Comparative Evaluation of Solubility of Gutta-Percha in Three Different Solvents: A Cone-Beam Computed Tomography (CBCT) Study.

Background Gutta-percha is the most frequently used filling material for root canal obturation. This thermoplastic material fulfills the primary requisites for root canal filling, one of which is easily removable material in cases of endodontic retreatment. The most commonly used solvents were chloroform, xylene, and orange oil due to their effectiveness in dissolving and removing maximum gutta-percha in a minimum time. Aims The aim is to evaluate and compare the solubility of gutta-percha in three different organic solvents, i.e., orange oil, xylene, and chloroform. Methods and material Forty extracted mandibular second premolars with a single canal were selected. The sample was categorized into control, orange oil, xylene, and chloroform. Access cavity preparations with cleaning and shaping were performed by k files and rotary files, followed by obturation. Two drops of assigned solvent were placed on the orifices of the obturated canal, and corona-gutta-percha ha was removed by gates glidden drills. Cone-beam computed tomography (CBCT) images were taken before and after the gutta-percha removal, and the solvents' efficacy was assessed. Statistical analysis The statistical test applied for the analysis was one-way analysis of variance (ANOVA). The confidence interval and p-value were set for this test at 95% and < 0.05, respectively. Results Gutta-percha Removal was found to be maximum with orange oil (Group II) followed by xylene (Group III) >Chloroform (Group IV) >Control Group. The Statistical Analysis by ANOVA revealed a significant difference between the four groups with a p-value of less than 0.05. Furthermore, the pair-wise comparison revealed that the amount of gutta-percha removal with orange oil significantly differs from xylene and chloroform, with a significance level of less than 0.021,001. However, there was no difference observed between control and chloroform. Conclusions Within the limitations of this in vitro study, it can be concluded that the maximum amount of gutta-percha removal was found in the orange oil group. The amount of gutta-percha removal with orange oil significantly differs from xylene and chloroform, with a significance level of less than 0.02,001. Hence there was no difference observed between Control and Chloroform groups.

Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future.

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications.

Background: COVID-19 has already claimed a considerable number of lives worldwide. However, there are concerns with treatment recommendations given the extent of conflicting results with suggested treatments and misinformation, some of which has resulted in increased prices and shortages alongside increasing use and prices of personal protective equipment (PPE). This is a concern in countries such as India where there have been high patient co-payments and an appreciable number of families going into poverty when members become ill. However, balanced against pricing controls. Community pharmacists play a significant role in disease management in India, and this will remain. Consequently, there is a need to review prices and availability of pertinent medicines during the early stages of the COVID-19 pandemic in India to provide future direction. Objective: Assess current utilisation and price changes as well as shortages of pertinent medicines and equipment during the early stages of the pandemic. Our Approach: Multiple approach involving a review of treatments and ongoing activities across India to reduce the spread of the virus alongside questioning pharmacies in selected cities from early March to end May 2020. Our Activities: 111 pharmacies took part, giving a response rate of 80%. Encouragingly, no change in utilisation of antimalarial medicines in 45% of pharmacies despite endorsements and for antibiotics in 57.7% of pharmacies, helped by increasing need for a prescription for dispensing. In addition, increased purchasing of PPE (over 98%). No price increases were seen for antimalarials and antibiotics in 83.8 and 91.9% of pharmacies respectively although shortages were seen for antimalarials in 70.3% of pharmacies, lower for antibiotics (9.9% of pharmacies). However, price increases were typically seen for PPE (over 90% of stores) as well as for analgesics (over 50% of pharmacies). Shortages were also seen for PPE (88.3%). Conclusion: The pandemic has impacted on utilisation and prices of pertinent medicines and PPE in India but moderated by increased scrutiny. Key stakeholder groups can play a role with enhancing evidenced-based approaches and reducing inappropriate purchasing in the future.