Salivary Irisin and periodontal clinical parameters in patients of chronic periodontitis and healthy individuals: A novel salivary myokine for periodontal disease.

OBJECTIVE: To evaluate changes in the levels of salivary irisin in chronic periodontitis, and to correlate the two. METHODS: The analytical cross-sectional study was conducted at Fatima Memorial Hospital & College of Dentistry, Lahore, Pakistan, from September 2017 to March 2018, and comprised patients of either gender visiting the periodontic out-patient department. The subjects were divided into group I, which had periodontally healthy controls, and group II, which had an equal number of chronic periodontitis patients. Chronic periodontitis was assessed on basis of pocket probing depth, clinical attachment level, plaque percentage and bleeding on probing. Also, 4ml of un-stimulated saliva was collected for the quantification of irisin protein using enzyme-linked immunosorbent assay. Data was analysed using SPSS 25. RESULTS: Of the 40 subjects, there were 20 (50%) in group I with 10 (50%) males and 10 (50%) females having an overall mean age of 37.60±2.58 years. The remaining 20 (50%) subjects were in group II with 16 (80%) males and 4 (20%) females having an overall mean age of 43.25±6.10 years. Mean salivary irisin level in group II was 6.80±3.97ng/ml compared to 3.99±2.48 ng/ml in group I (p=0.009). Periodontal clinical parameters in both the groups were positively but non-significantly correlated with salivary irisin levels (p>0.05) except for decreased plaque percentage in group I (p<0.05). CONCLUSION: Salivary irisin levels increased in chronic periodontitis and decreased with decreasing plaque percentage in healthy individuals, indicating that this myokine can act as a biomarker for chronic periodontal disease.

Financing constraints and firm-level responses to the COVID-19 pandemic: International evidence.

We explore whether financing constraints affected the ways in which small and medium-sized enterprises navigated through the economic disruptions caused by the COVID-19 pandemic. We draw on data from a novel source, the COVID-19 Impact Follow-up Surveys conducted in 19 countries by the World Bank Enterprise Analysis Unit as a follow-up to enterprise surveys conducted in these countries prior to the COVID-19 outbreak. We find that previous bank-lending credit constraints magnified the effects of the pandemic. More specifically, credit-rationed firms were more likely to experience greater liquidity and cash flow problems and more likely than unconstrained firms to be delinquent in meeting their obligations to financial institutions during the economic crisis. Furthermore, these firms were less likely to have access to bank funding as a principal source of financing to address pandemic-induced cash flow and liquidity problems during the COVID-19 outbreak. We further find that credit-constrained firms were more likely to use trade credit, delay payments to suppliers or employees, and rely on government grants to cope with pandemic-related liquidity and cash flow problems. We find little evidence that credit-rationed firms were more likely to raise equity capital during this economic crisis. Finally, we find that financing constraints were more likely to hamper firms' ability to adjust business operations in response to exogenous shocks. This study contributes to the literature on the impact of credit constraints on firm behavior in times of crisis.

Reorienting goals in endodontic therapy: Pulp revitalisation, on the brink of a paradigm shift.

OBJECTIVE: To assess literature related to the various aspects of dental pulp tissue engineering, its myriad protocols, inclusive of adjuvant surgeries, and to summarise the testing methodologies of pulp vitality. METHODS: The multidisciplinary systematic review was conducted at the Army Medical College, Rawalpindi, the National University of Medical Sciences, Rawalpindi, and HITEC Dental College, Taxilla, Pakistan, and comprised literature search on PubMed, Scopus, MEDLINE, Cochrane and Science Direct databases related to articles about 'revitalisation', 'revascularisation', 'dental pulp' and 'regeneration' published from January 2017 to January 2020. RESULTS: Of the 5,986 articles found through search, 14(0.23%) studies were selected; 8(57.1%) clinical trials, 1(7.1%) case series, and 5(35.7%) case reports with platelet concentrates. All the studies (100%) had observed standard clinical treatment procedures for canal disinfection. Current strategies of pulpal regeneration reported commendable success. Histological analysis of clinical trials is essential to ensure confirmatory evidence of quality of revitalisation. CONCLUSIONS: The assessment of the impact of oral factors and a long-term follow up are required to produce a definitive understanding of the phenomenon.

Antimicrobial, antioxidant and cytotoxic properties of Chenopodium glaucum L.

