Compliance with COTPA (Packaging and Labeling) Rules, 2008 and its amendments in smokeless tobacco products sold across Mangaluru taluk, Karnataka, India.

Introduction: India introduced the Cigarettes and Other Tobacco Products Act (COTPA) (Packaging and Labeling [P and L]) Rules in 2008. These rules utilize the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack. The enormous burden of tobacco-related oral cancers in India necessitates the compliance with the law regarding presentation of information in powerful and salient ways, intentionally designed to increase the awareness in target individuals. Objectives: The objectives of the study are to assess the compliance to implementation and enforcement of the COTPA (P and L) Rules, 2008 and its amendments in 2014 and 2018. Materials and Methods: Chewing tobacco products were retrieved and evaluated for compliance with the law. The specified pictorial and textual health warnings, area, clarity, rotation, and language were assessed as per the recommendations. Results and Conclusion: Even though chewing tobacco products in India have introduced pictorial and textual health warnings, majority of them do not comply with the law. The products displayed the specified health warnings on a total of 70.6% on average, failing to abide by the government-specified average of 85%. 50% of the products did not follow the rotation of pictorial and textual health warning even after completion of the interregnum period of 12 months (September 2019). To ensure consumers' right to be informed about the health risks from a product, all the details regarding the contents, health warnings and messages, and product care instructions must be mentioned as specified under the law.

Single perforator-based anterolateral thigh flap, the workhorse flap, in oral cancer reconstruction: A tertiary care institution experience.

Background: Ablative procedures of the oral cavity require composite removal of tissues, which results in compromise of both functional activities and esthetic mutilation and proves to be a reconstructive challenge. This paper focuses on the reliability and versatility of a single perforator-based anterolateral thigh (ALT) flap in oral cancer reconstruction. Materials and Methods: All patients who underwent reconstruction with a single perforator-based ALT for oral cancer defects at our center were included in the study. Results: Forty-seven patients who underwent reconstruction with a single perforator-based ALT flap were included in our study. The average flap size in our series was 111 cm2, with the largest measuring 375 cm2. They was a complete loss of flap in two patients; both of them underwent salvage procedure and were reconstructed with pectoralis major myocutaneous flap. One had a partial loss that underwent re-exploration. Conclusion: We conclude that a single perforator-based ALT is a very safe, reliable, and versatile flap for head and neck reconstruction. The microvascular anastomosis may be expensive and technically a limitation; however, it has found a permanent place in our head and neck reconstructive toolkit and is the workhorse flap for head and neck reconstruction.

Acantholytic variant of squamous cell carcinoma in the mandible: A rare entity and a brief review.

Acantholytic Squamous Cell Carcinoma (ASCC) is an uncommon histopathologic variant of Squamous Cell Carcinoma which occurs in the sun-exposed skin and rarely in the oral cavity. Although the World Health Organization (WHO) has defined ASCC as a unique entity, its occurrence in the oral cavity has been just about 60 cases in the literature. There have been cases reported in the lips, tongue, gingiva and maxillary alveolus but rarely in the mandible. Definitive diagnosis and treatment of such a rare condition is challenging as there are not much available data in the literature. We report a rare case of Acantholytic Squamous cell carcinoma with pathologic fracture of the mandible which was managed aptly considering its hostile clinical, radiological and histological presentation. The reconstruction was done using a vascularised free fibula graft which helped in achieving a functional and aesthetic rehabilitation for the patient thereby improving his quality of life.

Game-Based Dual-Task Exercise Program for Children with Cerebral Palsy: Blending Balance, Visuomotor and Cognitive Training: Feasibility Randomized Control Trial.

