A Comparative Evaluation of Arginine Complex Combined With Flouride and Two Standard Non-Fluoridated Remineralizing Agents: An In Vitro Study.

Background Dental caries represents a dynamic process, often reversible in its early stages. Fluoride has conventionally served as the cornerstone for remineralization and early caries arrest. However, excessive fluoride intake can lead to both local and systemic toxicity. Hence, there's a pressing need to develop adjunct therapies that enhance fluoride's efficacy while minimizing its dosage. This study aims to assess and compare the remineralization potential of a novel combination comprising arginine bicarbonate and fluoride against established technologies such as Bioactive glass (NovaMin Technology; Sensodyne Repair and Protect, GlaxoSmithKline, UK) and CPP-ACP technology (GC Tooth Mousse; Tokyo Japan). Materials and methods The experiment utilized extracted premolars designated for orthodontic extraction. The initial evaluation employed the DIAGNOdentTM fluorescence method. Subsequently, teeth underwent demineralization and were measured for values. Following this, the teeth were subjected to seven cycles of remineralization, after which moment values were reassessed. Statistical analysis was performed on the recorded values. Results Participants were divided into six groups (BR-A, AR-A, BR-B, AR-B, BR-C, AR-C). T-tests demonstrated significant reductions in moment values within each group, indicating the effectiveness of all remineralizing agents. Group C exhibited the most substantial difference (-6.900 ± 0.4), followed by Group A and Group B. ANOVA analysis revealed statistically significant differences among all three groups (p=0.016). Tables showed significant distinctions between the remineralizing values of Groups A and C and Groups B and C (p=0.02 and 0.002, respectively), with no discernible distinction between Groups A and B. Conclusion The study elucidates the superior efficacy of the arginine complex with fluoride combination compared to CPP-ACP and Bioactive Glass individually. This finding underscores the potential of the novel combination therapy in enhancing remineralization while minimizing fluoride dosage, thus presenting a promising strategy for addressing early-stage dental caries.

Comparing the Effectiveness of Different Techniques for the Management of Dental Implant Peri-Implant Mucositis: A Randomized Controlled Trial.

Background: Dental implant peri-implant mucositis is a prevalent complication that can lead to implant failure if left untreated. Various management techniques have been proposed, but their comparative effectiveness remains unclear of dental implant peri-implant mucositis. Materials and Methods: A total of 120 patients with peri-implant mucositis were randomly assigned to one of four treatment groups: Group A received mechanical debridement alone, Group B received mechanical debridement with adjunctive antiseptic mouthwash, Group C underwent laser therapy, and Group D received a combination of mechanical debridement and systemic antibiotics. Clinical parameters, including bleeding on probing (BOP), probing pocket depth (PPD), and plaque index (PI), were recorded at baseline and after a three-month follow-up period. Results: At the three-month follow-up, significant improvements were observed in all treatment groups. However, Group D, which received a combination of mechanical debridement and systemic antibiotics, showed the most substantial reduction in BOP (mean reduction of 78.2%), PPD (mean reduction of 2.5 mm), and PI (mean reduction of 1.7). Group C, treated with laser therapy, demonstrated the second-best outcomes with a mean reduction of 65.4% in BOP, 2.0 mm in PPD, and 1.3 in PI. Groups A and B showed moderate improvements, with no statistically significant differences between them. Conclusion: This randomized controlled trial (RCT) suggests that a combination of mechanical debridement and systemic antibiotics (Group D) is the most effective treatment for managing dental implant peri-implant mucositis, yielding superior clinical outcomes compared to other techniques.

Survivability of endodontically treated cracked tooth: A systematic review.

BACKGROUND: Literature evidence describes various treatment protocols that have been employed for the effectiveness in improving survival and addressing associated symptoms of cracked teeth. OBJECTIVE: This systematic review investigates the survivability of endodontically treated cracked teeth and associated assessments, focusing on various treatment protocols. METHODS: The PRISMA guidelines were utilised for guiding the article selection framework of this review. A comprehensive search of relevant literature was conducted in May 2023 across various databases, and studies meeting the inclusion criteria were selected. Data extraction, guided by a standardized form, captured crucial details, including study characteristics, treatment protocols, and treatment outcomes, enhancing the consistency and accuracy of information collection. Data extraction and synthesis was done by two reviewers independently. The Newcastle Ottawa tool was used to measure the methodological quality of the study. Six observational studies were eventually included. RESULTS: Mandibular molars are particularly prone to developing cracks, with research indicating a heightened susceptibility to this dental issue. Studies reveal that endodontically treated cracked teeth boast robust overall survival rates ranging from 75.8% to 100%. The risk of bias assessment, utilizing the Newcastle Ottawa scale, indicated a moderate risk across studies, highlighting the necessity for careful interpretation of findings. CONCLUSION: Endodontically treated cracked teeth show marked success in survival, with the incorporation of crowns post-endodontic treatment significantly enhancing longevity and resilience.

