Prevalence of elderly patients who refuse to get discharge from coronary intensive care unit in a tertiary care hospital of North India: a pilot study

Background: The elderly population ≥60 years is increasing as the life span is increasing. So is the number of elderly patients who are refusing to get discharge from the hospital is also increasing. Authors are conducting this study in the elderly population who want to stay against medical advice.The aim to find the prevalence of elderly patients who refuse to get discharge from Coronary Care Unit (CCU) in a Tertiary care hospital of North IndiaMethods: A retrospective, observational study conducted in patients of age ≥60 years admitted to the coronary intensive care unit of a tertiary health care centre who refused discharge from the unit, were included in the study. Results: Of the 575 patients 44(7.65%) were willing to stay against medical advice. Of these 24(54.5%) were males and 20(45.5%) females. 6(13.6%) patients were terminally ill suffering from malignancies. Among all the patients who were willing to stay against medical advice, 8(18.2%) were covered by some health insurance scheme of either State or Central Government. 3(6.8%) patients were discharged after 24 hours, 22(50%) patients after 48 hours, 14(31.9%) patients after 72 hours and 5(11.3%) patients after 96 hours of advising discharge from hospital.Conclusions: As the intensive care beds at tertiary healthcare level are limited, the treatment of other salvageable sick patients who need the intensive care is affected by the unnecessary stay in hospital. Apart from the worsened nurse to patient ratio this increases the cost of treatment. This is need of hour to provide safe environment for the elderly outside the hospital settings and increase resources to provide better homecare

Role of radiology in central hemangioma of jaws

Central hemangioma, a bone destructive lesion, is a benign tumor. Hemangiomas of jaws are rare entity and produ- ces many different radiographic images. Radiographic differential diagnosis includes osteosarcoma, fibrous dysplasia, central giant cell granuloma, ameloblastoma, odontogenic myxoma, multiple myeloma, dentigerous cyst and aneurysmal bone cyst. Since it involves proliferation of blood vessels so aspiration or biopsy of such lesions can lead to severe hemorrhage which can turn out to be lethal. We stress on the importance of radiology in the timely diagnosis of such lesions which can prevent the disaster not only to the patient but also to oral surgeon in legal and professional aspects

Reimplantation: clinical Implications and outcome of dry storage of avulsed teeth

Reimplantation refers to the insertion and temporary fixation of completely or partially avulsed teeth that have resulted from traumatic injury. Reimplantation of an avulsed tooth depends on certain clinical conditions like phy- siological status of periodontal ligament (PDL), the stage of root development and the length of extra oral time. Depending on the patient’s age, retention of the permanent incisor can maintain the aesthetic appearance, occlusal function and alveolar ridge height. Though the risk of progressive replacement resorption and subsequent tooth loss is high after a long dry storage, reimplantation makes a provision for an aesthetically acceptable permanent prosthesis at a later age. This article presents management of two cases with avulsed permanent incisors that were stored in dry conditions for seven hours and three days respectivel

Prevalence of traumatic dental injuries and role of incisal overjet and inadequate lip coverage as risk factors among 4-15 years old government school children in Baddi-Barotiwala area, Himachal Pradesh, India

Objective: To assess the prevalence of traumatic dental injuries (TDI) in school children in Baddi- Barotiwala, Himachal Pradesh, India. Methods: A cross-sectional survey was carried out in Government schools among 1059 government school children aged 4- 15 years. The study was conducted from October 2009 to March 2010 during the school hours. The demographic detail was carried on a structured questionnaire. The data regarding the traumatic injuries was recorded using modified Ellis' classification. Results: Prevalence of TDI was found to be 4.15%. 95.45% of the injuries were to the maxillary anterior teeth. Maxillary central incisor was the most common tooth to be affected due to trauma (54.5%). Enamel with dentin fracture with pulp exposure was the main type of TDI (43.1%). The majority of TDIs were untreated (97.7%). Falls (54.5%) were found to be the main cause. Over jet over 3 mm and inadequate lip coverage were found to be important contributing factors for TDIs. Conclusion: The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatment of traumatic dental injuries. It is crucial to generate considerable efforts to implement health promotion strategies to reverse the observed trends and to provide treatment to TDIs to prevent their biologic and psychological consequences. © Medicina Oral S. L

Oral myiasis in a cerebral palsy patient: a case report

Myiasis is a rare condition caused by the invasion of tissues by the larvae of flies, mainly from the order of Diptera. Many cases of myiasis involving various human organs have been reported. Oral Myiasis is very rare in healthy persons. It occurs mainly in the tropics and is usually associated with inadequate personal and public hygiene; sometimes accompanied by poor manual dexterity. We present a case of oral myiasis in a mentally retarded, 13- year-old boy suffering with cerebral palsy. The diagnosis was based on the characteristic clinical features and the visualization of wriggling larvae. Large numbers of larvae were found in the gingival sulcus. Treatment consisted of manual removal of the larvae, one by one, with the help of turpentine oil and clinical forceps, local debridement of the labial gingival and oral hygiene practice. Healing was uneventful, with resolution of the condition

