With the expansion of the world population, the environmental pollution and toxicity by chemicals raises concern. Rapid industrialization and urbanization processes has led to the incorporation of pollutants such as pesticides, petroleum products, acids and heavy metals in the natural resources like soil, water and air thus degrading not only the quality of the environment, but also affecting both plants and animals. Heavy metals including lead, nickel, cadmium, copper, cobalt, chromium and mercury are important environmental pollutants that cause toxic effects to plants; thus, lessening productivity and posing dangerous threats to the agro-ecosystems. They act as stress to plants and affect the plant physiology. In this review, we have summarized the effects of heavy metals on seeds of different plants affecting the germination process. Although reports exist on mechanisms by which the heavy metals act as stress and how plants have learnt to overcome, the future scope of this review remains in excavating the signaling mechanisms in germinating seeds in response to heavy metal stress.

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Amelogenesis Imperfecta (AI) represents a group of developmental conditions, genomic in origin, which affect the structure and clinical appearance of enamel of all or nearly all the teeth in a more or less equal manner. AI is a serious problem that reduces oral health-related quality of life and causes some physiological problems. We presented here four case reports of AI (Hypoplastic and Hypomaturation) which we diagnosed on the basis of classical clinical and radiographic features.

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Antimicrobial resistance is an important concern for the public health authorities at global level. However, in developing countries like India, recent hospital and some community based data showed increase in burden of antimicrobial resistance. Research related to antimicrobial use, determinants and development of antimicrobial resistance, regional variation and interventional strategies according to the existing health care situation in each country is a big challenge. This paper discusses the situational analysis of antimicrobial resistance with respect to its problem, determinants and challenges ahead with strategies required in future to reduce the burden in India. Recent data from Google search, Medline and other sources were collected which was reviewed and analyzed by the authors. Hospital based studies showed higher and varied spectrum of resistance in different regions while there are limited number of community based studies at country level. There exists lacunae in the structure and functioning of public health care delivery system with regard to quantification of the problem and various determining factors related to antimicrobial resistance. There is an urgent need to develop and strengthen antimicrobial policy, standard treatment guidelines, national plan for containment of AMR and research related to public health aspects of AMR at community and hospital level in India.

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Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation resulting from irreversible changes in the hormonal and reproductive functions of the ovaries and is associated with a large number of symptoms ranging from physical to psychological. Some of the common oral manifestations are oral burning sensation with associated mucosal infections, pain, altered taste perception, and alveolar bone loss. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to devise newer methods that would add along to the treatment modalities advised by gynecologists in relieving menopausal women from above symptoms. The present case report describes an innovative method of fabricating a metal base denture in an edentulous female that would help perimenopausal/menopausal/post-menopausal edentulous women feel hot/cold sensations of food/liquids, thereby giving them relief from pain, better taste perception, and relief from associated allergic and candidal infections that are common with conventional acrylic base dentures.

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Background: The global spread of antimicrobial resistance has acquired greater significance in the public health perspective. Drug resistance has posed a threat for the management of various hospital-acquired infections (HAI). For bacteria producing extended spectrum ß lactamase, carbapenems are the drug of choice. However, treatment failures are still a cause of concern due to carbapenemase producers. Aim: Various phenotypic and genotypic methods are available for the detection of carbapenemase producers. Studies thus far have mostly concentrated on comparing various methods for detection of carbapenemase producers. We used low-cost and the easily performed modified Hodge test (MHT) for detecting the carbapenemase producers in Enterobacteriaceae members isolated from various clinical specimens. Material and Methods: The study included 1072 clinical isolates of Enterobacteriaceae collected in India between April 2008 and February 2010. MHT was performed on all the isolates in accordance with CDC and CLSI guidelines. Results: The carbapenemase activity was detected in 35.9% (385/1072) of the isolates. Klebsiella spp. 28.7% (80/278), Citrobacter spp. 20.4% (25/122), 11.3% (38/334) in E. coli, 20.3% (45/221) in Enterobacter spp., and 16.2% (9/117) in Proteus spp. revealed variable resistance activities against carbapenems. Conclusion: Enterobacteriaceae members are among the most common and easily transferable bacterial species responsible for severe HAI. This study revealed a high percentage of Enterobacteriaceae clinical isolates producing carbapenemases in India. Detection of such bacteria, formulating hospital antibiogram, and monitoring the usage of antimicrobial drugs is recommended.

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Introduction: Reduction of functioning minor salivary glands may contribute to emergence of mucosal infections, mucosal ulceration, and possibly dental caries. A study was, therefore, designed to understand the exact role of minor salivary gland secretions over dental caries. Methodology: We studied the average labial distribution of functional minor salivary glands using various pre-defined locations, counted the minor salivary gland secretion imprints, and correlated the decayed missing filledlevels in subjects. The functional level and amount of secretion of minor salivary gland were evaluated. The radial immunodiffusion was performed by Diffu-Plate kit and the dimensions of the ring were correlated with the amount of immunoglobulin A in saliva. Results: The mean number of functional labial minor salivary glands, amount of secretion, level of glycoprotein secretion, and immunoglobulin A secretion levels could very well dictate the functional status and role of minor salivary glands over caries assessment. Conclusion: The above-mentioned tests could be of major significance in routine diagnosis of the most common oral disease, i.e., dental caries.

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Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities.

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The classification of odontogenic cysts is complicated and can create confusion for both clinicians and pathologists. The odontogenic keratocyst (OKC) is an enigmatic developmental cyst that deserves special attention. It has characteristic histopathological and clinical features; but, what makes this cyst special is its aggressive behavior and high recurrence rate. Despite of many classifications and nomenclature, unfortunately the clinicians still have to face difficulties in the management of this commonly found jaw lesion. This article is an effort to provide an overview of various aspects of OKC with emphasis on nomenclature, recurrence, molecular aspects, and management of OKC.

