Percentage of patients shifting to another treatment modality: An experience-guided decision

ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

A Cross-Sectional Study to Assess the Knowledge Regarding Rights and Responsibilities of Nurses at a Selected Tertiary Care Hospital

.Health care system could not function efficiently, if nurses were not present to perform their part. Nurses do their work responsibly and passionately to serve the mankind and the needy ones. Sense of responsibility makes a person more accountable to their duty, while the knowledge of the rights gives personal security and confidence. It is essential for the nurses to be well aware of their rights and responsibilities to provide comprehensive care to the patients. A cross-sectional survey was carried out at AIIMS, New Delhi, to assess nurses'#39; knowledge regarding rights and responsibilities. Convenient sampling was used to select 210 samples from ICU, ward, OPD, OT and emergency department. Structured knowledge questionnaire was used to collect the data. The study found that nurses had good knowledge regarding nurse'#39;s rights (mean score 27'plusmn;3.7). Similarly the nurses were well aware of their responsibilities with mean knowledge score of 15'plusmn;1.29. Knowledge regarding the rights of the nurses was significantly associated with age (p=0.034), educational qualification (p=0.018) and years of experience (p=0.003) whereas knowl- edge regarding the responsibility of the nurses was independent of socio-demographic variables; 65.7 percent of subjects had attended empowerment programmes. To conclude, nurses were well aware about their rights and responsibilities. Formal educational and empowerment programme are proved to be helpful in enhancing their knowledge. Therefore, the employers should plan an ongoing, appropriate empowerment programme for the nurses to keep them updated.

The outcome of primary percutaneous coronary intervention in patients with stent thrombosis

Background: Primary percutaneous coronary intervention (PCI) is a recommended management strategy for patients with de novo ST-segment elevation myocardial infarction (STEMI). Still, the efficacy of primary PCI in-stent thrombosis (ST) induced STEMI is unclear. The aim was to assess the clinical characteristics and the in-hospital outcomes of patients undergoing primary PCI for STEMI caused by acute, sub-acute, or late ST. Methods: A sample of hundred consecutive patients who presented with STEMI due to ST were included in this study. The angiographic evidence of a flow-limiting thrombus or total vessel occlusion (thrombolysis in myocardial infarction (TIMI) flow grade 0 to II) at the site of the previous stent implant was taken as ST. Primary PCI was performed, and all enrolled patients and in-hospital mortality were observed. Results: Male patients were 69, and the mean age was 58.9 ± 7.78 years. ST was categorized as acute in 40 patients, sub-acute in 53, and late in the remaining seven patients. Killip class III/IV was observed in 45 patients. Dissection was observed in 25, under deployment in 74, and/or malposition in 24 patients. Thrombus aspiration was performed in 97, plain old balloon angioplasty in 76, and stenting in 22 patients. Final TIMI III flow was achieved in 32 patients. During a mean hospital stay of 4.93 ± 2.46 days, the mortality rate was 27%. Conclusion: In-hospital mortality after primary PCI was observed in more than 1/4th of the patients with STEMI due to ST undergoing primary PCI

Refractive errors among commercial drivers

Purpose: To determine the pattern of refractive error among commercial drivers in north India. Methods: Descriptive study with convenient sampling conducted among commercial drivers of north India. Results: A total of 213 (75.8%) heavy?vehicle and 68 (24.2%) light?vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6–20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2–12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3–8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7–4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation. Conclusion: Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow?up.

Comparative analysis of P-POSSUM score at admission and pre-operatively in predicting postoperative mortality in patients undergoing emergency laparotomy

Introduction: Laprotomy remains one of the commonest emergency surgical procedure performed worldwide. But over the last few years, various perioperative quality improvement initiatives involving early interventions, intensive postoperative care, and indivisualised care approaches have ensured a decrease in the average mortality rate by 3.8%-8.3. An ideal scoring system should accurately predict outcomes, help determine who deserves more aggressive care, guide in deciding the extensiveness of surgery, and can be used broadly access emergency laprotomies for various disease pathologies. The scoring system should also be capable of analyzing risk adjusted morbidity and mortality amongst various healthcare providers. Aim: To access the accuracy of P-POSSUM score on predicting the mortality and morbidity in emergency laparotomy patients and to establish that the preoperative score is more accurate that admission score. Materials and Methods: 150 Cases of emergency laparotomy in General Surgery Department in IGIMS, Patna from September, 2020 to February, 2022 were taken up in this study. Patients below 18 years, routine surgery and 6 patients who could not be followed up for complete 30 days were excluded. Physiological P-POSSUM was calculated at the time of admission and just before operation, post resuscitation. Operative score was same for both Physiological P-POSSUM scores. Results: Mortality predicted at admission had statistically significant difference and p value was<0 xss=removed>.05. Most common complication was wound infection followed by septicaemia. Conclusion: P-POSSUM is a better predictor of mortality and morbidity in emergency laparotomies when scoring is done preoperatively.

