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The control of anchorage is essential in orthodontic treatment of adult patients. Complex tooth movements in lingual appliances and aligners require anchorage planning. Mini-screws enable the orthodontists to have good control over tooth movement in all three dimensions, while preserving the patient’s aesthetics. This article describes various clinical cases performed through aligners and lingual appliances by using mini-implants.

Superior mesenteric artery (SMA) syndrome also known as Wilkie’s Syndrome is a rare condition characterized by symptoms of small bowel obstruction. It is caused when the angle between the SMA and aorta, also known as the aorto-mesenteric angle, reduces to

Weakening interactions in a miscible blend induces demixing; the corresponding thermodynamic work can be integrated, and the free energy of the resulting interface measured. Combining these results gives the mixing free energy.

Lymphocytic lobulitis , is a fibroinflammatory benign condition of the breast which is associated with type 1 diabetes mellitus. This benign condition is uncommon and may be mistaken for inflammatory carcinoma of the breast. We report the case of a 61 year old female patient who presented with a lump in the right breast with a history of Type 2 diabetes mellitus. The lump was associated with discharge and recent onset pain. On examination a vague lump which was non mobile, involving the right breast was palpable. A single firm mobile right axillary lymph node was palpable. Peau d’orange or orange peel appearance which occurs due to blockage of sub dermal lymphatics by tumour infiltrates, was noted over the skin. Clinically the features were suggestive of inflammatory carcinoma. Mammogram suggested an inflammatory carcinoma. Ultrasound of the breast was suggestive of right duct ectasia and diffusely thickened breast with a Breast Imaging Radiology and Data System (BIRADS) score of 3. An incision biopsy was performed with histopathology confirming the lesion as lymphocytic lobulitis with fibrocystic breast disease. The patient was symptomatically managed with analgesics and reassured. She was observed on regular follow up and is currently healthy. Lymphocytic lobulitis is a rare benign lesion which mimics carcinoma. Clinically it presents with ill defined single or multiple breast lumps in young or middle aged women with thickening and hardening of skin. Magnetic Resonance Imaging better differentiates this otherwise indolent lesion from malignancies. A histopathological examination is usually confirmatory and required to alleviate concerns of patients regarding presence of a malignancy which has a much fearsome physical and psychological implication

The Flory Huggins interaction parameter χ measures the compatibility of different species in mixtures and governs their phase behavior. We have previously used molecular dynamics (MD) simulations a...

Globally, the pandemic of the coronavirus disease, which started in Wuhan, China, has become a major issue for public health. The COVID-19 epidemic notably causes health professionals to experience significantly more emotional stress than the general populace. The present study proposes to investigate the fear aspect in dentists in the initiation of clinical practice during these times. An online cross-sectional study was conducted among dental practitioners based on a pre-validated questionnaire. The data were expressed as frequency and percentage analyzed using the chi-square test using SPSS version 25. The data was obtained from 271 participants, where clinical practice after the first wave was mostly by freelancers (p-value = 0.01); most of whom were married (p-value = 0.065); 19.1% attached to institutes did not have changes in earnings; 28.1% of private practitioners had less than 10% reduction in cases. A total of 62% of private practitioners are concerned about the vaccine’s preventative effects (p-value = 0.026), and 57% of private practitioners worry about being sued for the delay in treatment (p-value = 0.036). Only 33.1% of employees in institutions worry that becoming sick could endanger their family. As dentists continue to work their way through this pandemic, these pressures only occasionally have an impact on them. According to the researchers, this is the first study that has captured the anxiety and apprehensions that dental practitioners experienced during the height of the COVID-19 outbreak in India in April 2021. The study’s findings demonstrate that the study population was generally upbeat and confident that they could quickly overcome their fear.

Objective: Acute appendicitis is one of the common abdominal emergencies encountered in surgical practice. However there are a host of other medical and surgical conditions that closely mimic it, clinically. The objective of this paper is to present a study and analysis of our burden of incidental encounters with such mimicking surgical conditions that were erroneously diagnosed as acute appendicitis, prior to surgery. Methods: Data was retrieved from the hospital’s electronic medical records about all patients operated for acute appendicitis, by a single surgeon, over a 14 year period. Results: A total of 450 patients were operated for acute appendicitis from 2008 to 2022. Out of these, we identified 20 patients who had a normal appendix with some other mimicking surgical condition (Incidence 4.44%). Conclusion: Acute appendicitis has many differential diagnoses, both common and rare. At times, some of these are confirmed ‘on table’; as seen in this case series. A sound, reliable and fool proof palpatory assessment of the abdomen is crucial in diagnosing it’s surgical conditions. It is interesting to note that although the initial diagnosis of acute appendicitis made for all the subjects of this case series was erroneous, all still turned out to have alternate conditions which merited surgery.

