Braided silk sutures coated with photoreduced silver nanoparticles for eradicating Staphylococcus aureus and Streptococcus mutans infections.

BACKGROUND: Infections resulting from surgical procedures and wound closures continue to pose significant challenges in healthcare settings. To address this issue, the investigators have developed antibacterial non-resorbable braided silk sutures using in situ deposited silver nanoparticles (AgNPs) and investigated their efficacy in eradicating Staphylococcus aureus and Streptococcus mutans infections. METHODS: The braided silk sutures were modified through a simple and efficient in situ photoreduction method, resulting in the uniform distribution of AgNPs along the suture surface. The synthesized AgNPs were characterized using scanning electron microscopy (SEM), dynamic light scattering analysis (DLS) and Fourier Transform Infrared Spectroscopy analysis (FTIR) confirming their successful integration onto the silk sutures. The antibacterial activity of the nanoparticle coated sutures were compared and evaluated with non-coated braided silk sutures through in vitro assays against both S. aureus and S. mutans. RESULTS: The surface and cross-sectional analysis of the treated sutures revealed a uniform and homogeneous distribution of silver particles achieved through the photoreduction of silver solution. This observation confirms the successful coating of silver nanoparticles (AgNPs) on the sutures. The antimicrobial studies conducted, demonstrated significant reductions in bacterial colonies when exposed to the silver nanoparticle-coated sutures. Notably, the width of the inhibition zone surrounding the coated sutures remained consistently wide and stable for duration up to 7 days. This sustained and robust inhibitory effect against gram-positive bacteria, specifically S. aureus and S. mutans, serves as strong evidence of the antibacterial efficacy of the coated sutures. CONCLUSION: The coating of silk sutures with AgNPs provided a significant and effective antibacterial capacity to the surgical sutures, with this activity being sustained for a period of 7 days. This suggests that AgNPs-in situ photoreduction deposited sutures have the potential to effectively manage S. aureus and S. mutans infections.

Obesity and its association with chronic periodontitis: A cross-sectional study.

BACKGROUND: Relationship among periodontitis, obesity, and chronic diseases may be multidirectional. Inflammatory diseases such as periodontitis induce the production of pro-inflammatory cytokines such as TNF-α, IL-1, and IL-6. It has been suggested that the secretion of TNF-α by adipose tissue triggered by lipopolysaccharides from periodontal Gram-negative bacteria promotes hepatic dyslipidemia and decreases insulin sensitivity. AIM: To study the association of obesity with the severity of periodontitis and to compare the blood glucose levels and plasma lipid profile in obese and non-obese subjects with chronic periodontitis. METHODOLOGY: A total of 84 systemically healthy subjects, aged 30-60 years, were included in the study. Periodontal status of the subjects was assessed by recording Community Periodontal Index (CPI) and Gingival Index (Loe and Silness, 1963). Body mass index (BMI) and waist circumference (WC) were used as measures to assess obesity. The fasting plasma lipids level and fasting blood glucose level were measured. Data were analyzed by unpaired 't'test, Fisher's Exact test, and Chi-square test. RESULTS: There was a statistically significant difference in Gingival Index and Community Periodontal Index between the obese and non-obese group. Total cholesterol, triglycerides, and low-density lipoprotein (LDL) levels showed significant difference between the two groups. There was no statistically significant difference in mean age, high-density lipoprotein (HDL) levels, and fasting blood glucose levels between the two groups. CONCLUSION: The present study showed a positive association between obesity and chronic periodontitis. Further long-term studies involving larger sample size are required to confirm this association.

Neutralization of Naja naja venom induced lethality, edema and myonecrosis by ethanolic root extract of Coix lacryma-jobi.

Coix lacryma-jobi, commonly known as job's tear, is a tall grain-bearing tropical plant of the family Poaceae. The ethanolic root extract (ERE) of the plant was investigated for the first time for anti-venom activity against Indian cobra Naja naja venom. In-vitro studies were conducted to determine neutralization of phospholipase A2 (PLA2) activity of the Naja naja venom by the ERE. ERE showed significant inhibition of PLA2 activity, which was further confirmed from effective neutralization of human red blood cells (HRBC) lysis induced by the venom. In addition, venom-induced proteolysis, fibrinogenolysis, DNase activity were also neutralized by the ERE, which contained carbohydrates, glycolides, resins and tannins. Oral administration of ERE at doses levels 100, 200 and 400 mg/kg effectively inhibited Naja naja venom-induced lethality in mice. Myotoxicity induced by Naja naja venom, measured by creatine kinase activity in rats was significantly neutralized by the ERE at a dose of 200 mg/kg. Stigmasterol, as one of the component isolated from the ERE, was found to have venom phospholipase A2 inhibition potential, which was confirmed by molecular docking studies with PLA2. In summary, these studies indicate the ability of ERE of Coix lacryma-jobi to effectively neutralize the toxic effects of the venom is, in part, contributed by the inhibition of PLA2 activity among other venom-derived factors.

A Study on Utilization and Evaluation of Antiemetics in Chemotherapy-induced Nausea and Vomiting.

PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) are the major adverse effects of cancer chemotherapy. The objectives of this study are to evaluate the utilization of antiemetics in CINV and to assess the emetogenicity of chemotherapy and to investigate the incidence of acute and delayed CINV. METHODS: A prospective observational study was carried out in patients undergoing chemotherapy. A suitable data collection form was designed to collect data regarding patient's demographics, cancer type, chemotherapy regimen, antiemetic prescribed, and incidence of CINV according to the standard methods utilizing morrow assessment of nausea and emesis form. RESULTS: Among 200 patients enrolled in the study, with age range of 18-83 (52 ± 11.65; mean ± standard deviation) of both sexes (44% of male and 56% of female), 38.5% of patients received highly emetogenic chemotherapy and 46.5% received moderate emetogenic chemotherapy. Among the patients, 88% received 5HT3-RA in combination with corticosteroid (99%) and NK1-RA (40.5%). Despite the administration of antiemetic, the incidence of acute and delayed nausea after chemotherapy treatment was reported by 54% and 15.5%, respectively. The comparable figures for acute and delayed vomiting were 36.5% and 14.5%. CONCLUSION: The incidence of CINV among the patients was relatively high and it indicates that more attention is needed for the treatment of both acute and delayed CINV. It also gives an idea for implementation of more efficient antiemesis guideline in the clinical practice.

Estimation and correlation of salivary thiocyanate levels in periodontally healthy subjects, smokers, nonsmokers, and gutka-chewers with chronic periodontitis.

AIM: This study was conducted to estimate and correlate salivary thiocyanate (SCN) levels in periodontally healthy subjects, smokers, nonsmokers, and gutka-chewers with chronic periodontitis. METHODOLOGY: The study population consisted of 40 systemically healthy subjects in the age group of 18-55 years that was further divided into four groups: Control, smokers, nonsmokers, and gutka-chewers with chronic periodontitis. Gingival index (GI) (Loe and Silness-1963), probing depth (PD), clinical attachment loss was assessed. Estimation of SCN was performed by ultraviolet spectrophotometer at 447 nm wavelength. Statistical analysis was performed using the one-way ANOVAs Welch test and Pearson's correlation test using SPSS version 17 software. RESULTS: Results showed statistically significant increase in SCN levels in smokers as compared to gutka-chewers with chronic periodontitis, control, and nonsmokers with chronic periodontitis subjects. Significantly higher PD and loss of attachment were seen in smokers group compared with other groups. A negative correlation observed between the GI and thiocyanate levels. CONCLUSION: The present study revealed a significant increase in SCN levels in smokers with periodontitis as compared to nonsmokers.

Assessment of salivary calcium, phosphate, magnesium, pH, and flow rate in healthy subjects, periodontitis, and dental caries.

AIM: This study was conducted to estimate and compare inorganic salivary calcium, phosphate, magnesium, salivary flow rate, and pH of unstimulated saliva and oral hygiene status of healthy subjects, subjects with periodontitis and dental caries, and to correlate salivary calcium level with number of intact teeth. MATERIALS AND METHODS: The study population consisted of 48 systemically healthy subjects in the age group of 18-55 years, which was further divided into three groups: healthy, periodontitis, and dental caries. Oral hygiene index-simplified, probing pocket depth, clinical attachment level, the number of intact teeth, and active carious lesions were recorded. Estimation of inorganic salivary calcium, phosphate, and magnesium was performed spectrophotometrically using Vitros 5.1 FS. Statistical analysis was performed using the one-way analysis of variance test at 5% significance level. RESULTS: There was a statistically significant increase in inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene status in periodontitis group compared to dental caries and healthy group. CONCLUSION: Subjects with increased inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene are at a higher risk of developing periodontitis. Since there is increased remineralization potential, these subjects have more number of intact teeth compared to the dental caries group.

Comparative analysis of gingival crevicular fluid ß-glucuronidase levels in health, chronic gingivitis and chronic periodontitis.

BACKGROUND AND OBJECTIVES: Current methods available for periodontal disease diagnosis are seriously deficient in terms of accuracy, in the ability to predict ongoing or future disease activity and indeed in determining whether previously diseased sites are in an arrested phase or still active. One area that is receiving a great deal of attention is the biochemical investigation of gingival crevicular fluid (GCF). ß-glucuronidase (ßG) is one of the enzymes found in GCF that is involved in degradation of the ground substance and fibrillar components of host connective tissue. GCF ßG activity might be a good indicator or predictor of periodontal disease activity. This study was conducted to estimate and compare the GCF ßG levels in patients with healthy periodontium, chronic gingivitis, and chronic periodontitis. METHODOLOGY: Subjects were classified into three groups of 20 patients each; healthy individuals, chronic gingivitis, and chronic periodontitis. After recording the plaque index, gingival index and probing pocket depth, 1 µL GCF was collected by placing a calibrated microcapillary pipette extracrevicularly and transferred to sterile plastic vials containing 350 µL of normal saline with 1% bovine serum albumin. Analysis of ßG was done by spectrophotometry. RESULTS: ßG levels in GCF were significantly higher in chronic periodontitis group (mean value - 2.04743), followed by chronic gingivitis group (mean - 1.11510) and healthy group (0.53643). CONCLUSION: Increased ßG levels were observed in patients with increased periodontal destruction, hence GCF ßG levels can be used as biochemical marker for periodontal disease activity.

Role of dried fruits of Carissa carandas as anti-inflammatory agents and the analysis of phytochemical constituents by GC-MS.

Inflammation plays an important role in various diseases with high prevalence within populations such as rheumatoid arthritis, ulcer, atherosclerosis, and asthma. Many drugs are available in the market for inflammatory diseases. They exhibit several unwanted side effects to humans. Therefore, alternative treatments with safer compounds are needed. Carissa carandas plant is used in traditional medicinal system for its various diseases curing property. In the present study, we examined the anti-inflammatory effects of dried fruit methanol extract on carrageenan-induced hind paw edema in rats. C. carandas was defatted with petroleum ether, followed by methanol extraction. The methanol extracts of the dried fruits of Carissa carandas were given orally to the experimental rats caused significant activity (P ≤ 0.05) when compared with the control group. The maximum inhibition of paw edema was found to be in Group V, that is, 76.12% with inhibition of paw volume in a dose-dependent manner. The anti-inflammatory activity of the methanol extract of the dried fruits shows that the presence of potential constituents present in this extract may provide assistance in the drug discovery process. The phytochemical compounds of the extract were screened by GC-MS analysis and it was found that 11 compounds are present in methanol extract of dried fruits of Carissa carandas.

Poor periodontal health: A cancer risk?

Evidence indicates that chronic infections and inflammation are associated with increased risk of cancer development. There has also been considerable evidence that proves the interrelationship between bacterial and viral infections and carcinogenesis. Periodontitis is a chronic oral infection thought to be caused by gram-negative anaerobic bacteria in the dental biofilm. Periodontal bacteria and viruses may act synergistically to cause periodontitis. Many studies have shown that periodontal pockets may act as reservoirs for human papilloma virus, cytomegalovirus, Epstein Barr virus, and suspected agents associated with oral cancer. Periodontitis, characterized by epithelial proliferation and migration, results in a chronic release of inflammatory cytokines, chemokines, growth factors, prostaglandins, and enzymes, all of which are associated with cancer development. This review article intends to shed light on the association between periodontal health and carcinogenesis.

Development and Validation of RP-HPLC Method for the Simultaneous Estimation of Montelukast Sodium and Ebastine in Tablet Dosage Form.

A rapid and sensitive RP-HPLC method with UV detection (244 nm) for routine analysis of montelukast sodium and ebastine in a pharmaceutical formulation (Ebast-M) was developed. Chromatography was performed with mobile phase containing a mixture of methanol:acetonitrile:ammonium acetate (80:10:10, % v/v/v), pH of mobile phase was adjusted 5.5 using glacial acetic acid and flow rate was 1.2 ml/min. The method was validated for linearity, accuracy, robustness and intermediate precision. The linearity was established over the concentration range of 0.01-0.06 mg/ml for both drugs. The correlation coefficients (r (2)) for ebastine and montelukast were 0.9989 and 0.9955, respectively. Statistical analysis of the data showed that the method was precise, accurate, reproducible and selective for the analysis of ebastine and montelukast drugs. The method was successfully employed for the determination of ebastine and montelukast in commercially available tablet dosage form.

Two stage surgical procedure for root coverage.

Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva.

Evaluation of the efficacy of a 5% calcium sodium phosphosilicate (Novamin) containing dentifrice for the relief of dentinal hypersensitivity: a clinical study.

CONTEXT: Dentinal hypersensitivity (DH) is a commonly encountered problem. Several products are used in management of DH with varying results. Need is felt in dentistry for a material that chemically reacts, physically occludes and adheres intimately to dentinal tubules to reduce the possibility of its recurrence. One such material is calcium sodium phosphosilicate-Novamin. AIM: To evaluate an efficacy of a 5% calcium sodium phosphosilicate (Novamin SHY NM) containing dentifrice compared to placebo for the relief of DH. SETTINGS AND DESIGN: Outpatients visiting Dept of Periodontics, Yenepoya Dental College with DH were deemed eligible for this case-control clinical trial after an informed consent. MATERIALS AND METHODS: 30 patients having at least 2 sensitive teeth with a VAS (Visual Analogue Scale) of >3 cm after air blast stimulation, qualified to participate in the study. Test (SHY NM toothpaste containing 5% calcium sodium phosphosilicate) and control (Pepsodent toothpaste without a desensitizing agent) groups, each containing 15 participants, were subjected to cold water and air blast stimulation for an assessment of DH at baseline, 6 th and 8 th week using VAS. STATISTICAL ANALYSIS USED: Unpaired t-test and repeated measures ANOVA. RESULTS: 5% Novamin containing dentifrice significantly reduced DH within 6 th and 8 th week of usage when compared to a placebo dentifrice. CONCLUSIONS: A Novamin containing dentifrice significantly reduced DH when compared to a placebo dentifrice.

Losartan potassium loaded sustained release matrix tablets: Influence of various hydrophilic and hydrophobic polymers on drug release behaviour.

Losartan potassium is an angiotensin II receptor antagonist readily absorbed from the GIT, following oral administration. It has low bioavailability as it undergoes extensive first pass metabolism and low elimination half-life. The present study was aimed at studying sustained release behaviour of the drug using hydrophilic and hydrophobic polymers and to optimise using a 3(2) full factorial design. Eudragit and HPMC were used to evaluate the effect of hydrophilic and hydrophobic polymers on the release pattern of the drug. A full factorial was implemented at 20, 30 and 40% concentration of hydrophilic polymer and 2.5, 5 and 7.5% of hydrophobic polymer correlating with the release behaviour. Process variables were investigated and the results showed excellent adaptability in releasing drug over prolonged periods. Based on the results, it was found suitable to formulate a dosage form using optimum concentration of hydrophobic polymer along with hydrophilic polymer to vary the release behaviour for over 12 hours.

Formulation and kinetic modeling of curcumin loaded intranasal mucoadhesive microemulsion.

It is a challenge to develop the optimum dosage form of poorly water-soluble drugs and to target them due to limited bioavailability, intra and inter subject variability. In this investigation, mucoadhesive microemulsion of curcumin was developed by water titration method taking biocompatible components for intranasal delivery and was characterized. Nasal ciliotoxicity studies were carried out using excised sheep nasal mucosa. in vitro release studies of formulations and PDS were performed. Labrafil M 1944 CS based microemulsion was transparent, stable and nasal non-ciliotoxic having particle size 12.32±0.81nm (PdI=0.223) and from kinetic modeling, the release was found to be Fickian diffusion for mucoadhesive microemulsion.

Phytochemical and antimicrobial study of Oroxylum indicum.

Oroxylum indicum(Linn.) Vent , the plant used in this study is one among the group of ten drugs named Dasamoola, widely used in Ayurvedic system of medicine. The officinal part of this plant, the root bark is often adulterated with the stem of the plant. Hence this comparative study of root and stem of this plant becomes highly significant.The Physico-chemical parameters, Thin Layer Chromatography and High Performance Thin Layer Chromatography studies of stem and root were carried out in this study separately. The TLC studies of three different fractions were isolated - (1) Lipids, fats and waxes (2) Glycosides, Terpenoids and Phenols (3) Alkaloids TLC studies showed that the phytochemicals isolated from root and stem separately are different from each other, thus helping to distinguish the part used.The review of Ayurvedic classical literature also reveals that the therapeutic actions of stem and root are different. The antibacterial activity of alcoholic extracts of stem and root were carried out separately using agar well diffusion method and found that the stem extract has more antibacterial activity especially against organisms causing diarrhea than root extract. This further validates therapeutic indications mentioned in Ayurveda.

Effect of hydrophilic natural gums in formulation of oral-controlled release matrix tablets of propranolol hydrochloride.

In order to develop a controlled delivery of highly water-soluble propranolol hydrochloride (PPHCl) using hydrophilic natural gums (xanthan gum [X] and locust bean gum [LBG]) as cost-effective, nontoxic, easily available. The granules of PPHCl were prepared by wet granulation method using a different ratios drug: gum ratios of X, LBG and XLBG(X and LBG in 1:1 ratios). To increase the flowability and compressibility of the granules, and to prevent its adhesion to punch and die, magnesium stearate and talc were added to the granules in 1:2 ratios before punching. The tablet was analysed to determine hardness, friability, % assay and invitro release study was carried out. The release of PPHCl from a gelatinous swollen mass, which controls the diffusion of drug molecules through the polymeric material into aqueous medium. The XLBG matrice shows precise controlled release than the X and LBG matrice because of burst effect and fast release in case of X and LBG matrice respectively and there was no chemical interaction between drug and polymer in XLBG formulation as confirmed by FTIR studies. First pass effect of PPHCl can be avoided by these formulations. Matrices with XLBG show zero-order release via swelling, diffusion and relaxation mechanism. The XLBG matrice leads to more precise result than X and LBG alone by the utilization of synergistic interaction between two biopolymers and uniformity in the hydration layer in dissolution media. However, according to the similarity factor (f(2)) XLBG3 were the most similar formulations to Lol-SR as the reference standard.

The efficacy of a herbal-based toothpaste in the control of plaque and gingivitis: a clinico-biochemical study.

OBJECTIVE: A double-blinded controlled clinical trial with parallel groups was designed to investigate the effectiveness of a herbal-based toothpaste in the control of plaque and gingivitis as compared with a conventional dentifrice. The efficacy of Colgate Herbal over Colgate tooth paste was assessed in this study. MATERIALS AND METHODS: Thirty subjects with gingivitis participated in the study. All participants had at least 20 natural teeth with no probing depths greater than 3 mm and a plaque index score of 2 or more at baseline. At baseline, the clinical parameters like gingival index, plaque index and salivary pH were estimated. Paired t-test was used to compare the difference within the groups and unpaired t-test was used to compare the difference between the groups at baseline and on the 30th day. RESULTS: At the end of the study, there were statistically significant reductions in the gingival index and the plaque index scores within the test group. However, there were no statistically significant differences between the test and the control groups. The salivary pH changes were not statistically significant in the test group but were displaced more toward the acidic range in the control group. CONCLUSION: It was however concluded that the herbal-based toothpaste was as effective as the conventionally formulated dentifrice in the control of plaque and gingivitis.

Metastasis to maxillary gingiva from carcinoma of breast. A case report.

A rare case of metastatic infiltrating duct carcinoma involving gingiva in relation to maxillary left canine-premolar of a 40 year old female is presented. The unilateral gingival enlargement in canine-premolar region was quite unusual. Pertinent history and histological examination revealed that the tumor was a metastatic carcinoma, the primary lesion of which was in the breast. The differential diagnosis of gingival enlargements is discussed in this paper. The resemblance of this mass to an inflammatory hyperplastic condition reflects the need for a detailed case history and examination.

Efficacy of Chitra granule and powder (hydroxyapatite) in alveolar bone regeneration in rabbits. A histological evaluation.

The reconstruction or restoration of osseous defects caused by inflammatory periodontal disease is a continuing challenge in periodontal therapy. Great strides are being made to this effect using alloplasts such as hydroxyapatite. The present study was designed in Newzealand dwarf rabbits to observe the biologic response of periodontal tissues to synthetically prepared hydroxyapatite in both powder and granule forms by Srichitra Tirunal Institute for Medical Sciences & Technology, Trivandrum and to compare it with that of a commercially available, pure resorbable hydroxyapatite, OsteoGen (HA Resorb). The test materials were implanted in the artificially created bonydefects in the mandible via an intraoral approach. The wounds were allowed to heal upto 26 weeks postimplantation. The clinical evaluation at 12 weeks and 26 weeks postimplantation revealed neither any evidence of inflammation, infection or abscess formation nor any exposure or exfoliation of test materials. The histological examination of the implant sites at 12 and 26 weeks postimplantation revealed varying extent of formation of new osseous tissue and periodontal fibers. A comparison between test materials and control suggested that Chitra granules exhibit a relatively greater potential for newbone and periodontal fibre formation.