Extranodal rosai dorfman disease: a case report of single soft tissue cystic lesion

Rosai-Dorfman disease (RDD) is an uncommon benign histiocytic disorder. It is found worldwide and slightly more common among in men (1.4:1), affecting individuals are with an average age of 20.6 years. Extranodal tissue involvement is documented in 25-43% of RDD patients. Here authors are discussing a case of 16-year-old male patient with the complaint of a single swelling over left forearm since one month with no lymphadenopathy. Radiology showed anechoic collection within the muscle and superficial to it. On microscopy, smear showed diffusely distributed histiocytes with cytoplasm showing intact lymphocytes with halo surrounding it (emperipolesis), without atypia. Based on cytomorphology diagnosis of Extranodal Rosai Dorfman Disease was made

Evaluation of complications during third stage of labour among women delivering at tertiary care center

Background: The common complications occurring during third stage of labor are PPH Retained Placenta, Morbid adherent placenta- placenta accreta, placenta increta, percreta, perineal tears, uterine inversion increasing the maternal morbidity and mortality. The objective of the present study was to evaluate percentage and spectrum of obstetrics complication occurring during third stage of labor.Methods: An observational study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Center, Bhopal from January 2016 to December 2017. All women delivering vaginally including instrumental deliveries were included. The medio-lateral episiotomy was given to all primigravida and for multigravida decision was case based as big size babies, instrumental deliveries, rigid perineum. Active management of third stage of labor was practiced.Results: 899 women delivered vaginally during the study period of 2 years (Jan -Dec 2016 Jan -Dec 2017). Among these 6.45% (58 women) had various complications during third stage of labor . 55% were primigravida. Complications which were observed to occur during third stage of labor were perineal tear 4% (37/899 deliveries). Atonic PPH occurred in 0.5% (9/899 deliveries) Traumatic PPH was in 1.44% (13/899 deliveries and 0.3% cases had retained placenta. Associated condition in perineal tear cases were 92% had big size babies 5% cases were preterm labor and in 3% cases ventouse application was done.Conclusions: Common complications were 1st and 2nd degree perineal tears occurred in 4% deliveries and traumatic PPH were in 1.44% of cases

SOLID DISPERSIONS: RESUSCITATING ORAL DELIVERY OF HYDROPHOBIC DRUGS

Objective: This review article explores solid dispersions (SDs) as one of the suitable approaches to formulate poorly water-soluble drugs. The objective of this review on SD techniques is to explore their utility as a feasible, simple, and economically viable method for augmentation of dissolution of hydrophobic drugs. Methods: Various types of SDs are classified and compared. Use of surfactants to stabilize the SDs and their potential advantages and disadvantages has been discussed. Different techniques for preparing and evaluating SDs are appraised along with discussions on scalability and industrial production. Review of the current research on SD along with future trends is also offered. Results: Based on the various researches, SDs offer an efficient means of improving bioavailability while concurrently contributing to lower toxicity and dose-reduction. Conclusion: Solid-dispersions have been and continue to be one of the key technologies for solving the issue of poor solubility for newer hydrophobic molecules which are being discovered. This would give a new lease of life for such drugs enabling them to be delivered in an effective way

Pattern of adverse drug reactions occurring at department of neurology of a tertiary care hospital in India

Background: The objective of the study was to study the pattern and trends of adverse effects of drugs used in department of neurology in a tertiary care hospital.Methods: A prospective, observational study was carried out for a duration of 12 months from November 2018 to October 2019 at Department of Neurology and Department of Pharmacology and Therapeutics, G.S.V.M. Medical College, Kanpur after getting an approval from institutional ethical committee. Data was collected by analyzing OPD prescription slip, treatment charts and investigation reports. All relevant information regarding adverse drug reactions (ADRs) were collected as per norms of Indian Pharmacopoeia commission (IPC).Results: During the study period, a total of 130 ADRs reported. Most of the ADRs were reported due to antiepileptic drugs followed by antiparkinsonian drugs. Dizziness was the most frequent ADR reported. Most of the ADRs were reported due to phenytoin. Other ADRs observed were drowsiness, nausea/vomiting, weakness, joint pain, dyskinesia.Conclusions: Most of the ADRs were due to anti-epileptic drugs. Most of the reactions were of mild severity

Predicting and grading the degree of difficulty of cochlear implant surgery by evaluating temporal bone using high resolution computed tomography and magnetic resonance imaging

