Abstract The subclavian artery is a significant branch of the aortic arch. We present a rare case of a bilateral variation in the branching pattern of the subclavian artery, observed in an adult male cadaver aged 70 years. On both the sides of the neck, all the branches of the subclavian artery took their origin from its first part. There was a rare occurrence of a cervicodorsoscapular trunk, which gave rise to superficial cervical, suprascapular, and dorsal scapular arteries. The same branching pattern was observed on the left side of the neck, with the presence of another cervicodorsoscapular trunk. Thyrocervical trunk and transverse cervical artery were both absent from the cervical region bilaterally. The inferior thyroid artery was a direct branch from the subclavian artery. Knowledge regarding variations of the subclavian artery is very important as lateral cervical region arteries are important for flap harvesting in plastic and reconstruction surgery. Preoperative radiologic evaluation of pedicles might help in choosing the optimal flap design, prevent ischemic complications, and help to improve overall treatment outcomes.

Resumo A artéria subclávia é um ramo significativo do arco da aorta. Apresentamos um caso raro de variação bilateral do padrão de ramificação da artéria subclávia, observada em um cadáver adulto do sexo masculino de 70 anos. Em ambos os lados do pescoço, todos os ramos da artéria subclávia originavam-se de sua primeira parte. Houve rara ocorrência de tronco escapular cervical dorsal, que deu origem às artérias cervical superficial, supraescapular e escapular dorsal. O mesmo padrão de ramificação foi observado no lado esquerdo do pescoço, com a presença de tronco escapular cervical dorsal. O tronco tireocervical e a artéria cervical transversa estavam ausentes em ambas as regiões cervicais direita e esquerda. A artéria tireóidea inferior consistia em um ramo direto da artéria subclávia. O conhecimento das variações da artéria subclávia é fundamental, pois as artérias da região cervical lateral são importantes para a obtenção de retalhos em cirurgias plásticas e reconstrutivas. A avaliação radiológica pré-operatória dos pedículos pode ajudar na escolha do desenho ideal do retalho, prevenir complicações isquêmicas e ajudar a melhorar o resultado geral do tratamento.

Abstract Over the years, a handful of drugs have been approved to be used in the fight against Alzheimer’s Disease but unfortunately none of these drugs have proven to be solid-treatments. Alzheimer’s Disease is one of the most prominent diseases observed in the elderly population. In this review article, we discuss how aluminum toxicity can lead to neuro degeneration. Aluminum is abundantly present on the earth’s crust and hence becomes easily accessible to man. This makes it an obvious choice in the preparation of numerous substances, packaging, etc. Such wide usage of the metal can pave an easy access to the body, leading to toxicities. Aluminum toxicity has been linked to oxidative stress which has an established relation with neurodegeneration and mitochondrial damage. We also discuss how consumption of antioxidants can be useful in combating oxidative stress.

Abstract Introduction: In developing countries like India, it is common for late presentation of Tetralogy of Fallot (TOF) patients to a hospital as compared to that of developed countries. The objective of this study is to analyze the surgical outcome of TOF patients with age > 15 years. Methods: This is a retrospective descriptive study of the surgical outcomes of 45 adult patients undergoing correction for TOF. Epidemiology, symptomology, and preoperative evaluation were performed. Results: Most of the patients were male (33 [73%]). The median age was 21 years. A total of 42 (93.33%) patients had subaortic ventricular septal defect (VSD), while three (6.6%) patients presented with doubly committed VSD. The most common type of right ventricular outflow tract (RVOT) obstruction was combined infundibular and valvular types, accounting for 34 cases (75.5%). Six patients had infundibular RVOT obstruction, while three patients (6.6%) had predominantly valvular pulmonary stenosis. We performed trans-right atrial repair in 33 patients. Right atrium-pulmonary artery approach was used in five patients (11.1%). The most common postoperative complication was right bundle branch block, seen in 14 patients, with a mortality rate of 2% in the early postoperative period. We achieved excellent early and midterm survival results and significant improvement in functions and disease-free quality of life. Conclusion: Intracardiac repair in adult TOF can be performed with low mortality, less residual RVOT obstruction, and need for revision of RVOT far less frequent by using the Jhajhria Infundibular Resection Adequacy Assessment technique (JIRAAT) to assess for adequacy of infundibular resection.

