A Comparative Evaluation of Push-Out Bond Strength of Six Different Root Canal Sealers: An In-Vitro Study.

BACKGROUND: Adhesiveness with radicular dentin is absent with gutta-percha, leading to microleakage and hence re-infection. Root canal sealer helps to achieve an adhesive interface between gutta-percha and root dentin thereby resisting the displacement forces during the functioning of teeth which is evaluated by the push-out test. The aim of this study is to compare the push-out bond strength and to assess the relative bond failure between dentin-sealer, sealer-main cone of (1) epoxy resin, (2) silicon, (3) mineral trioxide aggregate (MTA), (4) calcium hydroxide, (5) bioceramic, (6) zinc oxide eugenol containing root canal sealers. METHODOLOGY: Sixty human permanent lower premolars with one root were collected, disinfected, and decoronated at cemento-enamel junction. Instrumentation was done with a K3 40,0.06 Ni-Ti rotary file and obturated using the main cone and sealer. Based on the sealer utilized, six groups were created: Group 1: AH-Plus, Group 2: RoekoSeal, Group 3: MTA Fillapex, Group 4: Apexit, Group 5: Smart Paste Bio, and Group 6: Procosol. One slice each was obtained from the coronal, middle, and apicalsections of all the obturated canals. Push-out bond strength and failure modes were studied. Statistics involved analysis of variance (ANOVA) followed by the post hoc Tukey test. RESULTS: All three sections exhibited the highest strength for Smart Paste Bio sealer and the least was for RoekoSeal. With all the sealers, the apical section had the highest strength followed by the middle and coronal. CONCLUSION: The smart seal system was superior to all other sealers and displayed a good bond to dentin.

Histologic grading of salivary gland mucoepidermoid carcinoma: A comparison of four grading systems and correlation with survival.

BACKGROUND: Mucoepidermoid carcinoma (MEC) is the most common malignant lesion of salivary glands. A number of histologic grading systems are in use for MEC with variable agreement between them. METHODS: This study was aimed at comparison of four grading systems for MEC: two qualitative (modified Healy and MSKCC grading) and two quantitative (AFIP and Brandwein grading). A retrospective search for diagnosed cases of MEC over eight years yielded 11 cases with adequate clinical details and histologic slides available for review. All cases were reviewed and graded as per the four grading systems. An inter-system agreement was assessed, and Kaplan-Meier analysis was performed to correlate the grading with clinical outcomes. RESULTS: A general agreement between all four grading systems was seen in 72.7% of cases. Brandwein grading assigned the highest percentage of high grades (18.2%), whereas Memorial Sloan-Kettering Cancer Center (MSKCC) assigned the highest percentage of low-grade MEC (72.7%). The agreement between MSKCC and modified Healy was highest at 90% of cases. There was generally a poor agreement between MSKCC and Brandwein grading systems. The MSKCC grading system showed a significant correlation with disease-free survival in MEC patients. CONCLUSION: Hence, the MSKCC grading system might serve as a better histologic grading system with a predictive value for the biologic behavior of the tumor. Further larger studies are required to validate these findings and implement the uniform use of MSKCC grading for MEC of salivary glands.

Assessment of the impact of XP-Endo Finisher file on push-out bond strength of various endodontic sealers.

