Probing the influence of strontium doping and annealing temperature on the structure and biocompatibility of hydroxyapatite nanorods.

Among numerous biologically important metal cations, strontium (Sr2+) has received much attention in bone tissue regeneration because of its osteoinductive properties combined with its ability to inhibit osteoclast activity. In this study, strontium-doped hydroxyapatite (Sr-HAp) nanorods with varying molar ratios of Ca : Sr (10 : 0, 9 : 1, 5 : 5, 3 : 7 and 0 : 10) were synthesized using the chemical precipitation technique. The synthesized Sr-HAp nanostructures were characterized using powder X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), transmission electron microscopy, energy dispersive X-ray spectroscopy, and Raman and Fourier transform infrared (FTIR) spectroscopies to understand their structural and morphological features, and composition. XRD results revealed the formation of HAp nanostructures, whose unit cell volume increased as a function of the dopant level. The reaction process investigation showed the formation of hydroxyapatite (HAp), strontium apatite (SAp) and various Sr-HAp phases. FESEM micrographs displayed the morphological transformation of Sr-HAp from nanorods to nanosheets upon increasing the dopant level. In the FTIR spectra, the bands of the PO43- group shifted towards a lower wavenumber upon increasing the dopant concentration in Sr-HAp that signifies the structural distortion due to the presence of a large amount of strontium ions. The peaks of PO43- and OH- vibrations in the Raman spectra were further analysed to corroborate the structural distortion of Sr-HAp. Selected area electron diffraction patterns obtained using TEM reveal the reduced crystallinity of Sr-HAp due to Sr-doping, which is in line with the XRD results. Finally, the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay showed that the synthesized Sr-HAp has no toxic effect on the survival and growth of mesenchymal stem cells. In summary, the synthesized novel Sr-HAp nanorods exhibit great promise for bone tissue engineering applications.

Dengue risk zone mapping of Thiruvananthapuram district, India: a comparison of the AHP and F-AHP methods.

Dengue fever, which is spread by Aedes mosquitoes, has claimed many lives in Kerala, with the Thiruvananthapuram district bearing the brunt of the toll. This study aims to demarcate the dengue risk zones in Thiruvananthapuram district using the analytical hierarchy process (AHP) and the fuzzy-AHP (F-AHP) methods. For the risk modelling, geo-environmental factors (normalized difference vegetation index, land surface temperature, topographic wetness index, land use/land cover types, elevation, normalized difference built-up index) and demographic factors (household density, population density) have been utilized. The ArcGIS 10.8 and ERDAS Imagine 8.4 software tools have been used to derive the risk zone maps. The area of the risk maps is classified into five zones. The dengue risk zone maps were validated using dengue case data collected from the Integrated Disease Surveillance Programme portal. From the receiver operating characteristic (ROC) curve analysis and the area under the ROC curve (AUC) values, it is proved that the F-AHP method (AUC value of 0.971) has comparatively more prediction capability than the AHP method (AUC value of 0.954) in demarcating the dengue risk zones. Also, based on the comparison of the risk zone map with actual case data, it was confirmed that around 82.87% of the dengue cases occurred in the very high and high-risk zones, thus proving the efficacy of the model. According to the dengue risk map prepared using the F-AHP model, 9.09% of the area of Thiruvananthapuram district is categorized as very high risk. The prepared dengue risk maps will be helpful for decision-makers, staff with the health, and disaster management departments in adopting effective measures to prevent the risks of dengue spread and thereby minimize loss of life.

A systematic review of randomized controlled trials on survival rate of atraumatic restorative treatment compared with conventional treatment on primary dentition.

Background: In this COVID era, it's critical to promote nonaerosol procedures. Atraumatic restorative treatment (ART) is one of them, and it's particularly effective in children for lowering anxiety, enhancing dental health, and giving restorative care. Aim: The aim of this study was to assess the survival rate of ART compared with conventional treatment procedures in primary dentition. Materials and Methods: The review was done in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analysis statement and is been registered in PROSPERO (CRD42021213729). The studies included comprised clinical investigations with randomized controlled trials (RCTs) which compared the survival rate of ART and conventional restorative treatments using the same or different restorative materials to treat carious lesion. RCTs in which ART was compared with conventional treatment on patients in the age group of 6-10 years with minimum follow-up of 6 months. Studies available as open access and free full text in PubMed, DOAJ, and Google Scholar databases, and published in English Language only were included in the study. Cochrane's collaboration tool for RCTs was used for the assessment of risk of bias. Results: The survival rate of single surface and multiple surface in primary dentition treated according to the ART compared with conventional treatment was found to be similar. Conclusion: The ART approach is equally helpful in managing dental caries in children and this method may be considered a useful intervention in clinical practice to enhance the dental health of children.

