An insight into PI3k/Akt pathway and associated protein-protein interactions in metabolic syndrome: A recent update.

Akt, a known serine/threonine-protein kinase B has been revealed to be an imperative protein of the PI3K/Akt pathway. Akt is available in three isoforms, Akt1, Akt2, and Akt3. Ubiquitously expressed Akt1 & Akt2 are essential for cell survival and are believed to be involved in regulating glucose homeostasis. PI3K/Akt pathway has been evidenced to be associated with metabolic diseases viz. hypertension, dyslipidemia, and diabetes. Akt interacting proteins have been revealed to be scaffold proteins of the PI3K/Akt pathway. Notably, some protein-protein interactions are imperative for the inhibition or uncontrolled activation of these signaling pathways. For instance, Akt interacting protein binds with other protein namely, FOXO1 and mTOR, and play a key role in the onset and progression of metabolic syndrome (MS). The purpose of this review is to highlight the role of the PI3K/Akt pathway and associated protein-protein interactions which might serve as a valuable tool for investigators to develop some new promising therapeutic agents in the management of MS.

Development of a New Outcome Prediction Model in Early-stage Squamous Cell Carcinoma of the Oral Cavity Based on Histopathologic Parameters With Multivariate Analysis: The Aditi-Nuzhat Lymph-node Prediction Score (ANLPS) System.

The aim of this study was to evaluate the histopathologic parameters that predict lymph node metastasis in patients with oral squamous cell carcinoma (OSCC) and to design a new assessment score on the basis of these parameters that could ultimately allow for changes in treatment decisions or aid clinicians in deciding whether there is a need for close follow-up or to perform early lymph node dissection. Histopathologic parameters of 336 cases of OSCC with stage cT1/T2 N0M0 disease were analyzed. The location of the tumor and the type of surgery used for the management of the tumor were recorded for all patients. The parameters, including T stage, grading of tumor, tumor budding, tumor thickness, depth of invasion, shape of tumor nest, lymphoid response at tumor-host interface and pattern of invasion, eosinophilic reaction, foreign-body giant cell reaction, lymphovascular invasion, and perineural invasion, were examined. Ninety-two patients had metastasis in lymph nodes. On univariate and multivariate analysis, independent variables for predicting lymph node metastasis in descending order were depth of invasion (P=0.003), pattern of invasion (P=0.007), perineural invasion (P=0.014), grade (P=0.028), lymphovascular invasion (P=0.038), lymphoid response (P=0.037), and tumor budding (P=0.039). We designed a scoring system on the basis of these statistical results and tested it. Cases with scores ranging from 7 to 11, 12 to 16, and ≥17 points showed LN metastasis in 6.4%, 22.8%, and 77.1% of cases, respectively. The difference between these 3 groups in relation to nodal metastasis was very significant (P<0.0001). A patient at low risk for lymph node metastasis (score, 7 to 11) had a 5-year survival of 93%, moderate-risk patients (score, 12 to 16) had a 5-year survival of 67%, and high-risk patients (score, 17 to 21) had a 5-year survival of 39%. The risk of lymph node metastasis in OSCC is influenced by many histologic parameters that are not routinely analyzed in pathologic reports. These significant independent factors were graded to design a scoring system that permits accurate evaluation of the risk of metastasis with accuracy independent of the traditional TNM system or isolated histologic parameters. The need for neck node dissection can be predicted depending upon the scores obtained.

Dental considerations in cardiovascular patients: A practical perspective.

Cardiovascular disease trends, complications, and associated therapeutics impact the dental health and treatment. Such patients require special consideration with regard to when and which dental treatment is appropriate and what precautions are required. Alertness to potential oral adverse drug reactions enables referral of patient's to his physician or cardiologist. Cardiovascular drugs are also known to have mild to potentially fatal drug interactions. Dental professionals may be the first line of defense in the detection and referral of a patient suspected of having cardiovascular disease, an uncontrolled disease status, or oral adverse drug reactions, and they have a key role to play in oral and systemic disease prevention and treatment, in partnership with the patient and his physician.

Primary embryonal rhabdomyosarcoma of the liver.

