The anatomy of death.

Medical science does not treat death as an independent physiological phenomenon. It believes that disease is the cause of death and treats both as preventable phenomena. Doctors and relatives nurture a guilt complex when death occurs. The moment of natural death is robbed of its poignancy. There is no cause of death. Death of the physical body is an intrinsic, time governed, built-in ontolytic program. It completes the biologic trajectory of the individual organism which begins at conception and ends with death. In this article, the actual built-in mechanism and operation of the physiological process of death is suggested vis-a-vis biology and medicine. The physical body of an individual is like a biological gadget which is constantly charged with life force received from cosmic energy through the subtle body which is an implement that cannot be objectified in the same way as the gross physical body but is experienced only subjectively by one and all, as mind (antahkaran in Sanskrit and Indian languages, meaning inner instrument, a subtler instrument in contrast to external organs of actions like limbs, tongue, etc. of the physical body). This life force keeps the subtle body and the entire physical body live and functioning. It maintains the body's integrity and internal homeostasis throughout life. The physical body like a gadget has a built-in program which decides how much total capacity, pace and quantum of life force it can use. It is often referred to as breath quota and heartbeat quota, however, they are manifestations and not the mechanism and operation of life and death in the physical body. When the quantum of life force of the physical body is exhausted, the subtle body, a connector for life forces departs, leaving behind the physical body. The vital functions stop and the person is declared dead. It is usually referred to as departure of soul (Pran or Jiva in India) from the physical body in common parlance. This phenomenon of predetermined capacity, pace and fixed quota of life force is operational in all the components of the body. Each cell, each organ, each system and the whole body is a packed unit of bioenergy. They are in structural and functional dynamic homeostasis under constant flux resulting in constant change in the body. The rate of expenditure contributes towards deciding the total life span of the cell, organ, systems and individual. It accounts for the phenomena of cell death, progressive diminution in vitality, change in organ and system functions during life and physical death of an individual at the end. Death is a bio-cosmic phenomenon governed by biological laws. There is variation in life span at the interspecies and intraspecies levels because we measure lifespan of an individual in terms of physical time and not in terms of biological time which is an independent entity, not measurable and predictable as physical time. Everyone lives one full unit of life in terms of biological time which begins at conception and ends with death. The normal distribution of each biological feature, including the biological unit of life, is independent of one another making each individual unique. The biological clock runs at its own dynamic unique pace in every individual. The biological timer starts ticking at conception and stops when the life force quantum is over. When the person dies, the physical body stops functioning and is left behind for others to dispose of. The timing of death is beyond the realm of objective perception and cannot be equated with chronological or physical time. It is a trans-science and trans-technique phenomenon beyond the ken of humankind to alter its mechanism and operation. The article explains the impact of extrinsic and intrinsic diseases, various treatments such as organ transplant, as well as the impact of lifestyle on the biological time scale of an individual. It spells out the difference between natural and unnatural death. With this understanding, death can be appreciated, accepted and respected as a built-in operational intrinsic physiological phenomenon for the end of one's life. It is a must for the survival and healthy continuity of all the species in the biological world including mankind.

The Nature of Autoimmune Diseases.

