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REVIEW ARTICLES
Novel insight on probiotic Bacillus subtilis: Mechanism of action and clinical applications
Manoj A Suva, Varun P Sureja, Dharmesh B Kheni
July-December 2016, 2(2):65-72
DOI:10.4103/2455-3069.198381  
Probiotics are the living microorganisms that provide health benefits to the recipient. Lactobacillus and Bifidobacterium genera have been used since long for the competitive exclusion of pathogens from the gut. However, their limitations such as sensitivity to gastric acid, temperature, slow growth, and specific stability conditions lead to search for a novel probiotic that is stable through its shelf-life as well as during gastrointestinal transit; hence, offering better efficacy. Bacillus bacteria have strong scientific data which substantiates the validity of the use as preferred probiotics. In recent times, there has been significant progress in scientific evaluation and studies on probiotic Bacillus subtilis, revealing possible mechanisms of action like antimicrobial effect by synthesis of antimicrobial substances, antidiarrheal effect, immunostimulatory effect, competitive exclusion of pathogens, prevention of intestinal inflammation, and normalization of intestinal flora. Numerous preclinical and clinical studies on B. subtilis have shown its promising efficacy in the treatment and prevention of diarrhea of various etiologies. B. subtilis is certified as generally recognized as safe by Food and Drug Administration and features in the European Food Safety Authority Qualified Presumption of Safety, hence suggesting as safe for human use. All of these beneficial attributes make B. subtilis the most attractive probiotic species for various clinical conditions.
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GUEST EDITORIAL
Launching a multi-disciplinary journal for healthcare professionals
John Abraham
July-December 2015, 1(1):1-1
  1,098 2,614 -
ORIGINAL ARTICLES
Antimicrobial activity of Vitamin C demonstrated on uropathogenic Escherichia coli and Klebsiella pneumoniae
Rohan Jacob Verghese, Stephen K Mathew, Alice David
July-December 2017, 3(2):88-93
DOI:10.4103/jcrsm.jcrsm_35_17  
Purpose: Studies have demonstrated the ability of Vitamin C (ascorbic acid) to inhibit pathogenic bacteria and inhibit biofilms. The effect of varying concentrations of ascorbic acid on bacterial growth was studied on uropathogenic Escherichia coli and Klebsiella pneumoniae. The concentration at which maximal inhibition occurred was determined. Methods: All uropathogenic strains of E. coli and K. pneumoniae isolated from patients over a 3-month period were incubated in varying concentrations (5, 10 and 20 mg/ml) of Vitamin C-supplemented Trypticase Soy Broth. Effect on bacterial growth was quantified as a change in absorbance measured by spectrophotometry (450 nm), as compared to controls. Independent samples t-test was used to calculate P value. Results: Bacterial growth was inhibited at all Vitamin C concentrations. Mean absorbances of E. coli and K. pneumoniae broths containing 5, 10, and 20 mg/ml Vitamin C were significantly less than absorbances of growth control broths without Vitamin C (P < 0.005). This inhibition was independent of antimicrobial resistance profiles of isolates. Differences between mean absorbance at 10 and 20 mg/ml Vitamin C for both species were not significant (P > 0.005). Thus, the inhibitory activity of Vitamin C appears to be dose-dependent, with 10 mg/ml being the optimum concentration of ascorbic acid. Conclusions: Ascorbic acid's ability to inhibit bacterial growth may find novel clinical applications. Vitamin C may find potential use in topical antibacterial applications, or urinary bladder irrigation fluid for catheterized patients with urinary tract infections or during bladder instrumentation. There is a need to further explore the possibility of using Vitamin C safely as an effective antimicrobial agent.
  3,224 305 1
EDITORIAL
Journal impact factor: Does it really have an impact?
