Assessment of Effectiveness of Fluconazole and Clotrimazole in Treating Oral Candidiasis Patients: A Comparative Study.

AIMS: One of the most common fungal infections infecting humans is Candidiasis. Belonging to the group of opportunistic infections, it often affects individuals with various debilitating diseases. Fluconazole and clotrimazole are two of the commonly used anti-fungal agents for the treatment of oral candidiasis. Hence, we planned this study to evaluate the effectiveness of fluconazole and clotrimazole in the treatment of patients suffering from candidiasis. MATERIALS AND METHODS: A total of 180 participants were enrolled in the present study. All the patients of candidiasis were divided broadly into two study groups. Group I included patients who were treated with fluconazole mouthrinse whereas group II included patients who were treated with clotrimazole mouth paint. Grading of patient discomfort was done as noted from readings given by the patients. Specimen was collection by a swab from the lesional area of the oral cavity from the patients and were incubated in Sabouraud's dextrose agar medium and assessed. All the patients were treated with medication as give to their respective groups. Patients were recalled as assessed. All the readings were recorded and analyzed. RESULTS: For group I patients, the fungal eradication was 89.5%, whereas for group II patients, the fungal eradication was 86.7%. No significant results were obtained while comparing the mycological eradiation in patients of the two study groups. CONCLUSION: Approximately similar effectiveness in terms of treatment was noted with fluconazole and clotrimazole in treating patients with candidiasis.

Dengue vector abundance and diversity of breeding habitats in Puducherry, South India.

Puducherry had reported regular dengue outbreaks since 2003 with many-fold increase in number of cases every year. This study was done to assess the intensity of dengue vector breeding and diversity of breeding habitats. Aedes surveys were conducted in 8 Primary Health Centres (PHCs) representing both rural and urban areas of Puducherry district throughout the year 2012. Containers inside and outside randomly (simple) selected houses and vacant sites around houses were examined for presence of Aedes mosquitoes. The containers containing water with immature larvae were designated as positive containers (PC), while the containers holding only water were designated as wet containers and all the larvae/pupae from the positive containers were collected and entomological indices were determined using standard WHO methods. The vectors, Aedes aegypti and Ae. albopictus were encountered in the survey, with Ae. aegypti present in high numbers in urban as well as rural areas. The plastic containers were found as the most productive indoor breeding habitat as the 27.2% of the total pupae collected was contributed by plastic containers followed by flower vase (22.8%) and grinding stone (17.6%). Larval indices were found to vary throughout the year and highest indices were recorded during the months of October and November indicating the potential risk of dengue fever during this period.

Dengue vector abundance and diversity of breeding habitats in Puducherry, South India

Puducherry had reported regular dengue outbreaks since 2003 with many-fold increase in number of cases every year. This study was done to assess the intensity of dengue vector breeding and diversity of breeding habitats. Aedes surveys were conducted in 8 Primary Health Centres (PHCs) representing both rural and urban areas of Puducherry district throughout the year 2012. Containers inside and outside randomly (simple) selected houses and vacant sites around houses were examined for presence of Aedes mosquitoes. The containers containing water with immature larvae were designated as positive containers (PC), while the containers holding only water were designated as wet containers and all the larvae/pupae from the positive containers were collected and entomological indices were determined using standard WHO methods. The vectors, Aedes aegypti and Ae. albopictus were encountered in the survey, with Ae. aegypti present in high numbers in urban as well as rural areas. The plastic containers were found as the most productive indoor breeding habitat as the 27.2% of the total pupae collected was contributed by plastic containers followed by flower vase (22.8%) and grinding stone (17.6%). Larval indices were found to vary throughout the year and highest indices were recorded during the months of October and November indicating the potential risk of dengue fever during this period.

Squamous cell carcinoma and dental implants: A systematic review of case reports.

Cancer is one of the leading causes of death world-wide. Apart from the most common etiopathological factors related to cancer, at times very rare causes such as irritant or foreign body induced carcinogenesis is not to be overlooked. To systematically review case reports concerned with the association between dental implants and oral squamous cell carcinoma. A Medline (PubMed), Cochrane database, and Google Scholar search was conducted of dental article published in English related to case reports concerned with oral squamous cell carcinoma occurring around dental implants from 2000 to 2014. Twenty articles were retrieved, which included 20 rare case reports which were systematically reviewed and the results were obtained pertaining to age, clinical symptoms, habits, previous history of cancer, potentially malignant disorders, systemic illness, and local factors. It is imperative to identify promptly persisting inflammation associated with implants. Since malignancy may disguise as periimplantitis, especially in patients who are at risk with contributing prominent predisposing factors.

