Aim: The aim of the present study was to determine the prevalence of carotid artery calcification (CAC) in postmenopausal females on panoramic radiographs and to study the correlation of CAC with possible risk factors such as hypertension, osteoporosis, and hypercholesterolemia, among others. Materials and Methods: Totally, 1214 panoramic radiographs of postmenopausal females attending the Department of Oral Medicine and Radiology were examined for the presence of CAC. The subjects were also assessed for the presence of various risk factors and the possible correlation to CAC. Statistical analysis was done using Chi-square test, and P < 0.05 was considered to be statistically significant. Results: Two hundred and seventy-eight postmenopausal females presented with CAC and a prevalence of 22.9%. These patients presented with a medical history that was laden with risk factors, of which hypertension (71.2%) was the most common risk factor. Hypertension, hypercholesterolemia, osteoporosis, and obesity were significantly (P < 0.05) related to the presence of CAC while age, diabetes, and smoking were not significantly (P > 0.05) related to CAC. Conclusion: The incidental finding of CAC on panoramic radiographs during the routine dental examination can provide life-saving information for the identification of postmenopausal females who are at a higher risk for stroke. Oral clinicians should, therefore, record a proper medical history of such patients to identify the atherogenic risk factors and refer such patients to the physician for careful evaluation and conformation of the disease.

Objectives: We correlated the results of cervical lymph node (LN) status by T-tumor size, N-nodal metastasis, M-distant metastasis (TNM) staging, and fine needle aspiration cytology (FNAC) in oral cancer patients to assess the discrepancy index (DI) between nodal metastasis (N) and FNAC results of cervicofacial LNs. Materials and Methods: A total of 63 patients (29 females and 34 males) aged from 30 to 85 years were included in our study. Cervical LN status through TNM staging and FNAC results were matched and DI was calculated. Results: DI in case of nodal status was 64.10% and 43.47% for TNMN1 and N2, respectively, indicating that tendency for observation of positive result on FNAC increased from N1 to N2. Conclusion: Hence, we suggest that relying solely on clinical examination and routine diagnostic tests like FNAC may not be appropriate and additional diagnostic imaging modalities should be considered.

Background: Allergic conjunctivitis is commonly observed eye diseases in Sikkim, India due to the abundance of seasonal pollens, environmental pollutants, and house dust. We evaluated the efficacy of topical 0.03% tacrolimus eye ointment in the management of simple allergic conjunctivitis. Materials and Methods: A prospective observational study was designed consisting of 41 patients with refractory simple allergic conjunctivitis, whose condition responded very poorly to conventional anti-allergic eye drops (azelastine, olopatadine, chlorpheniramine maleate, sodium chromoglycate). Simple allergic conjunctivitis cases were diagnosed and followed up evaluating both subjective and objective findings (itching, photophobia, tearing, chemosis, conjunctival congestion, tarsal papilla, and eyelid edema). Existing ocular treatment was discontinued at enrolment and 0.03% tacrolimus ointment was applied into the conjunctival sac of the affected eyes twice daily for 4 weeks followed by a 2 weeks washout period. Patients were followed up at the end of 1 ^st week, 4 ^th week, and at 7 ^th week (2 weeks washout period). Results: Symptoms of simple allergic conjunctivitis (itching, tearing and photophobia) were significantly reduced at the end of 1 ^st week. Signs such as conjunctival chemosis, congestion, tarsal papillae, and eyelid edema were effectively treated in all cases at the end of 1 ^st week. At the end of 4 ^th week, all cases were fully cured and none of the patient had any recurrences up to 7 ^th week. Mean score at 1 ^st day (9.6 ± 3.27) was significantly (P < 0.0001) reduced by 7 ^th day (1.35 ± 1.19) of treatment. Conclusion: Topical application of tacrolimus ointment is an excellent alternative to anti-allergic and steroids eye drops for the treatment of simple allergic conjunctivitis as it significantly reduces recurrences.

Background: It is essential to understand the factors influencing the level of anxiety to dental treatment among different children as it can influence seeking dental care. Here, we assessed the impact of parental loss on dental anxiety among 6-13-year-old children. Materials and Methods: A total of 444 children within the age group 6-13 years were selected. Group 1 consisted of orphan children living in government-run orphanages, Group 2 consisted of orphan children taken care by a person with a motherly relationship, Group 3 consisted of abandoned children living in private organization and Group 4 consisted of children living with their parents. Dental anxiety was measured using children's fear survey schedule-dental subscale and modified faces version of modified child dental anxiety scale. Results: The highest number of anxious children were observed in Group 4 and the difference in the anxiety levels among the four groups was found to be highly statistically significant. Children living in government-run orphanages had least dental anxiety. Conclusion: All the orphans may not have the same anxiety levels and the environment of upbringing the orphans plays a significant role in the development of the anxiety.

