Tobacco use and its impact on survival in young patients with oral cancer

Background: Tobacco is a major risk factor associaetd with developing oral factor. Recent studies have shown that the age of onset, especially in Asia, is reducing. This study was to determine if tobacco exposure correlated with prognosis in oral squamous cell carcinoms (OSCC) based on age at diagnosis. Methods: Six hundred and forty three patients of OSCC treated in our institution were divided into four groups, younger patients (?45 years) with or without tobacco exposure and older patients (>45 years) with or without tobacco exposure, and compared with respect to prognostically relevant variables, disease?free survival (DFS) and overall survival (OS). Survival analysis was performed. Results: The percentage of those with tobacco exposure was comparable in both age groups. Tobacco correlated with known pathological determinants in OSCC; however, perineural invasion, lymphovascular invasion, and extranodal extension were significantly more common in the young. On survival analysis, tobacco exposure impacted OS (P = 0.04) and DFS (P = 0.03) in patients ?45 years, and not in older patients >45 years. On multivariate analysis, tobacco exposure in the young was significantly associated with recurrence (P = 0.03, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.07�94) but not survival. Conclusion: Younger patients with a history of tobacco use have a significantly higher risk of recurrence and mortality due to OSCC, but this difference could not be attributed to any of the known prognostic determinants in OSCC. Younger patients also had more adverse pathological features. Whether this occurs because of altered disease biology or pathways of carcinogenesis in the young wi

Differentiating Multisystem Inflammatory Syndrome in Children (MIS-C) and Its Mimics – A Single-Center Experience From a Tropical Setting

Objective: Identifying clinical and laboratory indicators that differentiate multisystem inflammatory syndrome in children (MIS-C) apart from other febrile diseases in a tropical hospital setting. Methods: Review of hospital records done in a tertiary care exclusive children’s hospital for children admitted from April, 2020 till June, 2021. Laboratory values, severe acute respiratory syndrome coronavirus (SARS-CoV-2) serological status, and clinical signs and symptoms of patients with MIS-C, and those with similar presentations were analyzed. Results: 114 children fulfilled the inclusion criteria (age group of 1 mo-18 y) for whom a diagnosis of MIS-C was considered in the emergency room based on the clinical features. Among them, 64 children had the final diagnosis of MIS-C, and the remaining 50 children had confirmatory evidence of infections mimicking MIS-C such as enteric fever, scrub typhus, dengue and appendicitis. Conclusion: Older age group, presence of mucocutaneous symptoms, very high C-reactive protein, neutrophilic leukocytosis, abdominal pain and absence of hepatosplenomegaly favor a diagnosis of MIS-C.

Evaluation of the agreement and reliability of Transpalpebral Tonometers compared with Goldmann Applanation Tonometer – A systematic Review and Meta-Analysis Protocol

In 2020, the global prevalence of glaucoma was estimated to be 76 million and it was projected to increase to 111.8 million by 2040. Accurate intraocular pressure (IOP) measurement is imperative in glaucoma management since it is the only modifiable risk factor. Numerous studies have compared the reliability of IOP measured using transpalpebral tonometers and Goldmann applanation tonometry (GAT). This systematic review and meta-analysis aims to update the existing literature with a reliability and agreement comparison of transpalpebral tonometers against the gold standard GAT for IOP measurement among individuals presenting for ophthalmic examinations. The data collection will be performed using a predefined search strategy through electronic databases. Prospective methods-comparison studies published between January 2000 and September 2022 will be included. Studies will be deemed eligible if they report empirical findings on the agreement between transpalpebral tonometry and Goldmann applanation tonometry. The standard deviation and limits of agreement between each study and their pooled estimate along with weights and percentage of error will be reported using a forest plot. Cochrane’s Q test and the I2 statistic will be used to assess heterogeneity, and the publication bias will be investigated using a funnel plot, Begg’s and Egger’s tests. The review results will provide additional evidence on the reliability of transpalpebral tonometers that, in turn, could possibly assist practitioners to make informed decision about using it as a screening or diagnostic device for clinical practice, outreach camps, or home-based screening. Institutional Ethics Committee registration number: RET202200390. PROSPERO Registration Number: CRD42022321693.

