A phase III randomized-controlled study of safety and immunogenicity of DTwP-HepB-IPV-Hib vaccine (HEXASIIL®) in infants.

A fully liquid hexavalent containing Diphtheria (D), Tetanus (T) toxoids, whole cell Pertussis (wP), Hepatitis B (Hep B), type 1, 2, 3 of inactivated poliovirus (IPV) and Haemophilus influenzae type b (Hib) conjugate vaccine (DTwP-HepB-IPV-Hib vaccine, HEXASIIL®) was tested for lot-to-lot consistency and non-inferiority against licensed DTwP-HepB-Hib + IPV in an open label, randomized Phase II/III study. In Phase III part, healthy infants received DTwP-HepB-IPV-Hib or DTwP-HepB-Hib + IPV vaccines at 6, 10 and 14 weeks of age. Blood samples were collected prior to the first dose and 28 days, post dose 3. Non inferiority versus DTwP-HepB-Hib + IPV was demonstrated with 95% CIs for the treatment difference for seroprotection/seroconversion rates. For DTwP-HepB-IPV-Hib lots, limits of 95% CI for post-vaccination geometric mean concentration ratios were within equivalence limits (0.5 and 2). Vaccine was well-tolerated and no safety concerns observed.Clinical Trial Registration - CTRI/2019/11/022052.

Oral health status and treatment needs among deaf, mute and visually impaired children of Gulbarga district - A population based cross sectional study.

BACKGROUND: Oral diseases can particularly have a harmful impact on the general health of individuals with certain systemic health problems or conditions. The aim of the study was to assess the oral health status and treatment needs among deaf, mute, and visually impaired children of the Gulbarga district. METHODOLOGY: A cross-sectional study was conducted among 284 deaf, mute, and visually impaired children of the Gulbarga district. A specially prepared structured questionnaire was used to record the demographic variables and oral hygiene practices. Type III clinical examination was carried out. Oral health status was assessed using the World Health Organization (WHO) assessment form (1997). Oral hygiene index-simplified (1964) was used to assess the oral hygiene status. RESULTS: A total of 284 children were examined, aged 6-24 years, with a mean age of 12.95 years (±3.13). The prevalence of dental caries was 49.3%, and 87.4% of the children suffered from periodontal disease. Oral hygiene status was poor in 24.7% of the children. CONCLUSION: The findings in the present study highlight the lack of dental treatment. There is a considerable need for the prevention and treatment of oral diseases among deaf, mute, and visually impaired children.

A Cross-sectional Study to Assess Factors that Determine Tobacco Habit Initialization and Cessation and Oral Cancer Awareness among General Population of Vikarabad District, Telangana.

AIMS: The aim of the study was to assess factors that determine tobacco habit initialization and cessation and oral cancer awareness among the general population of Vikarabad district, Telangana. MATERIALS AND METHODS: The current study was a cross-sectional study conducted among the general population of the Vikarabad district. All tobacco users satisfying inclusion criteria of age 18-40 years and at least 1 year of tobacco usage were included in the study. Multistage random sampling was followed to select tobacco users and structured, pretested questionnaires were distributed. The populations mean age was 30 years with majority being rural residents and men contributing the majority of the study population. RESULTS: The mean age at which a person begins to smoke was 20.4 ± 5.7 years among the general population. Peer influence (77%) was reported as one of the major reasons, and habit formation was found to be the major factor (55.6%) for continuing tobacco and also work stress (17%) and relaxation (17%). The primary reason for quitting was fear or awareness of the adverse effects of tobacco. Self-abstinence was reported as a predominant method that they followed to quit tobacco habit during the past year, while 16.3% reported that they did not give it a try. About 58.6% of participants were advised by a health-care provider to quit tobacco, respectively. A major proportion of tobacco users (71%) knew that tobacco causes oral cancer. Half of the study population is unaware of oral cancer's early symptoms, noncontagious progression, lifestyle modification, and early treatment have a good prognosis. CONCLUSION: Findings of the study highlight the factors to be considered in framing effective antitobacco policies applicable to the rural population.

Evaluation of Efficacy of Pilocarpine and Bethanechol in Xerostomic Denture Wearers.

