Maxillary Mucormycotic Osteonecrosis as a Manifestation of Post-COVID-19 Infection in Non-diabetic Patients: Report of Two Cases.

Mucormycosis is a rare, opportunistic fungal infection prevalent in the elderly, especially in patients with uncontrolled diabetes or a compromised immune system. However, the outbreak of the pandemic declared by the World Health Organization in late 2019 increased the incidence of mucormycosis cases in COVID-19 patients due to increased steroid usage that resulted in an immunocompromised state. The current report presents two cases of oral mucormycotic osteomyelitis in patients who developed diabetes post-COVID infection, along with a review and relevant literature.

Effects of pain education on disability, pain, quality of life, and self-efficacy in chronic low back pain: A randomized controlled trial.

BACKGROUND: Low back pain stands as a prevalent contributor to pain-related disability on a global scale. In addressing chronic low back pain (CLBP), there is a growing emphasis on incorporating psychological strategies into the management process. Among these, pain education interventions strive to reshape pain beliefs and mitigate the perceived threat of pain. This randomized controlled trial sought to assess the effects of pain education on various aspects, including pain levels, disability, quality of life, self-efficacy, and prognostic characteristics in individuals grappling with CLBP. METHODS: The clinical trial, retrospectively registered with the Clinical Trials Registry of India (CTRI/2021/08/035963), employed a two-arm parallel randomized design. Ninety-two participants with CLBP were randomly assigned to either the standard physiotherapy care with a pain education program or the control group. Both groups underwent a 6-week intervention. Assessment of pain intensity (using NPRS), disability (using RMDQ), self-efficacy (using the general self-efficacy scale), and well-being (using WHO 5I) occurred both before and after the 6-week study intervention. FINDINGS: Post-intervention score comparisons between the groups revealed that the pain education intervention led to a significant reduction in disability compared to the usual standard care at 6 weeks (mean difference 8.2, p < 0.001, effect size Cohen d = 0.75), a decrease in pain intensity (mean difference 3.5, p < 0.001, effect size Cohen d = 0.82), and an improvement in the well-being index (mean difference 13.7, p < 0.001, effect size Cohen d = 0.58). CONCLUSION: The findings suggest that integrating a pain education program enhances the therapeutic benefits of standard physiotherapy care for individuals dealing with chronic LBP. In conclusion, the clinical benefits of pain education become apparent when delivered in conjunction with standard care physiotherapy during the management of chronic low back pain.

Efficacy of Vagal nerve stimulation on anxiety among elderly retired teachers during COVID-19 pandemic.

BACKGROUND: Excessive fear, worry and behavioral disturbances define anxiety, with particular significance attributed to vagal nerve, a crucial transmitter of information to the brain regions governing anxiety. Highlighting the importance of vagal nerve, transcutaneous auricular vagal nerve stimulation (TaVNS) emerges as a tolerable and safe technique. The success of non-invasive vagal nerve stimulation in alleviating anxiety underscores the pivotal role of the vagal nerve. OBJECTIVES: The purpose of this study was to assess the effectiveness of physiotherapy interventions in mitigating anxiety among retired teachers during the COVID-19 pandemic, emphasizing the relevance of targeting the vagal nerve for improved mental well-being. METHODS: 60 retired teachers diagnosed with anxiety were chosen through random allocation. Participants were divided into two groups: Group A (Experimental group) received transcutaneous auricular vagal nerve stimulation (TaVNS), and Group B (Control group) underwent the Jacobson relaxation technique. Intervention period spanned 4 weeks, with four sessions per week, lasting 30 minutes. The outcome measures included Generalized Anxiety Disorder-7 (GAD-7) questionnaire and salivary cortisol levels. RESULTS: Following the 4-week intervention, both groups exhibited a significant reduction in Generalized Anxiety Disorder-7 (GAD-7) scores and salivary cortisol levels (P <  0.001). Notably, Group A demonstrated a significantly higher effectiveness rate compared to Group B. CONCLUSION: The study concludes that transcutaneous auricular vagal nerve stimulation (TaVNS) is effective in reducing anxiety among retired teachers. Transcutaneous auricular vagal nerve stimulation (TaVNS) proves to be a powerful and effective intervention in alleviating anxiety among retired teachers, emphasizing its potential significance in enhancing mental well-being.

