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The recurrence and relapse of vaginal infections in women is a major issue and a challenging pathway to identify and develop new approaches to treatment. In the case of antibiotic therapy, contraceptives, and dietary changes, the recurrence of vaginitis is more common these days. Anaerobic bacteria, Candida spp., and trichomonas in the vaginal microflora cause both symptomatic and asymptomatic vaginitis, which includes vaginal inflammation. It changes the vaginal microbiota and decreases Lactobacilli spp. growth, which is maintaining the vaginal pH (3.5-4.5) through lactic acid production, antimicrobial peptides, bacteriocin, and bacteriocin-like inhibitory substances. The remarkable antimicrobial activity of plant’s producing metabolites like alkaloids, tannins, phenolic compounds, flavonoids and terpenoids for several vaginal infections have been reported in previous studies. Presented review focuses on the pivotal role of monoterpenes, providing a detailed description of thymol, geraniol, limonene, eugenol, eucalyptol, and α-terpineol as antimicrobial molecules in the treatment of vaginal infections. These monoterpenes are very good at killing E. coli, Staphylococcus aureus, Pseudomonas aeruginosa, Aspergillus niger, Trichomonas vaginalis and Candida albicans which are the main microbes that cause vaginitis. Future research could explore the latent combinations of such monoterpenes as synergistic antimicrobial agents to treat bacterial and fungal vaginal infections, trichomoniasis, among other conditions.

Background: Hypertension is one of the main factors contributing to the global burden of non-communicable diseases. Previous research has revealed that stress, bad lifestyle choices and a lack of knowledge about the disease are the main causes of hypertension that can be controlled. The key cause behind the prevalence of the condition is the lack of medication adherence by patients. This study aims to evaluate medication adherence in patients with hypertension through the Morisky Medication Adherence Scale (MMAS) and to observe any adverse drug reaction leading to non-adherence of medications. Methods: A descriptive, cross-sectional study was conducted on 124 patients who attended the outpatient department of medicine. The descriptive tools were MMAS and causality scales for adverse drug reactions. Result: The mean MMAS score was 5.20±1.29. Amongst the demographic profile, age, sex, comorbidities and duration of disease were significantly associated with decreased mean MMAS scores. Forty-two patients experienced drug reactions and only four patients were adherent to their medications. Conclusion: Our study suggests that patients were poorly adherent to their medications. Effective interventions should be considered to improve adherence in patients. Monitoring for adverse drug reactions can lead to improved patient outcomes, whilst interventions to improve adherence can lead to better blood pressure control and reduced risk of cardiovascular events.

Abstract ATTR amyloidosis results from the conversion of transthyretin into amyloid fibrils that deposit in tissues causing organ failure and death. This conversion is facilitated by mutations in ATTRv amyloidosis, or aging in ATTRwt amyloidosis. ATTRv amyloidosis exhibits extreme phenotypic variability, whereas ATTRwt amyloidosis presentation is consistent and predictable. Previously, we found unique structural variabilities in cardiac amyloid fibrils from polyneuropathic ATTRv-I84S patients. In contrast, cardiac fibrils from five genotypically different patients with cardiomyopathy or mixed phenotypes are structurally homogeneous. To understand fibril structure’s impact on phenotype, it is necessary to study the fibrils from multiple patients sharing genotype and phenotype. Here we show the cryo-electron microscopy structures of fibrils extracted from four cardiomyopathic ATTRwt amyloidosis patients. Our study confirms that they share identical conformations with minimal structural variability, consistent with their homogenous clinical presentation. Our study contributes to the understanding of ATTR amyloidosis biopathology and calls for further studies.

Abstract Herbicide use may pose a risk of environmental pollution or evolution of resistant weeds. As a result, an experiment was carried out to assess the influence of different non-chemical weed management tactics (one hoeing (HH) at 12 DAS followed by (fb) one hand weeding at 30 DAS, one HH at 12 DAS fb Sesbania co-culture and its mulching, one HH at 12 DAS fb rice straw mulching @ 4t ha−1, one HH at 12 DAS fb rice straw mulching @ 6 t ha−1) on weed control, crop growth and yield, and economic returns in direct-seeded rice (DSR). Experiment was conducted during kharif season in a split-plot design and replicated thrice. Zero-till seed drill-sown crop (PN) had the lowest weed density at 25 days after sowing (DAS), while square planting geometry (PS) had the lowest weed density at 60 DAS. PS also resulted in a lower weed management index (WMI), agronomic management index (AMI), and integrated weed management index (IWMI), as well as higher growth attributes, grain yield (4.19 t ha–1), and net return (620.98 US$ ha–1). The cultivar Arize 6444 significantly reduced weed density and recorded higher growth attributes, yield, and economic return. In the case of weed management treatments, one HH at 12 DAS fb Sesbania co-culture and its mulching had the lowest weed density, Shannon-weinner index and eveness at 25 DAS. However, one hoeing at 12 DAS fb one hand weeding at 30 DAS (HH + WH) achieved the highest grain yield (4.85 t ha–1) and net returns (851.03 US$ ha–1) as well as the lowest weed density at 60 DAS. PS × HH + WH treatment combination had the lowest weed persistent index (WPI), WMI, AMI, and IWMI, and the highest growth attributes, production efficiency, and economic return.

Introduction: The sex ratio is a crucial social indicator to assess the level of equality between men and women. In several aspects, the gender difference between men and women is the major expression of social and cultural trends of the society. Aim: To analyse sex ratio at birth and the gender difference in health seeking behaviour among newborns and the natural survival advantage of female newborns by studying the admission, discharges, mortality, follow-up and Leave Against Medical Advice (LAMA) in Special Newborn Care Unit. Materials and Methods: This cross-sectional study was conducted in Netaji Subash Chandra Bose Medical College and Hospital, Madhya Pradesh and Lady Elgin Hospital, Madhya Pradesh from July 2017 to June 2019. The total number of newborns included in the study was 37,256. The difference in male and female newborns in terms of birth, LAMA, morbidity, mortality and follow-up were studied. The monthly statistical data were entered in an excel sheet. The data were analysed using SPSS version 22.0 for Windows. The mean values of the monthly percentage were compared gender-wise using the t-test. Results: Out 20108 male newborns and 17,148 female newborns advised for follow-up care, 1897 females (mean-14.64, SD-11.47) and 3029 males (mean-16.94, SD-12.47) came for follow-up care. The gender difference was statistically significant (p ≤0.001). Females (mean outborn unit-3.07, inborn unit-1.05) took LAMA more than males (mean outborn-2, inborn-0.84) which was statistically significant (outborn: p≤0.001, inborn: p=0.0254). This imples less health seeking behaviour towards females. Mortality (p-value: outborn-0.0041, inborn-0.0105) and morbidity (p≤0.001) were lesser in females compared to males which was statistically significant. These factors imply natural survival advantage in females. Conclusion: The present study concludes that the health seeking behaviour was less towards female newborns despite their natural survival advantage which plays an important role in the declining sex ratio.

Background: Fixed-dose combinations (FDCs) were brought into the market with the intent of providing benefits primarily to patients and physicians. Nevertheless, despite their multiple advantages, they have their own set of drawbacks, especially regarding irrational FDCs. If physicians continue to prescribe them, prohibiting their sale would become all the more challenging. This cross-sectional survey study was planned to comprehend the level of knowledge, attitude and practice of physicians regarding such FDCs at a tertiary care teaching institute of western Uttar Pradesh, India. Methodology: A pre-validated questionnaire was communicated electronically to all the attending physicians. For data analysis, descriptive statistics were applied and a χ2 test was performed for inter-group comparison. Results: Amongst the 108 respondents, participation was almost comparable from both medical and surgical branches, with most participants being junior residents (58%). Even with sound knowledge of FDCs, only 46.30% of them were aware of banned FDCs. Similarly, only 6.48% could correctly identify the disadvantages associated with the use of FDCs, and 33.18% could correctly recognize irrational FDCs. This finding was consistently reflected in their attitude and practice and only 15.74% of respondents cross-referenced FDCs with the available literature. Furthermore, despite 88.89% of respondents checking for rationality of FDCs before prescribing them, a compendium of irrational FDCs is routinely prescribed. Conclusion: To amend these shortcomings in prescribing of irrational FDCs, some recommendations are proposed by the authors herein.

Objective: To understand and highlight the differences in clinical, demographic, and image quality characteristics between patient-taken (PAT) and clinic-taken (CLIN) photographs of skin conditions. Patients and Methods: This retrospective study applied logistic regression to data from 2500 deidentified cases in Stanford Health Care’s eConsult system, from November 2015 to January 2021. Cases with undiagnosable or multiple conditions or cases with both patient and clinician image sources were excluded, leaving 628 PAT cases and 1719 CLIN cases. Demographic characteristic factors, such as age and sex were self-reported, whereas anatomic location, estimated skin type, clinical signs and symptoms, condition duration, and condition frequency were summarized from patient health records. Image quality variables such as blur, lighting issues and whether the image contained skin, hair, or nails were estimated through a deep learning model. Results: Factors that were positively associated with CLIN photographs, post-2020 were as follows: age 60 years or older, darker skin types (eFST V/VI), and presence of skin growths. By contrast, factors that were positively associated with PAT photographs include conditions appearing intermittently, cases with blurry photographs, photographs with substantial nonskin (or nail/hair) regions and cases with more than 3 photographs. Within the PAT cohort, older age was associated with blurry photographs. Conclusion: There are various demographic, clinical, and image quality characteristic differences between PAT and CLIN photographs of skin concerns. The demographic characteristic differences present important considerations for improving digital literacy or access, whereas the image quality differences point to the need for improved patient education and better image capture workflows, particularly among elderly patients.

Abstract Unlike the intense research effort devoted to exploring the significance of heparanase in cancer, very little attention was given to Hpa2, a close homolog of heparanase. Here, we explored the role of Hpa2 in breast cancer. Unexpectedly, we found that patients endowed with high levels of Hpa2 exhibited a higher incidence of tumor metastasis and survived less than patients with low levels of Hpa2. Immunohistochemical examination revealed that in normal breast tissue, Hpa2 localizes primarily in the cell nucleus. In striking contrast, in breast carcinoma, Hpa2 expression is not only decreased but also loses its nuclear localization and appears diffuse in the cell cytoplasm. Importantly, breast cancer patients in which nuclear localization of Hpa2 is retained exhibited reduced lymph-node metastasis, suggesting that nuclear localization of Hpa2 plays a protective role in breast cancer progression. To examine this possibility, we engineered a gene construct that directs Hpa2 to the cell nucleus (Hpa2-Nuc). Notably, overexpression of Hpa2 in breast carcinoma cells resulted in bigger tumors, whereas targeting Hpa2 to the cell nucleus attenuated tumor growth and tumor metastasis. RNAseq analysis was performed to reveal differentially expressed genes (DEG) in Hpa2-Nuc tumors vs. control. The analysis revealed, among others, decreased expression of genes associated with the hallmark of Kras, beta-catenin, and TNF-alpha (via NFkB) signaling. Our results imply that nuclear localization of Hpa2 prominently regulates gene transcription, resulting in attenuation of breast tumorigenesis. Thus, nuclear Hpa2 may be used as a predictive parameter in personalized medicine for breast cancer patients.

Abstract ATTR amyloidosis is caused by the deposition of transthyretin in the form of amyloid fibrils in virtually every organ of the body, including the heart. This systemic deposition leads to a phenotypic variability that has not been molecularly explained yet. In brain amyloid conditions, previous studies suggest an association between clinical phenotype and the molecular structures of their amyloid fibrils. Here we investigate whether there is such an association in ATTRv amyloidosis patients carrying the mutation I84S. Using cryo-electron microscopy, we determined the structures of cardiac fibrils extracted from three ATTR amyloidosis patients carrying the ATTRv-I84S mutation, associated with a consistent clinical phenotype. We found that in each ATTRv-I84S patient, the cardiac fibrils exhibited different local conformations, and these variations can co-exist within the same fibril. Our finding suggests that one amyloid disease may associate with multiple fibril structures in systemic amyloidoses, calling for further studies.

Abstract Haplotype-based breeding is an emerging and innovative concept that enables the development of designer crop varieties by exploiting and exploring superior alleles/haplotypes among target genes to create new traits in breeding programs. In this regard, whole-genome re-sequencing of 399 genotypes (landraces and breeding lines) from the 3000 rice genomes panel (3K-RG) is mined to identify the superior haplotypes for 95 drought-responsive candidate genes. Candidate gene-based association analysis reveals 69 marker-trait associations (MTAs) in 16 genes for single plant yield (SPY) under drought stress. Haplo-pheno analysis of these 16 genes identifies superior haplotypes for seven genes associated with the higher SPY under drought stress. Our study reveals that the performance of lines possessing superior haplotypes is significantly higher (p ≤ 0.05) as measured by single plant yield (SPY), for the OsGSK1-H4, OsDSR2-H3, OsDIL1-H22, OsDREB1C-H3, ASR3-H88, DSM3-H4 and ZFP182-H4 genes as compared to lines without the superior haplotypes. The validation results indicate that a superior haplotype for the DREB transcription factor (OsDREB1C) is present in all the drought-tolerant rice varieties, while it was notably absent in all susceptible varieties. These lines carrying the superior haplotypes can be used as potential donors in haplotype-based breeding to develop high-yielding drought-tolerant rice varieties.

