Longitudinal Analysis of Diagnostic Accuracy of Panoramic Radiography in Oral Pathology.

Objective: The purpose of this 5-year longitudinal study was to assess the diagnostic accuracy of panoramic radiography (PR) in identifying oral pathology at a tertiary care facility. Methods: A retrospective review of patient files was done, encompassing those of patients who had PR for suspected oral lesions, followed by a biopsy. At various times, several diagnostic accuracy metrics were computed, such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratio (DOR). Results: The research had 250 patients in total. In terms of identifying oral pathology, PR showed a sensitivity of 85% and a specificity of 90%. There were 80% and 92% PPV and NPV, respectively. With a computed DOR of 25, PR's total discriminating power was found to be high. Conclusion: In summary, PR consistently demonstrates great diagnostic accuracy in identifying oral pathology at a tertiary care facility. These results confirm that PR is a useful screening technique for oral lesions in standard clinical practice. In order to overcome PR's shortcomings and investigate methods for enhancing its diagnostic effectiveness, more investigation is necessary.

Unveiling the antinociceptive mechanisms of Methyl-2-(4-chloro-phenyl)-5-benzoxazoleacetate: insights from nociceptive assays in mice.

OBJECTIVE: Methyl-2-(4-chloro- phenyl)-5-benzoxazoleacetate (MCBA), a synthetic benzoxazole derivative with established antipsoriatic efficacy, was investigated for potential antinociceptive effects. This study employs various nociceptive assays in mice to elucidate MCBA's antinociceptive mechanisms. MATERIALS AND METHODS: MCBA's antinociceptive potential was tested against various nociception models induced by formalin, glutamate, capsaicin, a transient receptor potential vanilloid 1 (TRPV1) receptor agonist, and phorbol 12-myristate 13-acetate, a protein kinase C (PKC) activator. It was then assessed using the hot plate test and examined within the acetic acid-induced writhing test. During the acetic acid-induced writhing test, MCBA was pre-challenged against selective receptor antagonists such as naloxone, caffeine, atropine, yohimbine, ondansetron, and haloperidol. It was also pre-challenged with ATP-sensitive potassium channel inhibitor (glibenclamide) to further elucidate its antinociceptive mechanism. RESULTS: The results showed that oral administration of MCBA led to a dose-dependent and significant inhibition (p < 0.05) of nociceptive effects across all evaluated models at doses of 60, 120, and 240 mg/kg. Moreover, the efficacy of MCBA's antinociceptive potential was significantly counteracted (p < 0.0001) by specific antagonists: (i) directed at adenosinergic, alpha-2 adrenergic, and cholinergic receptors using caffeine, yohimbine, and atropine, respectively; and (ii) targeting ATP-sensitive potassium channels, employing glibenclamide. Antagonists aimed at opioidergic and serotoninergic receptors (naloxone and ondansetron, respectively) had poor utility in inhibiting antinociceptive activity. Conversely, the dopaminergic receptor antagonist haloperidol potentiated locomotor abnormalities associated with MCBA treatment. CONCLUSIONS: MCBA-induced antinociception involves modulation of glutamatergic-, TRVP1 receptors- and PKC-signaling pathways. It impacts adenosinergic, alpha-2 adrenergic, and cholinergic receptors and opens ATP-sensitive potassium channels.

Polyphenol fingerprinting and hypoglycemic attributes of optimized Cycas circinalis leaf extracts.

BACKGROUND: Cycas circinalis leaves are used to treat diabetes mellitus in local medicinal systems without any scientifically proved information on their medicinal potential and phytochemicals. In this study, the total phenolic contents, total flavonoid contents, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging and inhibitory effects on α-glucosidase and α-amylase were determined for optimized hydroethanolic leaf extracts. Secondary metabolites were identified using ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS). In vivo studies on diabetic albino mice were also carried out to evaluate the impact of the most active extract on their blood glucose levels. RESULTS: The 60% ethanolic extract showed the highest extract yield (209.70 ± 0.20 g kg-1 ) and total phenolic (154.24 ± 3.28 mg gallic acid equivalent) and flavonoid (78.52 ± 1.65 mg rutin equivalent per gram dried extract) contents and exhibited the maximum DPPH scavenging activity (IC50 = 59.68 ± 2.82 µg mL-1 ). The IC50 values for inhibition of α-glucosidase (58.42 ± 2.22 µg mL-1 ) and α-amylase (74.11 ± 1.70 µg mL-1 ) were also significant for the 60% ethanolic extract. The untargeted UHPLC-QTOF-MS/MS-based metabolite profiling confirmed the presence of iridoid glucoside, gibberellin A4, O-ß-d-glucosyl-4-hydroxy-cinnamate, 3-methoxy-2-phyenyl-4H-furo[2,3-h]chromen-4-one, kaempferol, withaferin A, amentoflavone, quercitin-3-O-(6″-malonyl glucoside), ellagic acid, and gallic acid. Plant extract at a dose of 500 mg kg-1 body weight reduced the blood glucose level by a considerable extent and also improved the lipid profile of diabetic mice after a 28-day trial. CONCLUSION: The findings revealed the medicinal potential of C. circinalis leaves to treat diabetes mellitus and provided the nutraceutical leads for functional food development. © 2020 Society of Chemical Industry.

