Multifunctional curcumin mediated zinc oxide nanoparticle enhancing biofilm inhibition and targeting apoptotic specific pathway in oral squamous carcinoma cells.

BACKGROUND: Oral health remains a significant global concern with the prevalence of oral pathogens and the increasing incidence of oral cancer posing formidable challenges. Additionally, the emergence of antibiotic-resistant strains has complicated treatment strategies, emphasizing the urgent need for alternative therapeutic approaches. Recent research has explored the application of plant compounds mediated with nanotechnology in oral health, focusing on the antimicrobial and anticancer properties. METHODS: In this study, curcumin (Cu)-mediated zinc oxide nanoparticles (ZnO NPs) were synthesized and characterized using SEM, EDAX, UV spectroscopy, FTIR, and XRD to validate their composition and structural features. The antioxidant and antimicrobial activity of ZnO-CU NPs was investigated through DPPH, ABTS, and zone of inhibition assays. Apoptotic assays and gene expression analysis were performed in KB oral squamous carcinoma cells to identify their anticancer activity. RESULTS: ZnO-CU NPs showcased formidable antioxidant prowess in both DPPH and ABTS assays, signifying their potential as robust scavengers of free radicals. The determined minimal inhibitory concentration of 40 µg/mL against dental pathogens underscored the compelling antimicrobial attributes of ZnO-CU NPs. Furthermore, the interaction analysis revealed the superior binding affinity and intricate amino acid interactions of ZnO-CU NPs with receptors on dental pathogens. Moreover, in the realm of anticancer activity, ZnO-CU NPs exhibited a dose-dependent response against Human Oral Epidermal Carcinoma KB cells at concentrations of 10 µg/mL, 20 µg/mL, 40 µg/mL, and 80 µg/mL. Unraveling the intricate mechanism of apoptotic activity, ZnO-CU NPs orchestrated the upregulation of pivotal genes, including BCL2, BAX, and P53, within the KB cells. CONCLUSIONS: This multifaceted approach, addressing both antimicrobial and anticancer activity, positions ZnO-CU NPs as a compelling avenue for advancing oral health, offering a comprehensive strategy for tackling both oral infections and cancer.

Early time wetting kinetics in surface-directed spinodal decomposition for off-critical quenches: A molecular dynamics study.

We present results from the molecular dynamics simulation of surface-directed spinodal decomposition in binary fluid mixtures (A + B) with off-critical compositions. The aim is to elucidate the role of composition ratio in the early time wetting kinetics under the influence of long-range surface potential. In our simulations, the attractive part of surface potential varies as V(z) = -ϵa/zn, with ϵa being the surface-potential strength. The surface prefers the "A" species to form the wetting layer. Its thickness [R1(t)] for the majority wetting (number of A-type particles [NA] > number of B-type particles [NB]) grows as a power-law with an exponent of 1/(n + 2). This is consistent with the early time kinetics in the form of potential-dependent growth present in the Puri-Binder model. However, for minority wetting (NA < NB), the growth exponent in R1(t) is less than 1/(n + 2). Furthermore, on decreasing the field strength ϵa, we recover 1/(n + 2) for a minority wetting case. We provide phenomenological arguments to explain the early time wetting kinetics for both cases.

Financial toxicity and mental well-being of the oral cancer survivors residing in a developing country in the era of COVID 19 pandemic - A cross-sectional study.

