Antimicrobial efficiency against fish pathogens on the green synthesized silver nanoparticles.

Fish-borne pathogens such as A. hydrophila and F. aquidurense are the most resistant strains in pisciculture farming. Removing the aforementioned pathogens without antibiotics presents a formidable challenge. To overcome this problem, silver nanoparticles (AgNPs) are synthesized using silver nitrate, water medium, and as an AzadirachtaIndica leaf extract via the green synthesis route. X-ray diffraction (XRD) pattern results authenticate the synthesized material is the face-centered cubic structure of silver. The optical absorption edge of the synthesized product was found at the wavelength of 440 nm from the UV-visible spectra, which is confirmed to relate to the Surface Plasmon Resonance peaks of silver particles. In addition, the optical band gap value of the synthesized Ag sample is measured to be 2.81 eV from the obtained optical absorption spectra. EDX spectrum of the synthesized product also supports confirming the silver particle formation. The FT-IR spectra of the neem extract and silver nanoparticles showed their characteristic functional groups, respectively. The presence of bands between 1000 cm-1 to 500 cm-1 indicates to the formation of silver particles. Spherical particles appeared in the synthesized Ag using Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). The particle size of Ag NPs was measured as 40 nm and 62 ± 10 nm by TEM and Dynamic Light Scattering (DLS). The zeta potential was also measured as -12 mV showing the synthesized sample's stable nature. Using the DPPH assay, synthesized AgNPs were taken along with the various concentrations of ascorbic acid (20, 40, 60, 80, and 100 µg/mL) to examine the free radical scavenging activity (RSA). RSA value is higher (84 ± 2 %) for synthesized AgNPs at higher concentration (100 µg/mL) than 21 ± 2 % at low concentration (100 µg/mL). The antimicrobial efficacy of the AgNPs against A. hydrophila and F. aquidurense was performed through the agar diffusion method and its results showed the inhibitory zones of the F.aquidurense and A. hydrophila were measured as 25 ± 3 mm, and 28 ± 4 mm respectively. The synthesized Ag particles showed excellent antimicrobial and antioxidant properties confirmed by antimicrobial and DPPH experiments. It implies that the green synthesized silver nanoparticles could be a good alternative for antibiotics in aquaculture farms. The exposure of low concentrations of silver nanoparticles to zebrafish and brine shrimp does not affect the viability and morphology. The exposure of silver nanoparticles in the fisheries in optimized concentration and time could control the fish-borne pathogens without antibiotics.

Exosome-Based Macromolecular neurotherapeutic drug delivery approaches in overcoming the Blood-Brain barrier for treating brain disorders.

Delivering drugs to the brain is a complex challenge in medical research, particularly for disorders like Alzheimer's and Parkinson's. The blood-brain barrier restricts the entry of many therapeutic molecules, hindering their effectiveness. Nanoparticles, a potential solution, face issues like toxicity and limited approvals. A new avenue explores the use of small extracellular vesicles (sEVs), i.e., exosomes, as natural carriers for drug delivery. sEVs, tiny structures below 150 nm, show promise due to their minimal immune response and ability to precisely deliver drugs. This review focuses on the potential of sEVs-based drug delivery systems for treating neurological disorders, brain cancers, and other brain-related issues. Notably, bioengineered sEVs-carrying therapeutic compounds exhibit promise in early studies. The unique features of sEVs, such as their small size and natural properties, position them as candidates to overcome challenges in drug delivery to the brain. Ongoing clinical trials and research into sEVs behavior within the body further highlight their potential for revolutionizing drug delivery and addressing complex brain conditions.

Evaluating the Plantar Pressure Loading and Its Correlation to Craniocervical Posture in Subjects With Skeletal Class II Malocclusion Before and After Surgical Mandibular Advancement.

