Journal of Advance Medical Sciences

Anti-inflammatory gel insulin leaf extract (Tithonia diversifolia) against lymphocyte cell count of periodontitis wistar rats (Rattus norvegicus)

Indeswati Diyatri — 2023-01-04

Background: Periodontitis is an inflammatory disease involving dental support tissue caused by pathogenic microorganisms. Periodontitis can result in damage to the periodontal ligaments and alveolar bones, and the formation of periodontal pockets. Periodontitis can cause inflammation; inflammation is one of the first responses of the body's immune system to infection. Inflammation is triggered by the release of chemical mediators from damaged tissues and cell migration. The inflammatory phase is characterized by chronic inflammatory cells namely macrophages, lymphocytes, and plasma cells. Insulin leaves contain flavonoids that can be used as an anti-inflammatory. This study looked at the anti-inflammatory effect of insulin leaf extract gel against a decrease in the number of lymphocyte cells in periodontitis conditions.

Purpose: To know the effective dose of anti-inflammatory gel insulin leaf extract.

Materials and Methods: Periodontitis Wistar rats were given treatment with insulin gel leaf extract (Tithonia diversifolia) with a concentration of 25%, 50%, and 75%, then the lymphocyte cells were counted using a light microscope.

Results: There were significant differences in lymphocyte cell counts in the control group and three treatment groups with concentrations of 25%, 50%, and 75%.

Conclusions: There were differences in the number of lymphocytes in Wistar rats with periodontitis after administration of insulin leaf extract gel with those that were not given insulin leaf extract gel and concentrations of 75% were the most effective dose to reduce the number of lymphocytes in periodontitis.

Case report on alternative therapy for dengue fever

Vaishali Tembhare — 2023-01-05

Introduction: Dengue fever is a flavivirus that is spread by arthropods and belongs to the Flaviviridae family. Japanese encephalitis and yellow fever are two more flaviviruses. Dengue fever is caused by four different viruses. Four separate serotypes of the virus cause dengue fever (DF) and dengue hemorrhagic fever (DHF) (DEN 1, DEN 2, DEN 3, and DEN 4). (DHF). Dengue fever is contracted by biting an infected mosquito.

Clinical findings: Abdominal pain, fever, (Temperature 100-degree f) Vomiting, Failure of thrive, Poor eating pattern.

Diagnostic evaluation: CBC Invesgition, Blood test, Hb -10.4gm%, Total RBC Count -4.37million /cu mm, RDW-13.3%, HCT-30.5%, Total WBC Cont-4000 /cu mm, Monocytes- 13%, Granulocytes-65%, Lymphocytes-30%, AST (SGOT)-28 U/L,

Peripheral smear: RBC-Normocytic mildly Hypochromic, with few microcytes, platelets-Adequate on Smear –no Hemiparasites Seen.

Therapeutic intervention: Blood Transfusion, Inj. Amin oven 200mg BD, Cefotaxime 400mg BD IV, Inj. Amikacin 130mg OD, Inj. Metrogyl 90mg BD, Inj. Pantop 10mg OD.

Outcome: After Treatment the child show improvement his frequently And relived Vomiting, fever, and increases the feeding pattern.

Conclusion: My client was admitted to pediatric ward no 16 at AVBRH with a know case of Dengue Disease, and he had complaint of fever and rashes all over the body. After getting appropriate treatment and alternative therapies his condition was improved.

Removal of displaced implant in to maxillary sinus using modified intra-oral approach- a case report

Abis Amir — 2023-01-09

Implants placed in the maxillary posterior alveolar ridges can get dislodged into the maxillary sinus at the time of placement or during the bone remodelling phase. If untreated, it may lead to various complications including sinusitis and migration into sphenoid or ethmoid sinus. In this case report a modified Caldwell-Luc approach is described to retrieve the implant fixture from the sinus.

Case report on compressive cervical myopathy

Vaishali Tembhare — 2023-01-13

Introduction: Cervical myelopathy is a condition describing a compression of the spinal cord at the cervical level of the spinal column resulting in spasticity, hyperreflexia, pathologic reflexes, digit/ hand clumsiness or gait disturbance. Classically it has an insidious onset progressing in a stepwise manner with functional decline. Without treatment, patients may progress toward significant paralysis and loss of function ^[1].

Clinical findings: Symptoms of cervical myelopathy include clumsiness in the hands, restricted ability to do fine motor skills, neck pain, weakness, pain in the shoulder or arms, and numbness in one or both hands.

