence intervals (CIs). The results revealed that wearing a face mask significantly reduced the risk of contracting a respiratory viral illness in hospital settings, with pooled OR (95% CI) of 0.11 (0.04 to 0.33) (probability value (P)

Objective: To compare the academic performance of students from two consecutive batches taught through different teaching strategies during their pre-clinical year. Methods: We compare two batches of the second year BDS in a basic dental science subject (a subject I and Subject II). The mode of intervention of the current batch was via interactive lectures compared with didactic lectures delivered to the previous batch. Both batches were assessed by Continuous Assessments Test CAT in mid of semester followed by the Semester Exam. The two-independent t-test was used to measure the difference in academic scores between two batches of students who received teachings through an interactive session and didactic lectures respectively. Results: The students of the current batch (n=41) obtained better scores during the continuous assessment test (65.1±11.01) than (55.3±11.80) previous batch students (n=43) at p

Candidiasis is recognized as a significant cause of morbidity, especially in immunocompromised individuals. An epidemiologic change in Candida species and emergence of resistance can impact the usage of antifungal agents as empirical therapy for Candidiasis in patients with or without AIDS. The present study was done to find out: i) The species of Candida isolated from H.I.V. and Non-HIV infected patients. ii) The resistance pattern of these Candida isolates to antifungal agents. A total of 160 Candida species isolates (80 isolates each from H.I.V. and Non-HIV infected patients) were characterized. Identification of yeast isolates was made by standard procedures including morphology (Staib agar, cornmeal agar, CHROMagar), germ tube test, fermentation, and assimilation of sugars and growth at 42°C. In addition, sensitivity testing was done using the broth microdilution method (M27-A2) as per the C.L.S.I. guidelines against amphotericin B, nystatin, voriconazole, fluconazole, ketoconazole, and itraconazole. In both the groups, i.e., H.I.V. and Non-HIV infected patients, Candida albicans was the most common species (61.2 % and 85 % respectively), followed by Candida guilliermondi (16.2 % and 5 %), Candida tropicalis (5 % and 3.7 %), Candida krusei (5% and 2.5 %), Candida dubliniensis 1(5 % and 1.2 %) and others. Among HIV infected patients fluconazole resistance was 16.25%, ketoconazole 13.5%, clotrimazole 12.5%, itraconazole 6.25 %. In the non-HIV infected group, fluconazole resistance was 8.75% and itraconazole 1.25%. For the appropriate treatment of Candida infections, antifungal susceptibility has become an essential tool, especially in the present scenario of increasing resistance.

Objective: To determine the prevalence of depression and associated socio demographic factors among personnel reporting to a field hospital in Sudan for routine medical care and analyze socio demographic factors associated with depressive symptoms. Study Design: Cross sectional descriptive study. Place and Duration of Study: This study was conducted in a field hospital, from Apr 2015 to Mar 2016 in Sudan. Methodology: The sample population comprised of 226 personnel who reported to the hospital for routine medical care. Beck Depression Inventory (BDI) was used to record the presence and severity of depressive symptoms. The following socio-demographic variables (rank, age, gender, ethnicity, education, marital status, socioeconomic status, family type, service in mission area, smoking habits, living conditions, lack of social support) were taken on a separate sheet. Results: Out of 226 subjects 58.4% had no depressive symptoms, 15.5% had mild, 21.2% had moderate and 4.9% had severe depressive symptoms. Unsatisfied with living condition in mission area, having more than 6 months of service and lack of social support were correlated with depressive symptoms. Tobacco smoking was highly associated with depression, while female gender and low education had a weak association with depressive disorder. Conclusion: The high prevalence of depressive symptoms in our study highlights the importance of developing good mental health care facilities for personnel deployed on different missions.

Introduction: Candidemia is a major cause of morbidity and mortality in hospitalized patients, especially pediatric population, justifying the importance of adequate antifungal therapy. Immunocompromised patients, preterm neonates, elderly patients and patients admitted to intensive care units are at higher risk of invasive candidiasis infections. A shift has been observed in the relative frequency of non-albicans Candida (NAC) and Candida albicans in blood stream infections. Studies on the prevalence of infections and antifungal susceptibility testing can help with deciding on clinical strategies to manage this problem. Aims and Objectives: The following study was performed to find the prevalence of various Candida species causing candidemia and their resistant pattern in Aligarh region of western Uttar Pradesh. Materials and Methods: Two thousand and eighty-four samples for blood culture were received in the microbiology laboratory over a period of 5 months. Seventy-one positive samples for Candida were identified and tested for antifungal susceptibility testing by Vitek-2 (21) and conventional methods (50). Results: 3.41% of the blood culture were positive for Candida species. Candida tropicalis (35.21%) was the most common species isolated followed by Candida glabrata (21.13%), C. albicans (14.08%), Candida krusei (9.86%), Candida pelliculosa (9.86%), Candida parapsilosis (4.23%), Candida guilliermondii (4.23%), and Candida utilis (1.41%). Maximum percentage of isolates were from neonates (47.89%) followed by infants (25.35%). Resistance to fluconazole and amphotericin B was seen in 11.27% and 1.41% of isolates. Conclusion: NAC species outnumbering C. albicans even as single most common species in candidemia patient isolates is alarming. Fluconazole is generally used as empirical therapy. NAC being more resistant and some being intrinsically resistant (C. krusei) to fluconazole strengthens the need of antifungal susceptibility testing on priority basis.

