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The chirality introduced at the C1 position of 1-substituted-1,2,3,4-tetrahydroisoquinolines, obtained by four methods of enantioselective reduction of 1-substituted-3,4-dihydroisoquinolines, are vital for various biological activities.

In situating the questions of how languages shape the ideas of history, history writing, and self-identification of community, the importance of colonialism is key. Allison Busch's scholarship framed an important intervention in our collective approach to the early-modern subcontinent. This article introduces a special section consisting of articles by students, colleagues, and mentors of Busch.

Although impacted canines concerning dental arch have been analyzed in prior studies. However, there is a lack of evidence to analyze the impact of impacted canines on dental arch characteristics using cone beam computed tomography (CBCT) models; therefore, knowing the impact of impacted canines on the dental arch can enhance awareness, contribute knowledge, and aid clinicians in managing impacted canine cases. Hence, it is critical to emphasize the strategies of proper diagnosis and interception for this clinical condition prior to any orthosurgical treatment procedures. This study aimed to analyze the impact of impacted canines on dental arch characteristics in orthodontic patients using CBCT. The method used was the review of clinical records of 350 patients with impacted canines who had CBCT scans and visited the dental clinics for orthodontic treatment pertaining to their arch by dividing them into a control group and a study group. The results revealed a significant relationship based on the dental arch dimension; inter first premolar width (IPW) (P = 0.012), inter first molar width (IMW) (P = 0.010), arch length (AL) (P = 0.041), palatal height (PH) (P = 0.019), and palatal height index (PHI) (P = 0.020). The article concludes that patients with impacted canines had significant changes in dental arch dimension compared to the control group. Dental arch dimensions were significantly deficient, with a higher palatal vault seen in impacted canine patients. The anatomical position of impacted canines has an effect on the dental arches and adjacent anatomical structures. These three-dimensional (3D) findings may provide clinical reference data for impacted canines and provide a valuable basis for delivering information and education on impacted canines assessment and treatment. CPD/Clinical Relevance: Canine impactions are common during routine examinations. Understanding the influence of impacted canines on the dental arch will help clinicians manage impacted canine patients.

Some advanced and slightly more invasive treatments require the use of certain drugs before, during and after the treatment like local anesthetics, vasoconstrictors, anxiolytics, analgesics and antibiotics. All of these can possibly interact with medications a patient is already taking and can also interfere with the current dental treatment and create complications. This article aims to provide necessary information about commonly encountered systemic diseases and associated treating medications, their mechanism of action, possible complications and their management. CPD/Clinical Relevance: This article discusses drugs that are used for treating various systemic conditions, but can have a harmful effect on minor oral surgery procedures.

As hand is a functional part of the body, dorsal surface of digits, hand and wrist is prone to injury causing complex wound. Thin, mobile and supple skin of the dorsal wrist and hand make significant for hand functions and aesthetic. Aims of the study were feasibility of the flap in terms of survivability of Superficial Inferior Epigastric artery (SIEA) flap, complications of flap and measurement of functional & aesthetic outcomes to achieve the reconstruction goal in hugely burden regional medical college hospital. 11 SIEA flaps were done in Rajshahi Medical College Hospital from August 2019 to July 2021 on both hands among both male and female patients. Only 2 (18.18%) flaps were lost partially. Almost all the wounds were covered successfully with good functional and aesthetic outcome. So, SIEA flap is the one of the best workhorses for extensive dorsal complex wound in overburdened regional medical hospital in Bangladesh.

Fingertip includes the portion of the digit which is distal to the insertion of flexor digitorum profundus (FDP) tendon and the extensor tendon. It is the most vulnerable part of the hand to be injured. So, reconstruction of this part requires a good outcome in sensation and function. To meet the goal of the reconstruction principle, "Like with Like" local flap is the most preferable. Such type of flap is a Volar oblique triangular flap based on volar perforator vessels from the Digital artery proper. The aim of the study is to identify its reconstruction outcome in viability, sensation, range of movement of DIPJ, and patients' satisfaction regarding contour. This was a prospective observational study; ten patients were included who were admitted in the Burn and Plastic surgery Department of Rajshahi Medical College Hospital, Rajshahi, from September 2019 to December 2020. Thirteen flaps were harvested to cover for the fingertip defect of ten patients; among them, three were female. The age range of our operated patient was 2- 38 years. None of the flaps was lost except marginal necrosis or epidermal loss. The range of movement of DIPJ and 2SPD were within the normal limit. Patients were satisfied with their contour. So, the modified volar oblique, triangular flap is one of the good options for fingertip defects. TAJ 2021; 34: No-1: 63-69

