Gingival Crevicular Fluid Levels of Neurokinin A and Substance P in Patients with Symptomatic Irreversible Pulpitis: A Systematic Review and Meta-Analysis.

Aims and Objectives: The levels of neuropeptides neurokinin A (NKA) and substance P (SP) in the gingival crevicular fluid of patients with symptomatic irreversible pulpitis (SIP) were evaluated using a comprehensive review and meta-analysis. Materials and Methods: The data bases of Pubmed, Scopus, EBSCOhost, Science Direct, Proquest and Cochrane library databases were thoroughly searched. The quality of the study was evaluated using the Joanna Briggs Criteria. Twenty four studies were listed following a thorough search of full texts, abstracts, and removal of duplicates. Only two of these papers were eligible for inclusion in the meta-analysis. Since the results obtained were in mean and standard deviation, the levels of neuropeptides in the test and control groups were examined using the meta-analysis. Results: When compared with healthy teeth, NKA was not significantly elevated in GCF of individuals with SIP (P = 0.06; odd ratio = 1.34 [-0.05 to 2.74] at 95% confidence interval [CI]). Additionally, there was no evidence of an association between SP and SIP (P = 0.08; odds ratio = 0.84 [-0.10 to 1.77] at 95% CI). Conclusion: This systematic research demonstrated that in individuals with SIP, NKA, and SP are not substantially linked. However, the lack of study in this area makes it evident that additional research is needed, particularly in relation to pulpal disorders and NKA.

Symptomatic Irreversible Pulpitis Induces Increased Levels of Human NLRP3 in Gingival Crevicular Fluid Compared to Saliva: A Case Control Observational Study.

INTRODUCTION: The goal of this case-control observational study was to compare the levels of the human nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing-3 (NLRP3) protein in the saliva and gingival crevicular fluid (GCF) of patients with symptomatic irreversible pulpitis (SIP) and healthy controls. METHODS: The 16 patients in the control group were matched with the 16 patients in the SIP group to create a total of 32 patients. In addition to saliva, GCF (n = 48) samples were collected from the involved tooth (n = 16), contralateral tooth (n = 16), and adjacent tooth (n = 16) in the SIP group. Saliva and GCF were taken from the healthy group as a baseline. An independent t-test was used for statistical analysis. The random-intercept model was used to compare the average NLRP3 levels in the SIP tooth, adjacent tooth, and contralateral tooth taking age as a covariate, and the P value was adjusted using Bonferroni correction. RESULTS: There were significantly higher levels of NLRP3 in the saliva of SIP patients (1.78 ± 1.14 ng/ml) compared to the healthy control (0.70 ± 0.70 ng/ml) and in the GCF of the involved tooth (5.72 ± 0.63 ng/ml) compared to healthy people (1.60 ± 0.42 ng/ml) (P < .001). In SIP patients the mean difference of NLRP3 levels between SIP and contralateral teeth was significant at 4.13 ng/ml (95% confidence interval, 3.52-4.70 P < .001) and a mean difference between adjacent teeth and contralateral teeth was significant at 3.53 ng/ml [95% confidence interval, 2.94-4.12 P < .001]. The NLRP3 in GCF and saliva had a negative association in the affected tooth but a negligible correlation in healthy controls. CONCLUSION: The NLRP3 inflammasome has the potential to be employed as a molecular diagnostic biomarker for pulpal disorders.

Salivary levels of NLRP3 protein are significantly raised in chronic periodontitis: A systematic review and meta-analysis of clinical studies.

