Cephalometric Assessment of Differences in Soft Tissue and Dental Compensation in Skeletal Class II Div 1 Malocclusion.

Background: This study was conducted to evaluate the differences in soft tissue as well as dental compensation in skeletal Class II div 1 malocclusion. Methods and Materials: The study sample consists of pre-treatment lateral cephalograms of 100 subjects of both gender having skeletal Class II and dental Class II div 1 malocclusion visiting the Department of Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth Dental College, and Hospital Navi Mumbai. Cephalograms of the subjects fulfilling the inclusion criteria were included in this study. Results: This research was conducted to assess dental and soft tissue compensation in skeletal Class II div 1 malocclusion and comparative assessment of lip prominence measured from two soft tissue vertical reference lines. The 100 subjects selected randomly out of which 44 men and 56 women, age ranging from 18 to 35 years. Conclusion: ARNETT'S method and PROFFIT'S method showed statistically significant as P < 0.0001. PROFFIT'S method and LEGAN-BURSTONE'S method showed statistically significant as P < 0.0001.

Renal transplant anastomotic time-Every minute counts!

The impact of anastomotic time in renal transplant is under recognized and not well studied. It is one of the few controllable factors that affect the incidence of delayed graft function (DGF). Our study aimed at quantifying the impact of anastomotic time. We performed a retrospective review of 424 renal transplants between the years 2006 and 2020. A total of 247 deceased donor renal transplants formed the study cohort. Patients were divided into two groups based on the presence or absence of DGF. Variables with p < 0.3 were analyzed using the binary logistic regression test. The final analysis showed anastomotic time to be significantly associated with DGF with odds ratio of 1.04 per minute corresponding to 4% increase in DGF incidence with every minute increment in anastomotic time. Other variables that had significant impact on DGF were DCD donor (odds ratio - 8.7) and donor terminal creatinine. We concluded that anastomotic time had significant impact on the development of DGF and hence should be minimized.

Case series of invasive lung infections by Aspergillus species and zygomycosis among post COVID-19 and post-transplant individuals.

Airborne pathogens like Aspergillus bring the lungs in the frontline for defense. Pulmonary diseases caused by Aspergillus species are broadly classified as aspergilloma, chronic necrotizing pulmonary aspergillosis, invasive pulmonary aspergillosis (IPA), and bronchopulmonary aspergillosis. Intensive care unit (ICU) admission is required for a large number of patients associated with IPA. It is not yet known whether patients with coronavirus disease 2019 (COVID-19) are at a similar risk for IPA as for influenza. However, usage of steroids plays a leading role in COVID-19. The family Mucoraceae includes filamentous fungi of the order Mucorales, causing a rare opportunistic fungal infection known as mucormycosis. The most commonly reported clinical presentations of mucormycosis are rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and others. Here, we report a case series of invasive pulmonary infection by various fungi like Aspergillus niger, Aspergillus fumigatus, Rhizopus oryzae, and Mucor species. Specific diagnosis was made based on microscopy, histology, culture, lactophenol cotton blue (LPCB) mount, and chest radiography and computed tomography (CT). To conclude, opportunistic fungal infections like those due to Aspergillus species and mucormycosis are most commonly associated with hematological malignancies, neutropenia, transplant patients, and diabetes. Therefore, early diagnosis by direct microscopy, surgical interventions, and effective antifungal treatment form the ideal management for invasive fungal infections like aspergillosis and mucormycosis, instead of waiting for the culture reports.

Correlation of Pharyngeal Airway Dimensions with Maxillomandibular Skeletal Relation and Mandibular Morphology in Subjects with Skeletal Class I and Class II Malocclusions and Different Growth Patterns: A Cephalometric Study in Selected Local Population.

