Safety and efficacy of multimatrix mesalamine in paediatric patients with mild-to-moderate ulcerative colitis: a phase 3, randomised, double-blind study.

Background: Previous studies have demonstrated the tolerability and efficacy of multimatrix mesalamine in inducing and maintaining remission in adults with mild-to-moderate ulcerative colitis (UC). We evaluated the safety and efficacy of low-dose and high-dose once-daily multimatrix mesalamine in children and adolescents with mild-to-moderate UC or those in remission. Methods: This prospective, randomised, parallel-group, phase 3 study (8-week double-blind acute [DBA] phase; 26-week double-blind maintenance [DBM] phase; and an additional 8-week, open-label acute [OLA] phase) was conducted in 33 sites across North America, Europe, and the Middle East between December 12, 2014, and November 28, 2018. Eligible patients aged 5-17 years and weighing 18-90 kg were randomised 1:1 to either low (900-2400 mg) or high (1800-4800 mg) oral doses of multimatrix mesalamine once daily, stratified by body weight. Interactive response technology was used for randomisation. The primary efficacy outcome was to estimate the clinical response of multimatrix mesalamine (two doses) in different weight groups. Efficacy and safety analyses were conducted in the safety analysis set (Clinicaltrials.gov: NCT02093663; Study completed). Findings: Overall, 107 patients were randomised into the DBA (n = 54) or DBM phase (n = 88; directly or after completing the double-blind or OLA phases); the overall safety analysis set included 105 patients. In the DBA phase, the high-dose group (n = 17; 65.4%) achieved a higher clinical response rate than the low-dose (n = 10; 37.0%) group; difference 28.3% (95% CI: 2.5-54.2; p = 0.039), odds ratio (OR) 3.21 (95% CI: 1.04-9.88). In the DBM phase at Week 26, similar proportions of patients maintained clinical response in the low-dose (n = 23; 54.8%) and high-dose (n = 24; 53.3%) groups: OR 0.99 (0.42-2.34); p = 0.981. Overall, 246 treatment-emergent adverse events (TEAEs) were reported in 73 patients (69.5%); 23 TEAEs in 14 patients (13.3%) were considered related to the study drug. No treatment-related deaths were reported. Interpretation: Our findings suggested that the benefit-risk ratio of once-daily multimatrix mesalamine in paediatric patients was favourable and comparable with that reported in adults with mild-to-moderate UC. Funding: Shire Development LLC, a Takeda company.

Seropositivity among Blood Samples Drawn from Suspected Dengue Cases at a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: The cases of dengue fever have been reported more frequently in Nepal these days. The aim of this study was to find the prevalence of seropositivity among blood samples drawn from suspected dengue cases at a tertiary care centre of Nepal. METHODS: A descriptive cross-sectional study was conducted at a tertiary care hospital from 1st June 2017 to 31st October 2018 after getting approval from the Institutional Review Committee (Reference number: 23/2016). A total of 537 suspected dengue patients were selected for the study using convenience sampling. These dengue positive sera were assayed for their reactivity with Immunoglobulin M and Immunoglobulin G present in sera and synthetic peptides of dengue virus by enzyme linked immunosorbent assay. Data was entered and analysed in Microsoft Excel 2016. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean and standard deviation. RESULTS: Among 537 suspected dengue cases, the seropositivity for dengue was found in 124 (23.09%) (19.52-26.65 at 95% Confidence Interval) of the serum. CONCLUSIONS: The present study revealed that dengue was more prevalent in our setting compared to similar studies. All the synthetic peptides showed reactivity with dengue-positive sera with maximum reactivity shown by RR2 peptide. In dengue-positive sera, RR2 peptide of dengue virus identified more Immunoglobulin M than Immunoglobulin G.

Influence of Implant Angulation and Implant Number on the Accuracy of Definitive Casts.

