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The aim of this study is to present a case of facial asymmetry secondary to unilateral long-standing temporomandibular joint (TMJ) ankylosis managed by a staged treatment protocol. Treatment for facial asymmetry secondary to unilateral TMJ ankylosis can have varied approaches followed by different workers according to their experiences. This predistraction arthroplasty versus prearthroplastic distraction debate has been at the center stage in literature for quite some time. Hereby, we present a case followed by the latter approach along with double-sliding genioplasty to correct chin asymmetry. A 25-year-old male patient with a history of facial trauma 15 years ago reported a complaint of inability to open mouth and gradually developing facial asymmetry. The patient was thoroughly evaluated using radiographs and cephalometric analysis to establish the diagnosis of TMJ ankylosis with facial asymmetry and suspected sleep apnea. The patient was treated according to our institutional protocol of prearthroplastic asymmetry correction followed by ankylosis release along with double-sliding genioplasty to correct residual deformity at a later date. Correction of facial asymmetry before ankylosis release provides a more evidence-based approach as supported by the current literature. Plus, any residual deformity can be rectified using orthomorphic procedures such as genioplasty. Since there is an ongoing debate in the current literature about sequencing in the treatment of facial asymmetry cases, the presented case adds to the argument that the approach followed herein provides for more favorable outcome., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 National Journal of Maxillofacial Surgery.)

Plasmepsin V (Plm V) is an essential aspartic protease required for survival of the malaria parasite, Plasmodium falciparum (Pf) . Plm V is required for cleaving the PEXEL motifs of many Pf proteins and its inhibition leads to a knockout effect, indicating its suitability as potential drug target. To decipher new inhibitors of Pf Plm V, molecular docking of four HIV-1 protease inhibitors active against Pf PlmV was performed on Glide module of Schrödinger suite that supported saquinavir as a lead drug, and therefore, selected as a control. Saquinavir contains an important hydroxyethylamine (HEA) pharmacophore, which was utilized as backbone coupled with piperazine scaffold to build new library of compounds. Newly designed HEA compounds were screened virtually against Plm V. Molecular docking led to a few hits ( 1 and 3 ) with higher docking score over the control drug. Notably, compound 1 showed the highest docking score (-11.90 kcal/mol) and XP Gscore (-11.948 kcal/mol). The Prime MMGBSA binding free energy for compound 1 (-60.88 kcal/mol) and 3 (-50.96 kcal/mol) was higher than saquinavir (-37.51 kcal/mol). The binding free energy for the last frame of molecular dynamic simulation supported compound 1 (-92.88 kcal/mol) as potent inhibitor of Pf Plm V over saquinavir (-72.77 kcal/mol), and thus, deserves experimental validations in culture and subsequently in animal models.Communicated by Ramaswamy H. Sarma.

Introduction: Blunt trauma to the orbital rim is a frequent cause of both orbital fractures and damage to the surrounding facial bones and soft tissues. The inception of endoscopy and minimal invasive intervention has revolutionized the surgical treatment of blow out fracture of orbital walls. Thus, the present study was conducted to compare the outcome of conventional open reduction approach with endoscopic approach for orbital floor repair., Materials and Method: The study included 10 patients with clinical and radiographic evidence of orbital floor fracture, divided randomly into two groups: Group I-operated using endoscopic approach; and Group II- operated using conventional external approach. All the patients were evaluated clinically preoperatively, immediate post-operative and after 1 month for Diplopia, Extrinsic ocular motility, Enophthalmos and Hypoglobus., Results: The study consisted of 40% females and 60% males, with mean age of Endoscopic and Conventional group being 27.20 ± 6.14 years and 27.60 ± 7.23 years respectively. In relation to diplopia, an insignificant difference was observed statistically. The mean change in enophthalmos and hypoglobus in endoscopic and conventional group showed a significant difference statistically (p < 0.001). Unrestricted ocular motility was present only in one case of each group and significantly increased to 5 cases in both the groups (p = 0.048). The mean duration of surgery in endoscopic and conventional group showed a significant difference statistically., Conclusion: Diplopia, hypoglobus and Enophthalmos correction was better achieved in endoscopic group as compared to conventional group. But duration of surgery was more in endoscopic group as compared to conventional group., (© 2022 Craniofacial Research Foundation. Published by Elsevier B.V. All rights reserved.)

