Treatment of dental complications in sickle cell disease.

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health.Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. OBJECTIVES: To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS: We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 11 April 2016.Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 03 March 2016. SELECTION CRITERIA: We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS: Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS: No randomised controlled studies were identified. AUTHORS\u27 CONCLUSIONS: This Cochrane review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease

Incremental Learning of Acoustic Scenes and Sound Events

In this paper, we propose a method for incremental learning of two distinct tasks over time: acoustic scene classification (ASC) and audio tagging (AT). We use a simple convolutional neural network (CNN) model as an incremental learner to solve the tasks. Generally, incremental learning methods catastrophically forget the previous task when sequentially trained on a new task. To alleviate this problem, we propose independent learning and knowledge distillation (KD) between the timesteps in learning. Experiments are performed on TUT 2016/2017 dataset, containing 4 acoustic scene classes and 25 sound event classes. The proposed incremental learner first solves the ASC task with an accuracy of 94.0%. Next, it learns to solve the AT task with an F1 score of 54.4%. At the same time, its performance on the previous ASC task decreases only by 5.1 percentage points due to the additional learning of the AT task.Comment: Accepted to DCASE2023 Worksho

Natural Healing Sciences

Ayurveda, Yoga and Naturopathy are ancient alternative therapies having similar principles with each other. The Panchabhoutic theory of Ayurveda and five elements of nature are used to cure ailment of common man. These aspects of life related to that are given in Ayurveda and in the similar way nature cure and in Yoga science also. The body as a whole and to correct the pathogenesis these natural healing sciences are very important

STUDY OF LEVELS OF SERUM CREATINE PHOSPHOKINASE AND LIVER ENZYMES AS A PROGNOSTIC INDICATORS IN ACUTE ORGANOPHOSPHORUS POISONING

Background: Organophosphorus (OP) poisoning is one of the most common poisoning in rural and in developing country. Due to their easy availability and cost effective it is used frequently for homicidal and suicidal attempts. Routinely used biochemical markers like Erythrocyte cholinesterase (EChE) and Plasma cholinesterase (PChE) are used for the diagnosis of acute organophosphorus (OP) poisoning but estimation of these are very costly and not easily available. The mortality increases with increase in initial creatine phosphokinase level and can be used as alternative biomarker. Hence study was done to estimate levels of serum Creatine Phosphokinase (CPK) and liver enzymes in acute OP poisoning patients and its prognostic significance. Methodology: Patients (80) admitted in our hospital were included in this study. A brief history and detailed clinical examination was performed and patients were categorized on the basis Modified Dreisbach\u27s clinical criteria classification. Serum levels of Creatine kinase (CK) and Liver enzymes were analysed at the time of admission. The outcome of the patients were observed. Results: Out of 80 patients recruited for the study, 41 cases (51.3%) were females, and 39 cases (48.8%) were males. Majority of them were in the age group of 21-30 years. More cases of OP poisoning were among agriculturalists 28 (35%) and housewife 21 (28.8%) and among students 15 (18.8%). Malathion was the most common compound used followed by Monocrotphos. 60% had mild, 31.3% had moderate and 8.8% had severe poisoning. There is increase in Creatine Phosphokinase (CPK) levels in 6 patients who survived with ventilator support and also in 2 patients who died with ventilator support which was statistically highly significant (p<0.05). Serum liver enzymes were within normal limits. Conclusion: Elevated Creatine kinase is commonly seen in OPC poisoning. High initial serum Creatine Phosphokinase (CPK) levels are associated with severe degree of poisoning and are associated with complications and mortality. Serum liver enzymes (SGOT AND SGPT) are not elevated in OP poisoning

Differentiating transudative and exudative pleural effusion by pleural fluid cholesterol

Background: Pleural effusion is one of the common condition encountered in day to day practise. Pleural effusions represent a very common diagnostic task to the physician. A correct diagnosis of the underlying disease is essential to rational management. Today there are a number of laboratory tests available to differentiate exudates and transudates which are considered cost effective to the patients, so this study was designed for the measurement of pleural fluid cholesterol to differentiate transudative and exudative pleural effusions (sensitivity-97.8%, specificity-100%) with the advantage that a contemporary blood sample is not required, thereby lowering cost of diagnostic procedure. Objectives: To study the diagnostic value of Pleural fluid Cholesterol in differentiating transudative and exudative pleural effusions. Methodology: This cross sectional descriptive study was conducted on patients of pleural effusion (n=60)age >18 years patients with definitive clinical diagnosis and evidenced by radiological diagnosis of pleural effusion were taken as inclusion criteria. Results: The results showed majority of the patients were males (63.3%) and females (36.7%). According to lights criteria 46 patients were exudates and 14 patients were transudates and according to Pleural fluid Cholesterol criteria 45 patients were exudates and 15 patients were transudates with sensitivity of 97.8% and specificity of 100% and accuracy of 98.3%. Conclusion: The pleural fluid cholesterol criteria were found to be the most efficient criteria. Since this parameter involves the measurement of only pleural fluid values of cholesterol, it has following advantages-Economically it reduces number of biochemical tests and Simpler as there is no need to take simultaneous blood sample at the time of thoracocentesis

