Suamandeep Vidyapeeth University

Acute generalised exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction which is caused due to drugs or other triggers in children. We report a very rare case of AGEP after introduction of oral cefixime for a female child who presented with complaints of fever, cough and cold for 6 days. It was noted that she developed a rash over the face within 24 hours and within the following few hours, it spread over the neck, in the axilla and over the groin. The patient has no history of allergy and had no history of similar reaction in the past. On examination, the patient was vitally stable with no sign of shock or any other significant systemic findings. The rash was characterised by erythematous base with multiple pinpoint pustules and culture of those was sterile. Haemogram was suggestive of mild leucocytosis with normal liver and renal functions. Treatment included stopping the triggering medication, that is, syrup cefixime and starting the child on oral corticosteroids along with antihistamines. The child started improving within 48 hours of medication, and rashes recovered with desquamation. AGEP is an adverse reaction which is rarely noted in children. It is treated with oral corticosteroids and supportive care of the local lesions.

A sensitive, accurate, robust, and precise analytical quality by design (AQbD)-based RP-HPLC (reverse-phase high-performance liquid chromatography) method has been developed for the simultaneous estimation of perindopril erbumine and moxonidine hydrochloride, both used in hypertension treatment. Initially, a three-level factorial design screened various parameters impacting chromatographic responses, followed by Central Composite Design (CCD) for optimizing the critical parameters. This cost-effective isocratic method employed a Shimpack ODS C-18 column (250 mm × 4.6 mm, 5 μm) as the stationary phase. The method, developed and validated in line with ICH Q2 (R1) guidelines, utilized a mobile phase comprising methanol: acetonitrile: phosphate buffer (34:30:36 v/v/v) adjusted to pH 3.5 with 1% ortho phosphoric acid, at a flow rate of 1.0 mL/min, a column temperature of 40 ºC, and UV detection at 214 nm, achieving efficient separation of both drugs. Linearity ranges were 25–125 μg/mL for perindopril erbumine (r2 = 0.9996) and 1–5 μg/mL for moxonidine hydrochloride (r2 = 0.9993). This newly developed RP-HPLC method effectively enables routine quantitative and simultaneous qualitative analysis of these compounds in bulk and synthetic mixtures. Additionally, the method’s greenness and environmental safety were evaluated using eco-analytical metrics (eco analytical scale, NEMI, GAPI, and AGREE), confirming its ecological capability.

Background The substantial saturation of the gingiva poses a significant esthetic issue for multiple individuals. Melanin saturation arises from melanin located within the gingival epithelium. Even though surgical depigmentation using a scalpel remains the favored system for managing gingiva pigmentation, it affects open wounds requiring specific dressing and management. Aim The purpose of the study was to evaluate and compare the efficacy of Coe-Pack dressing and BlueM active oxygen gel in reducing pain after surgical depigmentation and evaluating gingival healing. Materials and Methods Thirty-four nonsmoking individuals aged 20–38 years with physiologic gingival pigmentation index III and IV according to the Dummett–Gupta Oral Pigmentation index were enrolled in this split-mouth randomized clinical trial. These individuals were selected for an esthetic treatment for gingival hyperpigmentation of the gingiva. After depigmentation with a scalpel, the maxilla and mandible were separated to admit either BlueM gel or Coe-Pack as a dressing. A 1-week, 2 weeks, 3 weeks, and 4 weeks long follow-up period was observed, and indices, including the Dummet–Gupta Oral Pigmentation Index and re-epithelization index using toluidine blue dye, were evaluated and the Visual Analog Scale Pain index was also evaluated at 2 h, 24 h, 2 days, 3 days, 4 days, 5 days, 6 days, and 7 days follow-up period. Results In total, 34 surgical sites were covered in this investigation. The pain indicator showed statistically significant variations from 1 day to 5 days later. After 3 weeks, the reepithelization index showed an advanced meaningful difference in the BlueM gel group. Conclusion BlueM gel’s pain reduction, wound healing acceleration, and postoperative reepithelization make it a viable choice for the Coe-Pack dressing following gingival depigmentation.

Concrete technology is widely favoured in construction for its affordability, performance, and effectiveness. However, there's a growing need for it to be more durable, energy-efficient, and environmentally friendly. Achieving these goals involves incorporating or substituting energy-efficient materials from industries, such as bottom ash, fly ash, and steel slag. Additionally, recyclable materials like Sugarcane Bagasse Ash (SBA) and Metakaolin (MK) can be utilized in concrete production. The combined effects of MK and SBA on concrete's mechanical properties were investigated through various destructive and non-destructive tests, including compressive strength, splitting tensile strength, flexural strength, Ultrasonic Pulse Velocity (UPV), and Digital Schmidt Rebound Hammer (RH) testing. Different ratios of MK and SBA, ranging from 5% to 20%, were used to partially replace cement by mass in the design of M-35 grade concrete, while M-sand replaced fine aggregate entirely by volume. Experimental results suggest that concrete incorporating industrial waste materials like SBA and MK outperforms conventional concrete, as evidenced by both non-destructive and destructive testing methods.