Oral squamous cell carcinoma (OSCC) is a major form of oral malignant tumors (oral cancer) with less than 50% five year survival rate. Its pathogenesis involves dysregulation in apoptosis. Early dysregulation at molecular level could not be correlated with clinical presentations because of complex interactions at molecular levels. HSP70 (Heat shock Protein 70) and BCL2 (B cell lymphoma 2) are known molecular players in oncogenesis. However, their interaction is not known till date. Expression analyses of BCL2 and HSP70 was done through Enzyme Linked Immunosorbent Assay (ELISA) and Bioinformatic tools using blood samples from 41 OSCC, 35 Oral Potentially Premalignant Disorders (OPMD) and 4 controls in BCL2 study and 48 OSCC and 32 OPMD cases in HSP70 study. Bioinformatic software showed experimentally determined interaction value of 0.32 amongst the two, predicting similarity in molecular functions or pathways between the two, which was confirmed by ELISA. Our data showed that first HSP70 boosts BCL2 while in later stages of oncogenesis BCL2 consumes HSP70. Both molecules interact at several steps by complementing and supplementing each other. Because of this complex interaction various anti BCL2 therapies have not achieved desired results till date., Competing Interests: The authors declare that they have no conflict of interest., (© 2022 Craniofacial Research Foundation. Published by Elsevier B.V. All rights reserved.)

Background: Dysfunctional basic cognitions have been suggested as potential vulnerability markers for alcohol dependence (AD). Although there is a growing body of research on the role of distal cognitive vulnerability factors such as early maladaptive schema in the development of AD, little is known about the role of proximal cognitive factors such as cognitive distortions, dysfunctional attitude, and negative automatic thoughts., Methods: This comparative cross-sectional study aimed to examine dysfunctional cognitions in individuals with AD ( n = 84) in comparison with healthy individuals ( n = 60). The dysfunctional cognitions were assessed on the Young Schema Questionnaire third version of Short Form, Cognitive Distortion Scale, Dysfunctional Attitude Scale-Form A, and Automatic Thought Questionnaire. Multivariate analysis of covariance was conducted to analyze the group differences in dysfunctional cognitions., Results: After controlling for the group difference in employment status, 12 of 18 schemas were more prevalent in individuals with AD than in healthy individuals. Individuals with AD also scored higher on seven of 10 cognitive distortions, as well as in terms of dysfunctional attitude and negative automatic thoughts., Conclusion: Dysfunctional cognition may play a significant role in developing AD. The findings may enhance our understanding of the nature and severity of dysfunctional cognitions in the development of AD. The information may further assist the clinicians in implementing adequate intervention strategies to manage dysfunctional cognitions in individuals with AD., Competing Interests: Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2022 Indian Psychiatric Society - South Zonal Branch.)

Objectives: To compare and evaluate the modified tragus edge approach (MTEA) with retromandibular approach for surgical access to mid-level or low-level mandibular condylar fractures., Materials and Methods: This study comprised of 22 patients with mid-level or low-level condylar fracture. Patients with clinical and radiological evidence of mid-level or low-level condylar fracture are included only in this study. Patients were randomly divided into two groups: group A includes 11 patients, in which modified tragus edge approach was used, and group B includes 11 patients treated with retromandibular approach. Patients were evaluated clinically after first week, second week, fourth week, third month, and sixth month radiographically., Results: The mean age of the study subjects in group A was 32.45 ± 8.98 years, while in group B, the mean age was 26.91 ± 5.79 years. Post-operatively, no significant difference was seen in relation to pain, occlusal relationship, mouth opening, and deviation of jaw during opening and closing movements. In terms of post-operative complication, only significant difference found between two groups is post-operative scar visibility, which is higher in retromandibular incision group as compared to MTEA., Conclusion: Thus, we can conclude that MTEA provides ease of operation as a good exposure of mandibular mid- or low-level condylar fracture as retromandibular approach but with less visibility of post-operative scar as compared to retromandibular approach., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Association of Oral and Maxillofacial Surgeons of India 2020.)

