Nirmatrelvir plus ritonavir reduces COVID-19 hospitalization and prevents long COVID in adult outpatients.

Nirmatrelvir plus ritonavir received Emergency Use Authorization for treating mild to moderate COVID-19 in high-risk patients. Its efficacy against the Omicron variant of SARS-CoV-2 remains uncertain. This retrospective cohort study assessed the effect of nirmatrelvir-ritonavir in preventing severe disease progression and long COVID symptoms after acute COVID-19 in non-hospitalized adults. SALAMA medical records from Dubai's COVID-19 healthcare centers between May 22, 2022, and April 30, 2023, were used to identify 7290 eligible patients, 9.6% of whom received nirmatrelvir-ritonavir. Treatment was associated with a notable reduction in COVID-19-related hospitalizations (adjusted hazard ratio [HR] of 0.39; 95% CI, 0.18-0.85) by day 28 of symptom onset. Moreover, nirmatrelvir-ritonavir was associated with fewer long COVID symptoms (adjusted HR of 0.42; 95% CI, 0.19-0.95). This suggests the significant effectiveness of nirmatrelvir-ritonavir against the Omicron variant, reducing both severe and long-term COVID-19 symptoms.

Smoking and Its Impact on Orthodontic Treatment/Management Modalities: A Systematic Review and Meta-Analysis.

Background: We aimed to review studies that evaluated the effect of cigarette smoking on orthodontic treatment methods and determine whether the smoke affected appliances in a way that could impair the effectiveness of the overall treatment strategy. Methods: PubMed, Google Scholar, Cochrane Library, and Web of Science were scoured using pertinent keywords, reference searches, and citation searches in accordance with the PRISMA protocol regarding articles published from 2008 till 2022. Results: Ultimately, 7 papers were chosen for further analysis at the end of the selection protocol. Overall pooled odds ratio (OR) for the impact of cigarette smoking on orthodontic treatment was 0.25 (95% CI: 0.15, 0.43), with high statistical significance (P<0.00001) but also high heterogeneity (I2 = 81%). The relative risk (RR) was 0.50 (95% CI: 0.38, 0.66), indicating a 50% greater risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I2 = 79%), and the risk difference (RD), which was -0.33 (95% CI: -0.45, -0.21), suggesting a 33% higher risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I2 = 81%). The high heterogeneity in all measures indicates significant variability in the results across the included studies. Conclusion: All the 7 studies selected for our systematic review exhibited significant detrimental associations between smoking and orthodontic appliances and other modalities that were exposed to cigarette smoke. However, more studies need to be done in this regard, since the literature currently available on this relationship is quite poor and lacking in concrete evidence.

Ultrasensitive detection of histamine in spoiled meat employing silver nanoparticles decorated Perylene: An experimental-computational conjugation.

Meat spoilage has been acquiring increasing attention recently and is directly associated with food safety and human health. Biogenic amines are the spying organic compounds fostered from the microorganism-mediated decarboxylation of amino acids during meat spoilage. Histamine, a biogenic amine acts as a model analyte and is toxic if consumed substantially. It is crucial to monitor histamine levels in meat due to its adverse effects. In this study, a simple and quick fluorescent sensor was fabricated for sensitive and selective detection of histamine. Citrate-capped silver nanoparticles (AgNP) were loaded onto Perylene (PER) to develop a sensing probe that was characterized using UV-visible, FTIR, XRD, and FESEM, and its optical behavior toward histamine was investigated. Moreover, the binding affinity between histamine and PER@AgNP was assessed using a DFT-based computer simulation. Under optimal conditions, the sensor showed linear relationships for histamine concentrations from 25 µM to 3200 µM with LOD 13.52 µM.

Captive Breeding and Early Developmental Dynamics of Cirrhinus mrigala: Implications for Sustainable Seed Production.

