Evaluation of salivary nitric oxide levels in caries-free children and children with early childhood caries: An in vivo study

Background and Objectives: Early childhood caries (ECC) is one of the most prevalent diseases of childhood. Pediatric dentists must make conscious efforts to prevent this condition for optimal oral health. Normal salivary function is considered critical for the maintenance of a healthy oral cavity. Saliva provides an easily available, noninvasive medium for the diagnosis of wide range of diseases and clinical conditions. The objective of the present study was to estimate and compare salivary nitric oxide (NO) levels in caries-free children and children with ECC. Methodology: The children were divided into two groups. Group I comprised thirty caries-free children and Group II comprised thirty children with ECC. Saliva was collected by suction method. Griess reaction was used to estimate the NO levels. Unpaired t-test was used for comparing and evaluating the NO levels in both the groups. Results: Mean salivary Nitric Oxide level is significantly higher in caries free children as compared to that of children with early childhood caries (ECC). Interpretation and Conclusion: The present study clearly indicates a significant increase in salivary NO levels in caries-free children as compared to children with caries. This may be attributed to the antimicrobial action of NO

Duration of post-operative hypocortisolism predicts sustained remission after pituitary surgery for Cushing’s disease

Purpose: Transsphenoidal surgery (TSS) is the primary treatment modality for Cushing’s disease (CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long-term recurrence rates, as well as their respective predictive factors. Methods: A retrospective analysis of case records of 230 CD patients who underwent primary microscopic TSS at our tertiary care referral centre between 1987 and 2015 was undertaken. Demographic features, pre- and post-operative hormonal values, MRI findings, histopathological features and follow-up data were recorded. Remission and recurrence rates as well as their respective predictive factors were studied. Results: Overall, the post-operative remission rate was 65.6% (early remission 46%; delayed remission 19.6%), while the recurrence rate was 41% at mean follow-up of 74 ± 61.1 months (12–270 months). Significantly higher early remission rates were observed in patients with microadenoma vs macroadenoma (51.7% vs 30.6%, P = 0.005) and those with unequivocal vs equivocal MRI for microadenoma (55.8% vs 38.5%, P = 0.007). Patients with invasive macroadenoma had poorer (4.5% vs 45%, P = 0.001) remission rates. Recurrence rates were higher in patients with delayed remission than those with early remission (61.5% vs 30.8%, P = 0.001). Duration of post-operative hypocortisolemia ≥13 months predicted sustained remission with 100% specificity and 46.4% sensitivity. Recurrence could be detected significantly earlier (27.7 vs 69.2 months, P < 0.001) in patients with available serial follow-up biochemistry as compared to those with infrequent follow-up after remission. Conclusion: In our study, remission and recurrence rates were similar to that of reported literature, but proportion of delayed remission was relatively higher. Negative/equivocal MRI findings and presence of macroadenoma, especially those with cavernous sinus invasion were predictors of poor remission rates. In addition to early remission, longer duration of post-operative hypocortisolism is an important predictor of sustained remission. Regular biochemical surveillance may help in identifying recurrence early