Garcinol: A novel and potent inhibitor of hyaluronidase enzyme.

Extracellular matrix (ECM) contains hyaluronic acid (HA) as its integral part that is involved in numerous functional activities within the body. Degradation of HA by hyaluronidase enzyme involved in many pathophysiological conditions such as asthma, arthritis, COPD and in venom spreading during envenomation. Inhibitor of hyaluronidase enzyme has a wide range of application along with the hyaluronan-hyaluronidase system. In this present study, we have evaluated the inhibitory effect of garcinol against hyaluronidase from Hippasa partita spider venom (HPHyal), bovine testicular hyaluronidase (BTH) and human serum hyaluronidase. Garcinia indica fruit rind has been used to isolate the active component garcinol. Garcinol has been used in treatment of diverse ailments. Garcinol has exhibited anti-oxidant, anti-inflammatory, HAT inhibition and miRNA deregulator in development and progression of cancers. Experimental data have shown that garcinol completely inhibited all the three tested hyaluronidase enzymes. The inhibition was found to be non-competitive pattern with reversible type. In the docking study, garcinol with hyaluronidase enzyme has been stabilized by hydrogen bonding and hydrophobic interactions. Thus, garcinol could be a potent novel inhibitor of hyaluronidase enzyme which can be further used for pharmacotherapeutic applications.

Evaluating the Role of AI in Predicting the Success of Dental Implants Based on Preoperative CBCT Images: A Randomized Controlled Trial.

Background: Dental implant surgery has become a widely accepted method for replacing missing teeth. However, the success of dental implant procedures can be influenced by various factors, including the quality of preoperative planning and assessment. Cone beam computed tomography (CBCT) imaging provides valuable insights into a patient's oral anatomy, but accurately predicting implant success remains a challenge. Materials and Methods: In this randomized controlled trial (RCT), a cohort of 150 patients requiring dental implants was randomly divided into two groups: an artificial intelligence (AI)-assisted group and a traditional assessment group. Preoperative CBCT images of all patients were acquired and processed. The AI-assisted group utilized a machine learning model trained on historical data to assess implant success probability based on CBCT images, while the traditional assessment group relied on conventional methods and clinician expertise. Key parameters such as bone density, bone quality, and anatomical features were considered in the AI model. Results: After the completion of the study, the AI-assisted group demonstrated a significantly higher implant success rate, with 92% of implants successfully integrating into the bone compared to 78% in the traditional assessment group. The AI model showed an accuracy of 87% in predicting implant success, whereas traditional assessment methods achieved an accuracy of 71%. Additionally, the AI-assisted group had a lower rate of complications and required fewer postoperative interventions compared to the traditional assessment group. Conclusion: The AI-assisted approach significantly improved implant success rates and reduced complications, underscoring the importance of incorporating AI into the dental implant planning process.

AI-Assisted Treatment Planning for Dental Implant Placement: Clinical vs AI-Generated Plans.

Background: Dental implant placement is a critical procedure in modern dentistry, requiring precise treatment planning to ensure successful outcomes. Traditionally, treatment planning has relied on the expertise of clinicians, but recent advancements in artificial intelligence (AI) have opened up the possibility of AI-assisted treatment planning. Materials and Methods: Twenty patients requiring dental implant placement were included in this comparative study. For each patient, a clinical treatment plan was created by an experienced dentist, while an AI algorithm, trained on a dataset of implant placement cases, generated an alternative plan. Various parameters, including implant position, angulation, and depth, were compared between the two plans. Surgical templates were fabricated based on both plans to guide implant placement accurately. Results: The results of this study indicate that AI-generated treatment plans closely align with clinical plans in terms of implant positioning, angulation, and depth. Mean discrepancies of less than 1 mm and 2 degrees were observed for implant position and angulation, respectively, between the two planning methods. The AI-generated plans also showed a reduction in planning time, averaging 10 min compared to the clinical planning, which averaged 30 min per case. Additionally, the surgical templates based on AI-generated plans exhibited similar accuracy in implant placement as those based on clinical plans. Conclusion: AI-assisted treatment planning for dental implant placement demonstrates promising results in terms of accuracy and efficiency.

Antimicrobial susceptibility of Viridians Group of Streptococci isolated from infective endocarditis patients from 2018 to 2023.

INTRODUCTION: Viridans Group of Streptococci (VGS) are heterogeneous alpha hemolytic Streptococci that form commensal flora in the oral cavity, upper respiratory tract, gastrointestinal tract and female genital tract and are potential pathogens that can cause serious infections like infective endocarditis and bacteremia. Penicillin or Ceftriaxone is the recommended first line agent for definitive therapy of VGS endocarditis. Alteration in penicillin binding proteins can decrease the susceptibility of VGS to penicillin and other beta-lactam agents and complicate antimicrobial therapy for serious VGS infections like Infective endocarditis. The aim of our study was to determine the antimicrobial susceptibility pattern of viridians group Streptococci isolated from blood samples of infective endocarditis patients from April 2018 to September 2023 against betalactam and other agents. MATERIAL AND METHODS: Three sets of blood cultures with 8-10 ml per bottle were collected from suspected infective endocarditis and incubated in automated blood culture system (BACTEC from BD diagnostics). The broth from positive bottles was streaked on Blood agar, Chocolate agar and MacConkey agar plates and incubated at 37°C. Alpha hemolytic Streptococci that grew after 24-48 h were further identified and antimicrobial susceptibility determined by Vitek 2 system. RESULTS: A total of 100 VGS was isolated from blood samples of Infective endocarditis patients. The species most commonly isolated in our study was S. sanguinis (25%) and S.mitis/oralis group (23%) followed by Non speciated Viridans Streptococci (17%). The lowest penicillin susceptibility ie. PEN MIC <0.12 µg/ml of 40% was observed in S. alactolyticus group, followed by S. mitis (52%) and S. gallolyticus (56%). S. mitis/oralis group showed the lowest susceptibilities to betalactam antibiotics among all speciated and non speciated VGS. CONCLUSION: Infective endocarditis carries a very high mortality and morbidity and the emergence of resistance to betalactam agents like penicillin will only narrow available therapeutic options and further challenge the treatment.

ROI extraction in corona virus (COVID 19) CT images using intuitionistic fuzzy edge detection.

Edge detection is a vital aspect of medical image processing, playing a key role in delineating borders and contours within images. This capability is instrumental for various applications, including segmentation, feature extraction, and diagnostic procedures in the realm of medical imaging. COVID-19 is a deadly disease affecting people in most of countries in the world. COVID-19 is due to the coronavirus which belongs to the family of RNA viruses and causes various symptoms such as pneumonia, fever, breathing difficulty, and lung infection. ROI extraction plays a vital role in disease diagnosis and therapeutic treatment. CT scans can help detect abnormalities in the lungs that are characteristic of COVID-19, such as ground-glass opacities and consolidation. This research work proposes an Intuitionistic fuzzy (IF) edge detector for the segmentation of COVID-19 CT images. Intuitionistic fuzzy sets go beyond conventional fuzzy sets by incorporating an additional parameter, referred to as the hesitation degree or non-membership degree. This extra parameter enhances the ability to represent uncertainty more intricately in expressing the degree to which an element may or may not belong to a set. The IF edge detector generates proficient results, when compared with the traditional edge detection algorithms and is validated in terms of performance metrics for benchmark images. Intuitionistic fuzzy edge detection has been shown to be effective in handling uncertainty and imprecision in edge detection.

Accuracy of Dolphin Imaging software in predicting soft tissue changes of Class II Division 1 incisor relationship treated by all first premolar extraction compared with post-treatment lateral cephalogram.

