Pandit Bhagwat Dayal Sharma University of Health Sciences

Dear Editor, Mindfulness gives a sight to be aware of the present moment-by-moment sensations, emotions, thoughts, and experiences with a non-judgmental attitude.[1,2] Practitioners of mindfulness learn to live in the present moment and not travel in the past or future with their emotional interpretations of events which leads to pain in life. This technique is helpful in patient groups to overcome their depressive feeling, emotions, and behavior.[3-6] Two approaches of mindfulness that are widely evaluated and effective are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBCT and MBSR both are also effective in clinical depression. Practicing it decreases the risk of relapse in depression.[1-3] A, 30 yrs old female, post-graduate, married, Hindu, Hindi speaking, belongs to middle socioeconomic status, and from an urban area came to OPD with her husband for persistent low mood, crying spells, lack of joy in every activity, inability to perform household chores, avoiding others and try to live in her room alone, hopelessness, worthlessness, disturbed sleep and appetite from last three months. She was treated with antidepressants by a Psychiatrist with gradual response and referred for psychotherapy. A detailed interview showed that the patient’s illness was precipitated by her repeated failure to get her desired job. Strained relationships and conflicts with her in-law also contribute to maintaining her problems. Due to her husband’s job, they had to live far away from their native place leading to a sense of loneliness, lack of support, avoidance behavior, and poor motivation for activities. She was assessed with the Beck Depression Inventory (BDI), Hopelessness Scale of Beck et al.[4] (HSB), and WHOQOL-BRIEF at baseline, after 8 weeks of therapy sessions to understand the efficacy of Mindfulness-based cognitive therapy, and again after a follow-up period of next one month to know the durability of the management [Table 1].Table 1: Shows the pre-, post, and follow-up assessment scores of the patient on BDI, HSB, and WHOQOL-BRIEFHer scores on BDI suggest a severe level of depression at baseline. High on all domains of the hopelessness scale suggests a sense of hopelessness, negative expectations, and low motivation for the future. After intervention and in follow up she showed improvement in depressive symptoms and have hope in her life. Scores on WHOQOL-BRIEF were found low in baseline assessment on all domains. Anxiety and depression contribute to worsening the quality of life of sufferers due to poor support, lack of functioning, poor health, and low mood. Post-intervention scores were suggestive of improved quality of life in the patient which was maintained in follow-up. She improved in all domains of quality of life after intervention. Previous studies supported the result that MBCT provides an improvement in depressive symptoms, relapse prevention, and quality of life in patients with depression.[5-7] Depressive symptoms are colored with lots of negative emotions and cognitions, distorted ways of evaluation of self, others, and events, judgmental thinking, and pessimism. MBCT effectively deals with depressive symptoms. The results propose that depressive symptoms can be healed by disengaging from distorted cognition and restructuring it, increasing attention to the present moment through mindfulness exercises. It is a promising treatment for turning down the severity of depression and improving quality of life. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Author’s contribution Concept, design, definition of intellectual content, literature search, data acquisition: DK, NS Manuscript preparation: DK, NS. Manuscript editing and manuscript review. DK. Guarantor: DK. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Proteases are ubiquitous enzymes, having significant physiological roles in both synthesis and degradation. The use of microbial proteases in food fermentation is an age-old process, which is today being successfully employed in other industries with the advent of 'omics' era and innovations in genetic and protein engineering approaches. Proteases have found application in industries besides food, like leather, textiles, detergent, waste management, agriculture, animal husbandry, cosmetics, and pharmaceutics. With the rising demands and applications, researchers are exploring various approaches to discover, redesign, or artificially synthesize enzymes with better applicability in the industrial processes. These enzymes offer a sustainable and environmentally safer option, besides possessing economic and commercial value. Various bacterial and fungal proteases are already holding a commercially pivotal role in the industry. The current review summarizes the characteristics and types of proteases, microbial source, their current and prospective applications in various industries, and future challenges. Promoting these biocatalysts will prove significant in betterment of the modern world.

