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Low temperature combustion (LTC) strategies have the potential for simultaneous reduction in oxides of nitrogen (NOx) and soot emissions while achieving higher thermal efficiency. Commercial widespread implementation of LTC strategies demands addressing several challenges, including narrow operating load range, lack of ignition timing control, and reducing high unburned hydrocarbon (HC) and carbon monoxide (CO) emissions. These challenges could be because the conventional engine design and fuels cannot adapt well to LTC modes. Thus, replacing conventional diesel fuel with suitable alternative fuels for LTC strategies is essential. In the present work, three LTC strategies, Homogenous Charge Compression Ignition (HCCI), Premixed Charge Compression Ignition (PCCI), and Reactivity Controlled Compression Ignition (RCCI), are compared with conventional diesel combustion in a production, light-duty diesel engine from an alternative fuel perspective to come up with a befitting strategy and fuel to achieve wider operating range and lower emissions. The fuel selection strategy based on the fundamental fuel property requirements of the three LTC strategies has been discussed in detail. The baseline reference data is fixed by comparing three LTC strategies with conventional diesel combustion using diesel and gasoline as reference fuel at 40% load, the maximum common achievable load among the three LTC strategies. This is followed by an investigation of the effect of alternative fuels across three LTC strategies to address the shortcomings of the LTC strategies. The results show that the engine operating load range could be extended, and HC and CO emissions are reduced significantly with alternative fuels in the three LTC strategies. [ABSTRACT FROM AUTHOR]

It inhibits GR in cell-free system and in A549 cells which in turn modulates mitochondrial redox leading to ROS dependent apoptosis in A549 cells. Correspondence to: vikramgota@gmail.com I Background: i The dedicated thioredoxin and glutathione redox systems are the central antioxidant defense mechanisms by which mitochondria neutralize the excess ROS. [Extracted from the article]

Withaferin-A (WA) as an anti-inflammatory and immunomodulatory agent may have clinical utility either as a single agent or in combination for the prevention of aGvHD. Correspondence to: vgota76@gmail.com I Background: i Acute graft versus host disease (aGvHD) is a major complication of allogenic bone marrow transplantation (alloBMT). [Extracted from the article]

Background: Over the course of time, new developments associated with the embryogenesis of the murine heart have served to clarify the developmental processes observed in the human heart. This evidence allows for the creation of a developmental framework for many congenital cardiac defects. Aims: We aim to solidify the framework related to the categorization of both solitary and multiple ventricular septal defects. Materials and Methods: Mice having genetic perturbation of the Furin enzyme have demonstrated perimembranous and juxta‐arterial ventricular septal defects, permitting the inference to be made that these defects can co‐exist with defects occurring within the apical muscular septum. Results: Basis of developmental evidence, furthermore, all interventricular communications can be placed into one of three groups, namely those which are perimembranous, juxta‐arterial, and muscular. All of the defects are described based on their borders as seen from the morphologically right ventricle. Our focus here will be on those defects within the muscular ventricular septum, recognizing that such defects can co‐exist with those that are perimembranous. We discuss the differentiation of multiple discrete defects from those referred to as the "Swiss cheese" variant. Conclusions: As we show, appropriate surgical management requires an understanding of the specific terminology, as the surgical approach may differ depending on the combination of the individual defects. Data from the Society for Thoracic Surgeons revealed that both mortality and morbidity were increased in the setting of multiple as opposed to solitary ventricular septal defects. [ABSTRACT FROM AUTHOR]

Objective: To study the impact of coronavirus disease 2019 (COVID-19) pandemic on the utilization of pediatric cardiac care services and to determine the role of teleconsultation services in delivering healthcare in this subset of population. Methods: It was a retrospective, observational study. All children who attended pediatric cardiology outpatient/teleconsultation services or were admitted to pediatric cardiology ward between April 1, 2019 to July 31, 2019 and April 1, 2020 to July 31, 2020, were recruited in the study. Data for patients who underwent surgery or catheter intervention for congenital heart disease were also recorded and analyzed. Comparisons were drawn between the statistics during the two time-periods. Results: Physical outpatient services were discontinued and were replaced by teleconsultations from April 2020. Inpatient admissions during COVID-19 pandemic (n = 66) decreased by two-thirds as compared to the admissions during similar period in 2019 (n = 189). Similarly, the percentage decrease during these 4 mo of pandemic were 84% for catheter interventions, 90% for total congenital heart disease (CHD) surgeries, and 40% for emergency CHD surgeries. The number of patients availing successful teleconsultation was 1079, which was only 15% of the total number of patients attending physical outpatient services (n = 7176) during the corresponding period in the year 2019. During the pandemic, systematic teleconsultation and local evaluation and investigations aided in better management of patients with CHD. Conclusions: The utilization of cardiovascular services for CHD has reduced significantly during COVID-19 pandemic, for both out- and inpatient care. Teleconsultation services have streamlined the follow-up care to some extent and have helped in noncontact triaging of these patients for further care. [ABSTRACT FROM AUTHOR]

Low Temperature Combustion (LTC) strategies are most promising to simultaneously reduce oxides of nitrogen (NOx) and soot emissions from diesel engines along with offering higher thermal efficiency. Commercial wide spread implementation of diesel LTC strategies requires several challenges to be addressed, including lack of precise ignition timing control, widening the narrow operating load ranges and reducing high unburned fuel emissions. These challenges can be addressed through modifications in the engine or fuel design or both. The timing and rate of combustion in several LTC strategies are controlled primarily by the chemical kinetics of the fuel. Since, diesel fuel reactivity and volatility are tailor-made to perform well under conventional diesel combustion conditions, its application in LTC poses several problems, as highlighted in this paper. Hence, it is important to identify suitable alternative fuels for the different diesel LTC strategies. The published literature on LTC over the past 25 years is critically analyzed to discuss the evolution of the different diesel LTC strategies, their operability limits, the challenges and the controlling parameters for each strategy. This is followed by in-depth analysis of the role of the fuel and the fuel requirements for each strategy. Further, the importance of adopting a hybrid surrogate modeling approach to enable numerical simulation of diesel LTC is highlighted. A novel attempt of relating various diesel low temperature combustion (LTC) strategies based on the approach followed to achieve positive ignition dwell through different injection strategies, utilizing high exhaust gas recirculation (EGR), and dual fuels is presented. The need for replacing diesel with alternative liquid fuels in LTC strategies is presented by highlighting the fundamental problems associated with diesel fuel characteristics. The review concludes by suggesting potential alternative fuels for various diesel LTC strategies and provides directions for future work to address the challenges facing compression ignition LTC operation. [ABSTRACT FROM AUTHOR]

From the past till the present there has been numerous direct filling materials introduced in the dentistry. These materials replaces the specialized tissues of the tooth that have been lost due to caries, as it can further leads to impairment of shape and functioning of the tooth. These materials have exponentially evolved ranging from amalgam to Glass Ionomer Cement and composites. GIC is well liked in dentistry due to its fluoride releasing nature, it is aesthetically good and have variable other properties. But due to its poor mechanical properties it cannot be used in stress bearing areas. To overcome the shortcomings, new materials have been introduced that is Cention-N. Cention-N not only releases fluoride but also release calcium and hydroxide ions. The hydroxyl ions emission can neutralize the acidity caused by the microorganisms which leads to prevention of demineralization. Many factors affect the amount of fluoride release in GIC and Cention-N. Anticariogenic effect of fluoride depends on the amount and time of fluoride release. Due to release of ions from these materials there can be effect on the bond strength of GIC and Cention-N. So the aim of this study is to find the effect of fluoride release on bond strength of Cention-N and GIC. [ABSTRACT FROM AUTHOR]