Background: An endodontic treatment is considered a success after thorough chemomechanical debridement coupled with obturating root canals in a concrete way thereby providing hermetic seal. Gutta-percha being nonadherent necessitates use of a sealer to achieve hermetic seal. Adequate adhesion of root canal sealer with gutta-percha core and radicular dentin ensures lack of apical leakage. Materials and Methods: Sixty extracted mandibular premolars with single root canal decoronated at cementoenamel junction were selected and randomly allocated to two groups (n = 30). Samples in Group 1 were prepared with BT Race file, while Group 2 samples were prepared with BT Race alongwith XP Endo file. Absorbent paper points were used for canal drying and samples were randomly divided into six subgroups. In Subgroup I, obturation was done with bio-ceramic (BC) sealer (Endosequence BC) and BC gutta-percha. In Subgroup II, resin-based (AH plus) sealer and gutta-percha were used. In Subgroup III, calcium hydroxide-based (Sealapex) sealer and gutta-percha were used. Sectioning of root samples was done perpendicularly into coronal, middle, and apical segments of 3 mm each. A universal testing machine was used for sample testing, in which push-out bond strength corresponded to the highest value obtained. Stereomicroscopic (×20) study of the samples determined the failure mode at dentin/sealer/main cone interface. Statistical Analysis: Analysis of variance and post hoc Tukey's tests were used for data analysis. Results: Endosequence BC with XP-Endo files showed the highest mean push-out bond strength (16.31 MPa), whereas Sealapex without XP-Endo file had the lowest values (12.76 MPa). Mixed failure of adhesive and cohesive mode was observed for most samples. Conclusion: Adjunctive irrigation agitation technique utilizing XP-Endo Finisher facilitates biofilm eradication from difficult niches in root canals, thereby improving adhesion of sealer and subsequently the sealer bond strength.

Hypoxemia in School-age Children Undergoing One-lung Ventilation: A Retrospective Cohort Study from the Multicenter Perioperative Outcomes Group.

BACKGROUND: Risk factors for hypoxemia in school-age children undergoing one-lung ventilation remain poorly understood. The hypothesis was that certain modifiable and nonmodifiable factors may be associated with increased risk of hypoxemia in school-age children undergoing one-lung ventilation and thoracic surgery. METHODS: The Multicenter Perioperative Outcomes Group database was queried for children 4 to 17 yr of age undergoing one-lung ventilation. Patients undergoing vascular or cardiac procedures were excluded. The original cohort was divided into two cohorts: 4 to 9 and 10 to 17 yr of age inclusive. All records were reviewed electronically for the primary outcome of hypoxemia during one-lung ventilation, which was defined as an oxygen saturation measured by pulse oximetry (Spo2) less than 90% for 3 min or longer continuously, while severe hypoxemia was defined as Spo2 less than 90% for 5 min or longer. Potential modifiable and nonmodifiable risk factors associated with these outcomes were evaluated using separate multivariable least absolute shrinkage and selection operator regression analyses for each cohort. The covariates evaluated included age, extremes of weight, American Society of Anesthesiologists Physical Status of III or higher, duration of one-lung ventilation, preoperative Spo2 less than 98%, approach to one-lung ventilation, right operative side, video-assisted thoracoscopic surgery, lower tidal volume ventilation (defined as tidal volume of 6 ml/kg or less and positive end-expiratory pressure of 4 cm H2O or greater for more than 80% of the duration of one-lung ventilation), and procedure type. RESULTS: The prevalence of hypoxemia in the 4- to 9-yr-old cohort and the 10- to 17-yr-old cohort was 24 of 228 (10.5% [95% CI, 6.5 to 14.5%]) and 76 of 1,012 (7.5% [95% CI, 5.9 to 9.1%]), respectively. The prevalence of severe hypoxemia in both cohorts was 14 of 228 (6.1% [95% CI, 3.0 to 9.3%]) and 47 of 1,012 (4.6% [95% CI, 3.3 to 5.8%]). Initial Spo2 less than 98% was associated with hypoxemia in the 4- to 9-yr-old cohort (odds ratio, 4.20 [95% CI, 1.61 to 6.29]). Initial Spo2 less than 98% (odds ratio, 2.76 [95% CI, 1.69 to 4.48]), extremes of weight (odds ratio, 2.18 [95% CI, 1.29 to 3.61]), and right-sided cases (odds ratio, 2.33 [95% CI, 1.41 to 3.92]) were associated with an increased risk of hypoxemia in the older cohort. Increasing age (1-yr increment; odds ratio, 0.88 [95% CI, 0.80 to 0.97]) was associated with a decreased risk of hypoxemia. CONCLUSIONS: An initial room air oxygen saturation of less than 98% was associated with an increased risk of hypoxemia in all children 4 to 17 yr of age. Extremes of weight, right-sided cases, and decreasing age were associated with an increased risk of hypoxemia in children 10 to 17 yr of age.