Calcium hydroxide has been used extensively in dentistry for a century. Despite its widespread use as a pulp-capping agent, its mechanisms of action still remain ambiguous. Understanding its modes of action will lead to a broader understanding of the mechanisms associated with induced dentinogenesis and help in optimizing the currently available agents to target specific regenerative processes to obtain the best possible clinical outcomes. A literature search relating to mechanisms of dentinogenesis of calcium hydroxide up to December 2011 was carried out using pubmed and MEDLINE database searches as well as manual searching of cross-references from identified studies. Resulting suggestions regarding dentinogenic mechanisms of calcium hydroxide range from direct irritating action of the material to induction of release of biologically active molecules. The purpose of this article is to discuss various mechanisms through which calcium hydroxide may induce tertiary dentinogenesis in the light of observations made in included studies.

BACKGROUND: Oxidative stress has been considered to be a pathogenic factor of diabetic complications including nephropathy. There are many controversies and limited studies regarding the antioxidant enzymes in diabetic nephropathy. AIM: This study was to evaluate the levels of antioxidant enzymes and lipid peroxidation in Type-2 Diabetes Mellitus (DM) patients with and without nephropathy. MATERIALS AND METHODS: The study included 90 age and sex matched subjects. Blood samples of all subjects were analyzed for all biochemical and oxidative stress parameters. RESULTS: The malondialdehyde (MDA) levels and catalase (CAT) activity were significantly increased and reduced glutathione (GSH) levels and activities of glutathione peroxidase (GPx) and glutathione reductase (GR) were significantly decreased in Type-2 DM with and without nephropathy as compared to controls and also in Type-2 DM with nephropathy as compared to Type-2 DM without nephropathy. There were an excellent positive correlation of glycohemoglobin (HbA1c) with MDA and a good negative correlation of GPx with GSH in controls. There were positive correlations of GR, CAT, and superoxide dismutase (SOD) with MDA in Type-2 diabetes patients with nephropathy. CONCLUSIONS: Intensity of oxidative stress in Type-2 diabetic patients with nephropathy is greater when compared with Type-2 diabetic patients without nephropathy as compared to the controls.

BACKGROUND: Workplace violence (WPV) includes verbal abuse, physical violence, bullying or mobbing, assault and sexual harassment. The area has been well researched in the developed and high-income countries among nurses and healthcare professionals, but in the case of the low and upper-middle-income countries, there remains a paucity of comprehensive data on the prevalence of WPV and its contributing factors. AIMS: To estimate the prevalence and determinants of WPV among nurses working in the South-East Asian Region and Western Pacific Regions. DESIGN: Systematic review and Meta-analysis. METHOD: A comprehensive search was done to retrieve articles based on a PRISMA compliant protocol registered in PROSPERO: CRD 42020223605. Study selection, quality assessment and data abstraction were independently done by the team members and discrepancies addressed through mutual consensus. Random-effect meta-analysis, I2 statistics and subgroup analysis were done. RESULTS: The review included 41 studies conducted among 42,222 nurses from 13 countries. The pooled prevalence of WPV, verbal abuse, physical violence, threatening behaviour, physical assault, sexual harassment and bullying/mobbing were 58% (CI 51%-64%), 64% (CI 59%-70%), 23% (CI 14%-34%), 30(CI-11%-52%), 21% (CI 8%-38%), 12% (CI 7%-17%) and 25% (17%-33%), respectively. The various determinants of WPV included attributes related to the patient, nurses and organisation. Moreover, the impact of WPV included physical, psychological repercussions on nurses and the various measures used to manage it. CONCLUSION: Nurses encounter a high level of WPV especially verbal abuse in their workplace settings. Nursing councils and professional nursing organisations should put in their effort towards the formulation and implementation of occupational safety legislation in their respective countries through appropriate political lobbying. RELEVANCE TO CLINICAL PRACTICE: Our review highlights the emerging need to focus on the prevention of WPV among nurses working in lower, middle and upper-middle-income countries. Legislation changes and organisational commitment are vital for ensuring effective policies to combat WPV.

Abstract Background Suppression of immune system in treated cancer patients may lead to secondary infections that obviate the need of antibiotics. In the present study, an attempt was made to understand the occurrence of secondary infections in immuno-suppressed patients along with herbal control of these infections with the following objectives to: (a) isolate the microbial species from the treated oral cancer patients along with the estimation of absolute neutrophile counts of patients (b) assess the in vitro antimicrobial activity medicinal plants against the above clinical isolates. Methods Blood and oral swab cultures were taken from 40 oral cancer patients undergoing treatment in the radiotherapy unit of Regional Cancer Institute, Pt. B.D.S. Health University, Rohtak, Haryana. Clinical isolates were identified by following general microbiological, staining and biochemical methods. The absolute neutrophile counts were done by following the standard methods. The medicinal plants selected for antimicrobial activity analysis were Asphodelus tenuifolius Cav., Asparagus racemosus Willd., Balanites aegyptiaca L. , Cestrum diurnum L., Cordia dichotoma G. Forst, Eclipta alba L., Murraya koenigii (L.) Spreng. , Pedalium murex L. , Ricinus communis L. and Trigonella foenum graecum L. The antimicrobial efficacy of medicinal plants was evaluated by modified Kirby-Bauer disc diffusion method. MIC and MFC were investigated by serial two fold microbroth dilution method. Results Prevalent bacterial pathogens isolated were Staphylococcus aureus (23.2%), Escherichia coli (15.62%), Staphylococcus epidermidis (12.5%), Pseudomonas aeruginosa (9.37%), Klebsiella pneumonia (7.81%), Proteus mirabilis (3.6%), Proteus vulgaris (4.2%) and the fungal pathogens were Candida albicans (14.6%), Aspergillus fumigatus (9.37%). Out of 40 cases, 35 (87.5%) were observed as neutropenic. Eight medicinal plants ( A. tenuifolius, A. racemosus, B. aegyptiaca, E. alba, M. koenigii, P. murex R. communis and T. foenum graecum ) showed significant antimicrobial activity (P < .05) against most of the isolates. The MIC and MFC values were ranged from 31 to 500 μg/ml. P. aeruginosa was observed highest susceptible bacteria (46.6%) on the basis of susceptible index. Conclusion It can be concluded that treated oral cancer patients were neutropenic and prone to secondary infection of microbes. The medicinal plant can prove as effective antimicrobial agent to check the secondary infections in treated cancer patients.

INTRODUCTION: The viability of Platelet Rich Fibrin (PRF) on enhancement of osseous and associated tissue healing has been substantiated well in literature. However, paucity in the applicability of PRF to enhance peri-implant healing in oral region is not well-corroborated. PURPOSE: This prospective study evaluated the effect of Platelet PRF on peri-implant tissue response following one-stage implant placement with non-functional immediate provisionalization in maxillary anterior region. MATERIALS AND METHODS: A Prospective, Randomized Controlled Trial (RCT) was conducted across 20 (15 male, 5 Female) systemically healthy subjects with maintainable oral hygiene. Subjects were broadly divided into two groups i.e. Study group (PRF group) and Control group (Non-PRF group). Twenty standard SLA- AB/AE (alumina oxide blasted/acid etched surface treated) tapered threaded dental implants were randomly placed with and without PRF and immediately provisionalized. The subjects were evaluated clinically and radiographically at baseline (at time of implant placement), one month and three month post-operatively for peri-implant soft tissue and crestal bone responses. RESULTS: At 3 months, all implants remained osseointegrated. The mean marginal bone changes were observed from baseline to 3 months in both groups with lesser changes observed in PRF Group. No significant differences in probing depth and bleeding on probing were noted during follow-up. CONCLUSION: Within the limitations of this study, PRF could be considered as a healing biomaterial with potential beneficial effect on peri-implant tissue and can be used as a therapeutic adjuvant in clinical scenario of one stage, single tooth implant placement procedure in maxillary anterior region.

BACKGROUND: Lower respiratory tract infections (LRTIs) are the most frequent infections among patients in Intensive care units (ICUs). AIMS: To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU. SETTINGS AND DESIGN: Tertiary care hospital, retrospective study. MATERIALS AND METHODS: Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods. STATISTICAL ANALYSIS USED: SPSS software was used for calculation of % R of 95% confidence interval (CI). RESULTS: Of 207 specimens, 144 (69.5%) were culture positive and 63 (30.4%) showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6%) were Gram negative bacilli (GNB). In 17 (11.0%) patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%), Acinetobacter baumannii (23.6%), and Klebsiella pneumoniae (13.6%). A very high rate of resistance (80-100%) was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline. CONCLUSION: Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and beta-lactam-beta-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.

Apoptosis is an evolutionarily conserved sequential process of cell death to maintain a homeostatic balance between cell formation and cell death. It is a vital process for normal eukaryotic development as it contributes to the renewal of cells and tissues. Further, it plays a crucial role in the elimination of unnecessary cells through phagocytosis and prevents undesirable immune responses. Apoptosis is regulated by a complex signaling mechanism, which is driven by interactions among several protein families such as caspases, inhibitors of apoptosis proteins, B-cell lymphoma 2 (BCL-2) family proteins, and several other proteases such as perforins and granzyme. The signaling pathway consists of both pro-apoptotic and pro-survival members, which stabilize the selection of cellular survival or death. However, any aberration in this pathway can lead to abnormal cell proliferation, ultimately leading to the development of cancer, autoimmune disorders, etc. This review aims to elaborate on apoptotic signaling pathways and mechanisms, interacting members involved in signaling, and how apoptosis is associated with carcinogenesis, along with insights into targeting apoptosis for disease resolution.

BACKGROUND: This study investigates the levels of superoxide dismutase (SOD) activity in serum and saliva of patients with chronic periodontitis (CP). In addition, the outcome of scaling and root planing (SRP) with and without vitamin E supplementation is evaluated in terms of changes in periodontal parameters and SOD activity in patients with CP. METHODS: Serum and salivary SOD activity in 38 patients with CP were compared with those of 22 systemically and periodontally healthy individuals (control group). At periodontal examination, serum and saliva samples were obtained. Patients with CP were randomly divided into treatment groups 1 (TG-1) and 2 (TG-2). SRP was performed for both groups, and TG-2 also received 200 mg (300 IU) vitamin E every other day. Periodontal parameters and SOD activity were evaluated after 3 months. SOD activity was determined using an SOD assay and enzyme-linked immunosorbent assay reader at 450 nm. RESULTS: SOD activity in both serum (P <0.05) and saliva (P <0.001) was lower in patients with CP compared with controls. After 3 months of follow-up, SOD activity improved in both treatment groups; however, the improvement in TG-2 was higher than in TG-1, along with more improvement in periodontal parameters. Serum SOD levels in TG-2 increased even above the level of the control group. CONCLUSIONS: Systemic and local SOD levels are lowered in CP. Adjunctive vitamin E supplementation improves periodontal healing as well as antioxidant defense.

COVID-19 is a highly contagious and widespread disease that has strained the global healthcare system to the hilt. Silver nanoparticles (AgNPs) are well known for their potent antimicrobial, antiviral, immunomodulatory and biosensing properties. AgNPs have been found to be potential antiviral agent that act against many deadly viruses and is presumed to be effective against COVID-19. AgNPs can generate free radicals and reactive oxygen species (ROS) leading to apoptosis mediated cell death thereby inhibiting viral infection. The shape and size of AgNPs play an important role in its biomedical applications as alterations may result in variable biological interaction and activity. Herein, we propose that AgNPs can be utilized for effective management of the ongoing COVID-19 pandemic by highlighting the current status of AgNPs in the fight against COVID-19.

BACKGROUND: The association between serum lipids and periodontal disease has been studied predominantly in patients with chronic periodontitis with limited data available regarding periodontal status of patients with hyperlipidemia. Meanwhile, the impact of statins on the periodontal health of the population also remains largely underexplored. This study aims to assess the periodontal status among patients with hyperlipidemia and users of statins. METHODS: In this cross-sectional study, 94 patients with hyperlipidemia (50 receiving statins and 44 receiving non-pharmacologic therapy) and 46 control individuals who were normolipidemic underwent periodontal examination (plaque index, gingival index [GI], probing depth [PD], and clinical attachment level [CAL]). Biochemical parameters measured included serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol levels. RESULTS: PD and GI were significantly higher in patients with hyperlipidemia who were non-statin users compared with the normolipidemic individuals (P <0.001 [PD] and P <0.05 [GI]) and the statin group (P = 0.001 [PD] and P <0.05 [GI]). Periodontal parameters between statin users and the normolipidemic group did not differ significantly. After adjusting for confounders, positive and significant correlations were observed between PD and TG, and TC and LDL, whereas CAL shared correlation with TC and LDL. GI was correlated with TG and TC. Regression analyses revealed that whereas TC was associated significantly with PD (P <0.001), LDL showed significant association with CAL (P = 0.013). TG showed significant association with GI (P = 0.020). CONCLUSIONS: Our findings suggest that relative to the general population, patients with hyperlipidemia are more prone to periodontal disease. Also, within the limits of this study, statins have a positive impact on periodontal health.

The aim of this study was to determine whether the implementation of Kangaroo Mother Care (KMC) to low birth weight infants would improve physical growth, breastfeeding and its acceptability. A randomized controlled trial was performed over 16 months in which 110 neonates were randomized into a KMC group and a control group using a random number table. The KMC group was subjected to KMC for at least 6 h per day. The babies also received KMC after moving from the neonatal intensive care unit and at home. The control group received standard care (incubator or open care system). Weight, length and occipitofrontal circumference (OFC) were measured weekly for three months. The acceptability of KMC by mothers and nursing staff was assessed on day 7 after the start of KMC using a questionnaire incorporating the Likert scale. Breastfeeding rates were calculated based on history at end of three months. The mean gestational age was 35.48 ± 1.20 weeks in the KMC group and 35.04 ± 1.09 weeks in the control group (P > 0.05). KMC was initiated at a mean age of 1.72 ± 0.45 days and the duration of KMC was 9.74 ± 1.48 h/day. The mean birth weight was 1.69 ± 0.11 kg in the KMC group compared to 1.69 ± 0.12 kg in the control group (P > 0.05). The mean weight gain in gm/day in the KMC group was 21.92 ± 1.44 compared to 18.61 ± 1.28 in the control group (P < 0.05). The mean length gain in cm/week was 1.03 ± 0.5 in the KMC group compared to 0.74 ± 0.05 in the control group (P < 0.05). The mean OFC gain in cm/week was 0.59 ± 0.04 in the KMC group compared to 0.47 ± 0.03 in the control group (P < 0.05). The exclusive breast-feeding rate at end of three months was 88% in the KMC group compared to 72% in the control group (P < 0.05). KMC improved physical growth, breastfeeding rates and was well accepted by both mothers and nursing staff.

BACKGROUND: The internet is an integral part of everyone's life. College going adolescents are highly vulnerable to the misuse of the internet. AIMS: To estimate the pooled prevalence of internet addiction (IA) among college students in India. METHODS: Literature databases (PubMed, Web of Science, Scopus, EMBASE, PsycINFO and Google Scholar) were searched for studies assessing IA using the Young Internet Addiction Test (Y-IAT) among adolescents from India, published in the English language up to December 2020. We included studies from 2010 to 2020 as this is the marked era of momentum in wireless internet connectivity in India. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the fixed-effects model. Publication bias was evaluated using Egger's test and visual inspection of the symmetry in funnel plots. RESULTS: Fifty studies conducted in 19 states of India estimated the prevalence of IA and the overall prevalence of IA as 19.9% (95% CI: 19.3% to 20.5%) and 40.7% (95% CI: 38.7% to 42.8%) based on the Y-IAT cut-off scores of 50 and 40, respectively. The estimated prevalence of severe IA was significantly higher in the Y-IAT cut-off points of 70 than 80 (12.7% (95% CI: 11.2% to 14.3%) vs 4.6% (95% CI: 4.1% to 5.2%)). The sampling method and quality of included studies had a significant effect on the estimation of prevalence in which studies using non-probability sampling and low risk of bias (total quality score ≥7) reported lower prevalence. The overall quality of evidence was rated as 'moderate' based on the Grading of Recommendations Assessment, Development and Evaluation criteria. CONCLUSIONS: Our nationally representative data suggest that about 20% to 40% of college students in India are at risk for IA. There is a need for further research in the reconsideration of Y-IAT cut-off points among Indian college students. PROSPERO REGISTRATION NUMBER: CRD42020219511.

Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.

The effect of aqueous leaf extract of Azadirachta indica (A. indica) was evaluated in paracetamol induced hepatotoxicity in rats. Liver necrosis was produced by administering single dose of paracetamol (2 g/kg, p.o.). The liver damage was evidenced by elevated levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (gamma-GT) and by histopathological observations of liver sections. Aqueous A. indica leaf extract (500 mg/kg, p.o.) significantly (P < 0.01) reduced these elevated levels of AST, ALT and gamma-GT. Paracetamol induced liver necrosis was also found to be reduced as observed macroscopically and histologically.

BACKGROUND: In spite of major technological advances in conventional therapies, cancer continues to remain the leading cause of mortality worldwide. Phytochemicals are gradually emerging as a rich source of effective but safer agents against many life-threatening diseases. METHODS: Various phytochemicals with reported anticancer activity have been simply categorized into major phytoconstituents- alkaloids, polyphenols, saponins, tannins and terpenoids. RESULTS: The adverse effects associated with currently available anticancer medications may be overcome by using plant-derived compounds either alone or in combination. Exploration of plant kingdom may provide new leads for the accelerated development of new anticancer agents. CONCLUSION: Although numerous potent synthetic drugs have been introduced for cancer chemotherapy, yet their serious toxicity concerns to normal cells apart from drug resistance have emerged as the major obstacles for their clinical utility over a prolonged duration of time. Current status and potential of phytochemicals and their derivatives in cancer therapy have been briefly reviewed in the present manuscript.

Novel approaches for the aggressive treatment of cervical cancer will optimistically result in decreased side effects as well as toxicity, frequency of administration of existing drugs, to overcome MDR and to increase the survival rates.

BACKGROUND: Over the past decade, advances in cancer treatments have been counterbalanced by a rising number of immunosuppressed patients with a multitude of new risk factors for infection. Hence, the aim of this study was to determine risk factors, infectious pathogens in blood and oral cavity of oral cancer patients undergoing different treatment procedures. METHODS: The present prospective cohort analysis was conducted on the patients undergoing treatment in the radiotherapy unit of Regional Cancer Institute, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, during the period of January 2007 to October 2009. Total 186 patients with squamous cell carcinoma of oral cavity were analyzed in the study. Based on treatment procedures patients were divided into three groups, group I were under radiotherapy, group II under chemotherapy and group III were of radio chemotherapy together. Clinical isolates from blood and oral cavity were identified by following general microbiological, staining and biochemical methods. The absolute neutrophile counts were done by following the standard methods. RESULTS: Prevalent bacterial pathogens isolated were Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus mirabilis, Proteus vulgaris and the fungal pathogens were Candida albicans, Aspergillus fumigatus. The predominant gram negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumonia were isolated from blood of radiotherapy and oral cavity of chemotherapy treated cases respectively. The predominance of gram positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis) were observed in blood of chemotherapy, radio chemotherapy cases and oral cavity of radiotherapy, radio chemotherapy treated cases. Our study also revealed the presence of C. albicans fungi as most significant oral cavity pathogens in radiotherapy and radio chemotherapy cases. CONCLUSION: Gram positive bacteria and Gram negative were reported from the blood of all the three groups of patients. Oral mucositis played a significant role in oral cavity infection and make patients more prone to C. albicans infection.

INTRODUCTION: Despite reports of a high prevalence of chronic kidney disease (CKD) from the coastal Uddanam region of Andhra Pradesh, India, there are no accurate data on the distribution of kidney function abnormalities and CKD risk factors in this region. METHODS: A total of 2419 participants were recruited through multistage cluster random sampling from 67 villages. Serum creatinine and urine protein creatinine ratio were measured using validated methodologies. All abnormal estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio values were reconfirmed after 3 months. A range of sociodemographic factors were evaluated for their association with CKD using Poisson regression. RESULTS: were older, were more likely to be uneducated, manual laborers/farmers, or tobacco users, and were more likely to have hypertension, a family history of CKD, a diagnosis of heart disease, and a lower body mass index. Among those with low eGFR, there was no difference between those with urine protein creatinine ratio <0.15 or >0.15, except a lower frequency of males in the former. CONCLUSION: We confirmed the high prevalence of CKD in the adult population of Uddanam. The cause was not apparent in a majority. Subjects with a low eGFR with or without elevated proteinuria were phenotypically distinct from those with proteinuria and preserved eGFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies to understand the causes of CKD in this region.