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BACKGROUND Second Hand smoke (SHS) exposure to children causes several systemic problems like asthma, dental problems like caries and effects overall well being. This study was conducted to study impact of SHS on primary school children by associating it with dental caries, cotinine level, asthma severity and overall well being. METHODS Case control study was conducted amongst 200 children 9-15 years old that came to dental college in Muradnagar. Children who lived in smoking households were identified as SHS subjects-100 children and those who lived in non smoking households were identified as control group- 100 children. Parents completed questionnaire regarding their smoking status. In children's questionnaire severity of asthma was determined by using expert panel report (EPR3), dental caries was recorded by dmft index and psychological assessment of children was done using WHO- 5 well being index. Collection of unstimulated saliva of children was done in sterile plastic tubes and cotinine level was measured using enzyme-linked-immunosorbent assay (ELISA). Students t test and one way analysis of variance (ANOVA) was used for analysing data. RESULTS Mean number of children suffering from asthma was higher in SHS subjects in comparison to control group i.e. 348.9 ±166.509 and 247.3±15.86 respectively. dmft and WHO- well being scores increased as level of cotinine increased. Mean cotinine level was higher in SHS subjects than control group i.e. 348.9 ±166.509 and 247.3±15.86 respectively. CONCLUSIONS SHS has an adverse impact on young children reflected by poor dmft scores and psychological well being, increased cotinine levels and asthma severity in comparison to control group.

Aim: To study effect of educational status of Anganwadi Workers on oral health education program and its impact on improving oral health of preschool children in Muradnagar block, Ghaziabad. Materials and Methods: Study was done amongst 30 Anganwadi Centres of Muradnagar selected by simple random sampling. Sample size was calculated to be 503. Anganwadi Workers were divided into four groups depending on their educational status. Pre tested questionnaire was used to assess baseline knowledge of Anganwadi workers on oral health. Oral health education was imparted to them. Clinical examination of preschool children attending Anganwadi centres was done at baseline and after oral health education program. Data was analysed using descriptive statistics and Statistical Package for Social Sciences software version 18. Results: Mean values of knowledge scores were found to be higher in Anganwadi workers (36.7) with high educational status leading to higher improvement (76%) in oral health status of preschool children. Conclusion: Educational Status of Anganwadi Workers has a significant impact on their oral health knowledge and efficiency of improving oral health status of preschool children. Keywords: Educational status, Anganwadi workers, Pre school children.

Breast cancer is a carcinoma of mammary glands, which starts off as abnormal proliferation of ductal cells. This could, then, become either benign tumours or metastatic carcinomas. It is one of the most common causes of deaths because of cancer, and is one of the most common types of cancer in women in the whole world. India along with the US and China accounts for one-third of the breast cancer burden. The breast cancer carcinogenesis is attributed to epigenetics, which is the study of the reversible changes in the phenotype without any change in the DNA sequence. Genes, which are concerned with proliferation, anti-apoptosis, invasion, and metastasis, have been seen undergoing epigenetic changes in breast cancer. Cancer can be caused either by global hypomethylation (causing activation of oncogenes and leading to chromosomal instability) or by locus-specific hypermethylation (causing repression of gene expression and genetic instability due to inactivation of DNA repair genes). Other epigenetic mechanisms involved in carcinogenesis are histone modification and nucleosomal remodeling.