Comparison of Composite Resin (Duo-Shade) Shade Guide with Vita Ceramic Shades Before and After Chemical and Autoclave Sterilization.

BACKGROUND This study aimed to compare a composite resin (Duo-Shade) shade guide with Vita ceramic shades before/after chemical and autoclave sterilization. MATERIAL AND METHODS Color values (L*a*b*) were recorded directly from shade tabs of prefabricated composite resin (Brilliant NG Universal Duo-Shade) and ceramic (Vita classic) shade guide with a calibrated spectrophotometer (Vita Easy Shade Advance 4.0). Seventy-two composite resin disk samples with 6 different shades (A1/B1, A2/B2, A3/D3, A3.5/B3, A4/C4, and C2/C3) (n=12 each) were divided into 2 groups (Gp) - Gp A (Autoclave) and Gp C (Chemical) (15 cycles) - to assess their influence on respective shades. Mean values calculated the color differences (ΔE) while differences in color values (L*a*b*) were graded on the National Bureau of Standards (NBS) 6-grade scale and assessed for Clinical Acceptance/Perceptible Threshold (CAT), (CPT). All differences were considered significant if the color difference ΔE was ≥3.3. RESULTS Only 2 out of 12 Shade tabs (C2C3, A4C4) of composite resin matched to Vita shade tab C2 and C4 (ΔE ≤3.3). Both groups showed notable color differences after respective sterilization protocols, with color differences in Gp A significantly higher than Gp C (DE ³3.3). Within groups, all shades in Gp A showed remarkably different color changes, with shade C2C3 and A1B1 being denoted as clinically unacceptable. CONCLUSIONS Manufacturer-provided shade guides do not match ceramic shades as claimed and chemical sterilization using 10% Deconex was associated with less color changes than with autoclave sterilization.

Individualized Homeopathic Medicines as Adjunctive Treatment of Pediatric Epilepsy: A Double-Blind, Randomized, Placebo-Controlled Trial.

INTRODUCTION: Epilepsy, one of the most common neurological diseases, contributes to 0.5% of the total disease burden. The burden is highest in sub-Saharan Africa, central Asia, central and Andean Latin America, and south-east Asia. Asian countries report an overall prevalence of 6/1,000 and that in India of 5.59/1,000. We examined whether individualized homeopathic medicines (IHMs) can produce a significantly different effect from placebos in treatment of pediatric epilepsy in the context of ongoing standard care (SC) using anti-epileptic drugs (AEDs). METHODS: The study was a 6-month, double-blind, randomized, placebo-controlled trial (n = 60) conducted at the pediatric outpatient department of a homeopathic hospital in West Bengal, India. Patients were randomized to receive either IHMs plus SC (n = 30) or identical-looking placebos plus SC (n = 30). The primary outcome measure was the Hague Seizure Severity Scale (HASS); secondary outcomes were the Quality of Life in Childhood Epilepsy (QOLCE-16) and the Pediatric Quality of Life inventory (PedsQL) questionnaires; all were measured at baseline and after the 3rd and 6th month of intervention. The intention-to-treat sample was analyzed to detect group differences and effect sizes. RESULTS: Recruitment and retention rates were 65.2% and 91.7% respectively. Although improvements were greater in the IHMs group than with placebos, with small to medium effect sizes, the inter-group differences were statistically non-significant - for HASS (F 1, 58 = 0.000, p = 1.000, two-way repeated measures analysis of variance), QOLCE-16 (F 1, 58 = 1.428, p = 0.237), PedsQL (2-4 years) (F 1, 8 = 0.685, p = 0.432) and PedsQL (5-18 years) (F 1, 47 = 0.000, p = 0.995). Calcarea carbonica, Ignatia amara, Natrum muriaticum and Phosphorus were the most frequently prescribed medicines. No serious adverse events were reported from either of the two groups. CONCLUSION: Improvements in the outcome measures were statistically non-significantly greater in the IHMs group than in the placebos group, with small effect sizes. A different trial design and prescribing approach might work better in future trials. TRIAL REGISTRATION: CTRI/2018/10/016027.

