Case of Hallervorden-Spatz Syndrome: A Tale of Twin Sisters.

Hallervorden-Spatz syndrome, now known as pantothenate kinase-associated neurodegeneration (PKAN), is a rare autosomal recessive disorder that is characterized by cerebral iron deposition and leads to progressive extrapyramidal dysfunction and dementia. Most commonly seen in the first two decades of a person's life, it is a differential for patients presenting with atypical progressive extrapyramidal disorder and cognitive impairment. It is characterized by progressive degeneration of the basal ganglia, globus pallidus, and the reticular part of the substantia nigra due to iron accumulation. The characteristic MRI brain pattern of the disease shows the eye-of-the-tiger sign. We report cases of early onset PKAN in two sisters of the same family, in which diagnosis was based on clinical features, lab parameters, and MRI imaging findings. This report aims to differentiate PKAN from other static and progressive neurological illnesses.

Estimation of Loss of Crestal Bone Around Dental Implants in Various Tissue Biotypes Using CBCT.

Objectives: To evaluate the loss of crestal bone height around dental implants placed in various tissue biotypes. Materials and Methods: 20 patients with single edentulous sites were allocated randomly, with 10 samples in each into Group I (implants were placed in thick tissue biotype) and Group II (implants were placed in thin tissue biotype). Baseline cone-beam computed tomography (CBCT) was performed after implant placement in both groups, and follow-up CBCT was taken at the time of cementation prior to occlusal loading to assess the crestal bone loss around the mesial and distal side of implants in both groups. Result: A significant loss of crestal bone at both the distal and mesial sides of the implants at the time of cementation was observed in both groups but Group II showed more crestal bone loss as compared to Group I. Conclusion: Mean crestal bone loss was more in Group II (thin tissue biotype) in comparison to Group I (thick tissue biotype). The thick biotype causes less crestal bone changes than the thin biotype, which evokes more loss of crestal bone during the period of peri-implant healing.

Clinical and CBCT Assessment of Role of Bisphosphonate on Osteotomy Site and Implant Surface.

Objectives: To assess the role of bisphosphonate on osteotomy site and implant surface. Materials and Methods: Twenty patients with adequate width and height of edentulous space and a single missing posterior tooth between the ages of 25 and 55 were incorporated in this research. Ten participants received implant therapy alone; the other ten patients received implant therapy and bisphosphonate application to osteotomy site and the implant surface. Result: Changes in the crestal bone level were seen in both the study and control groups. At 1 year, crestal bone loss was less in the bisphosphonate-treated group than in the control group. Conclusion: The quantity of crestal bone loss was reduced when bisphosphonate (sodium alendronate) was applied locally near the implant and osteotomy site.

Brain Abscess Secondary to Streptococcus Intermedius Following an EGD with Biopsy in a Patient with Eosinophilic Esophagitis.

Brain abscess is a rare complication of esophagogastro- duodenoscopy (EGD) with few reported cases in the literature. In this report, we discuss a patient presenting with altered mental status, headache, and dysarthria due to brain abscess caused by S. intermedius shortly after an EGD with an esophageal biopsy showing a new diagnosis of eosinophilic esophagitis. We highlight the rare association of EGD and brain abscess, and discuss the importance of prompt diagnosis and treatment.

Evaluation of the Milled and Three-Dimensional Digital Manufacturing, 10-Degree and 20-Degree Preparation Taper, Groove and Box Auxiliary Retentive Features, and Conventional and Resin-Based Provisional Cement Type on the Adhesive Failure Stress of 3 mm Short Provisional Crowns.

