Refractory angiolymphoid hyperplasia with eosinophilia: Complete resolution with low dose thalidomide.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a difficult-to-treat and rare benign vascular proliferative condition which presents as painless, solitary, or multiple vascular papules or nodules in the head and neck area, with predilection for the ear. We report a case of ALHE that failed multiple therapeutic interventions but achieved complete resolution when treated with thalidomide.

A Shift to Synergistic Surface Treatment Using Laser to Enhance the Bonding of Zirconia to Veneering Ceramic: An In Vitro Study.

AIM: The aim of this study was to evaluate the effect of combination of surface treatment using laser along with other modalities of surface treatment on shear bond strength of zirconia to veneering ceramic. MATERIALS AND METHODS: Milled and sintered zirconia cylinders (n = 150) were used in the study which were divided into six groups that were subjected to various surface treatments. Samples in group I were subjected to sandblasting. In group II Laser (Er: YAG) surface treatment was performed. Samples in group III were subjected to sandblasting followed by laser ablation. In group IV laser ablation was carried out followed by liner application, and samples in group V were subjected to laser ablation followed by argon plasma treatment. Instron machine was used to test the shear bond strength (SBS). One-way ANOVA and Bonferroni test were used for statistical analysis. RESULT: Samples in group III showed highest values for SBS followed by groups I, IV, and V with less SBS value for group II. CONCLUSION: Thus, the results conclude the use of combination of surface treatment using laser to be an effective modality to enhance the shear bond strength of zirconia. CLINICAL SIGNIFICANCE: Synergistic surface treatment using laser increases the bond strength of zirconia prosthesis to veneering ceramic improving its clinical longevity.

Pyrimidine-2,4-dione targets STAT3 signaling pathway to induce cytotoxicity in hepatocellular carcinoma cells.

Signal transducer and activator of transcription 3 (STAT3) is a tumorigenic transcription factor that is persistently activated in various human cancers including hepatocellular carcinoma (HCC). Therefore, STAT3 is considered as a prominent target to counteract the uncontrolled proliferation of cancer cells. In the present report, pyrimidine-2,4-diones (N-methyluracil derivatives) (MNK1-MNK14) were synthesized in an ionic liquid (BMIm PF6) medium employing a ligand-free Suzuki-Miyaura cross-coupling process. Among the 14 derivatives, compound MNK8 showed good cytotoxicity towards both the tested cell lines and did not display a toxic effect against normal hepatocytes (LO2). MNK8 significantly increased the Sub-G1 cell count in both cell lines and the cytotoxic effect of MNK8 was found to be mediated through the suppression of constitutive phosphorylation of STAT3Y705. It also decreased the DNA interaction ability of nuclear STAT3 in HCC cells. MNK8 downregulated the levels of apoptosis-related proteins (such as Bcl-2, cyclin D1, survivin) and increased cleaved caspase-3 inferring the apoptogenic effect of MNK8. It also reduced the CXCL12-triggered cell migration and invasion in in vitro assay systems. Overall, MNK8 has been demonstrated as a new inhibitor of STAT3 signaling cascade in HCC cells.

Microhealth insurance and the risk coping strategies for the management of illness in Karnataka: a case study.

Risk coping strategies adopted by the households in the event of illness depends on the accessibility to healthcare financing mechanisms including health insurance. The empirical evidence on the effect of microhealth insurance (MHI) on the risk coping strategies of the households is scarce. This paper evaluates the impact of Sampoorna Suraksha Program, a nongovernmental organization-initiated MHI scheme and the risk coping strategies of households faced with medical illness in Karnataka state, India. In this descriptive cross-sectional study, we collected data from 416 insured households, 366 newly insured households and 364 uninsured households in randomly selected 10 taluks in three districts of Karnataka state, India. We hypothesized that insured individuals rely less on ex post risk coping strategies (borrowing, use of savings and sale of assets) compared with uninsured and newly insured individuals. Our hypothesis was tested using logistic and linear regression analysis. A significant difference among insured, uninsured and newly insured individuals was found for borrowing but not in the use of savings or sale of assets. A positive impact of MHI on illness-induced borrowing (both incidence and amount) was evident. The evidence from this study reinforces the role of MHI as a pivotal financing alternative to out-of-pocket expenditure in India.

