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Kiran K Rai,1 Rachel E Jordan,1 W Stanley Siebert,2 Steven S Sadhra,3 David A Fitzmaurice,1 Alice J Sitch,1 Jon G Ayres,1,3 Peymané Adab1 1Institute of Applied Health Research, 2The Department of Business and Labour Economics, 3Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK Background: Employment rates among those with chronic obstructive pulmonary disease (COPD) are lower than those without COPD, but little is known about the factors that affect COPD patients’ ability to work. Methods: Multivariable analysis of the Birmingham COPD Cohort Study baseline data was used to assess the associations between lifestyle, clinical, and occupational characteristics and likelihood of being in paid employment among working-age COPD patients. Results: In total, 608 of 1,889 COPD participants were of working age, of whom 248 (40.8%) were in work. Older age (60–64 years vs 30–49 years: odds ratio [OR] =0.28; 95% confidence interval [CI] =0.12–0.65), lower educational level (no formal qualification vs degree/higher level: OR =0.43; 95% CI =0.19–0.97), poorer prognostic score (highest vs lowest quartile of modified body mass index, airflow obstruction, dyspnea, and exercise (BODE) score: OR =0.10; 95% CI =0.03–0.33), and history of high occupational exposure to vapors, gases, dusts, or fumes (VGDF; high VGDF vs no VGDF exposure: OR =0.32; 95% CI =0.12–0.85) were associated with a lower probability of being employed. Only the degree of breathlessness of BODE was significantly associated with employment. Conclusion: This is the first study to comprehensively assess the characteristics associated with employment in a community sample of people with COPD. Future interventions should focus on managing breathlessness and reducing occupational exposures to VGDF to improve the work capability among those with COPD. Keywords: chronic obstructive pulmonary disease, work, employed, breathlessness, severity, VGDF, UK

Objective: The purpose was to examine in mice the efficacy of various polymeric-encapsulated C5a peptidase vaccine formulations in eliciting a long-term immune response and preventing group B streptococcus (GBS) infection.Study Design: C5a peptidase was encapsulated in semipermeable microspheres of poly(lactide-coglycolide) (PLGA). Female ICR mice were immunized with 0, 10, or 30 μg of encapsulated C5a peptidase within 2 different formulations of PLGA polymers. Booster doses were given at weeks 4 and 8. Antibody responses were measured by enzyme-linked immunosorbent assay at weeks 4, 8, 11, and 40. Vaginal challenges with GBS types 1a, III, and V were performed at week 12.Results: Thirty microgram doses of the 75:25 and 50:50 PLGA formulations generate the highest and most sustained C5a peptidase-specific immune responses. Mice that received encapsulated C5a peptidase were significantly protected from vaginal colonization compared with mice that received empty microspheres.Conclusion: Encapsulated C5a peptidase elicited significant immune responses and protection against a GBS challenge. C5a peptidase microsphere encapsulation has potential as a GBS vaccine. [ABSTRACT FROM AUTHOR]

