In the quest for safer and effective anesthesia and analgesia, local anesthetics such as levobupivacaine or ropivacaine have been introduced into the clinical practice. Several studies have been done to assess their efficacy and relative superiority to bupivacaine. The aim of this review is to provide the recent and comprehensive updates regarding the clinical and pharmacological utility of levobupivacaine. Using Google search for indexing databases, a search for articles published was performed using various combinations of the following search terms: (a) Pharmacology; (b) clinical; (c) profile; (d) levobupivacaine; (e) local anesthetic; (f) recent. Additional sources were also identified by exploring the primary reference list.

The infectious etiology of periodontitis is complex. Due to its high prevalence rate, this disease has created an interest in finding a solution in the form of vaccines. Vaccination is the best known and the most important application of immunological principles to human health. The complexity of the periodontopathic bacteria might be a problem in the determination of antigens, thus complicating the development of periodontal vaccine. An attempt to review the literature on periodontal vaccine, including active immunization: Whole bacterial cells, sub-unit vaccines, synthetic peptides as antigens; passive immunization: Murine monoclonal antibodies and plantibodies; and genetic immunization: Plasmid vaccines, live, viral vector vaccines, has been done in this study.

Objective: The purpose of this study was to find out the occurrence of depressive disorders in patients with freshly detected diabetes mellitus (DM) and its relationship with the sociodemographic status of the subjects, severity of the disease, and insulin resistance (IR) factor in the subjects suffering from depression and DM. Materials and Methods: In this cross-sectional study, 100 patients aged between 30 and 60 years who fulfilled the criteria for diagnosis as per the World Health Organization criteria of DM were selected randomly from endocrinology outpatient department (OPD) of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi. All patients who attended the OPD services from November 2014 to July 2015 were screened for participation in the study. The patients were assessed for depressive disorder as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and IR by blood chemistry measure of fasting insulin (by enzyme-linked immunosorbent assay KIT) and fasting glucose (GOD-POD method) using homeostasis model assessment method (HOMA-IR scale). Results: In the study group of 100 patients, 34% of the patients were found to be suffering from depressive illness and they were not on any treatment. Out of the 34% patients who had insulin resistance; most common psychiatric disorder was major depressive disorder found in 21%,mild to moderate depressive disorder in 7% and 4% were found to have depression mixed anxiety symptoms. The estimated IR by HOMA-IR scale was found higher in 25 patients (74%) with psychiatric illness. Conclusions: This study highlights the high comorbidity of depressions in newly detected diabetes and also emphasizes the need of psychiatric evaluation in subjects who are vulnerable at the time of being diagnosed as a case of DM.

Introduction: Hepatitis B and C viral (HBV and HCV) infections are the most common infections acquired by hemodialysis (HD) patients. The prevalence of HBV and HCV infections in dialysis patients in India is 3.4-43% and 20-80%, respectively. This study was carried out to find out the current prevalence rate of HBV and HCV infections in HD patients in Puducherry. Materials and Methods: Serum samples from 65 patients with chronic kidney disease, who were admitted to a tertiary care hospital for HD, were screened for hepatitis B surface antigen (HBsAg) and HCV antibodies. The samples were collected on the first visit to the center before starting the dialysis and thereafter periodically. The serological results were correlated with gender, age, and duration of disease. An attempt was made to correlate the evidence of viral infection with clinical evidence of hepatitis, liver profile, and history of any transfusions in the past 3 years. Results: Among the 65 patients, 14 individuals were found be infected with hepatitis, HBV (5), and HCV (10) accounting for 22%. A single individual was coinfected with both the virus. There was a male preponderance accounting for 77% of patients on dialysis. Hepatitis B vaccination was given to all HBsAg negative patients (77%). Two of the vaccinated individuals were infected with HCV. Conclusions: Further studies are required to determine risk factors and factors that determine why some escape infection for prolonged periods. Hepatitis B vaccination should be mandatory for individuals undergoing HD.

Objective: This experimental study examined the effect of the antioxidant drug "U-74389G," on rat model and particularly in an oviductal ischemia-reperfusion (IR) protocol. The probable beneficial effect of that molecule was studied pathologically using mean salpingitis (S) lesions. Materials and Methods: Forty rats of mean weight 231.875 g were used in the study. S lesions were evaluated at 60 min of reperfusion (Groups A and C) and 120 min of reperfusion (Groups B and D), A and B without but C and D with the U-74389G administration. Results: U-74389G administration nonsignificantly altered the S scores without S lesions by 0 (P = 1.0000). Reperfusion time nonsignificantly altered the S scores without S lesions by 0 (P = 1.0000). However, U-74389G administration and reperfusion time together nonsignificantly altered the S scores without S lesions by 0 (P = 1.0000). Conclusions: U-74389G administration whether it interacted or not with reperfusion time nonsignificantly altered without lesions the salpingitis lesions within short-term time context of 2 h. Perhaps, a longer study time than 2 h or a higher drug dose may provide significant effects.

