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Sporadic Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative spongiform encephalopathy that causes neuronal derangement secondary to prion protein. Its initial diagnosis is often complex and challenging due to non-specific clinical presentation, lack of awareness, and low clinical suspicion. This disease is invariably fatal, and most patients die within 12 months of presentation. Definite diagnosis of prion disease requires neuropathological analysis, usually done at autopsy. Here, we present the autopsy findings of a 57-year-old male patient, illustrating the complexity of diagnosing this disease early in the clinical course and the need for a broad differential diagnosis at the onset.
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Hallervorden-Spatz syndrome, now known as pantothenate kinase-associated neurodegeneration (PKAN), is a rare autosomal recessive disorder that is characterized by cerebral iron deposition and leads to progressive extrapyramidal dysfunction and dementia. Most commonly seen in the first two decades of a person's life, it is a differential for patients presenting with atypical progressive extrapyramidal disorder and cognitive impairment. It is characterized by progressive degeneration of the basal ganglia, globus pallidus, and the reticular part of the substantia nigra due to iron accumulation. The characteristic MRI brain pattern of the disease shows the eye-of-the-tiger sign. We report cases of early onset PKAN in two sisters of the same family, in which diagnosis was based on clinical features, lab parameters, and MRI imaging findings. This report aims to differentiate PKAN from other static and progressive neurological illnesses.
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Imageamento por Ressonância Magnética , Neurodegeneração Associada a Pantotenato-Quinase , Irmãos , Humanos , Feminino , Neurodegeneração Associada a Pantotenato-Quinase/genética , Neurodegeneração Associada a Pantotenato-Quinase/diagnóstico , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/patologiaRESUMO
ABSTRACT Sporadic Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative spongiform encephalopathy that causes neuronal derangement secondary to prion protein. Its initial diagnosis is often complex and challenging due to non-specific clinical presentation, lack of awareness, and low clinical suspicion. This disease is invariably fatal, and most patients die within 12 months of presentation. Definite diagnosis of prion disease requires neuropathological analysis, usually done at autopsy. Here, we present the autopsy findings of a 57-year-old male patient, illustrating the complexity of diagnosing this disease early in the clinical course and the need for a broad differential diagnosis at the onset.
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Objectives: This research was done to assess the efficacy of I-PRF and bone graft in immediate dental implant placement. Materials and Method: Twenty patients were selected randomly into 2 groups with 10 samples in each as Group I- using I-PRF and Group II with synthetic bone replacement alloplast (biograft-HT) after immediate implant placement. Postoperative clinical assessment after graft placement was done based on visual analog scale for pain, modified gingival index and modified plaque index at 2nd, 4th, and 6th months. A radiographic assessment of bone density was performed two and six months after the placement of the implant. Result: There was a statistically considerable variation between the change in modified plaque index and modified gingival index. There was a statistically insignificant divergence in the mean visual analog scale between the two groups at 1, 3, and 6 days. Group I demonstrated a higher change in bone density than group II, with a statistically significant difference (P = .002). Conclusion: An innovative, safe, and efficient method for controlling the healing process around immediate dental implants is provided by the use of I-PRF in conjunction with immediate dental implant placement.
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BACKGROUND: Type 2 diabetes mellitus (T2DM) is a metabolic disease of impaired glucose utilization. Imbalance in generation and elimination of free radicals generate oxidative stress which modulates glucose metabolism and insulin regulation, resulting in the occurrence and progression of diabetes and associated complications. Antioxidant supplements in T2DM can be seen as a potential preventive and effective therapeutic strategy. AIM: To compare randomized controlled trials (RCTs) in which antioxidants have been shown to have a therapeutic effect in T2DM patients. METHODS: We systematically searched the electronic database PubMed by keywords. RCTs evaluating the effect of antioxidant therapy on glycaemic control as well as oxidant and antioxidant status as primary outcomes were included. The outcomes considered were: A reduction in blood glucose; changes in oxidative stress and antioxidant markers. Full-length papers of the shortlisted articles were assessed for the eligibility criteria and 17 RCTs were included. RESULTS: The administration of fixed-dose antioxidants significantly reduces fasting blood sugar and glycated hemoglobin and is associated with decreased malondialdehyde, advanced oxidation protein products, and increased total antioxidant capacity. CONCLUSION: Antioxidant supplements can be a beneficial approach for the treatment of T2DM.
