Comparative assessment of cleaning efficacy of two exclusive paediatric rotary files in root canals of primary teeth: An in vitro study.

BACKGROUND: Paediatric rotary file systems have recently been developed for primary teeth use. AIM: To study the cleaning efficacies of two paediatric rotary endodontic files, the Prime PedoTM, and the Kedo-SG BlueTM against the standard H files. DESIGN: This in vitro study included 54 freshly extracted primary molars, which were randomised into three groups (n = 18 each) and were prepared using either Kedo-SG BlueTM, Prime PedoTM or hand H files after injecting methylene blue dye into the canals. Pre- and post-operative cone beam computerised tomography (CBCT) was performed to assess change in root canal volumes. Methylene blue dye removal from canals was assessed using stereomicroscopy, and canal cleanliness was examined by scanning electron microscopy (SEM). RESULTS: Both Prime PedoTM and Kedo-SG BlueTM files reduced significantly less dentine when compared with conventional hand filing with Prime PedoTM removing the least amount of dentine. No significant difference was found in median SEM scores among the groups in the cervical, middle and apical thirds of the roots. Stereomicroscopic assessment of root canal cleanliness using dye removal technique shows a statistically significant difference existing between Kedo-SG BlueTM and hand H files groups. CONCLUSION: Prime PedoTM removed the least amount of dentine. Kedo-SG BlueTM performed significantly better than conventional hand filing with H files when the root canal cleanliness was assessed.

Out of pocket expenditure and distress financing on cesarean delivery in India: evidence from NFHS-5.

BACKGROUND: Though over three-fourths of all births receive medical attention in India, the rate of cesarean delivery (22%) is twice higher than the WHO recommended level. Cesarean deliveries entail high costs and may lead to financial catastrophe for households. This paper examines the out-of-pocket expenditure (OOPE) and distress financing of cesarean deliveries in India. METHODS: We used data from the latest round of the National Family Health Survey conducted during 2019-21. The survey covered 636,699 households, and 724,115 women in the age group 15-49 years. We have used 159,643 births those delivered three years preceding the survey for whom the question on cost was canvassed. Descriptive analysis, bivariate analysis, concentration index (CI), and concentration curve (CC) were used in the analysis. RESULT: Cesarean deliveries in India was estimated at 14.08%, in private health centres and 9.96%  in public health centres. The prevalence of cesarean delivery increases with age, educational attainment, wealth quintile, BMI and high for those who had pregnancy complications, and previous birth as cesarean. The OOPE on cesarean births was US$133. It was US$498 in private health centres and US$99 in public health centres. The extent of distress financing of any cesarean delivery was 15.37%; 27% for those who delivered in private health centres compared to 16.61% for those who delivered in public health centres. The odds of financial distress arising due to OOPE on cesarean delivery increased with the increase of OOPE [AOR:10.00, 95% CI, 9.35-10.70]. Distress financing increased with birth order and was higher among those with low education and those who belonged to lower socioeconomic strata. CONCLUSION: High OOPE on a cesarean delivery leads to distress financing in India. Timely monitoring of pregnancy and providing comprehensive pregnancy care, improving the quality of primary health centres to conduct cesarean deliveries, and regulating private health centres may reduce the high OOPE and financial distress due to cesarean deliveries in India.

A holistic review on trend, occurrence, factors affecting pesticide concentration, and ecological risk assessment.

Demographic outbursts and increased food demands invoke excessive use of pesticides in the agricultural field for increasing productivity which leads to the relentless decline of riverine health and its tributaries. These tributaries are connected to a plethora of point and non-point sources that transport pollutants including pesticides into the Ganga river's mainstream. Simultaneous climate change and lack of rainfall significantly increase pesticide concentration in the soil and water matrix of the river basin. This paper is intended to review the paradigm shift of pesticide pollution in the last few decades in the river Ganga and its tributaries. Along with this, a comprehensive review suggests the ecological risk assessment method which facilitates policy development, sustainable riverine ecosystem management, and decision-making. Before 2011, the total mixture of Hexachlorocyclohexane was found at 0.004-0.026 ng/mL in Hooghly, but now, the concentration has increased up to 0.465-4.132 ng/mL. Aftermath of critical review, we observed maximum residual commodities and pesticide contamination reported in Uttar Pradesh > West Bengal > Bihar > Uttara Khand possibly because of agricultural load, increasing settlement, and incompetency of sewage treatment plant in the reclamation of pesticide contamination.

