Combined topography-guided photorefractive keratectomy and corneal collagen crosslinking

PURPOSE

This study aimed to report the long-term results of combined topography-guided photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) for keratoconus using the Zeiss refractive coordinated system.

METHODS

A prospective interventional study was conducted in a tertiary eye care hospital in South India. Patients with mild-to-moderate progressive keratoconus and corneal pachymetry greater than 450 μm were included. They underwent customized topography-guided PRK followed by CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and keratometry readings and complications were evaluated at 1, 3, 6, 12, and 24 months postoperatively.

RESULTS

Thirty patients (30 eyes) were included in the study. All study parameters showed a statistically significant improvement postoperatively over baseline values. At 24 months, the mean UDVA improved from 0.8 ± 0.180 logarithm of the minimum angle of resolution (logMAR) to 0.38 ± 0.118 logMAR (P-value <0.001) and CDVA improved from 0.467 ± 0.142 logMAR to 0.227 ± 0.078 logMAR (P-value <0.001). The mean flat, steep, and maximum keratometry values were significantly reduced by 2.133, 3, and 4.54 diopters, respectively, at the last follow-up examination (P-value <0.001).

CONCLUSION

The combined topography-guided PRK and accelerated CXL procedure seem to be a promising treatment alternative for early keratoconus. This is the first such study on the Zeiss refractive coordinated system. However, further studies with a larger study population and longer follow-up periods are required to draw final conclusions about the benefits of this procedure in keratoconus.

Profiling of Groundnut bud necrosis orthotospovirus-responsive microRNA and their targets in tomato based on deep sequencing

Tomato, an extensively cultivated vegetable crop produces miRNAs in response to infection with Groundnut bud necrosis orthotospovirus, a viral pathogen causing significant economic losses. High-throughput miRNA sequencing was performed on tomato leaves inoculated with GBNV and mock-inoculated leaves as controls. Analysis revealed 73 known miRNAs belonging to 24 miRNA families, with variable expression levels. Interestingly, 39 miRNAs were upregulated, and 34 were downregulated in response to GBNV infection. Stem-loop quantitative reverse transcription PCR validated the differential expression of selected miRNAs. Additionally, 30 miRNA encoded proteins were identified to be involved in disease resistance and susceptibility. The miRNA-target interactions were found to play significant roles in cellular and metabolic activities, as well as modulating signaling pathways during the plant-virus interaction. The findings shed light on the intricate regulatory network of miRNAs in tomato response to viral infection and may contribute to developing strategies for improving crop protection against viral diseases.

Outcomes of accelerated collagen cross linking in progressive paediatric keratoconus

Purpose

To determine the efficacy and safety of pediatric accelerated cross linking (CXL).

Methods

A prospective study on progressive keratoconus (KC) cases under ≤18 years of age. Sixty four eyes of thirty nine cases underwent epithelium-off accelerated CXL protocol. Visual acuity (VA), slit-lamp examination, refraction, pentacam reading of keratometry (K), corneal thickness, and thinnest location pachymetry were noted. Cases were followed up on days 1, 5, and at 1^st, 3^rd, 6^th, and 12th-month post procedure.

Results

Statistically, significant improvement of the mean aided VA, K, and mean corneal astigmatism (p < 0.0001) was noted. Mean Kmax reading reduced from 55.5 ± 5.64 (47.4-70.4) diopter (D) preoperatively to 54.41 ± 5.51 (46-68.3) D at 12 months postaccelerated CXL. Two cases had progression. Complications encountered were sterile infiltrate and persistent haze.

Conclusion

Accelerated CXL is effective and efficacious in pediatric KC.

To compare central corneal thickness measurements obtained by Pentacam with those obtained by IOLMaster 700, Cirrus anterior segment optical coherence tomography and Tomey specular microscopy in normal healthy eyes

Purpose:

To compare central corneal thickness measurements obtained by Pentacam with those obtained by IOL Master 700, Cirrus Anterior segment optical coherence tomography and Tomey Specular microscopy in normal healthy eyes.

Methods:

Two hundred and six eyes of healthy subjects were included in the study. Each subject was assessed by four different methods of measuring central corneal thickness using Pentacam, IOL Master 700, Cirrus AS-OCT and Tomey Specular microscopy by a single examiner.

Results:

The mean CCT [± standard deviation (SD)] for Pentacam, IOL Master 700, Cirrus AS-OCT and Tomey Specular microscopy were Pentacam (Oculus), AS-OCT (Cirrus), IOL Master 700 and Specular microscopy (Tomey) were 523.75 (±27.75), 525.29 (±28.81),517.13 (±28.43) and 512.82 (±27.60) μm, respectively. All the means were significantly different from one another (P < 0.000). The differences between pairs of mean central corneal thickness (CCT) for Pentacam and IOL Master, Pentacam and anterior segment- optical coherence tomography (AS-OCT), and Pentacam and Specular microscopy are statistically significant. Bland–Altman plots showed that pentacam and IOL Master 700 have the closest agreement, followed by AS-OCT. Specular microscopy was found to have the poorest agreement with Pentacam.

Conclusion:

We found that CCT measurements of Pentacam did not correlate with measurements of IOL Master, or AS-OCT or Specular microscopy. In clinical practice, the devices analyzed should not be used interchangeably due to low agreement regarding CCT values.

