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The volume and diversity of data in biomedical research have been rapidly increasing in recent years. While such data hold significant promise for accelerating discovery, their use entails many challenges including: the need for adequate computational infrastructure, secure processes for data sharing and access, tools that allow researchers to find and integrate diverse datasets, and standardized methods of analysis. These are just some elements of a complex ecosystem that needs to be built to support the rapid accumulation of these data. The NIH Big Data to Knowledge (BD2K) initiative aims to facilitate digitally enabled biomedical research. Within the BD2K framework, the Commons initiative is intended to establish a virtual environment that will facilitate the use, interoperability, and discoverability of shared digital objects used for research. The BD2K Commons Framework Pilots Working Group (CFPWG) was established to clarify goals and work on pilot projects that address existing gaps toward realizing the vision of the BD2K Commons. This report reviews highlights from a two-day meeting involving the BD2K CFPWG to provide insights on trends and considerations in advancing Big Data science for biomedical research in the United States. (C) 2017 Elsevier Inc. All rights reserved.

Background: Lobular capillary hemangioma is a common benign vascular tumor seen in the oral cavity. It occurs in response to various stimuli such as low-grade local irritation, traumatic insult, and hormonal factors or as a response to a wide variety of drugs. Materials and Methods: All patients presenting to the Department of Dentistry, Shyam Shah Medical College, Rewa, Madhya Pradesh during July 2014 to June 2016, who were diagnosed by histopathologic confirmation as oral lobular capillary hemangioma (OLCH), were evaluated for the area involved, clinicopathologic presentation, demographic features, and treatment. Results: A total of 94 cases were identified as OLCH by histopathologic confirmation during this period. The lesion occurred most commonly in the age group of 21–30 years. A characteristic female predominance (female: male ratio of 2.24:1) was seen. Anterior maxillary labial gingiva was most frequently involved (34.04%) followed by posterior maxillary buccal gingiva (14.89%). Conclusion: The clinicopathologic picture of OLCH found in this study was similar to other studies conducted on same as well different ethnic and geographical populations. Poor oral-dental-hygiene was observed in majority of patients (87.23%) dental health education should be an integral component of imparting oral health care by health providers. Surgical excision as a treatment modality renders good results with low recurrence rate.

Pulmonary vein isolation (PVI) with cryoballoon ablation (CBA) is routinely guided by fluoroscopy and utilizes contrast injection to ensure catheter positioning and pulmonary vein occlusion. Non-fluoroscopic imaging techniques including electromagnetic mapping (EM) and intracardiac echocardiography (ICE) have demonstrated reduced fluoroscopy times and contrast exposure. Utilization of color flow Doppler to evaluate vein occlusion with the balloon has not been evaluated as an alternative to contrast injection. In this study we evaluate the effectiveness of cryoablation guided by EM and ICE along with color Doppler to achieve PVI. We designed a retrospective cohort study comparing patients who were treated before and after implementation of EM (Carto 3, Biosense Webster) and ICE during CBA (AF Solutions, Medtronic). We analyzed patients receiving CBA with fluoroscopy plus EM and ICE (group 2; N = 24) versus fluoroscopy alone (group 1; N = 25). Procedural success was defined as freedom from atrial fibrillation or other atrial arrhythmias at 1 year post ablation. Primary outcomes were radiation time and contrast exposure. Procedural success was achieved in all cases. Total fluoroscopy time was reduced from 22.4 ± 9.8 min to 8.9 ± 5.1 min (P

Rapid progress in proteomics and large-scale profiling of biological systems at the protein level necessitates the continued development of efficient computational tools for the analysis and interpretation of proteomics data. Here, we present the piNET server that facilitates integrated annotation, analysis and visualization of quantitative proteomics data, with emphasis on PTM networks and integration with the LINCS library of chemical and genetic perturbation signatures in order to provide further mechanistic and functional insights. The primary input for the server consists of a set of peptides or proteins, optionally with PTM sites, and their corresponding abundance values. Several interconnected workflows can be used to generate: (i) interactive graphs and tables providing comprehensive annotation and mapping between peptides and proteins with PTM sites; (ii) high resolution and interactive visualization for enzyme-substrate networks, including kinases and their phospho-peptide targets; (iii) mapping and visualization of LINCS signature connectivity for chemical inhibitors or genetic knockdown of enzymes upstream of their target PTM sites. piNET has been built using a modular Spring-Boot JAVA platform as a fast, versatile and easy to use tool. The Apache Lucene indexing is used for fast mapping of peptides into UniProt entries for the human, mouse and other commonly used model organism proteomes. PTM-centric network analyses combine PhosphoSitePlus, iPTMnet and SIGNOR databases of validated enzyme-substrate relationships, for kinase networks augmented by DeepPhos predictions and sequence-based mapping of PhosphoSitePlus consensus motifs. Concordant LINCS signatures are mapped using iLINCS. For each workflow, a RESTful API counterpart can be used to generate the results programmatically in the json format. The server is available at http://pinet-server.org, and it is free and open to all users without login requirement.

