Search

Introduction: Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. Objective: To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%). Materials and Methods: This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. Observation and Result: In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48). Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups. Keywords: Celiac plexus, Neurolysis, Alcohol, Abdominal malignancy.

A case of localized argyria in a 36-year-old female jeweler is described who presented with 2 discrete and asymptomatic bluish-black pigmented macules on the pulp of her left middle finger. A skin biopsy from both lesions demonstrated deposition of brown/black pigmented granules along the basement membrane zone of eccrine glands, blood vessels, nerves, and the dermo-epidermal junction fully in keeping with silver deposition. In addition, there was yellow-brown deposition seen within the interstitial dermis mimicking an early form of ochronosis, so called "pseudo-ochronosis." This latter feature is rarely described in cases of argyria. Transmission electron microscopy and energy dispersive x-ray spectroscopy confirmed the presence of electron dense particles up to 150 nm in diameter and the presence of silver, respectively. On further questioning, the patient had a history of localized and chronic exposure to silver, which specifically involved holding and manipulating silver wires and rings over the left middle finger. This case highlights an unusual and rare presentation of localized argyria in a jeweler. In addition, our case showed preferential silver deposition on dermal elastic fibers which has not been previously described in the literature.

Introduction: Adolescent girls often have lack of knowledge and practices regarding reproductive health including menstruation. Objectives: To evaluate effectiveness of structured teaching program (STP) to increase level of knowledge and practices on menstrual hygiene among adolescent school girls. Methodology: Pre-experimental one group pre-posttest study design was applied in four government schools using power analysis for sample size calculation. Data were re- checked for its consistency and analyzed. Descriptive statistical methods were used for describing sample characteristic and inferential statistics was used to evaluate effectiveness of STP. Chi-squared test was used to examine association between selected demographic variables and pretest knowledge level of adolescent girls on menstrual hygiene. Result: The mean age of participants was 13.79 ±1.3 years (range from 11-18 years). Distribution of pre-test knowledge among respondents regarding menstrual hygiene showed, 49.21% moderate and 50.79% adequate knowledge respectively. In the case of post-test, all of them demonstrated adequate knowledge and none of them showed inadequate knowledge. Pre-test practices among respondents regarding menstrual hygiene recorded as 3.75% inadequate, 61.25% moderate and 35.0% adequate practices. The pre-test mean score for the level of knowledge was 13.36±1.64, whereas the post-test mean score was 15.8±0.73. Practice related pre-test mean score was 10.66±1.81 in comparison to, post-test mean score 13.34±0.75. There was no significant association found between knowledge regarding menstrual hygiene among adolescents with socio-demographic variables at p

Introduction: Rupture in an unscarred uterus prior to onset of labor in third trimester is a rare event and very few cases have been reported in literature so far. Case Report 1: We describe a case of a primigravida who presented in emergency with pain abdomen with placenta praevia and severe oligominos. An ultrasound was conducted which reported bicornuate unicollis uterus with single live foetus 33+4 weeks having severe oligohydromnios (AFI=2) with placenta anterior and reaching upto internal os in one cornua, the other cornua was empty. A MRI was conducted, which was also inconclusive. She was taken up for laprotomy, peroperatively pregnancy was present in left horn of uterus which had ruptured with intact amniotic sac and was covered with omentum, the placenta was covering the lower half of the left horn and the right horn looked like normal uterus and was empty. The omentum was carefully separated and baby that was delivered weighed 700gms. The left horn was excised and then uterus was closed in layers. Patient was followed up for 6 months, mother was doing well, though baby was 5 kg which was less than the weight for that age and had slow developmental milestones. Case Report 2: Our second case was a 30 years old gravida 5, para 2, abortion 2 woman with 8 months amenorrhea. She was referred with chief complaint of pain abdomen. On examination, she looked almost stable. Even though she was pale; vital signs were within normal parameters. An ultrasound was conducted which showed single live intrauterine foetus 29+2 weeks with absent liquor with placenta praevia with placenta acreta. Emergency laprotomy was decided in view of placenta acreta. It was found to be an abdominal pregnancy. Amnion along with omentum and blood clot matting sac like structure sitting over the fundus with placenta perforating the fundus small incision was given at the fundus and baby weighing 1.15 kg delivered through it. Placenta did not separate and so decision of hysterectomy taken.

Stenosis, the abnormal narrowing of artery, significantly affects dynamics of blood flow due to increasing resistance to flow of blood. Velocity of blood flow, arterial pressure distribution, wall shear stress and resistance impedance factors are altered at different degree of stenosis. Prior knowledge of flow parameters such as velocity, flow rate, pressure drop in diseased artery is acknowledged to be crucial for preventive and curative medical intervention. The present paper develops the solution of Navier–Stokes equations for conservation of mass and momentum for axis-symmetric steady state case considering constitutive relation for Reiner–Rivlin fluid. Reiner–Rivlin constitutive relation renders the conservation equations non-linear partial differential equations. Few semi-analytical and numerical solutions are found to be reported in literature but no analytical solution. This has motivated the present research to obtain a closed-form solution considering Reiner–Rivlin constitutive relation. Solution yields an expression for axial velocity, which is utilized to obtain pressure gradient, resistance impedance and wall shear stress by considering volumetric flow rate as initial condition. The effect of viscosity, cross viscosity, flow rate, taper angle of artery and degree of stenosis on axial velocity, resistance impedance and wall shear stress are studied.

