Applicability of Demirjian's method of age assessment in a North Indian female population

AIM

This study was conducted to determine whether the standards of dental maturation given by Demirjian et al. are applicable to North Indian children and to assess the relationship between dental age and chronological age.

METHODS

In this study OPGs of 100 females of 8-14 years were taken, and dental age was calculated according to the Demirjian method. Chronological age was recorded and compared to dental age.

STATISTICAL ANALYSIS

Collected data was statistically analysed. Pearson's correlation coefficient was used to correlate the dental and chronological age of the 100 girls. The statistical analysis was done by using SPSS version 10.0 software (SPSS Inc., Chicago IL). For all tests the p-value of <0.05 was considered for statistical significance.

RESULTS

A strong correlation was found between chronological and dental ages.

CONCLUSION

In the present pilot work it was concluded that the Demirjian method of dental age assessment showed high accuracy when applied to North Indian paediatric population.

Paediatric aesthetic dentistry: a review

AIM

A number of conditions can lead to aesthetically unacceptable dentitions like dental caries, discoloration, trauma, early loss of teeth, misalignment and any abnormality of shape and size. Today we have a large number of solutions available for aesthetic problems in paediatric dentistry. But the biggest dilemma is: How to choose what is best for a particular patient and that situation? Through this review we try to precisely highlight the various options for aesthetic restorations along with their indications, advantages and disadvantages.

METHODS

A search and analysis of international works on aesthetics in paediatric dentistry is presented.

RESULTS

A considerable number of studies have shown that people are more concerned about missing anterior teeth and their replacement than about posterior ones as aesthetics seems to be more important than function.

CONCLUSION

Dental caries, although not life threatening, causes nagging pain and physical as well as psychological discomfort. Nevertheless, it is clear that the condition is complex and multifactorial and hence it is important to review the various approaches available to restore the lost aesthetics.

Role of laparoscopy in diagnosis and treatment of ectopic pregnancy

Laparoscopy has a great role in early and effective diagnosis and treatment of ectopic pregnancy. This study was carried out to evaluate the feasibility and role of laparoscopy in diagnosis and treatment of ectopic pregnancy. This is a prospective observational study conducted in the Department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital from April 2009 to March 2011. All the women who underwent laparoscopy for ectopic pregnancy or diagnosed as ectopic pregnancy during laparoscopy done for other diagnosis were included. Data were collected by interviewing patients, operating surgeons, reviewing charts and operative notes and following up patients. There were 42 cases of ectopic pregnancy during study period, of whom 16 (38.1%) underwent laparoscopy. Preoperative diagnosis of ectopic pregnancy was confirmed clinically in 6 (37.5%) patients, who underwent laparoscopy as an operative procedure. In the remaining 6 (37.5%), laparoscopy was performed as a diagnostic procedure as clinical diagnosis was doubtful; two cases of negative laparoscopy was noted. Incidental diagnosis of ectopic pregnancy was made in another 4 (25%) patients who had undergone laparoscopy for other pre operative diagnosis. All the patients were surgically managed by laparoscopy without converting it to laparotomy. There were no intraoperative or postoperative complications except for primary port infection in few (25%). Therefore, laparoscopy has a significant role in the diagnosis of ectopic pregnancy and operative laparoscopy is a safe approach with minimal complications.

Do bicarbonate-based solutions for continuous renal replacement therapy offer better control of metabolic acidosis than lactate-containing fluids?

INTRODUCTION

Evidence that bicarbonate haemofiltration and dialysate fluids are superior to lactate in patients with acute kidney injury treated by continuous renal replacement therapy (CRRT) remains controversial.

METHODS

We prospectively audited acid-base during the first 48 h of CRRT in 62 patients, using bicarbonate and lactate fluids.

