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Background. Vitamin D has anti-inflammatory properties and the potential to increase the generation of antimicrobial peptides like cathelicidin and defensins that may have a good impact on oral health. Higher vitamin D consumption has also been linked to a reduced risk of periodontal disease progression. Hence, the primary objective of this study was to evaluate and compare the clinical and laboratory parameters of oral supplementation of vitamin D as an adjuvant to scaling and root planing and to assess the bone mineral density via qualitative ultrasound bone density scanner in chronic periodontitis patients. Methodology. This study included 40 patients with periodontitis categorized into 2 groups with twenty patients each, Group I comprising scaling and root planing (SRP) alone and Group II comprising SRP along with vitamin D supplementation. Plaque index, gingival index, probing pocket depth, and clinical attachment loss was measured as clinical parameters. Serum vitamin D levels were assessed before and after SRP at both baseline and 6 weeks. Results. The intergroup comparison of clinical parameters (PI, GI, PPD, and CAL) at 6 weeks for both the groups showed statistical significance. Intragroup comparison of clinical parameters from baseline to 6 weeks showed a statistically significant reduction in both groups. The mean bone mineral density level in both the control and test groups demonstrated a mean T score of –1.3 and –1.21, respectively. The mean vitamin D levels were 27.8460 and 28.1020 for the test and control groups, respectively, which was statistically insignificant ( p = 0.705 ) and those at six-week intervals improved to 31.3650 and 28.0240 which were statistically significant ( p ≤ 0.001 ). Conclusion. It could be stated that a positive relationship exists between periodontitis and osteopenia which could aggravate periodontal destruction. All periodontitis cases should thus be evaluated for BMD and supplemented with vitamin D3 in an appropriate dosage and time frame to treat both these diseases.

ObjectiveThe goal of these studies is to discover novel urinary biomarkers of lupus nephritis (LN).MethodsUrine from systemic lupus erythematosus (SLE) patients was interrogated for 1000 proteins using a novel, quantitative planar protein microarray. Hits were validated in an independent SLE cohort with inactive, active non-renal (ANR) and active renal (AR) patients, in a cohort with concurrent renal biopsies, and in a longitudinal cohort. Single-cell renal RNA sequencing data from LN kidneys were examined to deduce the cellular origin of each biomarker.ResultsScreening of 1000 proteins revealed 64 proteins to be significantly elevated in SLE urine, of which 17 were ELISA validated in independent cohorts. Urine Angptl4 (area under the curve (AUC)=0.96), L-selectin (AUC=0.86), TPP1 (AUC=0.84), transforming growth factor-β1 (TGFβ1) (AUC=0.78), thrombospondin-1 (AUC=0.73), FOLR2 (AUC=0.72), platelet-derived growth factor receptor-β (AUC=0.67) and PRX2 (AUC=0.65) distinguished AR from ANR SLE, outperforming anti-dsDNA, C3 and C4, in terms of specificity, sensitivity and positive predictive value. In multivariate regression analysis, urine Angptl4, L-selectin, TPP1 and TGFβ1 were highly associated with disease activity, even after correction for demographic variables. In SLE patients with serial follow-up, urine L-selectin (followed by urine Angptl4 and TGFβ1) were best at tracking concurrent or pending disease flares. Importantly, several proteins elevated in LN urine were also expressed within the kidneys in LN, either within resident renal cells or infiltrating immune cells, based on single-cell RNA sequencing analysis.ConclusionUnbiased planar array screening of 1000 proteins has led to the discovery of urine Angptl4, L-selectin and TGFβ1 as potential biomarker candidates for tracking disease activity in LN.

Emerging urinary biomarkers continue to show promise in evaluating lupus nephritis (LN). Here, we screen urine from active LN patients for 1129 proteins using an aptamer-based platform, followed by ELISA validation in two independent cohorts comprised of 127 inactive lupus, 107 active LN, 67 active non-renal lupus patients and 74 healthy controls, of three different ethnicities. Urine proteins that best distinguish active LN from inactive disease are ALCAM, PF-4, properdin, and VCAM-1 among African-Americans, sE-selectin, VCAM-1, BFL-1 and Hemopexin among Caucasians, and ALCAM, VCAM-1, TFPI and PF-4 among Asians. Most of these correlate significantly with disease activity indices in the respective ethnic groups, and surpass conventional metrics in identifying active LN, with better sensitivity, and negative/positive predictive values. Several elevated urinary molecules are also expressed within the kidneys in LN, based on single-cell RNAseq analysis. Longitudinal studies are warranted to assess the utility of these biomarkers in tracking lupus nephritis. Developing noninvasive diagnostic biomarkers for lupus nephritis (LN) diagnosis is an important clinical goal. Here the authors identify urinary proteins correlated with active LN and disease severity, which differ across ethnicities but collectively outperform the current clinical method.

Background In comparison to the slow progression of first wave of the COVID-19 pandemic, by March 2021, the second wave appeared to be much more aggressive with many more cases. We aimed to evaluate reported COVID-19 epidemiology data to better understand the pandemic's progression in Rural Bikaner. Methods A record-based descriptive analysis study between first and second covid-19 waves, on the variables of interest including positivity rates, case fatality rate, demographic profile of positive patients. Results the daily reported cases at the peak of the first wave in rural area in 2020 was 20-25 cases per day and in second wave number of cases was increased double to first wave. Death rate and severity was also increased in second wave. In second wave the mean age of positive patients was decreased. Conclusions In our analysis rural area had a more severe second wave of the COVID-19 pandemic than the first and highlights the importance of examining multiple epidemiological variables down to the regional and country levels over time. These country-specific and regional results informed the implementation of continent-wide initiatives and supported equitable distribution of supplies and technical assistance. Monitoring and analysis of these data over time are essential for continued situational awareness, especially as Member States attempt to balance controlling COVID-19 transmission with ensuring stable economies and livelihoods. Key messages Demographic profile of rural area plays a key role in spread of Covid-19 cases.

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

Cancers of the orofacial region can be devastating in their impact on physical structure and function of the affected individual, leading to potentially severe compromises in quality of life. A total of Twenty (20) mandibular resected patients were selected for this study. All the patients’ were rehabilitated with mandibular resection prosthesis. Novel scale known as Maxillofacial Prosthesis Performance Scale (MFPPS) was developed for mandibulectomy patients to assess the oral health related quality of life. This scale has been tested for validity and reliability. The OHRQol was measured using the oral health impact profile (OHIP-Edent-19), Obturator functioning scale (OFS-15) and Maxillofacial Prosthesis Performance Scale (MFPPS-10) with standardized questionnaire after 2 weeks & 3months of prosthesis function for twenty (20) mandibular resected patients. For OHIP –Edent scale; when comparing 2 weeks, all subscale scores shown significant progress on oral health impact profile-Edent scale after 3 months of prosthesis function. For OFS scale; when observing the score of 2 weeks and 3 months, there was dramatic improvement of (75%) in miscellaneous factors which include Problems in dryness of mouth, engagement in social events and obturator positioning. For MFPPS; all rehabilitated patients’ were observed two weeks later, negative impacts have been eliminated and positive impacts increased on oral health. The patient was reviewed again 3months later and confirming an even higher level of overall satisfaction with the Mandibular Resection Prosthesis. The maxillofacial prosthesis had a strong positive impact on quality of life .Hence mandibular resection prosthesis enhance the oral health related quality of life.

Maxillofacial defects cause impact on oral health related quality of life (OHRQol) including limitations in functional activities, communication, social interaction, and intimacy. The obturator prosthesis is commonly used as an effective means for rehabilitating maxillectomy patients. The purpose of this study was to investigate impact of definitive obturator prosthesis on oral health related quality of life. In the period between 2015 -2017, a total of twenty five (25) patients with acquired maxillary defects based on Okay classification have been selected and rehabilitated with definitive obturator prostheses .The OHRQol was measured using the Oral Health Impact Profile (OHIP-Edent-19) and Obturator functioning scale (OFS) with standardized questionnaire after 2 weeks & 3months of prosthesis function.To find the significant difference between the bivariate samples in Paired groups the Wilcoxon signed rank test was used. With respect to oral health impact profile –Edent 19 scale, the mean functional limitation score were 6.72 and 5.20 indicates that there is significant improvement in chewing performance after 2 weeks and 3 months of prosthesis function. Significant improvement in oral health impact profile was noticed in physical (M = 5.84, 4.88), Psychological (M=4.84, 3.96) and social disabilities (M=5.28, 4.16). Similarly, when observed with Obturator functioning scale, significant improvement were noted in chewing performance phonetics, appearance and miscellaneous aspects. Analysing the OHIP –Edent-19 scale and obturator functioning scale (OFS-15), statistically significant differences (Wilcoxon rank test p value = 0.0005) were observed. Within the limits of this study, it can be concluded that highly positive correlation exists between definitive obturator prostheses and oral health related quality of life (OHRQol).

To establish a definitive grading system & derive classification of maxillary &mandibular tori based on shape . A cluster sample of 72 patients who sought treatment at the dental college with maxillary and/or Mandibular tori were selected, alginate impression were made for each patient and the stone casts poured were evaluated based on the following criteria; shape, prominence and dimensions (length, width, height) to surface a new grading system for the tori. From a total sample size of 72 patients with tori, 38 (52.8%) patients were dentulous (either fully or partially dentulous), and remaining 34 (47.2%) patients were edentulous. A total of 5 patients only had both maxillary and mandibular tori simultaneously present at the time of inspection, while all other 67 patients had only maxillary tori. From the 72 patients who presented with torus palatinus, in relation to the tori shape, 10 (13.9%) were flat, 43 (59.7%) were lobular, 16(22.2%) were spindle shaped and only 3 (4.2%) were of nodular shape. From the 5 patients who presented with torus mandibularis, 3 presented with tori of mild prominence, and 2 others presented with a moderately prominent mandibular tori.In relation to torus palatinus dimension, the width of tori varied widely from 4.0mm to 25.0mm, while the length too had a wide variation from 10.0mm to 37.0mm. The height however hadn’t as much variation, ranging from 0.5mm to 5.0mm. A successful grading system was accomplished in relation to maxillary tori and its effect on the prognosis of maxillary denture stability and retention could be determined from this grading system; however this was not successful for mandibular tori due to insufficient sample size of patients in this category. The grading system devised in our study was reasonable for use by dental graduates, though the study had short comings in few aspects that were not looked upon on initiation, it would be a stepping stone towards more research in this field in relation to maxillary and mandibular tori.. From this study, it is anticipated that Prosthodontist can have a precise idea of the tori to prosthesis relationship when faced with such patients in their day to day practice.

Background: Knowledge of Community Medicine plays a pivot role in effective delivery of health care services. Effective Teaching-Learning (T-L) of a class of 150-200 students is a challenge. Research is needed to identify methods suitable to the needs of the students. Students’ perspective is an important diagnostic feedback tool in this context. Aims & Objectives: To know the students’ preferences and perceptions regarding current T-L methods and their felt need for modification in the T-L approach. Material & Methods: Responses were collected from students pursuing internship regarding their preferences and perception on a pretested, validated semi structured questionnaire, most of the responses were collected on a Likert type five point scale. The data was analyzed by calculating percentage, mean and Standard Deviation (SD). Result: Majority (66.2%) felt a need for modification in T-L Approach and 74% of these opined that it will improve their performance in assessments. Presentation of content was voted as most important component for effective T-L (mean 3.9± 1.39). Desirable modifications was more time allotment to integrated modular T-L (51%) and field visits (26%). Conclusion: A judicious combination of Power point presentations with Modular T-L sessions and Field visits can be a more effective T-L approach in Community Medicine from the students’ perspective.

Emerging urinary biomarkers continue to show promise in evaluating lupus nephritis (LN). Here, we screen urine from active LN patients for 1129 proteins using an aptamer-based platform, followed by ELISA validation in two independent cohorts comprised of 127 inactive lupus, 107 active LN, 67 active non-renal lupus patients and 74 healthy controls, of three different ethnicities. Urine proteins that best distinguish active LN from inactive disease are ALCAM, PF-4, properdin, and VCAM-1 among African-Americans, sE-selectin, VCAM-1, BFL-1 and Hemopexin among Caucasians, and ALCAM, VCAM-1, TFPI and PF-4 among Asians. Most of these correlate significantly with disease activity indices in the respective ethnic groups, and surpass conventional metrics in identifying active LN, with better sensitivity, and negative/positive predictive values. Several elevated urinary molecules are also expressed within the kidneys in LN, based on single-cell RNAseq analysis. Longitudinal studies are warranted to assess the utility of these biomarkers in tracking lupus nephritis., Developing noninvasive diagnostic biomarkers for lupus nephritis (LN) diagnosis is an important clinical goal. Here the authors identify urinary proteins correlated with active LN and disease severity, which differ across ethnicities but collectively outperform the current clinical method.