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Objective: To identify the clinical, laboratory, and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous meningitis. Methods: In this prospective, observational study, patients with tuberculous meningitis were systematically evaluated. Various clinical, laboratory [including cerebrospinal fluid (CSF) microscopy, culture, and GeneXpert], and neuroimaging factors were examined. All participants were administered anti-tuberculous treatment and corticosteroids. A six-month follow-up was done to evaluate the outcome. Results: Of the 116 patients studied, 54 (46.6%) tested positive for GeneXpert, while 62 (53.4%) were negative. Third cranial nerve involvement (OR 3.71, 95% CI 1.052-13.09, P=0.04) and the presence of basal exudates on neuroimaging (OR 5.22, 95% CI 2.03-13.42, P=0.001) emerged as independent predictive factors for a positive GeneXpert result. A positive CSF GeneXpert result (P=0.002) and drug resistance (P=0.004) were significantly linked to adverse outcomes. Additionally, a high score on the Medical Research Council stage III (OR 5.64, 95% CI 1.18-26.87, P=0.03) and elevated CSF cell counts (OR 1.002, 95% CI 1.00-1.001, P=0.03) were identified as independent predictors of poor prognosis. Conclusions: Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert result. MRC stage III disability and elevated CSF cell counts predicted poor outcomes.

Background: Phenotypic drug susceptibility testing (DST) is considered the gold standard for detecting linezolid (LZD) resistance in Mycobacterium tuberculosis (MTB), but it is time-consuming. Nanopore sequencing offers a potentially faster alternative approach. This study evaluated the agreement between phenotypically detected LZD resistance and mutations in the rrl and rplC genes of MTB isolates using nanopore sequencing. Methods: Consecutive drug-resistant MTB isolates from pulmonary samples collected in 2021 underwent liquid culture (LC) DST for LZD. All resistant isolates and an equal number of susceptible isolates were subjected to targeted sequencing of the rrl and rplC genes using nanopore technology. Results: Sequencing identified a C154R mutation in the rplC gene in only one LZD-resistant isolate. No mutations were detected in the rrl gene. The agreement between sequencing and LC-DST for detecting LZD resistance was poor (Cohen’s kappa: 0.03571, 95% confidence interval [CI]: −0.034–0.105). Additionally, no significant association was found between LZD resistance and clinical or microbiological outcomes at 6-month follow-up. Conclusion: This study revealed a considerable discrepancy between phenotypic and genotypic detection of LZD resistance in MTB. Further research is needed to better understand the genetic mechanisms underlying LZD resistance and to develop reliable molecular diagnostics for rapid resistance detection.

Objectives: The goal of the current study was to assess the effectiveness of a commercially available herbal mouthwash with chlorhexidine on the number of Streptococcus mutans in the saliva, the condition of the gingival tissue, and plaque development. Materials and Methods: Twenty-two adults in all, ranging in age from 20 to 30, were divided into two groups at random. Throughout the 14-day clinical trial, Group A (11) and Group B (11) received 10 mL of test herbal mouthwash and chlorhexidine, respectively. Result: Herbal mouthwash was discovered to be equally as effective as chlorhexidine in lowering the salivary mutans streptococci count and in affecting plaque and gingival scores. Conclusion: Alternatives from the herbal world may show to be a reliable and secure therapy option.

Purpose: To study the biomarkers present in primary pterygium samples of patients of Indian ethnicity and compare it with the samples obtained from the unaffected conjunctiva of the same eye. Methods: A prospective case-control study of 17 eyes in patients above 10 years of age with primary pterygium who underwent pterygium excision using limbal conjunctival autograft technique. The pterygium samples (cases) and conjunctival samples (controls) were sent for immunohistochemical (IHC) staining for the following biomarkers: p53, Bcl-2, Ki-67, and vascular endothelial growth factor (VEGF). Result: The immunohistochemistry of the samples and the controls revealed p53 positivity in 47.05% of pterygium samples and 29.4% of controls (P < 0.587). Nine cases each in pterygium and control samples were positive for Ki-67 expression. Differences in the staining pattern between the two groups were not statistically significant (P < 1.000). Bcl-2 positivity was seen in 10 pterygium samples (58.8%) and 12 controls (70.5%), with no statistical difference between the two groups (P < 0.455). VEGF expression was seen in both epithelial and endothelial cells of the samples and controls, with no statistical difference between the two groups, with P = 1.000 for the epithelial staining and P = 0.637 for endothelial staining. Conclusion: The expression of biomarkers was comparable in both groups. We conclude that pterygium, against common belief, might not be a localized disease process but a global ocular phenomenon where the apparently healthy tissue also has some ongoing disease process at a molecular level.

