In Silico Analysis of Functional SNPs in Genes of Complete Androgen Insensitivity Syndrome (CAIS): A Retrospective, Case-Control Study.

Background: Complete androgen insensitivity syndrome (CAIS) is one of the categories of androgen insensitivity syndrome (AIS) described as complete failure of the cell to react to androgens with external genitalia of a normal female. People with AIS condition are genetically male, with XY karyotype in each cell, but their bodies are unable to respond to male sex hormones (called androgens). It is associated with infertility as well as developing cancerous conditions. The genetic association of CAIS involves polymorphism of genes such as NR5A1, SOX9, SRD5A2, CBX2, GATA4, and SRY. Their mutation and participation in genetics of CAIS can be studied by Single Nucleotide polymorphism (SNP) analysis which is a way to detect genetic variations. SNP in coding region leads to synonymous and non-synonymous mutations. Hence, this study highlights analysis of SNPs associated with CAIS. Our aim is to study SNP analysis of NR5A1, SOX9, SRD5A2, CBX2, GATA4, SRY genes in Complete Androgen Insensitivity Syndrome. Methods: SIFT and Polyphen analysis was performed for all the genes and samples were subjected for PCR-SSCP technique. Results: SNPs were analyzed for the genes associated with CAIS. Benign and damaging SNPs were identified. DNA Samples were amplified using PCR technique and they will be analyzed using Single-strand conformation polymorphism (SSCP). Conclusions: As SNPs have decreased stability, damaging and benign character, they can be used as candidate hallmarks in study of Complete Androgen Insensitivity Syndrome.

Effect of schedule management plan in project management worth using structural equation modelling.

With the growing digitalization and the need for customers to have more personalized services available, there is a constant need to innovate and fulfil the demands of customers. However, this burden has contributed to further worsening the schedule management for the service companies. Customers now are demanding more personalized service but without having any compromise on the quality and time of delivery. This resulted in creating the need to have a schedule-driven management plan designed. Despite this advantage, there are very limited studies available that even focus on the concept whereas not any study works towards understanding its contribution in affecting project management for service companies. To overcome this, the study aims to assess the perception of 200 employees and 10 managers for understanding a schedule management plan and its impact on project management worth. The employee's perception evaluation via structural equation modelling revealed that there is no direct influence of schedule management on project management worth but via different factors and strategies the influence could be derived. Managers' perceptions validated the findings and provided insight that strategies like the building of a cloud-based platform or predictive modelling should be designed for better schedule management plan development.

Mucormycosis during Coronavirus Disease Pandemic: A Diagnosis we Cannot Afford to Miss.

Mucormycosis is a very aggressive, devastating opportunistic fungal infection commonly involving nasal, maxillary,orbital, and cerebral regions. In the second wave of the coronavirus disease 2019 (COVID-19) pandemic, a high frequency of mucormycosis infections has been seen because of the triad of COVID-19, systemic steroids, and preexisting diabetes mellitus. A patient might present with a simple mobile tooth/teeth with multiple gingival abscesses Necrotic bone could be seen in the palate. Blackish discoloration might be present in the oral mucosa. There might be extraoral swelling . If rhino-oculo cerebral mucormycosis is diagnosed, then there are two immediate treatment modalities to be followed. Both surgical and medical treatment are necessary. Surgical is thorough debridement of the necrotic tissue. To prevent the occurrence of mucormycosis, meticulous glycemic control and rational use of steroids and antibiotics for the shortest possible time with adequate attention toward the ventilators and tubing are necessary.

An appraisal on molecular and biochemical signalling cascades during arsenic-induced hepatotoxicity.

Arsenic is a ubiquitous metalloid compound commonly found in the environment, and it is usually found in combination with sulphur and metals. Arsenic is considered as a therapeutic as well as poisoning agent since ancient times. It causes toxic effects on different organs, mainly the liver. In this review, we focused on the molecular mechanism of arsenic-induced hepatotoxicity. Here we envisaged the bridge between arsenic and hepatotoxicity with particular focus on the level of hepatic enzymes such as ALT, AST, and ALP. Here, we attempted to elucidate the role of arsenic in redox imbalance on increased oxidative stress (elevated level of ROS, MDA and NO) and decreased antioxidant levels such as reduced GSH, catalase, and SOD. Oxidative stress induces mitochondrial dysfunction via apoptosis (AKT-PKB, MAPK, PI3/AKT, PKCδ-JNK, AKT/ERK, p53 pathways), fibrosis (TGF-ß/Smad pathway), and necrosis and inflammation (TNF-α, NF-ĸB, IL-1, and IL-6). Along with that, arsenic activates caspases and Bax, decreases Bcl2 through mitochondrial dysfunction, and induces apoptosis regulatory mechanism. We believe the alteration of all these pathways leads to arsenic-induced hepatotoxicity.

