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Introduction: Oral Submucous Fibrosis (OSMF) is a long-term condition characterised by the gradual buildup of fibrous tissue in the oral cavity, often extending to the throat and upper oesophagus. The primary symptoms include progressive limitation in mouth opening due to the formation of stiff fibrous bands in the oral mucosa, accompanied by muscle atrophy. However, the most concerning aspect of this restriction, known as trismus, is its hindrance to effective cancer monitoring. Surgical approaches typically aim to release these fibrotic bands, while medical interventions focus on managing inflammation and preventing further fibrosis. Need of the Study: A modification of the nasolabial flap has been suggested for the reconstruction of intraoral defects following ablative surgery for OSMF. The study will assess its merits in comparison to the conventional nasolabial flap. Aim: To evaluate and compare the aesthetic and functional outcomes of the rima oris between the Conventional Nasolabial Flap and the Nasolabial Flap with Fishtail Modification in patients undergoing surgical intervention for OSMF. Materials and Methods: A prospective, double-blinded, randomised controlled trial will be conducted in the Department of Oral and Maxillofacial Surgery at Acharya Vinoba Bhave Rural Hospital, associated with Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from November 2023 to November 2024. Patients older than 18 years of age diagnosed with OSMF, without any superimposing cancerous lesions, will be included in the study. They will be divided into two groups: Group A will be treated with bilateral fibrotomy, coronoidotomy and reconstruction with the conventional nasolabial flap, while Group B will undergo the same surgical intervention, except that the reconstruction will be performed using the fishtail modification of the nasolabial flap. The parameters that will be compared include interincisal mouth opening, intercommissural width, dehiscence and flap necrosis. The analysis will be conducted using the Chi-square test and Fisher’s-exact test for categorical data and the independent t-test for continuous data that follow a normal distribution. These statistical tests will help evaluate the association between different demographic, clinical and etiological factors and the outcomes under consideration. A p-value of

Corrosion of metals and alloys is one of the most frequent problems encountered in chemical and process industries. Inefficient corrosion control measures typically lead to an increased risk of unplanned downtime, huge economic loss, environmental damage, and health and safety hazards. Hence, it is essential to develop environment-friendly and cost-effective corrosion inhibitors over existing toxic anticorrosive agents. The main objective of this work is to examine the efficacy of eco-friendly ethanolic extract of Mangifera indica leaves (MIL) in different concentrations as a green corrosion inhibitor for stainless steel (SS-316L) under an acidic environment. The inhibition efficiency of Mangifera indica leaves extract in 1 M hydrochloric acid (HCl) was evaluated by conventional weight loss method along with adsorption isotherm analysis. Chemical compounds present in leaf extract and changes in surface morphology of SS-316L samples were assessed using Fourier Transform Infrared spectroscopy (FTIR) and Field Emission Scanning Electron Microscopy (FE-SEM) provided with elemental analysis. The results of the weight loss method revealed that the inhibition efficiency increases with increasing MIL extract concentration due to higher surface coverage. The highest inhibition efficiency of almost 63.43% in 14 days and minimum corrosion rate of 0.433 mm per year was obtained for SS-316 L in 1.0 M HCl with 1000 ppm concentration. The adsorption of MIL extract on SS-316L surface followed Freundlich adsorption isotherm, and the obtained value of free Energy of adsorption (ΔG˚ads = – 9.20 kJ.mol-1) indicates the physical adsorption mechanism. The developed regression-based models can predict the corrosion rate as a function of inhibitor concentration and exposure time with good accuracy (>80%). Thus, the present findings demonstrate that Mangifera indica L. leaves extract can suitably be applied as an inexpensive, non-toxic, biodegradable, efficient green corrosion inhibitor for the protection of stainless steel in acidic media.

