Dengue Fever: Clinical, Laboratory Profile and Outcome in Pediatric Patient

Introduction: Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. So a study was carried out to know its clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients. Aim: To study the clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients at tertiary care center. Method: Retrospective Observational study from 1st May 2019 to 31st April 2021. Result: Total 323 patients were studied during 1st May 2019 to 31st April 2021. Most common presentation was fever (100%), most common clinical finding is hepatomegaly (14.2%). All severe dengue infection has platelet count < 50000/cumm. In study of 323 patients 194(60%) of dengue fever,85(26.4%) of DHF GRADE 1,9(2.8%) of DHF GRADE 2 were discharged .13(4%) patients of DSS were expired.22 patients (6.8%) went DAMA. Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases. Keywords: dengue fever, platelet count, outcome

Risk Factors for Coronary Artery Disease in Patients Undergoing Coronary Angiogram at a Tertiary Level Hospital in Nepal

Background: Ischemic heart disease is the leading cause of CVD health loss globally, as well as in each world region, followed by stroke. In Nepal, CVD was found to be the second most common non-communicable disease among indoor patients of the non-specialist hospital. Age, gender, smoking, obesity, dyslipidemia, physical inactivity, hypertension, and diabetes mellitus (DM) are established risk factors for CVD. In Nepal, hypertension is found to be the most prevalent risk factor for CVD. Aims and Objectives: This study aimed to assess risk factors for coronary artery disease in patients undergoing coronary angiograms in Nepal. This study also investigated the socio-demographic characteristics of the participants and the nature of the involvement of coronary arteries. Materials and Methods: We examined in this cross-sectional study a total of 74 patients who underwent coronary angiography (CAG) at National Medical College between May 2020 and June 2021. Patients were grouped according to the number of major epicardial coronary arteries involved in SVD, DVD, and TVD. Patients were checked for risk factors like smoking, diabetes mellitus, hypertension, dyslipidemia, family history of coronary artery disease, and obesity. Microsoft Office Excel and SPSS version 21.0 were used for data analysis. The study was approved by the ethical committee. Results: Among 74 participants 53 were male. The mean age was 59.65±10.74 years. Premature coronary artery disease was present in six patients. SVD was the commonest CAD type. Hypertension was the commonest risk factor followed by Diabetes mellitus. Hypertension, Diabetes mellitus, Family history of premature CAD, and obesity were found to be statistically significant. Keywords: CAD, Risk factors for CAD, Premature CAD, Hypertension, Diabetes, obesity, family history of CAD, dyslipidemia, Smoking, SVD, DVD, TVD, Nepal

Polyphenols in Matily Herbal & Spices Boosts Antibodies in an Elderly Following COVID 19 Infections – A Case Study

An elderly patient had COVID-19 infection in August 2020 and started the home remedies treatment for the first 18 hours, followed by Azithromycin 250 mg for 6 days. The patient revered well, and the infection was confirmed by antibodies in the patient's serum. Later on, the patient was on Matily Herbal Drink and Matily Herbal & Spices Mix to avoid complications connected with COVID-19 re-infection. After completing 12 months of post COVID-19 infection, the antibodies were assessed to find the status. It was found to be increased in qualitative assessment. The quantitative assessment of antibodies showed a much higher value compared with individuals who had both the dose of vaccines and tested the blood after two weeks since the second dose of vaccine. We suggest that the increased antibodies could be because of the bioavailability of polyphenols present in the Matily Herbal Drink and Matily Herbal & Spices Mix. Polyphenols inactivate COVID-19 virus and this may have helped the body to increase its antibody production. The bioavailability of polyphenols depends on various factors, including acidulants in the diet. Based on the present studies, we suggest India should have her own strategies to increase antibodies in the population instead of just following the norms laid by International Agencies for the booster dose of vaccine Keywords: COVID-19, Matily Herbal Drink, Matily Herbal, Spices Mix

Efficacy of Nano Crystallised Calcium Phosphate (NCCP) and Casein Phosphopeptide – Amorphous Calcium Phosphate (CPP-ACP) for Controlling Postoperative Sensitivity After Power Bleaching-A Comparative In-Vivo Study

