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Background The prevalence of tobacco chewing, and related oral mucosal lesions is alarmingly high amongst the Paniya tribes of Wayanad. A deeper understanding of their socio-cultural factors, beliefs, attitudes and behaviours would shed greater insights into the indiscriminate use of smokeless tobacco and related products in this community. Methods Ethnography was the theoretical framework adopted with network and convenience sampling. Fifteen in-depth interviews and two focus group discussions were conducted among the key informants from within the tribal colonies of Cheepram and Madikkunnu. The data was audio recorded and converted into verbatim transcripts. Thematic content analysis was done using an inductive approach performed using computer-assisted qualitative data analysis software (NVivo). Results This study is suggestive of parental influence and peer pressure as the key factors for smokeless tobacco initiation amongst the adolescent. There was a greater predisposition for women to be chewers of tobacco, particularly after marriage. The key factors influencing initiation of the habit amongst men include peer pressure and availability of tobacco at workplace. The role of contextual factors such as enculturation, marginalization and perceived health benefits also play a substantial role in development of this habit. Conclusion Targeted strategies for effective tobacco control can be developed through an understanding of the socio-cultural factors leading to initiation of smokeless tobacco use among disadvantaged communities.

A comprehensive understanding of molecular and biochemical changes during sperm capacitation is critical to the success of assisted reproductive technologies. We reported involvement of the testis-specific isoform of Angiotensin Converting Enzyme (tACE) in bovine sperm capacitation. The objective of this study was to characterize the tACE interactome in fresh and heparin-capacitated bovine sperm through immunoprecipitation coupled with mass spectrometry. These interactions were validated by co-localization of tACE with beta-tubulin as an identified interactome constituent. Although interactions between tACE and several proteins remained unchanged in fresh and capacitated sperm, mitochondrial aldehyde dehydrogenase 2 (ALDH2), inactive serine/threonine protein-kinase 3 (VRK3), tubulin-beta-4B chain (TUBB4B), and tubulin-alpha-8 chain (TUBA8) were recruited during capacitation, with implications for cytoskeletal and membrane reorganization, vesicle-mediated transport, GTP-binding, and redox regulation. A proposed tACE interactional network with identified interactome constituents was generated. Despite tACE function being integral to capacitation, the relevance of interactions with its binding partners during capacitation and subsequent events leading to fertilization remains to be elucidated.

Background Recreation of the normal proximal femoral anatomy is paramount for a successful total hip arthroplasty. The study aims to look at whether the range of offset options available in the femoral stems available locally, would be adequate to restore the native femoral horizontal offset (FHO) of the South Indian population. Method This is a prospective single-center study of 1-year duration, where we study the FHO on radiographs and CT scans in 100 patients. We then look at the femoral stems available in the Indian market and see if the offset may be restored with the available stems. Result The FHO ranged from 23.3 to 46.9 mm with a mean of 35.7 ± 5.3 mm. The females in the group (33.86 ± 4.71 mm) had a lower FHO compared to males (37.78 ± 5. 21 mm). We found that 50% of the South Indian population and 62% of the females have an offset less than 35 mm. Among the 18 stems that we studied, four out of nine cemented and two out of nine uncemented stems did not offer an offset below 35 mm. Conclusion The native FHO in the South Indian population is significantly less than that of Caucasians. The surgeon should be aware that many implant systems available in India do not offer offset options in this range. In this group, even when a stem with smallest offset is used, there is a risk of increasing the FHO with a potential for intraoperative fractures due to difficult reduction and leg-lengthening. Hence, the surgeon should template carefully and choose only those implant systems which can offer an offset similar to the native offset to restore the anatomy accurately. We recommend that all manufacturers consider offering implants with smaller offset (25–35 mm).

