A Retrospective Study on Profile of Patients with Faciomaxilary Fractures in a Tertiary Care Center.

Maxillofacial injuries in general occur quite commonly following trauma and these injuries if not properly managed can negatively influence both the psychosocial and functional activities of the patient. This is as a result of the centrality of the facial region as a key factor in human identity, aesthetics, and general well-being. Fractures involving the facial skeleton may be isolated or complex. High velocity trauma is usually seen in urban and semi-urban areas while low velocity trauma is the common setting in rural areas. The pattern of faciomaxillary fractures vary with geographical area, socioeconomic condition, enforcements of law and order of a country. Trauma to the faciomaxillary region mandates special attention as important sensory systems are contained within the face (e.g. vision, auditory, somatic sensation, gustatory, olfaction and vestibular), also, vital structures in the head and neck region are intimately associated (airway, blood vessels, nerves and gastrointestinal tracts. It should be noted that the treatment outcome of maxillofacial fractures is mainly dependent among other things on the degree of injury, type of fracture, the expertise of the surgeon, and available technology. The aim of this study is to find out the incidence of faciomaxillary injuries resulting from various etiological factor Classification of facial bone fractures; Diagnosis and different treatment modalities. This is a prospective cross sectional study comprising of  75  patients who were having different faciomaxillary fractures and visited to L.G. hospital from December 2020 to April 2022. Patients were evaluated thoroughly by history taking, proper examination and routine investigations. In general examination consciousness, orientation to time, place and person, neck movements, and general mobility of the patients were checked. In local examination- facial oedema, facial asymmetry, skin lacerations, deep cuts, decreased mouth opening, improper teeth occlusion, teeth loss, nasal bleeding, black eye, eyeball movements and redness of eyes were checked. In specialized radiological investigations x- rays, 2D & 3D Computed Tomography (CT) of Facial bones were done in all cases. CT Brain and CT Cervical spine were done in patients if needed. From our study, it seems reasonable to assume that road traffic accident remains the leading cause of faciomaxillary fractures and is closely followed by fall especially among men in their productive years. It is necessary to diagnose faciomaxillary fracture at the earliest to prevent the complications of fractures such as infection and malocclusion, for that thorough clinical examination and radiological investigations are very important. 3D CT face is the gold standard investigation in case of different faciomaxillary fractures. In isolated fractures nasal bone fractures remains the most affected bone of the facial skeleton followed by mandible. Among the different sites of mandibular fractures body of the mandible is the most common site for mandibular fractures.

Satellite Epidemic of Covid-19 Associated Mucormycosis in India: A Multi-Site Observational Study.

BACKGROUND: Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality. METHODS: Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2. RESULTS: A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status. CONCLUSION: A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.

Potential of live Spirogyra sp. in the bioaccumulation of copper and nickel ions: A study on suitability and sustainability.

AIM: Various industrial and municipal wastes are the major sources of heavy metal contamination in water causing significant environmental issues. Bioremediation is an effective and affordable solution for the removal of metals and metal pollutants from industrial wastewater. This study aimed to assess the efficacy of live and dead Spirogyra sp. for sorption of metals like of Cu2+ and Ni2+ . METHODS AND RESULTS: The live Spirogyra sp. was used for the uptake of Cu2+ and Ni2+ from their aqueous solutions. The equilibrium data were fitted using a Langmuir and Freundlich isotherm model; the maximum uptakes for Cu2+ and Ni2+ were 29 and 521 mg g-1 , respectively. Scanning electron microscopic (SEM) and infrared (IR) spectroscopic studies of Spirogyra sp. and treated Spirogyra sp. with specific metal ions were used to assess the bonding site and extent of sorption mechanism. CONCLUSION: The initial study showed that this biomass takes up a significant amount of metal ions. Compared to the Langmuir model, the Freundlich model showed better sorption process. The pseudo-second-order rate model represented an enhanced kinetics of metal ion adsorption using live Spirogyra sp. SIGNIFICANCE AND IMPACT OF THE STUDY: As bioaccumulation technology is environmental friendly and potentially cost-effective, live Spirogyra sp. is expected to be a good candidate for managing industrial wastewater.

