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Dental caries is a major public health concern among other oral diseases in most developing and industrialized countries, particularly in those nations where preventative programs have not yet been developed. Adults and the elderly population in Tamil Nadu also face significant challenges related to dental caries beyond children and adolescents. This systematic review examined the comprehensive epidemiology of dental caries in all age groups in Tamil Nadu. The articles were collected using various electronic databases. From the 4509 initially collected articles, 22 articles were chosen for the current umbrella analysis. The collective dental caries prevalence for Tamil Nadu state, India, from 22 studies with 33,584 study participants was 42.8%, with a 95% confidence interval (CI) of 42.3–43.4%. Among the four regions of Tamil Nadu, Eastern Tamil Nadu showed the highest dental caries prevalence of 82.2%. Thus, the strategies by the government of Tamil Nadu should focus on raising awareness about improving oral hygiene practices, seeking access to timely oral healthcare treatments, and strengthening the oral healthcare infrastructure.

Aim: The aim of this study is to analyze the Indian public healthcare delivery system and compare it with other countries based on their gross domestic product (GDP) classification. Materials and Methods: The study was conducted to assess the Indian healthcare delivery system and the GDP among global nations based on their GDP potential as criteria. The data from 24 high-, middle-, and low-income countries were gathered from the World Bank from year 2018 to 2021. The parameters included GDP, GDP per capita, total number of population, and healthcare delivery system. The data were collected from various electronic sources of the World Health Organization, the International Monetary Fund, and the US Census Bureau's international data, National Health Profile 2021. The collected data were compiled and tabulated. The descriptive analysis was done using Microsoft Excel version 2016 and SPSS version 20. Results: India ranks in the high-income group based on the GDP, whereas when ranked based on GDP per capita, it drops down to the lower-middle-income group. This lag may be because of a larger population and lack of priority in public health delivery. In terms of overall expenditure, India spends US$63 million in total health expenditure, of which only US$20 million is spent by the government sector. On the other hand, the United States holds the highest rank with US$10,921 million of total health expenditure, of which US$5,552 million spent by the government sector and US$5,368 million by the private sector. Conclusion: The Indian healthcare delivery system is suffering from a shortage of public health workforce and infrastructure. In the last decade, India has seen remarkable economic development, particularly in terms of the GDP growth rate. Unfortunately, this progress does not accompany with the Indian healthcare delivery system. Still there is a shortage in public health workforce and infrastructure. India should prioritize the expenditure in healthcare delivery. [ABSTRACT FROM AUTHOR]

Apical periodontitis is an inflammation and destruction of the periradicular tissues due to various insults to the pulp in the form of infection, trauma, and faulty dental procedures. Conditions regarding this are treated employing root canal therapy. Recent innovations show that copper calcium hydroxide nanoparticles and their electrophoresis can be used to treat apical periodontitis effectively. To evaluate the effectiveness of copper calcium hydroxide nanoparticles in the treatment of apical periodontitis, a literature search was done using PubMed, Cochrane Central Register of controlled Trials (CENTRAL), Science Direct, and Lilacs using the MeSH (Medical Subject Heading) terms Copper calcium hydroxide, apical periodontitis, nanoparticles, and electrophoresis. Of a total of 167 articles screened, 44 were full-text articles assessed for eligibility and four articles were taken for the qualitative analysis. This review was recorded according to the PRISMA GUIDELINES. Four randomized controlled trials were included in the review process. The copper calcium hydroxide particles were compared with other root canal medicament materials. It was found that copper calcium hydroxide and its electrophoresis were used in the treatment of apical periodontitis and were found to be one of the effective methods. Copper calcium hydroxide nanoparticles were effective against the destruction of the periradicular tissues. [ABSTRACT FROM AUTHOR]