Aim The aim of the study was to compare and evaluate proximal contact tightness and contours using two newer contact-forming systems in Class II composite restorations. Materials and Methods After institutional ethical approval and Clinical Trials Registry-India registration, patients were chosen according to the inclusion-exclusion criteria with informed consent. A total of 60 patients were randomly assigned to two groups. Group A: LM Arte contact former ( n = 30) and Group B: The design village (TDV) contact former ( n = 30). Quadrant isolation was performed after the complete elimination of dental caries, preceded by the insertion of a matrix band and retainer with the proper wedging system. The LM Arte with the appropriate tip was selected for Group A, whereas the TDV contact former was selected for Group B based on the cavity size. Following the conversion of Class II cavities to Class I, nanohybrid resin composite restoration was done by cuspal layering. It was followed by finishing and polishing. E. B. Hencock criteria were used to evaluate gingival index, pocket depth, interproximal calculus, overhangs, food impaction, and contact integrity in both groups at baseline, 6 months, and 1 year. Statistical Methods The data were analyzed using the Chi-Square test with SPSS (Statistical Package for Social Sciences) software version 18.0, IBM. Results A statistically significant reduction in gingival index score was observed in both groups 6 months and 1 year after the procedure. However, the values revealed in terms of gingival index ( P < 0.05) and ( P > 0.05) for pocket depth, interproximal calculus, overhangs, food impaction, and contact integrity in both groups for 6 months ( P > 0.05) and ( P > 0.05) after the procedure. Conclusion Both the LM Arte and TDV contact-forming systems are effective in establishing perfect proximal contacts and contours. However, the LM Arte contact-forming system edges out the TDV contact-forming system.

Purpose : Anterior Cruciate Ligament injuries are the most commonly seen injuries in the athletes, not all of these injuries need to be operated and can be treated conservatively, while many of them choose surgical intervention there is no certainty of the person returning to pre injury level without proper rehabilitation. Here Cross-Bracing protocol plays an important role, which tends to heal the ACL without surgical intervention by usage of brace for a particular period of time while taking regular physiotherapy rehabilitation. There is a limited knowledge of the same among Physiotherapists, so our study aimed to check awareness about this protocol among the Physiotherapists. Methods : A google form questionnaire was circulated among the Physiotherapists via mail and all social media platforms and data was collected for a period of 8 months. Calculated sample size was 80. Descriptive statistics, including frequencies and percentages, were used to analyze the survey responses. Results : A total of 82 participants (34 males, 48 females), with ± 4 years of practice completed the survey, where varying levels of awareness about ACL injury management and cross bracing protocols was observed. With 16.9% incorporating the protocol in regular practice. Conclusion: The survey highlights that physiotherapists recognize the value of managing ACL injuries and using cross bracing, giving desired outcomes. Despite its perceived benefits, only few physiotherapist consistently use cross bracing in treatment plans, indicating a need for further education on clinical guidelines and its long-term advantages, especially for high-risk groups.

Background Knee arthrodesis was originally developed to manage severe joint infections such as tuberculosis before the advent of antibiotics and joint replacement techniques. The procedure aims to eliminate pain and infection by stabilizing the knee joint through bone fusion. Knee arthrodesis remains essential for cases where total knee arthroplasty is not feasible, such as in patients with severe bone loss, chronic infections, or failed knee replacements. Many studies have demonstrated fusion by external fixators because infection is the most common indication of this procedure. We studied knee arthrodesis using Charnley’s compression clamps which are easy to apply and economical. Methodology A prospective observational study was conducted on 15 patients for 18 months. Patients with an infection in the knee joint (septic or tuberculous), failed total joint arthroplasty, failed fracture fixation around the knee joint, and neuropathic joints were included in the study. Patients were evaluated using the pre and postoperative Knee Society Score and Knee Society Score (Functional). Results In the study, 80% of the patients were males. Septic arthritis and tuberculosis were common indications for the surgery. More than 70% of the patients were previously operated on the same knee joint. The duration of the fixator ranged from 32 weeks to 39 weeks (7.47 months to 9.1 months) with an average of 35.73 weeks (8.34 months). The final follow-up period ranged from 9.5 to 18 months with an average of 14.1 months. The knee score ranged preoperatively from 5 to 22 (average = 16.2) and improved postoperatively ranging from 50-56 (average = 54). The functional score ranged preoperatively from 40 to 50 (average = 43.60) and improved postoperatively ranging from 80 to 100 (average = 89.66). Conclusions The fusion by Charnley’s external clamps is easy, cost-effective, and comfortable for the patients. The complications are relatively fewer and the success rate of the fusion is higher with this treatment method.

