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Aim: To evaluate the acceptance of Dentist, Parents and child to therapy pets, child’s choice of pet and to analyse attitude of dentist towards animal-assisted therapy in the paediatric dental et-up as an aid to improve behaviour of the child during the dental treatment. Materials and Methods: A descriptive cross-sectional survey was conducted among 60 children and their parents and 108 dentists. Chi-square test was used to determine the association of independent variables with each of the main outcome of interest. Results: The consent to the presence of pet was given by 56.67% parents (p=0.0359, Significant) Children who chose dog as their preferred pet were 46.67% those who chose cat as their preferred pet were 25% (p=0.049, Significant) Almost 76% Dentist agreed that AAT helps in behaviour management for Pediatric dentist (p=0.0001,S). Conclusion: Animal-Assisted Therapy (AAT) can prove to be a good behaviour management technique and can be a part of the exclusive Pediatric dental clinic. Keywords: Animal-assisted therapy, Pediatric Dentist

Objective Literature regarding utility of 68 Ga-DOTATATE PET/CT in insulinoma localization across various subgroups [benign/malignant/multiple endocrine neoplasia-1 (MEN-1) syndrome associated] remains scarce. In this study, the performance of 68 Ga-DOTATATE PET/CT was compared with contrast-enhanced computed tomography (CECT) and 68 Ga-NODAGA-Exendin-4 PET/CT (whenever available) in an endogenous hyperinsulinemic hypoglycemia (EHH) cohort. Design Retrospective audit. Patients EHH patients [N = 36, lesions (n) = 49, final diagnosis: benign sporadic insulinoma (BSI) (N = 20), malignant insulinoma (N = 4, n = 14), MEN-1 syndrome associated insulinoma (N = 9, n = 15), Munchausen syndrome (N = 2) and drug-induced hypoglycemia (N = 1)] having both preoperative imaging modalities (CECT and 68 Ga-DOTATATE PET/CT). Measurements Per-lesion sensitivity (Sn) and positive predictive value (PPV) for histopathological diagnosis of insulinoma. Results Sn and PPV of 68 Ga-DOTATATE PET/CT were 67.3% and 89.2%; 55% and 100%; 85.7% and 100%; and 66.7% and 77% for overall EHH, BSI, malignant, and MEN-1 syndrome associated insulinoma cohorts respectively. Despite having comparatively lower sensitivity in BSI cohort, 68 Ga-DOTATATE PET/CT localized a pancreatic tail lesion missed by other modalities. 68 Ga-DOTATATE PET/CT had comparatively higher sensitivity in malignant insulinoma than BSI cohort. 68 Ga-DOTATATE PET/CT also paved the way for successful response to 177 Lu-based peptide receptor radionuclide therapy (PRRT). In MEN-1 cases, lower PPV as compared with BSI was due to uptake in non-insulinoma pancreatic neuroendocrine tumours (Pan-NET). Conclusions 68 Ga-DOTATATE PET/CT has supplemental role in selected cases of BSI with negative and/or discordant results with CECT and 68 Ga-NODAGA-Exendin-4 PET/CT. In malignant insulinoma, 68 Ga-DOTATATE-PET/CT has an additional theranostic potential. Interference due to uptake in non-insulinoma Pan-NET in MEN-1 syndrome may hinder insulinoma localization with 68 Ga-DOTATATE-PET/CT.

It is crucial to determine the safety profile of components used in food or pharma products. Acacia Nilotica exudate gum (ANG) and Soymida febrifuga exudate gum (SFG) have shown similar acacia gum properties, but their safety profile is not studied. In the present study, acute oral toxicity of ANG and SFG was investigated in female Sprague-Dawley rats for 14 days. The study aims to investigate the ANG and SFG exudate gums safety in terms of adverse reactions and mortality. Bodyweight and hematological parameters were monitored from zero-day in the interval of 2 and 7 days, respectively. This showed no significant reduction in ANG and SFG fed groups' body weight compared to the control group. Also, hematological parameters in the animal fed with ANG and SFG showed no considerable change compared to the control group. The significant increase in ALT and AST in the liver homogenate following the administration of 2000 mg/kg aqueous ANG because of the enzyme induction by the high dose of the exudate gums synthesizes the increased enzymes. The histopathological study showed no significant changes in the liver and other organ sections of animals fed with ANG and SFG compared to the control group. The LD50 of SFG and ANG were found to be more than 2000 mg/kg, and it suggested that these gum exudates were safe for food and pharmaceutical applications.