BACKGROUND: To quantify the accuracy of Dolphin Imaging software in predicting soft tissue changes of Class II Division 1 incisor relationship treated by all first premolar extraction compared with actual changes. METHODS: Pretreatment and post-treatment lateral cephalograms of 30 young adult subjects (25 females and 5 males; age range of 16 to 21 years) were imported and traced in Dolphin Imaging software (version 11.95). Tracings of actual treatment results and the Dolphin predicted treatment outcome were superimposed to calculate the prediction errors. The mean difference for the Holdaway soft tissue analysis and at each landmark was measured in both the X and Y axes. Paired t test was used to compare the statistical differences in Holdaway soft tissue analysis parameters. RESULTS: There were significant differences between the predicted and actual values in three parameters of the Holdaway soft tissue analysis (P < 0.05). The overall accuracy of estimation was better in vertical direction than horizontal. Prediction of upper and lower lip landmarks was overestimated horizontally and underestimated vertically, whereas that belonging to chin was underestimated horizontally and overestimated vertically. Soft tissue nasion and soft tissue A-point were most accurately predicted, whereas the least accuracy was found in soft tissue chin region. CONCLUSIONS: Dolphin Imaging Software (version 11.95) can be accurate enough for use in patient communication and education but should be used with caution. It is most accurate in predicting soft tissue changes in the nasion and A-point regions, but least accurate in chin region.

Emerging Strategies and Effective Prevention Measures for Investigating the Association Between Stroke and Sudden Cardiac Fatality.

Stroke-related cardiac death is a significant concern for patients with stroke and their healthcare providers. It is a complex and multifaceted condition that requires careful management of both modifiable and non-modifiable risk factors. This review provides an overview of the pathophysiology, risk factors, and prevention strategies for stroke-related cardiac death. The review highlights the importance of identifying and managing modifiable risk factors such as hypertension, diabetes, and lifestyle factors, as well as non-modifiable risk factors such as age and genetics. Additionally, the review explores emerging strategies for prevention, including the use of wearable devices and genetic testing to identify patients at risk, stem cell therapy and gene therapy for cardiac dysfunction, and precision medicine for personalized treatment plans. Despite some limitations to this review, it provides valuable insights into the current understanding of stroke-related cardiac death and identifies important areas for future research. Ultimately, the implementation of evidence-based prevention strategies and personalized treatment plans has the potential to improve outcomes for patients with stroke and reduce the burden of stroke-related cardiac death in the population.

Effect of Pb-exposure and B vitamin deficiencies on δ-aminolevulinic acid dehydratase activity among workers from Pb recycling plants.

Previous studies reported that Pb exposure causes a negative association with delta-aminolevulinic acid dehydratase activity (δ-ALAD), but the impact of Pb exposure (dose and time), B vitamin deficiencies, and lifestyle factors needs to be explored. In this study, the impact of Pb exposure, B vitamin deficiencies, and lifestyle factors on δ-ALAD activity among workers exposed to Pb from the Pb-recycling process was evaluated. Blood lead levels (BLLs), B vitamins (B6, B9, and B12), hematological factors (Hb% and HCT), lifestyle factors, and δ-ALAD activity was assessed in 170 male Pb-exposed workers engaged in the Pb recycling process. BLLs are estimated using the ICP-OES method. B vitamins in serum samples from workers were determined using the ELISA method. The δ-ALAD activity in whole blood samples was determined using the spectrophotometer method. The lifestyle factors were collected using a standard questionnaire. The δ-ALAD activity was significantly decreased in workers with the habits of alcohol use, tobacco consumption, hematocrit < 41%, mild and moderate categories of anemia, vitamin B6 and B12 deficiency, and BLL categories of 10-30, 30-50, and > 50 µg/dL. Multiple regression analysis revealed that the independent variables of alcohol consumption (ß = - 0.170; P = 0.025), BLLs (ß = - 0.589; P = 0.001) and Hb% (ß = 0.183; P = 0.001) significantly influenced the δ-ALAD activity with 44.2% (R2 = 0.442). Among the workers exposed to Pb from the Pb recycling plant, δ-ALAD activity was considerably reduced by Pb exposure, B vitamin deficiency, hematological parameters, and lifestyle factors.

