Effects of nonsurgical periodontal therapy on serum creatinine level in systemically healthy individuals with periodontitis: An interventional study.

Background: Several studies have suggested a relationship between periodontitis and serum creatinine levels. Both low and high serum creatinine levels have been reported in individuals with periodontitis. The impact of periodontal therapy on serum creatinine levels has not been fully investigated yet. The aim of the study is to estimate the influence of nonsurgical periodontal therapy (NSPT) on serum creatinine levels in systemically healthy individuals with periodontitis at stage II and stage III with grade A and grade B. Materials and Methods: Sixty-eight systemically healthy individuals included in the study were divided into Group A (GA) (Periodontally healthy) and Group B (GB) (Periodontitis: stage II and III with grade A and grade B). Gingival index, sulcular bleeding index, probing pocket depth, clinical attachment level, body mass index, and serum creatinine levels were recorded at baseline for both GA and GB, 90 days after NSPT for GB only. Collected data were analyzed statistically. Results: Serum creatinine levels in GB were significantly higher when compared with GA and serum creatinine levels in GB before and 90 days after NSPT were statistically insignificant. Conclusions: Serum creatinine levels were higher in individuals with periodontitis when compared with periodontally healthy individuals and NSPT has no considerable influence on the serum creatinine levels in individuals with periodontitis. Further studies are required to confirm these findings.

Association of minimum dietary diversity with anaemia among 6-59 months' children from rural India: An evidence from a cross-sectional study.

Introduction: Anaemia is one of the micronutrient deficiency disorders that have global public health implications. The present study aims to determine the association of minimum dietary diversity (MDD) with anaemia among children aged 6-59 months in rural North India. Methods: In Rohtak (a north Indian city), a cross-sectional survey was conducted in 2018-19 (n = 266). Univariate and bivariate analyses were performed. The Chi-square test was used for assessing the significance level during bivariate analysis. Further, multivariable regression analysis was used for determining the factors for anaemia prevalence among children aged 6-59 months. Results: About 62.4% (n = 166) of the children aged 6-59 months were found to have anaemia in the study area. The prevalence of MDD was 35.3% (n = 94). It was found that children with no MDD have a higher prevalence of moderate (42% vs. 25.5%; P < 0.001) and severe (12.8% vs. 8.5%; P < 0.001) anaemia. It was revealed that the children with no MDD had a significantly higher likelihood of being anaemic than children with MDD in model-1 [aOR: 2.09; CI: 1.23, 3.55] and model-3 [aOR: 1.70; CI: 1.01, 3.01]. Children with mothers who never attended school had significantly higher odds for anaemia in reference to those children whose mothers ever attended school in model-2 [aOR: 3.62; CI: 2.07,6.34] and model-3 [aOR: 3.00; CI: 1.62,5.56]. Conclusion: Measures to alleviate under-five anaemia should include empowering and educating women, expanding access to supplementation, fortification programmes, and promoting and raising awareness about feeding diverse foods, while also considering the socioeconomic status.

Modeling coarse-grained van der Waals interactions using dipole-coupled anisotropic quantum Drude oscillators.

The Quantum Drude Oscillator (QDO) model is a promising candidate for accurately calculating the van der Waals (vdW) interaction. Anisotropic QDO models have recently been used to represent quantum fluctuations of molecular fragments rather than that of single atoms. While this model promises accurate calculation of vdW energy, there is significant room for improvements, such as incorporating a proper fragmentation method, higher-order dispersion corrections, and so forth. The present work attempts to gauge dipole-dipole interactions' ability without fragmentation. A suitable anisotropic damping function is also introduced to work with anisotropic QDO. This revised model accurately predicts the binding energies of vdW complexes for most of the systems considered. This work indicates the limit of dipole approximation for an anisotropic QDO-based model.

Matrix metalloproteinase-9-1562 C/T promoter gene polymorphism in chronic periodontitis: A cross-sectional observational study.