Periodontal risk assessment is essential to ensure the successful outcome of periodontal therapy. Various assessment tools have been devised over the years of which the periodontal risk assessment(PRA) tool by Lang & Tonetti is one of the more authentic tools, and it assesses the risk of severity of periodontal disease by taking into account various components which are a combination of risk factors, indicators, and markers. The present study used this tool to evaluate the change in periodontal risk following phase 1 periodontal therapy. Following the approval from the institutional ethical committee, 299 male and female patients aged 18 to 60 years undergoing comprehensive clinical care (CCC) at ISNC dental clinics from October 2020 until April 2021 were selected, and PRA was assessed at baseline (before phase 1 therapy) and following a re-evaluation of phase 1 therapy (4-6 weeks after phase 1 therapy). All the parameters of the Lang and Tonetti’s PRA model were recorded, and the periodontal risk was calculated accordingly. The data collected was entered into a Microsoft excel sheet. Statistical analysis was carried out using SPSSV 22 software. The results showed significant differences in essential risk parameters – sites with bleeding on probing(BOP), alveolar bone loss, and polygon surface area for risk. (P0.05) These factors are usually permanent and often impossible to eliminate, even if under control. Concerning smoking, even if the patients quit or reduce the number of cigarettes smoked, the alteration in risk levels is minimal or negligible. Thus, Phase 1 periodontal therapy significantly influences the risk levels in adult patients.

Introduction: The outbreak of novel coronavirus disease (COVID-19) has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients primarily through aerosol generated procedures. This study aimed to assess the awareness and risks of getting infected among dentists in the western region of Saudi Arabia, while working during the current novel coronavirus disease (COVID-19) pandemic. In addition, dentists’ knowledge about various practice modifications to combat COVID-19 cross infection and spread were evaluated. Materials and Methods: A total of 329 participants including 123 males and 196 females responded to an online questionnaire consisting of 30 questions, which was circulated among all kinds of dental healthcare professionals through social media and e-mails after obtaining approval from the institutional ethical committee. Results: Chi square tests revealed significant differences when comparing the responses of the participants based on qualification with regard to key responses related to awareness and practice perceptions such as HEPA filters, pulse oximeter, wearing an N-95 mask, using a face shield, a High volume suction and rubber dam.(p

Cone beam computed tomography (CBCT) has gained wide popularity among dentists. This can be attributed to its ability to provide bone morphology, bone dimension details and vital structure locations by producing cross-sectional images along the arches. However, one of the reasons routine usage is hampered is its high cost. It would be a great benefit to the practice of dental implants if there was a more economical alternative. Anatomic landmarks in both the maxilla and the mandible are important to be considered during implant placement, and if overlooked, may lead to failures and complications and this is where Cone beam computed tomography (CBCT) has a slight edge over its other diagnostic counterparts. However, newer digital radiographs have been found to be economical and fairly accurate in line with the highly sophisticated CT scans. Therefore, this study aimed to compare and assess the diagnostic accuracy of CBCT and digital radiography (vistascan) in the placement of implants, which may provide an aid in terms of providing an accurate implant size during the surgical procedure for successful dental implant placement. Data was collected from CBCT and vistascan image measurements made pre-operatively prior to implant placement. The measurements were then compared using certain anatomical landmarks as reference in the maxillary and mandibular arches and additionally, with the actual size of implant placed post-operatively. Statistical analysis using SPSS V22 and paired ‘t’ tests and ANOVA revealed no significant differences in the measurements between both the images. (P>0.05). Additionally, both the image measurements were very close to the actual size of the implant placed. Since both imaging techniques were similar in terms of accuracy for implant placement, use of digital radiography (vistascan) may be encouraged as a cost effective option as against CBCT which is expensive for routine assessment.

COVID 19 was originated from Wuhan city of Hubei Province in China in December 2019. It is a viral disease spread due to severe acute respiratory Syndrome Coronavirus virus. The virus has been spread extensively worldwide leading to a worldwide emergency. The strain of the virus is new and not been studied earlier. However the transmission of the virus is quick and immoderate. Efforts to contain the spread of the disease have led to major disruptions forcing regional and in many cases national emergencies and lockdown, leaving only essential services to continue. Human transmission is predominantly through the respiratory track via droplets, respiratory secretions and or direct contact where the virus enters the mucous membrane of the mouth, nose and eyes. Although contact with symptomatic patients is the typical route of transmission, asymptomatic individuals or those within the viral incubation period may also be able to transmit COVID 2019. In many such efforts performing elective tasks including orthodontic treatment are required to be suspended on orders of the central, state and civic and public health regulatory bodies. Due to unpresented nature of this pandemic and the unknown length of time that mandatory suspension of elective treatment may be in effect in different regions, consolidated information and guidelines for the clinical orthodontic management of patients during the COVID-19 pandemic are lacking. Keywords: COVID19, SARSCoV2, Pandemic, Emergency protocol, Orthodontics, Dentistry, Patient management.

