Unravelling the success of transferosomes against skin cancer: Journey so far and road ahead.

Skin cancer remains one of the most prominent types of cancer. Melanoma and non-melanoma skin cancer are commonly found together, with melanoma being the more deadly type. Skin cancer can be effectively treated with chemotherapy, which mostly uses small molecular medicines, phytoceuticals, and biomacromolecules. Topical delivery of these therapeutics is a non-invasive way that might be useful in effectively managing skin cancer. Different skin barriers, however, presented a major obstacle to topical cargo administration. Transferosomes have demonstrated significant potential in topical delivery by improving cargo penetration through the circumvention of diverse skin barriers. Additionally, the transferosome-based gel can prolong the residence of drug on the skin, lowering the frequency of doses and their associated side effects. However, the choice of appropriate transferosome compositions, such as phospholipids and edge activators, and fabrication technique are crucial for achieving improved entrapment efficiency, penetration, and regulated particle size. The present review discusses skin cancer overview, current treatment strategies for skin cancer and their drawbacks. Topical drug delivery against skin cancer is also covered, along with the difficulties associated with it and the importance of transferosomes in avoiding these difficulties. Additionally, a summary of transferosome compositions and fabrication methods is provided. Furthermore, topical delivery of small molecular drugs, phytoceuticals, and biomacromolecules using transferosomes and transferosomes-based gel in treating skin cancer is discussed. Thus, transferosomes can be a significant option in the topical delivery of drugs to manage skin cancer efficiently.

Community resource centres to improve the health of women and children in informal settlements in Mumbai: a cluster-randomised, controlled trial.

BACKGROUND: Around 105 million people in India will be living in informal settlements by 2017. We investigated the effects of local resource centres delivering integrated activities to improve women's and children's health in urban informal settlements. METHODS: In a cluster-randomised controlled trial in 40 clusters, each containing around 600 households, 20 were randomly allocated to have a resource centre (intervention group) and 20 no centre (control group). Community organisers in the intervention centres addressed maternal and neonatal health, child health and nutrition, reproductive health, and prevention of violence against women and children through home visits, group meetings, day care, community events, service provision, and liaison. The primary endpoints were met need for family planning in women aged 15-49 years, proportion of children aged 12-23 months fully immunised, and proportion of children younger than 5 years with anthropometric wasting. Census interviews with women aged 15-49 years were done before and 2 years after the intervention was implemented. The primary intention-to-treat analysis compared cluster allocation groups after the intervention. We also analysed the per-protocol population (all women with data from both censuses) and assessed cluster-level changes. This study is registered with ISRCTN, number ISRCTN56183183, and Clinical Trials Registry of India, number CTRI/2012/09/003004. FINDINGS: 12 614 households were allocated to the intervention and 12 239 to control. Postintervention data were available for 8271 women and 5371 children younger than 5 years in the intervention group, and 7965 women and 5180 children in the control group. Met need for family planning was greater in the intervention clusters than in the control clusters (odds ratio [OR] 1·31, 95% CI 1·11-1·53). The proportions of fully immunised children were similar in the intervention and control groups in the intention-to-treat analysis (OR 1·30, 95% CI 0·84-2·01), but were greater in the intervention group when assessed per protocol (1·73, 1·05-2·86). Childhood wasting did not differ between groups (OR 0·92, 95% CI 0·75-1·12), although improvement was seen at the cluster level in the intervention group (p=0·020). INTERPRETATION: This community resource model seems feasible and replicable and may be protocolised for expansion. FUNDING: Wellcome Trust, CRY, Cipla.

Prosthodontic Approach in Management of Prolonged Neonatal Intubation.

Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa. Ineffective stabilization of the tubes is a frequent problem often resulting in accidental extubation and displacement of orotracheal and orogastric tube. Hence, these tubes must be stabilized against displacement from tongue and jaw movements to prevent discomfort and subsequent tissue trauma. Complications of prolonged endotracheal intubation include palatal groove formation by pressure against the hard palate, infection, accidental extubation, malposition, laryngeal or tracheal edema and ulceration, tracheal stenosis, vocal cord injury. Various oral appliances are used for infants to stabilize the tubes and prevent complications associated with long term intubation. This case report describes a prosthodontic approach in management of prolonged neonatal intubation.

Comparative Evaluation of Shear Bond Strength of Luting Cements to Different Core Buildup Materials in Lactic Acid Buffer Solution.

AIM AND OBJECTIVES: The core buildup material is used to restore badly broken down tooth to provide better retention for fixed restorations. The shear bond strength of a luting agent to core buildup is one of the crucial factors in the success of the cast restoration. The aim of this invitro study was to evaluate and compare the shear bond strength of luting cements with different core buildup materials in lactic acid buffer solution. MATERIALS AND METHODS: Two luting cements {Traditional Glass Ionomer luting cement (GIC) and Resin Modified Glass Ionomer luting cement (RMGIC)} and five core buildup materials {Silver Amalgam, Glass ionomer (GI), Glass Ionomer Silver Reinforced (GI Silver reinforced), Composite Resin and Resin Modified Glass Ionomer(RMGIC)} were selected for this study. Total 100 specimens were prepared with 20 specimens for each core buildup material using a stainless steel split metal die. Out of these 20 specimens, 10 specimens were bonded with each luting cement. All the bonded specimens were stored at 37(0)c in a 0.01M lactic acid buffer solution at a pH of 4 for 7days. Shear bond strength was determined using a Universal Testing Machine at a cross head speed of 0.5mm/min. The peak load at fracture was recorded and shear bond strength was calculated. The data was statistically analysed using Two-way ANOVA followed by HOLM-SIDAK method for pair wise comparison at significance level of p<0.05. RESULTS: Two-Way ANOVA showed significant differences in bond strength of the luting cements (p<0.05) and core materials (p<0.05) and the interactions (p<0.05). Pairwise comparison of luting cements by HOLM-SIDAK test, showed that the RMGIC luting cement had higher shear bond strength values than Traditional GIC luting cement for all the core buildup materials. RMGIC core material showed higher bond strength values followed by Composite resin, GI silver reinforced, GI and silver amalgam core materials for both the luting agents. CONCLUSION: Shear bond strength of RMGIC luting cement was significantly higher than traditional GIC luting cement for all core buildup materials except, for silver amalgam core buildup material. RMGIC core material showed highest shear bond strength values followed by Composite resin, GI Silver Reinforced, GI and Silver Amalgam core materials irrespective of luting cements.

