Background: Periodontal diseases could be regarded as an independent risk factor for the onset of cardiovascular diseases. Evidence documents that periodontal diseases have an independent statistically significant association with cardiovascular diseases, although weak to moderate, after adjusting for potential confounding factors, such as advancing age, gender, race, smoking, hypertension, diabetes, indicators of socioeconomic status, stress, obesity, lipid rich diet and others. Aim: The aim of the study is to evaluate a correlation between periodontitis and ECG abnormalities. Materials and Methods: This is a cross-sectional study constituting 15 systemically healthy subjects with moderate to severe periodontitis and 15 systemically healthy subjects without periodontitis. Subjects were selected with proper inclusion and exclusion criteria. For each patient clinical parameters including PI, MGI, PD, CAL, BP and Electrocardiograph (ECG) are recorded. ECG changes like LVH, ST depression etc. are evaluated and the relation with periodontal condition is assessed. Results: No significant ECG abnormalities were detected in moderate-severe chronic generalised periodontitis patients. Conclusion: The present study did not find a relationship between periodontitis and ECG abnormalities. Further longitudinal studies with a larger sample size are required to associate the relationship.

Over the past few years, a lot of research has been done to understand the role of osteitis, or inflammation involving bone for disease recalcitrance in chronic rhinosinusitis (CRS). This review article will discuss the current understanding of osteitis in CRS, including pathophysiology, diagnostic methods, clinical significance, and treatment modalities.

Objective: The clinical characteristics and experience of rural Indian children of West Bengal with paraquat poisoning – a retro prospective analysis. Methods: The study: From June 2014 through April 2019, fourteen children with paraquat poisoning who presented to the hospital were enrolled .The collected clinical indices of these cases were and analyzed. Results: oral ingestion of paraquat were found in most of the children and the commonest route of poisoning. Different degrees of damage were found in multiple systems in their bodies. Initial therapy consists of removing the paraquat from the body (decontamination) and preventing further absorption for oral exposures by using activated charcoal followed by pulse therapy using methylprednisolone (20 mg/kg/d×3d) and Gamma globulin (total 2 g/kg divided into 3 d to 5 d)for all children in the early stage. Prednisone was then given orally for 4wk to 8 wk. The total mortality rate of the patients was 64.8% (09 of 14 patients died). Statistical differences (P<0.05) were found between the surviving and dead patients, with regard to age, plasma paraquat levels, the highest levels of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, total bilirubin, direct bilirubin, indirect bilirubin, blood urea nitrogen,creatinine and pH value, the lowest levels of PaO2, PaCO2 and SaO2. Plasma paraquat level was positively related to pH value, but was negatively related to PaO2, PaCO2 and SaO2 levels. Hepatic and renal complications are encountered in admitted patients but the patients survived.However the fibrosis of the lung is one of the dreaded complications in the long run. Conclusions: There is no cure for Paraquat poisoning. In this study, pulmonary fibrosis was the primary cause of death.Treatment by administering pulse doses of methyl prednisolone and Gamma globulin seems to be effective in the early stage. However, the treatment may not reverse the development of pulmonary fibrosis. The long-term prognosis of paraquat poisoning was not optimistic.For predicting the prognosis, plasma paraquat level is significant.

Multiple myeloma is a malignant hematological neoplasm which, primarily involving the bone marrow, but it has a potent extension towards other organs and to present with various clinical manifestations. Involvement of the stomach presenting with epigastric pain and vomiting is extremely rare. We report a case of a 73-year-old male presented at the Gastroenterology Unit with epigastric pain and uncontrollable vomiting. He was known to have a history of multiple myéloma and had previously been treated with a very good partial response. The patient underwent esogastroduodenoscopy witch revealed nodular gastritis without ulceration. Histopathological and immunological analyses showed diffuse atypical plasma cell infiltration with prominent staining for CD138 of the gastric mucosa. Relapsing multiple myeloma was diagnosed. This case illustrates a very atypical presentation of recurrence multiple myeloma and should be kept in mind in a patients with atypical gastric pain, especially those with a history of hematologic malignancy.

