Panoramic Radiograph and Cone Beam Computed Tomography - Evaluation of Mandibular Impacted Third Molar and Mandibular Canal.

BACKGROUND: Management of mandibular third molar teeth requires accurate and precise information regarding exact location and its relationship with the inferior alveolar nerve (IAN) where these two structures are intimately related to prevent the injury of the nerve. For pre-operative screening of the cases, intraoral and panoramic radiograph is sufficient to determine the position of the third molar in relation to inferior alveolar nerve. But with advent of cone beam computed tomography (CBCT), it has become easy to localize the exact position of the tooth and IAN in all the three planes where both are closely related. AIM: The aim of the study was to evaluate the diagnostic utility of CBCT in preoperative assessment of impacted mandibular third molars where root tip is in direct proximity of the IAN as evaluated in panoramic radiograph. MATERIALS AND METHODS: Study sample was composed of 20 patients (40 teeth). High risk signs of IAN injury such as darkening of roots, interruption of white line of mandibular canal, superimposition of roots on mandibular canal, narrowing of mandibular canal, and deviation of mandibular canal were assessed in panoramic radiograph and subsequently CBCT images were evaluated for exact location of mandibular canal in relation to root tip, cortical lining of mandibular canal, and cortical plate perforation. RESULTS: In most of the cases mandibular canal in relation to root tip was at the level of roots and inferiorly positioned. There was statistical significant association between darkening of roots and cortical plate perforation, interruption of white line and absence of corticalisation of mandibular canal and superimposition of roots on mandibular canal and presence of corticalisation of mandibular canal. CONCLUSION: In the present study, exact localization of mandibular canal was done in relation to the mandibular third molar in all three planes with the help of CBCT in the cases showing the high risk signs of IAN injury. CBCT proved to be a promising diagnostic tool for preoperative assessment of mandibular third molar tooth and IAN in complicated cases

Endometrial evaluation with methylene blue staining in patients with normal hysteroscopy

Background: Normally, endometrium comprises of non-absorptive epithelium and does not take up stain. Conventional staining with methylene blue is explained on the basis of existence of apoptotic cells in endometrium.Methods: Of 50 patients of unexplained infertility, AUB, recurrent pregnancy loss were randomly selected and included in the study. Those with abnormal ultrasound and history of tuberculosis were excluded. Conventional hysteroscopy was performed using normal saline as distending medium and in those with grossly normal endometrium were subjected to staining with 5% methylene blue instilled trans cervically. After 5 min, irrespective of the size and pattern, focal dark blue stained areas were considered abnormal and randomly biopsied. Incidence of endometritis in both groups was compared after histopathological examination.Results: Of total 50 patients, histopathological report of only one patient with dark blue staining had evidence of endometritis. Rest had no evidence, of which 73.5% had light blue or unstained areas and 26.5% showed dark blue staining. No statistically significant difference was found between histopathological reports and light or dark blue staining (p=0.28). When percentage stained area was considered more than 50% only to be positive, sensitivity was 100%, specificity 94%, PPV 25% and NPV 100%. False positives were 75% and no false negatives were observed. Although p values improved but still statistically insignificant.Conclusions: Present study failed to establish any significant correlation between staining pattern and detection rate of endometritis. With no Indian studies published on chromohysteroscopy so far, role of methylene blue in detection of subtle endometrial changes in modern gynaecology in Indian subpopulation is yet to be established

