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Some of the traditional methods that are being employed in the repair of oroantral communication can be broadly divided into local and distant flaps. Recently, because of various advantages, buccal fat pad is increasingly being employed in the repair of oroantral fistula and other oral defects worldwide. However, there are some problems that can be encountered while harvesting BFP which has to be taken care of. In this paper, we present a case with one of such problems, its management, and review of literature on the same.

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Mirror neurons are one of the most important discoveries in the last decade of neuroscience. These are a variety of visuospatial neurons which indicate fundamentally about human social interaction. Essentially, mirror neurons respond to actions that we observe in others. The interesting part is that mirror neurons fire in the same way when we actually recreate that action ourselves. Apart from imitation, they are responsible for myriad of other sophisticated human behavior and thought processes. Defects in the mirror neuron system are being linked to disorders like autism. This review is a brief introduction to the neurons that shaped our civilization.

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Ludwig's angina is a form of severe diffuse cellulitis that presents an acute onset and spreads rapidly, bilaterally affecting the submandibular, sublingual and submental spaces resulting in a state of emergency. Early diagnosis and immediate treatment planning could be a life-saving procedure. Here we report a case of wide spread odontogenic infection extending to the neck with elevation of the floor of the mouth obstructing the airway which resulted in breathlessness and stridor for which the patient was directed to maintain his airway by elective tracheostomy and subsequent drainage of the potentially involved spaces. Late stages of the disease should be addressed immediately and given special importance towards the maintenance of airway followed by surgical decompression under antibiotic coverage. The appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection remains the standard protocol of treatment in advanced cases of Ludwig's angina.

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Obstructive sleep apnea (OSA) is common in adult population. OSA shows detrimental effects on health, neuropsychological development, quality-of-life, and economic potential and now it is recognized as a public health problem. Despite the availability of expanded therapeutic options, polysomnography and nasal continuous positive airway pressure (CPAP) are the gold standards for the diagnosis and treatment for OSA. Recently, American Academy of Sleep Medicine has recommended oral appliances for OSA. Hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Treatment of OSA can improve vitality, social and daytime functioning, family life and mental health of a person and hence the quality-of-life. Obesity is the main predisposing factor for OSA. Other than obesity, craniofacial abnormalities such as micrognathia and retrognathia, age, ethnic background and genetic predisposition, consumption of alcohol, smoking, and sedatives may also predispose to OSA. Treatment modalities for OSA are behavior modification, diet and medication, CPAP devices, surgical (maxillo-mandibular advancement surgery), and oral appliances. Treatment of a patient with OSA not only improves the physical health of the patients but also the mental and social well-being.

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Background: The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles. Materials and Methods: A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded. Results: The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height). Conclusion: We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation.

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Trichorhinophalangeal syndrome is a very rare genetic disorder, where damage and mutation to the number 8 chromosome affects sufferers in numerous ways. The syndrome has three types, all characterized by abnormally short stature, sparse hair, short deformed fingers with cone-shaped epiphyses visible in radiographs. Type I is the most common. Type II is characterized by the development of multiple bony exostoses and frequently, mental disability. Type III is a more severe form of type I and is associated with short stature. This report presents a 28-year-old man who had the characteristic features of type I with the presence of multiple erupted supernumerary teeth with normal mentation and karyotyping with high resolution G banding displayed normal chromosomal complements.

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Nardostachys jatamansi is traditionally used in alternative medicine for treatment of neuropsychiatric disorders. We investigated the potential of N. jatamansi extract (NJE) in protecting against chronic stress-induced impairments in spatial learning and memory. The rats were exposed to 21 days of chronic restraint stress and simultaneously received 100 mg or 200 mg/kg body weight of NJE following which acquisition and retention of hippocampus-dependent spatial memory were tested in a partially-baited eight arm radial maze. Animals treated with 200 mg/kg body weight NJE had learning curves comparable to control unstressed animals, made significantly more correct choices (38%, P < 0.001), and fewer reference memory errors (53%, P < 0.01) on the eighth day of training compared to untreated stressed animals as well as stressed animals which received vehicle or a lower dose (100 mg/kg) of NJE. NJE-treated animals also made significantly higher correct choices (31%, P < 0.001) than untreated animals in a retention test 10 days after the training period. We propose that NJE has a protective effect of stress-induced impairments in hippocampus-dependent learning and memory behavior in rats.

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Background: In recent years the incidence of Tinea capitis, infection of scalp by dermatophytes, has increased in United Kingdom and North America. The trend may be similar in India. The objective of this study is to find the prevalence of Tinea capitis in school going urban children in Kolkata, West Bengal state. Materials and Methods: The present study is a cross-sectional study conducted in a government higher primary school in Kolkata. Results: Totally 505 students were screened and 52 were diagnosed to have Tinea capitis by clinical examination, giving a prevalence rate of 10% among school children. Prevalence rates among the age groups of 6-8, 9-11 and 12-14 years were almost the same, ranging from 9 to 11%. The prevalence rate was significantly high among the boys (14%). There was no significant difference in prevalence of infection among coconut oil users and castor oil users. Measures of general hygiene were similar among those who were infected with Tinea capitis and those who were not. The commonest clinical type of infection found was dull grey patches. Itching with hair loss was the major symptom and most of the infected children had cervical lymphadenopathy. The potassium hydroxide studies revealed endothrix spores in majority of samples. Conclusion: Tinea capitis in prevalent in school going urban children in Kolkata, West Bengal state and necessary measures must be undertaken to curtail this incidence.

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Vascular anomalies constitute some of the most difficult diagnostic and therapeutic enigmas in the head and neck region. It is of paramount importance that a modern classification system is established to differentiate vascular lesions from vascular malformations. Vascular malformations are usually congenital and venous anomalies usually expand because of hormonal changes such as puberty, pregnancy, or secondary to trauma. Here, we report a case which was diagnosed as low flow vascular malformation of buccal mucosa involving the lower lip and subsequently treated with 3% sodium tetra decyl sulfate. This paper provides overall understanding regarding the presentation and management of small vascular lesions in the orofacial region. Percutaneous sodium tetradecyl sulfate when used either alone or as adjunct to surgery is a safe, effective, and inexpensive agent in the treatment of venous malformations. However, proper case selection, evaluation, and careful planning are necessary to reduce the unwarranted risks and complications.

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Objective: The aim of this study is to screen the polyherbal preparation for antidiabetic activity in rats. Materials and Methods: The blood glucose lowering activity of the polyherbal preparation-I (1:1:1 of wheat germ oil, Coraidrum sativum, and Aloe vera) was studied in normal rats after oral administration at doses of 1.0 ml/kg and 2.0 ml/kg and polyherbal preparation-I, II (wheat germ oil, fresh juice of C. sativum, and A. vera in the ratio of 2:2:1), and III (wheat germ oil, fresh juice of C. sativum and A. vera in the ratio of 1:2:2) on alloxan-induced diabetic rats, after oral administration at doses of 1.0 ml/kg and 2.0 ml/kg. Blood samples were collected from the tail vein method at 0, 0.5, 1, 2, 4, 8, 12, and 24 h in normal rats and in diabetic rats at 0, 1, 3, 7, 15, and 30 days. Blood plasma glucose was estimated by the GOD/POD (glucose oxidase and peroxidase) method. The data were compared statistically by using the one-way ANOVA method followed by the Dunnett multiple component test. Statistical significance was set at P < 0.05. Results: The polyherbal preparation-I produced significant (P < 0.05) reduction in the blood glucose level of normal rats and polyherbal preparation-I, II, and III produced significant (P < 0.01) reduction in the blood glucose level of diabetic rats during 30-day study and compared with that of control and glibenclamide. Conclusion: The polyherbal preparation-I showed a significant glucose lowering effect in normal rats and polyherbal preparation-I, II, and III in diabetic rats. This preparation is going to be promising antidiabetic preparation for masses; however, it requires further extensive studies in human beings.

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Introduction: A zygomatic complex fracture includes disruption of the four articulating sutures: zygomaticofrontal, zygomaticotemporal, zygomaticomaxillary and zygomaticosphenoidal sutures. All zygomatic complex fractures involve the orbital floor and therefore an understanding of orbital anatomic features is essential for those treating these injuries. Aims and Objectives: To analyze the efficacy and shortcomings of this approach. To evaluate the adequacy, role of tarsorrhaphy, difficulties, role of steroid in postoperative edema control in lower lid blepharoplasty approach. Materials and Methods: A total number of six patients were included in this study and all the patients were treated surgically under general anesthesia. All the patients were approached through lower eyelid blepharoplasty incision. The first skin crease in the lower eyelid region is selected for this incision. Results: All patients were administered with steroid injection. Frost sutures were placed in four cases and tarsorrhaphy was done in two patients. Three cases encountered immediate mild edema and immediate scar formation. Late scar was present only in two patients with a follow up of three months. Conclusion: Lower eyelid blepharoplasty incision is an excellent, non complicated, simple procedure in the management of fractures in the infraorbital region, orbital floor, which occurs as a part of zygomatic complex fractures.

