Regional functional and structural abnormalities within the aorta as a potential driver of vascular disease in metabolic syndrome.

NEW FINDINGS: What is the central question of this study? Is aortic dysfunction, a significant contributor to cardiovascular disease in metabolic syndrome, expressed uniformly across both the thoracic and abdominal aorta? What is the main finding and its importance? Our study shows that, in the setting of metabolic syndrome, functional and structural deficits in the aorta are differentially expressed along its length, with the abdominal portion displaying more extensive vascular abnormalities. It is, therefore, likely that early interventional strategies targeting the abdominal aorta might alleviate cardiovascular pathologies driven by the metabolic syndrome. ABSTRACT: The extent of vascular dysfunction associated with metabolic syndrome might vary along the length of the aorta. In this study, we investigated regional functional and structural changes in the thoracic and abdominal aorta of a rat model of metabolic syndrome, namely, high-fat diet (HFD) streptozotocin-induced diabetes mellitus (HFD-D). Four-week-old male Wistar albino rats were fed with either HFD or control diet (CD) for 10 weeks. At week 6, 40 mg/kg streptozotocin and its vehicle were injected i.p. into HFD and CD groups, respectively. At the end of the feeding period, rats were euthanised and aortic segments collected for assessment of vascular functional responses and histomorphometry. Tail-cuff systolic blood pressures (154 ± 6  vs. 110 ± 4 mmHg) and areas under the curve for oral glucose and i.p. insulin tolerance tests were greater in HFD-D versus CD rats. Abdominal aortic vasoconstriction in response to noradrenaline and KCl was greater in HFD-D compared with CD rats. Thoracic vasoconstrictor responses to noradrenaline, but not KCl, were greater in the HFD-D group. Abdominal, but not thoracic, endothelium-dependent vasorelaxation in response to acetylcholine was blunted in HFD-D relative to CD rats; however, nitric oxide-dependent vasorelaxation in HFD-D rats was impaired in both thoracic and abdominal segments. The abdominal aorta of HFD-D rats showed deranged interlamellar spacing and increased lipid plaque deposition. In conclusion, vascular dysfunction in metabolic syndrome is expressed differentially along the length of the aorta, with the abdominal aorta exhibiting increased susceptibility to vasoconstrictors and greater deficits in endothelium-dependent relaxation. These vascular functional abnormalities could potentially underlie the development of hypertensive cardiovascular disease associated with the metabolic syndrome.

Analgesic, anti-inflammatory and anti-platelet activities of Buddleja crispa.

BACKGROUND: Buddleja crispa Benth (Buddlejaceae) is a dense shrub; several species of genus Buddleja have been used in the management of various health conditions including pain and inflammation. The present study was aimed to investigate the analgesic, anti-inflammatory and anti-platelet properties of B. crispa. METHODS: Male rats (220-270 gm,) and mice (25-30 gm) were randomly divided into different groups (n = 6). Various doses of plant extract of B. crispa, its fractions and pure compounds isolated from the plant were administered intraperitoneally (i.p). The analgesic, anti-inflammatory and anti-platelet activities were assessed using acetic acid and formalin-induced nociception in mice, carrageenan-induced rat paw edema and arachidonic acid-induced platelets aggregation tests. RESULTS: The intraperitoneal administration of the methanolic extract (50 and 100 mg/kg), hexane fraction (10 and 25 mg/kg i.p) exhibited significant inhibition (P < 0.01) of the acetic acid-induced writhing in mice and attenuated formalin-induced reaction time of animals in second phase of the test. Pure compounds BdI-2, BdI-H3 and BH-3 isolated from B. crispa produced significant (P < 0.01) analgesic activity in acetic acid-induced and formalin tests. The crude extract of B. crispa (50-200 mg/kg i.p.) and its hexane fraction inhibited carrageenan-induced rat paw edema with maximum inhibition of 65 and 71% respectively (P < 0.01). The analgesic and anti-inflammatory effect of the plant extract and isolated pure compounds were comparable to diclofenac sodium. B. crispa plant extract (0.5-2.5 mg/mL) produced significant anti-platelet effect (P < 0.01) with maximum inhibition of 78% at 2.5 mg/ml. CONCLUSION: The findings from our present study suggest that B. crispa possesses analgesic, anti-inflammatory and anti-platelet properties. B. crispa could serve a potential novel source of compounds effective in pain and inflammatory conditions.

Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast.

