042398   DAMODARAN D, NIGAT FATHIMA P.A., PAI S, SHAIK A (Yenepoya Deemed To be univ, Nithyananda Nagar, Derlakatte-575 018) : Comparative study between efficacy of circuit training and interval training in improving exercise capacity among chronic kidney disease patients. Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

Exercise has several benefits in general population in reducing risk of cardiovascular mortality. Aerobic, resistance and combined exercise are several forms of exercises suggested in CKD to improve quality of life. Circuit training and interval training are two important forms of high intensity aerobic resistance training. There is a limited data that compares these two forms of exercise and their benefits in CKD. Hence this study was designed to find and compare the effectiveness of circuit training and interval training in improving exercise capacity amongst CKD.This was an intervention study. Patients aged between 36-71 years with CKD stage 2-5, who were hemodynamically stable, who could perform activities and not having associated co morbid conditions were included. Those with chronic heart failure and co morbid conditions were excluded. 82 patients were recruited, with 41 in each of circuit training and interval training group. The intervention (circuit based and interval based) lasted for 8 weeks in total, with exercise sessions lasting for 50-55 minutes at a frequency of 3 sessions per week. The progression of intensity, frequency and duration was monitored and controlled by Borg’s perceived exertion scale applied for resistance exercise. 6 minutes walk test prior and after exercise at baseline and after 8 weeks was recorded along with vitals. 120 patients were screened from February 2016 through January 2017 for eligibility to participate in this study, patients assessed for eligibility to participate, 38 individuals were excluded because they did not meet inclusion criteria or declined to participate in the study after the initial screening according to inclusion criteria selected the sample 41 patient each has selected for each group rest of them excluded from the study. Conducted study for total duration of 1 year, each patient had trained for 8 weeks. 2 weeks supervised and 6 weeks home based. All were performed well during training period. Baseline characteristics were similar and both circuit and interval exercise intervention showed improvement in 6 minutes walk test.

1 tables, 8 ref

042397   SHARMA B, THAKKAR H (D.Y. Patil Univ, Nerul, Navi Mumbai, Maharashtra) : ACL injury prediction in footballers using landing error scoring system (LESS). Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

The use of clinical field assessment tools is popular in sports rehabilitation settings. The purpose of these tools is not only prediction of injury but also to assist in development of injury prevention programs. Landing Error Scoring System (LESS) is a clinical tool that evaluates biomechanical performance during a jump-landing task with particular focus on aspects related to an increased risk for ACL injury. Of this study was to find the most common faulty biomechanics in football players. This is an evaluation-based study which predicts the risk of ACL injuries in 30 football playersbased on their jump landing mechanics. This evaluation was carried out with the help of software Kinovea that helps in analysis of joint kinematics. The data captured with the help of off-the-shelf cameras in frontal and sagittal planes and analysed. The frequency of common errors was identified. It was found out that 20 % of the players had poor landing mechanics having maximum errors, 20 % had moderate errors, while 13 % had good score and 47 % had excellent landing mechanics. The most common error was knee valgus at initial contact, stance width wider and knee valgus displacement. LESS is beneficial in identification of faulty biomechanics. LESS when used along with Kinovea helps analyse common jump landing errors. Knee valgus along with internal rotation of tibia was found to be the common error which predisposes footballers to ACL injury.

11 ref

042396   DANGI B, BHISE A (Government Physiotherapy Coll, Asarwa, Ahmedabad) : Effect of fireworks pollution on human health during diwali festival: A study of Ahmedabad, India. Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

India has a long tradition of celebrating diwali festival by burning firecrackers. The fireworks release a large amount of air pollutants which have a detrimental effect on human health. Very few studies have done to examine the detrimental effect of fireworks pollution on human health and no scientific study has done in Ahmedabad. The aim of the study is to examine the effect of fireworks pollution on human health. Four residential areas were included in Ahmedabad city. Total 252 people were participated in the study. The structured questionnaire was used to inquire about symptoms like breathlessness, cough, wheeze, runny nose, eye irritation, allergy, itchy skin. Microsoft excel 2010 software was used for analysis. We found that 48 % of subjects complained of cough, 38 % of subjects complained runny nose and eye irritation, 27 % subjects complained breathlessness, 5 % subjects complained allergy and itchy skin and 2 % subjects complained wheeze. The study concludes that there is harmful effect of fireworks pollution on human health and the symptoms of cough, runny nose and eye irritation were most common.

1 tables, 19 ref

042395   SHAH A, HONKALAS P (DPO’S Nett Coll of Physiotherapy, Thane, Mumbai) : Assessment of risk of fall in depressed elderly individuals. Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

Aged as the word is used in society may or may not correlate with the general condition of the individual but more often refers to the individual’s loss of capacity to maintain independence. Falling is a ubiquitous event experienced by all throughout life. Most falls in children and young adults are of minor consequences and readily forgotten and have no impact on subsequent function. To assess risk of fall in depressed elderly individuals. Observational study design. 60 subjects were included in the study according to the inclusion and exclusion criteria. Subjects having depression were included in the study. Risk of fall was assessed in depressed elderly individuals. The result shows that there is moderate to high risk of fall in depressed elderly individuals.. The study concluded that there is moderate to high risk of fall in depressed elderly individuals
which is statistically significant.

1 tables, 12 ref

042394   SHAIKH A A, GAD A (Opposite Maharashtra High School, Dadar West, Mumbai- 400 028, Email: akshayagad@gmail.com) : Physical activity promotion in the physical therapy setting: Perspectives from practitioners and students in Maharashtra. Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

Physical activity promotion and practice may vary in health care providers. 600 participants (300 Physiotherapy final year students and interns +300 practicing therapists) filled the Standardized Physical activity promotion and practice questionnaire. PT students and Practitioners strongly agreed that, they should promote physical activity and act as a role model for their patients to lead a healthy life style (54 and 65,60 and 71 percentages respectively). Percentage of students practicing physical activity and promoting it was higher than therapists (57 and 38, 37-some times, 45-rarely). Although students and therapists strongly agree for practice and promotion of physical activity they, lack in promotion of it due to various reasons. Students were found to be promoting and practicing physical activity more than the practitioners.

33 ref

042393   PATIL A M, THANGAVELU P D (Cardio Pulmonary Dep, Krishna Institute of Medical Sciences ‘Deemed To Be’ Univ, Karad, Maharashtra, Email: vishnudevi25@yahoo.com) : Effect of home exercise protocol on exercise tolerance and quality of life in post CABG subjects. Indian J Physiother Occup Ther 2020, 14(2), 10.37506/ijpot..

Coronary artery bypass grafting (CABG) rehabilitation protocols were developed to restore patient’s daily activities emphasizing physical and functional fitness. Home exercise protocol includes aerobic and resistance exercise framed to perform with graded complexity and much motivation. 1) To determine the effect of home exercise protocol on exercise tolerance and quality of life in post CABG subjects and 2) To determine the effect of conventional physiotherapy on exercise tolerance and quality of life in post CABG subjects. Ethical Clearance was obtained from institutional ethical committee. A total 70 post CABG subjects were selected and divided into two groups. Group A(n=35) received conventional physiotherapy which includes walking, shoulder and thoracic mobility exercises, breathing exercises along with medications for 1 hour/day and 5days/week and Group B (n=35) received home exercise protocol which includes aerobic exercises and resisted exercises along with conventional physiotherapy. The preassessment of exercise tolerance is measured by 6 Six Minute Walk test (6MWT)and quality of life with SF36 questionnaire an postinterventional assessment was taken for the same after 3 months. Intergroup statistical analysis for 6MWT revealed significant in postintervention for Group B(p<0.0001).QOL was extremely significant for group B (p<0.0001). Group B treated with home exercise protocol have statistically significant improvement over group A in 6 minute walk test and quality of life. Hence home exercise protocol is effective in improving exercise tolerance and showed increased quality of life in post CABG subjects.

4 illus, 3 tables, 18 ref

042392   PRABHU S, DESAI M, HARER S (Kinesiotherapy and Physical Diagnosis Dep, D.Y. Patil Univ, Nerul, Navi Mumbai, Maharashtra) : Effect of chalk dust exposure on PEFR and CAT in school teachers. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

In teachers, occupational exposure to chalk dust is very common. Classrooms contain of fine particulate matter that source from chalk dust. To further evaluate and study the symptoms of respiratory illness in school teachers, the present study was conducted in order to evaluate individual’s degree of obstruction using the PEFR, and its impact on their overall health, using COPD assessment test. This comparative study was conducted in 40 School teachers and 40 normal healthy individuals. The data for this study was collected using mini Bell’s PEFR device and the COPD Assessment test (CAT). An analysis of the data showed that the mean CAT score of group A (teachers) was significantly higher (p=0.001) than group B (normal individuals). The mean PEFR for group B was higher than group A, although the difference was not statistically significant.
Hence, the study concluded that respiratory symptoms significantly impacted the health of school teachers. They also showed signs of airway obstruction as compared to normal individuals.

1 illus, 25 ref

042391   BARUAH S, VIJAYAKUMAR R V (The Oxford Coll of Physiotherapy, Hongasandra, Bangalore) : Cross-sectional study to identify iliotibial band syndrome causes among treadmill runners and its impact on functional activities. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Running causes overuse injuries and ITBS (Iliotibial band syndrome) is one of the most common injury. Risk factors of ITBS includes ITB tightness, abductor weakness and biomechanical differences. People using treadmill without ruling out faulty biomechanics leads to ITBS. Objectives: i) To find the causative factor for ITBS among treadmill runners. ii) To find out the impact of ITBS in functional activities among treadmill runners. 120 samples fulfilling the selection criteria were included. Age, lateral knee pain, speed of running, number of days running per week, since how many months, for how many minutes were collected. Participants with lateral knee pain were assessed using NCT (Noble compression test). Subjects were assessed with hip abductor strength test, NPT (Navicular position test), TT test (tibial torsion test) and Q angle measurement. Common cause for ITBS among treadmill runners was evaluated. Participants were screened for their functional activity using the LEFS (lower extremity functional scale) and scored accordingly. Mean age calculated is 27.88±3.91 yrs, running since 12.08±5.82 months, for 23.58±4.91 minutes, 4.06±0.8 days a weeks, with a speed of 6.75±0.57 m/sec. 40.83 % of the subjects had ITBS due to hip abductor weakness, 15.83 % of the subjects had a FF(flat feet) and int.TT while 14.17 % had int.TT. Increased Q angle and ext.TT was found in 9.17 %. 5 % had hip abductor weakness and increased Q angle whereas 2.5 % of the subjects had all the four components present. The mean score obtained by all the subjects with ITBS in the LEFS scale is 63.12±5.33. Study concludes that hip abductor weakness alone is the major cause of ITBS among treadmill runners. FF and int.TT being second most important cause. Mean score of ITBS in LEFS scale is 63.12±5.33.