Native amine dehydrogenases (AmDHs) are rare and typically have narrow substrate specificity and low processivity. Therefore, they are often modified using protein engineering for industrial and pharmaceutical applications. This study presents identification and characterization of a novel native amine dehydrogenase (AmDH) encoding WD40 protein (All1750) from Anabaena PCC 7120. Heterologous expression of all1750 in E. coli enhanced its tolerance to abiotic stressors such as drought, cadmium, and NaCl, as evidenced by increase in gene expression (2-10-fold), spot assay results (3-4-fold) and decreased ROS generation (0.2-1.8-fold). Molecular docking analysis showed that All1750 has broad substrate binding activity, indicating its catalytic potential in amine oxidation. All1750 exhibited the appreciable enzymatic activity with acetophenone (0.8-1.0-fold increase), followed by 4-fluorophenyl acetone and 4-fluoropropiophenone. The Km values for acetophenone and 4-fluorophenyl acetone were 4.2-12.1-fold higher, suggesting a greater affinity of All1750 for these low-cost substrates compared to the expensive 4-fluoropropiophenone. Recombinant All1750 showed optimal enzyme activity at pH 8.0 and maintained thermo-stability at 70 °C with a half-life of approximately 3 h. Our findings provide valuable insights into the industrial application of the All1750 protein. This native AmDH from Anabaena can effectively utilize diverse cost-effective substrates, making it a promising biocatalyst for chiral amine biosynthesis., Competing Interests: Declaration of competing interest No conflicts, informed consent, human or animal rights applicable., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: The aim of the study is to estimate COVID-19 absenteeism and indirect costs, by care setting., Methods: A population-based retrospective cohort study using data from the German Statutory Health Insurance (SHI) database to define outpatient (April 2020-December 2021) and hospitalized (April 2020-October 2022) cohorts of employed working-aged individuals., Results: In the outpatient cohort ( N = 369,220), median absenteeism duration and associated cost was 10.0 (Q1, Q3: 5.0, 15.0) days and €1061 (530, 1591), respectively. In the hospitalized cohort ( n = 20,687), median absenteeism and associated cost was 15.0 (7.0, 32.0) days and €1591 (743, 3394), respectively. Stratified analyses showed greater absenteeism in older workers, those at risk, and those with severe disease., Conclusions: The hospitalized cohort had longer absenteeism resulting in higher productivity loss. Being older, at risk of severe COVID-19 and higher disease severity during hospitalization were important drivers of higher absenteeism duration., Competing Interests: Conflict of interest: J.Y., H.V., J.R., and J.L.N. are employees of Pfizer and may receive stock and/or stock options. K.K.R., M.S., H.G., and L.M. are employees of Adelphi Real World, who are paid consultants to Pfizer in connection with this study and development of the manuscript. A.S. and S.P. are employees of BioNTech., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Zygomatic bone contributes to the orbital walls, and therefore associated injuries carry a high risk of severe dysfunction of the visual apparatus. The aim of our study was to retrospectively assess the spectrum and frequency of ophthalmic involvement in patients presenting with malar fracture, and the need for referral to an ophthalmologist for evaluation. In total, 102 patients presenting with malar fracture between January 2008 and August 2017 at Bapuji Dental College and Hospital, Davangere, Karnataka were enrolled in this study. Patients with confirmed malar fracture were categorized according to Henderson's classification, and associated ocular injuries were recorded. Assessment of the spectrum and frequency of ophthalmic involvement in patients presenting with different types of malar fracture was then carried out, followed by categorization of the need for referral to the ophthalmologist with regard to the associated ocular injury, as per the Al-Qurainy et al. (1991) scoring system, allocating the patients to early, routine, and non-referral categories. Statistically significant differences in proportions of various types of ophthalmic involvement were found between categories of malar fracture, and in degrees of ophthalmic involvement within each category of malar fracture, except in the Type II group of patients. The most severe ocular injuries were noted in Type VII followed by Type V, with the least severe injuries noted in Type II patients. According to the Al-Qurainy et al. (1991) scoring system, eight patients required early referral, 10 patients needed routine referral, and 84 patients were in the non-referral category. Categorization of referral of patients to an ophthalmologist in hospitals lacking ophthalmology departments can be based on the Al-Qurainy et al. classification of referral for Henderson's Type III, IV, and VI. Henderson's Type I and II patients need to be referred only in medicolegal cases. Henderson's Type VII and V patients require mandatory referral., Competing Interests: Declaration of competing interest None., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: Although COVID-19 morbidity is significantly lower in pediatrics than in adults, the risk of severe COVID-19 may still pose substantial health care resource burden. This study aimed to describe health care resource utilization (HCRU) and costs associated with COVID-19 in pediatrics 1-17 years old in England., Methods: A population-based retrospective cohort study of pediatrics with COVID-19 using Clinical Practice Research Datalink (CPRD Aurum) primary care data and, where available, linked Hospital Episode Statistics Admitted Patient Care secondary care data. HCRU and associated costs to the National Health Service were stratified by age, risk of severe COVID-19 and immunocompromised status, separately for those with and without hospitalization records (hospitalized cohort: COVID-19 diagnosis August 2020-March 2021; primary care cohort: COVID-19 diagnosis August 2020-January 2022)., Results: This study included 564,644 patients in the primary care cohort and 60 in the hospitalized cohort. Primary care consultations were more common in those 1-4 years of age (face-to-face: 4.3%; telephone: 6.0%) compared with those 5-11 (2.0%; 2.1%) and 12-17 years of age (2.2%; 2.5%). In the hospitalized cohort, mean (SD) length of stay was longer [5.0 (5.8) days] among those 12-17 years old (n = 24) than those 1-4 [n = 15; 1.8 (0.9) days] and 5-11 years old [n = 21; 2.8 (2.1) days]., Conclusions: Most pediatrics diagnosed with COVID-19 were managed in the community. However, hospitalizations were an important driver of HCRU and costs, particularly for those 12-17 years old. Our results may help optimize the management and resource allocation of COVID-19 in this population., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: To create case definitions for confirmed COVID-19 diagnoses, COVID-19 vaccination status and three separate definitions of high risk of severe COVID-19, as well as to assess whether the implementation of these definitions in a cohort reflected the sociodemographic and clinical characteristics of COVID-19 epidemiology in England., Design: Retrospective cohort study., Setting: Electronic healthcare records from primary care (Clinical Practice Research Datalink, CPRD) linked to secondary care data (Hospital Episode Statistics) data covering 24% of the population in England., Participants: 2 271 072 persons aged 1 year and older diagnosed with COVID-19 in CPRD Aurum between 1 August 2020 and 31 January 2022., Main Outcome Measures: Age, sex and regional distribution of COVID-19 cases and COVID-19 vaccine doses received prior to diagnosis were assessed separately for the cohorts of cases identified in primary care and those hospitalised for COVID-19 (primary diagnosis code of ICD-10 U07.1 'COVID-19'). Smoking status, body mass index and Charlson Comorbidity Index were compared for the two cohorts, as well as for three separate definitions of high risk of severe disease used in the UK (National Health Service Highest Risk, PANORAMIC trial eligibility, UK Health Security Agency Clinical Risk prioritisation for vaccination)., Results: Compared with national estimates, CPRD case estimates under-represented older adults in both the primary care (age 65-84: 6% in CPRD vs 9% nationally) and hospitalised (31% vs 40%) cohorts, and over-represented people living in regions with the highest median wealth areas of England (20% primary care and 20% hospital admitted cases in South East vs 15% nationally). The majority of non-hospitalised cases and all hospitalised cases had not completed primary series vaccination. In primary care, persons meeting high-risk definitions were older, more often smokers, overweight or obese, and had higher Charlson Comorbidity Index score., Conclusions: CPRD primary care data are a robust real-world data source and can be used for some COVID-19 research questions, however, limitations of the data availability should be carefully considered. Included in this publication are supplemental files for a total of over 28 000 codes to define each of three definitions of high risk of severe disease., Competing Interests: Competing interests: KMA, LJM, MR, DM, JLN, CT, DM and JY are employees of Pfizer or Pfizer and may hold Pfizer stock or stock options. KKR and TT are employees of Adelphi Real World which has received consulting fees from Pfizer., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To quantify direct costs and healthcare resource utilisation (HCRU) associated with acute COVID-19 in adults in England., Design: Population-based retrospective cohort study using Clinical Practice Research Datalink Aurum primary care electronic medical records linked to Hospital Episode Statistics secondary care administrative data., Setting: Patients registered to primary care practices in England., Population: 1 706 368 adults with a positive SARS-CoV-2 PCR or antigen test from August 2020 to January 2022 were included; 13 105 within the hospitalised cohort indexed between August 2020 and March 2021, and 1 693 263 within the primary care cohort indexed between August 2020 and January 2022. Patients with a COVID-19-related hospitalisation within 84 days of a positive test were included in the hospitalised cohort., Main Outcome Measures: Primary and secondary care HCRU and associated costs ≤4 weeks following positive COVID-19 test, stratified by age group, risk of severe COVID-19 and immunocompromised status., Results: Among the hospitalised cohort, average length of stay, including critical care stays, was longer in older adults. Median healthcare cost per hospitalisation was higher in those aged 75-84 (£8942) and ≥85 years (£8835) than in those aged <50 years (£7703). While few (6.0%) patients in critical care required mechanical ventilation, its use was higher in older adults (50-74 years: 8.3%; <50 years: 4.3%). HCRU and associated costs were often greater in those at higher risk of severe COVID-19 than in the overall cohort, although minimal differences in HCRU were found across the three different high-risk definitions. Among the primary care cohort, general practitioner or nurse consultations were more frequent among older adults and the immunocompromised., Conclusions: COVID-19-related hospitalisations in older adults, particularly critical care stays, were the primary drivers of high COVID-19 resource use in England. These findings may inform health policy decisions and resource allocation in the prevention and management of COVID-19., Competing Interests: Competing interests: JY, KMA, MR, LJM, CT, TM, KN, DM, Tamuno Alfred, MA and JLN are employees of Pfizer and may hold stock or stock options. KKR, TT, PP, BEB and RW are employees of Adelphi Real World, which received funds from Pfizer to conduct the study and develop the manuscript., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Vascularized bone grafts are considered as the gold standard for mandibular reconstruction. However, there are certain limitations of them, such as they are contraindicated in patients with circulatory disturbances. Therefore, Non-vascular bone grafts become the viable option for reconstruction. Our study aims to prospectively compare the long-term viability of avascular iliac and fibula bone grafts in the reconstruction of mandibular defects. Objectives were to evaluate the difficulty in swallowing, mastication, speech problems, infection, wound dehiscence, restricted limb movement, and altered gait among the iliac and fibula group. A total of 14 patients, planned for the reconstruction of mandibular defects from 2016 to 2018 were randomly allocated into two groups; nonvascular iliac and fibula graft groups. Clinical assessment for improvement in function, esthetics, wound healing, pain, and donor site morbidity was done and was followed up for one year. Digital orthopantomogram was taken for radiographic evaluation for up to one year. Difficulty in swallowing, mastication, speech, infection, restricted limb movement, and altered gait was statistically significant and was seen more in the fibula group. Wound dehiscence with graft exposure was found in one subject. The overall success rate was 100% in the iliac group and 85.7% in the fibula group. Considering the long-term complications and success rate, the nonvascular iliac graft was found to be superior and can be used as an alternative to a nonvascular fibula graft for a defect length up to 7 cm., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Abiotic and biotic stresses negatively affect plant cellular and biological processes, limiting their growth and productivity. Plants respond to these environmental cues and biotrophic attackers by activating intricate metabolic-molecular signaling networks precisely and coordinately. One of the initial signaling networks activated is involved in the generation of reactive oxygen species (ROS), reactive nitrogen species (RNS), and reactive sulfur species (RSS). Recent research has exemplified that ROS below the threshold level can stimulate plant survival by modulating redox homeostasis and regulating various genes of the stress defense pathway. In contrast, RNS regulates the stress tolerance potential of crop plants by modulating post-translation modification processes, such as S -nitrosation and tyrosine nitration, improving the stability of protein and DNA and activating the expression of downstream stress-responsive genes. RSS has recently emerged as a new warrior in combating plant stress-induced oxidative damage by modulating various physiological and stress-related processes. Several recent findings have corroborated the existence of intertwined signaling of ROS/RNS/RSS, playing a substantial role in crop stress management. However, the molecular mechanisms underlying their remarkable effect are still unknown. This review comprehensively describes recent ROS/RNS/RSS biology advancements and how they can modulate cell signaling and gene regulation for abiotic stress management in crop plants. Further, the review summarizes the latest information on how these ROS/RNS/RSS signaling interacts with other plant growth regulators and modulates essential plant functions, particularly photosynthesis, cell growth, and apoptosis.

WD40 domain-containing proteins are one of the eukaryotes' most ancient and ubiquitous protein families. Little is known about the presence and function of these proteins in cyanobacteria in general and Anabaena in particular. In silico analysis confirmed the presence of WD40 repeats. Gene expression analysis indicated that the transcript levels of both the target proteins were up-regulated up to 4 fold in Cd and drought and 2-3 fold in heat, salt, and UV-B stress. Using a fluorescent oxidative stress indicator, we showed that the recombinant proteins were scavenging reactive oxygen species (ROS) (4-5 fold) more efficiently than empty vectors. Chromatin immunoprecipitation analysis (ChIP) and electrophoretic mobility shift assay (EMSA) revealed that the target proteins function as transcription factors after binding to the promoter sequences. The presence of kinase activity (2-4 fold) in the selected proteins indicated that these proteins could modulate the functions of other cellular proteins under stress conditions by inducing phosphorylation of specific amino acids. The chosen proteins also demonstrated interaction with Zn, Cd, and Cu (1.4-2.5 fold), which might stabilize the proteins' structure and biophysical functions under multiple abiotic stresses. The functionally characterized Alr0671 and All2352 proteins act as transcription factors and offer tolerance to agriculturally relevant abiotic stresses., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: In climate change, breeding crop plants with improved productivity, sustainability, and adaptability has become a daunting challenge to ensure global food security for the ever-growing global population. Correspondingly, climate-smart crops are also the need to regulate biomass production, which is imperative for the maintenance of ecosystem services worldwide. Since conventional breeding technologies for crop improvement are limited, time-consuming, and involve laborious selection processes to foster new and improved crop varieties. An urgent need is to accelerate the plant breeding cycle using artificial intelligence (AI) to depict plant responses to environmental perturbations in real-time., Materials and Methods: The review is a collection of authorized information from various sources such as journals, books, book chapters, technical bulletins, conference papers, and verified online contents., Conclusions: Speed breeding has emerged as an essential strategy for accelerating the breeding cycles of crop plants by growing them under artificial light and temperature conditions. Furthermore, speed breeding can also integrate marker-assisted selection and cutting-edged gene-editing tools for early selection and manipulation of essential crops with superior agronomic traits. Scientists have recently applied next-generation AI to delve deeper into the complex biological and molecular mechanisms that govern plant functions under environmental cues. In addition, AIs can integrate, assimilate, and analyze complex OMICS data sets, an essential prerequisite for successful speed breeding protocol implementation to breed crop plants with superior yield and adaptability., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Life skills are crucial for young adults to lead a successful, satisfying, and productive life. There is enough evidence suggesting a positive relationship between life skills and academic performance. Substance abuse among adolescents is a common problem that often leads to academic disorientation and delinquent behavior. This study aimed to determine whether life skills and attitudes toward alcohol abuse predicted school students' academic achievement., Material and Method: The participants ( N = 726) enrolled in senior secondary schools of Sikkim, a north-eastern state of India, constituted the population of the present study. Data were collected using the "Life Skills Assessment Scale" developed by Subashree and Nair (2014), and the "Attitude towards Alcohol Abuse Scale" developed by the investigators., Result: Life skills and attitude toward alcohol abuse significantly predict students' academic achievement. 15.3% variance in academic achievements of the students was explained by life skills and attitude toward alcohol abuse. Further, the t -test result reflects that both the variables had significant predictive power to predict students' academic achievement., Conclusion: The finding shows that there was a significant relationship between academic achievement and life skills and attitude toward alcohol abuse of school students. Life skills and attitude toward alcohol abuse predicted 15.3% of the variance in academic achievement., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

NAC transcription factors regulate stress-defence pathways and developmental processes in crop plants. However, their detailed functional characterization in tomatoes needs to be investigated comprehensively. In the present study, tomato hybrids subjected to 60 and 80 days of drought stress conditions showed a significant increase in membrane damage and reduced relative water, chlorophyll and proline content. However, hybrids viz., VRTH-16-3 and VRTH-17-68 showed superior growth under drought stress, as they were marked with low electrolytic leakage, enhanced relative water content, proline content and an enhanced activity of enzymatic antioxidants, along with the upregulation of NAC and other stress-defence pathway genes. Candidate gene(s) exhibiting maximum expression in all the hybrids under drought stress were subjected to detailed in silico characterization to provide significant insight into its structural and functional classification. The homology modelling and superimposition analysis of predicted tomato NAC protein showed that similar amino acid residues were involved in forming the conserved WKAT domain. DNA docking discovered that the SlNAC1 protein becomes activated and exerts a stress-defence response after the possible interaction of conserved DNA elements using Pro 72 , Asn 73 , Trp 81 , Lys 82 , Ala 83 , Thr 84 , Gly 85 , Thr 86 and Asp 87 residues. A protein-protein interaction analysis identified ten functional partners involved in the induction of stress-defence tolerance.

