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Background: Mycobacterium Tuberculosis (MTB) is one of the most ancient diseases of mankind. Pulmonary tuberculosis (PTB) is the most common, despite the diagnosis and treatment of TB. Many studies reported, a collaboration between PTB susceptibility. In our research study, we report meantime findings after enrolling 732 of a planned 212 participants. Study Design: A descriptive cross-sectional study. Methods: The study conducted on patients with TB in west India was conducted in the Department of Microbiology, Index Medical College; Indore Madhya Pradesh. Patients suspected of PTB were qualified for screening if their age varied from 25 to 60 years and with both gender, signs and symptoms associated with PTB such as cough for more than 2 weeks, fever, weight loss, chest pain, and abnormal chest X-ray findings in results and cartridge-based nucleic acid amplification test (CBNAAT) positive. All Patients were monitored monthly while they visited in TB and chest clinic for TB treatment. Results: A total of 937 patients were selected for the study. Out of which only 732 patients were enrolled. About 212 patents were positive for CBNAAT and 520 were found negative. The confirmed positive CBNAAT patients do not have a history of tuberculosis. In this study about 21.72% were ZN stain positive, 33.46% were culture positive and 28.96% were CBNAAT positive. Conclusion: The current scenario of traditionally AFB-negative PTB is not sensitive enough to establish the diagnosis of active tuberculosis without CBNAAT. They underdiagnose PTB and over-treat people without PTB.

This clinical report presents the rehabilitation of extensive hard and soft tissue defects caused by rhino-orbital-cerebral mucormycosis as a result of untreated diabetes mellitus. The patient underwent subtotal maxillectomy and was rehabilitated with an implant-supported maxillofacial prosthesis with zygomatic and pterygoid implants by following an immediate loading protocol.

This paper highlights the role of social media in the tourism industry. Social media provides various platforms to different stakeholders to communicate and exchange information among them. The essence of social media is growing rapidly in the tourism industry. More and more researchers are working on investigations in the areas of the impact of social media on many aspects of the tourism industry. The main objective of this research is to analyze the social media impact on hospitality firm’s performance. Due to its dynamics and viral capability, tourism businesses need to formulate some guideline or framework before start using Social Media. This study includes two-way methodological approach; primary and secondary as well. Structured questionnaire was designed and filled from hospitality firms (Travel agencies/ tour operators) and secondary part is based on the existing literature.

Summary Mucormycosis is an angioinvasive fungal infection, characterized by high morbidity and mortality and is strongly dependent on the patient’s general health condition, initial site of infection, and the time from diagnosis to treatment commencement. It has been reported that the occurrence of mucormycosis has increased rapidly, also among immunocompetent patients. Moreover, the rise in number is expected to continue. Among all clinical manifestations of mucormycosis, the rhino-orbital-cerebral type (ROCM) is the most common. The aim of this article is to increase the awareness of mucoral infections, especially ROCM, and to describe its first symptoms, as proper treatment requires immediate surgical and medical intervention.

Background: In December 2019, a cluster of pneumonia cases caused by a novel corona virus (2019-nCov), later named as severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) was detected in China. In India, 30th January 2020 first positive case ofSARS-CoV-2was reported from Kerala. The reverse transcriptase polymerase chain reaction (RT-PCR) is the standard method of choice for diagnosis of SARS-CoV-2 infection. Certain biomarker molecules that are being evaluated for assessment of severity and prognosis are; D-dimer, C reactive protein (CRP), lactate dehydrogenase (LDH), complete blood counts (CBC) and serum ferritin. The elevated levels of these biomarkers were associated with extent of inflammation. Objective: This prospective study was designed to assess the severity and prognosis of pneumonia cases caused by SARS-CoV-2 using different haematological and biochemical biomarkers. Materials and Methods: This study was conducted among 242 participants attending covid-19 facility of BRD Medical College Gorakhpur, after confirmation by RT-PCR. Different haematological and biochemical biomarkers were analyzed using 5 ml fasting venous blood samples and these were analysed in auto analysers using standard protocol as per manufacturer’s instructions. Finally result was analyzed using standard statistical calculation by %positivity, confidence interval, p values and ≤ 0.05 is considered as statistically significant. Results: Among a total of 242 COVID-19 cases based on different haematological and biomarkers assessment; 92 were critically ill and 150 non-critically ill. The mean ±SD of various haematological parameters among critically ill cases were; haemoglobin (13.0±1.8),TLC (13846.13±3903.76),PLT (92213.48±61415.07),NLR(36.5±30.4).The mean ±SD of the biochemical parameters of critically ill participant was; CRP 44.7±35.4 (95%CI 25.06,2.93),D. dimer 2.9±2.6 (95%CI 1.69,0.10), serum ferritin 1204.7±750.7 (95%CI 581.8,60.1),LDH 397.2±180.8 (95% CI 133.01,0.0163). The level of different haematological and biochemical parameters was raised also in non-critically ill cases but at lower side. Out of these 242 cases; 106 (43.8%) were died and 136 (56.2%) survived but the mortality was high in critically ill cases. Conclusion: Our findings show that level of D-dimer, LDH, CRP, NLR and serum ferritin,can be used to assess the severity and prognosis of COVID-19 cases. Among these biomarkers; D-dimer levels correlate more precisely with severity and can be considered as a reliable prognostic marker.