4 illus, 2 tables, 15 ref

042390   SRIKANTH I , SHISHIR SM S, YAMAMALINI S , NAJIMUDEEN SYED N (Physical Medicine and Rehabilitation Dep, Pondicherry Institute of Medical Sciences, Puducherry, Email: srikanth19804@gmail.com) : Proprioceptive and functional outcome of the knee in arthroscopic anterior cruciate ligament reconstruction of a preserved remnant tissue. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Injury to the ACL(Anterior Cruciate Ligament) not only causes mechanical instability but also leads to functional deficit in the form of diminished proprioception of the knee joint. This study analyzes and reviews our understanding of the sensory element of ACL deficiency, with specific reference to proprioception as an important component of functional knee stability. 100 patients who underwent ACL reconstruction surgery and completed Simple and Effective Rehabilitation Protocol(SERP) with minimum duration of 2 years from surgery to follow up, were all assessed for proprioception, stability and functional outcome of the reconstructed knee. They were assessed by the knee joint position sense, single leg hop test for both the normal and reconstructed knee and KOOS questionnaire respectively. Chi square table value for 1degree freedom at 0.05 was 3.84, hence the calculated Chi square values of proprioception knee in supine lying, proprioception knee in standing and single leg hop are less than table value of the accepted hypothesis which concludes that, there is no significant difference between the scores of selected outcome variables among reconstructed knee and normal knee subjects. The calculated paired‘t’ and ‘t’ table value with respect to the functional outcome of knee in operated and normal subjects was 6.53 and 2.66 respectively at 0.005 level. There was no significant difference of Proprioception between the scores of selected outcome variables among reconstructed knee and normal knee in supine lying, standing and single leg hop. But it shows that there is significant difference of 2.66 at 0.005 level between reconstructed knee and normal knee groups with respect to the functional outcome of knee after two years of follow-up in ACL reconstructed knees.

3 tables, 27 ref

042389   BASU S, EDGAONKAR R, BAXI G, PALEKAR T J , VIJAYAKUMAR M, SWAMI A, TAI M Z (Dr. D. Y. Patil Coll of Physiotherapy, Mumbai - 400 067, Email: rajasedgaonkar11@gmail.com) : Comparative study of instrument assisted soft tissue mobilisation vs ischemic compression in myofascial trigger points on upper trapezius muscle in professional badminton players. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Pre-post experimental study design. Background: The presence of trigger points over trapezius muscle is one of the major reasons of injuries in badminton players. Trigger points affect the flexibility of muscles which if untreated leads to dysfunctions. This alters the biomechanics of badminton gameplay. Hence, present study was undertaken to find out and compare the effects of Instrument Assisted Soft Tissue Mobilization and ischemic compression in trapezius trigger points in badminton players. In this study, 30 participants were recruited based on inclusion and exclusion criteria. They were divided in 2 groups of 15 each. Each intervention was administered to them for a period of 2 weeks, 2 sessions per week in respective groups. Pre and post assessment was taken using following outcome measures-NPRS, pain pressure threshold and cervical range of motion. There was significant increase in the pain pressure threshold of the players and the cervical range of motion in the IASTM group. There was decrease in the NPRS findings in the IASTM group. The results suggested that IASTM showed better results than ischemic compression in relieving trapezius trigger points.

3 illus, 2 tables, 16 ref

042388   PUNLOMSO S, SRIMUANG P, TUDPOR K (Mahasarakham Univ, Maha Sarakham, Thailand, Email: kukiat.t@msu.ac.th) : Fall prevention by otago exercise program based on health belief model in community-dwelling older persons. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Health belief model (HBM) has been widely used to communicate with older persons in order to change their behaviors. This group of people have a higher risk of fall due to poor postural balance and inappropriate fall-related behaviors. Home-exercise programs like Otago exercise program (OEP) can ameliorate postural balance, but most of the older persons do not well comply with the program. This mixed methods research study was aimed to investigate effects of a 12-week HBM-based OEP (HBM-OEP) on postural balance (Berg balance scale, BBS) and quadriceps torque in 72 healthy community-dwelling older persons (control group, n = 36 and HBM-OEP group, n = 36). Levels of fall-related HBM domains (knowledge, perception, and behaviors) were also recorded at baseline and 12-week post-intervention. Results showed that the BBS increased from 51.3±0.4 to 53.2±0.3 (p < 0.05). The quadriceps torque between baseline and post-intervention were not significantly different (181.7±12.2 vs 188.2±9.9 Nm). In contrast, the quadriceps torque in the HBM-OEP group significantly increased from 176.8±10.6 to 220.0±9.2 Nm (p < 0.05). Both quadriceps torque and BBS were positively correlated with the levels of knowledge, perception, and behavior scores. In conclusion, the 12-week HBM-based OEP was effective to improve postural balance and the levels fall-related health beliefs.

3 illus, 3 tables, 31 ref

042387   KAMBL S, YADAV T (Musculoskeletal Sciences Dep, Krishna Institute of Medical Sciences Deemed to be Univ, Karad, Maharashtra) : Effect of dynamo-static splint on post operative knee stiffness. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

To Study the effect of Dynamo-Static Splint on Post-operative knee stiffness. The Objectives of the study are as follows: (1) To find the effect of Dynamo-Static Splinting on Pain (2) To find the effect of Dynamo-Static Splinting on Knee Range of Motion. This study was conducted for the duration of 6 months. 20 subjects of age 20 to 60 years were screened out of which 10 subjects were selected for the study depending on the inclusive and exclusive criteria. Condylar Fracture of Femur and Tibial Plateau Fractures referred to Physiotherapy Department Between 4 to 5 weeks. These subjects were then divided into 2 groups Pre-treatment assessment and Post-treatment assessment were recorded. Statistically significant differences in the VAS at rest and activity, Pre and Post range of motion were seen between the two groups. Post treatment Range of motion It indicated that it was significant (p < 0.0001) and (p = 0.0460) in the interventional group subjects. VAS at rest. It indicated that it was significant (p < 0.0001) and (p = 0.0203) in the interventional group subjects. Intra group analysis of these values within the group was done using Wilcoxon test and the Inter group analysis between the groups was done by Mann-Whitney test. The present study provided evidence to support the use of dynamo static splint for post-operative knee joint stiffness. In addition, results supported splinting exercises were significantly effective in reducing the quality of pain and improving range of motion in post-operative knee stiffness.

6 tables, 11 ref

042386   GHULE S B, SURESHKUMAR T (MIP Coll of Physiotherapy, Latur, MH) : Effect of accu tens with accu band on nausea, vomiting, retching and quality of life in early pregnancy. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Nausea and vomiting are basic human preventive reflexes against the absorption of toxins, as well as responses to correct stimuli. They are often used together, although each phenomenon should be assessed separately.1 Nausea and vomiting in pregnancy (NVP) is repeatedly experienced in early pregnancy, most frequently between 6 and 12 weeks.its important to find out Accu tens and bands and related techniques have potential for nonpharmacologic relief of nausea and vomiting in pregnancy. Subjects were randomized into two groups. 124 subjects of above 18 years old subjects were recruited in each group. Accu (TENS) Transcutaneous Electrical Nerve Stimulation with accu band at P6 point or Neiguan acupuncture point of dominant hand was administered to experimental group while control group was subjected to placebo (TENS) Transcutaneous Electrical Nerve Stimulation with Accu band on dorsum of wrist joint. Both the groups received interventions for 5 days in a week for 3 weeks. The outcome of study assessed by Rhodex index,Nausea Vomiting of Pregnancy Quality of Life (NVPQOL) questionnaire, which was assessed before treatment and after treatment session regimen. Rhodex index scores shows that there is comparison between group A and group B mean value of group A and group B 18.61 and 12.29 respectively. The t-value were 6.66 and p<0.0001. NVPQOL scores shows that there is comparison between group A and group B mean value of group A and group B 115.23 and 80.58 respectively. The t-value were 7.25 and p<0.0001. The results obtained from this study showed that the Accu TENS with Accu band can be easy to perform, least expensive, feasible and most efficient management strategy for reducing nausea, vomiting and retching, weight gain and enhancing the quality of life of individuals with early pregnancy.

2 tables, 23 ref

042385   KHAN S, KANPARIYA H, NANDA D (SHRI USB Coll of Physiotherapy, Rajasthan -307 026, Email: saffu786.sk@gmail.com) : Comparison of immidiate effect of hold-relax proprioceptive neuromuscular facilitation and foam roller exercise on tight hamstring muscle in school going children” – An experimental study. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Hamstring tightness occurs in early childhood and tends to increase with age. Hold-relax PNF technique and foam roller exercise technique are used to improve flexibility of hamstring muscle. Comparison of immidiate effect of hold-relax proprioceptive neuromuscular facilitation and foam roller exercise on tight hamstring muscle in school going children. The interventional study was carried out in various primary schools of Aburoad. 60 subjects were included on the basis of inclusion and exclusion criteria and divided into 2 groups with 30 participants in each group. One group received hold-relax PNF and other group received foam roller exercise. Data was analyzed by using SPSS version 20. Wilcoxon signed-rank test was used for the pre treatment and post treatment comparison within both the groups and Mann-Whitney U test was used for the inter group comparison. Statistically is significant(p<0.05) the result showed high significant diffrence within and between the two groups. There was more effect of hold-relax PNF technique compared to foam roller exercise. The above study concluded that both the technique showed marked improvement but hold-relax PNF more effective in school going children with hamstring tightness.

