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Summary: Background: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. Methods: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. Findings: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2–2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3–0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2–18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46–13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99–17·34]) or anaesthesia complications (11·47 (1·20–109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7–5·0). Interpretation: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. Funding: Medical Research Council of South Africa.

Sugarcane crop is an efficient harvester of solar energy. As a renewable energy resource crop, assessment of energy production potential of sugarcane commercial hybrids, gives an estimate of energy availability as whole biomass or bagasse alone. The energy production potential was estimated in six popular varieties, whose photosynthetic rate and, light interception were more or less similar. The biomass production varied during different phenophases of the crop. The varietal difference was smoothened for total dry matter production at harvest, indicating compensatory ability of the hybrids in partitioning of the biomass to stalk. The estimated energy production potential (116322 kcal/m2Â (Co 86032) to 18856 kcal/m2 (Co 62175)) corresponding to the biomass as a whole is very high, while the bioenergy that can be obtained from stalk bagasse (14352 kcal/m2 to 16671 kcal/m2) still indicate variation for varieties, implying, varietal variability for energy purpose is strong. The leads are clear and the data emphasizes the importance of varietal identification for higher bioenergy production, efficiency as well as sustainability of commercial hybrids as dual purpose types.

The adaptation of dairy cows to methane (CH4)-mitigating feed additives was evaluated using the in vitro gas production (GP) technique. Nine rumen-fistulated lactating Holstein cows were grouped into three blocks and within blocks randomly assigned to one of three experimental diets: Control (CON; no feed additive), Agolin RuminantR (AR; 0.05 g/kg dry matter (DM)) or lauric acid (LA; 30 g/kg DM). Total mixed rations composed of maize silage, grass silage and concentrate were fed in a 40 : 30 : 30 ratio on DM basis. Rumen fluid was collected from each cow at days −4, 1, 4, 8, 15 and 22 relative to the introduction of the additives in the diets. On each of these days, a 48-h GP experiment was performed in which rumen fluid from each individual donor cow was incubated with each of the three substrates that reflected the treatment diets offered to the cows. DM intake was on average 19.8, 20.1 and 16.2 kg/day with an average fat- and protein-corrected milk production of 30.7, 31.7 and 26.2 kg/day with diet CON, AR and LA, respectively. In general, feed additives in the donor cow diet had a larger effect on gas and CH4 production than the same additives in the incubation substrate. Incubation substrate affected asymptotic GP, half-time of asymptotic CH4 production, total volatile fatty acid (VFA) concentration, molar proportions of propionate and butyrate and degradation of organic matter (OMD), but did not affect CH4 production. No substrate×day interactions were observed. A significant diet×day interaction was observed for in vitro gas and CH4 production, total VFA concentration, molar proportions of VFA and OMD. From day 4 onwards, the LA diet persistently reduced gas and CH4 production, total VFA concentration, acetate molar proportion and OMD, and increased propionate molar proportion. In vitro CH4 production was reduced by the AR diet on day 8, but not on days 15 and 22. In line with these findings, the molar proportion of propionate in fermentation fluid was greater, and that of acetate smaller, for the AR diet than for the CON diet on day 8, but not on days 15 and 22. Overall, the data indicate a short-term effect of AR on CH4 production, whereas the CH4-mitigating effect of LA persisted.

Objective: To evaluate a quick, safe, and minimally invasive method to screen for diabetes using gingival blood with the help of self-monitoring glucometer during periodontal examination. Materials and Methods: A hospital–based, cross-sectional comparative study was conducted among 40–59-year-old diabetic and nondiabetic population who had come for their master health examination to a private tertiary care hospital (Global Hospital and Health City) in Chennai. Among them, those who fulfilled the inclusion criteria were selected for the study. Thirty diabetic and thirty nondiabetic patients with moderate to severe gingivitis were enrolled and subjected to routine clinical periodontal examination. Blood samples of two sites were analyzed using a glucose self-monitoring device (Accu-Check). Patients were tested for venous fasting blood sugar (VFBS), venous postprandial blood sugar (VPPS), gingival fasting blood sugar (GFBS) level, gingival postprandial blood sugar (GPPS) level, peripheral fingerstick fasting blood sugar (PFBS) level, and peripheral fingerstick postprandial sugar (PPPS) level. Data obtained were statistically analyzed using Student's t-test, ANOVA, and Pearson's correlation test. Results: A significant positive correlation was found between GFBS and VFBS, GFBS and PFBS, GPPS and VPPS, and GPPS and PPPS (P < 0.01) in both diabetic and nondiabetic patients correlation. Using venous blood glucose level as a gold standard, the sensitivity and specificity of GFBS was 93% and 100%, respectively, whereas in GPPS, the sensitivity and specificity was 80% and 96%, respectively. Conclusion: Gingival blood glucometry can be used as a minimally invasive screening tool for diabetes mellitus in dental clinics.

Background: A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide. Objectives: To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency. Materials and Methods: In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin. Results: The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study. Conclusion: Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.

Genetic diversity among 35 rice varieties was investigated using 68 hyper variable polymorphic microsatellite markers to have more insights into the varietal diversity for future selection strategies in development of tailor made rice varieties suitable to different ecological niches of the state. In 68 polymorphic markers, a total of 298 alleles were detected with a range of 2 to 13 with an average allele number (Na) of 4.3 per locus. The Polymorphic Information Content (PIC) values ranged from 0.36 (RM24015) to 0.97 (RM 25310) with an average of 0.85. Overall estimation of number of alleles (Na) and genetic diversity index (He) indicated low to moderate level of diversity among the cultivars. The research station wise estimation on number of alleles (Na) and genetic diversity index (He) clearly indicated that the varieties developed from Rajendranagar varieties exhibited maximum while, Nellore varieties with minimum followed by Jagtial and varieties from remaining stations showed moderate values for both the parameters. The cluster analysis grouped 35 varieties into six clusters. The cultivars developed from Rajendranagar, Maruteru and Warangal tends to group together and the other station varieties are clustered in different groups. The results of this study revealed that genetic diversity among the varieties released from different research stations is moderate and thus warrants the breeders of particularly ARS, Nellore and RARS, Jagtial to broaden the genetic base by selecting diverse parents while making crosses.

In this study, drying process is modeled in porous media using random walk theory. In this line, first the effect of microscopic quantities derived from random walk theory has been studied on drying rate. Then, the relationship between drying rate and moisture content is obtained taking convection into account. The results obtained in this study indicates the effect of convection on the process of drying in porous media.

Background & aim: Borderline Personality Disorder is one of the most important health problems of people with undesirable consequences on family councils. The aim of the present study was to compare the executive function and difficulties in emotion regulation in addicted with upper and lower borderline personality traits. Methods: The present causal-comparative study included all male drug abusers who had been referred to addiction treatment centers. 80 addicts were selected by accessible sampling method and using a borderline personality traits (STB). Then, they were divided into two groups of 40 people for drug addicts in high and low. Using The Wisconsin Card Sorting Test and the scale of difficulty in the emotional regulation was conducted on two groups. Statistical data using multivariate analysis of variance MANOVA and LSD test were analyzed. Results: The results indicated that compared to drug addicts with high borderline traits, the ones with low borderline traits had lower performance in Wisconsin Card Sorting Test and the number of perseveration errors (p = 0.018) and total error (p = 0.002) was higher. Moreover, addicts with high borderline traits varied significantly higher scores in difficulty in emotional regulation (p=0.002) of the drug with low borderline personality traits. Conclusion: The results indicated that addicts with high borderline traits, had weaker performance in executive function and higher levels of difficulty with emotional regulation. This may be due to neurological effects of drug addiction on their performance which leads to poorer performance compared with drug people with low borderline traits.

Developmental malformations of the teeth might result in alterations of their size, shape, and structure. An accessory cusp is a developmental alteration to the shape of the teeth and is more commonly found in anterior teeth, and its occurrence in permanent molars is quite rare. Accessory cusps occurring in permanent mandibular molars are termed as protostylids. Although they do not pose any significant problem with respect to the function and occlusion, it is of tremendous importance in forensic odontology. This case report presents a rare finding of protostylid on the permanent mandibular molar, and its clinical implications are illustrated.

ObjectiveThis study aims to explore the contribution of implicit attitudes and associations towards conventional disease-modifying antirheumatic drugs (cDMARDs), alongside explicit measures, on medication-taking behaviour and clinical outcomes in adult patients with rheumatoid arthritis (RA).MethodsIn this observational study, implicit attitudes (positive-negative) and health-related associations (health-sickness) were measured with Single Category Implicit Association Tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs about Medicines Questionnaire Specific. The primary outcome of this study was medication-taking behaviour subjectively measured by self-report (i.e. validated Compliance Questionnaire on Rheumatology) and objectively measured with electronic drug monitors over a 3 month period. Spearman rank correlations were used to describe correlations between implicit and explicit outcomes. Nested linear regression models were used to assess the additional value of implicit measures over explicit measures and patient-, clinical-, and treatment-related characteristics.ResultsOf the 1659 initially-invited patients, 254 patients with RA agreed to participate in this study. Implicit attitudes correlated significantly with necessity-concerns differential (NCD) scores (ρ = 0.13, P = 0.05) and disease activity scores (ρ = -0.17, P = 0.04), whereas implicit health-related associations correlated significantly with mean scores for explicitly reported health-related associations (ρ = 0.18, P = 0.004). Significant differences in age, number of DMARDs, biologic DMARD use, NCD-scores, and self-reported correct dosing were found between the four attitudinal profiles. Nested linear regression models revealed no additional value of implicit measures in explaining self-reported medication-taking behaviour and clinical outcomes, over and above all other variables.ConclusionImplicit attitudes and associations had no additional value in explaining medication-taking behaviour and clinical outcomes over and above often used explicitly measured characteristics, attitudes and outcomes in the studied population. Only age and NCD scores contributed significantly when the dependent variable was correct dosing measured with self-report.

Schwannomas are infrequent tumours of oral cavity that are not routinely included in the differential diagnosis of oropharyngeal masses. The tumour presents with non-specific clinical symptoms and is clinically indistinguishable from varied soft tissue neoplasms of the oral cavity. Of the 84 cases of lingual schwannoma reported in English literature in the past 61 years, only 18 cases have been reported in paediatric age group ranging from 1 to 15 years. We, herein, report a rare case of schwannoma of the tongue in a 14-year-old boy, presented as a painless swelling with characteristic Antoni A and Antoni B pattern with Verocay bodies on histopathology. Strongly positive immunohistochemical staining with S 100 protein confirmed the Schwann cell origin.

OBJECTIVE: The “Meleti” Cognitive Rehabilitation Programme has been developed by the Cognitive Rehabilitation Unit of the Psychiatric Hospital of Attica and includes 40 hourly sessions of cognitive and social cognition exercises. It aims at the improvement of everyday functioning of individuals suffering from psychotic disorders through the remediation of their cognitive functioning. The Programme includes pre- and post-treatment sessions assessing both the symptoms and cognitive functions of participants. METHODS: We present the clinical and neuropsychological assessment domains and the respective clinical and cognitive tools used during the “Meleti” programme. RESULTS: The clinical evaluation of participants includes the assessment of symptoms, functioning, self-esteem and cognitive complaints. During a clinical interview conducted by the psychiatrists of the Unit the following inventories and rating scales are being administered: 1. Clinical Global Impression Scale (CGI), 2. Positive and Negative Syndrome Scale (PANSS), 3. Global Assessment of Functioning Scale (GAF), 4. Strauss-Carpenter Scale, 5. Personal and Social Performance Scale 6. Rosenberg self-esteem scale, 7. Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS). The cognitive assessments are conducted by the psychologists of the Unit which use computerized and non-computerized batteries and assess the following cognitive domains: 1. Psychomotor Speed 2. Judgement, 3. Intelligence, 4. Attention, 5. Immediate Memory, 6. Working Memory, 7. Verbal Learning, 8. Visual learning, 9. Cognitive Flexibility, 10. Cognitive Planning, 11. Brief Cognitive Screening, 12. Social Cognition. CONCLUSIONS: The “Meleti” Cognitive Rehabilitation Programme includes a thorough assessment of symptoms and cognition of participants which contributes to the individualization and evaluation of their treatment

The present research was framed to assess the awareness level of distance learners of Tamil Nadu Agricultural University. Three certificate courses were selected based on maximum number of enrollment, viz, Gardening & landscaping, Mushroom production & Solid waste management and vermicomposting. Ex-post facto research design was employed. A total of 150 respondents were selected from the three courses by equal allocation method proportionate random sampling. A well-structured questionnaire was prepared and the information was collected by sending questionnaires through post. The 108 individuals who responded were taken as the sample for the study. The results of the research pointed out that nearly three- fourths of the respondents possessed medium level of awareness on selected technologies.

Introduction: Multiple sclerosis (MS) is an acute disease of the central nervous system (CNS) associated with the degradation of myelin sheet around the nerve cells. It is assumed to be a multifactorial disorder that is to say numerous environmental and genetic factors are involved in the disease. Therefore, this study aimed to investigate the association between rs1800624 single nucleotide polymorphism (SNP), located in the promoter region of RAGE gene, and MS in Isfahan population. Methods: In this case-control study, tetra-primer ARMS PCR and newly designed primers were utilized in genotyping and determining allele frequency of rs1800624 SNP marker. A total of 300 individuals including 150 healthy and 150 MS patients participated in the study. In order to evaluate the association between genotypes and MS as well as the existence of Hardy-Weinberg equilibrium, SPSS and GENPOP softwares were used, respectively. Results: The study results showed that the frequency of TT, TA and AA genotypes were reported 42.7, 46.6 and 10.7 in the control group and 44, 42 and 14 in the case group. The studied population was in equilibrium in regard with rs1800624 marker. Moreover, no association was detected between rs1800624 marker and MS disease in the Isfahan population (p>0.5). Conclusion: The study findings indicated no association between SNP marker of rs1800624 and MS disease in the Isfahan population (p>0.5).

Background: Dental caries is as ancient as humankind and has the longest association with the dental profession, an association that is punctuated with agony and ecstasy. The agonizing fact is that despite several efforts toward total eradication, this disease is still prevalent. Nevertheless, an ecstatic success of the profession is the global decline in the incidence compared to the yesteryears' epidemics. Hence, predicting dental caries earlier is a boon. One such model to predict is cariogram developed by Bratthall in 1996. Aim: The aim of this study was to assess the caries risk among 12–13 year old school-going children of government and private schools of Tirupur district in Tamil Nadu using cariogram computer model. Methods: A cross-sectional survey was carried out among 136 study subjects of 12–13 year of age, who fulfilled the inclusion and exclusion criteria. Data were collected using a predesigned questionnaire and scored according to a standardized protocol. The Chi-square test was used to find differences between caries-related factors and cariogram group. The correlation was acquired using Spearman's correlation. Results: Government school study subjects had 56% of chance of avoiding caries whereas the private school study subjects had 66% of chance of avoiding caries in future and the differences were statistically significant (P = 0.001). A negative correlation was observed between the chance to avoid dental caries and cariogram sectors. Conclusion: The majority of the study subjects from government school belonged to medium-risk category and private school subjects belonged to low-risk category which inferred that private school students have high chance to avoid dental caries compared to government study subjects.

Introduction: Nephrotic syndrome (NS) is a genetic disease belonging to a heterogeneous group of glomerular disorders, which mainly occurs within the children. Linkage analysis using single nucleotide polymorphisms (SNP) is used as an indirect method in molecular diagnosis of the disease. A large number of SNP markers have been introduced in NPHS2gene in the available electronic databases. Method: In the present study, the genotype and informative status of rs2274625 marker in NPHS2 genewas investigated in 120 unrelated healthy individuals using Tetra-primer ARMS PCR technique and newly designed primers. Allelic frequency and presence of Hardy Weinberg Equilibrium (HWE) was estimated using GenePop website. Furthermore, PowerMarker software was utilized in order to compute the index of polymorphism information content (PIC). Results: The study results indicated allele frequency of 97% and 3% for C and T alleles, respectively, in regard with rs2274625 marker within Isfahan population. Moreover, the PIC for the rs2274625 marker was 0.5%, and HWE revealed the equilibruim of the study population in regard with the related marker. Conclusion: As the study findings indicated, rs2274625 could be introduced as an SNP marker in the linkage analysis in order to molecularly trace NPHS2 gene mutations in molecular NS diagnosis in Isfahan population as a representative sample of the Iranian population.

Background. The inclusion of ‘management’ competencies in medical curricula is widely propagated. There is some evidence in the literature that undergraduate dental students regard clinical skills as more important than management skills. Objective. To investigate student perceptions regarding Dental Practice Management (DPM) as a subject in the undergraduate dental curriculum at the University of Pretoria, South Africa (SA) and to relate these perceptions to their future career aspirations. Method. A cross-sectional survey was conducted in 2012 by means of an anonymous questionnaire among second-, third-, fourth- and fifth-year dental students (N=228) at the University of Pretoria’s School of Dentistry. Results. Of the 192 respondents, 92% (n=177) agreed that DPM should be a subject in an undergraduate curriculum, but there was no correlation with their career aspirations. Leadership and management skills (77.6%), people skills (64.6%), communication and listening skills (46.4%) and personal style (42.2%) were seen as the most important non-clinical skills. Students indicated their career aspirations as follows: private practice owners (45.3%, n=81), public sector and military (15.1%, n=27), working abroad (13.4%, n=24) and Medicross/Intercare (11.2%, n=21). There were statistically significant differences (p=0.001) among the study years with regard to private practice aspirations. Most students (81.7%, n=156) indicated that they would specialise if afforded the opportunity. Conclusion. In light of the prospects of the National Health Insurance (NHI) in SA, management and leadership skills will be vital to the successful long term implementation of the NHI; hence, academic institutions and government should address these issues as a priority in their undergraduate curricula.

Background and Objective: Significant increase in population and as a result, the production of excessive waste has recently made attention to municipal solid waste management a necessary issue. The objective of this study was to use matrix-based EIA process in order to determine best waste management option in Birjand City and to suggest appropriate solutions to managers and planners of this city. Materials and Methods: Assessing the environmental impacts of waste management options was done using Iranian Leopold Matrix. Through this method, the environmental impacts of waste management options were determined in the Birjand City. The options were Open dumping, Recycling, Composting, and Sanitary damping. Results: The results indicated that Open dumping with a final score of -3.06 had the highest environmental impact and was introduced as the fourth preference. In addition, composting with final score of -2.34 has the lowest environmental impact compared with other options. Conclusion: About 76.95% of the composition of municipal solid waste of Birjand City is household waste; therefore, putrescible organic materials are the predominant waste. Thus, according to the results of the Iranian Leopold matrix method, composting option was introduced as the first priority and the most logical option for waste management in the Birjand City.

Background: A spectrum of primary and secondary disorders that affect the bone marrow may manifestwith pancytopenia. This study was carried out to identify the various causes of pancytopenia in patients attending a tertiary care hospital in Lalitpur, Nepal.Materials and Methods: A descriptive study of 83 cases of pancytopenia was carried out in the Department of Pathology, Patan Academy of Health Sciences, Lalitpur, Nepal over a two year period from August 2010 to July 2012.Results: Eighty three patients underwent bone marrow examination. Mean age of the patients was 34 years (range: 4 to 75 years). Maximum number of patients (31.33%) was seen in the age group of 16 - 30 years. The commonest cause of pancytopenia was megaloblastic anemia which was seen in 34.94% (29/83) cases followed by aplastic anemia and hematological malignancies in 31.32% (26/83) and 14.46% (12/83) cases, respectively.Conclusion: This study concluded that megaloblastic anemia and aplastic anemia were the two most common causes of pancytopenia. Bone marrow aspiration is an established diagnostic modality in the evaluation of pancytopenia.Journal of Pathology of Nepal (2015) Vol. 5, 691 - 695

Introduction: Fetuin-A is a glycoprotein secreted by liver and has been shown to inhibit extraosseous mineralization. Urolithiasis may be a manifestation in the urinary tract due to fetuin deficiency in urine. The objective of this study was to compare the 24-h urine and serum fetuin-A levels of patients with and without urolithiasis. Methods: Serum and 24-h urine fetuin-A levels were measured in 41 patients with bilateral, multiple, or recurrent urinary tract calculi (Group A) and 41 matched controls with no calculi (Group B). Fetuin levels were measured by enzyme linked immunosorbent assay. Serum and urine fetuin-A levels in the two groups were compared. Results: The median (range) 24-h urine fetuin-A value in Group A was 11.9 (1.12–221) mg/day and in Group B was 37.7 (1.28–125) mg/day. This difference was statistically significant (Mann–Whitney test, P = 0.0169). The median (range) serum fetuin-A in Group A was 0.67 (0.05–2.68) g/L and in Group B was 0.99 (0.01–5.5) g/L. The difference between serum values in the two arms was not statistically significant (Mann–Whitney test, P = 0.1817). However, the serum creatinine-adjusted mean log serum fetuin and urine fetuin were significantly different in the two arms (P = 0.003). The mean ± standard deviation (range) serum creatinine in Group A was 0.98 ± 0.25 (0.56–1.58) mg% and in Group B was 0.83 ± 0.16 (0.58–1.18) mg% (two sample t-test, P = 0.0031). Conclusions: Patients with urolithiasis have lower urine fetuin-A and creatinine-adjusted serum fetuin-A levels.

Introduction: Xerostomia (dry mouth) is dryness of the mouth which is due to reduced salivary flow. Lack of adequate saliva causes discomfort in denture wearing patients and decreases retention of dentures. The ability of saliva to wet the tissue surface is one of the most important properties for oral comfort and retention of complete denture in dry mouth patients. Aim: This study was conducted to evaluate and compare the wetting ability of therapeutic Aloe vera saliva substitute and commercially available Aqwet saliva substitute on heatpolymerized acrylic resin. Contact angle of liquid saliva substitute was considered as an indicator of wettability. Materials and Methods: Aloe vera liquid (Aloe vera – Group I) and Aqwet saliva substitute (Aqwet – Group II) were compared in terms of their wetting ability. Forty samples of heat-polymerized acrylic resin were fabricated and divided into two groups with 20 samples in each. Advancing, receding contact angles and angle of hysteresis were measured using contact angle goniometer and DSA4 software analysis. Mann-Whitney U test was applied for statistical analysis of the study. Results: The mean advancing angle and receding angle of Group I (Aloe vera) was smaller than Group II (Aqwet). Mean angle of hysteresis of Group I (Aloe vera) was higher than Group II (Aqwet). Mann-Whitney U test revealed that there is no significant difference in contact angles between the two groups. Conclusion: Wetting ability of Group I (Aloe vera) saliva substitute was found to be better compared to Group II (Aqwet) on heat-polymerized acrylic resin.

The study aims to assess the knowledge level on Sustainable Sugarcane Initiative (SSI) of sugarcane growers in Villupuram district. It was found that more than three fourths of the respondents had high level of knowledge on SSI. It was inferred from the study that the awareness created through trainings, demonstrations, field days and exposure visits under Tamil Nadu Irrigated Agriculture Modernization and Water Bodies Restoration and Management project might be the reason for high level of technology-wise knowledge on SSI among the beneficiary respondents.

As demand rises for flexible electronics, traditionally prepared sintered ceramic sensors must be transformed into fully new sensor materials that can bend and flex in use and integration. Negative temperature coefficient of resistance (NTC) ceramic thermistors are preferred temperature sensors for their high accuracy and excellent stability, yet their high stiffness and high temperature fabrication process limits their use in flexible electronics. Here, a low stiffness thermistor based on NTC ceramic particles of micron size embedded in an epoxy polymer matrix is reported. The effect of particle-to-particle contact on electrical performance is studied by arranging the NTC particles in the composite films in one of three ways: (1) Low particle contact, (2) Improved particle contact perpendicular to the electrodes and (3) dispersing high particle contact agglomerated clumps throughout the polymer. At 50 vol.% of agglomerated NTC particles, the composite films exhibit a β -value of 2069 K and a resistivity, ρ , of $3.3\cdot {10}^{5}$ Ωm, 4 orders of magnitude lower than a randomly dispersed composite at identical volume. A quantitative analysis shows that attaining a predominantly parallel connectivity of the NTC particles and polymer is a key parameter in determining the electrical performance of the composite film.

