1
|
Dubey D, Roy M, Shah TH, Bano N, Kulshrestha V, Mitra S, Sangwan P, Dubey M, Imran A, Jain B, Velmurugan A, Bakthavatchalam YD, Veeraraghavan B. Compassionate use of a novel β-lactam enhancer-based investigational antibiotic cefepime/zidebactam (WCK 5222) for the treatment of extensively-drug-resistant NDM-expressing Pseudomonas aeruginosa infection in an intra-abdominal infection-induced sepsis patient: a case report. Ann Clin Microbiol Antimicrob 2023; 22:55. [PMID: 37408075 DOI: 10.1186/s12941-023-00606-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
Infections in critically-ill patients caused by extensively-drug-resistant (XDR)-Pseudomonas aeruginosa are challenging to manage due to paucity of effective treatment options. Cefepime/zidebactam, which is currently in global Phase 3 clinical development (Clinical Trials Identifier: NCT04979806, registered on July 28, 2021) is a novel mechanism of action based β-lactam/ β-lactam-enhancer combination with a promising activity against a broad-range of Gram-negative pathogens including XDR P. aeruginosa. We present a case report of an intra-abdominal infection-induced sepsis patient infected with XDR P. aeruginosa and successfully treated with cefepime/zidebactam under compassionate use. The 50 year old female patient with past-history of bariatric surgery and recent elective abdominoplasty and liposuction developed secondary pneumonia and failed a prolonged course of polymyxins. The organism repeatedly isolated from the patient was a New-Delhi metallo β-lactamase-producing XDR P. aeruginosa resistant to ceftazidime/avibactam, imipenem/relebactam and ceftolozane/tazobactam, susceptible only to cefepime/zidebactam. As polymyxins failed to rescue the patient, cefepime/zidebactam was administered under compassionate grounds leading to discharge of patient in stable condition. The present case highlights the prevailing precarious scenario of antimicrobial resistance and the need for novel antibiotics to tackle infections caused by XDR phenotype pathogens.
Collapse
Affiliation(s)
- Dilip Dubey
- Institute of Critical Care medicine, Medanta, Lucknow, India.
| | - Manish Roy
- Institute of Critical Care medicine, Medanta, Lucknow, India
| | - Tajamul H Shah
- Department of Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, India
| | - Noor Bano
- Institute of Critical Care medicine, Medanta, Lucknow, India
| | | | - Sandeep Mitra
- Institute of Critical Care medicine, Medanta, Lucknow, India
| | | | - Madhulika Dubey
- Department of Critical Care Medicine, ERA's Lucknow Medical College and Hospital, Lucknow, India
| | - Ali Imran
- Institute of Critical Care medicine, Medanta, Lucknow, India
| | - Bhawna Jain
- Department of Microbiology, Medanta, Lucknow, India
| | - Aravind Velmurugan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
| | | | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India.
| |
Collapse
|
2
|
Dubey DK, Bano N, Dubey M, Sangwan P, Mitra SK, Kulshrestha V, Jain B, Mehdi I. A case series of melioidosis: An underdiagnosed infection. IDCases 2023; 31:e01685. [PMID: 36691438 PMCID: PMC9860102 DOI: 10.1016/j.idcr.2023.e01685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Melioidosis is an infection caused by Burkholderia pseudomallei. It is a non notifiable disease and is not included in Integrated Disease Surveillance Program by National Center of Disease Control. India is predicted to have highest burden of disease with an estimated mortality of 32,000 per year. Melioidosis presents with a wide range of clinical manifestations like pneumonia, liver and splenic abscess, septicemia etc. This wide spectrum of presentation and mimicry with other infections leads to its misdiagnosis or underdiagnosis. The only source of disease burden in India is few case reports and the true burden and distribution of disease still needs to be assessed. We, hereby, report a case series of four cases aged 28 years, 53 years, 33 years and 22 years. All cases had different clinical presentation ranging from abdominal wall abscess to septicemia and neurological manifestations making the diagnosis challenging. Three of the four cases were discharged after complete recovery while one case went leave against medical advice. To our knowledge this is the first series describing complete recovery of three out of four cases. This case series will help the physicians to raise their index of clinical suspicion of melioidosis in high risk patients presenting with various findings thus improving the chances of correct diagnosis and treatment.
Collapse
Affiliation(s)
- Dilip Kumar Dubey
- Institute of Critical Care and Pulmonary Medicine, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Noor Bano
- Institute of Critical Care and Pulmonary Medicine, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Madhulika Dubey
- Department of Anaesthesiology and Critical Care, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003, India,Correspondence to: A-1005, Azea Botanica Apartments, Sector 11, Vrindavan Yojna, Lucknow, Uttar Pradesh 226029, India.
| | - Pushpender Sangwan
- Institute of Critical Care and Pulmonary Medicine, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Sandeep Kumar Mitra
- Institute of Critical Care and Pulmonary Medicine, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Vidushi Kulshrestha
- Institute of Critical Care and Pulmonary Medicine, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Bhawna Jain
- Department of Microbiology, Medanta Hospital, Lucknow, Uttar Pradesh 226030, India
| | - Imran Mehdi
- Department of Anaesthesiology and Critical Care, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003, India
| |
Collapse
|
3
|
Kumar G, Tewari S, Sangwan P, Tewari S, Duhan J, Mittal S. The effect of an intraorifice barrier and base under coronal restorations on the healing of apical periodontitis: a randomized controlled trial. Int Endod J 2019; 53:298-307. [PMID: 31587317 DOI: 10.1111/iej.13231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the effect of intraorifice barriers and bases on the healing of apical periodontitis following root canal treatment in mandibular molars. METHODOLOGY A total of 120 permanent mandibular molars with necrotic pulps and periapical radiolucencies (PAI score ≥ 3) were recruited. Root canal treatment was performed in all teeth using a standard protocol, following which they were randomly allocated to one of the three treatment groups: intraorifice barrier group: coronal 3-mm gutta-percha was removed and replaced with glass-ionomer cement (GIC) barrier. The floor of the pulp chamber was then sealed with 2-mm-thick GIC base followed by final composite resin restoration; base group: received 2-mm-thick GIC base before placement of composite resin restoration; and control group: had pulp chamber entirely filled with composite resin only. Follow-up was done at 3, 6, 9 and 12 months. Combination of clinical and radiographic parameters were used to assess treatment outcome. The data were analysed using Kruskal-Wallis, chi-square and Wilcoxon signed-rank tests and logistic regression analysis. RESULTS At the end of 12 months, the base group had the most favourable healing (97.1%), whilst the control group had the least favourable healing (83.8%). The intraorifice barrier group had healing of 92.1%. However, there was no significant difference in healing between groups at the end of the follow-up period (P > 0.05). Additional subgroup analysis revealed a nonsignificant effect of periodontal status and root filling level on periapical healing. CONCLUSION The use of an additional barrier under permanent restorations did not significantly improve the outcome of primary root canal treatment in posterior teeth after 12 months. However, its influence in the long term requires further evaluation.