Pre-Operative SARS CoV-2 Rapid Antigen Test and Reverse Transcription Polymerase Chain Reaction: A conundrum in surgical decision making

Purpose:

Since the eye is in close proximity to the oro-nasal cavity, transmission of SARS CoV-2 is higher during ophthalmic surgical procedures, it is vital to ensure the safety of the healthcare team by pre-operative Rapid Antigen Test (RAT) and real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for SARS CoV-2 viral RNA of all patients planned for elective or emergency surgery. Hence, understanding the profile of pre-operative RAT and real-time RT-PCR among patients planned for various ophthalmic procedures, will help us make better decisions for future guidelines, for optimal planning of ophthalmic elective or emergency surgeries, keeping in mind the current scenario.

Methods:

This is a prospective descriptive study conducted on patients planned for elective or emergency ophthalmic surgeries, who had no COVID-19-related symptoms pre-operatively and were subjected to preoperative RAT and real-time RT-PCR of nasopharyngeal and throat swabs for SARS CoV-2 viral RNA. Data was compiled and statistically analysed.

Results:

204 patients underwent pre-operative RAT and RT-PCR testing; of which, 85 were females and 119 were males. Mean age of the study population was 51.44 ± 16.501 years. Among the 204, 2 tested positive for SARS CoV-2 with Rapid Antigen testing as well as RT-PCR and 10 patients tested positive via RT-PCR after a negative RAT result of the same sample.

Conclusion:

Pre-operative testing for COVID-19 disease is indispensable as there is a high chance of transmission from patient to healthcare workers. RAT has the advantage of quick results and may play a role in case of emergency procedures. However, it is prudent to perform the more sensitive real-time RT-PCR before any elective, non-emergency procedures or surgeries to avoid any undue risk to the healthcare team.

Ophthalmic manifestations in the COVID-19 clinical spectrum

Purpose

The aim of this study was to determine the frequency and various types of ophthalmic manifestation of patients with COVID-19.

Methods

This is a prospective observational study conducted on patients with SARS-Co-V-2 infection, at a dedicated tertiary COVID-19 hospital in South India from April 1 to July 31, 2020. At the time of their admission to the COVID hospital, demographic data such as name, age, sex was recorded. A thorough history regarding the onset, duration, progression, nature of symptoms and its associated factors, medication history, treatment history were elicited and documented. Ocular examination was performed under torchlight by an ophthalmologist posted for COVID duty. Further investigations including imaging were sought for, depending on clinical indications. Serial follow-up examinations of all patients were carried out every 72 hours or when patients complained of any ocular symptoms whichever earlier, until discharge. All relevant data were compiled and statistically analyzed.

Results

A total of 2742 patients were examined. Of them, 1461 (53.28%) were males and 1281 (46.72%) were females. The mean age (±SD) was 39.46 ± 17.63 years. None of the patients in our study had any ocular symptoms or signs as the presenting complaint at the time of their admission. On subsequent follow-up, only 20 (0.72%) developed ocular manifestations, of which 19 (95%) had features suggestive of Bilateral viral conjunctivitis. However, 1 (5%) patient had orbital cellulitis secondary to pansinusitis.

Conclusion

Ophthalmic manifestations in the clinical spectrum of COVID-19 infection are uncommon and unlikely to be the presenting clinical impression. However, it has broadened our view to a wider spectrum of COVID-19 presentations enhancing our clinical acumen for staunch detection of COVID-19 suspects in our daily practice, augmenting early diagnosis and management and also break the chain of transmission for the greater good of humanity.

Accidental displacement of primary anterior teeth following extraction of neonatal teeth

Eruption of the first tooth at 6 months of age is a significant stage in a child's life. However, the presence of a tooth in the oral cavity of a newborn can lead to a lot of delusions. Natal and neonatal teeth are of utmost importance not only to a dentist but also for a pediatrician due to parental anxiety, folklore superstitions, and numerous complications associated with it. The present case report describes a 1.5 cm × 1.5 cm, slow-growing, soft-tissue gingival mass which developed following the extraction of a tooth-like structure in a 4-month-old male patient. Histological examination revealed that it contained a tooth-like hard tissue intermingled with bone and fibrous tissue. Based on clinical and histological findings, the present case was diagnosed as gingival hyperplasia with displaced tooth buds of 71 and 81, which might be due to chronic irritation or traumatic extraction of the neonatal teeth. No abnormal recurrence of the lesion was detected during the follow-up period. However, postoperative clinical and radiographic photographs further reconfirmed the absence of tooth in relation to 71 and 81.

A Survey among Teachers of Psychiatry to Improve the Quality of Undergraduate Training: Outcomes from Karnataka

BACKGROUND

In India, there is a large gap between the mental health morbidity in society and the availability of psychiatrists. However, the latest Indian undergraduate medical curriculum does not require any competency in psychiatry to be fulfilled for certification of medical graduates as doctors. Thus, the role of Indian psychiatry teachers is quite challenging. Interestingly, there has been hardly any effort to understand the felt needs of psychiatry teachers that may further improve the quality of undergraduate training.

METHODS

We used a survey questionnaire that was both qualitative and quantitative, with questions on topics such as years of psychiatry training and experience as a psychiatry teacher. Do they feel the need for training in undergraduate psychiatry teaching? Do they require training in teaching psychiatry theory or clinics or both? What are the specific areas where they want training? What more should be planned for psychiatry teachers? Based on an online survey further steps in the direction of psychiatry teachers felt needs were initiated.

RESULTS

Around 55 responses with a response rate of 37% were received. More than 50% were working in medical colleges for the last 5 years. About 80% felt the need for further training to teach medical students while 97% felt that additional training is required for handling theory as well as bedside clinic. More than 60% were keen to attend a 1-day workshop to upgrade their teaching skills. A majority wanted to have a forum to share their experiences and to learn from others. Based on the felt needs of psychiatry teachers from the survey, a 1-day workshop was carried out and a forum for psychiatry teachers was inaugurated.

