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ROLE OF DIFFERENT IRRIGANTS AND INTRACANAL MEDICAMENTS AGAINST E.FECALIS: AN IN VITRO STUDY
Get PDFThe aim of the present article was to evaluate the investigate the antimicrobial activity of 2% Chlorhexidine, 1% NaOCl , Ca(OH)2 and sterile saline against Enterococcus Faecalis infected dentin after a 7 day interval. In this study 80 premolars extracted for orthodontic purpose were used as specimen. The tooth were standardized to a length of 17 mm, the apices sealed with cyanoacrtylate and autoclaved. After with the specimen were autoclaved. They were then transferred to a broth containing E. Faecalis and incubated for 7 days. The chemomechanical preparation of the tooth was done using Race files and the specimens were irrigated with their respective irrigants. The orifices were sealed with cynocarylate and incubated for another 7 days. The coronal end was re accessed and dentinal shaving was collected using a size 5 Gates Glidden drill. The dentinal shaving were cultured and statically analyzed. Results should that though none of the medicaments were able to completely eradicate the bacteria, 2% CHX had the best results, followed by 1% NaOCl followed by Ca(OH)2. . Sterile saline was used as a control
KNOWLEDGE AND PRACTICE OF BREAST SELF EXAMINATION (BSE) & CLINICAL BREAST EXAMINATION (CBE) AMONG FEMALE WORKERS IN ABIA STATE UNIVERSITY TEACHING HOSPITAL ABA ABIA STATE, NIGERIA
Get PDFBackground: Breast cancer is the commonest cancer affecting women worldwide. Early detection and subsequent treatment using both breast self-examination (BSE) and clinical breast examination (CBE) screening methods are known to reduce the morbidity and mortality due to this cancer.
Objective: To determine the knowledge and practice of breast self-examination (BSE) and clinical breast examination (CBE) amongst female workers in Abia State University Teaching Hospital, (ABSUTH), Aba.
Method: Hospital-based cross-sectional descriptive study was carried out amongst female workers in ABSUTH, Aba. Knowledge was assessed using knowledge scores computed for respondents using four parameters. Knowledge was classified as good or poor.
Result: 124 female workers (including health workers and support staff) participated in this study. The mean age of the respondents was 40.7 ±8.7 years. About 13% (16/124) of study participants admitted that they had relatives who had had breast changes/cancer. While, 52.4% of respondents had good knowledge of BSE and CBE, 47.6% had poor knowledge. About 66.1% had practiced BSE in the past. Less than half (40%) of the participants knew about clinical breast examination (CBE). In addition, only 20% of those who knew CBE had done it in the past. Respondents that were health workers were more than 4 times more likely to have good knowledge compared to support staff Odds Ratio 4.86; 95% CI (2.2-10.8).
Conclusion: There is poor practice of CBE amongst these female workers, which undermines the efforts against early detection of breast cancer. We recommend greater awareness and education among the female workers to improve knowledge and practice of BSE and CBE
ANALYZING THE ROLE OF C-REACTIVE PROTEIN IN CARDIAC PATIENTS WITH UNSTABLE AND STABLE ANGINA
Get PDFBackground and objectives: Unstable angina is one of leading causes of hospital admissions for acute coronary disease, which accounts for >30% of admissions for acute myocardial infarction. This study was done to estimate the C-reactive protein level (CRP) as a marker of acute inflammation in patients with unstable and stable angina & to determine the prognostic value of CRP in coronary syndrome.
Methods: A case control study was done including 40 cases of stable angina/control group (attending OPD) and 40 patients unstable angina/study group who are admitted to Intensive coronary care unit. Cases were selected according to inclusion and exclusion criteria in a prescribed Proforma. CRP estimation was done twice in study group and once in control group by latex agglutination method.
Results: The study shows sex ratio 5:1 with maximum presentation between 4th to 6thdecade with mean age of 53.1 years. In study group (unstable angina) CRP levels were elevated in 29 (72.5%) and 12(30%) in control (stable angina) group. Second sample was taken on 7th day of illness in study group; persistent elevated CRP levels were maintained in 7(17.5%) patients.
Conclusion: Raised levels of CRP shows an evidence of growing inflammation at the coronary plaque and persistent elevated CRP levels in patients with unstable angina may indicate persistent instability of the disrupted plaque and is strongly related to the occurrence of subsequent ischemic complications. Serial evaluation of CRP plasmatic concentration may help in assessing the future ischemic events and thus help in preventing complications
SCAR ENDOMETRIOMA FOLLOWING CAESAREAN SURGERY ANALYSIS OF 6 CASES
Get PDFObjective:-
1. To See the incidence of scar endometrioma in our gynaec outpatient clinic.
2. To identify the clinical pattern of the disease.
3. Incidence of symptomatic relief post resection.
4. Post resection need for medical therapy.
Design and Setting:- Retrospective descriptive study of the etiology and prospective analysis of scar endometriosis and symptoms on pain scale, at Nice hospital of women, children & newborns at Shanthinagar Hyderabad, Telangana, India.
