Anesthetic efficacy of 4% articaine versus 2% lignocaine in root canal treatment of teeth with molar incisor hypomineralization.

CONTEXT: Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve profound anesthesia of the pulp has been reported in patients with molar incisor hypomineralization (MIH). Articaine 4% with epinephrine 1:100,000 has proven to provide total pain relief during most dental procedures. AIMS: This study aimed to assess and compare the pain perception level in children using Visual Analog Scale (VAS) during root canal treatment after administering 4% articaine buccal infiltration (BI), 4% articaine IANB, and 2% lignocaine IANB. SUBJECTS AND METHODS: Twenty-seven children aged 8-12 years, requiring root canal treatment of mandibular first permanent molars with MIH were randomly allocated into three groups - 4% articaine (1:100,000 epinephrine) BI, 4% articaine (1:100,000 epinephrine) IANB, and 2% lignocaine IANB. The efficacy of the anesthetic was determined by rating the pain perception of the child using a VAS. STATISTICAL ANALYSIS USED: The scores marked by the children on the VAS were recorded and were statistically analyzed. Data were entered into Microsoft excel data sheet and were analyzed using SPSS for Windows version 17.0. RESULTS: Patients anesthetized with 4% articaine IANB presented lesser pain scores compared to IANB with 2% lidocaine and 4% articaine BI on access opening and instrumentation of the root canals. CONCLUSION: 4% articaine IANB has better anesthetic efficacy than 4% articaine BI and 2% lignocaine IANB in anesthetising mandibular first permanent molars with MIH.

Translation, validation and cross-cultural adaptation of the geriatric depression scale (GDS-30) for utilization amongst speakers of Malayalam; the regional language of the South Indian State of Kerala.

BACKGROUND: The Geriatric Depression Scale (GDS-30) is a popular instrument that has been ratified and is being used around the world as a screening tool for over three decades. However, a validated version of the scale is not available for use among speakers of Malayalam. In this paper, we elaborate on the procedure involved in the translation and validation of the GDS-30 from the official English version into Malayalam, the hurdles encountered in the process, and how they were overcome. METHODS: The steps recommended by the World Health Organization (WHO) were applied for the translation of the original questionnaire. This involved initial forward translation of the English questionnaire, discussion by an expert panel, back-translation, pre-testing, and pilot testing of the final version. The Malayalam translation thus obtained was administered to 100 elderly persons in the community. These individuals were then examined by a qualified doctor, who had received the necessary training from a consultant psychiatrist in the diagnosis of depressive disorders. This doctor evaluated the study subjects clinically using theInternational Classification of Diseases-tenth revision (ICD-10) criteria for the diagnosis of depression, which is considered as the gold standard. Sensitivity, specificity, Cronbach'salpha, and split-half reliability were calculated to determine validity. RESULTS: The translated scale yielded a sensitivity of 87.20%, a specificity of 73.80%, an area under the Receiving Operator Curve (ROC) of 0.814, Cronbach's α of 0.920, and split-half reliability of 0.897, thereby proving to be a valid screening tool. CONCLUSION: The Malayalam translation of the GDS-30 is a valid instrument to screen for depression in an elderly Malayalam-speaking population.

Reversal of Peripheral Neuropathic Pain by the Small-Molecule Natural Product Physalin F via Block of CaV2.3 (R-Type) and CaV2.2 (N-Type) Voltage-Gated Calcium Channels.

No universally efficacious therapy exists for chronic pain, a disease affecting one-fifth of the global population. An overreliance on the prescription of opioids for chronic pain despite their poor ability to improve function has led to a national opioid crisis. In 2018, the NIH launched a Helping to End Addiction Long-term plan to spur discovery and validation of novel targets and mechanisms to develop alternative nonaddictive treatment options. Phytochemicals with medicinal properties have long been used for various treatments worldwide. The natural product physalin F, isolated from the Physalis acutifolia (family: Solanaceae) herb, demonstrated antinociceptive effects in models of inflammatory pain, consistent with earlier reports of its anti-inflammatory and immunomodulatory activities. However, the target of action of physalin F remained unknown. Here, using whole-cell and slice electrophysiology, competition binding assays, and experimental models of neuropathic pain, we uncovered a molecular target for physalin F's antinociceptive actions. We found that physalin F (i) blocks CaV2.3 (R-type) and CaV2.2 (N-type) voltage-gated calcium channels in dorsal root ganglion (DRG) neurons, (ii) does not affect CaV3 (T-type) voltage-gated calcium channels or voltage-gated sodium or potassium channels, (iii) does not bind G-protein coupled opioid receptors, (iv) inhibits the frequency of spontaneous excitatory postsynaptic currents (EPSCs) in spinal cord slices, and (v) reverses tactile hypersensitivity in models of paclitaxel-induced peripheral neuropathy and spinal nerve ligation. Identifying CaV2.2 as a molecular target of physalin F may spur its use as a tool for mechanistic studies and position it as a structural template for future synthetic compounds.

Contact lens trends over three decades in a hospital-based practice in India.

BACKGROUND: Contact lens fittings in a hospital-based practice are different from those in private practices because of specialised conditions. Few studies have been published on material preferences of such wearers, especially in long-term wearers. The aim of this study is to document contact lens prescribing trends in a hospital-based practice among long-term lens wearers and to identify their demographic profile. METHODS: Subjects reporting to a contact lens clinic of a tertiary eye-care centre in India from 1 January 2014 to 31 December 2014, with a minimum of five years of lens wear, were included in the study. Data were collected retrospectively from the electronic medical charts of these subjects. RESULTS: Three hundred and sixty subjects were included in the study. The average duration of contact lens wear among the subjects was 9 ± 5 years (range: 5-35 years). The average age of the subjects was 31.38 ± 11.75 years (age range: 5-78 years). Hydrogel material and soft spherical type were preferred by most of the soft lens wearers (53 per cent). Eighty per cent of subjects followed hand hygiene and cleaning regimen practices. CONCLUSION: The preference for monthly replacement lenses and silicone hydrogel material increased over the years. Regular after-care consultations could enforce the need for compliance with hand hygiene and cleaning regimens among lens wearers.