Pectoral?Intercostal Fascial Plane Block in Chronic Post?Sternotomy Pain

Persistent poststernotomy pain (PSP) is a well?known entity following cardiac surgery done with midline strenotomy. The severity of pain is usually mild to moderate in the majority of the patients. However, a small percentage of patients develop severe and persistent pain and need aggressive treatment. Our patient, a 63?year?old lady developed chronic severe parasternal pain following coronary artery bypass graft surgery. As multiple medications did not relieve her pain effectively, we did an ultrasound?guided pectoral?intercostal fascial plane block to which she responded with excellent and long?lasting pain relief. This is the first such case report of the use of this novel block technique for treating PSP.

Comparative study of wound healing following purse-string closure versus conventional linear closure for stoma reversal

Background: Stoma closure is associated with several complications, wound infection being the most common. This study is done to establish that purse string suture closure method for stoma closure is superior to the conventional linear mattress closure and is associated with better wound healing cosmesis. Materials and Methods: This Prospective randomized controlled study enrolled 80 patients who underwent stoma closure from April 2021 to March 2022 in department of General Surgery in IGIMS, Patna. Patients were divided in two groups inclusive of ileostomy and colostomy based on type of closure technique. Conventional linear closure method was applied to Group A and purse-string technique applied to Group B patients. All Patients were followed regularly upto three months after operation. Rate of infection, pain as assessed by VAS score and satisfaction as assessed by POSAS Score were done. Results: Purse string Closure had better outcome in terms of wound infection rate and Cosmetic results over a 3 months follow up. Ten patients in Group A and 2 from Group B out of 40 patients had wound infection. Patients with purse-string suture had statistically significant greater satisfaction over 3 months. Medium operative time of Group A was 100 minutes and that of Group B was 98 minutes. There were no significant difference in regards duration of hospital stay was more in Linear Group than Purse String (Group B). Conclusion: Purse-string closure was associated with better cosmesis and lower infection rate in comparison to Linear conventional closure.

Analysis of initial stress distribution in palatal bone around the implant in lingual orthodontics for single and double palatal implant systems: a FEM study

ABSTRACT Objective: To analyze and compare the Von Mises stress and principal stress distribution in palatal bone around the palatal implant in lingual orthodontics (LiO) for single and double palatal implant systems with varying lengths of lever arm. Methods: Two groups were assessed: single (Group 1) and double (Group 2) palatal implant systems, which were further divided into two subgroups, based on lever arm length, for analyzing stress in the palatal bone around the implant. Hence, two 3D finite element models of bilateral maxillary first premolar extraction cases were constructed in each system. Lingual brackets (0.018-in slot) were positioned at the center of the clinical crown. In both systems, 150g of retraction force was applied, and ANSYS v. 12.1 software was used to analyze and compare stress in the palatal bone around the palatal implant. Results: In this study, higher stress was observed at the inner threaded interface of cortical bone. Magnitude of Von Mises stress was higher in Group 2 (0.63 MPa and 0.65 MPa) in comparison to Group 1 (0.29 MPa and 0.29 MPa). Similarly, magnitude of principal stress was higher in Group 2, in comparison to Group 1. Higher stress was observed in the apical region of the implant-bone interface of cancellous bone. Conclusion: This study concluded that the Von Misses stress as well as principal stress in the palatal bone were within the optimal limit in both groups. Finally, it can be concluded that both systems (single and double palatal implant) were safe for the patients in clinical use of 150g of retraction force.