Abstract Background Thyroid nodules affect up to 65% of the population. Although fine needle aspirate (FNA) cytology is the gold standard for diagnosis, 15–30% of results are indeterminate. Molecular testing may aid in the diagnosis of nodules and potentially reduce unnecessary surgery. However, these tests are associated with significant costs. The objective of this study was to evaluate the cost-effectiveness of Afirma, a commercially available molecular test, in cytologically indeterminate thyroid nodules. Methods The base case was a solitary thyroid nodule with no additional high-risk features and an indeterminate FNA. Decision tree analysis was performed from the single payer perspective with a 1-year time horizon. Costing data were collected through micro-costing methodology. A probabilistic sensitivity analysis was performed. The primary outcome was the incremental cost effectiveness ratio (ICER) of cost per thyroid surgery avoided. Results Over 1 year, mean cost estimates were $8176.28 with 0.58 effectiveness for the molecular testing strategy and $6016.83 with 0.07 effectiveness for current standard management. The ICER was $4234.22 per surgery avoided. At a willingness-to-pay (WTP) threshold of $5000 per surgery avoided, molecular testing is cost-effective with 63% certainty. Conclusion This cost-effectiveness analysis suggests utilizing Afirma for indeterminate solitary thyroid nodules is a cost-effective strategy for avoiding unnecessary thyroid surgery. With a $5000 WTP threshold, molecular testing has a 63% chance of being the more cost-effective strategy. The cost effectiveness varies based on the cost of the molecular test and the value of Afirma for patients with indeterminate thyroid nodules depends on the WTP threshold to avoid unnecessary thyroid surgery. Graphical Abstract

Background: It is hypothesized that electrical vestibular stimulation may be an effective adjunctive therapy in the management of Temporomandibular disorder (TMD). Aims and Objectives: The aim of the present study is to assess the effectiveness of electrical vestibular nerve stimulation (VeNS) in the management of pain in patients with temporomandibular disorders. Materials and Methods: A total of 24 male and female participants newly diagnosed with TMD were recruited after obtaining the written informed consent. VeNS was administered for 4 weeks. Each daily session was for an hour (1 h), with three sessions being carried out each week. The pain was assessed using a numerical pain rating scale. The JFLS-8 is a short form for measuring global functional limitations of the jaw. The DASS-21 questionnaire is comprised of three self-reported scales to measure negative emotional states of depression, anxiety, and stress. Results: Age, height, weight and, BMI were not significantly different between the control and intervention groups (Table 1). There was a significant decrease in the pain score in the intervention group when compared with the control group (P

Introduction: Oral Submucous Fibrosis (OSMF) is a longterm condition characterised by the gradual buildup of fibrous tissue in the oral cavity, often extending to the throat and upper oesophagus. The primary symptoms include progressive limitation in mouth opening due to the formation of stiff fibrous bands in the oral mucosa, accompanied by muscle atrophy. However, the most concerning aspect of this restriction, known as trismus, is its hindrance to effective cancer monitoring. Surgical approaches typically aim to release these fibrotic bands, while medical interventions focus on managing inflammation and preventing further fibrosis. Need of the Study: A modification of the nasolabial flap has been suggested for the reconstruction of intraoral defects following ablative surgery for OSMF. The study will assess its merits in comparison to the conventional nasolabial flap. Aim: To evaluate and compare the aesthetic and functional outcomes of the rima oris between the Conventional Nasolabial Flap and the Nasolabial Flap with Fishtail Modification in patients undergoing surgical intervention for OSMF. Materials and Methods: A prospective, double-blinded, randomised controlled trial will be conducted in the Department of Oral and Maxillofacial Surgery at Acharya Vinoba Bhave Rural Hospital, associated with Jawaharlal Nehru Medical College, Wardha, Maharashtra, India, from November 2023 to November 2024. Patients older than 18 years of age diagnosed with OSMF, without any superimposing cancerous lesions, will be included in the study. They will be divided into two groups: Group A will be treated with bilateral fibrotomy, coronoidotomy and reconstruction with the conventional nasolabial flap, while Group B will undergo the same surgical intervention, except that the reconstruction will be performed using the fishtail modification of the nasolabial flap. The parameters that will be compared include interincisal mouth opening, intercommissural width, dehiscence and flap necrosis. The analysis will be conducted using the Chi-square test and Fisher's-exact test for categorical data and the independent t-test for continuous data that follow a normal distribution. These statistical tests will help evaluate the association between different demographic, clinical and etiological factors and the outcomes under consideration. A p-value of <0.05 will be considered statistically significant. [ABSTRACT FROM AUTHOR]

