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Background: Adequate horizontal and vertical bone volume is an ideal prerequisite to achieving good primary stability, osseointegration, and long-term survival of an implant. Several techniques are available to achieve adequate bone volume for implant placement. Among the various non-subtractive methods, ridge expansion with motorized bone expanders is a commonly used method to expand bone volume in the anterior maxilla. At the same time, osseodensification is another non-subtractive method that aims to improve primary stability., Aim: This study aimed to compare the expansion achieved by the two most commonly used expansion methods, i.e., motorized bone expanders technique and a relatively newer technique of osseodensification suggested by Densah Bur (Jackson, Michigan, United States), for expanding the alveolar ridge in the anterior maxillary region.  Materials and methods: A total of 30 implants were placed in the anterior maxillary region in 15 patients. Fifteen implants were placed with the bone expander method (Dentium Ridge Spreader (RS) kit, Cypress, California, United States) and 15 with the osseodensification method (Densah® Bur). At least two implants were placed in each patient. The implants were placed in the first and second quadrants of the same patients in whom one of the methods was performed. Alveolar ridge expansion was determined using pre-op and post-op cone beam computed tomography (CBCT) instantly before implant placement and after six months. Primary stability was also analyzed using Osstell (Gothenburg, Sweden) immediately after implant placement and after one month and secondary stability after six months in implant stability quotient (ISQ). These parameters were used to assess which method promoted greater alveolar ridge expansion and primary stability., Result: The test for normality was performed using the Shapiro-Wilk test between the pre- and post-treatment data between group A (motorized ridge expander) and group B (osseodensification technique). There were p-values of 0.737 and 0.429, which were not significant. Bone thickness was measured both preoperatively and postoperatively among the groups. The mean bone thickness in group A was 4.37 mm preoperatively and 5.8 mm postoperatively. The similarity between the preoperative and postoperative bone thickness was 4.336 mm and 5.24 mm, respectively. For the bone measurements, the p-value <0.001 is highly significant. On further analysis, the p-value for the paired samples t-test for group A postoperative bone thickness and group B postoperative bone thickness was 0.894, and the p-value for the t-test for group A postoperative bone thickness and group B postoperative bone thickness was 0.955. ISQ was also analyzed. In group A, the mean ISQ one month postoperatively was 53.2 and six months postoperatively was 73.4. In group B, the mean ISQ one month postoperatively was 65.4 and six months postoperatively was 76.2. The p-value for the ISQ of group A was 0.004, the ISQ of group B was 0.023, and the ISQ of groups A and B in the first month was 0.015. In the sixth month, the ISQ in group A and group B was 0.592.  Conclusion: According to the results of the study, motorized ridge expanders proved to be more effective in terms of ridge expansions and achieving better primary stability than the osseodensification technique., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee of the Institute of Technology and Sciences issued approval ITSDCGN/2018/001. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tushar et al.)

Aim: The present study assessed the three-dimensional bone loss, at three different levels, around implants placed immediately after extraction using the socket shield method versus immediate implant placement., Materials and Methods: A non-randomized clinical trial was conducted in 30 cases divided into two groups: socket shield method and immediate implant placement (15 cases each). Horizontal bone width (HBW) (at three different levels from baseline) and vertical bone level (VBL) (mesial and distal surfaces of the implant) were measured preoperatively and 6 months postoperatively by using cone beam computed tomography and radio visio graphy., Results: The mean difference at 2-mm and 8-mm HBW from the baseline was better in the socket shield technique, although the results were not significant. Significant results were found in Levene's test for equality of error variances. The VBL was significant at both the distal and mesial surfaces of the implant., Conclusion: The socket shield approach demonstrated promising clinical outcomes in preserving alveolar ridge morphology. It can be utilized as a substitute for the typical instantaneous implant placement in the aesthetic zone., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: This review aimed to comprehensively investigate the impact of Hormone Replacement Therapy (HRT) on implant osseointegration and bone loss. The study considered factors such as HRT type, osteoporosis, smoking, and diabetes mellitus, and analysed the available literature to provide insights into the association between HRT and implant outcomes., Methods: Multiple databases were utilized, and studies with diverse designs and methodologies were included that examined the relationship between HRT and implant osseointegration. The selected studies were analyzed and relevant data on implant success rates, bone loss, and other correlations was extracted., Results: The review findings indicate that HRT has a detrimental impact on implant osseointegration, as evidenced by lower implant success rates and increased bone loss in HRT-treated individuals. The odds ratio analysis further strengthens this association, with significant values of 0.59 (95% CI: 0.50-0.70) and 0.64 (95% CI: 0.54-0.76), indicating a higher likelihood of implant failure in HRT-treated patients., highlighting the need for caution when considering HRT as a treatment option in patients undergoing implant procedures. Smoking and diabetes mellitus were also found to significantly affect implant outcomes, emphasizing the importance of addressing these factors in patient management., Conclusion: The assessments demonstrate that HRT adversely affects implant osseointegration and increases bone loss. The results suggest the importance of considering the potential negative impact of HRT on implant outcomes and the need for thorough patient evaluation and management. Further research is warranted to explore the underlying mechanisms, assess the impact of specific HRT types and dosages, and evaluate preventive strategies to mitigate the detrimental effects of HRT on implant success., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 THE AUTHORS.)