Hepatoprotective activity of aqueous extract of Ipomoea mauritiana jacq against amoxicillin induced hepatotoxicity in male albino rats was evaluated. The aqueous extract of Ipomoea mauritiana jacq (200 mg/kg body weight ) was administered along with amoxicillin (2gm/kg body weight). The plant extract was effective in protecting the liver against the injury induced by amoxicillin in rats. This was evident from significant increase in total protein level and decrease in the level of Triglyceride, Cholesterol, Bilirubin, serum marker enzymes such as SGOT, SGPT, ALP, ACP. The hepatoprotective activity was also supported by istopathological studies of liver tissue. It was concluded that the aqueous extract of Ipomoea mauritiana jacq possesses hepatoprotective activity against amoxicillin induced hepatotoxicity in male albino rats. [ABSTRACT FROM AUTHOR]

Background: Zinc sulfate is an inorganic compound used as a nutritional supplement, and it is known to aid in enhancing anti-inflammatory properties. Recurrent aphthous stomatitis is a commonest oral mucosal conditions characterized by painful recurring ulcers. Many current studies focus on establishing Zinc sulfate's potency against Recurrent aphthous stomatitis and its other uses in dentistry as it has anti-inflammatory activity with minimal adverse effects. Aim: To determine the effectiveness of zinc sulfate in the treatment of recurrent aphthous stomatitis. Materials and methods: A systematic review of clinical trials using zinc sulfate as an effective agent against Recurrent aphthous stomatitis. Various databases were searched and obtained a total of 112 articles, among which three studies were included. A systematic review was performed using PubMed, Scholar, Wiley, Cochrane and Science direct. From the total 112 articles that appeared from various sources, 109 articles were screened, and three studies were related to the research topic. This article was reported according to the systematic review guidelines. Result: Three studies were included in the systematic review, of which all are clinical trials showed that Zinc sulfate had a crucial role in reducing inflammation and improving oral hygiene status. The P-value of the three articles selected are 0.001, 0.0001 and > 0.05. Conclusion: With a comparative analysis between the existing related articles about the effectiveness of zinc sulfate in treating the recurrent aphthous stomatitis, the sequel of the effectiveness of zinc sulfate in the treatment of recurrent aphthous stomatitis have to be given. [ABSTRACT FROM AUTHOR]

Background: Poor oral health and oral dysbiosis were found to be associated with cancers, especially of the gastrointestinal (GI) system. But the cause-and-effect relationship and the effect of the risk are not yet known due to scarcity of literature. Understanding such risk relationship can contribute to an integrated multi-disciplinary approach for GI cancer prevention., Aim: The aim of the present systematic review and meta-analysis is to assess the role of oral dysbiosis on increasing the risk of digestive system cancers., Objective: To evaluate the effect of poor oral health on increasing the risk of gastrointestinal cancers., Methods: We conducted a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in databases PubMed, Elsevier, Wiley's online library and Web of Science from inception to February 2023 to include recent cohort studies that assessed the association between poor oral health and the risk of cancer. We assessed bias using the New Castle Ottawa scale. We used inferential statistics to describe the effect of oral dysbiosis on gastrointestinal cancers. We performed a sub-group analysis to assess the effect of oral conditions on individual cancers., Results: We included 10 longitudinal studies in the meta-analysis. The overall effect size of poor oral health and GI cancer risk was hazard's ratio (HR) =1.30 (95% CI: [1.14, 1.46]) (p<0.001) (I 2 = 68.78). Sub-group analysis indicated that poor oral health increases the risk of esophageal cancer HR=1.61 (95% CI: [1.37, 1.85]), stomach cancer HR=1.33 (95% CI: [1.08, 1.58]), pancreatic cancer HR=1.90 (95% CI; [1.29, 2.50]) and colorectal and hepatocellular carcinoma HR=1.16 (95% CI: [1.08, 1.23])., Conclusion: The meta-analysis indicated that poor oral health was significantly associated with increasing the risk of GI cancers., (© 2024. Indian Society of Gastroenterology.)