Impact of mobile phone usage on dynamic postural control among South Indian college students.

BACKGROUND: Smartphones are a technical marvel that rapidly evolved to play an important role in our lives. One downside to smartphone use is that it significantly worsens posture. It is believed that using a smartphone while walking increases the risk of cognitive decline and the loss of dynamic balance needed to perform functional tasks. OBJECTIVE: The objective of the study was to determine the impact of smartphone usage on dynamic postural control among South Indian college students. METHODS: The study was carried out in a private college with 400 invited students through online social media platforms. The four-square step test and SAS-SV were used to determine the impact of smartphone usage on dynamic postural control. The students were informed about the study process. A total of 250 participants were included based on the inclusion criteria. RESULTS: There was a high percentage of agreement on smartphone usage on dynamic postural control measured with SAS-SV, revealing statistical significance with a mean value of 41.532 and SD of 10.010886. The four-square step test with a mean value of 22.5 and SD of 1.8995878 also proved significant impact. A positive correlation was found between smartphone usage and dynamic postural control, which was analysed using Pearson's correlation coefficient of 0.90130. CONCLUSION: A significant correlation was noted between mobile usage and dynamic balance. Smartphones can have a negative impact on dynamic balance by distracting users from their surroundings and increase the risk of falls.

Evaluation of ABCB5 immunostained epithelial stem cells in oral squamous cell carcinoma, inflammatory gingival hyperplasia and normal mucosa.

Oral cancer is the most prevalent head and neck cancer. Although tumor markers have been investigated for detecting the progression and prognosis of oral cancer, no reliable marker has been identified. We investigated the expression of ATP binding cassette subfamily B member 5 (ABCB5) positive stem cells in oral squamous cell carcinoma (OSCC) and in inflammatory gingival hyperplasia. We used tissue samples from normal subjects, patients with inflammatory gingival hyperplasia, and patients with OSCC. Samples were investigated using anti-ABCB5 monoclonal antibody immunohistochemistry to detect epithelial stem cells. Staining density, intensity, and immunoreactive scores of ABCB5 were analyzed for the three study groups. We found ABCB5 immunostaining in all three study groups, but different distributions of ABCB5 expression in different layers of the epithelium. We found no significant difference in staining intensity between inflammatory hyperplasia and normal mucosa, but we found significantly stronger expression in OSCC compared to normal and inflammatory hyperplasia individually. Elevated expression of ABCB5 in OSCC suggests an increased subpopulation of tumor cells with an undifferentiated stem cell phenotype, which facilitates cancer initiation and progression.

Anxiety's correlation with sleepiness and memory among security officers during the COVID-19 pandemic.

BACKGROUND: In the working population especially among older adults, anxiety problems have grown dramatically. This element has a significant impact on employee absenteeism and problems with physical and mental health. It was widely known that security personnel had several physical and mental difficulties during their various work hours. It is important to investigate the effects of anxiety on them. OBJECTIVE: The present study aims to provide insights into the prevalence of anxiety disorders and explore the correlations between anxiety symptoms, sleep, and memory during the COVID-19 pandemic. METHODS: To conduct a cross-sectional study, 42 older adult participants between the ages of sixty to seventy years were chosen and the procedure was explained.Data were gathered by giving instructions on how to complete the self-reported Generalized Anxiety Disorder Assessment -7 (GAD-7), the Epworth Sleepiness Scale, and the revised Everyday Memory Questionnaire. RESULTS: A total of 36 out of 42 participants (85.71%) experienced moderate to severe anxiety. Anxiety and sleep had a correlation of 0.8, while anxiety and memory had a correlation of 0.87 with a positive EMQ-R relationship. Moreover, there was a statistically significant association between sleep and memory, with a positive correlation of 0.73. CONCLUSION: The study concludes that, there is a substantial prevalence of anxiety accompanied by notable insomnia and memory problems in elderly security officers. Our findings indicate a clear relationship between sleep disturbances, memory issues, and most prevalent anxiety symptoms. These results emphasize the importance of incorporating mental health assessments and addressing an effective treatment for anxiety.