OBJECTIVE: To determine the effect of filled and unfilled sealants on micro-leakage of class V composite restoration. METHODOLOGY: This in-vitro experimental study was performed at department of dental materials from August 2018 to January 2019. Sample selection was performed through non probability convenience sampling. Class V cavities were prepared on the buccal surfaces of sixty extracted teeth at the level of cemento-enamel junction (CEJ), the coronal margins were facing towards enamel and gingival margins were at dentine. Later, cavities were filled with an adhesive system and composite, followed by polishing. Samples were randomly divided in to 3 groups according to surface sealants. Twenty teeth in each group (Clinpro, GC coat and Control) and preserved in the incubator at 37°C with in airtight containers that were filled with 10ml (5%) solution of Methylene blue dye. After 24 hours samples were dissected longitudinally in bucco-lingual direction and evaluated under a stereo microscope. The data were statistically analyzed by chi square test. RESULTS: Association among all 3 groups at gingival level was found to be statistically significant with p value of 0.001 and chi square value of 30.46. Furthermore, at coronal level micro leakage was found to be statistically insignificant with p value of 0.619 and chi square value of 2.64. CONCLUSION: Both surface sealants have shown effectiveness in reduction of micro-leakage. However, Clinpro has presented with better reduction in micro-leakage than GC coat.

Background: Tuberculosis (TB) remains a major global health problem. India accounts for the one-fourth of the global TB burden. For resource-limited countries like India having high burden of TB, smear microscopy is the most commonly used method for microbiological diagnosis. Although culture being highly sensitive and specific method, it is time-consuming. Under Revised National TB Control Program (RNTCP), Ziehl–Neelsen (ZN) stain-based microscopy and light-emitting diode-based fluorescent microscopy (LED-FM) are being recommended. Aim: The present study was done to determine the sensitivity and specificity of ZN stain-based microscopy and FM (LED-FM) keeping solid culture as gold standard. Materials and Methods: A total of 1503 sputum samples were collected from suspected cases of pulmonary TB (new or previously treated). They were processed and subjected to ZN (conventional light microscopy), Auramine-O (AO) staining (LED-FM) and solid culture on Lowenstein–Jensen medium for detection of acid-fast bacilli. Positive smears were graded according to RNTCP guidelines. Results: Sensitivity, specificity, positive predictive value, and negative predictive value of ZN staining technique were 84.93%, 95.74%, 96.50%, and 82.16%, respectively, and that of FM was 95.25%, 91.33%, 93.81%, and 93.31%, respectively. Conclusion: LED-FM being more sensitive, especially in detecting the paucibacillary cases and less time-consuming, has advantage over ZN method. Nation-wide implementation will lead to improved diagnosis, thus better control of TB.

Background: Varieties of methods are available for more obstinate tooth discoloration such as crowns, veneer, and micro and macro abrasion of enamel, but tooth bleaching gained high patient acceptance. The aim of the present research was to estimate changes in surface enamel composition after bleaching 16% carbamide peroxide (CP) (home-use bleaching) with 38% hydrogen peroxide (HP) (in office bleaching). Materials and Methods: A total of 90 enamel slabs from 45 sound human third molars were randomly divided into three groups. Of three groups, per group had thirty samples (n = 30), of which samples of Group 1 were placed in artificial saliva at 37°C in incubator (Memart, Germany) during complete experiment. Sample of Groups 2 and 3 was treated with power whitening gel (White Smile 2011, Germany) and tooth whitening pen (white Smile 2011, Germany), respectively. Later on, after bleaching treatment, discs were thoroughly washed and stored in artificial saliva at 37°C in incubator. Chemical analysis was done with energy dispersive spectroscopy (Edx) detector to detect changes in surface composition. Results: Energy dispersive X-ray spectroscopy (Edx) analysis showed no significant difference between all the three groups for Ca% mass (P > 0.99) and Ca% atomic (P > 0.99), C% mass (P = 0.78) and C% atomic (P = 0.76), and O% mass (P > 0.99) and O% atomic (P = 0.28). Similar results were shown for Na, Mg, P, and F. Conclusion: Statistically insignificant effect was observed on enamel composition with both bleaching agents (38% HP and 16% CP).

