Comparison of accuracy of immediate implant placement between planned and actual position in pre-extractive versus conventional method - A prospective study

This study aims to evaluate the accuracy of immediate implants in mandibular molars between the conventional method and the pre-extractive inter-radicular method.

MATERIALS AND METHODS

A total of 20 patients were equally divided into two groups. Implants were placed using the conventional method (Group A) and pre-extractive inte-rradicular method (Group B). Coronal, apical and angular deviation between planned and placed implants were evaluated by superimposing preoperative and postoperative three-dimensional (3D) STL models in Geomagic Freeform software. The data were subjected to an unpaired Student t-test.

RESULTS

Results revealed that the coronal, apical and angular deviation were lower in the pre-extractive inter-radicular drilling method than in the conventional method, which was statistically significant. Apical deviation was greater than coronal deviation in both the sagittal and coronal planes. It was also found that the mean deviation was greater in the sagittal plane (mesio-distal axis) than in the coronal plane (bucco-lingual axis).

CONCLUSION

Comparison of the two methods revealed significant changes between the planned and actual positions of implant. When stringent steps were followed, the degree of deviation was found to be less in the pre-extractive inter-radicular approach, proving it to be more accurate than the conventional method. However, large-scale research studies are required to extrapolate our findings.

Prognostic Significance of Proliferative Markers: Cyclin D1 and CENPF in Oral Squamous Cell Carcinoma Patients-A Cohort Study

Introduction

Oral cancer ranks sixth place worldwide among other cancers and is known for its high morbidity and mortality rates. Among oral cancer, oral squamous cell carcinomas (OSCC) remains the most common. Expression of specific biomarkers are known to be related to the prognosis of the OSCC.

Methodology

An immunohistochemistry study was performed to evaluate the expression of Cyclin D1 and CENPF for their prognostic significance in twenty OSCC patients. The follow-up period ranged from 10 to 18 months. The expression of these proliferative markers was correlated with demographic, clinical and histopathological grade of the disease.

Results

The results revealed 28% mortality rates in relation to OSCC involving retro-molar trigone. Based on the Cyclin D1 and CENPF expression, high mortality rate (Pearson coefficient = 0.800) was seen with grade 3 and 4 expressions of the markers. Decreased survival rates (Pearson coefficient = 0.824) were observed with stage III and IV disease with grade 3 and 4 expressions of the markers.

Conclusion

Cyclin D1 and CENPF have shown promising results as proliferative markers which can be linked with prognosis of OSCC in this study. Further studies with larger sample size are needed to extrapolate our findings.

The plausible effects of wearing face masks on sports performance - A scoping review

Objectives

The objectives of this scoping review are to discuss, firstly, the positive aspects of wearing face masks during training (such as a barrier to COVID-19 transmission, air pollutant exposure, and adding load on respiratory resistance flow); secondly, the negative aspects (adverse effects on body temperature and hypoxia risks); and thirdly, the training responses of wearing face masks on aerobic and anaerobic performance.

News

Besides social distancing and hand hygiene, wearing a face mask is proposed to be the prime advocacy for virus containment. During the period of high risk of contamination, the return to sport guidelines proposed by international and national sport federations included wearing face masks during training sessions. However, it is necessary to discuss the pros and cons of wearing face masks during exercise.

Prospects

Although it was essential to wear a face mask during exercise or sport-specific training, there is conflicting evidence on the implications of the use of face masks on physical, physiological as well as psychological well-being or performance. Based on the conflicting empirical findings and anecdotal evidence, certain recommendations have been made for adequate use of face masks during exercise; both to break the chain of transmission and prevent the physiological compromise expected from wearing face masks during exercise. The present review can help stakeholders balance sport guidelines in the event of a respiratory virus pandemic with athlete safety.

Conclusion

Conflicting evidence of mechanistic links between the dose of exercise and the possible adverse effects associated with exercising with face masks is available. Adequately powered studies with strong methodological quality on appropriate selection of masks and usage based on the intensity, duration, and type of sport, age, and gender is needed now for the stakeholders to make informed decisions with respect to exercising with face masks.

Management of recurrent lymphangioma of the cheek in an adult patient: An interdisciplinary approach

Lymphangiomas are congenital malformations. Swellings in the cheek may arise from infection, cyst and tumors.Pathological lesions are not always confined to its common site and age of occurrence. Occurrence of lymphangioma in buccal mucosa especially in adults are very rare. Exact knowledge about anatomy and nature of lesion is mandatory for its complete removal as incomplete removal results in recurrence. Herewith,a rare case of recurrent lymphangioma involving left buccal mucosa in an adult is presented with its management. Emphasis is laid on the necessity of combined approach through multidisciplinary team while treating such lesions.

