bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of ACE Polymorphism in Acute Ischemic Stroke
Authors: Goyal Ankit , Saluja Alvee , Saraswathy Kallur N , Bansal Priya , Dhamija Rajinder K
Published: September 2024

Background:

Stroke is one of the leading causes of death and disability in India. Angiotensin-converting enzyme (ACE) is involved in the development of hypertension, atherosclerosis, cardio, and cerebrovascular disease and is a plausible genetic candidate for stroke. The role of ACE polymorphism is still uncertain and requires further investigation.

Objective:

The aim of this study was to study the role of ACE insertion/deletion polymorphism in acute ischemic stroke (AIS).

Materials and Methods:

One hundred thirty AIS cases and 130 age and sex matched healthy controls were recruited. Ten milliliters venous blood was drawn and 6 mL of blood was used for routine hematological, biochemical tests. Remaining 4 mL of EDTA blood was used for DNA extraction, PCR amplification, and restriction digestion. Three genotypes (II, ID, and DD) were visualized on 3% agarose gel. Association between genotypes among stroke case was done by Chi-square test with P value <0.05 taken as significant.

Results:

DD genotype was significantly associated with the risk of stroke with P value of 0.0001. Both the dominant and recessive models showed that the DD genotype was independently associated with an increased risk of ischemic stroke (OR = 20.732; 95% CI: 2.7241–157.7864; P value = 0.003 for the recessive model and OR = 2.848; 95% CI: 1.5127–5.3649; P value = 0.001 for dominant model).

Conclusions:

Our study showed a strong association between ACE polymorphism and the risk of AIS. This study paves the way for further studies to confirm the role of ACE polymorphism as genetic risk factors for AIS.
Lead Encephalopathy with Distinctive Brain Magnetic Resonance Imaging Findings
Authors: Patwardhan Ameya , Atchayaram Nalini , Saini Jitender , Girija Manu S , Annapureddy Jagadish , Alumkadavath Mishab , Chawla Tanushree , Shingavi Leena , Vengalil Seena
Published: September 2024

Lead poisoning is a multisystem disorder, more commonly affecting children. Occupational exposure, traditional medicines, and contaminated alcohol have been associated with lead encephalopathy in adults. Herein, we report a patient of lead toxicity presenting to the emergency services as acute encephalopathy with symptomatic hyponatremia and chronic recurrent abdominal colic and vomiting. This 50-year-old battery mechanic had multisystem involvement with anemia, basophilic stippling, lead line on the gums, and chronic hypertension. The blood lead level was more than 65 mcg/dL. Computed tomography of the brain showed intracranial calcifications and the MRI brain showed bilateral symmetric involvement of the thalamus, basal ganglia, brainstem, and external capsule. His sensorium improved rapidly after the correction of hyponatremia, however, apathy and psychomotor slowing persisted. This case highlights the importance of recognizing clinical markers and characteristic imaging findings, which can provide clues to an early diagnosis of this otherwise rare clinical condition, and prompt chelation therapy and avoid further lead exposure.
Acute Lead Encephalopathy Secondary to Ayurvedic Medication Use
Authors: Raut Tushar P , Gholap Gopal , Shaikh Saud , Mani Jayanti , Sanghvi Darshana , Bhatt Mohit
Published: September 2024

Ayurvedic medicine is an ancient and traditional system of health care. It is safe but inadvert and unsupervised use can lead to serious health complications. Lead is a common constituent of these medicines. Here authors describe two cases of lead encephalopathy as a result of long-term ayurvedic medication intake. First case was a 54-year-old female taking ayurvedic medications since long time presented with acute confusional state and memory disturbances with abdominal pain. MRI brain showed symmetric basal ganglia and cortical signal changes and edema with significantly elevated lead levels in blood. She responded to chelation therapy with oral penicillamine with complete clinical and radiological resolution. Second case presented was a 45-year female taking ayurvedic medications for hypertension presented with headaches and rapid deterioration in sensorium leading to coma and death. MRI brain showed diffuse cerebral edema with basal ganglia signal changes with elevated lead levels in blood. These two cases highlight the need for increased awareness that some Ayurvedic medicines may contain potentially harmful levels of lead and people who use them are at risk of developing associated toxicity which can even be fatal.
Sagittal Balance Correction in Cervical Compressive Myelopathy
Authors: Panigrahi Manas , Patel Chirag , Chandrasekhar M Y B V K , Vooturi Sudhindra
Published: September 2024

Background:

Laminectomy with lateral mass and transfacet fixation are widely accepted surgical techniques for cervical compressive myelopathy (CCM).

Objective:

To evaluate multilevel fixation with additional fixation of C7-T1 transfacet junction may help achieve better surgical outcome both in short- and long-term follow-up.

Material and Methods:

Based on utilizing C7-T1 transfacet junction fixation, 102 consecutive patients undergoing surgery for CCM were divided into Group A: cervical laminectomy with lateral mass fixation only, and Group B: cervical laminectomy and lateral mass fixation including C7-T1 transfacet junction in fixation. The groups were compared for at 3 months and 2 years postsurgery for persistence of preoperative symptoms, neurological outcome, and sagittal balance (T1 slope) of cervical spine.

