Supplemental nutrition for retinal health: Evidence based analysis of commercial preparations in India

Purpose: Antioxidants have been lately postulated as supportive and prophylactic supplements for various retinal disorders, especially age?related macular degeneration (AMD). Forty?eight brands of such supplements containing lutein and zeaxanthin are available in India. The aim of the study was to assess the market leaders in supplements for ophthalmology in view of AREDS recommendations. Methods: Descriptive review of top?selling supplements for eye health were compared to the contents of the AREDS?recommended levels. Results: None of the top 10 selling brands had exact or near similar composition as recommended in the AREDS?2 study, which is the most widely accepted level?1 evidence in AMD prevention. Conclusion: Physicians prescribing these antioxidants, especially for the prevention of advanced AMD, should be vigilant and aware of the contents of the prescribed brands.

Customized Attachment Retained Hollow Cheek Plumper to Enhance Esthetics in Elderly: Report of a Novel Technique

Introduction: Esthetics is an integral part of dental treatment.Geriatric patients with completely edentulous arches areincreasingly demanding improved esthetics at the end oftreatment. Sunken cheeks are one of the major prostheticcomplication post denture insertion if the cheeks are notadequately supported by prostheses.Case Report: Cheek plumper is prosthesis that extend nearpremolar–molar region to support the cheek in edentulouspatients. They may either be attached or detachable accordingto requirement of case. This article describes the use andfabrication of a customized attachment for cheek plumperusing dowel pins commonly used in dental laboratories forfixed dental prosthesis fabrication.Conclusion: This article describes an innovative, simpleand cost-effective attachment system used in completelyedentulous patient requiring complete denture prostheses withdetachable cheek plumper.

Distribution of ABO and rh blood group in myeloproliferative diseases

Background: The aim of this study was to investigate the distribution of ABO and Rh blood group in myeloproliferative disease and if association, if any exists can be used as a preclinical marker for cancer development and risk; hence, we can modify other modifiable risks for myeloproliferative diseases (MPDs). Materials and Methods: This was a cross-sectional study which included 252 cases who were diagnosed as a patient with lymphoid malignancies of any age group of both gender, 350 controls were taken as healthy people who have donated blood. Cases and controls were collected between January 1, 2016 and May 30, 2017. Blood group sampling of all cases and controls was performed. The obtained information regarding the presence or absence of myeloproliferative disorder, blood group type, age group, and type of myeloproliferative disorder analyzed, the statistical analysis was performed using SPSS for windows version 16.0 software. The findings were present in number and percentage analyzed using frequency, percentage, and Chi-squared test. Results: Of 266 cases of MPDs, majority of cases were of blood Group B (35.34%), followed by O (27.81%), A (26.69%), and AB (10.16%). Majority of cases were Rh positive (85.33%). Of 266 cases of MPDs, the most common was chronic myeloid leukemia (CML) (53.38%), polycythemia vera (16.55%), essential thrombocytosis (15.78%), primary myelofibrosis (11.28%), mastocytosis (1.5%), chronic neutrophil leukemia (1.13%), and the least common chronic eosinophilia leukemia (0.38%). In CML, primary myelofibrosis, mastocytosis, chronic neutrophilic leukemia, and chronic eosinophilic leukemia blood Group B was the most common, while blood Group O was more common in polycythemia vera and essential thrombocytosis. In control group, the most common blood group was O (36%), followed by B (32.67%), A (21.33%), and AB (10%), respectively. Majority of control groups (94.33%) were Rh positive and (5.67%) were Rh negative. Conclusions: The present study revealed that there are significant associations between ABO blood group and patients with MPDs. Male gender and blood group B and Rh factor positive are more prone for the development of myeloproliferative disorder. These findings also raise the possibility of using blood groups as an epidemiological marker for identifying population subgroups who are at high risk of these MPDs.

Video laryngoscope: A boon for airway management in severe facial trauma.

We report the use of video laryngoscope for the exchange of orotracheal tube to nasotracheal tube needed for mandibular repair in a case of oromaxillofacial injury.