3 illus, 5 tables, 9 ref

042384   BACHANI S, KHAN M S, CHUGHTAI M R B (Physiotherapy Coll, Karachi, Pakistan) : Perception of physiotherapists about the effectiveness of therapeutic ultrasound. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

To determine the perception of physiotherapists about the effectiveness of therapeutic ultrasound as a treatment modality. descriptive cross-sectional study. Period 6 months after the approval of synopsis from June 2017 to November 2017. A self-administered questionnaire was distributed among the physiotherapists working in the clinical practice, 25-60 years of age of both genders. Questionnaire employing of both open and closed ended questions. Questions were asked regarding the usage, their knowledge of appropriate dosages and their perception of its effectiveness for various conditions. Perception was evaluated using Visual analogue Scale. One hundred and twenty questionnaires were completed and returned a response rate of 87.5 %. Physiotherapists perceived ultrasound to be effective in acute tendinitis, acute bursitis and chronic muscle strain. Respondents believe that therapeutic ultrasound become more effective when used in conjunction with other techniques at appropriate dosages, However, the placebo qualities of ultrasound were not perceived to be effective by most of the physiotherapists. Therapeutic ultrasound is perceived to be most commonly used electro physical agent among the physiotherapists. The findings suggest that ultrasound was thought to be as an effective treatment tool when applied appropriately. The results of this study will be useful for the clinicians however, further experimental studies investigating ultrasound efficacy are indicated.

2 illus, 2 tables, 25 ref

042383   HARIPRIYA S, EAPEN S S, RAGHU S R (Laxmi Memorial Coll of Physiotherapy, Karnataka-575 002, Email: sanil.rashmi06@gmail.com) : Improving upper limb function in a person with stroke using proprioceptive neuromuscular facilitation approach: A case study. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

A sixty-six-year-old male presented with right upper limb weakness of three years duration. Radiological studies identified an acute infarct with haemorrhagic component and absence of flow in the left middle cerebral artery. This case report discusses his presentation and effect of proprioceptive neuromuscular facilitation (PNF) approach in stroke to improve upper limb function.

2 illus, 15 ref

042382   THORAT S R, KANASE S (Krishna Institute of Medical Sciences Deemed To Be Univ Karad, Karad, Maharashtra) : Prevalence of recreational interest in geriatric population. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Recreational therapy “means a treatment services designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness. As well as reduce or eliminate the activity limitations and restrictions to participation in life situations caused by an illness or disabling condition. Recreational therapy especially in senior citizens is important because senior citizens can suffer from loneliness, depression and anxiety which can lead to loss of physical functioning and can contribute to early death. Objectives of the study were to determine the prevalence of Recreational interest in geriatric population. In this observational study, 100 subjects were assessed using Recreational Activity Interest Questionnaire and Recreational Activity Interest Scale. Results: Statistical analysis of Recreational Activity Interest Questionnaire and Recreational Activity Interest Scale were found to be extremely significant. The study concluded that majority of population were aware of recreational activities and those who were not aware of recreational activities should be made aware of the same.

10 ref

042381   SREE S D (Musculoskeletal Disorders and Sports Dep, The Oxford Coll of Physiotherapy, Bangalore) : To evaluate scapulohumeral rhythm in scapular dyskinesia in software professionals with neck pain. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Neck Pain a musculoskeletal condition which is increasing commonly throughout the World having considerable impact on individuals that affects their social, physical and psychological aspects. Neck Pain is more prevalent in office workers than in general community. Computers have become an epitome of modern life, being used in every aspect of life. Work related Neck pain is leading cause of disability and absenteeism. Evaluation, treatment planning for Neck Pain rehabilitation often fails to include an objective assessment of scapular motion. Methodology: A cross-sectional study,120 subjects with Neck Pain. Convenient sampling method was done. Subjects were screened for Scapular Dyskinesia using Lateral Scapular Slide Test(LSST) those fulfilling the inclusion criteria, further Scapular Upward Rotation(SUR) assessed by Digital Inclinometer at 00,450,900,1200 of Gleno-Humeral abduction and assessed for Scapulohumeral rhythm(SH rhythm). NDI questionnaire was asked to fill. Results: The results showed statistically significant correlation between all the variables. SUR is more in dominance hand and SH rhythm is more in non-dominance hand and is altered in all the angles and none were closely related to the clinically accepted ratio. SH rhythm is more in starting angles of humeral elevation and is less when reaching to full range.

1 illus, 4 tables, 12 ref

042380   CHOUDHARY R (Teerthanker Mahaveer Univ, Moradabad) : Age and gender- related test performance in community dwelling elderly population: six-minute step test and four square step test. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Aging is associated with a decrease in the efficiency of several functions, among which are posture control and functional capacity, even in the absence of diseases. There is little data available in literature describing variation in test performance for older adults who are functioning independently. The available data are less and often difficult for clinicians to use as a basis of comparison in documentation because they are not presented in terms of age and gender groupings. The purpose of this study is to investigate aging related changes in balance and functional capacity performance in community dwelling elderly people. Total 60 subjects were included and divided into 3 groups according to age groups. Group 1 (60-69), Group 2 (70-79), Group 3 (80-89) in each group 20 subjects with 10 males and 10 females. The informed consent was taken. Six Minute Step Test (6MST) and Four Square Step Test (FSST) were performed on them. The number of steps taken by the subjects in 6 minutes were recorded in 6MST and the time taken by the subjects to complete the FSST were recorded using stopwatch. The data obtained was analyzed using independent t- test and one way ANOVA. 6MST and FSST scores were significantly different in all 3 age groups. The results showed that there is a progressive decrease in the 6MST and progressive increase in the time taken to complete FSST with increasing age. However, there was no significant difference between males and females performance in 6MST and FSST. From the results it can be concluded that there is a progressive decrease in the test performance (6MST & FSST) with age in community dwelling elderly people.

2 illus, 26 ref

042379   AGRAWAL R, KARANDIKAR- AGASHE G (M. A. Rangoonwala Coll of Physiotherapy and Research, Pune, Email: gayatri.karandikar@gmail.com) : The effect of mobilization of an asymptomatic cervical spine on shoulder pain, shoulder range of motion and shoulder disability in patients with shoulder pain. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Shoulder pain is a common complaint for individuals of all ages and activity levels with a prevalence ranging from 7% to 34%.Along with involvement of shoulder joint, dysfunction at the cervico-thoracic spine and the adjacent ribs (also called the shoulder girdle) is considered to predict the recurrence and poor outcome of shoulder complaints. When shoulder joint is highly irritable, manual therapy cannot be given to it directly. Changes in the axio-scapular muscle activity during low-load functional tasks have been shown in individuals with chronic neck pain, which play an indirect role in shoulder biomechanics. Therefore, cervical spine mobilization techniques could be used during therapy to affect the more peripheral symptoms. 60 patients with shoulder pain were randomly divided into 2 groups of 30 patients each. Group A received lateral and postero-anterior Maitland’s mobilization of the C5, C6 and C7 spinous processes along with Short Wave Diathermy (SWD) to the shoulder while Group B received SWD to the shoulder alone for 5 days. Passive range of motion of the shoulder using a universal goniometer, Pain on VAS and a Shoulder Pain and Disability Index scale were assessed pre and post treatment. Mobilization of the asymptomatic cervical spine lead to a significant reduction of pain, significant increase in the overall shoulder ROM and a reduction in the functional disability after 5 days of treatment in individuals with shoulder pain. It has a lasting effect on improvement in functional disability. When two groups were compared (SWD + mobilization v/s SWD alone), no one group was statistically better than the other.

6 tables, 17 ref

042378   SUKHIYAJI R B, PATEL Z (Uka Tarsadia Univ, Tarsadi- 394 350, Gujarat, Email: rajal.sukhiyaji@utu.ac.in) : To compare the skilled based physical fitness such as agility, power and speed between the young college male basketball and football players. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Football and basketball players need good fitness, flexibility, power, strength, agility, endurance and vertical jumping ability to achieve sporting targets. Physical fitness is important for top class performance in sports and also for injury prevention. To compare the skilled based physical fitness such as Agility, Power and Speed between the Young college male Basketball and Football players. 60 players (only males), playing football and basketball since 1 year, age between 17-25 years from different colleges in Surat and Bardoli were included for the study. From these 30 players were football players and 30 players were basketball players. All players had filled up the informed consent form and the self-administered questionnaire. The physical fitness tests were carried out such as Illinois Agility Test (IAT), 20 meter sprint, and Vertical Jump Height (VJH) for all 60 players. The comparison was done between the football and the basketball players for each of the physical fitness tests. All statistical analysis was performed using SPSS version 16. The independent t-test was used for comparing means between two groups. Results were considered to be significant at p<0.05 and confidence interval was set at 95 %. Significant differences was found between players for IAT and VJH with p=0.000 (p<0.05). There was no significant difference found between players for 20 Meter Sprint Test with p=0.590. Agility was better in football players than basketball players. VJH was more in basketball players than football players. There was no difference found in 20 meter sprint test between basketball and football players.

