Efficacy of Injectable Platelet-Rich Fibrin (I-PRF) in Managing Temporomandibular Joint Pain: A Prospective Clinical Study.

BACKGROUND: Temporomandibular joint (TMJ) pain is a common condition that can significantly impact an individual's quality of life. Current treatment options often fall short of providing long-lasting relief. So, this prospective clinical study aimed to investigate the efficacy of injectable platelet-rich fibrin (I-PRF) in mitigating TMJ pain. METHODS: A total of 68 participants, aged 18-60 years, clinically diagnosed with TMJ pain, were recruited from dental clinics and specialist referrals. Participants were randomly assigned to either the intervention group (I-PRF injections) or the control group (placebo). Primary outcome measures included TMJ pain intensity and jaw function, assessed using the Visual Analog Scale and functional examinations, respectively. Secondary outcomes comprised patient-reported outcomes (PROs) on quality of life and satisfaction. Data were collected at baseline and six, 12, and 24 weeks post intervention. RESULTS: Baseline characteristics demonstrated successful randomization, with no significant differences in age, gender, or TMJ pain duration between groups. Post intervention, the intervention group exhibited a significant and sustained reduction in TMJ pain intensity compared to controls (p<0.001). Improvements in jaw function were also notable in the intervention group at all follow-up time points (p<0.001). PROs related to quality of life and satisfaction substantially increased in the intervention group compared to controls (p<0.001). CONCLUSION: I-PRF demonstrated significant efficacy in reducing TMJ pain intensity, improving jaw function, and enhancing PROs. These findings support the consideration of I-PRF as a valuable therapeutic intervention for individuals with TMJ pain.

Evaluation of the Blunt Pancreatic Injury, a Long-Term Tertiary Care Center Study: An Original Research.

Introduction: Pancreatic trauma is uncommon and challenging to diagnose. Contrarily, severe injuries to the kidney, spleen, and liver are frequent and typically easy to detect with imaging methods. Pancreas injuries can cause a significant amount of morbidity and mortality. Reviewing the institution's experience with this rather infrequent injury was the goal of this study. Materials and Method: The patients' records were collected from the data records at the tertiary care center for patients who had pancreatic damage and were followed up for a year. The American Association for the Surgery of Trauma pancreatic damage grade scores were assigned to each patient using the radiologic and surgical findings. Clinical examination and CT results were predominantly used to make the diagnosis in patients who underwent non-operative treatment. The data are presented as descriptive statistics. Results: Only 2.2% of the total cases that presented to the trauma center were finalized as pancreatic injuries. Trauma to the abdomen was seen in nearly half the cases brought. Most of the subjects in pancreatic injuries were in grade 3. Mortality was noted maximum for the grade 3 and 4 cases. Conclusions: While high-grade pancreatic injury almost always requires an operational intervention, low-grade pancreatic injury with an intact main pancreatic duct may be effectively handled non-operatively. When possible, distal pancreatectomy with spleen preservation is the ideal procedure for distal pancreatic trans-action. A patient who is hemodynamically stable with complex pancreaticoduodenal damage, which is related to a high death rate, should undergo Whipple resection.

Role of Salivary Physicochemical and Peptide Levels in Dental Caries among Children: An Original Research.

Introduction: Dental caries is a common oral disease that still needs to be thoroughly evaluated for understanding the pathophysiology. Hence, in our study, we evaluate the physicochemical and the peptide properties of the saliva and their role in dental caries among children. Materials and Methods: We conducted an observational in vitro study among 100 subjects of age 5-15 years. Decayed, missing, and filled surface (DMFT)/dmft was used to calculate the caries activity. The unstimulated saliva was evaluated for the peptides "LL-37, human neutrophil peptide (HNP) 1-3, and human beta-defensin-3" by ELIZA and for the "pH, buffer, and flow rate" of the saliva. The data thus obtained were analyzed to correlate caries and the salivary physiochemical and peptides using the "linear regression analysis." P < 0.05 was deliberated as significant. Results: Although no statistically significant variation was seen between low and high caries risk groups and the salivary parameters in our study, we observed a negative correlation of the salivary peptides and caries. For the salivary peptide "HNP1-3," there was a statistically significant variation. Conclusion: The salivary peptides may be carioprotective. However, further research has to be done to establish the mechanism of the action of these substances against caries.