Gears are one of the most commonly used power transmission mechanisms in most types of machinery and. The design of gears is highly complicated involving the satisfaction of many constraints such as strength, pitting resistance, bending stress, scoring wear, and interference in involute gears. In addition, using conventional or traditional optimization techniques to solve this problem could not give optimum results. In this study, a spur gear pair was modelled and was subjected to static structural analyses for varying gear material. Stress analyses and deformation analyses were performed for each material and the optimum design for reduced weight structural stability was chosen. The design was then subjected to optimisation by Genetic Algorithm. A stochastic approach as a Genetic Algorithm (GA) is applied in this paper to find the optimal combination of design parameters for minimum weight of spur gears. The purpose of this study is minimizing the weight and the centre distance of one pair of spur gears. This objective was accomplished by the means of the GA under some constraint such as bending strength, a contact stress and each dimension conditions of gears, which must be satisfied. The results are calculated by using MATLAB tools of Genetic algorithm with three type of materials, which are alloy steel, cast iron, and epoxy glass composites.

Introduction Current guidelines recommend continuation of dual anti-platelet therapy (DAPT) for 12 months after percutaneous coronary intervention (PCI). Recent studies have shown benefit in continuing DAPT beyond 12 months but at the risk of increase bleeding. To date, there has been little data on risk stratifying patients to determine who can continue DAPT beyond 12 months at minimal bleeding risk. Methods All patients who underwent drug-eluting stent (DES) placement from January 1, 2013 to September 30, 2014 were reviewed. Patients who had follow-up for at least 12 months, placement of 2nd generation everolimus-coated DES, and were on DAPT for at least 12 months were included. Patients with a history of atrial fibrillation, follow-up time less than 12 months, or were on concurrent oral anticoagulation therapy were excluded. Results Five hundred thirty-one patients were analyzed as described above. Two hundred two patients included in our study with 7 patients in the bleeding cohort and 195 patients in no-bleed cohort. The HAS-BLED score in patients who had a bleeding episode vs. those who did not was 3.29 vs. 2.24 (P value of 0.0009). Although not statistically significant, patients who had a bleeding episode were more likely to have renal dysfunction, alcohol use, be on prasugrel, and be on 325mg of aspirin. Conclusion The study shows that the HAS-BLED score can be of utility in risk stratifying patients in determining who can continue DAPT beyond 12 months. Furthermore, a HAS-BLED score of less than 2 may help guide extended DAPT beyond 12 months at minimal bleeding risk. © 2016 Wiley Periodicals, Inc.

Coronary vasculitis and atherosclerosis share similar presentations; routine laboratory testing and a careful history can alter management. A 39 year-old Senegalese man presented with chest pain after a recently diagnosed STEMI. Coronary angiography at that time showed multi vessel disease with 99

Takotsubo cardiomyopathy (TCM) occurs after an emotional or physical stressor. There have been case reports of patients undergoing electroconvulsive therapy (ECT) who have developed TCM. Prior reports were mainly female patients who developed TCM after their first treatment. This is a report of a

The NIH-funded LINCS Consortium is creating an extensive reference library of cell-based perturbation response signatures and sophisticated informatics tools incorporating a large number of perturbagens, model systems, and assays. To date, more than 350 datasets have been generated including transcriptomics, proteomics, epigenomics, cell phenotype and competitive binding profiling assays. The large volume and variety of data necessitate rigorous data standards and effective data management including modular data processing pipelines and end-user interfaces to facilitate accurate and reliable data exchange, curation, validation, standardization, aggregation, integration, and end user access. Deep metadata annotations and the use of qualified data standards enable integration with many external resources. Here we describe the end-to-end data processing and management at the DCIC to generate a high-quality and persistent product. Our data management and stewardship solutions enable a functioning Consortium and make LINCS a valuable scientific resource that aligns with big data initiatives such as the BD2K NIH Program and concords with emerging data science best practices including the findable, accessible, interoperable, and reusable (FAIR) principles.

