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Introduction: Several morphological alterations and remodelling occur in the mandibular condyle and glenoid fossa to adapt to trauma, malocclusion and other developmental disorders. Understanding these changes will aid healthcare providers in comprehending the pathophysiology of various Temporomandibular Joint (TMJ) problems. Aim: To evaluate the morphometric attributes of the condyle and glenoid fossa in the Gujarati population using Cone Beam Computed Tomography (CBCT). Materials and Methods: This cross-sectional radiographic morphometric investigation was conducted at the Department of Oral Medicine and Radiology at the College of Dental Sciences and Research Centre in Bopal, Gujarat, India using departmental archives from September 2019 to September 2022. A total of 40 CBCT scans (80 TMJs) were performed and analysed using the Papaya 3D and Genoray CBCT machines, along with Triana imaging software. Measurements were taken for condylar length, width, height, joint space (anterior, superior, posterior, medial, lateral) and the thickness of the Roof of the Glenoid Fossa (RGF) (sagittal, coronal) on the CBCT images. The aforementioned parameters were compared between genders, age groups and sides using a paired t-test and statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software package (Chicago, IL, USA), version 21.0 for Microsoft (MS) Windows. Results: The mean age of the study participants was 34±9.6 years. The condylar width between males and females was the only condylar characteristic that differed significantly (p-value 0.001). Apart from the gender analysis, no statistically significant variations (p>0.05) were found in the thickness of the RGF when comparing age or side. However, in the gender-wise examination of joint space, males had significantly higher measurements of Superior Joint Space (SJS), Medial Joint Space (MJS) and Lateral Joint Space (LJS) than females. Conclusion: Gujarati males had a significantly larger condylar width compared to females. When considering gender-specific data, males also exhibited greater SJSs, MJSs and LJSs, as well as increased thickness of the RGF. The results of the present study may provide a relevant and comparable reference for the clinical assessment of individuals with healthy, functional, or pathological TMJs.

It is necessary to treat textile effluents before discharging them into natural water bodies as they harm the environment. Compared to conventional treatment methods, catalytic ozonation has gained attention due to its effectiveness in removing refractory organic pollutants. In this study, the coprecipitation method was used to synthesize a composite metal oxide of silver and cerium oxide, and the synthesized catalyst was used to eliminate the Reactive Black 5 (RB5) dye. X-ray diffraction, scanning electron microscopic, and Brunauer–Emmett–Teller surface area analyses were performed to characterize the synthesized catalyst. Afterwards, relevant experimental parameters, such as pH, ozone and catalyst dosages, and initial dye concentration, were investigated. The experiments revealed that the optimal experimental conditions were a pH value of 10, a catalyst dosage of 0.7 g/L, and an ozone dosage of 60 L/h. In these optimized conditions, the RB5 dye was entirely removed, and a chemical oxygen demand removal efficiency of 88% was achieved within a reaction time of 80 min. Furthermore, the recycling potential of the catalyst was tested for three cycles, and no deterioration in its activity was observed. Additionally, studies were conducted using a hydroxyl radical scavenger in order to understand the reaction pathway of the system. As a result, the indirect pathway was more dominant than the direct pathway in the system.

Heavy metal contamination is one of the key environmental complications. Due to some disadvantages of conventional methods, the use of active organisms is becoming more popular technique to remove it. In the present study, primarily 35 bacterial strains were discovered in metal containing media. After being identified resistance power to different copper concentrations (100–1000 mg/l), JRHM33 had the highest level of resistance up to 1000 mg/l of copper. Using the 16S rRNA sequencing, bacterial strain JRHM33 was discovered and revealed 99% similarity to pseudomonas aeruginosa. Sequencing and bioinformatics study using conserved domain analysis supported the laccase gene is present in JRHM33 and has classification as a member of the multicopper oxidase superfamily, which has reduction capacity of metal ions. Analysis of phenotype microarray (PM) technology provides an insight into the metabolic profiling of microbial cell into Pseudomonas aeruginosa JRHM33. Furthermore, Using the central composite design of response surface methodology (CCD-RSM), the successive optimization of the process parameters was attempted for the maximum reduction of the copper. Maximum 68.71% Cu reduction was achieved at 6.71 pH, 90.61 min of incubation time, 5 ml of inoculum size, and 113 rpm of agitation. The generated model has R2 value of 0.9834, indicating that the ANOVA gave it a very significant result. The findings of the validation experiment showed a remarkable similarity between the projected and experimental results. It is determined that bacterial strains isolated from metal-contaminated effluent employ their natural capacity to change toxic heavy metals into less harmful or nontoxic forms.