Background: Acute rheumatic fever (ARF) and acute rheumatic carditis (ARC) continue to be a major public health problem in developing countries. Objective: To study the characteristics of children with ARC being treated at a tertiary centre. Methods and Results: We studied 126 children (mean age 10.4 ± 2.3 years, range 5–15 years, 60% males) diagnosed with ARC by treating cardiologists. Most had lower socio-economic status. Fifty of 126 (40%) presented with a first episode of ARC. Joint symptoms were present in 29% and fever in 25%. Only 2.4% had subcutaneous nodules and none had erythema marginatum or chorea. Fifty-one percent presented in NYHA class II and 29% in NYHA class III or IV. Tachycardia and heart failure were present in 53% and 21%, respectively. Recent worsening of NYHA class (dyspnoea) was the commonest feature (48%). Laboratory investigations showed raised antistreptolysin O titres (>333 units) in only 36.7% of patients. Raised C-reactive protein (CRP) was present in 70%, while raised erythrocyte sedimentation rate was found in only 37% of patients. On the basis of above findings, the modified Jones criteria (2015) for the diagnosis of ARF were satisfied only in 46% of children. Echocardiography showed mitral valve thickening in 77% and small nodules on the tip of the leaflets in 43% (27 and 8%, respectively for aortic valve). Left ventricular ejection fraction was <50% in only 3 patients. The dominant valve lesion was mitral regurgitation (MR) (present in 95% of patients; severe in 78%, moderate in 15%), while aortic regurgitation was present in 44% (severe in 14%). Conclusions: The criteria are often not satisfied by patients being treated for ARC. Recent unexplained worsening of dyspnoea, young age, significant MR, echocardiographic nodules, and elevated CRP are important indicators. [ABSTRACT FROM AUTHOR]

Justification: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition. Process: Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on 10th and 11th of August 2018 at the All India Institute of Medical Sciences, New Delhi. The meeting was supported by Children's HeartLink, a non-governmental organization based in Minnesota, USA. Objectives: To frame evidence based guidelines for (i) indications and optimal timing of intervention in common congenital heart diseases; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for congenital heart diseases. Recommendations: Evidence based recommendations are provided for indications and timing of intervention in common congenital heart diseases, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus and others), obstructive lesions (pulmonary stenosis, aortic stenosis and coarctation of aorta) and cyanotic congenital heart diseases (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein anomaly and others). In addition, protocols for follow-up of post surgical patients are also described, disease wise. [ABSTRACT FROM AUTHOR]

Vein of Galen malformation (VGM) is a rare intracranial vascular malformation. High output heart failure is common in infancy and is characterized by dilatation of all the cardiac chambers. We report an unusual case of VGM in a 3‐month‐old infant without dilatation of the right‐sided cardiac chambers. We then demonstrate importance of comprehensive evaluation in detecting rare coexistence of anomalous right superior caval vein connection to the left atrium. [ABSTRACT FROM AUTHOR]

Saline contrast echocardiography is an established imaging modality. Logical interpretation of a carefully performed study is vital to realize its diagnostic potential. In this review, we discuss utility of saline contrast echocardiography in evaluation of various pathologies within and outside the heart other than a patent foramen ovale. [ABSTRACT FROM AUTHOR]

The 5th Congress of Asia Pacific Pediatric Cardiac Society was held in New Delhi from 6-9 March 2014. This article describes the journey of preparing and hosting one of the largest international events in the specialty of Pediatric Cardiac Care ever held in India. A total of 938 delegates, including 400 from outside India, participated. The scientific program was inclusive keeping in mind the diverse background of delegates from the member nations. Large numbers of research papers were presented, mostly by fellows in training. [ABSTRACT FROM AUTHOR]

Aim This study evaluated patient satisfaction and clinical effectiveness of intracoronal bleach in traumatized anterior discolored intact teeth. Assessment of awareness and knowledge of the patient regarding treatment modalities for such cases was also performed. Material and method Forty-one patients were included in the study. Walking bleach was performed using sodium perborate (tetrahydrate) after root canal treatment and proper cervical seal. Patient was recalled after 1 week for evaluation. The bleaching procedure was repeated again till the patient agreed for it. On each recall visit, shade evaluation was performed using the Vita Classic shade guide. On completion of treatment, the patients were questioned as to their satisfaction level. Statistical analysis was carried out using anova. Results 87.8% of the subjects were highly satisfied with the results obtained; 7.32% were satisfied, while 4.9% were not satisfied. Average number of appointments needed for highly satisfied group was 2.75, and average shade change obtained was 11.97. Significantly more number of appointments were needed for the older patients ( P < 0.01) or patients with older trauma ( P < 0.05)/discoloration ( P < 0.05). Severity of discoloration did not affect the number of appointments ( P > 0.05). Most of the participants (97.6%) were not aware of bleaching procedure. The aspect of this treatment, which satisfied them the most, was improvement of the tooth coloration followed by conservation of tooth structure while the most perplexing thing was the unpredictability of final shade achieved and lack of color stability. Conclusions High level of patient satisfaction after non-vital tooth bleach treatment strongly supports this treatment modality to be a conservative treatment alternative for traumatized discolored anterior tooth. [ABSTRACT FROM AUTHOR]