Class II malocclusion is one of the most prevalent types of malocclusions following Class I. The most typical postural features observed in Class II patients are extended craniocervical posture, cervical lordosis, and increased forward loading away from the body's centre of mass for compensating the mandibular deficiency and reduced airway. Its treatment involves orthodontic, functional, and orthognathic surgery. The type of treatment regimen opted for depends upon the age, severity of malocclusion, and need of the patient. Thus, appropriate intervention brings about improvement in dentition along with an overall enhancement of the body posture and plantar loading. These variables undergo a significant change whenever there is a change in the maxillomandibular relationship. The main aim of this paper is to correlate the variation in the craniocervical angulation to the plantar pressure distribution during various phases of orthodontic treatment and bilateral sagittal split osteotomy (BSSO) advancement surgery. The craniocervical angulations were determined from the lateral cephalograms of the patients using cephalometric variables and the plantar pressure was estimated using a digital quanpressurometer device (designed and patented in India by Meenakshi Academy of Higher Education and Research; patent number 390136) at each phase, i.e., during pre-treatment, pre-surgery, post-surgery, post-treatment intervals. The outcome of this study indicated that there was a significant change in the craniocervical angulation and the plantar pressure distribution pattern of the subjects before and after orthognathic surgery and it remained constant for six months after orthognathic surgery. The limitation of the study was the limited sample size. This study reveals that there was an improvement in the craniocervical angulation and plantar pressure distribution during the course of orthodontic decompensation and orthognathic surgical treatment, thus bringing about change in the individual's overall body posture and their plantar loading pattern after orthognathic surgery. Therefore, the change in the stomatognathic system by orthodontic and orthognathic treatment influences the overall muscular and functional balance of an individual thereby improving their attitude and lifestyle.

A short review on minimally invasive implants.

In the last 30 years, the use of dental implants to replace missing teeth has increased immensely. Brånemark pioneered the use of extensive surgical flaps to visualise the surgical field during implant surgery. Since then, several changes have been made to the flap design with aesthetic considerations now being incorporated. Such major innovations have contributed to the wide acceptance of flapless implant surgery. Therefore, it is of interest to describe the various techniques, requirements, advantages and disadvantages of minimally implant surgery.

Investigation of emission characteristics in Er3+- doped bismuth phosphate glasses for NIR laser materials.

Bismuth flourophosphate glasses doped with Er3+ ions (0.5 mol %) were synthesized using different modifier fluorides with the aid of melt quenching route. The glass samples were labelled as PBiBaAFT (where AF = Li, Na, Mg, K, Ca and Sr fluorides). The influence of cations of network modifiers on the structure and thereby spectroscopic properties of Er3+ ions was analysed via Powder XRD, FTIR, optical absorption and photoluminescence. Existence of relevant vibrational groups and modifications in structure due to the different admixture modifier cations were recognized via FTIR spectra. The Judd-Ofelt parameters abide by the trend Ω2 > Ω6 > Ω4 in the PBiBaLiT, PBiBaKT, PBiBaCaTand PBiBaSrT glasses whereas the trend was noticed to be Ω2 > Ω4 > Ω6 for PBBiNaT and PBiBaMgT glasses respectively. The visible emission spectra were recorded by exciting at 379 nm exhibit three emission bands centered at 526 nm, 544 nm and 686 nm. NIR emission spectra were recorded by exciting at 980 nm exhibit broad emission at 1535 nm. Admixture of different cations could exhibit change in luminescence intensity and radiative parameters of the prepared glasses. Spectroscopic parameters such as radiative transition probability (A), branching ratio (ß), absorption cross section (∑), effective bandwidth (Δλeff) and optical band gain (σe × Δλeff) are calculated. The mid infrared spectroscopic features were investigated.

Biomedical applications of nanomaterials in the advancement of nucleic acid therapy: Mechanistic challenges, delivery strategies, and therapeutic applications.

In the past few decades, substantial advancement has been made in nucleic acid (NA)-based therapies. Promising treatments include mRNA, siRNA, miRNA, and anti-sense DNA for treating various clinical disorders by modifying the expression of DNA or RNA. However, their effectiveness is limited due to their concentrated negative charge, instability, large size, and host barriers, which make widespread application difficult. The effective delivery of these medicines requires safe vectors that are efficient & selective while having non-pathogenic qualities; thus, nanomaterials have become an attractive option with promising possibilities despite some potential setbacks. Nanomaterials possess ideal characteristics, allowing them to be tuned into functional bio-entity capable of targeted delivery. In this review, current breakthroughs in the non-viral strategy of delivering NAs are discussed with the goal of overcoming challenges that would otherwise be experienced by therapeutics. It offers insight into a wide variety of existing NA-based therapeutic modalities and techniques. In addition to this, it provides a rationale for the use of non-viral vectors and a variety of nanomaterials to accomplish efficient gene therapy. Further, it discusses the potential for biomedical application of nanomaterials-based gene therapy in various conditions, such as cancer therapy, tissue engineering, neurological disorders, and infections.