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Background: Ectodermal dysplasia (ED) is a group of rare, inherited disorders characterized by sparse hair, missing teeth and inability to sweat. Objective: To review and analyze cases of ED with an emphasis on clinical manifestations and parent's marriage history. Methodology: The present retrospective study was conducted by assessing the clinical records of nineteen cases of ED, available in the archives of the department; for age, gender, family history of consanguineous marriage and clinical manifestations. Results: It was observed that ED was more prevalent in males, with a ratio of 1.7:1. The hypohydrotic type was more common (78.95%) than hydrotic type (21.05%). The marriage history of parents revealed that 66.67% had consanguineous marriage and had 68.42% offspring's affected with ED; whereas 33.33% had history of non-consanguineous marriage and had 31.58% offspring's affected with ED. The clinical manifestations observed were- dry skin(94.74%); scaly skin(42.11%); sparse hair on scalp, eyebrows and eyelashes(100%); frontal bossing(63.18%); saddle nose (57.89%); hypertelorism (47.37%); nail abnormality(52.63%); normal sweat glands(21.05%); abnormal sweat glands(78.95%); hypoplastic maxilla(52.63%); protuberant lips (57.89%); palmo-plantar keratosis(21.05%); wrinkled & hyper pigmented facial skin(84.21%); partial anodontia(94.74%); conical shaped teeth(84.21%); high arched palate(68.42%); thin alveolar bone(100.00%); taurodontism(21.05%) and cleft lip & cleft palate(05.26%). The number of teeth present in all the cases ranged from 0 to 19. Conclusion: ED patients suffer from social problems and poor psychological and physiological development as a result of unacceptable esthetics and abnormal function of orofacial structures. Oral rehabilitation thus becomes mandatory, although it is often difficult; particularly in pediatric patients.

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Objective: The study aims to evaluate the effect of zinc sulfate on markers of glycemic control, lipid profile and inflammation in type-2 diabetes with microalbuminuria patients. Materials and Methods: Type-2 diabetes with microalbuminuria patients on oral hypoglycemic agents (OHA) and angiotensin converting enzyme (ACE) inhibitors were selected and divided into 2 groups: One group ( n = 27) continued with OHA alone, second group ( n = 27) was on OHA and in addition 50 mg elemental zinc as zinc sulphate supplementation for 12 weeks. Fasting, post-prandial blood glucose, glycosylated hemoglobin, lipid profiles, inflammatory marker hs-CRP and urine microalbumin were measured. Results: There were no significant differences in biochemical status among groups at baseline. After receiving zinc, the mean fasting blood glucose (FBS), post-prandial blood glucose (PPBS) and glycosylated hemoglobin (HbA1c) were decreased significantly ( P = 0.0001). Significant decrease was observed in TG ( P = 0.002) and VLDL-cholesterol ( P = 0.002), whereas there was no significant decrease in TC and LDL-cholesterol. The high-density lipoprotein (HDL) cholesterol was significantly ( P = 0.0001) increased from baseline. Zinc supplementation had significant effects in decreasing serum hs-CRP from 10.51 ± 1.68 mg/L to 7.75 ± 1.56 mg/L ( P = 0.0001) and microalbumin level from 146.87 ± 30.83 mg/day to 80.70 ± 33.99 mg/day ( P = 0.0001). There were no significant changes in the levels of all these parameters in OHA group. Conclusion: Our results conclude that supplementation of zinc improved the effectiveness of OHA and may be beneficial in decreasing blood glucose, TG, urinary albumin excretion and inflammation in diabetic nephropathy patients and thus reducing the risk of complications.

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Osteochondroma (OC) of temporo mandibular joint is a rare, slow growing, benign tumor that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporo mandibular joint (TMJ) dysfunction, limited mouth opening and malocclusion. Pain is rarely associated with this tumor. OC is composed of cartilaginous and osseous tissues. Radiographically, there is unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a rare case of osteochondroma of right mandibular condyle in a 45-year-old male who reported with painless swelling over TMJ area and progressive limited mouth opening. Panoramic radiograph and computed tomography (CT) was performed for better evaluation of the pathological condition. This paper describes the clinico-radiographic features and differential diagnosis of OC.

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Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder during pregnancy. GDM causes substantial morbidity and mortality and long- term complications. GDM-related risk factors have not been completely identified yet. Some studies have found relationship between increased serum ferritin and impaired oral glucose tolerance test but the relationship between serum ferritin and risk of GDM has been controversial. The aim of the study was to determine serum iron and ferritin levels and total iron binding capacity (TIBC) in women with GDM and comparison with normal pregnant women. Materials and Methods: This case-control study was performed among 200 pregnant women (case = 100, control = 100) who were referred to Yahya-Nejad Hospital in the second trimester in Babol from 2008 to 2009. GDM was diagnosed by impaired OGTT based on Carpenter and Coustan criteria. The 2 groups were matched in age, gestational age and parity. Results: High serum ferritin level increased the risk of gestational diabetes to 2.4-fold [OR = 2.4 (0.83-6.9) CI = 95% ( P = 0.10)], while in those with low ferritin levels, the risk of developing gestational diabetes was reduced to 82% [OR = 0.8 with (0.08-0.37) CI = 95% ( P = 0.001)]. Using the logistic regression model, after adjustment for BMI, the OR was 2.37 [(0.80-7.01) CI = 95% ( P = 0.11)] for low ferritin level and OR = 0.20 [(0.09-0.44) CI = 95% ( P = 0.0001)] for high ferritin level, which was statistically significant. Conclusion: The serum ferritin level was markedly higher in women with gestational diabetes than in normal pregnant women; therefore, high ferritin can be regarded as a significant risk factor for the development of gestational diabetes.

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Context: Septicemia in neonates refers to generalized bacterial infection documented by positive blood culture in the first four weeks of life and is one of the four leading causes of neonatal mortality and morbidity in India. Aim: To isolate and identify the bacterial etiologic agents responsible for neonatal sepsis and to determine the susceptibility pattern of isolates in a tertiary care hospital in North Karnataka. Materials and Methods: Six hundred eighty-three blood samples were collected and processed from patients in accordance with standard protocols. Antibiotic susceptibility of the isolates was done by disc diffusion method according to National Committee for Clinical Laboratory Standards (NCCLS) recommendations. Results: Blood culture reports were positive in 19.2% cases. Among the culture positive cases, there were 65.5% males and 34.5% females. Early-onset sepsis was present in 74.8% and late-onset sepsis was observed in 25.2% of the cases. Best overall sensitivity among Gram-negative isolates was to imipenem (93%), followed by amikacin (52%) and netilmicin (41%). Gram-positive isolates had sensitivity of 91% to linezolid, 68% to tetracycline, 64% to piperacillin/tazobactam erythromycin, and 52% to ciprofloxacin. Conclusion: Gram-negative organisms (Klebsiella, Acinetobacter), coagulase-negative staphylococci, and Staphylococcus aureus are the leading cause of neonatal sepsis in this study and most of them are resistant to multiple antibiotics. Therefore the results of this study suggest that, surveillance of antimicrobial resistance in our hospital is necessary.

