bluuebunny/crossref_metadata_2025 huggingface dataset:
Contemporary comprehension of root canal biofilms and future perspectives: Part 2
Authors: Vishwanath Vijetha , Neelakantan Prasanna
Published: September 2024

In Part 1 of this commissioned review, we discussed the basic biology of biofilms, its assembly, biogeography, and physicomechanical properties. In the second part of this review, we critically discuss the literature pertaining to microbiology of endodontic diseases, types of root canal infections, microbial dynamics, and host evasion strategies and highlight the concept of functional redundancy. Then, we review the role of fungi in endodontic diseases and provide an important narrative on the role of biofilms in weakening dentin. Finally, we briefly review the goals of prevention and treatment of apical periodontitis and provide futuristic perspectives to reinforce critical points that will aid future research and discovery.
Study of platelet activation, hypercoagulable state, and pulmonary hypertension in patients with transfusion-dependent beta-thalassemia
Authors: Haji Lanja Othman , Polus Ranan Kardagh , Mohammed Nawsherwan Sadiq
Published: September 2024

BACKGROUND:

Thalassemic patients require lifelong blood transfusions, which can lead to complications such as pulmonary arterial hypertension. The pathogenesis involves hypercoagulability, in which researches on coagulation abnormalities in this regard are limited.

OBJECTIVES:

The aims of the study was to investigate the mechanism of hypercoagulability and pulmonary hypertension in transfusion-dependent thalassemic patients and compare it with healthy controls.

PATIENTS, MATERIALS AND METHODS:

This case–control analysis enrolled 50 transfusion-dependent thalassemia patients and 50 healthy controls. Complete blood counts, liver function tests, coagulation markers (P-selectin, protein C, antithrombin III, and fibrinogen), serum ferritin, and transthoracic echocardiography were performed, and blood transfusion/chelation history and splenectomy status were recorded.

RESULTS:

Thalassemia patients revealed severe anemia, leukocytosis, thrombocytosis, significantly elevated serum ferritin (1957.50 ± 2455.05 g/L), elevated liver enzymes serum glutamic oxaloacetic transaminase (22.01 ± 9.89 U/L), serum glutamic pyruvic transaminase (22.70 ± 9.78 U/L) in comparison to controls, and mean serum P-selectin was significantly higher in thalassemic patients (100.48 ± 53.29 ng/mL). Mean serum antithrombin-III and protein C were significantly lower in thalassemic patients (89.27 ± 16.08 units/h, 86.04 ± 25.21 μg/mL) in comparison to controls.

CONCLUSIONS:

Transfusion-dependent thalassemia is characterized by severe anemia and splenomegaly, leading to complex hemodynamic changes with evidence of platelet activation, hypercoagulable state, liver injury, and increased atherosclerosis. It induces pulmonary artery thrombosis contributing to the development of pulmonary artery hypertension.
Pharmacological benefits of durva swaras (Cynodon dactylon L. Pers.) administration in APAP-induced liver injury model of mice – Assessment by metabolic and inflammatory markers
Authors: Sindhoora B. , Singh Vandana , Mungamuri Sathish Kumar , Bharatraj Dinesh Kumar
Published: September 2024

OBJECTIVE:

Liver derangement underlies the development of metabolic syndrome in perimenopause. Previously, we have observed that durva swaras (DS) improved metabolic-associated fatty liver disease (MAFLD) and abnormal liver enzymes (aspartate aminotransferase and alanine aminotransferase) along with other complications of menopause in ovariectomized rats. We aimed to decipher the hepatoprotective mechanisms of DS in acetaminophen (APAP)-induced liver injury model, which is analogous to the pathophysiology of MAFLD.

MATERIALS AND METHODS:

Male Swiss albino mice were distributed into three groups at random. Group I (Control) was administered with vehicle (distilled water) for 7 days. Group II (APAP) received vehicle for the first 6 days and APAP (350 mg/kg - single dose) on the 7th day. Group III (APAP + D) received test compound DS (quality complied) at a dose of 133 mg/kg for 6 days and APAP (350 mg/kg - single dose) on the 7th day. Subsequently, blood and liver tissues were subjected to biochemical, ultrastructural, and gene expression analysis.

RESULTS:

DS pretreatment protected the liver from APAP-induced disruption of sinusoids and necrosis. DS prevented the elevation of liver enzymes – AST and ALT induced by APAP. Importantly, DS inhibited the APAP-elicited increase in messenger ribonucleic acid levels of hepatic nuclear factor-kappa beta (NF-κB) and pro-inflammatory cytokines, namely interleukin-1 beta, interleukin 6, and tumor necrosis factor-alpha. Moreover, DS activated gene expression of nuclear factor erythroid 2-related factor 2 and liver-X-receptor-alpha (LXR-α) to combat the liver damage.