OBJECTIVES: To test the hypothesis that there is no positive correlation between skeletal Class II and mandibular morphology with pharyngeal dimensions in subjects with different growth patterns. MATERIALS AND METHODS: Lateral cephalograms of 60 patients were collected and divided into 2 groups, comprising of 30 in each group. Group 1 consisted of cephalograms of patients having Class I malocclusion, and was further divided into subgroups. 1a) Class I with normal growth 1b) Class I with vertical growth. Group 2 consisted of cephalograms of patients having class II malocclusion and was further divided into subgroups 2a) Class II with normal growth, 2b) Class II with vertical growth. RESULTS: The results showed that the estimated marginal mean for upper pharyngeal width in class I malocclusion group was 8.56 mm, for class II malocclusion group was 7.80 mm, for normal growth individuals was 9.73 mm and that for vertical growth individuals was 6.63 mm. The estimated marginal mean for lower pharyngeal width in class I malocclusion group was 9.62 mm, in class II malocclusion group was 9.10 mm, in normal growth individuals was 8.95 mm and that in vertical growth individuals was 9.77 mm. The estimated marginal mean for pharyngeal area in class I malocclusion group is 330.13 sq.mm, in class II malocclusion group is 308.17 sq.mm, in normal growth individuals is 328.47sq.mm and that in vertical growth individuals is 309.83 sq.mm. CONCLUSIONS: The null hypothesis for this study, as per the statistical analysis, has been rejected.

Nonextraction Correction of Class II Malocclusion by Pendulum Appliance.

A 13-year-old female patient, presented with the chief complaint of forwardly placed upper front teeth. On examination and analysis of relevant records, she was diagnosed as an Angle's Class II malocclusion on a skeletal Class I base. It was decided to treat the patient with a nonextraction treatment approach with the help of maxillary molar distalization followed by fixed mechanotherapy.

Anxiety and depression are common in rheumatoid arthritis and correlate with poor quality of life in Indian patients.

OBJECTIVES: We planned this study to assess the prevalence of anxiety and depression in rheumatoid arthritis (RA) patients and its correlation with quality of life (QOL) in these patients. MATERIAL AND METHODS: Eighty-eight patients (76 females) were included in this cross-sectional study. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Quality of life was measured using the World Health Organization WHOQOL-BREF. The severity of pain was measured by 100-millimetre-long Visual Analogue Scale (VAS), and functional disability was measured by using the Indian version of the Health Assessment Questionnaire (HAQ). The disease activity was measured by Disease Activity Score for 28 joints with 3 variables. RESULTS: Probable anxiety and depression were seen in 61 (69%) and 68 (77%) of the patients, respectively. Patients with anxiety had more severe pain (VAS 53.8 ±26.4 vs. 39.7 ±26.1, p < 0.05), and significantly lower scores in all the 4 domains of the WHOQOL-BREF. Patients with depression had more pain (VAS 54.2 ±25.2 vs. 33.5 ±27.3, p < 0.01), higher HAQ scores (1.0 ±0.7 vs. 0.5 ±0.7, p < 0.01), and lower QOL scores. Both anxiety and depression scores had a negative correlation with all the 4 domains of the WHOQOL-BREF. Anxiety had a significant negative effect on psychological (ß = -0.58, p < 0.001) and environmental domains (ß = -0.39, p < 0.001), while depression had a significant negative effect on psychological (ß = -0.57, p < 0.001) and environmental domains (ß = -0.53, p < 0.001). Both anxiety and depression predicted more pain in RA patients (ß = 0.24, p < 0.001 and ß = 0.44, p < 0.001, respectively). CONCLUSIONS: Anxiety and depression correlated with poor QOL in all 4 domains of the WHOQOL-BREF. Higher HADS scores had a negative effect on all the domains of the WHOQOL-BREF and predicted more severe pain in RA patients. Thus, patients with RA need to be screened and treated for underlying anxiety and depression to improve their QOL, pain, and functional status.

The toxicological effects of lead and its analytical trends: an update from 2000 to 2018.