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Background: Both lentil (Lens culinaris Medik.) and grass pea (Lathyrus sativus L.) in the family Fabaceae are two important cool-season food legumes, often experiencing water stress conditions during growth and maturity. Objective: The present study was undertaken to ascertain the response of these two crops under different water stress regimes. Materials and Methods: Different morpho-physiological and biochemical parameters were studied in a pot experiment under controlled environmental conditions. Along with control (proper irrigation, 0 stress), three sets of plants were subjected to mild (6 d), moderate (13 d) and severe (20 d) water stress by withholding irrigation at the appropriate time. Results: Compared with control, plant growth traits and seed yield components reduced significantly in both crops with increasing period of water stress, resulting in lowering of dry mass with more severe effect on lentil compared with grass pea. Foliar Relative Water Content (RWC) (%), K ⁺ /Na ⁺ ratio, chlorophyll (chl) a, chl a/b ratio, stomatal conductance and net photosynthetic rate declined considerably in both crops under water stress. Leaf-free proline level increased significantly in both crops, but it decreased markedly in nodules of lentil and remained unchanged in grass pea. Nodulation was also affected due to water stress. The impairment in growth traits and physio-biochemical parameters under water stress was manifested in reduction of drought tolerance efficiency of both crops. Conclusion: Impact of water stress was more severe on lentil compared with grass pea, and modulation of growth traits signified necessity of a detailed strategy in breeding of food legumes under water stress.

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Background: In the traditional system of medicine, the roots and rhizomes of Glycyrrhiza glabra (Gg) (family: Leguminosae) have been studied for their ability to improve a variety of health ailments. Aims: The present study was designed to investigate the beneficial effects of Gg root extract on learning and memory in 1-month-old male Wistar albino rats. Four doses (75, 150, 225, and 300 mg/kg) of aqueous extract of root of Gg was administered orally for six successive weeks. Materials and Methods: The aqueous extracts were evaluated for their effect on spatial learning and memory in rats using the elevated plus maze, Hebb-William maze, and Morris water maze tests which served as the exteroceptive behavioral model. Diazepam-induced amnesia served as the interoceptive behavioral model. Results: Results showed that all the doses of aqueous root extract of Gg significantly enhanced the memory; however, in the doses of 150 and 225 mg/kg, it showed a significant (P < 0.01) enhancement in learning and memory. Furthermore, Diazepam-induced amnesia was reversed by the aqueous root extract of Gg (150 and 225 mg/kg, p.o.). Conclusion: These findings suggest that the memory enhancement effects of Gg may be mediated by its antioxidant and anti-inflammatory activities. Thus, Gg appears to be a promising drug for improving memory in the management of impaired learning, dementia, Alzheimer's disease, and other neurodegenerative disorders.

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Objective: To evaluate the degree of expression of cyclin-D1, p27 and p63 in mild, moderate and severe dysplasia using immunohistochemical evaluation in order to illustrate their prognostic value and attempt to propose a molecular grading system for oral epithelial dysplasia. Materials and Methods: The analysis included thirty cases of mild, moderate and severe dysplasia from Department of Oral and Maxillofacial Pathology, Saveetha Dental College, Chennai after a critical review of the Hematoxylin and Eosin (H and E) stained sections. They were subjected to immunohistochemical evaluation using the markers cyclin-D1, p27 and p63. The assessment of the expression based on staining intensity and distribution of immunohistochemical staining of the various markers was analyzed followed by statistical analysis. Results: A highly significant increase in the expression of cyclin-D1 ( P < 0.000) and p63 ( P < 0.001) and a moderately significant decrease in the expression of p27 ( P < 0.012) with the increasing severity of dysplasia was observed in our study. Conclusions: The result of our research affirms the fact that the increase in the expression of markers of cell cycle regulators such as cyclin D1, decrease in the expression of cell cycle inhibitors like p27 and increased expression of p63 in parallel with the increasing severity of dysplasia, emphasizes the use of immunohistochemical markers cyclin D1, p27 and p63 as prognostic markers for better understanding the behaviour of these potentially malignant disorders aiming towards proposing a molecular grading system for oral epithelial dysplasia to enable timely management prior to their possible malignant transformation.

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Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin comprising 3% of all the odontogenic tumors. It is a benign, painless, noninvasive, and slow-growing lesion, with a relative frequency of 2.2-13% and often misdiagnosed as an odontogenic cyst on clinical examination. AOT affects young individuals with a female predominance, occurs mainly in the second decade, and usually surrounds the crown of unerupted teeth. This lesion is most commonly located in the anterior maxilla and rarely in the mandible. It is usually associated with an impacted canine. AOT frequently resembles lesions like dentigerous cyst or ameloblastoma. AOT has three variants, follicular, extrafollicular, and peripheral. The intraoral periapical radiograph is the best radiograph to show radiopacities in AOT as discrete foci having a flocculent pattern within radiolucency even with minimal calcified deposits. These calcified deposits are seen in approximately 78% of the lesions. Herewith, we present the report of four unusual cases of AOT located in the mandible, with an emphasis on radiographic findings and on pathologic correlation, and on reviewing the existing literature on this tumor.

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Aims: The aim of the study was to evaluate the difference in sodium, potassium, total protein in whole saliva in diabetic smokers, diabetic nonsmokers and healthy controls. Materials and Methods: Nonstimulated saliva samples were collected from a group of diabetic smokers, diabetic nonsmokers, and controls. Supernatant after centrifugation was used to determine the levels of sodium, potassium, and total protein by using semiautomatic analyzer. Results: There exists a statistical difference in the levels of potassium and total protein between diabetic smokers, nondiabetic smokers, and controls. Difference in the levels of sodium is only significant with nondiabetic smokers and controls. Conclusion: Diabetes mellitus is known to alter the composition of saliva. The purpose of this study was to estimate and compare the levels of salivary potassium, sodium, and total protein in smoker diabetic patients and nondiabetic smokers and controls, and to explore potential of salivary electrolytes [Na+, K+] and total proteins as markers. The estimated values of salivary constituents add to the data already recorded in Indian population. However, further studies using large samples are required to evaluate the findings in our study.