Diabetes mellitus is a chronic health problem of all age groups, both gender, involves rural and urban areas and developing and developed countries globally. The aim of this study was to assess the prevalence of type 2 diabetes mellitus in Pakistan. Systematic bibliographic search of scientific databases including PubMed, ISI-web of science and Google Scholar was conducted with key words of "type 2 diabetes mellitus" "prevalence", "incidence", "occurrence". A total of 22 peer reviewed papers published in ISI and PubMed indexed journals were selected and examined. All the epidemiologic and experimental studies reporting the diabetes prevalence in Pakistan were included. Lastly, we analyzed 18 publications and remaining 04 papers were excluded. The current prevalence of type 2 diabetes mellitus in Pakistan is 11.77%. In males the prevalence is 11.20% and in females 9.19%. The mean prevalence in Sindh province is 16.2% in males and 11.70 % in females; in Punjab province it is 12.14% in males and 9.83% in females. In Baluchistan province 13.3% among males, 8.9% in females; while in Khyber Pakhtunkhwa (KPK) it is 9.2% in males and 11.60% in females. The prevalence of type 2 diabetes mellitus in urban areas is 14.81% and 10.34% in rural areas of Pakistan. The prevalence of type 2 diabetes mellitus in Pakistan is11.77%. The prevalence is higher in males than females and more common in urban areas compared to the rural areas. Pakistan must include diabetes preventive measures in their national health policy to minimize the burden of the disease.

Research productivity of Gulf Cooperation Council (GCC) countries in science and social sciences.

OBJECTIVE: To investigate the research progress of Gulf Cooperation Council countries in science and social sciences. METHODS: This study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from June 2014 to February 2015.All research documents related to the 1996-2013 period having an affiliation with Gulf Cooperation Council countries, including Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain and Oman, were tracked. The main source for data-gathering was World Association of Universities, Sci-mago Journal and Country ranking and Web of Science Institute of Scientific Information (ISI) Thomson Reuters. RESULTS: Of the 544 institutions produced research papers, 141(25.92%) were universities or degree-awarding institutes, 372(68.38%) were research institutes and 31(5.7%) were Institute of Scientific Information-indexed scientific journals. The number of degree awarding institutes were 68(48.23%) in Saudi Arabia, 33(23.4%) in the United Arab Emirates and 12(8.51%) in Qatar. The total number of publications contributed by the region was 133638 (Mean ± SD: 22273 ± 26302.20); citable documents 127739 (Mean ± SD: 21289.83 ±25241.22); self-citations 105,716 (Mean ± SD: 17619.33 ± 23328.44); total citations 756141 (Mean ± SD: 126023.5 ± 143260.95) and citations per documents 33.22 (Mean ± SD: 5.53 ± 1.09).The overall and mean Hirschindex was 513and 85.5± 35.39. CONCLUSIONS: Among Gulf Cooperation Council countries, Saudi Arabia was the most productive country producing adequate number of research publications, citations and holding the highest Hirsch index value.

Comparison of De-Torque and Failure Load Evaluation of Selective-Laser-Sintered CoCr, CAD-CAM ZrO, and Machined Implant Abutment/Restoration.

AIM: This study aimed to compare the torque loss, fracture load, compressive strength, and failure types of selective-laser-sintered cobalt chromium (SLM-Co-Cr), computer-aided design and computer-aided manufacturing zirconium oxide (CAD-CAM-ZrO), and machined titanium (Ti) implant abutments. METHODS: Thirty endosseous dental implants were vertically embedded with machined Ti (control group), CAD-CAM-ZrO, and SLM-Co-Cr abutments. Abutment fabrication involved CAD-CAM milling and SLM technology. The de-torque assessment included preload reverse torque values (RTVs), cyclic loading, and post-RTVs using a customized protocol. Fracture load assessment employed ISO-14801 standards, and statistical analysis was conducted using ANOVA and Tukey Post hoc tests (p < 0.05). RESULTS: In pre-load RTVs, SLM-Co-Cr showed the lowest mean torque loss (24.30 ± 2.13), followed by machined Ti (27.33 ± 2.74) and CAD-CAM-ZrO (22.07 ± 2.20). Post-load RTVs decreased for all groups. Fracture load and compressive strength were highest for SLM-Co-Cr, with significant differences among groups (p < 0.001). Fracture types included abutment failures in SLM-Co-Cr and machined Ti, while CAD-CAM-ZrO exhibited crown separation with deformation. CONCLUSION: SLM-Co-Cr-fabricated implant abutments exhibited superior stability and resistance to rotational forces, higher fracture loads, and greater compressive strength compared to CAD-CAM-ZrO and machined Ti.

Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis.

BACKGROUND: This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri­implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri­implant mucositis (pi-M). METHODS: For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1ß, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS: Mean changes between baseline and 3-month follow-up in peri­implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri­implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1ß (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri­implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS: ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri­implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri­implant parameters.

11,12,20-Trihydroxy-eicosa-8(Z)-enoic acid: a selective inhibitor of 11,12-EET-induced relaxations of bovine coronary and rat mesenteric arteries.

Arachidonic acid is metabolized to four regioisomeric epoxyeicosatrienoic acids (EETs) by cytochrome P-450. 5,6-, 8,9-, 11,12-, and 14,15-EET are equipotent in relaxing bovine coronary arteries (BCAs). Vasorelaxant effects of EETs are nonselectively antagonized by 14,15-epoxyeicosa-5(Z)-enoic acid. The 11,12-EET analogs, 20-hydroxy-11,12-epoxyeicosa-8(Z)-enoic acid (20-H-11,12-EE8ZE) and 11,12,20-trihydroxyeicosa-8(Z)-enoic acid (11,12,20-THE8ZE) were synthesized and tested for antagonist activity against EET-induced relaxations in BCAs. In U-46619-preconstricted arterial rings, 5,6-, 8,9-, 11,12-, and 14,15-EET caused concentration-dependent relaxations with maximal relaxations ranging from 80 to 96%. Preincubation of arteries with 20-H-11,12-EE8ZE (10(-5) M) inhibited relaxations to 14,15- and 11,12-EET, but not 5,6- and 8,9-EET; however, greatest inhibitory effect was against 11,12-EET (maximal relaxation = 80.6 ± 4.6 vs. 26.7 ± 7.4% without and with 20-H-11,12-EE8ZE, respectively). Preincubation with the soluble epoxide hydrolase inhibitor (tAUCB, 10(-6) M) significantly enhanced the antagonist effect of 20-H-11,12-EE8ZE against 14,15-EET-induced relaxations (maximal relaxation = 86.6 ± 4.4 vs. 27.8 ± 3.3%, without and with 20-H-11,12-EE8ZE and tAUCB) without any change in its effect against 11,12-EET-induced relaxations. In contrast to the parent compound, the metabolite, 11,12,20-THE8ZE (10(-5) M), significantly inhibited relaxations to 11,12-EET and was without effect on other EET regioisomers. Mass spectrometric analysis revealed conversion of 20-H-11,12-EE8ZE to 11,12,20-THE8ZE by incubation with BCA. The conversion was blocked by tAUCB. 14,15-Dihydroxy-eicosa-5Z-enoic acid (a 14,15-EET antagonist), but not 11,12,20-THE8ZE (an 11,12-EET antagonist), inhibited BCA relaxations to arachidonic acid and flow-induced dilation in rat mesenteric arteries. These results indicate that 11,12,20-THE8ZE is a selective antagonist of 11,12-EET relaxations and a useful pharmacological tool to elucidate the function of 11,12-EET in the cardiovascular system.

Protective Effect of Rutin Trihydrate Against Dose-Dependent, Cisplatin-Induced Cardiac Toxicity in Isolated Perfused Rat's Heart.

