Bioselective and Radiopaque Zinc-Biopolymeric Complex-Based Porous Biomaterials Promote Mammalian Tissue Ingrowth In Vivo While Inhibiting Microbial Biofilm Gene Expression and Biofilm Formation.

Metal-organic complexes have shown astounding bioactive properties; however, they are rarely explored as biomaterials. Recent studies showed that carboxymethyl-chitosan (CMC) genipin-conjugated zinc biomimetic scaffolds have unique bioselective properties. The biomaterial was reported to be mammalian cell-friendly; at the same time, it was found to discourage microbial biofilm formation on its surface, which seemed to be a promising solution to addressing the problem of trauma-associated biofilm formation and development of antimicrobial resistance. However, the mechanically frail characteristics and zinc overload raise concerns and limit the potential of the said biomaterials. Hence, the present work is focused on improving the strength of the earlier scaffold formulations, testing its in vivo efficacy and reaffirming its action against biofilm-forming microbe Staphylococcus aureus. Scaling up of CMC proportion increased rigidity, and 8% CMC was found to be the ideal concentration for robust scaffold fabrication. Freeze-dried CMC scaffolds with or without genipin (GP) cross-linking were conjugated with zinc using 2 M zinc acetate solution. Characterization results indicated that the CMC-Zn scaffolds, without genipin, showed mechanical properties close to bone fillers, resist in vitro enzymatic degradation until 4 weeks, are porous in nature, and have radiopacity close to mandibular bones. Upon implantation in a subcutaneous pocket of Wistar rats, the scaffolds showed tissue in-growth with simultaneous degradation without any signs of toxicity past 28 days. Neither were there any signs of toxicity in any of the vital organs. Considering many superior properties among the other formulations, the CMC-Zn scaffolds were furthered for biofilm studies. CMC-Zn showed negligible S. aureus biofilm formation on its surface as revealed by an alamar blue-based study. RT-PCR analysis revealed that CMC-Zn downregulated the expression of pro-biofilm effector genes such as icaC and clfB. A protein docking study predicted the inhibitory mechanism of CMC-Zn. Although it binds strongly when alone, at high density, it may cause inactivation of the transmembrane upstream activators of the said genes, thereby preventing their dimerization and subsequent inactivation of the effector genes. In conclusion, zinc-conjugated carboxymethyl-chitosan scaffolds are mechanically robust, porous, yet biodegradable, harmless to the host in the long term, they are radiopaque and prevent biofilm gene expression in notorious microbes; hence, they could be a suitable candidate for bone filler applications.

Exploring Knowledge, Awareness, and Practices Regarding Periodontal Health Assessment and Mechanical Plaque Control Among the Shillong Population of Meghalaya, India: A Descriptive Cross-Sectional Investigation.

Background Periodontal diseases are widespread oral health conditions. However, there remains a lack of comprehensive understanding regarding the knowledge, awareness, and practices related to periodontal health assessment and mechanical plaque control among specific populations, such as those residing in Shillong, Meghalaya. Shillong, being the capital city of Meghalaya in northeastern India, represents a diverse demographic and cultural landscape. Aim This study aims to evaluate the knowledge, awareness, and practices related to mechanical plaque control among the population of Shillong City. Methodology A descriptive cross-sectional online survey was conducted among the residents of Shillong City, Meghalaya. Data collection involved the administration of an 18-item, closed-ended, self-structured questionnaire. Before the main data collection, a pilot study was conducted involving 63 individuals. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA), employing the chi-square test and ANOVA with a significance level of 0.05. Results Study participants were categorized into five age groups spanning from 21 to 64 years old, with the age group of 41 to 50 years demonstrating the highest mean knowledge score. Age exhibited a statistically significant influence on knowledge scores. Conclusion The study reveals a commendable level of knowledge, awareness, and adherence to practices regarding the primary tool for oral hygiene maintenance, the toothbrush, among the residents of Shillong City.

Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study.

AIM: The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth. MATERIALS AND METHODS: The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed. RESULTS: The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third. CONCLUSION: On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent. CLINICAL SIGNIFICANCE: Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study.

