Influence of ceramic (feldspathic) surface treatments on the micro-shear bond strength of composite resin

Objective: To test the null hypothesis that surface treatment has no influence on the micro-shear bond strength between orthodontic composite resin cement and ceramics (feldspathic porcelain). Materials and Methods: Circular specimens of feldspathic porcelain were fabricated and randomly divided into six groups: (1) no treatment; (2) treatment with a mixture of acidic primer and silane agent for 20 seconds; (3) etching with 9.5% hydrofluoric acid; (4) etching with 9.5% hydrofluoric acid and coating with a mixture of acidic primer and silane agent for 20 seconds; (5) airborne-particle abrasion with 50-μm aluminum oxide; and (6) airborne-particle abrasion and coating with a mixture of acidic primer and silane agent for 20 seconds. The porcelain disks were then bonded to resin cylinders with composite resin cement. A micro-shear bond test was carried out to measure the bond strength. Moreover, each ceramic surface was observed morphologically by scanning electron microscopy. One-way analysis of covariance was used to compare the groups for differences in micro-shear bond strength. Results: The mean micro-shear bond strength varied as a function of surface treatment. It ranged from 3.7 to 20.8 MPa. The highest values for micro-shear bond strength were found when the surface was acid-etched with hydrofluoric acid and coated with silane. On the other hand, the control group (no treatment) had significantly lower micro-shear bond strength than all the other groups. Conclusion: The null hypothesis that the surface treatment has no influence on the micro-shear bond strength of orthodontic composite resin was rejected. The bond strength between ceramics and orthodontic resin cement is affected by the ceramic surface treatment. The bond failure was of the adhesive type, except with the hydrofluoric acid + silane group, where it was a cohesive bond failure

Pattern of anti-diabetic drugs prescribed for type 2 diabetes mellitus patients in a tertiary care hospital of India: an observational study

Background: Type 2 diabetes mellitus (T2DM) is a leading cause of significant morbidity and mortality in developing countries. Evaluation of anti-diabetic drug use pattern guides the healthcare professionals to identify early signals of irrational prescribing and to plan interventions to optimize the benefits of pharmacotherapy.Methods: Observational descriptive study was conducted on 500 prescriptions of T2DM patients collected from Outpatient department of a tertiary care hospital. Prescriptions were analysed for type, number, generic/brand names, fixed dose combinations (FDCs) of anti-diabetic drugs and anti-diabetic drugs prescribed from within National List of Essential Medicines (NLEM) 2015.Results: Average number of anti-diabetic drugs per prescription was 2.5. Of these 49% were from within NLEM and only 39% were prescribed by their generic names. Among all the anti-diabetic groups of drugs used, biguanide (32.85%) was the most frequently prescribed followed by insulins (25.4%) and DPP-4 inhibitors (13.75%). Combined drug therapy was more prevalent than monotherapy (70% versus 30%). Metformin+sitagliptin and metformin+linagliptin were most commonly prescribed fixed dose combinations.Conclusions: Recent trend of anti-diabetic drug use included newer anti-diabetic drugs in combination with metformin to achieve better euglycemia and to minimize complications of T2DM

Mini-Implant-Assisted En Masse Protraction of Maxillary Posterior Segment

Protraction of posterior teeth to close the spaces in patients with congenitally missing maxillary lateral incisors is challenging. Mini-implants are a reliable source of anchorage for this purpose. This case report demonstrates the application of a T-bar protraction appliance with a palatal mini-implant for en masse protraction of posterior teeth into the lateral incisor space in an adolescent patient. The patient’s occlusion and esthetics were significantly improved, and ideal overjet and overbite were obtained after 30 months of treatment. Follow-up records six months after the completion of the treatment displayed stable results

Lichen planus of uterine cervix - the first report of a novel site of occurrence: a case report

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Supervised conventional interferon α2a in combination with ribavirin therapy is the preferred alternative for treatment of chronic hepatitis C

Objective: To document the significant sustained virological response with supervised conventional interferon α and ribavirin therapy in hepatitis C virus (HCV)-infected patients, this study was planned. Materials and Methods: Sixty chronic hepatitis C naive patients were included in this study. Complete blood counts, prothrombin time, ALT, AST, and qualitative HCV RNA were done. Conventional interferon (INF) α2a, 3MIU, S.C and ribavirin 1000 mg PO was given as supervised therapy for 24 weeks in genotype 3 and 48 weeks in genotype 1 and 4 HCV patients. Qualitative HCV RNA was repeated at 12 weeks, 24 weeks for HCV infections with genotype 1, 2, 3 and 4, at 48 weeks for genotype 1 and 4, and thereafter 6 months after completion of treatment. End virological and sustained virological responses were observed. Results: Out of 60 patients, 55 completed the study. Five patients were lost to follow-up. Overall SVR was seen in 47 patients (85.4%) and 4 patients had relapses. Conclusion: Significant sustained virological response rates were seen in patients with supervised conventional INF α2a and ribavirin therapy

Correlation of compliance to statin therapy with lipid profile and serum HMGCoA reductase levels in dyslipidemic patients

Background: The efficacy of statin therapy may be lost or vary with reduction in compliance and intensity of statin therapy. Objective: To study and correlate the quantitative effect of compliance on lipid profile and 3-hydroxyl-3-methylglutaryl coenzyme A reductase (HMGCoA-R) levels in dyslipidemic patients. Methods: Compliance to different intensity of statin therapy assessed by pill count was correlated with serum levels of total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (TG), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and HMGCoA-R. Results: Out of 200 patients, 160 received moderate intensity statin therapy whereas 40 were on high intensity statin therapy. The overall mean compliance of patients was 56.7%. The compliance of patients on moderate intensity statin therapy was higher (56.8%) than those on high intensity (56.4%) (p = 0.92). There was significant inverse correlation (p < 0.05) between compliance and TC, TG, LDL-C and HMGCoA-R levels and positive correlation (p < 0.05) with HDL-C levels. The mean serum HMGCoA-R levels did not fall below 9–10 ng/mL when compliance to either moderate or high intensity statin therapy was increased above 60%. Conclusions: It is appropriate to improve the compliance to existing statin therapy than switching over to higher intensity statin therapy. Estimation of HMGCoA-R levels may be explored as a surrogate marker to monitor and assess the compliance of patients to statin therapy

Randomized controlled trial comparing the efficacy of daily and every other day atorvastatin therapy and its correlation with serum hydroxymethylglutaryl-CoA reductase enzyme levels in naïve dyslipidemic patients

Objective: Data regarding efficacy comparison of daily regimen (DR) versus every other day regimen (EODR) atorvastatin therapy is not validated by estimation of serum hydroxymethylglutaryl-CoA reductase (HMGCR) levels and HMGCR correlation with lipid indices. Methods: In this randomized controlled trial, we compared the efficacy of DR versus EODR by measuring lipid indices and serum HMGCR levels at baseline and after 12 weeks of 10 mg atorvastatin therapy. Primary endpoint was comparison of mean change in serum HMGCR levels and lipid indices of both groups and their correlation with each other. Secondary endpoints were assessed by estimating serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase MM (CK-MM) levels and adverse drug reactions (ADRs). Results: A total of 61 patients were enrolled of which 46 completed the study (24 in DR vs 22 in EODR group). The mean reduction in total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and non-high density lipoprotein-cholesterol (HDL-C) was significantly higher in DR group, whereas mean reduction in triglycerides (TG) and increase in HDL-C was similar in both the groups. Reduction in serum HMGCR levels was comparable in both the groups (31.17% vs 28.19%). Change in serum HMGCR levels correlated more with change in lipid indices of DR group. Also, safety parameters were similar between the two groups. Conclusion: Both the regimens achieved therapeutic goals, however DR was found to be superior as it achieved greater reduction in TC and LDL-C. Further, these findings are substantiated by correlation of lipid indices with serum HMGCR levels. Keywords: Atorvastatin, Every other day atorvastatin, Dyslipidemia, Hydroxymethylglutaryl-CoA reductase enzym

Diversity of genotype and mode of spread of Hepatitis C virus in Northern India

Background/Aim : Hepatitis C is caused by hepatitis C virus (HCV), which is classified into 6 genotypes. It leads to chronic hepatitis in 80% of the cases. Genotype of the virus helps in predicting response to antiviral therapy and also the duration of treatment. Therefore, it is important to know the prevalence of each genotype. Knowledge regarding the route of entry of HCV in the blood is also necessary to formulate a strategy to prevent its spread. Patients and Methods : One hundred and two newly diagnosed patients with chronic hepatitis C, having anti-HCV antibody-positive were included in the study. Their HCV RNA viral load and genotype were determined by Reverse Transcriptase PCR assay on Roche Cobas Ampliprep analyzer. Results : Genotype 3 was commonly detected in 58.8% patients followed by genotype 1 in 20.6%. Twelve patients had genotype 4 (11.8%) and 9 had mixed infection with genotypes 3 and 4. Among these patients, 43.1% of patients had a history of multiple injection exposure. Blood transfusion received by 6.9% and 2.9% had donated blood. Only 1 patient had a history of drug abuse. Conclusion : The distribution of genotypes varies in different regions and therefore its knowledge is important, as it determines the response of the patient to the treatment. The use of autodisabled syringes, their proper disposal, following biomedical waste management guidelines, and organizing continued medical education and workshops will help in preventing the spread of HCV infection

Clinicomycological study of dermatophytoses in children: Presenting at a tertiary care center

Background: Superficial tinea infections are some of the most common dermatological conditions in children. Recently, few studies done showed abrupt increase in dermatophytic infection in adults; however, similar recent studies describing clinicoepidemiological pattern in pediatric population are lacking. Aims and Objectives: The aims and objectives of this study are to identify the epidemiological profile of the dermatophytoses among pediatric population. Materials and Methods: Pediatric patients with suspected tinea infections presenting in the Department of Dermatology at a tertiary care medical college hospital in Northern India from April 2016 to 2017 were evaluated for inclusion in this study. Samples were collected in two parts; if first part was found to be potassium hydroxide (KOH) positive for septate hyphae, the second part was sent for fungal culture subsequently. Statistical Analysis Used: SPSS version 20 was used for statistical analysis. Results: Out of 235 patients, 152 were male and 83 were female. Only 200/235 (85.1%) KOH positive enrolled patients yielded positive fungal culture. Most common species identified on culture was Trichophyton mentagrophytes, followed by Trichophyton rubrum, and Trichophyton violaceum. Trunk was the most common site affected in 29.4% patients, palms and soles were least affected. Conclusion: More number of patients applied topical steroid for a longer period of time in patients with extensive disease as compared to limited disease. The present study provides evidence that dermatophytosis in pediatric patients is following the pattern of adult dermatophytosis clinically and microbiologically now

Gender and growth variation in palatal bone thickness and density for mini-implant placement

Abstract Background The objective was to compare the palatal bone thickness (PBT) and palatal bone density (PBD) in the anterior, middle, and posterior part of the palate in males and females. Methods This retrospective study reviewed cone beam computed tomography scans of 359 patients. The scans were divided into 99 growing males, 105 growing females, 74 non-growing males, and 81 non-growing females. The measurements of PBT and PBD were made in between the canine and first premolar, the first premolar and second premolar, the second premolar and first molar, and the first molar and second molar. The measurements were made in the center of the palate and 4 mm away from the center. ANOVA was used to analyze the PBT and PBD in different areas between four different groups. Results The PBT was lower (P <  0.0001) as we moved from the anterior to the posterior palate. The PBT was more (P <  0.001) in the center of the palate than 4 mm away from the center, except in between the canine and first premolar. The growing male and non-growing male had higher (P <  0.0001) PBT than the growing female and non-growing female in between the canine and first premolar and the first premolar and second premolar both in the center and 4 mm away from it. The PBD was higher (P <  0.05) in between the canine and first premolar area at the center of the palate and between the second premolar and first molar 4 mm away from the center in all the experimental groups. Conclusions There exists a definite gender and growth variation in the PBT and PBD in different parts of the palate. Palatal bone thickness between the males and females revealed that the males had significantly higher PBT than the females