Effect of Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes among hyperglycemic mothers.

OBJECTIVE: Hyperglycemic mothers and their offspring are at increased risk of various maternal and neonatal complications such as macrosomia, future type 2 diabetes, and metabolic abnormalities. Early diagnosis and individualized dietary management, exercise, and emotional well-being are expected to reduce these risks. The study aims to identify the effect of the Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes of hyperglycemic mothers. PATIENTS AND METHODS: A pre-experimental study was performed among 89 hyperglycemic mothers. Glycemic control at 28 and 36 weeks, weight gain during pregnancy, pre-eclampsia, pregnancy-induced hypertension (PIH), mode of delivery, duration of exercise, emotional well-being, neonates' birth weight, incidence of hypoglycemia, and NICU admission were compared among the study and control groups. The intervention group received an individualized NBMP from their diagnosis of hyperglycemia until delivery. RESULTS: The results showed a significant difference in blood glucose between the study periods and groups at p<0.05 as per repeated ANOVA. Also, diet scores had a significant influence on BMI and glycemic control at p<0.05. Logistic regression models, adjusted for potential confounders including baseline blood glucose, age, economic status, previous GDM, family history of DM as well as baseline BMI, diet score, physical activity, and maternal well-being score, indicated that the NBMP reduced the blood glucose and BMI significantly at p<0.05 in the study group. NBMP also reduced the risk of SGA/LGA and preterm/post-mature birth, as well as increased the exercise duration and emotional well-being of mothers. CONCLUSIONS: The study's conclusions draw attention to the possible roles that maternal wellness, physical activity, and diet may have in reducing risks for both hyperglycemic mothers and their newborns. The NBMP resulted in higher adherence to lifestyle changes. Further research on a larger sample of hyperglycemic mothers is recommended to expand the generalizability of the findings.

Potential acetylcholinesterase inhibitors to treat Alzheimer's disease.

OBJECTIVE: Alzheimer's disease (AD) is identified by neuropathological symptoms, and there is now no effective treatment for the condition. A lack of the brain neurotransmitter acetylcholine has been related to the etiology of Alzheimer's disease. Acetylcholinesterase is an enzyme that breaks down acetylcholine to an inactive form and causes the death of cholinergic neurons. Conventional treatments were used but had less effectiveness. Therefore, there is a crucial need to identify alternative compounds with potential anti-cholinesterase agents and minimal undesirable effects. MATERIALS AND METHODS: Fluoroquinolones and benzimidazole-benzothiazole derivatives offer antimicrobial, anti-inflammatory, anti-oxidant, anti-diabetic, and anti-Alzheimer activities. To enhance the chemical portfolio of cholinesterase inhibitors, a variety of fluoroquinolones and benzimidazole-benzothiazole compounds were evaluated against acetylcholinesterase (AChE) butyrylcholinesterase (BChE) enzymes. For this purpose, molecular docking and adsorption, distribution, metabolism, excretion, and toxicology ADMET models were used for in-silico studies for both AChE and BChE enzymes to investigate possible binding mechanisms and drug-likeness of the compounds. The inhibitory effect of docked heterocyclic compounds was also verified in vitro against AChE and BChE enzymes. Fluoroquinolones (Z, Z3, Z4, Z6, Z8, Z12, Z15, and Z9) and benzimidazole-benzothiazole compounds (TBIS-16, TBAF-1 to 9) passed through the AChE inhibition assay and their IC50 values were calculated. RESULTS: The compound 1-ethyl-6-fluoro-7-(4-(2-(4-nitrophenylamino)-2-oxoethyl)piperazin-1-yl) -4-oxo-1,4 di-hydroquinoline-3-carboxylic acid and 2-((1H-benzo[d]imidazol-2-yl)methyl)-N'-(3-bromobenzyl)-4-hydroxy-2H-thiochromene-3-carbohydrazide 1,1-dioxide (Z-9 and TBAF-6) showed the lowest IC50 values against AChE/BChE (0.37±0.02/2.93±0.03 µM and 0.638±0.001/1.31±0.01 µM, respectively) than the standard drug, donepezil (3.9±0.01/4.9±0.05 µM). During the in-vivo investigation, behavioral trials were performed to analyze the neuroprotective impact of Z-9 and TBAF-6 compounds on AD mouse models. The groups treated with Z-9 and TBAF-6 compounds had better cognitive behavior than the standard drug. CONCLUSIONS: This study found that Z-9 (Fluoroquinolones) and TBAF-6 (benzimidazole-benzothiazole) compounds improve behavioral and biochemical parameters, thus treating neurodegenerative disorders effectively.