Circadian influence on post-exercise hypotension: a review

Circadian rhythm (CR) can influence the physiological and psychological parameters in every individual. There is a sinusoidal response to blood pressure brought about by the CR. A drop in blood pressure response immediately after an exercise is termed as post-exercise hypotension (PEH). The objective of the present paper is to review the influence of CR on PEH. Comparing the types of exercises, aerobic training showed a higher magnitude of the drop in PEH than resistance training. However, the majority of the studies have not considered the CR influence on PEH. With the evidence available, we can conclude that morning exercise shows the higher magnitude of the drop in PEH and could be sustained for a longer duration.

M-Mode Echomyography of Facial Muscle Function Following Facial Reanimation with Temporalis Muscle Galea Pedicled Flap: Analysis of Ten Cases with Review of Literature

Introduction

Facial palsy is a condition where the patients lack voluntary movement on the affected side of the face and are not able to convey their emotions. Besides that, they also succumb themselves to social isolation. Various techniques have been devised to overcome this devastating problem. The aim of this article is to evaluate and compare facial muscle function before and after facial reanimation with temporalis muscle galea pedicled flap by motion mode echomyography in patients with long-standing facial paralysis.

Patients and Methods

Ten patients with long-standing facial paralysis were included in the study (six patients with LMN palsy and four patients with facial weakness involving specific peripheral branches), and they subsequently underwent facial reanimation surgery with temporalis galea pedicled flap. These patients were followed postoperatively for a period of 1-2 years and were subjectively graded as excellent, good, fair and poor and objectively evaluated by M-mode echomyography, and the results were evaluated and statistically analyzed.

Results

Subjectively, out of 6 patients with LMN palsy, results were graded as excellent in 2 cases, good in 3 cases, fair in 1 case, and out of 4 patients with weakness in specific facial nerve branches, the subjective results were excellent in 2 cases, good in 1 case and fair in 1 case. Objectively, the effect of transposed temporalis galea on orbicularis occuli, levator labii superioris and orbicularis oris was found to be statistically significant in patients with LMN palsy.

Conclusion

Our study proves the versatility of temporalis muscle galea pedicled flap in cases of long-standing facial paralysis by motion mode echomyography.

Lingual Hypoglossal Reflex: An Unusual Reflex of Head and Neck

Introduction

Oral-pharyngeal reflexes demonstrate a wide range of complexities due to their intricate synaptic pattern. Most of the reflexes are protective in nature such as preventing aspiration. These reflexes in oral cavity affect the muscles and can be evoked either in isolation or in combination in order to achieve a specific response. Certain sensory inputs induce an entire motor behavior pattern as seen in lingual hypoglossal reflex.

Materials and Methods

A case report depicting this reflex have been presented. To our knowledge, this is the first case documented in a living human. Along with this, cadaveric studies have been also done in fifteen specimens.

Results

Extralingual anastomosis between lingual nerve and hypoglossal nerve were found in six specimens.

Conclusion

Hereby, we present a clinical paper of this unusual phenomenon which has not been documented in the literature.

Platelet-Rich Fibrin with Bone Grafts for Regeneration of Bony Defect following Extraction of Supernumerary Teeth: A Case Report

Supernumerary teeth are hyperdontic variants due to abnormalities during tooth development. Here, we report a case on regeneration of bony defect, which ensued following extraction of two supernumerary teeth in the mandibular premolar region, using a combination of bone grafts and platelet-rich fibrin. To the best of our knowledge, it is the first time synergistic use of biomaterials with bone grafts have been used for this type of management.

Application of platelet rich fibrin for management of an electrosurge induced osteonecrosis involving maxillary alveolus

BACKGROUND

Application of principles of electrocautery for hemostasis dates back to prehistoric times. Its modern implementation in various fields of general and head and neck surgeries have been well documented. However its usage in minor oral surgical procedures has gained popularity only recently. Complications associated with electro-surgery in the dental field are relatively rare and there is insufficient literature on its management.

CASE REPORT

We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars.

DISCUSSION

Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration.

CLINICAL IMPLICATIONS

Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.

Thermal burn of palate in an elderly diabetic patient

BACKGROUND

Burns of the oral mucosa may be caused by thermal, mechanical, chemical, electrical or radiation injury. Clinically, these burns can produce localised or diffuse areas of tissue damage depending on the severity and extent of the insult. Most oral thermal burns produce erosions or ulcers on the palate or tongue.

MATERIALS AND METHODS

A case of palatal burn in a 66-year-old diabetic patient caused by drinking hot cereal is presented. The role of diabetes in causing oral mucosal dysesthesia that predisposed the occurrence of this burn is also discussed.