4 tables, 19 ref

042377   GAZBARE P , DESHMUKH S, PALEKAR T J, VARGHESE N , ABRAHAM B, SINGH G, DESAI R (Dr. D. Y Patil Coll of Physiotherapy, Pimpri, Pune) : Assessment of body coordination, strength and agility using bruininks- oseretsky test of motor proficiency (BOT-2) in overweight and obese children aged 7-12 years. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Childhood obesity is a major health problem in many developing countries, including India. As a result, overweight and obese children achieve fewer opportunities to develop proficient motor skills. Early assessment should be done to evaluate children having poor coordination problem and early intervention should be given to avoid risk of any neuromotor disturbances later. This study is done to find out the level of motor proficiency in terms of Body coordination, strength and agility in overweight and obese school going children aged 7-12 years using BOT-2 test. A cross sectional analytical study was conducted using BOT-2 long form. Purposive sampling of 54 overweight and obese children (32 males and 22 females) aged 7-12 years who met the inclusion criteria were taken for the study and assessed under 2 motor area composite of BOT -2. The study was conducted after the ethical clearance obtained by the institutional ethical committee. Each task was explained verbally and demonstrated to each student, to ensure proper understanding of the task. 54 children were assessed (59.2 % males and 40.8 % females) and standard score of the BOT -2 test was calculated which signifies the level of proficiency. For Body coordination component mean standard score of 45.07 and for strength and agility component it was 37.79. This study concludes that according to Descriptive Category of BOT -2 test in Body coordination 33 %, in Strength and agility 74 % of overweight and obese children aged 7-12 years has motor deficits.

14 ref

044494   BHAT A, JAYAPRAKASH M (Father Muller Medical Coll, Mangalore- 575002, Karnataka, Email: akashbhat.m@gmail.com) : Comparison of fluorescent and ziehl-neelsen staining in fine needle aspirates of Tuberculous lymphadenitis. J Cont Med Dent 2020, 8(1), 70-4.

Tuberculosis remains a global health problem with an enormous burden of disease. Tuberculous lymphadenitis being the most common extra pulmonary manifestation Ziehl-Neelsen stain is the most commonly used method worldwide to detect tuberculous lymph node aspirates, however, Auramine – O Staining is being preferred owing to its high sensitivity, rapidity and ease of screening. The aims of our study was to compare fluorescence staining with Auramine-O with the conventional Ziehl-Neelsen (ZN) stain for detecting tubercle bacilli in tuberculous lymph nodes by Fine Needle Aspiration Cytology (FNAC) and study the efficacy and advantages of using the Auramine-O stain on lymph node aspirates under fluorescent microscopy.  We performed a prospective study of sixty-six patients clinically suspected to have tuberculous lymphadenitis from April 2016 to October 2016 at a tertiary care teaching hospital. Clinical and demographic data were collected. FNAC samples were obtained and stained with Papanicolaou and May Grunwald Giemsa stain to assess cytomorphological features. Staining of samples with ZN stain and AO stain was done to identify tubercle bacilli and compare the same.  Positive staining was noted in 2.7 % cases with AO stain and 16.7 % with ZN stain. 10.6 % cases showed lymphocytosis. Overall sensitivity, specificity and PPV of IF in comparison to ZN stain was 45.45 %, 81.82 %, 33.33 % respectively. Overall sensitivity, specificity and PPV of ZN in comparison to IF staining were 33.33 %, 88.8 %, and 45.45 %, respectively. IF staining is a more effective, easy and rapid alternative to ZN staining is detecting TB bacilli through FNAC, especially in paucibacillary cases.

4 illus, 5 tables, 12 ref

044493   ANITHA R, DEVAKUMARI S, DINESH D S, DEVAMEENA S (Dentistry Dep, Madurai Medical Coll, Tamil Nadu, Email: gopalsdevakumari@gmail.com) : Mandibular third molar impactions in South India-A descriptive cross-sectional study. J Cont Med Dent 2020, 8(1), 58-61.

Mandibular third molars are the most common impacted teeth in human dentition. This is attributed to the evolution and modern dietary habits. Infections and pathologies from third molars are major factors affecting oral health next to dental caries and periodontal diseases. Surgical removal of mandibular third molars is definitely indicated to prevent the risk of odontogenic cyst and tumors.  A descriptive cross-sectional study was undertaken to analyze the patterns and prevalence of mandibular third molars in Govt. Rajaji hospital Madurai, India. Demographic, clinical and radiological data of one hundred patients (N=100) who underwent surgical removal of lower third molars were retrieved tabulated and analyzed using SPSS software version 16. The results demonstrated that Females predominantly underwent surgical removal of mandibular third molars. The common age group is 26 to 35 years. The distoangular type being the most common impaction type and Pericoronitis is the most common etiology. The study proves that the mandibular third molar impactions are prevalent in the south Indian population in and around Madurai.

17 ref

044492   ANITHA R, DEVAKUMARI S, DINESH D S, CANMANY E, DEVAMEENA S (Dentistry Dep, Madurai Medical Coll, Tamil Nadu, Email: gopalsdevakumari@gmail.com) : Prevalence and patterns of maxillofacial trauma in South India- A retrospective study for seven years. J Cont Med Dent 2020, 8(1), 54-7.

Maxillofacial trauma is a complex fracture involving jaws and dentition. Documentation of these fractures are of paramount importance for improving patient care and development of infrastructure especially roads. A descriptive cross-sectional study was conducted in Rajaji govt. Hospital, Madurai for six years from 2011 to 2017 to analyze the patterns and prevalence of maxillofacial trauma. Patients demographic and clinical data were retrieved and analyzed using MS Office excel 2007. The total number of patients treated were N=707. The results show that males suffered more fractures than females. The most common etiology of trauma being RTA (MTW, motorized two wheelers) followed by assault and then falls and sports injuries. With respect to type of fractures the most common maxillofacial fracture reported in this region is mandible followed by maxilla and then zygomatic fractures. Recordings of Prevalence and patterns o maxillofacial trauma from this region clearly demonstrates that these fractures are more common in this part of south India.

1 table, 17 ref

044491   REDDY N S, NARSIMLU D (Orthopaedics Dep, Prathima Institute of Medical Sciences, Nagunur- 505415, Telangana, Email: narsimludyavarashetty@yahoo.com) : Evaluation of results of minimally invasive endoscopic management of haglund syndrome. J Cont Med Dent 2020, 8(1), 43-7.

The purpose of our study is to evaluate endoscopic treatment of Haglund's syndrome in which all patients showed a Haglund projection on radiography and none had a cavo-varus deformity. Our study included n=24 patients (30 heels) with a mean age of 32 years (range 26-44 years). They presented with posterior ankle impingement syndrome with Haglund’s deformity on radiography and were resistant to conservative therapy for more than 6 months. They underwent two portal endoscopic surgeries in Prathima Institute 1 of Medical Sciences, Nagunur, Karimnagar between May 2016 and October 2019. The mean follow-up was 24 months (range 6–41 months). In 27 heels, postoperatively we achieved negative parallel pitch lines on lateral radiographs. The average AOFAS score improved from 59.3±9.9 points preoperatively to 94.8±9.1 points at final evaluation (p<0.01). There were sixteen excellent results, ten good results, two fair results, and two poor results. For the Ogilvie Harris score, there were seventeen excellent, ten good, one fair, and two poor results. The VAS for pain decreased from 6.8 ± 1.4 (range 5-10) preoperatively to 1.8±0.8 (range 0-4) (p< 0.01) at final evaluation. There were no obvious intra or post-operative complications. All patients were satisfied with the result of the operation. Endoscopic calcaneoplasty is a safe and effective minimally invasive treatment option for Haglund disease after failure of conservative treatment for 6 months.

3 tables, 25 ref

044490   SURESH R, KALIDASS P (Dental surgery Dep, Thanjavur Medical Coll and Hospital, Thanjavur- 613 006, Email: sureshortho11@gmail.com) : Effects of autoclave sterilization on the surface parameters and mechanical properties of different composition of five orthodontic arch wires – An in vitro study. J Cont Med Dent 2020, 8(1), 36-42.

Objectives of the present study were to determine the effects of autoclave sterilization on the surface parameters and mechanical properties of five different compositions of orthodontic arch wires. Methods: Preformed orthodontic arch wires of stainless, Nickel titanium, Neo sentalloy with Ion guard, Titanium molybdenum alloy and Timolium were tested before and after sterilization with scanning electron microscopy, Atomic force microscopy and load deflection character. The results obtained were statistically analyzed by Paired ‘t’ test and ANOVA followed by Tukey HSD test. Surface parameters were classified from smoothest to roughest as Stainless steel (Rq 71.50), Nickel Titanium super elastic & Timolium (Rq 210.00), TMA (Rq 275.93) and Neo sentalloy with Ion guard (Rq 352.34). Load deflection requirement from lowest to highest as Neo sentalloy with Ion guard (2.90 N), Nickel Titanium super elastic (4.48N), TMA (18.13N), Timolium (21.77N) and Stainless Steel (27.73N).  The study results showed that autoclave sterilization of selected orthodontic wires does not affect surface characters and mechanical properties.

3 illus, 4 tables, 17 ref

044489   VENKATESHWAR P ( Pediatrics Dep, Prathima Institute of Medical Sciences, Karimnagar, Telangana, Email: govu941@gmail.com) : Etiological profile of non-traumatic coma and role of GCS in predicting the outcome of non-traumatic coma in pediatric age group. J Cont Med Dent 2020, 8(1), 31-5.

Acute non-traumatic coma is a common problem in pediatric practice accounting for 10-15 % of all hospital admissions and is associated with significant mortality. Assessment of the severity of coma is essential to comment on the likelihood of survival in comatose children. To assess outcome in a pediatric non-traumatic coma with the role of the Glasgow Coma Scale and Modified Glasgow Coma Scale. Methodology: N=80 cases of non-traumatic coma aged from 1 month to 12 years, coma severity was assessed by using the Modified Glasgow Coma Scale. A score of less than 8 and more than 8 was used for the analysis of the outcome. Out of 80 cases, n=8 cases expired (10%), n=4 cases were discharged against medical advice (4 %), n=68 cases were improved and discharged (85 %), among these, n=8 cases were discharged with complication (11.7 %). Overall mortality was (10 %) (8/80) males outnumbered females in frequency with a ratio of 1.28:1. CNS infection accounted for almost about 66 %. Children with GCS and MGCS scores of less than 8 have a poor prognosis and a very high probability of death. Those with a GCS score of more than 8 have a good prognosis. Identification of these cases at the outset can help prepare the treating physician to plan critical care referrals and to give a preliminary assessment of the outcome to the family.