CONCLUSION:

DS hinders APAP-induced liver damage by activating LXR-α and inhibiting the NF-κB-associated pro-inflammatory cytokine gene expression. These observations confirm the protective role of DS in metabolic dysfunction-associated liver conditions.
Implementing pharmacogenetic testing to optimize proton-pump inhibitors use among Indian population based on CPIC-CYP2C19-PPI dosing guidelines: The need of the hour
Authors: Chenchula Santenna , Atal Shubham , Jhaj Ratinder , Uppugunduri Chakradhara Rao S.
Published: September 2024

Proton-pump inhibitors (PPIs) are widely prescribed to decrease stomach acid and treat various acid-related Gastrointestinal tract (GIT) diseases. However, genetic variations, particularly in the CYP2C19 gene, affect PPIs metabolism and efficacy. Variants in CYP2C19 can result in different rates of PPI metabolism, influencing their effectiveness. Personalized medicine strategies, such as genotyping for CYP2C19, have the potential to enhance the effectiveness of PPI therapy and patient safety. This review aims to describe the relevance of CYP2C19 genetic profiling in the indian population, including normal function (e.g. CYP2C19*1, *11, *13, *15, *18, *28, and 38), decreased function (e.g., CYP2C19*9, *10, *16, *19, *25, and 26), loss of function (e.g., CYP2C19*2, *3, *4, *5, *6, *7, *8, *22, *24, *35, *36, and *37), and increased function (e.g., CYP2C19*17) variants. This review also examines the clinical pharmacogenomics implementation consortium (CPIC)-CYP2C19-PPI guidelines to highlight the importance of pharmacogenomics (PGx)-informed personalized PPI therapy for gastroesophageal reflux disease and peptic ulcer disease treatment. On average, each person in India possesses eight pharmacogenetic (PGx) variants that can be clinically significant, underscoring the need for preemptive testing. Implementing CYP2C19 genetic testing in India requires expanding laboratory capacity, increasing accessibility in primary care, increasing public awareness, collaboration between pharmacovigilance and PGx programs, investing in advanced sequencing technologies, data management systems, and integration with electronic health records and clinical decision support systems. Addressing challenges such as genetic diversity, socioeconomic factors, health-care access issues, and shortage of trained professionals is essential for implementation. Due to the lack of definitive country-specific policies and PGx guidelines from Indian drug regulatory agencies, guidelines from international consortia such as the Clinical Pharmacogenetics Implementation Consortium and drug labeling offer crucial foundational evidence. This evidence can be used to enhance patient outcomes and ensure the safe and effective use of PPIs in India.
Applying quantitative and systems pharmacology to drug development and beyond: An introduction to clinical pharmacologists
Authors: Ramasubbu Mathan Kumar , Paleja Bhairav , Srinivasann Anand , Maiti Rituparna , Kumar Rukmini
Published: September 2024

Quantitative and systems pharmacology (QSP) is an innovative and integrative approach combining physiology and pharmacology to accelerate medical research. This review focuses on QSP’s pivotal role in drug development and its broader applications, introducing clinical pharmacologists/researchers to QSP’s quantitative approach and the potential to enhance their practice and decision-making. The history of QSP adoption reveals its impact in diverse areas, including glucose regulation, oncology, autoimmune disease, and HIV treatment. By considering receptor–ligand interactions of various cell types, metabolic pathways, signaling networks, and disease biomarkers simultaneously, QSP provides a holistic understanding of interactions between the human body, diseases, and drugs. Integrating knowledge across multiple time and space scales enhances versatility, enabling insights into personalized responses and general trends. QSP consolidates vast data into robust mathematical models, predicting clinical trial outcomes and optimizing dosing based on preclinical data. QSP operates under a “learn and confirm paradigm,” integrating experimental findings to generate testable hypotheses and refine them through precise experimental designs. An interdisciplinary collaboration involving expertise in pharmacology, biochemistry, genetics, mathematics, and medicine is vital. QSP’s utility in drug development is demonstrated through integration in various stages, predicting drug responses, optimizing dosing, and evaluating combination therapies. Challenges exist in model complexity, communication, and peer review. Standardized workflows and evaluation methods ensure reliability and transparency.
Demographic profile of ophthalmic injuries following road traffic accidents at a tertiary care hospital in Western India
Authors: Tamboli Nikhat Iqbal , Jakkal Tapan P , Joshi Rajesh S , Husain Bilal
Published: September 2024

Context:

Road traffic accidents (RTAs) are one of the leading and most common causes of ocular injuries, especially in developing countries like India.

Aims:

The aim of the study was to study the incidence and clinical presentation of ophthalmic injuries in RTAs.

Settings and Design:

This was a prospective hospital-based study observational study.

Subjects and Methods:

A prospective cross-sectional study was conducted among 300 patients in the department of ophthalmology of a tertiary hospital in Western India from October 2021 to October 2023. Detailed ocular examination and investigations were done. Various parameters, including demographics, type of vehicle, type and severity of the injury, and visual acuity at presentation, were studied. The data obtained from the results were expressed in frequency and percentages.

Statistical Analysis Used:

Not applicable.

Results:

A total of 300 patients were included in the study. The right eye was affected in 177 out of 320 cases. Male preponderance was noted. The most common ocular finding was ecchymosis 168 (56%) followed by lid lacerations 81 (27%). Majority of the cases were in the age group of 31–40 years (31.67%). The incidence of injuries in two-wheeler riders was 283 (94.33%), of which people who were driving without a helmet were 256 (90.5%).