Objectives: The purpose of this study was to assess the effectiveness of various health education methods for improving oral health knowledge of accredited social health activists (ASHA) and Anganwadi workers of Muradnagar Block, Ghaziabad-Delhi NCR. Methods: A promotive interventional study was conducted amongst 301 ASHA and Anganwadi workers of Muradnagar block at three steps such as baseline, oral health education programme (OHEP), and reinforcement to assess their oral health knowledge using predesigned, close-ended, validated, questionnaire. Four different methods were used in OHEP to disseminate knowledge, namely, health talks, posters, and pamphlets, PowerPoint presentations, and a combination of all methods. Post-assessment was done one week after OHEP followed by reinforcement after 1 month which was followed by final post-assessment after 1 week. Students’ independent t-test and one-way ANOVA were used for analysing data. Results: At baseline, primary healthcare workers had mean knowledge scores as 14.67 ± 1.152 which was increased to 20.96 ± 1.053 after the intervention and 27.6 ± 0.762 after reinforcement. There was an increase of 7.6% and 14.3% of primary healthcare workers giving correct responses after OHEP and reinforcement, respectively. Conclusions: The combination method was the most effective in improving oral health knowledge of study population followed by posters and pamphlets and the least effective method was PowerPoint presentation. Dentists can play a vital role in mobilising the primary healthcare workers by consequently contributing towards improving the oral health status of the community.

How to cite this article: Sarma U, Mishra V, Aier I, et al. Staphylococcal Pyopericardium: A Rare and Fatal Complication Following a Common Viral Disease. Indian J Crit Care Med 2021;25(6):739-741.

Background: Oral health objectives prescribed by World Health Organization for the year 2020 have expressed that there ought to be an expansion in the quantity of people with functional dentitions (at least 21 common teeth) at ages of 35–44 and 65–74 years. Aim: The aim of this study is to examine the prevalence of tooth loss and to evaluate and compare the risk indicators associated with tooth loss among adult population in urban and rural areas of Muradnagar, Ghaziabad. Materials and Methods: A cross-sectional study was led among 1200 adults aged 35–74 years in urban and rural areas of Muradnagar, India. Information was assembled by an interview followed by clinical examination (number of missing teeth). Demographic and socioeconomic factors and self-perceived oral health were the independent variables assessed. One-way analysis of variance, post-hoc test (Bonferroni), Chi-square test, Student's t-test, and logistic regression analysis were used for statistical analysis. Results: Low educational status, no dental check-ups, low frequency of brushing, older age, and smoking habit were independent risk factors for tooth loss. The odds of tooth loss in older adults and illiterates were higher; the odds for tooth loss among those who expressed their desire for replacement of missing teeth were 1.3 times lower than their counterparts. Conclusion: The experiences gained up showed that tooth loss was very pervasive in Muradnagar populace and the critical hazard indicators identified were age, education, socioeconomic status, and cigarette smoking.

Aim: To assess the association between maternal dental anxiety and its effect on the oral health status of their child, in Murad nagar –An institutional cross-sectional study. Materials and Methods: Among the randomly selected 200 mother-child pairs, a cross-sectional study was done. The children of 2–5 years were selected for the study. A five-level Modified Dental Anxiety Scale (MDAS), Hindi edition, was used to assess dental anxiety among the mothers. Clinical examination of the wards was finished by using a modified gingival record and WHO dentition status (2013). The SPSS software version 20 was used for statistical analysis. Results: Approximately, 61% of the children were males, and 39% were females. The modified gingival index (MGI) score was high, if there should arise an occurrence of high MDAS values. The mean MGI score was most astounding in phobic class of MDAS and least in the not anxious classification. The MGI score expanded on increment in maternal anxiety. Dental caries expanded in kids, if there should be an occurrence of high maternal dental uneasiness. The MDAS demonstrated a critical association with clinical oral health results of the child. The children whose mothers were “extremely anxious” (phobic) had the highest mean decayed, missing, or filled teeth. Conclusion: Maternal dental anxiety significantly affects the oral health status of their ward.

Wireless Communication services have witnessed a dramatic growth in the past few years. With Telecommunication, there has been parallel growth in usage of different applications and services like VoIP, social network, e-commerce, entertainment etc. 5G is the next generation of telecommunication technology with elaborative and twirling services that can have a profound affect on the society. It can unleash new economic opening and societal benefits giving a potential for being a conversional force for the world. This paper elucidates the evolution of mobile wireless communication technologies. It includes details of architectures, salient features like data rate, primary services etc. To deliver next generation network services, 3GPP introduces IP Multimedia Subsystem (IMS) based on Universal Mobile Telecommunication System (UMTS). This paper also covers Software Defined Network (SDN) based architecture and explains various technologies like Network Function Virtualization (NFV), Network Slicing and certain pointers to research issues related to 5G.

