Introduction Pandemic caused by novel coronavirus has created an unprecedented situation of lockdown in India. This retrospective study was undertaken to evaluate the impact of COVID-19 restrictions on cases of maxillofacial trauma and its etiologic variation by comparing it with the previous year archived data. Materials and Methods Patients with maxillofacial fracture visiting during the lockdown period (Phase) were compared to the patient's record during the same time period in the year 2019 (Control). They were subcategorised based on the etiology of trauma, i.e., road traffic accident (RTA), self-fall, physical assault and animal attacks. Age and gender variations were also assessed. Degree of significance was calculated using t test and p value obtained. Result Mean age of trauma patients during lockdown and control period was 32.66 and 27.93 years, respectively. Number of cases of overall trauma had significantly decreased. Cases of RTA and self-fall were 22 and 4 in lockdown compared to 135 and 16 during control phase. Cases of physical assault increased by 50%, i.e., from 9 to 6 on comparison of both the phases. Animal attack maxillofacial injuries were 2 in each group. Conclusion RTA and subsequent drop in numbers of maxillofacial trauma can be shown as the benefit of lockdown nonetheless on the other side increase in number of physical assaults also shows how isolation and restrictions have psychological negative impact on society.

Objective: Our aim was to prospectively evaluate the accuracy of the bedside index for severity in acute pancreatitis (BISAP) score in predicting mortality, as well as intermediate markers of severity, in a tertiary care centre in east central India, which caters mostly for an economically underprivileged population.Methods: A total of 119 consecutive cases with acute pancreatitis were admitted to our institution between November 2012 and October 2014. BISAP scores were calculated for all cases, within 24 hours of presentation. Ranson’s score and computed tomography severity index (CTSI) were also established. The respective abilities of the three scoring systems to predict mortality was evaluated using trend and discrimination analysis. The optimal cut-off score for mortality from the receiver operating characteristics (ROC) curve was used to evaluate the development of persistent organ failure and pancreatic necrosis (PNec).Results: Of the 119 cases, 42 (35.2%) developed organ failure and were classified as severe acute pancreatitis (SAP), 47 (39.5%) developed PNec, and 12 (10.1%) died. The area under the curve (AUC) results for BISAP score in predicting SAP, PNec, and mortality were 0.962, 0.934 and 0.846, respectively. Ranson’s score showed a slightly lower accuracy for predicting SAP (AUC 0.956) and mortality (AUC 0.841). CTSI was the most accurate in predicting PNec, with an AUC of 0.958. The sensitivity and specificity of BISAP score, with a cut-off of ≥3 in predicting mortality, were 100% and 69.2%, respectively.Conclusions: The BISAP score represents a simple way of identifying, within 24 hours of presentation, patients at greater risk of dying and the development of intermediate markers of severity. This risk stratification method can be utilized to improve clinical care and facilitate enrolment in clinical trials.

Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. Glyceryl trinitrate (GTN) ointment (0.2%) has an efficacy of up to 68% in healing chronic anal fissure, but it is associated with headache as the major and most common side effect. Though botulinum toxin injected into the anal sphincter healed over 80% of chronic anal fissures, it is more invasive and expensive than GTN therapy. Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.

Ziziphus mauritiana (Rhamnaceae), commonly known as Indian jujube, is a pharmacologically diverse medicinal plant. A plethora of active phytochemical constituents of this plant has been revealed so far, namely, berberine, quercetin, kaempferol, sitosterol, stigmasterol, lanosterol, diosgenin, and so forth. Several studies demonstrated the exploration of pharmacological potential of various parts such as fruits, leaves, and stems of the plant as antioxidant, cytotoxic, antimicrobial, anti‐diarrhoeal, antidepressant, immunomodulator, and hepatoprotective. This review gives a unique summary including phytochemistry, nutritional value, and significant pharmacological importance of Z. mauritiana. The literature search was carried out via search engine PubMed, Science Direct, and so on. The data were heterogeneous in terms of leaves, stem, roots, and fruits which were used for different experimental findings, which made the comparison a lengthy task. Study findings suggested that the extracts from this plant may possess numerous types of pharmacological activities. As the search for novel drugs from botanical sources continues, there is need for future investigations to isolate and characterize pharmacologically active agents that confer medicinal properties on Z. mauritiana, as well as to elucidate the structures of these agents by which they exert their healing properties and to scientifically validate the existing traditional practices concerning its health benefits.

Aim: Are there differences in diabetes care between rural and non-rural US adults with diabetes? Background: Rural Healthy People 2010 includes diabetes as a major health priority, suggesting a possible disparity between diabetes care in rural settings as compared to non-rural locales. Methods: This cross-sectional study using population-based survey data sought to determine if there was a difference in the quality of diabetes care between rural and non-rural US adults (>18 years). A diabetes care index was computed from five separate dichotomous care-related variables (HbA1c checked, lipids checked, dilated eye exam, feet checked by health care provider, and diabetes education), with adequate care defined as receiving at least four of these interventions. Multivariate methods were used to detect differences in diabetes care received by individuals living in rural compared to non-rural settings. Results: Multivariate regression analysis revealed that US adults with diabetes living in rural communities were more likely to receive inadequate care than non-rural residents (OR 5 1.205; 95% CI 1.201, 1.209). Rural residents were more likely to receive inadequate diabetes care if they were: ,40 years of age, male, Caucasian, not a high school graduate, not partnered, without health insurance, inactive or without an identified health care provider. Those deferring medical care because of cost, or who did not have an annual routine physical or had fewer than two diabetes related office visits annually were also at greater risk for suboptimal care. Routine physical checkups and deferring medical care because of cost had a greater impact on diabetes care for rural adults compared to non-rural adults. Conclusion: The results of this study indicated that rural residents were less likely to receive adequate diabetes care compared to their nonrural counterparts. The findings suggest that efforts to identify and to address this disparity would likely improve the outcomes for diabetic individuals living in rural communities.