Sequestosome 1 (p62) mitigates hypoxia-induced cardiac dysfunction by stabilizing hypoxia-inducible factor 1α and nuclear factor erythroid 2-related factor 2

AIMS

Heart failure due to ischaemic heart disease (IHD) is a leading cause of mortality worldwide. A major contributing factor to IHD-induced cardiac damage is hypoxia. Sequestosome 1 (p62) is a multi-functional adaptor protein with pleiotropic roles in autophagy, proteostasis, inflammation, and cancer. Despite abundant expression in cardiomyocytes, the role of p62 in cardiac physiology is not well understood. We hypothesized that cardiomyocyte-specific p62 deletion evokes hypoxia-induced cardiac pathology by impairing hypoxia-inducible factor 1α (Hif-1α) and nuclear factor erythroid 2-related factor 2 (Nrf2) signalling.

METHODS AND RESULTS

Adult mice with germline deletion of cardiomyocyte p62 exhibited mild cardiac dysfunction under normoxic conditions. Transcriptomic analyses revealed a selective impairment in Nrf2 target genes in the hearts from these mice. Demonstrating the functional importance of this adaptor protein, adult mice with inducible depletion of cardiomyocyte p62 displayed hypoxia-induced contractile dysfunction, oxidative stress, and cell death. Mechanistically, p62-depleted hearts exhibit impaired Hif-1α and Nrf2 transcriptional activity. Because findings from these two murine models suggested a cardioprotective role for p62, mechanisms were evaluated using H9c2 cardiomyoblasts. Loss of p62 in H9c2 cells exposed to hypoxia reduced Hif-1α and Nrf2 protein levels. Further, the lack of p62 decreased Nrf2 protein expression, nuclear translocation, and transcriptional activity. Repressed Nrf2 activity associated with heightened Nrf2-Keap1 co-localization in p62-deficient cells, which was concurrent with increased Nrf2 ubiquitination facilitated by the E3 ligase Cullin 3, followed by proteasomal-mediated degradation. Substantiating our results, a gain of p62 in H9c2 cells stabilized Nrf2 and increased the transcriptional activity of Nrf2 downstream targets.

CONCLUSION

Cardiac p62 mitigates hypoxia-induced cardiac dysfunction by stabilizing Hif-1α and Nrf2.

Evaluation of microbial contamination in removable dental prosthesis at different time of usage

Aim

The current study evaluates and compares the percentage distribution of different microorganisms according to their strains and occurrence among the three studied groups.

Method and Methodology

Sample of 30 removable dental prosthesis wearing patients was selected: wearing either complete dentures or partial dentures and without any significant medical history or on prescription medication for the past 3-6 months. Samples were obtained in three subcategories based on the duration of prostheses worn by the patient. A sterile swab made up of cotton moistened with phosphate buffer saline (PBS) was scrubbed on the dental prosthesis at the fitting surfaces and the denture-bearing area of the oral cavity. Within two hours, the collected swab sample was infused in the sterile tube containing 1 ml of 0.84% PBS solution maintained at pH 7-7.2 and sent for microbiological analysis. The samples were then inoculated into different medias. Microbial growth was checked after incubating the culture plates for 48 h at 37°C. Microorganisms were recognized and counted by calibrated colony counter. Gram's stain was used to stain the colony smear and biochemical tests such as coagulase, catalase, oxidase, sugar fermentation with acid and gas production (triple sugar iron), methyl red test, test for indole production, hydrogen sulphide (H2S) production, citrate utilization, urease test, germ tube tests were performed.

Statistical Analysis

Descriptive statistics included calculation of means and standard deviation using multivariate analysis. All values were considered statistically significant for a value of P < 0.05.

Results

Streptococcus species, Coagulase-negative staphylococcus, Staphylococcus aureus, Candida albicans and Klebsiella pneumoniae showed the maximum positive culture among the secluded microorganisms in all three groups.