Cross sectional study was carried out on donkeys in some districts of Dhamar governorate with objectives to identify and determine the prevalence of gastrointestinal nematodes of donkeys from December 2017 to May 2018. Fecal samples were collected randomly from 369 donkeys and examined with flotation, McMaster and Baerman fecal examination techniques. The results revealed that, the overall prevalence of gastrointestinal nematodes was 67.75.5%. Seven species of gastrointestinal nematodes were identified. The species identified in descending order of prevalence are: Trichostrongylus axie (35.50%); Oxyuris equi (34.42%); Trichonema or Cyathostomins (24.93), Strongylus vulgaris (21.14%), Strongylus quinus (15.99), Strongylus edentatus (7.046%) and Parascaris equorum (4.065%). Statistically, significant differences (P=0.000) among prevalence of species were observed. The higher prevalence rate recorded in young animals, month of April, male animal and Maghreb anss district was as 83.57%, 78.26%, 68.06% and 88.24% respectively. The age-wise and month variation showed association (P=0.001) with prevalence; while, no with sex and area factors. The higher mean of FEC was recorded in the month of April (1482.04); whereas the lower in the month of December (729.3). It is concluded that working donkeys in study area harbor variety species of gastrointestinal nematodes. Raising awareness regarding gastrointestinal parasites and improved management practices are recommended to control gastrointestinal nematodes of donkeys.

Eyelid scars usually aren’t thick, but they’re important because they inhibit the movement of small, delicate structures. For concerns, both cosmetic and functional, post-traumatic scarring of eyelids and periorbital area can pose a challenge for ophthalmologists. But the antimetabolite 5-fluorouracil (5-FU) offers a versatile option for approaching this common problem. 5-FU injections given at the first sign of contracture can help minimize scar tissue and dramatically improve eyelid function. Given its proven and long-standing track record in oncology, off-label applications of 5-FU have expanded in recent years into orbital and adnexal efforts to modify keloids and hypertrophic scars.

First trimester sonographic diagnosis traditionally focused on evaluation of growth by serial examination to differentiate normal from abnormal gestations. Current trends in ultrasound late in the first trimester focus on measuring nuchal translucency thickness combined with maternal age and biochemical tests to determine the risk of chromosomal abnormalities and structural anomalies. The objective of the study was to compare normal reference range of mean fetal nuchal translucency (NT) thickness among pregnant women who were coming to the clinic with international reference values. A cross sectional study was conducted in a private ultrasound clinic, Lahore, Pakistan in one year starting from April 2016 to April 2017, after approval from the Institutional Review Committee of the University. A total of 59 pregnant women at 11-14 weeks gestation, were included in this study after taking consent. All NT measurements were performed by a certified sonographer using the Fetal Medicine Foundation (FMF) recommended protocol. Descriptive statistics were presented in the form of range, mean and standard deviation. The mean maternal age and mean gestational age were (27.9 ± 4.4 years) and (11.8 ± 0.8 weeks) respectively. The mean calculated for nuchal translucency thickness, which ranges from (0.6-2.9 mm), is 1.77 mm. This study results show that normal range of NT thickness coincides with the normal range of mean Nuchal translucency found internationally.

The aim of this study is to determine the effectiveness of corrugated rubber and tube drains in the management of Ludwig’s angina patients. This retrospective comparative study was designed for patients with Ludwig’s angina that presented to the Department of Oral and Maxillofacial Surgery, University of Benin teaching hospital, Nigeria between June 2008 and July 2018. Data collected from the case notes of the patients were age, gender, type of surgical drain, airway compromise, length of hospital stay, and retreatment. Descriptive and inferential statistics were performed with SPSS Version 17(SPSS Inc, Chicago, USA). All tests were 2-sided and P-Value less than 0.05 was considered statistically significant. Of the 55 patients studied, 32 (57.3%) had plastic tube drains while 23 (42.7%) had corrugated rubber drains. Their ages ranged from 19-72 years with a mean ± SD of 42.1 ± 13.7 years. There was significant higher incidence of airway compromise in patients that had corrugated rubber drains compared to those that had plastic tube drains inserted(P=0.03). However, the type of drain inserted was not an independent predictor of the presence of airway compromise in our patients. There were no significant differences between the two groups as regard retreatment and length of hospital stay. The insertion of open tube drain is as effective as the conventional corrugated rubber drain as it could decrease complications and improve the prognosis for patients with Ludwig’s angina.

Background: Leukaemia is a complex form of blood malignancy characterized by a high mortality rate, despite significant improvement in cancer treatments. The consumption of fruits and vegetables are inversely related to the incidence and mortality of cancer, as a result of the high level of polyphenols found in some fruits that has been reported to be potentially chemotherapeutic and having a considerable effect on haematological malignancies. Objectives: To explore the effect of Imatinib, Doxorubicin, and/or polyphenols (emodin, rhein, apigenin and cis-stilbene) on the proliferation, and apoptosis of myeloid and lymphoid leukaemia cells compared to non-tumour cells. Methods: one myeloid (K562), one lymphoid (CCRF-CEM), a leukaemia cell line and one non-tumour normal cell line (CD133) were treated with Imatinib, Doxorubicin, and/or different doses of polyphenols. The activity of leukaemia cell proliferation was assessed by Cell Titer-Glo® luminescent assay; the morphological changes of apoptosis, which includes DNA fragmentation and nuclear condensation, were detected by DAPI staining. Results: Emodin, cis-stilbene, apigenin and rhein showed different levels of effect on inhibition of ATP level and inducing apoptosis in K562 myeloid cells, CCRF-CEM lymphoid cells and CD133+ normal cells when these types of polyphenols used separately and combined with Imatinib or Doxorubicin. Generally, the CCRF-CEM lymphoid leukaemia cell line was more sensitive to polyphenol treatments alone and when combined with Doxorubicin compared to the K562 myeloid leukaemia cell line and CD133+ non-tumour cells. Conclusion: These results suggest that polyphenols have different effects according to the type of cell and polyphenol. The variant effect between leukaemia cells and non-tumour cell suggests that polyphenols are a potentially therapeutic agent for leukaemia. Polyphenols can enhance the effect of chemotherapy and reduce the required dose to induce cell death in cancer cells.