Introduction The coronavirus disease 2019 (COVID-19) epidemic began in Wuhan, China, in December 2019 on January 1, 2020. For dental practices and hospitals in countries/regions that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. Aim and objective To investigate knowledge and perception of COVID-19 among pedodontists in India. Population and methods A quick online cross-sectional study was conducted among 335 pedodontists in India. The questionnaire was sent to 410 pedodontists in India, out of those 335 responded. The study objective and questionnaire were sent to pedodontists via “Google Forms”. The collected data were sent for appropriate statistics. Results Of the total participants, 82% of pedodontists think that children are silent carriers of COVID-19. Sixty-two percent of pedodontists say that it is very difficult to treat pediatric dental patients by use of a personal protective equipment (PPE) kit. Sixty-four percent of pedodontists will overcome this financial crisis by increasing working time and 36% of them by increasing the cost of treatment. Conclusion The role of pedodontists in preventing the transmission of COVID-19 is critically important. Pedodontists’ role in the prevention of COVID-19 is crucial. How to cite this article Sajjanar A, Rojekar N, Gahlod N, et al. Knowledge and Perception of COVID-19 among Pedodontists in India: A Quick Online Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(S-1):S98–S101.

Background: The clinical outcome of anti-HIV therapy is poor due to the inherent fallouts of anti-HIV therapy. It is further worsened due to the presence of viral reservoirs in immune cells like the macrophages. An ideal anti-HIV therapy must reach, deliver the drug and exert its action inside macrophages. To address this, we developed novel cationic nanostructured lipid carriers of efavirenz (cationic EFV-NLC). Methods: The developed cationic EFV NLCs were evaluated for particle size, zeta potential, encapsulation efficiency, in-vitro drug release, DSC, XRD, TEM, cytotoxicity, cellular uptake studies and anti-HIV efficacy in a monocyte-derived macrophage cell line (THP-1). ANOVA was used for statistical analysis. Results: Cationic EFV-NLCs showed high encapsulation efficiency (90.54 ± 1.7%), uniform particle size distribution (PDI 0.3-0.5 range) and high colloidal stability with positive zeta potential (+23.86 ± 0.49 mV). DSC and XRD studies confirmed the encapsulation of EFV within NLCs. Cytotoxicity studies (MTT assay) revealed excellent cytocompatibility (CC50 13.23 ± 0.54 µg/mL). Fluorescence microscopy confirmed the efficient uptake of cationic EFV-NLCs, while flow cytometry revealed time and concentration dependant uptake within THP-1 cells. Cationic EFV-NLCs showed higher retention and sustained release with 2.32-fold higher percent inhibition of HIV-1 in HIV-1 infected macrophages as compared to EFV solution at equimolar concentrations. Interestingly, they demonstrated 1.23-fold superior anti-HIV efficacy over plain NLCs at equimolar concentrations. Conclusion: Cationic NLCs were capable of inhibiting the viral replication at higher limits consistently for 6 days suggesting successful prevention of HIV-1 replication in infected macrophages and thus can prove to be an attractive tool for promising anti-HIV therapy.

BACKGROUND Electrolyte balance plays key role in maintaining homeostasis along with fluids in paediatric patients. The higher and lower value of critical electrolytes like sodium, potassium and chloride can affect cellular processes drastically as it may result in cardiac and neurological complications. This can alter patient status in terms of morbidity and mortality. Hence, Electrolyte imbalance significantly affects the quality of life of the patient. In this study we have analysed three electrolytes; sodium, potassium and chloride. The accurate measurement of electrolytes is an important prognostic indicator in PICU patients where greater attention and proper analysis is recommended. METHODS 180 paediatric patients in the age group of 2-15 years with various critical illnesses admitted in PICU of a tertiary care hospital were included in the study. The serum samples were analysed on Transasia Biomedicals XL 640 – a fully automated biochemistry analyser which has Ion Selective Electrode (ISE-Na/K/Cl) and diffraction grating for high resolution measurement. RESULTS Out of the 180 paediatric patients enrolled for the study, 83 were females and 97 were males. Hypernatremia was observed in 35% patients while hyponatremia in 31%. Hyperkalaemia was observed in 27% patients while hypokalaemia in 14%. Hyperchloremia in 24% while hypochloraemia 5% patients. CONCLUSIONS The electrolyte balance plays a key role in treatment of patients admitted in PICU. The accurate measurement of electrolyte like sodium, potassium & Chloride is an important prognostic indicator where greater attention and proper analysis is recommended. Also, the presence of electrolyte imbalance at the time of admission is an important prognostic indicator in critically ill children irrespective of primary disease process and needs to be addressed aggressively. The study helped us in maintaining the electrolyte ‘homeostasis’ in the body which is vital for the organ’s support and optimal function and also evaluating therapies and matching severity of illness in the PICU.

