Treatment of pseudo Class III malocclusion by modified Hawleys appliance with inverted labial bow.

Pseudo Class III malocclusion is characterized by an anterior crossbite with functional forward mandibular displacement. Various appliances have been devised for early treatment of a pseudo Class III. The aim of this article is to highlight the method of construction and use a simple removable appliance termed as "Modified Hawleys appliance with inverted labial bow" to treat psuedo class III malocclusion in the mixed dentition period. It also emphasizes the importance of differentiating between true Class III and pseudo Class III. This appliance in this type of malocclusion enabled the correction of a dental malocclusion in a few months and therapeutic stability of a mesially positioned mandible encouraging favorable skeletal growth.

NiTi bonded space regainer/maintainer.

Early orthodontic interventions are often initiated in the developing dentition to promote favorable developmental changes. Interceptive orthodontic can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. Premature loss of deciduous tooth or teeth can often destroy the integrity of normal occlusion. There are many space regaining and maintaining devices mentioned in literature. In this article, I present a simple space regaining method by a piece of nickel titanium (NiTi) wire bonded between the teeth in active loop form, and the unique shape memory property of NiTi wire will upright or move the teeth and the lost space can be regained easily.

A study of neurocysticercosis in the foothills of the Himalayas.

OBJECTIVES: The present study was planned and carried out with the aim of determining the incidence of neurocysticercosis (NCC) among patients with clinically manifested neurological disorders attending the Himalayan Institute of Medical Sciences (HIMS) hospital. METHODS: Spanning a period of 18 months, serum samples of consecutively selected patients were screened by ELISA for the presence of anti-cysticercus antibodies after obtaining a detailed history. Physical examinations were performed along with routine hematological, stool and urine tests. All patients included in the study group were also subjected to radiological investigations such as CT scan/MRI/X-ray and/or ultrasonography. RESULTS: One hundred and three new patients were selected for the study group, with a male:female ratio of 2:1. Of these, 33 (32.0%) patients were positive for Taenia solium IgG antibodies in sera. Children in the 11-20 years age group were most affected (39.4%). Only 10 patients (30.3%) were found to be positive for ova in stool, which correlated well with the presence of multiple lesions in the central nervous system (p<0.01). Solitary lesions were more common (66.7%) than multiple lesions (33.3%) on radiological diagnosis by CT scan/MRI. CONCLUSIONS: A high incidence of neurocysticercosis in the region reflects the endemic presence of T. solium and advocates the practice of better hygiene, cooking methods and water filtration procedures for the prevention of infection.

Essential oil composition of valeriana jatamansi jones from himalayan regions of India.

Valeriana jatamansi Jones germplasm collected from sub-temperate Himalayan region of Uttarakhand and North-East state of Meghalaya, India was evaluated under identical conditions at National Bureau of Plant Genetic Resources, Bhowali, India, to study germplasm diversity based on essential oil composition. Twenty one compounds were identified in V. jatamansi root oil by GC and GC-MS. The major compounds identified were patchouli alcohol (0.4-63.7%), maaliol (2.9-53.8%), seychellene (4.1-27.4%), calarene/ß-gurjunene (3.0-20.8%), α-santalene (0.6-12.0%). Other compounds present were bornyl acetate (0.6-1.5%), α-guaiene (0.7-2.3%), α-bulnesene/δ-guaiene (0.7-6.3%), 7-epi-α-selinene (0.4-1.4%), kessane (2.1-3.3%), spathulenol (0.7-3.4%), viridiflorol (0.9-7.1%), α-patchoulene (0.8-6.6%), ß-patchoulene (0.4-0.8%). Two superior chemotypes identified in V. jatamansi oil from Uttarakhand were: patchouli alcohol rich (IC573221, 63.7%) and maaliol rich (IC573222, 53.8%; IC589096, 51.7%), while accession from north-east was patchouli alcohol rich chemotype (IC574522, 57.2%). These superior chemotypes with higher amounts of patchouli alcohol and maaliol could be used for promoting cultivation as well as for meeting need of pharmaceutical industries.

Azithromycin monthly pulse vs daily doxycycline in the treatment of acne vulgaris.