Pulmonary alveolar proteinosis a rare disease.

Pulmonary alveolar proteinosis is a rare lung disease in which abnormal accumulation of surfactant occurs with in the alveoli, interfering with gas exchange. PAP can occur in a primary form or secondarily in the settings of malignancy , pulmonary infection, or environmental exposure to dusts or chemicals. Rare familial forms have also been recognized suggesting a genetic component . we are going to present a rare case of pulmonary alveolar proteinosis.

Gunthers with haemolytic anaemia extremly rare: A case report.

Congenital erythropoietic porphyria (CEP), also called Gunthers is the rarest of the porphyrias, with a prevalence estimated at 1 in 1,000,000 or less. Only approximately 200 cases of CEP have been reported till now worldwide. CEP affects males and females equally, and occurs in all ethnic groups. Clinically it is a subacute to chronic type of porphyria, defect is expressed in infancy and clinical features such as extreme cutaneous photosensitivity, blistering, scarring, hyper and hypo pigmentation of photo exposed parts. Haemolytic anaemia with splenomegaly and retarded growth may also be present. Due to its rarity we are presenting Congenital erythropoietic porphyria with haemolytic anaemia.

Role of serum HsCRP as prognostic markers in septicemia in elderly population.

Background: Presence of elevated serum HsCRP is strongly associated with morbidity and mortality in diverse populations with sepsis and is a potentially useful biomarker to risk stratify patients with severe sepsis. Aims & Objective: We aimed to study whether the serum HsCRP level at presentation in elderly patients with sepsis correlate with stage of sepsis and ultimate outcome. Material and Methods: In a single centre prospective, observational study conducted in geriatric ward of tertiary care centre, 200 elderly patients (age>60 yrs) with sepsis were included. The primary outcome was 14 days in hospital mortality. Risk factor variable was venous serum HsCRP (mg/l) at presentation. Results: Mortality at 14 days in elderly patients with sepsis was 20%. Mean serum HsCRP in survivor group was 33.42 ± 21.56 while 57.28 ± 25.31 in mortality group (p value <0.001). The mean serum HsCRP level in survivor and non survivors was 32.49 ± 21.45 and 48.05 ± 16.40 in sepsis, 33.61 ± 25.45 and 67.71 ± 21.49 in severe sepsis, 46.62 ± 10.55 and 73.82 ± 32.87 in MODS while 49.0 ± 26.72 and 101.5 ± 9.19 in septic shock group. Conclusion: We conclude that initial high serum HsCRP level was associated with increased mortality independent of etiology of sepsis, it also correlate well with severity of sepsis and serum HsCRP level were high in those with septic shock.

Evaluation of the incidence, nature of injury and clinical outcomes of head injuries in North Eastern part of India.

Background: Incidence of head injuries/ traumatic brain injuries (TBI) is increasing day by day, and this is the major cause of morbidity and mortality in developing countries. Aims & Objective: To evaluate the incidence, nature of injury and clinical outcomes of head injuries in North eastern part of India. Material and Methods: 1300 patients of head injury were included in the study. On presentation a patient’s clinical status was grossly assessed with the Glasgow Coma Scales (GCS). X-ray cervical spine in suspicious cases and Non contrast computed tomography scan was done of all head injury patients. Results: 21-40 years age group (40.0%) was most commonly affected and most of patients (74%) were male. Road traffic accident (47.07%) was most common cause of head injury followed by fall from height (32%). Overall mortality in total head injury patient was 13%. According to GCS al 368 (43.5%) patients of severe head injury patient expired while mortality in moderate grade injury was 5.6% and 100% of mild head injury patients were saved. A total of 532 (40.92%) patients had skull bone fracture and among bone fracture simple bone fracture was most common. Conclusion: Most of the injuries occur more commonly in certain age groups, at certain localities and mostly in male. So the knowledge about the causes and pattern of head injury may be extremely helpful in making preventive policies.