AIM: The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface. MATERIALS AND METHODS: This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed. RESULTS: After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05). CONCLUSION: The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice. CLINICAL SIGNIFICANCE: The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al. Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Anionic species from multivalent metal salts are differentially retained during aqueous ionic gelation of sodium alginate and could fine-tune the hydrogel properties.

The role of anionic counterions of divalent metal salts in alginate gelation and hydrogel properties has been thoroughly investigated. Three anions were selected from the Hofmeister series, namely sulphate, acetate and chloride, paired in all permutations and combinations with divalent metal cations like calcium, zinc and copper. Spectroscopic analysis revealed the presence of anions and their interaction with the respective metal cations in the hydrogel. The data showed that the gelation time and other hydrogel properties were largely controlled by cations. However, subtle yet significant variations in viscoelasticity, water uptake, drug release and cytocompatibility properties were anion dependent in each cationic group. Computational modelling based study showed that metal-anion-alginate configurations were energetically more stable than the metal-alginate models. The in vitro and in silico studies concluded that acetate anions preceded chlorides in the drug release, swelling and cytocompatibility fronts, followed by sulphate anions in each cationic group. Overall, the data confirmed that anions are an integral part of the metal-alginate complex. Furthermore, anions offer a novel option to further fine-tune the properties of alginate hydrogels for myriads of applications. In addition, full exploration of this novel avenue would enhance the usability of alginate polymers in the pharmaceutical, environmental, biomedical and food industries.

In Vitro Assessment of Different Toothbrush Designs on Enamel Surface Abrasion: A Profilometric Study.

AIM: The purpose of this study was to evaluate the impact of three different toothbrush designs on enamel surface abrasion. MATERIALS AND METHODS: Sixty intact freshly extracted maxillary central incisors were considered for the study. All of the extracted teeth's surfaces were severely trimmed, leaving only the labial surface intact. In the trial, a conventional teeth-whitening dentifrice slurry was utilized. A brushing model was created to deliver uniform force in unidirectional motion. Dontrix Gauge was used to control the tension of the spring. The force was kept constant at 180 ± 20 g. The mounted enamel samples were separated into three groups (20 samples each) at random: group A: toothbrushes have a flat trim bristle design, group B: toothbrushes have a zigzag pattern, and group C: toothbrushes have a bi-level bristle design. For 2 weeks, each sample was brushed twice daily for 2 minutes. A profilometer was used to measure the average surface roughness. RESULTS: After toothbrushing, the maximum mean surface roughness score was found in zigzag pattern group (2.10 ± 0.23), followed by bi-level bristle design group (2.06 ± 0.12) and the least was in the flat trim bristle design group (1.96 ± 0.09). There was a significant difference between the different toothbrush bristle pattern groups (p < 0.001). CONCLUSION: On conclusion, the results of this study showed that, in comparison to toothbrushes with zigzag patterns and bi-level bristle designs, flat trim toothbrush bristle designs cause the least amount of surface abrasion and are relatively safe to use. CLINICAL SIGNIFICANCE: Toothbrushing with toothpaste contributes significantly to dental abrasion. A variety of parameters, including toothpaste abrasivity and concentration, brushing frequency, brushing length, brushing force, and toothbrush bristle stiffness, have the potential to influence the abrasion process of dental hard tissue.

Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study.

AIM: The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion. MATERIALS AND METHODS: A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope. RESULTS: In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20). CONCLUSION: The present study concluded that the fluoride dentifrices' preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride. CLINICAL SIGNIFICANCE: Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.

Assessment of the Impact of Commonly used Beverages on Durability of Suture Materials: An In Vitro Study.

