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Animal bites are a significant cause of morbidity and mortality across the globe and when involving the orofacial region, they commonly present to dental surgeons. Literature on their initial management provides a plethora of conflicting views and results and it is necessary to be up to date with the latest modalities of management of such facial injuries to give best functional and surgical outcomes to the patients. Antibiotics and anti-tetanus and anti-rabies vaccinations and immunoglobulins should be judiciously administered along with appropriate wound management.

The aim of this study was to compare the post-operative sequelae of removal of impacted third molars in participants treated with conventional flap elevation technique or with a minimally invasive flapless technique.Participants with bilaterally impacted mandibular third molars were included. They were divided into two sites constituting 2 groups. One group was operated by using conventional flap design and elevation and other with flapless technique. Objective clinical parameters were recorded and compared in the post-operative period like mouth opening, swelling, surgical time, and pocket depth. Subjective parameters including pain were also assessed and statistically analyzed.The sites operated in Group II (Flapless technique) had better results (p≤0.05) in terms of pain, swelling, trismus, and pocket depth distal to second molar when compared to Group I (Flap).The flapless technique gives better surgical results and improved healing process after third molar removal and so should be recommended in routine clinical practice.

Neonatal necrotizing fasciitis (NF) is an uncommon but often fatal bacterial infection of skin, fascia, and subcutaneous fat. High index of suspicion, appropriate antibiotics, supportive care, and prompt surgical intervention are the cornerstones of management. We report a term neonate with rapidly progressing NF of neck and scalp which complicated to skull osteomyelitis. The baby was managed with intravenous antibiotics and early wound debridement followed by skin grafting. The graft was taken up well and currently the baby is thriving.

Acute bacterial meningitis (ABM) is a life-threatening and neurologically debilitating infectious disease. We studied the clinical profile, organisms involved in bacterial meningitis in children, and compared the tests on cerebrospinal fluid (CSF), latex agglutination test (LAT), polymerase chain reaction (PCR), Gram stain (conventional) and Cyto-Tek cytospin centrifuge Gram stain to culture which is the gold standard. This was an observational cross-sectional study (age range 3 to 12 months) conducted in a tertiary care hospital, New Delhi, India over 1 year. A total of 101 patients were enrolled and divided into three age groups, namely, 5 years. Fever was the most common presenting symptom in all groups (84.2%). Refusal to feed, headache, altered sensorium, vomiting, and blurring of vision were significantly associated with bacterial meningitis in all age groups. Cranial nerve palsies and neck rigidity were significantly higher in older children. Age

Background: Advances in prenatal and postnatal care of neonates with rhesus hemolytic disease of the newborn (RHDN) have led to improved outcomes. Studies evaluating the postnatal outcomes in rhesus (Rh) isoimmunized infants from developing countries are limited. Objective: The objective of this study was to evaluate the postnatal outcomes of neonates ?32 weeks gestation with RHDN. Methods: A prospective observational study was conducted from July 2014 to June 2016 in a tertiary care neonatal unit in North India. Neonates affected by RHDN were managed as per the standard protocol and were followed up for the first 6 months of life. Primary outcomes were the duration of phototherapy (PT), need for exchange transfusion (ET), occurrence of late-onset anemia, and need for top-up transfusions. Results: A total of 33 newborns with RHDN were included in the study. Median duration of PT was 138 h (interquartile range 64–188) and was inversely correlated with intrauterine transfusion number (Spearman correlation coefficient ?0.46; p=0.02). Of 33 neonates with RHDN, 14 (42.4%) neonates required ET. Late-onset anemia was seen in 25 (75.7%) neonates and 17 (51.5%) required at least one top-up transfusion. Cholestasis was seen in 5 (15.1%) neonates. Conclusions: Despite advances in care, short-term morbidities in neonates affected by RHDN are common and require intensive management.

The donor-π-acceptor ferrocene conjugated malononitrile dimer [C5H5–Fe–C5H4–C(H) C(CN)–C(NH2) = C(CN)2] (1) has been synthesized and characterized with the aid of analytical and spectroscopic techniques [FT-IR, GC-Mass, 1H and 13C NMR]. The thermal stability of the compound 1 was investigated using thermogravimetric analysis (TGA) and differential thermal analysis (DTA), exhibit the compound is stable up to 180 °C. The photophysical properties were performed by UV–visible and fluorescence spectroscopic methods and the compound 1 exhibited weak fluorescence emission. In addition, the optical band gap (Eg) was calculated using diffused reflectance spectroscopic technique which shows the band gap value of Eg = 3.6 eV. The redox wave of the compound 1 was determined by cyclic voltammetry, revealed that one electron transfer ability of the ferrocene to ferrocenium ion. The experimentally observed HOMO and LUMO values are good agreement with the theoretical calculation by DFT-M06 method using 6–31 + G** as basis set. The solvatochromic studies of compound 1 shows negative solvatochromism due to the high ground state polarizability in presence of cyano acceptors. Further, the nonlinear optical properties were investigated by Q-switched Nd-YAG laser and second harmonic generation efficiency (SHG) using para-nitroaniline (p-NA) as a standard and the results of SHG efficiency is 0.35 times comparable with p-NA.

