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An experiment was conducted under the ICAR-All India Coordinated Research Project on Fruits to study the high-density planting (HDP) and nutrient requirement of banana at six research centres across the country, including Bhubaneswar (Orissa), Gandevi (Gujarat), Jalgaon (Maharashtra), Jorhat (Assam), Kannara (Kerala) and Mohanpur (West Bengal) to enable higher productivity of banana and profit to farmers. The objective of this study was to explore the possibility of increasing productivity through the intervention of only per unit plant population (through planting system) and level of nutrition, but without any interference to the regional choices of variety (eg., choice variety Nendran for Kerala or Martaman for West Bengal), production system (mono/poly- clone, single/multi-year plantation, and POP of respective states), for which national productivity ranges are much skewed also. Results indicated that intervention of only plant density could increase the productivity of banana within the existing system of production and choice of a variety of different regions or states. The experiment was laid out in RBD with four planting densities (S1P2, S1P3, S2P2 and S2P3, where S1=2m x 3m, S2=1.8m x 3.6m, P2=2 suckers/hill, P3=3 suckers/hill), three nutrition levels (F1, F2 and F3 , which is 100%, 75% and 50% of RDF) and one with region-specific conventional planting density and nutrition (100% of RDF) practices as control. The results of this experiment showed that HDP (S1P3, 5000 plants /ha) in banana, accommodating three suckers per hill at 2m x 3m spacing increased productivity over the conventional system at the Bhubaneswar, Gandevi, Jorhat, Kannara and Mohanpur centres. The increase in productivity due to HDP (5,000/ha) over control was 28.9% (RDF 25%) to 50.6% (RDF 100%) at Bhubaneswar, 15.2% (RDF 25%) to 21.9% (RDF 100%) at Gandevi, 4.0% (RDF 25%) to 7.4% (RDF 100%) at Jorhat, 33.5% (RDF 25%) to 43.5% (RDF 100%) at Kannara and 46.5% (RDF 25%) to 79.0% (RDF 100%) at Mohanpur centre. The nutrient requirement under HDP was 100% RDF at Kannara, 75% RDF at Bhubaneswar and Mohanpur and 50% RDF at Gandevi and Jorhat centres, which indicates a saving in cost of fertilizer input by 25% -50%. It is, therefore, recommended for HDP (5000 plants/ha) in banana, accommodating three suckers per hill at 2m x 3m (6.6 ft x 3.8 ft) spacing with 50% RDF in the agro-climatic regions of Gandevi and Jorhat, with 75% RDF in the agro-climatic regions of Bhubaneswar and Mohanpur and with 100% RDF in the agro-climatic region of Kannara in order to ensure higher productivity and profit to farmers.

Recent research has highlighted the link between childhood obesity, dental caries, and malocclusion, and how the Coronavirus Disease - 2019 (COVID-19) pandemic and social media have worsened these health issues. Increased screentime and decreased physical activity during the pandemic have significantly contributed to these conditions among children. Studies emphasise the need to address common risk factors such as unhealthy diets, limited healthcare access, and poor public health policies to reduce their negative effects. This review explores the complex relationship between childhood obesity, dental caries, and malocclusion, with a focus on their global importance. It examines the connections and shared risk factors between these conditions, particularly in the context of the pandemic and the growing influence of social media on children. The goal is to provide insights for developing effective interventions and management strategies to improve children's health worldwide. The present review stresses the urgent need for comprehensive strategies that target both individual and collective risk factors, while also considering broader socio-economic and digital influences on children's health behaviours. Promoting healthy lifestyles, access to nutritious foods, physical activity, and better dental care can help to alleviate these conditions. Understanding the interplay between these health issues and the digital environment is crucial to creating effective and adaptable public health interventions.