Tooth bleaching is one of the most popular cosmetic dental procedures opted by the patients who desire pleasing smile. It is the simplest, least invasive means available to lighten discolored vital teeth. A number of desensitizing agents have been tried in an attempt to counteract bleaching-related sensitivity. This study was done to compare the effect of two different desensitizing agents for controlling post operative sensitivity after power bleach procedure. Sixty volunteers with mild to moderate dental fluorosis in maxillary anterior teeth, who fulfilled the inclusion and exclusion criteria, were randomly selected for this study. After the bleaching procedurea demo was given to the patient while application of desensitising gel and was instructed to use the gel for 14 days.All the patients were recalled at an interval of 1st day, 3rdday, 5th day, 7th day, and on 14th day to record the post operative sensitivity after power bleach procedure. The observations were analyzed using one way analysis of variance (ANOVA), Tukeys post hoc test. On the basis of VAS results, all the groups showed post operative sensitivity of varied intensity at different intervals. NCCP showed less sensitivity followed by CPP-ACP and Control group. Keywords: Power Bleaching, Post operative sensitivity, Nano Crystallized Calcium Phosphate, Casein Phosphopeptide-Amorphous Calcium Phosphate

Pseudoexfoliation Glaucoma and its Systemic Association: A Clinical Study

Pseudoexfoliation [PXF] being a age related elastotic process is a well known entity among all ophthalmologists. PXF is most common form of secondary glaucoma. Objective: To study the clinical presentations and response to treatment of PXF glaucoma and also to throw light on its systemic associations. Methods: A total of 70 eyes of PXF glaucoma was considered for the study in duration of 6 months from june to November 2021 at a tertiary care center. All patients underwent detailed ophthalmic evaluation along with gonioscopy, optic disc assessment, visual fields and intraocular pressure. Based on all these , patients were graded as mild, moderate and advanced glaucoma and treated accordingly either with medical or surgical line of management. Patients were followed up for a duration of 6 months. ECG, echocardiography and dermatological evaluation of all the patients were done. Results: Mean age of 70 patients was 52.2 years and there was male preponderance .Powdery greyish white pseudoexfoliative material on pupillary margin was seen in 41 eyes[58.5%] and on anterior capsule was seen in 19 eyes[27.1%]. IOP in these 70 patients ranged between 14 to 40mmHg. Gonioscopy showed exfoliative material deposition in 14 eyes[20%] and increased pigmentation of trabecular meshwork in 44 eyes[62.85%]. Also, it revealed narrow angle( grade 1&2) in 6 eyes and open angle (grade 3&4) in rest .Visual filed changes were present in 57 of 70 eyes with PXF glaucoma. Optic disc changes in PXF glaucoma also showed variations with 17 eyes having CD ratio of<0.5,while 38 eyes had a cupping between 0.6-0.8. Eleven eyes showed advanced cupping of >0.8 while 4 eyes had glaucomatous optic atrophy.60 eyes were treated with medical line while 10 eyes were managed surgically. 4 patients had dermal nodules and diastolic dysfunction was noted in 31 patients. Conclusion: PXF confers a significantly higher risk of developing glaucoma in comparison with the general population and needs close monitering. PXF glaucoma and its systemic associations also has to be considered Keywords: PXF, pseudoexfoliative, ECG

“COVID 19- Two Waves & More” What Have We Learnt?

The first case of SARS-CoV2 admitted on 26th December 2019 in Central Hospital, Wuhan, China. Broncho-alveolar lavage and Polymerase chain reaction of the aspirate showed high abundance of a viral RNA which has 89.1 % nucleotide identity with bat coronavirus previously isolated in China. Soon human to human transmission was observed and the outbreak started spreading. World Health Organisation on 11th March 2020 declared it as pandemic. COVID 19, caused by SARS-CoV-2, a disease we are still struggling to contain. With vaccination drive throughout the world, though the severity in re-infection has come down, but there is still threat by the various variants which are arising from time to time in various countries. The most effective way of preventing the spread of the virus is to keep physical distance from others of at least 1 meter, wearing a well fitted mask, keep hands clean and use hand sanitizer frequently, stay in well ventilated place, avoid crowded place and cough into bent elbow or tissue paper and get vaccinated when once’s turn comes. Therefore, we urge people to follow COVID appropriate behaviour properly. Keywords: COVID 19, SARS-CoV2, COVID appropriate behaviour, Social Distancing

