10.5005/jp-journals-10015-1242 REVIEWShankargouda ARTICLE Patil et al Oral Microbial Flora in Health Shankargouda Patil, Roopa S Rao, N Amrutha, DS Sanketh
ABSTRACT Transient Flora 7KH RUDO ÀRUD FRPSULVHV RI SOHWKRUD RI PLFURRUJDQLVPV ZLWK 7KLVÀRUDFRPSULVHVRIRUJDQLVPVWKDWPD\EHSUHVHQWLQWKH DSUHGRPLQDQFHRIEDFWHULD7KHVHRUJDQLVPVDUHEHQH¿FLDO ZKHQSUHVHQWLQULJKWQXPEHUV7KHRUDOFDYLW\KDUERUVDYDULHW\ RUDOFDYLW\IRUYHU\VKRUWSHULRGV KRXUVWRGD\V RIWLPH RIKDELWDWVZLWKYDU\LQJHQYLURQPHQWDOFRQGLWLRQVPDNLQJWKH 7KHVHRUJDQLVPVPD\EHWHPSRUDULO\HVWDEOLVKHGGXHWR VWXG\RIRUDOPLFURELRORJ\FRPSOH[DQGGLI¿FXOW+HQFHDVRXQG H[RJHQRXVIDFWRUVOLNHIRRGRUGULQNVDQGDUHQRWKDUPIXOWR NQRZOHGJHRIWKHQRUPDOFRPPHQVDOVRIWKHRUDOFDYLW\LVDQ WKHKRVW7KLVÀRUDPD\ÀRXULVKDQGEHFRPHRSSRUWXQLVWLF HVVHQWLDOWRROIRUDFFXUDWHODERUDWRU\GLDJQRVLV7KHREMHFWLYHRI WKLVDUWLFOHLVWREHQH¿WWKHVWXGHQWSRSXODWLRQDVWKHFRQFHSWRI LQFRQGLWLRQVZKHUHWKHKRVWLVLPPXQRFRPSURPLVHG RUDOPLFURELDOÀRUDKDVEHHQSXWIRUZDUGLQDVLPSOL¿HGIRUPDW Keywords: 2UDOÀRUD$FTXLVLWLRQ1HRQDWHV$GXOWV ACQUISITION OF NORMAL ORAL FLORA How to cite this article: 3DWLO65DR56$PUXWKD16DQNHWK 7KHRUDOFDYLW\EHIRUHELUWKLVVWHULOH&RORQL]DWLRQEHJLQV '6 2UDO 0LFURELDO )ORUD LQ +HDOWK :RUOG - 'HQW DWRUVKRUWO\DIWHUELUWK7KRVHWKDWLQLWLDOO\FRORQL]H LPPHGLDWHO\DIWHUELUWKDUHFDOOHGSLRQHHUVSHFLHVHJ Source of support:1LO Streptococcus salivarius%\WKH¿UVWELUWKGD\WKHRUDO &RQÀLFWRILQWHUHVW 1RQHGHFODUHG FDYLW\LVLQYDGHGSUHGRPLQDQWO\E\DHUREHVDQGPD\ LQFOXGHStreptococcusNeisseriaVeillonellaLactobacillus INTRODUCTION DQGActinomyces2QFHWRRWKHUXSWLRQVWDUWVQRQVKHGGLQJ 2UDOÀRUDKDVDQHFRORJLFDOO\GLYHUVHPLFURELDOSRSXODWLRQ VXUIDFHVDUHHVWDEOLVKHGIRUWKHVHRUJDQLVPVWRFRORQL]H JURXSDQGFRQWDLQVDWOHDVWFXOWLYDEOHVSHFLHV1$VHDUO\ $IWHUDOOWHHWKKDYHHUXSWHGPRUHVXUIDFHVDUHHVWDEOLVKHG DV$QWRQ\9DQ/HHXZHQKRHNIDWKHURIPRGHUQGD\ JLQJLYDOFUHYLFHVGHYHORSIRUFRORQL]DWLRQRISHULRGRQWDO PLFURVFRSHREVHUYHGKLVRZQGHQWDOSODTXHDQGUHSRUWHG PLFURRUJDQLVPVSODTXHDFFXPXODWHVDWGLIIHUHQWVLWHVRQ µOLWWOHOLYLQJDQLPDOFXOHVSUHWWLO\PRYLQJ¶27KLVZDVWKH WKHWRRWKOLNHVPRRWKVXUIDFHVSLWDQG¿VVXUHVIRUGLIIHUHQW KDOOPDUNIURPZKLFKPDQ\RWKHUVWXGLHVHYROYHGLQUHODWLRQ PLFURELDOFRORQLHVWREHHVWDEOLVKHG%\WKLVSURFHVVDQG WRRUDOPLFURÀRUDLQGLVHDVHDQGKHDOWK PLFURELDOVXFFHVVLRQKLJKVSHFLHVGLYHUVLW\GHYHORSVDQG LVFDOOHGWKHFOLPD[FRPPXQLW\,QROGDJHRQFHDOOWHHWK TYPES OF ORAL FLORA DUHORVWWKHÀRUDLVVLPLODUWRFKLOGEHIRUHWRRWKHUXSWLRQ1 )ORZ&KDUW Indigenous Flora
,WUHIHUVWRWKHRUJDQLVPVSUHVHQWLQJUHDWHUWKDQRI ACQUISITION OF MUTANS STREPTOCOCCI WKHWRWDOYLDEOHFRXQWLQDSDUWLFXODUVLWHVXFKDVVXUIDFHRI IN NEONATES WRQJXHRUVXSUDJLQJLYDOSODTXH7KH\DUHLQDFRPSDWLEOH Vertical Transmission UHODWLRQVKLSZLWKWKHKRVWDQGGRQRWFRPSURPLVHWKH VXUYLYDORIWKHKRVW7KHFRPPRQLQGLJHQRXVRUJDQLVPV 9HUWLFDOWUDQVPLVVLRQLVGH¿QHGDVWKHSDVVLQJRIDPLFUREH SUHVHQWLQWKHRUDOFDYLW\DUHStreptococcusActinomyces IURPWKHSDUHQWWRWKHRIIVSULQJ7KHPDMRUUHVHUYRLUIURP DQGNeisseria ZKLFKLQIDQWVDFTXLUHPXWDQVVWUHSWRFRFFLDUHWKHLUPRWKHUV 9HUWLFDOWUDQVPLVVLRQRFFXUVGXULQJSDVVDJHRIWKHQHRQDWH Supplemental Flora WKURXJKWKHELUWKFDQDORUWKURXJKPDWHUQDOPLON ,WUHIHUVWRWKHPLFURRUJDQLVPVLGHQWL¿HGLQDVLJQL¿FDQW Horizontal Transmission DPRXQW OHVVWKDQ LQFHUWDLQLQGLYLGXDOV7KHPRVW FRPPRQLQFOXGHLactobacillus7KH\DUHLQÀXHQFHGE\ +RUL]RQWDOWUDQVPLVVLRQUHIHUVWRWKHSDVVLQJRIPLFUREHV HQYLURQPHQWDOFKDQJHVHJLactobacillusLVQRUPDOO\IRXQG IURPRQHLQGLYLGXDOWRDQRWKHULQWKHVDPHJHQHUDWLRQHLWKHU LQORZOHYHOVLQSODTXHLHWRRIWKHYLDEOH E\GLUHFWRULQGLUHFWFRQWDFW HJIDPLO\PHPEHUV ÀRUD,QDFDULRXVOHVLRQDVWKHS+RISODTXHEHFRPHVDFLGLF 0DWWRV*UDQHU DQG FROOHDJXHV LVRODWHG PXWDQV LactobacillusZKLFKLVDFLGWROHUDQWPXOWLSOLHVDQGEHFRPHV VWUHSWRFRFFLIURPJURXSVRIQXUVHU\VFKRROFKLOGUHQ DJH WKHGRPLQDQWPLFURRUJDQLVP PRQWKV DQGJHQRW\SHGWKHLVRODWHV7KH\UHSRUWHG
262 WJD
Oral Microbial Flora in Health
Flow Chart 1:#ESWKUKVKQPQHPQTOCNQTCNOKETQƀQTCKP ,WKDVVSHFL¿FDQGQRQVSHFL¿FGHIHQFHIDFWRUVOLNH,J* phases of life 1HXWURSKLOVIRXQGLQ*&)DUHLQYROYHGLQSKDJRF\WRVLV
