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The goal of prosthodontics is the rehabilitation of missing oral and extra-oral structures with the restoration of normal function of chewing, speech, swallowing, appearance, etc. Malignancies are common in the oral region and are treated through surgical intervention. Surgical intervention creates anatomic defect which forms communication among the oral cavity, nasal cavity, and maxillary sinus. In such cases, it is very difficult for the patient to perform various normal functions like mastication, swallowing, speaking, etc. Prosthodontic rehabilitation with an obturator prosthesis restores the missing structures and acts as a barrier between the communications among the various cavities. The main problem with the rehabilitation of defects difficulty involving in the processing of bulky prosthesis. Different techniques have been described in the literature using cardboard boxes,custom-made flasks or no flask at all which are having their own drawbacks affecting the dimensional stability of the prosthesis. This case report describes a simplified, inexpensive and easy method of processing an obturator for the rehabilitation of a maxillary defect using chlorinated polyvinyl chloride (CPVC) pipes. &nbsp

Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening syndrome characterized by pathologic immune hyperactivation, extreme inflammation, and multiorgan involvement with variable cytopenias. We report a case of a 53-year-old male with no known comorbidities, who presented with unrelenting dengue fever, pancytopenia, high ferritin levels, and multiple organ dysfunction with progressive clinical deterioration despite treatment. Based on the clinicolaboratory findings, he was diagnosed as dengue-associated HLH on day 6 of admission. As per HLH treatment protocol, he was started on immunosuppressants and showed significant improvement. In dengue patients with severe disease, prolonged hospital stay, persistent cytopenia, and multiorgan dysfunction out of proportion to the plasma leakage phase should prompt a high index of suspicion for the possibility of infection-triggered HLH. Although prompt diagnosis and early initiation of therapy is the key to prevent irreversible end organ damage and mortality, the hindrance lies in its rarity in adults, variable clinical presentation, and nonspecific laboratory findings.

Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting children aged between 9 months to, Author summary Rubella infection during the first trimester of pregnancy can affect fetus, resulting in spontaneous abortion, stillbirth or birth of a baby with a combination of birth defects known as congenital rubella syndrome (CRS). Vaccination with rubella containing vaccine (RCV) is recommended as one of the strategies for eliminating rubella/CRS. The Southeast Asia region has set a target to eliminate rubella/CRS by 2023. Towards this goal, India completed nationwide immunization campaigns using measles-rubella vaccine during 2017–19, targeting children aged 9 months to

For a successful space programme, the reusable spacecraft should survive numerous re-entry conditions. The re-entry of almost all the reusable space shuttles resembles a flat plate at high angles of attack because of its flat windward surface. The feasibility of concave ventral surface in space shuttles is analysed computationally with a commercially available solver scFLOW. A full three-dimensional Navier–Stokes equations are solved over a thin concave plate at different angles of attack to a hypersonic flow. The peak temperature and drag coefficients of different eccentric plates are compared with that of a flat plate normal to the flow. The air is assumed to be thermally perfect gas. The flow is assumed to be continuum. The total heat transfer rates and peak heat fluxes of a concave plate are compared with the flat plate. This paper discusses the results of these simulations and how the concavity behaves in the re-entry of spacecraft.

Composites fabricated from renewable sources have become important alternative materials for designing, manufacturing engineering and industrial products. Natural fiber composites have become a better alternative for synthetic fiber reinforced materials, due to their easy manufacturing process, high fiber content, pollution control, less weight, and even to burn to ash. So in the present research work a new fiber is introduced to find environmental friendly green composites. The present work evaluated the effect of fiber loading and fiber orientation on the mechanical properties of Hardwickia Binata fiber reinforced epoxy composites. Hardwickia Binata fiber is used as reinforcement which treated with 5% NaOH solution for enhancing the bonding strength between fiber and resin by removing moisture contents. Samples at different fiber loadings (5%, 10%, 15% and 20%) and varying fiber orientations (00, 300, 600, 900) were fabricated by hand lay-up moulding Process and investigated mechanical properties like tensile, flexural, impact and compressive strengths. The results of this study indicate at the 20% fiber loading and 00 fiber orientation shows superior mechanical properties compared to the other orientations and fiber loading. Morphological analysis was carried out to observe fracture of the internal surfaces, delaminating of fibers, fiber pullouts and morphology using scanning electron microscope.

