Long-Term Efficacy of Selective Laser Trabeculoplasty in Primary Angle-Closure Disease After Laser Peripheral Iridotomy.

PURPOSE: To evaluate the long-term efficacy of selective laser trabeculoplasty (SLT) in eyes with primary angle-closure (PAC) and primary angle-closure glaucoma (PACG) following a laser peripheral iridotomy (LPI). METHOD: In this prospective cross-sectional study, 45 eyes of 34 patients with PAC/PACG diagnosis, uncontrolled intraocular pressure (IOP), and visible pigmented trabecular-meshwork (TM) at least 180° on gonioscopy following a LPI were recruited. Following a detailed baseline ophthalmic evaluation, all eligible eyes underwent SLT, and the patients were examined on day1, at 1 week, 1-, 3-, and 6-months, and 1-, 2-, 3-, 4-, and 5-year subsequently. The main outcomes measured were IOP, number of IOP-lowering agents, and complications. RESULTS: The mean age of the cohort was 57.80 ± 6.44 years, the male-female ratio was 8:26, and 17 eyes were PACG, and 28 were PAC. The baseline IOP was 23.81 ± 1.78 mm Hg, and was significantly declined at all follow-ups (p < .0001). The cumulative probability of overall success was 91% and 84% at 2-, and 5-year, respectively. At 5-year SLT provided drug-freedom in 80% of PAC and 23% of PACG eyes. Six eyes had IOP spike at 1-week and two patients underwent repeat SLT after 1-year. No other complications, such as pain/discomfort, inflammation, an increase in peripheral anterior synechiae and cystoid-macular-edema, were noted. CONCLUSIONS: SLT appears a safe and cost-effective procedure in PAC/mild- moderate PACG eyes with uncontrolled IOP after laser iridotomy. The long-term effectiveness of SLT as adjuvant treatment was good, but need large sized randomized studies for more validation.

Ophthalmic presentations and long-term outcomes of subconjunctival and atypical orbital myocysticercosis.

PURPOSE: To study the clinical presentation, radiological features, diagnosis, and treatment response in subconjunctival and atypical orbital myocysticercosis. METHODS: Retrospective analysis of diagnosed subconjunctival and atypical (strabismus, diplopia, and blepharoptosis) orbital myocysticercosis was performed. A diagnostic criterion (2 of the 3) among clinical features, radiological findings, and treatment response was used in our study. A minimum of "post-treatment" follow-up of 12 months was observed. RESULTS: Thirty-five patients were included with a mean age of 16 years having male predominance (n = 22, 62.8%). All had a unilateral presentation, with 24 (68.6%) patients having subconjunctival cysticercosis, of which 22 were located in close proximity of the rectus muscle insertion. At presentation, 10 patients had diplopia, 7 had strabismus, and 6 had face turn. Pseudo Duane's and pseudo-Brown's syndrome were noted in 5 and 4 patients, respectively. Radiologically, single muscle myositis without scolex was seen in 12 (34.3%) cases. All patients first received medical treatment, and surgical intervention (cyst removal) was attempted after treatment failure. Complete resolution of symptoms was noted in 22 (after medical treatment only) and in 8 (after surgery). CONCLUSION: In the majority, the subconjunctival cysticercosis is found in proximity to the rectus muscle insertion, as a part of orbital myocysticercosis. In atypical scenarios, a satisfactory response to medical treatment can be considered as diagnostic of cysticercosis.

Enzymatic treatment of phenolic pollutants by a small laccase immobilized on APTES-functionalised magnetic nanoparticles.

