Effect of mandibular advancement therapy on inflammatory biomarkers in obstructive sleep apnea: A systematic review.

To review the literature on the effect of mandibular advancement therapy (MAT) on inflammatory biomarkers in obstructive sleep apnea (OSA). The present systematic review addresses the following focus question: What is the effect of MAT on inflammatory biomarkers in OSA? Electronic and manual literature searches were conducted on databases: PubMed/MEDLINE, Web of Science, and Cochrane Library for studies published until September 2021 to collect information about the effect of mandibular advancement therapy, a non-continuous positive airway pressure alternative measurement of OSA. A systematic literature review was performed following the PRISMA guidelines to identify studies evaluating the effect of MAT in patients suffering from OSA. Randomized clinical trials were included, and case reports, retrospective studies, literature reviews, in-vitro studies, observational studies, authors' opinions, letters to the editor, and engineering articles were excluded. Fifty-nine articles published before September 2021 were identified. Fifty-four articles met the inclusion criteria. After assessing inclusion criteria, three clinical trials were included with 148 patients suffering from OSA and treated with mandibular advancement therapy. The follow-up period ranged from two to three months, with the average follow-up being 1.66 months. The mean age of the patients was observed to be 53.11 ± 2.65 years. The mean Epworth Sleepiness Scale observed in patients in all three clinical trials was 9.75 ± 0.89. MAT in patients with moderate or severe OSA reduced apnea-hypopnea index but has less effect on inflammatory and metabolic biomarkers.

The surgical outcome of sutureless skin closures using Octyl-2-cyanoacrylate (Dermabond™) versus Steri-Strip™.

Introduction: Cosmesis is the primary concern for the patient undergoing facial surgery and there are numbers of well proven materials that are available such as adhesive tapes, subcuticular suture, skin adhesive or glue to achieve better cosmesis. The objective of our study was to assess the surgical outcome of sutureless skin closures using Octyl-2-cyanoacrylate (Dermabond™) versus Steri-Strip™. Method: The present prospective study was conducted in 20 patients. Patients were divided into two groups. After subcutaneous closure of wounds, either Dermabond™ or Steri-Strip™ was placed. The patients were assessed for wound complication (erythema, tenderness, dehiscence or any discharge), scar hypertrophy and cosmetic appearance also time consumed in surgical skin closure was evaluated. Wound assessment, scar hypertrophy and cosmetic appearance were assessed by using Chi-square test. Time closure was assessed by using Mann-whitney U test. Result: Twenty patients belonging to all age group were included in study. Ten patients undergone closure with Dermabond™ and ten with Steri-Strips™. Assessment of wound complications, cosmetic appearance and scar hypertrophy was done. There was no significant difference found between both the groups, but 2 patients had fair cosmetic outcomes at one month and 1 patient had fair scar hypertrophy at 6 month. However, excellent cosmetic outcome in terms of scar hypertrophy at 6 month was significantly more among group II. Conclusion: Octyl-2-cyanoacrylate (Dermabond™) and Steri-Strip™ provide similar outcomes in terms of wound complications. Cosmetic outcomes in terms of scar hypertrophy with steri-strip wound closure seem to be better and more economical.

Volumetric analysis of mastoid air cells in orthodontic malocclusions in 3D cone beam computed tomography (CBCT).

Objectives: To determine age- and sex-related changes in mastoid air cells volume in orthodontic malocclusions (class 1, class 2, class 3) in cone beam computed tomography (CBCT), morphometric analysis, and age prediction on the basis of mastoid air cells. Methods: In total, 150 3D CBCT scans of study subjects having class 1, class 2, and class 3 malocclusions have been analyzed retrospectively for the estimation of volume of mastoid air cells by Dolphin imaging software V11.9, and measurement data of volumes have been recorded and analyzed using SPSS software 24.v. Results: The volume of mastoid air cells was highest in age group of 14-28 years which was statistically not significant (P value >.05). The volume of mastoid air cells in the right side of cranium is greater than mastoid air cells in the left side. The mastoid air cell volume was higher in males than females. The volume of mastoid air cells (right side) was highest in class II malocclusion (2404.53 ± 1737.50 mm3) followed by class III and was least in class I malocclusion (1842.09 ± 1263.78 mm3). However, the volume of mastoid air cells in the left side was highest in class III malocclusion (2368.03 ± 1853.00 mm3) followed by class II and was least in class I (1920.52 ± 1285.34 mm3). Conclusions: The volume of mastoid air cells varies in different class of orthodontic malocclusions. The mastoid air cells volume is higher in males than females. On the basis of mastoid air cells volume, we are able to predict the age, sex, and class of orthodontic malocclusion.

Biobased heterogeneous renewable catalysts: Production technologies, innovations, biodiesel applications and circular bioeconomy.

The growing population and waste biomass accumulation are leading to increased environmental pollution and climate change. Waste biomass comprising of nutrient rich components has promising potential to produce value-added products for sustainable environmental solutions. This review explores the critical role of bio-based heterogeneous catalysts in enabling sustainable waste biomass utilization. In industrial chemical transformations, over 95% involve catalysts, with more than 90% being heterogeneous systems, prized for their robustness, ease of product separation, and reusability. Bio-based heterogeneous catalysts address the pressing need for sustainable waste biomass management, allowing the conversion of diverse waste biomasses into biodiesel as valuable products. Research on these catalysts, particularly for biodiesel production, has shown yields exceeding 90% with enhanced catalyst reusability. This surge in research is evident from the increasing number of published articles, notably in 2022 and 2023, highlighting growing interest and importance in the scientific community. The synthesis of these catalysts is examined, including novel approaches and techniques to enhance their efficiency, selectivity, and stability. The challenges with their feasible solutions of heterogeneous catalysts in catalyst-based processes are addressed. Altogether, this review underscores the immense potential of bio-based heterogeneous catalysts in sustainable waste biomass utilization, aligning with resource efficiency and environmental conservation goals while offering distinct insights and perspectives on the latest innovations in the field.

Analytical considerations for characterization of generic peptide product: A regulatory insight.

The Peptide therapeutics market was evaluated to be around USD 45.67 BN in 2023 and is projected to witness massive growth at a CAGR of around 5.63 % from 2024 to 2032 (USD 80.4 BN). Generic peptides are expected to reach USD 27.1 billion by 2032 after the patent monopoly of the pioneer peptides expires, and generic peptides become accessible. The generic manufacturers are venturing into peptide-based therapeutics for the aforementioned reasons. There is an abundance of material accessible regarding the characterization of peptides, which can be quite confusing for researchers. The FDA believes that an ANDA applicant may now demonstrate that the active component in a proposed generic synthetic peptide drug product is the "same" as the active ingredient in a peptide of rDNA origin that has previously been approved. To ensure the efficacy, safety, and quality of peptide therapies during development, regulatory bodies demand comprehensive characterization utilizing several orthogonal methodologies. This article elaborates the peptide characterization by segmenting into different segments as per the critical quality attribute from identification of the peptide to the physicochemical property of the peptide therapeutics which will be required to demonstrate the sameness with reference product based on the size of the peptide chain and molecular weight of the peptides. Article insights briefly on each individual technique and the orthogonal techniques for each test were explained. The impurities requirements in the generic peptides as per the regulatory requirement were also discussed.

Effect of Mn2+doping and DDAB-assisted postpassivation on the structural and optical properties of CsPb(Cl/Br)3halide perovskite nanocrystals.

Cesium lead halide perovskite (CsPbX3; X = Cl, Br, I) nanocrystals showing intense band-edge emission and high photoluminescence quantum yield are known to be a potential candidate for application in optoelectronic devices. However, controlling toxicity due to the presence of Pb2+in lead-based halide perovskites is a major challenge for the environment that needs to be tackled cautiously. In this work, we have partially replaced Pb2+with Mn2+ions in the CsPb(Cl/Br)3nanocrystals and investigated their impact on the structural and optical properties. The Rietveld refinement shows that CsPbCl2Br nanocrystals possess a cubic crystal structure withPm3̅mspace group, the Mn2+doping results in the contraction of the unit cell. The CsPb(Cl/Br)3: Mn nanocrystals show a substantial change in the optical properties with an additional emission band at ∼588 nm through a d-d transition, changing the emission color from blue to pink. Here, a didodecyldimethylammonium bromide (DDAB) ligand that triggers both anion and ligand exchange in the CsPb(Cl/Br)3: Mn nanocrystals have been used to regulate the exchange reaction and tune the emission color of halide perovskites by changing the peak position and the PL intensities of band-edge and Mn2+defect states. We have also shown that oleic acid helps in the desorption of oleylamine capping from the CsPb(Cl/Br)3: Mn nanocrystal surfaces and DDAB, resulting in the substitution of Cl-with Br-as well as provides capping with shorter branched length ligand which led to increase in the overall PL intensity by many folds.

Quality of Life Assessment and Comparative Analysis of Anterolateral Thigh Flap and Pectoralis Major Myo-cutaneous Flap for Reconstruction of Post Excision Defects of Oral Squamous Cell Carcinoma.

Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022. These 2 flaps were compared in terms of parameters like time utilised for reconstruction, hospital stay, overall survival and Washington University Quality of Life index(UW-QOL) for head and neck cancer. Patients were followed regularly for post-operative complications. The University of Washington Quality of Life score (UW-QOL) questionnaire, version 4, was completed at six months post-operatively. Obtained data was statistically analysed using IBM® SPSSⓇ. Washington University Quality of Life index scores and esthetics are better with Antero-lateral thigh flap, with less overall post-operative complications. On the other hand Pectoralis myocutaneous flap has less surgical time and more salvage potential. Despite of Antero-lateral thigh flap having Good Washington University Quality of Life index scores, lesser post-operative complications and better esthetics; scale of developing nations is still tipping towards economical, less time consuming and less technique sensitive Pectoralis major myocutaneous flap.

A comprehensive guide for secondary structure and tertiary structure determination in peptides and proteins by circular dichroism spectrometer.

Secondary structure refers to highly regular local sub-structures formed by the polypeptide backbone through hydrogen bonding. The two main types of secondary structures are α-helices and ß-strands (which can form ß-sheets). The development of a robust circular dichroism (CD) method for structural analysis of biomolecules requires careful consideration of several key factors. Solvent selection plays a crucial role in maintaining the native or desired conformation of the sample while ensuring transparency in the relevant wavelength regions. Aqueous buffers are often preferred for studying proteins in their native state. Optimizing the sample concentration and path length is essential to achieve an optimal absorbance range and maximize the signal-to-noise ratio. Typical concentrations for far-UV CD measurements range from 0.1 to 1 mg/ml, with shorter path lengths (1 mm) allowing for higher concentrations and longer path lengths (5 mm) suitable for dilute solutions. Instrumental parameters, such as scanning speed, accumulations, and nitrogen flow rate, significantly impact the quality and reliability of the acquired CD spectra. Data processing is a critical step in obtaining accurate and interpretable CD spectra. Baseline correction, smoothing, and conversion to mean residue ellipticity are essential for reliable secondary structure analysis.

Spinocerebellar ataxia type 27B (SCA27B) in India: insights from a large cohort study suggest ancient origin.

BACKGROUND: The ethnic diversity of India provides a unique opportunity to study the history of the origin of mutations of genetic disorders. Spinocerebellar ataxia type 27B (SCA27B), a recently identified dominantly inherited cerebellar disorder is caused by GAA-repeat expansions in intron 1 of Fibroblast Growth Factor 14 (FGF14). Predominantly reported in the European population, we aimed to screen this mutation and study the founder haplotype of SCA27B in Indian ataxia patients. METHODS: We have undertaken screening of GAA repeats in a large Indian cohort of ~ 1400 uncharacterised ataxia patients and kindreds and long-read sequencing-based GAA repeat length assessment. High throughput genotyping-based haplotype analysis was also performed. We utilized ~ 1000 Indian genomes to study the GAA at-risk expansion alleles. FINDINGS: We report a high frequency of 1.83% (n = 23) of SCA27B in the uncharacterized Indian ataxia cohort. We observed several biallelic GAA expansion mutations (n = 5) with younger disease onset. We observed a risk haplotype (AATCCGTGG) flanking the FGF14-GAA locus over a 74 kb region in linkage disequilibrium. We further studied the frequency of this risk haplotype across diverse geographical population groups. The highest prevalence of the risk haplotype was observed in the European population (29.9%) followed by Indians (21.5%). The observed risk haplotype has existed through ~ 1100 generations (~ 22,000 years), assuming a correlated genealogy. INTERPRETATION: This study provides valuable insights into SCA27B and its Upper Paleolithic origin in the Indian subcontinent. The high occurrence of biallelic expansion is probably relevant to the endogamous nature of the Indian population.

SGLT2 inhibitors for the treatment of diabetes: a patent review (2019-23).

INTRODUCTION: The sodium-glucose co-transporter 2 (SGLT2) inhibitors are FDA-approved class of drugs for diabetes management. They improve glycemic control by inducing glucosuria. Notwithstanding with potent anti-hyperglycemic activity, SGLT2 inhibitors are emerging as drugs with multifaceted therapeutic potential, evidenced for cardioprotective, renoprotective, antihypertensive, and neuroprotective activities. Continuous attempts are being accomplished through structural modification, development of new formulation, or combination with other drugs, to enhance the bioactivity spectrum of SGLT2 inhibitors for better management of diabetes and related complications. AREAS COVERED: This review comprises a summary of patent applications, acquired using the Espacenet Patent Search database, concerning SGLT2 inhibitors from 2019 to 2023, with focus on improving therapeutic potentials in management of diabetes and metabolic complications. EXPERT OPINION: SGLT2 inhibitors have provided an exciting treatment option for diabetes. Originally developed as anti-hyperglycemic agents, SGLT2 inhibitors exert pleiotropic metabolic responses and have emerged as promising antidiabetic agents with cardio-protective and reno-protective activities. Given their distinct therapeutic profile, SGLT2 inhibitors have revolutionized the management of diabetes and associated complications. Emerging evidences on their therapeutic potential against cancer, male reproductive dysfunctions, and neurodegenerative diseases indicate that further research in this field may unfold novel prospective on their plausible use in the management of other chronic conditions.

Systems genetics identifies methionine as a high risk factor for Alzheimer's disease.

As a dietary strategy, methionine restriction has been reported to promote longevity and regulate metabolic disorders. However, the role and possible regulatory mechanisms underlying methionine in neurodegenerative diseases such as Alzheimer's disease (AD), remain unexplored. This study utilized the data from BXD recombinant inbred (RI) mice to establish a correlation between the AD phenotype in mice and methionine level. Gene enrichment analysis indicated that the genes associated with the concentration of methionine in the midbrain are involved in the dopaminergic synaptic signaling pathway. Protein interaction network analysis revealed that glycogen synthase kinase 3 beta (GSK-3ß) was a key regulator of the dopaminergic synaptic pathway and its expression level was significantly correlated with the AD phenotype. Finally, in vitro experiments demonstrated that methionine deprivation could reduce the expression of Aß and phosphorylated Tau, suggesting that lowering methionine levels in humans may be a preventive or therapeutic strategy for AD. In conclusion, our findings support that methionine is a high risk factor for AD. These findings predict potential regulatory network, theoretically supporting methionine restriction to prevent AD.

Common Mental Disorders and Their Correlates: A Community-based Survey Among Women in Southern Karnataka, India.

Background: About 10% of Indians have common mental disorders (CMDs) which include depression and anxiety. These disorders are common in women, which not only impacts on their quality of life but also their family members. The objective of the study was to estimate the prevalence of CMDs, and factors associated with them among women residing in coastal Karnataka. Methods: A cross-sectional study was carried out among 980 women aged between 18 and 60 years from 2019 to 2021. Women were administered a baseline questionnaire along with Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder questionnaire-7 (GAD-7) and Cohen's Perceived Stress Scale-4 (PSS-4). Data were collected using Epi-info and were analysed using SPSS version 15.0. Association between CMDs and socio-demographic, reproductive health and behavioural factors were expressed as crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results: The prevalence of CMDs among women was 5.7%, with 4.6% having depression and 3.37% with anxiety disorders. Multivariate logistic regression analysis showed that residing in urban areas (OR = 2.15; 95% CI:1.10-4.17), having a chronic illness (OR = 2.38; 95% CI:1.14-4.97), history of recent bereavement in the family (OR = 2.20; 95% CI:1.02-4.75), early marriage (OR = 2.63; 95% CI:1.09-6.33), history of abortion (OR = 2.89; 95% CI:1.42-5.92), and exposure to domestic violence (OR = 3.08; 95% CI:1.14-8.33) were significantly correlated with CMDs in this sample. Conclusions: The study revealed that CMDs were prevalent among the surveyed women, which calls for routine screening of women for CMDs in primary care settings for early identification and appropriate interventions.

Fueling the Future: The Emergence of Self-Powered Enzymatic Biofuel Cell Biosensors.

Self-powered biosensors are innovative devices that can detect and analyze biological or chemical substances without the need for an external power source. These biosensors can convert energy from the surrounding environment or the analyte itself into electrical signals for sensing and data transmission. The self-powered nature of these biosensors offers several advantages, such as portability, autonomy, and reduced waste generation from disposable batteries. They find applications in various fields, including healthcare, environmental monitoring, food safety, and wearable devices. While self-powered biosensors are a promising technology, there are still challenges to address, such as improving energy efficiency, sensitivity, and stability to make them more practical and widely adopted. This review article focuses on exploring the evolving trends in self-powered biosensor design, outlining potential advantages and limitations. With a focal point on enzymatic biofuel cell power generation, this article describes various sensing mechanisms that employ the analyte as substrate or fuel for the biocatalyst's ability to generate current. Technical aspects of biofuel cells are also examined. Research and development in the field of self-powered biosensors is ongoing, and this review describes promising areas for further exploration within the field, identifying underexplored areas that could benefit from further investigation.

OsMED14_2, a tail module subunit of Mediator complex, controls rice development and involves jasmonic acid.

The Mediator complex is essential for eukaryotic transcription, yet its role and the function of its individual subunits in plants, especially in rice, remain poorly understood. Here, we investigate the function of OsMED14_2, a subunit of the Mediator tail module, in rice development. Overexpression and knockout of OsMED14_2 resulted in notable changes in panicle morphology and grain size. Microscopic analysis revealed impact of overexpression on pollen maturation, reflected by reduced viability, irregular shapes, and aberrant intine development. OsMED14_2 was found to interact with proteins involved in pollen development, namely, OsMADS62, OsMADS63 and OsMADS68, and its overexpression negatively affected the expression of OsMADS68 and the expression of other genes involved in intine development, including OsCAP1, OsGCD1, OsRIP1, and OsCPK29. Additionally, we found that OsMED14_2 overexpression influences jasmonic acid (JA) homeostasis, affecting bioactive JA levels, and expression of OsJAZ genes. Our data suggest OsMED14_2 may act as a regulator of JA-responsive genes through its interactions with OsHDAC6 and OsJAZ repressors. These findings contribute to better understanding of the Mediator complex's role in plant traits regulation.

Medial Pterygoid Abscess Masquerading as a Temporomandibular Joint Disorder: A Case Report.

A patient presenting with a history of restricted mouth opening and deflection of the mandible after a prolonged dental procedure raises a suspicion of temporomandibular joint disorder (TMD) due to its estimated high prevalence of 29%. Muscle relaxants and routine active physiotherapy established normal range of movement and pain reduction was achieved through TENS therapy and analgesics. However, the non-subsidence of deflection prompted an initial suspicion of TMD which was overturned by MRI. The MRI evaluation revealed left side medial pterygoid abscess. It is imperative to understand that despite strong history and relevant clinical features, for the definitive diagnosis radiographic evaluation is highly contributory. Misdiagnosing TMD due to its similar presentation can have significant implications for the patient's well-being and quality of life. The clinical features of medial pterygoid abscess including restricted mouth opening and pain can be similar to that of TMD. These abscesses are most commonly caused by odontogenic infections but can also occur as a result of septic inferior alveolar nerve block techniques. Limited literature reports of pterygoid space abscess have been described, but intramuscular and medial pterygoid abscess is an absolute rarity. Causal relationship to septic inferior alveolar nerve block further makes this case report an interesting read.

Evidence-based effectiveness of Ozone therapy in the treatment for oral lichen planus - A systematic review.

Oral lichen planus is a common, chronic mucocutaneous condition of uncertain origin. Early treatment of OLP can dramatically reduce the risk of further development, which in turn reduces the risk of developing cancer. Numerous methods can be used to treat OLP. Since the significance of ozone in treating this disease is still uncertain. This systematic review was conducted based on english databases, including PUBMED, SCOPUS, Embase, Ovid, and Journal of Web up to July 2022. We used the search phrases "ozone," "ozone in the treatment of oral lichen planus," "oral lichen planus," and "ozone therapy." Finally, five papers were selected for qualitative analysis. This review included a total of five papers, four of which were clinical trials and one was a longitudinal study. All studies included the erosive form of OLP, also ozone therapy was applied to patients who did not respond to conventional treatment. Ozone showed significant therapeutic effects in terms of reduction in pain and size of the lesion. The signs and symptoms associated with OLP such as burning sensation, lesion size, and scarring all considerably improved with ozone therapy.

Emerging Trends of Gold Nanostructures for Point-of-Care Biosensor-Based Detection of COVID-19.

In 2019, a worldwide pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged. SARS-CoV-2 is the deadly microorganism responsible for coronavirus disease 2019 (COVID-19), which has caused millions of deaths and irreversible health problems worldwide. To restrict the spread of SARS-CoV-2, accurate detection of COVID-19 is essential for the identification and control of infected cases. Although recent detection technologies such as the real-time polymerase chain reaction delivers an accurate diagnosis of SARS-CoV-2, they require a long processing duration, expensive equipment, and highly skilled personnel. Therefore, a rapid diagnosis with accurate results is indispensable to offer effective disease suppression. Nanotechnology is the backbone of current science and technology developments including nanoparticles (NPs) that can biomimic the corona and develop deep interaction with its proteins because of their identical structures on the nanoscale. Various NPs have been extensively applied in numerous medical applications, including implants, biosensors, drug delivery, and bioimaging. Among them, point-of-care biosensors mediated with gold nanoparticles (GNPSs) have received great attention due to their accurate sensing characteristics, which are widely used in the detection of amino acids, enzymes, DNA, and RNA in samples. GNPS have reconstructed the biomedical application of biosensors because of its outstanding physicochemical characteristics. This review provides an overview of emerging trends in GNP-mediated point-of-care biosensor strategies for diagnosing various mutated forms of human coronaviruses that incorporate different transducers and biomarkers. The review also specifically highlights trends in gold nanobiosensors for coronavirus detection, ranging from the initial COVID-19 outbreak to its subsequent evolution into a pandemic.

Systems Genetics Analyses Reveals Key Genes Related to Behavioral Traits in the Striatum of CFW Mice.

The striatum plays a central role in directing many complex behaviors ranging from motor control to action choice and reward learning. In our study, we used 55 male CFW mice with rapid decay linkage disequilibrium to systematically mine the striatum-related behavioral functional genes by analyzing their striatal transcriptomes and 79 measured behavioral phenotypic data. By constructing a gene coexpression network, we clustered the genes into 13 modules, with most of them being positively correlated with motor traits. Based on functional annotations as well as Fisher's exact and hypergeometric distribution tests, brown and magenta modules were identified as core modules. They were significantly enriched for striatal-related functional genes. Subsequent Mendelian randomization analysis verified the causal relationship between the core modules and dyskinesia. Through the intramodular gene connectivity analysis, Adcy5 and Kcnma1 were identified as brown and magenta module hub genes, respectively. Knock outs of both Adcy5 and Kcnma1 lead to motor dysfunction in mice, and KCNMA1 acts as a risk gene for schizophrenia and smoking addiction in humans. We also evaluated the cellular composition of each module and identified oligodendrocytes in the striatum to have a positive role in motor regulation.

Repeated Exposure of Vancomycin to Vancomycin-Susceptible Staphylococcus aureus (VSSA) Parent Emerged VISA and VRSA Strains with Enhanced Virulence Potentials.

The emergence of resistance against the last-resort antibiotic vancomycin in staphylococcal infections is a serious concern for human health. Although various drug-resistant pathogens of diverse genetic backgrounds show higher virulence potential, the underlying mechanism behind this is not yet clear due to variability in their genetic dispositions. In this study, we investigated the correlation between resistance and virulence in adaptively evolved isogenic strains. The vancomycin-susceptible Staphylococcus aureus USA300 was exposed to various concentrations of vancomycin repeatedly as a mimic of the clinical regimen to obtain mutation(s)-accrued-clonally-selected (MACS) strains. The phenotypic analyses followed by expression of the representative genes responsible for virulence and resistance of MACS strains were investigated. MACS strains obtained under 2 and 8 µg/ml vancomycin, named Van2 and Van8, respectively; showed enhanced vancomycin minimal inhibitory concentrations (MIC) to 4 and 16 µg/ml, respectively. The cell adhesion and invasion of MACS strains increased in proportion to their MICs. The correlation between resistance and virulence potential was partially explained by the differential expression of genes known to be involved in both virulence and resistance in MACS strains compared to parent S. aureus USA300. Repeated treatment of vancomycin against vancomycin-susceptible S. aureus (VSSA) leads to the emergence of vancomycin-resistant strains with variable levels of enhanced virulence potentials.

Efficacy of Oral Magnesium on Bone Regeneration and Implant Stability in Immediate Dental Implants: A Randomized Controlled Trial.

PURPOSE: The successful osseointegration around immediate implants requires high quality and quantity of osteogenesis around them. The role of magnesium as a boneenhancing mineral, and as an adjunctive analgesic has been well documented in orthopedic literature. However, there is a paucity of literature in its role in successful osseointegration around immediate implants. This randomized controlled trial sought to assess the promising impact of magnesium on osseointegration by examining various aspects of implant stability, correlating them with serum bone markers, and establishing a foundation for future research on its potential as a potent analgesic. MATERIALS AND METHODS: Immediate implant placement was done after the extraction of the indicated mandibular molar tooth, and all the patients were segregated into 2 groups (Placebo- Lactose, and Magnesium citrate). Bone regenerate in the peri-implant area was assessed radiographically immediate post-operatively, on the 6th week and 12 weeks. Implant stability was measured immediate post-operatively, at the 4th week and 12th week. Serum parameters were procured pre-operatively and post-operatively for serum calcium, serum alkaline phosphatase (ALP), and serum parathyroid hormone at the 8th week, and serum vitamin D3 levels preoperatively. RESULTS: 54 immediate implants placed showed the demographics and baseline serum, clinical, and radiographic parameters were comparable in both groups. Analysis of Implant Stability Quotient at 12th week showed statistically significant difference in intervention group both on intergroup and intragroup analysis. Radiodensity measurement showed a statistically significant difference in both intragroup and intergroup analysis in the intervention group at the 6th and 12th week. In bone gap analysis, the difference in mean change in the horizontal bone gap (HG) at 6 weeks was non-significant while the difference in HG at the 12th week was significant in the intervention group. On intragroup analysis, mean change HG at 6 weeks and 12 weeks both were significant only in intervention group. Intergroup analysis of vertical bone gap (VG) 12 and VG 12-0 (mean difference in the vertical bone gap from 12th week-day 0) showed a statistically significant difference in the intervention group. On intragroup analysis, VG 12 was significantly better in the intervention group. On serum analysis, ALP post-operatively was found to be significantly raised (P=0.013) in intervention group. Numerical rating Scale (NRS) analysis showed a significant decrease in post-op day 5 and 7, (P=0.017) and (P=0.002) respectively. CONCLUSION: The oral magnesium citrate supplementation after immediate implant placement helps in enhancing the stability of the immediate implants, along with improved radiodensity around them which was found to be statistically significant. It also helps in reducing the horizontal, and vertical gap around the implant and has significant analgesic potential.