Cancer persists as a global challenge necessitating continual innovation in treatment strategies. Despite significant advancements in comprehending the disease, cancer remains a leading cause of mortality worldwide, exerting substantial economic burdens on healthcare systems and societies. The emergence of drug resistance further complicates therapeutic efficacy, underscoring the urgent need for alternative approaches. Drug repurposing, characterized by the utilization of existing drugs for novel clinical applications, emerges as a promising avenue for addressing these challenges. Repurposed drugs, comprising FDA-approved (in other disease indications), generic, off-patent, and failed medications, offer distinct advantages including established safety profiles, cost-effectiveness, and expedited development timelines compared to novel drug discovery processes. Various methodologies, such as knowledge-based analyses, drug-centric strategies, and computational approaches, play pivotal roles in identifying potential candidates for repurposing. However, despite the promise of repurposed drugs, drug repositioning confronts formidable obstacles. Patenting issues, financial constraints associated with conducting extensive clinical trials, and the necessity for combination therapies to overcome the limitations of monotherapy pose significant challenges. This review provides an in-depth exploration of drug repurposing, covering a diverse array of approaches including experimental, re-engineering protein, nanotechnology, and computational methods. Each of these avenues presents distinct opportunities and obstacles in the pursuit of identifying novel clinical uses for established drugs. By examining the multifaceted landscape of drug repurposing, this review aims to offer comprehensive insights into its potential to transform cancer therapeutics.

Background: Aberrant deoxyribonucleic acid (DNA) contributes to inflammasome orchestrated progression of chronic inflammatory diseases like diabetes and periodontitis. The purpose of the present study was to estimate salivary levels of DNA sensing inflammasomes, absent in melanoma 2 (AIM2), interferon γ inducible protein (IFI16), and cytokine interleukin 18 (IL18) in individuals with periodontitis, diabetes, and healthy controls and interpret its association with periodontal and diabetic parameters., Methods: Salivary levels of AIM2, IFI16, and IL18 were estimated by enzyme linked immunosorbent assay (ELISA) in a total of 120 individuals (n = 30 in each group), namely, healthy (Group 1), periodontitis (Group 2), diabetes (Group 3), and diabetes with periodontitis (Group 4). Correlations of inflammasome levels and periodontal clinical parameters-plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), and periodontal inflamed surface area (PISA) were performed. Multiple regression was carried out to predict AIM2 and IFI16 with various independent variables., Results: The mean salivary levels of AIM2, IFI16, and IL18 were highest in diabetes with periodontitis (Group 4) and least in healthy (Group 1) and statistically significant between the groups (p = 0.000). Significant positive correlation between clinical periodontal parameters and AIM2, IFI16, and IL18 was present (p ≤ 0.05). Multiple regression showed glycated hemoglobin (HbA1C) (p = 0.002), GI (p = 0.016), PISA (p = 0.002), and CAL (p = 0.004) were significant predictors of AIM2, while HbA1C (p = 0.012), PISA (p = 0.003), and CAL (p = 0.007) predicted IFI16., Conclusion: The results of the present study showed higher levels of AIM2, IFI16, and IL18 in saliva of individuals with diabetes and periodontitis. HbA1C, PISA, and CAL were significant independent predictors of salivary AIM2 and IFI16 levels., (© 2023 American Academy of Periodontology.)

The understanding of roads and lanes incorporates identifying the level of the road, the position and count of lanes, and ending, splitting, and merging roads and lanes in highway, rural, and urban scenarios. Even though a large amount of progress has been made recently, this kind of understanding is ahead of the accomplishments of the present perceptual methods. Nowadays, 3D lane detection has become the trending research in autonomous vehicles, which shows an exact estimation of the 3D position of the drivable lanes. This work mainly aims at proposing a new technique with Phase I (road or non-road classification) and Phase II (lane or non-lane classification) with 3D images. Phase I: Initially, the features, such as the proposed local texton XOR pattern (LTXOR), local Gabor binary pattern histogram sequence (LGBPHS), and median ternary pattern (MTP), are derived. These features are subjected to the bidirectional gated recurrent unit (BI-GRU) that detects whether the object is road or non-road. Phase II: Similar features in Phase I are further classified using the optimized BI-GRU, where the weights are chosen optimally via self-improved honey badger optimization (SI-HBO). As a result, the system can be identified, and whether it is lane-related or not. Particularly, the proposed BI-GRU + SI-HBO obtained a higher precision of 0.946 for db 1. Furthermore, the best-case accuracy for the BI-GRU + SI-HBO was 0.928, which was better compared with honey badger optimization. Finally, the development of SI-HBO was proven to be better than the others.

Background: Poverty is directly linked to public health care delivery in many ways and dimensions. Every aspect of the human sphere is preplanned, but a health crisis is the only emergency which pushes humanity into severe economic stress. Therefore, every nation aims to safeguard its citizens from a health crisis. In this aspect, India needs to improve its public health infrastructure in order to protect its citizens and save them from poverty., Objectives: (1) To assess the current pitfalls in public critical health care delivery, (2) to analyze whether the health care delivery matches the requirements of its population in every state, (3) to produce solutions and guidelines to overcome the stress in this priority area., Materials and Methods: Data regarding the critical care workforce, which includes critical care doctors and nurses, were taken from official websites and other sources. Critical care infrastructure data were retrieved from the Internet sources. Data were validated by consulting state government sources and cross-checked for bias elimination. The data were analyzed using the "Statistical Package for Social Sciences" software version 20, and were presented using descriptive statistics., Results: There is a 1:10 percentage of deficit in the case of critical care workforce and infrastructure when compared with its need analysis. Critical care medicine specialists are in 1:75 when compared to other specialties., Conclusion: Overall, the public sector critical care needs a total boost through out of box solutions. According to the Stockholm International Peace Research Institute (SIPRI), India spent the third most on defense in the world in 2021. India spent 76.6 billion dollars on its military in 2021, up 33% from 2012 and 0.9% from 2020. However, since India is considered a fast-growing economy, there is still a huge disparity in critical care. Without resetting critical health care, India cannot grow in welfare indices even if it is among the top gross domestic product (GDP) countries., How to Cite This Article: Prabu D, Gousalya V, Rajmohan M, Dinesh MD, Bharathwaj VV, Sindhu R, et al. Need Analysis of Indian Critical Health Care Delivery in Government Sectors and its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure. Indian J Crit Care Med 2023;27(4):237-245., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Breast cancer is the most common malignancy in women worldwide. The cause of cancer is multifactorial. An early diagnosis and the appropriate treatment of cancer can improve the chances of survival. Recent studies have shown that breast cancer is influenced by the microbiota. Different microbial signatures have been identified in the breast microbiota, which have different patterns depending on the stage and biological subgroups. The human digestive system contains approximately 100 trillion bacteria. The gut microbiota is an emerging field of research that is associated with specific biological processes in many diseases, including cardiovascular disease, obesity, diabetes, brain disease, rheumatoid arthritis, and cancer. In this review article, we discuss the impact of the microbiota on breast cancer, with a primary focus on the gut microbiota's regulation of the breast cancer microenvironment. Ultimately, updates on how immunotherapy can affect the breast cancer-based microbiome and further clinical trials on the breast and microbiome axis may be an important piece of the puzzle in better predicting breast cancer risk and prognosis.