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Orphan Receptor of Nuclear Receptor superfamily is the one with no known endogenous ligands. Many of these orphan receptors are associated with different types of diseases and therefore deserve special attention to find the potential ligands they would be associated with. The major task of molecular pharmacology is the deorphanization of the large number of nuclear receptors with unidentified endogenous agonists. The deorphanization provides a promising research for new therapeutics. The Testicular Receptor 4 being negative modulator to other members of the nuclear receptor superfamily, is one of the Orphan members of this family and is associated with prostate cancer, breast cancer, sickle cell anemia and joint diseases. The knowledge that related receptors of the same family often have ligands with similar structural features has helped us to utilize the chemogenomic approach to deorphanize the orphan receptor. Chemogenomics approach involves screening of known ligands of a protein family having analogous domain architecture for identification of new leads for existing protein family members. The deorphanization involved the database homology searching, followed by domain identification, active site prediction, sequence and structure comparative studies. A ligand library set was prepared based on these studies and was used to deorphanize the receptor. The molecular docking study conducted using PyRx revealed that estradiol and tretinion as a potential ligand for Testicular Receptor 4.

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Objective: To evaluate the results of laparoscopic appendectomy using two suprapubic port incisions placed below the pubic hair line. Design: Prospective hospital based descriptive study. Settings: Department of surgery of a tertiary care teaching hospital located in Rohtas district of Bihar. The study was carried out over a period of 11months during November 2011 to September 2012. Participants: Seventy five patients with a diagnosis of acute appendicitis. Materials and Methods: All patients underwent laparoscopic appendectomy with three ports (one 10-mm umbilical for telescope and two 5 mm suprapubic as working ports) were included. Operative time, conversion, complications, hospital stay and cosmetic results were analyzed. Results: Total number of patients was 75 which included 46 (61.33%) females and 29 (38.67%) males with Mean age (±Standard deviation {SD}) at the time of the diagnosis was 30.32 (±8.86) years. Mean operative time was 27.2 (±5.85) min. One (1.33%) patient required conversion to open appendectomy. No one patient developed wound infection or any other complication. Mean hospital stay was 22.34 (±12.18) h. Almost all patients satisfied with their cosmetic results. Conclusion: A laparoscopic approach using two supra pubic ports yields the better cosmetic results and also improves the surgeons working position during laparoscopic appendectomy. Although, this study had shown better cosmetic result and better working position of the surgeon, however it needs further comparative study and randomized controlled trial to confirm our findings.

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Malocclusion can also be corrected by means of clear removable appliances called as "tooth positioners" or "aligners". A tooth positioner is used to control settling and to minimize or eliminate relapse of the teeth after an orthodontic treatment. In this article, a complete review of the objectives, course of treatment, fabrication, and the materials used for fabrication of tooth positioners along with their importance and disadvantages were discussed. Tooth positioners did improve the overall orthodontic treatment outcome as quantified by the ABO (American Board of orthodontics) objective scoring method. But once the initial occlusal contact was achieved, the vertical movement of teeth was found to be inhibited.

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Introduction : One of the target organs of heavy metals is testis and many authors proposed that oxidative stress could be responsible to induce their toxicity. An experimental study was conducted to evaluate the molecular mechanisms of lead (Pb) and cadmium (Cd) toxicity, their toxicodynamic interaction and to evaluate therapeutic potential of N-Acetyl L-cysteine (NAC) against the reproductive toxicity in male Wistar rats. Material and methods : rats were randomly divided into 8 groups comprising of 6 rats in each. Group 1 and 2 were syam and NAC control, Group 3, 4 and 5 were kept as toxic control groups such as lead, cadmium and lead + cadmium respectively, where as Group 6, 7 and 8 were therapeutic groups with NAC. The experiment scheduled for 3 months. Body weights, anti-oxidant profile (GSH, GST, TBARS and protein carbonyls) in testis, testis weight, testicular LDH, sperm count and histopathology were conducted. And also, interaction of Pb and Cd with zinc (Zn) and copper (Cu) in testis was assessed. Results : The present study revealed significant alterations in body weights, anti-oxidant profile, weights of testes, testicular LDH, sperm count, and concentration of Zn and Cu in toxic control groups 3, 4 and 5 as compared to control and NAC-treated groups. The toxic combination (Pb+Cd) group 5 showed significant alterations in protein carbonyls, GST levels and testicular LDH as compared to Pb and Cd alone administered groups and these results are substantiated with marked changes in the histopathology. All the NAC-treated groups revealed significant improvement in all the parameters. Conclusion : The results of the investigation revealed that Pb, Cd and their combination induces toxicity to the biological system due to the excess generation of free radicals and impairment of anti-oxidant defenses. Toxic effects were more pronounced in the group that received a combination of Pb and Cd, suggesting positive toxicodynamic interaction. Use of NAC countered the adverse effects of Pb and Cd induced toxicity to a major extent suggesting its anti-oxidant potential owing to replenishment of tissue pool of GSH. Further, NAC administration reduced the extent of accumulation of Pb and Cd in various tissues.

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Warthin's tumor undoubtedly is the most frequent monomorphic adenoma of the major salivary glands. Clinically, it appears as a slow-growing tumor often fluctuant on palpation due to its cystic nature. The treatment of choice is complete excision with wide tumor-free margins. This article highlights a case of Warthin's tumor of the parotid gland in an elderly male patient along with a review of the literature on the aforementioned pathology.

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Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side. Prompt closed reduction followed by immobilization in arm sling and subsequent rehabilitation ensured a good outcome.

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A simple, sensitive method for the determination of meta-chlorobenzoic acid in bupropion hydrochloride is described. Chromatographic separation of m-chlorobenzoic acid is achieved using a mobile phase consisting of n-hexane and ethanol (1000:50, v/v) at a flow rate of 1.0 ml/min on a Chiralpak ADH (250 × 4.6 mm). Absorbance is monitored at 235 nm. The method is linear for m-chlorobenzoic acid over concentration range of LOQ, 5.0 μg/ml to 15.0 μg/ml for m-chlorobenzoic acid with correlation coefficient greater than 0.99. This method is more selective and accurate than United States Pharmacopoeia method for the determination of m-chlorobenzoic acid in bupropion hydrochloride.