Aim: The current study was conducted to evaluate the influence of frequently ingested beverages on the stability of suture materials. Materials and Methods: This research comprised of two kinds of chromic catgut, polyglactin 910 (4-0) absorbable suture materials. Every specimen was subjected to tying using a square surgeon's knot. Subsequent to pretensioning, 80 suture samples (40 of every material) were employed in this research. Every specimen was subjected to immersion in artificial saliva to replicate the oral atmosphere. Specimens were sunken in the acidic drink (Coca Cola) and tea for 10 min every day. Tensile strengths of the suture specimens were subjected to test at particular time periods: before immersion and 1, 7, and 14 days after immersion. Tensile strength evaluation of the suture specimens was performed employing the microtensile tester at a cross-head speed of 2.0 mm/60 s. Results: When subjected to exposure to acidic beverages, the tensile strength of chromic catgut suture before immersing was 25.14 ± 0.16, 25.02 ± 0.08 on the first day, 16.34 ± 0.23 on the seventh day, and 9.18 ± 0.28 on the fourteenth day. When the suture substance made contact with tea, the tensile strength before immersing was 24.48 ± 0.02, 24.14 ± 0.16 on the first day, 18.26 ± 0.11 on the seventh day, and 12.39 ± 0.14 on the fourteenth day. When subjected to exposure to acidic beverages, the tensile strength of polyglactin 910 sutures before immersing was 25.21 ± 0.02, 25.08 ± 0.01 on the first day, 18.12 ± 0.06 on the seventh day, and 10.06 ± 0.32 on the fourteenth day. When the suture substance made contact with tea, the tensile strength before immersing was 25.02 ± 0.14, 24.96 ± 0.04 on the first day, 20.48 ± 0.18 on the seventh day, and 14.10 ± 0.08 on the fourteenth day. The differences between the groups were statistically significant. Conclusion: In conclusion, polyglactin 910 exhibited a maintained strength superior than chromic catgut sutures subsequent to 14 days.

Antimicrobial Efficacy of Three Different Mouthwashes on Periodontal Pathogens-An In vitro Study.

Aim: The aim of this research was to identify the antimicrobial effectiveness of three different mouthwashes on periodontal pathogenic microorganisms. Materials and Methods: 2 periodontal disease-causing microorganisms, i.e., Aggregatibacter actinomycetemcomitans, and Porphyromonas gingivalis, were chosen for this investigation. Prior to commencing this research, a variety of branded and commercially obtainable mouthwashes were procured. Three oral rinses, namely HiOra, Hexidine, and Amflor, were chosen for the current research. The subculture of A. actinomycetemcomitans as well as P. gingivalis was performed by subjecting them to incubation for 48 to 72 hours at 35-37°C. The disk diffusion method was employed to evaluate the antibacterial efficiency of the extract in opposition to the pathogens tested. The zone of inhibition was calculated in millimeters. The mean value of every sample was documented. Results: Hexidine oral rinse in pursuit by Amflor as well as HiOra oral rinse exhibited the highest zone of inhibition in opposition to A. Actinomycetemcomitans and P. gingivalis. The differences amid the groups were statistically significant with a P value < 0.001. Conclusion: The current research concluded that amid the three different oral rinses employed in the current research, Hexidine oral rinse exhibited greatest antimicrobial effectiveness versus Amflor and HiOra mouthrinse.

A Study on Speech Analysis in Acquired Maxillary Defect Patients Treated with Maxillary Obturator.

Aim: The aim of the present study was to assess the speech analysis in acquired maxillary defect patients treated with maxillary obturator. Materials and Methods: Total of 16 patients were considered in the study. The age group of these patients ranged from 40 to 75 years with a mean age of 59.5 years, irrespective of their gender. The surgical obturator was fabricated using self-cure acrylic. The surgical obturator was delivered immediately after surgery. After a healing period of about 2 weeks, the surgical obturator was replaced by an interim prosthesis. This was processed with the help of heat-cure polymethylmethacrylate. The total number of patients was divided into two groups, namely, (A) Definitive obturator group and (B) Interim obturator group. The speech intelligibility (SI), was analyzed. Results: The mean scores for SI before prosthesis in definitive and interim groups were 19.13 ± 3.22 and 19.87 ± 1.72, respectively. This was increased after prosthesis insertion to 24.38 ± 1.30 and 22.37 ± 1.18, which further increased after adaptation period of 2 months to 28.75 ± 1.28 and 24.62 ± 1.59 in two groups. Conclusion: The present study concluded that speech was severely affected by maxillary resection and that rehabilitation with maxillary obturator was successful in restoring these aspects of speech.