Isolation of Candida species from the oral cavity and fingertips of complete denture wearers.

BACKGROUND: Wearing a dental prosthesis is known to increase oral candidal colonization and predispose the wearer to oral candidosis. Denture wearers frequently use fingers to take the prosthesis out of their mouth. Oral Candida, if present may contaminate wearer's finger. The objective of this study was to investigate the simultaneous candidal colonization of oral cavity and fingertips of complete denture wearers. MATERIALS AND METHODS: A total of 25 apparently healthy male subjects who had worn complete dentures for at least 1 year were selected. Information about each patient's denture age, denture hygiene, handling, and wearing habits, and hand washing habits after denture handling were be obtained. Intraoral examination of all the patients was done. For microbiological examination samples were collected from the fingertip and oral rinse of each patient. Candida species were identified with use of germ tube test and commercially available yeast identification system. Data was statistically analyzed. Significance was set at p < 0.05. RESULTS: It was found that frequency of hand washing, denture handling and denture stomatitis with respect to fingertip candidal isolation was not statistically significant. But poor denture hygiene and denture stomatitis with respect to oral candidal colonization was statistically significant. CONCLUSION: Denture wearers with oral Candida had a higher prevalence of Candida contamination on their fingers. Patients with removable prostheses should be informed about the importance of proper prosthesis and personal hygiene and the possibility of microbial contamination of the hands and other parts of the body.

Prosthetic Correction of Postenucleation Socket Syndrome: A Case Report.

Postenucleation socket syndrome is a frequent late complication of enucleation of eye globe. Several pathophysiological mechanisms have been proposed to account for the symptoms of postenucleation socket syndrome, which include lost orbital volume, superior sulcus deformity, upper eyelid ptosis, lower eyelid laxity, and backward tilt of the prosthesis. The goal of postenucleation socket syndrome treatment is to achieve the best possible functional and esthetic result. The treatment can be either conservative or surgical. For the patient interested in a non-surgical correction, the conservative treatment is simple and non invasive and can be done with prosthesis modification for good positioning, comfort, and mobility. This paper describes prosthetic correction of a patient with postenucleation socket syndrome by modified ocular prosthesis.

An ocular prosthesis for a geriatric patient: a case report.

When geriatric patients with maxillofacial defects are handled, the clinician must be confident of addressing and managing the psychology of these patients. It is also required that the clinician must understand and be sensitive to the medical and financial states of geriatric patients. The loss of an eye has a far-reaching impact on an individual's psychology and an immediate replacement is necessary to promote the physical and psychological healing of the patient and to improve his/her social acceptance. Special approaches and treatment goals are considered while treating geriatric patients with ocular defects and special consideration is given to the appointment length, the number of appointments and their medical and financial statuses. This article presents the prosthetic rehabilitation of a geriatric patient with an ocular defect, with a customized stock ocular prosthesis, by using a minimal intervention geriatric approach.

Comparative analysis of the clinical techniques used in evaluation of marginal accuracy of cast restoration using stereomicroscopy as gold standard.

PURPOSE: This study assessed the effect of preparation design on marginal adaptation and also compared the sensitivity and specificity of clinical evaluation techniques for marginal accuracy of cast restorations to stereomicroscopy. MATERIALS AND METHODS: Three Ivorine molar teeth of different designs were prepared. (A)-A complete crown preparation with buccal shoulder and beveled finish line. (B)-A complete crown preparation with chamfer finish line. (C)-A three-quarter crown preparation with proximal boxes and beveled finish line. Twenty four castings were prepared with eight castings for each design respectively. Each casting underwent examination with an explorer, disclosing media, and a stereomicroscope. Stereomicroscopy at a value less than or equal to 30 microns was used as a gold standard to evaluate the significance of different designs on marginal adaptation. Chi-square tests of independence and Kruskal-Wallis were used to evaluate the effect of preparation design and compare the agreement between examination methods for detection of marginal gap size of greater than or equal to 30 microns (α=.05). Sensitivity and specificity for explorer and disclosing media as compared to stereomicroscope was calculated using statistical formula given by Park. RESULTS: The preparation design did not significantly affect overall marginal adaptation. Examination by explorer and disclosing media at 30 µm revealed 39% and 10.06% sensitivity and 91% and 82% specificity respectively. CONCLUSION: Preparation designs examined in this study did not significantly affect the marginal adaptation of the castings. Commonly used clinical evaluation techniques using explorer and disclosing media appeared to be inadequate for assessment of marginal accuracy.