Water-efficient genotypes along with conservation measures significantly reduce the green and blue water footprints in sugarcane (Saccharum spp.).

Sugarcane crop is irrigated using surface, overhead, and drip irrigation methods. Increased water use in sugarcane is a major concern around the world, implying the need for water accounting, developing water-efficient hybrids and water-saving agro-techniques for long-term conservation and use of water. "Water Footprint (WF)" is a measure of both direct and indirect water usage accountable for any product and/or process. In praxis, 'Green Water Footprint' (GWF) and 'Blue Water Footprint' (BWF) are extremely crucial for the restoration of essential ecosystem services (ES), such as sugarcane production. The WF metric was used as a priority tool in our study to evaluate water-efficient sugarcane hybrids, germplasm clones, deficit irrigation scheduling, crop geometry, and water conservation measures. Precise and accurate WF quantification would supplement the decision-making processes for managing available water resources in sugarcane agriculture. In split plot experimental design two research investigations on water management in sugarcane were undertaken at the ICAR-Sugarcane Breeding Institute, Coimbatore, Tamil Nadu, India. The major objective of the research trails was to find out suitable sugarcane hybrids and agronomic management practices to minimise water usage in sugarcane cultivation in water stressed and drought prone areas of tropical India. Our investigation comprised two phases; the first one being assessment of the impact of deficit irrigation scheduling, planting techniques and water conservation measures in sugarcane production, while the second phase dealt with genotypic evaluation under variable irrigation scheduling. Results showed that BWF reduced significantly in the first ratoon crop due to deficit irrigation scheduling coupled with planting of two budded setts and application of sugarcane trash at the rate of 5 t ha-1. Sugarcane hybrids viz., Co 85019, Co 10026, Co 12009, Co 13014, Co 14002, Co 14025, Co 15015, and Co 15018 were more water efficient, with a lower total WF. Among the germplasm clones, Fiji 55, ISH 111, ISH 107, Pathri, and Gungera exhibited lower GWF, BWF and total WF.

Bite Force Evaluation in Implant-Assisted Prosthetic Rehabilitation of Reconstructed Jaws Utilizing Vascularized Free Fibula Flap: A Retro-Prospective Cohort Study.

Introduction: Maxillary and mandibular defects due to tumor ablation pose considerable challenges to the reconstructive surgeon and in prosthetic management. Dental implants placed in vascularized fibula free flaps are considered to be a dependable technique for prosthetic rehabilitation in head and neck cancer patients. Although, there is evidence of survival of dental implants in the reconstructed jaw bones, there is lack of information regarding the masticatory performance and prosthetic success. The maximum bite force achieved through the prosthetic appliance is a measure of the therapeutic outcome. The purpose of this study was to determine the maximum bite force achieved through implant-assisted prosthetic rehabilitation in reconstructed jaw bones utilizing vascularized free fibula flap. Methods: The study included a total of 65 implants, from 16 patients who underwent surgical resection of jaw bones due to benign tumors followed by rehabilitation with implant-assisted fixed or removable prosthesis. The maximum bite force was determined with a transducer. Occlusal interferences were analyzed with mounted casts. The parameters were reviewed every 3 months have T 0 marked the baseline assessment, and T 3, T 6, T 9, T 12, and T 15 were subsequent review periods. Results: The mean occlusal force was increased in most of the patients through 15 months (P < 0.01). The maximum bite force measured in the reconstructed mandible and maxilla were 225.63 N and 176.51 N, respectively. Occlusal interferences were absent in 68.8% of the study population. Conclusion: The bite force measured in reconstructed maxilla and mandible is comparable to the masticatory force measured with conventional implant supported prosthesis in native mandible and maxilla.

Prosthetic Rehabilitation Options in Post-Ablative Maxillomandibular Microvascular Reconstructions.

Objective: Surgery remains the mainstay for managing most neoplasms arising in the head and neck area. Removable or fixed prostheses are commonly used for prosthetic rehabilitation of head and neck defects following surgical resection. Some major challenges in prosthetic rehabilitation after maxillomandibular microvascular reconstruction include excessive prosthetic space, soft tissue bulk, and occlusal disharmony in the remaining dentition. This review focuses on the challenges we have experienced in the real clinical scenario while rehabilitating reconstructed maxillomandibular defects and the effective prosthetic treatment options that could be considered in each situation. Discussion: Digital revolution has changed all arenas of life, and it has created a significant impact on cancer treatment planning and the delivery of quality treatment to the needy. Creating adequate retention while ensuring stability and support for the prosthesis can be challenging with temporary acrylic and cast partial removable dentures. Endosseous dental implants are considered a stable, reliable, and esthetic option for reconstruction with advantages such as increased chewing efficiency, preservation of the remaining bone height and width, and improved quality of life. The FP3 to RP5 (Misch's classification) are some commonly followed prosthetic rehabilitation options after microvascular reconstruction. The prosthetic design should permit the usage of interdental aids that ensure the longevity of prostheses. Conclusion: Occlusion-driven/prosthetic-driven implant-assisted prostheses are considered a reliable option that ensures stable and functional oral rehabilitation among patients with free fibula flap reconstruction. Multidisciplinary teamwork is mandatory for an optimal outcome that improves patients' quality of life.

