Impact of Peptide Structure on Colonic Stability and Tissue Permeability.

Most marketed peptide drugs are administered parenterally due to their inherent gastrointestinal (GI) instability and poor permeability across the GI epithelium. Several molecular design techniques, such as cyclisation and D-amino acid (D-AA) substitution, have been proposed to improve oral peptide drug bioavailability. However, very few of these techniques have been translated to the clinic. In addition, little is known about how synthetic peptide design may improve stability and permeability in the colon, a key site for the treatment of inflammatory bowel disease and colorectal cancer. In this study, we investigated the impact of various cyclisation modifications and D-AA substitutions on the enzymatic stability and colonic tissue permeability of native oxytocin and 11 oxytocin-based peptides. Results showed that the disulfide bond cyclisation present in native oxytocin provided an improved stability in a human colon model compared to a linear oxytocin derivative. Chloroacetyl cyclisation increased native oxytocin stability in the colonic model at 1.5 h by 30.0%, whereas thioether and N-terminal acetylated cyclisations offered no additional protection at 1.5 h. The site and number of D-AA substitutions were found to be critical for stability, with three D-AAs at Tyr, Ile and Leu, improving native oxytocin stability at 1.5 h in both linear and cyclic structures by 58.2% and 79.1%, respectively. Substitution of three D-AAs into native cyclic oxytocin significantly increased peptide permeability across rat colonic tissue; this may be because D-AA substitution favourably altered the peptide's secondary structure. This study is the first to show how the strategic design of peptide therapeutics could enable their delivery to the colon via the oral route.

Comparative evaluation of retention and cariostatic effect of glass ionomer, hydrophobic & hydrophilic resin-based sealants: a systematic review and meta-analysis.

OBJECTIVE: To compare the effectiveness of hydrophilic resin-based versus hydrophobic resin-based and glass-ionomer pit and fissure sealants. METHODS: The review was registered with Joanna Briggs Institute and followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Google Scholar, Virtual Health Library, and Cochrane Central Register of Controlled Trials were searched from 2009-2019 using appropriate keywords. We included randomized controlled trials and randomized split-mouth trials conducted among 6-13-year-old children. The quality of included trials was assessed using modified Jadad criteria and risk of bias using guidelines specified by Cochrane. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were used to assess the overall quality of studies. We used the random-effects model for meta-analysis. Relative risk (RR) and confidence intervals (CI) were calculated & heterogeneity was tested using I² statistic. RESULTS: Six randomized clinical trials and five split-mouth trials met the inclusion criteria. The outlier augmenting the heterogeneity was omitted. Based on very-low to low-quality evidence, loss of hydrophilic resin-based sealants was less likely as compared to glass-ionomer fissure sealants (4 trials at 6 months; RR = 0.59; CI = 0.40-0.86), while it was similar or slightly lower than hydrophobic resin-based sealants (6 trials at 6 months; RR = 0.96; CI = 0.89-1.03); (6 trials at 12 months; RR = 0.79; CI = 0.70-0.89); (2 trials at 18 months; RR = 0.77; CI = 0.48-0.25). CONCLUSION: This study revealed that retention of hydrophilic resin-based sealants is better than glass ionomer sealants but similar to hydrophobic resin-based sealants. However, higher-quality evidence is necessary to underpin the outcomes.

Advancing oral delivery of biologics: Machine learning predicts peptide stability in the gastrointestinal tract.

The oral delivery of peptide therapeutics could facilitate precision treatment of numerous gastrointestinal (GI) and systemic diseases with simple administration for patients. However, the vast majority of licensed peptide drugs are currently administered parenterally due to prohibitive peptide instability in the GI tract. As such, the development of GI-stable peptides is receiving considerable investment. This study provides researchers with the first tool to predict the GI stability of peptide therapeutics based solely on the amino acid sequence. Both unsupervised and supervised machine learning techniques were trained on literature-extracted data describing peptide stability in simulated gastric and small intestinal fluid (SGF and SIF). Based on 109 peptide incubations, classification models for SGF and SIF were developed. The best models utilized k-Nearest Neighbor (for SGF) and XGBoost (for SIF) algorithms, with accuracies of 75.1% (SGF) and 69.3% (SIF), and f1 scores of 84.5% (SGF) and 73.4% (SIF) under 5-fold cross-validation. Feature importance analysis demonstrated that peptides' lipophilicity, rigidity, and size were key determinants of stability. These models are now available to those working on the development of oral peptide therapeutics.