Background: Primary Tubulointerstitial Nephritis (TIN) is inflammation of predominantly tubular & interstitial compartment without involving glomeruli and vessels, which may be due to varied etiologies. Drugs are the most common culprit for Primary TIN worldwide. Here we studied a series of primary TIN in renal biopsies at a tertiary care center. Methods: In this retrospective study of ten year duration, we have studied all cases of primary TIN with history of drug intake. We reviewed these cases for symptoms, etiology and histomorphological features. Results: A total of 54 cases of primary TIN were described. The age range of the patients was 6 to 72 years with mean of 47.8 years. Pedal edema, puffiness of face were the most common symptoms followed by oliguria. Non-Steroidal Anti-Inflammatory (NSAIDs) were found to be the most common group of drugs causing acute TIN resulting in acute kidney injury (AKI). These are followed by antibiotics and ayurvedic/indigenous preparations. Acute TIN was more commonly seen histopathology than chronic TIN. Conclusion: NSAIDs are most common cause of TIN followed by ayurvedic drugs. Timely diagnosis and withdrawal of offending agent with prompt treatment may help to preserve or improve renal function.

Rationale and introduction To evaluate the computerised tomography (CT) characteristics of phaeochromocytoma (PCC) that differentiate them from other non-benign adrenal masses such as adrenocortical carcinoma (ACC), primary adrenal lymphoma (PAL) and adrenal metastases (AM). Methods This retrospective study was conducted at a tertiary health care institute from Western India. Patients presented between January 2013 and August 2016 with histological diagnosis of PCC or other non-benign adrenal mass having adequate reviewable imaging data comprising all four CECT phases were included. Results The study cohort consisted of 72 adrenal masses from 66 patients (33 PCC, 22 ACC, 4 PAL, 13 AM). Unlike other masses, majority of PCC (25/33) showed peak enhancement in early arterial phase (EAP). PCC had significantly higher attenuation in EAP and early venous phase (EVP), and higher calculated percentage arterial enhancement (PAE) and percentage venous enhancement (PVE) than other adrenal masses (P Conclusion Peak enhancement in EAP, PAE value ≥100% and EAP attenuation ≥100 HU differentiate PCC from other malignant adrenal masses with high specificity.

There is a dire need for dual-long-acting therapy that could simultaneously target different stages of the HIV life cycle and providing a dual-prolonged strategy for improved anti-HIV therapy while reducing oxidative stress associated with the prolonged treatment. Thus, in the present work, nanostructured lipid carriers of Etravirine were developed and modified with nano-selenium. The dual-loaded nanocarrier system was fabricated using the double emulsion solvent evaporation method, further screened and optimized using the design of experiments methodology. The spherical core-shell type of a system was confirmed with an electron microscope and small-angle neutron scattering, while XPS confirmed the presence of selenium at the core-shell of the nanocarrier. In vitro assessment against HIV1 (R5 and X4 strains) infected TZM-bl cells exhibited higher efficacy for the dual-loaded nanocarrier system than the plain drug, which could be attributed to the synergistic effect of the nano-selenium. Confocal microscopy and flow cytometry results exhibited enhanced uptake in TZM-bl cells compared to plain drug. A significant increase of GSH, SOD, CAT was observed in animals administered with the dual-loaded nanocarrier system containing nano-selenium, suggesting the protective potential of the lipidic nanoparticle containing the nano-selenium. Improvement in the in vivo pharmacokinetic parameters was also observed, along with a higher accumulation of the dual-loaded nanocarrier in remote HIV reservoir organs like the brain, ovary, and lymph node. The results suggest the potential of a dual-loaded formulation for synergistically targeting the HIV1 infection while simultaneously improving the intracellular anti-oxidant balance for improving a prolonged anti-HIV therapy.

Macrophages act as a cellular reservoir in HIV infection. Elimination of HIV from macrophages has been an unfulfilled dream due to the failure of drugs to reach them. To address this, we developed CD44 receptor-targeted, novel hyaluronic acid (HA)-coated nanostructured lipid carriers (NLCs) of efavirenz via washless layer-by-layer (LbL) assembly of HA and polyallylamine hydrochloride (PAH). NLCs were subjected to TEM analysis, size and zeta potential, in vitro release and encapsulation efficiency studies. The uptake of NLCs in THP-1 cells was studied using fluorescence microscopy and flow cytometry. The anti-HIV efficacy was evaluated using p24 antigen inhibition assay. NLCs were found to be spherical in shape with anionic zeta potential (-23.66 ± 0.87 mV) and 241.83 ± 5.38 nm particle size. NLCs exhibited prolonged release of efavirenz during in vitro drug release studies. Flow cytometry revealed 1.73-fold higher uptake of HA-coated NLCs in THP-1 cells. Cytotoxicity studies showed no significant change in cell viability in presence of NLCs as compared with the control. HA-coated NLCs distributed throughout the cell including cytoplasm, plasma membrane and nucleus, as observed during fluorescence microscopy. HA-coated NLCs demonstrated consistent and significantly higher inhibition (81.26 ± 1.70%) of p24 antigen which was 2.08-fold higher than plain NLCs. The obtained results suggested preferential uptake of HA-coated NLCs via CD44-mediated uptake. The present finding demonstrates that HA-based CD44 receptor targeting in HIV infection is an attractive strategy for maximising the drug delivery to macrophages and achieve effective viral inhibition.

