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A new type of coronavirus that causes pneumonia was first detected in December 2019, in Wuhan. It was first denoted as the 2019 novel coronavirus (2019-nCoV). The International Committee on Taxonomy of Viruses, Wuhan in December 2019, referred to a new coronavirus capable of infecting humans as SARS-CoV-2. At the same time, the World Health Organization declared the official name of the disease caused by this virus as COVID-19.In this cross-sectional questionnaire survey, 180 participants out of 190 participants were included to evaluate the knowledge and attitude about the pediatric dental treatment during covid-19 pandemic among parents, who visited the department of Pedodontics and Preventive Dentistry, of Universal College of Medical Sciences, during covid-19 pandemic for three months (February 2021 to April 2021), in Bhairahawa, Nepal.In this study out of 180 participants, 105(58.33%) were male and 75(41.66%) were female. All parents were concerned and aware of COVID-19. Every child was explained about covid-19 viruses by their parents.Even though the parents were aware of the Covid-19 pandemic and had discussed it with their children, still they do not prefer any kind of dental treatment even in severe pain. As they thought that other places are less infectious than a pediatric dental clinic.Thus, the aim of this study was to evaluate the knowledge and attitude of pediatric dental patients’ parents’ towards COVID-1 9 in Bhairahawa, Nepal.

Healing of periodontal tissue is a complex process which involves various molecular and biological sequence of co-ordinated events. Growth factors plays a vital role in periodontal regeneration. The following review gives insight into role of various growth factors involved in periodontal regeneration. Keywords: Cellular Biology, Growth factors, Healing, Regeneration.

Atherosclerosis, or the formation of fibrofatty lesions in the corridor divider, is liable for a brilliant deal of distress and mortality round the sector, along with most myocardial necrosis and plenty of strokes, in addition to incapacitating fringe deliver direction sickness. Low-thickness lipoprotein, a molecule that enables ldl cholesterol move thru the bloodstream, is idea to be required for the development of atherosclerotic lesions. High blood pressure, cigarette smoking, and diabetes mellitus are all risk factors for atherosclerosis and related thrombotic complications. Growing records additionally emphasizes the importance of the immune system, because irritation and clonal haematopoiesis are new risk factors. Atherogenesis research on the cellular and subatomic ranges has found out plenty approximately the mechanisms that relate every of these hazard factors to atheroma progression and scientific signs of the contamination. A spread of invasive (which include coronary angiography) and noninvasive (including blood biomarkers, strain checking out, CT, and atomic scanning) diagnostic strategies are to be had to assess cardiovascular disorder danger and treatment precedence. CONCLUSION: Atherosclerosis is a long-time period inflammatory condition that influences the inner partitions of huge and medium-sized arteries. Irritation and oxidative pressure are the number one pathogenic tactics, which can be prompted by a selection of genetic, epigenetic, and environmental variables. Through the generation of inflammatory cytokines, LDL-c and its oxidatively modified variants contribute to numerous levels of atherosclerotic plaque development.

In present time, lifestyle disorders are rapidly rising in our society. Over consumption of food, alcohol and fructose sweetened soft drinks in combination with a sedentary lifestyle has resulted in increased prevalence of visceral obesity, metabolic syndrome and gout in all socioeconomic groups of society including the lower socioeconomic status. Gout is one of the major life style disorders. The clinical manifestation and textual references of gout may be attributed with 'Vatarakta', also known as Vatashonita. Vata and Rakta are the Dosha and Dushya respectively which are primarily involved in the pathology of Vatarakta. Virudhaahar and Vihara aggravate Vata dosha and Rakta dhatu. Provocated Vata gets Aavrut with vitiated Rakta dhatu leading to the beginning of pathophysiological cascade of Vatarakta. The patients for this study were diagnosed based on Ayurvedic and modern parameters. Clinical signs and symptoms described in classical texts were considered for the diagnosis of Vatarakta, whereas serum uric acid was considered as investigation based diagnostic tool. Total 15 patients were registered in trial. The selected patients were given the trial drug i.e., Amrita guggulu one gram and Guduchi kwath 50ml twice a day with plain water after food. Out of 15 registered patients, 1 dropout from the trial, 4 patients (28.57%) showed marked improvement, 7 patients i.e., 50% showed moderate improvement and 3 patients 21.43% showed mild improvement. None of patient in present clinical trial remained unimproved or deteriorated during the clinical trials. In the present study, none of the patient reported any adverse effect to the trial drug during study and follow up period.

