Intramural hemotoma presenting as acute coronary syndrome: The importance of intravascular ultrasound

Intramural hematoma in major coronary epicardial vessels is a rare cause of chest pain. Afflicted individuals may present with acute coronary syndrome (ACS) or even sudden cardiac death. Spontaneous, isolated intramural hematoma may occur in the absence of associated intimal dissection. In this situation, lesions may be angiographically indistinguishable from ruptured atherosclerotic plaque. Intravascular ultrasound is important in the accurate diagnosis of isolated intramural hematoma. Although coronary stenting may be required in the presence of ongoing ischemia, intramural hematoma may be successfully managed medically. We describe the case of a middle-aged woman who presented with ACS due to an intramural hematoma and discuss the diagnosis and management of this rare illness

To evaluate the correlation between gingival crevicular blood glucose and capillary blood glucose to screen diabetes mellitus in the dental office

Background: Most of the Indian population goes undiagnosed for diabetes due to unawareness. This will lead to more serious and long-term complications of diabetes. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection. Research has explored the dental office as a strategic venue of opportunity for glucose testing, examining the possibility of using gingival crevicular fluid (GCF) for diabetes screening. Aim: The aim of this study is to evaluate the reliability of gingival crevicular blood (GCB) to screen the diabetes. Methodology: Thirty patients were randomly selected based on bleeding on probing and probing depth. GCB and capillary finger blood (CFB) glucose levels were calculated using glucometer from patients. Data for glucose levels were statistically analyzed. Results: The correlation between GCB and CFB was high. Conclusion: GCB can be used as the screening test for diabetes in the dental office. Clinical Significance: GCB blood glucose level detection can be used as chairside screening test for diabetes patients

Evaluation of antimicrobial activity of orange peel extract against oral biofilm forming organisms: an in vitro microbial study and scanning electron microscopic assessment

Background: To evaluate in vitro antimicrobial activity of orange peel extract, 0.2% chlorhexidine (CHX) and saline against dental biofilm-forming bacteria and their effect on plaque structure under SEM.Methods: Present study included 3 groups; Group A: Orange peel extract; Group B: 0.2% CHX and Group C: Saline.  MIC of each group was determined by broth and well diffusion method. Reference strains of Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.) and Aggregatibacter actinomycetemcomitans (A.a.) were selected as being colonizers in dental biofilm. For SEM analysis, plaque retained orthodontic e-chains were subjected to each group for 60s and studied under SEM.Results: The MIC of Group A by broth diffusion method is 66.66 µg/ml for P. intermedia, 75 µg/ml for P. gingivalis and 33.33 µg/ml for A.a. MIC of Group B was 14.58 µg/ml for P.i., 7.29 µg/ml for P.g. and 20.83 µg/ml for A.a. MIC of Group C was 83.33 µg/ml for A.a. while P.i. and P.g. showed resistance to Group C. The determination of MIC by well diffusion showed increase in clear zone diameter with increasing concentrations.  Greater zone of inhibition was seen in Group B with statistical significance for all 3 microorganisms. Morphologic changes in the SEM study showed maximum change in the surface characteristics and loss of adhesion of the clusters of microorganisms subjected to Group B.Conclusions: CHX and orange peel extract exhibited notable anti-microbial activity against biofilm organisms, but at varying concentrations. The plaque samples subjected to orange peel extract showed slightly shrunken and coarse form indicating its ability to disrupt the plaque biofilm

Efficacy of Lignocaine Hydrochloride with Adrenaline, Clonidine and Dexmedetomidine for Surgical Removal of Impacted Mandibular Third Molar: A Research Protocol for a Randomised Clinical Trial

Introduction: In human dentition, the most common impacted teeth are Mandibular Third Molars (M3M). Removal or extraction of these teeth leads to anxiety in the patients oweing to the perception of pain. Thus, pain control mechanism like anaesthesia needs to be executed appropriately. Using newer local anaesthetic drugs minimises side effects and drug interactions. Adrenaline is traditionally used vasoconstrictor along with Lignocaine. Dexmedetomidine and Clonidine are alpha agonists which in combination with Lignocaine provide a prolonged duration of anaesthesia thus decreasing the need for rescue analgesics. Need for the study: This research will assist in assessing and establishing the duration of anaesthesia and postoperative analgesia after the administration lignocaine hydrochloride with adrenaline, clonidine and dexmedetomidine in third molar surgery. This will eventually lead to less consumption of analgesics owing to the delay in ingestion of rescue analgesics. Aim: To evaluate and compare the safety and efficacy of adrenaline, clonidine and Dexmedetomidine as an adjuvant to lignocaine hydrochloride for perineural inferior alveolar nerve block in cases of IM3M surgeries. Materials and Methods: This is a prospective, triple blind, randomised, controlled, parallel arm study. The study will be conducted at the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Sawangi (M), Wardha from February 2023 to June 2024. A total of 45 consecutive systemically healthy patients requiring unilateral surgical extraction of impacted M3M with similar orientations will be divided into three groups randomly. The first group will receive lignocaine with adrenaline, the second group will receive lignocaine with clonidine and third group will receive lignocaine with dexmedetomidine during the extraction procedure which will be compared on following parameters the onset of anaesthesia, depth of anaesthesia, haemodynamic parameters and duration of postoperative analgesia. ‘One-way ANOVA’ will be used to analyse and evaluate.

