A large body of research implicates the brain and fat body (liver equivalent) as central players in coordinating growth and nutritional homeostasis in multicellular animals. In this regard, an underlying connection between immune cells and growth is also evident, although mechanistic understanding of this cross-talk is scarce. Here, we explore the importance of innate immune cells in animal growth during homeostasis and in conditions of nutrient stress. We report that Drosophila larvae lacking blood cells eclose as small adults and show signs of insulin insensitivity. Moreover, when exposed to dietary stress of a high-sucrose diet (HSD), these animals are further growth retarded than normally seen in regular animals raised on HSD. In contrast, larvae carrying increased number of activated macrophage-like plasmatocytes show no defects in adult growth when raised on HSD and grow to sizes almost comparable with that seen with regular diet. These observations imply a central role for immune cell activity in growth control. Mechanistically, our findings reveal a surprising influence of immune cells on balancing fat body inflammation and insulin signaling under conditions of homeostasis and nutrient overload as a means to coordinate systemic metabolism and adult growth. This work integrates both the cellular and humoral arm of the innate immune system in organismal growth homeostasis, the implications of which may be broadly conserved across mammalian systems as well.

Context:Antimicrobial efficacy of subgingival chlorhexidine (CHX) application using two different vehicles of delivery.Aims:The aim was to evaluate the efficacy of CHX varnish and gel as an adjunct to scaling and root planing (SRP) in reducing microbial count within moderate to deep periodontal pockets.Settings and Design:Experimental parallel mouth study.Subjects and Methods:A total of 30 subjects between the age groups 25 and 55 years having moderate to severe periodontitis, with pocket depth ≥ 5 mm were selected for the study. The selected patients were randomized into three groups of 10 each. Subjects in Group 1 received SRP followed by subgingival application of CHX varnish, subjects in Group 2 received SRP followed by subgingival application of CHX gel, subjects in Group 3 received SRP alone. Subgingival plaque samples were collected to estimate mean motile and nonmotile microbial counts using dark field microscopy at baseline, 1 week, 1 month, and 3 months.Results:After 3 months, there was statistically significant reduction in nonmotile microbial count in all the three groups. Motile microbial count was significantly reduced in all the three groups till 1 month from baseline. Only subjects in Group 1 who received subgingival CHXvarnish after SRP showed a significant reduction in motile microbial count till 3 months from baseline.Conclusions:Subgingival application of highly concentrated CHX varnish following SRP is beneficial in reducing microbial count in moderate to deep periodontal pockets.

Introduction: Myofascial pain dysfunction syndrome (MPDS) is a common presenting condition in the dental office. No specific therapy has proven its superiority over the other in managing myofascial pain dysfunction syndrome. Since phonophoresis was beneficial for other musculoskeletal medical conditions, the same strategy was adopted to prove its efficacy in MPDS. Aim and Objective: The aim of the study is to compare and evaluate the effectiveness of therapeutic ultrasound (ThUS) and diclofenac and thiocolchicoside gel phonophoresis in MPDS. Materials and Methods: Thirty patients with MPDS were randomly assigned into two groups. Group 1 (n = 15), therapeutic ultrasound was applied with ultrasound gel without any therapeutic ingredient for 10 min and five sessions. Group 2 (n = 15), ultrasound was applied with ultrasound gel with diclofenac and thiocolchicoside gel for 10 minutes and five sessions. Pain and mouth opening was taken as evaluation parameters. Result: A comparison of results obtained from the two groups before and after treatment at the end of each session shows significant improvement in both the parameters. However, in Group 2 more improvement in all outcome variables can be seen compared with group 1. Conclusion: Phonophoresis with diclofenac and thiocolchicoside (analgesic and muscle relaxant) proved to be an excellent treatment in MPDS. They proved more effective than therapeutic ultrasound in controlling pain and improving mouth opening.

Corticosteroid remains mainstay of treatment for immune mediated mucocutaneous disorders. The very usefulness of the drug, which has become a double-edged sword, when used for long time. The administration of immunomodulators decrease the dose of steroids, reduces the steroid side effects and improves rejuvenation time. In addition to immunomodulatory drugs there are some drugs that are used to spare corticosteroids in the treatment of immune mediated mucocutaneous diseases. This review attempts to elicit the use of steroid sparing drugs in immune mediated diseases.

Review Article IntroductIonCOVID-19 has created a vast impact on general population and health-care sector, since it was declared as pandemic by the WHO on March 11, 2020. [1] With emergence of second wave, there is increasing number of cases each day leading to scarcity of health-care resources affecting the outcome of the treatment. With all these consequences, COVID-19 has become India's fastest growing epidemic. [2] Among this crisis, there is increased incidence of mucormycosis, which is considered highly fatal. Mucormycosis is an angioinvasive opportunistic fungal infection caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. It was first described by Paultauf in 1889. [3] Mucormycosis, also referred to as Zygomycosis, is third most common invasive mycosis after candidiasis and aspergillosis in patients with compromised immunity, underlying debilitating systemic diseases, and hematological abnormalities. [4] The common Mucorales species involved are Rhizopus, Lichtheimia, and Mucor. Other species such as Rhizomucor, Saksenaea, Cunninghamella, and Apophysomyces are rare. Mucorales are ubiquitous, present mainly in bread molds, decaying foods, soil, and in putrefying organisms. The major route of infection is through inhalations of the airborne fungal spores, which can then spread to the paranasal sinuses (PNS), lungs, and extensive tissue involvement. [5] Six well recognized clinical forms of mucormycosis are the pulmonary, cutaneous, gastrointestinal, rhinocerebral, central nervous system, and disseminated. Rhinocerebral form followed by pulmonary is the most common type of this invasive infection. [6] Mucormycosis, commonly regarded as black fungus, is one of the most tissue destructing and devastating complications in uncontrolled diabetics with high fatality rates ranging between 60 and 80%. It is well established that there is direct association between diabetes and the severity of SARS-CoV-2 infection and thus diabetics are at higher risk of contracting the secondary opportunistic mucormycosis during COVID-19 infection. [7] However, it is offlate affecting individuals below 40 years without any comorbidities. Stress along with usage of corticosteroids could probably being the cause. Infection with mucormycosis is considered highly fatal due to its fulminating spread, disseminated infection, cavernous sinus thrombosis, carotid artery involvement, osteomyelitis, and death. [8] Emergence of "Black fungus" in this Covid-19 pandemic has created an situation of medical emergency. Black fungus, scientifically known as mucormycosis, is an rare opportunistic invasive fungal infection caused by Mucorales affecting uncontrolled diabetics, immunocompromised patients, patients with stem cell transplant, prolonged intensive care unit stay and in those with hematological abnormalities. Offlate, there has been upsurge of this potentially fatal infection in COVID patients and in post-COVID scenario due to the mutant strain and treatment protocol followed in COVID patients. Elev...