Introduction: Hemophilia B is an X-linked recessive genetic disease caused by mutations in the coagulation Factor IX gene. Mutations in the Factor IX gene result in dysfunction or deficiency of coagulation factor of IX. Direct mutation analysis involves the ideal method for molecular diagnosis of the disease. However, due to the high number of identified mutations in the gen, the lack of a common mutation spectrum, the large size of the gene, and the heterogeneous nature of its mutations, direct mutation analysis is regarded expensive and time-consuming. Alternatively, indirect investigation of the mutations by use of linkage analysis applying polymorphic markers present in the factor IX gene region could be considered as an appropriate approach for prenatal diagnosis and carrier detection of haemophilia B. Methods: In the present study the single nucleotide polymorphic marker rs438601 in the intron 3 of factor IX gene was genotyped by Tetra-primer ARMS-PCR method with newly desingd specific primers on 142 unrelated control females in the Isfahan (a city in Iran) population. Then the allele frequency and degree of heterozygosity were estimated utilizing GENEPOP program. Moreover, χ2 test was applied in order to investigate the Hardy-Weinberg equilibrium. Results: Allele frequency was reported as 71.83% and 28.17%, respectively for C and G alleles. Observed heterozygosity was 53.52% and Analysis of deviations from Hardy-Weinberg equilibrium demonstrated that the Isfahanian population were in equilibrium for rs438601 marker. Conclusion: The study findings demonstrated that rs438601 marker due to high heterozygosity could be suggested as an appropriate diagnostic marker in linkage analysis and carrier detection of hemophilia B in regard with a sample of Iranian population.

Control of cell-matrix adhesion has become an important issue in the regulation of stem cell function. In this study, a maltose-binding protein (MBP)-linked basic fibroblast growth factor (FGF2)-immobilised polystyrene surface (PS-MBP-FGF2) was applied as an artificial matrix to regulate integrin-mediated signalling. We sought to characterise human mesenchymal-stem cell (hMSC) behaviour in response to two different mechanisms of cell adhesion; (i) FGF2-heparan sulphate proteoglycan (HSPG)-mediated adhesion vs. (ii) fibronectin (FN)-integrin-mediated adhesion. Heparin inhibited hMSC adhesion to PS-MBP-FGF2 but not to FN-coated surface. The phosphorylation of focal adhesion kinase, cytoskeletal re-organisation, and cell proliferation were restricted in hMSCs adhering to PS-MBP-FGF2 compared to FN-coated surface. Expression of MSC markers, such as CD105, CD90 and CD166, decreased in hMSCs expanded on PS-MBP-FGF2 compared to expression in cells expanded on FN-coated surface. hMSCs that were expanded on FN-coated surface differentiated into osteogenic and adipogenic cells more readily than those that were expanded on PS-MBP-FGF2. Furthermore, we characterised the N-linked glycan structures of hMSCs depending on the cell adhesion mechanism using mass spectrometry (MS)-based quantitative techniques. MS analysis revealed that 2,3-sialylated glycans, a potential marker of stem cell function, were more abundant on hMSCs expanded on FN-coated surface than on those expanded on PS-MBP-FGF2. Thus, the differentiation potential of hMSCs is controlled by the type of adhesion substrate that might provide an idea for the design of biomaterials to control stem cell fate. Elucidation of the glycan structure on the cell membrane may help characterise hMSC function.

Background: Ovarian tumors are common forms of neoplasia in women. Among cancers of the female genital tract, it ranks only below carcinoma of the cervix and the endometrium, but is responsible for approximately 50% of the deaths. They arise from different cell lineages and hence constitute a wide variety of neoplastic entities with diverse morphological and clinical manifestations. Materials and Methods: A descriptive study of 363 cases of ovarian tumors was carried out during a three year period from January 2011 to December 2013. Results: Of the 363 ovarian tumors, 293 (80.72%) cases were benign, 57 (15.70%) were malignant and 13 (3.58%) were borderline. Germ cell tumour was the most common class of tumour and seen in 187 (51.52%) cases, followed by surface epithelial in 158 (43.53%) cases. The age distribution of the patients ranged from 10-82 years with a median age of 33 years. Benign tumors were more common than malignant ones in all age groups. Conclusion: Most of the ovarian tumors in this study were of germ cell origin. The incidence of malignant germ cell tumors was also significantly higher than in other studies. Mature cystic teratoma was the most common benign tumour while serous carcinoma was the most common malignancy. The incidence of malignant germ cell tumors was higher compared to other studies. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10295 Journal of Pathology of Nepal (2014) Vol. 4, 539-543

The yellow-spotted mountain newt Neurergus microspilotus (Caudata: Salamandridae) is listed as Endangered by the International Union for Conservation of Nature. In spite of its conservation status and laws protecting it, the species continues to decline in the wild. A captive breeding program was successfully established to support the species’ recovery. To learn more about the species’ ecology and winter mortality, 24 juveniles reared in captivity were released on 4 occasions in a small spring enclosure from July to September 2012 and monitored until December, when they disappeared for overwintering. In 12 visits to the site before and after overwintering, a total of 31 individuals were identified. Based on an average diurnal detection probability for this newt (0.61 ± 0.19 SD), the observed newts during the pre-overwintering period were estimated to represent 6.5 to 41.0% of the reintroduced newts. The newts observed after overwintering were 13 to 28% of the reintroduced newts. This study demonstrates that post-metamorph captive-bred N. microspilotus released into the wild can survive to the second growing season, and provides a choice of life stage for a reintroduction plan.

Second primary tumor (SPT) is defined as a second tumor that presents either simultaneously or after the diagnosis of an index tumor. Second primary malignancies are the leading cause of death in patients with heritable retinoblastoma (RB). Acute lymphoblastic leukemia (ALL), as SPT in RB patients, is extremely rare. To the best of our knowledge, only five cases of ALL as SPT in patients with RB has been documented in the literature. Herein, we report a case of a 6-year-old girl with bilateral RB, who developed ALL during the course of treatment of RB. This case highlights the importance of reviewing blood investigations regularly to diagnose leukemia as SPT in RB and also the necessity for proper counseling and lifelong follow-up in these patients.

A 53-year-old North African woman presented with a longstanding history of ulcerations of the right breast. Physical examination showed (Fig. 1 subfigure) an ulcer of 1.5 cm in the outer inferior quadrant, another smaller areolar ulcer and a discharging sinus tract in the inframammary sulcus. Apart from female genital mutilation, her past medical history was negative. Laboratory work up was essentially normal, culture of the ulcers were taken. Mammography showed infra-areolar skin retraction, associated with irregular, high density distortion of the breast tissue. Ultrasound (Fig. 1) revealed communicating sinus tracts coming from an intercostal mass with central necrosis. Mobile internal echoes were suggestive for abscess formation and a truecut biopsy was taken. An important granulomatous inflammatory pattern and fibrosis were found. Axillary lymphadenopathy was present.

This case report presents the MRI findings of aplasia of the anterior cruciate ligament with associated hypoplasia of the posterior cruciate ligament (Manner type 2). Radiographically the presence of a shallow femoral notch and hypoplastic tibial spines (the so-called “dromedar” sign) can aid in the diagnosis. Operative treatment is often not indicated since the congenital absence of the ACL implies longstanding altered biomechanics to which the knee has well adapted in the majority of cases.

