Management of Aberrant Frenum and Gingival Overgrowth in Orthodontic Patients: A Case Report.

The frenum, a fold of mucous membrane, connects the lip and cheek to the alveolar mucosa, gingiva, and underlying periosteum. When the frenum is positioned excessively near the gingival margin, it has the potential to compromise gingival health, impeding plaque control efforts and inducing muscular stress. A frenectomy is a commonly employed corrective measure for anomalous frenum attachments. In a recent clinical case, a 21-year-old female patient was referred from the Department of Orthodontics to the Department of Periodontics due to a papillary-type aberrant labial frenum attachment and excessive gingival tissue surrounding the upper right and left central incisors. The patient underwent a frenectomy, gingivectomy, and gingivoplasty procedures under local anesthesia to address the abnormal frenum attachment and gingival overgrowth using a scalpel. This approach has been demonstrated to yield optimal outcomes in orthodontic therapy for patients exhibiting elevated frenum attachment and gingival overgrowth. Following the achievement of hemostasis, a periodontal pack was applied to facilitate healing and preserve the soft tissue.

Repair of Iatrogenic Furcal Perforation With Mineral Trioxide Aggregate: A Case Report.

In endodontic and restorative procedures, an accidental perforation of the pulp chamber floor or roots presents a considerable risk, potentially leading to persistent inflammatory responses and ultimately tooth loss. Accidental root canal perforations are primary complications encountered by clinicians, requiring either surgical or non-surgical intervention, depending on the severity of the perforation. Over the years, various materials have been utilized for the treatment of such complications, but mineral trioxide aggregate (MTA) stands out prominently due to its exceptional biocompatibility, remarkable sealing capacity, and potent antibacterial properties. The unique ability of MTA to set in the presence of moisture facilitates the formation of a robust seal, thereby making it highly effective in managing root perforations and fostering tissue regeneration within the affected area. Its versatility and effectiveness have made MTA a cornerstone material in modern endodontic therapy, offering clinicians a reliable solution for enhancing the long-term prognosis of teeth affected by perforations.

Fetomaternal outcomes in pregnant women with congenital heart disease: a comparative analysis from an apex institute.

OBJECTIVE: With advancements in cardiac surgical interventions during infancy and childhood, the incidence of maternal congenital heart disease (CHD) is increasing. This retrospective study compared fetal and cardiac outcomes in women with and without CHD, along with a sub-analysis between cyanotic versus non-cyanotic defects and operated versus non-operated cases. METHODS: A 10-year data were retrospectively collected from pregnant women with CHD and a 1:1 ratio of pregnant women without any heart disease. Adverse fetal and cardiac outcomes were noted in both groups. Statistical significance was set at P<0.05. RESULTS: A total of 86 pregnant women with CHD were studied, with atrial septal defects (29.06%) being the most common. Out of 86 participants, 27 (31.39%) had cyanotic CHD. Around 55% of cases were already operated on for their cardiac defects. Among cardiovascular complications, 5.8% suffered from heart failure, 7.0% had pulmonary arterial hypertension, 8.1% presented in New York Heart Association functional class IV, 9.3% had a need for intensive care unit admission, and one experienced maternal mortality. Adverse fetal outcomes, including operative vaginal delivery, mean duration of hospital stay, fetal growth restriction, preterm birth (<37 weeks), low birth weight (<2,500 g), 5-minute APGAR score <7, and neonatal intensive care unit admissions, were significantly higher in women with CHD than in women without heart disease. CONCLUSION: Women with CHD have a higher risk of adverse fetal and cardiac outcomes. The outcome can be improved with proper pre-conceptional optimization of the cardiac condition, good antenatal care, and multidisciplinary team management.

Evaluation of supplemented protein-L-isoaspartate-O-methyltransferase (PIMT) gene of Carica papaya and Ricinus communis in stress survival of Escherichia coli BL21(DE3) cells.

