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Introduction: Increase in the number of primary shoulder arthroplasty has led to an increase in the number of revisions which presents many complex challenges and often has inferior outcomes. Materials and methods: Data was collected retrospectively, and patients were classified using Dines classification. Comprehensive case reviews were done to identify pre-operative and intra-operative challenges. The primary outcome measure was Oxford shoulder score (OSS). The secondary measures were range of motion (ROM) and patient satisfaction (very satisfied, satisfied, not satisfied or worse). Results: A total of 32 patients were identified with a mean age of 67.64 years and the most common cause of revision was a combination of bone and soft tissue failure (39.3%). All patients (n=8) with hemiarthroplasty had rotator cuff deficiency while patients with resurfacing had both rotator cuff failure and bony erosion. Four patients needed a proximal humeral osteotomy and six patients needed allograft reconstruction of the glenoid for bone loss. Twenty-one shoulders were revised to reverse total shoulder arthroplasty (TSA), 2 to anatomical TSA and 5 were left with cement spacer in situ. Mean duration of follow-up was 41.6 months. Mean OSS at the last follow-up was 26.88 with statistically significant improvement in ROM. There was no statistical difference in clinical outcomes (p>0.05) based on the type of primary prosthesis or cause of revision. A total of 70% patients were pain free. Patients with infection had inferior outcomes with a mean OSS of 17. Conclusion: Management of patients with failed shoulder arthroplasty is often challenging but has good clinical outcome except in infections.

Underwater Wireless Sensor Networks (UWSNs) are established by Autonomous Underwater Vehicles (AUVs) or static Sensor Nodes (SN) that collect and transmit information over the underwater environment. Localization plays a vital role in the effective deployment, navigation and coordination of these nodes for many applications, namely underwater surveillance, underwater exploration, oceanographic data collection and environmental monitoring. Due to the unique characteristics of underwater transmission and acquisition, this is a fundamental challenge in underwater networks. However, localization in UWSNs is problematic due to the unique features of underwater transmission and the harsh underwater environment. To address these challenges, this paper presents an Improved Grey Wolf Optimization Based Node Localization Approach in UWSN (IGWONL-UWSN) technique. The presented IGWONL-UWSN technique is inspired by the hunting behavior of grey wolves with the Dimension Learning-based Hunting (DLH) search process. The proposed IGWONL-UWSN technique uses the Improved Grey Wolf Optimization Based (IGWO) algorithm to calculate the optimal location of the nodes in the UWSN. Moreover, the IGWONL-UWSN technique incorporates the DLH search process to improve the convergence and accuracy. The simulation results of the IGWONL-UWSN technique are validated using a set of performance measures. The simulation results show the improvements of the IGWONL-UWSN method over other approaches with respect to various metrics.

Periodontitis and oral squamous cell carcinoma (OSCC) are prevalent oral diseases with distinct etiologies, yet they share certain molecular and biological characteristics. Gene expression datasets from the gene expression omnibus (GEO) repository (GSE30784 for OSCC and GSE10334 for periodontitis) were analyzed. Data preprocessing and differential gene expression analysis using GEO2R identified common differentially expressed genes (DEGs), and FunRich software facilitated the construction of a protein-protein interaction (PPI) network on the STRING database. Cytoscape, coupled with the CytoHubba plugin, identified Cluster of Differentiation 19 (CD19) and Von Willebrand Factor (VWF) as the top hub genes, with Complement C3 (C3) also highly ranked. Functional enrichment analysis highlighted pathways such as the B-cell receptor signaling pathway, complement and coagulation cascades, and hematopoietic cell lineage. Additionally, miRNet analysis identified key miRNAs, including hsa-mir-26a-5p, hsa-mir-129-2-3p, and hsa-mir-27a-3p, associated with these pathways. These findings suggested an association of molecular mechanisms between periodontitis and OSCC, with identified hub genes and miRNAs potentially serving as therapeutic targets.