Collapse
Affiliation(s)
- G Kumar
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - S Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - P Sangwan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - S Tewari
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - J Duhan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - S Mittal
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| |
Collapse
|
4
|
Parmar PD, Dhamija R, Tewari S, Sangwan P, Gupta A, Duhan J, Mittal S. 2D and 3D radiographic outcome assessment of the effect of guided tissue regeneration using resorbable collagen membrane in the healing of through‐and‐through periapical lesions – a randomized controlled trial. Int Endod J 2019; 52:935-948. [DOI: 10.1111/iej.13098] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/11/2019] [Indexed: 11/27/2022]
Affiliation(s)
- P. D. Parmar
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - R. Dhamija
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - S. Tewari
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - P. Sangwan
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - A. Gupta
- Department of Oral Medicine & Radiology Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - J. Duhan
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| | - S. Mittal
- Department of Conservative Dentistry & Endodontics Postgraduate Institute of Dental Sciences (PGIDS) Rohtak Haryana India
| |
Collapse
|
5
|
Malav K, Singariya G, Mohammed S, Kamal M, Sangwan P, Paliwal B. Comparison of 0.5% Ropivacaine and 0.5% Levobupivacaine for Sciatic Nerve Block Using Labat Approach in Foot and Ankle Surgery. Turk J Anaesthesiol Reanim 2017; 46:15-20. [PMID: 30140496 DOI: 10.5152/tjar.2017.03411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/28/2017] [Indexed: 11/22/2022] Open
Abstract
Objective Compared to ropivacaine, levobupivacaine is more lipophilic and a more potent vasoconstrictor. The study was conducted to compare the effect of 0.5% ropivacaine and 0.5% levobupivacaine in sciatic nerve block using conventional Labat approach in foot and ankle surgery. Methods A prospective double-blind, randomised study was carried out in 100 patients of either sex, aged between 20 to 60 years, and American Society of Anesthesiologist (ASA) grades I and II. Patients were randomly allocated into groups R and L of 50 each with 0.5% ropivacaine and 0.5% levobupivacaine, respectively, for sciatic nerve block using the Labat approach. We assessed the onset and duration of sensory and motor block, duration of analgesia, consumption of analgesic, and any untoward effect over 24 hours. Results Both the groups were comparable with regard to demographic variables and onset of sensory and motor block (p>0.05). Group L compared to group R had significantly longer median (95% confidence interval) duration of sensory block (647.50 min [624.99-674.41] vs. 535 min [524.77-559.83], respectively; p<0.0001) as well as motor block (1065.0 min [1054.5-1068.90] and 945 min [947.13-1013.30], respectively; p<0.0001). Postoperative analgesia also lasted significantly longer in group L compared to group R (1320 min [1273.4-1321.8] vs. 840 min [759.23-812.77]; p<0.0001]). Patients in group L had significantly better visual analogue scale (VAS) score and lesser consumption of analgesics (p<0.0001). None of the groups developed any adverse effect over the observation period. Conclusion Levobupivacaine provides prolonged postoperative analgesia in sciatic nerve block with reduction in postoperative analgesic consumption.
Collapse
Affiliation(s)
- Khushboo Malav
- Department of Anaesthesiology and Critical Care, Dr. S.N. Medical College, Jodhpur, India
| | - Geeta Singariya
- Department of Anaesthesiology and Critical Care, Dr. S.N. Medical College, Jodhpur, India
| | - Sadik Mohammed
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India
| | - Manoj Kamal
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India
| | - Pushpender Sangwan
- Department of Anaesthesiology and Critical Care, Dr. S.N. Medical College, Jodhpur, India
| | - Bharat Paliwal
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India
| |
Collapse
|
6
|
Sangwan P, Srinivasan B, Janweja S, Jangid S. Anesthetic considerations in a parturient with renal tubular acidosis and hypothyroidism undergoing cesarean delivery. Int J Obstet Anesth 2017; 33:78-80. [PMID: 29029882 DOI: 10.1016/j.ijoa.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 08/06/2017] [Accepted: 08/11/2017] [Indexed: 11/18/2022]
Abstract
Renal tubular acidosis, associated with hypothyroidism, is rare. We present the case of a woman with known renal tubular acidosis and treated hypothyroidism who underwent emergency cesarean delivery under uneventful combined spinal-epidural anesthesia. The rationale for choosing the anesthetic technique and the potential risks associated with anesthesia and renal tubular acidosis are discussed.
