A novel technique to detect cover screw location at stage two uncovery surgery over conventional technique - A randomized controlled trial.

AIM: The conventional technique of implant uncovery using a blade and scalpel is associated with various drawbacks, including profuse bleeding, soft-tissue trauma, delayed healing, and patient noncompliance. Therefore, there is a need to explore the alternative approaches that offer improved accuracy and time efficiency during the cover screw location at the second stage of recovery. This study aims to assess the accuracy and time efficiency of a novel technique that utilizes an apex locator in comparison to conventional locating techniques for implant uncovery. SETTINGS AND DESIGN: The study employed a simple randomized controlled trial with a sample size of 161. MATERIALS AND METHODS: The study employed apex locator (Woodpecker Woodpex III Gold 5th generation) in conjunction with a K-file (Mani k-file #10, 21 mm) for detecting the implant location. The accuracy of the novel technique was determined based on the values measured on the apex locator, with positive values indicating soft-tissue response and negative values indicating the cover screw (metal). The accuracy was cross-verified using radiovisiography (RVG). The clinician-based scoring was also done, considering RVG evaluation, amount of incision given, and ease of the procedure. The time required to locate the cover screw was recorded using a timer for both the novel technique and the conventional method. STATISTICAL ANALYSIS USED: All the recorded values were statistically analyzed using the independent t-test (P < 0.005) with the SPSS software (version 23). RESULTS: The results revealed a significant difference in terms of incision given, ease of treatment, and time taken for the procedure (P < 0.05), while the accuracy of the novel technique was not disturbed (P > 0.05). CONCLUSION: Based on the findings of this in vivo study, the use of an apex locator as an alternative to conventional methods for detecting cover screw location at the second stage of recovery is recommended. The novel technique demonstrated faster uncovering of implants without posing any risks to the surrounding tissues or implants.

Serum Prolactin Levels as a Novel, Practical Marker for Predicting Malignant Diseases of the Breast.

Background and objective Prolactin (PRL) has a high specificity toward breast cancer (BC), making it a valuable marker in both diagnosis and prognosis. In this study, we aimed to compare serum PRL levels between pre- and post-menopausal women with BC, as well as normal reference values. We also investigated the association of various risk factors with PRL levels in women with BC. Methods The study involved adult women diagnosed with BC based on clinical features and tissue histopathology receiving treatment at a tertiary care center in Pune, India. General and demographic information, anthropometric measurements (height, weight, and BMI), menstrual status (age at menarche and menopausal state), clinical presentation (signs and symptoms), duration of symptoms, and parity were recorded by using a pre-tested proforma based on hospital records or in-person interviews. Serum PRL was measured by the RIA method (sandwich assay). Results A total of 67 women (average age: 47.5 ± 11.8 years; 33 of them post-menopausal) with BC were included in the study. The participants had an average BMI of 24.9 ± 3.5 kg/m2, and 26 (39%) of them were overweight. The majority of women had BC stage IIA disease, involvement of the right side or upper outer quadrant, and had attained menarche after 14 years of age; 47 women had a BC duration of >3 months. Seven women were nulliparous, and the remaining had given birth to their first child before the age of 26 years. The average serum PRL level among the participants was 9.27 ± 7.62 ng/mL, with higher levels found in post-menopausal women compared to pre-menopausal women (11.08 vs. 7.51 ng/mL, respectively; p=0.08). Women with a higher stage and greater duration of disease had significantly higher serum PRL levels (p<0.001 for both). When compared with reference values, pre-menopausal women showed significantly lower (6.25 vs. 10.9, respectively; p=0.001) and post-menopausal women showed significantly higher (8.55 vs. 5.95; p=0.004) serum PRL levels. A positive correlation was found between serum PRL and age at the time of birth of the first child (p=0.068). Conclusions Based on our findings, PRL is an important hormone in the development of BC in women. Therapeutic modulation of PRL may be a realistic and novel approach to curing human BC, either administered alone or in combination with conventional treatments.

Admission Pattern of Gastrointestinal Cancer for 2020-2023 From a Single Tertiary-Care Hospital in Pune, Western Maharashtra.

The prevalence of gastrointestinal (GI) cancer is increasing across diverse regions of India, demanding further investigation at the state level. In response, a new department of surgical gastroenterology was started at a tertiary-care hospital in Pune, Western Maharashtra, in 2019. The objective of this study was to explore the pattern of admissions in terms of demographics and types of GI cancers over the last four years (i.e., 2020-2023). Retrospective admissions data were collected from hospital records for 2020-2023. A total of 2294 patients were treated at the outpatient department (OPD), and 135 patients were admitted to the inpatient department (IPD). The data comprised OPD/IPD admissions, age, gender, diagnosis, and length of stay (LoS). In addition to basic statistical reporting, t-tests were used to explore differences among the study variables. Out of 135 GI cancer patients, 57% were male. The mean age of inpatients per year ranged from 53 to 60 years, with an average age of 56.35 ± 10.14 years. The average LoS was 12.31 ± 9.39 days. From 2020 to 2023, the number of admissions increased from 5 to 57. The increase was more pronounced in men than women (57% vs. 43%, respectively). Furthermore, increased admission of younger patients was observed, and the average LoS decreased from 17 to 11 days from 2020 to 2023, respectively. A statistically significant difference in LoS (p = 0.023) was observed based on gender, where LoS was longer for women than for men on average (13.5 ± 10.8 vs. 9.46 ± 8.28, respectively). As GI cancer incidence is predicted to continue to increase in India, these new estimates will help to plan cancer prevention and control through intervention via early detection and management.