BackgroundApical microleakage is considered to be a common reason for the clinical failure of endodontic therapy. Three dimensional sealing of the root canal is one of the main goals of endodontic treatment and is essential for preventing reinfection of the canal and for preserving the health of the periapical tissues, Recently Epoxy resin sealers have been used because of their reduced solubility apical seal and micro-retention to root dentine. Aim and ObjectiveThis in vitro study was done to evaluate and compare the apical sealability of AH Plus and RealSeal SE using 5.25% sodium hypochlorite with 17% EDTA and 10% citric acid as irrigants. Materials and methods: 44 single-rooted premolars were selected and the teeth are randomly divided into 4 groups (n=10) and 2 control groups (n=2). The extent of dye penetration, from the apical to the coronal part of the root canal, was assessed using a stereomicroscope at 10x magnification for all groups.One-way ANOVA and Kruskal-Wallis tests were performed to compare statistically significant differences among the groups, using SPSS software version 10.0. ResultsGroup IV (Citric acid + RealSeal SE) showed a statistically lower mean microleakage when compared to all other groups. ConclusionFrom, the present study, it was concluded that, RealSeal SE sealer with 10% citric acid as irrigant (group IV) showed better apical sealability followed by RealSeal SE sealer with 17% EDTA as irrigant (group III), when compared to AH Plus groups which showed least sealability.

Wetlands are one of the important ecosystems which contribute much to primary productivity and atmospheric oxygen. Algal diversity and their ecological role in Pariyapurath Chali were studied. Standard methods for collection, identification and preservation were followed, and their importance in the ecosystem were noted. A total of 52 samples were collected, of which 65 taxa were identified. These taxa belonged to 4 classes; Chlorophyceae, Bacillariophyceae, Euglenophyceae and Cyanophyceae. The occurrence of cyanobacteria was high in the study site, the non-hetrocystous cyanobacteria were more frequent in all the sampling sites especially in the soil with high nitrogen and organic content. This contribution increases the taxonomic knowledge of Indian wetland algae.

Background: Owing to the improvements in the diagnostic and treatment modalities, survivorship outcomes have improved drastically among cancer survivors across the globe. A mounting body of evidence states that exercise can significantly benefit physical and mental health during the various stages of anti-cancer treatment. A frequently used outcome measure used to determine exercise adherence rates and the causes for adherence and non-adherence is the Exercise Adherence Rating Scale (EARS). Objective: To assess the adherence of a tailored home Multimodal Oncology Rehabilitation Exercise (MORE) program amongst head and neck cancer survivors in a tertiary care hospital in India using the Exercise Adherence Rating Scale (EARS). Methodology: The EARS tool was provided to a sample of 22 head and neck cancer (HNC) survivors with stages III to IVb during the 3rd month follow-up. The home exercise program consisted of a template provided to the survivors on the day of discharge. The program consisted of tailored exercises i.e., cognitive motor strategies, a physical exercise program and relaxation strategies. Additionally, the participants were provided with an activity log to record the time, duration and any adverse events occurring during the exercise program. Results: The 6-item EARS tool was administered to the 22 HNC survivors. 45.5% of the 22 survivors regarded ‘lack of time’ as a barrier to exercising regularly. 18% of the survivors claimed to often forget exercising on a regular basis as recommended by the therapist. However, 50% of the survivors performed most or all of the exercises on a regular basis. Conclusion: Lack of time, forgetting to exercise and not fitting the exercises into regular routine can be regarded as essential barriers to adherence to the exercise regimen. The participants did not report any adverse events during the course of the exercise routine.

