Association of family history of cardiometabolic diseases (CMDs) and individual health behaviours: Analysis of CARRS study from South Asia

Objectives: Family history is considered as an important predictor of cardiovascular diseases (CVDs) and diabetes. Available research findings suggest that family history of chronic diseases is associated with perceived risk of disease and adoption of healthy behaviours. We examined the association between family history of cardio-metabolic diseases (CMDs) and healthy behaviours among adults without selfreported CMDs. Methods: Cross-sectional data of 12,484 adults, without self-reported CMDs, from the baseline survey of Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) cohort study were analysed. Results: Family history was positively associated with non-smoking and high fruits & vegetables consumption in the age group of 45e64 years and moderate to high physical activity in the age group _x0001_65 years after adjusting for sex, education, wealth index, city and body mass index. Conclusions: Understanding perceived risks and cultural or psychological factors related to family history through ethnographic studies may deepen understanding of these associations.

Comparison of long-term outcomes of trabeculectomy and risk factors for failure in eyes post penetrating keratoplasty or Descemet’s stripping endothelial keratoplasty

Purpose: To evaluate the outcomes of trabeculectomy, graft survival, and risk factors for failure in post penetrating keratoplasty (PK) and Descemet’s stripping endothelial keratoplasty (DSEK) eyes. Methods: We reviewed charts of eyes that underwent trabeculectomy for post keratoplasty glaucoma PK [25 eyes] and DSEK [14 eyes] between 1993 and 2019. The demographics, clinical features, and surgical outcomes were evaluated. Success of trabeculectomy was defined as complete when the intraocular pressure (IOP) was >5 and ?21 mmHg without antiglaucoma medications (AGM) and qualified with AGM. Clear and compact graft was considered for graft success. Results: Median (interquartile range [IQR] preoperative IOP in post?PK eyes and post?DSEK eyes was comparable, 32 (28–38) vs. 31.5 (25–36) mmHg, P = 0.38). Median number of preoperative AGMs was comparable (P = 0.78). Median postoperative follow?up was longer in post?PK, compared with post?DSEK, 2.5 (1.3–3.3) vs. 1 (0.3–2.9) years (P = 0.05). Kaplan–Meier survival estimates for complete and qualified success of trabeculectomy at 3 years were 23.7% and 73.3%, respectively, for PK and 45.8% and 71.6%, respectively, for DSEK. Kaplan–Meier survival estimates for graft survival were 91.8% up to 3 years for PK and 100% until 2 years and 77.8% at 3 years for DSEK. Higher IOP prior to trabeculectomy was a risk factor for failure of trabeculectomy (P = 0.03) and older age was a risk factor for graft failure (P = 0.05) in PK eyes. Number of prior corneal surgeries (P = 0.05) was associated with failure of trabeculectomy and graft failure in post?DSEK eyes. Conclusion: Trabeculectomy had moderate qualified success in post?PK and DSEK eyes at 3 years. Higher pretrabeculectomy IOP and higher number of prior corneal surgeries were significantly associated with failure of trabeculectomy in PK and DSEK eyes, respectively

In vitro cytotoxicity assay of Fucoidan extracted from Turbinaria conoides against cancer cell lines MCF7, A549, and normal cell line L929

Abstract The main aim of the study is to quantify the cytotoxic property of the Fucoidan extracted from the Turbinaria conoides using the MTT assay with the standard fucose. Fucoidan was extracted using the soaked water method and it was determined using the HPLC procedure the obtained Test sample Fucoidan extracted from the Turbinaria conoides and standard fucose was subjected to the cytotoxicity assay against the MCF7 Human breast cancer cell line, A549 lung cancer cell line, and L929 normal mouse fibroblast cell line. From the results it was found that the Test sample showed good IC50 value for MCF7 cell line then A549 with an increasing concentration 24 hours incubation at 37°C The IC50 for MCF7 was 115.21 µg/ml and A549 396.46µg/ml and the Fucoidan extract was checked for its cytotoxicity against the normal mouse fibroblast cell line L929, Fucoidan was found non-lethal to the L929 mouse fibroblast normal cell line. Standard fucose also gave a significant result towards MCF7 and against the L929. This indicates that the Fucoidan extracted from Tubinaria conoides shows better anticancer potential in it. Hence its application can be further extended in the pharmacological fields.

