Protein profile pattern analysis: A multifarious, in vitro diagnosis technique for universal screening.

Universal health care is attracting increased attention nowadays, because of the large increase in population all over the world, and a similar increase in life expectancy, leading to an increase in the incidence of non-communicable (various cancers, coronary diseases, neurological and old-age-related diseases) and communicable diseases/pandemics like SARS-COVID 19. This has led to an immediate need for a healthcare technology that should be cost-effective and accessible to all. A technology being considered as a possible one at present is liquid biopsy, which looks for markers in readily available samples like body fluids which can be accessed non- or minimally- invasive manner. Two approaches are being tried now towards this objective. The first involves the identification of suitable, specific markers for each condition, using established methods like various Mass Spectroscopy techniques (Surface-Enhanced Laser Desorption/Ionization Mass Spectroscopy (SELDI-MS), Matrix-Assisted Laser Desorption/Ionization (MALDI-MS), etc., immunoassays (Enzyme-Linked Immunoassay (ELISA), Proximity Extension Assays, etc.) and separation methods like 2-Dimensional Polyacrylamide Gel Electrophoresis (2-D PAGE), Sodium Dodecyl-Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE), Capillary Electrophoresis (CE), etc. In the second approach, no attempt is made the identification of specific markers; rather an efficient separation method like High-Performance Liquid Chromatography/ Ultra-High-Performance Liquid Chromatography (HPLC/UPLC) is used to separate the protein markers, and a profile of the protein pattern is recorded, which is analysed by Artificial Intelligence (AI)/Machine Learning (MI) methods to derive characteristic patterns and use them for identifying the disease condition. The present report gives a summary of the current status of these two approaches and compares the two in the use of their suitability for universal healthcare.

Effect of Duration of Mobile Phone Use on the Salivary Flow and Total Antioxidant Capacity of Saliva and Salivary Immunoglobulin A Level: A Cross-sectional Study.

Introduction: The objective of this study was to observe the effects of the duration of handheld mobile phone usage on the salivary flow, salivary immunoglobulin A (IgA) level, and salivary markers for oxidative stress. Materials and Methods: Eighty-one students were categorized into three groups based on their duration of mobile phone usage after age- and gender-matching. Students were grouped as: mobile phone usage <20 min/day (Group A), mobile phone usage 20-60 min/day (Group B), and mobile phone usage >60 min/day (Group C). Saliva was collected to evaluate salivary flow rate, salivary IgA level, and salivary markers for oxidative stress. Results: The salivary flow rate showed no statistically significant difference between the three groups (P = 0.180). There was no statistically significant difference in the salivary IgA between the three groups (P = 0.237). There was a statistically significant difference in the malondialdehyde (MDA) level between the three groups (P = 0.042). On pair comparison between the groups, group B and group C had a statistically significant difference (P = 0.019) in the MDA level. There was no statistically significant difference in the salivary thiol level between the three groups (P = 0.237). Conclusion: The duration of handheld mobile phone usage did not show any significant effects on the salivary flow rate, salivary IgA, and thiol levels. There was an increase in the salivary MDA concentration in subjects using handheld mobile phones for a longer duration, indicating higher oxidative stress in salivary glands exposed to mobile phone radiofrequency electromagnetic waves for a longer duration.

Photonics of human saliva: potential optical methods for the screening of abnormal health conditions and infections.

Human saliva can be treated as a pool of biological markers able to reflect on the state of personal health. Recent years have witnessed an increase in the use of optical devices for the analysis of body fluids. Several groups have carried out studies investigating the potential of saliva as a non-invasive and reliable clinical specimen for use in medical diagnostics. This brief review aims to highlight the optical technologies, mainly surface plasmon resonance (SPR), Raman, and Fourier transform infrared (FTIR) spectroscopy, which are being used for the probing of saliva for diverse biomedical applications. Advances in bio photonics offer the promise of unambiguous, objective and fast detection of abnormal health conditions and viral infections (such as COVID-19) from the analysis of saliva.

A review on human body fluids for the diagnosis of viral infections: scope for rapid detection of COVID-19.

