Efficacy of Platelet-Rich Plasma Therapy in Oral Lichen Planus: A Systematic Review

Background and Objectives: Oral lichen planus (OLP) is an autoimmune, mucocutaneous, oral potentially malignant disorder (OPMD), which characteristically manifests with chronic, recalcitrant lesions, with frequent flare-ups and remissions. The precise etiopathogenesis of OLP is still debatable, although it is believed to be a T-cell-mediated disorder of an unidentified antigen. Despite the availability of various treatments, no cure for OLP exists due to its recalcitrant nature and idiopathic etiology. Platelet-rich plasma (PRP) has antioxidant, anti-inflammatory, and immunomodulatory properties, in addition to its regulatory action on keratinocyte differentiation and proliferation. These salient properties substantiate the possible role of PRP in the treatment of OLP. Our systematic review focuses on assessing the therapeutic potential of PRP as a treatment modality in OLP. Materials and Methods: We conducted a detailed literature search for studies assessing PRP as a therapeutic regimen in OLP, using the Google Scholar and PubMed/MEDLINE search engines. The search was limited to studies published from January 2000 to January 2023 and included a combination of Medical Subject Heading (MeSH) terms. ROBVIS analysis was carried out for the assessment of publication bias. Descriptive statistics were performed using Microsoft Excel. Results: This systematic review included five articles that met the inclusion criteria. Most of the included studies demonstrated that PRP treatment considerably ameliorated both objective and subjective symptoms in OLP subjects, with comparable efficacy to the standard corticosteroid treatment. Further, PRP therapy offers the added benefit of minimal adverse effects and recurrences. Conclusion: This systematic review suggests that PRP has significant therapeutic potential for treating OLP. However, further research with larger sample sizes is imperative to corroborate these findings.

The effect of photodynamic therapy on the salivary flow rate, IgA concentration and C-reactive protein levels in active smokers: a case-control study

OBJECTIVE

This study aimed to evaluate the effect of photodynamic therapy (PDT) on the salivary flow rate, secretory immunoglobulin A, and C-reactive protein levels in active smokers.

PATIENTS AND METHODS

The present study is a prospective case-control study. Twenty active smokers were allocated to two groups randomly of ten participants each: the experimental group was irradiated while the control was exposed to sham irradiation by turning off the equipment. In the experimental group, methylene blue mediated PDT was applied both intra- and extra-orally over the major and minor salivary glands using a diode laser. 780 nm wavelength and 4 J/cm2 of energy were used to irradiate the 10 points of major salivary glands (6 for parotid and 2 for submandibular glands and 2 for sublingual glands). On the other hand, 660 nm was used to apply 10 J/cm2 of energy over the minor salivary glands at numerous points. The samples of the stimulated and unstimulated saliva were collected from both groups to assess the SFR. ELISA method was used to assess the level of salivary IgA levels, statistical analysis was done using a one-way ANOVA, and a p-value of <0.05 was considered significant.

RESULTS

The results showed a significant increment in salivary and secretory immunoglobulin A levels of subjects undergone photodynamic therapy. C-reactive protein levels were significantly decreased in subjects exposed to irradiation.

CONCLUSIONS

The present study concludes that photodynamic therapy significantly improves the salivary flow rate, secretory Immunoglobulin A, and oral health quality of life in smokers. The inflammatory salivary marker C-reactive protein, which is usually raised in smokers, is also reduced.

Addition of transglutaminase enzyme in camel milk yoghurt to increase its sensorial aspects

Camel milk was obtained from A-block UVAS Ravi Campus Pattoki. After pasteurization at 72 °C (15 sec) it was cooled to 42 °C, then glutathione treated transglutaminase enzyme was added with the concentration of 0.5 g/300 mL, 1 g/300 mL, 1.5 g/300 mL, 2 g/300 mL while control sample with the addition of 1.5 g/300 mL gelatin. Then inoculation of milk was done with standard cultures of Yoghurt Lactobacillus delbrueckii subsp bulgaricus and Streptococcus thermophilus at the rate of 2% for 3-4 hours at 42 °C. Samples were stored at 4 °C and were analyzed on 1st day and 28th day of storage. In our findings, there was slight increase in sensorial properties of all the samples. It was also observed that syneresis was reduced with the increase of enzyme quantity.

Evaluating Time-Dependent Extraction of Exfoliated Oral Mucosal Cells from Used Toothbrushes and Miswak

An integral part of forensic work is DNA quantification and profiling, which necessitates many highquality samples for good results. Oral mucosal cells have become an essential source of genomic DNA in epidemiological studies. The time of collecting DNA samples is a critical factor in forensic science. To compares the time-dependent extraction of DNA yield and purity from exfoliated oral epithelial cells from toothbrushes and miswak used for time intervals up to 5 months. Thirty healthy volunteers were given toothbrushes and miswak to use for six days. The used toothbrushes and miswak were collected, stored at room temperature, and analyzed immediately and at the end of the first, second, third, fourth, and fifth months. Comparisons between the two independent groups of toothbrush and miswak were done by an independent two-sample t-test. The changes over time for each outcome were analyzed using repeated-measures ANOVA. DNA yield of the exfoliated oral epithelial cell samples was higher from female samples, while DNA purity was higher in the male samples. The Miswak contained a sufficient amount of DNA similar to toothbrushes. The yield and purity are not significantly altered by storing them for at least five months at room temperature.