Introduction: A significant proportion (20%) of patients with complex infrainguinal arterial occlusions cannot be recanalized using a conventional antegrade endovascular approach. Most of these patients will be poor candidates for open surgical reconstruction owing to the concomitant cardiovascular and pulmonary comorbidities or poor venous conduit. We present our experience using the percutaneous retrograde pedal approach for revascularization of infrainguinal arterial occlusions after failed conventional endovascular options. Materials and Methods: This is a retrospective observational study of all the patients admitted in our center from May 2019 to May 2021 for chronic limb-threatening ischemia with infrainguinal occlusive disease and attempted retrograde tibial approach after failed antegrade transfemoral approach. Procedural success was defined as residual stenosis of

Context: Dental tissue remains are the toughest, and chemically, the most stable tissue in the body. Its high resilience in the events of fire and bacterial decomposition makes them vital for DNA analysis by PCR method. Aims: Determination of sex of children through molecular analysis of pulp tissue of exfoliated deciduous teeth stored in different media and analyzed after a different time period. Settings and Design: Sixty samples of deciduous teeth were divided into three groups. Group IA and Group IIA were stored in natural soil and wet clay for 1 month, respectively. Group IB and Group IIB were stored in natural soil and wet clay for 6 months, respectively. Group III was analyzed immediately after extraction. Methods and Material: Sex determination was carried out in five steps: Pulp tissue removal, DNA isolation, DNA quantification, PCR amplification, Sex determination. X and Y specific chromosomes from each sample were amplified and compared. Statistical Analysis Used: Kruskal-Wallis test, Dunn's test, and Wilcoxon signed rank test. Results: Group III revealed the highest amount of DNA quantified. Amount of DNA quantified after 6 months of storage in natural soil and wet clay decreased in both the groups with the samples stored in wet clay showing a maximum decrease. Results of the PCR analysis also showed 100% accuracy rate in the samples of Group III. Conclusions: Sex determination from pulp tissue depends a lot on the quality and quantity of DNA extracted. Sex could be effectively determined among the samples evaluated immediately after extraction. This ability decreases as the storage condition changes and the time period increases. Samples stored in wet clay were found to show the least sex identification ability than dry soil.

Introduction: Cardiac autonomic neuropathy (CAN) is one of the microvascular complications of diabetes mellitus, which is due to the involvement of autonomic nerve fibers innervating the heart and blood vessels. CAN was found to have a greater degree of morbidity and mortality than their non-CAN counterparts as it is underdiagnosed. Hence, this study aims to determine the prevalence and severity of CAN in type 2 diabetics in the South Indian setting. Materials and Methods: Forty-two patients with type 2 diabetes mellitus were enrolled in the study. Patients underwent tests for CAN, with the severity of CAN estimated as a CAN score, which was the sum of the scores of the four cardiovascular autonomic function tests. Results: Out of the 42 patients, a total of 36 patients (85.7%) were diagnosed with CAN. Among those with CAN, 24 patients had early CAN (57.1%), and 12 were diagnosed with definite CAN (28.6%). Patients with any form of CAN (early and definite CAN) had higher HbA1c and mean glucose values than those without CAN. CAN was also found to be more severe among older patients with diabetes. Conclusion: In the present study, we found that more than 50% of the study population had early CAN and around 28.6% patients had definite CAN indicating higher prevalence of CAN in our population. Also, there was a positive correlation between the severity of CAN and the age of the patients. This study highlights the importance of understanding the importance of screening the diabetic patients for CAN to prevent adverse cardiovascular events.

Context: Medullary thyroid carcinoma (MTC), being an aggressive disease, requires meticulous follow-up and multidisciplinary management. The clinical presentation, management, outcome of MTC varies among different populations. Aims: An audit was conducted to evaluate the demography, clinical presentation, management, and outcome of MTC in a tertiary care center in South India. Settings and Design: A retrospective analysis was conducted of data from hospital records of patients with MTC treated at our center from 2004 to 2019. Statistical Analysis: All analyses were performed with SPSS software (version 16). Results: Among the 82 patients (M 42, F 40), mean age was 42.07 years (SD 14.5), 46 were operated at our center and 36, outside. Follow-up data were not available for all patients. Median duration of the disease was 36 months and median follow-up was 28 months. Lymphnode dissection was more common (37/46) in patients operated at our center than outside operated patients (17/36) (P < 0.01). At presentation, more than half of the patients had stage IV disease and 8 had distant metastases. Bone, lung, and liver were the common sites of metastases. Persistent hypercalcitoninemia >50 pg/mL was seen in 49.9%. Salvage surgeries of the neck were necessary in 29 patients (38.2%). Mean survival was 66 months and 10-year survival was 35%. Male gender (P = 0.008) and Stage IV disease at presentation (P = 0.038) were associated with poorer survival. Conclusion: MTC, in our population, presented at an advanced stage. Male gender and stage IV at presentation had poor survival. Early diagnosis, aggressive initial neck clearance, close follow-up with tumor markers, appropriate imaging, along with prompt surgical intervention will help to improve outcome.