Skeletal muscle is an endocrine organ secreting exercise-induced factors (exerkines), which play a pivotal role in interorgan cross talk. Using mass spectrometry (MS)-based proteomics, we characterized the secretome and identified thymosin β4 (TMSB4X) as the most upregulated secreted protein in the media of contracting C2C12 myotubes. TMSB4X was also acutely increased in the plasma of exercising humans irrespective of the insulin resistance condition or exercise mode. Treatment of mice with TMSB4X did not ameliorate the metabolic disruptions associated with diet induced-obesity, nor did it enhance muscle regeneration in vivo. However, TMSB4X increased osteoblast proliferation and neurite outgrowth, consistent with its WADA classification as a prohibited growth factor. Therefore, we report TMSB4X as a human exerkine with a potential role in cellular cross talk.

Thalassemias are a group of inheritable hemoglobinopathies where abnormal hemoglobin is synthesized leading to decreased hemoglobin levels in the body. Thalassemias are classified according to which chain of the hemoglobin molecule is affected. In α-thalassemias, production of the α-globins chain is affected, while in β-thalassemia, production of the β-globins chain is affected. Thalassemias are a grave menace in the modern world which need to be tackled effectively and quickly to improve the health status of people around the world.

Hypertension is emerging as a pandemic in the society. It can lead to severe health complications and increases the risk of many fatal diseases. Though a lot of potent antihypertensive drugs are available today but none of them is free from untoward effects. Due to these reasons the public acceptability for currently available antihypertensive drugs is very poor. The present study is aimed to evaluate the efficacy of an Ayurvedic formulation i.e., Jatamansyadi Kwatha and Shirodhara in the management of stage - I hypertension. Twenty patients of either sex of stage-I essential hypertension in the age group of 20-80 years were registered for the present study. Registered patients were randomly divided into two groups. In group-I, hypertensive patients were managed with Jatamansyadi Kwatha and in group-II patients, in addition to the administration of Jatamansyadi Kwatha, Shirodhara was also done. The duration of trial was 30 days. After one month of therapy, statistically highly significant reduction in both systolic B.P. and diastolic B.P. was observed in both groups. In group-II patients, statistically significant reduction in mean arterial B.P., pulse pressure and pulse rate were observed. Whereas in group-I, the effect of therapy on mean arterial B.P., pulse pressure and pulse rate were statistically insignificant. Therapy given in Group-II has shown the marginal advantage over the therapy given in Group-I. However statistically highly significant reduction was observed in both systolic and diastolic blood pressure in both the groups but the intergroup difference between the therapies was statistically insignificant.

The present study was undertaken to evaluate and compare the skeletal, dental, and soft tissue changes in skeletal Class II division 1 cases treated with Twin Block and Clear Block appliances using a cephalogram. A total of 40 patients of age between 12-14 years were randomly divided into two equal groups. Group 1: treated with Twin Block appliance and Group 2: treated with Clear Block appliance. The pre-treatment lateral cephalogram was taken and skeletal, dental, and soft tissue parameters were evaluated and the appliance was delivered. After 8 months, another lateral cephalogram of all the cases was taken and analyzed. The pre and post-treatment values were compared between the two groups. The pre-treatment cases were almost comparable in skeletal, dental, and soft tissue features in both groups. There was a significant change in mandibular growth by SNB angle. The retrusion and extrusion of maxillary incisors as well as a proclination and extrusion of mandibular incisors were seen in group 1 while no change was observed in group 2. Treatment with Clear Block appliances has shown significant and favorable Skeletal, Dental and Soft tissue changes which are similar to already proven by the Twin Block appliance. Clear Block provides an esthetic and less bulky option for growth modification with similar results as compared to conventional Twin Block with the additional benefit of preventing lower incisor proclination.

Introduction: Oral health is considered to be a mirror of systemic health and vice-versa. Medical professionals are considered to be the primary caregivers in a given population and as such a vast majority of the population visits them for health-related problems. Therefore, this study aimed to evaluate the level of knowledge and awareness of dentistry among first-year medical students, residents, and medical practitioners. Methods: A cross-sectional questionnaire survey was carried out to assess the knowledge and awareness of dentistry among MBBS first-year students, medical residents, and medical practitioners of Bhairahawa city, Nepal. Data analysis was done with SPSS version 11. Results: As per the demographic characteristics out of 147 subjects 82 (55.8%) were male and 65 (44.2%) were female. Most of the participants were from the age group of 21–30 years, 66 (44.9%) and 115 (78.2%) of them were married. Among 147 subjects every respondent (100%) knew about the profession of dentistry giving statistically significant results. Conclusion: The present study shows that medical professionals had better knowledge of dentistry as compared to medical students and residents. This unnecessary gap between dental and medical professionals can only be fulfilled by including dental education in both undergraduate and postgraduate medical curriculum.

Background COVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers. Methods The COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables. Results A total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ± 11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group > 45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR = 3.32; p = 0.020) of developing distress as compared to respondents with secondary education or lower. Conclusion There is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.

