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Objective: The present study was conducted to evaluate the effectiveness of treatment outcome using American Board of Orthodontics (ABO) scoring and total treatment time between labial and lingual appliance and also to assess patients’ perception of the lingual appliance system. Materials and Methods: Twenty patients requiring first premolar extraction were selected; 10 patients were treated with a lingual and 10 with a labial appliance. The treatment duration and ABO scores were recorded from the posttreatment dental casts and orthopantomogram (OPG). A questionnaire was used to evaluate the perception of patients on lingual treatment using a visual analogue scale (VAS). Results: The total ABO scores of the 2 groups were not statistically significant. The lingual- and labial-appliance treatments were completed in 19.30 ± 7.50 and 22.40 ± 6.35 months, respectively. The VAS showed that lingual-appliance patients experienced a moderate amount of pain and discomfort to the tongue and soft tissues. Patients did not have considerable difficulty with speech and in maintaining oral hygiene. Conclusion: Lingual appliance cases finished with a comparable quality of orthodontic treatment precision well within the normal treatment time frame. These patients had moderate difficulties with speech, tongue irritation, and pain. They did not have difficulty in maintaining their oral hygiene and were satisfied with their smile and treatment outcome.

Background The occurrence of adverse drug reactions with chemotherapy among cancer patients is a well-documented phenomenon. However, the understanding of contributoring factors and their influence on the severity of adverse drug reactions is incomplete without the psychosocial factors affecting them. Objective The present study was done to understand if factors like Health literacy and cognition levels have an association with the severity of adverse drug reactions of cancer chemotherapy. Setting This study was done in the Department of Medical Oncology in a tertiary care hospital in India. Method Two hundred and twenty-four patients meeting the study inclusion and exclusion criteria took part in the study. Details of adverse drug reactions were collected as per the central drugs standard control organization format and severity of adverse drug reactions assessed with National Cancer Institute common terminology criteria of adverse events, version 5.0. Health Literacy and Cognition Levels of patients were assessed using standardized questionnaires, i.e., Short test of functional health literacy in adults and short portable mental status questionnaire, respectively. Data were anonymized and analyzed using Statistical Package for Social Sciences version 16.0 software. Pearson’s Chi square test (p value ≤ 0.05 was considered statistically significant) was used to study the associations. Main outcome measure The associations of Health Literacy and Cognition Levels with the severity of adverse drug reactions. Result We found that both Health Literacy and Cognition Levels had a statistically significant association with Grade 3 and above adverse drug reactions in cancer patients receiving chemotherapy. Conclusion An initial assessment of Health Literacy and Cognition Levels in cancer patients by cancer care providers can help identify patients at high risk of developing severe adverse drug reactions. Interventional measures for improving Health Literacy by healthcare providers can help reduce the overall burden of disease on the patient due to adverse drug reactions.

Dynamic properties namely shear modulus (G) and damping (h) are input parameters for predicting the ground response of natural soil deposits. The dynamic properties of sands and clays are dependent on many factors such as void ratio, confining pressure, strain amplitude, morphology, and plasticity characteristics. Considerable research has been reported in the recent past by Seed and Idriss (Soil moduli and damping factors for dynamic response analysis, 1970), Hardin and Drnevich (J Soil Mech Found Div ASCE 98(7):667–692, 1972); Seed and Idriss (Ground motions and soil liquefaction during earthquakes. Earthquake Engineering Research Institute, Berkeley 1982), Vucetic and Dobry (J Geotech Eng Div ASCE 117(1):89–107, 1991) and many others on dynamic properties of sands and clays. The factors affecting the dynamic properties of sands and clays are well documented, but soils generally, occur as mixtures of sand, silt and clay in various proportions. There is very little effort made in understanding the dynamic behavior of sand–fines mixtures and therefore there is a need to investigate the dynamic properties of sand–fines mixtures. In the present paper, the results of the behavior of sand–fines mixtures under cyclic loads are discussed. The experimental program consisted of a series of cyclic triaxial shear tests conducted as per ASTM D 3999 (Standard Test Methods for Determination of the Modulus and Damping properties of soils Using the cyclic Triaxial Apparatus. American Society for Testing and Materials 1991) to investigate the strain dependent shear modulus and damping of sand–fines mixtures of different plasticity. Sand was obtained from the Sabarmati river and three types of locally available fines i.e. low-plastic, medium- plastic and bentonite fines were used. Fines content was varied from 15 to 60%. The effect of fines content, plasticity, and relative density on shear modulus and damping is reported. Shear modulus at 0.005% strain level correlates well with the plasticity index for sand–fines mixtures of low to medium plasticity i.e. 0