BackgroundVariability in imaging protocols and techniques has resulted in a lack of consensus regarding the incorporation of perfusion imaging into stroke triage and treatment. The objective of our study was to evaluate the available scientific evidence regarding the utility of perfusion imaging in determining treatment eligibility in patients with acute stroke and in predicting their clinical outcome.MethodsWe performed a systematic review of the literature using PubMed, Web of Science, and Cochrane Library focusing on themes of medical imaging, stroke, treatment, and outcome (CRD42016037817). We included randomized controlled trials, cohort studies, and case-controlled studies published from 2011 to 2016. Two independent reviewers conducted the study appraisal, data abstraction, and quality assessments of the studies.ResultsOur literature search yielded 13 studies that met our inclusion criteria. In total, 994 patients were treated with the aid of perfusion imaging compared with 1819 patients treated with standard care. In the intervention group 51.1% of patients had a favorable outcome at 3 months compared with 45.6% of patients in the control group (p=0.06). Subgroup analysis of studies that used multimodal therapy (IV tissue plasminogen activator, endovascular thrombectomy) showed a significant benefit of perfusion imaging (OR 1.89, 95% CI 1.43 to 2.51, p

Abstract Developing bees derive significant benefits from the microbes present within their guts and fermenting pollen provisions. External microbial symbionts (exosymbionts) associated with larval diets may be particularly important for solitary bees that suffer reduced fitness when denied microbe‐colonized pollen. To investigate whether this phenomenon is generalizable across foraging strategy, we examined the effects of exosymbiont presence/absence across two solitary bee species, a pollen specialist and generalist. Larvae from each species were reared on either microbe‐rich natural or microbe‐deficient sterilized pollen provisions allocated by a female forager belonging to their own species (conspecific‐sourced pollen) or that of another species (heterospecific‐sourced pollen). Our results reveal that the presence of pollen‐associated microbes was critical for the survival of both the generalist and specialist larvae, regardless of whether the pollen was sourced from a conspecific or heterospecific forager. Given the positive effects of exosymbiotic microbes for larval fitness, we then examined if the magnitude of this benefit varied based on whether the microbes were provisioned by a conspecific forager (the mother bee) or a heterospecific forager. In this second study, generalist larvae were reared only on microbe‐rich pollen provisions, but importantly, the sources (conspecific versus heterospecific) of the microbes and pollen were experimentally manipulated. Bee fitness metrics indicated that microbial and pollen sourcing both had significant impacts on larval performance, and the effect sizes of each were similar. Moreover, the effects of conspecific‐sourced microbes and conspecific‐sourced pollen were strongly positive, while that of heterospecific‐sourced microbes and heterospecific‐sourced pollen, strongly negative. Our findings imply that not only is the presence of exosymbionts critical for both specialist and generalist solitary bees, but more notably, that the composition of the specific microbial community within larval pollen provisions may be as critical for bee development as the composition of the pollen itself.

