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Management of diabetic foot ulcers is the biggest challenge to the clinician, as conventional antibiotic therapies and local wound care have their own limitations. They are not effective for control of infections and promotion of healing because of cytotoxic effects. In view of cytotoxicity of routinely used topical antiseptic agents, this article focuses on the search of an ideal topical antiseptic agent that is safe and effective in controlling infectious agents and also in promoting the healing process. This review focuses on the use of various acids such as citric, acetic, hyaluronic, and hypochlorous acids as topical agents in diabetic foot infections. This article also focuses on the different roles of acids in the treatment of diabetic foot infections.

Strongyloides stercoralis is a helminth, widely distributed in tropical and subtropical countries. Its infestation in humans usually does not produce symptoms. However, in some patients, severe and life-threatening forms of this infection can occur, especially in immunocompromised individuals. Severe parasitic infection is triggered by any imbalance in the host’s immunity favouring the auto-infective cycle. This results in an increase in the intraluminal parasitic burden. In addition, tissue infestation is also very common. Clinical presentation is variable, and it is very difficult to diagnose clinically. Diagnosis requires a high index of suspicion. In some cases, the diagnosis is established only on histopathological examination of the excised tissue by the pathologist. Here, the authors report a case of an elderly male diabetic patient, who presented to the emergency department with the features of acute abdomen. On exploratory laparotomy, he was found to have the features suggestive of gangrene of small bowel. Resection of the gangrenous bowel was done, and end-to-end anastomosis was done as the rest of the bowel appeared to be normal. However, the patient died of multi-organ failure and septicaemia on the second postoperative day. The resected intestine showed tissue infestation of Strongyloides stercoralis on histopathological examination. In this review article, the authors summarize a case of hyper infection syndrome of strongyloidiasis and discuss the various aspects of Strongyloides stercoralis infection with emphasis on life cycle of the parasite and different clinical features of the disease.

Like any other pandemic, Covid-19 scenario has also demanded effective treatment options. The circumstances demand to utilize all the possible weapons in the armamentarium. There have been many issues regarding the short-term and long-term safety and efficacy of these options. Some options are like uncharted seas and these need a detailed and critical review with respect to safety, efficacy, feasibility and financial constraints. Mesenchymal stem cells (MSCs) therapy has been studied for many years for its potential role in diseases with complex pathogenesis. Its efficacy in controlling cytokine imbalance and immuno-modulatory properties is well proven. These effects are being extensively studied for potential extension of the benefits for an effective option for management of COVID-19 patients with severe respiratory involvement. In this mini-review, an attempt has been made to review positive aspects, negative aspects, and challenges influencing MSCs therapy in the management of COVID-19 disease. The results of various studies and literature reviews show that MSCs therapy can be considered as one of the potential options. This article reviews the role of Mesenchymal Stem Cell (MSC) transplantation in critically ill SARS-COV-19 patients with lung involvement. The MSCs counteract the cytokine storm, regulate the immune responses, facilitate the expression of essential growth factors, and eventually improve the local milieu and promote the restoration of pulmonary vascular and alveolar linings for early healing. As with all new therapeutic options, MSC therapy will also have to stand the test of time with respect to safety, specificity, and constraints like mass production and “available for all” at “affordable cost.”

Background: Diabetic ketoacidosis (DKA) is one of the severe acute complications of diabetes. It has long been considered a key clinical characteristic of type 1 diabetes mellitus (T1DM) with severe and irreversible deficient insulin levels. Ketosis-prone diabetes (KPD) has pathophysiology close to T2DM but shows signs and symptoms associated with T1DM. In general, patients with ketosis-prone diabetes display elevated glucose and ketone levels; also, a higher hemoglobin A1C than conventional T2DM. Objectives: The current research aimed to elucidate the clinical presentation and outline a management plan for KPD in the Indian population. Methods: The present case series is a descriptive, prospective, and observational case series on six unprovoked cases of KPD. They were managed using the standard protocol of DKA management. Results: The recruited cases followed a set pattern of very high insulin requirement at diagnosis. On follow-up, the insulin requirement progressively declined, and all of the cases were able to stop insulin therapy after a mean period of four weeks. None of the cases presented any organ damage at diagnosis. There was no recurrence of DKA during the two-year follow-up. All of the cases had normal liver and renal functions. Autoantibodies were negative in all of the cases. Conclusions: Ketosis-prone diabetes is the most under-recognized and under-diagnosed among all types of diabetes. Its recognition is of utmost importance as the approach of its treatment varies widely from that of the conventional type of diabetes. Proper follow-up, especially in unprovoked cases of DKA with obese phenotype, could help elucidate this rare entity of KPD where insulin can be stopped and maintain normoglycemia for a substantial period without insulin.

