A cross-sectional study of opinion about mental illness among undergraduate medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training.

Background: A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training. Materials and Methods: This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data. Result: Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting. Conclusion: Opinions can change based on one's experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

Prediction of Depressed Left Ventricular Ejection Fraction Using Electrocardiogram.

Cardiac Failure is an organ system failure with a time sensitive treatment and is usually due to the failure of the left ventricle. Left ventricular function is most easily calculated by a 2D echocardiogram (ECHO). The 2D echo estimates accurately the ejection fraction(EF) of the heart thus, indicating the functioning of the left ventricle. But because of the restrains in availability of the 2D echo in rural set ups of India, it is essential to develop another method to calculate left ventricular function, which is cheap, rapid and accessible in peripheral settings. The objective of this study to calculate the sensitivity and specificity to predict low ejection fraction by Electrocardiogram (ECG). MATERIAL: This cross-sectional study was conducted in medicine department of B R Ambedkar medical college and hospital in Bangalore, from 1st November, 2019 to 31st August, 2021. The consenting participants underwent ECG and 2D ECHO. The ejection fraction values were obtained from the ECG using the formula (2.808 x QRS complex of aVR + 27.198) and by 2D Echo using the Simpson's method. Comparison of ECG and 2D ECHO derived ejection fraction was done, and the sensitivity and specificity was calculated for prediction of low ejection fraction by ECG, followed by stratification for age. OBSERVATION: A total of 340 subjects were included in this study. it was found that the EF value calculated using the ECG showed a sensitivity of 87.28% and a specificity of 40.12% to predict EF< 50%, with an accuracy of 64.12%. While the sensitivity and specificity to predict very low EF< 35% was 6.06% and 98.91% respectively, with an accuracy of 80.88%. The sensitivity and specificity of ECG to predict low EF was more for ages above 40 years. CONCLUSION: The ECG is found to be a good bedside screening tool of the left ventricle ejection fraction in age groups above 40 years of age. In primary care set ups in developing countries like India, the ECG can be used for decisions regarding emergency management and for referral to a cardiac centre/cardiologist, though it is always suggested to be followed up by a 2D- Echocardiogram whenever indicated. It can also be used to avoid unnecessary expensive testing like 2D ECHO, for patients belonging to poorer socio-economic status.

Identification of vaccine candidate proteins in Ureaplasma urealyticum causing infertility.

BACKGROUND: Ureaplasma urealyticum has gained resistance to number of antibiotics and has been of the greatest concerns nowadays. The treatment options remain extremely low due to the increased levels of intrinsic resistance gained by the pathogen. AIM: The present study focuses on designing a peptide-based vaccine as there is no vaccine available for the pathogen. MATERIALS AND METHODS: All the protein sequences of pathogen were collected and examined using various in silico methods to identify the most immunogenic proteins. The study identifies the proteins which are antigenic in nature which induce the immune response, which lends to quick response of immune system on reinfection. The study describes peptide-based vaccine against U. urealyticum using molecular docking and molecular dynamics simulation approach. RESULTS: The study identifies novel putative vaccine candidate proteins that are antigenic, membrane bound and non-allergenic. CONCLUSION: The results of the study imply that the vaccine candidate proteins identified may bring about vigorous enduring defensive immunity against U. urealyticum.

Immunomodulatory effects of Andrographis paniculata extract in healthy adults - An open-label study.

BACKGROUND: Andrographis paniculata (Burm.f.) Nees has been well-researched for its immunomodulatory effects. OBJECTIVE(S): To investigate the immunomodulatory effects of standardized A. paniculata extract (SAPE) in healthy adults. MATERIALS AND METHODS: The study was an open-label, single-centre study conducted for 30 days. Thirty participants with absolute lymphocyte counts of 1000-4000 cells/mm3 were enrolled and were instructed to ingest 200 mg of SAPE daily for 30 days. The participants visited the clinic at baseline, and days 3, 7, and 30. Immune cells such as NK cell (CD3-CD16+CD56+), T cells (CD3+), T helper cells (CD3+CD4+), T cytotoxic cells (CD3+CD8+) were measured using flow cytometry. Serum cytokines that include interferon gamma (IFN-γ), interleukin-4 (IL-4), interleukin-2 (IL-2), interleukin-12 (IL-12), and tumor necrosis factor alpha (TNF-α) were measured using ELISA. The SAPE used in this study was a standardized proprietary extract (AP-Bio®/KalmCold®) developed from the leaf extracts of A. paniculata. RESULTS: SAPE increased T cells, T helper cells and significantly increased IFN-γ, IL-4, and decreased IL-2 at day 30. A subgroup analysis of participants with absolute lymphocyte counts of 1000-3000 cells/mm3 indicated that there is a significant increase in the T cells, T helper cells at day 7 and 30 and significant increase in IFN-γ, IL-4 and decrease in IL-2 at day 30. There was no treatment related adverse effects following SAPE intake for 30 days. CONCLUSION: Supplementation of SAPE resulted in immunomodulatory effects evidenced by its effects on immune cells and cytokines and it was found to be safe and tolerable.