Robotics and medicine: A scientific rainbow in hospital.

The journey of robotics is a real wonder and astonishingly can be considered as a scientific rainbow showering surprising priceless power in the era of future technologies. The astonishing seven technologies discussed in this paper are da Vinci Robotic surgical system and sperm sorters for infertility, Veebot for blood investigation, Hanako the robotic dental patient for simulating the dental patient and helping a trainee dentist, RP-7 robot who is around-the-clock physician connecting the physician and patient, Robot for Interactive Body Assistance (RIBA) who is a RIBA serving as a nurse, Bushbot serving as a brilliant surgeon, and Virtibot helping in virtual autopsy. Thus, robotics in medicine is a budding field contributing a great lot to human life from before birth to afterlife in seven forms thus gracefully portraying a scientific rainbow in hospital environment.

Coalition of attitude and practice behaviors among dental practitioners regarding pregnant patient's oral health and pregnant patient's perception toward oral health in and around Pondicherry.

BACKGROUND: This study aims to evaluate the knowledge, attitude, practice behaviors among general dental practitioners and assess the perception toward oral health by pregnant patients in and around Puducherry. METHODOLOGY: A self-designed and structured questionnaire was used to obtain information from the dental practitioner and the pregnant patients. RESULTS: The majority of the dental practitioners had a lack of knowledge, attitude, practice behaviors regarding pregnant patient's oral health and similarly majority of pregnant patient's perception toward oral health was poor. CONCLUSIONS: Drowning and dilemmatic attitude and practice behavior of dentists to be streamlined to render right care to the pregnant women at the right time. Perplexing perception toward oral health care by pregnant women to be overcome to orient them to understand the impact of oral health on their general systemic health.

Community knowledge, awareness and preventive practices regarding dengue fever in Puducherry - South India.

OBJECTIVES: To ascertain the knowledge, attitudes and practices of adult population in Puducherry, India, regarding Dengue Fever (DF). STUDY DESIGN: A cross-sectional survey was carried out to assess the Knowledge, Awareness and Preventive practices (KAP) among a selected community in Puducherry on DF, following a major dengue outbreak in 2012. METHODS: Between October 2012 & February 2013, an epidemiological survey was conducted among 400 households (HHs) from the most affected areas during dengue outbreak, which came under eight health delivery jurisdictions i.e. Primary Health Centres (PHCs) in Puducherry. Knowledge of dengue and the use of preventive measures were assessed by means of a pre-tested structured questionnaire. Logistic regression analysis was done to examine the association between different levels of education and income status with the knowledge of DF. The DF knowledge map was created based on the results achieved through the questionnaire using Arc GIS 10.2 software. RESULTS: Although about 86% of the participants had heard of dengue, although there was no adequate knowledge on dengue vector breeding habitat as 68% of the respondents thought drains & garbage as breeding places of dengue vectors. Only 25% of participants were aware of clean water as a breeding habitat. Insufficient knowledge of disease symptoms was found, with fever (59%) being the most common symptom. CONCLUSIONS: There is a lack of in-depth knowledge on dengue epidemiology in the Puducherry community and observation revealed that more needs to be done by the Government as well as community members to prevent vector mosquito breeding.

Promoter hypermethylation profile of tumour suppressor genes in oral leukoplakia and oral squamous cell carcinoma.

PURPOSE OF THE STUDY: The present study was conducted to evaluate epigenetic alteration of five tumour suppressor genes in the oral precancer and cancer patients. MATERIALS AND METHODS: The study was carried out in three groups namely control group of five people (normal healthy individuals), 10 oral leukoplakia patients and 10 oral squamous cell carcinoma patients. Incisional biopsy was done and part of the tissue sent for histological examination and part of tissue sent for hypermethylation study of p16, p15, hMLH, MGMT, E-cadherin tumour suppressor genes. Methylation specific polymerase chain reaction was carried out for detecting methylation in promoter regions of tumour suppressor genes. The resultant PCR products were run in a 2.5% agarose gel and the promoter hypermethylation status of the five tumour suppressor genes were analysed. RESULTS: In oral Leukoplakia patients, 60% of methylation in the case of p16 gene, 30% of methylation in the case of MGMT gene and 60% of methylation in the case of E-cadherin gene. In oral Squamous cell carcinoma patients, 60% of methylation in the case of p16 gene, 40% of methylation in the case of MGMT, 60% of methylation in the case of E-cadherin gene, 20% in case of p15,10% in case of hMLH gene. CONCLUSION: Our results suggest that epigenetic mechanisms of inactivation of tumour suppressor genes, such as aberrant methylation of p16 and E-cadherin genes occur early in head and neck tumourigenesis and might play a role in the progression of these lesions.