The principle of plasma therapy can be used for prophylaxis and treatment purpose. In view of non-availability of suitable vaccine for prevention or no established definitive therapy for SARS-CoV-2, plasma therapy is gaining importance in a current pandemic as one of the treatment options for the treatment of COVID-19. Although, it has been reported to be an effective approach in various preliminary studies, convalescent plasma (CP) therapy has several limitations. In this mini review, an attempt has been made to review positive aspects, negative aspects and various limitations of the CP therapy for COVID-19 cases. The results of various studies show that CP therapy may be thought of one of the alternatives but while considering it as a therapeutic approach, in light of beneficial effects, the negative aspects and limitations are to be taken into consideration before its administration as a therapeutic agent.

BACKGROUND: Metabolic syndrome is a growing concern as it predisposes to cardiovascular comorbidities and type 2 diabetes mellitus. Medical students lead fairly sedentary lifestyle. Early detection of metabolic syndrome and follow-up would help in preventing complications. The objective of the study was to determine the prevalence of metabolic syndrome in healthy medical students of JN Medical College and to compare the prevalence among male and female students. METHODOLOGY: A cross-sectional observational study was conducted from January 2018 to July 2018 involving 120 students, of which 67 (55.83%) were female and 53 male (44.17%). The study was conducted using the criteria for metabolic syndrome defined by international diabetes federation. Data for height, weight, body mass index, waist circumference, fasting blood glucose, serum cholesterol, serum triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein were collected. Data were analyzed using SSPS version 20.0. Comparison of physiological parameters was done using independent t-test, and prevalence was estimated using Chi-square test. P < 0.05 was considered as statistically significant. RESULTS: Metabolic syndrome was observed in 10.83% of sample population comprising 11.94% female and 9.43% male population. The prevalence among females was found to be more than males but not statistically significant (P = 0.66). The prevalence of individual parameters for metabolic syndrome were abdominal obesity (59.17%), raised TG (2.50%), reduced HDL (38.33%), raised blood pressure (BP) (systolic BP [SBP] – 20.83% and diastolic BP – 28.33%), and raised blood glucose (5.83%). In terms of gender analysis, 46.27% females and 28.30% of male had lower HDL values (P = 0.04). SBP was higher in 37.74% male when compared to 7.46% female (P = 0.0001). CONCLUSION: The study concludes that the overall prevalence of metabolic syndrome was found to be 10.83%. The prevalence among female (11.94%) was more than male (9.43%) population but not found to be statistically significant. Early detection of metabolic syndrome would help bring about attitude and lifestyle changes to prevent the progression of disease and its complication.

BACKGROUND: To study the role of selective laser trabeculoplasty (SLT) in intraocular pressure (IOP) reduction in post-laser iridotomy primary angle-closure disease patients with inadequately controlled IOP. METHODS: In this prospective cross-sectional study, 34 patients with primary angle-closure disease with post-laser iridotomy open angles up to at least 180° were recruited. Following SLT, patients were examined at 1 day, 1 week, 1 and 3 months, 6 months and 1 year post SLT. RESULTS: Data of 34 patients (34 eyes; 8 males and 26 females), with a mean age of 57.80 ± 6.44 years, were analysed. The reduction in IOP at each follow-up visit was significant (p

Objectives: To evaluate the role of periodontitis in viridans group streptococci (VGS) bacteremia and infective endocarditis (IE). Methods: A total of 200 subjects including two groups. Group A- 34 subjects undergoing tooth extraction with periodontitis, 46 subjects undergoing tooth extraction without periodontitis and 40 healthy controls. Group B: 40 confirmed cases of IE (17 with and 23 without periodontitis) and 40 healthy controls. Subgingival plaque and blood samples were obtained and processed by standard procedures. Results: A total of 53 blood samples (66.25%) yielded positive cultures after tooth extraction. The relationship between the presence of periodontitis and a positive blood culture was significantly higher (p = 0.05) for tooth extraction cases with periodontitis (79.40%) than tooth extraction cases without periodontitis (56.50%). Periodontitis was observed in 42.5% of IE cases. Out of the 40 patients of IE, the blood samples yielded 40 different isolates, majority were viridans streptococci 15 (37.5%) and staphylococci nine (22.5%). No statistically significant difference was observed between the subgingival plaque and blood isolates of periodontitis in both the groups, indicating similarity of biotypes of viridans streptococci isolated from the blood and the subgingival plaque. Similarity was also observed between the antibiogram profiles of viridans streptococci from both the groups. Conclusions: Periodontitis enhances viridans streptococcal bacteremia and may be a potential risk factor for IE. Keywords: Infective endocarditis, Periodontitis, Viridans group streptococci

Objective: Oral ulcers are painful sores that appear in the mouth. Most of them are usually harmless and clear up on their own. Sometimes, they are non-responsive and difficult to manage. This report describes the case of an 80-year-old female patient with chronic oral ulcers of three years duration and which were refractory to conventional therapy. The ulcers were subsequently treated using 3% citric acid as a sole topical agent, applied three times a day that resulted in complete healing of oral ulcers by day 10 of treatment. The findings of this case report suggest that topical citric acid is a possible alternative treatment for chronic oral ulcers unresponsive to conventional treatment.