Background: Amyloid-β plaques (Aβ) are associated with Alzheimer's disease (AD). Pooled assessment of amyloid reduction in transgenic AD mice is critical for expediting anti-amyloid AD therapeutic research., Objective: The mean threshold of Aβ reduction necessary to achieve cognitive improvement was measured via pooled assessment ( n  = 594 mice) of Morris water maze (MWM) escape latency of transgenic AD mice treated with substances intended to reduce Aβ via reduction of beta-secretase cleaving enzyme (BACE)., Methods: Machine learning and statistical methods identified necessary amyloid reduction levels using mouse data (e.g., APP/PS1, LPS, Tg2576, 3xTg-AD, control, wild type, treated, untreated) curated from 22 published studies., Results: K-means clustering identified 4 clusters that primarily corresponded with level of Aβ: untreated transgenic AD control mice, wild type mice, and two clusters of transgenic AD mice treated with BACE inhibitors that had either an average 25% "medium reduction" of Aβ or 50% "high reduction" of Aβ compared to untreated control. A 25% Aβ reduction achieved a 28% cognitive improvement, and a 50% Aβ reduction resulted in a significant 32% improvement compared to untreated transgenic mice ( p  < 0.05). Comparatively, wild type mice had a mean 41% MWM latency improvement over untreated transgenic mice ( p  < 0.05). BACE reduction had a lesser impact on the ratio of Aβ 42 to Aβ 40 . Supervised learning with an 80% -20% train-test split confirmed Aβ reduction was a key feature for predicting MWM escape latency (R 2  = 0.8 to 0.95)., Conclusions: Results suggest a 25% reduction in Aβ as a meaningful treatment threshold for improving transgenic AD mouse cognition., Competing Interests: The authors have no conflict of interest to report., (© 2024 – The authors. Published by IOS Press.)

Background: This research paper aims to investigate the effectiveness of gender identification utilizing palatal rugae., Materials and Methods: The size of the sample that was selected included 100 people. They were made up of 50 men and 50 women, all in between the ages of 18 and 25. To examine their palatal rugae patterns, casts were made after taking maxillary impressions. Based on the size and rugae amount found on the left as well as the right sides, the palatal rugae patterns were investigated. Rugae patterns have been recognized based on the categorization provided by Thomas and Kotze (1983)., Statistical Analysis: Chi-square analysis has been used., Results: There were comparative variations in the shape of rugae patterns among male and female individuals. The study revealed that the circular pattern was higher in males ( P < 0.01) as compared to females and the unification pattern was comparatively greater in females ( P < 0.05) as compared to males. The most predominant pattern that was seen in both genders was the wavy pattern that was seen to be present in 57.17% of males and 53.42% of females. The rugae number on the right and left sides did not exhibit any significant variations., Conclusions: This research thus exhibits a relevant difference in patterns of rugae and also confirms the uniqueness of patterns in each individual. Hence, it could be utilized as an adjunct to other tools for identification in the forensic sciences., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: This research study aimed to evaluate and compare the capability of four various bite registration materials to reproduce precise interocclusal relationships in the vertical dimension., Materials and Methods: Ideal maxillary and mandibular casts were mounted on the semi-adjustable articulator in maximum intercuspation after mock tooth preparation on 46, 47, and 48. Models were scanned by the Medit T500 Dental Lab Scanner, and initial reading was noted at the predetermined points. Ten interocclusal bite registrations were made using four materials (CADbite, Jet Bite, Ramitec, and Aluwax). The mandibular model was demounted and again remounted using the interocclusal records, and the final reading was noted after scanning., Results: Ramitec showed superior results when compared to polyvinyl bite registration material and Aluwax, but the differences between Ramitec, CADbite, and Jet Bite were nonsignificant., Conclusions: Although all four materials are suitable for clinical use, elastomeric materials showed superior results. In that, polyether was found to be the best., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: The biocompatibility of 3D-printed dental resins has become a critical concern in modern dentistry due to the increasing utilization of additive manufacturing (AM) techniques in dental applications. These resins serve as essential materials for fabricating dental prostheses, orthodontic devices, and various dental components. As the clinical adoption of 3D printing in dentistry grows, it is imperative to comprehensively assess the biocompatibility of these materials to ensure patient safety and dental treatment efficacy. This systematic review aimed to evaluate the existing body of literature on the biocompatibility of 3D-printed dental resins, thereby providing valuable insights into the potential biological risks associated with their use., Methods: The search strategy to identify relevant papers was implemented across PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, CINAHL, and Google Scholar to identify relevant studies. Study selection was not limited to any particular timeframe of publishing. The revised CONSORT criteria were used to ascertain the authenticity and dependability of the review's outcomes. Comprehensive screening and eligibility assessment processes were conducted to select studies meeting predefined criteria. Biocompatibility-related parameters, including toxicity, mechanical properties, cell viability, and other relevant outcomes, were analyzed across selected studies using a standardized variable extraction protocol., Results: A total of 9 studies were included in the systematic review. The findings encompassed various aspects of biocompatibility assessment, including material composition, mechanical properties, cell viability, and cytotoxicity. Some studies revealed significant improvements in flexural strength and cell viability with specific resin formulations, demonstrating their potential for enhanced clinical utility. Conversely, certain resins exhibited cytotoxicity, while others displayed promising biocompatibility profiles., Conclusion: As per the assessed findings, material composition, post-processing techniques, and manufacturing methods emerged as critical factors influencing biocompatibility outcomes. While some resins exhibited favorable biocompatibility profiles, others raised concerns due to cytotoxicity. These findings emphasize the need for careful consideration when selecting and implementing 3D-printed dental resins, with a focus on materials engineering and comprehensive biocompatibility testing. Further research is warranted to elucidate the long-term biocompatibility and clinical implications of these materials., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Prakash et al.)