The objective of this exploratory randomized controlled trial (RCT) was to provide evidence for the feasibility and therapeutic value of a novel game-based dual-task balance exercise program in children with cerebral palsy (CP). Twenty children with CP were recruited and randomized into two groups: (a) the conventional balance training group (CG) and (b) the experimental group (XG), which received a game-based dual-task (DT) balance exercise program. Both groups received their respective therapy programs for 12 weeks at a frequency of three sessions per week. Semi-structured interviews with the parents and children and qualitative analysis were conducted to evaluate the children's experiences with the game-based exercise program. The quantitative analysis included (a) the Pediatric Balance Scale (PBS), (b) Gross Motor Function Measure-88 (GMFM-88), and (c) computerized measures of standing balance performance during various dual-task conditions. Compliance was 100% for all 20 participants. Four themes captured the range of each participant's experiences and opinions: (a) reasons for participation, (b) likes and dislikes with the technologies, (c) positive effects of the program, and (d) future expectations. Children in the XG demonstrated greater improvements in PBS, GMFM, and DT balance measures as compared to children in the CG. The findings demonstrate feasible trial procedures and acceptable DT-oriented training with a high compliance rate and positive outcomes. These findings support further research and development and progression to the next phase of a full-scale RCT to evaluate the clinical effectiveness of the game-based DT balance exercise program for children with CP.

Clinical and Radiological Profiles, Treatment, and Outcome of Pediatric Acquired Demyelinating Disorders of Central Nervous System.

INTRODUCTION: Demyelinating disorders of central nervous system are rare childhood disorders that cause significant physical and cognitive disabilities. Early diagnosis and appropriate treatment determines prognosis and outcome. OBJECTIVE: The objective of this work was to study clinical profile, investigative and radiological features, treatment, and outcome of children with demyelinating disorders. MATERIALS AND METHODS: A retrospective chart review of 32 children with demyelinating disorders admitted in a tertiary-care pediatric hospital from Bangalore between November 2013 and October 2017 was conducted. Sociodemographic data, clinical features, cerebrospinal fluid (CSF) findings, radiological features, treatment received, and outcome were collected and results were analyzed. RESULTS: Among 32 patients of demyelinating disorders, majority were acute disseminated encephalomyelitis (ADEM) (15, 46.9%), followed by transverse myelitis (9, 28.1%), multiple sclerosis (MS) (3, 9.4%), optic neuritis (3, 9.4%), and neuromyelitis optica (NMO) (2, 6.2%). Mean age of presentation was 7.8 years. Among 32 patients, 15 were male (47%). In patients with ADEM, the mean age of presentation was 5.5 years. Two patients had tumefactive ADEM and 10 recovered after steroid therapy. In patients with MS, the mean age of presentation was 10.6 years; one patient died and the condition of two patients improved. In patients with transverse myelitis, the mean age of presentation was 8.9 years and seven patients recovered. In a patient with NMO, CSF was positive for antibody to aquaporin-4. The child improved with steroids and intravenous immunoglobulin. Three patients with optic neuritis were treated with steroids and they recovered. CONCLUSION: Even though demyelinating disorders are rare in pediatric age group, one should be aware of this entity as early diagnosis and treatment improves outcome. Most common among them is ADEM.

Recognition of Oral and Maxillofacial Surgeons by Dental Professionals and Their Perceptions Regarding Cosmetic Facial Surgery-A Questionnaire-Based Study.

PURPOSE: The versatility of facial cosmetic surgery as a specialty has often been underestimated owing to the lack of knowledge and limited perception in our society. The present questionnaire-based study was performed to evaluate the attitude, knowledge, and perception of dentists regarding cosmetic facial surgery. MATERIALS AND METHODS: We devised a well-structured questionnaire study in which 3 population groups of subjects included 420 interns, 133 BDS graduates, and 564 MDS graduates of various specialties from various colleges in Mangalore City. Closed-ended questions were formatted to evaluate the knowledge regarding specific facial cosmetic procedures. The subjects were asked to match 5 different specialists with 10 conditions or procedures. To investigate whether the subjects had an understanding of the multidisciplinary characteristic of some of the procedures, they were also asked to choose the specialty surgeon who might have an additional role. The subjects were asked whether they were aware of any relative who had undergone a cosmetic facial procedure and whether they regarded the surgical result as acceptable. Furthermore, they were asked whether they would contemplate referring patients for cosmetic surgery for any facial malformation. The institutional review board granted exemption for our study. RESULTS: The results revealed that 94.9% of the professionals were ready to refer their patients for cosmetic facial surgery if required, and most had found the results satisfactory. Most of the dental professionals had knowledge regarding the various cosmetic facial procedures. However, they were not up to date regarding the magnitude of the progress and recent developments in the various specialties and were not able to refer their patients to the most appropriate specialist. CONCLUSIONS: It is essential to create awareness among dental professionals regarding the scope of cosmetic facial surgery and the range of cosmetic procedures that an oral and maxillofacial surgeon can perform.

Accuracy of palpation, ultrasonography, and computed tomography in the evaluation of metastatic cervical lymph nodes in head and neck cancer.

INTRODUCTION: India accounts for the majority of oral cancer cases occurring worldwide. The metastasis of oral cancer to the regional lymph nodes and distant sites determines the prognosis and the survival rate of this disease. OBJECTIVES: The aim and objectives of this study were to evaluate the accuracy of preoperative clinical methods such as palpation, ultrasonography (USG), and computed tomography (CT) in comparison with postoperative histopathological findings in determination of metastatic cervical lymph nodes and also to assess whether combining these techniques increases the specificity and sensitivity of lymph node metastasis in oral squamous cell carcinoma (SCC). METHODOLOGY: Totally, 26 consecutive biopsy proven cases of oral SCC were included, and the nodal status was evaluated by palpation, CT and ultrasound (US) and confirmed by histopathological examination. The results were presented in terms of sensitivity, specificity, predictive values, accuracy, and P value. RESULTS: Palpation, USG, and CT findings were compared with histopathologic findings by Fisher's exact test and the "P" value for palpation, US and CT were 0.003, 0.000, 0.000, respectively, which are statistically significant. CONCLUSION: US examination combined with CT gives a better assessment of the neck for nodal metastasis.

A rare case report of Ellis Van Creveld syndrome in an Indian patient and literature review.

Ellis Van Creveld syndrome (EVC) is a rare genetic disorder having autosomal recessive inheritance affecting the Amish population of Pennsylvania in USA with incidence of 1:244,000 for the general population. This syndrome consists of characteristic features such as bilateral postaxial polydactyly, chondroectodermal dysplasia, congenital heart defects and hypoplastic nails and teeth. There are few case reports of this syndrome reported in dental literature. We report a case of a 17 year old female presenting typical features of this syndrome and the oral findings of this patient which are the key diagnostic features.

Rising from Plagiarising.

Amongst the various forms of scientific misconduct, plagiarism has become increasingly prevalent in today's scientific process. Plagiarism is copying another author's ideas or words and portraying them as your own. Inclusion of another source's contents without giving credit to the source results in this unethical practice. Text derived directly from a source must always be put under quotation marks. Decreased awareness about plagiarism and what exactly constitutes it results in unintentional plagiarism. Plagiarism can be that of the ideas in which the author projects others' ideas as his own. It can also be that of the text also known as word to word plagiarism. Mosaic plagiarism is another form. Various guidelines formulated by esteemed scientific bodies such as World Association of Medical Editors, Committee on publication Ethics have provided an insight to authors, editors, publishers and peer reviewers into the practice of ethical writing. By understanding the true essence of plagiarism and following strict guidelines, it is certainly possible to avoid plagiarism. Various softwares are available to detect plagiarism. These softwares have a wide database which is scanned to reveal any kind of malpractice. If detected, it can have grave consequences causing not only retraction of the article but also loss of dignity. Failure to detect plagiarism reflects negatively on a journal. Originality is the true essence of any research or scientific paper. Any violation of this fact is an unforgivable offence. Thus, this review article attempts to cover the meaning, types, risks and ways to avoid plagiarism.

Peripheral calcifying epithelial odontogenic tumor - Case report.

The calcifying epithelial odontogenic tumor (CEOT), Pindborg tumor is a benign, slow growing, but locally invasive neoplasm. It is known to have a common intraosseous variant and a very rare extraosseous variant. We report an unusual case of an extraosseous variant of CEOT of unusual large size and maxillary anterior location, the treatment was planned considering the clinical, radiological and histological features. Though peripheral types are less aggressive and had no recurrence, in our case regular follow up is required considering the aggressiveness of the lesion and its proximity to important adjacent structures.

Oral and pharyngeal cancer in women.

Although in the United States the incidence of oral and pharyngeal cancer (OPC) has been significantly higher in men than in women, the identification of human papilloma virus as a risk factor for OPC has focused new scrutiny on who may develop OPC. One surprising element is that non-Hispanic white women have a higher incidence of OPC than of cervical cancer. OPC is thus a woman's disease, and diligence is needed to ensure that the occurrence of OPC in women does not go undetected by their oral health care providers.