Oxidative damage leading to loss of nutritional quality and pericarp discoloration of harvested litchi fruits drastically limits consumer acceptance and marketability. In the present investigation, the impact of postharvest melatonin application at different concentrations, i.e., 0.1 mM, 0.25 mM, and 0.5 mM, on fruit quality and shelf life of litchi fruits under cold storage conditions was studied. The results revealed the positive effect of melatonin application at all concentrations on fruit quality and shelf life. However, treatment with 0.5 mM concentration of melatonin resulted in minimum weight loss, decay loss, pericarp discoloration, and also retained higher levels of TSS, acidity, total sugar, ascorbic acid, anthocyanin, antioxidant, and phenolics content during cold storage. Melatonin administration also restricted the enzymatic activity of the polyphenol oxidase (PPO) and peroxidase (POD) enzymes in the fruit pericarp and maintained freshness of the fruits up to 30 days in cold storage. At the molecular level, a similar reduction in the expression of browning-associated genes, LcPPO, LcPOD, and Laccase, was detected in preserved litchi fruits treated with melatonin. Anthocyanin biosynthetic genes, LcUFGT and LcDFR, on the other hand showed enhanced expression in melatonin treated fruits compared to untreated fruits. Melatonin, owing to its antioxidant properties, when applied to harvested litchi fruits retained taste, nutritional quality and red color pericarp up till 30 days in cold storage.

Background: Acceptance of Covid-19 vaccination among the general population is one topic that has been discussed worldwide. Large number of doses of vaccine has been administered throughout the world, but, concerns about safety of Covid-19 vaccination still persists. There have been reports of adverse effects with Covid-19 vaccination which are mild and resolve spontaneously. This study was done to evaluate the side effects after first and second doses of Covid-19 vaccine among health care providers in tertiary care hospital. Material and methods: This cross-sectional, questionnaire based study was done among health care workers after first and second dose of vaccine in Teerthanker Mahaveer Medical College & Research Center, Moradabad, India between January 2021 to July 2021. In this survey, post Covid-19 vaccination questionnaire was designed using Google Forms and was shared to vaccinated participants through social media and mail. Snowball sampling method was used for gathering a total of 485 responses. Informed consent was obtained from all research participants and the study was approved by the Institutional Review Board (IRB) Results: The respondents were health care professionals which included Physician, Surgeons, and Other Health Care Workers. The most common adverse effects reported after both doses of vaccination were fever, chills and rigor, headache, myalgia, malaise and pain at site of injection. The results showed that 65% (n=338) of participants had mild symptoms like headache, fever, pain at injection site, malaise, myalgia, dizziness, nausea and vomiting after first dose of vaccination. In comparison 39% (n=190) of participants reported mild symptoms after the administration of second dose of vaccination. A total of 63% (n=330) and 41% (n=197) participants took medication for relief of symptoms during post-vaccination period after the first and second dose of vaccine with slight female preponderance. Conclusion: The most prevalent adverse effects following vaccination were nausea and vomiting, headache, dizziness, fever, chills, fatigue, including pain, redness and swelling at the injection site with more female preponderance. The adverse effect encountered were higher in number after the first dose of vaccination.

Energy consumption is a major concern in wireless sensor networks (WSNs) as it affects the lifespan of sensor nodes. Battery-based WSNs have a short operating period, which makes them impractical for real-time applications, for instance in agriculture. Energy harvesting and suitable medium access control (MAC) protocols have been used to extend the lifetime of nodes. Receiver-initiated protocols have been proved to be the best solution for energy harvesting WSNs. However, they suffer from a key disadvantage, i.e. an increase in collision rate. These collisions need to be reduced using a multi-layer protocol structure. In such a context, a new solar-based hybrid MAC (SHMAC) protocol relying on receiver-initiation and characterized by a multi-layer structure is proposed. It is an adaptive protocol capable of adapting to changing weather conditions. The nodes with a high energy harvesting rate have a higher level of residual energy and are active for longer time periods compared with those with low energy harvesting characteristics. The proposed work has shown improvements in two major MAC layer parameters, i.e. collision rate and energy neutrality operation ratio (ENO).

An experiment was conducted during the rainy (kharif) season of 2022–23 at the ICAR-Indian Agricultural Research Institute, Hazaribagh, Jharkhand to assess how well nano- urea performs in maize under different field conditions and investigate its compatibility with other N sources. Results showed that root weight (fresh and dry), partial factor productivity (N, P2O5 and K2O), N concentration (grain and stover), grain yield, biological yield and harvest index of maize were all significantly affected by the application of various N rates and nano-fertilizers. The grain yield of maize was comparable to the yield obtained under RDF and 75% of the recommended N + two nano-urea sprays. These findings indicate that the concurrent use of these nano-fertilizers has the potential to reduce N fertilization by as much as 25%. Furthermore, the results highlight the prospect of augmenting biological yield of maize by incorporating 2 nano-urea sprays alongside the prescribed N quantity from prilled urea, as well as full applications of P2O5 and K2O.

Schiff bases and their metal complexes are versatile compounds synthesized from the condensation of an amino compound with carbonyl compound and widely used for the industrial purposes. They also exhibit a broad range of biological activities including antifungal, antimalarial, antiproliferative, antibacterial, antipyretic and antiviral. Many Schiff base complexes exhibit excellent catalytic activity in various reactions. The activity is usually increased by complexation therefore, to understand the properties of both ligands and metal can lead to the synthesis of highly active compounds. The influence of certain metals on the biological activity of these compounds and their intrinsic chemical interest as multidentate ligands has prompted a considerable increase in the study of their coordination behaviour. Development of new Schiff base metal complexes is now attracting the attention of medicinal chemists. This review compiles the synthesis of various multidentate Schiff bases ligands and their complexation with various metals such as Zr, V, Mo, Mn, Fe, Zn, Re, Cd, and Ln. This review is an attempt to congregate complete survey on synthesis and biological activity of Schiff base metal complexes that will give glimpse on the future directions for successful development and discovery of useful drugs.

