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A rare metabolic condition called alkaptonuria (AKU) is caused by a decrease in homogentisate 1,2 dioxygenase (HGO) activity due to a mutation in homogentisate dioxygenase (HGD) gene. Homogentisic acid is a byproduct of the catabolism of tyrosine and phenylalanine that darkens the urine and accumulates in connective tissues which causes an agonizing arthritis. Employing the use of deep learning artificial intelligence (AI) drug design, this study aims to alleviate the current toxicity of the AKU drugs currently in use, particularly nitisinone, by utilizing the natural flavanol kaempferol molecule as a 4-hydroxyphenylpyruvate dioxygenase inhibitor. Kaempferol was employed to generate three effective de novo drug candidates targeting the enzyme 4-hydroxyphenylpyruvate dioxygenase using an AI drug design tool. We present novel AIK formulations in the present study. The AIK's (Artificial Intelligence Kaempferol) examination of drug-likeliness among the three led to its choice as a possible target. The toxicity assessment research of AIK demonstrates that it is not only safer to use than other treatments, but also more efficient. The docking of the AIGT with 4-hydroxyphenylpyruvate dioxygenase, which revealed a binding affinity of around -9.099â¯kcal/mol, highlights the AIK's potential as a therapeutic candidate. An innovative approach to deal with challenging circumstances is thus presented in this study by new formulations kaempferol that have been meticulously designed by AI. The results of the in vitro tests must be confirmed in vivo, even though AI-designed AIK is effective and sufficiently safe as computed.
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Objectives: Physicians and psychologists at psychiatric university hospitals are assigned teaching tasks from the first day of work without necessarily having the prerequisite training in teaching methods. This exploratory survey provides a needs-based analysis for the prospective didactic training of physicians and psychologists at psychiatric hospitals in Germany, Austria and Switzerland. Methods: An online questionnaire was distributed at medical schools via email in German-speaking countries in Europe. All physicians involved in teaching medical students at psychiatry faculties were eligible to participate in the survey. Participants were further requested to recruit eligible participants (snowball sampling). Responses were analyzed descriptively, and differences between groups were calculated using nonparametric Mann-Whitney U tests (p<.05). Results: Overall, 97 respondents (male=55, female=42; mean age= 40.6) from 19 medical schools completed the survey. The respondents consisted of 43 residents, 39 specialists, 6 chief physicians and 9 psychologists. Of the respondents, 97.6% rated didactic competence as either highly relevant or rather relevant for teaching medical students. The highest overall interest was shown for bedside teaching (mode=4; IQR: 2-4) and error culture (mode=3; IQR: 2-4). Respondents expressed the highest training needs for topics regarding presentation and communication (mode=3; IQR: 2-3). Resident physicians were significantly more interested in bedside teaching (U=362.0, p=0.004) and roleplay (U=425.0; p=0.036) than specialist physicians, who were more interested in examination didactics (U=415.0; p=0.022). Chief physicians displayed significantly deeper interest in group dynamics (U=51; p=0.023) than specialist physicians. In-person training was preferred by a majority of respondents, and 27.4% preferred online/web-based training. Conclusions: The majority of physicians and psychologists at psychiatric university hospitals considered professional development for faculty to be helpful for teaching medical students. Bedside teaching and error culture management were the most desired teaching topics for training medical teachers. Tailored educational interventions are recommended, with target-oriented priorities for different hierarchical levels.
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Docentes de Medicina , Avaliação das Necessidades , Psiquiatria , Humanos , Feminino , Masculino , Psiquiatria/educação , Inquéritos e Questionários , Adulto , Docentes de Medicina/psicologia , Alemanha , Áustria , Suíça , Estudos Prospectivos , Ensino , Currículo , Pessoa de Meia-IdadeRESUMO
The uncontrolled hyperglycemia that characterizes diabetes mellitus (DM) causes several complications in the organism. DM is among the major causes of deaths, and the limited efficacy of current treatments push the search for novel drug candidates, also among natural compounds. We focused our attention on caffeoylmalic acid, a phenolic derivative extracted from Urtica dioica, a plant investigated for its potential against type 2 DM. This compound was tested for its antidiabetic activity in vitro through a glucose uptake assay, in vivo in a mouse DM model and through molecular docking towards α-amylase and α-glucosidase. The effects on glucose blood level, liver enzymes, insulin and creatinine levels as well as on lipid and blood parameters, considered biochemical markers of diabetes, were also evaluated. The results showed an antidiabetic activity in vitro and in vivo, as the compound stimulates glucose absorbtion and reduces blood glucose levels. Moreover, it ameliorates lipid profile, liver and blood parameters, with moderate effect on insulin secretion. Taken together, these findings pave the way for the compounds from this class of caffeoylmalic acid as potential antidiabetic compounds.