Electrical stimulation of co-woven nerve conduit for peripheral neurite differentiation.

Electrically stimulable nerve conduits are implants that could potentially be utilized in patients with nerve injury for restoring function and limb mobility. Such conduits need to be developed from specialized scaffolds that are both electrically conductive and allow neuronal attachment and differentiation. In this study, we investigate neural cell attachment and axonal differentiation on scaffolds co-woven with poly-(L-lactic acid) (PLLA) yarns and conducting threads. Yarns obtained from electrospun PLLA were co-woven with polypyrrole (PPy)-coated PLLA yarns or ultrathin wires of copper or platinum using a custom built low-resistance semi-automated weaving machine. The conducting threads were first electrically characterized and tested for stability in cell growth media. Suitability of the conducting threads was further assessed via cell viability studies using PC12 cells. Neurite growth was then quantified after electrically stimulating rat dorsal root ganglion (DRG) sensory neurons cultured on the woven scaffolds. Electrical conductivity tests and cellular viability studies demonstrated better bio-tolerability of platinum wires over PPy-coated PLLA yarns and copper wires. Electrically stimulated DRG neurons cultured on platinum-PLLA co-woven scaffolds showed enhanced neurite outgrowth and length. We demonstrate that a woven scaffold design could be utilized to incorporate conducting materials into cell-tolerable polymer yarns for developing electrically stimulable nerve conduits.

Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application.

Withania somnifera Dunal, also known as Indian ginseng, has been in use since ancient times in the management of diabetes mellitus (DM). This systematic review and meta-analysis evaluated the efficacy/effectiveness, safety and tolerability of W. somnifera in managing DM. Literature search (published/unpublished) was performed from inception to April 2019 in guidelines recommended databases. A total of 6 in-vitro, 13 pre-clinical and 5 clinical studies were included for systematic evaluation. W. somnifera treatment in DM significantly restored the altered levels of blood glucose (experimental data; mean difference, -196.27; 95% confidence interval [-220.96, -171.58]; p < .00001) glycosylated haemoglobin (HbA1c), insulin, lipid profile, serum and oxidative stress markers with no safety concerns. The results suggest the potential role of W. somnifera in managing DM. However, the available clinical data are not considerably enough to provide novel and sufficiently robust evidence for the use of W. somnifera in managing DM. To further strength the anti-diabetic profile of W. somnifera, well-designed randomized-controlled trial(s) with a larger sample size and longer duration is warranted with evaluation of its effect primarily on blood glucose, HbA1c and insulin. Future research also needs to elucidate the molecular mechanism(s) of W. somnifera including its active principles in DM.

Intimate Partner Violence and Psychiatric Comorbidity in Infertile Women - A Cross-Sectional Hospital Based Study.

BACKGROUND AND AIM: In Asian countries, child bearing is a social obligation. Experience of infertility profoundly affects the personal well-being of women. Women with infertility are at a higher risk of anxiety, depression, and Intimate partner violence (IPV). In this background the present study was carried out to determine IPV and psychiatric comorbidity in women with infertility. METHODS: Hundred consecutive women with primary infertility in the age group of 18 years to 45 years were included in the study. Psychiatric diagnosis was made according to DSM-5. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used to assess the severity of the anxiety and depressive symptoms. IPV was assessed using WHO violence against women instrument. RESULTS: The mean age of the 100 women was 26.73 ± 4.23 years, duration of marriage was 7.11 ± 4.177 years and duration of infertility treatment in years was 5.56 ± 3.89. The prevalence of IPV among patients was 50% and psychiatric comorbidity was 46%. When we compared the women who experienced IPV and who did not, the prevalence of anxiety disorder and depressive disorder was high among IPV group. Anxiety, depressive scores in HAM A, HAM D were higher in IPV group compared to the other group and was statistically significant. CONCLUSION: A significant number of women who had infertility reported IPV. This emphasizes the importance of screening for IPV in these women. It is observed that women with IPV had higher psychiatric comorbidity and may require psychotherapeutic intervention.