Ileocolonic-Targeted JAK Inhibitor: A Safer and More Effective Treatment for Inflammatory Bowel Disease.

Janus kinase (JAK) inhibitors, such as tofacitinib (Xeljanz) and filgotinib (Jyseleca), have been approved for treatment of ulcerative colitis with several other JAK inhibitors in late-stage clinical trials for inflammatory bowel disease (IBD). Despite their impressive efficacy, the risk of adverse effects accompanying the use of JAK inhibitors has brought the entire class under scrutiny, leading to them receiving an FDA black box warning. In this study we investigated whether ileocolonic-targeted delivery of a pan-JAK inhibitor, tofacitinib, can lead to increased tissue exposure and reduced systemic exposure compared to untargeted formulations. The stability of tofacitinib in the presence of rat colonic microbiota was first confirmed. Next, in vivo computed tomography imaging was performed in rats to determine the transit time and disintegration site of ileocolonic-targeted capsules compared to gastric release capsules. Pharmacokinetic studies demonstrated that systemic drug exposure was significantly decreased, and colonic tissue exposure increased at 10 mg/kg tofacitinib dosed in ileocolonic-targeted capsules compared to gastric release capsules and an oral solution. Finally, in a rat model of LPS-induced colonic inflammation, targeted tofacitinib capsules significantly reduced concentrations of proinflammatory interleukin 6 in colonic tissue compared to a vehicle-treated control (p = 0.0408), unlike gastric release tofacitinib capsules and orally administered dexamethasone. Overall, these results support further development of ileocolonic-targeted tofacitinib, and potentially other specific JAK inhibitors in pre-clinical and clinical development, for the treatment of IBD.

Knowledge, attitude and practices among sanitation workers regarding SARS-CoV-2 prevention - A cross-sectional study.

Aim: : To evaluate knowledge, attitude and practices among sanitation workers regarding SARS-CoV-2 prevention during hospital waste management. Materials and Methods: A cross-sectional study was conducted among 426 sanitation workers using an interviewer-administered questionnaire to assess the knowledge, attitude and practices of the study participants. The unpaired t-test and Spearman's correlation were used to find the mean difference and correlation among different study variables. Statistical significance was set at 5% (confidence interval 95%). Results: The mean knowledge score of the participants was found to be 7.15 ± 2.02. About 93.7% of the participants had good knowledge about COVID-19. About 64.3% of the participants strongly agreed that COVID-19 is a life-threatening disease. Regarding practices, a majority reported (69.7%) that they washed hands frequently using water and soap. A significant positive correlation was found between knowledge, attitude, practices and education, indicating a favourable work environment in hospital settings. Conclusion: More than half of the sanitation workers and housekeeping staff had adequate knowledge of COVID-19, and their attitudes were found to be favourable. They also had satisfactory practices, which may be a result of the prompt training and sensitization of sanitation workers by the authorities. Clinical Relevance: Sanitation workers come under the essential services category and their knowledge, attitude and practices needed to be assessed and updated in the concerned area for their protection and better management of biomedical waste, especially in the current pandemic situation.

Lip incompetence and traumatic dental injuries: a systematic review and meta-analysis.

