Background: India is among the top three countries with diabetes and prediabetes, but interventional studies on prediabetes are less compared to other developed countries. Research design and Methods: This prospective open-label randomized interventional study was conducted among newly diagnosed prediabetes in selected districts of Kerala and Tamil Nadu in South India. Participants were randomized to six treatment groups: Group 1 – walking exercise, Group 2 – muscle-specific exercise (ME), Group 3 – metformin intervention, Group 4 – metformin with muscle-specific exercise, Group 5 – antioxidant intervention, and Group 6 – antioxidants with muscle-specific exercise. Drug intervention was for 12 weeks, and the study parameters of the subjects were measured at predefined intervals. The main outcome measures were homeostasis model assessment (HOMA), glycated hemoglobin (HbA1c), fasting blood sugar (FBS), body mass index (BMI), and waist-to-hip ratio. Results: ME intervention in prediabetes significantly reduced BMI, FBS, HbA1c, and HOMA levels (P < 0.05) during the study period. There was also a significant reduction in waist-to-hip ratio among participants taking low-dose metformin along with muscle-specific exercises. Environmental mobility barriers such as weather, traffic, pollution, social support, and even female gender created obstacles in the walking group that led to nonadherence and no significant results in the walking group compared to other groups. Conclusions: Results showed that muscle-specific indoor exercises can be an effective strategy in early management of insulin resistance with better exercise adherence compared to existing interventions. The Implementation of Prediabetes Education Program increased awareness and self-management skills among the prediabetes population.
Background: The serum nitric oxide (NO) data in Type 2 diabetes mellitus (T2DM) patients reported by different scientific literature are controversial. Some research articles reported increased NO levels in diabetes patients, whereas others reported the opposite. Hence, this study was designed to compare the serum NO levels in T2DM patients with or without hypertension among subjects reporting to the Diabetes Nutrition Clinic (DNC) of a tertiary care hospital of Tripura. Aims: The aim of this study was to estimate serum levels of NO among Type 2 diabetic patients with or without hypertension, to determine the endothelial NO synthase (eNOS) gene expression at the transcriptional level, and also to assess the correlation between serum NO and eNOS gene expression among the study subjects. Materials and Methods: This hospital-based cross-sectional study was conducted from March 2019 to February 2020 among 198 diabetic patients attending the DNC of a tertiary care hospital of Tripura. Estimation of serum NO was performed using the ELISA technique and eNOS gene expression was performed using the reverse transcription-polymerase chain reaction technique. All statistical analysis was done using SPSS software version 25. Results: This study was conducted among 98 type 2 diabetic patients having hypertension and 100 controls, i.e., type 2 diabetics without hypertension. The mean serum level of NO in diabetic patients with hypertension was 35.35 ± 13.65 μmoles/L, whereas in the control group, i. e., diabetic patients without hypertension, it was 89.83 ± 10.29 μmoles/L, which was statistically significant (P
Introduction: Fractures of the scaphoid bone mainly occur in young adults and constitute 70%–80% of all carpal bone fractures. The aim of our study was to assess the functional outcome of undisplaced and minimally displaced scaphoid fractures with percutaneous Herbert screw fixation. Materials and Methods: We conducted a prospective study from 2016 to 2018 including patients of more than 18 years of both sexes with waist fractures of scaphoid excluding avulsion fractures and compound injuries. The functional outcome of patients was assessed with the Modified Mayo Wrist Score (MMWS) at a minimum of 1-year follow-up. Results: Fifteen patients (M: F = 12:3) with a mean age of 39.4 years were enrolled in the study. The mean time to surgery after trauma was 5.75 days. Union was achieved in all the cases at a mean duration of 7.2 weeks; 93.3% (n = 14) of patients showed an excellent outcome, while the other 6.7% (n = 1) showed a good outcome with an average MMWS score of 92.6. Patients were able to reach this functional status as early as 3 months. The average duration of follow-up was 15 months. No major complications were encountered. Conclusion: Percutaneous Herbert screw fixation of scaphoid waist fractures provides excellent functional results enabling the patients to return to the preinjury status as early as 4 months without major complications.