BACKGROUND HELLP syndrome is an acronym for Haemolysis (H), Elevated Liver Enzymes (EL) and Low Platelet (LP). This is a rare complication of preeclampsia (10-15%). HELLP syndrome may develop even without hypertension. This syndrome is manifested by nausea, vomiting, epigastric or right upper quadrant pain along with haematological changes. Parenchymal necrosis of liver causes elevation in hepatic enzymes (AST and ALT >70 IU/L, LDH >600 IU/L) and bilirubin (>1.2 mg/dL). There may be subcapsular haematoma formation (which is diagnosed by CT scanning) and abnormal peripheral blood smear. Eventually, liver may rupture to cause sudden hypotension due to haemoperitoneum. Periportal haemorrhagic necrosis of the liver occurs due to thrombosis of the arterioles. The necrosis is seen at the periphery of the lobule. There may be subcapsular haemorrhage. Hepatic insufficiency seldom occurs because of the capacity and regenerative ability of liver cells. Liver function tests are especially abnormal in women with HELLP syndrome. A sincere effort has been put to study the HELLP syndrome incidence and its clinical prognosis and to understand its outcome. MATERIALS AND METHODS Forty patients were selected whose BP was recorded more than 140/80 mmHg after twenty weeks of gestation. Peripheral smear were taken to check for haemolysis or elevated indirect bilirubin or elevated LDH levels were checked, elevated liver enzymes and decreased platelet count

BACKGROUND Gestational Diabetes Mellitus (GDM) refers to any degree of glucose intolerance with onset or first recognition during pregnancy. Maternal diabetes constitutes an unfavourable environment for embryonic and foetoplacental development. The histomorphological changes in the placenta are associated with increased perinatal morbidity, increased risk of diabetes in the offspring and the mother in the ensuing years of life. Present study aims to study the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by GDM. MATERIALS AND METHODS A descriptive observational case-controlled study was conducted from January 2013 to November 2016 in King George Hospital, Visakhapatnam. Hundred and sixty four women diagnosed with GDM and hundred women with normal gestation were enrolled in the study. Foetal surveillance was done by Doppler ultrasound and kick count technique during the gestation. Foetal and maternal outcome was evaluated and compared to the outcome of normal gestation. Placental specimens from term gestations (38-42 weeks) diagnosed with GDM and normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures. RESULTS In the present study, 62.19% of the GDM cases terminated as normal gestations. Recurrent UTI was the most common complication (14.02%) during the antenatal period. 17.68% of the foetuses from GDM mothers presented with macrosomia, however, there were no cases of congenital anomalies or shoulder dystocia. Placental tissue from the GDM cases was larger, heavier and more cotyledonous as compared to placenta from normal subjects. The umbilical cord showed eccentric and central attachment in all the controls and most of the cases and 5.48% of the cases showed marginal attachment of the umbilical cord. CONCLUSION The study describes the various maternal, foetal and placental outcomes in pregnancies complicated by GDM. Recurrent UTI was the most common maternal complication during antenatal period while macrosomia was the most common foetal outcome. The morphological changes in the placenta were studied to understand the placental presentation in GDM patients. Thus, the study brings to light the possible pathophysiological areas of clinical research for disease modifying interventions.