Objective We evaluated the clinical safety and performance of the ultrathin strut biodegradable polymer-coated Supraflex Cruz (Sahajanand Medical TechnologiesLtd., Surat, India) sirolimus-eluting stent (SES) in an all-comer patient population requiring coronary stent implantation.Study design The study was a prospective, observational, multicentre, single-arm registry.Study settings The study was conducted at 19 NHS Hospitals across the UK, from March 2020 to September 2021.Study participants A total of 1904 patients with symptomatic coronary artery disease (age ≥18 years) who underwent percutaneous coronary intervention with at least one Supraflex Cruz SES were enrolled.Primary and secondary outcomes measure The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction (TV-MI) and clinically indicated target lesion revascularisation (CI-TLR), at 12 months. Safety endpoints were stent thrombosis, all-cause death and any MI. Prespecified subgroups analysis included patients with diabetes mellitus, bifurcation lesion, type B2/C lesion defined as per ACC/AHA (American College of Cardiology/American Heart Association) lesion classification and long coronary lesions (>20 mm).Results A total of 2973 Supraflex Cruz SES were implanted in 1835 patients (mean age: 65.20±11.03 years). Of these, 404 patients had diabetes mellitus (491 lesions), 271 had bifurcation lesions (293 lesions), 1541 had type B2/C lesions (1832 lesions) and 985 had long coronary lesions (>20 mm, 1139 lesions). Among the overall population, device success was achieved in 98.2% of lesions. TLF occurred in 12 (0.7%) patients (0.3% cardiac death, 0.2% TV-MI, 0.2% CI-TLR) at 30 days and in 43 (2.3%) patients (0.8% cardiac death, 0.8% TV-MI, 0.8% CI-TLR) at 12 months follow-up. The rate of definite stent thrombosis was 0.3% in the overall population at 12 months. The incidence of TLF and stent thrombosis was 6.2% and 1% in the diabetic, 1.8% and none in bifurcation lesion, 2.5% and 0.3% in type B2/C lesion, and 2.7% and 0.3% in long coronary lesions (>20 mm) subgroups, respectively. at 12 months follow-up.Conclusion The S-FLEX UK-II registry confirms the clinical safety and performance of the ultrathin Supraflex Cruz SES in an all-comer population with complex coronary artery disease, demonstrating low rates of TLF and stent thrombosis.Trial registration number ISRCTN39751665 (https://doi.org/10.1186/ISRCTN39751665)

Large amounts of wastewater are generated due to overpopulation and industrialization, The bioavailability, toxicity, and permanence of metals make heavy metal contamination a big environmental hazard. In order to maximize chromium (Cr+6) removal efficiency, the current investigation was carried out from industrial wastewater using Pseudomonas aeruginosa JRHM33.35 bacterial strains were discovered based on their physical, and biochemical properties and resistance towards chromium (Cr+6) heavy metal. The most significant bacterial strain JRHM33 found the highest-level of 1000 mg/L of chromium (Cr+6) resistance. The bacterial strain JRHM33, which has 99 % similarity to Pseudomonas aeruginosa, was found using 16 S rRNA sequencing and is employed in subsequent steps. Sequencing and study of conserved domains indicate that JRHM33 contains the laccase gene and belongs to the multicopper oxidase superfamily, which is known for its ability to reduce metal ions. Analysing phenotype microarray (PM) technology sheds light on Pseudomonas aeruginosa JRHM33 metabolic profile of microbial cells. Additionally, a series of process parameter optimizations were tried using the central composite design of response surface methodology (CCD-RSM) in an effort to reduce the amount of chromium (Cr+6) in the effluent as much as possible. At 6.8 pH, 90 min of incubation, inoculum size is 3.8 ml, and agitation is 104 rpm, a maximum 71 % Cr+6 reduction was attained. The model constructed has an R2 score of 0.983 indicates a very statistically significant outcome from the analysis of variance. The experimental outcomes and the predicted results were remarkably similar, according to the validation experiment. Studies have revealed that bacterial strains obtained from effluent containing high levels of metals utilize their inherent capability to change harmful heavy metals into less dangerous or harmless forms.

A focussed library of pyridyl and 2-hydroxyphenyl chalcones were synthesized and tested for growth inhibitory activity against Mycobacterium tuberculosis H37Rv, and normal and cancer breast cell lines. Pyridyl chalcones bearing lipophilic A-ring, e.g., dichloro-phenyl-(14), pyrene-1-yl (20)- and biphenyl-4-yl (21) moieties were found to be the most potent of the series inhibiting the growth of M. tuberculosis H37Rv with IC90 values ranging from 8.9–28 µM. Aryl chalcones containing a 3-methoxyphenyl A-ring and either p-Br-phenyl (25) or p-Cl-phenyl (26) B-rings showed an IC90 value of 28 µM. Aryl-chalcones were generally less toxic to HepG2 cells compared to pyridyl-chalcones. Dose-dependent antiproliferative activity against MDA468 cells was observed for trimethoxy-phenyl (16) and anthracene-9-yl (19) pyridyl-chalcones with IC50 values of 0.7 and 0.3 µM, respectively. Docking studies revealed that chalone 20 was predicted to bind to the M. tuberculosis protein tyrosine phosphatases B (PtpB) with higher affinity compared to a previously reported PtpB inhibitor.

Purpose: To report on a case of angle-closure glaucoma secondary to iridocorneal endothelial (ICE) syndrome effectively managed with the PreserFlo Microshunt. Observations: We report successful implantation of a PreserFlo Microshunt in a 57-year-old patient with secondary angle-closure glaucoma in the context of ICE syndrome. Following failure of medical therapy to adequately control intraocular pressure (IOP), the patient was consented for surgical intervention and underwent combined cataract surgery and PreserFlo Microshunt implantation. IOP at the last post-operative follow-up (5 months) was 12 mmHg with the patient on brinzolamide/timolol maleate (Azarga®). We report no complications in the post-operative period. Conclusions and importance: The PreserFlo Microshunt may be a promising option for patients with ICE syndrome who fail medical therapy. Implantation of this device was well tolerated in the presented case.