The goal of modern dentistry is to restore optimum oral health, function, and comfort for a patient. For an implant-supported fixed prosthesis, these goals cannot be met if the biomechanical factors governing the success of the prosthesis are overlooked. Mandibular flexure is one such factor that needs to be considered, especially when implants are being placed posterior to the interforaminal region. If not, it can lead to problems like increased stress, bone resorption, poor fit of the prosthesis, screw loosening, and patient discomfort. The use of a split-framework prosthesis is one of the measures that could be taken to decrease the stress, ensure a passive fit of the framework, and long-term maintenance of patient comfort and function. This case report describes the oral rehabilitation of a patient using a maxillary cast partial denture and mandibular split framework fixed prosthesis to compensate for mandibular flexure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, . et al.)

Objective: The objective is to comparatively assess the impact strength and flexural strength of polyether ether ketone (PEEK) vs. computer-aided design/computer-aided manufacturing (CAD/CAM) polymethyl methacrylate denture base material., Methods: A total of 90 samples were fabricated with traditional heat cure PMMA, PEEK, and CAD/CAM PMMA and divided into three groups of 30 samples each. The impact strength of all the samples was measured using an Izod impact tester with a pendulum in the air at 23±2°C. A three-point bending test was used in a Universal Testing Machine to assess the flexural strength of all the samples. The impact strength and flexural strength mean values were computed using a one-way ANOVA test., Result: Impact strength and flexural strength of PEEK (IS=10.22±1.25 kJ/m 2 and FS=120±8.0 MPa) is almost identical to CAD/CAM PMMA sample (IS=9.595±3.313 kJ/m 2 and FS=118.11±5.00 MPa) whereas for conventional heat cure PMMA (IS=4.00±.011 kJ/m 2 and FS=75.4±4.50 MPa) the values are least among the three., Conclusion:  PEEK or CAD/CAM PMMA share almost identical and superior mechanical properties, and both can be used as better alternatives for complete denture fabrication rather than using conventional heat cure PMMA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, . et al.)

Background: The phenotypical profile of cardiovascular malformations in patients with congenital rubella syndrome (CRS) is varied. We aimed to describe the profile of cardiac defects among CRS patients detected in the sentinel CRS surveillance in India during 2016-22., Methods: Sentinel sites enrolled infants with suspected CRS based on presence of cardiac defects, hearing impairment, eye signs, or maternal history of febrile rash illness. Suspected CRS cases underwent detailed systemic examination, including echocardiography and serological investigation for rubella. Cardiac defects were categorized as 'Simple' or 'Complex' as per the National Heart, Lung, and Blood Institute classification. We compared the distribution of cardiac defects among laboratory confirmed CRS cases and seronegative discarded cases., Findings: Of the 4578 suspected CRS cases enrolled by 14 sites, 558 (12.2%) were laboratory confirmed. 419 (75.1%) laboratory confirmed cases had structural heart defects (simple defects: n = 273, 65.2%, complex defects: n = 144, 34.4%), with ventricular septal defect (42.7%), atrial septal defect (39.4%), patent ductus arteriosus (36.5%), and tetralogy of Fallot as the commonest defects (4.5%). Laboratory confirmed CRS cases had higher odds of left to right shunt lesions (OR = 1.58, 95% CI: 1.15-2.17). This was mainly on account of a significant association of PDA with CRS (OR = 1.77, 95% CI: 1.42-2.21). Mortality was higher among CRS patients with complex heart defects (HR = 2.04, 95% CI: 1.26-3.30)., Interpretation: Three-fourths of the laboratory confirmed CRS cases had structural heart defects. CRS patients with complex cardiac defects had higher mortality. Detecting CRS infection early and providing timely intervention for cardiovascular defects is critical for the management of CRS patients., Funding: Ministry of Health and Family Welfare, Govt of India, through Gavi, the Vaccine Alliance., Competing Interests: None declared., (© 2023 The Author(s).)

Satisfactory restorations can be difficult in partially edentulous patients, especially those with unilateral or bilateral posterior ocular defects. With traditional and modern treatment options, recovery can be successful. Partial dentures with attachments are such a treatment. An implant-supported prosthesis is another option for therapy in these circumstances. Precision extracoronary attachments are the preferred treatment option when implant treatment does not give good results. This research offers two examples of partial cast prosthetic rehabilitation for distal extension utilizing precise attachments., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, S et al.)