AIM: The aim of this study was to evaluate effectiveness of bethanechol and pilocarpine among xerostomic denture wearers. MATERIALS AND METHODS: This in vitro study was conducted in 60 complete denture wearers of both genders. For assessment of salivary flow, resting saliva and stimulated saliva were collected. Patients were split into two groups consisting of 30 patients each. Pilocarpine was given to patients in group I and patients in group II received bethanechol. Salivary flow was measured at baseline, after 2 weeks, and after 4 weeks. RESULTS: The mean whole resting saliva in patients of group I was 0.61 mg/mL and in that of group II was 0.65 mg/mL. The mean whole stimulated saliva in patients of group I was 1.35 mg/mL and in group II it was 1.51 mg/mL. The mean whole resting saliva after 2 weeks in patients of group I was 0.83 mg/mL and in group II was 0.92 mg/mL. Whole stimulated saliva in patients of group I was 1.67 mg/mL, and in patients of group II it was 1.86 mg/mL. The difference noted was significant (P < 0.05). The mean whole resting saliva after 4 weeks in patients of group I was 1.23 mg/mL and in that of group II was 1.43 mg/mL. Whole stimulated saliva in patients of group I was 1.98 mg/mL and in patients of group II it was 2.04 mg/mL. CONCLUSION: Authors found that both agents were effective in increasing salivary secretions. However, pilocarpine is a more effective sialagogue as compared to bethanechol in completely edentulous patients with xerostomia.

Detection of Salivary Alkaline Phosphatase Levels in Smokers, Diabetic Patients, Potentially Malignant Diseases and Oral Malignant Tumours.

AIM: Alkaline phosphatase (ALP) is present in human and plays a key role in intracellular destructive processes and cellular damage. It has bicarbonate and phosphate ions, which help in buffering against acids. ALP activity is affected by smoking, which changes pH in oral environment and has harmful effects. Thus, the evaluation of ALP activity of smokers and healthy nonsmoker along with patients who were diabetic, potentially malignant, and malignant was carried out in this study. MATERIALS AND METHODS: The study took place between 2016 and 2017. A total of 150 smokers, non-smokers, and patients who were diabetic, potentially malignant, and malignant were included. Collection of unstimulated whole saliva was done from each participant, and salivary ALP levels were measured by spectrophotometric assay. RESULTS: Mean salivary ALP levels were significantly higher in smokers compared to those in nonsmokers. Mean ALP levels were also increased in patients who were diabetic, potentially malignant, and malignant compared to those in controls. CONCLUSION: ALP levels were significantly higher among smokers when compared to a healthy control group. Oral tissue function and side effects among smokers can be evaluated by these salivary enzyme alterations, which can serve as biomarkers for the diagnosis of any disease process. These salivary alterations could potentially be used as biochemical markers for the evaluation and early diagnosis. The higher levels were also found in patients who were diabetic, potentially malignant, and malignant, and ALP levels may also be used as biomarkers for the evaluation of the disease process.

To Compare Mineral Trioxide Aggregate, Platelet-rich Fibrin, and Calcium Hydroxide in Teeth with Irreversible Pulpitis: A Clinical Study.

AIM: Numerous pulp-capping agents such as mineral trioxide aggregate (MTA), calcium hydroxide (Ca(OH)2), platelet-rich fibrin (PRF), and biodentine have been suggested. This clinical study was conducted to compare MTA, PRF, and Ca(OH)2 in teeth with irreversible pulpitis. MATERIALS AND METHODS: The 60 mandibular molar teeth with irreversible pulpitis were used in this study, which were restored with Ca(OH)2, MTA, and PRF. Assessments of the treatment were carried out at 6 months and 1 year by clinical examination and also radiographically. RESULTS: A nonsignificant difference was observed in pain intensity recorded at numerical rating scale at baseline, 24h, 1 week, 1 month, 3 months, 6 months, and 1 year. A nonsignificant (P > 0.05) difference was reported in clinical and radiographic success rate recorded at 6 months and 1 year in all groups. CONCLUSION: Pulp-capping agents such as Ca(OH)2, MTA, and PRF yielded similar success rate when used in teeth with irreversible pulpitis.

Assessment of Aluminum Chloride Retraction Cords, Expasyl, and Tetrahydrozoline-Soaked Retraction Systems in Gingival Retraction.