Myofibroblast and pro-fibrotic cytokines in fibrosis of IgG4-related disease (IgG4-RD) patients from South Asia: preliminary data.

INTRODUCTION: Fibrosis is a typical pathological characteristic in IgG4-RD patients and often irreversible. There exists a lack of suitable markers for detection of earlier onset of fibrosis in various organs in IgG4-RD patients. Hence, this study aims at analysing ambispectively the myofibroblasts and the pro-fibrotic cytokines, IFN gamma and IL-33 involved in IgG4-RD associated fibrosis in South Asian patients. METHOD: Archived biopsy samples of definite/probable/possible cases of IgG4-RD, classified according to diagnostic criteria, taken from patients who attended the OPD and IPD of our tertiary care centre during January 2015-January 2020 were chosen for this study. The paraffin sections were examined qualitatively for fibrosis and the excessive collagen deposition by Hematoxylin & Eosin and Masson's Trichrome staining. Also, the presence of alpha-Smooth muscle actin (α-SMA) expressing myofibroblasts and the involvement of pro-fibrotic cytokines (IFN-gamma, IL-33) were assessed by Immunohistochemistry and scored semi-quantitatively (+mild, ++moderate, +++ severe). Serum IL-33 levels were analysed by indirect Elisa (R & D Systems). RESULTS: Myofibroblasts were present in 10/12 biopsy samples, in moderate levels in 4 (33%) and very high levels (+++) in 3 (25%) of the patients. IFN-gamma was expressed at low levels in 6 (50%) and absent in 6 (50%). All patients showed IL-33 expression with very high levels in tissue (6, 50%), as well as in serum samples. CONCLUSION: The findings of this study reinforce the role of myofibroblasts and profibrotic cytokines like IL-33 in fibrosis of Ig4-RD patients, pointing to their potential as earlier predictive markers of onset and extent of fibrosis.

The wake of the triple epidemic (Tripledemic): does it emphasizes the COVID-19 vaccine as a routine immunization for children? - A cross-sectional study.

OBJECTIVE: Many countries, including the USA, are currently confronting a triple epidemic in children as COVID-19 cases increase and new strains emerge which urge COVID-19 vaccination for children. The Advisory Committee on Immunization Practices (ACIP) for the CDC unanimously approved the inclusion of the COVID-19 vaccine (C19V) in the recommended immunizations. As healthcare professionals (HCPs) and parents are significant players in changing the trend of the triple epidemic by giving the C19V, the present study was done to determine awareness and perception of HCPs and parents on the tripledemic and the need for inclusion of C19V in vaccination schedules for children. PATIENTS AND METHODS: A cross-sectional study was conducted among 400 HCPs and 200 parents to assess their knowledge and perception of tripledemic and the need for the inclusion of C19V. RESULTS: Noticeably, half of the participants had either recent personal (36.2%) or family (21.8%) exposure to some of the tripledemic like RSV, Flu, or COVID-19. On perceived awareness, 42% were concerned about tripledemic, and 35% thought that regular C19V may prevent or reduce tripledemic. Ironically, 11% were not willing to give C19V to their children. The logistic regression model for positive perception of tripledemic and regular C19V identified significant relationships with education (OR 2.19, CI 1.48-3.81), gender (OR 0.9, CI 01.02-2.63), recent personal or family exposure to any of the tripledemic (OR 0.239, CI 0.87-1.63) and presence of children in the family (OR 0.71, CI 1.4-1.96). The reason for favorable perception was preventing self and family from tripledemic. CONCLUSIONS: The findings may give insight to the policymakers for a strategic plan to include C19V in the routine schedule to combat the pandemic and tripledemic by improving herd immunity.

