Comparative Evaluation of Er: YAG Laser, Diode Laser, and Novamin Technology for Dentinal Tubule Occlusion: An In-Vitro Scanning Electron Microscope (SEM) and Energy Dispersive X-Ray Analysis (EDX) Study.

BACKGROUND: Dentinal hypersensitivity is a brief and painful oral condition that is characterized by an abrupt shooting sensation. Stimulation occurs when hot, cold, sweet, or sour food comes into contact with exposed dentinal tubules. The present study used a scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX) to investigate the efficacy of Er: YAG, 810 nm diode LASER, and NovaMin Technology in obstructing dentinal tubules. MATERIAL AND METHODS: We extracted the outer layers of 30 human teeth to expose the tubules and then treated the surfaces with 17% ethylenediaminetetraacetic acid (EDTA) to create an etched effect. Three cohorts were created from the portions. Group A was subjected to the application of Erbium:Yttrium-Aluminum-Garnet (Er: YAG) laser with a power output of 2W in the non-contact mode for 1 minute. Group B was subjected to the application of an 810nm diode laser with a power output of 1W in continuous mode for 30 seconds. Group C was subjected to the application of NovaMin paste, which contains a 927 ppm fluoride content. Following the therapy, occluded dentinal tubules were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) for both quantitative and qualitative examination. The data analysis was conducted using a one-way analysis of variance (ANOVA) and Tukey's test, with a significance threshold of 0.05. RESULTS: The average percentages of complete blockage of dentinal tubules in Groups A, B, and C were evaluated using the number of entirely unobstructed dentinal tubules at magnifications of 2000X (F = 3.05, p = 0.064), 5000X (F = 5.33, p = 0.011), and 10000X (F = 8.63, p = 0.001). The count of partially open dentinal tubules seen at magnifications of 2000X, 5000X, and 10000X was F = 10.15 (P < 0.001), F = 5.97 (p = 0.007), and F = 2.12 (p = 0.140) accordingly. CONCLUSION: NovaMin technology has demonstrated more effectiveness in blocking dentinal tubules compared to 810nm diodes and Er: YAG lasers.

A picture of health? The quality of physical healthcare provided to adult patients admitted to a mental health inpatient setting.

The National Confidential Enquiry into Patient Outcome and Death reviewed the quality of physical healthcare provided to adults admitted to a mental health inpatient setting, highlighting areas of practice that need improving and making recommendations for clinical and organisational changes that will improve patient care.

Burden of Chronic Nonhealing Wounds: An Overview of the Worldwide Humanistic and Economic Burden to the Healthcare System.

Chronic wounds have long been a significant public health concern, but the true impact of these wounds is unknown since research designs and measuring techniques vary, leading to inconsistent estimates. The definition of a wound is a loss of epithelial continuity caused by damage to the tissue. The following conditions can cause chronic wounds: panniculitis, pyoderma gangrenosum, traumatic, neurological, metabolic, hematologic, neoplastic, or infection-related. The growing global incidence of diabetes and the aging population necessitate greater attention to chronic wounds. Regrettably, it is sad that significant healthcare institutions have overlooked wound research. The study of health-related illnesses and occurrences in particular populations, including their distribution, frequency, and determinants, and the application of this research to control health problems.

Role of Bovine Colostrum Dressing on Chronic Non-Healing Wounds in Comparison to Conventional Dressing: A Case-Control Study.

Colostrum has been shown to be suitable for oral and/or topical applications. Colostrum decreases the amount of discharge from wounds and also accelerates healing, leading to a decrease in the number of dressings. In this study, 40 patients with chronic non-healing wounds were divided into two groups, considering the inclusion and exclusion criteria. Group I included 15 patients with conventional dressings, and Group II included 25 patients with added topical colostrum dressings. All patients were assessed at the time of presentation and after 21 days. The results of the present study indicate that colostrum powder dressings may be used as an adjunct in the management of chronic non-healing wounds.

Emerging trends in gastrointestinal cancers: Targeting developmental pathways in carcinogenesis and tumor progression.