This study aimed to assess various auditory canal injuries in patients with direct or indirect temporomandibular joint (TMJ) trauma, and, in collaboration with an otolaryngologist, evaluate the need for intervention. A prospective study was conducted at the institution. Patients who had sustained trauma to the TMJ were assessed for auditory canal injury through clinical and CT scan examination. All the patients were cross-consulted by an otolaryngologist for diagnosis and eventual management of any auditory canal injury. A close 3-month follow-up was carried out for all patients. Out of 32 cases (64 sides) of TMJ trauma, the following auditory canal injuries were documented: five cases (six sides) with tympanic plate fracture; five cases (five sides) with soft-tissue injury to the EAC; two cases (two sides) with tympanic membrane (TM) perforation; and one case (one side) with external auditory canal (EAC) hematoma (all p < 0.001). Corroborative results for the diagnosis of auditory canal injuries between the oral and maxillofacial surgeon (OMFS) and ENT surgeon were found to be statistically significant (p < 0.001). One case of tympanic membrane perforation required tympanoplasty and the rest were treated by conservative management. No complications were seen after 3 months of follow-up. To conclude, maxillofacial surgeons should perform a thorough bilateral ear examination to rule out any auditory canal injury in all the cases presenting with direct or indirect trauma to the TMJ. Timely management of such injuries should be undertaken by an otolaryngologist before TMJ trauma management to avoid any complications., Competing Interests: Declaration of competing interest None., (Copyright © 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background and Objective: Oral submucous fibrosis is a scourge of Southeastern Asia since a long time resulting in significant health and social problems. Mainstay of the treatment is concentrated on attempts to improve mouth opening and relieve the symptoms by medicinal or surgical means. In moderate to severe cases, release of fibrous bands is advocated followed by placement of graft. The present study was conducted to evaluate the use of collagen-silicone bilayer membrane as a mucosal substitute in its management., Methodology: Study consisted of 12 clinically and histologically proven cases of OSMF. After the incision and release of fibrous bands, a collagen membrane was placed and secured over the raw area by placement of a silicone sheet of adequate thickness. Parameters were assessed pre-operatively, intra-operatively, and post-operatively at 1 week, 1 month, and 3 months. The data was recorded and statistical analysis was done., Results: Pre-operatively, the mean values of inter-incisal opening, cheek flexibility, and width of oral commissure were 16.92, 24.58, and 53.17 mm respectively whereas at 3 months post-operatively, it was 27.67, 26.58, and 55.00 mm, which was statistically significant. No incidence of infection was noted., Conclusion: The study concludes that the use of collagen membrane along with silicone sheet can be an alternative to other graft materials in context of reduced donor site morbidity as well as significant increase in inter-incisal opening. However, study with more sample size is needed to assess the long-term efficiency and surgical outcome of this material., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Oxidative stress is common consequence of abiotic stress in plants as well as cyanobacteria caused by generation of reactive oxygen species (ROS), an inevitable product of respiration and photosynthetic electron transport. ROS act as signalling molecule at low concentration however, when its production exceeds the endurance capacity of antioxidative defence system, the organisms suffer oxidative stress. A highly toxic metabolite, methylglyoxal (MG) is also produced in cyanobacteria in response to various abiotic stresses which consequently augment the ensuing oxidative damage. Taking recourse to the common lineage of eukaryotic plants and cyanobacteria, it would be worthwhile to explore the regulatory role of glyoxalase system and antioxidative defense mechanism in combating abiotic stress in cyanobacteria. This review provides comprehensive information on the complete glyoxalase system (GlyI, GlyII and GlyIII) in cyanobacteria. Furthermore, it elucidates the recent understanding regarding the production of ROS and MG, noteworthy link between intracellular MG and ROS and its detoxification via synchronization of antioxidants (enzymatic and non-enzymatic) and glyoxalase systems using glutathione (GSH) as common co-factor., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Tru-cut (core needle) biopsy has many advantages over open biopsy. It is quick and easy to perform, may be carried out in the outpatient department, avoids incision through previously irradiated skin and has few complications. The purpose of this study is to compare the two available biopsy techniques that are Tru-cut biopsy and incisional biopsy in achieving prompt diagnosis of maxillofacial pathology. A prospective study was conducted in 25 patients reported to our department. The Tru-cut biopsy was performed by using 14 gauge disposable Tru-cut biopsy needles (Baxter, made in the USA) by means of two successive insertions with different angulations of the needle into the core of the lesion followed by incisional biopsy. The diagnostic criteria which were evaluated include: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Tru-cut biopsy had sensitivity of 68.42%; specificity of 83.33%; PPV of 92.86%; NPV of 45.45% with accuracy rate of 72%. The Tru-cut biopsy method was evaluated as a very helpful method for prompt diagnosis of maxillofacial pathology since it is practical to perform, causes minimum trauma to the tissue, decreases the metastatic risk of malignant lesions during the procedure and relatively free from complications., Competing Interests: Conflict of interestOn behalf of all co-authors, the corresponding author declares that they have no conflict of interest. The copy of the signed form is attached separately., (© The Association of Oral and Maxillofacial Surgeons of India 2021.)

Low-grade fibromyxoid sarcoma (LGFMS) is a rare type of sarcoma that is characterized by benign-appearing histologic features but a paradoxically aggressive clinical course. Recognition of this lesion is important because of its indolent but metastasizing nature. These tumors generally occur in young to middle-aged adults, sometimes in children, but rarely in the high-aged adults. LGFMS typically affects the deep soft tissues of the trunk or lower extremities: however, it is rarely seen on the maxillofacial region. Here, we describe a case of LGFMS on the left lower one-third region of the face of a 35-year-old male patient with a 6-month history. On gross examination, the resected specimen consisted of an open ovoid mass of 2 cm × 2 cm × 1 cm. Light microscopy revealed well-circumscribed myxoid tumor with hypocellular areas in nodules merging to collagenized areas. Immunohistochemical examination revealed diffuse positivity to vimentin, whereas tests for desmin, S-100 protein were negative, thus confirming the diagnosis. After the initial healing of the surgical wound, the patient was advised 30 cycles of radiotherapy. Recurrence and metastasis have not been observed for 1 year of surgical excision now. Due to the notably indolent nature of LGFMS, long-term follow-up is necessary to evaluate its clinical course., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 National Journal of Maxillofacial Surgery.)

Key Message: Withania coagulans (L.) Dunal bio-synthesized silver nanoparticles (WcAgNPs) worked as an abiotic elicitor or auto-catalyst that enhanced root regeneration and withanolides production in in-vitro regenerated W. coagulans. Rapid development in the production / consumption of silver nanoparticles (AgNPs) raised serious concern over its effects on the growth of natural plant community. The knowledge related to impact of AgNPs on plant growth and biocompatibility is increasing day by day, but comprehensive mechanism and gaps regarding their impacts on plant health have yet to be addressed. In the present study, we investigated the impact of Withania coagulans biosynthesized AgNPs (WcAgNPs) on in-vitro plant growth and withanolides production. Obtained results showed that the low concentrations of WcAgNPs significantly induced the plant growth by regulating oxidative stress via anti-oxidative defense system. Physiological, morphology and anatomical features also reflected healthy plant growth under low WcAgNPs exposure. While higher concentrations of WcAgNPs have a negative impact on W. coagulans plant growth due to induced lipid peroxidation, ROS accumulation, and root cell death. At lower concentrations, WcAgNPs have shown a positive effect on in-planta withanolides biosynthesis stimulating withanolide A and withaferin A up to 11.15-22.8-fold, respectively. Furthermore, the expression of withanolides biosynthetic genes were also quantified upon WcAgNPs exposure and terpenes biosynthetic genes showed over-expression. Thus, the present study concludes that the lower concentrations of WcAgNPs positively induced plant growth via improved root organogenesis and also have potential to act as an elicitor for withanolides production.

Contamination of agricultural land and water by heavy metals due to rapid industrialization and urbanization including various natural processes have become one of the major constraints to crop growth and productivity. Several studies have reported that to counteract heavy metal stress, plants should be able to maneuver various physiological, biochemical and molecular processes to improve their growth and development under heavy metal stress. With the advent of modern biotechnological tools and techniques it is now possible to tailor legume and other plants overexpressing stress-induced genes, transcription factors, proteins, and metabolites that are directly involved in heavy metal stress tolerance. This review provides an in-depth overview of various biotechnological approaches and/or strategies that can be used for enhancing detoxification of the heavy metals by stimulating phytoremediation processes. Synthetic biology tools involved in the engineering of legume and other crop plants against heavy metal stress tolerance are also discussed herewith some pioneering examples where synthetic biology tools that have been used to modify plants for specific traits. Also, CRISPR based genetic engineering of plants, including their role in modulating the expression of several genes/ transcription factors in the improvement of abiotic stress tolerance and phytoremediation ability using knockdown and knockout strategies has also been critically discussed., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

The present study provides the first report of heterologous expression of phytochelatin synthase from Anabaena PCC 7120 ( anaPCS ) into the hairy roots of Artemisia annua . Transformed hairy roots of A. annua expressing anaPCS gene showed better tolerance to heavy metals, viz., arsenic (As) and cadmium (Cd) owing to 143 and 191% more As- and Cd-accumulation, respectively, as compared to normal roots with a bioconcentration factor (BCF) of 9.7 and 21.1 for As and Cd, respectively. Under As and Cd stresses, transformed hairy roots possessed significantly higher amounts of phytochelatins and thiols probably due to the presence of both AaPCS ( Artemisia annua PCS ) and anaPCS . In addition, artemisinin synthesis was also induced in transformed hairy roots under heavy metals stresses. In-silico analysis revealed the presence of conserved motifs in both AaPCS and anaPCS sequences as well as structural modelling of PCS functional domain was conducted. Interaction of AaPCS and anaPCS proteins with CdCl 2 and sodium arsenate gene ontology analysis gave insights to anaPCS functioning in transformed hairy roots of A. annua . The study provides transformed hairy roots of A. annua as an efficient tool for effective phytoremediation with added advantages of artemisinin extraction from hairy roots used for phytoremediation., Supplementary Information: The online version contains supplementary material available at 10.1007/s11816-021-00682-5., Competing Interests: Conflict of interestAuthors declare no conflict of interest., (© Korean Society for Plant Biotechnology 2021.)

Objectives: Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery., Materials and Methods: A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated., Results: The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient's sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery., Conclusion: Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.

Salicylic acid (SA) and nitric oxide (NO) are considered as putative plant growth regulators that are involved in the regulation of an array of plant's growth and developmental functions under environmental fluctuations when applied at lower concentrations. The possible involvement of NO in SA induced attenuation of high temperature (HT) induced oxidative stress in plants is however, still vague and need to be explored. Therefore, the present study aimed to investigates the biochemical and physiological changes induced by foliar spray of SA and NO combinations to ameliorate HT induced oxidative stress in Lablab purpureus L. Foliar application of combined SA and NO significantly improved relative water content (27.8 %), photosynthetic pigment content (67.2 %), membrane stability (45 %), proline content (1.0 %), expression of enzymatic antioxidants (7.1-18 %) along with pod yield (1.0 %). Heat Shock Factors (HSFs) play crucial roles in plants abiotic stress tolerance, however there structural and functional classifications in L. purpureus L. is still unknown. So, In-silico approach was also used for functional characterization and homology modelling of HSFs in L. purpureus. The experimental findings depicted that combine effect of SA and NO enhances tolerance in HT stressed L. purpureus L. plants by regulating physiological functions, antioxidants, expression and regulation of stress-responsive genes via transcriptional regulation of heat shock factor., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In agriculture, heat stress (HS) has become one of the eminent abiotic threats to crop growth, productivity and nutritional security because of the continuous increase in global mean temperature. Studies have annotated that the heat stress response (HSR) in plants is highly conserved, involving complex regulatory networks of various signaling and sensor molecules. In this context, the ubiquitous-signaling molecules salicylic acid (SA) and nitric oxide (NO) have diverted the attention of the plant science community because of their putative roles in plant abiotic and biotic stress tolerance. However, their involvement in the transcriptional regulatory networks in plant HS tolerance is still poorly understood. In this review, we have conceptualized current knowledge concerning how SA and NO sense HS in plants and how they trigger the HSR leading to the activation of transcriptional-signaling cascades. Fundamentals of functional components and signaling networks associated with molecular mechanisms involved in SA/NO-mediated HSR in plants have also been discussed. Increasing evidences have suggested the involvement of epigenetic modifications in the development of a 'stress memory', thereby provoking the role of epigenetic mechanisms in the regulation of plant's innate immunity under HS. Thus, we have also explored the recent advancements regarding the biological mechanisms and the underlying significance of epigenetic regulations involved in the activation of HS responsive genes and transcription factors by providing conceptual frameworks for understanding molecular mechanisms behind the 'transcriptional stress memory' as potential memory tools in the regulation of plant HSR., (© 2019 Scandinavian Plant Physiology Society.)

Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2019 The Korean Association of Oral and Maxillofacial Surgeons.)

Islamic religious settings (IRS) may be useful places to implement obesity interventions for Muslims. However, little is known about the level and nature of such activity in these settings. We searched bibliographic databases and grey literature, and requested grey information from Muslim organizations, local councils, and mosques in 13 selected areas in the United Kingdom. Thirty-five interventions were identified; most were poorly described and not evaluated. Twenty-seven interventions focused on physical activity behaviours, four on diet behaviours, one on both behaviours, and seven addressed long-term conditions associated with obesity. Most interventions were led by volunteers from the congregation/faith leaders and were funded through donations from congregants or charity organizations. The evidence suggests that health promotion interventions in IRS have a relatively high reach. Obesity interventions are commonly delivered in UK IRS. Most target physical activity behaviours, are instigated and led by volunteers from the congregation or faith leaders, receive no public funding, and are only recorded in people's memories. High-quality evaluations of well-specified interventions in this context are needed. We suggest that the methods used in this review, including the learning around positionality of researchers, could be adopted by other researchers as a way to locate opportunities for effective community-level interventions., (© 2019 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Main Conclusion: UV-B-induced flavonoid biosynthesis is epigenetically regulated by site-specific demethylation of AaMYB1, AaMYC, and AaWRKY TF-binding sites inAaPAL1promoter-causing overexpression ofAaPALgene inArtemisia annua. The present study was undertaken to understand the epigenetic regulation of flavonoid biosynthesis under the influence of ultraviolet-B radiation using Artemisia annua L. as an experimental model. In-vitro propagated and acclimatized plantlets were treated with UV-B radiation (2.8 W m -2 ; 3 h), which resulted in enhanced accumulation of total flavonoid and phenolics content as well as eleven individual flavonoids measured through HPLC-DAC. Expression of eight genes (phenylanaline ammonia lyase, cinnamate-4-hydroxylase, 4-coumarate: CoA ligase; chalcone synthase, chalcone isomerase, cinnamoyl reductase, flavonoid-3'-hydroxylase, and flavones synthase) from upstream and downstream flavonoid biosynthetic pathways was measured through RT-PCR and RT-Q-PCR and all were variably induced under UV-B irradiation. Among them, AaPAL1 transcript and its protein were most significantly upregulated. Global DNA methylation analysis revealed hypomethylation of genomic DNA in A. annua. Further epigenetic characterization of promoter region of AaPAL1 revealed cytosine demethylation at five sites, which in turn caused epigenetic activation of six transcription factor-binding sites including QELEMENT, EBOXBNNAPA/MYCCONSENSUSAT, MYBCORE, MYBCOREATCYCB1, and GCCCORE. MYB transcription factors are positive regulators of flavonoid biosynthesis. Epigenetic activation of transcription-enhancing cis-regulatory elements in AaPAL1 promoter and subsequent overexpression of AaMYB1 and AaMYC and AaWRKY transcription factors under UV-B irradiation may probably be the reason for higher AaPAL1 expression and hence greater biosynthesis of flavonoids in A. annua L. The present study is the first report that provides mechanistic evidence of epigenetic regulation of flavonoid biosynthesis under UV-B radiation in A. annua L.

Present study was conducted to explore the role of exogenous salicylic acid (SA), sodium nitroprusside (SNP), abscisic acid (ABA) and proline (PRO) in mitigating high-temperature (HT) induced oxidative stress in different Lablab purpureus L. cultivars. The attempt was made to examine whether these phytohormones, when applied exogenously, were able to regulate plant morpho-physiological behavior by modulating genes and proteins involved in antioxidant defense system. The HT stress induced membrane damage, degraded chlorophyll, generated redox metabolites and significantly reduced growth and biomass in all the cultivars. Among all the four treatments, foliar application of SA and SNP were most effective in the regulation of growth and physiological processes of the cultivars compared to ABA and PRO applications. Thus, signifying the protective role of SA and SNP in mitigation of HT induced oxidative stress and conferring HT stress tolerance in the cultivars. Gene expression and leaf proteome analysis revealed that these phytohormones were also involved in regulation of defense related gene expression, stress inducible proteins and de novo synthesis of specific proteins under HT stress. The experimental findings depict that foliar applications of SA and SNP enhances HT stress tolerance in lablab cultivars by modulating antioxidant defense system and by regulating bio-physical growth more effectively as compared to ABA and PRO application.

Salicylic acid (SA) and sodium nitroprusside (SNP, NO donor) modulates plant growth and development processes and recent findings have also revealed their involvement in the regulation of epigenetic factors under stress condition. In the present study, some of these factors were comparatively studied in hyacinth bean plants subjected to high temperature (HT) environment (40-42 °C) with and without exogenous application of SA and SNP under field condition. Exogenous application of SA and SNP substantially modulated the growth and biophysical process of hyacinth bean plants under HT environment. Exogenous application of SA and SNP also remarkably regulated the activities of antioxidant enzymes, modulated mRNA level of certain enzymes, improves plant water relation, enhance photosynthesis and thereby increasing plant defence under HT. Coupled restriction enzyme digestion-random amplification (CRED-RA) technique revealed that many methylation changes were "dose dependent" and HT significantly increased DNA damages as evidenced by both increase and decrease in bands profiles, methylation and de-methylation pattern. Thus, the result of the present study clearly shows that exogenous SA and SNP regulates DNA methylation pattern, modulates stress-responsive genes and can impart transient HT tolerance by synchronizing growth and physiological acclimatization of plants, thus narrowing the gaps between physio-biochemical and molecular events in addressing HT tolerance., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Background: We have evaluated the rationale of existing grading and staging schemes of oral submucous fibrosis (OSMF) based on how they are categorized. A novel classification and staging scheme is proposed., Methods: A total of 300 OSMF patients were evaluated for agreement between functional, clinical, and histopathological staging. Bilateral biopsies were assessed in 25 patients to evaluate for any differences in histopathological staging of OSMF in the same mouth. Extent of clinician agreement for categorized staging data was evaluated using Cohen's weighted kappa analysis. Cross-tabulation was performed on categorical grading data to understand the intercorrelation, and the unweighted kappa analysis was used to assess the bilateral grade agreement. Probabilities of less than 0.05 were considered significant. Data were analyzed using SPSS Statistics (version 25.0, IBM, USA)., Results: A low agreement was found between all the stages depicting the independent nature of trismus, clinical features, and histopathological components (K = 0.312, 0.167, 0.152) in OSMF. Following analysis, a three-component classification scheme (TFM classification) was developed that describes the severity of each independently, grouping them using a novel three-tier staging scheme as a guide to the treatment plan., Conclusion: The proposed classification and staging could be useful for effective communication, categorization, and for recording data and prognosis, and for guiding treatment plans. Furthermore, the classification considers OSMF malignant transformation in detail., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Several studies have assessed the impact of chronic obstructive pulmonary disease (COPD) on work ability and work productivity; however, this relationship is poorly understood., Aims: To undertake a systematic review to assess the effects of COPD on employment, absenteeism and presenteeism., Methods: A comprehensive search using CINAHL, Embase, MEDLINE and the Cochrane Library was conducted to include epidemiological studies from 1937 to August 2017. One reviewer screened all citations. Shortlisted full-text articles were independently assessed by a second reviewer. Data were extracted by one reviewer with a random sample of papers (45%) checked by a second reviewer., Results: Forty-four studies were included; the majority of evidence was from cross-sectional studies, and some cohort studies. COPD patients had lower employment rates than those without COPD. Among those in work, most studies showed patients with COPD took more time off work than those without and reported poorer work performance (presenteeism), although evidence for this association was weaker. The influence of disease severity on these outcomes was unclear; however, it appeared that increasing severity of airflow obstruction was associated with reduced likelihood of being employed. A number of methodological limitations were found among the evidence, including the lack of adjustment for important confounders., Conclusions: Future studies are required which assess the impact of COPD on presenteeism using validated presenteeism instruments and consistent reporting methods. Robust studies are now needed to identify modifiable factors associated with these poorer working outcomes to inform future interventions aimed at improving work productivity among those with COPD.