Effect of vagus nerve stimulation (taVNS) on anxiety and sleep disturbances among elderly health care workers in the post COVID-19 pandemic.

BACKGROUND: Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations. OBJECTIVE: The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals. METHODS: 42 participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) and Control group A received Jacobson's progressive muscle relaxation technique. RESULTS: With a p value of 0.001, taVNS stimulation significantly improved sleep quality and reduced anxiety after 4 weeks. The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001). CONCLUSION: The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.

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.

Clinicopathological characteristics of oral squamous cell carcinoma arising from oral submucous fibrosis: A systematic review.

Introduction: Oral submucous fibrosis (OSMF) is considered to be a potentially malignant oral disorder with high risk of malignant transformation. Oral squamous cell carcinoma (OSCC) arising from OSMF has peculiar clinical and histopathological features. Aim: To assess the clinicopathological features of OSCC arising in the background of OSMF in an attempt to identify the patients with OSMF who are at increased risk of developing OSCC. Methodology: A systematic review was performed based on PRISMA guidelines to include articles published until May 2021 in English, relating the clinicohistopathological characteristics of OSCC arising from OSMF (OSMF-OSCC) or OSMF associated with OSCC (OSCC-OSMF). All the eligible articles were analyzed and relevant data were extracted. Results: Seventeen articles were included for systematic review after following strict inclusion and exclusion criteria. The malignant transformation rate of OSMF-OSCC ranged from 1.9 to 9.13 and the prevalence of OSCC-OSMF ranged from 2.8 to 66. The mean age of the patients ranged from 36.6 years to 47.2 years and buccal mucosa was the common site to be affected. Majority of the OSCC-OSMF was well-to-moderately differentiated and majority of them did not metastasize to the lymph nodes. Conclusion: OSCC associated with OSMF presents at a younger age with early tumor stage, better differentiation, and better prognosis when compared to OSCC not associated with OSMF. However, more multicentric prospective studies with large sample size are required to determine the true biologic behavior of OSCC arising in the background of OSMF to establish less aggressive treatment strategies considering them as a separate entity.

Management of Denture Infection with Phytomedicine.

Natural teeth are an integral part of the masticatory system. Absence of dentition subjects the individual to compromised oral function, facial appearance and phonetics. Rehabilitation with dental prosthesis is imperative to restore form and masticatory activity. Currently, fabrication of removable and fixed prosthesis has become most predictable. Nonetheless, there is an increased prevalence of oral stomatitis observed over the years in edentulous individuals wearing removable dentures. Amongst the many pathogens that cause denture infections, Candida albicans is assumed to be the most virulent opportunistic agent. Different methods, such as mechanical, chemical, chemicmechanical, and pharmacological are tried to fight such infections. Regardless of various management strategies developed to treat denture stomatitis, the research continues to evolve the most optimal one. Improper oral and or denture hygiene maintenance, surface irregularities on denture, persistence of xerostomia and associated systemic illness pose risk for exaggeration of the disease. In extreme conditions, the development of aspiration pneumonia in geriatric patients is considered a threat to both dental and medical specialists. Therapeutic administration of synthetic anti-microbial drugs, along with meticulous oral hygiene maintenance are recommended protocols till date. However, limitations such as antibiotic resistance, side effects, counter drug reactions, cost of the medicaments predispose to origin of natural herbal products to treat denture stomatitis. Vast array of plant products are studied in previous literature, yet no definitive edge of one over the other is proven. This article intends to provide a mini-review on the different organic plant materials, also called as phytomedicines used for the treatment of candida associated denture stomatitis (CADS).