CONCLUSION

Training of psychiatry teachers is an important felt need for the challenges that are unique to Indian medical education. The outcome from the Karnataka survey is a progressive step in addressing this challenge.

Plant Root-Exudates Recruit Hyperparasitic Bacteria of Phytonematodes by Altered Cuticle Aging: Implications for Biological Control Strategies

Phytonematodes are globally important functional components of the belowground ecology in both natural and agricultural soils; they are a diverse group of which some species are economically important pests, and environmentally benign control strategies are being sought to control them. Using eco-evolutionary theory, we test the hypothesis that root-exudates of host plants will increase the ability of a hyperparasitic bacteria, Pasteuria penetrans and other closely related bacteria, to infect their homologous pest nematodes, whereas non-host root exudates will not. Plant root-exudates from good hosts, poor hosts and non-hosts were characterized by gas chromatography-mass spectrometry (GC/MS) and we explore their interaction on the attachment of the hyperparasitic bacterial endospores to homologous and heterologous pest nematode cuticles. Although GC/MS did not identify any individual compounds as responsible for changes in cuticle susceptibility to endospore adhesion, standardized spore binding assays showed that Pasteuria endospore adhesion decreased with nematode age, and that infective juveniles pre-treated with homologous host root-exudates reduced the aging process and increased attachment of endospores to the nematode cuticle, whereas non-host root-exudates did not. We develop a working model in which plant root exudates manipulate the nematode cuticle aging process, and thereby, through increased bacterial endospore attachment, increase bacterial infection of pest nematodes. This we suggest would lead to a reduction of plant-parasitic nematode burden on the roots and increases plant fitness. Therefore, by the judicious manipulation of environmental factors produced by the plant root and by careful crop rotation this knowledge can help in the development of environmentally benign control strategies.

Benign and Malignant Lesions of Jaw

Benign and malignant neoplasm of oral cavity is usually presented as swellings or ulcerations of affected tissue. The lesions are broadly categorized as potentially malignant disorders, benign and malignant neoplasm of epithelial and connective tissue origin for the convenience of learning. Neoplasm of oral cavity has a significantly lower incidence. Because of uncommon occurrence of oral neoplasm, retention of diagnostic skills is a challenging task. However, comprehensive understanding on clinical and pathologic details will help in correlating and presenting complaint and assisting in formulation of possible diagnosis. The key for successful therapeutic management depends on achieving right and timely diagnosis.

Computational Fluid Dynamics Studies of Gas-Solid Flows in a Horizontal Pipe, Subjected to an Adiabatic Wall, Using a Variable Gas Properties Eulerian Model

In the present paper, a variable gas properties Eulerian model is employed to model the gas-solid heat transfer in a three-dimensional horizontal pipe, subjected to an adiabatic wall. The numerical model has been validated with the benchmark experimental data and other theoretical results available in the literature, and found satisfactory agreements. Moreover, the numerical heat transfer results considering the variable gas properties (i. e. density, dynamic viscosity, thermal conductivity, and specific heat) and constant gas properties are compared. It is noticed that the variable gas properties significantly affect the heat transfer, when compared to the constant gas properties. Therefore, the consideration of constant gas properties for the prediction of heat transfer may not be suitable in gas-solid flows, subjected to an adiabatic wall. Moreover, the temperature profiles, solid volume fraction profiles, and gas-solid Nusselt number are discussed. Finally, the pressure drop prediction with respect to the solid loading ratio is studied, and found that the pressure drop slightly decreases with increasing the solid loading ratio.

Cephalometric Evaluation of Natural Head Position in Lingayat Population of Karnataka

Aims and Objectives:

To ascertain norms in cephalometry for 11- to 13-year-old Lingayat children in natural head position (NHP).

Materials and Methods:

Lateral cephalograms of children were obtained by using fluid level device. We determined the variance in Frankfort horizontal plane (FHP) inclination to extracranial horizontal in NHP. The G^*Power, version 20 for Windows was used for analysis.

Results:

Reduced facial convexity was observed when the analysis was carried out in relation to true horizontal with significant difference of “t” value of 3.05 and percentage difference of 1.1 (P < 0.01) and for girls “t” value of 9.69 and percentage difference of 2.5 (P < 0.001). The highest correlation coefficient for Lingayat boys (r = 0.77) was seen between palatal plane and occlusal plane. We found least correlation coefficient among FHP and Sella–nasion plane (SNP). The coefficient was r = 0.62 and correlation coefficient of r = 0.70 was between FHP and determination coefficient r² = 0.38 or 38%. For girls, highest correlation coefficient of r = 0.70 was seen among FHP and palatal plane.

Conclusion:

Conventional study of craniofacial forms of Lingayat children showed the average skeletal pattern as Class II with retrognathic mandible in comparison to Caucasians. However, when seen in NHP by new method of analysis based on the true horizontal, the skeletal model was Class III in comparison to Caucasians.