6 tables, 22 ref

044488   JYOTHSNA P S, DEVI V R (CKM Maternity Hospital, Matwada, Warangal, Email: avinjamoori@yahoo.com) : A study of incidence, clinical presentation, risk factors and morbidity associated with ectopic pregnancy in CKM- Government Maternity Hospital, Matwada,Warangal. J Cont Med Dent 2020, 8(1), 25-30.

In the past two decades, the incidence of ectopic pregnancy has been increasing dramatically, worldwide. One of the major triggering factors for this being the introduction of medically assisted procreation techniques. The present study of cases of ectopic pregnancy is to know our experience regarding the incidence, clinical presentation, risk factors, and associated maternal morbidity and mortality. All diagnosed cases of ectopic pregnancy admitted to CKM hospital during a period of 18 months. A detailed history and clinical evaluation were done abdominal examination was done for guarding, rigidity, tenderness, presence of masses presence free peritoneal fluid and presence of Cullen's sign. The Vaginal examination was done for the color of the cervix, tenderness, size of uterus its mobility and consistency and presence of masses of the fornix. The data was recorded and analyzed by SPSS version 17 on windows format.  A total of n=51 patients were admitted with a history suggestive of ectopic pregnancy from May 2018 to October 2019. The frequency of ectopic pregnancy was 1:259 of all pregnancies. Risk factors were found in 49.1 % of cases and the major contributors were dilatation and curettage (2 %), PID (5.9 %), infertility (13.7 %), Previous Tubal Surgery (13.7 %) and previous abortions (9.8 %). Out of the n=51 patients, surgical treatment was performed in n=48 patients and n=3 were medically managed. Blood transfusion was given in 72.5 % patients. The postoperative period was uneventful in all of them. As the incidence of ectopic pregnancy has been on the rise, screening of high-risk cases, early diagnosis, and early intervention are required to enhance maternal survival and conservation of reproductive capacity. 

7 tables, 14 ref

044487   KUMAR P R (Radiology Dep, Prathima Institute of Medical Sciences, Naganoor, Karimnagar, Email: psriramkumar@yahoo.com) : A comparative study of plain Radiography, Ultrasound and static MR Urography in evaluation of Urinary Tract Pathologies. J Cont Med Dent 2020, 8(1), 16-20.

Several techniques are available for the imaging of the urinary tract. CT urography and MR urography are used for of urinary collecting system, renal parenchyma, and adjacent structures. Recently, interest has grown for increased use of MR urography for imaging the urinary tract pathologies. The present study aimed to evaluate patients presenting with suspected urinary tract abnormalities using plain radiography, ultrasonography, and static MR urography. This is a prospective comparative study was done in the Department of Radio-Diagnosis, Prathima Institute of medical sciences Karimnagar, Telangana State, India. Data for the study were collected from patients with clinically suspected urinary tract pathologies undergoing plain X-ray KUB, ultrasonography and static MR urography in our Department. A total of n=60 patients were included based on the inclusion and exclusion criteria. Patients were selected based on their symptoms and clinical findings suggestive of urinary tract abnormalities such as loin pain, hematuria, edema, and congenital urinary tract anomalies. The most common presentation was presence of loin pain in n=32(47.70 %) followed by nausea and vomiting in n=10(14.90 %) patients. The urinary tract abnormalities among the population shows the presence of obstructive calculi in n=30(50 %) of patients followed by congenital abnormalities in n=18(%). In our study, most common site of obstruction of calculi was found to be PUJ followed by lower ureter. The presence of hydernephrosis was found in n=30 patients, out of the n=30 patients mild hydronephrosis was found in n=10(33.3 %) of patients. Moderate hydronpehrosis was found in n=15(50 %) of patients and severe hydronephrosis was found in n=5(16.7 %) of patients. The role of MR Urography in renal and urothelial imaging continues to emerge. MRU is a particularly useful technique for pregnant females, pediatric patients, cardiac patients and those with renal impairment. MRU is preferable to Xray and ultrasound in the assessment of collecting systems in case of obstruction, diagnosis, and staging of urothelial malignancies and assessment of renal function.

5 tables, 15 ref

044486   RAMREDDY V (Orthopedics Dep, Prathima Institute of Medical Sciences, Karimnagar, Telangana, Email: orthoramreddy@gmail.com) : Management of diaphyseal fractures of humerus with interlocking nail – A prospective study in a Tertiary Care Hospital. J Cont Med Dent 2020, 8(1), 10-5.

Fractures of the humeral shaft are very common in upper limb fractures. It accounts for 3 % of all fractures. Many treatment modalities are available for humeral shaft fractures. The present study tried to evaluate the outcome of the treatment of diaphyseal fractures of the humerus with interlocking nails. This cross-sectional study was conducted in the Department of Orthopedics, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. Patients included in the study were age more than 19 years the physis is fused. Closed reduction not feasible and patients with polytrauma where the closed reduction was not possible and patients with comminuted and pathological fractures. All the necessary blood investigations (complete blood count, blood urea, serum creatinine, blood sugar, HIV, HBsAg). ECGand chest X-rays were taken on a routine bases. All the cases were treated by closed intramedullary interlocking nailing in an antegrade manner except five cases which required the opening of fracture site to treat radial nerve palsy. In our study, n=16(53.3 %) patients had fractured at the middle third of the humerus, n=10(33.3 %) patients had fractured at the lower third of humerus and n=4(13.3 %) patients had fractured at the upper third of the humerus. In our study, n=10(33.3 %) patients had oblique fracture, n=10(33.3 %) patients had transverse fracture, another n=8(26.6 %) patients had comminuted fracture and n=2(6.6 %) patient had spiral fracture. Fixation of fracture n=25(83.4 %) patients was treated by closed intramedullary nailing. These nails were passed in an antegrade manner and locked in static mode. N=5(16.6 %) patients required open reduction because of associated radial nerve palsy, which was decompressed and the fracture was fixed with the interlocking nail in static mode. Closed intramedullary nailing with an interlocking nail is a safe and reliable method of treating humeral shaft fractures. It is an excellent method of managing comminuted and unstable humeral shaft fractures. Since closed nailing preserves the fracture hematoma, it appreciably decreases the time required for a fracture to consolidate and achieves a high rate of fracture union.

7 tables, 19 ref

044485   VAMSI N, NARSIMLU D (Orthopedics Dep, Prathima Institute of Medical Sciences, Nagunur, Karimnagar, Email: narsimludyavarashetty@yahoo.com) : A study of functional outcomes by using titanium elastic nails system for the treatment of femur shaft fractures in children. J Contemp Med Dent 2020, 8(1), 5-9.

Fractures of the femur are the most incapacitating fractures. For children aged 6-16 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and casting is no longer preferred. We report our experience in titanium elastic nailing for the treatment of pediatric femoral diaphyseal fractures. To study the functional outcome following the use of flexible titanium nails for femoral shaft fractures in children and to study the duration of the union in the above-mentioned fractures. To study the complications of fracture shaft femoral after intramedullary nailing. Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were stabilized with titanium elastic nails Patients were followed up clinically and radiologically for a minimum period of 6 months to 1 year. The final results were evaluated using Flynn’s criteria. Technical difficulties and complications associated with the procedure were also analyzed. Overall results were excellent in 23 cases and satisfactory in 02 cases. No patient had a poor result. The average hospital stay was 6.47 days. All the fractures healed in 70 days (10 weeks) of times with an average time of union of 60 days (7.5 weeks). The most common complication encountered was soft tissue irritation at the nail entry site seen in 2 cases. Clinically, shortening was noticed in 3 cases, while no patient had lengthened. Malalignment was seen in only 6 cases. There was no iatrogenic bone injury, delayed injury and non-union, bending or breaking of implant, refracture and avascular necrosis of femoral head. There was no evidence of physeal injury on follow up. Titanium elastic nails are relatively easy to use, minimally invasive, physeal-protective implant system with a high rate of good and excellent outcomes in children aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.

1 table, 18 ref

044484   GUPTA D, KAMAT S, HUGAR S, NANJANNAWAR G, KULKARNI R ( Conservative Dentistry and Endodontics Dep, Bharati Vidyapeeth, Sangli- 416 414, Maharashtra, Email: divyagupta8989@yahoo.com) : A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study. J Conserv Dent 2020, 23(1), 97-101.

The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5 % sodium hypochlorite against Enterococcus faecalis. Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5 % NaOCl, Group B: 20 % T. vulgaris, Group C: 12.5 % S. persica, Group D: 10 % A. nilotica, Group E: 10 % C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37 °C for 24 h. Bacterial zones of inhibition were recorded. The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey’s t‑test. The highest zone of inhibition against E. faecalis was shown by 5 % NaOCl, followed by 10 % C. arvensis, 20 % T. vulgaris and 10 % A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. 5 % NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl.

1 illus, 3 tables, 20 ref

044483   KAUSHAL R, BANSAL R, MALHAN S (Conservative Dentistry and Endodontics Dep, Luxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, Email: dr_aditya82@rediffmail.com) : A comparative evaluation of smear layer removal by using ethylenediamine tetraacetic acid, citric acid, and maleic acid as root canal irrigants: An in vitro scanning electron microscopic study. J Conserv Dent 2020, 23(1), 71-8.