Abstract In the present paper, the basic objective of our work is to define Δᵐ-statistical convergence in the setup of intuitionistic fuzzy normed spaces for double sequences. We have proved some examples which shows this method of convergence is more generalized. Further, we defined the Δᵐ-statistical Cauchy sequences in these spaces and given the Cauchy convergence criterion for this new notion of convergence.

ABSTRACT Introduction. The mathematical modeling of the pollutant-decontaminant agent interactions is a tool of recent use to facilitate the management of hydric resources in the environment. This paper studies the interactions between two pesticides of high environmental stability that cause severe damage to health: chlordecone (CLD) and β-hexachlorocyclohexane (β-HCH) and their corresponding analogous ones labeled with radioiodine (ICLD and I-β-HCH), with natural cyclodextrins (α-, β-, and γ-CD). Methods. The Multiples Minima Hypersurface methodology, quantum chemistry calculations based on the Density Functional Theory and a topological study of the pollutants and their radiotracers with the symmetrical conformers of the three CD. The Basis Set Superposition Error existent in DFT calculations was mitigated employing a modification to Counterpoise method developed in this work. The formation of nanoaggregates was also experimentally addressed for β-HCH@CD complexes. Results. The complexes formed were classified according to the occlusion of the pollutant inside CD cavity as: total occlusion, partial occlusion and external interaction (non-occlusion). The more stable complexes were obtained when the γ-CD is the host molecule, as it was confirmed experimentally by means of results of spectroscopic and electron microscopy analysis. The possibility of using ICLD and I-β-HCH as radiotracers analogous to pesticides studied was theoretically demonstrated. Conclusions: These results suggest the utility of these nanoaggregates in the separation of these pollutants and the possibility of using CD for the management, purification and treatment of water.

RESUMEN Introducción. La modelación matemática de las interacciones contaminante-agentes descontaminantes es una herramienta de uso reciente para facilitar el manejo del recurso hídrico en el medio ambiente. El presente trabajo estudia la interacción entre 2 plaguicidas de elevada estabilidad ambiental que causan severas afectaciones a la salud: la clordecona (CLD) y el β-hexaclorociclohexano (β-HCH) y sus respectivos análogos marcados con radioyodo (ICLD y I-β-HCH), con ciclodextrinas naturales (α-, β- y γ-CD). Métodos. La metodología de Hipersuperficie de Múltiples Mínimos, cálculos cuánticos basados en la Teoría del Funcional de la Densidad (DFT) y un estudio topológico de la densidad electrónica se emplearon para caracterizar el espacio de interacción de los contaminantes y sus radiotrazadores con los confórmeros simétricos de las 3 CD. El error de superposición de bases existente en los cálculos DFT se mitigó usando una modificación al método de contrapeso desarrollada en este trabajo. La formación de los nanoagregados para el caso de los complejos β-HCH@CD se comprobó experimentalmente. Resultados. Los complejos formados se clasificaron a partir del grado de oclusión del contaminante en la cavidad de la CD como: oclusión total, oclusión parcial e interacción externa (no oclusión). Los complejos más estables se obtuvieron cuando la γ-CD es la molécula anfitriona, lo que se confirmó experimentalmente a partir de resultados espectroscópicos y análisis de microscopía electrónica. Se demostró teóricamente la posibilidad de usar la ICLD y el I-β-HCH como radiotrazadores análogos a los plaguicidas estudiados. Conclusiones: Estos resultados demostraron la utilidad de estos complejos en la separación de estos contaminantes de las aguas.

Abstract Introduction Individual variability in the language outcomes of children with cochlear implantation (CI) is a major concern. In CI rehabilitation, there is lack of a protocol regarding uniform post-CI language assessment interval duration, which can ensure better understanding of the trajectory of language growth as well as optimize language outcomes by providing feedback in fine tuning the language intervention program. Objective To evaluate the receptive and expressive language in Hindi speaking children with up to 2 years of CI experience using revised receptive-expressive emergent language test-3ed. (REELT-3) at 6 months intervals and to compare it with that of children with normal hearing (NH). Methods The present study included 192 children divided in 2 groups, 96 children with CI (15.8 ± 6.7 months), and 96 age-matched children with NH (22.3 ± 7.9 months). A cross-sectional, prospective study design was used to measure the language ability score (LAS) at an interval of 6 months from the time of implantation (TIA), which is 0 to 6 months, 7 to 12 months, 13 to 18 months, and 19 to 24 months of CI usage. Results The two-way analysis of variance revealed that the LAS after 18 months of CI usage was similar to (F (3, 92) = 8.63, p= 0.19, ηp2 = 0.028) that of the children with NH. However, other demographic factors, for instance, gender (F (3, 92) = 1.73, p= 0.505, ηp2 = 0.002), parent's education, (F (3, 92) = 2.05, p= 0.937, ηp2 = 0.031), and financial background (F (3, 92) = 2.49, p= 0.351, ηp2 = 0.076) had no major impact on language. Conclusion Eighteen months of CI usage duration can potentially stimulate receptive and expressive language up to age-matched children with NH. A protocol of periodic assessment of language, at least of 6 months, may be developed to optimize language outcomes.