BACKGROUND: The present study determined the effect of implant angulation and implant number on the dimensional precision of implant definitive casts. MATERIALS AND METHODS: Three definitive casts with implant analogs placed in a triangular pattern were made from dental stone. Group I was control group, Group II in which implant numbers 1 and 3 were at 5° convergence to the implant number 2. Group III in which implant numbers 1 and 3 are at 5° divergence to the implant number 2. Group IV in which implant numbers 1 and 3 are at 10° convergence to the implant number 2. Implant analogs were secured in all the definitive casts with cyanoacrylate. Three open tray impressions of the definitive cast were obtained and poured in Type IV dental stone. Coordinates in the three planes were measured at implant analog top surface and base of the cast using a fine tip measuring stylus. The data were aligned and angular differences between implant analog vectors from definitive and duplicate casts were measured. RESULTS: There was a significant correlation between dental implant number and dental implant angulation (P < 0.05). There was a significant result when comparing the effect of the parallel group from 5° divergence and 10° convergence groups. A significant results while comparing the parallel group with 5° divergence and 10° convergence was obtained whereas while comparing 5° divergence, 5° divergence, and 10° convergence a nonsignificant difference was obtained (P > 0.05). CONCLUSION: Close proximity of implant angulation toward right-angled direction results in higher precision of implant.

Assessment of Titanium Level in Submucosal Plaque Around Healthy Implants and Implants with Peri-implantitis: A Clinical Study.

BACKGROUND: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. METHODOLOGY: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. RESULTS: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 µg and in Group II was 0.91 ± 0.04 µg. A highly significant difference between both groups was found (P < 0.05). CONCLUSION: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Evaluation of Quality of Endodontic Re-Treatment and Changes in Periapical Status.

BACKGROUND: The present study was conducted to assess quality of root canal (RC) filling before and after RC re-treatment. MATERIALS AND METHODS: Two hundred and thirty-eight radiographs of failed endodontic treatment were assessed. The periapical status of the endodontic treatment was evaluated with periapical index (PAI) scoring system. PAI <3 showed absence and PAI >3 showed presence of periapical lesion. RESULTS: There was a statistically significant increase in scores 1 and 3 and decrease in scores 2, 4, 5, and 6 after treatment (P < 0.05). PAI score >3 was seen in 37% before which decreased to 16% after endodontic retreatment. 34.6% obturation was homogenous and 65.4% was nonhomogenous before endodontic retreatment. After endodontic retreatment, 95.2% became homogenous and 4.8% nonhomogenous. The reason for endodontic failure was furcation in 2%, iatrogenic causes in 3%, loss of coronal seal in 16%, periapical pathology in 25%, and inadequate root filling in 54%. CONCLUSION: There was significant improvement and decrease in size of periapical lesions in re-endodontic cases as compared to primary RC treated teeth.

To Evaluate the Marginal Adaptation of Porcelain Fused to Metal Crown with Different Base Metal Alloys.

INTRODUCTION: The success of any restoration depends on the marginal seal. The adaptation of castings, luting cement, and the surface structures of the margins are all important factors in achieving marginal seal. AIM: The aim of this study was to evaluate the vertical marginal discrepancy of cast copings obtained by employing conventional casting technique with two different base metal alloys with two different finish lines before and after porcelain firing. MATERIAL AND METHODS: A total of forty wax copings were fabricated with stainless steel die assembly and divided into four groups with ten specimens for each metal and each finish line. Measurements were recorded from coping margin to the stainless steel die margin for vertical marginal gap recordings. Each metal coping was finished, and porcelain application was completed. Copings with porcelain were placed on their respective dies, again subjected to the same measuring microscope for checking the vertical marginal discrepancy by the same operator and results. RESULTS: The results of the present study showed that the mean vertical marginal gaps of all the cast copings obtained in each group (G1-G8) were within clinically acceptable limits. The mean vertical marginal gap of G1 was 135.36 ± 2.30 µm, G2 was 67.22 ± 4.25 µm, G3: 39.47 ± 2.98 µm, G4: 71.00 ± 3.97 µm, G5: 109.57 ± 2.98 µm, G6: 109.57 ± 2.98 µm, and G8: 114.58 ± 2.40 µm. CONCLUSION: The difference in the vertical marginal gap of cast copings obtained in different groups was statistically highly significant at 0.005 level, while the difference in the vertical marginal gap of cast copings obtained at different points was statistically nonsignificant.