Dodecanoic acid & palmitic acid disarms rifampicin resistance by putatively targeting mycobacterial efflux pump Rv1218c

Background & objectives: Drug-resistant tuberculosis (TB) jeopardizes the treatment process with poor outcomes. Efflux pumps (EPs) belonging to the ABC transporter family in Mycobacterium tuberculosis confer resistance to rifampicin (RMP) besides genetic mutations thus serving as a target for a potential adjunct therapeutic inhibitory molecule. Rv1218c is one such pump that was previously reported to be active in multidrug-resistant TB clinical isolates. Methods: In this study, the inhibition potential of Rv1218c-EP was tested on 8 molecules that were shortlisted by in silico methods. These molecules were subjected to the minimum inhibitory concentration (MIC) determination, checkerboard drug combination assay, ethidium bromide-DNA binding assay, and in vitro and ex vivo cytotoxicity assay. Results: Based on the outcome of the study, two molecules dodecanoic acid (DA) and palmitic acid (PA) were found to be potential enough to decrease the MIC of RMP by 8 to 1000 folds against multidrug-resistant clinical isolates and Rv1218c expressing recombinant Mycobacterium smegmatis. Interpretation & conclusions: These molecules were also found to reduce the time taken by RMP to kill these drug-resistant Mycobacteria to 48 h, unlike control isolates that survived more than 240 h of RMP exposure. The functional concentration of both molecules was non-toxic to the epithelial and blood mononuclear cells. With further comprehensive scientific validation, PA and DA could be recommended as adjunct therapeutic molecules with first-line anti-TB drugs to treat drug-resistant TB.

Versatile Use of Mycobacterium indicus pranii (MIP) Vaccine

Mycobacterium indicus pranii (MIP) earlier known as Mw is a soil-borne, non-pathogenic, saprophytic and rapidly growing strain of mycobacteria. MIP is approved as a vaccine/ immunomodulator for various indications including mycobacterium infections like leprosy in humans. Its administration has resulted in satisfactory clinical improvement, accelerated bacillary clearance, and increased immune responses to Mycobacterium leprae antigens, thereby shortening the full recovery time of the patients. It also shares its antigens with M.tuberculosis. In the last decade, RCTs have been done establishing immunotherapeutic properties of MIP in the treatment of leprosy, tuberculosis, warts and experimently in leishmaniasis. Through its immune inducing and cytotoxic property, it has also proved beneficial for human use especially in treating lung cancer. The beneficial role of it is also being explored in breast, cervical, oral, liver, and bladder cancers. Various studies on MIP have shown that it has immune-modulating properties in humans. The curiosity of the human mind has led to it being tried in Covid treatment trials. The results have shown that administering MIP has lowered inflammatory markers in Covid 19 patients, promising us for it to be a potential treatment option. More RCTs with a larger sample size should be done to establish this. Cytokine storm seen in bacterial sepsis is also decreased with MIP administration. Considering the encouraging results in hastening recovery in various diseases it appears that MIP is perhaps not being exploited to its fullest potential

Drug utilization study in patients affected with COVID-19 in a dedicated COVID hospital

Background: There exists a treatment dilemma regarding the optimal and effective use of therapeutic drugs (hydroxychloroquine/chloroquine/azithromycin) for COVID-19. Furthermore, with changing guidelines, the data on drug utilization patterns across India are limited. Hence, this study was conducted to assess the prescription pattern and drug utilization trends in COVID-19 patients with the aim to study the drug utilization pattern in patients affected with COVID-19 in a dedicated COVID-19 hospital. Aims and Objectives: The objectives of the study are as follows: (1) To study drug utilization patterns according to the severity of the disease. (2) To study the prevalence of adverse drug reactions (ADRs). Materials and Methods: Data were collected retrospectively from 100 medical records of patients ?18 years irrespective of sex admitted in the COVID ward and ICU of a dedicated COVID hospital from May to August 2020. Pregnant and lactating women were excluded from the study. ADRs reported were also analyzed. Results: About 71% were mild in this study, 18% were moderate, and 11% were severe COVID-19 patients. Overall, the most common drugs prescribed were multivitamins, followed by pantoprazole, paracetamol, and azithromycin. Hydroxychloroquine was prescribed in 22%, favipiravir in 7%, and remdesivir in 3% of cases. The majority of moderate COVID patients received injectables piperacillin-tazobactam, methylprednisolone, and enoxaparin. The mean number of medications, duration of admission, and number of days on oxygen were higher and significant in moderate compared to mild and severe COVID patients. Overall, ADRs were encountered in 9% of cases. Conclusion: The prescribed pattern of drugs was by the national standard guidelines. Multivitamins, followed by pantoprazole, paracetamol, and azithromycin dominated the prescription pattern. Polypharmacy was encountered, which needs to be addressed for the rational use of drugs.

The Role of Shunt Occlusion During Extracorporeal Life Support

ABSTRACT Introduction: The current recommendation for systemic to pulmonary artery shunt (SPS) patients requiring extracorporeal life support (ECLS) is to keep the shunt open, maintaining a higher pump flow. The practice in our center is to totally occlude the shunt while on ECLS, and we are presenting the outcome of this strategy. Methods: This is a retrospective analysis of patients who underwent SPS for cyanotic congenital heart disease with decreased pulmonary blood flow and required postoperative ECLS between January 2016 and December 2020. ECLS indication was excessive pulmonary blood flow, leading to either refractory low cardiac output syndrome (LCOS) or cardiac arrest. All patients had their shunts totally occluded soon after ECLS establishment. Results: Of the 27 SPS patients who needed postoperative ECLS (13 refractory LCOS, 14 extracorporeal cardiopulmonary resuscitation), wherein the strategy of occluding the shunt on ECLS initiation was followed, 16 (59.3 %) survived ECLS weaning and eight (29.6%) survived to discharge. Conclusion: Increased flow to maintain systemic circulation for a SPS patient while on ECLS is an accepted strategy, but it should not be applied universally. A large subset of SPS patients, who require ECLS either due to cardiac arrest or refractory LCOS due to excessive pulmonary flow, might benefit from complete occlusion of the shunt soon after commencement of ECLS, especially in cases with frank pulmonary edema or haemorrhage in the pre-ECLS period. A prospective randomized trial could be ethically justified for the subset of patients receiving ECLS for the indication of excessive pulmonary blood flow.

Synergistic effect of sorafenib with Platycladus orientalis (L) leaf extract on cervical cancer

The extracts of Platycladus orientalis (L.) Franco leaves have shown promising anti-cancer, anti-oxidant and anti-inflammatory potency with the traditional knowledge of healing HPV associated warts. The purpose of this research is to assess the synergistic activity of sorafenib and Platycladus orientalis (L) leaf extraction on cervical cancer cells. The cytotoxicity efficiency of different concentrations of Sorafenib and ethanol extract of Platycladus orientalis (L.) leaves were tested on HeLa cells by MTT and Trypan blue assays. The synergistic effect of the IC50 concentrations of Sorafenib and Platycladus orientalis (L.) on HeLa cell by MTT assay, and mRNA expression levels of tumor suppressor tazarotene-induced gene 3 (TIG3), proliferating cell nuclear antigen (PCNA) gene and apoptosis modulator (Bcl-2) gene by RT-PCR were evaluated with individual treatments. Combination treatment showed a relatively more expression of TIG3 and less expression of Bcl-2 and PCNA was observed. Growth factor-induced MAPKP activation was arrested by compound combination treatment, which and suppression of proliferation-induced apoptosis of cervical cancer cells. Based on the our results, the combination of sorafenib and crude leaf extract from Platycladus orientalis (L.) can effectively suppress cervical cancer cell growth, thereby providing an interesting rationale for further clinical trials and in-vivo studies.

