Rooban Thavarajah

Chemical and physical basics of routine formaldehyde fixation

Formaldehyde is the widely employed fixative that has been studied for decades. The chemistry of fixation has been studied widely since the early 20th century. However, very few studies have been focused on the actual physics/chemistry aspect of process of this fixation. This article attempts to explain the chemistry of formaldehyde fixation and also to study the physical aspects involved in the fixation. The factors involved in the fixation process are discussed using well documented mathematical and physical formulae. The deeper understanding of these factors will enable pathologist to optimize the factors and use them in their favor.

Mounting media: An overview

Histological sections, which need to be examined for any length of time or to be stored must be mounted under a cover-slip. There are various types of mounting media available both commercially and also are prepared in ones own laboratory for mounting tissue sections. Some types of mounting media harden to hold the coverslip firmly in place and other types use different solvents such as water, glycerin and xylene because the stains in the sample preparation are sensitive to particular solvent. In order to prevent the of immonoflurescent slides, few mounting media contain antifade reagents. As less emphasis is given in the literature on mounting media, an attempt is made to review, venture and summarize on various types of mounting media and their uses in routine histopathologically and immunochemical staining.

On Factors Influencing the Absorption Capacity of Surgical Sponges

BackgroundCotton balls and surgical gauzes (CSG) have been routinely used for mopping fluids and blood in surgeries. Polyurethane sheets (PUS) are increasingly used instead of CSG. The factors influencing the absorption of fluids by CSG and PUS have not been studied in detail. There are a variety of factors that could be modified by the manufacturer while a limited number of them could be manipulated by the operator.Materials and MethodsMathematical models and equations have been employed in this study. The impact of absorbency was performed by modulating various factors.Results and DiscussionA variety of factors such as thickness, density of the web, radius of fiber, temperature, surface tension and viscosity of fluid, all influenced the absorption rate and capacity to varying degrees. The optimal variation by which the PUS can be effectively used is discussed. The suggested mathematical model will help the operator to choose the appropriate type of PUS based on the individual’s needs.ConclusionIn an area of rapidly developing technology and change in biomaterials, where the choice of such materials are overwhelming, hopefully this basic knowledge will help the clinician to make a more educated and rational decision.

Potential role of septins in oral carcinogenesis: An update and avenues for future research

Septins belong to the GTPase superclass of conserved proteins and have been identified to play a role in diverse aspects of cell biology, from cytokinesis to the maintenance of cellular morphology. At least 14 septins have been identified in humans. With their complex patterns in gene expressions and interaction, it has been reported that alterations in septin expression are observed in human diseases. Although much is not known about the role of human septins in oral carcinogenesis, circumstantial evidence does indicate that it may play a major role. This review intends to summarize the basis of septin biology, with the focus being on the evidence for septin involvement in human oral cancer.

Influence of legislations and news on Indian internet search query patterns of e-cigarettes

Background: There is a paucity of data on the use of electronic nicotine delivery systems (ENDS) in India. In addition, the Indian internet search pattern for ENDS has not been studied. We aimed to address this lacuna. Moreover, the influence of the tobacco legislations and news pieces on such search volume is not known. Given the fact that ENDS could cause oral lesions, these data are pertinent to dentists. Methods: Using a time series analysis, we examined the effect of tobacco-related legislations and news pieces on total search volume (TSV) from September 1, 2012, to August 31, 2016. TSV data were seasonally adjusted and analyzed using time series modeling. The TSV clocked during the month of legislations and news pieces were analyzed for their influence on search pattern of ENDS. Results: The overall mean ± standard deviation (range) TSV was 22273.75 ± 6784.01 (12310–40510) during the study with seasonal variations. Individually, the best model for TSV-legislation and news pieces was autoregressive integrated moving average model, and when influence of legislations and news events were combined, it was the Winters additive model. In the legislation alone model, the pre-event, event and post-event month TSV was not a better indicator of the effect, barring for post-event month of 2nd legislation, which involved pictorial warnings on packages in the study period. Similarly, a news piece on Pan-India ban on ENDS influenced the model in the news piece model. When combined, no “events” emerged significant. Conclusions: These findings suggest that search for information on ENDS is increasing and that these tobacco control policies and news items, targeting tobacco usage reduction, have only a short-term effect on the rate of searching for information on ENDS.