The Awareness, Practice and Perception of InstrumentAssisted Soft Tissue Mobilization (IASTM) among Malaysian Physiotherapists

@#Introduction: Instrument-assisted soft tissue mobilization (IASTM) is a relatively recent method that has been shown to help reduce muscular tension, increase flexibility and prevent tissue adhesion. Nevertheless, there is a paucity of awareness and knowledge about the benefits of IASTM, especially following injury rehabilitation, despite its many advantages. The study aimed to investigate the awareness, practice and perception of instrument- assisted soft tissue mobilization (IASTM) among Malaysian physiotherapists (PTs). Methods: The cross-sectional study included 133 PTs who answered an online questionnaire via a google link on their awareness and perception of IASTM in their practice. The Google link was given to the participants through email and the official Malaysian Physiotherapy (MPA) social media group. Results: Majority of the respondents (73.7%) are aware of IASTM technique. Despite being aware on IASTM, 74.4% of respondents reported not practicing the technique. Furthermore, 73.7% of respondents stated that the main reason they don’t practice is because fingers have better force adjustment than IASTM. Over 80% of respondents revealed that practicing IASTM can save energy and convenient during myofascial release. Moreover, 82.7 % of respondents stated that one of the benefits of IASTM for PTs is that it helps alleviate stress on fingers and wrists during soft tissue mobilization. Beyond 55% of respondents stated that they will incorporate IASTM in practice in near future. Conclusion: According to the findings, the majority of Malaysian physiotherapists are aware of the IASTM. However, fewer than half of respondents declined to incorporate it into their future practice due to the PTs preference for feeling the patient’s muscle texture. More emphasis can be given to the IASTM techniques among the PTs as the participants have mentioned that IASTM has better force exertion and saves energy when applying soft tissue massage.

Salivary and serum acetaldehyde levels in betel quid chewers, pan masala chewers with or without tobacco and tobacco smokers: A comparative study using head space gas chromatography.

Background: Acetaldehyde, a natural by-product of combustion and photo-oxidation, has been detected at low levels in cigarette smoke. Various literature studies have shown increased salivary acetaldehyde production among smokers and heavy drinkers. Aim: The present investigation was performed to estimate the salivary and serum acetaldehyde levels in pan masala chewers (with or without tobacco), betel quid chewers and tobacco smokers. Methodology: Blood and Saliva samples were collected from 40 participants. The study participants were categorized into 4 groups of 10 individuals each. Subjects with no habits, betel quid chewing habit, pan masala chewing habit with or without tobacco and tobacco smoking habit. All the samples were centrifuged and subjected to gas chromatography (GC) analysis as per standard protocols provided by the manufacturer. Results and Discussion: No statistically significant difference in either serum or salivary acetaldehyde levels between Pan Masala chewers (with or without tobacco) and smokers was noted. However, higher mean serum and salivary acetaldehyde levels than the normal subjects and betel quid chewers was observed. It may be speculated that natural acetaldehyde, may not be released in estimated quantity of acetaldehyde by head space GC. Nevertheless, it is possible that addition of acetaldehyde as flavoring agents or preservatives for improving acceptability of the product can be a possible cause for these observations. Conclusion: Owing to various socio, economic and political reasons, implementation of the ban remains to be a formidable challenge. With these observations, we believe that absolute ban of all pan masala product is the ideal solution for minimizing the oral cancer burden in India.

Quantification of inflammatory, angiogenic, and fibrous components of reactive oral lesions with an insight into the pathogenesis.