Aneesh Basheer
July-December 2016, 2(2):63-64
DOI:10.4103/2455-3069.198378  
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CASE REPORTS
Elizabethkingia meningoseptica bacteremia in a neonate: A case report and mini-review of the literature
K Sandhya Bhat, R Priya, Lalitha Krishnan, Reba Kanungo
January-June 2016, 2(1):42-45
DOI:10.4103/2455-3069.184130  
Elizabethkingia meningoseptica is a nonfermentative Gram-negative bacillus that is ubiquitously found in hospital environments, and it has been associated with various nosocomial infections. Immunocompromised individuals are particularly at increased risk for developing severe infections due to E. meningoseptica, including bacteremia. E. meningoseptica is resistant to multiple antimicrobials commonly used for Gram-negative bacteria. Rapid diagnosis and early institution of appropriate therapy for prolonged period are essential in management of such infections. We report a case of bacteremia due to E. meningoseptica in a neonate who presented with clinical findings suggestive of epidermolysis bullosa. Based on the clinical diagnosis and preliminary blood culture report, baby was started on syrup cefixime, topical fucidin cream along with fluid correction for electrolyte imbalance. As baby's general and systemic status were stable, the baby was discharged with the advice to review after 3 days. Awareness among clinicians along with correct identification by the diagnostic microbiology laboratory is required to reduce the fatal outcome associated with E. meningoseptica infections.
  2,845 336 -
REVIEW ARTICLES
Periodontal vaccine: A new vista in periodontology - A review
Chandni Gupta, D Deepa
January-June 2016, 2(1):10-13
DOI:10.4103/2455-3069.184117  
The infectious etiology of periodontitis is complex. Due to its high prevalence rate, this disease has created an interest in finding a solution in the form of vaccines. Vaccination is the best known and the most important application of immunological principles to human health. The complexity of the periodontopathic bacteria might be a problem in the determination of antigens, thus complicating the development of periodontal vaccine. An attempt to review the literature on periodontal vaccine, including active immunization: Whole bacterial cells, sub-unit vaccines, synthetic peptides as antigens; passive immunization: Murine monoclonal antibodies and plantibodies; and genetic immunization: Plasmid vaccines, live, viral vector vaccines, has been done in this study.
  2,690 470 1
Standards for tuberculosis care in India, a road map to universal access in quality tuberculosis care
Anil J Purty, Zile Singh, Joy Bazroy, Ramesh C Chauhan, N Murugan
July-December 2015, 1(1):6-11
Tuberculosis (TB) remains one of the world's deadliest communicable diseases. In 2013, an estimated 9.0 million people developed TB, and 1.5 million died from the disease. The International Standards for TB Care (ISTC) were formulated to develop uniform guidelines for ensuring the delivery of widely accepted level of care by all healthcare workers in managing TB patients or those suspected to have TB. In India, the quality of care for TB patients receive varies considerably and often is not in accordance with the international standards. In this article, we provide an overview of the recent standards for TB care in India (STCI). These standards were developed after a national level consultation meeting involving over 120 national and international experts, these have been supported by the World Health Organization guidelines pertaining to TB care and are duly approved by the Central TB Division, Ministry of Health and Family Welfare, Government of India. The STCI has outlined 26 standards (diagnosis: 1–6; treatment: 7–11; public health: 12–21; social inclusion: 22–26) for effective prevention and control of TB in India. These standards need to be widely disseminated to all stakeholders to ensure universal access in quality TB care is available to all patients. The community health providers (both private and public), and governments should work as partners with a view to improve TB care and enhance the effectiveness of the healthcare process so that the ISTC is objectively implemented in day-to-day practice.
  2,214 357 -
Levobupivacaine: A safer alternative
Manazir Athar, Syed Moied Ahmed, Shahna Ali, Obaid Ahmad Siddiqi
January-June 2016, 2(1):3-9
DOI:10.4103/2455-3069.184114  
In the quest for safer and effective anesthesia and analgesia, local anesthetics such as levobupivacaine or ropivacaine have been introduced into the clinical practice. Several studies have been done to assess their efficacy and relative superiority to bupivacaine. The aim of this review is to provide the recent and comprehensive updates regarding the clinical and pharmacological utility of levobupivacaine. Using Google search for indexing databases, a search for articles published was performed using various combinations of the following search terms: (a) Pharmacology; (b) clinical; (c) profile; (d) levobupivacaine; (e) local anesthetic; (f) recent. Additional sources were also identified by exploring the primary reference list.
