Marginal integrity is a fundamental determinant of the clinical performance and longevity of direct dental restorations, as it influences the stability of the interface between restorative materials and dental hard tissues. Maintaining an effective marginal seal is essential for preventing microleakage, which involves the penetration of bacteria, fluids, and dissolved substances along the tooth-restoration interface. Microleakage may contribute to marginal discoloration, postoperative sensitivity, pulpal irritation, and secondary caries, potentially compromising restorative outcomes. Several factors influence marginal adaptation, including restorative material composition, polymerization shrinkage, adhesive system characteristics, cavity configuration, and clinical application techniques. Resin-based composites demonstrate favourable aesthetic and mechanical properties; however, polymerization contraction may generate interfacial stresses that promote marginal gap formation. Bulk-fill composites and glass ionomer-based materials exhibit different handling characteristics, bonding mechanisms, and dimensional behaviours, which can affect marginal performance. Adhesive effectiveness is influenced by dentin moisture conditions, surface preparation, and proper application protocols, while inadequate light curing may compromise polymerization efficiency and interfacial stability. Environmental conditions within the oral cavity, including thermal fluctuations, mechanical loading, moisture exposure, and chemical degradation, may accelerate deterioration of the adhesive interface over time. Clinical management of marginal defects requires careful assessment of restoration integrity, caries activity, and patient-related risk factors. Minor marginal irregularities do not necessarily indicate restorative failure and may be managed through monitoring, polishing, sealing, or localized repair when clinically appropriate. Preventive strategies emphasize adequate isolation, appropriate material selection, optimized bonding procedures, controlled polymerization, and regular clinical evaluation. Preservation of existing restorations through minimally invasive interventions can reduce unnecessary removal of healthy teeth and support long-term oral health. Understanding the interactions between restorative materials, clinical techniques, and environmental influences remains essential for minimizing microleakage, maintaining marginal integrity, and improving the durability and predictability of direct restorative treatments across different clinical situations and patient populations.
Background: Rajasthan being India's highest-revenue alcohol states, with approximate excise collections exceeding INR 9,229 crore by November 2023-24 and sales of 876.86 lakh bulk litres of total country liquor and 413.69 lakh bulk liters of Indian-Made Foreign Liquor (IMFL). Commercial determinants like excise policies, outlet density, pricing strategies, and surrogate advertising are increasingly recognized as structural drivers of consumption and health harm. Objectives of the study were to map commercial determinants against alcohol sales trends and health indicators in Rajasthan; to identify stakeholder perceptions of industry influence and regulatory barriers; and to recommend targeted mitigation strategies. Methods: A convergent parallel mixed-methods design was employed, adhering to COREQ guidelines. Secondary data from the Rajasthan State Excise Department, NFHS-5, and health records were analysed using descriptive statistics and multiple linear regression. Primary data comprised semi-structured interviews with 20-25 purposively sampled key informants, analysed thematically in NVivo 14. Results: Sales volumes grew approximately 18% between 2018 and 2023, closely tracking revenue-maximizing excise reforms. Outlet density was positively correlated with alcohol- attributable domestic violence (r=0.67, p<0.01). Surrogate advertising was identified by 78% of informants as the primary industry marketing channel. ABV awareness was absent in 41% of consumers. Conclusions: Commercial determinants substantially shape consumption patterns and health burdens in Rajasthan. A multi-pronged response combining outlet regulation, surrogate.
The methotrexate is prescribed as a single dose per week for rheumatoid arthritis. It is dangerous if patient consumes the medication daily by mistake. We present a case of a 64-year-old female with diabetes with newly diagnosed rheumatoid arthritis who consumed 10 mg of methotrexate daily for five to six days instead of once weekly. In a few days the patient developed oral painful ulcers, difficulty in swallowing, bilateral leg ulcers with peeling of skin and fever. Blood tests showed pancytopenia, leucocytes were 1.75×10³/µl, platelets were 50×10³/µl. The methotrexate was stopped and gave 15 mg of intravenous folinic acid every sixth hourly for five days. Her platelets increased within four days. The oral and leg ulcers began to heal by the end of the first week. Skin ulcers are very uncommon manifestation of this toxicity - but clear instructions for weekly dosing can prevent this medication error.
Background: Age at initiation of childbearing (AICB) may be associated with maternal healthcare utilisation. This study examined AICB patterns and their associations with maternal healthcare use across eight South and Southeast Asian countries. Methods: Data were drawn from the latest available Demographic and Health Survey rounds in Bangladesh, India, Indonesia, Maldives, Nepal, Pakistan, the Philippines and Timor-Leste. The analysis included women aged 15-49 whose first live birth occurred within five years before the survey. AICB was classified as early (<20 years), mid (20-29 years) or late (≥30 years). Country-specific logistic regression models assessed the outcomes: four or more antenatal care (ANC) visits, first-trimester ANC, full ANC, institutional delivery and a postnatal check, adjusting for sociodemographic and partner-related characteristics. Results: Mean AICB ranged from 19.98 years in Bangladesh to 24.38 years in Maldives. Early AICB was most prevalent in Bangladesh (54.3%) and Nepal (36.5%); late AICB was most common in the Philippines (15.0%) and Maldives (10.4%). Associations varied by country and outcome. Early AICB was associated with lower adjusted odds of four or more ANC visits in Bangladesh, Indonesia and Pakistan, and lower odds of first-trimester ANC in India, Indonesia, Nepal and the Philippines. Late AICB was associated with higher odds of full ANC in Bangladesh, India and Nepal. Postnatal care associations differed across countries. Conclusions: Associations between AICB and maternal healthcare utilisation were heterogeneous across countries and service indicators. Context-specific strategies should address gaps in timely ANC, completion of recommended ANC components, institutional delivery and postnatal follow-up.
Early-onset substance abuse (usually defined as initiation before age 15) is a widespread public health epidemic that has devastating consequences for long-term neurological, psychological, and social development. This paper considers the crossing and often conflicting influences on early-onset substance abuse among male adolescents, centering on perhaps the two most formidable psychosocial influences: peer pressure and parental monitoring. Male adolescents are a particularly vulnerable demographic group because of a combination of neurobiological development, socialization by society (masculinity), and an increased tendency for externalizing behaviours. By synthesizing established sociological and psychological frameworks, namely Social Learning Theory, Social Control Theory, Ecological Systems Theory, etc., this paper examines the role of peer socialization and deviancy training as key catalyst agents in substance initiation, coupled with parental monitoring, especially through the mechanism of child disclosure as an important protective buffer. The paper concludes with an examination of evidence-based interventions and implications for future research in sociology and Psychiatric Social Work.
