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Purpose: As per the recent World Health Organization estimates, approximately 2.2 billion people have near and distance vision impairment (VI) globally, and out of this almost 50% is avoidable. Methods: The Rapid Assessment of Avoidable Visual Impairment survey was a cross-sectional study conducted in September 2021, using cluster random sampling in 42 clusters with a cluster size of 140, giving a total of 6000 participants. Two teams comprising of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Distance visual acuity was measured using simplified tumbling “E” charts of different sizes for VA of 6/12, 6/18, and 6/60. The lens assessment was done in an un-dilated pupil with torch light by the optometrist. Results: Overall, 6520 individuals aged 6 years and above were enumerated, of whom 5440 (83.4%) were examined. The response rate for examination was better among females (93.1%) than males (73.9%), and it decreased from 93.8% in the age group 6–15 years to 77.1% in the 45+ age group. The prevalence of blindness and VI were 0.18% (95% CI: 0.06–0.29) and 4.19% (95%CI: 3.65–4.72), respectively. The major causes of VI in all age groups were uncorrected refractive error (65.4%), cataract (23.7%), cataract surgical complications (2.6%), corneal opacity (0.4%), and other posterior segment diseases (7.5%). The effective cataract surgical coverage (eCSC) was 61.8%, effective refractive error coverage (eREC) for distance vision was 59.8%, and eREC for near vision was 47.0%. Conclusion: The RAAVI methodology is suitable to measure effective coverage in the general population, both for baseline measurement and periodic monitoring. The 2030 targets for the surveyed district are 90% eCSC and 100% eREC. Such exercises need to be conducted in each district of the country to determine the baseline and target values of effective coverage.

The leaves of the Murraya koenigii aromatic plant contain various specific phytochemicals, including lutein, β-carotene, vitamin C, nicotinic acids, and other polyphenols, which act as reducing agents to produce metallic nanoparticles from their respective precursors. In this study, we report the green synthesis of iron–cobalt bimetallic nanoparticles (Fe–Co BMNPs) using natural resources of reducing and capping agents from aqueous extract of Murraya koenigii leaves. The synthesized Fe–Co BMNPs were characterized using SEM, EDS, BET surface area, TGA, XRD, TEM, and VSM techniques, revealing their crystalline structure with a surface area of 83.22 m2 g−1 and particle sizes 97% of 10 mg L−1).

Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.

Background: To study Visual Evoked Potential in patients with Optic Nerve diseases. Study design and settings: Cross – Sectional study. Material and Methods: 72 patients were included in our study, aged 12 years and above, diagnosed as optic nerve diseases like optic neuritis, Nonarteritc ischemic optic neuropathy (NAION), hereditary, nutritional and compressive optic neuropathy etc. Flash and Pattern VEPs were used. VEP amplitude and latency were noted. Results: Out of total 144 eyes, 107 eyes were affected. Ethambutol induced Toxic optic neuropathy was the most common etiology, followed by secondary optic neuropathy, idiopathic, traumatic optic neuropathy, optic neuritis, NAION, compressive and post CRAO (Central Retinal Artery Occlusion) optic neuropathy. Mean latency of all affected eyes was 132±22.5 msec. mean amplitude of the all affected eyes was 6.36±2.1 microvolt. Latency was moderately delayed (110-140 msec) in 45.8%, while severely delayed (>140 msec) in 40.3% of total eyes. Amplitude was reduced in 36.5% of total eyes. Prolonged latency with normal amplitude was found in most of the eyes with optic neuritis while latency was also prolonged in fellow eyes of optic neuritis. In case of NAION prolonged latency and reduced amplitude was found in all eyes. Conclusion: Flash or pattern VEP can be used as an important tool for diagnosis of optic neuropathies or revealing of recurrence of disease and for follow up. VEP can also be used to detect subclinical damage in the fellow eyes of optic neuritis and also useful in differentiating the optic neuritis from ischemic optic neuropathy.

The utilization of natural biomolecules in Murraya koenigii (MK) plant extracts attracted significant attention of the scientific community for the synthesis of single and bi-metallic nanoparticles (NPs) in recent years. The specific biomolecules and natural phenolic acids (apigenin, quercetin, eugenol, naringnin, etc.) in this plant extract act as reducing/capping and stabilizing agents during the green synthesis of stabilized metallic NPs (Ag, Cu, Zn, Se, Fe etc.) with the use of their respective metal ion precursor solution. In this review study, the information about phytochemical constituents in the extracts of MK plant and their utility in synthesis of various single and bi-metallic NPs are discussed. The physico-chemical characterization of the synthesized various single and bi-metallic NPs are also discussed along with their anti-cancer and anti-bacterial ability. In addition, unresolved issues related to nanoparticle synthesis at large scale and expected improvement for future studies are also highlighted which are highly needful for application in the real environment.