Background: Matrix metalloproteinases (MMPs) are a major group of enzymes, released in inflamed periodontal tissues in large quantities, resulting in connective tissue matrix breakdown. One of the most predominant MMPs is MMP-9. Association between chronic periodontitis (CP) and MMP-9 gene polymorphism (GP) in some ethnic populations has been already established. The aim of the current study was to assess the association of single-nucleotide polymorphism in the promoter region of MMP-9 gene with CP in Kolkata population, if any. Materials and Methods: Forty eligible individuals were recruited for the study and grouped as A and B: Group A (twenty periodontally healthy individuals) and Group B (twenty CP patients). Venous blood samples collected from all the forty individuals were used to isolate the genomic DNA. GP for MMP-9 gene was detected using polymerase chain reaction and sequencing method. The data obtained were then analyzed statistically. Results: A significantly different genotypic and allelic variation was observed in the control and test groups, with C/T genotype and T allele present in only CP group. Conclusion: Within the limitations of this study, we can conclude that there was no significant association between patients with periodontitis and MMP-9-1562 C/T promoter GP.

A simple fragment-based method for van der Waals corrections over density functional theory.

Modeling intermolecular noncovalent interactions between large molecules remains a challenge for the electron structure theory community due to the high cost. Fragment-based methods usually fare well in reducing the cost of computations in such systems. On the other hand, the interactions between quantum mechanical fluctuations of electron density can be modeled well by the interaction between atom-centered quantum Drude oscillators. In this paper, we have developed a simple yet effective method to describe intermolecular van der Waals interactions based on an amalgamation of Drude oscillator with the fragmentation of molecular systems. The resulting interaction energies have been used as corrections over low-cost DFT functional PBE. We have tested our method on the S66X8 database with significant success. While this work is a proof-of-concept study to employ anisotropic oscillators for modeling electron fluctuation, we have also reduced the number of empirical parameters compared to DFT-D methods without any loss of accuracy in the process. The resulting method shows accuracy at par with Grimme's DFT-D3 method while only using dipole-dipole interactions.

Expression of matrix metalloproteinase-9 in gingival tissue biopsy in patients with slowly/ moderately and rapidly progressing periodontitis: An observational study.

BACKGROUND: Matrix metalloproteinases (MMPs) are a group of host-derived zinc-dependent enzymes which mediates the destruction of the extracellular matrix. In periodontitis, there is excess production of MMPs associated with periodontal tissue destruction. The aim of this study was to estimate the level MMP-9 in both active and latent form in gingival tissue (GT) samples collected from periodontitis patients with different rates of progression and compare it with healthy individuals. MATERIALS AND METHODS: Sixty patients were selected and divided into three groups, 20 each: Group A (slowly/moderately progressing periodontitis), Group B (rapidly progressing periodontitis), and Group C (clinical periodontal health). Plaque index, gingival index, periodontal probing depth (PPD), and clinical attachment level were recorded. GT samples were collected from all 60 patients and MMP-9 expressions were measured using gelatin zymography and western blotting. RESULTS: Levels of active MMP-9 (aMMP-9) and latent MMP-9 (lMMP-9) were significantly high in both Group A (GA) (aMMP-9: 2.05 arbitrary unit [AU]/lMMP-9: 2.54 AU) and Group B (GB) (aMMP-9: 1.32 AU/lMMP-9: 1.74 AU) when compared to that of Group C (GC) (aMMP-9: 0.93/lMMP-9: 1.08 AU). In GA, levels of aMMP-9 showed a significant correlation with PPD values. No other correlations were found. CONCLUSION: The levels of aMMP-9 and lMMP-9 were increased in both the types of periodontitis when compared with periodontally healthy individuals. A significant correlation was found between PPD and activities of aMMP-9 in slowly/moderately progressing periodontitis patients. However, further studies are required to confirm these findings.

The Epistemology of a Positive SARS-CoV-2 Test.

We investigate the epistemological consequences of a positive polymerase chain reaction SARS-CoV test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each hypothesis: First, how much confirmation does a positive test lend to each hypothesis? Second, how much evidence does a positive test provide for each hypothesis against its negation? We respond to each question within a formal Bayesian framework. We construe degree of confirmation as the difference between the posterior probability of the hypothesis and its prior, and the strength of evidence for a hypothesis against its alternative in terms of their likelihood ratio. We find that test specificity-and coinfection probabilities when making inferences about C-were key determinants of confirmation and evidence. Tests with < 87% specificity could not provide strong evidence (likelihood ratio > 8) for V against ¬V regardless of sensitivity. Accordingly, low specificity tests could not provide strong evidence in favor of C in all plausible scenarios modeled. We also show how a positive influenza A test disconfirms C and provides weak evidence against C in dependence on the probability that the patient is influenza A infected given that his/her symptoms are not caused by SARS-CoV-2. Our analysis points out some caveats that should be considered when attributing symptoms or death of a positively tested patient to SARS-CoV-2.

A randomized split mouth clinical study to compare the clinical outcomes of subepithelial connective graft and acellular dermal matrix in Miller's Class I recession coverage therapy.

BACKGROUND: According to the American Association of Periodontology, subepithelial connective tissue graft (SCTG) is one the most reliable surgical technique available for the treatment of gingival recession (GR) with Miller's Class I defect. However, due to its various disadvantages, alternate grafts such as acellular dermal matrix (ADM) grafts have been introduced for recession coverage. The present study compares the clinical outcome of these two grafts in treating Miller's Class I GR. MATERIALS AND METHODS: All the 15 patients participated in the study who had totally 30 bilateral Miller's Class I GR were divided randomly into SCTG group and ADM group each containing 15 defects. In the SCTG group, coronally advanced flap (CAF) with SCTG was performed, and in ADM group, CAF with ADM was done. Clinical parameters were measured on the day of surgery (baseline) and after 6 months. Data collected were statistically analyzed using paired and unpaired t-tests. RESULTS: The analysis of the data collected at the baseline and 6 months later showed that there were no statistically significant differences in the recorded clinical parameters such as probing pocket depth, clinical attachment loss, and GR depth. ADM group showed a better color match than the SCTG group, while SCTG group achieved more keratinized tissue width than ADM group. CONCLUSION: From the outcome of the current study, we can conclude that ADM is an efficient substitute for SCTG for treating Miller's Class I GR. However, additional studies with greater number of samples and lengthier follow-up periods are necessary to validate the present inference.

Components of the interaction energy of the odd-electron halogen bond: an ab initio study.

In the realm of non-covalent interactions (NCI), the odd-electron halogen bond offers a fertile ground to explore the nature of such weak interactions. Here, an ab initio study of odd-electron halogen bonding (XB) is reported. The interactions of five radicals with several freons and interhalogens are studied using the Møller-Plesset (MP2) method. The regioselectivity, interaction energy and the components of the interaction energy of odd-electron XB were tuned by judicial selection of donor-acceptor pairs as revealed by scrutinizing the conceptual DFT parameters, NCI plot and LED-DLPNO-CCSD(T) analysis. The contribution from dispersion interaction is rather high for all XB bonded complexes and it increases when the interacting atom of the XB donor is highly polarizable. Additionally, the polarisation and intermolecular charge-transfer also contribute significantly when both the donor and acceptor atoms are soft species, resulting in a soft-soft interaction. We believe that our finding will not only shed new light on non-covalent interaction of odd-electron XB but will also be able to capture the pnictogen, chalcogen and tetrel bonding interactions. The ability of conceptual DFT parameters to predict the interaction energy and its components shown in this study will be helpful for tuning of substrates for desired products, modelling bio/macromolecules and crystal engineering.

Non-covalent interactions between epinephrine and nitroaromatic compounds: A DFT study.

Here, we present a density functional theory (DFT) study of hydrogen bonding and π-π stacking interactions between epinephrine and different aromatic nitro-compounds in gas phase as well as in methanol solvent. Detail investigations of hydrogen bonding and π-π interactions are performed and confirmed on the basis of theoretical IR spectra, natural bond orbital (NBO) analysis, non-covalent interaction (NCI), chemical reactivity descriptors and electronic spectra. Among different functionals used for the calculation, the results obtained from ωB97XD functional are found to be more suitable to describe the hydrogen bonding and π-π stacking phenomenon for our considered systems. Weakening of hydrogen bonding and π-π stacking interaction on solvent incorporation is observed. Electronic transition between different orbitals and transition probabilities of epinephrine and nitro-aromatic complexes are described using time dependent density functional theory (TD-DFT) method.

Unraveling the regioselectivity of odd electron halogen bond formation using electrophilicity index and chemical hardness parameters.

Odd electron halogen bonding of freons with five different free radicals have been investigated using M06-2X/6-311G++(d,p). Conceptual density functional theory parameters such as Fukui functions, electrophilicity index and chemical hardness have been utilised to examine the regioselectivity and strength of free radical induced halogen bonding. The strong electrophilic radical Cl˙ forms three-electron bonds upon interacting with the nucleophilic ring surrounding the sigma hole or fk- regions. This behavior is also observed for moderately electrophilic radicals OH˙ and OCl˙ for complexation with CHFCl2 only. In other complexes, these radicals along with least nucleophilic radicals ˙NO and ˙Ph form one-electron bond with sigma hole or fk+ regions of freons. This regioselectivity of radicals and the interaction energy upon complexation have been explained in terms of local electrophilicity index and chemical hardness. We hope that this finding will shed light on the understanding of non-covalent interactions in terms of conceptual density functional theory for halogen bonding as well as in pnictogen, chalcogen and tetrel bonding systems. This result may find applications in understanding the radical mediated reactions and ozone depletion in the stratosphere.

Application of Bayesian evidence synthesis to modelling the effect of ketogenic therapy on survival of high grade glioma patients.

BACKGROUND: Ketogenic therapy in the form of ketogenic diets or calorie restriction has been proposed as a metabolic treatment of high grade glioma (HGG) brain tumors based on mechanistic reasoning obtained mainly from animal experiments. Given the paucity of clinical studies of this relatively new approach, our goal is to extrapolate evidence from the greater number of animal studies and synthesize it with the available human data in order to estimate the expected effects of ketogenic therapy on survival in HGG patients. At the same time we are using this analysis as an example for demonstrating how Bayesianism can be applied in the spirit of a circular view of evidence. RESULTS: A Bayesian hierarchical model was developed. Data from three human cohort studies and 17 animal experiments were included to estimate the effects of four ketogenic interventions (calorie restriction/ketogenic diets as monotherapy/combination therapy) on the restricted mean survival time ratio in humans using various assumptions for the relationships between humans, rats and mice. The impact of different biological assumptions about the relevance of animal data for humans as well as external information based on mechanistic reasoning or case studies was evaluated by specifying appropriate priors. We provide statistical and philosophical arguments for why our approach is an improvement over existing (frequentist) methods for evidence synthesis as it is able to utilize evidence from a variety of sources. Depending on the prior assumptions, a 30-70% restricted mean survival time prolongation in HGG patients was predicted by the models. The highest probability of a benefit (> 90%) for all four ketogenic interventions was obtained when adopting an enthusiastic prior based on previous case reports together with assuming synergism between ketogenic therapies with other forms of treatment. Combinations with other treatments were generally found more effective than ketogenic monotherapy. CONCLUSIONS: Combining evidence from both human and animal studies is statistically possible using a Bayesian approach. We found an overall survival-prolonging effect of ketogenic therapy in HGG patients. Our approach is best compatible with a circular instead of hierarchical view of evidence and easy to update once more data become available.

Estimation of interleukin-18 in the gingival crevicular fluid and serum of Bengali population with periodontal health and disease.

CONTEXT: Host's immune response elicits cytokines in response to bacterial challenge. We explore role of one such cytokine interleukin-18 (IL-18) in periodontal health and disease. AIMS: IL-18 is a pro-inflammatory and tumor suppressive cytokine. Dental literatures suggest that IL-18 might have a role to play in the progression from oral health to periodontal disease. Therefore, this study was undertaken to elucidate the level and role of IL-18 in the gingival crevicular fluid (GCF) and serum of individuals with healthy gingiva, chronic gingivitis, chronic periodontitis, and aggressive periodontitis before and after periodontal therapy. SETTINGS AND DESIGN: Eighty individuals chosen for the study were divided into healthy control group (1A), chronic gingivitis (2A), chronic periodontitis (3A), and aggressive periodontitis (4A) with twenty individuals each. Criteria for the division were the subject's gingival index, probing pocket depth, clinical attachment loss, and radiographic evidence of bone loss. MATERIALS AND METHODS: The individuals underwent treatment (scaling in case of Groups 1A and 2A and scaling and root planing followed by flap surgery in Groups 3A and 4A) to form posttreatment Groups 1B, 2B, 3B, and 4B, respectively. Thus, a total of 160 GCF and 160 serum samples were collected and tested by ELISA. STATISTICAL ANALYSIS USED: Intergroup comparison was done by post hoc Tukey's test. RESULTS: The mean IL-18 concentration was greatest in Group 3A (GCF 144.61 pg/µl, serum 55.12 pg/ml) followed by Group 4A (GCF 98.55 pg/µl, serum 39.06 pg/ml), Group 2A (GCF 22.27 pg/µl, serum 27.73 pg/ml) and lowest (GCF 17.94 pg/µl, serum 11.49 pg/ml) in Group 1A. Posttreatment groups (1B-4B) showed reduction in the mean IL-18 concentration in both GCF and serum. CONCLUSIONS: As the inflammation increased, there was a concomitant increase in the level of IL-18 and vice versa following periodontal therapy.

Telomerase expression in individuals with chronic and aggressive periodontitis.

BACKGROUND: The aim of this study is to evaluate the expression of human telomerase reverse transcription (hTERT) enzyme in chronic periodontitis (CP) and aggressive periodontitis (AgP) compared with healthy individuals. METHODS: A total of 79 individuals consented to participate in the study. The study sample comprised healthy individuals (n = 30), patients with CP (n = 30), and patients with AgP (n = 19). Gingival tissue was collected and evaluated for hTERT expression by Western blot and immunohistochemical methods. Reverse transcription polymerase chain reaction was performed using the gingival crevicular fluid (GCF) samples. RESULTS: The hTERT messenger RNA (mRNA) and protein expression was significantly higher in AgP compared with CP (P <0.001). In GCF, 53.33% of patients with CP and 68.42% of patients with AgP were showing hTERT mRNA expression, but it was not detected in the control group. The AgP tissue showed higher hTERT expression compared with CP (P <0.001). The hTERT mRNA expression did not show a correlation with gingival index (GI), plaque index (PI), probing depth (PD), and clinical attachment loss (AL) in patients with AgP, whereas hTERT protein expression was strongly correlated with GI, PI, PD, and AL in patients with AgP. The protein expression of hTERT shows significant but moderate correlation with GI and AL in patients with CP. CONCLUSION: High expression of hTERT might be associated with periodontal disease progression, suggesting that hTERT could be a potential prognostic marker.

Exploring the role of cranberry polyphenols in periodontits: A brief review.

Cranberry juice polyphenols have gained importance over the past decade due to their promising health benefits. The bioactive component, proanthocyanidins is mainly responsible for its protective effect. A lot has been said about its role in urinary tract infection and other systemic diseases, but little is known about its oral benefits. An extensive search was carried out in the PubMed database using the terms "cranberry polyphenols" and "periodontitis" together. The institute library was also thoroughly scrutinized for all relevant information. Thus, a paper was formulated, the aim of which was to review the role of high molecular weight cranberry fraction on oral tissues and periodontal diseases.

Aggressive periodontitis: A clinico-hematological appraisal.

BACKGROUND: Human leukocyte antigens (HLA) have been considered a candidate of genetic risk markers for aggressive periodontitis (AP). AP has also been associated with polymorphonuclear leukocyte (PMN) dysfunction. The role of monocyte subsets in AP has also not been completely explored. Therefore, the present study was undertaken to assess in, AP subjects, the possible association between defective PMN adhesion and ß2-integrin expression; defective neutrophil migration and actin polymerization level; the expression of ABO blood group and HLA antigen; and the percentage of CD14+ CD16+ monocytes and CD45RA monocytes. All these parameters have been compared with the subjects of chronic periodontitis (CP) and healthy controls. MATERIALS AND METHODS: A total of 45 subjects of the age group 20-50 years, free from any known systemic disease, were divided into three groups - Group I - periodontally healthy control (n = 15), Group II - CP (n = 15) and Group III - AP (n = 15). Peripheral blood samples were collected. ABO grouping and HLA typing were performed. ß2-integrin expression, actin polymerization level and percentage of CD14+ CD16+ monocytes and CD45RA monocytes were estimated by fluorescence-activated cell sorter analysis. RESULTS: Most of the subjects of AP belonged to the blood group AB, and an increased frequency of HLA-A30, CW1 and DR1 (P < 0.1) and B44 and DQ2 (P < 0.05) were also observed in this group. In the AP group, both average values (ß2-integrin and actin level) were significantly less than those of normal subjects (P < 0.001). The mean percentage of CD14+ CD16+ monocytes was found to be maximum in CP, followed by AP, and then in healthy subjects, while the mean percentage of CD45RA was maximum in AP, followed by CP, and then in healthy subjects. CONCLUSIONS: With the present state of knowledge from this study, a definite association of ABO blood groups and HLA phenotypes with periodontal diseases is yet to be established. Leukocytic functional defects were found in AP subjects. A statistically significant percentage of CD14+ CD16+ and CD45RA monocytes were found in AP subjects as compared with the normal control and CP groups.

Cryosurgery by tetrafluoroethane: An answer to black gums.

To highlight the effect of 1,1,1,2 tetrafluoroethane (TFE), a new material for cryosurgery of gingival melanin pigmentation (GMP). Five patients were treated using a TFE-cooled swab and the pre- and post-treatment photographs were compared. Complete keratinization took place in 3-4 weeks after application without any trace of pigmentation. During the follow-up period, no side effects were observed and the improved esthetics were maintained upto 1 year.

A huge epidermoid cyst endangering life.

Epidermoid cyst of the neck or auricular area are relatively more common than that of the oral cavity. In most cases about 80% they remain asymptomatic. But in about 20% cases it becomes painful because of secondary infection seeking treatment. Here we present a case report of biopsy proved Epidermoid cyst with life threatening infection.

Management of amlodipine-induced gingival enlargement: Series of three cases.

Gingival enlargement is one of the side effects associated with certain drugs. Amlodipine, a calcium channel blocker, used as antihypertensive drug has been found associated with gingival hyperplasia. This case series presents diagnosis and management of amlodipine-induced gingival hyperplasia. Amlodipine-induced gingival enlargement was diagnosed and managed by thorough scaling and root planning. Drug substitution and surgical intervention was performed in first two cases. The pathogenesis of gingival enlargement is uncertain and the treatment is still largely limited to the maintenance of an improved level of oral hygiene and surgical removal of the overgrown tissue. Several factors may influence the relationship between the drugs and gingival tissues as discussed by Seymour et al. Meticulous oral hygiene maintenance, switchover to alternative drug, professional scaling and root planning and surgical excision of enlarged gingival tissue may help overcome the effect of these drugs.