In growing plant population, effect of stress is a perturb issue affecting its physiological, biochemical, yield loss and developmental growth. Protein-L-isoaspartate-O-methyltransferase (PIMT) is a broadly distributed protein repair enzyme which actuate under stressful environment or aging. Stress can mediate damage converting protein bound aspartate (Asp) residues to isoaspartate (iso-Asp). This spontaneous and deleterious conversion occurs at an elevated state of stress and aging. Iso-Asp formation is associated with protein inactivation and compromised cellular survival. PIMT can convert iso-Asp back to Asp, thus repairing and contributing to cellular survival. The present work describes the isolation, cloning, sequencing and expression of PIMT genes of Carica papaya (Cp pimt) and Ricinus communis (Rc pimt) Using gene specific primers, both the pimts were amplified from their respective cDNAs and subsequently cloned in prokaryotic expression vector pProEXHTa. BL21(DE3) strain of E. coli cells were used as expression host. The expression kinetics of both the PIMTs were studied with various concentrations of IPTG and at different time points. Finally, the PIMT supplemented BL21(DE3) cells were evaluated against different stresses in comparison to their counterparts with the empty vector control.

Zirconium-Coated ß-Cyclodextrin Nanomaterials for Biofilm Eradication.

Under alkaline treatment, zirconyl chloride (ZrOCl2.8H2O) became a zirconia gel and formed a stable complex with beta-cyclodextrin (ßCD). This complex was highly active in reactive oxygen species (ROS) formation via H2O2 decomposition. Its surface with numerous hydroxyl groups acts as an ionic sponge to capture the charged reaction intermediates, including superoxide (O2-•) and the hydroxyl radical (•OH). ROS, especially •OH radicals, are harmful to living microorganisms because of their kinetic instability, high oxidation potential, and chemical nonselectivity. Therefore, •OH radicals can engage in fast reactions with virtually any adjacent biomolecule. With H2O2, the complex with cationic and hydrophobic moieties interacted with the anionic bacterial membrane of two Gram-positive (Staphylococcus aureus and S. epidermidis) and two Gram-negative (Escherichia coli and Klebsiella pneumoniae) strains. The Zr-ßCD-H2O2 also eradicated more than 99% of the biofilm of these four pathogens. Considering the difficult acquisition of resistance to the oxidation of •OH, the results suggested that this ßCD-based nanomaterial might be a promising agent to target both drug-resistant pathogens with no cytotoxicity and exceptional antimicrobial activity.

In Contemporary Reproductive Medicine Human Beings are Not Yet Dispensable.

In the past few years almost every aspect of an IVF cycle has been investigated, including research on sperm, color doppler in follicular studies, prediction of embryo cleavage, prediction of blastocyst formation, scoring blastocyst quality, prediction of euploid blastocysts and live birth from blastocysts, improving the embryo selection process, and for developing deep machine learning (ML) algorithms for optimal IVF stimulation protocols. Also, artificial intelligence (AI)-based methods have been implemented for some clinical aspects of IVF, such as assessing patient reproductive potential and individualizing gonadotropin stimulation protocols. As AI has the inherent capacity to analyze "Big" data, the goal will be to apply AI tools to the analysis of all embryological, clinical, and genetic data to provide patient-tailored individualized treatments. Human skillsets including hand eye coordination to perform an embryo transfer is probably the only step of IVF that is outside the realm of AI & ML today. Embryo transfer success is presently human skill dependent and deep machine learning may one day intrude into this sacred space with the advent of programed humanoid robots. Embryo transfer is arguably the rate limiting step in the sequential events that complete an IVF cycle. Many variables play a role in the success of embryo transfer, including catheter type, atraumatic technique, and the use of sonography guidance before and during the procedure of embryo transfer. In contemporary Reproductive Medicine human beings are not yet dispensable.

Advancement in Epilepsy Pharmacotherapy: An Insight into the Pharmacophoric Approaches of Recent Drugs.

Epilepsy is the most general, extensive, and severe neurological disorder, affecting more than 50 million individuals globally. Initially, conventional medicines and simple salts like potassium bromide were employed as antiepileptic medication candidates. Nowadays, many anticonvulsant drugs have been discovered as first-generation and second-generation and newer drugs and are still in development phases. The pharmacophore-based drug design process includes pharmacophore modeling and validation, pharmacophore-based virtual screening, virtual hits profiling, and lead identification with special reference. This comprehensive article reviews recently developed anticonvulsant derivatives on the basis of pharmacophoric approaches. A literature survey was performed using various search engines like Google Scholar, Scopus, Sci Finder, ScienceDirect, Science gate, Scilit, PubMed, NINDS database of NIH, Bentham Sciences, and other online and print journals and scientific databases. The presented review discusses such kinds of newer drugs that are in the market as well as in clinical trial phases. Detailed outcomes of pharmacophoric modeling have been discussed for newly derived derivatives like targets involved in Epilepsy, lead molecules etc., for the treatment of epilepsy. This exhaustive review will assist the researchers in the further development of potential antiepileptic agents.

Discovery of imeglimin-inspired novel 1,3,5-triazine derivatives as antidiabetic agents in streptozotocin-induced diabetes in Wistar rats via inhibition of DPP-4.

Novel 1,3,5-triazine derivatives bearing oxazine have been synthesized and tested for their ability to inhibit a panel of dipeptidyl peptidase (DPP)-4, 8, and 9 enzymes. In a comparative inhibitory assay, the molecules showed potent inhibition of DPP-4 ranging from IC50 of 4.2 ± 0.30-260.5 ± 0.42 nM, with no activity against DPP-8 and DPP-9. Among the tested series, compound 8c demonstrated the strongest DPP-4 inhibitory activity with an IC50 of 4.2 ± 0.30 nM. It also showed the greatest binding affinity during docking studies with DPP-4 with a docking score of -8.956 and a glide energy of -78.546 kcal mol-1 and was found oriented in the S1 and S2 pockets of the DPP-4 active site, which is composed of the catalytic triad Ser 630, Asp 710, and His 740. The in vivo pharmacological assay revealed that compound 8c in a dose-dependent manner improved the insulin level, body weight, antioxidants, and HDL, and reduced the levels of blood glucose, LDL, and VLDL in streptozotocin-induced diabetes in Wistar rats. Our study demonstrated the discovery and development of novel 1,3,5-triazine derivatives bearing oxazine as a novel class of anti-diabetic agents via inhibition of DPP-4.

Probing Polarity and pH Sensitivity of Carbon Dots in Escherichia coli through Time-Resolved Fluorescence Analyses.

Intracellular monitoring of pH and polarity is crucial for understanding cellular processes and functions. This study employed pH- and polarity-sensitive nanomaterials such as carbon dots (CDs) for the intracellular sensing of pH, polarity, and viscosity using integrated time-resolved fluorescence anisotropy (FA) imaging (TR-FAIM) and fluorescence lifetime (FLT) imaging microscopy (FLIM), thereby enabling comprehensive characterization. The functional groups on the surface of CDs exhibit sensitivity to changes in the microenvironment, leading to variations in fluorescence intensity (FI) and FLT according to pH and polarity. The FLT of CDs in aqueous solution changed gradually from 6.38 ± 0.05 ns to 8.03 ± 0.21 ns within a pH range of 2-8. Interestingly, a complex relationship of FI and FLT was observed during measurements of CDs with decreasing polarity. However, the FA and rotational correlation time (θ) increased from 0.062 ± 0.019 to 0.112 ± 0.023 and from 0.49 ± 0.03 ns to 2.01 ± 0.27 ns, respectively. This increase in FA and θ was attributed to the higher viscosity accompanying the decrease in polarity. Furthermore, CDs were found to bind to three locations in Escherichia coli: the cell wall, inner membrane, and cytoplasm, enabling intracellular characterization using FI and FA decay imaging. FLT provided insights into cytoplasmic pH (7.67 ± 0.48), which agreed with previous works, as well as the decrease in polarity in the cell wall and inner membrane. The CD aggregation was suspected in certain areas based on FA, and the θ provided information on cytoplasmic heterogeneity due to the aggregation and/or interactions with biomolecules. The combined TR-FAIM/FLIM system allowed for simultaneous monitoring of pH and polarity changes through FLIM and viscosity variations through TR-FAIM.

A simple and efficient pathway for the total synthesis of marine natural products: bengamide E and 5-epi-bengamide E.

Total synthesis of the marine natural product bengamide E and 5-epi-bengamide E has been accomplished using two routes: (i) via a polyhydroxy acid precursor involving a total of 16 steps with an overall yield of 17.0% and (ii) via a cyclic lactone precursor with a total of 12 steps and overall 23.0% yield. The key steps involve (1) regioselective p-methoxybenzylidine ring opening, (2) a stereoselective Grignard reaction and (3) olefin cross-metathesis. The total synthesis could provide significant quantities of bengamide E and 5-epi-bengamide E as all the reaction processes were very efficient and the raw materials were inexpensive and highly abundant. The protocol has an advantage over previously reported methods as it provides ready access to the C-5 hydroxy group for further modification and its future structure-activity relationship studies for anti-tumor activity.

Discovery of novel 1,3,5-triazine derivatives as an antidiabetic agent in Wistar rats via inhibition of DPP-4.

Aim: To develop imeglimin-inspired novel 1,3,5-triazine derivatives as antidiabetic agents. Materials & methods: These derivatives were synthesized and tested against DPP enzymes. Compound 8c was tested for in vivo antidiabetic activity in streptozotocin-induced diabetes in Wistar rats by estimating various biochemical parameters. Docking experiments were also performed. Results: Compound 8c was identified as a selective and potent DPP-4 inhibitor. It was proficiently docked into the catalytic triad of Ser 630, Asp 710 and His740 in S1 and S2 pockets of DPP-4. In experimental animals, it also showed dose-dependent improvement in blood glucose, blood insulin, bodyweight, lipid profile and kidney and liver antioxidant profiles. Conclusion: This study demonstrated the discovery of imeglimin-inspired novel 1,3,5-triazines as a potent antidiabetic agent.

Type 2 diabetes mellitus is a complicated heterogeneous and polygenic metabolic disease. Therefore, in search of a potent antidiabetic drug, the authors have synthesized 13 novel 1,3,5-triazine-morpholino-pyrazole derivatives, compounds 8(a­m), and they were subsequently tested for in vitro inhibitory activity against a panel of DPP enzymes (DPP-4, DPP-8 and DPP-9) where they are found active toward DPP-4 while inactive toward DPP-8 and DPP-9. Compound 8c was observed to be the most potent DPP-4 inhibitor and showed excellent interaction with DPP-4 in docking analysis. Furthermore, in high-fat, low-dose streptozotocin-induced diabetes in rats, compound 8c significantly reduced blood glucose, cholesterol, triglyceride, low-density lipoprotein, very low-density lipoprotein and reactive species levels and increased high-density lipoprotein levels, possibly by the potent inhibition of DPP-4. It also showed intense antioxidant activity. The potent DPP-4 inhibition, antidiabetic and antioxidant activity render compound 8c a probable lead for antidiabetic drug discovery.

Role of N-acetylcysteine in liver injury due to dengue fever.

Dengue fever (DF) is a common mosquito-borne viral infection which is endemic in Southeast Asia. Liver involvement may vary from asymptomatic elevation of liver enzymes to fulminant hepatitis. Although the valuable effects of N-acetylcysteine (NAC) in paracetamol toxicity and non-paracetamol liver failure have been extensively studied, its use in DF-associated hepatitis remains unclear. We made a literature search in an online format from libraries such as PubMed, Google Scholar, and EMBASE, and selected 33 articles including original research articles, case reports, and systemic analyses. The majority of the articles reviewed had a positive outcome but treatment strategies involved NAC together with supportive care. Hence, data on sole use of NAC from large randomised control trials remain unclear.

