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Aim The purpose of this study was to retrospectively evaluate a series of patients with space infection. Patients and methods In this study 256 patients with space infection over a period of two years were treated with intravenous antibiotic and prompt incision and drainage followed by culture and sensitivity tests in some cases. Data collection included demographic, anatomic treatment and complication information.Results The sample consisted of 256 patients with a mean age of 28 years. 7 patients were immunocompromised and 20 female patients were pregnant out of 84 female patients who were included in the study. Caries followed by implant failure were identified to be the most frequent cause for space infection. Trismus and dysphagia were present in over 70% of the cases. The vestibular masticator, perimandibular (submandibular, submental and/or sublingual) and parapharyngeal, submaxillary spaces were involved. Abscess was found in 76% of the cases. All the patients were drained under local anesthesia or conscious sedation except one patient who was drained under GA. Three deaths occurred. Conclusion This study indicated that prompt incision and drainage along with intravenous antibiotic under local anesthesia or conscious sedation was the mainstay of treatment of severe space infection. Patients were relieved of their signs and symptoms by third day, however trismus may persist for 5-7 days.

Background The updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and HIV-specific biomarkers to generate a continuous score which accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD) we translate VACS Index 2.0 scores into validated probability estimates of mortality. Methods Because complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from 10/1999–4/2018. Mortality was observed up to 3/2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), gender, age </>50 years, race/ethnicity, HIV-1 RNA</>500, CD4</>350, and years 1999-2009/2010-2018. Because mortality rates have decreased over time, the final model was limited to 2010-2018. Results Among 37,230 PWH in VACS and 8,061 PWH in the NA-ACCORD subset, median age was 53 and 44 years; 3% and 19% were women; and 48% and 39% were Black. Discrimination in NA-ACCORD (C-statistic 0.842; 95% CI 0.830, 0.854) was better than in VACS (C-statistic 0.813; 95% CI 0.809, 0.817). Predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups. Conclusion Based on this validation, VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America.

Background: Pharmacology as a medical subject undergoes constant update and thus is ever expanding. Periodic review of the teaching-learning tools along with the evaluation methods and then improvisation of the same to make the curriculum effective as well as student friendly can help in making the medical student grasp the difficult subject easily. The present study was undertaken to get the students' feedback regarding the various teaching methodologies used in the Department of Pharmacology and the evaluation techniques to assess them. Methods: A prevalidated and anonymous questionnaire was given to the second professional MBBS students at the end of their session. The questionnaire had both closed ended and open ended questions. The data were compiled and evaluated as counts and percentages. Approval was taken from Institutional Ethics Committee. Results: About 57.9% students found the subject useful and interesting and the most common topics of interest among the students were general pharmacology (29.5%), cardiovascular system (17.9%), and autonomic nervous system (15.8%). Interactive lectures, audiovisual aids with demonstrations and tutorials were considered the most interesting method of learning pharmacology (42.1%, 31.6%, and 31.6%, respectively). The majority of the students (61%) wanted clinical case studies to be incorporated in the routine teaching of pharmacology for better understanding and better correlation of drugs used in diseases. The best method of evaluation according to the students was a combination of written and viva exam (51.6%), followed by written class test only (33.7%), and tutorials (22.1%). The suggestions about improvement in pharmacology teaching which were highlighted by the students were inclusion of clinical case studies with drug management, incorporation of multiple choice questions, and computer simulations. Conclusion: It is important to take regular feedbacks from the students to make the teaching more useful and interesting so that synchronization between teachinglearning, evaluation and assessment can be achieved for improved outcome.

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