PROGNOSTIC VALUE OF RIGHT VENTRICULAR FREE WALL STRAIN IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

AIM: To Determine the Prognostic Value Of 2D- Right ventricle Free Wall Longitudinal Strain In Patients With Acute Decompensated Heart Failure. BACKGROUND Ÿ The prognostic impact of 2-dimensional strain is unclear in patients with acute decompensated heart failure (HF). Ÿ we investigate whether left ventricular and right ventricular (RV) strain parameters assessed by speckle tracking echocardiography provide incremental prognostic information in hospitalized patients because of acute decompensated HF. METHODS AND RESULTS Ÿ FOURTY SIX patients (age, 54±9 years; 6.5% women; ejection fraction, 36±5%) hospitalized for acute decompensated HF underwent clinical and echocardiographic evaluation just before discharge. We performed strain analyses of left ventricular global longitudinal strain and RV longitudinal strain only from the free wall (RV-fwLS) and from all segments of the RV global longitudinal strain wall by echocardiogram. The primary composite end point was cardiovascular death and readmission for HF. There were 30.4% cardiac events during a median follow-up of 180 days. Among echocardiographic parameters, only impaired RV-fwLS (Less Than 11.4±4.9) was independently associated with cardiac events. Adding RV-fwLS to clinical risk evaluation (age, New York Heart Association class III/IV, blood urea nitrogen, and brain natriuretic peptide) markedly improved prognostic utility. CONCLUSIONS: Ÿ RV-fwLS is an independent predictor of cardiac events in acute decompensated HF. Although there are various standard echocardiographic parameters, RV-fwLS has improved prognostic utility.

Injecting drug use & HIV prevalence among female sex workers: Evidence from the National Integrated Biological & Behavioural Surveillance, India

Background & objectives: Female sex workers (FSWs) who inject drugs (FSW-IDs) have a higher risk of HIV infection and transmission. Understanding the socio-demographic characteristics and other risk behaviours among FSW-IDs will help in strengthening targeted interventions for HIV prevention and management. In the present study, the HIV prevalence, associated socio-demographic characteristics and risk behaviours among FSWs who injected drugs (FSW-IDs) and those who did not ID (FSW-NIDs) was determined in India. Methods: The national cross-sectional, community-based, integrated biological and behavioural surveillance was conducted in 2014-2015 at 73 randomly selected FSW domains across 28 States and Union Territories in India. The sample size was fixed at 400 for each domain, and a probability-based sampling method was followed. The data were analyzed by logistic regression methods. Results: Data from 27,007 FSWs were included in the analysis, of which 802 (3%) were FSW-IDs. HIV prevalence among FSW-IDs was significantly higher than that in FSW-NIDs (4.5 vs. 1.9%). Univariate analysis showed that factors significantly associated with higher HIV prevalence among FSW-IDs were older age, sex work as the only source of income, dissolved marriage, living with a sex worker, urban locality of sex work and consumption of alcohol or oral drugs. In multivariable analysis, factors such as older age of FSW-IDs (35 yr and above), having a dissolved marriage and sex work being the only source of income were observed to be independently and significantly associated with higher HIV prevalence. Interpretation & conclusions: Scaling up the HIV preventive interventions for FSW-IDs, such as facilitating awareness and improved access to needle and syringe exchange programme (NSEP) and opioid substitution therapy (OST), encouraging safe sex and injecting practices, educating on the harmful effects of alcohol and drugs and providing alternative vocation options to secure their financial needs are several strategies that may reduce HIV transmission among FSWs.