Highlights • This study reports about the success in regard to long term follow-up of an implant retained fixed prosthesis on free fibular reconstruction with a single piece zygomatic implant. • It also reports the superiority of using a single piece bicortical implant via a flapless approach and immediate functional rehabilitation. • Remote Bone Anchorage in conjunction with the union of grafted free fibula flap with the native mandible. • Moreover, it demonstrates the long term success of the technique of immediate functional rehabilitation in the fibular graft., Presenting to our knowledge, for the first time in literature, a case report on the long term follow-up of an implant retained fixed prosthesis on free fibular reconstruction with a single piece zygomatic implant and single piece bicortical implant via a flapless approach and immediate functional rehabilitation. The technique involved the concept of “Remote Bone Anchorage” in conjunction with the union of grafted free fibula flap with the native mandible. It was facilitated with a single piece zygomatic implant engaged in the mandible and splinted with single piece implants on the grafted fibula as needed for prosthetic functional reconstruction. The author has reported a unique concept of immediate functional rehabilitation in the fibular graft therefore providing additional splinting of the vascularized free fibula to the mandible by splinting them with single piece zygomatic cortical implant.

(1) Background: Dental implantology has been rapidly developing over the last decades. The introduction of new materials, surface modifications and implant designs has brought the need to rethink and systematize our knowledge regarding dental implants. Thus, the aim of this paper is to introduce a new classification and implant positioning indications that can be used to maximize the survival rate and the aesthetic outcome of single-piece compressive screw implants. (2) Materials and methods: This classification was based on a multicenter clinical and radiological observation of 151 patients, in whom 1057 implants were placed with a success rate of 98.5% (1041). The follow-up period was up to 82 months with a mean of 22.34 months. (3) Results: it seems that, in the case of single-piece implants, diameter and length of the implant have influence on their survival rate, whereas smoking and hypertension do not. (4) Conclusions: this paper provides clinicians with comprehensive information about the rationale, criteria and implementation of the new classifications based on a large number of implants and long-term observations.

Background: Many studies reported association between TB susceptibility and diabetes mellitus (DM). Some studies were retrospective, did not assess other co morbidities related with tuberculosis. The effects of diabetes on tuberculosis severity (EDOTS) can be hypothesizing that burden of cases India is leading in TB and runner-up in diabetic. We report interim findings after enrolling 732 of a planned 212 subjects.Methods: This study conducted on patients with TB in west India with DM and normoglycemia defined by glucose tolerance test (GTT) and glucose fasting. Glycocylated hemoglobin (HbA1c), lipids profile and 25-hydroxyvitamin D were measured at the time of enrollment of patients. All patients were monitored monthly while they visited in TB and chest clinic for TB treatment.Results: Of 212 eligible patients, 117 (55.18%) were classified as diabetic, 49 (23.11%) with pre diabetic history (PDM), and 46 (21.70%) as normoglycemic (NG). DM patients were more likely to have a family history of diabetes in comparison to NG patients. Low density lipoprotein (LDH)) was higher in KDM as compared with NDM and NG patients. More patients (32) found diabetic through OGTT as compared with HbA1c (29).Conclusions: Early EDOTS, glycemic control and improve lifestyle can reduce the heterogeneity and implications for the TB-DM. Early diagnosis of TB and DM plays an important role in the management and treatment of TBDM.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan City, China, in 2019. After that, the outbreak has grown into a global pandemic and definite treatment for the disease, termed coronavirus disease 2019 (COVID-19), is currently unavailable. The slow translational progress in the field of research suggests that a large number of studies are urgently required for targeted therapy. In this context, this hypothesis explores the role of bacteriophages on SARS-CoV-2, especially concerning phage therapy (PT). Several studies have confirmed that in addition to their antibacterial abilities, phages also show antiviral properties. It has also been shown that PT is effective for building immunity against viral pathogens by reducing the activation of NF kappa B; additionally, phages produce the antiviral protein phagicin. Phages can also induce antiviral immunity by upregulating expression of defensin 2. Phages may protect eukaryotic cells by competing with viral adsorption and viral penetration of cells, virus mediated cell apoptosis as well as replication. Moreover, by inhibiting activation of NF-κB and ROS production, phages can down regulate excessive inflammatory reactions relevant in clinical course of COVID-19. In this chapter, we hypothesize that the PT may play a therapeutic role in the treatment of COVID-19.