OBJECTIVES: The primary outcome measures evaluated the financial toxicity and mental well-being of the oral cancer survivors. METHODS: A cross-sectional study of oral cancer survivors who were disease-free for more than 6 months after treatment and visited the hospital for a routine follow-up is included in the study. Mental well-being and financial toxicity were evaluated using the Depression, Anxiety, and Stress Scale - 21 (DASS 21) and Comprehensive Score for financial Toxicity (COST- Functional Assessment of Chronic Illness Therapy) questionnaires. A literature review was done to compare the results with financial toxicity and mental health in cancer patients from the pre-pandemic era. RESULTS: A total of 79 oral cancer survivors were included in the study, predominantly males (M: F = 10:1). The age ranged from 26 to 75 years (The median age is 49). The full-time employment dropped from 83.5% in the pre-treatment period to 21.5% post-treatment. Depression was observed in 58.2% and anxiety in 72.2%. Unemployed survivors were observed to have more depression (OR = 1.3, 95% confidence interval (CI) = 0.3-5.4, p = 0.6), anxiety (OR = 3.5, 95% CI = 0.3-21.2, p = 0.1) and stress (OR = 1.6, 95% CI = 0.3-6.6, p = 0.5) than rest of the cohort. On univariate analysis, unemployed survivors (M = 11.8 ± 3.8, p = 0.01) had significantly poorer financial toxicity scores. Survivors with depression (M = 16.4 ± 7.1, p = 0.06) and stress (M = 14.4 ± 6.8, p = 0.002) had poor financial toxicity scores. On multifactorial analysis of variance, current employment (p = 0.04) and treatment modality (p = 0.05) were significant factors impacting the financial toxicity. CONCLUSION: There is a trend towards increased incidence of depression, anxiety, and stress among oral cancer survivors compared to the literature from the pre-COVID era. There is significant financial toxicity among either unemployed or part-time workers. This calls for urgent public/government intervention to prevent the long-term impact of financial toxicity on survival and quality of life.

Machine learning based prediction of phase ordering dynamics.

Machine learning has proven exceptionally competent in numerous applications of studying dynamical systems. In this article, we demonstrate the effectiveness of reservoir computing, a famous machine learning architecture, in learning a high-dimensional spatiotemporal pattern. We employ an echo-state network to predict the phase ordering dynamics of 2D binary systems-Ising magnet and binary alloys. Importantly, we emphasize that a single reservoir can be competent enough to process the information from a large number of state variables involved in the specific task at minimal computational training cost. Two significant equations of phase ordering kinetics, the time-dependent Ginzburg-Landau and Cahn-Hilliard-Cook equations, are used to depict the result of numerical simulations. Consideration of systems with both conserved and non-conserved order parameters portrays the scalability of our employed scheme.

Host-parasite coevolution: Role of selection, mutation, and asexual reproduction on evolvability.

The key to the survival of a species lies in understanding its evolution in an ever-changing environment. We report a theoretical model that integrates frequency-dependent selection, mutation, and asexual reproduction for understanding the biological evolution of a host species in the presence of parasites. We study the host-parasite coevolution in a one-dimensional genotypic space by considering a dynamic and heterogeneous environment modeled using a fitness landscape. It is observed that the presence of parasites facilitates a faster evolution of the host population toward its fitness maximum. We also find that the time required to reach the maximum fitness (optimization time) decreases with increased infection from the parasites. However, the overall fitness of the host population declines due to the parasitic infection. In the limit where parasites are considered to evolve much faster than the hosts, the optimization time reduces even further. Our findings indicate that parasites can play a crucial role in the survival of its host in a rapidly changing environment.

Long-Term Complications of Button Batteries in the Nose.

BACKGROUND: One of the common emergencies presenting to the emergency department is a child who has inserted a foreign body into their nose. Of the various things that children insert accidently, the most dangerous are button batteries. CASE REPORT: We followed up 11 cases of children with history of button battery insertion in the nose for 1 year. We found that all of the patients had developed a septal perforation; other sequelae included nasal adhesions and saddle nose. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Button batteries in the nose are dangerous and can lead to early complications with long-term consequences for the patients. Early diagnosis is required so that they can be removed as soon as possible to prevent the development of complications and long-term sequelae.

Comparative Evaluation of Speech Quality Before and After Functional Palatal Recontouring in Complete Dentures using Artificial Intelligence: A Study Protocol.

Introduction In the realm of dentistry, where precision and understanding of oral structures are paramount, the utilization of advanced technologies has revolutionized diagnostic and treatment methodologies. One such technology, palatography, holds significant importance in understanding the intricate dynamics of the oral cavity, particularly the interaction between the tongue and the palate during speech and swallowing. In the field of prosthodontics, achieving a successful outcome goes beyond simply restoring missing teeth. A well-designed denture or prosthesis should not only function properly but also consider factors like aesthetics, comfort, and speech intelligibility. Methods The speech quality analysis using artificial intelligence has been designed to assist in the palatal recontouring of complete dentures during the trial denture appointment and denture insertion. The study will be conducted on 12 completely edentulous patients, selected based on exclusion and inclusion criteria. Expected results The palatal recontouring assessment is expected to improve speech quality significantly. This could be incorporated into routine complete denture rehabilitation cases where the ease of technology can help enhance the phonetics of the prosthesis. Conclusions Patients undergoing full denture rehabilitation benefit greatly from phonetics. Taking this key factor into play through the use of advanced but readily available technology, palatography can be employed as a routine procedure for rehabilitation through complete dentures. There is definitely a learning curve involved while making it a routine procedure, but it is, nonetheless, a significant addition to holistic rehabilitation.