A 4-year-old, male French Brittany weighing 18 kg was presented for continuous disorexia associated with a large palpable mass in the cranial abdomen. Radiographic and ultrasonographic examination showed the presence of a mass close to the gastric wall. Percutaneous needle aspiration of the mass revealed pyogranulomatous inflammation. An exploratory laparotomy was performed in order to remove the mass. Actinomiycotic mycetoma was revealed after surgery by positive culture. After a three months antibiotic therapy, nine months follow up showed complete remission.

Background: Nurses are important health care professionals and should have wide knowledge about common diseases especially infectious diseases like dengue. Dengue is associated with shock and can lead to death. Aim: To assess the knowledge of nurses regarding dengue fever and to study the association between the demographic variables. Setting and design: A cross sectional study was conducted at the College of Medical Sciences-Teaching Hospital, Nepal among the nurses during December, 2010. Study tool: Semi structured question was prepared to assess the knowledge of nurses in which there was objective question and Yes or No type questionnaire. Statistical analysis: The filled questionnaires were collected and data were entered in Microsoft excel sheet and analyzed as per study objectives. Descriptive statistic was used to calculate the median (IQR) and non parametric tests (Kruskal Wallis test and Mann Whitney test) to compare the total scores with demographic profile of the subjects. Results: Of the study members 89% were from Proficiency Certificate level (PCL) background and the mean (IQR) age of the respondents was 21 years (20-22.75). Overall score of the nurses was 11 (9-13) with a maximum possible score of 17. There were no association between the respondents knowledge scores with age (p=0.14); educational qualifications (p=0.86); duration of experience (p=0.59); ward (p=0.28). Conclusion: The study findings report a low knowledge among the nursing practitioners on dengue fever and its complications and their knowledge did not have any association with their demographic variables. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 7-13 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9667

Aim: to study the prognostic value of biomarkers (urine neutrophil gelatinase-associated lipocalin (uNGAL), urine interleukin-18 (uIL-18), serum cystatin C (sCysC), serum N-terminal prohormone of brain natriuretic peptide (sNT-proBNP) depending on the acute kidney injury (AKI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). 58 patients with NSTE-ACS were examined. Patients with NSTE-ACS and early AKI had higher sCysC, sNT-proBNP, uNGAL and uIL-18 levels than the patients without AKI. No relationship between biomarkers and in-hospital mortality was revealed in patients with cardiorenal syndrome (CRS). AKI — acute kidney injury NSTE-ACS — non-ST-elevation acute coronary syndrome CRS — cardiorenal syndrome NT-proBNP — N-terminal prohormone of Brain Natriuretic Peptide IL-18 — interleukin-18 NGAL — neutrophil gelatinase-associated lipocalin

We report an incidental case of combined disproportionate deep inspiration and breath-old artifacts producing during computed tomography pulmonary angiography performed to exclude pulmonary embolism in a 69 year-old patient. These known but unwelcome cumulated artifacts may cause transient major attenuation or interruption of the contrast bolus which may occasionally obscure or mimic an embolus. We shortly review the mechanisms of these classical artifacts and the adequate breathing instructions to avoid them are remembered.

Limited success achieved in translating basic science discoveries into clinical applications for chronic airway diseases is attributed to differences in respiratory anatomy and physiology, poor approximation of pathologic processes, and lack of correlative clinical endpoints between humans and laboratory animal models. Here, we discuss advantages of using ferrets (Mustela putorus furo) as a model for improved understanding of human airway physiology and demonstrate assays for quantifying airway epithelial ion transport in vivo and ex vivo, and establish air-liquid interface cultures of ferret airway epithelial cells as a complementary in vitro model for mechanistic studies. We present data here that establishes the feasibility of measuring these human disease endpoints in ferrets. Briefly, potential difference across the nasal and the lower airway epithelium in ferrets could be consistently assessed, were highly reproducible, and responsive to experimental interventions. Additionally, ferret airway epithelial cells were amenable to primary cell culture methods for in vitro experiments as was the use of ferret tracheal explants as an ex vivo system for assessing ion transport. The feasibility of conducting multiple assessments of disease outcomes supports the adoption of ferrets as a highly relevant model for research in obstructive airway diseases.

Aim: According to the importance of stressful and impellent factors in severity of craving and after that treating successes, this study had done with purpose of examining the relationship between these factors with craving experience in addicted men in six groups (smoking of opium, inhalation of Heroin, smoking of Heroin, injection of Heroin, smoking of methamphetamine, smoking of crack). Method: In this descriptive-sectional study, 195 addicted men had referred to cold turkey centers in Rasht, during 10 months of 1389-1390 selected by available sampling method in six groups. Stress evaluation questionnaire of Markham and the questionnaire of instant craving drug of Franken and also profited by imaginary indexes of computer tests for severity of craving administered among selected samples. Results: The results showed that there is a significant and positive relationship between the stress and cue induction craving, and the stress and instant craving. Also, it proved that there is a significant difference between different users in degree of stress, and inductive craving, and instant craving. The average of stress scores, cue induction craving and instant craving in testing groups of methamphetamine users were more than other groups. Conclusion: According to findings of this survey, stress can be an important predicting factor for craving degree in addicted men so, attention of these aspects resulted in selecting an appropriate treatment of psychology for controlling of craving which is the most important factor leading to relapse in substance abuse.

Background: Caregiving has been identified as a basic component of human nature and a primary element of close relationship. This study aims to assess the extent and pattern of burden felt by the caregivers of patients with schizophrenia in comparison with bipolar disorder. Materials and Methods: Fifty-two patients with schizophrenia and fifty-one patients with bipolar disorder attending the outpatient department were assessed in the study. The burden among the caregivers was assessed using Burden Assessment Schedule. Results: The caregivers of schizophrenia group had significantly higher total burden score as compared to caregivers of bipolar disorder. Caregivers of schizophrenia experienced significantly higher burden in area of external support, caregivers routine, and other relations. Conclusion: The extent of burden among families of schizophrenic patients is more than those of bipolar disorder. The families of patients with bipolar disorder do also experience considerable burden. The pattern of burden among families of schizophrenia and bipolar disorder is almost identical in most of the domains except for external support, caregivers routine, and other relations.

Background: The 1μg cosyntropin test has some advantages over the 250μg test as a test of adrenal function. One of the concerns regarding the 1 μg test includes stability of the cosyntropin when reconstituted and stored. Classically the 5 th percentile responses to cosyntropin in normal individuals have been used to define a normal response. Recent studies have shown that these normative values should be determined for individual assays. Materials and Methods: We performed a 1μg cosyntropin test using reconstituted and refrigerated (4-8° C) cosyntropin in saline solution in 49 non pregnant adults who were apparently healthy and had no exposure to exogenous glucocorticoids. The cosyntropin solution was stored for up to 60 days following reconstitution. We analysed the data for any association between duration of cosyntropin solution storage and the cortisol responses to cosyntropin administration. Results: The mean ± SD cortisol level at baseline, 30 and 60 min were-12.19 ± 3 μg/dl, 20.72 ± 2.63 μg/dl, 16.86 ± 3.33 μg/dl. The 5 th percentile cortisol response at 30 min was 16.5 μg/dl (16.33 μg/dl rounded off). The correlation coefficients between number of days of cosyntropin solution storage and the cortisol responses at 30 and 60 min were (Spear mans rho = 0.06,-0.24 respectively) (P = 0.69 and 0.41). There were no differences in cortisol values whether the storage was for less than 30 days or more than 30 days (mean difference 0.25 μg/dl P = 0.44). Conclusion: The 5 th percentile normative values determined for our assay is lower than what is currently being used clinically and in research publications. Prolonged refrigerated storage of cosyntropin solution does not affect the validity of the 1 μg cosyntropin test.

Design of macroporous synthetic grafts that can promote infiltration of cells, their differentiation, and synthesis of bone-specific extracellular matrix is a key determinant for in vivo bone tissue regeneration and repair. In this study, we investigated the effect of the microarchitecture of the scaffold on osteogenic differentiation of human mesenchymal stem cells (hMSCs). Poly(ethylene glycol) diacrylate-co-N-acryloyl 6-aminocaproic acid cryogels were fabricated to have either a pore network consisting of cellular, randomly oriented pores (termed ‘spongy’) or a pore network consisting of lamellar columns (termed ‘columnar’), with both cryogel types showing a similar porosity. Both spongy and columnar cryogels supported comparable levels of cell viability and proliferation of hMSCs in vitro. However, spongy cryogels promoted osteogenic differentiation to a greater extent than their columnar counterparts, as evidenced by increased alkaline phosphatase activity and osteoblastic gene expression over 21 days post culture. Leveraging upon our previous work, we further evaluated the ability of these synthetic scaffolds in conjunction with mineralisation to promote ectopic bone formation upon subcutaneous implantation in nude rats. Mineralised spongy and columnar cryogels, both in the presence and absence of exogenous hMSCs, promoted ectopic bone formation in vivo. No such bone formation was observed in acellular cryogels devoid of mineralisation, with extensive host cell infiltration and vascularisation in columnar cryogels, and negligible infiltration into spongy cryogels. Our results thus present a novel method to tune the microarchitecture of porous polymeric scaffolds, in addition to suggesting their efficacy as synthetic bone grafts.

Small ruminants (sheep and goat) immensely contribute to the Indian meat food basket; yet regional preference for either sheep or goat meat varies. Owing to the differences in the market prices, these two closely resembling species meats are often misrepresented interchangeably. Prevention of such fraudulent practices requires authentic and sensitive speciation tools. A novel mitochondrial D-loop based species-specific polymerase chain reaction (PCR) technique was developed for the precise detection of origin of sheep and goat meats. Species-specific primers (SSP-G and SSP-S) developed for PCR in this study amplify 229 and 425 base pairs products specific to goat and sheep species. An additional herteroplasmic PCR product of size 350 bp was evident only in sheep. Primers designed in this study were checked for the absence of cross-species amplification in closely related animal species and was successfully applied for the authentication of a forensic case. Our results indicated prerogative applications of the novel species-specific PCR for the authentic identification of origin of sheep and goat species thereby aiding in the prevention of the menace of misrepresentation of meats.

Background and Objectives: Results of many studies suggest that prone position is effective in improving oxygenation. This study aims at comparing supine and prone positions on oxygenation of premature infants with respiratory distress syndrome who are under N-CPAP treatment. Methods: This study was conducted as a cross-sectional study on 44 premature infants of 29-34 weeks gestation who were under N-CPAP treatment in NICU of Tabriz Alzahra Hospital, 2010. The infants were randomly divided into 2 groups. The position of the first group was at first, prone and then supine, and for the second group was vice versa. arterial oxygen saturation (SatO2) and fraction of inspired oxygen (FiO2) were assessed in each position for 30 minutes and were recorded in a questionnaire. The data was analyzed by one-way ANOVA and repeated measures ANOVA. Statistical significance was considered at p

Introduction: Support , advice and guidance of students during of study are one of the most important responsibilities of universities. They are responsible to solve students' problem about this matter. Thus, this study has been designed to determine the students' view about of the Duties and Performance of Academic advisors. Methods: This study which is a descriptive- analytical study. Is performed on 250 nursing and midwifery and operation room students selected using by census method. In order to analysis of finding, Questionnaire has been used to determine the students' view of the duties and performance of academic advisors. SPSS 1 7 software and descriptive - inferential statistic has been used to analysis of finding. Results : The findings showed that, more than half of students were agree with academic advisors duties. From students' view "offering advice in terms of job and education" and "assessing the current academic status of students" were as main tasks of academic advisors. "Advisor' consult with other experts about the current problems" and the "introduction of relevant units to meet the needs of students" were the weakest cases of performance of academic advisors. And performance of academic advisors was good in students’ view about 31.6 percent. Conclusion: In this study views of students are well suited to the tasks of academic advisors. This issue indicated that, there is an appropriate potential to promote students consulting. According to the results on the performance of academic advisors need to make fundamental changes in the process of Supervisors is academic counseling

Background:Genetic diversity of three polymorphic markers in the phenylalanine hydroxylase(PAH) gene region including PvuII(a), PAHSTR and MspI were investigated.Methods:Unrelated individuals (n=139) from the Iranian populations were genotyped using primers specific to PAH gene markers including PvuII(a),MspI and PAHSTR. The amplified products for PvuII(a),MspI were digested using the appropriate restriction enzymes and separated on 1.5% agarose. The PAHSTR alleles were identified using polyacrylamide gel electrophoresis followed by silver staining. The exact size of the STR alleles was determined by sequencing. The allele frequency and population status of the alleles were estimated using PHASE, FBAT and GENEPOP software.Results: The estimated degree of heterozygosity for PAHSTR, MspI and PvuII (a) was 66%, 56% and 58%, respectively. The haplotype estimation analysis of the markers resulted in nine informative haplotypes with frequencies ≥5%.Moreover,the results obtained from Ewens-Watterson test for neutrality suggested that the markers were under balancing selection in the Iranian population.Conclusion:These findings suggested the presence of genetic diversity at these three markers in the PAH gene region. Therefore, the markers could be considered as functional markers for linkage analysis of the PAH gene mutations in the Iranian families with the PKU disease.

