BackgroundThe Bradykinesia Akinesia Incoordination (BRAIN) test is a computer keyboard-tapping task that was developed for use in assessing the effect of symptomatic treatment on motor function in Parkinson's disease (PD). An online version has now been designed for use in a wider clinical context and the research setting.MethodsValidation of the online BRAIN test was undertaken in 58 patients with Parkinson's disease (PD) and 93 age-matched, non-neurological controls. Kinesia scores (KS30, number of key taps in 30 seconds), akinesia times (AT30, mean dwell time on each key in milliseconds), incoordination scores (IS30, variance of travelling time between key presses) and dysmetria scores (DS30, accuracy of key presses) were compared between groups. These parameters were correlated against total motor scores and sub-scores from the Unified Parkinson's Disease Rating Scale (UPDRS).ResultsMean KS30, AT30 and IS30 were significantly different between PD patients and controls (p≤0.0001). Sensitivity for 85% specificity was 50% for KS30, 40% for AT30 and 29% for IS30. KS30, AT30 and IS30 correlated significantly with UPDRS total motor scores (r = −0.53, r = 0.27 and r = 0.28 respectively) and motor UPDRS sub-scores. The reliability of KS30, AT30 and DS30 was good on repeated testing.ConclusionsThe BRAIN test is a reliable, convenient test of upper limb motor function that can be used routinely in the outpatient clinic, at home and in clinical trials. In addition, it can be used as an objective longitudinal measurement of emerging motor dysfunction for the prediction of PD in at-risk cohorts.

OBJECTIVE The management of patients with brain metastases is typically dependent on their prognosis. Recursive partitioning analysis (RPA) is the most commonly used method for prognosticating survival, but has limitations for patients in the intermediate class. The aims of this study were to ascertain preoperative risk factors associated with survival, develop a preoperative prognostic grading system, and evaluate the utility of this system in predicting survival for RPA class 2 patients. METHODS Adult patient who underwent intracranial metastatic tumor surgery at an academic tertiary care institution from 1997 to 2011 were retrospectively reviewed. Multivariate proportional hazards regression analysis was used to identify preoperative factors associated with survival. The identified associations were then used to develop a grading system. Survival as a function of time was plotted using the Kaplan-Meier method, and survival rates were compared using log-rank analyses. RESULTS A total of 421 (59%) of 708 patients were RPA class 2. The preoperative factors found to be associated with poorer survival were: male gender (P < 0.0001), motor deficit (P = 0.0007), cognitive deficit (P = 0.0004), nonsolitary metastases (P = 0.002), and tumor size >2 cm (P = 0.003). Patients having 0–1, 2, and 3–5 of these variables were assigned a preoperative grade of A, B, and C, respectively. Patients with a preoperative grade of A, B, and C had a median survival of 17.0, 10.3, and 7.3 months, respectively. These grades had distinct survival times (P < 0.05). CONCLUSIONS The present study devised a preoperative grading system that may provide prognostic information for RPA class 2 patients, which may also guide medical and surgical therapies before any intervention is pursued.

Background: Supragingival plaque control is fundamental to the prevention and management of periodontal diseases. However significant proportions of all individuals fail to practice a high standard of plaque removal. The adjunctive use of chemicals would, therefore appear a way of overcoming deficiencies in mechanical tooth cleaning habits. This prospective, randomized positively controlled clinical trial was designed to evaluate the short-term clinical effects of a Herbal mouthwash in the reduction of plaque and gingival inflammation in subjects with gingivitis.Methods: Fifty subjects, 20 to 40 years of age diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups: Group 1 -Chlorhexidine mouthwash, Group 2 -Herbal mouthwash. Clinical evaluation was undertaken using the gingival index, the plaque index and bleeding on probing at baseline, 1 weeks, 2 weeks and 4 weeks. Results:Both chlorhexidine and herbal mouthwash showed a significant reduction in Plaque and gingival index scores from baseline to 1st week, 2nd week and at 4th week. However, the improvement in plaque and gingival index scores were better in chlorhexidine group than herbal mouthwash. Both mouthwashes were found to be equally effective in reducing bleeding on probing. Conclusions:Unlike chlorhexidine mouthwash, herbal mouthwash was not associated with any discoloration of teeth or unpleasant taste and was effective in reducing plaque accumulation and gingival inflammation. However, Chlorhexidine still remains a gold standard in reducing plaque, gingivitis and bleeding on probing.

Aim To determine the dental caries experience of pre-school children attending anganwadi and day care centre in Udupi Taluk. Materials and Methods A cross-sectional survey was conducted on 825 pre-school children attending Anganwadi and day care centers in Udupi Taluk. Dental caries was assessed using Dentition status and treatment needs (WHO, 1997). Data was analyzed using SPSS 16.0 with significance level at P value < 0.05. Chi-square test was used to find out the significant differences. Level of significance was taken Results Dental caries experience was significantly higher among anganwadi children (3.74±3.58) as compared to day care children (3.26±3.32). The prevalence of dental caries was 64.2% among anganwadi children and 61.0% among day care children. Girls had slightly higher mean deft score, mean number of decayed teeth, filled teeth and lower missing teeth as compared to boys. Conclusion High caries experience in this study revealed that there is a great need to plan and conduct oral health promotion initiatives and treatment activities for preschool children. The oral health education at initial stages would help in improving preventive dental behavior and attitude which is beneficial for lifelong.

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Background and objective: Candida albicans ( C. albicans ) play a significant role in oral mucosal carcinogenesis. It can be identified using various techniques in cytological smears. But, very few studies have been conducted on histopathological sections using calcofluor white M2R under fluorescent microscopy. Additionally, detection and quantification of Candida colonies and its correlation with various grades of oral leukoplakia and oral carcinomas have not been explored much. Methods: The current retrospective study included 80 samples from archives consisting of 60 samples in the study group (10 cases each of mild, moderate, and severe epithelial dysplasia (totally 30) and 30 cases of oral carcinoma). Sections were stained with calcofluor white (CFW) and 10% KOH for the observation under fluorescent microscopy and correlated with different grades of oral leukoplakia and oral carcinomas. Chi-square test was used in SSPS software to study the presence and absence of Candida sp. in different groups. Results: The study groups of oral carcinoma and dysplasia showed a significant association with Candida sp. (P=0). When carcinoma was compared with each grade of dysplasia, except mild dysplasia (P=4.4E-05), both moderate (P=0.402195) and severe dysplasia (P=0.558746) showed an insignificant P-value. When the groups of mild (13.3%), moderate (30%), and severe (33.3%) dysplasia were considered independently, the incidence of Candida sp. increased as the grade of dysplasia increased. The number of colonies have been counted and the maximum number of colonies have been observed in carcinoma and the least have been observed in mild dysplasia. Conclusion: A significant association of Candida colonies with epithelial dysplasia and oral cancer was established. Further, CFW was found a promising candidate to identify Candida colonies in tissue sections using fluorescent microscopy.

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