Implication Statement Podcasts are an increasingly popular medical education modality, especially in surgical fields. However, the cost of developing a high-quality medical education podcast presents a barrier to many content creators. The authors developed the podcast series ‘The Lenspod,’ designed to be a cost-efficient but high-quality education resource in ophthalmology. The REC financial framework has been previously used to estimate the financial costs of technology-based medical education. Using this framework, costs were competitive with other medical education podcasts. It is our hope that similar methodology may be used to create and disseminate future podcasts for medical education.

We report on a 55-year-old patient presenting with a 400 μm macular hole which failed to resolve with vitrectomy and internal limited membrane peeling. In accordance with patient wishes to avoid further surgery, subthreshold laser was applied to the macular hole followed by gas exchange with euvolemic C3F8. Successful hole closure was subsequently observed with vision improved by four Snellen lines. Subthreshold laser has several advantages over conventional laser techniques, including reduced collateral thermal damage to the adjacent cells. This case has demonstrated a new use for subthreshold laser, which combined with push-pull technique may be an effective treatment option for persistent MH.

Naturally occurring stilbenoids, such as the (E)-stilbenoid resveratrol and the (Z)-stilbenoid combretastatin A4, have been considered as promising lead compounds for the development of anticancer drugs. The antitumour properties of stilbenoids are known to be modulated by cytochrome P450 enzymes CYP1A1 and CYP1B1, which contribute to extrahepatic phase I xenobiotic and drug metabolism. Thirty-four methyl ether analogues of resveratrol were synthesised, and their anticancer properties were assessed, using the MTT cell proliferation assay on a panel of human breast cell lines. Breast tumour cell lines that express CYP1 were significantly more strongly affected by the resveratrol analogues than the cell lines that did not have CYP1 activity. Metabolism studies using isolated CYP1 enzymes provided further evidence that (E)-stilbenoids can be substrates for these enzymes. Structures of metabolic products were confirmed by comparison with synthetic standards and LC-MS co-elution studies. The most promising stilbenoid was (E)-4,3′,4′,5′-tetramethoxystilbene (DMU212). The compound itself showed low to moderate cytotoxicity, but upon CYP1-catalysed dealkylation, some highly cytotoxic metabolites were formed. Thus, DMU212 selectively affects proliferation of cells that express CYP1 enzymes.

Bacterial secondary metabolites (B-SMs) are low molecular weight (< 2.5 KDa) compounds that are produced by bacteria but are not required for their growth or replication. Instead, they are produced to give the organism a selective advantage. They are produced during the stationary/idio phase of the bacterial growth cycle by the gene clusters usually known as biological gene clusters (BGCs) which produce a variety of bioactive substances that boosts plant health directly or indirectly by providing several elements like antibiotics, degradative enzymes, siderophores and etc. These amalgams mainly cover phospholipids, peptides, polypeptides, quinols, polyketides, alkaloids, polyenes, phenazines, volatiles, amino-sugars, macro-lactones and aminoglycosides. B-SMs are widely used as antifungal, antibacterial, antiviral, antitumor and anti-algal bioactive components because of their effective defence against a variety of plant diseases, manage biotic stress, and ability to trigger host response. This review provides insight into a variety of important B-SMs characteristics, including their production, classification based on SMs, and use as defence molecules against pathogen and biotic stress to sustain the plant growth.

Tardive Dyskinesia is a movement disorder characterized by involuntary repetitive body movements, like chewing motions, cheek puffing, tongue protrusion and lip pursing. These symptoms appear during sleep and/or wakefulness. Report of involuntary movements of tongue is very rare, with a prevalence of only 15%–20%. Risk factors include old age, female gender, and patients receiving drugs with anti-dopaminergic activity, for long term. We report a case of 62 years old male patient with a long history of antidepressants and mood stabilizers, who presented with involuntary tongue movements. The patient was treated by altering the dose and discontinuation of a few medicines, which resulted in a slight decrease in the frequency of the movement. The case is discussed here to spread awareness and vigilance about this condition, in order to aid in early diagnosis and management, to avoid negative impacts on psychologic health and quality of life of the patient.

The present study assesses the clinical outcomes after left main coronary stenting, using clinical evaluation, angiography, and Fractional Flow Reserve (FFR). A prospective observational study was conducted on 72 patients undergoing left main coronary artery (LMCA) stenting, transthoracic echocardiography, coronary angiography, and percutaneous coronary intervention were done and FFR was recorded. At the end of 6 months, follow up check angiography, FFR study were performed. The stent was placed from LMCA to left anterior descending artery (LAD) artery among 45.83% of patients and 9.72% had from LMCA to Left circumflex artery. The mortality rate was 8.33%. The fractional flow reserve was 0.81 on an average ranging from 0.58 to 0.90. Relatively low incidence of major cardiac event was noted among patients with single vessel disease and ostial LMCA disease.