ABSTRACT Introduction: An upper respiratory tract infection which can be either due to increased airway bacterial load or emergence of new bacterial strain is the most common cause of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Other factors responsible for exacerbation include viral infections, pollution and other unidentified pathogens. Aim: To evaluate the local pattern of bacterial and fungal isolates from patients diagnosed with AECOPD and forming an antibiogram of the hospital. Materials and Methods: A total of 200 clinically diagnosed cases of AECOPD of age ≥40 years were included in the study. Sputum sample was obtained from the patients and processed according to standard lab procedures. Statistical analysis was done by using Statistical Package for Social Sciences (SPSS) version-20. The test applied in the current study was modified chi-square used for comparison of proportion to analyse statistical significance for antibiotic sensitivity. The p-value

Background: The prevalence of multidrug-resistant-tuberculosis (MDR-TB) among new and previously treated cases is increasing worldwide as well as in India. Rapid detection of MDR-TB allows the establishment of an effective treatment regimen; minimizes the risk of further resistance, and limits the spread of drug-resistant strains. Early diagnosis of MDR-TB is the need of the hour in high-TB burden countries like India, and GenotypeMTBDRplus is quite sensitive and specific in determining the molecular resistance in drugs such as rifampicin and isoniazid. Methods: The present study was done for molecular detection of rifampicin and isoniazid resistance and resistance patterns among MDR-TB suspects and comparison of resistance patterns among new and previously treated cases by GenoType® MTBDRplus Line Probe Assay. A total of 1268 sputum samples of MDR-TB suspects were subjected to fluorescent microscopy. Fluorescent microscopy positive samples were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay. Results: MDR-TB was detected 11.02%, 20.03% in new and previously treated cases. Among MDR-TB patients S531 L was the most common mutation detected in rpoB gene; 71.43% in new, and 72.17% in previously treated cases. S315T1 was the most common mutation noted in katG gene; 100% in new and 81.74% in previously treated. While in hA gene, it was C15T (7.8%) among previously treated cases. Conclusion: MDR-TB has high prevalence in the western part of Uttar Pradesh, India. Previously treated cases have even more high rate of MDR-TB than new TB cases. The most dominant gene mutations associated with resistance to INH and RIF were observed in codon 315 of the katG gene and codon 531 of the rpoB gene. While comparing the mutation patterns by Genotype MTBDRplus assay, previously treated cases showed more diversity of mutations and had greater number of unknown mutations.

Objective: To evaluate dental hygiene practices and dental caries status among medical and dental undergraduates studying in public sector colleges. Materials and Methods: It was a cross sectional study which was conducted among medical and dental undergraduates. A total of 500 study subjects were chosen through a non probability convenience sampling technique. A self administered closed ended pre-tested questionnaire was distributed among participants followed by clinical examination to assess the prevalence of dental caries in them by using WHO index of dental caries. Descriptive analysis of qualitative and quantitative variables was performed. Chi square was performed to find out association between dependent and independent variables. Results: The frequency of brushing teeth among dental graduate was found more as compared to medical counterparts (66% vs. 36%, p=0.044). Majority (n=457) study subjects stated that they used dental floss for inter-dental cleaning. The mean DMFT index was found to be higher with statistically significant difference among medical undergraduates: (5.04 vs. 3.38, p=0.010); but the filled component (FT), (4.11 vs. 2.04, p=0.001), was found to be significantly higher among dental study subjects. The decayed component of medical subjects were found to be more and statistically significant as compare to their dental peers respectively (4.22±3.8 vs 2.06±2.8, p=0.001). Conclusion: Dental undergraduates had better oral health awareness and oral hygiene.