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Objectives: To compare the polarization colors of collagen fibers of odontogenic keratocyst (OKC), radicular cyst, dentigerous cyst, and adenomatoid odontogenic tumor (AOT) with reference to their biological behavior. Study Design: Twenty cases each of OKC, radicular cyst, dentigerous cyst, and AOT were stained with picrosirius red stain and studied under polarized light. Results: A predominance of green to greenish yellow thick fibers was noted in OKC and AOT as compared to dentigerous cyst and radicular cyst. There was no significant difference between the polarization colors of the thin fibers in all the three groups. Conclusion: The stroma of OKC and AOT consists of poorly packed or pathologic collagen and plays a role in its neoplastic behavior.

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Background: Menarche seems be related to the relative distribution rather than the total amount of body fat. Previous studies showed that the ratio between lower-body vs. upper-body fat was associated with the timing of menarche. Aim: To compare the relative distribution of subcutaneous fat among Bengali Hindu pre- and post-menarcheal girls. Materials and Methods: The participants were 234 Bengali Hindu girls aged 11-14 years: 111 pre-menarcheal and 123 post-menarcheal girls, randomly selected from a secondary school from a suburb of Kolkata, West Bengal, India. Triceps, abdominal, sub-scapular, and calf skinfolds were measured. For each skinfold site, ratio was calculated as follows: Log (one skinfold/sum of skinfolds). Principal components (PC) analysis was performed to derive components which express the maximum contrast among the log of ratios. T-test was employed to assess differences between individual scores of components between pre- and post-menarcheal girls. Results: The three identified PC suggested extremities-trunk, lower trunk-upper trunk, and an upper extremity-lower extremity contrasts, respectively. Scores for second and third components showed significant differences between pre- and post-menarcheal groups of girls. Conclusion: The attainment of menarche by Bengali girls aged 11-14 years was associated with characteristically more relative subcutaneous fat distribution in the upper trunk and in the lower limbs, in contrast to lower trunk and upper limbs, respectively.

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Objective: To measure the arch width and Median mandibular flexure (MMF) values at relative rest and maximum jaw opening in young adults with Dolichofacial, Mesofacial, and Brachyfacial types and tested whether the variation in the facial pattern is related to the MMF values in South Indian population. Materials and Methods: This Prospective clinical study consisted of sample of 60 young adults. The subjects were grouped into 3 groups: Group 1: Brachyfacial, Group 2: Mesofacial and types, Group 3: Dolichofacial. Impressions were taken for all the 60 subjects and the casts were scanned and digitized. The intermolar width was measured for Dolichofacial, Mesofacial, and Brachyfacial subjects at relative rest (R) and maximum opening (O). Results: The statistical analysis of the observations included Descriptive and Inferential statistics. The statistical analysis was executed by means of Sigma graph pad prism software, USA Version-4. Kruskal wallis (ANOVA) followed by Dunns post hoc test was performed. Mann Whitney U-test was performed to assess the difference in MMF values between Males and Females of the three groups. The Mean (SD) Mandibular flexure in individuals with Brachyfacial type was 1.12 (0.09), Mesofacial type was 0.69 (0.21), and Dolichofacial type was 0.39 (0.08). Conclusions: The Mean intermolar width was maximum in Brachyfacial type and minimum in Dolichofacial type. MMF was maximum at the maximum mouth opening position and was maximum in individuals with Brachyfacial type.

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Background and Objectives: In orthodontic diagnosis and treatment planning, assessment of anteroposterior discrepancy is of importance to the orthodontist. Both angular and linear measurements have been incorporated into various cephalometric analyses to help the clinician diagnose anteroposterior discrepancies and establish the most appropriate treatment plan. Hence the present study is designed to establish the norms of Beta angle to assess the sagittal discrepancy for Nellore district population. Materials and Methods: The sample was screened from the old records of the Orthodontic department of Narayana Dental College and Hospital. One hundred and fifty pretreatment cephalometric radiographs (50 each of Class I, II, and III) were subdivided based on ANB, Wits appraisal, and Beta angle into skeletal Class I, II, III. The same cephalograms were again classified into skeletal Class I, II, and III based purely on Beta angle. Each group was again divided into 2 subgroups consisting of 25 male and 25 female subjects with a mean age limit between 15 and 45 years old. Results: The Newman-keuls post hoc test and ANOVA showed that the 3 groups were significantly different ( P ≤ 0.001). The Newman-keuls post hoc test also found the groups to be significantly different. Conclusions: There was statistically significant difference for, the mean values and the standard deviation for Beta angle within the three skeletal patterns (Class I, Class II and Class III skeletal patterns). There was no statistically significant difference among the mean values of beta angle between Nellore district population and Caucasian norms and between male and female sex groups.

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Aim: To assess the cases of ameloblastoma retrospectively for various parameters. Materials and Methods: Ninety-one previously reported cases of ameloblastoma from Government Dental College and Hospitals, Nagpur, were included in this study. Data were collected considering parameters such as age, sex, symptoms, radiographic, histopathology, treatment modalities, and recurrence. Our findings were also compared with world literature. Results: The average age was 32.5 years. Mostly men complained of an asymptomatic swelling and duration of less than one year. Posterior segment and vertical ramus of mandible was the frequently involved site. Radiographically, multilocular appearance was noted more than 60% of the cases. Plexiform and unicystic ameloblastoma occurred frequently. Surgery was the treatment of choice in this review. Recurrence was noted in more than 10% of the cases. Conclusion: There are variations in our review in comparison to reported literature.

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Background: Wedelia chinensis Merrill (Asteraceae) is a medicinally important herb, grown abundantly in soils contaminated with heavy metals, including toxic metalloid arsenic (As). The leaves have immense significance in treatment of various ailments. Objective: The present study was undertaken to ascertain whether the edible/usable parts experience oxidative stress in the form of membrane damage during As exposure or not. Materials and Methods: Responses of seven antioxidant enzymes were studied in leaves under 20 mg/L of As treatment in pot experiment. Results: When compared to control, activities of superoxide dismutase, monodehydroascorbatereductase, dehydroascorbatereductase, glutathione reductase, and gluathione peroxidase had increased, while the catalase level reduced and ascorbate peroxidase activity changed non-significantly in As-treated seedlings. This suggested overall positive response of antioxidant enzymes to As-induced oxidative stress. Although hydrogen peroxide content increased, level of lipid peroxidation and magnitude of membrane damage was quite normal, leading to normal growth (dry weight of shoot) of plant under Astreatment. Conclusion: W.chinensis is tolerant of As-toxicity, and thus, can be grown in As-contaminated zones.