AIM: The aim of this study was to assess different gingival displacement systems such as aluminum chloride retraction cords, expasyl, and tetrahydrozoline-soaked retraction cord to record intracrevicular margins of tooth preparations. MATERIALS AND METHODS: This study included 60 patients. Patients were divided into four groups of 15 each. In group I, aluminum chloride retraction cords, in group II expasyl, in group III tetrahydrozoline-soaked retraction cord, and in group IV no retraction cord were used. RESULTS: The mean gingival displacement (µm) in group I was 825.6, in group II was 482.1, in group III was 742.3, and in group IV was 214.8. Significant difference was seen in between groups by one-way analysis of variance as P < 0.05. Post hoc Tukey analysis showed significant difference during multiple comparison between groups. CONCLUSION: Authors found that maximum gingival retraction was achieved with aluminum chloride retraction cords followed by tetrahydrozoline and expasyl.

Olze et al. stages of radiographic visibility of root pulp and cameriere's third molar maturity index to estimate legal adult age in Hyderabad population.

CONTEXT: Predicting one's attainment of age of majority is a controversial issue and considered as important aspect in medicolegal cases. In India, individuals older than 18 years of age have full capacity regarding civil conduct and are tried as adults for criminal charges. AIMS AND OBJECTIVE: To compare the accuracy of Olze et al., stages of radiographic visibility of root pulp, and Cameriere's third molar maturity index (I 3M < 0.08) to estimate the age of majority. MATERIALS AND METHODS: A total of 615 digital orthopantomographs of children aged between 15 and 22 years. The lower left third molars were evaluated using ImageJ computer software. The effectiveness of both methods was evaluated using sensitivity, specificity, positive likelihood ratios (LR+), and LR negative (LR-). RESULTS: For I 3M < 0.08, the sensitivity, specificity, LR+, LR- were 0.76, 0.72, 2.79, 0.32 and 0.67, 0.76, 2.83, 0.43 in males and females respectively. For Stage 0, the sensitivity, specificity, LR+, LR- were 0.68, 0.86, 5.18, 0.36 and 0.72, 0.91, 8.63, 0.31, respectively. CONCLUSION: Stage 0 of Olze's radiographic root pulp visibility showed to be more accurate than cutoff value of I 3M< 0.08 in discriminating adults and minors of Hyderabad sample when a test of high sensitivity and specificity is required.

Expression of CD1a by Langerhan's Cells in Oral Lichen Planus - A Retrospective Analysis.

INTRODUCTION: Langerhan's Cells (LCs) are dendritic cells of the oral epithelium which play a role in a series of oral lesions from gingivitis to oral cancer. Oral Lichen Planus (OLP) is an oral mucosal T-lymphocyte mediated immunologic reaction to an unidentified putative antigen or allergen. AIM: The aim of this study was to quantify the presence of immature LCs in OLP comparing them with normal epithelium. MATERIALS AND METHODS: A retrospective study using 30 of OLP cases were conducted. Immunohistochemistry was performed using polyclonal anti-CD1a antibodies to identify LCs in 10 cases of normal tissue and 30 samples of OLP. The distribution of LCs among lesional tissue and normal mucosa was analysed using Mann-Whitney U test. RESULTS: LC population in OLP was significantly higher when compared to the normal epithelium (p<0.001). CONCLUSION: The increase in LCs indicates the active role played during the antigen detection in OLP and subsequent presentation to T-lymphocytes.

Ruptured intracranial lipoma--a Fatty outburst in the brain.

Intracranial lipomas are rare congenital lesions that occur because of abnormal differentiation of embryogenic meninges. These lipomas are usually seen incidentally on brain imaging, and are usually asymptomatic and do not require treatment. The authors present a case of ruptured intracranial lipoma, discovered in an elderly patient presenting with dizziness and episodes of falls.

Multi Centricity of Oral Verrucous Carcinoma: A Case Series of 22 Cases.

Verrucous carcinoma (VC) is an uncommon variant of squamous cell carcinoma characterized by proliferative outgrowing clinical appearance of the tumor, Incidence of VC is 2-12 % among oral cancers, the true incidence of VC can be accessed only from surgically treated cases since thorough processing of the entire tumor is necessary for accurate diagnosis, foci of invasive squamous cell carcinoma are found often in the substance of these tumors, thus, over reporting of this tumor is not uncommon. The retrospective data of a tertiary cancer hospital was analysed to understand the clinical challenges and outcome of patients with VC. The frequent association of VC with second primary oral cancer (22.7 %) observed in our series highlights the multi centricity of carcinogenesis in these patients.

The influence of implant abutment surface roughness and the type of cement on retention of implant supported crowns.