Pathogenicity of white spot syndrome virus (WSSV) after multiple passages in mud crab, Scylla olivacea.

White spot syndrome virus (WSSV) is a highly virulent shrimp pathogen with a broad host range. Among the hosts, though mud crab, Scylla olivacea is reported to be more susceptible to WSSV than S. serrata and S. paramamosain, a detailed study on the pathogenicity and genome stability of the virus after multiple passages has yet to be reported. Firstly, to test the pathogenicity of the virus, WSSV was intramuscularly injected into healthy shrimp, Penaeus vannamei. Experimentally infected P. vannamei showed the first mortality at 36 h post-injection (hpi), followed by 100 % cumulative mortality in 7 days post-injection (dpi). However, S. olivacea injected with the WSSV inoculum derived from infected shrimp showed the first mortality at 48 hpi and a cumulative mortality of 70 % at the end of the ten days experiment. Subsequently, WSSV was sequentially passaged five times in Scylla olivacea to find out any change in the virulence of the virus in each passage. S. olivacea groups injected with 1st, second, third and fourth passages derived from the crab recorded the first mortality between 48 and 56 hpi and the cumulative mortality of 60 to 70 % at the end of the ten days experiment. Injection of WSSV inoculum in P. vannamei derived from multiple passages in S. olivaceae revealed the retention of the pathogenicity of the virus. Shrimp groups injected with WSSV derived from different passages showed first mortality between 24 and 36 hpi and cumulative mortality of 100 % between 6 and 7 dpi. The average viral load in the shrimp groups injected with WSSV inoculum derived from shrimp was 3.6 × 108, whereas in shrimp injected with the inoculum derived from 1st, third and fifth passages from crab showed 4.0 × 108, 4.7 × 108 and 4.3 × 108 copies per 100 ng DNA. Histological examination of the gill and stomach tissue of shrimp injected with inoculum prepared from shrimp as well as the inoculum derived from 1st, third and fifth passages in S. olivacea revealed characteristic pathological manifestations of the WSSV infection in gill and stomach tissues such as hypertrophied nuclei, Cowdry A-type inclusions as well as massive basophilic intranuclear inclusions. Further, to study the genome stability, the primers targeting highly variable regions of the WSSV genome (ORF94, ORF125, ORF75, variable region (VR) 14/15 and VR 23/24) were used to amplify WSSV derived from different passages and the amplified PCR products were sequenced. The sequence analysis revealed the WSSV genome stability after multiple passages in mud crab, S. olivacea.

Investigating the Molecular Interactions of Quinoline Derivatives for Antibacterial Activity Against Bacillus subtilis: Computational Biology and In Vitro Study Interpretations.

Bacterial infections are evolving and one of the chief problems is emergence and prevalence of antibacterial resistance. Moreover, certain strains of Bacillus subtilis have become resistant to several antibiotics. To counteract this menace, the present work aimed to comprehend the antibacterial activity of synthesized two quinoline derivatives against Bacillus subtilis. Toxicity predictions via Protox II, SwissADME and T.E.S.T (Toxicity Estimation Software Tool) revealed that these derivatives were non-toxic and had little to no adverse effects. Molecular docking studies carried out in Schrodinger with two quinoline derivatives (referred Q1 and Q2) docked against selected target proteins (PDB IDs: 2VAM and1FSE) of B. subtilis demonstrated ideal binding energies (2VAM-Q1: - 4.63 kcal/mol and 2VAM-Q2: - 4.46 kcal/mol, and 1FSE-Q1: - 3.51 kcal/mol, 1FSE-Q2: - 6.34 kcal/mol). These complexes were simulated at 100 ns and the outcomes revealed their stability with slight conformational changes. Anti-microbial assay via disc diffusion method revealed zones of inhibition showing that B. subtilis was inhibited by both Q1 and Q2, with Q2 performing slightly better than Q1, pointing towards its effectiveness against this organism and necessitating further study on other bacteria in prospective studies. Thus, this study demonstrates that our novel quinoline derivatives exhibit antibacterial properties against Bacillus subtilis and can act as potent anti-bacterials.