In every developed and developing country, the major facing problem is heavy metals toxicity. Due to there is an increase in the heavy metals anthropogenic in day to day life by various factors, which are causing serious issues or harmful health hazardous for all types of living organisms. Moreover, they are present everywhere in the universe it causes the contamination of the food, dietary, and processed materials. Accordingly, the present review article further summarizes the studies related to the determination of lead as a toxic impurity with a total of 134 references in the period 2000 to 2018. In this write-up, emphasize the one of the highly toxic heavy metal element Lead (Pb) and it's toxicity in the animals, humans, plants, and aquatic systems. In addition, the purpose of this article is to evaluate the effectiveness of established analytical techniques and trends in analytical methods like AAS; ICP-OES; ICP-MS; ASV; X-ray fluorescence spectrometry, these techniques significantly applicable for the quantitative analysis of Pb in various sources. The various regulatory authorities for Pb throughout the globe like IOSH, EPA, EMA, and CDCSO. This reveals the need and scope of further research in the field of heavy metal toxicity and development of new analytical techniques in meeting the needs of the life scientists. The present comprehensive review is an attempt to transform the state of knowledge into the findings that may act as a guideline for all the interested groups at different levels.

Pulsar emission amplified and resolved by plasma lensing in an eclipsing binary.

Radio pulsars scintillate because their emission travels through the ionized interstellar medium along multiple paths, which interfere with each other. It has long been realized that, independent of their nature, the regions responsible for the scintillation could be used as 'interstellar lenses' to localize pulsar emission regions1,2. Most such lenses, however, resolve emission components only marginally, limiting results to statistical inferences and detections of small positional shifts3-5. As lenses situated close to their source offer better resolution, it should be easier to resolve emission regions of pulsars located in high-density environments such as supernova remnants 6 or binaries in which the pulsar's companion has an ionized outflow. Here we report observations of extreme plasma lensing in the 'black widow' pulsar, B1957+20, near the phase in its 9.2-hour orbit at which its emission is eclipsed by its companion's outflow7-9. During the lensing events, the observed radio flux is enhanced by factors of up to 70-80 at specific frequencies. The strongest events clearly resolve the emission regions: they affect the narrow main pulse and parts of the wider interpulse differently. We show that the events arise naturally from density fluctuations in the outer regions of the outflow, and we infer a resolution of our lenses that is comparable to the pulsar's radius, about 10 kilometres. Furthermore, the distinct frequency structures imparted by the lensing are reminiscent of what is observed for the repeating fast radio burst FRB 121102, providing observational support for the idea that this source is observed through, and thus at times strongly magnified by, plasma lenses 10 .

Successful Implantation of a Renal Allograft With Quintuple Arteries Retrieved From a Living Donor.

In renal transplant, multiple renal arteries in a donor require meticulous vascular reconstruction for successful allograft function in the recipient. Presence of more than 4 renal arteries is usually considered to be a relative contraindication for proceeding with renal donation. We report a living-donor renal transplant procedure where preoperative radiologic imaging of the donor showed 3 left renal arteries. Two additional arteries were identified intraoperatively. All 5 arteries were reconstructed during the back-table procedure, and the allograft was implanted in the recipient. At 3-month follow-up, computed tomographic imaging demonstrated patency of all 5 renal arteries, and the patient had a serum creatinine level of 0.8 mg/dL. Unidentified arteries on preoperative imaging may occasionally require complex reconstruction. A renal allograft with 5 renal arteries is usually a contraindication for renal donation. Here, we describe the first published case of successful kidney transplant after reconstruction of 5 renal arteries in the donor graft.

Role of Tranexamic Acid on Blood Loss in Laparoscopic Cholecystectomy.