Background: Developmental dysplasia of the hip (DDH) is the second-most common pediatric orthopedic condition in our country. The management of children presenting with DDH in the walking stage is primarily by surgical approach due to the changes in the femoral head, acetabulum, and other soft tissues surrounding the joint. This study evaluated the functional and radiological outcome of children with DDH in the walking age group who underwent open reduction with or without femur or pelvic osteotomy. Materials and Methods: Retro-prospective Cohort Study was conducted in tertiary care hospital. All children underwent open reduction through a standard anterior approach. The hip was reduced, and stability was assessed intraoperatively, and osteotomy was performed. The functional and radiological outcome was assessed at the end of follow-up; various variables which influence the outcome were looked. Chi-square test was used to measure the association between the types of surgery with the outcome, Tonnis grade with the outcome, and these are expressed as frequency and percentage. Results: Sixty-six percent of hips in our study had excellent functional outcomes, 27% had a good outcome. About 68% of hips in our study had excellent, and 2.5% of hips in our study had a poor radiological outcome. Conclusions: The assessment of outcomes suggested that appropriate surgery based on age and intraoperative assessment will give satisfactory functional outcome, irrespective of whether acetabular/femoral procedures are done. The re-surgeries rate in our study was low as all of them had single staged combined surgical intervention.
A patient reported with pain and sinus opening in relation to a previously root canal treated maxillary central incisor. Intraoral radiograph revealed periapical radiolucency with shortening of root indicating external apical inflammatory root resorption associated with failed endodontic treatment. Nonsurgical re-treatment was started and intracanal calcium hydroxide (CaOH) was placed for four weeks. The tooth was obturated with Biodentine. At 6, 12, and 24 months follow-up, the patient was asymptomatic and radiograph revealed satisfactory healing. Inflammatory apical root resorption due to failed root canal treatment could compromise the root length and prognosis. Early arrest of such resorption is indicated by nonsurgical re-treatment using CaOH for root canal disinfection and obturating with bioactive material such as Biodentine, which results in the successful arrest of resorption and periapical healing.
Background: Plasmodium vivax is reported to be the predominant cause of malaria in India. Recent emergence of resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) drugs has been attributed to multiple mutations in pvmdr-1 and pvdhfr regions of P. vivax, respectively. Hence, in this study, we have assessed the single-nucleotide polymorphisms (SNPs) in pvmdr-1 and pvdhfr genes for CQ and SP drug resistance, respectively, in cases of malaria from two regions of South India. Materials and Methods: A total of 36 P. vivax isolates from Bengaluru and Vijayapura were collected and sequenced for pvmdr-1 and pvdhfr genes, and the SNPs were analyzed. Results: Out of the total 45 positive P. vivax samples assessed in this study, 36 samples were mono infection cases. No wild-type pvmdr-1 gene was observed in any of the samples analyzed. Predominant presence (83.3%) of double mutations (T958M and F1076L) was observed. In the pvdhfr gene, wild-type (36.1%) and two mutations (41.6%; S58R and S117N) were observed. New mutations were not detected in pvmdr-1 or pvdhfr gene in this study. Conclusion: The present study reports the presence of SNPs in both pvmdr-1 and pvdhfr genes in P. vivax isolates from Bengaluru and Vijayapura. Continuous monitoring of drug resistance to antimalarial drugs is essential for undertaking optimal public health measures tailored to selected regions.
Nasoalveolar molding (NAM) is a recent infant orthopedic appliance constructed in cleft lip and palate patients below 3–4 months of age because the moldability of primary cartilage is very high due to high estrogen content in infants below 4 months of age. We started NAM therapy in this case at 3 weeks of age and continued till 4 months of age, the cleft lip gap decreased from 19 mm to 9 mm and palate (alveolar) gap reduced from 9 mm to 3 mm, there was also improvement in nasal anatomy. This is an important case report in which we have successfully completed NAM therapy and also followed the case after lip surgery for 6 months which resulted in better surgical outcome in terms of function and esthetics. In conclusion, we suggest that presurgical NAM improves esthetics, decreases cleft deformities, and prepares the patients for less surgical procedures with better results.