Background/aim Traumatic dental injury is an impact injury to the teeth and/or other hard and soft tissues severity of which can lead to pain, as well as aesthetic, psychological, behavioural and functional problems among children. Lip incompetence directly exposes teeth increasing the risk of traumatic dental injuries. This review aimed to assess the existing evidence regarding association of lip incompetence and dental trauma.Methods The review protocol was registered with PROSPERO with Protocol number: CRD42020163069. Electronic searches of grey literature and three databases were performed. Cross sectional studies conducted between the years 2009-2019 on children aged 0-15 years were selected. Studies were evaluated with the help of NIH quality assessment scale. Data on research question, study population, inclusion and exclusion criteria, sample size justification, exposure and outcome clearly defined and adjustment for confounding variables were assessed. All analyses were performed using Review Manager 5.4.Results The study identified 10,223 articles, 33 were included. Among these 20 identified articles reported 'Good' quality with 13 studies reporting 'Fair' quality post assessment. Subject with lip incompetence were at 2.44 (1.59-3.75) times the risk of developing traumatic injuries during primary dentition. This risk increases to 3.26 (2.21;4.53) times in mixed and permanent dentition. At 12 years of age the OR for dental trauma is 3.77 (2.06;6.91) in subjects with incompetent lips.Conclusions The results confirm the association between lip incompetence and dental trauma.

Effectiveness of Fluoride Varnish in Prevention of Early Childhood Caries in 3-4 Years Old Children - A 36 Month Prospective Community Based Randomized Controlled Trial.

BACKGROUND: Evidence for the benefit of applying Fluoride Varnish FV to permanent teeth is generally very positive. However, the caries-inhibiting effect of FVs on primary teeth is still debatable. AIM: To assess the effectiveness of fluoride varnish in prevention of early childhood caries in children over the period of 3 years in high fluoride areas. STUDY DESIGN: A double-blind cluster-randomized controlled trial was undertaken amongst 3-4 years old children. The varnish application was done at three points in the intervention group. RESULTS: Experimental group showed significantly lesser increment in mean ICDAS score than control group at both 12 month and 36 months. Preventive fraction was 72.4% at 12 months and 18.2% at 36 months. Multiple linear regression showed that at 12 months, intervention was the significant predictor with varnish group having 0.140 (95% CI 0.175-0.230) lower net caries increment. At 36 months, baseline ICDAS score and intervention were the significant predictors. CONCLUSION: This study suggests that fluoride varnish is an effective and a safe mode of prevention of early childhood caries in children residing in high fluoride zone. However, the overall effect is influenced by the baseline caries status.

Knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 Vaccines in Dental Colleges of Haryana, India - A cross-sectional study.

Aim: To assess knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 vaccines in dental colleges in Haryana, India. Objectives: To assess knowledge level, attitudes, and beliefs differences among BDS, MDS students and faculty members and find association between knowledge and COVID-19 vaccine inoculation among study participants. Materials and Methods: A cross-sectional study was carried out among students and faculty members of dental colleges in Haryana, India. Data collection was done via an online questionnaire based on questions to assess the knowledge, attitude and beliefs regarding COVID-19 vaccines. Results: The present study comprised of 270 study participants, where majority, i.e., 81.5% have reported COVID-19 vaccine inoculation. The mean knowledge score of the participants was reported to be 5.54 ± 2.19. A significant difference was found in the mean knowledge score of faculty members (7.81 ± 1.69), MDS (6.72 ± 1.49), and BDS (4.39 ± 1.68) students. COVID-19 vaccine inoculation was found to be significantly associated with average knowledge score of participants (OR = 6.1, P < 0.01). Conclusion: Dental professionals have an adequate degree of knowledge and attitude level regarding COVID-19 vaccines and are generally optimistic about resolving the pandemic situation with the immunization.

Dietary Practices as a Potential Predictor for Dental Erosion among Patients Having Gastroesophageal Reflux Disease: An Analytical Cross-sectional Study.

