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Abstract Background Interferon-gamma (IFNγ) exerts potent growth inhibitory effects on a wide range of cancer cells through unknown signaling pathways. We pursued complementary screening approaches to characterize the growth inhibition pathway. Methods We performed chemical genomics and whole genome targeting CRISPR/Cas9 screens using patient-derived melanoma lines to uncover essential nodes in the IFNγ-mediated growth inhibition pathway. We used transcriptomic profiling to identify cell death pathways activated upon IFNγ exposure. Live imaging experiments coupled with apoptosis assays confirmed the involvement of these pathways in IFNγ-mediated cell death. Results We show that IFNγ signaling activated ERK. Blocking ERK activation rescued IFNγ-mediated apoptosis in 17 of 23 (~ 74%) cell lines representing BRAF, NRAS, NF1 mutant, and triple wild type subtypes of cutaneous melanoma. ERK signaling induced a stress response, ultimately leading to apoptosis through the activity of DR5 and NOXA proteins. Conclusions Our results provide a new understanding of the IFNγ growth inhibition pathway, which will be crucial in defining mechanisms of immunotherapy response and resistance.

Conversion of patellofemoral arthroplasty to total knee arthroplasty (TKA) has been described as similar to primary TKA, although it may come with more challenges and worse outcomes. With the increased rate of revision following conversion TKA vs primary TKA, robotically assisted TKA provides an alternative technique to manual conversion. We present 3 cases of robot-assisted conversion of prior patellofemoral arthroplasty to TKA with good mechanical and clinical outcomes and no intraoperative complications.

Objectives: To study the relationship between serum-free T3 (FT3), C-reactive protein (CRP) and all-cause mortality in patients with acute myocardial infarction (AMI). Design: Prospective multicentre longitudinal cohort study. Methods: Between December 2014 and December 2016, thyroid function and CRP were analysed in AMI (both ST-elevation (STEMI) and non-ST-elevation) patients from the Thyroxine in Acute Myocardial Infarction study. The relationship of FT3 and CRP at baseline with all-cause mortality up to June 2020 was assessed. Mediation analysis was performed to evaluate if CRP mediated the relationship between FT3 and mortality. Results: In 1919 AMI patients (29.2% women, mean (s.d.) age: 64.2 (12.1) years and 48.7% STEMI) followed over a median (interquartile range) period of 51 (46–58) months, there were 277 (14.4%) deaths. Overall, lower serum FT3 and higher CRP levels were associated with higher risk of mortality. When divided the patients into tertiles based on the levels of FT3 and CRP; the group with the lowest FT3 and highest CRP levels had a 2.5-fold increase in mortality risk (adjusted hazard ratio (95% CI) of 2.48 (1.82–3.16)) compared to the group with the highest FT3 and lowest CRP values. CRP mediated 9.8% (95% CI: 6.1–15.0%) of the relationship between FT3 and mortality. Conclusions: In AMI patients, lower serum FT3 levels on admission are associated with a higher mortality risk, which is partly mediated by inflammatio n. Adequately designed trials to explore the potential benefits of T3 in AMI patients a re required.

In the original publication [...]

Dilated cardiomyopathy (DCM) is a cardiac condition with structural and functional impairment, where either the left ventricle or both ventricular chambers are enlarged, coinciding with reduced systolic pump function (reduced ejection fraction, rEF). The prevalence of DCM is more than 1:250 individuals, and mortality largely due to heart failure in two-third of cases, and sudden cardiac death in one-third of patients. Damage to the myocardium, whether from a genetic or environmental cause such as viruses, triggers inflammation and recruits immune cells to the heart to repair the myocardium. Examination of myocardial biopsy tissue often reveals an inflammatory cell infiltrate, T lymphocyte (T cell) infiltration, or other activated immune cells. Despite medical therapy, adverse outcomes for DCM remain. The evidence base and existing literature suggest that upregulation of CX3CR1, migration of immune cells, together with cytomegalovirus (CMV) seropositivity is associated with worse outcomes in patients with dilated cardiomyopathy. We hypothesise that this potentially occurs through cardiac inflammation and fibrosis, resulting in adverse remodelling. Immune modulators to target this pathway may potentially improve outcomes above and beyond current guideline-recommended therapy.

