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Introduction: Lichen planus is a chronic mucocutaneous disease that may affect the skin or any other mucosal surface. Although the etiology is largely unknown, role of stress in initiation or aggravation of the disease is a well-known fact. Apart from respiratory distress, COVID-19 has also been found to be associated with triggering autoimmune reactions such as oral lichen planus (OLP). Apart from its direct ill effect on health, the confusing nature, and the unknown course of COVID-19, the psychological stress of the lockdown and quarantine tremendously increased the stress levels. All this could be a trigger for the onset or exacerbation of existing OLP lesions. Objective: The primary outcome is to understand the likely association between OLP and COVID-19. The secondary outcome is to understand the role of COVID-19 in the pathogenesis of OLP if it is present. Materials and Methods: It was a unicentric cross-sectional study conducted on 57 patients suffering from OLP who had reported to the dental outpatient department of our tertiary health care center from September 2021 to April 2022. The clinical sign and symptoms associated with the OLP was recorded. A detailed history of COVID-19 exposure, vaccination status, and history of hospitalization were recorded. Results: The mean age of study participants was found to be 36.8 years the male:female ratio was found to be 1:2. Out of 57 patients, 45 patients had given a positive history of COVID-19 exposure. Conclusion: Apart from the immune dysregulation, the tremendous increase in stress levels due to COVID-19 has impacted everyone’s life very badly. The sudden increase in cases of OLP in post-COVID patients may be attributable to a combination of factors such as low Vitamin D levels COVID-19 and other comorbidities.

Background: The use of areca nut also known as supari or chaali is an age-old tradition and very popular in people living in South Asian countries. However, in general, people know very little about its ill effects. Aims: This study aimed to examine knowledge, attitudes, and practices regarding the health risks associated with chewing areca nuts and betel quid among the adult population and to evaluate the knowledge about its possible role as a contributing factor in oral cancer among the adult population. Materials and Methods: The unicentric cross-sectional survey was conducted on 1644 adult subjects belonging to the adult population of Aligarh and nearby places between March 2021 and December 2021. We analyzed the data using the Statistical Package for the Social Sciences (SPSS) software version 22. Results: The overall average age of the participants was 39.32 ± 14.18. The male-to-female ratio was 2:1. Among the study subjects, 54% were betel nut or betel quid chewers. Only 30.8% knew that areca nut may cause oral cancer and with low knowledge related to its systematic effect. Conclusion: Areca nut is a known carcinogenic agent and carries the risk of cancer even if it is used alone. However, information about the systemic ill effect especially its carcinogenic effect is very low among the general population.

Background: The growing concern for environmental and social issues has led to a focus on designing sustainable supply chains and increasing industrial responsibility towards society. In this paper, a multi-objective mixed-integer programming model is presented for designing a sustainable closed-loop supply chain. The model is aimed at the minimization of the total cost with the total used facilities, the negative environmental impacts, and the maximization of the positive social impacts. Methods: The epsilon-constraint method is utilized for solving the model and further extracting the Pareto solutions. Results: The result of the research clearly shows an optimal trade-off between the conflicting objectives, where, by paying more attention to the social and environmental aspects of sustainability, the total costs are increased or by optimizing the number of facilities, a better balance between the dynamics associated with the short-term and long-term goals is reached. The results of the sensitivity analysis also show that increasing the demand of the supply chain has the greatest impact on the supply chain costs compared to other objectives. Conclusions: Consequently, investigating such comprehensive sustainable objectives provides better insights into the impact of design variables on the expectations of stakeholders.

Background: In India, bidi smoking is prevalent among people of low socioeconomic status as it is cheaper than a cigarette. Aim: The aim of the current study was to analyze the pattern of distribution of oral and oropharyngeal cancer in bidi smokers in the Western Uttar Pradesh population. Materials and Methods: This unicentric cross-sectional study was conducted on patients having an exclusive habit of bidi smoking in the tertiary health care center from March 2019 to February 2022. Five hundred and eighty-five patients diagnosed with oropharyngeal or oral cancer, who were willing to share information related to the bidi smoking habit were enrolled. A Chi-square test and unpaired t-test were used for the statistical analysis. Results: The base of the tongue was found to be the most common site of oral cancer. It was our observation that 61.75% of men had cancer in the oropharynx, and about 34.8% had cancer in the oral cavity. Conclusion: Bidi smoke is dangerous and contains many carcinogenic agents. Bidi smokers have an increased risk of oropharyngeal cancer as compared to oral cancer.

Abstract Introduction Angiotensin Converting Enzyme Inhibitors (ACEI) are a common cause of Emergency Room presentation for angioedema. Although no treatment guidelines exist, C1 esterase inhibitor concentrate (C1-INH) is used on an off label basis for management of ACEI acquired angioedema (ACEI AAE). Objective To evaluate the efficacy of C1-INH in management of ACEI AAE at our local centers. Results Nine patients, from 3 academic sites, were identified through Allergy Service consultation data and records from Diagnostic Services Manitoba, Canada from 2010–2020. The majority of the patients (n = 8/9) required endotracheal intubation prior to the initiation of C1-INH. Overall, approximately 56% of patients (n = 5/9) had resolution of angioedema ranging between 12 and 17 h, with a median time of 13.5 h, and no recurrence after the administration of C1-INH concentrate. One patient had transient symptom resolution in 14 h, however, recurrence of angioedema required re-intubation. The remainder of patients (n = 4/9), had resolution of angioedema between 22 and 72 h, with a median time of 33.75 h. Conclusion Our findings demonstrate continued ambivalence of the efficacy and role of C1-INH concentrate in the treatment of ACEI AAE, secondary to multiple uncontrolled confounding factors. Further research into characterizing a subgroup of intubated patients in our study that responded to C1-INH concentrate needs to be completed.

Aim:Sodium hypochlorite, though considered an ideal root canal irrigant, cannot be used at required concentrations in children, due to its undesirable effects. Hence, it is imperative to search for an ideal root canal irrigant to avoid these undesirable effects which we hope to achieve with this study. The antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of the primary teeth has been compared. Materials and Methods: Sixty patients between 4 and 8 years of age with a single-rooted deciduous tooth indicated for pulpectomy were included. The infected teeth were randomly allocated to one of the three treatment groups based on the irrigating agents used, namely normal saline, green tea extract, or ozonated water. Specimens for anaerobic culture were collected three times from the teeth: before irrigation, after initial irrigation, and on the 3rd day after final irrigation. Results and Conclusion: Mean colony forming unit (CFU) count after both initial and final irrigation with ozonated water was significantly lower when compared with green tea and normal saline. Further, it was observed that the mean CFU count with green tea was significantly lower than the counts obtained with normal saline on the 3rd day after final irrigation. Hence, both ozonated water and green tea could be considered a good alternative to conventional root canal irrigants in the primary teeth. Larger sample sizes with a larger variety of irrigants are recommended.

Abstract Maintenance helps to extend equipment life by improving its condition and avoiding catastrophic failures. Appropriate model or mechanism is, thus, needed to quantify system availability vis-a-vis a given maintenance strategy, which will assist in decision-making for optimal utilization of maintenance resources. This paper deals with semi-Markov process (SMP) modeling for steady state availability analysis of mechanical systems that follow condition-based maintenance (CBM) and evaluation of optimal condition monitoring interval. The developed SMP model is solved using two-stage analytical approach for steady-state availability analysis of the system. Also, CBM interval is decided for maximizing system availability using Genetic Algorithm approach. The main contribution of the paper is in the form of a predictive tool for system availability that will help in deciding the optimum CBM policy. The proposed methodology is demonstrated for a centrifugal pump.