The Efficacy of Collaborative Referencing Intervention in Chronic Aphasia: A Mixed-Methods Study.

Purpose The feasibility of a collaborative referencing intervention (CRI) for adults with chronic aphasia has been documented in two descriptive case studies (Devanga, 2014; Hengst et al., 2010, 2008). The current Phase II mixed-methods treatment study replicates the CRI with four additional participants (using interpretive research) and investigates how it impacts a traditional measure, participants' confrontational naming abilities, outside of game play (using multiple-probe single-case experimental design). Method Four adults with chronic aphasia participated in the study composed of (a) three preparatory sessions, (b) five baseline sessions, (c) 15 CRI sessions with five treatment probes, and (d) six maintenance sessions. A collaborative confrontation naming (CCN) probe (i.e., dependent variable) was administered in each baseline, treatment probe, and maintenance session. Each CRI session (i.e., independent variable) consisted of a photo-matching game with participant and clinician partner taking alternative turns identifying and matching personally relevant treatment cards. CCN probes were scored using a multidimensional rating scale. Fidelity and social validity were also assessed. Results Replication of the CRI showed successful and consistent referential learning in all four participant pairs. The multiple-probe analysis of CCN revealed a positive treatment effect on naming in three participants indicating that the CRI was efficacious. High fidelity was maintained throughout the study. Social validity interviews revealed positive outcomes and significant impacts of treatment on the participants' lives. Conclusion The CRI demonstrates strong clinical implications for adults with chronic aphasia. Future research exploring the treatment effectiveness and the implementation to a variety of clinical settings is warranted.

Air embolism through open hub of external jugular vein intravenous cannula.

INTRODUCTION: Venous air embolism is a catastrophic complication that can result in sudden cardiac arrest and death. Massive air embolism has been reported with central venous catheter through the internal jugular and subclavian veins. Though external jugular vein is a potential site of an air embolism to cardiac chambers and subsequently to vital organs such as brain, heart and lungs but has not been reported yet in literature. CASE PRESENTATION: We are reporting a case of sudden pulmonary air embolism in a patient through the open hub of an intravenous cannula, vigilant monitoring and timely action saved the patient from a catastrophic outcome. CONCLUSION: We recommend vigilant monitoring and adequate precaution in patients with external jugular venous cannulation in the operation theater, intensive care unit or wards to prevent iatrogenic complications.

Level of Physical Activity in Population Aged 16 to 65 Years in Rural Kerala, India.

Kerala is a state in India with a high prevalence of cardiovascular diseases and diabetes. In order to control these diseases, the prevalence of modifiable risk factors such as low physical activity need to be studied. For this a cross-sectional study was conducted to assess the level of physical activity among 240 residents aged between 15 and 65 years in Kulappuram, a village in north Kerala. Low level of physical activity was seen in 65.8% of the study participants. The average duration of moderate to vigorous intensity physical activity per day in different domains such as work, travel, and recreation were 40.5, 10.1, and 12.7 minutes, respectively. The average duration of sedentary activities was 284.3 minutes per day. The level of physical activity was more among those engaged in unskilled work (adjusted odds ratio = 4.32; confidence interval = 1.38-13.51) and unmarried persons (adjusted odds ratio = 3.65; confidence interval = 1.25-10.65). No statistically significant difference in physical activity level was seen in different age, education, religious, and economic categories. The study concludes that the physical activity level was low in the study population.

Evaluation of three different agents for in-office treatment of dentinal hypersensitivity: a controlled clinical study.

CONTEXT: Dentin desensitizers are used for in-office treatment of dentinal hypersensitivity. They block the open tubules and bring about a reduction in hypersensitivity. AIM: The aim was to evaluate and compare the clinical effectiveness of a dentin desensitizer, a combination of a dentin desensitizer + adhesive and one-bottle self-etching adhesive for in-office treatment of dentin hypersensitivity. SETTINGS AND DESIGN: Institutional, prospective double-blind parallel clinical design. SUBJECTS AND METHODS: A total of 54 teeth in 20 patients were randomly allocated to one of the three study groups, with 18 teeth in each group as follows: Group A-Gluma Desensitizer (GD), Group B-Gluma Comfort Bond + Desensitizer (GCBD), Group C-Single Bond Universal (SBU). The patients' dentinal hypersensitivity scores for tactile (hand-held scratch device), thermal (cold), and evaporative (dental unit air syringe) stimuli were recorded on a visual analog scale. The parameters were recorded at baseline, immediately after application of the agent, 3- and 6-week posttreatment. STATISTICAL ANALYSIS USED: The data were analyzed with Friedman's test, Wilcoxon signed ranks test, Kruskal-Wallis test, and Mann-Whitney-U-test (P < 0.05). RESULTS: All three groups showed a significant reduction in dentinal hypersensitivity (P < 0.05) compared to baseline at all time intervals. Statistically, significant differences were noted between GD and SBU; between GCBD and SBU in all testing parameters. Between GD and GCBD no significant difference was noted. CONCLUSIONS: GD and GCBD showed a greater reduction in dentin hypersensitivity than SBU.

Papillon-Lefevre syndrome: Report of two cases in the same family.