Impact of Chronic Periodontitis on Intrauterine Growth of the Fetus: An Original Research.

Introduction: The human body goes through a roller coaster of hormonal changes during pregnancy. The periodontal pathologies may alter and may bring about different/altered responses to normal stimuli. Hence, in our study, we assessed the relation between the chronic periodontitis and its impact on the intrauterine growth of the fetus. Material and Method: We conducted a retrospective observational study, where the data was collected from the institutional records. We included 200 pregnant subjects and grouped them equally as those with and without periodontal pathologies. We compared the groups for various parameters of the subject and the new born, and measured the significance deliberating P < 0.05 as significant. Results: We observed that among the various clinical parameters, the female subjects were exponentially prone to "vulvo-vaginitis, premature rupture of membranes" and the new born had restricted growth. Conclusion: Oral health affects the general health. The periodontal disease specifically has an adverse impact among pregnant women. Hence care should be given to oral hygiene maintenance.

Ultrasonographic Evaluation of Gallbladder Diseases: An Original Study.

Introduction: The diagnostic accuracy for the diseases of the gall bladder is high for the Ultrasound. Hence, in the present study, we aimed to evaluate the application of the ultrasound as a major diagnostic aid for the gallbladder diseases. Materials and Methods: We piloted observational study among 100 patients with gallbladder diseases. The clinical, ultrasonograhic, and the histopathological parameters were compared to check the validity of the tests using t-test deliberating P < 0.05 as significant. Results: We observed that number of the cases that were positively identified radiographically were 93 out of 82 actual cases and 67 identified by the Fine Needle Aspiration Cytology (FNAC). There was no significant difference between the clinical, pathological diagnosis and the ultrasonograhic diagnosis indicating a accuracy similar to the clinical and FNAC methods. Conclusion: Ultrasonograhic diagnosis performed similar to the other forms of diagnosis and can be suggested as a convenient and accurate diagnostic test for the diseases of gallbladder.

A Surgical Approach in the Management of Mucormycosis in Trauma Patients.

Introduction: Fungal infections are rare occurrence in the oral cavity. They are most often seen in other medical conditions such as the immunocompromised states, diabetes, on immunosuppressants, and more recently, among the COVID patients. There are various ways that are employed to manage these infections. The most usual of fungal infection in these conditions is mucormycosis, also called as zygomycosis. Hence, in our study, we aim to evaluate the management of the fungal infection mucormycosis in trauma patients by the surgical approach. Materials and Methods: We piloted a retrospective observational study among 50 subjects who were admitted to the department with oral fungal infections with mucormycosis. We analyzed various clinical and demographic parameters among the subjects. The data thus obtained were analyzed with proper statistical tools deliberating P < 0.05 as significant. Results: We observed that among the 50 subjects, the mean age was 41 ± 1.7 years. There was no significant difference between the genders and the age groups. The most common reason for the oral involvement was uncontrolled diabetes. This was followed by malignancy, specifically leukemia, AIDS, and COVID. The most common site of the involvement was the palate, followed by the mandibular region. All the subjects tested positive for the fungal hyphae of Rhizopus arrhizus which was the most common of the species. The surgical debridement along with the medical management showed satisfactory results, while one death was noted in our study. Conclusion: Although rare, oral involvement in the fungal infection with the mucormycosis is often easily managed when diagnosed early. The proper surgical debridement is the best method of treatment along with the appropriate medications. The management of the underlying medical conditions is the primary key for the success of the treatments.