Physico-chemical and biological characterization of synthetic and eggshell derived nanohydroxyapatite/carboxymethyl chitosan composites for pulp-dentin tissue engineering.

Hybrid nanohydroxyapatite/carboxymethyl chitosan (nHAp-CMC) scaffolds have garnered significant attention in the field of regenerative engineering. The current study comparatively analyzed the physicochemical and biological properties of synthetic nanohydroxyapatite (SnHA)- and eggshell-sourced nanohydroxyapatite (EnHA)- based CMC biocomposites for pulp-dentin regeneration. EnHA and CMC were synthesized through a chemical process, whereas SnHA was commercially obtained. Composite scaffolds of SnHA-CMC and EnHA-CMC (1:5 w/w) were prepared using freeze-drying method. All biomaterials were characterized by FTIR, micro-Raman, XRD, HRSEM-EDX, and TEM analyses, and their in vitro bioactivity was assessed by immersing them in simulated body fluid for 21 days. The biological properties of the composite scaffolds were evaluated by assessing cytocompatibility using MTT assay and biomineralization potential by analyzing the odontogenic gene expressions (ALP, DSPP, DMP-1 and VEGF) in human dental pulp stem cells (DPSCs) using RT-qPCR method. Characterization studies revealed that EnHA displayed higher crystallinity and superior surface morphology compared to SnHA. The composite scaffolds showed a highly interconnected porous microstructure with pore sizes ranging between 60 and 220 µm, ideal for cell seeding. All tested materials, SnHA, EnHA, and their respective composites, displayed high cytocompatibility, increased ALP activity and degree of mineralization with significant upregulation of odontogenic-related genes on DPSCs (p < 0.05). Nevertheless, the odontogenic differentiation potential of EnHA-CMC on DPSCs was significantly higher when compared to SnHA-CMC. The findings from this study highlight the potential of EnHA-CMC as a promising candidate for pulp-dentin engineering.

Influence of strontium containing fluorophosphate glass onto structural and mechanical behavior of MTA network.

OBJECTIVE: This study aimed to evaluate the effect of incorporation of strontium based fluoro phosphate glass (SrFPG) 48P2O5-29CaO-14NaO-3CaF2-6SrO on physico chemical and biological properties of mineral trioxide aggregate (MTA). METHODS: Optimized SrFPG glass powder were prepared using planetary ball mill and incorporated into MTA in varying proportion (1, 5, 10 wt%) to obtain SrMT1, SrMT5, SrMT10 bio-composite respectively. The bio-composites were characterized using XRD, FTIR and SEM-EDAX before and after soaking for 28 days in stimulated body fluid (SBF) solution. To assess the mechanical properties and biocompatibility of the prepared bio-composite, density, pH analysis, compressive strength and cytotoxicity evaluation using MTT assay were done before and after soaking for 28 days in SBF solution. RESULTS: A nonlinear variation in compressive strength and pH values was noted. Of the bio-composites, SrMT10 was evidenced with rich apatite formation in XRD, FTIR and SEM with EDAX analysis. MTT assay showed increased cell viability in all the samples before and after in vitro studies.

Micro-Raman spectroscopy analysis of dentin remineralization using eggshell derived nanohydroxyapatite combined with phytosphingosine.

The aim of this study was to assess the remineralization efficacy of chicken eggshell-derived nano-hydroxyapatite (CEnHAp) combined with phytosphingosine (PHS) on artificially induced dentinal lesions. PHS was commercially procured whereas CEnHAp was synthesized using microwave-irradiation method and characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), high-resolution scanning electron microscopy-energy-dispersive X-ray spectroscopy (HRSEM-EDX), and transmission electron microscopy (TEM). A total of 75 pre-demineralized coronal dentin specimens were randomly treated with one of the following test agents (n = 15 each): artificial saliva (AS), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), CEnHAp, PHS, and CEnHAp-PHS under pH cycling for 7, 14, and 28 days. Vickers microhardness indenter, HRSEM-EDX, and micro-Raman spectroscopy methods were used to assess the mineral changes in the treated dentin samples. Data were submitted to Kruskal-Wallis and Friedman's two-way analyses of variance (p < 0.05). HRSEM and TEM analysis depicted irregular spherical structure of the prepared CEnHAp with a particle size of 20-50 nm. The EDX analysis confirmed the presence of Ca, P, Na and Mg ions. The XRD pattern showed the characteristic crystalline peaks for hydroxyapatite and calcium carbonate that are present in the prepared CEnHAp. Dentin treated with CEnHAp-PHS revealed highest microhardness values along with complete tubular occlusion compared to other groups at all test time intervals (p < 0.05). Specimens treated with CEnHAp showed increased remineralization than those treated with CPP-ACP followed by PHS and AS groups. The intensity of mineral peaks, as observed in the EDX and micro-Raman spectra, confirmed these findings. Further, the molecular conformation of the collagen's polypeptide chains, and amide-I and CH2 peaks attained peak intensities in dentin treated with CEnHAp-PHS and PHS whereas other groups revealed poor stability of collagen bands. Microhardness, surface topography, and micro-Raman spectroscopy analyses revealed that dentin treated with CEnHAp-PHS have an improved collagen structure and stability as well as highest mineralization and crystallinity.

Heart disease prediction using IoT based framework and improved deep learning approach: Medical application.

Heart disease is the biggest cause of death in the globe. The method of predicting cardiac disease is exceedingly complex. It can only be done properly if the doctor has a lot of expertise and is well-versed in the condition. IoT-based illness prediction is a relatively recent technology for accurately classifying diseases based on sensor data. This system proposes an enhanced deep learning-based framework for predicting the heart disease. The general publicly available Hungarian heart disease dataset is utilized for the implementation, which includes heart disease related data collected from patients through IoT sensor devices. The input dataset is preprocessed using Median Studentized Residual approach for resolving error data and missing values. Preprocessed data values are feature selected by Harris Hawk Optimization (HHO) approach. The selected features are then classified into normal and abnormal by Modified Deep Long Short-Term Memory (MDLSTM). The modification in LSTM output is altered using Improved Spotted Hyena Optimization (ISHO) algorithm. The results are implemented in the working platform of Phyton with the metrics such as specificity, sensitivity, F-Score, Kappa value, Accuracy, BER and Execution time. The analyzed results shows that the implemented methodology is superior in the prediction of heart disease with an accuracy of 98.01% and reduced error rate of 91.11 compared with other existing techniques.

Medium-term Outcomes of Urolift (Minimum 12 Months Follow-up): Evidence From a Systematic Review.

The urolift device has emerged as a novel intervention for men with lower urinary tract symptoms secondary to benign prostatic hyperplasia, and in recent years there has been an increasing amount of primary research published on it. However, critical medium-term appraisal remains lacking. Our objective was to perform a systematic review and therefore identify, appraise, and synthesize the existing evidence for the minimally invasive technique.

Hemifacial hypertrophy: Exploring new avenues of treatment modalities.

Congenital hemihyperplasia is a rare developmental disorder characterized by unilateral overgrowth of one or more body parts resulting in marked asymmetry. We are reporting here, a case of true hemifacial hypertrophy in a young female adult highlighting the clinical features and possible treatment options.

Environmental correlates of undernutrition among children of 3-6 years of age, Rajkot, Gujarat, India.

INTRODUCTION: There are lots of studies focusing on the role of reproductive and child health factors and dietary factors on the nutrition status of the child. The present study is an attempt to highlight the role of macro- and micro-environmental factors in predicting the occurrence of undernutrition in children. METHODS: This was a cross-sectional study conducted in field practice area of Community Medicine Department, PDU Medical College, Rajkot. The nutrition status of children was assessed using the weight for age WHO reference standards, 2006. Children below two standard deviation of the reference median (weight for age) were considered as malnourished. Data were collected for sociodemographic factors, sanitation, hygiene, and attitude of mother toward her child, etc., Data were entered in MS excel, and logistic regression was used. RESULTS: Analysis of 495 selected children showed 24% prevalence of undernutrition. Employment status of mothers (adjusted odds ratio [AOR] 1.65), drinking water quality (AOR 1.53), and cleanliness of mother's hands and clothes (AOR 1.91) significantly affected the nutrition status of the child. Children classified in fair or poor category for Briscoe's sanitation scale had 1.34 and1.92 times higher odds of being undernourished (P > 0.05), respectively. Children classified in fair or poor category for Elizabeth's microenvironment scale had 2.05 and 2.41 times higher odds of being undernourished (P < 0.05), respectively. CONCLUSIONS: Water, sanitation, and hygiene-related factors, as well as microenvironmental factors, significantly affected the nutrition status of the children.

Ocular Injuries Associated with Midface Fractures: A 5 Year Survey.

AIM: The aim of this study is retrospective analysis of ocular injuries after maxillofacial trauma reporting to the Department of Oral and Maxillofacial Surgery at V.S. Dental College and Kempegowda Institute of Medical Sciences and Hospital, Bangalore. STUDY DESIGN: A retrospective analysis of ocular injuries following facial trauma from 2008 to 2013. RESULTS: Road traffic incident was the most common etiology (55.46 %). Zygomaticomaxillary complex fracture was the most common fracture associated with ocular injuries (67.22 %). Out of 119 patients, 5 had severe visual impairment and (0.84 %) had blindness. CONCLUSION: Maxillofacial trauma particularly that associated with Lefort II, Lefort III and Zygomatico maxillary complex fracture may lead to opthalmic injuries and even blindness. A thorough opthalmic examination should be carried out for every patient with maxillofacial trauma and suspected cases should be placed under closed observation so that immediate and active treatment can be taken if necessary.

Learning style-based teaching harvests a superior comprehension of respiratory physiology.

Students entering medical college generally show vast diversity in their school education. It becomes the responsibility of teachers to motivate students and meet the needs of all diversities. One such measure is teaching students in their own preferred learning style. The present study was aimed to incorporate a learning style-based teaching-learning program for medical students and to reveal its significance and utility. Learning styles of students were assessed online using the visual-auditory-kinesthetic (VAK) learning style self-assessment questionnaire. When respiratory physiology was taught, students were divided into three groups, namely, visual (n = 34), auditory (n = 44), and kinesthetic (n = 28), based on their learning style. A fourth group (the traditional group; n = 40) was formed by choosing students randomly from the above three groups. Visual, auditory, and kinesthetic groups were taught following the appropriate teaching-learning strategies. The traditional group was taught via the routine didactic lecture method. The effectiveness of this intervention was evaluated by a pretest and two posttests, posttest 1 immediately after the intervention and posttest 2 after a month. In posttest 1, one-way ANOVA showed a significant statistical difference (P=0.005). Post hoc analysis showed significance between the kinesthetic group and traditional group (P=0.002). One-way ANOVA showed a significant difference in posttest 2 scores (P < 0.0001). Post hoc analysis showed significance between the three learning style-based groups compared with the traditional group [visual vs. traditional groups (p=0.002), auditory vs. traditional groups (p=0.03), and Kinesthetic vs. traditional groups (p=0.001)]. This study emphasizes that teaching methods tailored to students' style of learning definitely improve their understanding, performance, and retrieval of the subject.

Hereditary sensory and autosomal peripheral neuropathy-type IV: case series and review of literature.

Hereditary sensory and autonomic neuropathy (HSAN) IV is a rare autosomal recessive disorder which is characterized by a decrease in the number of myelinated and non-myelinated nerve fibers of peripheral nerves which causes diminished or absent pain sensation leading to increase in self-mutilative habits. A retrospective study of eight cases ranging from age group of 4 to 17 years for oral and digital signs and symptoms is presented. All the patients showed congenital insensitivity to pain and anhidrosis. Oral self-mutilations, such as autoextraction of teeth and severe bite injuries (with resultant scarring) of the finger tips and oral soft tissues (tongue, lip, and buccal mucosa) were found in most patients. Our study suggests that early diagnosis and specific treatment plan are important for prevention of characteristic of the oral as well as digital trauma associated with this disorder.

Comparison between stainless steel staples and silk sutures for primary closure of skin in patients undergoing neck dissection: A comparative clinical study.

INTRODUCTION: Comparison between stainless steel staples and silk sutures for primary closure of skin in patients undergoing neck dissection, in context of rapid application, approximation of the skin edges, economy and aesthetics of the resultant scar. AIM: (1) To compare surgical stainless steel staples and silk sutures for primary wound closure, with respect to presence/absence of wound infection and dehiscence (2) To compare the resultant scar following the two different methods of the closure at 3(rd) month postoperatively with the help of visual analog scale and analyze the result statistically DESIGN: This study was designed to compare skin closure using staples and silk sutures in patients undergoing neck dissection, using both methods in one-half of the same wound; thus each wound affording its own control. MATERIALS AND METHODS: The study was conducted on patients requiring collar line incision (high submandibular incision) with or without a cephalad extension of midline lower lip split incision for surgical access, who presented to the Department of Oral and Maxillo-Facial Surgery. (1) SAMPLE SIZE: 10 (2) STUDY DESIGN: Prospective Comparative study (3) Study duration: One and half years (4) Surgical stainless steel staples: Proximate Plus MD 35 W, Ethicon Endo Surgery (5) Sutures: 3-0 Ethiprime NW 5003, Non-Absorbable Surgical Suture, Mersilk-90 cm, Ethicon, (16 mm 3/8 circle cutting needle). CONCLUSION: It was concluded that there is no significant difference between the scars observed in the regions of incision which underwent primary closure by two different methods, that is surgical stainless steel staples and 3-0 Mersilk Sutures.

Bilateral adenomatoid odontogenic tumour of the maxilla in a 2-year-old female--the report of a rare case and review of the literature.

Multifocal odontogenic lesions are uncommon and have only been observed in conditions associated with known genetic mutations. To the best of our knowledge, only two cases of multifocal adenomatoid odontogenic tumours (AOT) have previously been reported in the literature. In this study, we report the first case of a bilateral, separate AOT in the maxilla in the midline in a 2-year-old female. The patient presented with bilateral expansile masses in the maxilla on either side of the midline which had been present for 6 months. She was asymptomatic and had occasional difficulty in breathing. The tumour was diagnosed as AOT and was surgically enucleated along with the associated teeth. The patient recovered well and has been on recall for 5 years. The follow-up panoramic radiograph made a fortnight ago revealed evidence of three new radio-opaque lesions with an associated tooth in the region of the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla. To acquire additional information about AOT, all reports regarding AOT cited in 'PubMed' from 1995 onward were reviewed and the incidence, clinical features, radiographic features and management of AOT are discussed in this study.

Massive keratocystic odontogenic tumor of mandible: a case report and review of literature.

Keratocystic odontogenic tumor (KCOT), also known as odontogenic keratocysts, as defined by World Health Organization (WHO), are known for their peculiar behavior, varied origin, debated development, unique tendency to recur, and disputed treatment modalities. We present a case of KCOT involving symphysis menti, right and left halves of the body of mandible in an 11-year-old girl treated with enucleation and open dressing (bismuth, iodoform, paraffin paste) with long-term follow-up.

Professional practice among woman dentist.

OBJECTIVE: This review aims to give an inside view of professional career of a women dentist, addresses the unique demands of being a woman dentist, and highlight ways to address these issues. MATERIALS AND METHODS: The Medline database, scholarly literature, and informal literature were considered for this review. RESULTS: Working hours of female dentists do not differ significantly from the working hours of their male counterparts, until they have children. The female dentists' working hours showed a distinct drop as soon as they started a family. It was also found that women dentists are more likely to take career break. It is clear that childrearing and family responsibilities have a great impact on women's working life. Significant differences between males and females in work title and specialization were evident in an academic institution. Due to the societal orientation which regards women as primarily home makers, the responsibilities for family caretaking continues to fall disproportionately on women, and this fact could explain why women abandon their careers in the advanced stages. CONCLUSIONS: Efforts should be made to identify and reduce barriers to women's advancement in dentistry.

Recurrent chronic suppurative osteomyelitis of the mandible.

Osteomyelitis of the maxillofacial skeleton is a rare condition in recent times. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis (CSO). This case report describes the successful surgical treatment of CSO of the mandible in an 18-year-old adult. Treatment included a pre-surgical course of antibiotics followed by sequestrectomy, resection of the coronoid process and removal of the pathologically fractured condylar process of the left side of the mandible. On post-operative clinical review at 1 week, the extra oral draining sinus healed with improved mouth opening.

Iodine nutritional status and goiter prevalence in 6-12 years primary school children of Saurashtra region, India.

BACKGROUND: Iodine deficiency disorder (IDD) or goiter is the cause of preventable brain damage, mental retardation, and stunted growth and development in children. This study aimed to detect the prevalence of IDD in Rajkot district, India by testing urinary iodine excretion levels and iodine salt intake of school children. METHODS: A cross-sectional study was conducted in 2940 school children of both sexes aged 6-12 years from 14 talukas subdivisions of the district. Thirty clusters were selected by using cluster sampling technique. Goiter was assessed in all the studied children along with biochemical analysis of iodine in 420 urine samples and iodine content in 840 edible salt samples in the studied area. RESULTS: Goiter was reported from all talukas subdivisions of the studied area. Goiter prevalence ranged from 1% to 35%, and the overall prevalence was 8.8% (grade 1: 7.6%; grade 2: 1.2%), indicating a mild public health problem. In the study areas, 18.1% of the population showed a level of urinary iodine excretion <50 microg/L. The median level of urinary iodine in the studied areas was 110 microg/L (range 10-415 microg/L). The iodine level of more than 15 ppm was found in 81% of salt samples tested at the household level. CONCLUSION: There is mild goiter prevalence in primary school children of Rajkot district, which is due to the inadequate iodine intake or content from salt at the household level.

Biopolymer from microbial assisted in situ hydrolysis of triglycerides and dimerization of fatty acids.

The present study demonstrates biopolymer production by in situ bio-based dimerization of fatty acids by microorganism isolated from marine sediments. Microbial isolate grown in Zobell medium in the presence of triglycerides for the period of 24-240 h at 37 degrees C, hydrolyze the applied triglycerides and sequentially dimerized the hydrolyzed products and subsequently polymerized and transformed to a biopolymer having appreciable adhesive properties. Physical (nature, odour, stickyness and tensile strength), chemical (instrumentation) and biochemical (cell free broth) methods of analyses carried out provided the hypotheses involved in the formation of the product as well as the nature of the product formed. Results revealed, lipolytic enzymes released during initial period of growth and the biosurfactant production during later period, respectively, hydrolyze the applied triglycerides and initiate the dimerization and further accelerated when the incubation period extended. The existence and the non-existence of in situ hydrolysis of various triglycerides followed by dimerization and polymerization and the mechanism of transformation of triglycerides to biopolymer are discussed in detail.

Working memory brain activation following severe traumatic brain injury.