Matrix-Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF) as an Indispensable Tool in Diagnostic Bacteriology: A Comparative Analysis With Conventional Technique.

INTRODUCTION: Owing to its accurate diagnosis, rapid turnaround time, cost effectivity, and less rates of error, Matrix-assisted Laser Desorption Ionization Time of Flight (MALDI-TOF) has replaced most of the phenotypic methods of identification. Thus, the objective of this study was to compare and evaluate MALDI-TOF MS to conventional biochemical-to identify bacterial microorganisms. METHODS: Different bacterial species isolated from 2010 to 2018 (pre-MALDI-TOF era), using routine bio-chemicals were compared to bacterial species isolated from 2019 to August 2021 (post MALDI-TOF), using MALDI-TOF, in the microbiology laboratory of a tertiary care hospital in North India. Chi-Square test (χ2) was used for the evaluation of bacterial identification between biochemical tests and MALDI-TOF MS association with a 95% confidence interval, considering wrong identification in genera or at a species level. RESULTS: Many different and new genera and species of bacteria could be identified using MALDI-TOF, which was not possible using only routine manual bio-chemicals like Kocuria rhizophilus, Rothia mucilaginosa, Enterococcus casseliflavus, Enterococcus gallinarum, Leuconostoc, Leclercia adecarboxylata, Raoultella ornithological, Cryseobacterium indologenes. Conclusion: Each of the newly identified bacteria played an important role in deciding treatment. Wide use of the MALDI-TOF system will not only strengthen diagnostic stewardship but also encourage antimicrobial stewardship programs.

Potassium Molten Salt-Mediated In Situ Structural Reconstruction of a Carbon Nitride Photocatalyst.

Metal-free polymeric carbon nitride (PCN) materials are at the forefront of photocatalytic applications. Nevertheless, the overall functionality and performance of bulk PCN are limited by rapid charge recombination, high chemical inertness, and inadequate surface-active sites. To address these, here, we employed potassium molten salts (K+X-, where X- is Cl-, Br-, and I-) as a template for the in situ generation of surface reactive sites in thermal pyrolyzed PCN. Theoretical calculations imply that addition of KX salts to PCN-forming monomers causes halogen ions to be doped into C or N sites of PCN with a relative trend of halogen ion doping being Cl < Br < I. The experimental results show that reconstructing C and N sites in PCN develops newer reactive sites that are beneficial for surface catalysis. Interestingly, the photocatalytic H2O2 generation rate of KBr-modified PCN was 199.0 µmol h-1, about three times that of bulk PCN. Owing to the simple and straightforward approach, we expect molten salt-assisted synthesis to have wide exploration in modifying PCN photocatalytic activity.

Synthesis, QSAR study and Pharmacological Evaluation of Novel Triazolidine-2-thione Analogues as Antimicrobial, Anti-inflammatory and Antioxidant agents.

BACKGROUND: The triazole analogues are molecules of immense attraction because of their wide pharmacological applications. METHODS: Present research deals with the synthesis of triazole-2-thione analogues and their QSAR study. The synthesized analogs are also evaluated for their antimicrobial, anti-inflammatory, and antioxidant effect. RESULTS: It was revealed that the benzamide analogues (3a, 3d) and triazolidine analogue (4b) were found to be most active against P. aeruginosa and E. coli with pMIC values of 1.69, 1.69 and 1.72, respectively. The antioxidant study of the derivatives showed that 4b was the most active antioxidant with 79% protein denaturation inhibition. The highest anti-inflammatory activity was shown by 3f, 4a and 4f. CONCLUSION: This study provides certain potent leads for further development of more potential anti-inflammatory, antioxidant and antimicrobial agents.

Effect of dexamethasone implant on intraocular cytokines in diabetic macular edema.