This review covers all aspects from the viewpoint of impacted canines that were missed by some articles. Most review studies focus on the epidemiology and incidence of the disease but rarely on the detailed investigation of this therapeutic disorder; therefore, appropriate awareness of canine impaction diagnosis and management is critical prior to any orthosurgical treatment procedures. Hence, it is crucial to emphasize the means of proper diagnosis and interception of this clinical condition. This study aimed to compare and review the various diagnostic methods used to identify canine impaction, its advantages, shortcomings, research, and clinical implications to guide the evaluation and management of cases in general dental practice. Based on the current literature, the epidemiology of canine impaction, diagnosis, classification systems, and surgical options for exposing impacted canines are discussed. To determine the anatomical position of impacted canines, a thorough clinical examination and appropriate diagnostic imaging should be performed. The surgical method for exposing impacted canines should consider the tooth’s anatomical position in regard to the alveolar ridge and the amount of keratinized mucosa/gingiva. The article concludes that displacement and non-eruption of impacted canines can be managed by administering an accurate and adequate diagnosis of canine impaction, proper investigation of tooth position, length, direction, and related structures, selecting the appropriate management approach, and also reducing the biomechanics involved during canine retraction using fixed orthodontic appliances when they are impacted, and thus can restrict the risk of s urgical t rauma o n t he a djacent h ard a nd s oft t issues in th e p atients . T his a rticle m ay su ggest th at 3 D im aging is re quired to as sist cl inicians in de veloping a su ccessful t reatment p lan f or d etecting i mpaction a nd t he s urrounding structures . CPD/Clinical Relevance: Canine impactions are frequent during routine examinations. Appropriate identification, investigation, and, if necessary, referral are crucial to the outcome o f t reatment s uccess.

Transformer models have emerged as the state-of-the-art in many natural language processing and computer vision applications due to their capability of attending to longer sequences of tokens and supporting parallel processing more efficiently. Nevertheless, the training and inference of transformer models are computationally expensive and memory intensive. Meanwhile, utilizing the sparsity in deep learning models has proven to be an effective approach to alleviate the computation challenge as well as help to fit large models in edge devices. As high-performance CPUs and GPUs are generally not flexible enough to explore low-level sparsity, a number of specialized hardware accelerators have been proposed for transformer models. This paper provides a comprehensive review of hardware transformer accelerators that have been proposed to explore sparsity for computation and memory optimizations. We classify existing works based on the strategies of utilizing sparsity and identify their pros and cons in those strategies. Based on our analysis, we point out promising directions and recommendations for future works on improving the effective sparse execution of transformer hardware accelerators.

Medicinal plants are extensively used in traditional folk medicine. High blood pressure is associated with the risk of cardiovascular diseases (CVDs) and many other serious health complications resulting from it as a major concern of morbidity and mortality in health sector. Use of diuretics, angiotensin converting enzyme (ACE) inhibitors, beta adrenergic receptor antagonists (beta blockers), alpha adrenergic receptor antagonists (alpha blockers), calcium channel blockers (CCBs) etc. are not efficient enough to cure hypertension. Side effects regarding these medications lead to intolerance, impaired control of the disease, and also mismanagement of therapy. So, approach regarding quenching new potent therapeutic compounds from medicinal plants draws attention nowadays. For example, as a first-line therapeutic agent, an alkaloid is highly effective in lowering systolic blood pressure which is isolated from root extract of the plant of Rauwolfia serpentina species, namely reserpine. This article comes up with a list of 63 plant species from 37 families, compiling information related to plant parts used for making extracts, types of extract and animals used in these studies, antihypertensive effect of the extracts etc. It also refers to 74 chemically defined molecules, with in vitro and in vivo anti-hypertensive potential, isolated from these extracts along with their dosage and mechanism of action by using electronic searches of published articles from various databases and reference books. Our present work would be beneficial for researchers to investigate and invent novel antihypertensive therapy to treat hypertension.