Acne vulgaris is a common skin disease seen primarily in adolescent and young adults. As the treatment involves long term therapy with antibiotics, an agent with a long half life can be very useful in increasing the compliance. To evaluate the role of a monthly dose of azithromycin and compare it with daily doxycycline, we conducted this randomized comparative study. Sixty patients with moderate to severe acne were randomly assigned to two treatment groups, A & B. Patients in group A received 100 mg doxycycline daily in addition to topical 0.05% tretinoin cream, whereas patients in group B were given 500 mg azithromycin once a day for four days per month along with 0.05% topical tretinoin for a total of 12 weeks. Of the 60 patients, 22 in group A and 28 in group B were evaluated. The monthly dose of azithromycin was found to be as effective as daily doxycycline on a pure protocol basis and statistically significantly better than doxycycline by intention to treat analysis.

Who decides?

PIP: The study examined the role of family members in decision making about the health and welfare of children in the Indian household. The sample was taken from three villages in Cholapur Primary Health Center, Varanasi, Uttar Pradesh state, India, during 1989-90. 100 pregnant women was randomly drawn for the sample. Separate interviews were conducted among decision makers who were other than the mother. 51% had monthly household incomes under Rs. 300; 25% had incomes ranging from Rs. 301 to 600; 16% had incomes of Rs. 601-1000; and 4% each had incomes of Rs. 1001-1500 and over Rs.1500. 80% were housewives. 20% were agricultural workers or laborers. 79% of mothers were illiterate. 12% had some primary schooling, and 5% had a high school education. 64% were joint families, and 36% were nuclear households. All mothers-in-law and fathers-in-law were illiterate or had received nonformal education. 56% of mothers deferred to the decision making of mothers-in-law. 15% of mothers deferred to the decision making by husbands. Mothers made their own decisions about child health in 12% of households. All decision makers considered a consultation with a doctor necessary for pregnancy complications. However 38% lacked knowledge about complications in pregnancy. 70% of decision makers preferred home delivery, and 80% desired delivery by an ancillary nurse-midwife. 76% of decision makers desired a doctor for treatment of a child with complications. 19% considered witchcraft a reasonable form of treatment, and 5% had no idea about what to do about child health problems. 53% recommended a baby be given tonics for small size or weakness. 16% were knowledgeable about oral rehydration therapy for diarrhea treatment. Improvement in perinatal, neonatal, and infant mortality care will depend on training, health education, and community participation.^ieng

Pentoxifylline and ciprofloxacin in chronic folliculitis of legs.

Clinically diagnosed 38 patients of chronic superficial folliculitis were divided into 2 equal grops. Group I was given combination of ciprofloxacin and placebo for two weeks followed by placebo for another 4 weeks whereas patients in group II were given combination of ciprofloxacin and pentoxifylline for two weeks followed by pentoxifylline for 4 weeks. The combination of pentoxifylline with ciprofloxacin was found to be superior in initial response as well as prevention of reccurrence.

Short term treatment of pityrosporum folliculitis with itraconazole.

We compared the efficacy and safely of short-term itraconazole with that of placebo in 26 patients of pityrosporum folliculitis. Twenty-six patients of mycologically proven pityrosporum folliculitis entered a double-blind placebo-controlled trial. Patients were randomly assigned to 7 days of treatment with either itraconazole, 200 mg once daily, or placebo. A global clinical assessment and mycological examination (KOH and smear examination) were performed at baseline and at 4 weeks after treatment. In this study, itraconazole in a dose of 200 mg for 7 days produced a distinct and statistically significant improvement over placebo (p<0.01). 84.6% of itraconazole treated patients were considered to be healed or markedly improved at the study's end point compared with 8.3% of placebo treated group (p<0.01). Eighty-four percent of patients receiving active treatment showed negative mycological examination as compared to 8.3% of placebo-treated group (p<0.01). Short-term treatment with itraconazole is effective and well tolerated in the management of pityrosporum folliculitis.

Evaluation of the usefulness of phage amplification technology in the diagnosis of patients with paucibacillary tuberculosis.

