Glutaraldehyde-Induced Allergic Contact Dermatitis: A Case Report and Safety Standards.

Glutaraldehyde (GA), a potent disinfectant and sterilizing agent extensively used in healthcare settings, has garnered attention for its association with contact dermatitis. This occupational skin condition, often induced by repeated exposure to GA, poses significant challenges to the well-being of healthcare professionals and patients alike. Understanding the causes, symptoms, and preventive measures against GA-induced contact dermatitis is essential for promoting a safe and healthy working environment in healthcare facilities. A 28-year-old female presented with a severe burning sensation and dark brown patches in the lower chin region, one day following root canal treatment. Based on the characteristic appearance of patches and the typical burning sensation associated with an allergic reaction, a diagnosis of acute contact dermatitis was made. Patch testing by an expert dermatologist confirmed that the patient was allergic to GA. GA, a popular commercial germicidal product, is widely used as a cold sterilizing agent for operative dental instruments. The patient developed a reaction as the endodontic files used during the root canal procedure were cold sterilized with 2% GA. The lesion experienced significant improvement and ultimately healed following the administration of corticosteroids and antihistamines. This report concerns a case of GA-induced contact dermatitis. As GA is being used more widely, particularly in dental clinics, this case was of interest and is reported in the safety interest of patients and clinicians.

Preventive hepatology at AIIMS Rishikesh: Delivering comprehensive and integrated care for liver diseases in Northern state of India.

Globally, liver diseases accounts for 4% of all deaths. Annually, over 2 million deaths occur due to preventable causes of chronic liver diseases and liver cancer like fatty liver diseases (alcoholic or non alcoholic) and viral hepatitis B and C. The burden of chronic liver diseases are increasing, and the epidemiology and demographics of people affected by these diseases are changing. Policy changes, vaccination, screening, lifestyle changes and public health awareness is the key to curb down liver disaeses. To achieve the ultimate goal of reducing mortality and linkage to care for those who need specialized care for liver disease, it is vital to have dedicated preventive hepatology clinics in sync with existing liver or gastroenterology clinics at tertary care level.

Development and quality evaluation of polyphenols enriched black carrot (Daucus carota L.) powder incorporated bread.

Black carrot is a prominent source of polyphenols and the cheapest source of anthocyanins in India. In this study, an attempt has been made to examine the feasibility of black carrot powder as an ingredient in bread. Black carrot bread was prepared by incorporating different concentrations of black carrot powder (BCP) at 2.5, 5.0, 7.5 and 10 %. The developed bread samples were analyzed for physical and textural quality, proximate composition, bioactive compounds, antioxidant properties, sensory characteristics, mineral content and storage quality. The results revealed that loaf volume and specific volume decreased (1995-1254 mL, 5.25-3.28 mL/g) with the incorporation of BCP into bread. Textural analysis revealed that the addition of BCP led to increased hardness in the bread (0.110-12 0.151 N), whereas the resilience (43.64-35.10 %), cohesion and springiness (89.930-13 82.146 %) decreased significantly. The content of bioactive compounds such as total phenols, anthocyanins (29.63-112.68 mg/100 g) and flavonoids increased to exceptionally high levels in BCP-incorporated bread and showed high antioxidant activity. Incorporation of BCP up to 7.5 % showed the most acceptable sensory analysis score (7.85) with a significant increase in dietary fiber (40 %) and total mineral content (50 %), which revealed that black carrot powder could be used up to 7.5 % as an ingredient into bread with high acceptability. The present study revealed significant enhancement in bioactive compounds and mineral content of bread after the incorporation of black carrot powder, which supports its immense potential in preventing hunger and oxidative stress-induced disorders in developing countries.

Humoral and cellular immune response in patients of liver cirrhosis and immunocompetent recipient of ChAdOx1nCoV-19 Vaccine (Covishield).