Background Cisplatin is a common anticancer drug with potential cardiac and renal toxicities. Rutin, a natural compound present in various medicinal plants, has been shown to protect against chemotherapy-induced toxicities. In this study, we explored the protective effect of rutin against the dose-dependent cardiotoxic effects of cisplatin such as perfusion pressure, histopathologic effect on the myocardium, and oxidative stress in isolated perfused rat hearts. Methodology The cardiotoxic effects of cisplatin were studied at three dosages (1, 7, and 14 mg/L) in isolated perfused rat hearts. The dose-dependent, cisplatin-induced toxic effects on left ventricular pressure (LVP), heart rate (HR), dp/dt (maximum), dp/dt (minimum), perfusion pressure, pressure-time index, contractility index, and duration of diastole were assessed. The effects of cisplatin were measured one minute before perfusion of cisplatin and 60 minutes after perfusion of the isolated rat hearts. Results Cisplatin (1-14 mg/L) caused a significant (p < 0.05) dose-dependent reduction in LVP. The percentage LVP values reduced from 94 ± 9 (control untreated hearts) to 70 ± 6, 69 ± 5, and 65 ± 4 in hearts treated with 1, 7, and 14 mg/L of cisplatin, respectively. Similarly, cisplatin at similar doses caused a marked reduction in the values of dp/dt (maximum), dp/dt (minimum), and pressure-time index in isolated rat hearts. The respective percentage values of these parameters compared to those of untreated hearts were significantly reduced from 101 ± 7 to 72 ± 5, 92 ± 8 to 69 ± 4, and 92 ± 12 to 57 ± 7 in hearts treated with 14 mg/L of cisplatin. Perfusion of hearts with rutin trihydrate (1 µM/L) 10 minutes before administration of cisplatin and throughout the experiment attenuated the detrimental effects of cisplatin on cardiac functions in isolated rat hearts (p < 0.05). In addition, cisplatin-induced degeneration and necrosis of cardiac muscle cells reduced with the concurrent administration of rutin and restored normal heart histology. Moreover, cisplatin-induced reduction in glutathione and increased level of malondialdehyde in the myocardium was reversed by concurrent administration of rutin in isolated rat hearts. Conclusions Cisplatin produced a dose-dependent impairment of several parameters of cardiac function such as LVP, contractility index, and pressure-time index. It caused histopathological alterations in isolated rat hearts. These harmful effects of cisplatin were suppressed by rutin trihydrate, suggesting the potential protective effects of rutin against cisplatin-induced cardiotoxicity. Rutin trihydrate also improved the reduced glutathione contents and suppressed the malondialdehyde contents in the cardiac tissue of isolated rat hearts, suggesting that the observed beneficial effects of rutin trihydrate in this study could be related to its antioxidant properties.

14,15-Dihydroxy-eicosa-5(Z)-enoic acid selectively inhibits 14,15-epoxyeicosatrienoic acid-induced relaxations in bovine coronary arteries.

Cytochrome P-450 epoxygenases metabolize arachidonic acid (AA) to epoxyeicosatrienoic acids (EETs). EETs relax vascular smooth muscle by membrane hyperpolarization. 14,15-Epoxyeicosa-5(Z)-enoic acid (14,15-EE5ZE) antagonizes many vascular actions of EETs. EETs are converted to the corresponding dihydroxyeicosatrienoic acids by soluble epoxide hydrolase (sEH). sEH activity in the bovine arterial endothelium and smooth muscle regulates endogenous EETs. This study examined sEH metabolism of 14,15-EE5ZE to 14,15-dihydroxy-eicosa-5(Z)-enoic acid (14,15-DHE5ZE) and the resultant consequences on EET relaxations of bovine coronary arteries (BCAs). BCAs converted 14,15-EE5ZE to 14,15-DHE5ZE. This conversion was blocked by the sEH inhibitor 12-(3-adamantan-1-yl-ureido)-dodecanoic acid (AUDA). 14,15-EET relaxations (maximal relaxation, 83.4 ± 4.5%) were inhibited by 14,15-DHE5ZE (10 µM; maximal relaxation, 36.1 ± 9.0%; p < 0.001). In sharp contrast with 14,15-EE5ZE, 14,15-DHE5ZE is a 14,15-EET-selective inhibitor and did not inhibit 5,6-, 8,9-, or 11,12-EET relaxations. 14,15-EET and 11,12-EET relaxations were similar in the presence and absence of AUDA (1 µM). 14,15-EE5ZE inhibited 14,15-EET relaxations to a similar extent with and without AUDA pretreatment. However, 14,15-EE5ZE inhibited 11,12-EET relaxations to a greater extent with than without AUDA pretreatment. These observations indicate that sEH converts 14,15-EE5ZE to 14,15-DHE5ZE, and this alteration influences antagonist selectivity against EET-regioisomers. 14,15-DHE5ZE inhibited endothelium-dependent relaxations to AA but not endothelium-independent relaxations to sodium nitroprusside. A series of sEH-resistant ether analogs of 14,15-EE5ZE was developed, and analogs with agonist and antagonist properties were identified. The present study indicates that conversion of 14,15-EE5ZE to 14,15-DHE5ZE produces a 14,15-EET-selective antagonist that will be a useful pharmacological tool to identify EET receptor(s) and EET function in the cardiovascular system.

Relationship between work-related ocular events, facial injuries and associated factors amongst dental professionals during COVID-19.