The genetic analysis of neurological disorders is a difficult and protracted endeavor. Genetics is one of the main disciplines that will be required for the etiology of several major neurological disorders due to viruses through the analysis of rare inherited subgroups. The identification of individual susceptibility genes with variants of smaller effect will be more difficult, but there is no sharp demarcation between large and small genetic effects, so that many new and important insights will emerge using existing and new technologies. The availability of improved neuroimaging, better animal models of disease, and new genetic tools, such as high-throughput gene chips, expression microarrays, and proteomics, are extending the range of traditional genetic mapping tools. Gene therapy is the most significant and unique treatment technique nowadays, which utilizes single or combinations of genes or short oligonucleotide sequences as therapeutic option, instead of conventional drugs. This technique is now widely used to treat many diseases caused by insertion/mutation of defective genes. Gene therapy involves the introduction of one or more foreign genes into an organism or cell to treat hereditary/acquired genetic diseases. In gene therapy, DNA encoding a desired therapeutic protein is packaged within a “vector,” which transports the desired DNA inside cells. The most recent demonstration of gene therapy is Zolgensma for spinal muscular atrophy also approved by the FDA. A more advancement on the horizon for other genetic neurological disorders such as Rett syndrome, a neurodevelopmental disorder that exhibits X chromosome linkage, leads to severe mental retardation in girls.

Coronavirus disease 2019 (Covid-19) is a highly infectious disease, and its replication decreasing rapidly after the first week, while some level of immunity is built up. A small proportion of discharged patients may become positive again for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) RNA, even if they meet the discharge criteria. Re-infection of SARS-CoV-2 is an apparently uncommon entity and only a few case reports or case series have been reported from across the whole world. Herein, we have reported two rare Covid-19 cases with recurrence of positive SARS-CoV-2 RNA after a complete clinical cure. The first case was redetected with Covid-19 with more severity after a gap of approximately three weeks after cure, and the second case has recurred after approximately seven weeks with a complication of pulmonary thromboembolism. We report here, the first few cases of a more vigorous Covid-19 recurrence with SARS-CoV-2 RNA in India. J Microbiol Infect Dis 2021; 11(2):108-114.

The intended target site to engage a fixture distal into the tuberosity is the pterygoid apophysis that comprises the maxillary tuberosity, pyramidal process of the palatine bone, and the pterygoid process of the sphenoid bone. Pterygoid implants are incorrectly labeled in literature owing to the fact that they are actually root form conventional implants and should hence be termed as 'tubero-pterygoid implant'. An implant engaging the pterygoid apophysis/pillar taking distal maxillary support and avoiding successfully the cantilever situation is called a pterygoid implant. It essentially does not acquire primary with support of distal maxilla initially from the tuberosity. Instead, it makes its way into the apophysis and sometimes via a transsinus approach. A tubero-pterygoid implant, because of the root form screw shape fixture that is wide at the crestal aspect and converging toward the apex, takes the primary support from the tuberosity and engages the pterygoid pillar apically, thus allowing more bone to implant contact but has its limitation in deficient/atrophied tuberosity.

