Comparison of Fracture Resistance of Immature Teeth Filled with Different Root Canal Filling Materials: An In Vitro study

INTRODUCTION: Traumatic dental injuries are frequent in children aged 8– 12 years, and the maxillary incisors are the most commonly affected teeth. A traumatic impact on the immature anterior teeth frequently results in arrested root development due to the loss of pulp vitality. The endodontic treatment of these teeth with necrotic pulps poses a challenge for the practitioner because of the widely open apices and the thin dentinal walls which predispose teeth to fracturing1, 2. Root fractures commonly occur in the cervical third and have been shown to have a rate of about 28–77%, depending on the stage of root development, with the highest percentage of fractures occurring in teeth with the least developed root. Numerous materials have been recommended for the apexification of immature teeth up to date. Calcium hydroxide (CH) has been used for the induction of an apical barrier in immature teeth due to the high pH and antimicrobial activity for years. However, CH has some disadvantages; the CH treatment may extend up to 1 year and this may decrease the fracture. AIM OF THE STUDY: To compare the fracture resistance of simulated human permanent immature teeth restored with different root canal filling materials as an apical plug after 3 months of aging. MATERIALS AND METHODS: Eighty single rooted extracted mandibular premolars were selected. The roots of teeth were standardized to a length of 10 mm as measured from the apex to the facial cementoenamel junction (CEJ) by cutting the root tip to simulate incomplete root formation. To achieve a simulation of teeth with immature apices, Peeso Reamers between #1 and #6 were introduced into the root canal until #6 pass freely out of the apex. Further 703 carbide bur was used to obtain the remaining dentin thickness around 1 to 1.5 mm. The teeth were randomly divided into 4groups (n = 20 for each group. In Group A, An immature tooth model were left unfilled without any reinforcement material (Control group). In Group B, the root canals were filled with 4mm apical plug of Biodentine and then backfilled with gutta-percha/AH Plus obturation. In Group C, 4mm apical plug of DiaRoot Bio Aggregate and then backfilled with gutta-percha/AH Plus obturation. In Group D, teeth were filled with 4mm apical plug of MTA-Angelus was placed in the root canal and then backfilled with gutta-percha/AH plus obturation. All root specimens were stored for 3 months at 100% humidity to allow the complete setting of the sealers. Each specimen was then subjected to fracture testing by using a universal testing machine at a crosshead speed of 1.0 mm/min until the root fractured. The force required to fracture each specimen was recorded, and the data were analysed statistically. RESULTS: The Biodentine group (Group B) had the highest fracture resistance that differed significantly (p < 0.05) from the other groups. There was statistically significant difference between group C (Bio Aggregate) and group D (MTA- Angelus) (P< 0.05). Group A (control group) had the lowest fracture resistance that differed significantly (p < 0.05) from the other groups. CONCLUSION: Within the limitations of this study, data suggests that the use of 4mm apical plug of Biodentine increased the fracture resistance of immature teeth compared with MTA angelus, Bioaggregate

Amoxicillin induced erythematous maculopapular rashes: a case report

Cutaneous adverse reactions (CAR) can occur with any class of drugs, however more widely caused by various antibiotics. Amoxicillin is a broad-spectrum, bactericidal, beta-lactam antibiotic, widely used for combating various infections. Cutaneous drug eruptions are known to be reported common while using penicillin class of drugs, specifically among children. These immune-mediated bizarre drug eruptions were range from mild to severe drug-induced cutaneous reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The present case reported with maculopapular, erythematous rashes induced by amoxicillin in a nine-year-old male patient. Amoxicillin was prescribed for his hyperactive respiratory disease and subsequently after three days developed generalized maculopapular erythematous rashes as a result of an antibiotic-induced skin rash. The present case is being reported to add more data, also to emphasize and gather the information for evidence-based practice and to promote efficient pharmacovigilance adverse drug reaction reporting

Hunig's base catalyzed synthesis of new 1-(2,3-dihydro-1H-inden-1-yl)-3-aryl urea/ thiourea derivatives as potent antioxidants and 2HCK enzyme growth inhibitors