RESULTS

Baseline lactate was greater in the bicarbonate group (4.76 ± 0.77 vs. 2.92 ± 0.5 mmol/l, p < 0.01), but pH, bicarbonate, chloride and base excess were similar. Lactate fell significantly in the bicarbonate group to 2.88 ± 0.3 mmol/l at 24 h and 2.39 ± 0.2 mmol/l at 48 h, but not in the lactate group. Base excess improved more with bicarbonate, median increase in the first 24 h was 51.6% (29.1-96.9) versus 18.5% (-5 to 55) with lactate and 74.2% (38.5-123) versus 36.1% (-3.6 to 68), p < 0.05 at 48 h. However, there were no significant differences in bicarbonate, chloride, pH, blood pressure and vasopressor requirements. 13.3% of patients were switched from lactate to bicarbonate fluids due to failure to correct acidosis. Subgroup analysis of 19 patients with liver failure showed similar results.

CONCLUSION

Bicarbonate fluids led to a more rapid fall in lactate and greater improvement in base excess during CRRT, but not overall control of acidosis.

Psychiatric aspects of burn

Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

Psychiatric aspects of burn

Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

Changing routes of hysterectomy: a cross sectional and comparative study

Hysterectomy is one of the most frequently performed major surgical procedure in women. Traditionally, the uterus has been removed either by abdominal or vaginal route. In spite of the recommendations in favor of vaginal hysterectomy majority of the hysterectomies are still done by the means of abdominal route and vaginal route is utilized mostly for prolapsed uterus. This study was done to see the current trend of routes of hysterectomy for benign condition at Kathmandu Medical College Teaching Hospital and its indication. This was a cross-sectional and comparative study done for 24 months (Jan 2008- Dec 2009). Data for the year 2009 was collected prospectively and for the year 2008 case notes of all the cases of hysterectomy was reviewed. Total 317 cases of hysterectomy were done for benign condition in KMCTH during the 2 year study period. Of the 317 cases 124 was done during the year 2008 and 193 during 2009. Three major route namely vaginal hysterectomy (VH), Abdominal Hysterectomy (AH), and Laparoscopic hysterectomy (LH) was utilized for performing hysterectomy. Major indication for hysterectomy was pelvic organ prolapse (POP) followed by abnormal uterine bleeding (AUB), and fibroid uterus during both the years. Route of hysterectomy in the cases with non prolapsed pelvic organ were AH (94.0%) and LH (6.0%) during the year 2008 and VH (6.0%), AH (76%) and LH (18.0%) during the year 2009. Major indications for hysterectomy are POP, AUB, and fibroid uterus. VH is mainly done for the cases of POP. AH is still the major route for indications other than POP. Minimally invasive approach like VH for non descent uterus and LH although is rising needs to be practiced more.

Indian psychiatry, research and Asian countries

Asia has some of the largest conglomerations of human populations and also the fastest growing economies of the world. About 23% of the world's population lives in the South Asian region, and one-fifth of psychiatrically ill patients in the world live in this part of the world. Despite vast cultural, religious, geographical, and political diversities, the factors influencing mental health remain the same throughout this wide region, as highlighted at the recently concluded Asian summit, where the slogan, 'One vision, one identity, one community,' was launched. Thus, the need to strengthen regional cooperation in the field of mental health has always been felt. This article highlights facts about influence of Indian Psychiatry research as well as of some Asian countries in the world psychiatry and vice versa.

Age trends of sibling resemblance for height, weight and BMI during growth in a mixed longitudinal sample from Sarsuna-Barisha, India

BACKGROUND

Even though some studies have considered that sibling resemblance remains constant throughout the life cycle, several investigations emphasize the importance of age and its interactions with genetic and environmental factors in determining sibling similarity in several bodily traits. In fact, the study of age changes in familial resemblance is of great importance for the analysis of certain sources of variation observed in growth processes.

AIM

The study examined sibling resemblance for height, weight and body mass index (BMI) in a mixed longitudinal sample from West Bengal, ages 2-19 years, in order to analyse the variations with age of the sibling resemblance for these phenotypes during growth.

SAMPLE AND METHODS

Two hundred and forty-five brothers and 213 sisters from 138 middle-class nuclear families living in a semi-urban area of South Kolkata, India were analysed. The analysis of sibling resemblance was performed through correlations estimated by the maximum-likelihood method. The patterns of different trends of sibling resemblance with age were examined by fitting a cubic non-linear regression to the observed correlations.