Background: The persistence of disease in periapical tissues is most commonly associated with difficulties or mishaps which occur during or after initial endodontic treatment. Aims and Objective: To isolate and identify the organisms in root canal failed cases & its current antibiotic susceptibility pattern. Materials and Methods: study was conducted on 51 patients attending the OPD of dental Department Nalanda Medical College and Hospital, Patna. The results were analyzed using VITEK-2 automated analyser (Bio Merieux UK). Results: A total of 18 types of bacteria were isolated and among them 17.3% cases reported E- faecalis and another 15.2% cases reported E-cloacae complex. Pseudomonas aeruginosa accounted for 8.7% while 6.5% constituted of E-faecium, Escherichia coli etc. Conclusion: Enterococcus species was found in majority of cases indicates that it is the predominant bacteria responsible for endodontic failure.

Objective To assess HIV-free survival and nutritional status of HIV-exposed infants. Methods This retrospective cohort study was conducted on infants born to woman with HIV infection born at our Institute between January 2011 to March 2016, and followed using current National guidelines. HIV transmission rate, HIV-free survival, and nutritional status were assessed 18 months age. Results Of the 155 infants, 10 (6.5%) died before 18 months of age. Two of 145 surviving infants were confirmed HIV-positive, the remaining were HIV-negative at 18 months (HIV-free survival 92.3%). Of the 10 infants who died, one was confirmed HIV-positive and three negative; the rest died before their HIV status could be ascertained. HIV infection rate among the 149 infants for whom the test reports were available was 2%. At 18 months age, 14% HIV-uninfected infants were wasted, 28% stunted, and 3% had microcephaly. Conclusions Infants born to mothers with HIV managed as per the current National guidelines have a good outcome at 18 months of age.

Thresholding is a primitive and one of the common operations performed on images for segmentation. They are widely being used in processing of medical images too. When intensity based operations are performed on images for segmentation and separation of specific regions of interest, the discriminability of these intensity based operations are to be analyzed. Discriminability refers to the capacity of the operation to isolate through segmentation, the region of interest (ROI) from the rest of the region unambiguously without performing any other region specific operations such as template based or other complex operations. In this paper, we provide some of our efforts made to identify the discriminability of thresholding operation on the Lung Image Database Consortium-Image Database Resource Initiative (LIDC-IDRI) lung cancer dataset.

Dentistry as a profession is quite demanding and challenging and is also associated with occupational hazards like musculoskeletal disorders and stress-related problems. The practice of yoga has been proven to be efficacious in management of quite a lot of stress and lifestyle disorders. It strengthens one physically, mentally, and emotionally. Moreover, yoga can also be used in the management of dental patients for stress-related oral conditions like lichen planus, burning mouth syndrome, aphthous ulcers, etc., Yoga has also been found to have antiinflammatory, antianxiety effect, and also a lot of other beneficial effects. This review emphasizes on the relevance of yoga in the dental profession, from the practitioners, students, and patients viewpoint. Data pertaining to the subject was obtained after a thorough search of the PubMed literature and Google search engine.

To compare growth, anemia prevalence, and sickness frequency in HIV-exposed uninfected infants on different feeding modes. In this retrospective cohort study, 109 HIV-exposed uninfected infants registered at our center were categorized into three groups as per their feeding mode during first 6 months viz. exclusively breast fed (n=50), animal milk fed (n=40) and commercial infant formula fed (n=19). Their anthropometric parameters, hemoglobin and frequency of sickness at the age of 6 months were compared. There were no significant inter-group differences in the weight for age, weight for length, length for age z-scores (P=0.16, 0.37 and 0.12, respectively); proportion of infants with underweight (P=0.63), wasting (P=0.82), or stunting (P=0.82), and mean hemoglobin levels among the 3 groups at 6 month of age. Animal milk fed and formula fed infant had increased risk of sickness compared to exclusively breastfed infants (OR 2.5 and 2.49, respectively; P