The prospective, 24-week assessment of cost-efficacy of and compliance to antidepressant medications in a rural setting (PACECAR) study.

BACKGROUND: Anxiety and depression are common mental health disorders that are responsible for considerable societal burden. There are no data on cost-efficacy and medication compliance related to the treatment of these disorders in rural India. MATERIALS AND METHODS: All consenting adults (n = 455) diagnosed with generalized anxiety or (unipolar) depressive disorders in Suttur village, Karnataka, were treated with open-label fluoxetine (20-60 mg/day), sertraline (50-150 mg/day), escitalopram (10-20 mg/day), desvenlafaxine (50-150 mg/day), duloxetine (30-90 mg/day), amitriptyline (75-150 mg/day), or clomipramine (75-150 mg/day) in a structured, monotherapy dosing plan. The study was nonrandomized and otherwise naturalistic. Patients were followed up every 4 weeks for 24 weeks. Study discontinuation was defined as medication noncompliance for 3 or more days or withdrawal due to treatment nonresponse. RESULTS: There was substantial discontinuation (34.5%) in the first 4 weeks; 55.4% had discontinued by 12 weeks. Subsequently, only 11.2% discontinued treatment. Only 33.4% of the subjects tolerated the treatment, responded to it, and remained compliant for 24 weeks. Such successful completion was highest for escitalopram and desvenlafaxine (46%-47%) and lowest for clomipramine and amitriptyline (10%-14%). Adverse events were the most common reason for noncompliance with clomipramine and amitriptyline (45%-46%); the experience of sufficient improvement was the most common reason for noncompliance with the remaining drugs (28%-49%). Whereas the average cost of efficacious treatment for a continuous period of 24 weeks was lowest for fluoxetine, an examination of the cost-efficacy tradeoff suggested maximum advantage for escitalopram, sertraline, and desvenlafaxine. The cost-efficacy profile for amitriptyline and clomipramine was poor. CONCLUSIONS: Reasons for noncompliance vary by drug class and need to be considered when prescribing antidepressant drugs. Escitalopram, sertraline, and desvenlafaxine perhaps have the most favorable 24-week cost-efficacy profile; tricyclics are poorly tolerated. Rural subjects need to be educated that treatment must be continued even after improvement is established.

Use of Polycaprolactone Electrospun Nanofibers as a Coating for Poly(methyl methacrylate) Bone Cement.

Poly(methyl methacrylate) (PMMA) bone cement has limited biocompatibility. Polycaprolactone (PCL) electrospun nanofiber (ENF) has many applications in the biomedical field due to its excellent biocompatibility and degradability. The effect of coating PCL ENF on the surface topography, biocompatibility, and mechanical strength of PMMA bone cement is not currently known. This study is based on the hypothesis that the PCL ENF coating on PMMA will increase PMMA roughness leading to increased biocompatibility without influencing its mechanical properties. This study prepared PMMA samples without and with the PCL ENF coating, which were named the control and ENF coated samples. This study determined the effects on the surface topography and cytocompatibility (osteoblast cell adhesion, proliferation, mineralization, and protein adsorption) properties of each group of PMMA samples. This study also determined the bending properties (strength, modulus, and maximum deflection at fracture) of each group of PMMA samples from an American Society of Testing Metal (ASTM) standard three-point bend test. This study found that the ENF coating on PMMA significantly improved the surface roughness and cytocompatibility properties of PMMA (p < 0.05). This study also found that the bending properties of ENF-coated PMMA samples were not significantly different when compared to those values of the control PMMA samples (p > 0.05). Therefore, the PCL ENF coating technique should be further investigated for its potential in clinical applications.

Comparative Evaluation of the Antibacterial Efficacy of Type II Glass lonomer Cement, Type IX Glass lonomer Cement, and AMALGOMER™ Ceramic Reinforcement by Modified "Direct Contact Test": An in vitro Study.

