Clinical efficacy of grape seed extract as an adjuvant to scaling and root planing in treatment of periodontal pockets.

Grape seed extract (GSE), a naturally producing polyphenolic compound, is found to be a potent hostmodulatory agent and considered for management of periodontal disease. Its anti-bacterial, antioxidant, and anti-inflammatory property may aid in achieving periodontal health. To assess the clinical efficacy of GSE in adjunct to scaling and root planing (SRP) in healing of periodontal pockets. The present study was a longitudinal, parallel design, randomized clinical trial. Seventy-two patients (mean age 39.2±8.6 years) with periodontal pockets were randomly divided into two groups; Test group received intra-pocket delivery of GSE with SRP and Control group received SRP alone. The clinical parameters like Plaque Index (PI), Gingival Index (GI), Probing Depth (PD) and Relative Attachment Level (RAL) were recorded at baseline and 3 months. 64 patients completed the study. Test group at the end of 3 months had statistically significant reduced PD (p=0.002) and RAL (p=0.01). No significant difference was observed for PI and GI at the end of 3 months. Intra-pocket application of GSE with SRP could be beneficial in management of periodontal pockets.

Clinical and antimicrobial efficacy of a controlled-release device containing chlorhexidine in the treatment of chronic periodontitis.

A controlled-release device (CRD) containing chlorhexidine gluconate, such as PerioCol(™)CG (Eucare Pharmaceuticals Pvt. Ltd,, Chennai, India), for subgingival application has little reported data with clinical as well as antimicrobial efficacy. This study evaluated clinical and subgingival microbial changes on using indigenously developed PerioCol™CG as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Forty posterior first molar sites having probing pocket depth ≥ 5 mm were selected and divided into two groups, with 20 sites in each group, in a split-mouth design. Group A (test site) was treated with SRP and PerioCol(™)CG, while group B (control site) was treated with SRP alone. Subgingival microbial samples were collected at baseline and 1 month after the initial SRP, while probing depth (PD), clinical attachment level (CAL) and gingival index (GI) were recorded at baseline, after 1 month and after 3 months. Microbial detection of Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) was done by means of polymerase chain reaction (PCR). A significant improvement was observed in all clinical measures in sites treated with PerioCol(™)CG as compared to the control sites during the study period. Also, there was a statistically significant reduction in the proportion of occurrence of P. gingivalis and T. forsythia after intervention in test sites as compared to control sites. Our data suggest that SRP combined with subgingival administration of PerioCol™CG has a significantly better and prolonged effect compared to SRP alone on the PD, clinical attachment loss and elimination of periodontopathogens.

Measuring sub-bandage pressure: comparing the use of pressure monitors and pulse oximeters.

OBJECTIVE: To test the use of low-cost sub-bandage pressure monitors and pulse oximeters as part of a quality-control measure for graduated compression bandaging in leg ulcer clinics. METHOD: Twenty-five healthy volunteers (mean age 40 years) providing 50 limbs were bandaged with a four-layer compression bandaging system. The ankle systolic pressure (ASP) was measured using a pulse oximeter (Nellcor NBP-40) before applying the graduated compression bandages. Interface pressure was measured by placing pressure sensors on the skin at three points (2cm above the medial malleolus; the widest part of the calf; and a point midway between them) in the supine and standing positions. The ASP was measured again with the pulse oximeter after the bandage had been applied, and the effect of the bandage on the ASP was recorded. The actual pressure created by the bandage was compared with the required pressure profile. RESULTS: Interface pressures varied with change of position and movement. With the operator blinded to the pressure monitors while applying the bandages, the target pressure of 35-40mmHg at the ankle was achieved in only 36% of limbs ([mean +/- 95% confidence interval]; 32.3 +/- 1.6mmHg [supine]; 38.4 +/- 2.4mmHg [standing position]). With the help of the pressure monitors, the target pressure was achieved in 78% of the limbs. There was no correlation between the pressure monitors and pulse oximeter pressures, demonstrating that the pulse oximeter is not a useful tool for measuring sub-bandage pressures. CONCLUSION: The results suggest a tool (interface pressure monitors) that is easy to operate should be available as part of quality assurance for treatment, training of care providers and education.