Educational Short Film versus PowerPoint Based Lecture in School Tobacco Awareness Programs: Study from a Tertiary Cancer Center, Kerala, India

Multimedia, being more attention?getting and attention?holding, is a powerful tool for mass awareness creation and is used for intervention among students in many studies. Our aim was to see the effectiveness of an educational short film in tobacco awareness generation and to compare it with the traditional lecture?based awareness. Selected schools were divided into two groups as per convenience. Short film was used as intervention in Group 1 and PowerPoint?based lecture in Group 2. The increase in awareness was assessed by a pre and posttest. On analysis, though both methods increased awareness as given by higher posttest score, it is found that the awareness levels showed a statistically significant difference between educational short film on hazards of tobacco and power point?based lecture using Mann–Whitney test. Our study proves that an educational short film carefully scripted and picturized can be used effectively in imparting awareness in school?based tobacco control programs.

Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets

Justification: The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India. Objectives: To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children. Process: A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members. Recommendations: The group reiterates the serum 25- hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as <12 ng/mL, 12-20 ng/mL and >20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD >100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400-600 IU/day) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of >20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.

TRAUMATIC PNEUMOCEPHALUS : AIR REPLACEMENT PROCEDURE VS CONTROLLED DECOMPRESSION WITH EXTERNAL DRAINAGE

Introduction: Air within cranium may be classified according to the site of occurrence. The pathophysiology of the same is varied and the effects are manifold. Methods: Patients with tension pneumocephalus are taken up for surgery.Results: In controlled decompression group, the pain requirement and duration of hospital stay was more. The air replacement procedure group had more recollection and one patient required a second procedure.Conclusion: Most of the cases subside with normobaric 100% oxygen therapy. In patients with persistent pneumocephalus for more than two weeks, more definitive procedures for sealing of the dural rent may be required

Correlation and comparative evaluation of nasal index and nasal cavity volume in nasal and mouth breathers A preliminary cone-beam computed tomographic study

Introduction: Mouth breathing is one of the most deleterious oral habits with a prevalence of 4%–6% among children. Due to the wide range of comorbidities associated with mouth breathing, early diagnosis and prompt treatment is indispensable. At present, there are very few objective methods available for the diagnosis of mouth breathing. The present study was planned to evaluate a possible correlation between nasal index (NI) and nasal cavity volume (NCV) among nasal and mouth breathers (MB). In addition, the average NCV of nasal and MB was also computed. The foresight of this research was to establish the significance of NI as an objective diagnostic tool for mouth breathing. Methods: This cross-sectional study was conducted among 8–11-year-old children. The NI was determined using a digital Vernier caliper and NCV was calculated using dolphin imagingsoftware. Results: There was a significant difference in NCV and nasal width (NW) in both groups, but no difference was seen in nasal height and NI. There was no statistically significant correlation between NCV and other parameters in both groups. Conclusion: The present study was a baseline analysis in this line. Even though this study did not reveal any significant correlation between both parameters, future studies are recommended to explore a plausible correlation.

Coronavirus Disease 2019 (COVID-19) Vaccination for Children: Position Statement of Indian Academy of Pediatrics Advisory Committee on Vaccination and Immunization Practices

Justification: Data generated after the first wave has revealed that some children with coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected COVID-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2-18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval. Objective: To provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use. Process: Formulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of COVID-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on COVID-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized. Recommendations: The IAP supports the Government of India’s decision to extend the COVID-19 vaccination program to children between 2-18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out.

