Predisposing Factors in Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Objective: To ascertain the prevalence of risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography at Isra University Hospital in Hyderabad. Methodology: This descriptive case series study was done at the gastroenterology department of Isra University Hospital, Hyderabad, from September 2018 to March 2020. Patients aged 18 to 50 years, both genders, and diagnosed with post-ERCP pancreatitis were included. All the patients were undergoing an ERCP procedure. The procedure was done under conscious sedation or propofol where needed. The serum amylase level was assessed in all patients at 4 hours. Patients had been considered to have post-ERCP pancreatitis if they developed new or worsening pain of abdomen and had a threefold increase in serum amylase. All the cases were assessed regarding risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography. All the data was recorded in the proforma. Results: The mean age of the patients was 42.7 years. The majority of the patients (65.47%) were females and 32.90% were males. The mean duration of pancreatitis was 3.1 days. Sphincter of Oddi dysfunction was found in 17.1% of cases. Precut papillotomy was done in 18(23.7%) cases. Repeated pancreatic duct injury was seen in 10(13.2%) cases. No significant difference was found in the effect of modifiers on predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis, p-values were almost insignificant. Conclusion: Cannulation attempts, Sphincter of Oddi dysfunction, precut papillotomy, repeated pancreatic duct injection, and female gender were observed to be the predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis

Literature Review of Omicron: A Grim Reality Amidst COVID-19

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan city in December 2019, and became a grave global concern due to its highly infectious nature. The Severe Acute Respiratory Coronavirus-2, with its predecessors (i.e., MERS-CoV and SARS-CoV) belong to the family of Coronaviridae. Reportedly, COVID-19 has infected 344,710,576 people around the globe and killed nearly 5,598,511 persons in the short span of two years. On November 24, 2021, B.1.1.529 strain, later named Omicron, was classified as a Variant of Concern (VOC). SARS-CoV-2 has continuously undergone a series of unprecedented mutations and evolved to exhibit varying characteristics. These mutations have largely occurred in the spike (S) protein (site for antibody binding), which attribute high infectivity and transmissibility characteristics to the Omicron strain. Although many studies have attempted to understand this new challenge in the COVID-19 strains race, there is still a lot to be demystified. Therefore, the purpose of this review was to summarize the structural or virologic characteristics, burden, and epidemiology of the Omicron variant and its potential to evade the immune response

Effect of Fluoride Concentration in Drinking Water on Dental Fluorosis in Southwest Saudi Arabia

This study was intended to evaluate the fluoride concentration in drinking water and its effect on dental fluorosis in Southwest Saudi Arabia. Water samples were gathered rom wells, filtration plants and commercial brands (bottled water) in distinct urban and rural areas of Asir region of the Kingdom of Saudi Arabia (KSA). Overall, 63 water samples were collected from 12 locations and 9 brands of bottled water. ExStik® FL700Fluoridemeter was used in the analysis of water samples for fluoride levels. The total number of screened patients for dental fluorosis, aged between 9 and 50 years, was 1150; among them, 609 were males and 541 were females. Dean’s index criteria were used to examine the patients for dental fluorosis. The results revealed that fluoride levels varied between 0.03 and 3.8 ppm. People who drank well water displayed increased fluoride levels (>0.81 ppm). The prevalence of dental fluorosis was established to be 20.43% among the total number of examined patients. The findings of this study show very mild to moderate dental fluorosis prevail among the patients who consume well water in the Asir region

Plasmodium falciparum enolase complements yeast enolase functions and associates with the parasite food vacuole

Plasmodium falciparum enolase (Pfeno) localizes to the cytosol, nucleus, cell membrane and cytoskeletal elements, suggesting multiple non-glycolytic functions for this protein. Our recent observation of association of enolase with the food vacuole (FV) in immuno-gold electron microscopic images of P. falciparum raised the possibility for yet another moonlighting function for this protein. Here we provide additional support for this localization by demonstrating the presence of Pfeno in purified FVs by immunoblotting. To examine the potential functional role of FV-associated Pfeno, we assessed the ability of Pfeno to complement a mutant Saccharomyces cervisiae strain deficient in enolase activity. In this strain (Tetr-Eno2), the enolase 1 gene is deleted and expression of the enolase 2 gene is under the control of a tetracycline repressible promoter. Enolase deficiency in this strain was previously shown to cause growth retardation, vacuolar fragmentation and altered expression of certain vacuolar proteins. Expression of Pfeno in the enolase-deficient yeast strain restored all three phenotypic effects. However, transformation of Tetr-eno2 with an enzymatically active, monomeric mutant form of Pfeno (Δ5Pfeno) fully restored cell growth, but only partially rescued the fragmented vacuolar phenotype, suggesting that the dimeric structure of Pfeno is required for the optimal vacuolar functions. Bioinformatic searches revealed the presence of Plasmodium orthologs of several yeast vacuolar proteins that are predicted to form complexes with Pfeno. Together, these observations raise the possibility that association of Pfeno with food vacuole in Plasmodium may have physiological function(s)