Iatrogenic arteriovenous fistula of the breast as a complication of core needle biopsy.

Ultrasonography guided core biopsy has become the standard of care in the assessment of breast cancer. Although the procedure is associated with low rates of complications, we present a case report of a rare complication of the procedure that has been reported only once previously in the medical literature.

A study of the routine use of venous photoplethysmography in a one-stop vascular surgery clinic.

INTRODUCTION: The decision to offer surgical treatment for varicose veins should be based on objective evidence of venous dysfunction and not only the subjective appearance or the reported symptoms. Special tests are required to identify the sub-group of patients with functional superficial venous reflux accurately. The initial test should be simple, cheap, objective, sensitive and easy to perform by a wide range of staff in order to screen out patients without reflux. The final test should be anatomically specific to identify the appropriate surgical procedure. The aim of this study was to test the feasibility of using photoplethysmography (PPG) as the initial test as part of a one-stop vascular clinic assessment protocol. PATIENTS AND METHODS: All patients referred to one consultant over a 68-week period were assessed using standard practice for the first 22 weeks and with an objective assessment protocol based on PPG for the subsequent 46 weeks. RESULTS: A total of 347 out-patient appointments for patients with venous disease were booked: 239 (69%) were new referrals. Of the new patients, 59% were CEAP C2/3 and 23% were CEAP C4-6. The introduction of the objective assessment protocol was associated with a reduction in patients offered surgery from 39% to 24% overall and 51% to 28% in new patients with CEAP C2. There was a corresponding increase in the number of patients discharged back to the GP from 19% to 29% overall and 17% to 32%, respectively. The number of patients referred for duplex ultrasound fell slightly from 26% to 22%. Overall, there was a significant change in practice between the two periods (chi(2) = 13.3; df = 3; P = 0.004). CONCLUSIONS: The introduction of an objective assessment protocol based on PPG as the initial objective test reduces the number of patients offered surgery based on objective evidence of venous dysfunction.

Biofilm inhibition and antimicrobial activity of a dentifrice containing salivary substitutes.

BACKGROUND/AIMS: A healthy mouth harbours the continuous combined action of a salivary defence system with that of a salivary peroxidase system, containing lactoferrin, lysozyme, immunoglobulin and growth factors. This system maintains neutral pH and creates an oral environment where harmful bacteria are inhibited, thus preventing the formation of biofilms. The objective of this clinico-microbiological trial was to evaluate the anti-plaque effect of a dentifrice containing salivary substitutes, compared with a placebo-control dentifrice and to assess the effect of dentifrice on oral bacterial count. METHODS: The design was a randomized controlled, double-blind, parallel study comparing a placebo-dentifrice to a dentifrice formulation containing salivary substitutes. Toothpaste slurry rinses were used over a 96-h period by 20 volunteers who refrained from all other oral hygiene procedures. Commercially available fluoride toothpaste was used as control. Plaque was scored and unstimulated salivary samples were collected at day 0 and after 4 days. A microbiological analysis was carried out for the salivary samples. Data were analyzed by using Student's t-tests. RESULTS: There was a statistically significant mean difference in plaque scores after using test paste (1.19 + 0.31) in comparison with those using placebo toothpaste (1.95 + 0.33). The difference between mean increase in colony forming units for the test and the placebo group was (25.2 + 8) x 10(5) and (17.5 + 6.01) x 10(5), respectively, which was statistically significant. CONCLUSIONS: The findings of the study support the hypothesis that toothpaste containing salivary substitutes prevents dental biofilm formation and exhibits antimicrobial property when compared with a placebo dentifrice.

Spontaneous regression of a rare tumour in a child: angiolymphoid hyperplasia with eosinophilia of the hand: case report and review of the literature.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign, idiopathic vasculoproliferative condition manifested by multiple or solitary subcutaneous nodules, usually in the head and neck region of young adults. It is very rare in the extremities especially in the hands. Although recurrence is common, surgical excision is still regarded as the treatment of choice. We report an 11-year-old girl with histologically confirmed ALHE on the dorsum of her left hand, which underwent complete spontaneous regression within 10 weeks. Angiolymphoid hyperplasia is a benign disease and it is important to recognise this condition so that early superficial lesions can be observed for 3-6 months pending spontaneous regression.