BACKGROUND This study evaluated the effects of milling (CADCAM), 3D printing, preparation taper angles (10-degree and 20-degree), auxiliary retentive features (groove and box), and provisional cement types (conventional and resin-based) on the adhesive failure stress of 3-mm short provisional crowns (PC). The research was motivated by the need to understand how digital dentistry technologies impact the retention and durability of provisional crowns. MATERIAL AND METHODS A total of 160 working models (3D-printed) and PCs [80 milled (CopraTemp)/80 printed (Asiga)] were fabricated from two 10- and 20-degree typodont master models and two 20-degree 3D-printed master models (groove and box), simulating a 3 mm high all-ceramic short PC. After provisional cementation with conventional (Kerr TempBond) and resin-based (ProviTemp) cements, 16 subgroups (n=10 each) underwent thermocycling (10 000 cycles; 5-55°C) and pull-off tests on a universal testing machine. Statistical analysis was performed using one-way ANOVA and post hoc Tukey test. RESULTS Conventional cement failed at lower stress for milled (47.68 to 73.54) and printed (48.40 to 77.91) as compared to resin cement for milled (104.2 to 137.27) and printed (184.85 to 328.84), respectively, with significant differences. Increased taper and groove decreased failure load except for the printed PC/resin cement combination. Use of proximal box preparation increased retention significantly. Except for 20-degree taper cemented with conventional cement, the differences in auxiliary retentive features for milled and printed provisional crowns were statistically significant at P≤0.05. CONCLUSIONS 3D-printed PC, resin-based cement, 10-degree taper, and proximal box preparation were associated with higher retention than milled, conventional cements, 20-degree taper, and vertical groove.

Gene sequencing applications to combat oral-cavity related disorders: a systematic review with meta-analysis.

Gene sequencing (GS) has numerous applications in combatting oral-cavity related disorders, including identifying genetic risk factors for diseases, developing targeted therapies, and improving diagnostic methods. It can help identify specific genetic mutations or variations that increase the risk of developing oral-cavity related disorders, such as oral cancer, periodontal disease, and cleft lip and palate. By the means of the following investigation, our primary objective was to assess the impact of GS technique in diagnosing and potentially treating diseases of the oral cavity by the means of a systematic review and meta-analysis. We commenced by defining the terms "gene sequencing," "oral cavity," and "disorders" as the important elements in our investigation's subject. Next, relevant databases like PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched using keywords and synonyms for each concept, such as "genomic sequencing," "DNA sequencing," "oral health," "oral diseases," "dental caries," "periodontal disease," "oral cancer," and "salivary gland disorders." We combined several search terms, such as "gene sequencing AND oral disorders AND periodontal disease" or "oral cancer OR genomic sequencing," to further hone your search results using Boolean operators like "AND" and "OR." The oral cavity analysis obtained by CS in the selected articles revealed that most of the disorders were, in fact, a direct causal event influenced by the oral microbiome. Moreover, each sampled oral cavity evidenced a different microbial community, which predicted the precipitation of benign as well as malignant conditions, though not on a definitive basis. In the last ten years, genomic sequencing had advanced remarkably as majority of our selected studies observed, making it possible to diagnose and treat a variety of oral and maxillofacial disorders, including cancer. It was also used to ascertain a person's genetic make-up as well as to spot numerous genetic abnormalities that can predispose individuals to diseases. Understanding the different sequencing techniques and the resulting genetic anomalies may help with their clinical application and lead to an improvement in illness diagnosis and prognosis as a whole in the field of dentistry.

Efficacy, Safety, Pharmacokinetics, and Immunogenicity of DRL-Trastuzumab Versus Herceptin in Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer: A Randomized Controlled Trial.

