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To evaluate the prevalence of risk factors associated with COVID-associated mucormycosis (CAM) in the maxillofacial region with emphasis on clinical and radiological characteristics of the disease reporting to the dentists. Archival records of the patients diagnosed with rhino-cerebral mucormycosis through histopathology or culture, were screened and 266 records were included. These records were divided into three groups-previously diabetic (PD, n = 122), recently diagnosed diabetic (RD, n = 105) and non-diabetic (ND, n = 39). All the records were evaluated and compared among the three groups for the duration of presentation, history of co-existing medical conditions, the association of treatment given during COVID-19, and the clinical and radiographic presentations of the disease. The results confirmed uncontrolled diabetes mellitus as the major risk factor for the disease. The prevalence of steroid administration was lower in our study in contrast to previous literature. The risk factors and treatment rendered during COVID-19 did not differ significantly among the three groups (p > 0.05). The findings indicate that the disease was milder and progressed more slowly in the ND group, both clinically and radiographically, and it had close resemblance to odontogenic infection. Patients with early CAM mimicked the odontogenic infection and were more likely to report in a dental setup. Hence, a multidisciplinary and holistic management approach is necessary. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: Surgical removal of mandibular third molars is associated with some degree of postoperative pain, trismus, and facial swelling. The purpose of the study was to evaluate the effect of photobiomodulation in reducing these postoperative side effects after surgical removal of mandibular third molars.Materials and Methods: This randomized, double-blinded, split-mouth pilot study was carried out in the Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, India, among patients with impacted mandibular third molars. In each patient, 1 side was treated by photobiomodulation and the other side received placebo. Photobiomodulation was performed by intraoral and extraoral application of an 830-nm and 30-mW laser at different time points. Pain, trismus, and facial swelling were evaluated at all time points. The number of analgesics taken also was recorded. The data were analyzed using descriptive, bivariate and multivariate statistics.Results: The study was conducted in 25 patients (56% male patients) with a mean age of 22.16 ± 4.60 years. There were 50 sites divided equally into both groups. The sites treated with photobiomodulation showed a significant reduction in pain and swelling (P < .05) compared with the sites in the placebo group. Moreover, an increase in mouth opening was noted after photobiomodulation compared with that in the placebo group, but this was not statistically significant (P > .05).Conclusions: The results of this study suggest that photobiomodulation is effective in reducing pain and swelling after mandibular third molar surgery. Hence, it can be used as an alternative and effective modality after surgical removal of mandibular third molars, thereby improving the quality of life of the patients. [ABSTRACT FROM AUTHOR]

Abstract Herein, we demonstrate a nanocomposite material Eu/ZnO/pPy for enhanced performance in photoelectrocatalytic degradation of chemical warfare agent sulphur mustard (SM) at ambient conditions which is growing concern of the Scientific Community amidst the current climate of terrorism. Eu/ZnO/pPy was electrochemically prepared on Au electrode at ambient conditions and was used for electrocatalytic reductive elimination of chloride from SM and results indicated one electron involvement process for the cleavage of the carbon-chloride bond. Surface morphology of Eu/pPy, ZnO/pPy and Eu/ZnO/pPy composites were characterized by SEM and confirmed the formation of the nanoparticles and nanorods on the modified electrode which leads to provide more surface area for the reductive elimination reaction. The elemental composition, functional groups and phase of materials on the modified electrode were deduced using EDX, Raman spectroscopy and XRD, respectively. Eu/ZnO/pPy/Au electrode was utilized for the photoelectrocatalytic degradation of SM as it exhibit excellent electrocatalytic activity and degradation products were analyzed by GC-MS. In the reductive elimination of SM, the following parameters were deduced (i) heterogeneous rate constant (0.127 s−1), (ii) transfer coefficient (0.32) and (iii) number of electron involved (1.0). The enhanced photoelectrocatalytic capability of this nanocomposite could serve as a novel and promising catalyst in defence and environmental applications. Graphical abstract Image 1 Highlights • Ambient condition electrochemical deposition of nanocomposite of rare earth metal and transition metal on Au electrode. • Characterization of nanocomposite with various techniques such as XRD, BET, SEM, EDX, Raman spectroscopy, CV and EIS. • Nanocomposite electrode was utilized for the photo-electrocatalytic degradation of CWA SM at ambient conditions. Nanocomposite (Eu/ZnO/pPy) of high surface area was electrochemically prepared and explored for the photo-electrocatalytic degradation of chemical warfare agent at ambient conditions. [ABSTRACT FROM AUTHOR]