Thromboembolic cerebrovascular accident remains a rare but potentially devastating complication of catheter-based atrial fibrillation (AF) ablation. Uninterrupted oral anticoagulant therapy with warfarin has become the standard of care when performing catheter-based AF ablation. Compared with warfarin, apixaban, a factor Xa inhibitor, has been shown to reduce the risk of stroke and major bleeding in nonvalvular AF. With an increase in apixaban use for stroke prophylaxis in patients with AF, there is an increased interest in the safety and efficacy of uninterrupted apixaban therapy during AF ablation. We compared the safety and efficacy of uninterrupted OA therapy with either warfarin or apixaban in all patients who underwent catheter-based AF ablation at the University of Alabama at Birmingham and at Augusta University Medical Center from January 7, 2013, to February 25, 2016. All patients underwent a transesophageal echocardiogram on the day of their ablation to assess for the presence of intracardiac thrombi. All complications were identified and classified as bleeding, thromboembolic events, or other. A total of 627 patients were analyzed as described earlier. There were 310 patients in the warfarin group and 317 patients in the apixaban group. There were 8 complications in the warfarin group and 5 complications in the apixaban group (p = 0.38). There were no thromboembolic complications in either group. In conclusion, the use of apixaban is as safe and effective as warfarin for uninterrupted OA therapy during catheter-based ablation of AF.

Malnutrition is one of the most common causes of morbidity in patients undergoing maxillofacial surgery. In these patients, normal food intake is impaired because of the disease state and is complicated further by the surgical procedures. Surgery imparts controlled injury and delays wound healing capacity. Consideration should be given to the nutritional status of these patients in both preoperative and postoperative period so as to reduce postoperative complications. It should be imperative upon the part of dental professional to identify patients at nutritional risk, perform nutritional screening tests and provide dietary guidelines. In this paper we have focused on nutritional risk, nutritional assessment, and recommendations for such kind of patients.

Summary: Haemostasis is a defence mechanism that protects vascular integrity, avoids blood loss, and maintains blood fluidity throughout the circulatory system. Per oral hematoma secondary to anticoagulation is a rare fatal condition. Haemorrhagic complications of warfarin therapy are well known.In any case, the most important concern is the prevention of bleeding complications by compiling a detailed clinical history, with adequate planning of treatment, and taking special care to avoid soft tissue damage during the dental treatment of such patients. Only occasional reports state sublingual and labial vestibule hematoma formation as a result of deficient coagulation. This particular case is very unique in that the patient was on warfarin for the past 3 years but did not develop any hematoma. However trauma by fall triggered the episode of sublingual and buccal vestibular hematoma in this patient. The patient was managed by temporarily stopping warfarin for 4 days and transfusing 2 units of fresh frozen plasma. Tab. Warfarin was restarted after 4 days on alternate days and INR dropped to 2. The sharp cusp of the mandibular tooth was smoothened to prevent ulcer development. The hematoma resolved and no new hematoma formation was observed for a period of 6 months.

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. It is the second most common odontogenic neoplasm, and only odontoma outnumbers it in reported frequency of occurrence. Its incidence, combined with its clinical behaviour, makes ameloblastoma the most significant odontogenic neoplasm. Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histological examination, it showed a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. It accounts for 5-15% of all intraosseous ameloblastomas. We report a case of unicystic ameloblastoma in a 16-year-old female, and review the literature.

Background and objectives: The aim of the study was to investigate the nickel and chromium ion release from the different brands of stainless steel brackets in to the normal saline. Materials and Methods: Five full set of Dentaurum,3M and Koden brackets were immersed in sterile plastic tube and marked A,B,C respectively, containing 50ml of Normal saline and maintained at 37°c for 3 weeks. The processing was done by using 0.5ml of saliva that was transferred to a 2ml plastic test tube with a micropipette. The chemical analysis for Ni and Cr is performed with an Atomic Absorption Spectrometer. The concentration of Ni and Cr are expressed in micrograms per litre.This process was done by 1st,7th,14th and 21st day. The values are analyzed. Results: The nickel and chromium release of Koden brackets is high. The least release of nickel and chromium is observed in Dentaurum brackets. The chromium release is insignificant within the groups but it significant in duration of days. The nickel release is significant within the groups but it is insignificant in duration of days. Interpretation and Conclusion: Nickel and chromium release from different company brackets are not uniform, it varies. Koden brackets show more amount of nickel release, Dentaurum brackets show least amount of Nickel release.

A graft is a non-living material or living tissue used for implantation or transplantation to replace a diseased part or compensate for a defect. We repaired a case with an oronasal fistula using split thickness palatal graft on oral side. A 55-year-old man presented an oronasal fistula of the hard palate, measuring 1.0 x 1.2 cm. The fistula was 2 cm posterior to the incisive foramen. The scar tissue around the fistula was unhealthy. A laterally based oral mucosal flap, 2.0 x 1.5 cm, was designed, raised, and transposed to the defect. The secondary defect was covered with palatal plate. The oral mucosal flap was viable, and no sign of recurrence of fistula was noted until one month postoperative. This method can be an alternative in repair of the oronasal defect when any local tissue for repair is not available or insufficient.