BACKGROUND I-gel and LMA supreme are single use second generation supraglottic airway devices. The objectives of this study are to compare the number of attempts of insertion, ease and time taken for insertion, airway leak pressure and complications during usage of these devices. MATERIALS AND METHODS Randomised single-blinded prospective study was conducted with sixty patients of ASA physical status I and II assigned into two groups undergoing elective procedures under general anaesthesia. The device was chosen according to weight of patient. We assessed the mean time of insertion in seconds, ease of insertion, number of attempts of insertion, oropharyngeal seal pressure, ease of insertion of gastric tube, complications postoperatively. RESULTS There was no difference between the demographic data in our study. Mean time for placement of i-gel was greater than LMA supreme (p=0.0001). LMA supreme was easily inserted in 93% compared to 57% in i-gel group (p=0.002. LMA supreme is superior to i-gel in comparison of number of attempts for supraglottic device placement (p=0.026). There was no statistically significant difference between two groups in oropharyngeal seal pressure (p=0.398). There was no incidence of desaturation, dental trauma or laryngospasm in both the groups. Blood staining of i-gel was noted in 3 cases and 2 cases of LMA supreme had complaints of postoperative sore throat. CONCLUSION Both i-gel and LMA supreme provided a satisfactory and secure airway during elective procedures under general anaesthesia. LMA supreme has a slight edge over i-gel in being superior to i-gel in terms of shorter time taken for insertion, number of attempts for insertion during anaesthesia. Both devices are similar in other aspects.

Background and Aims: The present study was conducted to assess failure rate of dental implant in medically compromised patients. Methods: This study comprised of 68 medically compromised patients of both genders who underwent dental implants 5 years ago (Group I). Equal number of healthy subjects was taken as control (Group II). Amount of bone loss around the implant over 1mm of bone loss in the first year and over 0.3 mm bone loss every subsequent year were considered as failures. Results: The age group of 30-40 comprised of 25 patients in group I and 35 in group II, 40-50 years had 27 in group I and 23 in group II and 50-60 years had 16 in group I and 10 in group II. Medically compromised patients were diabetes (25) with 30 dental implants followed by osteoporosis (16) with 17 dental implants, hypothyroidism (12) with 14 dental implants, organ transplant (10) with 12 dental implants and CVD (5) with 7 dental implants. Chi- square test was applied which revealed significant difference in patients (P < 0.05). In group I, there were 18 (22.5%) and in group II, there were 4 (5.56%) dental implant failures. The difference with chi- square test found to be significant P < 0.05). Conclusion: Among medically compromised conditions, higher failure rate was found in diabetes.

Background: Mangifera indica (MI) commonly known as mango belongs to the family anacardiaceae , distributed in rural and semi urban parts of India. According to Ayurveda, various medical properties are attributed to different parts of the mango tree. The purpose of the study was to evaluate anti-inflammatory activity of aqueous extract of Mangifera indica leaves. Methods: Aqueous extract of Mangifera indica leaves was prepared and tested for anti-inflammatory activity in albino rats weighing 200-250 gm. The in vivo anti-inflammatory activity was evaluated by using Acute (carrageenan induced paw edema) and chronic (Formalin induced paw edema) animal models. Rats were divided into 4 groups, 6 rats in each group. Group I (control) received 0.1 ml 4% gum acacia suspension. Group II and Group III received Mangifera indica extract at doses of 200 mg/kg and 400 mg/kg body weight. Group IV (standard) received diclofenac 10 mg/kg body weight. All the drugs were administered orally. Anti-inflammatory activity was expressed as percentage inhibition of paw edema. Results: The percentage inhibition in carrageenan induced paw edema with 200 mg/kg and 400 mg/kg Mangifera indica extract was 44.8% and 53% and in formalin induced paw edema was 47.5% and 64.4% respectively. The two doses of Mangifera indica extract showed significant anti-inflammatory action (p