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BACKGROUND AND AIMS: To assess the hospitalized sick children admitted to the pediatric emergency department (ED) and to find new patterns of clinical and laboratory attributes using association rule mining (ARM). METHODS: In this observational study, 158 children with median (IQR) age 11 months and a PRISM III score of 5 (2-9) were enrolled. Hotspot data mining method was applied to assess clinical attributes, lab investigations and pre-defined outcome parameters of children and their association in sick hospitalized children aged 1 month to 12 years. RESULTS: We obtained 30 rules with value for outcome as discharge is given attributes as follows: duration of hospitalization > 4 days, lactate > 1.2 mmol/L, platelet = 3.67/µL, dur_ventil = 0 h, serum K = 5.2 mmol/L, SBP = 120 mmHg, pCO2 = 41.9 mmHg, PaO2 = 163 mmHg, age = 92 months, heart rate > 114-159 per minute, temperature > 98 °F, GCS (Glasgow Coma Scale) > 7-14, gas K = 4.14 mmol/L, gas Na = 138.1 mmol/L, BUN (Blood Urea Nitrogen) = 18.69 mg/dL, Diagnosis > 1-718, Creatinine = 1.2 mg/dL, serum Na = 148 mmol/L, shock = 2, Glucose = 144 mg/dL, Mg(i) > 0.23 meq/L, BUN > 6.54 mg/dL. CONCLUSION: ARM is an effective data analysis technique to find meaningful patterns using clinical features with actual numbers in pediatric critical illness. It can prove to be important while analysing the association of clinical attributes with disease pattern, its features, and therapeutic or intervention success patterns.
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Glucose , Sódio , Humanos , Criança , Potássio , Nitrogênio da Ureia Sanguínea , Serviço Hospitalar de EmergênciaRESUMO
PURPOSE: Japanese encephalitis (JE), caused by the Japanese encephalitis virus (JEV), is the principal cause of viral encephalitis in South-East Asian and Western Pacific countries; accounting for 68,000 cases, and up to 20,400 fatalities, annually across the world. Despite being a high-risk condition, there is no specific treatment for JE. Given rapid additions in genomics databases and the power of data reanalysis in addressing critical medical questions, the present study was designed to identify novel host factors that might have potential roles in JEV infection. METHODS: We extracted microarray and RNA-Seq data sets from NCBI-GEO and compared mock and JEV-infected samples. Raw data from all the studies were re-analyzed to identify host factors associated with JEV replication. RESULTS: We identified several coding and non-coding host factors that had no prior known role in viral infections. Of these, the coding transcripts: Myosin Heavy Chain 10 (MYH10), Progestin and AdipoQ Receptor Family Member 8 (PAQR8), and the microRNAs: hsa-miR-193b-5p, hsa-miR-3714 and hsa-miR-513a-5p were found to be novel host factors deregulated during JEV infection. MYH10 encodes a conventional non-muscle myosin, and mutations in MYH10 have been shown to cause neurological defects. PAQR8 has been associated with epilepsy, which exhibits symptoms similar to JEV infection. JE is a neuro-degenerative disease, and the known involvement of MYH10 and PAQR8 in neurological disorders strongly indicates potential roles of these host factors in JEV infection. Additionally, we observed that MYH10 and PAQR8 had a significant negative correlation with Activating transcription factor 3 (ATF3), which is a previously validated modulator of JEV infection. ATF3 is a transcription factor that binds to the promotors of genes encoding other transcription factors or interferon-stimulated genes and negatively regulates host antiviral responses during JE. CONCLUSION: Our findings demonstrate the significance of data reanalysis in the identification of novel host factors that may become targets for diagnosis/ therapy against viral diseases of major concern, such as, JE. The deregulated coding and non-coding transcripts identified in this study need further experimental analysis for validation.
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Vírus da Encefalite Japonesa (Espécie) , Vírus da Encefalite Japonesa (Subgrupo) , Encefalite Japonesa , MicroRNAs , Vírus da Encefalite Japonesa (Espécie)/metabolismo , Encefalite Japonesa/genética , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , TranscriptomaRESUMO
The COVID-19 pandemic has caused huge socio-economic losses and continues to threat humans worldwide. With more than 4.5 million deaths and more than 221 million confirmed COVID-19 cases, the impact on physical, mental, social and economic resources is immeasurable. During any novel disease outbreak, one of the primary requirements for effective mitigation is the knowledge of clinical manifestations of the disease. However, in absence of any unique identifying characteristics, diagnosis/prognosis becomes difficult. It intensifies misperception and leads to delay in containment of disease spread. Numerous clinical research studies, systematic reviews and meta-analyses have generated considerable data on the same. However, identification of some of the distinct clinical signs and symptoms, disease progression biomarkers and the risk factors leading to adverse COVID-19 outcomes warrant in-depth understanding. In view of this, we assessed 20 systematic reviews and meta-analyses with an intent to understand some of the potential independent predictors/biomarkers/risk factors of COVID-19 severity and mortality.
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COVID-19 , Pandemias , Humanos , Fatores de Risco , SARS-CoV-2RESUMO
The risk of viral infection during pregnancy is well-documented; however, the intervention modalities that in practice enable maternal-fetal protection are restricted by limited understanding. This becomes all the more challenging during pandemics. During many different epidemic and pandemic viral outbreaks, worse outcomes (fetal abnormalities, mortality, preterm labor, etc.) seem to affect pregnant women than what has been evident when compared to non-pregnant women. The condition of pregnancy, which is widely understood as "immunosuppressed," needs to be re-understood in terms of the way the immune system works during such a state. The immune system gets transformed to accommodate and facilitate fetal growth. The interference of such supportive conversion by viral infection and the risk of co-infection lead to adverse fetal outcomes. Hence, it is crucial to understand the risk and impact of potent viral infections likely to be encountered during pregnancy. In the present article, we review the effects imposed by previously established and recently emerging/re-emerging viral infections on maternal and fetal health. Such understanding is important in devising strategies for better preparedness and knowing the treatment options available to mitigate the relevant adverse outcomes.
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Urease is an enzyme that plays a significant role in the hydrolysis of urea into carbonic acid and ammonia via the carbamic acid formation. The resultant increase in pH leads to the onset of various pathologies such as gastric cancer, urolithiasis, hepatic coma, hepatic encephalopathy, duodenal ulcers and peptic ulcers. Urease inhibitors can reduce the urea hydrolysis rate and development of various diseases. The Cinnamomum genus is used in a large number of traditional medicines. It is well established that stem bark of Cinnamomum cassia exhibits antiulcerogenic potential. The present study evaluated the inhibitory effect of seven extracts of Cinnamomum camphora, Cinnamomum verum and two pure compounds Camphene and Cuminaldehyde on urease enzyme. Kinetic studies of potential inhibitors were carried out. Methanol extract (IC50 980 µg/mL) of C. camphora and a monoterpene Camphene (IC50 0.147 µg/mL) possess significant inhibitory activity. The Lineweaver Burk plot analysis suggested the competitive inhibition by methanol extract, hexane fraction and Camphene. The Gas Chromatography-Mass Spectroscopy (GC-MS) analysis of hexane fraction revealed the contribution of various terpenes. The present study targets terpenes as a new class of inhibitors that have potential therapeutic value for further development as novel drugs.