The bacterial agent of Lyme disease, Borrelia burgdorferi, exists in an enzootic cycle by adapting to dissimilar mammalian and tick environments. The genetic elements necessary for host and vector adaptation are spread across a bacterial genome comprised of a linear chromosome and essential linear and circular plasmids. The promoter trap system, In Vivo Expression Technology (IVET), has been used to identify promoters of B. burgdorferi that are transcriptionally active specifically during infection of a murine host. However, an observed infection bottleneck effect in mice prevented the application of this system to study promoters induced in a tick environment. In this study, we adapted a membrane-based in vitro feeding system as a novel method to infect the Ixodes spp. vector with B. burgdorferi. Once adapted, we performed IVET screens as a proof of principle via an infected bloodmeal on the system. The screen yielded B. burgdorferi promoters that are induced during tick infection and verified relative expression levels using qRT-PCR. The results of our study demonstrate the potential of our developed in vitro tick feeding system and IVET systems to gain insight into the adaptive gene expression of the Lyme disease bacteria to the tick vector.

We propose a novel dark-energy equation-of-state parametrization, with a single parameter η that quantifies the deviation from ΛCDM cosmology. We first confront the scenario with various datasets, from the Hubble function (OHD), Pantheon, baryon acoustic oscillations (BAO), and their joint observations, and we show that η has a preference for a non-zero value, namely, a deviation from ΛCDM cosmology is favored, although the zero value is marginally inside the 1σ confidence level. However, we find that the present Hubble function value acquires a higher value, namely, H0=66.624−0.013+0.011 Km s−1 Mpc−1, which implies that the H0 tension can be partially alleviated. Additionally, we perform a cosmographic analysis, showing that the universe transits from deceleration to acceleration in the recent cosmological past; nevertheless, in the future, it will not result in a de Sitter phase since it exhibits a second transition from acceleration to deceleration. Finally, we perform the statefinder analysis. The scenario behaves similarly to the ΛCDM paradigm at high redshifts, while the deviation becomes significant at late and recent times and especially in the future.

IntroductionRegulatory T cell (Treg)-targeting cancer immunotherapy aims to transiently deplete Treg cells in the tumor microenvironment, without affecting effector T cells (Teff), thus both enhancing anti-tumor activity and avoiding autoimmunity. This study evaluated whether adding E7777 (a new formulation of denileukin diftitox [DD]) improved the efficacy of anti-PD-1 antibody therapy. DD is a recombinant protein containing the hydrophobic and catalytic portions of diphtheria toxin fused to full-length human IL-2. E7777 has the same amino acid sequence and brief circulatory half-life as DD, but with greater purity and potency.MethodsSubcutaneous syngeneic murine solid tumor models (colon cancer CT-26 and liver cancer H22) were used to evaluate safety, efficacy, and overall survival with E7777 and anti-PD-1 antibodies, each administered as monotherapy or in concurrent or sequential combination. In Experiment 1, treatments were compared to assess anti-tumor activity at various time points, with tumors excised and dissociated and tumor leukocytes characterized. In Experiment 2, tumor growth, response, and overall survival were characterized for 100 days following a 3-week treatment.ResultsE7777 administered in combination with anti-PD-1 led to significantly increased anti-tumor activity and durable, extended overall survival compared to either treatment alone. In both tumor models, the Treg cell infiltration induced by anti-PD-1 treatment was counterbalanced by co-treatment with E7777, suggesting potential synergistic activity. Combination therapy showed the most favorable results. Treatment with E7777 was safe and well-tolerated.DiscussionCombined E7777 and anti-PD-1 therapy was well tolerated and more effective than monotherapy with either drug.

The symbiotic association of pigeonpea (Cajanus cajan (L.) Millsp.) with rhizobia plays a pivotal role in plants’ growth and development. The present study was carried out at Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh during 2018–2020 to explore the diversity of rhizobia present in the Cajanus cajan root under Inceptisols and identify an elite strain that exhibits exceptional plant growth promotion and of nitrogenase activity for efficient nitrogen fixation. The bacterial identification using 16s rDNA sequencing revealed bacteria strains Bradyrhizobium japonicum (S12), Bradyrhizobium subterraneum (S1, S7, S8, S10, S13), Bradyrhizobium yuanmingense (S2, S3, S4, S6, S9, S11) while two bacteria were the endophytes identified as Pseudomonas azotoformans (S5) and Paenibacillus seodonensis (S15). Genetic diversity using UPGMA clustering revealed remarkable genetic variations, classifying 14 strains into three primary clusters and four secondary clusters. Strains S1, S3, S6, S9, and S13 exhibited elevated nitrogenase activity, indicative of their proficient nitrogen fixation capability. In plant growth experiments, all strains demonstrated significant growth of the plants compared to control. The notable growth enhancement by these five strains can be attributed to their remarkable efficiency in nitrogen fixation, as indicated by significantly higher nodule formation and nitrogenase activity. These findings provide valuable insights for identifying potential rhizobial inoculants to enhance pigeonpea productivity.

Introduction: Among many anatomical landmarks in the human skull, the mental foramen is a stable landmark on the mandible. The diverse morphology of the mandible indicates the specific characteristics of such anatomical structures in each individual. The aim of this study was to find out the mean distance of mental foramen from the inferior border of the mandible visiting the Outpatient Dental Department in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing orthopantomogram in the Outpatient Dental Department of a tertiary care centre from 3 February 2022 to 31 July 2022. Ethical approval was obtained from the Institutional Review Committee. The patients with complete denture in the region of measurements were included in the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 207 patients, the mean distance from the inferior border of the mandible to the lower border of the mental foramen was 11.83±1.83 mm (11.58-12.07, 95% Confidence Interval). Conclusions: The mean distance of mental foramen from the inferior border of the mandible was found to be similar to other studies done in similar settings.

Bone regeneration of large maxillary and mandibular alveolar ridge defects is clinically challenging. Various techniques have been described for the reconstruction of these deficiencies before implant placement. The tent screw-pole technique is one of the effective methods available for clinicians to perform the predictable functional and esthetic reconstruction. The aim of this prospective report was to evaluate clinical and three-dimensional radiographic analyses of two patients treated with xenograft and particulate autogenous bone using tenting screws for regeneration of compromised partial edentulous ridges.

Purpose: The current study intended to provide a comparison of biomechanical behaviors of two different treatment concepts for full-mouth rehabilitation with dental implants placed according to the “All-on-four” concept and “All-on-six” concept with analysis of the stress patterns of the implant support system using three-dimensional finite element analysis (FEA). Materials and Methods: The edentulous mandible was treated with two different implant designs. “All-on-Four” implant placement concept was used in Model 1 with two central axial implants and two distally tilted implants at 17° and in Model 2, “All-on-Six” concept was applied with six vertically placed implants. Individual vertical and horizontal load of 100 N and oblique load of 141 N at 45° was applied to all implants. To evaluate and compare the results in terms of maximum principal stress, we used FEA. Results: All-on-six showed smaller maximum principal stress values on the cortical bone and implants. However, maximum principal stress values obtained on trabecular bone was smaller in the All-on-four design for vertical and horizontal loading conditions. Conclusions: The All-on-six approach showed more favorable biomechanical behavior.

Hashimoto’s encephalopathy is a rare life-threatening disease entity with clinical presentation like psychiatric as well as neurological diseases, thus making it a challenging clinical scenario for physicians leading to delay in diagnosis and management of the patient. The incidence overall is under-estimated because of low overall awareness about the disease. Here, we report a 44-year-old female who was being treated for psychiatric disorders because of clinical presentation like catatonia but ultimately was diagnosed with Hashimoto’s encephalopathy and responded very well to steroids.

Introduction: Anthropometric indices such as body mass index (BMI), waist circumference (WC), and waist hip ratio (WHR) have been used for a long time as a measure of obesity and abdominal fat and the relationship between these indices and hypertension has been well established. But these indices cannot discriminate between fat and muscle mass, leaving a greater population not categorized adequately. Recent studies have also demonstrated that not only the amount of fat but also the distribution of fat is important in hypertensive patients. So, new indices have come up through various studies to overcome this lag. The indices ABSI-Body shape index and BRI-Body roundness index are now being increasingly used to assess the risk of hypertension. Very few studies have been conducted on the Indian population in relation to this index. Material and Methods: The study included 700 patients with hypertension visiting the medicine outpatient department (OPD). Anthropometric indices—Height, weight, WC, HC, and WHR were calculated. The indices ABSI-Body shape index and BRI-Body roundness index were calculated as per the respective formulas. The comparison of various indices of anthropometry and hypertension was done as per the statistical analysis. Results: Our study concluded the positive correlation of hypertension with older as well as newer hypertensive indices. Conclusion: Early screening for the detection of hypertensives should be carried out to ease the disease burden and the anthropometric indices being a cost-effective and easy-to-conduct method can be used to facilitate the detection of hypertension. Appropriate lifestyle interventions should be promoted to decrease the prevalence of hypertensive patients.

Abstract Photocatalytic degradation is essential for the successful removal of organic contaminants from wastewater, which is important for ecological and environmental safety. The advanced oxidation process of photocatalysis has become a hot topic in recent years for the remediation of water. Cadmium sulphide (CdS) nanostructures doped with Titanium oxide (CdS/TiO2) nanocomposites has manufactured under ambient conditions using a simple and modified Chemical Precipitation technique. The nanocomposites crystal structure, thermal stability, recombination of photo-generated charge carriers, bandgap, surface morphology, particle size, molar ratio, and charge transfer properties are determined. The production of nanocomposites (CdS-TiO2) and their efficient photocatalytic capabilities are observed. The goal of the experiment is to improve the photocatalytic efficiency of TiO2 in the visible region by doping CdS nanocomposites. The results showed that as-prepared CdS-TiO2 nanocomposites has exhibited the highest photocatalytic activity in the process of photocatalytic degradation of AB-29 dye, and its degradation efficiency is 84%. After 1 h 30 min of visible light irradiation, while CdS and TiO2 showed only 68% and 09%, respectively. The observed decolorization rate of AB-29 is also higher in the case of CdS-TiO2 photocatalyst ~ 5.8 × 10−4mol L−1 min−1) as compared to the reported decolorization rate of CdS ~ 4.5 × 10−4mol L−1 min−1 and TiO2 ~ 0.67 × 10−4mol L−1 min−1. This increased photocatalytic effectiveness of CdS-TiO2 has been accomplished by reduced charge carrier recombination as a result of improved charge separation and extension of TiO2 in response to visible light.

Complex implant prosthetic reconstruction poses several challenges. The lost anatomy of periodontium due to trauma or long-standing missing teeth, especially in esthetic area, requires several surgical visits for recovery. The augmentation procedures are technique sensitive and unpredictable and need long commitment from the patient. They are time-consuming and expensive, and patients are often unwilling. The alternative for anatomically deficient partial edentulous sites could be prosthetic gingival restoration. They help in re-establishing natural contours, interproximal papilla, and further eliminating complex procedures. The other advantage is perfect horizontal and vertical transition between the prosthesis and adjacent tissues. This article describes two cases of completed gingival prosthetic prosthesis which corrected the missing architectures around lost teeth. It was well accepted by the patients and can be an alternative for unpredictable regenerative procedures.

Objective: Due to the lack of resources for culture and antibiotic susceptibility testing in most underdeveloped countries, puerperal sepsis is treated empirically with a wide range of antibiotics. Empirical treatment, on the other hand, does not ensure treatment effectiveness and may even contribute to antibiotic resistance. So, we studied cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity in a tertiary health center. Material and Methods: This was a cross-sectional study conducted at the obstetrics and gynecology department of a tertiary health center in India from April 2019 to September 2020. During this time, all patients with sepsis who met the criteria for inclusion were included. After granting an informed written consent, the subjects were registered on a pre-designed proforma. Results: There were 2,049 obstetrical admissions throughout this period, with 106 (5.1%) of these having puerperal sepsis. The majority of these women (58.7%) were between the ages of 21 and 30, were multiparous (96.5%), and unbooked. Fever 104 (98.1%) was the most prevalent clinical characteristic, whereas wound gape was the most common consequence (47.1%). Klebsiella aerogens was the most common organism found in various cultures. Many organisms were shown to be multidrug-resistant and sensitive to gentamycin and amikacin. Conclusion: Klebsiella aerogens wasthe most common cause of puerperal sepsis in this investigation. Because the causal agents of puerperal sepsis and their antibiotic sensitivity patterns change over time, positive blood culture and antibiotic susceptibility of the isolates are the best guides for selecting the optimum antimicrobial therapy for treating sepsis.

Complete tooth wear dentition is multifactorial and has challenges with diagnosis and etiology. Their rehabilitation often requires orthognathic surgery, orthodontics, periodontal surgery, and prosthodontic guidelines for occlusion with harmonious facial and dental esthetics. A patient needs a multidisciplinary approach with systematic analysis to formulate evidence-based approach to improve function and esthetics. Contemporary periodontal therapy also encompasses esthetic treatment where needs are frequently associated with changes in tooth size, shape, proportion, and balance that can adversely affect smile appearance. The article provides an evidence-based guideline for reconstruction of a worn dentition. The completed work includes crown lengthening, provisionalization, socket shield technique, oral implants, and gain in lost vertical dimension with occlusion correction and minimally invasive prosthetic restorations.

