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Aim: The purpose of this study is to compare the efficacy of ibuprofen and paracetamol in the treatment of post-extractive dental pain. Objective: The objective of this study was to segregate post-extraction patients into two groups where one group will be prescribed paracetamol and the other group with ibuprofen. Materials and Methods: Patients reporting to Saveetha Dental College and Hospital with the chief complaint of pain and advised extraction were included in the study. Each participant was given a brief explanation of the study, and an informed consent was obtained from each participant before inclusion in the study. The extraction of the tooth was done, and the drug paracetamol was administered to half of the patients and the drug ibuprofen to the remaining patients. Result: The result of the study showed that patients taking ibuprofen had less dental pain compared to the patients on paracetamol. Ibuprofen scored 91.4% compared to 83% of paracetamol in Score 0. Ibuprofen scored 85.6% compared to 69% of paracetamol in Score 1. In Score 2, ibuprofen was 66.6% and paracetamol 52.4%. In Score 3, ibuprofen got 60% and 44.6% for paracetamol. Conclusion: From the result of this study, it is clearly evident that a patient who received ibuprofen had less dental pain when compared with a patient who received paracetamol. This will help clinicians in prescribing medication after dental extraction. [ABSTRACT FROM AUTHOR]

Pemphigus is a group of disease characterized by IgG antibodies directed against epidermal adhesion complexes (desmosomes) of keratinocytes, leading to loss of cell adhesion, a phenomenon called acantholysis. The term 'Pemphigus' is derived from Greek word 'Pemphix' that means blister or bubbles. Different types of Pemphigus have been identified based on clinical and histopathological characteristics. Among this pemphigus vulgaris and pemphigus foliaceus were discussed. The patient has fluid filled itchy lesions, multiple facial bullae and erosions all over the body. It was initially diagnosed as a PV, but the patient does not have any blisters on the oral or mucosal membrane and then the blisters were not painful. The patient feels itching on the blisters. Through this evaluation it clearly shows, that the patient is suffering due to PF. The PV and the PF can be treated with corticosteroids and immunosuppresants. In this case, the patient was treated with Inj. Dexamethasone, T.Azothioprine, T.Cetrizine, T.CPM Betamethasone cream and cetrimide cream. Rituximab has been used to treat severe forms with complete remissions in patients and was the firstline treatment in Europe and United States approved by European Academy of Dermatology and Venereology (EADV). The patient should be reviewed periodically to achieve the remission and avoid reaccurance of the disease. [ABSTRACT FROM AUTHOR]

Artificial water fluoridation refers to the addition of fluoride compounds usually hexafluorosilicic acid to public drinking water supplies. It is a controversial public health intervention, the ethics of which have been debated since its inception in the 1950s. Dr. Trendley Dean, in 1931, found that there was an inverse relationship between the concentration of fluoride and the incidence of dental caries. It was concluded that a concentration of 1 parts per million (ppm) of fluoride in water offered significant protection against dental caries. On the other hand, higher concentrations than 1 ppm fluorides have adverse effect on the teeth. Dr. Frederick McKay who was the pioneer in this field, his research based in Colorado Springs, did extensive research as to the effect of fluoridated water and its role in staining and mottling of the enamel. This “Mottled enamel" is characterized by small white flecks or yellow-to-brown spots scattered over the surface of the tooth. Furthermore, fluoride at even higher concentrations leads to a number of complications including skeletal fluorosis and fluoride toxicity which can affect multiple organs. The ethical debate as to the artificial fluoridation of water still goes on. There is significant research proving its efficacy in combatting dental caries. However, the counter argument stating that in the light of the increasing evidence of harm fluoridation poses, artificial water fluoridation must be abandoned and replaced with other effective community-wide and targeted oral health intervention. [ABSTRACT FROM AUTHOR]

