A comparative evaluation of smear layer removal using apical negative pressure (EndoVac), sonic irrigation (EndoActivator) and Er:YAG laser - an in vitro SEM study

This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy. 40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test. The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups. None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal

Comparative evaluation of antibacterial effect of nanoparticles and lasers against Endodontic Microbiota : an in vitro study

Present study was conducted with the aim of evaluating antimicrobial efficacy of silver (AgNP) and gold nanoparticles (AuNP) with and without Nd: YAG laser (L) irradiation against experimentally inoculated Enterococcus faecalis in infected human root dentin. 120 extracted single rooted human teeth were prepared and inoculated with E. faecalis for 24 hrs. The teeth were then randomly divided into 4 experimental group: AgNPs group: irrigation for 3minutes with 50 ?l of 100 ppm, the AuNPs group: irrigation with 50 ?l of 100 ppm, the AgNPs & Nd: YAG lasers group: irrigation with 50 ?l of 100 ppm + irradiation with 1.5W laser for 60 seconds, the AuNPs & Nd: YAG lasers group: irrigation with 50 ?l of 100 ppm + irradiation with 1.5W laser for 60 seconds. One control group consisting of 2% CHX irrigation for 3 minutes was also there (n = 20). The specimens were collected from the canal before and after irrigation, and colony forming units were observed. Significant difference was found among all the groups in comparison to the control group (p<0.05). The greatest reduction in CFU?s was observed with combination of AgNPs & Nd: YAG lasers group. AgNPs in combination with Nd: YAG laser irradiation has the potential to be used as root canal disinfectant

A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis

Aim of this trial was to evaluate the combined clinical and radiographic success rate of endodontic treatment using passive ultrasonic irrigation (PUI) and laser activated irrigation (LAI) as compared to conventional syringe irrigation. Permanent incisors and single rooted premolars were assessed for eligibility and 69 patients were randomly divided into three treatment groups (n=23) by allocation concealment method and irrigation was performed in accordance with the allocated group. Teeth were evaluated clinically and radiographically with CBCT after 6 months and 12 months of the treatment. A significant difference was observed in the radiographic healing rates among three groups (?2=12.29, p=0.05). On comparing the final outcome among the three groups (n=19), it was found that 2 (10.5%) cases of group I(Conventional Syringe irrigation), 7 (36.8%) cases of group II (Passive ultrasonic irrigation) and 8 (42.1%) cases of group III(Laser activated irrigation) were healed while under healing category 13 (68.4%) cases of group I, 12 (63.2%) cases of group II and 11 (57.9%) of group III were observed whereas 4 (21.1%) cases were categorised as diseased in group I only. LAI and PUI can increase the predictability of the endodontic treatment success in cases of chronic apical periodontitis

Establishment of the mechanism of purification and levigation of green chemistry-assisted biocomposites of red ochre (Gairika): synthesis, characterization, and antibacterial, prebiotic, antioxidant, and antacid activities of the traditional Ayurvedic medicine Laghu Sutashekhara Rasa

Gairika (red ochre) has a long history of influencing human civilization. Gairika is a rich source of nutrients used for reproductive and brain health. Gairika is mentioned as an antacid drug in Indian Ayurvedic medicine under Laghu Sutashekhara Rasa (LSR). However, a detailed study on LSR has not been reported to date. In the present study, LSR was prepared, and a pharmaceutical SOP (standardization procedure) was reported to obtain batch-to-batch reproducibility. LSR was characterized using FTIR, XRD, SEM-EDX, and TGA analyses. LSR was tested in vitro for its antacid activity. Advanced instrumentation revealed that LSR formation produced symmetrical particles (5–8 µm) with kaolin, kaolinite, quartz, goethite, and hematite, along with the phytoconstituents of Goghrita (clarified cow’s butter), Shunthi, and Nagawalli, as confirmed by GC-MS/MS analysis. The FTIR study revealed the formation of a chelating complex of goethite and hematite along with their phytoconstituents. XRD analysis confirmed the presence of kaolin, kaolinite, quartz, goethite, and hematite. Using in vitro antacid experiments, LSR and Shunthi demonstrated significant antacid activity as compared to antacid drugs and standards in the market, such as CaCO3. The DPPH assay revealed IC50 values of 12.16 ± 1.23 mg/mL, which is 0.0029 of Trolox-equivalent antioxidant activity. The inhibition (18 ± 4 mm) against pathogens (S. aureus, E. coli, P. aeruginosa, and B. subtilis) and the prominent growth of gut microbiota-supported strains (S. boulardii, L. paracasei, and L. plantarum) observed on LSR formulation were indicative of LSR application as a prebiotic. Here, the mechanism of purification and levigation mentioned in the classical literature of LSR was established. Overall, purification of Gairika with cow ghee and levigation with Nagawalli may enhance the solubility, bioavailability, and shelf-life of LSR through hydration and co-crystallization mechanisms. This is the first comprehensive report on the pharmaceutical validation of LSR and its characterization. The results of the present study could contribute to the development and reliable reproduction of LSR and the utility of environmental red ochre as a medicine in combination with Shunthi (Zingiber officinale Roxb.), as prescribed under Indian Ayurvedic medicine

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Comparison of Algorithms for Social Networks using Ontology

The choice of appropriate algorithm(s) to the large graphs like social networks is always a challenge to the researchers for different applications. In this work, we propose a model to compare algorithms for large graphs such as social networks using ontology. Using ontology, the features and the dimensions of the social networks are summarized properly and through experiments it is shown how to choose any algorithm for a given objectives

Crop Residue Burning and Its Relationship between Health, Agriculture Value Addition, and Regional Finance

Crop residue burning (CRB) poses a serious threat to the climate, soil fertility, human health and wellbeing, and air quality, which increases mortality rates and slumps agricultural productivity. This study conducts a pan-India analysis of CRB burning based on the spatial characteristic of crop residue management practices and analyzes the linkage among health, agriculture value addition, and regional finance using the simultaneous equation to find the causality and panel quantile regression for direct effect and intergroup difference. We discuss some of the alternative crop residue management practices and policy interventions. Along with in situ management, this paper discusses ex situ crop residue management (CRM) solutions. The ex situ effort to manage crop residue failed due to the scarcity of the supply chain ecosystem. Force of habit and time constrain coupled with risk aversion have made farmers reluctant to adopt these solutions. Our results show that financial viability and crop residue have bidirectional causality; therefore, both the central and state governments must provide a financial solution to lure farmers into adopting residue management practices. Our analysis shows that framers are likely to adopt the management solution (farmers have some economic benefits) and are reluctant to adopt the scientific solution because the scientific solution, such as “pusa decomposer”, is constrained by the weather, temperature, and humidity, and these parameters vary throughout India