Effectiveness of digital data acquisition technologies in the fabrication of maxillofacial prostheses - A systematic review.

OBJECTIVE: The systematic review was designed to review and analyze the outcomes of various digital data acquisition technologies used for treatment planning in the prosthetic rehabilitation of maxillofacial defects. METHODS: The review protocol was registered in PROSPERO data with registration number: CRD42020188415. The PICOS inclusion criteria was employed in the systematic review. An electronic search (PubMed, databases) yielded twenty-eight eligible case reports. The qualitative methodological assessment was done according to an article that provided criteria for special considerations in evaluating case reports. It consisted of four questions, each carrying grading of 0, 1, and 2. During the full-text screening, the reviewers shortlisted six outcomes (time, aesthetics, cost, dimensional accuracy, patient satisfaction, and fabrication process) and graded (0, 1, 3) according to the outcomes they met. RESULTS: The majority of the included case reports used LASER scanners. Auricular and orbital defects were the highest reported cases. In nasal and orbital defects, the mean outcome of the shorter time required for the fabrication was the highest. In auricular prostheses, the mean outcome of dimensional accuracy was highest. In facial prostheses, aesthetics, dimensional accuracy, and patient satisfaction had the highest mean outcome whereas, in obturators, the shorter time required, dimensional accuracy, and patient satisfaction had the highest mean outcome. A total of 18 studies were graded as highly significant studies according to the methodological qualitative assessment. CONCLUSION: LASER scanning systems in nasal prostheses, LASER scanners and combination of CT scan and digital photography in auricular prostheses, digital photography and stereophotogrammetry in case of large facial defects and combination of MRI and CT scan for obturators appeared to be a superior method of digital data acquisition.

Effect of Particle Size of Nano-Oxides on Color Stability and Mechanical Properties of Maxillofacial Silicone Elastomers: An In Vitro Study.

PURPOSE: To evaluate the physical and mechanical properties of maxillofacial silicone elastomers following the incorporation of a specific particle size and concentration of nano-titanium dioxide (TiO2) and nano-zinc oxide (ZnO). MATERIALS AND METHODS: Nano-TiO2 and nano-ZnO of 20-nm and 40-nm particle sizes and in 1% and 2% concentrations were chosen. Silicone elastomer samples were prepared according to the manufacturer's recommendations. The nano-oxides were incorporated via hand spatulation. The samples were subsequently tested for hardness and color stability and were then subjected to aging in an aging chamber for 1,008 hours, following which they were again evaluated for hardness, color stability, and surface roughness. RESULTS: A significant change was noted in the physical and mechanical properties post-aging in all the groups. The samples with nano-TiO2 of 40-nm particle size/2% concentration had the highest hardness, while color stability and surface roughness were higher in samples with nano-TiO2 of 20-nm particle size/1% and 2% concentrations, respectively. CONCLUSION: It can be concluded that 20-nm nano-TiO2 particles best maintain the ideal properties of maxillofacial silicone elastomers and can potentially be used as alternative opacifiers when mixed with A-2186 maxillofacial silicone elastomers.

Challenges Encountered While Providing Holistic Care to a Cluster of COVID-19 Patients.

COVID-19 emerged as a unique type of health-care crisis. With no established protocols, it became a difficult task to manage this pandemic. Not only individual patients were the point of concern but also multiple clusters were getting reported. Management of these clusters has its own challenges varying from administrative and infrastructural to psychosocial- and stigma-related issues. A well-sought administrative will power along with a dedicated team of health care professionals handled the situation in their best capacity leaving an imprint of peace and harmony.

Why I Can't Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother.

A 26-year-old postpartum COVID-positive mother admitted in COVID isolation facility at a tertiary care center in India. Her primary physical concern was suture site pain and concerns related to expressed breast milk discarding. Her psychological concerns include distrust on COVID report, belief of unjust isolation, lack of family support, loneliness, feeling of not breast feeding her baby, fear, anxiety, anger, stress, and depression. She was concerned about the stigma anticipated for herself and her baby. Spiritually, she was concerned as she was not able to make harmony between herself and environment.