Introduction: Salivary substitutes are gaining popularity these days because of the increase in patients with dry mouth. These substitutes must satisfy certain criteria to fulfill the patient's needs. One of these is wettability., Materials and Methods: One hundred fifty rectangular specimens of heat-cured denture base acrylic resin were prepared. A drop of test liquids (human saliva, distilled water, aqwet, saleva, and wet mouth) was placed over the test specimen and right and left contact angles were measured using optical contact angle machine., Results: All test liquids performed better than distilled water. Human saliva has the least contact angle followed by aqwet., Conclusion: Carboxymethyl cellulose base aqwet saliva substitute was found to be best having similar contact angle values to human saliva., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Pharmacy and Bioallied Sciences.)

Background: The discrimination power of the pediatric risk of mortality (PRISM), pediatric index of mortality (PIM), sequential organ failure assessment (SOFA), and pediatric logistic organ dysfunction (PELOD) may not always be true for countries such as India due to differences in factors from those nations where these scoring systems were validated. Therefore, this study was undertaken to determine and compare severity, course of illness, and outcomes in critically ill children admitted to the pediatric intensive care unit (PICU) using different scoring systems such as PRISM 4, PIM 3, PELOD 2, and the pediatric sequential organ failure assessment (pSOFA ) score, and to analyze the clinical spectrum and demographic profile of children admitted to the PICU., Materials and Method: This was a prospective, single-center, observational study conducted in the PICU of the Indira Gandhi Institute of Medical Science, Patna, India, over two years. Two hundred children in the age group of one month to 14 years admitted to the PICU were recruited into the study. Prognostic scoring systems, including PRISM4 and PIM3, were used to compare the outcome, mortality, and length of PICU stay, whereas PELODS and pSOFA were descriptive scores that assessed the multiorgan dysfunction. A correlation between the different scoring systems and the outcome was determined., Results: The majority of children (26.5%, n=53) were one to three years of age. The maximum number of patients was male (66.5%, n=133). Renal complications were the predominant admission diagnosis in 19% (n=38) of children. The mortality rate was found to be 18.5%. The mortality was most common in infants <1 year of age (n=11, 29.73%) and those of the male sex (n=22, 59.46%). A significant correlation was found between length of stay and mortality (p<0.00001). A significant positive correlation was observed between mortality and PRISM 4, PIM 3, PELOD 2, and pSOFA scores on the first day of admission (p<0.00001). The pSOFA and PELOD2 showed better discrimination power (area under the curve (AUC): 0.77 and 0.74, respectively)., Conclusion: The study concluded that the pSOFA and PELOD2 scores are reliable predictors of mortality in critically ill children., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, . et al.)

Background: In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016-2021 from 14 sentinel sites to describe the epidemiology of CRS., Method: We analyzed the surveillance data to describe the distribution of suspected and laboratory confirmed CRS patients by time, place and person characteristics. We compared clinical signs of laboratory confirmed CRS and discarded case-patients to find independent predictors of CRS using logistic regression analysis and developed a risk prediction model., Results: During 2016-21, surveillance sites enrolled 3940 suspected CRS case-patients (Age 3.5 months, SD: 3.5). About one-fifth (n = 813, 20.6%) were enrolled during newborn examination. Of the suspected CRS patients, 493 (12.5%) had laboratory evidence of rubella infection. The proportion of laboratory confirmed CRS cases declined from 26% in 2017 to 8.7% in 2021. Laboratory confirmed patients had higher odds of having hearing impairment (Odds ratio [OR] = 9.5, 95% confidence interval [CI]: 5.6-16.2), cataract (OR = 7.8, 95% CI: 5.4-11.2), pigmentary retinopathy (OR = 6.7, 95 CI: 3.3-13.6), structural heart defect with hearing impairment (OR = 3.8, 95% CI: 1.2-12.2) and glaucoma (OR = 3.1, 95% CI: 1.2-8.1). Nomogram, along with a web version, was developed., Conclusions: Rubella continues to be a significant public health issue in India. The declining trend of test positivity among suspected CRS case-patients needs to be monitored through continued surveillance in these sentinel sites., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Urinary Neutrophil Gelatinase Associated Lipocalin (uNGAL) has been demonstrated to be a powerful marker of progression in chronic kidney disease. The present study was done to find out the ability of uNGAL as a biomarker to differentiate steroid-sensitive nephrotic syndrome (SSNS), steroid-dependent nephrotic syndrome (SDNS), and steroid-resistant nephrotic syndrome (SRNS) from each other., Method: The cross-sectional study included 45 patients with Idiopathic Nephrotic Syndrome (INS) (15 each of SSNS, SDNS, and SRNS). uNGAL was measured by ELISA. Demographic profile of patients with INS, lab parameters including Serum albumin, cholesterol, urinary albumin, creatinine, etc., were estimated using standard laboratory methods. Various statistical methods were used to assay the usefulness of NGAL as a diagnostic marker., Results: Among the three groups, the median value of uNGAL was 8.68 ng/ml in SSNS, higher in SDNS (32.8 ng/ml), and highest in the SRNS group (50 ng/ml). The receiver operating curve (ROC) was generated for uNGAL to differentiate between SDNS and SSNS. Cut-off 13.26 ng/ml had a sensitivity of 86.7% and specificity of 97.4%, PPV 92.9%, and NPV 87.5 % with an area under the curve (AUC) of 0.958. Another ROC was generated for uNGAL to differentiate between SRNS and SDNS, and cut-off 40.02 ng/ml had a sensitivity of 80% and specificity of 86.7% with an AUC of 0.907. A similar result was observed when ROC was generated to differentiate SRNS from SSNS and SDNS combined., Conclusion: uNGAL can distinguish between SSNS, SDNS, and SRNS., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kumar et al.)