Gaurav Pande,1 Manjunath Hatti,1 Mohit Kumar Rai,2 Praveer Rai,1 Kamlesh Kumar,1 Krishna VP,1 Abhimanyu Nehra,1 Sudeep Kumar,3 Smarak Ranjan Rout,3 Sourav Kumar Mishra,3 Dinesh Kumar,4 Umesh Kumar,4 Prabhaker Mishra,5 Abdul Majeed,1 Vivek Anand Saraswat,1,&ast; Kritika Singh,2 Harshit Singh,2 Durga Prasanna Misra,2 Vikas Agarwal2,&ast; 1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; 2Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; 3Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; 4Department of Advanced Spectroscopy and Imaging, Center of Biomedical Research, Lucknow, India; 5Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India&ast;These authors contributed equally to this workCorrespondence: Vikas Agarwal, Unit III, Clinical Immunology and Rheumatology, SGPGIMS, Raebareli Road, Lucknow, India, Tel +918004904390, Fax +91522268812, Email vikasagr@yahoo.comBackground and Aims: Acute-on-chronic liver failure (ACLF) with increasing organ failure is associated with poor outcomes. Severely deranged systemic hemodynamics and decreased effective arterial blood volume contribute to tissue damage and organ failure. Response-guided therapy with albumin, vasoconstrictors, and furosemide may help overcome effective hypovolemia, improve diuresis and impact survival.Methods: In the observation cohort, 230 patients with ACLF (CANONIC criteria) with ascites (≥Grade II) and ACLF ≥Grade I were enrolled. A total of 136 patients (GROUP I) received response-guided (urine sodium > 80mmol/day) slow albumin-furosemide infusion ± terlipressin (SAFI ± T), while 94 patients (GROUP II) received standard medical therapy. Twenty-eight-day survival, ascites mobilization (nil or grade 1), and adverse events were noted. In another mechanistic cohort (n = 40), laboratory evidences for improvement in various pathophysiological alterations; gut permeability, endotoxemia, cytokine storm, neutrophil dysfunction, and hemodynamic alterations following SAFI ± T/Noradrenaline (NAdr) were evaluated.Results: Age, gender, CLIF-C-ACLF, SOFA and MELD scores, ACLF grades and urine sodium were not different between the two groups in the observation cohort. Ascites was mobilized in 102/136 in GROUP I (SAFI ± T) and 23/94 in GROUP II (p < 0.05). Twenty-eight-day survival was significantly higher in GROUP I = 103/136 (75.7%) vs GROUP II = 50/94 (53.2%), (P = < 0.001). All those who were unable to reach urine sodium > 80 mmol/day died. Four patients in GROUP I developed scrotal gangrene. In the mechanistic cohort, 72% of patients survived with significant improvement in gut permeability, endotoxemia, serum cytokines, neutrophil dysfunction, and hemodynamic alterations.Conclusion: Ascitic fluid mobilization by response-guided SAFI ± T/NAdr therapy improves survival by improving splanchnic and systemic hemodynamics, decreasing gut congestion, gut permeability, and endotoxemia, improving neutrophil functions, and reducing pro-inflammatory cytokines in circulation.Graphical Abstract: Keywords: urine sodium, hemodynamics, renal artery resistive index, cytokines, neutrophil extracellular traps

Analysing the functionality of electrical systems allows for an evaluation of the characteristics of different power sources over varying periods and enables the coordination of multiple units. This is crucial for assessing the effects of uncertainty on the system considering load and energy generation for the effectiveness of power system monitoring and smart scheduling and cost-effectiveness of electrical grid operation. This research introduces an approach for simulating the operation of an electrical grid considering different time scales based on economic and technical indices. First, a series of standard source load scenarios is established. Subsequently, multiple scenarios are produced to show the stochastic nature of renewable energy and demand and utilise the probability features of uncertain data. The system described in this paper shifts the power balance issue from a yearly scale to weekly and daily electricity balances based on different time scales. The performance of the stochastic simulation solution is significantly enhanced by effectively coordinating in different time periods. The total coal consumption, economic index, abandoned renewable energy, and the rate of abandoned renewable energy are all closely monitored to maintain a high level of accuracy in reflecting the system’s performance.