PURPOSE: Dr Reddy's Laboratories Trastuzumab (DRL_TZ) is a biosimilar to Herceptin under development. The present study was conducted to evaluate efficacy, safety, pharmacokinetics (PKs), and immunogenicity of DRL_TZ in comparison with the reference medicinal product (RMP) along with concomitant weekly paclitaxel in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). METHODS: This was a randomized, double-blind study in female patients with HER2-positive MBC, randomly assigned in a 1:1 ratio to receive either DRL_TZ or the RMP, that is, an innovator product sourced from the European region, along with additional chemotherapy, as first-line treatment for up to 24 weeks. The primary end point was the best overall response rate (ORR) as per RECIST 1.1 criteria. Progression-free survival rate at 6 months (PFS6), safety, immunogenicity, and PK parameters were assessed as secondary end points. RESULTS: A total of 164 patients were randomly assigned to receive either DRL_TZ or the RMP. Best ORR in the per-protocol population was comparable, 91.9% (93.3% CI, 83.2 to 96.3) versus 82.1% (93.3% CI, 72.0 to 89.1) in DRL_TZ and RMP arms, respectively; the difference between the arms was 9.8% with a 93.3% CI of -1.3 to 20.8. The PFS6 rate, safety, PK profile, and antidrug antibody incidence were comparable. An additional 44 patients were recruited in the postrandomization phase, in an open-label manner, and started on DRL_TZ to generate more data on efficacy, safety, and immunogenicity. The additional data with DRL_TZ, when pooled, were similar to the RMP data. CONCLUSION: DRL_TZ was found to have similar efficacy and comparable safety, PK, and immunogenicity profiles as the RMP.

Sideways propelled bimetallic rods at the water/oil interface.

The motion of self-propelling microswimmers is significantly affected by confinement, which can enhance or reduce their mobility and also steer the direction of their propulsion. While their interactions with solid boundaries have already received considerable attention, many aspects of the influence of liquid-liquid interfaces (LLI) on active particle propulsion still remain unexplored. In this work, we studied the adsorption and motion of bimetallic Janus sideways propelled rods dispersed at the interface between an aqueous solution of hydrogen peroxide and oil. The wetting properties of the bimetallic rods result in a wide distribution of their velocities at the LLI. While a fraction of rods remain immotile, we note a significant enhancement of motility for the rest of the particles with velocities of up to 8 times higher in comparison to those observed near a solid wall. Liquid-liquid interfaces, therefore, can provide a new way to regulate the propulsion of bimetallic particles.

Fabrication of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) Fibers Using Centrifugal Fiber Spinning: Structure, Properties and Application Potential.

Biobased and biodegradable polyhydroxyalkanoates (PHAs) are currently gaining momentum. Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) polymer has a useful processing window for extrusion and injection molding of packaging, agricultural and fishery applications with required flexibility. Processing PHBHHx into fibers using electrospinning or centrifugal fiber spinning (CFS) can further broaden the application area, although CFS remains rather unexplored. In this study, PHBHHx fibers are centrifugally spun from 4-12 wt.% polymer/chloroform solutions. Beads and beads-on-a-string (BOAS) fibrous structures with an average diameter (ϕav) between 0.5 and 1.6 µm form at 4-8 wt.% polymer concentrations, while more continuous fibers (ϕav = 3.6-4.6 µm) with few beads form at 10-12 wt.% polymer concentrations. This change is correlated with increased solution viscosity and enhanced mechanical properties of the fiber mats (strength, stiffness and elongation values range between 1.2-9.4 MPa, 11-93 MPa, and 102-188%, respectively), though the crystallinity degree of the fibers remains constant (33.0-34.3%). In addition, PHBHHx fibers are shown to anneal at 160 °C in a hot press into 10-20 µm compact top-layers on PHBHHx film substrates. We conclude that CFS is a promising novel processing technique for the production of PHBHHx fibers with tunable morphology and properties. Subsequent thermal post-processing as a barrier or active substrate top-layer offers new application potential.

Therapeutic efficacy of adjunctive photodynamic therapy in the treatment of denture stomatitis.