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Retained primary teeth is a well-known process but multiple retained primary, permanent, and supernumerary teeth that too in an asymptomatic, non-syndromic patient is a rare possibility that has rarely been reported in literature. This case report discusses the clinical and radiographic details along with treatment options in a 21-year-old patient having a total number of 50 teeth, i.e., 16 retained primary teeth, 32 permanent teeth, and 2 supernumerary teeth without being associated with any known syndrome complex or metabolic disorder.

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Objective: Early childhood caries (ECC) is a particularly destructive form of tooth decay that afflicts young children. The etiology and associated factors of ECC should be studied adequately to overcome this health hazard. The aim of this study was to determine caries prevalence and its consequences in toddlers in an Anatolian city, Kırıkkale. Materials and Methods: Examinations were performed in family medicine centers by three calibrated dentists during a period of 6 months. The status of dental caries was recorded according to the World Health Organization (WHO) criteria. We recorded the clinical indexes of decayed, missed, and filled teeth (DMFT and dmft; upper-case letters refer to permanent and lower-case letters to primary teeth), and decayed, missed, and filled surfaces (DMFS). Results: Totally 3171 toddlers were included (52% males and 48% females). The mean age was 25.8 ± 10.1 months. The prevalence of ECC in preschool children was 17.3%, while the mean df(t) was 0.63 ± 1.79. ECC increased significantly with age. Dental caries were mostly observed in primary maxillary central teeth. Occlusal and buccal surfaces were the most affected sites. The difference in distribution of caries between maxilla and mandibula was found to be statistically significant ( P < 0.05). Conclusions: When compared to other data obtained from various epidemiologic studies, the toddlers living in Kırıkkale city center had a significant caries level. This observation had clearly suggested that early preventive measures should urgently be put into effect all over the city.

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Background: Nepenthes species are used in traditional medicines to treat various health ailments. However, we do not know which types of endophytic bacteria (EB) are associated with Nepenthes spp. Objective: The objective of this study was to isolate and to identify EB associated with Nepenthes spp. Materials and Methods: Surface-sterilized leaf and stem tissues from nine Nepenthes spp. collected from Peninsular Malaysia were used to isolate EB. Isolates were identified using the polymerase chain reaction-amplified 16S ribosomal DNA (rDNA) sequence similarity based method. Results: Cultivable, 96 isolates were analyzed; and the 16S rDNA sequences analysis suggest that diverse bacterial species are associated with Nepenthes spp. Majority (55.2%) of the isolates were from Bacillus genus, and Bacillus cereus was the most dominant (14.6%) among isolates. Conclusion: Nepenthes spp. do harbor a wide array of cultivable endophytic bacteria.

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Ochronotic arthropathy is a rare condition found in patients with alkaptonuria, which is a hereditary metabolic disease associated with deposition the of homogentisic acid derivatives in various connective tissues of the body. We present the case of a 30-year-old woman in whom arthroscopic examination of the left knee prior to meniscectomy for bucket handle tear of medial meniscus revealed brown-black discoloration of the articular cartilage and menisci leading to the diagnosis of alkaptonuria by further laboratory evaluation. After medical and surgical treatment, patient's complaints were alleviated and no further complaints were registered, during the next follow-up.

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Background: Alterations in serum lipids have long been associated with cancer as lipids play an important role in maintenance of cell integrity. Aims: To evaluate alterations in plasma lipid profile in oral cancer patients, to compare and correlate the serum lipid profile in different grades of carcinoma and to evaluate the correlation of serum lipid profile between the tobacco habituates and non-habituates. Materials and Methods: Among 75 study subjects, 50 individuals were oral carcinoma patients and 25 individuals were healthy controls. The parameters assessed included total cholesterol (TC), high-density lipoprotein-cholesterol (HDLC), low-density lipoprotein-cholesterol, very low-density lipoprotein-cholesterol and triglycerides (TGL). These groups were subdivided into subjects with no habit of tobacco (NHT) and subjects with habit of tobacco (WHT). Stastical Analysis Used: Evaluation of results and statistical analysis was carried out using Student's t-test and one-way Analysis of Variance. Results: There was a significant decrease in TC, HDLC and TGL in the oral cancer group as compared with the control group. The lipid profile levels between histological grading of the oral cancer and between WHT and NHT had no statistical significance. Conclusions: There was an inverse relationship between serum lipid profile and oral cancer. The lower serum lipid status may be considered a useful indicator for initial changes occurring in the neoplastic cells.

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Background : Chronic periodontitis in amultifactorial inflammatory disease which is caused by various microorganisms. Many studies have found close association between chronic periodontitis and C-reactive protein (CRP). CRPis an inflammatory marker which increases in all inflammatory condition. Aims and Objective : The present clinical study was designed to show the effect of periodontal treatment on the CRP levels of gingival crevicular fluid and to determine the effect of nonsurgical therapy in minimizing the CRP levels in chronic generalized periodontitis. Material and Method : Gingival crevicular fluid was collected using a micro capillary pipette that was hand calibrated at every 1 mm till 10 mm, from selected sites in the subjects on the 1st, 14th and 45th days. Results and Conclusion : Decreased CRP levels of gingival crevicular fluid were observed at the end of the study. There was a 37% reduction in probing pocket depth and 45% gain in clinical attachment level and a reduction of about 57% after 14 days and 90% reduction of CRP levels in gingival crevicular fluid after 45 days. Thus, the results show that the presence of CRP level is more significant in gingival crevicular fluid and confirms the underlying inflammatory component of the disease activity in chronic periodontitis.

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Aim: To assess the dental health status and treatment needs of transport workers working in Chandigarh Transport Undertaking (C.T.U.) buses, Chandigarh. Materials and Methods: A cross-sectional study was conducted on all the available C.T.U. workers at all three bus depots. The data were recorded on a modified W.H.O. format (1997). A total of 1008 subjects constituted the final sample size. Results: The mean age of the subjects was 45.3 ± 7.8 years, and 97% (978) were males. Prevalence of dental caries was 63.4% and mean DMFT was 5.02. 47.6% of subjects needed some prosthesis in the maxillary arch while 53.3% needed some prosthesis in the mandibular arch. Regarding highest CPI (Community Periodontal Index) score, 8.13% of the subjects had healthy periodontium while maximum subjects (73.2%) had a score 2 (Calculus). Conclusion: Mean DMFT (Decayed, Missing and Filled Teeth) was satisfactory. Prosthetic need of the subjects was high with only a few subjects possessing prosthesis. Advanced periodontal disease (CPI score, 4) affected small number of subjects with maximum subjects (73%) having a CPI score of 2.