We evaluated phytochemical composition, antibacterial, antifungal, anti-oxidant and cytotoxic properties of aqueous (water) and organic extracts (methanol, ethyl acetate and n-hexane) of Chenopodium glaucum. Highest phenolic content 45 mg gallic acid equivalents (GAE)/g d.w was found in aqueous extract followed by ethyl acetate (41mg GAE/g d.w) and methanol extract (34.46 mg GAE/g d.w). Antibacterial potential of aqueous and organic extracts of C. glaucum was examined against Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis. The aqueous, methanolic, ethyl acetate, and n-hexane extract showed antibacterial activity against A. baumannii, K. pneumoniae, E. coli and S. epidermidis. However, against A. baumannii significantly higher inhibition zone (19 mm and 18.96 mm respectively) was shown by ethyl acetate and methanol extracts. Aqueous extract possessed highest growth inhibition (11 mm) against E. coli. Aqueous, ethyl acetate and methanol extracts showed 9 mm, 10 mm, and 10.33 mm zone of inhibition against the K. pneumoniae. For antifungal activity, the extracts were less effective against Aspergillus niger but showed strong antifungal activity against Aspergillus flavus (A. flavus). The antioxidant activity was measured as DPPH (2, 2-diphenyl-1-picrylhydrazyl), H2O2 and ABTS (2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) scavenging activity of free radicals. All the organic extracts of C. glaucum possessed ABTS, DPPH and H2O2 scavenging properties. The highest cytotoxic activity measured as half maximal inhibitory concentration (IC50) against human lungs carcinoma cells was recorded for methanolic (IC50 = 16 µg/mL) and n-hexane (IC50 = 25 µg/mL) extracts, respectively. The Gas chromatography-mass spectrometry (GC-MS) analysis showed 4 major and 26 minor compounds in n-hexane extract and 4 major and 7 minor compounds in methanol extract of the C. glaucum. It is concluded that aqueous and organic extracts of C. glaucum would be potential therapeutic agents and could be exploited on a pilot scale to treat human pathogenic diseases.

Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection in Patients With Multiple Comorbidities: Long-Term Safety and Efficacy Results From a Tertiary Care Community Hospital.

BACKGROUND: Cure rates of Clostridium difficile infection (CDI) with fecal microbiota transplant (FMT) have been promising. However, there is debate regarding success of FMT in patients with comorbidities. METHODS: Electronic chart review was done to collect data on patients who underwent FMT from January 2015 to August 2017. Charts were analyzed in November 2018 with a median follow-up of 25.4 months (interquartile range 20 - 31 months). RESULTS: Twenty patients underwent FMT. The primary success rate at our institution was 90% and overall success rate was 100%. Six patients (43%) had FMT failure (two early and four late). CONCLUSIONS: This case series is a description of our center's initial experience with FMT for treatment of recurrent CDI. Our high success rate reiterates the efficacy and safety of FMT in this population including patients with comorbidities.

Myokines: Discovery Challenges and Therapeutic Impediments.

Physical activity has been linked with maintenance of bodily health and prevention of numerous pathologies which might arise in its absence. Physical surge renders the skeletal muscles of the body to come into action which then, besides per forming the basic functions of locomotion and maintenance of body posture, produce various proteinaceous secretions. These secretions contain skeletal muscle-released biochemical products known as myokines. More than 650 myokines have been identified and this list is increasing so rapidly that this branch of proteomics can now be designated as a 'myokinome'. This review was planned to describe the major challenges faced in myokine discovery, barriers in use of myokines as a treatment modality and the techniques utilised to overcome these scientific hurdles. Establishment of correlation of myokines with the state of health and disease can help improve clinical diagnostics and will ultimately improve the quality of life of patients.

Isolated Left Ventricular Metastasis from Renal Cell Carcinoma: Diagnostic and Therapeutic Dilemma.

BACKGROUND: The treatment of metastatic renal cell carcinoma (RCC) has been radically changed by the advent of tyrosine kinase inhibitors (TKIs). However, few reports have described their role in cardiac metastases. We present a case of a left ventricular metastasis from RCC that was managed with pazopanib therapy. CASE REPORT: A 74-year-old male with stage I RCC underwent right nephrectomy in 2004 and right lung metastasis resection in 2009. He was well till March 2016, when he presented with chest pain. Cardiac catheterization revealed a highly vascular mass in the apex. Cardiac magnetic resonance imaging revealed a left ventricular mass with full-thickness involvement of the myocardium, and the open cardiac biopsy was consistent with metastatic RCC. The patient was initially treated with pazopanib with response but later developed therapy-related side effects, and the dose was reduced. Due to tumor progression, he is currently on nivolumab instead and is stable. CONCLUSION: RCC with cardiac metastasis poses unique challenges with regard to diagnosis as well as treatment. The use of TKI therapy is associated with cardiotoxicity and has not been adequately studied in cardiac metastasis. Choosing the right treatment for this subgroup of patients continues to pose an ongoing dilemma.

Hybridization effects on wave packet dynamics in topological insulator thin films.

Theoretical study of electron wave packet dynamics in topological insulator (TI) thin films is presented. We have investigated real space trajectories and spin dynamics of electron wave packets in TI thin films. Our focus is on the role of hybridization between the electronic states of the two surfaces. This allows us to access the crossover regime of a thick film with no hybridization to a thin film with finite hybridization. We show that the electron wave packet undergoes side-jump motion in addition to zitterbewegung. The oscillation frequency of zitterbewegung can be tuned by the strength of hybridization, which in turn can be tuned by the thickness of the film. We find that the spin expectations also exhibit zitterbewegung tunable by hybridization. We also show that it is possible to obtain persistent zitterbewegung, oscillations which do not decay, in both the real space trajectories as well as spin dynamics. The zitterbewegung oscillation frequency in TI thin films falls in a parameter regime where it might be possible to observe these effects using present day experimental techniques.