Introduction: Clinical governance in radiology is an improved quality assurance program where the patient well-being is the central focus concerning radiologic service using the radiology request form (RRF). Methodology: The study was a 6-month descriptive study conducted from January 2020 to June 2020. A total of 2053 request forms were collated retrospectively and evaluated to ascertain the appropriateness of the clinical information with the investigation requested. A 3 stage Likert scale of appropriate somewhat appropriate and inappropriate was used and the data analyzed using the statistical package for the social sciences (SPSS) IBM Corp. version 23.0 (Armonk, NY: USA). The results were expressed in percentages and frequencies and presented in tables and charts. Results: Of the 2053 request forms, X-rays constitute 32.54% while ultrasound scans and computed tomography (CT) investigations constitute 43.21% and 5.46%, respectively. Clinical information was indicated in 51.39% of the RRF, out of which 75.95% of the clinical information were adequate while 13.93% were not in keeping with the investigation. Ultrasound scan request had the highest inappropriate clinical information (54.68%) followed by plain radiography request (41.73%) whereas all the CT request was in tandem with the investigation. Conclusion: There are occasional clinical information and radiologic request mismatch. This may be due to the filling of the RRF by medical interns or nonmedical personnel such as allied health workers with less knowledge on radiologic imaging modalities. The audit recommends proper supervision of young clinicians and continues medical education concerning the rational use of imaging modality.

Mucormycosis is a rare but fatal, invasive opportunistic fungal infection generally described among immunocompromised individuals. The ongoing pandemic coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 has severely compromised the immune system of patients thereby making them vulnerable to mucormycosis, especially when they are lined up with associated comorbidities. Here, we present a case of one such 64-year-old male patient being on corticosteroids and a case of long-standing diabetes mellitus and chronic kidney disease. COVID-19 triggered the mucormycosis in this patient thereby leading to a condition we have described as rhino-orbital pulmonary mucormycosis.

The presence of small quantities of genetically heterogeneous cells in an organism is known as microchimerism. Fetal microchimerism is the presence of small quantities of fetal cells in the maternal system during and after pregnancy. Since these cells are semi-allogeneic in the mother's body, they have an impact on the mother's health. Recent studies suggest contradictory outcomes. Some suggest an involvement in autoimmune diseases and cancer. Others suggest involvement in tissue repair and wound healing. Fetal cells have been detected in maternal organs decades after pregnancy. It was found that these cells participate in the healing process post a chronic injury. In other cases, these cells initiate an immune response which may lead to the development of autoimmune diseases. Further, studies show that fetal cells have been discovered in the tumor microenvironment, either aiding in cancer development or eradicating the cancer cells. Here, I review the different outcomes that can occur in the female body because of fetal cell microchimerism. I discuss the presence of fetal cells in maternal organs such as the heart and the central nervous system organs and their involvement in disease development and tissue repair in the mother.

Background: The thermal changes in environments that composite materials are exposed to has a great effect on fatigue and wear behavior. Aim: Micro-cracks and interfacial deformations occur in the composite material structure because of heating and cooling environments occurring on material surfaces. Considering the environment to which bio-composite materials used in the human body are exposed, it is inevitable that they are exposed to a thermal change cycle environment. Material and Method: In this study, the mechanical behaviors of Silorane, X-Trafil and Valux-Plus bio-composite materials were examined after being exposed to thermal cycles in an artificial mouth environment in the temperature range of minimum 5 °C and maximum 65 °C. Micro-tensile strengths of bio-composite materials after thermal cycle test procedures were determined using a universal micro tensile tester device. In addition, microstructural analyzes of bio-composite materials were evaluated using scanning electron microscopy (SEM). Results: Within the scope of the data obtained as a result of this study, it was concluded that the thermal changes in environments significantly affects the micro-shrinkage behavior of bio-composite materials. Conclusion: The behavior of the matrix structure of the composite material significantly affected the formation of micro cracks.

Mitochondrial DNA (mtDNA), as its name implies, is an embodiment of the mitochondrial genetic information that constitutes about 1% of the mammalian genome. It fills a vital niche in tracing matrilineality; the mtDNA is inherited solely from the mother and plays a crucial role in genealogical research. Even a single mutation in the mtDNA can have debilitating and life-altering consequences. Mothers carrying mtDNA mutations will inevitably pass it on to the future generation. Three-parent In vitro fertilization (IVF), a breakthrough technique, shows promising potential to prevent mothers with mtDNA defects from passing it on to their future generation, while also maintaining the genetic link to their posterity. In this review, I delve into the intricacies of this technique, compare and analyze the difference between maternal spindle transfer and pronuclear transfer, discuss the prospective therapeutic effects, and highlight the ethical concerns surrounding this procedure. Considering the various challenges and ethics of this contentious technique, the paper seeks to answer the rousing question – Is three-parent IVF the answer to preventing mitochondrial defects?