Balvir S Tomar,1 Mahaveer Singh,2 Deepak Nathiya,3 Abhishek Sharma,4 Eshan Sharma,4 Hemant Bareth,3 Supriya Suman,3 Darshan Purshotambhai Ruparelia,4 Jaykumar Bharatbhai Patel,4 Vikrant Kantilal Gajera4 On Behalf of the NIMS COVID 19 Investigator Group1Institute of Gastroenterology, Hepatology & Transplant, Nims University Rajasthan, Jaipur, India; 2Department of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, India; 3Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India; 4Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, IndiaCorrespondence: Mahaveer SinghDepartment of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, IndiaTel +91 8949836075Email drms.mamcmed@gmail.comDeepak NathiyaDepartment of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, 303121, IndiaTel +91 9929600137Email dnathiya@nimsuniversity.orgPurpose: To assess the prevalence of post-COVID symptoms in patients with recovered COVID-19 (nasopharyngeal RT PCR negative) who were discharged from an acute COVID care facility at a tertiary care teaching hospital in North India.Methods: This study was an observational study with retrospective data collection, conducted in the COVID follow-up clinic, a combined clinic of medicine and endocrinology. Patients discharged from the acute COVID care facility were recruited after 14 days of discharge if they fulfilled inclusion and exclusion criteria. The retrospective data was collected from the hospital records/EMR and analysed by the SPSSv23.Results: Fifty patients, who fulfilled the inclusion and exclusion criteria, were included in the study. The Mean age of patients was 53.4± 13.8 years (range 28– 77). Seventy six percent were male, and 38% had type 2 diabetes. Fever (94%), cough (78%) and breathlessness (68%), were the most common symptoms at presentation to acute care facility. Oxygen saturation at presentation had a negative correlation with D-Dimer, age, and C reactive protein. When patients were evaluated clinically, after 14 days (range 15 to 50 days) of the discharge, 82% of patients had at least one persistent symptom. Fatigue (74%) was the most common symptoms in follow-up followed by breathlessness (44%), and muscle weakness (36%). Two patients had persistent fever, even after negative RT PCR status.Conclusion: Patients discharged from the acute COVID care facility had a high prevalence of post-COVID symptoms even after 14 days.Keywords: COVID-19, diabetes, SARS-CoV-2, oxygen saturation, post-COVID

Aims: To assess left ventricular (LV) function before and after transcatheter aortic valve implantation (TAVI) using conventional echocardiographic parameters and global longitudinal LV strain (GLS) and compare outcomes between Edwards S3 and Evolut R valves. Methods and results: Data were collected for consecutive patients undergoing TAVI at Hammersmith hospital between 2015 and 2018. Of the 303 patients, those with coronary artery disease and atrial fibrillation were excluded leading to a total of 85 patients, which constituted our study group. The mean follow-up was 49 ± 39 days. In total, 60% of patients were treated with Edwards S3 and 40% Evolut R. TAVI resulted in an early improvement of GLS (−13.96 to −15.25%, P = 0.01) but not ejection fraction (EF) (47.6 to 50.1%, P = 0.09). LV mass also improved, especially in patients with marked baseline LV hypertrophy (P < 0.001). There were no appreciable differences of LV function improvement and overall LV remodelling after TAVI between the two types of valves used (P = 0.14). Conclusions: TAVI results in reverse remodelling and improvement of GLS, especially in patients with impaired baseline LV function. There were no differences in the extent of LV function improvement between Edwards S3 and Evolut R valves but there was a greater incidence of aortic regurgitation with Evolut R.

Abstract Introduction This study examined the safety and pharmacodynamic effects of selective muscarinic M1 receptor orthosteric agonist HTL0018318 in 60 patients with mild‐to‐moderate Alzheimer's disease (AD) on background donepezil 10 mg/day. Methods A randomized, double‐blind, placebo‐controlled 4‐week safety study of HTL0018318 with up‐titration and maintenance phases, observing exploratory effects on electrophysiological biomarkers and cognition. Results Treatment‐emergent adverse events (TEAEs) were mild and less frequently reported during maintenance versus titration. Headache was most commonly reported (7–21%); 0 to 13% reported cholinergic TEAEs (abdominal pain, diarrhea, fatigue, nausea) and two patients discontinued due to TEAEs. At 1 to 2 hours post‐dose, HTL0018318‐related mean maximum elevations in systolic and diastolic blood pressure of 5 to 10 mmHg above placebo were observed during up‐titration but not maintenance. Postive effects of HTL0018318 were found on specific attention and memory endpoints. Discussion HTL0018318 was well tolerated in mild‐to‐moderate AD patients and showed positive effects on attention and episodic memory on top of therapeutic doses of donepezil.