Aim: The aim of this study was to assess how dietary practices impact gastroesophageal reflux disease (GERD) patients in Haryana state, India, from the perspective of either preventing or promoting dental erosion. Objectives: The primary objective of this study was to find a correlation between the presence of dental erosion and dietary practices among patients with GERD.The secondary objective of this study was to assess the correlation between GERD patients' dietary practices and dental erosion severity. Materials and Methods: Three hundred and thirty study participants, who've been 18 years of age or older with the diagnosis of GERD for at least six months or more were included. Evaluation of dental erosion was performed with basic erosive wear examination (BEWE) index. On age, gender, medical history, medication history, and dietary habits, a pretested structured questionnaire was used. Statistical analysis software SPSS (Statistical Package for the Social Sciences) variant 20.0 was used to conduct the statistical analysis. Analytic statistics and descriptive statistics were used in the data analysis. Results: Dental erosion was present in 84.8% of the study participants. The majority of study participants, 122 (37%), had no risk of dental erosion. The occurrence of dental erosion was shown to be substantially adversely associated to the intake of acidic meals and soft drinks in the present investigation (odds ratio [OR] = 0.5, P < 0.05). There has not been any proven link between the severity of dental erosion and the frequency of consuming acidic meals, fruit juice, and soft drinks. Milk consumption frequency and dental erosion severity were observed to be considerably inversely associated (r = -0.1, P = 0.001). Conclusion: Patients with GERD frequently experienced dental erosion. One probable risk factor for the development of erosive dental lesions can be considered GERD. Most of the patients had dental erosion with a low degree of severity. When dental erosion occurs, the mineral quantity that dissolves from enamel is influenced by several factors, including the buffering action of the acids, pH, and duration of exposure. Whereas if the food and drinks contain adequate amounts of fluoride, calcium, and phosphate, the dissolution can be prevented. The intake of fruit juice, acidic foods, as well as soft drinks was not consumed to be a risk factor in the current study for directly causing or for promoting the severity of dental erosion since they were consumed less frequently. A higher frequency of milk ingestion was found to reduce the severity of dental erosion. Regular milk consumption could be regarded as an alternative dietary practice to stop dental erosion. As dental erosion is a complex condition, it's essential to have an early diagnosis and implement the proper preventive measures. It is vital to inform people about dental erosion and how it is interrelated to GERD and dietary practices.

5-Aminolevulinic Acid as a Novel Therapeutic for Inflammatory Bowel Disease.

5-Aminolevulinic acid (5-ALA) is a naturally occurring nonprotein amino acid licensed as an optical imaging agent for the treatment of gliomas. In recent years, 5-ALA has been shown to possess anti-inflammatory and immunoregulatory properties through upregulation of heme oxygenase-1 via enhancement of porphyrin, indicating that it may be beneficial for the treatment of inflammatory conditions. This study systematically examines 5-ALA for use in inflammatory bowel disease (IBD). Firstly, the ex vivo colonic stability and permeability of 5-ALA was assessed using human and mouse fluid and tissue. Secondly, the in vivo efficacy of 5-ALA, in the presence of sodium ferrous citrate, was investigated via the oral and intracolonic route in an acute DSS colitis mouse model of IBD. Results showed that 5-ALA was stable in mouse and human colon fluid, as well as in colon tissue. 5-ALA showed more tissue restricted pharmacokinetics when exposed to human colonic tissue. In vivo dosing demonstrated significantly improved colonic inflammation, increased local heme oxygenase-1 levels, and decreased concentrations of proinflammatory cytokines TNF-α, IL-6, and IL-1ß in both plasma and colonic tissue. These effects were superior to that measured concurrently with established anti-inflammatory treatments, ciclosporin and 5-aminosalicylic acid (mesalazine). As such, 5-ALA represents a promising addition to the IBD armamentarium, with potential for targeted colonic delivery.

Effectiveness of silver diamine fluoride and glass ionomer cement combined with fluoride varnish in arresting dental caries among intellectually disabled individuals: A randomized controlled trial.

AIM: To assess the clinical effectiveness of 38% silver diamine fluoride (SDF) in arresting dental caries when compared to combination of fluoride-containing glass ionomer cement (GIC) and fluoride varnish(FV) (5%) among intellectually disabled (ID) individuals. METHODOLOGY: A randomized controlled trial was conducted among ID (n = 82) individuals, in permanent posterior teeth with Nyvad score 2 and 3 (active caries) of dental caries, randomly allocated to experimental arm (38% SDF) (n = 41) and control arm (GIC along with FV) (n = 41). The caries arrest rate and caries preventive fraction was observed at 6-months among both groups. RESULTS: The caries arrest rate was 94.5% with SDF and 90.1% with GIC and FV (p = 0.405).The caries preventive fraction of SDF over GIC with FV was 45%, with hazard ratio (-0.588) at 6 months (p = 0.292). The binary logistic regression revealed that the Odds of arresting caries in SDF group is two times when compared to GIC group with p value = 0.218 which is not significant. CONCLUSION: The present study concluded that the SDF is as clinically effective as combination of GIC and fluoride varnish in arresting caries. Further research and longer follow-up required for more conclusive results.

Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi.

BACKGROUND: Emotional intelligence (EI) is understanding one's own feeling and able to handle those feelings without disturbing themselves. Medical schools are stressful and the ability to manage stress is a major factor of success for these students. The current study contributes further insight to body of research in EI as it relates to students' stress in education, especially among dental undergraduates of Delhi. MATERIALS AND METHODS: A cross-sectional, convenient sampling-based survey was conducted among 323 dental undergraduates from all the 3 dental Institutions across Delhi. The Schutte Emotional Intelligence and Perceived Stress scale instruments were administered to all the students of four professional years. The data analysis was done using SPSS V.17 and various statistical tests were used to determine significant difference. RESULTS: No significant differences were found among gender as well as among professional groups for EI. There was a significant difference (0.008) among gender with respect to perceived stress. Correlation analysis showed an inverse relationship between EI and PS (r = -0.227) which was found to be statistically significant. CONCLUSION: Training in dental education could be quite stressful due to their time-bound work, but regular student performance assessment and associated factors would allow understanding student behavior in handling situations. HOW TO CITE THIS ARTICLE: Yadav V, Mohanty V, Balappanavar AY, et al. Emotional Intelligence and Perceived Stress among Dental Undergraduates in Delhi. Int J Clin Pediatr Dent 2020;13(4):344-347.

Molecular Biomarkers for Early Detection and Prevention of Ovarian Cancer-A Gateway for Good Prognosis: A Narrative Review.

Gynecological cancers are one of the most lethal and deadliest cancers in the world. In India, the prevalence of ovarian cancer accounts for 2.5% to 3%. Despite the availability of improved treatment option along with improved technology, the survival rate of ovarian cancer in the early-stage and the advanced stage is poor. Therefore, due to the heterogeneity of ovarian cancer, to detect it at an early stage and to prevent further mortality turns out to be a big challenge. Researchers are still in the process to identify any single biomarker with good sensitivity and specificity. Various traditional and serum approaches to identify ovarian cancer have been successful in the early stages. The invention of molecular biomarkers such as the use of genomic profiling, DNA methylation, and other approaches have proven to be of higher sensitivity and specificity, which overall affects the prognosis of ovarian cancer. With the use of whole-genome analysis, the detection of possible location of critical tumor suppressor gene (TSGs) in the paired region of chromosomes has been identified, which are associated with BRCA1 and BRCA2 which further makes these novel molecular biomarkers as potential biomarkers. Moreover, studies are required to assess the combined use of traditional, molecular biomarkers that might be useful for enhanced sensitivity and specificity for early detection and prevention of ovarian cancer in early stages which will lead to reduced mortality and good prognosis.

Progestogens Are Metabolized by the Gut Microbiota: Implications for Colonic Drug Delivery.

Following oral administration, the bioavailability of progestogens is very low and highly variable, in part due to metabolism by cytochrome P450 enzymes found in the mucosa of the small intestine. Conversely, the mucosa in the colon contains much lower levels of cytochrome P450 enzymes, thus, colonic delivery of progestogens may be beneficial. Microbiota in the colon are known to metabolize a great number of drugs, therefore, it is important to understand the stability of these hormones in the presence of colonic flora before developing formulations. The aim of this study was to investigate the stability of three progestogens: progesterone, and its two synthetic analogues, medroxyprogesterone acetate (MPA) and levonorgestrel (LNG), in the presence of human colonic microbiota. Progesterone, MPA, and LNG were incubated in mixed fecal inoculum (simulated human colonic fluid) under anerobic conditions. Progesterone was completely degraded after 2 h, whereas levels of MPA and LNG were still detectable after 24 h. The half-lives of progesterone, MPA, and LNG in fecal inoculum were 28, 644, and 240 min, respectively. This study describes the kinetics of colonic microbial metabolism of these hormones for the first time. MPA and LNG show promise for delivery to the colon, potentially improving pharmacokinetics over current oral delivery methods.