Background: Clinico-epidemiological profile of the Human immunodeficiency virus (HIV) epidemic in India is varied and depends on multitude of factors including geographic location. We analyzed the characteristics of HIV-infected patients attending our Immunodeficiency Clinic to determine any changes in their profile over five years. Settings and Design: A retrospective observational study. Materials and Methods: The study sample included all patients with HIV infection from January 1, 2003 to December 31, 2007. Diagnosis of HIV was made according to National AIDS Control Organization guidelines. Results: Of 3 067 HIV-infected patients, 1 887 (61.5%) were male and 1 180 (38.5%) were female patients. Mean age of patients was 35.1 ± 9.0 years. Majority (91.8%) of patients were in the age group of 15 to 49 years. Progressively increasing proportion of female patients was noted from year 2004 onward. Median CD4 count at presentation in year 2003 was 197/μl (Interquartile range [IQR] = 82.5-373) while in year 2007 it was 186.5/μl (IQR = 86.3-336.8). Mean CD4 count of male patients was 203.7 ± 169.4/μl, significantly lower as compared with female patients, which was 284.8 ± 223.3/μl (P value ≤0.05). Every year, substantial proportions of patients presenting to clinic had CD4 count

Objective: To compare the efficacy of cranial imaging techniques in adult patients with acute febrile encephalopathy. Methods: We enrolled one hundred and two patients presenting to the emergency with fever of shorter than 15-day duration and altered sensorium. All the patients were subjected to routine investigations, detailed cerebrospinal fluid analysis, computerized tomograms (Non contrast followed by contrast enhanced) and Magnetic resonance imaging of the brain. Final diagnosis was reached after considering the clinical, biochemical findings, imaging results and response to therapy. The positive yield of radiological investigations was compared against the final diagnosis. Results: The patients were divided into three groups. Of these patients, 48 had evidence of meningoencephalitis, 22 patients had pyogenic meningitis, and 20 were combined together in others group. In other 12 patients, a definitive diagnosis could not be made. Only 37% patients were detected to have abnormal computerized tomograms and the commonest abnormality was diffuse edema, which failed to point to an etiological diagnosis. Magnetic resonance imaging was abnormal in 62.75% cases and was able to suggest an etiological diagnosis in 100% cases of cerebral venous thrombosis, tubercular meningitis, 95% cases of meningoencephalitis and 45% with meningitis. Conclusions: Magnetic resonance imaging provides better information than computerized tomography in adult patients with acute febrile encephalopathy.

There is considerable evidence for the fact that early life environment in human beings are associated with future development of various metabolic diseases. Fetal programming and perinatal events appear to exert effects on later life that are independent of environmental risk factors in adults. Our understanding of the underlying mechanisms are limited and remains unclear. However several animal models and epidemiological studies have shown this association, and it is assumed secondary to the penalties of developmental plasticity. In this review, we amalgamate facts from several disciplines to support this hypothesis.

Background: The commonly accepted idea concerning root planing is that excessive removal of cementum is not necessary for removal of endotoxins. The ideal instrument should enable the removal of all extraneous substances from the root surfaces, without causing any iatrogenic effects. Aim: To compare the remaining calculus, loss of tooth substance, and roughness of root surface after root planing with Gracey curette, ultrasonic instrument (Slimline® insert FSI-SLI-10S), and DesmoClean® rotary bur. Materials and Methods: The efficiency of calculus removal, the amount of lost tooth substance, and root surface roughness resulting from the use of hand curette, ultrasonic instrument, and rotary bur on 36 extracted mandibular incisors were examined by SEM. We used three indices to measure the changes: Remaining calculus index (RCI), Loss of tooth substance index (LTSI), and Roughness loss of tooth substance index (RLTSI). Twelve samples were treated with each instrument. The time required for instrumentation was also noted. Statistical Analysis: Kruskal-Wallis ANOVA was used for multiple group comparisons and the Mann-Whitney test for group-wise comparisons. Analysis was carried out with SPSS® software (version 13). Results and Conclusion: The RCI and LTSI showed nonsignificant differences between the three groups. RLTSI showed a significant difference between Slimline™ and hand curette as well as Slimline™ and Desmo-Clean™. Slimline™ showed the least mean scores for RCI, LTSI, and RLTSI. Thus, even though the difference was not statistically significant, Slimline™ insert was shown to be better than the other methods as assessed by the indices scores and the instrumentation time.

Background : Paroxysmal nocturnal hemoglobinuria (PNH) results due to decrease or absence of glycosylphosphatidylinositol-anchored (GPI) molecules, such as CD55 and CD59, from the surface of the affected cells. PNH-phenotype has been described in various hematological disorders, mainly aplastic anemia and myelodysplastic syndromes; recently it has been reported in patients with lymphoproliferative syndromes and multiple myeloma (MM). Materials and Methods : We evaluated the presence of CD55 negative and/or CD59 negative red blood cell (RBC) populations in newly diagnosed treatment naive-54 chronic lymphocytic leukemia (CLL) and 29 MM patients by flow cytometry. Results : PNH-phenotype was not reported in any patient; however, RBC populations deficient in CD55 were detected in 16.66% (9/54) CLL and 6.89% (2/29) MM patients. Clinical presentation or the hematological parameters did not show any relationship with the presence of CD55 deficient RBC population. Conclusion : Our study showed absence of PNH-phenotype in patients with CLL and MM; however, isolated CD55 deficient RBC were identified in both CLL and MM. Larger prospective studies by other centers, including simultaneous analysis of granulocytes for the presence of PNH-phenotype, are needed to corroborate these findings and to work out the mechanisms and the significance of the existence of this phenotype in these patients.