This review covers all aspects from the viewpoint of impacted canines that were missed by some articles. Most review studies focus on the epidemiology and incidence of the disease but rarely on the detailed investigation of this therapeutic disorder; therefore, appropriate awareness of canine impaction diagnosis and management is critical prior to any orthosurgical treatment procedures. Hence, it is crucial to emphasize the means of proper diagnosis and interception of this clinical condition. This study aimed to compare and review the various diagnostic methods used to identify canine impaction, its advantages, shortcomings, research, and clinical implications to guide the evaluation and management of cases in general dental practice. Based on the current literature, the epidemiology of canine impaction, diagnosis, classification systems, and surgical options for exposing impacted canines are discussed. To determine the anatomical position of impacted canines, a thorough clinical examination and appropriate diagnostic imaging should be performed. The surgical method for exposing impacted canines should consider the tooth’s anatomical position in regard to the alveolar ridge and the amount of keratinized mucosa/gingiva. The article concludes that displacement and non-eruption of impacted canines can be managed by administering an accurate and adequate diagnosis of canine impaction, proper investigation of tooth position, length, direction, and related structures, selecting the appropriate management approach, and also reducing the biomechanics involved during canine retraction using fixed orthodontic appliances when they are impacted, and thus can restrict the risk of surgical trauma on the adjacent hard and soft tissues in the patients. This article may suggest that 3D imaging is required to assist clinicians in developing a successful treatment plan for detecting impaction and the surrounding structures. CPD/Clinical Relevance: Canine impactions are frequent during routine examinations. Appropriate identification, investigation, and, if necessary, referral are crucial to the outcome of treatment success.

Conventional convolutional neural networks (CNNs) present a high computational workload and memory access cost (CMC). Spectral domain CNNs (SpCNNs) offer a computationally efficient approach to compute CNN training and inference. This paper investigates CMC of SpCNNs and its contributing components analytically and then proposes a methodology to optimize CMC, under three strategies, to enhance inference performance. In this methodology, output feature map (OFM) size, OFM depth or both are progressively reduced under an accuracy constraint to compute performance-optimized CNN inference. Before conducting training or testing, it can provide designers guidelines and preliminary insights regarding techniques for optimum performance, least degradation in accuracy and a balanced performance-accuracy trade-off. This methodology was evaluated on MNIST and Fashion MNIST datasets using LeNet-5 and AlexNet architectures. When compared to state-of-the-art SpCNN models, LeNet-5 achieves up to 4.2× (batch inference) and 4.1× (single-image inference) higher throughputs and 10.5× (batch inference) and 4.2× (single-image inference) greater energy efficiency at a maximum loss of 3% in test accuracy. When compared to the baseline model used in this study, AlexNet delivers 11.6× (batch inference) and 5× (single-image inference) increased throughput and 25× (batch inference) and 8.8× (single-image inference) more energy-efficient inference with just 4.4% reduction in accuracy.

Jyoti Gulati Balachandran, Narrative Pasts: The Making of a Muslim Community in Gujarat, c. 1400–1650. Delhi: Oxford University Press, 2020, 248 pp.

The purpose of this article is to compare and contrast the different types of endodontic access cavity designs based on the current available evidence. Four types of access cavity designs, namely, traditional endodontic access cavity design (TEC), contracted/conservative endodontic access cavity design (CEC), ultra-conservative or ninja endodontic access cavity design (NEC) and truss endodontic access cavity design (TREC) have been suggested, and the latter three are currently in the limelight. Studies in vitro have been performed comparing the TECs, CECs, TRECs and NECs; except for the TECs, the other three types have not undergone clinical trials on patients. The choice of endodontic access cavity design affects fracture strength of the tooth, but remnants of pulpal tissue, due to ineffective instrumentation, can cause root canal treatment failure. CPD/Clinical Relevance: Root canal treatment with new access cavity designs has been proposed. However, there is lack of evidence to support such practices. It is important to consider the potential deleterious effects of such access cavity designs rather than emphasizing the preservation of tooth structure alone.

Objective. The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder. Methods. PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software. Results. This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias. Conclusion. TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients’ better outcome. This trial is registered with PROSPERO (CRD42020177562).

Sialolithiasis is considered as one of the most frequently encountered diseases of the salivary glands. The most susceptible site is the submandibular gland and its duct. However, megaliths have been sparsely reported in the literature. This article portrays management of a sialolith and a megalith in a 26-year-old and a 59-year-old male patient, respectively. The sialolith in the first case case was 4 mm long, whereas the second case demonstrated a megalith measuring 46 mm at its greatest size. Follow-up revealed normal functioning and a painless gland in the first case, while the second case showed no eventful complications. It is interesting to know that both patients remained relatively pain-free, despite having such longstanding sialolith/megaliths. After removal of the small sialolith, the gland regained its normal functioning swiftly, whereas in the case of the megalith, the gland removal was mandatory because such a longstanding megalith led to irreversible functional injury to the gland. CPD/Clinical Relevance: A giant sialolith can be easily misdiagnosed as a submandibular infection or neoplasm, especially when the patient presents with a longstanding pain-free swelling. Hence, early and appropriate referral and investigation is necessary for early diagnosis and treatment.

Cold recycling of asphalt pavement is an effective rehabilitation technique in terms of saving natural resources and cost of construction. The current study focuses on cold-recycled asphalt...

The average time consumed for disimpaction of mandibular third molar using rotatory instruments was approximately 17 mins and 23 mins while using a piezotome. The authors introduce a new technique of disimpaction of mandibular third molar with the least amount of bone removal ever achieved during mandibular third molar removal. This technique can be readily included in routine clinical practice and can be performed by using routine rotary instruments. This technique was successfully accomplished in 10 individuals with the least amount of discomfort and post-operative complications reported from day 1 to day 14. The procedure was evaluated based on time of the procedure, pain score, bleeding, nerve injury, trismus, swelling & dry socket. Third molar removal has been the most frequently performed oral surgical procedure in the modern world of dentistry.1 Although, mandibular third molar is the most commonly performed procedure, it demands skill, technique and experience. Several techniques have been implied for disimpaction of mandibular third molar, but every method involves either considerable amount of bone removal or splitting the bone. Bone manipulation is done by using a rotary instruments or chisel and mallet. The most popular techniques are buccal bone guttering, distal bone removal, lingual bone split technique and lingual bone guttering.2 According to the traditional classifications of impacted mandibular third molar (Pell & Gregory and Winter’s classification), the minimum amount of bucco-distal bone removed during disimpaction of mesioangularly positioned class I A impacted mandibular third molar using rotary instruments and conventional techniques can be calculated as 157.5 mm2 (volume of a rectangle = L X W X H; where L = 15 mm, W = 1.5 mm [width of the bur] and H = 7 mm). The mandibular third molar requiring osteotomy and tooth section have the highest risk of complications3. Surgical time had significantly increased in cases which required osteotomy and tooth section. Post-operative swelling and pain has been recorded as significant complications after using rotary instruments via buccal approach followed by use of chisel & mallet and least in lingual split approach. On the contrary, post-operative nerve injury and trismus were significantly high in lingual split technique. Dry socket was more in patients of bur technique.2

Since its inception in 1919, the Journal of Dental Research has continually published high-quality articles that span the breadth of research topics relevant to dentistry, oral surgery, and medicine. As part of the journal’s centennial celebration, we conducted an electronic search on Scopus to identify and analyze the top 100 most cited articles from 1919 to 2018. Since Scopus does not capture older citations, we conducted an additional analysis by Google Scholar to identify key articles published in the first 50 y of the journal. Based on Scopus, the articles were ranked in descending order per their citation counts. The citation counts of the 100 most cited articles varied from 262 to 1,503. The year in which the largest number of top 100 articles were published was 2004 ( n = 6). Within the top 100, the majority of articles originated from the United States ( n = 52). Research Reports–Biomaterials & Bioengineering was the most frequent category of cited articles ( n = 35). There was no significant association between total citation count and time since publication (correlation coefficient = –0.051, P = 0.656). However, there was a significant negative association of citation density (correlation coefficient = –0.610, P < 0.01) with time since publication. Our analyses demonstrate the broad reach of the journal and the dynamics in citation patterns and research agenda over its 100-y history. There is considerable evidence of the high variance in research output, when measured via citations, across the globe. Moreover, it remains unclear how patients’ priorities and dental health care needs are aligned with the perceived influence of single research pieces identified by our search. Our findings may help to inspire future research in tackling these inequalities and highlight the need for conceptualizing research priorities.

Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine (diabetes mellitus [DM]), hematological, gastrointestinal, cutaneous, and neurological diseases. The intent of this review is to accentuate the correlation between DM and oral disorders, like those upsetting oral mucosa and supporting tissues. A review of literature was performed using relevant key words (“Oral Manifestations of Diabetes” OR “Oral Complications of Diabetes” OR “Oral Impacts of Diabetes” OR “Oral Repercussions of Diabetes“) in prominent journals pertaining to Endocrinology and Dentistry (Journal of Periodontology, Periodontology 2000, British Dental Journal, The Lancet Diabetes and Endocrinology, PloS ONE, and Nature Reviews Genetics). The most frequently witnessed diabetic manifestations in oral cavity include gingivitis and periodontitis leading to premature tooth loss, salivary dysfunctions, dental caries, delayed wound healing, bacterial and fungal infections, lichen planus, taste impairment, tongue abnormalities, neurosensory oral disorders, halitosis, and dry socket. In the end, I have comprehensively described the role of antidiabetic drugs in the management of DM and eventually leading to prevention of its oral complications. In this review, etiopathophysiology of each oral complication has been prudently analyzed to contemplate the establishment of a possible preventive and treatment approach.

Oral health is a cardinal element of nutritional as well as systemic well-being and plays a substantial part in sustaining optimum general health condition. Various factors influence oral health including metabolic diseases such as endocrine, hematological, gastrointestinal, cutaneous, and neurological diseases. The intent of this review is to highlight the treatment as well as prevention strategies for one of the most devastating repercussions of chemotherapy (CT) and radiotherapy (RT) on the oral cavity in the form of oral mucositis (OM). A review of literature was performed using relevant key words (“Mucositis” OR “Oral Mucositis” OR “Oral Stomatitis” AND “Treatment of Mucositis” OR “Treatment of Oral Mucositis” OR “Treatment of Oral Stomatitis” AND “Prevention of Mucositis” OR “Prevention of Oral Mucositis” OR “Prevention of Oral Stomatitis“) in prominent journals pertaining to Oncology and Dentistry (CA: A Cancer Journal for Clinicians, Cancer, Frontiers in Oncology, Journal of Clinical Oncology, and Oral Oncology). It is basically sequelae of CT, RT, and radiochemotherapy in patients suffering from malignant diseases as well as those who require hematopoietic stem cell transplants. In addition to its negative effects on the oral cavity and consequently on the overall quality of life, OM may lead to delay in cancer treatment which incriminates in a poor prognosis of the disease.

Interconnection network topology is critical for the overall performance of HPC systems. While many regular and irregular topologies have been proposed in the past, recent work has shown the promise of shortcut-augmented topologies that offer multi-fold reduction in network diameter and hop count over conventional topologies. However, the large number of possible shortcuts creates an enormous design space for this new type of topology, and existing approaches are extremely slow and do not find shortcuts that are globally optimal. In this paper, we propose an efficient heuristic approach, called EdgeCut, which generates high-quality shortcut-augmented topologies. EdgeCut can identify more globally useful shortcuts by making its considerations from the perspective of edges instead of vertices. An additional implementation is proposed that approximates the costly all-pair shortest paths calculation, thereby further speeding up the scheme. Quantitative comparisons over prior work show that the proposed approach achieves a 1982× reduction in search time while generating better or equivalent topologies in 94.9% of the evaluated cases.

BACKGROUND: Sleep apnoea is a diagnosed condition in which appurtenances interrupt breathing whilst sleeping. The consequence of obstructive sleep apnoea (OSA) includes road traffic accidents due to drowsiness, systemic hypertension, heart disease, diabetes mellitus and neurocognitive disorders. This condition extends the duration of recovery phase after traumatic brain injury. OBJECTIVE: This study was intended to assess the knowledge and attitude towards OSA and compare it among dental and medical undergraduate students of University Sains Malaysia (USM). METHODS: In this study, a total of 216 clinical undergraduate students (36 from each year; 108 from medical and 108 from dental school) of University Sains Malaysia (USM) Health campus were recruited for the study by non-probability stratified random sampling method. Total study period was October 2017 to October 2018. A self-administered questionnaire was used to assess the sociodemographic status and OSAKA questionnaire was used to assess knowledge and attitude regarding sleep apnoea of the respondents. Descriptive analysis was carried out to assess the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. The Mann–Whitney U test was carried out to compare the knowledge and attitude of OSA amongst dental and medical undergraduate students of USM. RESULTS: Our study findings revealed that 0.9 %and 6.5 %of the dental undergraduate students and medical undergraduate students could answer all the questions correctly regarding knowledge of OSA. Based on the assessment of the difference between medical and dental students in terms of knowledge towards OSA patients, significant difference was observed at the significance level of 95%, where p

