Jorhat Medical College

Introduction Ninety-five percent ethanol is the routinely used and standard cytological fixative. However, commercially available ethanol is expensive and not freely available in some institutions. There is always a search for an ideal alternative. Aim and Objective In the present study, we evaluated 100% coconut water (CW) and 30% aqueous honey solution as cytological fixative at different time points and compared them with routinely used spray fixative of ethanol. Materials and Methods Oral smears were prepared from 30 healthy volunteers, and a total of 270 smears were prepared. From each volunteer, 9 smears were prepared. One smear was fixed in ethanol, four smears were fixed in 100% CW and four in 30% aqueous honey solution. Of the four smears fixed in CW or honey, one smear was fixed for 15 min, one for 30 min, one for 45 min, and one for 1 h, respectively. The slides were dried and then the smears were stained with Papanicolaou staining. Slides were evaluated by two independent observers who were blinded to the procedures. The following parameters were evaluated – nuclear staining, cytoplasmic staining, cell morphology, clarity of staining, and uniformity of staining. Statistical analysis was done using post hoc pairwise comparison, and P < 0.05 was considered to be statistically significant. Results The results of the study showed that fixation with 30% aqueous solution of honey or 100% CW for more than 15 min yields useful and evaluable results. Conclusion These readily available materials can be used as alternatives of alcohol in oral cytology.

Background Global alcohol consumption poses a serious threat to humankind. It is estimated that between 5% and 7% of Indian adults struggle with alcohol abuse. Alcoholism is associated with a number of disorders, impacting different organ systems and nutritional status, including symptoms of withdrawal that can vary in severity from moderate symptoms to delirium tremens (DT). An increase in oxidative stress in the body is linked to alcohol withdrawal. Aim This study aimed to evaluate the role of vitamins with antioxidant properties on oxidative stress caused by the severe alcohol withdrawal state. Materials and Methods 60 patients with DT and 30 control subjects were recruited using a purposive sampling method. They were evaluated for liver function test, antioxidant enzyme superoxide dismutase, glutathione peroxidase, and serum vitamin D level on day 0, day 14 and on day 0 of treatment for patients and controls, respectively. Results The mean age of the study group was 41.12 years. The mean duration of substance use while coming for treatment was 22 years. Means of liver function test were found to be aspartate transaminase (AST) 196 IU/L, alanine transaminase (ALT) 71 IU/L, and alkaline phosphatase (ALP) 143 IU/L of patients on day 0 of evaluation. When comparisons of liver enzymes and antioxidant enzymes were conducted between cases and controls on day 0, significance was found. Further comparison of day 0 and day 14 levels of liver enzymes and antioxidant enzymes also had shown significant differences. However, no significant correlation was found with vitamin D level and liver enzyme, antioxidant enzyme level. Conclusion Oxidative stress evaluated via antioxidant enzyme was found to be at a higher level in patients with DT than in patients with mild withdrawal symptoms. This study has shown an association between antioxidant enzymes with severity of withdrawal; however, no such association with vitamin D level was found.

Microplastics (MPs), defined as plastic particles smaller than 5 mm, are increasingly recognized as environmental contaminants with potential health risks. These emerge as breakdown products of larger plastics and are omnipresent in marine, freshwater, and terrestrial ecosystems. They are primarily composed of polymers such as polyethylene, polypropylene, polystyrene, and additives that enhance their performance. MPs also adsorb harmful environmental chemicals like persistent organic pollutants and heavy metals, posing risks to human and environmental health. Human exposure to MPs occurs mainly through ingestion and inhalation, with MPs detected in food products, water, and even the air. MPs have been shown to accumulate in the gastrointestinal tract, disrupting the gut microbiome, and causing dysbiosis-a harmful imbalance between beneficial and harmful bacteria. This disruption has been linked to various health issues, including gastrointestinal disorders, systemic inflammation, and chronic diseases. Furthermore, the gut-brain axis may be affected, with potential neuroinflammatory consequences. As research continues to unravel the health impacts of MP exposure, understanding the mechanisms of accumulation and the broader implications on human health is crucial. This review highlights the effects of MPs on human health, emphasizing their impact on the gut microbiome. We discuss the potential connections between MP exposure and cardiometabolic and inflammatory diseases, and disorders related to the Gut-Brain Axis. By synthesizing the latest research, this work sheds light on the silent yet pervasive threat posed by MPs and underscores the importance of further studies to understand their health impacts fully.