Abstract Aim Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites. Methods The study included 66 consecutive non-septic cirrhosis patients with ascites. RAI was defined by a delta cortisol lower than 9 μg/dL and/or a peak cortisol lower than 18 μg/dL. Results Sixty-six patients with cirrhosis and ascites were studied. The mean Child-Turcotte-Pugh (CTP) and model for end stage liver disease (MELD) scores were 10.6 ± 1.9 and 21.5 ± 7.3, respectively. The prevalence of RAI in patients with cirrhosis and ascites was 47% (31/66). The prevalence of RAI in patients with and without spontaneous bacterial peritonitis, renal failure and type 1 hepatorenal syndrome (HRS) was comparable. Baseline hyponatremia was common in RAI (42% versus 17%, p = 0.026). There was a significant correlation of prevalence of RAI with prothrombin time, international normalized ratio, MELD scores and CTP class. During follow-up, there was no association between RAI and the risk to develop new infections, severe sepsis, type 1 HRS and death. Conclusions RAI is common in non-septic cirrhotic patients with ascites and its prevalence increases with severity of liver disease. However, it does not affect the short-term outcome in these patients. [ABSTRACT FROM AUTHOR]

The present study was aimed at analyzing uninfected wheat grain ( Triticum aestivum ) and wheat seed gall nematodes ( Anguina titici ) by means of wave-dispersive X-ray fluorescence (WD-XRF), Fourier transform infrared (FTIR) spectroscopy and Diffuse reflectance spectroscopy to assess their elemental and molecular compositions. WD-XRF was used to detect and quantify the major and trace elements in the tested samples. The minerals detected and quantified in no-infection, low infection and high infection wheat samples were potassium (K), sulphur (S), phosphorus (P), chlorine (Cl), calcium (Ca), magnesium (Mg), iron (Fe), silicon (Si), and zinc (Zn). Copper (Cu) was only observed in wheat samples showing no-infection and high infection. Chromium (Cr), manganese (Mn), and nickel (Ni) were detected only in wheat samples of low infection and high infection, and it was completely absent in uninfected wheat samples. Sodium (Na) was only detected in low infection samples whereas aluminium (Al) was only found in high infection wheat samples. The concentrations of these elements in different wheat samples varied. FTIR spectroscopy was used to study the molecular compositions of the infected and uninfected wheat grain samples. Diffuse reflectance measurements of uninfected and infected wheat samples were used to identify spectral differences among wheat samples. In the present investigation a detailed comparison of these samples has been presented at the elemental and molecular levels. [ABSTRACT FROM AUTHOR]

Objective The purpose of the study was to evaluate the clinical, imaging and histopathological features of orofacial cysticercosis. Materials and method This study is a retrospective analysis of orofacial cysticercosis that was diagnosed in the Department of Oral Medicine and Radiology, PGIDS, Rohtak during the period from January 2012 to December 2014. A total of 16 cases were analyzed for their clinical, imaging, histological features and management. Result From all the 16 evaluated patients 68.75% were females and 31.25% males. Age ranged from 10 years to 55 years with a mean of 25.69 years. In all the patients, the chief complaint was a nodular swelling of variable duration with a wide variation in the location. Most of the cases were diagnosed on ultrasonography alone except for one case that needed MRI. All the patients were managed medically with only five out of 16 patients requiring surgical intervention. Conclusion Cysticercosis should be included in the differential diagnosis of all the nodular swellings of head and neck region. Ultrasound is an economic, easily accessible, safe and noninvasive method that can be used with a considerable reliability in the diagnosis of cysticercosis along with histopathological examination. Clinical relevance Cysticercosis is a rare disease difficult to diagnose clinically due to nonspecific presentation and inconclusive investigations. This study, to the best of our knowledge, is the first compilation of 16 cases of orofacial cysticercosis. Dentist may play a key role in diagnosis, which may have more widespread implications. [ABSTRACT FROM AUTHOR]