  2,141 385 -
ORIGINAL ARTICLES
Radiological imaging of motorcycle-related injuries in a developing country: Experience in a tertiary health facility in the South-Western Nigeria
Olufunso Simisola Aduayi, Olusola Comfort Famurewa, Victor Adebayo Adetiloye
July-December 2015, 1(1):36-40
Background: Trauma is one of the major clinical indications for radiological investigation, and this often comes to the fore during hospital care of patients involved in motorcycle crashes. The aim of this study is to highlight the pattern of medical imaging utilization and spectrum of radiological findings among adults presenting with motorcycle-related injuries (MCRI) in a tertiary health facility in the South-Western Nigeria. Patients and Methods: A cross-sectional descriptive study was carried out prospectively between August 2011 and July 2012. The study population included adult patients referred for investigations at the radiology department following involvement in motorcycle crashes. Appropriate radiological investigations were done, and imaging findings were reported by radiologists. The data was entered into a spreadsheet and analyzed using SPSS version 16.0 for windows, Chicago, USA Inc. Results: A total of 150 patients were recruited into the study out of which 119 (79.3%) were males and 31 (20.7%) were females. There were 74 (49.3%) motorcycle riders, 55 (36.7%) pillion passengers, and 21 (14%) pedestrians. The limbs (n = 92, 61.3%) were the most imaged site in the body followed by the head (n = 78, 52.0%). Plain radiography (n = 113, 75.0%) was the most utilized radiological investigation among the study population, followed by computed tomography (n = 65, 43.3%), ultrasonography (n = 11, 7.3%), and magnetic resonance imaging (n = 1, 0.6%). Conclusion: This study highlights the burden of MCRI in our environment from a radiological perspective. The need for continuous advocacy on prevention of MCRI in a developing nation cannot be overemphasized.
  2,202 163 -
Insulin resistance factor in subjects suffering from depressive disorder
Mona Srivastava, Surendra Pratap Mishra, Roshni Gavel, Ashish Nair
January-June 2016, 2(1):14-19
DOI:10.4103/2455-3069.184118  
Objective: The purpose of this study was to find out the occurrence of depressive disorders in patients with freshly detected diabetes mellitus (DM) and its relationship with the sociodemographic status of the subjects, severity of the disease, and insulin resistance (IR) factor in the subjects suffering from depression and DM. Materials and Methods: In this cross-sectional study, 100 patients aged between 30 and 60 years who fulfilled the criteria for diagnosis as per the World Health Organization criteria of DM were selected randomly from endocrinology outpatient department (OPD) of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi. All patients who attended the OPD services from November 2014 to July 2015 were screened for participation in the study. The patients were assessed for depressive disorder as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and IR by blood chemistry measure of fasting insulin (by enzyme-linked immunosorbent assay KIT) and fasting glucose (GOD-POD method) using homeostasis model assessment method (HOMA-IR scale). Results: In the study group of 100 patients, 34% of the patients were found to be suffering from depressive illness and they were not on any treatment. Out of the 34% patients who had insulin resistance; most common psychiatric disorder was major depressive disorder found in 21%,mild to moderate depressive disorder in 7% and 4% were found to have depression mixed anxiety symptoms. The estimated IR by HOMA-IR scale was found higher in 25 patients (74%) with psychiatric illness. Conclusions: This study highlights the high comorbidity of depressions in newly detected diabetes and also emphasizes the need of psychiatric evaluation in subjects who are vulnerable at the time of being diagnosed as a case of DM.
  2,142 144 -
REVIEW ARTICLES
Sinus radiography for sinusitis: “Why” and if considering it then “how”?