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Proteínas de Bactérias , Cinnamomum/química , Inibidores Enzimáticos/química , Simulação de Acoplamento Molecular , Extratos Vegetais/química , Urease , Proteínas de Bactérias/antagonistas & inibidores , Proteínas de Bactérias/química , Urease/antagonistas & inibidores , Urease/químicaRESUMO
Cellulose is the most abundant renewable resource which has found a diverse range of applications. Cellulose dissolution is a significant property for manufacturing man-made cellulosic fiber through viscose process. Crystalline microfibrillar structure and relatively high ordered packing of polymeric chains contribute to recalcitrance and poor reactivity of cellulose. One of the most common methods to improve cellulose dissolution is cellulase treatment. Herein, cellulase treatment at different doses was studied to explore the correlation of cellulose dissolution with crystallinity. Pulp showed improvement in Fock reactivity and other properties related to viscose application. But contrary to previous studies, cellulose crystallinity as determined by XRD and FTIR did not correlate with Fock reactivity at a higher dose of cellulase. The results indicated some complex mechanism to be involved between the cellulose dissolution and crystallinity than a simple negative correlation. Cellulase treatment at 150 HCU/g resulted in the upgraded pulp suitable for viscose application.
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The potential of alkaline cellulo-xylanolytic enzymes from non-pathogenic Bacillus subtilis strain was tested for deinking of photocopier waste paper. Cellulase and xylanase play a crucial role in deinking of different types of waste paper. Partial purification of cellulo-xylanolytic enzymes was carried out using ultrafiltration followed by ammonium sulfate precipitation. The ultrafiltered enzyme was used for deinking the photocopier waste paper along with chemical deinking. An enzyme dose of 0.6 IU/g and reaction time of 60 min for ultrafiltered cellulo-xylanolytic enzyme significantly increased deinking efficiency, tear index (9.52%) and folding endurance (5±2%) as compared to chemical deinking. There was improvement in strength properties such as tear index and double-fold along with freeness of pulp (18%). There was slight decrease in tensile index (0.6%) and burst index (16%) while ISO brightness remained unaffected. Enzymatic deinking (74.3%) by ultrafiltered cellulo-xylanolytic from Bacillus subtilis was found significant over conventional chemical deinking.
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Celulase , Tinta , Endo-1,4-beta-Xilanases , PapelRESUMO
The artificial stacking of nanohybrid films helps to enhance their properties and thus intrigues researchers to explore this possibility in emerging technologies. The layer-by-layer approach was used to fabricate samples of zinc sulfide/reduced graphene oxide (ZnS/rGO) by using spin coating technique. The structure and optoelectronic properties has been extensively studied by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), UV-VIS-NIR spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) and Hall measurements. Raman spectrum elucidates the phonon contribution of ZnS and breathing mode of κ-point phonons and sp2 bonds of carbon atoms of rGO. The electron-phonon interactions reveal reduction in electron mobility and enhancement in holes contribution with rGO content leading to surface charge transfer doping (SCTD). XPS results explain the valence band edge and conduction band edge to form type-I band alignment to reconfirm carrier-type reversal. A change in the dispersion of refractive indices along with a small rise in the value of absorption coefficient in terahertz (THz) region for ZnS/rGO nanocomposite films has been observed. These results will open up new opportunities to furthering the science of this technologically important class of materials for future electronics.
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An estimated 3.9 billion individuals in 128 nations (about 40% of global population) are at risk of acquiring dengue virus infection. About 390 million cases of dengue are reported each year with higher prevalence in the developing world. A recent modeling-based report suggested that half of the population across the globe is at risk of dengue virus infection. In any given dengue outbreak, a percentage of infected population develops severe clinical manifestations, and this remains one of the "unsolved conundrums in dengue pathogenesis". Although, host immunity and virus serotypes are known to modulate the infection, there are still certain underlying factors that play important roles in modulating dengue pathogenesis. Advanced genomics-based technologies have led to identification of regulatory roles of non-coding RNAs. Accumulating evidence strongly suggests that viruses and their hosts employ non-coding RNAs to modulate the outcome of infection in their own favor. The foremost ones seem to be the cellular microRNAs (miRNAs). Being the post-transcriptional regulators, miRNAs can be regarded as direct switches capable of turning "on" or "off" the viral replication process. Recently, role of long non-coding RNAs (lncRNAs) in modulating viral infections via interferon dependent or independent signaling has been recognized. Hence, we attempt to identify the "under-dog", the non-coding RNA regulators of dengue virus infection. Such essential knowledge will enhance the understanding of dengue virus infection in holistic manner, by exposing the specific molecular targets for development of novel prophylactic, therapeutic or diagnostic strategies.