Abstract: This article reports a case of 45-year-old female presented with pain and swelling in lower jaw with generalised burning sensation over the gums, mobility in upper anterior teeth and difficulty in feeding. On intra oral examination diffuse reddish inflamed and fragile gingiva was noticed with granular appearance. Painful whitish sloughed and indurated ulcerative lesion with erythematous margins was found over midpalate to buccal mucosa over anterior border of ramus. Consistent radiographic examination revealed cavitatory defect over right pleural base. List of various diagnostic possibilities has been given as differential diagnosis and finally findings of our case were most consistent with Wegener''s granulomatosis which was confirmed by biopsy and serum testing for anti-neutrophilic cytoplasmic antibodies. Patient was cured with oral prednisolone and cyclophosphamide in the standard dose. After 3months cyclophosphamide was replaced with myecophenolate moeftil 500mg BD. At the follow up of 6months the patient was quiet normal and was relieved of all the symptoms. We feel that the clinicians should be aware of the possible, occurrence of oral lesions of WG and consider them in the differential diagnosis of any oral ulcer of unknown etiology. On further assessment, it is imperative for clinicians to conduct further laboratory and radiographic and histopathological investigations to rule out the disease. [Copyright &y& Elsevier]

Abstract: Compound semiconductors provide a large range of materials with varying band gaps for application in devices. Usually these devices are made in the form of thin films, whose crystalline quality and stoichiometry play a pivotal role in the stability and the performing characteristics of the device. Vacuum deposition of thin films is the most popular and dependable method of preparing thin films. However, it is a general problem that the compound semiconductors thermally dissociate into their constituent components during evaporation. To overcome this difficulty, we optimize a method, wherein good quality films of sulphide semiconductors were grown by using a low ambient H2S atmosphere inside the vacuum chamber while thermally evaporating the sulphide semiconductor materials. The substrate was kept at an elevated temperature, which was high enough for the dissociated sulphur ions to be ejected from the substrate while the dissociated metallic cations quickly combined with the highly reactive H2S molecules to get deposited as sulphide molecules. Such films naturally had better stiochiometric ratio, better crystallinity, and had less structural defects. Such films were remarkably pin hole free and had better adhistivity with the substrates. Such films would be inherently more suitable for any electro-optical devices. [Copyright &y& Elsevier]

Abstract: Oxidative stress has been found to be associated with the progression of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, Lou Gehrig’s, etc. In the recent years, cerium oxide nanoparticles (CNPs) have been studied as potent antioxidant agents able to exert neuroprotective effects. This work reports polyethylene glycol (PEG)-coated and antibody-conjugated CNPs for the selective delivering to Aβ aggregates, and the protective effect against oxidative stress/Aβ-mediated neurodegeneration. In this study PEG-coated and anti-Aβ antibody-conjugated antioxidant nanoparticles (Aβ-CNPs-PEG) were developed, and their effects on neuronal survival and brain-derived neurotrophic factor (BDNF) signaling pathway were examined. Aβ-CNPs-PEG specifically targets the Aβ aggregates, and concomitant rescue of neuronal survival better than Aβ-CNPs, by modulating the BDNF signaling pathway. This proof of concept work may allow in the future, once validated in vivo, for the selective delivery of CNPs only to affected brain areas. [Copyright &y& Elsevier]