Efficacy of Individualized Homeopathic Medicines in the Treatment of Cervical Spondylosis: A Double-Blind, Randomized, Placebo-Controlled Trial.

INTRODUCTION: Cervical spondylosis (CS) is a degenerative condition of the cervical spine, with approximately 80-90% of people suffering from disc degeneration by the age of 50 years. This trial attempts at evaluating the efficacy of individualized homeopathic medicines (IHMs) against placebos in the treatment of CS. METHODS: A 3-month, double-blind, randomized, placebo-controlled trial was conducted at the Organon of Medicine outpatient department of the National Institute of Homoeopathy, India. Patients were randomized to receive either IHMs (n = 70) or identical-looking placebos (n = 70) in the mutual context of concomitant conservative and standard physiotherapeutic care. Primary outcome measures were 0-10 Numeric Rating Scales (NRSs) for pain, stiffness, numbness, tingling, weakness, and vertigo, and the secondary outcome was the Neck Disability Index (NDI), measured at baseline and every month until 3 months. The intention-to-treat sample was analyzed to detect group differences and effect sizes. RESULTS: Overall, improvements were clinically significant and higher in the IHM group than the placebo group, but group differences were statistically nonsignificant with small effect sizes (all p > 0.05, two-way repeated measure analysis of variance). After 2 months of time points, improvements observed in the IHM group were significantly higher than placebo on a few occasions (e.g., pain NRS: p < 0.001; stiffness NRS: p = 0.024; weakness NRS: p = 0.003). Sulfur (n = 21; 15%) was the most frequently prescribed medication. No harm, unintended effects, or any serious adverse events were reported from either group. CONCLUSIONS: An encouraging but nonsignificant direction of effect was elicited favoring IHMs against placebos in the treatment of CS.

Expression analysis of cyclin D, Ki-67, MCM3 and MCM2 in oral squamous cell carcinoma.

The expression analysis of cyclin D1, Ki-67, MCM3 and MCM2 in oral squamous cell carcinoma to identify biomarkers is of interest. 45 formalin-fixed paraffin embedded tissue blocks collected from archives of Department of Oral and Maxillofacial Pathology and Oral Microbiology, Government Dental College and Hospital, Jamnagar, India were subjected to a retrospective cross-sectional immuno-histo-chemistry examination. 30 blocks of OSCC with histological diagnosis have 15 tissue blocks of well-differentiated oral carcinoma and 15 tissue blocks of moderately-differentiated oral carcinoma. 15 specimens of normal oral mucosa (NM) were also examined for comparison. In each of the categories, the immuno-histo-chemistry expression of cyclin D1, MCM 3, MCM 2, and ki67 was studied. Data shows that cyclin D1, Ki-67, MCM3 and MCM2 effectively indicate cellular proliferation for consideration as potential biomarkers of oral squamous cell carcinoma.

Evaluation of immuno-histochemical markers in oral squamous cell carcinoma.

Evaluation of immuno-histochemical (IHC) markers like p53, p63, PDPN, C-erb-B2, CK19, and VEGF in oral squamous cell carcinoma (OSCCs) is of interest to dentists. Sixty formalin-fixed paraffin embedded tissue blocks from the Department of Oral Pathology, New Horizon Dental College and Research, Institute, Sakri, Bilaspur, Chhattisgarh, India. The conventional IHC method was used to assess the expression of p53, p63, PDPN, C- erb-B2, CK19 and VEGF using the different antibodies. Data shows that P53, p63 had high values of labeling index (LI) of staining while PDPN, C-erb-B2 had low values of LI of staining. The values of LI of staining for CK19, and VEGF were in between the two types of IHCs. Combining the analysis of multiple IHC markers for OSCC can yield precise cancer diagnosis results.

Effect of NaOCl on cyclic fatigue resistance.