RESULTS

The results show clear variations with age in the sibling resemblance for the traits height and weight, though to a lesser extent for BMI. In general, we found the highest correlation values during the period of infancy, a remarkable decrease during puberty, and a trend of increase towards the end of the growth cycle.

CONCLUSION

The study confirms the effect of age on the degree of similarity among siblings for height, weight and BMI in the sample. The sharp decline of correlation at adolescence can be interpreted in terms of the individual variation in age of reaching the adolescent growth spurt.

UV-spectrophotometric determination of imatinib mesylate and its application in solubility studies

A new, simple and sensitive UV-spectrophotometric method was developed for the determination of imatinib mesylate in bulk and pharmaceutical formulations (tablets and nanoparticles). The developed spectroscopic method was validated for selectivity, linearity and range, precision, accuracy and sensitivity. The method has demonstrated excellent linearity over the range of 2.5-25 microg/mL with regression equation: absorbance (AU) = 0.047 x concentration (microg/mL) + 0.008 and r2 = 0.9998. The developed method demonstrated consistent high recoveries (99-102%) and low relative standard deviation (< 5%) at 285 nm. Moreover, the method was found to be highly sensitive with low limit of detection (0.57 microg/mL) and limit of quantitation (1.71 microg/mL). The apparent molar absorptivity and Sandell's sensitivity was found to be 2.75 x 10(3) L/M cm and 2.15 microg/cm2 respectively. The validated method was successfully employed for the drug content analysis from tablets and nanoparticles preparations. Additionally, the method was successfully employed for pH metric solubility analysis of the drug.

Incidence of summer associated symptoms, host susceptibility and their effect on quality of life among women 18 to 40 years of age in an urban slum of Delhi

OBJECTIVES

To study whether individual susceptibility plays a role in the occurrence of summer associated symptoms (dizziness, giddiness, fainting and weakness) among women 18-40 years of age and their effect on the quality of life.

METHODS

It was a prospective community based study carried out in an urban slum of Delhi as a follow up of an earlier study. All women who had "given symptoms" during summer in the earlier study and a sample of those who were asymptomatic were included in the current study. Both the groups were studied for the occurrence of "given symptoms" and quality of life during next summer and winter using a pre structured questionnaire and WHOQOL-BREF.

RESULTS

Incidence of "given symptoms" during summer was more than three times among women who were symptomatic earlier compared to women who were asymptomatic. The incidence of these symptoms was significantly higher among the former across different age groups and BMI categories. Their physical domain of quality of life was also adversely affected.

CONCLUSIONS

Continued high incidence of summer associated symptoms with adverse effect on their physical quality of life, among women who were symptomatic earlier too, points to individual susceptibility rather than random occurrence. This aspect requires for further studies.

Awareness and perception about tuberculosis in the general population of Delhi

The present study was conducted to assess awareness and perception regarding tuberculosis among the general population of Delhi. A total of 1008 adults, selected by multistage stratified systematic sampling, were interviewed using a pre-tested proforma. The majority had heard about tuberculosis (99.1%) and most (89.2%) perceived it to be an infectious disease. The correct mode of transmission i.e. airborne (coughing/sneezing) was known to 71.8% study subjects. The majority (90.1%) knew cough as a symptom. Nearly all (98.2%) perceived Tuberculosis to be a preventable disease, citing the treatment of patients as the mainstay of preventing spread of the disease. However, responses like separation of utensils or hospitalisation of the patient to prevent the spread of the disease indicate persistence of stigma and discrimination in a small proportion of the population. There is a need to widen the scope and intensify the information and education being provided to the population based on gaps identified.

Perimortem caesarean delivery (PMCD)

When a woman in late pregnancy has cardiac arrest and resuscitation fails, should an attempt be made to deliver the baby by Caesarean section? Many obstetricians would hesitate to operate in these circumstances for fear of delivery a baby who survives but shows profound neurological handicap. Obstetricians need to have a clear view on whether and when to operate in such cases. Here we report two cases of PMCD.