Gestational weight gain and its effect on fetomaternal outcome

Background: In normal pregnancy, variable amount of weight gain is a constant phenomenon. The study aims to find an association between gestational weight gain and fetomaternal outcome. GWG (using institute of medicines guidelines meant for US population) and pregnancy outcomes among Asian Indians across different BMI categories (according to WHO Asia Pacific BMI cut points) were studied.Methods: 300 women were split into the three groups based on their gestational weight gain. Namely, below recommended GWG, recommended GWG and above recommended GWG group. Comparison of various fetomaternal outcomes was done between these groups.Results: In women, who had higher than recommended GWG, 30.5% developed GDM, 23.2% had gestational hypertensive disorder, 36.6% developed hypothyroidism, 12.2% had pre-term birth and 15.9% had low birth weight. In recommended GWG category, these were 5.4%, 4.5%, 30.6%, 7.2% and 17.1% respectively; and in below recommended category, these were 14%, 1.9%, 22.4%,12.1% and 24.3% respectively.Conclusions: GWG generally follows the BMI pattern at the time of entering into pregnancy, higher the BMI more the GWG. More GWG was associated with GDM, Gestational hypertensive disorders and poor APGAR at birth. Below recommended GWG was associated with higher occurrence of GDM. No statistical correlation, between GWG and mode of delivery, NICU stay, preterm birth and birth weight was observed. Larger study is required to establish the applicability of IOM Guidelines for GWG on Indian women

Awareness of cervical cancer and its screening methods in Indian women

Background: In spite of effective screening methods, cervical cancer continues to be a major public health problem in India. Therefore, the present study was carried out to assess the knowledge of cervical cancer and its screening among women, it also focuses on the reasons for not undergoing regular screening and the effect of counseling for the same.Method: 400 women were randomly enrolled from the women attending/visiting/working at a tertiary hospital. They were asked questions related to cervical cancer. All answers were obtained verbally and recorded in the questionnaire by the same investigator.Results: Out of 400 women, only 103 were aware of cervical cancer as well as its screening, and only 10 of them were undergoing regular screening. Among those who were aware of cervical cancer, majority (95.14%) were health care workers and most of them got this knowledge form their textbooks. After counseling, all except 6 women were willing for regular screening. The reason for refusal for the same was either they believed they were not at risk or they found pelvic examination uncomfortable.Conclusions: The study found that women had poor knowledge about cervical cancer and its screening. Awareness was higher among the women who had received higher education or were healthcare workers. However, cervical cancer screening rate was low even in these women. Government and health care professionals need to actively promote awareness of the risk factors of cervical cancer and encourage women to undergo regular Pap smear as a cervical cancer screening method

FORMULATION AND EVALUATION OF SEABUCKTHORN LEAF EXTRACT LOADED ETHOSOMAL GEL.

Objective: The objective of present research work is develop an ethosome as a carrier system for 75% ethanolic SBT leaf extract, its incorporationin to gel formulations and to characterize the prepared is to develop ethosomes and gel formulations using various parameters including estimationof total phenol content in terms of Gallic Acid Equivalents (GAE). Seabuckthorn (Hippophae rhamnoids. SBT) is a cold desert medicinal plant, and hashigh antioxidant content, especially phenol content. There are many reports revealing pharmacological potential of SBT extracts, however, only fewliterature reports highlight the conversion of these extract in to suitable dosage.Methods: Twelve batches (F1 – F12) of ethosomes were prepared using Soyaphosphatidylcholine (SPC) (1-3%) and ethanol (10-40%). Carbopol934P was used to prepare ethosomal gel. The range of entrapment efficiency (EE) of ethosomes was 51.05%-91.09%, polydispersity index (PDI)ranges between 0.041-0.392 and vesicle size from 96.98 nm to 395 nm. Four ethosomal batches were selected on the basis of EE and PDI to be used forfurther incorporation in to 4 gel formulations (G1, G2, G3 & G4, respectively). Prepared gels were then evaluated for their physicochemical properties,drug content and diffusion characteristics.Results: The pH of the gel formulations was found to be in the range of 6.2 to 6.6. Viscosities of the gels were ranging between 4900 - 4550 centipoises.The drug content of the gels ranged between 46.47% - 82.47%. The cumulative release of ethosomal gel was maximum in G4 formulation (94.34%)and minimum in G1 (70.75%). These ethosomes, when converted in to gels, were found to show good physicochemical properties, drug content anddiffusion pattern.Conclusion: The present study revealed ethosomal gel as an efficient carrier for herbal extract.Keywords: Ethanol, Hippophae rhamnoides, Soyaphosphatidylcholine, Total phenol content