Background In India, competency-based medical education (CBME) was introduced for the 2019–2020 batch of Bachelor of Medicine, Bachelor of Surgery (MBBS) students. Methods The objective of this study was to identify the key challenges perceived by the medical college faculties in the implementation of the CBME curriculum for MBBS students. This was a qualitative cross-sectional study using the free-lists method to obtain data from 25 faculties about their perceptions of challenges regarding the implementation of CBME. Results The most frequent items mentioned by faculty members were: less workforce, inadequate infrastructure, less training, assessment methodology and non-simplified curriculum. The challenge regarding the workforce had the highest Smith’s salience index score of 0.41, followed by inadequate infrastructure and inadequate time distribution for competencies in the curriculum. Conclusions As the challenges related to the curriculum were identified, addressing them with the incorporation of local needs and aspirations is the need of the hour.

Objective To investigate whether induction/augmentation of labor in pregnant women with anemia increases the risk of postpartum hemorrhage (PPH) and whether this risk varied by indications for labor induction/augmentation and by anemia severity in pregnancy. Methods In a prospective cohort study of 9420 pregnant women from 13 hospitals across India, we measured hemoglobin concentrations at recruitment (≥28 weeks of gestation) and blood loss after childbirth during follow‐up and collected clinical information about PPH. Clinical obstetric and childbirth information at both visits were extracted from medical records. Anemia severity in the third trimester was categorized using hemoglobin concentrations (no/mild anemia: hemoglobin ≥10 g/dL; moderate: hemoglobin 7 to 9.9 g/dL; severe: hemoglobin <7 g/dL), while PPH was defined based on blood loss volume (vaginal births: ≥500 mL or cesarean sections: ≥1000 mL) and clinical diagnosis. Indications for labor induction/augmentation were classified as clinically indicated and elective as per guidelines. We performed multivariable modified Poisson regression analyses to investigate the associations of anemia severity and indications for labor induction/augmentation, including their interaction, with PPH, adjusted for potential confounders. Results PPH was associated with anemia but not with indications for labor induction/augmentation. However, there was a significant interaction between the two factors in relation to PPH (P = 0.003). Among pregnant women with severe anemia, a higher risk of PPH was associated with elective (adjusted risk ratio, 3.44 [95% confidence interval, 1.29–9.18]) but not with clinically indicated (adjusted risk ratio, 1.22 [95% confidence interval, 0.42–3.55]) labor induction/augmentation. No associations were observed among pregnant women with no/mild and moderate anemia. Conclusion The risk of PPH is higher in women who have moderate–severe anemia in late pregnancy. Induction/augmentation of labor is generally safe for women with anemia, but it can increase the risk of PPH in women with severe anemia if performed electively.

Dental caries, a persistent oral health challenge primarily linked to Streptococcus mutans, extends its implications beyond dental decay, affecting over 4 billion individuals globally. Despite its historical association with childhood, dental caries often persists into adulthood with prevalence rates ranging from 60 to 90% in children and 26 to 85% in adults. Currently, there is a dearth of multiepitope vaccines (MEVs) specifically designed to combat S. mutans. To address this gap, we employed an immunoinformatics approach for MEV design, identifying five promising vaccine candidates (PBP2X, PBP2b, MurG, ATP-F, and AGPAT) based on antigenicity and conservation using several tools including CELLO v.2.5, Vaxign, v2.0, ANTIGENpro, and AllerTop v2.0 tools. Subsequent identification of linear B-cell and T-cell epitopes by SVMTrip and NetCTL/NetMHC II tools, respectively, guided the construction of a MEV comprising 10 Cytotoxic T Lymphocyte (CTL) epitopes, 5 Helper T Lymphocyte (HTL) epitopes, and 5 linear B-cell epitopes, interconnected by suitable linkers. The resultant MEV demonstrated high antigenicity, solubility, and structural stability. In silico immune simulations showcased the MEV’s potential to elicit robust humoral and cell-mediated immune responses. Molecular docking studies revealed strong interactions between the MEV construct and Toll-Like Receptors (TLRs) and Major Histocompatibility Complex (MHC) molecules. Remarkably, the MEV–TLR-4 complexes exhibited a low energy score, high binding affinity, and a low dissociation constant. The Molecular Dynamic (MD) simulation analysis suggested that MEV–TLR-4 complexes had the highest stability and minimal conformational changes indicating equilibrium within 40 nanosecond time frames. Comprehensive computational analyses strongly support the potential of the proposed MEV to combat dental caries and associated infections. The study’s computational assays yielded promising results, but further validation through in vitro and in vivo experiments is needed to assess its efficacy and safety.