Stress distribution and displacement in the maxillofacial complex during intrusion and distalization of the maxillary arch using miniplates versus mini-implants: a 3-dimensional finite element study.

OBJECTIVES: To three-dimensionally analyse the stress distribution and displacement pattern in the maxillofacial complex following intrusion and distalization of the maxillary arch using finite element analysis in skeletal class II malocclusion with prognathic maxilla and vertical maxillary excess using miniplates and mini-implants. MATERIALS AND METHODS: Finite Element models of a skull, Y-shaped stainless steel miniplate, mini-implant and a posted arch were generated. Three force levels (1) 200 g (2) 300 g and (3) 500 g per side were applied to the assembly. The models were pre-processed and the analysis was performed using ANSYS version 18.1 software. Alterations in von mises stress, principal maximum stress, principal minimum stress and compressive stress were analysed around the sutures and surface landmarks. RESULTS: With miniplates, there was a maximum stress concentration at the zygomatic buttress with even stress distribution at the fronto-maxillary, zygomatico-temporal, zygomatico-frontal and pterygomaxillary sutures along with anatomical landmarks such as frontal process of maxilla, ANS, Point A, prosthion and maxillary process of zygoma. First molars experienced greater distalization effects with buccal flaring when miniplates were used. With mini-implants, canine and premolars also exhibited greater distalization effects. In the root apices, lateral incisors showed increased lingual root movement with mini-implants. CONCLUSION: Miniplates provide a greater distalizing effect while mini-implants produce increased intrusive effect. The distalizing effect is greater when 500 g of force is applied using miniplates with significantly even stress distribution and displacement pattern.

Can IGF-1 serve as a reliable skeletal maturity indicator? A meta-analysis.

BACKGROUND: Many clinical studies have evaluated the role of biochemical mediators like insulin-like growth factor 1 (IGF-1) in assessment of skeletal maturity. But still the reliability of IGF­1 as an indicator of skeletal maturity remains controversial. OBJECTIVE: To assess the correlation between IGF­1 and different radiographic skeletal maturity indicators. SEARCH METHODS: Seven electronic databases (PubMed, Scopus, EMBASE, Medline, Cochrane CENTRAL, Web of Science and SciELO) were searched until January 2020 without any restriction based on language or date of publication. SELECTION CRITERIA: The study design included cross-sectional and longitudinal studies comparing IGF­1 and other skeletal maturity indicators (SMIs). DATA COLLECTION AND ANALYSIS: Data extraction was done by two reviewers independently; 15 studies were eligible to be included in the quantitative synthesis. RESULTS: There was significant positive correlation between IGF­1 and different SMIs until puberty which was 0.95 (confidence interval [CI] = 0.89, 1.02) for males and 0.87 (CI = 0.77, 0.97) for females. A negative correlation between IGF­1 and different SMIs was found after puberty which was -0.86 (CI = -0.97, -0.75) for males and -0.89 (CI = -0.98, -0.81) for females. The type of SMI compared and type of IGF­1 sample used accounted for the high heterogeneity found across the studies. Chronological age and number of months passed after puberty showed moderate negative correlation with mean IGF­1 levels which were -0.57 (CI = -0.67, -0.47) and -0.54 (CI = -0.66, -0.42). Annual increments in mandibular length showed significant positive correlation of 0.69 (CI = 0.48, 0.90). CONCLUSIONS: IGF­1 would serve as a promising alternative to conventional radiographic skeletal maturity indicators and in predicting the amount of residual mandibular growth.

New Insights for Consummate Diagnosis and Management of Oral Submucous Fibrosis Using Reactive and Reparative Fibrotic Parameter Derived Algorithm.

