Evaluating the Efficacy of Certain Intermediate Irrigants in Preventing Precipitate Formed Due to Sodium Hypochlorite and Chlorhexidine Within the Root Canal System: An In Vitro Study.

AIM: Root canal irrigation using a mixture of sodium hypochlorite (NaOCL) and chlorhexidine gluconate (CHX) might cause a precipitate to develop. This study aims to check the efficacy of sodium thiosulfate and normal saline as irrigating solutions. MATERIALS AND METHODS: Roots of 45 teeth were biomechanically prepared, and the teeth were then tested. A size 15k file was introduced to the point where the apical foramen could be visible in order to provide an accurate reading of the working length. As a precaution against irrigating solutions leaking out, the specimens' tips were sealed with modeling wax before being instrumented. Each group's root canals were instrumented with #F4 hand Protaper (Dentsply Sirona, USA) as recommended by the manufacturer. Between instrumentation, The canals were lubricated with ethylenediamine tetraacetic acid (EDTA) and irrigated with 2.5% sodium hypochlorite (RC Help, Prime Dental, Mumbai, India). Fifteen samples were randomly assigned to one of three experimental categories based on the middle watering arrangement used: Group 1 (control), Group 2 (saline irrigant), and Group 3 (3.86% sodium thiosulfate). The jewel plate was submerged in water to cool it down, while two longitudinal scores were made on the root's buccal and lingual surfaces. We used a stereomicroscope to examine the exposed surfaces of the root trench in the coronal, middle, and apical thirds for the orange-earthy colored material (Stereozoom Nikon magnifying lens under 20X amplification), and we used the Mann-Whitney U test and the Kruskal Wallis test during our thorough analysis. RESULTS: The precipitation generated in the coronal, middle, and apical thirds had significantly different thicknesses. While precipitation did occur in all three regions, it was at a much lower rate in the apical third compared to the coronal and middle regions. In Group 1, the control group, the precipitate was thicker than in Groups 2 (saline irrigant) and 3 (3.86% sodium thiosulfate). CONCLUSION: Sodium thiosulfate, which is a biocompatible solution, can be used as an intermediate irrigant as it shows less precipitate as compared to saline.

A scoping review of persistent symptoms after COVID infection at different follow-up periods.

The clinical entity termed as long COVID has gained importance in the recent past. As this phenomenon is still evolving, it is important to document the magnitude of the syndrome during different time periods. This scoping review attempts to synthesize evidence generated from longitudinal studies which have follow-up periods beyond 3 months, up to 12 months. The review also documents the reported prevalence of long COVID for the different regions of the World Health Organization. Longitudinal studies published till March 2022 were systematically searched on PubMed, Google Scholar, and medRxiv. Among the identified 594 studies, 48 were included in this review. Data from selected studies were synthesized. The overall pooled prevalence of long COVID was 49% (40%-58%). The pooled estimates after 3 months, 4-6 months, 7-9 months, and 10-12 months were 44% (32%-57%), 50% (43%-57%), 49% (37%-62%), and 54% (46%-62%), respectively. Eastern Mediterranean Region (EMR) had the highest pooled prevalence of 63% (34%-92%] and the South East Asian Region (SEAR) had the least pooled estimate of 15% (10%-21%). The study brings out the high prevalence of long COVID even after 12 months of follow-up. It also shows the regional differences in the reported prevalence of the syndrome. This review highlights the need for well-planned follow-up studies, especially in developing nations to understand the magnitude and the pattern of long COVID-related symptoms as they emerge.

Genomic Characterization of Mosquito Isolates of Chikungunya Virus (Outbreak Strains 2022) Using Next-Generation Sequencing.

Background: A massive outbreak of dengue-like illness was reported from Pune district of Maharashtra, India during May-June 2022. Isolation and characterization of the etiological agent at genomic level for possible mutations that led to higher transmissibility is the topic of the study. Methods: Entomological investigations were carried out by ICMR-National Institute of Virology (Pune, India); Aedes aegypti mosquitoes were collected and processed for virus detection by molecular techniques. Positive mosquito pools were processed for virus isolation in cell culture. Sanger sequencing and whole-genome sequencing (WGS) using Oxford Nanopore Technology platform were used for genomic characterization. Results: Reverse transcriptase RT-PCR and qRT-PCR analysis detected chikungunya virus (CHIKV) in mosquito samples. Six CHIKV isolates were obtained. WGS revealed four nonsynonymous mutations in the structural polyprotein region, and five in the nonstructural polyprotein encoding region when compared with Yawat-2000 and Shivane-2016 strains. Sixty-four nucleotide changes in the nonstructural polyprotein region and 35 in the structural polyprotein region were detected. One isolate had an exclusive amino acid change, T1123I, in the nsP2 (protease) region. Conclusion: Abundant Ae. aegypti breeding and detection of CHIKV RNA in mosquitoes confirmed it as a chikungunya outbreak. Novel mutations detected in the epidemic strain warrants investigations to address their role in disease severity, transmission, and fitness.

Rural Elderly and Access to Palliative Care: A Public Health Perspective.