Disorders of the hemostatic system such as hypercoagulation and hypofibrinolysis are clinical manifestations in patients with schizophrenia, depression, and bipolar disorder. However, the role of the type of antipsychotic medication as well as the duration of use on disturbances in the hemostatic system is poorly understood. This study was, therefore, carried out to determine the possible impact of antipsychotic treatment as well as the duration of use on selected acute-phase proteins involved in coagulation and fibrinolysis. Plasma levels of fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were determined in 124 patients with major mental illnesses: schizophrenia, depression, and bipolar disorder. Thereafter, the participants were grouped based on the type of antipsychotic medication (typical vs. atypical) and the duration of antipsychotic use. Patients on typical antipsychotics had a slightly elevated level of PAI-1 but a similar level of fibrinogen when compared with patients on atypical antipsychotics. Furthermore, the median plasma levels of fibrinogen and PAI-1 in patients who have been on antipsychotic use for more than 10 years were slightly higher than in patients who have been on the drug for 10 years or less. It could be concluded from this study that patients on typical antipsychotics and those who have used any form of antipsychotics for more than 10 years might benefit from periodic assessment of markers of prothrombosis as it could facilitate early identification of those at risk of venous thromboembolism.

Objectives: New Delhi metallo-β-lactamase (NDM), which has emerged as a major mechanism of resistance to carbapenems in Gram-negative bacteria (GNB), challenges effective patient management of health-care systems. Nonpathogenic environmental bacteria present on abiotic touch surfaces in hospitals may serve as reservoirs for the NDM gene and contribute to the emergence and spread of resistance to carbapenems. The aim of this study was to determine the presence of NDM-positive GNB in the environment of a tertiary care center. Materials and Methods: Fifty-eight swab samples were collected from various touch surfaces in 12 different wards between January and February 2017. The swabs were cultured in nutrient broth and subsequently subcultured onto McConkey agar plates. Both lactose and nonlactose fermenting colonies grown were identified by biochemical methods. The polymerase chain reaction method was used to detect NDM carriage. Results: Twenty-seven (46%) of the samples were positive for microbial growth, of which 21 (36%) samples yielded bacterial growth on McConkey agar plates. Of the 30 isolates identified, 25 (83%) were nonfermenting GNB (NFGNB) and 5 (17%) were Klebsiella spp., of which 1 was Klebsiella oxytoca. NFGNB were isolated mostly from tables and infusion stands in various wards. Four of the five Klebsiella spp. were from patients' beds. Two isolates of NFGNB and one Klebsiella spp. were positive for the NDM gene. Conclusion: In addition to serving as potential pathogens of nosocomial infections, environmental bacteria present on abiotic touch surfaces in hospitals may serve as reservoirs for the NDM gene.

With the advent of contemporary molecular tools, the conventional microbiological isolation, enrichment techniques, and approaches have changed considerably. Molecular techniques such as polymerase chain reaction, cloning, and sequencing have shown that the major percentage of microbial diversity in an ecosystem remain “unculturable” or “as yet uncultivable” due to the lack of information on their biology, limited selection media, and culture conditions that could support their growth. Identifying and knowing more about them have become an important objective in the microbiological research. The ecological, environmental, and functional implications of a microbial ecosystem can be deciphered by knowing its microbial composition and interactions. The areas of whole-cell and targeted gene metagenomics are playing a key role in accomplishing this objective. The present review discusses the 16S ribosomal RNA (16S rRNA) gene metagenomics approach, which has found major applications in identifying the composition of a given microbial ecosystem. Different systems, processes, and analysis tools are available to perform 16S rRNA metagenomics; however, there are few concerns that require more investigation to gain the maximum benefit of these techniques.

Premenstrual syndrome (PMS) is a distinct clinical syndrome during the recurrent luteal phase of menstrual cycle wherein there is a significant deterioration in the quality of life due to disruptive physical and psychiatric symptoms caused by an abnormal central nervous system response to the hormonal changes of the female reproductive cycle. It happens in the postovulation phase because estrogen and progesterone levels fall dramatically if there is no pregnancy. Physical symptoms include breast tenderness and bloating sensation, and emotional symptoms may manifest as mood swings, depression or feeling of hopelessness, intense anger and conflict with others, tension, anxiety, irritability, decreased interest in usual activities, difficulty in concentrating, fatigue, and changes in appetite. Symptoms emerge 1–2 weeks before menses and resolve completely with the onset of menses. This review article outlines the pathophysiology, presentation, severity and timing of symptoms, diagnosis and treatment of PMS and reiterates that it is a transient and physiological phase during the menstrual cycle and not a pathological entity.

Background: In recent years, the use of composite materials as biomaterials has been increasing in dentistry. It is important to perform in vitro experiments of biomaterials before living tissue. Aim: The purpose of this work was to examine the effect of contact load upon attrition-corrosion wear behavior of bio-composite materials: in vitro off-axis sliding contact chewing simulation. Material and Method: In this study, 2 mm × 12 mm (weight × diameter) cylindrical test specimens were prepared from Filtek Supreme and Clearfil AP-X bio-composite materials with different filler structure. The surface roughness and Vicker's Hardness values of the bio-composites were measured before the wear test procedures. Then, the test specimens were subjected to off-sliding abrasion test procedures under different mechanical loads in artificial saliva and citric acid medium. Wear volume loss of bio-composite materials was determined after wear test procedures using the three-dimensional noncontact profilometer. Results: As the mechanical loading increased, the loss of wear volume in both composite materials increased irrespective of test medium. However, this increase in wear volume loss in test specimens was more pronounced in the citric acid environment. Conclusion: As a result of, the organic matrix structure (such as Ba glass particle) of the composite material contributes to more volume loss in corrosive environment.