Rhabdomyosarcomas are malignant neoplasms with striated muscle differentiation. This is the most common type of soft-tissue sarcoma in children, but occurs rarely in adults. Its occurrence in liver is infrequent. We report a case of primary hepatic embryonal rhabdomyosarcoma in a 67-year-old man. The tumour was occupying the left lobe of the liver with large component of lesion seen bulging in left subhepatic space indenting over the stomach, compressing the pancreas and gall bladder. A percutaneous biopsy was performed which revealed embryonal rhabdomyosarcoma. He underwent a successful left lobectomy with complete resection of the tumour, followed by adjuvant chemotherapy. The patient is free of disease at 24 months of follow-up. Hence, an early diagnosis, prompt surgical resection with negative resection margin along with adjuvant chemotherapy can provide complete remission. This case is extremely rare both due to the age of the patient at presentation and location of the tumour.

Evaluation of the effectiveness of enamel matrix derivative, bone grafts, and membrane in the treatment of mandibular Class II furcation defects.

The combination of osseous graft with barrier membrane and enamel matrix protein derivative (EMD) has the potential to result in a synergistic effect. Therefore, the aim of this study was to evaluate the effectiveness of EMD in combination with demineralized freeze-dried bone allograft (BG) and bioresorbable membrane (Biomesh) in the treatment of human mandibular Class II furcation defects over a period of 12 months. Thirty patients with chronic periodontitis and a single Class II furcation defect on the buccal or lingual surface of mandibular teeth were included. The clinical parameters evaluated were probing pocket depth (PPD), horizontal probing depth (HPD), vertical relative attachment level (V-RAL), and relative gingival margin level (RGML). three groups were created based on treatment method: EMD + BG + guided tissue regeneration (GTR), BG + GTR, and open flap debridement (OFD). All three groups showed a statistically significant PPD reduction of 1.74 ± 1.00 mm, 0.81 ± 0.31 mm, and 0.46 ± 0.52 mm at 12 months postsurgery. EMD + BG + GTR showed a significantly greater PPD reduction compared with BG + GTR, as well as OFD. EMD + BG + GTR showed a statistically significant vertical clinical attachment gain of 2.12 ± 1.07 mm at 12 months compared with BG + GTR as well as OFD. Significant reductions in mean HPD were observed for EMD + BG + GTR (2.10 mm) as well as BG + GTR (1.5 mm). The number of Class II furcation defects that closed or converted to Class I was greatest for EMD + BG + GTR. It can be concluded that EMD + BG + GTR resulted in a statistically significant reduction of PPD, V-RAL gain, and a nonsignificantly greater reduction of HPD compared to BG + GTR.

Evaluation of subantimicrobial dose doxycycline as an adjunct to scaling and root planing in chronic periodontitis patients with diabetes: a randomized, placebo-controlled clinical trial.

AIM: Diabetic patients have more severe periodontal destruction, but periodontal therapy can improve metabolic control. Recently, interest has focused on the use of subantimicrobial dose doxycycline (SDD) as a treatment paradigm. Therefore, this study was undertaken to evaluate clinical efficacy of SDD with scaling and root planning (SRP) in chronic periodontitis patients with diabetes. METHODS AND MATERIALS: Twenty chronic periodontitis patients with diabetes mellitus were randomly allocated to either a test and a control group. Clinical measurements were recorded at baseline and at six months for probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR). After SRP, patients in the test group were instructed to take SDD 20-mg capsules twice a day while patients in the control group took a placebo twice a day. Both groups were on this regimen for a six-month period. RESULTS: A greater reduction in mean PPD was demonstrated in patients in the test group compared to the control group. The mean CAL increase observed in the test group was significantly greater (0.67 mm) than that in the control group. CONCLUSION: It can be concluded that SRP, in conjunction with the SDD therapy described, is more effective then SRP alone in terms of CAL gain and PPD reduction in diabetic patients with severe periodontal disease. CLINICAL SIGNIFICANCE: Given the widespread prevalence of both chronic periodontitis and diabetes, the proposed treatment approach will prove to be of great value and contribute significantly to the overall health of the patients.