OBJECTIVE: Reproducibility of qualitative changes in histopathological diagnosis involving narrow variation is often challenging. This study aims to characterize the histological fibrotic events in detail so as to derive an in-depth multiparametric algorithm with individually quantified histological parameters for effective monitoring of the. disease process in oral submucous fibrosis and for potential therapeutic targets for early intervention. METHODS: Formalin fixed paraffin embedded (FFPE) blocks of oral submucous fibrosis (OSMF), were taken and sections were stained with Hematoxylin & Eosin stain and Masson Trichrome stain. Photomicrographs were assessed for various morphometric parameters with Image J software version 1.8. Linear Regression was used to model the relationship using Inflammatory Cell Count, Extent of Inflammation collagen stained area, Epithelial thickness integrated density of collagen, MVPA, Area, Perimeter, were taken as variables. RESULT: Inflammatory cell count and the extent of inflammation also decreased with increasing grades of OSMF. Collagen proportionate area, integrated collagen density and epithelial thickness were compared among different grades of OSMF. Grade IV OSMF had greatest mean collagen proportionate area , highest integrated collagen density and lowest epithelial thickness when compared to other grades of OSMF. Linear regression model revealed smaller variation between Grade I to Grade II. Whereas Grade II to Grade IV exhibited larger variation suggestive of increased growth rate and all the coefficients were found to lie within 95% confidence limits. CONCLUSION: Diagnostic algorithm with multiparametric regression model were derived and combinatorial therapeutic approaches have been suggested for more effective management of oral submucous fibrosis.

An effective strategy for development of docetaxel encapsulated gold nanoformulations for treatment of prostate cancer.

Nanoformulation based drug delivery is one of the most important research areas in the field of nanomedicine, which provides promising alternatives to the limitations of conventional chemotherapy. Nano drug delivery enables improved pharmacokinetic profile, bioavailability and therapeutic efficiency compared to the regular chemotherapeutic drugs. Herein, we have established a simple method for the synthesis of docetaxel (Dtx) encapsulated poly (ethylene glycol) (PEG) functionalized gold nanoparticles (AuNPs) for targeted drug delivery to prostate cancer. AuNPs were synthesized by the citrate ion reduction method followed by functionalization with thiol-PEG-amine (SH-PEG-NH2). SH-PEG-NH2 functionalized AuNPs were conjugated with the targeting vehicle, folic acid (FA). The anticancer drug, Dtx was encapsulated within AuNPs by the non-covalent linkage method. The physicochemical characteristics of the synthesized nanoformulations were extensively characterized by various spectral and microscopic studies. HR-TEM indicates the average size of the AuNPs is 16 nm and the nanoformulations is 18 nm. The encapsulation efficiency of the Dtx is ~ 96% which is confirmed by the elemental mapping analysis. The in vitro drug release profile of Dtx and AuNPs nanoformulations were studied by the dialysis membrane method. The anticancer activity of docetaxel encapsulated AuNPs were evaluated with prostate cancer cell lines (PC3). The drug encapsulated nanoformulations reduced the cell viability to about 40% (40 µM concentration at 24, 48 and 72 h of treatment). The optical microscopy observation reveals that the damage of prostate cancer cells after exposure to Dtx encapsulated AuNPs. The good cytotoxic activity of the present nanoformulation against prostate cancer cell lines enables its application for targeted drug delivery to prostate cancer.

Coping with diabetes during the COVID - 19 lockdown in India: Results of an online pilot survey.

AIM: The management of diabetes has become a challenge due to the COVID 19 lockdown. An online-based pilot survey was conducted to study how people with diabetes were coping with their Diabetes during the COVID - 19 lockdown. METHOD: The questions were designed in an online survey, Survey Monkey, to conduct this cross-sectional study. The link was generated and sent to 100 registered patients of the MV Hospital for Diabetes Royapuram who had not contacted the hospital after the lockdown announcement. The survey was done between April 1 and April 15, 2020.Oral consent was obtained through telephone before the link was sent by Whatsapp to them.The questionnaire consisted of questions on home blood glucose monitoring, regularity in doing their physical activity and dietary compliance and anxiety about the viral infection. RESULTS: 92% of the participants had Type 2 diabetes. Only 28% of the participants were checking their blood glucose levels regularly. 80% of the participants mentioned that they were following regular exercise and diet control during the lockdown period. 40% of the participants were anxious about the Covid infection. CONCLUSION: SMBG needs to be practiced on regular basis, especially among the patients with diabetes on insulin therapy. Most of the people surveyed were coping well with their Diabetes. Patients have reported that they were able to maintain proper dietary compliance and be more physically active at home during this lockdown. These findings need to be ascertained in larger sample of patients.