Abstract The entanglement wedge cross sections (EWCSs) are postulated as dual gravity probes to certain measures for the entanglement of multiparty systems. We test various proposed inequalities for EWCSs. As it turns out, contrary to expectations, the EWCS is not clearly monogamous nor polygamous for tripartite systems but the results depend on the details and dimensionality of the geometry of the gravity solutions. We propose weaker monogamy relations for dual entanglement measures, which lead to a new lower bound on EWCS. Our work is based on a plethora of gravity backgrounds: pure anti de Sitter spaces, anti de Sitter black branes, those induced by a stack of Dp-branes, and cigar geometries in generic dimension.

Purpose: To evaluate the effectiveness of repeat deep anterior lamellar keratoplasty (DALK) in patients of previous failed DALK. Methods : A retrospective analysis of records of seven patients who had undergone repeat DALK following the failure of the primary DALK was done. The indications for repeat surgery, time elapsed since the first surgery, and pre- & postoperative best-corrected visual acuity (BCVA) were noted for all the patients. Results: The follow-up period ranged between one- to four-year post repeat DALK. The indication of primary DALK was keratoconus with vernal keratoconjunctivitis (VKC) (n = 3), corneal amyloidosis (n = 2), Salzman nodular keratopathy (n = 1), and healed keratitis (n = 1). The need for repeat surgery arose when the BSCVA dropped to less than 20/200. The time interval elapsed since the first surgery ranged from two months to four years. Postoperatively, the BSCVA improved from 20/120 to 20/30 at the end of one-year post repeat DALK in all except one patient. All regrafts were clear at the most recent examination, performed after a mean period of 18 months after the secondary graft. No complication was encountered during the resurgery. The dissection of the host bed was easier in the second surgery owing to weaker adhesions. Conclusion: The prognosis for repeat DALK for failed DALK is excellent, and the outcomes of secondary grafts were comparable to those of primary DALK grafts. Re DALK offers the advantage of an easier dissection and lower chances of graft rejection compared to penetrating keratoplasty.

Background: Nasotracheal intubation alters respiratory and cardiovascular physiology by reflex response mediated by both sympathetic and parasympathetic nervous systems and by the physical presence of the nasotracheal tube. Hypertension and tachycardia are the most common responses to intubation mediated by sympathetic efferent through cardio accelerator nerve and sympathetic chain ganglia. MgSO4 inhibits catecholamine release from adrenergic nerve endings and adrenal medulla resulting in attenuation of stress response. Aims and Objectives: In this study, we observed the effects of MgSO4 on the hemodynamic stress response. Materials and Methods: This prospective randomized controlled study was conducted on 60 patients after approval of the Institutional Ethics and Scientific Review committee over the period of 1 year. They were divided into two groups, Group M (MgSO4 group) received 40 mg/kg of intravenous magnesium sulfate in 100 ml normal saline and Group C (control group) received normal saline 10 min before induction. Hemodynamic parameters (HR, SBP, DBP, and MAP) were recorded at baseline, just before induction and at 1, 3, 5, 10, 15, and 30 min after intubation and every 15 min till the end of surgery. Results: After conducting this study, we observed that heart rates at 1, 3, 5, and 10 were significantly lower in the M group as compared to the C group (P