BACKGROUND: The present report assessed the efficacy of curcumin-mediated photodynamic therapy (CUR-mediated PDT) as an adjunct to antifungal gel treatment by evaluating the salivary interleukin-6 (IL-6) and matrix metalloproteinases-8 (MMP-8) levels together with Candida species counts in denture stomatitis (DS) patients. METHODS: In total, 50 DS subjects were randomly categorized into 2 groups: Group-1: subjects who received the antifungal gel treatment and Group-2: participants who received CUR-mediated PDT. The Sabourad Dextrose Agar and CHROMAgar were utilized for evaluating Candida species counts, while the Enzyme-Linked Immunosorbent Assay was employed to estimate the salivary levels of IL-6 and MMP-8. All clinical evaluations were performed at the baseline, 1 month, and 2 months. RESULTS: In total, group-2 subjects showed a significant decrease in Candida albicans (C. albicans) counts on both follow-ups (i.e., 1-month and 2-month) than group-1 participants. C. krusei count also reduced in group-2 subejcts than group-1 participants at the 2nd follow-up as compared to the baseline, nevertheless, a slight increase in C. krusei count was noticed in group-2 subjects at the 2nd follow-up than the 1st follow-up. The salivary IL-6 and MMP-8 levels in both groups reduced significantly at both follow-ups than the baseline. According to the stepwise logistic regression analysis, no statistically significant correlation was observed between Candida species count and other parameters such as age and gender of the patient, duration of DS, and frequency of treatment(s). CONCLUSION: CUR-mediated PDT is an efficaciousness therapeutic modality for alleviating Candida species counts on the surface of denture and the palatal mucosa, as well as improving the salivary IL-6 and MMP-8 levels in DS patients.

Developing High-Performance In-Plane Flexible Aqueous Zinc-Ion Batteries with Laser-Scribed Carbon-Supported All Electrodeposited Electrodes.

Developing high-performance, safer, and affordable flexible batteries is of urgent need to power the fast-growing flexible electronics market. In this respect, zinc-ion chemistry employing aqueous-based electrolytes represents a promising combination considering the safety, cost efficiency, and both high energy and high-power output. Herein, we represent a high-performance flexible in-plane aqueous zinc-ion miniaturized battery constructed with all electrodeposited electrodes, i.e., MnO2 cathode and zinc anode with polyimide-derived interdigital patterned laser-scribed carbon (LSC) as the current collector as well as the template for electrodeposition. The LSC possesses a cross-linked network of graphitic carbon sheet, which offers large surface area over low footprint and ensures active materials loading with a robust conductive network. The LSC with high zincophilic characteristic also offers dendrite-free zinc deposition with very low Zn2+ plating stripping overpotential. Benefitting from the Zn//MnO2-rich redox chemistry, the ability of the 3D LSC network to uniformly distribute reaction sites, and the architectural merits of in-plane interdigitated electrode configuration, we report very high capacity values of ∼549 mAh/g (or ∼523 µAh/cm2) and 148 mAh/g (or 140 µAh/cm2) at 0.1 A/g (0.095 mA/cm2) and 2 A/g (1.9 mA/cm2) currents, respectively. The device was also able to maintain a high capacity of 196 mAh/g (areal capacity of 76.19 µAh/cm2) at 1 A/g (0.95 mA/cm2) current after 1350 cycles. The flexibility of the device was demonstrated in polyacryl amide (PAM) gel polymer soaked with a 2 M ZnSO4 and 0.2 M MnSO4 electrolyte, which exhibited a comparable specific capacity of ∼102-110 mAh/g in flat condition and different bending (100° or 160° bending) conditions. The device does not use any conventional current collector, separator, and conductive or polymer additives. The overall process is highly scalable and can be completed in less than a couple of hours.

Efficacy and Safety of Molnupiravir in Mild COVID-19 Patients in India.