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Non-Hodgkin's lymphoma (NHL) is seldom seen in the oral cavity, and has been reported with some frequency in HIV-positive patients. Oral HIV-related lymphomas exhibit an aggressive course and can mimic other oral tumors and infections that make early recognition and diagnosis difficult. This paper presents a case of NHL on the gingiva of a 28-year-old HIV-positive male patient.

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Introduction: Mismatch repair is a highly conserved process from prokaryotes to eukaryotes. Defects in mismatch repair can lead to mutations in human homologues of the Mut proteins and affect genomic stability which can result in microsatellite instability (MI). MI is implicated in most human cancers and majority of hereditary nonpolyposis colorectal cancers (HNPCCs) are attributed to defects in MLH1. Materials and Methods: In our study we analyzed MLH1 protein and the associated nucleotide and other protein sequences. The protein sequences involved in mismatch repair in different organisms have been found to be evolutionary related. Several other related proteins to MLH1 have also been identified through protein-protein interactions. All associated proteins are either mismatch repair proteins or associated with MLH1 in various pathways. Pathways information was also confirmed through MMR and other pathways in KEGG. QSite Finder showed that the active site of MLH1 protein involves residues from the conserved pattern and is involved in ligand-protein interactions and could be a useful site. To analyze linkage disequilibrium (LD) and common haplotype patterns in disease association, we performed statistical haplotype analysis on HapMap genotype data of SNPs genotyped in population CEU on chromosome 3 for MLH1. Results: Various markers have been found and LD plot was also generated. Two distinct blocks have been identified in LD plot which can be independent region of action, and there is involvement of 7 and 17 markers in first and second blocks, respectively. Conclusion: Overall correlation of 0.95 has been found among all interactions of genotyped SNPs which is significant.

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Background: Typhoid is one of the most important diseases of human beings caused by Salmonella Typhi. There are many vaccine reported against Salmonella Typhi, but search for new candidate vaccine antigens is still going on because presently available vaccines have several limitations such as short-term immunity, high cost, and allergic reaction. Several approaches such as subunit vaccines, Vi polysaccharide, mutant vaccines, and r-DNA vaccines have been tested. r- DNA vaccines have shown some promising potential (targeted Omp). Omp 28 had shown very promising results and suggests that it should be used in further studies of animal protection against the disease. Objective: Cloning, Sequencing and In silico analysis of Omp 28 gene to develop r-DNA vaccine of S.Typhi. Materials and Methods: Omp 28 is made up of three identical subunits of 9.6 kDa showing PCR amplicon of 330 bp which has been cloned in the pJET vector. Recombinant clones has been sequenced, and data submitted to NCBI. Secondary structure was deduced by the Chou Fasman and Garnier method. The sequence of Omp 28 was studied for antigenic indexing, epitope mapping, and MHC mapping using various bioinformatics tool. Results and Conclusion: The sequence of Omp 28 has been assigned accession no GQ 907044.1 by NCBI. Secondary structure has shown it has more alpha region. Hydrophobic plot and surface probability plot shows most amino acids are surface exposed which is a requirement to develop a r-DNA vaccine. Antigenic sites are located within surface exposed regions and eight antigenic determinants are present in Omp 28. On Prosite analysis of Protein shown two motifs i.e. anaphylatoxin domain signature motif at position 219-252 and other one was iron sulphur binding region signature motif at position 36-44. On epitope analysis total six major B cell epitopes were observed which can provoke humoral immunity .On T cell epitope mapping several major epitopes has been found in case of MHC class I and MHC class II. It indicates that Omp 28 can provoke cell mediated as well as humoral immunity and can be proven a promising candidates of Salmonella Typhi.

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Objectives: The aim of the present study was to analyze the influence of smoking on the salivary immunoglobulin response in smokers and to evaluate the salivary immunoglobulin A in patients with recurrent aphthous ulcers. Materials and Methods: The study included total of 80 subjects, of whom 40 were having history of chronic smoking habit, 20 were clinically diagnosed cases of recurrent aphthous ulcer and 20 were in the control group. Sample of unstimulated saliva was collected, centrifuged and analyzed for the level of salivary immunoglobulin A with turbidimetric immunoassay. For all the tests, a P- value of < 0.05 was considered for statistical significance. Results: The mean salivary immunoglobulin A level in control group was 0.20 Grams/litre and in smokers the mean salivary immunoglobulin A level was 0.13 Grams / Litre. In patients with recurrent aphthous ulcers mean salivary immunoglobulin A level was 0.31 Grams / Litre. The mean salivary immunoglobulin A levels showed a decreasing trend from controls to smokers. These results were highly significant for values between control groups to smokers. Conclusion: The mean salivary immunoglobulin A levels demonstrated a progressive decrease from controls to smokers. This investigative procedure although non-specific, can be used as a diagnostic marker in smokers and patients with recurrent aphthous ulcers.