Purpose: To evaluate the feasibility of sternoclavicular graft (SCG) as an adaptive center along with buccal fat pad (BFP) lining for temporomandibular joint (TMJ) reconstruction in TMJ ankylosis. Patients and Methods: A prospective, preliminary, short-term study with only 6 months'' follow-up was performed in 10 patients with TMJ ankylosis. All patients had complete osseous ankylosis, and the mean duration of ankylosis was 6.4 years (range, 3 to 13 years). Interpositional arthroplasty with SCG along with BFP lining was done in all cases. Postoperative clinical and radiographic follow-up was performed for 6 to 9 months. Results: Maximum interincisal opening at 6 months'' follow-up was 35.6 ± 4.97 mm (range, 31 to 45 mm). Similarly, protrusive movement at follow-up of 6 months was 2.7 ± 1.25 mm (range, 1.5 to 5.5 mm), whereas laterotrusive movement was 4.1 ± 1.98 mm (range, 1.5 to 7.0 mm) toward the affected side and 2.4 ± 0.99 mm (range, 1 to 4.0 mm) toward the normal side. After 3 months, 9 of 10 patients had no pain on function, and all the patients were relieved of pain at the end of 6 months. On radiographic follow-up at 9 months, there was noticeably significant adaptation and remodeling of SCG as observed on panoramic radiography and computed tomography scan. In all the patients there was some degree of mandibular deviation toward the operated side, although the occlusion was satisfactory and they were pleased with the outcome. Conclusion: On the basis of the findings of this study, we conclude that after release of TMJ ankylosis, reconstruction with SCG combined with interposition of BFP lining followed by vigorous physiotherapy is a successful strategy for the management of TMJ ankylosis with short-term follow-up of 6 months. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility and usefulness of buccal fat pad as an interpositional graft in the treatment of temporomandibular joint (TMJ) ankylosis. Materials and Methods: A retrospective study of 10 patients with TMJ ankylosis (9 unilateral and 1 bilateral) was performed with follow-up of 6 months to 2 years. Results: In the present study, patients had a maximum interincisal opening of 32 to 41 mm (mean, 35.1 mm) at the latest follow-up. Mean deviation to the affected side on mouth opening was 1.6 mm (range, 0 to 4 mm), but chewing function was good and all the patients were satisfied. No major occlusal changes were observed and all the patients had satisfactory occlusion at the follow-up periods. No facial paresis of temporal and zygomatic branch of facial nerve was observed in any case. Periodic panoramic radiographs showed well-maintained intra-articular space because of the interposed tissue, with no signs of relapse. Conclusion: The findings of this study showed the short-term successful management of TMJ ankylosis using buccal fat pad as an interpositional graft. [ABSTRACT FROM AUTHOR]

Purpose: We propose a new classification of subcondylar fractures of the mandible based on ramal height shortening and degree of fracture angulation and present our treatment experience using this classification system. Patients and Methods: Eighty patients with subcondylar fractures of the mandible were evaluated. We categorized the fractures into 3 classes: Class 1 (minimally displaced), fracture with ramal height shortening: <2 mm and/or degree of fracture displacement: <10°; Class 2 (moderately displaced), fracture with ramal height shortening: 2 to 15 mm and/or degree of fracture displacement: 10 to 35°; Class 3 (severely displaced), fracture with ramal height shortening: >15 mm and/or degree of fracture displacement: >35°. Our treatment protocol is closed treatment for Class 1 fractures; either closed or open treatment for Class 2 fractures; and open treatment for Class 3 fractures. Results: Among 80 patients, 20 had Class 1 fractures (25%), 40 had Class 2 fractures (50%), and 20 had Class 3 fractures (25%). In Class 2 fractures, 22 patients were managed by closed treatment (Class 2a) and 18 by open treatment (Class 2b). No statistically significant differences were found between the 3 classes in terms of functional outcome, while, within Class 2 patients, significantly (P = .00) better functional results were observed in open (Class 2b) group compared with closed group (Class 2a). Conclusions: Our new classification based on ramal height shortening and degree of fracture displacement can better guide clinical treatment. Class 1 fractures are treated by closed method, while open reduction is recommended in Class 2 and Class 3 cases. [ABSTRACT FROM AUTHOR]

Abstract: This study proposes boron nitride nanotube (BNNT) reinforced hydroxyapatite (HA) as a novel composite material for orthopedic implant applications. The spark plasma sintered (SPS) composite structure shows higher density compared to HA. Minimal lattice mismatch between HA and BNNT leads to coherent bonding and strong interface. HA-4 wt% BNNT composite offers excellent mechanical properties—120% increment in elastic modulus, 129% higher hardness and 86% more fracture toughness, as compared to HA. Improvements in the hardness and fracture toughness are related to grain refinement and crack bridging by BNNTs. HA–BNNT composite also shows 75% improvement in the wear resistance. The wear morphology suggests localized plastic deformation supported by the sliding of outer walls of BNNT. Osteoblast proliferation and cell viability show no adverse effect of BNNT addition. HA–BNNT composite is, thus, envisioned as a potential material for stronger orthopedic implants. [ABSTRACT FROM AUTHOR]