The impact of 5.25 percent NaOCL on the resistance offered by TruNatomy, Hero Gold and ProtaperGold against cyclic fracture as against the treatment of NiTi rotary files with distilled water is of interest to dentists. Inside the stainless steel blocks, man-made canals were created for the purpose of testing the cyclic fatigue. 60 endodontic files were taken as study specimens. It was observed that values of number of cycles to fracture in NaOCl among three file systems were in the order of TruNatomy (1053.50 ± 134.81)>Hero Gold (652.66 ± 58.66) > ProtaperGold (494.50 ± 47.69). The TruNatomy file system reflected greatest cyclic fatigue resistance. It was also found that cyclic fatigue resistance in NiTi rotary files studied here is not hampered by 5.25% NaOCl.

Subepithelial Hyalinisation Predicts Recurrence of Unicystic Ameloblastomas.

The inductive effect of hyalinisation and its influence on the biologic behaviour of ameloblastoma variants represent a scarcely researched domain of oral pathology. The complexity of the induction effects within the odontogenic apparatus, with the involvement of both ectodermal and mesodermal tissues, is responsible for diverse histopathological characteristics, hyalinisation being the major feature. The present study aims to deduce for the first time the correlation between the severity of hyalinisation (SOH) and recurrence in three unicystic ameloblastoma (UA) variants, namely, intra-luminal (UA-IL), luminal (UA-L) and mural (UA-M). Retrospectively diagnosed archival cases of UA-IL (n = 08), UA-L (n = 22) and UA-M (n = 30) were assessed for SOH and its correlation with recurrence. A subgroup comparison (between UA-IL/UA-L and UA-M) was also performed. The clinical parameters of the patients were also analysed from files for clinicopathological correlation with recurrence. Results: sub-epithelial hyalinisation (SEH) significantly correlated with the recurrence of UA-L and UA-M (p = 0.001). When the histologic types (UA-L and UA-IL vs. UA-M) were grouped and the correlation of SOH with recurrence was checked, it was observed that both groups (p = 0.001) showed strong statistical correlation. UA-M lesions with multilocular radiolucency (p = 0.001) also showed significant correlation with recurrence. SOH can be a reliable histological predictor of recurrence and of aggressive biologic behaviour in UA. The present study shows a significant association of hyalinisation with the biologic behaviour of UA. Further studies with immunohistochemical investigations could validate the presence of hyalinisation and identify the origin of the hyalinised product in UAs.

Efficacy of Individualized Homeopathic Medicines in Treatment of Acne Vulgaris: A Double-Blind, Randomized, Placebo-Controlled Trial.

BACKGROUND: Acne is estimated to affect 9.4% of the global population, making it the 8th most prevalent disease worldwide. Acne vulgaris (AV) is among the diseases that directly affect quality of life. This trial evaluated the efficacy of individualized homeopathic medicines (IHM) against placebo in AV. METHODS: In this double-blind, randomized, placebo-controlled trial conducted at the National Institute of Homoeopathy, India, 126 patients suffering from AV were randomized in a 1:1 ratio to receive either IHM (verum) in centesimal potencies or identical-looking placebo (control). The primary outcome measure was the Global Acne Grading System score; secondary outcomes were the Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires - all measured at baseline and 3 months after the intervention. Group differences and effect sizes (Cohen's d) were calculated on the intention-to-treat sample. RESULTS: Overall, improvements were greater in the IHM group than placebo, with small to medium effect sizes after 3 months of intervention; however, the inter-group differences were statistically non-significant. Sulphur (17.5%), Natrum muriaticum (15.1%), Calcarea phosphorica (14.3%), Pulsatilla nigricans (10.3%), and Antimonium crudum (7.1%) were the most frequently prescribed medicines; Pulsatilla nigricans, Tuberculinum bovinum and Natrum muriaticum were the most effective of those used. No harms, unintended effects, homeopathic aggravations or any serious adverse events were reported from either group. CONCLUSION: There was non-significant direction of effect favoring homeopathy against placebo in the treatment of AV. TRIAL REGISTRATION: CTRI/2018/11/016248; UTN: U1111-1221-8164.

Cellulosic Polymers for Enhancing Drug Bioavailability in Ocular Drug Delivery Systems.