Despite the effectiveness of COVID-19 vaccination in reducing the severity of the disease, the demand for booster is increasing in vulnerable populations like elderly and immunocompromised individuals especially with each new wave of COVID-19 in different countries. There is limited data on the sustained immunity against COVID-19 in patients with liver cirrhosis. The study was aimed to compare the T cell and humoral immune response after 1 year of ChAdOx1nCoV-19 Vaccine in patients with liver cirrhosis and healthy health care workers (HCW). This was a prospective observational study including 36 HCW, 19 liver cirrhosis patients and 10 unvaccinated individuals. Anti-SARS-CoV-2S antibody, neutralizing antibody and memory T cell subsets were evaluated by ELISA and flow cytometry, respectively, in all three groups after 1 year of initial vaccination. Compared to HCW and unvaccinated individuals, liver cirrhosis patients had significantly depleted T cells, although CD4:CD8 + T cell ratio was normal. Both cirrhotic patients and HCW developed memory T cell subset [effector memory RA (P = 0.141, P < 0.001), effector memory (P < 0.001, P < 0.001), central memory (P < 0.001, P < 0.01), stem cell memory (P = 0.009, P = 0.08) and naïve (P < 0.001, P = 0.02)] compared to unvaccinated unexposed individuals of CD4 + T and CD8 + T, respectively. However, among HCW and cirrhotic group no difference was noted on central memory and stem cell memory cells on T cells. Patients with liver cirrhosis developed comparable memory T cells after vaccination which can evoke sustainable immune response on reinfection. Therefore, additional vaccine doses may not be necessary for cirrhosis patients.

Comparative analysis of salivary microbiota in diabetic and non-diabetic individuals of North India using metagenomics.

Background: Saliva, an oral secretion is considered an essential biological modulator involved in maintaining oral homeostasis. Increased glucose levels in diabetic patients' saliva may have an impact on diversity of microbes. Comparing the salivary microflora of diabetic and non-diabetic cohorts will help in diagnosis and risk assessment of oral health complications. This will provide greater knowledge about the contribution of oral microbes to the development of oral illnesses. The association between salivary microbiota and diabetic state is less explored in the North Indian population, hence current observational study was performed to analyze the salivary microflora of diabetic and non-diabetic individuals using metagenomic analysis. Materials and methods: This single-center non-randomized observational trial was conducted in Uttar Pradesh, India. Participants were enrolled into either diabetic (n = 68) or non-diabetic groups (n = 68) based on their diabetes status. Following saliva collection, DNA was extracted and metagenomic sequencing was performed. Results: Phylum Bacteroidetes and Fusobacteria were significantly abundant in diabetic individuals (p < 0.0001), while Proteobacteria was significantly higher among non-diabetic individuals (p < 0.0001). No statistical difference in phylum Actinobacteria and Firmicutes among diabetics and non-diabetics. Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were greater in diabetics whereas the abundance of Capnocytophaga and Neisseria was more among non-diabetics (p < 0.05). Conclusions: The genera Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were comparatively over the odds with the diabetics in India. The association between microbiota in diabetic population and risk related to increase in occurrence of caries, gingivitis, and periodontitis in diabetic population prevalence should be investigated.

Effectiveness of Diabetes Self-Management Education on Distress and HbA1C among Indian Type 2 Diabetes Mellitus Patients: A Randomized Controlled Trial.

Introduction: The interrelationship of diabetes with mental illness has increased in recent years. Diabetes-related distress is the emotional burden, stress, and worries associated with diabetes, which does not reach the threshold for depressive disorder. A diabetes self-management education (DSME) is a structured educational approach to improve glycemic control and diabetes-related distress. This study aimed to assess the effectiveness of DSME in comparison with usual diabetes care in improving glycemic control and diabetes-related distress. Material and Methods: This is a single-center, parallel randomized controlled trial. A total of 106 participants were recruited for both intervention and control groups with 53 participants each. The control group received only routine outpatient department (OPD) care. The intervention group received DSME in addition to routine OPD care. Diabetes-related distress and HbA1C were assessed after 3 months. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 25. Per-protocol analysis was done. Results: Of 127 patients screened, 106 met the eligibility criteria and were randomized. At 3-month follow-up, the reduction in mean HbA1C, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and diabetes distress were significant in the intervention group compared with the control group (p 0.001). The mean HbA1C reduction in the intervention group was significant (mean difference: -1.3, SD: 0.4). The mean DDS had decreased significantly in the intervention group from 2 to 1.2 (mean difference: -0.8, SD: 0.1). Conclusion: The DSME was effective in improving the glycemic control, diabetes-related distress, and self-care among type 2 diabetes (T2DM) mellitus patients.