Irrigants remove or dissolve smear layer formed during instrumentation. Thus it is important to study the effect of different irrigant solutions on smear layer removal. Objectives: The aim of this study is to determine which irrigant effectively removes the smear layer from the coronal, middle, and apical third of the root canal. One hundred and twenty single‑rooted mandibular premolars were decoronated and biomechanical preparation was done through hand instrumentation up to size 40 k file with 2.5 % NaOCl irrigation between each successive filing, followed by irrigation with 5 ml of saline. The teeth were divided into Groups I, II, III, and IV containing 30 samples each and irrigated with 5 ml of 17 % ethylenediamine tetraacetic acid (EDTA), 10 % Citric acid, 7 % Maleic acid and normal saline respectively for 1 min and final irrigation was done with 5 ml of distilled water of each sample. The canals were dried with 2 % absorbent paper points. The roots were then split with a chisel and mallet. One‑half of each tooth was selected and then was analyzed using a scanning electron microscope. The dentinal surfaces were observed at the cervical, middle, and apical third with ×2000 for the smear layer. The scores were attributed, according to Torabinejad et al. rating system. 7% maleic acid and 10 % citric acid both are equally effective in smear layer removal from coronal and middle third, but in apical third 7 % maleic acid is more effective than 10 % citric acid. Between citric acid and EDTA, both are equally effective in smear layer removal from coronal and middle third, but in apical third, 10 % citric acid is more efficacious than 17 % EDTA. Within the limitations of the study, it can be concluded that all three tested irrigants removed the smear layer from coronal, middle, and apical third. However, in apical third 7 % maleic acid is the most efficacious irrigant in smear layer removal.  

5 illus, 6 tables, 37 ref

044482   SHAHI M, VELUGU G R, CHOUDHARY E (Sharda Univ, Greater Noida- 201 310, Uttar Pradesh, Email: shahi.mohnisha@gmail.com) : Comparative evaluation of the effect of 10 %, 20 %, and 30 % guava seed extract on reversing compromised resin bond strength after enamel bleaching in 120 min, 10 min, and 5 min: An in vitro study. J Conserv Dent 2020, 23(1), 66-70.

Bonding of composite with enamel and dentin gets compromised if the tooth is restored with composite immediately post bleaching. The application of antioxidants has shown to have a positive effect on it. The aim of this study was to evaluate and compare the effect of guava seed extract solutions in various concentrations on the shear bond strength (SBS) of composite resin to bleached enamel when applied for 5 min, 10 min, and 120 min. Fifty‑five maxillary incisors were procured, and labial surfaces of 50 specimens were bleached with 37.5 % hydrogen peroxide. These specimens were divided into 3 experimental groups: Group 1–3 comprising 15 specimens each (n = 15), and the remaining specimens were divided into two groups: Group 4 (positive control group) and Group 5 (negative control group). Groups 1–3 were further divided into 3 subgroups according to the application period of antioxidant: subgroups A, B, and C. Specimens were stored in distilled water for 24 h. SBS testing was done using the universal testing machine. Data were tabulated and subjected to statistical analysis using a three‑way analysis of variance with post hoc Tukey’s test.  Guava seed extract showed a complete reversal of the compromised bond strength, and promising results were seen with increased concentration. The use of antioxidants effectively reversed the compromised bond strength of bleached enamel, and an increase in the concentration of antioxidants reduces the duration of its application.

3 illus, 23 ref

044481   KAKANI A K, VEERAMACHANENI C (Conservative Dentistry and Endodontics Dep, Nanded Rural Dental Coll and Research Center, Nanded- 431 606, Maharashtra, Email: abhijeetkakani@yahoo.com) : Sealing ability of three different root repair materials for furcation perforation repair: An in vitro study. J Conserv Dent 2020, 23(1), 62-5.

The present study aimed to evaluate and compare the sealing ability of mineral trioxide aggregate (MTA)‑Angelus, Biodentine™, and EndoSequence cement in furcation perforations using protein leakage assessment. The present study was conducted using seventy extracted human maxillary and mandibular molars with intact furcation. The samples were randomly allocated into three groups (n = 20) based on repair material used: Group 1 – MTA‑Angelus, Group 2 – Biodentine™, and Group 3 – EndoSequence. Two additional groups served as positive and negative controls (n = 5). Using the leakage assessment apparatus, the presence of protein was detected with a reagent (Coomassive Brilliant Blue) every day for 60 days. One‑way ANOVA and post hoc Tukey’s test were used for statistical analysis using SPSS software. All the groups exhibited protein leakage from day 1. Biodentine showed minimum (0.1201 mg/ml), MTA showed maximum (0.3738 mg/ml), and EndoSequence had intermediate (0.2465 mg/ml) leakage. None in the negative control and all of the positive control specimens leaked during the experimental period of 60 days. The newer biomaterials, Biodentine and Endosequence with better handling properties, could be used as alternatives to MTA‑Angelus while repairing furcation perforations.

2 illus, 1 table, 18 ref

044480   MEENAKSHI C M, SIRISHA K (Conservative Dentistry and Endodontics Dep, GITAM Dental Coll and Hospital, Visakhapatnam, Andhra Pradesh, Email: sirishaky@gmail.com) : Surface quality and color stability of posterior composites in acidic beverages. J Conserv Dent 2020, 23(1), 57-61.

Consumption of acidic beverages has been reported to alter the physical and esthetic properties of resin composites, which in turn can affect clinical success. This study aimed to evaluate the effect of acidic beverages on surface roughness and color stability of Filtek™ Bulk‑Fill posterior restorative composite in comparison with Filtek P60 posterior restorative composite. Settings and Design: Ninety composite discs were used for surface change analysis and another ninety were used for color change analysis. Ninety Filtek P60 and Filtek Bulk‑Fill composite discs were fabricated and divided into three subgroups according to the solutions – artificial saliva (control group), orange juice, and Coca‑Cola® (test groups). The samples were immersed in each beverage for 10 min each day for 56 days. To measure the surface roughness, a profilometer was used, and the surface was qualitatively analyzed using a scanning electron microscope. A reflectance spectrophotometer was used for assessing the color change. Two‑way analysis of variance was used to compare the surface alteration and color change values between the two composite groups and their respective three subgroups. Tukey’s multiple post hoc test was performed for pair‑wise comparison. Filtek P60 had exhibited higher color change than Filtek Bulk‑Fill in all immersion solutions. Coca‑Cola resulted in highest staining in both the composites. The surface roughness and color change of both composites increased significantly in acidic beverages and more in Coca‑Cola. Bulk‑fill exhibited better surface quality and color stability than P60. 

2 illus, 2 tables, 21 ref

044479   NAGESH HONAP M, DEVADIGA D, HEGDE M N (Conservative Dentistry and Endodontics Dep, Chettinad Dental Coll and Rsearch Institute, Kancheepuram, Tamil Nadu, Email: drmanjiri21@gmail.com) : To assess the occurrence of middle mesial canal using cone‑beam computed tomography and dental operating microscope: An in vitro study. J Conserv Dent 2020, 23(1), 51-6.

Failures of root canal treatments are mainly attributed to missed canals and ignorance about the complex anatomy of the root canal system. One such example of anatomic variation is the middle mesial canal (MMC) in mandibular molars which is often missed, and literature on methods for identifying them is limited. This in vitro study aimed to assess the occurrence of MMCs with cone‑beam computed tomography (CBCT) and then under magnification in the mandibular first and second molars.  A total of 120 extracted intact human permanent mandibular first and second molars were selected. These were subjected to CBCT imaging and magnification for the detection of MMCs. The percentage of incidence in the detection of MMC was compared between these two methods. The incidence of MMC detected in mandibular molars using CBCT was 13.33 % (16 of 120 teeth), while using a dental operating microscope, the incidence was 18.33 % (22 of 120 teeth) and the comparison between the two methods was statistically not significant. The MMCs were classified based on the Pomeranz Classification. The most prevalent canal configuration was a confluent type which was found to be in 72 % cases (16 of 22), followed by fin type which was 22.7 % (5 of 22) and independent type was only 4.54 % (1 of 22). The incidence of the location of MMC orifice was studied. In 50 % of the cases, orifice was located closer to the mesiolingual canal, whereas in 27 % of the cases, it was closer to the mesiobuccal canal and in 4.95 % of the cases, it was detected midway.  Since the incidence of MMC was higher with the use of a microscope, it is preferred to use simpler, chairside aids like magnification and ultrasonic troughing. On the other hand, one should be judicious while subjecting a case to preoperative CBCT evaluation owing to its ionizing radiation.

11 illus, 3 tables, 24 ref

044478   CHANDKI R, NIKHIL V, KALYAN S S (Swami Vivekanand Subharti Univ, Meerut, Uttar Pradesh, Email: chandki.rita@gmail.com) : Comparative evaluation of substantivity of two biguanides ‑ 0.2 % polyhexanide and 2 % chlorhexidine on human dentin. J Conserv Dent 2020, 23(1), 46-50.

Substantivity is one of the desirable characteristics of root canal irrigants. Among conventional endodontic irrigants, only chlorhexidine (CHX) is known to exert significant substantivity on root canal dentin. This study explored the substantivity activity of a polymeric biguanide‑poly hexamethylene biguanide (PHMB). Aim: The aim of this study was to determine the substantivity of a polymeric biguanide ‑ 0.2 % PHMB and compare it with that of 2 % CHX. To evaluate and compare the substantivity of 0.2 % PHMB and 2 % CHX on root canal dentin, dentin disks were prepared and substantivity after 1 h, 24 h, 7 days and 21 days was measured using spectrophotometry. The data so obtained were analyzed, and the intergroup comparison was made using unpaired t‑test. The results of this study indicated that 0.2 %. PHMB exerts significantly greater substantivity than 2 % CHX on human dentin.  Within the limitations, this study supports the use of 0.2 % polyhexanide as an endodontic irrigant based on its property of substantivity

2 illus, 2 tables, 58 ref

044477   DEEPTHI K, BORTHAKUR B J, SWATHIKA B, GANESAN S (Conservative Dentistry and Endodontics Dep, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, Email: dr.deepthikangarajan@gmail.com) : Assessment of the viability of human periodontal ligament cells in black tea, lime juice, and passion fruit concentrate – A comparative in vitro study. J Conserv Dent 2020, 23(1), 42-5.