In near future, the elderly population will increase to a high proportion. This will increase the burden of Age-Related Diseases (ARDs) to a significant level. Most of the ARDs need palliative care (PC) for a fairly long duration. Some statistical extrapolations are discussed to help in identifying this future burden. The existing PC centers are limited in numbers, situated mainly in urban areas, and mostly attached to cancer hospitals. Socioeconomic vulnerabilities of the elderly, especially in rural areas, are high, and access to health is also not optimal. In the coming decades, the number of needy people, as well as the demand for PC, will increase. Existing numbers indicate that exponential increment in quantum and quality of PC services is required to deal with the imminent burden. Specific suggestions are made to use existing public health programs to cater to the rural elderly.

Measuring the Drudgery and Time-Poverty of Rural Women - A Pilot Study from Rural Rajasthan.

CONTEXT: Women's hard-work toward family responsibility is rarely examined from a health perspective. Excessive physical work translates into musculoskeletal disorders (MSDs). It is essential to understand certain parameters of this burden. SUBJECTS AND METHODS: This was a cross-sectional study of 565 rural women. The participants were selected using a stratified random sampling method. A pre-tested questionnaire was used, focusing mainly on physical activities, durations, and health complaints. RESULTS: The self-reported mean durations of various physical were quite high. On average, a woman spent around 11 h per day in domestic work-related physical activities. Older women (more than 50 years) spent similar durations for most of the physical activities compared to younger women (50 years or less). In the sample, 53.4% (n = 302) participants reported at least one Chronic MSD, and 16.99% (n = 96) took medication for the same in the last one year. Point prevalence of low back pain (LBP) was 29.2% (CI 25.5 to 33.1). Women worked even with MSDs as there was no significant difference in the mean durations among women with and without MSDs for most of the activity categories except for 'work in bending position' and 'work in farm'. General caste women spent higher time in domestic work. CONCLUSIONS: Higher self-reported MSDs were likely to be contributed by continuous and repeated strenuous domestic work. Women had to continue working even with MSDs or higher age. Women got very less time for rest. Provision of basic amenities like electricity, water, cooking fuel, etc. at doorstep can help. Below poverty line women seem to have higher burden of MSDs.

Current Asbestos Exposure and Future Need for Palliative Care in India.

Asbestos-related diseases (ARDs) are incurable but entirely preventable. Due to India's continuing use of asbestos, ARD patients will increase to a high number in the next three to four decades. This will increase the burden on palliative care system which is in nascent stage presently. Palliative care is the mainstay of the management of ARDs. Unfortunately, the burden on palliative care is likely to increase due to multiple factors contributed by India's demographic and economic changes. In the near future, there will be at least 12.5 million ARD patients and 1.25 million asbestos-related cancer patients worldwide, and half of these will be in India. It is high time to introspect about our ability to engage with this future problem. The paper also discusses the organization of this future problem of ARDs and possible action points toward future access to palliative care for ARD patients.

1,6-Hydroolefination and Cascade Cyclization of p-Quinone Methides with Styrenes: Total Synthesis of (±)-Isopaucifloral F.

A Lewis acid-catalyzed intermolecular 1,6-hydroolefination of p-quinone methides with styrenes leading to vinyl diarylmethanes and indenes has been developed. This protocol was also elaborated to the total synthesis of (±)-isopaucifloral F. Besides, interestingly, the reaction between 2-alkynylated p-quinone methides and styrenes provided a straightforward access to dihydrobenzo[ a]fluorene derivatives in one pot with 100% atom-economy.

Tandem One-Pot Approach To Access 1,2,3-Triazole-fused Isoindolines through Cu-Catalyzed 1,6-Conjugate Addition of Me3SiN3 to p-Quinone Methides followed by Intramolecular Click Cycloaddition.

A Cu-catalyzed one-pot approach has been developed for the synthesis of 1,2,3-triazole-fused tricyclic heterocycles. This tandem approach actually involves the 1,6-conjugate addition of Me3SiN3 to o-alkynylated p-quinone methides followed by an intramolecular [3+2]-cycloaddition reaction. This protocol allowed us to access a wide range of 1,2,3-trazole-fused isoindoline derivatives in moderate to good yields.

Exploring Gold Catalysis in a 1,6-Conjugate Addition/Domino Electrophilic Cyclization Cascade: Synthesis of Cyclohepta[ b]indoles.

An effective method for the construction of the structurally complex fused cyclohepta[ b]indole core has been developed through an intermolecular 1,6-conjugate addition of indoles to 2-alkynyl p-quinone methides followed by an intramolecular electrophilic cyclization under oxophilic and alkynophilic gold catalysis.

1,6-Conjugate addition of zinc alkyls to para-quinone methides in a continuous-flow microreactor.

An efficient method for the synthesis of alkyl diarylmethanes through the 1,6-conjugate addition of dialkylzinc reagents to para-quinone methides (p-QMs) has been developed under continuous flow conditions using a microreactor. This protocol allows to access unsymmetrical alkyl diarylmethanes in moderate to excellent yields using a wide range of p-QMs and dialkylzinc reagents. Interestingly, this transformation worked well without the requirement of a catalyst.

