Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice

Among the myriad emergencies that could arise in the dental clinical setting there are a few that occur occasionally despite being entirely preventable. Ingestion or aspiration of dental materials, appliances, or instruments comprises this category. Regardless of incidence, foreign body ingestion or aspiration episodes are recognized as potential complications in the specialty of orthodontics. Despite their infrequent occurrence, the morbidity from a single incident and the amount of specialty medical care that may be needed to manage such incidents is too high to ignore. There is also the associated risk of malpractice litigation given the fact that these incidents are preventable. At present, no clear guidelines exist regarding prevention of this emergency in practice. This article attempts to review relevant literature and aims to formulate certain recommendations based on best available evidence to minimize the incidence of such events, while also suggesting guidelines toward making their management more effective. A flow chart outlining management options and strategies to aid the clinician in the event of such an emergency is also presented

TUMOR NECROSIS FACTOR-ALPHA LEVEL IN SERA OF SOUTH INDIAN PATIENTS WITH RHEUMATOID ARTHRITIS: CORRELATION WITH ANTICYCLIC CITRULLINATED PEPTIDE ANTIBODY LEVEL

Objective: The present study was aimed to find out the anticyclic citrullinated peptide (CCP) antibody level and expression level Th2 cytokine-liketumor necrosis factor-alpha (TNF-α) in patients with rheumatoid arthritis (RA) from South India.Methods: The patients attending the Arthritis and Rheumatism Care Centre, Vadapalani, Chennai and healthy individuals from the Presidency College, Chennai, were enrolled for this study. The study group included 74 patients with RA and 50 healthy individuals without history of RA. 3-5 ml of blood samples was aseptically collected using Vacutainer, and the separated serum samples were transported to the Department of Microbiology, Presidency College, Chennai, Tamil Nadu, in cold chain. Anti-CCP antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Serum concentrations of TNF-α were studied in patients with RA and in healthy controls, using an ELISA method.Results: The results of anti-CCP enzyme immunoassay revealed that out of 74 patients, all were anti-CCP positive, which included 65 females and 9 males. Higher levels of anti-CCP (456 IU/ml) were present in the age group between 41 and 50 followed by 21-30 years age group which shows 335.28 IU/ml of anti-CCP antibody level. The level of serum TNF-α was measured in the range of 4.6-1082.84 pg/ml for RA patients and6.630-459.74 pg/ml for the healthy control group.Conclusion: TNF-α levels were significantly increased in RA patients compared to healthy individuals. A negative correlation was found between anti- CCP antibody and TNF-α level in RA patients.Keywords: Rheumatoid arthritis, Tumor necrosis factor-alpha, Enzyme-linked immunosorbent assay, Anticyclic citrullinated peptide antibodie

Bacterial succession in the colon during childhood and adolescence: molecular studies in a Southern Indian village

Background: The colonic bacterial flora, largely anaerobic, is believed to establish and stabilize in the first 2 y of life. Objective: This study was undertaken to determine whether the bacterial flora of the colon undergoes further changes (succession) during childhood and adolescence. Design: This cross-sectional study examined fecal samples from 130 healthy children and adolescents in the age group 2-17 y and from 30 healthy adults (median age: 42 y) residing in a single village in southern India. DNA was extracted and subjected to 16S rDNA-targeted real-time polymerase chain reaction to determine the relative predominance of Bifidobacterium genus, Bacteroides-Prevotella-Porphyromonas group, Lactobacillus acidophilus group, Eubacterium rectale, and Faecalibacterium prausnitzii. Results: Bifidobacterium species and Bacteroides-Prevotella group were dominant fecal bacteria overall. E. rectale and Lactobacillus species were considerably less abundant. Clear age-related differences emerged, with a steep decline in Bifidobacterium species in adults (P < 0.0001), a steep decline of Lactobacillus species >5 y of age (P < 0.0001), an increase in Bacteroides during late adolescence and in adults (P = 0.0040), an increase in E. rectale during childhood and adolescence followed by a steep decline in adults (P < 0.0001), and a late childhood peak of F. prausnitzii with decline in adolescents and adults (P < 0.0001). Conclusions: Changes in the bacterial flora occur during childhood and adolescence characterized by reduction in Lactobacillus and Bifidobacterium species and an increase in Bacteroides, E rectale, and F. prausnitzii peaked during late childhood in this population

State Activities Impacts on the Residential Mobility Dynamics in Kandy and Suburbs

Residential mobility is becoming a significant phenomenon in the contemporary urbanized world. City residents engage in mobility, which influences the shaping and reshaping of urban spaces. Residential mobility takes place due to several determinants, and urban development activities of the state are one of the significant structural factors among them. Kandy is the second-largest city in Sri Lanka which has been declared as a World Heritage City in 1988 by the UN. The Government of Sri Lanka has implemented urban policies, regional and city plans, urban development programmes, and strategic projects to preserve the unique urban characteristics of Kandy city. The objective is to assess how far state activities are responsible for the present residential mobility dynamics in Kandy city and its suburbs. The attributes of urbanisation and resultant neighbourhood changes discovered from the study conducted between 2016 - 2018, by collecting secondary data from relevant sources. Primary data which was acquired through indepth interviews, key informant interviews, unstructured discussions and observations comprises a part of the study. The study resulted in identifying the dynamics of an urban neighbourhood and its residential mobility changes. State activities are directly and indirectly stimulating the urban residential mobility diffusion waves towards Kundasale suburb that promote Kundasale as a popular residential suburb of Kandy city. The process, prospects, and products of urbanisation and residential mobility are discussed in detail in this paper