Background: Reactive oral lesions pose diagnostic difficulties as they mimic each other clinically. A definitive diagnosis is made based on the histopathological presentation of this group of lesion. Stromal microenvironment is the key to the sequence of the stages of these lesions. Stringent quantification of each component of the stroma is important to understand the pathogenesis. The aim is to evaluate inflammation, angiogenesis, and fibrosis in the reactive group of lesions through quantitative analysis. Materials and Methods: Blocks of irritation fibroma, inflammatory fibrous hyperplasia, pyogenic granuloma, and normal mucosa were retrieved from the archives and Hematoxylin and Eosin (H&E) and Masson Trichrome staining were done. The severity of inflammation, epithelial thickness, collagen proportionate area, integrated density of collagen, Mean Vascular Area (MVA), Mean Vascular Perimeter (MVP), and Mean blood vessel percentage area (MBVPA) were analysed quantitatively using Image J software version 1.8. The pattern of rete ridges at the epithelium-connective tissue interface was analysed qualitatively. Results: Inflammatory fibrous hyperplasia presented with severe inflammation (60%). Mean Vascular Percentage Area (MVPA) and Mean Vascular Perimeter (MVP) were increased in pyogenic granuloma. The mean collagen proportionate area and the integrated density of collagen were found to be more in irritation fibroma (64.47%, 2519638.01 ± 810471.58 µm2). The epithelial thickness was highest in inflammatory fibrous hyperplasia (62.71 ± 18.86 µm). Conclusion: Reactive oral lesions are histologically distinct, yet they exhibit considerable overlap depending on the stage of the lesion. A morphometric quantitative exploration of the individual pathogenic components may aid in specific diagnosis.

Barreiras à atividade física percebidas entre adultos da Malásia durante a pandemia de COVID-19: um estudo transversal / Perceived barriers to physical activity among Malaysian adults during COVID-19 pandemic: a cross-sectional study

INTRODUÇÃO: A pandemia COVID-19 trouxe um impacto relativamente significativo no mundo. A Malásia implementou uma estratégia de isolamento social em todo o país para nivelar a curva da epidemia. À medida que os limites ao movimento e à interação social entraram em vigor, mais indivíduos parecem menos ativos fisicamente. OBJETIVO: determinar as barreiras percebidas para a atividade física entre jovens adultos da Malásia durante a pandemia de COVID-19. MÉTODOS E MATERIAIS: Total de 217 participantes incluídos na faixa etária de 18 a 40 anos participaram voluntariamente deste estudo. Os participantes foram excluídos se não fossem malaios e apresentassem quaisquer problemas psicológicos e deficiência física que impedissem a atividade física. O questionário Barrier to Being Active (BBAQ) foi distribuído por várias plataformas de mídia social de janeiro de 2021 a maio de 2021. Os dados categóricos foram apresentados usando frequência simples e absoluta na distribuição de perfis sociodemográficos e respostas do BBAQ. Qui-quadrado de Pearson com nível de confiança de 95%, p <0,05 foi utilizado como nível de significância para analisar a associação entre gênero e barreiras. RESULTADOS: A barreira relatada pelos participantes foi "falta de força de vontade" 136 (62,7%), seguida de "falta de energia" 117 (53,9%), "falta de recursos" 113 (52,1%), "falta de tempo", 109 (50,2%), "influência social" 100 (46,1%), "falta de habilidade" 48 (22,1%) e "medo de se machucar" 40 (18,4%). Não houve relação significativa entre gênero e barreira à atividade física entre jovens adultos da Malásia. CONCLUSÃO: A "falta de energia", "falta de força de vontade" e "falta de recursos" foram as barreiras mais percebidas para a atividade física entre jovens adultos da Malásia durante o confinamento por causa da COVID-19. Não houve associação significativa entre as barreiras de atividade física e o gênero.

INTRODUCTION: The COVID-19 pandemic has had a relatively significant impact on the world. Malaysia implemented a countrywide social isolation strategy to flatten the epidemic curve. As limits on movement and social interaction have come into force, more individuals appear less physically active. OBJECTIVE: To determine the perceived barriers to physical activity among Malaysian young adults during the COVID-19 Pandemic. METHODS AND MATERIALS: A total of 217 participants included with age group from 18-40 years old voluntarily participated in this study. Participants were excluded if they were non-Malaysian and had any psychological problems and physical impairment that hindered physical activity. The barrier to Being Active quiz (BBAQ) questionnaire was circulated through various social media platforms from January 2021 to May 2021. Categorical data were presented using simple and absolute frequency on the distribution of sociodemographic profiles and BBAQ responses. Pearson Chi-square with 95% confidence level, p<0.05, was used as the significant level to analyze the association between gender and barriers. RESULTS: The barrier reported by the participants was "lack of willpower" 136 (62.7%), followed by "lack of energy" 117(53.9%), "lack of resource" 113(52.1%), "Lack of time," 109(50.2%), "social influence" 100(46.1%), "lack of skill" 48(22.1%) and "fear of injury" 40(18.4%). There was no significant relationship between gender and Barrier to Physical Activity among Malaysian young adults. CONCLUSION: The "lack of energy," "lack of willpower," and "lack of resource" were the most perceived barriers to physical activity among Malaysian young adults during COVID-19 lockdown, and there was no significant association between physical activity barriers and gender.

