Background: Hepatitis B is one of the most common infections seen in all age and all around the world with high mortality and morbidity. Healthcare workers (HCW) are at risk of contracting the hepatitis B virus (HBV) from infected patients. Hence his study was conducted with an objective to study the coverage and factors affecting hepatitis B vaccination among medical students. Methods: The descriptive study was carried out among final year MBBS students of B. R. Ambedkar medical college, Bengaluru by adopting convenient sampling technique. A total of 72 students had given consent for the study. Results: Majority of the students 86% seem to have a good knowledge regarding hepatitis B and 97.2% have responded that it is necessary to get vaccinated. But on the other side only 33.3% students have been vaccinated with a minimum of single dose against hepatitis B. Top 3 reasons for not being vaccinated are lack of motivation, no need felt and never thought of vaccination. Conclusions: This study reveals that only 33.3% have been vaccinated with a minimum of single dose and 66.6% students are not vaccinated against hepatitis B. After the completion of analyses, the students were briefly educated on the necessity of vaccination, completion of course and the complications that could be avoided in future by volunteering to get vaccinated. Following this event, we saw the 91.7% of students who are motivated or have changed their perception towards vaccination. This shows the importance of health education and counselling.
Abstract Introduction: The optimal treatment approach for fractures of the mandibular condyle continues to spark debate within the medical community, though surgical intervention through open reduction and internal fixation has garnered increasing acceptance, largely propelled by innovations in osteosynthetic materials and techniques. Aim: This study aimed to compare the outcome of delta plates versus two miniplates for mandibular condyle fracture fixation. Materials and Methods: Sixty patients with subcondylar fractures were randomized into two groups: Group A (two miniplates) and Group B (delta plate). Patients were randomly assigned to either Group A or Group B using a computer-generated randomization sequence with a 1:1 allocation ratio. The allocation was concealed using sealed opaque envelopes opened only after patient enrollment. Evaluation parameters included mouth opening, occlusion status, operative time, and complications. Results: Baseline characteristics were similar between the two groups. The mean mouth opening was similar between the groups at most time points, with Group B (delta plate) showing slightly better outcomes at 3 months (35.87 mm vs. 33.73 mm). Intraoperative time was significantly less for delta plates (mean 16.03 min) compared to two miniplates (mean 24.16 min). Postoperative occlusion was comparable, with both the groups achieving 100% stability by 1 month. Complication rates were low and similar between the groups, with only 6.7% of patients experiencing minor wound dehiscence at 1 week, resolving by 1 month. Radiographic evaluation showed successful reduction and fixation in all cases, with no plate bending or screw loosening observed during the 6-month follow-up. Conclusion: Both delta plates and two miniplates are equally effective in managing subcondylar fractures. Delta plates offer the advantage of easier placement and reduced operative time.
Objectives: (1) The objective of the study was to determine the value of USG and computed tomography (CT) in early diagnosis of acute pancreatitis (AP). (2) The study aimed to compare which of the above two radiological investigations (USG/CT) provides the most important information of the disease process and to determine value of CT in evaluating complications, morbidity/severity, and predicting prognosis of AP using modified CT severity index (MCTSI). Methods: This study included 50 patients diagnosed with pancreatitis, consisting of 38 cases of AP and 12 cases of chronic pancreatitis (CP). Both USG and contrast-enhanced CT (CECT) were used to visualize the pancreas, assess its size, detect peripancreatic inflammation and fluid collections, and identify the extent of necrosis and complications. The sensitivity and specificity of USG and CECT were compared. The severity of AP was classified using the MCTSI within 3 days of symptom onset. Clinical outcomes, including hospital stay duration, organ failure, systemic infection, and the need for surgical intervention, were recorded and correlated with MCTSI scores. Statistical Package for the Social Sciences 22.0 was used for statistical analysis and p<0.05 was taken as statistically significant. Results: The mean age of patients was 37.92±12.14 years. USG had a sensitivity of 58% for detecting AP, significantly lower than the 95% sensitivity of CECT, primarily due to bowel gas interference. Both USG and CECT had high positive predictive values. The MCTSI effectively classified the severity of AP, with 41.5% of cases categorized as mild, 39% as moderate, and 19.5% as severe. Extrapancreatic complications were significantly correlated with adverse clinical outcomes and end-organ failure when included in the MCTSI scoring. USG was adequate for diagnosing CP through visualization of dilated ducts, calcifications, and atrophic pancreas, but CECT demonstrated higher specificity and accuracy, especially for rare forms like groove and mass-forming pancreatitis. The study showed a strong correlation between MCTSI scores and patient outcomes. The mortality rate was 2%, observed only in patients with severe AP. Conclusion: The MCTSI is a valuable tool for accurately classifying the severity of AP and predicting clinical outcomes. CECT is superior to USG in diagnosing and managing pancreatitis, providing better visualization and assessment of complications. While USG is useful for diagnosing CP, CECT offers greater specificity and accuracy. The study supports the use of MCTSI in routine clinical practice to guide the management and predict outcomes in patients with AP.
Colorectal cancer is a major type of gastrointestinal cancer that significantly contributes to disease burden and mortality, particularly among younger people. Early colorectal cancer refers to the early stages of the disease that require early detection and treatment to improve the overall prognosis and survival. There are various treatment options available for early colorectal cancer, such as endoscopic resection, including methods like transanal endoscopic microsurgery (TEMS), endoscopic mucosal resection (EMR), or submucosal dissection (ESD), as well as surgical resection, including open and laparoscopic techniques. However, to make informed decisions about which approach is best, it is crucial to thoroughly understand the long-term outcomes associated with each option. We systematically reviewed the PubMed and Google Scholar databases from 2013 to August 11, 2023, to obtain such knowledge. We selected nine for in-depth analysis after carefully reviewing 2761 articles, including those written in English and focusing on human studies. The review focused on individual benefits, merits, and drawbacks, considering the extent of the disease, clinical outcomes, survival, and complication rates. Although endoscopic resection has the advantage of being less invasive and promoting faster patient recovery, it should be noted that its primary objective may not necessarily be achieving complete excision (R0). This is because there are potential obstacles, including inadequate lymph node removal and inaccurate T staging that may prevent the achievement of R0. Nevertheless, it is important to stress that both endoscopic and surgical resection ultimately share the goal of complete excision and curing the patient. Finally, this systematic review emphasizes the need for additional research to fill knowledge gaps, improve clinical decision-making, and promote the application of sophisticated technology. As the landscape of early colorectal cancer treatment evolves, a balanced integration of endoscopic and surgical resection procedures, together with emerging technologies, can improve patient outcomes and increase treatment efficacy.
Background and Objective: Periodontitis is a highly prevalent disease, and it affects approximately 10.5% to 12% of the world's population. Tobacco smoking adversely affects periodontal health. ALP is an essential enzyme, as it is part of the normal turnover of periodontal ligament and bone homeostasis. Saliva has many advantages as a diagnostic media. With this background this study was undertaken to evaluate Serum and Salivary Alkaline phosphatase level in tobacco cigarette smokers with chronic periodontitis. Methods: A total sample size of 40 subjects with age range of 25-65 years were included and were divided into 2 groups. Group I included 20 male healthy never smokers as control group and Group II included 20 male subjects with the habit of tobacco cigarette smoking using more than 5 cigarettes per day with onset of minimum six months duration and above as study group. Alkaline phosphatase level in serum and saliva was estimated. The obtained data was subjected to statistical analysis using Mann Whitney test and Spearman's correlation test. Results: It was found that Serum ALP was higher than Salivary ALP and there was a signicant correlation between Serum ALP and Salivary ALP in Group I (Control group) and Group II (Study group). Serum ALP and Salivary ALP were both increased in Group II (Study group) compared to healthy controls. In Group II (Study group) with an increase in number of cigarettes smoked and duration of smoking there was an increase in both Serum ALP and Salivary ALP. In Group II (Study group) Serum ALP and Salivary ALP were higher in generalized periodontitis than localized periodontitis indicating the severity of chronic periodontitis. Conclusion: We therefore recommend salivary ALP as an early potential biomarker in tobacco cigarette smokers with chronic periodontitis for diagnosis, monitoring the disease progression, prognosis and treatment outcome.