Cross-cultural Adaptation and Validation of Hindi Version of Child Oral Impacts on Daily Performance Index.

INTRODUCTION: Oral diseases may have an impact on quality of life (QoL) and the oral health-related quality of life (OHRQoL). As compared to clinical measures which are unable to provide a complete picture, OHRQoL indices quantify the oral health impact on overall health. Worldwide indices have been developed to measure the OHRQoL in children but none can be applicable in Indian context. AIM: The aim of the study was cross-cultural adaptation and psychometric analysis of Hindi version of child oral impacts on daily performance (C-OIDP) index. MATERIALS AND METHODS: Translation and back translation were done for index using prescribed guidelines for cross-cultural adaptation. A pilot study was conducted in 32 children and required modifications were done. The final Hindi version was tested for reliability and validity on a convenience sample of 64 children aged 11-14 years selected from public schools in Delhi. The psychometric properties of the Hindi version were tested for face, content, construct validity along with internal consistency, and test-retest reliability. RESULTS: The mean age of the final sample (n = 64) was 13.02 ± 0.93 years with boys (51.6%) and girls (48.4%). The mean C-OIDP score was 8.8 ± 7.8. Significant association was obtained when C-OIDP was compared with self-perceived oral health. Interitem correlation ranged from -0.008 to 0.45. Kappa for categories of child OIDP ranged from 0.711 to 1.00 and intraclass correlation coefficient was 0.91. CONCLUSION: The Hindi version of C-OIDP is a valid and reliable tool to measure OHRQoL in Hindi-speaking children in India. HOW TO CITE THIS ARTICLE: Chahar P, Mohanty V, Balappanavar AY, et al. Cross-cultural Adaptation and Validation of Hindi Version of Child Oral Impacts on Daily Performance Index. Int J Clin Pediatr Dent 2020;13(2):124-129.

Gastrointestinal Tracking and Gastric Emptying of Coated Capsules in Rats with or without Sedation Using CT imaging.

Following oral administration, gastric emptying is often a rate-limiting step in the absorption of drugs and is dependent on both physiological and pharmaceutical factors. To guide translation into humans, small animal imaging during pre-clinical studies has been increasingly used to localise the gastrointestinal transit of solid dosage forms. In contrast to humans, however, anaesthesia is usually required for effective imaging in animals which may have unintended effects on intestinal physiology. This study evaluated the effect of anaesthesia and capsule size on the gastric emptying rate of coated capsules in rats. Computed tomography (CT) imaging was used to track and locate the capsules through the gastrointestinal tract. Two commercial gelatine mini-capsules (size 9 and 9h) were filled with barium sulphate (contrast agent) and coated using Eudragit L. Under the effect of anaesthesia, none of the capsules emptied from the stomach. In non-anaesthetised rats, most of the size 9 capsules did not empty from the stomach, whereas the majority of the smaller size 9h capsules successfully emptied from the stomach and moved into the intestine. This study demonstrates that even with capsules designed to empty from the stomach in rats, the gastric emptying of such solid oral dosage forms is not guaranteed. In addition, the use of anaesthesia was found to abolish gastric emptying of both capsule sizes. The work herein further highlights the utility of CT imaging for the effective visualisation and location of solid dosage forms in the intestinal tract of rats without the use of anaesthesia.

Effectiveness of dental health education on oral hygiene among hearing impaired adolescents in India: A randomized control trial.

AIM: To assess the effectiveness of two different methods of dental health education (DHE) for improving oral hygiene among hearing impaired adolescents in school aged 11-20 years. METHODOLOGY AND RESULTS: A randomized double blind controlled parallel time series trial was done among 178 hearing impaired adolescents. Considering existing literature, the required sample size was found to be 82 per group, at 95% confidence interval, design effect = 1, type I error = 5%, power of study = 80%, and 20% attrition rate. Two out of five schools were randomly selected. Different methods of DHE were used, schools were coded as School A (DHE using sign language by the investigator) and School B (DHE by conventional visual method, using only posters). The mean reduction in Simplified Oral Hygiene Index (OHI-S), Plaque Index (PI), and Gingival Index (GI) scores was 1.13 ± 0.81, 0.66 ± 0.31, and 0.58 ± 0.32, respectively, in school A. The mean reductions seen in school B was 0.52 ± 0.89 in OHI-S, 0.44 ± 0.44 in PI, and 0.34 ± 0.32 in GI index (P-value < 0.05). CONCLUSION: Basic training of dental professionals in sign language is both effective and feasible, and brings about greater improvement in oral hygiene status and gingival health as compared to the conventional methods of health education.