In the analysis of neural data, measures of non-Gaussianity are generally applied in two ways: as tests of normality for validating model assumptions and as Independent Component Analysis (ICA) contrast functions for separating non-Gaussian signals. Consequently, there is a wide range of methods for both applications, but they all have trade-offs. We propose a new strategy that, in contrast to previous methods, directly approximates the shape of a distribution via Hermite functions. Applicability as a normality test was evaluated via its sensitivity to non-Gaussianity for three families of distributions that deviate from a Gaussian distribution in different ways (modes, tails, and asymmetry). Applicability as an ICA contrast function was evaluated through its ability to extract non-Gaussian signals in simple multi-dimensional distributions, and to remove artifacts from simulated electroencephalographic datasets. The measure has advantages as a normality test and, for ICA, for heavy-tailed and asymmetric distributions with small sample sizes. For other distributions and large datasets, it performs comparably to existing methods. Compared to standard normality tests, the new method performs better for certain types of distributions. Compared to contrast functions of a standard ICA package, the new method has advantages but its utility for ICA is more limited. This highlights that even though both applications—normality tests and ICA—require a measure of deviation from normality, strategies that are advantageous in one application may not be advantageous in the other. Here, the new method has broad merits as a normality test but only limited advantages for ICA.

Abstract Enterococcus faecium is an emerging ESKAPE bacterium that is capable of causing severe public health complications in humans. There are currently no licensed treatments or vaccinations to combat the deadly pathogen. We aimed to design a potent and novel prophylactic chimeric vaccine against E. faecium through an immunoinformatics approach The antigenic Penicillin-binding protein 5 (PBP 5) protein was selected to identify B and T cell epitopes, followed by conservancy analysis, population coverage, physiochemical assessment, secondary and tertiary structural analysis. Using various immunoinformatics methods and tools, two linear B-cell epitopes, five CTL epitopes, and two HTL epitopes were finally selected for vaccine development. The constructed vaccine was determined to be highly immunogenic, cytokine-producing, antigenic, non-toxic, non-allergenic, and stable, as well as potentially effective against E. faecium. In addition, disulfide engineering, codon adaptation, and in silico cloning, were used to improve stability and expression efficiency in the host E. coli. Molecular docking and molecular dynamics simulations indicated that the structure of the vaccine is stable and has a high affinity for the TLR4 receptor. The immune simulation results revealed that both B and T cells had an increased response to the vaccination component. Conclusively, the in-depth in silico analysis suggests, the proposed vaccine to elicit a robust immune response against E. faecium infection and hence a promising target for further experimental trials.

Corneal collagen cross-linking (CXL) is an effective treatment for arresting progression in patients with keratoconus. CXL was approved by United States Food and Drug Administration for the treatment of progressive keratoconus in 2016. It is a relatively safe procedure with a low complication rate. As this approach becomes more popular, it is paramount to be familiar with the potential complications associated with the procedure and its management. This article aims to report and review the complications of CXL for the treatment of keratoconus and post-LASIK ectasia.

Background: Nail fold capillaroscopy (NFC) is mainly used in connective tissue diseases (scleroderma, mixed connective tissue disease, and inflammatory myositis). It is not used routinely in the evaluation of diabetic patients and no specific patterns of nail fold capillary changes have been established in diabetes. We studied morphological patterns of nail fold capillaries by video capillaroscope in diabetic patients and their association with diabetic retinopathy (DR). Methods and Material: Fifty diabetics were recruited after informed consent. The mean age of patients was 49.5 ± 10.6 years. Seventeen patients had DR. Capillary length, capillary density, and various morphological parameters were assessed and these parameters were compared between patients with DR and without DR. Results: The most frequent NFC morphological alterations, among diabetics as a group, were tortuous capillaries (56%), giant capillaries (46%), and cross-linked capillaries (44%). Overall, mean nail fold capillary length was reduced in diabetic patients. When individual morphological alterations were compared in patients with DR versus without DR, statistically significant differences were seen for presence of giant capillaries, tortuous capillaries, and avascular areas. On further analysis, mean nail fold capillary length and mean nail fold capillary density were also significantly lesser in patients with DR versus without DR. Conclusions: The presence of nail fold capillary morphological abnormalities among diabetics and a significant association with microangiopathic changes in the retina suggest that microvascular changes can be detected early using a simple, non-invasive office-based method of NFC. More large-scale studies in the future can establish a characteristic pattern for diabetes as seen in systemic sclerosis so that microvascular changes in diabetics can be detected at the earliest with the simple noninvasive method by using NFC.