Gastrointestinal carcinomas are a group of cancers associated with the digestive system and its accessory organs. The most prevalent cancers related to the gastrointestinal tract are colorectal, gall bladder, gastric, hepatocellular, and esophageal cancers, respectively. Molecular aberrations in different signaling pathways, such as signal transduction systems or developmental pathways are the chief triggering mechanisms in different cancers Though a massive advancement in diagnostic and therapeutic interventions results in improved survival of patients with gastrointestinal cancer; the lower malignancy stages of these carcinomas are comparatively asymptomatic. Various gastrointestinal-related cancers are detected at advanced stages, leading to deplorable prognoses and increased rates of recurrence. Recent molecular studies have elucidated the imperative roles of several signaling pathways, namely Wnt, Hedgehog, and Notch signaling pathways, play in the progression, therapeutic responsiveness, and metastasis of gastrointestinal-related cancers. This book chapter gives an interesting update on recent findings on the involvement of developmental signaling pathways their mechanistic insight in gastrointestinalcancer. Subsequently, evidences supporting the exploration of gastrointestinal cancer related molecular mechanisms have also been discussed for developing novel therapeutic strategies against these debilitating carcinomas.

Segmental Abdominal Paresis Attributed to Herpes Zoster Infection Mimicking an Abdominal Hernia: An Interesting Case From a Surgical Unit of a Tertiary Healthcare Center.

The varicella-zoster virus reactivates to cause herpes zoster, commonly referred to as shingles. Shingles traditionally manifest as itchy vesicles in a dermatomal distribution, accompanied by related constitutional symptoms in immunocompetent patients. Usually, the rash resolves completely in seven to ten days. Herpetic neuralgia is the most typical herpes zoster consequence. Around 1% to 5% of individuals have motor impairments, with Ramsay-Hunt syndrome being the most prevalent ailment. Additional problems encompass abdominal pseudohernia, paralytic ileus/colonic pseudo-obstruction, hemidiaphragm paralysis, bladder dysfunction, localized paresis, constipation, and visceral neuropathy. Herpes zoster infection typically involves the posterior root ganglia, and most of the symptoms are sensory. Motor involvement can occur in the same distribution but is relatively uncommon. Segmental zoster paresis is a rare motor complication of herpes zoster, mimicking an abdominal hernia, which has an incidence of approximately 0.7%, but it needs no surgery different from the real abdominal wall hernia. In this case report, we describe a patient who, three weeks after developing a herpes zoster rash, acquired an abdominal protrusion, i.e., herpes-induced pseudohernia.

Small molecules that disrupt RAD54-BLM interaction hamper tumor proliferation in colon cancer chemoresistance models.

RAD54 and BLM helicase play pivotal roles during homologous recombination repair (HRR) to ensure genome maintenance. BLM amino acids (aa 181-212) interact with RAD54 and enhance its chromatin remodeling activity. Functionally, this interaction heightens HRR, leading to a decrease in residual DNA damage in colon cancer cells. This contributes to chemoresistance in colon cancer cells against cisplatin, camptothecin, and oxaliplatin, eventually promoting tumorigenesis in preclinical colon cancer mouse models. ChIP-Seq analysis and validation revealed increased BLM and RAD54 corecruitment on the MRP2 promoter in camptothecin-resistant colon cancer cells, leading to BLM-dependent enhancement of RAD54-mediated chromatin remodeling. We screened the Prestwick small-molecule library, with the intent to revert camptothecin- and oxaliplatin-induced chemoresistance by disrupting the RAD54-BLM interaction. Three FDA/European Medicines Agency-approved candidates were identified that could disrupt this interaction. These drugs bound to RAD54, altered its conformation, and abrogated RAD54-BLM-dependent chromatin remodeling on G5E4 and MRP2 arrays. Notably, the small molecules also reduced HRR efficiency in resistant lines, diminished anchorage-independent growth, and hampered the proliferation of tumors generated using camptothecin- and oxaliplatin-resistant colon cancer cells in both xenograft and syngeneic mouse models in BLM-dependent manner. Therefore, the 3 identified small molecules can serve as possible viable candidates for adjunct therapy in colon cancer treatment.

Exploring the Staphylococcus aureus Gyrase Complex and Human Topoisomerase: Potential Target for Molecular Docking and Biological Studies with Substituted Polychloroaniline.

This paper targets the nuclease activity of polymeric chemical compounds toward bacterial genomic DNA and also elucidates their probable drug-like properties against the enzymes bacterial gyrase complex and human topoisomerase. Poly-o-chloroaniline, poly-m-chloroaniline, and poly-o,m-chloroaniline were synthesized by a chemical oxidation method. The structure of the polymers was characterized by the powder X-ray diffraction pattern, which suggested the ordered structure of the polymer, where the parallel and perpendicular periodicities of the polymeric chain were arranged systematically. The molecular transition of polymers was determined by a UV-visible spectrum study. A polymeric arrangement of the molecule can be seen in scanning electron microscopy (SEM) images. Among the three polymers chosen for the biological study and molecular docking studies, poly-m-chloroaniline showed more affinity to bind against both the selected targets (HT IIIb TB and SAGS) in comparison to the ortho- and ortho-meta substituents of polyaniline. The biophysical interaction analysis is in line with molecular docking, which shows that poly-m-chloroaniline forms many different categories of interactions and binds very strongly with the selected targets. The synthesized and tested molecules have potential nuclease activity, which is well aligned with molecular docking studies against the bacterial gyrase complex and human topoisomerase.

An Interesting Case of Isolated Cysticercosis of Breast Masquerading as a Breast Lump in a Young Female.

Human cysticercosis can affect any tissue or organ in the body and may be asymptomatic or manifest clinical signs and symptoms depending on the area of the body where cysticerci are found. However, at the same time, the involvement of the breast by cysticercosis is an extremely rare phenomenon, with very few case reports published before. In this report, we present the case of a 26-year-old married woman who came with a history of painless swelling in the left breast.

A Comparative Study on Outcomes and Quality of Life Changes Following Ventral Transabdominal Preperitoneal (Ventral-TAPP) and Laparoscopic Intraperitoneal Onlay Mesh (IPOM)-Plus Repair for Ventral Hernia.

Background Ventral transabdominal preperitoneal (ventral-TAPP) repair and intraperitoneal onlay mesh (IPOM) plus repair are two options among the available techniques of laparoscopic ventral hernia repair (LVHR). We conducted a comparative study to evaluate the clinical and quality of life (QoL)-related outcomes between ventral-TAPP and IPOM-plus repair. It was hypothesized that both procedures offered similar outcomes and QoL. Materials and methods The study included 32 consecutive patients undergoing LVHR, divided equally between ventral-TAPP and IPOM-plus groups. In the ventral-TAPP procedure, a peritoneal flap was created around the defect, followed by defect approximation and polypropylene mesh placement in the pre-peritoneal pocket. For the IPOM-plus procedure, the defect was closed and a composite (dual-side) mesh was placed around the defect. The minimum overlap beyond the original defect margin in both groups was 5 cm. Data regarding pre-operative parameters and postoperative outcomes, including pain and QoL at one week, one month, and three months, were recorded. A p-value of less than or equal to 0.05 was considered to be statistically significant. Results While the mean duration of surgery was longer, the cost of treatment was lower in group 1 (ventral-TAPP) with a p-value of <0.05 for both parameters. The length of hospital stay was significantly shorter in group 1 (ventral-TAPP), while the return to normal activity was similar in both groups. The visual analog scale (VAS) score for overall pain perception and the European registry for abdominal wall hernias (EuraHS; hernia-related QoL) score for 'Pain at Site' and 'Restriction of Activity' domains were significantly higher in group 2 (IPOM-plus) at one week. Conclusion Although the ventral-TAPP procedure requires more time and expertise to perform, the EuraHS QoL assessment at one week was better in group 1 (ventral-TAPP). Ventral-TAPP group scored better in terms of length of hospital stay and cost-effectiveness as well.

Role of Human Epicardial Adipose Tissue-Derived miR-92a-3p in Myocardial Redox State.

BACKGROUND: Visceral obesity is directly linked to increased cardiovascular risk, including heart failure. OBJECTIVES: This study explored the ability of human epicardial adipose tissue (EAT)-derived microRNAs (miRNAs) to regulate the myocardial redox state and clinical outcomes. METHODS: This study screened for miRNAs expressed and released from human EAT and tested for correlations with the redox state in the adjacent myocardium in paired EAT/atrial biopsy specimens from patients undergoing cardiac surgery. Three miRNAs were then tested for causality in an in vitro model of cardiomyocytes. At a clinical level, causality/directionality were tested using genome-wide association screening, and the underlying mechanisms were explored using human biopsy specimens, as well as overexpression of the candidate miRNAs and their targets in vitro and in vivo using a transgenic mouse model. The final prognostic value of the discovered targets was tested in patients undergoing cardiac surgery, followed up for a median of 8 years. RESULTS: EAT miR-92a-3p was related to lower oxidative stress in human myocardium, a finding confirmed by using genetic regulators of miR-92a-3p in the human heart and EAT. miR-92a-3p reduced nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase-derived superoxide (O2.-) by targeting myocardial expression of WNT5A, which regulated Rac1-dependent activation of NADPH oxidases. Finally, high miR-92a-3p levels in EAT were independently related with lower risk of adverse cardiovascular events. CONCLUSIONS: EAT-derived miRNAs exert paracrine effects on the human heart. Indeed miR-92a-3p suppresses the wingless-type MMTV integration site family, member 5a/Rac1/NADPH oxidase axis and improves the myocardial redox state. EAT-derived miR-92a-3p is related to improved clinical outcomes and is a rational therapeutic target for the prevention and treatment of obesity-related heart disease.

PM2.5 pollution exceeding Indian standard over a semi-urban region at eastern IGP: Chemistry, meteorological impact, and long-range transport.

A year-long study (January-December 2019) on the chemical characterization and meteorological impact on PM2.5 was conducted over a semi-urban station, Shyamnagar, in the easternmost part of the Indo-Gangetic Plains (IGP). PM2.5 concentrations (Mean = 81.69 ± 66.27 µgm-3; 7.10-272.74 µgm-3), the total carbonaceous aerosols (TCA) (Mean = 22.85 ± 24.95 µgm-3; 0.77-102.97 µgm-3) along with differential carbonaceous components like organic carbon (OC) (Mean = 11.28 ± 12.48 µgm-3; 0.48-53.01 µgm-3) and elemental carbon (EC) (Mean = 4.83 ± 5.28 µgm-3; 0.1-22.13 µgm-3) exhibited prominent seasonal variability with the highest concentrations during winter, followed by post-monsoon, pre-monsoon and lowest during monsoon. A similar seasonal variation was observed for the total water-soluble ionic species (Mean = 31.91 ± 20.12 µgm-3; 0.1-126.73 µgm-3). We observed that under the least favorable conditions (low ventilation coefficient), high PM2.5 pollution (exceeding Indian standard) was associated with a high increase in secondary components of PM2.5. Eastern, central and western parts of IGP, as well as Nepal, were the major long-distant source regions whereas the northern part of West Bengal and parts of Bangladesh were the major regional source region for high PM2.5 pollution over Shyamnagar. The ratios like char-EC/soot-EC, non-sea-K+/EC and non-sea-SO42-/EC strongly indicated the dominance of fossil fuel burning over biomass burning. Compared with other studies, we observed that the PM2.5 pollution over this semi-urban region was comparable (and even higher in some cases) with other parts of IGP. The high exceedance of PM2.5 over the Indian standard in Shyamnagar strongly demands an immediate initiation of systematic and regular based air pollution monitoring over semi-urban/non-urban regions in India, especially IGP, in addition to the polluted cities.

Clinical management and histopathological analysis of composite type of gingival Stillman's cleft.

Gingival Stillman's cleft is one of the least-studied mucogingival defects that may jeopardize the periodontal health and esthetic of the affected teeth. The etiology behind this lesion is believed to be multifactorial, and the histopathology remains unclear. In this report, we present a case of composite gingival Stillman's cleft in anterior maxillary teeth that was clinically treated with a laterally moved coronally advanced flap. The cleft tissue was removed during root coverage surgery and then was harvested for histopathological analysis using hematoxylin and eosin, Masson's trichrome, and van Gieson's stain. In the cleft site, microscopic examination revealed variable degrees of epithelial bifurcations with elongated forking of rete ridges into the stroma. Endothelial-lined blood vessels and inflammatory cells, primarily lymphocytes and fibroblasts, were seen in the stroma. The Masson trichrome (blue) and Van Gieson (pink) revealed colored gingival tissue with prominent collagen fiber distribution at the cleft site, which is suggestive of gingival fibrous hyperplasia brought on by repeated damage from tooth brushing.

Comparative transcriptome profiling of near isogenic lines PBW343 and FLW29 to unravel defense related genes and pathways contributing to stripe rust resistance in wheat.

Stripe rust (Sr), caused by Puccinia striiformis f. sp. tritici (Pst), is the most devastating disease that poses serious threat to the wheat-growing nations across the globe. Developing resistant cultivars is the most challenging aspect in wheat breeding. The function of resistance genes (R genes) and the mechanisms by which they influence plant-host interactions are poorly understood. In the present investigation, comparative transcriptome analysis was carried out by involving two near-isogenic lines (NILs) PBW343 and FLW29. The seedlings of both the genotypes were inoculated with Pst pathotype 46S119. In total, 1106 differentially expressed genes (DEGs) were identified at early stage of infection (12 hpi), whereas expressions of 877 and 1737 DEGs were observed at later stages (48 and 72 hpi) in FLW29. The identified DEGs were comprised of defense-related genes including putative R genes, 7 WRKY transcriptional factors, calcium, and hormonal signaling associated genes. Moreover, pathways involved in signaling of receptor kinases, G protein, and light showed higher expression in resistant cultivar and were common across different time points. Quantitative real-time PCR was used to further confirm the transcriptional expression of eight critical genes involved in plant defense mechanism against stripe rust. The information about genes are likely to improve our knowledge of the genetic mechanism that controls the stripe rust resistance in wheat, and data on resistance response-linked genes and pathways will be a significant resource for future research.

