Mean Distance of Mental Foramen from Inferior Border of Mandible among Patients Visiting the Outpatient Dental Department in a Tertiary Care Centre.

Introduction: Among many anatomical landmarks in the human skull, the mental foramen is a stable landmark on the mandible. The diverse morphology of the mandible indicates the specific characteristics of such anatomical structures in each individual. The aim of this study was to find out the mean distance of mental foramen from the inferior border of the mandible visiting the Outpatient Dental Department in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing orthopantomogram in the Outpatient Dental Department of a tertiary care centre from 3 February 2022 to 31 July 2022. Ethical approval was obtained from the Institutional Review Committee. The patients with complete denture in the region of measurements were included in the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 207 patients, the mean distance from the inferior border of the mandible to the lower border of the mental foramen was 11.83±1.83 mm (11.58-12.07, 95% Confidence Interval). Conclusions: The mean distance of mental foramen from the inferior border of the mandible was found to be similar to other studies done in similar settings. Keywords: gender; mandible; mental foramen.

Oral Potentially Malignant Disorders among Patients Attending the Department of Oral Medicine and Radiology of a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.

Introduction: Despite oral cancer being a common cancer in Nepal, little is known about oral potentially malignant disorders which have a high likelihood of malignant transformation. This study aims to find out the prevalence of oral potentially malignant disorders among patients attending the Department of Oral Medicine and Radiology of a tertiary care dental hospital. Methods: A descriptive cross-sectional study was carried out among 611 patients from 14th January, 2021 to 15th July, 2021 at the Department of Oral Medicine and Radiology of a tertiary care centre after receiving ethical clearance from the Institutional Review Committee (Reference number: 2306202002). Convenience sampling was done. Patients aged 18 years and above were enrolled into the study. Follow-up cases and patients requiring emergency treatment were, however, excluded. All demographic data, cancer and dietary history and clinical examinations were recorded. Descriptive analysis was done using Statistical Package for the Social Sciences version 22.0. Point estimate was done at a 95% Confidence Interval for frequency and percentages for binary data. Results: Among 611 total participants, the prevalence of oral potentially malignant disorders was found to be 26 (4.25%) (2.65-5.85 at a 95% Confidence Interval), where males were 19 (73.07%), females were 7 (26.92%), and 23 (88.46%) of them had history of consuming various forms of tobacco, areca nut, and alcohol. Conclusions: The prevalence of oral potentially malignant disorders in this hospital-based study was found to be lower than previous studies conducted in similar settings. Keywords: Nepal; oral cancer; prevalence; tobacco.

Compression of the Inferior Alveolar Canal by Mandibular Third Molar among Images Taken from Patients Visiting Dental Imaging Centres of Kathmandu: A Descriptive Cross-sectional Study.

INTRODUCTION: Third molars are common teeth to be impacted. The position of mandibular third molar is such that it is in close contact with inferior alveolar canal which may lead to nerve damage during its removal. So, this study was conducted to find out the prevalence of compression of inferior alveolar canal by mandibular third molars. METHODS: This descriptive cross-sectional study was conducted on images collected from Dental Imaging Centers of Nepal from 25th June 2020 to 15th February 2021 after obtaining ethical clearance from Nepal Health Research Council (Reference number: 2100). A convenience sampling method was used to collect 433 cone-beam computed tomography images showing the relation between the third molars and inferior alveolar canal. Data were analyzed using the Statistical Package for the Social Sciences version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for the binary data. RESULTS: Out of 433 images, 135 (31.17%) (26.80-35.53 at 95% Confidence Interval) images showed compression of inferior alveolar nerve by mandibular third molar. The study result indicated that 16 (11.85%) buccally placed, 50 (37.03%) lingually placed and 69 (51.11%) inferiorly placed inferior alveolar canal were compressed by apices of mandibular third molars. CONCLUSIONS: The prevalence of compression of inferior alveolar canal by mandibular third molar was found to be similar to other studies done in similar settings. Compression of the canal was more evident when inferior alveolar canal is situated lingually.

Hypoxia-sensitive drug delivery to tumors.

Achievement of a high dose of drug in the tumor while minimizing its systemic side effects is one of the important features of an improved drug delivery system. Thus, developing responsive carriers for site-specific delivery of chemotherapeutic agents has become a main goal of research efforts. One of the known hallmarks of cancerous tumors is hypoxia, which offers a target for selective drug delivery. The stimuli-sensitive micellar system developed by us, (PEG-azobenzene-PEI-DOPE (PAPD) has proven to be effective in vitro. The proposed construct developed, PAPD, contains an azobenzene group as a hypoxia-sensitive moiety that triggers the shedding of the PEG layer from the nanoparticle surface under conditions of hypoxia to improve cellular uptake. Using microfluidics, we show significantly improved cellular association and penetration under hypoxia in both single cells and in a 3D tumor model. Employing an in vivo model, we demonstrate slower tumor growth that did not induce systemic side effects, including weight loss in an experimental animal model, when compared to the free drug treatment. This complex-in-nature but simple-in-design system for the simultaneous delivery of siRNA to silence the P-glycoprotein and doxorubicin with active tumor targeting and proven therapeutic efficacy represents a universal platform for the delivery of other hydrophobic chemotherapeutic agents and siRNA molecules which can be further modified.

Lipids for Taste masking and Taste assessment in pharmaceutical formulations.