One of the major impediments to drug development is low aqueous solubility and thus poor bioavailability, which leads to insufficient clinical utility. Around 70-80% of drugs in the discovery pipeline are suffering from poor aqueous solubility and poor bioavailability, which is a major challenge when one has to develop an ocular drug delivery system. The outer lipid layer, pre-corneal, dynamic, and static ocular barriers limit drug availability to the targeted ocular tissues. Biopharmaceutical Classification System (BCS) class II drugs with adequate permeability and limited or no aqueous solubility have been extensively studied for various polymer-based solubility enhancement approaches. The hydrophilic nature of cellulosic polymers and their tunable properties make them the polymers of choice in various solubility-enhancement techniques. This review focuses on various cellulose derivatives, specifically, their role, current status and novel modified cellulosic polymers for enhancing the bioavailability of BCS class II drugs in ocular drug delivery systems.

A Comprehensive in Silico Analysis for Identification of Immunotherapeutic Epitopes of HPV-18.

Human papillomavirus (HPV) remains the major cause of cervical cancer, globally. High risk HPV (Hr-HPV) 16 and 18 together account for more than 70% of cervical cancer cases, whereas the hr-HPV-18 is the second most prevalent hr-HPV type, causing about 5.2% of all cancers worldwide. Considering the high prevalence and mortality rate, cervical cancer remains a noteworthy health problem among women. As of now, no registered immunotherapies are available after the HPV infection. Thus, developing an immunotherapeutic candidate against hr-HPV would be of major clinical benefit. Nowadays, the T-and B-cell peptide based targeted vaccines have been considered as the best candidate for vaccine development against viral infections. In this study, both prophylactic and therapeutic vaccine candidates against hr-HPV-18 were predicted. To achieve this, the prediction of T-and B-cell epitopes of major histocompatibility complex (MHC) were accomplished, that can be used for HPV immunotherapy. For MHC-I, a maximum number (20) of potent peptides were found, against HLA-B*51:01 (L1 = 9, L2 = 6, E2 = 4, and E4 = 1) having percentile value < 1 and, immunogenicity scores higher than 0.5, followed by HLA-A*11:01 (L1 = 8, E2 = 7 L2 = 2, and E6 = 1, E7 = 1); 19 epitopes. For MHC-II, the highest number of peptides found, against the HLA-DRB1*04:01 (L2 = 10, E5 = 7, and E4 = 4), HLA-DRB1*04:05 (E5 = 7, E2 = 5, E4 = 5, and L1 = 4) HLA-DPA1*01:03/DPB1*04:01 (E7 = 7, E6 = 5, L2 = 5, and E2 = 2), HLA-DRB5*01:01(E6 = 6, L1 = 6, and L2 = 6); peptides 21, 21, 19 and 18 respectively. For B-cell, total 94, 16 amino acid long B-cell epitopes were predicted. In conclusion, these predicted epitopes can be valuable candidates for in vitro or in vivo therapeutic vaccine studies against hr-HPV-18 associated cancer.

Individualized Homeopathic Medicines in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled, Pilot Trial.

INTRODUCTION: Evidence favoring homeopathy in generalized anxiety disorder (GAD) remains scarce. The objective of this pilot trial was to test feasibility of a definitive trial in future. We also experimented whether individualized homeopathic medicines (IH) plus psychological counseling (PC) can produce significantly different effects beyond placebo plus PC in the treatment of GAD. METHODS: A double-blind, randomized, placebo-controlled, parallel arm, pilot trial was conducted on 62 GAD patients at the National Institute of Homoeopathy, India. GAD-7 questionnaire and Hamilton Anxiety Scale (HAM-A) were used as the primary and secondary outcomes, respectively, measured at baseline and 3 months. Patients received either IH plus PC (n = 31) or identical-looking placebo plus PC (n = 31). Intention-to-treat sample was analyzed to detect group differences using unpaired t tests. RESULTS: Recruitment and retention rates were 56 and 90%, respectively. Mean age was 31.5 years; 56.5% were male. GAD-7 reductions were non-significantly higher in IH than placebo (p = 0.122). Group differences on HAM-A favored IH significantly (p = 0.018). Effect sizes were small to medium. Calcarea carbonica was the most frequently indicated medicine. No serious adverse events happened. CONCLUSIONS: A small but positive direction of anxiolytic effect was observed favoring homeopathy over placebo. A definitive trial appeared feasible in future.