A BSTRACT Context Stretching and strengthening for rheumatoid arthritis of the hand (SARAH) is a progressive and individually designed recommended treatment exercise program. Aims The aim was to translate the SARAH hand exercise program into Gujarati and assess the adherence rate, usefulness, and understanding of the Gujarati SARAH exercise program. Methods and Materials Mixed-method qualitative study was conducted among 25 participants at the outpatient departments of Institute Nadiad and Niruj Rheumatology Clinic, Gujarat, and via professional contact, a telephonic semi-structured interview was conducted among 13 participants using an interview guide, and interviews were audio-recorded following transcription verbatim. Overall adherence rates of 25 participants to a 12-week exercise program were determined using the cross-sectional method. Statistical Analysis Used IBM SPSS software version 23.0 was used for analyzing quantitative data, and NVivo Plus version 11 was used for qualitative data. Results The adherence rate was 97.22%. Participants completed all 72 sessions ( n = 7) with an adherence rate of 100%. The least number of sessions completed was 25 ( n = 2), with an adherence rate of 34% due to a lack of interest in exercising on a daily basis. Qualitative findings showed that the booklet is understandable, useful, and beneficial in terms of reducing symptoms and improving activities of daily life as well as occupational work. Conclusion The translated strengthening and stretching for rheumatoid arthritis in the hand exercise booklet is effective and beneficial to patients who exercise at home. Participants can self-track their exercise by using dairy, which eliminates travel costs and attendance at clinic sessions.

Background Mothers and fathers may experience negative emotions as a result of an unusual early delivery and giving birth to high-risk newborns who require hospitalization in the neonatal intensive care unit (NICU) adds layers of stress on them. Hence, a variety of psychological and emotional services are required. Aim The aim of this study was to identify common stressors in both parents of preterm children in the NICU and determine the effect of psychological intervention in the form of acceptance and commitment therapy (ACT) on stress in both parents. Materials and Methodology A total of 60 parents of preterm children were randomly assigned to Intervention Group A and Control Group B. Group A received five sessions of ACT and routine counseling, while Group B received only routine nursing staff counseling. The Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) was used for pre- and postassessments to measure the parents’ stress levels on the 1 st and 5 th days, respectively. Results Mothers’ stress levels in the NICU are significantly higher when they have a higher socioeconomic status, a higher education level, and a length of stay of more than 6 days, but significant stress is not found in fathers. ACT, when used along with routine counseling, is effective in reducing stress in both parents. Conclusion ACT can be combined with routine counseling to help parents cope with depression, anxiety, and stress associated with preterm birth in the NICUs.

Background India started the National Programme of Pharmacovigilance in 2005, which was renamed as Pharmacovigilance Programme of India in 2010. This is the main portal for detecting and reporting the adverse effects of drugs. Aim This study aimed to evaluate the knowledge, attitude, and practice (KAP) of pharmacovigilance (Pv) in a dental teaching institute in Western India. Materials and Methods The KAP questionnaire regarding Pv was distributed among the dental faculties. The knowledge-based questions were corrected and the scoring was given as excellent knowledge, good knowledge, fair knowledge, and poor knowledge for the scores between 0–5, 6–10, 11–15, and 16–20, respectively. Descriptive statistical analysis was performed which is presented as frequencies ( n ) and percentages (%) in all three sections of the questionnaire. Results and Observations The knowledge of 24 (44%) participants was found to be fair with scores between 6 and 10. The knowledge of 23 (42%) participants was found to be poor with scores between 0 and 5 and the knowledge of 8 (14%) participants was found to be good with scores between 11 and 15. A positive and promising attitude was exhibited by the dental faculties toward reporting adverse drug reactions (ADRs). Only two study participants had reported an ADR event. Conclusion The deficiencies in knowledge appear to be the underlying factor for the underreporting of adverse reactions encountered by dental practitioners.

Background A strong gag reflex could make it difficult for patients to accept and get dental care. Orthodontic models are needed for the diagnosis and treatment planning of occlusion and space management. Digital impressions can help to eliminate certain disadvantages, especially in children. Aim To compare the anxiety, comfort, and time required to record digital and alginate impressions in children (8–12 years). Materials and Methods A sample size of 30 was estimated and allocated into two groups. Group A: Alginate impressions were recorded on day 1. Group B: The digital impressions were recorded on day 1. Dave’s Hand Gesture Scale was given to measure the anxiety. After 7 days, the impressions of Group A were recorded using digital technique, whereas alginate impressions were recorded of children under Group B. The intraoral and overall time was recorded for both the impression techniques. Finally, a questionnaire was given to all the children to evaluate their comfort and preferences. Results The data were analyzed with SPSS software version 20.0 and used Chi-square analysis and Student’s t -tests where a significance value <0.05 was considered. The intraoral and overall time was less in digital impressions, and anxiety and comfort were found more in alginate impressions than digital impressions. Conclusion Digital impressions were recorded faster than alginate. When the anxiety was assessed, the digital impressions were considered to be more comfortable than the alginate methods.

Background Maintaining optimal oral health is crucial for all children, but it holds particular significance for visually impaired children (VIC). Neglecting oral health can lead to a myriad of issues such as dental caries, gum disease, traumatic dental injuries (TDI), and even systemic health problems. Therefore, tailored interventions are essential to ensure their well-being and life quality. Aim The current research aimed to assess the oral health status and treatment needs among VIC. Materials and Methods The cross-sectional survey was conducted on 300 VIC in Vadodara city between September 2022 and December 2022. The oral examination was done in the respected school in the daylight with a normal sitting chair. Oral health status was checked according to the World Health Organization criteria (2013). Malocclusion was checked according to Angle’s classification of malocclusion. Descriptive statistical analysis was used. Results The prevalence of dental caries was found to be 65%. 70% of children showed periodontal condition. TDIs among VICs were 40%. There is a high prevalence (91%) of Class I malocclusion. Most of the children require prompt treatment. Conclusion The study reveals alarming dental health issues among VIC in Vadodara. With 65% experiencing dental caries, 70% displaying periodontal conditions, and 40% suffering from TDI, the oral health challenges are significant. Furthermore, a striking 91% exhibit Class I malocclusion. These findings underscore an urgent need for comprehensive dental care and tailored interventions to address the substantial oral health disparities in this vulnerable population. Immediate attention and specialized treatment plans are crucial to improving their overall well-being and quality of life.

An accessory abductor pollicis longus (APL) tendon is present in more than 80% of people, but a separate muscle belly is present in only 20% of people. The present article documented the atypical anatomical variation of APL found during routine dissection. The muscle had three bellies and three tendons with unique bifurcation and attachments in the right upper limb of a 52-year-old male cadaver. The variation of APL is clinically important for surgeons doing flap surgeries, tendon transfer, for surgeons dealing with De Quervain’s tenosynovitis, and in any operative procedure involving the forearm and hand. Multiple APL tendons can be regarded as a functional advantage since injured tendons can be compensated by healthy ones. In addition, knowledge of the anatomy of the area is essential for treating this condition surgically by performing a tendon release after conservative treatment has failed.

A class of intricate musculoskeletal diseases known as temporomandibular disorders (TMDs) affects the temporomandibular joint (TMJ) and its supporting structures. The majority of individuals will at some point in their lives experience some degree of TMD symptoms, as these diseases are highly prevalent in the general population. TMDs are multifactorial and are attributed to various physical and biopsychosocial factors. The TMD patients typically experience preauricular pain, tenderness of masticatory muscles, and joint sounds, and these in turn affect their quality of life. To carry out the appropriate course of treatment, it is critical to make an accurate and timely diagnosis. The TMDs are classified as myofascial pain, internal disc derangement, and degenerative disorders of TMJ. Myofascial pain, which is identified by palpating the affected muscles of mastication and tenderness, is one of the most common findings. The muscles in this condition become stiff due to the contraction of myofibrils and are known as trigger bands. The diagnosis of trigger bands involving the masticatory muscles commonly involving the masseter muscle in myofascial pain to date is subjective, and palpation is the only tool used for its diagnosis. An objective assessment of the masticatory muscles is desirable for accurate diagnosis and treatment planning. Various tools like electromyography and hardness meters have been for assessing muscle stiffness, but their application in TMJ muscle disorders has not yielded valuable results. A novel diagnostic method called ultrasound elastography evaluates muscle stiffness both qualitatively and quantitatively using an elastogram and the muscular elasticity index. In this paper, we will review the ultrasound elastographic techniques utilized for the diagnosis and management of TMDs.