Lymphangioma of the tongue - a case report and review of literature.

Lymphangiomas are benign tumours resulting from a congenital malformation of the lymphatic system. They are relatively uncommon and usually diagnosed in infancy and early childhood. Commonly located at head and neck, they rarely occur in the oral cavity. Intraoral lymphangiomas occur more frequently on the dorsum of tongue, followed by palate, buccal mucosa, gingiva, and lips. Lymphangioma of the tongue is a common cause of macroglossia in children associated with difficulty in swallowing and mastication, speech disturbances, airway obstruction, mandibular prognathism, openbite and other possible deformities of maxillofacial structures. We present the case of a 13-year-old female with lymphangioma of tongue. The clinical, radiological, and treatment modalities of this case are discussed.

Gustatory dysfunction.

Tastes in humans provide a vital tool for screening soluble chemicals for food evaluation, selection, and avoidance of potentially toxic substances. Taste or gustatory dysfunctions are implicated in loss of appetite, unintended weight loss, malnutrition, and reduced quality of life. Dental practitioners are often the first clinicians to be presented with complaints about taste dysfunction. This brief review provides a summary of the common causes of taste disorders, problems associated with assessing taste function in a clinical setting and management options available to the dental practitioner.

Theranostics: A treasured tailor for tomorrow.

Emerging as a targeted, safe, and efficient pharmacotherapy is the approach of theranostics, which focuses on patient-centered care. It is a combination of diagnosis and therapeutics. It provides a transition from conventional medicine to personalized medicine. It deals with the custom made treatment plan based on uniqueness of every individual thus resulting in right drug for the right patient at the right time. Genetics plays a significant role in theranostics. Theranostics provides a cost-effective specific successful treatment protocol. Pharmacogenetics, proteomics and biomarker profiling forms the backbone of theranostics. The role of theranostics is interestingly appreciated at multi levels with special consideration in oncology wherein nano formulations in the form of liposomes, dendrimers, polymeric nanoparticles, metallic nanoparticles, quantum dots and carbon nanotubes play a very important role. Thus, theranostics is a holistic transition from trial and error medicine to predictive, preventive and personalized medicine leading to improved quality care of pharmacotherapy.

The baffling human body and the boundless nanomaterial boon-a trap for cancer crab.

Life is a balance of infinite physiochemical balanced harmonies and the basic unit cell is responsible in maintaining it. Cardiovascular diseases and Cancer are the prime causes of death worldwide. Cancerous cells break the harmonious balance and result in uncontrolled growth and spread. Emerging among the existing modalities for management of cancer, as a ray of hope is Nanotechnology based treatment. Dendrimers, Quantum dots and nanobubbles contribute significantly as part of nano based diagnosis and treatment in the management of cancer. Dendrimers are nanoparticles which employ the principle of Trojan horse strategy in that encapsulation and conjugation of anti cancer agents helps in targeting the cancerous cells specifically without affecting the adjacent healthy cells. Quantum dots are cadmium based nanoparticles which when exposed to UV light glow and help in destroying the cancerous cells in the incipient stage. Nanobubbles are generated with short pulses of laser, which helps in identifying the individual cancerous cells and explodes them. Apart from them other technologies such as liposomes, fullerenes, carbon nanotubes, nanoshells, paramagnetic nanoparticles, nanoburrs, respirocytes, microbiovores, nanopores, smart coating and nano bandaid contribute a great lot as boundless nanomaterial boon for the management of cancer, cardiovascular problems and overall systemic health.

Cytological evaluation of Apiaceae Lindl. from Western Himalayas.