A series of 1-(2,3-dihydro-1H-indan-1-yl)-3-aryl urea/thiourea derivatives (4a-j) have been synthesized from the reaction of 2,3-dihydro-1H-inden-1-amine (2) with various aryl isocyanates/isothiocyanates (3a-j) by using N,N-DIPEA base (Hunig's base) catalyst in THF at reflux conditions. All of them are structurally confirmed by spectral (IR, 1H & 13C NMR and MASS) and elemental analysis and screened for their in-vitro antioxidant activity against DPPH and NO free radicals and found that compounds 4b, 4i, 4h & 4g are potential antioxidants. The obtained in vitro results were compared with the molecular docking, ADMET, QSAR and bioactivity study results performed for them and identified that the recorded in silico binding affinities were observed in good correlation with the in vitro antioxidant results. The Molecular docking analysis had unveiled the strong hydrogen bonding interactions of synthesized ligands with ARG 160 residue of protein tyrosine kinase (2HCK) enzyme and plays an effective role in its inhibition. Toxicology studies have assessed the potential risks of 4a-j and inferred that all of them were in the limits of potential drugs. The conformational analysis of 4a-j inferred that the urea/thiourea spacer linking 2,3-dihydro-1H-inden-1-amino and substituted aryl units has facilitated all these molecules to effectively bind with ARG 160 amino acid residue present on the α-helix of the protein tyrosine kinase (2HCK) enzyme specifically on chain A of hemopoetic cell kinase. Collectively this study has established a relationship between the antioxidant potentiality and ligands binding with ARG 160 amino acid residue of chain A of 2HCK enzyme to inhibit its growth as well as proliferation of reactive oxygen species in vivo

Determinants of Cognitive Development in the Early Life of Children in Bhaktapur, Nepal

Background: Children in low and middle income countries may have many risk factors for poor cognitive development, and are accordingly at a high risk of not reaching their developmental potential. Determinants for cognitive development in early life can be found among biological and socioeconomic factors, as well as in stimulation and learning opportunities. Objective: The present study aimed to identify determinants of cognitive, language and motor development in 6-11 months old Nepalese infants. Methods: Six hundred infants with a length-for-age z-score <-1 were assessed with the Bayley Scales of Infant and Toddler development, 3rd edition (Bayley-III). Information on socioeconomic factors, child and maternal demographics, clinical and biological factors, and the home environment were collected. In a manual stepwise variable selection procedure, we examined the association between selected biological, socioeconomic and stimulation and learning opportunity variables and the Bayley-III cognitive, language and motor development subscale scores in multiple linear regression models. Results: The length-for-age z-scores was positively associated with the cognitive composite score [standardized beta (ß): 0.22, p < 0.001] and the motor composite score [(ß): 0.14, p = 0.001]. Children born with low birth weight (<2500 g) scored significantly lower on all subscale scores. Diarrheal history was associated with poor language composite scores, and females had higher language composite scores than boys [(ß): 0.11, p = 0.015]. Children who had been hospitalized during the first month of life had also lower cognitive and motor composite scores than those who had not been hospitalized. Parental reports of physical punishment and lack of spontaneous vocalization were associated with poor cognitive and language composite scores, respectively. The statistical models with the various subscale scores as dependent variables explained between 8 to 16 percent of the variability in the cognitive developmental outcomes. Conclusion: Our findings reveal important determinants for developmental scores in infancy, and underline the role of biological risk factors faced by marginalized children in low and middle income countries such as in Nepal. Copyright © 2019 Ranjitkar, Hysing, Kvestad, Shrestha, Ulak, Shilpakar, Sintakala, Chandyo, Shrestha and Strand.publishedVersio

Multiple molecular targets mediated antioxidant activity, molecular docking, ADMET, QSAR and bioactivity studies of halo substituted urea derivatives of α-Methyl-l-DOPA

A series of novel α-methyl-l-DOPA urea derivatives viz., 3-(3,4-dihydroxyphenyl)-2-methyl-2-(3-halo/trifluoromethyl substituted phenyl ureido)propanoic acids (6a-e) have been synthesized from the reaction of α-methyl-l-DOPA (3) with various aryl isocyanates (4a-e) by using triethylamine (5, TEA) as a base catalyst in THF at reflux conditions. The synthesized compounds are structurally characterized by spectral (IR, 1H & 13C NMR and MASS) and elemental analysis studies and screened for their in-vitro antioxidant activity against DPPH, NO and H2O2 free radical scavenging assays and identified compounds 6c & 6d as potential antioxidants. The acquired in vitro results were correlated with the results of molecular docking, ADMET, QSAR and bioactivity studies performed for them and predicted that the recorded in silico binding affinities are in good correlation with the in vitro antioxidant activity results. The molecular docking analysis has comprehended the strong hydrogen bonding interactions of 6a-e with 1CB4, 1N8Q, 3MNG, 1OG5, 1DNU, 3NRZ, 2CDU, 1HD2 and 2HCK proteins of their respective SOD, LO, PRXS5, CP450, MP, XO, NO, PRY5 and HCK enzymes. This has sustained the effective binding of 6a-e and resulted in functional inhibition of selective aminoacid residues to be pronounced as multiple molecular targets mediated antioxidant potent compounds. In addition, the evaluated toxicology risks of 6a-e are identified with in the potential limits of drug candidates. The conformational analysis of 6c & 6d prominently infers that urea moiety uniting α-methyl-l-DOPA with halo substituted aryl units into a distinctive orientation to comply good structure-activity to inhibit the proliferation of reactive oxygen species in vivo