This paper presents the dynamic properties of sand-fines mixtures based on the results of undrained cyclic triaxial tests. The sand was obtained from Sabarmati River, and three types of fines F1, F2, and F3 were obtained from locally available fine grained soils i.e. Black cotton soil, Suddha soil, and Bentonite soil. Sand-fines mixtures of wide range of plasticity from non-plastic to highly plastic mixture with PI = 86 were prepared using the fines passing 75 μ size. The initial shear moduli of all sand-fines mixtures are evaluated in terms of fines content, Plasticity Index (IP) and equivalent plasticity index (IP*) determined for soil passing 2 mm size IS Sieve. There is good correlation between the initial shear modulus of sand-fines mixtures and equivalent plasticity index (IP*) compared to Plasticity Index (IP). An empirical equation for obtaining initial shear modulus is formulated based on equivalent plasticity index and mean-effective stress.

Universally, hooks are meant for application of a force delivery system. Recently, hooks bent into the archwire/soldered hooks were replaced with crimpable archwire hooks in clinical practice. An alternative to crimpable hooks, a simpler, cost-effective method to reduce the chairside time was thought, which leads to innovation. This article describes the stepwise fabrication and application of simple self-customized crimpable hooks onto the archwire. These self-customized crimpable hooks are very economical and extremely useful for practitioners and can be easily fabricated at the chairside. They can be positioned where ever required and also can be used as an alternative to crimpable hooks without welding. It has added advantage of easy removal with a crimpable hook removal plier without causing distortion of the main archwire.

One peek into the history of malaria, shows us that despite many attempts by mankind to counter the development and propagation of malaria, it has always risen back like a ‘phoenix from its ashes’. This has been possible by virtue of the singular ability of the malarial parasite to mutate and evade the actions of various anti-malarial drugs. The emergence of drug resistant malarial parasites by virtue of the various molecular mechanisms, has put the authorities under the cosh and forced the scientists to start generating newer and better anti-malarial drugs. In this review, we have dwelt upon the various molecular mechanisms which have allowed the malarial parasite to develop resistance, as it can serve to educate the scientists in their effort to generate newer anti-malarials.

Background: Prevention and control of AIDS are now a major problem as there is no vaccine or effective-curative treatment for this disease. Health care workers (HCWs) are at increased risk for HIV infection. There were inadequate studies about post-exposure prophylaxis (PEP) of HIV among HCWs in southern India. Hence, we are conducting this study to assess the attitude and practice of PEP toward HIV among HCWs. Methods: The cross-sectional study was done among HCWs (doctors, surgeons, nurses, and dentists). Pre-tested questionnaire was given and requested to fill it after explaining the purpose of the study. About 65% and above correct answers was considered as adequate response. Values expressed as mean, proportions and analyzed by SPSS version 17. Results: Overall 6 (66%) of the total 9 questions in attitude were answered satisfactorily, and thus can be said to have good attitude regarding PEP in HIV. Only 16 people (10%) of the participants had taken PEP regimen. Among those who took PEP, the responses for the questions about the time of initiation of regimen, completion of prescribed duration of therapy and checking of HIV status after completion of regimen were unsatisfactory. Among the professions, surgeons were exposed more compared to other professions. Conclusion: Overall attitude toward PEP was positive among all the HCWs. The practice of PEP was not satisfactory even after exposure to risks. Informing HCWs about completing treatment course and post-treatment testing is important to prevent HIV transmission. Awareness of PEP should be improved among health professionals, by regular training meetings and introducing the guidelines of the safe practices in the academic syllabus of all the professions.