Context: Insulin autoantibody syndrome (IAAS) is considered to be a rare cause of hyperinsulinaemic hypoglycaemia. Lack of familiarity with the varied clinical manifestations leads to underdiagnosis. Localization techniques aimed at insulin-secreting neoplasms and nesidioblastosis, which are expensive often are ordered when the correct diagnosis is not made. Aims: We describe the myriad of clinical manifestations associated with IAAS based on single centre experience. Settings and Design: Retrospective analysis of patients who got admitted with symptoms suggestive of hypoglycaemia and underwent mixed meal test and prolonged hypoglycaemic test from 2016 to 2019. Subjects and Methods: Retrospective data of 12 patients with IAAS who were diagnosed in the threeyear time period between 2016 and 2019 are included in this analysis. Clinical details, biochemical parameters and imaging modalities were analysed. Statistical Analysis: All analyses were performed with SPSS software (version 17). Results: Total of twelve patients 12 (5 male and 7 females) were identified as IAAS. Median age of presentation was 57 years. Median insulin levels and median C-peptide levels were 300 miu/ml and 18.5 ng/ml respectively. Only 3 (25%) patients had spontaneous resolution. Steroid induced remission occurred by 3 months in the remaining patients. Intermittent hyperglycaemia was seen in 9 (75%) patients. Implicatable drug use preceding the occurrence of the clinical symptoms was observed in five patients. Conclusion: IAAS is not uncommon in India. The diagnosis should be pursued in patients with hyperinsulinaemic hypoglycaemia especially when insulin levels are very high or when there is intermittent hyperglycaemia.

Introduction: Endogenous hyperinsulinemic hypoglycemia (EHH) is a condition in which the insulin levels are inappropriately high in the presence of low plasma glucose. Materials and Methods: We did a retrospective analysis of case records of those patients admitted and evaluated for EHH from June 2004 to June 2016 in our center, excluding those that were diagnosed with reactive hypoglycemia. We collected data regarding demographics, clinical presentation, laboratory results, localization techniques, and treatment administered. Results: Sixteen patients who were admitted for evaluation based on history suggestive of repeated hypoglycemic episodes were included in the study. All but one pregnant patient was subjected to a supervised fast in the hospital. All patients developed hypoglycemia (defined using Whipple's triad) within the first 24 h. Three patients had autoimmune hypoglycemia which differed significantly from insulinoma-mediated hypoglycemia in certain clinical and laboratory parameters. They were older in age with marked fluctuations in the 24 h glucose profile ranging from frank hypoglycemia to frank hyperglycemia. The insulin levels were markedly elevated in this group of patients along with a significantly elevated insulin C peptide molar ratio (ICMR) when compared with patients with insulinoma-mediated hypoglycemia. Conclusions: Although insulinoma is the most common cause of EHH, autoimmune hypoglycemia should be considered as a differential diagnosis, particularly in older individuals with plasma glucose values increasing to the hyperglycemic range. Degree of elevation of insulin levels and ICMR may provide additional clues. Overall, the survival and prognosis of patients with EHH are excellent.