Abstract Stable nitrogen (15N/14N) and carbon (13C/12C) isotopic compositions of amino acids in organisms have widely been employed as a powerful tool to evaluate resource utilization and trophic connection among organisms in diverse ecosystems. However, little is known about the physiological factors or mechanisms responsible for determining the isotopic discrimination (particularly for carbon) within amino acids of organisms. In the present study, we investigated the inter-trophic discrimination of nitrogen and carbon isotopes within amino acids (Δδ 15NAA and Δδ 13CAA, respectively) using four consumer–diet pairs. Each pairing illustrates a metabolic perspective of isotopic fractionation of amino acids. The Δδ 15NAA values in these combinations reveal a trend consistent with those observed in many other combinations in previous studies. This further validates a standard scenario: the deamination preferentially removes 14N amino group from diet-derived amino acids, leaving behind the 15N-enriched amino acids in consumer biomass. The Δδ 15NAA values thus mirror the activity of amino acid deamination in consumers. In contrast, the trends in the Δδ 13CAA value suggest a different metabolic fate for the amino acid carbon isotope. Based on our results, we predict the following scenario: decarboxylation preferentially removes 12C α-carbon (i.e., carbonyl-carbon) from pyruvic acid in glycolysis, and from α-ketoglutaric acid in the tricarboxylic acid cycle, leaving behind the 13C-enriched both pyruvic and α-ketoglutaric acids. The 13C is then transferred to amino acids that are synthesized from the 13C-enriched precursor molecules within consumers. The Δδ 13CAA values therefore mirror the pathways of de novo amino acid synthesis in consumers. The proposed link between nitrogen and carbon isotopes can refine our knowledge of the potential processes affecting the isotopic fractionation within diet and consumer compartments, as well as environmental samples. Graphical abstract

Background: Globally about 5 million deaths every year can be ascribed to tobacco use. It leads to many systemic and oral diseases. These diseases in geriatric population are common and more hazardous. Methods: Cross-sectional study was conducted in rural area of a teaching hospital to assess general health status and oral health scores of 500 geriatric age group tobacco users and non users. Data analysis was done with SPSS version-20. Chi square test and Mann Whitney U rank test were applied. Results: Poor self assessed health status was found in tobacco users as compared to nonusers. Significant limitation was found among the tobacco users as compared to nonusers. Significant association was found between the presence of diabetes, COPD, and tobacco use. Tobacco use was found to be significantly associated with poor oral health. Conclusion: Statistically significant poor general and oral health was found in tobacco users than nonusers.

Introduction Diabetes mellitus cases are increasing worldwide. It affects almost all systems of the body including audio-vestibular system. Diabetic otopathy (DO) is the presence of symptoms and signs of vestibular and auditory disorders in patients with diabetes mellitus after the exclusion of other causes. In this review we aimed to study the mechanism of development of hearing loss in diabetes, the relationship between duration and severity of diabetes, and association of other complications with hearing loss. Materials and Methods We searched the MEDLINE & PubMed database using terms ‘diabetic otopathy’ and ‘diabetes & hearing loss’ for the articles published since 1970. Twenty articles were selected and reviewed. Results The mechanism of development of DO is not yet clearly known. But it is suggested to be multifactorial. This review of literature suggested that hearing impairment is two times more prevalent in subjects with diabetes as compared to those without diabetes. The relationship between diabetic otopathy and diabetic kidney disease is most commonly noticed. Conclusion The higher prevalence of hearing impairment in diabetic patients compared with nondiabetic patients was consistent. It is necessary to establish a screening and monitoring strategy for patients with diabetes mellitus to prevent the development of hearing loss and its consequences on life quality.

Background: Chronic neck pain is observed to be commonly kindred with forward head posture (FHP). Rib cage mechanics is found to be altered that decreases thoracic mobility. This reduced mobility of thorax reduces the effectiveness of diaphragm, intercostals, and abdominal muscles in terms of ventilation. Therefore this study was done to evaluate the effectiveness of exercises meant for enhancing the stability of the neck with feedback on neck stabilization exercises with feedback in improving the respiratory status. Methods: This was an experimental study. Based on inclusion & exclusion criteria, 100 subjects (54 males and 46 females) enrolled for the study, which was further allotted into Experimental and Control groups. The experimental group was given Cervical Stabilization Exercise with feedback in addition to routine Physiotherapy treatment. Control group was given only regular Physiotherapy treatment for six weeks. The digital camera assessed the FHP by measuring of Craniovertebral Angle (CVA). Spirometry assessed pulmonary function (FEV1) and Micro RPM assessed inspiratory muscle strength (PImax). All measurements were taken on the day of study, on 3rd and 6th week Results: Significant reduction in forward head posture measured by improvement in Craniovertebral angle, improvement in Inspiratory muscle strength (PIMax) and pulmonary functions (FEV1) were found in the group that received cervical stabilization exercises with feedback along with the conventional Physiotherapy (p< 0.05). Therefore it is suggested that cervical stabilization exercises correct the head posture and helps to improve the biomechanics of respiratory muscles. Conclusion: Cervical stabilization exercise is an effective approach to correct the forward head posture, and it should be included in the intervention measures of patients with forward head posture.