Background: Drug-related problems are an important cause of morbidity and mortality and a significant burden on healthcare resources. There are few studies to account for errors in drug intake leading to adverse drug reactions (ADRs). This study was pursued with the objective of determining the frequency and severity of the ADRs resulting from erroneous drug intake, the expenses incurred in treating the same. Methods: The study was a prospective, cross-sectional, observational study. The study subjects were patients with ADRs due to errors in drug intake and from self-medication. All the information regarding the ADR were collected as per ADR reporting form issued by Central Drugs Standard Control Organization. Causality was assessed by both Naranjo and the WHO criteria for causality assessment. Direct cost of all the medications, hospital charges (admission, bed charges, consultations paid, treatment charges, investigations, and conveyance charges) were recorded to find the financial burden due to error in drug intake. Results: The study showed that nearly 30% of the ADRs were due to errors in drug intake and the major contributing factor is self-modification either by discontinuation or missed doses. Major drugs that are implicated in these ADRs were that of metformin and insulins among anti-diabetic drugs and amlodipine and atenolol among antihypertensives. These two groups contributed to 18 (62%) of the total 29 ADRs. Organ system commonly involved was central nervous system and that was followed by musculoskeletal system. The average direct cost incurred in the management of these ADRs was Rs. 5773 for non-serious adverse events (SAE’s) and Rs. 11,400 for SAE’s. Conclusion: Proper education about the importance of compliance and damaging consequences of self-modification of drug dosage in patients who are on treatment for chronic disorders like diabetes and hypertension will be an effective strategy to prevent many of these ADRs.

Introduction: Crowding of teeth is one of the most common problem that motivates the patient to seek orthodontic treatment. Determination of etiology of crowding could have a significant effect on treatment planning and prognosis of Class II malocclusion. Aim: Aim of this study was to evaluate the relationship of skeletal and dental parameters to amount of dental crowding in patients with Class II Divison 1 (div.1) malocclusion. Materials and Methods: Pretreatment lateral cephalograms and dental casts of 60 patients with skeletal Class II malocclusion were collected for the study. The sample was divided into two groups according to severity of pretreatment mandibular crowding. Group I consisted of cases with crowding ≥3 mm and Group II with crowding

This review attempts to understand the reasons for the successes and failures of the two novel strategies that have slowly begun to emerge as potential counters for anti-malarial drug resistance—“Triple Combination Therapy” and “Drug Cycling.” Recent reports have suggested that increasing the heterogeneity within the parasite’s environment, both at an individual and the population level, may help raise the probabilistic barrier of development of resistance in the parasite. The encouraging results following the implementation of a few experimental triple combination therapies like atovaquone–proguanil–artesunate along with the re-emergence of chloroquine sensitive Plasmodium falciparum parasites in the sub-Saharan African nations have re-kindled mankind’s hope of curbing anti-malarial drug resistance. The addition of a third drug with traits like a medium half-life and benign safety profile is crucial to achieving SERCAP (single encounter radical cure and preventive therapy), the principle of a triple combination therapy. Simultaneously, the plausible reasons behind the re-emergence of chloroquine sensitive Plasmodium falciparum malaria in the high transmission regions could be the re-expansion of an existing chloroquine susceptible parasite reservoir and a greater predisposition towards the development of polyclonal infections. Another potential reason for this observation could be an impaired deoxyribonucleic acid (DNA) repair mechanisms in the south-east Asian Plasmodium falciparum parasites. These strategies may potentially emerge as the key players in warding off anti-malarial drug resistance in the near future. However, their implementation would be dictated by a host of factors like the epidemiological knowledge, population pharmacokinetics, drug-resistance patterns, cost, availability, and ease of adherence.

Most often the missing teeth are conventionally managed with either implants or other fixed or removable prostheses. This article describes another possibility of orthodontically closing these spaces, thereby restoring an ideal occlusion and arch integrity without the need of prosthesis. This article presents case reports where the spaces of missing teeth were closed orthodontically, leaving no room for prosthesis, thereby providing a physiologically balanced occlusion and avoiding the lifelong maintenance of prosthesis. How to cite this article Restorative – Orthodontics: A substitution for missing teeth. G. Shivaprakash, CODS J Dent 2015;7:36-38.

Aim: The objective of this study was to compare the dental and skeletal asymmetry seen in subjects with Class II subdivision malocclusion and normal occlusion. Materials and Methods: The sample consisted of 30 subjects in each group with Angle Class II subdivision malocclusions and with Angle Class I malocclusions. Postero-Anterior cephalographs were obtained from each subject. The cephalometric measurements were obtained according to the method described by Grummon's and Van de Coppell. Results are expressed as Mean and Standard Deviation. Differences between two groups are compared by unpaired t test. P = 0.05 or less was considered as statistically significant. Results: Sub-division cases exhibited 10.5% more asymmetry with angular measurements and exhibited 38% more asymmetry with linear measurements as compared with normal group. Conclusion: There was a significant amount of radiographic mandibular asymmetry in relation to Class II subdivision malocclusions in general. As a consequence of the more frequent asymmetry in the lower third of face, the mandibular dental midline and the antegonial angle were deviated on the Class II side, as evaluated on the postero-Anterior radiograph.