Methods: - Data from the medical records of patients from OPD Clinics and IP Records during Jan 2013 to Oct 2016 with pre operative diagnosis of scar endometrioma who underwent surgery between 2013 to 2016 were survey and reviewed .Current data of confirmation of diagnosis by High-Resolution Ultrasound Scan and MRI and histopathological examination of respected mass. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size& palpation, duration of complaint, diagnosis, and treatment. All underwent tumor excision with a safety margin.
Results: - There were 6 patients , a mean age 30.1+ 5.0yrs plus or minus (Range 18-40 yrs) 100% located in and around cesarean scars. The main symptom was localized cyclical pain (80- 100%) of mean duration 20-24 months , the interval between LSCS and onset of Scar Endometrioma was between 3yrs to 7yrs. Surgical treatment was successful in all cases.
Conclusion: - This is an uncommon disease. Most important a diagnostic criterion is a Cyclical pain at the local site during menstruation. Patient undergoing cesarean section is at the greatest risk. The surgical treatment of choice is excision of the endometrioma with a safety margin. Post-operatively medical therapy given in all cases. The patient is followed up every 6 months to assess any recurrence
ARNOLD-CHIARI MALFORMATION TYPE 1 WITH SYRINGOMYELIA, KYPHOSCOLIOSIS, AND CAFÉ-AU-LAIT SPOTS
Get PDFWe present a case report of a 39-year old woman with Arnold-Chiari malformation type 1 with syringomyelia, kyphoscoliosis, and café-au-lait spots. The first complaints started 2 years ago and included paresthesias/numbness and diminished temperature sensation of the right arm, followed by muscle weakness. There has also been a remitting-relapsing pain in the right arm recently. The neurologic examination revealed a syndrome of cervical intumescence impairment with C8 dermatome hypesthesia, temperature anesthesia for the right arm, a lower motor neuron paresis in the distal part of the upper extremities (predominantly for the right arm), spastic muscle tone of the lower extremities, mild right leg weakness, positive Babinski sign bilaterally. Several café-au-lait spots in the trunk were found. MRI visualized kyphoscoliotic deformation of the cervicothoracic spine, a homogenous intraspinal lesion from C2 to Th9 level, hypointense on T1 and hyperintense on T2 (syrinx), and a prolapsed left cerebellar tonsil through the foramen magnum. The patient was unsuccessfully treated with medications. The case is of interest with the extremely rare combination of the abovementioned clinical and neuroimaging manifestations, the late onset of sensory complaints, lack of family history, headache, and other congenital abnormalities, as well as the late diagnosis confirmation. We consider this combination to be more than coincidental and a rare variant of Chiari type 1 malformation. The relevant literature has been reviewe
CLINICAL SIGNIFICANCE OF T LYMPHOCYTE SUBSETS AND HLA-DR IN PERIPHERAL BLOOD OF PATIENTS WITH SEVERE PREECLAMPSIA
Get PDFObjective: To observe the variation of T lymphocyte subsets and human histocompatibility antigen (HLA-DR) in peripheral blood of patients with severe preeclampsia（ SPE).
Method: Peripheral blood from 30 patients with SPE (SPE group), 30 healthy pregnant women (healthy pregnant group) and 18 healthy un-pregnant women (healthy un-pregnant group) was a collected． The percentage of CD4+T, CD8+T and HLA-DR in each group were compared by Flow cytometry (FCM).
Results: There was no difference in the expression of CD4+T in each group ((35.6±5.4)%VS (37.8±8.9), (35.6±5.4)%VS(37.1±9.6)%). The expression of CD8+T in SPE group was significantly higher than those in the healthy pregnant group ((32.1±7.4)% VS(26.9±7.7)%, P＜ 0.01) and in the healthy un-pregnant group ((32.1±7.4)% VS(25.4±7.6)%, P＜ 0.01). The expression of HLA-DR in SPE group was significantly lower than that in healthy pregnant group ((43.7±12.7)% VS(58.3±13.9)%； P＜ 0.01)．
Conclusions: Higher expression of CD8+T was found in peripheral blood of SPE patients which lead to T lymphocyte subsets imbalance. The decrease of HLA-DR may contribute to the pathologic process of SPEï¼
ADVANCES IN THE MANAGEMENT OF NECK DISSECTION: A REVIEW
Get PDFThe proper management of neck in patients with head and neck malignancies is one of the unresolved oncologic questions. Cervical metastasis is one of the major risk factor and the best prognostic indicators for patient with head and neck cancer. Patients who present with tumors localized at the primary site without dissemination to regional lymph node enjoy an excellent prognosis and can be cured by appropriate use of surgery, radiotherapy or both. On the other hand once dissemination to regional lymph nodes takes place, the probability of 5 years survival, regardless of treatment, reduces to nearly one half of that seen in early staged patients. The purpose of this article is to study the current concepts in cervical lymph node metastases and development of various techniques in neck dissection to reduce morbidity while eradicating the pathology completely
KEY POINTS AND GOLDEN STANDARDS FOR MASS BURNED EVENTS PREPAREDNESS
Get PDFBackground: Massive fire events are the most challenging emergency situation, testing rapid response, efficiency, and resilience of the emergency medical systems.