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Objective: The present study is envisaged to evaluate and compare the microleakage of mineral trioxide aggregate (MTA) with commonly used retrograde filling materials, like light-cured composite with dentin-bonding agents, light-cured glass ionomer cement (LC GIC) and resin-modified zinc oxide eugenol. Materials and Methods: Ninety freshly extracted non-carious single-rooted human anterior teeth were used in the study. They were randomly divided into four experimental groups and two control groups of 15 each. Following the biomechanical preparation, all teeth were obturated and then the apices of the obturated teeth were resected by removing 3 mm of each apex at 90° to the long axis of the tooth with a straight fissure bur in a high-speed air-rotor handpiece with water coolant. A 3-mm-deep root end cavity was prepared and the root end fillings were placed as per the manufacturer's instructions and according to the groups divided. The samples were then immersed in 1% methylene blue at room temperature for 72 h, 96 h and 1 week and the dye penetration was measured. Results and Conclusion: All the four materials used in the study showed some microleakage throughout the experimental period. The sealing ability in terms of microleakage can be summarized as: MTA > Composite resin with dentin bonding agent > LC GIC > Resin modified zinc oxide eugenol.

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Background: Sexual disorders among diabetic men have been proved in different studies but sexual dysfunction of diabetic women has received attention only recently. Neuropathy, vascular impairment, and psychological complaints have been implicated in the pathogenesis of decreased libido, low arousability, decreased vaginal lubrication, orgasmic dysfunction, and dyspareunia among diabetic women. Aim: The aim of this research was to study the prevalence of sexual dysfunction in different areas among diabetic women. Materials and Methods: A cross-sectional study was conducted on 500 women who were recruited from a diabetes center, based on questionnaires completed by them. Data regarding demographic features, physical complications, and sexual disorders were obtained. Medical records of patients were used to obtain body mass index (BMI) and details of complications. Results: Mean age of participants, duration of diabetes, and BMI was 48.8 ± 0.4, 8.9 ± 0.32 years, and 28.9 ± 0.23, respectively. Prevalence of sexual dysfunction was 32.3%. Low sexual desire was seen in 81.8%, disorders of arousal in 78.3%, of orgasm in 47.5%, and 35.1% had disorder in resolution area. There was no significant relationship between some factors such as age, duration of diabetes, BMI, and frequency of sexual dysfunction. Frequency of diabetic complications demonstrated a significant effect on the prevalence of sexual dysfunction. Conclusion: Sexual problems are frequent among diabetic women and deserve more attention in clinical practice and researches.

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Background: Pre-eclampsia (PE) complicates approximately 5-7% of all pregnancies. This study investigates the effects of S-nitroso-N-acetylpenicillamine (SNAP) and S-nitrosoglutathione (GSNO) on the classical features of PE. Materials and Methods: On day 14 of gestation, female Sprague-Dawley rats were separated into five groups and treated intravenously for 7 days as follows: (i) 0.3 mL 0.9% saline (control, n = 11); (ii) 50 mg/kg Body Weight (BW) N-nitro-L-arginine methyl ester (L-NAME) in 0.3 mL saline ( n = 10); (iii) 50 mg/kg BW L-NAME and 8 mg/kg BW GSNO in 0.15 mL saline ( n = 6); (iv) 50 mg/kg BW L-NAME in 0.15 mL saline and 8 mg/kg BW SNAP in 0.15 mL DMSO ( n = 9); and (v) 0.15 mL DMSO and 0.15 mL saline (SNAP control, n = 7). Blood pressures were measured on day 14 through day 20, a 4-h urine sample was taken on day 20, and animals were sacrificed on day 21. Pups were counted and weighed individually. Results: SNAP and GSNO significantly decreased systolic, diastolic, and mean arterial pressures in PE-induced rats from day 14 through day 20 ( P < 0.05). Pup weights in SNAP and GSNO groups were higher than in L-NAME group but lower than in controls ( P ≤ 0.001). SNAP and GSNO partially reversed growth retardation. Conclusion: Elevated blood pressure, proteinuria, and intrauterine growth restriction associated with PE were induced in Sprague-Dawley rats using L-NAME. These were partially reversed with the use of GSNO and SNAP. The mechanism of action of these S-nitrosothiols (RSNOs) should be further explored.

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Elbow dislocation associated with ipsilateral distal radius fracture is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a rare case of a 20-year-old male who had a posterior elbow dislocation and ipsilateral distal radius fracture. Elbow dislocation was first reduced in extension and distal radius fracture was then reduced in flexion. Both the injuries were conservatively managed. At 6 months follow-up, the patient had no pain in his elbow and minimal pain in his wrist on heavy lifting and had resumed his work as a laborer.

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Choriocarcinoma is a highly malignant tumor of the trophoblastic origin. Most cases are present within 1 year of antecedent pregnancy. We present an extremely rare case of choriocarcinoma of the anterior abdominal muscle in a 41-year-old female who presented as mass in anterior abdominal wall 4 months after undergoing a total abdominal hysterectomy with bilateral salpingo oophorectomy for a diagnosis of fibroid uterus. Laparotomy done for the mass revealed it to be an extraperitoneal mass within the rectus muscle that on histopathological examination was confirmed to be primary choriocarcinoma. Computed tomography scan revealed pulmonary metastases and patient was given combination chemotherapy to which she responded well.

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Objective : The present study was aimed to study protective role of N-acetyl cysteine (NAC) was assessed against arsenic (As)-induced hepatotoxicity in rats. Methods : Twenty four male Wistar rats were divided into 4 groups of 6 animals each and treated as follows: Group 1: sham control, 2: arsenic control (sodium arsenite @ 10 mg/kg b. wt orally for 4 wks), 3: Pre-treatment with NAC (@ 300 mg/kg orally for 2 wks) followed by sodium arsenite along with NAC (as per above doses) and 4: Sodium arsenite + NAC (as per above doses for 4 wks). Results : The concentration of thiobarbituric acid reacting substances (TBARS) and protein carbonyls was significantly (P<0.05) increased, while the concentration of reduced glutathione (GSH), and the activity of CYP450, Na+ - K+ ATPase and Mg2+ ATPase in liver were significantly (P<0.05) reduced in group 2 as compared to control. Groups 3 and 4 revealed improvement in the parameters in study. Conclusion : The study revealed that arsenic induces hepatotoxicity by inducing oxidative stress and supplementation of NAC is beneficial in countering the adverse effects.

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Intramedullary nailing is considered the standard of care for closed femoral shaft fractures. Several studies have shown that reamed intramedullary nailing is a safe procedure in fracture shaft femur with lower nonunion rates than unreamed nailing. Reamed intramedullary nailing provides better stability because of increased contact between the nail and medullary canal. However, careful attention to reaming techniques as well good instrumentation is necessary while undertaking such a procedure. We report what is, to the best of our knowledge, the first case of uncoiling of reamer while reaming the medullary canal. Possible causes and measures to avoid such a complication are discussed.

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Kikuchi-Fujimoto disease, characterized by histiocytic necrotizing lymphadenitis, closely mimics tuberculosis, and lymphoma are two most common etiologies of cervical lymphadenitis. It is a rare, benign, and self-limited disease. Viral infections or autoimmunity are hypothesized as its etiology, but no causal relationship is definitely established till date. No specific treatment is available, only supportive treatment is given. Here, we represent a rare case of Kikuchi's disease in a 29-year-old male patient who presented to us with right-sided posterior cervical lymphadenopathy with low-grade fever for three months.

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Myxomas of the head and neck are rare tumors of uncertain histogenesis. Odontogenic myxomas in maxilla are less common but behave more aggressively, as it spreads through maxillary antrum. It therefore reaches considerable size before being detected. The current case arouses particular interest due to the rapid growth and infiltrating nature of the lesion in a 25-year-old female patient, who denied any leading symptoms, even with the lesion involving extensively. Radiographic and microscopic similarities to a number of entities make diagnostic interpretation of odontogenic myxoma challenging. Therefore sound knowledge of clinical, radiographic and histopathologic features is important to establish an appropriate treatment aimed at a good clinical course and patient cure.

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A patient presented with multiple nodulo-ulcerative lesions over neck and chest. Lymphadenopathy and systemic involvement were absent. Patient was seronegative for HIV. There was no history of local injury and no history of travel. Histopathological findings were consistent with histoplasmosis. Diagnosis of primary cutaneous histoplasmosis was made. We highlight this case owing to its rare and atypical presentation, in an attempt to promote clinical and micro-pathological awareness regarding such occurrences.

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Background: In middle age people, hypercholesterolemia (HC) has been included as a risk factor for cardiovascular disease. Objectives: The main objective of this study was to evaluate the prevalence of HC and some related factors in the north of Iran. Materials and Methods: This was a population-based cross-sectional study that enrolled 1995 subjects (997 males and 998 females) in 25-65 year age using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Plasma cholesterol was measured in the morning after a 12-hour fast and determined by an auto-analyzer. HC was defined by a total plasma total cholesterol level over 200 mg/dl. The SPSS.16 software was used to analyze data. Results: The mean age of the participant was 44.2 years and mean ± SD plasma total cholesterol level in men and women was 196.7 ± 39.11 and 209.4 ± 42.9, respectively. Generally, the prevalence of HC was 50.4% with a significant differences between men (44.7%) and women (57%) ( P < 0.05). The mean plasma total cholesterol levels were significantly differenced among age groups, location area, BMI, and waist circumferences ( P < 0.001). Women gender (OR = 1.64), 55-65 years old (OR = 2.79), BMI ≥40 kg/m ² (OR = 10.0), and abdominal obesity (OR = 2.47) were associated with increased risk of HC ( P = 0.001 and 95%CI for all). Conclusion: HC is one of the most health problems in the northern Iran and it is more common in women than in men. General and abdominal obesity are the most common risk factors for HC.

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Idiopathic juvenile osteoporosis (IJO) is a term used to describe a primary osteoporosis of unknown etiology in prepubertal children. It is rarely described in the literature and treatment modalities vary with spontaneous remission also being reported at the time of puberty. We report a 5-year-old girl with IJO who had spinal deformities and was successfully treated with oral alendronate.

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Objective: To evaluate the associated factors in reinitiating the smoking habit among the participants of a smoking cessation program conducted in a tobacco cessation clinic of Manipal University, Manipal. Materials and Methods: This cross-sectional study was conducted among participants of a smoking cessation program who reinitiated smoking habit. A self-administered questionnaire was used that had information on demographic, habit history, knowledge on harmful effects of smoking behavior related to oral cavity and associated factors due to which individual was unable to quit the habit. Results: A total of 102 males (mean age = 39.91 ± 9.57) constituted the final sample. The results showed that habitual smokers were more likely to be ≥40 years and occasional smokers were all reported to be <93 years ( P < 0.001). Cigarette smokers were more likely to be of younger age group while majority of the Beedi and cigarette + Beedi smokers were older adults ( P < 0.001). The mean duration of the habit was significantly higher for older adults than young adults ( P < 0.001). There was no significant difference in the number of packs between the age groups ( P = 0.054). A significantly higher proportion of young adults than older adults were aware about oral cancer ( P < 0.001). Significantly higher proportion of older adults than young adults tend to have a closest person to be a smoker ( P = 0.05). A significant higher proportion of young adults reason their habit as for pleasure (84.6%) and relaxation (68.8%), while older adults reason it to be as tension (64.1%) or combined factors (70.6%). Peer pressure was almost same in both the age groups ( P = 0.006). There were no significant differences in the withdrawal symptoms among young and older adults ( P = 0.41). Conclusion: Considerable differences were noticed between younger and older age groups in the factors which might play a role in re-intiating the smoking habit. A structured cessation program focused more on the above characteristics should be planned in public health programs based on the characteristics of the participants.

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Schwannoma is an intraoral rare, benign neoplasm arising from and consisting solely of Schwann cells. Its etiology is unknown. It presents as a solitary, slow growing, smooth surfaced, generally asymptomatic firm mass. Schwannomas commonly occur between 30 and 50 years. It is relatively uncommon, although a quarter of all Schwannoma's occurs in the head and neck region. Schwannoma of the floor of the mouth is rare in the oral region. Described is a case of Schwannoma of the floor of the mouth in a 28-year-old male, of large size.

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