Increased incidence of bone fractures in the elderly is associated with gradual sarcopenia. Similar deterioration of bone quality is seen with prolonged bed rest, spinal cord injuries or in astronauts exposed to microgravity and, preceded by loss of muscle mass. Signaling mechanisms involving uridine-5'-triphosphate (UTP) regulate bone homeostasis

Ocrelizumab is a recombinant humanized antibody targeted against CD‐20 molecule, which was approved for the treatment of relapsing and primary progressive multiple sclerosis. Common adverse events of ocrelizumab include infusion‐related reactions like rash, pruritus, and flushing. Late‐onset neutropenia (LON) is a rarely reported complication of ocrelizumab therapy. We report a case of severe late‐onset neutropenia in a patient with primary progressive multiple sclerosis treated with ocrelizumab with neutropenia occurring 3 months after the last dose received treated with empirical broad‐spectrum intravenous antibiotics and filgrastim. Severe late‐onset neutropenia is a rare unpredictable adverse event and outlines the importance of regular routine blood workup for detecting severe neutropenia early in its course., We would like to acknowledge Rohit Rauniyar for his valuable inputs during the writing of this article.

Background: Human Immunodeficiency Virus (HIV) has become one of the most serious challenges to public health due to its high morbidity, mortality and economic impacts. Good Knowledge, positive attitudes and practices are important aspects of providing nursing care for people living with HIV/AIDS. Aim: This study aimed to assess knowledge, attitudes and practices of nurses working with HIV/AIDS patients. Methods: This study was descriptive, performed on 200 nurses working with HIV/AIDS patients at a tertiary care Hospital, Amroha. Data was collected using pretested, validated, self administered questionnaire consisting of knowledge, attitude and practice based questions related to HIV/Aids and infected patients along with demographic variables of nursing staff under study. Results: The result of this study showed that majority of nurses (81%) working with HIV/AIDS patients possess adequate level of knowledge. Most of the nurses under study showed high level of empathic attitude toward people living with HIV/AIDS (above 80%) but at the same time high level of avoidance was observed among some nurses. Practice of nurses working with HIV/AIDS patients was found good. Conclusions: There was satisfactory knowledge, positive attitudes and good practice level among nurses under study. Recommendations: Training should focus on Preventive methods and modes of HIV transmission, care and support of all patients no matter what the disease, emphasizing confidentiality as a patient right that should not be ignored and should train nurses and monitor nursing skills. Keywords: Public health, Nurses, HIV, Knowledge, Attitude, Practices

Synthetic dyes cause hazardous health-related problems in humans and affect the biological system underwater. They also have a negative impact on the nutritive value of soils and thereby on crops. Until now there is no effective method to remove the harmful component of dyes from the environment. However, the integrated treatment using bio agents with implication of physical and chemical processes can be effective in the treatment of dye effluents. From the complex azo dyes to their dissociation via thallophytes is a new scope for sustenance. Various studies have supported that laccases have the capability to degrade synthetic dyes that have different chemical structures. Thallophytes have been used to degrade the complex dyes with varying ranges of temperature and pH. Thallophytes have recently been used to treat the textile effluents with effective higher temperature and alkaline pH with decreasing BOD and thus cleaning them from environment in an eco-friendly and cost-efficient manner.

Quorum quenching is the process that prevents quorum sensing through the disruption of signalling cascade and bacterial communication among themselves mediated by the degradation of the signalling molecules. Therefore, quorum quenching has a considerable contribution in the negative regulation of threatening diseases and eventually increasing soil reclamation through different mechanism mediated by microorganisms in reclamation of soil. Quorum sensing has a significant contribution in enhancement of soil quality through microbial-based enzymes and mechanism in the versatile fields which are a component of the environment. The current chapter discusses the details of various direct and indirect mechanisms mediated by microbial systems that have a significant role in soil reclamation for the sustenance of the environment.

Multiple myeloma is a malignant expansion of plasma cells and aggressively affects bone health. We show that P2X7 receptor altered myeloma growth, which affects primary bone cells in vitro. Expression on six human myeloma cell lines confirmed the heterogeneity associated with P2X7 receptor. Pharmacology with 2&prime, (3&prime, )-O-(4-benzoylbenzoyl) adenosine 5&prime, triphosphate (BzATP) as agonist showed dose-dependent membranal pores on RPMI-8226 (p = 0.0027) and blockade with P2X7 receptor antagonists. Ca2+ influx with increasing doses of BzATP (p = 0.0040) was also inhibited with antagonists. Chronic P2X7 receptor activation reduced RPMI-8226 viability (p = 0.0208). No apoptosis or RPMI-8226 death was observed by annexin V/propidium iodide (PI) labeling and caspase-3 cleavage, respectively. However, bromodeoxyuridine (BrdU) labelling showed an accumulation of RPMI-8226 in the S phase of cell cycle progression (61.5%, p = 0.0114) with significant decline in G0/G1 (5.2%, p = 0.0086) and G2/M (23.5%, p = 0.0015) phases. As myeloma pathology depends on a positive and proximal interaction with bone, we show that P2X7 receptor on RPMI-8226 inhibited the myeloma-induced suppression on mineralization (p = 0.0286) and reversed the excessive osteoclastic resorption. Our results demonstrate a view of how myeloma cell growth is halted by P2X7 receptor and the consequences on myeloma&ndash, osteoblast and myeloma&ndash, osteoclast interaction in vitro.

Additional file 1. Online questionnaire.

Background: Chronic kidney disease (CKD) is associated with several cutaneous manifestations as a result of CKD per se, underlying disease(s) leading to it or the treatment thereof. Cutaneous manifestations get altered following hemodialysis. We studied the prevalence of various dermatoses and the effect on pruritus in patients with CKD on hemodialysis.Methods: Seventy-three patients with CKD having at least one cutaneous manifestation undergoing hemodialysis in Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune were included.Results: Sixty-four (87.67%) of the participants belonged to the age group of 40-69 years; 28 (38.35%), to the sixth decade. The male to female ratio was 1.8:1. Forty-eight patients (65.75%) suffered from diabetes mellitus, 37 of these also from hypertension. Xerosis (72.6%), pallor (65.8%) and pruritus (60.3%) were the common manifestations. The intensity of pruritus remained unchanged in 82% of those affected. Nail changes were seen in 47.9% cases (half-and-half nail, 19.2%; subungual hyperkeratosis, 11%; leukonychia, 6.8%; melanonychia, 6.8%; Beau’s lines, 4.1%). Infections were observed in 32.8% cases (superficial mycoses, 19.2%; bacterial, 6.8%; scabies, 4.1%; viral, 2.7%). Dyspigmentation was documented in 30.1% (hyperpigmentation, 21.92%; yellow tinge, 8.22%), hair changes in 23.3% (sparse scalp hair,16.4%; lusterless hair, 6.9%), acquired perforating dermatoses in 19.2%, and arteriovenous shunt dermatitis in 2.7% cases.Conclusions: Xerosis was the commonest finding and pruritus, the commonest symptom; the intensity of the latter remained largely unaffected by hemodialysis. Half-and-half nail was the most common nail change and superficial mycoses, the most common infection.

Tumour metastasis is a complex process involving reciprocal interplay between cancer cells and host stroma at both primary and secondary sites, and is strongly influenced by microenvironmental factors such as hypoxia. Tumour-secreted proteins play a crucial role in these interactions and present strategic therapeutic potential. Metastasis of breast cancer to the bone affects approximately 85% of patients with advanced disease and renders them largely untreatable. Specifically, osteolytic bone lesions, where bone is destroyed, lead to debilitating skeletal complications and increased patient morbidity and mortality. The molecular interactions governing the early events of osteolytic lesion formation are currently unclear. Here we show hypoxia to be specifically associated with bone relapse in patients with oestrogen-receptor negative breast cancer. Global quantitative analysis of the hypoxic secretome identified lysyl oxidase (LOX) as significantly associated with bone-tropism and relapse. High expression of LOX in primary breast tumours or systemic delivery of LOX leads to osteolytic lesion formation whereas silencing or inhibition of LOX activity abrogates tumour-driven osteolytic lesion formation. We identify LOX as a novel regulator of NFATc1-driven osteoclastogenesis, independent of RANK ligand, which disrupts normal bone homeostasis leading to the formation of focal pre-metastatic lesions. We show that these lesions subsequently provide a platform for circulating tumour cells to colonize and form bone metastases. Our study identifies a novel mechanism of regulation of bone homeostasis and metastasis, opening up opportunities for novel therapeutic intervention with important clinical implications.

The role of the P2X7 receptor (P2X7R) is being explored with intensive interest in the context of normal bone physiology, bone-related diseases and, to an extent, bone cancer. In this review, we cover the current understanding of P2X7R regulation of bone cell formation, function and survival. We will discuss how the P2X7R drives lineage commitment of undifferentiated bone cell progenitors, the vital role of P2X7R activation in bone mineralisation and its relatively unexplored role in osteocyte function. We also review how P2X7R activation is imperative for osteoclast formation and its role in bone resorption via orchestrating osteoclast apoptosis. Variations in the gene for the P2X7R (P2RX7) have implications for P2X7R-mediated processes and we review the relevance of these genetic variations in bone physiology. Finally, we highlight how targeting P2X7R may have therapeutic potential in bone disease and cancer.