Conclusion:

We concluded from our study that the most common age group, 31–40 years, was involved in ocular injuries due to RTAs with male preponderance. Most of those who sustained injuries were riding two-wheeler vehicles without helmets. The involvement of the right eye was more common in unilateral cases. The most common injury found was blunt trauma presenting as preorbital edema and ecchymosis.
Ethambutol-induced optic neuropathy: Another conundrum
Authors: Kharkande Pinank Chetan , Chandran Avani B. , Kumar Karthik , Shah Virna
Published: September 2024

Purpose:

The purpose was to study the effect of ethambutol (EMB) and cause for optic neuropathy in the hope that better understanding of the condition will help us to reduce the burden of visual loss.

Materials and Methods:

A retrospective analysis of patients with EMB-induced optic neuropathy was done, which included 30 patients attending our outpatient department from January 2022 to March 2022.

Results:

The mean age was 53.73 with male (70%) preponderance. Visual fields showed bitemporal hemianopia in 43% (13), temporal field defects in 26% (8), centrocecal scotoma in 17% (5), and low reliability in 10% (3). Visual evoked potential amplitude was reduced in 87% (26). Magnetic resonance imaging showed enhancement of optic chiasma in 40% (12). After discontinuing and replacing EMB, with Vitamin B complex and zinc supplements, 53% (16) had visual improvement on 1-month follow-up.

Conclusion:

India has launched the Pradhan Mantri TB Mukt Bharat Abhiyan “Ni-kshay 2.0” portal to eradicate tuberculosis by 2025. Hence, aggressive treatment protocols are underway. The increased duration of EMB in new directly observed therapy short-course regimen has caused increased incidence of EMB optic neuropathy. Regular screening is needed to diagnose and prevent further visual deterioration in these patients. Timely replacement of the drug with another drug is a key in visual recovery of these patients. Further studies are needed to assess if the genetic predisposition is responsible for optic nerve damage.
Congenital retinal eye disorders with poor visual outcome from a developing country: A case series
Authors: Lobo Sarita RJ , Lobo Geover Joslen
Published: September 2024

Congenital eye disorders are an important cause of childhood blindness. They can be due to defective development of ocular tissues during the intrauterine life, which can result from adverse genetic, environmental factors, teratogens, or chromosomal anomalies in the developing embryo. We report three such cases with congenital retinal disorders where even surgical intervention would result in a poor visual outcome. Preconceptional genetic counseling of prospective parents can maximize the chances of the couple having a healthy baby. Premarital counseling for consanguinity and screening for carriers of genetic diseases can help prevent many congenital diseases. Proper diagnosis and early intervention may provide a favourable outcome.
Janus kinase 2 mutation-negative polycythemia-associated retinal changes in otherwise asymptomatic patients
Authors: Singh Alok Pratap , Gala Deep A. , Husain Ahmad , Yadav Sanjeev , Maroof Lubna , Kanaujia Vikas
Published: September 2024

Purpose:

The purpose of this study was to document secondary polycythemia (SP)-associated retinal changes and the favorable role of phlebotomy in the treatment of SP-induced retinal complications.

Design:

This was a retrospective, observational, noncomparative case series.

Participants:

A total of 8 eyes of 4 male patients with an age range of 28–78 years were studied.

Materials and Methods:

A total of 04 consecutive patients were received over a year on an outpatient basis at a single tertiary care center, with only vision-related complaints. After documentation of ocular findings, all the patients were subjected to meticulous clinical and laboratory evaluation to determine the cause of ocular conditions. Patients were subjected to the treatment for underlying pathological conditions based on the outcomes of their clinical and laboratory evaluation.

Main Outcome Measures:

Determination of Janus kinase 2 (JAK2) mutation-negative SP as a cause of associated retinal complications and favorable role of phlebotomy as a treatment measure.

Results:

All the patients were adult, nonsmoker, and nonalcoholic males. A total of 05 eyes were diagnosed with proliferative vitreoretinopathy while 2 eyes had retinal venous occlusion. One eye was normal. Except SP, no other cause for retinal lesions could be ascertained in all patients. Three patients underwent phlebotomy as decided by the hematologists. Each patient was followed monthly for 6 months. All the patients showed resolution of retinal lesions at the end of follow-up.

Conclusion:

Nonpolycythemia vera (PV) erythrocytosis or unmutated JAK2 SP is still a very poorly studied entity. Almost no information is available regarding ocular involvement and its treatment in SP. Our observations suggest that SP may run a chronic course causing serious retinal damage such as other myeloproliferative disorders or PV and that phlebotomy has an important role in the management of such cases.
A study of nonglaucomatous optic neuropathies in a teaching hospital in Western Maharashtra
Authors: Kakulavaram Manasa Reddy , Joshi Ajit Kamalakar
Published: September 2024

Background:

Nonglaucomatous optic neuropathy (NGON) is defined as clinical evidence of optic nerve impairment without glaucomatous field/disc changes. Etiology is diverse and elusive in many patients. Causes of NGON include traumatic, compressive, inflammatory, demyelinating, toxic, nutritional, hereditary, vascular, infiltrative, and idiopathic. NGON disorders can be misdiagnosed as glaucoma and can be preventable or life-threatening. In some, fellow eye involvement is common. This can lead to inadequate management and influence prognosis which can be prevented by multispecialty approach. Physicians and ophthalmologists must be vigilant against threatening NGON forms. It is essential to track burden as most literature focused on particular NGON subtype.