Purpose: To compare open reduction and internal fixation with closed treatment and maxillomandibular fixation for the management of subcondylar fractures of the mandible. Patients and Methods: Forty patients with subcondylar fractures of the mandible were evaluated. All fractures were displaced; either angulated between 10° and 35° or the ascending ramus was shortened by more than 2 mm. Clinical and radiographic evaluation was performed 6 months after the trauma. Clinical parameters included mouth opening, protrusion, laterotrusion, deviation on mouth opening, and occlusion. Radiographic parameters included level of the fracture, deviation of the fragment, and shortening of the ascending ramus. Subjective parameters included pain according to a visual analog scale. Nonparametric data were compared for statistical significance with a χ2 analysis and parametric data with an independent samples t test (P < .05). Results: Correct anatomical position of the fragments was achieved significantly more accurately in the operative group in contrast to the closed treatment group. Regarding mouth opening/lateral excursion/protrusion, significant (P = .00) differences were observed between both groups (open 39.6/12.5/5.9 mm vs closed 33.5/9.8/4.1 mm). The visual analog scoring revealed significant (P = .00) difference with less pain in the operative treatment group (1.1 open vs 5.2 closed). No statistically significant difference was found between the 2 groups for occlusion (P = .86). Conclusion: Both treatment options for condylar fractures of the mandible yielded acceptable results. However, operative treatment was superior in all objective and subjective functional parameters except occlusion. [Copyright &y& Elsevier]

There is controversy regarding the inclusion of granulocyte colony stimulating factor (G-CSF) in the treatment of decompensated cirrhosis. Previous studies tested only a single cycle of G-CSF administration or were underpowered to detect changes in survival time. We performed an adequately powered study to determine whether multiple cycles of G-CSF increased the survival of patients 1 year after the start of therapy. We conducted an open-label trial of 100 patients with decompensated cirrhosis without acute-on-chronic liver failure at a tertiary center from July 2016 through June 2018. The patients were assigned randomly to a group given 5 days of G-CSF every 3 months, with standard medical therapy, in 4 cycles (group A, n = 50), or standard medical therapy alone (group B, n = 50). The primary outcome was survival for 12 months after treatment began. Secondary outcomes were an increase in the number of CD34+ cells at day 6 compared with day 0, along with reductions in Child–Turcotte–Pugh and model for end-stage liver disease scores, increased control of ascites, reduced decompensation and episodes of infection, fewer hospitalizations, lower liver stiffness measurements, increased quality of life and nutrition, fulfilment of liver transplant criteria, and fewer adverse events at 12 months after the start of treatment. Groups A and B were comparable at baseline. Survival at 12 months after initiation of treatment was significantly higher in group A (74%) than in group B (42%) (P <.001). Blood samples from patients in group A had significantly more CD34+ cells on day 6 than on day 0 (P <.001); there was no significant change in group B. Compared with patients in group B, patients in group A had significant reductions in Child–Turcotte–Pugh and model for end-stage liver disease scores, increased ascites control, fewer infections and hospitalizations, lower liver stiffness measurements, an increased quality of life, and a lower number fulfilled the liver transplant criteria (P <.05). There was no improvement in nutrition in either group compared with baseline. G-CSF was safe and well tolerated. Administration of multiple cycles of G-CSF increases the numbers of hematopoietic stem cells and survival of patients with decompensated cirrhosis receiving standard medical treatment. The addition of G-CSF to medical treatment might provide a bridge to liver transplantation for these patients. ClincialTrials.gov no: NCT03415698. [ABSTRACT FROM AUTHOR]

Abstract: A parotid fistula is a rare, extremely unpleasant disease. It may be due to chronic pathologies of the facial soft tissues, trauma (tangential injury to face), infection or congenital. Various treatment modalities including surgical and conservative management are present to treat this disease. Conservative management plays a vital role in patients who are systemically compromised and unfit for surgery. In the present case report an alternative conservative technique of parotid fistula management has been described in a 28-year-old girl who was severe anemic with parotid fistula since last 25 yrs. [Copyright &y& Elsevier]