Abstract Purpose: To measure the prevalence and causes of visual impairment (VI) among the 40+ age population in two coastal districts of India and to determine the levels of effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC) in the study population. Methods: A cross-sectional study was done on 4200 people chosen using cluster sampling in two coastal districts of Odisha, an eastern state in India. A team consisting of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Results: Overall, 3745 (89.2%) participants were examined from 60 study clusters, 30 in each district. Among those examined, 1677 (44.8%) were men, 2554 (68.2%) were educated and number? (17.8%) used distance spectacles during the survey. The prevalence of VI adjusted for age and gender was 12.77% (95% CI 11.85–13.69%). Multiple logistic regression showed that older age (OR 3.1; 95% CI 2.0–4.7) and urban residence (OR 1.2; 95% CI 1.0–1.6) were associated with VI. Being educated (OR 0.4; 95% CI 0.3–0.6) and using glasses (OR 0.3; 95% CI 0.5–0.2) were found to provide protection; therefore, resulting in lower instances of VI. Cataract (62.7%) and uncorrected refractive errors (27.1%) were the two main causes of VI. The eCSC was 35.1%, the eREC for distance was 40.0%, and the eREC for near was 35.7%. Conclusion: VI remains a challenge in Odisha, as the prevalence is high and the surgical coverage is poor. Nearly 90% of VI is avoidable indicating that targeted interventions are required to address this problem.

Background: Effective Cataract Surgical Coverage (eCSC) is a core outcomes domain indicator to assess accessibility and quality of eye care services with limited available information. Purpose: To generate baseline estimates of eCSC for India. Methods: We performed the analysis of data pooled from Rapid Assessment of Avoidable Blindness surveys conducted in 31 districts of India during 2015-2019 among persons aged 50+ years. eCSC was calculated at various thresholds, the primary being operable cataract at best corrected visual acuity

Summary: Resolution of cohesion between sister telomeres in human cells depends on TRF1-mediated recruitment of the polyADP-ribosyltransferase tankyrase to telomeres. In human aged cells, due to insufficient recruitment of TRF1/tankyrase to shortened telomeres, sisters remain cohered in mitosis. This persistent cohesion plays a protective role, but the mechanism by which sisters remain cohered is not well understood. Here we show that telomere repeat-containing RNA (TERRA) holds sister telomeres together through RNA-DNA hybrid (R-loop) structures. We show that a tankyrase-interacting partner, the RNA-binding protein C19orf43, is required for repression of TERRA R-loops. Persistent telomere cohesion in C19orf43-depleted cells is counteracted by RNaseH1, confirming that RNA-DNA hybrids hold sisters together. Consistent with a protective role for persistent telomere cohesion, depletion of C19orf43 in aged cells reduces DNA damage and delays replicative senescence. We propose that the inherent inability of shortened telomeres to recruit R-loop-repressing machinery permits a controlled onset of senescence.

Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to “Gum Care for All”, is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.

Abstract Chloroplasts have evolved from photosynthetic cyanobacteria-like progenitors through endosymbiosis. The chloroplasts of present-day land plants have their own transcription and translation systems that show several similarities with prokaryotic organisms. A remarkable feature of the chloroplast translation system is the use of non-AUG start codons in the protein synthesis of certain genes that are evolutionarily conserved from Algae to angiosperms. However, the biological significance of such use of non-AUG codons is not fully understood. The present study was undertaken to unravel the significance of non-AUG start codons in vivo using the chloroplast genetic engineering approach. For this purpose, stable transplastomic tobacco plants expressing a reporter gene i.e. uidA (GUS) under four different start codons (AUG/UUG/GUG/CUG) were generated and β-glucuronidase (GUS) expression was compared. To investigate further the role of promoter sequences proximal to the start codon, uidA was expressed under two different chloroplast gene promoters psbA and psbC that use AUG and a non-AUG (GUG) start codons, respectively, and also showed significant differences in the DNA sequence surrounding the start codon. Further, to delineate the role of RNA editing that creates AUG start codon by editing non-AUG codons, if any, which is another important feature of the chloroplast transcription and translation system, transcripts were sequenced. In addition, a proteomic approach was used to identify the translation initiation site(s) of GUS and the N-terminal amino acid encoded when expressed under different non-AUG start codons. The results showed that chloroplasts use non-AUG start codons in combination with the translation initiation site as an additional layer of gene regulation to over-express proteins that are required at high levels due to their high rates of turnover.

Introduction: During the era of COVID-19 pandemic, online learning has become more prevalent as it was the most available option for higher education training which has been a challenging experience for the students and the lecturers especially in the medical and health sciences training. The study was conducted to determine the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic. Methods: A cross sectional study was conducted to clinical year medical students at University Tunku Abdul Rahman. The validated Online Learning Environment Survey (OLES) was used as a tool to conduct the study. Results: Total 84 clinical year students participated in the study. Among four domains of OLES questionnaire, the domain; “Support of online learning” had the highest mean perception scores, 4.15 (0.55), followed by “Usability of online learning tools” 3.89 (0.82), and “Quality of Learning; 3.80 (0.68) and the domain “Enjoyment” was the lowest mean perception scores 3.48 (1.08). Most of the students (52.4%) rated the overall satisfaction of online teaching experiences “Very good” while (13.1) % rated “Excellent”. Conclusion: In conclusion, the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic were satisfactory although there were challenging online learning experiences during the pandemic. It was recommended to include qualitative method in future studies to provide more useful in-depth information regarding online learning environment.

