Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city,India

BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and in anyone. Effective management of an emergency situation in the dental office is ultimately the dentist's responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal complications. Therefore, health professionals including dentists must be well prepared to deal with medical emergencies. This study was undertaken to assess the knowledge about and attitude towards basic life support(BLS) among dental interns and postgraduate students in Bangalore city, India.METHODS: A cross sectional survey was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants.RESULTS: The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121(59.9%) had a positive attitude and 81(40.1%) had a negative attitude towards BLS.CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the dental curriculum. Workshops on a regular basis should be focused on skills of cardiopulmonary resuscitation for dental students.     

Corneal Keratocyte Density and Corneal Nerves Are Reduced in Patients With Severe Obesity and Improve After Bariatric Surgery

PurposeObesity is associated with peripheral neuropathy, which bariatric surgery may ameliorate. The aim of this study was to assess whether corneal confocal microscopy can show a change in corneal nerve morphology and keratocyte density in subjects with severe obesity after bariatric surgery.MethodsTwenty obese patients with diabetes (n = 13) and without diabetes (n = 7) underwent assessment of hemoglobin A1c (HbA1c), lipids, IL-6, highly sensitive C-reactive protein (hsCRP), and corneal confocal microscopy before and 12 months after bariatric surgery. Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and keratocyte density (KD) from the anterior, middle, and posterior stroma were quantified. Twenty-two controls underwent assessment at baseline only.ResultsCNFL (P < 0.001), CNBD (P < 0.05), and anterior (P < 0.001), middle (P < 0.001), and posterior (P < 0.001) keratocyte densities were significantly lower in obese patients compared to controls, and anterior keratocyte density (AKD) correlated with CNFL. Twelve months after bariatric surgery, there were significant improvements in body mass index (BMI; P < 0.001), HDL cholesterol (P < 0.05), hsCRP (P < 0.001), and IL-6 (P < 0.01). There were significant increases in CNFD (P < 0.05), CNBD (P < 0.05), CNFL (P < 0.05), and anterior (P < 0.05) and middle (P < 0.001) keratocyte densities. The increase in AKD correlated with a decrease in BMI (r = –0.55, P < 0.05) and triglycerides (r = –0.85, P < 0.001). There were no significant correlations between the change in keratocyte densities and corneal nerve fiber or other neuropathy measures.ConclusionsCorneal confocal microscopy demonstrates early small fiber damage and reduced keratocyte density in obese patients. Bariatric surgery leads to weight reduction and improvement in lipids and inflammation and an improvement in keratocyte density and corneal nerve regeneration.     

Presentation and outcome of primary tumors of the patella

Demographics, pathology, and outcomes of 7 patellar tumors, including 2 giant cell tumors, 2 chondroblastomas, 1 osteoid osteoma, 1 osteitis fibrosa cystica, and 1 case of myelomatous infiltration, are described. Five male and 2 female patients with a mean age of 42.5 years were followed for an average of 3.5 years. Anterior knee pain was the main presenting symptom. Two patients presented with pathologic fracture. One patient with chondroblastoma underwent curettage only; the second patient underwent curettage and bone grafting. Both patients with giant cell tumors underwent total patellectomy. Patients with osteoblastoma and osteitis fibrosa cystica underwent excision of the lesion. The patient with myeloma underwent radiotherapy. Patellar tumors represent special management problems because of their subcutaneous location, relationship to the extensor mechanism, and difficulties in interpretation of radiographs. A satisfactory outcome can be expected in the majority because of the predominantly benign nature of the lesions and straightforward operative intervention after diagnosis.     

Severe bilateral rachitic genu valgum in patients with nonbullous congenital ichthyosiform erythroderma: a report of two cases and review of literature

We present two cases of ichthyosiform erythroderma associated with severe bilateral genu valgum. Other musculoskeletal features associated with this condition are described. The details and outcome of operative intervention for the correction of the deformities are discussed. The disturbances of the metabolism of vitamin D and medical management are discussed. A review of literature is presented.     