Comparative analysis of cyanobacterial superoxide dismutases to discriminate canonical forms

<p>Abstract</p> <p>Background</p> <p>Superoxide dismutases (SOD) are ubiquitous metalloenzymes that catalyze the disproportion of superoxide to peroxide and molecular oxygen through alternate oxidation and reduction of their metal ions. In general, SODs are classified into four forms by their catalytic metals namely; FeSOD, MnSOD, Cu/ZnSOD and NiSOD. In addition, a cambialistic form that uses Fe/Mn in its active site also exists. Cyanobacteria, the oxygen evolving photosynthetic prokaryotes, produce reactive oxygen species that can damage cellular components leading to cell death. Thus, the co-evolution of an antioxidant system was necessary for the survival of photosynthetic organisms with SOD as the initial enzyme evolved to alleviate the toxic effect. Cyanobacteria represent the first oxygenic photoautotrophs and their SOD sequences available in the databases lack clear annotation. Hence, the present study focuses on structure and sequence pattern of subsets of cyanobacterial superoxide dismutases.</p> <p>Result</p> <p>The sequence conservation and structural analysis of Fe (<it>Thermosynechococcus elongatus </it>BP1) and MnSOD (<it>Anabaena </it>sp. PCC7120) reveal the sharing of N and C terminal domains. At the C terminal domain, the metal binding motif in cyanoprokaryotes is DVWEHAYY while it is D-X-[WF]-E-H-[STA]-[FY]-[FY] in other pro- and eukaryotes. The cyanobacterial FeSOD differs from MnSOD at least in three ways <it>viz</it>. (i) FeSOD has a metal specific signature F184X₃A188Q189_.......T280_......F/Y303 while, in Mn it is R184X₃G188G189_......G280......W303, (ii) aspartate ligand forms a hydrogen bond from the active site with the outer sphere residue of W243 in Fe where as it is Q262 in MnSOD; and (iii) two unique lysine residues at positions 201 and 255 with a photosynthetic role, found only in FeSOD. Further, most of the cyanobacterial Mn metalloforms have a specific transmembrane hydrophobic pocket that distinguishes FeSOD from Mn isoform. Cyanobacterial Cu/ZnSOD has a copper domain and two different signatures G-F-H-[ILV]-H-x-[NGT]-[GPDA]-[SQK]-C and G-[GA]-G-G-[AEG]-R-[FIL]-[AG]-C-G, while Ni isoform has an nickel containing SOD domain containing a Ni-hook HCDGPCVYDPA.</p> <p>Conclusion</p> <p>The present analysis unravels the ambiguity among cyanobacterial SOD isoforms. NiSOD is the only SOD found in lower forms; whereas, Fe and Mn occupy the higher orders of cyanobacteria. In conclusion, cyanobacteria harbor either Ni alone or a combination of Fe and Ni or Fe and Mn as their catalytic active metal while Cu/Zn is rare.</p

Studies on structural, optical nonlinearity and antibacterial activity of Piperazine (bis) p-toluenesulfonate single crystal for optical limiting and biological applications

Piperazine (bis) p-toluenesulfonate (PPTSA), an organic single crystal was synthesized and grown at environmental temperature by slow evaporation process using methanol as the solvent. The grown PPTSA crystal is from the triclinic system and belongs to the space group P1-. Powder X-ray diffraction was performed to ensure lattice parameters. Analysis and confirmation of functional groups and bonds were carried out through FT-IR spectral study. The optical characteristics were investigated using the UV-Vis spectrum such as the optical absorption, cut-off wavelength were calculated. The photoluminescence investigation was conducted to assess the luminous characteristics of grown crystal. The calculated NLO parameters like β, n2, and χ(3) were found to be 0.0495×10-4 (cm/W), 8.705×10-10 (cm2/W), 5.316×10-7 (esu) and Optical Limiting threshold value was found to be 3.074×10-3 (Wcm-2). Antibacterial studies were carried out to investigate the biological significance against selected foodborne germs

A Framework of Building and Locational Characteristics Ranking for Purpose-built Offices in Malaysia

The development of purpose-built office market in Malaysia is primarily resolved by a supplydemand market. Since the office market in Malaysia has displayed significance improvement due to increasing level of competitiveness, many characteristics of purpose-built office have appeared and become prominent during the process of assessment. These characteristics were generally used as indicators in property valuation, building performance as well as office market appraisal. Based on these characteristics, property market participants can evaluate their property proficiently based on their requirements, especially in decision making during business planning, investment or property management. Technology growth and national policy also gave contribution factors on revealing newly characteristics of purpose-built office such as green building, intelligent building and sustainable development model. The purpose of this article is to identify suitable characteristics of purpose-built office that can be used in Malaysia. Integral to achieving this objective, exploration on purpose built office characteristics in a global and local context will be reconsidered. As a result, a building and locational framework of purpose-built office’s characteristics in Malaysia will be diagnosed and verified appropriately