An Electrocardiogram Signal is a bioelectrical Signal which records the heart’s electrical activity versus time. It’s a crucial diagnostic tool for assessing heart functions. The first detection of arrhythmia is essential for cardiac patients. ECG arrhythmia is often defined as any gaggle of conditions during which the guts’ electrical activity is irregular and may cause the heartbeat to be slow or fast. It can happen during a healthy heart and be of minimal consequence, but it’ll also indicate a Significant problem that results in stroke or sudden cardiac death. As the ECG Signal is a non-stationary Signal, the arrhythmia may occur randomly within the time-scale, which suggests, the arrhythmia symptoms might not show up all the time. Still, they would manifest at certain irregular intervals during the day. Thus, automatic classification of arrhythmia is critical in clinical cardiology, especially for treating patients within the medical care unit. This project implements a MATLAB platform simulation tool to detect abnormalities within the ECG Signal and calculate heartbeat. The ECG Signal is downloaded from the MIT-BIH Arrhythmia Database. Since this Signal contains some noise and artifacts hence preprocessing of the ECG Signal is performed first. The preprocessing of ECG Signal is performed with Wavelet toolbox’s help wherein baseline wandering, denoising, and removal of high frequency and low frequency is performed to enhance SNR ratio of ECG Signal. The Wavelet toolbox and FarukUYSAL are additionally used for feature extraction of ECG Signals. Classification of arrhythmia is predicated on basic classification rules. The entire project is implemented on the MATLAB platform. The performance of the algorithm is evaluated on MIT-BIH Database.

BACKGROUND: The cases of intrauterine contraceptive device (IUCD) with missing strings have risen due to increasing popularity of postpartum IUCD in Indian women. This has lead to increase in the burden of referral cases in tertiary care centres. Manual vacuum aspiration (MVA) device is a cheap and non-invasive method, well established for surgical abortion in first trimester of pregnancy. This study was undertaken to assess if MVA device can be used in retrieving IUCD in low resource setting, hence, reducing the need for referral or need of expensive and invasive techniques. METHOD: A prospective interventional study was conducted over a period of 6 months. A total of 50 women who were desirous of IUCD removal with non-visibility of strings at the external cervical os were included in the study. All cases were more than 12 weeks postpartum and had an ultrasound confirmed intrauterine location of IUCD. Women with pregnancy, extrauterine location of IUCD, active pelvic infection and cervical cancer were excluded. RESULTS: The incidence of IUCD with missing strings was 19.4%. Almost a third of the cases (36%) were referred from outside Delhi for IUCD removal to our centre. In 30% cases IUCD could successfully be removed using the MVA device. Majority of the IUCDs were inserted in hospital by a gynaecologist (90%), and most of the insertions were post-placental (62%). CONCLUSION: Retrieval of IUCD with missing strings with MVA device is a novel method and can be an initial approach in low resource setting before referral to a higher centre for management.

Objective The aim was to find the prevalence of colonization of vagina with aerobic bacteria among low-risk Indian women in active labor and its association with early-onset neonatal sepsis (EONS) and puerperal sepsis. Methods The study was conducted prospectively from October 2018 to March 2020 in a tertiary hospital in New Delhi, India. Low-risk pregnant women (N=920) in active labor with intact membranes were recruited. High vaginal swabs were collected, cultured by standard methods to detect aerobic bacteria. The primary outcomes were the development of puerperal sepsis and EONS. Results In a total of 920 low-risk subjects, vaginal colonization was found in 484 (52.6%), coagulase-negative Staphylococcus being the predominant colonizer (13.2%) followed by Escherichia coli (8.9%). Multigravida women were at 1.4 times higher risk of colonization than primigravida (odds ratio [OR] 1.399; 95% CI 1.064, 1.84). Women whose sample was collected at the first vaginal examination were at 0.34 times lower risk of colonization as compared to women with more than one vaginal examination (OR 0.34; 95% CI 0.241, 0.481). The incidence of colonization increased with progressive vaginal examinations (p

Background Episiotomy is a common procedure in vaginal deliveries. It was thought that episiotomy reduces the risk of severe perineal injuries, but now in various studies it has been observed that it is associated with increased perineal pain, sexual problems, and incontinence in the postpartum period. Purpose This study was carried out to assess pain score on first postnatal day in women with episiotomy during breastfeeding and daily activities. Method The consecutive patients who underwent normal vaginal delivery with episiotomy from November 1, 2020 to December 1, 2020 in the Department of Obstetrics and Gynecology at Safdarjung Hospital were evaluated. The patients with vulval edema; vulval hematoma; instrumental delivery; and cervical, vaginal, and perineal tear were excluded from the study. The episiotomy pain during routine activities and breastfeeding was assessed at first postnatal day by Visual Analogue Scale (VAS) pain score. The analysis of variance (ANOVA) was used to compare the VAS score in different positions for breastfeeding and routine activities. The most comfortable posture was with lowest VAS pain score. Results and conclusion Overall 73 patients were enrolled in the study, mean age was 23.48 ± 2.49 years, 47/73 (64.38%) were primigravida, and mean birth weight of neonate was 2.79 ± 0.43 kg. The mean VAS pain score during breastfeeding in crossed-leg position was 74.82 ± 28.33, and in left lateral position, the score was 14.51 ± 11.65 (p [U1] = 0.0001). The mean VAS pain score during resting position in sitting with leg down was 56.52 ± 21.23, and in left lateral position, the score was 21.25 ± 13.95 (p= 0.0001). The VAS score was increased as the birth weight (p= 0.302), and the duration of second stage of labor was increased (p = 0.047). The severe pain was in 5/73 patients using Western toilet and in 46/73 Indian toilet (p≤ 0.0001). Conclusion The left lateral position for breastfeeding and resting supine are least painful positions. The Western-style toilets are more comfortable than Indian-style toilets.

Background and Objective: Glossopharyngeal nerve block (GNB) technique has been used as alternative of treatment of cancer and noncancer pain of the oral cavity. The objective of the study is to compare the two approaches (extraoral and intraoral) of GNB in patients of carcinoma of the tongue in terms of efficacy, duration, and complications. Materials and Methods: This was a prospective comparative randomized study over a period of 1 year. Fifty patients of either sex of ASA physical status and 2, between 21 and 70 years of age, suffering from carcinoma of the tongue, were selected. The patients were randomly divided into two groups. Group I received 4 mL of 0.5% bupivacaine combined with 40 mg, of triamcinolonacetonide by extraoral approach of GNB, and Group II received the same amount of drug by intraoral approach of GNB. Hemodynamic parameters, degree of pain relief using visual analog scale (VAS), number of attempts, effect on quality of life (QOL), and complication were noted during the performance of GNB. Results: Demographic profile in both groups was comparable. Rate of complication and number of attempts to complete intervention were higher in Group I, which was found to be statistically significant. However, mean VAS scores in Group I were significantly higher as compared to those in Group II during most of the study period starting from the 1st follow-up at 30 min to the 2nd month postintervention (P Conclusion: The intraoral approach of GNB was better with respect to pain control and improvement in QOL whereas the rate of complication and number of attempts was lower in extraoral approach of GNB.

Lung nodule segmentation is an essential step in any CAD system for lung cancer detection and diagnosis. Traditional approaches for image segmentation are mainly morphology based or intensity based. Motion-based segmentation techniques tend to use the temporal information along with the morphology and intensity information to perform segmentation of regions of interest in videos. CT scans comprise of a sequence of dicom 2-D image slices similar to videos which also comprise of a sequence of image frames ordered on a timeline. In this work, Farneback, Horn-Schunck and Lucas-Kanade optical flow methods have been used for processing the dicom slices. The novelty of this work lies in the usage of optical flow methods, generally used in motion-based segmentation tasks, for the segmentation of nodules from CT images. Since thin-sliced CT scans are the imaging modality considered, they closely approximate the motion videos and are the primary motivation for using optical flow for lung nodule segmentation. This paper also provides a detailed comparative analysis and validates the effectiveness of using optical flow methods for segmentation. Finally, we propose methods to further improve the efficiency of segmentation using optical flow methods on CT scans.

Aim: The purpose of this study was to compare the canal transportation, centering ability, canal curvature, dentin removal, the volume of the curved root canals, and time taken during and after instrumentation with Wave One, Reciproc, F360, and One shape (OS) by using cone-beam computed tomography (CBCT). Materials and Methods: According to the file systems used for canal preparation, eighty mesiobuccal canals of mandibular molars were distributed into four groups (20 samples each): OS (Group 1), F360 (Group 2), Wave One (Group 3), and reciproc (Group 4). According to the manufacturer's instructions, all groups were prepared until size 25 taper. Canals were scanned using CS three-dimensional CBCT scanner (Carestream) before and after preparation at 2 mm, 5 mm, and 8 mm from the apex. The data collected were evaluated using SPSS software with ANOVA and post hoc for a significant difference. Results: Significant difference was found between the entire group at 2 mm and 5 mm (P = 0.021) and at 8 mm (P = 0.037), where F360 showed the least canal transportation. The mean values for centering ability were not found significant at 2 mm and 5 mm. OS proved to remain more centered than the other groups. Curved canals were instrumented better with minor canal straightening by using Reciproc. The dentin was removed more by using Wave One, whereas least dentin was removed by F360. During pre- and post-instrumentation scans the change in volume of the root canal were not found statistically significant. Wave One showed the maximum increase in the volume of the canal after instrumentation. For the preparation of the canal, the time taken was less with reciproc as compared to other groups. Conclusion: Therefore, according to the study single-file rotary instrument like F360 used in the continuous rotation is suitable instrument for the root canal preparation followed by Reciproc, OS, and Wave One.

Neurological disorders have aroused a significant concern among the health scientists globally, as diseases such as Parkinson’s, Alzheimer’s and dementia lead to disability and people have to live with them throughout the life. Recent evidence suggests that a number of environmental chemicals such as pesticides (paraquat) and metals (lead and aluminum) are also the cause of these diseases and other neurological disorders. Biomarkers can help in detecting the disorder at the preclinical stage, progression of the disease and key metabolomic alterations permitting identification of potential targets for intervention. A number of biomarkers have been proposed for some neurological disorders based on laboratory and clinical studies.In silicoapproaches have also been used by some investigators. Yet the ideal biomarker, which can help in early detection and follow-up on treatment and identifying the susceptible populations, is not available. An attempt has therefore been made to review the recent advancements ofin silicoapproaches for discovery of biomarkers and their validation.In silicotechniques implemented with multi-omics approaches have potential to provide a fast and accurate approach to identify novel biomarkers.