The purpose of the study: We aimed to identify the key points of incident command system and golden standards of emergency management in scenes of massive fire with mass victims involvement. Materials and methods -observational analysis of a series of 33 events and simulation of mass burned casualty in three different regions from Romania.
Conclusions: Incident Command System is crucial to assist simultaneously a massive number of severe injured casualty’s, having three golden tasks: scene assessment and security, search and rescue and medical chain set up. The white plan of the hospitals has to be set up immediately. For fire incidents in town buildings with inhabitants, the median time for the maximum influx of victims to the hospitals is about 25-39’, all victims being in hospitals in about 1 h. Dispatch center may be a keystone of the intervention success, through the correct and prompt decision of red plan triggering, hospitals alert, chief emergency director involvement, networking maintaining with different structures. The red plan of pre-hospital intervention have to be started with maximal resources alert from the first emergency call, and all the subsequent information will be taken as soon is possible. The exact number of casualty s cannot be estimated accurately, so the emergency team has to be prepared for the worst case scenario. All these aspects must become specific educational objectives of training programs in crisis management
STUDY OF EPITHELIAL PHENOTYPE AFTER PTERYGIUM EXCISION BY USING CONJUNCTIVAL IMPRESSION CYTOLOGY
Get PDFPurpose: To compare the process of conjunctival epithelial regeneration after three types of pterygium excision procedures.
Methods: Twenty-two patients (27 Eyes) with primary progressive pterygium were randomly assigned to the bare-sclera procedure (group I, 9 eyes), pterygium excision with amniotic membrane transplantation (group II, 9 eyes), and pterygium excision with conjunctival autografting (group II, 9 eyes). Controls were healthy fellow eyes and ten eyes of age and sex matched subjects. Conjunctival impression cytology was performed with Millipore filter paper (0.025-0.22 microns) of 3 x 3 mm pieces pre and postoperatively at 2 weeks, 1, 3, 6, and 12 months. The nucleus to cytoplasm ratio of goblet epithelial cells and goblet cell density in pterygium area were calculated and compared between groups.
Results: Pterygium excision wounds healed in a similar four-stage process in all the groups, but at different rates. The nucleus-to-cytoplasm N/C ratio was highest at 2 weeks, 1 month, 3 months in group III, II, and I respectively, before gradually returning to control levels. Pre-operatively, the goblet cell density GCD in treated eyes was twice than controls (p 0.001) but fell to zero post-operatively. Goblet cells first appeared in group III, followed by group II. At 12 months, the mean GCD in group III was not significantly different from controls, whereas in group I and II were still less than controls (P 0.02)
Conclusion: Conjunctival autograft prevents pterygium recurrence more effectively than AMT. Impression cytology revealed a marked decrease in goblet cell density in the bare sclera and AMT cases while goblet cells returned to normal size, shape, and density in conjunctival autograft group. Even 1 year after surgery, the ocular surface remained abnormal with respect to epithelial phenotypes in all techniques
MUSCULOSKELETAL DISORDERS AMONG RURAL POPULATION IN SOUTH INDIA – CROSS SECTIONAL ANALYSIS
Get PDFIntroduction: Musculoskeletal disorders (MSD) are a group of disorders that affect the structures including the nerves, tendons, muscles, joints and inter vertebral disc. MSD could result in pain, injury, illness poor quality of life and reduced productivity. These disorders were equally prevalence among rural population. Aims & objectives of this original research was to analyses the prevalence of MSD among rural population of Kanchipuram district southern India. Also, to lay the importance of strengthening tertiary heath care in rural India.
Methods: Community health screening and treatment by physician, physiotherapist and pharmacist were conducted once a month during the period from October 2016 to January 2017. 600 subjects identified with MSD were evaluated and treated. Home programme was taught to them. Various MSD such as low backache, osteoarthritis, cervical spondylosis, shoulder and other ailments were recorded and treated with physiotherapy specific therapy for MSD. Their level of literacy, occupation tobacco and alcohol habits were recorded and analyzed.
Results: 62% female subjects have MSD, 31% have osteoarthritis, 26% low backache and 66% of the subjects were between 30-60 years. 18% of the participants were above 60 years. While 53% of male subjects had low backache, female participants had 58% with osteoarthritis knee, 51% with shoulder and 68% with neck ailments related to MSD.
Conclusions: The findings of the study points at strengthening of our rural health care system, for musculoskeletal disorder prevention and management. Primary health care in India needs to be re- evaluated and immediately reformed. Concrete steps to be taken for effective rural health care planning and delivery so as we can collectively develop with our fellow rural brother