Introduction: The unprecedented outbreaks of corona virus disease of 2019 (COVID-19) have highlighted the necessity of readily available, reliable, precise, and faster techniques for its detection. Nasopharyngeal swab has been the gold standard for the diagnosis of COVID-19. However, it is not an ideal screening procedure for massive screening as it implicates the patient's stay in the hospital or at home until diagnosis, thus causing crowding of the specimen at the diagnostic centers. Present study deal with the exploration of potential application of different body fluids using certain highly objective techniques (Optical and e-Nose) for faster detection of molecular markers thereby diagnosing viral infections.Areas covered: This report presents an evaluation of different body fluids, and their advantages for the rapid detection of COVID-19, coupled with highly sensitive optical techniques for the detection of molecular biomarkers.Expert opinion: Tears, saliva, and breath samples can provide valuable information about viral infections. Our brief review strongly recommends the application of saliva/tears and exhaled breath as clinical samples using technics such as high-performance liquid chromatography-laser-induced fluorescence, photoacoustic spectroscopy, and e-Nose, respectively, for the fast diagnosis of viral infections.

Bilateral Bell's palsy in a young female: a rare case report.

Bell's palsy is described as a type of facial paralysis, which is unilateral in 70% of the cases. Bell's palsy accounts for about 23% of bilateral facial paralysis. Here, we present a rare case of bilateral Bell's palsy in a 15-year-old female who developed sudden facial weakness with no associated symptoms. The patient was subjected to thorough clinical, laboratory, and necessary radiological investigations. As there was no conclusive evidence from any of the investigations, this could be a case of idiopathic bilateral Bell's palsy. This is the first ever case of bilateral Bell's palsy in a young female which has been reported in the Indian population.

Occupation-related musculoskeletal disorders among dental professionals.

BACKGROUND AND AIM: Dentists are exposed to a wide range of work-related factors that may result in various occupational diseases of which musculoskeletal disorders (MSDs) are common. The purpose of this study was to determine the prevalence and distribution of MSDs among dental professionals of our institution and to compare the prevalence of MSDs among the various dental specialists. METHODS: A self-administered questionnaire, which included basic demographic details, work experience in dentistry, and work profile related questions along with the Standard Nordic Questionnaire, was administered to the study participants. Statistical analysis for the data obtained was performed using SPSS Version 16.0 (Chicago, SPSS Inc.). The chi-square test was applied to test the association between MSD and variables such as gender, designation, type of dentistry and usage of computers. The Mann Whitney U test was used to assess the relationship between MSD and age, experience, sick leave, number of patients attended per day. A p-value < 0.05 was considered significant. RESULTS: 151 subjects participated in the study, and the prevalence of MSD in the last 12 months among dental professionals was 58.3% (88 out of 151 subjects). The most common site affected by MSD was the neck (66.7%). Also, it was noted that among various dental specialists, the Endodontists suffered the maximum (88.02%) musculoskeletal pain. Fifty individuals (33.11%) suffered from pain in multiple sites. CONCLUSION: Work-related musculoskeletal disorders and pain can be reduced through proper operator-patient positioning, taking adequate breaks between patients, maintaining good physical health through regular exercises.

Oral manifestations in chronic kidney disease patients undergoing hemodialysis: a hospital-based study.

BACKGROUND: Chronic kidney disease (CKD-HD) patients undergoing routine hemodialysis have been reported to have oral signs and symptoms due to disease process or various comorbidities like diabetes mellitus (DM). Both CKD and DM can cause oral changes. Hence this study aimed to evaluate the prevalence of oral symptoms and signs in CKD-HD patients and to rule out DM as possible confounding factor for the oral findings. METHODS: Oral manifestations were assessed in 102 CKD-HD patients, and compared with 100 DM patients and 101 non-diabetic patients with no renal impairment. RESULTS: Most common symptom reported by patients with CKD-HD were xerostomia, altered taste. The most prevalent objective findings were oral dryness. There was statistically significant difference in symptoms and signs between CKD-HD and non-CKD patients. However, no significant difference between CKD-HD with and without DM. CONCLUSIONS: This study showed increased prevalence of oral findings in CKD patients. It also revealed that Diabetes mellitus cannot be a contributing factor for increased prevalence of oral manifestations in CKD patients.