Introduction: Choriocarcinoma ovary is a rare neoplasm. It is gestational or nongestational. Very few cases of NGCO have been reported. Case Report: We describe a case of a multiparous 31 year old woman who came to gynae receiving room with acute pain abdomen in shock. On examination abdominal distension with ascitis was present. On pervaginal examination uterus was bulky, os was closed and tenderness in right fornice was present. Her UPT was positive and blood was aspirated in culdocentesis. Emergency laprotomy was done with a provisional diagnosis of ectopic pregnancy, followed by right sided salpingoophrectomy with left sided tubal ligation. A right ovarian mass around 6X7 cm was found ruptured and was bleeding profusely. There was 2 liters of haemoperitoneum. Patient was transfused 2 units of PCV and 4 units of FFP. Postoperative period was uneventful. Her βhcg levels were 42,416, 48 hours postsurgery. Histopathological and immunohistochemical report were suggestive of nongestational Choriocarcinoma ovary showing sheets of cytotrophoblastic and syncytiotrophoblastic cells and extensive areas of haemorrhage and necrosis. Patient was started on BEP chemotherapy. Computed tomographic scan revealed no brain or lung metastases. Though she took 3 cycles and went LAMA.She was followed up on phone and was reportedly alive and healthy. Keywords: Choriocarcinoma, Non gestational, Ovarian cancer.

Campylobacteriosis is a deadly disease which has developed resistance to most of the available chemotherapeutic agents. Although various studies provide evidence of acquired immunity following exposure to Campylobacter jejuni, no effective vaccine has been developed, still. Hence, there is an urgent need to identify potential vaccine candidates for Campylobacter species. In the proposed study, Campylobacter jejuni subsp. jejuni serotype O:2 (strain NCTC 11168) was taken and computational approach was employed to screen C. jejuni genome for promising vaccine candidates. From 1623 protein-coding sequences, 37 potential antigens were screened for epitope prediction based on surface association, consensus antigenicity predictions, solubility, transmembrane domain, and ortholog analysis. Comprehensive immunogenic analysis of these 37 antigens revealed that antigen Q0PA22 shows the greatest potential for experimental immunogenicity analysis. It has several potential CD4+ and CD8+ T-cell epitopes, as well as high probability of B-cell epitope regions as compared to well-characterized antigen Omp18 (Uniprot ID:Q0PC24). Among the highest scoring predicted epitopes, an optimal set of epitopes with respect to overall immunogenicity in target populations for campylobacteriosis viz. Europe, North America and Southwest Asia was determined. An epitope AMLTYMQWL from antigen no. 6(Q0PA22) binds to the most prevalent allele HLA-A*0201, and this epitope has most immunogenicity for all the target populations. In addition, this epitope exhibited highly significant TCR-pMHC interactions having a joint Z value of 4.87. Homology mapping studies of the predicted epitope show best homology to a well-studied antigenic peptide from influenza virus H5N1. Therefore, the predicted epitope might be a suitable vaccine candidate.

Image based Lung cancer diagnosis offers an effective and non-intrusive method for identification and diagnosis of lung cancer in a patient. This is done by segmentation of lung nodules from radiological images obtained from patients. This paper proposes a framework to segment nodule lesions in images. The novelty of the proposed framework is that we use optical flow information along with the morphological operations on images. The proposed framework applies the Farneback method of optical flow extraction algorithms for the nodule segmentation task. This work validates and demonstrates that optical flow information is useful for nodule segmentation and can be used in tandom with other features.

Context: Celiac plexus block (CPB) (is an effective way to reduce cancer-associated pain in upper abdominal malignancies. Aims: To evaluate the efficacy and safety of different volumes of 70% alcohol in CPB. Settings and Design: Prospective, randomized, controlled clinical study. Subjects and Methods: Thirty patients of carcinoma gall bladder were randomly divided into three groups (n = 10) to receive 20, 30, and 40 ml of 70% alcohol in CPB. Statistical Analysis Used: All the continuous data were assessed analysis of variance followed by post-hoc tests (Tukey′s Honestly Significant Difference test). Ordinal data were compared using Kruskal-Wallis H-test followed by Mann-Whitney U-test. Categorical comparisons were performed using Chi-square test. Results: A significant difference in visual analog scale (VAS) score of Group I, Group I and Group III was observed from week 6 onward until the end of the study. At all these time intervals, VAS scores in Group I was higher than both Groups II and III during this time interval. VAS scores in Group III were significantly lower as compared to Group II from week 10 onward until the end of the study. As compared to baseline, at all the follow-up intervals, mean morphine requirement was significantly lower in Group II and Group III. A quality of life (QOL) score of Group III were higher as compared to Group I. Between Group II and Group III, significant difference was observed at week 16 only when Group III had a higher score as compared to Group II. Conclusions: VAS score, QOL, and reduction in morphine consumption were increased on increasing the volume of alcohol in CPB, 40 ml being most effective.

Background: Endodontically treated teeth with extensive loss of tooth structure lacks sufficient support for a permanent restoration. While restoring them with post and core it is important not to disrupt the apical seal. Aim: Evaluation of apical leakage after immediate and delayed postspace preparation using two root canal sealers. Materials and Methods: Sixty single-rooted teeth were decoronated and roots were biomechanically prepared and obturated with gutta-percha and 2 sealers: AH Plus (Group A, n = 30) and Sure-Seal root canal sealer (Group B, n = 30). Groups A and B were subdivided into A1, A2 and B1, B2. Postspace was prepared immediately for A1 and B1. For A2 and B2 post space was prepared after storage in physiologic saline for 1 week. The samples were kept in Rhodamine B dye for 72 h and then sectioned longitudinally to observe dye penetration along the root canal wall under Stereomicroscope. The dye penetration was measured linearly and the values were subjected for statistical analysis using one-way analysis of variance and t-test. Results: Statistically significant difference between Group A (1.00 mm) and B (2.71 mm) was observed (P < 0.001). However, the subgroups for immediate and delayed post space preparation did not show statistically significant difference (A1 = 0.947; A2 = 1.043; B1 = 2.306 and B2 = 3.120, P < 0.001). Conclusion: AH plus sealer showed lesser leakage compared to Sure-Seal Root canal sealer. The difference in leakage values was not statistically significant in delayed and immediate post space preparation groups, Time of postspace preparation has no influence on apical leakage.

Uterine leiomyosarcomas are rare aggressive tumors, with high recurrence rates, even when confined to the uterine corpus at the time of diagnosis. It arises from smooth muscle of uterus and is a rare tumor that accounts for 2-5% of all uterine malignancies. These tumors typically spread hematogenously. Patients present with vague symptoms similar to those of patients with leiomyomas. Most patients are diagnosed with leiomyosarcoma postoperatively. Although prognosis remains dismal, various ongoing studies are investigating the role of advanced imaging, multimodality treatment, prognostic nomograms, and unique biomedical pathways to increase understanding of leiomyosarcoma and improve therapeutic options for patients. 46 years old para2 live2 postmenopausal (since 1.5 year) female presented to outpatient clinic with complaints of bleeding per vaginum, foul smelling discharge, unquantified weight loss and something coming out of vagina since 1.5 months. On abdominal examination, an irregular midline mass arising from pelvis corresponding to 20 weeks gestational size of uterus was present. On vaginal examination, 3 infected vaginal growths were present in vagina maximum 4x4cm. Intra-operatively, uterus was nearly 20 weeks size with irregular surface. A 3×3 cm subseroal fibroid with necrotic surface was present on posterior wall of uterus. Cut section of the operative specimen showed myohyperplasia which was compressing the uterine cavity, some necrotic areas were also present. Vaginal growths - 4×4 cm on left vaginal wall near introitus with necrotic surface, 3×3 cm on right vaginal wall, 1×1 cm on right upper vaginal wall present. Excision of vaginal growth was done and was sent for histopathology. Histopathologic examination of sections of uterus showed all features were suggestive of leiomyosarcoma uterus.

The trends in the acceptability of contraceptives is globally shifting from permanent sterilisation to long acting reversible contraceptive (LARC). With the increasing use of IUCD, the knowledge of its common and rare complications has become pertinent. One of them is cervical perforation in which strings are mostly visible and hence it can be easily missed. Here we present a rare case of cervical perforation which was timely detected before it could have caused more damage. A patient complaining of IUCD associated pain should undergo thorough examination and a probability of perforation should be kept in differential diagnosis despite string visibility. A clinician has to be more vigilant about this rare complication to prevent damage to cervix and avoid unwanted pregnancy.

3-Arylbenzopyran based non-steroidal osteogenic agents have been explored as structural templates of estrogen and vitamin-D3. The target molecules 18a–c, 19a–c, 26a–c, 27a–c and intermediates 17a–c and 25a–c were studied for their osteogenic activity in an osteoblast differentiation assay in vitro using mouse calvarial osteoblast cells. Compounds 25c, 26b, 27b and 27c effectively increased ALP activity at 1 pM concentration compared to the untreated cells. The active compounds were devoid of inherent toxicity at 1 pM concentration in osteoblast cells. The most active compound, 27b, was studied for mineralization of osteoblast cells and expression of marker genes, viz. BMP-2, RUNX-2 & Osx, involved in osteogenesis. Molecular docking analysis performed for 27b showed its possible interactions with estrogen receptor-α and -β (ER-α and ER-β) as well as the vitamin-D receptor (VDR).