To Assess Symptomatic Profile in Patients with Chronic Rhinosinusitis Before and After Functional Endoscopic Sinus Surgery by Sinonasal Outcome Test-22.

Purpose: This study designed to compare the symptomatic profile of diagnosed patients of chronic rhinosinusitis (CRS) before and after functional endoscopic sinus surgery (FESS) by a 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire. Study design: Observational mixed-design study. Materials and Methods: It is an observational mixed-design study conducted in the department of ENT, Dr. S.N. Medical College, jodhpur from February 2021 to September 2022. A total of 50 patients were included in our study who underwent functional endoscopic sinus surgery. Their symptomatic improvement based on the SNOT-22 score, was compared before and after surgery. Follow-up of patients was done at 1 month and 3 months by SNOT-22 score. Results: A total of 50 patients were included in our study, 42 patients were telephonically communicated and followed up, and 8 patients were lost to follow-up, so 42 patients' data were analyzed. The mean age was 35.42 years. The mean total SNOT-22 score preoperatively was 45.64, postoperatively at 1 month was 6.57, and postoperatively at 3 months was 2.52. The mean difference between preoperative and postoperative scores was 43.11. This shows a significant reduction in postoperative scores as well as improvement in symptoms at the end of 3 months. Conclusion: Preoperatively 64.24% of the patients had a grand total score of 20-50 (showing a moderate impact on quality of life) and 35.71% of patients having a score > 50 (showing a severe impact on quality of life). Observations in our study suggest that Functional endoscopic sinus surgery provides a significant symptom-specific improvement as well as a significant quality of life improvement in patients with chronic rhinosinusitis with or without polyposis. SNOT-22 questionnaire provides an ideal way to understand and grade the disease severity preoperatively and compare the symptomatic improvement after functional endoscopic sinus surgery in patients with chronic rhinosinusitis.

Perception of Current and Future Commitment of Medical Teachers to the Varied Roles of a Teacher: An Observational Study.

Background Medical education is gradually moving towards self-directed learning, thus the roles of a teacher have assumed wider dimensions than before. The awareness of these roles among medical teachers has been studied in several countries, but no study on the awareness of these roles among Indian medical faculty has been found. The aim of this research was to assess the current and future commitment perception of the roles of a teacher among Indian medical faculty. Methods A cross-sectional questionnaire-based survey regarding the 12 roles of a teacher, as defined by Harden and Crosby, was conducted among medical teachers in a tertiary-level hospital and medical college. The questionnaire consisted of three categories: importance in medical teaching, current commitment, and preferred future commitment to these roles, all measured on a five-point Likert scale. Results The highest mean scores were given to the roles of learning facilitator and on-the-job role model. In contrast, the lowest scores were designated to the production of study guides. Interestingly, the teachers' current commitment to roles such as curriculum planner and course organizer was found to be low. A significant difference was observed between the three categories for the majority of the roles. Younger faculties showed significant difference among categories, while the senior professors did not show significant variations across the roles. Conclusion This study of Indian medical teachers emphasizes the decreased importance attributed to roles like curriculum planning and course organization. Further studies in other developing countries are essential to understand this issue more comprehensively.

Comparison of HPV 16/18 Genotyping and p16/Ki67 Dual Staining for Detection of High-Grade Cervical Lesion in Patients with Low-Grade Cervical Smears.