History of periodontal disease is a risk factor for the development of peri-implantitis. Implant treatment in susceptible patients should be followed by adequate periodontal treatment and stringent supportive programs. The assessment of the patient needs to be carefully evaluated before the procedure for implants. The risk associated with the sites to be treated requires evaluation with regular visits. The completion of treatment will still require committed follow-up visits with checks for pockets, bone loss, and plaque scores around implant-retained prosthesis as well as complete dentition. In our report, we describe in detail the reconstruction of lost dentition with implants in treated periodontitis subjects. The patients are still being followed with regular recall programs.

Anemia is the most common haematological disorder in pregnancy. Anemia increases maternal morbidity and mortality. It is a condition that can be diagnosed and treated during antenatal period, preventing the serious complications of anemia during pregnancy and labour. Aims: This study investigated the prevalence of types of anemia during pregnancy and fetomaternal outcomes among pregnant women. Study Design: This was a cross-sectional study that enrolled 1100 pregnant women who were in the third trimester of pregnancy with haemoglobin level

The increased global prevalence of viral and noninfectious liver illnesses has coincided with a surge in scientific interest in gut microbiota (GM), a multispecies community of bacteria, fungi, archaea, and protozoans. Dietary nutrients that make up the host’s microbiome are responsible for maintaining intestinal homeostasis, whereas a disconnect between gut flora and nutrition might have serious consequences for digestive health. The risk of liver dysfunction was continuously elevated by changes in the commensal bacteria of the gut microbiome, which were carried to the liver via the portal vein. Insights into the role of gut microbiota in alcoholic liver disease, nonalcoholic liver disease, primary sclerosing cholangitis, and other liver disorders, as well as their link to liver cancer, continue to emerge. Systemic host defence against infections by the gut microbiota depends on the interplay between the microbiome, liver immunology, and liver disorders. Translocation of microbiota to the liver following injury and/or inflammation may mediate dysbiosis and the formation of gut microbial metabolite. This review discusses the role of the gut microbiota in connection to dysbiosis and how this knowledge might help us better understand the pathophysiology of various liver illnesses.

Background: Considering the need for developing and examining evidenced-based programs using a brief group format for management of social anxiety disorder (SAD) at the community level, we studied the efficacy of two brief versions of cognitive-behavioral therapy (CBT) programs, brief cognitive-behavioral group therapy (bCBGT), and verbal exposure augmented cognitive behavioral therapy (VE-CBT), on social anxiety among university students. Methods: A single-center, randomized, parallel-group design was adopted. We delivered six weekly two-hour group sessions, bCBGT and VE-CBT, to 41 university students diagnosed with SAD. An independent rater assessed participants using the Liebowitz Social Anxiety Scale (LSAS) and Clinical Global Impression scale-Severity (CGI-S) at baseline, postintervention, and two-month follow-up. A patient-rated measure, Social Phobia Inventory (SPIN), was assessed at the same time-points. Results: There was a significant improvement in severity of social anxiety from baseline to posttreatment and baseline to two-month follow-up in both groups. However, the treatment effects in bCBGT were statistically superior to VE-CBT at postintervention (SPIN, P = 0.038; LSAS, P = 0.028; CGI-S, P = 0.036) and follow-up (SPIN, P = 0.006; LSAS, P = 0.01; CGI-S, P = 0.04). Conclusions: Brief CBT treatments, both bCBGT and VE-CBT, are efficacious for SAD among university students. They have the potential to address barriers associated with SAD management. However, we recommend a longer follow-up and replications in diverse settings. Clinical trial registration number: CTRI/2019/11/021954

Introduction: Several computer-aided diagnosis systems for depression are suggested for use by clinicians to authorize the diagnosis. EEG may be used as an objective analysis tool for identifying depression in the initial stage to avoid it from reaching a severe and permanent state. However, artifact contamination reduces the accuracy in EEG signal processing systems. Methods: This work proposes a novel denoising method based on Empirical Mode Decomposition (EMD) ( with Detrended Fluctuation Analysis (DFA) and wavelet packet transform. Initially, real EEG recordings corresponding to depression patients are decomposed into various mode functions by applying EMD. Then, DFA is used as the mode selection criteria. Further Wavelet Packets Decomposition (WPD)-based evaluation is applied to extract the cleaner signal. Results: Simulations were conducted on real EEG databases for depression to demonstrate the effects of the proposed techniques. To conclude the efficacy of the proposed technique, SNR and MAE were identified. The obtained results indicated improved signal-to-noise ratio and lower values of MAE for the combined EMD-DFA-WPD technique. Additionally, Random Forest and SVM (Support Vector Machine)-based classification revealed the improved accuracy of 98.51% and 98.10% for the proposed denoising technique. Whereas the accuracy of the EMD- DFA is 98.01% and 95.81% and EMD combined with DWT technique equaled 98.0% and 97.21% for the EMD- DFA technique for RF and SVM, respectively, compared to the proposed method. Furthermore, the classification performance for both classifiers was compared with and without denoising to highlight the effects of the proposed technique. Conclusion: Proposed denoising system results in better classification of depressed and healthy individuals resulting in a better diagnosing system. These results can be further analyzed using other approaches as a solution to the mode mixing problem of the EMD approach.

Cytokinins, a type of phytohormones that induce division of cytoplasm, have considerable value in agriculture due to their influences on several physiological processes of plants such as morphogenesis, development of chloroplast, seed dormancy, leaf senescence, etc. Previously, it was assumed that plants obtain cytokinin from the soil produced by microbes as these hormones were first discovered in soil-inhabiting bacteria i.e., Agrobacterium tumefaciens. Later, the cytokinin biosynthesis gene, i.e., ipt gene, has been reported in plants too. Though plants synthesize cytokinins, several studies have reported that the exogenous application of cytokinins has numerous beneficial effects including the acceleration of plant growth and boosting economic yield. Cyanobacteria may be employed in the soil not only as the source of cytokinins but also as the source of other plant growth-promoting metabolites. These organisms biosynthesize the cytokinins using the enzyme isopentenyl transferases (IPTs) in a fashion similar to the plants; however, there are few differences in the biosynthesis mechanism of cytokinins in cyanobacteria and plants. Cytokinins are important for the establishment of interaction between plants and cyanobacteria as evidenced by gene knockout experiments. These hormones are also helpful in alleviating the adverse effects of abiotic stresses on plant development. Cyanobacterial supplements in the field result in the induction of adventitious roots and shoots on petiolar as well as internodal segments. The leaf, root, and stem explants of certain plants exhibited successful regeneration when treated with cyanobacterial extract/cell suspension. These successful regeneration practices mark the way of cyanobacterial deployment in the field as a great move toward the goal of sustainable agriculture.

Abstract Cytoskeletal structures of Apicomplexan parasites are important for parasite replication, motility, invasion to the host cell and survival. Apicortin, an Apicomplexan specific protein appears to be a crucial factor in maintaining stability of the parasite cytoskeletal assemblies. However, the function of apicortin, in terms of interaction with microtubules still remains elusive. Herein, we have attempted to elucidate the function of Plasmodium falciparum apicortin by monitoring its interaction with two main components of parasite microtubular structure, α-tubulin-I and β-tubulin through in silico and in vitro studies. Further, a p25 domain binding generic drug Tamoxifen (TMX), was used to disrupt PfApicortin-tubulin interactions which led to the inhibition in growth and progression of blood stage life cycle of P. falciparum.

Abstract Hijacking of host metabolic status by a pathogen for its regulated dissemination from the host is prerequisite for the propagation of infection. M. tuberculosis secretes an NAD+-glycohydrolase, TNT, to induce host necroptosis by hydrolyzing Nicotinamide adenine dinucleotide (NAD+). Herein, we expressed TNT in macrophages and erythrocytes; the host cells for M. tuberculosis and the malaria parasite respectively, and found that it reduced the NAD+ levels and thereby induced necroptosis and eryptosis resulting in premature dissemination of pathogen. Targeting TNT in M. tuberculosis or induced eryptosis in malaria parasite interferes with pathogen dissemination and reduction in the propagation of infection. Building upon our discovery that inhibition of pathogen-mediated host NAD+ modulation is a way forward for regulation of infection, we synthesized and screened some novel compounds that showed inhibition of NAD+-glycohydrolase activity and pathogen infection in the nanomolar range. Overall this study highlights the fundamental importance of pathogen-mediated modulation of host NAD+ homeostasis for its infection propagation and novel inhibitors as leads for host-targeted therapeutics.

Introduction: Establishing the diagnosis of splenomegaly is a clinical and pathological conundrum. The present study aimed to evaluate the clinicohematological findings and the significance of bone marrow examination in establishing the etiology of splenomegaly. Materials and Methods: This study was a retrospective analysis of patients with splenomegaly who had indications for bone marrow examination. The study was conducted over a period of 2 years. Detailed hematological and serological investigations were analyzed in those patients. Results: There were 96 males and 60 females. Most of the patients presented with fever. A mild degree of splenomegaly was found in 56.4% of the patients, followed by moderate (39.7%), and massive (3.9%) degree of splenomegaly. Pancytopenia was noted in 15.4% of the patients. Anemia was observed in 96.2% of the cases. Erythroid hyperplasia was the most common bone marrow finding (37.2%). Etiologies of splenomegaly were documented by the clinico-laboratory evaluation in 45.5% of the patients. Bone marrow examination along with peripheral blood examination alone established etiologies in 15.4% of the patients. Conclusion: Anemia and hematological malignancies formed a major part of the etiologies of splenomegaly. Bone marrow examination was an inevitable investigation in these situations. Serological investigations were useful in the diagnosis of nutrition deficiency anemia and infectious etiology. The grade of splenomegaly assessed clinically at the time of presentation provided an important clue for the etiology. Bone marrow examination proved to be an important diagnostic tool in the workup of patients with splenomegaly.

Background: Genioplasty has nowadays become a routine procedure in the correction of dentofacial deformities. The present study aimed to evaluate and compare the osseous and soft-tissue stability after advancement genioplasties, stabilized using wire and plate osteosynthesis. Methodology: The study was conducted on ten patients who underwent advanced genioplasty. The patients were divided equally into two groups. In the Group I patients, plates and in Group II, wires were used for stabilization. Lateral cephalograms preoperative and 6 months postoperative were analyzed using Park et al. method of cephalometric analysis. Results: All the ten patients experienced a reliable improvement in esthetics. Although statistically not significant, Group II wire patients have slightly more relapse in the horizontal direction than Group I. The mean ratio of sagittal changes of osseous soft tissue for Group I was 1:0.88 and for Group II wires was 1:0.80. Conclusion: The choice of method of fixation following genioplasty would entirely be based on the merits of the individual cases. The marginal edge of advantage seen in miniplate osteosynthesis when compared to wire osteosynthesis is seen in cases that require larger chin advancements.

Introduction: Knowledge and acceptance of COVID-19 vaccine among health-care professionals (HCPs) are an important aspect in the success of the vaccination drive in India, as HCPs are the first group to receive the vaccine. Various factors affecting the attitude of getting COVID-19 vaccine and to better address those factors will help in widespread acceptance among the general public. Materials and Methods: This was a cross-sectional study which was conducted among HCPs by circulating Google form. The form was distributed among the medical students and physicians through social networking sites such as E-mail and WhatsApp. The questionnaire consisted of 18 questions focusing on the assessment of knowledge and acceptance about COVID-19 vaccine. It was a self-administered and pilot-validated questionnaire. Results: Out of total participants, 473 (78%) were willing to take vaccination and were in the opinion that getting vaccination is a good idea. Eighty-eight percent of the participants were worried about the effectiveness of the COVID-19 vaccine. Fifty-five percent of the participants were anxious regarding getting vaccine and its efficacy. Conclusion: Knowledge and acceptance were moderate, but overall attitude of getting vaccination was positive. Majority of the HCPs are still anxious about the long-term efficacy; therefore, appropriate steps need to be taken to address the factors contributing to the low acceptance of the COVID-19 vaccine.

Background: Restoration of severely damaged primary molars with very short clinical crowns is a big challenge and often extracted due to the lack of restorative options. Total crown replacement (TCR) is a novel treatment alternative for the restoration of such teeth through bonding of the biological restorations which are the sterile decoronated crowns of the extracted human teeth, obtained from a tooth bank. Case Report: Presented here is a report of two cases restored with the TCR technique. A 9-month follow-up showed satisfactory results in terms of function, esthetics, gingival health, and morphology including occlusal wear. TCR can be a viable and economical alternative for restoration of severely decayed/damaged primary teeth, otherwise indicated for extraction.

Introduction: Despite oral cancer being a common cancer in Nepal, little is known about oral potentially malignant disorders which have a high likelihood of malignant transformation. This study aims to find out the prevalence of oral potentially malignant disorders among patients attending the Department of Oral Medicine and Radiology of a tertiary care dental hospital. Methods: A descriptive cross-sectional study was carried out among 611 patients from 14th January, 2021 to 15th July, 2021 at the Department of Oral Medicine and Radiology of a tertiary care centre after receiving ethical clearance from the Institutional Review Committee (Reference number: 2306202002). Convenience sampling was done. Patients aged 18 years and above were enrolled into the study. Follow-up cases and patients requiring emergency treatment were, however, excluded. All demographic data, cancer and dietary history and clinical examinations were recorded. Descriptive analysis was done using Statistical Package for the Social Sciences version 22.0. Point estimate was done at a 95% Confidence Interval for frequency and percentages for binary data. Results: Among 611 total participants, the prevalence of oral potentially malignant disorders was found to be 26 (4.25%) (2.65-5.85 at a 95% Confidence Interval), where males were 19 (73.07%), females were 7 (26.92%), and 23 (88.46%) of them had history of consuming various forms of tobacco, areca nut, and alcohol. Conclusions: The prevalence of oral potentially malignant disorders in this hospital-based study was found to be lower than previous studies conducted in similar settings.

Abstract Background Migraine has many presumed comorbidities which have rarely been compared between samples with and without migraine. Examining the association between headache pain intensity and monthly headache day (MHD) frequency with migraine comorbidities is novel and adds to our understanding of migraine comorbidity. Methods The MAST Study is a prospective, web-based survey that identified US population samples of persons with migraine (using modified International Classification of Headache Disorders-3 beta criteria) and without migraine. Eligible migraine participants averaged ≥1 MHDs over the prior 3 months. Comorbidities “confirmed by a healthcare professional diagnosis” were endorsed by respondents from a list of 21 common cardiovascular, neurologic, psychiatric, sleep, respiratory, dermatologic, pain and medical comorbidities. Multivariable binary logistic regression calculated odds ratios (OR) and 95% confidence intervals for each condition between the two groups adjusting for sociodemographics. Modeling within the migraine cohort assessed rates of conditions as a function of headache pain intensity, MHD frequency, and their combination. Results Analyses included 15,133 people with migraine (73.0% women, 77.7% White, mean age 43 years) and 77,453 controls (46.4% women, 76.8% White, mean age 52 years). People with migraine were significantly (P

Many publications have delineated strategies for mental health care to respond to psychological concerns and ramifications related to coronavirus disease 2019 (COVID-19). The current review aims to encapsulate existing guidelines and recommendations of psychological management for mental health care for the general population, health-care professionals, children, and elderly populations, applied to a pandemic in particular reference to COVID-19. The literature on psychological care of such repercussions of COVID-19 was retrieved via a search in PubMed and Google database. Of 91 retrieved initial articles, only 18 were selected for final analysis, which was divided into two categories: (a) guidelines by government/public health bodies (n = 11) and (b) publications in peer-reviewed journals (n = 7). The recommendations can be summed but not limited to psychoeducation from a reliable source, normalization of stress, behavioral activation, scheduling of activities with a bespoke blending of recreational and daily chores, supportive care, staying digitally connected, relaxation techniques, ensuring rest, rotating shifts and short breaks during working hours, curtailing media consumption, fostering community resilience, seeking and sharing support from colleagues/supervisors, avoidance of abusing psychoactive substances, online consultation of mental health professionals on need, and participatory communication in a developmentally appropriate way with children. In the absence of observational and controlled studies on psychological management during pandemic times, we recommend such research soon.

Titanium oxide (TiO2) is one of the most scrutinized material because of its in-built fundamental properties and has been developed as an outstanding photo-catalytic material intended for many different industrial applications. In order to further explore the properties of TiO2, we prepared Copper-loaded TiO2 (Cu-TiO2) nanoparticles (NPs) for inhibiting the growth of bacterial cells and also to serve as a chemical sensor. The physico-chemical characteristics of the synthesized Cu-TiO2 NPs were characterized by many different techniques for the crystallinity, bonding and functionality, morphology, elemental composition, and absorption characteristics. From the results, we confirm for the formation of anatase phase of TiO2 having a tetragonal crystal system, while the morphology studies indicated that the Cu dope TiO2 has spherical morphology. The elemental analysis confirmed for the inclusion of Cu into TiO2 crystal lattice and the absorption spectroscopic analysis helped for the bandgap calculation and visible light absorption property of Cu-TiO2 NPs. The metal nanoclusters of Cu are observed to be deposited on different phases and sites of TiO2 resulting in the inter-band transitions. Further, the sensitivity of Cu-TiO2 as a chemical sensor is determined by fabricating the electrode at the FTO glass substrate where the ethanol sensitivity was found to be little increased/enhanced with Cu loading. Finally, the antibacterial activity of Cu-TiO2 NPs was confirmed by its activity against various bacterial cultures and are found to be efficient.

Non-bullous neutrophilic lupus erythematosus is a rare form of cutaneous lupus erythematosus (LE). We hereby present a case of 24-year-old female, known case of discoid LE (DLE) with negative ANA stabilized on hydroxychloroquine for 2 years. She reported new occurrence of erythematous, mildly pruritic, papular lesions and painful mucosal ulceration. The ANA became strongly positive by ELISA and urine showed proteinuria. A provisional diagnosis of Rowell syndrome was made, skin biopsy was taken, and patient started on steroids. Histopathology showed interface vacuolar change and many neutrophils in the dermis with leukocytoclasia without any bulla formation. The skin lesions responded promptly to addition of dapsone following biopsy report. We conclude that the presence of neutrophils associated with interface pathology on biopsy represents a muted form of bullous LE, especially in patients on immunosuppression. This case highlights the importance of histopathologic examination in the evaluation of any new skin lesions in a patient of lupus on therapy.

Context: The etiopathogenesis of oral lichen planus (OLP) is still debatable. According to literature, many studies have illustrated OLP as a T-cell-mediated chronic autoimmune disease. Currently, there is increased evidence of chronic inflammation in OLP and its association with vascular adhesion molecules (VAMs). Aim: The aim of this study was to evaluate the expression of VAM (PECAM-1) in OLP. Setting and Design: Tissue samples involved 20 archival cases of histopathologically confirmed OLP (n = 15) and normal mucosa (n = 5) as controls. Materials and Methods: The sections were subjected to immunohistochemical analysis using antibody to PECAM-1. Brown staining of the endothelial cells of blood vessels was considered positive. The expression of PECAM-1 in OLP was statistically analyzed using Wilcoxon sign-rank test. Results: The expression of PECAM-1 in OLP was statistically significant when compared with normal mucosa (P < 0.05). A statistically significant difference was also observed in PECAM-1 expression between the reticular type and erosive type of OLP. Conclusion: PECAM-1 was found to be overexpressed in OLP; difference in PECAM-1 expression was noted between the reticular and erosive types. The VAMs could be exploited as a possible therapeutic target in OLP to modulate the disease process thereby reducing the dependency on corticosteroids.