Comparative evaluation of soft and hard tissue changes following endosseous implant placement using flap and flapless techniques in the posterior edentulous areas of the mandible-a randomized controlled trial.

BACKGROUND: Dental implant-supported restorations have long been used as a successful modality for replacing missing teeth. There are two well-established methods of implant placement. The traditional approach to implant surgery involves raising a mucoperiosteal flap and the alternative approach does not involve reflecting a flap, each having its own advantages and disadvantages. The purpose of the present study was to compare and evaluate the soft and hard tissue changes around endosseous implants placed using flap and flapless surgery in mandibular posterior edentulous sites over a period of time. MATERIALS AND METHODS: A total of 20 systemically healthy patients with a single edentulous site in the posterior mandible were enrolled in this study and 20 endosseous implants were placed (10 in the flap group and 10 in the flapless group). The peri-implant probing depth was assessed. Radiographic assessment was done for changes in the marginal bone levels at the mesial and distal side of the implant with measurements made at baseline, 6 months, and 12 months. Patient-centered outcomes were assessed by using the visual analogue scale (VAS). All these parameters were statistically analyzed using the Wilcoxon signed-rank test, paired Student t test, and two-way ANOVA test and were considered to be significant if the p value was ≤ 0.05. RESULTS: Twenty patients were enrolled in the present study and endosseous implants were placed. Eighteen subjects were followed up throughout the study period and two patients were excluded from the study. The mean PD in the flapless group was comparatively less than the flap group at 12 months and was found to be statistically significant. During the observation period of 12 months, reduction of crestal bone height around the implants placed by flapless and flap surgery were statistically significant. The flapless group showed less change in the crestal bone height which was statistically significant compared to the flap group. The mean VAS score on day 0 in the flap and flapless group was statistically significant. The flapless group showed significantly less pain when compared to the flap group. CONCLUSION: Although the flapless technique of endosseous implant placement had statistically significant less PD, bone loss, and pain than the flap technique, the difference was found to have uncertain clinical significance.

Chronic exposure of interleukin-13 suppress the induction of matrix metalloproteinase-1 by tumour necrosis factor α in normal and scleroderma dermal fibroblasts through protein kinase B/Akt.

Peripheral blood mononuclear cells taken from patients with scleroderma express increased levels of interleukin (IL)-13. Moreover, the expression of matrix metalloproteinase-1 (MMP-1) from involved scleroderma skin fibroblasts is refractory to stimulation by tumour necrosis factor (TNF)-α. To elucidate the mechanism(s) involved, we examined the effect of IL-13 on TNF-α-induced MMP-1 expression in normal and scleroderma human dermal fibroblast lines and studied the involvement of serine/threonine kinase B/protein kinase B (Akt) in this response. Dermal fibroblast lines were stimulated with TNF-α in the presence of varying concentrations of IL-13. Total Akt and pAkt were quantitated using Western blot analyses. Fibroblasts were treated with or without Akt inhibitor VIII in the presence of IL-13 followed by TNF-α stimulation. MMP-1 expression was analysed by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using analysis of variance (anova) or Student's t-test. Upon TNF-α stimulation, normal dermal fibroblasts secrete more MMP-1 than systemic sclerosis (SSc) fibroblasts. This increase in MMP-1 is lost when fibroblasts are co-incubated with IL-13 and TNF-α. IL-13 induced a significant increase in levels of pAkt in dermal fibroblasts, while Akt inhibitor VIII reversed the suppressive effects of IL-13 on the response of cultured fibroblasts to TNF-α, increasing their expression of MMP-1. We show that IL-13 suppresses MMP-1 in TNF-α-stimulated normal and scleroderma dermal fibroblast. Akt inhibitor VIII is able to reverse the suppressive effect of IL-13 on MMP-1 expression and protein synthesis. Our data suggest that IL-13 regulates MMP-1 expression in response to TNF-α through an Akt-mediated pathway and may play a role in fibrotic diseases such as scleroderma.