Single piece zygomatic implant, or a remote anchorage implant, is an effective tool for the rehabilitation of the atrophic/resected jaws with least postoperative complications such as screw loosening, screw fractures, bone loss, mucositis, and peri implantitis. The aim of this paper was to summarize a technique for the use of a zygomatic approach for single piece implants. We used the key-words 'single piece implants" and the search revealed 700 papers in the PubMed database. After screening through the abstracts, we selected 50 articles that we finally reviewed. Zygomatic fixtures avoid the grafting procedures and cantilever situation, restoration of atrophic or postablative jaws are completed with immediate loading. It is advisable placement of zygomatic implant flapless with surgical guide, but the author believes more on the tactile perception and when the splint is at mucosal or bone level, a small change in orientation will lead the dramatic error in desired angulation leading to unwanted complication.

Corona virus is one of the major pathogens that primarily target the human respiratory system. Previous outbreaks of corona viruses include the severe acute respiratory syndrome (SARS)-CoV-2 and the Middle East respiratory syndrome (MERS)-CoV which have been previously characterized as agents that are a great public health threat. In late December 2019, a cluster of patients was admitted to hospitals with an initial diagnosis of pneumonia of an unknown etiology. These patients were epidemiologically linked to a sea food and wet animal wholesale market in Wuhan, Hubei Province, China. In India on 30th January 2020 first positive case in a student from Kerala of the SARS-CoV-2 infection, who was studying in Wuhan University and had travelled to India, tested positive by reverse transcriptase polymerase chain reaction (RT-PCR). As of 15th March 2021, in India total confirmed cases 94,61,901 recovery 88,47,600 death 1,37,582 have been reported from 32 states/union territories in U.P. state has 6,05,290 confirmed cases, resulting in 8,746 deaths and 595,637 recoveries. The case fatality rate in Uttar Pradesh was stands at 1.4%. Among different districts of U.P., the Lucknow was listed as first with 82,213 cases, 80,740 recovered and 1,190 deaths. Next states were Kanpur; 33,111 cases, and 839 deaths, Prayagraj 29,436 cases, and 409 deaths, Meerut; 22477 cases, and 442 deaths, Ghaziabad 26902 cases, 26694 recovered, 102 death and Gorakhpur 21510 confirmed case 21115 recovered and 366 deaths till 15th March 2021.

Highlights • Rheumatoid Arthritis is an auto-immune disease that affects the cartilage and small joints of the body. Moreover, it complicates oral therapy due to the associated medication induced xerostomia, accompanying periodontitis and increasing bone-loss which may lead to peri-implantitis with surface treated implants. Hence treating these patients with conventional implants can often pose a challenge to the attending dentist, however making them excellent candidates for smooth surface single piece implants. • These bicortical smooth surface single piece implants engage into the cortical bone as well as preclude the use of bone grafts and hence can be safely placed in Rheumatoid Arthritis patients with atrophic jaws successfully. • The greatest advantages associated with these implants are that they are placed in a flapless manner with an immediate loading protocol of 72 h. This precludes the need for bone augmentation via additional surgeries as well as the increase costs associated with bone grafting procedures. It also reduces overall chairside appointments thereby making it a convenient treatment alternative for the patient., Introduction and importance The aim of this article is to report the long-term outcome of full mouth rehabilitation with single piece, smooth surface implants following immediate loading protocol on a patient suffering with RA and severe unilateral condylar resorption. Case presentation Here, we present a challenging case of a patient suffering from Rheumatoid Arthritis who was stabilized and completed successfully with a 4 year follow-up period. Prosthetic management optimized the inter-occlusal relationship to maintain both function and esthetic integrity. Single piece implants are designed to engage and take support from the cortical bone low in metabolic activities thus promoting the force transmission through apical threads that are engaged in the cortical bone. Discussion Rheumatoid Arthritis [RA] is an auto-immune inflammatory condition in which the inflamed and hypertrophic synovial membrane grows into the articulation surfaces. The Temporomandibular Joints [TM] are frequently involved in rheumatoid arthritis. According to the literature on RA, due to frequent periodontitis, decreased salivary secretion, medication, as well as decrease in bone regenerative potential, RA is often considered as a relative contraindication in the use of implants. Atrophic jaws and cases with comorbidities like osteoporosis, diabetes, rheumatoid arthritis, periodontally infected cases are restored with high success by single piece smooth surface. Conclusion To the best of our knowledge, this may be the first case of immediate functional loading by bi-cortical single piece implants.

