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The article presents speech of the author delivered on October 13, 2014, at Tirupati on the occasion of the 5th convocation of Sri Venkateswara Institute of Medical Sciences, Tirupati, India. Topics discussed in the speech included central objective and mission of medical profession, revolutionary change in the evolution of medicine and pervasive influence of science and technology in medical theory and practice. It also discusses challenges in providing training to physicians.

Background: Ayurveda represents the traditional medicine system of India. Since mechanistic details of therapy in terms of current biology are not available in Ayurvedic literature, modern scientific studies are necessary to understand its major concepts and procedures. It is necessary to examine effects of the whole Ayurvedic formulations rather than their ''active'' components as is done in most current studies. Methods: We tested two different categories of formulations, a Rasayana (Amalaki Rasayana or AR, an herbal derivative) and a Bhasma (Rasa-Sindoor or RS, an organo-metallic derivative of mercury), for effects on longevity, development, fecundity, stress-tolerance, and heterogeneous nuclear ribonucleoprotein (hnRNP) levels of Drosophila melanogaster using at least 200 larvae or flies for each assay. Results: A 0.5% (weight/volume) supplement of AR or RS affected life-history and other physiological traits in distinct ways. While the size of salivary glands, hnRNP levels in larval tissues, and thermotolerance of larvae/adult flies improved significantly following feeding either of the two formulations, the median life span and starvation resistance improved only with AR. Feeding on AR or RS supplemented food improved fecundity differently. Feeding of larvae and adults with AR increased the fecundity while the same with RS had opposite effect. On the contrary, feeding larvae on normal food and adults on AR supplement had no effect on fecundity but a comparable regime of feeding on RS-supplemented food improved fecundity. RS feeding did not cause heavy metal toxicity. Conclusions: The present study with two Ayurvedic formulations reveals formulation-specific effects on several parameters of the fly's life, which seem to generally agree with their recommended human usages in Ayurvedic practices. Thus, Drosophila, with its very rich genetic tools and well-worked-out developmental pathways promises to be a very good model for examining the cellular and molecular bases of the effects of different Ayurvedic formulations. [ABSTRACT FROM AUTHOR]

Ayurveda, according to Caraka, is knowledge which seeks to weigh life in the scales of wholesomeness and happiness against their opposites. Its main themes of health and disease, and recovery of health from disease take the stage against an inspiring background of intuitive philosophy, lofty idealism, and vivid compassion, which are the hallmarks of India's cultural inheritance. After centuries of neglect and stagnation, Ayurveda has witnessed an unprecedented resurgence from the twentieth century in India and abroad. Ayurveda viewed health as a state of many-sided equilibrium, and disease as its reversal. Ayurvedic practice of medicine aimed at the restoration of equilibrium and, in that process, represented more than the sum of dietary regimen, procedures and medications. [ABSTRACT FROM AUTHOR]

In a search for geochemical factors that could play a role in the pathogenesis of tropical endomyocardial fibrosis, endomyocardial tissue samples obtained from patients at necropsy or operation were analysed for major elements present in laterite and monazite, which are important soil constituents of Kerala State of India. Atomic absorption spectrophotometry was used for detecting iron, silicon, aluminium, zinc, magnesium, calcium, sodium, potassium, and manganese and neutron activation analysis for thorium. Compared with control samples from victims of fatal accidents, an excess of thorium, sodium, and calcium and a deficiency of magnesium were present in samples from patients. It has been shown earlier that the staple diets of people in Kerala have high concentrations of thorium, and these data show that thorium can become concentrated in cardiac tissues. It is speculated that thorium excess in conjunction with magnesium deficiency may play a role in the causation of tropical endomyocardial fibrosis. [ABSTRACT FROM PUBLISHER]

The application of various polymers, both synthetic and natural, for biomedical purposes has made such tremendous progress during the last two decades that a wide variety of biomaterials and blood-contacting devices are currently being used in cardiovascular, orthopaedic, and dental applications throughout the world. Implantation of heart valves, catheters, etc. has become more or less a routine affair in cardiovascular surgery. Most of these devices are being fabricated from polymers, and the basic requirements for developing such a biocompatible polymer are very rigid. It has to be sterilizable, nontoxic, easily fabricable, highly resistant to mechanical strains, should not produce allergy or hypersensitivity, not incite any inflammatory response, and also should not degrade chemically [1]. [ABSTRACT FROM PUBLISHER]