In this study, we have successfully synthesized magnetic nanoparticles (MNPs), functionalised them by silanization and used them for the covalent immobilization of a recombinant small laccase (rSLAC) from Streptomyces coelicolor. The immobilized recombinant laccase (MNP-rSLAC) was subsequently used for the treatment of phenol, 4-chlorophenol (4-CP) and 4-fluorophenol (4-FP). The enzyme completely degraded 80 µg/mL of the selected phenolic compounds within 2 h in the presence of a natural mediator, acetosyringone. The MNP-rSLAC retained > 73% of initial activity (2,6-dimethoxyphenol as substrate) after 10 catalytic cycles and could be easily recovered from the reaction mixture by the application of magnetic field. Furthermore, immobilised rSLAC exhibited better storage stability than its free counterpart. The Michaelis constant (Km) value for the immobilised rSLAC was higher than free rSLAC, however the maximum velocity (Vmax) of the immobilised SLAC was similar to that of the free rSLAC. Growth inhibition studies using Escherichia coli showed that rSLAC-mediated treatment of phenolic compounds reduced the toxicity of phenol, 4-CP and 4-FP by 90, 60 and 55%, respectively. Interestingly, the presence of selected metal ions (Co2+, Cu2+, Mn2+) greatly enhanced the catalytic activity of rSLAC and MNP-rSLAC. This study indicates that immobilized small laccase (MNP-rSLAC) has potential for treating wastewater contaminated with phenolic compounds. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-021-02854-0.

Enhancing the expression of recombinant small laccase in Pichia pastoris by a double promoter system and application in antibiotics degradation.

Low-expression levels remain a challenge in the quest to use the small laccase (rSLAC) as a viable catalyst. In this study, a recombinant Pichia pastoris strain (rSLAC-GAP-AOX) producing rSLAC under both AOX and GAP promoters (located in two different plasmids) was generated and cultivated in the presence of methanol and mixed feed (methanol:glycerol). Induction with methanol resulted in a maximum laccase activity of 1200 U/L for rSLAC-GAP-AOX which was approximately 2.4-fold higher than rSLAC-AOX and 5.1-fold higher than rSLAC-GAP. The addition of methanol:glycerol in a stoichiometric ratio of 9:1 consistently improved biomass and led to a 1.5-fold increase in rSLAC production as compared to induction with methanol alone. The rSLAC removed 95% of 5 mg/L ciprofloxacin (CIP) and 99% of 100 mg/L tetracycline (TC) in the presence of a mediator. Removal of TC resulted in complete elimination of antibacterial activity while up to 48% reduction in antibacterial activity was observed when CIP was removed. Overall, the present study highlights the effectiveness of a double promoter system in enhancing SLAC production.

Long-term ophthalmic anatomical and functional outcomes after surgical removal of intraorbital foreign bodies.

PURPOSE: To analyze the anatomical and functional ophthalmic parameters after the surgical removal of various intraorbital foreign bodies. METHODS: A retrospective analysis of medical records was performed featuring detailed history, ophthalmic examination, orbital computed tomographic scans, treatment details, and outcomes. The analyzed anatomical factors included extraocular movements, the position of the eyeball (proptosis, dystopia, and enophthalmos), and fullness of orbital sulci. The functional assessment was based on visual acuity, pupillary reactions, and diplopia. The outcomes were defined as complete, partial, and failure after a minimum follow-up of 1 year. RESULTS: Of 32 patients, the organic and inorganic intraorbital foreign bodies were surgically removed from 18 (56.25%) and 14 (43.75%) orbits, respectively. At presentation, anatomically the extraocular movement restriction, proptosis/dystopia/enophthalmos, and orbital sulcus fullness were noted in 26 (81.25%), 24 (75%), and 15 (46.88%), respectively. Functionally, diminished visual acuity, diplopia, and pupil abnormalities were seen in 27 (84.38%), 14 (43.75%), and 8 (25%), respectively. After intraorbital foreign body removal at a mean follow-up of 14 months, the improvement of anatomical factors (same sequence) were observed in 8 (30.77%), 20 (83.33%), and 12 (80%), respectively. In functional factors (same sequence), the improvement was noted in none (0%), 13 (92.86%), and 5 (62.5%), respectively. Hence, the majority of patients (n = 20, 62.5%) achieved partial success, while 8 (25%) had complete success. Four (12.5%) had treatment failure despite similar management protocols. CONCLUSION: The anatomical outcomes are better than the functional outcomes after surgical removal of the intraorbital foreign bodies. The visual acuity does not improve considerably after the surgical removal of intraorbital foreign bodies. Overall, the wooden intraorbital foreign bodies have poorer anatomical and functional prognosis.

Impact of percutaneous coronary intervention on patients with impaired baseline renal function.

BACKGROUND: Acute kidney injury (AKI) frequently co-prevails with acute coronary syndromes (ACS), which could improve post percutaneous coronary intervention (PCI). We sought to evaluate the impact of PCI on post-procedural renal function in patients with impaired baseline serum creatinine (Cr). METHODS: Retrospective evaluation of 185 patients undergoing PCI with impaired basal serum Cr (≥ 1.5 mg/dl) was done, including 88 (47.5%) patients with recent ACS (≤2 weeks old) in group I and 97 (52.4%) patients in group II (stable angina or ACS >2 weeks old). Patients were classified into worsening or improving renal function based on a corresponding increase or decrease of ≥0.5 mg/dl (ΔCr) in serum Cr 24-48 h post PCI. ΔCr < 0.5 mg/dl was termed as no change. RESULTS: A trend towards improving renal function was seen in the study cohort (mean serum Cr: 2.37 ± 1.25 mg/dl vs 2.28 ± 1.59 mg/dl); (p = 0.09) with decrease in group I from 2.28 ± 1.09 mg/dl to 2.12 ± 1.44 mg/dl (p = 0.03) and in group II from 2.45 ± 1.38 mg/dl to 2.43 ± 1.71 mg/dl (p = 0.81). Post PCI, worsening occurred in 20/185 (10.8%) patients in the total study cohort, 5/88 (5.6%) in group I and 15/97 (15.4%) in group II (p = 0.03). Improvement in serum Cr was seen in 49/185 (26.4%) in the total study cohort, 30/88 (34.1%) in group I and 19/97 (19.6%) patients in group II (p = 0.03). CONCLUSION: - Post PCI, only a small proportion of patients with impaired baseline creatinine showed worsening in renal function. Improved renal function was observed in at least one-third of the patients with recent ACS.

Ophthalmic features and management outcomes of 30 children having Goldenhar syndrome.

PURPOSE: To study the ophthalmic clinical profile and the management outcomes of children having Goldenhar syndrome (GS). METHODS: Retrospective review of included children fulfilling the diagnostic criteria of GS was performed. The demography, ophthalmic features, systemic anomalies, and treatment outcomes were recorded manually from patient files. An ENT, pediatrics, cardiology, and orthopedics consultation was sought for all GS patients before taking up for any ophthalmic surgical procedure. The anatomical (ocular surface and eyelid) and functional {vision and extraocular movements (EOM)} factors were exclusively studied. We ensured a minimum postoperative follow-up of 12 months, and our data were compared with the major studies featuring 'ophthalmic features' of GS. RESULTS: Totally 30 children (females = 18, 60%) were included with a median presenting age of 48 months. Twenty-seven (90%) had unilateral ophthalmic involvement with major features being upper eyelid coloboma (n = 25, 75.76%), lipodermoid (n = 18, 54.55%), and limbal dermoid (n = 10, 30.3%). Diminution of visual acuity was recorded in 22 (73.3%), while five (16.7%) had limitation of EOM. Systemically, the prominent features included hemifacial hypotrophy (100%), auricular anomalies (80%), cardiac anomalies (10%), and scoliosis (6.67%). The eyelid colobomas were repaired with the direct closure ± cantholysis technique or using a Tenzel's flap. All children had satisfactory anatomical and functional outcomes after ophthalmic surgical interventions without any significant complications. CONCLUSION: The tailored ophthalmic surgical intervention(s) provides satisfactory restoration of anatomy and functionality of the eye. These children need specific multi-discipline consultations for the holistic management and complete care.

A report of orbital metastasis from a urinary bladder adenocarcinoma.