Data-driven modeling and rendering is a general approach in haptics aiming to provide highly accurate haptic perceptual experiences simulating complex real physical dynamics, such as deformable or textured objects. A prevalent problem in the present methods for data-driven haptics is that the computational cost for modeling grows rapidly, even becoming intractable, as the interaction complexity or the number of data increases. This paper proposes one data-driven method featured with greatly improved computational efficiency for modeling viscoelastic deformable objects. This advantage is enabled by the use of fractional derivatives for modeling features and regression forests for data-interpolation models. For the benchmark of normal interaction on deformable objects, we describe a computational framework for data-driven haptic modeling and rendering. Its performance is validated by physical experiments for modeling accuracy and cost and a perceptual experiment for the similarity between real and virtual objects. The experiments demonstrate that our method offers highly realistic haptic perceptual experiences with markedly better modeling cost (at least ten times) than other state-of-the-art methods.

Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.

Background: Family physicians (FPs) encounter numerous patients who need eye care services. For providing eye care services at the primary level, they need to be abreast with the common disorders, their management and appropriate referral. Objectives: The aim of this study was to describe the socio-demographic and ocular morbidity profile of the beneficiaries, seasonal pattern of few ocular disorders and to find the proportion of blindness that is avoidable at the primary level. Methodology: Study was conducted in 25 vision centers across Delhi. Chart review was done in each center and retrospective data of previous 4 years was analyzed. Socio-demographic, ocular morbidity profile and trend of selected diseases was deducted and causes of blindness were determined. Results: Around 62.76% of patients were women and 78.26% were new patients. A seasonal peak of conjunctivitis was observed during the spring season. The common conditions detected by optometrists were refractive errors (34.68%), presbyopia (14.15%), cataract (14.02%), conjunctivitis (9.84%) and diseases of ocular adnexa (1.35%). In the age group ≥50 years, the proportion of patients who were blind was 2.5%, 39.0% had VI. The proportion of VI patients in all the categories was higher in women as compared to men. In patients ages ≥50 years, 81.4% of the blindness was avoidable. Conclusions: Women outnumbered men in availing services at the center and the proportion of visual impairment was also higher in them. The major causes of blindness in the older population were cataract and corneal-opacity, and it is avoidable by strengthening primary eye care services by FPs.

Gingival recession which is described as the loss of gingival attachment due to apical migration of the gingival margin from the cementoenamel junction leading to the exposure of the root surface, is one of the most prevalent diseases in the world. The treatment of gingival recession is therefore essential to achieve good aesthetics, relieve root hypersensitivity, prevent root caries and cervical abrasions. Till date, many root coverage techniques have been implicated for the coverage of recession defect. This case report focuses on the Vestibular Incision Subperiosteal Tunnel Access (VISTA™) technique for the root coverage procedure and simultaneous application of the microsurgical principles helps in executing the procedure in the most minimally invasive manner. Here, this technique has been accomplished in a 24-year-old female, with the chief complaint of poor aesthetics in the region of maxillary central incisors due to recession defects. Furthermore with the use of microsurgical instruments and magnifying loupes; complete coverage of the recession defects was achieved in a single stage surgery along with superior aesthetics, causing minimal trauma to the patient that was followed by an uneventful inflammatory phase.

Since the advent of the coronavirus disease (COVID-19) infection, this highly infectious virus has spread worldwide infecting millions of people. Not only it has affected the pulmonary function of the body, leading to difficulty in breathing, but at the same time, an array of other systemic infections which may or may not be directly due to coronavirus infection, due to an absent established relationship. The mucocutaneous manifestations seen in COVID-19 infection include depapillation of the tongue, lesions seen on alveolar mucosa, gingiva, buccal mucosa, dysgeusia, and dry mouth. This case report highlights the effect of COVID-19 on the tongue also known as COVID tongue seen as depapillation of the tongue surface. Due to the absence of long-term studies and time-limited research, a direct relationship between COVID-19 and the systemic manifestation is not yet established. More research has to be done in this direction, to chart out the exact etiology of these systemic infections.

Gingival recession is defined as the apical displacement of the gingival margin leading to exposure of the root surface. Occurrence of the gingival recessions in the anterior teeth is a major concern for the patients as it leads to compromised aesthetics and achieving the aesthetics and functional requirements of the patients remains a major therapeutic challenge for the treating dental surgeon. Incorporating the principles of Minimally Invasive Surgical Technique (MIST), surgical trauma is minimised, thus causing less cell damage, eventually resulting in less inflammation and less discomfort. MIST aims to achieve aesthetically superior outcomes that are made possible due to improved visual acuity. Therefore, the intent of this case report was to emphasise the impact of implementing the minimally invasive surgical procedure in the management of marginal gingival recessions using the conventional Coronally Advanced Flap (CAF) and the Tarnow’s technique, with the use of microsurgical instruments and magnifying surgical loupes.