Cirrhinus mrigala is an important edible fish with a significant aquaculture contribution in Southeast Asian countries. The current study aims to enhance our understanding of the developmental biology of Cirrhinus mrigala, which is crucial for implementing sustainable fish farming practices. To induce spermiation and ovulation in Cirrhinus mrigala brooders, the synthetic hormone Ovaprim® (GnRH + dopamine inhibitor) was administrated as a single injection dose of 0.2 mL/kg to males and 0.4 mL/kg to females. After induction, the fish spawned, and the eggs produced were fertilized artificially and cell division commenced successfully. The characteristics of each larval developmental stage were closely observed and recorded using a time-lapse imaging technique. The fertilized eggs were spherical, demersal, and non-adhesive throughout their incubation period. The spawned eggs ranged in diameter from 2.1 mm to 2.13 mm and possessed circular yolk sacs. The gastrula stage initiated approximately 4 h after fertilization, with 25% of the yolk sphere covered by blastoderm, reaching 75% coverage at the end of the gastrula stage, approximately 6 h post fertilization. Organogenesis was marked by the formation of notochord and the visibility of rudimentary organs such as the heart, eyes, and gills, followed by tail movement, which was observed at the time of hatching. Compared to other cyprinid fishes, C. mrigala exhibited distinct features at certain stages of embryonic development. Blood circulation was observed to start at the onset of hatching. The lengths of the newly hatched larvae ranged from 2.9 to 3.2 mm, smaller than other reports on induced breeding in carps. The findings of the present study provide a detailed reference for the embryonic development of C. mrigala, which will assist its future research endeavors and large-scale seed production for sustainable aquaculture.

Hypersensitivity Pneumonitis: An Interesting Case of Acute Shortness of Breath in a Young Patient.

Hypersensitivity pneumonitis (HP) is a rare disease caused by an inflammation of the distal airway caused by an immune response to inhaled allergens. The clinical presentation and radiological and histological findings can overlap with other pulmonary conditions such as idiopathic pulmonary fibrosis. Therefore, it is essential to consider focused assessment for the patient if a diagnosis of HP is suspected. We present a case involving a young female patient who presented with symptoms of cough, flu-like illness, and dyspnea. Subsequent investigations revealed a diagnosis of nonfibrotic HP. The patient experienced acute respiratory failure and was managed with high-flow oxygen therapy. A detailed investigation determined that the patient's prior exposure to pet parrots at home was a significant factor. Following treatment with steroids and counseling regarding the removal of parrots from the home environment, the patient's condition improved, and she was successfully weaned off of oxygen therapy. This case underscores the importance of a comprehensive social history in evaluating common complaints such as dyspnea. The rarity of parrot-induced HP related to the patient's age, and exposure warrants attention.

Investigating the Efficacy of Various Natural Products in Raw Form against Multidrug-Resistant Bacteria.

BACKGROUND: The alarming increase in antibiotic resistance urges alternative and efficacious antimicrobial solutions. Historically, medicinal plants have been used for therapeutic purposes, such as relieving pain and healing wounds. However, the evaluation of the natural therapeutic effects of medicinal plants in a manner that resembles how humans typically consume them is lacking. Therefore, in this study, many medicinal plants known to have some antimicrobial effects, including Frankincense, Garlic, Myrrh, and Ginger, were evaluated for their direct antibacterial activity in raw form. MATERIALS AND METHODS: The direct antimicrobial activity of medicinal plants was evaluated against a variety of Gram-positive and Gram-negative bacterial strains, such as Staphylococcus aureus (S. Aureus), Acinetobacter baumannii and Klebsiella pneumoniae using agar well diffusion method and turbidity measurements in suspension culture. RESULTS: Out of all the tested medicinal plants, only raw garlic (Allium sativum) powder, when dissolved in water or vinegar, offered a straightforward antibacterial activity. A combination of garlic extract and vinegar increased antibacterial activity. Aqueous garlic extracts displayed robust antimicrobial activity against many resistant bacteria. Other medicinal plants used in this study had absent or minimal antibacterial effects. CONCLUSION: Only garlic in its raw form was effective against antibiotic-resistant bacteria. The increase in the antibacterial activity of garlic when combined with vinegar suggests the synergistic activity of garlic. The straightforward antibacterial action of raw garlic may be strategically harnessed to combat the continuous challenge of increasing antibiotic resistance. This work promotes additional testing of more natural products (in raw form) and assesses their therapeutic effects clinically.

Analysis of Long-Term Success and Biological Complications in Zygomatic Implant-Supported Prostheses.