Abstract Wideband, dual sense circularly polarized (CP), asymmetric circular slot fed by coplanar waveguide is proposed and designed. Dual polarizations are obtained by using a horizontal stub to the feed line and embedding the L-shaped strip onto the slotted ground plane. The simulated result of impedance bandwidth shows wideband performance is produced by four resonant modes. Some key parameters are studied to analyze the characteristics of the proposed antenna. The overall volume of the proposed antenna is 18 mm × 18 mm × 1.6 mm. The measured value of 10 dB impedance bandwidth is 112%at frequencies from 4.2 GHz to 14.9 GHz with voltage standing wave ratio (VSWR) ≤ 2. The 3-dB axial ratio bandwidths are 39.3% for the lower band which senses right-hand circular polarization (RHCP) and 2.8% for the upper band which senses left-hand circular polarization (LHCP) relative to the center frequency of 6.1GHz and 14.1 GHz, respectively. The proposed structure gives a good radiation pattern with moderate gain.

Resumo A resistência aos antibióticos é uma preocupação crescente para a saúde pública. Os antibióticos continuam a ser prescritos por alguns dentistas para resolver a dor dentária, embora pesquisas indiquem que os antibióticos não são eficazes no tratamento de condições como a pulpite irreversível. O objetivo deste estudo foi determinar em que medida as pesquisas atuais e as evidências em torno da pulpite irreversível foram traduzidas em prática odontológica e as lacunas existentes no conhecimento dos dentistas. Um questionário de pesquisa em formato de vinheta clínica on-line sobre o tratamento da pulpite irreversível foi distribuído para os membros da Academia de Odontologia Operatória e da Academia de Odontologia Geral (órgãos dentários internacionais dos EUA). Suas respostas foram registradas e avaliadas. Um total de 403 dentistas participou da pesquisa. Mais de um terço (39,3%) indicaram que prescreveriam antibióticos para pulpite irreversível sintomática em um dente permanente sem qualquer sinal de infecção sistêmica. O restante respondeu que eles não prescreveriam antibióticos; a maioria deles prescreveria um analgésico combinado com pulpectomia. Aqueles que realizaram o treinamento de educação avançada obtiveram uma pontuação de conhecimento médio significativamente maior em comparação com aqueles com apenas um grau primário de conhecimento odontológico (p=0,011). Da mesma forma, acadêmicos em tempo integral ou parcial tiveram uma pontuação média de conhecimento maior do que os clínicos que trabalham apenas em consultório particular (p=0,014). Alguns dentistas continuam a prescrever antibióticos inadequadamente para aliviar a dor decorrente de pulpite irreversível. Práticas de prescrição de antibióticos por dentistas com educação avançada ou envolvimento acadêmico foram melhores em comparação com os outros participantes. Há evidências claras de excesso de prescrição de antibiótico para pulpite irreversível que precisa ser tratada com urgência.

Abstract Antibiotic resistance is a growing public health concern. Antibiotics continue to be prescribed by some clinicians to resolve dental pain even though research indicates that antibiotics are not effective for treating conditions such as irreversible pulpitis. The objective of this study was to determine the extent to which current research and evidence around irreversible pulpitis has been translated into dental practice and the gaps in dentists’ knowledge. An on-line clinical vignette format survey questionnaire about treatment of irreversible pulpitis was distributed to the members of the Academy of Operative Dentistry and Academy of General Dentistry (US based international dental bodies). Their responses were recorded and evaluated. A total of 403 dentists participated in the survey. Over a third (39.3%) indicated they would prescribe antibiotics for symptomatic irreversible pulpitis in a permanent tooth occurring without any signs of systemic infection. The rest indicated they would not prescribe antibiotics; most of them would prescribe an analgesic combined with pulpectomy. Those who had undertaken advanced education training achieved a significantly higher mean knowledge score compared to those with just a primary dental degree (p=0.011). Similarly, full or part time academicians had a higher mean knowledge score than the clinicians who work only in private practice (p=0.014). Some dentists continue to prescribe antibiotics inappropriately for alleviating pain due to irreversible pulpitis. Antibiotic prescribing practices of dentists with advanced education or academic engagement were better as compared to the other participants. There is clear evidence of antibiotic over-prescribing for irreversible pulpitis which needs to be addressed urgently.