Bioaccumulation of arsenic(V) from wastewater by live and dead Spirogyra sp.

Contaminated water with arsenic causes a negative impact on socioeconomic status in the concerned area. Existing methods are not much adequate, efficient, and appropriate. Bioremediation of heavy metals with microalgae seems to be a promising and holistic approach to counter the pre-existing associated with heavy metal toxicity. A pure culture of live and dead Spirogyra sp. was tested for its ability to adsorb arsenic(V) and modeling of experimental data was used to interpret the mechanism of bioaccumulation. Langmuir and Freundlich isotherm models were used to explain the sorption of arsenic. The maximum sorption capacity of live Spirogyra sp. was 315 mg/g and dead Spirogyra sp. was 207 mg/g. Mechanism of bioaccumulation for As(V) ions by live and dead Spirogyra sp. were studied using several advanced techniques including Fourier-transform infrared, fluorescence microscopy, and scanning electron microscope. The study summarizes, bioaccumulation of AsO4 -3 by live and dead cells of Spirogyra sp. seems to be promising. The pseudo-second-order rate equation described better the kinetics of As(V) adsorption with good correlation coefficients. The results suggested that live Spirogyra sp. was more suitable to remove As(V) as compared to dead Spirogyra sp.

Undifferentiated embryonal sarcoma of liver: Paradoxical imaging appearance.

Undifferentiated embryonal sarcoma of the liver is a rare entity. It is a malignant primitive mesenchymal tumor seen in the pediatric age group often between 6 to 10 years of age. It involves the right lobe of the liver commonly and is usually asymptomatic. Acute presentation in these cases is secondary to its rupture/ wall dehiscence. Alfa fetoprotein, a tumor marker elevated in most of the hepatic malignant tumors is however normal in undifferentiated embryonal sarcoma. Imaging wise it is a large encapsulated multiseptated lesion. It shows a "paradoxical appearance" with a predominantly solid appearance on ultrasonography and cystic appearance on CT/MRI. This is a peculiar feature that can help in the early diagnosis of this entity. Besides, normal serum alfa fetoprotein levels favor its diagnosis. Hereby we present a case of a 5-year-old female child, presented with complaints of acute onset abdominal pain and distension which on imaging investigation showed a liver mass with typical paradoxical appearance on ultrasonography, CT and MRI as described.

Posterior Reversible Encephalopathy (PRES) in a Child with Severe Dengue.

Among neurological complications associated with dengue, posterior reversible encephalopathy syndrome (PRES) has not been reported in pediatric population. We report a 10-year-old girl with severe dengue who developed PRES. The patient presented with hemorrhagic shock that required fluid resuscitation and inotropic support. She developed seizures with encephalopathy 2 days after recovering from the shock. Cerebrospinal fluid (CSF) examination was negative for dengue (no white blood cells in CSF with negative polymerase chain reaction for dengue). Her clinical features and magnetic resonance imaging (MRI) findings showed typical changes associated with posterior encephalopathy that reverted after resolution of hypertension. Repeat MRI after a month was normal. PRES should be considered as a possible differential diagnoses of dengue associated encephalopathy, especially in cases with normal CSF examination and characteristic MRI changes.

Cytosorb for Management of Acute Kidney Injury due to Rhabdomyolysis in a Child.

A 6-year-old girl presented with rhabdomyolysis following a febrile illness. Polymerase chain reaction (PCR) for Influenza B and enterovirus was positive. Her serum creatine kinase (CK) and myoglobin levels were very high. She developed myoglobinuria with oliguria leading to acute kidney injury. Continuous renal replacement therapy along with Cytosorb filter resulted in good outcome.

Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified?

Role of high resolution computerized tomography (HRCT) of temporal bone is established in cases of atticoantral chronic suppurative otitis media (CSOM) with intracranial complications. Routine use of HRCT in management of patients of atticoantral CSOM without intracranial complications has been an issue of debate. The aim of this study was to evaluate the routine use of HRCT of temporal bone in such cases. This study was a prospective study done at LG hospital, AMC MET Medical College, Ahmedabad to evaluate and compare the temporal bone findings in HRCT and intraoperative findings in 100 patients with atticoantral CSOM. All patients underwent HRCT screening followed by surgical exploration of middle ear cleft. In extent of disease HRCT showed very high sensitivity and specificity for epitympanum (100, 94%) and mesotympanum (98, 98%) areas. It gave valuable information of disease extent in hidden areas like sinus tympani and facial recess of mesotympanum. HRCT satisfactorily delineated malleus and incus erosion but had 75% sensitivity for detecting erosion of stapes suprastructure, though specificity was of 97%. For bony anatomical landmarks HRCT showed very high sensitivity and specificity for detecting erosion of lateral semicircular canal, tegmen tympani and sinus plate. Detection of facial canal erosion on HRCT had moderate sensitivity of 75%. We concluded that routine use of HRCT is justified as a reliable preoperative tool in patients with atticoantral CSOM without intracranial complications and it helps to plan type of surgical intervention. HRCT has limited role to distinguish between granulations and cholesteatoma and also to delineate stapes supra structure and facial nerve canal.

Hantavirus and tuberculosis co-infection in an Indian child.

Hantaviruses are a group of antigenically distinct viruses carried out in rodents and insectivores. Humans are accidental hosts and get infected by aerosols generated from contaminated urine, faeces and saliva of infected rodents. Hantaviruses are identified as aetiological agents of two human diseases, haemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Hantavirus causing pulmonary renal disease has rarely been reported in children in India. Hantavirus infection is uncommon under the age of 12 years. We report a 9-year-old girl from Mumbai, India with fever, bilateral pleural effusion, thrombocytopaenia, haemoconcentration and oliguria due to hantavirus infection. She also had associated tuberculosis.

Benzothiazole analogues: Synthesis, characterization, MO calculations with PM6 and DFT, in silico studies and in vitro antimalarial as DHFR inhibitors and antimicrobial activities.

Benzothiazole analogues are of interest due to their potential activity against malarial and microbial infections. In search of suitable antimicrobial and antimalarial agents, we report here the synthesis, characterization and biological activities of benzothiazole analogues (J 1-J 10). The molecules were characterized by IR, Mass, 1H NMR, 13C NMR and elemental analysis. The in vitro antimicrobial activity was investigated against pathogenic strains; the results were explained with the help of DFT and PM6 molecular orbital calculations. In vitro cytotoxicity and genotoxicity of the molecules were studied against S. pombe cells. In vitro antimalarial activity was studied. The active compounds J 1, J 2, J 3, J 5 and J 6 were further evaluated for enzyme inhibition efficacy against the receptor Pf-DHFR, computational and in vitro studies were carried out to examine their candidatures as lead dihydrofolate reductase inhibitors.

1,2,4-Triazole and 1,3,4-oxadiazole analogues: Synthesis, MO studies, in silico molecular docking studies, antimalarial as DHFR inhibitor and antimicrobial activities.

1,2,4-Triazole and 1,3,4-oxadiazole analogues are of interest due to their potential activity against microbial and malarial infections. In search of suitable antimicrobial and antimalarial compounds, we report here the synthesis, characterization and biological activities of 1,2,4-triazole and 1,3,4-oxadiazole analogues (SS 1-SS 10). The molecules were characterized by IR, mass, 1H NMR, 13C NMR and elemental analysis. The in vitro antimicrobial activity was investigated against pathogenic strains, the results were explained with the help of DFT and PM6 molecular orbital calculations. In vitro cytotoxicity and genotoxicity of the molecules were studied against S. pombe cells. In vitro antimalarial activity was studied. The active compounds were further evaluated for enzyme inhibition efficacy against the receptor Pf-DHFR computationally as well as in vitro to prove their candidature as lead dihydrofolate reductase inhibitors.

Synthesis, characterization and in silico designing of diethyl-3-methyl-5-(6-methyl-2-thioxo-4-phenyl-1,2,3,4-tetrahydropyrimidine-5-carboxamido) thiophene-2,4-dicarboxylate derivative as anti-proliferative and anti-microbial agents.

A series of eight compounds diethyl-3-methyl-5-(6-methyl-2-thioxo-4-phenyl-1,2,3,4-tetrahydropyrimidine-5-carboxamido) thiophene-2,4-dicarboxilate (KM10-17) analogues have been prepared by conventional methods and characterized by IR, Mass, NMR and elemental analysis. In silico docking studies on Human topoisomerase IIbeta (PDB Id: 3QX3) have been performed for all molecules (KM10-17) synthesized. The compounds were tested for in vitro anti-proliferative activity on VERO and 786-O cell lines. Out of all the synthesized compounds, KM11 &KM16 showed moderate activity on both cell lines. In vitro anti-microbial activity was also checked against Bacillus subtilis (BS), Staphylococcus aurous (SA), Pseudomonas aeruginosa (PA), Escherichia coli (EC) and Candida albicans (CA) by well diffusion method. The compound KM11 was found to have highest zone of inhibition against BS, SA, PA and EC. The molecules KM13 and KM16 exhibited good activity against CA. The compounds KM14 and KM16 indicated good zone of inhibition against BS.

6-Tosyl-4,5,6,7-tetrahydrothieno[2,3-c]pyridine-3-carboxamide analogues: synthesis, characterization, MO calculation, and antibacterial activity.

A series of 6-tosyl-4,5,6,7-tetrahydrothieno[2,3-c]pyridine-3-carboxamide analogues are synthesized by conventional techniques and characterized by elemental analysis, IR, MS, (1)H, and (13)C NMR. These are tested for their antibacterial activity against Bacillus subtilis (abbreviated as BS), Staphylococcus aureus (abbreviated as SA), and Escherichia coli (abbreviated as EC). The synthesized compounds are able to inhibit the growth of the SA and EC. None of the compounds are effective against BS. All valence molecular orbital (abbreviated as MO) calculations with PM6 have been carried out for the molecules for which bioactivity data are available. Ciprofloxacin is taken as the standard antibiotics to compare activity with the molecules synthesized. It has been attempted to correlate the activity of the molecules with their electronic structure.

Temporary neonatal atrial pacing through the umbilical venous route: A novel technique.

Atrial pacing in the neonate is rarely done due to constraints of equipment, technical knowhow, and risk of complications. We describe a novel method of atrial pacing in the new born using equipment readily available in any intensive care unit. Atrial pacing can be achieved using an adult bipolar pacing wire directly introduced through the umbilical venous route. We have used this method in 5 neonates, and achieved atrial capture in 4 patients. Temporary atrial pacing is a therapeutic option in a few neonatal arrhythmias, such as atrial flutter, a few types of re-entrant tachycardias, such as accessory pathway mediated tachycardia and junctional reciprocating tachycardia, and has a limited role in cardiopulmonary resuscitation where sinoatrial node dysfunction is suspected.

Bioaccumulation of heavy metals by green algae.

The biosorption of metal ions (Cr(+3), Cr(2)O(7)(-2), Cu(+2), and Ni(+2)) on two algal blooms (designated HD-103 and HD-104) collected locally was investigated as a function of the initial metal ion concentration. The main constituent of HD-103 is Cladophora sp., while Spirulina sp. is present significantly in the bloom HD-104. Algal biomass HD-103 exhibited the highest Cu(+2) uptake capacity (819 mg/g). This bloom adsorbed Ni(+2) (504 mg/g), Cr(+3) (347 mg/g), and Cr(2)O(7)(-2), (168 mg/g). Maximum of Ni(+2) (1108 mg/g) is taken by HD-104. This species takes up 306, 202, and 576 mg/g Cr(+3), Cr(2)O(7)(-2), and Cu(+2), respectively. Equilibrium data fit very well to both the Langmuir and the Freundlich isotherm models. The sorption process followed the Freundlich model better. Pseudo-first-order kinetic model could describe the kinetic data. Infrared (IR) spectroscopic data were employed to identify the site(s) of bonding. It was found that phosphate and peptide moieties participate in the metal uptake by bloom HD-103. In the case of bloom HD-104, carboxylate and phosphate are responsible for the metal uptake. The role of protein in metal uptake by HD-103 was investigated using polyacrylamide gel electrophoresis.

Bioremediation potential of Chlorella: spectroscopic, kinetics, and SEM studies.

A dead dried alga, Chlorella sp., was used for the uptake of Cr+3, Cr2O7(-2), Cu+2, and Ni+2 from the aqueous solutions of these metal ions. The equilibrium data were fitted using the Langmuir and Freundlich isotherm model and the maximum uptakes for Cr+3, Cr2O7(-2), Ni+2, and Cu+2 were 98, 104, 108, and 183 mg/g, respectively. The Freundlich model, in comparison to the Langmuir model, better represented the sorption process. The kinetics of metal ions uptake by Chlorella sp. was best described by a pseudo-second order rate equation. Infrared spectroscopic data were employed to identify the site(s) of bonding in Chlorella sp. A scanning electron microscopic (SEM) study of pure dead Chlorella sp. and the species treated with different metal ions provided an idea of the extent of metal uptake by this species. The dead Chlorella sp took up maximum Cu(II). The size of the cell of the metal-treated Chlorella sp. obtained from SEM data is in agreement with the extent of metal uptake.

Biosorption of cadmium by live and dead Spirulina: IR spectroscopic, kinetics, and SEM studies.

Cadmium is an important environmental pollutant and a potent toxicant to bacteria, algae, and fungi. Mechanisms of Cd+2 toxicity and resistance are variable, depending on the organism. The present work reports the use of live and dead Spirulina sp. for sorption of Cd+2. This investigation shows that this biomass takes up substantial amount of Cd+2 ions. IR spectroscopic study, kinetics models, Langmuir & Freundlich adsorption isotherms, scanning electron microscopic analysis of Spirulina sp., and the Spirulina sp. treated with different metal ions have been employed to understand the sorption mechanism. Infrared spectra of live Spirulina treated with Cd+2 ions for different lengths of time have been taken to understand the time dependency of metal interaction.

Bioremediation potential of live and dead Spirulina: spectroscopic, kinetics and SEM studies.

Metal binding by algae has enormous potential for environmental bioremediation targeting towards detoxification of water bodies. The present work reports the use of live and dead Spirulina sp. for sorption of metals like Cr(3+), Ni(2+), Cu(2+), and Cr(6+) in form of Cr(2)O(7)(2-). Preliminary investigation shows that this biomass takes up substantial amount of metal ions indicated above. IR spectroscopic study, kinetics models, Langmuir and Freundlich adsorption isotherms, SEM analysis, and fluorescence microscopic study of Spirulina sp. and the Spirulina sp. treated with different metal ions have been employed to understand the sorption mechanism. It is hoped that live Spirulina sp. will be a strong candidate for management of industrial wastewater.

Spectroscopic and scanning electron microscopy studies of bioaccumulation of pollutants by algae.

The ability of Chlorella species and two other algal blooms collected locally to take up Cu(+2) and Ni(+2) was investigated using infrared and scanning electron microscopy (SEM) data. The percentage of metal uptake was determined with atomic absorption spectroscopy. The effects of pH and initial concentrations of metal ions on bioaccumulation were examined. The uptake of methyl orange dye by Chlorella species was also studied using Langmuir and Freundlich adsorption isotherms.