Microbial biopesticides for insect pest management in India: Current status and future prospects

The biopesticide industry in India is undergoing rapid change, reflecting increased global trade in agricultural commodities, a changing regulatory environment and evolving consumer preferences. Currently biopesticides comprise ≈ 5% of the Indian pesticide market, with at least 15 microbial species and 970 microbial formulations registered through the Central Insecticides Board and Registration Committee (CIBRC). As of 2017, over 200 products based on entomopathogenic fungi (Beauveria bassiana, B. brongniartii, Metarhizium anisopliae s.l., Lecanicillium lecanii and Hirsutella thompsonii) and nematicidal fungi (Purpureocillium lilacinum and Pochonia chlamydosporia) are registered for use against various arthropods and plant parasitic nematodes. Regarding bacteria, over 30 products based on Bacillus thuringiensis (Bt) subsp. kurstaki are registered against bollworms, loopers and other lepidopterans, while 12 based on Bt subsp. israelensis and three with Bt subsp. sphaericus have been used against mosquitoes. Two viruses are registered, namely Helicoverpa armigera nucleopolyhedrovirus (22 products) and Spodoptera litura nucleopolyhedrovirus (5 products) for use against bollworms and armyworms. Four entomopathogenic nematode species are sold in Indian market. These include long-lasting wettable powder formulations of Heterorhabditis indica developed by the ICAR-National Bureau of Agricultural Insect Resources, Bengaluru which have been distributed on a large scale to control white grubs and other sugarcane pests. Biopesticide research on the subcontinent is at a relatively early stage, but evolving rapidly, and focusing on indigenous entomopathogens. Despite onerous regulation, quality-control issues and limited large-scale production facilities, investment in domestic fermentation technologies, improved delivery systems, and promotion of biological control through private and public initiative will increase the share of microbial biopesticides in the country.

Fish Scales as Potential Substrate for Production of Alkaline Protease and Amino Acid Rich Aqua Hydrolyzate by Bacillus altitudinis GVC11

Fish processing industries generate large quantities of fish scales as processing waste, if not treated leading to environmental pollution. Fish scales are hard to degrade, hence cause difficulty in waste management. In this context present study was made to utilize fish scales as substrate for the production of alkaline protease by Bacillus altitudinis GVC11 and subsequently amino acid rich aqua hydrolyzate. B. altitudinis GVC11 efficiently utilized five types of fish scales as substrates and produced maximum alkaline protease using Labeo rohita (28,150 U/mL) followed by Catla catla (23,320 U/mL) at 48 h and Cyprinus carpio (17,146 U/mL) Mugil cephalus (18,917 U/mL), Cirrhinus mrigala (12,430 U/mL) at 72 h. The HPLC analysis of protein hydrolyzate obtained after fermentation was enriched in essential amino acids, leucine, isoleucine, phenylalanine, lysine and non-essential amino acids, tyrosine, arginine and cysteine which can be used as animal feed supplement and organic fertilizer.

Histological evaluation of mineral trioxide aggregate and enamel matrix derivative combination in direct pulp capping: An in vivo study

AIM

The aim of this study is to evaluate the response of human pulp tissue to mineral trioxide aggregate (MTA), Emdogain (EMD), and combination of MTA/EMD.

MATERIALS AND METHODS

This study was performed on sixty intact first and second premolars of human maxillary and mandibular teeth. A standard pulpal exposure was done on all the teeth and was divided into three groups of twenty teeth each and was capped with MTA, EMD, and MTA/EMD combination. The final restoration was done with resin-modified glass ionomer cement. The teeth were then extracted on the 15^th or 45^th day and histological evaluation done.

RESULTS

Differences in inflammatory response and thickness of dentin bridge formation of the exposed pulp to the three different groups were statistically evaluated using Chi-square and Mann-Whitney tests and were found to be significant. No significant difference was found between MTA/EMD and MTA in terms of calcified bridge formation and pulp inflammatory response to the capping materials.

CONCLUSIONS

MTA and MTA/EMD combination produced a better quality hard tissue response compared with the use of EMD.

A comparative study of different modalities of treatment in nicotine dependence syndrome

There are different modalities for management of Nicotine dependence, but it is still inconclusive which is the best modality for the treatment of Nicotine dependence syndrome (NDS). In this background the present study was carried out to assess the efficacy and to compare different modalities for the treatment of NDS.

METHODS

Patients diagnosed as NDS as per ICD-10 were taken up for study. These patients were administered proforma to elicit sociodemographic details, Fagerstrom test for Nicotine Dependence, Questionnaire of Smoking Urges-Brief and breath analysis was done using carbon monoxide meter. Assessment was done at base line and at weekly follow-ups for 12 weeks. Patients were divided into six groups randomly. Group A received BUP at a dose of 150mg/day for 3 days; subsequently increased to 300mg/day, Group B: for initial 6 weeks Nicotine gum of 4mg every 1-2 hourly was used and next 6 weeks every 2-4 hourly was used, Group C: BI, Group D: BI+BUP, Group E: BI+NRT, Group F received BUP+NRT+BI.

RESULTS

The quit rates at end of the study were BUP-30%, NRT-26.66%, BI-23.33%, BI+BUP-43.33%, BI+NRT-33.33%, and BI+BUP+NRT-50%. BI+BUP+NRT had 2-3 times more quit rates than the individual modality treatment group.

CONCLUSION

There was no statistically significant difference between the study groups, but there was clinical difference in quit rates. Among the groups BI+BUP+NRT had higher quit rates compared to other groups. Combination modalities yield better quit rates than individual modalities.