An Alternative Approach for the Rehabilitation of a Complete Denture Patient With Parkinson's Disease.

Parkinson's disease (PD) affects one to two out of every 1,000 individuals. PD, being age-related, is affecting a percentage of those over and around the sixth decade. Lewy bodies containing α-synuclein and a reduction in dopaminergic neurons in the substantia nigra, which impairs the region's capacity to promote voluntary movements, are the main neuropathological findings. The three main symptoms of PD are stiffness, bradykinesia, and tremor. Treatment of edentulous conditions in patients with PD becomes a challenge due to decreased neuromuscular coordination and decreased mobility. This case report outlines a 64-year-old male patient with complete edentulism suffering from PD. Complete denture fabrication was done using the concepts of the neutral zone and denture characterization. Significantly, it not only improves the stability of the dentures but also establishes good denture aesthetics.

Optimizing Implant Placement in Cases of Limited Interocclusal Space: Strategies and Challenges.

Effective treatment planning is crucial for implant-supported dental prostheses' success, requiring a thorough assessment of various factors, including bone quality, quantity, and available space. Evaluating space availability, encompassing height, width, and angulation, is imperative to ensure optimal implant positioning devoid of anatomical limitations. Adequate vertical space is essential for accommodating the implant-supported restoration while preserving proper occlusal function and esthetics. However, not all cases adhere to ideal standards, especially those featuring limited interocclusal space, as seen in scenarios of long-standing edentulous areas lacking prior prosthetic rehabilitation. Ideally, the interocclusal space should measure between 8-12 mm vertically. This case report details the management of reduced interocclusal space through the strategic placement of deeply positioned implants and the incorporation of a screw-retained fixed partial denture, effectively addressing the challenges associated with limited space.

Fabrication of Hollow Acrylic Vaginal Stents Using Frozen Coconut Oil for Vaginal Agenesis Management.

In a rare condition known as vaginal agenesis, the uterus (womb) may develop only partially or not at all, while the vagina fails to develop altogether. It is common to diagnose vaginal agenesis, when a female does not start menstruation at puberty. This is a prenatal disorder that may also be linked to bone or kidney issues. Mullerian agenesis, Mullerian aplasia, and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome are other names for the illness. Treatment modalities encompass surgical and nonsurgical interventions, including the utilization of prefabricated or customized vaginal stents for neovagina reconstruction and maintenance. This case report describes the development of a neovagina in a 27-year-old female diagnosed with vaginal agenesis, a characteristic of MRKH syndrome. A customized clear acrylic stent, designed to provide a resilient surface, serves as a straightforward and cost-efficient alternative for managing this condition. Significantly, it enhances patient's compliance and comfort during treatment, addressing both the physical and psychological ramifications of this congenital anomaly. This customized vaginal stent not only provides a practical solution but also contributes to enhancing the quality of life for individuals grappling with vaginal agenesis, thereby offering a promising avenue for addressing the multifaceted challenges associated with this condition.

Otoendoscopy as a better preoperative predictor than pure tone audiometry for ossicular erosion in mucosal chronic otitis media.