Introduction: Proximal femoral nail is a better choice of implant for the treatment of an unstable trochanteric fracture, however it is associated with screw migration and cutout because of greater trochanteric comminution and coronal split. This study is to evaluate the results of Trochanteric Buttress Plate (TBP) combined with PFN in an unstable IT fractures for buttressing lateral wall and reinforcing fixation. Materials and Methods: We carried out a consecutive study of 32 patients of Unstable intertrochanteric fracture femur with lateral wall comminution. It was studied at Ashwini Sahakari Rugnalaya and Sanshodhan Kendra Solapur India and Government medical college Chandrapur India from April-2015 to December-2017 using innovative Trochanteric buttress plate along with PFN. Eighteen male and fourteen female in the age group of 55 to 80 years were included in the study. There were 26 cases of A3 and six cases of A2 were fixed by PFN combined with trochanteric buttress plate to augment the comminuted lateral wall. Results: The bone healing is observed in all the cases in the mean period of 12.6 weeks. Four patients developed complications, including lateral migration of neck screws (n = 2), superficial infection (n = 2). Patients were followed up for a mean of 10.6 months. At the end of follow-up the Salvati and Wilson hip function was 36 (out of 40) in 87.5% of patients [twenty eight patients]. The clinical, radiological and functional outcomes were found to be satisfactory. Conclusion: The stabilization of lateral trochanteric wall with trochanteric buttress plate restores anatomy, increases the stability of construct and prevents inherent complication of screw migration and cutout.

Acute angle closure is usually thought to be secondary to pupillary block, which is relieved by laser iridotomy. Anterior rotation of the ciliary body at the scleral spur following development of an inflammatory ciliochoroidal detachment may result in a presentation of acute angle closure. It is imperative to recognize this condition correctly, because the management is with cycloplegics and anti-inflammatory drugs, which is diametrically opposite to the treatment of primary angle closure. More importantly, it has been reported as a consequence of serious systemic disease such as HIV infection and Vogt Koyanagi Harada (VKH) syndrome. We report a patient who presented to the medical emergency with headache and vomiting and was subsequently found to have acute angle closure in 1 eye secondary to a tubercular choroidal granuloma. This presentation of ocular tuberculosis has not been reported previously.

BACKGROUND People with type II diabetes have altered circadian rhythm of blood pressure and are associated with increased risk of cardiovascular and renal morbidity and mortality. Our study aimed to explain the Ambulatory Blood Pressure Monitoring (ABPM) characteristics or patterns in diabetic patients with hypertension. MATERIALS AND METHODS 70 patients with type II diabetes and hypertension were monitored with 24 hours ambulatory blood pressure changes and the data was analysed. RESULTS Normal dipping was observed in 38.6%, non-dipping in 47.1%, extreme dipping in 2.9% and 11.4% were reverse dippers in patients having type 2 diabetes and hypertension. CONCLUSION We conclude that there was a remarkably high prevalence of alterations in ABPM in patients with diabetes. Abnormalities in systolic BP during night and in circadian BP pattern could be linked with excess of BP related cardio vascular risk of diabetes.

PURPOSE To evaluate the feasibility and utility of microscope-integrated optical coherence tomography in patients undergoing full-thickness neurosensory retinal autograft for refractory macular hole (MH)-associated retinal detachment. METHODS We analyzed two eyes of two patients who had undergone a neurosensory retinal autograft for large MH associated retinal detachment. Both cases had microscope-integrated optical coherence tomography-guided placement and sizing of the retinal autograft. Time taken for obtaining microscope-integrated optical coherence tomography images, morphology of the retinal autograft (intraoperative and postoperative), and anatomic and functional outcomes were noted. RESULTS The first case had optic disc pit-related maculopathy with a large MH and total retinal detachment. She had undergone a vitrectomy with internal limiting membrane peeling elsewhere. The second patient had a treatment-naive large MH with total retinal detachment. Both patients underwent vitrectomy with microscope-integrated optical coherence tomography-guided autologous neurosensory retinal autograft placement and silicone oil tamponade. At 6 months and 3 months follow-up, respectively, both patients had closed MHs, attached retinas, and improvement in visual acuity. CONCLUSION Microscope-integrated optical coherence tomography provides intraoperative visualization of MHs and provides real-time feedback regarding dimensions of the retinal autograft, thus aiding in accurate sizing of the graft. This ensures that the autograft fits snugly in the MH, thereby restoring macular structure and improving visual acuity.

Background: Childhood pneumonia is one of the major causes of under-five mortality in developing countries. Any interventions which can reduce the mortality and morbidity of pneumonia are of great importance. Adjuvant zinc therapy is one such intervention studied in various parts of the world with inconclusive results. Objective: We aim to study the impact of a single dose of zinc therapy on the outcome of childhood severe pneumonia. Material and Methods: Randomized, placebo-controlled study of young children between 2 and 24 months was conducted to study the impact of single dose zinc administration on time to resolution of severe pneumonia. The subjects were assigned two groups, zinc group and non-zinc group, by stratified randomization. The zinc group received unlabeled oral zinc syrup 20 mg of elemental zinc as single dose for children >6 months of age and 10 mg of elemental zinc as single dose for children

Idiopathic intracranial hypertension (IIH) is a common cause of papilledema in young females and causes headache with transient visual loss. Severe visual loss occurs due to optic atrophy or peripapillary choroidal neovascular membrane (PCNVM). PCNVM in IIH has an incidence of 0.5% with a benign course in the majority of patients. Intravitreal Anti-vascular endothelial growth factor agents have anecdotally been used to manage these patients, with complete resolution reported in all cases after a single injection. Our case of IIH-associated PCNVM was treated with three injections of intravitreal ranibizumab with no recurrence at 6-month follow-up.

Noroendokrin tumorler vazoaktif maddelerin salinimindan dolayi genellikle semptomlara yol acarlar. Idrarda yuksek duzeyde 5-hidroksi indol asetik asit belirlenmesiyle tani dogrulanir. Ozellikle gastrointestinal kanalda ortaya ciktiginda bu tipik semptomlar olmayabilir. Gastrointestinal noroendokrin tumorler sessizce gelisirler, bu nedenle baslangic evrelerinde teshis edilmeleri zordur. Ancak dogru bir sekilde tedavi edilirlerse iyi prognoz gosterirler. Bu calismada, sag hemikolektomi uygulanan ve ameliyat sonrasinda numunenin histopatolojik incelemesinde ileocekal noroendokrin tumoru oldugu ortaya cikan bir hastanin basarili yonetimi sunulmaktadir.

Introduction: The reported cases of ‘Slip-And-Fall’ (SAF) injuries among inpatients are increasing at an alarming rate, causing increased morbidity and mortality, productivity losses, financial losses, and raising questions about the healthcare facility’s capacity to provide safe patient care. Moreover, the lack of studies on SAF injuries in Indian healthcare settings impedes attempts to identify and prevent such inpatient injuries in the future. Aim: To the documented causes of SAF injuries and identify the contextual factors related to the injuries. Materials and Methods: A retrospective study conducted in Kasturba Hospital, Karnataka, India, analysis (data from July 31st 2000 to July 31st 2015) of 61 case reports was carried out. A checklist was developed according to the objectives which consisted the time, outcome, area and the root cause of SAF injuries in the study setting. Results: In the present study, out of 61, 28 cases were reported to have occurred in the wards, 21 cases occurred between 7:30 pm and 7:30 am, no noticeable injuries were the outcome in (36%) of the reported cases. Conclusion: The present study concludes by providing recommendations for reducing SAF injuries in hospitals, and for improving the quality of reporting in SAF injury reports.

IntroductionThe SILK flow diverter (SFD) is used for the treatment of complex intracranial aneurysms. Small case series have been reported in the literature but few studies with a large number of patients have been published. We present our experience with the SFD for the treatment of intracranial aneurysms in Canada.MethodsCenters across Canada using SFDs were contacted to fill out a case report form for patients treated with an SFD in their center. Individual centers were responsible for approval from their ethics committee. Image analysis was performed by individual operators. The case report forms were collected and the final analysis was performed.ResultsA total of 92 patients were treated with SFDs in eight centers in Canada between January 2009 and August 2013. The aneurysms were located in the posterior circulation in 16 patients and in the anterior circulation in 76 patients. Most aneurysms (75%) were saccular in shape; 22% were fusiform and 3% were blister aneurysms. The size of the aneurysms varied from 2 to 60 mm with the neck varying from 2 to 60 mm. Perioperative morbidity and mortality were 8.7% and 2.2%, respectively. At the last available follow-up, 83.1% of the aneurysms were either completely or near-completely occluded. The rate of complications was higher for fusiform aneurysms (pConclusionsThe SFD appears to be an important tool for the treatment of complex intracranial aneurysms. Treatment outcomes and complication rates remain a problem, but should be considered in the context of available alternative interventions. Ongoing analysis of flow-diverting stents for radiographic and clinical performance is required.