National viral hepatitis control program in India: Call for update.

Viral hepatitis is a serious yet manageable and preventable public health menace that infects about 3 million of people and leads to 1.1 million deaths worldwide every year. An acute episode of viral hepatitis usually subsides on its own, however, if not intervened timely, chronic infection puts people at risk of cirrhosis, liver cancer, and eventually death. In 2015, the global community allied to tackle viral hepatitis, as a result of which combating viral hepatitis target was included in the sustainable development goals (SDGs), and the World Health Organisation (WHO) constituted the first-ever global health sector strategy on viral hepatitis for 2016 to 2021 which is also renewed recently. Conforming to the global commitment, India launched the National Viral Hepatitis Control Program in the year 2018 with the aim to eliminate viral hepatitis as a public health threat by the year 2030. In the Subsequent years, WHO and various other international societies have released updated recommendations with respect to vaccination, prevention of mother-to-child transmission, strategies to increase testing uptake including self-testing, newer diagnostics including point of care and reflex testing approaches, simplified treatment algorithms, expanded treatment eligibility criteria, and simplified service delivery models. With the program being in its fifth year of implementation, there is a need to revamp the operational guidelines based on various global evidence-based advancements in order to attain the ambitious elimination goal by 2030.

Fossils of the oldest diplodocoid dinosaur suggest India was a major centre for neosauropod radiation.

The Early Jurassic and Cretaceous deposits of India are known for their diverse sauropod fauna, while little is known from the Middle and Late Jurassic. Here we report the first ever remains of a dicraeosaurid sauropod from India, Tharosaurus indicus gen. et sp. nov., from the Middle Jurassic (early-middle Bathonian) strata of Jaisalmer Basin, western India. Known from elements of the axial skeleton, the new taxon is phylogenetically among the earlier-diverging dicraeosaurids, and its stratigraphic age makes it the earliest known diplodocoid globally. Palaeobiogeographic considerations of Tharosaurus, seen in conjunction with the other Indian Jurassic sauropods, suggest that the new Indian taxon is a relic of a lineage that originated in India and underwent rapid dispersal across the rest of Pangaea. Here we emphasize the importance of Gondwanan India in tracing the origin and early evolutionary history of neosauropod dinosaurs.

Comparative Study Between the First and Second Wave of COVID-19 Deaths in India: A Single Center Study.

Introduction  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously evolving, and many mutant variants of the virus are circulating in the world. Recurrent waves of COVID-19 have caused enormous mortality all across the globe. Considering the novelty of the virus, it becomes crucial for healthcare experts and policymakers to understand the demographic and clinical attributes of inpatient deaths in the first and second waves of COVID-19. Methods This hospital record-based comparative study was conducted at a tertiary care hospital in Uttarakhand, India. The study included all COVID-19 RT PCR-positive patients admitted to the hospital during the first wave, from 1st April 2020 to 31st January 2021, and the second wave from 1st March 2021 to 30th June 2021. Comparisons were made with respect to demographic, clinical, laboratory parameters, and course of hospital stay. Results The study exhibited 11.34% more casualties in the second wave, with the number of deaths being 424 and 475 for the first and second waves, respectively. A male preponderance of mortality was evident in both waves with significant differences (p=0.004). There was no significant difference in age between the two waves (p=0.809). The significantly different comorbidities were hypertension (p=0.003) and coronary artery disease (p=0.014). The clinical manifestations demonstrating a significant difference were cough (p=0.000), sore throat (p=0.002), altered mental status (p=0.002), headache (p=0.025), loss of taste and smell (p=0.001), and tachypnea (p=0.000). The lab parameters with a significant difference across both waves were lymphopenia (p=0.000), elevated aspartate aminotransferase (p=0.004), leukocytosis (p=0.008), and thrombocytopenia (p=0.004). During the hospital course of the second wave, in terms of intensive care unit stay, the need for non-invasive ventilation and inotrope support was higher. The complications manifesting in the form of acute respiratory distress syndrome and sepsis were observed more in the second wave. A significant difference was discerned in the median duration of hospital stay in both waves (p=0.000). Conclusion Despite being of shorter duration, the second wave of COVID-19 culminated in more deaths. The study demonstrated that most of the baseline demographic and clinical characteristics attributed to mortality were more common during the second wave of COVID-19, including lab parameters, complications, and duration of hospital stays. The unpredictable nature of COVID-19 waves calls for instituting a well-planned surveillance mechanism in place to identify the surge in cases at the earliest possible time and prompt response, along with developing infrastructure and capacity to manage complications.

