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Pemphigus Vulgaris is an uncommon autoimmune skin disorder that is characterized by persistent and blistering lesions. In approximately 50% of patients, mucous membrane erosions are the initial symptom. The primary presenting symptom is often oral mucosal erosions. Affected individuals frequently experience flaccid blisters and erosions on healthy skin and mucous membranes, and other areas of the body may also be affected. This condition is the result of autoantibodies that target desmosomal antigens. We are presenting a case of a 28-year-old male who presented to the hospital with fluid-filled lesions on his forehead and in his oral cavity. A skin biopsy was performed, and he was diagnosed with pemphigus vulgaris. Initially, he was started on a combination of steroids and azathioprine, but he did not respond to this treatment regimen. However, he was successfully treated with injection rituximab. Rituximab has been found to be an effective treatment approach towards pemphigus vulgaris. It can help prevent further complications and reduce the severity of the disease. By targeting the autoantibodies that cause the disorder, rituximab can help control the patient’s symptoms and improve their quality of life. It is important to note that early diagnosis and treatment can play a critical role in the management of pemphigus vulgaris.

Background: Congenital diaphragmatic hernia (CDH) is a life-threatening condition. It happens when the fetal diaphragm does not develop normally during pregnancy. In CDH, the diaphragm breach permits abdominal contents to leak into the thoracic cavity. Pulmonary hypoplasia and pulmonary vascular disease are present in varying degrees of CHD syndrome. Typically leads to pulmonary hypertension, due to anatomical and functional pulmonary vascular abnormalities. Case presentation: Here we report a case of a 5-day-old male neonate born with respiratory distress. After undergoing radiological examination patient was diagnosed with CDH. Transabdominal surgical management was given. The prognosis was good. Conclusion: Transabdominal surgical approach was effective in the case of CDH management.

Vibrio vulnificus (Vv) and Vibrio parahaemolyticus (Vp) are water- and foodborne bacteria that can cause several distinct human diseases, collectively called vibriosis. The success of oyster aquaculture is negatively impacted by high Vibrio abundances. Myriad environmental factors affect the distribution of pathogenic Vibrio, including temperature, salinity, eutrophication, extreme weather events, and plankton loads, including harmful algal blooms. In this paper, we synthesize the current understanding of ecological drivers of Vv and Vp and provide a summary of various tools used to enumerate Vv and Vp in a variety of environments and environmental samples. We also highlight the limitations and benefits of each of the measurement tools and propose example alternative tools for more specific enumeration of pathogenic Vv and Vp. Improvement of molecular methods can tighten better predictive models that are potentially important for mitigation in more controlled environments such as aquaculture.

Introduction: New ceramic materials have been introduced with less research on their aesthetic outcome and durability for clinical implications. Lithium disilicate is one of the widely used materials for restoration. Recently, Zirconia-reinforced Lithium Silicate (ZLS) glass-ceramic enriched with 10% zirconia in highly dispersed glass phase of ceramic has been introduced. Aim: To investigate the translucency of pressable Lithium Disilicate (LS2) and ZLS and their effects on wear of opposing enamel. Materials and Methods: This in-vitro study was carried out at MGM Dental College and Hospital, Mumbai, Maharashtra, India, between January 2017 and January 2020. Twenty disks of 15×3 mm; 10 each of LS2 and ZLS were fabricated by hot pressing method. For translucency Commission Internationale de l’Eclairage (CIE) L*a*b values for each sample were measured against black and white background using a laboratory reflectance spectrophotometer. Translucency was calculated using Translucency Parameter (TP)= {(L*B-L*W)2+(a*B- a*W)2+(b*B-b*W)2}1/2. For wear testing same 20 disks were used as an antagonist. Enamel specimen of 20 maxillary premolar were abraded against each antagonist with two body wear testing machine in rotational motion under a constant load of 20 N at 350 rpm for 5000 cycles. The initial readings and final readings of enamel specimen in μm were measured using contact stylus profilometer. Non parametric Mann-Whitney U test was used to compare the significance of difference between two groups. Results: The TP values obtained were 23.07 and 24.04 for LS2 and ZLS, respectively (p-value=0.004). The mean wear values obtained were 0.71860 μm and 1.09500 μm for LS2 and ZLS, respectively (p-value=0.049). The difference for both the parameters was statistically significant. Conclusion: Within the limitation of this study, ZLS showed higher translucency values than LS2. Wear rate of opposing enamel was more with ZLS than LS2. Thus ZLS may provide excellent aesthetics which can be used as an option for rehabilitation in aesthetic zone.