Disorders of temporomandibular joint (TMDs) are characterised by a variety of symptoms, including discomfort in the orofacial region, muscle tenderness, restricted jaw motion and noise at the joint. Additional neurological symptoms such as headaches, vertigo, heaviness, and altered vision may also coexist with TMDs. Because prostaglandin production is a critical mediator of inflammatory reaction and is inhibited by corticosteroids, they have anti-inflammatory effects. Platelet rich plasma popularly considered as PRP is a concentration of platelets and related growth factors that may have therapeutic effects by attracting, promoting, and differentiating cells as well as redesigning tissue. 64 joints totaling 40 individuals with temporomandibular joint problems were split into two categories (Category A and Category B). PRP was applied to category A's (36 joints of 20 patients) joints, while Group B's joints received hydrocortisone combined with local anaesthetic (28 joints of 20 patients). Patients were evaluated for tenderness, , maximum inter incisal opening (MIO) and clicking sound at TMJ prior to and following treatment at intervals of one week, one month and 6 months of the first week and third month. When there was comparison of outcomes in study participants receiving injections of platelet rich plasma and study participants receiving injections of hydrocortisone with local anesthetic then it was found that although both type of study participants got reduction in pain, increased opening of mouth and reduction in clicking sound however the difference between two groups was not significant statistically. There was no statistically significant difference between injections of platelet rich plasma and hydrocortisone with local anesthetic solution regarding outcomes in disorders of temporomandibular joint, however the results were slightly better in study participants receiving platelet rich plasma injections. This study demonstrated that while treating patients with TMJ issues, local anaesthesia combined with hydrocortisone as well as intra-articular injection of PRP help in reduction in pain, increase mouth opening, and minimize joint sound. Additionally, it was discovered that intra-articular injection of PRP was more successful in treating patients in this trial than local anaesthetic combined with hydrocortisone., (© 2022 Biomedical Informatics.)

Background: Post and core restorations are performed (generally after treating the root canals of the tooth) when the majority of the tooth structure has been rendered ineffective to support itself/the crown of the tooth. In this clinical study, we aim to compare the difference between post and core treatment of anterior and posterior teeth and their success/failure rates., Objective: Our investigation aimed to compare the clinical survival rates of custom-fabricated cast metal post-and-cores in cases of anterior and posterior teeth while controlling for the population's age and gender, type of post material, length of the post, amount of alveolar bone tissue supporting the roots, tooth location in the dental arch, and type of cement used, as well as the effect of opposing dentition and the type of definitive prosthetic treatment received., Methods: 112 individuals who had received root canal therapy (RCT) and were chosen to receive post and core therapy following their RCT were chosen for the study, and a total of 164 teeth were scheduled to undergo the therapy. All the posts used were made of cast metal, and the patients were divided into two groups: 48 individuals had the posts placed in their posterior teeth (a total of 71 teeth in this case), and the second group was made up of the remaining 64 patients, all with 93 teeth in the anterior region. The follow-up was done twice at a six-month interval after cementation was complete., Results: No significant changes were observed between the stability of the post structures in the anterior and posterior teeth that were examined, and the survival rates were found to be similar in both instances., Conclusion: The cast metal posts performed at a similar success rate for the one-year period when the teeth were under our observation, and there were no considerable changes seen statistically. But it must be mentioned that a short follow-up period was observed, so the results might probably see some variations when a longer period of time is taken into consideration., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Prakash et al.)

Background An epidemiological survey was conducted among the geriatric population to determine the status and need for dental prosthetics and their influence on oral health-related quality of life (OHRQoL). Methodology The study population consisted of 270 patients aged 60 or older. All pertinent demographic information, clinical data on prosthesis status and need, and the Oral Health Impact Profile (OHIP)-14 questions to assess OHRQoL were collected using a pretested structured questionnaire written in the patient's native tongue. In addition, a type 3 oral examination was performed on a sample of the geriatric population. Results The OHRQoL was found to be unaffected by the prosthetic status. However, there was a strong correlation between the elderly study population's OHRQoL and the need for a prosthetic. Of each variable in OHRQoL, physical pain, discomfort when eating, and loss of taste were the most affected in this population. Conclusions The prosthetic needs of the study population must be given high priority as there are many unmet needs. The concerned health departments need to seriously consider increasing facilities with an affordable system. There is a lack of appreciation for OHRQoL. However, given that a satisfactory clinical assessment of the mouth does not always indicate good oral health status, the justification for evaluating dental care with respect to oral well-being is compelling., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Prakash et al.)

