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BACKGROUND Fibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla. CASE SUMMARY A 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion. CONCLUSION The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.

The objective of this study was to describe the authors' long-term experience with the management of odontogenic keratocysts (OKCs). All OKC cases treated at the study centre between 1999 and 2015, with a minimum of 5 years of follow-up by December 2019, were reviewed retrospectively. Operative procedures including decompression/marsupialization, enucleation (E), E+Carnoy's solution (CS), E+CS+peripheral ostectomy (PO), and resection were assessed for complete resolution, partial resolution, and recurrence rates. In the parakeratinized non-syndromic group, E+CS+PO resulted in the lowest recurrence rate among the minimally invasive procedures (4.3%), while enucleation resulted in the highest rate (60%). Regarding the other modalities, recurrence was 12.5% for decompression, 11.5% for marsupialization, 16.7% for E+CS, 26.7% for E+PO, and 0% for resection. In the syndromic group, marsupialization resulted in a significantly higher recurrence (23.1%), while E+CS+PO cases showed no recurrence. No recurrence was observed in the orthokeratinized group patients treated with marsupialization or with E+CS. Based on clinico-radiographic features and observed results, it is concluded that OKC, although having a high recurrence rate, is a benign lesion and responds well to conservative procedures in most cases. Radical procedures should be reserved for unresponsive lesions and those with extensive tissue destruction.

The purpose of this trial was to study the effect on pain and mouth opening of intramuscular injection of botulinum toxin-A into masticatory muscles following surgical intervention in oral submucous fibrosis (OSMF) cases. Injections of either botulinum toxin A (BTX-A) (study group) or normal saline (control group) were given 2 weeks prior to surgical intervention in OSMF patients, into the bilateral masseter and temporalis muscles. All patients were evaluated for pain and ease of active physiotherapy at 1 week and 1, 3, and 6 months after surgery using a numerical rating scale and appropriate questionnaires, with comparisons made between the study and control group patients. Electromyographic studies of the masticator muscles were also carried out in all patients before injection, and at 1 month and 6 months after injection. 20 OSMF patients were equally divided into study and control groups (n = 10 each). At 1, 3, and 6 months after surgery, the study group patients showed significantly greater decreases in pain (p-values of 0.007, 0.001, and 0.005, respectively) and greater ease in physiotherapy compared with the control group. EMG recordings of masticator muscles showed a transient drop in microvolt value in the study group 1 month after injection, unlike the control group recordings. It was concluded that preoperative BTX-A injection was a good addition to surgical therapy in the patient group.

A systematic review was performed to assess the clinical outcomes of the reconstructive methods using autogenous grafts for the management of temporomandibular joint (TMJ) ankylosis A comprehensive electronic and manual search of the literature without date or language restriction was performed in January 2021 to identify randomized controlled trials, prospective, and retrospective studies with the aim of comparing the various surgical modalities for TMJ ankylosis. Twenty-six publications were included: prospective (n ​= ​17), retrospective (n ​= ​7), randomised control trial (n ​= ​1) and ambispective study (n ​= ​1). Costochondral graft was the most common graft used followed by Coronoid process graft. Meta-analysis was not possible as most of studies were non-controlled in nature. Based on the available data, there was a strong evidence that autogenous grafts especially Costochondral grafts and coronoid grafts have remained one of the most favoured methods of reconstruction. Prospective and randomized control studies are recommended for the best stratification for the use of autogenous grafts for the management of TMJ ankylosis.

Aggressive or Desmoid fibromatosis (AF) is a benign fibrous soft tissue tumor that consists of dense masses of fibroblasts and myofibroblasts with marked collagen production. The lesions are considered to be aggressive and non-metastasizing but invade locally and recur frequently after surgical excision. Although the head and neck are not an unusual site of involvement, very few cases of fibromatosis of the cheek are reported till date. We report a case of fibromatosis of cheek in an adult female that was managed successfully by surgical intervention and to discuss the review of literature on this subject.

Purpose This paper aims to discuss the successful fabrication of customized tubular scaffolds for tracheal tissue engineering with a novel route using solvent-based extrusion 3D printing. Design/methodology/approach The manufacturing approach involved extrusion of polymeric ink over a rotating predefined pattern to construct customized tubular structure of polycaprolactone (PCL) and polyurethane (PU). Dimensional deviation in thickness of scaffolds were calculated for various layer thicknesses of 3D printing. Physical and chemical properties of scaffolds were investigated by scanning electron microscope (SEM), contact angle measurement, Fourier Transform Infrared Spectroscopy (FTIR) and X-ray diffraction (XRD). Mechanical characterizations were performed, and the results were compared to the reported properties of human native trachea from previous reports. Additionally, in vitro cytotoxicity of the fabricated scaffolds was studied in terms of cell proliferation, cell adhesion and hemagglutination assay. Findings The developed fabrication route was flexible and accurate by printing customized tubular scaffolds of various scales. Physiochemical results showed good miscibility of PCL/PU blend, and decrease in crystalline nature of blend with the addition of PU. Preliminary mechanical assessments illustrated comparable mechanical properties with the native human trachea. Longitudinal compression test reported outstanding strength and flexibility to maintain an unobstructed lumen, necessary for the patency. Furthermore, the scaffolds were found to be biocompatible to promote cell adhesion and proliferation from the in vitro cytotoxicity results. Practical implications The attempt can potentially meet the demand for flexible tubular scaffolds that ease the concerns such as availability of suitable organ donors. Originality/value 3D printing over accurate predefined templates to fabricate customized grafts gives novelty to the present method. Various customized scaffolds were compared with conventional cylindrical scaffold in terms of flexibility.

Purpose To study the outcomes of cultivated oral mucosal epithelial transplantation (COMET) in eyes with chronic Stevens-Johnson syndrome (SJS) sequelae. Design Prospective interventional case series. Methods Forty-five eyes of 41 patients with chronic SJS sequelae were recruited and evaluated from 2013 to 2017 in an institutional setting. All patients underwent COMET, with an aim of fornix reconstruction and visual rehabilitation. Change in corrected distance visual acuity (CDVA), severity scores of various ocular surface parameters, and the occurrence of complications were documented during a follow up period of 2 years. Attainment and maintenance of a stable ocular surface, as assessed by change in the ocular surface severity scores was the primary outcome measure, while change in CDVA was the secondary outcome measure. Results The mean preoperative CDVA was 2.7± 0.5 logMAR, which improved to 1.5± 0.7 logMAR and 1.49± 0.98 postoperatively, at 1- and 2-year follow-up visit. Overall, 82.2% eyes (37/45) had improvement in visual acuity, 13.3% (6/45) experienced no change, whereas 2 eyes (4.4%) had worsening of visual acuity. The total ocular surface severity scores improved from a mean preoperative value of 29.1± 9.7 to 18.7± 7.2 postoperatively, at 2-year follow-up. Two eyes developed persistent epithelial defects, with progression to corneal melting requiring keratoplasty. Conclusions COMET allows successful and sustained restoration of ocular surface anatomy with functional improvement, in eyes with chronic sequelae of SJS.