Purpose: The aim of present study was to evaluate extended curing times on the degree of conversion (DC) of filled and unfilled resin-based materials used as pit and fissure sealants. Materials and methods: The materials examined were a flowable composite (Filtek™ Z350 XT Flowable) and a pit and fissure sealant (Clinpro™ Sealant). Thirty disks of each material were prepared. The 30 made of the flowable composite were divided into three groups (n = 10 each) according to the three different curing times studied: 20 s (group 1), 40 s (group 2), and 60 s (group 3). Similarly, the 30 disks made of the pit and fissure sealant were divided into three groups (n = 10 each) according to the three different curing times: 20 s (group 4), 40 s (group 5), and 60 s (group 6). After polymerization, the disks were removed from the mold and stored in dry, lightproof containers in an incubator at 37 °C for 24 h. The DC was obtained using an Avatar 320 FTIR spectrometer. Then the data were analyzed using the Kruskal–Wallis test and the Fisher’s least significant difference post hoc test for multiple comparisons (alpha = 0.05). Results: DC values for the flowable composite (Filtek™ Z350 XT) were higher (p = 0.002) than those for the pit and fissure sealant (Clinpro™ Sealant). Group 2 and group 5 showed significantly higher DC values than group 1 and group 4, respectively. There was no difference between groups 2 and 3 or between groups 5 and 6 (p = 2.93). Conclusion: An extended curing time improves the DC to some extent for both materials. Keywords: Degree of conversion, Pit and fissure sealants, Curing time, Spectrometer

Background: With increasing incidence of resistance to antibiotics carbapenems are used as the last resort because they are stable even in response to extended spectrum and AmpC beta-lactamases. However, Gram-negative bacilli producing the acquired metallo-beta-lactamases (MBL) are on the rise. Aim: The aim of the following study is to detect phenotypically the presence of extended spectrum beta-lactamase (ESBL), AmpC and MBL in Gram-negative bacteria isolated from clinical specimen. Materials and Methods: Gram-negative isolates from clinical samples were screened and confirmed for the presence of ESBLs by double disk synergy test (DDST), for AmpC by disk approximation assay and for MBL by Modified Hodge Test and imipenem-ethylenediaminetetraacetic acid DDST. Results: Among 251 isolates studied, 138 (54.98%) were ESBL producers, 49 (19.52%) were AmpC producers and 45 (17.93%) were MBL producers. Highest rates of ESBL detection was by Cefoperazone sulbactam (109/138) 78.98%. Out of 92 of the AmpC producing strains 20 (21.73%) were inducible and 72 were stably derepressed (78.26%). Out of 251 strains studied 45 (17.93%) were phenotypically identified as MBL producers, the highest no. being of Pseudomonas aeruginosa. Among the methods employed for detection of MBL production, Hodge test (62.22%) proved better than DDST (40%). Conclusions: High level of antibiotic resistance pattern exists in various clinical isolates. ESBL production should be looked for routinely in Gram-negative bacteria other than Escherichia coli and Klebsiella. A high percentage of derepressed AmpC mutants are noteworthy and alarming. We recommend phenotypic identification methods as routine practice in laboratories as genotypic methods are not cost-effective.

Purpose: To examine the effect of apple and orange juices on the surface hardness of direct tooth-colored restorative materials. Materials and methods: The materials included resin-modified glass ionomer cement (Vitremer 3M™ ESPE™ Core buildup restorative) and composite resin (Filtek™ 3M™ ESPE™ Z350). A total of 45 disks of each restorative material were prepared. The disks were divided into groups of 15, which were immersed for 7 days in deionized water (G1/G4, control group), apple juice (G2/G5), or orange juice (G3/G6). The pH of the apple juice was approximately 4.8 and the pH of the orange juice was approximately 4.9. Surface hardness tests were performed before immersion and at various times following immersion. Statistical analysis included two-way ANOVA with repeated measurement and Tukey’s test. Results: Exposure to juices significantly reduced the hardness of both materials (p

C-reactive protein (CRP) is an acute-phase protein synthesized predominantly by the hepatocytes in response to tissue damage or inflammation. Levels of acute-phase proteins rise rapidly, during infection and after injury. We take up the study to correlate serum CRP levels with other important predictive markers of outcome in COPD. Patient with stable COPD (no exacerbation in the last two months) were taken up for the study. Parameters taken to correlate were age, grade of dyspnea, FEV1. It was found the CRP is negatively correlated with FEV1 and grade of dyspnea but not correlated with age.

Hydatid disease remains a serious health problem in Mediterranean countries. Living in a rural area is an important risk factor for the disease. Hydatid cysts are usually located in the liver, lungs and brain. Mediastinal hydatid disease is very rare and has been noted only anecdotally in the literature. The present article reports a case of a mediastinal hydatid cyst rupturing into the pleural cavity, which was associated with pneumothorax of the same side. The patient’s previous chest x-rays (posteroanterior and left lateral views) showed a well-defined mediastinal mass on the left side, and contrast-enhanced computed tomography of the thorax (taken a few days after the chest x-ray) showed multiple round-to-oval soft tissue opacities with partial collapse of the left lung. An indirect hemagglutination test for echinococcus was positive. Even after two weeks of intercostal tube drainage, the patient’s condition did not improve. During thoracotomy, multiple daughter cysts were found in the pleural cavity, and the diagnosis of a hydatid cyst was confirmed after histopathological examination.