OBJECTIVE: To compare the diagnostic accuracy of angled otoendoscopy with pure tone audiometry in predicting ossicular discontinuity in patients of mucosal chronic otitis media. METHODS: Ninety-four patients were included in this prospective study. A 2.7-mm 30° otoendoscope was used to examine ossicular status preoperatively. Hearing thresholds were recorded by pure tone audiometry. Intraoperative ossicular status was recorded as the gold standard. Otoendoscopic findings were recorded as per the criteria has been devised by the authors of this manuscript. RESULTS: Otoendoscopy was conclusive in 56 (59.6 per cent) patients, with 100 per cent sensitivity, 95.56 per cent specificity, 84.62 per cent positive predictive value, and 100 per cent negative predictive value in the conclusive group. Overall (in 94 patients), diagnostic test values of otoendoscopy were 73.33 per cent sensitivity, 97.47 per cent specificity, 84.62 per cent positive predictive value, and 95.06 per cent negative predictive value. As per the ROC curve, air-bone gap > 38.12dB had the optimal diagnostic test values, with 73 per cent sensitivity, 72 per cent specificity, 33.3 per cent positive predictive value, and 93.4 per cent negative predictive value. CONCLUSION: Angled otoendoscopy has better diagnostic accuracy (93.6 per cent) than pure tone audiometry (72.3 per cent; p < 0.001) for preoperative ossicular discontinuity prediction in patients of mucosal chronic otitis media.

Median Rhomboid Glossitis of the Tongue-Associated Kissing Lesion: A Report of a Rare Case.

A 50-year-old female patient visited the dental outpatient department with the chief complaint of ulceration associated with pain and burning sensation on the anterior and middle parts of the tongue and the posterior portion of the hard palate, which showed contact lesions that were similar in shape and size. The patient gave the history of the following symptoms a week before the patient visited the department. The patient was asymptomatic six months ago when she initially observed yellowish deposits on her tongue that could be scraped off. The patient misjudged these deposits as food debris and did not undergo any treatment for them. It was in the past week that she developed ulceration on the posterior portion of the hard palate.

Troubleshooting Vaginal Stents: A Critical Review of Common Problems and Solutions.

This review aims to examine the use of vaginal stents in clinical practice, specifically for treating vaginal agenesis and related complications and problem associated with vaginal stents. Vaginal agenesis, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital disorder characterized by the uterus not developing or developing only partially. Vaginal stents are medical devices that preserve the structural integrity and patency of the vaginal canal after trauma or surgery. They play an important part in gynecological treatments such as post-radiation therapy, reconstructive surgery, and vaginal stenosis management. The review also discusses the primary applications of vaginal stents, such as preventing adhesions, healing mucosa, and maintaining patency. It also investigates frequent concerns associated with stent use, such as complications and the need for better designs. Vaginal stents are essential in a variety of therapeutic settings, providing major benefits in maintaining vaginal tissue and function. However, their use is fraught with complications, including the risk of infection, discomfort, and the possibility of inappropriate placement.

Achieving negative superficial resection margins with NBI and white light in carcinoma oral cavity: Could it be a norm?

INTRODUCTION: In India, oral cavity cancer rates are the highest, largely due to tobacco and areca nut use. The primary goal of oncologic surgery is complete tumor resection with adequate margins, yet no accepted guidelines exist margin identification. NBI enhances mucosal lesion detection and may improve margin assessment in OSCC. AIMS: This study aims to evaluate the proportion of negative superficial resection margins using NBI and to compare these results with margins assessed using white light (WL) examination. MATERIALS AND METHODS: The study at AIIMS, Rishikesh, included 38 patients with T1-T3 biopsy-proven OSCC. Surgical margins were marked using WL and NBI. Histopathology classified margins as clear (>5mm), close (1-5 mm), or involved. Sensitivity, specificity, and predictive values of NBI were calculated. RESULTS: The average NBI examination duration was 227 s. Negative margins were achieved in 68.42 % (>5mm) and 78.94 % (>3mm) of NBI cases, compared to 71.05 % and 84.21 % for WL. NBI had a sensitivity of 12.50 %, specificity of 96.67 %, and overall accuracy of 78.95 %. DISCUSSION: NBI showed high specificity but low sensitivity. This could be due to the smaller number of patients in NBI positive group. In the present study, the single positive margin identified with NBI could also have been detected with the combined approach of white light and palpation, ensuring that no positive margins were missed. CONCLUSION: NBI can complement WL for margin assessment in oral SCC but requires a long learning curve and a dedicated team. Integrating NBI into standard protocols could improve surgical outcomes and reduce recurrence.