Aim:

The aim was to study the clinical presentation of NGON in a teaching hospital.

Setting and Design:

This was a prospective, hospital-based, cross-sectional, observational study.

Materials and Methods:

A total of 86 eyes of 61 NGON patients were studied from January 2021 to June 2022 in a tertiary care hospital. Detailed history and comprehensive ophthalmic examination were performed in ambulatory patients. Nonambulatory patients were examined using torchlight. Ancillary investigations were performed, to confirm the clinical diagnosis wherever applicable.

Statistical Analysis:

Microsoft Excel was used for statistical analysis.

Results:

The mean age of study patients was 44.87 ± 16.05 years with a male: female ratio of 2.8:1. Unilateral eye involvement was seen in 36 (59.02%). Best-corrected visual acuity = 3/60–1/60 was noted in 41 (47.67%) patients. Red-green defect and contrast sensitivity were reduced by 59.30% and 66.28%, respectively. Relative afferent pupillary defect (RAPD) was noted in 52.46% of patients with Grade 5 RAPD in 40.63%. The most common visually evoked potential type and visual field defect noted were axonal and central scotoma (n = 31 [36.05%] and n = 26 [30.23%]), respectively. Traumatic optic neuropathy was diagnosed in 15 (24.59%) followed by inflammatory optic neuritis in 11 (18.04%) patients.

Conclusion:

Diagnosing cause of NGON in clinical practice is challenging, but emerging burden cannot be neglected. Knowledge of various NGON types helps narrow differential diagnoses and execute efficient, targeted workup. Timely recognition alters visual, neurological prognosis and saves the lives of patients sometimes.
The 2023 outbreak of viral conjunctivitis: Clinical features and treatment patterns from five states in India
Authors: Chatterjee Samrat , Kapur Neha , Chanda Sanjay , Bhavatharini M. , Sawant Sanil , Sangwan Virender Singh , Majumdar Atanu
Published: September 2024

Background:

In July 2023, an outbreak of viral conjunctivitis swept across India. A knowledge of clinical features and outcome of treatment helps in the management of future outbreaks.

Aim:

The aim of this study was to report the clinical presentation, treatment, and outcome in patients affected during the outbreak of viral conjunctivitis.

Setting and Design:

This was a multicentric retrospective case series.

Materials and Methods:

This study reviewed the medical records of all consecutive patients diagnosed with viral conjunctivitis between July 1, 2023, and August 10, 2023, in five centers across India.

Results:

Of the 793 patients, 525 (66.2%) were male and 268 (33.8%) were female, with a mean age of 34.1 ± 19.0 years. The mean symptom duration was 2.6 ± 2.1 days with bilateral disease in 591 (74.5%) patients. The common ocular signs were conjunctival congestion (793, 100%), lid edema (479, 60.4%), follicles (607, 76.5%), and conjunctival hemorrhages (339, 42.7%). Artificial tears were used in 730 (92.1%) patients, antibiotic eye drops in 661 (83.4%) patients, and steroid eye drops in 428 (54.0%). The time to resolution was the least in patients who had been treated with only artificial tears (4.61 ± 2.24 days) and was maximum in patients who had been treated with topical steroids (6.5 ± 2.51 days), and the difference was significant (P < 0.001).

Conclusion:

The presence of conjunctival hemorrhages indicated acute hemorrhagic conjunctivitis. Although many patients were treated with topical antibiotics, it was unnecessary, as the shortest resolution time was found in patients who had been received supportive therapy with artificial tear eye drops and not topical antibiotics or steroids.
Advancing Precision in Penile Length Measurement: Evidence-based Synthesis of Stretched Penile Length INdicator Technique (SPLINT)
Authors: Goel Prabudh , Choudhury Prativa , Saroya Komal Kaur , Jain Vishesh , Dhua Anjan Kumar , Yadav Devendra Kumar , Anand Sachit , Agarwala Sandeep , Sharma Kanika , Agrawal Vikesh , Saha Subhasis , Singh Harpreet , Sharma Naveen , Singh V. P.
Published: September 2024

ABSTRACT

Purpose:

The purpose of this study was to synthesize evidence and propose a technique for estimation of stretched penile length (SPL) applicable to children.

Materials and Methods:

This review has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Embase, and Scopus databases were queried on penile length (PL) measurement techniques in humans published from 1990 onward. The devices and the techniques used for PL measurement, state of the penis, the habitus of the participants, proximal and distal landmarks for measurement, handling the foreskin and pubic pad of fat, optimal stretching of the penis, and other factors (including the environment) which should be accounted for in the technique were identified from the study cohort (90895 participants across 145 included studies).

Results:

PL has been represented through flaccid (33.79%), stretched (81.3%), and erect (12.41%) PLs as well as the greatest corporeal length (1.4%). Following devices have been used to measure the PL in the study cohort: rulers [54.68%], calipers [9.7%], measuring tapes [14.5%], coloured measuring strips [2.06%], spatulas/tongue depressors [11.03%], FitKit, syringe [1.4%], cotton swab (and ruler), titan cylinders, slide gauge and ultrasonography [1.37%]. The factors relevant to SPL measurement have been incorporated into the proposed SPL INdicator Technique (SPLINT) which is essentially a holistic extension of the “Conventional PL Measurement” technique.