The complexity of basophobia and aging: covariates and consequences.

OBJECTIVE: The study aim is to determine the drug-induced incidence of basophobia, falls, its' related variables and the consequences among older adults. PATIENTS AND METHODS: A descriptive, cross-sectional study was adopted with 210 older adult samples. The tool consisted of 6 sections: a standardized, semi-structured questionnaire and physical examination. Descriptive and inferential statistics were used to analyze the data. RESULTS: Among the study participants, 49% had falls or near falls and 51% had basophobia in the past 6 months. As per final simultaneous regression analysis model of the study, the covariates to activity avoidance were age (ß=-0.129, CI=-0.087 to -0.019), having >5 chronic diseases (ß=-0.086, CI=-1.41 to -1.182), depressive symptoms (ß=-0.09, CI=-0.089 to -0.189), vision impairment (ß=-0.075, CI=-1.28 to -1.56), basophobia (ß=-0.26, CI=-0.059 to -0.415), taking regular antihypertensives (ß=-0.096, CI= -1.21 to -1.56), oral hypoglycemics and insulin (ß=-0.17, CI=-0.442 to -0.971) and sedatives and tranquilizers (ß=-0.37, CI=-1.32 to -1.73). Use of antihypertensives (p<0.001), oral hypoglycemics and insulin (p<0.01), sedatives and tranquilizers (p<0.001) were strongly associated with fall related to activity avoidance. CONCLUSIONS: The result of this current study suggests that the falls, basophobia and its related activity avoidance among elderly may set in a "vicious cycle" of falls, basophobia, and the numerous negative outcomes such as functional impairment, a decrease in quality of life, and hospitalization. Preventive strategies such as tittering dosage, home- and community -based exercises, cognitive behavioral therapy, yoga, meditation and sleep hygiene may be the choice to break this vicious cycle.

Beneficial effects of Naringin against lopinavir/ ritonavir-induced hyperlipidemia and reproductive toxicity in male albino rats.

OBJECTIVE: This research work was planned to determine whether Naringin (NG) had any protective effects against lopinavir/ritonavir (LR)-induced alterations in blood lipid levels, hepatotoxicity, and testicular toxicity. MATERIALS AND METHODS: Four groups of six rats each were used for the study: Control (1% ethanol), naringin (80 mg/kg), lopinavir (80 mg/kg)/ritonavir (20 mg/kg), and lopinavir (80 mg/kg)/ritonavir (20 mg/kg) + naringin (80 mg/kg). The drug treatment was continued for 30 days. On the last day, the serum lipid fractions, liver biochemical parameters, testicular antioxidants (enzymatic and non-enzymatic), and the histopathology of the liver and testis tissue were assessed for all rats. RESULTS: Treatment with NG decreased significantly (p<0.05), the baseline serum levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C), and increased high-density lipoprotein cholesterol (HDL-C). But these parameters were significantly (p<0.05) increased in LR-treated animals. Naringin, co-administered with LR, restored the liver and testicular biochemical, morphological, and histological balance. CONCLUSIONS: This study shows that NG can be used as a treatment for LR-induced biochemical and histological changes in the liver and testes and changes in serum lipid levels.

Optimal Deep Learning-Based Vocal Fold Disorder Detection and Classification Model on High-Speed Video Endoscopy.