Differentiating transudative and exudative pleural effusion by pleural fluid cholesterol

Background: Pleural effusion is one of the common condition encountered in day to day practise. Pleural effusions represent a very common diagnostic task to the physician. A correct diagnosis of the underlying disease is essential to rational management. Today there are a number of laboratory tests available to differentiate exudates and transudates which are considered cost effective to the patients, so this study was designed for the measurement of pleural fluid cholesterol to differentiate transudative and exudative pleural effusions (sensitivity-97.8%, specificity-100%) with the advantage that a contemporary blood sample is not required, thereby lowering cost of diagnostic procedure. Objectives: To study the diagnostic value of Pleural fluid Cholesterol in differentiating transudative and exudative pleural effusions. Methodology: This cross sectional descriptive study was conducted on patients of pleural effusion (n=60)age >18 years patients with definitive clinical diagnosis and evidenced by radiological diagnosis of pleural effusion were taken as inclusion criteria. Results: The results showed majority of the patients were males (63.3%) and females (36.7%). According to lights criteria 46 patients were exudates and 14 patients were transudates and according to Pleural fluid Cholesterol criteria 45 patients were exudates and 15 patients were transudates with sensitivity of 97.8% and specificity of 100% and accuracy of 98.3%. Conclusion: The pleural fluid cholesterol criteria were found to be the most efficient criteria. Since this parameter involves the measurement of only pleural fluid values of cholesterol, it has following advantages-Economically it reduces number of biochemical tests and Simpler as there is no need to take simultaneous blood sample at the time of thoracocentesis

STUDY OF SERUM HOMOCYSTEINE LEVELS IN CEREBROVASCULAR ACCIDENT

Background: Stroke is the second most common cause of death and major cause of disability worldwide. Plasma homocysteine concentration is one of the emerging modifiable risk factor for stroke. The objective of this study was to evaluate the fasting homocysteine level in different type of stroke (Ischemia & Hemorrhage). MATERIAL & METHOD: The present study is case control study in which 90 patients with diagnosis of stroke (intracerebral infarct & hemorrhage) were enrolled and fasting serum homocysteine were measured in all and its comparison was done with matched healthy controls. Result: In study group the mean serum homocysteine level is 31.47±39.89µmol/L and in control group 16.62±22.08µmol/L, it indicates that serum homocysteine level is highly significantly raised (P value < 0.0001) in cases of stroke compared with control patients. However there is no significant difference in homocysteine level between intracerebral infarct and intracerebral hemorrhage (P= 0.5817). There is significant relationship of raised serum homocysteine level with hypertension & smoking. Conclusion: The present study revealed that hyperhomocysteinemia appears to be an important risk factor for cerebrovascular accidents. It is therefore important to use serum homocysteine level as an important tool to investigate all cases of cerebrovascular accidents and also in those who are at risk of developing stroke

STUDY OF LEVELS OF SERUM CREATINE PHOSPHOKINASE AND LIVER ENZYMES AS A PROGNOSTIC INDICATORS IN ACUTE ORGANOPHOSPHORUS POISONING

Background: Organophosphorus (OP) poisoning is one of the most common poisoning in rural and in developing country. Due to their easy availability and cost effective it is used frequently for homicidal and suicidal attempts. Routinely used biochemical markers like Erythrocyte cholinesterase (EChE) and Plasma cholinesterase (PChE) are used for the diagnosis of acute organophosphorus (OP) poisoning but estimation of these are very costly and not easily available. The mortality increases with increase in initial creatine phosphokinase level and can be used as alternative biomarker. Hence study was done to estimate levels of serum Creatine Phosphokinase (CPK) and liver enzymes in acute OP poisoning patients and its prognostic significance. Methodology: Patients (80) admitted in our hospital were included in this study. A brief history and detailed clinical examination was performed and patients were categorized on the basis Modified Dreisbach's clinical criteria classification. Serum levels of Creatine kinase (CK) and Liver enzymes were analysed at the time of admission. The outcome of the patients were observed. Results: Out of 80 patients recruited for the study, 41 cases (51.3%) were females, and 39 cases (48.8%) were males. Majority of them were in the age group of 21-30 years. More cases of OP poisoning were among agriculturalists 28 (35%) and housewife 21 (28.8%) and among students 15 (18.8%). Malathion was the most common compound used followed by Monocrotphos. 60% had mild, 31.3% had moderate and 8.8% had severe poisoning. There is increase in Creatine Phosphokinase (CPK) levels in 6 patients who survived with ventilator support and also in 2 patients who died with ventilator support which was statistically highly significant (p<0.05). Serum liver enzymes were within normal limits. Conclusion: Elevated Creatine kinase is commonly seen in OPC poisoning. High initial serum Creatine Phosphokinase (CPK) levels are associated with severe degree of poisoning and are associated with complications and mortality. Serum liver enzymes (SGOT AND SGPT) are not elevated in OP poisoning