Introduction and Objective: Abortion is the most common complication of pregnancy, defined as spontaneous expulsion of products of conception before 24 weeks of pregnancy or termination of pregnancy with a fetus weighing <500 g. The aim of this study was to compare the efficacy of intravenous immunoglobulin (IVIG) in combination regimens with aspirin and heparin versus aspirin and heparin combination alone in women with idiopathic recurrent abortion. Materials and Methods: This randomized, clinical trial was performed at Imam Khomeini Hospital in Sari-Iran between March 2010 and March 2013. Sixty people were randomly allocated into two groups. The control group was treated by subcutaneous enoxaparin 40 mg daily up to 24 weeks associated with aspirin 80 mg daily up to 37 weeks of gestation. The intervention group received IVIG 200 mg/kg monthly up to 24 weeks of gestation with enoxaparin and aspirin for the same therapeutic period and the same dose as the control group. Results: Three patients (10%) in the intervention group had abortion and 25 (90%) had live births with mean birth weight 3.5 ± 0.9 kg. Four patients (13%) in the control group had abortions, and 28 (87%) had live births with birth weight 3.4 ± 1.2 kg (P = 0.74). The difference was not statistically significant. Conclusions: It seems that employing the heparin and aspirin combination therapeutic regimen is appropriate for idiopathic abortions and avoids the high cost of IVIG use and its complications.

Aim: Tobacco use is the major cause of oral cancer, which is the sixth most common form of malignancy globally. Even in the absence of clinical manifestations, early changes in the oral mucosa can be detected microscopically by exfoliative cytology. The present study aimed to study and compare the cellular changes in the oral mucosa of tobacco users using cytomorphometry. Materials and Methods: A total of 80 subjects were included: 20 without any tobacco use habits, 20 tobacco chewers, 20 smokers, and 20 mishri users. Smears were collected from each subject, fixed, and stained using Papanicolaou stain. All slides were evaluated for nuclear and cytoplasmic changes using image analysis software. Results: Statistically significant decrease in cytoplasmic area and an increase in nuclear area and nuclear-cytoplasmic ratio were observed in tobacco users. Conclusion: Tobacco in any form causes significant cellular changes, which could be the earliest indicators of developing malignant pathology. Exfoliative cytology can be used to detect such changes.

Introduction: Although diarrheal diseases with known etiologies are under regular surveillance by the integrated disease surveillance project in India, only limited food-borne outbreaks were subjected to systematic epidemiological investigation. We examined one incidence of a food-borne outbreak among medical students in Bhopal, India, to identifying the source and mode of transmission, and to implement appropriate preventive measures. Materials and Methods: We constituted two teams. We did the line listing, filled the structured questionnaire and collected the biological samples. We did in-depth interviews of the case patients. We interviewed food handlers in mess. We randomly collected food and water samples. Results: The study results identified 30 hosteller case patients for a total of 239 students (overall attack rate [AR]: 12.6%). In female students, the AR was 18.1% and in the male students it was 6.7%. The AR was highest in female hostel no. One compared to other female and male hostel (19.8% vs. 14.3%, 6.7%). We identified four different risk factors for the illness. Discussion : As AR s are high compared to the general population. As the AR was high among the girls, the probable source of infection resides in the female hostel.

Background: Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas. Aims and Objectives: The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India. Materials and Methods: The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA). Results: A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs. Conclusions: A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI.

Background: Argyrophilic nucleolar organizer regions (AgNORs) is demonstrated to be useful in diagnostic pathology, mainly to distinguish benign lesions from their malignant counterparts. We aimed to correlate AgNORs pleomorphism with the severity of lesion in oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) using a retrospective study on 45 archival tissues. Materials and Methods: Silver nitrate staining was performed on archival tissues consisting of 20 OSMF and 20 OSCC. Five biopsies from normal oral mucosa acted as a control. One hundred cells per slide were observed for AgNORs dots, which were classified as typical (spherical) and atypical (large, kidney-shaped and clustered). Results: A positive and significant correlation was found between increased atypical shapes and increasing grades of OSMF and OSCC. Conclusions: AgNORs pleomorphism can be a reliable criterion to assess disease severity and progression in OSMF and OSCC.

Context: Glycyrrhizic acid (GA) is a triterpene glycoside representing the main active component of licorice root extract obtained from plants of the Glycyrrhiza glabra L. and widely used as a complex-forming agent for the synthesis of new transport forms of the well-known drugs. Aims: For the first time, the complexation of GA with chloramphenicol antibiotic (ChlA) was investigated by electrospray ionization mass spectrometry (ESI MS). Subjects and Methods: ESI MS was utilized in order to determine the composition and evaluate the stability of complexes of the GA and ChlA. The validation of the complex formation was confirmed by ultraviolet/visible and infrared (IR) spectroscopy. Results: MS data confirmed the noncovalent interactions between chloramphenicol and GA. Formation of the host: guest complexes of GA and chloramphenicol with the ratio 1:1 and 2:1 were registered in the negative ion mode. Binding of GA and ChlA was accompanied by changes in absorbance and IR spectrum of ChlA indicating the complex formation of these compounds. Conclusions: The research results confirmed the considerable potential of ESI MS as a technique for simple and fast detection of formation of the complexes of GA and the well-known drugs.