There are innumerable theories proposed for the cause of autoimmune diseases. Repeatedly it is stated that it is multifactorial inheritance, i.e., polygenes and environment factors together are responsible. That is another way of saying that the cause is not known. None of the causes proposed so far can satisfy the basic requirement that the cause should always precede and be consistently present for the occurrence of a given disease. brbrA concept is presented here that there is no cause for autoimmune diseases. They are, in reality, an integral part of cell program. It is an established fact that the cell doubling capacity in vivo and in vitro is finite. What is proposed here is that on exhaustion of that capacity one of the preprogrammed alternatives for the cells is to alter their morphology of "identity as self " within the body in such a manner that invites immune system to react on them as foreign elements. This is the basis of all varied autoimmune diseases in the body which can be put together under one heading as autoimmune disease group in the same way as it is done for cancer or vascular diseases. This preprogrammed alteration in morphology can involve any cell system of body including those of immune system. This phenomenon is cell specific and hence can manifest as organ specific disease or system specific disease depending on the type of cell involved. This built-in program makes autoimmune disease group a time-governed intrinsic, senescent process. This concept accounts for all the common features of varied autoimmune diseases in the group of autoimmune disease.brbrThey are seen in the cellular systems in plant and animal kingdoms. In humankind, they are universal and democratic. They affect all the races and both sexes. Their incidence progressively increases with age. In a given population, the distribution, the incidence, and varied features of any given autoimmune disease follow normal distribution curves. Each normal distribution curve of any one characteristic of a given autoimmune disease is independent of their other characteristics and their normal distributions. This makes each autoimmune disease unique. The total incidence of autoimmune disease group remains fixed in a given population. The herd determines its random distribution at individual level. Therefore, one can predict total incidence of autoimmune disease group in a given population but at an individual level - who, when, where, what, why and how - can be predictable only in terms of probability. The features of its being chronic, acute exacerbation and/or constant deterioration can also be accounted by being a cellular built-in program.brbrAll the varied types of autoimmune diseases show these common features. These observations establish that they are an integral part of the biological trajectory and follow biological principles in their manifestations. The autoimmune disease group operates at bio-cosmic level displaying order in apparent chaos and making it a trans-science and trans-technique phenomenon.

An ambient-temperature storage and stabilization device performs comparably to flash-frozen collection for stool metabolomics in infants.

BACKGROUND: Stool metabolites provide essential insights into the function of the gut microbiome. The current gold standard for storage of stool samples for metabolomics is flash-freezing at - 80 °C which can be inconvenient and expensive. Ambient temperature storage of stool is more practical, however no available methodologies adequately preserve the metabolomic profile of stool. A novel sampling kit (OMNImet.GUT; DNA Genotek, Inc.) was introduced for ambient temperature storage and stabilization of feces for metabolomics; we aimed to test the performance of this kit vs. flash-freezing. To do this stool was collected from an infant's diaper was divided into two aliquots: 1) flash-frozen and 2) stored in an OMNImet.GUT tube at ambient temperature for 3-4 days. Samples from the same infant were collected at 2 different time points to assess metabolite changes over time. Subsequently, all samples underwent metabolomic analysis by liquid chromatography - tandem mass spectrometry (LC-MS/MS). RESULTS: Paired fecal samples (flash-frozen and ambient temperature) from 16 infants were collected at 2 time points (32 individual samples, 64 aliquots). Similar numbers of metabolites were detected in both the frozen and ambient temperature samples (1126 in frozen, 1107 in ambient temperature, 1064 shared between sample types). Metabolite abundances were strongly correlated between storage methods (median Spearman correlation Rs = 0.785 across metabolites). Hierarchical clustering analysis and principal component analysis showed that samples from the same individuals at a given time point clustered closely, regardless of the storage method. Repeat samples from the same individual were compared by paired t-test, separately for the frozen and OMNImet.GUT. The number of metabolites in each biochemical class that significantly changed (p < 0.05) at timepoint 2 relative to timepoint 1 was similar in flash-frozen versus ambient temperature storage. Changes in microbiota modified metabolites over time were also consistent across both methodologies. CONCLUSION: Ambient temperature storage and stabilization of stool in the OMNImet.GUT device yielded comparable metabolomic results to flash freezing in terms of 1) the identity and abundance of detected biochemicals 2) the distinct metabolomic profiles of subjects and 3) changes in metabolites over time that are plausibly microbiota-induced. This method potentially provides a more convenient, less expensive home collection and storage option for stool metabolomic analysis.

Dental Management of Factor XIII Deficiency Patients: A Case Series.

