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Introduction: Stigma among family members of people with mental illness has a serious impact on the disease outcome and lives of people with mental illness. Objectives: To determine the level of perceived stigma among family members of psychiatric patients. Methods: A crosssectional study was designed. Self-stigma of Mental Illness Scale was used. A structured interview was conducted among 50 family members of people with psychiatric problems in psychiatry outpatient and inpatient department of National Medical College Teaching Hospital, Birgunj. Data on sociodemographical characteristics, clinical profile and stigma question were collected. Descriptive statistics was calculated using SPPS 16. Results: The mean stigma score was 42.16 ± 5.10 48% of the respondents perceived high level of stigma. Conclusion: Nearly half of family members of the psychiatric patients perceived high level of stigma. Hence, there is a need for conducting stigma reduction program. [ABSTRACT FROM AUTHOR]

Accelerated partial breast irradiation and lumpectomy cavity boost radiation therapy plans generally use volumetric expansions from the lumpectomy cavity clinical target volume to the planning target volume (PTV) of 1 to 1.5 cm, substantially increasing the volume of irradiated breast tissue. The purpose of this study was to quantify intrafraction lumpectomy cavity motion during external beam radiation therapy to inform the indicated clinical target volume to PTV expansion. Forty-four patients were treated with a whole breast irradiation using traditional linear accelerator-based radiation therapy followed by lumpectomy cavity boost using magnetic resonance (MR)-guided radiation therapy on a prospective registry study. Two-dimensional cine-MR images through the center of the surgical cavity were acquired during each boost treatment to define the treatment position of the lumpectomy cavity. This was compared with the reference position to quantify intrafraction cavity motion. Free-breathing technique was used during treatment. Clinical outcomes including toxicity, cosmesis, and rates of local control were additionally analyzed. The mean maximum displacement per fraction in the anterior-posterior (AP) direction was 1.4 mm. Per frame, AP motion was <5 mm in 92% of frames. The mean maximum displacement per fraction in the superior-inferior (SI) direction was 1.2 mm. Per frame, SI motion was <5 mm in 94% of frames. Composite motion was <5 mm in 89% of frames. Three-year local control was 97%. Eight women (18%) developed acute G2 radiation dermatitis. With a median follow-up of 32.4 months, cosmetic outcomes were excellent (22/44, 50%), good (19/44, 43%), and fair (2/44, 5%). In approximately 90% of analyzed frames, intrafraction displacement of the lumpectomy cavity was <5 mm, with even less motion expected with deep inspiratory breath hold. Our results suggest reduced PTV expansions of 5 mm would be sufficient to account for lumpectomy cavity position, which may accordingly reduce late toxicity and improve cosmetic outcomes. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate the longitudinal changes in electromyographic (EMG) activity of the masseter and temporalis muscles before and after temporomandibular joint (TMJ) total joint replacement (TJR) in ankylosis patients. A prospective longitudinal study was designed on patients undergoing unilateral or bilateral TMJ-TJR. EMG activity at rest and maximal voluntary contraction (MVC) was recorded for the muscles preoperatively (T0), and at one-week (T1) and six-month (T2) follow up. The study sample was composed of 10 (male: female 2.3:1) patients undergoing TMJ-TJR. The number of unilateral and bilateral cases was three and seven, respectively. In both unilateral and bilateral cases a statistically significant reduction in EMG activity of the masseter and anterior temporalis muscles was observed at T1. At T2, EMG activity of the muscles was found to be approaching the preoperative value. In unilateral cases, when the affected side at T0, T1, and T2 was compared with T0 for the unaffected side, statistically significant differences were seen for the masseter. In the case of the temporalis, similar results were seen except at T2 for the postural rest position. The results indicate that re-attachment of the masseter and temporalis muscles occurs progressively post TMJ-TJR. [ABSTRACT FROM AUTHOR]