Background At the peak of the coronavirus disease 2019 (COVID-19) pandemic, the need for an orally administered agent to prevent the progression of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection became increasingly evident, which was the impetus behind our investigations with molnupiravir. Molnupiravir has been shown to be effective in preventing hospitalizations and/or clinical complications in patients with mild-to-moderate COVID-19. In this study, we evaluate the efficacy and safety of molnupiravir in Indian patients with mild SARS-CoV-2 infection and at least one risk factor for disease progression (CTRI/2021/05/033739). Methodology This was a phase III, multicenter, randomized, open-label, controlled study conducted in Indian adults aged 18-60 years with mild SARS-CoV-2, reverse transcription polymerase chain reaction (RT-PCR)-positive within 48 hours of enrollment in the study, and within five days of first symptom onset. Enrolled patients were randomized to treatment arms in a 1:1 ratio to receive molnupiravir or placebo in addition to the standard of care (SoC) for SARS-CoV-2 infection. The SoC was in compliance with Government of India guidelines that were in force at the time. The primary endpoint was the rate of hospitalization up to day 14. Safety endpoints included incidence of adverse events (AEs). Results Eligible patients were randomized in a 1:1 ratio to receive molnupiravir in addition to SoC treatment (n = 608) or SoC alone (n = 610). In the molnupiravir group, nine (1.48%) patients required hospitalization versus 26 (4.26%) patients in the control group (risk difference = -2.78%; 95% CI = -4.65, -0.90; p = 0.0053). Overall, 45 (3.70%) patients reported 47 AEs during the study, most of which were mild and resolved completely. The molnupiravir group reported 30 AEs compared to 17 AEs in the control group. Headache and nausea were the two most commonly reported AEs. Conclusions The molnupiravir arm showed a lower rate of hospitalization and a shorter time for the improvement of clinical symptoms coupled with early RT-PCR negativity. Molnupiravir was well tolerated, and AEs were mild and rare. The addition of molnupiravir to standard therapy has the potential to prevent the progression of mild COVID-19 disease to the severe form.

High-Power Holmium with MOSES Technology or Thulium Fiber Laser in MiniPerc with Suction: A New Curiosity.

Purpose: To present initial clinical comparison between high-power holmium laser with MOSES technology (HPH-M) and thulium fiber laser (TFL) during mini-percutaneous nephrolithotomy (PCNL) for renal calculi with specific emphasis on fragmentation efficiency, fragment size distribution, and stone-free rates (SFRs). Materials and Methods: Between August 2018 and December 2019, we performed mini-PCNL for renal calculi <3 cm using HPH-M (Lumenis, Israel) or TFL (Urolase SP, IPG Photonics). Data were collected prospectively in our institutional stone registry. Propensity score matching (1:1) was performed using stone size and density as predictors resulting in matched cohort of 51 patients in each group. Mini-PCNL with active suction sheath was standard across all patients. Primary end-point was SFR at immediate postprocedure and 1 month using CT/kidney, ureter, and bladder radiograph. Stone fragments were retrieved and segregated to assess proportion of dust (<1 mm), small (1-3 mm), and large (>3 mm) fragments. Result: Both groups were comparable in terms of stone size (p = 0.74), volume (p = 0.17), and density (p = 0.69). SFR at 48 hours was 78.43% in HPH-M group and 68.63% in TFL group. Patients with residual fragments were completely clear at 1 month. Lasing time (678.6 vs 551.95 seconds; p = 0.17), stone fragmentation rate (4.6 vs 5.2 mm3/s; p = 0.23), and total laser energy (21.9 vs 16.3 KJ; p = 0.09) were comparable in both arms. Both groups produced similar dusting (46.8 vs 46.41%; p = 0.93). TFL produced a greater proportion of fragments >3 mm (36% vs 22.68%, p = 0.002). On subset analysis based on stone density, all outcome parameters were comparable except a shorter total operative time with TFL (p ≤ 0.05). Conclusion: HPH-M and TFL showed similar SFR. Within constraints of the laser fiber size and energy settings, both modalities were equivalent in terms of fragmentation efficiency and proportion of dusting across stone densities.