Age-related sperm DNA methylation changes are transmitted to offspring and associated with abnormal behavior and dysregulated gene expression

Advanced paternal age (APA) has been shown to be a significant risk factor in the offspring for neurodevelopmental psychiatric disorders, such as schizophrenia and autism spectrum disorders. During aging, de novo mutations accumulate in the male germline and are frequently transmitted to the offspring with deleterious effects. In addition, DNA methylation during spermatogenesis is an active process, which is susceptible to errors that can be propagated to subsequent generations. Here we test the hypothesis that the integrity of germline DNA methylation is compromised during the aging process. A genome-wide DNA methylation screen comparing sperm from young and old mice revealed a significant loss of methylation in the older mice in regions associated with transcriptional regulation. The offspring of older fathers had reduced exploratory and startle behaviors and exhibited similar brain DNA methylation abnormalities as observed in the paternal sperm. Offspring from old fathers also had transcriptional dysregulation of developmental genes implicated in autism and schizophrenia. Our findings demonstrate that DNA methylation abnormalities arising in the sperm of old fathers are a plausible mechanism to explain some of the risks that APA poses to resulting offspring.

A study on oral mucosal lesions in 3500 patients with dermatological diseases in South India

BACKGROUND

Oral mucosal lesions that are observed in the dermatological diseases are categorized under mucocutaneous conditions. The oral lesions in dermatological diseases may be the early aspects of the disease manifestation or the most significant clinical appearance or the only sign/and or symptom of such dermatological diseases and occasionally lesions occur simultaneously in the skin as well as mucous membrane.

AIM

This present study attempts to find out the prevalence of oral mucosal lesions in patients with dermatological diseases.

SUBJECTS AND METHODS

The study includes 3500 patients who attended out-patient Department of Dermatology. Patients with oral manifestation were subjected for clinical examination in the Department of Oral Pathology. Diagnostic procedures were performed to confirm the clinical oral diagnosis. The results of the study were analyzed by SPSS software version 19.0 (Armonk, NY) and presented as descriptive statistics. Correlation of oral manifestions with their respective dermatological disease was statistically analysed by Pearson's correlation test.(P < 0.05 were considered as statistically significant).

RESULTS

The prevalence rate of oral mucosal lesions in the present study was 1.8% (65/3500). The most frequent lesions observed were psoriasis 32.3% (21/65), lichen planus 18.4% (12/65), Stevens Johnson Syndrome 18.4% (12/65), pemphigus 10.7% (7/65), toxic epidermal necrolysis 4.6% (3/65), systemic lupus erythematosus 3% (2/65), discoid lupus erythematosus 1.5% (1/65), pemphigoid 1.5% (1/65). Gender distribution in the study population was statistically significant (P < 0.001). Employed and unemployed individuals in the study population were statistically significant (P < 0.001). Pearson's correlation analysis of oral manifestations with their respective dermatological disease showed r = 0.466 and signifies a positive correlation and is statistically significant at the 0.01 level (two-tailed).

CONCLUSION

The prevalence rate of oral mucosal lesions in patients with dermatological diseases was relatively low. However, predominant oral mucosal lesions observed in the study were autoimmune in origin with a high morbidity and mortality index. Hence, multidisciplinary approach will definitely help in the prognosis of patients.

Comparative Evaluation of Friction Resistance of Titanium, Stainless Steel, Ceramic and Ceramic with Metal Insert Brackets with Varying Dimensions of Stainless Steel Wire: An In vitro Multi-center Study

BACKGROUND

The orthodontist seeks an archwire-bracket combination that has both good biocompatibility and low friction. Hence, the aim of this multicenter in vitro study was to evaluate and compare the frictional resistance generated between titanium (Ti), stainless steel (SS), ceramic and ceramic with metal insert (CMI) brackets with SS wires of varying dimensions in a specially designed apparatus.

MATERIALS AND METHODS

The material used in this study were Ti, SS, Ceramic and CMI with 0.018″ slot manufactured with zero degree tip and -7° torque premolar brackets (3M, Unitek) and SS wires of varying dimensions (0.016″ round, 0.016 × 0.016″ square, 0.016 × 0.022″ rectangular and 0.017 × 0.025″ rectangular) used. The frictional resistance was measured using Instron Universal testing machine (Model no. 4301). The specimen population in each center composed each of 160 brackets and wires. Differences among the all bracket/wire combinations were tested using (one-way) ANOVA, followed by the student Newman Keuls multiple comparisons of means ranking (at P < 0.05) for the determination of differences among the groups.

RESULTS

Ti bracket in combination with 0.017 × 0.025″ SS rectangular wire produced significant force levels for an optimum orthodontic movement with least frictional resistance.

CONCLUSION

Ti brackets have least resistance and rectangular wires produced significant force. These can be used to avoid hazards of Nickel. SS brackets revealed higher static frictional force values as the wire dimension increased and showed lower static friction than Ti brackets for all wires except the thicker wire. Our study recommends the preclusion of brackets with rough surface texture (Ti brackets) with SS ligature wire for ligating bracket and archwire are better to reduce friction.

Differential regulation of defense-related gene expression in response to red rot pathogen Colletotrichum falcatum infection in sugarcane

Red rot is a serious disease of sugarcane caused by the fungus Colletotrichum falcatum imposing a considerable economic loss annually in all sugarcane-producing countries. In this study, we analyzed the early resistance response of sugarcane to red rot fungus by comparing the differences between control and inoculated stalk tissues. Differential display reverse transcription polymerase chain reaction (DD-RT-PCR) was employed to identify altered expression of genes in disease-resistant cv Co 93009, in response to pathogen infection. DD-RT-PCR identified 300 differentially expressed transcripts of which 112 were selected for further analysis. Cloning and sequence analysis of the isolated cDNA fragments resulted in functional categorization of these clones into five categories, of which the defense/stress/signaling group was the largest, with clones homologous to genes known to be actively involved in various pathogenesis-related functions in plant species. This group showed overexpression of several transcripts related to ethylene-mediated and jasmonic acid pathway of plant defense mechanisms. Of the 112 expressed sequence tags, validation of expression was carried out for five important genes whose role in plant defense mechanisms is well established. This is the first report of Colletotrichum-mediated gene regulation in sugarcane which has provided a set of candidate genes for detailed molecular dissection of signaling and defense responses in tropical sugarcane during the onset of red rot resistance.

