Comparative in vitro antibacterial and antifungal efficacy of chemical, herbal and probiotic mouthrinses against Streptococcus mutans and Candida species

Background: Dental caries and oral candidiasis are predominant biofilm-associated infections, primarily driven by Streptococcus mutans and Candida species. While mechanical plaque removal is fundamental, mouthrinses are widely used as adjunctive treatments. This study evaluated and compared the in vitro antibacterial and antifungal efficacy of commercially available chemical, herbal and probiotic mouthrinses against key oral pathogens. Methods: 15 commercial mouthrinses, comprising five each of chemical, herbal and probiotic formulations were tested against S. mutans MTCC 457, Candida albicans MTCC 227 and clinical isolates of C. albicans, C. tropicalis and Pichia kudriavzevii. Antibacterial and antifungal activity was assessed using the agar well diffusion method. Zones of inhibition were measured following 24 - 48 hours of incubation at 37°C with positive controls penicillin or fluconazole. Results: Chemical mouthrinses demonstrated the strongest antimicrobial activity, where Hexidine produced the largest mean ZOI, followed by Colgate maXFresh PLAX. Herbal formulations such as Himalaya active fresh and K. P. Namboodiri’s Herbal Fresh showed moderate efficacy. Probiotic mouthrinses displayed limited and selective activity, primarily against S. mutans and non-albicans Candida spp., with Perfora probiotic rinse demonstrating the highest mean ZOI. Several products in each category produced no measurable ZOI. Conclusions: Chlorhexidine based mouthrinses remain the gold standard for rapid, broad-spectrum microbial reduction. Herbal formulations provide a moderate, phytochemical dependent alternative with a safer profile, while probiotic mouthrinses offer limited but selective antimicrobial effects

Deep neck space infection with airway edema and sepsis in a non diabetic patient: a case report

Deep neck space infections (DNSIs) are serious clinical entities with the potential for rapid deterioration due to their anatomical proximity to critical cervical structures, making complications such as airway obstruction and sepsis particularly concerning. We present the case of a 55-year-old female who developed rapidly progressive bilateral swelling involving the parotid and submandibular regions, with extension to the chest and back. She had no history of diabetes mellitus or other significant comorbid illnesses. Her clinical course was marked by worsening laryngeal edema, respiratory distress, and features of sepsis, necessitating urgent airway stabilization. Surgical management with incision and drainage was performed, resulting in subsequent clinical improvement. This case demonstrates that severe DNSIs may arise even in the absence of traditional risk factors, and while contrast-enhanced computed tomography (CT) plays an important diagnostic role, priority should be given to airway security and timely clinical intervention in unstable patients

Association of Mehran risk score and contrast-induced nephropathy in patients undergoing primary PCI

Background: Contrast-induced nephropathy (CIN) remains a common and serious complication following primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Early risk stratification is essential to identify high-risk patients. The Mehran CIN risk score is widely used in elective PCI, but evidence in the primary PCI setting is limited. This study aimed to evaluate the association between Mehran risk score and the development of CIN in STEMI patients undergoing primary PCI. Methods: This cross-sectional analytical study was conducted in the department of cardiology, National Heart Foundation Hospital and Research Institute, Dhaka, from January 2018 to July 2019. Consecutive STEMI patients undergoing primary PCI were enrolled using a non-randomized purposive sampling method. Results: Among the study population, 34 (13.7%) patients developed CIN, while 214 (86.3%) did not. CIN occurred most frequently in higher Mehran risk categories, with a statistically significant association (p<0.05). Factors such as anemia, diabetes mellitus, baseline serum creatinine >1.5 mg/dl, eGFR <60 ml/minute/1.73 m2, and age >75 years were significantly associated with CIN. The ROC analysis showed an area under the curve of 0.774 (95% CI: 0.692-0.855; p<0.001). A Mehran score of 8 demonstrated 70% sensitivity and 71% specificity, while a score of 9 showed 61% sensitivity and 78% specificity. Conclusions: The Mehran CIN risk score is a useful and reliable tool for predicting contrast-induced nephropathy in STEMI patients undergoing primary PCI and may aid in early risk stratification and preventive strategies

Study of hepato-renal syndrome in patients of cirrhotic ascites in an academic hospital