The inadequate bioavailability and toxicity potential of antiretroviral therapy limit their effectiveness in the complete eradication of HIV from viral reservoirs. The penetration of these drugs into the brain is challenging because of the unfavorable physicochemical properties required to cross the membranes, limiting the transport of the drugs. Thus, in the current study, the authors report a nanocarrier-based drug delivery of a highly hydrophobic drug to overcome the existing limitations of the conventional therapies. An explicitly simple approach was used to overcome the limitations of existing anti-HIV therapies. The monophasic hot homogenized solution of lipid, drug, and solubilizer was diluted with the predetermined hot surfactant solution followed by the ultrasonication to generate the polydisperse nanoparticles with the size range of 50-1000 nm. The anti-HIV1 potential of nanostructured lipid carriers of Etravirine on HIV-infected cell lines showed efficacy with an appreciable increase in the therapeutic index as compared with the plain drug. Further, the results obtained from confocal microscopy along with flow cytometry exhibited efficient uptake of the nanocarrier loaded with coumarin-6 in cells. The pharmacokinetics of Etravirine nanostructured carriers was significantly better in all aspects compared to the plain drug solution, which could be attributed to molecular dispersion in the lipid matrix of the nanocarrier. A significant enhancement of Etravirine concentration of several-fold was also observed in the liver, ovary, lymph node, and brain, respectively, as compared to plain drug solution when assessed by biodistribution studies in rats. In conclusion, ETR-NLC systems could serve as a promising approach for simultaneous multi-site targeting and could provide therapeutic benefits for the efficient eradication of HIV/AIDS infections.

Glucose meters are excellent tools for self-monitoring of blood glucose especially in the circumstances where continuous monitoring is mandatory and at decision-making levels. Tight glycemic control protocols are important for preventing ill effects of fluctuating glucose levels. As technology advances, glucometers are getting better in terms of quality of results. The purpose here is to study the quality of glucose meter results in terms of clinical outcomes. The study was conducted in a tertiary care referral hospital. A total of 125 patients were recruited from pediatric wards. Bland-Altman plot, Parke error grid, and surveillance error grid analysis were used for comparing the results of the glucose meters with a standard laboratory method. It was found that there was a significant difference between the results of the 2 methods. Although usually minimal, the glucose meter results deviated from the results of the standard laboratory method. This will affect overall patient care especially in emergency conditions. Sometimes, the risk may be so high that the patient may be mislabeled as hypoglycemic when they actually are hyperglycemic and vice versa. This study is the first of its kind because no similar studies have been reported in the pediatric population. For effective use of glucose meters, the devices should give as accurate results as possible. Results should not only be accurate but also precise, without which critical errors may be possible. We recommend that for any glucose meter there should be regular calibration so that agreement with the reference laboratory method is maintained and effective medical decisions are possible.

Kimura disease (KD) is a rare, idiopathic chronic inflammatory disorder that usually presents as unilateral painless lymphadenopathy or soft tissue swelling of the head and neck region in young Asian males. The disease lacks pathognomonic clinical and cytomorphological features and can be mistaken for many reactive and malignant conditions. We report three cases of KD presenting as bilateral swelling of the head and neck region, and describe the cytomorphological features of each. In the correct clinical setting, a polymorphous lymphoid aspirate with eosinophils and Warthin-Finkeldey giant cells should raise a suspicion of KD and prompt further work up.

A key challenge of HIV treatment with multiple antiretroviral drugs is patient adherence. Thus, there is an urgent need for long-acting depot systems for delivering drugs over an extended duration. Although the parenteral route is preferred for depot systems, it is associated with obvious drawbacks, such as painful injections, potentially-contaminated sharps waste, and the necessity of trained healthcare personnel for administration. Amongst a small number of alternatives in development microneedles are versatile delivery systems enabling systemic drug delivery and potentially improving patient adherence due to their capacity for self-administration. We have developed dissolving microneedle (DMNs) embedded with etravirine nanosuspension (ETR NS) as a long-acting HIV therapy to improve patient adherence. The ETR NS prepared by sonoprecipitation yielded particle sizes of 764 ± 96.2 nm, polydispersity indices of of 0.23 ± 0.02, and zeta potentials of -19.75 ± 0.55 mV. The DMNs loaded with ETR NS demonstrated 12.84 ± 1.33% ETR deposition in ex-vivo neonatal porcine skin after 6 h application. In in vivo rat pharmacokinetic studies, the Cmax exhibited by DMNs loaded with ETR powder and ETR NS were 158 ± 10 ng/mL and 177 ± 30 ng/mL, respectively. DMN groups revealed a higher t , Tmax, and mean residence time compared to intravenous ETR solutions, suggesting the long-acting potential of etravirine delivered intradermally using DMNs. [Abstract copyright: Copyright © 2021. Published by Elsevier B.V.]