A distal occlusion exerts restraining occlusal forces on the mandibular dentition, and the maxillary dental arch is narrow from distal positioning of the lower dentition. These factors may not allow the mandible to grow to its full genetic potential In severe class II. In the hands of an experienced clinician, full time functional appliances are most efficient in correcting severe class II malocclusion than conventional fixed appliance techniques without mandibular propulsion. This is especially true when the treatment is timed to coincide with the pubertal growth spurt. A case successfully treated with two phase treatment to meet the functional treatment objective is presented.

Objectives : Self-ligating brackets are becoming more common in the marketplace with many manufacturers offering one form or another. A number of studies have evaluated the frictional characteristics of different self-ligating brackets but there have been only few studies which have actually evaluated their clinical efficiency. The present study was done to compare the efficiency and effectiveness of three contemporary selfligating bracket systems (Smart Clip, Damon 2, In-Ovation). Materials and methods: This was a prospective in vivo study in which a total of 18 patients were randomly divided into three groups treated with Smart Clip, Damon 2 and In-Ovation bracket systems. The total treatment time and the number of appointments required to complete the treatment were recorded. As a measure of quality of treatment, the ABO scores were measured at the end of treatment from the post-treatment dental casts and OPG. Results: The average time taken for the completion of treatment in Smart Clip, Damon 2, and In-Ovation group was 14.0 ± 2.6, 15.3 ± 3.2 and 17.2 ± 3.2 months respectively. The total number of appointments required for the completion of treatment in Smart Clip, Damon 2, and In- Ovation group were 16.0 ± 2.5, 16.8 ± 3.3 and 19.8 ± 2.6 respectively. The mean ABO score in Smart Clip, Damon 2, and In-Ovation group were 26.2 ± 1.0, 27.5 ± 2.3 and 27.0 ± 1.3 respectively. Interpretation and conclusion: There was no statistically significant difference in the treatment time, number of appointments and quality of treatment outcome between the three bracket systems.

Static Random Access Memory (SRAM) is one of the core components in the digital world. Generally, it consumes enormous amount of power and die area. Thereby extensive research in SRAM is in progress related power dissipation, memory chip area and supply voltage requirement. In this paper SRAM analysis in terms of Static Noise Margin, Data Retention Voltage, Read Margin (RM) and Write Margin (WM) for low power application is considered. Static Noise Margin (SNM) is one of the most essential parameter for memory design because it affects both read and write margin. SNM is related to the threshold voltages of the Negative Metal Oxide Semiconductor (NMOS) and Positive Metal-Oxide Semiconductor (PMOS) devices of the SRAM cell. High Read and Write Noise Margin are also significant challenges in the design of SRAM. Data Retention Voltage (DRV) is calculated for 6T-SRAM cell for high-speed application. Different types of curve are taken straightforwardly to analyses the 6t-SRAM by varying the size of the transistor. Performance analysis is estimated in 6T-SRAM designed and implemented in 90nm technology.

The awareness about orthodontics has lead to drastic increase in many adult & adolescent seeking orthodontic treatment over the past decade. The two major setbacks for non acceptance include visibility of the appliance and the long duration of treatment. To overcome the aboveinvisible braces like - ceramic brackets, lingual brackets came into existence, but could not reduce the treatment time to a greater extent. Later surgical procedures like periodontal distraction, dentoalvelor distraction & inclusion of implant came to play. But involved surgical risk. To overcome these - the invisible braces so called clear aligners came into existence. Clear aligners are a series of clear, removable teeth aligners that orthodontists use as an alternative to traditional metal/ceramic braces. They are more comfortable, kinder to tissues and used for minor orthodontic corrections.

Objective : The aim of this study was to compare the perception of male and female Indian facial profile esthetics between dental specialists, dentists, dental students and laypersons. Need for study : It was necessary to assess the profile preferences of Indian adults, as similar study has not been done till date for the Indian population. Materials and methods : The facial profile photographs and lateral cephalometric radiographs of an Indian man and a woman were digitized. The digital images were modified using Viewbox 3.1 software to obtain seven facial profiles for each sex. An online and a paper questionnaire was created and a total of 343 subjects assessed the profile attractiveness. Results : Orthognathic profiles were considered highly attractive for Indian males and females by all the four groups. Bimaxillary protrusion for males and maxillary protrusion for females were found to be least attractive for the Indian population. All groups were highly correlated for the perception of male and female profile esthetics. Conclusion : Most preferred is orthognathic profile in both sexes. The least attractive profiles were bimaxillary protrusion for males and maxillary protrusion for females. It was found that female mild bimaxillary protrusion cases can be treated without extraction, whereas extraction treatment can be used in similar male cases. While mandible position was more critical for males, it was maxillary position in case of females.

The main objective of this innovation was to ease, minimise the working time at chair side by loading the crimpable hook for retraction/protraction/any other clinical situation demanding placement of the crimpable hook when the archwire is in position. For the same reason a plier routinely used which can be modified to suit the above purpose was thought off. This innovative plier serves dual purpose. As it is a modified distal end cutter, there is an added feature of crimping the hook to the arch wire apart from serving the basic purpose of cutting the distal end. Thus saves time at chairside. The innovative FAS *twin function plier has a high efficiency, ease of use, is economic, for distal end cutting of the arch wire.

Aim To evaluate the extent of the alveolar bone remodeling after incisor retraction using lateral cephalograms. Materials and methods Lateral cephalograms of 30 patients with age of 16 years and above requiring therapeutic extraction of both maxillary and mandibular first premolars, mainly for the purpose of retraction of anterior teeth, had been taken at the start of treatment and after retraction of anterior teeth. Various hard tissue anatomical landmarks were traced, and linear parameters of pretreatment (T1) and postretraction (T2) lateral cephalometric radiographs were measured. The mean and standard deviation were calculated, the data were tabulated, and comparison of T1 and T2 readings was made utilizing paired Student’s t-test. Results When maxillary incisors are retracted, the labial bone thickness at the midroot level (MxL2) and at apical level (MxL3) increased during upper incisor retraction. There was a significant reduction in alveolar bone thickness on the lingual/palatal side after maxillary and mandibular incisor retraction. Conclusion When tooth movement is limited, forcing the tooth against the cortical bone may cause adverse sequelae. This type of approach must be carefully monitored to avoid negative iatrogenic effects. How to cite this article Dhanani D, Shivaprakash G. Cephalometric Evaluation of Alveolar Bone Remodeling following Anterior Teeth Retraction. CODS J Dent 2016;8(1):21-24.

Background: There has been keen research interest in exploring Indian Traditional Medicine of Ayurveda which comprises thousands of medical concepts and hypothesis. Due to increase in scientific validation in various concepts, Ayurveda has got its deserved recognition and its scientific endeavor has increased significantly in the past decade. Aims and Objectives: The aim of this study is to compare different anthropometric indices along with body composition analysis parameters in individuals with dominant primary dosha of Ayurvedic Tridosha Concept. Materials and Methods: A cohort study was designed and conducted from January 2016 to December 2016. Healthy participants aged between 18 and 22 years willing to participate in the study were included in the study. Questionnaires were administered to collect information including demographic data, certain physical and psychological characteristics to assess the Ayurvedic Prakriti of the individual. The individuals were examined by an Ayurvedic Physician for assessment of Prakriti by physical examination. Anthropometric parameters such as waist circumference, height, weight, body mass index (BMI) and hip circumference were measured. Total body composition was assessed using Bodystat1500MD. Results: The participants with the dominance of kapha prakriti had significantly higher BMI, fat mass index and basal metabolic rate compared to vata and pitta groups. Conclusions: This study highlights the use of an assessment of Prakriti as a screening tool for obesity.

Background Although a number of studies have been undertaken to evaluate the friction characteristics of self-ligating brackets, there have been only few studies which have actually evaluated the clinical efficiency of these self-ligating brackets. This study was done to evaluate the clinical efficiency of Passive SLB (Smart Clip) in terms of anchorage loss and total treatment duration by comparing it with a Conventional pre-adjusted edgewise (M.B.T.) bracket system. Methods This was a retrospective study in which the study sample comprised of ten patients treated with Passive SLB (Smart Clip, 0.022″) and ten patients treated with Conventional pre-adjusted edgewise (M.B.T.) bracket system (0.022″) who required therapeutic extraction of U/L first premolars as a part of their orthodontic treatment plan. Pretreatment and post treatment lateral cephalograms were taken to evaluate the amount of anchorage loss. The total time required to complete the treatment was also recorded. Results Anchorage loss observed with Passive SLB (Smart Clip) sagittally was 1.90 ± 0.68 mm in the maxilla and 1.90 ± 0.43 mm in the mandible and vertically was 0.52 ± 0.53 mm in the maxilla and 0.70 ± 0.69 mm in the mandible. Anchorage loss observed with Conventional pre-adjusted edgewise (M.B.T.) bracket system sagittally was 2.08 ± 0.43 mm in the maxilla and 1.95 ± 0.44 mm in the mandible and vertically was 0.50 ± 0.49 mm in the maxilla and 0.68 ± 0.53 mm in the mandible. The average time taken for the completion of treatment in Passive SLB (Smart Clip) and Conventional pre-adjusted edgewise (M.B.T.) bracket system was 14.0 ± 2.4 and 17.2 ± 2.6 months respectively. Conclusion There was no statistically significant difference in the quantum of anchor loss between Smart Clip self-ligating bracket system and Conventional pre-adjusted edgewise (M.B.T.) bracket system although Smart Clip self-ligating bracket system is efficient in reducing the overall treatment time.

Introduction: The present study was carried out to study the role of metabotropic glutamate receptor 7 (mGluR7) using its agonist, N,N’-bis(diphenylmethyl)-1,-ethanediamine (AMN082) for nociceptive stimuli, in animal models. By conducting this research, we aim to introduce a novel target for acute pain management. Objective: To study the role of metabotropic glutamate receptor 7 (mGluR7), in analgesia, using mGluR7 agonist AMN082 in animal models. Materials and Methods: Swiss albino mice of either sex, weighing 20-30gm were used for the study. The animals were divided into 3 groups with 6 mice in each group: Control or Normal group received 0.5% methylcellulose in normal saline; Standard group received the drug tramadol HCl at 40mg/kg; and test group received drug AMN 082 at 5mg/kg. All the drugs were administered by intraperitoneal route. Hot plate test and Tail flick test were done to evaluate the analgesic effect of the drug. Reaction time for the end points in both the models were noted before drug administration at 0 min and after drug administration at 15, 30,60,90 and 120 min. Statistical analysis was done using One-Way-ANOVA followed by Tukeys post hoc test. p-value was considered significant at ≤ 0.05. Results: The group that received AMN082 showed significantly lesser reaction time compared to normal and standard groups in both the analgesia models. Conclusion: The mGluR 7 stimulation by an agonist AMN082, did not show analgesic effect but induced hyperalgesia in response to thermal nociceptive stimuli.

The aim of this report is to illustrate treatment mechanics for torque control in lingual mechanotherapy using a lever arm and transpalatal arch (TPA) tab system during en masse retraction of anterior teeth. An 18-year-old female with bimaxillary dentoalveolar proclination with crowding was treated with a lever arm-TPA tab system. The retraction tabs bent into the TPA placed across the maxillary second molars were used as anchorage. The retraction force on the maxillary anterior teeth was applied using lever arm hooks soldered between the lateral incisors and canines on a lingual mushroom archwire. By applying a retraction force to the lever arm hooks, the maxillary anterior teeth experienced greater palatal root movement as compared to the conventional retraction forces applied at the crown level. The tabs, placed high in the TPA, produced a distal tipping moment on the maxillary second molars, reinforcing their anchorage. The retraction force applied to the long lever arm hooks from the TPA tabs at the level of center of resistance (CRes) of anterior and posterior teeth is advantageous mainly in two aspects. First, it reinforces the anchorage, and second, it favors the palatal root movement of anterior teeth, thus obtaining better control over the torque during en masse retraction.

