Use of dorsalis pedis artery flap in coverage of distal lower leg defects

Soft tissue defect in the distal one third of leg have always posed a challenge for reconstructive surgeons. Such wounds are difficult to manage due the tenuous blood supply, limited subcutaneous cover over the tendons and bones. The aim of our study is to investigate the outcome of Dorsalis pedis artery flap for the coverage of such defects. In the present study, we share our clinical experience with the use of dorsalis pedis artery flap for the coverage of defect in the distal one third leg. This is a series of 4 cases where dorsalis pedis artery flap was used to cover lower one third defect. One case had focal squamous cell carcinoma due to long standing post burns contracture in distal one third of leg anteriorly. Other 3 cases had chronic non healing ulcer in the malleolar region. Patient outcome was assessed according to patients’ age distribution, duration of surgery, hospital stay, and post-operative complications. All 4 patients had excellent outcome with no major donor site complications, infection, and graft loss. Donor site was closed with split thickness skin graft. One patient developed a minor raw area over the dorsum of foot which healed secondarily. Although a potential risk in applying this flap is insufficient venous drainage, no problems with blood inflow or outflow were encountered in the present case series. The flaps survived, and the patient had good postoperative outcome. Hence dorsalis pedis flap can be used for the coverage of the distal foot as a good option

THE EVALUATION Of PHYSICOCHEMICAL ANALYSIS OF PARAD SHODHAN

Rasa Shastra Dravyas includes minerals and metals which are mainly Bhumij in origin (obtained from earth), Parad (mercury) is also one among them. In Rasa Shastra, the extra ordinary importance of mercury is easily seen as the whole branch is named after Parad. In Rasa Shastra Parad cannot be adopted for therapeutic purposes without purification. Owing to their origin all the metallic and mineral drugs are likely to be associated with different varieties of impurities up to various degrees. Hence, they are advised to be processed with certain specific methods before their internal use. These methods are called Shodhan and they occupy a major portion of Rasa Shastra processing. These Shodhan procedures play a very important role in making metallic and mineral preparations free of toxicity and highly absorbable for quicker therapeutic effects even in minute doses. Parad is invariably a major constituent in most of the rasa preparations; it needs thorough purification and detoxification to render it fit for internal use. Rason is best among the Shodhandravya in Parad Samhita Paradshodhan with only Rason is mentioned..In this study Parad is triturated with Rasonkalka and then Kshalan is done. Parad loss in this study is very less amount. In ICP AES, Qualitative Analysis is done it reveals that following element in Parad before Shodhan Ag, Fe, Ga, Hg, Mg, Mn, Sr, Zn and after Shodhan Ag, B, Ca, Cr, Fe, Ga, Hg, Mg, Mn, Sr, Ti, Zn

SCREENING OF IMMUNOMODULATORY EFFECT OF SHATAPUTI ABHRAK BHASMA- AYURVEDA'S RASAYAN

Rasashastra, one of the branches of Ayurveda, deals with the pharmacological aspects of drugs, some of which have unique attributes. These unique attributes need to be validated and explored using the scientific and technological advances of todays world, which shall open up new avenues for drug processing, development and therapeutics in Ayurveda.Abhrak Bhasma is one of the drugs of Rasashastra having some peculiar attributes. Acharyas have mentioned Shataputi and Sahastraputi Abhrak Bhasma which are indeed unique attributes of Abhrak. Shataputi Abhrak Bhasma is regarded as a Rasayan, as given in Rasa Tarangini, which says Abhrak Bhasma given 20-100 Putas (incinerations) helps eliminate ailments, when given 100-1000 Putas acts like a Rasayan.Review of the current literature available on Rasayanas indicates that Anti-oxidant and Immunomodulation are the most studied activities of the Rasayan drugs. The effect Immunomodulation has on the human body can be compared to some extent with the effect of Rasayan dravyas, given in various Classical texts. In view of this correlation, Shataputi Abhrak Bhasma was subjected to Invitro screening to assess its Immunomodulatory effect using the Nitroblue Tetrazolium (NBT) assay. The results were self conclusive and indicated that Shataputi Abhrak Bhasma brings about stimulation of Leucocytes in concentration dependent manner. 5% and 10 % solutions of Shataputi Abhrak Bhasma stimulated 93% and 93.5% leucocytes respectively, which is an indicator of highly significant phagocytic activity. Thus, the study revalidates the reference of Shataputi Abhrak Bhasma as a Rasayan and hence also establishing it as an Immunomodulator

Pervasiveness of Tobacco associated Oral Lesions among Women residing in Urban Slum of Bhopal

Background: The urban-slum population has emerged as a new section which is known to fare very poorly on issues related to oral health. The proportion of the urban-slum population is also increasing at a rapid rate. The deleterious habits are highly prevalent so is the tobacco, in this population. Hence, the study was steered to evaluate the association of tobacco consumption and oral mucosal lesion (OML) in this population. Aim of the study: To assess the prevalence and patterns of tobacco use and related oral lesions among women residing in urban-slum of Bhopal city (Central India). Materials and methods: The descriptive cross-sectional questionnaire based study was deliberated by a convenience sample technique. A predesigned structured questionnaire was the tool used for data collection. All the female participants available on the day of survey were included. Entailing in the study was 130 participants residing in various slums of Bhopal city. Results: Oral health is an important parameter to extent holistic health. The quantum of tobacco is widely prevalent among under-privileged populations. Ramifications are depleted oral health and gross impact on overall health too. Tobacco affects from mild to major lesions in oral cavity. Most devastating is oral cancer directly related to tobacco consumption. Conclusion: The concludory points derived out of this study are sufficient enough to conclude that women were aware of the trivial general ill effects of tobacco consumption but major harmful effects on oral health is still below the iceberg due tounawareness and low socioeconomic status (SES).&nbsp

Virulence factors and antifungal susceptibility profile of non albicans Candida species isolated from blood stream infections

Background: The spectrum of fungal infections, once only considered to be restricted only to cutaneous and mucocutaneous tissue has been changed. Invasive mycosis have emerged as an increase threat to mankind. Despite of the advent in both therapeutic and diagnostic modalities, invasive mycosis is associated with high mortality. Candida spp., is often the most important cause of blood stream infection. Although C. albicans is considered as the most pathogenic species from the genus, recent studies have documented the emergence of unusual, relatively uncommon and treatment resistant non albicans Candida (NAC) spp. Material and methods:NAC spp. isolated from blood cultures were included in the study. Candidaisolates were identified up to species level by standard mycological protocol. NAC spp. were screened for production of virulence factor like extracellular hydrolytic enzymes, haemolysin and biofilm formation. The antifungal susceptibility profile of these isolates was studied by Ezy MIC Strip.Results:The rates of isolation of bacterial and fungal pathogens from blood cultures were 78.4% and 21.6% respectively. Candida spp. was the only fungal pathogen isolated from blood cultures. The isolation of NAC spp. was highly significantly compared to C. albicans. C. tropicalis followed by C. glabrata and C. krusei were most common isolates from NAC spp. ICU admission and fluconazole prophylaxis/treatment were significantly associated with BSI due to NAC spp.Fluconazole resistance was observed in 40.7% of NAC spp. All isolates of C. krusei were resistant to fluconazole. No isolates were resistant to voriconazole and echinocandins. Conclusion: Hitherto rare and new fungal species and fungi once considered to be non-pathogenic are increasingly implicated in human infections.NAC spp. have emerged as an important cause of infections including candidemia. These NAC spp., produce virulence factors once attributed to C. albicans. As NAC spp. differ widely in susceptibility to routine used antifungal agents, antifungal susceptibility testing plays an important role in evaluating therapy for Candida infections