Background: Staphylococcus aureus is a pathogen worldwide with large disease burden. Methicillin resistant staphylococcus aureus (MRSA) is prevalent in hospital care settings and community. Timely diagnosis and treatment is essential to avert further complications of this infection as compared to Methicillin sensitive Staphylococcus aureus (MSSA). Aim of the study was to determine the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) from pus samples in a tertiary care hospital and to analyze the antibiotic susceptibility patterns of MRSA isolates. Methodology: A cross sectional study which was done in a tertiary care hospital from Jan 2018-June 2018. Various clinical specimens were cultured and staphylococcus aureus was isolated and identified using standard biochemical tests and CLSI guidelines. Results: Out of 1090 pus samples processed 597 were growth positive and among these 196 were gram positive. Out of 196 gram positive isolates 119 were staphylococcus aureus of which 56 were MRSA & 63 were MSSA. All MRSA isolates were sensitive to Vancomycin and Linezolid and moderate sensitivity to Gentamicin and Co-trimoxazole. Conclusion: In hospital setting MRSA infection cause of worry due to resistance to commonly prescribed drugs. Regular surveillance and robust Antimicrobial stewardship can help to limit these infections.

Background: Acute onset seizure is one of the common causes of childhood hospitalization with significant mortality and morbidity. There is limited data regarding acute seizures episodes and its outcome from developing countries. Current study aims to find the common etiology of seizure and classify seizure types in various age groups. It was also aimed to find outcome in relation to diagnosis, abnormal imaging, EEG and requirement of monotherapy or polytherapy. Material and Method: This was a hospital based prospective study carried out in the department of Pediatrics, Calcutta National Medical College and Hospital from June 2016 to May 2017. Children aged 1 month to 12 years presented with acute onset seizure were enrolled. Variables collected were demographics, clinical presentation, laboratory tests, brain imaging, elect- roencephalography, diagnosis and therapy. The data was analysed using Statistical Package for the Social Sciences (SPSS) for Windows version 16.0 (SPSS Inc ; Chicago, IL, USA). Results: A total of 491 patients were admitted for acute onset seizure with 289(58.8%) males and 202(41%) females. Among these patient 280(57%) presented with fever and 55(10.9%) children presented with status epilepticus. Generalised onset tonic clonic was the most common seizure type, central nervous system infection was the most common etiology in all the age groups. Final outcome was made at the time of discharge as discharged without sequelae, dischaeged with sequelae and death. Patient with CNS infection had highest mortality. Conclusion: CNS infection and febrile seizure were common cause of seizure in fewer than 5 children. Group of children presenting with unprovoked seizure require long term follow up studies including neurophysiologic studies and neuroimaging for better understanding of childhood seizure disorder in developing countries.

89 nonvigorous neonates with meconium stained liquor were followed in the immediate neonatal period. 41 neonates received endotracheal tube (ET) suctioning at birth and 48 neonates did not receive ET suctioning at birth. Of the 41 ET neonates 16 had meconium related morbidity /mortality at NICU stay and 25 was normal. Of the 48 non ET neonates 9 had meconium related mortality /morbidity, 39 were normal. Odds ratio of mortality/ morbidity is significantly high (2.77)in ET group with narrow confidence interval (1.063,7.234),P value 0.03.Relative risk of ET group of having nonfavorable outcome is 1.7.Tracheal suctioning of meconium in nonvigorous neonates at birth did not decrease the meconium related morbidity /mortality during NICU stay.