• A scintillator detector was evaluated for small field dosimetry in MR-linacs. • Scintillator and MC OFs were within 2 % and k Q clin , Q msr f clin , f msr was <1 % • Large differences in OFs up to 8% were found for the smaller field sizes. • Small-field OFs were found to be sensitive to focal spot size and beam quality. Although plastic scintillator detectors (PSDs) are considered ideal dosimeters for small field dosimetry in conventional linear accelerators (linacs), the impact of the magnetic field strength on the response of the PSD must be investigated. A linac Monte Carlo (MC) head model for a low-field MR-linac was validated for small field dosimetry and utilized to calculate field output factors (OFs). The MC-calculated OFs were compared with the treatment planning system (TPS)-calculated OFs and measured OFs using a Blue Physics (BP) Model 10 commercial PSD and a synthetic diamond detector. The field-specific correction factors, k Q clin , Q msr f clin , f msr , were calculated for the PSD in the presence of a 0.35 T and magnetic field. The impact of the source focal spot size and initial electron energy on the MC-calculated OFs was investigated. Good agreement to within 2 % was found between the MC-calculated OFs and BP PSD OFs except for the 0.415 × 0.415 cm2 field size. The BP PSD k Q clin , Q msr f clin , f msr correction factors were calculated to be within 1 % of unity. For field sizes ≥1.66 × 1.66 cm2, the MC-calculated OFs were relatively insensitive to the focal spot size and initial electron energy to within 2.5 %. However, for smaller field sizes, the MC-calculated OFs were found to differ up to 9.50 % and 7.00 % when the focal spot size and initial electron energy was varied, respectively. The BP PSD was deemed suitable for small field dosimetry in MR-linacs without requiring any k Q clin , Q msr f clin , f msr correction factors. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate whether the rigid fixation at one site and functional fixation at other site is enough in double mandibular fractures (DMF). The specific aim of the study was assessment of masticatory function on the basis of bite force and other clinical parameters. A prospective, randomized controlled trial was conducted on patients having DMF. The patients were randomized into 3 groups. Group-1, managed with 2-miniplates at anterior and 1-miniplate at posterior site, group-2 patients managed with one 2.4 mm reconstruction plate at anterior and 1-miniplate at posterior site and in group-3, both fractures were managed with 1-reconstruction plate. Primary outcome variable was bite force. Secondary outcome variables were type of fracture, pain, swelling, mobility between fracture segments, occlusal discrepancy, paresthesia, implant exposure/fracture. The study sample included 60 (20 in each group) patients with mean age of 29.28 ± 12.35 years. Statistically significant difference was seen in bite force from preoperative to follow-up (p = 0.0) in all the groups. Difference in bite force was statistically significant between group 1 and 2 (p = 0.0) and group 1 and 3 (p = 0.0) at follow-up but the difference was statistically insignificant between group 2 and 3. The present study concludes that treatment of DMF with rigid fixation at one site and functional fixation at other fracture site provides enough fixation. [Display omitted] [ABSTRACT FROM AUTHOR]

