Root Canal Morphology of Primary Molars – A Cone Beam Computed Tomography (CBCT) Study

Objectives: To evaluate the root and canal morphology of primary maxillary and mandibular molars in an Indian population using cone?beam computed tomography (CBCT). Methods: A retrospective cross?sectional study was performed, where CBCT scans of children less than 10 years of age taken for valid diagnostic purposes previously were considered and images were analyzed. The number of roots, root canals, and variations in morphology were recorded. Left–right symmetry was also noted. Results: A total of 433 deciduous maxillary and mandibular primary molars were studied. It was observed that two separate roots with three separate canals were common in primary mandibular first molars, whereas two separate roots with two canals in each root were common in mandibular second primary molars. In primary maxillary molars, three separate roots with one canal each were the most common. Maxillary first molars (17.21%) and 17.35% second molars had fused distobuccal and palatal roots. It was observed that primary maxillary molars showed more left–right symmetry (86.7% in first molars and 82.7% in second molars) compared to primary mandibular molars (54.05% in first molars and 68% in second molars). Conclusions: It was concluded that in both primary maxillary first and second molars, three separate roots, a mesiobuccal root, a distobuccal root, and a palatal root with one canal in each root, were the most common. Two separate roots with three separate canals were the most common in primary mandibular first molars, whereas two separate roots with two canals each in both roots were more common in mandibular second primary molars.

Validation of micro-chip based PCR assays for diagnosis of both Plasmodium falciparum and Plasmodium vivax

Background & objectives: Microscopy is considered as the gold standard for malaria diagnosis, however sub-microscopic infections can only be detected by Polymerase chain reaction, which demands high cost and elaborate laboratory setup. The Micro-chip PCR based Truenat Malaria Pv-Pf and Pf assay is a portable solution for detection of sub-microscopic/asymptomatic cases of malaria in the field, three lots of which were evaluated for P. falciparum and P. vivax malaria. Methods: Three lots of Truenat® Malaria Pv-Pf and Pf assay (kits) were assessed using blood samples of P. vivax and P. falciparum as well as malaria negative blood samples. DNA was extracted from the blood samples using the Trueprep Auto v2 Universal Cartridge based sample prep device and real time qPCR was performed using Truelab DUO micro PCR Analyzer with three lots of Truenat® Malaria Pv-Pf and Pf Assays. Mean, Standard deviation and one-way analysis of variance (ANOVA) was used to assess the significance of inter-lot variability in Cycle threshold values. Results: The Truenat® Malaria Pv-Pf and Pf assays identified the malaria parasites with 100% accuracy. Based on the test for variance (ANOVA) the inter-lot variability in cycle threshold values were not significant, indicating a high degree of precision. Interpretation & conclusion: Based on high accuracy and precision between different lots, the Truenat® Malaria Pv-Pf and Pf assays were found to be suitable for the diagnosis of sub-microscopic infections in field conditions to provide support in elimination of malaria.

Study of efficacy and safety of drug eluting stent versus bare metal stent in ST elevation MI

Background: The present study was conducted with the aim of determining whether drug-elutingstents are superior to uncoated stents in the setting of primaryPCI in terms of occurrence of serious adverse cardiac events.Methods: In this prospective, single blind, randomized study, 20 to 80 years old patients with acute myocardial infarction with ST-segment elevation with >30 minutes of chest pain and at least 1 mm of ST-segment elevation in at least two standard leads or a new LBBB or 2 mm of ST-segment elevation in at least two contiguous leads were included. Patients were randomly assigned to receive either drug eluting stent (DES) (Everolimus Eluting stent, Endevour-Medtronics) or bare metal stent (BMS, Cordis-Dx sonic) in a 1:1 ratio. During follow ups at 30 days and 12 months, all serious adverse cardiac events like death from cardiac or non-cardiac cause, recurrent MI, revascularization of target vessel, coronary artery bypass grafting (CABG) or other intervention to target or non-target vessel etc. were recorded and compared between groups.Results: No significant differences were found between the two treatmentgroups for occurrence of adverse events during first 30 days after the intervention. At one year follow-up, trends were observed in favorof the DES group, none of the differences weresignificant.Conclusions: No significant benefit was observed with the use of Everolimus-eluting stents in primaryPCI for acute myocardial infarction with ST-segment elevation,in comparison with baremetal stents.

25-Year trends in hypertension prevalence, awareness, treatment, and control in an Indian urban population: Jaipur Heart Watch

Objectives We evaluated trends in hypertension prevalence, awareness, treatment and control in an Indian urban population over 25 years. Trends were projected to year 2030 to determine attainment of World Health Organization (WHO) Global Monitoring Framework targets. Methods Adult participants (n = 7440, men 4237, women 3203) enrolled in successive population based studies in Jaipur, India from years 1991 to 2015 were evaluated for hypertension prevalence, awareness, treatment and control. The studies were performed in years 1991–93 (n = 2212), 1999–01 (n = 1123), 2003–04 (n = 458), 2006–07 (n = 1127), 2009–10 (n = 739) and 2012–15 (n = 1781). Descriptive statistics are reported. We used logarithmic forecasting to year 2030 and compared outcomes to WHO target of 25% lower prevalence and >50% control. Results The age-adjusted hypertension prevalence (%) among adults in successive studies increased from 29.5, 30.2, 36.5, 42.1, 34.4 to 36.1 (R2 = 0.41). Increasing trends were observed for hypertension awareness (13, 44, 49, 44, 49, 56; R2 = 0.63); treatment in all (9, 22, 38, 34, 41, 36; R2 = 0.68) and aware hypertensives (61, 66, 77, 79, 70, 64; R2 = 0.46); and control in all (2, 14, 13, 18, 21, 21; R2 = 0.82), aware (12, 33, 27, 46, 37, 37; R2 = 0.54) and treated (9, 20, 21, 48, 36, 49; R2 = 0.80) hypertensive participants. Projections to year 2030 show increases in prevalence to 44% (95% CI 43–45), awareness to 82% (81–83), treatment to 62% (61–63), and control to 36% (35–37). Conclusion Hypertension prevalence, awareness, treatment and control rates are increasing among urban populations in India. Better awareness is associated with greater control. The rates of increase are off-target for WHO Global Monitoring Framework and UN Sustainable Development Goals.

Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism

BACKGROUND/AIMS: Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. METHODS: Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15–20 MBq of Technetium-99m sulfur colloid diluted in 10–15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. RESULTS: Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P < 0.05). Esophageal transit time improved and in some patients even normalized after treatment with thyroxine. A positive correlation (r = 0.39, P < 0.05) albeit weak existed between the serum thyroid stimulating hormone and the observed esophageal transit time. CONCLUSIONS: A significant number of patients with primary hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels.

Evaluation Of The Periodontal Disease In Individuals Involved In Night Duties.

Background: Shift duty or night duty is usually associated with various problems in the oral and general health of the individuals. The present study was planned to find the incidence of periodontal disease in night duty workers. Methodology: The study was carried on individuals involved in night duties as their profession. A total of 109 participants were involved in the study group. Also a control group of 109 individuals, who were working in day time, were taken. All the participants involved in the study were males. The periodontal condition of the study population was examined using periodontal disease index (PDI) and the scoring was done according to standard criteria. Statistical analysis was performed with the help of IBM SPSS statistics 20 by applying student’s t test. Results: The comparison of the periodontal condition of the control group and the study group had shown a statistically significant difference. This shown that the individuals involved in the night duties have more incidences of periodontitis. Conclusion: The results of the present study added focus on the oral health of the individuals with profession having shift duties or night duties.

Evaluation of implementation of "5S Campaign" in urban health center run by municipal corporation, Gujarat, India.

Background: Despite significant progress in improvement of Government health care delivery system over past decade, community is reluctant to accept it because of substandard level of quality. “5S” is one of the strategies used to improve the physical quality and work efficiency of organization. 5S stands for five Japanese words which can be translated in English as Sort, Set in order, Shine, Standardize, and Sustain. Rajkot Municipal Corporation has adopted 5S strategy within its health centers with the aim to improve image of public health care facility among community and thereby to increase coverage of health services. This study was conducted to assess 5S implementation status at all Urban Heath Centers under health department of Rajkot Municipal Corporation, Gujarat, India. Methods: “5S” was implemented by the corporation in campaign mode in 18 Urban Health Centers in July 2014. Campaign included training, baseline assessment, and observing 5S week. A cross sectional study was carried out by personal observation and interview to assess the implementation of 5S campaign. Standard audit check list recommended by the State Quality Assurance Cell, Gujarat was used to evaluate. Results: Overall; all five components of 5S showed significant improvement (p<0.001) with highest improvement in Sorting and Setting in order. Significant improvement in utilization of Out Patient, laboratory services, immunization, family planning services etc were observed in comparison to previous year’s corresponding period. Conclusions: Significant improvement in utilization in major health care services was noted in the study after implementation of 5S. ‘5S’ practice can be sustained with sincere and continuous efforts.

Studying the effectiveness of mixed models of community based and institutional based interventions for management of severe acute malnourished children.

Background: Children with severe acute malnutrition (SAM) have nine times higher risk of dying than well- nourished children. Child malnutrition can be managed by community based approach (80-85% SAM children) and institution based approach (10-15% SAM children). The objective of the study is to know the effectiveness of the mixed interventions to improve the nutritional status of the children (0-6 yrs), to decrease the prevalence of malnutrition in the children attending ICDS in Rajkot city for combating child malnutrition. Methods: A baseline survey of total registered 26578 children was carried out at 330 anganwadis and 701 SAM children were identified till the end of June 2014. A model of mixed interventions i.e. i) Community based management consisting of special food program, monthly health checkup and treatment and health education to parents, ii) Institution based management of SAM children with complication was planned and implemented since July 2014. Results: 701 children were identified as SAM at the beginning of the intervention while 160 children were SAM at the end of March 2015. The difference in the proportion of SAM children before and after intervention was statistically significant. An improvement of 80.9% in the status of SAM children was seen among boys while 74.1% was seen among girls. Conclusion: Convergence of Health and ICDS activities, high risk approach, community based and institutional management and community awareness in combating the malnutrition showed significant effect. This model can be replicated elsewhere and sustainability may be ensured for long term results.

Impact of CO2 Enhancement on Photosynthesis and Protein Profile - Response Studies with a CO2 Responsive Black Gram Genotype.

Black gram (Vigna mungo (L.) Hepper) var. IC-282009 - a highly CO2 responsive genotype for biomass and seed yield was grown in Open top chambers (OTCs) under three levels of CO2 i.e. ambient (390 ppm) and two elevated levels 550ppm and 700ppm to assess photosynthetic acclimation to elevated CO2. Net photosynthetic rate (PN), change in leaf soluble protein profile and leaf carbohydrate constituents such as total soluble sugars, reducing sugars and starch content in leaves was quantified at all three CO2 concentrations. Photosynthetic rate was enhanced by 78% and 30% at flowering stage with 550ppm and 700ppm CO2 as compared with ambient control. It was also observed a higher accumulation of starch, total soluble sugars and reducing sugars in leaves at elevated CO2 levels. However, the leaf protein content recorded a decrease and altered the profile of ploy peptides with enhanced CO2 levels. At elevated CO2 concentrations significant differences were observed in ploy peptide profile at vegetative and flowering stages, the intensity of 260 kDa poly peptide increased at vegetative stage, whereas 72 kDa polypeptide increased at flowering stage, while 52 kDa poly peptide decreased at both stages. Enhanced CO2 concentrations improved the PN though certain polypeptides of leaf protein are down regulated and necessitate further experimentation to confirm their involvement in responsiveness of the selected black gram genotype.

Comparative study to test efficacy of topical permethrin and oral ivermectin in the management of scabies- a prospective randomized, single blinded controlled study.

Background : Scabies is a contagious intensely pruritic ectoparasitic infestation caused by mite Sarcoptes scabiei hominis. Various treatment modalities are available but topical permethrin and oral ivermectin is considered to be safe and effective in the treatment of scabies. Aim : To compare the efficacy of topical permethrin and oral ivermectin in the treatment of scabies. Material And Methods : It was an interventional study conducted in the out patient department Rohilkhand Medical College and Hospital.100 clinically diagnosed cases of scabies belonging to either sex and from 10-60 yrs of age were selected and divided into two groups. Oral ivermectin was given to group A and topical 5% permethrin was given to the group B and follow up at 1, 2 and 4 weeks of interval. at each visit and cure rate was compared. Results : Permethrin showed the efficacy of 89.1% in completely clearing scabietic lesions at 4 week interval as compared to oral ivermectin which showed 78.5% clearing of lesions in 4 weeks. Thus both the treatment modalities were almost equally effective. Conclusion : Oral ivermectin and topical permethrin both are almost equally effective but permethrine has rapid onset of action.

Cervical Perineural Cyst Masquerading as a Cervical Spinal Tumor

Tarlov (perineural) cysts of the nerve roots are common and usually incidental findings during magnetic resonance imaging of the lumbosacral spine. There are only a few case reports where cervical symptomatic perineural cysts have been described in the literature. We report such a case where a high cervical perineural cyst was masquerading as a cervical spinal tumor.

Temporal changes of Japanese encephalitits virus in different brain regions of rat.

Background & objectives: Japanese encephalitis virus (JEV) infection results in acute encephalitic illness. The affinity of JEV to different regions of brain and temporal changes in viral load have not been studied. This study was conducted to describe localization of JEV to different regions of the brain at different stages of disease in a rat model of Japanese encephalitis (JE). Methods: Twelve days old Wistar rats were inoculated intracerebrally with a dose of 3 x 106 pfu/ml of JEV. After 3, 6, 10 and 20 days post-inoculation, brains were dissected out and different regions of brain (cortex, striatum, thalamus and mid brain) were taken. Motor deficit was assessed by the rota rod and JEV RNA copies were evaluated using real-time PCR assay. Results: There was a significant increase in motor deficit in rats inoculated with JEV compared to the controls. JEV RNA copies were present in all studied regions of the brain on days 3, 6 and 10 post-inoculation. Maximum number of JEV RNA copies were present in the mid brain on days 3 and 10 post-inoculation. JEV RNA copies were not detected in any of the brain regions on day 20. Interpretation & conclusions: This study reports JEV RNA load in different brain regions of rat with higher affinity of JEV virus to thalamus and mid brain compared to other regions.

Tribological Issues Related to the Use of Biofuels: A New Environmental Challenge.

The aim of the special issue “Interactions of Forests, Climate, Water Resources, and Humans in a Changing Environment” is to present case studies on the influences of natural and human disturbances on forest water resources under a changing climate. Studies in this collection of six papers cover a wide range of geographic regions from Australia to Nigeria with spatial research scale spanning from a tree leaf, to a segment of forest road, and large basins with mixed land uses. These studies clearly show the strong interactions among forests, global climate change, water quantity and quality, and human activities at multiple scales. Understanding the underlying processes of response of natural ecosystems and society to global climate change is essential for developing actionable science-based climate change mitigation and adaptation strategies and methodologies. Future research should focus on feedbacks among forests, climate, water, and disturbances, and interactions of ecohydrologic systems, economics and policies using an integrated approach.

An ultrasonographic evaluation of masseter muscle thickness in different dentofacial patterns.

Objectives: The aim of this study is to compare the masseter muscle thickness in different vertical dentofacial patterns and identify the possible sexual dimorphism and also to correlate masseter muscle thickness with craniofacial morphology using cephalometric parameters. Materials and Methods: The masseter muscle thickness was measured using ultrasonography in 60 subjects (30 females and 30 males). Standardized lateral and posteroanterior cephalograms were taken to determine the facial morphology. The subjects were divided into three vertical pattern groups (I, II, and III) according to their Jarabak ratio: hypodivergent ( n = 20), normodivergent (n = 20), and hyperdivergent (n = 20). The sample was further subdivided into males and female subgroups. Results: Masseter muscle thickness relaxed (MMTR) in hypodivergent group was 13.94 ± 1.51. Mean value of MMTR in normodivergent group was 12.53 ± 1.21 and the MMTR in hyperdivergent group was 11.13 ± 1.18. The mean value of masseter muscle thickness contracted (MMTC) in hypodivergent group was 15.46 ± 1.33. Mean value of MMTC in normodivergent group was 13.81 ± 1.38 and the mean value of MMTC in hyperdivergent group was 12.27 ± 1.26. MMTC showed a significant, negative correlation with mandibular plane angle and gonial angle. Posterior facial height, symphysis width, intermolar width of maxillary first molars, maxillary width, and facial width (bizygomatic width) showed significant ( P < 0.05 or P < 0.01) positive correlation. Conclusion: The masseter muscle thickness varied among the three vertical dentofacial patterns and sexual dimorphism also existed except in the hyperdivergent group. Masseter muscle thickness was found to be negatively correlated to vertical facial pattern and positively associated with transverse craniofacial morphology.

Tribological Issues Related to the Use of Biofuels: A New Environmental Challenge.

Due to gradual depletion of world petroleum reserves and the impact of environmental pollution of increasing exhaust emissions, there is an urgent need for suitable alternative fuels for use in engines. The heightened awareness of green house gas emissions and global warming compels introduction of more stringent environmental regulations worldwide. Renewable biofuels are considered potential solution for these problems. But use of biofuel is creating tribology related new challenges world over. In this paper a critical analysis of tribology related issue of three main biofuels, namely Straight Vegetable Oil (SVO), biodiesel and alcohols are discussed. Many issues like lubricity of blends, carbon deposit, viscosity, corrosion of engine components, etc are discussed in detail. Quality control of biofuels, identified as a key factor for sustainable market growth of these fuels and can lead to many tribological issues. In this regard a dire need for global harmonized standards is also discussed. Different solutions for alcohol fuel related engine problems are discussed. Critical discussion in relation to the problems due to the use of SVO in engine, like engine performance decrease, injector choking, oil ring sticking, etc took place in this paper. Potential solutions to these problems found by academia as well as industry are discussed here.

Caudodontia of mandibular 2nd molar with bilateral maxillary canine – premolar transposition - a case report.

Transposition of teeth is a developmental anomaly manifested by a positional interchange of two permanent teeth. It is often associated with hypodontia, peg lateral crowding, severe rotation and malformation like dilaceration and missing teeth, retained teeth and even with impaction which are clinically important for diagnosis as well as treatment plan. However, this case is a deviation from the afore mentioned group of associated anomalies. Surprisingly, in this case bilateral maxillary canine – premolar transposition is associated with idiopathic resorption of the crown of the second mandibular molar. The persistence of only the caudal part of the tooth in such a case merits denoting it as ‘Caudodontia’ by us.