OBJECTIVE: Despite the guideline‑directed therapy, complete absence of nausea was noted only in 33% of breast cancer patients on anthracycline‑cyclophosphamide regimen. Hence, we sought to compare the efficacy of aprepitant (APT) versus olanzapine (OLP) in preventing chemotherapy‑induced nausea and vomiting (CINV) in breast cancer patients on doxorubicin‑cyclophosphamide regimen. PATIENTS AND METHODS: A prospective, open‑label, nonrandomized study was conducted at the Department of Oncology. Eighty‑three patients completed the study with 43 in the APT group and 40 in OLP group. Data about nausea and vomiting were collected using Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT). The severity of nausea and vomiting was assessed by the MAT and Common Terminology Criteria for Adverse Events (CTCAE) version 4.03, respectively. RESULTS: Complete response (no emesis and no rescue medication) was achieved in 81% of the patients in APT group and 85% in the OLP group in the acute period (P = 0.661); 74% of patients in APT group and 85% in OLP group had no nausea during the same period (P = 0.233). Among the OLP patients who had nausea, 67% had moderately severe and 33% had Severe grade, and in the APT group, severity was equally distributed in mild, moderate, and severe grades. Among the patients who had vomiting, severe (CTCAE) vomiting was noticed in 81% of patients who were treated with APT compared to 50% in OLP group. CONCLUSION: OLP was found to be an equally effective alternative to APT in the antiemetic prophylaxis of CINV in breast cancer patients receiving chemotherapy with doxorubicin‑cyclophosphamide regimen. Keywords: Breast cancer, chemotherapy, olanzapine

Background: Acanthosis nigricansis was viewed recently as a possible marker of an increased risk for diabetes. Acanthosis Nigricans (AN) can help in identifying the patients with an increased risk for Type 2 Diabetes Mellitus (T2DM) among Polycystic Ovary Syndrome (PCOS) cases. Hence, this study was carried to know the prevalence of AN in PCOS and its correlation with diabetes mellitus and the body mass. Methods: A prospective, longitudinal study in the patients with PCOS, who attended the Department of Medicine, Kasturba Medical College [KMC] Hospital, Attavar, Mangalore, Karnatka, India between December 2008 to April 2010, was carried out. A total of 119 patients with PCOS were included in the study. A complete history, along with the demographic data of the patients who were aged between 15-35 years, were considered for the analysis. Results: AN was observed in 56% of the PCOS patients. The Body Mass Index (BMI) and the waist circumference were significantly higher in the PCOS patients with AN, as compared to those without AN. Among the 119 PCOS patients,77% were found to have BMI values which were above the normal. Among the obese PCOS patients, 58% had BMI values of more than 30kg/m2 as compared to 19% of the patients who did not have AN. Type 2 DM was observed in 77% of the PCOS patients with AN, while none of the PCOS patients were found to be diabetic among those without AN. A family history of DM in the first degree relatives was present in all the patients with AN. The results were analyzed by the Mann Whitney U test for the continuous data and by the Chi square test for the categorical data. Conclusion: The PCOS patients who had a family history of diabetes and obesity with a body mass index of more than 30 kg/m2 and a waist circumference of ≥ 90 cm were more likely to develop AN, which is a marker of hyperinsulinaemia and insulin resistance. Identifying such PCOS patients will stimulate the discussions of the lifestyle modifications in the primary care setting.

Dyslipidemia is a well-known modifiable risk factor for preventing cardiovascular diseases. The present therapy mainly aiming at pharmacologicaltreatment to reduce lipid levels may not be effective in each individual to meet the target levels. Diet and lifestyle modification has an important rolein treating such chronic illnesses. Nutraceuticals, which are derived from food products, provide one such alternate therapy for the management ofdyslipidemia. Some of them have proven to be effective for treating dyslipidemia while others require further studies. Much work is still required tounderstand the pharmacokinetics and mechanism of action of these products. Nutraceuticals hold promise in the clinical management of dyslipidemiaand can be used as primary preventive therapy as more evidence from studies comes in light.Keywords: Dyslipidemia, Nutraceuticals, Cardiovascular disease, Statins.

The mastication, phonation and esthetics: The trident factors are very important and should be given due consideration when any dental procedure is initiated to achieve the successful outcome of treatment. The prosthetic management of edentulous patient has long been a major challenge for dentistry. For well over a century, complete maxillary and mandibular denture have been the traditional standard of care. However, most of the patients report significantly more problems adapting to their mandibular denture due to a lack of comfort (e.g., they suffer from an increase in pain and soreness), retention, stability and inability to chew and eat. Recent scientific studies carried out over the past decade have determined that the benefits of a mandibular two implant over denture/coping retained are sufficient to propose the two implant over denture - rather than conventional denture - as the first treatment option. This in the prosthodontics literature has led to shift in therapeutic philosophy regarding restoration of the edentulous patient. This article presents four and two tooth supported conventional over denture - two case reports.