Objective: To triage low-grade cervical smears (ASCUS/LSIL) by HPV 16/18 genotyping and dual staining with p16/Ki67 and to compare the sensitivity and specificity of these two triage methods for detection of high-grade cervical intraepithelial neoplasia (HGCIN). Methods: In this prospective cross-sectional study, we evaluated a total of 89 women with low-grade smears (54 ASCUS, 35 LSIL) recruited from a tertiary care hospital. All patients underwent colposcopy guided cervical biopsy. Histopathology was used as gold standard. All samples were subjected to HPV 16/18 genotyping (excluding 9) using DNA PCR and p16/Ki67 dual staining (excluding 4) using Roche® kit. We then compared the two triage methods to detect high-grade cervical lesions. Results: Overall, in all low-grade smears sensitivity, specificity and accuracy of HPV 16/18 genotyping, was found to be 66.7%, 77.1% and 76.2% respectively (p = 0.03). In low-grade smears sensitivity, specificity and accuracy of dual staining, was found to be 66.7%, 84.8% and 83.5% respectively (p = 0.01). Conclusions: Overall, in all low-grade smears the sensitivity of the two tests was comparable. However, dual staining had a higher specificity and accuracy than HPV 16/18 genotyping. It was concluded that both are effective triage methods but dual staining had a better performance than HPV 16/18 genotyping.

Eccrine Porocarcinoma of Dorsum of Nose: A Rare Case Report.

Eccrine porocarcinoma (EPC) is an uncommon malignant tumor derived from the eccrine sweat glands. Because of its various pathological features, it is often confused with other malignant cutaneous tumors. We present a case of 78-year- old female having ulcerative lesion over external nasal pyramid. Biopsy suggested of squamous cell carcinoma. Tumor was excised and reconstruction was done using paramedian forehead flap. Post operative Histopathological Examination (HPE) suggested of eccrine porocarcinoma.

Artificial Intelligence-driven Digital Cytology-based Cervical Cancer Screening: Is the Time Ripe to Adopt This Disruptive Technology in Resource-constrained Settings? A Literature Review.

Cervical cancer is still a public health scourge in the developing countries due to the lack of organized screening programs. Though liquid-based cytology methods improved the performance of cervical cytology, the interpretation still suffers from subjectivity. Artificial intelligence (AI) algorithms have offered objectivity leading to better sensitivity and specificity of cervical cancer screening. Whole slide imaging (WSI) that converts a glass slide to a virtual slide provides a new perspective to the application of AI, especially for cervical cytology. In the recent years, there have been a few studies employing various AI algorithms on WSI images of conventional or LBC smears and demonstrating differing sensitivity/specificity or accuracy at detection of abnormalities in cervical smears. Considering the interest in AI-based screening modalities, this well-timed review intends to summarize the progress in this field while highlighting the research gaps and providing future research directions.

Systematic review of determinants and interventions of areca nut cessation: curbing a public health menace.

BACKGROUND: Areca nut (AN) is a proven human carcinogen and a global public health menace. There is yet no review providing comprehensive information on the determinants and interventions available for cessation of AN. This systematic review was aimed at summarizing the available literature on drivers and interventions for cessation of AN chewing habit and to highlight the research lacunae. METHODS: A systematic literature search (from 1990 till March 2021) was conducted for studies on AN cessation. Relevant data were extracted independently by two authors. RESULTS: A total of 16 studies were included, which highlighted the influence of socio-cultural factors, addictive nature of AN and withdrawal symptoms as barriers to quitting. However, the knowledge of ill-effects of AN use on health, absence of concurrent alcohol use or smoking and family pressure were associated with likelihood of AN cessation. The interventions utilized for AN cessation have been behavioural in majority of the studies except for one where antidepressants were used for this purpose. CONCLUSIONS: The current review emphasizes the imperative need of appropriate cessation strategies for AN chewing habit including enhancing awareness of the harmful effects and research into additional behavioural and pharmacologic cessation therapies to control this significant public health problem.

Point-of-care tests for human papillomavirus detection in uterine cervical samples: A review of advances in resource-constrained settings.

Incidence of cervical cancer and associated mortality are still high in resource-constrained countries due to the lack of infrastructural facilities and trained workforce. Human papillomavirus (HPV)-based screening tests offer a better sensitivity (>90%) for the detection of cervical high-grade lesions. However, these tests usually require an extensive laboratory set-up and trained technical staff. Moreover, the high cost of the currently available and approved HPV tests precludes their use in the cervical cancer screening programmes in resource-limited settings. Hence, there is a felt need for a low-cost point-of-care (POC) HPV test with good performance characteristics to help augment cervical cancer screening in such settings. A recent meta-analysis demonstrated a good sensitivity and specificity for two of the commercially available POC HPV tests. The present review discusses the merits and limitations of the current commercially available POC and near-POC devices for HPV-based cervical cancer screening. The technologies that have the potential to be developed into low-cost POC tests and newer promising modalities for HPV-based POC or near POC have also been highlighted. This review underscores the need for collaborative and coordinated research for development of POC or near-POC HPV-based tests to be used in cervical cancer screening. Efforts need to be focussed on technologies that offer ease of performance without the requirement of sophisticated equipment or extensive sample pre-processing coupled with a good sensitivity and cost-effectiveness.

Cancer awareness & its association with demographic variables & mobile phone usage among the rural population of a district in north India.

Background & objectives: Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Methods: Using a stratified random sampling technique, households in three villages of Gautam Buddh Nagar district of India were selected. A house-to-house survey on cancer awareness was conducted among adults in selected households and data were analyzed to check for the association of such an awareness with sociodemographic factors and internet usage. Results: The study included 59 males and 145 females, with majority (115) being in the age group of 18-30 yr. Although most (96.5%) of the participants were aware of cancer, the common risk factors and warning signs of cancer were known to only a few. Specific risk factors for cervical and breast cancers were, however, not known to a majority (79.9% and 72.2%). A significant association between the awareness of general risk factors and warning signs as well as specific aspects including risk factors for breast, cervical and oral cancer, HPV vaccine and the education level of the participants (P<0.05 for all). Knowledge of risk factors, warning signs and cancer prevention modalities was higher among mobile phone users who accessed internet for health information. There was no significant association between age group and cancer risk factor awareness, though females were more aware of the risk factors for breast cancer (P=0.002). Interpretation & conclusions: The findings of this study highlight the existing low level of awareness of cervical and breast cancers among the rural population. The association of cancer awareness with education level and mobile phone-based internet usage suggests the potential utility of internet-based platforms such as m-health programmes for cancer prevention activities.

Stromal microenvironment namely angiogenesis, tumor-infiltrating lymphocytes, and matrix metalloproteinase in invasive breast carcinoma: Do they have a prognostic role?

Background: The role of stromal microenvironment in growth, invasiveness, and metastatic potential of breast carcinoma (BC) is being recognized increasingly, both to predict prognosis and as potential therapeutic targets. The present study aimed to evaluate the correlation of angiogenesis, tumor-associated lymphocytes, and stromal CD10 expression with clinicopathologic parameters. Materials and Methods: This study included 100 consecutive cases of invasive BC undergoing modified radical mastectomy. Relevant clinical details, pathological grade, lymph nodal status, and clinical stage were noted. Paraffin-embedded sections were subjected to immunohistochemistry for CD34, CD20, CD45RO, and CD10. Microvessel density (MVD), tumor-associated lymphocytes, and stromal CD10 expression were estimated from these sections. Statistical analysis was done using nonparametric tests to correlate the clinic-pathologic features with each of these parameters. Results: MVD was found to be significantly higher in Grade III, node-positive cases, and higher stage breast cancers (P < 0.05). The number of T-lymphocytes was higher in node-positive cases, while B-lymphocytes were lower in number in higher grade tumors. CD10 expression showed a significant positive association with tumor grade, nodal status, and stage (P < 0.05 for each). Conclusion: This study demonstrates that changes in stromal microenvironment of BC such as MVD, tumor-associated lymphocytes, and stromal CD10 expression correlate with the clinicopathological parameters and hence may be exploited as prognostic markers or therapeutic targets, based on further larger studies.

