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Background There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation. Objectives i) To evaluate the readability of internet content (Google) regarding tobacco cessation using Flesch–Kincaid readability tests and the quality of internet content (Google) by using the JAMA benchmark, HONcode and DISCERN questionnaire. Methods A content review was employed to screen the content of the Google search engine for educational tobacco cessation websites, and the top 50 websites were selected according to criteria and reviewed by two reviewers. The readability of the internet content (Google) regarding tobacco cessation was evaluated using Flesch–Kincaid readability tests. The quality of the screened sites was evaluated by using the JAMA (Journal of the American Medical Association) benchmark, HONcode (The Health on the Net Code of Conduct) and DISCERN (Discerning the Quality of Information for Choosing Treatments) questionnaire, and the readability and quality of the screened websites were correlated using the above instruments. Results FK readability ease was found to be 49% standard and 30% easy. The FK grade test found that 33% of the content could be easily understood by < 5th grade. All 4 JAMA benchmarks were met by 23% of websites, and authorship was the least fulfilled criterion. Correlation analysis revealed a significant association between FK ease score and FK grade score. Conclusions The Read-ability Ease and Read-ability Grade Levels of the websites related to tobacco cessation were not standard, and few websites fulfilled the JAMA benchmarks and had HONcode certification.

In this study, the Chaotic Sinusoidal Map (CSM)-enhanced Zebra Optimization Algorithm (CZOA) is introduced. CZOA combines CSM's integration strengths with ZOA's optimization skills. ZOA already exhibits great optimization capabilities, but the addition of CSM increases its potential even more. This addition greatly strengthens ZOA's exploration and exploitation skills and increases its flexibility for various optimization tasks. CZOA outperforms both the original ZOA and contemporary optimisation methods on 23 benchmark functions, including high-dimensional (FD), multimodal (MM), and unimodal (UM) challenges. Using the chaos of CSM to investigate regional optimal and determine better convergence and exploration-exploitation equilibrium are shown by CZOA, which also shows more profitable solution locations. CZOA demonstrates its resilience and versatility through multiple benchmark activities, underscoring its potential as an adaptable optimisation tool. CZOA becomes a potent metaheuristic by combining biological inspiration and chaotic dynamics to solve difficult optimisation problems. Inspired by the natural behaviour of zebras, the Zebra Optimisation Algorithm (ZOA) is a relatively new optimisation technique. It makes use of a herd behaviour mechanism and the ideas of leadership and following, in which members of the population—zebras in this case—cooperate to solve optimisation issues in the best possible ways

Tropical endomyocardial fibrosis (EMF) is endemic in southern districts of Kerala state in India, and sporadic cases are reported from other parts of Kerala. Transthoracic echocardiogram (TTE) is the initial imaging tool and is diagnostic for this condition. The inherent limitation of TTE is its limited sensitivity in the detection of intracardiac thrombus. Transthoracic echocardiography, contrast-enhanced cardiac computed tomography, and cardiac magnetic resonance imaging (CMR) are the imaging modalities for the detection of intracardiac thrombus. This report describes a 46-year-old male with right ventricular EMF (RVEMF) who presented with right heart failure. The TTE diagnosed RVEMF but failed to demonstrate the right atrial thrombus which was clearly seen on CMR. The merits of different imaging modalities for the detection of intracardiac thrombus are discussed.

An echocardiographic investigation is one of the key modalities of diagnosis in patients suffering from COVID-19, especially if they are elderly, have associated comorbid conditions, and pregnant. Hence, it is becoming extremely essential to look into the correct safety precautions, health-care professionals must take while conducting an echo investigation. At the same time, a focused echo examination aimed at correct imaging view acquisition in the shortest possible time is the need of the hour. The decision matrix formulated for conducting an echocardiographic evaluation is based on the presence or absence of cardiological comorbidity vis-a-vis positive or suspected for COVID-19. The safety measures and image acquisition have been constructed keeping in mind the current safety precautions by the World Health Organization, the Centers for Disease Control and Prevention, and the Ministry of Health and Family Welfare, India.

Background: The disadvantaged communities are often susceptible to poor oral health due to low incomes, lack of awareness, and low health-care utilization. Untreated dental diseases can lead to loss of teeth which may result in unmet prosthodontic needs. The present study assessed tooth loss, prosthetic status, and treatment needs of a fishing community in Mangalore, India. Materials and Methods: Oral examination of 400 individuals from a fishing community was done through a house-to-house cross-sectional survey using the World Health Organization oral health assessment form 1997. Data on demography, personal habits, and dental utilization were collected using a questionnaire. Results: The prevalence of tooth loss was 43%, and the mean number of missing teeth was 2.32 ± 5.21. More tooth loss was observed in older age groups and smokers. About 97% of the participants did not use any prosthesis, whereas it was needed in 23% in the maxillary arch and 33% in the mandibular arch. Prosthetic need was higher in older age groups. Majority of the participants had never visited a dentist before. Conclusions: Tooth loss was associated with age and smoking in this population. Utilization of oral health services was low, and prosthetic need was high. Targeted health promotion is recommended to prevent tooth loss and improve prosthetic status.