Lymphocytic lobulitis , is a fibroinflammatory benign condition of the breast which is associated with type 1 diabetes mellitus. This benign condition is uncommon and may be mistaken for inflammatory carcinoma of the breast. We report the case of a 61 year old female patient who presented with a lump in the right breast with a history of Type 2 diabetes mellitus. The lump was associated with discharge and recent onset pain. On examination a vague lump which was non mobile, involving the right breast was palpable. A single firm mobile right axillary lymph node was palpable. Peau d’orange or orange peel appearance which occurs due to blockage of sub dermal lymphatics by tumour infiltrates, was noted over the skin. Clinically the features were suggestive of inflammatory carcinoma. Mammogram suggested an inflammatory carcinoma. Ultrasound of the breast was suggestive of right duct ectasia and diffusely thickened breast with a Breast Imaging Radiology and Data System (BIRADS) score of 3. An incision biopsy was performed with histopathology confirming the lesion as lymphocytic lobulitis with fibrocystic breast disease. The patient was symptomatically managed with analgesics and reassured. She was observed on regular follow up and is currently healthy. Lymphocytic lobulitis is a rare benign lesion which mimics carcinoma. Clinically it presents with ill defined single or multiple breast lumps in young or middle aged women with thickening and hardening of skin. Magnetic Resonance Imaging better differentiates this otherwise indolent lesion from malignancies. A histopathological examination is usually confirmatory and required to alleviate concerns of patients regarding presence of a malignancy which has a much fearsome physical and psychological implication.

Platelets and leukocytes activated in response to periodontal microorganisms during bacteremia can go on to excite other cells, enhancing the likelihood of atherosclerosis and coronary artery disease. Reports also indicate that decrease in the number of erythrocytes may occur secondary to periodontal disease. Smoking is a known risk factor for periodontal disease by virtue of its adverse effects on the blood cells. It was therefore decided to investigate the relationship between the red blood cel l(RBC), white blood cell (WBC) and platelet counts and periodontal parameters among smokers and non- smokers; to subsequently assess any implication of the systemic effects. Blood counts(RBC, WBC, platelets) for the present study were obtained from peripheral venous blood of 126 patients , both male and female aged between 18-45 years, in each group as follows: GROUP 1 :Periodontally healthy (n = 42) (non-smokers) GROUP 2: Chronic periodontitis (n = 42)( non- smokers) GROUP 3: Chronic periodontitis (n = 42) ( smokers) The clinical parameters to assess periodontitis included plaque index(PI), bleeding index(BI) and Clinical Attachment Loss( CAL) and history of smoking was elicited based on amount, frequency and duration of smoking. ANOVA tests followed by post HOC –Tukey HSD test revealed that there were significant differences between the 3 groups with respect to PI, BI and RBC counts(p

Background: Both periodontal disease and hypertension individually, have been found to be linked to certain blood groups. However, the association of the blood groups to abnormal blood pressure and co-existing periodontal disease has not yet been explored. The objective of this study was to explore a possible association, if any among the three conditions. Materials and Methods: In this pilot project, a total of 300 patients were screened initially, of which, 270 patients (205 males and 65 females) with mean age range of 34.5 years from various ABO blood groups, with gingivitis / periodontitis were selected and their blood pressure was measured in a standardized manner with a digital automated BP monitor. Patients with any systemic disease or condition or consuming any kind of medications and smokers were excluded from the study. The data thus obtained was statistically analyzed to assess prevalence and associations. Results: Overall, blood group O(29.26%) reported the highest number of patients with abnormal blood pressure in the presence of periodontal disease followed by B(18.89%) and A(17.03%). No association was found with abnormal blood pressure and blood groups in the individual gingivitis and periodontitis groups. However, a significant association with abnormal blood pressure in males over females in blood group A and B in the gingivitis group and in blood group A in the periodontitis group was observed.(P

The Flory–Huggins interaction parameter χ quantifies the excess free energy of mixing unlike species and governs phase behavior in polymer blends and block copolymers. Chain architecture affects ho...