Abstract: Cross-Lingual Information Retrieval (CLIR) enables a user to query to the different language target documents. CLIR incorporates a Machine Translation (MT) technique which is in growing state for Indian languages due to the unavailability of enough resources. In this paper, a Statistical Machine Translation (SMT) system is trained on two parallel corpora separately. A large English language corpus is used for language modeling in SMT. Experiments are evaluated by using BLEU score, further, these experimental setups are used to translate the Hindi language queries for the experimental analysis of Hindi-English CLIR. Since SMT does not deal with morphological variants while the proposed Translation Induction Algorithm (TIA) deals with that, therefore, TIA outperforms the SMT systems in perspective of CLIR.

Resumo Justificativa e objetivos Pé caído no período pós-operatório é muito raro após a anestesia espinhal. Avaliação clínica e intervenções diagnósticas precoces são de primordial importância para estabelecer a etiologia e iniciar o tratamento adequado. Um acompanhamento atento é justificado no pós-operatório imediato nos casos em que o paciente se queixa de parestesia ou dor durante a inserção da agulha ou da injeção de fármacos. Relato de caso Paciente do sexo masculino, 22 anos, submetido a cirurgia ortopédica de membros inferiores sob anestesia espinhal. Durante a transferência para a sala de recuperação pós-operatória, houve suspeita de pé caído durante a avaliação rotineira da regressão do nível espinhal. O paciente foi imediatamente enviado ao neurologista e uma ressonância magnética foi feita, mas não foi conclusiva. O manejo conservador foi iniciado e o estudo de condução nervosa foi feito no 4° dia de pós-operatório, o que confirmou a neuropatia motora pura do nervo fibular direito. O paciente foi dispensado com imobilizador de tornozelo e fisioterapia após ligeira melhoria da força motora (2/5). Conclusões Pé caído é muito raro após a anestesia espinhal. Qualquer paciente suspeito deve ser submetido à consulta neurológica de emergência e ressonância magnética para excluir o principal achado e a necessidade de intervenção cirúrgica precoce.

Abstract Background and objectives Foot drop in postoperative period is very rare after spinal anesthesia. Early clinical assessment and diagnostic interventions is of prime importance to establish the etiology and to start appropriate management. Close follow-up is warranted in early postoperative period in cases when patient complain paresthesia or pain during needle insertion or drug injection. Case report A 22-year-old male was undergone lower limb orthopedic surgery in spinal anesthesia. During shifting from postoperative ward footdrop was suspected during routine assessment of regression of spinal level. Immediately the patient was referred to a neurologist and magnetic resonance imaging was done, which was inconclusive. Conservative management was started and nerve conduction study was done on the 4th postoperative day that confirmed pure motor neuropathy of right peroneal nerve. Patient was discharged with ankle splint and physiotherapy after slight improvement in motor power (2/5). Conclusions Foot drop is very rare after spinal anesthesia. Any suspected patient must undergo emergent neurological consultation and magnetic resonance imaging to exclude major finding and need for early surgical intervention.