Exposure to Neighborhood-Level Racial Residential Segregation in Young Adulthood to Midlife and Incident Subclinical Atherosclerosis in Black Adults: The Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Neighborhood-level racial residential segregation has been linked to several cardiovascular disease risk factors and outcomes in Black adults, but its impact on subclinical atherosclerosis remains unknown. In addition, although the impact of segregation on health may vary over the life course, most studies have examined segregation exposure at a single point in time. This article takes a life course approach by examining associations of exposure to neighborhood-level racial residential segregation in young adulthood and patterns of exposure from young adulthood to midlife with coronary artery calcification (CAC) incidence. METHODS: We used data on 1125 Black CARDIA study (Coronary Artery Risk Development in Young Adults) participants free of CAC. Residential segregation was assessed using the Gi* statistic and measured when participants were young adults (18-30 years old, in 1985-1986) and as the pattern from young adulthood to midlife (15 years later). Poisson regression with generalized estimating equations models was used to measure CAC incidence. RESULTS: We found participants living in low segregation neighborhoods in young adulthood had 0.52 (rate ratio [95% CI: 0.28-0.98]) times lower risk of developing CAC compared with high segregation after adjusting for young adulthood sociodemographic characteristics and neighborhood poverty. Associations were attenuated and no longer statistically significant with adjustment for midlife CAC risk factors hypothesized to be on the causal pathway (rate ratio: 0.56 [95% CI: 0.29-1.09]). Findings for patterns of segregation over time suggest participants living in low segregation neighborhoods in young adulthood were less likely to develop CAC than those who started out in medium/high segregation neighborhoods, regardless of where they lived in midlife (rate ratio for increase from low to medium/high: 0.42 [95% CI: 0.19-0.95]; rate ratio for continuously low versus continuously medium/high segregation neighborhoods: 0.75 [95% CI: 0.31-1.83]). CONCLUSIONS: We found that participants living in more segregated neighborhoods in young adulthood were more likely to develop CAC due at least in part to differences in CAC risk factor burden accumulated over follow-up.

Size Distribution of Fragments by High-power Holmium Laser Lithotripsy in MiniPCNL with Suction.

PURPOSE OF REVIEW: Data are lacking on distribution of size of fragments created with the laser lithotripsy, stone density, and composition. Dust (< 1 mm) and small fragments (1-3 mm) may be too small to be efficiently removed with forceps compared to larger fragments (> 3 mm). We aim to report the size distribution of fragments formed during holmium laser lithotripsy. RECENT FINDINGS: One hundred ten patients with renal calculi < 3 cm underwent miniPCNL using ClearPetra sheath (Well Lead Medical Co., China) with controllable irrigation and suction system that minimizes fragment dispersion and maximizes fragment aspiration. Moses holmium laser (Lumenis INC, Israel) was used with predefined laser energy settings for lithotripsy. Proportion of fragment size < 1 mm was 46.36 ± 16.68%, 1-3 mm was 28.18 ± 10.01%, and > 3 mm was 25.19 ± 16.18% for the entire cohort. Complete stone clearance at 48 h was achieved in 77.3% cases. The remaining 22.7% patients had complete clearance at 1-month follow-up CT. In all the stone density, volume, and composition groups, majority of fragments created were either < 1 mm or 1-3 mm. Only 25% fragments were > 3 mm that would get aspirated out through the sheath with suction or could be retrieved with forceps. The combination of a high-power holmium laser and suction would help in complete stone clearance with effective aspiration of smaller stone fragments and dust simultaneously during lasing.

Extrusion and Injection Molding of Poly(3-Hydroxybutyrate-co-3-Hydroxyhexanoate) (PHBHHx): Influence of Processing Conditions on Mechanical Properties and Microstructure.