Telomere function is regulated by the telomere repeat binding proteins TRF1 and TRF2. Here the authors show that decreased levels of TRF1 proteins at shortened telomeres in aged human cells results in persistent telomere cohesion, protecting from premature senescence.

Introduction: This observational study with the random sampling was done to locate maximum discomfort and pain experienced with three different nickel–titanium (NiTi) arch wires during the initial leveling and aligning phase of orthodontic treatment in moderate crowding in mandibular arch, and variations in pain and discomfort level associated with area, gender, and age. Materials and Methods: This observational survey was conducted on a sample of 60 orthodontic patients (20 in each group of arch wire) taking little’s irregularity (moderate 4–6 mm) crowding as criteria. The survey has started on the day of bonding along with three different types of initial arch wires (Superelastic NiTi, thermoelastic NiTi, or conventional NiTi), On the same day of bonding appointment and arch wire insertion, all participants were given the Modified Mc Gill pain questionnaire with the Visual Analog Scale and asked to fill and submit to the investigator on their next appointment positively. Results: The results were statistically insignificant in relation to the objectives of an observational study. Conclusion: Any of the three arch wires independent of age, gender, and area can be used by orthodontist during initial leveling and alignment phase of the treatment since the pain and discomfort level for all of them are same.

Background: Epidemiological studies based on hospital population, geographic isolates, smaller population, and focused groups provide valuable information on the pattern of diseases, but do not reflect on the true prevalence rates or the changing trends of disease over a period of time in different communities. The present study was undertaken to determine the prevalence and pattern of various neurological disorders in Himachal Pradesh. Methodology: Study was carried out in urban and rural population of district Kangra of Himachal Pradesh. A proportional representation was given to each area in the allocation of sample size as per probability proportional to size (PPS) method using a two-phase design: 1) A screening phase and 2) a clinical evaluation phase. All subjects were screened and a subset (screen positive and 10% of screen negative) was identified for the detailed clinical evaluation after screening. A standardized screening battery (NIMHANS protocol) was used for this purpose. An individual was confirmed as a case of neurological disorder only after clinical evaluation. Results: A total of 260 (out of 10,000 studied) individuals were found positive for neurological disorders yielding a crude prevalence of 2.6%. The crude prevalence for rural areas was found to be 2.28% (206/9000), whereas the crude prevalence in urban area was found to be 5.4% (54/1000). Migraine was the most common disorder. Conclusion: In view of the high crude prevalence of major neurological disorders, there is a need to develop capacity among healthcare professionals regarding them.

Florida has a distinct wet season, which serves the annual water needs of the State and beyond. Our earlier studies have indicated that in addition to the seasonal rainfall anomalies, the variations of the length of the season also contribute significantly to variability of the wet season over Florida. Furthermore, the variations of the onset date of the rainy season relate significantly to the seasonal anomalies of length of the season and rainfall. In this study, we have used the National Aeronautics and Space Administration's (NASA's) Integrated Multi-Satellite Retrievals for Global Precipitation Mission version 6 (IMERG) rainfall dataset to monitor the rainy season over the five Water Management Districts (WMDs) of Florida for 2021. This effort was complimented by analyzing and verifying the variations of the rainy season over the preceding 20 wet seasons from the IMERG datasets. IMERG produces rainfall datasets at various latencies, with the final product having a 3.5-month latency since the satellite measurements of radiance are made. However, in this study, we find that an intermediate 12-h latency product of rainfall analysis from IMERG is reasonable to use for near real-time monitoring of the wet season over Florida. The operational monitoring of the 2021 wet season using the 12-h latency dataset from IMERG was also supplemented with the extended weather 6- to 10-day and 8- to 14-day forecasts of precipitation probability issued by the NOAA's Climate Prediction Center. Our study suggests that the current methodology of monitoring the onset date variations of the rainy season provides a viable alternative to assess and anticipate the seasonal variations amidst the moderate to insignificant weather and climate prediction skill of the numerical forecast models of the wet season of Florida.

The Ogallala Aquifer is one of the most productive agricultural regions and is referred to as the “breadbasket of the world”. It covers approximately 225,000 square miles beneath the Great Plains region spanning the states of Texas, New Mexico, Oklahoma, Kansas, Nebraska, South Dakota, Wyoming, and Colorado. The aquifer is a major water source for the region, with its use exceeding recharge. Previous studies have documented climate changes and their impacts in the region. However, this is the first study to document temperature and precipitation changes over the entire Ogallala region from 35 General Circulation Models participating in Phase 5 of the Climate Model Intercomparison Project (CMIP5). The main study objectives were (1) to provide estimates of present and future climate change scenarios for the High Plains Aquifer, (2) to translate the temperature and precipitation changes to agro-ecosystem indicator changes for Kansas using scenario funnels, and (3) to make recommendations for water resource and ecosystem managers to enable effective planning for the future availability of ecosystem services. The temperature change ranged from −4 °C to 8 °C, while the precipitation changes were between −50% to +50% over the region. This study improves the understanding of climate change on water resources and agro-ecosystems. This knowledge can be used to evaluate similar resources where the replenishment rate is slow.