Diabetes, characterized by heightened blood sugar levels, can lead to a condition called Diabetic Retinopathy (DR), which adversely impacts the eyes due to elevated blood sugar affecting the retinal blood vessels. The most common cause of blindness in diabetics is thought to be Diabetic Retinopathy (DR), particularly in working-age individuals living in poor nations. People with type 1 or type 2 diabetes may develop this illness, and the risk rises with the length of diabetes and inadequate blood sugar management. There are limits to traditional approaches for the early identification of diabetic retinopathy (DR). In order to diagnose diabetic retinopathy, a model based on Convolutional neural network (CNN) is used in a unique way in this research. The suggested model uses a number of deep learning (DL) models, such as VGG19, Resnet50, and InceptionV3, to extract features. After concatenation, these characteristics are sent through the CNN algorithm for classification. By combining the advantages of several models, ensemble approaches can be effective tools for detecting diabetic retinopathy and increase overall performance and resilience. Classification and image recognition are just a few of the tasks that may be accomplished with ensemble approaches like combination of VGG19,Inception V3 and Resnet 50 to achieve high accuracy. The proposed model is evaluated using a publicly accessible collection of fundus images.VGG19, ResNet50, and InceptionV3 differ in their neural network architectures, feature extraction capabilities, object detection methods, and approaches to retinal delineation. VGG19 may excel in capturing fine details, ResNet50 in recognizing complex patterns, and InceptionV3 in efficiently capturing multi-scale features. Their combined use in an ensemble approach can provide a comprehensive analysis of retinal images, aiding in the delineation of retinal regions and identification of abnormalities associated with diabetic retinopathy. For instance, micro aneurysms, the earliest signs of DR, often require precise detection of subtle vascular abnormalities. VGG19's proficiency in capturing fine details allows for the identification of these minute changes in retinal morphology. On the other hand, ResNet50's strength lies in recognizing intricate patterns, making it effective in detecting neoneovascularization and complex haemorrhagic lesions. Meanwhile, InceptionV3's multi-scale feature extraction enables comprehensive analysis, crucial for assessing macular oedema and ischaemic changes across different retinal layers., Competing Interests: Declaration of competing interest No authors will not be having conflicts of interests., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: Remote patient monitoring systems (RPMS) are increasingly integrated into hospital wards to improve patient safety and reduce the workload on healthcare professionals (HCPs). This study evaluates the efficacy of RPMS in general wards, focusing on their impact on nursing efficiency, patient care, HCPs, and patient satisfaction., Methods: A comprehensive time-motion study was conducted along with surveys targeting HCPs and patients in M.S. Ramaiah Memorial Hospital, Bangalore, India, which has implemented RPMS in general wards. The study involved observing and comparing nursing activities in RPMS-equipped wards versus control wards without RPMS across various shifts. In addition, feedback on the system's impact on patient safety, overall care quality, and usability was gathered through a survey form., Results: RPMS decreases the amount of time nurses spend on routine monitoring, communication, and coordination, enabling a 43.11% increase in time available for patient care. More than 89% of HCPs noted improvements in the level of care and overall patient safety. More than 80% of the HCPs also noted improvement in the patient's experience. More than 50% of HCPs find RPMS easy to use and user-friendly. More than 60% of the patients noted an overall improvement in care quality., Conclusion: RPMS has proven to be a valuable asset in hospital wards, enhancing patient monitoring and safety while reducing the workload on staff. In addition, significant time savings on routine tasks and high satisfaction levels from both staff and patients underscore the system's benefits., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. M S Ramaiah Medical College and Hospitals Ethics Committee issued approval MSRMC/EC/AP-01/11-2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, L S et al.)

Aim: In this, in vitro study's objective is to assess the shear bond strength (SBS) of metal and ceramic orthodontic brackets that have been adhered to enamel using a conventional acid etch/primer and self-etching primer (SEP) adhesive method., Materials and Methods: One hundred excised human premolars were bonded on brackets and were divided into group 1 -Metal brackets were bonded on teeth and group 2 -Ceramic brackets were bonded on teeth. These two groups were further subdivided: subgroup 1a - 25 metal brackets bonded using conventional acid etch/primer adhesive system, subgroup 1b - 25 metal brackets bonded using SEP, subgroup 2a - 25 ceramic brackets bonded using conventional acid etch/primer adhesive system, and subgroup 2b - 25 ceramic brackets bonded using SEP; brackets were debonded using a computerized Instron universal testing machine., Results: The mean value of SBS of metal and ceramic brackets bonded using conventional acid etch/primer adhesive systems had higher SBS than those bonded using SEP. SBS ranged from 7.95 to 12.24 MPa which was in the acceptable clinical range., Conclusion: SBS values of all four subgroups exceeded the range of 6-8 MPa observed to be acceptable for routine clinical use., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: Yoga and naturopathy (Y&N) is a system of medicine primarily focusing on restoration of health and well-being. Objective of this study is to understand the knowledge, attitude, and perception about Y&N among the inpatients of a government Y&N institution in south India. Methods: Focus group discussion was conducted in eight adult patients aged between 30 and 60 years who took Y&N treatments for a period of 10 days or more. Purposive sampling method was adopted. Oral informed consent was obtained. Results: Knowledge about the Y&N system of medicine was primarily through referral or "word of mouth." Perceived benefits were both physical and psychological. Uniqueness of the hospital as mentioned by participants includes individual attention, tailor-made treatment protocols, and one-to-one care to the needy patients. Conclusion: An integrated approach is very much essential that might bring about better treatment outcomes in patients.