Bond Strength of Acrylic Denture Tooth to a Novel Thermo-Polymerized Denture Base Copolymer Containing Cycloaliphatic Comonomer after Mechanical and Thermal Aging.

BACKGROUND: There are numerous artificial denture tooth materials available of which acrylic resin teeth were used widely. The resin teeth bond chemically to the denture base resin, and this bonding is affected by numerous intrinsic and extrinsic factors. The type of cross-linker in the denture base monomer is one such factor which has a questionable influence on the bond strength. Recently, cycloaliphatic comonomer was added in the methyl methacrylate monomer and the resultant novel copolymer possessed good physico-mechanical and biological properties. PURPOSE: The purpose of this study was to evaluate the shear bond strength (SBS) between acrylic denture tooth and resultant novel copolymer after cyclic loading and thermal aging. MATERIALS AND METHODS: Sixty central incisor denture teeth were bonded to three types of acrylic denture base resin groups (n = 20 per group) categorized based on the presence of the cycloaliphatic comonomer - Control group (G0): denture bases without cycloaliphatic comonomer and trial groups G10 and G20 contain 10 vol.% and 20 vol.% comonomer, respectively, substituted in the denture base monomer component. The specimens were processed and subjected to cyclic loading and thermal aging which was then followed by SBS testing. RESULTS: G20 possessed the highest SBS followed by G10. G0 had the least SBS. All the specimens of the control and trial groups exhibited adhesive-cohesive mixed failure at the resin tooth-base resin interface. CONCLUSION: The addition of cycloaliphatic comonomer increased the SBS between the resultant novel copolymer and the resin teeth after cyclic loading and thermal aging.

Morphometric Analysis of Suprabasal Cell Layer in Oral Epithelial Dysplasia: A Computer-assisted Microscopic Study.

BACKGROUND: Oral leukoplakia is the most common precancerous lesion. Various grading systems based on histological findings have been proposed for dysplasia. Recently, computer-assisted morphometric analysis has been established to reduce the interobserver and intraobserver variability during the histological grading of epithelial dysplasia. This study was undertaken to establish the morphometric changes in the suprabasal cell layer of different grades of oral epithelial dysplasia. MATERIALS AND METHODS: Forty paraffin-embedded tissue sections (10 normal mucosa, 10 mild dysplasia, 10 moderate dysplasia, and 10 severe dysplasia cases) were stained using hematoxylin and eosin stain, and analyzed for cellular and nuclear morphometry using binocular microscope. RESULTS: Our results showed that values of nuclear area, nuclear perimeter, nuclear volume density, and nuclear/cytoplasmic (N/C) ratio were increased gradually in dysplasia compared to control groups and the values were statistically significant (P = 0.001). Nuclear diameter and cellular area were increased in dysplasia when compared to control group (P = 0.001). Mild and moderate dysplasia showed decreased value of nuclear form factor compared to control group, whereas severe dysplasia showed highest value. A fair correlation was found when comparing histological grading and grouping based on nuclear area, nuclear perimeter, N/C ratio, and nuclear volume density. CONCLUSION: Nuclear features reflect cell behavior, and its morphometric analysis can be considered as a reliable tool for differentiating various grades of epithelial dysplasia.