The current study aimed to perceive and estimate the distribution of stress generated by the forces on the maxillary anterior teeth during orthodontic retraction using the bilateral mini screw implant. Finite element models were generated from the three-dimensional (3D) reconstruction of the maxillary arch via cone–beam computed tomography (CBCT). These models imitate the retraction of maxillary anterior teeth with the mini screw placed as the skeletal anchorage. The titanium mini screw of 1.3 mm × 8 mm dimension was placed at a height of 9 mm between the first molar and second premolar on both sides of the maxilla. A nickel titanium (NiTi) coil spring of 9 mm length was attached from the mini screw implant to the power arm which generated a force of 250 gm/side. Two different power arms were placed between the lateral incisor and canine at a height of 4 mm (group 1) and 8 mm (group 2), respectively. There were no significant differences observed when the stress values were compared to the left side and the right side in group 1 with a power arm of 4 mm. In group 2, the stresses around the lateral incisors were found to be on the higher side when compared with the central incisors and canines. The length of the power arm shows no significant difference in stress distribution pattern on the left and right sides except for stresses moving from the canine region to the lateral incisor region with the increase in power arm height.

Background: A high number of patients with Periodontitis may have undiagnosed diabetes mellitus (DM). Diabetes is an associated risk factor for chronic periodontitis and has several other oral symptoms including dry mouth and oral infection. Expanding the role of the dentist may prove to be an efficient method of early detection and management of diabetes. Aim: The purpose of the present study was to evaluate whether blood oozing from gingival crevice during routine periodontal examinztion can be used for determining glucose levels. Materials and Methods: A total of 120 male/female patients with Chronic Periodontitis in the age group of 30 years and above were selected and divided into three groups i.e. Control Group (Plasma glucose level), Test Group 1 (Finger capillary blood) and Test Group 2 (Gingival crevicular blood). Blood glucose measurements were made using gingival crevicular blood and finger capillary blood using glucose self monitoring device (Accu-Chek Active) and at the same time venous blood was collected for measurement of serum (plasma) glucose. Data obtained were statistically analyzed using Paired t-test (p), and Pearson's correlation test (r). Results: The results revealed a strong correlation between (a) gingival crevicular blood and finger capillary blood (r = 0.999; P < 0.133); and also (b) between GCB and Plasma glucose level (r =0.984; P < 0.230). Conclusion: The data from this study has shown that gingival crevicular blood collected during diagnostic periodontal examination can be an excellent source of blood for glucometric analysis. GCB can be used as a marker for blood glucose estimation using glucometer. The technique described is safe, easy to perform and helps to increase the frequency of diabetes screening in dental office.

In oral cavity, the site for localised growth is usually gingiva which is considered as reactive in nature. Many of these lesions can be identified only on the basis of typical and consistent histomorphology and are difficult to identify clinically. One such reactive lesion which is clinically similar in presentation is Peripheral Ossifying Fibroma (POF). Females are affected more often than males. The presented case report is of a 45-year-old female with a significant growth of large POF in the anterior maxilla. The various clinical, radiological and histological features and diagnosis of POF with its treatment of choice are explained.

Abstract We present in this paper the interannual variability of seasonal temperature and rainfall in the Indian meteorological subdivisions (IMS) for boreal winter and summer seasons that take in to account the varying length of the seasons. Our study reveals that accounting for the variations in the length of the seasons produces stronger teleconnections between the seasonal anomalies of surface temperature and rainfall over India with corresponding sea surface temperature anomalies of the tropical Oceans (especially over the northern Indian and the equatorial Pacific Oceans) compared to the same teleconnections from fixed length seasons over the IMS. It should be noted that the IMS show significant spatial heterogeneity in these teleconnections.

Tankyrase 1 and 2 are poly(ADP-ribose) polymerases that mark proteins for degradation, but there is a current lack of knowledge about their distinct functions and substrates. Here, the authors elucidate the cellular roles and substrates of these polymerases using comparative functional and proteomics analyses of tankyrase knockout cell lines.

Aim: To estimate the prevalence of visual impairment (VI) due to uncorrected refractive error (URE) and to assess the barriers to utilization of services in the adult urban population of Delhi. Materials and Methods: A population-based rapid assessment of VI was conducted among people aged 40 years and above in 24 randomly selected clusters of East Delhi district. Presenting visual acuity (PVA) was assessed in each eye using Snellen's "E" chart. Pinhole examination was done if PVA was

The acute-phase response (APR) is a prominent systemic reaction of the organism to local or systemic disturbances in its homeostasis caused by infection, tissue injury, trauma or surgery, or immunological disorders. The tissue macrophage is most commonly regarded as initiating the APR through direct stimulation and secretion of various cell communicating factors. Proinflammatory cytokines and mediators are significantly elevated with gingival inflammation and during the destructive phase of periodontitis. Cytokines appear to play a major role in the clinical symptoms and tissue destruction associated with progressing periodontitis. Many of these cytokines are derived from activated macrophages and can act both locally and distally to amplify cytokine production from other cell types. The host responses to periodontal disease and cardiovascular diseases were reflected by an increase in the acute-phase proteins (serum amyloid A and C-reactive protein).

Background: Role of various etiologic factors in periodontal disease has been investigated by means of epidemiologic surveys and clinical studies. The community periodontal index of treatment needs (CPITN) provides a picture of the public health requirements in the periodontal field, which is essential for national oral health policy-making and specific interventions. Materials and Methods: This study was conducted on 4000 individuals among rural, semi-urban, and metro population of Gurgaon District, Haryana State, to find out the oral health status and periodontal treatment needs (TNs) using CPITN index. Results: An inference was drawn from the results that among 4000 participants from all the four population groups' maximum, i.e., 63.80% of individuals needed TN2 whereas 18.20% of individuals needed TN3 and 18.10% of individuals needed TN1. Conclusion: It can be concluded with a word of hope and a word of warning. Hope lies in the fact that the measurement of periodontal diseases by epidemiological study of this condition is improving and receiving wide spread attention. The warning lies in the varied nature of the condition which goes to make up periodontal disease and perplexing ways in which these conditions blend. In addition to dental practitioner, periodontist and public health workers must devote more time and effort toward controlling periodontal disease than they seem to be devoting at present.

Stress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified over a 1-month period, and their charts were reviewed to determine whether American Society of Health-System Pharmacists guidelines were followed. Inappropriate usage was calculated as inappropriate patient-days and converted to incidence per 100 patient-days. Two interventions were implemented: (1) Pharmacists reviewed indications for SUP on each patient during daily team rounds and daily medication reconciliation and (2) residents rotating on ICU services were educated on a bimonthly basis. Postintervention data were obtained in a similar fashion. Prior to intervention, the incidence of inappropriate SUP usage was calculated to be 26.75 per 100 patient-days (n = 1099 total patient-days). Total cost attributable to the inappropriate use was $2433. Post intervention, we were able to decrease the inappropriate incidence of SUP usage to 7.14 per 100 patient-days (n = 1149 total patient-days). In addition, total cost of inappropriate use was reduced to $239.80. Our study highlights an effective multidisciplinary approach to reduce the inappropriate use of SUP in an academic medical ICU. We were able to reduce the incidence of inappropriate use of SUP by 73.31% ( P < .001). Furthermore, we were able to decrease the costs by approximately $2200/month.

The nick translation property of DNA polymerase I (Pol I) ensures the maturation of Okazaki fragments by removing primer RNAs and facilitating ligation. However, prolonged nick translation traversing downstream DNA is an energy wasting futile process, as Pol I simultaneously polymerizes and depolymerizes at the nick sites utilizing energy-rich dNTPs. Using an in vitro assay system, we demonstrate that the β-clamp of the Escherichia coli replisome strongly inhibits nick translation on the DNA substrate. To do so, β-clamp inhibits the strand displacement activity of Pol I by interfering with the interaction between the finger subdomain of Pol I and the downstream primer-template junction. Conversely, β-clamp stimulates the 5' exonuclease property of Pol I to cleave single nucleotides or shorter oligonucleotide flaps. This single nucleotide flap removal at high frequency increases the probability of ligation between the upstream and downstream DNA strands at an early phase, terminating nick translation. Besides β-clamp-mediated ligation helps DNA ligase to seal the nick promptly during the maturation of Okazaki fragments.

Emblica officinalis (Amla) is widely used in the Indian system of medicine and believed to increase defense against diseases. Amla is called amalaki in Sanskrit. It is one of the oldest oriental medicines mentioned in Ayurveda as potential remedy for assorted ailments. A wide range of phytochemical components present in amla including alkaloids, tannins, and flavonoids have been shown to procure useful biological activities. It is an ingredient of many Ayurvedic medicines and tonics as it removes excessive salivation and internal body heat. Research has been done with amla evaluating its role as an antioxidant. Amla is useful in ulcer prevention, for diabetic patients, and for memory effects. Amla Tonic has a hematinic and lipalytic function useful in scurvy, prevents indigestion, and controls acidity as well as it is a natural source of anti-aging.

Periodontal research is increasing nowadays. Various number of scientific papers are published highlighting the various aspects of periodontal research methodology. There are still current issues which need to be emphasized in both basic and clinical periodontal research methodology. The purpose of this review paper is to summarize the unresolved issues pertaining to prevalence, etiology, pathogenesis, diagnosis and therapy in periodontology.