A 60-year-old man presented with sudden-onset proptosis of the left eye and intermittent diplopia of 2 months duration. Ophthalmic examination revealed bilateral eyelid retraction, left eye proptosis and a firm, non-tender mass (2 cm × 1.5 cm) in left supero-medial orbit with restricted extraocular movements. Contrast-enhanced computed tomography showed a well-defined, enhancing antero-medial orbital mass which was removed via anterior orbitotomy approach. The histopathology/immunohistochemistry showed adenocarcinoma; metastasis of urothelial origin. The oncology consultation and metastatic workup revealed a urinary bladder carcinoma with distant metastasis. Our patient expired within 6 months of diagnosis. The ophthalmic symptoms due to orbital metastasis may be the first presentation of some cancer patients.

Nasal endoscopic features and outcomes of nasal endoscopy guided bicanalicular intubation for complex persistent congenital nasolacrimal duct obstructions.

Purpose: To study the clinical presentation, nasal endoscopic features, and outcomes of nasal endoscopy guided (NEG) bicanalicular intubation (BCI) in children with complex persistent congenital nasolacrimal duct obstruction (pCNLDO). Methods: A prospective, interventional study including eligible children (age ≤ 12 years) having complex pCNLDO. The demographics, number of previous probings, nasal endoscopy findings, and outcomes; were noted in all children who underwent NEG-BCI with Crawford's stents. Matting of eyelashes (MoE, upper, and lower eyelid), tear-film height (TFH), and fluorescein dye disappearance test (FDDT) was assessed pre and postoperatively. The minimum stent in-situ period was 12 weeks, and the minimum follow-up was 6 months (after stent removal). Results: Total 32 children (36 eyes) including 18 females (56.25%) were studied. At a mean age of 4.9 years, all children had epiphora and discharge with MoE (both upper and lower), raised TFH and positive FDDT. Previously, all children underwent conventional probing (s)- once in 12 (33.3%), twice in 18 (50%) and thrice in 6 (16.7%) eyes. The general ophthalmologists performed the majority (n = 21, 58.33%) of those. The BCI was performed under GA in all eyes, and at a mean follow-up of 8.5 months, the "complete" success was noted in 29 eyes (80.5%), 'partial' success in 4 (11.1%) and failure in 3 (8.3%). The stent prolapse was seen in three. Conclusion: NEG-BCI may provide a satisfactory resolution to complex pCNLDO after single or multiple failed probings. NEG provides confident and efficient management of coexistent intranasal complexities related to the inferior turbinate and meatus.

Effect of antioxidant on orthodontic bracket bond strength after vital bleaching.

OBJECTIVES: : The objective of this study is to compare the neutralization effect of various antioxidant agents on the bond strength of composite resins on stainless steel and ceramic brackets immediately bonded to previously bleached teeth. MATERIALS AND METHODS: One hundred and sixty human maxillary premolars were used for the study. Teeth were divided into four groups (n = 40): Group 1 (control), Group 2 (bleached), Group 3 (sodium ascorbate), and Group 4 (tocopherol acetate). Each group was divided into two subgroups, one was bonded with stainless steel and other with ceramic brackets using 3M Transbond XT. Universal testing machine was used to determine the shear bond strength (SBS). RESULTS: Among the metal brackets, Group 1A had the highest SBS (12.18 + 1.41 MPa) and Group 2A had the least SBS (6.18 + 1.49 MPa). Weibull analysis indicated that bond strength for a 90% probability of failure was highest for Group 1A (13.99 MPa) and lowest for Group 2A (8.49 MPa). For ceramic brackets, Group 1B had the highest SBS (13.80 + 1.69 MPa) and Group 2B had the least SBS (8.05 + 1.85 MPa). Weibull analysis indicated that bond strength for a 90% probability of failure was highest for Group 1B (14.61 MPa) and lowest for Group 2B (8.85MPa). CONCLUSION: The in vitro study showed that bleaching reduced the SBS significantly, and this could be effectively reversed by the application of antioxidants in both metal and ceramic brackets.

Secretory expression of recombinant small laccase from Streptomyces coelicolor A3(2) in Pichia pastoris.