Purpose: The metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin that appear to promote development of cardiovascular disease. It has become one of the most important topics for this decade because of marked increase in cardiovascular disease associated with risk factors. Paraoxonase (PON) is a family of three enzymes, PON1, PON2 and PON3, the gene which is located on chromosome 7. This is high-density lipoprotein (HDL)-associated enzyme with antioxidant activity. The objective of the present study aimed at measurement of PON1 activities in patients with MetS, to compare PON1 activities in patients with MetS with those in controls and assess its relationship with the lipoproteins in serum. Material and Method: Cases were included as per the criteria put forth by the International Diabetes Federation. Serum PON1 activities were measured using spectrophotometer. Statistical analysis was done using SPSS 20.0. Result: Serum PON1 arylesterase and lactonase activities were found to be reduced significantly in patients with MetS than in controls. PON1 activities showed a positive correlation with HDL, fasting blood glucose and diastolic blood pressure. Linear regression analysis showed a significant correlation between PON1 activities and body mass index. Discussion: From the present study, it is clear that reduction in PON1 activities in MetS is mainly due either to abnormalities with synthesis or secretion of HDL cholesterol or oxidative stress as a consequence of excess production of the free radicals. This study also iterates that it is the quality and not the quantity of HDL cholesterol is important while studying the pathophysiology of MetS.

BACKGROUND Adequate symptom relief is a central aspect of medical care in all patients, especially those with incurable diseases. Treatment may help in symptomatic relief, but in some cases palliation is needed. Sometimes, as disease progresses, palliation becomes the paramount goal of care. We have conducted the study to look for the experience and scenario of patients towards PC. The aim of the study is to clarify the number of palliative care services and to obtain information regarding patient’s view about palliative care, we have conducted the study. MATERIALS AND METHODS A cross-sectional non-experimental survey design was used. We have recruited 288 patients. Participants were invited to participate via personal visits, telephonic and email invitations, hospital visits and personnel interview. They were given forms with predefined questionnaire. RESULTS Through this survey, we got the information regarding geographical location, experience, disease from which patient is suffering. Along with this, we also got the information about need of Palliative Care (PC) based on age group and organ system involved. CONCLUSION Present study tells us about the perspective of the patients towards palliative care. It gives an account of need of present situation of palliative care as well as expectations of patients from palliative care. From the present study, it is clear that geriatric population and cardiovascular disorders need palliative care most. In present study, some lacunae also exist. There is great scope for improvement in service and orientation towards palliative care. After all palliative care is meant for ‘adding life to years and not years to life.’

Background Dieulafoy lesion, also known as calibre persistent artery is a rare cause of massive GI bleeding. It’s an abnormal sub-mucosal artery protruding from a minute mucosal defect (≤3 mm). Commonest location is in proximal stomach while occurrence in small intestine, especially ileum is extremely rare. Case presentation A 26 year old female presented with lower gastrointestinal bleeding. Preliminary investigations failed to locate the exact source of bleed. At laparotomy, an ulcerated nodular lesion, approximately 0.8 cm in diameter was identified in distal ileum. Histology revealed it to be Dieulafoy lesion. Conclusion Although uncommon, ileal dieulafoy is one of the causes of obscure gastrointestinal bleeding that could result in treacherous and life-threatening gastrointestinal haemorrhage. Hence, it should be considered in the differential diagnosis of active GI bleeding. The definitive diagnosis is based only on histopathology.

Granular cell tumours are uncommon, usually benign soft tissue tumours. They are thought to be neural, arising from Schwann cells and can occur at various sites. Their occurrence in gastrointestinal tract is rare, the commonest site being oesophagus followed by large intestine. Gastric localization is unusual. A young female presented with abdominal discomfort since 3 months. Endoscopy showed a nodule in the body of stomach. Biopsy revealed features of granular cell tumour on microscopy, which was confirmed by immunohistochemical positivity for S100 and CD68. Wide excision of the tumour was performed. At the 6-month follow-up, patient was asymptomatic. The diagnosis of gastric granular cell tumour is based on endoscopic biopsy. Unless there is histological evidence of malignancy, wide local excision is an adequate surgical treatment.

