The aim of the present study was to evaluate the nephroprotective effect of methanolic extract of Heliotropium eichwaldii (MHE) in mice with cisplatin-induced acute renal damage.

Background: Third molar (M3) agenesis and impaction are associated with evolution, changed dietary habits, and human jaw growth. The aim of the study was to radiographically evaluate the prevalence of M3s agenesis, impacted M3s with different impaction patterns, and the approximation of Inferior Dental Canal (IDC) with impacted mandibular M3s roots among the Sriganganagar population. Methods: The study included 700 randomly selected subjects from OPD with an age range of 25–45 years. Digital OPGs were taken for all subjects using Kodak 8000C digital OPG machine. The M3 impaction patterns were evaluated using Winter’s classification. Results: The prevalence of subjects with at least one M3 agenesis was found to be 34.1% and with 95% confidence interval was 30.6% to 37.6%. The overall M3s agenesis was 16.8% with more prevalence in the males. The patients with agenesis of one M3, two M3s, three M3s, and four M3s were 14.4%, 11.3%, 3.7% and 4.7%, respectively. M3 agenesis was more in the upper jaw and on the left side. The total impacted M3s were 21.11% with more prevalence in mixed diet subjects. Mesioangular was most common impaction pattern, and notching was most prevalent IDC relationship with impacted mandibular M3s roots. Conclusion: This study highlighted the evolutionary increasing M3 agenesis and the importance of diagnostic OPG for seeing the status of M3s in jaws.

Objective: The large flowering plant genus Callistemon is belongs to family Myrtaceae and reported for its medical importance. Various parts of different species exhibit different medicinal importance and yet to be phytochemically investigated. In the different time various scientist have investigated the genus and reported the chemical constituents. A survey of literature on genus Callistemon reported the isolation of triterpenoids and steroids from leaves, seeds and stem bark of different species.

Background and Objective: For improving overall care in epileptic patients, careful evaluation of pharmacotherapy, seizure control, quality of life (QOL) and cost effectiveness are helpful but such data are relatively meagre from developing countries. The present study was undertaken to audit all these said factors with different drug combinations comparing older with newer drugs in the setting of a tertiary care epilepsy hospital in India. Methods: Forty patients were divided into four treatment groups, of ten each which were valproic acid + lamotrigine (Group-I), valproic acid+ clonazepam (Group-II), oxcarbazepine + clobazam (Group-III) and phenobarbitone + phenytoin (Group-IV), based on most commonly used dual therapy in local clinical practice. The patients were followed at monthly intervals for six months. Effi cacy was assessed by reduction in seizure frequency, QOL was assessed by using an adapted version of 31- items questionnaire QOLIE-31 (quality of life in epilepsy) and cost effectiveness was calculated as ratio of direct cost of medicine and improvement in quality of life. Results: There was a signifi cant reduction in seizure frequency and improvement in QOL in all four groups at 2nd and 6th months. Cost-effectiveness analysis at the end showed that group-IV paid the least for same improvement in QOL. Conclusion: Older drugs are equally effi cacious as compared to newer in controlling seizure frequency and improving QOL, but are more cost effective.

AIM: To explore single centre results of sutureless intrascleral fixation of single-piece posterior chamber intraocular lens(IOL).

METHODS: In this prospective study, 50 aphakia cases were evaluated. Preoperative and postoperative visual acuity, slit lamp and fundus examination, applanation tonometry, keratometry, IOL MASTER measurement, optical coherence tomography(OCT), Scheimpflug imaging were done for an extensive evaluation.

RESULTS: All IOLs were successfully implanted at the desired position without intraoperative complications. Postoperative complications included corneal edema(n=2), raised intraocular pressure(IOP)(n=3), cystoid macular edema(CME)(n=1)and decentration(n=2). All were managed to the level of good visual recovery. Surgery videos were retrospectively evaluated in cases of postoperative complications. There was no significant change in corneal astigmatism.