Characterization of SH-SY5Y neurons subject to 92kHz ultrasound stimulation / Caracterización de neuronas SH-SY5Y sujetas a estimulación por ultrasonido de 92 kHz

SUMMARY: Cellular microstructural changes due to ultrasound exposure are critical to understand and characterize in order to further the establishment of ultrasonics in cell and tissue engineering and medicine. In this study, neurite length, nuclear morphology, and cellular toxicity are assessed at varying intensities of 92 kHz ultrasound provided by a piezoceramic disk element and incident upon SH- SY5Y neurons in vitro. Findings suggest that stimulation increases neurite length up to 2.73 fold tested at α = 0.05 in an intensity dependent manner. Additionally, stimulation causes a statistically significant (α = 0.05) decrease in nuclear area and less elongated nuclei, by 1.78 fold and 1.38 fold respectively, also in an intensity dependent manner. For maximum transducer surface intensities ranging from 0 to 39.11 W/cm2, the toxicity of 92 kHz ultrasound is assessed and a nontoxic range is determined using Caspase-3 and Annexin V staining, in addition to Calcium imaging via Calcein-AM staining. Intensities of up to 1.6 W/cm2 are found to be nontoxic for the cells under the parameters used in this study.

RESUMEN: Los cambios micro estructurales celulares debidos a la exposición a los ultrasonidos son fundamentales para comprender y caracterizar el establecimiento de los ultrasonidos en la ingeniería y la medicina de células y tejidos. En este estudio, la longitud de las neuritas, la morfología nuclear y la toxicidad celular se evalúan a intensidades variables de ultrasonido de 92 kHz proporcionado por un elemento de disco piezocerámico e incidente sobre las neuronas SH-SY5Y in vitro. Los resultados sugieren que la estimulación aumenta la longitud de las neuritas hasta 2,73 veces probada a α = 0,05 de una manera dependiente de la intensidad. Además, la estimulación provoca una disminución estadísticamente significativa (α = 0,05) en el área nuclear y núcleos menos alargados, en 1,78 veces y 1,38 veces, respectivamente y también de una manera dependiente de la intensidad. Para intensidades máximas de la superficie del transductor que oscilan entre 0 y 39,11 W / cm2, se evaluó la toxicidad del ultrasonido de 92 kHz y se determinó un rango no tóxico mediante tinción con Caspasa-3 y Anexina V, además de imágenes de calcio mediante tinción con Calceína-AM. Se encontró que las intensidades de hasta 1.6 W / cm2 no son tóxicas para las células bajo los parámetros usados en este estudio.

Nuclear elongation correlates with neurite induced cellular elongation during differentiation of SH-SY5Y neural cells / El alargamiento del núcleo se correlaciona con el alargamiento celular inducido por neuritas durante la diferenciación de las células neuronales Sh-Sy5Y

SUMMARY: Cellular differentiation is a highly regulated process that has vast implications for the mechanics of the cell. The interplay between differentiation induced cytoskeletal mechanical changes and strain on the nucleus is a potential cause of gene level changes. This study explores mechanical changes in SH-SY5Y neural cells during differentiation mediated by Retinoic Acid (RA) across Days 0 through 9. Findings suggest that cellular elongation increases 1.92-fold over a 10-day differentiation period, from 48.97 ±16.85µm to 93.96 ± 31.20 µm over 3 repeated trials and across multiple cells analyzed on ImageJ. Nuclear elongation increases less substantially from 17.51 ± 2.71 µm to 23.26 ± 3.10 µm over 3 repeated trials and across multiple cells. Results are statistically significant at a significance level of α = 0.05. This study is one of the first studies to show that during the process of RA mediated neural differentiation in SH-SY5Y neural cells, nuclear elongation is initially not significantly correlated with cellular elongation, but it becomes correlated during the differentiation process with an overall correlation coefficient of 0.4498 at a significance level of α = 0.05. Given the time course of the mechanical changes and the known coupling between the cytoskeleton and nuclear lamina, this study suggests a causative and correlative relationship between neurite-driven cellular elongation and nuclear elongation during neural differentiation.