Reader, Dept. of Maxillofacial surgery. Peoples Dental Academy, Peoples University, Bhopal. India. H.O.D. Dept of Peadodontics&Preventive Dentistry.Peoples Dental Academy, Peoples University, Bhopal. India. Post graduate student, Dept. of Public health Dentistry, Peoples Dental Academy, Peoples University, Bhopal. India. Post graduate student, Dept. of Peadodontics & Preventive Dentistry,Peoples Dental Academy, Peoples University, Bhopal. India. Lecturer, Dept. of Maxillofacial surgery.Peoples Dental Academy, Peoples University, Bhopal. India.

Background: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial in inflammation and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered diclofenac sodium and dexamethasone with diclofenac sodium with tramadol on the postoperative pain, swelling and trismus after surgical removal of third molars. Patients and Methods: A prospective randomized study was conducted at the Chowdhary hospital Bhopal. A total of 100 patients (age range: 20-35 years), with impacted third molar who underwent surgical removal were randomly allocated to two treatment groups. Group A of 50 patients who were given diclofenac sodium (50 mg Oral before and after surgery and dexamethasone (prophylactic 8 mg and postoperative 4 mg IV 8 th hourly) , and Group B of 50 patients who were given diclofenac sodium(50 mg Oral before and after surgery) with tramadol(50 mg orally). Postoperative pain was assessed with a visual analogue scale at 8 th hourly and 3 rd and 7 th postoperatively day (POD). Swelling was measured at 3 and 7th POD Maximal interincisor distance was measured at 3 and 7 POD. Patient treated with diclofenac sodium + dexamethasone showed lower pain score, larger postoperative mouth opening and less swelling compared to diclofenac sodium with tramadol. Results: Co-administration of dexamethasone and diclofenac sodium was significantly superior to diclofenac with tramadol for the relief of pain (P < 0.05), and facial swelling and post operative trismus up to postoperative 48 hour (P < 0.05). Conclusion: This study illustrates enhanced effects of co-administered dexamethasone and diclofenac sodium on short-term post-operative pain and swelling, compared to diclofenac with tramadol in third molar surgery.

Pulmonary vein isolation (PVI) with cryoballoon ablation (CBA) is routinely guided by fluoroscopy and utilizes contrast to ensure catheter positioning. Non-fluoroscopic techniques include electromagnetic mapping (EM) and intracardiac echocardiography (ICE) which have demonstrated reduced fluoroscopy

Malaria parasites grow within erythrocytes, but are also free in host plasma between cycles of asexual replication. As a result, the parasite is exposed to fluctuating levels of Na(+) and K(+) , ions assumed to serve important roles for the human pathogen, Plasmodium falciparum. We examined these assumptions and the parasite's ionic requirements by establishing continuous culture in novel sucrose-based media. With sucrose as the primary osmoticant and K(+) and Cl(-) as the main extracellular ions, we obtained parasite growth and propagation at rates indistinguishable from those in physiological media. These conditions abolish long-known increases in intracellular Na(+) via parasite-induced channels, excluding a requirement for erythrocyte cation remodelling. We also dissected Na(+) , K(+) and Cl(-) requirements and found that unexpectedly low concentrations of each ion meet the parasite's demands. Surprisingly, growth was not adversely affected by up to 148 mM K(+) , suggesting that low extracellular K(+) is not an essential trigger for erythrocyte invasion. At the same time, merozoite egress and invasion required a threshold ionic strength, suggesting critical electrostatic interactions between macromolecules at these stages. These findings provide insights into transmembrane signalling in malaria and reveal fundamental differences between host and parasite ionic requirements.

Orthokeratinized odontogenic cyst (OOC) is a developmental cyst that occurs in the jaw. it was initially defined by the world health organization as the orthokeratinized variant of odontogenic keratocyst (OKC). However, studies have shown that OOC has a peculiar clinicopathologic aspects when compared with other developmental odontogenic cysts, especially OKC's. The orthokeratinized odontogenic cyst is a distinct clinicopathologic entity and is histologically characterized by a thin, uniform, epithelial lining with orthokeratinization. Clinically, the orthokeratinized cyst is a single cyst, shows a predilection for males, and is most often found in the second to the fifth decade. It is not a dentigerous cyst but is often mistaken for a dentigerous cyst because of its association with unerrupted or impacted tooth in the posterior mandible. It exhibits lower clinical aggressiveness compared to its counterpart OKC. The purpose of the article is to present a case of large aggressive OOC in the anterior mandible and to highlight the importance of, distinguishing it from the more commonly occurring OKC or keratocystic odontogenic tumour (KCOT).