Challenging Concerns of Transgender Community Amidst COVID-19.

A 30-year-old transgender woman was admitted to the dedicated COVID hospital. She presented with mild symptoms and had various psychosocial insecurities, which remained unattended on reaching our health-care facility. From being left alone by her peers, lack of proper deliverance of information, and the stigma attached to the gender issues made her anxious and fearful. Although there are studies showing the prevalence of psychosocial burden in transgender people, a comprehensive approach led by a palliative care physician is yet to be initiated.

A Child with Acute Lymphoblastic Leukemia in Institutional Isolation during the COVID Pandemic: A Multifaceted Responsibility.

The occurrence of the COVID-19 pandemic has caused big challenges in medical communities due to its unpredictable and uncertain nature. It leads to a great deal of physical and psychological concerns. It is more prone to patients with comorbidities such as hypertension and diabetes mellitus and also to immune-compromised patients such as cancer patients. Children are no exception. Acute lymphoblastic leukemia (ALL) is the most common malignancy in the pediatric age group. In this case, we discuss the concerns and reflect the issues of a 10-year-old boy of ALL who was tested COVID positive during the evaluation and treatment of his disease and was admitted in a COVID isolation center along with his mother who was COVID negative.

Psychosocial Burdens of a Renal Transplant Recipient with COVID-19.

The impact of COVID-19 on transplant recipients is yet to be fully understood. Apart from the physical implications, little has been discussed regarding the psychosocial burden it exerts on the already chronically ill patients. Here, we discuss a case of a 40-year-old male who received kidney transplantation 2 years ago and has tested positive for COVID-19. At the time of admission, he presented with mild symptoms and subsequently developed fever for which he had been managed conservatively. However, a comprehensive approach addressing psychosocial, emotional, and spiritual domains from a palliative care physician's perspective is often overlooked, whether in times of COVID-19 or not and this report aims to identify and assess such gaps.

COVID-19-Positive Report Posing a Delay in Treatment Course in a Middle-Aged Metastatic Neuroendocrine Tumor Patient.

The COVID-19 outbreak is an unexpected challenge to all areas of health-care delivery, including cancer centers. The novel coronavirus is known to affect individuals in all age groups, especially patients with multiple comorbidities. A nationwide lockdown has restricted the routine patient care, with health-care services focusing mainly on emergency services and COVID patient management. These restrictions in health services may delay the treatments of non-COVID patients. This conundrum is especially true in cancer patients as they require frequent visits to the hospital, and there is a lack of understanding of the treatment prioritization in cancer patients. In this case, we discuss the concerns faced by a 37-year-old male with neuroendocrine tumor of the anal canal who was tested COVID positive. His surgery was canceled following the report and was shifted to the COVID care facility. Best supportive care was given till further management.

Physiological Root End Closure in a Traumatized Young Permanent Tooth Using Collagen Particles as Pulpal Dressing.

The management of traumatized young permanent teeth has always been a challenge to the clinician, considering the importance of retaining the vitality of the tooth. Recently, collagen particles have been successfully used as pulpotomy medicaments in primary teeth. This case report shows the use of collagen particles as pulpal dressing in a traumatized young permanent tooth of a nine-year-old child presenting with complicated fracture of young permanent left maxillary central incisor. Partial pulpotomy was performed with collagen particles (Biofil-AB) as pulpal dressing. At six months follow up, apexogenesis was found to be nearly complete. Thus, collagen can be considered as a potential pulpal medicament for apexogenesis procedures.

Surgical Derotation Technique: A Novel Approach in the Management of Rotated Immature Permanent Incisor.

Surgical derotation is a method of placing a rotated tooth in normal alignment in a dental arch; surgically, immediately and permanently. It is a potentially convenient and cost-effective treatment modality as compared to conventional orthodontic procedure for rotated maxillary incisor with open apex. Here is a presentation of a severely rotated maxillary left permanent central incisor in a nine and half years old girl, with a radiographic evidence of immature root apex which was surgically derotated, orthodontically retroclined and intruded to its normal position. Postsurgical clinical and radiographic evaluation was done for a period of one and half years to confirm the vitality and continued physiological root formation of the affected tooth. How to cite this article: Dutta B, Krishnapriya V, Sriram CH, Reddy MKR. Surgical Derotation Technique: A Novel Approach in the Management of Rotated Immature Permanent Incisor. Int J Clin Pediatr Dent 2015;8(3):220-223.