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To compare the alveolar ridge augmentation using either a 1:1 combination of autograft and bovine graft or bovine graft alone and a slow resorbing collagen membrane with simultaneous placement of implants.

Thumb sucking is the process of sucking on the thumb for oral pleasure. Thumb and finger sucking habits, or nonnutritive sucking, are considered to be the most prevalent of oral habits. Some parents are concerned by thumb sucking and may even try to restrain the infant or child. In most cases, this is not necessary. Most children stop thumb sucking on their own. When older children continue to suck their thumbs, it could mean they are bored, anxious, or have emotional problems such as depression. This article presents a case report of a child with Hurler′s syndrome along with thumb sucking/biting habit. Hurler′s syndrome, also known as mucopolysaccharidosis I, is a rare condition inherited as an autosomal-recessive trait. It represents the classical prototype of mucopolysaccharide disorder. A unique appliance to prevent thumb sucking/biting was developed and termed as "RURS′ elbow guard," which was successfully used to break thumb sucking of the child with Hurler syndrome. The present report also describes the steps in fabrication of this new habit-breaking appliance, which is also designed to protect the finger from the effects of the sucking habit.

Pierre Robin sequence (PRS) or anomalad, a well-recognized presentation, is the association of the first brachial arch malformation. It presents with a classic triad of micrognathia, glossoptosis, and cleft palate. In a neonate with a complete cleft palate, problems with feeding are commonly encountered. Presented here are two cases with PRS in whom palatal obturators were constructed.

Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB). It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP) can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP) harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I) in which one unit of whole blood was withdrawn, and PRP group (Group II) where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p

Background: Senior citizens, or individuals over 60 years, constitute 8.6% of India’s population. As a result of shifting family dynamics brought about by growing urbanization and globalization, these elderly populations are flocking to elder care centers. The objectives of this research are to ascertain the elderly’s self-reported chronic morbidities, disabilities, and the relationship between these factors with their quality of life (QOL). Methodologys: This cross-sectional study was conducted among 110 residents of old age homes in Mangalore block of Dakshina Kannada district. The data was collected using a semi-structured questionnaire consist of, Indian Disability Evaluation and assessment Scale and the World Health Organization Quality of life Brief Version (WHOQOL BREF) questionnaire and the data obtained was analyzed using SPSS version 24. Odd’s ratio was calculated, independent T test was used to compare the means across the groups and a ‘p’ value < 0.05 was considered as statistically significant. Results: In the current study 65.5% participants were female (N=72) and most of the study participants reported hypertension and musculoskeletal pain (41.8% & 36.7% respectively) as the major ailment they are seeking health care, followed by diabetes mellitus (20.0%), angina (12.3%), asthma (10.9%), COPD (6.4%) and heart attack (4.5%). There was a statistically significant association between age, male gender, and level of disability with quality of life. Age of the participant was found to be directly proportional to quality of life in 2 domains – psychological and social relationships. Male gender was found to be significantly associated with social relationships domain of quality of life. Conclusion: It was shown that there was no clinically significant correlation between chronic morbidities and any dimension of quality of life, suggesting that the frequency and quality of health examinations delivered in the care homes were sufficient, which must carry on in the subsequent years.

The possibility of arbitrary spatial control of incident wavefronts with the subwavelength resolution has driven research into dielectric optical metasurfaces in the last decade. The unit-cell based metasurface design approach that relies on a library of single element responses is known to result in reduced efficiency attributed to the inadequate accounting of the coupling effects between meta-atoms. Metasurfaces with extended unit-cells containing multiple resonators can improve design outcomes but their design requires extensive numerical computing and optimizations. We report a deep learning based design methodology for the inverse design of extended unit-cell metagratings. In contrast to previous reports, our approach learns the metagrating spectral response across its reflected and transmitted orders. Through systematic exploration, we discover network architectures and training dataset sampling strategies that allow such learning without requiring extensive ground-truth generation. The one-time investment of model creation can then be used to significantly accelerate numerical optimization of multiple functionalities as demonstrated by considering the inverse design of various spectral and polarization dependent splitters and filters. The proposed methodology is not limited to these proof-of-concept demonstrations and can be broadly applied to meta-atom-based nanophotonic system design and in realising the next generation of metasurface functionalities with improved performance.

A novel series of 2-(substituted phenoxy)-N-(1,7,7-trimethylbicyclo[2.2.1]heptan-2-yl)acetamide and N-(2-bromocyclohexyl)-2-(substituted phenoxy)acetamide derivatives having cyclohexyl nucleus as common in both types were synthesized and assessed for their anti-inflammatory activity by a carrageenan induced rat paw oedema method, analgesic activity by Eddy’s hot plate method and antipyretic activity by brewer’s yeast induced pyrexia method. All the novel derivatives have been synthesized by the reaction of camphor and similar ketone having cyclohexane nucleus (e.g. 2-bromocyclohexanone) with ammonium carbonate and formic acid resulting in the formation of aromatic amines (1a-b). These amines on further chloroacetylation with chloroacetylchloride give compounds (2a-b). Compounds (2a-b) are converted to 2-(substituted phenoxy)-N-(1,7,7-trimethylbicyclo[2.2.1]heptan-2-yl) acetamide and N-(2-bromocyclohexyl)-2-(substituted phenoxy)acetamide derivatives on treatment with substituted phenol. Among the series 3a-f, 3i, 3k, 3l compounds showed significant anti-inflammatory activity as compared to the standard drug diclofenac sodium and also compound 3a-f, 3h, 3j, 3k exhibit significant analgesic activity as compared to the standard drug. Compounds 3a-f and 3k showed antipyretic activity nearly to the standard drug indomethacin. Compounds 3a-f and 3k possess anti-inflammatory, analgesic and antipyretic activities near to the standard.

We report a case of a 3-year-old boy who underwent an arterial switch operation with relief of left ventricular outflow tract obstruction and later presented with recurrent episodes of flash pulmonary edema. High-flow humidified oxygen with positive pressure support (Vapotherm) was used as a treatment modality, thereby avoiding intubation and mechanical ventilation.

Nasopalatine duct cyst is an intraossseous developmental cyst of the midline of the anterior palate. Management of a case of nasopalatine duct cyst in a 10 yr old male child is reported.

Abstract Background Recessive mutations of fibroblast growth factor 3 (FGF3) can cause LAMM syndrome (OMIM 610706), characterized by fully penetrant complete labyrinthine aplasia, microtia and microdontia. Methods We performed a prospective molecular genetic and clinical study of families segregating hearing loss linked to FGF3 mutations. Ten affected individuals from three large Pakistani families segregating FGF3 mutations were imaged with CT, MRI, or both to detect inner ear abnormalities. We also modeled the three dimensional structure of FGF3 to better understand the structural consequences of the three missense mutations. Results Two families segregated reported mutations (p.R104X and p.R95W) and one family segregated a novel mutation (p.R132GfsX26) of FGF3. All individuals homozygous for p.R104X or p.R132GfsX26 had fully penetrant features of LAMM syndrome. However, recessive p.R95W mutations were associated with nearly normal looking auricles and variable inner ear structural phenotypes, similar to that reported for a Somali family also segregating p.R95W. This suggests that the mild phenotype is not entirely due to genetic background. Molecular modeling result suggests a less drastic effect of p.R95W on FGF3 function compared with known missense mutations detected in fully penetrant LAMM syndrome. Since we detected significant intrafamilial variability of the inner ear structural phenotype in the family segregating p.R95W, we also sequenced FGF10 as a likely candidate for a modifier. However, we did not find any sequence variation, pointing out that a larger sample size will be needed to map and identify a modifier. We also observed a mild to moderate bilateral conductive hearing loss in three carriers of p.R95W, suggesting either a semi-dominant effect of this mutant allele of FGF3, otitis media, or a consequence of genetic background in these three family members. Conclusions We noted a less prominent dental and external ear phenotype in association with the homozygous p.R95W. Therefore, we conclude that the manifestations of recessive FGF3 mutations range from fully penetrant LAMM syndrome to deafness with residual inner ear structures and, by extension, with minimal syndromic features, an observation with implications for cochlear implantation candidacy.

This paper investigates the significance of combining cepstral features derived from the modified group delay function and from the short-time spectral magnitude like the MFCC. The conventional group delay function fails to capture the resonant structure and the dynamic range of the speech spectrum primarily due to pitch periodicity effects. The group delay function is modified to suppress these spikes and to restore the dynamic range of the speech spectrum. Cepstral features are derived from the modified group delay function, which are called the modified group delay feature (MODGDF). The complementarity and robustness of the MODGDF when compared to the MFCC are also analyzed using spectral reconstruction techniques. Combination of several spectral magnitude-based features and the MODGDF using feature fusion and likelihood combination is described. These features are then used for three speech processing tasks, namely, syllable, speaker, and language recognition. Results indicate that combining MODGDF with MFCC at the feature level gives significant improvements for speech recognition tasks in noise. Combining the MODGDF and the spectral magnitude-based features gives a significant increase in recognition performance of 11% at best, while combining any two features derived from the spectral magnitude does not give any significant improvement.