Arbuscular mycorrhizal fungi (AMF) and plant symbiosis is the old, fascinating and beneficial relation that exist on earth for the plants. In this review, we have elaborated that the strigolactones (SLs) are released from the roots and function with root parasite, seeds and symbiotic AMF as contact chemicals. They are transported through the xylem in the plants and can regulate plant architecture, seed germination, nodule formation, increase the primary root length, influence the root hairs and physiological reactions to non-living agents by regulating their metabolism. SLs first evolved in ancient plant lineages as regulators of the basic production processes and then took a new role to maintain the growing biological complexities of terrestrial plant. SLs belongs to a diversified category of butenolide‐bearing plant hormones related to various processes of agricultural concern. SLs also arouses the development of spores, the divergence and enlargement of hyphae of AMF, metabolism of mitochondria, reprogramming of transcription process, and generation of chitin oligosaccharides which further stimulate the early response of symbiosis in the host plant, results from better communication in plant and ability of coexistence with these fungi. The required nutrients are transferred from the roots to the shoots, which affect the physiological, biochemical, and morphological characteristics of the plant. On the other hand, the plant provides organic carbon in the form of sugars and lipids to the fungi, which they use as a source of energy and for carried out different anabolic pathways. SLs also lead to alteration in the dynamic and structure of actin in the root region as well as changes the auxin's transporter localization in the plasma membrane. Thus, this study reveals the functions that SLs play in the growth of roots, as well as their effect and interaction with AMF that promote plant growth.

Objectives The clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare National Health Service Trust, UK.Methods We retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7 March to 7 April 2020. Patient data were collected for baseline demographics, comorbidities and in-hospital outcomes, especially relating to cardiovascular intervention.Results Mean age was 67.4±16.1 years and 62.2% (n=310) were male. 64.1% (n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4% (n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%, p

The use of minimally invasive glaucoma surgery (MIGS) devices has become increasingly common for the management of elevated intraocular pressure (IOP) in the context of glaucoma. These technologies have traditionally been associated with fewer postoperative complications than conventional surgical techniques. However, we report on a rare case of transient XEN occlusion associated with pupil dilation following XEN gel stent implantation. This case highlights that in future XEN implantations, it may be preferable to position the XEN at a lesser angle to the iris to prevent such an occlusion. The use of different positionings of XEN is performed to optimize outcomes. However, it is highlighted that complications may arise in certain circumstances.

Aims: To determine whether the number of patients presenting with acute coronary syndromes has reduced during the COVID-19 pandemic. Methods: Numbers of primary percutaneous coronary intervention (PPCI) activations, ST elevation myocardial infarctions (STEMIs) and non-ST elevation myocardial infarctions (NSTEMIs) in a large tertiary Greater London centre and a large district general hospital, both of which have on-site heart attack centres, were collected. We compared the number of PPCI activations, STEMI, NSTEMIs and all MIs prior to the COVID-19 era (January to third week of February 2020), after the start of some COVID-19 restrictions taking place (fourth week of February 2020) and after formal instruction by the United Kingdom Government that all citizens were to observe strict social distancing measures (20 March 2020). We further obtained data for the corresponding weekly figures from 2019. Results: The average weekly figure of all myocardial infarction in 2020, prior to the COVID-19 social distancing restrictions/awareness in the UK (beginning of January to third week of February), did not differ when compared with corresponding weeks in 2019 (23.3 ± 5.4 in 2019 versus 21.13 ± 3.5, p = 0.411). With increased media reporting and associated public awareness of the threat of COVID-19 (last week of February), there was a significant reduction in all myocardial infarction (27.1 ± 4.7 in 2019 versus 15.9 ± 3.6 in 2020, p

Down syndrome (DS) is the most frequent genetic cause of developmental abnormalities leading to intellectual disability. One notable phenomenon affecting the formation of nascent neural circuits during late developmental periods is developmental switch of GABA action from depolarizing to hyperpolarizing mode. We examined properties of this switch in DS using primary cultures and acute hippocampal slices from Ts65Dn mice, a genetic model of DS. Cultures of DIV3–DIV13 Ts65Dn and control normosomic (2 N) neurons were loaded with FURA-2 AM, and GABA action was assessed using local applications. In 2 N cultures, the number of GABA-activated cells dropped from ~100% to 20% between postnatal days 3–13 (P3–P13) reflecting the switch in GABA action polarity. In Ts65Dn cultures, the timing of this switch was delayed by 2–3 days. Next, microelectrode recordings of multi-unit activity (MUA) were performed in CA3 slices during bath application of the GABAA agonist isoguvacine. MUA frequency was increased in P8–P12 and reduced in P14–P22 slices reflecting the switch of GABA action from excitatory to inhibitory mode. The timing of this switch was delayed in Ts65Dn by approximately 2 days. Finally, frequency of giant depolarizing potentials (GDPs), a form of primordial neural activity, was significantly increased in slices from Ts65Dn pups at P12 and P14. These experimental evidences show that GABA action polarity switch is delayed in Ts65Dn model of DS, and that these changes lead to a delay in maturation of nascent neural circuits. These alterations may affect properties of neural circuits in adult animals and, therefore, represent a prospective target for pharmacotherapy of cognitive impairment in DS.