Effectiveness of oral health education on oral hygiene status among schizophrenic patients: A randomized controlled study.

AIM: The study aims to assess the effectiveness of oral health education on oral hygiene status among schizophrenic patients. METHODS AND RESULTS: A randomized parallel controlled trial was conducted among schizophrenic patients (n = 111) with BPR score of ≤ 48 to assess the role of oral health education on their oral hygiene status. The experimental group (n = 56) received oral health education while the control group (n = 55) were administered standard care advice. Reinforcement in the form of printed calendar was done after 1 month followed by final assessment of KAP (knowledge, attitude and practice) through DCBS (Dental Coping Beliefs Scale), while oral hygiene through the oral hygiene index done after 2 months. Majority of subjects were males with mean age of 34.73 ± 9.9 years and mean duration of illness of 6.41 ± 5.2 years. All domains of the modified DCBS showed significant improvement in the experimental group. Frequency of brushing twice a day increased from 5.4% to 23.2% (p < 0.05) in the experimental group. DI score was 2.28 ± 0.93 versus 2.98 ± 1.3 (p < 0.02) in the experimental group as compared to the control group. CONCLUSION: The oral health education with reinforcement in the form of printed calendar although showed statistically significant changes but lacked clinical importance.

The unc-53 gene negatively regulates rac GTPases to inhibit unc-5 activity during Distal tip cell migrations in C. elegans.

The unc-53/NAV2 gene encodes for an adaptor protein required for cell migrations along the anteroposterior (AP) axes of C. elegans. This study identifies unc-53 as a novel component of signaling pathways regulating Distal tip cell (DTC) migrations along the AP and dorsoventral (DV) axes. unc-53 negatively regulates and functions downstream of ced-10/Rac pathway genes; ced-10/Rac and mig-2/RhoG, which are required for proper DTC migration. Moreover, unc-53 exhibits genetic interaction with abl-1 and unc-5, the 2 known negative regulators of ced-10/Rac signaling. Our genetic analysis supports the model, where abl-1 negatively regulates unc-53 during DTC migrations and requirement of unc-53 function during both AP and DV DTC migrations could be due to unc-53 mediated regulation of unc-5 activity.

Electronic Nicotine Delivery Systems (ENDS): Mapping the Indian Online Retail Market.

INTRODUCTION: Motivating tobacco consumers to change their behavior, and harm reduction strategies, are the predominant traditional approaches to tobacco cessation. Recent trends worldwide have shown the emergence of Electronic Nicotine Delivery Systems (ENDS), such as electronic cigarettes (e-cigarettes), as a purported harm reduction strategy to traditional cigarettes. Considering the global rise in the popularity of ENDS, our study aims to survey the online retail market for ENDS in India. METHODS: The current study was conducted in September-October, 2015 and 4 keywords were used to search Google India to identify online retail websites marketing ENDS. Each website was searched using the same keywords and all specific website pages displaying ENDS models were considered. Thus, data was obtained for various measures of ENDS present on the model descriptions. RESULTS: A total of 6 retail shopping websites were searched which revealed 65 different models of ENDS (34 brands). Forty-five models (69%) were flavored and 21 models (33%) mentioned about nicotine strengths. Seventeen models (26%) provided health warnings in their product descriptions. "No tar no tobacco" was most common claim accounting to 34 models (51%). CONCLUSIONS: This article provide insight into the current status of evident online sales of ENDS in India. There is urgent need to implement regulations on online sales of these products and protect the future from such approaches of tobacco control which still have divided opinions. IMPLICATIONS: The study permits the use of web search engine to explore market availability of ENDS at various online retail websites. Recommendations from the study can be used to guide policy makers in developing strategies tailored to regulate availability and online sales of ENDS in India.