In this paper, we have tried to encapsulate the recent developments in the field of Symmetry based approaches to detect tumor and then came up with a new parameter which plays a crucial role in proving that a high degree of Symmetry is present in an axial normal human brain MRI (Magnetic resonance Imaging) and this symmetry get affected or not present in abnormal cases highlighting the fact that tumor might be present. This paper also reveals one of the major technical flaw or loophole that is present in almost all Symmetry based approaches to detect tumor. As Symmetry is one of the most important properties of a human brain that can be utilized to detect the presence of tumor and other anomalies present in the human Brain. This paper tried to provide the proof of symmetry in human brain through a pixel based analysis using a number of neuro images cases. For the pixel based analysis T2 weighted MRI modality images are used. In this paper we are using T2 MRI images because in it an anomaly appears Hyper intense (brighter than the normal brain tissue).

Background Children living with HIV (CLHIV) commonly experience growth failure. We report growth parameters in CLHIV at baseline and during 3 years of antiretroviral therapy (ART). Methods Records of CLHIV who had completed at least 3 years on ART were reviewed after excluding subjects who died, were lost to follow-up or developed treatment failure to assess impact of sustained administration of ART. Height-for-age (HFA) and body mass index for age (BFA) Z scores were calculated, and proportion of CLHIV with wasting and stunting estimated at baseline, 6, 12, 24 and 36 months after starting ART using the linear mixed model. Factors influencing significant changes in growth parameters were assessed. Results HFA Z score improved steadily from -3.12 at baseline to -2.33 at 36 months of ART. The prevalence of stunting declined from 77.7% to 59.2% during this period. BFA Z scores improved from -1.2 at baseline to -0.4 at12 months on ART but declined to -1.0 at 36 months. The proportion of subjects with wasting was 29.3%, 9.7% and 16.7% at baseline, 12 and 36 months, respectively. Baseline clinical stage (1 + 2), absence of wasting and lower HFA Z score had significant positive influence on changes in HFA Z score, while younger age at ART initiation and a low baseline BFA Z score had a positive influence on catch-up in body mass index. Including data of children who died or developed treatment failure did not impact upon the results. Conclusion Majority of CLHIV are stunted at the start of ART. ART was only partially effective in countering malnutrition and growth failure in CLHIV.

A series of substituted 8,8-dimethyl-8H-pyrano[2,3-f]chromen-2-ones (chromeno-coumarin hybrids) was synthesized from scopoletin (11) as vasorelaxing agents. The synthesized compounds 21a-f, 22, 23a-e and scopoletin (11) were evaluated for vasorelaxation in endothelium intact rat main mesenteric artery (MMA). Compounds 11, 21a, 21c-f and 22 showed significant vasorelaxation in precontracted MMA within the range of EC50 value 1.58–5.02 µM. These derivatives presented 29.40–70.89 fold increased sensitivity for experimental tissue compared to scopoletin (11), the parent molecule. Among others, 22 was found to be the most active compound which had EC50 1.58 µM with 70.89 fold increased sensitivity. The mechanistic evaluation of 22 showed that it exerted vasorelaxation through Ca2+-activated K+ (BKca) channel and the effect was endothelium-independent.

BACKGROUND To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. METHODS Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. RESULTS Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. CONCLUSIONS CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

A 36-year-old man of Pakistani origin presented with a 10-year-history of unilateral lesions involving his left arm, left torso and left leg. The lesions were painful following showers and on light touch. He was otherwise well with no significant past medical history. There was no family history of similar lesions and his parents were non-consanguineous. On examination, groups of firm reddish brown papules were seen over the left hand side of the body (Fig. 1). The lesions did not cross the midline. On histological examination of a Unilateral Eruption of Painful Papules: A Quiz

Mosquito-borne flaviviruses (MBFVs) are important cause of emerging and re-emerging human diseases nearly worldwide, transmitted by arthropod vectors (mostly aedes and culex mosquitoes), with particular reference to yellow fever virus, Japanese encephalitis virus, dengue fever virus, St. Louis encephalitis virus, Murray Valley encephalitis virus, etc. In over 100 countries, more than 2.5 billion people are at risk of infection, and approximately 20 million infections are reported annually. Through the analysis of gene sequence data of these virus populations it is possible to infer phylogenetic relationships, which in turn can yield important epidemiological information, including their demographic history. Early attempts to define the evolutionary relationships and origins of viruses in the genus flavivirus are hampered by the lack of genetic information particularly amongst the MBFVs. In this study, complete genome, translated polyprotein, structural and non-structural proteins of MBFVs have been targeted and revealed an extensive series of clades defined by their epidemiology and disease associations. The branching patterns of at the deeper nodes of the resultant trees were different from those reported in the previous study. The significance of these observations is discussed.

Japanese encephalitis (JE) is an acute central nervous system inflammatory disease caused by the Japanese encephalitis virus (JEV). JEV is a small, enveloped, plus-strand RNA virus belonging to the genus Flavivirus. In this study, envelope protein (E) that mediates the entry of JEV into host cell has been preferred as potential molecular target for drug development. The 3-D structure of E protein was designed and validated using modeler9.10 and procheck tool, respectively, and also optimized using molecular dynamics simulation. A number of lead molecules were used for computational virtual screening against JEV E protein. Three top ranked lead molecules with strong binding affinity to JEV E protein were identified based on minimum binding energy. Molecular dynamic simulation was also performed for protein–ligand complex to study the mobility of complex at various time intervals. Drug likeliness and comparative bioactivity analysis for these leads using OSIRIS Property Explorer had shown that these molecules would have the potential to act as better drug. The mycophenolate was found to be most suitable as entry inhibitor therapeutic molecule for JEV E protein, which may be considered as a potential ligand for treatment of Japanese encephalitis.

