Microplastics in packaged water, community stored water, groundwater, and surface water in rivers of Tamil Nadu after the COVID-19 pandemic outbreak.

The increased load of plastic in waste streams after the COVID-19 pandemic outbreak has increased the possibility of microplastics (MPs) contamination channelling through the rivers and infiltrating the aquatic ecosystems. MPs in packaged water, community-stored water, groundwater, and surface water of Kaveri River (KR), Thamirabarani River (TR), Adyar River (AR), and Cooum River (CR) in Tamil Nadu were therefore investigated about 2 years after the COVID-19 pandemic outbreak. Using µFTIR and µRaman spectroscopy, polyamide, polypropylene, polyethylene, ethylene vinyl alcohol copolymer resin, and polyvinyl chloride were identified as the primary polymer types. The average number of MPs was 2.15 ± 1.9 MP/L, 1.1 ± 0.99 MP/L, 5.25 ± 1.15 MP/L, and 4 ± 2.65 MP/L in KR, TR, AR, and CR, respectively, and 1.75 ± 1.26 MP/L in groundwater, and 2.33 ± 1.52 MP/L in community stored water. Only LDPE was detected in recycled plastic-made drinking water bottles. More than 50% of MPs were found to be of size less than 1 mm, with fibrous MPs being the prevalent type, and a notable prevalence of blue-coloured microplastics in all the sample types. The Pollution Load Index (PLI) was >1 in all the rivers. Toxicity rating based on the polymer risk index (PORI) categorized AR and TR at medium risk (category II), compared to KR and CR at considerable risk (category III). Overall pollution risk index (PRI) followed a decreasing trend with CR > AR > KR > TR of considerable to low-risk category. Ecological risk assessment indicates a negligible risk to freshwater biota, except for four sites in the middle and lower stretches of Adyar River (AR - 2, AR - 4) and upper and lower stretches of Cooum River (CR - 1, CR - 3), located adjacent to direct sewer outlets, and one location in the lower stretch of Kaveri River (KR - 9), known for fishing and tourist activities.

Polyethylene terephthalate waste derived nanomaterials (WDNMs) and its utilization in electrochemical devices.

Plastics are a vital component of our daily lives in the contemporary globalization period; they are present in all facets of modern life. Because the bulk of synthetic plastics utilized in the market are non-biodegradable by nature, the issues associated with their contamination are unavoidable in an era dominated by polymers. Polyethylene terephthalate (PET), which is extensively used in industries such as automotive, packaging, textile, food, and beverages production represents a major share of these non-biodegradable polymer productions. Given its extensive application across various sectors, PET usage results in a considerable amount of post-consumer waste, majority of which require disposal after a certain period. However, the recycling of polymeric waste materials has emerged as a prominent topic in research, driven by growing environmental consciousness. Numerous studies indicate that products derived from polymeric waste can be converted into a new polymeric resource in diverse sectors, including organic coatings and regenerative medicine. This review aims to consolidate significant scientific literatures on the recycling PET waste for electrochemical device applications. It also highlights the current challenges in scaling up these processes for industrial application.

Investigation of thermal conductivity and thermal performance of heat pipes by structurally designed copolymer stabilized ZnO nanofluid.

The present study concentrated on estimating the thermal conductivity, stability, efficiency, and resistance of a heat pipe for heat exchangers, which were essential for many industrial applications. To achieve this, copolymer of amphiphilic poly (styrene-co-2-Acrylamido-2-methylpropane sulfonic acid) poly (STY-co-AMPS) was synthesized by free radical polymerisation technique. The dispersant were used for homogeneous solution and stabilization of ZnO nanofluids. The effect of dispersant on the thermal conductivity of nanofluids was analysed using a KD2 pro thermal property analyser. There is a significant increase in fluid conductivity had a nonlinear relationship with the volume fraction. The maximum enhancement was observed at an optimized concentration of dispersant at 1.5 vol%. Same time, the influence of dispersant agent on the thermal conductivity of nanofluids were compared with linear polyelectrolytes. Further, the experimental values were compared to the existing classical models based on the reasonable aggrement, the prepared nanofluids were employed as a working medium. The conventional screen mesh heat pipe and the temperature distribution to the thermal resistance of the heat pipe was investigated experimentally. The result shows, optimum concentration of dispersants on nanoparticles exhibits an enhanced heat efficiency as compared with the base fluids. Further, the thermal resistance and temperature distribution show decreased behaviour by increasing the particle volume fraction and dispersant concentration.

Multi-spectroscopic, calorimetric and molecular dynamics evaluation on non-classical intercalation of antiviral drug Molnupiravir with DNA.

The interaction of an antiviral drug Molnupiravir (MOL) with calf thymus DNA (CT-DNA) was investigated using a series of biophysical techniques. A significant hyperchromism with a blue shift nm in the UV-Vis spectra indicated a high binding affinity of MOL for CT-DNA with binding constants in the order of 105 M-1. Competitive fluorescent dye displacement assays with ethidium bromide (EB) and Hoechst 33258 suggested an intercalative mode of binding of MOL with CT-DNA. Thermodynamic profiles determined using fluorescence titration and isothermal titration calorimetric (ITC) analysis matched well with each other. The negative free energy change revealed that the MOL/CT-DNA complexation is a spontaneous process. The negative values of enthalpy and entropy changes indicated that H-bonding and van der Walls interactions play dominant roles in stabilizing the complex. A decrease in viscosity of CT-DNA solution upon adding MOL indicated a partial intercalation mode of binding which was well supported by circular dichroism (CD) spectral and effect of KI and denaturation studies. Molecular docking and metadynamics simulation studies clearly showed the partial intercalation of the pyrimidine ring of MOL into the base pairs of DNA. Free energy surface (FES) contour indicated that the drug/DNA complex is stabilized by H-bonding and pi-pi/pi-cation interactions.Communicated by Ramaswamy H. Sarma.

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.

Prevalence of Ectopic Canine in Different Sagittal and Vertical Skeletal Patterns.

AIM: The present investigation aims to find out the prevalence of ectopic canines among skeletal class I, II, and III malocclusions and to evaluate its variability among different genders and their growth patterns. MATERIAL AND METHODS: The study sample included orthopantomograms (OPGs), lateral skull views, and study models of 999 patients collected from departmental archives. Among the selected samples, 258 were males and 738 were females. They were divided into skeletal class I, II, and III malocclusions sagittally and hypodivergent, normodivergent, and hyperdivergent groups according to their angle formed between point A-Nasion - point B (ANB) and angle formed between the Sella-Nasion (SN) plane and Gonion (Go) - Gnathion (Gn) plane (SnGoGn) values respectively. RESULTS: Of the 999 samples, 738 (73.9%) were female and 260 (25.8%) were male patients. When compared to men, females had a higher proportion of ectopic canines. An estimated 62.3% of skeletal class I, 29.1% of skeletal class II, and 8.6% of skeletal class III cases were found to have ectopic canines. An estimated 720 (72.1%) patients were found to have maxillary ectopic canines and out of the available sample, 474 patients have horizontal growth patterns, 335 have average growth patterns and 190 patients have vertical growth patterns. Labial impaction was the commonest (65.4%) followed by palatal (24.8%). Bilateral impaction was comparatively more (51.1%) than unilateral impaction (48.2%). Maxilla was more prevalent (72.1%) as compared to the mandible (16.3%) and for both the arches it was (11.6%). Ectopic canines were identified in a total of 62.3% of cases with skeletal class I, 29.1% of cases with skeletal class II, and 8.6% of cases with skeletal class III. CONCLUSION: The bilateral ectopic canine was mostly seen in skeletal class I and class III malocclusions, whereas, a unilateral presentation was mostly seen in skeletal class II malocclusions. CLINICAL SIGNIFICANCE: Knowing the likelihood of a maxillary canine erupting ectopically will aid clinicians in starting with interceptive therapy since this condition necessitates complex orthodontic mechanics.

Multi-spectroscopic and molecular simulation methods of analysis to explore the mode of binding of Mebendazole drug with calf-thymus DNA.

UV-vis, fluorescence, circular dichroism (CD) and 1H NMR spectroscopic techniques have been employed to explore the mode of binding of Mebendazole (MBZ) drug with calf thymus DNA (CT-DNA). UV-vis and fluorescence spectral studies suggested a complex formation between the drug and nucleic acid. The fluorescence of MBZ was found to enhance upon binding with CT-DNA through a ground state complex formation with Kb in the order of 104 M-1. The thermodynamic aspects indicated that the complex formation is a spontaneous process and an entropy-driven one. ΔH0 > 0 and ΔS0 > 0 revealed that hydrophobic interaction plays a dominant role in the stabilization of the complex. Competitive dye displacement assays with ethidium bromide (EB) and Hoechst 33258 dyes and viscosity measurements pointed out that MBZ binds with CT-DNA via intercalation mode, which is confirmed by CD and 1H NMR spectral studies as well as denaturation studies. Molecular docking analysis could not match well with the experimental results. However, molecular simulation studies and the resultant free energy surface (FES) analysis clearly showed that the benzimidazole ring of MBZ intercalated between the base pairs of the nucleic acid, which is in excellent agreement with the results of the various biophysical experiments.

Mercury sources, contaminations, mercury cycle, detection and treatment techniques: A review.

Mercury is considered a toxic pollutant harmful to our human health and the environment. Mercury is highly persistent, volatile and bioaccumulated and enters into the food chain, destroying our ecosystem. The levels of mercury in the water bodies as well as in the atmosphere are affected by anthropogenic and natural activities. In this review, the mercury species as well as the mercury contamination towards water, soil and air are discussed in detail. In addition to that, the sources of mercury and the mercury cycle in the aquatic system are also discussed. The determination of mercury with various methods such as with modified electrodes and nanomaterials was elaborated in brief. The treatment in the removal of mercury such as adsorption, electrooxidation and photocatalysis were explained with recent ideologies and among them, adsorption was considered one of the efficient techniques in terms of cost and mercury removal.

Comparative Evaluation of Intrapulpal Thermal Changes during the Polymerization of Different Adhesive Resin Materials: An In Vitro Study.

AIM: Aim of this study was to assess the thermal changes within the pulp at the time of polymerization of three different adhesive resin materials. MATERIALS AND METHODS: Sixty human premolar teeth that had been recently extracted for orthodontic reasons and were devoid of dental caries/flaws were included in this research. Following preparation of the cavities, all 60 samples consisting of 20 premolars in every group, depending on the adhesive resins that were positioned as were assigned at random to one of the following three groups: Group I: RelyX self-adhesive resin cement; Group II: Breeze self-adhesive resin cement; Group III: Pan F self-etch adhesive resin cement. The temperature changes were calculated using a thermocouple wire attached to a digital thermometer. The dissimilarities amid the baseline temperature as well as the temperatures at different time intervals (1, 5, 10, and 15 minutes) were established. RESULTS: The thermal value was higher at first minute (1.84 ± 0.34) and gradually reduced at 5 minutes (1.36 ± 0.29), 10 minutes (0.62 ± 0.11), and 15 minutes (0.06 ± 0.03) in RelyX self-adhesive resin cement. The maximum thermal value was found at the first minute (2.66 ± 0.21) and gradually reduced at 5 minutes (1.42 ± 0.13), 10 minutes (0.86 ± 0.09), and 15 minutes (0.28 ± 0.01) in Breeze self-adhesive resin cement. The higher thermal value was found at the first minute (1.98 ± 0.19) and gradually reduced at 5 minutes (1.49 ± 0.14), 10 minutes (0.76 ± 0.10), and 15 minutes (0.16 ± 0.09) in Pan F self-etch adhesive resin cement and there was a statistically significant difference found between various time points and with all three adhesive resin material groups (p <0.001). CONCLUSION: This current research arrived at a conclusion that each of the three adhesive resin substances showed a safe temperature change within the pulp. However, the lowest heat scores within the pulp were depicted by RelyX self-adhesive resin in pursuit by Pan F self-etch adhesive resin cement as well as the Breeze self-adhesive resin cement in that order. CLINICAL SIGNIFICANCE: The clinical triumph of a restoration is dependent partially on the method of cementation, which is utilized to establish a connection amid the restoration and the tooth. Temporary and permanent pulp inflammation can be avoided by the decreased temperature changes in the adhesive resin cement at the time of polymerization.

Impact of Fluoridated Mouthwashes on Strength and Durability of Three Different Synthetic Absorbable Suturing Materials: An In Vitro Study.

AIM: The aim of the current in vitro research was to assess the effect of fluoride-containing mouthwashes on the strength and durability of three different synthetic absorbable suturing materials. MATERIALS AND METHODS: Three types of synthetic absorbable suture materials were employed in this research, and every group comprised 20 suture samples. These include group I: Polyglactin 910, group II: Polyglycolic acid, and group III: Poliglecaprone 25. This research utilized 4-0 gauge sutures. Each example was tied using a square surgeon's knot about elastic rubber tubing. The biology of the oral milieu was replicated in vitro through the use of artificial saliva. The medium that was subjected to test prior to inclusion were 0.2% chlorhexidine gluconate as well as 0.044% sodium fluoride. The tensile strength of the specimen suture materials was subjected to test at a particular time intervals: prior to immersion, the 1st day, the 7th day, as well as the 14th day after immersion. Tensile strength was evaluated using a Universal Ultra Test machine. RESULTS: Post-immersion in 0.2% chlorhexidine gluconate mouthrinse, the mean tensile strength of polyglactin (PLG) 910 sutures was 24.48 ± 0.08 at pre-immersion and 4.36 ± 0.01 on the 14th day. The mean tensile strength of polyglycolic acid (PGA) sutures was 24.04 ± 0.26 at pre-immersion and 2.10 ± 0.02 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 23.82 ± 0.11 at pre-immersion and 1.34 ± 0.08 on the 14th day. Post-immersion in 0.044% sodium fluoride mouthrinse, the mean tensile strength of PLG 910 sutures was 24.18 ± 0.02 at pre-immersion and 5.12 ± 0.21 on the 14th day. The mean tensile strength of PGA sutures was 24.88 ± 0.34 at pre-immersion and 4.58 ± 0.10 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 24.48 ± 0.27 at pre-immersion and 5.08 ± 0.14 on the 14th day. A statistically noteworthy difference was noted amid the three types of sutures at dissimilar time points evaluated with p <0.001. CONCLUSION: The current research arrived at a conclusion that there is a significant difference between the mean tensile strength and purpose of the medium used for immersion as well as the tenure. Polyglactin suture material exhibited superior strength as compared to PGA and poliglecaprone suture substances following immersion in the investigational media. CLINICAL SIGNIFICANCE: Suture materials are employed in the closure of incised flaps, to aid healing by primary intention, along with control of bleeding. In oral as well as periodontal surgery, the right choice of sutures is very important for good healing. Suture choice for the mouth should be influenced by the requirements of the anticipated repair and the surgeon's fondness.

Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study.

AIM: Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope. MATERIALS AND METHODS: Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM). RESULTS: The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001). CONCLUSION: The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups. CLINICAL SIGNIFICANCE: Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

Applying LEAN Healthcare in Lean Settings: Launching Quality Improvement in Resource-Limited Regions.

BACKGROUND: Lean methodology is frequently utilized in high income settings to maximize capacity and operational efficiency during process improvement (PI) initiatives. To date there has been little published on the application of these techniques in low- and-middle-income countries (LMIC) despite the potential benefits in resource limited settings. We describe a pilot project developed in 2018 to promote sustainable operating theater efficiency at two hospitals in Abuja, Nigeria. This study details the first known attempt to use Lean techniques to improve surgical care systems in LMIC. METHODS: Perioperative committees were established at two Nigerian institutions to evaluate current processes, identify problems, and compile a list of priorities. A physician champion and a PI specialist in conjunction with local physician-partners held a workshop to teach practical applications of PI methodology as part of an ongoing collaboration. Pre and post-workshop surveys were administered, and theme coding was used to categorize free responses. Results were compared with a chi-square test. RESULTS: In total, 42 individuals attended the PI workshop. After the workshop, 37 respondents reported the workshop as valuable both personally and for the perioperative committee (P < 0.001), and all reported that PI methodology could benefit the institution overall. CONCLUSIONS: By identifying stakeholders, holding a workshop to teach tools of PI, and establishing a committee for ongoing improvement, it is possible to implement quality improvement techniques at LMIC hospitals, which may be of future benefit. Sustainability in this project will be facilitated by tele mentoring, and future efforts include expansion beyond the perioperative setting.

In Vitro Assessment of Intracanal Calcium Hydroxide Removal Using Various Irrigation Systems: An SEM Study.

AIM: The aim of this research was to assess the effectiveness of three different irrigation systems in elimination of calcium hydroxide [Ca(OH)2]from root canals. MATERIALS AND METHODS: This in vitro research included ninety recently extracted mandibular premolar teeth with a solitary root. The sample teeth were subjected to disinfection employing sodium hypochlorite at 5.25%. The root canal preparation was performed followed by placement of premixed Ca(OH)2 within every canal. The sample teeth were then randomly allocated into one of the three experimental groups (each comprising 30 samples) as follows: Group 1, NaviTip FX irrigation system; group 2, Vibringe sonic irrigation system; and group 3, EndoVac apical negative pressure irrigation system. Following the preparation, each of the sample teeth was examined beneath a scanning electron microscope (SEM) at a magnification of 1000×. RESULTS: An intragroup comparative analysis revealed that the highest Ca(OH)2 elimination was seen at middle third (0.82 ± 0.09, 0.30 ± 0.11) in NaviTip FX irrigation system and Vibringe sonic irrigation system, respectively. Higher Ca(OH)2 was eliminated at the apical third (0.26 ± 0.02) by the EndoVac irrigation system. At coronal third, maximum Ca(OH)2 removal was seen in EndoVac irrigation system (0.49 ± 0.03). A statistically significant difference was noted amid Vibringe sonic irrigation and EndoVac irrigation systems. The intergroup evaluation of Ca(OH)2 elimination at coronal, middle, and apical third showed a statistically significant difference between NaviTip FX irrigation and Vibringe sonic irrigation as well as between NaviTip FX irrigation and EndoVac irrigation at a p value of 0.001. The difference between EndoVac irrigation and Vibringe sonic irrigation was not statistically significant. CONCLUSION: Amid the limitations of this research, this research concludes that none among the irrigation methods employed could totally eliminate the Ca(OH)2 off the root canals. Nevertheless, EndoVac apical negative pressure irrigation has slightly superior potential in eliminating Ca(OH)2 from the root canals in comparison with Vibringe sonic irrigation as well as the NaviTip FX irrigation system. CLINICAL SIGNIFICANCE: Even though the Ca(OH)2 is largely suggested as medicament, its elimination at the point of canal obturation is likewise significant and complex as any remaining portion may avoid sealer diffusion inside the dentinal tubules, consequently substantially escalating the apical leakage of endodontically treated teeth.

Phenolic fraction extracted from Kedrostis foetidissima leaves ameliorated isoproterenol-induced cardiotoxicity in rats through restoration of cardiac antioxidant status.

In this study, the cardioprotective effects of partially purified phenolic fraction of Kedrostis foetidissima leaves (PFK) were evaluated in isoproterenol (ISO)-induced myocardial infarction rat model. ISO induction to experimental rats for two consecutive days significantly increased the levels of triglycerides, cholesterol, phospholipids, free fatty acids, low-density lipoproteins, and cardiac biomarker enzymes, and decreased the levels of high-density lipoproteins and antioxidant enzyme activity. Pretreatment of experimental rats with PFK for 45 days led to a significant elevation in antioxidant enzyme activity. PFK-pretreated rats exhibited significantly reduced levels of circulating lipids and cardiac-specific biomarker enzymes compared to ISO-treated rats. Thus, the present study demonstrated that PFK ameliorated ISO-induced cardiotoxicity through the augmentation of the endogenous cardiac antioxidant system, thereby modulating the lipid peroxidation caused by ISO-induced free radicals, and prevented the myocardial damage, which was confirmed through histopathological analysis. PRACTICAL APPLICATIONS: Kedrostis foetidissima is edible medicinal plant and phenolic fraction extracted from the leaves of this plant may help the common man in the protection of heart. The phenolic fraction shows significant antioxidant activity, so this might be referred to as dietary supplement and also helps to develop new pharmaceutical formulations.

A Natural History of Gastrojejunostomy Tubes in Children.

BACKGROUND: Gastrojejunostomy (GJ) tubes are frequently used to provide nutrition in patients who do not tolerate gastric feeding. Despite their widespread use, there is little literature on the lifespan of GJ tubes, reasons for failure, and recommendations for optimal techniques and timing of replacement. We aimed to evaluate the natural history of GJ tubes in pediatric patients. MATERIALS AND METHODS: We reviewed all pediatric patients who underwent GJ tube placement or exchange at our institution from January 2012 to July 2018. Demographic data, time, and indication for replacement or removal of GJ tubes were collected. End points were permanent removal of GJ tube or mortality. RESULTS: Seventy-nine patients underwent 205 GJ tube procedures with a median of 2 GJ tubes per patient. Median GJ tube lifespan was 98 d (interquartile range = 54-166). The two most common indications for tube exchange were structural or mechanical problems (43.1%) and GJ tube dislodgement (34.6%). Although most GJ tube exchanges (66%) were performed under general anesthesia or with moderate sedation, 34% of exchanges were done without sedation. During the study period, 12 patients (15.2%) died from their primary disease, nine patients (11.4%) required subsequent fundoplication, one (1.3%) underwent a jejunostomy, and 23 (29.1%) progressed to gastric feeds without fundoplication at a median time of 208 d. CONCLUSIONS: GJ tubes offer a safe and effective feeding option in patients intolerant of gastric feeding. GJ tubes fail most commonly from intrinsic structural or mechanical issues, and many patients ultimately tolerate gastric feeds without need for further intervention. Exchange of tubes without anesthesia is a viable option.

Impact of Fluoridated and Non-fluoridated Mouth Rinses on Frictional Resistance between Orthodontic Archwire and Bracket: A Comparative Study.

AIM AND OBJECTIVE: The present study aimed to assess the effect of fluoridated and nonfluoridated mouth ri nses on resistance to friction between orthodontic bracket and archwire. MATERIALS AND METHODS: This study comprises 60 premolar stainless steel (SS) brackets with 0.022 inches slot size. The 0.019 × 0.025 dimensions SS archwires were cut into 5 cm long specimens. They were grouped into three main categories, group I: artificial saliva (control solution), group II: Aloe Dent mouthwash (ALO), and group III: 0.05% sodium fluoride mouthwash. The specimens from each group were either immersed in the test solution or in the control solution for 10 hours. Later, the specimens were transferred to an incubator maintained at 37°C. Post 10 hours, the specimens were immersed for 30 minutes in distilled water. A scanning electron microscope was used to study the surface morphology and a universal testing machine was used to measure the frictional resistance. RESULTS: The distribution of normality for three study groups' recorded data was checked using Shapiro-Wilk test. The highest frictional resistance (1.94 ± 0.02) was demonstrated by specimens immersed in 0.05% sodium fluoride mouthwash than those immersed in Aloe Dent mouthwash (1.28 ± 0.66) and artificial saliva (1.10 ± 0.32). The difference found between the groups by an analysis of covariance was statistically significant. The highest surface roughness (22.30 ± 0.12) was revealed by specimens immersed in 0.05% sodium fluoride mouthwash than those immersed in Aloe Dent mouthwash (18.28 ± 0.26) and artificial saliva (15.86 ± 0.42). A statistically significant difference between the groups was shown by an analysis of covariance. CONCLUSION: After considering the drawbacks of this study, we conclude that specimens immersed in Aloe Dent mouthwash demonstrated less frictional resistance and surface roughness when compared to those immersed in 0.05% sodium fluoride mouthwash. CLINICAL SIGNIFICANCE: During sliding mechanism, the frictional resistance between orthodontic archwire and brackets imposes problems, such as lessening the applied force and movement of tooth, and also results in anchorage loss. So, orthodontists should always take care while prescribing mouthwashes to reduce their effects on the friction.

Impact of Different Root Conditioning Agents on Periodontally Affected Root Surface: A Scanning Electron Microscope Study.

AIM: The present study aimed to evaluate the effect of various root-conditioning agents on root surfaces that are periodontally affected. MATERIALS AND METHODS: A total of 90 human teeth having single root that were extracted because of chronic periodontitis were chosen. The extracted teeth were cleaned of saliva and blood using a soft-bristled brush and distilled water. The investigational groups were categorized into group I-doxycycline HCl, group II-ethylenediaminetetraacetic acid, and group III-tetracycline HCl. Samples were readied for histological study by scanning electron microscope (SEM). The SEM was used to assess the effectiveness of smear layer removal, amount of patent dentinal tubules out of the totality of dentinal tubules present, and the appreciation of collagen fiber-like structures inside the intertubular area. RESULTS: The highest efficacy for smear layer removal was seen for group III-tetracycline HCl samples (1.80 ± 0.148) followed next by group II-EDTA (1.36 ± 0.230), and group I-doxycycline HCl (1.30 ± 0.283). The highest number of patent dentinal tubules were seen in group III-tetracycline HCl (44.50 ± 0.18) followed immediately by group II-EDTA (38.10 ± 0.42), and group I-doxycycline HCl (34.90 ± 0.23). The highest number of appreciation of collagen-like structures was recorded in group III-tetracycline HCl (2.64 ± 0.04) followed next by group I-doxycycline HCl (1.88 ± 0.10) and group II-EDTA (1.76 ± 0.28). CONCLUSION: The present in vitro study concludes tetracycline HCl root-conditioning agent to be significantly more efficient in smear layer removal, exposing collagen fibers and amount of patent dentinal tubules than doxycycline HCl and EDTA. CLINICAL SIGNIFICANCE: The modification of the root surface of human teeth with the use of root conditioning agents leads to enhanced attachment by connective tissue resulting in improved reconstructive periodontal treatment goals.

Isorhamnetin Has Potential for the Treatment of Escherichia coli-Induced Sepsis.

Isorhamnetin is a flavonoid that is abundant in the fruit of Hippophae rhamnoides L. It is widely studied for its ability to modulate inflammatory responses. In this study, we evaluated the potential of isorhamnetin to prevent gram-negative sepsis. We investigated its efficacy using an Escherichia coli-induced sepsis model. Our study reveals that isorhamnetin treatment significantly enhances survival and reduces proinflammatory cytokine levels in the serum and lung tissue of E. coli-infected mice. Further, isorhamnetin treatment also significantly reduces the levels of aspartate aminotransferase, alanine amino transferase and blood urea nitrogen, suggesting that it can improve liver and kidney function in infected mice. Docking studies reveal that isorhamnetin binds deep in the hydrophobic binding pocket of MD-2 via extensive hydrophobic interactions and hydrogen bonding with Tyr102, preventing TLR4/MD-2 dimerization. Notably, binding and secreted alkaline phosphatase reporter gene assays show that isorhamnetin can interact directly with the TLR4/MD-2 complex, thus inhibiting the TLR4 cascade, which eventually causes systemic inflammation, resulting in death due to cytokine storms. We therefore presume that isorhamnetin could be a suitable therapeutic candidate to treat bacterial sepsis.