RESUMEN: La diferenciación celular es un proceso altamente regulado que tiene vastas implicaciones para la mecánica de la célula. La interacción entre los cambios mecánicos citoesqueléticos inducidos por la diferenciación y la tensión en el núcleo es una causa potencial de cambios a nivel genético. Este estudio explora los cambios mecánicos en las células neurales SH-SY5Y durante la diferenciación mediada por el ácido retinoico (RA) durante los días 0 a 9. Los resultados sugieren que el alargamiento celular aumenta 1,92 veces durante un período de diferenciación de 10 días, de 48,97 ± 16,85 µm a 93,96 ± 31,20 µm en 3 ensayos repetidos y en múltiples células analizadas en Image J. El alargamiento nuclear aumenta menos sustancialmente de 17,51 ± 2,71 µm a 23,26 ± 3,10 µm durante 3 ensayos repetidos y en múltiples células. Los resultados son estadísticamente significativos a un nivel de significancia de α = 0,05. Esta investigación es uno de los primeros estudios en demostrar que durante el proceso de diferenciación neural mediada por RA en las células neurales SH-SY5Y, el alargamiento nuclear inicialmente no se correlaciona significativamente con el alargamiento celular, pero se correlaciona durante el proceso de diferenciación con un coeficiente de correlación global de 0,4498 a un nivel de significancia de α = 0,05. Dado el curso temporal de los cambios mecánicos y el acoplamiento conocido entre el citoesqueleto y la lámina nuclear, este estudio sugiere una relación causal y correlativa entre el alargamiento celular impulsado por neuritas y el alargamiento nuclear durante la diferenciación neural.

Evaluation of the average pulp cavity volume of primary second molar and canine for obturation of a single primary tooth A preliminary cone-beam computed tomographic study

Objective: Metapex/Vitapex is one of the most commonly used obturating materials in pediatric dental practice in recent times. It is available in a premixed syringe which poses numerous practical difficulties. This study aimed to calculate the root canal volume of maxillary and mandibular canine and second molar using cone-beam computed tomography (CBCT) to determine the quantity/grams of obturation material to obturate a single tooth (mass = density × volume). Materials and Method: This nonrandomized clinical trial is comprised of two parts. The first part involved calculation of average root canal volume using CBCT which was used to calculate the quantity/grams of obturating material. This predetermined quantity was used to obturate primary mandibular second molars and canines, and the quality of obturation was assessed. Results: Assessment of quality of obturation showed optimum length obturation in 53.33% primary second molars and 66.66% primary canines. Conclusion: It can be inferred that even with the use of exact predetermined quantity/grams of obturating material, optimum quality obturation could be achieved, thus avoiding wastage, preventing cross contamination, and simultaneously offering good clinical results. Hence, this study opens further gateways to device ampules containing predetermined mass of obturating material for a single use for obturation of a single primary tooth.

Comparative evaluation of nasal and alveolar changes in complete unilateral cleft lip and palate patients using intraoral and extraoral nasoalveolar molding techniques: randomized controlled trial

Objectives@#Cleft lip and palate is a common congenital anomaly that impairs the aesthetics, speech, hearing, and psychological and social life of an individual. To achieve good aesthetic outcomes, presurgical nasoalveolar molding (NAM) has become important. Currently, the intraoral NAM technique is widely practiced. Numerous modifications have been made to intraoral NAM techniques, but the original problem of compliance leading to discontinuation of treatment remains unsolved. Therefore, the present study compared an extraoral NAM technique with the intraoral NAM technique. @*Materials and Methods@#Twenty infants with complete unilateral cleft lip and palate were included and divided into two equal groups. Group A received the intraoral NAM technique, and Group B received the extraoral NAM technique. Pre- and postoperative extraoral and intraoral measurements were recorded. @*Results@#Groups A and B did not differ significantly in any extraoral or intraoral parameter. @*Conclusion@#The extraoral NAM technique is as effective as the intraoral NAM technique in achieving significant nasal and alveolar changes in complete unilateral cleft lip and palate patients. Additionally, it reduces the need for frequent hospital visits for activation and the stress associated with the insertion and removal of the intraoral NAM plate, thereby improving compliance.