Aim: The present study was undertaken to evaluate patient response and recurrence of pigmentation following gingival depigmentation carried out with a surgical blade and diode laser. Materials and Methods: Twenty patients who were esthetically conscious of their dark gums and requested treatment for the same were selected for this study. Complete phase I therapy was performed for all the patients before performing the gingival depigmentation procedures with laser and scalpel on a split-mouth basis. Patients were evaluated for pain (1 day, 1 week), wound healing and melanin repigmentation (Melanin Pigmentation Index) immediately and at 1 week, 1 month and 3 months, respectively. Results: The final results were statistically analyzed and significance was evaluated. The results of this study indicated that both scalpel and laser were efficient for gingival depigmentation. Comparative pain assessment (P = 0.148) and repigmentation scores (P = 0.288) at various time intervals between the two groups did not show any statistical significance. Conclusion: Both the procedures did not result in any post-operative complications and the gingiva healed uneventfully. When compared, both the techniques were found to be equally efficacious. Care must be taken to assess the gingival biotype and the degree of pigmentation in deciding which technique is to be used. Clinical Significance: Various methods of depigmentation are available with comparable efficacies. Depigmentation is not a clinical indication but a treatment of choice where esthetics is a concern and is desired by the patient.

Objectives: This study was carried out to correlate the relationship between early childhood caries and maternal education level and socio-economic status (SES). Materials and Methods: The study was conducted on 500 pairs of children of ≤6 years age and their mothers, who reported to the private dental clinic in Gurgaon, Haryana, India. The association between mother′s educational level and SES of the family were estimated through a self-structured questionnaire. Caries status of the children was estimated using deft index (World Health Organization criteria). Results: Collected data was statistically analyzed. There was an inverse relationship between the education level of mothers and caries status of their children. There was no relationship between the SES of mothers and caries status of their children. Conclusion: It was concluded that, mothers are responsible for their children primary oral health.

We make use of satellite-based rainfall products from the Tropical Rainfall Measuring Mission (TRMM) Multi-satellite Precipitation Analysis (TMPA) to objectively define local onset and demise of the Indian Summer Monsoon (ISM) at the spatial resolution of the meteorological subdivisions defined by the Indian Meteorological Department (IMD). These meteorological sub-divisions are the operational spatial scales for official forecasts issued by the IMD. Therefore, there is a direct practical utility to target these spatial scales for monitoring the evolution of the ISM. We find that the diagnosis of the climatological onset and demise dates and its variations from the TMPA product is quite similar to the rain gauge based analysis of the IMD, despite the differences in the duration of the two datasets. This study shows that the onset date variations of the ISM have a significant impact on the variations of the seasonal length and seasonal rainfall anomalies in many of the meteorological sub-divisions: for example, the early or later onset of the ISM is associated with longer and wetter or shorter and drier ISM seasons, respectively. It is shown that TMPA dataset (and therefore its follow up Global Precipitation Measurement (GPM) Integrated Multi-satellite Retrievals for GPM (IMERG)) could be usefully adopted for monitoring the onset of the ISM and therefore extend its use to anticipate the potential anomalies of the seasonal length and seasonal rainfall anomalies of the ISM in many of the Indian meteorological sub-divisions.

Human brucellosis is a multisystem disease that commonly presents as a febrile illness along with variable spectrum of clinical manifestations. Neurological complications include encephalitis, meningoencephalitis, radiculitis, myelitis, peripheral and cranial neuropathies, subarachnoid hemorrhage, and psychiatric manifestations. We report a case diagnosed as neurobrucellosis who presented with fever and bilateral upper motor neuron symptoms and signs along with bilateral sensorineural deafness. Diagnosis was confirmed by Rose Bengal Test (RBT) and standard tube agglutination test (SAT).

Probiotics have been found to be beneficial to host health. In medicine, probiotics are used mainly in support therapy for gastro-intestinal diseases. In recent years, probiotics have been used as a treatment to promote oral health. There has also been a change in understanding of the oral disease process because of better understanding of the ecology and microbiology of the oral cavity. Very encouraging studies exploring probiotics in the fields of caries, periodontal diseases and few other areas have come up in the recent past and the results tend to suggest beneficial effects of probiotics on oral health and on the whole body in general. Extensive research to create a probiotic product intended to maintain dental and periodontal health is needed. This article reviews the role of probiotics in dental caries and periodontal disease. [Arch Clin Exp Surg 2012; 1(1.000): 45-49]

To determine the prevalence, causes and associated demographic factors related to visual impairment amongst the urban population of New Delhi, India.A population-based, cross-sectional study was conducted in East Delhi district using cluster random sampling methodology. This Rapid Assessment of Visual Impairment (RAVI) survey involved examination of all individuals aged 40 years and above in 24 randomly selected clusters of the district. Visual acuity (VA) assessment and comprehensive ocular examination were done during the door-to-door survey. A questionnaire was used to collect personal and demographic information of the study population. Blindness and Visual Impairment was defined as presenting VA < 3/60 and < 6/18 in the better eye, respectively. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for visual impairment.Of 2421 subjects enumerated, 2331 (96.3%) were available for ophthalmic examination. Among those examined, 49.3% were males. The prevalence of visual impairment (VI) in the study population, was 11.4% (95% C.I. 10.1, 12.7) and that of blindness was 1.2% (95% C.I. 0.8, 1.6). Uncorrected refractive error was the leading cause of VI accounting for 53.4% of all VI followed by cataract (33.8%). With multivariable logistic regression, the odds of having VI increased with age (OR = 24.6[95% C.I.: 14.9, 40.7]; p < 0.001). Illiterate participants were more likely to have VI [OR = 1.5 (95% C.I.: 1.1,2.1)] when compared to educated participants.The first implementation of the RAVI methodology in a North Indian population revealed that the burden of visual impairment is considerable in this region despite availability of adequate eye care facilities. Awareness generation and simple interventions like cataract surgery and provision of spectacles will help to eliminate the major causes of blindness and visual impairment in this region.

Racemose cysticercosis is a less frequent presentation of neurocysticercosis (NCC). It′s presentation and management is quite different from cerebral parenchymal NCC. Diagnosis of racemose cysticercosis is based on the combination of clinical, epidemiologic, radiographic, and immunologic information. Compared with cysticercus cellulose, which most commonly presents as seizures, racemose NCC due to its extraaxial location presents with raised intracranial pressure and meningitis, and frequently requires neurosurgical intervention. Dementia as a sole presenting feature of NCC is rare. We report a case of racemose NCC with dementia as the presenting manifestation. The outcome of dementia patients with NCC seems favorable in most cases therefore a high index of suspicion for NCC should be kept especially in endemic areas.

Xylanases belong to an important class of industrial enzymes. Various xylanases have been purified and characterized from a plethora of organisms including bacteria, marine algae, plants, protozoans, insects, snails and crustaceans. Depending on the source, the enzymatic activity of xylanases varies considerably under various physico-chemical conditions such as temperature, pH, high salt and in the presence of proteases. Family 10 or glycosyl hydrolase 10 (GH10) xylanases are one of the well characterized and thoroughly studied classes of industrial enzymes. The TIM-barrel fold structure which is ubiquitous in nature is one of the characteristics of family 10 xylanases. Family 10 xylanases have been used as a “model system” due to their TIM-barrel fold to dissect and understand protein stability under various conditions. A better understanding of structure-stability-function relationships of family 10 xylanases allows one to apply these governing molecular rules to engineer other TIM-barrel fold proteins to improve their stability and retain function(s) under adverse conditions. In this review, we discuss the implications of N-and C-terminal interactions, observed in family 10 xylanases on protein stability under extreme conditions. The role of metal binding and aromatic clusters in protein stability is also discussed. Studying and understanding family 10 xylanase structure and function, can contribute to our protein engineering knowledge.

Vascular anomalies comprise a widely heterogeneous group of tumours and malformations. Haemangioma is the most common benign tumour of vascular origin of the head and neck region. The possible sites of occurrence in oral cavity are lips, tongue, buccal mucosa, and palate. Despite its benign origin and behaviour, it is always of clinical importance to the dental profession and requires appropriate management. This case study reports a rare case of capillary haemangioma on the palatal gingiva in a 14-year-old female.

BACKGROUND: Stabilization strategies adopted by proteins under extreme conditions are very complex and involve various kinds of interactions. Recent studies have shown that a large proportion of proteins have their N- and C-terminal elements in close contact and suggested they play a role in protein folding and stability. However, the biological significance of this contact remains elusive. METHODOLOGY: In the present study, we investigate the role of N- and C-terminal residue interaction using a family 10 xylanase (BSX) with a TIM-barrel structure that shows stability under high temperature, alkali pH, and protease and SDS treatment. Based on crystal structure, an aromatic cluster was identified that involves Phe4, Trp6 and Tyr343 holding the N- and C-terminus together; this is a unique and important feature of this protein that might be crucial for folding and stability under poly-extreme conditions. CONCLUSION: A series of mutants was created to disrupt this aromatic cluster formation and study the loss of stability and function under given conditions. While the deletions of Phe4 resulted in loss of stability, removal of Trp6 and Tyr343 affected in vivo folding and activity. Alanine substitution with Phe4, Trp6 and Tyr343 drastically decreased stability under all parameters studied. Importantly, substitution of Phe4 with Trp increased stability in SDS treatment. Mass spectrometry results of limited proteolysis further demonstrated that the Arg344 residue is highly susceptible to trypsin digestion in sensitive mutants such as DeltaF4, W6A and Y343A, suggesting again that disruption of the Phe4-Trp6-Tyr343 (F-W-Y) cluster destabilizes the N- and C-terminal interaction. Our results underscore the importance of N- and C-terminal contact through aromatic interactions in protein folding and stability under extreme conditions, and these results may be useful to improve the stability of other proteins under suboptimal conditions.