Government programs supporting self help groups (SHGs) generally target women on the assumption that doing so enhances women's decision-making. The empirical evidence, however, is mixed. We advance and test one explanation: the loan amounts offered by most SHGs may be too small to impact women. Our analysis is based on SHGs developed under India's National Rural Livelihoods Mission, a program that supported both small loans from internal savings and larger loans through Community Investment Funds (CIFs). Exploiting variation in their phasing and amount, we document a large effect of CIFs on women's decision-making and on intra-household allocations., (© 2022 The Authors.)

Aim: The primary objective was to assess set-up errors (SE) and secondary objective was to determine optimal safety margin (SM)., Background: To evaluate the SE and its impact on the SM utilizing electronic portal imaging (EPI) for pelvic conformal radiotherapy., Material and Methods: 20 cervical cancer patients were enrolled in this prospective study. Supine position with ankle and knee rest was used during CT simulation. The contouring was done using consensus guideline for intact uterus. 50 Gy in 25 fractions were delivered at the isocenter with ≥95% PTV coverage. Two orthogonal (Anterior and Lateral) digitally reconstructed radiograph (DRR) was constructed as a reference image. The pair of orthogonal [Anterior-Posterior and Right Lateral] single exposure EPIs during radiation was taken. The reference DRR and EPIs were compared for shifts, and SE was calculated in the X-axis, Y-axis, and Z-axis directions., Results: 320 images (40 DRRs and 280 EPIs) were assessed. The systematic error in the Z-axis (AP EPI), X-axis (AP EPI), and Y-axis (Lat EPI) ranged from -12.0 to 11.8 mm, -10.3 to 7.5 mm, and -8.50 to 9.70 mm, while the random error ranged from 1.60 to 6.15 mm, 0.59 to 4.93 mm, and 1.02 to -4.35 mm. The SM computed were 7.07, 6.36, and 7.79 mm in the Y-axis, X-axis, and Z-axis by Van Herk's equation, and 6.0, 5.51, and 6.74 mm by Stroom's equation., Conclusion: The computed SE helps defining SM, and it may differ between institutions. In our study, the calculated SM was approximately 8 mm in the Z-axis, 7 mm in X and Y axis for pelvic conformal radiotherapy., (© 2020 Greater Poland Cancer Centre. Published by Elsevier B.V. All rights reserved.)

Background: Children are uniquely susceptible to craniofacial trauma because of their greater cranial mass-to-body ratio. The craniofacial injuries comprise approximately 11.3% of an overall pediatric emergency, and its etiology affects the incidence, clinical presentation, and treatment modalities, which are influenced by sociodemographic, economic, and cultural factor of the population being studied., Materials and Methods: A retrospective review to analyze the epidemiology of facial injuries in pediatric population (age range-0-16 years), divided into three age groups, i.e., group I (0-5 years), group II (6-11 years) and group III (12-16 years), was carried out over a 3-year span, in order to determine the facial injury pattern, mechanism and concomitant injury by age., Results: A total of 1,221 patients with facial injuries, reporting to our trauma center and outpatient department were identified. Majority of these injuries were encountered among boys (64%). Motor vehicle collision (46.5%) was the most common cause of facial fracture and dentoalveolar injuries in group II and group III, while fall was the most common cause among the group I (30.2%). Mandible was the most commonly fractured bone (34.7%) followed by nasal (33.3%), maxilla (17.5%), and zygoma (14.3%). More than 50% sustained concomitant injuries., Conclusion: The importance of epidemiological analysis lies in the identification of trauma burden, which could help motivate and develop more efficient ways to plan resources allocation and deliver adequate care and preventive steps. Improvisation upon National Prevention Programs could lower incidences of such injuries., How to Cite This Article: Bhutia DP, Singh G, Mohammed S, et al. Prevalence and Etiology of Pediatric Maxillofacial Injuries: A Unicenter-based Retrospective Study. Int J Clin Pediatr Dent 2019;12(6):528-531., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.)