Biobased and biodegradable polyhydroxyalkanoates (PHAs) have great potential as sustainable packaging materials. However, improvements in their processing and mechanical properties are necessary. In this work, the influence of melt processing conditions on the mechanical properties and microstructure of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) is examined using a full factorial design of experiments (DoE) approach. We have found that strict control over processing temperature, mold temperature, screw speed, and cooling time leads to highly increased elongation at break values, mainly under influence of higher mold temperatures at 80 °C. Increased elongation of the moldings is attributed to relaxation and decreased orientation of the polymer chains together with a homogeneous microstructure at slower cooling rates. Based on the statistically substantiated models to determine the optimal processing conditions and their effects on microstructure variation and mechanical properties of PHBHHx samples, we conclude that optimizing the processing of this biopolymer can improve the applicability of the material and extend its scope in the realm of flexible packaging applications.

CHARGE syndrome protein CHD7 regulates epigenomic activation of enhancers in granule cell precursors and gyrification of the cerebellum.

Regulation of chromatin plays fundamental roles in the development of the brain. Haploinsufficiency of the chromatin remodeling enzyme CHD7 causes CHARGE syndrome, a genetic disorder that affects the development of the cerebellum. However, how CHD7 controls chromatin states in the cerebellum remains incompletely understood. Using conditional knockout of CHD7 in granule cell precursors in the mouse cerebellum, we find that CHD7 robustly promotes chromatin accessibility, active histone modifications, and RNA polymerase recruitment at enhancers. In vivo profiling of genome architecture reveals that CHD7 concordantly regulates epigenomic modifications associated with enhancer activation and gene expression of topologically-interacting genes. Genome and gene ontology studies show that CHD7-regulated enhancers are associated with genes that control brain tissue morphogenesis. Accordingly, conditional knockout of CHD7 triggers a striking phenotype of cerebellar polymicrogyria, which we have also found in a case of CHARGE syndrome. Finally, we uncover a CHD7-dependent switch in the preferred orientation of granule cell precursor division in the developing cerebellum, providing a potential cellular basis for the cerebellar polymicrogyria phenotype upon loss of CHD7. Collectively, our findings define epigenomic regulation by CHD7 in granule cell precursors and identify abnormal cerebellar patterning upon CHD7 depletion, with potential implications for our understanding of CHARGE syndrome.

To assess the efficacy of safety measures adopted during endoscopy in the Corona Virus Disease-19 era for health care professionals-A single-centre tertiary care hospital experience.

BACKGROUND AND OBJECTIVES: During Corona Virus Disease-19 (COVID-19) pandemic, it has been estimated that approximately 10% of health care professionals (HCPs) have been diagnosed contacting  COVID-19. Aerosol-generating procedures have led to change in safety practices among HCPs. We thus evaluated the efficacy of the endoscopic safety measures among HCPs posted in the endoscopy unit. METHODS: In this retrospective analysis, all endoscopic procedures performed over a period of 4 months, from 1 April to 31 July 2020 were included. We noted indications and number of COVID-positive procedures as well as comprehensive screening of HCPs posted in our endoscopy unit. The aim of the study was to evaluate the incidence and outcome of COVID-19 among HCPs. RESULTS: Three thousand four hundred and sixty procedures were included in the analysis. Indications were divided as urgent (n = 190, 5.49%), semi-urgent (n = 553, 16%) and non-urgent group (n = 2717, 78.52%). Thirty-four procedures (0.98%) were done on diagnosed COVID-19 patients. The most common indications were gastrointestinal bleed (n = 12/34, 35.30%) followed by biliary sepsis (n = 9/34, 26.5%). Among the HCPs, the incidence of symptomatic COVID-19 was 6.58% (n = 5/76). All HCPs recovered with excellent outcomes. A comprehensive screening showed 7.90% (n = 6/76) HCPs having Immunoglobulin G (IgG) antibody in their sera. CONCLUSION: Addition of safety measures in endoscopy leads to low risk of transmission among HCPs.

An in vitro evaluation of tensile bond strength of soft liners bonded to different denture base resins.