Conclusions:

There is a wide range of heterogeneity in the technique for estimation of PL across the study cohort; the underlying factors have been identified along with the respective variables, and the SPLINT for SPL has been described.
Correlation of Hand Digit Length Ratio, Anogenital Distance, and Severity of Hypospadias among Prepubertal Boys
Authors: Prasad Gaurav , Dhua Anjan Kumar , Goel Prabudh , Yadav Devendra Kumar , Agarwala Sandeep , Pandey Shivam
Published: September 2024

ABSTRACT

Aims:

Antenatal androgen exposure has been suggested as a contributing factor in hypospadias etiology. This study aimed to investigate the correlation between anogenital distance (AGD), index finger-to-ring finger ratio (2D:4D ratio), and hypospadias severity in prepubertal boys, with the goal of exploring these parameters as potential markers of genital anomalies in utero.

Materials and Methods:

A cross-sectional observational study was conducted on boys under 8 years old presenting to our outpatient department (April 2020–December 2022). Those with hypospadias were included in the study group, whereas those without hypospadias formed the comparator group. Confounding factors (age, weight, and height) were accounted for using multivariate linear regression analysis. AGD, 2D:4D ratio, and hypospadias severity were measured during clinical visits, with still images taken for precise measurements. Statistical analysis was performed using the Mann–Whitney U and student’s t-tests (software: STATA Version 14).

Results:

Data were collected for 100 cases of hypospadias (26 proximal and 74 distal) and 50 controls. There was no significant difference in mean age between groups (P = 0.90). AGD was slightly lower in cases (3.44 ± 1.13 cm) compared to controls (3.70 ± 1.43) (P = 0.88). 2D:4D ratios were marginally higher in cases compared to controls (P = 0.12 for both hands).

Conclusions:

Although our study did not find significant associations between AGD and 2D:4D ratios with hypospadias severity, it offers insights into the role of prenatal androgen in genital development. The lack of significance underscores the need for region-specific research, suggesting AGD and 2D:4D ratio may not universally apply as hypospadias markers.
Effect of temperature on rehydration and fracture resistance of reattached tooth fragments after crown fracture: An in vitro study
Authors: Atif Mohammad , Tewari Nitesh , Jhunjhunwala Garima , Nehta Hemlata , Rahul Morankar , Mathur Vijay Prakash , Bansal Kalpana
Published: September 2024

Background:

Uncomplicated crown fractures of maxillary anterior teeth are common dental injuries, and the bonding of fractured fragments is recommended for management. Rehydration of fragments improves bonding and fracture resistance. Therefore, the aim of this study was to compare the fracture resistance of the reattached tooth fragment of the incisor crown after rehydration using either a steamer or a humidifier.

Materials and Methods:

Bovine teeth were used as a model. Fractured fragments were divided into three groups: Group I (no rehydration), Group II (rehydration by humidifier), and Group III (rehydration by steamer). Fragments were reattached using a standard bonding protocol. Fracture resistance was tested using a universal testing machine. Statistical analysis was performed using analysis of variance and Chi-square tests.

Results:

The force required to fracture the reattached fragments was significantly higher in Group II (humidifier) compared to Group I (no rehydration) (P = 0.005). Group III (steamer) had a force value similar to Group I, indicating no significant improvement in fracture resistance with steamer rehydration. The temperature inside the steam-based chamber reached an average of 95.7°C with 95% humidity, whereas the conventional humidification chamber had an average temperature of 39.2°C and 84% humidity.

Conclusion:

Within the limitations of the present study, the rehydration protocol using a steam-based chamber was found to have a significantly lower force required to fracture the reattached fragments as compared to humidifier-based chamber. This was not significantly different from the fragments which were reattached without rehydration.
Influence of maternal attention-deficit hyperactive disorder on child dental neglect – An analytical cross-sectional study
Authors: Selvaraj Yazhini , Geethapriya P. R. , Asokan Sharath , Thoppe-Dhamodharan Yogesh Kumar , Viswanath Sudhandra
Published: September 2024

Background:

Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards’ oral health has not been explored in the Indian scenario.

Aim:

The aim of this study was to assess the prevalence of ADHD in mother–child dyads in western Tamil Nadu and the mothers’ dental neglect toward their children.

Methodology:

The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done.

Results:

The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children.

Conclusion:

Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child’s oral health. Child dental neglect was more prevalent among mothers with ADHD.
Comparative evaluation of antimicrobial efficacy of various intracanal medicament in young permanent teeth: An in vivo study
Authors: Dixit Anusha , Kapoor Rishabh , Doneria Divya , Mathur Shivani , Goel Saakshi , Singh Rishba
Published: September 2024

Introduction:

Bacteria and their byproducts are key contributors to the onset and perpetuation of pulpoperiapical pathosis. Intracanal medication is vital in achieving successful endodontic outcomes as it targets and eradicates remaining microorganisms following biomechanical preparation.

Aim and Objective:

The aim of the study was to compare and evaluate the antimicrobial efficacy of calcium hydroxide (CH) paste, triple antibiotic paste (TAP), and probiotics (PBs) as intracanal medicament in 12–17-year-old children undergoing root canal treatment for the management of infected pulpal tissues in young permanent teeth.