Saffron (Crocus sativus L.) extract attenuates chronic scopolamine-induced cognitive impairment, amyloid beta, and neurofibrillary tangles accumulation in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Crocus sativus L. known as saffron, is a popular food condiment with a high aroma, deep colour, and long and thick threads (stigmas) cultivated in Iran, Morocco, Spain, Italy, China, Japan, France, Turkey, and India. In 'Ayurveda', saffron is acknowledged for its immunostimulant, aphrodisiac, cardiotonic, liver tonic, nervine tonic, carminative, diaphoretic, diuretic, emmenagogue, galactagogue, febrifuge, sedative, relaxant, and anxiolytic activities. The renowned Persian physician and philosopher, Avicenna, delineated saffron as an antidepressant, hypnotic, anti-inflammatory, hepatoprotective, bronchodilator, and aphrodisiac in his book, the Canon of Medicine. Within traditional Iranian Medicine (TIM), saffron is characterized as a mood elevator and a rejuvenator for the body and senses. Further, the ethnopharmacological evidence indicates that saffron has shown an effect against neurodegenerative disorders namely, dementia, Alzheimer's, and Parkinson's with its bioactive constituents i.e., carotenoids and apocarotenoids. AIM: The present study aimed to investigate the potential of standardized (Kashmir Saffron, India) Crocus sativus extract (CSE) in chronic scopolamine-induced cognitive impairment, amyloid beta (Aß) plaque, and neurofibrillary tangles (NFT) accumulation in rat brains by targeting AChE inhibition and scopolamine mechanistic effect. METHODS: The experimental animals were divided into six groups: group 1: normal control, group 2: scopolamine, group 3,4 and 5 rivastigmine tartrate, CSE (p.o. 10 mg/kg, 15 mg/kg, and 20 mg/kg) respectively. Each treatment group received scopolamine after 20 min of dosing, till 4 weeks. The effects of different treatments on learning, acquisition, and reversal memory were performed using a Morris water maze test. In addition to behavioral assessments, biochemical parameters such as AChE, IL-6, and antioxidants were measured in isolated brains. Histological observations were also conducted to assess the presence of Aß plaques and NFT. Furthermore, molecular docking was performed to explore the potential AChE inhibitory activity of the bioactive constituents of standardized CSE. RESULTS: Scopolamine produces memory impairment, and its chronic administration forms Aß plaque and NFT in rat brains. Supplementation with CSE in presence of scopolamine has shown remarkable effects on behavioural activity, special acquisition, and reversal memory. The CSE has also shown promising effects on AChE inhibition and antioxidant activity. The results of the docking study also indicate that trans-crocetin, i.e., a biologically active metabolite of Crocins, has strong AChE inhibitory activity, supported by an in vivo animal experiment. CONCLUSION: Supplementation with CSE significantly attenuates the formation of Aß plaque and NFT in the hippocampus at a dose of 20 mg/kg per day. In addition, CSE also counters scopolamine-induced neuroinflammation.

Universal fast mode regime in wetting kinetics.

We present simulation results from a comprehensive molecular dynamics (MD) study of surface-directed spinodal decomposition (SDSD) in unstable symmetric binary mixtures at wetting surfaces. We consider long-ranged and short-ranged surface fields to investigate the early stage wetting kinetics. The attractive part of the long-ranged potential is of the form V(z)∼z^{-n}, where z is the distance from the surface and n is the power-law exponent. We find that the wetting-layer thickness R_{1}(t) at very early times exhibits a power-law growth with an exponent α=1/(n+2). It then crosses over to a universal fast-mode regime with α=3/2. In contrast, for the short-ranged surface potential, a logarithmic behavior in R_{1}(t) is observed at initial times. Remarkably, similar rapid growth is seen in this case too. We provide phenomenological arguments to understand these growth laws. Our MD results firmly establish the existence of universal fast-mode kinetics and settle the related controversy.

Novel Modifications to Total Maxillary Swing Approach in Extensive Nasopharyngeal Angiofibroma to Minimize Complications.