Red and White Cabbage Extracts: Antioxidant Effects on Bovines Albumins

Background: Reactive oxygen species (ROS) may cause extensive tissue damages in various disease conditions.It may also induce an irreversible structural and/or functional modification of proteins. Flavonoids and theirderivatives are the largest group in plant polyphenols that are known to have an antioxidant effect. The aim ofthe present study is to evaluate the antioxidant effects of red or white cabbage on bovine serum albumin (BSA).Methods: Fresh leaves of red or white cabbage were washed with distilled water, and sliced into small pieces.Finally, the pieces were dried and extracted with 80% ethanol overnight. The antioxidant activity of cabbageextracts were studied by ferric reducing antioxidant power (FRAP) and H2O2 scavenging assays. Statisticalanalysis: Statistical significances were analyzed by one-way analysis of variance (ANOVA) by using software Rversion 2.8.1 (R Development Core Team, 2008). Significant differences (p < 0.05) are denoted by differentletters. Results: Red and white cabbage extract showed a pronounced antioxidant activity. White cabbageexhibited a highest antioxidant activities compared to red cabbage extract. Conclusion: Both red and whitecabbages have a high antioxidant effects. White cabbage extract had higher antioxidant activity than red cabbageextract.

Oral Habits: Prevalence and Effects on Occlusion Among 7 to 13 Years Old School Children in Aseer, Saudi Arabia

Abstract Objective: To evaluate the prevalence of deleterious oral habits and its effect on occlusion in school going children from 7 to 13 years old, in Aseer region of Saudi Arabia. Material and Methods: A cross-sectional study was conducted by clinical examination for the total sample of 750, who were attending private/ government schools in Aseer region school. Students were selected by stratified cluster random sampling. Clinical findings of each oral habits, including assessment of malocclusion, were examined involving the following parameters, i.e., crowding, spacing, open bite, crossbite and deep bite. Logistic regression analysis was conducted. Results: Boys had 26.2 % of crowded teeth, while 16.3% of girls were found to have crowded teeth; the difference was found to be significant (p=0.002). Spacing was present in 26.4% of boys and 16.7% girls; a significant difference was found between the two (p=0.002). Sleep bruxism was observed more among male subjects than females with a statistically significant difference in detrimental habits (p<0.001). Those subjects having tongue thrusting are 1.264 times at more risk of having crowded teeth than those with no tongue thrusting. Conclusion: There was a high prevalence of malocclusion associated with harmful oral habits in children. This highlighted the need to implement programs of oral care and health education for preventive orthodontic treatment at an early age.

New flavonoid with antidiabetic and antioxidant potential from Tetrastigma angustifolia (Roxb. ) Deb leaves

Ethnomedicinal survey documents the traditional practices of Tetrastigma angustifolia leaves in the management of diabetes in the North-eastern region of India. The present study was aimed at isolation of possible antidiabetic principle(s) from T. angustifolia leaves and evaluation of antidiabetic efficacy of isolated compound(s) in experimental animal model. The methanolic extract of T. angustifolia leaves was obtained by Soxhlet extraction method and subjected to silica gel column chromatography (100-200 mesh). Fraction 18-176 chloroform:methanol (70:30) yielded a pale yellow colored compound. The structure of pure compound was elucidated with the help of UV, IR, NMR and Mass spectrometric/techniques. The antioxidant activity of the isolated compound was evaluated in vitro by various radical scavenfing assay methods.. Oral acute toxicity study was carried out according to OECD guideline 423 in Wistar rats. The antidiabetic efficacy of the isolated compound was evaluated in STZ-induced diabetic rats at the dose of 5 mg/kg b.w. for duration of 21 days. The present study reports a new flavocnoid compound isolated from the methanolic extract of T. angustifolia leaves and identified as 8-hydroxyapigenin 7-O-D-glucopyranoside. The flavonoid compound exhibited potent antidiabetic (hypoglicemic) activity in STZ-induced diabetic rats with promising antioxidant (radical scavenging activity) potential in vitro.

