ABSTRACT
An unprecedented outbreak of dengue occurred during 2017 in Kerala. Thiruvananthapuram was worst affected. We carried out a joint investigation with the Health department of the State, to understand the epidemiological and entomological factors involved in this outbreak, so as to develop strategies to contain it. Blood samples from suspected patients were collected from three worst affected areas and genomic analysis of the Dengue virus (DENV) was performed. Also, a cross sectional entomological survey was carried out in these areas. The data obtained was compared with the available secondary data of DENV in Kerala. The investigations revealed a genetic shift from the erstwhile predominant DENV2/DENV3 serotypes to the newly introduced DENV1 Asian genotype during the current outbreak. Breeding indices of Aedes aegypti, the predominant vector species was also found to be remarkably high. Asian genotype of DENV1 was detected in field collected Ae. aegypti also. The index cases of the Asian genotype of DENV1 in Kerala were detected from Erumeli village (gateway to the famous Sabarimala shrine) among two plantation workers migrated from the neighbouring Karnataka state, during 2013. This introduced virus strain attained an epidemic proportion in 2017 in Thiruvananthapuram, owing to immunologically naïve population and high receptivity.
ABSTRACT
Background: One of the most common manifestations of stroke is hand function affectation. This can have a negative impact on daily, social and leisure activities. A formal evaluation protocol will be able to identify specific needs of a patient. The objective was to find out the stability of the Chedoke arm hand activity inventory in sub-acute and chronic stroke patients in India Method.Methods: This was an observational study with sample size 29 and the sampling was convenience sampling. Participant criteria were sub-acute and chronic stroke patients, male and female, patients who follow commands, stable vitals, CMSA score of hand and leg function with stage 3, foot with stage 2, postural control with 6 or 7 and ability to walk 25 meters indoor. Recurrent stroke and hand dysfunction due to any reason other than stroke were excluded. Twenty-nine stroke patients, sub-acute and chronic where CMSA score taken prior to administration of CAHAI. A score of 1-7 for each task in CAHAI 13, total score of minimum 13 and maximum 91 with other considerations where “unsafe for the patient” was considered as score 1. Data analysis were done using SPSS version 22.0 and Pearson’s correlation coefficient.Results: A total of 29 participants included where the test retest reliability was r=0.98 with significance <0.001.Conclusions: CAHAI found to be a highly reliable outcome measure.
ABSTRACT
To tackle a large midline diastema and generalized spacing existing before extraction often poses a challenge to the treating prosthodontist. The situation becomes even more complicated if the patient is a teenager, with multiple missing teeth, associated deep bite and where the jaw bone growth has not yet been completed. Possible treatment options would include a removable prosthesis, a fixed partial denture or an implant supported prosthesis. Treating such cases with a simple removable prosthesis cannot be justified if a deep bite existed which would result in posterior disocclusion. Also a conventional fixed partial denture or closure of the diastema with light cure composite (LCC), would result in a seemingly large tooth, which would be unaesthetic in appearance. Implant supported prosthesis is a possibility, if the patient’s jaw bone growth has been completed. Another simple non-invasive solution to this problem would be to fabricate a non-rigid connector using loops. This presentation describes the procedure for fabrication of an interim loop connector for a 16 year old female patient who had lost one of her maxillary central incisors as a result of trauma. Patient also had multiple spacing in the maxillary anterior teeth and an associated deep bite. Her cephalogram revealed that she had a Class III skeletal pattern. A permanent treatment at this stage was not possible due to ontoward mandibular growth pattern as revealed on the cephalogram. Hence to dodge all these problems, a simple and non-invasive treatment using loop connectors was chosen till the growth period was completed.