Introduction Anthracyclines are included in chemotherapy regimens to treat several different types of cancer and are extremely effective. However, it is recognised that a significant side effect is cardiotoxicity; anthracyclines can cause irreversible damage to cardiac cells and ultimately impaired cardiac function and heart failure, which may only be evident years after exposure. The PROACT trial will establish the effectiveness of the ACE inhibitor enalapril maleate (enalapril) in preventing cardiotoxicity in patients with breast cancer and non-Hodgkin’s lymphoma (NHL) receiving anthracycline-based chemotherapy.Methods and analysis PROACT is a prospective, randomised, open-label, blinded end-point, superiority trial which will recruit adult patients being treated for breast cancer and NHL at NHS hospitals throughout England. The trial aims to recruit 106 participants, who will be randomised to standard care (high-dose anthracycline-based chemotherapy) plus enalapril (intervention) or standard care alone (control). Patients randomised to the intervention arm will receive enalapril (starting at 2.5 mg two times per day and titrating up to a maximum dose of 10 mg two times per day), commencing treatment at least 2 days prior to starting chemotherapy and finishing 3 weeks after their last anthracycline dose. The primary outcome is the presence or absence of cardiac troponin T release at any time during anthracycline treatment, and 1 month after the last dose of anthracycline. Secondary outcomes will focus on cardiac function measured using echocardiogram assessment, adherence to enalapril and side effects.Ethics and dissemination A favourable opinion was given following research ethics committee review by West Midlands—Edgbaston REC, Ref: 17/WM/0248. Trial findings will be disseminated through engagement with patients, the oncology and cardiology communities, NHS management and commissioning groups and through peer-reviewed publication.Trial registration number NCT03265574.

Abstract Background There are scenarios where pre-mixing and infusing analgesic and anaesthetic agents as a single intravenous (IV) solution is highly desirable; however, it is important to ensure the agents are compatible when mixed. As such, the long-term stability of a remifentanil-propofol mixture, and means of improving this, were assessed across a range of remifentanil concentrations, diluents, and time points. Methods Remifentanil was reconstituted with ultrapure water, 0.9% saline, 20% saline, or 8.4% sodium bicarbonate solution (the latter two chosen for their pH characteristics, rather than their use in pharmaceutical reconstitution) and then mixed with propofol (1%) or further diluted with water to derive concentrations of 10–50 μg mL− 1. Remifentanil and propofol concentrations were determined initially and then periodically for up to 24 h using high performance liquid chromatography (HPLC). Mass spectrometry (MS) was used to detect degradation products in solutions containing 30 μg mL− 1 of remifentanil. Statistical analysis was performed using ANOVA and Student’s t-test, with a significance value of 0.05. Results Isolated remifentanil (pH