Evaluation of Root Dentin Damage during Retreatment Procedure using Various Engine-Driven Retreatment File Systems-A Micro-CT Study.

Aim: The aim of this research was to assess the damage to root dentin that arises from retreatment with different engine-driven NiTi retreatment files employing micro-computed tomography. Materials and Methods: Sixty mandibular premolar teeth having a single root and root canal that were recently extracted were gathered and stored. The specimens were de-coronated at the cementoenamel junction under water irrigation to achieve a homogeneous root length of 16 millimeters. Gutta-percha cones were coated with sealants and placed within the radicular canal till the WL. All sixty premolars were randomly assigned to one of the following three groups, with every group comprising 20 sample teeth each. Group 1: MTwo Retreatment files, Group 2: ProTaper Universal Retreatment files, Group 3: Edge File XR Retreatment rotary files. The quantity of root dentinal injury was estimated by deducting the dentin volume (mm3) in the pre- and post-therapy micro-CT scans at apical, middle, and cervical 3rd points. Results: An intra-group comparative scrutiny showed that lower radicular dentinal injury was noted at apical 3rd (0.31 ± 0.16, 0.62 ± 0.02) in Edge File XR Retreatment file system and MTwo Retreatment file system in that order. The statistically significant disparity was seen amid the MTwo Retreatment file, Edge File XR Retreatment file system and ProTaper Universal Retreatment file, Edge File XR Retreatment file system with P value of 0.001on intergroup assessment. Conclusion: In spite of the limitations that this research had, it was inferred that each assessed file system proficiently eradicated the obturated material through the retreatment procedure performed. In addition, it was seen that the Edge File XR group showed lesser root dentin damage in contrast to MTwo and ProTaper Universal file systems.

Knowledge, attitudes and practices of resident doctors and interns on safe blood transfusion practices: a survey-based study

ABSTRACT Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

The exclusion of anti-D alloantibody in a suspected anti-G antibody in a pregnant 28-year-old Odiya Indian woman.

The Rh-D negative pregnancy is commonly associated with alloimmunization against D-antigen. It can be prevented by anti-D prophylaxis in pregnant patients with negative results on antibody screening. Hence, it is essential to exclude alloantibody-D in the presence of multiple alloantibodies. Anti-G antibody is formed after exposure to G antigen in neonate RBCs. Blood-group discrepancy was noted in reverse grouping, and antibody-screening results were positive in our case individual, a 28-year old Odiya Indian woman. We performed antibody identification on serum specimens from this patient, which revealed the pattern of anti-D + anti-C antibody specificity. Blood-group discrepancy was solved using rr (ce/ce)-phenotype pooled cells for reverse grouping. We identified anti-G antibodies by themselves without anti-D and anti-C after performing sequential adsorption of serum with r'r' (Ce/Ce) and R2R2 (DcE/DcE) group-O RBCs in the mother, who had rr phenotype and primigravida designation. After completing antibody screening at the first antenatal check-up, we recommended prophylactic anti-D for the mother in any future pregnancies she may have.

Estimation of Gingival Crevicular Blood as Noninvasive Method to Determine the Blood Glucose Level: A Comparative Study.