BACKGROUND: Streptococcus mutans (ATCC25175) has a profound effect on the incidence of dental decay in the human population. Many studies have been performed to assess the antimicrobial activity of different cements. However, little or no information is available about the antibacterial properties of Type II glass ionomer cement (GIC), Type IX GIC, and AMALGOMER™ ceramic reinforcement (CR). AIM: To comparatively evaluate the antibacterial activity of Type II GIC, Type IX GIC, and AMALGOMER™ CR by modified direct contact test. MATERIALS AND METHODS: The total sample size was 72 which was divided into four study groups. Six wells were coated by each: Type II GIC, Type IX GIC, AMALGOMER™ CR, and control group (only S. mutans). Statistical analysis was done using analysis of variance and the intergroup comparison was done using post hoc Tukey test. RESULTS: AMALGOMER™ CR was found to have a better antibacterial effect as compared with Type II and IX GIC. CONCLUSION: AMALGOMER™ CR can serve as a valuable cement in pediatric dentistry due to its anticariogenic property. How to cite this article: Hugar SM, Assudani HG, Patil V, Kukreja P, Uppin C, Thakkar P. Comparative Evaluation of the Antibacterial Efficacy of Type II Glass lonomer Cement, Type IX Glass Ionomer Cement, and AMALGOMER™ Ceramic Reinforcement by Modified "Direct Contact Test": An in vitro Study. Int J Clin Pediatr Dent 2016;9(2):114-117.

A comparative evaluation of antibacterial effectiveness of sodium hypochlorite, Curcuma longa, and Camellia sinensis as irrigating solutions on isolated anaerobic bacteria from infected primary teeth.

CONTEXT: In endodontics, most of the commercial intra-canal medicaments have cytotoxic reactions and because of their inability to eliminate bacteria from dentinal tubules, recent medicine has turned its attention to the usage of biologic medication prepared from natural plants. The literature to testify the efficacy of natural alternatives in primary teeth is meagre and its effects as irrigating solutions need to be evaluated. AIM: To evaluate the antibacterial effectiveness of sodium hypochlorite, ethanolic extracts of Curcuma longa (turmeric) and Camellia sinensis (green tea) as irrigating solutions against the anaerobic bacteria isolated from the root canals of infected primary teeth. MATERIALS AND METHODS: Thirty patients were selected based on the selected inclusion and exclusion criteria. Preoperative radiographs were taken. Rubber dam isolation and working length estimation were done, following which thirty samples were taken from the root canals of infected primary teeth using sterile absorbent paper points and transferred to tubes containing thioglycolate transport medium. The bacteria were then isolated using standard microbiological protocols and were subjected to antibiotic sensitivity testing using the three test irrigants. STATISTICAL ANALYSIS: SPSS 18 software using Chi-square test was used for statistical analysis. RESULTS: The most commonly isolated bacteria included Porphyromonas sp., Bacteroides fragilis, Peptostreptococcus, and Staphylococcus aureus. Sodium hypochlorite and C. longa (turmeric) showed good antibacterial effect and were effective against most of the isolated bacteria. There was statistically significant difference in the antibacterial effect among the three tested groups (P < 0.001). The least effective was C. sinensis (green tea). CONCLUSION: The infected primary teeth almost always present with a polymicrobial structure with a wide variety of anaerobic bacteria. The chemo-mechanical preparation plays an important role in eradicating the population of predominant micro-organisms in treating these teeth with promising effects with the use of newer test irrigants while avoiding the side effects of sodium hypochlorite.

Bilateral Calcifying Odontogenic Cyst: A Rare Entity.

The calcifying odontogenic cyst (COC) accounts for 1 % of jaw cysts, found most commonly as central lesion. The COC usually manifests itself as a painless, slow growing swelling, anterior to the first molar region. Radiographically it appears as a well-defined, unilocular radiolucency, and may have a radiopaque mass in its center. Majority of the cases appear before the fourth decade of life. The COC is found rarely in patients in the first decade of life. Histopathological features include a cystic lining demonstrating characteristic "Ghost" epithelial cells with a propensity to calcify. Here we report the unusual occurrence of a case of 8 year child diagnosed with bilateral COC on right and left side of mandible.

Multiple Pathology in a Single Lesion: AOT Associated with Dentigerous Cyst.

Odontogenic cysts and tumors are quite common occurrences in jaw bones, although both of them occurring together are rare. The epithelial lining of odontogenic cyst has a potential to transform into neoplastic conditions like squamous cell carcinoma and mucoepidermoid carcinoma, and odontogenic tumors like ameloblastoma and adenomatoid odontogenic tumor. However, the frequency of such cases being encountered is very less. Here, we report a case of adenomatoid odontogenic tumor (AOT) associated with a dentigerous cyst around the crown of an unerupted lateral incisor (follicular variant), in a 14-year-old boy. We also attempt to unravel its mechanism of cytodifferentiation and tumor progression. The origin and nature of such kind of lesions (i.e., independent development of multiple pathologies as a single lesion in a single location, single pathology giving rise to another pathology or a distinct entity/new variant) cannot be explained with certainty at this point of time. The molecular mechanism of tumor development needs to be further elucidated in order to conclude that a different entity called 'hybrid' AOT exists.