Background: The purpose of our study was to evaluate the osteolytic lesions of bone reported at the department of pathology in a tertiary care hospital in West Bengal. Materials and Methods: We performed a retrospective study over a period of 7 years from February 2013 to January 2020. Entirely osteosclerotic lesions were excluded from our study. The lesions were classified as nonneoplastic lesions, benign lesions, tumor like lesions and malignant lesions. Results: Over 7 years, 147 cases of osteolytic lesions of bone were reported. Of these, 36.1% were malignant lesions. The most common sites of osteolytic lesions were the femur (n = 46), tibia (n = 24), and humerus (n = 20). The most frequent histological diagnosis was of giant cell tumor (GCT) (n = 31), followed by chronic osteomyelitis (n = 19) and osteosarcoma (n = 17). The most frequent benign neoplasm was GCT and osteosarcoma was the predominant malignant lesion. Relatively uncommon lesions like adamantinoma were also reported. Conclusions: Malignant neoplasms are the most common osteolytic lesions. Bones of the extremities are the most frequent sites of involvement by both benign and malignant tumors. In addition to radiological correlation, a thorough knowledge of the age, sex, site of the common bone lesions is required for a correct histopathological diagnosis so that proper treatment can be instituted. Most of these lesions do not require immunohistochemistry for diagnosis. The possibility of rare tumors presenting at a given age and at a particular site is to be considered.

We propose a holographic entanglement negativity conjecture involving the bulk geometry, for mixed states of adjacent intervals in (1+1)-dimensional dual conformal field theories through the AdS/CFT correspondence. The holographic entanglement negativity is obtained from a specific algebraic sum of the geodesics anchored on respective intervals on the boundary which reduces to the holographic mutual information between them. Utilizing our conjecture we obtain the entanglement negativity of adjacent intervals in zero and finite temperature (1+1)-dimensional holographic conformal field theories dual to the bulk AdS3 vacuum and the Euclidean BTZ black hole respectively. Our holographic conjecture exactly reproduces the conformal field theory results obtained through the replica technique, in the large central charge limit. We briefly elucidate the corresponding issue for the AdSd+1/CFTd scenario.

Context-Aware Recommender Systems generate more relevant recommendations by adapting them to the specific contextual situation and have become one of the most active research areas in the recommender systems. However, there remains a key issue as how contextual information can be used to create intelligent and useful recommender systems. Use of too many context variables increases dimensionality that leads to loss of accuracy while few context variables fail to bring contextual effects in recommendations. To assist the development and use of context-aware capabilities, we propose a framework, RCFS-CARS that uses influential contexts, make their sets with appropriate relaxation to be applied on different parts of the algorithm. We also propose a strategy to detect the noisy ratings in the datasets and fix them to refine the recommendation results. The experimental results on two datasets reveal that the noise detection and correction process in RCFS-CARS method is much superior and effective in context-aware recommendation scenarios.

The main aim of e-commerce websites is to turn their visitors into customers. For this purpose, recommender system is used as a tool that helps in turning clicks into purchases. Obtaining explicit ratings often faces problems such as authenticity of the ratings given by customers and queries that leads to low accuracy of the recommendations. Implicit ratings play a vital role in providing refined ranking of products. Preference level of the customers are predicted based on collaborative filtering (CF) approach using implicit details and mining click stream paths of like-minded users. Extracting the similarity among products using sequential patterns improves the accuracy of ranking. Integrating these two approaches improves the recommendation quality. Based on the results of experiment carried out to compare the performance of CF, sequential path of products viewed and integration of the two, we conclude that integration of mentioned approaches is superior to the existing ones.

Abstract We study the application of our recent holographic entanglement negativity conjecture for mixed states of adjacent subsystems in conformal field theories with a conserved charge. In this context we obtain the holographic entanglement negativity for zero and finite temperature mixed state configurations in d-dimensional conformal field theories dual to bulk extremal and non extremal charged $$AdS_{d+1}$$ AdSd+1 black holes. Our results conform to quantum information theory expectations and constitute significant consistency checks for our conjecture.

Background and Aims: Both transversus abdominis plane (TAP) block and combined ilioinguinal-iliohypogastric (IIN/IHN) blocks are used routinely under ultrasound (USG) guidance for postoperative pain relief in patients undergoing inguinal hernia surgery. This study compares USG guided TAP Vs IIN/IHN block for post-operative analgesic efficacy in adults undergoing inguinal hernia surgery. Methods: Sixty adults aged 18 to 60 with American Society of Anesthesiologsts' grade I or II were included. After general anaesthesia, patients in Group I received USG guided unilateral TAP block using 0.75% ropivacaine 3 mg/kg (maximum 25 mL) and those in Group II received IIN/IHN block using 10 mL 0.75% ropivacaine. Postoperative rescue analgesia was with tramadol (intravenous) IV ± diclofenac IV in the first 4 h followed by oral diclofenac subsequently. Total analgesic consumption in the first 24 h was the primary objective, intraoperative haemodynamics, number of attempts and time required for performing the block as well as the postoperative pain scores were also evaluated. Results: Time to first analgesic request was 319.8 ± 115.2 min in Group I and 408 ± 116.4 min in Group II (P = 0.005). Seven patients (23.33%) in Group I and two (6.67%) in Group II required tramadol in first four hours. No patient in either groups received diclofenac IV. The average dose of tablet diclofenac was 200 ± 35.96 mg in Group I and 172.5 ± 34.96 mg in Group II (P = 0. 004). Conclusion: USG guided IIN/IHN block reduces the postoperative analgesic requirement compared to USG guided TAP block.

Management of bleeding disorders poses a challenge to dentists. These conditions can be inherited, acquired, or congenital are associated with an increased risk of hemorrhage, poor wound healing, and infection. Fanconi anemia (FA) is a rare autosomal recessive disease which belongs to a group of chromosome break up or DNA repair disorders. Hematologic abnormalities represent the most prevalent pathologic manifestation of FA. Herein, we report a case of FA in which various classical signs of the disease were present. We have given emphasis on oral manifestations and the role of a pedodontist in making an early diagnosis and providing comprehensive care for the maintenance of oral health of the affected individuals.

Introduction: Traumatic dental injuries (TDIs) are very common in childhood. Majority of TDI occur at home followed by schools. The prognosis of TDIs to a great extent is dependent on prompt emergency measures taken at the site of accident. Hence, it is of paramount importance to assess the knowledge of people present at the site of accident that generally includes parents, teachers, and sports coaches. Aim of Study: The aim of the study was to assess the knowledge, attitude, and awareness of school teachers of Kolkata regarding management of TDIs. Materials and Methods: A cross-sectional survey was conducted on 400 school teachers of Kolkata over a period of 2 months using a pretested close-ended questionnaire. The questionnaire had three parts: Part 1 contained questions on personal information, Part 2 contained questions based on two imaginary cases of trauma, and Part 3 related to their attitude toward dental trauma education. Chi-square test was done to describe the strength of the associations. Results: : The overall knowledge of school teachers regarding management of TDIs was not found to be satisfactory. It was observed that most of the teachers were in favor of taking immediate professional consultation for the emergency management, but most of them were unaware of the steps to be taken on their part to minimize complications and improve prognosis. Conclusion: Despite the lack of knowledge and awareness regarding management of dental trauma, school teachers of Kolkata had a good attitude toward management of dental trauma and its education.

Anterior supernumerary teeth in the permanent dentition may be supplemental or rudimentary. Rudimentary types are further classified as conical, tuberculate, and molariform. The molariform type has been only rarely reported. We report a rare variety of anterior supernumerary teeth - the molariform type, occurring bilaterally and in association with a midline supernumerary tooth. We also suggest a hypothesis for the bilateral occurrence of supernumerary teeth.

Objectives: The purpose of the present study was to investigate the relationship of the measured distance between two mandibular points (distance M-Me) to chronological age and to find out whether the absolute values of distance M-Me could be classified age-wise into a unique range, which could be directly read for predicting the stage of mandibular growth. Methods and Materials: The study sample consists of lateral cephalometric records of 65 patients (34 females and 31 males; age range: 6–21 years). Chronological age was calculated in decimal years. Lateral cephalograms were assessed by two independent examiners. Points M and Me were located on the lateral cephalograms, and linear distance between them was measured. Results: Pearson product-moment correlation coefficients showed a high correlation between chronological age and distance M-Me (0.746 for females and 0.869 for males, p < 0.01). When the values of distance M-Me were compared with chronological age, it was possible to make four age groups (for females and males separately), where each group showed a unique range of value for distance M-Me. The values increased with increasing age. Conclusions: Increase in value of distance M-Me with age, showing reduced individual variation, depicts a well-conserved linear dimension. Values of distance M-Me can be directly read for predicting the stage of mandibular growth and can be used as a valuable adjunct or substitute to chronological age.

Introduction: Collagen distribution alterations are well known in dilated cardiomyopathy. There are also changes in microvasculature along with other histomorphorphological features. Aims and Objectives: To study the histomorphological features of DCM along with their quantitative correlation with LVEF. Alterations in collagen IV distribution pattern and microvasculature in DCM were also evaluated. Materials and Methods: The present study includes 34 right ventricular endomyocardial biopsies, 7 explanted native hearts and 41 autopsy control hearts. Sections were taken from lower half of right interventricular septum and stained for H and E, Masson trichrome and immunohistochemistry for CD34, SMA and Collagen IV to study the histological features, pattern of fibrosis, capillary and arteriolar distribution and collagen IV expression respectively. Morphometric analysis was carried out in all cases and controls using Image analysis software Image pro plus 7 and correlated with left ventricular ejection fraction. Results: The histomorphological changes of DCM include myocyte hypertrophy, nucleomegaly, and interstitial fibrosis. Interfiber fibrosis was the commonest. There was evidence of myocarditis, ischemic change and vessel wall alterations. Considerable alteration in Collagen IV distribution was observed with reduction in intensity and proportion of staining around myocytes quantified using Allred scoring against uniform pericellular staining in controls. Morphometric analysis revealed significant increase in nuclear area, myocyte width, percentage of fibrosis and reduction in capillary myocyte ratio in cases as compared to controls. There was no significant difference in arteriolar density. No significant association was observed between morphometric parameters and LVEF. Conclusion: Histomorphological changes in DCM are non-specific. Quantitation of histological parameters cannot be used to predict the disease progression as there was no significant correlation with LVEF. There is appreciable alteration in Collagen IV distribution in DCM owing to extracellular matrix alterations.

Varicella, a common exanthematous disease of childhood, can have atypical presentation in immunosuppressed patients. We report a case of a 14-year-old female who presented with multiple hemorrhagic tense bullae and a monomorphic presentation that created an initial diagnostic dilemma. Patient's treatment history was remarkable for taking methotrexate for arthritis for the last 2 months. The patient was treated with a prolonged course of intravenous acyclovir that eventually led to her uneventful recovery.

We propose a covariant holographic entanglement negativity construction for time dependent mixed states of adjacent intervals in (1+1)-dimensional conformal field theories dual to non-static bulk AdS3 configurations. Our prescription applied to (1+1)-dimensional conformal field theories with a conserved charge dual to non-extremal and extremal rotating BTZ black holes exactly reproduces the corresponding replica technique results, in the large central charge limit. We also utilize our construction to obtain the time dependent holographic entanglement negativity for the mixed state in question for the (1+1)-dimensional CFT dual to a bulk Vaidya-AdS3 configuration.