INTRODUCTION India has the third largest HIV epidemic in the world. In 2013, there were about 2.1 million people living with HIV. (1) The prevalence in India varies geographically. Andhra Pradesh seconds the list amongst the five states with highest prevalence in India. East Godavari District of AP has a high incidence of HIV/AIDS patients, next only to Guntur. Dermatological diseases are very common in HIV infected patients and are often its presenting features. So, this study was undertaken to evaluate the incidence of various mucocutaneous manifestations in HIV patients and their socio demographic determinants. This cross-sectional study was conducted in D.V.L department, KIMS, Amalapuram, East Godavari District, AP over a period of 18 months extending from July 2013 to December 2014. The study population consisted of 200 patients. Out of these, 46 patients were those who attended the D.V.L OP of KIMS, Amalapuram with various mucocutaneous diseases and found to be positive for HIV infection and the rest 154 patients were from amongst established cases of HIV admitted in other departments of KIMS and showing mucocutaneous manifestations. This study emphasizes the need for meticulous search for various mucocutaneous manifestations in HIV patients. Their presence mandates HIV testing in patients who are not screened for HIV.

Background: Hibiscus rosa sinensis which belongs to family Malvaceae is traditionally used in various diseases due to its medicinal properties. Most of the uses were studied in detail by many researchers, but the studies evaluating the skeletal muscle relaxant activity of H. rosa sinensis leaves are limited. Aims and Objectives: The present study was undertaken to evaluate the skeletal muscle relaxant activity of the methanolic extract of H. rosa sinensis leaves (MEHRL) in albino rats. Materials and Methods: MEHRL was prepared and tested for skeletal muscle relaxant activity in albino rats weighing 200–250 g. The animals were divided into four different groups. Group I (control) received normal saline 10 ml/kg, Group II (standard) received diazepam 10 mg/kg, and Groups III and IV received MEHRL 200 mg/kg and 400 mg/kg body weight, respectively. Skeletal muscle relaxant activity (motor coordination) on rotarod and locomotor activity on photoactometer was performed. Statistical analysis was carried out using analysis of variance, followed by Dunnett’s multiple comparison tests. Results: The results from the actophotometer and rotarod test showed that MEHRL significantly reduced the motor coordination and locomotor activity of tested animal. Conclusion: MEHRL showed significant dose-dependent skeletal muscle relaxant activity.

Dengue fever , scrub typhus ,chikungunya and leptospirosis are common infections in Asia that often present as acute febrile illness of unclear aetiology. Though dengue fever is often considered and investigated by the physicians in all such cases, other infections are often ignored . There is a need to investigate for scrub typhus which is a re-emerging disease in India. The present pilot study was undertaken to elucidate etiology of acute undifferentiated fevers and prevalence of scrub typhus among these patients admitted to the tertiary care hospital. Among the 100 patients studied ,39 samples were positive for dengue serology ,19 were found to be positive for antibodies to Orientia Tsusugamushi by Rapid immuno chromatography and

A LabVIEW based general purpose module to understand and visualize the electromagnetic field patterns inside the commonly used microwave devices is developed. The module provides both the electric and magnetic field patterns for any arbitrary mode configuration inside the rectangular waveguide and the cavity, which are the microwave devices mostly being taught at the undergraduate levels in the electrical engineering. The developed module helps the user in gaining a better and deeper understanding of the electric and magnetic field patterns and modes inside the guiding and closed structures.

Acrochordons are soft, skin colored pendunculated lesions primarily seen in skin creases such as neck, armpit, eyelids, trunk & groins. Etiology of skin tags is unknown but they tend to occur in obese people and frequent irritation seems to be an important causative factor. A pedunculated small acrochordons can be removed with curved or serrated blade scissors; larger skin tags may require excision. For small acrochordons, application of aluminum chloride prior to removal will decrease the amount of minor bleeding.