Background: Routine testing of hemodialysis patients for COVID-19 (outside of those identified as “at risk” based on regional practice) is not universally recommended. However, there is variability in the clinical presentation of COVID-19; patients may experience symptoms that do not meet regional criteria for testing and some patients with active infection may be asymptomatic. To avoid missing individuals who are infected, consideration could be made for regular screening, particularly among those residing in areas with evidence of community spread. Objective: To describe the clinical characteristics, symptom burden, and COVID-19 status in a cross-section of hemodialysis patients residing in areas with evidence of community spread. Design: Cross-sectional study. Setting: Three hemodialysis units in a large tertiary care facility in Nova Scotia, Canada. Patients: In-center hemodialysis patients who resided in areas with evidence of community transmission at the time of the study. Methods: All dialysis patients (irrespective of whether or not they resided in areas with community spread) completed a standard “at-risk” questionnaire for COVID-19 based on (1) 2 or more of new or worsening cough, fever greater than 38°C, sore throat, headache, runny nose/new or acute respiratory illness consistent with infection or (2) any one of close contact with a known/suspected case, travel outside of the province or residence in a facility with an outbreak prior to entry into the dialysis unit at each treatment. Patients residing in areas with evidence of community spread were swabbed for SARS-CoV-2 over a 1-week period (May 1-7, 2020) using a combined oropharyngeal/nares swab irrespective of whether or not they were identified as “at-risk.” Measurements: Baseline characteristics of patients were acquired using electronic records. In addition to the “at-risk” questionnaire, patients answered “yes” or “no” to any of the following symptoms at the time of the swab (sneeze, fatigue, myalgia, nausea/vomiting, diarrhea, malaise, abdominal pain, loss of taste, and loss of smell). Results: Of the 334 patients receiving dialysis at the time of the study, 133 resided in areas with evidence of community transmission and 104 consented for the study. No patients met our regional criteria for being “at-risk” and no patients reported cough, sore throat or fever at the time of swab. Many other symptoms were noted, including sneezing (24%), fatigue (16%), myalgias (11%), nausea/vomiting (11%), loss of taste (4%), and loss of smell (4%). Overall, 100% of swabs performed for this study were negative for SARS-CoV-2. Limitations: Single-center study, and the daily new case rate was exceedingly low (4-14) at the time of the study, emphasizing that the findings are not generalizable to areas of higher prevalence of SARS-CoV-2. Conclusions: In this study of hemodialysis patients residing in areas with community spread who otherwise did not meet symptom criteria for being “at-risk,” we did not identify any individual who tested positive for SARS-CoV-2. Future studies are needed to examine the utility of routine testing for COVID-19 (outside of those who are “at-risk”) in areas of higher disease prevalence. Trial Registration: Not applicable as this is not a clinical trial.

Background Guidelines recommend heart team discussion and coronary artery bypass graft consideration in patients with proximal left anterior descending (LAD) artery stenosis. Evidence suggests that outcomes of proximal LAD angioplasty might not differ from treatment of nonproximal LAD locations. We aim to determine clinical outcomes of patients undergoing percutaneous coronary intervention in the proximal LAD segment in comparison with nonproximal LAD angioplasty, using a thin‐strut drug‐eluting stent. Methods and Results In this analysis of the e‐Ultimaster registry, patients undergoing angioplasty in the proximal LAD territory were compared with those treated in nonproximal LAD locations. Multivariate analysis and propensity score were used to adjust for differences among the groups. The primary outcome was target lesion failure: a composite of cardiac death, target‐lesion–related myocardial infarction, and/or clinically driven target lesion revascularization at 1‐year follow‐up. Of the 17 805 patients (mean age, 64.2±11; 76% male), 5452 (30.6%) underwent proximal LAD and 12 353 (69.4%) nonproximal LAD percutaneous coronary intervention. Patients in the proximal LAD group had more multivessel disease (48.7% versus 43.5%; P

Triple-negative breast cancer (TNBC) occurs in 10–15% of all breast cancer patients, yet it accounts for about half of all breast cancer deaths. There is an urgent need to identify new antitumor targets to provide additional treatment options for patients afflicted with this aggressive disease. Preclinical evidence suggests a critical role for insulin-like growth factor-2 (IGF2) and androgen receptor (AR) in regulating TNBC progression. To advance this work, a panel of TNBC cell lines was investigated with all cell lines showing significant expression of IGF2. Treatment with IGF2 stimulated cell proliferation in vitro (p < 0.05). Importantly, combination treatments with IGF1R inhibitors BMS-754807 and NVP-AEW541 elicited significant inhibition of TNBC cell proliferation (p < 0.001). Based on Annexin-V binding assays, BMS-754807, NVP-AEW541 and enzalutamide induced TNBC cell death (p < 0.005). Additionally, combination of enzalutamide with BMS-754807 or NVP-AEW541 exerted significant reductions in TNBC proliferation even in cells with low AR expression (p < 0.001). Notably, NVP-AEW541 and BMS-754807 reduced AR levels in BT549 TNBC cells. These results provide evidence that IGF2 promotes TNBC cell viability and proliferation, while inhibition of IGF1R/IR and AR pathways contribute to blockade of TNBC proliferation and promotion of apoptosis in vitro.

This article explores the relationship between the Anti-Defamation League (ADL) and the John Birch Society (JBS) in the 1960s. The ADL, along with other liberal organizations, worked to counter the activities of the far-right JBS, which had members with antisemitic views. The ADL's efforts were effective in pressuring the JBS to distance itself from antisemitism, but the ADL's focus shifted to countering left-wing movements in the late 1960s. This shift allowed the JBS's far-right ideas to gain more mainstream acceptance through the rise of the New Right in the 1970s. [Extracted from the article]

The article considers the 1950s history of the right-wing popular front which embraced anti-Semitic and/or conspiratorial elements of the right, by discussing the magazine "American Mercury" and its owner Russell Maguire. It reports businessman Maguire gained control of the magazine in 1952 which was at that point under the editorial leadership of William Bradford Huie became the editor. It provides background of Maquire's education, business experience, and character and an overview of conservatism during the period.

We have successfully treated 20 patients with atrial fibrillation using antazoline hydrochloride (Arithmin) and have converted them to a normal sinus rhythm. The dosage used has varied from 100 mg three times daily to 200 mg four times daily orally. In no case did we use the injectable form. We have observed minimal side effects, although two patients had a parkinsonian reaction which was completely reversible after the drug was discontinued. The drug also has been effective in atrial flutter, premature ventricular contractions and atrial tachycardia. [ABSTRACT FROM AUTHOR]

Objective To determine whether drug-eluting stent (DES) use varies among Scottish hospitals, and the extent to which any variations are explained by differences between operators, patients and lesions. Methods Multi-level analysis of consecutive patients treated with percutaneous coronary intervention (PCI) between April 2005 and March 2006 in Scotland, using the Scottish Coronary Revascularization Registry. Results A total of 38 operators performed 5967 PCI procedures on 8489 lesions. Crude level of DES use was 47.6%, and the results varied among hospitals (range 30.6–61.8%, χ2 = 341.6, P Conclusions Within Scotland, marked variation existed among hospitals in the use of DES. Operator was the most important factor at patient level, and hospital of treatment, rather than case-mix, was the most important modifier of between-operator variation. Patient selection for DES is complex and may contribute to much of the variations demonstrated. Consensus criteria would provide more detail than is included in current guidance, may aid decision-making for individual patients, reduce opportunity costs and ensure equity of access. [ABSTRACT FROM AUTHOR]

Background and Objectives: Early detection and treatment of oral cancer will significantly improve the survival rate and prognosis of the patients. Adjunctive diagnostic aids such as vital staining have been developed to supplement clinical examination and improve the diagnosis. The current study was conducted to evaluate the diagnostic efficacy of acetic acid (2%) (AA), lugol's iodine (3% dilution) (LIS), and toluidine blue (1%) (TBS) in oral leukoplakia (OL) and erosive variant of oral lichen planus (OLP). Materials and Methods: A hospital-based, cross-sectional study was conducted with 30 randomly selected subjects having clinically proven cases of OL and erosive OLP. Every patient underwent AA, LIS, and TBS application to their oral lesions in a sequential manner. Subsequently, clinical and histopathologic diagnosis was compared with staining results of each. Cases which were diagnosed as epithelial hyperplasia were considered as a control group. Data are presented in numbers and percentages. Chi-square test was used to compare between TBS, LIS and AA. Diagnostic efficiency and reliability was calculated by sensitivity and specificity test in terms of its utility in predicting the dysplastic nature of the lesion. Results: Sensitivity of both TBS and LIS staining was calculated as 90.48% whereas the specificity of the former test was 22.22% and latter was 11.11%. AA test showed a sensitivity of 57.14% and specificity of 33.33%. Multiple comparisons of staining with three agents and the histopathologic variants did not show any statistically significant difference. Conclusion: TBS and LIS staining showed high sensitivity in diagnosing OL and erosive OLP compared to AA. The specificity of all three modalities used was low.

Background: Various nonsurgical interventions have been used for the management of patients with temporomandibular joint (TMJ) disorders, but their clinical effectiveness remains unclear. Hence, the purpose of this systematic review and meta-analyses was to assess the evidence of the effectiveness of nonsurgical interventions in the management of TMJ disorders. Materials and Methods: A literature search on five databases such as PubMed, PubMed Central Cochrane, TRIP, NGCH databases and hand searching was conducted for a period from October 1995 to 2015. Randomized control trials (RCTs) on the nonsurgical management of TMJ disorders were included and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the articles was assessed by JADAD scoring. Finally, out of 23 RCTs, 11 articles having any of the primary outcomes (pain pressure threshold [PPT], pain, maximal pain-free mouth opening, and level of dysfunction) were selected. The extracted data were analyzed using NCSS software. Results: The results showed the evidence of pain reduction (P = 0.00), maximal pain-free mouth opening (P = 0.0138), and decrease in level of dysfunction (P = 0.0007) but no improvement in PPT to a significant level (P = 0.6600). Conclusion: Our results suggest that the simplest, cost-effective nonsurgical treatments have a positive therapeutic effect on the initial management of TMJ disorders. However, a consistent methodology recording both the objective and subjective outcomes would be a better choice for added reliability.

Marfan syndrome (MFS) is the autosomal dominant-inherited multisystem connective-tissue disorder, with a reported incidence of 1 in 10,000 individuals and equal distribution in both genders. The main clinical manifestation of this disorder consists of an exaggerated length of the upper and lower limbs, hyperlaxity, scoliosis, alterations in the cardiovascular and pulmonary systems, and atypical bone overgrowth. Orofacial manifestations such as high-arched palate, hypodontia, long narrow teeth, bifid uvula, mandibular prognathism, and temporomandibular disorders are also common. Early diagnosis of MFS is essential to prevent the cardiovascular complications and treatment of orofacial manifestations, thus to increase the quality of life of the patient.

Introduction: Mobile phones generate heat and radiofrequency radiation. The parotid gland is one potential target, because mobile phones are pressed against the side of the face where the gland is located. Aims and Objectives: To compare the effect of mobile phone radiation on parotid gland volume, systolic velocity, salivary flow rate, and protein concentration between the dominant and the nondominant side of mobile phone usage among heavy mobile phone users. Materials and Methods: Ultrasonography of the superior lobe of parotid was performed bilaterally to measure gland volume. Systolic velocity of the external carotid artery in gland was calculated bilaterally using color Doppler imaging. Saliva flow rate was measured bilaterally with modified Schrimer strip. Carlson-Crittenden device was used to collect 0.5 ml saliva sample from the duct and biuret assay was done to determine the protein concentration. Settings and Design: A cohort study was conducted with 50 undergraduate students of a dental college based on the inclusion and exclusion criteria. Statistical Analysis Used: Pearson correlation test was used to correlate and compare changes in the parameters of parotid gland and analyzed to a significant level of 0.05. Results: The volume, systolic velocity of blood flow of the external carotid artery, the salivary flow rate, and protein concentration of the parotid gland were significantly more by 11.9, 18, 23, and 8%, respectively, on the dominant side than the nondominant side of mobile phone usage. Conclusion: The study emphasized that prolonged mobile phone usage causes biological changes in parotid gland.

Aim: The purpose of this study was to evaluate the expression of cyclo-oxygenase-2 (COX-2) enzyme in the tissue samples of patients with various clinicopathological stages of oral leukoplakia and oral squamous cell carcinoma (OSCC). Materials and Methods: The samples for the study were divided into 4 groups. Group A comprised 20 healthy individuals with no habits. Twenty healthy individuals with habitual tobacco usage and no oral lesions were included in Group B. Twenty cases of leukoplakia diagnosed clinically and histopathologically were included in Group C. Staging was done using the modified classification and staging system of oral leukoplakia. Twenty cases of OSCC diagnosed clinically and histopathologically were included in Group D. Immunohistochemical staining was done on these 80 samples (paraffin blocks) for COX-2 expression by indirect method using polymer based Horseradish peroxidase system. Statistical analysis was performed using Kruskal-Wallis test and Spearman′s rank correlation test. Results: Significant and proportional increase of COX-2 staining was noted with the increase in the severity of dysplasia. Eighty percent of OSCC expressed COX-2, increasing in its intensity of staining with the decrease in differentiation. Seventy five percent of leukoplakia showed positive COX-2 expression. Only 15% of positive controls were COX-2 positive. No normal mucosa showed positive expression of COX-2. Conclusion: High expression of COX-2 is seen in advanced stages of leukoplakia and OSCC. Hence, COX-2 enzyme increases cell proliferation, promotes angiogenesis and inhibits immune surveillance in carcinogenesis; it can be an early detection marker in oral leukoplakia and a prognostic marker of OSCC.

Aim and Objective: The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA) levels in various stages of oral submucous fibrosis (OSMF) patients and relate it to total serum protein (TSP) and hemoglobin (Hb) levels. Materials and Methods: The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. Results: Serum and salivary IgA and IgG levels were statistically significantly increased (P < 0.001) in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased (P < 0.01) in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased (P < 0.001) in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t -test were used for statistical analysis. Conclusion: The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.

Radiopaque lesions of the jawbones are frequently encountered in dental radiographs. A variety of conditions such as chronic inflammation, soft tissue calcifications, fibrosseous lesions, odontogenic tumors, and bone neoplasms can manifest as radiopaque lesions on the jawbones. These radiopaque lesions are often difficult to distinguish from each other, hence making the formulation of differential diagnosis challenging. A thorough patient's history and clinical examination supplemented by appropriate investigations will enable the clinician in narrowing down the differential diagnosis and to identify the condition accurately. Presented here is a case of the large radiopaque lesion on posterior mandible surrounded by lytic areas in a 20-year-old male patient.

Background: Imbalances between the oxidant-antioxidant status have been implicated in the pathogenesis of several diseases, including cancer. The aim of this study was to evaluate the extent of lipid peroxidation and antioxidants in the tissue samples of oral squamous cell carcinoma (OSCC) patients of different clinical stages in comparison with the healthy controls. Materials and Methods: A case-control study was designed with 20 new histopathologically proven oral carcinoma patients and an equal number of age, sex, and tobacco chewing habit matched healthy subjects. Their tissue samples were subjected to evaluation of lipid peroxidation product and antioxidant enzymes, namely, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and glutathione peroxidase (GPx) using spectrophotometric methods. The data are expressed as mean ΁ standard deviation. The statistical comparisons between the study groups were performed by independent Student′s unpaired t-test and one-way analysis of variance. Post-hoc analysis was performed for within study group comparisons. Karl Pearson correlation was performed for the biochemical parameters within the group and between the groups. For statistically significant correlations, simple linear regression was performed using SPSS (α=0.05). Results: Significant reduction in lipid peroxidation (P < 0.001) SOD and CAT (P < 0.001) was observed in the tissue of OSCC patients as compared with the healthy controls. On the other hand, reduced GSH and GPx were significantly increased in tumor samples. Conclusion: Reduced lipid peroxidation and increased activity of reduced GSH and GPx provides the suitable environment for the local growth and invasion of the tumor and metastasis in the later stages. Among the antioxidant enzymes, GSH reductase appears to have a profound role in carcinogenesis and thus it can be considered as potential prognostic marker.

Intramuscular vascular anomalies are rare congenital hamartomatous lesions. Less than 1% of these occur in skeletal muscle out of which 15% arise in head and neck musculature. In the head and neck region, masseter muscle is the most common site. It accounts for about 5% of intramuscular vascular malformations. They are present from birth but are clinically apparent during infancy and childhood and occasionally during adulthood. Due to its location it is often mistaken for a parotid swelling. The usual treatment of choice is surgical excision with a margin. This is associated with loss of motor function, hemorrhage, nerve damage. Intralesional sclerotherapy, embolization are nonsurgical alternatives for treatment of slow flow venous malformations. Sclerotherapy can be used solely in multiple sittings or as an adjunct to surgery. This article presents a case report of a 28-year-old male with recurrent intramuscular vascular malformation in the masseter muscle, which was successfully treated by ethanol sclerotherapy.

Background: The development of dental caries has been associated with the oral prevalence of Streptococcus mutans. Four serotypes of S. mutans have been reported, namely serotype c, e, f, and k that are classified based on the composition and linkages of cell wall polysaccharides, response to physiological reactions, sero-specificity and 16s rRNA homology. Although the oral prevalence of S. mutans serotype c in Indian subjects with or without caries is known, the prevalence of the other three serotypes, e, f, and k are not known. Hence in this study, we have investigated the occurrence of the e, f, and k serotypes in children with or without caries within the age group of 6-12 years. Materials and Methods: Genomic DNA isolated from whole saliva of caries active (CA) and caries free (CF) groups were first screened for the presence of S. mutans by strain specific polymerase chain reaction (PCR). Those samples that tested positive for the presence of S. mutans were further analyzed by serotype specific PCR to identify the prevalence of the serotypes. Results: Strain specific PCR indicated a higher prevalence of S. mutans in CA group (80%) relative to CF group (43%). Further analysis of the S. mutans positive samples in both groups indicated a higher prevalence of serotype k and e, followed by serotype f in CA group. Conclusion: The present data clearly establishes a novel S. mutans serotype prevalence hierarchy in children from this region, compared with those that have been reported elsewhere. Besides, the data are also clinically significant as the occurrence of serotype k has been associated with infective endocarditis.

Objective: The purpose of this study is to evaluate the salivary cortisol levels in patients with dry mouth. Materials and Methods: The study population consisted of 20 patients with a complaint of dry mouth and 20 asymptomatic age- and sex-matched controls. In patients who complained of dry mouth, the salivary flow rate (ml/minute) was estimated by measuring the quantity of the saliva collected in the collector. The concentration of cortisol in the saliva (΅g/dl) was determined by using a salivary enzyme-linked immunoassay (ELISA) kit. Statistical Analysis: The results were evaluated using the Student′s t-test. Results: There was only a mild increase in salivary cortisol in both stimulated and unstimulated saliva in patients with dry mouth compared to the controls (p-value 0.981 and 0.481, respectively), which was not statistically significant. Conclusion: There may not be a clear association between the salivary cortisol level and dry mouth. In older individuals, age-associated salivary gland hypofunction and life changes may be the main risk factors for dry mouth compared to stress and anxiety.

Background: Imbalances between the oxidant-antioxidant status have been implicated in the pathogenesis of several diseases, including oral cancer. Majority of oral cancer are preceded by a well-recognized group of pre-malignant lesions. However, only a small fraction of those lesions, undergo malignant transformation. Hence, there is a great need to identify biological markers, which will assist in identifying lesion carrying high-risk. This study aims to evaluate and compare the status of oxidative stress and antioxidant enzymes in tissue samples of patients with various clinicopathological stages of oral pre-malignancy. Materials and Methods: A case control study consisting of 20 new histopathologically proven leukoplakia patients and equal number of age, sex, and habit matched healthy subjects were recruited for this study. Their tissue samples were subjected to evaluation of lipid peroxidation product, thiobarbituric acid reactive substances and antioxidant enzymes, namely, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and glutathione peroxidase (GPx) using spectrophotometric methods. The data are expressed as mean ± standard deviation. The statistical comparisons were performed by independent Student′s unpaired t-test and one-way analysis of variance. Pearson′s correlation was performed for the biochemical parameters within the group and between the groups. For statistically significant correlations, simple linear regression was performed. P- value < 0.05 was considered statistically significant. Results: Significant reduction in lipid peroxidation (P < 0.001) SOD and CAT (P < 0.001) was observed in the tissue of leukoplakia patients as compared to the healthy controls. On the other hand, GSH and GPx were significantly increased in tumor samples. Conclusion: Reduced lipid peroxidation and increased activity of GSH and GPx provides the suitable environment for the tumor growth and malignant transformation in the later stages. Among the antioxidant enzymes, glutathione reductase appears to have a profound role in carcinogenesis.

Background: Imbalances between the oxidant -antioxidant status have been implicated in the pathogenesis of several diseases, including cancer. Aim: The aim of this study was to evaluate the extent of lipid peroxidation and antioxidants in the venous blood samples of oral squamous cell carcinoma patients of different Clinicopathologic stages in comparison with the healthy controls. Setting and Design: A Case control study was designed in a hospital (Rajah Muthiah Dental College and Hospital, Annamalai University) based setting. Materials and Methods: Twenty new histopathologically proven oral carcinoma patients, and equal number of age, sex and habit matched healthy subjects were recruited for this study. Their blood samples were subjected to evaluation of Thiobarbituric Acid Reactive Substances (TBARS) and antioxidant enzymes, namely, superoxide dismutase (SOD), Catalase (CAT) reduced glutathione (GSH) and glutathione peroxidase (GPx) using spectrophotometric methods. Statistical Analysis: The data are expressed as mean±SD. The statistical comparisons were performed by independent Student′s t-test and One Way ANOVA. P value

Objective: The purpose of this study was to evaluate the efficacy of ultrasound in the diagnosis of inflammatory swellings of odontogenic origin. Study design: The study group consisted of 25 patients with inflammatory swellings of odontogenic origin. Only patients with unilateral swellings were considered for inclusion in the pathologic study group and normal contralateral side was taken as control. Results: Clinically, four cases were diagnosed as cellulitis and 21 cases as abscesses. Under ultrasonography (USG) diagnosis, six cases were diagnosed as edema and two cases as cellulitis and 15 cases as preabscess and two cases as abscesses, considering the intra operative diagnosis as the gold standard technique. The ultrasonography technique presented sensitivity of 92%. Conclusion: USG can differentiate facial edema, facial cellulitis, and dentoalveolar abscess. USG can also evaluate the extension of these swellings. It is prudent to subject patients with inflammatory swellings of the maxillofacial region to USG in order to determine the appropriate treatment plan.

Background: Oral Squamous cell carcinoma (OSCC) is often preceded by potentially malignant disorders (PMDs) like oral submucous fibrosis (OSMF). The rate of transformation of OSMF to OSCC ranges from 3 to 19%. OSMF is etiologically related to chewing of areca nut (betel nut), a habit prevalent among the population groups in south-east Asia. Along with alkaloids, the high copper content in areca nut plays an important role in the pathogenesis of OSMF. The increased prevalence of OSMF in the last two decades or so corresponds with the increased processing and commercialization of areca nut products. Aim: The aim of the study was to estimate and compare the copper content of raw areca nuts in three different stages of maturity, and commercial areca nut products. Materials and Methods: Raw areca nut samples of three different maturities were obtained from four plantations in Sullia, Karnataka, India and commercial areca nut products were obtained from local shops in Chidambaram, Tamil Nadu, India. The samples were grounded and subjected to Atomic Absorption Spectrometry (AAS) for copper analysis. Results: There was statistically significant difference in copper content in raw areca nuts of all three maturities (p

ABSTRACT Purpose To review microbial contamination rates and examine guidelines about preparation of individual and batch doses using aseptic techniques within pharmaceutical (controlled) and clinical (ward and theatre) environments. Methods Systematic review and meta-analysis. Results A total of 18 studies (7293 doses) were identified for analysis. A lower rate of contamination was found in a pharmaceutical compared to clinical environments when preparing either individual (6.8% v 3.3%; p=0.051; 10 studies (8 clinical 2 pharmaceutical)) or batch doses (8% v 0.05%; p

"PICA" means perverted appetite for substances not fit as food or of no nutritional value such as, bricks, clay, soil, ice, laundry starch, etc. The word ′′PICA′′ is derived from Latin word for Magpie, a species of bird that feeds on whatever it encounters. ′′PICA′′ has been observed in ethnic groups worldwide in primitive and modern cultures, in both sexes and in all age groups. The case presented here reports a 30 year old female patient who had craving for ingestion of gravel and brick fragments since the age of 13 years. Iron deficiency anemia was found after complete blood count and iron studies. The diagnosis of "PICA" requires that the patient is persistently eating non-food substances for at least 1 month and such behavior is appropriate for the child′s stage of development.