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Abstract The spectrum of gastrointestinal (GI) issues in the older population varies from common physiological age-related changes to devastating, less common sinister pathological illness. GI system has direct exposure to external environment. Thus, it is modeled to embrace the pathophysiological changes that occur due to interaction with external factors. Gastrointestinal tract (GIT) per se is more resilient to aging as compared to other organ systems. On the other hand, elderly may present with a large plethora of GI symptoms. This presents a challenge to all echelons of medical consultation for accurate attribution for the aging process or pathophysiological causation of GI symptoms. This dichotomy leads to hindrance in adequate and appropriate treatment of GI ailments. In GI system, non-neoplastic disorders are far more common than neoplastic disorders. Hence, it becomes imperative to understand the aging evolution of the GI system and management of GI disorders in the older population.

Abstract Aim To study the various presentations and manifestations of complicated rhinosinusitis in COVID era- ranging from bacterial rhino sinusitis to invasive fungal rhino sinusitis. Methods Design-A retrospective observational study was carried out from March 2020 to May 2021. Setting-Tertiary care hospital subjects—all COVID-positive patients who had paranasal sinus involvement. Methods-Patients were evaluated based on their symptomatology profile. Fungal stains and culture were carried out for all. They underwent Magnetic resonance Imaging and Computed Tomography scan on case-to-case basis, apart from routine nasal endoscopy. All were managed both medically and surgically depending upon their diagnosis. The natural course including outcomes, was studied, documented and analyzed. Results Out of 496 patients presenting with sinonasal disease, 126 were COVID-positive, 16 patients had complicated rhino sinusitis, of which 4 patients had complicated rhinosinusitis with intraorbital, intracranial or combined complications. All patients were managed successfully with combined medical and surgical approach. Twelve patients had invasive mucormycosis with overall mortality rate of 37%. Conclusion Complicated sinusitis was encountered in COVID-positive patients either when they were being actively treated for COVID-19 or as part of post-COVID sequalae. Though rhino-orbito-cerebral mucormycosis constituted the major disease burden in such patients but the possibility of bacterial rhino sinusitis with or without complications must also be kept in mind while evaluating such patients. We must remember every complicated rhinosinusitis in COVID-positive patient may not be mucor and manage appropriately.

Solid Papillary Carcinoma (SPC) of the breast is a rare tumor with an incidence of less than 1%, mainly affecting elderly females. It is morphologically characterized by well-defined nodules with low-grade nuclear features associated with fibrovascular cores and shows neuroendocrine differentiation. SPC can be in-situ or invasive but has a favorable prognosis. It is a morphological mimicker of some pre-malignant conditions leading to its frequent misdiagnosis. An appropriate immunohistochemical (IHC) panel workup helps in distinguishing this tumor from its various morphological mimics. In this report, we present one such case of SPC with a small focus of invasion, reviewing the literature.

Dental trauma is a serious and highly prevalent health issue across the globe. Most of the frequent dental injuries result in the loss of teeth and affects the overall quality of life. The loss of a tooth is usually compensated by a dental implant. The common methods adopted while placing the implant tooth are platform switching and platform matching. A plethora of works has studied the qualitative performance of these methods across different situations clinically. However, a detailed comparative work studying in-depth the mechanical parameters has not been attempted yet. In this computational work, two commonly available different platform-switched and one platform-matched implant-abutment configurations were compared. A 3D model of an implant (5.5 × 9.5 mm) was designed and inserted into a human mandibular bone block using computer-aided design (CAD) and extracting the clinical imaging data. Three separate models of implant-abutment configurations such as Platform Switched (PS)-I, a 5.5 mm implant with a 3.8 mm wide abutment, Platform Switched (PS)-II, a 5.5 mm implant with a 4.5 mm wide abutment, and Platform Matched (PM), a 5.5-mm implant with a 5.5 mm wide abutment were analyzed. Clinically relevant vertical-, horizontal-, and oblique-type of occlusal loadings were applied to each model to characterize the mechanical response. Mechanical parameters such as von Mises stresses, deformations, and strain energies were obtained using finite element modeling (FEM). These parameters showed lower values for platform switching within the peri-implant bone and that may help to limit marginal bone loss. However, the same parameters were increasing more in the abutment, implant, and screw for the platform-switched implant configuration than that of platform-matched configuration. The computational framework, along with the results, are anticipated to guide the clinicians and medical practitioners in making better decisions while selecting the commonly available methods.