Obesity can have a significant impact on pregnancy outcomes by compromising the ability of the uterus to relax, which increases the likelihood of conditions such as preterm labor. One of the key pathways responsible for uterine relaxation is the β-adrenergic signaling pathway, and it is well-documented that obesity, often linked to a high-fat diet, can disrupt this pathway within the uterine environment. Hyperleptinemia is a significant feature of pregnancy as well as obesity. However, the effect of leptin on β-adrenergic signaling pathway has not been studied. In the present study, we studied the effects of leptin on transcriptions of the major proteins defining the β-adrenergic signaling pathway in pregnant rat uterus. Leptin treatment at a supraphysiological concentration to pregnant rat uterine strips increased the mRNA and protein expressions of Gs protein but not the mRNA of β 2 - and β 3 -adrenoceptors. It also enhanced the expression of Gi-protein, but not the Gq protein. Nevertheless, the mRNA ratio of Gs to Gi protein experienced a significant decrease. Further, leptin reduced the transcription of BK Caα and BK Caβ channel subunits. In leptin-stimulated tissues, there was also an increase in the expression of leptin receptor and JAK-2. In conclusion, leptin decreases the ratio of Gs to Gi proteins and BK Caα and BK Caβ channel subunits suggesting hyperleptinemia is a likely factor inducing uterine relaxant dysfunction in obesity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The natural circadian rhythm in an individual governs the sleep-wake cycle over 24 h. Disruptions in this internal cycle can lead to major health hazards and sleep disorders. Reports suggest that at least 50 % of people worldwide suffer from sleep-related disorders. An increase in screen time, especially in the wake of the COVID-19 pandemic, is one of the external causative factors for this condition. While many factors govern the circadian clock and its aberrance, the PER2 gene has been strongly linked to chronotypes by many researchers. The current paper provides an extensive examination of key Single Nucleotide Polymorphisms within the PER2 gene and their potential connection to four major types of sleep disorders. This study investigates whether these SNPs play a causative role in sleep disorders or if they are solely associated with these conditions. Additionally, we explore whether these genetic variations exert a lifelong influence on these sleep patterns or if external triggers contribute to the development of sleep disorders. This gene is a crucial regulator of the circadian cycle responsible for the transcription of other clock genes. It regulates a variety of physiological systems such as metabolism, sleep, body temperature, blood pressure, endocrine, immunological, cardiovascular, and renal function. We aim to establish some clarity to the multifaceted nature of this gene, which is often overlooked, and seek to establish the mechanistic role of PER2 gene mutations in sleep disorders. This will improve further understanding, assessment, and treatment of these conditions in future., Competing Interests: Declaration of Competing Interest The authors declare no potential conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Lysophosphatidic acid (LPA) is known to increase uterine contraction in the estrus cycle and early pregnancy, however, the effect of LPA in late pregnant uterus and its mechanisms are not clear. In the present study, we show the LPA receptor subtypes expressed and the mechanism of LPA-induced contractions in late pregnant mouse uterus. We determined the relative mRNA expression of LPA receptor genes by quantitative PCR and elicited log concentration-response curves to oleoyl-L-α-LPA by performing tension experiments in the presence and absence of nonselective and selective receptor antagonists and inhibitors of the TXA2 pathway. LPA1 was the most highly expressed receptor subtype in the late pregnant mouse uterus and LPA1/2/3 agonist (Oleoyl-L-α LPA) elicited increased contractions in this tissue that had lesser efficacy compared to oxytocin. LPA1/3 antagonist, Ki-16425, and a potent LPA1 antagonist (AM-095) significantly inhibited the LPA-induced contractions. Further, the nonselective COX inhibitor, indomethacin, and potent thromboxane A2 synthase inhibitor, furegrelate significantly impaired LPA-induced contractions. Moreover, selective thromboxane receptor (TP) antagonist, SQ-29548, and Rho kinase inhibitor, Y-27632 almost eliminated LPA-induced uterine contractions. LPA1 stimulation elicits contractions in the late pregnant mouse uterus using the contractile prostanoid, TXA2 and may be targeted to induce labor in uterine dysfunctions/ dystocia., Competing Interests: Conflict of interest The authors declare that no conflict of interest could be perceived as prejudicing the impartiality of the research reported., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Altered lipid metabolism in obesity causes pregnancy complications in humans and animals. Leptin levels increase in pregnancy, as well as obesity. However, the effect of obesity on uterine leptin receptors and its distal signaling is not clear. The present study aimed to understand the effect of increased fat on leptin signaling in rat uterus. Wistar female rats were fed with an HF diet (40% Fat, 17% Sucrose, 1.25% Cholesterol, 0.75% Cholic acid) for 6 weeks before the mating and during pregnancy. HF diet significantly increased the fat depots, liver weight, serum, and tissue cholesterol levels. It produced fatty degeneration in the liver and caused infiltration of inflammatory cells, cystic endometrial glands, and sub endometrial fibrosis of the uterus. In isometric tension experiments, leptin caused a significant increase in uterine contractions in high fat-fed animals compared to control animals. Analysis of receptor expressions revealed no significant difference between the groups. However, a significant decrease in the JAK2 and BKCaα mRNA expression was observed in the uterus of high fat-fed rats. No change in the BKCaβ, eNOS, iNOS, MLCP, and MLCK mRNA expressions was noticed in the HF group compared to the control. The findings of the present study suggest that the contractile response to leptin in the uterus of high fat-fed rats may be attributed to reduced signaling through JAK2 and, lowered expressions of BKCa channel α subunits., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

In this present research, we succeeded in synthesizing nanostructured silver particles (NS-AgPs) using bio active agent present in the leaf extracts of Cleome gynandra (CG) under green synthesis. While adding silver nitrate (AgNO 3 ) solution in green extracts of CG leaf containing bio compound, the mixture turns from yellow to reddish brown, as a consequence of existence of nanostructured silver particles (NS-AgPs) and later UV instrument is used to obtain the Ultraviolet visible spectroscopy (UV-vis) spectra to confirm existing nanostructured silver particles (NS-AgPs) in aqueous solutions (synthesized sample). To confirm existing functional groups in NS-AgPs, the fourier transform infrared spectroscopy (FTIR) study is carried throughout this research. The scanning and tunneling of wave like nature of electrons passing through powdered NS-AgPs sample gives Scanning electron microscopy (SEM) and Transmission electron microscopy (TEM) images respectively, which are carried out to find out the 2-dimensional size and shape distribution of NS-AgPs. Further dynamic light scattering (DLS) and zeta potential studies are used to confirm the size and good stability of NS-AgPs respectively. It is evident that NS-AgPs exhibits a strong toxic activity against microorganism and to confirm this mechanism the antibacterial (against Escherichia coli and Staphylococcus aureus) study is carried out., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Elimination of heavy metals from wastewater has been a significant process to improve the aquatic source's quality. Various materials act as very effective adsorbents to remove heavy metals, which cause toxicity to plants and all other living organisms. Thus, the present work focuses on removing heavy metals chromium (Cr) and copper (Cu) ions containing wastewater using biodegradable and cost-effective chitosan-based hydrogel composite. The composite was prepared via chemical cross-linking of radical chitosan with polyacrylamide and N,N'-Methylene bisacrylamide and blended with orange peel. The synthesis of the adsorbent has been confirmed by using Fourier-transform infrared spectroscopy (FT-IR), Scanning electron microscopy - Energy dispersive X-ray analysis (SEM-EDAX) and X-ray diffraction (XRD) studies. The adsorption power of the composite of metal ions at different time, pH, adsorbent dosages, different metal ion concentrations were analyzed by using Atomic Absorption Spectroscopy (AAS). The results concluded that the optimum pH for Cr(VI) and Cu (II) were 4 and 5, contact time: 360 min, adsorbent dosage: 4 g, and initial metal ion concentration: 100 mg/L for each metal ions. The adsorption isotherm models follow the Freundlich model and pseudo-second-order kinetics. From the results, the adsorption capacity was observed to be 80.43% for Cr(VI) and 82.47% for Cu(II) ions, respectively., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Leber congenital amaurosis (LCA) is a severe autosomal recessive retinal degenerative disease. The current study describes exome sequencing results for two unrelated Indian LCA patients carrying novel nonsense p.(Glu636*) and frameshift p.(Pro2281Leufs*63) mutations in the ALMS1 gene. Although ALMS1 gene mutations are associated with Alstrom syndrome (AS), the current patients did not exhibit typical syndromic features of AS. These data suggest that ALMS1 should be included in the candidate gene panel for LCA to improve diagnostic efficiency.

The present study focuses on fabrication and characterisation of porous composite scaffold containing hydroxyapatite (HAP), chitosan, and gelatin with an average pore size of 250-1010 nm for improving wound repair and regeneration by Electrospinning method. From the results of X -Ray Diffraction (XRD) study, the peaks correspond to crystallographic structure of HAP powder. The presence of functional group bonds of HAP powder, Chitosan and scaffold was studied using Fourier Transform Infrared Spectroscopy (FTIR). The surface morphology of the scaffold was observed using Scanning Electron Microscope (SEM). The Bioactivity of the Nano composite scaffolds was studied using simulated body fluid solution at 37 ± 1°C. The biodegradability test was studied using Tris-Buffer solution for the prepared nanocomposites [nano Chitosan, nano Chitosan gelatin, Nano based Hydroxyapatite Chitosan gelatin]. The cell migration and potential biocompatibility of nHAP-chitosan-gelatin scaffold was assessed via wound scratch assay and were compared to povedeen as control. Cytocompatibility evaluation for Vero Cells using wound scratch assay showed that the fabricated porous nanocomposite scaffold possess higher cell proliferation and growth than that of povedeen. Thus, the study showed that the developed nanocomposite scaffolds are potential candidates for regenerating damaged cell tissue in wound healing process.

Outpatient parenteral antimicrobial therapy (OPAT) programs are becoming an increasingly popular trend in clinical practice as they offer several benefits to both patients and health-care setups. While OPAT is an established clinical practice in the Western world, the concept itself is alien to patients in India as they prefer the security of hospitals to receive antibiotics over OPAT. We evaluated the clinical response and cost comparison of ertapenem under OPAT versus inpatient settings in patients with extended-spectrum beta-lactamase (ESBL)-positive acute pyelonephritis (APN) given the increasing importance of optimizing both hospital beds and overall cost of patient care in India. APN was chosen as the indication to be studied as it is one of the common complicated urinary tract infections treated in our OPAT unit requiring 10-14 days of parenteral therapy with an agent active against various Gram-negative bacilli and multidrug-resistant organisms. One hundred patients were retrospectively studied based on whether antibiotics were administered during hospital stay alone (hospital only), during both hospital stay, and also as OPAT post discharge (hospital/OPAT) or as OPAT alone (OPAT only). Response to ertapenem and cost of treatment in inpatient versus OPAT settings were compared using Pearson's Chi-square or Fisher's exact test for categorical variables. ANOVA (or Kruskal-Wallis) was used for continuous variables. Baseline urine cultures were ESBL positive with 98% prevalence of Gram-negative bacilli (GNB). Colony counts were ≥100,000 in 74% patients. Only ertapenem, imipenem, and meropenem showed 100% sensitivity to ESBL-positive GNB in baseline urine culture and sensitivity reports. Ertapenem showed 100% sensitivity and complete clinical resolution for 96% patients with APN due to ESBL Enterobacteriaceae . It was administered as OPAT in 90% patients and significantly reduced overall treatment costs., Competing Interests: S. Puthran and T. Petigara are employees of MSD Pharmaceuticals Pvt. Ltd., Mumbai or Merck and Co., Inc., Kenilworth, NJ, USA and are involved in data analysis, interpretation, and report writing.

We report the detailed gross, histopathological and immunohistochemical study of Strobilocercus fasciolaris infection, the metacestodal stage of Taenia taeniaeformis, in the liver of laboratory Wistar rats. Necropsy examination of seventeen rats revealed transparent or white or cream to clear, thick walled cysts, 1 to 97 in number, measuring about 2mm to 12mm on one or many of the liver lobes and containing strobilocercus of Taenia taeniaeformis. Histopathological examination revealed the presence of the cross-section of larva surrounded by a thick fibrous capsule and moderate infiltration of lymphocytes, plasma cells and a few eosinophils. Fatty degeneration of hepatocytes, gastric mucosal hyperplasia, distended gastric glands and marked increase in the mucosal epithelial cells and goblet cells in the duodenum were also observed. Contamination of feed and bedding materials seems to be the probable source in these naturally infected rats., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Supernumerary tooth is an additional entity to the normal series and is seen in all the quadrants of the jaw. The prevalence rates of supernumerary teeth in the permanent dentition, reported in the literature, vary between 0.1% and 6.9%. The presence of supernumerary teeth may be part of developmental disorders. As supernumerary tooth is a rare condition, it can be used as identification tool for crime investigation., Material and Methods: A total of 30 volunteers with a supernumerary tooth were analyzed and casts were made after taking alginate impression. All the casts were coded and were given to five observers for correct identification of those volunteers with respective prepared cast., Result: Personal identification and the cast identification of volunteers were done (cast of the volunteers). The matching identification is followed as below: Of five observers 1(st) observer able to detect 25 (83%), 2(nd) observer 27 (90%), 3(rd) observer 26 (87%), 4(th) observer 25 (83%) and 5(th) observer 28 (91%)., Conclusion: As positive matching identification was 87%, supernumerary tooth can be used for crime investigation and used as greatest weapon in criminal identification.

Background: The bond strength to bleached enamel is reduced, if adhesive restorations are carried out immediately. So the purpose of this in vitro study was an attempt to regain the lost bond strength, for which, the comparison of shear bond strength of composite resin to bleached enamel was carried out using various antioxidants: 10% Sodium ascorbate, Rosemary extracts, Pedicularis extracts., Materials and Methods: Fifty human extracted single rooted teeth were collected. They were decoronated and coronal portions were embedded in self cure acrylic resin with their buccal surfaces facing upwards. The samples were randomly divided into positive, negative control groups and three experimental groups (n = 10). In positive control group, specimens were not bleached, before bonding procedure. In negative control group, bleaching was done with 10% carbamide peroxide and bonding was carried out immediately. In experimental groups, following antioxidants were used after bleaching: Group A: 10% Sodium ascorbate, Group B: Rosemary extracts, Group C: Pedicularis extracts. Then the bonding procedures were carried out in all the groups and were subjected for shear bond strength analysis., Results: Results clearly showed that groups A and B were effective in reversal of bond strength immediately., Conclusion: 10% sodium ascorbate solution and rosemary extracts were effective in reversal of shear bond strength immediately after bleaching.

Background: Venous thromboembolism (VTE) is a prevalent disease with potential serious consequences. Idraparinux and idrabiotaparinux are two kinds of long-acting pentasaccharides. Evidence has shown that idraparinux and idrabiotaparinux are effective anticoagulants. However, up to now, there is no consensus on whether they are better than other anticoagulation methods for long-term VTE treatment., Objective: To evaluate the effect of idraparinux or idrabiotaparinux versus other anticoagulation methods for long-term VTE treatment., Methods: We searched Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of science, clinical trial registry web sites (clinical trials,WHO clinical trial registry), Googlescholar, PubMed related articles and companies' web sites electronically up to Dec 30(th), 2012 and manually searched the reference lists and conference proceedings. Only randomized controlled trial (RCT) involving adult patients comparing idraparinux and/or idrabiotaparinux versus other anticoagulation methods for long-term VTE treatment was included. Two reviewers evaluated the studies and extracted data independently. Pooled risk ratios (RRs) were calculated as outcome measures and Revman 5.2 software was used to analyze data. Our primary efficacy and safety outcomes were the recurrent VTE and major bleeding rates., Results: We included four RCTs and involved 8584 participants on idraparinux or idrabiotaparinux versus standard warfarin for VTE treatment from 9364 references. We did not perform meta-analysis on the VTE rate because of the significant heterogeneity. We used the fixed effect model to analyze the safety outcomes and demonstrated that idraparinux or idrabiotaparinux decreased major bleeding rate significantly (RR 0.73, 95% CI 0.54 to 0.98, P = 0.04) but had a trend to increase the all cause mortality (RR 1.26, 95% CI 1.00 to 1.57, P = 0.05) compared with warfarin., Conclusions: Until now there is not sufficient evidence to clarify whether idraparinux or idrabiotaparinux is as effective and safe as the standard warfarin treatment for VTE treatment.

Aims: To ascertain and compare between highly active antiretroviral therapy (HAART) and non-HAART patients, the stimulated salivary flow rates and unstimulated salivary flow rates (USFR and SSFR) and to correlate the salivary flow rates with immune suppression., Materials and Methods: One hundred human-immuno deficiency virus seropositive patients attending RAGAS-YRG CARE were examined and divided into two groups, a HAART group (patients on combination antiretroviral therapy) comprising 50 patients and a non-HAART group comprising 50 patients. The HAART group was followed every 3 months after the baseline visit (0) for a period of 9 months, during which a clinical oral examination and collection of unstimulated and stimulated saliva was done. Their salivary gland function was assessed using a xerostomia inventory during each visit. The study on non-HAART group was cross-sectional., Statistical Analysis: Statistical analysis were performed with the aid of the Statistical Package for the Social Sciences (SPSS version 10.05) software., Results: There was no significant difference in mean SSFR and USFR between the two groups at baseline. In the HAART group, the mean stimulated salivary flow rate increased from baseline to 3 months (P = 0.02), with the increase being maintained at 6 months and 9 months. When salivary flow rates were correlated with Cluster of Differentiation, CD4 counts, patients in the HAART group with a CD4 ≤ 200 at 6 months visit had a higher mean stimulated salivary flow rate when compared with patients with CD4 ≥ 200 (P = 0.02). The xerostomia inventory did not reveal any significant difference between the two groups and HAART was not significantly associated with xerostomia., Conclusion: In our study HAART was neither associated with xerostomia nor a reduction in salivary flow rate and immune suppression was not a significant factor for decreasing the salivary flow rate.

A 14-year-girl presented with solitary exuberant warty plaque over her right great toe since the age of 4 years. Ten years ago, an excisional biopsy was performed by a surgeon, and a histopathological diagnosis of angiokeratoma was made. A wide local excision of the lesion followed by a plantar digital artery flap in a V-Y fashion adjacent and just proximal to the excision wound was performed. This procedure has not only led to complete growth removal, but also a well-preserved digit with an excellent color and contour match.