Objective: The objective of the study is to seal the permanent first molars in high-risk children aged 7–8 years with GC Fuji VII and evaluate its retention and caries preventive effect over 3 years. Methodology: The present study was a longitudinal, randomized, interventional trial with a sealant and control group. 538 residential schoolchildren with high caries risk received sealants. 495 day scholars did not receive sealant formed the control group. Children of both the groups were evaluated annually for sealant retention and development of caries for 3 years. Independent sample t-test and Chi-square test were used to compare the sealant retention and caries incidence rates. Kaplan–Meier survival analysis and log-rank test were performed to compare the cumulative molar survival and sealant retention rates over 3 years. Results: Comparison of baseline oral health characteristics between sealant and control group revealed no statistically significant variation (P > 0.05). At the end of 3 years, total retention was 43.4% (n = 178), 45.9% (n = 188), 44.9% (n = 184), and 44.4% (n = 182), respectively. Cumulative mean incidence of dental caries at the end of 3 years showed statistically significant higher caries incidence among control 2.15 ± 3.33 as compared to sealant 0.25 ± 0.85 with mean difference of 1.90 (P = 0.001). Conclusion: School-based sealant program targeting low socioeconomic, high caries risk population can form comprehensive approach for caries-free generation. GC Fuji VII may be a better choice for preventing dental caries in school-based sealant program.
Hemangiomas are benign tumors of the blood vessel origin. They appear as raised or flat reddish-blue lesions and are generally solitary, affecting women in younger age groups. The tumor may be slowly progressive, involving extensive portions of the superficial and deep blood vessels, and affect function, depending on the location. They are mostly common in the head and neck region but rarely in the oral cavity. This case report presents a case of capillary hemangioma in the labial mucosa of a female patient, which was diagnosed by histopathology after laser excision.
Background: Zinc is an essential trace element that has been shown to play a crucial role in viral infections. As a part of RNA polymerases, zinc helps in the replication of many viruses. Cholinesterases are low-grade inflammatory markers that have zinc-dependent carboxypeptidase activity. Plasma butyrylcholine esterase is an indicator of dietary zinc level. Matrix metalloproteinases (MMP) that participate in inflammatory processes and contribute to tissue remodeling and repair are zinc containing endopeptidases. The present study attempts to establish the association of zinc with these enzymes in dengue. Materials and Methods: Plasma zinc, butyrylcholinesterase (BChE), and erythrocyte acetylcholinesterase (AChE) were estimated spectrophotometrically in 100 dengue patients and 50 healthy controls. MMP9 was determined using ELISA. Results: Plasma zinc was markedly lower in dengue fever patients compared to healthy controls (P < 0.05). Both BChE and AChE decreased significantly in these patients (P < 0.001) compared to healthy controls. There was an elevation of MMP9 in dengue, although the increase was statistically insignificant. Cholinesterases and MMP9 correlated positively with zinc in controls and dengue, although the correlation was statistically insignificant. Conclusion: The study highlights the role of zinc in the pathology of dengue, as it is essential for the maintenance of activities of cholinesterases and MMP9 that are involved in anti-inflammatory and tissue remodeling processes. Further, prompt administration of micronutrients like zinc may reduce the adverse manifestations and morbidity in dengue.
Impaction of teeth is a relatively common manifestation that comes across a clinician, however, multiple impacted unerupted teeth are rarely seen and are manifested due to several genetic, systemic, and local factors. In this case report, A 14-year-old male patient presented with unilateral multiple impacted unerupted primary and permanent teeth affecting the left side of the face and also delayed eruption of teeth on the opposite side. The history and relevant clinical findings depicted a picture toward primary failure of eruption (PFE) as provisional diagnosis. This paper also discusses the clinical presentation of the case and various treatment options that can be employed for the management of such a case. The rarity of this case report lies in the fact that although PFE is seen with a common picture of bilateral involvement based on the clinical and radiographic presentation, this case report presented with unilateral involvement of the dentition, a less commonly described variant in the literature.