The plasmodial surface anion channel (PSAC) increases erythrocyte permeability to many solutes in malaria but has uncertain physiological significance. We used a PSAC inhibitor with different efficacies against channels from two Plasmodium falciparum parasite lines and found concordant effects on transport and in vitro parasite growth when external nutrient concentrations were reduced. Linkage analysis using this growth inhibition phenotype in the Dd2 × HB3 genetic cross mapped the clag3 genomic locus, consistent with a role for two clag3 genes in PSAC-mediated transport. Altered inhibitor efficacy, achieved through allelic exchange or expression switching between the clag3 genes, indicated that the inhibitor kills parasites through direct action on PSAC. In a parasite unable to undergo expression switching, the inhibitor selected for ectopic homologous recombination between the clag3 genes to increase the diversity of available channel isoforms. Broad-spectrum inhibitors, which presumably interact with conserved sites on the channel, also exhibited improved efficacy with nutrient restriction. These findings indicate that PSAC functions in nutrient acquisition for intracellular parasites. Although key questions regarding the channel and its biological role remain, antimalarial drug development targeting PSAC should be pursued.

susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87). Materials and methods: In total, 118 pus specimens from 118 consecutive patients with abscesses (31 cases) and cellulitis (87) of the head and neck were evaluated from 2006 to the end of 2011. The patients were admitted to the University Hospital of Maxillofacial Surgery, Bhopal, India, and comprised 76 men and 42 women: Four children, 103 adults and 11 elderly people. Results: Anaerobic bacteria (174 strains within 18 genera) were found in 88 (74.6%) of the 118 specimens. Anaerobes only were present in 23 (19.5%) specimens, aerobic/facultative bacteria only in 20 (16.9%) and mixed aerobic/anaerobic flora in 65 (55.1%). No growth was detected in 10 (8.5%) specimens. Two or more anaerobes per specimen were found in 56 (63.6%) of the specimens yielding anaerobes. The incidence of isolation of anaerobes from patients with identified odontogenic sources of infection was 82.2% (60 of 73 cases) and that in patients with other sources of infection was 71.4% (15 of 21, p > 0.20). Conclusion: The start of empirical treatment could influence the frequency or rate of isolation of Fusobacterium species. The involvement of the Bacteroides fragilis group in some head and neck infections should be considered.

Current guidelines recommend continuation of dual anti-platelet therapy (DAPT) for 12 months after percutaneous coronary intervention (PCI). Recent studies have shown benefit in continuing DAPT beyond 12 months but at the risk of increase bleeding. To date, there has been little data on risk stratifying patients to determine who can continue DAPT beyond 12 months at minimal bleeding risk.All patients who underwent drug-eluting stent (DES) placement from January 1, 2013 to September 30, 2014 were reviewed. Patients who had follow-up for at least 12 months, placement of 2nd generation everolimus-coated DES, and were on DAPT for at least 12 months were included. Patients with a history of atrial fibrillation, follow-up time less than 12 months, or were on concurrent oral anticoagulation therapy were excluded.Five hundred thirty-one patients were analyzed as described above. Two hundred two patients included in our study with 7 patients in the bleeding cohort and 195 patients in no-bleed cohort. The HAS-BLED score in patients who had a bleeding episode vs. those who did not was 3.29 vs. 2.24 (P value of 0.0009). Although not statistically significant, patients who had a bleeding episode were more likely to have renal dysfunction, alcohol use, be on prasugrel, and be on 325mg of aspirin.The study shows that the HAS-BLED score can be of utility in risk stratifying patients in determining who can continue DAPT beyond 12 months. Furthermore, a HAS-BLED score of less than 2 may help guide extended DAPT beyond 12 months at minimal bleeding risk. © 2016 Wiley Periodicals, Inc.

SummaryDevelopment of malaria parasites within vertebrate erythrocytes requires nutrient uptake at the host cell membrane. The plasmodial surface anion channel (PSAC) mediates this transport and is an antimalarial target, but its molecular basis is unknown. We report a parasite gene family responsible for PSAC activity. We used high-throughput screening for nutrient uptake inhibitors to identify a compound highly specific for channels from the Dd2 line of the human pathogen P. falciparum. Inheritance of this compound's affinity in a Dd2 × HB3 genetic cross maps to a single parasite locus on chromosome 3. DNA transfection and in vitro selections indicate that PSAC-inhibitor interactions are encoded by two clag3 genes previously assumed to function in cytoadherence. These genes are conserved in plasmodia, exhibit expression switching, and encode an integral protein on the host membrane, as predicted by functional studies. This protein increases host cell permeability to diverse solutes.PaperFlick

Ossifying fibromas are uncommon benign lesion with aggressive local growth. These tumors thought to originate from the periodontal ligament. WHO 2005 classified juvenile ossifying fibroma (JOF) into juvenile psammomatoid ossifying fibroma and juvenile trabecular ossifying fibroma. These tumors must be treated by radical excision to prevent recurrence. We report a case of JOF of psammomatoid pattern in a 12 year old boy, the treatment was radical en bloc resection.