The use of high-speed video-endoscopy (HSV) in the study of phonatory processes linked to speech needs the precise identification of vocal fold boundaries at the time of vibration. The HSV is a unique laryngeal imaging technology that captures intracycle vocal fold vibrations at a higher frame rate without the need for auditory inputs. The HSV is also effective in identifying the vibrational characteristics of the vocal folds with an increased temporal resolution during retained phonation and flowing speech. Clinically significant vocal fold vibratory characteristics in running speech can be retrieved by creating automated algorithms for extracting HSV-based vocal fold vibration data. The best deep learning-based diagnosis and categorization of vocal fold abnormalities is due to the usage of HSV (ODL-VFDDC). The suggested ODL-VFDDC technique starts with temporal segmentation and motion correction to identify vocalized regions from the HSV recording and gathers the position of movable vocal folds across frames. The attributes gathered are fed into the deep belief network (DBN) model. Furthermore, the agricultural fertility algorithm (AFA) is used to optimize the hyperparameter tuning of the DBN model, which improves classification results. In terms of vocal fold disorder classification, the testing results demonstrated that the ODL-VFDDC technique beats the other existing methodologies. The farmland fertility algorithm (FFA) is then used to accurately determine the glottal limits of vibrating vocal folds. The suggested method has successfully tracked the speech fold boundaries across frames with minimum processing cost and high resilience to picture noise. This method gives a way to look at how the vocal folds move during a connected speech that is completely done by itself.

Impact of coronavirus disease 2019 on head and neck urgent suspected cancer referral pathways in rural Wales.

OBJECTIVE: To assess the impact of the coronavirus disease 2019 pandemic on head and neck urgent suspected cancer referral pathways in rural areas of Wales. METHOD: A retrospective audit was conducted of 2234 head and neck urgent suspected cancer referrals received from January 2019 to November 2020. RESULTS: The referrals dropped by 35 per cent in 2020 compared to the same period in 2019. The time from general practitioner referral to the first ENT appointment improved during the pandemic (8.0 vs 10.0 days; p < 0.001). Of referrals, 92.1 per cent were seen within a 14-day period in 2020, compared with 79.6 per cent in 2019 (p < 0.001). There were no differences between 2020 and 2019 in terms of: the (confirmed cancer) conversion rate (10.6 per cent vs 9.7 per cent; p = 0.60), general practitioner referral to multidisciplinary team discussion time (35.5 vs 41.5 days; p = 0.40) or general practitioner referral to initiation of treatment time (68.0 vs 78.0 days; p = 0.16). CONCLUSION: Whilst coronavirus disease 2019 reduced the number of overall head and neck urgent suspected cancer referrals, the pathways were generally unchanged, if not slightly improved, in rural Wales.

Study on the inflammatory response of PMMA/polystyrene/silica nanocomposite membranes for drug delivery and dental applications.

BACKGROUND: The application of polymeric materials in medical industry has grown drastically in the last two decades due to their various advantages compared to existing materials. The present research work emphases on the sol-gel technique to formulate the polymethyl methyl acrylate/polystyrene/silica composite membrane. METHODS: The characteristic of the composite was investigated through modern state art of instrumentation. RESULTS: The functional groups attached to the polymer was absorbed by FTIR. The FTIR spectrum confirm that the blend was mixed thoroughly and the formation of unite intimately between the polymers. The membranes were observed by SEM for its surface homogeneity which depends upon the composition of the two blending polymers. The captured SEM images showed the formation of microcracks on the surface, which was evidently controlled by varying the constituent polymer ratios. The prepared blend membranes with 2:1 ratio of PMMA/PS/Si displayed higher water uptake compared to other blended membranes. The composite membranes had good hydroxyl apatite growth in SBF solution. Furthermore, the in vitro cytotoxicity studies carried out by MTT method, using RAW macrophage cells showed that all the samples exhibited excellent cell viability. CONCLUSION: The inflammatory response of composite with equal concentration of PMMA-PS were performed and observed no inflammation in comparison with control and other tested concentrations.

Role of High-Resolution Dynamic Contrast-Enhanced MRI with Golden-Angle Radial Sparse Parallel Reconstruction to Identify the Normal Pituitary Gland in Patients with Macroadenomas.

BACKGROUND AND PURPOSE: Preoperative localization of the pituitary gland with imaging in patients with macroadenomas has been inadequately explored. The pituitary gland enhancing more avidly than a macroadenoma has been described in the literature. Taking advantage of this differential enhancement pattern, our aim was to evaluate the role of high-resolution dynamic MR imaging with golden-angle radial sparse parallel reconstruction in localizing the pituitary gland in patients undergoing trans-sphenoidal resection of a macroadenoma. MATERIALS AND METHODS: A retrospective study was performed in 17 patients who underwent trans-sphenoidal surgery for pituitary macroadenoma. Radial volumetric interpolated brain examination sequences with golden-angle radial sparse parallel technique were obtained. Using an ROI-based method to obtain signal-time curves and permeability measures, 3 separate readers identified the normal pituitary gland distinct from the macroadenoma. The readers' localizations were then compared with the intraoperative location of the gland. Statistical analyses were performed to assess the interobserver agreement and correlation with operative findings. RESULTS: The normal pituitary gland was found to have steeper enhancement-time curves as well as higher peak enhancement values compared with the macroadenoma (P < .001). Interobserver agreement was almost perfect in all 3 planes (κ = 0.89). In the 14 cases in which the gland was clearly identified intraoperatively, the correlation between the readers' localization and the true location derived from surgery was also nearly perfect (κ = 0.95). CONCLUSIONS: This study confirms our ability to consistently and accurately identify the normal pituitary gland in patients with macroadenomas with the golden-angle radial sparse parallel technique with quantitative permeability measurements and enhancement-time curves.

Lingual tonsil: clinically applicable macroscopic anatomical classification system.

OBJECTIVE: To classify the adult lingual tonsil according to the macroscopic appearance. STUDY DESIGN: Prospective study. LEVEL OF EVIDENCE: Four. METHODS: Lingual tonsils were classified according to their appearance and relationship to surrounding structures. This was possible following serial views of lingual tonsils. The classification was named 'Swansea classification for lingual tonsil', representing the place of origin. The classification was then discussed with fellow clinicians. Independent professional observers graded lingual tonsil pictures. Intra-observer agreements were measured to validate the classification. RESULTS: A total of 22 professional observers went through a set of six pictures of three different grades of lingual tonsil. The pictures were then graded for validation. The intra-observer agreement was 0.81, confirming good agreement. CONCLUSION: Swansea classification for lingual tonsil is reliable and reproducible. This classification should be routinely used during ENT examination, enabling accurate documentation and providing opportunities for future research and audit of practice.

Evaluation of protective effects of diosmin (a citrus flavonoid) in chemical-induced urolithiasis in experimental rats.

Context There have not been any conclusive studies of the effects of diosmin, a modified flavanone glycoside obtained from Teucrium gnaphalodes L'Her (Lamiaceae), on urolithiasis. Objective To evaluate anti-urolithiatic effects of diosmin in ammonium chloride and ethylene glycol-induced renal stone in experimental animals. Materials and methods Thirty Sprague-Dawley were divided into five groups (n=6) receiving the following treatments, respectively, p.o. for 15 consecutive days: distilled water, 0.75% v/v ethylene glycol + 2% w/v ammonium chloride, 0.75% v/v ethylene glycol + 2% w/v ammonium chloride + cystone® 750 mg/kg, 0.75% v/v ethylene glycol + 2% w/v ammonium chloride + diosmin 10 mg/kg or 0.75% v/v ethylene glycol + 2% w/v ammonium chloride + diosmin 20 mg/kg. Different biomarkers of urolithiasis in urine and serum were evaluated and histopathological examination of kidney was done. Results Animals treated with diosmin (both 10 and 20 mg/kg) had significantly (p < 0.005) decreased in kidney weight, urinary pH, total urinary protein, urinary calcium, phosphorus, serum potassium, sodium, magnesium, creatinine, uric acid and blood urea nitrogen levels and significantly (p < 0.005) increased in urinary volume, urinary magnesium, potassium, sodium, creatinine, uric acid and serum calcium levels in comparison to animals treated with ethylene glycol and ammonium chloride. However, results were better with diosmin 20 mg/kg in comparison to the control group. Conclusion Diosmin (10 and 20 mg/kg) has very good anti-urolithiatic activity similar to the standard drug cystone®.

Evaluation of Anti-diarrheal Potential of Hydro-alcoholic Extracts of Leaves of Murraya koenigii in Experimental Animals.

BACKGROUND: The indigenous medical system of India mentions the use of Murraya koenigii leaves for the treatment of different types of diarrheas over ages. OBJECTIVE: To evaluate the anti-diarrheal activity of hydro-alcoholic extracts of leaves of Murraya koenigii and to check its effects on intestinal transits in experimental rat model. MATERIALS AND METHODS: The hydro-alcoholic extract of Murraya koenigii leaves was obtained with Soxhlet extraction method. Animals were divided into four groups (n = 6) receiving daily for three consecutive days: vehicle, standard drug atropine (3mg/kg, i.p.), leaf extracts 200 & 400 mg/kg respectively in oral route. Effects of the drugs on normal defecation were noted and then castor oil induced diarrhea was used to measure the effects of leaf extract on stool frequency and consistency. Finally, charcoal meal test was used to evaluate the effect of the extract on intestinal transit. Statistical evaluation was done using SPSS version 17, one way ANOVA followed by Dunnett's t-test was done and P< 0.001 was considered as significant. RESULTS: Murraya koenigii leaf extracts in 200 and 400 mg/kg dose reduced stool frequency, increased stool consistency and increased small intestinal transit time. CONCLUSION: Hydro-alcoholic extract of Murraya koenigii leaves possesses significant anti-diarrheal activity due to its inhibitory effect on gastrointestinal motility, making it useful for a wide number of gastrointestinal diseases.

Chronic social defeat stress increases dopamine D2 receptor dimerization in the prefrontal cortex of adult mice.

The present study aimed to examine the effects of chronic social defeat stress on the dopamine receptors and proteins involved in post-endocytic trafficking pathways. Adult mice were divided into susceptible and unsusceptible groups after 10 days of social defeat stress. Western blot analysis was used to measure the protein expression levels of dopamine D2 receptors (D2Rs), a short (D2S) and a long form (D2L) and, D2R monomers and dimers, dopamine D1 receptors (D1Rs), neuronal calcium sensor-1 (NCS-1) and G protein-coupled receptor-associated sorting protein-1 (GASP-1), and reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression levels of D2S, D2L, D2R monomers and dimers, and D1Rs in different brain areas. We observed increased expression of D2S, D2L and D2Rs dimers in the prefrontal cortex (PFC) of susceptible and/or unsusceptible mice compared with controls. The only significant findings with regard to mRNA expression levels were lower expression of D2S mRNA in the amygdala (AMYG) of susceptible and unsusceptible mice compared with controls. The present study demonstrated that chronic social defeat stress induced increased expression of D2S, D2L, and D2R dimers in the PFC of susceptible and/or unsusceptible mice.

A case of losartan-induced severe hyponatremia.

This case report outlines a very rare case of losartan-induced severe hyponatremia in a 73-year-old type 2 diabetic patient. The patient was initiated with 50 mg daily oral losartan monotherapy for newly diagnosed moderate hypertension. After 3.5 months of taking the drug, he presented to the emergency department in a drowsy state with severe generalized weakness and occasional palpitations. He was a known diabetic for the last 3 years and well controlled by oral metformin alone. On examination, his serum sodium level was found to be 123 meq/L. There were no evidences of any other possible metabolic, infective, organic or other pathologic causes giving rise to that condition, except losartan itself. De-challenge was done and he was treated vigorously resulting in reversal of the diseased state. Naranjo adverse drug reaction probability scale suggested that it was "probable" that oral losartan was responsible for the development of severe hyponatremia in this patient.