This work reports for the first time the secretory expression of the small laccase (SLAC) from Streptomyces coelicolor A3(2) in Pichia pastoris. Using an AOX1 promoter and α factor as a secretion signal, the recombinant P. pastoris harbouring the laccase gene (rSLAC) produced high titres of extracellular laccase (500 ±â€¯10 U/l), which were further increased seven fold by pre-incubation at 80 °C for 30 min. The enzyme (∼38 kDa) had an optimum activity at 80 °C, but optimum pH varied with substrate used. Km values for ABTS, SGZ and 2,6-DMP were 142.85 µM, 10 µM and 54.55 µM and the corresponding kcat values were 60.6 s-1, 25.36 s-1 and 27.84 s-1, respectively. The t1/2 values of the rSLAC at 60 °C, 70 °C, 80 °C were 60 h, 32 h and 10 h, respectively. The enzyme deactivation energy (Ed) was 117.275 kJ/mol while ΔG, ΔH and ΔS for thermal inactivation of the rSLAC were all positive. The rSLAC decolourised more than 90% of Brilliant Blue G and Trypan Blue dye in 6 h without the addition of a mediator. High titres of SLAC expressed in P. pastoris enhance its potential for various industrial applications.

Inducing mutations through γ-irradiation in seeds of Mucuna pruriens for developing high L-DOPA-yielding genotypes.

PURPOSE: To develop elite genotypes in Mucuna pruriens (L.) DC with high L-DOPA (L-3, 4 dihydroxyphenylalanine) yields, with non-itching characteristics and better adaptability by applying γ-irradiation. Molecular and chemical analysis was performed for screening based on specific characteristics desired for developing suitable genotypes. MATERIALS AND METHODS: Developed, mutant populations were analyzed for L-DOPA % in seeds through TLC (thin layer chromatography), and the results obtained were validated with the HPLC (High performance liquid chromatography). The DNA (Deoxyribonucleic acid) was isolated from the leaf at the initial stage and used for DNA polymorphism. RNA (Ribonucleic acid) was isolated from the leaf during maturity and used for expression analysis. RESULTS: The selected mutant T-I-7 showed 5.7% L-DOPA content compared to 3.18% of parent CIM-Ajar. The total polymorphism obtained was 57% with the molecular marker analysis. The gene expression analysis showed higher fold change expression of the dopadecarboxylase gene (DDC) in control compared to selected mutants (T-I-7, T-II-23, T-IV-9, T-VI-1). CONCLUSION: DNA polymorphism was used for the screening of mutants for efficient screening at an early stage. TLC was found suitable for the large-scale comparative chemical analysis of L-DOPA. The expression profile of DDC clearly demonstrated the higher yields of L-DOPA in selected mutants developed by γ-irradiation in the seeds of the control.

Diarylheptanoids Rich Fraction of Alnus nepalensis Attenuates Malaria Pathogenesis: In-vitro and In-vivo Study.

Diarylheptanoids from Alnus nepalensis leaves have been reported for promising activity against filariasis, a mosquito-borne disease, and this has prompted us to investigate its anti-malarial and safety profile using in-vitro and in-vivo bioassays. A. nepalensis leaf extracts were tested in-vitro against chloroquine-sensitive Plasmodium falciparum NF54 by measuring the parasite specific lactate dehydrogenase activity. Among all, the chloroform extract (ANC) has shown promising anti-plasmodial activity (IC50 8.06 ± 0.26 µg/mL). HPLC analysis of ANC showed the presence of diarylheptanoids. Efficacy and safety of ANC were further validated in in-vivo system using Plasmodium berghei-induced malaria model and acute oral toxicity in mice. Malaria was induced by intra-peritoneal injection of P. berghei infected red blood cells to the female Balb/c mice. ANC was administered orally at doses of 100 and 300 mg/kg/day following Peter's 4 day suppression test. Oral administration of ANC showed significant reduction of parasitaemia and increase in mean survival time. It also attributed to inhibition of the parasite induced pro-inflammatory cytokines as well as afford to significant increase in the blood glucose and haemoglobin level when compared with vehicle-treated infected mice. In-vivo safety evaluation study revealed that ANC is non-toxic at higher concentration. Copyright © 2016 John Wiley & Sons, Ltd.