Riboflavin (Vitamin B2), Turmeric (Curcumin) Photosensitizers Mediated Photodynamic Therapy, and Er, Cr: YSGG on Microleakage of Class V Cavities Restored by Resin-Modified Glass-Ionomer Cement

Purpose: The present study aimed to assess the effect of RF and CP intervened PDT and Er, Cr: YSGG laser on microleakage in class V RMGIC restorations in permanent teeth. Materials and Methods: In-vitro eighty standardized class V cavities (4×4×2) were prepared in extracted permanent molars based on ICDAS II (International Caries Detection and Assessment System II) caries severity code 0. All samples were arbitrarily alienated into four groups: Group 1, PDT mediated riboflavin photosensitizer (RF) [concentration of 150 μg/mL]; Group 2, PDT with curcumin photosensitizer (CP) [concentration of 100 μg/mL]; Group 3, Er, Cr: YSGG laser application; Group 4, control group: rinsed and dried dentin. Cavities were restored with conventional RMGIC. The specimens were immersed in 0.5% Fuchsine solution for 24 hrs. and sectioned. Microleakage scores were assessed under a microscope. Intergroup and intragroup comparisons were made at enamel and cementum margin respectively. Data were analyzed by non-parametric Kruskal-Wallis test and Wilcoxon tests at the level of significance deemed p < 0.05. Results: Riboflavin and curcuminmediated PDT would produce a superior reduction (95% viz 90%) of microleakage as compared to Er, Cr: YSGG laser (85%), and no control groups. Cu-PDT observed the highest amount of microleakage with the least amount of microleakage in the control group. Conclusion: Riboflavin and curcumin photosensitizers mediated PDT and Er, Cr: YSGG laser has the potential to be utilized in class V cavities before RMGIC restorations at enamel margins without adversely affecting the marginal integrity.

Mucoepidermoid carcinoma of minor salivary gland in a patient with asymptomatic palatal swelling – A case report

Incidence of abundant minor salivary gland tissues in the posterior part of hard palate surges the likelihood of salivary gland neoplasm especially in this part of the oral cavity. Minor salivary gland tumor accounts for virtually 15% of all the salivary gland neoplasm, wherein mucoepidermoid carcinoma comprises of 35.9%. Current paper reports a case of mucoepidermoid carcinoma of the posterior part of the hard palate which was an incidental finding. It presented as well-defined smooth swelling, the preliminary radiographic investigation revealed no appreciable bony changes and offered an impression of a benign tumor. Histopathological investigation displayed features of mucoepidermoid carcinoma of intermediate grade. The lesion was surgically excised and the patient was under regular follow up for 3years. The paper focus on the magnitude of swift clinical diagnosis of specific lesions, so increasing the survival rate and reducing the morbidity.

Bond assessment of enamel conditioned with Er, Cr: YSGG laser and methylene blue photosensitizer activated by photodynamic therapy to orthodontic metallic brackets

AIM

To assess bond integrity and failure mode after enamel pretreated with conventional and contemporary conditioning methods were bonded to metallic brackets (MB).

MATERIAL AND METHODS

Forty maxillary central incisors were selected and disinfected. All specimens were mounted up to the cement-o-enamel junction and divided into four experimental groups randomly based on the enamel conditioning technique. Photodynamic therapy (PDT) was used to condition enamel in group 1, Total-etch and rinse (TER) was used to treat samples in group 2, Specimens in group 3 were conditioned with ECL, and samples in group 4 surface pretreated with SEP. Bonding of MB was performed on the surfaces of all the specimens with a Transbond XT. Specimens from all investigated groups were positioned on a universal testing machine maintaining buccal surfaces similar to the direction of the force. After bracket debonding bond failure was assessed using ARI. The bond integrity of all four groups was compared using analysis of variance (ANOVA). Post hoc Tukey test was used for pairwise comparison among different groups.

RESULTS

Group 2, TER+MB (15.38±0.14 MPa) displayed the highest bond value whereas the lowest values of SBS were exhibited by group 1, PDT+MB (10.11±0.17 MPa). The inter-group comparison revealed that specimens of group 2 and group 3, ECL+MB (14.61±0.55 MPa) demonstrated comparable bond strength (p>0.05).

CONCLUSION

Enamel conditioned with TER and ECL demonstrated comparable SBS. However, bond integrity after PDT and SEP (self-etch primer) surface treatment of enamel bonded with MB significantly lowered bond values.

Effect of ultrasonic scaling with adjunctive photodynamic therapy on the treatment of gingival inflammation among diabetic patients undergoing fixed orthodontic treatment

BACKGROUND

The aim of the present clinical trial was to evaluate the effect of methylene blue-mediated antimicrobial photodynamic therapy (aPDT) on the gingival and immunological parameters in diabetic adolescent patients undergoing fixed orthodontic treatment.

METHODS

The selected 40 participants were randomized equally into two groups; Group I (ultrasonic scaling + oral hygiene instructions) and Group II (ultrasonic scaling/oral hygiene instructions + aPDT). Serum HbA1c levels was assessed for all the participants at chairside. Plaque index (Pi), and bleeding on probing (BOP) were analyzed. Moreover, the assessment of crevicular fluid matrix metalloproteinase 8 (MMP-8) and macrophage inflammatory protein 1 alpha (MIP-1α) was performed using enzyme-linked immunosorbent assay technique. All measurements were recorded at baseline, 6 weeks, and 12 weeks follow-up periods, respectively. Intergroup comparisons for p-value were computed using Mann-Whitney test and Wilcoxon singed ranks test to compute p-value for intra-group comparisons. Stepwise logistic regression analysis was used to identify explanatory variables for reduction in plaque scores and bleeding on probing, after controlling for the effects of other covariates. Odds ratios and 95% confidence intervals were used to assess the direction and strength for associations. Significance level was set at 5% for all analyses.

RESULTS

All 40 individuals completed the clinical trial. There was a statistically significant reduction in Pi and BOP in both Group I and Group II from baseline to 12 weeks of follow up (P<0.05). However, there was slight reduction in the plaque scores in Group-II as compared to Group-I at 12 weeks visit (P<0.05). There was also a statistically significant difference for BOP when Group-I was compared with Group-II on 12 weeks follow up assessment (P<0.05). HbA1c assessment indicated no statistically significant difference either within or between groups at any time point (P>0.05). Both MMP-8 and MIP-1α reported a significant decrease for both Groups I and II at 6 weeks and 12 weeks follow-up periods in comparison to baseline (P<0.05). Inter-group comparison indicated a statistically significant difference noted at both 6 weeks follow up that was maintained at 12 weeks follow up (P<0.05). The logistic regression analysis revealed that even after controlling the mean BMI as a predictor, the change of biomarker levels along with the improvement in plaque scores and bleeding on probing was not significant (p> 0.05).