Comparison of the single dose pharmacokinetics, pharmacodynamics, and safety of two novel oral formulations of dimethandrolone undecanoate (DMAU): a potential oral, male contraceptive.

Dimethandrolone (DMA, 7α,11ß-dimethyl-19-nortestosterone) has both androgenic and progestational activities, ideal properties for a male hormonal contraceptive. In vivo, dimethandrolone undecanoate (DMAU) is hydrolyzed to DMA. We showed previously that single oral doses of DMAU powder in capsule taken with food are well tolerated and effective at suppressing both LH and testosterone (T), but absorption was low. We compared the pharmacokinetics and pharmacodynamics of two new formulations of DMAU, in castor oil and in self-emulsifying drug delivery systems (SEDDS), with the previously tested powder formulation. DMAU was dosed orally in healthy adult male volunteers at two academic medical centers. For each formulation tested in this double-blind, placebo-controlled study, 10 men received single, escalating, oral doses of DMAU (100, 200, and 400 mg) and two subjects received placebo. All doses were evaluated for both fasting and with a high fat meal. All three formulations were well tolerated without clinically significant changes in vital signs, blood counts, or serum chemistries. For all formulations, DMA and DMAU showed higher maximum (p < 0.007) and average concentrations (p < 0.002) at the 400 mg dose, compared with the 200 mg dose. The powder formulation resulted in a lower conversion of DMAU to DMA (p = 0.027) compared with both castor oil and SEDDS formulations. DMAU in SEDDS given fasting resulted in higher serum DMA and DMAU concentrations compared to the other two formulations. Serum LH and sex hormone concentrations were suppressed by all formulations of 200 and 400 mg DMAU when administered with food, but only the SEDDS formulation was effectively suppressed serum T when given fasting. We conclude that while all three formulations of oral DMAU are effective and well tolerated when administered with food, DMAU in oil and SEDDS increased conversion to DMA, and SEDDS may have some effectiveness when given fasting. These properties might be advantageous for the application of DMAU as a male contraceptive.

Endotracheal and aerosol administrations of ceftazidime in patients with nosocomial pneumonia: pharmacokinetics and absolute bioavailability.

Pharmacokinetic studies on ceftazidime, an aminothiazole cephalosporin with a wide spectrum of antibacterial activity, including activity against Pseudomonas aeruginosa, were performed in patients with nosocomial pneumonia. The concentration-time profiles of ceftazidime in plasma, urine, and bronchial secretions of 12 patients were investigated after intravenous (i.v.) (n = 12), endotracheal (n = 10), and aerosol (n = 5) administrations. In all cases a 1-g dose was administered. Concentrations of drug in all samples were assayed by high-performance liquid chromatography with UV detection. The elimination of the drug from the blood followed a biexponential (i.v. administration) or a monoexponential (endotracheal and aerosol administrations) decay, with an elimination half-life of 6 h and a total body clearance of 4.2 liters/h. The apparent volume of distribution was 0.36 liter/kg of body weight. Renal clearance of the drug accounted for 58% of the total clearance; 66% +/- 17.7%, 33.5% +/- 17.3%, and 6.59% +/- 3.45% of the administered dose were eliminated in urine as parent drug after i.v., endotracheal, and aerosol administrations, respectively. The absolute bioavailabilities were 0.47 and 0.08 for endotracheal and aerosol administrations, respectively. Very high concentrations were found in bronchial secretions after local administration. The MICs for 90% of the most important pathogens responsible for nosocomial infections were exceeded by concentrations in bronchial secretion for up to 12 h after i.v. infusion and for up to 24 h after endotracheal and aerosol administrations.

Stimulation of food intake in rats by the alpha 2-adrenoceptor agonists xylazine and detomidine.

Effects of the alpha 2-adrenoceptor agonists xylazine and detomidine on food intake in freely feeding male rats were evaluated. Intraperitoneal (i.p.) injection of xylazine (0.25-3 mg/kg) and detomidine (25 and 50 micrograms/kg) significantly increased the 2 and 24 h food intake from control values. Treatment of rats with the alpha 2-adrenoceptor antagonist yohimbine (1 mg/kg, i.p.) 15 min before xylazine (0.5 mg/kg, i.p.) or detomidine (50 micrograms/kg, i.p.) significantly inhibited the increase in food intake. Yohimbine treatments alone at 0.5, 1 and 2 mg/kg, i.p. did not significantly change the 2 and 24 h food intake from control values. The results suggest that the alpha 2-agonists xylazine and detomidine enhance food intake in rats.