CONCLUSION

Insensate palatal burn as a rare complication of diabetes mellitus is reported here. With the disease being more widespread now, its potential oral complications will be seen with increasing frequency.

Mechanistic insight into active chlorine species mediated electrochemical degradation of recalcitrant phenolic polymers

Degradation of recalcitrant phenolic syntan by electro-oxidation was investigated. The kinetics of mineralization of phenolic syntan was followed both in terms of TOC and COD measurements.

A microscopic evaluation of collagen-bilirubin interactions: in vitro surface phenomenon

This study is carried out to understand the morphology variations of collagen I matrices influenced by bilirubin. The characteristics of bilirubin interaction with collagen ascertained using various techniques like XRD, CLSM, fluorescence, SEM and AFM. These techniques are used to understand the distribution, expression and colocalization patterns of collagen-bilirubin complexes. The present investigation mimic the in vivo mechanisms created during the disorder condition like jaundice. Fluorescence technique elucidates the crucial role played by bilirubin deposition and interaction during collagen organization. Influence of bilirubin during collagen fibrillogenesis and banding patterns are clearly visualize using SEM. As a result, collagen-bilirubin complex provides different reconstructed patterns because of the influence of bilirubin concentration. Selectivity, specificity and spatial organization of collagen-bilirubin are determined through AFM imaging. Consequently, it is observed that the morphology and quantity of the bilirubin binding to collagen varied by the concentrations and the adsorption rate in protein solutions. Microscopic studies of collagen-bilirubin interaction confirms that bilirubin influence the fibrillogenesis and alter the rate of collagen organization depending on the bilirubin concentration. This knowledge helps to develop a novel drug to inhibit the interface point of interaction between collagen and bilirubin.

A Constraint Satisfaction Framework for Executing Perceptions and Actions in Diagrammatic Reasoning

Diagrammatic reasoning (DR) is pervasive in human problem solving as a powerful adjunct to symbolic reasoning based on language-like representations. The research reported in this paper is a contribution to building a general purpose DR system as an extension to a SOAR-like problem solving architecture. The work is in a framework in which DR is modeled as a process where subtasks are solved, as appropriate, either by inference from symbolic representations or by interaction with a diagram, i.e., perceiving specified information from a diagram or modifying/creating objects in a diagram in specified ways according to problem solving needs. The perceptions and actions in most DR systems built so far are hand-coded for the specific application, even when the rest of the system is built using the general architecture. The absence of a general framework for executing perceptions/actions poses as a major hindrance to using them opportunistically -- the essence of open-ended search in problem solving. Our goal is to develop a framework for executing a wide variety of specified perceptions and actions across tasks/domains without human intervention. We observe that the domain/task-specific visual perceptions/actions can be transformed into domain/task-independent spatial problems. We specify a spatial problem as a quantified constraint satisfaction problem in the real domain using an open-ended vocabulary of properties, relations and actions involving three kinds of diagrammatic objects -- points, curves, regions. Solving a spatial problem from this specification requires computing the equivalent simplified quantifier-free expression, the complexity of which is inherently doubly exponential. We represent objects as configuration of simple elements to facilitate decomposition of complex problems into simpler and similar subproblems. We show that, if the symbolic solution to a subproblem can be expressed concisely, quantifiers can be eliminated from spatial problems in low-order polynomial time using similar previously solved subproblems. This requires determining the similarity of two problems, the existence of a mapping between them computable in polynomial time, and designing a memory for storing previously solved problems so as to facilitate search. The efficacy of the idea is shown by time complexity analysis. We demonstrate the proposed approach by executing perceptions and actions involved in DR tasks in two army applications.

Variability of soil-water quality due to Tsunami-2004 in the coastal belt of Nagapattinam district, Tamilnadu

In this study, the Tsunami-caused deterioration of soil and groundwater quality in the agricultural fields of coastal Nagapattinam district of Tamilnadu state in India is presented by analyzing their salinity and sodicity parameters. To accomplish this, three sets of soil samples up to a depth of 30 cm from the land surface were collected for the first six months of the year 2005 from 28 locations and the ground water samples were monitored from seven existing dug wells and hand pumps covering the study region at intervals of 3 months. The EC and pH values of both the soil and ground water samples were estimated and the spatial and temporal variability mappings of these parameters were performed using the geostatistical analysis module of ArcGIS((R)). It was observed that the spherical semivariogram fitted well with the data set of both EC and pH and the generated kriged maps explained the spatial and temporal variability under different ranges of EC and pH values. Further, the recorded EC and pH data of soil and ground water during pre-Tsunami periods were compared with the collected data and generated variability soil maps of EC and pH of the post-Tsunami period. It was revealed from this analysis that the soil quality six months after the Tsunami was nearing the pre-Tsunami scenario (EC< 1.5 dS m(-1); pH<8), whereas the quality of ground water remained highly saline and unfit for irrigation and drinking. These observations were compared with the ground scenarios of the study region and possible causes for such changes and the remedial measures for taking up regular agricultural practices are also discussed.