RESUMO Objetivo: Analisar e comparar as tensões de Von Mises e a distribuição das tensões principais no osso palatino ao redor de implantes palatinos em Ortodontia Lingual (OL) para sistemas de implantes palatinos unitários ou duplos com comprimentos variados do braço de alavanca. Métodos: Foram delineados dois grupos para o presente estudo: Grupo 1 - com sistema de implante palatino unitário e Grupo 2 - com sistema de implantes palatinos duplos. Em seguida, os grupos foram divididos em dois subgrupos, com base no comprimento do braço de alavanca, para analisar as tensões no osso palatino ao redor do implante. Para cada sistema, foram construídos dois modelos 3D de elementos finitos (MEF) de casos com extração bilateral de primeiros pré-molares superiores. Braquetes linguais (slot 0,018") foram posicionados no centro das coroas clínicas. Nos dois sistemas, foram aplicados 150g de força de retração nos dentes anteriores, e o software ANSYS v. 12.1 foi usado para analisar e comparar as tensões no osso palatino ao redor dos implantes. Resultados: Foram observados maiores níveis de tensões na parte interna rosqueada no osso cortical. A magnitude das tensões de Von Mises foi maior no Grupo 2 (0,63MPa e 0,65MPa) em comparação ao Grupo 1 (0,29MPa e 0,29MPa). De forma semelhante, foi observada maior magnitude das tensões principais no Grupo 2 do que no Grupo 1. Maiores tensões foram observadas na região apical da interface osso/implante no tecido ósseo esponjoso. Conclusão: A tensões de Von Mises e as tensões principais no osso palatino ficaram dentro do limite ideal em ambos os grupos. Ambos os sistemas de implantes palatinos (unitário e duplo) foram seguros para o uso clínico em pacientes com força de retração de 150g.

A study of effect of aminoglycoside therapy on auditory brainstem evoked responses in preterm and term neonates

Background: Aminoglycosides are widely used drugs in neonates with associated ototoxic side effects, that can be diagnosed with auditory brainstem evoked responses, which is the recommended screening technique in neonatal intensive care unit infants.  This study was conducted to evaluate the effect of aminoglycoside therapy on auditory brainstem evoked responses in term and preterm neonates.Methods: A cross-sectional case control study. Two groups of 26 term and 22 preterm neonates who received aminoglycosides, with no other known risk factors for ototoxicity, were compared with suitable matched control group of 10 neonates in each. ABER was done after at least 5 days of aminoglycoside therapy and results were compared to suitable matched controls.Results: Mean latency of wave I in term neonates at 90 dB and 60 dB and mean interwave latencies of I-V waves in preterm neonates at 30 dB was higher in study group and statistically significant. No statistically significant difference in any of ABER parameters was observed in any group, at all other intensities.Conclusions: Wave I latency was prolonged in study group of term neonates at two intensities which indicates effect of aminoglycoside therapy on distal portion of acoustic nerve. But as there were no such findings at other intensities in term study group and in preterm study group and moreover no other ABER abnormalities were observed, it was concluded that the aminoglycoside therapy has low potential for ototoxicity. Authors support the ABER screening for early detection of hearing abnormalities, and recommend study on larger group of neonates and meta-analysis for final conclusion for evidence-based recommendations to use aminoglycosides in neonates, in view of audiometric and neurological abnormalities.

Prospective study on outcome and advantage of primary skin grafting in cases of avulsion scalp injury following trauma

Background: Traumatic avulsion injury poses severe risk as the overlying protective covering is lost and the raw tissue is exposed to the environment. Avulsion injuries involving the scalp are even more complicated to treat because of significant cosmetic concern involved. Aim of the study was to find a better solution than the existing method, we conducted a prospective study involving 13 patients with isolated traumatic scalp avulsion injury.Methods: This prospective study was conducted in Motilal Nehru Medical College and associated Swaroop Rani Nehru Hospital, Prayagraj,  after taking written and informed consents from the patients, between June 2017 and June 2019.These were divided into two groups (A and B) based on whether the underlying periosteum was intact or not.Results: Patients with intact periosteum (Group A) underwent primary thin thickness skin grafting within a few hours of their admission while the other group (Group B) was treated with a traditional conservative approach. We compared the results of both the groups and found that Group A patients not only had satisfactory graft uptake (≥85 TBSA) but also had significant decreased risk of infection, lesser hospital stay, overall decreased healthcare cost, better cosmoses and early return to routine activity.Conclusions: For the surgeon, this single step procedure is safe and technically easy. Thus this approach was found to be superior than the current traditional approach.

An Infant with Milky Serum and a Rare Mutation

A 40-day-infant having milky serum, eruptive xanthomas,hepatosplenomegaly, lipemia retinalis, high cholesterol andtriglyceride, was found to have lipoprotein lipase (LPL) deficiencyon genetic workup. Triglyceride decreased with dietary fatrestriction, medium chain triglyceride and fibrates.LPLdeficiency in early infancy can be treated with pharmacologicaland dietary interventions.