India.) Abstract: Neurofibromas arise from a mixture of cell types including Schwann cells and perineural fibroblasts. They may occur as solitary lesions or in association with neurofibromatosis. Although most commonly reported in soft tissues, neurofibromas do occur in bone. And very few cases have been reported in association with the inferior alveolar nerve. We report a case of neuro-fibroma of spindle cell origin associated with the inferior alveolar nerve in a 22 year old man. Pain or paresthesia may result from lesions of the inferior alveolar nerve. Patients presents with cortical expansion. Intra-osseous lesions may produce a well demarcated or poorly defined unilocular or multilocular radiolucency. Adjacent soft tissue neurofibromas may produce cortical erosion. Solitary neurofibromas and those found in association with neurofibromatosis share the same microscopic features 1 . The tumor is composed of spindle-shaped cells with fusiform or wavy nuclei in a delicate

Necrotizing fasciitis (NF) is a rare infection of the facial planes and it is less common in head and neck, because of the rarity and higher vascularity in the region. We report a case of necrotizing fasciitis in a 67- year-old man, arising from a dental infection treated successfully by early diagnosis, prompt surgical management, antibiotic therapy and adjunctive hyperbaric oxygen (HBO) therapy. It is associated with a high mortality and results in severe disfigurement of the face, posing challenging reconstructive problems. The authors present their experience on the comprehensive management of NF of face

The plasmodial surface anion channel (PSAC) is an unusual small-conductance ion channel induced on erythrocytes infected with plasmodia, including parasites responsible for human malaria. Although broadly available inhibitors produce microscopic clearance of parasite cultures at high concentrations and suggest that PSAC is an antimalarial target, they have low affinity for the channel and may interfere with other parasite activities. To address these concerns, we developed a miniaturized assay for PSAC activity and carried out a high-throughput inhibitor screen. Approximately 70,000 compounds from synthetic and natural product libraries were screened, revealing inhibitors from multiple structural classes including two novel and potent heterocyclic scaffolds. Single-channel patch-clamp studies indicated that these compounds act directly on PSAC, further implicating a proposed role in transport of diverse solutes. A statistically significant correlation between channel inhibition and in vitro parasite killing by a family of compounds provided chemical validation of PSAC as a drug target. These new inhibitors should be important research tools and may be starting points for much-needed antimalarial drugs.

Human erythrocytes infected with the malaria parasite Plasmodium falciparum have increased permeabilities to many solutes. The plasmodial surface anion channel (PSAC) may mediate these changes. Despite good understanding of the biochemical and biophysical properties, the genetic basis of PSAC activity remains unknown. Functional polymorphisms in laboratory isolates and two mutants generated by in vitro selection implicate a parasite-encoded channel, although parasite-induced modifications of endogenous channels have not been formally excluded. Here, we identified stable differences in furosemide efficacy against PSAC activity induced by HB3 and 3D7A parasites. This difference was apparent in both single PSAC patch-clamp recordings and in sorbitol-mediated osmotic lysis measurements, confirming that Cl(-) and sorbitol are transported by a single-channel type. Examination of 19 progeny from a genetic cross between HB3 and 3D7A revealed complex inheritance with some cloned progeny exhibiting furosemide affinities outside the range of parental values. Isolates generated by selfing of the 3D7A clone also exhibited altered furosemide affinities, implicating changes in one or more alleles during meiosis or passage through a primate host. PSAC may be encoded by multiple parasite genes (e.g. a multi-gene family or multiple genes that encode distinct channel subunits) or a single polymorphic gene under strong selective pressure.

International audience; The altered permeability characteristics of erythrocytes infected with malaria parasites have been a source of interest for over 30 years. Recent electrophysiological studies have provided strong evidence that these changes reflect transmembrane transport through ion channels in the host erythrocyte plasma membrane. However, conflicting results and differing interpretations of the data have led to confusion in this field. In an effort to unravel these issues, the groups involved recently came together for a week of discussion and experimentation. In this article, the various models for altered transport are reviewed, together with the areas of consensus in the field and those that require a better understanding.

Erythrocytes infected with malaria parasites exhibit marked increases in permeability to organic and inorganic solutes. The plasmodial surface anion channel (PSAC), an unusual voltage-dependent ion channel induced on the host membrane after infection, may play a central role in these permeability changes. Here, we identified a functional PSAC mutant through in vitro selection with blasticidin S. Resistance to blasticidin S was generated during culture and correlated with significant reductions in permeability to multiple solutes, consistent with uptake via a common pathway. Single channel recordings revealed marked changes in PSAC gating with the addition of a subconductance state not present in wild-type channels. The channel's selectivity profile and pharmacology also were significantly altered. Eventual loss of the mutant phenotype upon removal of selective pressure and slower growth of mutant parasites suggest that PSAC serves an important role in intracellular parasite survival. These findings provide solid evidence for the uptake of diverse solutes via PSAC and implicate one or more parasite genes in expression of this channel.

A prospective study on 100 patients presented with a mesioangular impacted mandibular third molar in close proximity to the inferior alveolar nerve canal (IANC) was done to evaluate the efficacy of tooth sectioning in reducing the incidence of inferior alveolar nerve (IAN) injury during their surgical removal. The patients were divided into two groups: group A, where tooth sectioning was not performed, and group B, where tooth sectioning was performed. Patients were recalled 7 days, 15 days, 30 days, 3 months, and 6 months postoperatively for evaluation of nerve injury and its recovery. A total of 13 patients suffered from nerve damage out of which 10 patients (10/50 or 20 %) belonged to group A and 3 patients (3/50 or 6 %) belonged to group B. All patients showed complete recovery from nerve damage within 6 months except 1 patient. The result of the study showed that tooth sectioning significantly reduces the incidence of nerve damage by 14 %. Deviation of the IANC, increased depth of the impacted tooth, intraoperative hemorrhage within socket/nerve exposure, and increased duration of procedure were found to be the significant risk factors associated with nerve injury.

To ascertain the pattern, incidence, causes, age and sex distribution, types, condition and treatment of maxillofacial fractures and their interwoven relationship being practiced in Bhopal. Retrospectively 3 year records of patients with maxillofacial fractures from 12 selected centres in Bhopal were reviewed. The following data were extracted from the medical records: age; gender; site of the fracture(s); other associated injury(ies); cause of the trauma and method of treatment(s). In 1268 patients, a total of 2613 fractures were found of which 44.58 % patients had mandibular fractures. Parasymphysis was the most common site of fracture overall. Most patients were in the 21–30 year old age group, and the male: female ratio was 3.3:1. Road traffic accident accounted for 858 cases (67.67 %). Head injury was the highest occurring associated injury. Open surgical modalities was the most employed treatment modality in 52.60 % of cases. Preference for open surgical treatment along with increasing trend of supplemental intermaxillary fixation was found, which prompts us to check for the underlying reason behind this, which could be the increasing number of displaced and comminuted fracture cases or the decreasing efficiency of open reduction treatment rendered. Latter reason prompts to re-evaluate the existing surgical techniques and expertise of the practicing surgeons.

We report a case of severe streptococcal cellulitis in a healthy 47 year old male, where the sole microbial isolate was a beta-haemolytic group G Streptococcus. Treatment failure with high dose penicillin was observed despite in vitro sensitivity. The addition of clindamycin resulted in dramatic clinical improvement. This may indicate an Eagle-type effect (whereby antibiotics exhibit paradoxically reduced bactericidal activities at high drug concentrations), in group G beta-haemolytic infections. Although well documented with group A streptococcal infections, this phenomenon has not been fully recognised with group G beta-haemolytic streptococcal infections. This may have important implications for clinical management.

Syphilis is a sexually transmissible disease caused by treponema palladium, a microaerophilic spirochete. Syphilis may progress from primary to tertiary stage if left unnoticed and untreated. Dentists should be vigilant and suspect sexually transmitted infections such as syphilis in the differential diagnosis of oral inflammatory or ulcerative lesions with palatal perforation. Moreover, it is imperative that dentists should have knowledge about its stages, characteristic features, oral presentation and prosthetic rehabilitation. This case report describes a case of tertiary syphilis with palatal perforation and the prosthetic rehabilitation of the defect with a prosthetic obturator.