Introduction: Corona Virus Disease-19 (COVID-19) caused by the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARSCoV-2) has led to a global pandemic. Currently, the standard method for the diagnosis of COVID-19 is the detection of SARSCoV-2 by Reverse Transcriptase Quantitative Polymerase Chain Reaction (RT-qPCR). Lower Cycle threshold (Ct) value of PCR is found to be associated with increased probability of progression to severe disease and infectivity. Blood group A individuals have been found to be more susceptible to infection by SARS-CoV-2 while that of O blood group have lower risk of infection. There has been growing scientific interest to obtain data which may characterise the susceptibility to COVID-19 infection and determine the risk factors which may be associated with progression and severity of the disease. Aim: To study the association of RT-qPCR Ct values for SARSCoV-2 with ABO blood group types. Materials and Methods: A prospective observational study was conducted at tertiary care centre in western Maharashtra, India where in a total of 116 symptomatic admitted patients between mid-July to mid-August 2020 and was found to be positive for SARS-CoV-2 by RT-qPCR were enrolled in the study. Ct values for pan-Sarbecovirus E-gene and SARSCoV-2 specific RdRP gene were recorded for each patient. In addition, all the patients were typed for ABO blood grouping. Distribution of different ABO blood group types in SARS-CoV-2 positive patients were analysed and was compared with blood groups in 882 non-COVID-19 blood donors comprising control group. Ct values for E and RdRP gene were also analysed in respect to different age group, gender and blood group types. Blood group records of voluntary healthy blood donors reporting at our centre between September to November 2019 were obtained. Results: Of the 116 patients, 33 (28.45%) comprised of type A, 34 (29.31%) of type B, 41 (35.34%) were of type O and remaining 8 (6.90%) had AB blood group type. Compared to the control group, no significant difference was noted in the distribution of ABO blood types in SARS-CoV-2 positive patients. Also, no statistical significance was found in the Ct values with respect to age, gender and different ABO blood group types. Conclusion: RT-qPCR Ct values for SARS-CoV-2 infection have no association with ABO blood group types.

Context: Dentinal hypersensitivity (DH) is a chronic disorder in which patients report sharp and acute pain to a variety of stimuli. Till date, a standardized procedure to treat DH is missing, though several alternative treatment strategies have been designed, including laser therapies. Aim: The aim of the study was to treat DH with minimum chemical concentration and least laser energy level with longer follow-up period. Materials and Methods: One hundred and twenty patients were randomly divided into four groups: (i) Group 1-5% potassium nitrate (KNO3); (ii) Group 2 - gallium-aluminum-arsenide diode laser (62.2 J/cm2, wavelength - 980 nm, noncontact pulse mode, and power wattage - 0.5 W); (iii) Group 3 - combined 5% KNO3and the diode laser; and (iv) Group 4 - placebo (control). The visual analog scale (VAS) scores were recorded, analyzed, and compared to tactile stimuli, cold water, and air blast tests at different intervals for 6 weeks. Results: Synergistic use of 5% KNO3and diode laser (Group 3) significantly reduced the DH pain, which was almost negligible after 6th week (97%–99% of the pain was reported to be relieved) and showed promising results than any other studied groups. Further, the diode laser (Group 2) showed better results than 5% KNO3 (Group 1). One-way ANOVA and Bonferroni correction post hoc test revealed the combination of groups with significant differences in the mean VAS scores at the different interval of time (P < 0.01). Conclusions: Convincingly, the combined application of 5% KNO3with the diode laser can be recommended for treating DH patients.

Algae are often promoted as feedstock organisms to produce a sustainable petroleum fossil fuel alternative. However, to induce lipid accumulation most often requires a severe stress that is difficult to induce in large batch cultures. The objective of this study is to analyze and mathematically model heat stress on growth, chlorophyll content, triacylglyceride, and starch synthesis in algae. We initially screened 30 algal species for the most pronounced induction of lipid droplets from heat stress using confocal microscopy and mass spectroscopy techniques. One species, Coccomyxa subellipsoidea C169, was selected and subjected to further biochemical analyses using a jacketed bioreactor amended with 1% CO2 at 25°C, 30°C, 32°C, 33°C, 34°C, 35°C, and 36°C. Lipid and starch accumulation was less extreme than N stress. Growth was reduced above 25°C, but heat stress induced lipid droplet synthesis was negatively correlated with growth only past a demonstrated threshold temperature above 32°C. The optimal temperature for lipid accumulation was 35°C, which led to 6% of dry weight triglyceride content and a 72% reduction from optimal growth after 5 days. Fatty acid influx rates into triglycerides and 15N labeling of amino acids and proteins indicate that heat stress is mechanistically distinct from N stress. Thus, this study lends support to a novel hypothesis that lipid droplet triglycerides result from a redistribution of carbon flux as fatty acids to neutral storage lipids over membrane or other lipids.

Damaged DNA Binding 1 (DDB1)-binding WD40 (DWD) proteins are highly conserved and involved in a plethora of developmental and physiological processes such as flowering time control, photomorphogenesis, and abiotic stress responses. The phylogeny of this family of proteins in plants and algae of viridiplante is a critical area to understand the emergence of this family in such important and diverse functions. We aimed to investigate the putative homologs of DWD in the viridiplante and establish a deeper DWD evolutionary grasp. The advancement in publicly available genomic data allowed us to perform an extensive genome-wide DWD retrieval. Using annotated Arabidopsis thaliana DWDs as the reference, we generated and characterized a comprehensive DWD database for the studied photoautotrophs. Further, a generic DWD classification system (Type A to K), based on (i) position of DWD motifs, (ii) number of DWD motifs, and (iii) presence/absence of other domains, was adopted. About 72-80% DWDs have one DWD motif, whereas 17-24% DWDs have two and 0.5-4.7% DWDs have three DWD motifs. Neighbor-joining phylogenetic construction of A. thaliana DWDs facilitated us to tune these substrate receptors into 15 groups. Though the DWD count increases from microalgae to higher land plants, the ratio of DWD to WD40 remained constant throughout the viridiplante. The DWD expansion appeared to be the consequence of consistent DWD genetic flow accompanied by several gene duplication events. The network, phylogenetic, and statistical analysis delineated DWD evolutionary relevance in the viridiplante.