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Ethnopharmacological relevance: Pelvic inflammatory disease (PID) is a frequently occurring gynecological disorder mainly caused by the inflammation of a woman's upper genital tract. Generally, antibiotics are used for treating PID, but prolonged use poses potential risks of gut bacterial imbalance, bacterial resistance, super bacteria production, and associated adverse reactions. Traditional Chinese medicine (TCM) has shown unique advantages in various ailments and has received widespread clinical research attention. Fuke Qianjin (FUKE) capsule is an approved National Medical Products Administration (NMPA License No. Z20020024) Chinese herbal prescription that has been widely used individually or in combination with other Western medicines for the treatment of various gynecological inflammatory diseases, including chronic cervicitis, endometritis, and chronic PID. Aim: This clinical trial was designed to assess the safety and efficacy of FUKE capsule in mild-to-moderate symptomatic PID patients. Materials and methods: This phase 2, randomized, double-blind, positive controlled clinical trial was conducted in mild-to-moderate symptomatic PID patients at a single center in Pakistan from 21 September 2021 to 11 March 2022. Eligible female participants were randomly assigned to a test and a control group with a ratio of 1:1. The test group subjects received two metronidazole (METRO) tablets and one doxycycline hyclate (DOXY) simulant at a time, twice daily for 14 days, and two Fuke Qianjin (FUKE) capsules, three times a day after a meal for 28 days. Subjects in the control group received two METRO tablets and one DOXY tablet at a time, twice daily for 14 days, and two FUKE simulant capsules, three times a day after meal for 28 days. The primary efficacy outcome was an improvement in pelvic pain symptoms assessed through a visual analog scale (VAS). The secondary outcomes were the improvement in secondary efficacy symptoms like local physical signs, clinical assessment of leucorrhea and cervical secretions through laboratory examination, and improvement in the maximum area of pelvic effusion assessed through gynecological ultrasound after the treatment. The safety outcomes were assessed through vital signs, laboratory tests, electrocardiogram findings, and adverse events/serious adverse events. Results: A total of 198 subjects with active PID were randomly assigned to a test group (n = 99) and a control group (n = 99). The baseline characteristics of the subjects in the two groups were similar. In the intention-to-treat analysis, the primary efficacy was 84.9% for the test group and 71.6% for the control group, with a statistically significant difference (p = 0.0370; 95% CI -0.2568 to -0.0088). The secondary clinical efficacy was 88.4% for the test group and 82.7% for the control group, with no significant difference (p = 0.2977; 95% CI -0.1632 to 0.0501). The improvement in local physical signs was 95.8% for the test group and 76.9% for the control group, with no significant difference (p = 0.0542; 95% CI -0.3697 to -0.0085). The inter-group non-inferiority comparison showed that the upper limit of the 95% CI was less than 0.15 and thus met the non-inferiority requirements of the test group to the control group. The results of clinical signs of leucorrhea and cervical secretions showed that there was no difference in the rate of improvement between the test and control groups, indicating that FUKE was non-inferior to DOXY. A total of 14 adverse events in eight subjects were observed in the trial, with an incidence rate of 4.7%. Four subjects in each group experienced seven adverse events with 4.5% and 4.8% incidence rates of adverse reactions in the test and control groups, with no statistically significant differences (p = 0.2001). No serious adverse events occurred in the trial. Conclusion: The results of this trial indicate that the test drug (Fuke Qianjin capsule) is non-inferior to the control drug (doxycycline hyclate tablet) in treating mild-to-moderate PID patients with comparable efficacy, safety, and tolerability to the control drug. Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT04723069.
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Introduction: Obesity had been the most neglected public health problem increasing at an alarming rate affecting both the developed and developing countries. Periodontitis is a chronic inflammatory disease which is highly prevalent worldwide affecting 20-50% of the global population. Thus, a research was conducted to evaluate the relationship between obesity and periodontal disease among 35-44-year-old patients who were visiting the Oral Medicine and Radiology Department (OMDR) in TMDCRC, Moradabad. Objective: To know the prevalence of obesity and periodontal health. To record the body mass index (BMI) and to co-relate with periodontal disease. To recommend preventive measures for periodontitis and the obese population. Materials and Method: A cross-sectional study was conducted in the Department of OMDR, TMDCRC, Moradabad. A total of 566 subjects were examined aged 35-44 years visiting the out patient department (OPD) of the OMDR Department. Informed consent was obtained from the participants. Questionnaire-based proforma was used comprising information regarding oral hygiene practices, frequency of toothbrushing, and method of brushing. A World Health Organization (WHO)-modified 2013 assessment form was used to record the periodontal status of the participants. Results: The examination of 550 subjects was done. It was found that there is a significant association of periodontal disease in factors like BMI, age, gender, smoking status, and loss of attachment (LOA) is found in BMI, gender, smoking status, and smoking frequency. It was also found that there is a significant association of the community periodontal index (CPI) scores in obese individuals. Conclusion: The main aim is to find and control the risk factor and eliminate it. Our study confirms that obesity is one of the risk indicators of periodontitis. With the scope and limitations of the study, it has been concluded that obesity and periodontitis have a significant relationship with each other. This study states the importance of good oral hygiene maintenance in obese and normal patients.