Acacetin 7-O-α-l-rhamnopyranosyl (1-2) ß-D-xylopyranoside Elicits Life-span Extension and Stress Resistance in Caenorhabditis elegans.

The advancements in the field of gerontology have unraveled the signaling pathways that regulate life span, suggesting that it might be feasible to modulate aging. To this end, we isolated a novel phytomolecule Acacetin 7-O-α-l-rhamnopyranosyl (1-2) ß-D-xylopyranoside (ARX) from Premna integrifolia and evaluated its antiaging effects in Caenorhabditis elegans The spectral data analysis revealed the occurrence of a new compound ARX. Out of the three tested pharmacological doses of ARX, viz. 5, 25, and 50 µM, the 25-µM dose was able to extend life span in C. elegans by more than 39%. The present study suggests that ARX affects bacterial metabolism, which in turn leads to dietary restriction (DR)-like effects in the worms. The effect of ARX on worms with mutations (mev-1, eat-2, sir-2.1, skn-1, daf-16, and hsf-1) indicates that ARX-mediated life-span extension involves mechanisms associated with DR and maintenance of cellular redox homeostasis. This study is the first time report on longevity-promoting activity of ARX in C. elegans mediated by stress and DR-regulating genes. This novel phytomolecule can contribute in designing therapeutics for managing aging and age-related diseases.

Diarylheptanoids from Alnus nepalensis attenuates LPS-induced inflammation in macrophages and endotoxic shock in mice.

Diarylheptanoids, a group of plant secondary metabolites are increasingly recognized as potential therapeutic agents. The aim of study was to ascertain the anti-inflammatory profile of diarylheptanoids from Alnus nepalensis against lipopolysaccharide (LPS)-induced inflammation in macrophages and endotoxic shock in mice. Extracts prepared from dried leaves of A. nepalensis using standard solvents were tested against LPS-induced inflammation in macrophages. Among all, butanol extract (ANB) has shown most significant inhibition of pro-inflammatory cytokines without any cytotoxicity. HPLC analysis of ANB showed the presence of diarylheptanoids. The diarylheptanoids were further isolated and tested in-vitro for anti-inflammatory activity. Treatment of isolated diarylheptanoids (HOG, ORE and PLS) was able to reduce the production and mRNA level of pro-inflammatory cytokines (TNF-α and IL-6). Furthermore, we demonstrated that it inhibited the expression of NF-kB protein in LPS-induced inflammation in macrophages. In-vivo efficacy and safety profile of ANB revealed that oral treatment of ANB was able to improve the survival rate, and inhibited the production of pro-inflammatory cytokines in serum, attenuated vital organ injury in a dose dependent manner without any toxic effect at higher dose in mice. The results suggest that diarylheptanoids from A. nepalensis can be considered as potential therapeutic candidates for the management of inflammation related diseases.

Effect of tooth bleaching on orthodontic stainless steel bracket bond strength.

