Assessment of awareness regarding human papilloma virus vaccine among medical students: a knowledge attitude and practice study

Background: Assessment of knowledge and awareness regarding human papilloma virus and cervical cancer among medical students.Methods: Questionnaire based prospective study of 200 III and IV year consenting medical students willing to be a part of the study. 25 questions were in the questionnaire and they were asked to tick in front of the answer which they felt was correct. 3 questions regarding demographic details were formulated. To assess knowledge, attitude and practice total of 10, 8 and 4 questions were formulated respectively. Score of 0, 1, 2 and 3 were given to answers for statistical analysis.Results: A 110 (55%) belonged to III year and 90 (45%) belonged to IV year. 112 (56%) were females and 88 (44%) were males. 180 (90%) were aware regarding agent causing cervical cancer. 77.8% of IV MBBS and all students of III MBBS knew the etiology. 98% knew the screening technique while 190 (95%) knew that vaccine availability for cervical cancer. 60% knew that the infection was sexually transmitted, and majority knew it is not curable with antibiotics. 70% knew route of administration while most were unaware about age of administration. 91% had not taken the vaccine while 41.5% would if offered. 73% knew the vaccine is ineffective against other STD’s and most agreed that vaccine should be in the national immunization schedule. 40% knew that men should be vaccinated while 79% would recommend it to others.Conclusions: Primary prevention of cervical cancer with vaccination is a novel concept. Health professionals can play a role in propagating this practice. Syllabus in medical schools must emphasize on such topics

Comparative analysis of the remineralization potential of CPP?ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX ? An in vitro study

In recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX). 40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX. The Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP. CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface

Antenatal umbilical cord parameters and perinatal outcome

Background: The objective of the study was to study the association between antenatally determined umbilical cord thickness and coiling index at/after 34 weeks of gestation and the measures of perinatal outcome.Methods: Umbilical cord thickness and coiling index were determined sonographically at or after 34 weeks of gestation in 100 singleton pregnancies. The influence of the antenatal cord findings was analyzed for their associations with measures of perinatal outcome in high and low risk pregnancies. Intrapartum fetal heart rate abnormalities, meconium staining of liquor, birth weight, Apgar score and the need for neonatal intensive care (NICU) admission were considered as measures of perinatal outcome.Results: Mean cord thickness was 1.62 ± 0.26 cm and the coiling index was 0.42 ± 0.08 in the present observation of 100 cord sonographies. There were 39 pregnancies with high risk attributes. High risk pregnancies were found to have higher proportion of cases with lean (<1.3 cm; p = 0.04) and hypercoiled cord (>0.5; p = 0.00). Among individual associations thicker cord (>1.9 cm) and macrosomia (p = 0.01), hypercoiled cord and polyhydramnios (p = 0.02) were significant. More number of primigravidas were seen to have hypercoiled cord (p = 0.04). Association between cord parameters and meconium stained amniotic fluid, low Apgar score or NICU requirement could not be established.Conclusions: No association between antenatal umbilical cord characteristics and perinatal outcome was found in pregnancies at high risk for poor perinatal outcome

Benign cystic peritoneal mesothelioma

A well-defined but rare entity of Benign Cystic Peritoneal Mesothelioma (BCPM) is reported. The aetiology of this neoplasm remains obscure. The presenting features make a precise preoperative diagnosis difficult but information provided by computed tomography and cytology may help. A firm diagnosis can only come from an electronic microscopy or immunohistological examination of the tumour. Diagnostic accuracy and diligent follow up are essential because, although the tumour is considered benign, it does tend towards local recurrence