Diagnostic evaluation: Blood test: Hb-13.5 gm%, Total RBC count-4.95 millions/cu.mm, Total WBC Count-14700 / cu mm, Total Platelet Count: 2.28, RDW- 14.6 %, Monocytes-04%, Granuloctyes-64%, Lymphpocytes-30%, Therapeutic Intervention: Tab MVBC OD, Tab Dolo 650 SOS, Tab Neurovit 1 Tab OD.

Outcomes: After treatment patient shows improvement.

Conclusion: Patient was hospitalized to AVBRH Neurosurgery Department with chief complain of tingling sensation in both lower limbs and also involved bilateral upper limbs associated with generalized weakness.

To assess the stress level among mother of neonates admitted in Neonatal Intensive Care Unit (NICU) and step-down ICU-Intermediate Care Nursery (ICN) unit

Himani — 2022-01-16

Background: Hospitalization is the traumatic event to the family member it causes stress to the family member especially mother. As we address the multiple challenges such as handling of their ill babies, dealing with people and medical staff in NICU, this cause physiological as well as the psychological changes in mother.

Objective: This study aims to determine maternal stress as perceived by the mother whose neonates admitted in the neonatal intensive care unit (NICU) step down nursery (ICN).And to find out the association between the selected sociodemographic variables with the level of the stress.

Methods: Non probability purposive sampling technique was used, in GMCH -32 Chandigarh, with 70 mothers assess the stress level by using Standardize scale PSS:NICU(parental stress scale: neonatal intensive care unit ) of 26 questions.

Results: Out of 70 subjects in NICU, 57.1% mother had severe level of stress and 42.8% mother had moderate level of stress, Whereas in ICN, 65.7% had moderate level of stress and 31.4% had severe level of stress and only 2.8% mother was having mild level of stress. Findings of the study shows that the mother whose neonates admitted in NICU had severe level of stress. In present study it shows that the mother belongs to the age group 24-28 year had severe level of stress 54.3% in NICU as compare to ICN mother stress level is 51.4% age of mother is also affecting the stress.

Conclusion: The study findings revel that mother of neonates admitted in NICU had severe level of stress when compare to mother of neonates admitted in Step down nursery (ICN). The further intervention study is planned to decreases the stress level among the mother.

Quorum sensing Streptococcus mutans and Lactobacillus salivarius (prospects of prevention of dental caries in the future): narrative review

Indah Listiana Kriswandini — 2023-01-20

Background: Dental caries is the most widespread infectious disease, affecting millions of people worldwide. Streptococcus mutans is a major caries-causing microorganism in which its acidogenic and aciduric properties and its ability to adhere to tooth surfaces mediate its ability to produce extracellular polysaccharides from sucrose, all of which are virulence factors associated with the pathogenesis of dental caries. Lactobacillus salivarius is a type of lactic acid bacteria that can inhibit the growth of pathogenic bacteria through communication between bacterial cells called Quorum Sensing (QS).

Purpose: To analyze the mechanism of Quorum Sensing Streptococcus mutans and Lactobacillus salivarius.

Method: This study uses a narrative review method. The literature sources used in compiling the review are digital databases such as Pubmed, Sciencedirect, and Google Scholar regarding QS S. mutans and L. salivarius.

Discussion: Several literatures report that Lactobacillus salivarius can inhibit the growth of S. mutans through downregulation of genes that play a role in biofilm formation. The K35 and K43 proteins resulting from the activation of the L. salivarius gene work by inhibiting the expression of the LuxS gene resulting in downregulation of the VicK, VicR and ComC genes which act as coding for the glucosyltransferase (gtfBCD) gene for S. mutans biofilm formation and decreased autoinducer-2 signaling molecules. (AI-2) is used in the QS mechanism.

Conclusion: Lactobacillus salivarius in the oral cavity has prospects as an agent for preventing dental caries in the future by inhibiting the growth of S. mutans through the QS mechanism.