Disparity in cost of oral hypoglycemic agents available in Indian market

Background: Diabetes is one of the most common non-communicable disease worldwide, of which India has been crowned with the title of “diabetes capital of the world”. On an average a person spends 20% of his or her income for the treatment of diabetes per year. So, it’s become very important to conduct a complete cost disparity study among oral hypoglycemic agent available in the market. Information generated from the current analysis, will be helpful to doctors in choosing the right drug for their patient and for the health sector in successfully utilizing the available resources.Methods: The study was conducted in the department of pharmacology AIIMS, Patna 2019. Price of the drugs per tablet/capsule/vial were reviewed from “Current Index of Medical Specialties” January-April 2019 and “Drug Today” October-December, 2018 for analysis of different formulations of oral hypoglycemic agents.Results: The cost of total 16 drugs belonging to 6 different classes, available in 38 different formulations were analyzed. Total 44 different pharmaceutical companies were involved in the manufacture of oral hypoglycemic agents. Overall glibenclamide (5 mg) and bromocriptine (2.5 mg) showed maximum % price variation of 422.79 and 586.27 respectively. Dapagliflozin and canagliflozin both belonging to sodium glucose cotransporter-2 inhibitors shows minimum price variation of 9.86 and 0.9 respectively.Conclusions: The current study shows that there is a huge price variation among oral hypoglycemic agents manufactured by different companies and government needs to take essential steps to bring about the uniformity in the price.

A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients

Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most common group prescribed was angiotensin receptor blocker (ARB) (29.45%) and ARB+CCB (calcium channel blockers) (34.92%) were the commonest fixed drug combination. Overall, it was amlodipine (21.47%) that was most frequently prescribed among all antihypertensive drugs.Conclusions: ARB was the most commonest class, ARB+CCB was the most frequent fixed drug combination prescribed to the study patient while amlodipine was the highly utilized individual antihypertensive drug in the study. Prescriptions evaluation revealed that 94.88% prescription were rational and were in accordance with the JNC-8 hypertension treatment guidelines except the use of beta blockers (5.12%).

Comparative Evaluation of Nemoceph and Foxit PDF Reader for Steiner’s Cephalometric Analysis

Cephalometry is used to quantify and qualify the type of malocclusion. The digital technology has overcome the limitations of manual method. A high cost of the commercially available software is unaffordable for its wide spread use. Objectives: The aim of this study was to evaluate and compare the values of Steiner’s cephalometric analysis using Nemoceph and Foxit PDF reader. No significant difference between the two methods will result in that Foxit PDF reader can be used as an cost effective alternative. Methods: This study was conducted on 100 digital lateral cephalogram taken from the same machine. The samples were collected by non-probability convenience sampling procedures. These images were analyzed for Steiner’s Cephalometric Analysis using the two software. Results: The skeletal and dental values showed no statistical significant difference in the majority, except for the L1-NA (Linear) and L1-NB (Linear). Conclusion: Results showed that there is a high agreement between the two methods.

Comparative Evaluation of CEPH Ninja for Android and Nemoceph for Computer for Steiner’s Cephalometric Analysis

Orthodontics and Dentofacial Orthopaedics, requires a cautious acquisition and interpretation of a large amount of information to achieve a correct diagnosis and treatment planning. Manual techniques are time consuming and tedious. The digital technology is advantageous but the affordability remains obstacle. Objectives: The main aim of this study was to compare the linear and angular measures between the two methods, Ceph Ninja and Nemoceph. No significant difference between the two methods will result in that Ceph Ninja can be used as an alternative. Methods: This study was conducted on 100 digital lateral cephalogram taken from the same machine. The samples were collected by non-probability convenience sampling procedures. These images were analyzed for Steiner’s Cephalometric Analysis using the two software. Results: The results of this study showed the skeletal and dental values had no statistical significant difference in the majority, except for the linear values of Lower Incisor and Upper Incisor with N-A and N-B respectively. Conclusion: It seems that the two software can be used interchangeably with high confidence.

Intussusception associated with celiac disease in a child: case report and review of literature

Intussusception and celiac disease both are common in children.' Intussusception has been rarely associated with celiac disease in children, which mostly involved small bowel, are transient without classical symptoms, reduced spontaneously and rarely needs intervention. Authors are reporting a 2-year girl who presented initially as gastroenteritis and later on intestinal obstruction and on investigation revealed ileo-ileal intussusception which resolved spontaneously during laparotomy preparation. The patient had growth retardation and microcytic hypochromic anemia and on further evaluation diagnosed with celiac disease. This case report highlights the need of celiac testing in children with intussusception, and such intussusception resolved spontaneously with gluten free diet and rarely needs any active intervention, thus preventing from undue nonsurgical or surgical interventions for intussusception.