Randomized, placebo-controlled trials of dichlorphenamide in periodic paralysis

Objective: To determine the short-term and long-term effects of dichlorphenamide (DCP) on attack frequency and quality of life in hyperkalemic (HYP) and hypokalemic (HOP) periodic paralysis. Methods: Two multicenter randomized, double-blind, placebo-controlled trials lasted 9 weeks (Class I evidence), followed by a 1-year extension phase in which all participants received DCP. Forty-four HOP and 21 HYP participants participated. The primary outcome variable was the average number of attacks per week over the final 8 weeks of the double-blind phase. Results: The median attack rate was lower in HOP participants on DCP than in participants on placebo (0.3 vs 2.4, p 0.02). The 9-week mean change in the Physical Component Summary score of the Short Form-36 was also better in HOP participants receiving DCP (treatment effect 7.29 points, 95% confidence interval 2.26 to 12.32, p 0.006). The median attack rate was also lower in HYP participants on DCP (0.9 vs 4.8) than in participants on placebo, but the difference in median attack rate was not significant (p 0.10). There were no significant effects of DCP on muscle strength or muscle mass in either trial. The most common adverse events in both trials were paresthesia (47% DCP vs 14% placebo, both trials combined) and confusion (19% DCP vs 7% placebo, both trials combined). Conclusions: DCP is effective in reducing the attack frequency, is safe, and improves quality of life in HOP periodic paralysis. Classification of evidence: These studies provide Class I evidence that DCP significantly reduces attack frequency in HOP but lacked the precision to support either efficacy or lack of efficacy of DCP in HYP

k-Kernel Symmetric Matrices

In this paper we present equivalent characterizations of k-Kernel symmetric Matrices. Necessary and sufficient conditions are determined for a matrix to be k-Kernel Symmetric. We give some basic results of kernel symmetric matrices. It is shown that k-symmetric implies k-Kernel symmetric but the converse need not be true. We derive some basic properties of k-Kernel symmetric fuzzy matrices. We obtain k-similar and scalar product of a fuzzy matrix

Development of novel TGDDM epoxy nanocomposites for aerospace and high performance applications – Study of their thermal and electrical behaviour

The present work focuses on a study of the thermal and electrical behaviour of pure N,N′-tetraglycidyl diaminodiphenylmethane (TGDDM) for use in aerospace, high performance applications. The synthesis of the tetraglycidyl epoxies was done and they were characterized by FT-IR (Fourier transform infrared spectra) and Nuclear magnetic resonance spectra (1H NMR and 13C NMR). Nanoclay and POSS-amine nanoreinforcements denoted as N1 and N2 were incorporated into the synthesized epoxy resins. Curing was done with diaminodiphenylmethane (DDM) and bis(3-aminophenyl)phenylphosphine oxide (BAPPO) curing agents denoted as X and Y, respectively. The thermal behaviour of the tetraglycidyl resins and their corresponding nanocomposites was studied by thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The electrical behaviour namely dielectric strength, comparative tracking index (CTI), volume resistivity, surface resistivity and arc resistance of the nanocomposites was also studied and the interesting results obtained are discussed

Development and Validation of a Stability-Indicating LC-Method for the Simultaneous Estimation of Levodropropizine, Chloropheniramine, Methylparaben, Propylparaben, and Levodropropizine Impurities

A simple, fast, and efficient RP-HPLC method has been developed and validated for the simultaneous estimation of Levodropropizine, Chloropheniramine, Methylparaben, Propylparaben, and the quantification of Levodropropizine impurities in the Reswas syrup dosage form. A gradient elution method was used for the separation of all the actives and Levodropropizine impurities by using the X-Bridge C18, 150 mm × 4.6 mm, 3.5 μm column with a flow rate of 1.0 mL/min and detector wavelength at 223 nm. The mobile phase consisted of a potassium dihydrogen orthophosphate buffer and acetonitrile. All the peaks were symmetrical and well-resolved (resolution was greater than 2.5 for any pair of components) with a shorter run time. The limit of detection for Levodropropizine and its Impurity B was 0.07 μg/ml &amp; 0.05 μg/ml, whereas the limit of quantification was 0.19 μg/ml &amp; 0.15 μg/ml respectively. The method was validated in terms of precision, accuracy, linearity, robustness, and specificity. Degradation products resulting from the stress studies were well-resolved and did not interfere with the detection of Levodropropizine, Chloropheniramine, Methylparaben, Propylparaben, and Levodropropizine Impurity B, thus the test method is stability-indicating. Validation of the method was carried out as per International Conference on Harmonization (ICH) guidelines