Rickettsial diseases are caused by arthropod-borne obligate intracellular parasites. One such rickettsial infection is scrub typhus, which is an important cause of fever of unknown origin. Spectrum of presentation is variable. There are reports of scrub typhus with CNS complication, like meningoencephalitis, in adolescents and adults from various parts of India but not from Delhi. There are recent case reports of scrub typhus without CNS involvement in adults from Delhi. Its occurrence in the form of hemorrhagic fever with meningoencephalitis is rarer in children and is not so far reported from the state of Delhi. We present a case of a 4-year-old child from Delhi presenting with hepatosplenomegaly, thrombocytopenia, and altered sensorium, whose timely diagnosis and management saved her life, and this brings to our notice the emergence of scrub encephalitis in children.

Poly unsaturated fatty acids (PUFAs) have usually been associated with beneficial health effects on early life and later life disease such as cardiovascular diseases (CVD). Emerging evidence, however, suggests that PUFA species (n-3, n-6) have differential health effects. N-6 PUFAs, in particular, have sparked a scientific debate regarding their role in human physiological processes. Current dietary recommendations for n-6 fatty acids have been based on animal studies, insufficient epidemiological evidence and mixed PUFA interventions, therefore, require reconsideration. This review has analyzed human epidemiological and interventional studies, published in the last five years, focusing on n-6 fatty acids’ impact on CVD outcomes (CVD events, blood lipids, blood pressure, inflammation, oxidative stress/atherosclerosis). The evidence is mixed, with differential effects within the n-6 fatty acid series. These outcomes are also dependent on ethnicity and background health status. Further, data from developing countries are sparse, thus, well designed intervention trials and population based studies in developing country settings on specific n-6 fatty acid intake and health effects are desired.

BackgroundCommunity health workers known as mitanins undertook family-level counseling and mobilized the community to improve coverage of maternal and child health services in the state of Chhattisgarh, India. The Nutrition Security Innovation (NSI) project was launched in selected blocks with additional inputs for promoting appropriate complementary feeding practices and disseminating information on Public Distribution System (PDS) entitlement. Within 3 years of project implementation, all NSI inputs in the project group (PG) were scaled up in the entire state.ObjectiveTo study the impact of interventions on nutritional status in PG and non-NSI comparison group (CG) blocks.MethodsQuasi-experimental mixed methods were used. The sample consisted of 3,626 households with children under 3 years of age and 268 mitanins.ResultsA ratio of 1 mitanin per 250 to 500 population was effective. The coverage of exclusive breastfeeding, timely introduction of complementary feeding, DPT immunization, and antenatal care services was more than 70%. The PDS reached almost 90% of beneficiaries. In both the PG and the CG, one-third of children were undernourished, with one-quarter of children under-nourished by 6 months of age. The prevalence of low birthweight was over 40%, and half of all women were undernourished. The estimated annual average reduction rate (AARR) for the entire state was estimated to be 4.22% for underweight and 5.64% for stunting.ConclusionsThe strategy of Mitanin Programme in the Indian state of Chhattisgarh was unique with the implementation of direct nutrition actions being spearheaded by the health sector and community health volunteers in coordination with the Integrated Child Development Services (ICDS) and the Public Distribution System (PDS). The highest priority was given to interventions in the first 92 weeks of life. This implied ensuring frequent counseling and delivery of services through the entire pregnancy period and continued follow up till the children were at least one year of age. An accelerated decrease in the annual rate of reduction of underweight and stunting was observed. The emerging findings point to the significant contributions that can be made by the National Rural Health Mission (NRHM) in India by involvement of community health volunteers known as Accredited Social Health Activists (ASHAs) towards reducing the persistent problem of undernutrition in the country.

Objective: To determine the prevalence of vitamin D deficiency (25-hydroxycholecalciferol) in infants with hypocalcemic seizures and the relation of severity of vitamin D (25-hydroxy Cholecalciferol) deficiency with the occurrence of hypocalcemic seizures. Design: Cross sectional analytical study. Setting: pediatric emergency department of a tertiary care hospital. Methods: 60 consecutive term neonates and infants (upto 1 year) presenting with seizures with documented hypocalcemia (total serum calcium was