Is Orthodontic Treatment Fearful?

Objective: To evaluate the anxiety level of prospective orthodontic patients. Methods: Dental Anxiety ScaleRevised (DAS-R) questionnaire was modified and filled by 101 subjects (53 females and 48 males) visiting for their orthodontic treatment. Results: 62.4 % patients had no or low anxiety levels and 9.9% and 5.9% showed high to severe anxiety levels respectively. There was no statistical significant difference seen between the anxiety levels in male and female patients. Conclusions: 37.6 % patients for orthodontic treatment showed moderate to severe anxiety levels with no significant difference seen in the overall anxiety levels between the genders.

Do Braces Causes Caries?

Attaining improved aesthetics and proper occlusion are main reasons for commencing orthodontic treatment in any patient. However it is anticipated that orthodontic treatment increases the risk of carious lesions. Objective: To analyze prevalence of dental caries in relation to gender, age group, duration of orthodontic treatment and malocclusion type; and to assess oral hygiene and food habit practice in young orthodontic patients. Methods: A cross sectional study was done in 212 orthodontic patients (age range 11-30 years) having fixed appliance for at least six months duration. A survey form based on ‘Dentition Status & Treatment Need, WHO’ was used to depict DMFT Index and prevalence of dental caries. A questionnaire was used to assess the practice of oral hygiene measures and food habits of the orthodontic patients. The association between dental caries and gender, age group, duration of orthodontic treatment and malocclusion type were analyzed using chi-square test (p<0.05). Results: The prevalence of dental caries (DMFT) was 79.2% and mean DMFT value was 2.87 among orthodontic patients studied. Occurrence of dental caries among male and female patients was 69.44% and 60% respectively. Caries occurrence was highest in age group 16-20 years (72.22%), in more than 18 months treatment duration group (63.92%) and in Class I malocclusion group (68.38%). Similarly, 30.2% consume sweets foodstuff, 26.9% consume junk food and 14.2% consume snacks in between meals frequently. Conclusions: Fairly good proportion of orthodontic patients practice normal oral hygiene methods but very few use special oral hygiene measures. The study showed no association between dental caries occurrence and gender groups, age groups, duration of orthodontic treatment and malocclusion types.

Falknor's needling method as a potential immunotherapy in palmo-plantar warts

Background and Aim: Treatment of palmoplantar warts is a challenge for dermatologists. We aimed to study the efficacy and safety of Falknor's needling method in palmoplantar warts. Methods: In an open, nonrandomized study, the index wart of eligible patients was punctured several times with a 26-gauge needle to produce a “beefy” red wound. Patients were followed up to 6 months. Results: Out of 82 patients, complete resolution occurred in 58 (70.7%) and partial response in 5 (6.1%) patients. Nine (10.9%) patients developed secondary infection. Limitations: Small sample size, No comparison group. Conclusion: Falknor's needling method provides a high rate of complete resolution after a single treatment session. It is easy to perform and is cost effective.

Mild and transient heat shock enhances DNA integration following lipofection of recombinant plasmids in 4T1 cells

Cancer cells having stably integrated genes encoding tumor-associated antigens could be utilized as a vaccine, in-vitro stimulators of antigen-primed T-cells, and target for cytotoxicity assay, etc. Lipofection is a simple and safer technique for stable transfection of plasmid DNA. However, the poor rate of genomic integration has limited its application. In the current study, the effect of mild and transient heat shock following lipofection on the improvement of genomic integration was evaluated. The cDNA fragments encoding chicken MMP-11peptide (V32-K365) and the immunoglobulin-like domain 2 of chicken VEGFR-2 were cloned separately into pcDNA3.1 vector. Lipofection was carried out using Lipofectamine® 2000 (Life Technologies, USA) in 4T1 cells followed by a heat shock at 42°C for 10 min. Transfected cells were selected for a period of four weeks against 500 µg/mL G418 in RPMI 1640 media supplemented with 10% fetal bovine serum. Distinct G418-resistant colonies appeared after 14 days of selection. Heat shock significantly (P <0.05) increased the number of viable colonies following antibiotic selection. The immunofluorescent study confirmed the stable integration of the target DNAs into the cells. It is concluded that mild and brief heat shock following lipofection improves the stable integration of recombinant pcDNA3.1 plasmids into 4T1 cells.