The present paper deals with cytological studies on 31 populations covering 17 species belonging to 10 genera of Apiaceae from Western Himalayas. The chromosome numbers in the two species as Chaerophyllum capnoides (n = 11) and Heracleum brunonis (n = 11), along with additional cytotypes for Pimpinella acuminata (n = 9) and Sium latijugum (n = 12) have been reported for the first time on world-wide basis. The genus Pleurospermum, although cytologically worked out earlier from outside India, its species densiflorum (n = 11) makes first representation of the genus from India. Besides, the chromosome number in Chaerophyllum aromaticum (n = 11) have been worked out for the first time from India. The course of meiosis varies from normal to abnormal in different populations of Chaerophyllum villosum, Pimpinella achilleifolia and Sium latijugum while abnormal meiotic course has been observed in all the studied populations of Chaerophyllum acuminatum, C. aromaticum, C. capnoides, Pimpinella acuminata, P. diversifolia, Pleurospermum densiflorum and Vicatia coniifolia. Such taxa are marked with meiotic abnormalities in the form of cytomixis, chromatin stickiness, formation of laggards and bridges resulting into abnormal microsporogenesis. The occurrence of structural heterozygosity has been recorded in the Chaerophyllum acuminatum and C. aromaticum. The effect of these abnormalities is clearly seen on the pollen size and fertility.

Idiopathic orofacial granulomatosis - a diagnostic and treatment challenge.

Orofacial granulomatosis is an uncommon disease, usually presenting as recurrent or persistent swelling of the soft tissues, predominantly lips - termed as Cheilitis Granulomatosa. Though various aetiological factors like foreign body reactions, infections, Crohn's disease and Sarcoidosis have been implicated in the disease process. Delayed Hypersensitivity reaction with a predominant Th1-mediated immune response provide further evidence to the etiopathogenesis in Orofacial granulomatosis. The term Idiopathic Orofacial Granulomatosis is used in cases with unknown aetiology. This case report describes Idiopathic Orofacial granulomatosis in a 25-year-old male patient with persistent upper lip swelling and gingival enlargement. Management with intralesional triamcinolone acetonide 40mg, twice a week for three weeks, resulted in significant remission without recurrence after a eight month follow up.

Cytological studies of Brassicaceae burn. (Cruciferae juss.) from Western Himalayas.

Cytological studies have been carried out on 12 species of Brassicaceae Burn. on population basis from different geographical areas of Kashmir and Himachal Pradesh in the Western Himalayas. Variable chromosome reports for Barbaraea intermedia (n = 16), Cardamine loxostemonoides (n = 8), Nasturtium officinale (n = 8), Sisymbrium orientale (n = 14) on world-wide basis have been added to the previous reports of these species. The chromosome numbers in seven species as Barbaraea intermedia (n = 8), B. vulgaris (n = 8), Capsella bursa-pastoris (n = 8), Descuriania sophia (n = 10), Rorippa islandica (n = 8), Sisymbrium strictum (n = 7) and Thlaspi alpestre (n = 7) have been worked out for the first time from India. The meiotic course in the populations of seven species such as Barbaraea intermedia, Capsella bursa-pastoris, Coronopus didymus, Descuriania sophia, Nasturtium officinale, Sisymbrium orientale and S. strictum varies from normal to abnormal while all the populations of two species Barbaraea vulgaris and Sisymbrium irio show abnormal meiotic course. Meiotic abnormalities are in the form of cytomixis, chromosomal stickiness, unoriented bivalents, inter-bivalent connections, formation of laggards and bridges, all resulting into abnormal microsporogenesis. Heterogenous sized fertile pollen grains and reduced reproductive potentialities have invariably been observed in all the meiotically abnormal populations. However, the meiotic course in all the populations of Cardamine loxostemonoides, Rorippa islandica and Thalspi alpestre is found to be normal with high pollen fertility.

Triterpenoids from Arctium lappa.

Phytochemical investigation of the leaves of Arctium lappa led to the isolation of two triterpenoids, characterised by NMR, IR and MS as 3α-hydroxylanosta-5,15-diene and 3α-acetoxy-hop-22(29)-ene. 3α-hydroxylanosta-5,15-diene is a new triterpenoid and is isolated for the first time from this genus.

Mechanism of bubble coalescence induced by surfactant covered antifoam particles.

Mechanism of inter-bubble coalescence by an aqueous fatty alcohol particle suspension antifoam containing a nonionic surfactant has been investigated. By observing visually two colliding air bubbles in a liquid pool in the presence of the antifoam, a four-step mechanism is identified. The role of the surfactant in the antifoam is, for the first time, proposed. A surface tension gradient due to the local surfactant concentration difference enables a surfactant laden hydrophobic particle located on bubble surface to move from the periphery of a liquid film between two colliding air bubbles to their region of contact. Drop volume tensiometry and macroscopic foam column experiments are used to further prove this observation. Subsequently, the particle bridges and dewets the bubbles resulting in film rupture. The rate of drainage of the liquid film depends on the particle hydrophobicity, which necessitates complete surfactant desorption from particle surface. This is corroborated experimentally by Wilhelmy plate tensiometry. In addition, cryo-scanning electron and atomic force microscopy are used to determine the particle shape and the force for its entry into the bubble.