Conclusion

A progressive increase in the microbial contamination was directly proportional to the duration of removable prosthesis usage.

Abstract MP248: Sequestrosome1/p62 Regulates Redox Homeostasis Via The Nrf2-keap1 Pathway In The Murine Heart

Sequestosome1 (p62) is a multifunctional signaling molecule and an autophagy adaptor protein. Previous work demonstrated that mice with whole-body p62 knockout recapitulated many detrimental features of aging. Of note, these mice developed late onset obesity and systemic abnormalities that could have contributed to their aging phenotype. Multiple studies have also shown that cardiac dysfunction can be linked to an increase in oxidative stress. The Nrf2-Keap1 pathway is critical for protection against oxidative stress and p62 has been shown to interact with Keap1, thus allowing Nrf2 activation to induce anti-oxidant responses. However, the role of p62 in the heart is not well known. We tested the hypothesis that p62 plays an important homeostatic role in the heart through the regulation of redox homeostasis via the Nrf2-Keap1 pathway. Wild-type and cardiomyocytes-specific p62 knockout (cp62 KO) mice at 8 weeks and 60 weeks of age were used. At 8 weeks, cp62KO mice exhibited mild but significant contractile dysfunction compared to the wild-type controls. By 60 weeks, the KO mice developed cardiac hypertrophy, fibrosis and increased oxidative stress. cp62 KO hearts had decreased Nrf2 nuclear translocation and activation as evidenced by a 50% (p<0.005) reduction in the expression of the Nrf2 target glutathione S-transferase A4 ( Gsta2 ) gene. These findings were further validated by transcriptomic analysis followed by KEGG pathway analysis, which indicated that redox pathways were altered in the 60-week p62 null hearts. To examine the mechanisms involved in p62 regulation of Nrf2-Keap signaling, we utilized rat cardiac H9c2 myoblasts. Loss of p62 using p62 siRNA in H9c2 cells resulted in decreased Nrf2 levels and increased oxidative stress. These pathological consequences of suppressing p62 could be attributed to increased Nrf2 degradation via the proteasome. Together, these results reveal a previously uncharacterized role for p62 in the maintenance of cardiac redox signaling in the mouse heart.

Antifungal activity of Syzygium samarangense leaf extracts against Candida

Candida species are opportunistic human fungal pathogens that cause acute and chronic infections against which only few antifungal agents are available. Here we have elucidated the antifungal effect of Syzygium samarangense leaf extracts (SSLE). Antifungal activity of SSLE was studied against Candida albicans, C. krusei, C. parapsilosis, C. glabrata, C. auris and C. tropicalis. Following experiments were performed: minimum fungicidal concentration (MFC) determination, agar well disc diffusion assays, fungal morphology analysis using scanning electron microscope (SEM), ex vivo fungal survival assays on porcine tongue and skin and in vivo fungal survival assays using Drosophila melanogaster fly model. Results demonstrated MFC of SSLE ranges between 100 and 125 mg ml^-1 . SEM images showed cell wall degradation of C. albicans when treated with SSLE. Around 75% decrease in C. albicans viability was observed when infected porcine tongue and skin were treated using SSLE. The C. albicans infected D. melanogaster when fed with SSLE showed significant decrease (around 80%) of fungal count than the infected control. Furthermore, agar plate disc diffusion assays demonstrated that the antifungal activity of SSLE could be due to chalcone, which is one of the active constituents in SSLE. Our study demonstrated that SSLE could be used for the topical treatment of Candida infections.

A comparative evaluation of the dimensional accuracy of heat polymerised PMMA denture base cured by different curing cycles and clamped by R S technique and conventional method - An In-vitro study

BACKGROUND

The aim of this study is to evaluate the dimensional accuracy of heat polymerized PMMA denture base clamped by the conventional method and by R.S technique and cured by a different curing cycle.

MATERIALS & METHODS

In this study, a total of 40 standardized maxillary record bases were fabricated with seven reference points: Point A - Incisive papilla, Point B & C - Canine region on either side, Point E & G - Midpoint of tuberosities on either side, Point F- Midpoint of the line joining the two tuberosities, Point D- Midpoint between the line joining A and F. Group A: Ten maxillary record bases were fabricated by conventional clamping method and cured by long curing cycle. Group A1: Ten maxillary record bases were fabricated by R.S tension clamping method and cured by long curing cycle. Group B: Ten maxillary record bases were fabricated by conventional clamping method and cured by short curing cycle. Group B1: Ten maxillary record bases were fabricated by R.S tension clamping method and cured by short curing cycle. The distances between the reference points i.e. A-B, A-C, A-D, D-F, B-E, C-G, E-F, F-G, B-D, D-G, CD, D-E of all three thermoplastic denture base plates were measured and recorded with the help of a travelling microscope and were used for comparison with the measured and recorded readings of processed acrylic denture bases. The data obtained was analyzed by using the One Way Analysis of Variance.

RESULTS

The overall results of the in vitro study indicate that among all the PMMA bases cured by the two clamping systems and the different curing cycle, group A` was the most dimensionally stable, followed by control group A, then followed by B` and B was most unstable.

CONCLUSION

The study concluded that the denture bases fabricated by the R.S Technique using the long curing cycle would produce the most dimensionally stable PMMA denture bases. How to cite the article: Babu MR, Rao CS, Ahmed ST, Bharat JS, Rao NV, Vinod V. A comparative evaluation of the dimensional accuracy of heat polymerised PMMA denture base cured by different curing cycles and clamped by R S technique and conventional method - An In-vitro study. J Int Oral Health 2014;6(2):68-75.

'How can I halt thee?' The puzzles involved in autophagic inhibition

The strategy for interpreting the role of autophagy on the basis of evidence obtained through autophagic inhibition sounds logical, but is beset with practical constraints. The knock down of autophagy-related (ATG) gene(s) or blockage of class III PI3-Kinase are the most common approaches for inhibiting autophagy. However, during stressful conditions, autophagy may operate in synchrony with other processes such as apoptosis; autophagy-related genes, unlike what their name implies, exert their regulation on apoptosis as well. Knocking down such genes not only blocks autophagy but also renders apoptosis defective, making the interpretation of autophagic roles unreliable. Similarly, class III PI3-Kinase aids in initiating autophagy but it is not a quintessential autophagic regulator. Class III PI3-Kinase also has a role in regulating almost all membrane transport in cells. Blocking it not only inhibits autophagy, but also hampers all the membrane trades, including endosomal transport. The pharmacological inhibitors used to block autophagy by blocking class III PI3-Kinase further compound these limitations with their off-target effects. Knowing the limitations involved in blocking a target or using an autophagy-blocking tool is a prerequisite for designing the experiments meant for analyzing autophagic functions. This review attempts to provide a detailed overview about the practical constraints involved in using autophagic inhibition as a strategy to understand autophagy.

Partial Edentulism based on Kennedy's classifcation: an epidemiological study

BACKGROUND

The aim of this study was to determine the incidence of different Kennedy's classes of partial edentulism during 18 months period.

MATERIALS AND METHODS

Patients were clinically examined for various Kennedy's classes of partial edentulism in the outpatient department (OPD), prosthodontics, GPRDCH, Kurnool (Andhra Pradesh).

RESULTS

Of the total 1,420 OPD patients, Kennedy's class III was the most frequent classification encountered (62%) and followed by Kennedy's class I (18%), class II (11%), and class IV (9%) in decreasing order.

CONCLUSION

The patients with various Kennedy's classes of partial edentulism can be offered various treatment modalities like removable cast partial dentures, fixed partial dentures, over dentures and implant supported dentures. This study can be crucial for screening the population for incidence of tooth loss as a factor of gender and age. Clinical significance: Tooth loss appears to have an important role in the loss of esthetics and mastication. Study of incidence of various classes of partial edentulism provides clinically useful information for dental training and continuing education.

Isolation, characterization and identification of pericarp-degrading bacteria for the production of off-odour-free white pepper from fresh berries of Piper nigrum L

AIM

To isolate, fermentatively evaluate and identify black pepper (Piper nigrum L.)-associated bacteria for the microbial decortication of fresh ripened berries and dried black pepper for preparation of off-odour-free white pepper.

METHODS AND RESULTS

Among 45 bacterial isolates obtained from black pepper, seven of them were found to decorticate black pepper (>60%) and fresh pepper berries (98-100%) into white pepper within 5 days of immersion in bacterial suspension. The 16S rRNA genes (1500-bp amplicon) of these bacteria were sequenced, and species identity was established by closest match in GenBank. Superior-quality white pepper was obtained with Bacillus subtilis (IISR WP 33, 34, 38), Bacillus licheniformis (IISR WP 43), Acinetobacter baumanii (IISR WP 35), Klebsiella pneumoniae (IISR WP 19) and Microbacterium barkeri (IISR WP25). The bacterial isolates were found to secrete multiple hydrolytic enzymes such as cellulase, pectinase, amylase, protease and xylanase. Bacterial cultures were deposited with International Depository Authority at Microbial Type Culture Collection, India, as patent deposits as prescribed in Budapest Treaty for microbial deposits. The white pepper, thus obtained from bacterial decortication process, was free from off-odour compound, especially skatole. Other biochemical constituents such as oleoresin, piperine and essential oils were found in the acceptable range. The bacterial decortication did not affect inherent constituents of pepper such as essential oil constituents, oleoresin and piperine content.

CONCLUSION

One of the most significant findings of the work is identification of specific bacterial species for decortication of fresh berries or black pepper berries into value-added white pepper.

SIGNIFICANCE AND IMPACT OF THE STUDY

This work paved way for developing a technological process for microbial decortication of fresh/black pepper for the production of superior-quality white pepper.

Effectiveness of desensitizing agents in relieving the pre- and postcementation sensitivity for full coverage restorations: a clinical evaluation

Patients frequently report sensitivity of prepared abutment teeth during the temporization period and after the fnal cementation of full coverage restoration. Purpose of this clinical investigation was to evaluate the effectiveness of desensitizing agents in reducing the pre- and postcementation sensitivity for full coverage restorations and to compare the relative effcacy of three in offce applied desensitizing agents in relieving the postcementation sensitivity with the use of glass ionomer luting cement.

MATERIALS AND METHODS

This study consisted of 30 patients requiring either full coverage restoration or 3 unit fxed partial denture. Total of 40 restorations (n = 40) were made and were randomly assigned into four groups comprising 10 restoration (n = 10) in each group. Group C control where no desensitizer application was done, group BB applied with BisBlock dentin desensitizer (Bisco Inc.), group ST applied with Systemp desensitizer (Ivoclar Vivadent), group GC applied with GC Tooth Mousse desensitizer (GC Asia). Desensitizer application was done immediately after the tooth preparation. Sensitivity of the tested abutment was determined by the patient response to cold, hot and bite stimuli and were recorded on visual analog scale (VAS). Sensitivity level scores was evaluated at 4 time intervals, i.e. 1 week after desensitizer application at baseline precementation appointment and others at 5 minutes, 1 day and 1 week postcementation appointment. VAS score data was statistically analyzed using one-way ANOVA followed by post hoc Tukey's test.

RESULTS

BisBlock and GC Tooth Mousse desensitizer resulted in statistically signifcant (p < 0.01) reduction in postcementation sensitivity of glass ionomer cement in comparison to Systemp desensitizer at 5 minutes, 1 week postcementation time interval with no statistical difference was seen between all desensitizer groups at 1 day postcementation. Application of BisBlock and GC Tooth Mousse desensitizer resulted in highly signifcant (p < 0.01) reduction in sensitivity level at the end of 1 week.

CLINICAL SIGNIFICANCE

Desensitizer's application on the prepared abutment teeth is considerably effective in relieving both pre- and postcementation sensitivity for full coverage restoration over the short duration of time. Immediate reduction in postoperative sensitivity relatively in a short time period may be benefcial in terms of patient's comfort. Nonetheless, multicenter long-term clinical trials should be conducted to confrm the results.

CONCLUSION

Efficacy of BisBlock and GC Tooth Mousse desensitizer was more in relieving the postcementation sensitivity of glass ionomer cement at various time intervals in comparison to Systemp desensitizer. In conclusion, application of desensitizers was beneficial to reduce the pre- and postcementation abutment sensitivity.

Comparative evaluation of compressive strength and flexural strength of conventional core materials with nanohybrid composite resin core material an in vitro study

Several dental materials have been used for core build-up procedures. Most of these materials were not specifically developed for this purpose, but as a consequence of their properties, have found application in core build-up procedures. Improvements in composites and the development of nanocomposites have led to their use as a core build up material due to their superior mechanical properties, optical properties and ease of handling. However it is not clear if they have better mechanical properties than the conventional core build up materials like amalgam, GIC and dual cure composite core build up material. The strength of the core material is very important and this study was undertaken to compare the mechanical properties of materials used for direct core foundations. The differences between the compressive strength and flexural strength of Filtek Z350 nanocomposite with conventional core build up materials like Amalgam, Vitremer GIC and Fluorocore were tested. Cylindrical plexi glass split molds of dimension 6 ± 1 mm [height] x4 ± 1 mm [diameter] were used to fabricate 15 samples of each core material for testing the compressive strength and rectangular plexi glass split molds of dimension 25 ± 1 mm [length] x 2 ± 1 mm[height] x2 ± 1 mm [width] used for fabricating samples for flexural strength. The samples were stored a water bath at 250 °C for 24 h before testing. The samples were tested using a Universal Instron testing machine. The results of the study showed that Fluorocore had the highest compressive strength and flexural strength followed by Filtek Z350 [nanocomposite] Amalgam had the least flexural strength and Vitremer GIC had the least compressive strength. Thus flurocore and nanocomposite are stronger than other core build up materials and hence should be preferred over other conventional core build up materials in extensively damaged teeth.

A cephalometric study to determine the center of anteroposterior curve of occlusion in the cranium

Proper management of the occlusal plane is an essential consideration when multiple long span posterior restorations are designed. When restorations are added to an existing tooth arrangement characterized by rotated, tipped or extruded teeth, excursive interferences may be incorporated. The curve of Spee which exists in natural dentition, allows harmony to exist between the anterior teeth and the condylar guidance. Broadrick fag or occlusal plane analyzer is used to assist in the reproduction of tooth morphology that is commensurate with the curve of Spee when posterior restorations are designed; its use prevents the introduction of protrusive interferences. The current study determines the relationship of the center of anteroposterior curve of occlusion in the cranium and its relationship to other cephalometric landmarks and also evaluates the relationship of anteroposterior curve of occlusion to the condyle.

A comparative evaluation of the dimensional accuracy of heat polymerized acrylic resin denture base clamped by the conventional method and by new-press technique and cured by long curing cycle: an in vitro study

AIM

The aim of this study is to evaluate the dimensional accuracy of heat polymerized acrylic resin denture base clamped by the conventional method and by new-press technique and cured by long curing cycle.

MATERIALS AND METHODS

In this study, a total of 60 standardized maxillary record bases were fabricated with seven reference points as follows: Point A: Incisive papilla, Point B and C: Canine region on either side Point E and G: Midpoint of tuberosities on either side Point F: Midpoint of the line joining the two tuberosities Point D: Midpoint between the line joining A and F.

GROUP A

Ten maxillary record bases were fabricated by conventional clamping method and cured by long curing cycle. GROUP A': Ten maxillary record bases were fabricated by New Press or RS tension clamping method and cured by long curing cycle. The distances between the reference points, i.e. A-B, A-C, A-D, D-F, B-E, C-G, E-F, F-G, B-D, D-G, C-D, D-E of all three thermoplastic denture base plates were measured and recorded with the help of travelling microscope and were used for comparison with the measured and recorded readings of processed acrylic denture bases. The data obtained was analyzed by using the one-way analysis of variance and HSD Multiple Comparison Test.

RESULTS

The overall results of the study indicate that among all the denture bases cured by the two clamping systems and the long curing cycle, group A' were the most dimensionally stable, followed by control group A.

CONCLUSION

The study concluded that the denture bases fabricated by the New Press method using the long curing cycle would produce the most dimensionally stable denture bases.

Comparative analysis for selection of resin luting cements based on filler content: an in vitro study

CONTEXT

Resin luting of all-ceramic restorations results in increased performance; however, the strengthening mechanism and the role of the mechanical properties of the resin are not fully understood.

OBJECTIVE

The aim of this study was to investigate the effect of filler content on the flexural properties of resin luting agents and thereby selecting an appropriate resin luting cement.

MATERIALS AND METHODS

Three esthetic resin luting agents studied were Calibra (Dentsply); RelyX ARC and Panavia F. Ten beam-shaped specimen (L * W * H: 30 * 8 * 2 mm) were made for each of the material tests carried out. The specimens were stored in distilled water for 24 hours at 37°C. The specimens were then tested for flexural strength (MPa) and flexural modulus (GPa) using the three-point bending method on a universal material testing machine at a cross head speed of 0.5 mm/min. Data obtained were statistically analyzed using ANOVA followed by post-hoc-Tukey's test with p < 0.05 for statistical significance.

RESULTS

Increase in mean strength related to an associated increase in the elastic modulus which in turn was related to the filler loading of the resin luting cements.

CONCLUSION

Strength and performance of resin-cemented allceramic restoration can be enhanced by the use of a resin luting cement having increased filler content.

CLINICAL IMPLICATIONS

Resin-composite cements may be most suitable for adhesively bonded restorations, where margins are placed on supragingival enamel, and where ultimate strength and energy absorption are paramount. The selection criteria for a resin cement depends on its flexural strength. To a great extent, the flexural strength is dependent on the filler loading of the resin luting cement.

Evaluation of mutagenic and antimutagenic activities of neem (Azadirachta indica) seed oil in the in vitro Ames Salmonella/microsome assay and in vivo mouse bone marrow micronucleus test

AIM OF THE STUDY

The possible mutagenic and antimutagenic activity of neem oil (NO) and its DMSO extract (NDE) were, examined in the Ames Salmonella/microsome mutagenicity test and the mouse bone marrow micronucleus assay.

MATERIALS AND METHODS

Eight different strains of Salmonella typhimurium were, used to study the genotoxicity of neem oil both in the presence and absence of Aroclor-1254 induced rat liver homogenate (S9). Two-dose treatment protocol was, employed to study the cytogenetic activity in micronucleus assay. Similarly, the antimutagenic activity of neem oil and NDE was studied against mitomycin (MMC) and 7,12-dimethylbenz[a]anthracene (DMBA) in the above two test systems.

RESULTS

Neem oil was non-mutagenic in all the eight tester strains of Salmonella typhimurium both in the presence and absence of S9 mix. In the present study, there was no significant increase in the frequency of micronucleated polychromatic erythrocytes (MNPCEs) in neem oil treated groups over the negative control (DMSO) group of animals, indicating the non-clastogenic activity of neem oil in the micronucleus test. Neem oil showed good antimutagenic activity against DMBA induced mutagenicity compared to its DMSO extract. However, neem oil showed comparatively less antimutagenicity against MMC in the Ames assay. In vivo anticlastogenic assays shows that neem oil exhibited better activity against DMBA induced clastogenicity.

CONCLUSION

These results indicate non-mutagenic activity of neem oil and significant antimutagenic activity of neem oil suggesting its pharmacological importance for the prevention of cancer.

Efficacy of erbium YAG laser-assisted autologous epidermal grafting in vitiligo

BACKGROUND

Of the various modalities of therapy available for the treatment of vitiligo, a combination of psoralen + ultraviolet A (PUVA) with autologous epidermal grafting appears to offer the best results. The erbium YAG laser can be used to prepare the recipient site in both punch grafting and suction blister grafting.

METHODS

In this study 29 subjects, 26 with localized and three with generalized stable vitiligo, had received pregrafting PUVA and underwent further PUVA starting 2 weeks after surgery until maximal pigmentation was achieved. The erbium YAG laser was used on 16 subjects; the recipient site for punch grafting was prepared with laser and minigrafts harvested by manual punch were placed into the prepared sites. For suction blister grafting, the site was dermabraded with a laser and the harvested blister roof (created using suction apparatus) was transplanted on to the site.

RESULTS

More than two-thirds (68.75%) of the subjects who were punch grafted using a laser showed repigmentation of more than 75%, but only one-half of those who underwent conventional punch grafting showed a similar response. All subjects with laser-assisted suction blister grafting showed a good response, compared with only 60% of those who underwent conventional suction blister grafting.

CONCLUSIONS

The results obtained with laser-assisted grafting are more satisfactory than those achieved with conventional grafting techniques. We found that the repigmentation zones are larger (up to 9 mm in the former vs. 3 mm in the latter) and cobblestoning does not occur with laser-assisted grafting. Also, the procedure is precise, relatively atraumatic and can be performed rapidly even when covering vast areas.

Modified Active Surveillance System (MASS); a novel clinicopathological evaluation of PB leprosy patients after RFT, in Mangalore, India

The current recommendations for leprosy control programmes include stopping active surveillance in view of the very low relapse rates and a phased integration of leprosy services with the general health services. Passive surveillance may not be adequate, more so because of the introduction of newer, shorter drug regimens. This study is an effort to evolve a modified active surveillance, which is cost-effective, simple and also a novel substitute for the increased workload caused by the dwindling number of PMWS. One thousand one hundred RFT-PB leprosy patients were recalled for a review under the Modified Active Surveillance System (MASS), carried out over two phases. Patients were divided into groups as per the mode of response to the mailed postcards; Responders (patients who reported to the OPD in person), Untraceables (patients whose postcards returned back) and non-responders (patients who did not report of the OPD after receiving the mail). At the end of phase I, we had 120 Responders, 480 Untraceables and 500 Non-responders. In phase II, which began 2 months later, the 500 non-responders were dispatched reminders. In this phase, there were 31 responders, 60 untraceables and 409 non-responders. Thus, at the completion of phases I and II, there were 151 responders, 540 untraceables and 409 non-responders. Of the 151 patients examined, 71 had no complaints (category 1), 41 had fresh leprosy-related complaints (category IIA), 14 had fresh leprosy-unrelated complaints (category IIB) and 25 had persistence of old complaints (category III). Cumulative PYR of the 151 patients was 1155.42. Forty-one patients had fresh leprosy-related complaints. Skin biopsy was done in the 17 patients with fresh skin patches, of whom four showed histopathological evidence of relapse. Relapse rate in our study was 0.35/100 PYR. Mean duration after RFT at relapse was 4.9 years. Our scepticism towards passive surveillance systems is justified by these 41 patients with fresh leprosy-related complaints, who voluntarily reported only after receiving the postcards. We recommend the introduction of a phase III, wherein the services of PMWs may be used to contact the 409 patients who remained unresponsive at the completion of phases I and II. We also recommend the introduction of a universal format for recording addresses of all new patients, which would be of immense help in patient retrieval in all such surveillance systems in the future.