Prevalence of human papillomavirus 16 genotype in Anuppur district, Madhya Pradesh.

India contributes to 1/3rd of worldwide cervical cancer deaths caused by HPV. High risk human papillomavirus (hr-HPV) 16 and 18 infections are responsible for more than 70% of cases. Early detection of hr-HPV infection can help in prevention and disease management. In rural India, HPV infection is uncontrolled due to poor hygiene, lack of awareness, screening, and vaccination. Hence, our study aims to screen HPV infection in central India starting with Anuppur district of MP. Married women above 15 and women with or without clinical conditions were recruited for the study. Unmarried, pregnant and women with cervical cancer history were excluded. A cross-sectional study was conducted on 782 enrolled married adolescents and middle aged women by obtaining clinical information and cervical swabs between March 2019 to March 2020. Genomic DNA was extracted and screened for HPV using MY09/11 and HPV-16 specific primers, data was analysed using IBM-SPSS statistics software. An overall prevalence of 7.1% HPV infection was observed, and a significant incidence (95%) of hr-HPV 16 genotype was found. There was a considerable decrease in HPV prevalence with age; young adults between 15 and 29 years (86.4%) followed by women aged between 30 and 54 years (13.2%). Among positives, hr-HPV-16 prevalence was not significantly different among the different age-groups (p > 0.05). Hr-HPV-16 infection was detected highest in Scheduled Tribes (ST) 70%, followed by other categories. Interventions such as screening and awareness programs will help in better management of HPV infection.

Individualized Homeopathic Medicines in Chronic Rhinosinusitis: Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Chronic rhinosinusitis (CRS) is a common disorder, with up to an estimated 134 million Indian sufferers, and having significant impact on quality of life (QOL) and health costs. Despite the evidence favoring homeopathy in CRS being inadequate, it is highly popular. This trial attempts to study the efficacy of individualized homeopathy (IH) medicines in comparison with placebo in patients with CRS. METHODS: A double-blind, randomized (1:1), placebo-controlled, preliminary trial (n = 62) was conducted at the National Institute of Homoeopathy, West Bengal, India. Primary outcome measure was the sino-nasal outcome test-20 (SNOT-20) questionnaire; secondary outcomes were the EQ-5D-5L questionnaire and EQ-5D-5L visual analog scale scores, and five numeric rating scales (0-10) assessing intensity of sneezing, rhinorrhea, post-nasal drip, facial pain/pressure, and disturbance in sense of smell, all measured at baseline and after the 2nd and 4th months of intervention. Group differences and effect sizes (Cohen's d) were calculated on the intention-to-treat sample. RESULTS: Groups were comparable at baseline. Attrition rate was 6.5% (IH: 1, Placebo: 3). Although improvements in both primary and secondary outcome measures were higher in the IH group than placebo, with small to medium effect sizes, the group differences were statistically non-significant (all p > 0.05, unpaired t-tests). Calcarea carbonica, Lycopodium clavatum, Sulphur, Natrum muriaticum and Pulsatilla nigricans were the most frequently prescribed medicines. No harmful or unintended effects, homeopathic aggravations or any serious adverse events were reported from either group. CONCLUSION: There was a small but non-significant direction of effect favoring homeopathy, which ultimately renders the trial as inconclusive. Rigorous trials and independent replications are recommended to arrive at a confirmatory conclusion. [Trial registration: CTRI/2018/03/012557; UTN: U1111-1210-7201].

Cross-sectional observational study evaluating the association between odontogenic cystic content and size.

OBJECTIVES: To evaluate and correlate the cystic content and the size of odontogenic cysts. METHODS: The study included 29 cases of odontogenic cysts reported in the Outpatient Department of Sharad Pawar Dental College. The cystic aspirate was analyzed for levels of sodium, potassium, calcium, chloride, total protein, globulin, albumin, and cholesterol. The sodium/potassium ratio was calculated. Pearson's correlation coefficient (ρ) was used to correlate the size of the cyst with the sodium/potassium ratio and other cystic contents. P < 0.05 was considered statistically significant. RESULTS: A positive and statistically significant correlation (ρ = 0.625, p = 0.020) was noted between the sodium to potassium ratio and the size of the cyst. The correlation between the other cystic contents and the size of the cyst was not statistically significant (p > 0.05). CONCLUSION: The sodium to potassium ratio is positively correlated with the radiographic size of cysts. A thorough analysis of cystic fluid components could provide valuable insights into the potential expansion of odontogenic cysts.

