Management of Cervically Fractured Central Incisors: A Multidisciplinary Approach.

INTRODUCTION: Fracture of tooth structure at or below the gingival margin compromises rehabilitation and hampers esthetics and function. MANAGEMENT: Management of such cases by a post-core and crown restoration, or periodontal surgery or orthodontic extrusion alone may not always suffice in attaining a good result. CASE REPORT: A multi-disciplinary approach which includes all of the above mentioned procedures helps in long term success. CONCLUSION: Careful case evaluation, treatment planning and meticulous attention to detail are the keys to the best treatment outcome.

Remote ischaemic preconditioning suppresses endogenous plasma nitrite during ischaemia-reperfusion: a randomized controlled crossover pilot study.

AIM: The aim of this article is to test the hypothesis that remote ischaemic preconditioning (RIPC) increases circulating endogenous local and systemic plasma (nitrite) during RIPC and ischaemia-reperfusion (IR) as a potential protective mechanism against ischaemia-reperfusion injury (IRI). METHODS: Six healthy male volunteers (mean age 29.5 ± 7.6 years) were randomized in a crossover study to initially receive either RIPC (4 × 5 min cycles) to the left arm, or no RIPC (control), both followed by an ischaemia-reperfusion (IR) sequence (20 min cuff inflation to 200 mmHg, 20 min reperfusion) to the right arm. The volunteers returned at least 7 days later for the alternate intervention. The primary outcome was the effect of RIPC vs. control on local and systemic plasma (nitrite). RESULTS: RIPC did not significantly change plasma (nitrite) in either the left or the right arm during the RIPC sequence. However, compared to control, RIPC decreased plasma (nitrite) during the subsequent IR sequence by ~26% (from 118 ± 9 to 87 ± 5 nmol l-1 ) locally in the left arm (P = 0.008) overall, with an independent effect of -58.70 nmol l-1 (95% confidence intervals -116.1 to -1.33) at 15 min reperfusion, and by ~24% (from 109 ± 9 to 83 ± 7 nmol l-1 ) systemically in the right arm (P = 0.03). CONCLUSIONS: RIPC had no effect on plasma (nitrite) during the RIPC sequence, but instead decreased plasma (nitrite) by ~25% during IR. This would likely counteract the protective mechanisms of RIPC, and contribute to RIPC's lack of efficacy, as observed in recent clinical trials. A combined approach of RIPC with nitrite administration may be required.

Quality of Life Perspective Towards Acne among Adolescents at Tertiary Care Center of Gujarat, India.

INTRODUCTION: Acne is the most common disease of skin affecting adolescents, which can have a significant psychological impact leading to anxiety and depression. AIMS: Study was undertaken to see the impact of acne on the Quality of life. MATERIALS AND METHODS: The study was conducted from March 2012 to February 2013, in the age group 14-25, using a validated self-administered questionnaire The questions were evaluated using 4 point Likert scale (0-3). STATISTICAL ANALYSIS: Statistical calculations were done using Excel 2010 and Statgraphics Centurion XVI.I. RESULTS: Among 869 participants, 608(69.97%) had acne while 261 (30.03%) had no acne. Of acne sufferers 43.75% were males and 56.25% were females with maximum 67.93% in the age group 18-21. Of Non-acne participants 57.09% considered acne as a problem and 54.02% were disturbed by the idea of having acne. Study showed p-values<0.05 indicating statistically significant non-zero correlations at 95.0% confidence level. CONCLUSION: The quality of life scale of acne varies according to individual perception and differs from population to population. Questionnaire evaluation is a useful tool, but cannot replace proper psychological assessment.

Paradoxical normoxia-dependent selective actions of inorganic nitrite in human muscular conduit arteries and related selective actions on central blood pressures.

BACKGROUND: Inorganic nitrite dilates small resistance arterioles via hypoxia-facilitated reduction to vasodilating nitric oxide. The effects of nitrite in human conduit arteries have not been investigated. In contrast to nitrite, organic nitrates are established selective dilators of conduit arteries. METHODS AND RESULTS: We examined the effects of local and systemic administration of sodium nitrite on the radial artery (a muscular conduit artery), forearm resistance vessels (forearm blood flow), and systemic hemodynamics in healthy male volunteers (n=43). Intrabrachial sodium nitrite (8.7 µmol/min) increased radial artery diameter by a median of 28.0% (25th and 75th percentiles, 25.7% and 40.1%; P<0.001). Nitrite (0.087-87 µmol/min) displayed conduit artery selectivity similar to that of glyceryl trinitrate (0.013-4.4 nmol/min) over resistance arterioles. Nitrite dose-dependently increased local cGMP production at the dose of 2.6 µmol/min by 1.1 pmol·min(-1)·100 mL(-1) tissue (95% confidence interval, 0.5-1.8). Nitrite-induced radial artery dilation was enhanced by administration of acetazolamide (oral or intra-arterial) and oral raloxifene (P=0.0248, P<0.0001, and P=0.0006, respectively) but was inhibited under hypoxia (P<0.0001) and hyperoxia (P=0.0006) compared with normoxia. Systemic intravenous administration of sodium nitrite (8.7 µmol/min) dilated the radial artery by 10.7% (95% confidence interval, 6.8-14.7) and reduced central systolic blood pressure by 11.6 mm Hg (95% confidence interval, 2.4-20.7), augmentation index, and pulse wave velocity without changing peripheral blood pressure. CONCLUSIONS: Nitrite selectively dilates conduit arteries at supraphysiological and near-physiological concentrations via a normoxia-dependent mechanism that is associated with cGMP production and is enhanced by acetazolamide and raloxifene. The selective central blood pressure-lowering effects of nitrite have therapeutic potential to reduce cardiovascular events.