Present case series describes the three different types of attachments use for tooth supported overdenture for prosthetic rehabilitation. Loss of teeth causes continuous resorption of the bone leading to a compromised treatment. Retaining two or more natural teeth can be used as an abutment for prosthetic rehabilitation of partial edentulism arches. Preventive prosthodontics includes tooth supported overdentures which preserves natural teeth, roots and maintains propioception. Depending upon the interarch distance available various types of attachments can be used to enhance the retentive factors. The first case (71-year-old female patient) describes the use of telescopic attachment overdenture on 33, 43 with available interarch space of 15 mm in mandibular arch. The second case (62-year-old female patient) describes the use of ball attachments overdenture on 34 and 35 with available interarch space of 13 mm in mandibular arch. The third case (60-year-old female patient) is about equator attachment overdenture on 33, 43 with available interarch space of 12 mm in mandibular arch. Use of telescopic, ball and equator attachments for tooth supported overdentures has enhanced the retention, stability, function and aesthetic outcome of the removable prosthesis in mandibular arch. The natural teeth provide additional support, stability and retention of the overdenture than the edentulous ridges alone which is particularly advantageous for mandibular arch.

Heat and drought stresses have negative impacts on wheat yield and growth worldwide, causing up to 60% and 40% yield losses, respectively, but their combined effect can cause severe losses. The present study aimed to identify the high-yielding genetic resources tolerant to drought and/or heat stresses under climate change scenarios. The field trials on 42 genotypes were conducted at three locations in four environments (normal TSIR-NS, drought TSRF-DR, heat LSIR-HT, and heat and drought combined LSRF-DHT) each for two consecutive years. Yield contributing traits were recorded in all the experiments and all the locations: SI (susceptibility index) and STI (stress tolerance index) were also estimated. GY (Grain yield) was severely affected by LSRF-DHT (48.6%), followed by TSRF-DR (23.6%) and LSIR-HT (16.8%). GY had a positive correlation with BM (biomass), HI (harvest index), and TGW (1000-grain weight) under all environments and negative with DH (days to heading) (LSIR-HT and LSRF-DHT). Stepwise regression analysis revealed a higher contribution of BM and HI towards GY under all environments. GW (grain weight/spike) contributed under LSIR-HT and LSRF-DHT, and GN (grain number/spike) under TSIR-NS and TSRF-DR. GFD (grain-filling duration), TGW, and PTL (productive tillers) contributed under all conditions except LSRF-DHT. WS 2016-4 was the only genotype that yielded high under all the conditions. WS 2016-12 and CNM 16-1 were tolerant to heat and drought stresses and high yielding. HINDI 62, HTW 11, and QBP 1606 were less sensitive to all the stresses but low yielding. Overall, out of 30 tolerant genotypes (10 of each category), 19 adapted to escape mechanism which is irrespective of their yielding level. The study demonstrated the potential of identified genotypes in wheat breeding for climate resilience and the traits imparting tolerance to these genotypes.

A 28-year-old male patient reported with a chief complaint of poor aesthetic due to missing tooth in upper front region of jaw since two years. Extraoral examination [Table/Fig-1] showed squarish facial form, straight profile and adequate lip support with thin long competent lips. Intraoral examination showed Ellis class III fracture with maxillary Right Central Incisor (11) [Table/Fig-2]. As the amount of tooth structure was less and it was carious so it was decided to extract 11. The site was allowed to heal for three weeks. The patient did not agreed for the implant placement due to the time and cost factor. So a minimally invasive all ceramic maryland bridge was planned to restore missing maxillary right central incisor. Shade selection of A2 was done with maxillary left central incisor as reference. A diagnostic impression was made using irreversible hydrocolloid [Table/Fig-3] and diagnostic mock-up was done [Table/Fig-4] followed with mock trial for patient approval [Table/Fig-5]. Minimal tooth preparation on the lingual surfaces of the abutments 12 and 21 was done using deep chamfer 1.0 diamond bur and finished using finishing bur. Preparations were not extended beyond the linguo-proximal line angles on the abutments. Lingual preparation ended 0.5 mm from the incisal edge and a feather finish line was prepared 0.5 mm supragingivally [Table/Fig-6] [1]. Single step final impression was made using addition silicone (flexceed). Final wax up was done on the final cast for all ceramic lithium disilicate maryland bridge [Table/Fig-7]. Lithium disilicate bridge was fabricated using pressable technique [Table/Fig-8]. Shade, aesthetic, fit and occlusion was evaluated during bisque trial. The final finishing and polishing was done. Following bonding protocol was followed for lithium disilicate maryland bridge with 12, 21. Ceramic was etched with 10% of hydrofluoric acid for 10 seconds and teeth were etched using 37% of phosphoric acid for 20 seconds followed by cleaned and washed under water and air dried giving a white frosty appearance [Table/Fig-9] [2]. Followed by application of bonding agent to the teeth and bridge and light cured using light curing unit [Table/Fig-10]. Following this final cementation of maryland bridge with 12, 11 and 21 was done using variolink resin cement [Table/Fig-11]. The following post cementation instructions were given to the patient. Do not bite from the front teeth as the prosthesis can get fracture. Oral hygiene instructions to be followed of 45o angle brushing twice a day and flossing once a day to avoid getting a cavity or gum disease around your new prosthesis. Flossing is especially important in preserving the health of your bridge [3]. The patient follow-up was done at interval of 1 day, 1 week, 3 months and yearly; the prosthesis was in good condition [Table/Fig-12,13]. Implants fixed prosthesis, three unit fixed dental prosthesis, adhesive bridges, fibre reinforced prosthesis are various treatment options available for replacement of missing single anterior teeth. Implant is a surgical procedure and requires longer time, three unit fixed dental prosthesis requires more preparation of the abutment teeth, fibre reinforced prosthesis are temporary option to overcome these disadvantages a conservative treatment option of all ceramic lithium disilicate maryland bridge was chosen. The maryland bridge, also known as resin-bonded bridge can be used for anterior as well as for posterior single missing tooth as concluded by Gulati JS et al., [4]. A maryland bridge consists of a metal framework with porous surface and a porcelain tooth connected onto the front of the framework [5]. Advantages of maryland bridge are conservative, reversible, less trauma to pulp of abutment tooth, unaltered natural teeth and less periodontal irritation [6]. Disadvantages of maryland bridge are indicated for single missing tooth, colour change due to metal hue, debonding of metal wing and recementation [6]. To overcome the problems of metal wing and with the advancement in metal free materials we have opted for all ceramic pressable lithium disilicate maryland bridge (IPS e.max) which has increased strength, better retention and aesthetics as compared to metal adhesive bridges [7]. However, the failures can occurs in the form of debonding (78%), fracture (13%) as concluded by Balasubramanian GR in 2017 [8]. On two year follow-up the maryland bridge was in good condition without any signs of failure or fracture or debonding.