Squamous cell carcinoma of the eyelid is the second most common malignant neoplasm of the eye with the incidence of 0.09 and 2.42 cases/100 000 people. Orbital invasion is a rare complication but, if recognized early, can be treated effectively with exenteration. Although with advancements in technology such as computer-aided design and computer-aided manufacturing, material science, and retentive methods like implants, orbital prosthesis with stock ocular prosthesis made of methyl methacrylate retained by anatomic undercuts is quiet effective and should not be overlooked and forgotten. This clinical report describes prosthetic rehabilitation of two male patients with polymethyl methacrylate resin orbital prosthesis after orbital exenteration, for squamous cell carcinoma of the upper eyelid. The orbital prosthesis was sufficiently retained by hard and soft tissue undercuts without any complications. The patients using the prosthesis are quite satisfied with the cosmetic results and felt comfortable attending the social events.

Acute Encephalitis Syndrome (AES) is a major seasonal public health problem in Bihar, India. Despite efforts of the Bihar health department and the Government of India, burden and mortality of AES cases have not decreased, and definitive etiologies for the illness have yet to be identified.The present study was undertaken to study the specific etiology of AES in Bihar.Cerebrospinal fluid and/or serum samples from AES patients were collected and tested for various pathogens, including viruses and bacteria by ELISA and/or Real Time PCR.Of 540 enrolled patients, 33.3% (180) tested positive for at least one pathogen of which 23.3% were co-positive for more than one pathogen. Most samples were positive for scrub typhus IgM or PCR (25%), followed by IgM positivity for JEV (8.1%), WNV (6.8%), DV (6.1%), and ChikV (4.5%).M. tuberculosis and S. pneumoniae each was detected in ~ 1% cases. H. influenzae, adenovirus, Herpes Simplex Virus -1, enterovirus, and measles virus, each was detected occasionally. The presence of Scrub typhus was confirmed by PCR and sequencing. Bihar strains resembled Gilliam-like strains from Thailand, Combodia and Vietnam.The highlights of this pilot AES study were detection of an infectious etiology in one third of the AES cases, multiple etiologies, and emergence of O. tsutsugamushi infection as an important causative agent of AES in India.

Tuberculous granuloma of the tongue is a rare entity and constitutes a negligible percentage of all inflammatory lesions of that organ. Herein, we report two cases of granulomatous lesion of the tongue of tuberculous origin, both presented with only a small swelling. Fine-needle aspiration cytology (FNAC) and biopsy proved them to be granulomatous lesions. Antitubercular drugs (ATDs) were started, lesions healed completely without any residual effect.

Myocarditis is a challenging diagnosis for both clinician and pathologist due to the extreme diversity of clinical presentation and low sensitivity of detection of myocarditis in the endomyocardial samples. The exact incidence of myocarditis is still not known as endomyocardial biopsy (EMB) is not performed in all suspected cases of myocarditis in majority of the centers. Identification of Dallas criteria in EMB is still considered as a gold standard in the diagnosis of myocarditis. Viral myocarditis is one of the most common causes of myocarditis next to idiopathic or primary myocarditis. Virtually any type of virus can affect the heart. Idiopathic myocarditis should be categorized depending upon the histopathological findings and clinical features as fulminant, chronic active, eosinophilic, granulomatous, or giant cell myocarditis. Hence, a thorough basic set of all relevant investigations including molecular study should be carried out in the evaluation of clinically suspected viral myocarditis patients to identify the active phase of the viral disease process which ultimately helps in the determination of treatment protocol and prognosis.

CaMn7O12 is a magnetic multiferroic material, in which large ferroelectric polarization has reportedly been induced by magnetic ordering. In this work, we observe remarkable changes in the spontaneous ferroelectric polarization PS as well as the magnetization M with only 2% Sr doping. In Ca0.98Sr0.02Mn7O12, PS dramatically becomes more than double the PS in the un-doped material and concomitantly M is reduced to less than half of its value therein. Increase of PS together with the decrease of M points out clearly the coupling of PS and M in CaMn7O12. We stress here that as Ca and Sr are isovalent, no charge carriers (electrons and holes) are added in the system due to Sr-doping. X-ray diffraction shows that all our Sr-doped materials Ca1-xSrxMn7O12 (x = 0.01, 0.02, 0.05, 0.10) are free from secondary phases. From our work, it becomes clear why SrMn7O12 exhibits no or weak ferroelectricity.

