Effect of Three Different Cooling and Insulation Techniques on Pulp Chamber Temperature during Direct Temporization with Polymethyl methacrylate-based Resin.

AIM AND OBJECTIVE: This in vitro study evaluates and compares the changes in pulp chamber temperature during direct fabrication of provisional restorations in maxillary central incisors after using three different cooling techniques. MATERIALS AND METHODS: Total of 60 samples of maxillary central incisors along with their putty indices were divided into four groups (one control and three experimental) and were prepared using a surveyor cum milling machine. Teeth were sectioned 2 mm below cementoenamel junction and a K-type thermocouple wire was inserted in the tooth and secured at the pulpal roof using amalgam. Putty index filled with DPI tooth molding resin material [polymethyl methacrylate (PMMA)] was placed on the tooth and temperature changes per 5 seconds were recorded by temperature indicating device for the control, on-off, precooled putty, and dentin bonding agent (DBA) group. RESULTS: The highest mean obtained was of the control (11.04°C), followed by DBA group (9.53°C), precooled putty group (6.67°C), and on-off group (1.94°C). Precooled putty index group took maximum time to reach the baseline temperature (847.5 seconds). CONCLUSION: On-off technique is the most effective method to reduce the intrapulpal temperature during polymerization, as compared to the other techniques used in the study. Retardation in the polymerization process was seen in precooled putty group, which may make this technique clinically inadvisable. CLINICAL SIGNIFICANCE: Thermal protection of pulp must always be considered during direct fabrication of provisional restoration when a PMMA-based resin is used. By using on-off technique, not only the thermal insult to the pulp can be effectively minimized but also the harmful effects of residual monomer (poor marginal fit and pulpal irritation) can be eliminated.

Economic gradient of onset of disability in India.

BACKGROUND: Disability in India is associated with increasing non-communicable diseases, rising longevity, and increasing accidents and injuries. Though studies have examined prevalence, patterns, and socioeconomic correlates of disability, no attempt has been made in estimating age of onset of disability in India. OBJECTIVE: This paper investigates the economic gradient of age of onset of locomotor, visual, hearing, speech, mental retardation, mental illness, and other disabilities in India. METHOD: We use nationally representative data of 106,894 disabled individuals from the 76th round of National Sample Survey (NSS), 2018. Descriptive statistics, kernel density, Kaplan-Meier survival curves, and linear regression models are used in the analysis. RESULT: The disability rate in India was 2184 per 100,000 persons. The disability rate was highest for locomotor (1353) followed by hearing (296), visual (234), speech (228), mental retardation (158), and mental illness (131). Over 85% of mental retardation and 80% of speech disabilities occur at birth, while 82% of locomotor and 81% of visual disabilities occur after birth. Among those who had disability after birth, the median age for mental retardation was 2 years followed by mental illness (28 years), speech (29 years), locomotor (42 years), visual (55 years), and 56 years for hearing disability. Adjusting for socioeconomic covariates, the age of onset of locomotor and speech disabilities among the poorest individuals were 7 and 11 years earlier than the richest, respectively. CONCLUSION: The economic gradient of onset of locomotive and speech disabilities are strong. The age of onset of disability was earliest for mental retardation followed by mental illness and speech disability.

Morbidity compression or expansion? A temporal analysis of the age at onset of non-communicable diseases in India.

While there is evidence of morbidity compression in many countries, temporal patterns of non-communicable diseases (NCDs) in developing countries, such as India, are less clear. Age at onset of disease offers insights to understanding epidemiologic trends and is a key input for public health programs. Changes in age at onset and duration of major NCDs were estimated for 2004 (n = 38,044) and 2018 (n = 43,239) using health surveys from the India National Sample Survey (NSS). Survival regression models were used to compare trends by sociodemographic characteristics. Comparing 2004 to 2018, there were reductions in age at onset and increases in duration for overall and cause-specific NCDs. Median age at onset decreased for NCDs overall (57 to 53 years) and for diabetes, hypertension, heart disease, asthma, mental diseases, eye disease, and bone disease in the range of 2-7 years and increased for cancer, neurological disorders, some genitourinary disorders, and injuries/accidents in the range of 2-14 years. Hazards of NCDs were higher among females for cancers (HR 1.51, 95% CI 1.19-1.90) and neurological disorders (HR 1.18, 95% CI 1.06-1.32) but lower for heart diseases (HR 0.88, 95% CI 0.79-0.97) and injuries/accidents (HR 0.87, 95% CI 0.77-0.99). Hazards were greater among those with lower educational attainment at younger ages and higher educational attainment later in life. Unlike many countries, chronic disease morbidity may be expanding in India for many chronic diseases, indicating excess strain on the health system. Public health programs should focus on early diagnosis and prevention of NCDs.

Metabolism of the colonic mucosa in patients with inflammatory bowel diseases: an in vitro proton magnetic resonance spectroscopy study.

Metabolism of the colonic mucosa of patients with ulcerative colitis (UC; n=31) and Crohn's disease (CD; n=26) and normal mucosa (control, n=26) was investigated using in vitro high-resolution proton magnetic resonance spectroscopy. Of the 31 UC patients, 20 were in the active phase and 11 were in the remission phase of the disease. Out of 26 CD patients, 20 were in the active phase, while 6 were in the remission phase of the disease. Twenty-nine metabolites were assigned unambiguously in the perchloric acid extract of colonic mucosa. In the active phase of UC and CD, significantly lower (P