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Dengue , MicroRNAs , Animais , Interações Hospedeiro-Patógeno , Humanos , Imunidade Inata , Interferons , MicroRNAs/genética , Replicação ViralRESUMO
BACKGROUND: Interaction of various drugs and its effects on gingival and periodontal health is the area of concern; hence the aim of the present study was to explore factors affecting the awareness and practice of primary health care professionals towards the interaction of various medications used for systemic diseases on periodontal health. MATERIALS AND METHODS: It was a cross-sectional, descriptive, questionnaire study conducted among 203 primary health care professionals which include 94 medical officers and 109 nurses working in primary health centers in rural areas of Udaipur district. The study was conducted in December 2019. Sampling techniques was stratified random sampling technique. A close-ended questionnaire was prepared to conduct an interview schedule. RESULTS: The majority of health professionals had poor awareness (157 [77.33%]) and poor practice (168 [82.75%]) regarding the interaction of various medications used in systemic conditions and periodontal health. Factors that significantly affect awareness and practice of study participants were age (0.01*), degree (0.05*), and number of patients with oral problems seen in a week (0.05*), gender (0.05*), designation (0.05*). CONCLUSION: From above it was concluded that awareness and practice of primary care health professionals were poor. The factors that affect significantly affect awareness and knowledge of study participants was age, degree and number of patients with oral problems seen in a week, gender, designation, no. of patient attended in a day.
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INTRODUCTION: High prevalence of chronic kidney disease (CKD) not associated with known risk factors has been reported from coastal districts of Andhra Pradesh. The Study to Test and Operationalize Preventive Approaches for Chronic Kidney Disease of Undetermined Etiology in Andhra Pradesh (STOP CKDu AP) aims to ascertain the burden (prevalence and incidence) of CKD, the risk factor profile, and the community perceptions about the disease in the Uddanam area of Andhra Pradesh. METHODS: Study participants will be sampled from the Uddanam area using multistage cluster random sampling. Information will be collected on the demographic profile, occupational history, and presence of conventional as well as nonconventional risk factors. Glomerular filtration rate (GFR) will be estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and proteinuria will be measured. All abnormal values will be confirmed by repeat testing after 3 months. Cases of CKD not associated with identified etiologies will be identified. Biospecimens will be stored to explore future hypotheses. The entire cohort will be followed up every 6 months to determine the incidence of CKD and to identify risk factors for decline in kidney function. Qualitative studies will be performed to understand the community perceptions and expectations with respect to the interventions. IMPLICATIONS: CKD is an important public health challenge in low- and middle-income countries. This study will establish the prevalence and determine the incidence of CKD not associated with known risk factors in a reported high-burden region, and will provide insights to help design targeted health systems responses. The findings will contribute to the policy development to tackle CKD in the region and will permit international comparisons with other regions with similar high prevalence.
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The aim of the current longitudinal study was to assess the levels of serum Bone-specific alkaline phosphatase (BALP) and serum Insulin like growth factor-1 (IGF-1) in different cervical vertebral maturation index (CVMI) stages and observe their association with the mandibular growth. Blood samples and lateral cephalograms of 63 subjects (age group of 11-17 years) were obtained at two time points, 12 months apart. On the basis of CVMI, all subjects were divided into six groups based on whether the subjects remained in same CVMI stage or transitioned to the next CVMI stage. Annual mandibular length was related with serum BALP and serum IGF-1 levels estimated using ELISA. Serum IGF-1 and BALP attained highest levels at CVMI stage 3 with peak BALP levels observed earlier than IGF-1. Although a positive correlation was determined between IGF-1 and BALP but BALP followed skeletal growth pattern more precisely. Overall IGF-1 and BALP were negatively correlated with mandibular length with notable growth in CVMI groups 3-3 (P < 0.01), 3-4 (P < 0.01), 4-4 (P < 0.001) and 5-5 (P < 0.001). In conclusion, BALP is a potential biomarker for skeletal growth assessment. However, the mandibular growth pattern was independent of changes in IGF-1 and BALP.
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Fosfatase Alcalina/sangue , Fator de Crescimento Insulin-Like I/análise , Mandíbula/crescimento & desenvolvimento , Adolescente , Biomarcadores/sangue , Criança , Feminino , Humanos , Estudos Longitudinais , MasculinoRESUMO
To improve the process economy of reactivity improvement, crude cellulase from Bacillus subtilis was employed for the treatment and significant dissolving pulp properties were analyzed. With increase in enzyme dose from 0.25 to 2 U/g o.d. pulp, improvement in Fock reactivity and alkali solubilities (S10 and S18) were observed with simultaneous reduction in viscosity and yield. Fourier transform infrared spectroscopy and scanning electron microscopy were used to observe the molecular level effects on dissolving grade pulp. The most suitable cellulase dose for reactivity improvement with lowering of viscosity was 0.25 U/g o.d. pulp. With increases in enzyme dose, alkali solubilities (S10 and S18) of dissolving pulp showed continuous increment, while alpha-cellulose of pulp showed reduction due to chain scission of long cellulose fiber fraction.
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The present work highlights the synthesis of the adsorbent based on Gum xanthan-psyllium hybrid backbone graft co-polymerized with polyacrylic acid-co-polyitaconic acid chains for the rapid sequestration of auramine-O (Aur-O) and eriochrome black-T (EBT) dyes from the aqueous fluid. The excellent dye removal efficiency of 90.53% for EBT and 95.63% for Aur-O was found at initial dye concentration of 30mgL-1 (EBT) and 15 mgL-1 (Aur-O) 40mL-1 with an adsorbent dose of 600mg within time duration of 5h and 323K temp. The adsorption isotherm data fitted well with Langmuir isotherm and Freundlich isotherm for Aur-O and EBT dyes (R2 ≥ 0.90), respectively. The adsorption kinetics depicted that pseudo-second order kinetics was followed simultaneously with intra-particle diffusion for both the dyes. Thermodynamic parameters such as ΔG°, ΔH° and ΔS° were also calculated and confirmed the spontaneity, randomness and endothermic nature of the adsorption process. Further, the adsorbent exhibited good recyclability efficiency for the capture of Aur-O and EBT from aqueous solution with minimal activity decline after six and three cycles, respectively. So, the synthesized adsorbent could be used successfully by the textile industries for the treatment of dye contaminated water with excellent competency.
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Corantes/análise , Hidrogéis/química , Polímeros/química , Polissacarídeos Bacterianos/química , Psyllium/química , Poluentes Químicos da Água/análise , Purificação da Água/métodos , Adsorção , Compostos Azo/análise , Benzofenoneídio/análise , Difusão , Hidrogéis/síntese química , Cinética , Temperatura , Indústria Têxtil , TermodinâmicaRESUMO
OBJECTIVE: The present study was aimed to assess levels of serum Bone-specific alkaline phosphatase (BALP) and serum Insulin-like growth factor-1 (IGF-1) and comparing with cervical vertebral maturation index (CVMI) stages. DESIGN: Cross-sectional study. SETTING: Maulana Azad Institute of Dental Sciences, New Delhi, India. PARTICIPANTS: 150 subjects (75 males and 75 females) in the age group of 8-20 years. METHODS: Subjects were divided into six CVMI stages. Enzyme-linked immunosorbant assay was performed for the estimation of serum BALP and serum IGF-1 levels. Mann-Whitney U test was performed to compare mean ranks of serum BALP and serum IGF-1 with different CVMI stages. Spearman correlation between serum BALP and serum IGF-1 was done across 6 CVMI stages. RESULTS: Peak serum IGF-1 levels were found at CVMI stages 4 and 3 for males and females respectively. Peak levels for serum BALP were found at stage 3 for both genders with significant differences from other stages. A statistically significant correlation was seen between serum IGF-1 and serum BALP from CVMI stages 1 to 3 and 4 to 6 (p < .01). CONCLUSIONS: BALP showed promising results and can be employed as a potential biomarker for the estimation of growth status.