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Glicemia , Hipoglicemiantes , Simulação de Acoplamento Molecular , Urtica dioica , Animais , Hipoglicemiantes/farmacologia , Hipoglicemiantes/isolamento & purificação , Camundongos , Urtica dioica/química , Masculino , Glicemia/efeitos dos fármacos , Estrutura Molecular , Diabetes Mellitus Experimental/tratamento farmacológico , Malatos/farmacologia , Compostos Fitoquímicos/farmacologia , Compostos Fitoquímicos/isolamento & purificação , Insulina/sangue , Ácidos Cafeicos/farmacologia , Ácidos Cafeicos/isolamento & purificaçãoRESUMO
Fernandoa adenophylla, due to the presence of phytochemicals, has various beneficial properties and is used in folk medicine to treat many conditions. This study aimed to isolate indanone derivative from F. adenophylla root heartwood and assess in-vitro anti-inflammatory and anti-diabetic characteristics at varying concentrations. Heat-induced hemolysis and glucose uptake by yeast cells assays were conducted to evaluate these properties. Besides, docking analyses were performed on four molecular targets. These studies were combined with molecular dynamics simulations to elucidate the time-evolving inhibitory effect of selected inhibitors within the active pockets of the target proteins (COX-1 and COX-2). Indanone derivative (10-100 µM) inhibited the lysis of human red blood cells from 9.12 ± 0.75 to 72.82 ± 4.36% and, at 5-100 µM concentrations, it significantly increased the yeast cells' glucose uptake (5.16 ± 1.28% to 76.59 ± 1.62%). Concluding, the isolated indanone might act as an anti-diabetic agent by interacting with critical amino acid residues of 5' adenosine monophosphate-activated protein kinase (AMPK), and it showed a binding affinity with anti-inflammatory targets COX-1, COX-2, and TNF-α. Besides, the obtained results may help to consider the indanone derivative isolated from F. adenophylla as a promising candidate for drug delivery, subject to outcomes of further in vivo and clinical studies.
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Anti-Inflamatórios , Ciclo-Oxigenase 2 , Hipoglicemiantes , Simulação de Acoplamento Molecular , Humanos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/química , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/química , Ciclo-Oxigenase 2/metabolismo , Indanos/farmacologia , Indanos/química , Ciclo-Oxigenase 1/metabolismo , Simulação de Dinâmica Molecular , Glucose/metabolismo , Hemólise/efeitos dos fármacos , Saccharomyces cerevisiae/metabolismo , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Simulação por ComputadorRESUMO
Medicinal plants are the main source of active chemical constituents responsible for curing or mitigating various ailments. To discover new, safe, and effective drug candidates the isolation and screening of natural products are essential. In the current research work, lapachol was isolated from Fernandoa adenophylla, which was evaluated for anti-inflammatory effect followed by molecular docking. The isolated compound was tested for anti-inflammatory effects using in vitro (HRBC assay) and in vivo (xylene-induced ear edema) experimental models. Various concentrations of lapachol demonstrated anti-inflammatory effects with a percent potential of 77.96 at 100 µM. Different concentrations of Lapachol demonstrated a dose-dependent anti-edematous effect with a maximum percent effect of 77.9 % at a higher dose. The histopathological study revealed that the application of xylene led to a significant increase in ear thickness, along with clear signs of ear edema and infiltration of inflammatory cells, as well as epidermal hyperplasia of the dermis when compared to the control group. However, treatment with the investigated compound showed a significant reduction in ear thickness and pathological differences comparable to those observed in the group treated with diclofenac. Density functional theory calculations are accomplished to gain insight into structural and spectroscopic properties. Geometry optimization, FMO, and MEP analyses are performed. Overall, the molecular docking results indicate that lapachol has potential as a COX inhibitor by binding to the active sites of both COX-1 and COX-2 enzymes.