Tooth avulsion is considered as a severe form of dental trauma, causing damage to the periodontium. Hence, the preservation of healthy periodontal ligament (PDL) cells in the storage medium are pivotal for the success of replantation. The aim of this study is to assess the viability of human PDL cells in black tea, lime juice, and passion fruit concentrate. Human periodontal cells were cultured and stored in three experimental media – black tea, lime juice, and passion fruit concentrate and subjected to 3‑(4, 5‑dimethylthiazol‑2‑yl)‑2, 5‑diphenyltetrazolium bromide assay for 1 h and the cell viability was determined. Mean and standard deviation were statistically analyzed using one‑way analysis of variance to identify the significant groups. The human PDL cells showed 100 % viability in lime juice and passion fruit concentrate, followed by 98 % viability in black tea. Black tea, lime juice, and passion fruit concentrate can be used effectively as storage media for maintaining PDL cells viability in avulsed teeth, with 100 % viability exhibited by lime juice and passion fruit concentrate.

1 illus, 1 table, 24 ref

044476   CHAVES L V D F, LIMA R X D S, SILVA L J D A, ALONSO R C B, GERALDELI S, BORGES B C D (Dentistry Dep, Federal Univ of Rio Grande do Norte, RN, Brazil, Email: leticiafreitas_c@hotmail.com) : Bonding performance and mechanical properties of flowable bulk‑fill and traditional composites in high C‑factor cavity models. J Conserv Dent 2020, 23(1), 36-41.

The aim of this study is to evaluate bond strength (BS), shrinkage stress (SS), flexural strength (FS), and elastic modulus (E) of three flowable bulk fill in comparison with conventional composites. Three bulk fill (Filtek Bulk Fill Flow, Surefil SDR, X‑tra Base) and three conventional composites (Filtek Z250 XT, Grandioso, Dentsply TPH3) were used. For BS, conical cavities (n = 10) were prepared in bovine dentine and restored with materials and were analyzed through push‑out test in a universal testing machine (UTM). For FS/EM, 60 (n = 10) bar specimens (7 mm × 2 mm × 1 mm) were prepared and evaluated with a UTM. SS was measured in UTM coupled to an extensometer (n = 5). The data were statistically evaluated using one‑way ANOVA/Tukey tests (P < 0.05). Conventional composites showed higher E when compared to bulk‑fill composites. Regarding FS, they showed similar results, except for (XBF) Xtra Bulk Fill that was inferior. SS and BS of bulk‑fill composites were significantly lower and higher than conventional composites, respectively, except for XBF, which showed similar BS to conventional ones. Flowable bulk‑fill composites, except XBF, showed higher BS, lower SS, similar FS, and lower E when compared to conventional ones.

2 tables, 25 ref

044475   ARHUN N, KALENDER B, TUNCER D, BERKMEN B, CELIK C (Restorative Dentistry Dep, Baskent Univ, Kirikkale, Turkey, Email: brcmklndr@gmail.com) : Influence of operator experience on bond strength of different adhesives to dentin. J Conserv Dent 2020, 23(1), 32-5.

Application of adhesive systems on dentin is a multistep, technique-sensitive procedure. Thus, the aim was to assess the effect of operator experience on the shear bond strength of an etch-and-rinse adhesive system and a self-etch adhesive system on dentin. Forty-eight extracted human molar teeth were used in the study. They were embedded in an acrylic resin after cutting off the roots. The mesial and distal enamels of the teeth were removed to expose dentin surfaces. The samples were allocated to four groups (n = 12): Group 1: restorative dentistry specialist with 13 years of experience, Group 2: with 6 years of experience, Group 3: postgraduate operator with 2 years of experience, and Group 4: undergraduate student with 1 year of experience and familiar with adhesive with systems. Each operator applied an etch-and-rinse adhesive system (Adper Single Bond 2) to mesial surface and a self-etch adhesive system (Clearfil SE Bond) to distal surface (n = 12). Then, a composite resin (Filtek Z250) was inserted with the aid of a plastic ring (2 mm × 2 mm) and light polymerized. The specimens were stored in distilled water before shear bond strength test. A two-way ANOVA test was used for statistical analysis. No statistically significant difference was found between each operator type with respect to etch-and-rinse adhesive system (P > 0.05); however, the undergraduate student performed better than 2-year experienced operator with respect to self-etch system application (P < 0.05). The shear bond strength of a self-etch system might vary according to the operator’s experience.

2 tables, 22 ref

040543   SINGH S K, KUMAR V, RAI T (Dermatology and Venereology Dep, Banaras Hindu Univ, Varanasi - 221 005, Uttar Pradesh, Email: drsatyendraderma@gmail.com) : Comparison of efficacy of platelet‑rich plasma therapy with or without topical 5% minoxidil in male‑type baldness: A randomized, double‑blind placebo control trial. Indian J Dermatol Venereol Leprol 2020, 86(2), 150-7.

Male‑type baldness is a common chronic hair loss disorder among males. Male type baldness is characterized by stepwise miniaturization of the hair follicle, due to alteration in the hair cycle dynamics, leading to transformation of the terminal hair follicle into a vellus one. Platelet‑rich plasma (PRP) seems to be a new technique which may improve hair regrowth. We planned a randomized, double‑blinded placebo control trial to see the efficacy of PRP with and without topical minoxidil and to compare with placebo and standard treatment. The study design was a randomized, double‑blind placebo control trial. The sample size was calculated, and randomization was done. Patients with male type baldness were allocated into four groups; first group topical minoxidil only, the second group PRP with minoxidil, the third group normal saline (NS), and fourth group PRP only. Interventions were done monthly for 3 months and patients were followed up for the next 2 months. Effects of interventions were assessed by hair density, patient self‑assessment, and clinical photography. A total of 80 patients were included. The maximum improvement was found in PRP with minoxidil group. Increase in hair density (in descending order) was PRP with minoxidil group, PRP‑alone group, minoxidil‑alone group, while a decrease in hair density was found in NS group, after 5 months. The maximum patient satisfaction was found in PRP with minoxidil group followed by (in descending order), PRP‑alone group, minoxidil‑alone group, and NS group. Long‑term follow up of patients was not done. Hair counts and hair thickness estimation were not estimated. In our study, we found PRP with topical minoxidil is more effective than PRP alone and topical minoxidil alone.

1 illus, 6 tables, 22 ref

040542   MUSHTAQ S, DOGRA N, DOGRA D, FAIZI N (Dermatology Dep, Government Medical Coll, Jammu - 180 001, Jammu and Kashmir, Email: smqazi.gmc@gmail.com) : Trends and patterns of leprosy over a decade in a tertiary care hospital in Northern India: A retrospective analysis. Indian J Dermatol Venereol Leprol 2020, 86(2), 141-9.

Leprosy was declared to be eliminated from India in 2006, but recent reports point to an increase in newly detected cases despite the overall fall in prevalence. This study aimed to analyze the patterns and trends of epidemiological and operational indicators of leprosy at a tertiary care center in northern India over a decade. This is a 10‑year retrospective study from 2005 to 2014 conducted at the urban leprosy centre (ULC) of the Department of Dermatology, Venereology, and Leprology, Government Medical College, Jammu (J and K), India. Data were obtained from the preformatted standard leprosy cards of the urban leprosy centre. Details of demographic data, clinical features, smear results and treatment received were collected from individual cards and analyzed to observe various epidemiological trends. A total of 743 cases were analyzed for the period 2005–2014, of which 8.6 % were childhood cases, 52.5 % patients were immigrants, and 56.4 % were farmers and laborers. Lepromatous cases showed a significantly increasing trend when compared with tuberculoid cases (P < 0.05). Smear positivity was seen in 29.6 % of cases and showed an increasing trend (P < 0.05). An important observation was the increase in multibacillary cases. World Health Organization (WHO) grade 2 disability also showed an increasing trend over the past decade pointing to delayed diagnosis. The study is limited by its retrospective design. The increasing trend of lepromatous and multibacillary cases and cases with grade 2 disability is a poor sign as it indicates delays in diagnosis. Further, smear‑positive cases contribute to continued transmission of disease in the community. Leprosy has been declared to be eliminated, but recent reports including the present study suggest a rise in newly detected cases and hence in disease burden.

3 illus, 4 tables, 27 ref

040541   HU J, GE W, MAO S, DING Q, HU M, JIANG H (Urology Dep, Fudan Univ, 200040 Shanghai, China, Email: humengbo@fudan.edu.cn) : First‑time versus recurrent penoscrotal extramammary Paget’s disease: Clinicopathological characteristics and risk factors in 164 Chinese male patients. Indian J Dermatol Venereol Leprol 2020, 86(2), 134-40.

Penoscrotal extramammary Paget’s disease is a rare, slow‑growing neoplasm with high frequency of local recurrence. The aim of this study was to investigate the difference in clinicopathological characteristics between first‑time and recurrent penoscrotal Paget’s disease, and to discover the potential risk factors of recurrence. Between January 2007 and February 2014, a total of 164 Chinese patients with biopsy‑proven tramammary Paget’s diseaseex in penis and scrotum underwent wide local resection in our institution. Among them, 142 patients with first‑time disease and other 22 patients with recurrent disease were enrolled in this retrospective analysis. The median duration of symptoms was much shorter in recurrent disease than in first‑timers (3 vs. 24months, P < 0.001). Patients with recurrent disease tended to have lower lesion exudation rates (27.3 % vs. 51.8 %, P = 0.032). In addition, patients with distant stage were more likely to obtain recurrent disease compared with first‑time disease (P = 0.005). Through immunohistochemical detection of extramammary Paget’s specimen, we found that HER2/neu protein expression in the recurrent group was significantly higher than first‑timers (P = 0.036). : In this study, the information on familial history of most patients was insufficient. Moreover, due to the lack of follow‑up data of our included cases, we were unable to evaluate the prognosis after diagnosis of extramammary Paget’s disease. Patients with penoscrotal Paget’s disease, especially those with shorter duration of symptoms, exudation of lesions, distant‑stage, Paget cells infiltrating into adnexa, and HER2/neu expression, should be followed up more carefully after surgery, as they were more likely to suffer recurrence.