Oral Hygiene and Dentition Status in Patients with Congenital Hemorrhagic Disorders: A Comparative Study

Abstract Objective: To compare the status of oral hygiene and dentition in patients with congenital hemorrhagic disorders with their age-matched healthy counterparts. Also, the prevalence of fear of dentists/ dental treatment among these patients was assessed. Material and Methods: This study was performed on children and adults with von Willebrand disease (vWD), hemophilia (A or B), and healthy subjects. Oral health and dentition status was assessed using the simplified oral hygiene index (OHI-S), plaque index, and the decayed, missing, filled teeth (dmft/DMFT) index. One-way ANOVA test was employed to compare the oral hygiene and dentition status of subjects in the three groups. A p-value of <0.05 was considered statistically significant. Results: The DMFT score did not vary significantly between the groups (p>0.05). Higher OHI-S scores and a poor oral hygiene status was observed more in the hemophilia group than the vWD group and healthy controls. A total of 27.3% of the subjects in the vWD group, 18.2% of subjects in the hemophilia group, and no subjects in the healthy group had a fear of dentists or dental treatment. Conclusion: Subjects with vWD had a higher number of carious teeth when compared to the other groups. Poor oral hygiene status was observed in subjects with hemophilia.

Solitary Large Intraoral Neurilemmoma of the Maxillary Vestibule: A Rare Case with Brief Literature Review.

AIM: This current report aimed at presenting a rare case of a large solitary intraoral neurilemmoma of the buccal vestibule followed by a brief review of literature of neurilemmoma published between 1997 and 2017. BACKGROUND: The diagnosis of slow-growing intraoral lesions requires a thorough patient history and clinical examination. Despite the best efforts of even the most experienced oral medicine expert, a definitive diagnosis may sometimes only be reached through excisional biopsy and histopathological evaluation. CASE DESCRIPTION: To the best of our knowledge, there have been only two cases of neurilemmoma of the buccal vestibule reported in the literature till date and, looking at the size of the lesion, our case is the largest among the ones reported. CONCLUSION: In the present case, a rare presentation of solitary buccal vestibular neurilemmoma establishes the need for the consideration of a wide range of pathologies in the differential diagnosis. CLINICAL SIGNIFICANCE: Clinicians should include neurilemmoma in their differential diagnosis for asymptomatic, slow-growing intraoral growths and ensure complete excision to prevent tumor recurrence. The reader should be able to recognize the clinical features of neurilemmoma and describe the histopathological features and management of the condition.

Comparison of Conventional Techniques and Higher Imaging Modalities in the Evaluation of Relation between the Third Molar and Inferior Alveolar Nerve Canal: A Pilot Study.

CONTEXT: Mandibular third molars are the most commonly impacted teeth, and their surgical removal can be associated with inferior alveolar nerve (IAN) injury. To avoid the deleterious complication of nerve injury on patients, a thorough visualization of IAN and its localization are essential. AIMS AND OBJECTIVES: The aims and objectives of this study were to evaluate the efficacy of two conventional localization techniques in determining the relationship of mandibular third molars to IAN and to assess its reliability in comparison with computed tomography (CT). SETTINGS AND DESIGN: Panoramic radiograph (PR) was taken using Kodak 8000C Digital Panoramic and Cephalometric system. Intraoral periapical radiographs (IOPAs) were taken using Kodak 2200 Intraoral X-ray machine. CT scan images were taken using multidetector CT scans. MATERIALS AND METHODS: Two IOPAs (0° and -20° vertical angulation) and PR and CT scan images of thirty mandibular third molars were taken. Two combinations were used (i) a combination of two IOPAs and (ii) a combination of PR and IOPA (-20°). Tube-shift localization technique was applied to both these combinations to derive the relation between third molar and IAN canal as "in contact," "separate," "buccal," "lingual," and "in line with the apex" and the results were compared with CT images. STATISTICAL ANALYSIS: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using SPSS software version 15.0. RESULTS: The combination of PR and IOPA radiographs showed 14 teeth to be in contact with IAN. This gave a sensitivity of 100%, specificity of 94.1%, PPV of 92.9%, and a NPV of 100% in determining the relation as "in contact" or "separate." 78.3%, 85.7%, 94.7%, and 54.5% were the sensitivity, specificity, PPV, and NPV in localizing it as "buccal," "lingual," or "in line with apex." These results were better than that of the combination of the two IOPAs. CONCLUSIONS: Localization using PR and IOPA could better deduce the relation between IAN and mandibular third molar.