Determination of Heavy Metals in Waters of Lower River Kuywa

Heavy metals are required by the biological organisms as nutrients but their availability above certain limits leads to adverse conditions such as bone, nerve and internal body organs damage like liver, high blood pressure, acute poisoning and death in animals and human beings and reduction of photosynthesis production, inhibition of seed germination and decreased crop yield in plants. River Kuywa being in a rich inorganic farming of sugarcane and maize area aswell as industrial and urban environment, it is exposed to pollution. The objective was to determine the levels of heavy metal concentration using an Atomic absorption spectrometer and the effects of physicochemical parameters to the metal ions concentration which could arise from pollution. Temperature, pH, electrical conductivity and total dissolved solids were found to be (22.9, 23.3 C̊), (7.19, 4.34), (312.43, 318.45 μS) and (201, 204 mg/L) for upstream and downstream side of pollutants entry point respectively. Chromium, Copper and Zinc ions had relatively high concentrations compared to Cadmium ions. Lead ions were below the detection limit. Chromium, Copper and Zinc had (0.2660 ppm, 0.4276 ppm), (0.1306 ppm, 0.085 ppm) and (0.1369 ppm, 0.1395 ppm) while Cadmium had (0.0684 ppm, 0.0513 ppm) for upstream and downstream respectively. All physicochemical parameters were within WHO limits except pH. Chromium and Cadmium concentrations were above WHO limits while Copper and Zinc were below. Chromium had elevated concentration compared to other metals. There should be continuous and close monitoring of Chromium levels by reducing the factors leading to high rate of rock weathering and leaching.The water having Chromium and Cadmium concentrations above recommended limits, it should be treated first for Quality Assurance before it is consumed. Agencies like NEMA and WARMA should increase water quality surveillance operations for surface water.

Rate and Predictors of Type 1 Diabetes Mellitus Poor Glycemic Control In Tabuk

Background: Recently, great advances in the quality of careregarding type 1 diabetes have been achieved. Despite of that,glycemic control remains suboptimal for many patients withtype 1 diabetes even in Western countries.Objectives: To identify rate and predictors of glycemic controlamong type 1 diabetic patients in Tabuk Region, Saudi Arabia.Subjects and Methods: A cross-sectional study was carriedout in Tabuk city, Saudi Arabia. All type 1 diabetic patientsattending the military hospital in Tabuk throughout the studyperiod (December, 2018-February, 2019) constituted the targetpopulation for the study. Data collection questionnairedeveloped by the researcher and validated by threeDiabetology consultants (face validity) was used. Glycosylatedhemoglobin (HBA1c) Levels above 8%, independent of agewas considered as poor control, and levels below or equal 8%were considered as acceptable control.Results: The study included 150 type 1 diabetic patients. Theirage ranged between 8 months and 27 years with amean±standard deviation of 15.44±4.73 years. The prevalenceof poor glycemic control among type 1 DM patients was 70.7%.Multivariate logistic regression analysis revealed thatadmission to the hospital twice or more than twice wereassociated with higher risk of poor glycemic control (Adjustedodds ratio (AOR) and their 95% confidence intervals (CI) were2.19, 1.03-8.01 (p=0.046) and 3.02, 1.79-11.13 (p=0.009),respectively. With increase in age at diagnosis of type 1 DMby one year, there was a reduction in poor glycemic control by38% (AOR=0.62, 95% CI=0.54-0.71, p<0.001) while withincrease in the duration of diabetes by one year, the risk ofpoor glycemic control increased by 31% (AOR=1.31, 95%CI=1.09-1.98, p=0.001). Non availability of glucose test devicewas associated with almost 4-folds risk of poor glycemiccontrol (AOR=4.12, 95% CI=2.23-5.03, p=0.007). Conclusion:Majority of type 1 diabetic patients in Tabuk Region, KSA hadpoor glycemic control. Many factors were associated with poorcontrol, some of them are modifiable. Therefore, efforts mustbe done to overcome these factors.