To Evaluate the Prevalence of Edentulousness, the Present Prosthetic Status, and the Need for Prosthetic Treatment in the Population of Garhwa, Jharkhand.

AIM: This study aimed to evaluate the prevalence of edentulousness, the present prosthetic status, and the need for prosthetic treatment in the population of Garhwa, Jharkhand. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among the population of Garhwa, Jharkhand. The sample size included 460 subjects belonging to an age group of 25 years and above. Detailed case history and thorough dental examination was done and all the findings were recorded and compiled. Each subject was interrogated with the help of a predesigned closed ended questionnaire. RESULTS: A total of six patients were completely edentulous, while 55.04% of males and 42.80% of females were partially edentulous. All patients who were completely edentulous were denture wearer, while among partially edentulous patients, 6.31% of males and 3.15% of females had RPD and 13.68% and 6.31% of males and females, respectively, had FPD as prosthesis. Prosthetic status of females was better than males In a comparison of prosthetic status between male and female, out of 460 subjects, 195 subjects opted for prosthesis, in which 117 were male and 78 were female. CONCLUSION: Community-based oral health education programs should be conducted to improve patients' oral health knowledge. Educating patients regarding the limitations of prosthesis as mechanical substitutes for natural teeth must be a continuing process from the initial patient contact until adjustments are completed.

A new perspective in understanding rainfall from satellites over a complex topographic region of India.

Present study focuses on rainfall over Western Ghats (WG), a complex topographic region (elevation > 500 m) of India to evaluate and to better understand the satellite behavior in contrast with a flat region (FR) (elevation < 500 m) of central India from 1998 to 2016 using the combinatory data sets of TMPA and IMERG (satellite rainfall estimation). The categorical Intra Seasonal Oscillations (ISO) of Indian summer monsoon (ISM) namely, Madden Julian Oscillation (MJO) and Quasi Bi-Weekly Oscillation (QBWO) are tested in satellite and India Meteorological Department (IMD) gridded rainfall data sets to find out the satellite performance. As the accurate estimation of rainfall from satellites over higher elevation zones is challenging, here we propose a new perspective to select the rainfall products of satellite for better comparison with ground measurements. Considering the satellite's best capability in detecting the cold clouds resulting from deep convection and its coupling with higher-level circulation, we show that the rainfall from satellites yield fruitful comparison with ground measurements when moist static stability, tropical easterly jet is above the climatological values.

Functional outcome in unstable Hangman's fracture managed with anterior approach: A prospective study.

AIM: To study the functional outcome in unstable Hangman s fracture managed with anterior decompression and stabilization with cervical locking plate and tricortical bone graft. MATERIALS AND METHODS: Between 2010 and 2016, 44 patients (range: 19-75 years) with unstable Hangman's fracture underwent anterior decompression and stabilization with cervical locking plate and tricortical bone graft in our institution. RESULT: According to the Levine and Edwards classification, all patients were unstable with Type IA 6 (13.6), Type IIA 35 (79.5%), Type II (0), and Type III (6.8). The mean period of follow-up was 17 months (range: 6-48 months). Neurological recovery was observed in all nine patients. All patients were relieved from axial pain. None of the patients received blood transfusion. All patients showed solid fusion with no complication related to bone graft and plate. CONCLUSION: The anterior C2/C3 discectomy, fusion, and stabilization with cervical locking plate and tricortical bone graft are feasible and safe method in treating HangmanÊs fracture, with the benefit of high primary stability, anatomical reduction, and direct decompression of the spinal cord.