Introduction: Many surgeons perform intra operative frozen section to overcome the limitations of FNAC, to differentiate benign lesions from malignant lesions and to determine the extent of surgery. However, the use and cost effectiveness of FS is controversial in follicular lesions. Nevertheless FS is most useful in cases where FNA results are indeterminate or suspicious and it is a cost effective way to avoid second surgical procedure if a total thyroidectomy is indicated. Aim: To study the diagnostic utility of frozen section and fine needle aspiration cytology thyroid lesions utilizing final histopathology diagnosis as gold standard. Methods: The present study was conducted on 237 cases of thyroid tissue submitted for frozen section for a study period of 5 years. Among those, 95 cases had preoperative FNAC done. Results: The sensitivity, specificity and diagnostic accuracy of FNAC was 42.86%, 96.72% and 82.93%, whereas that of FS was comparatively superior (82%, 100% and 95.65% respectively). Conclusion: Thus, the overall sensitivity, specificity and diagnostic accuracy of FS was superior to that of FNAC in the present series. The main limitations of FS and FNAC in our study were- Capsular/ vascular invasion in follicular neoplasm was not detected in many cases and papillary microcarcinomas were missed. Key words: FNAC; Frozen section; Thyroid lesions.

A novel approach for the electromagnetic modeling and characterization of metamaterials and advanced composites in the microwave band is presented. The modeling approach is based on the concept of a properly defined unit cell, which is simulated and optimized for a particular structure using the full wave electromagnetic field simulator in order to obtain the reflection and transmission coefficients in the specified frequency band. The characterization involves the determination of the effective dielectric and magnetic properties of the test sample corresponding to the particular unit cell in terms of the scattering coefficients using the proposed method. The characterization is first carried out with the help of simulated data, and then a number of metamaterials and composite structures are fabricated. The scattering coefficients of these fabricated structures are measured with the help of a vector network analyzer by fitting them precisely into a section of X-band rectangular waveguide, and the effective dielectric and magnetic properties of these samples are determined from the measured scattering coefficients using the proposed method. A comparison is made between the simulated and the experimental results, and any difference between the actual and the determined values is properly analyzed.

The routing of nets or a set of interconnection points is a complete intensive application encountered in CAD for VLSI design. This paper proposes a gridless algorithm for area routing based on the Hightower's Maze routing algorithm for message passing multiprocessor systems. The suitability of k-d trees as a data structuring technique for gridless maze routing is established. Since segments of routes are stored as rectangular objects in the k-d tree, the algorithm facilitates routing with variable width conductor paths. Results obtained both through simulation techniques and those obtained on an actual multiprocessor system based on message passing exhibit speedup proportional to the number of processors in the multiprocessor system.

Background: Mangifera indica (MI), also known as mango, aam, has been an important herb in the Ayurvedic and indigenous medical systems for over 4000 years. Mangoes belong to genus Mangifera , which consists of about 30 species of tropical fruiting trees in the flowering plant family Anacardiaceae. According to Ayurveda, varied medicinal properties are attributed to different parts of the mango tree. This study was undertaken to evaluate the analgesic activity of aqueous extract of MIleaves in albino rats. Methods: Analgesic activity was evaluated by hot plate method and acetic acid induced writhing with four groups of six rats each. Group 1 was control, Group 2 received standard drug (tramadol and diclofenac for hot plate and writhing method, respectively), and Groups 3 and 4 received aqueous extract of MI leaves extract 200 mg/kg and 400 mg/kg. Results: The reaction time (seconds, mean±standard error mean [SEM]) in hot plate method at 120 mins increased significantly (p

Waldenstr's Macroglobulinemia (WM) is a clonal disorder of small lymphocytes that show maturation to plasma cells synthesizing IgM. It is the biological activity of IgM protein that determines most of the clinical manifestations of the disease. WM most closely corresponds to lymphoplasmacytic lymphoma or immunocytoma of the REAL classification of lymphoma. Here, we report a case of a 50 year old male with squamous cell carcinoma of buccal mucosa. On routine investigations we found autoagglutination of RBCs; on workup with this feature we had suspicion of Waldenstr's Macroglobulinemia. The diagnosis of WM was established after cytomorphology and immunohistochemistry (IHC) analysis of the bone marrow which revealed the presence of a lymphoid/lymphoplasmacytoid-like bone marrow infiltrate along with an elevated serum IgM level. Waldenstr's Macroglobulinemia and its co-existence with autoimmune diseases and non hematological malignancies has already been described in the literature, but the present case was asymptomatic for WM with carcinoma of buccal mucosa, which is the first case reported so far.