species are a major cause of nosocomial infections, contributing significantly to morbidity and mortality globally. This study aimed to evaluate the antibiotic susceptibility profiles of isolates derived from various clinical specimens at a tertiary care hospital in Vadodara, Gujarat. : Specimens were cultured on 5% sheep blood agar and MacConkey agar, followed by identification and antibiotic susceptibility testing using the VITEK 2 automated system (BioMerieux, France). : Among 107 positive samples collected from January 2021, to October, 2021, the highest frequency of isolates was observed in urine samples (48, 44.86%). A significant majority of isolates (89, 83.17%) exhibited resistance to three or more classes of antibiotics. Colistin susceptibility was observed in 101 isolates (94.4%). The susceptibility rates for were 75.7% for tigecycline and 47.7% for carbapenems. : The combination of colistin and tigecycline remains crucial for treating multidrug-resistant until new therapeutic options become available. This study underscores the necessity of ongoing antimicrobial resistance surveillance and the strengthening of antibiotic stewardship programs to reduce the prevalence of resistant Acinetobacter strains and other bacteria.

The VA assessment of children within the different age groups is a very tough task somewhat due to of cooperation of children. However, the method of estimation of pediatric VA is based on different types of concern according to age. VA is a compound function of the minimum visibility, resolution, recognition and minimum discriminability. Sometimes the VA is hampered due to the types of refractive error and the initial correction of the error is also an important issue. The 5 to 6 years of age children with normal growth respond easily and they can be observed with the adult method but the youngest school-age children can be estimated with nonverbal methods. The growth of social and educational development of the children can retard due to acuity impairment but early detection and visual correction enhances the issue.The pathological disorders in childhood like corneal and lenticular disorders, macular degeneration, tumours, multiple sclerosis etc., turning of the eye from the standard called strabismus and it happens due to the reduction of the VA and the loss of binocular vision. Thus visual acuity is an approach for the assessment of ocular health along with the visual brain and its pathway.

Purpose Handgrip strength and hand–arm anthropometric measures were essential for preventing injuries and developing overall strength in player selection and practice enhancement in sports like basketball and volleyball. The purpose of the study was to assess the hand grip strength and hand–arm anthropometry measures of both players and compare the hand grip strength and hand anthropometric measures of volleyball and basketball players. Methods A cross sectional study was conducted at the sports field. Data was collected over a three-month period (February–April 2019). A total of 60 players (n = 30 volleyball and n = 30 basketball) were recruited for the study based on inclusion criteria using the purposive sampling method. Hand–arm anthropometric measurements were used to measure the components of the arm, hand, and fingers, along with their grip strength. Descriptive analysis was performed to analyze the anthropometric measures and grip strength of both groups. Pearson correlation analysis was performed to ascertain the relationship between anthropometric variables and grip strength. T test was performed to compare the grip strength of both groups. Data were analyzed using SPSS version 23. Results There was a major difference (MD = 3.63) seen among volleyball and basketball players. The hand grip strength of basketball players was greater (p = 0.021) than the volleyball players. The finger span, finger length, and perimeter showed significant correlation (p < 0.05) between basketball and volleyball players. Conclusion The study concludes that basketball players had relatively more strength than volleyball players. A significant correlation has been seen between grip strength, finger span, and hand perimeter.

Background Children’s fear and distress in dental settings often lead to anxiety and behavior issues. This study delves into why some children experience dental anxiety, whereas others do not, attributing differences to child-rearing and personality traits. Emotional intelligence (EQ), the ability to comprehend, generate, and manage emotions, is explored as a factor influencing a child’s dental experience. This novel intelligence theory accommodates the intricacies of human–environment interactions. Aim The study aimed to investigate the relationship between EQ and a child’s dental anxiety, fear, and behavior in children aged 8–12 years. Materials and Methods The Trait Emotional Intelligence Questionnaire-Child Short Form, specifically developed for children aged between 8 and 12 years, was used among 100 participants reporting to the department outpatient department. The Frankl’s Behavior Rating Scale, Modified Child Dental Anxiety Scale, and Children’s Fear Survey Schedule-Dental Subscale were used to evaluate behavior, anxiety, and fear, respectively. Results Results show a positive correlation between EQ and dental behavior ( P = 0.002) whereas a negative correlation between EQ and dental anxiety and fear ( P < 0.001). Conclusion This study sheds light on the intricate interplay between emotional intelligence, dental behavior, anxiety, and fear among children. By recognizing the impact of EQ, dental practitioners could adopt personalized strategies to alleviate anxiety and enhance cooperation, improving overall dental experiences for young patients.