Vedolizumab and chickenpox in immune patient during pregnancy

Silvia Bonassisa — 2023-01-23

Vedolizumab (VDZ) is a humanized immunoglobulin G1 monoclonal antibody approved for use in adults affected by moderately to severely active Crohn’s disease (CD) and ulcerative colitis (UC). In accordance with the Food and Drug Administration (FDA), VDZ is safe during pregnancy. Immunosuppressive drugs increase the risk of infections especially when used in combination, but some treatments may also expose the patients to the reactivation of latent infections. A 39-years old pregnant woman G1 P0 started immunosuppressive therapy with Vedolizumab, after the failure of previous treatments. She had already been tested for HBV, EBV and VZV, in addition to previous serology, resulting in immunity. At the 12 weeks of pregnancy, a first suspicious symptomatology for VZV began to appear and chickenpox caused by Varicella-Zoster virus was suspected. Blood tests showed a strong positivization of viral DNA in the blood. The patient decided to terminate the pregnancy for the fear of congenital chickenpox syndrome. In this case we observed an unexpected viral reactivation to an extent like a first infection although the patient was immune. It is therefore essential to carefully evaluate the administration of Vedolizumab in the first trimester, underlining that a reactivation of the VZV and the manifestation of chickenpox is possible even if the women was cataloged as immune.

Refractory rhinorrhoea secondary to superior vena cava syndrome

Sharanabasappa Patil — 2023-02-06

Superior vena cava (SVC) syndrome is a collection of clinical signs and symptoms resulting from either partial or complete obstruction of blood flow through the SVC. This obstruction is most commonly a result of thrombus formation or tumour infiltration of the vessel wall. Incidence of SVC syndrome, post haemodialysis catheter insertion, is about 5% to 19 %, however, with regards to refractory rhinorrhoea secondary to SVC syndrome, this is the first case report in medical literature. Common symptoms of SVC syndrome are facial puffiness, upper limb oedema, hoarseness of voice, cough and rarely, bilateral reversible hearing loss and cerebrospinal fluid (CSF) rhinorrhoea. Here, we present a case of refractory rhinorrhoea and bilateral conductive hearing loss in a patient with SVC syndrome which resolved immediately after relieving the SVC obstruction. There is extreme paucity of data regarding refractory rhinorrhoea as manifestation of SVC syndrome and hence should always be considered in differential diagnosis, with predisposing thrombotic background. This case also highlights the limitations of radiological procedure and timely surgical intervention in SVC syndrome.

Anti-inflammatory and antibacterial properties of almond by-products as wound healing potential agent: a review

Salsabilavi Soffarina — 2023-02-08

Patients who have suffered significant trauma are at higher risk of developing bacterial infections which could lead to bacteremia and prolonged inflammation on wound healing process. Thus, antibacterial and anti-inflammatory agents are essential to facilitate wound healing. Since natural substances have a tendency to be less toxic, therapeutic agents like almonds are frequently used. This study is aimed to summarize the antibacterial and anti-inflammatory properties of almond by-products. According to phytochemical investigations, almond by-products phenolic compounds such as flavonoids, tannin, phenolic acids, and aldehyde. Several studies have found that almond by-products are able to inhibit the growth of some bacterial strains of gram negative and positive. In addition, it has been demonstrated that almond by-products have anti-inflammatory properties through reducing the expression of pro-inflammatory cytokines. Thus, almond by-products are potential as wound healing agents to prevent further infections through its anti-inflammatory and antibacterial activities. Therefore, additional research such as clinical trials, are recommended to investigate its effectiveness on wound healing and safety application.

Dengue encephalitis: clinical manifestations and molecular pathogenesis

Nurlisa Naila Aulia — 2023-02-20

Background: Dengue encephalitis is an inflammation of the brain parenchyma that occurs due to direct neuronal infiltration by the dengue virus. It is estimated that 50 million dengue infections occur annually and about 2.5 billion people live in dengue endemic countries. When dengue infection is endemic in Brazil, dengue encephalitis is the highest cause of viral encephalitis and also causes meningitis in 10% of cases, in Indonesia is not yet available.

Objective: To know the clinical manifestations and molecular pathogenesis of dengue encephalitis.

Discussion: Neurological manifestations due to the dengue virus are related to differences in viral serotypes that occur in secondary infections with antibodies formed. Dengue virus or DENV will be neutralized by antibodies and immune protection is formed, but when the second infection happens with a different serotype, DENV cannot be neutralized by antibodies which then activate phagocytic cells such as monocytes and carry out viral replication, causing dengue hemorrhagic fever, dengue shock syndrome including neurologic manifestations.

Conclusion: The dengue virus can reach the brain hematogenously. The clinical manifestations of dengue encephalitis are fever, headache, loss of consciousness, meningismus seizures, positive plantar pedis extension pathological reflex, positive signs of frontal lobe symptoms, abnormal posture, cranial nerve paresis, and tetraparesis.