Background This study aimed to determine the clinical and echocardiography profile of congenital heart diseases (CHDs) among admitted children as well as patients presenting to the outpatient department of the Indira Gandhi Institute of Medical Sciences, Patna, which is a tertiary care and apex institute located in Bihar, India. Methodology A retrospective, cross-sectional study was conducted in a tertiary care hospital from January 2019 to January 2021. In total, 200 patients aged 0-12 were enrolled in the study. The study design was exploratory, with a proforma drafted to study patients with features suggestive of CHDs. All pediatric echocardiography was performed by a trained cardiologist. Records were obtained from the departmental record-keeping register, and reports were available for analyzing the data. For data collection, cardiology and pediatric department registers were reviewed and all CHD data were collected. Data analysis was done using SPSS software version 25.0 (IBM Corp., Armonk, NY, USA). Results Of the 200 children with CHDs, 142 were diagnosed to have acyanotic heart disease (ACHD), while 58 had cyanotic congenital heart disease (CCHD). Among 200 cases of CHD, ventricular septal defect (VSD) constituted 62 cases comprising 31% of the total CHD cases and 44% of all ACHD cases. Atrial septal defect (ASD) was the second most common CHD comprising 23% of all CHD cases. Tetralogy of Fallot (TOF) constituted 23 cases accounting for 11.5% of all CHD cases. It was the most common CCHD. Based on the age at the time of presentation, 90 (45%) cases were diagnosed below one year of age. Congestive heart failure (CHF) was most common in ACHD comprising 30% compared to CCHD in which only 7% of cases had CHF. This finding was statistically significant (p < 0.05). Analyzing the symptoms of different CHDs, of both ACHDs and CCHDs, the common symptoms were fast breathing (38%). Conclusions Among ACHD patients, 31% VSD and 21% ASD were noted. In CCHD, TOF was the most common with 11.5% of cases. Respiratory tract conditions were the most common comorbidities encountered. Because this is one of the first studies conducted in Bihar in the pediatric age group, it can help know the prevalence of CHDs in this region and will be useful for developing policies by stakeholders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kishore et al.)

Background Hospital-acquired infections (HAIs) are the most severe complications of intensive care stay, especially in pediatric patients. Proper hand hygiene (HH) is the cheapest, simplest, but often neglected method to prevent HAIs. The World Health Organization (WHO) has formulated and promoted a standardized recommendation for HH. Both the WHO and the Centers for Disease Control and Prevention (CDC) recommend the use of soap and water for handwashing whenever there is visible dirt on the hands. In all other situations, an alcohol-based hand rub is an effective alternative. The quality improvement (QI) methodology has been widely followed in many countries to improve basic and advanced healthcare systems. The QI strategy follows the plan-do-study-act (PDSA) method. Methodology This quasi-experimental (pre- and post-intervention), prospective, QI study was conducted at the neonatal intensive care unit and pediatric intensive care unit of the pediatrics department in a tertiary care hospital in Bihar, India. A QI team was formed. The study was divided into four phases. WHO charts for assessing HH compliance were used for observation and data collection. The EQUATOR Checklist (Squire Checklist) was used to accurately report the QI work. Epi Info™ (version 7.2.5) was used for statistical analysis. The chi-square test was used to measure the statistical difference between pre- and post-intervention HH compliance (proportions). Results In the pre-intervention phase, a total of 106 HH opportunities were observed. The HH compliance at this stage was 40.6%. The QI team conducted several meetings, and a root cause analysis was performed with the help of the Fishbone diagram. It was decided to target three probable causes, namely, (a) less awareness, (b) inconvenient locations of hand rub dispensers, and (c) forgetfulness. The QI team decided to run three PDSA cycles. In the last phase, 212 HH opportunities were observed with a compliance percentage of 69.8%. There was a significant improvement when data of pre- and post-intervention HH compliance were compared in all categories of healthcare workers (HCWs), except doctors, where the improvement was not statistically significant. When the cumulative data of all subtypes of HCWs were analyzed, there was a significant improvement (p < 0.0001). Run charts and box plots were used for the easy depiction of the results. Conclusions Adopting proper HH methods remains the most effective way of preventing nosocomial infections, especially in intensive care units. We used the WHO model of HH in our study. The pre-intervention HH compliance was 40.6%. QI methodology using root cause analysis and implementation of three PDSA cycles were used to increase the HH compliance percentage. Post-intervention HH compliance increased to 69.8% and the effect was sustained. The study highlights the usefulness of the QI methodology in bringing small but important changes in clinical practice for better patient care., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kumar et al.)

Aim: The aim of the study was to assess the symptoms associated with temporomandibular disorders (TMD) and bruxism among elderly population in Ranchi, India., Materials and Methods: A cross-sectional study was done on 600 elderly subjects; data regarding the signs and symptoms associated with temporomandibular disorder and bruxism were recorded using both structured questionnaire and clinical examination. Spearman correlation analysis was done to find the association between TMD and bruxism., Results: Out of 600 subjects, 49% were males and 51% were females. The overall prevalence of TMD-related symptoms like temporomandibular joint (TMJ) pain, difficulty in jaw opening, TMJ sounds, and bruxism were 10.5, 11.2, 14, and 17% among elderly subjects. TMD symptoms and bruxism were relatively more commonly seen among females when compared to males. According to logistic regression (significantly correlated independent variables, i.e., TMD symptoms among analyzed variables), the dependent variable like bruxism had highest odds ratio, i.e., 8 for 60-70 years age-group and 15.1 for 70-80 year age-group., Conclusion: There was a lesser prevalence of symptoms related to TMD and bruxism among the study population, and bruxism had the highest odds ratio in TMD between the analyzed variables., Clinical Significance: Human aging contributes too many oral problems, while resolving these, the felt needs of the population are sometimes ignored which adds up to the growing list of issues. Studies have shown inconclusive evidence regarding the prevalence of symptoms related to TMD and bruxism as these are known to trouble elderly populations.

Objective: The objective of the research was to review the literature on clinical evaluation and success of screw-retained dental implants by assessing the marginal bone loss (MBL)., Methods: Online electronic databases such as PubMed/MEDLINE, Google Scholar, and Cochrane Library were searched using appropriate keywords for the last 20 years, dated from January 1, 2000, till August 1, 2021, with a restriction on language. Additional sources like major journals, unpublished studies, conference proceedings, and cross-references were explored. Information curated for data extraction included methodology, population, type of implants used, and duration of follow-up., Results: The PubMed/MEDLINE, Google Scholar, Cochrane Library, and additional sources identified a huge number, out of which 637 search results were screened, out of which 322 were duplicates. The remaining 315 unique studies were screened for the titles and abstracts, and 23 articles were selected for full-text screening. A total of six articles that matched the eligibility criteria were processed for qualitative analysis., Conclusion: Despite the uncertain retrievability of screw-retained implant-supported fixed restorations, this treatment option in fixed implant prosthodontics is a reliable and effective choice, especially for implant-supported long-span fixed partial dentures (FPDs), full-arch FPDs, and cantilever FPDs.

Background: Autism is reportedly the most severe neuropsychiatric disorder affecting children. Autistic subjects can be characterized by impairments in social interactive behavior along with restricted interests and quite frequently, are seen exhibiting repetitive behavior patterns in stereotyped manner. The inability to perform routine tasks can widely impact the oral health and also, the constant care and sense of helplessness might drastically affect quality of life., Aim: The aim of the study was to assess the oral health status and perceptions regarding an autistic child's oral health among parents., Materials and Methods: Parental perception regarding the quality of life among the afflicted autistic children was done using a self-assessment questionnaire that included eight questions which were replied to in an affirmation or negative answer. 300 parents of autism affected children formed the study participants. Recorded responses were evaluated and percentage of each response was derived. Oral health status was measured by determination of dental caries prevalence and OHI-S index using chair light illumination, mouth mirror, diagnostic probe and a standard WHO periodontal probe. For statistical analysis, the calculations were performed by using the paired t test. Statistical significance, which was fixed at P < 0.05, which is statistically significant., Results: Approximately 18.33% of parents showed were aware that oral health can influence general health; 15% did have exhibit awareness. 15% of parents did not consider that primary teeth were important; 59.1% visited any dentist only when suffering from pain; 5% went for an annual dental examination; 15% and 24.6% parents visited dental practitioners at intervals of 3 and 6 months, respectively. 30%, 25% and 51.66% parents considered obtaining consultation and getting treatment from pediatric dentist; general dentist and general physician. 41.6% parents had taken their children for restorations. 52% reported constant stress whereas 48% reported with constant distressed emotions. No significant difference was determined between the parameters. 75% of autistic children suffered from dental caries whereas oral hygiene scores demonstrated high mean value of 4., Conclusion: Autism is a severely distressing condition wherein oral health along with general physical health is affected. Since parents are directly involved in upbringing of these individuals, they also subsequently show a reduction in quality of life., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Heterogeneity among Alzheimer's disease (AD) patients confounds clinical trial patient selection and therapeutic efficacy evaluation. This work defines separable AD clinical sub-populations using unsupervised machine learning. Clustering (t-SNE followed by k-means) of patient features and association rule mining (ARM) was performed on the ADNIMERGE dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Patient sociodemographics, brain imaging, biomarkers, cognitive tests, and medication usage were included for analysis. Four AD clinical sub-populations were identified using between-cluster mean fold changes [cognitive performance, brain volume]: cluster-1 represented least severe disease [+17.3, +13.3]; cluster-0 [-4.6, +3.8] and cluster-3 [+10.8, -4.9] represented mid-severity sub-populations; cluster-2 represented most severe disease [-18.4, -8.4]. ARM assessed frequently occurring pharmacologic substances within the 4 sub-populations. No drug class was associated with the least severe AD (cluster-1), likely due to lesser antecedent disease. Anti-hyperlipidemia drugs associated with cluster-0 (mid-severity, higher volume). Interestingly, antioxidants vitamin C and E associated with cluster-3 (mid-severity, higher cognition). Anti-depressants like Zoloft associated with most severe disease (cluster-2). Vitamin D is protective for AD, but ARM identified significant underutilization across all AD sub-populations. Identification and feature characterization of four distinct AD sub-population "clusters" using standard clinical features enhances future clinical trial selection criteria and cross-study comparative analysis.

Link prediction in artificial intelligence is used to identify missing links or derive future relationships that can occur in complex networks. A link prediction model was developed using the complex heterogeneous biomedical knowledge graph, SemNet, to predict missing links in biomedical literature for drug discovery. A web application visualized knowledge graph embeddings and link prediction results using TransE, CompleX, and RotatE based methods. The link prediction model achieved up to 0.44 hits@10 on the entity prediction tasks. The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, served as a case study to demonstrate the efficacy of link prediction modeling for drug discovery. The link prediction algorithm guided identification and ranking of repurposed drug candidates for SARS-CoV-2 primarily by text mining biomedical literature from previous coronaviruses, including SARS and middle east respiratory syndrome (MERS). Repurposed drugs included potential primary SARS-CoV-2 treatment, adjunctive therapies, or therapeutics to treat side effects. The link prediction accuracy for nodes ranked highly for SARS coronavirus was 0.875 as calculated by human in the loop validation on existing COVID-19 specific data sets. Drug classes predicted as highly ranked include anti-inflammatory, nucleoside analogs, protease inhibitors, antimalarials, envelope proteins, and glycoproteins. Examples of highly ranked predicted links to SARS-CoV-2: human leukocyte interferon, recombinant interferon-gamma, cyclosporine, antiviral therapy, zidovudine, chloroquine, vaccination, methotrexate, artemisinin, alkaloids, glycyrrhizic acid, quinine, flavonoids, amprenavir, suramin, complement system proteins, fluoroquinolones, bone marrow transplantation, albuterol, ciprofloxacin, quinolone antibacterial agents, and hydroxymethylglutaryl-CoA reductase inhibitors. Approximately 40% of identified drugs were not previously connected to SARS, such as edetic acid or biotin. In summary, link prediction can effectively suggest repurposed drugs for emergent diseases.

Introduction: Bidi, a leaf rolled cigarette, is the most popular form of smoking in India. Bidi cigarette contains higher tar, ammonia, and nicotine content than a conventional cigarette and is more hazardous., Aim of Study: The aim of this study was to determine the effect of bidi smoking on periodontitis by assessing the interleukin (IL)-1β and IL-8 from a gingival crevicular fluid (GCF)., Materials and Methods: A total of 60 patients were selected, which included 40 patients diagnosed with chronic periodontitis (20 bidi smokers and 20 non-bidi smokers) and 20 periodontal healthy controls. Diseased and healthy sites were selected from each of the chronic periodontitis subjects. Clinical parameters assessed were plaque index (PI), gingival index (GI), periodontal probing depth (PPD), recession (RC), and clinical attachment level (CAL). Pooled GCF samples were taken from the same site and analyzed for IL-1β and IL-8 using enzyme-linked immunosorbent assay., Results: Bidi smokers displayed decreased levels of IL-1β and IL-8 than non-bidi smokers for both healthy and diseased sites and significantly reduced IL-8 levels among bidi smokers when compared to controls. Among bidi smokers, the diseased site had significantly higher levels of IL-8 than the healthy site. Non-smoker subjects with chronic periodontitis especially diseased sites contained significantly higher amounts of IL-1β and IL-8 than smokers and controls. The PI scores were highest among bidi smokers with reduced BOP and GI scores., Conclusions: Bidi smoking influenced the cytokine profile among periodontitis patients exhibiting decreased levels of IL-1β and IL-8., Competing Interests: None

Background: There is lack of information regarding pattern of distribution of pediatric cancers in Bihar. Aim: The aim of this study is to identify the pattern of distribution of pediatric cancers., Objectives: To analyze demographic data, type, and pattern of pediatric cancers in Bihar by retrospective clinical audit., Materials and Methods: All individual consecutive patients between ages 0 and 18 years registered in the Department of Medical and Pediatric Oncology from January 1, 2018 till December 31, 2018, were enrolled in this study. Data pertaining to age, sex, and type of cancer were retrieved from clinical database by retrospective audit and stratified into hematolymphoid and solid pediatric cancer cohorts. Frequency distribution and descriptive statistics were used to analyze the data using SPSS version 17.0., Results: A total of 247 pediatric cancers were registered, of which 142/247 (57%) and 15/247 (43%) were pediatric hematolymphoid and solid cancers, respectively. The median age was 9 years, while male-to-female ratio was 2.26. Acute lymphoblastic leukemia (ALL), 76/247 (31%) was the most common pediatric cancer overall. Hodgkin's lymphoma, 27/142 (19%) was the second most common hematolymphoid malignancy, after ALL was 76/142 (54%). Among solid tumors, Wilms' tumor was the most common, 28/105 (27%) followed by Ewing's sarcoma, 16/105 (15%), and germ cell tumor, 15/105 (14%). Central nervous system malignancies were among the least common solid tumor cancers, 3/105 (3%)., Conclusion: ALL and Hodgkin's lymphoma are the most common pediatric cancers. Among solid malignancies, Wilms tumor, Ewing's sarcoma, and Germ cell tumor are predominant., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 The South Asian Journal of Cancer.)

Tuberous sclerosis complex (TSC) is an autosomal dominant, multisystem genetic disorder. It is characterised by formation of benign hamartomas, neurofibromas, and angiofibromas located in different organs. We describe a case of a 13-year boy who complained of gingival enlargement. Clinical examination showed distinctive dermatological signs like hypopigmented macules, shagreen plaques, miliary fibromas, fibrous plaques and multiple angiofibromas. Oral manifestation included localised gingival enlargement. Gingivectomy was performed and the excised tissue was submitted for histopathological examination. The microscopic examination of gingival tissue revealed multiple bundles of collagen fibres with proliferating fibroblast and multiple proliferating blood vessels in the connective tissue. The clinical and histopathological findings were consistent with gingival angiofibromas of TSC. Gingivectomy allowed the patient to have better function and aesthetics. Periodontal examination in conjunction with dermatological examination is important for early diagnosis of TSC.