AIM: To create awareness about rare clotting disorders in children and to highlight the different dental treatment approaches that can be used while planning the management in such cases. BACKGROUND: A prerequisite for successful wound healing is achieving good hemostasis by effective vascular spasm, platelet plug formation, and finally blood coagulation. In the general population, postoperative bleeding after dental treatment is self-limiting. However, a certain segment of the population does suffer from inherited bleeding and clotting disorders, where in standard invasive dental procedures can trigger bleeding episodes, which could be life-threatening in absence of the requisite precautionary measures being followed. CASE DESCRIPTION: One such condition is congenital factor XIII deficiency, a rare autosomal recessive disease usually associated with early onset of serious or life-threatening bleeding episodes, such as, intracranial hemorrhage or umbilical cord bleeding. This case series details the complete dental management of three children suffering from factor XIII deficiency. CONCLUSION: Factor XIII is a rare coagulation cascade, and by this case series, complete dental treatment varying from noninvasive to be kept under observation to invasive dental extraction and fracture reduction was carried out with the hematologists consultations. CLINICAL SIGNIFICANCE: This case series creates awareness about this rare condition and the need for a multidisciplinary approach involving dentists and hematologists in the effective management of such patients. HOW TO CITE THIS ARTICLE: Pai NG, Mehta LK, Padhye NM, et al. Dental Management of Factor XIII Deficiency Patients: A Case Series. Int J Clin Pediatr Dent 2020;XX(X):1-4.

Buccally displaced flap versus sub-epithelial connective tissue graft for peri-implant soft tissue augmentation: a pilot double-blind randomized controlled trial.

BACKGROUND: This article describes a novel surgical technique, the buccally displaced flap, for keratinized mucosa (KM) augmentation during implant uncovering. Furthermore, it clinically compares this technique with sub-epithelial connective tissue graft (SCTG) for peri-implant KM augmentation. Twelve weeks following implant placement, subjects were randomly divided for KM augmentation into group A (buccally displaced flap) and group B (SCTG). The width (WKM) and thickness (TKM) of the KM were assessed prior to the implant uncovering, 4 weeks and 1 year after implant loading. Post-operative pain assessment was performed using the Numeric Rating Scale. RESULTS: The study comprised of 20 implants that were uncovered in 20 subjects. For group A, the mean WKM increased from 0.98 (± 0.23 mm) to 3.01 mm (± 0.18 mm), and the mean TKM increased from 1.45 (± 0.13 mm) to 2.21 mm (± 0.16 mm) at 1 year. For group B, the mean WKM increased from 0.93 (± 0.18 mm) to 3.28 mm (± 0.13 mm), and the mean TKM increased from 1.41 (± 0.15 mm) to 2.25 mm (± 0.11 mm) at 1 year. Post-operative pain was significantly higher for group B 4.15 (± 1.35) as compared to group A 2.6 (± 1.22) (p < 0.001). CONCLUSION: The buccally displaced flap increased the WKM and TKM during implant uncovering, with results comparable to SCTG. The main advantages of the technique were lack of sutures, maintenance of blood supply, reducing number of surgical sites, and it was relatively atraumatic with lesser post-operative pain. TRIAL REGISTRATION: Clinical trials registry-India CTRI/2019/09/021059 . Date of registration-September 4, 2019, retrospectively registered.

Ethics tries handling inner conflicts scientifically/spiritually.

"Ethic: from ethos, character, L ethos, adopted by English especially in sense of 'character and spirit of a people'. Intimately akin to Gr ethos, custom, Skt. sva-dha one's own doing or action; sva self (cf suicide) + dha to self." "Sva-dha:self-position, self-power, inherent power, custom, rule, ease, comfort, according to one's habit or pleasure, spontaneously, willingly, easily, freely, undisturbedly, wantonly, sportively." Words reveal their meanings to those who establish intimacy with them, as the bride unveils her face only to the beloved one.

Spine revisited: principles and parlance redefined.

A revised appreciation of the evolution and the nature of bone in general and of vertebrae in particular, allows revisiting the human spine to usher in some new principles and more rational parlance, that embody spine's phylogeny, ontogeny, anatomy and physiology. Such an approach accords primacy to spine's soft-tissues, and relegates to its bones a secondary place.