Background: Promoting oral self-care capacity and the use of fluoride toothpaste is an appropriate strategy for the prevention of oral diseases among schoolchildren, especially in a developing country like India. Aim: To assess the oral health behavior of fluoridated toothpaste usage among parents of 12-year-old schoolchildren in Mangalore, South India. Materials and Methods: Around 523, 12-year-old school students selected by cluster random sampling were given questionnaires to be completed by the parents to elicit their dental health behavior. Data were analyzed using SPSS software version 16.0. Bivariate analysis of the association of dental health behavior and the type of the school was conducted using Chi-square test. Finally, we fitted a multivariate binary logistic regression model to estimate the strength of association, and P < 0.05 was considered statistically significant. Results: In this study, all the schoolchildren used toothpaste to clean their teeth, and the major factors which influenced the selection of toothpaste were promotional offer and advertisement for government and private schools, respectively. Multivariate analysis revealed that private schoolchildren had higher odds for using fluoridated toothpaste (odds ratio [OR] – 6.04 confidence interval [CI]: 1.929–18.912), receiving instructions from dentist (OR – 4.63 [CI: 2.770–7.741]), and brushing twice daily (OR – 0.37 [CI: 0.219–0.629]). Enrollment in government schools was associated with lower odds for selecting toothpaste based on professional advice (OR – 0.11 [CI: 0.072–0.177]). Conclusions: Private schoolchildren had higher usage of fluoridated toothpaste. Private schoolchildren had higher usage of fluoridated toothpaste and receiving instructions from dentist about dental health behavior. To overcome the Inverse Care Law, it is of utmost importance to create awareness among government schoolchildren.

Introduction: Dental anxiety is a known barrier to oral health-care utilization. The data on dental anxiety and oral health services utilization of young adults in India are scarce. Aim: The present study was conducted to assess the social determinants of dental anxiety and utilization patterns of oral health services among young adults aged 18–21 years in Mangalore city, India. Materials and Methods: A total of 575 young adults aged 18–21 years were selected from degree colleges in Mangalore city. Dental anxiety was assessed using the Modified Dental Anxiety Scale and utilization of oral health services was assessed using a questionnaire. Data were also collected on age, gender, and socioeconomic factors. Statistical analysis was done using Statistical Package for the Social Sciences software. Level of statistical significance was fixed at P < 0.05. Results: The prevalence of dentally anxious individuals was 81.2%. The mean dental anxiety score of respondents was 14.69 ± 4.29. Females reported a statistically higher dental anxiety than males (P = 0.004). Participants with past negative dental experience also showed greater dental anxiety scores (P = 0.04). Dental anxiety was found to be negatively correlated with age (P = 0.003) and father's occupation (P = 0.037). A total of 48 (8.3%) individuals visited a dentist twice a year, whereas 79 (13.7%) individuals had never visited a dentist. The total number of irregular visitors was 448 (77.9%), out of which 268 respondents (46.6%) visited a dentist only for emergency treatments. Dental anxiety scores and utilization of dental health services did not show a statistically significant association. Conclusions: There was a high prevalence of dental anxiety in this population of young adults. Females and individuals with past negative dental experience showed significantly higher dental anxiety. Age and father's occupation were also correlated with dental anxiety. Focus on the social determinants and measures to reduce dental anxiety and improve oral health utilization are needed.

On-demand cloud computing is one of the rapidly evolving technologies that is being widely used in the industries now. With the increase in IoT devices and real-time business analytics requirements, enterprises that ought to scale up and scale down their services have started coming towards on-demand cloud computing service providers. In a cloud data center, a high volume of continuous incoming task requests to physical hosts makes an imbalance in the cloud data center load. Most existing works balance the load by optimizing the algorithm in selecting the optimal host and achieves instantaneous load balancing but with execution inefficiency for tasks when carried out in the long run. Considering the long-term perspective of load balancing, the research paper proposes Stackelberg (leader-follower) game-theoretical model reinforced with the satisfaction factor for selecting the optimal physical host for deploying the tasks arriving at the data center in a balanced way. Stackelberg Game Theoretical Model for Load Balancing (SGMLB) algorithm deploys the tasks on the host in the data center by considering the utilization factor of every individual host, which helps in achieving high resource utilization on an average of 60%. Experimental results show that the Stackelberg equilibrium incorporated with a satisfaction index has been very useful in balancing the loading across the cluster by choosing the optimal hosts. The results show better execution efficiency in terms of the reduced number of task failures by 47%, decreased 'makespan' value by 17%, increased throughput by 6%, and a decreased front-end error rate as compared to the traditional random allocation algorithms and flow-shop scheduling algorithm.