The present study was undertaken to assess the performance of the Fast Plaque TB(TM) (FPTB) test in the diagnostically difficult group of paucibacillary tuberculosis (TB) and to compare its results with the conventional bacteriological methods. The study was conducted on a total of 139 patients, who were negative for TB in sputum-smear examination. Bronchoalveolar lavage (BAL) or pleural biopsy specimens collected from these patients were subjected to smear examination, LJ culture and FPTB test. The smear, culture and the FPTB positivity rates were compared between patients with pulmonary and pleuro-pulmonary involvement. The FPTB test was found to register an overall sensitivity of 58.8% and specificity of 97.9%. The positive and negative predictive values of the test were 98.1 and 56.5, respectively. Among patients with paucibacillary TB, on head-to-head comparison, we found that the sensitivity and specificity values of the FPTB test were marginally better than smear-microscopy and inferior to culture on LJ media.

Cimetidine and levamisole versus cimetidine alone for recalcitrant warts in children.

Various immunomodulating agents have been used in the treatment of recalcitrant warts, but none is uniformly effective. Aggressive surgical therapy of warts in children is painful and may require general anesthesia. Drugs such as cimetidine and levamisole have been tried with varying success rates. Given the different target of activities of immunomodulation by cimetidine and levamisole, we questioned whether the combination might be more effective and conducted a double-blind comparative trial of a combination of cimetidine and levamisole versus cimetidine alone. Forty-four patients with multiple recalcitrant warts were assigned to one of two treatment groups (groups A and B) in double-blind fashion. Of the 44 patients, 19 in group A and 20 in group B could be evaluated. At the end of therapy, cure rates (complete clearance) obtained were 31.5% of those in group A and 65% of those in group B (combination treatment). A statistically significant improvement was seen in patients treated with the combination of levamisole and cimetidine (p=0.0150). The rate of regression was faster in group B (average regression period of 7.8 weeks compared with 11 weeks in group A). The present study demonstrated that the combination of cimetidine with levamisole is more effective than cimetidine alone and is a highly effective therapy for the treatment of recalcitrant warts.

Topical metronidazole in seborrheic dermatitis--a double-blind study.

OBJECTIVE: To evaluate the role of topical metronidazole gel in the treatment of seborrheic dermatitis. METHODS: Forty-four patients with seborrheic dermatitis were enrolled in the study. All topical treatments were stopped for at least 2 weeks before the patients were allocated at random to receive either metronidazole 1% gel or placebo for 8 weeks. The severity score was measured at the initial evaluation, and the patients were followed up at 2-week intervals for 8 weeks. A global evaluation of improvement was done at 8 weeks. RESULTS: Thirty-eight patients completed the study; 21 patients in the metronidazole group and 17 patients in the placebo group could be evaluated. There was a statistically significant decrease of the mean score even at week 2; the difference became highly significant at 8 weeks (p < 0.001). On the final evaluation at 8 weeks, 14 patients in the metronidazole group showed marked improvement to complete clearance as compared to only 2 patients having moderate improvement in the placebo group (p < 0.001). CONCLUSION: The present trial has demonstrated the effectiveness of topical 1% metronidazole gel in seborrheic dermatitis.

Comparison of combination of cimetidine and levamisole with cimetidine alone in the treatment of recalcitrant warts.

Various immunomodulating agents have been used in the treatment of recalcitrant warts, but none is uniformly effective. Drugs like cimetidine and levamisole have been tried with varying success rates. Given the different target activities of immunomodulation by levamisole and cimetidine, we questioned whether the combination might be more effective and conducted this double-blind comparative trial of a combination of cimetidine and levamisole versus cimetidine alone. Forty-eight patients with multiple recalcitrant warts were assigned to two treatment groups (A and B) in double-blind fashion. Of the 48 patients, 22 in group A and 21 in group B were able to be evaluated. At the end of therapy, cure rates obtained were 45.5% (10/21) in cimetidine treated patients (group A) and 85.7% (18/21) in combination treated patients (group B). A statistically significant improvement was seen in patients treated with the combination of levamisole and cimetidine (P < 0.01). A similar statistically significant result was obtained on using intention to treat analysis (P < 0.02). The rate of regression was faster in group B (average regression period of 7 weeks compared with 10 weeks in group A). The present study demonstrated that the combination of cimetidine with levamisole is more effective than cimetidine alone and is a highly effective therapy for the treatment of recalcitrant warts.