Traumatic herniation of buccal fat pad in 1 year old child: case report and review of literature.

Traumatic herniation of buccal fat pad (BFP) is very rare, usually seen in infants and young children ranging from 5 months to 12 years of age. Etiology will be blunt injury to buccal mucosa from foreign objects or trauma due to teeth and fall. The suckling activity in infants may also encourage the herniation following trauma. A minor injury or perforation to the buccal mucosa can cause herniation of BFP. The size of herniated mass is very large when compared to the size of the perforation. The history of trauma, absence of prolapse before the injury, its occurrence in infants and young children, specific anatomic sites and location of perforation in mucosa, histopathological appearance of adipose tissue are the characteristic features important for diagnosing the condition. The treatment options for the herniated BFP are usually excision. Alternative to excision is repositioning of the herniated fat in its anatomical location if noticed early.

Suttur study: An epidemiological study of psychiatric disorders in south Indian rural population.

BACKGROUND: Based on review of literature World Health Organization (WHO) Global Burden of Disease Study has estimated that psychiatric disorders are among the most burdensome, around the globe and has suggested general population surveys for future research. This study aims to estimate the prevalence of psychiatric disorders and study their association with various socioeconomic variables. MATERIALS AND METHODS: This was an exploratory study where a door-to-door survey of the entire population residing in a South Indian village was done (n = 3033). Mini international neuropsychiatric interview kid (MINI) or MINI plus were administered to all the subjects according to the age group. RESULTS: It was found that 24.40% of the subjects were suffering from one or more diagnosable psychiatric disorder. Prevalence of depressive disorders was found to be 14.82% and of anxiety disorders was 4%. Alcohol dependence syndrome was diagnosed in 3.95% of the population. Prevalence of dementia in subjects above 60 years was found to be 10%. CONCLUSION: Our study is among the very few epidemiological studies with respect to methodological design which does not use screening questionnaires and evaluates each subject with detailed administration of MINI. It concluded that one among four were suffering from a psychiatric disorder. Improving the training of undergraduate medical and nursing students is likely to play a significant role in addressing the increasing psychiatric morbidities.

Mandibular reconstruction using AO/ASIF stainless steel reconstruction plate: a retrospective study of 36 cases.

AIM: The study was aimed at esthetic and functional results as well as patient tolerance after reconstruction with reconstruction plate. The follow-up ranged from 1 to 4 years. MATERIALS AND METHODS: A retrospective study of 36 patients who had mandibular reconstruction with AO/ASIF stainless steel reconstruction plates after oncologic resection was evaluated. The indications and postoperative outcomes were studied. RESULTS: At the end of study, 24 of 36 patients (67%) still had the plate in place. Around three (8%) plates were fractured. Nine (25%) plates got exposed leading to surgical intervention. Surgical results were satisfying, particularly when looking at delayed healing or long-term tolerance. Esthetic (79% rated results as good or acceptable) and functional results of this reconstruction were satisfying. CONCLUSION: We conclude by saying that reconstruction plate provides a solution for safe and rapid mandibular reconstruction for patients with poor prognosis or poor condition. This method also preserves the possibility of secondary reconstruction. CLINICAL SIGNIFICANCE: The reconstruction plate may be a good clinical choice for safe and rapid mandibular reconstruction.

Platelet refractoriness in acquired hemophagocytic syndrome.

BACKGROUND: Acquired hemophagocytic syndrome (AHPS) is a severe inflammatory disorder often caused by Epstein-Barr virus (EBV). Proliferation of activated macrophages produces uncontrolled cytokine production. Thrombocytopenia is common in AHPS, previously attributed to inadequate or ineffective marrow platelet (PLT) production. PLT transfusion response is not well reported. Two patients with fatal AHPS developed unexplained PLT transfusion refractoriness before definitive diagnosis. CASE REPORTS: PLT refractoriness was noted during the care of two patients. The refractoriness was determined to be nonimmune and both demonstrated various clinical signs and laboratory findings consistent with AHPS. The first patient's AHPS was attributable to EBV infection. In the other patient, no underlying cause could be found. Both patients had an aggressive clinical course and succumbed to this relatively rare syndrome. The PLT refractoriness was evident before the AHPS diagnosis was made. DISCUSSION: AHPS is not generally a consideration in the evaluation of nonimmune PLT refractoriness. However, these illustrative cases make an argument for its consideration in the differential diagnosis of PLT refractoriness in severely ill patients. Once present, it is unclear if the refractoriness can be reversed by AHPS-targeted therapy.