Functional magnetic resonance imaging (fMRI) has shown that brain activation during performance of working memory (WM) tasks under high memory loads is altered in adults with severe traumatic brain injury (TBI) relative to uninjured subjects (Perlstein et al., 2004; Scheibel et al., 2003). Our study attempted to equate TBI patients and orthopedically injured (OI) subjects on performance of an N-Back task that used faces as stimuli. To minimize confusion in TBI patients that was revealed in pilot work, we presented the memory conditions in two separate tasks, 0- versus 1-back and 0- versus 2-back. In the 0- versus 1-back task, OI subjects activated bilateral frontal areas more extensively than TBI patients, and TBI patients activated posterior regions more extensively than OI subjects. In the 0- versus 2-back task, there were no significant differences between the groups. Analysis of changes in activation over time on 1-back disclosed that OI subjects had decreases in bilateral anterior and posterior regions, while TBI patients showed activation increases in those and other areas over time. In the 2-back condition, both groups showed decreases over time in fusiform and parahippocampal gyri, although the OI group also showed increases over time in frontal, parietal, and temporal areas not seen in the TBI patients. The greatest group differences were found in the 1-back condition, which places low demand on WM. Although the extent of activation in the 2-back condition did not differ between the two groups, deactivation in the 2-back condition was seen in the OI patients only, and both groups' patterns of activation over time varied, suggesting a dissociation between the TBI and OI patients in recruitment of neural areas mediating WM.

Altered brain activation during cognitive control in patients with moderate to severe traumatic brain injury.

BACKGROUND: Persistent deficits in cognitive control have been documented following traumatic brain injury (TBI) but are inconsistently related to the presence and location of focal lesions. OBJECTIVE: Functional magnetic resonance imaging (fMRI) was used to examine brain activation during a cognitive control task in patients with moderate to severe TBI or orthopedic injury (OI). METHODS: Fourteen TBI patients and 10 OI patients underwent fMRI at 3 months postinjury using a stimulus-response compatibility task in which response accuracy and reaction time were measured. Performance between the groups was equated by individually adjusting the amount of training. Groups did not differ in age, gender, or education. RESULTS: Brain activation during stimulus-response incompatibility was greater in TBI patients than in OI patients within the cingulate, medial frontal, middle frontal, and superior frontal gyri. However, the positive regression of activation with response accuracy during stimulus-response incompatibility indicated a stronger relationship for OI patients than the TBI group within the anterior cingulate gyrus, medial frontal, and parietal regions, as well as deep brain structures (eg, brainstem). The number of focal lesions within either the whole brain or within prefrontal areas was not related to brain activation, but there was a relationship between activation and TBI severity. CONCLUSIONS: These findings suggest that neural networks mediating cognitive control are altered after moderate to severe TBI, possibly as a result of diffuse axonal injury, and that the typical relationship of brain activation to performance is disrupted.

Prolongation of the lifetime of the charge-separated state at low temperatures in a photoinduced electron-transfer system of [60]fullerene and ferrocene moieties tethered by rotaxane structures.

A rotaxane tethering both fullerene (C60) and ferrocene (Fc) moieties (abbreviated as (C60;Fc)rotax+) was synthesized in a good yield by the urethane end-capping of pseudorotaxane based on the crown ether-secondary amine motif. In (C60;Fc)rotax+, the C60 group serving as an electron acceptor is attached to the crown ether wheel, through which the axle with a Fc group acting as an electron donor on its end penetrates. The intrarotaxane photoinduced energy-transfer and electron-transfer processes between C60 and Fc in (C60;Fc)rotax+ have been investigated by time-resolved transient absorption and fluorescence measurements with changing solvent polarity. Nanosecond transient absorption measurements of the rotaxane demonstrated that the charge-separated state (C60*-;Fc*+)rotax+ is formed mainly via the excited triplet state of C60 in polar solvents. The lifetime of (C60*-;Fc*+)rotax+ was evaluated to be 20 ns in dimethylformamide (DMF) at room temperature. With lowing temperature, the lifetime of (C60*-;Fc*+)rotax+ extends to 270 ns in DMF at -65 degrees C, due to the structural changes leaving C60*- and Fc*+ at a relatively long distance in the low-temperature region.