Efficacy and safety of the Arctic Sun device for hypoxic-ischemic encephalopathy in adult patients following cardiopulmonary resuscitation: A systematic review and meta-analysis.

AIM: The principal objective of this study was to carry out a comprehensive and thorough analysis to compare the safety and effectiveness of the Arctic Sun, a servo-controlled surface cooling device, with conventional cooling techniques for providing therapeutic hypothermia in adult patients who had experienced hypoxic-ischemic brain injury following cardiopulmonary resuscitation. METHODS: In order to achieve our goal, we conducted an extensive search of multiple databases including PubMed, Embase, Cochrane, and ClinicalTrials.gov up to the date of July 30, 2021. We only included studies that compared the safety and efficacy of the Arctic Sun surface cooling equipment with standard cooling approaches such as cooling blankets, ice packs, and intravenous cold saline for treating comatose adult patients who had recovered after experiencing cardiac arrest. We evaluated various outcomes, including all-cause mortality, good neurological outcome at 1 month, and the occurrence of adverse effects such as infections, shock, and bleeding. We employed a random-effects meta-analysis to estimate the odds ratio (OR) with 95% confidence intervals (CIs) for dichotomous outcomes. RESULTS: One hundred and fourteen records were identified through our search; however, only three studies met our eligibility criteria, resulting in overall 187 patients incorporated in the meta-analysis. The findings indicated no significant difference in mortality rates among the Arctic Sun device and conventional cooling techniques (OR: 0.64; 95% CI: 0.34-1.19; P = 0.16; I2 = 0%). In addition, we found no significant difference in occurrence of good neurological outcomes (OR: 1.74; 95% CI: 0.94-3.25; P = 0.08; I2 = 0%) between the two cooling methods. However, the application of the Arctic Sun device was associated with increased incidence of infections compared to standard cooling methods (OR: 2.46; 95% CI: 1.18-5.11; P = 0.02; I2 = 0%). While no significant difference occurred in the incidence of shock (OR: 0.29; 95% CI: 0.07-1.18; P = 0.08; I2 = 40%), the use of the Arctic Sun device was linked to significantly fewer bleeding complications compared to standard cooling methods (OR: 0.11; 95% CI: 0.02-0.79; P = 0.03; I2 = 0%). CONCLUSIONS: After analyzing the results of our meta-analysis, we concluded that the use of the Arctic Sun device for targeted temperature management following cardiopulmonary resuscitation did not result in significant differences in mortality rates or improve neurological outcomes when compared to standard cooling techniques.

Comparative Evaluation of Buccal Exfoliated Cells in Individuals with Diabetes Mellitus and Healthy Controls: A Cytomorphometric Analysis.

Background: Diabetes mellitus is the third most frequent cause of mortality and morbidity worldwide. Patients with diabetes exhibit a variety of oral symptoms, and hence the early detection of this condition can be addressed by a dentist. Aim: The current study aimed to study the cytomorphometric alterations of buccal exfoliated cells in individuals with type II diabetes mellitus. Methodology: The study included thirty diabetics and thirty healthy controls. The smears were obtained from the buccal mucosa and stained with Papanicolaou stain and hematoxylin and eosin stain. The presence of inflammatory cells, microbial carriage, nuclear enlargement, and perinuclear halo and binucleation were examined on the slides. Cellular and nuclear parameters were quantitatively measured using Image J software. Statistical analysis was done using SPSS software, and the Student's t-test was employed. Results: No inflammatory cells or microbes were observed in Group I individuals; however, the perinuclear halo was observed in 16.6% and binucleated cells in 3.3% of the controls. Inflammatory cells, consisting mainly of neutrophils and lymphocytes were seen in 40%, microbial carriage in 26.6%, perinuclear halo in 73.3%, and binucleated cells in 36.6% of the diabetic patients. The mean nuclear diameter, area, and nuclear-cytoplasmic ratio were significantly high in diabetic patients when compared to healthy controls. Conclusion: Oral exfoliated mucosal cells of patients with diabetes mellitus exhibit distinct cytomorphometric alterations such as increased nuclear diameter, nuclear area, and nuclear-cytoplasmic ratio.

Comparative study of concurrent conventional chemoradiotherapy versus hypofractionated chemoradiotherapy in newly diagnosed glioblastoma multiforme postoperative patients.

Purpose: To assess the treatment response and toxicity profile among two groups of newly diagnosed glioblastoma multiforme (GBM) postoperative patients receiving conventional radiotherapy (RT) versus hypofractionated RT with concurrent temozolomide (TMZ) in both. Materials and Methods: A total of 50 patients randomly allotted into two arms (25 in each). Dose received 60 Gy (2 Gy/#) in conventional fractionation RT versus 50 Gy (2.5 Gy/#) in hypofractionated RT with concurrent TMZ 75 mg/m2 orally daily in both arms, respectively. Follow-up was done at 1, 3, 6, and 12 months after completion of treatment to evaluate toxicities, treatment response, and progression-free survival (PFS). Results: All patients were well tolerated with treatment; no major adverse effects were monitored in two arms. There was no statistical significant difference in treatment response, which was found 64% versus 60% in arm A and arm B, respectively, at 3 months of follow-up (P = 0.768). Toxicity profiles were also noted similar in both arms. The 6-month PFS was 84% and 80% in arm A and arm B, respectively (P = 0.71) and 12-month PFS was 60% and 52% in arm A and arm B, respectively (P = 0.69). Conclusion: Among the patients followed, this study showed that hypofractionated RT regimen was not inferior to conventional RT regimen.

Interfraction variations in doses at OARs during three-dimensional high dose rate brachytherapy planning of cervix cancer.

Objective: The American Brachytherapy (BT) Society recommends that BT must be included as a component of the definitive radiation therapy for cervical carcinoma because recurrences and complications are decreased when BT is used in addition to external beam radiotherapy. The aim of this study is to quantify the interfraction dose variations (VARacts) during high dose rate (HDR) BT, the effect of variation in dose in terms of excess "unrecognized" dose to OAR and to conclude the reason of the variation in reference of applicator position/geometry versus deformation of the organ at risk (OAR) concerned. Materials and Methods: Total 30 patients of carcinoma cervix, biopsy proven, between June 2018 and May 2019, were taken for the study. All patients were treated with external beam radiation therapy to a dose of 50 Gy in 25 fractions over 5 weeks, followed by three fractions of HDR intracavitary brachytherapy (ICBT) (7.5 Gy to point A in each fraction) by two-dimensional (2D) X-ray-based planning. Before treatment in the first and last fraction of BT, computed tomography (CT) scan was done for every patient. Then, a 3D-based planning was performed with CT images on our HDR Plus software with image sequence option. VARact was calculated. Rigid image registration of consecutive fraction images was used for quantification of the hypothetical variation in dose (VARhypo) arising exclusively due to changes in applicator placement and geometry. Results: The mean contoured rectal volumes for the first and third fractions were 41.49 cc and 44.72 cc, respectively, while the respective volumes for bladder were 9.33 cc and 9.35 cc cm. These differences were statistically insignificant (P value: 0.263 and 0.919 for rectum and bladder, respectively). The mean equivalent dose in 2 Gy fraction (EQD2) bladder D2cc was 5.68 Gy and 5.79 Gy in the first and third fraction ICBT, respectively. The mean EQD2 for the rectal D2cc was 11.63 Gy and 12.85 Gy in the first and third fraction ICBT, respectively. None of the patients had an actual cumulative EQD2 more than 90 Gy for bladder, but 36.66% of the patients had a rectal dose exceeding the tolerance (75 Gy). Regression plots showed that VARhypo alone could predict about 42.2% of the VARact in the rectum and 19.2% of the VARact in the bladder. Thus, the remaining variation was due to the organ deformation-related dose variations between the two fractions. Conclusions: There were no statistically significant variations in the volumes or doses of OAR between the two fractions. However, a significant proportion of patients may have a higher dose to the OAR in the third fraction in the absence of individualized planning. This increase is likely to be more detrimental where higher doses per fraction are used. Variations in OAR doses may be caused by organ deformation and/or changes in applicator placement/geometry.