Introduction: Patients with significant maxillary atrophy who are not candidates for standard implants now have an option thanks to zygomatic implants. Long-term statistics on difficulties and success are, however, scarce. Methods: A tertiary care center's patient data were retrospectively analyzed. Included were patients who underwent zygomatic implant surgery between 2017 and 2022. This research gathered and examined data on follow-up, surgical techniques, complications, demographics, and implant features. Findings: There were 100 patients in all. 92% of the implants were successful, and 92 of them survived. Peri-implantitis (20%), soft tissue dehiscence (15%), sinusitis (10%), prosthesis fracture (8%), and infection (5%), were among the biological consequences. In summary, zygomatic implants have the potential to help individuals with severe maxillary atrophy recover, but close observation and effective management of any problems are necessary to maximize results. To enhance patient care and improve treatment regimens, further research is required.

Symptoms and management of cow's milk allergy: perception and evidence.

Introduction: The diagnosis and management of cow's milk allergy (CMA) is a topic of debate and controversy. Our aim was to compare the opinions of expert groups from the Middle East (n = 14) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) (n = 13). Methods: These Expert groups voted on statements that were developed by the ESPGHAN group and published in a recent position paper. The voting outcome was compared. Results: Overall, there was consensus amongst both groups of experts. Experts agreed that symptoms of crying, irritability and colic, as single manifestation, are not suggestive of CMA. They agreed that amino-acid based formula (AAF) should be reserved for severe cases (e.g., malnutrition and anaphylaxis) and that there is insufficient evidence to recommend a step-down approach. There was no unanimous consensus on the statement that a cow's milk based extensively hydrolysed formula (eHF) should be the first choice as a diagnostic elimination diet in mild/moderate cases. Although the statements regarding the role for hydrolysed rice formula as a diagnostic and therapeutic elimination diet were accepted, 3/27 disagreed. The votes regarding soy formula highlight the differences in opinion in the role of soy protein in CMA dietary treatment. Generally, soy-based formula is seldom available in the Middle-East region. All ESPGHAN experts agreed that there is insufficient evidence that the addition of probiotics, prebiotics and synbiotics increase the efficacy of elimination diets regarding CMA symptoms (despite other benefits such as decrease of infections and antibiotic intake), whereas 3/14 of the Middle East group thought there was sufficient evidence. Discussion: Differences in voting are related to geographical, cultural and other conditions, such as cost and availability. This emphasizes the need to develop region-specific guidelines considering social and cultural conditions, and to perform further research in this area.

A multi-institutional meningioma MRI dataset for automated multi-sequence image segmentation.

Meningiomas are the most common primary intracranial tumors and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on brain MRI for diagnosis, treatment planning, and longitudinal treatment monitoring. However, automated, objective, and quantitative tools for non-invasive assessment of meningiomas on multi-sequence MR images are not available. Here we present the BraTS Pre-operative Meningioma Dataset, as the largest multi-institutional expert annotated multilabel meningioma multi-sequence MR image dataset to date. This dataset includes 1,141 multi-sequence MR images from six sites, each with four structural MRI sequences (T2-, T2/FLAIR-, pre-contrast T1-, and post-contrast T1-weighted) accompanied by expert manually refined segmentations of three distinct meningioma sub-compartments: enhancing tumor, non-enhancing tumor, and surrounding non-enhancing T2/FLAIR hyperintensity. Basic demographic data are provided including age at time of initial imaging, sex, and CNS WHO grade. The goal of releasing this dataset is to facilitate the development of automated computational methods for meningioma segmentation and expedite their incorporation into clinical practice, ultimately targeting improvement in the care of meningioma patients.

Risk factors and early preventive measures for long COVID in non-hospitalized patients: analysis of a large cohort in the United Arab Emirates.

OBJECTIVES: Long COVID is characterized by persistent symptoms lasting for 4 weeks or more following the acute infection with SARS-CoV-2. Risk factors for long COVID and the impact of pre-COVID vaccination and treatment during acute COVID-19 remain uncertain. This study aimed to investigate patient-specific factors associated with long COVID in a large cohort of non-hospitalized adult patients with mild to moderate COVID-19 in Dubai. STUDY DESIGN: Cohort study. METHODS: The study included 28,375 non-hospitalized adult patients diagnosed with mild to moderate COVID-19 between January 1, 2021, and September 31, 2022, in Dubai, who were followed up for 90 days. The presence of long COVID symptoms was documented by physicians during patient visits to the family medicine department. Furthermore, long COVID-related risk factors were collected and analyzed, including patient demographics, comorbidities, pre-COVID vaccination status, and the COVID-related treatments received during the acute phase of the illness. Cox proportional hazard models were applied for the statistical analysis. RESULTS: Among the cohort, 2.8% of patients experienced long COVID symptoms during the 90-day follow-up. Patients with long COVID tended to be younger, female, and of Caucasian race. Common symptoms included fatigue, muscle pain, respiratory symptoms, abdominal and neurological symptoms, allergic reactions, skin rashes, and hair loss. Risk factors for long COVID were identified as diabetes mellitus, asthma, and Vitamin D deficiency. Females and Caucasians had a higher risk of long COVID during the pre-Omicron period compared to the Omicron period. Pre-COVID vaccination was associated with a reduced risk of long COVID in all patient subgroups. Treatment with favipiravir or sotrovimab during the acute phase of COVID-19 was linked to a decreased risk of long COVID, although favipiravir showed limited effectiveness in the high-risk group. CONCLUSION: This study contributes to the existing knowledge by identifying risk factors for long COVID among non-hospitalized patients and emphasizing the potential benefits of pre-COVID vaccination and timely treatment.

Design of Experimental Approach for Development of Rapid High Performance Liquid Chromatographic Process for Simultaneous Estimation of Metoprolol, Telmisartan, and Amlodipine from Formulation: Greenness and Whiteness Evaluation.

The design of an experimental approach, the Box-Behnken design, was implemented to optimize the chromatographic condition to develop a rapid HPLC procedure for quantification of a ternary mixture of metoprolol (MET), telmisartan (TEL), and amlodipine (AML) from the formulation. The perturbation plots, contour, and 3D response surface pictures were developed to study the impact of each variable on the analytes' retention time and the probable interaction between the parameters with fewer chromatographic runs. The optimized HPLC method separated the three analytes within 5 min with excellent selectivity and peak shape on a Zorbax C18 HPLC column using acetonitrile and phosphate buffer (20 mM, pH 5.8) with isocratic elution at a 1.1 mL/min flowrate. A wavelength 230 nm was utilized to monitor the elute. The validation of proposed method demonstrated a wide linearity range of 10-200 µg/mL for MET and TEL and 5-50 µg/mL for AML along with an excellent correlation coefficient. The correctness of the HPLC approach was further confirmed by excellent recovery of the added amount of analytes utilizing the standard addition technique. The recommended HPLC approach was employed safely for quality assurance of the formulation, because the evaluation of the method's greenness and whiteness confirmed the environmentally friendly nature of the approach.

The cadaveric research model for calcaneus fractures: A scoping review of biomechanical, anatomical, radiographic and fracture fixation studies.

BACKGROUND: Calcaneal fractures remain a big challenge in orthopaedic surgery and lead to long lasting disabilities. Cadaveric research plays an important role in determining optimal fracture treatment. This scoping review aims to provide insight into cadaveric research that has been conducted on calcaneal fractures, including biomechanics, fixation, approaches and radiographic studies. METHODOLOGY: A search strategy was created and implemented as per PRISMA guidance. 3 databases, Medline, Embase and Scopus, were used when conducting this review. RESULTS: 484 individual studies were retrieved across the 3 databases, of which 186 duplicates were excluded. Study abstracts were individually reviewed, of which 208 studies were excluded in accordance with study criteria. 90 papers were sought for retrieval, of which 83 full text papers were successfully retrieved. Of the full papers retrieved, 22 did not meet our inclusion criteria, and 19 papers related only to talus fractures. In the end, 43 cadaveric studies pertaining to this scoping review were included and reviewed. DISCUSSION: Studies were grouped into biomechanical, anatomical, fixation and radiographic studies for review. CONCLUSION: Evaluation of current cadaveric studies pertaining to calcaneal fractures has allowed greater insight into the myriad challenges in the management of these injuries. Effects of intra-articular fractures on calcaneal biomechanics assist in establishing surgical goals. Whilst fixation studies showing good stability of nail fixations could encourage further development in minimally invasive techniques. Avoiding pitfalls seen in the extensile lateral approach. Recommendations of areas for further research include use of external fixators, fixation in non-Sanders Type 2 fractures, and comparison of intraoperative CT/3D fluoroscopy with o conventional fluoroscopy.

Diversity and genetic structure of freshwater shark Wallago attu: an emerging species of commercial interest.

Pakistan has natural freshwater resources acting as a hotspot for diverse fish fauna. However, this aquatic fauna is declining at an alarming rate due to over-exploitation, habitat degradation, water pollution, climate change, and certain anthropogenic activities. The freshwater shark, Wallago attu, is a popular edible catfish inhabiting these freshwater ecosystems. Habitat degradation, overfishing, and human activities are heavily impacting the natural population of this species. So, sound knowledge about its population structure is necessary for its proper management in natural waters. The current study involves utilizing two mtDNA markers (COI, Cytb) to assess the genetic structure and differentiation among W. attu populations of Pakistani Rivers. Genetic variability analysis indicated a high haplotype (0.343 ± 0.046-0.870 ± 0.023) and low nucleotide diversity (0.0024 ± 0.012-0.0038 ± 0.018) among single and combined gene sequences, respectively. Overall, River Indus was populated with more diverse fauna of Wallago attu as compared to River Chenab and River Ravi. Population pairwise, Fst values (0.40-0.61) were found to be significantly different (p < 0.01) among three Riverine populations based upon combined gene sequences. The gene flow for the combined gene (COI + Cytb) dataset among three populations was less than 1.0. The transition/transversion bias value R (0.58) was calculated for testing of neutral evolution, and it declared low genetic polymorphism among natural riverine populations of Wallago attu. The current study's findings would be meaningful in planning the management and conservation of this economically important catfish in future.

Low-grade fibromyxoid tumor of the dura: A new entity?

Background: Low-grade fibromyxoid tumors are uncommon in children. Their differentiation from high-grade fibromyxoid tumors, as seen in adults, is imperative to diagnosis. Awareness of the entity and its subsequent behavior may guide management and predict outcomes. Case Description: We describe the case of a previously unreported low-grade fibromyxoid tumor of the cerebellum in an 8-year-old male. Extensive immunohistochemical, next-generation sequencing, and attempted DNA methylation profiling are reported. There has been no recurrence during the 6-year follow-up. Screening excluded multiple myxoid tumors, including low-grade fibromyxoid sarcoma. The findings suggest that, with gross total resection, the lesions may not recur. Conclusion: The case of fibromyxoid tumor with 6-year follow-up and the limited literature of similar tumors are reviewed.

Exploring the aspirations, expectations and impediments of 'dental anaesthesiology' as a medical and dental speciality: A scoping review.

BACKGROUND: Local anaesthesia is the anaesthetic technique most frequently used in dentistry. Advanced anaesthetic treatments like conscious sedation and/or general anaesthesia are required for major dental surgical procedures. Although general dentists are capable of administering local anaesthesia, additional training is needed for advanced anaesthetic procedures. It is generally disputed whether advanced anaesthetic techniques should be related to one or two dental specialties or whether they should receive a separate degree. OBJECTIVE: This paper aims at introducing the field of 'dental anaesthesiology' in routine dental practice as applicable within laws laid down for dental and medical specialities. METHODS: Publications, articles and mouthpieces relevant to the topic of dental anaesthesiology were identified using various search engines like MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were 'Dental anaesthesiology', 'General anaesthesia', and 'Dental care'. Articles about dental treatment done under anaesthesia were only considered describing various anaesthesia techniques. Additionally, the authors being regular caregivers of dentistry including oral and maxillofacial surgeon have shared their personal experiences and information on the said theme. RESULTS: In total, 127 articles were found of which 33 were available as full texts. Unrelated articles from the available full text were excluded. Finally, 17 studies were incorporated into the review. Majority of dental anaesthesiologist has a positive and favourable attitude towards the profession. Pediatric dentistry, oral and maxillofacial surgery, and special needs dentistry are the fields with the highest service demand. Also, the field is lucrative if the practitioner is refined and provides sophisticated services. It is easier and time saving to train the dentists, especially the ones with oral and maxillofacial surgery background. CONCLUSION: A degree of dental anaesthesiologist will open new doors to the budding dentist seeking for jobs or wanting to provide the best outcome.

Recent Modalities in Pain Control and Local Anesthesia in Dentistry: A Narrative Review.