Acetylcholinesterase inhibition, antioxidant and identification of some chemical constituents of Phyllanthus atropurpureus cultivated in Egypt

Investigation of the lipid constituents of the aerial parts of Phyllanthus atropurpureus resulted in isolation and identification of the fatty acid mixture which consists of eight acids with linolenic acid as major and the unsaponifiable fraction that contain a series of hydrocabons, sterols, in addition to one triterpene (α-amyrin). The acetone insoluble fraction was found to contain two fatty alcohols and three n-hydrocabons in which the n-eicosane is the most abundant (44.16%). The flavonoidal constituents were isolated from ethyl acetate and butanol fractions which were identified as: luteolin-7-O-glucoside, kaempferol 3-O-(p-coumaroylglucoside), kaempferitrin, luteolin and kaempferol. Evaluation of different extracts as acetylcholinesterase inhibitors (AChI), established the chloroform fraction as a promising inhibitor of the enzyme. The antioxidant testing with DPPH radical revealed the potential of precipitate from MeOH extract as a radical scavenger.

A study of serious adverse drug reactions with antiepileptic drugs: a pharmacovigilance study

Background: Approximately 50 million people worldwide have epilepsy, making it one of the most common neurological diseases globally. There are currently more than 25 drugs in the market for the treatment of epilepsy, many of which have similar efficacy but differ in their tolerability profile. Besides unmatched beneficial potential of antiepileptic drugs, it is associated with many adverse reactions too. This study aims to identify the serious adverse reactions caused by prescribed antiepileptics, reported at the pharmacovigilance centre of government tertiary care centre.Methods: This is a retrospective, pharmacovigilance study of the antiepileptic drugs adverse reactions reported over a period of 1 year at a tertiary care centre.Results: A total of 120 ADRs of antiepileptic drugs were reported and collected at the pharmacovigilance centre. According to the WHO-ART system organ classification of ADRs, 78% of ADRs belonged to skin and appendages disorder. Based on the modified Hartwig and Siegel scale of severity, 60.8% ADRs were mild, 18.5% were moderate and 20.8 % were severe ADRs. The severe ADRs included: Steven-Johnson syndrome, Toxic epidermal necrolysis, Erythroderma, DRESS syndrome and Acute pancreatitis. Phenytoin has been found to be the antiepileptic drug causing the most number of severe ADRs amongst the prescribed antiepileptics. According to the modified Schumock and Thornton criteria most of the severe ADRs were not preventable.Conclusions: This study analyses the ADRs associated with antiepileptics reported at the pharmacovigilance centre. 20.8% ADRS were severe, this indicates that the epileptic patients should be closely monitored for ADRs, to avoid clinically significant harmful consequences. The awareness of ADRs would help physicians to identify patients with greater risk of ADRs and therefore, might benefit from ADRs monitoring and reporting programmes.

Interprofessional Education: An Approach to Improve Healthcare Outcomes

Interprofessional education (IPE) approach allows learners from different health professions viz. – medical, dental, nursing,physiotherapy, psychotherapy, psychology etc., learn from, learn with, and learn about, each other. The scope of learning depends uponthe requirements and curriculum. Interprofessional education can help in creating a workforce that learns to perform collaborativepractice thereby ensuring better health-care outcomes. Medical educators’ and practitioners’ understanding about teaching, learning,and assessment of IPE is rudimentary. Strategies to incorporate IPE in regular curricula need to be debated and barriers associated withits implementation require to be identified. This review highlights the teaching-learning and assessment tools for IPE and discussespotential challenges in its implementation.