Bilateral orthodontic extractions using physics versus conventional forceps among Indian patients.

It is of interest to assess whether or not physics forceps are superior to traditional forceps for the extraction of premolar teeth in orthodontic procedures. Tooth and buccal bone fractures, as well as extraction time, lacerated gingiva, postoperative discomfort, and infection, were all measured in this research of both types of forceps extraction. Twenty individuals who need orthodontic extraction on both jaws were enrolled in the research. One arch's premolars were removed in two appointments, the first using Physics forceps and the second using conventional ones. The subsequent assignment included extraction from the obverse arch. Intraoperative evaluations included assessments of factors such as tooth and buccal bone fractures, surgical time, and gingival lacerations; postoperative assessments of pain and infection were conducted on days 1, 3, and 7. With physics forceps, the average time to remove a patient's mandible was 86.55 seconds, whereas traditional forceps required just 35.70 seconds. Using traditional forceps, the average pain score was 0.865 on day one after surgery, but with physics forceps, it was 3.30. The use of physics forceps resulted in one buccal bone fracture out of twenty premolar extractions. That so, no meaningful statistical change was seen. There was no tooth damage or post-operative infection with either set of forceps, it was found. Each forceps caused a Grade I laceration to the gingiva. The average time required removing a maxillary using physics forceps was 224.05 seconds, whereas the time required doing it with conventional forceps was 141.50 seconds. On a Visual Analogue Scale (VAS), the average first-day pain after surgery using physics forceps was 4.90, whereas using traditional forceps resulted in just 3.15. The difference between using physics forceps and regular forceps was statistically significant by the third postoperative day (2.05 vs 0.75). There was a statistically insignificant increase in the occurrence of buccal bone fracture and tooth fracture while using physics forceps. Both forceps and scissors caused just grade I lacerations, and there was no postoperative infection. These findings suggest that the use of physics forceps, as opposed to conventional forceps, may significantly lengthen the time required to remove orthodontic premolars on both sides of the mouth. Non-significant results were also found for additional criteria such as buccal bone fracture, tooth fracture, gingival laceration, and post-operative discomfort. When it comes to orthodontic premolar extraction, this research found that traditional forceps performed better than modern forceps across a range of measures, including intraoperative time and postoperative discomfort.

Assessment of the diagnostic accuracy of Vibrasense compared to a biothesiometer and nerve conduction study for screening diabetic peripheral neuropathy.

AIMS: Peripheral neuropathy is a common microvascular complication in diabetes and a risk factor for the development of diabetic foot ulcers and amputations. Vibrasense (Ayati Devices) is a handheld, battery-operated, rapid screening device for diabetic peripheral neuropathy (DPN) that works by quantifying vibration perception threshold (VPT). In this study, we compared Vibrasense against a biothesiometer and nerve conduction study for screening DPN. METHODS: A total of 562 subjects with type 2 diabetes mellitus underwent neuropathy assessments including clinical examination, 10-g monofilament test, VPT evaluation with Vibrasense and a standard biothesiometer. Those with an average VPT ≥ 15 V with Vibrasense were noted to have DPN. A subset of these patients (N = 61) underwent nerve conduction study (NCS). Diagnostic accuracy of Vibrasense was compared against a standard biothesiometer and abnormal NCS. RESULTS: Average VPTs measured with Vibrasense had a strong positive correlation with standard biothesiometer values (Spearman's correlation 0.891, P < 0.001). Vibrasense showed sensitivity and specificity of 87.89% and 86.81% compared to biothesiometer, and 82.14% and 78.79% compared to NCS, respectively. CONCLUSIONS: Vibrasense demonstrated good diagnostic accuracy for detecting peripheral neuropathy in type 2 diabetes and can be an effective screening device in routine clinical settings. TRIAL REGISTRATION: Clinical trials registry of India (CTRI/2022/11/047002). Registered 3 November 2022.  https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=76167 .