The Efficacy of Dental Caries Telediagnosis Using Smartphone: A Diagnostic Study in Geriatric Patients.

Background and aim The major barrier to oral health care for geriatrics is access to dental care. Teledentistry is the field of dentistry that uses telecommunication with digital imaging for the exchange of valid information for diagnosis, treatment, and continuing dental education, enabling some means of approach to oral health care. This study aimed to assess the accuracy of diagnosing dental caries in the older age group by examining intraoral photographs taken by smartphone camera compared with standard clinical dental examination. Methods and material A calibrated dentist examined 18 patients aged 60-75 for six variables: sound tooth, decayed tooth, filled tooth with and without caries, missing tooth, and the presence of prosthesis. Intraoral photographs of each patient were taken using a smartphone. The photographs were then sent to six different examiners through WhatsApp. The accuracy of the diagnosis was measured by applying Cohen's kappa, sensitivity, and specificity. Fleiss' kappa was used to measure the agreement index using the software R (R Foundation for Statistical Computing, Vienna, Austria) version 4.2.1. Results The overall agreement between the tele-examiners and the control was measured, with the kappa scores ranging from 0.897 to 0.921, and the mean kappa score was 0.909. There was high specificity and sensitivity in the value observed. The agreement index, measured through Fleiss' kappa for six teeth conditions, reported the perfect agreement (0.867) among six examiners. Conclusions Under the limitations of the study, teledentistry using a mobile phone has acceptable accuracy for diagnosing caries in the older age group compared to a standard clinical dental examination.

Undergraduate students' perception of the Indian dental curriculum: A focus-group based, multi-centric questionnaire survey.

Aim: the present study was designed to take a student's perception regarding the current dental education curriculum. Methodology: A structured, pre-validated questionnaire made on Google Forms was shared amongst participants pursuing undergraduate dental program in a DCI recognized dental college via e-mail, Facebook or WhatsApp. The questionnaire consisted of questions about the admission procedure (5questions), curriculum design (12 questions) teaching methods (5 questions) and assessment (5 questions) methods. The respondents were divided into 2 focus groups; Pre-clinical: BDS first & second year students and Clinical: BDS third & fourth year students. Results: The questionnaire was circulated amongst a total of 510 potential candidates, out of which 403 responded (response rate 79%). 48.4% (195/403) were from government dental colleges and 51.6% (206/403) were from private dental colleges. Preclinical group had 89 students (1st year = 27, 2nd year = 62) and clinical group 344 students (3rd year = 138, 4th year = 176). Students of both focus groups responded similarly to many questions relating to curriculum (need of syllabus revision, p = 0.912; horizontal/vertical integration, p = 0.076; and early clinical exposure p = 0.843), teaching methods (need of mixed teaching methods) and assessment methods (methods which are not based on quota-chasing p = 0.588). Statistically significant difference was seen to "whether the students are able to retain or relate to the basic sciences subjects taught in first & second year" (p < 0.0001). Conclusion: Students expressed a need for a horizontal & vertical integration of topics, frequent syllabus revision, Early Clinical Exposure, a mixed teaching method, and better assessment methods.

Comparative evaluation of remineralizing effect of fluoride and nonfluoride agents on artificially induced caries using different advanced imaging techniques.