Purpose: The purpose of the study was to qualitatively and quantitatively assess bone regeneration potential of tentpole technique using beta tricalcium phosphate bone graft in vertically deficient alveolar ridges., Materials and Method: This prospective study comprised of 20 patients with vertically deficient alveolar ridges, wherein thirty one implants were placed. Tenting of the soft tissue matrix was done using titanium screws and beta tricalcium phosphate synthetic bone graft was filled in the vertical defect. Clinical and radiographic assessment was done at 1, 3 and 6 months. Preoperative biochemical analysis of Osteopontin and RANKL was done and then reassesed at 3 months postoperative. Bone core collected at 6 postoperative months, while removal of screw, was analysed histologically., Results: A significant gain in bone height of 2.87 ± 0.79 mm was seen at 6 months postoperative. All implants osseointegrated. Loosening of screw was seen in two patients.There was no postoperative wound dehiscence. Histologic analysis revealed new bone formation .There was no significant change in the levels of RANKL and Osteopontin at 3 months postoperative., Conclusion: This is a safe and effective technique for bone regeneration in vertically deficient alveolar ridges and has minimal complications. The regenerated bone has new and viable bone content and supports implant material. More studies with long term follow up are needed to assess the stability of bone after long term loading.

Introduction: The term oro-antral fistula is understood to mean of fistular canal covered with epithelia which may or may not be filled with granulation tissue or polyposis of the sinus mucous membrane. With the presence of a fistula the sinus is permanently open, which enables the passage of microbial flora of the oral cavity into the maxillary sinus and the occurrence of inflammation with all possible consequences. Every now and then various researchers have proposed innumerable techniques to treat this defect. Starting from simple tissue flaps to autogenous grafts to alloplastic materials, an array of procedures have been evaluated in literature but the most promising technique still needs to be evaluated. Consequently, after reviewing an array of such procedures, our present study focussed on a new technique for the closer of oro-antral fistulas using autogenous auricular cartilage graft supported by buccal advancement flap., Material and Method: A total of 20 patients of oro-antral fistula were included in the study and after excising the fistular tract a double layer closure was done by placing auricular cartilage over the defect followed by buccal mucoperiosteal flap. The graft was harvested using posterior auricular approach. Assessment of patients was done at the end of 1 week, 3 weeks, 6 weeks, and 3 months., Conclusion: We found that the autogenous auricular cartilage graft is an effective sealing material in oro-antral fistula closure. We recommend this technique for the defect size ≤10 mm 2 in which future dental implant placement is sought as it allows easy sinus lifting procedure.

Piriformospora indica biomass generated in different growth media Rose Bengal medium, Kaefer's Medium, Enriched Soil Medium, Malt extract Medium and Czapek Dox was quantified and? their bioinoculum potential was compared using? moong bean (Vigna radiata) as? test plant. Plant chlorophyll content in response to inoculations was lowest in Rose Bengal medium (2.772mg plant-1) and highest due to inoculum produced on Enriched soil Medium (3.694 mg plant-1). The highest nitrogen content (19.260 mg plant-1) was recorded by inoculum produced on Kaefer's Medium followed by Enriched Soil Medium (19.123 mg plant-1), ME (18.19 mg plant-1) and CD medium (17.71 mg plant-1). The highest plant phosphorus uptake was registered in Enriched Soil Medium (17.153 mg plant-1) followed by Kaefer's Medium (17.023 mg plant-1). Maximum dry weight of plants was observed by inoculation with fungus cultured in Kaefer's Medium (3.416 g pot-1) and Enriched Soil Medium (3.349 g pot-1). Thus, growth medium used for the culture of fungus can influence its bioefficacy as plant growth promoting agent and Piriformospora indica can be grown on cost effective and simple mass multiplication medium which could augment its usage for commercial purposes.