Nonionic block copolymer antifoams.

Aqueous dispersions of alkoxylated alcohol block copolymer (BCP) drops are investigated as antifoams. A model aqueous nonionic surfactant solution of Polysorbate 20 and an industrial white water suspension are used as foaming systems. Visual evidence obtained using a two-bubble technique involving a CCD camera coupled with high magnification lenses clearly revealed the role of BCP droplets in the bubble coalescence process. The enhancement of bubble coalescence decreased as the temperature increased from 25 to 60 degrees C, which is due to the corresponding decrease in the rigidity associated with the weak interfacial structure and reduced viscosity of the BCP drops. The antifoaming efficiency measured in the macroscopic recirculation foam column increased with temperature from about 13 to 26 degrees C (attaining a maximum) and decreased as temperature increased further. Oscillatory thermo-rheometric measurements showed a sudden increase in the storage modulus (G') by several orders of magnitude, indicating gel formation initiated at about 13 degrees C and having a maximum at around 26 degrees C for an aqueous solution of the BCP above a critical concentration of around 20 wt %. Results obtained using small-angle X-ray scattering, micro-differential scanning calorimetry, and proton nuclear magnetic resonance confirmed the existence of ordered gel-like structures. Furthermore, macroscopic tests using a sparged air foam column showed a significant increase in antifoaming efficiency when highly hydrophobic particles are embedded in the BCP drops dispersed in water.

Local film thinning due to concentration gradient of an insoluble surfactant at an interface.

The local thinning of a viscous liquid film on a substrate driven by a surface (or interfacial) tension gradient due to a concentration gradient of a monolayer of an insoluble surfactant initially non-uniformly distributed at a liquid interface relevant to chemical engineering, biomedical and other applications is investigated. A simple model is presented for the temporal evolution of the profiles of radial variation in the thickness of a thin liquid film, the effects of gravity and capillarity due to deformation of the interface in slowing down the film thinning process being allowed. As time increases, the surfactant spreads and the radius of its front increases inversely with decrease in the two-third power of the film thickness at the center. The model describes well not only the published experimental results but also those obtained by other authors using numerical simulations of a set of coupled partial differential equations.

Percutaneous drainage compared with surgery for hepatic hydatid cysts.

BACKGROUND: In recent years percutaneous drainage has been used successfully to treat the hepatic hydatid cysts of echinococcal disease. We performed a controlled trial to compare the safety and efficacy of percutaneous drainage with those of surgical cystectomy, the traditional treatment. METHODS: In a prospective study, we randomly assigned 50 patients with hepatic hydatidosis to treatment with percutaneous drainage (25 patients) or cystectomy (25). Albendazole (10 mg per kilogram of body weight per day for eight weeks) was administered to the patients who underwent percutaneous drainage. Serial assessments included clinical and biochemical examinations, ultrasonography, and serologic tests of echinococcal-antibody titers. RESULTS: The mean (+/-SD) hospital stay was 4.2+/-1.5 days in the drainage group and 12.7+/-6.5 days in the surgery group (P<0.001). Over a mean follow-up period of 17 months, the mean cyst diameter decreased from 8.0+/-3.0 to 1.4+/-3.5 cm (P<0.001) after percutaneous drainage and from 9.1+/-3.0 to 0.9+/-1.8 cm (P<0.001) after surgery. The final cyst diameter did not differ significantly between the two groups (P=0.20). The cysts disappeared in 22 patients (88 percent) in the drainage group and in 18 (72 percent) in the surgery group (P=0.29). After an initial rise, the echinococcal-antibody titers fell progressively and at the last follow-up were negative (<1:160) in 19 patients (76 percent) in the drainage group and 17 (68 percent) in the surgery group (P=0.74). There were procedure-related complications in 8 patients (32 percent) in the drainage group and 21 (84 percent) in the surgery group, 17 of whom had fever postoperatively (P<0.001). CONCLUSIONS: Percutaneous drainage, combined with albendazole therapy, is an effective and safe alternative to surgery for the treatment of uncomplicated hydatid cysts of the liver and requires a shorter hospital stay.