Introduction: Objective of this study is to determine the knowledge, attitude and practice regarding type 2 diabetes in diabetics as well as in Non-diabetics and also to determine the knowledge versus practice gap among diabetics. There is almost no study of this kind from Uttar Pradesh region of India. Material and method: A pretested and validated questionnaire were used for assessment of these parameters. This questionnaire was divided in to 3 parts. First part used for assessment of knowledge in all the study subjects and had 8 questions. Second part had five questions based on risk factors and complication of diabetes. Third part was used only for diabetics and again had five questions based on their health care seeking behavior. A total of 412 study subjects (206 diabetics and 206 Non-diabetics) were interviewed and their responses were noted in this questionnaire form. Results: 50% of the diabetics are in the age group category of 41-60 years. > 50% of non-diabetics are in the age group category 21-40 years. Most of the respondents were aware of symptomatology, non-communicability, need of self-monitoring of glucose at home and rapidly increasing incidence of diabetes. Almost 70 % of diabetics were aware about foot care and Very nominal number of diabetics (7.8%) was consuming sweets daily. A disheartening fact revealed that approximately 87% of diabetics do not carry sugar candy or any form of sugar before leaving home to correct any hypoglycemic episode. Conclusion: Knowledge of symptomatology of diabetes and requirement of self-monitoring of blood glucose at home was adequate among most of the study subjects and uniformly distributed among diabetics and Nondiabetics. More than 80% of diabetics were not aware about hypoglycemia symptoms and its treatment. Training of health care providers and large-scale education and awareness campaigns are the need of the hour for this region to further improve the knowledge and to improve self-care practices among all Diabetics.

Aim and Objectives: To evaluate the pattern, prevalence, etiology, site of fractures, and their management in patients with maxillofacial injury in Delhi-NCR region. Materials and Methods: A total of 1278 maxillofacial trauma patients visiting different registered hospitals from Delhi-NCR region from January 2012 to December 2017, treated by open reduction and internal fixation under general anesthesia (GA)/local anesthesia (LA) or closed reduction/conservatively, were taken into the study. The parameters considered in the study were age and sex distribution, etiological factors and incidence of maxillofacial trauma, pattern and site distribution of maxillofacial fractures, and management. Results: From a total of 2250 trauma patients, 1278 patients (1053 males and 225 females) had maxillofacial injury. The average prevalence rate was 56.8%. Yearly incidence rate was 20.4%. Road traffic accident (RTA) was the most common cause of trauma in 1029 (80.5%) patients, followed by physical assault [158 (12.3%)] with significant male predominance in different age groups. Isolated mandibular fractures were the most common [48.6% (parasymphysis 31.6%, condyle 28.2%)], followed by midface with maxilla fracture [27.6% (zygomatic bone and arch 50.2% and Lefort II fractures 18%)]. Treatment modalities were conservative management, closed reduction, and open reduction with internal fixation under GA/LA. Conclusion: RTA followed by physical assault is still the leading cause of maxillofacial trauma in young males in Delhi-NCR region. Mini plate osteosynthesis is the main treatment procedure for maxillofacial trauma. We need to enforce strict traffic rules, road safety law, and preventive measures along with improvement in education and socioeconomic status in the population to avoid maxillofacial injuries.