BK polyoma virus (PV) is one of the commonest post-transplant viral infections, affecting approximately 15% of renal transplantation recipients, leading to graft failure in more than half of cases. The epithelial cells with polyoma viral inclusions in urine cytology specimens are termed "decoy cells" to caution pathologists not to misdiagnose these cells as cancer cells. The infected cells in urinary sediments are characterized by enlarged nucleus, basophilic intranuclear homogenous inclusions, and ground glass chromatin, which may cause diagnostic error in urine cytology. We report five cases of renal transplant patients, in which urine sample was positive for decoy cells. Routine urine cytology of post renal transplant patients with worsening renal function is a useful screening procedure to rule out PV reactivation, before ascertaining transplant rejection. Its cost-effectiveness in addition to the short processing time makes it an invaluable tool in the evaluation of transplant recipients with symptoms suggestive of graft rejection.

The pulsed oxygen plasma treatment (POPT) of the ritonavir (RTV) powder/compacts was investigated as a novel possible physical technique for improving wettability, intrinsic dissolution rate (IDR), and, consequently, solubility of the poorly water-soluble RTV drug. Induction of POPT for 30 min enhanced 5.87-folds apparent solubility and 1.95-folds IDR at 24 h, attributed to RTV's surface hydrophilization. The POPT RTV exhibited zero contact angle compared to RTV suggesting improved wettability (untreated RTV = 74° and 30 min after POPT = 0°). The ATR-FTIR showed a broad peak of –OH group around 3300 cm -1, and XPS showed an increase in surface oxygen concentration from 9 % to 12 % aided through POPT lead to improved wettability of RTV. Moreover, the increased negative zeta potential was observed due to surface hydroxylation on the POPT RTV, resulting in increased surface polarity and RTV's solubility. It was found that there was no substantial thermal or physical alteration after POPT, as evident from DSC, SEM, and XRD studies. This study successfully demonstrated the impact of POPT on improvement in the wettability, solubility, and IDR of hydrophobic drugs RTV.

Background Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there. Methods Present study was conducted in the tertiary care referral hospital. One hundred twenty five patients were recruited from pediatric wards. Bland-Altman plot, Parke error grid and Surveillance error grid analysis were used for comparing results of glucose meter with that of standard laboratory method. Results It is found that there is significant difference between the results by two methods. Though minimal but glucose meter results deviate from the results of standard lab method. This will affect the overall patient care especially in emergency conditions. Conclusions This study is the first of its kind as no similar studies have been reported in the pediatric population. For effective use of glucose meter it should give as accurate as possible estimate of actual glucose levels. Results should not only be accurate but also precise without which critical errors may be possible. We recommend that for any glucose meter there should be regular maintenance as well as calibration is to be done. So that agreement with reference laboratory method is maintained and effective medical decisions are made.

Introduction: Dengue is a highly prevalent mosquito-borne disease which requires serum ferritin and lipid profile testing to understand the severity of the infection. Iron and lipids are essential elements for the formation of viral organelles and the proliferation of DNGV. Hyperferritinaemia correlates with the severity of Dengue virus (DNGV) infection. Serum ferritin level is disproportionately high and indicates the increased risk of developing the complications. Hypolipidaemia is an independent predictor of the severity of dengue infection in critical patients. Due to the unavailability of dengue treatment, there is an upsurge in the demand for a prognostic biomarker for the DNGV infection. In dengue fever, serum ferritin is disproportionately raised compared to any bacterial or viral infection and this elevated level substantiates an increased risk of rising complications. Objective: This study is aimed to investigate the correlation of serum ferritin, platelets and lipid profile with disease severity and if these could serve as a predictive marker for progression to severe disease. Materials and Methods: This cross-sectional, observational study was conducted on 100 subjects (50 cases and 50 controls) in a tertiary care referral hospital in western India. Complete blood count at the time of admission and at 48 hours along with Ferritin, renal and liver function tests, and lipid profile were performed on XL-640 Biochemistry FAA manufactured by Transasia Biomedicals, ERBA Mannheim. Tests to identify the normality of data distribution and tests of correlation were applied. Result: Platelet (p=0.02), total cholesterol (p=0.04), LDL (p=0.04) were found to be decreased while ferritin (p

Cutaneous myxomas are rare benign neoplasms which are frequently associated with Carney complex (CNC). Although more than 500 cases of CNC are reported, there is no literature on cytologic diagnosis of Cutaneous myxomas. An 18-year-old male, with no significant family history, presented with multiple cutaneous swellings, largest measuring 15 cm on the right cheek. He also had spotty skin pigmentations, raised adrenocorticotropic hormone levels and recurrent cardiac myxomas. Fine-needle aspiration cytology from the right cheek and suprapubic swellings revealed paucicellular smears with abundant myxoid material in the background, admixed with fragments of spindle and stellate cells with bland nuclear morphology, and vascular proliferation in few fragments. There was no mitosis, necrosis, or any epithelial element. Hence, diagnosis of cutaneous myxomas in CNC was made which was confirmed on histopathology. This is the first report of cytologic diagnosis of multiple cutaneous myxomas in CNC and the largest cutaneous myxoma reported in literature.