Mycobacteriophage Superphikiman is a cluster J bacteriophage which was isolated from soil collected in Philadelphia, PA. Superphikiman has a 109,799-bp genome with 239 predicted genes, including 2 tRNA genes., (Copyright © 2018 Pradhan et al.)

Background: Patients with chronic obstructive pulmonary disease (COPD) are more likely to take time off work (absenteeism) and report poor performance at work (presenteeism) compared to those without COPD. Little is known about the modifiable factors associated with these work productivity outcomes., Aim: To assess the factors associated with work productivity among COPD patients., Methods: Cross-sectional analysis of baseline data from a subsample (those in paid employment) of the Birmingham COPD Cohort study. Absenteeism was defined by self-report over the previous 12 months. Presenteeism was assessed using the Stanford Presenteeism Scale. Logistic regression analysis was used to assess the effects of sociodemographic, clinical and occupational characteristics on work productivity., Results: Among 348 included participants, increasing dyspnoea was the only factor associated with both absenteeism and presenteeism (p for trend<0.01). Additionally, increasing history of occupational exposure to vapours, gases, dusts or fumes (VGDF) was independently associated with presenteeism (p for trend<0.01)., Conclusions: This is the first study to identify important factors associated with poor work productivity among patients with COPD. Future studies should evaluate interventions aimed at managing breathlessness and reducing occupational exposures to VGDF on work productivity among patients with COPD., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Oral submucous fibrosis (OSMF) is a debilitating condition of oral cavity which has significant potential for malignant transformation. In spite of over 20 years of research, the pathogenesis of the condition is still obscure and no single management modality is effective. Many OSMF treatment protocols have been proposed to alleviate the signs and symptoms of the disorder and there is overwhelming evidence that as areca nut is primary cause, stopping its use may have a considerable effect on symptoms rather than reversing pre-existing fibrosis. We present a review of the current protocols for managing OSMF., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Over the last 40 years, many theories linking oral submucous fibrosis (OSMF) to various risk factors have been proposed. Spicy, pungent foods and irritants such as supari (areca nut), paan (betel leaves), tobacco (through chewing or smoking)-the common Asian habits of chewing the aforementioned agents-have all been incriminated as causative agents. Systemic factors such as nutritional deficiency, genetic predisposition and autoimmunity have also been proposed in the pathogenesis of OSMF. However, the precise aetiology of OSMF is still unknown, and no conclusive evidence has been found despite many extensive investigations on implicated factors. Most of the ideas proposed have been derived from the existing clinical and epidemiological data. We present a comprehensive review of the various theories regarding the pathogenesis of the condition, but have not concentrated on malignant transformation in this article., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems., Methodology: A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively., Results and Conclusion: It can be concluded from this study that females of relative low age (<18 years) appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant), and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value., Competing Interests: There are no conflicts of interest.

Objective: The aim of this study was to determine the incidence of trismus before and after surgery and subsequent radiotherapy for patients of oral cancer and to determine the risk factors for the same., Methods: 30 patients diagnosed with oral cancer were included. Maximum mouth opening was measured for each patient as the inter incisal distance and was measured on 4 occasions - preoperatively at the time of diagnosis, post-operatively at discharge from the hospital, post-radiotherapy and at 6 months follow-up. The site of cancer, staging and grading of the malignancy, the surgical treatment performed, method of reconstruction, details of radiotherapy and compliance to physiotherapy were recorded, to evaluate the risk factors for developing trismus., Results: Trismus was observed in 53.3% patients at the time of diagnosis which increased significantly post-surgery (86.7%) and post-radiotherapy (85.7%) and gradually decreased (65.4%) at 6 months. The use of flaps for reconstruction, delay in radiotherapy post-surgery and non-compliance of patients to physiotherapy were the risk factors for developing trismus, showing statistical significance ( p  < 0.05)., Conclusion: Trismus is a significant complication of oral malignancies or its surgical and radiotherapy treatment, or both. Consideration must be given to its early diagnosis, to help in timely intervention and planning of preventive strategies.

Introduction: Spontaneous regeneration of bone is commonly seen in the small surgical defects caused by enucleation of cysts. However, in case of large surgical defects caused by the enucleation, spontaneous regeneration of bone is a rare phenomenon and it depends on factors, such as age of the patient, intact periosteum, and proper stabilization., Materials and Methods: The study included 16 patients, who reported to the department of oral and maxillofacial surgery with the complaint of pain and swelling in the jaws diagnosed as cyst. The sample included equal numbers of male and female subjects aged between 15 and 40 years. Panoramic radiographs were taken pre- and postoperatively on day 2 of the enucleation. The dimensions of the cyst were evaluated on the radiograph according to the proforma. Subsequent radiographs were taken at regular intervals of 1.5, 3, and 6 months using standard parameters and were analyzed using MCID™ analysis software of imaging research., Results: Mean reduction was seen in up to 39 and 60% in the cystic cavity size and increase in the mean density up to 59 and 90.2% at 3 and 6 months intervals respectively., Conclusion: Spontaneous bone regeneration was seen even after primary closure of the large cystic defect without the need for placement of foreign substances or grafts and it also eliminated the complications resulting from placement of foreign substance. Further studies are required in a larger sample with longer follow-up durations to confirm the outcome of the present work for the benefit of patients., Clinical Significance: The present study depicted that spontaneous bone regeneration can occur with accepted results after simple enucleation of jaw cyst without the aid of any graft material. Hence, simple enucleation may be considered as a first line of treatment modality for cystic lesion of the jaws. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications. Follow-up is necessary along with patient's compliance for the success of treatment.

A laboratory study was delineated to ascertain the impact and the extent of Dolichos yellow mosaic virus (DYMV) on biochemical constituents and various enzyme levels in the leaves of hyacinth bean. DYMV-infected leaves of all the genotypes used in the study revealed significant and consistent changes in activities of CAT, APX, PPO, DHAR, and MDHAR paralleled with a compelling hike in proline levels. Unlike that in non-infected leaves of the genotypes VRSEM-301 and VRSEM-749, VRSEM-894 and VRSEM-855, the enzyme level did not alter much which extended equally with increased phenolics, suggesting a well-coordinated generation of free radicals thereby suppressing oxidative stress in the latter. The genotypes were also evaluated at molecular level for elucidating the presence of the virus by using five sets of primer pairs. Two primers viz., DAC1 and DAC2 witnessed the presence of the virus in both non-infected and infected leaves. The difference in the appearance and/or disappearance of bands according to non-infected to infect reverberates the variation between genotypes in defense against infection.