Unconventional Endodontics for the Aesthetic Rehabilitation of Fractured, Discolored and Rotated Maxillary Central Incisor

Management of traumatic injuries to the teeth is a challenge to the practicing dentist. It has no prescriptive method for occurring, possesses no significant predictable pattern of intensity or extensiveness and occurring at times when dentists are least prepared for it. Ninety-two percent of traumatic injuries results in fracture of maxillary permanent central incisors because of its protrusive and anterior positioning. The young permanent maxillary central incisor root canal chamber is large and tapered. This case report describes the management of Ellis Class III fractured tooth in a young permanent maxillary central incisor by an innovative clinical procedure. Keywords: tooth fracture, cast post core, trauma, metal ceramic

A Comparative Study of Fluoride Containing Chlorhexidine and Non Chlorhexidine Mouthrinses in a Teenage Group

Background: Mouthwashes are important means used in chemical control of dental plaque. There is strong evidence suggestive of better effectiveness, when fluoride is added to chlorhexidine mouthwash. Objectives: The study was planned to assess the effect of a mouthrinse containing Chlorhexidine (CHX) and amine/stannous fluoride (AmF) on plaque accumulation, gingivitis and salivary fluoride levels in comparison with two mouthrinses containing either essential oils (EO) or cetylpyridinium chloride (CPC) with sodium fluoride (NaF) in a teenage group. Methodology: For this study 90 healthy teenage between 12 and 20 years were recruited for participation. The experimental gingivitis model consisted of a 2-weeks recruitment phase, followed by a 6-day rinsing period with one of the 4 mouthrinse formulations was used for the study. At the end of the pre-phase period and the rinsing period (Day-0/Day-6), gingival index (GI), plaque index (PI) and salivary fluoride levels were recorded. The statistical analyses were performed using Wilcoxon sign test and the dependent t test. Results: A reduction in plaque re-growth was seen for the CHX+AmF formulation rinse, although there were no significant differences among all groups (p>0,001). During the experimental periods, the gingivitis indices increased significantly for all formulations (p<0,001), except for the CHX+AmF formulation. The CHX+AmF formulation scored higher levels of salivary fluoride at the end of the rinsing period (p>0,001). Conclusion: We would like to conclude that the adjunctive use of AmF containing CHX mouthrinses to mechanical oral hygiene should be recommended for teenage at risk groups. Keywords: CT KUB, Radiation safety, Minimise radiation

CAD/CAM in Restorative Dentistry

Computers have had a huge impact on the dental place of work and dental exercise major to huge adjustments in communication, financial accounting, and administrative functions. Computerized systems have greater currentlygenerated developing variety of software program for the delivery of affected character treatment. Digital effect systemsand chairside CAD/CAM systems offer opportunities to mix virtual impressions and entire contour restorations withinside the dental place of work. Systems depend on single picturegraph and video cameras to report the digital file that is the foundation for an accurate outcome. This article gives key elements of automatic generation using the CAD/CAM process. CAD/CAM technique appears to be the most common technique currently available; this is fast, easy and maintains time. CAD/CAM systems are variable; therefore, using the right gadget with a logical approach for treating patients are quite mandatory. Keywords: CAD/CAM systems

ABO Blood Group as a Potential Risk Factor for Dental Caries: A Cross-Sectional Study

Introduction: Dental caries is a multifactorial disease that affects people of all ages due to a complex interplay between genetic and environmental variables. The significance of genetics in an individual's vulnerability to caries has recently been explored in scientific literature. One such inherited genetic characteristic is blood group. The relationship between blood type, lifestyle, and dental caries may shed light on the above idea. Aim: To explore into blood type as a possible risk factor for the development of dental caries. Material And Methods: Blood samples from 39 people of the index ages (5, 12, 15, 35-44, and 60-74 years) were taken, and blood grouping was done before oral screening to determine the DMFT index. A self-administered questionnaire was used to conduct a complete diet analysis. SPSS software was used to do statistical analysis on the data. Results: In different age groups, there was a strong link between different blood types, DMFT index, and diet. Conclusion: The current study's results demonstrate that genetic and epigenetic variables play a significant influence in the development of dental caries. As a result, blood groups can be utilised to detect if a certain diet is associated with the development of dental caries. Keywords: Dental caries, ABO antigens, Blood group, DMFT index, risk predictors