Evaluation of low-level laser therapy and platelet-rich fibrin on donor site healing after vascularized interpositional periosteal connective tissue flap: a randomized clinical study.

AIM: To evaluate the effectiveness of platelet-rich fibrin (PRF) and low-level laser therapy (LLLT) on donor site healing after vascularized interpositional periosteal connective tissue (VIP-CT) flap. MATERIALS AND METHODS: For the present clinical study, the selected patients requiring VIP-CT flap were randomly assigned into either of the two treatment groups (VIP-CT/PRF and VIP-CT/LLLT). For VIP-CT/PRF, palatal donor site treated with platelet-rich fibrin (PRF, n = 15) after harvesting VIP-CT flap; and for VIP-CT/LLLT, palatal donor site treated with low-level laser therapy (LLLT, n = 16) after harvesting VIP-CT flap. RESULTS: The mean thickness of palatal mucosa at surgical site was increased from 2.91 ± 0.65 to 2.93 ± 0.55 mm after 1 week and to 3.02 ± 0.55 mm after 12 weeks while in PRF-treated site, while in LLLT-treated sites, palatal mucosal thickness decreased after 1 week from 3.35 ± 0.56 mm to 1.83 ± 0.48 mm and then increase to 3.35 ± 0.55 mm after 12 weeks, and the mean difference was significantly higher for PRF-treated group compared to LLLT-treated group. In regard to contour, absence of hypertrophic tissue was observed in VIP-CT/LLLT compared with VIP-CT/PRF group (40% of patients, p = 0.003) at 4 weeks. "Absence" of pain and burning sensation were observed as early as at 1 week in LLLT-treated palatal donor sites compared to PRF-treated palatal donor site after VIP-CT. Improvement in post-surgical complications like ecchymosis, tissue necrosis, swelling, and infection were observed almost 100% at 4 weeks in both the groups. CONCLUSION: Favourable clinical outcomes in terms of tissue thickness, consistency, color, contour, scar, pain, and burning sensation and patient comfort were obtained in both LLLT- and PRF-treated donor palatal sites at 12 weeks. Non-significant increase in tissue thickness was observed compared to baseline in PRF-treated donor sites at 12 weeks compared to LLLT-treated donor sites. CLINICAL SIGNIFICANCE: Both low-level laser therapy (LLLT) using 940 nm wavelength and autologous platelet-rich fibrin (PRF) can be utilized to enhance early wound healing and reduce the palatal donor site morbidity.

Prospective, Randomized, Open-Label, Blinded End Point, Two-Arm, Comparative Clinical Study to Evaluate the Efficacy and Safety of a Fixed Ayurvedic Regimen (FAR) as Add-on to Conventional Treatment in the Management of Mild and Moderate COVID-19 Patients.

BACKGROUND: The traditional healthcare systems are being avidly looked into in the quest for effective remedies to tackle the menace of COVID-19 pandemic. OBJECTIVE: This was a prospective randomized, controlled open-label, blinded end point (PROBE) study to evaluate the efficacy and safety of a fixed ayurvedic regimen (FAR) as an add-on to conventional treatment/standard of care (SOC) in the management of mild-to-moderate COVID-19 infection. METHODOLOGY: A total of 68 patients were recruited who consumed either FAR + SOC (n = 35) or SOC only (n = 33) for 28 days. Primary outcomes assessed were mean time required for clinical recovery and proportion of patients showing clinical recovery between the groups. Secondary outcomes assessed included mean time required for testing SARS-CoV-2 negative, change in clinical status on World Health Organization (WHO) ordinal scale, number of days of hospitalization, change in disease progression and requirement of oxygen/intensive care unit admission/ventilator support/rescue medication, health status on WHO quality of life (QOL) BREF and safety on the basis of occurrence of adverse event/serious adverse event (AE/SAE) and changes in laboratory parameters. RESULTS: Patients consuming FAR as an add-on SOC showed faster clinical recovery from the day of onset of symptoms by 51.34% (P < 0.05) as compared to SOC group. A higher proportion of patients taking FAR recovered within the first 2 weeks compared to those taking only SOC. It was observed that 5 times more patients recovered within 7 days in FAR group when compared to SOC (P < 0.05) group. An earlier clinical recovery was observed in clinical symptoms such as sore throat, cough, loss of taste and myalgia (P < 0.05). Improvement in postclinical symptoms such as appetite, digestion, stress and anxiety was also obs served to be better with the use of FAR. Requirement of rescue medications such as antipyretics, analgesics and antibiotics was also found to be reduced in the FAR group (P < 0.05). FAR showed a significant improvement in all the assessed domains of QOL. None of the AEs/SAE reported in the study were assessed to be related to the study drugs. Further, FAR did not produce any significant change in the laboratory safety parameters and was assessed to be safe. CONCLUSION: FAR could be an effective and safe add-on ayurvedic regimen to standard of care in the management of mild and moderate COVID-19 patients. CTRI number: CTRI/2020/09/027914.

Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser.