COVID-19 is a serious viral infection that struck the world in December 2019 starting from Wuhan in China, spreading subsequently to all over the world. The disease has baffled scientists and doctors worldwide in terms of its presentation, behaviour, and treatment options till now. A low mortality rate is the only relief we get so far from COVID-19 in terms of numbers. Treatment options have gradually streamlined to steroids and very few FDA approved antiviral as well as plasma therapy and supportive treatment. Monoclonal antibodies are used to tide over any impending cytokine storm but are not equally effective in all patients. Ventilation support is invariably required for moderate to severe disease varying from a simple High Flow non-rebreathing mask to BiPAP (Bilevel Positive Airway Pressure) and HFNO (High-Flow Nasal Oxygen) extending to full-fledge ventilation via a Mechanical Ventilator. Because of the non-availability of satisfactory treatment so far, many researchers from different biomedical fields are looking for alternative therapeutic strategies to manage the pandemic. One such therapeutic approach showing a ray of hope to combat COVID-19 infection is Mesenchymal stem cell therapy. Mesenchymal cells have immunomodulatory, anti-inflammatory as well as regenerative properties and various preliminary studies have shown that MSCs can reverse the lung damage and overcome the cytokine storm incited by COVID-19 infection. Also, it has improved the recovery rate of critically ill patients on mechanical ventilation. In this review, we will discuss the possibility and relevance of MSCs in COVID-19 treatment and preview of various MSCs clinical trials., Graphical abstract Unlabelled Image

A case of cervical spinal cord injury and quadriparesis with prolonged fever is being described. Initially, the patient received treatment for well-documented catheter-related bloodstream infection. High spiking fever returned and persisted with no obvious evidence of infection. The usual non-infectious causes too were carefully excluded. QUAD fever or fever due to spinal cord injury itself was considered. The pathogenetic basis of QUAD fever is unclear but could be attributed to autonomic dysfunction and temperature dysregulation. Awareness of this little known condition could help in avoiding unnecessary antimicrobial therapy and in more accurate prognostication. Unlike several previous reported cases that ended fatally, the present case ran a relatively benign course. The spectrum of presentations may therefore be broader than hitherto appreciated.

With the increase in number of Internet connected devices per user, load on the server side has increased considerably from sending alert messages to all the devices. These unnecessary duplicate messages instead of notifying the client, has resulted into a source of inconvenience. The proposed model termed as Load Optimization by Activity Monitoring (LOAM) manifest a customer driven approach to convey the alert messages to the active device at the right time so that the customer can respond in minimal time possible. The main aim of LOAM is to monitor the activities of a user on all the active devices based on which the notification will be generated for a particular device.

Objective: To determine the effects of parenteral omega 3 fatty acids (10% fatty acids) on respiratory parameters and outcome in ventilated patients with acute lung injury. Measurements and Main Results: Patients were randomized into two groups – one receiving standard isonitrogenous isocaloric enteral diet and the second receiving standard diet supplemented with parenteral omega 3 fatty acids (Omegaven, Fresenius Kabi) for 14 days. Patients demographics, APACHE IV, Nutritional assessment and admission category was noted at the time of admission. No significant difference was found in nutritional variables (BMI, Albumin). Compared with baseline PaO2/FiO2 ratio (control vs. drug group: 199 ± 124 vs. 145 ± 100; P = 0.06), by days 4, 7, and 14, patients receiving the drug did not show a significant improvement in oxygenation (PaO2/FiO2: 151.83 ± 80.19 vs. 177.19 ± 94.05; P = 0.26, 145.20 ± 109.5 vs. 159.48 ± 109.89; P = 0.61 and 95.97 ± 141.72 vs. 128.97 ± 140.35; P = 0.36). However, the change in oxygenation from baseline to day 14 was significantly better in the intervention as compared to control group (145/129 vs. 199/95; P < 0.0004). There was no significant difference in the length of ventilation (LOV) and length of ICU stay (LOS). There was no difference in survival at 28 days. Also, there was no significant difference in the length of ventilation and ICU stay in the survivors group as compared to the non survivors group. Conclusions: In ventilated patients with acute respiratory distress syndrome, intravenous Omega 3 fatty acids alone do not improve ventilation, length of ICU stay, or survival.

CytoSorb® (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb® in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity. She was diagnosed to have septic shock with multi-organ dysfunction (MODS) and a low perfusion state. CytoSorb® hemoadsorption column was used as an attempt at blood purification. Acute physiology and chronic health evaluation score, MODS score, and sequential organ failure assessment score were measured before and after the device application. CytoSorb application as an adjuvant therapy could be considered in septic shock.