Background: Despite the importance of CAD for women, there is persistent perception that CAD is a man’s disease. Contributing to this notion is the observation of differences in incidence rates according to age; the incidence of CAD in women is lower than men, but rises steadily after fifth decade. The distribution of CAD risk factors varies between men and women across age ranges and failure to consider these differences may have contributed to the belief that women are at lower risk of CAD compared with men. In addition, women are more likely to have symptoms considered atypical compared with men. There is an urgent need to better understand the presentation of cardiac symptoms in women, in order to facilitate diagnosis and treatment, to initiate aggressive risk factor intervention and to improve the quality of life. Methods: We studied clinical and angiographic profile of women undergoing coronary angiogram over a period of 6 years at Nanavati Hospital, Mumbai. The objectives were to examine the distribution of risk factor and coronary angiographic patterns of CAD in women. Results: It was observed that coronary artery disease is most commonly involving females between the age 60 to 80 years. Raised LDL-C was found to be most common risk factor involved in development of coronary artery disease in females. Most common presentation of CAD in women is unstable angina or non-ST segment elevation MI. Most common coronary angiography finding was single vessel disease. Conclusion: Though coronary artery disease is late to present in women it significantly hamper quality of life. The clinical presentation of coronary artery disease in women varies from asymptomatic to severe unstable angina to myocardial infarction. Stress testing and 2D-ECHO helps to some extent for prediction of coronary artery disease but false positive as well as false negative test results are not negligible. Coronary angiography is the conclusive test to determine spectrum and characterization of coronary artery anatomy in women. As this study is based on experience at single center, various biases may be possible. Widespread data collection involving multiple center and multiple operators will be helpful.

abstract: Transradial approach for coronary angiography was first described in 1989. Coronary interventions through radial approach are becoming more frequent and preferred procedure now a days. There are many advantages of using radial route, which includes less puncture site related complications, less bleeding, early ambulation, early discharge and low cost. Although like other procedures, it is not free of complications. Rare vascular complications may include radial artery spasm, dissection, occlusion, perforation and compartment syndrome. Here we present an unusual case of radial artery pseudoaneurysm. Although pseudoaneurysm is a well-known complication related to femoral access (0.2 to 3%), it is very infrequent (0.009%) in case or radial access. Usually after the catheter or sheath is removed, a clot is formed at the arteriotomy site that typically seals the lumen and prevents the continuous egress of blood. If this thrombus is inadequate, a pseudoaneurysm, that communicates with the arterial lumen can form external to the artery. Till date very few such cases have been reported for which recommended is surgical management of the pseudoaneurysm. Although recently there have been reports of successful nonsurgical treatment in some patients. In this report, we present an efficient, safe and noninvasive management protocol using modification of transradial band (TR Band) application technique with combination of ultrasonography (USG) guided compression of pseudoaneurysm. The approach is cost-effective and efficient and ensures correction without occlusion of the radial artery.

This article evaluates a Participatory Action Research (PAR) approach with mixed methods including concept mapping, q-sorting and deliberative dialogue in the context of a research project on young people’s experiences with digital communications technologies, and addresses some of the central insights of intersectionality theory and praxis. Our approach seeks to ensure that, insofar as possible, the gathered data provide a rich and layered window into the experiences of young people from a range of marginalized communities served by our project partners. The article revisits some key insights and contestations relating to intersectionality and addresses their relationship to our approach. We evaluate whether these methods enhance understandings of the interactions of structures of subordination with other factors identified in intersectionality scholarship, as well as the extent to which they centre the knowledge and expertise of those subordinated by matrices of domination as discussed by authors such as Crenshaw and Hill Collins. Our approach is just one of many that social science researchers interested in advancing intersectionality’s key insights could deploy. While it falls short of full consistency with these insights, its mixed methods work toward our partners’ social justice objectives while facilitating exploration of intersecting axes of subordination. Our approach can also help our project recapture the politic at the heart of many intersectional feminist critiques, such as those of Crenshaw and Hill Collins - that reconceptualizing knowledge requires centring the knowledge and expertise of those traditionally excluded due to interlocking systems of subordination.

The petals of the saffron crocus (Crocus sativus L.) are considered a waste material in saffron production, but may be a sustainable source of natural biologically active substances of nutraceutical interest. The aim of this work was to study the cardiovascular effects of kaempferol and crocin extracted from saffron petals. The antiarrhythmic, inotropic, and chronotropic effects of saffron petal extract (SPE), kaempferol, and crocin were evaluated through in vitro biological assays. The antioxidant activity of kaempferol and crocin was investigated through the 2′,7′-dichlorodihydrofluorescein diacetate (DCFH-DA) assay using rat cardiomyoblast cell line H9c2. The MTT assay was applied to assess the effects of kaempferol and crocin on cell viability. SPE showed weak negative inotropic and chronotropic intrinsic activities but a significant intrinsic activity on smooth muscle with a potency on the ileum greater than on the aorta: EC50 = 0.66 mg/mL versus EC50 = 1.45 mg/mL. Kaempferol and crocin showed a selective negative inotropic activity. In addition, kaempferol decreased the contraction induced by KCl (80 mM) in guinea pig aortic and ileal strips, while crocin had no effect. Furthermore, following oxidative stress, both crocin and kaempferol decreased intracellular ROS formation and increased cell viability in a concentration-dependent manner. The results indicate that SPE, a by-product of saffron cultivation, may represent a good source of phytochemicals with a potential application in the prevention of cardiovascular diseases.