Response of laboratory-adapted human hookworm and other nematodes to ivermectin

The activity of ivermectin was examined in Necator americanus, a human hookworm, adapted to the laboratory hamster. A dose of 30 mg kg-1 X 1 or 10 mg kg-1 X 2 was required for complete clearance of pre-adult N. americanus; however, hamsters carrying adult N. americanus were completely cured of infection by doses of 15 mg kg-1 or 7.5 mg kg-1 X 2. The doses of ivermectin required for complete elimination of N. americanus were much higher than those reported for other intestinal nematodes. The probable reasons for these higher doses are discussed. Tests were also carried out with other rodent parasites, namely Nematospiroides dubius, Strongyloides ratti and Trichuris muris. Doses as low as 0.3 mg kg-1 X 1 completely eliminated adult N. dubius from mice, whereas++ S. ratti needed a repeated dose (0.3 mg kg-1 X 2). None of the mice was cured of T. muris infection even at doses of 10 mg kg-1 X 2, although some degree of cure was apparent at the toxic dose. It thus appears that ivermectin is in no way superior in its activity against N. americanus and T. muris than the existing anthelmintics.     

In vivo comparison of screw versus plate and screw fixation for first metatarsophalangeal arthrodesis: does augmentation of internal compression screw fixation using a semi-tubular plate shorten time to clinical and radiologic fusion of the first metatarsophalangeal joint (MTPJ)?

A retrospective analysis of first metatarsophalangeal joint fusion in 26 consecutive patients (34 feet), treated between April 1998 and February 2002, comparing single compression screw versus a compression screw supplemented with a dorsal quarter tubular plate, was undertaken. The study aimed to assess whether or not plate augmentation of the single interfragmental compression screw lead to an earlier fusion. There were 18 women and 8 men with a mean age of 54.6 +/- 11.02 years and a mean follow-up of 2.9 +/- 1.1 years. Successful fusion was determined clinically and radiologically by means of identifying transarticular trabeculation. The overall incidence of fusion was 97.06% (33/34 fusions). Observed complications included 4 cases of superficial wound infection, each of which resolved with antibiotic therapy; 3 cases of paraesthesia involving the dorsomedial aspect of the big toe; and 2 cases of transfer metatarsalgia. Statistical analyses did not reveal any significant associations between the type of fixation and time to fusion, patient satisfaction, and complications. In regard to the methods of osteosynthesis compared in this investigation, the choice of first metatarsophalangeal fusion fixation can be determined based on surgeon's preference. ACFAS Level of Clinical Evidence: 2c.     

Multiplicity of solid organ injury: influence on management and outcomes after blunt abdominal trauma

OBJECTIVE: The current study was undertaken to examine how concomitant injury to liver and spleen after blunt abdominal trauma affects management and outcomes. METHODS: This study was a retrospective chart review of all blunt abdominal trauma patients admitted with a diagnosis of liver or spleen injury at two Level I trauma centers over a 4-year period. Presentation, injury grade, management, and outcomes were analyzed. Patients with single-organ injury (liver or spleen) were compared with patients having injury to both organs (liver and spleen). Significance was set at 95% confidence intervals. RESULTS: Of 1,288 patients who met entry criteria, 1,125 had single (spleen, 573; liver, 552) organ injury (group S) and 163 had injury to both organs (group B). Group B patients had significantly higher Injury Severity Score, higher admission lactate, and lower admission systolic blood pressure and base excess. Eighty-one percent (915 of 1,125) of group S and 69% (112 of 163) of group B patients were managed nonoperatively (p < 0.05). Of the nonoperatively managed patients, 5.8% (53 of 915) in group S and 11.6% (13 of 112) in group B failed this form of therapy (p < 0.05). Higher failure rate in group B was because of bleeding from injured solid organ(s), and not non-solid organ related failures. Mortality, intensive care unit and hospital lengths of stay, and transfusion requirements were all significantly higher in group B. CONCLUSION: Blunt trauma patients with concomitant injury to liver and spleen have higher Injury Severity Score, mortality, lengths of stay, and transfusion requirements. There is a higher failure rate with nonoperative management, and therefore extra vigilance is warranted when choosing this form of therapy in the presence of injury to both organs.     

Necator americanus and Ancylostoma ceylanicum: development of protocols for dual infection in hamsters

Two-day-old baby hamsters were infected initially with the infective larvae of hamster-adapted human hookworm, Necator americanus (NaL3). After a specified period they were again infected orally with infective larvae of Ancylostoma ceylanicum (AcL3). Three weeks after the second infection they were killed and the establishment of N. americanus and A. ceylanicum was assessed. The effect of different infection levels and exposure period of N. americanus on the concurrent establishment of A. ceylanicum was also examined. An infection with 50 NaL3 percutaneously, and 3 weeks later, a second infection with 50 AcL3 orally has produced reasonably equal number of hookworms (no statistical difference in the burden of N. americanus and A. ceylanicum) in the intestine of hamsters. Thus this protocol of dual infection was found suitable to develop two species of hookworms in hamsters for anthelmintic screening.