Abstract: We describe the case of a large unilocular cystic lesion in a young patient in the body–ramus region extending up to the coronoid process of the mandible that was removed via sagittal split of the mandible. The benefits of the approach as compared with other surgical approaches for the management of such lesions were also discussed. This article shows that the sagittal split osteotomy continues to have a valuable role in the removal of various cysts, benign tumors and deeply impacted lower third molars, particularly when they are in high ramal region and in close proximity to the inferior alveolar nerve. [Copyright &y& Elsevier]

Abstract: Aim: To compare open reduction and internal fixation (ORIF) with closed treatment and maxillomandibular fixation (CRMMF) for management of bilateral subcondylar fractures of the mandible. Patients and methods: This study involved a retrospective analysis of bilateral subcondylar fractures of the mandible treated at Government Dental College, Rohtak from 2007 to 2010. Data were collected by a review of pertinent inpatient and outpatient clinic records, and radiographic results. Patients were followed up weekly for 4 weeks and then at 2, 3 and 6 months after surgery. At these visits, careful attention was paid to clinical parameters included mouth opening, protrusion, laterotrusion, deviation on mouth opening and occlusion. Results: The patient sample ranged in age from 19 to 55 years, with an average age of 28.2 years. In total, 44 patients with 88 mandibular subcondylar fractures were included in the study. Out of these, 20 patients were managed by closed treatment and 24 by ORIF of the subcondylar fractures (19 unilateral and 5 bilateral). Regarding mouth opening/lateral excursion/protrusion, significant (p =0.00) differences were observed between both groups (open 37.6/11.5/5.9mm versus closed 31.5/7.8/3.1mm). The visual analogue scoring revealed significant (p =0.00) difference with less pain in the operative treatment group (1.3 open versus 7.2 closed). Statistically significant difference was found between two groups for occlusion (p =0.00). Conclusion: The current retrospective study shows that operative treatment was superior in all objective and subjective functional parameters. It is concluded that if either of the condyles is displaced ORIF is the most satisfactory method of treatment. [Copyright &y& Elsevier]

Abstract: The melanotic neuroectodermal tumor of infancy (MNTI) is a rare childhood neoplasm with a classical clinical presentation. It appears as a rapidly enlarging pigmented mass in the upper jaw and can be easily mistaken for a malignant neoplasm. Although possessing an aggressive growth rate and radiographic appearance, the MNTI almost always behaves in a benign fashion and can be treated with local excision. However, few cases of malignant transformation and recurrences have been reported in literature and that makes follow-up very important. This paper describes two cases of MNTI with classical histological presentation. [Copyright &y& Elsevier]

Abstract: Oral myiasis is a rare pathology in humans with higher incidence in developing countries having hot climatic conditions. Most of the infestations are associated with various predisposing factors like poor oral hygiene, suppurative lesions, senility, alcoholism and debilitating conditions. The diagnosis is made basically by presence of larvae. This article deals with traumatic oral myiasis in healthy male and myiasis in mentally challenged female patient. The treatment consisted of manual removal of the larvae by topical application of turpentine oil and surgical debridement of the wound. [ABSTRACT FROM AUTHOR]