Highly active antiretroviral therapy (HAART) and outcome of cervical lesions and high-risk HPV in women living with HIV (WLHIV): A systematic review and meta-analysis.

BACKGROUND: Collating evidence on the impact of highly active antiretroviral therapy (HAART) on the outcome of cervical lesions or human papillomavirus (HPV) infection among women living with HIV (WLHIV) is essential to inform cervical cancer prevention in this vulnerable group. METHODS: We performed a systematic review and meta-analysis of cohort studies that were conducted between January 1, 1996 and January 31, 2022 and reported on the association of HAART with any of the outcomes: incidence, progression, or regression of cervical lesions or acquisition or clearance of HPV infection in WLHIV. Random-effect analysis was used for summary statistics and heterogeneity was assessed through I2 statistic. The protocol for this review has been registered on the PROSPERO database with registration number CRD42021285403. RESULTS: Among 11 studies, the summary estimate of incident cervical lesions was lower in WLHIV on HAART (0.81, 95% CI 0.60-1.08). HAART was associated with lower risk of cervical lesion progression (0.76, 95% CI 0.64-0.92, I2 55.6%) and higher regression rate of these lesions (1.43, 95% CI 1.06-1.94, I2 81%). Though HPV acquisition was not significantly lower in HAART users (0.83, 95% CI 0.40-1.70), the clearance of HPV infection was higher in WLHIV on HAART (1.41, 95% CI 1.14-1.76, I2 2.4%). CONCLUSION: This review provides evidence that HAART assists in reducing the incidence and progression of cervical lesions and enhancing their regression in women living with HIV. Hence, the HAART regime should be recommended to all WLHIV with advice for adherence to allow for early immune reconstitution.

Comparative evaluation of mineral trioxide aggregate and biodentine apical plug thickness on fracture resistance of immature teeth: An In vitro study.

Aim: This study aims to compare the fracture resistance of simulated immature teeth after using different thicknesses of Mineral Trioxide Aggregate (MTA) and Biodentine apical plug. Materials and Methods: Forty human maxillary anterior teeth were selected. Teeth were randomly divided into eight groups of five teeth in each group. Positive control group = 5 teeth; prepared without access cavity preparation. Access cavities of the remaining 35 teeth were prepared, and instrumented with Peeso reamers. Negative control = 5 teeth; filled with calcium hydroxide. Thirty teeth divided into Groups 1 and 2 of MTA (MTA-Angelus, Londrina, Brazil) and Biodentine (Septodant, Saint Maur des Fosses, France) and each group divided into three subgroups: subgroup A - 3 mm apical plug; subgroup B - 6 mm apical plug; and subgroup C: full canal length. The rest of the canals in subgroups A and B were filled with gutta-percha and AH Plus sealer. After the required storage period, all the samples were subjected to fracture testing under universal testing machine and fracture strength was recorded. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test for multiple comparisons. Results: The negative control group showed the lowest fracture resistance compared with the other groups (P < 0.0001). The 6-mm apical plug subgroup of biodentine showed the highest fracture resistance. Conclusion: Within the limitations of this study, MTA and Biodentine can be used as an apical plug instead of root canal filling material to increase the fracture resistance of immature teeth.