AIM: The current study's aim was to assess gingival crevicular blood as a noninvasive method to measure blood glucose levels. MATERIALS AND METHODS: The current study comprised a total of 50 patients who had been diagnosed with chronic periodontitis and age was ≥30 years old. The study's procedures were carried out after receiving informed consent. For finger capillary blood collection method, a sterile lancet was used to prick the finger and a drop of blood was taken, for gingival crevicular blood collection method, blood was taken from the gingival margin of the chosen site, and for venous blood collection method with the aid of a disposable syringe, a venous blood sample was taken from the patient's antecubital fossa for determining blood glucose levels. One-way analysis of variance (ANOVA) was used to examine the differences between the three methodologies' significance, and Karl Pearson's correlation (r) was used to determine their correlation. RESULTS: The maximum glucose level was found in venous blood (187.78 ± 18.23), followed by finger capillary blood (181.88 ± 21.67) and gingival crevicular blood (169.04 ± 11.24). And there was no significant difference between the different blood collection methods (p > 0.05). The positive significant correlation was found between gingival crevicular blood and finger capillary blood (r = 0.912, p < 0.001). Correlation with gingival crevicular blood and venous blood showed a positive correlation (r = 0.898, p < 0.001). Correlation between venous blood and finger capillary blood also showed a strong positive correlation (r = 0.988, p < 0.001). CONCLUSION: In conclusion, the findings of the current study suggest that blood drawn from the gingival crevicular during a clinical examination may be a great source for glucometric analysis. The gingival crevicular blood may show to be a promising technique for routine dental office screening for diabetes mellitus in periodontal patients, even if capillary/venous blood samples used for diabetes mellitus screening are the gold standard. CLINICAL SIGNIFICANCE: Oral health is crucial for the early detection of many systemic disorders. As a result, dentists are crucial in the screening for systemic disorders. One of the prevalent chronic disorders is diabetes. Any systemic disease that is detected early enough can avoid long-term problems.

A SEM Evaluation of the Permeability of Different Desensitizing Methods on Occlusion of Dentinal Tubules: An In-vitro Study.

AIM: The purpose of the current research was to assess the permeability of three various desensitizing techniques on dentinal tubule occlusion using a scanning electron microscope (SEM). MATERIALS AND METHODS: For this research, 100 human sound premolar teeth that were extracted for orthodontic purposes were gathered. With the aid of a water-cooled diamond saw, the teeth were divided in a mesiodistal (vertically) orientation. A sectioned sample (5 mm long by 5 mm wide by 3.5 mm deep), including the cervical region, was taken from each buccal side. To fully open the dentinal tubules, these samples were then kept in 17% ethylenediaminetetraacetic acid (EDTA) for 40 minutes. The samples were divided into four groups (n = 25), each receiving the following dentin surface treatments: Group I: Control, Group II: Samples received NaF 5% varnish treatment, Group III: Samples received diode laser treatment, and Group IV: Samples received CPP-ACP treatment. An SEM was used to inspect each specimen at a magnification of about × 3000 and photomicrographs was assessed. RESULTS: The maximum occlusion of dentinal tubules was found in samples were treated with Diode laser (2.96 ± 0.14) followed by samples treated with NaF 5% varnish (3.38 ± 0.10), samples were treated with CPP-ACP (3.42 ± 0.06) and control group (4.26 ± 0.19). There was a statistically significant difference found between the groups. CONCLUSION: In conclusion, all three desensitizing methods used in the present study were successful in the occlusion of dentin tubules. But the application of the Diode laser was effective in the reduction of dentin permeability compared to NaF 5% varnish and CPP-ACP. CLINICAL SIGNIFICANCE: Dentin hypersensitivity (DH) is characterized by a brief period of intense discomfort. One approach to managing DH is to obstruct dentin tubules in order to decrease dentin permeability. There are many substances that can reduce hypersensitivity, but the finest commercially available substance for treating the condition by occluding the tubes should be acknowledged.

A comparative evaluation of the quality of cryoprecipitate prepared from 350 ml versus 450 ml of whole blood and different methods of thawing of plasma: A prospective observational study.

INTRODUCTION: Cryoprecipitate is used in conditions like hypofibrinogenemia, massive transfusion with bleeding, and factor XIII deficiency. The current guidelines support the preparation of cryoprecipitate from 450 ml whole blood. But 350 ml of whole blood collection is expected from low body weight (<55 kg) donors. However, no standardized criteria exist for preparing cryoprecipitate from 350 ml of whole blood. AIM OF THE STUDY: This study compared the fibrinogen and factor VIII levels in cryoprecipitate units prepared from 350 ml versus 450 ml whole blood collection. The study also compared the fibrinogen and factor VIII levels prepared by circulating water bath versus blood bank refrigerator (BBR) thawing method. METHODOLOGY: A total of 128 blood bags were equally divided into groups A and B for 450 and 350 ml whole blood collection further subdivided into subgroups based on thawing methods. The fibrinogen and factor VIII yield were analyzed in the cryoprecipitates prepared from both groups. RESULTS: The factor VIII levels were significantly higher in cryoprecipitate made from 450 ml whole blood collection (P = 0.02). The BBR method of plasma thawing resulted in better fibrinogen recovery than the cryo bath method. Whereas vice versa in the case of factor VIII recovery. A weak but significant positive correlation was noted in factor VIII levels with the plasma volume. CONCLUSION: Over 75% of the cryoprecipitates prepared from 350 ml whole blood passed the fibrinogen and factor VIII quality control criteria. So, 350 ml whole blood collection from low body weight (<55 kg) donors could be utilized to prepare cryoprcipitates. However, future clinical studies should focus on the cryoprecipitate's clinical efficacy prepared from 350 ml of whole blood.