Collapse
Affiliation(s)
- P Sangwan
- Department of Anesthesia and Intensive Care, Dr. Sampurnanand Medical College, Jodhpur 342003, India.
| | - B Srinivasan
- Department of Anesthesia and Intensive Care, Dr. Sampurnanand Medical College, Jodhpur 342003, India
| | - S Janweja
- Department of Anesthesia and Intensive Care, Dr. Sampurnanand Medical College, Jodhpur 342003, India
| | - S Jangid
- Department of Anesthesia and Intensive Care, Dr. Sampurnanand Medical College, Jodhpur 342003, India
| |
Collapse
|
7
|
Middha M, Sangwan P, Tewari S, Duhan J. Effect of continuous ultrasonic irrigation on postoperative pain in mandibular molars with nonvital pulps: a randomized clinical trial. Int Endod J 2016; 50:522-530. [DOI: 10.1111/iej.12666] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/26/2016] [Indexed: 01/23/2023]
Affiliation(s)
- M. Middha
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - P. Sangwan
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - S. Tewari
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - J. Duhan
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| |
Collapse
|
8
|
Saini HR, Sangwan P, Sangwan A. Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial. Int Endod J 2015; 49:1116-1123. [DOI: 10.1111/iej.12583] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 11/12/2015] [Indexed: 11/27/2022]
Affiliation(s)
- H. R. Saini
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - P. Sangwan
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - A. Sangwan
- Postgraduate Institute of Dental Sciences (PGIDS); Rohtak India
| |
Collapse
|
9
|
Arora M, Sangwan P, Tewari S, Duhan J. Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial. Int Endod J 2015; 49:317-24. [PMID: 25866134 DOI: 10.1111/iej.12457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/08/2015] [Indexed: 01/09/2023]
Abstract
AIM To evaluate the association between apical patency and post-operative pain in posterior teeth with pulp necrosis and apical periodontitis. METHODOLOGY Sixty-eight patients requiring primary root canal treatment in mandibular first molars with necrotic pulps and apical periodontitis were included. The patients were randomly allocated to one of two groups: patency (n = 34) and nonpatency (n = 34). After administering local anaesthesia, root canal preparation was completed using ProTaper rotary instruments. A size 10 K-file was used as a patency file and carried 1 mm beyond the working length (WL) between each instrument change in the patency group, while it was carried up to WL in the nonpatency group. Patients were asked to record their pain experience on a pain chart daily for 7 days. Three patients (two in the patency group, one in the nonpatency group) did not return with completed pain charts on the subsequent visit, resulting in a total of 65 patients for the final analysis (patency, n = 32; nonpatency, n = 33). Data was analysed using Chi Square test, t-test, Mann-Whitney test and Wilcoxon Signed Ranks test. RESULTS Overall, 43% of the patients experienced post-operative pain. The patency group had less incidence of pain (34%) as compared to the nonpatency group (52%), but the difference was not significant (P = 0.163). CONCLUSION Maintenance of apical patency during chemomechanical preparation had no significant influence on post-operative pain in posterior teeth with necrotic pulps and apical periodontitis.
Collapse
Affiliation(s)
- M Arora
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - P Sangwan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - S Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - J Duhan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| |
Collapse
|
10
|
Gupta A, Duhan J, Tewari S, Sangwan P, Yadav A, Singh G, Juneja R, Saini H. Comparative evaluation of antimicrobial efficacy of Syzygium aromaticum, Ocimum sanctum and Cinnamomum zeylanicum plant extracts against Enterococcus faecalis: a preliminary study. Int Endod J 2013; 46:775-83. [PMID: 23506110 DOI: 10.1111/iej.12058] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 01/01/2013] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the antimicrobial efficacy of Ocimum sanctum, Cinnamomum zeylanicum, Syzygium aromaticum and 3% sodium hypochlorite (NaOCl) against Enterococcus faecalis in planktonic suspension and biofilm phenotypes. METHODOLOGY The antibacterial efficacy of different concentrations of aqueous ethanolic extracts of O. sanctum, C. zeylanicum and S. aromaticum against E. faecalis at various time intervals was assessed using the agar well diffusion test, microdilution test and biofilm susceptibility assay (BSA) on cellulose nitrate membrane as well as in a tooth model. NaOCl was used as the positive control. Distilled water was used as negative control for agar diffusion and microdilution tests and phosphate-buffered saline for the BSA. The results of the agar diffusion test were analysed statistically using anova and Tukey's tests. RESULTS Cinnamomum zeylanicum, S. aromaticum and O. sanctum exhibited minimum bactericidal concentration at 10%, 10% and 40%, respectively. Cinnamomum zeylanicum, S. aromaticum, O. sanctum and NaOCl showed complete bacterial inhibition in planktonic form after exposure of 30, 15, 35 and 1 min, respectively. In BSA on cellulose nitrate membrane, NaOCl was associated with complete bacterial inhibition after contact of 2 min, whilst 10% C. zeylanicum, 10% S. aromaticum and 40% O. sanctum showed cessation of growth after 12, 12 and 24 h, respectively. The results of BSA on tooth model were similar except for O. sanctum, which was not included in the model. CONCLUSION Cinnamomum zeylanicum, S. aromaticum and O. sanctum demonstrated antimicrobial activity against planktonic and biofilm forms of E. faecalis with C. zeylanicum and S. aromaticum having better antimicrobial efficacy than O. sanctum. NaOCl had superior antimicrobial efficacy amongst all the groups.
Collapse
Affiliation(s)
- A Gupta
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Sangwan P, Sangwan A, Duhan J, Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J 2012; 46:3-19. [PMID: 22889347 DOI: 10.1111/j.1365-2591.2012.02101.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 06/25/2012] [Indexed: 11/30/2022]
Abstract
Calcium hydroxide has been used extensively in dentistry for a century. Despite its widespread use as a pulp-capping agent, its mechanisms of action still remain ambiguous. Understanding its modes of action will lead to a broader understanding of the mechanisms associated with induced dentinogenesis and help in optimizing the currently available agents to target specific regenerative processes to obtain the best possible clinical outcomes. A literature search relating to mechanisms of dentinogenesis of calcium hydroxide up to December 2011 was carried out using pubmed and MEDLINE database searches as well as manual searching of cross-references from identified studies. Resulting suggestions regarding dentinogenic mechanisms of calcium hydroxide range from direct irritating action of the material to induction of release of biologically active molecules. The purpose of this article is to discuss various mechanisms through which calcium hydroxide may induce tertiary dentinogenesis in the light of observations made in included studies.
Collapse
Affiliation(s)
- P Sangwan
- Department of Conservative Dentistry, Government Dental College, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India.
| | | | | | | |
Collapse
|
12
|
Sangwan P, Kaushik CP, Garg VK. Vermicomposting of sugar industry waste (press mud) mixed with cow dung employing an epigeic earthworm Eisenia fetida. Waste Manag Res 2010; 28:71-75. [PMID: 19748951 DOI: 10.1177/0734242x09336315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In India, millions of tons of press mud (PM) are generated by sugar mills every year. This paper reports the potential of vermitechnology to convert sugar industry waste PM mixed with cow dung (CD) into vermicompost, employing an epigeic earthworm Eisenia fetida. A total of six different reactors were established having different ratios of PM and CD including one control (CD only). The growth and fecundity of E. fetida was monitored for 13 weeks. Maximum growth was recorded in 100% CD, but earthworms grew and reproduced favourably up to 1:1 PM and CD feed composition. However, greater percentages of PM in different reactors significantly affected the growth and fecundity of worms. Vermicomposting resulted in a decrease in carbon concentration and an increase in nitrogen, phosphorus and calcium concentrations of the vermicompost. Investigations indicated that vermicomposting could be an alternative technology for the management of PM into useful fertilizing material, if mixed at maximum 50% with CD.
Collapse
Affiliation(s)
- P Sangwan
- Department of Environmental Science and Engineering, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | | | | |
Collapse
|