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Aim: The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC). Setting and Design: This was an in vitro study. Materials and Methods: Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated. Statistical Analysis: The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD. Results: Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin. Conclusion: C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.

Aim: The aim of this study was to evaluate the effect of different treatment modalities for temporomandibular joint (TMJ) pain and their relevance to chronic cervical pain after 12 months. Settings and Design: This was a randomized controlled trial. Materials and Methods: Forty-eight participants with chronic cervical and TMJ pain were selected using research diagnostic criteria and randomized into four groups (n = 12), which included control, soft splints, transcutaneous electrical nerve stimulation (TENS), and low-level laser (LLL). The cervical and TMJ pain was recorded using visual analog scale (VAS) scores at baseline, 3 months, 6 months, and 12 months. Occlusal equilibration was done for all groups except for the control. Statistical Analysis Used: The mean pain scores were statistically analyzed using one-way analysis of variance and post hoc test. Results: The mean VAS scores in TMJ pain patients between the four groups at baseline and at final follow-up were 7.27 ± 1.29 in Group 1, 7.53 ± 0.70 in Group 2, 7.76 ± 0.80 in Group 3, and 7.61 ± 0.61 in Group 4. The mean difference between Groups 1 and 3, Groups 1 and 4, and Groups 2 and 3 was statistically significant (P < 0.00). Pearson correlation test yielded a mild and negative correlation between TMJ and cervical pain. Conclusion: TENS and LLL were found to be equally effective in reducing pain in the jaw joint region, followed by soft splints, and there was no correlation between TMJ and cervical pain.

Parallelism to the ala-tragus line is commonly used as a guide for the orientation of the occlusal plane with the help of a fox plane. The accuracy of parallelism is affected by improper judgment or patient movement. This report describes a method with a modified fox plane that aids in occlusal plane determination. The device is placed in the patient's mouth with the maxillary occlusal rim to determine parallelism to the ala-tragus line and interpupillary line. The adjustments are made until the laser light on the device runs parallel to the ala-tragus line, and the spirit bubble is centered between the lines of the tube. This technique facilitates direct visualization of parallelism, thereby avoiding parallax errors.

Abstract Background Chorea hyperglycemia basal ganglia syndrome is a rare disorder causing involuntary movements in both upper and lower limbs. Uncontrolled hyperglycemia causes neurotransmitter derangements in basal ganglia resulting in involuntary movements. These cases pose different challenges to anaesthesiologist in both general and regional anaesthesia. Case presentation Here, we discuss a case of chorea hyperglycemia basal ganglia syndrome with lower limb gangrene posted for knee amputation done under spinal anaesthesia. Our patient had recurrent choreiform movements due to non-compliance to diabetic medications. Strict glycemic control always aids in reduction of choreiform movements along with improved wound healing. Conclusions Tight glycemic control and good anesthetic plan in perioperative period can reduce morbidity in patients affected with chorea hyperglycemia basal ganglia syndrome.

Introduction: The extremely sensitive tactile sensors periodontal mechanoreceptors play a key role in sensory innervation of teeth. The oral kinaesthetic perceptual abilities in the absence of periodontal mechanoreceptive input can be achieved by osseointegrated prosthesis. Aim: To evaluate the passive tactile sensibility associated with osseointegrated dental implant in various regions of the maxillary and mandibular arch. Materials and Methods: A prospective cohort study was performed in SRM Dental College, Chennai, India between August 2013 to February 2015. Fifty patients who had single tooth replacement with functioning implants loaded six months before were included. A compressive force was applied along the long axis of the implant supported prosthesis using a push type force measuring gauge until the subject felt the first sensation of pressure and subsequently, it displayed the magnitude of force that provided the tactile sensation. The force measuring gauge used was Model: FG 5000 A form Lutron electronic enterprises co., ltd. The procedure was repeated thrice. The patient was guided to record the force perception on visual analogue scale with continuous force. The visual analogue scale has values 0-4 starting from no sensation, mild, moderate, intense and pain and the average force measured. The values of the force recorded were statistically analysed using the t-test, Statistical Package for the Social Sciences (SPSS) version 17.0 was used. The p-value of 0.05 was considered statistically significant. Results: The overall mean value of maxilla was 23.12 N and the standard deviation was ±2.88 N. The overall mean value of mandibular was 22.44 N and the standard deviation of ±2.06 N and there was no significant difference in the threshold for passive tactile perception between maxilla and mandible. Conclusion: The results showed that mandibular anterior teeth had least threshold for force applied than any other region of the mouth and the maxillary posterior had the highest threshold. The anterior region exhibited better passive tactile threshold measure when compared to posterior region.

Byline: Ramya. Ravi, Ranjith. Sivakumar, Srinivasan. Suganya, Muthapillai. Senthilnathan Sir, We read with interest the captioned letter 'Use of a pre-injection technique to identify neural elements in the costoclavicular space [...]

Background: Rapid sequence induction and intubation (RSII) with application of “Cricoid pressure ” and avoidance of “facemask ventilation ” (FMV) is believed to minimize the risk of pulmonary aspiration of gastric contents during general anesthesia. However, some patients may be at risk of developing hypoxemia and may benefit from FMV during RSII. The purpose of this study was to assess the effectiveness of “cricoid pressure ” in preventing gastric insufflation during FMV using gastric ultrasonography. Materials and Methods: Eighty-four adult patients were randomized to receive cricoid pressure (CP) or no cricoid pressure (NCP), during FMV after induction of general anesthesia. Gastric antral cross-sectional area (CSA) was measured with ultrasonography before and after FMV in supine and right lateral decubitus positions (LDP). Appearance of “comet tail ” artifacts created by acoustic shadows of gas in the gastric antrum was noted. Results: The incidence of insufflation indicated by “comet tail ” artifacts during FMV was lower in group CP (17 vs 71%; P < 0.001). The lowest Paw at which gastric insufflation occurred was higher in group CP (20 vs 14 cmH2O). The change in mean gastric antral CSA was significantly lower in group CP than in group NCP in supine (0.02 vs 0.36 cm2, P = 0.012) and right LDP (0.03 vs 0.67 cm2, P < 0.001). Conclusion: Cricoid pressure is effective in preventing gastric insufflation during FMV at Paw less than 20 cmH2O. Observation of comet tail artifacts in gastric antrum along with measurement of change in antral CSA on ultrasound examination is a feasible and reliable method to detect gastric insufflation.

Introduction: Titanium has become the material of choice with greater applications in dental implants. The success of the dental implant does not only depend on the integration of the implant to the bone but also on the function and longevity of the superstructure. The clinical condition that demands long-term interim prosthesis is challenging owing to the decreased bond between the abutment and the veneering material. Hence, various surface treatments are done on the abutments to increase the bond strength. Aim: This study aimed to evaluate the bond strength between the abutment and the provisional veneering materials by surface treatments such as acid etching, laser etching, and sand blasting of the abutment. Materials and Methods: Forty titanium alloy abutments of 3 mm diameter and 11 mm height were grouped into four groups with ten samples. Groups A, B, C, and D are untreated abutments, sand blasted with 110 μm aluminum particles, etched with 1% hydrofluoric acid and 30% nitric acid, and laser etched with Nd: YAG laser, respectively. Provisional crowns were fabricated with bis-acrylic resin and cemented with noneugenol temporary luting cement. The shear bond strength was measured in universal testing machine using modified Shell–Nielsen shear test after the cemented samples were stored in water at 25°C for 24 h. Load was applied at a constant cross head speed of 5 mm/min until a sudden decrease in resistance indicative of bond failure was observed. The corresponding force values were recorded, and statistical analysis was done using one-way ANOVA and Newman–Keuls post hoc test. Results: The laser-etched samples showed higher bond strength. Conclusion: Among the three surface treatments, laser etching showed the highest bond strength between titanium alloy implant abutment and provisional restorations. The sand-blasted surfaces demonstrated a significant difference in bond strength compared to laser-etched surfaces. The results of this study confirmed that a combination of surface treatments and bond agents enhances the bond strength.

Introduction: Adhesion of Candida albicans on denture surfaces is one of the main aetiology of denture stomatitis. Currently, chemical disinfectant agents have been employed to prevent its adhesion on the denture surface. However, due to its harmful effects on the physical properties of the denture material there has been a lookout for a natural product as a replacement. Aim: Investigate the effects of Bamboo Salt Solution (BSS) on inhibition of adhesion of Candida albicans (C. albicans) to denture acrylic surface. Materials and Methods: Transparent acrylic strips were pretreated with bamboo salt at concentration of 5, 10, 20 w/v %, normal saline (negative control) and 0.2% chlorhexidine gluconate (positive control) for 30 minutes followed by inoculation with C. albicans (107 cells/mL). Adherent yeast cells were then counted under microscope at 40X magnification in 20 randomly selected fields on each strip after staining with crystal violet. The statistical significance was calculated by Kruskal-Wallis and Mann-Whitney non-parametric tests at a significance level of p

Background: All ceramics are the material of choice for aesthetic tooth replacements. The success of all ceramic restoration depends on the bond between the ceramic and the tooth surface hence this study was done to evaluate the shear bond strength of Feldspathic CAD/CAM ceramic with

Hemolytic transfusion reactions (HTRs) remain one of the dreaded complications of transfusion-related morbidity and mortality. Here, we describe the diagnosis and management of acute HTR following transfusion of ABO-incompatible packed red blood cell under general anesthesia which manifested solely as acute intraoperative hematuria. A 65-year-old, diabetic male was scheduled for emergency re-explorative laparotomy in view of suspected anastomotic leak following subtotal gastrectomy. One unit of packed cell was transfused intraoperatively. Toward the end of surgery, hematuria was noted by the attending anesthesiologist, and the accidental bladder injury was ruled out by the surgeon. Transfusion of ABO-incompatible blood was spotted; direct Coombs test became positive. To mitigate the impact of incompatible blood, 1 L of 0.9% normal saline was administered. Mannitol 0.5 g/kg and furosemide 20 mg were administered every 8th hourly, and 1 ml/kg/h of urine output was targeted. Sodium bicarbonate (7.5%) 20 meq was administered intravenously to alkalinize the urine. [ABSTRACT FROM AUTHOR]

Aim: Critically ill individuals may have left ventricular diastolic dysfunction (LVDD) which can prolong their intensive care unit (ICU) stay. The purpose of this study was to determine the prevalence of LVDD in critically ill adult patients requiring mechanical ventilation in ICU, the effect of LVDD on 28-day survival, and weaning from mechanical ventilation., Methodology: A total of 227 adults who had been on mechanical ventilation for more than 48 hours in an ICU were recruited for this study. The study's parameters were recorded on the third day of mechanical ventilation using a low-frequency phased array probe. A simplified definition of LVDD in critically ill adults was utilized to determine the presence or absence of LVDD. Weaning failure and 28-day mortality were noted., Results: The prevalence of LVDD in adults requiring mechanical ventilation in the ICU was found to be 35.4% ( n = 79). Patients with LVDD had the odds of having a 28-day mortality increase by 7.48 (95% CI: 3.24-17.26, p < 0.0001). Patients with LVDD had the odds of having weaning failure increase by 5.37 (95% CI: 2.17-13.26, p = 0.0003)., Conclusion: Measures should be taken to detect critically ill adults with LVDD with systolic dysfunction or heart failure with preserved ejection fraction early so that their fluid balance, myocardial contractility, and afterload can be optimized to minimize their morbidity and mortality., Highlights: Critically ill adults with LVDD may have adverse outcomes. Hence, protocol should be in place for diagnosing LVDD early in critically ill adults thereby, measures can be taken to minimize morbidity in those patients., How to Cite This Article: Luitel B, Senthilnathan M, Cherian A, Suganya S, Adole PS. Prevalence of Diastolic Dysfunction in Critically Ill Patients Admitted to Intensive Care Unit from a Tertiary Care Hospital: A Prospective Observational Study. Indian J Crit Care Med 2024;28(9):832-836., Competing Interests: Source of support: JIPMER Intramural Grant Fund. Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)