CONTEXT: Nonsurgical uses of tranexamic acid include the management of bleeding associated with leukemia, ocular bleeding, recurrent hemoptysis, menorrhagia, hereditary angioneurotic edema, and numerous other medical problems. However, there is hardly any documentation of the use of tranexamic acid in laparoscopic cholecystectomy. AIMS: This study was conducted to evaluate the role of tranexamic acid in limiting blood loss in laparoscopic cholecystectomy and to evaluate the effect of blood loss on morbidity in terms of hospital stay and mortality of the patient. SUBJECTS AND METHODS: The study was conducted on sixty patients admitted with gallstones, candidates for laparoscopic cholecystectomy. Thirty patients received an intravenous 20 mg/kg bolus dose of tranexamic acid at induction of anesthesia (Group A), and another thirty did not receive the aforementioned drug at induction (Group B). STATISTICAL ANALYSIS: The two groups were compared, and the data collected were entered and tabulated using Microsoft Office Excel and analyzed using appropriate statistical tests. RESULTS: The mean postoperative hospital stay (2.4 vs. 2.63, P = 0.4147), drain fluid hemoglobin (Hb) (0.83 vs. 0.90, P = 0.2087), drain fluid hematocrit (0.2434 vs. 0.2627, P = 0.3787), mean drain output (85 vs. 87.23, P = 0.9271), mean pulse rate at the start of surgery (74.2 vs. 75, P > 0.999), mean pulse rate 24 h after surgery (75.9 vs. 76.4, P = 0.5775), and mean change in Hb (0.240 vs. 0.266, P = 0.2502) in both the groups were not significant. CONCLUSIONS: There is no active role of tranexamic acid in elective laparoscopic cholecystectomy.

Ultrasound-guided angioplasty for treatment of peripheral stenosis of arteriovenous fistula - a single-center experience.

PURPOSE: In patients with end-stage renal disease, arteriovenous fistulas (AVFs) are the access of choice for hemodialysis but are often complicated by stenosis. We present single-center experience of 78 ultrasound-guided angioplasty procedures for treating peripheral stenoses of AVFs. METHODS: Between January 2013 and November 2015, 78 angioplasties were performed under ultrasound guidance in 53 patients with end-stage renal disease who were referred from dialysis centers with low flow rate, difficult cannulation, increased cannulation site bleeding, immature or thrombosed AVF. Angioplasties were carried out in the presence of a structural lesion in the AVF resulting in at least 50% reduction in vein diameter with a blood flow of <250 mL/min or a peak systolic velocity >300 cm/s. Clinical success, anatomical success and post-intervention primary and secondary patency rates at 6, 12, 18 and 24 months were studied. RESULTS: In 49/53 patients (92.4%), 74 angioplasty procedures were successfully performed, whereas 4/53 patients (7.6%) had primary failure. A total of 35/49 patients (71.4%) underwent single angioplasty procedure whereas 14/49 patients (28.6%) underwent multiple angioplasty procedures. Post-intervention primary patency rates at 6, 12, 18 and 24 months were 78.6%, 60.2%, 53.8% and 48.9%, respectively. Post-intervention secondary patency rates at 6, 12, 18 and 24 months were 100%, 100%, 95.4% and 89%, respectively. Clinical success and anatomical success was 94.8% and 89.7%, respectively. CONCLUSIONS: Ultrasound-guided angioplasty is an effective method with good long-term outcomes in selected dialysis patients with peripheral stenosis of AVF.

Aesthetic acceptance equals to nature's compensation plus surgical correction.

Orthognathic surgery has become an acceptable treatment plan for patients with various maxillofacial deformities. The rehabilitation of severe class III adult patients requires a complex interdisciplinary orthodontic and orthognathic approach. This presentation aims to show a case of combination of camouflage and bilateral sagittal split osteotomy (BSSO).Camouflage in maxillary arch was accepted after analysing visual treatment objective (VTO) and pleasing soft tissue compensation which gave us the clue to go ahead for surgical correction of excess mandibular length to achieve best aesthetic outcome while maintaining nature's compensation in upper arch.