Clinical and microbiological efficacy of systemic roxithromycin as an adjunct to non-surgical periodontal therapy in treatment of chronic periodontitis. A randomized, double-blinded, placebo-controlled clinical trial.

PURPOSE: The objective of this randomized clinical trial was to evaluate the clinical and microbiological effects of systemic administration of roxithromycin (RXM) as an adjunct to non-surgical periodontal therapy (NSPT) in the treatment of individuals with moderate to severe chronic periodontitis (CP). METHODS: 70 individuals (38 males and 32 females, aged 25 to 60 years) with moderate to severe CP were randomly allocated into two groups. 35 individuals were allocated to full mouth SRP+RXM while 35 individuals were allocated to SRP+ Placebo group. The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI) and % bleeding on probing sites (%BOP) at baseline (B/L), 1-, 3- and 6-month intervals while microbiologic parameters included percentage of sites positive for periodontopathic bacteria A. actinomycetemcomitans, P. gingivalis and T. forsythia at B/L, 3 and 6 months using polymerase chain reaction. RESULTs: Both groups showed improved clinical and microbiologic parameters over 6 months. RXM group showed a statistically significant reduction in mean PD and CAL gain as compared to the placebo group (P < 0.0001). There was reduction in percentage of sites positive for periodontopathic bacteria over the duration of the study in both groups and a statistically significant reduction in the number of sites positive for A. actinomycetemcomitans in RXM group (P < 0.001).

Clinical evaluation of the periodontal health condition and oral health awareness in Parkinson's disease patients.

OBJECTIVE AND BACKGROUND: The objectives were to compare periodontal status between subjects with and without Parkinson's disease (PKD) to determine the influence of PKD on periodontal disease. This study was conducted to evaluate the relationship of periodontal status with severity of PKD. MATERIALS AND METHODS: This study was conducted on 45 subjects with PKD (subjects with PKD were divided into 5 groups from group 2 to group 6 according to Hoehn and Yahr stages) and 46 control subjects (group 1). Probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI) and percentage of bleeding sites (%BoP) were evaluated. All subjects were interviewed regarding their practice of oral hygiene and access to professional dental care. RESULTS: There were statistically significant differences in PD, CAL, GI, PI and %BoP in subjects with PKD and controls (p < 0.001). All the evaluated periodontal clinical parameters and indices deteriorate with increase in severity of PKD. The mean PD value increased from 2.75 mm for group 1 to 6.17 mm for group 6, and mean CAL value increased from 3.14 mm for group 1 to 6.74 mm for group 6. The mean GI, PI and %BoP values increased from 0.55, 1.35 and 20.37 to 2.66, 3.80 and 70.86, respectively with increasing severity of PKD. CONCLUSION: There is a need for dental care and encouragement to use plaque control methods for subjects with PKD as periodontal pathology presented a high prevalence even in the early stages of PKD.

Correlation of human S100A12 (EN-RAGE) and high-sensitivity C-reactive protein as gingival crevicular fluid and serum markers of inflammation in chronic periodontitis and type 2 diabetes.

OBJECTIVE: The aim of the present study was to evaluate the levels and correlation of human S100A12 and high-sensitivity C-reactive protein (hs-CRP) in gingival crevicular fluid (GCF) and serum in chronic periodontitis (CP) subjects with and without type 2 diabetes mellitus (DM). MATERIALS AND METHODS: A total of 44 subjects were divided into three groups: group 1 had 10 periodontally healthy subjects, group 2 consisted of 17 CP subjects and group 3 had 17 type 2 DM subjects with CP. GCF and serum levels of human S100A12 and hs-CRP were quantified using enzyme-linked immunosorbent assay and immunoturbidimetric analysis, respectively. The clinical outcomes evaluated were gingival index, probing depth and clinical attachment level and the correlations of the two inflammatory mediators with clinical parameters were evaluated. RESULTS: Both human S100A12 and hs-CRP levels increased from group 1 to group 2 to group 3. The GCF and serum values of both these inflammatory mediators correlated positively with each other and with the periodontal parameters evaluated (p < 0.05). CONCLUSION: Human S100A12 and hs-CRP can be considered as possible GCF and serum markers of inflammatory activity in CP and DM.

Clinical and microbiological effects of levofloxacin in the treatment of Aggregatibacter actinomycetemcomitans-associated periodontitis: a randomized placebo-controlled clinical trial.

AIM: To evaluate the clinical and microbiological effects of systemic levofloxacin (LFX) in subjects with Aggregatibacter actinomycetemcomitans-associated chronic periodontitis (AA-ACP). MATERIALS AND METHODS: Subjects with severe periodontitis with subgingival detection of A. actinomycetemcomitans were randomly divided into two treatment groups; a test group (n = 35) that received scaling and root planing (SRP) and LFX (500 mg o.d.) and a control group (n = 34) that received SRP and placebo (o.d.) for 10 days. Plaque index (PI), gingival index (GI), percent of sites with bleeding on probing (% BoP), probing depth (PD) and clinical attachment level (CAL) were recorded and subgingival plaque samples were cultivated for detection of A. actinomycetemcomitans at baseline to 6 months at various intervals. RESULTS: Subjects receiving LFX showed the greatest improvements in mean PD and CAL. The difference in the reduction of PD and CAL in the two groups was significant at 1, 3 and 6 months for PD and 3 and 6 months for CAL (p < 0.05). The inter-group difference in PI, GI and % BoP was not significant at any interval. Detectable levels of A. actinomycetemcomitans were significantly less in the test group 3 and 6 months post-therapy. CONCLUSION: Systemic LFX as an adjunct to SRP improves clinical outcomes and suppresses A. actinomycetemcomitans below detectable levels.

Association of metabolic syndrome and periodontal disease in an Indian population.

BACKGROUND: Metabolic syndrome, the whole of interconnected factors, presents with local manifestation, such as periodontitis, related by a common factor known as oxidative stress. The aim of the present study was to assess the association between metabolic syndrome and periodontal disease in an Indian population. METHODS: Clinical criteria for metabolic syndrome included 1) abdominal obesity; 2) increased triglycerides; 3) decreased high-density lipoprotein cholesterol; 4) hypertension or current use of hypertension medication; and 5) high fasting plasma glucose. Serum C-reactive protein (CRP) levels were also measured. Periodontal parameters including gingival index (GI) average and deepest probing depth (PD) and clinical attachment level (CAL) were recorded on randomly selected quadrants, one maxillary and one mandibular. Based on the presence or absence of metabolic syndrome, individuals were divided into two groups. RESULTS: The periodontal parameters PD, CAL and GI differed significantly between the two groups. The GI values in Group 1 (2.06 ± 0.57) were greater than in Group 2 (1.79 ± 0.66; p = 0.0025). Similarly PD and CAL values in Group 1 (4.58 ± 1.69 and 2.63 ± 1.61 mm) were significantly greater (p < 0.001) than in Group 2 (3.59 ± 1.61 and 1.61 ± 1.40 mm, respectively). Also, three metabolic components and serum CRP correlated with average PD, and the strength of the correlation was medium in Group 1 as compared to Group 2, in which it was weak. CONCLUSION: The association between metabolic syndrome and periodontal disease was significant, and abdominal obesity appeared to be the most important contributing metabolic factor to periodontal disease.