Packaging helps to protect and preserves the quality of the goods available for storage and transport purposes. Many businesses have begun to look for new techniques and tactics for better design in order to sell their products, which has boosted the need for change packaging materials. This market segmentation is expected to change significantly by the end of 2018 as Asia is projected to reach for more than 40% of global demand. Many of the popular packaging were plastic materials in form of boxes, cans, bags, bottles, wrappers, envelopes and containers. Those plastic-packaging materials performs well but it becomes non-degradable waste that causes unnecessary landfills and harmful to environment. To overcome such drawbacks, the recent researches reported that the renewable and biodegradable materials have drawn much attention in the packaging domain due to their eco-friendly nature. In this research, the biodegradable composite material has introduced for packaging applications using natural fibres. The different material of natural fibres such as Aloe Vera, Jute and Coir have used as reinforcement to make composite material. The mechanical behavior of Tensile, Compression, Flexural strength and Impact for different composition have studied experimentally and conducted the SEM analysis to determine casting failures. Comparatively, the obtained results show that the Jute material behaves better than others to replace packaging material do.

In order to boost strength or corrosion resistance, two or more metallic components are mixed to form an alloy, which is a type of metal. A metallic material composed of two or more elements is called an alloy, sometimes known as a compound or a solution. Although the non-metal carbon is an essential part of steel, the constituents of alloys are normally metals. Alloys are often created by melting the mixture of components. According to customer specifications and drawings, Alloys Industries manufactures and exports a variety of machined and un-machined castings made of Carbon Steel, Stainless Steel, Low Alloy Steel, Heat Resistant Steel, Martensitic Stainless Steel (CA6NM), Precipitated Hardened Steel (CB7Cu-1), Nickel Alloy, and Duplex Stainless Steel. The phrase "stress managements" is broad and includes training, facilitation, and education about the effects that stress has on an individual or group. The study of stress management fosters and encourages the development of coping mechanisms. Employees' physiology and psyche are stressed out by organisational elements such management-labor relations, working conditions, resource distribution, the role of trade unions, employee behaviours, etc. The working practises and policies of an organisation are among its most important influencing variables. This study examined the occupational stress experienced by Alloy Industries in Coimbatore, employees in great detail.

Electric vehicles (EVs) offer a compelling solution for mitigating pollution, addressing environmental alterations, and enhancing energy security. This research presents a methodology employing the Broyden Fletcher Gold- farb Shanno quasi-Newton technique to streamline the charging costs associated with plug-in electric vehicles (PEVs). The initial step involves formulating an objective function directed at minimizing the expenses tied to PEV charging. This function takes into account crucial constraints pertaining to charger specifications, state of charge limitations, and voltage levels. Subsequently, we de- tail the application of the BFGS Quasi-Newton algorithm in computing node topology voltages within a microgrid featuring distributed energy resources (DERs). The findings demonstrate that the BFGS-enabled method outperforms alternative approaches in minimizing the cost of charging PEVs

Abstract Forced degradation study is a systemic characterization of degradation products of active pharmaceutical ingredient (API) at conditions which posses more harsh environment that accelerates degradation of API. Forced degradation and stability studies would be useful in selection of proper, packaging material and storage conditions of the API. These are also useful to demonstrate degradation pathways and degradation products of the API and further characterisation of the degradation products using mass spectrometry. TGR5 is a G protein-coupled receptor, activation of which promotes secretion of glucagon-like peptide-1 (GLP-1) and modulates insulin secretion. The potent and orally bioavailable TGR5 agonist, ZY12201, shows activation of TGR5 which increase secretion of GLP-1 and help in lowering blood glucose level in animal models. Hence it is necessary to establish and study degradation pathway and stability of API for better handling and regulatory approval. Force degradation studies of ZY12201 have shown presence of one oxidative impurity during oxidative degradation in HPLC analysis. The oxidized product is further characterized by LC–MS to elucidate structure of impurity and characterize its degradation pathway.

Background: Viral warts are caused by human papillomavirus. There are various treatment modalities which cause destruction of the warts. Not all of them are very effective on difficult-to-treat warts. For the treatment of difficult-to-treat warts, new and effective treatment includes intralesional immunotherapy. Objectives: The aim was to evaluate and compare the efficacy of intralesional Vitamin D and tuberculin purified protein derivative (PPD) as immunotherapy in difficult-to-treat warts. Materials and Methods: A total of 100 patients with difficult-to-treat viral warts were enrolled in this randomized controlled study. Group A patients were injected intralesionally with 2.5 TU of tuberculin PPD (0.1 ml) and Group B patients were injected with 0.1 ml of Vitamin D3 per lesion to a maximum of ten lesions. The clinical assessment was done by photographic measurements at baseline, before each treatment session, and after the completion of the treatment every 2 weeks for a total of four sessions. Unpaired t-test was used to compare both the treatment modalities. Results: In Group A, a total of 38 (76%) patients showed complete clearance and 12 (24%) showed partial response, while in Group B, a total of 42 (84%) patients showed complete clearance, while 8 (16%) showed partial response. There was no statistically significant difference between both the modalities. Conclusions: Intralesional Vitamin D3 injection and intralesional PPD may be a treatment option for difficult-to-treat warts that are unresponsive to conventional treatments. Both are equally effective with minimal side effects.

For cloud providers, workload prediction is a challenging task due to irregular incoming workloads from users. Accurate workload prediction is essential for scheduling the resources to the cloud applications. Thus, in this paper, the authors propose a predictive cloud workload management framework to estimate the needed resources in advance based on a hybrid approach, which is a combination of an improved Long Short-Term Memory (LSTM) network and a multilayer perceptron network. By improving the traditional LSTM architecture by using opposition-based differential evolution algorithm and dropout technique on recurrent connection without memory loss, the proposed approach has the ability to perform a better prediction process. A novel hybrid predictive approach is aiming at enhancing the prediction performance of the cloud workload. Finally, the authors measure the proposed approach’s effectiveness under benchmark data sets of NASA and Saskatchewan servers. The experimental results proved that the proposed approach outperforms the other conventional methods.

Hassan Tariq, 1, 2 Harish Patel, 1, 2 Muhammad Umar Kamal, 1 Naeem Abbas, 1, 2 Muhammad Ameen, 1 Sara Azam, 1 Kishore Kumar, 1, 2 Madhavi Ravi, 1, 2 Vamshidhar Vootla, 1, 2 Danial Shaikh, 1, 2 Vamsi Amanchi, 1 Ali N Hussain, 3 Jasbir Makker 1, 2 1Department of Medicine, BronxCare Health System, Bronx, NY 10457, USA; 2Division of Gastroenterology, BronxCare Health System, Bronx, NY 10457, USA; 3Baruch College, City University of New York (CUNY), New York, NY 10010, USACorrespondence: Muhammad Umar KamalBronxCare Health System, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USATel +1 718-960-1234Fax +1 718-960-2055Email muhammadumarkamal@gmail.comBackground: Helicobacter pylori is a common cause of gastritis, peptic ulcer disease, and non-ulcer dyspepsia, and is also associated with gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Despite being known about for more than 30 years, finding an effective therapeutic strategy against it remains a challenge.Aim: There are no US studies evaluating the efficacy of a Levofloxacin based therapy for H. pylori infection. We here intend to study the efficacy of Levofloxacin based triple antibiotic regimen as compared to Clarithromycin based triple therapy and Bismuth based quadruple therapy in our patient population.Methods: This is a retrospective single center observational study. Patients with Helicobacter pylori infection who underwent treatment for H. pylori with one of the three therapies, i.e. Clarithromycin triple, Bismuth Quadruple or Levofloxacin triple, were included in the study and the eradication rates were compared. The confirmation of the H. pylori was done 4 weeks after the completion of anti-microbial therapy.Results: A total of 177 individuals underwent the H. pylori treatment in our retrospective review. Of these, 54% (n=97) of patients were treated with Clarithromycin based triple therapy (Group 1), 35% (n=63) were treated with Levofloxacin based regimen (Group 2), and the remaining 11% (n=17) were treated with Bismuth based quadruple therapy (Group 3). The eradication rates were significantly higher in patients treated with Clarithromycin based triple therapy as compared to Levofloxacin based triple therapy and Bismuth quadruple therapy (78.3% vs 49.2% vs 41.1% P=0.001).Conclusion: In conclusion, our study shows significantly lower eradication rates with Levofloxacin triple therapy among a selected US population. Thus, it may not be a good first-line therapy among this US population and the Clarithromycin based regimen may still be used successfully.Keywords: Helicobacter pylori, clarithromycin, levofloxacin, quadruple therapy, peptic ulcer

This paper analyzes the problem of septage management related to opportunities and solution. in accordance with present treatment technologies. The scenario in India is about 41 % of septage sludge is disposed in local area without treatment Still some of the individual housing is not connected to suitable public sewage system. The current scenario of FSM in Warangal city is 77 % of the households have proper access to toilet and 23% insanitary toilet and open defecation were found. The samples were collected from the Warangal city and were tested for the characteristics. BOD and COD were very high above 9800 mg/l. As per CPHEEO norms TSS should be less than 15000 mg/l, but it is observed in all the samples it is in the range of 24,800 mg/l to 82,460 mg/l. Currently the treatment such as sludge drying beds, lime treatment, anaerobic baffled reactor, stabilization pond, constructed wetland, composting with solid waste, Mechanical dewatering,. Neglected septage waste ash was tried for several trial run in the mix design and found 20 % to be optimum replacement of septage ash. Strength enhancement is achieved by adding glass chopped strands and workability is improved by Super plasticizer Polycarboxlate ether. Utilization of residue in septage treatment plant in cost effective and ecofriendly way by replacing cement in concrete was tried in the pilot scale study near Warangal and proven to be effective.

Wire Cut EDM technique is widely used to make small and precision cuts. Generally, a material with fragile geometry and hard structure is cut using a wire cut EDM. The main advantage of this method is that, it is a non-conventional machining process therefore it does not have a contact between the tool (wire) and the workpiece. This advantage gives it an edge over other machining techniques and it makes the process capable of machining even the weak structured and delicate materials. In the present experimental work, by using various machining parameters (Pulse on Time, Pulse off Time, and Wire Speed) were optimized using Taguchi’s L9 orthogonal array. Welding is most the important industrial processes, therefore lots of techniques have been developed to get an efficient and low-cost welding process for different types of materials. In this we will discuss about the welding characteristics of the of tig welding joints produced using different currents. That is, by changing the voltages for the number of passes to improve and strengthen the welded joint The research work aims to optimize the wire cut EDM process parameters for AISI 308 steel and analyze the welding characteristics of Tungsten Inert Gas (TIG) welded joints of the same material. The study intends to find the optimum combination of process parameters that would lead to the highest material removal rate, lowest wear rate, and best tensile properties of the material.

In the present study, turning of two grades of composites such as ZA43 silicon carbide and ZA43 silicon carbide and graphite was carried out. The fabrication of both categories of composites were done using stir casting technique. The silicon carbide of grit size 60μm with concentration of 5% was reinforced for one category of the composite and for the other grade of composite, 5% silicon carbide and graphite were added. Thus fabricated materials were turned on a conventional lathe using coated carbide tools (SNMG). Dry turning of the fabricated composite was carried out with varying cutting parameters. Measurement of cutting force was done for the both compositions of fabricated materials using lathe tool dynamometer. It was observed that, while machining composite containing silicon carbide and graphite, tool experience more cutting force than composite containing silicon carbide alone.

Natural fibres have emerged as a renewable and cheaper substitute to synthetic materials such as glass and carbon. A composite material can be defined as combining two or more materials that result in better properties. The constituents are reinforcement, and the other is a matrix. The main advantages of composites are high strength, stiffness combined with low density. As natural fibres are gaining more importance in recent times, many industries are focusing on these natural fibre composites, so that is why they are used as a component in composite materials. In this experiment, the analysis aims to characterize different natural fibres when combined with different ratios of the coconut coir and the bamboo. So, to fabricate the specimen, the hand lay-up method is used. The coconut coir and the bamboo composition are considered in three different variations. Then the natural fibres are subjected to resin and hardener compositions to test the suitability, tensile strength, flexural strength, and shore hardness test. We also conduct static analysis through ANSYS software.

Background: Multisystem Inflammatory Syndrome in Adults (MIS-A) is a recently emerging condition that occurs as a delayed complication of COVID-19 infection. It involves inflammation of multiple extra-pulmonary organ systems. Diagnostic criteria and treatment recommendations have yet to be clearly defined. We present a case of a young adult with suspected MIS-A who initially displayed symptoms and radiological findings of colitis.Case: A 22-year-old male with no past medical history suffered a minor respiratory illness for a few days and tested positive on SARS-CoV-2 RT-PCR. Approximately 6 weeks later, he presents after 3 days of right-sided abdominal pain, diarrhoea and fever. He is initially admitted with a working diagnosis of gastroenteritis. Sustained fever and escalating blood markers of illness led to abdominal CT; showing inflammation of ascending colon as well as some loops of small bowel. Hypotension becomes increasingly pronounced and on the fourth day of admission he developed type 1 respiratory failure with evidence of fluid overload. He was transferred to critical care for vasopressor and respiratory support. All microbiological and autoimmune screens performed return negative results but inflammatory markers were significantly elevated, he was diagnosed as MIS-A. IVIg was added to the antibiotics on day 4. His clinical condition dramatically improved and he was discharged home after 10 days in hospital. His blood tests have returned to normal and he has no lasting complications from his illness. Discussion: This case displays the potential for MIS-A to present in various ways, with this example a primarily gastroenterological illness. It therefore highlights the importance of physicians in different fields having an awareness of the condition, in order to identify when MDT input is required to guide treatment. We review the current literature on various presentations and treatments of MIS-A, and discuss the need for clear case definition.

The combination of central odontogenic fibroma and central giant cell granuloma is extremely rare and has been reported in only 46 cases worldwide in previous articles. The lesion is called a hybrid central odontogenic fibroma with central giant cell granuloma like lesion (HCOF-CGCG) due to a histopathological characteristics of multinucleated giant cell and odontogenic epithelium in fibro-cellular background. We report a case of HCOF-CGCG in a 27-year old Thai male patient who was identified as the first case in Thailand. Radiographic examination showed a well-defined radiolucency lesion at posterior mandibular area. Enucleation and curettage were done and microscopic study revealed a fibro-cellular proliferating tissue containing numerous strands, cord of odontogenic epithelium, and numerous multinucleated giant cells. This report also included a literature review of the previous 45 cases.

Introduction of semi-dwarfism and early maturity in rice cultivars is important to achieve improved plant architecture, lodging resistance and high yield. Gamma rays induced mutations are routinely used to achieve these traits. We report the development of a semi-dwarf, early maturing and high-yielding mutant of rice cultivar 'Improved White Ponni', a popular cosmopolitan variety in south India preferred for its superior grain quality traits. Through gamma rays induced mutagenesis, several mutants were developed and subjected to selection up to six generations (M6) until the superior mutants were stabilized. In the M6 generation, significant reduction in days to flowering (up to 11.81% reduction) and plant height (up to 40% reduction) combined with an increase in single plant yield (up to 45.73% increase) was observed in the mutant population. The cooking quality traits viz., linear elongation ratio, breadthwise expansion ratio, gel consistency and gelatinization temperature of the mutants were similar to the parent variety Improved White Ponni. The genetic characterization with SSR markers showed variability between the semi-dwarf-early mutants and the Improved White Ponni. Gibberellin responsiveness study and quantitative real-time PCR showed a faulty gibberellin pathway and epistatic control between the genes such as OsKOL4 and OsBRD2 causing semi-dwarfism in a mutant. These mutants have potential as new rice varieties and can be used as new sources of semi-dwarfism and earliness for improving high grain quality rice varieties.