Transradial approach for coronary intervention has gained popularity amongst experienced as well as upcoming interventional cardiologist. As compared to femoral access, the radial access has many advantages. Although like any other procedure, transradial approach is also not free of complications. Many vascular anomalies and complications are described, which includes radial artery spasm, tortuous course of axillary or subclavian artery, arteria lusoria, intimal dissection, perforation, compartment syndrome and rarely pseudoaneurysm formation. A few cases had been reported about kinking/twisting of radial catheter followed by trapping of catheter in the radial artery. Here we present such unusual case of an entrapped catheter in the radial artery and its successful retrieval with the help of goose snare. We would also like to propose a stepwise approach in such a case scenario.

Teledentistry is a relatively new field that combines telecommunication technology and dental care. Teledentistry′s roots lie in telemedicine. Telemedicine (and by inclusion teledentistry) has been defined as "the practice of health care delivery, diagnosis, consultation, treatment and education using interactive audio, video or data communications′. Improvement in accessibility of health care and lowered health care costs are only two of the many advantages that will emerge as teledentistry becomes integrated with, and fundamentally change, the practice of dentistry. Some barriers still exist for teledentistry practice, including legal, educational and insurance issues. In spite of having these "teething troubles", the potential of telemedicine and teledentistry is tremendous. In this article, we review the development of teledentistry, its use in dental education and treatment planning, its strengths and limitations, and its future role.

The lack of a mutant phenotype in homozygous mutant individuals' due to compensatory gene expression triggered upstream of protein function has been identified as genetic compensation. Whilst this intriguing process has been recognized in zebrafish, the presence of homozygous loss of function mutations in healthy human individuals suggests that compensation may not be restricted to this model. Loss of skeletal α-actin results in nemaline myopathy and we have previously shown that the pathological symptoms of the disease and reduction in muscle performance are recapitulated in a zebrafish antisense morpholino knockdown model. Here we reveal that a genetic actc1b mutant exhibits mild muscle defects and is unaffected by injection of the actc1b targeting morpholino. We further show that the milder phenotype results from a compensatory transcriptional upregulation of an actin paralogue providing a novel approach to be explored for the treatment of actin myopathy. Our findings provide further evidence that genetic compensation may influence the penetrance of disease-causing mutations.

BACKGROUND:There is uncertainty about the influence of diet during pregnancy and infancy on a child's immune development. We assessed whether variations in maternal or infant diet can influence risk of allergic or autoimmune disease. METHODS AND FINDINGS:Two authors selected studies, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings. We searched Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) between January 1946 and July 2013 for observational studies and until December 2017 for intervention studies that evaluated the relationship between diet during pregnancy, lactation, or the first year of life and future risk of allergic or autoimmune disease. We identified 260 original studies (964,143 participants) of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies (542,672 participants) of other maternal or infant dietary exposures, including 80 trials of maternal (n = 26), infant (n = 32), or combined (n = 22) interventions. Risk of bias was high in 125 (48%) milk feeding studies and 44 (25%) studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with nonpathogenic micro-organisms (probiotics) during late pregnancy and lactation may reduce risk of eczema (Risk Ratio [RR] 0.78; 95% CI 0.68-0.90; I2 = 61%; Absolute Risk Reduction 44 cases per 1,000; 95% CI 20-64), and 6 trials suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitisation to egg (RR 0.69, 95% CI 0.53-0.90; I2 = 15%; Absolute Risk Reduction 31 cases per 1,000; 95% CI 10-47). GRADE certainty of these findings was moderate. We found weaker support for the hypotheses that breastfeeding promotion reduces risk of eczema during infancy (1 intervention trial), that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus (28 observational studies), and that probiotics reduce risk of allergic sensitisation to cow's milk (9 intervention trials), where GRADE certainty of findings was low. We did not find that other dietary exposures-including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake-influence risk of allergic or autoimmune disease. For many dietary exposures, data were inconclusive or inconsistent, such that we were unable to exclude the possibility of important beneficial or harmful effects. In this comprehensive systematic review, we were not able to include more recent observational studies or verify data via direct contact with authors, and we did not evaluate measures of food diversity during infancy. CONCLUSIONS:Our findings support a relationship between maternal diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively.

Chronic myeloproliferative disorders (CMPD) are rarest hematological disorders (malignant myeloid neoplasms). The three most common chronic myeloproliferative disorders are polycythemia vera, essential thrombocythemia and chronic idiopathic myelofibrosis. Clinical manifestations (including oral manifestations) of these disorders are overlapping with each other and with other hematologic disorders, which makes the diagnosis of CMPD a challenging task. In this article we report a rare to rarest case of CMPD at dental outpatient department, its oral manifestations and its management in dental clinics.

Cenesthopathy is characterized by bizarre or strange sensations at various parts of body, and it is common to occur at the oral area (oral cenesthopathy). In such cases, the patients seek dentists for medical care, but will mostly fail to find any causes of the disease. The nosography of oral cenesthopathy has been discussed in some case reports and reviews but is overlooked in mainstream medicine. Thus the aim of this article is to focus review on the various aspects of oral cenesthopathy with report of two cases.

Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature.