Materials and Methods:

A total of 30 patients aged 12–17 years indicated for endodontic therapy in maxillary incisors and with no systemic complications were selected. They were randomly divided into three groups, i.e., Group I – CH group, Group II – TAP, and Group III – PB allocating 10 teeth in each group. After access opening, the first sample (S1) was collected by inserting a paper point into the root canal, the second sample (S2) was collected immediately after biomechanical preparation, and the third sample (S3) was collected after 7 days, i.e., postintracanal medication. Samples were sent for microbiological analysis to assess the microbial count, and statistical analysis was done for the obtained data.

Results:

The three intracanal medicaments were successful in reducing the microbial counts of Enterococcus faecalis in the infected root canals. However, according to the results of the study, the PB group demonstrated greater effectiveness against E. faecalis compared to the CH group and displayed similar antimicrobial efficacy as the TAP group.

Conclusion:

PB exhibited antimicrobial efficacy comparable to TAP but greater than Ca (OH) 2 paste. Hence, PB can be utilized as an intracanal medicament in young permanent teeth.
Effect of silver diamine fluoride application on the microtensile bond strength of three commonly used restorative materials in primary teeth: An ultrastructural study
Authors: Banerjee Ishita , Chatterjee Ananjan , Kundu Gautam Kumar , Zahir Shabnam , Purkait Swapan Kumar , Kumar Shikhar
Published: September 2024

Introduction:

Caries in primary teeth rapidly advances owing to its thin structure, thereby requiring restoration. However, restorations often fail due to various causes such as secondary caries and reduced microtensile bond strength (μTBS), which calls for the use of antimicrobial agents such as silver diamine fluoride (SDF).

Aim:

This study aims to measure and analyse the effect of SDF application on the μTBS of three regularly used restorative materials to dentin of primary teeth as well as compare the types of bond failure interfaces under SEM.

Materials and Methods:

The study comprised 60 samples equally divided into six groups among three restorative materials, namely, glass ionomer cement (GIC, Groups I and II), resin-modified glass ionomer cement (RMGIC, Groups III and IV), and composite resin (Groups V and VI) with subdivisions of A and B, where A represented samples with SDF application and B represented samples without SDF application.

Results and Observations:

It was observed that μTBS of RMGIC to sound and carious dentin irrespective of SDF application was found to be statistically significant (P < 0.05), and when GIC, RMGIC, and composite resins were compared to both sound and carious dentin irrespective of SDF application, it was statistically significant (P < 0.05). SEM analysis revealed predominantly cohesive failures among all the groups.

Conclusion:

Based on the results, it was concluded that SDF has no adverse effect on the μTBS of GIC, RMGIC, and composite resin to both carious and sound dentin of primary teeth.
Fat mass and obesity–mediated m6A modification modulates neuroinflammatory responses after traumatic brain injury
Authors: Chen Xiangrong , Lai Jinqing , Wu Zhe , Chen Jianlong , Yang Baoya , Chen Chunnuan , Ding Chenyu
Published: September 2024

The neuroinflammatory response mediated by microglial activation plays an important role in the secondary nerve injury of traumatic brain injury. The post-transcriptional modification of N6-methyladenosine (m6A) is ubiquitous in the immune response of the central nervous system. The fat mass and obesity (FTO)-related protein catalyzes the demethylation of m6A modifications on mRNA and is widely expressed in various tissues, participating in the regulation of multiple diseases' biological processes. However, the role of FTO in microglial activation and the subsequent neuroinflammatory response after traumatic brain injury is unclear. In this study, we found that the expression of FTO was significantly down-regulated in both lipopolysaccharide-treated BV2 cells and a traumatic brain injury mouse model. After FTO interference, BV2 cells exhibited a pro-inflammatory phenotype as shown by the increased proportion of CD11b+/CD86+ cells and the secretion of pro-inflammatory cytokines. FTO-mediated m6A demethylation accelerated the degradation of ADAM17 mRNA, while silencing of FTO enhanced the stability of ADAM17 mRNA. Therefore, down-regulation of FTO expression leads to the abnormally high expression of ADAM17 in microglia. These results indicate that the activation of microglia and neuroinflammatory response regulated by FTO-related m6A modification plays an important role in the pro-inflammatory process of secondary injury following traumatic brain injury.
Regulator of G protein signaling 6 mediates exercise-induced recovery of hippocampal neurogenesis, learning, and memory in a mouse model of Alzheimer’s disease
Authors: Spicer Mackenzie M. , Yang Jianqi , Fu Daniel , DeVore Alison N. , Lauffer Marisol , Atasoy Nilufer S. , Atasoy Deniz , Fisher Rory A.
Published: September 2024

JOURNAL/nrgr/04.03/01300535-202510000-00027/figure1/v/2024-11-26T163120Z/r/image-tiff