A Comparative Study of Ischemia-Modified Albumin: A Promising Biomarker for Early Detection of Acute Coronary Syndrome (ACS).

Introduction The second most common cause of emergency department (ED) visits is chest pain and discomfort. Timely identification or threat stratification is crucial for identifying high-risk individuals who benefit from sophisticated diagnostic investigations (including cardiac biomarkers) and early relevant therapies. We aimed to assess the levels of ischemia-modified albumin (IMA) and also to study its sensitivity and specificity in comparison with cardiac troponin T/troponin I and electrocardiogram (ECG) (alone and in combination) in the diagnosis of acute myocardial infarction. Methods Adults (either gender) presented at the ED of a tertiary care centre with classical chest pain suggestive of angina pectoris or angina-like chest pain and ECG changes suggestive of ACS, ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial MI (NSTEMI), and unstable angina, within three hours of onset were enrolled. Demographic and clinical information was recorded. ECG, haematological investigations like complete blood count, blood sugar level, lipid profile, IMA, troponin I, and creatinine kinase-MB (CK-MB), and radiological investigations like 2D-echocardiography (2D-ECHO) and coronary angiography were performed. Results A total of 100 subjects were enrolled in the study out of which 50 were cases and 50 were controls. Cases were older as compared to controls (mean age 60.5 versus 46.0 years). Of the 50 cases, 33 (66%) were males. There were equal numbers of males (33 each) and females (17 each) subjects in both the groups. Typical chest pain, risk factors, and history of coronary artery disease (CAD) were higher in cases. ECG diagnosis revealed the presence of STEMI (52%) and coronary angiography revealed the presence of double vessel CAD (60%) in cases. Among controls, gastroesophageal reflux disorder was the most common cause of chest pain followed by costochondritis and pneumonia. Glucose (fasting and postprandial), all lipid profile parameters (except high-density lipoprotein) and IMA values were significantly higher in cases as compared to controls. A combination of ECG+IMA has the highest sensitivity (90%) with 79% PPV in the diagnosis of ACS within three hours of the onset of chest pain, and ECG+IMA+2D-ECHO had similar results. However, ECG is equally sensitive. IMA alone has 64% sensitivity with 82% diagnostic accuracy which was higher than other biomarkers (CK-MB, cardiac troponin I). Conclusions As found in our study, among the biomarkers used, the diagnostic accuracy of IMA was the highest and better than that of cardiac troponin I and CK-MB. Although ECG is the preferred diagnostic tool for diagnosing ACS (STEMI, NSTEMI, and unstable angina) in patients presenting within three hours of the onset of chest pain, a confirmation can be done with the help of other diagnostic tests and investigations like serum IMA levels and further treatment can be initiated.

Accuracy of multiple implant impressions using different combinations of impression materials using closed tray technique: An in vitro study.

Decision for precision! The first stage in creating an accurate, passively fitting prosthesis is to replicate the intraoral relationship of implants using impression methods. The technique and the impression material utilized are the key elements that influence the accuracy of the implant imprint. The goal of this study was to assess the accuracy of the described implant impression technique using various impression materials, as well as to look into the clinical aspects that influence implant impression accuracy. Two holes (4.3 mm × 10 mm) were drilled in a U-shaped study plastic model representing the partially edentulous maxilla, and the appropriate Nobel Biocare Replace select implants were implanted. Closed tray copings were placed for the relevant implants, and closed tray impressions were taken with several impression materials (PVS-1) Dentsply, medium-bodied, and 2) Regular setting-Zhermack Elite HD+). To assess passive fit accuracy, a jig trial and RVG IOPA were used. Stereomicroscopy was used to evaluate the precision of the implant and analog interface from two perspectives: buccal and lingual. On the buccal aspect, Group 1 had a mean value of 13703.29, whereas Group 2 had a mean value of 11395.58. On the lingual aspect, Group 1's mean value was 8415.61, whereas Group 2's was 9192.01. In the closed tray technique, no statistically significant differences between different imprint materials were found. There was no significant difference in the accuracy of closed tray implant impression techniques with different impression materials, according to the findings.

Knowledge, awareness, and attitude of dentists toward use of denture adhesives in Tamil Nadu: A questionnaire survey.

Dentists, especially the clinicians, struggle to achieve comfort, stability, and retention in removable dentures, which eliminates need of denture adhesives, and often prescribe denture adherents as an adjunct aid in denture aftercare. The aim of this study was to assess the knowledge, awareness, and attitude of dentists in Tamil Nadu toward use of denture adhesives in clinical practice. This survey was conducted among 150 dentists in Tamil Nadu, of which 128 dentists responded. The survey had 22 close-ended questions circulated through online forms. The data were collected, tabulated, and interpreted. Respondents were 24.2% general practitioners, 14.8% undergraduate students, 25.8% postgraduate students - prosthodontics, 30.5% other than prosthodontics, and 4.7% were prosthodontists. Awareness of usage of denture adhesives, 99.2% of the population responded positively and 1.6% respondents had no awareness. Majority of clinicians were not familiar with the toxic effects and thus a difference in recommendation was seen. The results of this survey conclude that knowledge and attitude of dentists in state of Tamil Nadu pertaining to use of denture adhesives as a retentive adjunct in denture fabrication is good overall, but depth of knowledge about its indication in clinical practice, toxicity, and complications needs some improvement.