Papillon-Lefevre syndrome is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset of a severe destructive periodontitis, leading to premature loss of both primary and permanent dentitions. Various etiopathogenic factors are associated with the syndrome but a recent report has suggested that the condition is linked to mutations of the cathepsin C gene. Two cases of Papillon-Lefevre syndrome in the same family, having all of the characteristic features, are presented. An 11-year-old girl and a 9-year-old boy presented with the complaints of loose teeth. Both expressed hyperkeratosis of palms, soles, and knees. Severe generalized periodontal destruction, with mobility of teeth, was evident on intraoral examination; orthopantomograph examination showed severe generalized loss of alveolar bone in both the patients.

Progression of artificial caries in fluorotic and nonfluorotic enamel: an in vitro study.

BACKGROUND AND OBJECTIVES: Fluorosis is an important clinical and public health problem in several parts of the world. Although the relationship of fluoride level in drinking water to dental caries and dental fluorosis is known, relationship of fluorosis with the caries is not clear. This study was conducted to evaluate and compare the thickness of enamel and depth of lesion after inducing artificial caries in fluorotic and non-fluorotic teeth. METHODS: Study group included 15 fluorosis affected and 15 normal teeth. Artificial caries was induced and teeth were sectioned to 150 microns and observed under polarized light microscope to measure the enamel thickness and depth of lesion in microns. RESULTS: Statistical analyses of the measurements were made using student's unpaired t-test. Thickness of the enamel of nonfluorotic teeth was found to be significantly more when compared with the fluorotic teeth (p-value 0.0404) and depth of lesion was significantly more in fluorotic teeth when compared with the nonfluorotic teeth (p-value 0.0218). CONCLUSION: Although fluoride is acknowledged as an essential factor in the prevention of dental caries there has to be careful balance in the amount consumed to ensure that fluorosis does not occur.

Malignant myoepithelioma of the parapharyngeal space - a case report.

Malignant myoepithelioma (MM) of parapharyngeal space provide both a diagnostic and therapeutic challenge. Malignant myoepitheliomas are rare tumour of salivary glands. Most occur in the parotid gland, few other sites of origin are described. Malignant myoepithelioma of the parapharyngeal space are extremely rare with only a few cases has been reported. We present a case of malignant myoepithelioma in the parapharyngeal space and discuss its diagnostic and therapeutic aspects.

Garre's sclerosing osteomyelitis.

Garre's sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly affects children and young adults. This disease entity is well-described in dental literature and is commonly associated with an odontogenic infection resulting from dental caries. This paper describes a case of Garre's osteomyelitis in a 10-year-old boy, in whom the condition arose following pulpoperiapical infection in relation to permanent mandibular right first molar. Clinically the patient presented with bony hard, non-tender swelling and the occlusal radiograph revealed pathognomic feature of "onion skin" appearance. The elimination of periapical infection was achieved by endodontic therapy and the complete bone remodeling was seen radiographically after three months follow-up.

Influence of phytin phosphorous and dietary fibre on in vitro iron and calcium bioavailability from rice flakes.

The study was undertaken with the objective of analysing the bioavailable iron, calcium and related constituents in rice flakes of four different thicknesses. Rice flakes of four different thicknesses were procured from four different commercial sources. They were analysed for moisture, mineral, iron, calcium, phosphorous, dietary fibre and phytin phosphorous using standard methods. Bioavailable iron and calcium were estimated using the equilibrium dialysis method. The thickness of flakes ranged from 0.08 to 1.20 mm for thin to thick flakes. The mineral content of the flakes ranged from 0.5 to 1.2 g, iron content from 3.38 to 6.86 mg and calcium content from 107 to 210 mg/100 g in samples of different thickness. Phosphorous (111-430 mg/100 g), phytin phosphorous (23-164 mg/100 g) and dietary fibre (5.64-11.5 g/100 g) reduced with the degree of flaking. The percentage of available iron ranged from 7% to 26% and that of available calcium from 8% to 25% from thick to thin flakes, but the differences were nonsignificant. Multiple regression analysis of the data showed a significant association of phytin phosphorous and dietary fibre (dependent variables) for binding of iron and calcium.

Pneumothorax following tracheostomy and its management.

Although pneumothorax is a known complication of tracheostomy, bilateral pneumothorax is comparatively rare. The case of suuh a complication is being reported here in a patient with a glottic carinoma who underwent emergency trackeostamy and developed hilaterluttrl pneuimothoriax and its subsuente. management is discussed.

Crystallization and preliminary X-ray studies of a recombinant calcium-binding protein from Entamoeba histolytica.

A calcium-binding protein (CaBP) of Entamoeba histolytica was purified from an E. coli recombinant clone carrying the CaBP gene in a pET-3c expression vector using anion-exchange and size-exclusion chromatography. Examination of the amino-acid sequence of the recombinant protein suggested that it has four independent EF-hand motifs. The protein dissolved in cacodylate buffer was crystallized using the hanging-drop method with 2-methylpentane-2,4-diol (MPD) as the precipitant. X-ray diffraction data have been collected on these crystals using a MAR Research imaging-plate detector system attached to a Rigaku RU200 rotating-anode X-ray generator. The crystals belong to the hexagonal space group P6122 with unit-cell dimensions of a = b = 96.21, c = 65.48 A. Preliminary molecular-replacement computations suggest that the structure of this protein is likely to be similar to that of calmodulin (CAM).