BACKGROUND: Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient's overall clinical diabetic management. OBJECTIVE: To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis. MATERIALS AND METHODOLOGY: After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-µm fiber optic delivery system. RESULTS: Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05). CONCLUSION: Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.

Clinical validation of efficacy and safety of herbal cough formulation "Honitus syrup" for symptomatic relief of acute non-productive cough and throat irritation.

BACKGROUND: Acute cough represents the most common illness evaluated in the outpatient settings. Available remedies for its management are generally allopathic combinations of antihistamines and decongestants that achieve antitussive activity, but often with unpleasant side effects prompting the need to explore safer and effective options. Honitus is an Ayurvedic proprietary herbal cough syrup with benefits of honey, intended to provide relief in acute nonproductive cough and throat irritation without causing drowsiness. This study investigated the safety and efficacy of Honitus in reducing acute nonproductive cough and throat irritation in comparison to a standard marketed allopathic cough syrup intended for use in similar conditions. MATERIALS AND METHODS: This was a randomized double-blind study conducted in 105 individuals who received orally 2 tsp (10 ml) of either Honitus or marketed cough syrup (MCS) four times a day for 3 days. Response to treatment was evaluated from baseline to the end of treatment period on the basis of changes in day and night frequencies of cough, throat irritation and development of adverse events (AEs). RESULTS: Honitus was found safe and effective in reducing symptoms of acute nonproductive cough, throat irritation, and comparable to MCS in reducing day and night frequencies of cough, the time to relief from cough and throat irritation and the Physician's Global Assessment of cough. Honitus showed comparably better results than MCS on throat irritation, the duration of relief from cough and throat irritation without causing drowsiness. No AEs related to study or study products were reported. CONCLUSION: Honitus Syrup is safe and effective in reducing the symptoms of acute nonproductive cough and throat irritation without causing drowsiness.

Evaluation of Ratnaprash for its effect on strength, stamina and fatigue using swim endurance test and biochemical estimation in swiss albino mice.

CONTEXT: Traditional medicines have been considered as important resources for postponing fatigue, accelerating elimination of fatigue related metabolites and improving physical ability. Rasayanas or rejuvenative therapies are mentioned as one of the eight clinical specialties in Ayurveda for attaining longevity, healthy life and regulation of bodily balance. Eventhough more detailed studies are needed to confirm the claims of benefits in the light of evidence based research, Ratnaprash, a herbo-mineral rasayana formulation, is proposed here to be an antifatigue supplement that is good in promoting strength and stamina. MATERIALS AND METHODS: In the present study, anti fatigue, strength and stamina enhancing properties of Ratnaprash were examined based on swim endurance capacity and the change in biochemical parameters in Swiss Albino mice. Treatment groups were orally administered Ratnaprash at various test doses (500, 1000, 2000 mg/Kg per day), while the control group received distilled water at similar dose volumes. Effect of therapy was evaluated after 28 days of treatment. RESULTS: At the end of study period, the swimming times to exhaustion were longer in the treated groups than in the control group. Plasma lactate levels of treated groups were lower than those of the control group (P < 0.05) while tissue ATP levels were higher. These effects were dose dependent and the strongest effect was seen in groups treated at 1000 mg/Kg. CONCLUSION: Ratnaprash enhanced the forced swimming capacity of mice and exhibited elevated anti-fatigue activity, reduced blood lactate levels and increased tissue ATP levels in preclinical models in comparison to vehicle control, exhibiting possible role in increasing strength and stamina and contributing anti-fatigue activity.

Variation in oil content and fatty acid composition of the seed oil of Acacia species collected from the northwest zone of India.

BACKGROUND: The oil content and fatty acid composition of the mature seeds of Acacia species collected from natural habitat of the northwest zone of the Indian subcontinent (Rajasthan) were analyzed in order to determine their potential for human or animal consumption. RESULTS: Oil content varied between 40 and 102 g kg⁻¹. The highest oil content was obtained in Acacia bivenosa DC. (102 g kg⁻¹) among the nine Acacia species. The fatty acid composition showed higher levels of unsaturated fatty acids, especially linoleic acid (~757.7 g kg⁻¹ in A. bivenosa), oleic acid (~525.0 g kg⁻¹ in A. nubica) and dominant saturated fatty acids were found to be 192.5 g kg⁻¹ palmitic acid and 275.6 g kg⁻¹ stearic acid in A. leucophloea and A. nubica respectively. Seed oils of Acacia species can thus be classified in the linoleic-oleic acid group. Significant variations were observed in oil content and fatty acid composition of Acacia species. CONCLUSION: The present study revealed that the seed oil of Acacia species could be a new source of high linoleic-oleic acid-rich edible oil and its full potential should be exploited. The use of oil from Acacia seed is of potential economic benefit to the poor native population of the areas where it is cultivated. The fatty acid composition of Acacia seed oils is very similar to that reported for commercially available edible vegetable oils like soybean, mustard, sunflower, groundnut and olive. Hence the seed oil of Acacia species could be a new source of edible vegetable oil after toxicological studies.