IntRoductIonDapsone is an antibiotic belonging to sulfone group with potent anti-inflammatory and immunosuppressive properties. [1] Dapsone was traditionally used as an anti-leprosy drug and later, its use has been expanded to conditions such as acne vulgaris, dermatitis herpetiformis, thrombocytopenic purpura, and pemphigoid. [2] Dapsone is metabolized in the liver through cytochrome P-450 pathway to metabolites which are potent oxidants, responsible for the adverse hematological effects such as methemoglobinemia. Here, we report a case of methemoglobinemia secondary to use of dapsone for the treatment of chronic immune thrombocytopenia (c ITP) and also discuss the relevant pathophysiology, clinical presentation, and management. Since the incidence of dapsone-induced methemoglobinemia is rare, our aim here is to enhance awareness about this life-threatening adverse event. Few studies (six case reports) were identified from India using the MeSH terms (Dapsone, Methemoglobinemia) in Pubmed from 2008 to 2018 to the best of our knowledge. [3] case RepoRt A 53-year-old female belonging to the middle class socioeconomic strata, residing in the rural area in Kerala with no habits, was diagnosed with immune thrombocytopenia in 2009. She was treated with steroids and later was put on a second line agent azathioprine which was stopped subsequently. In 2017, she presented to us with a relapse and was given dapsone at a dose of 3 mg /kg/day [150 mg/day] with folic acid 2.5 mg/day. Two weeks later, she had presented to the emergency department with complaints of fatigability and excessive tiredness. Her past medical history included hypertension and type II diabetes mellitus. She is not glucose-6-phosphate dehydrogenase (G6PD) deficient. There is no significant family history.Dapsone, a sulfone group antibiotic, was traditionally used for the treatment of leprosy. It has potent anti-inflammatory and immunosuppressive properties. Hence later, its use has been expanded to conditions such as acne vulgaris, dermatitis herpetiformis, chronic immune thrombocytopenia, pemphigoid, malaria, and cutaneous leishmaniasis. Dapsone is less expensive and effective second-line treatment used in chronic immune thrombocytopenia (c ITP). It is metabolized in the liver by cytochrome P-450 enzymes to potent oxidants that are responsible for the adverse hematological complications like methemoglobinemia. We hereby report a case of dapsone-induced methemoglobinemia in an adult female patient used for the treatment of c ITP. She presented with hypoxia, fatigability, and improved subsequently on low-dose intravenous methylene blue. The patient was discharged without any complications. Initial assessment at Emergency services was suggestive of probable adverse drug reaction according to the WHO causality assessment scale and Naranjo algorithm. The preventability assessment was unpreventable according to Schumock and Thornton preventability assessment scale. A key to the diagnosis of methemoglobinemia is cyanosis with low-oxygen saturation and normal ...

In several deterioration cases , composite competes with amalgams, metallic and ceramic inlays. In relatively small cavities of posterior teeth, utility of direct composite restorations is restricted due to its polymerisation stresses. A much-appreciated alterative to ceramics in posterior teeth is indirect composite. Due to recent technological advancements in composite materials and bonding techniques, its use escalates steadily. Touati and Mormann introduced the first generation of indirect resins composite in early 1980s. Although there is a successful accomplishment in direct composite restoration, the use of composite restoration with indirect or extra-oral method remains ambiguous. In this article, we will inquire into composite systems used at the laboratory for indirect restoration in a clinical ground.

With the advancement of technology, we can implement a variety of ideas to serve mankind in numerous ways. Inspired by this, we have developed a smart hand glove system which will be able to help the people having hearing and speech disabilities. In the world of sound, for those without it, sign language is a powerful tool to make their voices heard. The American Sign Language (ASL) is the most frequently used sign language in the world, with some differences depending on the nation. We created a wearable wireless gesture decoder module in this project that can transform the basic set of ASL motions into alphabets and sentences. Our project utilizes a glove that houses a series of flex sensors on the metacarpal and interphalange joints of the fingers to detect the bending of fingers, through piezoresistive (change in electrical resistance when the semiconductor or metal is subjected to mechanical strain) effect. The glove is attached with an accelerometer as well, that helps to detect the hand movements. Simple classification algorithms from machine learning are then applied to translate the gestures into alphabets or words. Keywords: Arduino; MPU6050; Flex sensor; Machine learning; SVM classifier