Comparative Evaluation of Flexural Strength and Flexural Modulus of Different Periodontal Splint Materials: An In Vitro Study

Splinting of the mobile teeth is a critical part of periodontal management to improve the prognosis and longevity of stable results of periodontally compromised teeth with increased mobility. Different types of splints are used in the dental field based on their mechanical and physical properties.The objective of the current in vitro study was to evaluate the flexure strength and flexural modulus of different types of splinting materials, such as: composite block, ligature wire, Ribbond®, InFibra®, and F-splint-Aid® bonded utilizing Flowable composites resin material. Seventy-five bar specimens were prepared with the dimensions of 25 × 4 × 2 mm, utilizing split metallic mold. Specimens were divided equally (n = 15) into five groups (one control group, four test groups). Different layers of splinting material were placed in between the layers of composite before curing. All the specimens were subjected to a three-point bending test by using a universal testing machine to calculate the flexural strength and flexural modulus. The entire data was subjected to statistical tests to evaluate the significance. Specimens from composite block groups showed the least mean value for flexural strength (89.15 ± 9.70 MPa) and flexural modulus (4.310 ± 0.912 GPa). Whereas, the highest mean value for flexural strength (168.04 ± 45.95 MPa) and flexural modulus (5.861 ± 0.501 GPa) were recorded by Ribbond® specimens. Inter group comparison of flexural strength showed statistically significant differences (P-value < 0.05), whereas comparison of flexural modulus showed non-significant difference among the groups (P-value > 0.05). Within the limitation of the present study, it was concluded that the Ribbond® exhibits maximum flexural strength and flexural modulus, whereas the composite blocks recorded the least values. Still, the decision making depends on the clinical scenario and the unique characteristic of each splint material

Fabrication of Ceftriaxone-Loaded Cellulose Acetate and Polyvinyl Alcohol Nanofibers and Their Antibacterial Evaluation

Nanotechnology provides solutions by combining the fields of textiles and medicine to prevent infectious microbial spread. Our study aimed to evaluate the antimicrobial activity of nanofiber sheets incorporated with a well-known antibiotic, ceftriaxone. It is a third-generation antibiotic that belongs to the cephalosporin group. Different percentages (0, 5%, 10%, 15%, and 20%; based on polymer wt%) of ceftriaxone were incorporated with a polymer such as polyvinyl alcohol (PVA) via electrospinning to fabricate nanofiber sheets. The Kirby-Bauer method was used to evaluate the antimicrobial susceptibility of the nanofiber sheets using Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). For the characterization of the nanofiber sheets incorporated with the drug, several techniques were used, such as Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM). Our results showed that the nanofiber sheets containing ceftriaxone had potential inhibitory activity against E. coli and S. aureus as they had inhibition zones of approximately 20–25 mm on Mueller-Hinton-agar-containing plates. In conclusion, our nanofiber sheets fabricated with ceftriaxone have potential inhibitory effects against bacteria and can be used as a dressing to treat wounds in hospitals and for other biomedical applications

Root canal treatment from patients’ perspective: Knowledge, awareness, and expectations

Background/Aim. Root canal treatment (RCT) is one of the most common endodontic procedures for which patients visit the dentist. Patient's knowledge, awareness, and attitude regarding root canal treatment are an interesting problem in everyday dentistry. Therefore, the study aimed to evaluate the knowledge, awareness, and attitude of patients coming for endodontic treatment. Methods. Questionnaire surveys were carried out in a group of 209 patients, including queries characterizing their knowledge, awareness, and attitude towards the RCT – their experiences, expectations, potential problems, and management expenses. Results. Exploring the knowledge of individuals concerning RCT, it was noticed that 51% of the surveyed patients in the past had experienced endodontics treatment. Fifty-two percent of participants reported that they knew the charges of the RCT, and 50% of them said that the price was sufficient for the difficulty of the process. The study confirmed that 47% of the participants still prefer specialists to perform the RCT. Conclusion. An enhancement of knowledge and awareness of people about the RCT has been observed, as well as a need of providing more information to patients about endodontics and the benefits of saving teeth. This article has been corrected. Link to the correction 10.2298/VSP2205532E</font

Dental Anxiety and Influencing Factors in Adults

Dental anxiety is one of the most common conditions present amongst the masses globally. It is this fear that makes individuals avoid seeking dental treatment which results in a deteriorated oral health-related quality of life (OHRQoL). Discrepancies exist in the prevalence of dental anxiety based on gender, education levels, level of deprivation of a society and its socioeconomic status. In this study, a sample size of 522 respondents was collected. Kuppuswamy’s socioeconomic status scale and modified dental anxiety scales were used to collect the necessary data. These data were analyzed by cross tabbing and chi-square test of significance was applied to assess the association between dental anxiety and other factors. Female gender was significantly associated with dental anxiety with p-value = 0.03. Higher education levels and dental anxiety also displayed significant associations with each other, with a p-value of 0.048. Seventy-six percent of the individuals of lower socioeconomic status were prone to be more dentally anxious. Dental anxiety was more significant in individuals with higher levels of education in our study. Respondents who were part of a lower socioeconomic class were also more prone to being anxious while receiving dental treatment. Knowing the factors that cause dental anxiety can help dentists effectively manage and treat their patients

Augmented Reality and Virtual Reality in Dentistry: Highlights from the Current Research

Many modern advancements have taken place in dentistry that have exponentially impacted the progress and practice of dentistry. Augmented reality (AR) and virtual reality (VR) are becoming the trend in the practice of modern dentistry because of their impact on changing the patient’s experience. The use of AR and VR has been beneficial in different fields of science, but their use in dentistry is yet to be thoroughly explored, and conventional ways of dentistry are still practiced at large. Over the past few years, dental treatment has been significantly reshaped by technological advancements. In dentistry, the use of AR and VR systems has not become widespread, but their different uses should be explored. Therefore, the aim of this review was to provide an update on the contemporary knowledge, to report on the ongoing progress of AR and VR in various fields of dental medicine and education, and to identify the further research required to achieve their translation into clinical practice. A literature search was performed in PubMed, Scopus, Web of Science, and Google Scholar for articles in peer-reviewed English-language journals published in the last 10 years up to 31 March 2021, with the help of specific keywords related to AR and VR in various dental fields. Of the total of 101 articles found in the literature search, 68 abstracts were considered suitable and further evaluated, and consequently, 33 full-texts were identified. Finally, a total of 13 full-texts were excluded from further analysis, resulting in 20 articles for final inclusion. The overall number of studies included in this review was low; thus, at this point in time, scientifically-proven recommendations could not be stated. AR and VR have been found to be beneficial tools for clinical practice and for enhancing the learning experiences of students during their pre-clinical education and training sessions. Clinicians can use VR technology to show their patients the expected outcomes before the undergo dental procedures. Additionally, AR and VR can be implemented to overcome dental phobia, which is commonly experienced by pediatric patients. Future studies should focus on forming technological standards with high-quality data and developing scientifically-proven AR/VR gadgets for dental practice

Comparative Evaluation of Gingival Crevicular Fluid Interleukin-17, 18 and 21 in Different Stages of Periodontal Health and Disease

Background and Objectives: The elicitation of a host&rsquo;s immune&ndash;inflammatory responses to overcome oral bacterial biofilm challenges is mediated by numerous cytokines. We explored the role of three such cytokines, viz. interleukin (IL)-17, 18 and 21, by measuring their levels in the gingival crevicular fluid (GCF) of Indian individuals with healthy gingiva, chronic gingivitis, or chronic periodontitis. Materials and Method: Ninety systemically healthy individuals were enrolled in the study on the basis of predefined criteria and were categorized into three groups of 30 participants each. Groups A, B and C were composed of a control group with healthy gingiva, subjects with chronic gingivitis and subjects with chronic periodontitis, respectively. The periodontal disease status was assessed on the basis of a subject&rsquo;s gingival index, probing pocket depth, clinical attachment loss and radiographic evidence of bone loss. After the complete history-taking and identification of gingival sulcus/pocket depth areas for GCF collection, a sample was collected from each subject in all groups for an estimation of the cytokine levels using ELISA. Statistical analysis was performed using SPSS v 21.0. Intergroup comparisons were conducted using a post hoc Tukey&rsquo;s test. A value of p &lt; 0.05 was considered to be statistically significant. Results: The mean IL-17, 18 and 21 concentrations in pg/mL was the greatest for Group C (99.67 &plusmn; 18.85, 144.61 &plusmn; 20.83 and 69.67 &plusmn; 12.46, respectively), followed by Group B (19.27 &plusmn; 2.78, 22.27 &plusmn; 2.43 and 22.74 &plusmn; 1.43, respectively) and finally by Group A (healthy control; 11.56 &plusmn; 0.99, 17.94 &plusmn; 1.24 and 12.83 &plusmn; 1.21 respectively). A statistically significant difference in the mean concentrations of two interleukins (IL-17 and IL-18) was observed between Groups A and C and also between Groups B and C. A statistically significant difference in the mean concentrations of IL-21 was observed between Groups B and C. Conclusions: Within the limitations of the present study, the findings revealed that the GCF levels of IL-17, IL-18 and IL-21 rose and correlated well with the severity of the disease. Thus, these cytokines present in GCF have the potential to be considered as biomarkers for periodontal tissue destruction. IL-21 in particular appears to be a promising biomarker for differentiating between gingivitis and periodontitis