Purpose To evaluate safety and efficacy of angiogenesis induced by intraarterial autologous bone marrow–derived stem cell (BMSC) injection in patients with severe peripheral arterial disease (PAD). Materials and Methods Eighty-one patients with severe PAD (77 men), including 56 with critical limb ischemia (CLI) and 25 with severe claudication, were randomized to receive sham injection (group A) or intraarterial BMSC injection at the site of occlusion (group B). Primary endpoints included improvement in ankle–brachial index (ABI) of > 0.1 and transcutaneous pressure of oxygen (TcPO2) of > 15% at mid- and lower foot at 6 mo. Secondary endpoints included relief from rest pain, > 30% reduction in ulcer size, and reduction in major amputation in patients with CLI and > 50% improvement in pain-free walking distance in patients with severe claudication. Results Technical success was achieved in all patients, without complications. At 6 mo, group B showed more improvements in ABI of > 0.1 (35 of 41 [85.37%] vs 13 of 40 [32.50%]; P 15% at the midfoot (35 of 41 [85.37%] vs 17 of 40 [42.50%]; P = .0001] and lower foot (37 of 41 [90.24%] vs 19 of 40 [47.50%]; P 30% reduction in ulcer size among patients with CLI or in > 50% improvement in pain-free walking distance among patients with severe claudication. Conclusions Intraarterial delivery of autologous BMSCs is safe and effective in the management of severe PAD.

Statement of the problem The study aimed to compare the efficacy of superficial, subfascial, and deep subfascial approaches in patients with temporomandibular joint (TMJ) disorders and to correlate its effect on facial nerve function and quality of the surgical field. Materials and methods The study comprised of 15 cases indicated for TMJ surgery divided randomly into 3 study groups: Groups I, II, and III based on the surgical approach used (Figure 1). In Group I patients, the superficial approach was used and dissection was limited to the superficial layer of temporalis fascia. In Group II, a subfascial approach was used where dissection was carried between the 2 layers of the fascia. In Group III, a deep subfascial approach was used where dissection was kept between the deep layer of fascia and muscle. Intraoperatively, the quality of surgical field was assessed using Fromme, et al. Scale and intraoperative blood loss were calculated for each group. The dissection time was measured as the time elapsed from the skin incision to reach the dissection plane. All patients were evaluated for pain and swelling on the first, third, and seventh postoperative day. The facial nerve function test was performed post-surgically after 24 hours, 1 week and 1, 3, and 6 months using the House-Brackman scale. Methods of data analysis Statistical analysis was performed using SPSS software (IBM Corp, Armonk, NY). Data were presented as mean and appropriate. Statistical tests were applied. Results The inter-group comparison showed that the outcomes of all intraoperative parameter were superior in Group II in comparison to the other groups (Table 1), whereas postoperative pain and swelling and facial nerve function were better in Group III (Table 2). Outcomes data The mean time required for exposure of TMJ was least in Group I as compared to the other groups (mean score for Groups I, II, and III, respectively, 20.8 ±1.36;19.0±3.3.17; and 29.2±4 minutes). The quantity of blood loss was minimum in Group II (mean score for Groups I, II, and III, respectively, 311.8±5.15; 244.4 ±6.19; and 249.6±10.58). Similarly, the quality of the surgical field was highest in Group II (mean score for Groups I, II, and III, respectively, 2.2±0.87;1.00±0.44; and 1.04±0.33). Mean pain scores were generally better for Group III when compared to Groups I and II on all days. Highest mean score observed on the first postoperative day was 5.2±1.33; 6.2±1.17; and 4.8±1.16 for Group I, Group II and Group III, respectively. It was also observed that deep subfascial approach resulted in lesser postoperative swelling as compared to the other groups (mean score for Group I, Group II, and Group III, respectively, at seventh postoperative day was 27.2±1.13;22.1±0.86; and 20.14±2.09). At 6 months, all surgical sites in Group III had normal facial nerve function, whereas total palsy of temporal branch was seen in 1 case for Group I and mild dysfunction was noted in 1 case of Group II (Figure 1). Conclusion The deep subfascial approach is the safest approach among the preauricular approaches to avoid injury of the facial nerve and yielded better postoperative result for pain and swelling. However, the traditional subfascial technique provided a quicker and blood-less field of dissection. Thus, either of the 2 approaches could be used depending on the surgeon's preference and training.

Introduction There are numerous dependable techniques of wound closure, employing a wide range of materials. The proposed hypothesis for this single blind prospective randomized comparative study is tissue adhesive has better clinical outcome in terms of time taken, inflammatory changes, complications, esthetic outcome and cost efficacy for surgical wound closure of standardized submandibular incisions with sutures and staples. Methods Patients from either gender in the age group of 15–40 years, undergoing closure of submandibular incision were randomly allocated to three group i.e tissue adhesive, suture and staples groups respectively. Following surgical intervention patients were then followed up for a period of 4 months. Wounds were evaluated by two independent investigators on 7th, 14th, 30th, 60th, 90th and 120th post-operative day. The parameters measured were time consumption for closure during surgery, quality of wound healing and cosmesis during follow up. Results 42 patients, 14 in each group were treated in the present study. A statistically significant time efficiency was noted in the staple group (64.5 ± 21.4 s, p Conclusion The hypothesis was thus rejected as tissue adhesive has no significant clinical outcome in submandibular incision. The result of the present study demonstrate that skin closure by suture may increase the duration of surgery but wound cosmesis was better and face being an esthetic area, cosmetic outcome is paramount.