Background and Aims Suicide among people experiencing homelessness is a rising concern, as due to the current economic and geopolitical reasons, people experiencing homelessness are on the rise. Studies have reported a higher rate of suicide among persons experiencing homelessness than the general population. The current available data and interventions to address this issue are limited. This research is aimed to review interventions available, specifically to address suicide and suicidal behavior among people experiencing homelessness. Material and Methods Electronic literature search was conducted using Google Scholar, PubMed, Science Direct, EMBASE, and Scopus up to July 31, 2024. Result A total search of 4035 studies was identified via literature, among which seven studies were included for the review. Discussion The factors causing higher suicide in the homeless population are multifaceted. The few studies available in this area show the efficacy of cognitive therapy for suicide prevention (CTSP), dialectial behavioral therapy (DBT), and electroconvulsive therapy (ECT) along with the efficacy of housing and emotional regulation in suicide prevention. Conclusion Limited data is available in this area. This marginalized group needs a holistic approach in suicide prevention, addressing both psychiatric as well as social aspects.

In many regions of the world, significant data collection, analysis, and availability on comorbidity and fatality incidents caused by COVID-19 during the lockdown period (2020–2022) is rare. This is especially true for hospitals and COVID treatment facilities in India. This lack of understanding impedes the development of appropriate treatment options, potentially resulting in inferior planning, patient recovery results, and a load on healthcare resources. This project intends to bridge the gap and enhance patient care in Assam, India, in light of the COVID pandemic. Furthermore, this study aims to determine baseline patient characteristics associated with an elevated risk of death among hospitalized COVID-19 patients in Assam. We employed machine learning (ML) and deep learning (DL) approaches to discover hidden patterns in patient data that could predict which individuals are more sensitive to severe consequences. This knowledge has the potential to transform patient care by allowing doctors to personalize treatment plans and prioritize resources for individuals who are most at risk. A retrospective observational analysis was performed using data from 5329 individuals hospitalized with SARS-CoV-2 illness between April and December 2021. ML and DL algorithms could be used to examine patient characteristics and identify risk factors for death (in this case, 554). We expect this to help us better understand the risk factors for in-hospital death among COVID19 patients in Assam. The findings could be useful in building risk assessment tools to guide patient care.

Background: Aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) is considered as an effective treatment option for oral premalignant lesions. ALA is a Food and Drug Administration (FDA) approved second-generation photosensitizer (PS) used both orally as well as topically. Objective: This systematic review aims to evaluate the efficacy of ALA-PDT for the treatment of oral premalignant lesions. Methods: The focused question was, "Is ALA-PDT effective in the treatment of oral premalignant lesions?"A literature search was made in PubMed/Medline and GoogleScholar using different combinations of the following keywords: photodynamic therapy, oral premalignant lesions, oral leukoplakia (OL), erythroplakia, oral erythroleukoplakia (OEL), oral verrucous hyperplasia (OVH); and oral lichen planus (OLP). Review articles, preclinical studies, case-reports, commentaries, letters to the Editor, unpublished articles, studies on photodynamic therapy used in areas other than the oral cavityand, articles published in languages other than English were excluded. The relevant information was summarized. Results: There were initially 64 results for the above parameters; 47 studies were excluded, leaving 17 studies for analysis. Characteristics of the included studies, PS, and PDT protocol were summarized. Conclusion: The outcome of the included studies suggested that ALA-PDT is an effective, easy to perform technique, well tolerated treatment with encouraging achievements in the treatment of oral premalignant lesions. No systemic side effects and skin photosensitivity were reported with topical ALA even within initial 48 hours after PDT, and patients were not required to avoid exposure to light following treatment. The clinical outcome of the ALA-PDT application, as reported in the studies, was also very promising, with either diminution in the size of the lesion or complete remission or improvement in signs and symptoms as well as reduced recurrence.