Résumé Objectif: Cette étude vise à comparer la résistance à la fracture de dents immatures simulées après utilisation de différentes épaisseurs de trioxyde minéral Agrégat (MTA) et bouchon apical Biodentine. Matériel et Méthodes: Quarante dents antérieures maxillaires humaines ont été sélectionnées. Les dents étaient divisé au hasard en huit groupes de cinq dents dans chaque groupe. Groupe témoin positif = 5 dents; préparé sans préparation de la cavité d'accès. Les cavités d'accès des 35 dents restantes ont été préparées et instrumentées avec des alésoirs Peeso. Contrôle négatif = 5 dents; rempli de calcium hydroxyde. Trente dents réparties en groupes 1 et 2 de MTA (MTA-Angelus, Londrina, Brésil) et Biodentine (Septodant, Saint Maur des Fosses, France) et chaque groupe divisé en trois sous-groupes: sous-groupe A - bouchon apical de 3 mm; sous-groupe B - bouchon apical de 6 mm; et sous-groupe C: longueur totale du canal. Les autres canaux des sous-groupes A et B étaient remplis de gutta-percha et de scellant AH Plus. Après le stockage requis période, tous les échantillons ont été soumis à des essais de fracture sous une machine d'essai universelle et la résistance à la rupture a été enregistrée. Les données étaient analysé à l'aide d'une analyse de variance unidirectionnelle avec le test post hoc de Tukey pour des comparaisons multiples. Résultats: le groupe témoin négatif a montré la résistance à la fracture la plus faible par rapport aux autres groupes (p <0,0001). Le sous-groupe du bouchon apical de 6 mm de la biodentine a montré le plus résistance à la fracture. Conclusion: Dans les limites de cette étude, le MTA et la Biodentine peuvent être utilisés comme bouchon apical au lieu de canal radiculaire matériau de remplissage pour augmenter la résistance à la fracture des dents immatures. Mots-clés: bouchon apical, biodentine, résistance à la fracture, agrégat de trioxyde minéral.

Concurrent Cervical and Anal High-Risk Human Papillomavirus Infection in Women Living With HIV: An Observational Case-Control Study.

BACKGROUND: To evaluate the prevalence and correlates of concurrent uterine cervical and anal HR-HPV infections in women living with HIV (WLHIV). SETTING: A cross-sectional study was undertaken at a tertiary care hospital and linked ART center. METHODS: One hundred and forty-one WLHIV and 161 HIV-negative women were enrolled for cervical and anal cytology as well as HR-HPV testing using the HC2 method. Screen-positive women were followed-up with colposcopy/anoscopy and/or repeat cytology. Appropriate statistical tests were applied to assess the association of concurrent HR-HPV with various parameters. RESULTS: Concurrent cervical and anal HR-HPV infection was detected in 22 WLHIV (16.3%) and 5 HIV-negative women (3.1%), the difference being statistically significant ( P < 0.001 ). Among WLHIV, concurrent HR-HPV was associated with tobacco use ( P < 0.001 ), receptive anal intercourse ( P = 0.02 ), low CD4 counts ( P = 0.001 ), and negatively with ART intake ( P = 0.004 ) on bivariate analysis. Multivariate logistic regression analysis showed a positive association of concurrent HR-HPV positivity with tobacco use ( P = 0.02 ) and low nadir CD4 counts ( P = 0.03 ). CONCLUSIONS: WLHIV, especially those with CD4 counts less than 200/µL, should be offered HR-HPV screening and follow-up to detect cervical and anal lesions.

Research and academic output evaluation for career initiation or progression: Critical issues for Health Professionals.

In current times, much stress is being laid on the evaluation of research productivity of researchers or faculty in addition to the academic qualifications and experience for the purposes of recruitment, promotion, and research grant funding. Over the years, several quantitative indices have been devised for this purpose. Some of these indices such as h-index, impact factor and e-index are being extensively used by research organizations, universities, accreditation bodies and funding agencies for basic scientists as well as health professionals. In the absence of any formal training, these parameters or their advantages and shortcomings may not be well understood by the health professionals, especially in the early stages of their careers and sometimes, even by the evaluators. A big unanswered question is the validity of the same criteria for health professionals as are applicable for the basic science researchers. Since health professional undertaking research assignments are neither adequately trained in basic research nor can they comprehend these indices well, the same yardstick to evaluate these two widely different groups of researchers often places the health professionals at a disadvantage.This paper aims to highlight certain vital issues related to the application of research productivity indicators for recruitment and career progression of health care professionals.

High Prevalence of Cervical High-Grade Lesions and High-Risk Human Papillomavirus Infections in Women Living with HIV: A Case for Prioritizing Cervical Screening in This Vulnerable Group.

INTRODUCTION: Women living with HIV (WLHIV) are at an increased risk of developing cervical precancerous lesions and cervical human papillomavirus (HPV) infection. This study aimed at evaluating the prevalence of cervical lesions and high-risk HPV (HR-HPV) infection in WLHIV in comparison to the HIV-negative women undergoing opportunistic screening. In addition, these findings among WLHIV were correlated with the clinic-demographic factors. METHODS: A cross-sectional study was conducted among WLHIVs at a tertiary hospital and linked antiretroviral therapy (ART) center, while HIV-negative women were recruited from the health promotion clinic at our institute. With informed consent, a semi-structured questionnaire was filled on demographic and epidemiological parameters. Conventional cervical smears and samples for HPV DNA detection by HC2 high-risk HPV DNA test were collected in all participants. Cervical smears were reported using the Bethesda system 2014. Appropriate statistical analysis was performed for bivariate and multivariate logistic regression analysis for comparison between WLHIV and HIV-negative women and for correlation of abnormal cervical cytology and HR-HPV infection among WLHIVs. RESULTS: The clinic-demographic characteristics of WLHIVs and HIV-negative women were similar. On cytology, the prevalence of cervical cytological abnormalities were significantly higher (p < 0.001) among WLHIVs (14.1%) compared to HIV-negative women (3.1%). High-grade lesions were seen in 3.7% of WLHIVs, while no high-grade lesions were detected in HIV-negative women. Cervical HR-HPV infection was also significantly higher (p < 0.001) in WLHIVs (28.9%) than HIV-negative women (9.3%). Cervical precancerous lesions in WLHIVs showed positive association with current sexually transmitted infection (STI), multiple sexual partners, tobacco use, and CD4 count less than 200/µL, while cervical HPV was positively associated with current STI, tobacco use, CD4 count less than 200/µL and negatively with ART intake. On multivariate logistic regression, cervical cytological abnormalities showed a significant association with multiple sexual partners (p < 0.001), while cervical HR-HPV infection was positively associated with current STI (p = 0.01), nadir CD4 count <200/µL (p = 0.004), abnormal cervical cytology (p = 0.002) and negatively with ART intake (p = 0.03). CONCLUSION: Women living with HIV have a significantly higher prevalence of cervical precancerous lesions and HR-HPV infection compared to the general population. Considering the lack of an organized population-based cervical cancer screening program in many low-resource countries like ours, specific focus on screening this highly vulnerable population to reduce the morbidity and mortality due to cervical cancer is imperative.

Encapsulation-Led Adsorption of Neutral Dyes and Complete Photodegradation of Cationic Dyes and Antipsychotic Drugs by Lanthanide-Based Macrocycles.

Molecular architectures offering large cavities can accommodate guest molecules, while their compositional engineering allows tunability of the band gap to support photocatalysis using visible light. In this work, two lanthanide (Ln)-based macrocycles, synthesized using a cobalt-based metalloligand and offering large rectangular cavities, exhibited selective adsorption of neutral dyes over both anionic and cationic dyes. Both Ln macrocycles illustrated complete photodegradation of cationic dyes using visible light without the use of any oxidant. Both Ln macrocycles exhibited complete photodegradation of not only cationic dyes but also a few phenothiazine-based antipsychotic drugs. Photocatalysis involved the generation of reactive oxygen species (ROS), which was corroborated with the band gap of two Ln macrocycles. These results were supported by radical scavenger studies and the quantitative estimation of superoxide and hydroxyl radicals. Complete photodegradation of both dyes and drugs was confirmed by spectral studies, while the generation of CO2 and N2 gases was established by gas chromatography. Importantly, Ln macrocycles were able to distinguish between the neutral dyes that were quantitatively adsorbed and the cationic dyes/drugs that were completely photodegraded.