Background & Aims Bacterial infections are common and life-threatening in patients with cirrhosis. Little is known about the epidemiology of bacterial infections in different regions. We performed a multicenter prospective intercontinental study to assess the prevalence and outcomes of bacterial and fungal infections in patients with cirrhosis. Methods We collected data from 1302 hospitalized patients with cirrhosis and bacterial or fungal infections at 46 centers (15 in Asia, 15 in Europe, 11 in South America, and 5 in North America) from October 2015 through September 2016. We obtained demographic, clinical, microbiology, and treatment data at time of diagnosis of infection and during hospitalization. Patients were followed until death, liver transplantation, or discharge. Results The global prevalence of multidrug-resistant (MDR) bacteria was 34% (95% confidence interval 31%–37%). The prevalence of MDR bacteria differed significantly among geographic areas, with the greatest prevalence in Asia. Independent risk factors for infection with MDR bacteria were infection in Asia (particularly in India), use of antibiotics in the 3 months before hospitalization, prior health care exposure, and site of infection. Infections caused by MDR bacteria were associated with a lower rate of resolution of infection, a higher incidence of shock and new organ failures, and higher in-hospital mortality than those caused by non-MDR bacteria. Administration of adequate empirical antibiotic treatment was independently associated with improved in-hospital and 28-day survival. Conclusions In a worldwide study of hospitalized patients, we found a high prevalence of infection with MDR bacteria in patients with cirrhosis. Differences in the prevalence of MDR bacterial infections in different global regions indicate the need for different empirical antibiotic strategies in different continents and countries. While we await new antibiotics, effort should be made to decrease the spread of MDR bacteria in patients with cirrhosis. Graphical abstract [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to compare the effect of dexmedetomidine added to lidocaine against epinephrine added to lidocaine on local anesthetic potency and to look for future prospects of dexmedetomidine as an additive to local anesthesia in dentistry.Materials and Methods: The study included 25 healthy volunteers in whom extraction of all first premolars was scheduled as part of their orthodontic treatment plan. In this split-mouth, double-blind, crossover, randomized controlled trial, patients were randomized into 2 groups: Group 1 received injection lidocaine plus dexmedetomidine, and group 2 was administered lidocaine plus epinephrine. Patients were assessed for the onset of action of anesthesia, duration of analgesia, pain perception, and vital signs.Results: The mean values (±standard deviations) for the onset of anesthetic action in groups 1 and 2 were 113 ± 24.9 and 141 ± 34.8 seconds, respectively, for the mandible. For the maxilla, the mean values were 113 ± 24.9 seconds for group 1 and 165 ± 43.8 seconds for group 2. The duration of anesthesia was longer in group 1 (lidocaine plus dexmedetomidine), in which the requirement for the first analgesic on request was seen after a longer time interval, when compared with group 2 (lidocaine plus epinephrine). Pain perception elicited statistically significant results with less perception of pain in group 1 (lidocaine plus dexmedetomidine). The vital parameters remained stable, and the results were not statistically significant.Conclusions: In this study, we observed that the addition of dexmedetomidine to lidocaine for maxillary and mandibular nerve blocks significantly prolonged the block duration and shortened the onset of action, as well as improved postoperative analgesia in terms of the need for fewer analgesics in the postoperative period. Furthermore, the vital parameters remained stable and no complications were encountered. The findings were supportive of the use of dexmedetomidine as an adjunct to local anesthetics in dental procedures. [ABSTRACT FROM AUTHOR]

Background & Aims Patients with alcoholic hepatitis (AH) have high mortality, so new therapies are needed. Administration of granulocyte colony stimulating factor (G-CSF) increases survival times of patients with AH. It is not known whether addition of N-acetyl cysteine (NAC) to G-CSF could further increase survival time. We performed a randomized controlled pilot study to compare the efficacy of standard medical therapy with pentoxifylline to treatment with a combination of G-CSF and standard medical therapy as well as to the combination of NAC, G-CSF, and standard medical therapy in patients with severe AH. Methods We performed an open-label, single-center study of 57 patients with severe AH admitted to a Liver Intensive Care unit in India from October 2014 through March 2017. Patients were randomly assigned to groups that received standard medical therapy (with pentoxifylline) plus G-CSF for 5 days (G-CSF group; n = 18), standard medical therapy plus G-CSF and intravenous NAC for 5 days (combination group; n = 19), or standard medical therapy alone (n = 20). Clinical data and blood samples were collected at baseline; on day 6; and 1, 2, and 3 months after the study began. CD34+ cells were measured in blood samples collected on days 0 and 6. The primary outcome was proportion of patients surviving for 90 days. Secondary outcomes were mobilization of CD34+ cells at day 6, as well as Child Turcotte Pugh, model for end-stage liver disease, and modified discriminant function scores until day 90. Results Significantly higher proportions of patients in the G-CSF group (16/18) and the combination group (13/19) survived for 90 days than in the standard medical therapy group (6/20) (P =.0001 for G-CSF group and P =.037 and combination group). The GGSF and combination groups each had increased numbers of CD34+ cells from baseline until day 6, compared with the standard medical therapy group. The G-CSF group (but not the combination group) had significantly larger median reductions in modified discriminant function scores at study months 1 (reduction of 60.36%), 2 (reduction of 75.36%), and 3 (reduction of 88.73%) vs the standard medical therapy group (P =.02; P =.05; and P =.00, respectively). The G-CSF group had a significantly larger median reduction in model for end-stage liver disease score at 3 months (reduction of 55.77%; P =.01), but not in Child Turcotte Pugh score, compared with the standard medical therapy group. All groups had similar numbers of complications. Conclusion In a pilot randomized controlled trial, we found administration of G-CSF to improve liver function and increase survival times in patients with severe AH, compared with standard therapy. We found no evidence for benefit of adding NAC to G-CSF. These findings require confirmation in larger trials. ClincialTrials.gov , number: NCT02971306. [ABSTRACT FROM AUTHOR]