Myxomas are the most common benign cardiac tumors constituting approximately 75% of all the cardiac tumors. Rest 25% are malignant and sarcomas being the commonest. Among the sarcomas primary cardiac malignant peripheral nerve sheath tumors are extremely rare. They usually arise in relation to the branches of vagus or phrenic nerves, 5-42% being associated with neurofibromatosis type 1. Clinical signs and symptoms depend on the location and extent of involvement. Complete resection is the treatment of choice but local recurrence is common.

Introduction: Maximal opening of mouth is described as the greatest distance between incisal edge of maxillary central incisor to the incisal edge of mandibular central incisor, when the mouth is opened as wide as possible painlessly or as the inter incisal distance plus the overbite. Clinical measurement of normal range of Maximum Mouth Opening (MMO) in children is an important diagnostic criterion for evaluation of stomatognathic system, especially for those with temporomandibular and neurogenic dysfunctions. Aim: To determine the correlation of maximal mouth opening with age, sex, height, body weight and different facial types. Materials and Methods: The study was a cross-sectional study which was conducted on 434 children, who were randomly divided into three groups based on their age: Group I- children of age 6 to 8 years, Group II- children of age 8.1 to 10 years, Group III- children of age 10.1 to 12 years. For each child, the examiner took three readings of MMO in millimeters (mm) and the mean of the three readings was considered. Age, sex, standing height, body weight and facial type of each child were also recorded simultaneously. Pearson correlation was used to determine the relationship between the different parameters. p-value

Introduction: Traumatic dental injuries are one of the commonly encountered dental emergencies. Missing anterior tooth in children due to any injury can be a source of considerable physical and psychological discomfort for the child. The prognosis of some dental injuries depends to a great extent on parents’ knowledge of correct and prompt emergency measures. Aim: The purpose of this cross-sectional study was to assess the knowledge, attitude and awareness level of parents regarding the emergency management of dental trauma and to find out the relation of the responses to social variables. Materials and Methods: A total of 2000 parents were surveyed over a period of three months using a pretested close ended questionnaire prepared in English, Hindi as well as in the regional language which was divided into three parts: Part 1 contained questions on personal information, Part 2 on an imaginary case of trauma to assess their knowledge regarding trauma management and Part 3 related to their attitude towards dental trauma management education. The data was statistically analysed using descriptive and chi-square statistics. Results: The overall knowledge of parents regarding emergency management of trauma was not satisfactory. Although most of the people were in favour of taking professional consultation for emergency management of trauma but most of them were unaware of the steps that need to be taken on their part so as to minimize complications and improve prognosis. Conclusion: Educational campaigns are the need of the day to increase the knowledge of parents regarding emergency management of dental trauma.

Pigment dispersion syndrome (PDS) is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA) of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS.

BackgroundThe DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum) and its novel function in salinity stress tolerance in plant.ResultsThe pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS) accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities.ConclusionsTo the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance.

Recent advances in microelectronic and optoelectronic industries have spurred interest in the development of reticulate doped polymer films containing “metallic” charge transfer complexes. In this study, such reticulate doped polymer films were prepared by exposing solid solutions of bis(ethylenedioxy) tetrathiafulvalene (BEDO-TTF) in polycarbonate (PC) to iodine, forming conductive charge transfer complexes. The resulting films exhibited room temperature conductivities ranging from 6.33 to S cm−1. The colored iodine complexes in the film were reduced by cyclic voltammetry yielding conductive, colorless, transparent films. We were intrigued to examine the dielectric properties of BEDO-TTF in solid solution in PC prior to formation of the charge transfer complex as no such studies appear in the literature. Dielectric analysis (DEA) was used to probe relaxations in neat PC and BEDO-TTF/PC. BEDO-TTF plasticized the PC and decreased the glass transition temperature. Two secondary relaxations appeared in PC films, whereas the transitions merged in the BEDO-TTF/PC film. DEA also evidenced conductivity relaxations above 180°C which are characterized via electric modulus formalism and revealed that BEDO-TTF increased AC conductivity in PC.