Comparative Study on Fracture Resistance of Endodontically Treated Tooth in Relation to Variable Ferrule Heights Using Custom-made and Prefabricated Post and Core: An In Vitro Study.

INTRODUCTION: Endodontically treated teeth have significantly differentphysical properties compared to vital teeth. To ensure functional longevity,endodontically treated teeth must have at least 5 mm of tooth structure coronalto the crestal bone, 2 mm of coronal tooth structure incisal to the preparationfinish line are necessary to ensure functional integrity. AIM AND OBJECTIVES: To evaluate fracture resistance of endodontically treated teeth restored withcustom cast post, custom cast post with variable ferrule height and teethwithout ferrule, prefabricated post with variable ferrule height and teethwithout ferrule. To compare fracture resistance of teeth restored with customcast post and prefabricated post with variable ferrule heights. MATERIALS AND METHODS: Methodology includes selection of teeth, root canal preparation,post space preparation, grouping of samples, Group A-custom cast post andcore with sub groups of variable ferrule height, pattern fabrication, Group A- pattern fabrication for customized cast post. Group B-pattern fabricationfor prefabricated post and core, investing and casting, cementation, custommade acrylic jig preparation, testing of specimens. RESULTS: The differencein the fracture load between the samples of Group A was highly significantat the 0.001 level. Subgroup A4 had highest fracture resistance while GroupA, possessed the least fracture resistance. Subgroups A2, A3 had fractureresistance value intermediate between A1, A4. CONCLUSION: Increasing theferrule height significantly increases (P < 0.001) the fracture resistance ofendodontically treated teeth restored with both custom made cast post andcore and prefabricated post with metal core. Comparatively the custom madecast post and core with variable ferrule height, especially 2 mm ferrule showedsignificant fracture resistance than prefabricated post with metal core. Thepresence of 2 mm ferrule height significantly increases (P < 0.001).

Biofriendly Substitutes for Xylene in Deparaffinization.

BACKGROUND: Xylene is an aromatic hydrocarbon that is routinely used in histopathological laboratories. It is biohazardous and produces many toxic effects like carcinogenesis. A safer substitute for xylene is necessary to minimize its usage. AIM: The aim of this study was to evaluate the effectiveness of 1.7% dishwashing solution, 95% lemon water, and 100% coconut oil when compared to xylene as a deparaffinizing agent during hematoxylin and eosin (H&E) staining. MATERIALS AND METHODS: Fifteen paraffin-embedded tissue blocks were selected. Four sections were made from each block. One section was stained with conventional H&E method using xylene (group A) as deparaffinizing agent and other three sections were stained with xylene-free H&E method using 1.7% dishwashing solution (group B), 95% lemon water (group C), and 100% coconut oil (group D), respectively. Slides were scored blindly by a single pathologist considering the parameters such as nuclear and cytoplasmic staining; uniformity, clarity, and crispness of staining; and presence or absence of wax retention. RESULTS: Adequate nuclear staining was noted in 100% of sections of groups A, B, C, and D (P < 0.001), whereas adequate cytoplasmic staining was noted in 93.33% each in groups A, C, and D when compared with 100% in group B (P > 0.05). Uniform staining was present in 80% of groups A and B and in 73.33% of groups C and D (P > 0.05). Clarity of staining was present in 86.66% of groups A and B and in 80% of groups C and D (P > 0.05), whereas crispness of staining was seen in 73.33% of groups A and D, 86.66% of group B, and 80% of group C (P > 0.05). Wax retention was noted in 20% of groups A and B, and 26.66% of groups C and D (P > 0.05). Adequate staining for diagnosis was noted in 100% of group A sections followed by 93.33% in group B, 86.66% in group C, and 80% in group D as compared with 90% in group B (P > 0.05). CONCLUSION: Dishwashing solution, lemon water, and coconut oil can be used as safer and cost-effective substitutes to xylene for deparaffinization in H&E staining procedure.

Smokeless Tobacco Products (STPs) Harbour Bacterial Populations with Potential for Oral Carcinogenicity.