Approximately 99.9% of microorganisms came in contact with biological and inert surfaces; then, they form biofilm. Skin diseases including atopic dermatitis, various forms of chronic ulcers, paronychia, necrotizing fasciitis, miliaria, cellulitis, erythema nodosum, and erysipelas are usually caused by polymicrobial pathogens. The etiology of these diseases is well studied in recent years and associated with initiation of bacterial accumulation and biofilm formation on the soft tissues or epidermal layer of the skin. Hence, the polymicrobial nature of microorganism can find its way to wound from both exogenous (from water and soil) and endogenous (saliva, urine, skin, and feces) sources. The predominant floras in the skin are Staphylococcus spp., Corynebacterium spp., and Propionibacterium spp., which cumulatively represent more than 60% of the microbial load in the human skin. It is important to diagnose skin infection for rational treatment decisions, and it provides very useful information for understanding the etiology as well as pathogenesis of the different skin diseases.

In a vast majority of metabolically active strains results in negative culture even if the patient is infectious, the usage of molecular methods is one of the important tools for analyzing approximately 99% of strains causing microbial colonies directly on biofilms and also permits the information to be assembled on a protocol of treatment. This technique not only provides an authenticated source to understand the information of bacterial biofilm but also does the assessment of targeted biofilm interference strategies in vivo and marks in identification of mono or multi-species population of bacteria. Different molecular techniques like next-generation sequencing (NGS), polymerase chain reaction (PCR), hybridization and microarray technology are highly specific and sensitive, which enables the discovery of new concepts regarding the role of molecular methods for diagnosis of microorganisms in biofilms. This advancement is designed in order to detect the presence of the etiologic agents as well as used to design the protocol for antibiotics.

Homogenous or heterogeneous networks of bacteria, responsible for the synthesis of biofilms, can attach themselves to lattices of natural polymers or extracellular polymeric substances (EPSs). These polymers include glycopeptides, lipids, and lipopolysaccharides holding the biofilm together via a structured framework. Microbiota found within biofilms often play a part in the decomposition of organic matter, the restoration of various ecological recalcitrant pollutants, and the fixation of gas, sulfur, and metals. Aside from these helpful effects, biofilms can be extremely pathogenic. A significant number of biofilms associated with different diseases are comprised of solitary bacterial categories. The exception to this generalization are biofilms associated with catheters and voice prostheses—quite similar to oral cavity biofilms in that they are regularly comprised of diversified pathogenic and non-pathogenic organisms. The etiology of such diseases are known to be related to bacterial aggregation and biofilm development on indwelling devices or tissues. Biofilms likewise encourage gene transfers among bacteria, which can favor the incorporation of several virulent strains. Another possible component mediated by biofilm cells is differential gene expression. An optimal example of species complexity is found in oral biofilms—caused by many different microorganisms. To date more than 350 bacterial species have been found to be responsible for dental plaques.

This article analyses published prior article regarding the questions: is the study setup correct (true) and if comparable cases are evaluated for the compared methods. Futhermore the content, the pictures, the tables, the graphs and the pictures legends of the article and statistics are analysed for truth, relevance and applicability. We investigate furthermore if this article addresses all relevant questions regarding bias, the study groups, the evaluation of the outcomes and the evaluation of patient parameters such as burden of the treatment. As a result of the analysis, we state that the analysed article is misleading and it does not provide valuable information regarding decision making for other healthcare professionals in the dental implant field.

Background: Acute bacterial meningitis (ABM) is one of the most severe and potentially life-threatening infectious diseases. It is defined as an inflammation of the meanings, globally distributed as either sporadic or epidemic forms. ABM remains a major cause of mortality and long-term neurological sequel worldwide. Objective of the present study was undertaken to evaluate the bacteriological analysis in term of pathogens frequency and their sensitivity pattern in the cerebrospinal fluid of acute meningitis patients at a tertiary care hospital in eastern Uttar Pradesh, India. Methods: The study was carried out at a tertiary care hospital from June 2014 to November 2015 irrespective of age group. A total of 3803 samples of cerebrospinal fluid (CSF) from clinically suspected cases of meningitis were subjected for bacteriological analysis. Results: During the study period, a total of 3803 CSF samples were studied. Out of these, 343 were confirmed as bacterial meningitis based on Gram staining and or culture showing 9.01% incidence. ABM was more common in paediatric patients than adults. The most common organisms were Gram positive (66.18%) bacteria. Conclusions: Acute bacterial meningitis is a medical emergency and making an early diagnosis and providing early and accurate treatment, are lifesaving and to reduce morbidity. This study may play an important role in the diagnosis and more accurate treatment for the ABM patients.