MENDING AESTHETICS IN ANTERIOR REGION-A CASE REPORT

Lately esthetic rehabilitation has come to be a demanding treatment as a way to correct malposed as well as missing anterior dentition, the advent of creating an esthetic smile has become a part of routine dental practice. An attractive or appealing smile sincerely enhances the recognition of an individual in our society with the aid of enhancing the initial impact in interpersonal relationships. Any esthetic correction calls for right expertise and knowledge. Such rehabilitation can be achieved successfully with the aid of numerous treatment approaches. Orthodontic treatment is one of the most conservative approach for such cases but it is not an acceptable treatment option for most of the patients due to various reasons like long treatment time, financial constraints, appearance during the therapy, and relapse after the treatment. Alternatively, endodontic approach combined with prosthodontics offers a brief, reliable and economic treatment modality for such cases. Placement of implants has also become a treatment of choice for replacement of teeth in esthetic zone with advantages like preservation of unrestored adjacent teeth and halting the resorption of edentulous spaces to provide support for the prosthesis. This case report illustrates the multidisciplinary approach for rehabilitating aesthetics in anterior region

Estimating heritability using family and unrelated individuals data

For the family data from Genetic Analysis Workshop 17, we obtained heritability estimates of quantitative traits Q1 and Q4 using the ASSOC program in the S.A.G.E. software package. ASSOC is a family-based method that estimates heritability through the estimation of variance components. The covariate-adjusted mean heritability was 0.650 for Q1 and 0.745 for Q4. For the unrelated individuals data, we estimated the heritability of Q1 as the proportion of total variance that can be accounted for by all single-nucleotide polymorphisms under an additive model. We examined a novel ordinary least-squares method, a naïve restricted maximum-likelihood method, and a calibrated restricted maximum-likelihood method. We applied the different methods to all 200 replicates for Q1. We observed that the ordinary least-squares method yielded many estimates outside the interval [0, 1]. The restricted maximum-likelihood estimates were more stable than the ordinary least-squares estimates. The naïve restricted maximum-likelihood method yielded an average estimate of 0.462 ± 0.1, and the calibrated restricted maximum-likelihood method yielded an average of 0.535 ± 0.121. Our results demonstrate discrepancies in heritability estimates using the family data and the unrelated individuals data

Methylation of HIN-1, RASSF1A, RIL and CDH13 in breast cancer is associated with clinical characteristics, but only RASSF1A methylation is associated with outcome

BACKGROUND: Aberrant promoter CpG island hypermethylation is associated with transcriptional silencing. Tumor suppressor genes are the key targets of hypermethylation in breast cancer and therefore may lead to malignancy by deregulation of cell growth and division. Our previous pilot study with pairs of malignant and normal breast tissues identified correlated methylation of two pairs of genes - HIN-1/RASSFIA and RIL/CDH13 - with expression of estrogen receptors (ER), progesterone receptors (PR), and HER2 (HER2). To determine the impact of methylation on clinical outcome, we have conducted a larger study with breast cancers for which time to first recurrence and overall survival are known. METHODS: Tumors from 193 patients with early stage breast cancer who received no adjuvant systemic therapy were used to analyze methylation levels of RIL, HIN-1, RASSF1A and CDH13 genes for associations with known predictive and prognostic factors and for impact on time to first recurrence and overall survival. RESULTS: In this study, we found that ER was associated with RASSF1A methylation (p < 0.001) and HIN-1 methylation (p = 0.002). PR was associated with RIL methylation (p = 0.012), HIN-1 (p = 0.002), and RASSF1A methylation (p = 0.019). Tumor size was associated with RIL and CDH13 methylation (both p = 0.002), and S-phase was associated with RIL methylation (p = 0.036). Only RASSF1A was associated with worse time to first recurrence (p = 0.045) and worse overall survival (p = 0.016) after adjusting for age, tumor size, S-phase, estrogen receptor and progesterone receptor. CONCLUSIONS: Methylation of HIN-1, RASSF1A, RIL and CDH13 in breast cancers was associated with clinical characteristics, but only RASSF1A methylation was associated with time to first recurrence and overall survival. Our data suggest that RASSF1A methylation could be a potential prognostic biomarker

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH