Characteristics, detection methods and treatment of questionable occlusal carious lesions: findings from the national dental practice-based research network.

Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities or staining. An earlier analysis of data from this study indicates 1/3 of patients have a QOC. The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p < 0.001). Lesions light in color were less common in adults than in pediatric patients (9 vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than among adult patients (22 vs. 6%; p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions is relevant when making diagnostic and treatment decisions.

Antihyperglycemic, antihyperlipidemic and antioxidative evaluation of compounds from Senna sophera (L.) Roxb in streptozotocin-induced diabetic rats.

Senna sophera (L.) Roxb (Common name: Kasunda, Baner) (Leguminosae) is used as traditional medicine in Africa and Asia. The compounds were isolated from methanolic extract of leaves of Senna sophera (MFCS). Compound A was identified as Hexahydroxy diphenic acid and Compound B as Kaempferol. MFCS administration to diabetic rats exhibited significant reduction in the blood sugar level and showed gain in body weight. After the treatment of 100 mg/kg of MFCS, the blood sugar level was reduced to 52.33 ± 2.83 mg/dl in comparison to the blood sugar level of vehicle control 76.66 ± 3.17 mg/dl, whereas treatment with 50 mg/kg of MFCS reduced the blood sugar level slightly (72.33 ± 2.42 mg/dl). The daily continuous administration of MFCS for a period of 21 days normalised the serum lipid levels confirming the effect of MFCS on diabetic hyperlipidemia. Treatment with MFCS also reversed the activities of antioxidants, which could be a result of decreased lipid peroxidation.

Refractory Crohn's disease of the vulva treated with infliximab: a case report.

Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disorder of the gastrointestinal tract. The common presentation includes abdominal pain, abdominal cramping and diarrhea. Many patients may exhibit systemic symptoms of fever and weight loss. Approximately 20% to 40% of patients will experience extraintestinal manifestations that involve the eyes, skin and joints. Women may experience a variety of gynecological manifestations, including vulvovaginal involvement, which is often not recognized and also difficult to treat. A case of refractory vulvovaginal CD is presented and the literature of gynecological manifestations of CD and its treatment are reviewed.

Taxol-induced bcl-2 phosphorylation in ovarian cancer cell monolayer and spheroids.

Expression of Bcl-2, Bax, p53 and induction of apoptosis were studied in cisplatin or Taxol treated monolayer and spheroid cultures of ovarian cancer cell lines (SKOV-3, UL-1, UL-3C). While cisplatin (15-75 microg/ml) induced apoptosis in monolayer and spheroid cultures, Taxol (100-800 nM) induced fragmentation in monolayers only. Cisplatin induced up to 5-fold DNA fragmentation in monolayers, while 3-fold (UL-3C, SKOV-3), and 1.5-fold (UL-1) in spheroids. Taxol treatment of monolayers resulted in the characteristic phosphorylation of Bcl-2, which was not demonstrated in spheroid cultures. Bax expression was reduced in spheroids following cisplatin or Taxol treatment, while p53 levels remained unchanged.

Alterations in hepatic drug metabolism and lipid peroxidation during administration of Baygon, a pesticide.

Biochemical studies during low- and high-dose administration of Baygon (a pesticide) to young male rats were performed. It was observed that the activities of drug-metabolizing enzymes were decreased even at a low dose of Baygon and the decrease was much more significant during high-dose injections. Lipid peroxidation was increased with a low dose and the increase was much more pronounced with a high dose. Besides these changes the animals showed physical changes such as salivation, fasciculations, etc. The presence of conjugated diene absorption patterns and malonaldehyde formation indicated the in vivo lipid peroxidation dut to Baygon administration. Toxic effects leading to death were noted when the animals were injected with a high dose of the pesticide, Baygon above 25 mg/kg.

Methylmercury- and mercuric-chloride-induced alterations in rat epididymal sperm.

Four-week-old male albino rats weighing 70 +/- 5 g were treated intraperitoneally daily with 0, 5 and 10 micrograms methylmercuric chloride (MMC)/kg or 0, 50 and 100 micrograms mercuric chloride (MC)/kg body weight, respectively, over a period of 90 days. Studies were carried out a intermittent intervals, i.e. on days 0, 15, 30, 60 and 90 of the experiment. Gradual decrements in body and epididymal weights were observed from day 30 onwards in both the MMC- and MC-treated groups. Morphological deformations of epididymal epithelium were noted from day 30 onwards in the mercurial-treated groups. MMC treatment caused severe degeneration of the epididymal epithelium on days 60 and 90 in comparison to MC treatment. Total sperm count was significantly less in the MC-treated groups, while motile sperm count was affected most in the MMC-administered groups. The frequency of sperm abnormality increased consistently at both doses of mercurial treatment over a period of 90 days. Maximum sperm abnormality among the treated groups was noted in the groups given 10 micrograms MMC/kg. The observations revealed that MMC and MC have variable potency to alter epididymal structure and the sperm.

Octreotide in intestinal lymphangiectasia: lack of a clinical response and failure to alter lymphatic function in a guinea pig model.

Intestinal lymphangiectasia, which can be classified as primary or secondary, is an unusual cause of protein-losing enteropathy. The main clinical features include edema, fat malabsorption, lymphopenia and hypoalbuminemia. Clinical management generally includes a low-fat diet and supplementation with medium chain triglycerides. A small number of recent reports advocate the use of octreotide in intestinal lymphangiectasia. It is unclear why octreotide was used in these studies; although octreotide can alter splanchnic blood flow and intestinal motility, its actions on lymphatic function has never been investigated. A case of a patient with intestinal lymphangiectasia who required a shunt procedure after failing medium chain triglycerides and octreotide therapy is presented. During the management of this case, all existing literature on intestinal lymphangiectasia and all the known actions of octreotide were reviewed. Because some of the case reports suggested that octreotide may improve the clinical course of intestinal lymphangiectasia by altering lymphatic function, a series of experiments were undertaken to assess this. In an established guinea pig model, the role of octreotide in lymphatic function was examined. In this model system, the mesenteric lymphatic vessels responded to 5-hydroxytryptamine with a decrease in constriction frequency, while histamine administration markedly increased lymphatic constriction frequency. Octreotide failed to produce any change in lymphatic function when a wide range of concentrations were applied to the mesenteric lymphatic vessel preparation. In conclusion, in this case, octreotide failed to induce a clinical response and laboratory studies showed that octreotide did not alter lymphatic function. Thus, the mechanisms by which octreotide induced clinical responses in the cases reported elsewhere in the literature remain unclear, but the present study suggests that it does not appear to act via increasing lymphatic pumping.

Utilization of used human immunodeficiency virus ELISA microplates & surplus reagents for HIV antibody testing.

Used non-competitive enzyme-linked immunosorbent assay (ELISA) microplates were washed and reused to test samples and positive and negative controls, utilising the surplus reagents provided with the kit, which otherwise would have been discarded as useless after the entire 960 test kit had been utilized. These surplus reagents could be used for additional 220 tests over and above the recommended 960 tests per kit. A total of 839 unknown serum samples, 54 negative controls and 36 positive controls were tested using both washed and fresh (new) ELISA plates simultaneously. The optical density (OD) value of the control sera was within the prescribed limits in both the methods and 15 samples were found to be positive for HIV antibodies by the fresh plates whereas the washed plates showed 18 samples to be positive for HIV antibodies. None of the samples positive by fresh plates were negative by washed plates.

Stability indicating HPTLC method for the simultaneous determination of pseudoephedrine and cetirizine in pharmaceutical formulations.

The combination of pseudoephedrine and cetirizine is widely used in the treatment of allergic rhinitis. A rapid, selective and stability indicating high performance thin layer chromatographic method was developed and validated for their simultaneous estimation in pharmaceutical dosage forms. The method employed TLC aluminium plates precoated with silica gel 60F-254 as the stationary phase. The solvent system consisted of ethyl acetate-methanol-ammonia (7:1.5:1, v/v/v). This system was found to give compact spots for both pseudoephedrine (Rf value of 0.69+/-0.01) and cetirizine (Rf value of 0.38+/-0.01). Also the degraded products were well separated from the pure drugs. Spectrodensitometric scanning-integration was performed at a wavelength of 240 nm. The polynomial regression data for the calibration plots showed good linear relationship with r(2)=0.9947 in the concentration range of 10-26 microg for pseudeophedrine and 200-1200 ng for cetirizine with r(2)=0.9973. The method was validated for precision, accuracy, ruggedness and recovery. The minimum detectable amounts were found to be 2 microg and 500 pg for pseudoephedrine and cetirizine, respectively. The limits of quantitation were found to be 6 microg for pseudoephedrine and 800 pg for cetirizine. Both the drugs do not undergo degradation under acidic and basic conditions. The samples degraded with hydrogen peroxide showed additional peaks at Rf values of 0.75 and 0.28 for pseudoephedrine and cetirizine, respectively. This indicates that both the drugs are susceptible to oxidation. Statistical analysis proves that the method is reproducible and selective for the simultaneous estimation of pseudoephedrine and cetirizine. As the method could effectively separate the drugs from their degradation products, it can be employed as a stability indicating one.

Methylmercury induced biochemical and histochemical alterations in rat testis.

The methylmercurry chloride (MMC) administered at doses of 5 and 10 micrograms/kg over a period of 90 days to male rats caused enzymatic impairments in testicular tissue. The study at intervals of 15, 30, 60 and 90 days showed gradual diminution of testicular weight and gradual decrements in testicular protein and inhibition in testicular succinic dehydrogenase activity. Histochemical and biochemical studies revealed that testicular acid phosphatase activity was also inhibited at both the doses of MMC treatment. The inhibition of enzyme activity in testicular tissues after MMC treatment caused the impairment of both spermatogenesis and steroidogenesis in rats.

Age dependent changes in human serum lipid peroxide levels in rural population around Ambajogai.

Serum lipid peroxide levels were estimated in 205 healthy human subjects. The serum lipid peroxide levels in terms of malondialdehyde/ml was 1.47 nmol in male subjects with 11-20 years and which rose to a peak 2.97 in subjects with 51-60 years. Male subjects exhibited significantly higher (P less than 0.01) values as compared to female subjects in whom this increase with age was not observed.

Study of suspected plague cases for isolation and identification of Yersinia pestis.

A total of 62 suspected patients of plague were investigated for evidence of Yersinia pestis, by blood culture, lymph node aspirate culture, sputum culture, animal inoculation and serology for f1 antibodies against f1 antigen of Yersinia pestis. None of the samples was positive by direct smear examination and culture for Yersinia pestis, as well as for serology. The non positivity of the cultures is discussed.

Purification of erythrocyte cytochrome P-450 from goat and chick.

Cytochrome P-450 has been purified from goat and chick erythrocytes and characterized. Goat erythrocyte cytochrome P-450 content was higher than that of chick erythrocytes cytochrome P-450. Elution profile of purified protein from DEAE-cellulose column showed a single peak. The catalytic activities of aminopyrine-N-demethylase and acetanilide hydroxylase were found to be higher in purified proteins. Molecular weight was determined by SDS-polyacrylamide gel electrophoresis.

Slime producing Staphylococci from clinical specimens - a simple diagnostic test.

Coagulase negative Staphylococci are now being increasingly recognised as pathogens. Some strains produce a viscous extracellular material or slime. These strains are uniquely adapted for adherence to even smooth surfaces. Present study is a preliminary report of 101 isolates of coagulase negative Staphylococci from different clinical specimens. Forty three of these 101 isolates (42.5%) were slime producers. The percentage of slime producing Staphylococci ranged from 20% in peritoneal fluid to 66.6% in Cerebrospinal fluid. The test for slime production may have an important application in deciding the pathogenecity of the strains of coagulase negative Staphylococci and should be done routinely in a diagnostic laboratory.

Carbapenem resistance and phenotypic detection of carbapenemases in clinical isolates of Acinetobacter baumannii.

BACKGROUND AND OBJECTIVES: Multidrug-resistant Acinetobacter baumannii (MDR-Ab) reported worldwide has become one of the most difficult nosocomially acquired Gram-negative pathogens to control and treat. The clinical utility of carbapenems is under threat with the emergence of acquired carbapenemases, particularly Ambler class B metallo-lactamases (MBL). Because of the global increase in the occurrence and dissemination of MBLs, early detection is critical. This study was undertaken to detect resistance to carbapenems in clinical isolates of A. baumannii from hospitalized patients by both disk-diffusion and minimum inhibitory concentration (MIC) methods and to assess the rate of carbapenemase and MBL production among the isolates. MATERIALS AND METHODS: A. baumannii were identified from various clinical samples and antibiotic susceptibility profile was determined by the standard disk-diffusion method. Meropenem-resistant strains were tested further by agar dilution MIC for meropenem. Resistant isolates were screened for carbapenemase production by the modified Hodge test and positive isolates were further checked for metallo-ß-lacatmase production by the EDTA disk synergy test. RESULTS: 42 isolates (31.81%) showed resistance to meropenem by the disk diffusion method. 47.6% were carbapenemase positive by the modified Hodge test and 19% were MBL producers phenotypically by the EDTA disc synergy test (EDS). These meropenem-resistant isolates were resistant to most of the other antibiotics tested. These 42 isolates were recovered mostly from patients admitted to intensive care units. Four isolates of the A. baumannii complex were pan drug resistant and showed resistance to even tigecycline and polymyxin B. CONCLUSION: Carbapenem resistance has been increasingly reported, necessitating their detection. This study reports simple, carbapenemase, and MBL detection method that can be easily incorporated into the daily routine of a clinical laboratory.