Ujwala R Newadkar
January-June 2017, 3(1):9-15
DOI:10.4103/jcrsm.jcrsm_13_17  
Sinonasal imaging is performed in two major clinical scenarios: inflammatory rhinosinusitis or a suspected mass lesion. The diagnosis of rhinosinusitis is based on clinical grounds. Radiological diagnosis forms an important tool in the armamentarium to diagnose and classify rhinosinusitis. Computed tomography (CT) scan, as well as magnetic resonance imaging, may at times complement each other, to aid the clinician arrive at a diagnosis. CT scans are the gold standard study guiding management of sinusitis because they accurately depict the sinus anatomy, including soft tissue changes, anatomic variations; the osteomeatal complex, and complications, especially those involving the orbit or intracranial structures. Nevertheless, despite the best radiologic modalities, a clinicoradiological correlation is a must to accurately diagnose this often deceptive condition called rhinosinusitis.
  2,114 152 -
LETTERS TO EDITOR
The blue whale challenge: Why do people commit suicide for an online game?
Parthasarathy Ramamurthy
July-December 2017, 3(2):137-138
DOI:10.4103/jcrsm.jcrsm_49_17  
  1,988 226 -
ORIGINAL ARTICLES
Detection of virulence factors and phenotypic characterization of Candida isolates from clinical specimens
Nisha Vincy Jose, Nagaraja Mudhigeti, Johny Asir, Sheela Devi Chandrakesan
July-December 2015, 1(1):27-31
Context: Infections associated with different Candida species have increased over the last decade especially with nonalbicans Candida. Species identification and antifungal susceptibility are vital for treatment and management of Candida infections. Virulence factors, including biofilm formation (BF) and secretion of hydrolytic enzymes have been demonstrated in Candida albicans and few other nonalbicans Candida. Aim: The aim of this study was to speciate and detect virulence factors of different Candida species isolated from a clinical specimen. Methods: All clinically significant Candida species isolated during the study period from various clinical samples were speciated by standard phenotypic methods and using the chromogenic medium. BF, Phospholipase and protease activities were determined by tissue culture plate method, precipitation, and bovine serum albumin agar medium respectively. Results: C. albicans was the most common species isolated followed by Candida tropicalis and Candida krusei. Chromogenic medium (CHROM agar Candida) was found to be 92% specific for identification of Candida species. BF was observed more in urine isolates of C. tropicalis followed by C. krusei. Phospholipase activity was seen only in C. albicans, whereas protease activity was observed in all four species of Candida but most commonly in C. tropicalis. Conclusion: Rapid identification and speciation of Candida species is essential in guiding appropriate anti-fungal therapy. CHROM agar Candida is a simple and rapid test for speciation of Candida; however, when used along with other phenotypic methods they give more reliable results. Detection of virulence factors in Candida species might indicate invasiveness.
  1,867 345 -
REVIEW ARTICLE
Biofilm formation as a virulence factor of Acinetobacter baumannii: An emerging pathogen in critical care units
A Arockia Amala Reena, Anandhalakshmi Subramaniyan, Reba Kanungo
July-December 2017, 3(2):74-78
DOI:10.4103/jcrsm.jcrsm_66_17  
Acinetobacter baumannii, an emerging nosocomial pathogen, is increasingly associated with serious infections among hospitalized patients, especially those on life-support systems. A. baumannii has become resistant to almost all currently available antibacterial agents, including carbapenems, which were once considered the drug of choice for the treatment of infections with multidrug-resistant (MDR) organisms. A. baumannii is notorious in its ability to spread among hospitalized patients and causes outbreaks which have been reported worldwide. The capability of these strains to circulate widely seems to depend on the expression of virulence factors that allow bacterial colonization as well as on the expression of antibiotic resistance. Biofilm production by A. baumannii appears to be one of the major contributing factors in colonization, notably of medical devices. This review explores published literature on the association of biofilms and MDR A. baumannii in hospitalized patients. An online search was made for articles of original work and reviews on biofilms production among Acinetobacter and their association with virulence. The articles were reviewed and results were analyzed based on biofilm production and the factors associated with it, namely biofilm cycle, biofilm-associated protein, chaperone-usher secretion system, and quorum sensing.