Hemolytic Disease of Newborn due to ABO Incompatibility between B Blood Group Mother and A Blood Group Neonate.

ABO incompatibility between O blood group mother and non-O blood group neonate is common. It rarely causes anemia and hyperbilirubinemia in neonate, requiring invasive management. Direct antiglobulin test may be positive in these cases with immunoglobulin (Ig)-G antibody specificity. There are few cases of hemolytic disease of newborn due to ABO incompatibility between mother and newborn with non - O blood group mother. After obtaining consent from the patient, we reported a case of incompatibility in a B blood group mother and A blood group neonate, and it was managed with phototherapy.

Impact of dose and storage duration of platelet concentrates on platelet recovery between ABO identical and ABO non-identical random donor platelet transfusions in hemato-oncology patients.

INTRODUCTION AND OBJECTIVES: It is challenging to adopt a policy of ABO identical platelet transfusion in hemato-oncological patients because of the high demand. Moreover, there are no global standards for the management of ABO non-identical platelet transfusions due to limited evidence. The current study compared the impact of dose and storage duration of platelets on percent platelet recovery (PPR) at 1 h and 24 h between ABO identical and ABO non-identical platelet transfusions in hemato-oncological conditions. The other objectives were to assess the clinical efficacy and compare adverse reactions between the two groups. METHODS: A total of 130 random donor platelet transfusion episodes (81 ABO identical and 49 ABO non-identical) were evaluated in 60 eligible patients with different malignant, as well as non-malignant, hematological conditions. All analysis was performed using two-sided tests, and p-values <0.05 were considered significant. RESULTS: The PPR at 1 h and 24 h was significantly higher in ABO identical platelet transfusion. Platelet recovery and survival were not affected by the gender, dose or storage duration of platelet concentrate. Aplastic anemia and myelodysplastic syndrome (MDS) disease conditions were observed to be independent risk predictors for 1-h post-transfusion refractoriness. CONCLUSION: ABO identical platelets have higher platelet recovery and survival. Both ABO identical and ABO non-identical platelet transfusions have similar efficacy in controlling bleeding episodes up to World Health Organization (WHO) grade two. Assessment of other factors, such as platelet functional properties in the donor, anti-HLA and anti-HPA antibodies, may be needed to better understand the platelet efficacy of platelet transfusions.

Knowledge, attitudes and practices of resident doctors and interns on safe blood transfusion practices: a survey-based study.

INTRODUCTION: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. METHODS: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. RESULT: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. CONCLUSION: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

Hemolytic disease of the fetus and newborn due to minor blood group alloimmunization in a mother of sickle cell disease with multiple alloantibodies.

Hemolytic disease of the fetus and newborn is due to maternal IgG antibodies that transport through the placenta and destroy neonatal red cells. A mismatch of antigens between mother and fetus causes isoimmunization resulting in mild anemia, which may progress to fetal hydrops in the intrauterine period and severe hyperbilirubinemia to kernicterus in neonates. The isoimmunization is mainly caused by Rh-D and ABO antibodies. In this case report, we found neonatal hyperbilirubinemia due to the presence of anti-c alloantibody previously developed in a sickle cell disease (SCD) pregnant female. It is an unusual case of fetal hyperbilirubinemia due to minor blood group alloimmunization in a SCD needing exchange transfusion. Multi-transfused patients should be counseled regarding the need to perform antibody screening frequently before pregnancy for better treatment of both mother and child.