Comparative cross-sectional study for understanding the burden of low back pain among public bus transport drivers.

BACKGROUND: Even though low back pain (LBP) is common, some occupations pose a higher risk. Identifying these occupations and specific factors will help to reduce the suffering and burden. This study aims to compare the prevalence of chronic LBP among bus drivers and to find its association with some occupational factors. MATERIALS AND METHODS: It is a cross-sectional study to compare prevalence of LBP and factors associated with it, in two groups of drivers (n = 178) and nondrivers (n = 184). RESULTS: The 10 years' percentage prevalence of LBP was found to be 70.8 and 51.6 among drivers and nondrivers respectively, whereas point prevalence in the same was 64.0 and 44.6. Drivers are at a higher risk for LBP with Odds ratio-2.270 (1.471-3.502). Risk factors such as prolonged sitting in one posture, night shifts, job dissatisfaction, tobacco use, and lack of exercise were significantly higher among drivers. Though the prevalence and intensity of LBP was higher among drivers, their number of leaves and hospital admitted days were less among drivers. CONCLUSION: This is a potential group for intervention as prevalence of LBP, neck pain, and most of the suspected risk factors were higher among the drivers. Drivers got less recovery time and had higher sequelae.

Sjögren's Syndrome: A Case Study.

Sjögren syndrome is chronic, systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. It is an elaborate involvement of the lacrimal and salivary glands, which eventually lead to keratoconjunctivitis sicca and xerostomia. It may occur in two forms - Primary and secondary, which is associated with another autoimmune disease, most commonly rheumatoid arthritis. Numerous criteria were proposed for diagnosis of Sjögren syndrome. Most widely accepted are American and European group developed international classification criteria for Sjögrens syndrome. These criteria include ocular symptoms, oral symptoms, ocular signs, histopathology, salivary gland involvement and sialography. The classification requires four of the six items, one of which must be positive minor salivary gland biopsy or a positive antibody test. Early diagnosis is important to prevent further complications. The aim of this paper is to emphasis on oral changes, advanced diagnosis, and management of Sjögren's syndrome.

A room-temperature protocol to access isoquinolines through Ag(I) catalysed annulation of o-(1-alkynyl)arylaldehydes and ketones with NH4OAc: elaboration to berberine and palmatine.

An efficient and mild protocol for the direct construction of aryl- and alkyl-substituted isoquinolines has been realized through silver nitrate catalyzed aromatic annulation of o-(1-alkynyl)arylaldehydes and ketones with ammonium acetate. The salient feature of this methodology is that this annulation could be effected at room temperature leading to a wide range of isoquinoline derivatives in good to excellent yields. Additionally, this approach has been employed to the synthesis of biologically important isoquinoline alkaloids such as berberine and palmatine.

Efficacy of microwaves and chlorhexidine for disinfection of pacifiers and toothbrushes: an in vitro study.

PURPOSE: The purpose of this study was to evaluate, in vitro, the contamination of toothbrushes and pacifiers by Streptococcus mutans, and the efficacy of microwave and chlorhexidine for their disinfection. MATERIALS AND METHODS: Sixty pacifiers and 60 toothbrushes were contaminated with S. mutans and then divided into groups according to the disinfection protocol: Group 1-chlorhexidine solution; group 2-microwave sterilization; and group 3-sterile tap water. The devices were evaluated microbiologically after disinfection for the survival of S. mutans colonies and were examined. The results were analyzed statistically by ANOVA and Turkey test. RESULTS: The results of both types of evaluation showed a large number of S. mutans colonies after spraying with sterile tap water, and chlorhexidine spraying and microwaving were effective in eliminating colonies. Groups 1 and 2 were statistically similar to each other (p > 0.05) and differed significantly from group 3 (p < 0.05). CONCLUSION: The 0.12% chlorhexidine solution spray and 7 minutes of microwave irradiation were almost equally effective for disinfection of pacifiers and toothbrushes.

Asbestosis: Past voices from the Mumbai factory floor.

BACKGROUND: Asbestos's production, processing, and consumption is on very high scale in India and it is increasing, and so do the related diseases. Asbestosis is such a disease which causes progressive respiratory disability. AIM: To find out perceptions and thinking about this disease and its risk among the patients which will help in constructing an effective community-based prevention and rehabilitation program. MATERIALS AND METHODS: It was a community-based, qualitative study using a semi-structured interview schedule with 17 asbestosis patients from Mumbai, disgnosed by specialist with pulmonary function test and X-rays as per International Labour Organisation's recommandations. RESULTS: The risk percived by the patients is very less and attitude toward the illness is bengine as there is no clear understanding about the causation. The prolong latent period appears to be the main cause. It suggests a need of very strong program for prevention of asbestosis with the incorporation of worker awareness and eduaction for safety. The socio-economical status and educational levels of the workers make this floating population more vulnarable for manipulation by the corporates. CONCLUSION: Apart from the radical step of ban on asbestos, there is a need of community-based sustainable, affordable, and accessible rehabilitation program with a component of palliative care which will consider the different needs of this marginalized group. The need for such a program is intense as the number of asbestisis patients will keep on increasing till 30 to 40 years of asbestos ban.