Nasal prosthesis after partial rhinectomy. A case report.

Maxillofacial defects can result from several reasons, including neoplasia, congenital malformations, trauma, oral infections, etc. This kind of defects can be severely debilitating to the patients. To improve the quality of life of these patients, the options include surgical reconstruction and maxillofacial prosthesis. However, surgical approaches have many inherent disadvantages and limitations. This case report describes the prosthetic rehabilitation of a female patient who underwent partial rhinectomy secondary to basal cell carcinoma. The case was planned with a silicone prosthesis with anatomic and spectacle retention. A non-surgical method of rehabilitation was followed owing to the patient's choice and financial constraints. The final prosthesis was aimed at enhancing the esthetics and function of the patient, thereby improving her quality of life.

Review of health-care services for older population in India and possibility of incorporating AYUSH in public health system for geriatric care.

BACKGROUND: In a developing country like India, which has 10.11% population of >60 years age and a projection of rise of the same by 300% in 2050, health care of elderly is an enormous challenge. The developed world has evolved many models for elderly care, for example, nursing home care, health insurance, etc. Indian Government has also taken multiple measures in this direction by initiating National Policy on Older Persons, 1999, the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, the Old Age Pension Scheme, Rashtriya Vayoshri Yojana 2017, etc. However, there is a necessity that, India must rapidly adapt to the complex health related, social and economic challenges caused by these demographic changes. This may be an opportunity for innovation in the health system by developing a perspective for healthy and active aging, though it is a major challenge. Health care of the older people cannot be achieved unless total health, i.e., physical, social, economic, psychological, and spiritual aspects are addressed. OBJECTIVE: The objective is to study current policies regarding geriatric health care in India and to propose the possibility to develop a model to provide comprehensive and dedicated health-care services to the older population by integrating conventional and indigenous systems of medicine dwelling in the country. MATERIALS AND METHODS: Electronic search in various scientific journals for research and review articles; electronic along with hand searching of conference proceedings, brochures, government policy documents, press releases, Ayurveda classical texts, etc., regarding geriatric health care in India and model health-care facilities in other countries and regarding of AYUSH systems in geriatric health care in India. RESULTS: There is an urgent need of adaptation and modification in the National Health System to cater the actual requirements of the elderly with plans and strategies dedicated to face their health-related challenges. Adoption of inclusive health-care interventions, can improve health outcomes by making it more acceptable, accessible, and affordable. CONCLUSION: Integration of AYUSH at various levels of health-care delivery system can potentially contribute to provide unique newer dimensions to the field of geriatric care in India.

Oro-facial manifestations in lepromatous leprosy patients in Central India: clinical findings from a cross-sectional study.

OBJECTIVES: To clinically evaluate the oro-facial manifestations in lepromatous leprosy patients undergoing multidrug therapy in Central India. MATERIALS AND METHODS: Two hundred patients from 2 leprosy treatment centers in Central India who satisfied the diagnostic criteria set by the WHO (2006-2010) committee on leprosy were included in the study. To avoid bias, only patients who started the multi-drug treatment regimen less than 1 year ago were included. All the patients were examined for the presence of oral and facial manifestations. To confirm that the oro-facial manifestations were not due to HIV co-infection, serological diagnostic tests including ELISA, Immunocomb, and Tri-dot were performed. RESULTS: Majority of the patients (n = 189) exhibited oral (n = 145) and/or facial (n = 147) manifestations. The most common oral lesions were found to be fissuring and depapillation of the tongue followed by fibrosis and loss of uvula. Among the facial manifestations, facial skin lesions and loss of eyebrows were most prevalent followed by sagging of facial skin and facies leonine. CONCLUSION: The facial manifestations of leprosy are quite common, readily recognizable, and relatively specific to the disease. Thus, the presence of facial manifestations, especially with co-existing oral lesions must prompt the clinician to mandate further investigations to confirm the diagnosis. CLINICAL RELEVANCE: As evidenced by the present study, facial manifestations and oral lesions are an integral part of leprosy. In addition to being a diagnostic parameter, facial manifestations and oral lesions could potentially be used to monitor the disease progression and treatment outcome.