Significance of pre-treatment panoramic radiographic assessment of edentulous patients-A survey

Objectives: The present study was undertaken to review the significance of pre-treatment panoramic radiographic assessment of edentulous patients, in the dental patient population of Haryana, India. Study Design: In this study a total of 525 completely edentulous patients were selected randomly. A panoramic radiograph was taken using Panoramic machine (Rotagraph plus) and all the radiographs were evaluated by 2 oral radiology specialists for the following clinically significant radiographic findings: retained root fragments, embedded teeth, radiolucencies, radiopacities and location of the mental foramen at the crest of the residual alveolar ridge. The data were analyzed using the chi square test. Results: A total of 245 radiographic findings were seen in 168 (32%) patients. Out of total 525 cases 16.4% (n=86) patients had submucosal or intrabony root stumps, 4.8% (n=25) had embedded teeth, 2.5% (n=13) had radiolucencies, 9.9% (n=52) had radiopacities and 1.7% (n=9) had mental foramen at the crest of the residual alveolar ridge. Conclusion: The results of this study suggest that Routine radiographic examination of completely edentulous patients is critical before construction of complete denture. © Medicina Oral S. L

Papillon Lefevre syndrome: bridge between Dermatologist and Dentist

Papillon-Lefevre syndrome is a rare autosomal recessively inherited condition which shows features common to both dentistry and dermatology. This disease is characterized by palmoplantar hyperkeratosis and severe periodon- titis. Therefore both the dentist and the dermatologist should be aware of the same because an early diagnosis of the syndrome can help to preserve the teeth by early institution of treatment, using a multidisciplinary approach. Here we present a case report of Papillon-Lefevre syndrome, along with a comprehensive review of the etiology, pathology, clinical features, differential diagnosis and management of the condition

Acute colonic pseudo-obstruction (ogilvie’s syndrome) or colonic perforation: A rare complication following cesarean section

Ogilvie’s syndrome or pseudo-obstruction of the colon shows up as a clinical picture of acute obstruction of the large bowel without an associated pathological lesion as usually occurs in older patients. Here, we report a case series of three cases of Ogilvie’s syndrome following caesarean section. The caesarean section seems to be the most common operative procedure associated with this syndrome. The diagnosis was made by plain X-ray of the patient’s abdomen, which revealed dilated gut loops or air under the diaphragm in case of perforation. The pathological cause seems to be the disturbance of the autonomic innervation of the colon. The colon should be decompressed rapidly using colonoscopy. Surgery should be reserved for cases that have complications or that have been refractory to conservative treatment. Of our three cases, one was treated successfully by colonoscopic decompression and IV neostigmine, whereas, rest two patients presented late with colonic perforation. So they were immediately taken for exploratory laparotomy

Exploring Herbal Remedies for Anti-Leishmanial Activity: A Comprehensive Review

- Leishmaniasis remains a serious neglected illness worldwide, posing significant challenges in its treatment due to the side effects of existing medications and the rising cases of parasite resistance resulting from indiscriminate treatment. To address this issue, exploring complementary remedies using natural products presents a promising option by combining the empirical knowledge of local populations with scientific research on the medicinal properties of plants. Several studies have investigated herbal treatments for leishmaniasis; however, more research is needed to identify safe and non-toxic remedies. To consolidate the latest findings, researchers from around the globe have compiled a comprehensive article on herbal and organic medicines used to treat leishmaniasis. While many medicinal plants have not been extensively studied, promising candidates have undergone prospective clinical trials. Recent articles have explored the active constituents of these medicinal plants, such as quinones, phenolic compounds, lignans, tannins, terpenes, and oxylipins, shedding light on their potential therapeutic benefits. Pharmacognosy views medicinal plants as valuable sources for developing novel medications and supporting traditional therapies, offering a practical approach to managing various illnesses. In summary, harnessing the power of natural goods and integrating traditional knowledge with scientific research provides a viable and desirable strategy to combat leishmaniasis, promoting safer and more effective treatment options in the future

Designing and implementing a resilient immutability mechanism for enhanced supply chain management in E-healthcare systems

Counterfeit drugs pose significant health risks due to their variable efficacy and potential harmful ingredients. To combat this issue, a reliable and secure track-and-trace system is essential for pharmaceutical supply chains. This paper proposes an Immutable and Decentralized Pharma (IDP) model, leveraging blockchain technology to ensure the safe and efficient distribution of medications. The IDP model utilizes smart contracts to record transactions between entities onto a blockchain, enabling end-to-end product tracking and provenance. Experimental results on a polygon blockchain test network demonstrate the feasibility and enhanced security of the IDP model in a collaborative environment. Our solution addresses the challenges of data privacy, openness, and authenticity inherent in centralized track-and-trace systems, providing a promising approach to eliminate counterfeits and guarantee product safety in pharmaceutical supply chains