Comparative analysis of copy number variations in ulcerative colitis associated and sporadic colorectal neoplasia.

BACKGROUND: The incidence of and mortality from colorectal cancers (CRC) can be reduced by early detection. Currently there is a lack of established markers to detect early neoplastic changes. We aimed to identify the copy number variations (CNVs) and the associated genes which could be potential markers for the detection of neoplasia in both ulcerative colitis-associated neoplasia (UC-CRN) and sporadic colorectal neoplasia (S-CRN). METHODS: We employed array comparative genome hybridization (aCGH) to identify CNVs in tissue samples of UC nonprogressor, progressor and sporadic CRC. Select genes within these CNV regions as a panel of markers were validated using quantitative real time PCR (qRT-PCR) method along with the microsatellite instability (MSI) in an independent cohort of samples. Immunohistochemistry (IHC) analysis was also performed. RESULTS: Integrated analysis showed 10 overlapping CNV regions between UC-Progressor and S-CRN, with the 8q and 12p regions showing greater overlap. The qRT-PCR based panel of MYC, MYCN, CCND1, CCND2, EGFR and FNDC3A was successful in detecting neoplasia with an overall accuracy of 54% in S-CRN compared to that of 29% in UC neoplastic samples. IHC study showed that p53 and CCND1 were significantly overexpressed with an increasing frequency from pre-neoplastic to neoplastic stages. EGFR and AMACR were expressed only in the neoplastic conditions. CONCLUSION: CNVs that are common and unique to both UC-associated and sporadic colorectal neoplasm could be the key players driving carcinogenesis. Comparative analysis of CNVs provides testable driver aberrations but needs further evaluation in larger cohorts of samples. These markers may help in developing more effective neoplasia-detection strategies during screening and surveillance programs.

Clinical evaluation of expanded mesh connective tissue graft in the treatment for multiple adjacent gingival recessions in the esthetic zone.

BACKGROUND: Multiple approaches have been used to replace lost, damaged or diseased gingival tissues. The connective tissue graft (CTG) procedure is the golden standard method for root coverage. Although multiple sites often need grafting, the palatal mucosa supplies only a limited area of grafting material. To overcome this limitation, expanded mesh graft provides a method whereby a graft can be stretched to cover a large area. The aim of this study was to evaluate the effectiveness and the predictability of expanded mesh CTG (e-MCTG) in the treatment of adjacent multiple gingival recessions. MATERIALS AND METHODS: Sixteen patients aged 20-50 years contributed to 55 sites, each site falling into at least three adjacent Miller's Class 1 or Class 2 gingival recession. The CTG obtained from the palatal mucosa was expanded to cover the recipient bed, which was 1.5 times larger than the graft. Clinical measurements were recorded at baseline and 3 months, 12 months postoperatively. RESULTS: A mean coverage of 1.96 mm ± 0.66 mm and 2.22 mm ± 0.68 mm was obtained at the end of 3(rd) and 12(th) month, respectively. Twelve months after surgery a statistically significant increase in CAL (2.2 mm ± 0.68 mm, P < 0.001) and increasing WKT (1.75 ± 0.78, P < 0.001) were obtained. In 80% of the treated sites, 100% root coverage was achieved (mean 93.5%). CONCLUSIONS: The results of this study demonstrated that multiple adjacent recessions were treated by using e-MCTG technique can be applied and highly predictable root coverage can be achieved.

Sinonasal hemangiopericytoma: A rare case report with review of literature.

Hemangiopericytoma (HPC) is a rare tumor of uncertain malignant potential. Stout and Murray described HPC as "vascular tumor arising from Zimmerman's pericyte" in 1942. The World Health Organization (WHO) reclassified HPC as a fibroblastic/myofibroblastic tumor, after further characterization. HPC is found mostly wherever there is increased vascularity seen. The incidence of the tumor in head and neck area is only 15%, mostly seen in adults. We report here a case of HPC of a 22-year-old female, who presented to our department with a tender swelling in maxillary anterior region and the mass was well-circumscribed, sessile and soft on palpation. The skin over the tumor was intact and normal. The tumor was completely removed with wide surgical resection. The histopathological staining supported the diagnosis of HPC, this was further confirmed by immunohistochemistry (IHC) in which CD99 showed strong positivity.

Rehabilitation of complicated crown-root fracture by fragment reattachment and intraradicular splinting: case reports.

This paper describes the rehabilitation of two traumatised teeth in two patients namely; A maxillary left central incisor with a relatively rare combination of multiple fractures- uncomplicated crown fracture, complicated crown-root fracture along with an oblique fracture in middle third of the root and A traumatised mandibular central incisor with a horizontal fracture in cervical third of the root and complete separation of the fragments. In both cases, initially the fractured crown fragments were extracted which was followed by pulpectomy and placement of fiber posts luted with resin cement. The fractured fragments were then reattached to the respective teeth using resin cement. In the first case, the fractured incisal edge of the fragment was built up with a hybrid composite. Teeth were splinted with fibre splint (Ribbond) in both the cases. The patient was recalled regularly for follow ups for six months in first case. The patient presented with normal clinical and radiographic findings at each visit. In the second case, follow ups were carried out for 3 weeks and being continued and both the cases are still under observation by regular recalls. How to cite this article: Ruchi Arora, B Shivakumar, H Murali Rao, R Vijay. Rehabilitation of Complicated Crown-Root Fracture by Fragment Reattachment and Intraradicular Splinting: Case Reports. J Int Oral Health 2013; 5(5):129-38.

A chemogenomics based approach for deorphanization of testicular receptor 4: An orphan receptor of nuclear receptor superfamily.

Orphan Receptor of Nuclear Receptor superfamily is the one with no known endogenous ligands. Many of these orphan receptors are associated with different types of diseases and therefore deserve special attention to find the potential ligands they would be associated with. The major task of molecular pharmacology is the deorphanization of the large number of nuclear receptors with unidentified endogenous agonists. The deorphanization provides a promising research for new therapeutics. The Testicular Receptor 4 being negative modulator to other members of the nuclear receptor superfamily, is one of the Orphan members of this family and is associated with prostate cancer, breast cancer, sickle cell anemia and joint diseases. The knowledge that related receptors of the same family often have ligands with similar structural features has helped us to utilize the chemogenomic approach to deorphanize the orphan receptor. Chemogenomics approach involves screening of known ligands of a protein family having analogous domain architecture for identification of new leads for existing protein family members. The deorphanization involved the database homology searching, followed by domain identification, active site prediction, sequence and structure comparative studies. A ligand library set was prepared based on these studies and was used to deorphanize the receptor. The molecular docking study conducted using PyRx revealed that estradiol and tretinion as a potential ligand for Testicular Receptor 4.

Synchronous colorectal neoplasms in ulcerative pancolitis of 6 years duration: pathological and molecular heterogeneity.

Colorectal cancer (CRC) complicating ulcerative colitis (UC) accounts for about 1% of all cases of CRC. Such tumours develop from pre-existing foci of dysplasia in patients with extensive and long-standing UC. We report a case of UC-associated synchronous CRC and foci of high-grade dysplasia with an additional malignant focus in the appendix in a female patient after only 6 years of pancolitis who did not have other risk factors for the development of complications. The multiplicity and the timings of the early changes noted suggest that long-standing inflammation in UC randomly damages multiple genes in epithelial cells known to contribute to colorectal carcinogenesis. Current findings also support a molecular and pathological heterogeneity during multiclonal origin of synchronous tumours whereby differences occur at various sites that were absent during the initial stages of the disease.

Colorectal neoplasia in long-standing ulcerative colitis - a prospective study from a low-prevalence area.