Purpose: Our primary aim was to evaluate intraocular cytokines (IC) before and after dexamethasone in diabetic macular edema (DME). Our secondary aim was to study the early and late effects of single dexamethasone implant in DME. Methods: This before and after comparative study was conducted at the Department of Ophthalmology and Centre for Nanosciences at a quaternary referral center in Kerala, India, from September 2016 to September 2018. Patients underwent complete ophthalmological examination and cytokine analysis before and after dexamethasone implant. Levels of cytokines at baseline and repeat sample were studied. Results: Twenty-seven eyes (21 patients) were divided into two groups depending on time from baseline to second injection. Group 1 included patients with <3 months between the two samples - 12 (44.4%). Group 2 included patients with >3 months between the two samples -15 (55.6%). Best corrected visual acuity (BCVA) and central macular thickness (CMT) improved significantly post-dexamethasone in group 1, but not in group 2. Interleukin (IL)-4, IL-6, IL-10, vascular endothelial growth factor (VEGF), IL-1ß, interferon-gamma inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), and IL-2 decreased post-injection in group 1. But cytokines increased post-dexamethasone in group 2, except IL-10. When compared to baseline, IL-6 reduced to half in group 1 (P-value 0.814) and it tripled in group 2 ( P-value 0.009). The level of VEGF in the first and second samples was not different in either group. Conclusion: Our study suggests that dexamethasone acts more on IC than VEGF in DME. This is significant in the first 3 months with a rebound effect on IL-6 after 3 months. Our study also suggests that repeat injection of DEX in DME should be done at 3 months to prevent deterioration of visual acuity (VA) and worsening of CMT.

Can the Therapeutic Spectrum of Probiotics be Extended: Exploring Potential of Gut Microbiome.

Natural therapeutic microorganisms provide a potent alternative healthcare treatment nowadays, with the potential to prevent several human diseases. These health-boosting living organisms, probiotics mostly belong to Gram-positive bacteria such as Lactobacillus, Bifidobacterium, Streptococcus, Saccharomyces, Bacillus and Enterococcus. Initiated almost a century ago, the probiotic application has come a long way. The present review is focused on the potential therapeutic role of probiotics in ameliorating multiple infections, such as upper respiratory tract infections and viral respiratory infections, including COVID-19; liver diseases and hepatic encephalopathy; neurological and psychiatric disorders; autoimmune diseases, particularly rheumatoid arthritis, systemic lupus erythematosus and multiple sclerosis. Apart from these, the therapeutic exacerbations of probiotics in urinary tract infections have been extremely promising, and several approaches are reviewed and presented here. We also present upcoming and new thrust areas where probiotic therapeutic interventions are showing promising results, like faecal microbial transplant and vaginal microbial transplant.

Ultrasonic-assisted synthesis of lignin-capped Cu2O nanocomposite with antibiofilm properties.

Under ultrasonication, cuprous oxide (Cu2O) microparticles (<5 µm) were fragmented into nanoparticles (NPs, ranging from 10 to 30 nm in diameter), and interacted strongly with alkali lignin (Mw = 10 kDa) to form a nanocomposite. The ultrasonic wave generates strong binding interaction between lignin and Cu2O. The L-Cu nanocomposite exhibited synergistic effects with enhanced antibiofilm activities against E. coli, multidrug-resistant (MDR) E. coli, S. aureus (SA), methicillin-resistant SA, and P. aeruginosa (PA). The lignin-Cu2O (L-Cu) nanocomposite also imparted notable eradication of such bacterial biofilms. Experimental evidence unraveled the destruction of bacterial cell walls by L-Cu, which interacted strongly with the bacterial membrane. After exposure to L-Cu, the bacterial cells lost the integrated structural morphology. The estimated MIC for biofilm inhibition for the five tested pathogens was 1 mg/mL L-Cu (92 % lignin and 8 % Cu2ONPs, w/w %). The MIC for bacterial eradication was noticeably lower; 0.3 mg/mL (87 % lignin + 13 % Cu2ONPs, w/w %) for PA and SA, whereas this value was appreciably higher for MDR E. coli (0.56 mg/mL, 86 % lignin and 14 % Cu2O NPs). Such results highlighted the potential of L-Cu as an alternative to neutralize MDR pathogens.