Results:

The average age of the study population was 59.11 ± 12.05 years with 71 (69.6%) men. There were no significant differences between the groups neither for presenting complaints nor for postoperative complications. Patients in group B had lesser length of postsurgical hospital stay (7.57 ± 6.61 vs 5.55 ± 1.81; P = 0.018). At 3 months follow-up, patients in group B had higher motor power of upper limb (3.64 ± 1.91 vs 4.47 ± 0.57; P < 0.001), lower limbs (5.07 ± 1.72 vs 5.92 ± 1.13; P = 0.005), and total modified Japanese orthopedic association score (MJOS) score (13.68 ± 3.42 vs 15.51 ± 1.87; P = 0.001). Patients in groups B had lower postoperative T1 slope scores (26.93 ± 8.73 vs 17.60 ± 4.97; P = <0.001). At 2 years follow-up of 53 patients, patients in group B had a better upper limb motor function (3.77 ± 1.14 vs 4.44 ± 0.50; P = 0.021) and total MJOS score (13.85 ± 3.49 vs. 15.37 ± 1.86; P < 0.052).

Conclusion:

Normalizing sagittal balance in patients with CCM by cervical laminectomy and posterior fixation including cervical thoracic junction (C7-T1 transfacet junctional fixation) may significantly improve neurological outcome both in short-term and long-term follow-up.
Cortical and Subcortical Brain Area Atrophy in SCA1 and SCA2 Patients in India
Authors: Tamuli Dibashree , Kaur Manpreet , Sethi Tavpritesh , Singh Anup , Faruq Mohammed , Jaryal Ashok K , Srivastava Achal K , Kumaran Senthil S , Deepak Kishore K
Published: September 2024

Introduction:

Genetically defined spinocerebellar ataxia (SCA) type 1 and 2 patients have differential clinical profile along with probable distinctive cortical and subcortical neurodegeneration. We compared the degree of brain atrophy in the two subtypes with their phenotypic and genotypic parameters.

Methods:

MRI was performed using a 3T scanner (Philips, Achieva) to obtain 3D T1-weighted scans of the whole brain and analyzed by FreeSurfer (version 5.3 and 6 dev.) software. Genetically proven SCA1 (n = 18) and SCA2 (n = 25) patients with age-matched healthy controls (n = 8) were recruited. Clinical severity was assessed by the International Cooperative Ataxia Rating Scale (ICARS). To know the differential pattern of atrophy, the groups were compared using ANOVA/Kruskal-Wallis test and followed by correlation analysis with multiple corrections. Further, machine learning-based classification of SCA subtypes was carried out.

Result:

We found (i) bilateral frontal, parietal, temporal, and occipital atrophy in SCA1 and SCA2 patients; (ii) reduced volume of cerebellum, regions of brain stem, basal ganglia along with the certain subcortical areas such as hippocampus, amygdala, thalamus, diencephalon, and corpus callosum in SCA1 and SCA2 subtypes; (iii) higher subcortical atrophy SCA2 than SCA1 (iv) correlation between brain atrophy and disease attributes; (v) differential predictive pattern of two SCA subtypes using machine learning approach.

Conclusion:

The present study suggests that SCA1 and SCA2 do not differ in cortical thinning while a characteristic pattern of subcortical atrophy SCA2 > SCA1 is observed along with correlation of brain atrophy and disease attributes. This may provide the diagnostic guidance of MRI to SCA subtypes and differential therapies.
ApoE ε4 and IL-6-174G/C Polymorphism may Lead to Early Onset of Alzheimer's Disease with Atypical Presentation
Authors: Chakraborty Sayantan , Joardar Anindita , Roy Sarnava , Gangopadhyay Gautam , Biswas Atanu
Published: September 2024

Background:

Alzheimer's disease (AD) is the most common cause of dementia. Although genetic mutations are known in rare familial form, exact cause of neurodegeneration in sporadic AD is still unknown. While ApoE ε4 and IL-6 C-174G/C patterns have been found to increase the risk of AD in Caucasians, the results are inconsistent in other ethnic groups.

Objective:

The aim of this study was to evaluate the effect of ApoE and IL-6-174G/C polymorphisms among patients of AD in the Eastern part of India.

Materials and Methods:

Consecutive patients of probable AD diagnosed as per National Institute on Aging-Alzheimer's Association (NIA-AA) criteria with age, gender, and education-matched healthy controls were recruited between December 2015 and September 2018. Patients were clinically evaluated and along with controls were genotyped for ApoE and IL-6-174G/C polymorphisms by the polymerase chain reaction method.

Results:

A total 115 patients and 162 controls showed a similar pattern of ApoE and IL-6-174G/C polymorphism pattern. While ε3ε3 and GG patterns were the commonest, followed by ε3ε4 and GC pattern in ApoE and IL-6 respectively, the effect of ApoE ε4 and IL-6-174 C allele on AD symptoms could not be established. However, patients with onset before 50 years were found to have significantly higher proportion of ApoE ε4 and C allele of IL-6-174 in comparison to patients with onset above 50. These young patients were also having more atypical presentation than their older counterpart.