Synchronization of cells in the S phase of the cell cycle by 3'-azido-3'-deoxythymidine: implications for cell cytotoxicity

The mechanism of synergy between 3'-azido-3'-deoxythymidine (AZT) and anticancer agents was investigated with emphasis on cell-cycle events. Exposure of exponentially growing WiDr human colon carcinoma cells to AZT resulted in synchronization of cells in the S phase of the cell cycle. Following treatment with AZT at 50 or 200 microM, 62% +/- 3% or 82% +/- 4% of the cells were in the S phase as compared with 36% +/- 2% in the control. Bromodeoxyuridine uptake studies revealed that the synchronized cells actively synthesized DNA. At concentrations of up to 200 microM, AZT produced a cytostatic rather than cytotoxic effect as indicated by viability and cell growth measurements. At 200 microM, AZT-induced synchronization was significant (P = < 0.001) after 12 h of drug exposure, reached a maximum at 24 h, and reversed to baseline levels by 72 h even in the continued presence of the drug. This indicates that AZT-induced cytostasis is a transient and reversible effect. The cell-cycle events seen with AZT in WiDr cells were also observed in eight of nine human tumor cell lines tested. Isobologram analysis of WiDr cells preexposed to AZT for 24 h and then exposed to either AZT-5-fluorouracil or AZT-methotrexate for a further 72 h revealed synergy between AZT and the anticancer agents, indicating that AZT-induced synchronization may have therapeutic benefits.

Composite fish culture for mosquito control in rice fields in southern India

Composite culture of edible fishes (common carp, Cryprinus carpio; silver carp, Hypopthalmithys molitrix, grass carp, Ctenopharyngodon idella; catla, Catla catla; rohu, Labeo rohita; and mrigal, Cirrhinus mrigala) in rice fields in the Cauvery delta of Tamil Nadu, southern India, resulted in 81.0% reduction in the immature mosquito population of anophelines and 83.5% of culicines. Analysis of fish feces for mosquito larval head capsules showed that common carp and silver carp are effective larvivores. The selective feeding of common carp on culicines and silver carp on anophelines is correlated to their trophic niches. Net profit in the fish-cum-rice fields was 2.5 times greater than fields in which rice alone was cultured. Hence, rice-cum-fish culture can be recommended to the farming community in this area.

Designing medical informatics research and library--resource projects to increase what is learned

Careful study of medical informatics research and library-resource projects is necessary to increase the productivity of the research and development enterprise. Medical informatics research projects can present unique problems with respect to evaluation. It is not always possible to adapt directly the evaluation methods that are commonly employed in the natural and social sciences. Problems in evaluating medical informatics projects may be overcome by formulating system development work in terms of a testable hypothesis; subdividing complex projects into modules, each of which can be developed, tested and evaluated rigorously; and utilizing qualitative studies in situations where more definitive quantitative studies are impractical.

Deoxypyrimidine-induced inhibition of the cytokinetic effects of 1-beta-D-arabinofuranosyluracil

Ara-U-induced S-phase accumulation and the interaction between high concentrations of ara-U (HiCAU) and ara-C were investigated in L1210 leukemia cells in vitro. Treatment of exponentially growing L1210 murine leukemia cells with ara-U (200-1000 microM) for 48 h caused a dose-dependent accumulation of cells in the S-phase. The extent of this ara-U-induced S-phase accumulation correlated with ara-U incorporation into DNA and with increases of up to 172% and 464% in the specific activities of deoxycytidine kinase and thymidine kinase, respectively, over control values. Metabolism of 1 microM ara-C following the exposure of cells to ara-U (1 mM) resulted in 4.5 pmol araC DNA/mg protein vs 2.1 pmol/mg protein in control cells. Although 48-h exposure of cells to 200 and 400 microM ara-U is not cytotoxic, it enhances the cytotoxicity of ara-C (10-100 microM) 4- to 10-fold. Ara-U-induced S-phase accumulation is inhibited by deoxypyrimidine nucleosides but not by pyrimidine or deoxypurine nucleosides. Some of the ara-U and ara-C concentrations used in this study are achievable in clinical practice, and ara-U/ara-C interactions may explain in part the unique therapeutic utility of high-dose ara-C.