Background: Dengue is a common vector-borne disease in countries like India, where it occurs in specific pockets including many in Maharashtra. During July–August 2018, an outbreak of dengue was suspected in a village of Wardha district, following an increase in the number of fever cases from the village, which demanded an urgent outbreak investigation to be carried out before it progressed into an epidemic/larger outbreak. Objectives: The aim of this study was to find out more cases, source of infection and to recommend necessary actions to control the dengue outbreak. Materials and Methods: This was a cross-sectional epidemiological study, where we used pre-tested, pre-designed epidemiological case sheets obtained from Integrated Disease Surveillance Program (IDSP). A case definition was proposed before beginning the investigation. Line listing, collection of blood samples, distribution of paracetamol tablets to fever cases, and making a spot map were some of the important steps carried out during the investigation. Results: Out of a total of 64 suspected fever cases, 36 cases fulfilled the case definition of dengue, set for the purpose of outbreak investigation. Twenty-three of them got admitted in different hospitals among whom two of them died. Apart from that, four of them were found to be positive for both dengue IgM and NS1 antigen in their blood samples. It was age group of 21–30 years which was mostly affected. Compared to males, the female population suffered more from the illness. House, container, and Breteau index were found to be 0.26, 0.09, and 0.32, respectively. Conclusion: Following the investigation, a detailed report was made, which was shared with the district health authority. The report also contained recommendations for necessary actions to be taken to control this outbreak and to further prevent such outbreaks in future.

Introduction: Cholera, though a preventable and treatable disease, is still regarded as an important public health problem in developing countries including India. Migration, unhygienic living conditions, overcrowding, open field defecation, and ignorance about the spread of disease are the major reasons for the occurrence of cholera in the slum areas. Cholera was detected in the stool sample of a 3-year-old child from a slum area of urban Wardha, which demanded an urgent outbreak investigation to be carried out before it progressed into an epidemic. Materials and Methods: This was a cross-sectional epidemiological study, where we have used pretested, predesigned epidemiological case sheets obtained from IDSP. A case definition was proposed before beginning the investigation. Linelisting, collection of stool and water samples, immediate referral, and treatment of the patients suffering from loose stool and/or vomiting were performed. A detailed epidemiological report was made with recommendations and plan of action that was forwarded to the district health system. Results: In all, 28 suspected cases of cholera were line listed. Among the affected population, more than half of the suspected cases were from the age group of 0–10 years of age. Males were more affected when compared with females. The overall attack rate was 27% and case fatality rate was 0%. There was positive history of travel in the index case. Two of the water samples were found to be unsatisfactory for drinking. Conclusion: The investigation report was soon developed and shared with the district health authorities, and recommendations were given to prevent such outbreaks in future.

Background: Epidemiological transition with increasing burden of cardiovascular risk factors is evident not only in adults but also in children. The data on the prevalence of prehypertension and hypertension in children show large regional differences in India and such data are not available from Central India. We, therefore, conducted a large cross-sectional study in Indore to determine the distribution of blood pressure (BP) and the prevalence of hypertension and prehypertension among schoolchildren. Methods: A total of 11,312 children (5305 girls, 6007 boys) aged 5–15 years, drawn from 80 government and private schools in equal proportion, were evaluated. Anthropometric measurements were obtained and BPs were measured using The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents as reference standard. BP ≥90th to