Aim: The aim of the study is to evaluate and compare the in-vitro remineralization efficacy of remineralizing agents, i.e., fluoride-free toothpaste, fluoride toothpaste, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), CPP-amorphous calcium fluoride phosphate (CPP ACFP), and silver diamine fluoride (SDF) paste on dentine over time. Methodology: Seventy-five extracted human permanent molars were selected. The buccal section of these samples was shaped into a slab. Artificial caries was induced by dipping the samples into the demineralizing solution (pH 4.5) for 21 days. They were then divided into five groups (n = 15). Each experimental group underwent one of the following treatments: Group 1 - Fluoride-free toothpaste (negative control), Group 2 - Fluoride toothpaste (positive control), Group 3 - CPP-ACP, Group 4 - CPP-Amorphous Calcium fluoride Phosphate and Group 5 - SDF. Postremineralizing treatment, Scanning electron microscope, Energy dispersive X-ray and Quantitative light induced fluorescence imaging were carried out to analyze the remineralizing efficacy. The data obtained was then subjected to statistical analysis using ANOVA and Paired t-tests. Results: It was seen that SDF showed highest remineralization efficacy followed by CPP-amorphous calcium fluoride phosphate, CPP-ACP, fluoride toothpaste and fluoride-free toothpaste. The difference in mean value among the groups was statistically significant (P < 0.001). Conclusion: SDF showed the highest remineralizing potential in scanning electron microscopy and energy dispersive X-ray, followed by CPP-ACFP, CPP-ACP, Fluoride toothpaste, and Fluoride-free toothpaste. Quantitative light fluorescence analysis showed more fluorescence changes in the CPP-ACFP followed by CPP-ACP, Fluoride toothpaste, and Fluoride-free toothpaste.

Correction: Viral Hepatitis as a Public Health Concern: A Narrative Review About the Current Scenario and the Way Forward.

[This corrects the article DOI: 10.7759/cureus.21907.].

Viral Hepatitis as a Public Health Concern: A Narrative Review About the Current Scenario and the Way Forward.

Viral hepatitis is one of the emerging public health problems, which urgently needs special attention. The disease has a varied presentation at the time of diagnosis, and it can progress from an accidental finding to life-threatening conditions like liver cirrhosis. It belongs to the rare group of diseases that can cause chronic inflammation inside the body, and it can have a delayed presentation. It contributes substantially to the global burden on healthcare. In terms of mortality, the burden due to viral hepatitis is similar to that of HIV and tuberculosis. It is among the major global public health challenges along with other communicable diseases, such as HIV, malaria, and tuberculosis; the major difference is that there are very limited preventive models in place for viral hepatitis, especially in developing countries like India. With limited resources for diagnosis and treatment, varied levels of presentation, and a rapidly increasing burden, it can become the next silent pandemic. In the current review, the authors aimed to compile the available global strategies for combating hepatitis, protocols available for disease surveillance, and the salient points from the national program for hepatitis control in India [National Viral Hepatitis Control Program (NVHCP)], and propose some recommendations. Ensuring a health facility equipped with a rapid diagnostic kit for screening, proper lab for the confirmation, robust Health Management Information System (HMIS) portal for the data management, and organizing regular workshops for physicians and lab technicians are some of the recommendations that we put forward.

Descriptive Epidemiology of COVID-19 Deaths during the First Wave of Pandemic in India: A Single-center Experience.

