Mechanobiological Analysis of Nanoparticle Toxicity.

Nanoparticles (NPs) are commonly used in healthcare and nanotherapy, but their toxicity at high concentrations is well-known. Recent research has shown that NPs can also cause toxicity at low concentrations, disrupting various cellular functions and leading to altered mechanobiological behavior. While researchers have used different methods to investigate the effects of NPs on cells, including gene expression and cell adhesion assays, the use of mechanobiological tools in this context has been underutilized. This review emphasizes the importance of further exploring the mechanobiological effects of NPs, which could reveal valuable insights into the mechanisms behind NP toxicity. To investigate these effects, different methods, including the use of polydimethylsiloxane (PDMS) pillars to study cell motility, traction force production, and rigidity sensing contractions, have been employed. Understanding how NPs affect cell cytoskeletal functions through mechanobiology could have significant implications, such as developing innovative drug delivery systems and tissue engineering techniques, and could improve the safety of NPs for biomedical applications. In summary, this review highlights the significance of incorporating mechanobiology into the study of NP toxicity and demonstrates the potential of this interdisciplinary field to advance our knowledge and practical use of NPs.

Oral Health-Related Quality of Life in Patients with Chronic Oral Mucosal Diseases: Reliability and Validity of Urdu Version of Chronic Oral Mucosal Disease Questionnaire (COMDQ).

The aim of the study was to translate and validate the Urdu version of the Chronic Oral Mucosal Disease Questionnaire (COMDQ) and measure the oral health-related quality of life (OHRQoL) in Pakistani patients with chronic oral mucosal disease. One hundred and twenty patients with chronic oral mucosal diseases were recruited for this study. Two types of reliability of the COMDQ were tested. First, the internal consistency was calculated using Cronbach's alpha, and second, test-retest reliability was calculated using intraclass correlation coefficients (ICC). Convergent validity was assessed for testing the validity of the COMDQ by examining the correlations with the Visual Analogue Scale (VAS) and OHIP-14 using Pearson's correlations coefficient, and a t-test was used to compare the COMDQ domains and the socio-demographic characteristics. The most prevalent chronic oral mucosal disease (COMD) among the participants was recurrent aphthous stomatitis (47.5%), and the least prevalent was oral granulomatosis (6.6%). The total mean score for COMDQ was 43.5 (SD = 18.4). It showed a high level of internal consistency (Cronbach's a = 0.81), and test-retest reliability was also good (r = 0.85). The total score of COMDQ was strongly correlated with the total score of OHIP-14 and VAS (r = 0.86 and r = 0.83), which indicated good convergent validity. The score of pain and the functional limitation domain reported a significant difference with age (p < 0.021) and employment status (p < 0.034). The Urdu version of COMDQ is an accurate, valid, and reliable instrument that can be used to assess the OHRQoL in patients with chronic oral mucosal diseases in Pakistani and other Urdu-speaking populations of different age groups.

Comparison Of Efficacy Of Steroids Alone And Combination Of Steroids With Hyaluronidase On Mouth Opening In Oral Submucous Fibrosis Patients.

BACKGROUND: Eventually Oral submucous fibrosis causes pronounced stiffness and failure to open the mouth. Objectives are to determine compare the efficacy of intralesional steroids alone and combination of steroids with hyaluronidase on mouth opening in oral submucous fibrosis. METHODS: It was a prospective comparative cohort study. Total of 74 patients both male and female having history of pan chewing and limited mouth opening and burning sensations were included in the study. Informed consent was taken and divided into two groups. Patients of group 1 were managed with mixture of betamethasone 1 ml and hyaluronidase 1500 IU and patients of group 2 were treated with only steroid injection of betamethasone 1 ml given intralesional, both injections were given intralesional, by multiple puncture technique and once a week and continued for twelve weeks (3 months). And data compiled and analyzed in SPSS-20. RESULTS: The mean age of group 1 was 40.027±6.97 years, and mean age of Group 2 was 37.351±5.48 years. In both groups, the greatest number of cases aged from 31-59 years. Compared to females in both groups, the majority of patients were males. In 32 (86.4)% patients of group 1 showed efficacy compared with 18[43.2] patients in group 2 [p-0.000]. Conclusion: In this study Intralesional steroids with hyaluronidase injections are more efficient for opening the mouth in patients with oral sub-mucus fibrosis.

Work-Related Musculoskeletal Disorders and Their Associated Risk Factors among Pakistani Dental Practitioners: A Cross-Sectional Study.