Pharmaceutical products often have drawbacks of unacceptable taste and palatability which makes it quite difficult for oral administration to some special populations like pediatrics and geriatrics. To curb this issue different approaches like coating, granulation, extrusion, inclusion complexation, ion-exchange resins, etc for taste masking are employed and among them use of lipids have drawn special attention of researchers. Lipids have a lower melting point which is ideal for incorporating drugs in some of these methods like hot-melt extrusion, melt granulation, spray drying/congealing and emulsification. Lipids play a significant role as a barrier to sustain the release of drugs and biocompatible nature of lipids increases their acceptability by the human body. Further, lipids provide vast opportunities of altering pharmacokinetics of the active ingredients by modulating release profiles. In taste sensors, also known as electronic tongue or e-tongue, lipids are used in preparing taste sensing membranes which are subsequently used in preparing taste sensors. Lipid membrane taste sensors have been widely used in assessing taste and palatability of pharmaceutical and food formulations. This review explores applications of lipids in masking the bitter taste in pharmaceutical formulations and significant role of lipids in evaluation of taste and palatability.

Hypoxia-sensitive micellar nanoparticles for co-delivery of siRNA and chemotherapeutics to overcome multi-drug resistance in tumor cells.

Recently, it has been discovered that the PEG layer on nanoparticle surface can create steric hindrance, preventing efficient cellular uptake of PEGylated nanoparticles. Thus, it would be ideal to have a nanoparticle system that sheds the PEG layer upon reaching the tumor microenvironment. Hypoxia, which is a hallmark of cancerous tumors, can be used as a trigger to shed the PEG layer from the nanoparticle surface. In this study, a hypoxia-sensitive PEG-azobenzene-PEI-DOPE (PAPD) construct, with an azobenzene group as a hypoxia-sensitive moiety, was prepared. The feasibility of co-delivering Doxorubicin (Dox) and anti-P-gp siRNA (siPgp) using the PAPD nanoparticles was evaluated in monolayers of the Adriamycin-resistant human ovarian cancer cell line, A2780 ADR, and in 3D spheroids of the multidrug-resistant human breast cancer cell line, MCF7 ADR. Under hypoxic conditions, the PAPD nanoparticles showed up to a 60% increase in cellular uptake by monolayers and a significantly greater tumor penetration in a spheroid model. siPgp, when delivered using PAPD nanoparticles, showed up to a 60% P-gp downregulation under hypoxic conditions. The combination of siPgp and Dox delivered using PAPD nanoparticles led to an 80% cytotoxicity in cell monolayers and 20% cytotoxicity in spheroids under hypoxic conditions. In this research, a novel hypoxia-sensitive nanoparticle system was developed that demonstrated improved delivery of an encapsulated cargo and augmented cytotoxicity on multidrug-resistant cancer cells under hypoxic conditions.

Anatomical Position of Lower Third Molar in Relation to Mandibular Canal on Cone-Beam Computed Tomography Images in A Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: The positional relationship between the mandibularcanal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury. The purpose of this study wasto classify the anatomical three dimensional relationship between the proximity of impacted mandibular third molars to the inferior alveolar canal. METHODS: The descriptive cross-sectional study was conducted inthe Department of Oral and Maxillofacial Surgery of a tertiary care hospital from July 2020 to August 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number 2506202001). Cone-beam computed tomography images of 200 patient's mandibular third molars were used. A convenient sampling method was used. Data were analyzed using Statistical package for the Social Sciences. RESULTS: Mandibular canal relative to the roots of the mandibular third molar was observed on the apical side in 104 (52.0%) and 173 (86.5%) third molars had direct contact with the mandibular canal. About 36 (97.3%) lingually placed mandibular third molars had contact with the mandibular canal. CONCLUSIONS: The findings of the study conclude that most of the mandibular third molars situated lingually had a higher occurrence of mandibular nerve involvement. The anatomic structures of the mandibular third molar and the mandibular canal may be helpful to draw upon the adequate surgical plan to avoidor reduce nerve involvement.

Orofacial Herpes Zoster Infection in Dental practice: A Case Report.

Herpes zoster infection, commonly known as Shingles, is caused by reactivation of the Varicella-Zoster virus which may have remained latent in the dorsal root ganglia. HZI is characterized by prodromal symptoms of unilateral deep aching, burning pain followed by a maculopapular rash, vesicular eruptions, ulcers, and scab formations over the affected nerve distribution. The ophthalmic branch of the trigeminal nerve is more commonly involved in HZI than maxillary and mandibular branches; in particular, the maxillary involvement is rare. This is a case report of HZI in a 65-years-old male patient involving the maxillary division of the trigeminal nerve. This case highlights the importance of early diagnosis and prompt use of antivirals in managing orofacial HZI in dental practice.

AIDS related Kaposi's sarcoma presenting with palatal and eyelid nodule.

UNLABELLED: Kaposi sarcoma is a low-grade vascular neoplasm associated with Human Herpesvirus-8 (HHV8) infection. Although India has a large HIV infected population, Kaposi's sarcoma is rare and only 12 cases of AIDS related Kaposi's sarcoma from India have been reported in the published literature to our knowledge. The 50% of total cases in India has been reported from Mumbai. The incidence of AIDS related Kaposi's sarcoma is increasing as more than 50% of the cases are reported in 2008 to 2010. SUMMARY: We report a case of 26-year-old, HIV seropositive, Indian male with multiple, non-blanching, purplish blue nodular swellings in the palate and right upper eye lid. Similar lesions were also present on the face and the extremities. On the basis of clinical and histopathological examination, a diagnosis of AIDS related Kaposi's sarcoma was made.