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Background: The morphometry of tricuspid valve complex is of clinical importance for cardiovascular surgeons and there is scarcity of such data in Indian literature. The study was conducted to record normal tricuspid valve measurements which would serve as baseline data for the Indian population. Material and Methods: The study was carried out on 100 formalin fixed hearts without any pathology from patients who had died of non-vascular causes and whose age ranged from 8 to 85 yrs. The hearts were grouped into three cohorts corresponding to age, 54 hearts aged between 8 to 40 yrs, 42 hearts aged between 41 to 64 yrs and 4 hearts aged 65 yrs and above. Dissection was performed according to standard autopsy techniques. The measurements were recorded using a flexible millimeter ruler and surgical suture material. The dimensions measured were the attachment lengths of anterior, posterior and septal leaflets. The circumference of the valve along with the frontal and sagittal dimensions was measured. Area of the valve expressed as a triangle and as an ellipse was calculated. Results: The measurements obtained were assessed using SPSS software. Statistically significant increase in tricuspid valve measurements were observed with advancing age both in men and women. In younger hearts the tricuspid valve resembled a triangle and with advancing age the tricuspid valve became more elliptical in shape. Conclusion: We hope this study will serve as baseline data for the tricuspid valve measurements in the Indian population and it will be of clinical use for patients with various tricuspid valve abnormalities.

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Background: TP53, located on chromosome 17p13, is one of the most mutated genes affecting many types of human cancers. Thus, we aimed at investigating the association of SNPs in TP53 gene with chronic myeloid leukemia (CML). Materials and Methods: A total of 236 CML and 157 control samples were analysed for mutations in TP53 gene using polymerase chain reaction followed by direct sequencing. Results: Sequencing analysis for mutations in exons 7-9 of the TP53 gene revealed four SNPs, three in intron 7 (C14181T, T14201G, and C14310T) and one SNP in intron 6 (A13463G) of TP53 gene. The mutation C14181T is located at position 72 base pairs downstream of the 3′-end of exon 7 of the P53 gene. This mutation is in complete linkage disequilibrium with a T14201G mutation, 20 base pairs further downstream occurring at position 14201. This mutation occurred only in the presence of C14181T mutation and these mutations showed association with advanced phase and cytogenetic poor response. Another two novel mutations, C14310T in intron 7 and A13463G in intron 6 were also found to be associated with cytogenetic poor response. Conclusion: Our study suggests that TP53 intronic SNPs might have a strong influence on disease progression and poor response in CML patients.

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A survey was conducted to determine the cancer profile in Nainital and adjoining districts of Uttarakhand. Epidemiological information was collected from the records of patients with confirmed cancer cases. A total of 354 cases were studied for the year 2010. Lung cancer was found to be leading cancer type (17.23%) overall. Breast cancer was most prevalent in females (22.29%) followed by cervical (14.86%) and ovarian cancers (13.51%). Men were mainly suffering from tobacco- and alcohol-related cancers, e.g., lungs (26.21%), larynx (11.16%), oropharynx (9.7%), oral cavity (6.79%), and esophagus (6.79%). Cancers of unknown primary site (1.41%) were also detected.

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The commonest constituent of all hair dyes is paraphenylene diamine (PPD) being used by the people to color their hair all over the world. Hair dye poisoning is emerging as one of the emerging causes of intentional self-poisoning to commit suicide. In this article, the importance of clinical manifestations and of hair dye poisoning is discussed due to the lack of specific diagnostic tests. Since there is no specific antidote for PPD poisoning, the early supportive treatment modalities are discussed.

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A 45-day-old boy presented with increased drowsiness for a day. His mother was giving the child a mixture of several herbs for the past 15 days for general well-being of the child. Urine analysis revealed the presence of opium and benzodiazepines in the child. On searching through the herbs, opium seeds were identified. The child recovered on his own and needed no antidote.

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Dens evaginatus (DE) is an odontogenic developmental anomaly that can be defined as a tubercle or protuberance from the involved surface of the affected tooth consisting of an outer layer of enamel, a core of dentin, and may contain a slender extension of pulp tissue. Early diagnosis and management of DE is important in order to prevent occlusal interference, compromised esthetics, carious developmental grooves, periodontal problems due to excessive occlusal forces, or irritation of the tongue during speech and mastication. DE usually affects the mandibular second premolars as an accessory cusp or a protuberance between the buccal and lingual cusps. Reports of DE on maxillary premolar are rare in the literature. We report one such extremely rare case of DE on maxillary first premolar.

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