3 illus, 2 tables, 24 ref

040540   SHI H-X, ZHANG R-Z, XU B, XU C-X, LI D, WANG L, XIAO L (Dermatology Dep, The Third Affiliated Hospital of Soochow Univ, Changzhou 213003, China, Email: zhangruzhi628@163.com) : Experimental study and clinical observations of autologous hair follicle cell transplants to treat stable vitiligo. Indian J Dermatol Venereol Leprol 2020, 86(2), 124-33.

Vitiligo is characterized by the loss and/or dysfunction of melanocytes in the skin and has a profound impact on the social interactions of patients. Although there are many treatment options for vitiligo, the outcome is frequently unsatisfactory, especially for patients with stable vitiligo. To study the biological properties of melanocytes derived from human hair follicles and to observe the efficacy of using transplants of autologous hair follicle cells to treat patients with stable vitiligo. From February 2014 to March 2017, 26 patients with stable vitiligo, who were refractory to all current routine therapy, underwent treatment with transplanted autologous hair follicle cells. The skin graft from each patient’s occipital region was trimmed to remove excess adipose tissue and some of the upper part of the dermis. The remaining tissue, including hair follicles and dermal papillae, was cut into pieces and incubated in collagenase type IV and then in trypsin‑ethylenediaminetetraacetic acid solutions. The cells were recovered, resuspended in the patient’s own serum and then applied to the recipient area. Clinical observations continued for 6months to 1 year. Laboratory experiments were also performed during this time on scalp specimens obtained from normal human volunteers. Cells migrating from the outer root sheath and the dermal papillae at various times of culture were observed using a microscope. Most of the repigmentation in the vitiligo areas appeared within 8 weeks of transplantation of autologous hair follicle cells. Early skin repigmentation was not uniform and appeared more repigmented than the surrounding normal skin. As time went by, the repigmentation became more obvious and matched the color of the skin around the lesion. Most of the pigmentation presented as a diffuse pattern and was not localized around the hair follicles. Among the 26 patients, 9 (34.6 %) achieved excellent repigmentation, while 13 (50.0 %) had good, 3 (11.5 %) fair and 1 (3.9 %) poor repigmentation. During the follow‑up visit at 1 year, no excess hair growth was observed in the recipient areas and there was no scarring or ulcer formation in the donor or recipient areas. In the experimental part of the study, many keratinocytes, melanocytes and fibroblasts migrated from the adherent outer root sheath. In later subcultures using a specialized medium, pure melanocytes were obtained that had a strong proliferative capacity and had bipolar or poly‑dendritic shapes. On the other hand, cells from the dermal papillae grew radially in primary culture and were almost fibroblast‑like. However, a few bipolar melanocytes appeared in the later stage of culture. The results of our study show that transplantation of autologous hair follicle cells is a simple and effective method to treat patients with stable vitiligo. Hair follicles (especially the outer root sheath) harbor many melanocytes with potential proliferative ability. There are a few limitations of the present study: a small sample size, a short follow‑up period, no cell counting or viability testing.

7 illus, 1 table, 19 ref

040539   PALIT A, KAR H K (Dermatology and Venereology Dep, AIIMS, Bhubaneswar, Odisha, Email: apalit2011@gmail.com) : Prevention of transmission of leprosy: The current scenario. Indian J Dermatol Venereol Leprol 2020, 86(2), 115-23.

With the worldwide implementation of WHO multidrug therapy in the 1980s, the global burden of leprosy has decreased. However, the annual new case detection rate around the world has remained nearly static over the past decade with India, Brazil, and Indonesia contributing the majority of these new cases. This has been attributed to the ongoing transmission of Mycobacterium leprae from existing untreated cases and partly to the intensive new case detection programs operative in endemic areas. The WHO has called for a “global interruption of transmission of leprosy by 2020”. Targeted chemoprophylaxis of contacts may help bring down the number of new cases. The single‑dose rifampicin currently in use for post‑exposure prophylaxis (PEP) has limitations and so newer antileprosy drugs and regimens have been trialed for chemoprophylaxis. BCG re‑vaccination in combination with chemoprophylaxis for the prevention of leprosy transmission has not been very encouraging. The use of the anti‑phenolic glycolipid‑1 (PGL‑1) antibody test to detect subclinical cases and administer targeted chemoprophylaxis was unsuccessful owing to its low sensitivity and technical difficulties in a field setup. There is a pressing need for newer multidrug chemoprophylactic regimens using second‑line antileprosy drugs. The Netherlands Leprosy Relief has proposed an enhanced PEP++ regimen. A simple but highly sensitive and specific serological test to detect subclinical cases at the field level needs to be developed. Although there are a number of challenges in the large‑scale implementation of strategies to halt leprosy transmission, it is important to overcome these in order to move towards a “leprosy‑free world.”

5 tables, 81 ref

040538   DE D, BISHNOI A, HANDA S, MAHAPATRA T, MAHAJAN R (Dermatology Dep, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, Email: dr_dipankar_de@yahoo.in) : Effectiveness and safety analysis of rituximab in 146 Indian pemphigus patients: A retrospective single‑center review of up to 68 months follow‑up. Indian J Dermatol Venereol Leprol 2020, 86(1), 39-44.

Rituximab is being increasingly used for the treatment of pemphigus. Data derived from single‑center studies following a uniform treatment protocol are limited. Effect of demography and disease type on treatment response is poorly characterized. Our aim was to assess the effectiveness of biosimilar rituximab in pemphigus patients who had received rituximab as per rheumatoid arthritis protocol (2 doses, 1g each, infused 14 days apart). It was a retrospective review of 146 eligible patients to assess the proportion of patients achieving complete remission off treatment, time to achieve complete remission off treatment, proportion of patients who relapsed after achieving complete remission off treatment, time taken to relapse, duration and total cumulative dose of corticosteroids administered after rituximab. Additionally, we tried to find whether a correlation existed between age, gender, total duration of illness before rituximab and pemphigus disease type with the above‑mentioned outcome measures. Of 146 patients, 107 (73.3 %) attained complete remission off treatment. Mean interval between first dose rituximab administration and complete remission off treatment was 6.6 ± 3.4months. Complete remission off treatment was sustained for a mean duration of 9.1 ± 8.5months before relapse. Over a mean follow‑up duration of 24.9 ± 17.1 months (median 23, maximum 68 months), 75 of 107 patients (76.5 %) who had achieved complete remission after first cycle of rituximab relapsed. Amean total cumulative dose of 3496 ± 2496 mg prednisolone was prescribed over a mean duration of 7.2 ± 4.7 months after first cycle of rituximab. Time taken to achieve remission was significantly longer in pemphigus foliaceus and these patients required significantly higher cumulative dose of prednisolone over a longer duration after rituximab. No deaths and long‑term complications were recorded. Only clinical parameters were assessed. Immunological parameters including B‑cell counts and enzyme‑linked immunosorbent assay for anti‑desmoglein antibody titers were not carried out. This study reinforces the beneficial role of rituximab in pemphigus. Pemphigus foliaceus patients required a higher total cumulative dose of prednisolone over a longer time to achieve remission and the remission lasted longer than that in pemphigus vulgaris.

1 illus, 1 table, 15 ref

040537   JAKHAR D, GROVER C, SINGAL A (Dermatology and STD Dep, Medical Sciences Univ Coll, Delhi - 110 095, Email: chandergroverkubba@rediffmail.com) : Nailfold capillaroscopy with USB dermatoscope: A cross‑sectional study in healthy adults. Indian J Dermatol Venereol Leprol 2020, 86(1), 33-8.

Nailfold capillaroscopy (NFC) is a convenient method for studying capillary morphology in the proximal nailfold (PNF) and is used for the evaluation of connective tissue and other diseases affecting the microvasculature. However, capillary density and morphological patterns in healthy individuals are largely unknown and this compromises the evaluation of the microvasculature in disease states. To describe and quantify the morphological characteristics of nailfold capillaries in healthy adult Indians. A USB 2.0 dermatoscope (Dinolite AM413ZT) with polarizing light was used to study nailfold capillary characteristics in 50 consecutive healthy adult individuals. NFC was performed on all 10 fingers. Images were assessed for both quantitative and qualitative features. The mean capillary density in healthy Indian adults was 7.63 ± 1.12 capillary/mm. Tortuosity (22 %), meandering capillaries (14 %) and microhemorrhages (14 %) were frequently seen in these individuals. The small sample size limited a conclusive determination of statistically significant differences in NFC findings with respect to gender and age. NFC with a USB dermatoscope is a useful technique for studying the PNF capillaries. The normal PNF capillary density in healthy Indian adults was 7.63 ± 1.12 capillary/mm. Capillary alterations such as tortuosity, meandering capillaries and microhemorrhages are seen in a significant number of healthy individuals.

2 illus, 4 tables, 18 ref

042376   TAWREJ P , KAUR R, GHODEY S (MAEER’s Physiotherapy Coll, Talegaon Dabhade, Maharashtra) : Immediate effect of muscle energy technique on quadratus lumborum muscle in patients with non-specific low back pain. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

The aim of this study was to evaluate the immediate effect of Muscle Energy Technique on Quadratus Lumborum Muscle on pain level and active Lumbar Range of motion in patients with acute and sub acute nonspecific Low back pain. Sixty patients with nonspecific low back pain and limited lumbar ROM were selected. The subjects were randomly assigned to an experimental group(n=30), which received treatment consisting of Muscle Energy Technique to Quadratus Lumborum muscle and hot pack, while that of control group received only hot pack to lower back. Pain levels using NPRS and Lumbar ROM using Modified Schober’s test were measured before and immediately after the interventions in both groups. Both the groups showed significant improvement in outcome measures. However, the Experimental group showed better results on comparing with control group. The combination of Muscle Energy Technique to Quadratus Lumborum muscle along with hot pack treatment was found to be effective in reducing pain and improving lumbar ROM after a single intervention session.

2 illus, 6 tables, 7 ref