Cloud computing is an emerging internet- based paradigm of rendering services on pay- as -per -use basis. Increasing growth of cloud service providers and services creates the need to provide a tool for retrieval of the high-quality optimal cloud services composition with relevance to the user priorities. Quality of Service rank- ings provides valuable information for making optimal cloud service selection from a set of functionally equiva- lent service candidates. To obtain weighted user-centric Quality of Service Composition, real-world invocations on the service candidates are usually required. To avoid the time-consuming and expensive real-world service invocations, this paper proposes framework for prediction of optimal composition of services requested by the user. Taking advantage of the past service usage experiences of the consumers more cost effective results are achieved. Our proposed framework enables the end user to deter- mine the optimal service composition based on the input weight for individual service Quality of Service. The Ge- netic algorithm and basic Tabu search is applied for the user-centric Quality of Service ranking prediction and the optimal service composition. The experimental results proves that our approaches outperform other competing approaches.

Prosthetic rehabilitation post resection and radiotherapy demand a thorough understanding of the biomechanics of the jaw, its associated structures, and their post radiation changes at the bone level. Restoring lost structures can often pose a challenge, especially with regard to the dentition. Due to inadequate hard- and soft-tissue structures as well as their demand for “biologic osseointegration,” it is difficult to conduct immediate loading as a treatment option on conventional implants. Alternatives are today available. Since piece smooth surface cortical implants transmit occlusal forces at cortical bone/buttress by engaging them, with or without reliance on the alveolar bone, it can be considered as an option. Here, we report a case of immediate loading with single-piece smooth surface implants in a male patient who had undergone a marginal mandibulectomy 3 years back for the removal of an oral squamous cell carcinoma of the retromolar trigone area that was closed by an anastomosed radial forearm flap, followed by radiation therapy. The dentition was restored successfully using a single piece smooth surface cortically anchored implant and reported favorable success and survival rate with high patient acceptance. Single piece corticobasal implant technology is one of the most predictable methods for the functional and sociopsychological correction, with minimal invasive immediate functional loading protocol restoring function and post resection surgical deformation of the jaw, thus improving lifestyle and survival.

This Consensus-Document is issued by the International Implant Foundation (Munich/Germany). It describes distinct methods of placement of cortico-basal oral implants in different areas of the jaw bone and the maxillo-facial skeleton. The implants utilize the method of “osseofixation” instead of “osseointegration” for achieving primary, functional stability, hence they work according to the (AO-) principles of fracture treatment. The concept of the technology allows for immediate functional loading, just as it allows for various types of loading following orthopaedic surgery. The 16 methods and sub-methods as described and displayed here have been undergoing extensive observation and testing and they have been approved by the Board of the International Implant Foundation. All Consensus Documents of the International Implant Foundation are revised every three years. This is the 3rd version of the Consensus Document on placement of corticobasal oral implants Level of Evidence: S3 (evidence based, systematically developed consensus guideline).

Background: India has approximately 2.4 million of people living with HIV and out of these two thirds live in rural areas. This study may yield significant data to understand epidemiology of HIV/AIDS in this region that would help in designing techniques for effective implementation to prevent this infection.Methods: The present study was a comprehensive retrospective hospital-based investigation of the HIV infection in eastern Uttar Pradesh, India based on a large number of clinical samples at HCTS centre, representing different geographic regions and has been functional since 2002, conducting HIV tests, counselling of patients as well as maintains proper records.Results: A total of 444 HIV positive clients were registered in this retrospective study. The male and female ratio among all positive clients was 1.67:1 and the most common age group for both the genders was 35-49 years. Among 444 HIV positive clients, HIV-TB co-infection found in 72 (16.21%) cases. Out of 444 clients, 177 (40%) and 167 (38%) found extremely immunocompromised with low CD4 cells count in range between of 0-100 cells/mm3 and >100-350 cells/mm3 respectively. Mortality was seen in 72 (16%) out of 444 HIV positive clients.Conclusions: There is an urgent need of information, education about this disease and by providing suitable occupation or to make them aware, which will markedly help in preventing the spread of HIV pandemic in this geographical region.