Introduction: Dentin hypersensitivity (DH) due to exposed dentine is common among periodontitis patients. The present study compares & evaluates the dentinal tubule occlusion achieved with NovaMin® containing dentifrice & 810 nm diode laser by means of SEM. Materials and Methods: Sixty human premolar dentin discs of 2mm thickness were sanded with wet 600-grit carborundum paper and treated with 17% EDTA. Specimens were allotted to three groups of twenty each: Group 1- Control group, Group 2 –NovaMin® containing dentifrice application, Group 3 - lased with 810 nm diode laser. The proportion of completely occluded tubules and of partially occluded tubules to the total tubules (CO/TT & PO/TT) in the three groups were calculated, and analyzed. Results: Both NovaMin® and Laser demonstrated more complete and partial occlusion of tubules than control group. The incidence of complete occlusion was more with NovaMin®, but that of partial occlusion was similar to diode laser group. Conclusions: Although dentinal tubules occlusion was effective by both NovaMin®& diode laser (810 nm), NovaMin® produced a more complete occlusion of dentinal tubules. Keywords: Dentin hypersensitivity, Diode laser, Dentinal tubule occlusion, Scanning electron microscope.

Gesture controlled wheelchair is designed and intended to perform specific job functions combining software interfacing with the hardware along with the embedded electronics, through hand controlled gestures. In this paper, a novel multiple control option-based wheelchair is proposed to cater to the needs of handicapped patients and senior citizens. This work is aimed at designing, integrating, coding, interfacing and testing a fully motorized, gesture controlled wheelchair which involves the physical implementation of the hardware, the software interfacing and testing. This Smart wheelchair is furnished with sensors, interactive cameras controlled by a processor unit that can control the various tasks it is designed to perform. The proposed Smart Wheelchair utilizes micro-electro-mechanical-system (MEMS) accelerometers to recognize various hand gestures performing a specific task. It is an accelerometer-based system which controls a robotic arm wirelessly using a small, low-cost, 3-axis degrees of freedom accelerometer through RF signals. The gestures are also trained by machine learning to identify the training patterns by choosing the appropriate mode selection. The hand gestures are thus based on motion sensor and pattern recognition. Apart from these hand gestures, the smart wheelchair can also be controlled by an android mobile app through a smartphone or by a hand held device that can navigate the smart wheelchair in the forward, backward, right, left directions and also perform a stop operation. The Smart Wheelchair also detects an obstruction present on the way of navigation and is operated in accordance with the command. An interactive camera equipped with a microphone and speaker is meant for communication for the elderly for sending and receiving voice commands remotely. The camera can be accessed through an IoT environment which can be communicated on remote IP addresses on smartphones and personal computers. There are two Arduino Uno Rev3 Controller modules programmed to control the gestures of the gyroscopic accelerometer and other control methods based on a mode selection switch held by the user. The proposed methodology is also realized by Proteus, a simulation tool to check its practical credibility. The proposed circuitry is physically realized as a Smart Wheelchair prototype implemented with the above multi control which could be modified as any physical structure platform having two wheels.

Crime is on the rise in today's world and with the emergence of the digital world, a whole new aspect to crime is open. With the rise in crime, a number of investigations at various fronts is necessary to bring the culprits to justice. Digital forensic investigation is one such branch of these investigations that has been increasingly popular and mandatory for providing justice. One of the problems that hinders the efficient execution of the investigation is the possible tampering of evidence. In digital forensics, it is digital evidence. Tampering of such evidence can lead to wrong judgments and erroneous accusations and can lead the investigation to be inaccurate. It is a serious offence and the culprit needs to be identified before being dealt with.The current system in place is able to identify the team or the agency responsible for the discrepancy but recognizing the individual that is the true culprit is almost impossible. The solution we propose is to integrate Blockchain to record and store the changes during an ongoing investigation. The chain of custody can be determined easily if only authorized people are allowed to access and the records of the access are being stored. This helps in maintaining the integrity of the digital evidence that is vital to an investigation. The creator creates the blockchain after collecting the necessary evidence. The investigators of the case are allowed to access this evidence for further analysis after providing their ID for recording who is accessing the evidence.Only the creator will be allowed to delete the evidence. The integrity of the evidence is preserved because Blockchain is immutable.This solution aims to help aid investigations to move on the right track with the accurate evidence required to prove the accused guilty or not guilty. It helps to supervise and observe that none of the investigators are indulging in any malpractices.

Background: The medical prescription is a valid and legal document. Prescriptions can also be used as a measure of the quality of medical education, observance of the laws and regulations, and sociocultural beliefs. Aims: To assess the quality of prescription written by dental and medical students and practitioners. Settings and Design: A cross-sectional study was conducted in three dental and two medical colleges in Kerala covering 345 participants (dental - 235 and medical - 110). Materials and Methods: Simulation exercise was conducted for drafting a model prescription based on a given clinical condition. The variables were identified based on the model prescription format by the Medical Council of India and were classified into four domains. Points were assigned for each variable. Statistical Analysis Used: Analysis was performed using descriptive statistics and Mann–Whitney U-test. Results and Conclusion: The total scores were found to be higher among dental fraternity (10.93 ± 2.88) to medical (10.81 ± 2.55). The medical house surgeons and postgraduates fared better in the doctor identification domain. Among the dental professionals, there was a significant difference among the undergraduates (mean score = 1.91) and postgraduates (mean score = 1.60) in the doctor identification domain. However, among the medical professionals, in the patient identification domain, house surgeons had a significantly higher score compared to postgraduates. There were no significant differences in quality of prescription writing among medical and dental professionals.

Background To compare the anti plaque efficacy of Modified Bass, Fones and Normal brushing techniques in young adults. Material and methods An investigator blinded randomized controlled trial with parallel design was adopted to compare the anti plaque efficacy of three tooth brushing techniques. The study population consisted of 120 dental students aged between 18 and 30 years. Results At the baseline, the mean plaque scores were 0.74 ± 0.39, 0.77 ± 0.34 and 0.98 ± 0.36 respectively, for Modified Bass, Fones and Normal brushing technique. After 24 hours without any oral hygiene activity, the plaque scores increased to 1.04 ± 0.30, 1.11 ± 0.32 and 1.21 ± 0.40, respectively. After 1 week of using the intervention, the mean plaque scores were 0.78 ± 0.36, 0.94 ± 0.34 and 1.03 ± 0.43, respectively and increased to 1.13 ± 0.44, 1.14 ± 0.40 and 1.08 ± 0.34 after 28 days. The mean gingival scores were 0.23 ± 0.66, 0.02 ± 0.52 and 0.42 ± 0.74 for Modified Bass, Fones and Normal Brushing technique during baseline visit and after 28 days. Conclusions There was a significant reduction in the amount of plaque with the three brushing techniques. Although the short-term outcomes with the Modified Bass method were promising, a long-term effect was not evident. Further, there was no significant difference in plaque control between the three groups. Key words:Gingival scores, plaque scores, tooth brushing techniques, young adults.

Page kidney is a rare phenomenon that can present with hypertension. The presence of a subcapsular perirenal collection causes parenchymal compression leading to renal hypoperfusion. Subsequent activation of the renin–angiotensin–aldosterone system results in an increase in systemic blood pressure. The causes of renal subcapsular collections are varied, with most cases being secondary to post-traumatic haematomas. We present the case of a young hypertensive patient, treated as primary hypertension with persistently uncontrolled blood pressures. This was despite good treatment adherence. On further investigation, imaging identified the presence of bilateral subcapsular collections. This case illustrates the importance of a thorough workup in a young hypertensive patient with refractory hypertension. Given that Page kidney is curable, timeous intervention can save the patient from unnecessary medications and the morbidity of uncontrolled blood pressures.

Tuberous sclerosis (TS) is an autosomal dominant, neurocutaneous disorder. Mutations of TSC1 and TSC2 genes which lead to the mechanistic target of rapamycin (mTOR) pathway dysregulation have been identified. In addition to the neurological and neuropsychiatric manifestations, the disease can have many other systemic manifestations affecting skin, kidneys, lungs, heart and eyes. The psychiatric manifestations can be broadly considered under neurodevelopmental, behavioural, intellectual, and psycho ocial symptoms. The diagnosis is often confirmed after a detailed evaluation. Treatment options include symptomatic management, prevention of loss of function of the affected organs and the etiological approach through mTOR inhibitors. Researches are being conducted using mTOR inhibitors like Rapamycin, everolimus and sirolimus on this regard. A case of organic delusional disorder with paranoid schizophrenia like symptomatology in a patient with TS is also described at the end.