Abstract: BACKGROUND: Narrow-band UVB (NB-UVB) has been shown to be one of the most effective treatment modalities for psoriasis. Tazarotene, a known effective anti-psoriatic modality, when combined with NB-UVB may enhance the therapeutic success. OBJECTIVE: To study clinical efficacy and safety of combination of NB-UVB with topical tazarotene 0.05% gel in psoriasis. METHOD: Thirty patients with plaque psoriasis having symmetrical lesions were enrolled for 12 weeks. All patients were instructed to apply tazarotene gel on target plaque on left side of body once daily. In addition, the whole body was irradiated with NB-UVB twice weekly. Efficacy was assessed by target plaque scoring and number of treatment sessions for clearance. RESULT: Our study resulted in 3 key findings: Firstly, therapeutic efficacy of NB-UVB was enhanced by addition of tazarotene. This enhanced efficacy was more apparent in decreasing scaling and thickness as compared to decrease in erythema. Secondly, combination therapy showed faster clearance of target plaques, with reduction in mean number of treatment sessions. Thirdly, mean cumulative NB-UVB dose needed to achieve clearance of target plaques was significantly reduced with combination therapy. STUDY LIMITATIONS: The study was not randomized or controlled, but an open-label trial. The study period was relatively short, i.e., 12 weeks, without any follow-up period. CONCLUSION: Tazarotene gel significantly enhances the therapeutic efficacy of NB-UVB irradiation with faster clearance and without serious side effects.

Abstract: Background: Narrow-band UVB is the most innovative steroid sparing treatment in atopic dermatitis. There are studies showing efficacy of Narrow-band UVB in childhood atopic dermatitis, but there is lack of clinical trials in the literature determining the length of remission. Therefore, we sought to highlight its efficacy, safety and its post-treatment efficacy in childhood atopic dermatitis. Objective: To assess the clinical efficacy, safety of Narrow-band UVB in the treatment of paediatric atopic dermatitis and length of remission during 2 years of post-treatment follow-up. Methods: Thirty children (4-14 years) having moderate to severe AD (SCORAD index > 25) were enrolled for 12 weeks. Narrow-band UVB phototherapy was administered twice a week on non-consecutive days for three months. SCORAD index was calculated by the same dermatologist at baseline, 6th, 12th, 18th and 24th treatment session. Secondary outcomes were measured using visual analog scale for pruritus and sleep loss. Patients were also followed-up for 2 years to know the length of remission after end of therapy. Results: There was a significant reduction in SCORAD index at 6th, 12th, 18th and 24th treatment session in comparison to baseline. This improvement in SCORAD was also maintained during the 2 years of post-treatment follow-up period. Consequently, pruritus and sleep loss improved significantly from baseline to end of therapy and even during the 1st and 2nd year of follow-up. Study limitation: Open-label trial without control group. Conclusions: Narrow-band UVB is an efficacious and safe modality of treatment in childhood atopic dermatitis with good therapeutic index and minimal side effects.

Abstract: Dyshidrosiform pemphigoid is an acquired autoimmune variant of bullous pemphigoid with persistent vesicobullous eruptions localized on the palms or soles, or both. It generally occurs in the elderly and is rarely reported in childhood. Hereby, we describe the first case of dyshidrosiform pemphigoid in a 12-year-old child, which was limited to the dorsal hands and treated successfully with dapsone (diaminodiphenyl sulfone). Along with this report, we also review the clinical features of various types of dyshidrosiform pemphigoid.

Castor (Ricinus communis L.) is a primary food plant of eri silkworm, Samia ricini Donovan endemic to Northeast India. Plant growth promoting rhizobacteria (PGPR) plays crucial role in growth and productivity of agricultural crops. Eighty-five Pseudomonas strains were isolated from thirty rhizosphere soil samples of castor and their in vitro potentiality was screened for growth promoting ability and antifungal potentialities. Most of the selected Pseudomonas sp. produced indole acetic acid, gibberellic acid, ACC deaminase activity, ammonia, hydrogen cyanide and siderophore, when tested in-vitro for PGP activity. Besides, the strains MAJ PIA01, MAJ PIA03 and MAJ PIA24 have got antifungal activity against five common plant pathogens. Upon their formulation and application in field by curtailing the recommended dose of inorganic fertilizers to 50 %, isolate no. MAJ PIA03 efficiently enhanced the agronomical traits such as number of leaves per plant, leaf biomass, root length, stem base diameter, shoot length, root biomass and leaf moisture content. Isolate no. MAJ PIA03 has significant impact on leaf biochemical constituents and augments the nutritional quality of castor leaf. The most efficient isolate MAJ PIA03 was identified as Pseudomonas aeruginosa MAJ PIA03 by polyphasic approach and its 16S rRNA gene homology. The bio-formulation of Pseudomonas aeruginosa MAJ PIA03 with 50 % diminution on recommended inorganic NPK dose could be used as an effective mechanism to improve Ricinus communis plant growth as well as leaf nutritional enhancement for sustainable eri sericulture.