Hippocampal neuronal loss causes cognitive dysfunction in Alzheimer’s disease. Adult hippocampal neurogenesis is reduced in patients with Alzheimer’s disease. Exercise stimulates adult hippocampal neurogenesis in rodents and improves memory and slows cognitive decline in patients with Alzheimer’s disease. However, the molecular pathways for exercise-induced adult hippocampal neurogenesis and improved cognition in Alzheimer’s disease are poorly understood. Recently, regulator of G protein signaling 6 (RGS6) was identified as the mediator of voluntary running–induced adult hippocampal neurogenesis in mice. Here, we generated novel RGS6fl/fl; APPSWE mice and used retroviral approaches to examine the impact of RGS6 deletion from dentate gyrus neuronal progenitor cells on voluntary running–induced adult hippocampal neurogenesis and cognition in an amyloid-based Alzheimer’s disease mouse model. We found that voluntary running in APPSWE mice restored their hippocampal cognitive impairments to that of control mice. This cognitive rescue was abolished by RGS6 deletion in dentate gyrus neuronal progenitor cells, which also abolished running-mediated increases in adult hippocampal neurogenesis. Adult hippocampal neurogenesis was reduced in sedentary APPSWE mice versus control mice, with basal adult hippocampal neurogenesis reduced by RGS6 deletion in dentate gyrus neural precursor cells. RGS6 was expressed in neurons within the dentate gyrus of patients with Alzheimer’s disease with significant loss of these RGS6-expressing neurons. Thus, RGS6 mediated voluntary running–induced rescue of impaired cognition and adult hippocampal neurogenesis in APPSWE mice, identifying RGS6 in dentate gyrus neural precursor cells as a possible therapeutic target in Alzheimer’s disease.
Glucocorticoid receptor signaling in the brain and its involvement in cognitive function
Authors: Su Chonglin , Huang Taiqi , Zhang Meiyu , Zhang Yanyu , Zeng Yan , Chen Xingxing
Published: September 2024

The hypothalamic–pituitary–adrenal axis regulates the secretion of glucocorticoids in response to environmental challenges. In the brain, a nuclear receptor transcription factor, the glucocorticoid receptor, is an important component of the hypothalamic–pituitary–adrenal axis’s negative feedback loop and plays a key role in regulating cognitive equilibrium and neuroplasticity. The glucocorticoid receptor influences cognitive processes, including glutamate neurotransmission, calcium signaling, and the activation of brain-derived neurotrophic factor–mediated pathways, through a combination of genomic and non-genomic mechanisms. Protein interactions within the central nervous system can alter the expression and activity of the glucocorticoid receptor, thereby affecting the hypothalamic–pituitary–adrenal axis and stress-related cognitive functions. An appropriate level of glucocorticoid receptor expression can improve cognitive function, while excessive glucocorticoid receptors or long-term exposure to glucocorticoids may lead to cognitive impairment. Patients with cognitive impairment–associated diseases, such as Alzheimer’s disease, aging, depression, Parkinson’s disease, Huntington’s disease, stroke, and addiction, often present with dysregulation of the hypothalamic–pituitary–adrenal axis and glucocorticoid receptor expression. This review provides a comprehensive overview of the functions of the glucocorticoid receptor in the hypothalamic–pituitary–adrenal axis and cognitive activities. It emphasizes that appropriate glucocorticoid receptor signaling facilitates learning and memory, while its dysregulation can lead to cognitive impairment. This provides clues about how glucocorticoid receptor signaling can be targeted to overcome cognitive disability-related disorders.
The necessity and reasons for referrals to endodontists among general dentists in Mashhad: A cross-sectional study
Authors: Gharechahi Maryam , Rouhani Armita , Ahmadi Amin Khazai , Davaji Mina
Published: September 2024

Introduction:

This study aimed to identify the necessity and reasons for patient referral to endodontists among general dentists in Mashhad, Iran, in 2021.

Materials and Methods:

This research employed a descriptive cross-sectional study design. Two hundred general dentists participated in the survey, answering a questionnaire with confirmed reliability and validity. The questions focused on their reasoning for deciding to perform or not perform root canal treatment, their rationale for referring or not referring patients to endodontists, and the factors influencing these decisions. Data were analyzed using the SPSS-19 software, using Chi-square and Mann–Whitney tests (α = 0.05).

Results:

Of the respondents, 68% performed root canal therapy routinely, while 8.5% reported never performing root treatment. Men were more likely to perform root canal therapy than women (P < 0.001). Among the dentists who performed root canal therapy, 76.5% considered endodontic referrals necessary, and the number of referrals was higher among female dentists than male dentists (P < 0.001). Overall, the main reasons for referral to endodontists include noncooperation of the patient, open apex, and mouth opening limitations. Fear of losing the patient and the high costs of specialized treatment were the reasons for nonreferral to endodontists.

Conclusion:

There is a need to eliminate the barriers to endodontic referral among general dentists in Mashhad. Economic issues played a substantial role in dentists’ unwillingness to perform root canal therapy and endodontic referral. The study provides insights into the reasons for referral, which can guide the development of strategies to improve endodontic care and patient outcomes.
Preparation and characterization of novel nano-tricalcium silicate-58s bioactive glass-based root canal sealer
Authors: Al-Sabawi Nawal Atiya , Al-Jubori Sawsan Hameed
Published: September 2024

Introduction:

Calcium silicate-based root canal sealers are gain significant interest in the recent endodontic treatment, but the high solubility and long setting time are the most shortcoming. Therefore, this study aimed to develop new nano-tricalcium silicate-58s bioactive glass (BG)-based root canal sealer with phosphate-buffered saline (PBS) as a liquid precursor, as well as to evaluate the hydration reaction of the newly prepared sealer.

Materials and Methods:

Different formulae were prepared by adding nano-zirconium dioxide (ZrO2) and 58s BG to the tricalcium silicate (C3S) at different concentrations. Furthermore, two types of liquid were used as precursors (PBS and distilled water). Then after, the setting time and solubility were evaluated for each prepared formula. Statistical analysis was performed using analysis of variance and Tukey tests. The formula that had the best properties was characterized by X-ray diffraction and Fourier transform infrared spectroscopy.

Results:

It was found that the ZrO2 at 25%, BG at 30%, and the use of PBS as a liquid improved the physical properties of the prepared sealer. Results indicated that the main hydration reactions by products for the best formula were noncrystalline calcium silicate hydrate, crystalline Ca(OH)2, CaCO3, Ca(H2PO4)2, Ca3(PO4)2, and hydroxyapatite.

Conclusions:

The experimental formula that composed mainly of 45% C3S, 25% ZrO2, and 30% BG as a powder and PBS as a liquid precursor had superior properties, which is in line with the American Dental Association specification.
The effect of different reciprocating angles on debris extrusion produced by R-Motion files – An in vitro study
Authors: Al-Omari Taher Mohammed Nabil , Arican Burcin , Ates Ayfer Atav
Published: September 2024

Introduction:

Extrusion of debris resulting from canal preparation is an important topic of interest for dentists. This study assessed the performance of the R-Motion (RM) and Reciproc Blue (RB) systems on extracted teeth, for both apically extruded debris and time of preparation.

Materials and Methods:

Sixty mandibular premolar teeth with straight match canal anatomy were indiscriminately allocated to one of the three groups: RM-WO (WaveOne ALL-mode), RM-R (Reciproc ALL-mode), and RB with glide path (R ALL-mode). The amount of extruded debris apically was collected in preweighed plastic laboratory tubes during treatment, and the procedure time was recorded. The mean values of extruded debris were calculated by subtracting the postinstrumentation weight of tubes from the preinstrumentation weight. The data were statistically analyzed using the one-way analysis of variance (ANOVA) and Tukey pairwise comparison tests.

Results:

Extrusion of debris was observed with all the samples. The RM group had less apical extrusion of debris compared to the RB group. Extruded debris in the RM-R group was numerically less than in the RM-WO group (P > 0.05) and significantly less than in the RB group (P < 0.05) (one-way ANOVA test; P < 0.05). In both motions, the preparation time required by RB was equal to that required by the RM file (One-way ANOVA test; P > 0.05).

Conclusions:

All samples showed extrusion of debris to some extent, irrespective of the motion used. RM-R was associated with the least amount of extruded debris.
Regenerative endodontic therapy after autogenous transplantation of mandibular third molar
Authors: Falahi Negar , Baniasadi Mohadese
Published: September 2024

Autogenous tooth transplantation involves moving a tooth from its original position to replace a missing tooth. Complications, such as pulp necrosis, can occur following autotransplantation of teeth with incomplete root formation. There are insufficient studies on managing pulp necrosis in autotransplanted immature teeth by regenerative endodontic treatment (RET). In this case, a 21-year-old woman developed a sinus tract 3 months after autotransplantation of an immature third molar that replaced the lower left mandibular first molar. She presented with pain while chewing in the area of her autografted third molar. Based on clinical findings and periapical radiolucency in radiographic findings, the tooth was diagnosed with necrotic pulp and apical periodontitis. It was decided to perform RET for the tooth. The tooth underwent chemomechanical debridement and calcium hydroxide dressing in the first session. After 2 weeks, the patient’s pain and sinus tract were resolved. In the second session, the periapical tissue was stimulated by inserting a K-file 2 mm over the apex to induce bleeding in the root canal. Mineral trioxide aggregate was placed over the blood clot, and the tooth received final restoration. After 11 months of recall appointments, the apical foramen size had decreased the thickness of the apical dentin wall increased, there was no periapical pathosis, and the periodontal ligament space width was normal. This case report provides valuable insights into the pulpal management of autotransplanted immature teeth.
Interesting case of nasolabial cyst mimicking endodontic lesion
Authors: Johari Maryam , Nikraftar Roxana Sadegh Amal , Soleymani Ali
Published: September 2024

Nasolabial cysts are rare nonodontogenic soft-tissue cysts, which include 0.7% of maxillofacial cysts. It is usually not seen in plain radiograph images and Computed tomography (CT) and Magnetic Resonance Imaging (MRI) can be helpful in diagnosing the cases. A 35-year-old healthy man reported with a complaint of painless swelling in the upper anterior teeth for a few months. He did not report a history of trauma and medical history, but he has a history of endodontic treatment of right maxillary central and lateral incisors in the past 2 years. This case was initially diagnosed as an endodontic lesion. A con-beam CT radiographic examination showed a homogeneous circular lesion was observed in the buccal soft tissue of the right incisor tooth and a depression in the Buccal plate. The lesion was removed intraorally and sent for pathology, which confirmed the diagnosis of the nasolabial cyst. The patient was asymptomatic with no swelling at the 6-month follow-up. This case showed that the preparation of appropriate radiographic images along with a good clinical examination can prevent misdiagnosis and inappropriate subsequent treatment.