Background: To date, there is no confirmatory diagnostic test that can identify the type of periodontal disease and the disease progress. With the advent of "molecular biomarkers," this systematic review and meta-analysis were designed with the sole purpose of identifying a novel biomarker, namely, nucleotide leucine rich repeat pyrin protein-3 (NLRP3) inflammasome which has already been extensively researched for chronic inflammatory and autoimmune diseases. Types of Studies Reviewed: Only case observational studies that evaluated the presence of human NLRP3 inflammasome in the saliva of patients with chronic periodontitis with no overlying systemic disease and compared the same to healthy patients to obtain quantitative data that can be statistically analyzed were included. The confirmatory test used in all the studies was the enzyme-linked immunosorbent assay. Results: The broad-based search led to a total of three articles that fulfilled the inclusion criteria so that a meta-analysis of the results could be carried out. Data reveal that NLRP3 levels are raised in chronic periodontitis cases (P = 0.05; relative risk = 1.05 [0.00-2.09]). The risk of bias assessment was carried out according to the Joanna Briggs Institute Critical Appraisal Checklist where ten-point criteria were outlined indicating a low risk of bias for three studies. Clinical Implications: NLPR3 inflammasome could be tested as a reliable biomarker in saliva to identify the type and progress of the periodontal disease.

Evaluation of Efficacy of Coenzyme Q10 as an Adjunct to Nonsurgical Periodontal Therapy and Its Effect on Crevicular Superoxide Dismutase in Patients with Chronic Periodontitis.

OBJECTIVES: To assess the efficacy of coenzyme Q10 (CoQ10) as an adjunct to nonsurgical periodontal therapy and its effect on superoxide dismutase (SOD) in gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP). MATERIALS AND METHODS: A total of 16 patients aged between 30 and 50 years having mild to moderate CP of both sexes having pocket depth of 5 to 7 mm in four nonadjacent interproximal sites were selected. The sites were randomized and divided into treatment and control groups. CoQ10 and a placebo gel were administered in the treatment and control sites, respectively, at baseline after scaling and root planing (SRP). GCF was collected using microcapillary method at baseline and 3 months and was assessed for SOD using enzyme-linked immunosorbent assay reader at 450 nm wavelength. Probing pocket depth, gingival index, and plaque index were assessed at baseline, 1 month, and 3 months, respectively. STATISTICAL ANALYSIS: For each assessment point, data were statistically analyzed using Student's t-test and paired t-test. Level of significance was set at p < 0.05. RESULTS: On intergroup comparison, there was no statistically significant difference between the clinical parameters of both the groups at all the time intervals (p > 0.05), but there was a significant increase in the level of SOD in the test group (p > 0.05) compared with the control group at 3 months. CONCLUSIONS: Adjunctive use of CoQ10 with SRP can boost the antioxidant concentration, but it is not superior to SRP in the treatment of CP.

NSAIDs and self-medication: A serious concern.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used by the patients frequently for pain which may be acute, acute-on-chronic, and chronic. For the relief of pain and inflammation, some patients may take the analgesics without consulting the family physician as they can procure the same easily, not realizing that there may be adverse effects associated with regular self-medication of NSAIDs. The NSAIDs have a risk of upper gastrointestinal bleeding or perforation, which may vary between individual NSAIDs at the doses commonly used by the patients. Thus, there is a need to create awareness in the society regarding the same to prevent self-medication associated complications.

Awareness about breast cancer in males in urban area of Delhi.

BACKGROUND: Breast cancer in males is still an issue that is not known to majority of the population across the globe. People in general are not aware that breast cancer can occur in males too as increasing campaigns are done to raise awareness in females. OBJECTIVE: To assess the level of awareness of male breast cancer (MBC) in males of urban population residing in the Soami Nagar colony, Panchsheel, New Delhi. METHODOLOGY: A cross sectional survey was conducted through a self-administered questionnaire to know the awareness of the occurrence of MBC, its diagnosis and criticality. RESULTS: It was found that only 19% of men were aware of the fact that breast cancer can occur in males as well and remaining 81% were ignorant. CONCLUSION: Because a whopping 81% of the surveyed population did not know that breast cancer could even occur in males, they were made aware about all the symptoms to look for and not to ignore any sort of bulge/lumps/knots that they may feel in their breast region or under the armpits. Findings of this study would serve as a baseline to focus on making people aware of this life threatening problem. Increased awareness of MBC would help males to discuss the problem in initial phase and reach out to primary health care physicians for early diagnosis and treatment.