Objective: Sound periodontal foundation of abutment teeth is essential for successful restorative therapy and also for long-term success of prosthodontic restorations. Porcelain fused to metal (PFM) has been a popular choice of novel esthetic material in fixed prosthodontics over the last few decades. The present study aimed to assess the long term effect and tissue responses of fixed partial prosthesis using PFM material on vital and non- vital abutments on the periodontal parameters both clinically and radiographically. Methodology: Following ethical committee approval, the study group comprised of 86 abutment teeth in 41 systemically healthy patients (24 males and 17 females) aged between 18 – 45 years who had received 3 unit fixed prosthesis made of PFM, having equigingival margins using vital and non-vital abutments. The following parameters were assessed at baseline, phase 1, 3 and 4 (1 year follow up) – CAL, Probing depth, Distance between CEJ/ cervical crown margin and alveolar crest of the abutment teeth (radiograph). Results: Statistical analysis carried out by SPSSV22 software revealed no significant changes in probing depth and CAL (p>0.05) and significant changes in radiographic bone levels (p0.05) with non vital abutments. However, significant differences were observed between vital and non vital abutments with regard to probing depth at the end of 2years, CAL and radiographic bone levels at 6months, 1 year and 2 years (p

Objective To assess the feasibility and impact of integrating electronic patient-reported outcome measures (PROMs) into the routine outpatient care of patients with SLE. Methods We conducted a prospective cohort study, utilizing a mixed-methods sequential explanatory design, of SLE outpatients receiving rheumatology care at two academic medical centres. Participants completed electronic PROMs at enrolment and then prior to their next two routine rheumatology visits. PROM score reports were shared with patients and rheumatologists before visits. Patients and rheumatologists completed post-visit surveys evaluating the utility of PROMs in the clinical encounters. Focus groups of patients and interviews with treating rheumatologists were conducted to further explore their experience utilizing PROMs. Results A total of 105 SLE patients and 17 rheumatologists participated in the study. Patients completed PROMs in 159 of 184 encounters (86%), with 93% of surveys completed remotely. Patients reported that PROMs were ‘quite a bit’ or ‘very’ useful (55% of encounters) and beneficial to communication (55% of encounters). In contrast, physicians found PROMs useful (20%) and beneficial to communication (17%) less frequently. There was no significant change in visit length, health-related quality of life or disease activity after implementation of PROMs; however, patient satisfaction improved slightly. Qualitative analyses revealed that patients felt PROMs provided utility primarily by facilitating communication, particularly when physicians discussed the surveys. Conclusion The remote capture and integration of electronic PROMs into clinical care was feasible in a diverse cohort of SLE outpatients. PROMs were useful to patients and enhanced their clinical experience primarily by facilitating communication.

High levels of cholesterol in the body can be alarming and point toward a possible cardiac or diabetic problem. Current evidence reveals that the harmful low-density lipoproteins (LDL) cholesterol tend to increase in poorly controlled diabetes, whereas the useful high-density lipoprotein (HDL) cholesterol, known for its protective anti-inflammatory and antioxidant activities, is decreased. With a positive evidence of periodontal disease being implicated in diabetes, it was decided to investigate whether there was any association between serum HDL, LDL, glycated hemoglobin (HbA1c) and periodontal status with Type II diabetes mellitus patients.A total of 500 nonsmoking patients (males and females) aged between 35 and 55 years with Type 2 diabetes mellitus and no other systemic disease were selected from the diabetic center, Diacon hospital, Bengaluru, Karnataka, India. Periodontal examination consisted of the clinical parameters, namely, attachment loss, gingival index (GI) and plaque index based on which the patients were divided into periodontally healthy and diseased groups. Blood samples were collected from each patient to evaluate the serum levels of HDL, LDL and HbA1c.No significant differences were observed between the HDL, LDL and HbA1c levels in both the periodontal groups (Varied associations were found between dyslipidemia, glycemic control and periodontal inflammation. Further longitudinal as well as interventional studies may be beneficial to ascertain the causal relationship between cholesterol levels, periodontal status and diabetes mellitus.