Background & objectives: In the current scenario, with availability of different surgical procedures for limbal stem cell deficiency (LSCD), there exists no common consensus as to the standardization of the management protocol for the same. In addition, there also exists diversity in the views about the clinical diagnosis, ancillary investigations and clinical parameters. The objective of the present study was to evaluate the reported outcomes of surgical interventions for the management of LSCD. Methods: A systematic review of published literature on limbal stem cell transplantation (LSCT) was performed using Ovid Medline, Embase and PubMed for a duration of 2009 to 2019. Original studies including prospective, retrospective case series and randomized controlled trials, articles in English language, articles with access to full text and studies with more than or at least 10 patients were included in this review. Data related to clinical and visual outcomes were evaluated, and pool estimates of different surgeries were calculated using random-effects model and individually using Pearson's Chi-square test. Results: A total of 1133 abstracts were evaluated. Finally, 17 studies were included for the analysis. Among these 17 studies, direct limbal lenticule transplantation was performed in five studies, of which autologous tissue from the fellow eye [conjunctival limbal autograft (CLAU)], allograft from a cadaver/live donor [keratolimbal allograft (KLAL)/conjunctival limbal allograft (CLAL)] and combination of CLAU plus KLAL were done in one, three and one studies, respectively. The ex vivo expanded cultivated limbal epithelial transplantation (CLET) was reported in six studies and simple limbal epithelial transplantation (SLET) in four studies. Two were comparative studies comparing CLET and CLAL (living-related CLAL) with cadaveric KLAL, respectively. Outcome analysis of the included studies showed significant heterogeneity. Calculated pool rate for various types of surgeries was calculated. The pool estimate for CLAL was 67.56 per cent [95% confidence interval (CI), 41.75-93.36; I2=83.5%, P=0.002]. For KLAL, this value was 63.65 per cent (95% CI, 31.38-95.91; I2=92.4%, P=0.000). Pool estimate for CLET was 78.90 per cent (95% CI, 70.51-87.28; I2=73.6%, P=0.001). Corresponding values for SLET were 79.08 per cent (95% CI, 74.10-84.07; I2=0.0%, P=0.619). CLAU and combination of CLAU plus KLAL were done in one study each; hence, statistical analysis could not be done. The functional outcome in terms of gain in visual acuity post-operatively was better in KLAL (P

Central giant cell Lesion (CGCL) of the jaw is a relatively uncommon benign lesion of unknown etiology. Essentially a destructive process, the most common treatment is surgical removal; however, alternative therapies (intra-lesional injections of corticosteroids, interferon alpha, and calcitonin) have been used in order to avoid undesirable damage to the jaws and teeth. Clinically along with facial asymmetry, the lesion often results in deranged occlusion that must be treated orthodontically. This case report illustrates sequential management of CGCL with intra-lesional corticosteroids followed by surgical re-contouring along with orthodontic considerations in management of associated malocclusion. Difficulties in handling such cases and projecting the recurrence of CGCL shall also be discussed. Keywords: Central giant cell lesion, Buccal cross-bite, Intra-lesional corticosteroids, Orthodontic treatment.

Objectives The aim of this study was to evaluate diffusion-weighted imaging (DWI) in comparison with morphologic magnetic resonance imaging (MRI) in differentiating among odontogenic keratocyst (OKC), unicystic ameloblastoma (UAB), and dentigerous cyst (DC). Study Design Contrast-enhanced MRI, including DWI, was performed on 27 patients with the 3 lesions. Signal intensity characteristics were evaluated on T1- and T2-weighted MRI. The apparent diffusion coefficient (ADC) cutoff value to most effectively differentiate among the 3 lesions was calculated with receiver operating characteristic analysis. Results In total, 17 OKCs, 5 UABs, and 5 DCs were diagnosed histologically. There were no significant differences among them in signal intensity on T1- or T2-weighted images (P ≥ .13). On DWI, 14 of 17 OKCs showed restricted diffusion with a mean ADC value of 0.954 × 10-3 mm2/s. All 5 UABs and all 5 DCs exhibited facilitated diffusion with ADC values ≥ 2.150 × 10-3 mm2/s. The ADC cutoff to differentiate OKCs from UABs was 2.137 × 10-3 mm2/s (P = .01); UABs from DCs was 2.422 × 10-3 mm2/s (P = .03); and OKCs from DCs was 2.347 × 10-3 mm2/s (P = .01). Conclusions Addition of diffusion-weighted sequences to MRI jaw protocols can assist in the characterization of OKCs, UABs, and DCs.

Objective To compare the efficacy of conventional 2D miniplate with 3D 4-hole and 8-hole miniplates in the management of mandibular angle fractures. Methods A prospective study was conducted on 24 patients with isolated mandibular angle fractures that were divided into three following groups (n = 8 each) based on the osteosynthesis technique used: Group A- conventional 2D four-holed miniplate Group B- 3D- 4-holed miniplate Group C- 3D- 8-holed miniplate Post-operative pain, inter-incisal opening, range of motion, bite force and incidence of complications were assessed at various time intervals up to a period of six months. Results A steady improvement in all parameters was seen in the three groups over six months. A significantly greater amount of 1 week post-operative trismus was observed in the 8-holed miniplate group (p 0.05). The incidence of complications was greatest in Group B (25 %). Conclusion The conventional 2D miniplate system still holds its place as the method of choice for management of mandibular angle fractures.

In recent years, the Internet of Things (IoT) has gained increasing popularity due to the usage of Internet-enabled devices. However, Internet-enabled devices, also known as smart devices, share the information using an insecure channel, i.e., the Internet. Hence, the security and privacy of shared information remain the biggest concern. To ensure both security and privacy, many smart card based and biometric based schemes have been proposed for different Internet-based applications. Telecare Medical Information System (TMIS) is such an application which makes medical treatment easier by interacting with the patient and doctors. However, the transmission of the patient’s private information over an insecure channel is prone to several attacks. In order to protect the medical privacy of the patient and the reliability of the system, both the patient and medical server should be mutually authenticated. In this paper, we propose a three factor-based authentication scheme for health care system using IoT enabled devices (TFASH) that are secure and more efficient than other relevant schemes. We use Elliptic Curve Cryptography (ECC) for the scheme due to its smaller key size and high level of security. The session key security and the mutual authentication of the TFASH scheme have been proved using Real-Or-Random (ROR) model and Burrows–Abadi–Needham (BAN) logic. The simulation result of the proposed scheme shows that the scheme is safe under the OFMC and CLAtSe models. Moreover, compared to the existing schemes, the TFASH scheme provides better communicational and computational cost, which makes it suitable for practical use.

Purpose The aim of the present study was to determine the effect of intramuscular injection of botulinum toxin A (BTX-A) into the masticatory muscles on the physiotherapy pain and mouth opening outcomes after surgical intervention of temporomandibular joint (TMJ) ankylosis and to verify the effects using electromyographic studies. Patients and Methods The study included 20 patients with TMJ ankylosis. The patients were further subdivided into control and interventional groups. The interventional group was given intramuscular injections of BTX-A in the masticator muscles before surgery. Only saline injections were given to the control group. All 20 patients were evaluated for pain and ease of active physiotherapy at the 1-week and 1-, 3-, and 6-month follow-up visits using a questionnaire. Intergroup comparisons were performed for both groups. Electromyographic (EMG) studies were also performed in the intervention group for each patient. EMG recordings were performed of the individual masticator muscle in each patient before injection and at 1 and 3 months after injection. Results The intervention group showed better results with respect to pain during the mouth opening exercises and improvements in mouth opening. All the interventional group patients showed a transient decrease in the microvolt value on the EMG studies of their masticator muscles on injection of BTX-A. Conclusions BTX-A injection can be a straightforward and useful adjunct to surgical treatment of TMJ ankylosis for the reduction of pain during postoperative physiotherapy.

Purpose To compare and evaluate pain and healing following orthodontic tooth extraction using Low Level Laser Therapy [LLLT] and Cryotherapy. Materials and methods 62 patients referred for orthodontic extraction of bilateral bicuspids were included. Subjects were alternatively divided into two groups with 31 patients each. One of the bilateral extraction sites was subjected to either intervention, LLLT or Cryotherapy, while the other site was kept as control. Pain was assessed for 7 consecutive days by Visual Analogue Scale and Wound healing on 4th, 7th and 14th days using a modified wound healing scale. Results Pain scores were generally better for Group I [LLLT] when compared to Group II [Cryotherapy] on all days. The highest mean score for pain observed on the 1st post-extraction day was 4.00 ± 0.93 and 4.16 ± 0.93 for Group I and Group II respectively [p = 0.42]. It was also observed that LLLT helped in better wound healing as compared to cryotherapy with a significant difference in wound healing on 7th [mean score for Group I and Group II- 1.16 ± 0.52 and 1.6 ± 0.62 respectively: p = 0.01] and 14th [mean score Group I and Group II- 0.23 ± 0.43 and 1.0 ± 0.58 respectively: p = 0.00] post-extraction days. Conclusion LLLT has better analgesic and wound healing properties as compared to Cryotherapy, suggesting that LLLT should be preferred over cryotherapy whenever possible.

The purpose of the study is to assess the healing temporomandibular joint morphology and function after closed treatment of unilateral mandibular condylar fracture.A prospective interventional cohort study was designed in patients recruited from the outpatient department who underwent closed reduction for unilateral condylar fractures, and mean mouth opening, mean maximum protrusion, laterotrusion, and radiological pattern of healing were noted.Forty patients in the age group of 18-50 years (mean 24.5 years) were included. The difference between the pretreatment mean mouth opening (26.94 mm), mean maximum protrusion (1.22 mm), and laterotrusion (3.82 mm and 1.45 mm) values and the 6-month post-treatment values (46.3 mm, 4.45 mm, and 11.82 mm and 9.82 mm, respectively) was found to be statistically significant (P .001). Deranged pretreatment occlusion seen in 20 cases was improved in 18 patients (85%) at the 6-month post-treatment visit, with persisting malocclusion in 2 patients (5%). Clinically, cases that had healed with the anatomical pattern (M1) were found to have significantly better clinical outcomes (P value .05) than that achieved with cases healed with spherical pattern (M2), L-shaped pattern (M3), or detached pattern (M4). On radiographs, the greatest improvement (21.16 mm) in mean mouth opening values was seen in the M1 group (anatomical pattern), followed by similar improvement in groups M2 and M3 (18.39 and 18.66 mm, respectively). Least improvement (7.06 mm) was seen in the single case of the M4 group (detached pattern), although the 6-month post-treatment value was still an acceptable one (34 mm).Favorable functional outcomes can be achieved after closed treatment, including adequate mouth opening, pain-free jaw excursions, and stable occlusion, with the anatomical healing pattern showing the most superior results and the detached pattern being associated with relatively poorer outcomes compared with other healing patterns.

Now days, Internet of Things (IOTs) plays an important role due to sophisticated state-of-the-art low power, low-cost wireless technologies. There are different areas that have witnessed an ever-increasing application of IOTs like smart home, smart city, smart industry, and smart factory etc. In each of these applications, an important aspect is to localize the person/ object/ device with an acceptable precision and accuracy. All the devices are interconnected to each other via internet in IOT. Localization can be categorized as measurements based on distance, angle, area etc. There are a slew of wirelesses technologies like WiFi, bluetooth low energy (BLE), radio frequency identification (RFID), ultra-wideband (UWB) etc used for achieving reliable localization in IOT based system. UWB has been found to play an important role in localization in IOTs due to a high frequency range (3.1GHz10.6GHz), low duty cycle (maximum on time 5ms and off time 38ms),high accuracy of ranging(cm),usage of very small pulses(ns to localize), ability to penetrate through the obstacles, capability to avoid multipath fading etc. In a wireless sensor network (WSN), it gives robust performance and has been investigated to be a potential candidate for indoor localization. This paper represents the low energy UWB pulse for localization in an IOT based system and the use of channel impulse response (CIR) of a UWB channel model 4(CM 4) in carrying out localization.

Wireless group communication has gained much popularity recently due to the increase in portable, lightweight devices. These devices are capable of performing group communication by enabling every participant to agree upon a group key for secure communication in an insecure network. Many authenticated group key agreement schemes have been proposed, but most of the schemes lack the dynamic property of mobile node joining/leaving the group such that the session key is updated without affecting the protocol. In this paper, we propose a pairing-free certificateless authenticated group key agreement protocol based on elliptic curve cryptosystem for resource-constrained mobile nodes. The objective of the proposed key-agreement protocol is to ensure the un-deniability of any message exchanged between the sender and receiver, contributory property for group key agreement, and allowing mobile users to join or leave the group dynamically by enabling forward and backward secrecy. Through the rigorous security analysis, we show that the proposed scheme achieves the well-known security functionalities against various types of attacks using informal security analysis and rigorous formal analysis using the random oracle model. Moreover, the protocol validation result using broadly-accepted automated validation of internet security protocols and applications shows that the protocol is safe under OFMC and CL-AtSe back-ends. Furthermore, the result of performance analysis shows that our proposed scheme achieves desirable security properties as compared to the existing related schemes by reducing the overall computation and communication cost despite a gradual increase in the number of participating mobile nodes.

Objective The current study aims to evaluate the anatomic and functional outcome in patients with masseter hypertrophy following surgical debulking of the masseter. Methods 18 patients (28 sites) of masseter hypertrophy underwent surgical muscle debulking with / without osseous recontouring. Post-operative assessment was done by measuring change in: a) muscle thickness using ultrasonography, b) electrical activity of the muscle using electromyography (EMG) and c) maximum bite forces generated 1 year following surgery. Visual Analogue Scale (VAS; 1–10) was used to evaluate the patients’ aesthetic satisfaction. Results An average reduction in muscle thickness at rest and clench by 6.35 and 5.25 mm, respectively was seen 12 months after surgery. Mean bite force and clench EMG showed a statistically significant decrease 1 year post-operatively (p = 0.001 and p = 0.0001 respectively). The average mouth opening increased significantly by 8 mm (p Conclusion Surgical debulking is a reliable treatment modality for masseter hypertrophy providing good aesthetic and functional outcomes.

Study question Does autologous bone marrow derived stem cell (BMDSC) ovarian transplantation optimize ovarian reserve parameters in young infertile women with diminished ovarian reserve (DOR) ? Summary answer The autologous stem cell ovarian transplantation (ASCOT) improves AFC and AMH by facilitating the recruitment of existing dormant follicles in young women with DOR. What is known already Oocyte donation is the practical therapeutic option when patients with premature ovarian ageing desire pregnancy. It involves significant psychological burden in terms of not able to have their own biological child. ASCOT has opened new doors in poor responders and premature ovarian insufficiency through its beneficial effects on ovarian reserve and IVF outcomes. However recent studies have shown contradictory results in terms of its efficacy. No prior study has been contemplated in DOR group Study design, size, duration An open label non randomized controlled trial was conducted at Division of Reproductive Medicine in collaboration with stem cell facility at tertiary care institute. Forty two infertile women less than 35 years age with DOR (AFC8IU/l) were enrolled in the study during a period from January 2020 to December 2020. 20 women who did not opt for the intervention were treated as control group whereas 22 women received the intervention. Participants/materials, setting, methods Baseline hormonal profile ( Day 2 FSH, estradiol, AMH and AFC) was done in all patients. Women with abnormal uterine cavity, endometriosis, prior ovarian surgery, abnormal karyotype were excluded. Bone marrow aspiration followed by mesenchymal stem cells isolation was performed. The stem cells were transplanted in both the ovaries through transvaginal route on the same day. Follow up visits were planned at one and six months to assess ovarian reserve parameters. Main results and the role of chance The mean age, BMI and duration of infertility were comparable between the control and study group (29.5±3.34vs 29.36±2.95years, 21.51±1.40vs21.87±1.93kg/m2, 6.9±1.94vs7.04±3.67 years). The positive response in terms of improved AMH and AFC was seen in 68% (15/22) patients. The mean number of stem cells injected in these women were 77.71±25.33 million. At first follow up, there was no significant difference between mean FSH, estradiol levels and mean right and left ovarian volume (9.23±3.95 vs 9.02±3.92mIU/l, 61.46±29.25 vs 68.12±62.52 pg/ml, 2.82±2.18 vs 2.44±1.25 cc, 2.02±1.54 vs 2.72±1.06 cc, p Limitations, reasons for caution The limitation of present study is small sample size and non randomization. However, time period for which positive effect lasts has not been documented in earlier studies. This study is currently being endeavored, and women with improved ovarian reserve are followed up for any spontaneous conception or following assisted reproduction. Wider implications of the findings The present study demonstrates beneficial role of stem cells in improving ovarian reserve parameters in women with DOR with no acquired cause. If supported by future randomized clinical studies, it could represent a paradigm shift for fertility treatment in these women providing an opportunity to have their own biological child Trial registration number CTRI/2020/01/022726

Mesenchymal Stem Cells are potent therapeutic candidates in the field of regenerative medicine, owing to their immunomodulatory and differentiation potential. However, several complications come with their translational application like viability, duration, and degree of expansion, long-term storage, and high maintenance cost. Therefore, drawbacks of cell-based therapy can be overcome by a novel therapeutic modality emerging in translational research and application, i.e., exosomes. These small vesicles derived from mesenchymal stem cells are emerging as new avenues in the field of nano-medicine. These nano-vesicles have caught the attention of researchers with their potency as regenerative medicine both in nanotherapeutics and drug delivery systems. In this review, we discuss the current knowledge in the biology and handling of exosomes, with their limitations and future applications. Additionally, we highlight current perspectives that primarily focus on their effect on various diseases and their potential as a drug delivery vehicle.

Acute-on-chronic liver failure (ACLF) is a distinct clinical entity with high probability of organ failure and mortality. Since patients generally present late, experimental models are needed to understand the pathophysiology and natural course of the disease. To reproduce the syndrome of ACLF, chronic liver disease was induced in C57BL6 mice (6–8 weeks; approximately 20–24 g weight) by intraperitoneal administration of carbon tetrachloride (CCl4) for 10 weeks followed by an acute injury with acetaminophen (APAP) and lipopolysaccharide (LPS). Blood, ascitic fluid, and organs were collected to study cell death, regeneration, and fibrosis. At 24 h post-APAP/LPS infusion, the liver tissue showed increased hepatocyte ballooning and endothelial cell TUNEL positivity. This was followed by progressive hepatocyte necrosis from perivascular region at day 7 to lobular region by day 11. ACLF (day 7 and day 11) animals showed increase in bilirubin (p

PurposeMolecular pathogenesis underlying persistent ocular surface inflammation in chronic Stevens-Johnson syndrome (SJS) still remains largely unexplored. The present study investigates the expression of matrix metalloproteinase 2 (MMP2), MMP3, MMP9, MMP11 and TIMP1 (tissue inhibittor of matrix metalloproteinase 1) in pannus tissues of chronic ocular SJS undergoing cultivated oral mucosal epithelial transplantation (COMET) and their prognostic relevance.MethodsIn this prospective study, 45 eyes with chronic SJS underwent COMET for visual and anatomical rehabilitation. Preoperative and postoperative clinical parameters were documented. MMP2, MMP3, MMP9, MMP11 and TIMP1 expression were assessed using immunohistochemistry and quantitative real time PCR. Inflammadry MMP9 assay was performed at 1-year follow-up. Kaplan-Meier curves and Cox proportional hazard models were used to correlate protein expression with clinicopathological parameters and COMET graft survival outcomes.ResultsMMP9 and MMP11 positivity was seen in both pannus epithelia (48% and 55%, respectively) and in stromal layer (57% and 33%, respectively) while MMP2 and MMP3 showed only pannus epithelial positivity in 35% and 51% cases, respectively. High MMP9 stromal expression was significantly associated with preoperative corneal keratinisation (p=0.011), conjunctival hyperaemia (p=0.014), symblepharon (p=0.028). High MMP9 and MMP3 epithelial expression were found to be independent risk factors for poor best-corrected visual acuity (BCVA) outcomes post-COMET (p=0.022 and p=0.048). Multivariate analysis revealed MMP9 to be the best prognostic marker (p=0.050).ConclusionOur findings suggest that differential expression of MMPs and TIMP1 is seen in SJS in chronic stage. Emergence of MMP9 as a poor prognostic predictor of BCVA post COMET and postoperative MMP9 immunoassay positivity could be a useful tool in further studies to understand the unresolved ocular surface inflammation seen in SJS.

Background and Objective. Acquired aplastic anemia (aAA) is a bone marrow failure disorder characterized by pancytopenia and bone marrow aplasia. Bone marrow Mesenchymal Stem Cells (BM-MSCs) are an important component of BM microenvironment, associated with hematopoietic and immune homeostasis. Any alterations in BM microenvironment can disrupt the normal functioning and it needs to be assessed. Methods. In the current study, we investigated the morphological differences, proliferation capacity, population doubling time (PDT), surface marker profiling, trilineage differentiation potential, and immunosuppressive ability of BM Mesenchymal Stem Cells (BM-MSCs) from untreated aAA patients and in the same number of age- and gender-matched controls. Results. We observed similar morphology, proliferation capacity, phenotype, trilineage differentiation potential, and immunomodulatory properties of BM-MSCs in aAA patients and control subjects. Conclusion. Our results confirm that the basic and immunosuppressive properties of BM-MSCs from aAA patients do not differ from normal BM-MSCs. Our data suggest that BM-MSCs from aAA patients might not be involved in disease pathogenesis. However, owing to a smaller number of samples, it is not conclusive, and future studies with more exhaustive investigation at transcriptome level are warranted.

OBJECTIVE: To assess the treatment outcome of custom made maxillary transport distractor appliance for closure of large alveolar clefts. METHOD: A pilot study was conducted on 12 large alveolar cleft defects present in 11 non-syndromic cleft lip and palate patients (1 bilateral and 10 unilateral) in the age group of 16–25 years. All the subjects underwent pre-surgical orthodontics followed by alveolar distraction using custom-made distractor appliance. Study models, lateral cephalogram, panoramic radiograph and cone beam computed tomograms were obtained pre-surgically (T0) and after distractor removal (T1). The reduction in the width and volume of the alveolar cleft defect and change in the mesiodistal axial inclination of the teeth in transport segment following distraction were recorded. P value ​

Pandanus odorifer (Forssk.) Kuntze (kewda) is an industrially important aromatic plant currently having huge demand for the unique fragrance possessed by its essential oil. Phenyl ethyl methyl ether is the major component which imparts this exquisite odour to the kewda male flower essential oil. This distinctive aroma instigates its extensive usage in the cosmetic, pharmaceuticals and flavour and fragrance industries. Almost every part of the plant (flower, stem, root, leaves) possess numerous pharmacological and ethnic utilities. The plant propagation using elite genetic material is therefore imperative to produce improved quality kewda plants to meet the global need. The accelerated demand of kewda perfumes has resulted in a hike in the price of kewda oil. Hence, the farmers require its large-scale cultivation mainly in the coastal and sub-coastal regions. The present chapter focuses on the botanical, phytochemical, pharmacological, agronomical and biotechnological aspects of Pandanus odorifer. This comprehensive information will conclusively allow better utilization of this industrially important plant for various industrial uses and improve the socio-economic growth of low-income coastal villagers.

Frontal sinus wall fracture is a unique fracture of the face that often requires complex management. The location of the frontal bone, containing frontal sinus, is adjacent to vital structures, including the brain and eyes. A frontal wall fracture mostly occurs along with fractures of the skull, orbital roof and nose and naso-orbito-ethmoid (NOE) and Le Fort fractures. In addition, management of a frontal sinus wall fracture is complicated not only by the presence of concomitant injuries but also by mucosal membranes and the nasofrontal ducts. Meticulous assessment of a frontal bone fracture will subsequently lead to the appropriate treatment plan critical for the long-term health of the patient and reduction of complications.

The recent pandemic situation transpired due to coronavirus novel strain SARS-CoV-2 has become a global concern. This human coronavirus (HCov-19) has put the world on high alert as the numbers of confirmed cases are continuously increasing. The world is now fighting against this deadly virus and is leaving no stone unturned to find effective treatments through testing of various available drugs, including those effective against flu, malaria, etc. With an urgent need for the development of potential strategies, two recent studies from China using Mesenchymal Stem Cells (MSCs) to treat COVID-19 pneumonia have shed some light on a potential cure for the COVID-19 infected patients. However, MSCs, despite being used in various other clinical trials have always been questioned for their tendency to aggregate or form clumps in the injured or disease microenvironment. It has also been reported in various studies that exosomes secreted by these MSCs, contribute towards the cell's biological and therapeutic efficacy. There have been reports evaluating the safety and feasibility of these exosomes in various lung diseases, thereby proposing them as a cell-free therapeutic agent. Also, attractive features like cell targeting, low-immunogenicity, safety, and high biocompatibility distinguish these exosomes from other synthetic nano-vesicles and thus potentiate their role as a drug delivery nano-platform. Building upon these observations, herein, efforts are made to give an overview of stem cell-derived exosomes as an appealing therapeutic agent and drug delivery nano-carrier. In this review, we briefly recapitulate the recent evidence and developments in understanding exosomes as a promising candidate for novel nano-intervention in the current pandemic scenario. Furthermore, this review will highlight and discuss mechanistic role of exosomes to combat severe lung pathological conditions. We have also attempted to dwell into the nano-formulation of exosomes for its better applicability, storage, and stability thereby conferring them as off the shelf therapeutic.

Temporomandibular joint disorders are a common cause of chronic musculoskeletal pain worldwide. Among these, internal disc derangement is the most frequent type of disorder. Internal derangement is defined as an abnormal positional and functional relationship between the disc and articulating surfaces. Common clinical symptoms include pain and clicking. Imaging plays a key role in diagnosing temporomandibular joint disorders. It is important for the radiologist to detect early imaging signs of internal derangement, thereby avoiding the evolution of this condition to degenerative joint disease. The aim of this article is to familiarise the reader with the spectrum of imaging findings that are encountered at different stages of the disease.

Stroke has a debilitating effect on the human body and a serious negative effect on society, with a global incidence of one in every six people. According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled. Motor and cognitive deficits like hemiparesis, paralysis, chronic pain, and psychomotor and behavioral symptoms can persist long term and prevent the patient from fully reintegrating into society, therefore continuing to add to the costly healthcare burden of stroke. Regenerative medicine using stem cells seems to be a panacea for sequelae after stroke. Stem cell-based therapy aids neuro-regeneration and neuroprotection for neurological recovery in patients. However, the use of stem cells as a therapy in stroke patients still needs a lot of research at both basic and translational levels. As well as the mode of action of stem cells in reversing the symptoms not being clear, there are several clinical parameters that need to be addressed before establishing stem cell therapy in stroke, such as the type of stem cells to be administered, the number of stem cells, the timing of dosage, whether dose-boosters are required, the route of administration, etc. There are upcoming prospects of cell-free therapy also by using exosomes derived from stem cells. There are several ongoing pre-clinical studies aiming to answer these questions. Despite still being in the development stage, stem cell therapy holds great potential for neurological rehabilitation in patients suffering from stroke.