Background: Clinically, adhesion failure is the most critical problem because of the failure of the optimal bond between denture base and the soft liner. Objectives: This study was performed to assess the tensile bond strength of two temporary soft liners to different denture base resins. Materials and Methods: Forty-eight blocks with 16 samples each of heat-cured denture base resin of three different types were fabricated from custom-made stainless steel die after de-waxing mold space. Surface roughening of each acrylic resin specimens which bonds with soft liners was done by abrading the surface and to this temporary soft liners (Perma soft denture liner and Pro soft denture liner) were bonded. The universal testing machine was used to test the tensile strength of bonded space. The results were statistically analyzed using the Statistical Software IBM SPSS Statistics for Windows, version 20.0. (Armonk, NY, USA: IBM Corp.) using the Chi-square test, Post hoc Tukey's HSD, and two way ANOVA tests. Results: It was observed that Perma soft was prevalent over Pro-soft denture liner on the basis of tensile bond strength with all three different types of denture base resins. Trevalon HI and acrylic composite exhibited better bond strength results with both Perma soft and GC Pro-soft denture liner as compared to other types of denture base resins. Conclusion: Perma soft had a better bond strength compared to Pro-soft denture liner in bonding modified denture base and conventional resins.

RésuméFond: Cliniquement, l'échec d'adhésion est le problème le plus critique à cause de l'échec de l'obligation optimale entre la base de râtelier et le paquebot mou. Objectifs: Cette étude a été exécutée pour évaluer la force d'obligation extensible de deux paquebots mous temporaires à de différentes résines de base de râtelier. Matériel et Méthodes: les blocs de Forty-eight avec 16 échantillons chacune de résine de base de râtelier heat-cured de trois différents types ont été fabriqués de l'acier inoxydable custom-made meurent après que de-waxing moisissent l'espace. Le fait de rendre rude de surface de chaques exemplaires de résine en acrylique que les obligations avec moules paquebots ont été faits en abrasant la surface et à ce temporaire les paquebots mous (Perma le paquebot de râtelier mol et le paquebot de râtelier mol Avantageux) étaient bonded. La machine de mise à l'essai universelle a été utilisée pour évaluer la limite élastique à traction d'espace bonded. Les résultats ont été statistiquement analysés en utilisant le Statistique Le logiciel IBM la Statistique de SPSS pour Windows, la version 20.0. (Armonk, NEW YORK, Etats-Unis: Société d'IBM.) l'utilisation de l'épreuve de Chi-square, Postez le HSD de Tukey hoc, et deux voie. Résultats: Il a été remarqué que Perma mol était qui prévaut sur le paquebot de râtelier Pro-soft sur la base de l'obligation extensible la force avec tous les trois différents types de râtelier base des résines. Trevalon SALUT et le composite en acrylique a exposé de meilleurs résultats de force d'obligation avec tant Perma mous que GC Pro-soft le paquebot de râtelier en comparaison d'autres types de râtelier basent des résines. Conclusion: Perma mol avait une meilleure obligation la force comparée au paquebot de râtelier Pro-soft dans bonding a modifié la base de râtelier et les résines conventionnelles.

An Unusual Case of Candida kefyr Fungemia in an Immunocompromised Patient.

An immunocompromised patient with a known history of cerebrovascular accident (CVA) with right-sided hemiparesis of long duration, type 2 diabetes mellitus, and hypertension presented with signs of rhabdomyolysis and later acute kidney injury (AKI). He subsequently developed Guillain Barre syndrome. Initially, hemodialysis was followed by plasmapheresis. After hemodialysis, the patient presented with multiple episodes of vomiting and weakness of all limbs. A culture showed growth of Enterococcus faecalis, and on Day 6, a bloodstream infection with Candida kefyr and a urinary tract infection with Enterococcus faecalis were diagnosed. We report a rare case of bloodstream infection due to C. kefyr.