• High-Z inhomogeneities are more prevalent in older patients and dosimetry is uncertain. • This study compares dose calculation algorithms from various treatment planning systems. • It compares with dose calculation and measurements in a real hip prosthesis. • Provides guidelines for dosimetry. A multi-institutional investigation for dosimetric evaluation of high-Z hip prosthetic device in photon beam. A bilateral hip prosthetic case was chosen. An in-house phantom was built to replicate the human pelvis with two different prostheses. Dosimetric parameters: dose to the target and organs at risk (OARs) were compared for the clinical case generated by various treatment planning system (TPS) with varied algorithms. Single beam plans with different TPS for phantom using 6 MV and 15 MV photon beams with and without density correction were compared with measurement. Wide variations in target and OAR dosimetry were recorded for different TPS. For clinical case ideal PTV coverage was noted for plans generated with Corvus and Prowess TPS only. However, none of the TPS were able to meet plan objective for the bladder. Good correlation was noticed for the measured and the Pinnacle TPS for corrected dose calculation at the interfaces as well as the dose ratio in elsewhere. On comparing measured and calculated dose, the difference across the TPS varied from −20% to 60% for 6 MV and 3% to 50% for the 15 MV, respectively. Most TPS do not provide accurate dosimetry with high-Z prosthesis. It is important to check the TPS under extreme conditions of beams passing through the high-Z region. Metal artifact reduction algorithms may reduce the difference between the measured and calculated dose but still significant differences exist. Further studies are required to validate the calculational accuracy. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) provides excellent soft-tissue contrast, which makes it useful for delineating tumor and normal structures in radiation therapy planning, but MRI cannot readily provide electron density for dose calculation. Computed tomography (CT) is used but introduces registration uncertainty between MRI and CT. Previous studies have shown that synthetic CTs (sCTs) can be generated directly from MRI images with deep learning methods. However, mainly high-field MRI images have been validated. This study tested whether acceptable sCTs for MR-only radiation therapy planning can be synthesized using an integrated MR-guided linear accelerator at 0.35T, using MRI images and treatment plans in the liver region. Two models were investigated in this study: a convolutional neural network (Unet) with conventional mean square error (MSE) loss and a Unet using a secondary convolutional neural network for perceptual loss. A total of 37 cases were used in this study with 10-fold cross validation, and 37 treatment plans were generated and evaluated for target coverage and dose to organs at risk (OARs) in the MSE loss model, perceptual loss model, and original CT. The sCTs predicted by the perceptual loss model had improved subjective visual quality compared with those predicted by the MSE loss model, but both were similar in mean absolute error (MAE), peak-signal-to-noise ratio (PSNR), and normalized cross-correlation (NCC). The MAE, PSNR, and NCC for the perceptual loss model were 35.64, 24.11, and 0.9539, respectively, and those for the MSE loss model were 35.67, 24.36, and 0.9566, respectively. No significant differences in target coverage and dose to OARs were found between the sCT predicted by the perceptual loss model or by the MSE model and the original CT image. This study indicated that a Unet with both MSE loss and perceptual loss models can be used for generating sCT images from a 0.35T integrated MR linear accelerator. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to compare the efficacy of dexmedetomidine (DEX) and clonidine (CLON) infusion to produce hypotensive anesthesia in patients undergoing orthognathic surgery.Material and Methods: The investigators designed a randomized controlled trial on patients undergoing orthognathic surgery. Patients were randomized into 2 groups (DEX and CLON group). The DEX group patients received loading dose of 1 ug/kg DEX over 10 minutes followed by 0.2 to 0.5 ug/kg/hour as maintenance dose. Similarly, CLON group patients received 3 ug/kg loading dose followed by maintenance dose of 0.3 to 2 ug/kg/hour. Primary objectives were to compare the quality of surgical field, duration of surgery, amount of blood loss and secondary objectives were to compare total and rescue analgesia used, need for blood transfusion and associated adverse effects. The P value of <.05 was taken significant at confidence interval of 95%.Results: The study sample included 30 patients (15 in each group), (m:f = 1:1.1) requiring orthognathic surgery. Single jaw cases were 11 (DEX:CLON = 4:7) and bijaw cases were 19 (DEX:CLON = 11:8) in number. There was statistically insignificant difference in quality of surgical field between 2 groups (P = .15). Duration of surgery was 293.33 ± 58.75 and 247 ± 70.45 minutes in the DEX and the CLON group, respectively (P = .06). Blood loss was more in the DEX group (316.61 ± 147.19 mL) than the CLON group (263.33 ± 112.54 mL), (P = .71). Total drug used (P = .33) and rescue analgesia (P = .25) was less in the DEX group. Adverse effects were more in the CLON than the DEX group.Conclusion: The results of the present study showed no significant difference between the 2 groups for any parameter. It can be concluded that both dexmedetomidine and clonidine are effective and safe in achieving controlled hypotension and safe operative field visibility. [ABSTRACT FROM AUTHOR]