Vibriosis is the general term for human illnesses caused by infection of pathogenic Vibrio species. Vibrio vulnificus (Vv) and parahaemolyticus (Vp) are two problematic waterborne pathogens that have yet to be enumerated in northwest Florida coastal Gulf of Mexico estuaries. In this regionally novel study, we surveyed 43 locations in two subtropical estuarine systems, Perdido Bay and Pensacola Bay, over seven dates in winter 2020. Sampling included three substrate types: surface waters, sediments, and invertebrate biofilms. We determined baseline abundances of presumptive viable Vv and Vp appearing as colonies on CHROMagar (Vv, blue; Vp, purple). Vv was detected in 37 out of 43 water samples, with maximum levels of 3,556 CFU/mL. Vp was only detected in 15 water samples, with a maximum concentration of 8,919 CFU/mL. Sediments contained Vv in all but one sample, with concentrations ranging from 121 to 607,222 CFU/mL. In contrast, Vp were only detected in 33 sediment samples, where concentrations ranged from 28 to 77,333 CFU/mL. Opportunistically-sampled surface swabs (biofilms), collected from shells (either oyster or barnacle) and polychaete worms found in sediment samples, contained on average 7,735 and 1,490 CFU/mL of Vv and Vp, respectively. Surface water Vv abundances covaried with bottom water pH, maximum prior cumulative wind speeds, and tidal coefficient on the day of sampling. Vp surface water abundances negatively correlated with surface water salinity, surface water pH, and bottom water pH and positively correlated with total surface dissolved inorganic and total Kjeldahl nitrogen concentrations, and wind. Spatially, there was large variation in Vibrio densities in surface waters; abundances of both species were strongly correlated with wind, suggesting resuspension was important. Sedimentary abundances of both putative Vv and Vp shared a correlation with one parameter: salinity stratification. Due to the length of this study, temperature was not considered a major factor. This short-term (1 month) study was designed not to enumerate pathogenic Vv or Vp, but rather to establish the first winter baseline of Vibrio abundances for this region. Determination of these baseline winter cultivable putative Vibrio abundances will be valuable in predicting relative risk factors in each waterbody of interest.

Purpose: The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods. Materials and Methods: Independent search was conducted in Cochrane Library, EBSCO, and PubMed/ PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications. Results: A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10). Conclusion: The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and meta-analysis aimed to evaluate the accuracy of different methods used for measuring horizontal condylar guidance (HCG) angle in comparison with protrusive interocclusal record (IOR) for dentulous patients. Settings and Design: The design involves systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Materials and Methods: An electronic search was carried out by two reviewers in the Google Scholar search engine and the EBSCO host, Cochrane Library, and PubMed/MEDLINE databases for quasi-experimental studies, in vivo studies, and cross-sectional studies published from January 2005 to February 2023 determining the HCG angle in dentulous patients. Statistical Analysis Used: Meta-analysis was performed to evaluate the quantitative data. Results: A total of 577 articles were identified, 29 analytical cross-sectional studies that fulfilled the eligibility criteria were included for qualitative synthesis and 26 studies were included for meta-analysis. A statistically significant difference was observed for the right and left HCG angles obtained by the panoramic radiograph method and cone-beam computed tomography (CBCT) method and for the right side HCG angle obtained by cephalogram method showing higher values than the protrusive IOR method. No statistically significant difference was observed for the left side HCG angle obtained by the cephalogram method and both the right and left side HCG angles obtained by the intraoral tracer method. Conclusions: The panoramic radiograph, cephalogram, and CBCT obtained higher HCG angles in dentulous patients than the protrusive IOR method. [ABSTRACT FROM AUTHOR]