CD44 Expression in Oral Lichen Planus and Related Lesions-An Immunohistochemical Study.

Background: Cluster of differentiation 44 (CD44) is a cell surface adhesion protein involved in the progression and metastasis of oral squamous cell carcinoma. The current study aims to evaluate the expression of CD44 in oral lichen planus and related lesions and thereby assess the relative risk of malignant transformation of these lesions. Materials and Methods: Formalin-fixed paraffin-embedded tissue blocks of 10 oral lichen planus (Group 1), 10 oral lichenoid lesions (Group 2), 8 with oral lichen planus with dysplasia (Group 3), and 5 with lichenoid dysplasia (Group 4) were included in the study. Immunostaining was done for the tissue sections using CD44 mouse monoclonal antibody. Staining density, staining intensity, and immunoreactive scores of CD44 were evaluated in all four groups. Statistical analysis was done by Statistical Package for the Social Sciences® software and the Kruskal-Wallis test was used. Results: CD44 staining pattern of lichenoid dysplasia and lichen planus with dysplasia changed from membranous to cytoplasmic. The membranous CD44 immunoreactivity was mild with a score of 2.25 for Group 3 and 1.6 for Group 4 whereas moderate for other groups with a P-value of 0.009. The cytoplasmic immunoreactivity was significantly high in Group 3 (5.3 ± 2.6) followed by Group 4 (3.2 ± 1.2), Group 2 (1 ± 1.8), and Group 1 (0.7 ± 1.3) with a P-value of 0.001. Conclusion: The CD44 membranous immunoreactivity scores were low while the cytoplasmic immunoreactivity was high in oral lichen planus with dysplasia and oral lichenoid dysplasia when compared to oral lichen planus and oral lichenoid lesions. CD44 immunostaining pattern can help in assessing the malignant transformation of oral lichen planus or lichenoid lesions.

Current management of appendicular mas - a narrative review.

Appendicular mass is considered as one of the complications of acute appendicitis but there is no consensus on the optimal management of this condition. The management of this condition has always been conservative management with interval appendectomy as popularized by Oschner and Sheerin. The need for interval appendectomy has now been questioned, and an emerging trend has been early appendectomy by laparoscopic method. There are no guidelines on the management of appendicular mass and treatment is decided by the surgeon. We have conducted a narrative review to investigate what is the current practice in the management of appendicular mass.

Synthesis, crystal structure and Hirshfeld surface analysis of naphthalene-2,3-diyl bis-(3-benz-yl-oxy)benzoate.

In the title compound, C38H28O6, the dihedral angles between the naphthalene ring system and its pendant benz-yloxy rings A and B are 88.05 (7) and 80.84 (7)°, respectively. The dihedral angles between the A and B rings and their attached phenyl rings are 49.15 (8) and 80.78 (8)°, respectively. In the extended structure, the mol-ecules are linked by weak C-H⋯O and C-H⋯π hydrogen bonds, and π-π stacking inter-actions, which variously generate C(11) chains and R 2 2(12) loops as part of a three-dimensional network. The Hirshfeld surface [fingerprint contributions = H⋯H (42.3%), C⋯H/H⋯C (40.3%) and O⋯H/H⋯O (15.7%)] and inter-molecular inter-action energies are reported, with dispersion (E dis = -428.6 kJ mol-1) being the major contributor.