Palatal defects are rehabilitated by fabricating maxillofacial prostheses called obturators. The treatment incorporates taking deviously unpredictable impressions to facsimile the palatal defects into plaster casts for obturator fabrication in the dental laboratory. The casts are then digitally stored using expensive hardware to prevent physical damage or data loss and, when required, future obturators are digitally designed, and 3D printed. Our objective was to construct and validate an economic in-house smartphone-integrated stereophotogrammetry (SPINS) 3D scanner and to evaluate its accuracy in designing prosthetics using open source/free (OS/F) digital pipeline. Palatal defect models were scanned using SPINS and its accuracy was compared against the standard laser scanner for virtual area and volumetric parameters. SPINS derived 3D models were then used to design obturators by using (OS/F) software. The resultant obturators were virtually compared against standard medical software designs. There were no significant differences in any of the virtual parameters when evaluating the accuracy of both SPINS, as well as OS/F derived obturators. However, limitations in the design process resulted in minimal dissimilarities. With further improvements, SPINS based prosthetic rehabilitation could create a viable, low cost method for rural and developing health services to embrace maxillofacial record keeping and digitised prosthetic rehabilitation.

Objective: To determine the association of socio-demographic and clinic-pathological risk factors with oral cancer in Kelantan, Malaysia . Material and Methods: A 19-year cross-sectional survey was performed in Hospital Universiti Sains Malaysia (HUSM), Malaysia. Medical record of 301 oral cancer patients was retrieved from the Medical Records office. Results: The majority of the oral cancer cases were male (62.8%), non-smokers (57.5%), non-alcohol consumers (83.4%), non-betel quid chewers (96.7%), and belonged to Malay ethnicity (68.8%). At the time of diagnosis, most of the patients were at stage II (38.9%). Approximately one-third (30.6%) of the total OC patients experienced loco-regional/distant metastasis, whereas no metastasis was detected in around two-thirds of cases (69.4%). A combination of surgery and radiotherapy was the most commonly employed treatment modality (27.2%). At the time of this study, the survival status of most of the patients was alive (69.1%). The most frequently encountered oral cancer in the Kelantanese population was oral squamous cell carcinoma (70.1%), with the tongue being the most frequently involved oral cavity site (35.5%) . Conclusion: More than three-fourths of the cases were alive at follow-up, which included the cases that did not undergo any form of treatment.

In this essay, I reflect on the position of a postcolonized historian traversing space and time, thinking and linking to histories of European arrivals to Mexico and India. The essay is concerned with early seventeenth-century histories by Chimalpahin and Firishta, who documented their worlds before and after the arrival of Europeans. I argue for a transregional decolonial approach to thinking about historical violence and the formation of disciplinary histories.

More than 15,000 prescriptions and over the counter drugs are available according to the US Food and Drug Administration website. Moreover, several herbal medicines and dietary supplements are readily available to add to the list of possible drugs, which can potentially cause adverse drug interactions. These are a pressing concern for all as they can interfere with many dental procedures. Additionally, the number of geriatric patients seen in routine dental practice has increased over time. This implies that there are more patients with multiple diseases and health conditions like hypertension, diabetes, problems associated with the cardiovascular, renal and gastrointestinal systems, arthritis, osteoporosis, etc. All these require patients to be on certain medications. Furthermore, advancement in the dental field has led to more complex dental procedures (implants, grafts) being carried out in a general dental practice. These advanced and slightly more invasive treatments require the use of certain drugs before, during and after the treatment like local anesthetics, vasoconstrictors, anxiolytics, analgesics and antibiotics. All of these can possibly interact with medications a patient is already taking and can also interfere with the current dental treatment and create complications. This article aims to provide necessary information about commonly encountered systemic diseases and associated treating medications, their mechanism of action, possible complications and their management. The classes of drugs discussed include anti-platelet agents, vitamin K antagonists, novel oral anticoagulants, bisphosphonates, disease-modifying anti-rheumatic drugs and oral contraceptives.

Additional file 1: Supplementary methods: Additional details for handling missing data and evaluating predictive performance of models. Table S1: Search strategy for pre-eclampsia prediction models. Table S2: Predictors evaluated in the models externally validated in the IPPIC-UK cohorts. Table S3: Prediction models and equations identified from the literature search. Table S4: Study level characteristics of IPPIC-UK cohorts. Table S5: Patient characteristics of IPPIC-UK cohorts. Table S6: Number and proportion missing for each predictor in each cohort used for external validation. Table S7: Risk of bias assessment of the IPPIC-UK cohorts using the PROBAST tool. Table S8: Summary of linear predictor values and predicted probabilities for each model in each cohort. Table S9: Predictive performance statistics for models in the individual IPPIC-UK cohorts. Table S10: Predictive performance statistics for models in nulliparous women in all cohorts and in the POP cohort. Fig. S1: Decision curves for early pre-eclampsia models in SCOPE, UPBEAT and POP. Fig. S2: Decision curves for late pre-eclampsia models in SCOPE, Allen 2017, UPBEAT and POP.