Background: Acute renal impairment is common in patients with chronic liver disease, occurring in approximately one fifth of hospitalized patients with cirrhosis. Considering limited evidence of epidemiological information of this topic, the study was designed to identify the number of patients suffering from hepatorenal syndrome (HRS) among patients of cirrhotic ascites admitted in an academic hospital. Methods: This hospital based cross-sectional type observational study was conducted at the department of medicine and gastroenterology. Total 100 subjects were interviewed. Data were collected by researcher with a structured questionnaire. After the interview the investigator recorded the collected information and later on transcribed into statistical software. Finally, data were analyzed by the SPSS 21. Results: Total 100 subjects were studied and mean age was 46.31±10.75 years, ranging from 22 to 65 years. Majority of the participants were male (69%). The most common cause of cirrhosis of liver was chronic hepatitis B infection (45%), followed in second and third by NAFLD (25%) and chronic hepatitis C (18%). In according to the Child-Turcotte-Pugh class, about 51% were in CP class A, 36% were in class B and remaining 13% were in class C. Overall frequency of HRS was 17% and type 2 was predominant (7%-type 1 HRS vs 10%-type 2 HRS). Conclusions: Less than one fifth of the patients developed HRS and it is associated with higher Child-Pugh class. However, further studies are needed to establish and use the findings

A prospective case-control study on the efficacy of subcutaneous suction drainage in reducing surgical site infections following laparotomy

Background:  Surgical site infections (SSIs) are one of the major postoperative complications and their management still remains to be a gruelling task. The worldwide incidence of SSI ranges between 0.5 and 15%, but in India it shows a significant increase of about 23 to 38%. The placement of suction drains in surgical wounds has proved to be quite promising especially in emergency laparotomies. The objective of this study was to compare the incidence of SSIs in abdominal surgical wounds with subcutaneous suction drains versus those where drains were not used.  Methods: This is a case-control study of 60 patients undergoing midline exploratory laparotomy surgeries admitted in the gastrosurgery and general surgery department of Hitech Medical college and Hospital, Bhubaneswar. Among them, closed subcutaneous drain was placed before the skin closure for every alternate patient and for the others no subcutaneous drain was placed. The patients for whom subcutaneous drain were placed were considered as cases while the other group of patients were considered as control group.  Results: The patients in the case group had lower incidence of SSI compared to the control group. When compared between the emergency and elective cases, the emergency cases showed higher propensity for SSI. Conclusions: Subcutaneous suction drains have proved to be safe and effective in preventing SSIs in abdominal surgeries, especially in emergency and colorectal surgeries

Prevalence of asymptomatic malaria in patients of a secondary care hospital presenting with non-febrile symptoms

Background: Malaria remains a major public health problem in endemic regions such as Odisha, India, where asymptomatic infections can sustain transmission and hinder elimination efforts. This study assessed the prevalence of asymptomatic malaria among afebrile patients in a secondary care hospital and compared the diagnostic performance of peripheral blood smear (PBS) and rapid diagnostic tests (RDT). Methods: An observational cross-sectional study was conducted at a secondary care hospital in Gopalpur, Odisha, from January 2021 to March 2022. A total of 300 OPD and inpatient cases from Medicine, Surgery, and Obstetrics & Gynecology departments were enrolled. Inclusion criteria included residence in Odisha for ≥10 years, absence of fever in the preceding month, and no malaria diagnosis in the previous six months. All participants underwent PBS and RDT testing. Positive cases were reconfirmed externally, and treatment was provided as per national guidelines. Results: Of the 300 participants (171 males, 129 females), none were positive on PBS, while 46 cases (15.3%) were detected by RDT. Plasmodium vivax accounted for 59% of cases, P. falciparum for 30%, and mixed infections for 11%. Although 44% reported previous malaria treatment, only 30% completed the full regimen, and radical therapy with primaquine was administered in 10.8% of cases. Conclusions: A substantial burden of asymptomatic malaria was observed in this hospital-based population. The poor sensitivity of PBS and inadequate treatment adherence highlight the need for sensitive diagnostic tools, active surveillance, and improved therapeutic compliance to support malaria elimination in endemic regions

Metabolic, neurological and endocrine safety profiles of atypical antipsychotics: focus on quetiapine, olanzapine and risperidone: an updated review