Pain in the orofacial region or within the tooth is one of the most common complaints patients report to a dental office. An efficient practitioner must have adequate knowledge and tools to address and remedy the problem. Pain control in dentistry has a rich history and learning about it gives an insight into how the current modalities being used came into existence. As dentistry keeps evolving, newer and more efficient modalities have been developed for pain control. Dental pain is primarily remedied by dental practitioners and clinicians involved in emergency medicine; it may result due to various causes, mainly insulting the tooth or complications involved in and after oral surgery. Several modalities have been developed to reduce and eliminate this, including pharmacological and non-pharmacological treatment modalities. Pharmacological modalities include using drugs. Many medications are used for pain management, such as non-steroidal anti-inflammatory drugs, corticosteroids, and muscle relaxants. Non-pharmacological modalities include behavior control methods based on several theories of pain. These modalities are used mainly for children, but some can also be used for adult patients. Several advances in delivery systems for local anesthesia involve using newer technologies to deliver a sustained dose of anesthetic agent. This review aims to enlist both modalities of pain control management in dental practices along with the newer advancements in this field.

Median Rhomboid Glossitis: A Developmental Disorder Involving the Central Part of the Tongue.

Median rhomboid glossitis (MRG), also known as posterior midline atrophic candidiasis, is a developmental disorder of the oral cavity. It usually involves the central part of the dorsum surface of the tongue. It is a papillary atrophy that is generally well-defined and symmetrical in presentation. It is usually a painless lesion, but some patients may complain of mild itching and irritation in that region. This lesion is more predominant in males than females. It has been widely argued that this lesion is not a developmental disorder but a clinical manifestation of a fungal etiology. This article presents a case report of a 55-year-old woman who reported to the oral medicine department in a tertiary care center in Wardha, India, with the chief complaint of an oval-shaped, discolored area on the dorsum of her tongue since birth. This article also emphasizes the role of a dental practitioner in diagnosing the lesion and appropriate patient education regarding the condition.

Smoker's Palate: An Often Misunderstood Benign Lesion of the Oral Cavity.

Smoker's palate is a type of lesion that occurs on the mucosa of the hard and soft palate almost exclusively in smokers. This lesion is prevalent in smokers who practice reverse smoking and less common in cigar and cigarette smokers. The lesion known as smoker's palate is also referred to as nicotina stomatitis and nicotina palatini, which suggests the role of nicotine in the manifestation of the lesion, but this is a misnomer as the lesion occurs due to the impact of heat coupled with the irritation caused by agents such as tobacco and marijuana; there is no role of nicotine in it. Patients who notice this lesion tend to misinterpret it as an early manifestation of squamous cell carcinoma. Although this is not true, this can be an excellent opportunity to counsel patients regarding the ill effects of smoking and guide them to quit the habit, citing that it causes cancer. This article presents a case report of a 27-year-old male with a smoker's palate. This article also highlights the importance of dental practitioners in diagnosing the lesion and how patients often misunderstand this lesion as a severe condition.

Overcoming Barriers to Dental Care in India by the Use of Mobile Dental Vans.

The aim of this literature review was to compile and present information on the use of mobile dental vans (MDVs) in India and to figure out if the use of these vans can be used to eliminate the barriers that prevent Indian people from getting access to quality and affordable dental care. Since the working of an MDV is quite complex, this article also serves to summarize the information available in the existing literature in a much simpler yet elaborate manner. An electronic database search was done using relevant keywords such as MDVs, mobile health units, dental vans, mobile dentistry, and portable dentistry on search engines PubMed, Scopus, and Medline. After removing the irrelevant and duplicate articles, 30 were shortlisted and reviewed. It is a difficult task to provide access to affordable dental care to every person in a country like India, which has such a large population and a large number of people living in rural areas. People who live in rural areas and/or belong to a lower socioeconomic class are more susceptible to oral diseases. Lower economic status, geographical location, motivational barriers, lack of public transportation, etc., deter people from receiving adequate dental care. MDVs are vehicles that can work as independent, efficient operatories to provide dental care and act as an adjunct as well as an alternative to conventional methods of improving the oral health of the community. The global impact of MDVs, coupled with efficient and organized implementation, can make them an instrumental tool for the good. The various barriers to providing dental care to the underserved groups of the population can be easily overcome through this powerful tool.