Anthropogenic risk assessment of riverine habitat using geospatial modelling tools for conservation and restoration planning: a case study from a tropical river Pranhita, India.

The riverine ecosystem provides multiple benefits to human community and contributes to the sustainable development of the ecoregion. The growing dependency on these ecosystems has largely contributed to aggravating the ecological risks, habitat degradation, and loss of ecosystem services. The present study evaluates the ecological risk emanating from nine anthropogenic stressors including river use, hydro-morphology, catchment pollution, and biological stressor on river Pranhita in Godavari Basin of Peninsular India using InVEST (Integrated Valuation of Ecosystem Services and Tradeoffs) Habitat Risk Assessment model. The primary field survey, remote sensing, and secondary data-assisted spatial modelling results revealed low ecological risk (R = 0.65 of 3) in river Pranhita due to anthropogenic activities. Sediment loading, the inflow of nitrogen, and habitat fragmentation were the major stressors with relatively higher risk score (> 1); influence on a sizeable portion of riverine habitat (29-75% of the total area under high-risk zone) indicates the mounting threat from catchment activities. The low-risk value observed in protected river reaches as compared to unprotected areas is likely to be influenced by the abundant presence of intact riparian vegetation which mitigate the catchment stressors and minimal anthropogenic activity within protected areas. This study demonstrates the application of InVEST HRA model for ecological risk assessment of riverine ecosystems and fish assemblages along with their input data generation framework. This has the potential for prioritization of sensitive habitats based on computed ecological risk and stressor identification based on their exposure and consequences for developing appropriate mitigation measures. This model is spatially explicit and accommodates user-defined criteria for ecosystem-level assessment at a regional and national scale to facilitate the resource managers and policymakers for conservation and restoration planning and implementation of targeted management measures for sustainable development.

Quantitative assessment of sediment delivery and retention in four watersheds in the Godavari River Basin, India, using InVEST model - an aquatic ecosystem services perspective.

Sediment export and retention are important ecosystem processes in any landscape causing soil erosion and sediment loading in waterways consequently affecting the health of aquatic habitats downstream. The present study quantifies sediment export and retention in four watersheds, viz., Hivra, Satrapur, Konta, and Jagdalpur in the Godavari River Basin, India, using Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) ecosystem service modelling tool. The  results revealed that the sediment export yields ranged from 0.75 (Hivra) to 2.77 t/ha/year (Jagdalpur). The mean deviation between modelled values and observed sediment export yield was - 11.11%, which indicated good prediction by the model. The sediment retention ranged from 16.04 (Hivra) to 101.52 t/ha/year (Konta). Most sediment export and retention occurred on cropland or shrubland land use land cover types in all four watersheds. For decision making on soil conservation, soil loss tolerance limits have been established for these watersheds. For aquatic habitats, sediment concentration is considered more important than the total annual sediment export, since water turbidity is an important determinant of water quality, and the aquatic lives therein. Therefore, the temporal distribution of rainfall and corresponding sediment export becomes important, since these two factors determine the sediment concentration as well as turbidity in the waterbody. In current study, "Precipitation Concentration Index adjusted Sediment Export Yield Index" was developed to account for the effects of the temporal rainfall distribution and its impact on sediment export. The index for four watersheds was quantified (Hivra > Satrapur > Konta > Jagdalpur), which is concordant to the turbidity values reported by respective gauge stations. Thus, the proposed index can efficiently capture the impact of temporal rainfall distribution on sediment export, and consequently its effect on water turbidity. The study revealed the potential of InVEST model to quantify the sediment export and retention in the watersheds studied. Together with the proposed index, it would help the policy makers in making informed decisions for planning conservation strategies for aquatic biodiversity.

Applications of Sentinel-2 satellite data for spatio-temporal mapping of deep pools for monitoring the riverine connectivity and assessment of ecological dynamics: a case from Godavari, a tropical river in India (2016-2021).

Rivers are dynamic ecosystems with diverse habitats that require ample connectivity to ensure the flow of ecosystem services, thus empowering the sustainable development of an entire basin. Geo-spatial tools offer powerful prospects for monitoring of aquatic ecosystems. The usefulness of Sentinel-2 datasets to assess river connectivity has been explored for an un-gauged seasonal river system. The present study was undertaken in five ecologically unique river reaches viz. Wainganga, Wardha, Pranhita, Godavari-mid and Manair in Godavari Basin in the Indian Deccan Plateau to map water spread dynamics at various time scales, i.e., fortnightly, monthly, seasonal, annual and demi-decadal during 2016-2021. The maximum value of perennial water spread per square kilometre of total floodplain area (2016-2021), determined using Sentinel-2 imageries, was observed in river Wardha (0.18) followed by Pranhita (0.12) and Wainganga (0.11). The water spread showed a decreasing trend, while the number of patches in the river corridor increased over time from post-monsoon to pre-monsoon season. The copious perennial habitat with relatively larger patches, incessant flow in river Pranhita and obstructed flow, large-sized patches reported in river Wardha during summer months, hold importance in terms of providing refuge to aquatic biota. This study provides evidence for the impact of water projects on spatio-temporal water spread dynamics in Godavari Basin. The demonstrated utility of Sentinel-2 imagery coupled with gauge station measurements for river continuity assessment and deep pool mapping would aid in enhancing our understanding on environmental flow at a spatial scale, which in turn would aid in effective river management to achieve the Sustainable Development Goals. The implications of this study for sustainable environmental management and limitations are also discussed.

Are cesarean deliveries equitable in India: assessment using benefit incidence analysis.

BACKGROUND: In the last two decades, cesarean section (CS) deliveries in India have increased by six-fold and created economic hardship for families and households. Although several schemes and policies under the National Health Mission (NHM) have reduced the inequality in the use of maternal care services in India, the distributive effect of public health subsidies on CS deliveries remains unclear. In this context, this paper examines the usage patterns of CS delivery and estimates the share of public health subsidies on CS deliveries among mothers by different background characteristics in India. DATA: Data from the fourth round of the National Family Health Survey (NFHS-4) was used for the study. Out-of-pocket (OOP) payment for CS delivery was used as a dependent variable and was analyzed by level of care that is, primary (PHC, UHC, other) and secondary (government/municipal, rural hospital). Descriptive statistics, binary logistic regression, benefit incidence analysis, concentration curve and concentration index were used for the analysis. RESULTS: A strong economic gradient was observed in the utilization of CS delivery from public health facilities. Among mothers using any public health facility, 23% from the richest quintile did not pay for CS delivery compared to 13% from the poorest quintile. The use of the public subsidy among mothers using any type of public health facility for CS delivery was pro-rich in nature; 9% in the poorest quintile, 16.1% in the poorer, 24.5% in the middle, 27.5% among richer and 23% in the richest quintile. The pattern of utilization and distribution of public subsidy was similar across the primary and secondary health facilities but the magnitude varied. The findings from the benefit-incidence analysis are supported by those obtained from the inequality analysis. The concentration index of CS was 0.124 for public health centers and 0.291 for private health centers. The extent of inequality in the use of CS delivery in public health centers was highest in the state of Mizoram (0.436), followed by Assam (0.336), and the lowest in Tamil Nadu (0.060), followed by Kerala (0.066). CONCLUSION: The utilization of CS services from public health centers in India is pro-rich. Periodically monitoring and evaluating of the cash incentive schemes for CS delivery and generating awareness among the poor would increase the use of CS delivery services in public health centers and reduce the inequality in CS delivery in India.

Comprehensive health risk assessment of microbial indoor air quality in microenvironments.

The higher airborne microbial concentration in indoor areas might be responsible for the adverse indoor air quality, which relates well with poor respiratory and general health effects in the form of Sick building syndromes. The current study aimed to isolate and characterize the seasonal (winter and spring) levels of culturable bio-aerosols from indoor air, implicating human health by using an epidemiological health survey. Microorganisms were identified by standard macro and microbiological methods, followed by biochemical testing and molecular techniques. Sampling results revealed the bacterial and fungal aerosol concentrations ranging between (300-3650 CFU/m3) and (300-4150 CFU/m3) respectively, in different microenvironments during the winter season (December-February). However, in spring (March-May), bacterial and fungal aerosol concentrations were monitored, ranging between (450-5150 CFU/m3) and (350-5070 CFU/m3) respectively. Interestingly, Aspergillus and Cladosporium were the majorly recorded fungi whereas, Staphylococcus, Streptobacillus, and Micrococcus found predominant bacterial genera among all the sites. Taken together, the elevated levels of bioaerosols are the foremost risk factor that can lead to various respiratory and general health issues in additional analysis, the questionnaire survey indicated the headache (28%) and allergy (20%) were significant indoor health concerns. This type of approach will serve as a foundation for assisting residents in taking preventative measures to avoid exposure to dangerous bioaerosols.

Studies on Zero-cost algae based phytoremediation of dye and heavy metal from simulated wastewater.

In the present study, filamentous algae, an emerging candidate for biofuel and other useful chemical production, has been investigated as a biological adsorbent for the removal of contaminants from synthetic wastewater. Operational parameters were optimized in batch phytoremediation experiments. The adsorption equilibrium isotherm models such as Langmuir, Freundlich, and Dubinin-Radushkevitch and kinetics models such as pseudo-1st and pseudo-2nd order in methylene blue decolorization and Cr(VI) removal were also investigated. The D-R isotherm theory provided the best fit. The pseudo-2nd order model accurately described the adsorption kinetic data. Maximum adsorption capacities were observed to 5.03 mg.g-1 and 0.77 mg.g-1 along with removal efficiencies were achieved to 91.3% and 91.4% for methylene blue and Cr(VI) remediation, respectively. Moreover, intra-particle diffusion kinetic theory was used to describe the mechanism. These outcomes are significant in the development of algae-based zero-cost pollutants removal technology in wastewater treatment.

Economic gradient of onset of disability in India.

BACKGROUND: Disability in India is associated with increasing non-communicable diseases, rising longevity, and increasing accidents and injuries. Though studies have examined prevalence, patterns, and socioeconomic correlates of disability, no attempt has been made in estimating age of onset of disability in India. OBJECTIVE: This paper investigates the economic gradient of age of onset of locomotor, visual, hearing, speech, mental retardation, mental illness, and other disabilities in India. METHOD: We use nationally representative data of 106,894 disabled individuals from the 76th round of National Sample Survey (NSS), 2018. Descriptive statistics, kernel density, Kaplan-Meier survival curves, and linear regression models are used in the analysis. RESULT: The disability rate in India was 2184 per 100,000 persons. The disability rate was highest for locomotor (1353) followed by hearing (296), visual (234), speech (228), mental retardation (158), and mental illness (131). Over 85% of mental retardation and 80% of speech disabilities occur at birth, while 82% of locomotor and 81% of visual disabilities occur after birth. Among those who had disability after birth, the median age for mental retardation was 2 years followed by mental illness (28 years), speech (29 years), locomotor (42 years), visual (55 years), and 56 years for hearing disability. Adjusting for socioeconomic covariates, the age of onset of locomotor and speech disabilities among the poorest individuals were 7 and 11 years earlier than the richest, respectively. CONCLUSION: The economic gradient of onset of locomotive and speech disabilities are strong. The age of onset of disability was earliest for mental retardation followed by mental illness and speech disability.

Potential risk assessment of soil salinity to agroecosystem sustainability: Current status and management strategies.

Soil salinization has become a major global agricultural issue that threatens sustainable development goals related to food security, agriculture, resource conservation, and nutrition. The higher levels of salinity have detrimental effects on soil physico-chemical and biological characteristics and plant metabolism. Also, salinity poses a negative impact on the abundance and distribution of soil microbes and soil-dwelling organisms. Research has always been trying to overcome the salinity issue, but it does not fit well in conventional approaches. This review unravels traditional and modern salinity management techniques. Out of the available salinity management techniques, some are focused on enhancing soil properties (chemical amendments, biochar, earthworms, and their vermicompost, compost, microbial inoculants, electro remediation), some focus on improving plant properties (seed priming, afforestation, crop selection, genetic improvements, agroforestry) and some techniques augment both soil as well as plant properties in a synergic manner. Therefore, it is imperative to find a conclusive solution by integrating traditional and modern methods to find the most effective response to regionally-specific salinity related problems. This review aimed at critical analysis of the salinity problems, its impact on agroecosystem, and different management approaches available to date with a balanced viewpoint that would help to draw a possible roadmap towards the future investigation in this domain for sustainable management of salinity issues around the globe.

Genetic and morphological assessment of a vulnerable large catfish, Silonia silondia (Hamilton, 1822), in natural populations from India.

Silonia silondia is a commercially important fish distributed in Asian countries, which is under threat due to overexploitation. This study focuses on the morphological analysis and genetic variation of S. silondia individuals, through truss network and sequencing of two mitochondrial regions, respectively, from six wild populations of the Ganga and Mahanadi river systems in India. A total of 38 haplotypes was observed by analysing combined mitochondrial genes (cytochrome b + ATPase 6/8) in 247 individuals of S. silondia collected from six populations. Average haplotype and nucleotide diversities were 0.8508 and 0.00231, respectively. Genetic structure analysis showed the predominant cause of genetic variation to be within populations. The two clades were observed among the haplotypes and time of divergence from their most probable ancestor was estimated to be around 0.3949 mya. Analysis of combined mitochondrial genes in six populations of S. silondia resulted into three management units or genetic stocks. The truss network analysis was carried out by interconnecting 12 landmarks from digital images of specimens to identify phenotypic stocks. Sixty-five truss morphometric variables were analysed for geometric shape variation which revealed morphological divergence in River Son specimens. The present study presents molecular markers and genetic diversity data which can be critical input for conservation and management of differentiated populations and future monitoring of the genetic bottleneck. The morphological shape analysis clearly shows that variation in the insertion of adipose fin is an important parameter influencing the morphological discrimination.

Characterization of heavy metal pollution in an anthropogenically and geologically influenced semi-arid region of east India and assessment of ecological and human health risks.

The present study evaluated the heavy metal contamination in groundwater and associated ecological and human health risks of a geologically and anthropogenically diverse semi-arid region of Birbhum district, India. For a reliable evaluation, concentrations of nine heavy metals in 680 groundwater samples (N = 680) which were collected during premonsoon and postmonsoon seasons of consecutive two years from 170 wells were measured. The human health risk assessment using the USEPA model which is based on single value for each parameter may inherit certain inaccuracy and uncertainties in the evaluation. Unlike earlier studies, a higher degree of accuracy in carcinogenic and noncarcinogenic health risk assessments was achieved through Monte Carlo simulations, sensitivity analysis and uncertainty analysis. The study revealed the occurrence of the target heavy metals in groundwater with mean dominance order of Fe > Zn > Sr > Mn > Cr > Pb > Ni > Cu > Cd where mean concentrations of the carcinogens, Pb and Fe exceeded their maximum permissible limits. The water quality status evaluated using the modified heavy metal pollution index, Nemerow index and Heavy metal evaluation index methods resulted in medium to high heavy metal contamination in groundwater within a large portion of the study area which indicated its unsuitability for drinking purpose. The study suspects a moderate to very high risk for the groundwater dependent ecosystems in major part of the study area. The study further revealed cancer risks, ranging from high to very high within the residents due to accumulative exposure of the carcinogenic heavy metals in groundwater through ingestion and dermal contact. Minor populations of the study area were found to be more vulnerable to the carcinogenic and noncarcinogenic diseases than teenagers and adults, mainly through oral exposure. The study recommends the residents to consume treated groundwater since the primary route of heavy metal exposure was identified to be the ingestion route.

Microsatellite marker set for genetic diversity assessment of primitive Chitala chitala (Hamilton, 1822) derived through SMRT sequencing technology.

In present study, single molecule-real time sequencing technology was used to obtain a validated set of microsatellite markers for application in population genetics of the primitive fish, Chitala chitala. Assembly of circular consensus sequencing reads resulted into 1164 sequences which contained 2005 repetitive motifs. A total of 100 sequences were used for primer designing and amplification yielded a set of 28 validated polymorphic markers. These loci were used to genotype n = 72 samples from three distant riverine populations of India, namely Son, Satluj and Brahmaputra, for determining intraspecific genetic variation. The microsatellite loci exhibited high level of polymorphism with PIC values ranging from 0.281 to 0.901. The genetic parameters revealed that mean heterozygosity ranged from 0.6802 to 0.6826 and the populations were found to be genetically diverse (Fst 0.03-0.06). This indicated the potential application of these microsatellite marker set that can used for stock characterization of C. chitala, in the wild. These newly developed loci were assayed for cross transferability in another notopterid fish, Notopterus notopterus.

Reduction of greenhouse gases (GHGs) and short-lived climate pollutants (SLCPs) from municipal solid waste management (MSWM) in the Philippines: Rapid review and assessment.

Municipal solid waste management (MSWM) is considered one of the serious environmental issues in the Philippines, with corresponding linkages to the climate change and Sustainable Development Goals (SDGs). However, methane (CH4) linked with indiscriminate dumping of municipal solid waste has received the much attention with regard to public health and climate change. The impacts of black carbon (BC) are less documented and understood. This paper aims to review the status of MSWM in the Philippines and makes efforts to assess the scale of short-lived climate pollutants (SLCPs), including both CH4, and BC, associated with the country's waste sector. Utilising available national level data and following a life-cycle assessment (LCA) approach, the paper offers preliminary projections of SLCP emissions resulting from present MSWM practices. In addition, it examines model mitigation scenarios based on priority actions identified within the country's national policy on waste management, Republic Act 2003 (RA 9003). Data analysis was conducted using an Emission Quantification Tool (EQT) developed by the Institute for Global Environmental Strategies (IGES) through its work under the Climate and Clean Air Coalition (CCAC) - Municipal Solid Waste Initiative (MSWI). Following a summary of key findings, the paper affirms that control of methane from disposal practices and of BC from waste collection and open burning requires urgent attention in the Philippines. Continued awareness raising, institutionalising regulatory policies on SLCPs, and further enhancing data collection and capacity building on waste-related BC emissions remain key priorities for the country.

Comparative study of linkage between environmental policy instruments and technological innovation: Case study on end-of-life vehicles technologies in Japan and EU.

A growing population and urbanization is a challenge for finite natural resources. Without strict regulation to recycle, recover and reuse resources, waste is discarded with no value. Every year throughout the world, more than twenty-five million vehicles turn into end-of-life vehicles (ELV) and most of their valuable resources end up in landfill sites. This research analyses the effect of regulation on ELV innovation for additional recovery of resources in Japan and EU nations using patent data as a proxy. The analysis determines the statistical difference in patent activity before and after regulations were enacted in the case studies. The relevant data on ELV technologies was gathered for the period 1985-2013. The study suggests that in general environmental regulation in Japan drove innovation and reveals that environmental policy in Japan was more effective in enabling innovation compared to EU nations. Specifically, the results from these developed countries can be used by the rapidly growing developing countries in automobile manufacturing like China for amendment of their ELV regulation accordingly.

Non-invasive assessment of portal hypertension using quantitative magnetic resonance imaging.

BACKGROUND & AIMS: Hepatic venous pressure gradient (HVPG) measurement is currently the only validated technique to accurately evaluate changes in portal pressure. In this study, we evaluate the use of non-contrast quantitative magnetic resonance imaging (MRI) as a surrogate measure of portal pressure. METHODS: Thirty patients undergoing HVPG measurement were prospectively recruited. MR parameters of longitudinal relaxation time (T1), perfusion of the liver and spleen (by arterial spin labelling), and blood flow in the portal, splanchnic and collateral circulation (by phase contrast MRI) were assessed. We estimated the liver stiffness measurement (LSM) and enhanced liver fibrosis (ELF) score. The correlation of all non-invasive parameters with HVPG was evaluated. RESULTS: The mean (range) HVPG of the patients was 9.8 (1-22) mmHg, and 14 patients (48%) had clinically significant portal hypertension (CSPH, HVPG ⩾10mmHg). Liver T1 relaxation time, splenic artery and superior mesenteric artery velocity correlated significantly with HVPG. Using multiple linear regression, liver T1 and splenic artery velocity remained as the two parameters in the multivariate model significantly associated with HVPG (R=0.90, p<0.001). This correlation was maintained in patients with CSPH (R=0.85, p<0.001). A validation cohort (n=10) showed this linear model provided a good prediction of HVPG. LSM and ELF score correlated significantly with HVPG in the whole population but the correlation was absent in CSPH. CONCLUSIONS: MR parameters related to both hepatic architecture and splanchnic haemodynamics correlate significantly with HVPG. This proposed model, confirmed in a validation cohort, could replace the invasive HVPG measurement. LAY SUMMARY: In patients with cirrhosis, the development and progression of portal hypertension is related to worse outcomes. However, the standard technique of assessing portal pressure is invasive and not widely used in clinical practice. Here, we have studied the use of non-invasive MRI in evaluating portal pressure. The MRI measures of liver architecture and blood flow in the splenic artery correlated well with portal pressure. Therefore, this non-invasive method can potentially be used to assess portal pressure in clinical trials and monitoring treatment in practice.

Management of trismus following radiation therapy by cost-effective approach.

Radiotherapy when used in head and neck cancer treatment can produce side effects in patients such as the trismus. If allowed to progress trismus can become so severe that the patient becomes debilitated due to lack of nutrition. Furthermore, trismus and limited oral access present a challenge to the clinician for dental treatment. This article describes a simple and cost-effective appliance for management of trismus.