Aim The aims of the present study were to determine the prevalence of cusp 7 in permanent mandibular first molars in an Indian population, and to comparatively evaluate the variations in occlusal morphology of these teeth, including the difference in the number of cusps and fissure patterns. Methods A total of 1123 Indian participants from the Government College of Dentistry, Indore, Madhya Pradesh, India, were selected for the study. For the analyses of cusp 6 and cusp 7 in permanent mandibular first molars, the Arizona State University Dental Anthropology System was used. Groove patterns were analyzed and classified as Y, +, X, and Ұ. Results Of the 1123 individuals, 132 (11.75%) were found to have cusp 7, while 78 (6.95%) had cusp 6. Thus, a total of 210 participants had the six-cusped mandibular first molars, 98 (8.73%) had the four-cusped mandibular first molars, and two had the seven-cusped variant. Overall, the most common fissure pattern was the Y pattern (50.36%), while the least common was the X pattern (1.25%). Mandibular first molars with cusp 7 demonstrated a highly significant ( P < 0.05) dominance of the Ұ pattern (36.80%) over the Y (30.74%), + (27.71%), and X (4.46%) fissure patterns. Conclusion A significant prevalence of cusp 7 (11.25%) in permanent mandibular first molars was found in the present study in an Indian population. [ABSTRACT FROM AUTHOR]

Background: Amplatzer vascular plugs (AVPs) are devices ideally suited to close medium-to-large vascular communications. There is limited published literature regarding the utility of AVPs in congenital cardiovascular malformations (CCVMs). Aims: To describe the use of AVPs in different CCVMs and to evaluate their safety and efficacy. Materials and Methods: All patients who required an AVP for the closure of CCVM were included in this retrospective review of our catheterization laboratory data. The efficacy and safety of AVPs are reported. Results: A total of 39 AVPs were implanted in 31 patients. Thirteen (33%) were AVP type I and 23 (59%) were AVP type II. AVP type III were implanted in two patients and type IV in one patient. The major indications for their use included closure of pulmonary arteriovenous malformation (AVM) (n = 7), aortopulmonary collaterals (n = 7), closure of a patent Blalock-Taussig shunt (n = 5), systemic AVM (n = 5), coronary AVM (n = 4), patent ductus arteriosus (PDA) (n = 3), pulmonary artery aneurysms (n = 3), and venovenous collaterals (n = 2). Deployment of the AVP was done predominantly via the 5--7F Judkin's right coronary guide catheter. Overall 92% of the AVPs could be successfully deployed and resulted in occlusion of the target vessel in all cases, within 10 minutes. No procedure-related or access site complication occurred. Conclusions: AVPs are versatile, easy to use, and effective devices to occlude the vascular communications in a variety of settings. AVP II is especially useful in the closure of tubular structures with a high flow. [ABSTRACT FROM AUTHOR]

Although local anesthesia remains the backbone of pain control in dentistry, researches are going to seek new and better means of managing the pain. Most of the researches are focused on improvement in the area of anesthetic agents, delivery devices and technique involved. Newer technologies have been developed that can assist the dentist in providing enhanced pain relief with reduced injection pain and fewer adverse effects. This overview will enlighten the practicing dentists regarding newer devices and methods of rendering pain control comparing these with the earlier used ones on the basis of research and clinical studies available. [ABSTRACT FROM AUTHOR]

Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date. [ABSTRACT FROM AUTHOR]

Aortopulmonary collaterals (APCs) are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD). If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO) device delivered through the transvenous route. [ABSTRACT FROM AUTHOR]