Evaluation of cytotoxic activity of docetaxel loaded gold nanoparticles for lung cancer drug delivery.

The effective use of the gold nanoparticle (AuNPs) conjugated drugs for targeted drug delivery applications is one of the most promising research areas in the field of cancer. Herein, we aimed to establish a nano drug conjugated with docetaxel as a possible therapy option. Gold nanoparticles were synthesized by chemical reduction method. This is followed by the conjugation with an anticancer drug, docetaxel (Dtx) by a non-covalent method and folic acid (FA) was conjugated by a covalent method. The physicochemical characteristics of the synthesized AuNPs, Dtx and FA were studied by various analytical techniques such as UV-vis spectroscopy (UV-vis), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), field emission scanning electron microscope (FE-SEM) high-resolution transmission electron microscope (HR-TEM) and energy dispersive X-ray spectroscopy (EDS). The surface morphology and microstructure of the synthesized AuNPs and gold conjugates (AuNPs-Dtx-FA) were examined by FESEM and HR-TEM. The average size of the spherical shaped AuNPs was observed in the range of 5-18 nm. XPS and EDS spectra were examined the oxidation state and chemical composition of the synthesized nanoparticles. The cytotoxicity of the synthesized AuNPs nano-conjugates was evaluated by in-vitro studies against lung cancer cell line (H520). The chemical reduction method followed here in the development of AuNPs is a simple and one-step process, which exhibits the excellent binding specificity, biocompatibility and feasible for the large scale up process of the AuNPs.

Surgical Correction of Brodie Bite in Adults: A Novel Surgical Splint.

INTRODUCTION: The incidence of telescopic bite is a rare occurrence. Brodie bite malocclusions manifest with severe skeletal and dental transverse, sagittal and vertical problems. MATERIALS AND METHODS: A patient presenting with a telescopic bite and mandibular retrognathism was treated by orthognathic approach. A unique surgical splint was used as an aid in performing the maxillary constriction and segmental osteotomy. CONCLUSION: The telescopic bite was corrected successfully and occlusal rehabilitation was achieved.

SLCO1B1 gene polymorphisms do not influence plasma rifampicin concentrations in a South Indian population.

OBJECTIVE: To determine the effect of SLCO1B1 gene polymorphisms (rs11045819, rs4149032 and rs4149033) on rifampicin (RMP) concentrations in adult tuberculosis (TB) patients from south India. METHODS: We genotyped adult TB patients for three SLCO1B1 gene polymorphisms-rs11045819, rs4149032 and rs4149033-and compared 2-h post-dosing RMP concentrations of the different genotypes for each of the polymorphisms. Plasma RMP was determined using high-performance liquid chromatography. Genotyping was performed using direct sequencing. RESULTS: Among the 256 study patients, minor allele frequencies were respectively 0.01 (A), 0.46 (C) and 0.07 (A) for rs11045819, rs4149032 and rs4149033 polymorphisms; genotype distributions followed Hardy-Weinberg equilibrium. RMP concentrations did not significantly differ between the different genotypes of the three polymorphisms. CONCLUSION: This is the first study to show that rs11045819, rs4149032 and rs4149033 polymorphisms in the SLCO1B1 gene did not influence RMP concentrations in Indian patients.

A novel pattern mining approach for identifying cognitive activity in EEG based functional brain networks.

The complex nature of neuronal interactions of the human brain has posed many challenges to the research community. To explore the underlying mechanisms of neuronal activity of cohesive brain regions during different cognitive activities, many innovative mathematical and computational models are required. This paper presents a novel Common Functional Pattern Mining approach to demonstrate the similar patterns of interactions due to common behavior of certain brain regions. The electrode sites of EEG-based functional brain network are modeled as a set of transactions and node-based complex network measures as itemsets. These itemsets are transformed into a graph data structure called Functional Pattern Graph. By mining this Functional Pattern Graph, the common functional patterns due to specific brain functioning can be identified. The empirical analyses show the efficiency of the proposed approach in identifying the extent to which the electrode sites (transactions) are similar during various cognitive load states.

Effectiveness of TB sensitization initiatives in improving the involvement of self help group members in rural TB control in south India.

Background: The 'End TB strategy' has highlighted the importance of inter-sectoral collaboration and community mobilization for achieving zero TB deaths by 2020. Objective: The aim of the study was to develop and test a model TB sensitization programme involving self help groups (SHGs). Methodology: This experimental study was conducted in two blocks (intervention and control), in Tiruvallur district. The intervention content included short-lecture, musical story telling activity, role play, short film on TB. The impact was compared at baseline, third and sixth months in terms of SHGs' awareness, promotion of awareness, identification and referral of presumptive TB cases and provision of TB treatment. Results: A total of 764 vs 796 SHGs were enrolled in control and intervention groups, respectively. The knowledge attitude, and practice score (lower score indicated a better attitude and practice), from baseline to 6 months was significantly reduced (29 to 24) in the intervention group. Similarly, a significant difference was observed in identification and referral of chest symptomatics in the intervention group at 3 and 6 months. During the 3 month follow-up a significantly higher proportion of SHG members were involved in TB awareness activities in the intervention (623/748 [83.3%]) vs control group (471/728 [64.7%]; p<0.001). Conclusions: Findings from this study highlight the feasibility of involving SHGs through a model TB sensitization program for strengthening TB prevention and control activities.

A rare case of foreign body causing recurrent vaginal discharge in prepubertal child.

Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic.

Small cell neuroendocrine carcinoma of the paranasal sinus.

Small cell neuroendocrine carcinoma (SNEC) is an uncommon tumor. This tumor usually occurs in the lungs, the extra-pulmonary form accounts for only about 4% of all cases. Primary SNEC of the paranasal sinuses is extremely rare; only about 76 cases have been reported in literature. Unfortunately due to the rarity of this neoplasm, there are no specific recommendations pertaining to the management, treatment options are generally extrapolated from similar tumors of pulmonary origin. While Surgery was used in the past, upfront chemoradiation now seems to be evolving as the treatment of choice. We report a case of sinonasal SNEC who had undergone definitive concurrent chemoradiation and is currently disease-free for close to 2 years. The clinical presentation, imaging studies, histopathological diagnosis with immunohistochemistry correlation, management protocols, and a brief review of literature of this rare tumor is discussed.

Osteogenesis imperfecta/lobstein syndrome associated with dentinogenesis imperfecta.

Osteogenesis imperfecta is a collagen related disorder characterized by increased bone fragility and low bone mass. The important oral finding in osteogenesis imperfect is the presence of dentinogenesis imperfecta. This article presents a case of osteogenesis imperfecta (type IV B) with dentinogenesis imperfecta where a 7-year-old girl had opalacent primary teeth associated with severe bone deformity, scoliosis, barrel shaped rib cage, and short stature. The clinical, radiographic ad histologic features are reviewed along with management aspects.

The relevance of "Nonsmoking-associated lung cancer" in India: a single-centre experience.

BACKGROUND: Lung cancer remains a major cause of morbidity and mortality worldwide, accounting for more deaths than any other cancer cause. AIM: The aim of this study was to analyze the clinical profile and the epidemiological trends in lung cancer patients from a single centre with an emphasis on the smoking practices. MATERIALS AND METHODS: This is a retrospective analysis of prospectively collected data of 258 consecutive hospital in-patients with a proven diagnosis of lung cancer at a tertiary care oncology centre between 2003 and 2007. RESULTS: The median age of patients in our study was 56 years; the male to female ratio was approximately 3.5:1. Non-small-cell lung cancer (NSCLC) was the predominant histology in 224 patients; the histology in the remaining 34 patients was small-cell carcinoma. Within NSCLC, the most common histology was adenocarcinoma followed by squamous cell carcinoma. One hundred and two patients were never-smokers as compared to 156 patients who were ever-smokers. Among the smokers, the majority of them were found to be cigarette smokers compared to 28.2% bidi smokers. There was a very significant correlation found with adenocarcinoma among nonsmokers, and with squamous cell carcinoma among the smokers compared to non-smokers. CONCLUSIONS: Our study suggests that the epidemiology of lung cancer in India is possibly changing, with close to 40% of our lung cancer patients being nonsmokers. More importantly, our study reflects the global trend of rise in adenocarcinoma histology. These observations need to be substantiated in similar studies of larger magnitude, preferably population-based.