Introduction: Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. Aim: The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. Materials and Methods: Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student's and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. Results: The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. Conclusion: The students and faculty expressed a "need" for early clinical exposure to enhance the learner’s understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India.

Introduction: Oral health inequalities imply unequal distribution of health and disease across socioeconomic gradients. Oral health related behaviour and its psychosocial antecedents can have a major impact on oral disease pathways in communities. Aim: To ascertain disparities in oral health behaviour and its psychosocial antecedents among young adults in Mangalore, Karnataka, India. Materials and Methods: Present study was carried out among 341 degree students at three randomly chosen institutions belonging to government, aided and private colleges in Mangalore. Oral health behaviour was assessed by a structured, pre-tested, self-administered questionnaire. Information about oral hygiene habits, tobacco use, sugar consumption, dental attendance patterns were collected. Respondent's selfreported gingivitis, perceived general and oral health, perceived need for care and locus of control were assessed. Information about demographic details was collected. Correlation analysis employed Pearson’s correlation coefficient and binary logistic regression analysis was employed with snacking as dependent variable. Results: Twice daily brushing was significantly associated with gender (r=0.142, p=0.009), type of college (r=-0.164, p=0.003) and father’s occupation (r=0.107, p=0.049), while tobacco use was significantly associated with gender (r=0.284, p=0.000), religion (r=-0.234, p=0.000), type of college (r=0.312, p=0.000), father’s education (r=0.130, p=0.017) and occupation (r=0.120, p=0.027). Self-perceived oral health was significantly associated with snacking (r=0.173, p=0.001) and tobacco use (r=-0.261, p=0.000), while locus of control was associated with snacking (r=0.140, p=0.009). Regression analysis revealed that father’s education (OR=0.399, p=0.014), self-perceived need for care (OR=0.354, p=0.009), and locus of control (OR=0.166, p=0.003) emerged as significant predictors of snacking behaviour. Conclusion: Psychosocial antecedents were significantly associated with oral health behaviour among the respondents. Policy and decision makers should consider causes of causes while tackling oral health problems. Present study may contribute towards addressing oral health inequalities in developing nations, where oral health issues are compounded by a definite paucity of resources.

Background There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation. Objectives i) To evaluate the readability of internet content (Google) regarding tobacco cessation using Flesch–Kincaid readability tests and the quality of internet content (Google) by using the JAMA benchmark, HONcode and DISCERN questionnaire. Methods A content review was employed to screen the content of the Google search engine for educational tobacco cessation websites, and the top 50 websites were selected according to criteria and reviewed by two reviewers. The readability of the internet content (Google) regarding tobacco cessation was evaluated using Flesch–Kincaid readability tests. The quality of the screened sites was evaluated by using the JAMA (Journal of the American Medical Association) benchmark, HONcode (The Health on the Net Code of Conduct) and DISCERN (Discerning the Quality of Information for Choosing Treatments) questionnaire, and the readability and quality of the screened websites were correlated using the above instruments. Results FK readability ease was found to be 49% standard and 30% easy. The FK grade test found that 33% of the content could be easily understood by < 5 th grade. All 4 JAMA benchmarks were met by 23% of websites, and authorship was the least fulfilled criterion. Correlation analysis revealed a significant association between FK ease score and FK grade score. Conclusions The Read-ability Ease and Read-ability Grade Levels of the websites related to tobacco cessation were not standard, and few websites fulfilled the JAMA benchmarks and had HONcode certification.

Introduction: Global Smokeless Tobacco (SLT) consumption is on the rise and constitutes a major Public Health problem. Controlling SLT intake is central to containing the increasing tobacco menace. Aim: The present study was undertaken to comprehensively explore various factors involved in SLT consumption and its cessation among current SLT users. Materials and Methods: Present study was conducted among current SLT users visiting Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore, Karnataka, India. A structured, pretested and self-administered questionnaire was employed for the present study. Knowledge, attitude, behaviour, worksite practices of respondents towards SLT consumption and its cessation, barriers to SLT cessation were explored. Information about socio-demographic variables was also collected. Results: Overall, 170 current SLT users participated in the present study. Results revealed that the mean knowledge, attitude, worksite related practices and barrier scores were 9.96(55.33%), 48.89(81.48%), 2.70(33.75%) and 54.25(60.27%) respectively. Correlation analysis revealed significant association of socio-demographic factors with knowledge, attitude and worksite related practices (p