This chapter makes two broad claims. The first is to incorporate a longer history of statecraft in north India into our examination of Mughal regime. The second is to take medieval Indian Ocean texts as critical source material for understanding forms of state-making, negotiation of difference, and encounters between social actors. Toward these claims, the chapter reads a set of ninth- and tenth-century narratives linking Sindh and Gujarat to Aden and Cairo. Within these texts are representations of various forms of encounters between those understood as Arabs and Muslims and those labeled Hindi or Sindhi. The chapter explicates accounts of embeddedness of Islam in India, of crime and punishment as modes of statecraft, of everyday gendered lives, and of networks of exchange in order to provide a longer history of understanding pivotal concerns of the Mughal regime in the sixteenth century.

Autism is a severe disorder affecting 1 in 160 children globally. Autism comprises of several development disabilities such as social, communicational and behavioural challenges. Children being diagnosed by the autism mainly face a hard time studying curriculum in inclusive classrooms based on their IQ level and the autism levels. Although, different strategies and learning teaching tools are available to support autistic children, only few systems aid them in learning efficiently, and are not highly interactive. Thus, the proposed Intelligent Education System primarily focuses on providing interactive learning experience to the autistic children with IQ level >50% and efficient teaching assistance to their tutors using augmented reality and machine learning in both English and Arabic The capability of the education system to perform an action, allows the autistic child to interact with the playable sand and gain interest. In learning stage, once the child scribbles on the sandbox, Kinect 3D camera captures and recognizes the drawn image. After the refinement and recognition of the image using OpenCV and classification model, the stored set of real world object are projected on the canvas. Besides, a webcam captures the facial expression of the child, and emotion detection algorithm determines the reaction of the child. Based on the child’s emotion, the current object is projected and pronounced three times to enforce better learning. Once the instructor chooses the language and character to be taught using the developed mobile application, the system displays it over the sandbox and further three objects that starts with the particular character are pronounced and projected. The system is tested rigorously with large set of users, and the results prove the efficiency of the system and happiness of the autistic children in better learning.

An essay on the process of Islamophobic response to COVID-19 in India. I draw upon a longer history of minoritizations, such as in Europe and in US to draw parallels to how Hindutva structures Muslim presences in 2020 India

A brief discussion of Area studies within European contexts

This prospective study on result of internal fixation of femoral shaft nonunion with implant failure by SIGN interlocking nail was carried out during the period of January 2009 to December 2016at Rajshahi Medical College Hospital, Bangladesh. Mean age of the patient was 34 years (11-70 years), majority of the patients were male (76%), injury was due to high energy trauma (88%), right side involvement was more (68%).Closed exchange nailing was done in 28 cases (56%) and open nailing was done in 22 cases (44%). In the open cases previous implants were removed, refreshening of the fracture ends was done. Antegrade or retrograde SIGN interlocking nailing depend on the site involvement. Reaming materials were used as internal bone graft in all the cases. Autogenouscancellous bone graft was given in 5 cases due to comminution at fracture site (2 cases) and severe osteoporosis (3 cases). The final outcome satisfactory result was found in 44 (88%) cases and unsatisfactory result in 6 (12%) cases.TAJ 2017; 30(1): 11-16

The study was carried out to report the results of marginal resection in sacral chordoma using a posterior midline approach. The study was carried out between July 2008 to June 2016, there were 21 patients who underwent the operation. Fourteen patients were male and seven were female and age ranging from 28 and 76 years. All most of the patients presented with pain, sacral mass and neurological deficit. Total sacrectomy and bone reconstruction were carried out in 11 patients. Subtotal sacrectomy was carried out in the remaining ten patients. Patients were followed up for at least seven years. Recovery after the operation was good. Duration of operation ranged between three to six hours. Three to five units blood was transfused in all patients after operation .Bowel and bladder dysfunction were almost all patients. After surgery following local complications including infection and wound disruption occurs in three patients and seroma occurs in two patients. Three patients (14%) had tumor recurrence and one patient expired three years after operation. 18 patients were still tumor-free at long term (seven years) follow-up. Marginal resection of sacral chordoma through posterior approachcan be a management plan for sacral chordoma with acceptable results.TAJ 2017; 30(1): 21-26

Background : Expansive open-door laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. However, one acknowledged complication is spring-back complication or closure of the door which may result in re-stenosis of cervical canal and neurologic deterioration. The study aimed for addressing our cervical open-door laminoplasty technique with plate and screw and subsequently the follow-up outcomes.Methods: Thirty consecutive patients who underwent open-door laminoplasty with the novel technique were included and followed for minimum 5 years from July 2011 to June 2016. Antero-posterior diameter (APD) of the vertebral canal of C4 was measured in lateral cervical radiographs. Neurologic scenarios were assessed using the Japanese Orthopaedic Association (JOA) scores.Results: Twenty-five males (83.3%) and five (16.7%) females with an average follow-up of 68 months were enrolled. The preoperative APD was 13.22 mm (±1.15), whereas the postoperative APD increased to 31.23 mm (±2.43) with an expansion ratio of 136.23% (P < 0.05). The JOA score increased from 8.5 preoperatively to 13.45 postoperatively with a recovery rate of 58.2% (P < 0.05). The elevated laminas were maintained open during the follow-up period.Conclusions: Our technique with plate and screw for laminoplasty is a simple and efficient method for maintaining the decompression of cervical canal and neurologic improvement.TAJ 2016; 29(1): 33-38

Ewing's sarcoma is a primary bone malignancy with the highest incidence in the first decade of life. Although it mostly affects the diaphyseal as well as metaphysical region of growing long bones but involvement of spine is not very uncommon especially the sacrum. Nonsacral spinal Ewing's sarcoma is rarer and often mimics a benign condition before spreading extensively. They present with neurologic deficits due to spinal cord compression, but acute onset paraplegia is very rare.A high index of clinical suspicion can clinch the diagnosis early in the course of the disease. A prompt intervention is required to keep neurological damage to a minimum, and a correct combination of surgery, chemotherapy, and radiotherapy is required for better long-term patient outcome. We report a 15-years old male who presented with acute paraplegia and had an excellent postoperative outcome after posterior decompression of a D 11 Ewing's sarcoma.TAJ 2013; 26: 92-97

Aim The purpose for this study was to investigate and elucidate the relationships between the mandibular third molar and mandibular angle fractures. Materials and methods This retrospective study incorporated the presence, position and angulation of mandibular third molar and prevalence of fracture of angle of mandible among patients treated in Hospital Universiti Sains Malaysia. The medical records were scanned and 427 patients with mandibular fractures from 2001 until 2016 were identified. Depending on the notes and various radiographic images, 77 of 427 patients had mandibular angle fracture. The presence or absence of impacted mandibular third molar was assessed for each patient that had angle fracture. In presence of impacted mandibular third molar, their position and angulation of the tooth were evaluated. The positions were classified using Pell and Gregory system while the angulations were classified using Winter's classification. Data were analysed using SPSS 22.0 system and applying a chi-square test. Results Among 77 patients with angle fracture, 67 (87%) had impacted mandibular third molar while 10 (13%) had no evidence of mandibular third molar. The incidence of mandibular angle fracture was found to be significantly greater when impacted third molar was present (P < 0.05). Conclusion The results of this study showed that the patients with impacted mandibular third molar have an increased risk of mandibular angle fracture compared to those without.

In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population.In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P

Various iatrogenic mishaps can impede adequate biomechanical preparation of the root canal system. Instrument separation can be treated by orthograde retreatment, with or without instrument removal, endodontic surgery or extraction. The aim of this case report is to describe a minor surgical procedure to resect an infected root containing a separated instrument. A fractured instrument was detected in the mesiobuccal root of the maxillary first molar extending beyond the apex. This fractured instrument was serving as a niche for infection and formation of a sinus tract. The fractured instrument could not be retrieved through the root canal, hence the root canal was obturated up to the fractured instrument and the apical half of the mesiobuccal root was resected surgically. At the two years recall the clinical and radiographic outcome was considered favourable. CPD/Clinical Relevance: Endodontic surgery, while classically being considered as the last resort, becomes important when orthograde retreatment fails to remove the cause of persisting infection.

Shahid Amin, Conquest and Community: The Afterlife of Warrior Saint Ghazi Miyan, Delhi: Orient BlackSwan, 2015, 348 pp.