Clinical efficacy of grape seed extract as an adjuvant to scaling and root planing in treatment of periodontal pockets

Grape seed extract (GSE), a naturally producing polyphenolic compound, is found to be a potent hostmodulatory agent and considered for management of periodontal disease. Its anti-bacterial, antioxidant, and anti-inflammatory property may aid in achieving periodontal health. To assess the clinical efficacy of GSE in adjunct to scaling and root planing (SRP) in healing of periodontal pockets. The present study was a longitudinal, parallel design, randomized clinical trial. Seventy-two patients (mean age 39.2±8.6 years) with periodontal pockets were randomly divided into two groups; Test group received intra-pocket delivery of GSE with SRP and Control group received SRP alone. The clinical parameters like Plaque Index (PI), Gingival Index (GI), Probing Depth (PD) and Relative Attachment Level (RAL) were recorded at baseline and 3 months. 64 patients completed the study. Test group at the end of 3 months had statistically significant reduced PD (p=0.002) and RAL (p=0.01). No significant difference was observed for PI and GI at the end of 3 months. Intra-pocket application of GSE with SRP could be beneficial in management of periodontal pockets.

Clinical effectiveness of Lactobacillus reuteri in the treatment of peri-implant diseases: a systematic review and meta-analysis

In the last decades, the presence of peri-implant diseases (PD) has increased. One of the therapies currently used is probiotics with Lactobacillus reuteri (LR). The aim of this article is to determinate, through a systematic review and meta-analysis, the clinical effectiveness of LR in the treatment of PD. We searched the literature until January 2021, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, Scopus, SIGLE, LILACS, Google Scholar and Cochrane Central Registry of Clinical Trials. The selection criteria of the studies were: randomized controlled clinical trials, without language and time restriction, reporting the clinical effects (depth to probing, plaque index and bleeding index) of the LR in the PD treatment. The risk of study bias was analyzed through the Cochrane tool for randomized studies using Review Manager software. The search strategy resulted in 6 articles of which four investigated peri-implantitis and three peri-implant mucositis. All studies reported that there was a difference in the depth of the probing in the treatment of PD, in favor of the group using LR, though not always achieving significance. The use of LR can be clinically effective in terms of pocket depth reduction in the treatment of PD.

Effect of internet use on medical students before and after 4g internet service in india: A comparative study

BACKGROUND

Internet is being used extensively throughout the world from last decade. In India internet service has entered into new generation called 4G. Medical students are particularly vulnerable group for problematic internet use on account of the time they spend online. This might have negative effects on their physical, psychological and social health. Hence they are more prone to internet addiction.

AIMS

To compare use and effect of internet service among medical students before and after the availability of 4G service.

STUDY DESIGN

Institution based cross sectional study.

METHODS AND MATERIAL

Predesigned validated questionnaires were provided to the medical students in the year 2014. The questionnaire included demographics, pattern of internet use and Young's internet addiction test. Again in the year 2018 the similar procedure was carried out after introduction of 4G service. The data was collected and compared. Analysis was done using SPSS 25.

STATISTICAL ANALYSIS

Descriptive statistics, Chi² test and Mann-Whitney test was applied.

RESULTS

Among 424 medical students 207 students were assessed in the year 2014 and 217 students in 2018.There was a significant change of pattern of use. Also significant increase in number of female users and severity of internet addiction in 2018. The ill effect of internet was on rise after availability of 4G service.

CONCLUSIONS

The prevalence of internet addiction and its ill effect on behavior among medical students was higher after availability of 4G service in same college. So appropriate preventive and interventional strategies need to be developed in professional institutions.

Paget's disease of bone in a 85-year-old woman

Paget's disease of bone is a rare disorder in India. Patients are usually asymptomatic and incidental radiological investigation invariably clinches the diagnosis. Increased alkaline phosphatase, X-ray, CT scan and scintiscan of bone can be done to confirm the diagnosis. Here we report a case of an 85-yr-old lady who had bilateral hearing loss for last 10 yrs, was admitted incidentally for some other complaints and on investigation diagnosed to have advanced Paget's disease of bone.

Malarial hepatitis as a component of multiorgan failure--a bad prognostic sign

A prospective study among the patients (n = 301) belonging to the coastal districts of Orissa having complicated falciparum malaria with multiorgan failure fulfilling modified APACHE II criteria, for a period of two years in this hospital setting was carried out with particular emphasis on hepatic involvement. There were 206 males and the rest females. Hepatic involvement in the form of raised serum bilirubin levels > or = 6 mg% and prothombin time > 4 compared to controls was found in 192 cases (63.8%). On analysis out of 192 cases predominantly conjugated hyperbilirubinaemia, mixed patterns and unconjugated hyperbilirubinaemia were seen in 115 (59.9%), 64 (33.3%) and 13 (6.8%) cases respectively. Serum bilirubin ranged from 6 to 38 mg%. Aminotransferase aspartate (AST, SGOT) and aminotransferase alkaline (ALT, SGPT) were raised almost two-fold in 98% cases of multiorgan failure with hepatic failure with mean values of 78 +/- 30.4 IU/l and 81 +/- 29.06 IU/l respectively. Nearly three-fold elevation of alkaline phosphatase was observed in 80% cases with mean (315 +/- 39.4 IU/l). Prothombin time was prolonged with mean 7 +/- 3 seconds. Serum proteins and albumin/globulin ratio were normal. There was no difference in glycaemic status over controls. In selected cases, liver histopathological study showed abnormalities in the form of Kupffer cell hyperplasia, mononuclear cell infiltration, hepatocyte necrosis, fatty changes and cholestasis. Majority of patients in multiorgan failure who died, had hepatic failure.

Randomized control trial of quinine and artesunate in complicated malaria

OBJECTIVE

To study the comparative efficacy of the quinine and artesunate in complicated malaria in children.

METHODS

All cases admitted to the Pediatrics ward of our hospital with clinical features of complicated malaria (WHO criteria) having asexual forms of P. falciparum in the peripheral smear, were included in the study. Relevant investigations were carried out for confirmation of diagnosis and to assess the prognosis. The patients were sub-grouped into 6 categories as per clinical presentations and each subgroup received alternatively either quinine or artesunate by systematic random sample method. Every odd number received quinine (Group-1) and every even number received artesunate (Group-2). 40 cases in each group were considered for the study and the data obtained were compiled and analyzed by suitable statistical tests.

RESULTS

80 children with complicated malaria enrolled in the present study, of which 48 were boys and 32 were girls. The mean age was 7.93+3.56 years. The most common presentations were fever, splenomegaly and altered sensorium. The CRT, FCT and PCT were significantly less in the artesunate group (50.4 +/- 31.49 hrs; 43.55 +/- 20.12 hrs, and 41.67 +/- 16.78 hrs respectively) as compared to the quinine group (70.15 +/- 17.56 hrs, 62.23 +/- 16.99 hrs, and 52.24 +/- 12.69 hrs respectively) ( p<0.05) No side effects were observed in the artesunate treated group.

CONCLUSION

Artesunate is a much better drug than quinine in complicated malaria in terms of rapid coma resolution, fever clearance, parasite clearance and better tolerability.

Reduction of mechanical heart valve thrombosis through a clinical audit

BACKGROUND AND AIM OF THE STUDY

Patients with mechanical heart valves implanted at four cardiothoracic centers were followed up in a hospital in Eastern India. Despite successful surgery and regular hospital visits, long-term survival was compromised by anticoagulation-related complications.

METHODS

Systematic analysis revealed under-anticoagulation in most patients. Thrombosis risk in 80 patients on regular follow up from 1989 to 1997 was 8.68 per 100 patient years (pt-yr). The incidence of both thrombotic and bleeding complications was reported as less than two per 100 pt-yr, when prothrombin time was consistently in the range of INR 2.5 to 3.9. In targeting this low event rate, impediments to optimum anticoagulation in the local set-up were identified. International Normalized Ratio (INR) was introduced to report prothrombin time (PT). Patients and doctors were educated about drug and diet interactions with oral anticoagulants (OAC) and the early features of valve thrombosis. Treatment protocols were evolved. The impact of the remedial measures was studied in 81 patients (64 old, 17 new) over a total of 254 pt-yr of follow up, from 1998 to 2001.

RESULTS

Thrombosis risk was reduced from 8.68 to 5.12 per 100 pt-yr, while non-fatal bleeding events increased from 0.28 to 1.96 per 100 pt-yr. Due to early recognition of occlusive prosthetic valve thrombosis and institution of fibrinolytic therapy, fatal events were reduced from 3.8 per 100 pt-yr to none for four consecutive years (statistically significant at 99% CI).

CONCLUSION

The clinical audit proved to be a valuable tool for understanding the problems in health care delivery, and bringing about improvement.

Acute erythroleukemia--M6B

Acute Erythroleukemia is a rare disorder of hematopoietic system, accounts for 1-3% of all acute leukemia and 15% of myeloid leukemia. Recently, the World Health Organisation & Society of Haematopathology proposed a change in the categorization, with M6a and M6b subgroups of the original FAB classification. Hereby we report a case of acute erythroleukemia--M6b subtype, presented with pain abdomen and vomiting. The patient died within two days. The case is being reported for its rarity and uncommon presentation.

Retroperitonial atypical lipomatous tumour--a case report

We report a case of atypical lipomatous tumor-sclerosing type, a rare retroperitoneal soft tissue liposarcoma, presented with vague musculoskeletal symptoms. Patient was managed with complete resection of the tumor mass with adjuvant chemotherapy. The patient is doing well, with no evidence of recurrence 22 months after the treatment.

Diffuse cavernous haemangioma of the rectosigmoid with bladder involvement--a case report

Haemangiomas of large bowel are very rare. We report extensive colonic haemangiomatosis in one young boy affecting bladder, sigmoid colon & descending colon. The patient was managed with sphincter saving operation.