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This editorial is the outcome of my clinical, academic and research experience. With due respect to all stake holders, I wish to point out that mental health research has neglected this important aspect; namely, unqualified and untrained people administering and interpreting various rating scales and other assessment instruments. In this paper, I discuss why this issue is so important, and suggest what authorities, especially journal editors could do.

Introduction: The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. Aim: To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars. Materials and Methods: Twenty five patients with bilaterally symmetrical impacted mandibular third molars requiring surgical removal under local anesthesia were selected for the controlled clinical study. The third molar sites of all patients enrolled in the trial were randomly assigned into 2 groups: Local Anesthesia (Lignocaine) Alone [LAA] and Local Anesthesia plus ketamine [LAK]. 5ml of local anesthetic (Lignocaine Hydrochloride 2% with epinephrine 1:100,000) was injected in the ‘LAA’ group while the ‘LAK’ group received 5ml of local anesthetic plus 0.2mg/kg ketamine. Patients were blinded to the solution used and the operator recorded the group (LAA or LAK) and the respective site (Right or Left) for analysis. Bilaterally symmetrical impacted mandibular molars were removed at an interval of 15 days. Results: Facial swelling on post-operative days was significantly lower in the LAK group than in the LAA group (p

Clinical tools to guide in the appropriate treatment selection in immunoglobulin light chain (AL) amyloidosis are not well developed. We evaluated the response and outcome for various regimens at first-line treatment (n=681) and first progression (n=240) stratified by the immunoparesis status at diagnosis. Immunoparesis was assessed by the average relative difference of the uninvolved immunoglobulins, classifying patients into a negative average relative difference (i.e. significant immunoparesis) or a positive average relative difference (no/modest immunoparesis). Treatment was categorized as autologous stem cell transplant and four non-transplant regimens (melphalan-based; bortezomib-based, immunomodulatory drug-based and dexamethasone alone). Patients with significant immunoparesis who underwent stem cell transplant had a significantly lower rate of very good partial response or better response (58%), progression-free survival (median 30 months) and overall survival (108 months), compared to those without significant immunoparesis (80%, 127 months, median not reached, respectively; P

Introduction- BMI can be used to estimate the prevalence of overweight and obesity within a population. It does not, however, account for the wide variations in obesity between different individuals and populations. BMI may not correspond to the same degree of fatness in different populations due to differences in body proportions. Material and Methods- This was a cross sectional study. The subjects were 232 pre final MBBS students. It was double stage cluster sampling. The students calculated BMI, waist circumference, Waist hip ratio and Calorie consumption of their own. Results- Mean Waist circumference (Male= 84.76, 7.646 SD; Female= 79.37, 9.343 SD) and waist hip ratio( male=0.880,0.055SD; Female=0.819, 0.067) were below cut off line. Calorie intake as per Indian standard was poor (Male=2098.5. 503.78SD; Female=1759.2, 362.90SD). Females were having increased risk and substantial increased risk of metabolic disorders as per waist circumference measurement (P>0.001, P>0.001). Males were more at risk as per waist hip ratio (P>0.001). At the BMI of pre-obese category, the female waist circumference was higher than cut off value (86.37 cm). Sensitivity found to be highest for waist hip ratio (28%). Conclusion- The WHR truly finding out the abdominal obesity.

Background: Travelers play a significant role in the spread of infectious diseases across international borders, through their travel patterns and behaviors. This study was conducted to assess the Knowledge, Attitude and Practices regarding travel vaccine among medical students and doctor. Materials and Methods: A cross-sectional study was conducted at SAMC & PGI, Indore from July to September 2015 using quantitative method of data collection among 114 medical student and doctors. Result: The mean age of the respondents was 27.85 years with 68 (59.65%) males and 46 (40.35%) female respondents. 21(18.42 %) participants are married and 93 (81.58 %) are single. 88.60 % of the respondents were aware of the concept of travel vaccines while 88.33 % of the respondents could give correct definition of travel vaccine. Knowledge regarding travel vaccine was found to have improved the uptake of travel vaccine (P = 0.04). Conclusion: The study shows that as the knowledge improves the uptake of travel vaccine increases significantly.

Circulating tumor cells (CTCs) demonstrated the potential as prognostic markers of metastatic development. However, the incurable metastasis can already be developed at the time of initial diagnosis with the existing CTC assays. Alternatively, tumor-associated particles (CTPs) including exosomes can be a more valuable prognostic marker because they can be released from the primary tumor long before CTCs and in larger amount. However, little progress has been made in high sensitivity detection of CTPs, especially in vivo. We show here that in vivo integrated photoacoustic (PA) and fluorescence flow cytometry (PAFFC) platform can provide the detection of melanoma and breast-cancer-associated single CTPs with endogenously expressed melanin and genetically engineered proteins or exogenous dyes as PA and fluorescent contrast agents. The two-beam, time-of-light PAFFC can measure the sizes of CTCs and CTPs and identify bulk and rolling CTCs and CTC clusters, with no influence on blood flow instability. This technique revealed a higher concentration of CTPs than CTCs at an early cancer stage. Because a single tumor cell can release many CTPs and in vivo PAFFC can examine the whole blood volume, PAFFC diagnostic platform has the potential to dramatically improve (up to 105-fold) the sensitivity of cancer diagnosis.

Background: The economic costs and proportion of disease burden attributable to mental, emotional and behavioural disorders (MEBs) is enormous. This emphasizes on the need for treating the MEBs. Choosing the most cost effective intervention is the key aspect in planning mental health services. Objective: The aim of the present article is to review the studies on cost-effective interventions for MEBs. Methodology: A review of various studies on the above subject was done using Google Scholar and PubMed. Results: Most of these studies are from developed countries. Many of them are conducted by World Health Organization (WHO). There is paucity of data on cost-effectiveness of interventions in the developing world. There are cost-effective interventions available for most of the MEBs. Conclusions: There are cost-effective interventions for MEBs. The available cost-effective strategies need to be incorporated with necessary modifications to tailor to the local needs. Proper planning is crucial for successful approach to mental health. Prevention is the most cost-effective strategy.

This is one among a series of editorials related to ethics in publication. The present editorial deals with a key issue of the declaration of conflicts of interest (COI), which all stake holders, especially authors should be aware of. Such issues are now mandatory ethical requirements and not just for name sake. Broadly speaking, COI comes into existence when someone's position may be influenced by his vested interests. World Association of Medical Editors (WAME) says ‘journals have a responsibility to raise awareness and educate the research community about COI.’

Antiepileptic drugs (AEDs) are increasingly being used for psychiatric indications. Few of them have FDA approval, while many others are used off-label. The objective of this article is to give an overview of the use of newer AEDs in the treatment of psychiatric disorders.

Background: Mental health is not a priority area for policy makers even today. Objective: The objective of the present review is to sensitize policy makers regarding the importance of investing in mental health. Appraising the policy makers about the costs of mental illness and the negative economic consequences of poor investment in mental health on the society are the aims. Methodology: A review of various studies on the above subject was done using Google Scholar and PubMed. Results: Most of the studies are from World Health Organization (WHO). There is paucity of studies from the developing world. The costs of mental illnesses are high. The indirect costs are much higher than direct costs. Mental illnesses impact not only the individuals but also the family and society at large. Conclusions: The indirect costs of mental illnesses are much higher than the direct costs i.e. the negative economic consequences of not treating the mental illness is much higher than the costs of treatment as concluded by the World Economic Forum. Mental health and socio-economic development appear to go hand in hand. Investing in mental health is therefore investing for development.

Incorrect attribution of somebody else's work or idea as one's own without adequate citation of the original source is called plagiarism. This is considered a serious ethical problem. Most authors do not know that this is unacceptable. Most of them, who know, are not aware what exactly constitutes plagiarism. This editorial is written with an intention to increase awareness regarding this important issue. I discussed the concept and various types of plagiarism, focussing only on biomedical research. Some suggestions on how to be at guard against plagiarism have been discussed.

Introduction: To histologically evaluate the mirror image biopsy obtained from the apparently normal looking mucosa at corresponding contralateral anatomical sites to determine the incidence of multiple premalignant and malignant lesions in oral cancer. Materials and methods: Fifty patients with unilateral, single, untreated, histologically confirmed oral squamous cell carcinoma underwent mirror image biopsy from apparently normal looking mucosa at corresponding contralateral anatomical site. The mirror image biopsy specimens were subjected to histopathological examination Results: The age group of the patients ranged from 42 to 70 years with male to female ratio of 12:1. Of 50 patients, 38 (76%) revealed abnormal epithelial changes ranging in the degree from hyperkeratosis (12%), dysplasia (48%) and premalignant changes like leukoplakia, erythroplakia, submucous fibrosis, etc. (16%) in the mirror image sites. The incidence was high in males, with increasing age of the patient and duration of exposure to habits. Conclusion: Mirror image biopsies should be considered as useful diagnostic tool for early detection of premalignant changes so as to prevent further progression of these changes to oral cancer.

Background: Food borne illness cases may occur due to improperly prepared or mishandled food, unhygienic sanitation and cleaning practice at home by home kitchen handlers. Objective: Objectives of the study was to explore the knowledge and practice of literate female of Indore city who are dealing with Home kitchen every day. Methodology: A Cross-Sectional study among 160 participants ac- cording to their profession (Health sector workers, Non-health sector workers, House Makers and Students) were selected randomly and interviewed using self administered questionnaire. Result: It shows that the mean percentage score for the good know- ledge and hygienic practice was 79.44% and 71.15%. Knowledge practice scores was significantly (p < 0.0006) different by the levels of education and for Hygienic practice a significant difference (p

Cytochrome P450 monooxygenases (CYPs/P450s) are among the most catalytically-diverse enzymes, capable of performing enzymatic reactions with chemo-, regio-, and stereo-selectivity. Our understanding of P450s’ role in secondary metabolite biosynthesis is becoming broader. Among bacteria, Bacillus species are known to produce secondary metabolites, and recent studies have revealed the presence of secondary metabolite biosynthetic gene clusters (BGCs) in these species. However, a comprehensive comparative analysis of P450s and P450s involved in the synthesis of secondary metabolites in Bacillus species has not been reported. This study intends to address these two research gaps. In silico analysis of P450s in 128 Bacillus species revealed the presence of 507 P450s that can be grouped into 13 P450 families and 28 subfamilies. No P450 family was found to be conserved in Bacillus species. Bacillus species were found to have lower numbers of P450s, P450 families and subfamilies, and a lower P450 diversity percentage compared to mycobacterial species. This study revealed that a large number of P450s (112 P450s) are part of different secondary metabolite BGCs, and also identified an association between a specific P450 family and secondary metabolite BGCs in Bacillus species. This study opened new vistas for further characterization of secondary metabolite BGCs, especially P450s in Bacillus species.

The odontogenic keratocyst has been the subject of great interest ever since Philipsen introduced the term in 1956. Investigations continue into the lesion′s pathologic classification, diagnosis and biologic behavior. Considerable controversy exists regarding the proper management of these lesions - conservative or aggressive?. Here we report two cases of large odontogenic keratocysts of the mandible which were treated by aggressive surgical approach.

Members of the family of calcium dependent protein kinases (CDPK's) are abundant in certain pathogenic parasites and absent in mammalian cells making them strong drug target candidates. In the obligate intracellular parasite Toxoplasma gondii TgCDPK3 is important for calcium dependent egress from the host cell. Nonetheless, the specific substrate through which TgCDPK3 exerts its function during egress remains unknown. To close this knowledge gap we applied the proximity-based protein interaction trap BioID and identified 13 proteins that are either near neighbors or direct interactors of TgCDPK3. Among these was Myosin A (TgMyoA), the unconventional motor protein greatly responsible for driving the gliding motility of this parasite, and whose phosphorylation at serine 21 by an unknown kinase was previously shown to be important for motility and egress. Through a non-biased peptide array approach we determined that TgCDPK3 can specifically phosphorylate serines 21 and 743 of TgMyoA in vitro. Complementation of the TgmyoA null mutant, which exhibits a delay in egress, with TgMyoA in which either S21 or S743 is mutated to alanine failed to rescue the egress defect. Similarly, phosphomimetic mutations in the motor protein overcome the need for TgCDPK3. Moreover, extracellular Tgcdpk3 mutant parasites have motility defects that are complemented by expression of S21+S743 phosphomimetic of TgMyoA. Thus, our studies establish that phosphorylation of TgMyoA by TgCDPK3 is responsible for initiation of motility and parasite egress from the host-cell and provides mechanistic insight into how this unique kinase regulates the lytic cycle of Toxoplasma gondii.