CONCLUSION

aPDT significantly improved bleeding on probing and proinflammatory biomarkers among diabetic adolescent patients undergoing fixed orthodontic therapy.

Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study

AIM AND OBJECTIVE

The aim of the study is to assess "Myths in dentistry related to Oral Hygiene and its association with Gingival Health Status among patients visiting Institutional diagnostic clinic in Aseer region of Saudi Arabia."

MATERIALS AND METHODS

The present study was a cross-sectional study done on 152 subjects attending Institutional diagnostic clinic in Aseer region Saudi Arabia. Myths in dentistry related to oral hygiene were assessed by using a ten-item, multiple-choice, close-ended structured questionnaire and Gingival Health Status was assessed using gingival index described by Loe and Silness on the Ramfjord teeth. For the comparison of proportions, a Chi-Square test was used with continuity correction whenever appropriate. "p" value of <0.05 was taken to be statistically significant for the purpose of analysis.

RESULTS

A total of 152 study subjects were included in the study, of which 60.5% were males and the rest 39.5% were females. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. Combinational use of household ingredients (like apple vinegar, turmeric, lemon, baking soda, coal, honey, and sodium bicarbonate) was seen among 40% of the subjects. A majority of 48% learned from family as a source of information and 53% believed that use of household ingredients would improve the esthetical value (bleaching) of the tooth. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. 40.8% had some form of gingival health problem. There was no statistically association observed between myths in dentistry related to oral hygiene and gingival health.

CONCLUSION

The present study revealed that myths in dentistry related to oral hygiene are quite prevalent in society. The use of household ingredients can influence oral health status and one has to ensure the judicious use if good oral health is to be expected.

CLINICAL SIGNIFICANCE

Myths in dentistry related to oral hygiene can influence a lot on oral health and this can augment the health of the individual in any direction. So as a responsible clinician, it is very important to address these issues and bring in more health awareness among the study population to achieve the social goal-"health for all." How to cite this article: Assiri KI, Ajmal M, Al-Ahmari BM, et al. Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study. J Contemp Dent Pract 2021;22(5):506-510.

Effectiveness of photodynamic therapy as an adjunct to topical antiviral therapy in the treatment of herpes labialis: A randomized controlled clinical trial

BACKGROUND

The present clinical trial assessed the effectiveness of photodynamic therapy in association with topical acyclovir in the treatment of herpes labialis in adolescent patients.

MATERIALS AND METHODS

45 individuals with herpes labialis were divided into three groups on the basis of provision of treatment. (a) Group I: Topical acyclovir therapy (AVT) (n = 15, mean age: 17.5 years) (b) Group 2: photodynamic therapy (PDT) (n = 15, mean age:16.8 years) and (c) Group III: AVT + adjunctive PDT (n = 15, mean age: 17.0 years) respectively. HSV-1 quantification and pain scales [visual analogue scale (VAS) and McGill Pain Questionnaire (MPQ)] were calculated. Pro-inflammatory biomarkers including interleukin (IL-6) and tumor necrosis factor-alpha (TNF-α) were quantified using enzyme linked immunosorbent assay (ELISA). Shapiro-Wilk test was used to assess the normality. The Friedman test was employed to compute the comparison for changes recorded in pain scores, proinflammatory cytokines and HSV-1 quantification, whereas Mann-Whitney test was used to analyze the mean values and establish inter-group comparisons. All assessments were performed at baseline, immediate post op, 2-weeks, 4-weeks, 3-months, and 6-months.

RESULTS

A total of 44 individuals completed the clinical trial. According to the data obtained from the clinical assessment, all the study groups reported a decrease in the parameters being observed. However, Group III (anti-viral (acyclovir) therapy + adjunctive PDT) showed a statistically significant decrease, in comparison to Group II (PDT) and Group I [AVT] respectively. The quantified HSV-1 among all groups showed significant reduction among all groups at each successive follow-up. However, Group-III (AVT + PDT) showed statistically significant reduction as compared to Groups I and II, respectively (p < 0.05).

CONCLUSION

Topical anti-viral therapy with adjunctive PDT significantly helped in reducing the pain and pro-inflammatory biomarkers in adolescent herpes labialis patients.

Efficacy of root canal treatment in c-shaped canals with adjunctive photodynamic therapy using micro-CT

AIM

To investigate the efficacy of conventional root canal treatment (cRCT) with adjunctive photodynamic therapy (aPDT) against microbial biofilms within infected c-shaped root canals.

METHODS

In this in vitro report, the inoculation of 20 freshly extracted human mandibular molar teeth having c-shaped root canal configuration was performed with E. faecalis and P. aeruginosa to produce three-day biofilms in prepared canal system. PDT used a combination of chlorin (ce6) and polyethylenimine (PEI) as the photosensitizer (PS). A 200 μ-fiber was employed to deliver a 660 nm diode laser light into the root canal, and this was compared and conjugated with conventional endodontic treatment utilizing antiseptic irrigation and mechanical debridement.

RESULTS

The utilization of aPDT (group-2) resulted in a considerable decrease in the count of E. faecalis and P. aeruginosa from 12.84 ± 2.18 CFU/mL to 5.13 ± 0.67 CFU/mL, and from 14.06 ± 3.98 CFU/mL to 4.82 ± 1.05 CFU/mL pre-and post-treatment, respectively. A statistically significant reduction in the bacterial counts of both microbes was observed after treatment among the samples of the both study groups (p < 0.05). Specimens in group-2 (8.42 ± 1.14 MPa) demonstrated the highest mean push-out bond strength, whereas the lowest was shown by samples in group-1 (7.08 ± 1.09 MPa). ANOVA showed no statistical difference between the research groups (p = 0.676). The independent t-test revealed that the mean push-out bond strength scores of the cervical segments were higher than the apical and middle segments of roots in research groups (p < 0.05).