BACKGROUND: In dental settings, COVID-19 can be transmitted directly from patients to dentists through small droplets, saliva splashes, blood, and other body fluids liberated as a result of dental procedures. OBJECTIVE: To determine the prevalence of ocular and facial injuries in dental professionals and to investigate factors in dental practice contributing to ocular injuries. METHODS: An analytical cross-sectional study was performed in public and private sector universities. The study had 301 participants including final year undergraduate students, interns, postgraduate trainees, general practitioners, and dental specialists. Data were gathered online using Google forms. Information on sociodemographic, practice details, history of ocular and facial encounters during the clinical experience, and protective measures adopted by the dentists were collected. Means and standard deviations were calculated for continuous variables whereas frequencies and percentages were calculated for categorical variables. A Chi-square test was applied for association between variables. RESULTS: Ocular events and facial injuries occurred more in females 204 (67.8%) than in males 97(32.2%). Final year students reported more incidence of ocular encounters than specialists (40.9%, 3.3%). Dentists working in the government sector underwent more ocular encounters than those in private sectors 185(61.4%) and 96 (31.8%). Majority of participants reported that scaling was the procedure in which dentists experienced an ocular event. A significant association was found between ocular events, qualification, years of experience in clinical practice, number of patients treated per day, improper posture, and proper armamentarium (p < 0.05). However, no association was found between ocular events, gender, working sector, and dental procedures. CONCLUSION: Occurrence of ocular injuries were high compared to facial injuries and these outcomes were dependent on dental expertise and experiences. Appropriate measures should be adopted to minimize the risk of disease transmission and COVID-19 through the eyes among practicing dentists.

Analgesic, anti-inflammatory and anti-platelet activities of the methanolic extract of Acacia modesta leaves.

The current study was aimed to evaluate Acacia modesta for analgesic, anti-inflammatory, and anti-platelet activities. The analgesic and anti-inflammatory effects were assessed in rodents using acetic acid and formalin-induced nociception, hot plate and carrageenan-induced rat paw oedema tests. The intraperitoneal (i.p.) administration of the methanolic extract (50 and 100 mg/kg) produced significant inhibition (P\0.01) of the acetic acid-induced writhing in mice and suppressed formalin-induced licking response of animals in both phases of the test. In the hot plate assay the plant extract (100 mg/kg) increased pain threshold of mice. Naloxone (5 mg/kg i.p.) partially reversed the analgesic effect of the extract in formalin and hot plate tests.A. modesta (100 and 200 mg/kg i.p.) exhibited sedative effect in barbiturate-induced hypnosis test similar to that produced by diazepam (10 mg/kg i.p.). The plant extract(50-200 mg/kg i.p.) produced marked anti-inflammatory effect in carrageenan-induced rat paw oedema assay comparable to diclofenac and produced a dose-dependent(0.5-2.5 mg/mL) inhibitory effect against arachidonic acid induced platelet aggregation. These data suggest that A. modesta possesses peripheral analgesic and antiinflammatory properties, with analgesic effects partially associated with the opioid system.

The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients.

AIM: The current clinical trial aimed to assess the effectiveness of adjunctive photodynamic therapy (aPDT) and adjunctive antibiotic gel therapy (aAGT) to treat peri-implantitis among patients with type 2 diabetes mellitus (T2DM). METHODS: Selected T2DM participants with peri-implantitis were distributed into 3 groups: Group-1: received a single session of adjunctive (aPDT); Group-2: received a single session of adjunctive (aAGT) (metronidazole 400 mg and amoxicillin 500 mg); and Group-3: received MD alone. Clinical (probing depth [PD], bleeding on probing [BOP], and plaque scores [PS]) and radiographic (crestal bone loss [CBL]) peri-implant variables were recorded. Levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) were assessed after the collection of peri-implant sulcular fluid (PISF). All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05. RESULTS: At 3-and 6-months of follow-up, all the three groups showed significant alleviation in PS (p < 0.05), BOP (p < 0.05), and PD (p < 0.05) when compared with the baseline. At baseline, no significant variation was observed in all clinical and radiographic peri-implant parameters among all three research groups. At 3-months follow-up, a considerable alleviation of in PS, BOP, PD, and CBL was noticeable in group-1 patients when compared with the baseline. At 6-months follow-up, a comparable difference was observed in BOP, PD, and CBL between group-1 and group-2. At baseline, no significant variation was observed in the PISF levels of IL-6 and TNF-α among all three research groups. At 3- and 6-months follow-up, a considerable alleviation of TNF-α and IL-6 levels was observed in group-1 and group-2 patients, respectively, when compared with the baseline. CONCLUSION: The application of aPDT demonstrated improved clinical, radiographic, and immunological peri-implant parameters for the treatment of peri-implantitis among T2DM patients.

Photodynamic activation of irrigation (using different laser prototypes) on push out bond strength of fiber posts.

BACKGROUND: To evaluate the influence of photodynamic therapy (PDT) and light activated irrigation (LAI) using different laser prototypes Er,Cr:YSGG (ECYL), Er:Yag (EYL), Nd-Yag (NYL) on pushout bond strength of Pre-fabricated fiber reinforced composite (PFRC) post to radicular dentin. MATERIAL AND METHOD: Fifty maxillary and mandibular teeth were collected, cleaned and decoronated. Canals were instrumented using crown-down technique. Flaring of canals was performed using protaper S1, SX files. F1, F2 and F3 files were utilized for finishing of canal preparations. Prepared root canals were dried and obturated with gutta percha. Teeth were placed vertically within the section of polyvinyl pipes using acrylic resin. Post space preparation was completed using peso-reamers. Based on the PDT and laser activated irrigation (LAI) with different laser prototypes, samples were divided into five groups of 10 specimens each. Group 1- PDT, group 2-5.25 % NaOCl (sodium hypochlorite) and 17 % EDTA (ethylene diamine tetra acetic acid), group 3-5.25 % NaOCl with 17 % EDTA and NYL, group 4-5.25 % NaOCl with 17 % EDTA and EYL ; and group 5-5.25 % NaOCl +17 % EDTA and ECYL. Fiber post were luted in root canals with self-etch dual cure cement and teeth were sectioned at three levels (apical, middle and coronal). Push-out test was performed by placing the specimens in universal testing machine. Failure analysis of debonded surfaces was evaluated using stereomicroscope at 40× magnification. Means and standard deviations of push out bond strength were assessed by one-way analysis of variance (ANOVA). Comparison between means of push out bond strength was evaluated using Tukey multiple comparison tests (p = 0.05). RESULT: The highest push out bond strength was observed in group 5 at all three levels, coronal (10.08 ± 0.74 MPa), middle (8.95 ± 0.94 MPa) and apical (6.00 ± 0.88 MPa). The lowest push out bond strength was demonstrated by group 2 at all levels, coronal (6.15 ± 1.22 MPa), middle (5.65 ± 0.95 MPa) and apical (2.25 ± 0.55 MPa). Intra-group comparison showed decrease in push out bond strength in the coronal to apical direction among all investigated groups. Inter-group comparison exhibited comparable push out bond strength at all three levels of root for group 1 and group 2 specimens (p > 0.05). CONCLUSION: LAI with different laser prototypes improved push out bond values of PFRC post to root dentin as an adjunct to NaOCl and EDTA treatment. PDT improved push out strength compared to conventional canal cleaning regime.

Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among shamma users and non-users: A randomized controlled trial.

BACKGROUND: Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non-users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form). METHODS: The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma-chewers that underwent SRP + PT; 3) group 3: Non-chewers that underwent SRP alone; and 4) group 4: Non-chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3- and 6-month follow-ups. Level of significance was set at P < 0.05. RESULTS: In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3-month follow-up. There was no significant difference in periodontal parameters at 3- and 6-month follow-ups in patients that underwent SRP with and without adjunct PT. CONCLUSIONS: Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.

Comparison of self-rated oral symptoms and periodontal status among cigarette smokers and individuals using electronic nicotine delivery systems.

Objective: The aim was to compare the self-rated oral symptoms (OS) and clinical and radiographic periodontal status among cigarette smokers and electronic nicotine delivery systems (ENDS) users.Participants: Self-reported cigarette smokers and electronic cigarette and JUUL users were included.Methods: Self-rated OS and demographic data were recorded. Clinical attachment loss (AL), plaque index (PI), probing depth (PD), number of missing teeth, and bleeding on probing (BOP) were determined. p Values<.05 were deemed significant.Results: Bad breath (p<.001) and pain in gums (p<.001) were more often reported by cigarette-smokers than ENDS users. Compared with never-smokers, pain in teeth (p<.001), bad-breath (p<.001), and pain in gums (p<.001) were higher among cigarette smokers. There was no significant difference in pain in teeth, bleeding gums, bad breath, and pain in gums when JUUL users were compared with never-smokers and electronic cigarette users. PI (p<.05) and PD (p<.05) were increased in cigarette smokers than ENDS users and never-smokers.Conclusions: Pain in teeth and gums are more often perceived by cigarette smokers than electronic cigarette and JUUL users and never-smokers.

Influence of root debridement with adjunct photodynamic therapy on periodontal parameters and gingival crevicular fluid cortisol levels among patients with and without type-2 diabetes mellitus.

OBJECTIVE: The aim of the present study was to assess the influence of scaling and root planing (SRP) with adjunct antimicrobial photodynamic therapy (aPDT) on periodontal parameters and gingival crevicular fluid (GCF) cortisol levels in type-2 diabetic and non-diabetic patients with periodontitis. METHODS: One hundred and twenty-eight patients with periodontitis (64 with and 64 without type-2 diabetes mellitus, respectively) were included. In the test- and control-groups, patients underwent SRP with and without aPDT, respectivey. In both groups, plaque and gingival indices (PI and GI), probing depth (PD), clinical attachment loss (CAL), marginal bone loss (MBL) and GCF volume and cortisol levels were assessed at baseline and three and six-months after SRP with or without aPDT. The aPDT was performed at baseline using methylene blue and photobiomodulation. The Kruskall-Wallis test was used to assess data normality; and group-comparisons were done. P-values, which were below 0.01 indicated statistical significance. RESULTS: Sixty-four type-2 diabetic patients with and 64 non-diabetic patients with periodontitis were included. All individuals had Stage-III/Grade-C periodontitis. Among patients with type-2 diabetes mellitus (DM), there was no statistically significant difference in hemoblobin A1c, PI, GI, PD, CAL and MBL at baseline and at 3- and 6-months intervals. Amongst diabetic patietns, there was no difference in the GCF volume and cortisol levels in the test- and control-groups at all time intervals. In non-diabetic patients, there was a significqnt reductionin GCF volume and cortisol levels when SRP was done with aPDT than when SRP was carried out as the sole treatment strategy CONCLUSION: Among non-diabetic patients, SRP with aPDT helps reduce periodontal inflammation and GCF cortisol levels for up to 6-months; however poorly-controlled DM compromises the beneficial effects of this treatment strategy.

Cardioprotective Effect of Olive Oil Against Ischemia Reperfusion-induced Cardiac Arrhythmia in Isolated Diabetic Rat Heart.

Background Olive oil is rich in monounsaturated fatty acids and has been reported for a variety of beneficial cardiovascular effects, including blood pressure lowering, anti-platelet, anti-diabetic, and anti-inflammatory effects. Diabetes is a major risk factor for cardiac dysfunctions, and olive oil prevents diabetes-induced adverse myocardial remodeling. Objective The study aimed to evaluate the effects of olive oil against streptozotocin-induced cardiac dysfunction in animal models of diabetes and ischemia and reperfusion (I/R)-induced cardiac arrhythmias. Methods Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg i.p), rats were treated for five, 15, or 56 days with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose and body weight were monitored every two weeks. At the end of the treatment, rats were sacrificed and hearts were isolated for mounting on Langedorff's apparatus. The effect of olive oil on oxidative stress and histopathological changes in the cardiac tissues were studied. Results The initial blood glucose and body weight were not significantly different in the control and olive-treated animals. Streptozotocin (60 mg/kg i.p) caused a significant increase in the blood glucose of animals as compared to saline-treated animals. The control, saline-treated diabetic animals exhibited a 100% incidence of I/R-induced ventricular fibrillation, which was reduced to 0% with olive oil treatment. The protective effects of olive oil were evident after 15 and 56 days of treatment. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The cardiac tissues isolated from diabetic rats exhibited marked pathological changes in the cardiomyocytes, including decreased glutathione (GSH) and increased oxidative stress (malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and decreased MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes. Conclusion Olive oil possesses cardiac protective properties against I/R-induced cardiac arrhythmias in rats. It attenuated oxidative stress and diabetes-induced histopathological changes in cardiac tissues. The observed cardiac protectiveness of olive oil in the present investigation may be related to its antioxidant potential.

Relationship of Body Adiposity with Platelet Function in Obese and Non-obese Individuals.

Background Adiposity is firmly linked to a higher incidence of various cardiovascular and metabolic morbidities, including diabetes, hypertension, and thromboembolism. This research study was aimed to verify the association of increased adiposity and hyperreactivity of platelets in obese and non-obese individuals. Methods This cross-sectional study was conducted on 42 subjects aged 18 years and above. Subjects were divided into obese and non-obese groups based on their body mass index (BMI). The data was collected through self-administered questionnaires. All participants underwent body composition analysis. Blood samples were collected from all subjects and taken to the Pharmacology Department for the preparation of platelet-rich plasma (PRP) and poor platelet plasma (PPP). Platelet aggregation was induced by arachidonic acid and was monitored with a Bio/Data multichannel aggregation profiler (Bio/Data Corp., Horsham, PA, USA). Results Significant differences were observed in most parameters, such as fat mass, body fat percentage, free fat mass (FFM), the percentage of trunk fat, total body water, waist-hip ratio (WHR), and basal metabolic rate (BMR) of obese and non-obese subjects. The average percent of platelet aggregation in obese and non-obese subjects was 56.33 ± 15.62 and 59.38 ± 12.62, respectively. The average area under the curve (AUC) for platelet aggregation for both groups was 339.33 ± 191.55 and 342 ± 146.68, respectively. Platelet function was not significantly different and didn't positively correlate with most parameters of the body composition, except WHR, which positively correlated with AUC for platelet function.  Conclusion There was no significant direct correlation between adiposity and platelet activation in obese subjects. However, a significant positive correlation of AUC for platelet aggregation with WHR was observed (resistance (r)-value: 0.307, p < 0.05). These findings suggest that WHR could be an effective determinant to assess the risk of thromboembolism in obese individuals.

Biological, molecular and pharmacological characteristics of chloroquine, hydroxychloroquine, convalescent plasma, and remdesivir for COVID-19 pandemic: A comparative analysis.

OBJECTIVES: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, also known as COVID-19 pandemic has caused an alarming situation worldwide. Since the first detection, in December 2019, there have been no effective drug therapy options for treating the SARS-CoV-2 pandemic. However, healthcare professionals are using chloroquine, hydroxychloroquine, remdesivir, convalescent plasma and some other options of treatments. This study aims to compare the biological, molecular, pharmacological, and clinical characteristics of these three treatment modalities for SARS-COV-2 infections, Chloroquine and Hydroxychloroquine, Convalescent Plasma, and Remdesivir. METHODS: A search was conducted in the "Institute of Science Information (ISI)-Web of Science, PubMed, EMBASE, ClinicalTrials.gov, Cochrane Library databases, Scopus, and Google Scholar" for peer reviewed, published studies and clinical trials through July 30, 2020. The search was based on keywords "COVID-19" SARS-COV-2, chloroquine, hydroxychloroquine, convalescent plasma, remdesivir and treatment modalities. RESULTS: As of July 30, 2020, a total of 36,640 relevant documents were published. From them 672 peer reviewed, published articles, and clinical trials were screened. We selected 17 relevant published original articles and clinical trials: 05 for chloroquine and/or hydroxychloroquine with total sample size (n = 220), 05 for Remdesivir (n = 1,781), and 07 for Convalescent Plasma therapy (n = 398), with a combined total sample size (n = 2,399). Based on the available data, convalescent plasma therapy showed clinical advantages in SARS-COV-2 patients. CONCLUSIONS: All three treatment modalities have both favorable and unfavorable characteristics, but none showed clear evidence of benefit for early outpatient disease or prophylaxis. Based on the current available data, convalescent plasma therapy appears to show clinical advantages for inpatient use. In the future, ongoing large sample size randomized controlled clinical trials may further clarify the comparative efficacy and safety of these three treatment classes, to conclusively determine whom to treat with which drug and when to treat them.

Presence of blood-pressure lowering and spasmolytic constituents in Buddleja crispa.

This aim of this study was to investigate the crude extract of Buddleja crispa (Bc.Cr) and its active constituent(s) for their antihypertensive and antispasmodic activities. The Bc.Cr caused a dose-dependent (3-10 mg/kg) fall in mean arterial pressure in rats under anesthesia. In rabbit aorta preparations, Bc.Cr (0.03-1 mg/mL) caused inhibition of high K(+) (80 mM) precontractions. The Bc.Cr (0.03-1 mg/mL) also inhibited spontaneous and high K(+) precontractions in rabbit jejunum preparations, suggestive of calcium channel blocking (CCB) activity. CCB activity was further confirmed when pretreatment of the tissues with Bc.Cr (0.03-0.10 mg/mL) caused a rightward shift in Ca(++) concentration response curves, similar to verapamil. Among the pure compounds, BdI-H3 was more potent against the high K(+) than spontaneous contractions and was around eight times more potent than Bc.Cr against the spontaneous contractions while the other two compounds, BdI-2 and BH-3 were inactive. Activity-directed fractionation revealed that the hexane fraction was more potent against K(+) precontractions. These data indicate that Bc.Cr possesses a blood-pressure lowering effect, mediated possibly through CCB, though additional mechanism(s) cannot be ruled out. Among the pure compounds, Bdl-H3 is likely to be the active compound involved in the spasmolytic and possibly BP lowering effect of the parent crude extract.