CONCLUSION: After extensive 6mo follow up with evaluation of a variety of parameters, our technique of sutureless, glueless scleral fixation of IOL using single-piece IOL has shown favorable results and a potential option in visual rehabilitation.

Cervicogenic headache (CeH) is caused by the disorder of the cervical spine and its anatomical structures. Patients who fail to respond to conservative therapies can undergo interventional treatment. The purpose of this review is to describe the various interventions and compare their relative efficacies. Although a few reviews have been published focusing on individual interventions, reviewing studies on other available treatments and establishing the most efficacious approach is still necessary. We performed a systematic review of studies available on the various interventions for CeH. The PubMed, Embase, and Cochrane databases were searched for literature published between January 2001 and March 2021. Based on the inclusion criteria, 23 articles were included. Two reviewers independently extracted the data from the studies and summarized them in a table. Eleven of twenty-three studies evaluated the effect of radiofrequency ablation (RFA), 5 evaluated occipital nerve blocks, 2 each for facet joint injections and deep cervical plexus blocks, and 1 study each evaluated atlantoaxial (AA) joint injections, cervical epidural injection, and cryoneurolysis. Most of the studies reported pain reduction except 2 studies on RFA. In conclusion, based on the available literature, occipital nerve blocks, cervical facet joint injection, AA joint injection, deep cervical plexus block, cervical epidural injection may be reasonable options in refractory cases of CeH. RFA was found to have favorable long-term outcomes, while better safety has been reported with pulsed therapy. However, our review revealed only limited evidence, and more randomized controlled trials are needed to provide more conclusive evidence.

Tardive dyskinesia (TD) is arguably the most serious and potential irreversible side effect of antipsychotic medication. Traditionally first generation antipsychotics are the neuroleptics considered to have higher risk of TD as compared to second and third generation antipsychotics. Aripiprazole is a third-generation antipsychotic with a novel mechanism of action. Risk of developing TD with use of aripiprazole has been unknown. Recently many cases of aripiprazole associated TD have been reported. A case of 52 year old Caucasian woman is discussed who presented to us with first manic episode. Patient had never been treated with any antipsychotic medication in her life before. During current episode, she was treated with aripiprazole 30 mg/day. During follow up, patient was found to have developed dyskinetic oro-facial movements within 2 months of starting aripiprazole. She was not taking any other antipsychotic/anti-dopaminergic medication at that time. Patient's abnormal oro-facial movements could not be reversed in spite of immediate discontinuation of aripiprazole. Multiple medications are tried over the next 2 years but her movement disorder never remitted. Above case (along with other recent reports) suggest that risk of movement disorder with aripiprazole use could be higher than previously thought. Further studies are required to find out incidence of movement disorder with aripiprazole. Aripiprazole use should be preferably restricted to FDA approved indications. Clinician needs to be very vigilant about emergence of any movement disorder while using aripiprazole, especially in patients with risk factors for TD.
Antipsychotic Agents ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Movement Disorders* ; Risk Factors ; Aripiprazole

No abstract available.

PURPOSETo report complications in the management of complex closed proximal tibial fractures.

METHODA retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11.59) years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted.

RESULTSThe overall complication rate was 30.65% (19 out of 62). Infectious complications were noted in 20.97% cases (13/62). In majority of the cases (8/13), superficial infection was seen which managed with regular dressing and antibiotic administration. The patients (5/13) who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention.

CONCLUSIONProximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.

Adult ; Fasciotomy ; Female ; Fracture Fixation ; adverse effects ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Retrospective Studies ; Tibial Fractures ; surgery

Background:In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs) under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs). ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits.Methods:A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing.Results:We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96%) and delayed bathing (64%) were better adopted than cord care (49%), safe breastfeeding (48%), hand washing (30%), kangaroo care (20%) and eye care (9%). Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM), delayed referral and transportation were the other challenges.Conclusion:Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.