Background: As malaria is still an important life-threatening infection in many tropical countries and drug resistance has become increasingly common to drugs used nowadays, there is a pressing need to find more drugs that may contribute to the reduction of malaria in the future. This calls for an inward look into harnessing the full potential of medicinal plants that abound around us. Objective: To evaluate the antiplasmodial activity of aqueous leaf and root extracts of Cymbopogon citratus against Plasmodium berghei in mice. Materials and Methods: Cymbopogon citratus extracts of 200, 400, 800 mg/kg, and 5 mg/kg of chloroquine were used. Antiplasmodial activity of the extracts was evaluated using 4-day suppressive test model. Results: The extracts exhibited significant (P < 0.05) antiplasmodial activity in all the experimental doses used. The aqueous leaf extract produced a percentage suppressive effect of 20.83%, 55.56%, and 80.56% while that of the root extract produced a percentage suppression of 50.38%, 77.78%, and 100%. The suppressive effect of the extracts followed a dose-dependent pattern with 800 mg/kg of the aqueous root extract having the highest activity and producing the same 100% suppressive effect as chloroquine. In addition, the extracts had a mild effect on the body temperature of the infected mice; there was a significant increase only on the 2 ^nd day of the study. Conclusion: The results of the study suggested that the aqueous root extract possesses a better antiplasmodial activity than the aqueous leaf extract.

Malaria is the most common parasitic infection in tropical countries such as India, and it causing a major economic burden on the Asian and African countries. Splenic complication is common in Plasmodium falciparum infection, but splenic infarction itself is a rare clinical entity in P. falciparum infection. Herein, we are presenting a case report of an 18-year-old male patient who presented to the department of medicine with a complaint of pain abdomen. On the next day of admission, the patient had complained of fever with chills and rigor. Routine blood investigations including peripheral smear examination for malarial parasites were sent. Contrast-enhanced computed tomography (CECT) of the abdomen was performed to diagnose the cause of abdominal pain after the findings of infarction in ultrasonography. CECT showed multiple infarctions of spleen and peripheral blood film showed ring forms of P. falciparum. Hence, we should always rule out splenic complication in cases of malaria which present with fever and left hypochondrium pain.

A 5-year-old girl presented with continuous wetting with normal voiding pattern since birth. Ultrasonography (USG) showed a solitary left kidney. Excretory urography showed a normal left kidney. Right kidney was not seen but lower ureter was faintly delineated. Hence, contrast enhanced computed tomography (CECT) was done to look for any right kidney which was not seen on USG. CT showed a normal left kidney with a small ectopic kidney in right hemipelvis but ureteric orifice could not be traced to its insertion. Dimercaptosuccinic acid confirmed it to be a poorly functioning (6%) ectopic right kidney. Cystourethroscopy and vaginoscopy done could not localize the right ureteric orifice. The child underwent right nephrectomy along with excision of ectopic ureter inserting into vagina with complete resolution of her symptoms.

Elizabethkingia meningoseptica is a nonfermentative Gram-negative bacillus that is ubiquitously found in hospital environments, and it has been associated with various nosocomial infections. Immunocompromised individuals are particularly at increased risk for developing severe infections due to E. meningoseptica, including bacteremia. E. meningoseptica is resistant to multiple antimicrobials commonly used for Gram-negative bacteria. Rapid diagnosis and early institution of appropriate therapy for prolonged period are essential in management of such infections. We report a case of bacteremia due to E. meningoseptica in a neonate who presented with clinical findings suggestive of epidermolysis bullosa. Based on the clinical diagnosis and preliminary blood culture report, baby was started on syrup cefixime, topical fucidin cream along with fluid correction for electrolyte imbalance. As baby's general and systemic status were stable, the baby was discharged with the advice to review after 3 days. Awareness among clinicians along with correct identification by the diagnostic microbiology laboratory is required to reduce the fatal outcome associated with E. meningoseptica infections.

Progressive inflammatory periodontal disease, if left untreated, it will ultimately result in attachment loss. This can affect the bifurcation or trifurcation of multirooted teeth. Dentists are challenged to save those teeth that earlier would have been extracted without a second thought to save it. Hence, resective therapy has been utilized in the treatment of furcation defects. Hemisection is a removal of compromised root and the associated crown portion. It is one of the treatment options for preserving remaining part of molar having sound periodontium. This case report presents a patient in whom distal half of the carious and periodontally compromised tooth was resected, and after healing, fixed dental prosthesis was given to restore proper form and function.

Calcium channel blockers (CCBs) are one of the most commonly used drugs for the management of cardiovascular disorders. Amlodipine, a third-generation CCB, has been shown to promote gingival overgrowth (GO). The mechanism through which these medications trigger a connective tissue response is still poorly understood. Surgical intervention is the most effective treatment of drug-induced GO along with withdrawal or substitution of medication combined with meticulous oral hygiene, plaque control, and removal of local irritants. Here, we report successful management of a case of amlodipine-induced gingival enlargement by combination of the above-mentioned treatment modalities.

The aim of this case report is to describe the oral rehabilitation of a young patient of hypohidrotic ectodermal dysplasia (ED) with maxillary and mandibular complete dentures. Such patients often present with poor aesthetics, mastication, and social behavior. Treatment resulted in an improvement of esthetics, function and psychology of the patient. Children with EDs do not have normal patterns of growth and a risk and benefit analysis must be made to access the value of implant placement. Replacement of teeth by implants is usually restricted to patients with completed craniofacial growth.