Fostering critical thinking and collaborative learning skills among medical students through a research protocol writing activity in the curriculum / 한국의학교육

PURPOSE: This intervention was aimed to analyse the effect of academic writing and journal critiquing as educational approaches in improving critical thinking and collaborative learning among undergraduate medical students. METHODS: A research proposal writing format was created for the 4th year medical students of Melaka Manipal Medical College, Malaysia during their ophthalmology clinical postings. The students worked in small groups and developed research protocols through an evidence based approach. This was followed by writing reflective summaries in academic portfolios about the activity undertaken. A mixed methods study was designed to explore the possible role of collaborative research proposal writing in enhancing critical thinking and collaborative learning. RESULTS: Analysis of reflections submitted by 188 medical students after the intervention indicate that majority of them found an improvement in their skills of critical thinking and collaborative learning as a result of research protocol writing. All participants agreed that the model helped in applying concepts to new situations in the form of designing their own study, which reflected in enhanced higher order cognitive skills. CONCLUSION: This study shows that the introduction of a structured module in the core medical curriculum that focuses on research writing skills embedded with collaborative and reflective practices can enhance collaborative learning, critical thinking, and reasoning among medical students.

A study on the role of small intestinal bacterial overgrowth in patients with functional dyspepsia

Background: Functional dyspepsia (FD) accounts for majority of dyspepsia. Before labeling them as FD, a bunch of investigations to be done to rule out organic cause. Small intestinal bacterial overgrowth (SIBO) which is one of the cause for dyspepsia is not commonly sought and always neglected among physicians. So we aimed to study the frequency of SIBO in patients with dyspeptic symptoms and whether to include investigations to diagnose SIBO in the algorithm of approach to dyspepsia. Materials and methods: We consecutively enrolled 50 newly diagnosed functional dyspepsia patients based on Rome III criteria and 50 healthy controls in this study. They underwent glucose hydrogen breath test (GHBT) after overnight fasting. Results: In the cases with FD, 6 (12%) subjects were found to have positive GHBT and diagnosed as SIBO, whereas in the controls 2 (4%) had positive GHBT with no statistical significant difference among groups with a P value of 0.140. In the cases with FD, the most common subtype was post prandial distress syndrome (46%), followed by epigastric pain syndrome (36%) and mixed type Sabarinathan Ramanathan, Premkumar Karunakaran, Kani Shaikh Mohamed, Ratnakar Kini, Pugazhendhi Thangavel, Murali Ananthavadivelu, Mohammed Ali, Rabindranath Eswaran, Thinakar Mani, Chandrashekar Patil. A study on the role of small intestinal bacterial overgrowth in patients with functional dyspepsia. IAIM, 2017; 4(5): 88-97. Page 89 (18%). Patients with SIBO were treated with rifaximin 1200 mg/day in divided doses for 10 days. GHBT was repeated after 4 weeks and found to be normalized in all cases. Conclusion: SIBO should be considered before making a diagnosis of FD. GHBT is a simple noninvasive method to diagnose SIBO. One could avoid taking unnecessary drugs by timely diagnosis of SIBO in patients with dyspepsia.

First line management of adult diabetic ketoacidosis patients

BackgroundiDiabetic Ketoacidosis [DKA] is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided

Aim of the Study: was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department

Methods:A literature search was carried out on MEDLINE [including MEDLINE in-process], CINAHL,Embase and the Cochrane Library. Databases using [diabetic ketoacidosis] as a MeSH heading and as textword. High yield journals were also hand searched

Findings: The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment

Conclusion: Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It's therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit

Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition

effect of mehotrexate in the treatment of alopecia areata

Background: Alopecia areata [AA] is one of the most common autoimmune disorders and its severe types are resistant to almost all conventional therapies. Methotrexate [MTX] has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids

Aim of the study: was to evaluate the outcome and safety of MTX therapy in patients with severe forms of AA, whether as monotherapy or in combination with systemic or intralesional corticosteroids; and to assess therapeutic response according to sex, age, pattern of AA, disease duration and cumulative MTX dose

Methods: 28 patients were evaluated in a retrospective, non-controlled study, with alopecia areata in current or prior treatment with methotrexate to assess the therapeutic response according to sex, age, pattern of alopecia areata, disease duration, and cumulative dose of methotrexate as well as the use of systemic corticosteroids or other treatments, and drug safety

Results: 77.8%% of patients experienced a more than 50% regrowth rate, with the best responses observed in those with <5 years of disease progression [81%], age over 40 years [84.6%], male patients [80%], cumulative dose of methotrexate 1000-1500 mg, and multifocal alopecia areata [83.3%], patients receiving systemic corticosteroids in combination with methotrexate, 78.5% had greater than 50% regrowth, compared with 45.3% in those who used methotrexate alone. The therapeutic dose ranged from 10-25 mg/week. No patient had serious adverse effects. Relapse was observed in 35.4% of patients with more than 50% regrowth

Conclusion: methotrexate is a convenient and relatively inexpensive drug that could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse

Prediction of preterm birth in women with short cervix

Background: Second trimester short cervical length identifies women at increased risk for an early spontaneous Preterm birth [sPTB], hence raising a compelling needed for Cervical Assessment for prediction and possible Preventing Preterm Delivery

Objective of the study: to assess the implications associated with a short cervical length as well as the use of ultrasonographic-derived cervical length measurement in predicting preterm birth. Methods: the present review includes relevant randomized controlled trials [RCTs] that investigated the in Medline [via PubMed], Cochrane Library and Embase. Retrospective and Prospective Cohort studies, Case-control and Randomised controlled trials. There were no restrictions by outcomes examined, language or publication status

Results: The critical search results yielded 6 articles [randomized trials=2, cohort studies=3, case-control study=l] representing 653 patients . Five of the 6 presented similar pregnancy outcomes [spontaneous preterm birth or pregnancy Joss < 24 weeks' gestation] between the ultrasound-indicated and the history-indicated cerclage groups. 45-69% of the patients followed with cervical ultrasound were able to avoid cerclage

Conclusion: Evidence from randomized trials supports that transvaginal ultrasound is predictive of preterm birth in women with prior preterm birth and a short cervix. The thresholds proposed vary from 15 mm to 28 mm and cerclage is thus recommended

Evaluation of a personal and professional development module in an undergraduate medical curriculum in India / 한국의학교육

The study aimed at evaluating the personal and professional development (PPD) module in the undergraduate medical curriculum in Melaka Manipal Medical College, India. PPD hours were incorporated in the curriculum. A team of faculty members and a faculty coordinator identified relevant topics and students were introduced to topics such as medical humanities, leadership skills, communication skills, ethics, professional behavior, and patient narratives. The module was evaluated using a prevalidated course feedback questionnaire which was administered to three consecutive batches of students from March 2011 to March 2013. To analyze faculty perspectives, one to one in-depth interviews and focus group discussions were conducted by the coordinators with faculty members who conducted the PPD classes. Analysis of the course feedback form revealed that majority (80%) of students agreed that the module was well prepared and was "highly relevant" to the profession. Faculty found the topics new and interdisciplinary and there was a sense of sharing responsibility and workload by the faculty. PPD modules are necessary components of the curriculum and help to mould students while they are still acquiescent as they assume their roles as doctors of the future.

Surgical Management of Cases Presenting with Diabetic Foot in Kosi Region of Bihar.