A level playing field for children with disabilities

Harish, a 10-year-old child at our Khushboo Special School, i comes walking towards us, drawing our attention to his superman-themed mask. A child with cerebral palsy (CP) and intellectual disability, Harish, like all children, is eager to play, run and make conversations despite his lack of verbal skills. He shows patience as he waits for his turn. He even cheers his friends from the sidelines. Quick wins, high-fives and verbal praise motivate him to continue doing activities and not give up. This child, who used to be very quiet, had limited social interactions and needed physical support can today not only perform activities confidently but if asked to demonstrate instructions to his peers, does not shy away

Granular cell tumour of clitoris: a case report

Granular cell tumour (GCT) is tumours showing neuroectodermal differentiation. It occurs mostly in the dermis and subcutaneous tissue and occurrence in the muscle layer is rare. The most common site is the head and neck region. It has been known to occur in the vulva, with clitoris being a very rare site. Granular cell tumours are slow growing tumours, which are mostly asymptomatic. We report a case of lump in the clitoris in a 42-year-old woman which was managed with surgical excision. Histopathology confirmed the diagnosis of granular cell tumour. Very few cases of granular cell tumour of clitoris have been reported in literature till date. Although mostly benign, the differential diagnosis of granular cell tumour should be borne in mind by the clinicians in cases of clitoral lump

A Study on Energy Import Dependency in India

In today's globalized world, the interconnection between the economy and the environment is evident. A nation's prosperity and self-reliance hinge on adopting sustainable methods of energy production. Lack of energy security and self-sufficiency compels a country to import necessary energy resources, significantly impacting both sustainability and the foreign reserves. This paper addresses India's suboptimal utilization of energy resources, focusing on the import dependency in the energy sector due to the prevalent use of fossil fuel-based energy (conventional energy) from 2006 to 2020. Data analysis, incorporating graphical representations of conventional energy import and consumption, highlights the status, growth, and import dependency trends. The findings reveal that India heavily relies on imports for conventional energy resources, particularly crude oil. The paper concludes that the key solution for improving economic and environmental conditions lies in transitioning towards renewable energy resources

Cone Beam Computed Tomography Evaluation and Surgical Treatment of an Open Apex Case with Biodentine

Trauma to the facial region is a common event with injury of teeth. The treatment is aimed at the functional restoration of tooth along with complete biologic healing. Biodentine (Septodont, St Maurdes Fossés, France) introduced in the year 2011. It is a calcium silicate based material and is claimed by the manufacturers as repair of crown and root dentin repair treatment, perforations, resorptions, apexification, and root end fillings. This article presents a case report of conebeam computed tomography (CBCT) diagnosis and surgical management of an open apex case using biodentine as retrograde filling material

Molecular cloning of HSP17 gene (sHSP) and their differential expression under exogenous putrescine and heat shock in wheat (Triticum aestivum)

Polyamines (PAs) are low molecular weight ubiquitous nitrogenous compounds found in all the living  organisms, which have been implicated in the expression of various stress-proteins against the abiotic  stresses. Small heat shock proteins (sHSPs) are of particular importance in the thermotolerance and have  been reported to act as molecular chaperones preventing denaturation or aggregation of the target proteins. Here, we report cloning of a small HSP of ~573 bp from C-306 cultivar of wheat (Triticum aestivum L), having open reading frame of 162 amino acids. In silico analysis showed the presence of an alpha crystalline domain (ACD), the signature domain for small HSPs. Consensus localization prediction (ConLoc) provides 98%  consensus prediction of HSP17 in the nucleus. Quantitative real time polymerase chain reaction (qRT-PCR) analysis of HSP17 gene showed maximum (34 fold) transcript in C-306 and minimum (1.5 fold) in HD2329  cultivars of wheat in response to differential treatment of putrescine (1.5 to 2.5 mM + heat shock of 42°C for 2 h). Putrescine seems to enhance the transcript levels against the heat shock much more pronounced in  thermotolerant than in the susceptible cultivars.Key words: Triticum aestivum, heat stress, small heat shock protein, putrescine, HSP17, polyamine, domain, cloning