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Objective: Alveolar osteitis is a painful complication that often arises after tooth extraction, presenting a significant clinical challenge. It is imperative to gain a comprehensive understanding of both its occurrence and the contributing factors to enhance the quality of dental care. The aim of this study was to assess the frequency and prevalence of alveolar osteitis among patients and compare these variables based on demographic characteristics (age and sex), the number of teeth extractions, operator experience, health status, and smoking habits in the target population. Methods: This cross-sectional observational study was conducted from May 2019 to April 2020. It included all patients above 16 years of age, of both genders, who underwent permanent tooth extraction for various reasons. Patient demographics, smoking habits, health status, operating dental surgeon's clinical experience, extraction technique, and the number of teeth extracted were recorded. Statistical analysis was performed using SPSS version 25. Chi-square test and regression analysis were used to assess differences between age, sex, smoking habit, dentist category, and the number of teeth extractions in relation to alveolar osteitis. Results: A total of 679 permanent tooth extractions were performed in 438 patients. Alveolar osteitis was observed in 107 cases (15.7%) following tooth extractions. Among these, 36 cases (33.6%) occurred in single tooth extraction cases, while 71 cases (66.4%) were present in patients with multiple extractions. Moreover, 67 cases (62.6%) of alveolar osteitis were found in cigarette smokers. In addition, 61 cases (57%) of dry sockets were reported after tooth extractions performed by dental interns, while 46 cases (43.0%) were noted in extractions performed by experienced dental surgeons and specialists. Conclusion: The study found a 15.7% incidence of alveolar osteitis in tooth extraction patients in the Al-Jouf region. Alveolar osteitis was more prevalent in males and the age group of 56-77 years. Multiple tooth extractions were associated with higher alveolar osteitis incidence, while operator inexperience increased post-extraction complication risks. In addition, a promising novel protocol and risk assessment scoring system have been devised which require further validation and future research.
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Objective: Traditionally, Olea ferruginea Royle (Oleaceae) has been used as a painkiller and antidiabetic in various ailments. To provide a scientific background to this folklore the current study was designed to anti-inflammatory and antidiabetic effects of one of the isolated compound from this plant. Methods: Ferruginan A was isolated from the ethyl acetate extract of Olea ferruginea bark. This isolated molecule was subjected to in-vitro anti-inflammatory and antidiabetic effects using HRBCs and glucose uptake tests. The compound was also tested for molecular docking and ADMET study. Results: Regarding the anti-inflammatory effect, the tested compound demonstrated a 69.82 % inhibition at a concentration of 100 µg/mL, while the Ferruginan A (100 µl/mL) increased the uptake of glucose (3.79-71.86 %) in the yeast cell. Similarly, the zone of inhibition values of Ferruginan A (24.98 mm) against Escherichia coli were found to be comparable to standard (Imipenem: 31.09 mm). The mechanism of antidiabetic and anti-inflammatory effects was explored by using docking simulations performed on four molecular targets related to diabetes and inflammation. The results showed that the isolated compound may act as an antidiabetic agent by inhibiting the 5' Adenosine monophosphate-activated protein kinase (AMPK). While it also showed inhibition of anti-inflammatory targets COX-1, COX-2, and Tumor necrosis factor alpha (TNF-α). The ADMET prediction study revealed that isolated compound possesses favorable ADMET profile. Conclusion: It was concluded that Ferruginan A might be a significant anti-inflammatory and antidiabetic molecule.
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BACKGROUND: The aim of the current study was to investigate the anticancer potential of bioactive compounds isolated from the leaves of Olea ferruginea (O. ferruginea). Lignans from O. ferruginea were previously described to possess antibacterial, antileishmanial, and antioxidant properties. Nevertheless, the antiproliferative activity of cycloolivil (1), ferruginan (2), and ferruginan A (3) have not been investigated in depth. METHODS: The compounds were isolated from the ethyl acetate fraction of the leaves extract of O. ferruginea. The isolated molecules were evaluated for their anticancer activity against U-87 MG malignant glioma cells. In parallel, molecular docking studies were also performed to investigate the interaction of the compounds with a duplex DNA sequence and epidermal growth factor receptor (EGFR). RESULTS: In vitro tests showed that all three compounds inhibit U-87 MG malignant glioma cell proliferation dose-dependently in the µM range, and ferruginan A (3) was highlighted as the most promising compound of the set. Molecular docking studies showed that the compounds could interfere with double stranded DNA possessing a cisplatin 1,2-d(GpG) intrastrand cross-link and EGFR. CONCLUSIONS: Overall, the findings suggest that the tested compounds from O. ferruginea may represent a starting point for the identification of novel tools to inhibit glioma cell proliferation.
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Glioma , Lignanas , Olea , Lignanas/farmacologia , Extratos Vegetais/farmacologia , Simulação de Acoplamento Molecular , Receptores ErbBRESUMO
BACKGROUND: Targeted mental health interventions are increasingly described as individualised, personalised or person-centred approaches. However, the definitions for these terms vary significantly. Their interchangeable use prevents operationalisations and measures. OBJECTIVE: This scoping review provides a synthesis of key concepts, definitions and the language used in the context of these terms in an effort to delineate their use for future research. STUDY SELECTION AND ANALYSIS: Our search on PubMed, EBSCO and Cochrane provided 2835 relevant titles. A total of 176 titles were found eligible for extracting data. A thematic analysis was conducted to synthesise the underlying aspects of individualisation, personalisation and person-centredness. Network visualisations of co-occurring words in 2625 abstracts were performed using VOSViewer. FINDINGS: Overall, 106 out of 176 (60.2%) articles provided concepts for individualisation, personalisation and person-centredness. Studies using person-centredness provided a conceptualisation more often than the others. A thematic analysis revealed medical, psychological, sociocultural, biological, behavioural, economic and environmental dimensions of the concepts. Practical frameworks were mostly found related to person-centredness, while theoretical frameworks emerged in studies on personalisation. Word co-occurrences showed common psychiatric words in all three network visualisations, but differences in further contexts. CONCLUSIONS AND CLINICAL IMPLICATIONS: The use of individualisation, personalisation and person-centredness in mental healthcare is multifaceted. While individualisation was the most generic term, personalisation was often used in biomedical or technological studies. Person-centredness emerged as the most well-defined concept, with many frameworks often related to dementia care. We recommend that the use of these terms follows a clear definition within the context of their respective disorders, treatments or medical settings. SCOPING REVIEW REGISTRATION: Open Science Framework: osf.io/uatsc.
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Atenção à Saúde , Serviços de Saúde Mental , Humanos , Instalações de Saúde , Saúde Mental , LinguísticaRESUMO
Serious human health impacts have been observed worldwide due to several life-threatening diseases such as cancer, candidiasis, hepatic coma, and gastritis etc. Exploration of nature for the treatment of such fatal diseases is an area of immense interest for the scientific community. Based on this idea, the genus Aspergillus was selected to discover its hidden therapeutic potential. The genus Aspergillus is known to possess several biologically active compounds. The current research aimed to assess the biological and pharmacological potency of the extracts of less-studied Aspergillus ficuum (FCBP-DNA-1266) (A. ficuum) employing experimental and bioinformatics approaches. The disc diffusion method was used for the antifungal investigation, and the MTT assay was performed to assess the anticancer effects. Mice were employed as an in vivo model to evaluate the antispasmodic effects. A standard spectrophotometric technique was applied to gauge the urease inhibitory activity. The antifungal studies indicate that both n-hexane and ethyl acetate extracts were significantly active against Candida albicans (C. albicans) with their zone of inhibitions (ZOI) values reported as 19 ± 1.06 mm and 25 ± 0.55 mm, respectively at a dose of 30 µg.mL-1. In vitro cytotoxicity assay against HeLa, fibroblast 3T3, prostate PC3, and breast MCF-7 cancer cell lines was performed. The ethyl acetate extract of A. ficuum was found to be significantly active against MCF-7 with its IC50 value of 43.88 µg.mL-1. However, no substantial effects on the percent cell death of HeLa cancer cell lines were observed. In addition, the A. ficuum extracts also inhibited the urease enzyme compared to standard thiourea. The antispasmodic activity of A. ficuum extract was assessed by an in vivo model and the results demonstrated promising activity at 150 mg.kg-1. Molecular docking results also supported the antifungal, anticancer, and antiurease potency of A. ficuum extract. Overall, the results display promising aspects of A. ficuum extract as a future pharmacological source.
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Antifúngicos , Urease , Humanos , Animais , Camundongos , Antifúngicos/farmacologia , Simulação de Acoplamento Molecular , Células HeLa , Extratos Vegetais/farmacologia , AspergillusRESUMO
BACKGROUND: The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strategies. However, having a closer look is still necessary to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff. OBJECTIVE: This study aimed to obtain quantitative information on job-related stressors of physicians and nurses and the coping strategies of HCPs and nonmedical staff at 2 periods of the COVID-19 pandemic. By further analyzing qualitative comments, we wanted to gain more information on the psychosocial stressors and unmet needs of HCPs as well as nonmedical staff on different levels of experience. METHODS: A cross-sectional survey was conducted at 2 time points during the COVID-19 pandemic in several European countries. The first study period (T1) lasted between April 1 and June 20, 2020, and the second study period (T2) lasted between November 25, 2021, and February 28, 2022. On a quantitative level, we used a questionnaire on stressors for physicians and nurses and a questionnaire on coping strategies for HCPs and nonmedical staff. Quantitative data were descriptively analyzed for mean values and differences in stressors and coping strategies. Qualitative data of free-text boxes of HCPs and nonmedical staff were analyzed via thematic analysis to explore the experiences of the individuals. RESULTS: T1 comprised 609 participants, and T2 comprised 1398 participants. Overall, 296 participants made 438 qualitative comments. The uncertainty about when the pandemic would be controlled (T1: mean 2.28, SD 0.85; T2: mean 2.08, SD 0.90) and the fear of infecting the family (T1: mean 2.26, SD 0.98; T2: mean 2.02, SD 1.02) were the most severe stressors identified by physicians and nurses in both periods. Overall, the use of protective measures (T1: mean 2.66, SD 0.60; T2: mean 2.66, SD 0.60) and acquiring information about COVID-19 (T1: mean 2.29, SD 0.82; T2: mean 1.99, SD 0.89) were identified as the most common coping strategies for the entire study population. Using thematic analysis, we identified 8 themes of personal experiences on the micro, meso, and macro levels. Measures, working conditions, feelings and emotions, and social climate were frequently mentioned topics of the participants. In T1, feelings of isolation and uncertainty were prominent. In T2, feelings of exhaustion were expressed and vaccination was frequently discussed. Moreover, unmet psychosocial needs were identified. CONCLUSIONS: There is a need for improvement in pandemic preparedness. Targeted vocational education measures and setting up of web-based mental health support could be useful to bridge gaps in psychosocial support needs in future crises.
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COVID-19 , Pandemias , Humanos , Estudos Transversais , Pessoal de Saúde , Europa (Continente)RESUMO
The objective of this study was to evaluate the outcomes of the nasolabial flap in the management of oral submucous fibrosis (OSMF). The descriptive case series included 75 patients diagnosed with OSMF who underwent surgical intervention under general anesthesia. Preoperative mouth opening measurements were compared with postoperative measurements taken after 2 months. Regarding mouth opening, out of the 75 patients, 4 (5.3%) had unsatisfactory results after treatment, while 22 (29.3%) experienced satisfactory outcomes. The majority of patients, 49 (65.3%), achieved normal mouth opening (more than 30 mm) following the Nasolabial flap procedure. This indicates that the Nasolabial flap yielded favorable results in terms of restoring normal mouth opening and benefiting the patients. Based on the findings of this study, the Nasolabial flap was determined to be a viable surgical option for managing oral submucous fibrosis due to its ease of operation, reliable flap vascularity, and low post-operative complication rate. The only drawback identified was the presence of a surgical scar, which can be addressed through secondary correction procedures.
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Background: Size and shape of the sella turcica is considered vital for many radiographic analyses. Objectives: To assess and compare the linear dimensions and shape of sella turcica on digital lateral cephalograms in Saudi subpopulation with different skeletal patterns, age groups and genders. Methodology: A total of 300 digital lateral cephalograms were retrieved from the hospital archive. The selected cephalograms were grouped based on the age, gender, and skeletal types. The linear dimensions and shape of sella turcica were measured on each radiograph. Data were analyzed using an independent t-test and a one-way ANOVA. To test the inter-relationship of age, gender, and skeletal type with the dimensions of sella turcica, regression analyses were used. Statistical significance was set at P ≤ 0.01. Results: Significant differences in linear dimensions between the age groups (P < 0.001) and genders (P < 0.001) were noted. On comparing sella size with different skeletal types, a significant difference was found for all sella dimensions (P < 0.001). The mean length, depth and diameter among skeletal class III were significantly higher than that among classes I and II. On comparing age, gender, and skeletal type with size of sella, age and skeletal type were significantly related to the change of length, depth and diameter (P < 0.001), whereas gender was found to be significantly related only to a change in length of the sella (P < 0.01). For the sella shape, normal morphology was noted in 44.3% of patients. Conclusion: According to the findings of this study, the measurements of sella can be used as reference standards for future studies in Saudi subpopulation.
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In India, where cereal-based meals make up the majority of the daily diet, bread wheat (Triticum aestivum L.) is a key grain crop. Micronutrient deficiencies are a result of the lack of a diverse food culture in the nation. Genotypes of bread wheat that have been biofortified might be introduced to address this. It is anticipated that more information on the genotype x year interaction of these nutrients in grain will help us better understand the size of this interaction and perhaps even identify more stable genotypes for this attribute. Year revealed divergent responses to grain iron and zinc. Compared to zinc, iron showed lowest variation across year. Maximum temperature was the major determinant for the four traits. Iron is also significant correlation with zinc. Among the total fifty-two genotype, HP-06, HP-22, HP-24, HP-25, HP-33, HP-44, and HP-45 were found superior for zinc and iron content. These genotypes with high levels of zinc and iron can be used in a hybridization programme to further crop improvement. Wide-scale cultivation of the chosen genotype with high zinc and iron content in the agro-climatic conditions of Jammu will work with the region's current cropping systems.
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Estado Nutricional , Oligoelementos , Triticum/genética , Micronutrientes , Zinco , Ferro , Grão Comestível , GenótipoRESUMO
BACKGROUND: Breast cancer is one of the most prevalent diseases, and ignoring dental health care before and after treatment can have severe long-term consequences. Additionally, this may have a negative impact on the patient's general quality of life. AIM: The aim of the present study was to assess oral health-related quality of life (OHRQoL) among breast cancer patients and identify possible factors associated with the outcome. METHODOLOGY: In this observational cross-sectional study, 200 women who had received breast cancer therapy and were being followed up at a hospital made up the sample. The study was conducted between January 2021 and July 2022. Information on sociodemographic characteristics, general health, and breast cancer was recorded. The decayed, missing, and filled teeth index was used in clinical examinations to identify caries experience. OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) questionnaire. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. RESULTS: The mean OHIP-14 score was 11.48 (SD 1.35). There was a 63.0% prevalence of negative impacts. Age and the time frame from cancer diagnosis were found to be significantly linked with the outcome by binary logistic regression analysis. CONCLUSIONS: Breast cancer survivors who were ≤55 years old and the time elapsed since diagnosis was less than 36 months had a poor OHRQoL. To lessen the negative impacts of cancer treatment and enhance quality of life, patients with breast cancer need special oral care and should be monitored before, during, and after cancer treatment.
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The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown's classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible.