OBJECTIVES: To provide relative data on the retentive characters of the commonly used cements on different implant abutment surfaces. MATERIALS AND METHODS: A total of 20 implant abutments were divided into 2 groups. Ten implants were unaltered and ten were air borne particle abraded with 50µ aluminium oxide. Three luting agents (Tempbond, IRM and ImProv) were used to secure the crowns to abutments. All the crowns were removed from the abutment with an Instron machine at 0.5mm per minute and tensile bond strengths were recorded. Statistical analysis was performed using Anova, Paired t-test and Post-Hoc tests. RESULTS: IRM showed the highest mean tensile strength among the three cements when used with treated and untreated implant abutment surfaces. Change in the abutment surface roughness had no effect on the mean tensile bond strength of TempBond and IRM cements, whereas ImProv cement showed reduced tensile strength with sandblasted surface. CONCLUSION: When increased retention is required IRM cement with either sandblasted or milled surface could be used and when retrievability is required cements of choice could be either TempBond or ImProv.

A qualitative analysis to compare the effects of surface machining of conventional denture base resin and two soft liners: a scanning electron microscopic study.

INTRODUCTION: The denture base acrylic resins require adjustments for various reasons. During this process there is an alteration in the surface characteristics of the denture base. Rough surfaces promote the bacterial adhesion and plaque accumulation; therefore it is important to know the character of the surface left by instrumentation on denture base materials. This study evaluated the surface characteristics of the machined surfaces of heat-cured acrylic denture base resin, GC supersoft and Permasoft softliners. MATERIALS AND METHODS: Thirty 15×15×1.5mm acrylic resin specimens were fabricated with each of three acrylic resins: Lucitone 199 denture base resin (Group I), GC supersoft (Group II) and Permasoft (Group III) softliners. They were further divided into three sub Groups A, B and C, in which Sub Group A was control group that is smooth produced against the glass. Sub Group B was produced by machining with the tungsten carbide bur and Sub group C is machined with the stone bur. Each surface was evaluated by a Scanning electron microscope and data were analyzed by analysis of variance followed by Tukey's HSD test. RESULTS: Stone bur produced smoother surface (Ra 3.6681µm± 0.254) on Lucitone199 than the tungsten carbide bur (Ra 5.3881µm ± 0.3373). Carbide bur produced a smoother surface on the GC super soft (Ra 1.617097µm ± 0.191767) and Permasoft softliners (Ra 2.237419µm ± 0.354259). Whereas stone bur produced rougher surface on GC supersoft(Ra 2.6µm) and Permasoft (Ra 4.184839µm ± 0.409869) softliners. CONCLUSION: The present study shows each type of rotary instrument produces its own characteristic surface on each type of denture base materials and that care is needed when selecting the most appropriate instrument to adjust denture base materials. These results can have a significant clinical implication. While using Lucitone 199 stone bur can be used for chair side adjustments. Tungsten carbide bur can be used for GC supersoft and Permasoft softliners to achieve smoother surface.

Analysis of silver stained nucleolar organizing regions in odontogenic cysts and tumors.

OBJECTIVE: The present study aimed to investigate the probable differences in cell proliferation index of odontogenic cysts and tumors by means of a comparative silver stained nucleolar organizing region (AgNOR) quantification. STUDY DESIGN: This descriptive cross-sectional study was done on archival paraffin blocks (n = 62), consisting of 10 odontogenic keratocysts, 10 dentigerous cysts, 10 radicular cysts, 10 conventional ameloblastomas, 10 adenomatoid odontogenic tumors, 10 calcifying epithelial odontogenic tumors and 2 ameloblasic carcinomas. RESULTS: The mean AgNOR count of odontogenic cysts was 1.709 and the benign odontogenic tumors was 1.862. Highest AgNOR count was recorded in odontogenic keratocyst and lowest was seen in radicular cyst. Statistically significant difference in AgNOR counts of ameloblastoma and adenomatoid odontogenic tumor, amelobalastoma and calcifying epithelial odontogenic tumor, benign odontogenic tumors and ameloblastic carcinoma were seen. AgNORs in ameloblastic carcinoma were more in number and more widely spread. CONCLUSION: AgNOR technique may be considered a good indicator of cell proliferation in odontogenic cysts and tumors.

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

BACKGROUND: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. METHODS: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. RESULTS: There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. CONCLUSION: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.