Purpose: The purpose of vitro study was to assessment of the bacterial contamination on daily twice-used toothbrushes in different conditions after 1-month and 3 months. Materials and Methods: Forty children aged between 6 and 12 years were selected for this study. Toothbrushes and toothpaste were distributed among those children. Among those children, 20 children brushed their teeth for 1-month and 20 brushed their teeth for 3 months twice a day. Among those, 10 were kept in same brush box with a family member and 10 were kept in separate brush box after the use. Toothbrush from every child was recollected to investigate the contamination of microorganisms. Head of the toothbrushes transferred to a tube containing 10 ml of tryptone soy broth. This was followed by vortex mixing for 1 min to dislodge suspected adherent bacteria. The bacterial suspension was serially diluted to obtain dilution factors of up to 10⁻³ . 1 ml each of the dilution factors was obtained using a sterile pipette and plated on plate count agar. Petri dishes containing agar media were incubated and examined using a compound microscope. Results: There was high mean difference between 1-month and 3 months, twice a day used toothbrush those kept with family members and those kept separate. Conclusions: Toothbrush should keep in a separate box. Moreover, toothbrush should to be change after 3-4 weeks.

Aims: We aimed to validate Mannheim peritonitis index (MPI) for prediction of outcome in patients with perforation peritonitis. Materials and Methods: A prospective study involving 100 subjects operated for perforation peritonitis over the period of 2 years was designed. Postevaluation of predesigned performa, MPI score was calculated and analyzed for each patient with death being the main outcome measure. The MPI scores were divided into three categories; scores <15 (category 1), 16-25 (category 2), and >25 (category 3). Results : Our study consisted of 82 males and 18 females (male:female ratio 4.56:1), with the mean patients age of 37.96 ± 17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3, respectively. The most common origin of sepsis was ileal with small intestine dominating the source of perforation. When the individual parameters of MPI score were assessed against the mortality only, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) significantly associated with mortality. The sensitivity of MPI was 92% with a specificity of 78% in receiver operating characteristic curves. Conclusion : MPI is an effective tool for prediction of mortality in cases of perforation peritonitis.

Aim: We compared the clinical efficacy of three gingival displacement systems to accurately record intra-crevicular margins of tooth preparation. Materials and Methods: One mechanical (magic foam cord) and two chemico-mechanical (expasyl paste and retraction cord impregnated with 15% aluminum chloride) gingival displacement systems were used. This study was conducted on the maxillary central incisors of 20 patients (20-60 years old) requiring full coverage restoration. All the three gingival displacement systems were tested in three sessions at an interval of 14 days in same order. The casts were sectioned and viewed under an optical microscope, followed by quantitative measurements of the width of the pre and postretracted sulci. Results: All the three displacement systems produced highly significant horizontal gingival displacement. Retraction cord soaked in 15% aluminum chloride produced maximum displacement (0.74 mm), followed by expasyl paste (0.48 mm) whereas magic foam cord produced the least displacement (0.41 mm). Conclusions: Gingival displacement shown by each displacement system was found to be more than the accepted value necessary for elastomeric impression accuracy (0.2 mm) to record intra-crevicular margins of tooth preparation.

Introduction: Diabetes mellitus is one of the emerging epidemics. Regular clinical and biochemical monitoring of patients, adherence to treatment and counseling are cornerstones for prevention of complications. Clinical audits as a process of improving quality of patient care and outcomes by reviewing care against specific criteria and then reviewing the change can help in optimizing care. Objective: We aimed to audit the process of diabetes care using patient records and also to assess the effect of audit on process of care indicators among patients availing diabetes care from a rural health and training center in Puducherry, South India. Materials and Methods: A record based study was conducted to audit diabetes care among patients attending noncommunicable disease clinic in a rural health center of South India. Monitoring of blood pressure (BP), blood glucose, lipid profile and renal function test were considered for auditing in accordance with standard guidelines. Clinical audit cycle (CAC), a simple management tool was applied and re-audit was done after 1-year. Results: We reviewed 156 and 180 patients records during year-1 and year-2, respectively. In the audit year-1, out of 156 patients, 78 (50%), 70 (44.9%), 49 (31.4%) and 19 (12.2%) had got their BP, blood glucose, lipid profile and renal function tests done. Monitoring of blood glucose, BP, lipid profile and renal function improved significantly by 35%, 20.7%, 36.4% and 56.1% over 1-year. Conclusion: CAC improves process of diabetes care in a primary care setting with existing resources.

Background: There is confusion in the current literature regarding the value of obtaining predebridement wound cultures in the management of open fractures with several studies reporting contrasting results. We undertook a pilot study to determine the initial bacterial flora of open fractures in our environment and determine the correlation between subsequent wound infection if any, and the initial bacterial flora. Materials and Methods: Initial/predebridement wound swabs were obtained for 32 patients with open fractures. Patients underwent a debridement of the open wound and preliminary stabilization of fracture in the operating room within 24 h. Postdebridement wound cultures were obtained at 48 h and repeated subsequently, if indicated, during the follow-up period. The antibiotic therapy was modified based on the culture reports. Results: Initial wound swab culture showed bacterial contamination in 18 patients (56%); 14 patients (44%) developed an infection in the immediate postoperative period or during follow-up. Age, gender, co-morbid medical condition, delay in presentation, and grade of open fracture were not found to be predictors of postoperative infection. No patient had an infection with the same organism, which was present in the initial culture. Conclusion: The findings of this study suggest that the initial flora are not the infecting organisms in the open fracture wounds, and predebridement wound cultures have no value in predicting postdebridement wound infection.

Background: Rural population in developing countries face water, sanitation, and hygiene-related health issues. To objectively highlight these issues, we studied the knowledge, attitude, and practices-related to drinking water and sanitation facilities among the rural population of Chennai, India. Materials and Methods: A cross-sectional study was designed involving individuals over 18 years of age living in Thandalam village, Chennai, India. Basic information about sociodemographic profile and existing drinking water and sanitation related knowledge, attitude, and practices was collected using a modified version of previously validated questionnaire and analyzed. Results: Forty-five percent of the participants were not following any methods of water treatment and among them half of the participants felt that water available to them was clean and did not require any additional treatment. Twenty-five percent of the participants surveyed did not have access to toilets inside their household. Conclusion: There is a need for intervention to educate individuals about drinking water treatment methods, sanitation, and hand washing practices.

Background: The main objectives of this study were to: (1) Evaluate the levels of thyroid hormones and glycosylated hemoglobin (HbA1c) among patients, (2) correlate between thyroid hormones and HbA1c and different types of lipids and HbA1c among diabetic patients. Materials and Methods: A retrospective chart review study was conducted at Department of Clinical Chemistry, King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia, during the period from August 2014 to December 2014, including 100 male and female patients diagnosed with diabetes mellitus (DM) type 2 and excluding patients with DM type 1. These patients were admitted to the hospital in 2013. Biochemical laboratory results were retrieved from biochemistry laboratory database while age and sex of patients were retrieved from patient files. Statistical analysis was performed using SPSS software conducting frequency analysis and correlation test. Results: The result showed increased mean levels of HbA1c (8.4%) and normal level of thyroid stimulating hormone (TSH) (4.5 mlU/L) and T4 (14.1 pmol/L). The results also showed a weak positive correlation between HbA1c and TSH (r = 0.212, P = 0.034) and insignificant correlation with thyroxin T4 (r = −0.018, P = 0.855). There was a weak positive correlation between HbA1c and total cholesterol and low density lipoprotein (r = 0.258, P = 0.001), (r = 0.297, P = 0.003), respectively. Conclusion: It is concluded that increased blood glucose could trigger anterior pituitary gland to increase secretion of TSH, whereas there was no direct correlation between increased glycemic index and the rate of thyroxine secretion. Furthermore, it is concluded that there is an association between blood glucose and some lipid markers.

Background: Diabetes mellitus (DM) is a significant risk factor for developing cardiac diseases. Hence, we compare the serum levels of cardiac troponin I (CTnI) among type 2 diabetic and healthy patients. We additionally correlated CTnI and creatinine levels with duration of disease. Materials and Methods: A cross-sectional study was conducted at Department of Clinical Chemistry, Sudan University of Sciences and Technology, Khartoum, Sudan, from February 2008 to February 2011. 200 patients diagnosed with DM type 2 from Jabir Abulizz Diabetes Centre in Khartoum state, Sudan, and 100 healthy volunteers were included in this study. Blood samples were collected from both groups, and the serum levels of CTnI, creatinine, fasting plasma glucose and glycosylated hemoglobin (HbA1c) levels were measured. Results: Significant increase in serum levels of CTnI, glucose, HbA1c, and creatinine was observed in diabetic patients compared to healthy controls. In addition, the significant increase in CTnI and creatinine levels was observed among diabetic patients with ischemic heart disease or hypertension when compared with those without ischemic heart disease or hypertension. Further a strong positive correlation was observed between the duration of diabetes and the serum levels of CTnI and creatinine (r = 0.84, P > 0.01) and (r = 0.72, P > 0.01), respectively. Conclusion: The higher levels of CTnI and creatinine may be indicative of progressive cardiovascular disease and nephropathy among diabetic patients.

Background: Notwithstanding, the growing incidence of sickle cell hemoglobinopathies (SCH) such as sickle cell anemia (SCA) or sickle cell disease, sickle/beta-thalassemia; the exact prevalence remains obscure in Saudi Arabia. Hence, this study is an attempt to determine the frequency of SCA and sickle cell trait (SCT) among all anemic patients with SCH treated at the King Abdul-Aziz Medical City (KAMC), Riyadh, Saudi Arabia. Furthermore, the hemoglobin (Hb) S and other Hb patterns (Hb AS and Hb F) were also estimated in SCA and SCT patients. Materials and Methods: Results of Hb capillary electrophoresis performed on all patients with SCH from January 2011 to December 2013 were evaluated retrospectively. Results: Of a total of 3332 patient data analyzed, 307 were anemic patients (58% males and 42% females) with SCH. The sickling test showed all the patients to be positive. Hb electrophoresis revealed the incidence of 96.7%, 3.3%, and 0% of the patients suffered from SCA, SCT and sickle/beta-thalassemia, respectively. Patients with SCA had a higher level of Hb F and showed no crisis when compared with other SCA patients who had lower or no Hb F levels. Conclusion: SCA is relatively frequent among males (56.4%) than females out of all patients with SCH. The SCA incidence was more common (48.5%) among children, frequency of SCT among adult age group was 1.6%, while sickle/beta-thalassemia was 0%.

Aim: We aimed to evaluate the levels of urine microalbumin, urine albumin creatinine ratio, plasma creatinine and glycosylated hemoglobin (HbA1c) among type 2 diabetic patients and assessed the correlation between microalbuminuria and plasma creatinine levels. Materials and Methods: A retrospective chart review study was conducted at Department of Clinical Chemistry, King Abdulaziz Medical City in Riyadh, Saudi Arabia, during August to December 2014. The study included 100 male and female patients diagnosed with type 2 diabetes mellitus (DM) and excluding patients with type 1 DM. Medical history and biochemical laboratory data were obtained from medical records and from biochemistry laboratory database. Results: Increase in mean level of plasma creatinine (138 μmol/L), urine microalbuminuria (240 mg/L), albumin creatinine ratio (82) and HbA1c (8.7%) was observed among type 2 DM patients. Moderate positive correlation was observed between microalbuminuria and urine albumin creatinine ratio (r = 0.509 P = 0.0006) and between urine albumin creatinine ratio and plasma creatinine (r = 0.553 P = 0.017). Conclusion : We concluded that type 2 DM patients who are at risk of developing renal impairment must be regularly monitored for microalbuminuria, urine albumin creatinine ratio, and HbA1c levels.

Aim: We evaluated the periodontal health status and oral health behavior among hospitalized patients with chronic obstructive pulmonary disease (COPD) to assess the association of COPD with dental health. Materials and Methods: A group of 100 hospitalized patients with COPD and a group of 100 age, sex, and race-matched control patients were included in this study. Detailed case histories along with standardized measures of oral health including gingival index, plaque index (PI), and simplified oral hygiene index (OHI) were estimated and compared. Probing depths and clinical attachment levels (CALs) were recorded at four sites per tooth. C-reactive protein (CRP) levels in saliva and serum were also measured. Results: The study subjects had similar demographics and distribution in either group. Patients with COPD had significantly lower brushing frequency, poor periodontal health (OHI and PI), greater gingival inflammation, and deeper pockets/CALs compared to controls. Further COPD patients had significantly higher serum and salivary CRP levels compared to control groups. Conclusions: Lower brushing frequency, poor oral health, and presence of destructive periodontal disease were observed among patients with COPD, which warrants promoting dental care and oral health knowledge as an integrated approach to treating COPD patients.

Hyperprolinaemia is characterized by increased tissue accumulation of proline (Pro) and is known to exert serious cognitive and/or neuropsychiatric symptomatology as a direct result of Pro accumulation in the brain. The aim of this study was to explore a putative link between experimentally-simulated hyperprolinaemia and the activity of acetylcholinesterase (AChE); a crucial neurotoxicity marker. In vitro experiments were undertaken on purified eel-derived AChE, as well as on adult mouse brain homogenates, in order to examine the effect of a spectrum of Pro concentrations (3, 30, 500, and 1000 μM) on this marker. Our data showed that although Pro exerted a significant inhibitory effect on pure AChE activity, mouse brain-derived membrane-bound AChE activity was found either unaltered or significantly increased following incubation with Pro. The use of AChE activity as a neurotoxicity marker within the context of experimentally-simulated hyperprolinaemia should be considered with caution and in parallel with a number of other experimental parameters.

Aims and Objectives: Harnessing Mother Nature's bountiful remedies for rejuvenation has been in vogue since time immemorial. Turmeric contains the polyphenol Curcumin in its rhizome. It produces reactive oxygen species (ROS) with visible light irradiation as photodynamic therapy (PDT) - which validates its use in the treatment of periodontitis. This study compares Curcumin and Curcumin PDT as an adjunct to conventional Scaling and Root Planing (SRP) with SRP alone in the treatment of patients with chronic periodontitis. Materials and Methods: Sixty sites in fifteen untreated chronic periodontitis patients were randomly assigned in a split mouth design for one of the treatment modalities; 1) Scaling and root planing (SRP) alone, (2) SRP + Curcumin application for 5 min, (3) SRP + Curcumin application for 5 min + irradiation with blue light emitting diode of wavelength 470 nm for 5 min. (Curcumin PDT) on "0" day.(4) SRP + Curcumin PDT on 0, 7 ^th and 21 ^st day. The clinical parameters included plaque index (PI), bleeding on probing (BOP) measured by sulcus bleeding index (SBI), probing pocket depth (PPD), clinical attachment level (CAL) recorded at the baseline & 3 ^rd month. The site with greatest probing pocket depth (PPD) was selected from each quadrant for bacterial sampling and culturing for Aggregatibacter actinomycetemcomitans (Aa) and other black pigment producing microorganisms (BPB) like Porphyromonas gingivalis & Prevotella intermedia. Conclusion: The present study showed that Curcumin photodynamic therapy is a valuable treatment modality adjunctive to conventional scaling and root planing over Curcumin application. Moreover, multiple adjunctive applications of photodynamic therapy are more beneficial than single application in reducing clinical & microbiological parameters.

Aim: To understand the dental health among prison inmates, we assessed the dental caries status of central prison inmates in Chennai, India. Materials and Methods: A total of 1060 inmates from three divisions of the central prison in Chennai were assessed by a single investigator for dental caries status based on World Health Organization specifications. Results: Among the inmates, 58.2% of males and 54.2% of females had decayed teeth. About 4.1% of males and 2.9% of females had filled teeth. The mean decayed, missing, filled teeth index was 5.1 and 3.9 for female and male prisoners, respectively. The prevalence of dental caries was highest among inmates younger than 24 years age. Conclusion: Our study suggests that a high proportion of prison inmates was affected by dental caries, which necessitates the need for initiating oral health promotion activities among prison inmates.

Introduction: In orthodontic treatment, three-dimensional (3D) dental casts has a significant role in diagnosis and treatment planning. The aim of this study was to evaluate Pont's index predictability in orthodontics. Materials and Methods: Premolar arch width, molar arch width and mesiodistal width of the maxillary incisors were measured three-dimensionally to assess shape of dental arches. The data source was cone beam computed tomography (CBCT) high volumetric data acquisitions from Malay ethnic background. Arch widths were measured and recorded from 53 subjects (32 male and 21 female with the mean age, 25.81), both the maxillary and mandibular arches, to obtain CBCT high volumetric data. All measurements were obtained through CBCT Planmeca Romexis TM Software 2.3.1.R (Helsinki, Finland). Results: Pont's formula overestimated the upper and lower interpremolar distance, with mean differences of 8.35 ± 3 mm and 12.02 ± 3.20 mm, respectively. Furthermore, the formula overestimated the upper and lower intermolar distance, with mean differences of 7.87 ± 3 mm and 16.14 ± 5.86 mm, respectively. Conclusions: The results indicate that Pont's index is not practical for use with the Malaysian population since the index overestimated interpremolar and intermolar widths. This raises questions whether the index is a true predictor of arch width measurements.

Background: Due to competitiveness and academic benefits, most dental professionals feel an urgent need to increase their publications. Hence, we explored the attitude of students and faculty members toward scientific publications through a questionnaire. Materials and Methods: A questionnaire consisting of 13 questions was sent by e-mails and posting the printed copies to dental postgraduate (PG) students (second and third year) and faculty members (n = 500 each). The returned completed questionnaires were analyzed. Results: About 37% of dental PG faculty and 35.6% PG students responded to the questionnaire, with overall response of 72.6%. Among the PG faculty, professors (P) had more scientific publications, followed by senior lecturers (SL) and readers (R). The publications as first or corresponding author were less among both faculty and PG students while co-authorship was more among PG students compared to faculty members. Awareness about the term "plagiarism" was overall high and relatively highest among R, followed by SL, P and PG students. The percentage of publications in fee charging journals was more among PG students than faculty members and self-funding for publication was observed in 86.4% of PG students and 94-100% among faculty members. Conclusion: About 72.6% of dental professionals were involved in publishing of their research work and the number of publications increased steadily with an increase in their academic experience. All the dental professionals concurred publications as the criteria for academic excellence.

Background: Misoprostol is very effective in cervical ripening and is used for termination of pregnancy. A similar effect on the nonpregnant uterus will facilitate gynecological operations, and hence we assessed the effect of misoprostol on the nonpregnant uterus of premenopausal women. Materials and Methods: In a prospective double-blinded randomized controlled trial, 280 women were randomly allocated into two groups (12 women did not complete the intervention). Study (A) and control (B) group received 400 μg of misoprostol or 400 mg of metronidazole tablets (as a placebo) respectively in the posterior vaginal wall 6 h prior to gynecological procedures. Results: The mean cervical dilatation was significantly higher (P < 0.0001) in misoprostol compared to placebo group (4.6 ± 0.96 mm vs. 3.6 ± 0.82 mm), benefit were also observed on secondary outcome measures which were need for further dilatation, time taken for further dilatation, ease of dilatation, subjective assessment of pain by visual analog scale. Only 3.61% patients complained of intolerable pain during dilatation in the study group while in control group 48.74% complained of intolerable pain and required anesthesia. Most common side effects of misoprostol were abdominal pain and mild vaginal bleeding. Conclusion: Misoprostol was effective in cervical ripening of nonpregnant premenopausal uterus to facilitate gynecological procedures.

Background: The oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC), although initiated by tobacco carcinogens, their progression is due to inability of Langerhans cells (LCs) to detect these abnormal cells and promote lymphocytes to destroy these cells. We assessed and quantified the tumor associated LCs and inflammation in OED and OSCC to understand their role. Materials and Methods: Fifty-five microscopic sections were assessed (27 OED and 28 OSCC). The LCs were detected using S-100 immunohistochemical marker. The number of tumor associated LCs were counted. The presence of abnormal appearing large cells and its relation to histopathologic grade and inflammation was assessed. Results: Significant increase in the LC count was observed in OSCC when compared to dysplasia. Large, abnormal appearing cells were observed in dysplasia and carcinomas however, these were more pronounced in moderate dysplasia and poorly-differentiated carcinomas. The presence of these abnormal appearing cells was associated with decrease in lymphocytic infiltrate. Conclusion: The present study indicates more LC are recruited into the carcinoma. These accumulated nonfunctional LC in the tumor tissue are indicative of aggressive tumor with potential malignant transformation.

Background: One of the most common causes of lymphadenopathy in India is tuberculosis. It can be diagnosed by a minimally invasive procedure known as fine-needle aspiration cytology (FNAC), and thereby unnecessary surgical interventions are avoided. Aim: This study was undertaken to evaluate cytomorphological patterns of tuberculous lymphadenitis including human immunodeficiency virus-positive cases, to correlate the acid-fast Bacilli (AFB) positivity with cytomorphological patterns and also to find out overall AFB positivity. Materials and Methods: In this study, a total of 212 cases of cytologically proven tuberculous lymphadenitis were retrieved and analyzed retrospectively between March 2012 and March 2015 for three different cytomorphological patterns (epithelioid granuloma without necrosis [pattern A], epithelioid granuloma with necrosis [pattern B], and necrosis without epithelioid granuloma [pattern C]) and bacillary loads on Ziehl-Neelsen stain (ZN) for AFB. Results: Pattern A through C was observed in 40 (18.9%), 102 (48.1%), and 70 (33%) cases, respectively. AFB positivity was found in 2 (5%) cases of pattern A, 62 (60.8%) cases of pattern B, and 54 (77.1%) cases of pattern C. The highest percentage of AFB positivity (64.7%) was observed in aspirate containing purulent/pus and caseous/cheesy material. The overall AFB positivity was seen in 55.7% (118/212) cases. On grading of AFB positivity, Grade 1+ was observed in 29.7%, Grade 2+ was observed in 28.8%, and Grade 3+ was observed in 41.5% cases. Conclusion: FNAC is a sensitive, simple, convenient, safe, minimally invasive procedure to diagnose tuberculous lymphadenitis. Study of both cytomorphological patterns and ZN staining for AFB can improve the diagnostic yield. Regardless of the presence of granuloma, ZN stain must be employed whenever infective pathology is suspected.

Background: Information on out of pocket (OOP) health care expenditure is essential for health planning and devising strategies for Universal Health Coverage (UHC). Aims and objectives: To describe morbidity profile, treatment preferences and OOP expenditure toward health care of under five children in an urban primary health center of Puducherry. Materials and Methods: A cross-sectional study was conducted in four Anganwadi centers selected randomly from a total of 13 centers in the urban service area of JIPMER, Puducherry. All mothers of under five children from selected centers were interviewed regarding sociodemographic details, treatment preferences, and expenditure incurred on illness of under five children by the family for a period of 15 days and 3 months (exclusive of past 15 days) preceding the day of interview. Results: Among the 164 children studied, 23.8% and 30% reported illnesses in the past 15 days and 3 months, respectively. Most frequent illness reported was respiratory infections. Private facilities (60%) were the preferred sources for seeking health care. Median OOP expenditure in last 15 days was Rs. 375 and Rs. 450 for the past 3 months, amounting to 8% and 6.8% of the total family income, respectively. The majority of the health care expenditure was toward drugs (71%). No money was spent toward healthcare in government facilities. Conclusion: Almost all OOP health care expenditure was incurred when the illnesses were managed by private providers. Hence, strategies can be planned to include private providers under UHC.

Preservation of ridge dimensions is critical for denture success. For long the concept of an internally weighted denture, which suggested that gravity and the additional weight to the mandibular complete denture aids in prosthetic retention is widely accepted. However, excessive weight and pressure can accelerate bone resorption. Here, we describe a unique modification of internally weighted metal denture base for the resorbed mandibular ridge with an incorporated additional hollow section over the anterior knife-edge ridge. The weight provided retention and stability while the hollow portion prevented further resorption of the bone.

Dental plaque is the primary etiologic factor for the periodontal diseases. Although pathogenic bacteria in dental plaque are necessary for the incidence of periodontal disease, but a susceptible host is as important. The susceptibility of the host can be modified by various systemic factors with hormones level being one. The periodontium shows an exaggerated inflammatory response to plaque modified by female sex hormone during puberty, pregnancy, in women taking oral contraceptives and at the postmenopausal stage. This paper presents such few cases where periodontium is influenced by variation in sex steroid hormones of female during different phases of their life time and to discuss how much a same hormone at different age and stage shows an exaggerated gingival response to plaque.

The inguinoscrotal hernia with colonic malignancy in the sac presents rare but severe consequence. The most common side of this type of hernia is the left one while the most common part of the large bowel is the sigmoid colon. The clinical picture can be easily confused with simple inguinoscrotal hernia unless the clinician is alert to the presence of certain sinister symptoms and signs. We report an extremely rare case of a 91-year-old man presented with anemia who had a right inguinoscrotal hernia containing a sigmoid colon carcinoma.

An inguinoscrotal hernia is a common disorder that usually contains intraperitoneal organs (small intestine, colon, appendix, ovaries). Extraperitoneal ureteral herniation into an inguinoscrotal hernia is a rare condition and often associated with congenital abnormalities or postoperative anatomic changes. A high index of suspicion is needed in order to avoid intraoperative ureteric injuries. We herein report the case of a ureteric herniation into an inguinoscrotal hernia incidentally found during a scheduled hernia repair.

The myriads of technological advancements in dentistry in last two decades have led to a dramatic shift from conventional invasive procedures to more conservative biomimetic therapies. In this series, management of traumatic dental injuries has taken a big leap in that now it is possible to conserve many of these teeth which were otherwise doomed to extraction. Depending on the extent of injury, esthetic and functional requirements, traumatic dental injuries can be managed by a variety of clinical procedures including composite resin restorations, reattachment of fractured fragment, endodontic therapy with or without post and core or lastly extraction. Reattaching natural tooth structure offers an advantage over the others in that it is instant, provides superior esthetics, preserves the natural tooth structure and is best accepted by the patient. This paper describes the comprehensive management of traumatized maxillary central incisor involving pulp exposure while maintaining pulp vitality and natural appearance of a tooth.

High tibial osteotomy (HTO) is an accepted treatment option for correcting deformities and reducing pain in the treatment of uni-compartment osteoarthritis of the knee. The principle is to redistribute the weight-bearing load. Medial open wedge HTO (MOWHTO) has gained popularity over lateral closed wedge osteotomy due to its decreased incidence of complications. MOWHTO surgical techniques have many variations in fixation techniques and in the use of bone grafts or bone substitute augmentation. In spite of the existing guidelines, there are no clear indications of grafting at the osteotomy site. Delayed union and nonunion although are possible complications, nonunion is especially rarely reported. Thus authors in this case report, like to point attention towards this under-reported complication and its management.

A number of developmental anomalies of morphology are there. However, as compared to the more common oral diseases like caries or periodontal problems, they account for a relatively lower number. When present, they may pose various problems of esthetic, function, malocclusion, or possible disposition to other oral problems. Hence, though rare, their timely diagnosis is very vital in proper treatment planning to avoid unseen complications during extractions, endodontic or orthodontic treatment. The present case is of a patient reporting with two very rare developmental anomalies, that is, fusion and root dilaceration, in contralateral sides of the same patient. To the knowledge of the author, reportedly it is the first such case. The terminologies, etiology, and epidemiology of both these anomalies are also discussed.

Complex odontomas, hamartomas of aborted tooth development, mainly occur in posterior part of the mandible and rarely erupt into the oral cavity. The spontaneous eruption may be associated with pain, inflammation of adjacent soft tissues or recurrent infection. The present case of complex odontoma is of particular interest due to its apparent eruption in the maxillary posterior segment, its association with agenesis of the second molar and impacted third molar; with the lesion being completely asymptomatic.