A Validated RP-HPLC Method for the Estimation of Lapatinib in Tablet Dosage form using Gemcitabine Hydrochloride as an Internal Standard

A simple, selective, rapid, precise and economical reverse-phase high-performance liquid chromatography method has been developed for the determination of lapatinib in tablet using gemcitabine hydrochloride as an internal standard. Chromatography was carried out on an ODS C-18 RP column (4.6 mm i.d. ×250 mm) using a mixture of acetonitrile and water (50:50 v/v) as the mobile phase at a flow rate of 1.0 ml/min. The drug was monitored at 232 nm. The retention times for lapatinib and gemcitabine hydrochloride were found to be 4.25±0.05 and 6.10±0.05 min, respectively. The method produced linear responses in the concentration range of 2-60 μg/ml of lapatinib. The limit of detection and limit of quantitation were 0.265 and 0.884 μg/ml, respectively.

Dose-escalated image-guided radiation and weekly cisplatin for inoperable squamous cell carcinoma of thoracic esophagus

e15120

Background: This study evaluates feasibility, toxicity and early outcomes of image guided volumetric modulated arc therapy (IG-RA) and weekly cisplatin for locally advanced inoperable squamous cell carcinoma (LAI-SCC) of thoracic esophagus. Methods: 41 patients diagnosed with LAI-SCC were included. Patients with performance status (ECOG) more than 1, involvement of cervical esophagus or gastroesophageal junction, distant metastasis were excluded from study. Radiotherapy was planned in two phases to a dose of 5940cGy. Phase I CTV was generated by expanding the GTV-primary craniocaudally(CC) by 4cm and laterally to include electively, the corresponding level mediastinal nodes. In the Phase II, GTV was expanded by 2cm CC and 1cm radially. ITV was generated by expanding the CTV by 0.5cm which was then expanded by 0.5cm to yield PTV. Chemotherapy consisted of 4-6 cycles of weekly cisplatin 40mg/m2. Results: The median age of patients was 53 yrs (43-72). The median length of involvement was 6cm with 80% of lesions in upper and middle third. 37/41(90%) patients completed planned chemotherapy with atleast 4 cycles of cisplatin and 40/41 patients completed full dose of radiotherapy. 10% of patients required tube feeding and 5% required hospital admission for supportive care. Endoscopy at 8 weeks post treatment was performed in 38/41 patients of whom 53% had CR, 42% had PR and 5% had stable disease locally. With a median follow up of 19 (6-32) months, 41% of total patients (17/41) are alive at last follow-up of which 32% (13/41) are disease free with no dysphagia, the 1 and 2 year overall survival are 70% and 40% respectively and median survival of 14 months. 16% alive patients have post radiotherapy stricture. The analysis of CBCT and KV image data sets showed a significant intra-fraction and inter-fraction motion of the target. The ITV and PTV margins of 0.5cm each were found to be adequate with current imaging protocol. Conclusions: IG-RA to a dose of 60Gy with concurrent weekly cisplatin is a feasible treatment option for LAI-SCC of thoracic esophagus with low acute and late toxicity and with promising early clinical outcomes. The ITV and PTV margins of 0.5cm were found to be adequate only with image guidance.

Comparison of Opal self-ligating brackets with manually ligating brackets

This study was conducted with aim to evaluate the efficiency of the newly introduced Opal self-ligating brackets (SLB). The chairside time saved, appliance efficiency, bracket bond failures, breakages and bracket staining in the Opal SLBs were compared with the conventional standard metal manually ligating brackets (MLBs) of MBT system. Seven patients were compared in each group. Standard light curing bonding methods were used in both the group. Chairside time saving, appliance efficiency and bracket bond failures were compared among the groups whereas staining was observed with the SLBs. Appliance efficiency was evaluated by PAR scores. Results showed significant chairside time being saved in SLBs, whereas the appliance efficiency was not significant. Bond failures were found only in SLBs as well as breakages along with staining. Henceforth, we could conclude that though SLBs had advantage of saving chairside time but also had disadvantage of losing more time with bond failures.

Unusual presentation of Kimura's disease involving the parotid gland in an Indian male: a case report and review of literature

Kimura's disease (KD) is a rare chronic inflammatory disorder that involves the subcutaneous tissues and occurs predominantly in the head and neck region, frequently associated with regional lymphadenopathy or salivary gland involvement. Although, not an uncommon condition in the Asian countries, it is quite rare among the occidental civilization and in the western countries is more commonly diagnosed among Asian migrants. Kimura's disease is sometimes confused with angiolymphoid hyperplasia with eosinophilia, which occurs in the superficial skin of the head and neck region. The classical features of angiolymphoid hyperplasia with eosinophilia are characterized by a triad of painless subcutaneous masses in the head and neck region, blood and tissue eosinophilia, and markedly elevated immunoglobulin E (IgE) levels. Here, we report a case of a 33-year-old Indian male with KD who presented with unilateral nodular swelling in the right parotid region. The diagnosis was based on characteristic histopathologic findings in conjunction with peripheral eosinophilia and elevated serum IgE levels.