The maxillary canine being the last anterior tooth to erupt in the oral cavity, is commonly impacted and the reasons for which are multifocal. It is necessary to locate the position of the impacted tooth in order to carry out a proper treatment plan. Various clinical and radiologic methods have been carried out to localize the position of the impacted tooth. The most commonly used methods include the parallax / tube shift, right angle technique, occlusal and the panoramic radiographs. This article reviews the various radiographic techniques and summarizes the current literature about the localization of impacted maxillary canine. This study confirms that the single panoramic radiograph is adequate to localize the position of the impacted maxillary canine, provided that both the magnification index and the vertical restriction criteria are used.

The odontogenic keratocyst is a cyst of odontogenic origin that exhibits a keratinised epithelial lining. Odontogenic keratocyst has been the topic of numerous investigators and is known for its potentially aggressive behavior and significant rate of recurrence. This cyst often occurs as a solitary lesion in the angle of the mandible, however in some, multiple such cysts may occur in association with a syndrome called "Nevoid basal cell syndrome". Here we report a case of a bilateral odontogenic keratocyst in a 60 yr old male patient, wherein multiple cysts were present but, without any other associated manifestations.

Introduction: Traditionally live related renal donors are evaluated with intravenous urography and renal ar-teriography. The computerized tomographic angiogra-phy (CTA) can offer a less invasive alternative to demonstrate the necessary anatomical and functional information. The present study evaluates the accuracy of helical CTA in depicting renal vascular and paren-chymal anatomy in live renal donors. Patients and Methods: During March 1999 to March 2000 all live donors were evaluated with ultrasound ab-domen (USG), intravenous urography (IVU) and heli-cal CT (Picker PQ 5000, Picker Intl. USA). Renal arterial and venous anatomy was documented prospec-tively by a radiologist, which was correlated with the operative findings. Sensitivity, specificity and accuracy of CTA in depicting the renal vascular anatomy were assessed. Results: Of 120 live donors evaluated, overall con-cordance between CT angiography and operative find-ings in delineating the arterial anatomy was found in 110 (91.6%) and venous in 116 (96.6%) donors. The sensitivity, specificity, and accuracy of CTA in depict-ing arterial anatomy was 91.6%, 98.2% & 91.6% and for venous anatomy was 96.7%, 90.0% and 97.0% re-spectively. We could not gather any additional informa-tion by performing intravenous urography. Conclusions: Helical CT angiography, which is highly specific for arterial and venous anatomy as well as other anatomical and functional details, can become the single imaging modality for preoperative assessment of poten-tial donors in place of conventional angiography and IVU. CTA, being minimally invasive and cost effective, is well accepted by a normal healthy donor

Calcium-dependent protein kinases (CDPKs) are conserved in plants and apicomplexan parasites. In Toxoplasma gondii, TgCDPK3 regulates parasite egress from the host cell in the presence of a calcium-ionophore. The targets and the pathways that the kinase controls, however, are not known. To identify pathways regulated by TgCDPK3, we measured relative phosphorylation site usage in wild type and TgCDPK3 mutant and knock-out parasites by quantitative mass-spectrometry using stable isotope-labeling with amino acids in cell culture (SILAC). This revealed known and novel phosphorylation events on proteins predicted to play a role in host-cell egress, but also a novel function of TgCDPK3 as an upstream regulator of other calcium-dependent signaling pathways, as we also identified proteins that are differentially phosphorylated prior to egress, including proteins important for ion-homeostasis and metabolism. This observation is supported by the observation that basal calcium levels are increased in parasites where TgCDPK3 has been inactivated. Most of the differential phosphorylation observed in CDPK3 mutants is rescued by complementation of the mutants with a wild type copy of TgCDPK3. Lastly, the TgCDPK3 mutants showed hyperphosphorylation of two targets of a related calcium-dependent kinase (TgCDPK1), as well as TgCDPK1 itself, indicating that this latter kinase appears to play a role downstream of TgCDPK3 function. Overexpression of TgCDPK1 partially rescues the egress phenotype of the TgCDPK3 mutants, reinforcing this conclusion. These results show that TgCDPK3 plays a pivotal role in regulating tachyzoite functions including, but not limited to, egress.

Studying the dynamics of fibrin clot formation and its morphology is an important problem in biology and has significant impact for several scientific and clinical applications. We present a label-free technique based on quantitative phase imaging to address this problem. Using quantitative phase information, we characterized fibrin polymerization in real-time and present a mathematical model describing the transition from liquid to gel state. By exploiting the inherent optical sectioning capability of our instrument, we measured the three-dimensional structure of the fibrin clot. From this data, we evaluated the fractal nature of the fibrin network and extracted the fractal dimension. Our non-invasive and speckle-free approach analyzes the clotting process without the need for external contrast agents.

In this editorial, I give a background and history of Telangana Journal of Psychiatry, the challenges it faces, and provide suggestions to improve its standards.

We applied customized targeted next-generation exome sequencing (NGS) to determine if mutations in genes associated with renal malformations, Alport syndrome (AS) or nephrotic syndrome are a potential cause of renal abnormalities in patients with equivocal or atypical presentation. We first sequenced 4,041 exons representing 292 kidney disease genes in a Caucasian woman with a history of congenital vesicoureteral reflux (VUR), recurrent urinary tract infections and hydronephrosis who presented with nephrotic range proteinuria at the age of 45. Her biopsy was remarkable for focal segmental glomerulosclerosis (FSGS), a potential complication of longstanding VUR. She had no family history of renal disease. Her proteinuria improved initially, however, several years later she presented with worsening proteinuria and microhematuria. NGS analysis revealed two deleterious COL4A3 mutations, one novel and the other previously reported in AS, and a novel deleterious SALL2 mutation, a gene linked to renal malformations. Pedigree analysis confirmed that COL4A3 mutations were nonallelic and compound heterozygous. The genomic results in conjunction with subsequent abnormal electron microscopy, Collagen IV minor chain immunohistochemistry and progressive sensorineural hearing loss confirmed AS. We then modified our NGS approach to enable more efficient discovery of variants associated with AS or a subset of FSGS by multiplexing targeted exome sequencing of 19 genes associated with AS or FSGS in 14 patients. Using this approach, we found novel or known COL4A3 or COL4A5 mutations in a subset of patients with clinically diagnosed or suspected AS, APOL1 variants associated with FSGS in African Americans and novel mutations in genes associated with nephrotic syndrome. These studies demonstrate the successful application of targeted capture-based exome sequencing to simultaneously evaluate genetic variations in many genes in patients with complex renal phenotypes and provide insights into etiology of conditions with equivocal clinical and pathologic presentations.

Toxoplasma gondii critically relies on cell invasion as a survival strategy to evade immune clearance during infection. Although it was widely thought that Toxoplasma entry is parasite directed and that the host cell is largely a passive victim, recent studies have suggested that host components such as microfilaments and microtubules indeed contribute to entry. Hence to identify additional host factors, we performed a high-throughput siRNA screen of a human siRNA library targeting druggable proteins using a novel inducible luciferase based invasion assay. The top 100 hits from the primary screen that showed the strongest decreases in invasion were subjected to confirmation by secondary screening, revealing 24 proteins that are potentially involved in Toxoplasma entry into host cells. Interestingly, 6 of the hits appear to affect parasite invasion by modifying host cell actin dynamics, resulting in increased deposition of F-actin at the periphery of the cell. These findings support the emerging notion that host actin dynamics are important for Toxoplasma invasion along with identifying several novel host factors that potentially participate in parasite entry.

Endometrial cancer is a chemosensitive disease. Studies have established a clear benefit of chemotherapy in advanced stages and trials are ongoing to define its role in early stages as well. As more molecular pathways are being elucidated there is increasing role for targeted agents and future looks quite promising. We did an extensive search both online and offline for all the relevant articles including chemotherapy and targeted therapy for endometrial cancer.

Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with a stratified growth pattern but without destructive stromal invasion. Little is known about the histological subtypes and outcome, role of fertility sparing surgery and role of postoperative therapy in advanced stage in Indian scenario. While there is ample data in the world literature about this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. Objective: To study the demographic profile, clinical features, imaging, treatment and outcome of borderline ovarian tumors. Methods: This is a retrospective study of eighty seven patients with pathologically proven diagnosis of borderline ovarian tumor, diagnosed and treated from January 2006 to October 2011 at our institution. Most patients underwent surgical staging which incuded total abdominal hysterectomy and bilateral salphingo-oophorectomy, infracolic omentectomy, bilateral pelvic and para aortic lymphadenectomy. Young patients who had not completed their family underwent fertility sparing surgery. Patients with invasive metastatic implants received adjuvant chemotherapy. The outcome of these patients was correlated with stage, type of peritoneal implant, type of surgical procedure and with histological subtype. Results: At a median follow-up of 48 months, 100 percent survival was noted. One patient with stage III disease had recurrence. Conclusions: Borderline ovarian tumors occur at a younger age compared to invasive tumors. In patients with early stage disease who wish to preserve fertility, hysterectomy and contralateral oophorectomy are not necessary. Serous tumors occur at a younger age. They can be associated with invasive peritoneal implants and raised CA125 values. Majority of the serous tumors are bilateral and smaller in size compared to mucinous and endometroid tumors. Raised CA125 values did not correlate with the stage of disease. These patients have an excellent prognosis even in Indian scenario where majority of patients present with big ovarian masses.

Background. Delirious mania (DM) as a clinical entity is well described, yet is often unrecognized in clinical practice. While most often misdiagnosed as acute psychotic episodes of organic delirium, these patients meet the criteria for mania with attendant delirium and pose therapeutic challenges. In addition to the case presentation, this paper also discusses the available literature on DM. Case Presentation. A 29-year-old man with DM was treated with a combination of electroconvulsive therapy (ECT), divalproex 2000 mg/day, loxapine 100 mg/day, and lorazepam 4 mg/day. He demonstrated clinically significant improvement by day 10, which persisted through the twelve-month follow-up period. Conclusions. DM is a severe psychiatric syndrome which should be accurately diagnosed. Patients with DM should be treated aggressively, especially with ECT. Lack of recognition of DM can lead to serious morbidity or fatal outcomes. Though the concept of DM is well established, recent psychiatric literature does not make a mention of this life threatening yet treatable condition. We propose that there is a dire need to keep this concept alive.

The title compound, C19H18O4, exhibits a long C—C bond [1.575 (2) Å] in the cage structure. In the crystal, pairs of O—H...O hydrogen bonds link the molecules into centrosymmetric dimers. C—H...O interactions also occur.

Enhancing the affinity of therapeutic T cell receptors (TCR) without altering their specificity is a significant challenge for adoptive immunotherapy. Current efforts have primarily relied on empirical approaches. Here, we used structural analyses to identify a glycine-serine variation in the TCR that modulates antigen sensitivity. A G at position 107 within the CDR3β stalk is encoded within a single mouse and human TCR, TRBV13-2 and TRBV12-5 respectively. Most TCR bear a S107. The S hydroxymethyl side chain intercalates into the core of the CDR3β loop, stabilizing it. G107 TRBV possess a gap in their CDR3β where this S hydroxymethyl moiety would fit. We predicted based on modeling and molecular dynamics simulations that a G107S substitution would increase CDR3β stability and thereby augment receptor sensitivity. Experimentally, a G107S replacement led to an ∼10-1000 fold enhanced antigen sensitivity in 3 of 4 TRBV13-2(+) TCR tested. Analysis of fine specificity indicated a preserved binding orientation. These results support the feasibility of developing high affinity antigen specific TCR for therapeutic purposes through the identification and manipulation of critical framework residues. They further indicate that amino acid variations within TRBV not directly involved in ligand contact can program TCR sensitivity, and suggest a role for CDR3 stability in this programming.

The title compound, C33H36N2O8, is the first example of a disubstituted peptidic pentacycloundecane (PCU) diol. The structure displays an array of inter- and intramolecular hydrogen bonding by both amide and alcohol functional groups. This hydrogen-bonding system connects the molecules into a three-dimensional network.