Microbial Factors 7KHUHLVFRPSHWLWLRQIRUUHFHSWRUVDPRQJGLIIHUHQW PLFUREHVUHVXOWLQJLQSUHYHQWLRQRIDWWDFKPHQWE\µODWH FRPHUV¶3URGXFWLRQRIWR[LQV S. salivariusSURGXFHV HQRFLQWKDWLQKLELWVS. pyogenes 3URGXFWLRQRIPHWDEROLFHQGSURGXFWVE\FHUWDLQEDFWHULD ORZHUWKHS+ 6RPHEDFWHULDXVHWKHPHWDEROLFHQGSURGXFWVRIRWKHU EDFWHULDIRUQXWULWLRQDOSXUSRVHV &RDJJUHJDWLRQRIVDPHRUGLIIHUHQWVSHFLHV HJEDFWHULD FRUQFREIRUPDWLRQ
Miscellaneous Factors D /RFDOHQYLURQPHQWS+ 7KLVLVUHJXODWHGE\VDOLYDDQGLWGHSHQGVRQ WKDWPDQ\FKLOGUHQFRQWDLQHGLGHQWLFDOJHQRW\SHVRI IUHTXHQF\RIGLHWDU\FDUERK\GUDWHV 0DQ\PLFUREHVIDYRUQHXWUDOS+ZKLOHRWKHUVJURZ PXWDQVVWUHSWRFRFFLVWUDLQVZKLFKLQGLFDWHVWKDWKRUL]RQWDO ZHOOLQDFLGLFHQYLURQPHQW ODFWREDFLOOL WUDQVPLVVLRQPD\EHDQRWKHUYHFWRUIRUDFTXLVLWLRQRIWKHVH E Oxidation-reduction potential 7KLVYDULHVLQGLIIHUHQW RUJDQLVPV ORFDWLRQVRIPRXWKIDOOVGXULQJSODTXHGHYHORSPHQW FACTORS CONTRIBUTING TO NORMAL ZKLFKIDYRUVJURZWKRIEDFWHULD MICROBIAL GROWTH F Antimicrobial therapy %URDGVSHFWUXPDQWLELRWLFVZLSH Anatomical RXWPRVWHQGRJHQRXVÀRUDDQGDOVRIDYRUWKHHPHUJHQFH RI\HDVWVSHFLHV $QDWRPLFDOIDFWRUVWKDWUHVXOWLQEDFWHULDOVWDJQDWLRQDQG G Diet )HUPHQWDEOHFDUERK\GUDWHVDUHWKHPDMRUVRXUFH JURZWKDUHDVIROORZV RIQXWULHQWVZKLFKSURPRWHDFLGRJHQLFEDFWHULD 6KDSHWRSRJUDSK\PDODOLJQPHQWRIWKHWHHWK H Iatrogenic factors 'HQWDOVFDOLQJDOWHUVWKHFRPSRVLWLRQ 3RRUTXDOLW\RIUHVWRUDWLRQV RISHULRGRQWDOSRFNHWÀRUDRIGLVHDVHGVLWHV 1RQNHUDWLQL]HGVXOFXODUHSLWKHOLXP I Diurnal variations %DFWHULDOFRXQWVKLJKHVWLQWKH Saliva PRUQLQJGHFUHDVHVGXULQJWKHGD\ J Drugs 0D\FDXVHGHFUHDVHLQVDOLYDU\ÀRZWKHUHE\ 6DOLYDFRQWULEXWHVWRWKHRUDOHFRV\VWHPLQPDQ\ZD\V DOORZLQJWUDQVLHQWPLFURÀRUDWRSUROLIHUDWHDQGFDXVH $GVRUSWLRQRIVDOLYDU\JO\FRSURWHLQVUHVXOWVLQIRUPDWLRQ LPPXQRVXSSUHVVLRQOHDGLQJWRRSSRUWXQLVWLFLQIHFWLRQV RIVDOLYDU\SHOOLFOHZKLFKLQWXUQIDFLOLWDWHVEDFWHULDO HJVWHURLGV DGKHVLRQ K Extraction of teeth /HDGVWRGHFUHDVHLQS. sanguisDQG ,WLVDULFKVRXUFHRIIRRGLHFDUERK\GUDWHVDQGSURWHLQV S. mutans WKDWFRORQL]HRQWHHWK ,WKDVWKHSURSHUW\RIJURZWKLQKLELWLRQRIH[RJHQRXV L Intraoral appliance $SSOLDQFHVPD\KHOSLQKDUERULQJS. RUJDQLVPVRZLQJWRWKHSUHVHQFHRIQRQVSHFL¿FGHIHQFH sanguis DQGS. salivarius )ORZ&KDUWDQG 7DEOH IDFWRUVOLNHO\VR]\PHODFWRIHUULQKLVWDWLQVDQGVSHFL¿F GHIHQFHIDFWRUVOLNH,J$VDOLYDU\OHXNRF\WHSURWHDVH ORAL MICROBIAL FLORA IN LQKLELWRU 6/3, NEONATES ,WSOD\VDPDMRUUROHLQPDLQWHQDQFHRIS+GXHWRLWV Mutans Streptococci EXIIHULQJFDSDFLW\$FLGLFVDOLYDSURPRWHVJURZWKRI FDULRJHQLFEDFWHULD Controversies related to Gingival Crevicular Fluid (GCF) Mutans Streptococci in Neonates *&)ÀXVKHVPLFUREHVRXWRIFUHYLFH (DUOLHUVWXGLHVGHPRQVWUDWHWKDWLQIDQWVDFTXLUHPXWDQV ,WDOVRDFWVDVDSULPDU\VRXUFHRIQXWULHQWVWRWKH VWUHSWRFRFFLRQO\DIWHUWKHHUXSWLRQRISULPDU\WHHWKDV FUHYLFXODUEDFWHULD PXWDQVVWUHSWRFRFFLUHTXLUHDQRQVKHGGLQJRUDOVXUIDFHIRU 0DLQWDLQVS+RIWKHJLQJLYDOFUHYLFH LWVSHUVLVWHQWRUDOFRORQL]DWLRQ
World Journal of Dentistry, October-December 2013;4(4):262-266 263 Shankargouda Patil et al
Flow Chart 2: (CEVQTUKPƀWGPEKPIVJGQTCNOKETQƀQTC Table 1:3URVDQGFRQVRIQRUPDOPLFURELDOÀRUD Advantages Disadvantages
+HOSVLQSUHYHQWLQJGLVHDVH 6RXUFHRIHQGRJHQRXV E\EDFWHULDODQWDJRQLVP LQIHFWLRQZKHQKRVW FRPSHWLWLRQIRUQXWULWLRQ UHVLVWDQFHGHFUHDVHV DOWHUDWLRQRIHQYLURQPHQW +RVWLPPXQHUHVSRQVH 0D\SUHGLVSRVHKRVWWR VWLPXODWLRQ H[RJHQRXVLQIHFWLRQ 3URYLVLRQRIHVVHQWLDO 6HQVLWL]DWLRQRIWKHKRVW QXWULWLRQWRWKHKRVW WRRUDOPLFURELDODQWLJHQV± DFFHQWXDWHGUHVSRQVHWR VXEVHTXHQWVSHFL¿FDQWLJHQLF HQFRXQWHUV (QKDQFHPHQWRIUHPRYDO DQGPDWXUDWLRQUDWHVRIRUDO HSLWKHOLXP
5HFHQWVWXGLHVLQGLFDWHWKDWPXWDQVVWUHSWRFRFFLFDQ QXPHURXVIDFWRUVVXFKDVWKHSUHVHQFHRIHFRORJLFDOQLFKHV FRORQL]HWKHPRXWKRISUHGHQWDWHLQIDQWV7KHIXUURZVRIWKH HJQDWXUDODQIUDFWXRVLWLHVRIWKHWHHWK WRQJXHDSSHDUWREHDQLPSRUWDQWHFRORJLFDOQLFKH /DFWREDFLOOLZHUHLVRODWHGIURPWKHWRQJXHVXUIDFHDQG 7DQQHUHWDOUHSRUWHGWKDWPXWDQVVWUHSWRFRFFLZHUHIRXQG JXPVLQVRXQGFKLOGUHQDQGZDVQRWHGWKDWRIWKH WREHSUHVHQWLQRISODTXHVDPSOHVDQGRIWRQJXH ODFWREDFLOOLFDPHIURPWKHWRQJXHDQGIURPWKHJXPV VFUDSLQJVDPSOHVRIFKLOGUHQDJHGWRPRQWKVOLYLQJ DQGVSHFLHVL. fermentum DQGL. plantarum DUHSUHGRPLQDQW LQ6DLSDQ7KHVHUHFHQWVWXGLHVRQDFTXLVLWLRQRIPXWDQV RQWKHWRQJXH L. rhamnosusLVSUHGRPLQDQWRQWKHJXP VWUHSWRFRFFLUDLVHGRXEWVWKDWDQRQVKHGGLQJRUDOVXUIDFHLV $PRQJFKLOGUHQWKHSUHVHQFHRIODFWREDFLOOLLQFRURQDO UHTXLUHGIRUWKHLURUDOFRORQL]DWLRQ9 FDULHVLVLQFRQWHVWDEOH$PRQJDGXOWVLactobacilli casei Lactobacilli JURXSDUHIRXQGLQURRWFDULHV,QFKLOGUHQL. caseiLV /DFWREDFLOOLDEVHQWIURPWKHRUDOFDYLW\RIQHZERUQVDSSHDU SUHGRPLQDQWEXWLQHDUO\FKLOGKRRGFDULHVL. fermentum GXULQJWKH¿UVW\HDURIOLIH7KHLUSUHVHQFHGHSHQGVRQ LVWKHPRVWIUHTXHQWO\IRXQGVSHFLHV
Flow Chart 3: 9QTMKPIENCUUKſECVKQPQHPQTOCNQTCNƀQTC
264 WJD
Oral Microbial Flora in Health
Anaerobes Actinomyces 0LQRUFRPSRQHQW A. israelii 2EOLJDWHDQDHUREHVVeillonella VSHFLHVDQGWKHPrevotella RIKHDOWK\JLQJLYDO A. gerencseriae ÀRUD A. odontolyticus melaninogenica JURXSRUJDQLVPVDVZHOODVIDFXOWDWLYH A. naeslundii Actinomyces DQDHUREHV VSHFLHVDUHFRPPRQVDOLYDU\ Lactobacillus RIWKHRUDO L. casei ILQGLQJVLQPRQWKROGLQIDQWVDQGLQDGGLWLRQWKH ÀRUD L. fermentum IUHTXHQF\RIF. nucleatumPorphyromonas catoniae L. acidophilus QRQSLJPHQWHGPrevotella VSHFLHVDQGLeptotrichia VSHFLHV Eubacterium 'HQWDOSODTXHDQG E. brachy, FDOFXOXV E. timidum, DOVRUHPDUNDEO\LQFUHDVHVEHWZHHQDQGPRQWKVRIDJH E. nodatum, P. catoniaeZDVPRUHIUHTXHQWLQLQIDQWVZLWKWKHHDUO\ E. saphenum HPHUJHQFHRIWKH¿UVWWRRWK Propionibacterium 'HQWDOSODTXH E. brachy $PRQJ WKH µODWH FRORQL]HUV¶ FRUURGLQJ URGV E. timidum E. nodatum CapnocytophagaVSHFLHVDQGRWKHUFusobacterium UHDFKHG Neisseria WKHSUHYDOHQFHRILQLQIDQWVXSWR\HDURIDJH2QFH 7RQJXHVDOLYD 1VXEÀDYD RUDOPXFRVDDQG N. mucosa HVWDEOLVKHGWKHVSHFLHVWHQGWRSHUVLVWLQWKHPRXWK HDUO\SODTXH N. sicca $IWHUWKH¿UVW\HDURIOLIH Veillonella 7RQJXHVDOLYDDQG V. parvula, $ 5HPDUNDEOHLQFUHDVHVLQWKHIUHTXHQF\RIVHYHUDORUDO GHQWDOSODTXH V. dispar, DQDHURELFJURXSVRFFXU V. atypia % (DUO\FRORQL]LQJVSHFLHVFDQEHLVRODWHGQHDUO\IURP Hemophilus 'HQWDOSODTXH H.
HYHU\PRXWK VDOLYDDQG SDUDLQÀXHQ]DH PXFRVDH H. segnis, & 7KHµODWHFRORQL]HUV¶VXFKDVRWKHUIXVREDFWHULDWKDQ H. aphrophilus F. nucleatumCapnocytophaga VSHFLHVFRUURGLQJURGV Actinobacillus 3HULRGRQWDOSRFNHW A. actinomycete- Selenomonas VSHFLHVDQGWKHPrevotella intermedia mcomitans JURXSRUJDQLVPVDUHIUHTXHQWO\SUHVHQWLQWKHRUDOFDYLW\ VHURW\SHDH EHIRUH\HDUVRIDJH Eikenella 'HQWDOSODTXH E. corrodens GHQWRDOYHRODU P. intermedia Prevotella nigrescens $PRQJWKH JURXS DQG DEVFHVV Prevotella pallens DUHFRPPRQFRORQL]HUVGXULQJFKLOGKRRG Capnocytophaga 'HQWDOSODTXH &JLQJLYDOLV ,QGHHGFKLOGUHQZLWKGHFLGXRXVGHQWLWLRQDOUHDG\ PXFRVDVDOLYD C. sputigena, KDUERUDPXOWLIRUPRUDODQDHURELFPLFURÀRUD+RZHYHU C. ochracea WKHWUDQVLWLRQWRPDWXUHRUDOPLFURÀRUDFRUUHVSRQGLQJWR Porphyromonas *LQJLYDOFUHYLFH P. gingivalis, P. endodontalis WKDWRIDGXOWVSUREDEO\GRHVQRWWDNHSODFHXQWLOSXEHUW\ DQGVXEJLQJLYDO SODTXH DQGWKHFRORQL]DWLRQRIPDLQSHULRGRQWDOSDWKRJHQV Prevotella 3HULRGRQWDO P. intermedia, UDUHO\WDNHVSODFHLQHDUO\FKLOGKRRG HJActinobacillus SRFNHWGHQWDO P. nigrescens, actinomycetemcomitansPorphyromonas gingivalis DQG SODTXH P. loescheii 11 Bacteroides forsythus Fusobacterium 1RUPDOJLQJLYDO F. nucleatum, FUHYLFH F. alocis, F. sulci ORAL MICROBIAL FLORA IN ADULTS (TABLE 2) Leptotrichia 'HQWDOSODTXH L. buccalis
Table 2:2UDOPLFURELDOÀRUDLQDGXOWV Wolinella *LQJLYDOFUHYLFH W. succinogenes Bacteria Treponema *LQJLYDOFUHYLFH T. denticola, Microorganism Habitat Most common T. macrodentium species Entamoeba 3HULRGRQWDO E. gingivalis Streptococcus 2UDOÀRUDJLQJLYDO Mutans gingivalis WLVVXHHVSHFLDOO\ DQGVXSUDJLQJLYDO salivarius LQSDWLHQWV SODTXHWRQJXH anginosus DQG ZKRUHFHLYHG DQGVDOLYD mitis JURXS UDGLRWKHUDS\ Stomatococcus 0DLQO\WRQJXHDQG 1RVSHFLHVW\SHV Trichomonas *LQJLYDOFUHYLFH T. tenax mucilaginosus JLQJLYDOFUHYLFH tenax Fungi 6WDSK\ORFRFFL +XPDQVDOLYD S. aureus, S. epidermidis &DQGLGDVSHFLHV 6XEJLQJLYDOÀRUD C. albicans, DQG SHULRGRQWLWLV C. glabrata, S. saprophyticus C. krusei, C. tropicalis Contd...
World Journal of Dentistry, October-December 2013;4(4):262-266 265 Shankargouda Patil et al
REFERENCES ABOUT THE AUTHORS 6DPDUQD\DNH/3-RQHV%0(VVHQWLDOPLFURELRORJ\IRU Shankargouda Patil (Corresponding Author) GHQWLVWU\UGHG8. &KXUFKLOO/LYLQJVWRQH,QF(OVHYLHU 'REHOO&$QWKRQ\YDQ/HHXZHQKRHNDQG+LVµ/LWWOH$QLPDOV¶ 6HQLRU/HFWXUHU'HSDUWPHQWRI2UDO3DWKRORJ\065DPDLDK /RQGRQ 6WDSOHV3UHVV 'HQWDO&ROOHJHDQG+RVSLWDO1HZ%HO5RDG%HQJDOXUX.DUQDWDND 1HZPDQ0*1LVHQJDUG52UDOPLFURELRORJ\DQGLPPXQRORJ\ ,QGLD3KRQH HPDLO GUUDYLSDWLO#JPDLOFRP QGHG3KLODGHOSKLD86$ 6DXQGHUV -RKQ357H[WERRNRIRUDOPHGLFLQHQGHG1HZ'HOKL,QGLD -D\SHH%URWKHUV0HGLFDO3XEOLVKHUV 3 /WG Roopa S Rao %HUNRZLW]5-$FTXLVLWLRQDQGWUDQVPLVVLRQRIPXWDQV 3URIHVVRUDQG+HDG'HSDUWPHQWRI2UDO3DWKRORJ\065DPDLDK 6WUHSWRFRFFL-&DOLI'HQW$VVRF $QDQWKDQDUD\DQDQ53DQLNHU&.7H[WERRNRIPLFURELRORJ\ 'HQWDO&ROOHJHDQG+RVSLWDO%HQJDOXUX.DUQDWDND,QGLD WKHG$QGKUD3UDGHVK,QGLD 8QLYHUVLW\3UHVV 0DKRQ&5/HKPDQ'&0DQXVHQLV*7H[WERRNRIGLDJQRVWLF N Amrutha PLFURELRORJ\WKHG3KLODGHOSKLD86$ 6DXQGHUV 0DUVK30DUWLQ092UDO0LFURELRORJ\WKHG8. &KXUFKLOO 3RVWJUDGXDWH6WXGHQW'HSDUWPHQWRI2UDO3DWKRORJ\065DPDLDK /LYLQJVWRQH,QF(OVHYLHU 'HQWDO&ROOHJHDQG+RVSLWDO%HQJDOXUX.DUQDWDND,QGLD /RHVFKH:-1XWULWLRQDQG'HQWDO'HFD\LQ,QIDQWV$P-&OLQ 1XWU %DGHW&7KHEDXG1%(FRORJ\RI/DFWREDFLOOLLQWKH2UDO DS Sanketh &DYLW\ $5HYLHZRI/LWHUDWXUH2SHQ0LFURELRO- .RQRQHQ(2UDOFRORQL]DWLRQE\DQDHURELFEDFWHULDGXULQJ 3RVWJUDGXDWH6WXGHQW'HSDUWPHQWRI2UDO3DWKRORJ\065DPDLDK FKLOGKRRG UROHLQKHDOWKDQGGLVHDVH2UDO'LV 'HQWDO&ROOHJHDQG+RVSLWDO%HQJDOXUX.DUQDWDND,QGLD
266