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Rutin is a flavonoid glycoside abundant in many plants exhibiting pharmacological activities like antioxidant, anticancer, anti-inflammatory and antimicrobial activities. Plant biomarkers suffer low bioavailability and solubility that lack clinical effectiveness. The smart nanoparticles conversion addresses this limitation with optimal particle size and targeted drug delivery. The present study involves QbD approach for formulation of Rutin silver nanoparticles and evaluation of antioxidant, anticancer and anticlastogenic potential. QbD experimentation involved particle size and drug release as dependent variables over the silver nitrate concentration, methanol and sonication time as independent variables devising 15 formulations (F1 –F15). F12 formulation was found to be optimized with 126.3 nm average size, stable and dispersible characterized by UV, FTIR, SEM and DLS studies. The calibration curve of Rutin was plotted at 352 nm with linearity (LOD = 0.061 μg/ml and LOQ = 0.187 μg/ml). The invitro drug release studies by USP dissolution apparatus I (Basket type) proved the sustained release characteristics with 97.3 % drug release when compared to the Rutin. The pharmacological screening for potential antioxidant and anticancer activity on G361 and MCF 7 cell line of F12 formulation have shown promising results and also enhanced solubility in water compared to Rutin. Anticalstogenic potential as a function of induced micronuclei frequency was evaluated as a characteristic feature in bone marrow cells obtained from mice. Results indicate pre-treatment with the F12 reduced frequency of micronuclei in mouse bone marrow cells caused by Cyclophosphamide (CP) significantly. The protective effect of F12 in suppression was demonstrated at both dosages of 100 and 200 mg/kg. Thus the findings suggest the novel Rutin silver nanoparticles as lead drug serving as antioxidant, anticancer and anticlastogenic agent.

Background: Patients around the world when attending the dental clinic are prone to undergo the feelings of fear and anxiety. This may impact the dental follow-up and prognosis. Aim: The aim of the study is to evaluate the dental anxiety in the patients attending for the dental treatment in a college, in India. Materials and Methods: A sample of 500 adults with ages 15–60 years was considered for the study. Modified dental anxiety questionnaire was used in the present study to assess the anxiety faced by the patients attending for the dental treatment. ANOVA and Chi-square test were used to test for the significance between the variables, and the correlation between these variables was assessed using the Spearman's correlation. Likert scale was used to know the cutoff for the severity of the dental anxiety. Results: Only in the 4% of the participants in the present study had dental anxiety. Gender, age, financial status, education impacted the dental anxiety and the regularity toward the appointments. Conclusion: It can be concluded from our study that there was a low anxiety in the dental patients toward the dental treatment and also anxiety decreased with the age. However, regular dental visits are advised to prevent the overall impact of the oral health on the general health.

Pain is most common symptom associated with progressive disorder, chronic kidney disease (CKD), and is usually undertreated during the early stages of CKD. So, present review was conducted to evaluate the challenges for the management of pain in CKD patients and addresses the scope for considering Diclofenac as suitable alternative for pain management in CKD patient. The database PubMed and Google Scholar were searched from 1970 to Dec 2020 for literature published in English and all studies, review articles that examined the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in pain management in CKD patients were included. Literatures revealed that there is a considerable challenge in appropriate management of pain in CKD patients include understanding the altered pharmacokinetics and pharmacodynamics of analgesics in CKD patients and the risk of acute interstitial nephritis. The shorter duration of analgesics is acceptable and considered to pose a low risk of acute interstitial nephritis in patients. Considering that Diclofenac has a shorter half-life and high efficacy, it may be well tolerated in patients with CKD. The acceptance of Diclofenac is partly attributed to being a potent COX-2 inhibitor with the lowest IC50 and its rapid onset of action at lowest effective dose. In conclusion, diclofenac may be well tolerated in patients of renal impairment when used at lowest effective dose for shortest dose duration. Diclofenac is worthy of consideration in mild to moderate cases of CKD. For effective pain management, it is vital to evaluate the tolerability and efficacy of the available analgesics critically.

Aim: The aim of this study was to evaluate the relationship of central corneal thickness (CCT) with age, sex, refractive status, and keratometry (KM). Materials and Methods: In our cross-sectional study, 1000 eyes of 500 patients from the outpatient department were randomly selected between July 2014 and December 2015. CCT was measured with a Humphrey ultrasonic pachymeter. Horizontal and vertical curvatures of the cornea were measured with a Bausch and Lomb keratometer, and its mean was calculated. Refractive state was measured with a Priestley-Smith retinoscope and converted to spherical equivalent (SE). The patients were divided into three age groups (Group A [16–30 years], Group B [31–45 years], and Group C [46–60 years]), and the data were analyzed statistically by the Statistical Package for the Social Sciences programme. Results: The mean SE, KM, and CCT of the patients under the study were(-) 0.47 ± 2.26, 43.79 ± 1.18D, and 528.41 ± 19.1 μm. The mean CCT was higher in age Group C (46–60 years) than other groups (P = 0.008), but we found that an increase in age has no impact on CCT after regression analysis. CCT was not affected by sex (p = 0.168). The mean CCT for myopic patients was 522.87 ± 18.03 μm, which was less compared to 536.39 ± 17.753 μm in hypermetropic patients (p ≤ 0.001). Positive correlation was found between CCT and SE (r = 0.520,P≤ 0.001). KM showed negative correlation with CCT (r = −0.288,p≤ 0.001). Conclusion: From our study, we concluded that CCT was related to age, refractive status, and KM, but not to sex.

Introduction: In early childhood, children are more susceptible to opportunistic microbial colonization in the oral cavity due to immature immune system and not fully established micro flora. The current literature proposes a probable role of Candida albicans, a fungus in the etiopathogenesis of dental caries. Aim: This study was conducted to compare the Candida albicans count in children with severe early childhood caries and caries free children. Materials and Methods: A cross-sectional study was conducted in 40 randomly selected healthy children between 12 to 71 months of age, who were divided into two groups based on the caries experience as Severe Early Childhood Caries (SECC) (dmfs ≥4) and caries free (dmfs = 0). The caries experiences (dmfs index) of the 40 children were recorded using visible light and diagnostic instruments. A 2ml sample of unstimulated whole saliva collected from the children was transported to the microbiology laboratory in universal containers and evaluated for Candida albicans count using the selective media. The data was statistically analyzed using SPSS software 17.0. Results: Candida albicans was found in both the SECC group and caries free group. Median Candida albicans of the SECC group was numerically greater than the caries free group and this difference was highly statistically significant (p=0.012). Conclusion: In this present cross-sectional study, we found a 100% prevalence of Candida albicans in the saliva of the study children. There was a highly significant increase in Candida albicans count in SECC children compared to the caries free children.

Introduction: The caries process has been thought to be irreversible, resulting in the permanent loss of tooth substance and eventually the development of a cavity. Recent approaches focused on application of remineralizing agents to incipient carious lesions, aim at controlling demineralization and promoting remineralization. Remineralizing agents create a supersaturated environment around the lesion; thus, preventing mineral loss and forces calcium and phosphate ions in the vacant areas. Aim: To compare and evaluate the remineralization potential of Fluoride Varnish, CPP-ACP Paste (Casein PhosphopeptideAmorphous Calcium Phosphate) and fTCP Paste (functionalized Tricalcium Phosphate) using confocal microscope. Materials and Methods: Two windows of 3X3mm were created on the labial cervical and incisal thirds in 60 permanent maxillary central incisors. The teeth were demineralized to create artificial caries and divided into three groups of 20 each. Group I specimens were coated with Fluoride Varnish once whereas those in CPP-ACP paste group and fTCP group were brushed for 2 minutes, twice daily for 20 and 40 days. The specimens were stored in artificial saliva during the study period and were later sectioned and observed under confocal microscope. Data obtained was statistically analyzed using Fischer’s exact test, ANOVA and post-hoc Bonferroni’s test. Results: Fluoride Varnish, CPP-ACP Paste and fTCP Paste showed remineralization of artificial carious lesions at both the time intervals. Fluoride varnish showed the highest remineralization followed by CPP-ACP Paste and fTCP Paste. A statistically significant increase in remineralization potential of CPP-ACP Paste and fTCP Paste was observed at the end of 40 days as compared to 20 days. Conclusion: Fluoride varnish showed the greatest remineralization potential of artificial carious lesions followed by CPPACP Paste and fTCP Paste respectively.