A microwave-induced technique has been developed for the synthesis of a series of novel spiro indoline-based heterocycles (7a–g) at atmospheric pressure in an open vessel using an environmentally benign procedure. This rapid method produces pure products in good yields within a few minutes in comparison to the conventional procedure developed for the synthesis of these heterocycles. The synthesized compounds have been screened in vitro for antifungal activity against two fungal strains (i.e., Aspergillus niger and Aspergillus flavus). All compounds have shown significant activity against these pathogens. [Supplementary materials are available for this article. Go to the publisher's online edition of Synthetic Communications® for the following free supplemental resource: Full experimental and spectral details.]

Aim Prevalence of oral mucosal lesions and conditions among children of 12 and 15 years of age of Lucknow. Material and methods 1198 school going children were selected by multistage cluster random sampling technique. A total of 594 respondents from urban area and 604 from rural area were surveyed for the present study. Oral mucosal lesions were assessed using WHO Oral Health Assessment form 1997. Chi-square test was used to test the significance of the association between two factors. Results In urban 16 (2.69%) subject had ulceration and 6 (1.01%) had other condition like angular cheilitis and glossitis. In rural 9 (1.49%) had ulceration and 28 (4.63%) had angular cheilitis and glossitis, considering the age group and gender wise no significant differences were noted. There was a statistical significant difference seen in urban and rural group ( p Conclusion Health education through dental health programs regarding adverse effects of pan chewing should be spread in all schools and colleges.

Introduction Root canal preparation leads to deviation of the canal anatomy causing canal transportation which affects the success of the treatment. Cone Beam Computed Tomography (CBCT) is a non invasive imaging technique to analyse the shape of the root canal before and after the preparation. Aim The purpose of this study was to investigate and evaluate the canal transportation in curved mandibular molar root canals and centering ability of Reciproc and One Shape file systems after instrumentation using CBCT. Materials and methods Twenty mandibular molars were taken and allocated into two groups (n=10): Group 1-One Shape and Group 2-Reciproc. The canals were then scanned using CS 3D CBCT scanner (Carestream) before and after preparation, to assess the transportation and centering values at different levels respectively from the apex. The data gathered were then assessed statistically with Mann-Whitney test. Results Analysis revealed that Reciproc and One Shape showed statistically no significant difference in terms of canal transportation and centering ability (p>0.05). Conclusion One shape and Reciproc performed similar in terms of canal transportation & centering ability.

A cyclization of chalcones with guanidine yields benzo[h]quinazolines which can be easily further converted to compounds (VII) or (IX).

Background Oral submucous fibrosis (OSMF) is a wellestablished precancerous condition affecting the oral mucosa. It is a disease that causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). Aim The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF. Materials and methods Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent. Group A included 20 patients who received Aloe vera gel (forever living gel) along with physiotherapy. Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day. The following parameters, that is, burning sensation, mouth opening, tongue protrusion and cheek flexibility were recorded at each visit. Results Majority of the participant enrolled were in the age range of 30 to 35 years. Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants. Conclusion So, Aloe vera being a soothing, simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF. The analgesic effects of Aloe vera with the physiotherap exercises provide better results in reducing burning sensation and improving mouth opening, tongue protrusion and cheek flexibility in comparison to antioxidants. How to cite this article Singh N, Hebbale M, Mhapuskar A, Ul Nisa S, Thopte S, Singh S. Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis. J Contemp Dent Pract 2016;17(1): 78-84.

Background: The small delta antigen protein of hepatitis delta virus (HDV) has been shown to be important for replication of the virus and essential for the viral life cycle. Therefore, it may be an appropriate target for designing biological experiments for drug development to identify the potential inhibitors of hepatitis D. Objectives: To identify a novel molecule as possible drug candidate for the treatment of Hepatitis D. Materials and Methods: In the present study, a computational approach was used for the identification of novel small-molecule inhibitors against HDV replication using docking studies. An Autodock tool was used for docking and identifying the active binding sites in target proteins. The Lipinski filter and preADMET program were also used for deter- mining the pharmacokinetic properties in order to filter out potential ligand molecules to restrain virus replication. Results: Our results suggest that pyridinone (3-((4,7-dichloro-1,3-benzoxazol-2-yl) methylamino)-5-ethyl-6-methyl-pyridin-2(1H)-one) is a validated potential inhibitor of HDV replication and could be as a novel antiviral drug for the treatment of hepatitis D. Counclusions: We have identified a novel antiviral drug by using innovative computa- tional approaches. The results provide a basis to experimentally develop into drug which can be used for the treatment of delta hepatitis.