Passage through the carotid sheath: An alternative path to the pre-spinal route for direct repair of contralateral C7 to the lower trunk in total brachial plexus root avulsion injury

Context: In surgical management of global brachial plexus injuries, direct repair of contralateral C7 (cC7) to the anterior division of the lower trunk, can produce good extrinsic finger flexion. The pitfalls associated with the pre-spinal passage have, perhaps, proved to be a deterrent for using this technique routinely. Aims: The aim of this study is to demonstrate an alternative to pre-spinal route for cC7 transfer in brachial plexus avulsion injuries. Methods: We noted that the mobilised lower trunk, which reaches the level of the scalenus anterior by passage deep to the clavicle, can be brought to the suprasternal notch when brought out from below the clavicle. This area was dissected in two cadavres, and safe passage was found through the carotid sheath with the common carotid artery medially and the internal jugular vein with the vagus nerve laterally. The cC7 root dissected medial to the scalenus anterior muscle can be directly transferred along this path to the subcutaneous plane at the suprasternal notch. This study allowed us to execute a direct repair in ten clinical cases of global brachial plexus injuries. In each case, the passage was prepared rapidly and uneventfully. The repair was technically simple and could be performed comfortably using suitable fine suture materials. In none of these cases, did we need to shorten the humerus. Results: The clinical outcome of this technique is awaited. Conclusions: We advocate carotid sheath route to approximate the cC7 to the injured lower trunk in global palsies, as the risks associated with the pre-spinal route can be readily avoided

Effect of internals and sparger design on mixing behavior in sectionalized bubble column

An experimental study has been carried out to investigate the effect of internals and sparger design on mixing time (θ<SUB>mix</SUB>) and fractional gas hold-up (ε<SUB>G</SUB>) in a batch mode sectionalized bubble column. Air and water were used as the gas-liquid phases, respectively. In the present work, sparger with the percent free area (% FA) of 0.136 and 0.6% has been used and the superficial gas velocity (V<SUB>G</SUB>), liquid height to column diameter (H<SUB>c</SUB>/D), percent free area of the sectionalizing plate was varied from 0.06 to 0.295 m s<SUP>−1</SUP>, 3 to 4 and 4 to 23%, respectively. It was found that there is no significant effect of the sparger design on the mixing time but it does strongly depend on V<SUB>G</SUB>, H<SUB>c</SUB>/D and % FA of the sectionalizing plate. The one-dimensional dispersion model successfully predicts the tracer concentration profile and the longitudinal dispersion coefficient. Also, the effect of the presence of the electrolyte too has been studied by adding a known volume of the tracer solution (NaCl). Correlations have been developed for the estimation of the fractional gas hold-up, mixing time, longitudinal dispersion coefficient (D<SUB>L</SUB>) and the intercell exchange velocity (u<SUB>B</SUB>)

Concentration of salivary immunoglobulin A, in relation to periodontal disease, plaque, and calculus

Background: It has become apparent that every pathologic process in the body involves the immune system. Periodontal inflammation is not an exception. Periodontal health depends on the interaction of microbial flora and host response. Since long, research is focused on understanding the immunopathologic mechanism operating in the development and maintenance of periodontal inflammatory changes. Methods: Patients of age 20-35 were selected. Nonstimulated saliva was collected and assessed using radial immunodiffusion assay to estimate levels of IgA. Results: The present study suggests patients with gingival index 0.2-0.5 and periodontal index 0 have a concentration of IgA less than 21.4%. As values of gingival and periodontal index go on increasing, the concentration of salivary IgA also increases. Conclusion: the concentration of salivary IgA is directly and positively correlated to severity of inflammation. Also the concentration of IgA depends on the presence of plaque

Mixing time studies in bubble column reactor with and without internals

Sectionalized bubble columns are finding a wide use in the case of FT synthesis, petroleum refining, wastewater treatments, extraction, absorption, leaching, ion exchange etc., due to their superiority in terms of reduced liquid phase back-mixing. The present work covers a mixing aspect in a 0.41 m id. sectionalized bubble column over a wide range of superficial gas velocity, liquid height to column diameter ratio, percent free area of the sectionalizing plates and electrolyte concentration for Air-water system. The acquired conductivity data was optimized using a compartmental and axial dispersion models and the model parameters have been estimated. For a given Hc/D ratio; mixing time was found to decrease with an increase in gas superficial velocity and free area of the sectionalizing plate. The compartmental model successfully predicts the tracer concentration profile and the longitudinal dispersion coefficient. The mixing time in a sectionalized bubble column was also compared with a non-sectionalized bubble column and was found to be order of magnitude higher