Endomyocardial fibrosis is a fatal disease of obscure aetiology which is notably prevalent in Uganda, Brazil, Kerala State in India, and certain other parts of the world. The main disability in the disease results from fibrotic obliteration of ventricular chambers and insufficiency of the mitral and tricuspid valves. The poor response to medical treatment and the bleak prognosis of the patients led to the introduction of endocardiectomy and replacement of the atrioventricular valves as a palliative procedure by Dubost and colleagues. The present report on the early results in 17 patients from Kerala State would support the continued use of this palliative procedure in endomyocardial fibrosis with severe disability. [ABSTRACT FROM AUTHOR]

The survival pattern, morbidity, and clinical course of 145 patients with endomyocardial fibrosis who were followed up between November 1975 and June 1987 were studied. The diagnosis was confirmed in all cases by cardiac angiography, or echocardiography, or necropsy. Percentage survival at the end of one and 9.5 years was 76.11 and 26.35 respectively. History, physical examination, electrocardiography, and cardiac catheterisation were studied at the first presentation. The determinants of early mortality were studied by univariate Kaplan-Meier estimates compared by the log rank test and Cox proportional hazards multiple regression analysis. Significant univariate predictors of early mortality were QRS axis above +90 degrees, intraventricular conduction delay (QRS duration greater than 0.12 s), duration of symptoms before presentation, New York Heart Association functional classes III and IV, presence of embolic episodes, right atrial mean pressures greater than 20 mm Hg, right ventricular end diastolic pressure greater than 20 mm Hg, and aortic oxygen saturation less than 85%. The significant multivariate predictors of mortality were cyanosis, New York Heart Association functional class at first presentation, and right atrial mean pressure greater than 20 mm Hg. The bleak prognosis of endomyocardial fibrosis did not substantially improve despite advances in the medical management of congestive cardiac failure during the period of the study. [ABSTRACT FROM PUBLISHER]

The author discusses the Ayurvedic biology and history of Ayurveda in India. Topics discussed include works of Portuguese physician Garcia da Orta who practiced medicine in Goa, India for 36 years and wrote "Colloquies on the Simples and Drugs of India;" determine the prakriti on the basis of a number of traits like physical, mental and behavioural; and traditional methods of making Ayurvedic products and their effect on the composition and characteristics of the drug.

Analysis of hearts of patients dying from endomyocardial fibrosis showed a significantly greater concentration of cerium, a lanthanide present in leafy vegetables and root tubers, than in control hearts. This may be important in the pathogenesis of the disease and provides a geographical basis for the prevalence of the disease in the tropics. [ABSTRACT FROM PUBLISHER]

An obituary for cardiologist and teacher Kappiareth Gopal Nair is presented.

This article explores the various challenges systemic conditions can pose before and during orthodontic treatment. Cardiovascular conditions like infective endocarditis require antibiotic prophylaxis before certain orthodontic procedures are started. Patients with bleeding disorders require special considerations in regards to viral infection risk and maintenance of excellent atraumatic oral hygiene. Orthodontists play an important role in early identification of signs and symptoms of eating disorders and should deal with these patients sensitively. Congenital disorders, craniofacial anomalies, and nutritional deficiencies require special considerations and should be addressed appropriately before orthodontic treatment is started., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This article explores the intersection of various systemic conditions with orthodontic treatment. Renal diseases, including chronic kidney disease and renal transplant, present challenges such as delayed tooth eruption and gingival overgrowth, necessitating careful orthodontic planning and collaboration with physicians. Liver diseases, particularly hepatitis, heighten the risk of periodontal disease and mandate strict infection control measures during orthodontic procedures. Ehlers-Danlos syndrome poses challenges related to collagen fragility, rapid tooth movement, and orthodontic relapse. Autoimmune diseases like diabetes mellitus and juvenile idiopathic arthritis require tailored orthodontic approaches considering oral complications and joint involvement., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to evaluate the volumetric airway changes using three-dimensional images following unilateral vertical mandibular distraction osteogenesis (uVMD) among patients with hemifacial microsomia (HFM)., Design: This retrospective study analyzed cone-beam computed tomography (CBCT) scans of patients with HFM at three different timepoints; pretreatment (T0), posttreatment (T1), and at least 6 months post-distraction (T2). The individuals underwent uVMD between December 2018-Januaray 2021. The nasopharyngeal (NP) volume, oropharyngeal (OP) volume, and the area of maximum constriction (MC) were measured. Wilcoxon signed-rank test was used to compare the airway volumes between T0-T1, T1-T2, and T0-T2., Results: Five patients met the inclusion criteria (mean age = 10.4 years; 1 female, 4 males). Intraclass correlation analysis showed excellent interrater reliability ( r  > .86, P  < .001). Posttreatment, the OP airway volume exhibited a significant mean increase of 56% ( P  = .043) from T0 to T1, but decreased from T1-T2 by 13%. Likewise, the total airway volume presented with a significant mean increase of 48% between T0-T1 ( P  = .044), and a decrease of 7% from T1-T2. The changes in the NP airway volume and area of MC were not statistically significant ( P   >   .05 ), but an increase in the mean values were observed., Conclusion: Surgical intervention with uVMD may significantly increase the OP airway volume and the total airway volume among patients with HFM immediately after distraction. However, the statistical significance diminished after six months post-consolidation, but the mean percent change may remain of clinical significance. The NP volume did not seem to show significant changes in response to uVMD., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Periodontally accelerated osteogenic orthodontics (PAOO) is a periodontal-orthodontic interrelationship procedure that helps in accelerating orthodontic treatment by periodontal procedure reinforcement. This depends on the principle of the regional acceleratory phenomenon which involves inducing changes in the biology of periodontal tissues to fasten the orthodontic tooth movement by creating a surge in the osteopenic environment for tooth movement followed by bone deposition and mineralisation to stabilise the tooth in newly moved position. This PAOO involves the intentional creation of surgical corticotomy cuts followed by a grafting procedure to maintain bone resorption and thickness. Numerous modifications have been incorporated to reduce surgical complications and to improve treatment results by minimally invasive techniques. Hence, this case report incorporated piezosurgery-assisted corticotomy cuts involving the buccal side along with particulate bone grafting to fasten the orthodontic tooth movement, reducing the overall treatment time, root resorption and stabilising the orthodontic treatment results., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. 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, Mari et al.)

Maintenance of biological width serves as a primary factor in periodontal-restorative relationships. Crown lengthening (CL) is a technique to prevent violation of biological width, with the laser method offering the advantage of surgical and patient-related outcomes. Laser CL with retraction helps with the excision of tissues, increasing the CL, maintaining the gingival contour with adequate exposure to the finish line to record the tooth preparation features. This helps to achieve the functional and esthetic outcomes essential for restorative dentistry. The marginal fit, contour, and adaptation of the crown can be further enhanced by computer-aided design and computer-aided manufacturing (CAD/CAM) technology improving patient and clinical outcomes. Hence, this case report aims to indulge the laser-assisted procedures and CAD/CAM technology to fabricate and deliver a zirconia crown maintaining the periodontal-restorative factors., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. 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, Valiathan et al.)

In periodontal care, where patient results are crucial in guiding the development of surgical techniques, gingival recession management is a critical issue. The periosteum eversion technique (PET) emerges as a modern strategy that leverages the intrinsic regenerative capabilities of the periosteum to attain root coverage. A detailed case study showcases the effectiveness of PET in managing a Miller Class I gingival recession alongside an adjunctive platelet-rich fibrin (PRF) procedure. This approach entailed the deliberate elevation and eversion of the periosteal flap to encompass the recession area, securing it meticulously through suturing. Across a six-month observation period, this method exhibited successful root coverage, augmentation of keratinized tissue, and enhanced patient comfort, as reported, with no significant complications observed. These outcomes provide support for the incorporation of PET into standard periodontal protocols, underscoring its capacity to reshape the treatment landscape for gingival recession., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, S et al.)

Background Conventionally, undersized osteotomies were used to increase initial bone-to-implant contact to achieve primary stability in implantology. This is particularly evident in regions with low bone density. The potential for severe bone compression and ischemia poses a challenge to secondary stability. Instead, lateral bone compaction is caused by the idea of osseodensification. Research on the potential benefits of this method for narrow ridges is lacking. This study aimed to determine if the osseodensification drilling technique affects primary stability and how much the alveolar ridge expands following implant site preparation. Methodology A total of 30 participants aged 20 to 80 years were included in this randomized controlled clinical investigation. Each participant was randomly assigned to one of the following two groups: one that received standard drill preparation, and another that received osseodensification drill preparation. Implant stability using implant stability quotient values, crest width, apical width (5 mm from crest), and bone density were assessed both before and after six months using cone-beam computed tomography. Results Osseodensification impacted the width at the apex (5 mm from the crest) and radiographic bone density, adding to the quality, but did not affect implant stability and crestal width after osseointegration. The mean difference in conventional and osseodensification groups was 0.46 and 0.68 mm, respectively, concerning the crestal width. Moreover, the mean difference was 0.74 and 0.58 mm for conventional and osseodensification groups, respectively, concerning the width at the apex (5 mm from the crest). Conclusions This study demonstrates that the osseodensification process increased both the radiographic bone density and the width at the apex, demonstrating that osseodensification drilling techniques allow for the placement of implants with larger diameters in narrow alveolar ridges., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Shanmugam et al.)

Dense, longitudinal sampling represents the ideal for studying biological growth. However, longitudinal samples are not typically possible, due to limits of time, prohibitive cost, or health concerns of repeat radiologic imaging. In contrast, cross-sectional samples have few such drawbacks, but it is not known how well estimates of growth milestones can be obtained from cross-sectional samples. The Craniofacial Growth Consortium Study (CGCS) contains longitudinal growth data for approximately 2000 individuals. Single samples from the CGCS for individuals representing cross-sectional data were used to test the ability to predict growth parameters in linear trait measurements separately by sex. Testing across a range of cross-sectional sample sizes from 5 to the full sample, we found that means from repeated samples were able to approximate growth rates determined from the full longitudinal CGCS sample, with mean absolute differences below 1 mm at cross-sectional sample sizes greater than ~ 200 individuals. Our results show that growth parameters and milestones can be accurately estimated from cross-sectional data compared to population-level estimates from complete longitudinal data, underscoring the utility of such datasets in growth modeling. This method can be applied to other forms of growth (e.g., stature) and to cases in which repeated radiographs are not feasible (e.g., cone-beam CT)., (© 2023. The Author(s).)

Competing Interests: Declaration of competing interest The corresponding author Prof. Kalpana Joshi and Prof. Bhushan Patwardhan are editorial board members of Journal of Ayurveda and Integrative Medicine. However, both of them were not involved in any reviewing and publication process related to this manuscript in order to facilitate double anonymized review.

To evaluate orthodontic care for patients with craniofacial anomalies (CFA) by identifying orthodontic residents' preparedness to treat certain conditions and willingness to receive more training in CFA., A 12-question survey was sent through the American Association of Orthodontics (AAO) organization to orthodontic residents. Questions were primarily designed to obtain information on the frequency with which they dealt with patients with CFA in their training, specific craniofacial conditions that orthodontic residents feel comfortable treating., A total of 150 participants out of 1066 responded. Of the 150 responses, 35% were first-year residents, 43% second year, and 22% were third-year residents. Thirty nine percent of residents saw 3 or more CFA patients during their residency followed by 24% that saw no patients with CFA. Forty five percent reported that 1 to 3 hours of lecture time was devoted to CFA per month. Sixty percent felt their training in CFA was not sufficient to feel comfortable treating these patients in practice. Specifically, 62% felt comfortable treating Down syndrome, 84% unilateral cleft lip and/or palate, and 64% bilateral cleft lip and/or palate, while the majority did not feel comfortable treating Pierre Robin sequence (68%), Cleidocranial dysplasia (65%), Crouzon syndrome (75%), Pfeiffer syndrome (80%), Treacher Collins syndrome (76%), Apert syndrome (76%), CHARGE syndrome (84%), and DiGeorge sequence (84%). Seventy eight percent of residents reported that they would like more training in treating craniofacial., Orthodontic residents did not feel comfortable treating patients with CFA. Majority of the residents felt that they would like to learn more about CFA.