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This observational study was conducted to evaluate the clinical signs and symptoms of maxillary sinus tumors and to propose a clinical examination sieve and a unique risk alarm score to be used for timely patient referral and vigilance. The study consisted of 70 patients between 20 to 82 years of age from both sexes. The clinical information gained was collected from the upper dentoalveolar segment, orbit, and nasal sites. Regarding the early clinical sign and symptoms of patients, nasal obstruction was found in 67 patients (95.7%), facial swelling in 69 patients (98.6%), paresthesia in 41 patients (58.6%), and epistaxis in 50 patients (71.4%). Furthermore, in terms of the late signs and symptoms, a palpable mass in buccal sulcus was observed in 65 (92.9%) of the patients, lymphadenopathy in 24 (34.3%), paresthesia in 38 (54.3%), and diplopia in 22 (31.4%). Furthermore, general sign and symptoms like exophthalmos was present in 35 patients (50%), anosmia was observed in 37 patients (52.9%), and oroantral fistula was noted in 37 patients (55.9%). Additionally, 67 (95.7%) of the patients complained of nasal obstruction. Similarly, facial asymmetry was observed in 69 (98.6%) of the patients and double vision was observed in 24 (34.4%). Tumors of the maxillary sinus have a very insidious course of spread and uncertain clinical signs and symptoms. What makes diagnosis worse is the fact that the symptoms of these tumors are so well hidden in the sponge-like nature of the midfacial region that they are easily misinterpreted by patients. Therefore, diagnoses must be made early, dentists must be vigilant, and patients must be fully investigated at the slightest suspicion of a tumor, albeit benign.
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BACKGROUND: Immune-mediated diseases are a diverse group of conditions characterized by alteration of cellular homeostasis and inflammation triggered by dysregulation of the normal immune response. Several immune-mediated diseases exhibit oral signs and symptoms. Traditionally, these conditions are treated with corticosteroids or immunosuppressive agents, including azathioprine, cyclophosphamide, and thalidomide. Recent research into the developmental pathways of these diseases has led to the exploration of novel approaches in treatment. This review examines newer treatment modalities for the management of immune-mediated diseases with oral presentations. Topical calcineurin inhibitors (TCIs) such as tacrolimus and pimecrolimus have been employed successfully in managing oral lichen planus and pemphigus vulgaris. Biologic agents, comprising monoclonal antibodies, fusion proteins, and recombinant cytokines, can provide targeted therapy with fewer adverse effects. Neutraceutical agents comprising aloe vera, curcumin, and honey are commonly used in traditional medicine and offer a holistic approach. They may have a place as adjuvants to current standard therapeutic protocols. Photodynamic therapy (PDT) and low-level laser therapy (LLLT) utilize a specific wavelength of light to achieve desired cellular change. While the use of PDT in immune-mediated diseases is contentious, LLLT has shown positive results. Newer therapeutic modalities involve kinase inhibitors, S1P1 receptor modulators, MSCs, and iRNA providing targeted treatment of specific diseases.
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Terapia a Laser , Líquen Plano Bucal , Doenças da Boca , Humanos , Inibidores de Calcineurina/uso terapêutico , Doenças da Boca/tratamento farmacológico , Líquen Plano Bucal/tratamento farmacológico , Corticosteroides/uso terapêutico , Administração TópicaRESUMO
Periodontitis, an inflammatory condition, is linked to a higher risk of developing oral cancer. Periodontitis may be a precipitating factor for tumorigenesis and the aggressiveness of specific cancer variants. Although genetics is considered the primary etiologic factor for the development of most cancers, many factors have come to be recognized in the initiation and progression of oral cancer. Consecutively, it is suggestive that periodontitis and oral cancer are distinct disease entities but share common pathogenic mechanisms. Oxidative stress and epigenetic mechanisms are among the most researched mechanisms responsible for initiating apoptotic mechanisms implicated in periodontitis and oral cancer. Current research aims to formulate therapeutic agents to intercede in these mechanisms via host modulation therapy and epigenetic therapy. These advances can revolutionize the treatment of periodontitis and oral cancer. This review aims to shed light on the common pathogenic mechanisms of these diseases and the various host modulation agents that could be beneficial in their treatment.