Mucormycosis associated with juvenile diabetes

Mucormycosis is one of the most rapidly progressing and lethal form of fungal infections in humans which usually begins in the nose and paranasal sinuses. The fungus assaults the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. The purpose of this article is to describe a rare case of maxillary necrosis due to mucormycosis in a 12-year-old diabetic patient and emphasizes on early diagnosis and timely management of this potentially fatal fungal infection.

Lead(II) adsorption from aqueous solutions by raw and activated charcoals of Melocanna baccifera Roxburgh (bamboo)--a comparative study

Melocanna baccifera (Poaceae) is the most abundant and economically important non-timber product in state of Mizoram, India. The communities of the region use this potential resource in many ways, charcoal production is one of them. Bamboo charcoal has application in food, pharmaceutical and chemical industries. Activated charcoal was prepared from M. baccifera charcoal by chemical pretreatment in order to make better use of this abundant biomass material. Batch experiments were conducted under varying range of pH (2.0-6.0), contact time (15-360 min) and metal ion concentrations (50-90 mg L(-1)). The optimum conditions for lead biosorption are almost same for M. baccifera raw charcoal (MBRC) and M. baccifera activated charcoal (MBAC)-pH 5.0, contact time 120 min, adsorption capacity q(max) 10.66 mg g(-1) and 53.76 mg g(-1), respectively. However, the biomass of MBAC was found to be more suitable than MBRC for the development of an efficient adsorbent for the removal of lead(II) from aqueous solutions. FTIR analysis revealed that -OH, C-H bending, C=O stretching vibration and carbonyl functional groups were mainly responsible for Pb(II) biosorption. Thus, this study demonstrated that both the charcoal biomass could be used as adsorbents for the treatment of Pb(II) from aqueous solution.

Transgenic resistance by N gene of a Peanut bud necrosis virus isolate of characteristic phylogeny

The nucleocapsid protein (N) gene of a Tospovirus devastating tomato crop in the south Indian state of Tamil Nadu was cloned and characterized. The high identity of the cloned sequence to a Peanut bud necrosis virus (PBNV) tomato isolate (97.8/99.6% nucleotide/amino acid) and a PBNV peanut isolate (94.4/96.3% nucleotide/amino acid) identified the Tospovirus as an isolate of PBNV, designated PBNV Coimbatore tomato (PBNV CT) isolate. Phylogenetic analysis of PBNV CT N gene provided useful insights into the movement and evolution of PBNV within Indian Territory. The characteristic phylogeny of PBNV CT N gene implied its potential to be an efficient transgene to confer effective PBNV resistance on crop plants. The efficacy of PBNV CT N gene in conferring PBNV resistance was studied by generating tobacco (Nicotiana tabacum L. cv Wisconsin) lines transgenic to the sense or antisense version of the gene. Several transgenic lines showed transgenic mRNA and/or protein accumulation, ranging from very high to undetectable levels, accompanied by different degrees of PBNV resistance. The undetectable or very low levels of transgene transcripts in certain PBNV-resistant sense or antisense N gene transgenic lines suggested RNA-mediated resistance by post-transcriptional gene silencing (PTGS) mechanism. However, PBNV resistance of certain transgenic lines with high levels of N gene transcripts was suggestive of possible operation of RNA-mediated non-PTGS mechanism(s) of resistance in those lines. Moreover, the high levels of N protein in certain PBNV-resistant sense N gene transgenic lines suggested protein-mediated resistance. The results predict the potential of PBNV CT N gene to confer effective PBNV resistance on tomato and other economically important crops.

Phaeohyphomycosis

Phaeohyphomycosis, caused by heterogeneous group of phaeoid fungi causes both subcutaneous and systemic infections. The disease is more of a histopathological than a clinical entity. We present a case of phaeohyphomycosis in a 29-year-old male who presented with the complaint of painful swelling of the right eye of 1-year duration. Computed tomography (CT) scan showed an abnormal hyper dense enhancing soft tissue in the extra coronal aspect of the right orbit along the superolateral and superomedial aspect. A provisional clinical diagnosis of lymphoma or fungal infection was entertained. Histopathology revealed granulomas with numerous multinucleated giant cells and fungal hyphae within and in between the giant cells. Per-iodic acid Schiff (PAS stain) was used to confirm the presence of hyphae. Based on the clinical, CT and histopathological features, a diagnosis of Phaeohyphomycosis was given.

Oral submucous fibrosis: a clinico-histopathological study in Chennai

BACKGROUND

Oral submucous fibrosis (OSF) is a precancerous condition associated with the use of areca nut in various forms. There are very few reports to correlate the clinical stage to histopathological grading in OSF.

MATERIALS AND METHODS

A hospital-based study was conducted on 75 OSF cases who visited our hospital in Chennai from 2000-2003. A detailed history of each patient was recorded along with a clinical examination. Biopsy was performed for histopathological correlation. Clinical stage of the disease in terms of the ability to open one's mouth was correlated with histopathological grading.

RESULTS

The male to female ratio of OSF cases was 6:1. All forms of areca nut products were associated with OSF. Chewing of paanmasala was associated with early presentation of OSF as compared to chewing of the betel nut. Out of 57 cases, which were in clinical stage II, 91.2% had histological grading of I and II in equal proportions and 8.8% had histological grade III. Out of 13 cases that showed a clinical stage of III, 52% showed a histological grade of II, 40% grade III and 8% grade I.

CONCLUSION

In the present study, there was no direct correlation between clinical stages and histopathological grading. The possibility of difference in the severity and extent of fibrosis in different regions of the oral mucosa and involved muscles were considered as contributory factors for this variation.

Pyramiding transgenic resistance in elite indica rice cultivars against the sheath blight and bacterial blight

Elite indica rice cultivars were cotransformed with genes expressing a rice chitinase (chi11) and a thaumatin-like protein (tlp) conferring resistance to fungal pathogens and a serine-threonine kinase (Xa21) conferring bacterial blight resistance, through particle bombardment, with a view to pyramiding sheath blight and bacterial blight resistance. Molecular analyses of putative transgenic lines by polymerase chain reaction, Southern Blot hybridization, and Western Blotting revealed stable integration and expression of the transgenes in a few independent transgenic lines. Progeny analyses showed the stable inheritance of transgenes to their progeny. Coexpression of chitinase and thaumatin-like protein in the progenies of a transgenic Pusa Basmati1 line revealed an enhanced resistance to the sheath blight pathogen, Rhizoctonia solani, as compared to that in the lines expressing the individual genes. A transgenic Pusa Basmati1 line pyramided with chi11, tlp, and Xa21 showed an enhanced resistance to both sheath blight and bacterial blight.

Integration of mental health care into primary care. Demonstration cost-outcome study in India and Pakistan

BACKGROUND

Targeting resources on cost-effective care strategies is important for the global mental health burden.

AIMS

To demonstrate cost-outcome methods in the evaluation of mental health care programmes in low-income countries.

METHOD

Four rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to seek treatment, and assessed prospectively on symptoms, disability, quality of life and resource use.

RESULTS

Between 12% and 39% of the four screened populations had a diagnosable common mental disorder. In three of the four localities there were improvements over time in symptoms, disability and quality of life, while total economic costs were reduced.

CONCLUSION

Economic analysis of mental health care in low-income countries is feasible and practicable. Our assessment of the cost-effectiveness of integrating mental health into primary care was confounded by the naturalistic study design and the low proportion of subjects using government primary health care services.

Study of the safety, immunogenicity and seroconversion of a hepatitis-B vaccine in malnourished children of India

Sixty rural children who were seronegative for HBV markers received three doses of 10 microgram of a new Hepatitis-B vaccine, Revac-B (1 ml of vaccine contains 20 microgram recombinant surface antigen) that was formulated from hepatitis-B surface antigen expressed in a recombinant strain of Saccharomyces cerevisiae. Vaccines were administered on a 0, 30 and 60-day schedule. Levels of anti-HBs titres were determined on the 30th, 60th and 90th days following the initial injection. None of the participants in the trial had serious adverse reactions and the frequencies of minor side effects were minimal. No clinically important adverse effects which could be considered as directly related to the vaccination were recorded. The volunteers showed a very good immune response and were seroprotected on the 30th day after the first dose of vaccination. The present study revealed that the new vaccine, Revac-B is highly immunogenic and is well tolerated.

On the weakening relationship between the indian monsoon and ENSO

Analysis of the 140-year historical record suggests that the inverse relationship between the El Nino-Southern Oscillation (ENSO) and the Indian summer monsoon (weak monsoon arising from warm ENSO event) has broken down in recent decades. Two possible reasons emerge from the analyses. A southeastward shift in the Walker circulation anomalies associated with ENSO events may lead to a reduced subsidence over the Indian region, thus favoring normal monsoon conditions. Additionally, increased surface temperatures over Eurasia in winter and spring, which are a part of the midlatitude continental warming trend, may favor the enhanced land-ocean thermal gradient conducive to a strong monsoon. These observations raise the possibility that the Eurasian warming in recent decades helps to sustain the monsoon rainfall at a normal level despite strong ENSO events.

Beaded reactive polymers. 3. Effect of triacrylates as crosslinkers on the physical properties of glycidyl methacrylate copolymers and immobilization of penicillin G acylase

Various glycidyl methacrylate (GMA) copolymers were synthesized by suspension polymerization, using pentaerythritol triacrylate (PETA), trimethylolpropane triacrylate (TMPTA), and trimethylolpropane trimethacrylate (TRIM) as crosslinking comonomers. These copolymers were evaluated for the immobilization of penicillin G acylase. Broad pore-size distribution that was observed was in the range 5-300 nm. Both surface area and pore volume increased with increase in the mole fraction of crosslinking comonomer (increasing crosslink density). The pore volume of the copolymers was more than doubled by including lauryl alcohol as porogen. Binding of penicillin G acylase (PGA) was quantitative on highly crosslinked copolymers. The expression of bound PGA was better on the relatively more hydrophilic GMA-TMPTA and GMA-PETA copolymer supports compared to the GMA-TRIM copolymers. Among the different copolymers studied, GMA-TMPTA copolymer 7411 exhibited highest activity of immobilized penicillin G acylase (167.4 IU/g) with 35.1% expression.

Evaluation of product analogues for purification of penicillinase by affinity chromatography

Among different matrices prepared, ampicilloic acid-polymer matrix offered 86.7% adsorption, 95% elution and 82.4% overall recovery of penicillinase. The structure of both the side chain and penicilloic or cephalosporoic acid moieties contribute to the affinity interactions.

recA mutations reduce adherence and colonization by classical and El Tor strains of Vibrio cholerae

Two recA mutants of Vibrio cholerae (classical and El Tor biotypes) were constructed by disruption of the wild-type recA gene with mutated recA sequences of V. cholerae cloned in the suicide vector pGP704. Mutants defective in the recA gene were compared with their respective RecA+ parent strains with regard to their adherence to isolated rabbit intestine and colonization of intestine of infant mice. The recA mutation in V. cholerae was found to diminish adherence and markedly affected colonization.