The atypical antipsychotics (second-generation antipsychotics, SGAs) are commonly used in the treatment of schizophrenia, bipolar disorder and other mental illnesses because they have fewer extrapyramidal side effects than first-generation agents. Nonetheless, their growing utilization has brought to light serious safety issues, especially in metabolic, neurological and endocrine spheres. This review aims at comparing three widely used SGAs, which are Quetiapine, Olanzapine, and Risperidone, with comparison in their pharmacological and safety profiles. Olanzapine presents the greatest metabolic risk often leading to weight gain, dyslipidaemia and insulin resistance. Quetiapine exhibits less sensitive metabolic responses accompanied by reduced pyramidal and prolactin increase rates at low off-label doses but is risky. Risperidone is an effective treatment of psychotic and bipolar disorders, but it is closely linked to hyperprolactinemia and dose-related extrapyramidal symptoms. The review also points out that there is now emerging evidence on changes in gut microbiota and changes in pharmacogenetic variations that affect individual response to drug and drug adverse effects. In general, the results highlight the importance of identifying unique antipsychotic treatment, regular checks of metabolic, endocrine indicators to ensure optimal safety and treatment. It is recommendable that future studies concentrate on genetic predictors, new formulations (e.g. olanzapine-samidorphan), and microbiome-targeted interventions as a way of reducing adverse effects

Linagliptin in type 2 diabetes mellitus: glycemic control and beyond

Type 2 diabetes mellitus (T2DM) is a progressive metabolic disorder requiring comprehensive strategies to achieve sustained glycemic control and reduce complications. Linagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4i), provides effective glycemic control with a low risk of hypoglycaemia and weight neutrality. Its once-daily dosing without the need for renal or hepatic dose adjustment makes it suitable for patients with multiple comorbidities. Large clinical trials, including CARMELINA and CAROLINA, have established its cardiovascular and renal safety. Beyond monotherapy, combination therapy with dapagliflozin, a sodium-glucose co-transporter-2 inhibitor (SGLT2i), demonstrates synergistic benefits. This combination improves glycemic parameters, supports weight reduction, and enhances cardiorenal outcomes. Phase III trials show that fixed-dose combinations of dapagliflozin and linagliptin achieve superior HbA1c reduction and improved postprandial glucose control compared with monotherapy, with favourable safety and tolerability

Histological and clinicoradiographic evaluation of desmoplastic ameloblastoma

A rare histologic variant of ameloblastoma, desmoplastic ameloblastoma is an odontogenic neoplasm that is challenging to diagnose. According to the case report, a 37-year-old female patient with history of intermittent pain and a hard swelling in the maxillary anterior region that measured 10×12 mm is discussed here. This variant frequently occurs in the anterior maxilla, despite the fact that ameloblastomas are typically found in the mandible. Following radiographic and clinical evaluation, surgical enucleation was carried out, and histopathological analysis was completed with the aid of H and E staining. In order to diagnose this uncommon form of ameloblastoma, we are attempting to shed light on the clinico-radiographic and histopathological features of desmoplastic ameloblastoma

Efficacy and safety of robotic laparoscopic surgery in the treatment of ureteropelvic junction obstruction in pediatric patients: a systematic review

Pediatric ureteropelvic junction obstruction (UPJO) has been replaced by robotic-assisted laparoscopic pyeloplasty (RALP) more and more frequently as compared to open and conventional laparoscopic procedures. This method is desirable as it leads to increased dexterity and visualization, but the method is constrained by cost, learning and lack of long-term consistency. The paper is a systematic review that summarizes the data regarding the effectiveness and safety of RALP in the child population. A detailed search of PubMed, Cochrane, Embase and Scopus (20002025) found 20 eligible studies including randomized controlled trials, prospective cohort and retrospective series. The inclusion criteria included patients aged less than 18 years who had undergone RALP to treat UPJO and have recorded successful outcomes. Information that was extracted included operative time, success, complications and hospital stay. The tools of quality assessment were RoB 2, ROBINS-I, NIH and AMSTAR-2. Synthesis of pooled data were done using random effects model. Across 1,420 pediatric cases, pooled success was 95.2% (range 92.6-100) with an overall complication rate of 8.5%, of which 2.1% were major (Clavien-Dindo ≥III). Mean operative time averaged 110 minutes for RALP versus 144 minutes for conventional laparoscopy, while hospital stay was comparable or shorter for RALP (1.8 vs 3.5 days vs open). Infants and complex UPJO cases demonstrated similar outcomes with slightly longer operative times. RALP achieves high success and low complication rates in pediatric UPJO, outperforming conventional laparoscopy in efficiency and postoperative recovery but heterogeneity, short follow-up and limited cost-effectiveness data temper definitive conclusions. Multi-institutional randomized trials with standardized outcome definitions remain essential to confirm long-term renal benefits and economic feasibility