Elevated serum uric acid (SUA) or urate is associated with inflammation and gout. Recent evidence has linked urate to cancers, but little is known about urate effects in prostate cancer. Activins are inflammatory cytokines and negative growth regulators in the prostate. A hallmark of prostate cancer progression is activin insensitivity; however, mechanisms underlying this are unclear. We propose that elevated SUA is associated with prostate cancer counteracting the growth inhibitory effects of activins. The expression of activins A and B, urate transporter GLUT9 and tissue urate levels were examined in human prostate disease. Intracellular and secreted urate and GLUT9 expression were assessed in human prostate cancer cell lines. Furthermore, the effects of urate and probenecid, a known urate transport inhibitor, were determined in combination with activin A. Activin A expression was increased in low-grade prostate cancer, whereas activin B expression was reduced in high-grade prostate cancer. Intracellular urate levels decreased in all prostate pathologies, while GLUT9 expression decreased in benign prostatic hyperplasia, prostatitis and high-grade prostate cancer. Activin responsive LNCaP cells had higher intracellular and lower secreted urate levels than activin-insensitive PC3 cells. GLUT9 expression in prostate cancer cells was progressively lower than in prostate epithelial cells. Elevated extracellular urate was growth promoting in vitro, which was abolished by the gout medication probenecid, and it antagonized the growth inhibitory effects of activins. This study shows for the first time that a change in plasma or intracellular urate levels, possibly involving GLUT9 and a urate efflux transporter, has an impact on prostate cancer cell growth, and that lowering SUA levels in prostate cancer is likely to be therapeutically beneficial.

Context: Guidelines on the use of prophylaxis in venous thromboembolism (VTE) are poorly implemented in clinical practice., Objective: To evaluate the extent to which the American College of Chest Physicians (ACCP) 2001 guidelines on VTE prophylaxis are adhered to in clinical practice by determining whether patients admitted to a medical center with an objective diagnosis of VTE had received adequate prophylaxis., Methods: The medical records of medical and surgery patients with an objective diagnosis of VTE were reviewed. Patients were classified as having either preventable or nonpreventable VTE according to indication for prophylaxis, VTE risk, and adequacy of prophylaxis if administered. Adequacy was determined by adherence to the ACCP 2001 guidelines., Results: Of 44 patients, 17 (38.6%) had not received adequate prophylaxis and were classified as having potentially preventable VTE. Venous thromboembolism developed in the remaining 27 (61.4%) patients despite adequate prophylaxis. In general, adequate prophylaxis rates were lower among surgery patients compared with medical patients. Four (80%) of the very-high-risk surgery patients received inadequate prophylaxis. The most common VTE risk factor in both categories was immobility., Conclusions: Adherence to the ACCP guidelines is suboptimal, with a substantial proportion of patients with VTE receiving inadequate prophylaxis. The additional finding that the incidence of VTE is high despite adequate prophylaxis indicates that the guidelines may need to be reevaluated.

A Cl- and NO3- insensitive oxalate oxidase, purified from the roots of 10-day old seedlings of grain Sorghum has been immobilized on polyvinyl alcohol (PVA) membrane through entrapment with 96.07% retention of initial activity. The membrane bound enzyme showed an increase in optimum pH (from 5.0 to 6.5), time of incubation (from 5 to 10 min) and Km for oxalate (from 0.38 to 6.23 mM), but decrease in incubation temperature for maximum activity (from 37 to 30 degrees C) and Vmax (from 70 nmol/min/ml to 9.7 nmol H2O2/min) and was unaffected by Cl- and NO3. The membrane bound enzyme lost 50% of its initial activity after 30 days of storage at room temperature. The use of membrane bound oxalate oxidase in determination of serum oxalate of urinary stone patients is demonstrated.

Background: Prenatal karyotyping using foetal blood samples obtained by cordocentesis is a useful method of detecting abnormal chromosomes in the foetus., Methods: Cordocentesis was performed in 187 cases for prenatal karyotyping between January 1995 and September 2000. Pregnant women were between 18 and 38 weeks of gestation and their ages ranged from 18 to 40 years. The common indications were ultrasonographic abnormalities (47.6%), history of previous Down syndrome (13.3%), advanced maternal age (11.7%), low maternal serum alpha foetoprotein levels (10.7%), previous child with malformation (10.7%), previous child with trisomy (chromosome 13/18) (2.6%), parent a balanced translocation carrier (1.6%) and high maternal serum alpha foetoprotein levels (1.6%)., Results: Analysis of 137 successful cultures showed 8 (5.2%) karyotype abnormalities. The remaining samples could not be reported due to the presence of maternal contamination of the sample (12.3%), inadequate sample (6.4%) or culture failure (9.8%). In those with an abnormal karyotype, obstetric management could be altered appropriately., Conclusion: In foetuses at high risk of a chromosomal aberration, a rapidly obtained karyotype is helpful in obstetric management.