Background Recent studies have demonstrated mesenchymal stem cells (MSCs) as effective mitochondrial donors with therapeutic success in multiple experimental models of human disease. MSCs obtained from different tissue sources such as bone marrow (BM), adipose (AD), dental pulp (DP), and Wharton’s jelly (WJ) are routinely used in clinical trials with no known study of their mitochondrial donor capacity. Here, we show for the first time that MSCs derived from different tissue sources have different mitochondrial donor properties and that this is correlated with their intrinsic respiratory states. Methods MitoTracker®-labeled MSCs were co-cultured with Cell Trace–labeled U87-MG cells or rat cardiomyocytes. Mitochondrial transfer abilities of MSCs were assessed by using flow cytometry analysis and fluorescence imaging. Mitochondrial reactive oxygen species (mtROS) levels were analyzed by using MitoSOX red–based staining, and mitochondrial respiration parameters were analyzed by using a Seahorse XF Analyzer. Results AD-MSCs and BM-MSCs displayed higher mitochondrial transfer than DP-MSCs and WJ-MSCs. Counterintuitively, DP-MSCs and WJ-MSCs were more effective in suppressing mtROS levels in stressed recipient cells than AD-MSCs or BM-MSCs. Interestingly, the oxygen consumption rates and intrinsic mitochondrial respiration parameters like ATP levels, basal and maximal respiration, and mitochondrial DNA copy number in donor MSCs showed a highly significant inverse correlation with their mitochondrial donation. Conclusions We find that there are intrinsic differences in the mitochondrial respiration, donation capacity, and therapeutic efficacy among MSCs of different tissue origin. MSCs with high mitochondrial respiration capacities are associated with lower mitochondrial transfer but more effective suppression of mtROS in stressed recipient cells. This is most compatible with a model where recipient cells optimally regulate mitochondrial transfer such that they take more mitochondria from MSCs with lower mitochondrial function. Furthermore, it appears to be advantageous to use MSCs such as DP-MSCs or WJ-MSCs with higher mitochondrial respiratory abilities that achieved better therapeutic effect with lower mitochondrial transfer in our study. This opens up a new direction in stem cell therapeutics. Electronic supplementary material The online version of this article (10.1186/s13287-018-1012-0) contains supplementary material, which is available to authorized users.

Sarcomas of the Oral and Maxillofacial Region (SOMR) are rare lesions which pose diagnostic and management challenges. We analyzed 26 cases of SOMR with respect to clinical presentation, histopathological subtype, treatment modalities, recurrence, and treatment outcome. In our series, Osteosarcoma (OS) was the most common type of sarcoma (7 cases), followed by 5 cases of Ewing's Sarcoma (ES), 3 cases each of Chondrosarcoma (CS) and Leiomyosarcoma (LMS), 2 cases each of Malignant Peripheral Nerve Sheath Tumor (MPNST), Pleomorphic Undifferentiated Sarcoma (PUS), Myeloid Sarcoma (MS)and Rhabdomyosarcoma (RMS). Surgery was the primary treatment modality in most cases and was combined with adjuvant chemo/ radiotherapy in few cases. 24 of the 26 cases were followed up for an average period of 40.67 months. Adverse disease outcomes like recurrence were seen in 2 cases whereas death due to the disease was reported in 7 cases. In view of the diagnostic challenges faced in SOMRs, it appears practical to stress on the underlying genetic aspects of the disease process rather than histological subtyping to improve disease outcome.

The smart card based password authentication scheme is one of the most important and efficient security mechanism, which is used for providing security to authorized users over an insecure network. In this paper, we analyzed major security flaws of Jangirala et al.’s scheme and proved that it is vulnerable to forgery attack, replay attack, user impersonation attack. Also, Jangirala et al.’s scheme fail to achieve mutual authentication as it claimed. We proposed an improved two factor based dynamic ID based authenticated key agreement protocol for the multiserver environment. The proposed scheme has been simulated using widely accepted AVISPA tool. Furthermore, mutual authentication is proved through BAN logic. The rigorous security and performance analysis depicts that the proposed scheme provides users anonymity, mutual authentication, session key agreement and secure against various active attacks.

Authentication protocols with anonymity have gained much popularity recently which allows users to access any public network without compromising their identity. Several key exchange protocols have been proposed in the literature using either public key infrastructure or identity-based cryptosystem. However, the former suffers from heavy computation cost and latter fails to prevent key escrow problem. Recently, Islam et al. have proposed a self-certified authenticated key agreement protocol based on ECC which removes the above limitations. However, through careful analysis, we found that their scheme lack anonymity and vulnerable to trace the attack, clogging attack, and fails to prevent the replay attack. To overcome these weaknesses, we propose an anonymous self-certified authenticated key exchange protocol by including the required security features. The scheme is formally proved using Automated Validation of Internet Security protocols and Applications software. Also, the formal authentication proofs using Burrows–Abadi–Needham logic ensures successful authentication. Furthermore, the performance analysis demonstrates that the proposed scheme accomplishes less computational cost and is applicable to a client–server architecture.

Background Noncultured, extracted follicular outer root sheath suspension (NC-EHF-ORS-CS) is a recently introduced technique for the treatment of stable vitiligo. Objective To study the clinical efficacy of this technique and to determine the viability and cell composition of the suspension. Methods Twenty-five patients with stable vitiligo were included in this prospective study. Fifty follicles were extracted from occipital scalp and were incubated with trypsin–ethylenediaminetetraacetic acid to separate outer root sheath cells. The cell suspension was filtered and centrifuged to obtain a cell pellet, which was resuspended and applied to the dermabraded recipient area. Cell viability of the suspension was assessed using trypan blue staining, and markers of keratinocyte stem cells (CD200) and melanocytes (S100) were evaluated using flow cytometry and immunocytochemistry, respectively. Results At 6 months, the mean (±SD) repigmentation was 52 ± 25.1%, and >75% repigmentation was seen in 8/25 (32%) patients. Mean percentage cell viability of the suspension was 80 ± 17.2% with a mean concentration of CD200 + and S100 + cells being 7.91 ± 8.68% and 9.93 ± 1.22% (n = 3), respectively. Recipient site infection was seen in 4 of 25 (16%) patients and a color mismatch in 11 of 25 (44%) patients. Conclusion NC-EHF-ORS-CS is a useful minimally invasive therapy for vitiligo.

Aim To evaluate the role of bone marrow-derived stem cells in the treatment of advanced dry age-related macular degeneration (AMD) using multifocal electroretinogram (mf-ERG) and fundus autofluorescence imaging. Methods Thirty patients (60 eyes) with bilateral central geographic atrophy (GA) were recruited. Worse eye of each patient received autologous bone marrow-derived hematopoietic stem cells (BM-HSCs) (group 1) and the fellow eye with better visual acuity served as control (group 2). The effect of stem cell therapy was determined in terms of visual acuity, amplitude and implicit time in mf-ERG and size of GA on fundus autofluorescence imaging. These tests were performed at presentation and first, third and sixth month follow up. Adverse events (if any) were also monitored. Results At 6mo follow-up there was no statistically significant improvement in median logMAR best corrected visual acuity (BCVA) in either group. Mf-ERG revealed significant improvement in amplitude and implicit time in the intervention group. A significant decrease was also noted in greatest linear dimension (GLD) of GA in the eyes receiving stem cells [6.78±2.60 mm at baseline to 6.56±2.59 mm at 6mo (P=0.021)]. However, no such improvement was noted in the control group. Conclusion Electrophysiological and anatomical improvement in the intervention group sheds light on the therapeutic role of BM-HSCs. Further studies are required to determine the stage of disease at which the maximal benefit can be achieved and to standardize the dose and frequency of stem cell injection.

Introduction: Stem cell (SC) therapy has been envisioned as a therapeutic vehicle to promote recovery in resistant neurological diseases. Knowing the logistics and paradigms in recovery processes after Stroke, clinicians have pioneered the transplantation therapy. This study presents four-year follow up of our previous trial transplanting bone-marrow-derived animal-free culture expanded intravenous mesenchymal stem cells (MSCs) in chronic stroke which was published in 2010. Methods: We performed an open-label, pilot trial on 12 patients with chronic stroke. Patients were allocated to two groups, those who received intravenous autologous ex vivo cultured mesenchymal stem cells (MSC group) or those who did not (control group), all followed for four years from the day of cell transplantation. Results: The reports have been optimistic regarding safety as we did not find any cell related side effects / mortality till 208th week. We observed that modified Barthel Index showed statistical significant improvement at 156 and 208 weeks of transplantation (95 % CI : -10.27 to 0.07; p =0.041) follow up in the MSC group as compared to controls. The 2nd and 3rd quartile for mBI in MSC group was 89 & 90 respectively suggesting good performance of patients in the stem cell group. The impairment scales i.e., Fugl Meyer, Ashworth tone scale, strength of hand muscles (MRC) did not show any significant improvement at 208th week which is similar to our previous published report. Conclusion: This follow up study primarily indicates safety, tolerance and applicability of autologous mesenchymal stem cells in Stroke. MSCs may act as "chaperones" or work through paracrine mechanisms leading to functional recovery post stroke.

Cell replacement therapy holds a promising future in the treatment of degenerative diseases related to neuronal, cardiac and bone tissues. In such kind of diseases, there is a progressive loss of specific types of cells. Currently the most upcoming and trusted cell candidate is Mesenchymal Stem Cells (MSCs) as these cells are easy to isolate from the tissue, easy to maintain and expand and no ethical concerns are linked. MSCs can be obtained from a number of sources like bone marrow, umbilical cord blood, umbilical cord, dental pulp, adipose tissues, etc. MSCs help in tissue repair and regeneration by various mechanisms of action like cell differentiation, immunomodulation, paracrine effect, etc. The future of regenerative medicine lies in tissue engineering and exploiting various properties to yield maximum output. In the current review article, we have targeted the repair and regeneration mechanisms of MSCs in neurodegenerative diseases, cardiac diseases and those related to bones. Yet there is a lot to understand, discover and then understand again about the molecular mechanisms of MSCs and then applying this knowledge in developing the therapy to get maximum repair and regeneration of concerned tissue and in turn the recovery of the patient.

Purpose Originally introduced for mandibular reconstruction more than 40 years ago, the sternoclavicular graft (SCG) has gained widespread popularity for the reconstruction of the ramus-condyle unit (RCU) owing to its anatomic and histological likeness to the normal mandibular condyle. Conventional longitudinal osteotomy design for its harvest has been fraught with considerable complications at the donor site including fracture clavicle and major neurovascular injury. In an attempt to alleviate these ill effects, a new technique for procuring the sternoclavicular graft is presented. Material and methods A split-thickness cortico-cancellous graft was harvested form the sternal end of the clavicle along with the articular disk with the osteotomy cut oriented parallel to the coronal plane, with limited soft tissue dissection. Donor site complications were assessed in terms of incidence of clavicle fracture, neurovascular injury, pleural tear and radiographic healing as seen in the six-month postoperative chest radiograph. Results 17 patients suffering from unilateral temporomandibular joint ankylosis underwent SCG harvesting for RCU reconstruction following osteoarthrectomy. No adverse events were seen in the intra- and post-operative period in any patient and satisfactory radiographic osseous healing was observed after six months. Conclusion The proposed harvest technique for SCG results in reduced donor site morbidity and favourable healing and greater patient comfort.

We designed this study to determine the efficiency and stability of anterior segmental osteotomies (ASO) without orthodontics for various dentofacial deformities. Records of patients treated with maxillary or mandibular ASO, or both, without orthodontics in the past 15 years were analysed. The assessment included postoperative analysis of patients' aesthetics and functional satisfaction using a questionnaire and grading (score 0 - 4) system, and the amount of relapse calculated from 12-month postoperative cephalograms. A total of 26 ASO subjects (age range 13- 31 years) were studied (14 maxillary, two mandibular, and 10 bimaxillary). Long-term stability was acceptable in all cases with no significant relapse (p>0.05). No major complications were encountered. All patients reported good to excellent (score=3 to 4) satisfaction following surgery. Using meticulous planning and a careful surgical technique, ASO without orthodontics is a simple, quick, safe, and stable option for the correction of dentofacial deformities.

Objective Oral submucous fibrosis (OSMF) is a chronic, progressive precancerous condition of oral mucosa, predominantly seen in the Indian subcontinent. This technical note describes the use of oral screen prosthesis used as an adjunct to surgery to prevent relapse following surgical correction. Methods The modified oral screen appliance was inserted in the patient’s labial and buccal vestibule as oral screen. The appliance was intended to be used as an oral stent along with mouth exercises to counteract relapse of the corrected mouth opening. Results The possibility of flap shrinkage and interference with occlusion results in surgical failure of the treatment of OSMF. Securing the flap in position using oral screen prosthesis has been tried as an adjunct to treat such cases. Conclusions This modified approach can be performed in routine clinical practice, making the rehabilitation of such a case possible with relative ease.

The current therapies for oxidative stress-induced lung diseases are majorly based on the reduction of airway obstruction and improved exacerbations. However, none of the available treatments have been proven to avoid disease progression or reduce mortality. In this context, mesenchymal stem cell (MSC) therapy has become a strong contender for better therapeutic strategies for several pulmonary diseases. MSCs can be readily harvested from various tissues and efficiently propagated and possess strong immunomodulatory/suppressive properties. Animal studies have shown encouraging outcomes with MSC therapy for various lung disorders, like COPD and emphysema. These studies have inspired research groups to understand the mechanisms by which MSCs may bring about their beneficial effects upon transplantation; however, clinical trials have not been as successful. This chapter summarizes and highlights the various aspects of MSC therapy in cellular, preclinical, and clinical settings.

The rapid development of wireless communication technologies provides convenient and efficient online services to make life easier. Wireless body area network (WBAN) such type of service which provides a simple and low-cost strategy for health monitoring without going to the hospital. WBAN consists of a number of sensors, which embedded into the patient's body and send the collected information to the server. However, the privacy of the patient is an essential feature as the leakage of patient's sensitive data cause threats to tampering of health. This study proposes a privacy preservation user authentication scheme (PUASW) for WBAN based on the chaotic map. The formal security analysis of the scheme has been done using ROR model. In addition, PUASW can achieve several security features and can withstand several well-known attacks. AVISPA tool is used for the formal verification of our scheme. The communicational and computational cost of the proposed scheme is less compared to other related schemes.