  1,567 606 -
ORIGINAL ARTICLES
Reconstruction of interdental papilla with platelet-rich fibrin membrane
Nitin Tomar, Vineeta Singal, Divya Dureja, Amit Wadhawan
July-December 2016, 2(2):112-115
DOI:10.4103/2455-3069.198369  
Search for aesthetic treatment and smile enhancement has persisted in the routine of dental professionals. However, the appearance of black triangles in the anterior region compromises aesthetic looks and hampers one's self-esteem. Etiological factors for open gingival embrasures include aging, periodontal disease, loss of height of the alveolar bone relative to the interproximal contact, length of embrasure area, root angulations, interproximal contact position, and triangular-shaped crowns. Several surgical and non-surgical techniques have been proposed to treat soft tissue deformities and to manage the interproximal space. The surgical techniques aim to recontour, preserve, or reconstruct the soft tissue between the teeth. The aim of the present case report is to present a minimally invasive papillary regenerative procedure using platelet-rich fibrin membrane which was tucked into the pouch, followed by coronal displacement of the entire gingival-papillary unit.
  1,965 193 -
Seroprevalence of hepatitis B and C in patients on hemodialysis and their antibody response to hepatitis B vaccination
Anandh Perumal, Philip Vivian Joseph Ratnam, Shashikala Nair, Patricia Anitha, Veerappan Illangovan, Reba Kanungo
January-June 2016, 2(1):20-23
DOI:10.4103/2455-3069.184119  
Introduction: Hepatitis B and C viral (HBV and HCV) infections are the most common infections acquired by hemodialysis (HD) patients. The prevalence of HBV and HCV infections in dialysis patients in India is 3.4-43% and 20-80%, respectively. This study was carried out to find out the current prevalence rate of HBV and HCV infections in HD patients in Puducherry. Materials and Methods: Serum samples from 65 patients with chronic kidney disease, who were admitted to a tertiary care hospital for HD, were screened for hepatitis B surface antigen (HBsAg) and HCV antibodies. The samples were collected on the first visit to the center before starting the dialysis and thereafter periodically. The serological results were correlated with gender, age, and duration of disease. An attempt was made to correlate the evidence of viral infection with clinical evidence of hepatitis, liver profile, and history of any transfusions in the past 3 years. Results: Among the 65 patients, 14 individuals were found be infected with hepatitis, HBV (5), and HCV (10) accounting for 22%. A single individual was coinfected with both the virus. There was a male preponderance accounting for 77% of patients on dialysis. Hepatitis B vaccination was given to all HBsAg negative patients (77%). Two of the vaccinated individuals were infected with HCV. Conclusions: Further studies are required to determine risk factors and factors that determine why some escape infection for prolonged periods. Hepatitis B vaccination should be mandatory for individuals undergoing HD.
  1,821 263 -
REVIEW ARTICLES
Scrub typhus meningoencephalitis
Nayyar Iqbal, Sudhagar Mookkappan, Aneesh Basheer
July-December 2015, 1(1):3-5
Scrub typhus is one of the most common undifferentiated fevers in South India. Scrub meningoencephalitis commonly presents with a severe headache and altered sensorium, along with fever. Sometimes, it is associated with seizures and focal neurological deficit. The cerebrospinal fluid analysis shows lymphocytic predominance with elevated protein and normal glucose. Tubercular meningitis is a common differential diagnosis. Prompt treatment with doxycycline is associated with favorable outcome.
  1,590 454 -
ORIGINAL ARTICLES
Implementation of active surveillance system to track hospital-acquired infections in a tertiary care hospital in India
R Deepashree, Ramya Raghavan, Apurba Sankar Sastry
January-June 2017, 3(1):21-28
DOI:10.4103/jcrsm.jcrsm_16_17  
Background: Hospital-acquired infections (HAIs) are a threat to public health and addressing this issue will help to plan appropriate preventive strategies. Full-fledged active HAIs surveillance is the cornerstone in assessing the burden of HAIs. This study was planned to assess the burden of HAIs by implementing a hospital-wide active surveillance system in a large tertiary care teaching hospital in south India and compare findings with those of National Health Safety Network United States (NHSN US) and International Nosocomial Infection Control Consortium (INICC) India HAI rates. Materials and Methods: Active HAIs' surveillance was initiated in 18 Intensive Care Units (ICUs) from January 2015 to September 2016. All patients admitted in the ICUs were followed up by the infection control nurses, and surveillance was done for device-associated infections (DAIs). The cumulative rates of the DAIs and device utilization (DU) rates and surgical site infection (SSI) rates were determined for all the ICUs. These data were compared with corresponding NHSN and INICC India HAI rates. Results: Total number of patient days for the entire study period was 111294, pooled mean ventilator-associated pneumonia rate was 25.00/1000 ventilator days (NHSN US 2.0 and INICC India 9.4); Pooled mean central line-associated blood stream infection rate was 7.2/1000 central line days (NHSN US 1.1 and INICC India 5.1). The pooled mean ICU catheter-associated urinary tract infection rate was 6.1/1000 catheter days (2.1 NHSN US and 2.9 INICC India). The pooled mean SSI rate was found to be 3.5/100 surgeries. The DU rates had a significant positive agreement with the DAI rates. The DAI rates of most of the ICUs were found be to be higher than NHSN US and INICC India rates. Conclusion: There is an increasing need to implement an active surveillance system to detect and monitor the HAI rates which would be vital to implement infection control measures in a proactive manner rather than reactive.
  1,804 233 -
REVIEW ARTICLES
Evidence-based medicine in action: Critical appraisal of articles on therapy or intervention
Aneesh Basheer
January-June 2017, 3(1):3-8
DOI:10.4103/jcrsm.jcrsm_14_17  
Evidence-based medicine (EBM) has gained acceptance as a means to improve patient outcomes. However, the practice of EBM necessitates the acquisition of certain skills beginning with the formulation of an answerable clinical question, effective search of the literature to find the best evidence, critically evaluating the evidence for its validity and the application of good evidence to patients giving due respect to their preferences and the clinician's individual expertise. Systematically analyzing the evidence is crucial to identifying the presence and degree of bias in the study, to determine the magnitude of the results in clinically relevant terms and deciding on the applicability to a particular patient. This process is termed critical appraisal. As research questions decide the appropriate study designs, the tools used for critically appraising different types of articles also vary. In general, critical appraisal of articles on therapy or intervention seek to clarify three issues – the internal validity of the study, the magnitude and precision of results, and the external validity of the study. This review aims to elucidate the practical ways in which each of these components of a critical appraisal can be approached and finally enable the clinician to use or ignore the evidence at hand. Since the acquisition of skills such as critical appraisal needs repetitive exposures and continuous constructive feedback, journal clubs offer ideal occasions where they can be initiated, pursued, and mastered. Judicious application of critical appraisal would no doubt aid the effective practice of EBM and ultimately improve patient care.
  1,818 204 -
EDITORIAL
Antibiotic resistance: Have we reached the end of the road?
Reba Kanungo
July-December 2015, 1(1):2-2
  1,168 833 -
CASE REPORTS
Platelet phagocytosis in peripheral blood during acute phase of dengue virus infection
Nidhya Ganesan, Indira Gunasekaran, Somanath Padhi, Anita Ramdas, Manjiri Phansalkar
July-December 2015, 1(1):51-53
We aimed to describe peripheral blood phagocytosis of platelets as a possible underlying mechanism of thrombocytopenia during the acute phase of dengue virus infection in a young male. Furthermore, enhanced platelet phagocytosis through the apoptotic mechanism is also briefly highlighted.
  1,791 164 -
ORIGINAL ARTICLES
Improving medical education: Need for educational research
Kurien Thomas, Aneesh Basheer, Ashok Kumar Das, Sheela Kuruvilla, N Nagaraj, Thomas Alexander, Georgi Abraham, Bhirappa Shriman
July-December 2015, 1(1):12-17
Background: A formal evaluation of the Postgraduate (PG) training program has not been previously carried out at Pondicherry Institute of Medical Sciences. An evidence-based participatory approach was considered important to identify activities and to improve the training program. Population: Important stake holders to the PG training program including PG students, faculty in the Department of General Medicine, Faculty of Specialty Training the PGs, PG program administrator, and representative from the educational unit of the institution participated in the program evaluation (PE). Methods: The strategic planning (SP) exercise consisted of three activities. (1) A rapid assessment of present status by an anonymous cross-sectional survey of all identified stake holders (2) presentation of the results of the survey and discussion on different dimensions of PG training (3) a situational analysis of strengths, weakness, opportunities, and threats (SWOT) to develop an evidence-based recommendations on the definite steps to be under taken to improve the program. Results: There were 25/28 (89%) identified stake holders participated in the exercise. Through the exercise, consensus was obtained to broaden the training objectives to include seven competencies necessary for PG student. The overall satisfaction with training was 80.5% (95% confidence interval [CI]: 74.3–86.7). However, there were five responders (20% 95% CI: 9–39) who scored <80% for overall score. It identified 15 definite steps to strengthen the program in the dimensions of (1) educational resources and inputs, (2) educational interactions and postings, and (3) student evaluation. Conclusions: Participatory research, including PE and SWOT analysis are valid tools, which can be used to understand the present status and identify activities as for evidence-based SP in academic medical institutions.
  1,681 225 -
CASE REPORTS
A worthwhile attempt to remove a bent intra-medullary femoral nail before attempting extensive procedures
SM Shishir, Pascal Noel Deniese, R Kanagasabai, Syed Najimudeen, James J Gnanadoss
July-December 2015, 1(1):44-48
Extraction of the broken/bent nail will be needed in the revision surgery in cases where the fracture is ununited. A broken nail can be removed easily through the fracture site. However, there is no standard protocol that exists in the literature for extraction of a bent nail. We report a case of 5 weeks postoperative bent intra-medullary (IM) interlocking femoral nail in a 33-year-old male who had undergone nailing for femoral shaft fracture, due to a trivial fall during rehabilitation. A radiograph of the affected limb revealed that the IM nail was bent to 30° with a varus deformity. The fracture was still uniting. The nail was unbent after anesthesia and exchange nailing was carried out. A closed manipulation should be attempted prior to any surgical procedure, in order to prevent damage to soft tissue, bone and avoid complications that may arise due to extensive surgery.
  1,765 137 -
Hemisection: A conservative approach of tooth preservation
Pankaj Mishra, Anjna Sharma, Sunil Kumar Mishra
January-June 2016, 2(1):46-48
DOI:10.4103/2455-3069.184134  
Progressive inflammatory periodontal disease, if left untreated, it will ultimately result in attachment loss. This can affect the bifurcation or trifurcation of multirooted teeth. Dentists are challenged to save those teeth that earlier would have been extracted without a second thought to save it. Hence, resective therapy has been utilized in the treatment of furcation defects. Hemisection is a removal of compromised root and the associated crown portion. It is one of the treatment options for preserving remaining part of molar having sound periodontium. This case report presents a patient in whom distal half of the carious and periodontally compromised tooth was resected, and after healing, fixed dental prosthesis was given to restore proper form and function.
  1,662 141 -
EDITORIAL
Human pythiosis: Old wine in a new bottle
Savitri Sharma
January-June 2016, 2(1):1-2
DOI:10.4103/2455-3069.184113  
  1,540 260 -