Background: Work-related musculoskeletal disorders (WMSDs) have a negative impact on quality of life, and dentists are at risk of WMSDs due to the nature of work being static, repetitious, and for a long duration. The study was aimed at measuring the prevalence and distribution of work-related musculoskeletal disorders and determining the risk factors associated with affliction among Pakistani dentists. Methods: An online cross-sectional survey was conducted using a validated questionnaire consisting of four sections. The first section had questions related to sociodemographic information, the second section had questions that assessed the intensity and frequency of musculoskeletal pain (MSP), third section questions were concerned with the effect of MSP on the respondents' daily life, while the last section contained questions on whether they perceived their work in the dental clinic as a cause of their pain. Chi-square and one-way ANOVA tests were used for the analysis of the data in SPSS-23. Results: A total of 600 completely filled questionnaires were received with a response rate of 76.4%, and about 87% of the dental practitioners had some sort of MSD. The intensity and frequency of WMSDs were statistically significant (p < 0.05) in association with all the sociodemographic characteristics. The lower back area was the most reported site of WMSD pain (51.3%) followed by the neck/upper back (21.3%) and shoulder (17.6%). The site of pain was statistically significant (p < 0.05) in association with all the sociodemographic characteristics except gender (p = 0.11). A majority of participants (95.4%) had sought medical treatment and taken sick leaves (70%) due to WMSDs pain during their life. Participants attributed a number of working years and working posture as the two main reasons behind WMSDs. Conclusion: Considering the high prevalence of WMSDs among dentists, preventive strategies that minimize the occurrence of WMSDs should be adopted by dental professionals. The impact of WMSDs can be reduced by maintaining good posture, taking breaks and rest in between work, doing regular exercise, and improving the work environment.

Sequence variants in three genes underlying leukodystrophy in Pakistani families.

Leukodystrophies (LDs) are a heterogeneous group of rare and progressive genetic diseases that affect brain, spinal cord, and often the peripheral nerves. They are characterized by abnormal development or destruction of the myelin sheath of the brain. This study was aimed to search for the causative variants in three unrelated consanguineous families presented with LD. Detailed clinical investigations were carried out on probands in three unrelated consanguineous families of Pakistani origin. Targeted gene sequencing and Whole Exome Sequencing (WES) were performed for variant identification. Candidate variants were checked for co-segregation with the phenotype using Sanger sequencing. Public databases including ExAC, gnomAD, dbSNP, and the 1,000 Genome Project were searched to determine frequencies of the alleles. Conservation of the missense variants was ensured by aligning orthologous protein sequences from diverse vertebrate species. Targeted gene sequencing identified a novel homozygous missense mutation [c.2135G > A, p.(Arg712His) in the ATP Binding Cassette Subfamily D Member 1 (ABCD1; OMIM# 300371) in three affected siblings in family A.WES followed by validation by Sanger sequencing revealed previously reported homozygous missense variants [c.162C > A; p.(Asn54Lys)] in ASPA (OMIM# 608034) in family B and [c.361G > C,p.(Gly121Arg)] in ARSA (OMIM# 607574) in family C. Investigation of three families underlies importance of WES as an amazing diagnostic tool for conclusive determination of a specific type of LD. Further, the study would assist in carrier testing and prenatal diagnosis of the affected families. In addition, searching for common variants in the genes causing LD would help in designing low-cost targeted variation testing in patients.

The current use of anti-cariogenic agents and fluoride agents to cure write spot lesion: A systematic analysis.

To find the best option to treat White Spot Lesion in existing caries treatments, and to identify the selected articles discussing etiology of caries along with White spot lesion. Null hypothesis was that "Only anticariogenic agent can cure White Spot Lesion". PRISMA guidelines were used to conduct the systematic analysis. An electronic customized search was performed using mesh terminologies on PubMed database based on inclusion criteria that included studies with; any treatment option that can treat or prevent WSL; and minimally invasive treatment options that may be altered to treat WSL. While exclusion criteria comprised studies with treatment of rampant caries, severe early childhood caries and root caries. Inclusion criteria for etiological factors incorporated studies with factors that lead to white spot lesion or carious lesion. Finally, therapeutic agents of dental caries were analyzed. Only the use of anti-cariogenic agent cannot cure White Spot Lesion. Hence study fails to prove the null hypothesis. Although combination of anti-cariogenic agents with a re-mineralizing agent can provide additional options for the treatment or prevention of WSL.

Comparison Of Two Intracanal Medicaments In Resolution Of Apical Radiolucency.

BACKGROUND: As a gold standard, calcium hydroxide has always been used as a root canal medicament against root canal pathogens but its combination with chlorhexidine is not being employed in routine despite its documented efficacy and results. The objective of the study is to compare calcium hydroxide and combination of calcium hydroxide with 2% CHX on the basis of radiographic evidence of resolution of periapical radiolucency when they are used as an interappointment dressing /intracanal medicament for 14 days.. METHODS: A total of 60 patients of either gender was included in the study. The age range was 15-60 years with the radiographic evidence of radiolucency of 2-4 mm in size. Both maxillary and mandibular teeth till first molar were selected. Teeth with previous endodontic treatment mentally handicapped and terminally ill patients were excluded. Selected patients were placed randomly into Group 1 (calcium hydroxide alone) and in Group 2 (calcium hydroxide in combination with 2% chlorhexidine gel). Obturation and permanent filling was done at 14th day. The patient was recalled after 90 days of obturation and a radiograph was taken. Final outcome was measured at the end of 90thday of obturation. RESULTS: The mean of percentage reduction in size of apical radiolucency at 3 months was 91.03% for group 1 and 97.26% for group 2 with p-value 0.13 (not significant). The results suggested equivalent results after medication with 2%chlorhexidine with calcium hydroxide but 2% chlorhexidine still showed better results than the group without CHX in terms of healing. CONCLUSIONS: This study concluded that calcium hydroxide in combination with 2% chlorhexidene as intracanal medicament results in better resolution of periapical radiolucency in terms of percentage resolution of periapical radiolucency.