Pleomorphic Adenoma (P A), the most common benign tumor of salivary gland, is common to occur in parotid gland and the submandibular gland. However, as far as minor salivary glands are concerned, the most common site is hard palate and very few cases are reported to occur in soft palate. In the present case report, one case found in soft palate, three cases involving hard palate and one case is found extra orally involving submandibular gland. All the cases were diagnosed on the basis of clinical features. CT Scan report (as in case I) and confirmed by histopathological report. The patient was given palliative radiotherapy due to poor cardiac condition of the patient. Other cases were treated with surgical excision. Follow up examination of all five cases was done for different durations. No re-occurrence was reported.

Arteriovenous malformations (AVMs) are extremely rare conditions that can result from congenital or acquired abnormalities in the structure of blood vessels. They are potentially fatal. AVMs may be asymtomatic or may show various signs and symptoms including soft tissue swellings, pain, changes in skin and mucosal colour, erythematous and bleeding gingiva, bruit and paresthesia. Radiographically, there are no pathognomic features. The present case illustrates an AVM in a 25-year-old male with history of trauma to mandible and no characteristic signs (except a swelling) suggesting AVM.

Background: Conventional topical tretinoin formulation is often associated with local adverse events. Nanogel formulation of tretinoin has good physical stability and enables good penetration of tretinoin into the pilo-sebaceous glands. Aim: The present study was conducted to assess the efficacy and safety of a nanogel formulation of tretinoin as compared to its conventional gel formulation in the treatment of acne vulgaris of the face. Materials and Methods: This randomized, active controlled, multicentric, phase IV clinical trial evaluated the treatment of patients with acne vulgaris of the face by the two gel formulations locally applied once daily at night for 12 wk. Acne lesion counts (inflammatory, non-inflammatory & total) and severity grading were carried out on the monthly scheduled visits along with the tolerability assessments. Results: A total of 207 patients were randomized in the study. Reductions in the total (72.9% vs. 65.0%; p = 0.03) and inflammatory (78.1% vs. 66.9%; p = 0.02) acne lesions were reported to be significantly greater with the nanogel formulation as compared to the conventional gel formulation. Local adverse events were significantly less (p = 0.04) in the nanogel group (13.3%) as compared to the conventional gel group (24.7%). Dryness was the most common adverse event reported in both the treatment groups while peeling of skin, burning sensation and photosensitivity were reported in patients using the conventional gel only. Conclusion: In the treatment of acne vulgaris of the face, tretinoin nanogel formulation appears to be more effective and better tolerated than the conventional gel formulation.

The occurrence of atherosclerosis and diabetes is expanding rapidly worldwide. These two metabolic disorders often co-occur, and are part of what is often referred to as the metabolic syndrome. In order to determine future therapies, we propose that molecular mechanisms should be investigated. Once the aetiology of the metabolic syndrome is clear, a nutritional intervention should be assessed. Here we focus on the protective effects of some dietary flavonoids, and their metabolites. Further studies may also pave the way for development of novel drug candidates.

Nicotinic acid (NA) regresses atherosclerosis in human imaging studies and reduces atherosclerosis in mice, mediated by myeloid cells, independent of lipoproteins. Since GPR109A is expressed by human monocytes, we hypothesized that NA may drive cholesterol efflux from foam cells. In THP-1 cells NA suppressed LPS-induced mRNA transcription of MCP-1 by 76.6±12.2% (P

Abnormalities of chromosome copy number are called aneuploidies and make up a large health load on the human population. Many aneuploidies are lethal because the resulting abnormal gene dosage is highly deleterious. Nevertheless, some whole chromosome aneuploidies can lead to live births. Alterations in the copy number of sections of chromosomes, which are also known as segmental aneuploidies, are also associated with deleterious effects. Here we examine how aneuploidy of whole chromosomes and segmental aneuploidy of chromosomal regions are modeled in the mouse. These models provide a whole animal system in which we aim to investigate the complex phenotype-genotype interactions that arise from alteration in the copy number of genes. Although our understanding of this subject is still in its infancy, already research in mouse models is highlighting possible therapies that might help alleviate the cognitive effects associated with changes in gene number. Thus, creating and studying mouse models of aneuploidy and copy number variation is important for understanding what it is to be human, in both the normal and genomically altered states.

Abstract Background Malignant arthritis is a rare manifestation of metastatic disease. We describe the case of a previously well 28 year old man in whom hip pain was the presenting symptom of disease. We describe the case and discuss the aetiology of colorectal cancer in young patients. We then review the literature and discuss the investigation and management of malignant joint arthritis. Case presentation We present the case of a 28 year old man who presented to the emergency department with an acute monoarthritis of the hip. He had an unremarkable past medical history and was systemically well. A diagnosis of malignant joint effusion was reached after a heightened index of clinical suspicion, magnetic resonance imaging and cytological evaluation of the synovial fluid. Computed tomography and bone scan confirmed widespread metastatic disease from a primary colonic adenocarcinoma. The patient tolerated three cycles of oxaliplatin and capecitabine but died 4 months after presentation. Conclusion The metastatic spread of cancer to the joint and the synovium is one of the rarest manifestations of malignant disease and has not been previously reported as the presenting symptom of disease. The diagnosis is a difficult one to reach and is associated with a poor prognosis. This case illustrates the importance of thorough investigation in reaching this diagnosis and entertaining the possibility in individuals who do not respond to conventional management of acute monoarthritis, even in young patients and individuals who do not display any other symptoms of disease.