Aim The novel coronavirus disease‐2019 (COVID‐19) is a major health problem and has affected innumerable people around the world. The current online‐based study was conducted to assess the knowledge, attitude and practice (KAP) of dental students and professionals during the early days of lockdown in India from 2 April to 1 May 2020. Methodology An online‐based cross‐sectional study was undertaken through WhatsApp messenger and e‐mail groups among dental students and professionals. The KAP on COVID‐19 was ascertained using an investigator designed and validated questionnaire. The results were stratified based on student vs professionals. The data were expressed as frequency and percentage analysed using the chi‐square/Fishers exact test using IBM version 17. A probability value of

Conjugated polymers are potential next-generation materials for organic electronic devices. The ability of these materials to transport charges is a key factor limiting their performance. Charge carriers in conjugated polymers are localized by disorder and polaronic effects. Charge transport in these materials is often described by thermally activated hopping, with a rate given by Marcus theory. The polaron hopping activation energy determines the temperature dependence of the Marcus rate. This energy barrier is dictated by the transition state, in which the charge carrier is equally divided between the initial and final locations. The prefactor for the polaron hopping rate is set by the charge tunneling rate between the initial and final locations. We use a tight-binding polaron model, in which charge carriers are stabilized by both nuclear reorganization and polarization of the surrounding dielectric, to compute the activation energy, charge tunneling rate and overall rate constant for intrachain and interchain charge hopping processes in poly(3-hexylthiophene) (P3HT) crystalline lamellae and amorphous melts. Charge transport in these two environments is limited by interchain hopping processes. Both hopping barriers and rates predicted by the model are in good agreement with experiments on a variety of crystalline and amorphous P3HT materials. Qualitatively, the barriers largely depend on how well the transition state is stabilized by polarization effects, and on the hopping integral between the initial and final locations, both of which penalize hopping over longer distances.

Agriculture plays a vital role in our lives. We are aware of how much time and effort is put into the tasks involved in the field of agriculture hence we came up with a system that serves as a boon to the farmers. Agribot is a machine designed specifically to focus on serving as an aid to the farmers and perform various tasks on the field efficiently. Since farming accounts for one of the major occupations in India, it is essential to automate tasks in this field in order to reduce manpower. This bot takes into account features such as automated disease detection, data of which is sent to the corresponding mobile unit and displayed using an interactive user interface. The bot uses deep learning algorithms like CNN to analyze the disease spread on the plant by taking a picture as a sample of the leaf. In addition to this, the bot also looks over the process of pesticide spraying, hence minimizing health risks and labour work.

Objective Traditional gauze dressings, occlusive, and transparent film dressings for treating burns cause discomfort to patients either due to sepsis formation or by undesirable skin adherence. This study focuses on fabricating and evaluating a biocompatible patch for the treatment of burn wounds which can promote re-epithelization, reduce healing time, prevent scarring and eschar formation, avoid septicemia, and reduce patient’s discomfort. Methods The proposed patch is bi-layered. The top layer made of polydimethylsiloxane acts as the mechanical support and the bottom layer is a drug matrix with antibacterial drug silver (I) sulfadiazine incorporated in it. Results The fabricated patch is evaluated for various parameters related to wound healing such as the release of the drug, swelling index, bio-adhesion, and ability to kill pathogens. Conclusion The evaluated parameters depicted that the patch was quite efficient for treatment and its design has an advantage over the current treatments available. Significance The unique design of the patch and ease of application can make it popular for use among patients.

Classic experiments show that polybutadiene oligomers align in a network of stretched chains. Furthermore, the oligomers orient almost as strongly as the network, which suggests a large nematic coupling, despite polybutadiene being a flexible polymer. Here, we combine self-consistent field theory (SCFT) and atomistic molecular dynamics (MD) simulations of polymer chains under tension to obtain the nematic coupling constant α in polybutadiene. Using α, we compute the ratio of orientation of free chains and stretched chains of polybutadiene in a melt of stretched chains. We show that nematic coupling in polybutadiene, though not quite enough to induce a nematic phase, is surprisingly strong. When extrapolated to the experimental temperature, we find an orientation ratio of 0.8, consistent with the experimental value of 0.9.

Energy is important for almost all activities and therefore plays a vital role in all aspects of day to day life. Life is hard to imagine without energy. Currently, most energy is produced from non-renewable sources like oil, coal, natural gas, petroleum, uranium, etc. These exhaustible energy sources contaminate our air and water, damage the earth’s climate, and destroy balanced eco-system and put human health in danger. This energy which is generated from non-renewable energy sources is harmful, is costly and gets finished fast. This problem can be overcome by using the renewable energy sources which can safeguard our health, wealth and climate. That is, by the use of clean, renewable energy such as the sun, hydro and wind energy. These renewable energy sources are abundantly available in nature, free of cost, reusable and inexhaustible. Among these, water is one of the abundant sources from which energy can be exploited for different purposes. Till now, there are different techniques which generate electricity from flowing water. Even the falling rainwater has the potential which can be used for various applications. This idea can be collaborated with already existing solar panels for better harnessing of the energy. Since these sources do not use these exhaustible fuels, the costs and price alterations are not a problem.