Xanthomas are papulonodular skin lesions present in lipoprotein metabolism disorders, which result in cholesterol deposits in subcutaneous tissue, tendons, ligaments, periosteum, etc. A 11-year-old male presented with multiple soft tissue swellings, prominently over joints. Fine-needle aspiration (FNA) from multiple sites had similar appearance with foamy histocytes and giant cells. Oil Red O and polarized microscopy were also positive for fat. We describe an unusual case of tendinous and tuberous xanthoma diagnosed by cytology. Acquaintance with fine-needle aspiration cytology findings in xanthomas can help to avoid the need of surgical biopsy, as xanthomas can regress on medical therapy alone.

BACKGROUND There are many mosquito-borne infections in the tropical countries including India. Dengue and malaria being the commonest. Despite this, coinfection with dengue fever are scarcely reported in literature and more so in children. Malaria and dengue are rampant illnesses with overlapping presentation. Both have high morbidity and mortality. Coinfection of dengue and malaria are seldom reported, especially in children. Authors wish to quantify the prevalence of this coinfection in this article. MATERIALS AND METHODS Retrospective descriptive design was adopted and ethical committee approval was taken. Indoor record papers of paediatric patients admitted with suspected dengue fever in paediatric ward of RGMC between January to December 2016 were studied. RESULTS Out of 71 confirmed dengue cases, 18 were also positive for malaria (25.35%). Of these confirmed 18 malaria cases, 15 were P. vivax (83.33%) and 3 were P. falciparum (16.6%). The high number of coinfection cases that we got 25.35% suggests that the prevalence of coinfection of dengue and malaria is reasonably high. CONCLUSION Our study highlights the importance of need of awareness on the part of treating paediatricians of dengue coinfection in endemic areas. High index of suspicion should be maintained especially when one infection is found to proactively look for second infection.

Objective: An important predictor for infant survival is birth weight. Normal fetal growth is related to various intrauterine factors. Low birth weight is thought to have relation with oxidative stress which plays an important role in reducing the birth weight. Among the paraoxonase family PON1 protects LDL and HDL from the lipid peroxidation. This is HDL associated enzyme having antioxidant property. We aimed to evaluate the arylesterase and lactonase activity of PON1 in cord blood in relation to birth weight. We hypothesized that cord blood PON1 arylesterase and lactonase activities will be compromised in neonates having low birth weight. Methods: We included 80 neonates born in our hospital irrespective of mode of delivery as 40 cases and 40 controls. PON1 arylesterase and lactonase activity were measured using spectrophotometer. Results: Serum arylesterase activity decreased significantly in low birth weight babies (p

Lipoleiomyomas are benign mesenchymal tumours of smooth muscle and adipose tissue and uncommonly occur in the uterus. Here we report a case of uterine lipoleiomyoma that manifested purely as intravenous component and clinically presented as a large retroperitoneal mass with extension into inferior vena cava and right atrium. The connection of the mass to the corneal end of the uterus was noted only at surgery.

Estimation of stature is an important objective in the identification of an individual from dismembered and skeletal remains in forensic osteology. Stature estimation, however, is a constantly changing target for forensic anthropologists because of the secular trends in stature, allometric changes in long bones, and the migration of world population. It’s a challenging task for forensic anthropologist or forensic medicine personnel to establish the identity of the dead, especially in mass disasters. The present research was hence, undertaken to study the correlation between stature and the length of the sternum. The present study was conducted in a tertiary care referral hospital and medical college in western India. The institutional clinical ethical committee has cleared the study protocol. Cadaver and sternum length was obtained from196 subjects. As we go from manubrium to total sternal length through mesosternum, the area under curve (AUC) goes on increasing. In the similar manner McFadden's Rho-square, Cox and Snell R-square, Naglekerke's R-square all have shown upward trend. The present study concludes that the length of the sternum is one of the reliable predictor of stature in the adult Western Indian population and can be used as a tool for stature estimation when better predictors of stature like the long bones of the limbs are not available during practical forensic case work involving examination of skeletal remains.

Villous adenomas of the urinary tract are uncommon neoplasms which share similar morphological features with gastrointestinal villous adenomas. Only two case series and around 20 scattered case reports of villous adenoma in the urinary tract have been published in English literature till date. They have been identified mainly in the urinary bladder, urethra, prostate and urachus, but the occurrence of villous adenomas at the vesicoureteric junction has not been described. We present a case of villous adenoma of the vesicoureteric junction which completely occluded the lumen and led to gross pyonephrosis.

Since ages, the skin colour is an important issue for human race. Melanocyte abnormalities are mentioned during the fetal developmental stages in literature from ancient cultures. The deciding factor for the pigmentation is melanin. An old notion of melanocyte producing melanin is now obsolete. It is the epidermal unit which is responsible for the process of melanogenesis, production and distribution of the melanin. Various systemic diseases are having hyper or hypo-pigmenatation as their signs. The present review briefly describes a few of these systemic disorders.

Background: In India, the developing economy and growing population simultaneously made a strong impact on increase in motor vehicle population. This increase in motorization has some adverse effects such as increase in road accidents with economic and functional loss. Head injury is the most common cause of mortality in road traffic accidents. The aim of this study was to know the incidence, pattern, mechanism, mode of head injury along with its distribution in relation to site of vault fracture and intracranial hemorrhage.Methods: Total 391 post-mortem cases of head injury were enrolled during study period. The information regarding age, sex, residence, marital status, date and time of time of accident and of death was gathered from police inquest report, relatives, dead body challan and clinical details from hospital records. During autopsy, detailed examination was carried out and data regarding both external and internal injuries were carefully recorded and analyzed.Results: The peak incidence of head injury was observed in the age group of 21-30 years. Most of deceased were from early age group and the male deceased were more than females. Majority victims of head injury were from road Traffic Accidents followed by fall from height, railway accidents and assault. Fissured fracture of vault was found in almost half cases. Subdural and subarachnoid hemorrhage were the most common one we encountered.Conclusions: Head injury due to RTA is well known public health problem causing death and disability. It is required from concerned government authority to take appropriate and immediate measures for reducing the incidence of head injury.

Acute aortic dissection in pregnancy is a rare condition with a potentially catastrophic outcome. The low rate of incidence together with variable presenting features in such circumstances makes diagnosis elusive. A high degree of clinical suspicion and diagnostic acumen is especially required in pregnant women without any history of connective tissue disorder, congenital aortic valvular malformation, or chronic hypertension. In this report, we present a case of aortic dissection with multiple aortic intimal tears in a medicolegal autopsy of a young pregnant woman who developed circulatory collapse and died during labor.

Background Genetic aetiology of pheochromocytoma (PCC) and paraganglioma (PGL) is increasingly being studied; however, Asian Indian data on this aspect are scarce. Objective To study the prevalence of germline mutations and genotype–phenotype correlation in Asian Indian PCC/PGL patients. Design In this study, 150 index patients (M:F, 73:77) with PCC/PGL were evaluated. Phenotypic data were collected. Germline mutations in five susceptibility genes (RET, VHL, SDHB, SDHD and SDHC) were tested by sequencing and NF1 was diagnosed according to phenotype. Result Of the total population, 49 (32.7%) PCC/PGL patients had germline mutations (VHL: 23 (15.3%), RET: 13 (8.7%), SDHB: 9 (6%), SDHD: 2 (1.3%) and NF1: 2 (1.3%)). Amongst the 30 patients with familial and/or syndromic presentation, all had germline mutations (VHL: 14 (46.7%), RET: 13 (43.3%), SDHB: 1 (3.3%) and NF1: 2 (6.7%)). Out of 120 patients with apparently sporadic presentation, 19 (15.8%) had a germline mutation (VHL: 9 (7.5%), SDHB: 8 (6.7%) and SDHD: 2 (1.7%)). Mutation carriers were younger (29.9 ± 14.5 years vs 36.8 ± 14.9; P = 0.01) and had a higher prevalence of bilateral PCC (26.5% vs 2.9%, P P = 0.06). Based on syndromic features, metastasis, location and number of tumours, around 96% mutations in our cohort could be detected by appropriately selected single gene testing. Conclusion Asian Indians with PCC/PGL differ from Western cohorts in having preponderance of VHL mutations in multifocal tumours and apparently sporadic unilateral PCC. Syndromic presentation, metastasis, location and number of PCC/PGL can be effectively used for guiding genetic prioritisation.

To evaluate arylesterase and lactonase activity of paraoxonase (PON)1 in cord blood of neonates in relation to their birth weight. The authors hypothesized that cord blood PON1 arylesterase and lactonase activities will be compromised in neonates having low birth weight.Eighty neonates born in authors' hospital, irrespective of mode of delivery were included. Forty children with low birth weight were included in case group and 40 with normal birth weight were included as controls. PON1 arylesterase and lactonase activities were measured.Serum arylesterase activity decreased significantly in low birth weight babies (p0.05). Linear regression analysis (R = 0.728) indicated significant correlation between arylesterase and birth weight. Serum lactonase activity was also reduced in low birth weight babies. Its linear regression analysis (R = 0.727) indicated significant correlation between lactonase and birth weight.PON 1 activity is significantly reduced among low birth weight babies in comparison to normal weight babies.