Comparison of frequency of post-obturation pain of single versus multiple visit root canal treatment of necrotic teeth with infected root canals. A Randomized Controlled Trial.

OBJECTIVE: To determine the pain of single versus multiple visit endodontic treatment after obturation in teeth with necrotic pulps and infected canals. METHODS: The randomized controlled study was conducted from January to June 2016 at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Dental patients aged 18-60 years of either gender were selected who were subjected to computer-generated randomisation. Both maxillary and mandibular single rooted teeth till second premolar were included. Single visit endodontic treatment to Group-I subjects was carried out by gaining access to canals, cleaning, shaping and obturation at same visit whereas in Group-II patients, who underwent multiple visits, cleaning and shaping was followed by placement of intra-canal medicament, while obturation was done 5 days later. Patients were recalled within 48 hours after obturation to record the pain score using visual analogue scale.. RESULTS: Of the 60 patients, 30(50%) were in each of the two groups. There was no significant difference in post-operative pain in the two groups (p=0.8). The frequency of post-operative pain was not significant either (p>0.05). The post-operative mean pain score was 2.23±1.736 in Group-I and 2.38±1.94 in Group-II (p=0.8).. CONCLUSIONS: Treatment carried out in single visit or multiple visits showed no difference in pain frequency.

Comparison Of Frequency Of Post Operative Sensitivity In Amalgam Restorations Using Copal Varnish And Dentin Adhesive Liner.

BACKGROUND: Micro leakage around the margins of a restoration is believed to be one of the main causes of postoperative sensitivity. Dental amalgam is a non-insulating material and has the potential to transfer heat and cold causing irritation of the pulp. Different dentin tubule sealers are used under amalgam restoration to compensate for this post-operative sensitivity. This study was conducted to compare the frequency of sensitivity in amalgam restorations using copal varnish and dentin adhesive liner (dentin bonding agent). METHODS: A total of 60 patients of either gender, aged 18-40 years having class 1 carries in posterior teeth were included. Teeth with restorations, dentinal sensitivity and patients taking analgesic drugs for chronic pain conditions were excluded. The selected patients were placed randomly into Group A (copal varnish) & Group B (dentin adhesive liner), by using computer generated table of random numbers. Restored teeth were evaluated 1-month post operatively for sensitivity. RESULTS: Mean age was 25.63±5.42 years. Out of 60 patients, 68.0% were females and 32.0% were males with a female to male ratio of 2:1. The mean post-operative pain score was 2.83±2.79 in Group A and in Group B, it was 1.43±2.14 with a p-value of 0.03. There was no pain on application of a cold stimulus in 14 (46.7%) patients in Group A (copal varnish) while in Group B (Dentin adhesive), no pain was seen in 23 (76.7%) patients with p-value of 0.02. CONCLUSIONS: This study concluded that dentin adhesive liner (dentin bonding agent) is better than copal varnish in reducing postoperative sensitivity in amalgam restorations.

Myocardial infarction in young versus older adults: clinical characteristics and angiographic features.

BACKGROUND: Coronary artery disease is now frequently encountered in young adult population. However, being a relatively uncommon entity, not many studies are available in this regard. Therefore, the present study was designed to evaluate the clinical characteristics and angiographic features of patients less than 40 years of age with a history of myocardial infarction and compare them to patients older than 40 years. METHODS: A total of 281 patients who underwent coronary angiography from April, 2009 to December, 2009, were included in this study. The patients were divided into two groups on the basis of age. Group A included patients 40 years of age or younger. Group B included patients older than 40 years. Both the groups were compared with respect to gender, hypertension, diabetes mellitus and extent and severity of coronary artery disease as assessed on coronary angiography. RESULTS: Of the total 281 patients, 45 (16%) were < or =40 years old (Group-A) and 236 (84%) were older than 40 years (Group-B). There was no significant difference between the two groups with respect to the risk factors like gender, hypertension and diabetes mellitus. On coronary angiography, the two groups neither differed in the number of totally occluded vessels, nor in the severity of the culprit lesion. There were only 3 patients in group-A (6.7%) and 5 patients in group-B (2.1%) with normal coronaries (p=NS). Majority (60%) of the patients in group-A had no significant disease or single vessel disease while majority (69%) of the patients in group-B had two or more vessels involved (p<0.001 ). As far as the number of lesions in the coronary arteries is concerned, 62.3% patients had 2 or lesser lesions in group-A while 68.6% patients in group-B had three or more lesions (p=0.001). CONCLUSION: These data suggest that in our study, young patients with MI do not have significantly high prevalence of normal coronaries compared to older patients. Young patients are similar to the older patients with respect to severity of CAD. Lesser number of coronaries is involved and there is lesser number of lesions per patient in young patients compared to older ones.