Objectives The aim of this study is to evaluate the position of impacted third molars based on the classifications of Pell & Gregory and Winter in a sample of Bhopal patients. Study design In this retrospective study, up to 1100 orthopantomograms (OPG) of the patients who were reported to the MaxilloFacial Department of PDA and Chowdhary hospital from January 2011 to December 2012 were evaluated. Results Among 1100 patients, 730 were male and 370 were female patients. Of the 1100 OPGs studied, 3,910 third molars were noticed either impacted or erupted and 490 third molars were missing. The most common angulation of impaction in the mandible was in vertical position (41.4%) followed by mesioangular impaction (33.3%) and the most common angulation of impaction in the maxilla was the vertical (67.4%) which was followed by 15.2% in distoangular impaction. The level of eruption of impacted third molar was found to be 43.9% at level A, 34.8% at level B and 21.3% at level C. There was no significant difference between the right and left sides in both the jaws. Conclusion The pattern of third molar impaction in the region of Bhopal is characterized by a high prevalence of impaction, especially in the mandible. The most common angulation was the vertical in the mandible as well as in the maxilla. The most common level of impaction in mandible was level A and in maxilla is level C and there was no any significant difference between the right and left sides in both jaws.

Malaria parasites grow within vertebrate erythrocytes and increase host cell permeability to access nutrients from plasma. This increase is mediated by the plasmodial surface anion channel (PSAC), an unusual ion channel linked to the conservedclaggene family. Although PSAC recognizes and transports a broad range of uncharged and charged solutes, it must efficiently exclude the small Na+ion to maintain infected cell osmotic stability. Here, we examine possible mechanisms for this remarkable solute selectivity. We identify guanidinium as an organic cation with high permeability into human erythrocytes infected withPlasmodium falciparum, but negligible uptake by uninfected cells. Transport characteristics and pharmacology indicate that this uptake is specifically mediated by PSAC. The rank order of organic and inorganic cation permeabilities suggests cation dehydration as the rate-limiting step in transport through the channel. The high guanidinium permeability of infected cells also allows rapid and stringent synchronization of parasite cultures, as required for molecular and cellular studies of this pathogen. These studies provide important insights into how nutrients and ions are transported via PSAC, an established target for antimalarial drug development.

The aesthetic replacement of anterior teeth in cases of immediate partial denture is always a challenging work for prosthodontists. There is always problem of matching size, colour, shade and shape of the replaced tooth with those of the natural teeth. It was most difficult to satisfy the patients who have high aesthetic demands. Here is a report of a case where patient’s own natural tooth was used for replacement in an immediate partial denture. An immediate denture is defined as “any removable dental prosthesis which is fabricated for placement immediately, following the removal of a natural tooth/teeth” . Patients with missing anterior teeth lack an impressive appearance aesthetically and as well as psychologically. Tooth loss leads to a certain degree of loss of function. This loss of function might lead to an impairment of oral health which is related to quality of life. An immediate denture can replace 1-16 teeth in either the maxillary or the mandibular arch, or in both arches. The need for the immediate replacement of a missing tooth is more in case of an anterior tooth, where aesthetics is of prime concern. The replacement of an anterior tooth is most technique sensitive, as it includes the patient’s expectations, which include, matching with proper shade, shape and size as those of his/her natural teeth. So, here is a case presentation where modern day patient expectations were taken into consideration.

Salivary dysfunction may be due to systemic diseases and medications. The development of sialoliths is a multifactorial event in which disturbance in secretion, microliths and bacteria may play a major role. A case of sialolith in the parotid gland of a 25-year-old man, with no relevant medical history is reported here.

Malaria parasites increase their host erythrocyte's permeability to a broad range of ions and organic solutes. The plasmodial surface anion channel (PSAC) mediates this uptake and is an established drug target. Development of therapies targeting this channel is limited by several problems including interactions between known inhibitors and permeating solutes that lead to incomplete channel block. Here, we designed and executed a high-throughput screen to identify a novel class of PSAC inhibitors that overcome this solute-inhibitor interaction. These new inhibitors differ from existing blockers and have distinct effects on channel-mediated transport, supporting a model of two separate routes for solute permeation though PSAC. Combinations of inhibitors specific for the two routes had strong synergistic action against in vitro parasite propagation, whereas combinations acting on a single route produced only additive effects. The magnitude of synergism depended on external nutrient concentrations, consistent with an essential role of the channel in parasite nutrient acquisition. The identified inhibitors will enable a better understanding of the channel's structure-function and may be starting points for novel combination therapies that produce synergistic parasite killing.

Sickle cell disease is a common inherited autosomal disease that is characterised by abnormally shaped (sickle-shaped) red blood cells (RBCs). It can involve virtually any organ system. The clinical manifestations of sickle cell disease vary and are classified as vaso-occlusion, chronic anaemia and infection. The imaging appearances of central nervous system and musculoskeletal involvement by sickle cell disease have been well documented; however, involvement of the head and neck region is often unreported, although it is not uncommon. In the head and neck, sickle cell disease can involve the inner ears, orbits, paranasal sinuses, bones, lymph nodes and vessels. This paper describes a case of idiopathic facial swelling associated with sickle cell disease in a young patient.