Objective: Privacy protection in the medical field means the protection of individuals from being associated with undesirable conditions, diagnoses or treatments (Sensitive Attributes). The problem of knowledge discovery from health care data by applying data mining algorithms is inversely related to the privacy of individuals. Due to the tremendous growth of data in a large scale, there is a demand to protect the sensitive data accessible from medical datasets. Methods: This paper considers the problem of building privacy preserving association rule mining algorithm using the notion of TF * IDF derived from the information retrieval domain. The highly sensitive transaction is chosen using the product of Relative Item Frequency and Condensed Frequency. Finally, sensitive fuzzy data is perturbed to hide these refined rules. Results: It has been found that the number of non-sensitive rules lost as a side effect of hiding sensitive rule is 20% less and number of ghost rules is 30% less in proposed work than in previous work using Transactional Impact factor method. The execution time of hiding a rule is 26% lesser on an average in the proposed technique for various values of minimum confidence threshold. It has been observed that the number of modifications to the original dataset after hiding three rules were reduced by 66% in proposed method than in previous work. As the number of modifications to original data is less the chances of generating false association is also reduced. Conclusion: In this paper, a novel method was presented to hide the sensitive rule in quantitative data by decreasing the support of the RHS of the rule. Experimental results demonstrate that the proposed approach is more efficient as it facilitates better rule hiding and minimizes the number of lost rules and ghost rules. Also, this approach makes minimum modifications to the dataset., (Creative Commons Attribution License)

Aim: Left vocal cord paralysis (LVCP) is variably reported post ligation of patent ductus arteriosus (PDA). Our objective was to determine the incidence of LVCP and identify predictive factors and associated morbidities in preterm infants post PDA ligation., Methods: This is a retrospective cohort study of infants less than 29 weeks gestational age from 2006 to 2014 who underwent PDA ligation. Infants with laryngeal symptoms underwent flexible fibreoptic nasopharyngolaryngoscopy to evaluate vocal cord function. We compared short- and long-term morbidities among infants with and without symptomatic LVCP., Results: A total of 35 infants underwent PDA ligation in the study period, of which 11 infants (31%) developed symptomatic LVCP. Dysphonia was the presenting symptom in all neonates with LVCP and stridor was present in 46% (5/11) of them. The median (interquartile range) gestation (25 weeks (24-27) vs. 25 weeks (23-28)), birthweight (810 g (550-1180) vs. 825 g (550-1220)) and age at surgery (19 days (9-27) vs. 20 (5-69)) were similar in infants with and without LVCP, respectively. Infants with LVCP took significantly longer to reach suck feeds (128 vs. 90 days, P = <0.001), stayed longer in hospital (119 vs. 95 days, P = 0.01) and were more likely to go home on oxygen (73 vs. 27%; P = 0.024). Neurodevelopmental outcomes were similar in the two groups., Conclusions: LVCP was noted in 31% of infants post PDA ligation and was associated with prolonged hospital stay, a longer time to reach suck feeds and a need for home oxygen. No predictive factors for development of LVCP were identified., (© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Glycation and lipid peroxidation are two important processes known to play a key role in complications of many pathophysiological processes. Malondialdehyde (MDA) has been reported to play a possible role in the genesis of glycated proteins. This study was undertaken to unravel the possible association of MDA with glycated hemoglobin and fructosamine in prehypertensive patients. A case-control study was performed on 42 prehypertensive and 30 control subjects. Plasma glucose, MDA, fructosamine, and glycated hemoglobin were analyzed in both the groups. Partial correlation analysis was performed to predict the independent association of MDA and fasting glucose on fructosamine and glycated hemoglobin. Plasma of prehypertensive subjects revealed significantly higher concentrations of lipid peroxides and fructosamine than in controls. Glycated hemoglobin concentrations were also found to be significantly increased in test group when compared with healthy controls. When the effects of fasting glucose on the concentrations of glycated hemoglobin and fructosamine were refuted by partial correlation analysis, MDA was found to be a significant determinant of glycated hemoglobin and fructosamine in subjects with prehypertension. These data also support the premise that lipid peroxides per se could play a role in the glycation of hemoglobin and plasma proteins in prehypertension.

Prehypertension has been recently described as an independent category of blood pressure. Mounting evidence suggests that blood pressure in the prehypertensive range is associated with an increased risk of developing hypertension and cardiovascular disease. Several reports have assigned a critical role for oxidative stress in these disease processes. This review focuses on the clinical and experimental studies done in prehypertension and hypertension within the context of oxidative stress. This article also provides insights into why diverse therapeutic interventions, which have in common the ability to reduce oxidative stress, can impede or delay the onset of hypertension in prehypertension subjects.