Purpose: It is not known if the muscle matrix that becomes functional after gap arthroplasty (GA) in temporomandibular joint ankylosis (TMJA), induces growth of the mandible or the reconstructive arthroplasty with costochondral graft (CCG) is responsible for growth. The study aimed to evaluate the mandibular growth and functional outcome with the use of CCG/GA in the management of pediatric TMJA.Methods: The investigators designed a cluster randomized controlled trial on pediatric (3 to 16 years) TMJA patients. Treatment applied (CCG and GA), was the primary predictor variable. Patients were divided into CCG and GA groups. The primary outcome variable was growth. Secondary outcome variables included etiology and duration of ankylosis, maximal incisal opening (MIO), reankylosis, occlusion, laterotrusion, chin deviation, facial asymmetry, occlusal tilt, and complications. The distance condylion (Co) to gnathion (Gn) was used to measure mandibular length. Ramal height was measured from Co- gonion (Go). Lower facial height was measured from the anterior nasal spine to Gn. Generalized estimating equations were used to calculate the regression coefficient adjusted for the cluster. The patient was considered as a cluster and the unit of analysis was joint.Results: Fifty-six {n = 28 in each group, (n = 33 joint in the CCG group and n = 31 joints in GA group)} patients were analyzed. The median follow-up was 33-months (31.93 ± 15.24) in the CCG group and 32-months (32.85 ± 17.84) in the GA group. Intergroup comparison between the CCG and GA group showed a statistically significant difference in mandibular length (CCG = 77.51 ± 9.31 and GA = 66.66 ± 8.32 mm, P < .001), ramal height (CCG = 44.21 ± 7.3 and GA = 31.87 ± 8.4 mm, P < .001), and statistically insignificant difference in lower facial height (CCG = 52.53 ± 6.1 and GA = 50.19 ± 6.3 mm, P = 0.14) at follow-up. Statistically, significant improvement was seen in MIO in both groups (<.001).Conclusions: The results of the present study concluded that growth and jaw functions were better in reconstructive arthroplasty with CCG than GA in pediatric TMJA. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine mean intercanine arch width & mean intermolar arch width in Angle's class I, Class II division I, Class II Division 2 and Class III malocclusion patients. Materials and Methods: Pre-treatment maxillary and mandibular dental casts of 104 Nepali adult patients were used for this study. Maxillary and mandibular intercanine arch width and intermolar arch width were measured with digital caliper. Descriptive statistics was used to measure mean, minimum, maximum, standard deviations and ranges of maxillary and mandibular intercanine and intermolar arch width. P value < 0.05 was considered significant. Results: Mean intercanine arch width in mandible in class I was 26.72 ± 1.57 mm, Class II division I 26.91 ± 2.77 mm, class II division 2 27.39 ± 2.07 mm and class III 28.31 ± 1.65 mm while mean intercanine arch width in maxilla in class I was 35.11 ± 1.51 mm, Class II division I 32.86 ± 3.29 mm, class II division 2 34.33 ± 2.66 mm and class III 34.73 ± 2.32 mm. Mean intermolar arch width in mandible in class I was 51.3 ± 2.83 mm, Class II division I 50.23 ± 1.80 mm, class II division 2 50.33 ± 4.01 mm and class III 53.94 ± 3.95 mm while mean intermolar arch width in maxilla in class I was 53.52 ± 2.97 mm, Class II division I 50.87 ± 2.21 mm, class II division 2 52.07 ± 3.67 mm and class III 55.20 ± 3.50 mm. Conclusion: Class II division I malocclusion showed narrow maxillary arch width while Class III malocclusion showed wider mandibular arch width. Males showed wider intercanine and intermolar arch width in all the Angle's Classes of malocclusion. [ABSTRACT FROM AUTHOR]

COVID 19 has hardly left any part of the world untouched. Two hundred thirteen countries have been affected by this disease, with 17,208,324 cases and 670,626 deaths as of July 30, 2020. If we look at the death toll caused by Malaria, this year, it is closely nearing COVID 19 deaths, 5, 68,700 deaths. Malaria mostly occurs in poor, tropical, and subtropical regions across the globe. In 2018, Malaria was most rampant in Africa, followed by Southeast Asian Regions (SEAR). SEAR is at the greatest risk of both COVID 19 and malaria. Strategies for essential commodities and antimalarial activities are affected by COVID 19 when the rainy season registers the maximum malaria load. We searched the literature to explore the evidence regarding efficacious antimalarial activities and the gap created by the COVID 19 pandemic, responsible barriers, and challenges, with the possible approaches towards accomplishing a target for malaria control. [ABSTRACT FROM AUTHOR]

Background: This review represents many significant methods of chemometrics applied as data assessment methods originated by many hyphenated analytical techniques containing their application since its origin to today. The study has been divided into many parts, which contain many multivariate regression methods. The main aim of this study is to investigate the chemometrics tools used in GSR (gunshot residue) or forensic ballistics. Short conclusion: As a final point, the end of part of this review deals with the applicability of chemometric methods in forensic ballistics. We select to give an elaborate description of many significant tools established with their algorithm in admire of utilizing and accepting them by researchers not very aware with chemometrics. [ABSTRACT FROM AUTHOR]

Both autogenous and alloplastic material have been used in management of temporomandibular joint (TMJ) ankylosis. Second surgical site, donor site morbidity, possibility of over/undergrowth, graft fracture or resorption and increased surgical time are the disadvantages of autogenous graft. Alloplastic total joint replacement (TJR) has become a promising technique in management of adult temporomandibular joint ankylosis (TMJA). This paper intends to present the role of alloplastic TJR in management of TMJA. There is significant current evidence of the role of alloplastic TJR in the management of TMJA. Results in TMJA are excellent with sustained improvement in pain free mouth opening, correction of facial asymmetry, reduction in recurrence and improved quality of life. TMJ TJR is becoming the gold standard of care in the management of TMJA, although costs can sometime preclude access to this mode of therapy. [ABSTRACT FROM AUTHOR]

• Technological innovation in Radiotherapy led to Magnetic Resonance guided RT systems. • Artificial Intelligence can play a significant role in MR guided RT. • Many manual procedures can be automatized and standardized thanks to AI. • Medical Physicists are expected to be major actors in AI clinical implementation. • The current status of AI integration in MRgRT will be presented and discussed. Over the last years, technological innovation in Radiotherapy (RT) led to the introduction of Magnetic Resonance-guided RT (MRgRT) systems. Due to the higher soft tissue contrast compared to on-board CT-based systems, MRgRT is expected to significantly improve the treatment in many situations. MRgRT systems may extend the management of inter- and intra-fraction anatomical changes, offering the possibility of online adaptation of the dose distribution according to daily patient anatomy and to directly monitor tumor motion during treatment delivery by means of a continuous cine MR acquisition. Online adaptive treatments require a multidisciplinary and well-trained team, able to perform a series of operations in a safe, precise and fast manner while the patient is waiting on the treatment couch. Artificial Intelligence (AI) is expected to rapidly contribute to MRgRT, primarily by safely and efficiently automatising the various manual operations characterizing online adaptive treatments. Furthermore, AI is finding relevant applications in MRgRT in the fields of image segmentation, synthetic CT reconstruction, automatic (on-line) planning and the development of predictive models based on daily MRI. This review provides a comprehensive overview of the current AI integration in MRgRT from a medical physicist's perspective. Medical physicists are expected to be major actors in solving new tasks and in taking new responsibilities: their traditional role of guardians of the new technology implementation will change with increasing emphasis on the managing of AI tools, processes and advanced systems for imaging and data analysis, gradually replacing many repetitive manual tasks. [ABSTRACT FROM AUTHOR]

• Beam quality correction factors for the 0.35 T MR-linac were calculated using Monte Carlo simulations. • The angular, energy, and magnetic field dependence of k Q msr B , f msr correction factors was investigated. • Beam quality dependence of up to 2.17% and magnetic field dependence of up to 5.40% was found. • A parallel alignment of the ion chamber with respect to the magnetic field led to minimal magnetic field dependence. The purpose of this study was to directly calculate k Q msr B , f msr correction factors for four cylindrical ICs for a 0.35 T MR-linac using the Monte Carlo (MC) method. A previously-validated TOPAS/GEANT4 MC head model of the 0.35 T MR-linac was employed. The MR-compatible Exradin A12, A1SL, A26, and A28 cylindrical ICs were modeled considering the dead volume in the air cavity. The k Q msr B , f msr correction factor was determined for initial electron energies of 5–7 MeV. The correction factor was calculated for all four angular orientations in the lateral plane. The impact of the 0.35 T magnetic field on the IC response was also investigated. The maximum beam quality dependence in the k Q msr B , f msr exhibited by the A12, A1SL, A26, and A28 ICs was 1.10 %, 2.17 %, 0.81 %, and 1.75 %, respectively, considering all angular orientations. The magnetic field dependence was < 1 % and the maximum k Q msr B , f msr correction was < 2 % when the detector was aligned along the direction of the magnetic field at 0° and 180° angles. The A12 IC over-responded up to 5.40 % for the orthogonal orientation. An asymmetry in the response of up to 8.30 % was noted for the A28 IC aligned at 90° and 270° angles. A parallel orientation for the IC, with respect to the magnetic field, is recommended for reference dosimetry in MRgRT. Both over and under-response in the IC signal was noted for the orthogonal orientations, which is highly dependent on the cavity diameter, cavity length, and the dead volume. [ABSTRACT FROM AUTHOR]

• Two radiomic features were identified as response predictors in rectal cancer. • This study aims to validate such features on an external larger dataset. • The analysis was performed considering clinical and pathological complete response. • The variation of length least showed good performance in predicting both outcomes. • Grey Level non uniformity reported limited performance as predictor. A recent study performed on 16 locally advanced rectal cancer (LARC) patients treated using magnetic resonance guided radiotherapy (MRgRT) has identified two delta radiomics features as predictors of clinical complete response (cCR) after neoadjuvant radio-chemotherapy (nCRT). This study aims to validate these features (ΔL least and Δglnu) on an external larger dataset, expanding the analysis also for pathological complete response (pCR) prediction. A total of 43 LARC patients were enrolled: Gross Tumour Volume (GTV) was delineated on T2/T1* MR images acquired during MRgRT and the two delta features were calculated. Receiver Operating Characteristic (ROC) curve analysis was performed on the 16 cases of the original study and the best cut-off value was identified. The performance of ΔL least and Δglnu was evaluated at the best cut-off value. On the original dataset of 16 patients, ΔL least reported an AUC of 0.81 for cCR and 0.93 for pCR, while Δglnu 0.72 and 0.54 respectively. The best cut-off values of ΔL least was 0.73 for both outcomes, while Δglnu reported 0.54 for cCR and 0.93 for pCR. At the external validation, ΔL least showed an accuracy of 81% for cCR and 79% for pCR, while Δglnu reported 63% for cCR and 40% for pCR. The accuracy of ΔL least in predicting cCR and pCR is significantly higher than those obtained considering Δglnu, but inferior if compared with other image-based biomarker, such as the early-regression index. Studies with larger cohorts of patients are recommended to further investigate the role of delta radiomic features in MRgRT. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the outcome and complications of open reduction and internal fixation (ORIF) with closed treatment, as well as to review the literature. This was a retrospective study on pediatric patients with mandible fracture. The primary objective was a comparison of outcomes in terms of bone healing, maximal incisal opening (MIO), and occlusion, and the secondary objective was to review complications. A total of 77 pediatric patients (age <12 years) were managed with closed treatment and 23 with ORIF. In all, 62 patients were found with a single fracture (22 patients with parasymphysis fracture and 21 with condyle fracture, followed by symphysis, angle, and body fracture) and 38 patients with more than one fracture, with symphysis and bilateral condyle fracture being the most common. Bone healing was observed in all the patients. Mean MIO was 26.9 ± 2.8 mm and 29.3 ± 1.7 mm in the closed and ORIF group, respectively, and the difference was statistically nonsignificant (p = 0.5). One patient (1.3%) had deranged occlusion, and mobility was observed in one patient (1.3%) in the closed treatment group. Infection and nerve paresthesia were not seen in any patient at follow-up. Although closed treatment is preferred, as it preserves the soft tissue and periosteum, a displaced mandible fracture especially with co-existing condylar fracture should be treated by ORIF. [ABSTRACT FROM AUTHOR]

The article discusses radiation therapy, with surgery and chemotherapy, has used to treat various cancers. Topics include the MRIdian Linac consists of a 6-mV flattening filter-free linear accelerator fit between a 0.35 T splitbore magnet; and the system has acquired scans in 17 or 25 seconds using the true fast imaging with steady-state free-precession imaging sequence.

Background: Cytomegalovirus is an important viral pathogen causing infection in immunodeficient patient especially in solid organ transplant like renal transplant. This study aims to evaluate the prevalence and clinical impact of CMV infection in renal transplant patients in a tertiary care hospital in Northern India. Materials and Methods: 145 renal transplant patients were tested for cytomegalovirus DNA by polymerase chain reaction (PCR) and for presence of IgM and IgG antibody against cytomegalovirus by ELISA. PCR amplified product were detected by Agarose gel electrophoresis. Results: Out of 145 transplant patients CMV Viremia was detected by PCR in 16(11.0%) patients. Two patients died in the study period in which one patient had HBV and other had HCV infection. IgM antibody against CMV was detected in one out of 145 donors while IgG anti-CMV antibody was detected in all 145 donors and recipients by ELISA. Two out of 145 transplant recipients had positive CMV PCR in pre-transplant period, and both had positive CMV PCR in post-transplant period. Out of sixteen positive patients histopathology changes of CMV disease was found in 2 patients (12.5%). Conclusion: Cytomegalovirus disease is major cause of morbidity and mortality in renal transplant patients. PCR to detect specific CMV genome sequences is important tool for early diagnosis and specific anti viral therapy. In our study out of 145 transplant patients, CMV Viremia was detected by PCR in 16 patients (11.0%). Two patients in the study period died, in which one patient had HBV and other had HCV infection, remaining patients survived with varying range of serum creatinine levels. Diagnostic histological changes of CMV is seen only in minority of cases(12.5%) who are positive by PCR for CMV. [ABSTRACT FROM AUTHOR]

Purpose: Adult temporomandibular joint ankylosis (TMJA) lacks a uniform management protocol. The purpose of the study was to evaluate the outcome of stock total joint replacement (TJR) along with fat grafting around the joint in adult TMJA patients. Specific aim was to find out whether TJR can be a definitive management for adult TMJA.Methods: The investigators implemented a prospective study on adult TMJA patients treated with ostearthrectomy of ankylosis and stock temporomandibular joint (TMJ) TJR with fat grafting. Concomitant orthognathic correction of facial asymmetry was performed in some unilateral cases. Follow-up was carried out at regular intervals for assessing primary outcome variable of maximal incisal opening (MIO) and reankylosis. Secondary outcome variable included demographic data, etiology, duration of ankylosis (DOA), correlation between DOA and preoperative and postoperative MIO, occlusion and complications of hemorrhage, facial nerve paresis, periprosthetic joint infection, dislocation, and implant failure.Results: The study sample was composed of 41 patients (54 joints) (bilateral, n = 13; unilateral, n = 28 [right side, n = 12; left side, n = 16]). The number of recurrent cases was 15. Trauma as etiology of ankylosis was seen in n = 30 (73.2%), infection in n = 7 (17.1%), unknown in n = 3 (7.3%), and ankylosing spondylitis in n = 1 (2.4%) cases. Mean DOA was 11.95 years. Paired t test revealed a statistically significant difference between preoperative and follow-up MIO (P < .001). None of the cases showed reankylosis in the follow-up period. Pearson correlation revealed statistically negative correlation between DOA and postoperative MIO.Conclusions: The result of this study suggests that stock TMJ TJR along with fat grafting around the joints provides adequate mouth opening without any sign and symptoms of reankylosis. Stock TMJ TJR with fat grafting can be considered as a definitive treatment modality in adult TMJA with minimum comorbidity. [ABSTRACT FROM AUTHOR]

The article offers information on the recent developments in radiation therapy, along with information on the role of radiation therapy to treat malignancies with a large radiation field. It discusses the development of hematologic stem cell transplantation procedures. It mentions the advantages and disadvantages of the radiation therapy.

Agricultural productivity is constantly being forced to maintain yield stability to feed the enormously growing world population. However, shrinking arable and nutrient-deprived soil and abiotic and biotic stressor (s) in different magnitudes put additional challenges to achieving global food security. Though well-defined, the concept of macro, micronutrients, and beneficial elements is from a plant nutritional perspective. Among various micronutrients, selenium (Se) is essential in small amounts for the life cycle of organisms, including crops. Selenium has the potential to improve soil health, leading to the improvement of productivity and crop quality. However, Se possesses an immense encouraging phenomenon when supplied within the threshold limit, also having wide variations. The supplementation of Se has exhibited promising outcomes in lessening biotic and abiotic stress in various crops. Besides, bulk form, nano-Se, and biogenic-Se also revealed some merits and limitations. Literature suggests that the possibilities of biogenic-Se in stress alleviation and fortifying foods are encouraging. In this article, apart from adopting a combination of a conventional extensive review of the literature and bibliometric analysis, the authors have assessed the journey of Se in the " soil to spoon " perspective in a diverse agroecosystem to highlight the research gap area. There is no doubt that the time has come to seriously consider the tag of beneficial elements associated with Se, especially in the drastic global climate change era. • Three types of selenium (Se) (bulk, nano and biogenic) have been considered in the review. • Selenium has exhibited a dual role in crops, based on dose, and species in agroecosystem. • The efficacy of Se in stress mitigation and biofortification has been discussed in the review. • Enrichment of plants with Se as a means of micronutrient can be useful for hidden hunger. • Machine-based Se analysis as a mean of useful tool has been highlighted in the study. [ABSTRACT FROM AUTHOR]

The use of costochondral graft is controversial for pediatric temporomandibular joint reconstruction due to its unpredictable growth. The height of the cartilage is directly responsible for the growth capacity of costochondral graft. Even after keeping the cartilage in costochondral graft to a recommended height, overgrowth has been reported. Traditionally during costochondral graft fixation, chin deviation is corrected intraoperatively. The investigators hypothesized that this intraoperative manipulation of mandible to correct chin deviation and maintaining the chin in new position causes excessive stress and strain in the muscular functional matrix. The authors believe that this may be the reason for excessive growth trigger on the grafted side. This study intends to prove the hypothesis of no-intraoperative correction of chin deviation can prevent overgrowth of the costochondral graft. We implied this technique in pediatric temporomandibular joint ankylosis patients managed with osteoarthrectomy and reconstructed with costochondral graft. Patients with at least a follow-up of 30-months were included in the study. The study sample consisted of 20 patients. All the patients had adequate growth with improvement in facial asymmetry. The results of the present study supports our hypothesis of no-intraoperative correction of chin deviation as a technique to prevent overgrowth of costochondral graft. We recommend this technique to allow catch-up of growth rather than acceleration of growth. This change in technique needs more research, randomized controlled trial for reliability and long-term results. [Display omitted] [ABSTRACT FROM AUTHOR]

Alloplastic replacement of temporomandibular joint is the preferred treatment for temporomandibular joint ankylosis (TMJA) in ankylosing spondylitis (AS) patients. These patients exhibit neck rigidity due to fixed flexion deformity or fusion of vertebrae that make the intubation and surgical positioning of patients difficult and challenging. Chin on the chest makes tracheostomy almost impossible. Fiberoptic-assisted intubation is recommended. It is mandatory that no neck flexion or rotation is performed during intubation or surgical positioning. The use of an operating table that permits lateral tilt is recommended for surgical positioning. 15-20-degrees tilt of table or a lateral positioning of the patient, can provide sufficient neck support and reduce the chances of lateral neck rotation or neck flexion. Improper positioning may result in readjusting the patient's neck repeatedly during operative procedure. This may cause serious neurological injury. Minimal documentation exists for proper and secure positioning of the patient for bilateral alloplastic joint replacement in AS patients. The authors present a case of bilateral TMJA in AS patient who was managed successfully by awake fiberoptic intubation and lateral positioning for alloplastic total joint replacement (TJR). [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract Multi-wall carbon nanotubes (MWCNTs) and Polycarbonate/Multi-wall carbon nanotubes nanocomposite were prepared by chemical vapor deposition (CVD) and twin-screw compounding extruder method, respectively. The morphology and dispersion were characterized by Scanning Electron Microscopy. The Raman analysis confirmed good interaction between multi-wall carbon nanotubes and polycarbonate. The dielectric impedance spectroscopy of polycarbonate/multi-wall carbon nanotubes nanocomposite varying from 0.25 to 1.5 weight percentages has been carried out in the frequency range of 1.0 Hz–1.0 MHz. One dielectric relaxation mode is observed in pristine polycarbonate at low frequency region (∼10 Hz), whereas polycarbonate loaded with multi-wall carbon nanotubes induced one more dielectric relaxation in kHz region (∼10 kHz). The percolation threshold of the polycarbonate/multi-wall carbon nanotubes composites was observed at 0.75 wt.% of MWCNTs. [ABSTRACT FROM AUTHOR]