This article presents oral mucosal lesions findings from a state oral health survey of Karnataka, India. A total of 46,579 subjects aged 1-4 to 65+ years were selected by using multistage-cluster-stratified random sampling method and subjects were examined by 32 dentists trained in standardized clinical diagnostic criteria for oral mucosal lesions. In the present study, 7.53% of subjects had one or more oral mucosal lesions, in which, male subjects (9.41 %) had a significantly higher prevalence of lesions compared to female subjects (4.38%); urban subjects (11.61%) had a significantly higher prevalence than rural subjects (5.01 %) and the Christian subjects had a significantly higher prevalence of lesions than the Hindus, Muslims and others (F=211.594,

Genital seborrheic keratosis (SK) is a rare entity, which can be easily misdiagnosed as genital warts. Dermoscopy is a useful tool to make diagnosis of SK in such cases. We report a 50-year-old woman with a large polypoidal growth on the external genitalia. Dermoscopic examination showed fissures and ridges, cerebriform appearance, and comedo-like openings consistent with SK. The histopathology confirmed the diagnosis of SK.

Background There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation. Objectives i) To evaluate the readability of internet content (Google) regarding tobacco cessation using Flesch–Kincaid readability tests and the quality of internet content (Google) by using the JAMA benchmark, HONcode and DISCERN questionnaire. Methods A content review was employed to screen the content of the Google search engine for educational tobacco cessation websites, and the top 50 websites were selected according to criteria and reviewed by two reviewers. The readability of the internet content (Google) regarding tobacco cessation was evaluated using Flesch–Kincaid readability tests. The quality of the screened sites was evaluated by using the JAMA benchmark, HONcode and DISCERN questionnaire, and the readability and quality of the screened websites were correlated using the above instruments. Results FK readability ease was found to be 49% standard and 30% easy. The FK grade test found that 33% of the content could be easily understood by < 5 th grade. All 4 JAMA benchmarks were met by 23% of websites, and authorship was the least fulfilled criterion. Correlation analysis revealed a significant association between FK ease score and FK grade score. Conclusions The Read-ability Ease and Read-ability Grade Levels of the websites related to tobacco cessation were not standard, and few websites fulfilled the JAMA benchmarks and had HONcode certification.

Purpose. To assess a protected mobilisation programme (dynamic treatment) for proximal phalangeal fracture of the hand, irrespective of the geometry. Methods. Clinical and radiological results of 32 consecutive patients with proximal phalangeal fracture of the hand treated from January 2001 to February 2007 were evaluated. Our supervised rehabilitation programme was strictly followed to gain full range of movement of the proximal interphalangeal joint and to prevent the development of an extension lag contracture. Patients were followed up for a mean period of 15 (range, 13–16) months. Results were evaluated using the Belsky classification. Results. The results were excellent in 72% of the patients, good in 22%, and poor in 6%. Some patients defaulted follow-up, which made long-term assessment difficult. The poor results may have been related to patient non-compliance or default from rehabilitation. Many good results upgraded to excellent following further rehabilitation. Conclusion. Skeletal stability, not rigidity, is necessary for functional movements of the hand. Proximal phalangeal fractures can be effectively treated by closed methods, using the stabilising effect of soft tissues (zancolli complex–metacarpophalangeal retention apparatus) and external devices (metacarpophalangeal block splint), thus enabling bone healing and movement recovery at the same time.

This research investigates the impact of unique spherical ball shoulder enhancement tool pin configurations on the friction stir welding (FSW) of AA2219 aluminum alloy under various parameters. FSW was performed using three different pin shapes: square, hexagonal, and octagonal. Testing samples were prepared using an L9 orthogonal array layout with varying welding parameters. The material behavior in the three distinct weld zones was evaluated for each pin configuration. Results indicated superior microhardness values in the heat-affected zone (HAZ) and thermo-mechanically affected zone (TMAZ) compared to the weld nugget zone. Elemental composition analysis of the TMAZ revealed significant differences, highlighting the influence of thermal stress and material behavior due to the tool pin and shoulder configuration. The square-headed tool demonstrated improved tensile strength and microhardness. Optimal welding performance was achieved with a spindle speed of 1000 RPM, a travel speed of 25 mm/min, and a tilt angle of 3°. Variations in Cu content in the TMAZ and HAZ underscored localized modifications within the material structure, driven by the spherical ball spinning effects on the shoulder. Tensile tests showed that welds made with the square pin consistently exhibited higher tensile strength compared to those made with hexagonal and octagonal pins. [ABSTRACT FROM AUTHOR]