INTRODUCTION: Smokeless Tobacco Products (STPs) vary significantly in their carcinogenicity, a feature accredited to the variation in the concentrations of carcinogenic chemicals. Tobacco associated bacteria are known to produce Tobacco-specific N-nitrosamines (TSNAs) and hence are determinants of TSNA levels in Tobacco. The primary objective of this study was to conduct a microbiological survey of STPs and to provide a baseline information of the bacterial communities present in the STPs. MATERIALS AND METHODS: The present study analyzed the constituency of microbial communities in 7 different smokeless Tobacco products including four chewable (T1_CW to T4_CW), two snus (T5_Snus and T6_Snus) and one snuff sample (T7_Snuff) using high-throughput sequencing of the 16S rRNA based next generation sequencing. The Tobacco samples were also analyzed for pH and moisture content. Statistical analysis of the data obtained was done using SPSS software version 20. Pearson's Correlation was done to analyze the correlation between pH and moisture content of the Tobacco samples. RESULTS: A total of 11 phyla were identified in all smokeless Tobacco products. A total of 36 classes were identified across all smokeless Tobacco products and bacilli was the predominant class in all the products followed by Actinobacteria and Bacteroidia. In species level, a total of 2369 species were identified across all smokeless Tobacco products. In T1 chewable Tobacco products, predominant species was staphylococcus whereas in T2 and T3, Bacillus subtilis and pumilus were predominant. In T4 chewable Tobacco product, Virgibacillus was predominant followed by halodentrificans, staphylococcus epidermidis. In snus 1 and 2, Bacillus pumilus and subtilis were predominant. In snuff, Bacillus cereus was predominant. Snus products had the highest moisture content (15.4% and 14.3%) compared to the chewable Tobacco and snuff products. The snus products analyzed had alkaline values (pH 8.50 and 8.15) and snuff and chewable Tobacco had acidic values ranging from 5.62 to 6.09. CONCLUSION: The current study demonstrates that ST products differ qualitatively, quantitatively, and in their bacterial composition. There is a possibility that some of these species may contribute to oral carcinogenesis, either by influencing levels of TSNAs or directly inducing chronic inflammation.

Dentin degradonomics - The potential role of salivary MMP-8 in dentin caries.

BACKGROUND: Dentin caries involves dissolution of minerals which eventually leads to degradation of organic matrix. This degradation which was thought to be by bacterial proteases is now considered to be orchestrated by endogenous collagenases such as Matrix Metalloproteinases (MMPs). This paper aims to estimate the salivary levels of MMP-8 in dental caries and also to asses the various risk factors that contribute to the formation of dental caries. MATERIAL AND METHODS: A random sample of 75 adults aged 18-35 were included and categorized based on the number of caries lesions (MCL). Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentrations of MMP-8 using enzyme-linked immunosorbent assay. Caries risk factors were assessed using a chair-side kit. Correlation of MMP-8 in varying MCL using Spearman's correlation was done. Multiple linear regression analysis was done to asses the relationship between various caries risk factors with MMP-8 and MCL as dependent variable. RESULTS: The study results showed a statistically significant higher concentration of MMP-8 in carious group (MCL 1-2) and MCL ≥3 compared to non-carious group. On correlating, the levels of MMP-8 were seen to be higher in MCL ≥3 than in MCL = 0 and MCL 1-2. The mean MMP-8 of controls, MCL 1-2, and MCL ≥3 were 131.34ng/ml, 230.14ng/ml, and 391.91ng/ml respectively. Multiple linear regression analysis with MMP-8 as the dependent variable revealed caries, buffer capacity and S. mutans count as significant variables. Using MCL as the dependent variable the only significant variable was MMP-8 levels. CONCLUSIONS: The study suggests that subjects with caries have elevated MMP-8 levels compared with subjects with no carious lesions. There is also a positive correlation between the number of carious lesions and MMP-8 levels suggesting that MMP-8 plays an important role in the degradation of dentin and causes progression of caries. Key words:Caries, Dentin, Enzyme-linked Immunosorbent Assay, MMP-8.