Gingival Crevicular Fluid Levels of RANKL and OPG After Placement of Collagen Membrane With Simvastatin in the Treatment of Intrabony Defects in Chronic Periodontitis.

PURPOSE: The aim of this study was to estimate the Receptor activator of nuclear factor kappa-B ligand (RANKL) and Osteoprotegrin (OPG) levels in gingival crevicular fluid (GCF) after placement of collagen membrane with simvastatin in intrabony defects. MATERIALS AND METHODS: Sixty subjects were grouped according to the treatment plan as Group I and Group II. Group I included patients with intrabony defects treated with collagen membrane. Group II included patients with intrabony defects treated with simvastatin of 1.5 mg concentration incorporated into the collagen membrane. A split-mouth design was planned, in which two contralateral sites with >5 mm probing pocket depth and radiographic evidence of bone loss at baseline were chosen. Probing pocket depth was standardized with acrylic stent in all the selected areas. GCF samples were collected at baseline and 21 days. The amount of RANKL and OPG in the samples was determined by commercial ELISA kits (Biomedica Medizinprodukte, Austria). RESULTS: When comparing both the groups, Group II had more statistically significant (P < 0.001**) decrease in the levels of RANKL than Group I. In contrast to RANKL, the OPG levels were significantly increased in patients (Group II) having intrabony defects treated with collagen membrane along with simvastatin. CONCLUSION: Simvastatin-loaded collagen membrane expressed increased OPG and decreased RANKL levels, which could have a potential role in periodontal regeneration.

Antiobesity, antioxidant and hepatoprotective effects of Diallyl trisulphide (DATS) alone or in combination with Orlistat on HFD induced obese rats.

The increasing rate of obesity in the past years has become a worldwide concern and it causes many diseases. Even though, Orlistat, a synthetic anti-obesity drug approved by FDA, it causes severe side effects. DATS, a natural product from garlic have gained attention in many biological activities. The aim of the study is to determine the impact of Dially trisulpide (DATS) and its combination with Orlistat therapy on obese animals. 30 male Wistar rats (150-180g) were assigned into 5 groups (n=6). Group 1 rats received normal diet and Group 2 fed with high fat diet (HFD) for 14 weeks. Group 3-5 animals fed with HFD for 8 weeks, after that respective drugs were given simultaneously along with HFD for 6 weeks; Group 3: HFD+Orlistat; Group 4: HFD+DATS; Group 5: HFD+Orlistat+DATS. Before and after drug treatment, body weight was measured and blood was collected for assessment of lipid and liver function profiles. After end of the treatment 14 weeks, liver and adipose tissues were collected for antioxidants determination and histological observations. The significantly (p<0.05) increased body weight, serum glucose, total cholesterol, triglycerides, LDL-cholesterol were observed while significantly (p<0.05) decreased HDL-cholesterol and liver function parameters in HFD induced rats when compared to control group. The significantly (p<0.05) decreased activities of SOD, CAT, GPx and GSH levels were observed while significantly (p<0.05) increased LPO in both the tissues of HFD treated group when compared to control. Histopathological changes were observed in both the liver and adipose tissue of HFD treated group. The DATS and its combination with orlistat supplementation restored all the parameters significantly (p<0.05) especially liver function parameters and also retrieved histopathological changes when compared to orlistat alone. DATS and its combination with Orlistat had great effect than Orlistat alone.

Pharmacodynamic responses of exogenous epinephrine during mandibular third molar surgery.

BACKGROUND: The systemic effects attributable to the injection of dental local anesthetic solutions have been the subject of discussion for many years. AIM AND OBJECTIVE: The aim of the present study was to investigate the biochemical and hemodynamic effects of adrenaline in lignocaine local anesthetic solutions when used in clinical doses in patients undergoing third molar surgery under general anesthesia. MATERIALS AND METHODS: Of the total 30 patients, 15 were given local anesthetic solution containing adrenaline and the other 15 were given the same without adrenaline. Hemodynamic and biochemical parameters were recorded at considerable intervals. The changes from the pre-local anesthetic (baseline) values with each treatment were compared by analysis of variance and Student's t-test. The changes within each treatment were compared by the paired t-test. RESULTS AND CONCLUSION: This study shows that exogenous adrenaline administration in clinical doses produces systemic effects even in conditions where the endogenous release of the catecholamines would be expected to be considerable.

How subjective is nasal endoscopy? A study of interrater agreement using the Lund and Mackay scoring system.

BACKGROUND: Scoring systems exist to standardize the recording of nasal endoscopy findings. The extent to which two surgeons will agree on the findings of nasal endoscopy in adults currently is unknown, although a study in children showed high rates of agreement between two observers. We studied the interobserver agreement of adult nasal endoscopy scored with the system proposed by Lund and Mackay. METHOD: A consecutive series of otolaryngology patients attending with a variety of nasal complaints were recruited. All were examined with a 0 degrees 4-mm endoscope by two surgeons on the same clinic visit. Each independently recorded their findings using the Lund and Mackay scoring system. Neither surgeon was aware of the other's findings. RESULTS: Thirty patients were studied (16 women and 14 men). Because the endoscopic findings were recorded separately for each side of the nose, each surgeon made 60 observations. Interrater agreement was calculated as Cohen's kappa, and suggested moderate agreement for edema (kappa = 0.45), good agreement for crusting (kappa = 0.62), and very good agreement for polyp (kappa = 0.93) and discharge (kappa = 0.84). CONCLUSION: Two independent observers agree on the findings of nasal endoscopy in a high proportion of cases. Nasal endoscopy is a reliable tool, especially when a scoring system such as that of Lund and Mackay is used.

Malleus relocation in ossicular reconstruction: managing the anteriorly positioned malleus: results in a series of 268 cases.

OBJECTIVE: The objective of this study was to report an original method of malleus relocation allowing for better placement of both partial and total prostheses in ossicular reconstruction. STUDY DESIGN: We conducted a retrospective review of clinical and audiometric findings. SETTING: A tertiary referral center. MATERIALS AND METHODS: This is a study of 268 patients who underwent ossiculoplasty surgery from October 1997 to October 2000 for chronic otitis media, noninflammatory disease, and otosclerosis revision. Malleus relocation with total and partial ossicular replacement prostheses was used in all cases. Audiometric assessment included pre- and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone-conduction thresholds, and air-conduction thresholds were measured. RESULTS: A postoperative air-bone gap closed to within 10 dB was achieved in 56% of cases. An air-bone gap smaller than 20 dB was obtained in 78% of cases. Postoperative improvement of air-conduction thresholds superior to 20 dB was found in 41.5% of cases. The postoperative bone-conduction thresholds were unchanged in 98% of cases. One case of total postoperative sensorineural hearing loss was seen in this series (0.4%). Extrusion of the protheses was not observed in this series. Follow up ranged from 6 to 36 months (mean, 12.4 months). CONCLUSION: This study shows that malleus relocation is a safe and efficient technique for ossicular reconstruction. The ideal position of the relocated malleus allows easier and more stable placement of middle ear prostheses.

An association between acquired epiphora and the signs and symptoms of chronic rhinosinusitis: a prospective case-control study.

BACKGROUND: It has been suggested that chronic rhinosinusitis may lead to epiphora because of inflammatory edema at the nasal end of the nasolacrimal duct and that treatment of the underlying nasal disease may obviate the need for dacryocystorhinostomy. The aim of this study was to establish whether or not there is an association between the signs and symptoms of chronic rhinosinusitis and a complaint of epiphora in a blinded, prospective case-control study. METHODS: A consecutive series of 15 adult patients presenting to the ophthalmology department with acquired epiphora were compared with 29 patients presenting with chronic open-angle glaucoma over the same study period. Nasal symptoms and the findings on nasal endoscopy were recorded by a single otolaryngologist blinded to the diagnosis and using a standardized staging system RESULTS: The age and sex distributions of the two groups were similar. Scores for headache and altered smell were significantly higher in the epiphora cases than in controls (p = 0.05 and 0.03, respectively). Trends for higher scores for congestion and discharge were not statistically significant (p = 0.06 and 0.07, respectively). Mucosal edema and discharge were significantly more common on endoscopy in the epiphora cases than in the control cases (p < 0.02). CONCLUSION: We have shown an association between rhinosinusitis and acquired epiphora, and this would be consistent with chronic rhinosinusitis being the cause of the epiphora in some cases.