AIM: Despite increasing recognition of ulcerative colitis (UC) in Asia in recent decades, reports on the occurrence of colorectal neoplasia (CRN) in UC are scarce and surveillance for this complication is not routinely practised in this region. We aimed to assess the outcome of a newly initiated pilot screening programme for screening CRN among UC patients in India. METHOD: In this prospective study from an academic hospital setting, patients with UC at high risk of CRN were offered screening by magnifying chromocolonoscopy and the frequency of neoplastic lesions was assessed. RESULTS: Twenty-nine (70.7%) of 41 eligible patients [a median age of 46 (interquartile range 36-54.5) years; 17 (58.6%) men] enrolled for surveillance; 41 colonoscopies were undertaken over 42 months. The median disease duration was 10 (interquartile range 7.5-14.5) years. Sixteen (55.1%) had extensive colitis. On initial screening, low-grade dysplasia (LGD) was seen in five (17.2%) and high-grade dysplasia (HGD) in three (10.3%). Of these three, one accepted proctocolectomy immediately, one underwent surgery for adenocarcinoma and one refused surgery. Twelve follow-up colonoscopies in nine patients revealed three new LGD. CONCLUSIONS: High-grade dysplasia and subsequent adenocarcinoma can be detected with careful follow-up in Indian patients with long-standing UC but acceptance of surveillance and subsequent therapy are suboptimal. We found evidence that screening and surveillance programmes are useful for detecting neoplasias in UC, and need to be customized for this region.

Novel treatment of white spot lesions: A report of two cases.

This case report describes a technique used to treat smooth surface white spot lesions microinvasively. It is based on the infiltration of an initial enamel caries lesion with low-viscosity light-curing resins called infiltrants. The surface layer is eroded and desiccated, followed by resin infiltrant application. The resin penetrates into the lesion microporosities driven by capillary force and is hardened by light curing. Infiltrated lesions lose their whitish appearance and look similar to sound enamel. Additionally, the treatment prevents lesion progression. This technique might be an alternative to microabrasion and restorative treatment in treating of white spot lesions of esthetically relevant teeth.

In vitro antiproliferativeactivity of Annona reticulata roots on human cancer cell lines.

BACKGROUND: The phytochemical and pharmacological activities of Annona reticulata components suggest a wide range of clinical application in lieu of cancer chemotherapy. MATERIALS AND METHODS: Ethanol and aqueous extracts of roots of Annona reticulata Linn were studied for their in vitro antiproliferative activity on A-549 (human lung carcinoma), K-562 (human chronic myelogenous leukemia bone marrow), HeLa (human cervix) and MDA-MB (human adenocarcinoma mammary gland) cancer cell lines by MTT [3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide] colorimetric assay. RESULTS: The ethanol extract exhibited a prominent inhibitory effect against A-549, K-562, HeLa and MDA-MB human cancer cell lines at a concentration range between 10 and 40 µg/ml, whereas the aqueous extract showed a lower activity at the same concentration. Simultaneously, the effect of the ethanol extract toward the inhibition of Vero cell line proliferation was lower in comparison with the cancer cell lines. CONCLUSION: The significant antiproliferative activity of the ethanol extract of Annona reticulata roots against A-549, K-562, HeLa and MDA-MB human cancer cell lines may be attributed toward the collective presence of acetogenins, alkaloids and lower inhibitory effect on Vero cell line, which suggests Annona reticulata be used as a chemopreventive agent in cancer therapy.

Microencapsulation: an acclaimed novel drug-delivery system for NSAIDs in arthritis.

Arthritis refers to different medical conditions associated with disorders of the primary structures that determine joint functioning, such as bones, cartilage, and synovial membranes. Drug discovery and delivery to retard the degeneration of joint tissues are challenging. Current treatment of different types of arthritis such as osteoarthritis, rheumatoid arthritis, septic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis involves the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac, aceclofenac, ibuprofen, flurbiprofen, indomethacin piroxicam, dexibuprofen, ketoprofen, nabumetone, nimesulide, and naproxen, mainly by the oral, parenteral, or topical route. However, the frequent dosing that is required with NSAIDs often leads to patient noncompliance, so drug-delivery technologies should be developed to reduce the frequency of dosing and to allow sustained release of medications. Microencapsulation is one of the novel drug-delivery technologies employed to sustain drug release. This method reduces dosing and eliminates gastrointestinal irritation, thus ultimately improving patient compliance in the pharmacotherapy of arthritis. We provide a comprehensive overview of several microencapsulation technologies used in the treatment of arthritis that may reduce the dose-related adverse effects caused by NSAIDs.

Retrograde peri-implantitis.

Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation.