Efficacy of Lornoxicam as a Pre-emptive Analgesic in Mandibular Third Molar Surgery - A Comparative Study.

Introduction: The most common complication following third molar surgery is pain. The purpose of the study is to determine the efficacy of lornoxicam as a preventive analgesic in patients undergoing surgical removal of impacted mandibular third molars. Materials and Methods: This study included 26 participants aged 18-28 years with bilateral symmetrical third molars. Group A, the control group, received lornoxicam 8 mg 1 h after surgery, whereas Group B, the study group, received lornoxicam 8 mg 1 h before surgery. All patients were evaluated for pain at the 1st, 2nd, 4th, 6th, 8th and 12th post-operative hours. The number of rescue analgesics taken within 24 h of the procedure, as well as the first occurrence of pain postoperatively, was recorded and analysed. Results: Using the Mann-Whitney U-test and Friedman's analysis, the resulting data were statistically analysed. When Group B was compared to Group A, there was a significant difference in pain reduction levels in the immediate post-operative hours. When compared to Group A, Group B had a lower need for rescue analgesics within the first 24 h postoperatively. Discussion: Following mandibular third molar surgery, pre-emptive use of lornoxicam is effective in reducing post-operative pain and reducing the need for rescue analgesic consumption.

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.

Infected Dentigerous Cyst and its Conservative Management: A Report of Two Cases.

AIM: To check the efficacy of decompression technique in children with dentigerous cysts. BACKGROUND: Most commonly occurring odontogenic cysts in the oral cavity are radicular cysts and dentigerous cysts.1 According to Kramer, a cyst is defined as a pathological cavity having fluid, semi-fluid, or gaseous contents, which is not created by the accumulation of pus. A cyst which is lined by epithelium is known as a true cyst and that which is not lined by epithelium known as a pseudocyst.2 The dictionary meaning of dentigerous is "structures resembling teeth".3 A dentigerous cyst is found enveloping the crown of an unerupted, embedded, or submerged tooth by the expansion of its follicle till the neck of the tooth.1 It is not unusual for a dentigerous cyst to mimic a radicular cyst, especially when the cyst is associated with a pulpectomized or carious primary tooth and its unerupted permanent successor. This article presents two cases of infected dentigerous cysts. The first case was of a female patient associated with tooth 45; and another case was of a male patient associated with tooth 35. The infected dentigerous cyst in both the cases was treated with the most conservative option available, i.e., decompression technique. CASE DESCRIPTION: In this article, two cases of infected dentigerous cysts are discussed, in which one case deals with the female patient associated with tooth 45 and the other case deals with the male patient associated with tooth 35. The infected dentigerous cysts in both the cases were treated conservatively, i.e., with the decompression technique. CONCLUSION: The present case report states that the decompression technique may be the most conservative method available for managing dentigerous cysts in children. HOW TO CITE THIS ARTICLE: Patil AS, Jathar PN, et al. Infected Dentigerous Cyst and its Conservative Management: A Report of Two Cases. Int J Clin Pediatr Dent 2019;12(1):68-72.

TRIP12 as a mediator of human papillomavirus/p16-related radiation enhancement effects.

Patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC) have better responses to radiotherapy and higher overall survival rates than do patients with HPV-negative HNSCC, but the mechanisms underlying this phenomenon are unknown. p16 is used as a surrogate marker for HPV infection. Our goal was to examine the role of p16 in HPV-related favorable treatment outcomes and to investigate the mechanisms by which p16 may regulate radiosensitivity. HNSCC cells and xenografts (HPV/p16-positive and -negative) were used. p16-overexpressing and small hairpin RNA-knockdown cells were generated, and the effect of p16 on radiosensitivity was determined by clonogenic cell survival and tumor growth delay assays. DNA double-strand breaks (DSBs) were assessed by immunofluorescence analysis of 53BP1 foci; DSB levels were determined by neutral comet assay; western blotting was used to evaluate protein changes; changes in protein half-life were tested with a cycloheximide assay; gene expression was examined by real-time polymerase chain reaction; and data from The Cancer Genome Atlas HNSCC project were analyzed. p16 overexpression led to downregulation of TRIP12, which in turn led to increased RNF168 levels, repressed DNA damage repair (DDR), increased 53BP1 foci and enhanced radioresponsiveness. Inhibition of TRIP12 expression further led to radiosensitization, and overexpression of TRIP12 was associated with poor survival in patients with HPV-positive HNSCC. These findings reveal that p16 participates in radiosensitization through influencing DDR and support the rationale of blocking TRIP12 to improve radiotherapy outcomes.

A survey of the dentist attire and gender preferences in dentally anxious children.

BACKGROUND: Anxiety about doctors among children is very common. White coat phobia which is a classical conditioning phenomenon is said to be prevalent among children. OBJECTIVES: To analyze the association between anxious states of children about dentists and their preference of dentist attire and gender in the dental office. MATERIALS AND METHODS: The 9-12-year-old middle school children were selected for the study. Children were asked to fill a questionnaire containing children's fear survey schedule-dental subscale (CFSS-DS) and asked to prefer dental attire from four different pictures displaying the single anonymous dentist in four different attires in the same operator. The CFSS-DS gave the anxiety scale, and age, gender, and experience were also plotted against children preference in an apron, protective wear, and gender preference. Results were tabulated and statistically analyzed using Chi-square test. RESULTS: About 718 (62%) were scored as anxious children. Of all anxious children, 502 (69.9%) had preference of colored attires of the dentist, and 408 (66.8%) anxious children preferred dentist with protective wear. Female dentists were preferred by 452 (66%) anxious children. Same gender preference was also prevalent.

Conservative management of large radicular cysts associated with non-vital primary teeth: a case series and literature review.

Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin. Large radicular cyst is comparatively less frequently associated with primary teeth. They represent only 0.5-3.3% of the total number of cysts in primary dentition. Radicular cysts arising from deciduous teeth are reported to occur in age range of 3-19 years with a male predominance. Although large radicular cysts are treated by enucleation with extensive removal of bone and vital teeth, marsupialization can be preferred as a conservative approach to reduce the morbidity. The purpose of this article is to report a case series of large radicular cysts associated with badly mutilated and traumatized primary teeth and to demonstrate how best they can be conservatively treated during mixed dentition period.

The reverberations of traumatized primary dentition: a practitioner's perspective.

UNLABELLED: The traumatized primary teeth have a great clinical significance because it not only have consequences on itself but also on its succedaneous developing permanent teeth due to its close anatomical relationship. The extent of severity is adjudged by the type of trauma and the age of the child at the time of trauma. For instance, avulsion and intrusive injuries present with high percentage of developmental disturbances in permanent teeth than subluxation and extrusive injuries. When considering the age of the child at the time of trauma, consequences are less severe in children over 4 years of age than in the younger age group. CLINICAL SIGNIFICANCE: It highlights the sequelae of trauma to primary teeth with the aim of aiding in detection of probable alterations in the traumatized primary teeth and its succedaneous permanent teeth.

Pompe's Disease in Childhood: A Metabolic Myopathy.

BACKGROUND: Myopathy of metabolic origin in childhood occurs due to a variety of conditions. Pompe's Disease also known as Glycogen storage disease Type II, is a rare storage disorder with clinical presentation akin to spinal muscular atrophy. METHODS: A series of patients with suspected metabolic myopathy were reviewed at a tertiary care service hospital over a period of three years. The diagnosis was confirmed by estimation of acid alpha glucosidase activity. RESULT: At our centre, these cases presented with generalized hypotonia, organomegaly (hepatomegaly, cardiomegaly) and congestive cardiac failure. Infantile onset, the most severe form of Pompe's disease, was the commonest form accounting for 75% of the cases. Four of the babies with infantile onset Pompe's disease expired, three due to refractory heart failure and one to fulminant respiratory infection before 15 months of age. CONCLUSION: Pompe's Disease is now being increasingly diagnosed, due to definitive enzyme estimation facilities. With the recent availability of enzyme replacement therapy with Myozyme, the prognosis is likely to change for the better.

Meconium Aspiration Syndrome: An Insight.

Meconium aspiration syndrome (MAS) is respiratory distress in a newborn baby caused by the presence of meconium in the tracheobronchial airways. The aspiration of meconium stained amniotic fluid by the fetus can happen during antepartum or intrapartum periods and can result in airway obstruction, interference with alveolar gas exchange, chemical pneumonitis as well as surfactant dysfunction. These pulmonary effects cause gross ventilation-perfusion mismatching. To complicate matters further, many infants with MAS have primary or secondary persistent pulmonary hypertension of the newborn as a result of chronic in utero stress and thickening of the pulmonary vessels. Although meconium is sterile, its presence in the air passages can predispose the infant to pulmonary infection. MAS is essentially a clinical diagnosis and should always be suspected in a child with respiratory distress and meconium-stained amniotic fluid at delivery. Though a known entity for a long time, its management still remains contentious. Intubation and direct tracheal suction is performed when meconium is observed in the amniotic fluid and the infant is not vigorous. Subsequent management involves ventilation, surfactant instillation and lavage, inhaled nitric oxide and high frequency ventilation. The role of steroids continues to be controversial.

Obesity and risk of the less commonly diagnosed subtypes of breast cancer.

OBJECTIVES: A set of common epidemiologic risk factors have been associated with the risk of breast cancer despite of its molecular sub-classifications. We implemented a case series study with the primary objective of evaluating if obesity is associated with the diagnostic risk of "ER+ and/or PR+, HER2+", "ER-/PR-, HER2-", or "ER-/PR-, HER2+" relative to the most commonly diagnosed subtype of breast carcinoma, "ER+ and/or PR+, HER2-". METHODS: Demographic, clinical and pathologic data were collected from existing databases. The statuses of HER2/neu biomarker and hormone receptors were dichotomized as either positive or negative. Immunohistochemical staining was used to assess the prevalence of different subtypes. Body mass index was calculated from weight and height data collected at the time of consultation. CONCLUSIONS: Findings from the present study suggest that excess body weight decreases the diagnostic risk of "ER-/PR-, HER2-", or "ER-/PR-, HER2-" relative to "ER+ and/or PR+, HER2-". Obese and overweight women are more likely to be diagnosed with to "ER+ and/or PR+, HER2-", the subtype that has best prognosis and mostly associated with personal lifestyle. Weight gain with the population attributable-risk factor of 21.3% contributes the most to the incidence of invasive post menopausal breast cancer. Younger pre-menopausal women were more likely to be diagnosed with "ER+ and/or PR+, HER2+". In younger women biology of breast cancers with positive expression for hormone receptors and epidermal growth factor is a complex that extends beyond the currently assessed prognostic markers.

ACR II: improved absolute cryogenic radiometer for low background infrared calibrations.

A second-generation absolute cryogenic radiometer (ACR II) was developed for use at the Low Background Infrared calibration facility at the National Institute of Standards and Technology. The need for spectral calibrations of very sensitive [D* = 10(14) cm (Hz)1/2W(-1)] infrared detectors necessitated the use of a cryogenic infrared monochromator and a more sensitive radiometer. The improved low-power performance of the ACR II compared with the older absolute cryogenic radiometer (ACR) has also made it useful as the primary standard for the calibration of cryogenic blackbody sources that are used as low-power infrared sources. The responsivity of the new radiometer's receiver is 210 K/mW with a type A (random component) standard uncertainty of at most 7 pW when making power measurements of less than 10 nW. The original ACR has a responsivity of 29 K/mW and has a type A standard uncertainty of approximately 100 pW when making a similar low-noise-power measurement. Other properties of the radiometers are also described and compared.

Release of oncofetal fibronectin from human placenta.

Oncofetal fibronectin (onfFN) is an extracellular matrix (ECM) protein synthesized by tumours and fetal tissue including placenta. The appearance of onfFN and other cellular FNs in cervico-vaginal secretions and maternal blood is associated with adverse pregnancy outcomes. In the current study, we used dual (maternal and fetal) perfusion of human term placentae and primary cultures of syncytiotrophoblasts (SCTs) to determine whether the human placenta releases onfFN. ELISA and Western blotting revealed that onfFN is preferentially released to the maternal perfusate in a time-dependent manner. Immunodetection with FDC-6, extra domain A (EDA) and cell binding domain-specific antibodies revealed onfFN in maternal perfusate to be a high molecular weight (>450 kDa) protein dimer, similar to that found in amniotic fluid. This suggested that onfFN was released intact from placenta and not cleaved from an ECM. In addition, a similar high molecular weight dimeric onfFN species was noted in conditioned media from cultures of SCTs. Since SCTs directly release proteins to the intervillous space, this suggests that SCTs may be a source of onfFN detected in maternal perfusate. These results indicate that onfFN is released from human placenta and thus levels in maternal sera may provide insight into placental pathophysiology.

Maternal smoking and the risk of congenital birth defects: a cohort study.

BACKGROUND: The literature linking gestational smoking to congenital defects has been very inconsistent. The purpose of this study was to reinvestigate the relation between gestational smoking and congenital malformations. METHODS: This study was a retrospective cohort (N = 18,016) of live births in the TriHealth Hospital system from 1 January 1998 to 31 December 1999. The cohort included 1,943 mothers who were smokers. Congenital defects were grouped into 22 different categories. Multifactorial logistic regression was used to find any association between exposure and the possible outcomes. RESULTS: Mothers who smoked were significantly younger and had babies of lower birth weight and shorter gestational age (P < .05). Of the 22 categories of congenital defects, only cardiovascular system abnormalities showed a significant difference (P < .01) between the two groups. The remaining 21 categories of congenital defects showed no statistical difference. CONCLUSION: Women who smoke during pregnancy have infants that are significantly smaller and of shorter gestational age compared with mothers who do not smoke. Based on these data and findings from most of the available literature, however, gestational smoking is unlikely to cause a large increase in congenital birth defects.

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study.

We assessed the association of postmenopausal serum levels of oestrogens and sex hormone-binding globulin (SHBG) with endometrial cancer risk in a case-control study nested within the NYU Women's Health Study cohort. Among 7054 women postmenopausal at enrolment, 57 cases of endometrial cancer were diagnosed a median of 5.5 years after blood donation. Each case was compared to 4 controls matched on age, menopausal status at enrolment, and serum storage duration. Endometrial cancer risk increased with higher levels of oestradiol (odds ratio = 2.4 in highest vs lowest tertile, P for trend = 0.02), percent free oestradiol (OR = 3.5, P< 0.001), and oestrone (OR = 3.9, P< 0.001). Risk decreased with higher levels of percent SHBG-bound oestradiol (OR = 0.43, P = 0.03) and SHBG (OR = 0.39, P = 0.01). Trends remained in the same directions after adjusting for height and body mass index. A positive association of body mass index with risk was substantially reduced after adjusting for oestrone level. Our results indicate that risk of endometrial cancer increases with increasing postmenopausal oestrogen levels but do not provide strong support for a role of body mass index independent of its effect on oestrogen levels.

Estrone and estradiol metabolism in vivo in human breast cysts.

Fibrocystic disease of the breast manifesting palpable cysts express breast cyst fluids frequently containing estrogen sulfates at concentrations far exceeding those found in sera of the patient. The study explored the potential of the breast cyst to synthesize some of these estrogen sulfates. Deuterated estrone and estradiol were synthesized and either (estradiol, 4 cases or estrone, 2 cases) was injected into a cyst. The cyst was aspirated at approximately 0, 4 and 8 h, the target being 1 ml, 50% and complete aspiration respectively. Metabolites were purified sequentially by ether extraction, enzymatic hydrolysis of estrogen conjugates, chromatography on Sephadex LH 20 and identified by gas chromatography linked to mass spectrometry. The unconjugated fraction isolated from the ether extract was subjected to the same purification and detection scheme. Among the conjugates, deuterated estrone sulfate was the major metabolite of either precursor in all studies, while estradiol sulfate was not detected in any of the 6 experiments. The sulfate fractions also yielded traces of 16alpha-hydroxyestrone (2 studies), 4-hydroxyestrone (4 studies) and 2-hydroxyestrone (1 study). In the unconjugated fraction, one study with deuterated estradiol, 4- hydroxyestrone was obtained. In one study with deuterated estrone, traces of 2-hydroxyestrone and 16alpha- hydroxyestrone were obtained. These novel data are significant because patients with fibrocystic disease are at slightly elevated risk for developing breast cancer and 16alpha-hydroxyestrone and 4- hydroxyestrone are reported carcinogens.

Radiation-induced transcription factor activation in the rat cerebral cortex.

PURPOSE: To determine the effects of ionising radiation on the DNA-binding activity of the injury-related transcription factors AP-1, Sp-1, p53 and NFkappaB in the rat brain. MATERIALS AND METHODS: Male Sprague-Dawley rats were irradiated with 137Cs gamma-rays at 3.8Gy/min and the cerebral cortex was isolated at intervals up to 24h. Nuclear protein extract of the cerebral cortex was analysed by electrophoretic mobility shift assay for DNA-binding activity of AP-1, Sp-1, p53 and NFkappaB. In addition, total RNA was extracted from the cerebral cortex and subjected to northern analysis. RESULTS: The DNA-binding activity of each of the transcription factors increased in a time- and dose-dependent manner after irradiation. Maximum increase in the activity of AP-1, Sp-1, and p53 DNA binding was seen after exposure to 10Gy and then decreased after higher doses. In contrast, NFkappaB DNA-binding activity continued to increase out to at least 30Gy. The levels of bFGF and p21WAF-1 mRNA increased after irradiation, suggesting an increase in the transactivating activity of AP-1, Sp-1, and p53. CONCLUSIONS: These data indicate that the response of the CNS to irradiation includes the activation of a similar set of transcription factors as previously observed after other types of insults.