Introduction: The major complication of diabetes is the foot ulcer with a poor tendency to heal thus leading to complications. The outcome of the complications of a patient with diabetic foot can be favorable if proper and timely surgical intervention is provided by the attending surgeon by means of regular dressing, wound debridement, amputation, and use of proper antibiotics supported by sensitivity report. Aim: The aim of the present study was to undertake different surgical treatments available in management of diabetic foot. Materials and Methods: A total of 100 diagnosed cases of diabetic foot were studied over a period of 3 years in the Department of General Surgery at Katihar Medical College with emphasis on surgical modalities of treatment of diabetic foot and its complications. Results: Males are more prone to surgical complications 3 times than females because of more outdoor activities. It is more prevalent in the age group 51-60 years (36%). In the treatment schedule, 38 patients were managed by daily dressing and wound debridement and slough excision, 20 patients with a split skin graft, 16 patients under went incision and drainage for an abscess. 16 patients with gangrene of toes and phalanges underwent disarticulation. Transmetatarsal amputation was done in 4 cases, below the knee amputation in 4 cases and above knee amputation in 2 cases. In the course of treatment, the minimum stay in hospital was 1 week and maximum 96 days. Conclusion: Diabetic foot has varied presentation as shown by this study. Good results can be obtained by adopting a multidisciplinary approach for diabetic foot lesions. The patient education for care of feet such as pairing of nails, wearing proper footwear, and prompt reporting to doctor in case of early lesion in foot is important as diabetic foot is very prevalent in Kosi region of Bihar.

Acute accidental poisoning in children admitted to child's central teaching hospital in Baghdad

Background: Poisoning defined as any substance causing a harmful effect when administrated accidently. Acute accidental poisoning is important medical emergency in children worldwide

Objective: To determine the pattern of accidental poisoning in children, the association between accidental poisoning with gender and residence and to determine the clinical presentation and outcome of each poison

Methods: A prospective study was carried out in Childs Central teaching hospital in Baghdad for all children bellow ten years with history of accidental poisoning during six months period Data including: age, gender, residence, type of poisoning, presenting symptoms, and outcome were studied

Results: Total number of children admitted were 10280 cases, of these 250 cases were presented with history of accidental poisoning, accounting for [2.43%] of total cases admitted. Most of patients [93.2%] were within age group of 1-5 years. Males to females ratio was [1.27:1].Most common poison was hydrocarbons [50.8%] followed by medications [3 1.2%] Most of patients were from urban backgrounds [78.0%].Vomiting was the most common clinical presentation [28. 8%]. [80.0%] Patients discharged from emergency reception within 24 hours. The mortality rates were [0.8%]

Conclusion: Poisoning in children are well recognized problem and affecting large number of children. The mortality rate was low

Knowledge, Attitude and Practice on Preventive Dentistry among Senior Dental Students in Yemen

There is a strong and increased worldwide interest on the aspects of prevention of oral disease and oral health promotion in dental education. However, some studies imply that dental students are not knowledgeable enough in this issue. This study aimed to evaluate the knowledge of, attitude towards and practice on preventive dentistry among senior dental students in Yemen. Self-administered questionnaires were distributed among senior dental students in six dental schools in Yemen. The questionnaire obtained personal information, and questions about knowledge on preventive dental care, attitudes towards and practice on preventive dentistry. Among 346 students who filled the questionnaire, a total of 91.6% has good knowledge about fissure sealant effectiveness, only 34.7% knows about the importance of fluoride toothpaste compared to brushing technique in preventing caries, with significant gender difference (p=0.005). Odds of good knowledge among non-Qat chewers was 1.9 (95%CI: 1.26-4.42). Multivariable regression analysis indicated that female gender was associated with higher positive attitudes (OR: 2.03, 95%CI:1.21-3.36,p=0.007). Attitudes were significantly associated with Qat chewing (OR = 1.95, 95%CI: 1.04-3.66, p=0.03), type of university (OR = 0.59, 95%CI: 0.36-0.94, p=0.02), and mothers' level of education (OR = 1.91, 95%CI: 1.05-3.47, p=0.03). There was a high percentage of competency in practicing preventive measures among students (80.9%). Dental education should emphasize the overall aspects of preventive dentistry with early exposure of preventive dental training in order to improve students' knowledge and attitudes and consequently practice on preventive care.​