Tubercular osteomyelitis of midfacial bones is extremely rare, although tuberculosis of long bones and the vertebral column is not uncommon. Because of the rare incidence, myriad presentation, and lack of specific symptoms, this condition presents a challenge in diagnosis and calls for acute clinical awareness. This article presents a case report of a 12-year-old girl with complaints of gradually increasing swelling lateral to and below her right eye for 4 months with pus discharge. She was treated with surgical curettage and 4-drug antitubercular therapy and responded with complete remission of the sinus. [ABSTRACT FROM AUTHOR]

All cut flowers are destined to die, and the challenge for post harvest researchers is to slow the processes controlling flower death to enable cut flowers to reach distant markets with a display life. An experiment was carried out to study the effect of nitric oxide (NO), provided through sodium nitroprusside (SNP; 100 ppm L −1 ) on physiology and vase life of cut flowers of Gladiolus grandiflora variety “Snow Princess”. The vase solution having SNP showed significant increment in cumulative uptake of vase solution by flower spikes as compared to control and improved vase life. The level of lipid peroxidation, lipoxygenase (LOX) and protease activity was lower while the activity of superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX) and membrane stability was improved in SNP treated florat/spike. Moreover, the expression of senescence associated genes (SAGs) viz ., GgCyP1 was downregulated, while, GgDAD1 expression was up-regulated in SNP treated spikes. Finding of the study suggested that the application of SNP increases vase life by increasing the scavenging mechanism of reactive oxygen species (ROS) in terms of antioxidants activity, membrane stability and down-regulation of GgCyP1 expression in gladiolus cut flowers. [ABSTRACT FROM AUTHOR]

Abstract: Since 2003 India has been actively promoting the cultivation of Jatropha on unproductive and degraded lands (wastelands) for the production of biodiesel suitable as transportation fuel. In this paper the life cycle energy balance, global warming potential, acidification potential, eutrophication potential and land use impact on ecosystem quality is evaluated for a small scale, low-input Jatropha biodiesel system established on wasteland in rural India. In addition to the life cycle assessment of the case at hand, the environmental performance of the same system expanded with a biogas installation digesting seed cake was quantified. The environmental impacts were compared to the life cycle impacts of a fossil fuel reference system delivering the same amount of products and functions as the Jatropha biodiesel system under research. The results show that the production and use of Jatropha biodiesel triggers an 82% decrease in non-renewable energy requirement (Net Energy Ratio, NER=1.85) and a 55% reduction in global warming potential (GWP) compared to the reference fossil-fuel based system. However, there is an increase in acidification (49%) and eutrophication (430%) from the Jatropha system relative to the reference case. Although adding biogas production to the system boosts the energy efficiency of the system (NER=3.40), the GWP reduction would not increase (51%) due to additional CH4 emissions. For the land use impact, Jatropha improved the structural ecosystem quality when planted on wasteland, but reduced the functional ecosystem quality. Fertilizer application (mainly N) is an important contributor to most negative impact categories. Optimizing fertilization, agronomic practices and genetics are the major system improvement options. [ABSTRACT FROM AUTHOR]