Modulation of the metabolism and pharmacokinetics of 1-beta-D-arabinofuranosylcytosine by 1-beta-D-arabinofuranosyluracil in leukemic mice

The interaction between high concentrations of 1-beta-D-arabinofuranosyluracil (HiCAU) and 1-beta-D-arabinofuranosylcytosine (ara-C) was investigated in vivo with emphasis on cell kinetics, pharmacokinetics, and drug metabolism. Mice bearing L5178Y leukemia were given a 48-h s.c. infusion of high-dose ara-U (HiDAU) to achieve a plasma level of 0.5 to 1 mM. A total dose of 7.35 g/kg/day for 2 days was nontoxic; the mean survival of control (saline treated) leukemic mice was 12.2 +/- 1.8 days and 11.7 +/- 2.0 days for the HiDAU-treated leukemic mice. Using flow cytometry, cell cycle progression of L5178Y ascites cells was monitored during HiDAU infusion. At 48 h, the proliferative index (PI) percentage of the leukemic cells is significantly different (P less than 0.001) in HiDAU-treated leukemic mice (mean = 50.8) versus control (mean = 45.6). A higher PI percentage is associated with accumulation of cells in S phase. This effect was highly variable in the ara-U-treated mice, and the ara-U "perturbed" group was defined as those mice whose cells had an increase in the PI to greater than or equal to 50%. The higher PI percentage in HiDAU-treated mice correlated with HiCAU in ascites fluid, leukemic cells, and kidney of perturbed mice. HiCAU in the "ara-U-perturbed" group altered the plasma pharmacokinetics of high-dose ara-C (HiDAC, 1 g/kg), increased the cellular metabolism of ara-C to 1-beta-D-arabinofuranosylcytidine triphosphate (ara-CTP) (3-fold), and increased ara-C-DNA synthesis (3-fold). In mice bearing the L5178Y leukemia, a 48-h infusion of ara-U followed by a 24-h s.c. infusion of 40 mg/kg resulted in a 260% increase in life span and seven 90-day survivors among 16 treated mice. In contrast, ara-U or ara-C alone had a negligible therapeutic effect. ara-U-induced alterations in the systemic pharmacokinetics of ara-C are the result of inhibition of cytidine deaminase activity by HiCAU in liver and kidneys. This results in a decrease in ara-C catabolism and prolongs the plasma half-life of ara-C. The dual alteration of the pharmacokinetics of ara-C and cytokinetics of the leukemia cells by HiCAU results in enhanced survival of leukemic mice. These results may help explain the clinical utility of HiDAC treatment programs for patients with acute leukemia.

Biochemical mechanisms for the scheduled synergism of (alpha S, 5S)-2 amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid and 5-fluorouracil in P388 leukemia

A study was made of the in vivo effects of equitoxic doses of AT-125 and 5-FU combination, being administered either simultaneously (% ILS 152) or with a 6-h pretreatment with AT-125 (% ILS 184). To examine the biochemical basis for the scheduled synergism, measurements were made of the concentration of PRPP, the specific activities of CPS II, cytidine, thymidine, uridine, deoxyuridine kinases, and fluorinated nucleotide formation in P388 tumors and the small intestine. Two hours after in vivo simultaneous treatment of mice bearing tumors the concentration of PRPP increased 9- and 6-fold above baseline in the tumor and the small intestine, respectively. In the AT-125 pretreatment arm the concentration of PRPP increased 18- and 7-fold above baseline in the tumor and the small intestine, respectively. CPS II activity was reduced to 28%-18% of control in the tumors in the simultaneous and pretreatment groups, respectively, whereas it remained unchanged in the small intestine. Specific activities of cytidine kinase (5.5 +/- 1), thymidine kinase (4.0 +/- 1.6), uridine kinase (35.6 +/- 6.5), and deoxyuridine kinase (2.4 +/- 1.1) nmol/mg protein/h remained unchanged with treatment. In concert with the increased intratumor concentration of PRPP, fluorinated nucleotide formation was proportionally increased in the treatment arms. These results indicate the importance of drug scheduling of the above two agents in treating P388 leukemia.

Expert systems as aids for interpretive reporting

Interpretive reporting is an established part of the function of many clinical laboratories. Of the three types of information included in these reports, expert system technology is being demonstrated as useful in producing interpretive comments. The ability of expert systems to explain their reasoning and to be easily updated make them superior to prior attempts to computerize this type of interpretation using traditional computer languages. In the future, the broader application of these systems in realistic clinical environments should be expected given recent commercial success in embedding such programs in laboratory instruments.