CONCLUSION

In c-shaped root canals, the application of photodynamic therapy as an adjuvant to conventional root canal treatment contributes to a statistically significant decrease in the microbial count of E. faecalis and P. aeruginosa along with an improved push-out bond strength of the root canal filling material with root.

Correlation of Buccal Micronucleus with Disease Activity Score Using Buccal Micronucleus Cytome Analysis (BMCA) in Systemic Lupus Erythematosus

Background:

A disease activity score obtained by using systemic lupus erythematosus disease activity index (SLEDAI) has traditionally been a reliable method to assess the SLE status of patients. More recently, a buccal micronucleus cytome assay (BMCA) has been developed for use as a biomarker of DNA damage in patients with SLE. There has been a very limited number of studies pertaining to the oral lesions in Arab population suffering from SLE in Asir region. Hence, it became utmost important to study epidemiological data of oral mucosal lesions in SLE patients. Distribution of oral lesions in SLE patients could also be helpful in better management of oral complications.

Aim:

The aim of this study was to determine the existence of a correlation between SLEDAI score and the degree of micronuclei (MN) formation using BMCA.

Materials and Methods:

After thorough oral examination of adult Saudi SLE patients of Asir hospital and that of healthy control subjects, the subjects underwent BMCA from normal unaffected bilateral buccal mucosae.

Results:

Pearson's correlation test showed that MN count did not significantly correlate with either disease activity or duration of SLE.

Conclusions:

Controlled state SLE does not lead to a significant increase in MN formation. Thus, the occurrence of premalignant lesions in the oral cavity could be minimized using proper management protocols.

Prevalence and psychological stress in recurrent aphthous stomatitis among female dental students in Saudi Arabia

Introduction

Recurrent Aphthous Stomatitis (RAS) is a common oral mucosal disorder which is characterized by recurrent ulcerations mainly confined to non-keratinized oral mucosa. Though the exact etiology is imprecise, stress and anxiety were found to be linked with the onset of RAS. The present study was directed to know the prevalence of RAS among female dental students in King Khalid University, to find out the association between RAS and psychological stress and the effectiveness of Hospital Anxiety and Depression scale (HADS) in finding out the psychological profile of RAS patients.

Method

122 female dental students of age group 17 to 25 years were selected for the study. Subjects with relevant medical problems and deleterious habits were excluded. A questionnaire comprising general stress related questions and HAD scale were used to assess stress. Those who were giving history of ulcer were diagnosed as RAS based on the clinical features. The questionnaire results were used for statistical analysis and processed.

Result

14% of the total students were having RAS. 70% could correlate the onset of ulcer with certain specific factors; stress being the major causative agent (91%). In HAD scale, 88% of students were having anxiety and 65% had depression; all patients with depression had anxiety.

Conclusion

The prevalence of RAS in female dental students in KKU was around 14%. There is a strong relationship between psychological stress and RAS, as in most of the other studies. HAD scale alone can be used for detecting the psychological factor in RAS.

Synthesis and characterization of graphene oxide sheets integrated with gold nanoparticles and their applications to adsorptive removal and catalytic reduction of water contaminants

Here, we report the facile synthesis of graphene oxide–gold (GO–Au) nanocomposites and their use as adsorbents for the removal of toxic industrial dyes from water and as catalysts for the individual and simultaneous reduction of a dye and a nitro compound in aqueous medium. GO sheets were prepared using a modified Hummers method while Au nanoparticles were integrated on GO sheets by reducing Au(iii) ions on the surfaces of GO sheets using sodium citrate as a reducing agent. The prepared composite was characterized with field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), elemental dispersive X-ray analysis (EDX), X-ray diffraction (XRD), Fourier transform infra-red (FT-IR) spectroscopy and thermal gravimetric analysis (TGA). The GO–Au nanocomposite demonstrated efficient adsorption capacities and recyclability for malachite green (MG) and ethyl violet (EV) dyes. The effects of various experimental parameters including temperature, pH, contact time, and adsorbent dose were studied. From the simulation of experimental data with different adsorption isotherms and kinetic models it was found that the adsorption of both the dyes followed the Freundlich adsorption model and a pseudo-second order kinetic model, respectively. Moreover, the adsorbent showed better recyclability for both dyes without any compromise on the removal efficiency. Similarly, the catalytic performance for the reduction of 2-nitroaniline (2-NA) has been investigated in detail by using the prepared nanocomposite as a catalyst. Most importantly, we reported the simultaneous adsorption of cationic and anionic dyes from water using the prepared nanocomposite as well as the simultaneous catalytic reduction of a mixture of EV and 2-NA. So, considering the facile synthesis process and the efficient removal of a variety of dyes and the catalytic performance this work opens up a tremendous opportunity to bring GO based nanocomposites from experimental research to practically applied materials for wastewater treatment.

Preparation of graphene oxide–gold (GO–Au) nanocomposites as adsorbents and catalysts for decontamination of water.

Gene mapping in an anophthalmic pedigree of a consanguineous Pakistani family opened new horizons for research

Clinical anophthalmia is a rare inherited disease of the eye and phenotype refers to the absence of ocular tissue in the orbit of eye. Patients may have unilateral or bilateral anophthalmia, and generally have short palpebral fissures and small orbits. Anophthalmia may be isolated or associated with a broader syndrome and may have genetic or environmental causes. However, genetic cause has been defined in only a small proportion of cases, therefore, a consanguineous Pakistani family of the Pashtoon ethnic group, with isolated clinical anophthalmia was investigated using linkage mapping. A family pedigree was created to trace the possible mode of inheritance of the disease. Blood samples were collected from affected as well as normal members of this family, and screened for disease-associated mutations. This family was analyzed for linkage to all the known loci of clinical anophthalmia, using microsatellite short tandem repeat (STR) markers. Direct sequencing was performed to find out disease-associated mutations in the candidate gene. This family with isolated clinical anophthalmia, was mapped to the SOX2 gene that is located at chromosome 3q26.3-q27. However, on exonic and regulatory regions mutation screening of the SOX2 gene, the disease-associated mutation was not identified. It showed that another gene responsible for development of the eye might be present at chromosome 3q26.3-q27 and needs to be identified and screened for the disease-associated mutation in this family.

Modeling and experimental validation of hydrodynamics in an ultrasonic batch reactor

Simulation of hydrodynamics in ultrasonic batch reactor containing immobilized enzymes as catalyst is done. A transducer with variable power and constant frequency (24 kHz) is taken as source of ultrasound (US). Simulation comprises two steps. In first step, acoustic pressure field is simulated and in second step effect of this field on particle trajectories is simulated. Simulation results are compared with experimentally determined particle trajectories using PIV Lab (particle image velocimetry). Effect of varying ultrasonic power, positioning and number of ultrasonic sources on particle trajectories is studied. It is observed that catalyst particles tend to orientate according to pattern of acoustic pressure field. An increase in ultrasonic power increases particle velocity and also brings more particles into motion. Simulation results are found to be in agreement with experimentally determined data.

Genetic association analysis of serotonin transporter polymorphism (5-HTTLPR) with type 2 diabetes patients of Pakistani population

AIMS

It is well established that the serotonergic system contributes to the regulation of glucose homeostasis and feeding and therefore it has been presumed to contribute to the biological susceptibility to type 2 diabetes mellitus (T2DM) and body-mass index (BMI). 5-HTTLPR is a serotonin transporter (5-HTT) gene-linked polymorphic region that regulates the transcriptional activity of 5-HTT. Our aim was to investigate the possible association of 5-HTTLPR polymorphism (L and S alleles) in the promoter region of the serotonin transporter gene with T2DM and/or higher BMI in Pakistani population.

METHODS

In this study, 574 subjects diagnosed with T2DM and 402 unrelated normal controls from the general Pakistani population were genotyped for 5-HTTLPR polymorphism by PCR amplification and agarose gel electrophoresis. The genotyping data (S/S, S/L and L/L) were recorded and analysed statistically using various software and online available tools.

RESULTS

In the total sample, patients with type 2 diabetes and controls without diabetes, genotypes were distributed according to Hardy-Weinberg equilibrium, and S allele frequency was 61.52% (0.61). There was no statistical association between 5-HTTLPR polymorphism and the development of T2DM in this Pakistani population (p=0.12).

CONCLUSIONS

No significant statistical association of 5-HTTLPR polymorphism with type 2 diabetes and obesity in Pakistani population shows that 5-HTTLPR polymorphism is not a major factor in determining type 2 diabetes and obesity in Pakistan.

Magnetic Co–Fe bimetallic nanoparticle containing modifiable microgels for the removal of heavy metal ions, organic dyes and herbicides from aqueous media

Poly(methacrylic-co-acrylonitrile) (p(MAc-co-AN)) microgels were prepared and nitrile groups were converted to amidoxime groups by chemical modification.

Subjective image quality comparison between two digital dental radiographic systems and conventional dental film

OBJECTIVES

Digital radiography has become an integral part of dentistry. Digital radiography does not require film or dark rooms, reduces X-ray doses, and instantly generates images. The aim of our study was to compare the subjective image quality of two digital dental radiographic systems with conventional dental film.

MATERIALS & METHODS

A direct digital (DD) 'Digital' system by Sirona, a semi-direct (SD) digital system by Vista-scan, and Kodak 'E' speed dental X-ray films were selected for the study. Endodontically-treated extracted teeth (n = 25) were used in the study. Details of enamel, dentin, dentino-enamel junction, root canal filling (gutta percha), and simulated apical pathology were investigated with the three radiographic systems. The data were subjected to statistical analyzes to reveal differences in subjective image quality.

RESULTS

Conventional dental X-ray film was superior to the digital systems. For digital systems, DD imaging was superior to SD imaging.

CONCLUSION

Conventional film yielded superior image quality that was statistically significant in almost all aspects of comparison. Conventional film was followed in image quality by DD, and SD provided the lowest quality images. Conventional film is still considered the gold standard to diagnose diseases affecting the jawbone.

RECOMMENDATIONS

Improved software and hardware for digital imaging systems are now available and these improvements may now yield images that are comparable in quality to conventional film. However, we recommend that studies still use more observers and other statistical methods to produce ideal results.

A prospective study on Adverse Drug Reactions of antibiotics in a tertiary care hospital

Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. The main aim of this study was to detect and analyze Adverse Drug Reactions of antibiotics in inpatients of a tertiary care hospital. A prospective spontaneous reporting study by active and passive methods was carried out for a period of six months. A total of 49 ADRs were reported during the study period with male predominance (53.06%) and geriatric age group. More number of ADRs was from General Medicine and Pediatric departments in which the most affected organ systems were the GIT (38.77%) and the skin (30.61%). The antibiotic classes mostly accounted were cephalosporins (34.69%) followed by fluoroquinolones and others in which type A reactions were more compared to type B and 59.18% of them were predictable. The severity assessment revealed that most of them were moderate (63.26%) followed by mild and severe reactions. Of the reported reactions, 55.10% were definitely preventable and causality assessment was done which showed that 71.42% of the reactions were probable, possible (18.36%), definite (10.20%) and no reactions were unlikely. The study concluded that Adverse Drug Reactions to antibiotics are common and some of them resulted in increased healthcare cost due to the need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of Adverse Drug Reactions to antibiotics, proper documentation and periodic reporting to regional pharmacovigilance centers to ensure drug safety.

Evaluation of mental foramen position from panoramic dental radiographs

OBJECTIVE

Evaluate the position of mental foramen by measuring the vertical bone height from digital panoramic radiograph and also the variation of resorption pattern by gender and extraction time frame. Materials and methods/study design: Digital panoramic radiographs of 500 patients were reviewed. The study population was divided into four age groups aged 30 to 70 years as (30-39, 40-49, 50-59 and 60-70 years of age). Radiographic Position of mental foramen was evaluated in each panoramic radiograph by measuring the distance from the marginal bone to the mental foramen was being measured. Measurements were taken in each radiograph using Clini-view software. The data collected was subjected to statistical analysis using paired students t-test and chi-square tests.

RESULTS AND CONCLUSION

In our study it was noted that the vertical measurements calculated from the superior margin of mental foramen to the crest of alveolar ridge were greater in edentulous men than in women. This measurement decreased significantly with age. We have noted here that resorption pattern between males and females can be used as an early diagnostic tool and for implant analysis. Studies comparing right and left side edentulous mandibular region are needed for further confirmation.

Highly versatile p(MAc)–M (M: Cu, Co, Ni) microgel composite catalyst for individual and simultaneous catalytic reduction of nitro compounds and dyes

Poly(methacrylic acid) (p(MAc)) microgels were synthesized by inverse suspension polymerization and used as a template for copper, nickel, and cobalt nanoparticle preparation.

Age estimation using third molar teeth: A study on southern Saudi population

OBJECTIVE

To estimate the age of an individual between 13 and 23 years, using Demirjian method in Saudi male patients in the southern region of the Kingdom of Saudi Arabia.

MATERIALS AND METHODS

A total of 360 male patient's digital panoramic radiographs were used to evaluate the morphology of mandibular 3rd molar teeth roots according to the Demirjian method. Using descriptive statistical method, age was calculated.

RESULTS

Result showed a strong relation of age with stages of root development of 3rd molar teeth. The standard deviation of mean of root development stages is 1.47 years of age.

CONCLUSION

This study suggests that age can be predicted with a statistical significant result for ages between 13 and 23. Further studies with large population are needed for better statistical results and for female age assessment.

Choanal atresia treated with transpalatal approach

A case of unilateral choanal atresia (CA) presented in adulthood with unilateral nasal discharge and obstruction, and coloboma of right lower eyelid. Diagnosis of choanal atresia was made with 0 degree telescope and CT scan. It was treated surgically by transpalatal (TP) approach. Stent was kept for 6 weeks. Few adhesions developed, which were broken. There was no other complication in follow-up.

Laryngotracheal reconstruction in total laryngotracheal transection

A case of laryngotracheal trauma (LTT) was brought to hospital in emergency. After securing airway, neck was explored and total laryngotracheal separation together with crushed anterior and posterior tracheal walls was found. Cricotracheal anastomosis and anterior tracheal wall was repaired with perichondrium lined rib graft. Recovery was good, required dilatation once without any serious postoperative complication in close follow-up.

Odontoid Lateral Mass Interval (OLMI) asymmetry and rotary subluxation: a retrospective study in cervical spine injury

The aim of the study was to evaluate the significance of odontoid lateral mass interval (OLMI) asymmetry on open-mouth view, in neck injury patients who have otherwise normal cervical spine x-rays. Thirteen neck injury patients were reviewed. Average age was 23.5 years (range, 16-30 years) and average follow-up was 15 weeks (range, 6-39 weeks). All the patients, referred from the casualty department, had computed tomography (CT) scans because of the OLMI asymmetry to rule out rotary subluxation. Clinically none of the patients had torticollis. CT scans were reported normal except for OLMI asymmetry, in 11 patients. Two patients were reported as having rotary subluxation and one was found, after normal initial plain films, to have an undisplaced lateral mass fracture of the atlas with bony avulsion of the transverse ligament. The average OLMI asymmetry was 3.1 mm (range, 2-4 mm). The authors concluded that although OLMI asymmetry has low sensitivity and specificity for true subluxation or instability, it may be a sign of significant cervical injury and should be evaluated with CT.

Age estimation using three established methods. A study on Indian population

Age estimation is an important factor in the identification of an individual in forensic cases. Adult age determination from teeth was carried out using three methods, namely, Johanson method, methods of Kashyap and Koteswar Rao and the average stage of attrition method (ASA). A total of 100 patients were selected. Johanson and Kashyap method uses microscopic measurements, whereas ASA is purely a clinical method. ASA method was found to be the best method. Unsatisfactory results were seen more in Kashyap's technique. In all the three methods overestimates of age were common in mandibular teeth and in teeth taken from female individuals. More studies are needed in Kashyap's method as there are certain difficulties encountered in measuring a few criteria.

Antegrade locked intramedullary nailing in humeral shaft fractures

Thirty-three humeral nailings were carried out using the Russell-Taylor nail. Twenty-two acute fractures and one non-union united, gave an overall union rate of 70%. Eighteen patients (56%) experienced pain in the shoulder or at the fracture site. Thirteen patients (41%) had poor shoulder function. Only 17 (51%) of the patients were satisfied with the outcome. Fourteen patients (42%) needed further surgery. We conclude that antegrade intamedullary nailing of humeral shaft fractures leads to a substantial risk of non-union and impairment of shoulder function. There was no significant correlation between fracture comminution and fracture healing in our study.

Removal and recovery of heavy metals from electroplating wastewater by using Kyanite as an adsorbent

Kyanite, a commercial mineral has been utilized as an adsorbent for the removal of heavy metals, such as Ni(II), Zn(II), Cr(VI) and Cu(II) from electroplating wastewater. The effect of contact time, pH, concentration, adsorbent doses, particle size of the adsorbent, salinity and hardness, both in natural and wastewater on the adsorption of Cu(II) have been studied in detail. The adsorption of metal ions seems to be an ion exchange process. The adsorbed metals ions from electroplating wastewater were recovered by batch as well as column operation using dilute HCl solution. The column operation was found to be more effective compared to batch process.

Adsorption behaviour of some aromatic amines on pyrolusite and activated carbon and recovery of beta napthylamine from water sample

The adsorption behaviour of Diphenylamine (DPAM), beta napthylamine (beta NAM), alpha napthylamine (alpha NAM) and aniline on pyrolusite and activated carbon has been studied. Pyrolusite shows remarkable sorption capacity for DPAM and beta NAM as compared to aniline; (the adsorption followed the order: Activated Carbon:--> DPAM = beta NAM > alpha Aniline; Pyrolusite: DPAM: --> beta NAM > alpha NAM > Aniline) The maximum adsorption of beta NAM occurred in the concentration range 4-20 microg mL(-1) on pyrolusite (95%) and 4-50 microg mL(-1) on activated carbon (100%). The effect of various doses of activated carbon on the adsorption of beta NAM confirm Langmuir and Freundlich isotherms where as Freundlich isotherm is obeyed by pyrolusite. The adsorption of beta NAM on both the absorbents is not affected in presence of DPAM over a wide range of their initial concentrations (20-60 microg mL(-1)). The desorption studies of beta NAM on pyrolusite was carried out by batch as well as column processes. Excellent results were obtained when a mixture of n-hexane and isopropanol (91:1) was used as eluent.

Adsorption studies on Citrus reticulata (fruit peel of orange): removal and recovery of Ni(II) from electroplating wastewater

The ability of fruit peel of orange to remove Zn, Ni, Cu, Pb and Cr from aqueous solution by adsorption was studied. The adsorption was in the order of Ni(II)>Cu(II)>Pb(II)>Zn(II)>Cr(II). The extent of removal of Ni(II) was found to be dependent on sorbent dose, initial concentration, pH and temperature. The adsorption follows first-order kinetics. The process is endothermic showing monolayer adsorption of Ni(II), with a maximum adsorption of 96% at 50 degrees C for an initial concentration of 50 mg l(-1) at pH 6. Thermodynamic parameters were also evaluated. Desorption was possible with 0.05 M HCl and was found to be 95.83% in column and 76% in batch process, respectively. The spent adsorbent was regenerated and recycled thrice. The removal and recovery was also done in wastewater and was found to be 89% and 93.33%, respectively.

Co-administration of gamma-vinyl GABA and cocaine: preclinical assessment of safety

Gamma-vinyl GABA (GVG, Vigabatrin), an irreversible inhibitor of GABA transaminase (GABA-T) that inhibits cocaine-induced place preference and self administration has been proposed as a treatment for cocaine addiction. It was therefore important to assess if there was an enhanced toxicity from the combination of GVG with cocaine. No mortality was observed with administration of GVG (60 mg/kg i.v.) alone (n=8) or in combination (n=6) with cocaine (5 mg/kg i.v.). Cocaine-induced EKG alterations were not affected by GVG pretreatment. Plasma alanine amino transferase activity was reduced by GVG treatment and this was not further modified by cocaine administration. These results suggest that acute co-administration of GVG and cocaine does not result in immediate cardiovascular or hepatic toxicity of sufficient significance, to preclude further clinical trials.

Application of high-performance liquid chromatography of plasma fatty acids as their phenacyl esters to evaluate splanchnic and renal fatty acid balance in vivo

Plasma fatty acids from renal and hepatic veins, and arterialized hand vein obtained in 20 subjects before and after insulin infusion were separated by reversed-phase high-performance liquid chromatography following phenacyl esterification. Separation and quantification over the range 1.0-100 nmol per injection of nine fatty acids was achieved within 60 min using [2H31]palmitic acid as internal standard. Analytical recoveries were greater than 90% and the intra- and inter-assay coefficients of variation were less than 2.5 and 4.0%, respectively. Following insulin infusion, net splanchnic uptake of total fatty acids decreased from 3.0+/-0.3 to 1.0+/-0.1 micromol/kg min (p<0.01), whereas net renal balance remained neutral (-0.04+/-0.04 vs. -0.06+/-0.03 micromol/kg min, p=N.S.). Individual fatty acid balance varied from a low of 0.012+/-0.005 (myristic acid) to a high of 0.95+/-0.08 (oleic acid) micromol/kg min across the splanchnic tissues and from 0.005+/-0.002 (stearic acid) to 0.21+/-0.1 (oleic acid) micromol/kg min across the kidney. There is a substantial diversity in changes in plasma concentration and regional balance of individual fatty acid during short-term fasting and hyperinsulinemia. This method is simple, accurate, and can be applied to assess individual fatty acid metabolism in vivo.

Effects of beta-adrenergic blockade on hepatic and renal glucose production during hypoglycemia in conscious dogs

To investigate the role of beta-adrenergic mechanisms in the counterregulatory response of the liver and kidney to hypoglycemia, we studied 10 dogs before and after a 2-h constant infusion of insulin (4 mU. kg-1. min-1) either without (n = 4) or with (8 micrograms/min, n = 6) propranolol and variable dextrose to maintain hypoglycemia, 7 days after surgical placement of sampling catheters in left renal and hepatic veins and femoral artery. Systemic glucose appearance (Ra) and endogenous (EGP), hepatic (HGP), and renal (RGP) glucose production were measured by a combination of arteriovenous difference and peripheral infusion of [6-3H]glucose, renal blood flow with a flow probe, and hepatic plasma flow by indocyanine green clearance. Without beta-adrenergic blockade, arterial glucose decreased from 5.12 +/- 0.02 to 2.53 +/- 0.07 mmol/l, glucose Ra increased from 17.8 +/- 0.7 to 30.5 +/- 2.5 (P < 0.01) when EGP was 22.2 +/- 0.5, HGP from 13.5 +/- 1.1 to 19.3 +/- 1.3, and RGP from 2. 4 +/- 1.0 to 8.6 +/- 0.9 micromol. kg-1. min-1 (all P < 0.05). When propranolol was infused, glucose decreased from 5.97 +/- 0.02 to 2. 71 +/- 0.03 mmol/l, glucose Ra increased from 16.3 +/- 1.0 to 25.1 +/- 1.6 when EGP was 9.9 +/- 0.4, HGP decreased from 14.4 +/- 0.7 to 10.4 +/- 0.6, and RGP decreased from 3.8 +/- 1.3 to 1.1 +/- 0.8 micromol. kg-1. min-1 (all P < 0.05). Our data indicate that beta-adrenergic blockade impairs glucose recovery during sustained hypoglycemia, in part, by preventing the simultaneous compensatory increase in HGP and RGP.

Energy metabolism and fuel mobilization: from the perioperative period to recovery

To determine the metabolic responses to surgical trauma, we assessed the rates of whole body (WB) proteolysis and glucose turnover using established isotopic techniques in combination with interorgan amino acid and substrate balances (using arteriovenous differences times flow) after laparotomy. Circulating levels of hormones and mediators known to affect these parameters were also examined. Mongrel dogs (n = 5-8 per group) were studied postoperatively under general anesthesia (immediate postoperative period) and at 3 days postoperatively (3 dPO) and 2 weeks later. Our results show that the immediate postoperative period is characterized by significant hyperglycemia, secondary to decreased glucose clearance (without any alterations in the rates of hepatic glucose production) and significant increase in gut proteolysis, with a mild increase in WB proteolysis. The gut proteolysis accounted for nearly 40% of WB proteolysis. At 3 dPO, blood glucose levels returned to normal, whereas the rate of WB proteolysis was maximally increased. Gut proteolysis was mildly elevated and accounted for nearly 8% of WB proteolysis. All metabolic parameters were back to near basal at 2 weeks postoperatively. These metabolic changes were accompanied by significant elevations in the plasma levels of endogenous morphine and cortisol and lower glucagon and insulin growth factor-I levels in the immediate postoperative period and at 3 dPO. These studies underscore the importance of the gut as a reservoir of amino acids during the immediate postoperative period, accounting for more than one-third of WB proteolysis. At 3 dPO, when maximal stimulation of WB proteolysis and amino acid oxidation are observed, the contribution from the gut is negligible and is most likely replaced by breakdown from skeletal muscle.

Heavy metals: leaching from glazed surfaces of tea mugs

Heavy metals (zinc, lead, cadmium, iron, chromium, copper, manganese, nickel and cobalt) were found to leach from the glazed surfaces of tea mugs collected from 13 different pottery units of Khurja (U.P.) and one each from Ghaziabad (U.P.) and Calcutta (West Bengal) determined under different conditions. The leachates used were: tea at 80 degrees C, orange juice at room temperature and 4% acetic acid at room temperature, 40 degrees C and 60 degrees C, respectively. The volume (capacity) of mugs ranged between 200 and 250 ml. The duration for leaching was 24 h in each case without stirring. The concentrations of metals leached in tea at 80 degrees C were found in the range (in microgram/l): Zn, 236-730; Fe, 98-925; Cr, 62-119; Cu, 63-299; Mn, 710-2670; and Ni, 70-80 micrograms/l. The concentrations of metals leached in orange juice at room temperature were in the range (in microgram/l): Zn, 393-1262; Cd, 25-349; Fe, 122-342; Cr, 66-945; Cu, 135-853; Mn, 166-424; and Ni, 70-134 micrograms/l. The concentrations of heavy metals extracted by 4% acetic acid at room temperature were found in the range (in microgram/l): Zn, 18-192; Fe, 143-372; Cu, 51-190; and Mn, 0-48 micrograms/l; at 40 degrees C (in microgram/l): Zn, 118-837; Fe, 124-639; Cu, 230-722; and Mn, 30-63 micrograms/l and at 60 degrees: Zn, 33-900; Fe, 83-576; Cu, 90-685; and Mn, 43-778 micrograms/l, respectively.

Role of the kidney in plasma glucose regulation during hyperglycemia

Little is known about the role of the kidney in plasma glucose regulation during hyperglycemia. We studied 12 overnight-fasted conscious dogs after either intrarenal (IR, n = 6) or peripheral (PH, n = 6) dextrose infusion to maintain hyperglycemia without glycosuria. Systemic and renal glucose kinetics were measured with [6-3H]glucose, lactate balance was measured by arteriovenous difference, and glycogen content was assayed in the kidneys. Plasma glucose (approximately 5.5 vs. approximately 6.3 mM), insulin (approximately 70 vs. approximately 110 pM), and glucose appearance (approximately 14 vs. approximately 16 mumol.kg-1.min-1 increased comparably in both groups (P < 0.05). In IR, fractional extraction of glucose (FEGlc) increased from 4.1 +/- 0.2 to 16.1 +/- 0.5% (P < 0.001) and lactate balance reversed to renal output (+1.3 +/- 0.2 vs. -0.9 +/- 0.2 mumol.kg-1.min-1, P < 0.01). Glycogen content was twofold higher in the left (127 +/- 33 micrograms/g tissue) than in the right kidney (56 +/- 11 micrograms/g tissue, P < 0.01). In PH, FEGlc decreased from 4.9 +/- 0.6 to 2.2 +/- 0.3% (P < 0.05), renal glucose utilization did not change (approximately 1.3 mumol.kg-1.min-1); and glycogen content was equal in both kidneys (approximately 45 micrograms/g tissue). We conclude that, although the kidney plays a minor role in plasma glucose disposal in physiological hyperglycemia, increased glucose uptake, glycogen storage, and lactate formation precede glycosuria and may represent important mechanisms by which the kidney contributes to normalization of plasma glucose in diabetes.

Gas chromatography - mass spectrometric analysis of four polluted river waters for phenolic and organic compounds

Forty-four water samples from eleven sampling points were collected from four highly polluted rivers of northern India once in each four seasons during 1988-1989. The samples were analyzed for phenol, chlorophenols, a few bromophenols and other organics. Phenol was found to be absent in all the analyzed samples. Trichlorophenol and pentachlorophenol were frequently detected. Comparatively, the Ganges river was most polluted at Kannauj followed by Narora, Kachala and Fatehgarh. Maximum phenols were found at Mathura downstream of the Yamuna river followed by Mathura upstream, Okhla, ITO and none at Wazirabad. No phenols were detected in the water of the rivers Hindon and Kali at Ghaziabad and Aligarh, respectively. Some other organic pollutants were also identified by their mass spectra and supported by data from the computerized library, but, not quantified.