A study on suicide among Indians living with cancer during 2001–2014

BACKGROUND A small subset of Indian people living/diagnosed with cancer commits suicide. The prevalence and changing trends in such cancer-related suicides are not much reported in literature. An attempt is made to address this subset of suicides during 2001-2014. MATERIALS AND METHODS Data for this study were collected from the Indian National Crime Bureau Record, cancer registry publication in open domain, and published literature. Trends in the number of suicides associated with state, age groups, genders, and years were the only available parameters. Using these data, descriptive statistics of the rate of suicides, linear trend with age groups, gender, and geographical divisions are presented. RESULTS During the study period of 14 years, 1,721,946 suicides with an average of 122,996 suicides per year were observed. One in five suicides was related to illness. In total, a sum of 10,421 cancer-related suicides were noted accounting a mean of 744 suicides per year. Males were commonly involved than females. The commonly involved age group was 45-59 years. Southern parts of India had more instances of cancer-related suicides. Among Indian states, West Bengal reported the highest of such instances. DISCUSSION Suicide trends among Indians living with cancer during 2001-2014 are presented. The possible causes behind this phenomenon and implications are presented. The effect of changes in the trends in terms of geographical distribution, age group distribution, and gender dynamics is presented and discussed in this context. CONCLUSION Suicide among PLWC is a multi-dimensional, complex phenomenon, orchestrated by several factors, including mental health. The nascent field of psycho-oncology in India needs to explore this through large scale validated studies.

Drilling Deeper into Toothbrushing Skills: is Proactive Interference an Under-Recognized Factor in Oral Hygiene Behavior Change?

Proper toothbrushing is a seemingly simple motor activity that can promote oral health. Applying health theories, such as the Information-Motivation-Behavioral Skills (IMB) model, motivational interviewing (MI), and integrative health coaching (IHC), may help optimize toothbrushing technique in those with sub-optimal skills. Some motor activities, including toothbrushing, may over time become rote and unconscious actions, such that an existing habit can inhibit new learning, i.e., exert proactive interference on learning the new skill. Proactive interference may impede the acquisition of new toothbrushing skills; thus, in this report, we (1) review how the habit of toothbrushing is formed, (2) postulate how proactive interference could impede the establishment of proper toothbrushing retraining, (3) discuss the merits of this hypothesis, and (4) provide guidance for future work in this topic within the context of an approach to behavior change that integrates IMB, MI, and IHC methodology.

Saliva and dental practice

Human saliva plays an important role in the health of the oral cavity and of the body as a whole. It is a complex fluid that is actively secreted by the major and minor salivary glands. Its composition shows variations that reflect the physiology and the systemic health of the individual. It has the potential to be used for early detection of disease and assessment of its progression and treatment outcome. As a diagnostic tool, saliva has the unique advantage of being readily-available, and its collection is non-invasive. The field of salivary diagnostics and research is gaining importance and is becoming a major area of focus for researchers. Discovery of salivary biomarkers and its validation had broadened the use of salivary diagnostics from assessment of dental caries to the diagnosis of cardiac diseases and malignancies remote from the oral cavity. This article intends to give an overview of this exciting area of salivary research.

An audit of Indian health insurance claims for mental illness from pooled insurance information bureau's macroindicator data

Introduction: Information on the social and voluntary insurance coverage of mental illness in India is scarce. We attempted to address this lacuna, utilizing a secondary macrodata approach for 3 years. Mental illness per se is not covered by most of existing Indian health insurance policies. Materials and Methods: Publicly available de-identified claim macrodata for all health (nonlife) insurance for Indian financial year from 2011–2012 to 2013–2014 were collected. The age group, gender, amount of claims, proportion of claims, and details of number of days of hospitalization were collected and analyzed. Descriptive statistics, Chi-square test, and Wilcoxon tests were used appropriately. P≤ 0.05 was considered statistically significant. Results: In 2011–2012, there were 2864 claims from the registered 2,591,781 members citing mental illness (0.11%) which decreased to 0.03% in 2012–2013 and marginally rose to 0.07% of all claims. The total amount of claims paid for mental illness was Rs. 51.7 millions in 2011–2012, Rs. 97.2 million in 2012–2013, and Rs. 150 million in 2013–2014. Statistically significant difference emerged in terms of age group, gender, amount and proportion of claim, and number of days of hospitalization. Conclusion: The penetration of health insurance is low and claim for mental illness remains low. The difference in patterns of age, gender, amount of claims, and number of days for mental illness provides detailed relevant information to formulate future policies.

Contribution and Performance of Indian Psychiatrists and a Pan-Indian Psychiatry Journal to Mental Health Literature during 2010-14

Introduction: The quality and quantity of manuscript contribution by Indian Psychiatrist and those by Indian Journal of Psychiatry (IJP) has not been assessed till date. Such a data would be helpful for the policymakers and all stakeholders to plan the future outlook of publishing in and by Psychiatrists. Material and Methods: Using previously described method, contribution of Indian Psychiatrists as well as that of IJP was collected from various resources. Also, such details were collected by hand from PubMed, Journal website and cross-checked with Google Page Ranking system via a specialized software. Results: Indian psychiatrists published 350 articles in 2010 that arose to 506 in 2014. Among the articles published in 2007-2009, only 75.14% were cited within three years while for the period, 2011-13, only 20.36% were cited. In the same time frame, manuscript published in IJP garnered 29.07% and 39.76%. Discussion: IJP is increasingly getting cited surpassing the other journals and nearly 2.5 times of the general medical field. Besides citation, the other quality parameters of IJP are being discussed. Increasing the quality of Indian psychiatrist research output will require a structured and planned program. The manuscript would aid to chalk future policy of research promotion among Indian Psychiatrists.