BACKGROUND:The replacement of missing teeth with fixed partial dentures is largely dependent upon the health and stability of the surrounding periodontal structures. FPDs are often prepared on vital teeth as abutments. Esthetic materials have become popular in fixed prosthodontics today. AIM:The present study aimed to assess the long term effect and tissue responses of various types of fixed partial prosthesis placed on vital abutment teeth on the periodontal parameters both clinically and radiographically. MATERIALS AND METHOD: Following ethical committee approval, the study group comprised of 87 abutment teeth in 41 systemically healthy patients (24 males and 17 females) aged between 18 – 45 years who had received 3 unit fixed prosthesis(IPS empress, PFM or zirconia), having equigingival margins using vital teeth as abutments. The following parameters were assessed at the time of bridge placement and 1 year follow up – CAL, Probing depth, Distance between CEJ/ cervical crown margin and alveolar crest of the abutment teeth(radiograph). RESULTS:Statistical analysis carried out by SPSSV22 software revealed significant changes in clinical parameters with IPS empress and radiographic parameters with PFM and Zirconia from time of bridge placement till the 1 year follow up.(P CONCLUSION:There seemed to be favorable responses of the periodontal tissues to the various esthetic materials used on vital abutments of FPDs.

An inguinal hernia is one of the most common diseases known to mankind, and inguinal herniorrhaphy is the most commonly performed general surgical procedure in the world. Approximately one-third of these inguinal hernias are asymptomatic or minimally symptomatic. These asymptomatic hernias have historically been treated surgically due to the fear of complications such as strangulation or bowel obstruction. This concept has been challenged in the last 10 years based on two randomized, controlled trials that have compared a strategy of watchful waiting (WW) for asymptomatic or minimally symptomatic inguinal hernias to routine repair. Initial results from both studies demonstrated no significant increase in emergency hernia surgery in the group that underwent WW. However, in the long-term analysis, it was found, by both groups independently, that eventually the majority in the watchful waiting group would cross over to surgery due to progression of symptoms, most commonly pain and discomfort.

Die Leistenhernie ist eine der haufigsten der Menschheit bekannten Erkrankungen, und die Operation der Leistenhernie ist der am haufigsten durchgefuhrte Eingriff auf dem Gebiet der Allgemeinchirurgie weltweit. Ungefahr ein Drittel dieser Leistenhernien sind asymptomatisch oder minimal symptomatisch. Diese asymptomatischen Hernien sind in der Vergangenheit deshalb chirurgisch behandelt worden, weil man Komplikationen wie Einklemmung und Darmverschluss furchtete. Dieses Konzept wurde in den letzten 10 Jahren aufgrund der Ergebnisse zweier randomisierter kontrollierter Studien, die eine Strategie des „watchful waiting“ (WW) fur asymptomatische Hernien mit einer routinemasigen Operation verglichen, infrage gestellt. Erste Ergebnisse aus beiden Studien zeigten keine signifikante Zunahme an Notfalleingriffen in der Gruppe des WW. Jedoch wurde in der Langzeitanalyse von beiden Gruppen unabhangig voneinander herausgefunden, dass die Mehrheit der Patienten in der WW-Gruppe wegen zunehmenden Symptomen, meistens Schmerz und Missempfinden, operiert werden musste.

Background:The outcomes of techniques employed for depigmentation are varied and no one method can be deemed as ideal. The present case series is an evaluation of 4 popular depigmentation procedures `carried out today. Material and methods: 5 patients with non-syndrome associated gingival hyperpigmentation in all 4 quadrants based on Dummetts scoring criteria were included. Healing and pain were assessed following depigmentation carried out by scalpel, bur, electro surgery and laser in the 4 quadrants respectively and followed up for a period of 2 years. Results: Healing following Scalpel method and laser were better than bur and electro surgery. Post-operative pain was less with the use of scalpel and laser when compared to the other 2 techniques at the end of 1month. Pain was still evident at the site of electro surgery at the end of 2 months. However at the end of 3, 6 months and 1 and 2 years there was no difference in all 4 techniques. Conclusion: Better treatment outcomes were observed with the scalpel and laser techniques than bur and electrosurgery.

Introduction: Fibrolipoma, a histologic variant of lipoma, mostly affects the buccal mucosa and causes functional and cosmetic disabilities. Oral lipomas are benign and rarely seen in the oral cavity. Fibrolipoma of the oral cavity has also been infrequently reported. This report presents a rare case of intraoral fibrolipoma detected on the right buccal mucosa. The lesion was removed using electrosurgery (ES).Case Presentation: A 40-year-old female patient presented with a chief complaint of a painless growth on the right buccal mucosa causing irritation when opening and closing the mouth. Provisionally diagnosed as irritational fibroma, the growth was excised using ES under local anesthesia. No sutures were placed, and the bleeding was controlled in the intermittent coagulation mode. The histopathologic report revealed the lesion to be a fibrolipoma. Healing was uneventful, and no recurrence was observed for a period of 1 year.Conclusions: Compared with scalpel surgery, ES requires more expertise, but th...

Pseudomyxoma peritonei (PMP), a peritoneal mucinous neoplasm of appendiceal origin, is associated with inflammation and fibrosis, which is central to its biology. The significance of the microenvironment in PMP has not been well characterized.Immunoassays were used to measure cytokines and C-reactive protein (CRP). Forty-two cytokines were initially measured in 23 PMP ascites and 10 PMP peritoneal washings. On the basis of these results, matching serum and ascites samples were analyzed for ten relevant cytokines (n = 32) and CRP (n = 28). Immunohistochemistry was performed on formalin-fixed tissue sections. Statistical analysis was by Wilcoxon signed rank test, Mann-Whitney U-test, and bivariate analysis.Serum CRP was elevated in PMP and correlated to CRP level in ascites. Interleukin (IL)-6, IL-8 (CXCL8), interferon gamma-induced protein 10 (IP-10), (CXCL10), monocyte chemotactic protein (MCP)-1 (CCL2), and macrophage inflammatory protein (MIP)-1α (CCL3) levels were grossly elevated in ascites but did not correlate with serum levels. Cytokines normally associated with infection or tissue injury (e.g., IL-1, IL-2, interferon gamma) were not elevated. Immunohistochemistry localized IL-6 to stroma, IP-10, and MCP-1 to tumor cells and IL-8 to adipose tissue. There were complex interactions among cytokines. IL-6, in particular, had many significant correlations in ascites. Serum IL-8, MIP-1β, and CRP were higher in PMP compared to controls.The pattern of cytokines in PMP is distinct from infection- or injury-associated inflammation. The results support peritoneal synthesis for cytokines. CRP, IL-8, and MIP-1β are potential serum markers for PMP. IL-6 appears to play a central role in PMP biology. This study provides new details about PMP tumor biology and identifies possible therapeutic targets.

Background and Objectives Herbal dentifrices are fast gaining popularity in most parts of Asia and Europe. Although effects of dentifrices on pathogenic plaque microorganisms has been documented, little or no evidence exists with regard to their effects on the useful microflora, which help to keep the pathogenic strains at bay. The present study was attempted to evaluate and compare these effects of herbal and conventional dentifrice. Methods 60 student participants in the age group of 18 to 28 years with good oral hygiene (OHI score = 0) were randomly divided into two groups, test and control. The test group used herbal dentifrice and the control group, a regular dentifrice. Plaque and saliva samples were collected at baseline, immediately after brushing, 12 hours after brushing, at 1 week and at 1 month, and cultured. The Streptococcus mitis and Lactobacillus counts along with total microbial counts were estimated at the various time intervals. Results Day 1 showed no significant difference between test and control groups with regard to Streptococcus mitis and Lactobacillus counts as well as total CFU (P>0.05), but at one week control group showed significant increase in streptococcus count in plaque and saliva(P>0.01). Whereas, the test group showed significant increase in L. bacillus and total CFU count in saliva, 12 hrs after brushing, when evaluated at one month (p>0.01). Conclusion Herbal dentifrices may be slightly more effective in preservation of beneficial oral microflora when compared to regular dentifrices, although both are equally effective in inhibiting the pathogenic microorganisms.

To explore the effect of full-mouth disinfection (FMD) on glycemic control and insulin resistance in type 2 diabetes mellitus (DM).Sixty dentate patients who were never-smokers with type 2 diabetes mellitus were recruited for the study. Based on clinical examination they were divided into two groups: one with chronic periodontitis and the other without chronic periodontitis. Periodontal parameters Plaque Index (PI), Gingival Index (GI), and probing pocket depth (PPD) were evaluated. Blood samples were assessed for the levels of fasting glucose (FG), insulin, and C-reactive protein (CRP), and insulin glucose ratio was calculated using a mathematical equation (HOMA-IR). All parameters were assessed at baseline, and at 3 months and 6 months after FMD.The results showed a significant reduction in PI, GI, PPD, FG, and HOMA-IR from baseline to 6 months. The CRP levels were constant throughout the study period.Within the limitations of the present study it can be concluded that FMD contributes to significant reduction in insulin resistance, thereby improving the glycemic control in type 2 diabetes mellitus patients.