The frequency of nosocomial fungal infections is being increased because of the advent of newer diagnostic and therapeutic techniques. Among various fungal pathogens, Candida spp. are the cause of substantial morbidity and mortality in hospitalized patients, especially among critically ill hospitalized patients. The frequency of non-ablicans spp. of Candida (NAC) causing nosocomial infections is increasing. The Candida infections are usually endogenous, however, the exogenous infections may also occur. The important predisposing factors leading to nosocomial candidiasis include treatment with broad spectrum antibiotics, immunosuppression, malignancy, surgical intervention, diabetes and prolonged hospitalization. Virulence factors like adherence to biotic and abiotic substances and production of hydrolytic enzymes play important role. Also the biofilm forming ability makes it more noxious. Nosocomial Candida infections are difficult to diagnose clinically and refractory to therapy. Therefore, rapid and accurate laboratory diagnosis is very important to provide appropriate antifungal treatment. This review is structured to know the key factors responsible for emergence of Candida spp. as important nosocomial pathogens. The available data suggests that the nosocomial infections caused by Candida spp. should be dealt through awareness and constant vigilance.

Introduction: Tracheostomy is commonly used to secure the airway during the immediate postoperative period in maxillofacial oncological operations. We conducted a study to review the utility of elective tracheostomy in head and neck surgery. Aim: To review the incidence of intraoperative, perioperative and postoperative complications and its management in elective tracheostomy and to analyse its utility in head and neck surgery. Materials and Methods: The study included review of 50 patients, who were treated for head and neck cancers in the Department of Oral And Maxillofacial Surgery of our centre between January 2011 to December 2014. Results: The study showed a male predilection with mean tracheostomy time of 25 minutes and operative time of 11 hours. The patients had an ICU stay of two days and elective ventilation of one day with mild tracheal secretion seen postoperatively. No other complications were noted intraoperatively or postoperatively. Conclusion: Elective tracheostomy even though an invasive tool when used properly in selected patients, can be safe and beneficial to the patients.

To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs). Retrospective, non-consecutive, comparative, interventional case series. Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments. The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued. Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9). 25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

Background: Neonatal mortality rate (NMR) is one of the major contributors to infant mortality rate. The neonatal mortality depends on many factors birth weight, gestational age, post-natal care; it also depends on maternal social and environmental conditions which contribute to the social determinants of maternal health. This study was taken up to identify maternal social determinants contributing to outcome among outborn neonates in order to reduce neonatal deaths. The present was conducted to assess the outcome among the outborn neonates and assess the maternal social determinants of health affecting the outcome.Methods: A cross sectional study conducted in sick newborn care units (SNCU), Hassan Institute of Medical Sciences, Hassan among all out born neonates. After taking prior written consent, all mothers/bystanders of outborn neonates were interviewed using predesigned, pretested semi-structured proforma. Social factors, environmental conditions and antenatal care affecting the maternal health were collected. Neonatal outcome data was collected from SNCU register. The mothers/bystanders of outborn neonates not willing to give consent and re-admitted neonates were excluded from the study. Data analysis was done using SPSS V20.0.Results: Of 353 outborn neonates admitted, 16.1% was mortality rate. Number of antenatal care visits, consumption of iron tablets, gestational age, high risk mother, staff attending delivery, birth weight, referral time (at p≤0.5) and distance from hospital, passive smoking exposure, maternal services utilization (at p-value

Background: Present observational study, to surveying the growth of children with thalassemia from Solapur District, Maharashtra State, India. Aims: The purpose of this article is to determine the growth of thalassemia in children by analyzing age and gender. One hundred twenty five thalassemic children’s with age 6 months to 18 Years, coming for to get blood transfusion from different parts of Solapur district during June 1st , 2009 to May 1st, 2013. The questionnaires included general information, medical and dental history. Results: This clinical research studied 125 patients, 73 males and 52 females. The growth of thalassemic children was observed and compared with Indian Standard Height Chart. Normal growth was: male (13.61%), female (19.23%) avarage (16.00%); growth retardation was: male (86.30%), female (80%) averages (84.00%) were observed. Conclusions: Thalassemia major is a serious medical problem. Growth retardation is commonly seen in poly-transfused beta thalassemia patients. DOI: http://dx.doi.org/10.3329/bjms.v14i1.16149 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.22-25

Wound bed preparation is the management of a wound in order to accelerate endogenous healing or to facilitate the effectiveness of split-skin grafting. The formation of a healthy wound bed is a prerequisite to the use of advanced wound care products. Unless this is achieved, even the most sophisticated and expensive materials are unlikely to function correctly. An attempt has been made to use 3% citric acid ointment for wound bed preparation to prepare wound for grafting in five cases of wounds with large raw areas infected with multiple antibiotic-resistant bacteria.

Background: Scorpion stings are common in India. Presentation of scorpion sting may vary from localised pain at the site of the sting to life threatening condition. Systemic envenomation will even result in death among one third of the subjects. The present study was conducted to determine the clinical presentation, course, complications and outcomes of scorpion sting envenomation among children as they are sensitive to scorpion envenomation.Methods: 50 cases of scorpion sting, admitted to 2 hospitals, under JJMMC, Davangere for 1 year were included. A detailed clinical history followed by examination was done. Relevant investigations were also done. All the cases were monitored for complications and managed accordingly.Results: Maximum number of cases were noted in the age group of 1-3 years and 10-12 years. 58% of them were boys, 54% of the cases had red scorpion sting. Pain at the sting site, diaphoresis and restlessness were the most common presenting symptoms. The common signs noted were restlessness, cold extremities and tachycardia. Commonest complications were peripheral circulatory failure, pulmonary oedema, myocarditis and congestive cardiac failure. Majority of cases recovered without any sequelae.Conclusions: Present study we conclude that majority of the cases were among boys belonged to 1-3year age group. Red scorpion sting was common, and commonest presentation was pain and recovered without any sequelae.

Background: Placenta plays a major role in growth and development of the fetus as it helps in both exchange of nutrients and removal of waste. Even though it yields a valuable information of prognostic significance for the newborn, majority of the time it will be discarded after the gross examination. Hence the present study was conducted to determine the placental pathology and its correlation with fetal outcome.Methods: The present study was carried out in Davangere for a period of 2 years. The placenta of 100 parturients, more than 28 weeks of gestation were included for the present study. The data was collected after detailed review of the obstetric case records. Placentas were examined soon after delivery. After the gross examination was complete, the placentas were put in a labelled plastic container. The placentas were re-examined macroscopically again by the pathologist. Cut-section examination was done. Then, at least 4 appropriate blocks were taken for each placenta. They were stained with hematoxylin-eosin stain and examined under the microscope. The histopathological examination was conducted as per proforma.Results: One hundred placentae belonging to one hundred babies were studied among which 80% of the maternal cases had anaemia, 68% were term infant, 37% had IUGR. Eccentric insertion of the cord was observed to be the commonest (51). Marginally inserted membranes were seen most frequently (97).Conclusions: In the present study we conclude that placental reserve is large and small alteration do not affect the pregnancy outcome. The placental changes are not specific to a particular condition affecting the pregnancy.

Context: Earlier evidences show that periodontitis with inflamed and ulcerated crevicular or pocket epithelium surrounding the teeth may be a portal of entry for bacteria into the bloodstream. A newly proposed causal model predicts that an early bacteremia may affect the endothelial surface of the heart over many years and promote valve thickening rendering the heart valve susceptible to vegetation by a later bacteremia that would culminate over a few weeks into fulminant infection. Evidence Acquisition: In this review, various published sources of information pertaining to periodontitis, bacteremia and infective endocarditis were reviewed. This review is focused on the role of the viridans group streptococci (VGS) in periodontitis, bacteremia and infective endocarditis. Results: The viridans group streptococci present in the oral cavity were the most important causes of bacteremia following dental procedures and infective endocarditis. In most of the studies, significantly higher rates of bacteremia occurring in patients with periodontitis than patients without periodontitis indicated that periodontitis opens up the route for oral streptococci to gain entry into the bloodstream. In addition, the significantly higher rates of isolation of the VGS from the patients of infective endocarditis with periodontitis showed that there was a positive association between periodontitis, infective endocarditis and the VGS. Conclusions: The literature survey presented in this review suggests that there is a definite relation between periodontitis, bacteremia and infective endocarditis and would provide valuable data for the future dentists as well as the physicians, because a large proportion of the world’s population lives a lifetime with periodontitis. Moreover, infective endocarditis still remains a cause of concern as this disease is a cause of considerable morbidity and mortality regardless of modern antimicrobial and surgical treatment.

Ischemic stroke following snake bite is rare. We report a 35 year female developed right sided hemiplegia with left UMN facial palsy with broca’s aphasia following a snake bite.CT brain plain showed acute large infarct in left middle cerebral artery territory. The possible mechanisms for cerebral infarction in this scenario include disseminated intravascular coagulation, toxin induced vasculitis and endothelial damage.

A 54 year old female patient reported to the Department of Conservative Dentistry and Endodontics, with the chief complaint of dull aching pain in the lower right front teeth region since one month. History of present illness revealed intermittent pain with hot and cold stimuli for the past three months. Past dental history revealed asymptomatic, endodontically treated right mandibular first premolar. The patient’s medical history was noncontributory.

Background and objectives Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible, invariably fatal fibrotic lung disease with no lasting option for therapy. Mesenchymal stem cells (MSCs) could be a promising modality for the treatment of IPF. Aim of the study was to investigate improvement in survivability and anti-fibrotic efficacy of human adipose-derived mesenchymal stem cells (AD-MSCs) in comparison with pirfenidone in the bleomycin-induced pulmonary fibrosis model. Methods Human AD-MSCs were administered intravenously on day 3, 6 and 9 after an intra-tracheal challenge with bleomycin, whereas, pirfenidone was given orally in drinking water at the rate of 100 mg/kg body weight three times a day daily from day 3 onward. AD-MSCs were labelled with PKH-67 before administration to detect engraftment. Disease severity and improvement was assessed and compared between sham control and vehicle control groups using Kaplan-Meier survival analysis, biochemical and molecular analysis, histopathology and high resolution computed tomography (HRCT) parameters at the end of study. Results Results demonstrated that AD-MSCs significantly increase survivability; reduce organ weight and collagen deposition better than pirfenidone group. Histological analyses and HRCT of the lung revealed that AD-MSCs afforded protection against bleomycin induced fibrosis and protect architecture of the lung. Gene expression analysis revealed that AD-MSCs potently suppressed pro-fibrotic genes induced by bleomycin. More importantly, AD-MSCs were found to inhibit pro-inflammatory related transcripts. Conclusions Our results provided direct evidence that AD-MSC-mediated immunomodulation and anti-fibrotic effect in the lungs resulted in marked protection in pulmonary fibrosis, but at an early stage of disease.

Introduction Spontaneous regeneration of bone is commonly seen in the small surgical defects caused by enucleation of cysts. However, in case of large surgical defects caused by the enucleation, spontaneous regeneration of bone is a rare phenomenon and it depends on factors, such as age of the patient, intact periosteum, and proper stabilization. Materials and methods The study included 16 patients, who reported to the department of oral and maxillofacial surgery with the complaint of pain and swelling in the jaws diagnosed as cyst. The sample included equal numbers of male and female subjects aged between 15 and 40 years. Panoramic radiographs were taken pre- and postoperatively on day 2 of the enucleation. The dimensions of the cyst were evaluated on the radiograph according to the proforma. Subsequent radiographs were taken at regular intervals of 1.5, 3, and 6 months using standard parameters and were analyzed using MCID™ analysis software of imaging research. Results Mean reduction was seen in up to 39 and 60% in the cystic cavity size and increase in the mean density up to 59 and 90.2% at 3 and 6 months intervals respectively. Conclusion Spontaneous bone regeneration was seen even after primary closure of the large cystic defect without the need for placement of foreign substances or grafts and it also eliminated the complications resulting from placement of foreign substance. Further studies are required in a larger sample with longer follow-up durations to confirm the outcome of the present work for the benefit of patients. Clinical significance The present study depicted that spontaneous bone regeneration can occur with accepted results after simple enucleation of jaw cyst without the aid of any graft material. Hence, simple enucleation may be considered as a first line of treatment modality for cystic lesion of the jaws. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications. Follow-up is necessary along with patient's compliance for the success of treatment. How to cite this article Wagdargi SS, Rai KK, Arunkumar KV, Katkol B, Arakeri G. Evaluation of Spontaneous Bone Regeneration after Enucleation of Large Cysts of the Jaws using Radiographic Computed Software. J Contemp Dent Pract 2016;17(6):489-495.

Background: Forward head posture (FHP), the most common deviation from the normal curvature in cervical spine. Craniocervical flexor muscle strengthening is frequently used treatment for FHP. Scapular dykinesia (SD) is the alter ation in the normal static or dynamic motion of the scapula during coupled scapulohumeral movements. Shoulder stabilization exercises are an effective treatment for SD. As both FHP and SD are related to each other, the objective of the study was to find and compare the effect of FHP correction and shoulder stabilization exercises on SD and shoulder proprioception. Methods: 40 athletes (18-30yrs) were recruited. Subjects were randomly allocated into two groups. Group A received deep neck flexor strengthening and anterior scalene stretch, group B received shoulder stabilizing exercises. Paired t test and chi-square test were used to judge the statistical significant difference. The level of significance was set at p < 0.05. All data was analyzed using SPSS program version 12. Result: No statistical significant difference was found between the groups for the 4 outcome variables, but significant improvement was seen within the groups. Shoulder proprioception was found to be significant between the groups where group B (p =

The need to cover the exposed periostium has meant that a number of materials including mucosal and skin grafts are regarded as suitable for grafting in oral and maxillofacial surgery. To circumvent the disadvantages of other materials such as skin, biological membranes have been suggested as options, including fetal membrane. The objective of the present study was to evaluate the clinical efficacy of amnion as a graft material for vestibuloplasty, to increase the depth of the sulcus for complete rehabilitation with dentures in 10 patients with a follow up period of 3 months. Ten patients with deficient depth of the mandibular vestibular sulcus who were referred from the Department of Prosthodontics were listed for mandibular labial vestibuloplasty using Clark's technique followed by grafting with amnion over the denuded periostium. The vestibular depth was evaluated at the end of the 1st week, 2nd week, 4th week, and 3rd month postoperatively, and compared with the preoperative vestibular depth. We had no cases of graft necrosis either complete or partial. However, the reduction in the depth of the labial vestibule ranged from 17% to 50% after 3 months’ follow up. A mean (SD) labial vestibular depth of 13.3 (1.8) mm was achieved immediately postoperatively, and 10.0 (3.1) mm at 3 months’ follow up. We conclude that grafts of amniotic membrane are viable and reliable for covering of the raw surface, prevent secondary contraction after vestibuloplasty, and maintain the postoperative vestibular depth.

In contrast with many other countries, isoniazid preventative therapy is not recommended in clinical care guidelines for human immunodeficiency virus (HIV)-infected persons with latent tuberculosis (TB) in India.Seven hundred fifteen HIV-infected mothers and their infants were prospectively followed up for 1 year after delivery at a public hospital in Pune, India. Women were evaluated for active TB during regular clinic visits, and tuberculin skin tests were performed. World Health Organization definitions for confirmed, probable, and presumed TB were used. Poisson regression was performed to determine correlates of incident TB, and adjusted probabilities of mortality were calculated.Twenty-four of 715 HIV-infected women who were followed up for 480 postpartum person-years developed TB, yielding a TB incidence of 5.0 cases per 100 person-years (95% confidence interval [CI], 3.2-7.4 cases per 100 person-years). Predictors of incident TB included a baseline CD4 cell count200 cells/mm(3) (adjusted incident rate ratio [IRR], 7.58; 95% CI, 3.07-18.71), an HIV load50,000 copies/mL (adjusted IRR, 3.92; 95% CI, 1.69-9.11), and a positive tuberculin skin test result (adjusted IRR, 3.08; 95% CI, 1.27-7.47). Three (12.5%) of 24 women with TB died, compared with 7 (1.0%) of 691 women without TB (IRR, 12.2; 95% CI, 2.03-53.33). Among 23 viable infants with mothers with TB, 2 received a diagnosis of TB. Four infants with mothers with TB died, compared with 28 infants with mothers without TB (IRR, 4.71; 95% CI, 1.19-13.57). Women with incident TB and their infants had a 2.2- and 3.4-fold increased probability of death, respectively, compared with women without active TB and their infants, controlling for factors independently associated with mortality (adjusted IRR, 2.2 [95% CI, 0.6-3.8] and 3.4 [95% CI, 1.22-10.59], respectively).Among Indian HIV-infected women, we found a high incidence of postpartum TB and associated postpartum maternal and infant death. Active screening and targeted use of isoniazid preventative therapy among HIV-infected women in India should be considered to prevent postpartum maternal TB and associated mother-to-child morbidity and mortality.

Giant cell tumor (GCT) of bone is a benign but locally aggressive tumor with tendency for local recurrence. Here we report a case of giant cell tumor of the right sided distal radius treated by en-bloc resection and reconstruction arthroplasty using autogenous non-vascularized ipsilateral proximal fibular graft. Early radiological union at host-graft junction was achieved at 12 weeks and solid incorporation with callus formation was observed at 20 weeks. Functional range of motion of the wrist was 20 degrees dorsiflexion and 20 degrees palmerflexion. Grip strength was moderate. Soft tissue recurrence and fibulo-carpal subluxation was not observed. Reconstruction arthroplasty of wrist following en-blocresection of GCT of the distal radius with non-vascularized proximal fibular graft was found useful in preserving the movements and functions as well as stability of the wrist.

BACKGROUND: Balance is highly integrative dynamic process involving coordination of multiple neurological pathways that allows for the maintenance of the COG over BOS . Football players often perform lower extremity passing , shooting , twisting , cutting and dribbling skills while wearing shoes , these actions require body to be in the equilibrium position to perform the task . This leads to t he conclusion of the great importance of the ability of balance in football . AIMS: 1 . To study the effect of 4 week multidirectional balance board training on dynamic balance in football players . 2 . To study the effect of 4 week Both Sides Up ball training on dynamic balance in football players . 3 . To compare the effect of multidirectional balance board training program and BOSU ball training program on dynamic balance in football players . STUDY DESIGN: Randomized Clinical trial . METHODS: Total of 60 competitive badminton players with age group between18 - 25 were recruited in this study . The participants were allocated into 2 groups viz ., Group A (multidirectional balance board training) and Group B (BOSU ball Training) for a period of 4 we eks . Participants were test for SEBT and vertical jump test on first day and after 4 weeks of balance training . STATISTICAL ANALYSIS: Student t test , Chi - Square Test . RESULTS: The data analysis and statistical inference showed that , after 4 weeks of balanc e training there was improvement in dynamic balance in both the groups but there was no significant difference in dynamic balance between two groups . As seen by difference in the SEBT and VJT scores pre and post training with p

A case of 45-years-old male patient with a large non-healing ulcer over right leg is reported. Patient was a known case of chronic liver disease and was having multiple underlying problems. The ulcer was not responding to conventional treatment for more than one month. This non-healing ulcer was treated simply by local application of three percent citric acid ointment every day for a month, which led to complete healing of the ulcer without any complications.