Recent computing world has seen rapid growth of the number of middle and large scale enterprises that deploy business processes sharing variety of services available over cloud environment. Due to the advantage of reduced cost and increased availability, the cloud technology has been gaining unbound popularity. However, because of existence of multiple cloud service providers on one hand and varying user requirements on the other hand, the task of appropriate service composition becomes challenging. The conception of this chapter is to consider the fact that different quality parameters related to various services might bear varied importance for different user. This chapter introduces a framework for QoS-based Cloud service selection to satisfy the end user needs. A hybrid algorithm based on genetic algorithm (GA) and Tabu Search methods has been developed, and its efficacy is analysed. Finally, this chapter includes the experimental analysis to present the performance of the algorithm.

Maxillary jaw is restricted superiorly with maxillary sinus in the posterior region and nasal cavity in the anterior region. Augmentation of distal maxilla with recessed maxillary sinus has been documented since, last few decades. Sinus lifts the procedure either through crestal or lateral approach proves to be an effective way for augmenting bone for the placement of dental implants in atrophied posterior maxilla. However, when it comes to vertically deficient anterior maxilla, lifting of the nasal membrane is not considered. Perhaps, recent studies have shown greater success of dental implant placed after augmentation of the nasal floor. This report emphasizes on an observation of significant bone formation after indirect lifting of the nasal membrane with smooth polished surface bi-cortical implants.

In a cloud based service environment, finding the user-centric optimal service composition has become increasingly necessity. A consumer needs the service composition which meets the quality requirements in a cost effective manner. The service level agreement (SLA) signed by both, the consumer and the service provider, includes Quality of Service (QoS) requirements and penalties in case of violation. The violation of a quality requirement for a service composition needs a suitable service substitution which incurs a considerable adaptation cost. Therefore, an efficient tool is needed to address the user-specific service requirement in a cost effective manner. The work proposed a heuristic based approaches using hybrid Genetic and Tabu algorithm to determine the optimal QoS based service composition with maximum utility value and minimum adaptation cost. The blending of a basic Genetic algorithm and Tabu search has been formulated as Memetic approach for service utility prediction and ranking the service compositions. The work also simulates the basic GA and Memetic approach to compare the performance of the two methods in terms of utility, violation cost and adaptation cost of a service composition.

Direct and indirect oxidation of guanine in DNA produces guanidinohydantoin (Gh), which is capable of inhibiting replication and inducing mutations during cellular activities. Although some biochemical studies have proposed that Gh may induce exclusively G to C mutations in DNA, other studies have predicted the occurrence of both G to C and G to T mutations. However, the exact reasons for these mutations and the dubious character of Gh in this context are not yet understood. Further, due to insufficient structural data, the electronic structure of Gh that can participate in the formation of different base pair complexes in DNA is also not known. Here, density functional theory (DFT) is used to find the most stable tautomers of Gh at the base level out of a total 112 possible tautomers and their involvement in mutagenesis is investigated by computing structures, energies and electronic properties of different base pair complexes formed between the syn- and anti-conformations of the most stable tautomer of Gh (aGh) and all the bases of DNA. It is found that aGh can coexist in R- and S-diastereoisomeric configurations. Due to the flexible guanidinium group, it can rotate about the N3–C4 bond in each of the above diastereoisomers to form two different stable conformations (aGh1 and aGh2). It is further shown that among the different base pair complexes involving aGh1, syn-aGh1:G is the most stable. This indicates that G would be easily incorporated against syn-aGh1 giving rise to G to C mutations in DNA. However, in the case of aGh2, G is the preferred base pair partner of syn-aGh2 and T is the preferred base pair partner of anti-aGh2. This implies that in addition to G to C mutations, the occurrence of aGh2 in DNA may also induce G to A mutations. Further, due to similarities between base pairing patterns and binding energies of syn-aGh1:A and syn-aGh2:A complexes with those of the T:A complex, DNA polymerases may mistakenly insert A opposite aGh1 or aGh2 by misrecognizing the latter as T. This may ultimately induce G to T mutations in DNA. However, as the constraints imposed by the DNA backbones and stacking interactions were not considered here, the possibilities of aGh2:T and aGh2:A base pairs need to be investigated experimentally. It is further found that the mutagenic character of aGh in the R- and S-diastereoisomeric forms is similar.

A new transitive closure algorithm is presented for implication graphs that contain partial implications. In the presence of partial implications, a vertex can assume the true state when all vertices that partially imply it become true. Such graphs provide a more complete representation of a logic circuit than is possible with the conventional pair-wise implications. An application of the new transitive closure algorithm to redundancy identification shows significantly improved results. Empirically, we find the computational complexity of transitive closure to be linear for the implication graphs of the ISCAS benchmark circuits.