Background: The current study was designed to assess the challenges that arise during cochlear implantation. Hence imaging based grading system, using a structured, 12-point scoring chart was developed with an aim to assess various anatomical factors of temporal bone helpful in contemplating complications involved in surgery and to assess various congenital and acquired abnormalities if detected during scan which can affect cochlear implant surgery.Methods: This was a descriptive study done on 60 patients with sensorineural hearing loss. They were evaluated preoperatively by using HRCT and MRI findings and subsequently underwent cochlear implantation. A 12-point scoring chart was developed based on imaging findings. Surgical times were noted in each case and each imaging point on the scoring chart was correlated with the surgical times.Results: Eleven out of 12 points in the scoring chart proved to be statistically significant in predicting the degree of difficulty of the surgical procedure. One point was not correlating with the surgical timings. Based on the grading system, in the present study, there were 37 patients (61.66%) classified as Grade 1, 16 patients (26.67%) classified as Grade 2 and 7 patients (11.67%) classified as Grade 3.Conclusions: These radiological image findings and its related grading system are relatively easy and quick to assess on readily available pre-operative temporal bone CT scan and MRI. They can form a pre-operative checklist that provides a formalized approach for the surgeons and, in particular surgical trainees, predict and, thus prepare for, potentially challenging cochlear implant cases

Effect of antenatal corticosteroids on neonatal outcome in term elective caesarean section: a randomised controlled trial

Background: Infants born at term by elective caesarean section are more likely to develop respiratory morbidity than infants born vaginally. Prophylactic corticosteroids in singleton preterm pregnancies accelerate lung maturation and reduce the incidence of respiratory complications. Thus, the aim of this randomized controlled trial was to assess the effect of antenatal corticosteroids on neonatal outcome among term pregnant women undergoing elective caesarean section.Methods: It was an open labelled randomized controlled trial conducted among women with term pregnancy of 37-38+6 weeks and planned for caesarean section at term and who were willing to participate in the study. We randomized 50 pregnant women into intervention group which received antenatal corticosteroids in the form of injection dexamethasone 12 mg IM, 4 doses at 12 hourly intervals before term elective caesarean section and 50 pregnant women into control group which did not receive antenatal corticosteroid. Fetal outcomes were compared in both groups after caesarean section. Data were analysed using SPSS vs.20.Results: Nearly half (54%) of pregnant women belonged age group of 21-25 years and majority (58%) of pregnant women belonged to 38-39 weeks of gestation. Out of 50 pregnant women in intervention group, only two percent neonates developed RDS, four percent neonates developed transient tachypnea of neonate (TTN) and six percent neonates required NICU admission which was lower than control group. However, difference between fetal outcomes in intervention and control group was not statistically significant (p>0.05).Conclusions: Administration of prophylactic antenatal corticosteroids before 48 hours of elective term caesarean section does not have impact on fetal outcome in our study

The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life

Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals

The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life

Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals

Anti-Microbial Activity of Hempseed Oil and Sage Oil against Streptococcus mutans and Candida albicans: An In-Vitro Study

Objective: To assess the anti-microbial activity of sage oil and hempseed oil against Streptococcus mutans and Candida albicans. Material and Methods: The sage oil and hempseed oil in pure extract form were collected from an authorized government organization. The anti-microbial activity from the oils was assessed by Kirby-Bauer disc diffusion method. Standard antibiotics Vancomycin and Fluconazole were taken as a positive control for Streptococcus mutans and Candida albicans, respectively. The mean zone of inhibition (ZOI) was measured at 24 hours, 48 hours and 72 hours by HI-MEDIAs antibiotic zone scale. One-way Analysis of variance with Tukey’s Post Hoc was applied for statistical analysis. Results: The mean zone of inhibition of sage oil and hempseed oil at 24 hours, 48 hours and 72 hours against Streptococcus mutans was (7.0 ± 4.24, 9.1 ± 3.71 and 8.4 ± 3.02) and (0.0, 3.2 ± 0.75, 1.9 ± 1.24) respectively. The zone of inhibition against Candida albicans 24 hours, 48 hours and 72 hours for sage oil (2.80 ± 1.151, 6.70 ± 1.30 and 6.30 ± 1.44), hempseed oil (0.0, 3.80 ± 0.75, 3.10 ± 0.41). Sage oil presented potential anti-microbial activity against Streptococcus mutans and Candida albicans. Comparing the anti-microbial efficacy, standard antibiotic (Vancomycin/Fluconazole) was more effective than test oils. Conclusion: Test oils showed anti-bacterial and anti-fungal activity against Streptococcus mutans and Candida albicans. Among these, sage oil showed efficacy at 24 hours, while hempseed oil did not show any effect at this time point. Further studies are needed to affirm the same and test their efficacy in different forms and concentrations