OBJECTIVES: The objective was to assess the shear bond strength (SBS) of composite resins on stainless steel brackets immediately bonded to previously bleached teeth with 35% hydrogen peroxide and to compare the neutralization effect of various antioxidant agents on the bond strength after bleaching. MATERIALS AND METHODS: One hundred sound human maxillary premolars were used for the study. Teeth were divided into 5 groups (n = 20); Group 1 (control), Group 2 (bleach treatment), Group 3 (sodium ascorbate treatment), Group 4 (tocopherol acetate treatment), and Group 5 (retinol acetate treatment). Teeth in Group 3, 4, and 5 were treated as in Group 2, but after that and before bleaching received treatment with sodium ascorbate, tocopherol acetate, and retinol acetate, respectively. Subsequently, teeth were bonded with stainless steel brackets (Ormco) using 3M Transbond XT. After 24 h, each specimen was loaded into a universal testing machine to determine the SBS at debonding. The data were exposed to the analysis of variance, Bonferroni, and Weibull Analysis. RESULT: There significant SBS difference (P = 0.000, F = 32.125) between various groups. Group 1 had the highest SBS (12.182 ± 1.41 MPa) and Group 2 the least SBS (6.182 ± 1.49 MPa). Significant SBS differences observed between Group 1 and 2; Group 2 and 3; Group 2 and 4; and Group 2 and 5 (P = 0.000). There was no significant SBS difference between Group 1 and 3; Group 1 and 4; and Group 3 and 4 (P = 1.000). Bonferroni results also indicated that there was a significant difference between Group 1 and 5 (P = 0.002); Group 3 and 5 (P = 0.144); and between Group 4 and 5 (P = 0.008). Weibull analysis indicated that bond strength for a 90% probability of failure, which was highest for Group 1 (13.99 MPa) and lowest for Group 2 (8.49 MPa). CONCLUSION: The in-vitro study showed that bleaching with 35% hydrogen peroxide reduced the SBS significantly and this could be effectively reversed by the application of 10% sodium ascorbate, 10% tocopherol acetate, or 10% retinol acetate. Thus, treatment of bleached teeth with antioxidants can be a good clinical option for bonding immediately after bleaching.

A comparative evaluation of tray spacer thickness and repeat pour on the accuracy of monophasic polyvinyl siloxane impression material: in vitro study.

PURPOSE: This study was aimed to determine the effect of various tray spacer thickness and subsequent repeated pours on the accuracy and dimensional stability of the impression made from monophasic polyvinyl siloxane material. MATERIALS AND METHODS: Custom trays with different spacer thickness (2, 4 and 6 mm) were used for making an impression of a master model simulating 3 unit fixed partial denture with monophasic polyvinyl siloxane material. These impressions were poured with die stone and repoured. Distance between the reference points were measured and subjected to statistical analysis. RESULT: Casts obtained from 1 st , 2 nd and 3 rd pour of the impression in 2, 4 and 6 mm spacer thickness tray have similar dimensional accuracy amongst each other and with the master model except in molar diameter and inter-abutment distances of cast obtained from 6 mm spacer thickness tray. CONCLUSION: The vertical distance of stone dies were decreased, whereas horizontal distance increased as the thickness of impression material is increased. There were statistically non-significant changes occurring among the repeated pours in 2, 4 and 6 mm spacer thickness. CLINICAL IMPLICATION: 2 and 4 mm spacer thickness are acceptable for making an impression for three unit fixed partial denture with monophasic polyvinyl siloxane material and it was not affected by two subsequent (1 st and 2 nd) repeated pours.

Ergonomic risk factors and their association with musculoskeletal disorders among Indian dentist: a preliminary study using Rapid Upper Limb Assessment.

CONTEXT: Ergonomics is the scientific study of people and their work. The manufacturers typically do not design to accommodate the dimensions of the individual user. Work-related musculoskeletal disorders (MSDs) have emerged as major health problem among workers in both industrialized and industrially developing countries. Rapid Upper Limb Assessment (RULA) was developed to investigate the exposure of the individual workers to risk factors associated with work-related upper limb disorders. AIMS: The assessment of the posture using RULA, which is quick reliable tool to determine the posture, has not been done in the Indian dentist population, indicating the need for the same. SETTINGS AND DESIGN: A total of 104 subjects were included from New Delhi/NCR. SUBJECTS AND METHODS: The procedure was explained, and the questionnaire was distributed and assessment was done using RULA. The MSDs can be recorded using the standard Nordic questionnaire. STATISTICAL ANALYSIS USED: The data were collected from 104 subjects out of the 192 evaluated and was statistically analyzed using SPSS software. RESULTS: The study sample included 70 male and 34 female dentists. The posture of the subjects and the MSDs are not associated with a significant difference as according to Pearson's Chi-square test (0.231). CONCLUSIONS: RULA can be used as a screening tool for postural risks following a short training session regardless of the assessor's experience in postural risk assessments.