PRE-084 ameliorated kidney injury by reducing endoplasmic reticulum stress in the rat model of adenine-induced chronic kidney disease.

BACKGROUND: Endoplasmic reticulum (ER) stress plays an important role in the development of chronic kidney disease (CKD). Sigma-1 receptors (σ1Rs) are novel chaperone proteins that regulate ER stress. However, effect of σ1R activation on renal ER stress is yet unexplored. So, in the present study we investigated the effects of PRE-084, a σ1R agonist on renal injury and ER stress in the rat model of CKD. METHODS: CKD group rats were fed adenine for 28 days and CKD treatment group rats were additionally administered PRE-084 intraperitoneally at 1, 3 and 10 mg/kg body weight dose from Day 22-28. ER stress markers were evaluated using molecular biology techniques such as immunohistochemistry and Western blot. RESULTS: Marked kidney injury was observed in CKD rats as revealed by biochemical and histological findings. Expression of ER stress proteins such as phosphorylated protein kinase R-like ER kinase (p-PERK), cleaved activating transcription factor-6 (ATF-6f), phosphorylated inositol requiring enzyme1α (p-IRE1α) and caspase-12 were higher in CKD rats. Nevertheless, CKD rats treated with PRE-084 particularly at 10 mg/kg dose showed considerably lesser kidney injury along with higher expression of σ1R and marked reduction of all the ER stress proteins studied. CONCLUSION: Results reveal that PRE-084 likely ameliorated the adenine-induced kidney injury by lowering ER stress through increased σ1R expression.

Hard to swallow? A review into dysphagia care in patients with Parkinson's disease.

The National Confidential Enquiry into Patient Outcome and Death reviewed the quality of dysphagia care provided to patients with Parkinson's disease admitted to hospital when acutely unwell. It highlights both clinical and organisational changes that should be made to improve patient care and outcomes.

Prediction of Conformational and Linear B-Cell Epitopes on Envelop Protein of Zika Virus Using Immunoinformatics Approach.

The current spread of Zika virus infection in India has become a public health issue due to the virus's possible link to birth abnormalities and neurological disorders. There is a need for enhanced vaccines or drugs as a result of its epidemic outbreak and the lack of potential medication. B-cell mediated adaptive immunity is capable of developing pathogen-specific memory that confers immunological protection. Therefore, in this study, the envelope protein of the Zika virus was retrieved from the NCBI protein database. The ABCpred and BepiPred software were used to discover linear B-cell epitopes on envelope protein. Conformational B-cell epitopes on envelope protein were identified using SEPPA 3.0 and Ellipro tools. Predicted B-cell epitopes were evaluated for allergenicity, toxicity, and antigenicity. Two consensus linear B-cell epitopes, envelope165-180 (AKVEITPNSPRAEATL) and envelope224-238 (PWHAGADTGTPHWNN) were identified using ABCpred and BepiPredtools. SEPPA 3.0 and Elliprotools predicted consensus conformational envelope98-110 (DRGWGNGCGLFGK) and envelope248-251 (AHAK) epitopes and one residue (75PRO) within envelope protein as a component of B-cell epitopes. These predicted linear and conformational B-cell epitopes will help in designing peptide vaccines that will activate the humoral response. However, in-vitro and in-vivo laboratory experimental confirmations are still needed to prove the application's feasibility.

Locally Advanced Rectal Cancer: What We Learned in the Last Two Decades and the Future Perspectives.

The advancement in surgical techniques, optimization of systemic chemoradiotherapy, and development of refined diagnostic and imaging modalities have brought a phenomenal shift in the treatment of the locally advanced rectal cancer. Although each therapeutic option has shown substantial progress in their field, it is finding their ideal amalgamation which has baffled the clinician and researchers alike. In the effort to identifying the perfect salutary treatment plan, we have even shifted our attention from the trimodal approach to non-operative "watchful waiting" to more recent individualized care. In this article, we acknowledge the scientific progress in the management of locally advanced rectal cancer and compare the opportunities as well as the obstacles while implementing them clinically. We also explore the current challenges and controversies surrounding the multidisciplinary approach and highlight the new trends and recent advances with an ultimate goal to improve the patients' quality of life.