Maxillary swing approaches provide excellent exposure of the anterior, mid, and anterolateral skull base offering a wide window to approach nasopharyngeal neoplasms; however, they are also associated with complications. The present study aimed to evaluate the results of a modified total maxillary swing (TMS) approach developed to minimize postoperative complications. The modified TMS approach was used to treat five patients who had extensive juvenile nasopharyngeal angiofibromas between March and October 2019 at our tertiary care center. Surgical technique, preoperative image findings, and intra-operative findings were recorded. In the postoperative follow-up, patients were examined to rule out all possible complications associated with the procedure according to the literature. A retrospective analysis was performed to assess tumor extensions, surgical modifications, and postoperative complications. All tumors had orbital and infratemporal (lateral limit) involvement while four had intracranial involvement. No per-operative complications were reported, and postoperative clinical and endoscopic evaluation was performed at 1, 2, and 3 months. There was no evidence of complications including residue, recurrence, maxillary necrosis, ophthalmoplegia, epiphora, palatal fistula, or jaw malocclusion. Besides, minor complications such as infraorbital margin skin retraction, infraorbital serous collection, maxillo-zygomatic abscess, and unsightly scar were also not seen. Only one case presented with maxillary osteomyelitis which was resolved with mini-plate removal and antibiotics. A modified TMS approach is a prudent option to ensure complete removal of juvenile nasopharyngeal angiofibromas with negligible complications.

Metastasis in Sinonasal Region Revealing a Silent Primary: A Series of 2 Cases with Review of Literature.

Metastasis to the nasal cavity and paranasal sinuses are very rare and only few cases have been reported so far. Metastatic nasal mass with silent primary renal cell carcinoma (RCC) is even rarer. So are giant cell tumors which rarely affects soft tissues whether superficial or deep. These rarely occur in nasal cavity. We would like to discuss 2 cases-one being a 74 year old female with a solitary asymptomatic extensive metastatic lesion in sinonasal area of silent primary renal cell carcinoma and other being a 38 year old female multiple lytic expansile lesions in facial and skull bones who was previously treated for giant cell tumor of long bone-tibia. We aim to bring their occurrence to notice as they are rare, to highlight importance of these tumors in differential diagnosis of sinonasal masses and treatment options for the same.

Head and Neck Lipomas at Uncommon Subsites: A Series of Four Cases.

Lipomas are benign soft tissue tumors; the most common ones present in subcutaneous planes distributed throughout the body. However, there are few sites which are unusual location for lipomas. Here, we discuss the presentation of 4 cases of head and neck lipomas at unusual subsites. Though its prevalence is high in the body, lipomas are rarely seen in upper aerodigestive tract and these lesions can cause severe deglutition and respiratory distress problems in addition to cosmetic deformities. In the head and neck, most common location of lipoma is the cheek, followed by the tongue. Tonsillar lipomas are very rare. The mainstay treatment for lipomas is complete surgical excision and recurrence following complete removal is rarely known. We are here discussing a series of 4 cases of lipomas, presenting at uncommon subsites in head and neck region. These include lesions over neck, tongue, palate and tonsillar fossa. Lipomas are benign mesenchymal tumors, that are initially non bothersome. However, with increasing size they can cause severe aerodigestive problems with functional compromise and need complete surgical excision.

Microscopic Parotidectomy: A Prospective Study.

To assess the parameters' setting of the microscope during parotidectomy and the impact of microscopic parotidectomy on facial nerve functional status. A prospective study was conducted on 28 patients in a tertiary care center, who underwent microscopic parotidectomy. Microscope's settings' like magnification, focal length, diameter of the visualized field, and clock position were recorded. Facial nerve functional status was also recorded. All surgeries were performed by right-handed surgeons using Leica F 20 M525 microscope. Clock position of microscope for right parotidectomy ranged between 7 and 10 o clock and for left, it ranged between 7 and 12 o clock. Magnification ranged between 1.3 × and 3.2 ×; magnifications of 1.3 × and 1.8 × were preferred from incision to separation of parotid from sternocleidomastoid muscle, 1.8 × and 2 × for dissection of the facial nerve trunk, and 2 × and 3.2 × for individual branches of the facial nerve. Focal length ranged between 251 and 410 mm and the diameter of the visualized field ranged between 7 and 14.7 cm. Out of 24 cases of benign lesions, 2 (8.3%) developed facial paresis which resolved in 3 months. Two out of four cases of malignancy developed permanent palsy as nerve branches were sacrificed to achieve tumor clearance. Using a microscope for parotidectomy is advantageous for facial nerve dissection, reducing chances of facial paralysis. The microscope was also found to be useful for teaching. The use of appropriate microscopic parameters avoids the glitch of transition from open to microscopic approach.