BACKGROUND: With the looming threat of recurrent waves of coronavirus disease-2019 (COVID-19) in the presence of mutated strains, it is of paramount importance to understand the demographic and clinical attributes of COVID-19 related mortalities in each pandemic wave. This could help policy makers, public health experts, and clinicians to better plan preventive and management strategies to curb COVID-19 related mortality. MATERIALS AND METHODS: This was a hospital record-based, retrospective cross-sectional descriptive study, at a tertiary care hospital in Rishikesh, India. The study included all deceased patients between March 2020 and January 2021 (first wave) who had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) and were hospitalized. The study was done to describe demography, clinical presentation, laboratory parameters, treatment given, and associated complications of all COVID-19 deaths. RESULT: Out of 424 mortalities, 298 (70.38%) were males and 126 (29.62%) were females. Mean age of patients was 55.85 ± 16.24 years, out of which 19.5% were less than 45 years old, 33.6% were 45-60 years old, and 41.8% were more than 60 years old. Comorbidity in the form of type II diabetes mellitus was present in 41.4% [95% CI (41.4-51.1)], hypertension in 39.8% [95% CI (35.1-44.6)], and coronary artery disease (CAD) in 15.2% [95% CI (11.8-18.8)]. At the time of presentation, shortness of breath was present in 73.6% [95% CI (69.1-77.7)], fever in 64.92% [95% CI (60.1-69.4)], and cough in 46.1%, [95% CI (41.1-50.8)]. Deranged laboratory parameters were lymphopenia in 90.2% [95% CI (86.8-92.7)], transaminitis in 59.7% [95% CI (54.8-64.3)], and hypercreatinemia in 37.7% [95% CI (33.1-42.5)]. Complications manifested were acute respiratory distress syndrome (ARDS) in 78.3% [95% CI (74-82.1)] and shock in 54.7% [95% CI (49.8-59.5)]. Median time duration between onset of symptom and hospital admission was 5 days (interquartile range (IQR) = 3-5 days) and median length of hospital stay was 9 days (IQR = 4-14 days). CONCLUSION: During the first pandemic wave, COVID-19 related mortality was 2.37 times higher among males, 2.14 times in the age group >60 than <45 years. The most common associated comorbidities (>40%) were type II diabetes mellitus and hypertension. The most common associated symptoms (>60%) were shortness of breath and fever. Lymphopenia was seen in >90% cases while liver involvement in 60% and kidney in 38% cases. Median hospital stay was doubled the prehospital illness. HOW TO CITE THIS ARTICLE: Tendulkar P, Pandey P, Panda PK, Bhadoria AS, Kulshreshtha P. Descriptive Epidemiology of COVID-19 Deaths during the First Wave of Pandemic in India: A Single-center Experience. Indian J Crit Care Med 2022;26(1):71-75.

Evaluation of knowledge and attitude of dental students regarding COVID-19: A multicentric study.

Background: Despite the life-threatening risk that corona virus disease (COVID-19) poses to dentists, their role in suppressing its transmission and the need to deliver dental care to the patients is inevitable. In this regard, it is essential to determine the awareness and knowledge among Indian dental students regarding COVID-19 and to assess their preparedness to handle the current situation. Methods: This cross-sectional study enrolled 408 dental undergraduate (UG) and postgraduate (PG) students from private and government dental teaching hospitals. A closed-ended online questionnaire containing crucial elements of COVID management during dental procedures was given to the participants assessing their knowledge and perception pertaining to COVID-19 regarding dental practice. Chi-square, Mann-Whitney U, and Kruskal-Wallis tests were employed for statistical analysis. P ≤ 0.05 was considered statistically significant. Results: The study consisted of 64.71% UG and 35.29% PG dental students, with a mean age of 25.75 ± 3.69 years and M: F ratio of 0.5:1. COVID-19 knowledge increased significantly with age (P = 0.0055) and educational level (P < 0.01). Awareness was also significantly greater in students from government institutions in comparison with private colleges (P < 0.001), with 91.67% of participants being aware of the transmission routes. However, familiarity with survival of virus in aerosols, considerations regarding the use of masks, and strategies for confirmed/suspected COVID-19 health-care workers to return to work after recovery were seen in only 35%, 53.9%, and 38.9% of the students, respectively. Conclusion: COVID-19 awareness among Indian dental students is significantly related to their education level. The lacunae in this knowledge need to be filled by adequate training by incorporating it as a part of their education.

Prevalence of Hepatitis B and C Among Prison Inmates in India: A Systematic Review and Meta-Analysis.

Viral hepatitis is still considered a major cause of the burden of disease in India. It is the most common cause of cirrhosis and liver cancer. Prisoners are one of the groups at most risk for hepatitis. This study aimed to estimate the pooled estimates of the prevalence of hepatitis B and C among prisoners in India. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study selection. The extensive search was done through databases of PubMed, Embase, and Google Scholar. All cross-sectional studies conducted to find the prevalence of hepatitis B and C among prison inmates in India published till June 2020 were screened and included in this meta-analysis. The analysis was conducted using the random-effects model. The heterogeneity was estimated using the I2 indicator. After extracting the required data, the meta-analysis was performed using the software Stata, version 12 (StataCorp LLC, College Station, Texas). The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration no: CRD42020185137). Out of a total of 970 articles searched through the database of PubMed, Embase, and Google Scholar, five studies that met the inclusion criteria were included and analyzed. Hepatitis B and C prevalence were given in four studies each. The results showed that the overall prevalence of hepatitis B and C in prisoners was 8% (95% CI: 4-12) and 7% (95% CI: 1-13). The studies show high heterogeneity with no evidence of publication bias. The prevalence of hepatitis B and C among male prisoners was 4.48% (95% CI: 3.64%-5.32%) and 6.35% (95% CI: 5.48%-7.23%), respectively, while the prevalence among female prisoners was 1.53% (95% CI: 0.31-2.75) and 2.10% (95% CI: 0.28-3.93), respectively. The study findings show a high prevalence of hepatitis B and C in prisoners, which is of particular concern. Appropriate and effective interventions to reduce the transmission of hepatitis B and C in prisons are essential.

Geo-Mapping of Early Childhood Caries Risk: A Community Oriented Preventive Oral Health Promotional Approach.

CONTEXT: Given the uneven distribution of dental caries, there is an exigent need for a database of dental caries and its spatial distribution for better planning and efficient delivery of health promotional and preventive programs. Geo-mapping is a helpful tool for policy makers/administrators for efficient allocation of limited resources. AIMS: To geo-map spatial distribution of caries risk in preschoolers of Lucknow and to identify associated predisposing factors. SETTINGS AND DESIGN: A cross-sectional study was done among 1000 preschool children (3-5 years of age) attending pediatrics, outpatient department at a medical college in Lucknow, Uttar Pradesh. METHODS AND MATERIAL: Children were enrolled using the systematic random sampling. Each child was geo-coded with respect to his/her residence, clinically examined for dental caries and given a Decayed Missing Filled Tooth (DMFT) index score. A pre-tested questionnaire was used to collect socio-demographic data. Caries prevalence was geo-mapped using color codes. STATISTICAL ANALYSIS USED: Median DMFT scores were compared using Mann-Whitney and Kruskal-Wallis test. QQ plot/Shapiro-Wilk's test was used to check the normality of data. RESULTS: Prevalence of caries was found to be 76%. 10% children had DMFT score of 4 and more. A significant difference in distribution of DMFT score was observed for gender, income levels and between wards. Wards closer to the center of Lucknow district had a higher prevalence of caries. CONCLUSIONS: Geo-mapping of caries prevalence gives a quick visual glance of specific areas vulnerable to caries and help deliver specific tailor-made services.

Pupil dynamics: A potential proxy of neural preparation for goal-directed eye movement.

The pupils reflexively constrict or dilate to regulate the influx of light on the retinae. Pupillary light reflex (PLR) is susceptible to many non-visual cognitive processes including covert orientation of attention and planning rapid saccadic eye movement. The frontal eye field (FEF) and superior colliculus (SC), which also send projections to the PLR pathway, are two important areas in primate's brain for planning saccade and orientation of attention. The saccadic reaction time (SRT) and the rate of increase in activity of movement neurons in these areas are inversely correlated. This study addressed how pupil dynamics, activity in the FEF and SC and SRT are related in a saccadic decision-making task. The rate of visually evoked pupil constriction was found inversely related to SRT. This was further verified by simulating a homeomorphic biomechanical model of pupillary muscle plants, wherein we projected signals similar to build-up activity in the FEF and SC to the parasympathetic (constriction) and sympathetic (dilation) division of the PLR pathway, respectively. A striking similarity between simulated and observed dynamics of pupil constriction suggests that PLR is a potential proxy of saccade planning by movement neurons in the FEF and SC. Indistinguishable pupil dynamics when planned saccades were elicited versus when they were cancelled eliminated the possibility that the obligatory pre-saccadic shift of attention alone influenced the rate of pupil constriction. Our study envisages a mechanism of how the oculomotor system influences the autonomic activity in an attempt to timely minimize saccadic visual transients by regulating the influx of light.