Background: Autism is a neurodevelopmental disorder which interferes with the person's ability to communicate and relate to others. Median of global prevalence of autism spectrum disorders is 62/10 000. Both genetic and environmental factors are responsible for its development. The aim of this study was to investigate the sociodemographic, prenatal, perinatal, and neonatal risk factors of autism. Methods: This study was done from the digital database of the child guidance clinic of the department of Psychiatry of a tertiary care hospital in Kolkata. Results: In this study male-female ratio among autistic children was found 3:1. Two thirds of the children came from urban nuclear families. Families of autistic children were more or less evenly distributed among all social classes. Antenatal, Perinatal and neonatal factors which were found to be significantly associated with Autism were antepartum haemorrhage or threatened abortion, pregnancy induced hypertension, prematurity and pathological jaundice. Conclusion: The present study found significant correlation between birth factors like antepartum haemorrhage, pregnancy induced hypertension, prematurity and pathological jaundice with autism. Further studies are needed to verify our findings, and investigate the effects of multiple factors on autism.

There is growing trend of psychiatric morbidity among children and adolescents all over the world. Medications are prescribed to this age group mainly depending on data obtained from adult population. Proper study to find out exact burden of the problem and the effects of these drugs to young population has not been done in our part of the world. The study was done to identify the incidence of different psychiatric problems with the most common pharmacotherapy given in children and adolescents. It is a cross sectional observational study conducted in the Psychiatry OPD of Medical College Kolkata by the department of Pharmacology from May 2014 to October 2014. After institutional ethics committee approval and consent from guardians, 86 patients of either sex were included in the study. Patient demographics (gender distribution, age of the patients, diagnosis) and drug-related information (antipsychotic drugs, route of administration) was recorded on a customized data collection sheet. Data was analysed using descriptive statistics. 61.9% in children and 67.69% in adolescent age group were boys. Mood disorder, mental retardation and epilepsy are 3 major diagnosis encountered. Average number of psychotropic drug per prescription was 1.41±0.8. 91.73% drugs were prescribed by generic name. 80.16% of the drugs supplied from hospital pharmacy. Antidepressants (29.75%) most commonly prescribed followed by Antipsychotics (26.44%). 30% patients were receiving polytherapy. We found 1-18 year age group was common in psychiatry OPD. Most common diagnosis was behavioural and neurotic disorders, while the most commonly prescribed drugs were antidepressants and antipsychotics.

Fresh seeds of Piper nigrum were procured from the botanical garden of Kokan Krushi Vidyapeeth, Dapoli, Ratnagiri. The ethanolic extract of the seeds was carried out by soxhlate extraction method. Sixty four (64) Sprague- Dawley rats (average weight 150 - 240 g) of either sex were used for the experiment. The ETH and PAS drugs and Piper nigrum were given to respective groups daily for 28 days. At the end of study various biochemical parameters were analyzed from serum such as of Serum Albumin, Urea, Creatinine, Total proteins and Blood Urea Nitrogen (BUN). The kidney tissues were analyzed for Histopathology. Graph Pad Prism 7 was used for statistical analysis by one way variance (ANOVA). The value p< 0.05 considered as significant. Ethanolic seed extract of Piper nigrum (Linn.) was administered independently as well as in combination with ETH and PAS drugs. It is found that the pretreated test groups with Piper nigrum ameliorated the toxic effect of the drugs. Piper nigrum (.Linn) also showed the normalization of histoarchitecture of the kidney by confirming nephroprotective activity against ETH and PAS drugs. Based on the above results it is concluded that the Piper nigrum act as nephroprotective agent and a good bio-enhancer against nephrotoxicity induced by ETH and PAS drugs in Sprague-Dawley rats.

Background: Many patients diagnosed with autoimmune connective tissue disease cannot be categorised easily into one of the established clinical entities such as systemic lupus erythematosus, dermatomyositis, or systemic sclerosis. The term overlap syndrome is used to identify such patient and is useful in terms of clarifying prognosis and facilitating disease management. Methods: This was a retrospective study of the patients diagnosed with connective tissue diseases. The study was done among patients attending the outpatient clinic of a teaching hospital in the South Western Nigeria. The study spanned from July 2013 to June 2016. Data on clinical characteristics, diagnosis, age at onset of disease, and gender were extracted from their files. Results: Five hundred and two patients attended the rheumatology outpatient clinic over the study period. There were 41(8.2%) cases of connective tissue disease. Systemic lupus erythematosus constituted 29.3%, undifferentiated connective tissue disease 19.5%, and scleroderma 14.6%. Others were secondary Sjogren's syndrome 14.6% and overlap syndrome 7.3%. There were 3 overlap syndromes and all were females. A case of rheumatoid arthritis/systemic lupus erythematosus (RA/SLE), SLE/polymyositis, and Scleroderma/Polymyositis. Patients were aged 18 to 64 years, and the mean age was 42±5 years. Female constituted 85.4% of the total population with a female to male ratio of 5.8:1. Conclusion: There is the need to detect an overlap syndrome early. An early classification will guide the management plan of such patients. The traditional high dose steroid for the treatment of SLE and inflammatory muscle disease may be hazardous in overlap syndromes.