Oral hygiene and dentition status in children and adults with hemophilia: A case-control study.

BACKGROUND & OBJECTIVES: People with hemophilia constitute a significant proportion of the population and an oral health care professional faces a considerable challenge while treating them. This study aimed to assess the oral health and dentition status as well as fear of dental treatment in patients with hemophilia and compare it with age-matched healthy subjects. PATIENTS & METHODS: This single-center, case-control cross-sectional study was performed on 100 subjects with hemophilia and 100 age-matched healthy controls. Oral health and dentition status was recorded for all the subjects and scored using the simplified oral hygiene index (OHI-S), plaque index, and the dmft/DMFT index. RESULTS: There were a total of 41 children and 59 adults in the hemophilia group and 36 children and 64 adults in the healthy group. When compared to healthy subjects it was observed that individuals with hemophilia had higher debris and calculus scores which was indicative of poor orodental status. There was no significant difference observed in the DMFT scores among the study groups. INTERPRETATION & CONCLUSIONS: The oral hygiene of the hemophilics was poorer when compared to the healthy controls. The findings highlight the need for establishing interdisciplinary care for such individuals.

Evaluation of the Effect of Age, Gender, and Skeletal Class on the Dimensions of Sella Turcica Using Lateral Cephalogram.

CONTEXT: Sella turcica or pituitary fossa is a saddle-shaped concavity housing the pituitary gland and seen clearly on lateral cephalogram. This makes it a good source of additional diagnostic information related to pathology of the pituitary gland or to various syndromes that affect the craniofacial region. AIMS: The aim of this retrospective study was to determine the average dimensions and morphological variations of the sella turcica in different age groups and to evaluate any difference in size between males and females in the study population. SETTINGS AND DESIGN: All the lateral cephalograms were taken by trained radiographic technicians using Planmeca Promax Ceph X-ray Machine, Finland, Inc., in a standardized manner using the same cephalostat. MATERIALS AND METHODS: Four hundred and eighty lateral cephalograms were obtained under standardized conditions. With age range between 7 and 43 years, all the radiographs were distributed according to skeletal class and gender. Size and morphology of sella turcica were recorded and compared with age, gender, and skeletal class. STATISTICAL ANALYSIS USED: A Student's t-test, one-way ANOVA test, and Pearson's correlation coefficient were used. RESULTS: The mean age of the study population was found to be 16.8 years comprising 48.6% males and 51.3% females. There was a gradual increase in linear dimensions of sella turcica with the advancement of age. The normal sella was observed in 20.6%, whereas 79.35% showed variation in morphology. Oblique anterior wall was a most common abnormal variant, whereas pyramidal shaped dorsum was rarest. CONCLUSIONS: There was no statistically significant difference in linear dimensions or morphological variations with age, gender, or type of malocclusion.

Rebamipide gargle in preventive management of chemo-radiotherapy induced oral mucositis.

BACKGROUND & OBJECTIVES: Oral mucositis is inflammation of mucosa of oral cavity which is an inevitable and acute side effect in patients undergoing chemoradiotherapy for head & neck cancer. Though many agents have been tried in prevention & treatment of oral mucositis, until date no single agent exists that is universally established to be effective. METHODS: 60 Patients diagnosed with Head & Neck cancer recruited for concurrent chemo-radiotherapy were assigned in a double blind fashion into 2 groups using computer based 1:1 ratio randomization. Subjects in Group 1 were given Rebamipide gargle while subjects in Group 2 were given Placebo gargle in similar colour coded bottles to gargle 6 times/day. Subjective assessment of oral mucositis was done by Numeric Rating Scale (NRS) and objective scoring according to RTOG system. RESULTS: All subjects in the Group 1 reported good treatment compliance but 4 subjects in Group 2 developed burning sensation to gargle and were excluded. Onset of oral mucositis was 3.5days earlier in Group 2 (mean=11.17) as compared to Group 1 (mean=14.63). At the end of chemo-radiotherapy, severity of oral mucositis was significantly lower in Group 1 (mean=1.97) than in Group 2 (mean=2.81). INTERPRETATION & CONCLUSION: Findings of this study revealed that Rebamipide gargle may be an effective means to prolong the onset of oral mucositis and may reduce the severity of oral mucositis in undergoing chemo-radiotherapy.