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Introduction: Dental fear and anxiety is the most common distressing problem for children. Management of dental anxiety in children is one of the most difficult tasks in dentistry. Recently, alternative and contemporary medical approaches such as aromatherapy have received much attention. The potential effects of essential oils such as lavender and patchouli have been found to reduce anxiety, improve mood, and increase sedation. Thus, the study was conducted to compare the evaluation of lavender and patchouli essential oils used in aromatherapy and their effect on dental anxiety in children. Aim: To compare the efficacy of lavender and patchouli essential oils in aromatherapy and its effect on dental anxiety in children. Materials and methods: A total of 60 children between 6 and 12 years were randomly allocated to either an experimental or control group that received lavender and patchouli before dental treatment. Child anxiety was measured by using the Chotta Bheem-Chutki scale. A pulse oximeter was used to record the pulse rate. Data was tabulated and analyzed by Statistical Package for the Social Sciences (SPSS) software. Results: There was a significant reduction in anxiety score and pulse rate between the intervals. Statistical differences were observed in the lavender group compared to patchouli oil. Conclusion: The positive effects of both lavender and patchouli oil on children can be used to reduce anxiety in children. In our study, lavender oil showed slightly better results than patchouli oil. How to cite this article: Tripathy S, Kohli A, Sharma K, et al. Comparative Evaluation between Lavender Essential Oil and Patchouli Essential Oil in Aromatherapy and Its Effect on Dental Anxiety in Children. Int J Clin Pediatr Dent 2023;16(5):681-685.
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Herpes simplex virus 1 infection is a common cause of encephalitis (HSVE) in the United States. Post-HSVE development of N-methyl-D-aspartate receptor (NMDAR) antibodies resulting in autoimmune encephalitis is a rare complication, primarily affecting children and young adults. Anti-NMDAR develops 1-4 weeks after HSVE, manifesting as choreoathetosis and/or orofacial dyskinesia in children and psychiatric symptoms in young adults. We describe a case of a 61-year-old male who presented with agitation, behavioral changes, and confusion eight months after being treated for HSVE. Extensive investigation was unrevealing except for cerebrospinal fluid lymphocytic pleocytosis, a positive anti-NMDAR Ab titer 1 : 64, and imaging changes consistent with postviral encephalitis suggestive of HSV-induced anti-NMDAR encephalitis. Aggressive therapy resulted in limited success and persistent neurologic deficits. The unique features of this case are the old age of the patient and preceding HSVE which triggered this autoimmune process. Physicians should consider anti-NMDAR encephalitis in the differentials for relapsing patients after HSVE.
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Abiotrophia defectiva (ABI), a nutritional variant Streptococcus (NVS), is an uncommon cause of infective endocarditis (IE) involving both native and prosthetic heart valves. Due to the fastidious nature and special nutritional requirements, contribution of ABI to IE had been underestimated. Here we describe a case of Abiotrophia spp. native valve endocarditis in a 40-year-old female intravenous drug user who did not have any other potential source of infection. Blood cultures grew ABI along with Acinetobacter spp. perhaps from licking the needle before injecting. Transesophageal echocardiogram showed mobile vegetations attached to tricuspid and mitral valves. Susceptibility testing is important due to underlying differences in susceptibility to both penicillin and ceftriaxone between ABI and other genera of NVS, though both antibiotics are recommended alternate empiric first-line therapies along with synergistic gentamicin use in accordance with established guidelines to treat NVS endocarditis. She was successfully treated with intravenous ceftriaxone and gentamicin for 6 weeks with clinical and echocardiographic resolution of IE. This case highlights the importance of modern microbial techniques and equipment for accurate and rapid identification of challenging pathogens.
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Moisture content (MC) and aflatoxin contamination were analysed to determine Red Chilli quality. A wide range (9.1-19.8%) of MC with a mean value of 11.4 ± 2.4% was found. Of 116 chilli samples, about 37% had low MC (<10%), 29.4% had medium-low MC (10-12%), 18.9% had medium-high MC (12 < MC < 14%) and 14.7% were above 14%. These four chilli groups had average aflatoxin levels of 2.1 ± 1.1, 5.3 ± 4.2, 8.9 ± 5.9 and 37 ± 20 µg/Kg, respectively. A direct relationship between moisture and aflatoxin content was found. The data best fitted a polynomial trend (R² = 0.89). The obtained equation could be utilised to assess aflatoxin levels based on MC. This study highlights the importance of using properly dried chillies with low MC, that is, ≤10%, to minimise health hazards associated with aflatoxin contamination.