Background Streptococcus mutans and Lactobacilli play an important role in the etiopathogenesis and progression of dental caries (DC). Their quantification and identification may be helpful for epidemiological and early intervention measures. Objectives We conducted the study to evaluate the colony counts of S. mutans and Lactobacillus with the location of DC and correlate their prevalence with the age of the patient. Materials and methods The study population comprised 60 patients with DC. They were divided into two groups according to age, and each group was further divided into three subgroups based on involvement of enamel, dentin, and pulp by DC. The swab samples were collected, and organisms were isolated using Mitis Salivarius Bacitracin (MSB) Agar and Lactobacillus MRS Agar. Manual counting of colonies on plates illuminated by transmitted light was done. Results were summarized and analyzed statistically. Results The caries prevalence was found to be higher in children, with females being more affected. In both groups, posterior teeth were more affected, and occlusal/incisal surface caries were more common. The mean colony count of S. mutans (61.3%) and Lactobacillus (63.4%) was significantly higher in group I compared to group II. In both groups, the mean colony counts of S. mutans were higher in enamel, followed by dentin and pulp. In contrast, in both groups, the mean colony counts of Lactobacillus were higher in pulp, followed by dentin and enamel. Conclusion Bacterial colony counts may help in taking specific measures against specific organisms and thereby prevent the development of new carious lesions. How to cite this article Tandon A, Srivastava A, Singh P, et al. Beyond Decay: Exploring the Age-associated Variations in Streptococcus mutans and Lactobacillus in Dental Caries. Int J Clin Pediatr Dent 2024;17(9):993–998.

Arsenic contamination in groundwater poses a significant threat to human health, affecting millions worldwide. This study presents a novel approach for simultaneous remediation of both As(III) and As(V) by using iron-functionalized polythiophene (PTh@Fe) composites. The PTh@Fe composite was synthesized by a reduction process involving FeCl2/FeCl3 byproducts of polymerization, resulting in a highly efficient adsorbent for both As(III) and As(V) species. The investigation systematically examined key parameters influencing arsenic removal, including adsorbent dosage, pH, initial arsenic concentration, and contact time. The composite exhibited exceptional adsorption capacities, with maximum removal percentages of 98.7% for As(III) and 98.8% for As(V) under the optimized conditions. Thermodynamic and kinetic analyses suggested endothermic and spontaneous adsorption processes following a pseudo 2nd-order mechanism. Furthermore, the Langmuir isotherm model provided an excellent fit to the experimental data, with maximum adsorption capacities of 8.62 mg/g for As(V) and 7.57 mg/g for As(III). Density functional theory (DFT) calculations confirmed the feasibility of arsenic adsorption onto iron species in various oxidation states, offering valuable theoretical insights into the process. Furthermore, the composite demonstrated good reusability over multiple adsorption–desorption cycles and tolerance to coexisting anions, highlighting its practical applicability for water purification. This research demonstrates the potential of iron-functionalized polythiophene composites as a promising solution for addressing arsenic contamination in water sources, bridging the gap between innovative materials and theoretical understanding in environmental science and water treatment technologies.

Aim and objective: - To determine the pattern of ocular injuries and identify the most common cause of ocular injury attending tertiary eye care centre. Introduction: - Although the eyes make up only 0.1% of the body's surface, they are crucial for vision, a key part of daily life. Ocular trauma, a leading cause of preventable blindness and visual impairment, is under-recognized and lacks comprehensive population-based data, especially in developing countries, despite its signicant socioeconomic impact. Materials And Methods: - A Hospital based cross sectional study conducted on 240 patients, during a period of 6 months. This study was conducted based on the age, gender, visual acuity, time of presentation, mode of ocular injury, type of ocular injury, subtypes and laterality. Results: - Of the total 240 patients, the age group 21-30 years were the most affected with 64 cases (26.67%), the male gender made up the majority of cases with 178 numbers (74.1%), and the most common mode of injury was RTA with 116 (48.33%) of which lid laceration making up for 126 cases (52.50%). Conclusion: - RTA contributing to the majority of ocular injury cases in young adults is a matter of great concern, it not only affects the vision, but also impacts overall productivity at work. Creating road and driving safety awareness to youngsters must be made a priority by the administration.

Abdominal solid organs like liver, spleen and kidneys are one of the most vital organs of the human body. Liver is the second largest organ of human body with about 2 percent of body weight in adults. The spleen is the largest organ of the lymphatic system. Both the kidneys together represent 0.4 percent of the total body weight. They perform many of the vital functions involving excretion and detoxification, coagulation, immune function, absorption and storage of essential minerals and storage and filtration of blood. Injury to the liver, spleen and kidneys are one of the most common solid organ injuries in blunt trauma. The expected line of management includes initial diagnostics and resuscitation in the emergency room (including chest and pelvic X-ray, and bedside ultrasonography) followed by cross-sectional imaging (protocol-based trauma imaging with CT and contrast-enhanced multiphase protocols according to need). Initial resuscitation should be done in parallel with monitoring of vital signs with observation preferably in an ICU or high-dependency ward until definitive imaging and reporting has been completed and a management is planned. Treatment should be planned as per age, presence of co-morbidities, and changes in physiological status of the patient. Non-operative management should be preferred in patients of all ages irrespective of the grade of injury and in the absence of other abdominal injuries requiring interventions provided that the haemodynamic status is stable. Key words: Abdominal, solid, liver, spleen, kidney, injury, non-operative

INTRODUCTION Medical education in a global context as well as in India has evolved over a period of time. Adaption of competency-based medical education (CBME) through adequate faculty training and stakeholder participation can bring about vast changes in the ways of teaching and learning medical science. To gain more insight into the preparedness and perspectives of the faculties regarding the newly introduced CBME in a government medical college which is also an NMC Regional Centre, this study has been conducted. METHODOLOGY Faculties of Jorhat Medical College, Assam who gave consent to participate were taken up for the study. A questionnaire was prepared and circulated among the eligible faculties. Faculties who were unable to submit even after three visits were excluded from the study. The total duration of data collection was 2 months. A total of 87 responses had been documented. RESULTS 32.43% of the interviewed faculties had UG teaching experience of < 5 years, 67.56% more than 5 years, and 17.24% more than 20 years. 71.26% of the faculties have been trained in revised basic course workshops and 62.06% of the curriculum implementation support program. 62.06% of faculty members were able to both understand the concept and implement the CBME. Most of the faculties (65.51%) are of the opinion that having a separate logbook although highly feasible, it will be lowly acceptable. 80.45% of the faculties are of the opinion that early clinical exposure in Phase I will make the basic science curriculum more relevant. 66.67% of faculty views that around 1–3 years will be required for proper implementation of CBME. CONCLUSIONS The majority of the faculty members in the study were prepared to take on the challenge of execution of CBME. They also had a positive perception of the change of the curriculum and the facelift given to it.

Aim: To evaluate the aspect of Clinical Nihilism and Self fullled prophecy (SFP) in emergency neurosurgical patients in our Centre, Jorhat Medical College Hospital. Method and materials: A retrospective analysis was done in Jorhat medical college from November 2016 to October 2018 in which 483 patients critically ill patient evaluated with predicted poor outcome or death by neurosurgery department were included in the study. Data was collected using patients' data sheets and presented in tables and graphs. Simple descriptive data analysis was done with MS Excel. Results and observation: 483 patients who were predicted with poor outcome or death were included in our study. Among these 49 patients underwent operative management (14%) and 304 patients were treated medically (86%). The mortality in post operative group was 3 (6%) and in that of medical group were 42 (14%). 130 patients refused aggressive management (27%) and left against medical advice of which 113 (87%) died during transportation. 4 patients (3%) came back for follow up after 1 month with neurological improvement and rest 13 patients lost to follow up.64.5 % patients survived who were critically ill and was expected to have a poor outcome. Conclusion: There is no universally accepted accurate prediction model. Decisions to limit treatment should be balanced with avoidance of self-fullling prophecies of poor outcome due to clinical nihilism.