Background: In the Asia-Pacific region, limited systematic assessment has been conducted on HIV service delivery models. Applying an analytical framework of the continuum of prevention and care, this study aimed to assess HIV service deliveries in six Asia and Pacific countries from the perspective of service availability, linking approaches and performance monitoring for maximizing HIV case detection and retention., Methods: Each country formed a review team that provided published and unpublished information from the national HIV program. Four types of continuum were examined: (i) service linkages between key population outreach and HIV diagnosis (vertical-community continuum); (ii) chronic care provision across HIV diagnosis and treatment (chronological continuum); (iii) linkages between HIV and other health services (horizontal continuum); and (iv) comprehensive care sites coordinating care provision (hub and heart of continuum)., Results: Regarding the vertical-community continuum, all districts had voluntary counselling and testing (VCT) in all countries except for Myanmar and Vietnam. In these two countries, limited VCT availability was a constraint for referring key populations reached. All countries monitored HIV testing coverage among key populations. Concerning the chronological continuum, the proportion of districts/townships having antiretroviral treatment (ART) was less than 70% except in Thailand, posing a barrier for accessing pre-ART/ART care. Mechanisms for providing chronic care and monitoring retention were less developed for VCT/pre-ART process compared to ART process in all countries. On the horizontal continuum, the availability of HIV testing for tuberculosis patients and pregnant women was limited and there were sub-optimal linkages between tuberculosis, antenatal care and HIV services except for Cambodia and Thailand. These two countries indicated higher HIV testing coverage than other countries. Regarding hub and heart of continuum, all countries had comprehensive care sites with different degrees of community involvement., Conclusions: The analytical framework was useful to identify similarities and considerable variations in service availability and linking approaches across the countries. The study findings would help each country critically adapt and adopt global recommendations on HIV service decentralization, linkages and integration. Especially, the findings would inform cross-fertilization among the countries and national HIV program reviews to determine county-specific measures for maximizing HIV case detection and retention.

Introduction: Oral submucous fibrosis (OSF) is an insidious disease affecting the oral cavity, pharynx, and upper digestive tract. It is characterized by a juxtaepithelial inflammatory reaction followed by fibroelastic change in the lamina propria and associated epithelial atrophy. Higher levels of TGF-β present in patients with OSF could be responsible for impetus to remnants of Reichert's cartilage present in styloid complex leading to partial or complete ossification of associated ligaments. So, a study was conducted to evaluate the elongation of the styloid process in patients with OSF by using panoramic radiographs., Materials and Methods: Panoramic radiographs of patients with OSF were studied from 2007-2011. The apparent lengths of styloid process were measured with the help of divider and steel metric ruler. The length of the styloid process and/or ossification of stylomandibular ligaments which were longer than 30 mm were considered., Results: Out of 47 patients, 35 patients (34 males & 1 female) met the inclusion criteria. Eleven patients (31.4%) were found to have elongated styloid processes which included 10 male patients and 1 female patient., Conclusion: It had been estimated that between 2 % and 4% of the general population presents radiographic evidence of an ossified portion of the styloid complex. The high incidence of elongation of styloid process (31.4 %) in patients with oral submucous fibrosis highlights that progressive OSF might have some influence on elongation of styloid process.

Despite extensive distribution of free condoms and lubricants to prevent HIV transmission among men having sex with men (MSM) in Nepal, the prevalence of HIV and risky sexual behaviors remain high. The influence of individual-level, social-capital, and social-structural factors on HIV risk has been insufficiently explored in MSM. The authors assessed association of these factors with HIV risk among 150 MSM enrolled using snowball sampling in the Kathmandu Valley. HIV risk was calculated on the basis of number and type of sexual partners and condom use during anal sex. Multivariate analysis showed a high risk of HIV infection was significantly associated with being involved in sex work, having no knowledge of male sexually transmitted infection (STI) symptoms, and having a history of STI symptoms. HIV prevention could be made more effective by targeting MSM who are involved in sex work and by improving their knowledge of male STI symptoms and early diagnosis and treatment.

Tuberculosis is still a major health hazard in the developing world, while its incidence has recently started to escalate after decreasing for many years. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This paper presents a case of tuberculosis of the submasseteric space, manifesting as a persistent swelling at ramus and angle of mandible. The diagnosis was confirmed based on histopathology after an open incisional biopsy. Patient underwent antituberculosis therapy and his extraoral swelling completely resolved after 4 months of the therapy. The purpose of this paper is to emphasize the importance of early and definitive diagnosis of orofacial tuberculosis, to recognize it based on signs and symptoms, and to refer the patients suspected of active tuberculous infection for appropriate medical treatment.

This study aims to evaluate efficacy of V-Y closure of upper lip incision on facial esthetics in comparison to simple continuous closure after Le Fort I advancement and superior repositioning of maxilla. Thirty-four patients were divided in two groups i.e. V-Y closure group (group I = 17 patients) and simple continuous closure group (group II = 17 patients). The preoperative and 1 year post-operative linear and angular changes of hard and soft tissue points of groups I and II were statistically compared. Labial changes were more favourable in V-Y closure group in comparison to simple continuous closure group in both the Le Fort I maxillary movements. The upturning and forward movement of the nose were seen in both the maxillary movements but these nasal changes did not differ significantly between the groups. It was observed that the technique of V-Y closure of upper lip delivers adequate results contributing to better facial esthetics when compared to simple continuous closure.

Pre-emptive analgesia aims at preventing the central nervous system from reaching a hyper-excitable state known as central sensitization, in which it responds excessively to afferent inputs. The clinical implication would be more effective pain management, thereby reducing post-operative pain and analgesic requirements. This study aimed at investigating the existence of pre-emptive analgesia and to compare the pre-emptive analgesic efficacy of im ketorolac [NSAID] versus tramadol [SYNTHETIC OPIOD] for post-operative pain management following third molar surgery. Fifty patients under the age group of 16-25 years with asymptomatic, symmetrically impacted mandibular third molars were equally divided into 2 groups and underwent third molar surgery under local anesthesia. Ketorolac 30 mg and tramadol 50 mg were used in the study group, while sodium chloride 0.9 % was used in the control group. Study parameters included pain intensity scores for 12 post-operative hours, time to 1st rescue analgesia, total number of analgesics consumed during the 5 post-operative days and patients' self assessment of efficacy of the surgery with regardsto no pain. Statistically, the data are presented as the mean values with their standard deviations and a 95 % confidence interval [p is significant, if p < 0.05] for the mean are applicable. Incidences of adverse events like pain on injection of the study drug, local reactions, nausea and vomiting were noted. Patients in the study group significantly performed better than the control group in terms of all the parameters; while among the study group, ketorolac fared better than tramadol. All the drug related complications were mild and did not require any intervention. Pre-operative ketorolac or tramadol in comparison to placebo resulted in a significantly better post-operative pain management. However as against tramadol, ketorolac is a better choice as a pre-emptive analgesic agent for the post-operative pain management following third molar surgery.