Conclusion:

Our study revealed a novel role of both ApoE ε4 and C allele of IL-6-174 together in developing early onset AD with more atypical clinical features.
Anesthetic Management of Hashimoto's Encephalopathy Presenting for Spine Surgery
Authors: Nedunchezhian Aishvarya S , Hrishi Ajay P , Ajayan Neeraja , Prathapadas Unnikrishnan , Sethuraman Manikandan
Published: September 2024

Hashimoto's encephalopathy (HE) is a rare neuroendocrine disorder, and there are no reports regarding anesthetic implications in a patient diagnosed with HE. These patients can have a plethora of systemic manifestations involving cardiovascular, respiratory, renal, gastrointestinal, hematologic, and central nervous systems. Once diagnosed, meticulous preoperative assessment is essential to rule out systemic involvement and to reduce the perioperative morbidity. Perioperative steroid therapy, neuromonitoring in the perioperative period, opioid free analgesia, and avoidance of nephrotoxic drugs are of paramount importance in the management of such patients. Awareness of the clinical condition and extreme vigilance can detect relapses in the perioperative period. Thus, a meticulous preoperative assessment, balanced anesthesia, perioperative neuromonitoring, and steroid therapy are essential to reduce the perioperative morbidity.
Effect of Monochromatic Infrared Energy on Quality of Life and Intraepidermal Nerve Fiber Density in Painful Diabetic Neuropathy
Authors: Rastogi Ashu , Uppula Pavan , Saikia Uma , Bhansali Anil
Published: September 2024

Background:

Monochromatic infrared energy (MIRE) has evoked mixed results for symptomatic relief of painful diabetic peripheral neuropathy (DPN). However, intraepidermal nerve-fiber density (IENFD) the gold standard for small-fiber neuropathy has not been evaluated.

Objective:

We assessed the IENFD, pain symptoms and quality of life (QoL) with MIRE therapy compared to placebo in painful DPN.

Material and Methods:

Participants with type 2 diabetes and painful DPN were randomized to receive MIRE or sham therapy dosed thrice a week for 12 weeks. Quantitative assessment of IENFD was performed from 3 mm skin punch-biopsy specimens at baseline and after 12 weeks. We also assessed the QoL with Norfolk QOL, symptom severity with visual analogue scale (VAS), and neuropathy assessment with Michigan neuropathy severity instrument and neuropathy disability score.

Results:

Thirty-eight participants were enrolled and 30 completed the study protocol. The mean age of participants in MIRE cohort was 59.1 ± 9.2 years, duration of diabetes 12.9 ± 3.1 years, and symptom duration of 3.9 ± 3.7 months. The mean IENFD was 0.90 ± 0.73/mm2 (P < 0.01) and 1.71 ± 1.11/mm2 in the MIRE cohort and 0.60 ± 0.89/mm2 and 2.17 ± 0.98/mm2 (P < 0.01) in sham cohort at baseline and after 3 months. The median decline in VAS was 5.1 (4.0-7.6) and 3.0 (0.4-5.6) points (intergroup difference, P = 0.01); and an increase in Norfolk QoL-DN by 15 (11-18) and 4 (4-14.2) points (intergroup difference, P = 0.021) in MIRE and sham cohort, respectively after 3 months.

Conclusions:

MIRE therapy does not increase IENFD over short-term usage. However, MIRE therapy provides symptomatic benefit and improves QoL in patients with painful DPN.
Pure Neuritic Leprosy with Bilateral Foot Drop and Central Nervous Involvement
Authors: Bhoi Sanjeev K , Naik Suprava , Purkait Suvendu
Published: September 2024

Background:

Central nervous system (CNS) involvement in leprosy is sparsely documented. Neurophysiological tests and magnetic resonance imaging (MRI) helps in demonstrating CNS involvement in the patient of pure neuritic leprosy.

Objectives:

To demonstrate CNS involvement in pure neuritic leprosy.

Methods:

Detailed clinical presentation and skin lesions were evaluated. Sural nerve biopsy, MRI diffusion tensor imaging of spinal cord and optic nerve were performed. Visual evoked potential and tibial somatosensory evoked potential were done. Their clinical, electrophysiological, and MRI were done at follow-up visits.

Results:

We report three patients of pure neuritic leprosy with bilateral foot drop as the initial presentation. MRI T2W sequence of cervico dorsal cord showed dorsal column hyperintensity in two patients. Diffusion-weighted MR revealed decrease fractional anisotropy and an increase in the apparent diffusion coefficient. Similar findings were also noted in the optic nerves. The patients were managed with multidrug therapy multibacillary regimen and steroid in tapering dose. At follow-up, they showed clinical improvement in vision and power of ankle dorsiflexor.

Conclusions:

Patients of pure neuritic leprosy may manifest with bilateral foot drop with the involvement of posterior column and cranial nerves.
A Rare Case of Primary Pituitary Tubercular Abscess Mimicking a Pituitary Adenoma
Authors: Gotecha Sarang , Chugh Ashish , Punia Prashant , Kotecha Megha , Kashyap Dushyant
Published: September 2024

Primary pituitary tuberculosis (PTA) is a very rare disease. The clinical diagnosis is difficult as it is clinically radiologically indistinguishable from other sellar lesions. We present a case of PTA without any predisposing etiology and radiologically mimicking a pituitary macroadenoma. The patient underwent endoscopic transsphenoidal resection where pus admixed with mucoid was seen coming out of the lesion intraoperatively. Histology of the cyst wall was suspective of tuberculous etiology and QuantiFERON Tb Gold done for confirmation was positive. Postoperatively patient showed obvious improvement in visual symptoms. Patient developed diabetes insipidus and was put on desmopressin and was started with anti-tuberculosis medication for 18 months. Timely surgical intervention followed by anti-tubercular therapy and hormone replacement is the mainstay of treatment in these cases. For intraoperative management, we advise thorough wash with antibiotic and saline rather than curetting the walls of the abscess to decrease the postoperative incidence of endocrine abnormalities.
Prevalence and Factors Associated with “Ever Use of Smokeless Tobacco” among Participants Attending Life Skills Training and Counseling Services Program Across Karnataka from 2017 to 2022
Authors: Sonia Therat , Pradeep Banandur S. , Sukumar Gautham M. , Shenoy Anusha B. , Arvind Banavaram A. , Srividya R. N. , Rai Veeksha , Medhi Upashana , Devyani Azad
Published: September 2024

Introduction:

Smokeless tobacco (SLT) use is an intermediate risk factor for various noncommunicable diseases. Identifying the risk factors associated with ever use of SLT is important when we focus on the prevention of its initiation.

Objectives:

To estimate the prevalence and identify the factors associated with ever use of SLT among participants attending life skills training and counseling services program across Karnataka from 2017 to 2022.

Methodology:

Pretraining data of 3104 participants from 108 training programs between 2017 and 2022 were utilized. Univariate and multivariable logistic regression analysis was performed with various hypothesized exposure variables based on a conceptual framework and ever use of SLT as the outcome.

Results:

The overall prevalence of ever use of SLT among participants was 4.2%. Being men (adjusted odds ratio [AOR] = 7.05, 95% confidence interval [CI]: 1.68–29.57), having a diagnosed health problem (AOR = 1.88, 95% CI: 1.23–2.87), use of smoked tobacco products (AOR = 21.76, 95% CI: 13.79–34.33), use of SLT products among peers (AOR = 3.88, 95% CI: 2.43–6.21) significantly increased the odds of ever use of SLT while every unit increase in the environmental quality of life score (AOR = 0.98, 95% CI: 0.96–0.99) was significantly associated with reduced odds of ever use of SLT.

Conclusion:

This study contributes to a growing understanding of factors associated with ever use of SLT products. Gender, use of smoked tobacco, peer influences, and environmental quality of life needs to be stressed on while targeting SLT initiation, especially among teachers. Our study provides important insights while planning cost-effective health promotion interventions, specifically in countries like India.
Comparative evaluation between guided endodontics and conventional techniques for calcific metamorphosis – A systematic review and meta-analysis
Authors: Banka Aanchal , Patri Gaurav , Pradhan Prasanti Kumari , Lath Harshita
Published: September 2024

The aim of the study was to review and determine whether guided endodontic treatment or conventional technique is a better treatment alternative for patients with calcific metamorphosis. The review was done according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement (PRISMA) guidelines. Databases were searched from 2000 to December 2022 for studies reporting the treatment of calcific metamorphosis through guided endodontic treatment or conventional technique. Quality assessment of the included was evaluated using the critical checklist put forward by the Joanna Briggs Institute for case reports, while for the included in vitro studies, the critical checklist put forward by the Critical Appraisal Skills Program was used. Results were plotted through pooled forest plots and publication bias was explored through funnel plots using RevMan (Review manager) 5.3 version. Summary statistic measure in the form of standardized mean difference (SDM) was used. Five studies were included in qualitative synthesis and three studies for quantitative synthesis. The pooled estimate (SMD) of −0.97 (−1.83–0.10) favors guided endodontic treatment employing a random effect model with an I
2 (heterogeneity) value of 83% and a P = 0.03. Publication bias showed symmetric distribution with a systematic heterogeneity. These procedures and techniques are highly promising with better results. Treatments of a minimally invasive nature can be performed, with a reduction in chairside time.
Comparative analysis of remineralizing efficacy of strontium-doped bioactive glass, BioMin, and NovaMin containing dentifrice on artificial white spot lesions after chlorhexidine pretreatment - An in vitro study
Authors: Nandhini G. , Samraj Jemima Shalini , Anish S. Mohamed , Ramachandran Anil Kumar , Nirmala Chandrasekaran , Denis G. F. Luke
Published: September 2024

Aim:

This study aimed to compare the remineralizing efficacy of strontium-doped bioactive glass, BioMin, and NovaMin containing dentifrices on artificial white spot lesions (WSLs) after chlorhexidine (CHX) pretreatment using energy-dispersive X-ray analysis (EDAX).

Materials and Methodology:

Twenty-four samples of maxillary first premolars extracted for orthodontic purposes were selected. Artificial WSLs were produced by immersing the samples in a prepared demineralizing solution for 3 days. All the samples were pretreated with CHX and divided into four groups and six samples each. Group A treated with strontium-doped bioactive glass, Group B with BioMin, Group C with NovaMin, and Group D with artificial saliva as the control group for 14 days. pH-cycling model was used to simulate the oral cavity changes. EDAX was used to record the values at baseline, demineralization, and after remineralization.

Statistical Analysis:

Data were analyzed using one-way ANOVA (post hoc), followed by unpaired t-test and Scheffe tests with Statistical Package for the Social Sciences version 16.

Results:

Strontium-doped bioactive glass exhibited a greater mineral regain compared to BioMin, NovaMin, and control groups.

Conclusion:

Strontium-doped bioactive glass has enhanced mineral deposition on carious teeth and may provide an alternative clinical strategy for remineralizing early enamel lesions.
Middle mesial canal incidence and morphology in mandibular first molars: A cone-beam computed tomography and micro-computed tomography evaluation
Authors: Singh Harpreet , Sroa Renu Bala , Mann Jagvinder Singh
Published: September 2024

Background:

Mandibular first molar (MFM) being the first permanent posterior tooth to erupt, quite often gets involved in dental caries, which subsequently requires endodontic treatment in many cases. Thus, it is essential that the clinicians be aware of the root canal and the morphology of these teeth in detail. Over a period of years, the cases reporting with middle mesial canals (MMCs) in the MFMs have been seen on the rise; thus, it is imperative to know its incidence so that the data can be passed on to the clinicians for better management.

Aim:

The aim of the current research was to evaluate the incidence of MMC in the MFMs using cone-beam computed tomography (CBCT) and further evaluating its morphology with micro-computed tomography (micro-CT).

Materials and Methods:

Five hundred and fifty extracted permanent MFMs were collected and subjected to CBCT scan. The teeth in which MMC was found, were further subjected to micro-CT to evaluate the detailed morphology.

Observations and Results:

The data exhibited the presence of MMC in 29 teeth out of 550 (5.27%). The most frequent morphological pattern observed in the MMC as per micro-CT was the confluent type (86.2%), followed by independent type (6.8%) and fin type (3.4%). Double MMC was observed in 1 tooth (3.4%).

Conclusion:

The incidence of MMC was observed to be 5.27% and the confluent type of morphological configuration was the most common type noticed.
Influence of occlusal surface reduction on post endodontic pain following instrumentation and obturation: A randomized double blinded clinical study
Authors: Manigandan Kuzhanchinathan , Karthick Soundararajan , Rajendran Mathan Rajan , Gopal Kalaiselvam Rajeswari
Published: September 2024

Objective:

The purpose of this randomized clinical study was to investigate the influence of occlusal surface reduction on postendodontic pain.

Methodology:

Sixty patients were included with a diagnosis of acute irreversible pulpitis and acute apical periodontitis and divided randomly into two groups. In the intervention group, occlusal surfaces were reduced and left intact in the control group. Postoperative pain was evaluated at the 6th, 12th, 24th, and 48th h after the root canal instrumentation and 6th and 12th h following obturation using visual analog scale. Data were evaluated using the Chi-square test, t-test, Friedman test, Mann–Whitney U-test, and Wilcoxon rank test.

Results:

Postoperative pain levels in both groups were reduced significantly over the time period evaluated, however, between the two groups, there was no difference evident.

Conclusion:

Occlusal surface reduction did not influence the pain following root canal instrumentation and obturation.
Effect of medicated toothpastes and Tooth Mousse on cariogenic microbes of the oral cavity: An in vitro study
Authors: Hegde Mithra N. , Hegde Nishanth N. , Shetty Preethesh , Hegde Nishmitha N. , Vittal Chaithra Lakshmi , Ravinanthan Manikandan
Published: September 2024

Background:

Dental caries, commonly known as tooth decay is a widespread oral health problem mainly attributed to the activity of cariogenic bacteria, such as Streptococcus mutans and Lactobacillus species. Tooth Mousse, containing remineralizing agents, herbal and fluoride containing toothpaste with antimicrobial agents have been developed to target cariogenic bacteria. Herbal, fluoride toothpaste, and Tooth Mousse are commonly prescribed to prevent, reduce, and control dental caries.

Aim:

This study aims to analyze the effect of Tooth Mousse and medicated toothpastes on S. mutans and Lactobacillus acidophilus using direct contact test.

Methodology:

L. acidophilus and S. mutans were cultured on Mueller–Hinton agar (MHA-Hi media) using sterile cotton swabs and plates were dried for 15 min. Toothpastes (Dabur Red, Pepsodent) and Tooth Mousse were used at 1:1 dilution using sterile pyrogen-free distilled water. Fifty microliter of toothpastes and Tooth Mousse were introduced into each well. The plates were incubated at 37°C for 24 h.

Results and Discussion:

The antimicrobial activity was evaluated by measuring the diameter of zones of inhibition (mm). The toothpaste containing fluoride (A) showed greater zone of inhibition compared to herbal toothpaste (B) whereas Tooth Mousse (C) did not show any zone of inhibition.

Conclusion:

Among herbal and fluoride toothpaste, fluoride containing toothpaste showed more zone of inhibition thereby attributing to its increased antimicrobial property on S. mutans and L. acidophilus.
Comparative analysis of an epoxy resin-based and a premixed calcium silicate-based sealer’s push-out bond strength with and without incorporation of chitosan nanoparticles: An in vitro investigation
Authors: Harishma S. , Jeyalakshmi K. B. , Shetty K. Shibani , Harshini S.
Published: September 2024

Aim and Objectives:

The aim of the study was to compare and evaluate the push-out bond strength (POBS) of epoxy resin-based and calcium silicate-based sealers with and without incorporating chitosan nanoparticles (CSNPs).

Methodology:

Eighty human mandibular premolars with a single canal were taken. A standard root length of 15 mm was established. Canals were instrumented with Neoendo files up to size 30, 4% and were irrigated with 5 ml of 2.5% NaOCl, and 5 ml of ethylenediaminetetraacetic acid 17%. Then, samples were obturated using the size 30, 4% gutta-percha, single-cone technique using respective sealers. For POBS, it was grouped as Group 1 Adseal, Group 2 CeraSeal, Group 3 Adseal + 2% wt/vol CSNP, and Group 4 CeraSeal + 2% wt/vol CSNP. Samples embedded in acrylic resin were sectioned transversely at 11 and 7 mm from the apex. Dislodgment resistance was calculated using a universal testing machine. The data were analyzed using a one-way ANOVA test, followed by Tukey’s post hoc analysis. The level of significance (P value) was set at P < 0.05.

Results:

At 7 mm from the apex, Group 4 (CeraSeal + 2% wt/vol CSNP) demonstrated significantly higher mean POBS. However, no significant difference was observed between Groups 1 (Adseal), Group 2 (CeraSeal), and Group 3 (Adseal + 2% wt/vol CSNP). At 11 mm from the apex, Group 2 (CeraSeal) and Group 4 (CeraSeal + 2% wt/vol CSNP) demonstrated significantly higher mean POBS. On comparison between POBS at 7 mm and 11 mm from the apex, the mean POBS at the 11 mm region from the apex was significantly higher in all study groups, which was statistically significant.

Conclusion:

Within the limitations of the study, it has been concluded that Group 4 (CeraSeal + 2% wt/vol CSNP) has better bond strength compared to the other groups.
Effect of platelet-rich fibrin and concentrated growth factor on the regenerative potential of human-induced pluripotent stem cells: A comparative analysis
Authors: Bharti Ramesh , Anisha  , Tikku Aseem Prakash , Verma Promila , Yadav Rakesh Kumar , Pant Aditya Bhushan
Published: September 2024

Background:

Platelet-rich fibrin (PRF) has been used, while concentrated growth factor (CGF) has recently evolved as a bioscaffold in regenerative endodontics.

Aims:

This study aimed to evaluate the effect of PRF and CGF on the proliferation, migration, and differentiation of human-induced pluripotent stem cells (hiPSCs).

Materials and Methods:

CGF and PRF were fabricated from voluntarily donated human blood, and a conditioned medium was prepared. HiPSCs were isolated and cultivated on a conditioned medium for 12 days. The proliferation rate was analyzed using a trypan blue assay on days 9, 10, and 11. The migratory rate was evaluated using a wound healing assay after 24, 48, and 72 h. For assessing the differentiation of hiPSCs, various markers with quantitative real-time polymerase chain reactions on day 12 were used.

Results:

Mesenchymal phenotypic transition was seen with an increase in proliferation rate in the PRF group more than in the CGF group on day 9, along with the differentiation of cells with an increase in osteoblastic markers on day 12 in both groups. The migratory capacity of cells was significantly increased in the CGF and PRF groups, with a greater increase in the CGF group.

Conclusions:

CGF and PRF extend the duration of growth factor activity and enhance cell proliferation and osteogenic differentiation, with hiPSCs serving as a bioscaffold with high regenerative potential.
Evaluation of peroxide release during nonvital bleaching using three different coronal barriers: An in vitro study
Authors: Roy Debosmita , Kataki Rubi , Gogoi Sherin , Seal Mukut
Published: September 2024

Background:

Peroxide from bleaching agents can cause external cervical resorption. An intracoronal barrier is used to prevent leakage of bleaching agents into the periradicular space.

Aim:

This study aims to determine and compare the amount of peroxide released, during non vital bleaching at the end of 1st and 3rd day using Glass ionomer cement (GIC), Mineral Trioxide aggregate (ProRoot MTA) and Biodentine as intracoronal barriers.

Materials and Methods:

Forty-five single-rooted teeth were selected for the study and root canal therapy was performed. Three millimeters of the coronal gutta-percha were removed and according to the coronal barrier placed, samples were divided into Group A: GIC, Group B: ProRoot MTA, and Group C: Biodentine. Nonvital bleaching was done using sodium perborate and 30% H2O2. Peroxide released at the end of the 1st and 3rd day was analyzed using potassium iodide and ultraviolet spectrophotometer.

Statistical Analysis:

This was done using the Wilcoxon matched pair test and the Kruskal–Wallis test.

Results:

No significant difference in intergroup comparison at the end of 1st and 3rd day, respectively (P > 0.05), a significant difference was found in the MTA group at follow-up dates (P < 0.05).

Conclusion:

All the three tested materials (GIC, MTA, and Biodentine) may be preferred as intracoronal barrier for nonvital bleaching.
Discrete pulp canal calcification in a case of full pulpotomy: A 2-year follow-up case report
Authors: Kumari Ragini , Murmu Lugu Buru , Ghosh Amrita , Mazumder Dibyendu
Published: September 2024

Pulpotomy is recognized as a promising treatment option, especially for immature permanent teeth, as it prevents the unnecessary removal of radicular pulp tissue. The aim of the study was to evaluate the clinical and radiographic outcome of full pulpotomy using Biodentine in the young permanent tooth with symptomatic irreversible pulpitis. Full pulpotomy with Biodentine was performed on a 15-year-old male patient diagnosed with irreversible pulpitis in tooth #47. Follow-up was done at 6 months, 1 year, and 2 years postoperatively. The patient was asymptomatic throughout the follow-ups. 12-month postoperative radiograph revealed periapical healing and apical closure. 24-month radiographic follow-up revealed complete healing of the periapical lesion, but discrete pulp canal calcifications were also seen. Pulpotomy can be used successfully in the management of carious pulp exposure of fully erupted immature teeth to maintain pulp vitality and root maturation.
A comparative evaluation of human enamel remineralization ability of biomimetic nacre against casein phosphopeptide-amorphous calcium phosphate: An in vitro study
Authors: Reddy Vantari Swathi , Surakanti Jayaprada Reddy , Sharma Deepak Kumar
Published: September 2024

Introduction:

This study aimed to assess and compare the efficacy of Nacre and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the remineralization of enamel using surface microhardness analysis, scanning electron microscopy (SEM), and energy dispersive X-ray (EDX) spectroscopy.

Materials and Methods:

Twenty human maxillary premolars extracted for orthodontic reasons were collected. Under cool water spray, the crowns were sectioned mesiodistally into buccal and palatal halves using a diamond disc. The samples were subsequently mounted in self-cure acrylic resin. The samples were then subjected to Vickers hardness testing and SEM-EDX for baseline. To simulate carious lesions, all of the samples were acid-etched with 37% phosphoric acid for 30 s in a specific area on the enamel samples and subjected to surface microhardness testing and SEM-EDX. The enamel samples were randomly assigned to Group 1: Nacre water-soluble matrix (WSM), Group 2: Nacre varnish, and Group 3: CPP-ACP for remineralization. After 21 days, remineralization assessment of the test samples was done using SMH analysis and SEM-EDX analysis. Data obtained were statistically analyzed using the one-way analysis of variance to reveal the significant differences between the groups. Tukey’s test was used for post hoc comparisons.

Results:

All three groups showed a significant increase in surface microhardness. All three groups showed a significant calcium and phosphorous ratio increase after remineralization. Among the three groups, the highest Ca:P ratio was seen in the Nacre WSM group (0.58) followed by the Nacre Varnish (0.57) and CPP-ACP group (0.57). SEM images of the Nacre surface revealed the presence of extensive interlocking. A layer of packed hydroxyapatite particles was formed on the surface of the nacre through surface reactions.

Conclusion:

All the groups in the present study showed some extent of remineralizing ability irrespective of the different materials and mechanisms of action. Nacre WSM showed a remarkable hardness spike close to natural enamel after demineralization.
A rare case report on endodontic management of calcified structures within large periapical pathology: An 8-year follow-up outcome
Authors: Galani Mohit , Gogia Monica , Prasad Pankaj , Narain Satya , Patnana Arun Kumar
Published: September 2024

Periapical lesions with mixed radiographic appearance can have odontogenic or nonodontogenic origin. A number of neoplastic lesions either benign or malignant can present as radiolucent, radiopaque, or mixed in jaws and if present near the root apices can be misdiagnosed as odontogenic infection/etiology. The present case report describes a rare case of two elongated radiopaque structures within periapical pathology located beneath the apices of mandibular central incisors in a 26-year-old male. Further, it describes its nonsurgical and surgical endodontic management along with histological confirmation and long-term radiographic healing outcome using cone-beam computed tomography. Microscopic examination revealed the presence of dentin and cementum with fringes of periodontal ligament suggestive of tooth-like structures. No case report has yet reported tooth-like calcifications within the large periapical lesion. Biopsy of such lesions is deemed necessary to differentiate from nonodontogenic lesions which could be benign or malignant in nature.
The relationship between salivary alpha-amylase, nitric oxide, pain and anxiety-induced stress in patients during dental treatment
Authors: Swathi Siripurapu , Pasupuleti Swetha , Manyam Ravikanth , Kumar Varma D. Praveen
Published: September 2024

Background:

Pain and anxiety are the most reported negative effect of orthodontic treatment which can influence the quality of life and are responsible for the discontinuation of treatment. These unpleasant experiences raise the stress levels reflected by the increase in the concentration of salivary alpha-amylase and nitric oxide. These can be assessed through various subjective methods which have limited value as it depends on the patient's honesty, assessing whether using objective methods are reliable.

Objectives:

To assess pain and anxiety-induced stress levels using both physiological (Salivary alpha-amylase and Salivary nitric oxide) and psychological testing instruments (Visual analog scale and State Trait Anxiety Inventory Y6) during the initial phases of fixed orthodontic treatment.

Materials and Methods:

A total of 30 patients were included. Pain and anxiety instruments were applied and saliva samples were collected from patients before and after separator placement, before and 48 h after archwire insertion and 1 month after archwire insertion.

Results:

The mean values of alpha-amylase (235.3600), nitric oxide levels (2.060) and pain scores (7.8667) were higher 48 h after archwire insertion (T3) which are statistically significant, P = 0.00. Anxiety scores (57.7000) were high before separator placement (T0). No statistically significant correlation was found among pain and alpha-amylase, anxiety and nitric oxide levels.

Conclusion:

Initial alignment phases of fixed orthodontic treatment affect patients' anxiety and stress levels. The findings could be a result of the psychological stress due to procedures in the initial phases of the treatment.
Evaluation of microbial contamination in removable dental prosthesis at different time of usage
Authors: Singh Tulika , Bhojaraju Nandakishore , Vinod V , Anjali K , Shah Samsuddeen , Kumar Naveen
Published: September 2024

Aim:

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

Method and Methodology:

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

Statistical Analysis:

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

Results:

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

Conclusion:

A progressive increase in the microbial contamination was directly proportional to the duration of removable prosthesis usage.
Expression of EGFR and survivin in ameloblastoma, odontogenic keratocyst and calcifying odontogenic cyst – An immunohistochemical study
Authors: Baddireddy Sita M. , Manyam Ravikanth , Thomas Davis C
Published: September 2024

Context:

Odontogenic lesions have diverse biological behaviour which is characterised by local invasiveness, and a high recurrence rate. EGFR and survivin was found to be involved in the aggressiveness, recurrences and metastasis of a variety of epithelial malignancies.

Aims:

To assess and compare the expression of EGFR and survivin in Ameloblastoma (AB), Odontogenic keratocyst (OKC) and Calcifying odontogenic cyst (COC).

Settings and Design:

The study's goal was to use immunohistochemistry to assess the qualitative and quantitative expression of EGFR and survivin and to correlate their expression patterns in AB, OKC and COC.

Methods and Material:

Study included 30 AB, 15 OKC and 10 COC. All the slides were immunohistochemically analysed for qualitative, quantitative and semi-quantitative data. In each group, the presence of EGFR and survivin was assessed in terms of stain localisation, intensity and percentage of positive cells.

Statistical Analysis Used:

Data were analysed using Chi-square test and one-way ANOVA, P value < 0.05 was considered statistically significant.

Results:

EGFR positivity was found in all cases. Survivin was found to be 96% positive in AB and 100% positive in OKC and COC. Both EGFR and survivin showed predominant cytoplasmic staining. All the slides that are stained with EGFR are also stained with survivin. The intensity varied significantly between the layers. OKC showed higher immunoreactive scores (IRSs).

Conclusions:

The current study provides insight into the role of EGFR and survivin in the pathogenesis of AB, OKC and COC. OKC appears to be more aggressive than ameloblastoma and COC, owing to its higher IRS.
Immunohistochemical evaluation of superficial and invasive front of oral squamous cell carcinoma using epithelial membrane antigen as a marker
Authors: Jayaswal Amrita , Tandon Aanchal , Jain Amol , Sharma Apoorva , Iqbal Haider , Jaiswal Rohit
Published: September 2024

Background:

Epithelial membrane antigen (EMA) has been used as a marker for the expression of tumour margins in various glandular neoplastic lesions. Histopathologically, oral squamous cell carcinoma (OSCC) may exhibit several features within the same tumour cells, portraying that these cells at the invasive margins commonly display certain features that differ from those of the superficial part of the tumour.

Aim:

To identify and study the invasive tumour front and also to recognise any micrometastases in an OSCC lesion.

Materials and Method:

A retrospective study of 30 OSCC cases with superficial and most invasive parts were sectioned at 4 μm. Routine H&E staining and immunohistochemical staining with mouse antihuman EMA were done. The OSCC cases were graded into well differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC) and poorly differentiated squamous cell carcinoma (PDSCC). The EMA-stained slides were observed and analysed under higher magnification to identify the individual EMA-stained cells.

Results:

Analysis of Variance (ANOVA) analysis revealed that when comparing the superficial and invasive fronts of OSCC, it was evident that the P values were significant across the groups. In WDSCC, positive predictive value was 70.6% and sensitivity was 100% when the same slide was analysed for large and small islands to individual cells in an EMA-stained section, while MDSCC and PDSCC showed both sensitivity and positive predictive value to be 100%.

Conclusion:

EMA could be considered a useful prognostic marker for describing the nature of the neoplastic epithelium as well as recognising the typical anaplastic cells in cases of OSCC.
Comparative immunohistochemical analysis of WT-1, Syndecan and Snail in Ameloblastoma and odontogenic keratocyst: A retrospective study
Authors: Mukhopadhyay Arka , Panda Abikshyeet , Mishra Pallavi , Chowdhary Gopal , Mohanty Aishwariya , Sahoo Pravudeva D.
Published: September 2024

Background:

The purpose of this experimental study was to evaluate and compare the degree of expression of Wilm's Tumor Gene-1 (WT-1), Syndecan (CD 138) and Snail in Ameloblastoma and odontogenic keratocyst (OKC) and to analyse their potential role in pathogenesis.

Methods and Material:

Immunohistochemical analysis was performed to evaluate WT-1, Syndecan and Snail expression in Ameloblastoma (n = 20) and OKC (n = 20). Topographical immunoexpression pattern of Ameloblast-like cells, Stellate Reticulum-like cells in Ameloblastoma and basal layer as well as suprabasal layer of cells of OKC were also compared. The results obtained were subjected to ANOVA test and Tukey HSD test through SPSS software 20.0 for Microsoft Windows.

Results:

WT-1 and Snail overexpression was seen in both Ameloblastoma and OKCs. Syndecan, responsible for maintaining normal cellular morphology, cell–cell adhesion and differentiation was significantly downregulated in both the lesions. The Ameloblasts-like cells and the basal cells showed significantly higher immunopositivity for WT-1 and Syndecan as compared to that of basal cells. An inverse relation was noted for Snail protein. The ANOVA test predicted a statistically significant difference of expression across the lesions with a P value <0.0001 for Syndecan and Snail.

Conclusions:

The under-expression of epithelial membrane protein Syndecan-1 and upregulation of EMT transcription factor Snail can promote local invasion and is indicative of poor prognosis of these lesions. The overexpression of WT-1 results in tumorigenesis, proliferation and localized aggressiveness of Ameloblastoma and intrabony growth of OKC. Further investigation on the biologic behaviour of OKC is still recommended to arrive at more specific conclusions regarding its nature.