Context: Dental environment is one of the most anxiety-provoking stimuli for children, which makes patient management a constant challenge in both typically growing and intellectually disabled children. Distraction is a nonpharmacological technique to manage anxiety in children during dental treatment. Aim: This study compares the effect of audio and virtual reality (VR) distraction on the dental anxiety of healthy and mild intellectually disabled children. Methods: Forty children aged 6–14 years were divided into two groups (Group I: children with mild intellectual disability and Group II: healthy children). Groups I and II were further subdivided into two subgroups of 10 children each, based on the distraction technique given to them during the first appointment. After 1 month, we carried out a cross-over of the subgroups. Anxiety levels were measured using physiological and observational parameters at three-time intervals. Statistical Analysis: Performed using paired t-test for the intergroup comparison and Wilcoxon Signed Rank test for the intra-group comparison. Results: A decrease in the pulse rate, improvement in oxygen saturation levels, and lower Venham's anxiety rating scores were observed on introducing audio and VR distraction in all the subgroups. The inter-group comparison revealed that audio and VR were more effective in healthy children than children with mild intellectual disabilities. Conclusions: Audio and VR distraction techniques can be employed successfully to reduce anxiety in children with mild intellectual disability and healthy children undergoing dental restorative treatment.

The use of medicinal herbs in dentistry continues to expand rapidly across the globe. Herbal dentistry presents an attractive alternative to conventional synthetic materials. With a shift towards evidence-based dental practice, there is a need for dental clinicians to be fully aware of the alternatives and options currently available to them. This review article provides insight into the various herbal products currently available in dentistry. It provides a better understanding of the mechanism of action of the herbal products used to treat various dental problems. This narrative review identifies and summarises the most common medicinal herbs in various preventive and therapeutic spheres of dentistry. High anti-microbial, anti-inflammatory, antioxidant, and immunomodulatory activities along with wound healing ability and sedative-anxiolytic were identified to be the properties favouring use of these medicinal plants in dentistry. Although the natural alternatives discussed in the current narrative review have shown to be either superior or comparable to the synthetically available options, further long-term in-vivo clinical trials are required to substantiate this evidence and justify the replacement of later with herbal alternatives in dentistry.

Aim: The present study aimed to evaluate the effectiveness of pulp tissue collected from deciduous teeth for the determination of gender using polymerase chain reaction (PCR). Materials and Methods: 140 extracted deciduous teeth were selected. The control group comprised 20 teeth that were subjected to DNA analysis immediately. Whereas Group I and Group II consisted of 60 teeth which were stored in the open environment and salt water, respectively, for a period of 3, 9, and 15 months. DNA was isolated and quantified followed by the amplification of X and Y chromosomes by PCR and compared with the actual gender of the child. The data were analysed using the Shapiro-Wilk test, the independent sample t-test, paired t-test, and the Chi-square test. Result: The PCR analysis results of Group I showed a more correct interpretation of gender as compared to Group II on storage for a period of 15 months. The PCR analysis results of the Control group showed a 100% accuracy rate as compared to the samples in Groups I and II. Conclusions: Gender could be effectively determined from the samples evaluated immediately after extraction. But the period of storage and the method of storage conditions affected the quality of isolated DNA and thus decreased the ability of gender determination.

Background: Age estimation methods in the permanent dentition are numerous in number and well established and evaluated. However, there exists a dearth of methods available for the estimation of age based on the eruption status of primary teeth, despite various studies displaying greater accuracy using such methods. Aim: The purpose of this study was to develop the methods of age estimation based on the eruption status of primary teeth and based on previous methods developed for permanent teeth and to assess the accuracy of the methods in a clinical situation. Materials and Methods: A total of 50 children were randomly selected between the age group of 6 and 38 months for the assessment of primary tooth emergence in the oral cavity. New methods of age estimation (triangles and regression equations) were developed for used in the Indian population. Results: Data were analyzed using receiver operating characteristics curve and intraclass correlation coefficient. Our results conducted in a validation sample of 30 children suggested high levels of accuracy using the new methods, with greater accuracy displayed using the regressive equation (0.928) as compared to the new triangle of age estimation (0.897). Conclusion: Such methods of age estimation will be of unparalleled importance in rural setups, which cannot afford the luxury of panoramic radiography.