The impact of weight for age on survival in acute lymphoblastic leukemia: Report from a tertiary care center in North India.

BACKGROUND: Undernutrition is considered to have a negative impact on survival in children with malignancies. The objective of this retrospective analysis was to evaluate the morbidity pattern and outcome of therapy in undernourished (UN) children with acute lymphoblastic leukemia. METHODS: A retrospective analysis of impact of weight for age was performed in children treated for ALL. The IAP & CDC criteria for undernutrition were used in the two different time periods of analysis. RESULTS: There were two cohorts in the study: Between 1995 and 2005, 360 children were evaluated where the weight for age was classified using the Indian Academy of Pediatrics criteria for undernourishment (Group A). Group B of the study included 373 children treated from 2007 to 2011, who were graded as per the Centers for Disease Control criteria for weight for age. In Group A, 35% of the children were malnourished at presentation. The morbidity and supportive care needed in the well-nourished and UN group were similar. The event-free survival and mortality were similar in both groups. Analysis of Group B showed an overall survival of 62.6% with a greater survival in children with a weight of ≥10th centile for age compared to children at the <10th centile, (P = 0.026) with a higher mortality (P = 0.011) in the UN group. CONCLUSION: Our data have yielded conflicting results. The older cohort did not show a significant difference in survival using malnutrition as a risk factor. However, in the subsequent cohort, a difference in survival was noted. This could be due to the reason that different criteria for classification of undernutrition were applied in the two groups. This analysis lays the foundation for a future prospective analysis to evaluate nutrition as an independent risk factor nutrition as an independent risk factor in the outcome of childhood malignancies.

Serum and salivary sialic acid as a biomarker in oral potentially malignant disorders and oral cancer.

Background: Aberrant glycosylation is the universal feature of cancer and components of various glycoconjugates, such as sialic acid is found to rise in various malignancies. The objective of this study was to evaluate the serum and salivary sialic acid in oral potentially malignant disorders (OPMD) and oral cancer (OC) to investigate the possibility of using this as a diagnostic marker. Materials and Methods: The study included 85 subjects, who were grouped as control (30), OPMD patients (25), and oral cancer patients (30). Serum and unstimulated whole saliva was collected from subjects of all groups and sialic acid estimation was done using spectrophotometry. The results were tabulated and analyzed statistically. Results: The mean serum sialic acid levels in normal, OPMD, and oral cancer group were 7.515, 19.620, and 55.235 mg/dL, respectively, whereas the levels of salivary sialic acid were 1.5113, 2.3302, and 9.0304 mg/dL, respectively. A very highly significant rise (P < 0.005) in serum and salivary sialic acid was observed in the study subjects compared with that of the control. Conclusions: The present study showed a significant and gradual increase in serum and salivary sialic acid from control to oral potentially malignant disorders to oral cancer. From this study we can suggest that sialic acid can be used as a reliable biomarker. As this monosaccharide is observed in saliva in detectable quantity, saliva can be used as a diagnostic medium for screening and early detection of oral cancer.

Mandibular facial talon cusp: a rare case report.

Talon cusp (TC) is a relatively uncommon developmental anomaly characterized by cusp-like projections from the cemento-enamel junction to a variable distance toward the incisal edge of an anterior tooth. It usually presents on palatal/lingual surface of the anterior teeth. Studies have revealed that it consists of enamel, dentine and a variable amount of pulp tissue. Presence of this cusp on the facial surface of an anterior tooth is a rare finding with very few cases being reported in the literature. The effects of TCs are mainly aesthetic and functional. The management requires a sufficient knowledge of the present clinical entity and the problems associated with it. Early detection and treatment plays a very vital role in avoiding the future complications. The present case reports a 25-year-old male patient with a facial TC on the mandibular left central incisor in which a prophylactic enameloplasty was carried out to avoid the stagnation of debris and stain.