Background Host modulation is fast gaining popularity as one of the most safe and effective therapeutic modalities in a number of systemic ailments and also periodontal disease. Of these, herbal agents and probiotics have emerged as popular therapeutic agents. The present study was attempted to comparatively evaluate for the first time the effects of both these agents on chronic periodontitis. Materials and methods In this double blinded randomized controlled clinical trial, 96 systemically healthy patients with chronic periodontitis between the ages of 25-55 years were randomly divided into 3 groups. Following scaling and root planing, group 1 was administered the herbal immunomodulator tablets twice daily for 2 weeks, group 2, probiotic tablets twice daily for 2 weeks and group 3 was not administered any agent. Changes in gingival index, gingival bleeding index, pocket depth and interleukin - 6 (IL-6) levels in saliva and GCF were assessed at day 0, at 1 month, at 3 months and 6 months following which statistical analysis was done. Results Statistically significant reduction (p

Diffuse malignant peritoneal mesothelioma is a rare, aggressive disease. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved outcomes where systemic chemotherapy has not succeeded. In this study, we compare outcomes of patients treated with mitomycin or carboplatin as perfusate. In this retrospective study, 47 procedures (CRS + HIPEC) were conducted on 44 patients between March 2003 and August 2010 with either mitomycin or carboplatin. χ2 and Student's t test were used for comparison of clinicopathological variables and Kaplan-Meier curves and log rank test were used to compare overall survival. Median survival of the mitomycin group was 18 months with 1- and 5-year survivals of 72.3 and 27.3 per cent, respectively. Median survival of the carboplatin group was not reached and 1- and 5-year survivals were 89.7 and 62.5 per cent, respectively ( P = 0.014). Mean hospital and intensive care unit length of stay was 18.9 and 8.7 days in the mitomycin group and 12.5 and 2.3 days in the carboplatin group ( P = 0.0069). Mean number of packed red blood cell units transfused was higher in the mitomycin group compared with the carboplatin group (3.54 vs 0.83, P < 0.05). There was no postoperative mortality. HIPEC with carboplatin in diffuse malignant peritoneal mesothelioma is associated with improved overall survival and shorter hospital stay compared with HIPEC with mitomycin.

Host modulation is fast gaining popularity as a preferred therapeutic modality for periodontal disease. Recent research in the medical field into herbal immunomodulators such as Septilin® has spurred an interest in evaluating its efficacy in periodontitis for the first time.The aim of the study was to assess the immunomodulatory effects of the herbal immunomodulator Septilin® (Himalaya Drug Company, Bangalore, India) when used as an adjunct to scaling and root planing in chronic periodontal disease.Forty systemically healthy patients aged between 25 and 55 years of age and with chronic periodontitis were randomly divided into two groups. The test group was administered Septilin® tablets for two weeks following scaling and root planing whereas the control group was treated by scaling and root planing alone. Changes in gingival index (GI), gingival bleeding index (GBI), serum C-reactive protein (CRP) levels and salivary tumour necrosis factor-alpha (TNF-α) levels were assessed at day 0, at two weeks, and at three and six months.The GI and GBI showed a statistically significant reduction at two weeks, three months and six months (P0.001) in both groups. Salivary TNF-α level reduction was significant in the test group only (P0.001). No significant change was found in serum CRP levels in both groups (P0.05).In this pilot evaluation, Septilin® was found to be a safe and effective immunomodulator as an adjunct to routine periodontal therapy. Further long-term studies to test Septilin® on larger sections of the population are recommended.

Background: The search for an agent that would predictably and permanently occlude the tubules, and blend with them led to the discovery of HYDROXYAPATITE (HAP). The present double blinded randomsed controlled clinical trial aimed to compare the desensitizing effects of two forms of HAP with 2 other popular agents, potassium nitrate and potassium nitrate with sodium monofluorophosphate. Methods: Clinical study: 716 hypersensitive teeth in 50 patients with hypersensitive symptoms, confirmed by visual analogue scale (VAS) and verbal rating scale (VRS), were randomly divided into 4 groups (A,B,C and D) treated with HAP dry sol gel and liquid precipitate form, potassium nitrate and sodium monofluorophosphate respectively. The responses were evaluated at 0, 1 day, 1, 2, 4 and 8 weeks respectively for all groups and later statistically analysed. Results: HAP treated teeth showed statistically significant reduction in hypersensitive symptoms (p