Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial

Background@#Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M.Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P 0.05). @*Conclusion@#The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

Quantitative Predictive Imaging Biomarkers of Lumbar Intervertebral Disc Degeneration

STUDY DESIGN: Observational comparative study. PURPOSE: To compare fractional anisotropy (FA) maps with T2 values of the nucleus pulposus (NP) and annulus fibrosus (AF) of intervertebral discs in healthy volunteers and patients to develop a predictive disc health scale. OVERVIEW OF LITERATURE: T2-weighted magnetic resonance imaging (MRI) is not sensitive to early morphological changes and provides no quantitative biomarker profile for early degeneration. METHODS: We examined 59 healthy controls and 59 patients with back pain by MRI using T2 relaxometry and diffusion tensor imaging (DTI). Each group was divided into three age subgroups: A (50 years, n=21). We obtained FA values for AF and NP and T2 values for NP for each intervertebral disc. Furthermore, we calculated the FA (AF/NP) ratios. RESULTS: We categorized 590 intervertebral discs from 118 participants, 566 of which were analyzed with T2 relaxometry and DTI. The T2 values were as follows: subgroup A, 55.8±4.4 ms; B, 48.5±6.9 ms; C, 45.8±8.7 ms (p120 ms, 90–100 ms, and 70 ms, respectively (p<0.001). Control subgroup A had higher T2 values and AF/NP ratios than subgroups B and C; the AF values were not significantly different. Control subgroup B had higher T2 values and AF/NP ratios than subgroup C but lower FA (NP). CONCLUSIONS: FA maps of the AF/NP ratio and T2 values of NP are potential microstructure biomarkers of normal and degenerating discs and can help detect early degeneration using a predictive disc health score on a continuous scale.

Keratocystic Odontogenic Tumour Admixed With Giant Cells: Case Report and Review on the Role of RANK/RANKL in its Pathogenesis

‘Odontogenic keratocyst’ (OKC) was the term coined by Philipsen in the year 1956, while Pindborg and Hansen in the year 1963 described the details of this cyst[1,2]. OKC is renamed as keratocystic odontogenic tumour (KCOT) by WHO[3] taking into view its aggressive and recurrent nature. OKC arises from the rests of dental lamina[1]. It can occur anywhere in the oral cavity wherever the osseous structures are present, but most commonly in the posterior regions of the mandible[2,4]. Since the clinical and radiological profile of OKC mimics other lesions it may affect the appropriate diagnosis. Here we report a case of aggressive OKC which affected an entire quadrant of the mandible along with the ramus.

Caries Vaccine – A Review

Streptococcus mutans play a key role for the development of dental caries and that a vaccine directed against this microorganism could be a valuable adjunct to existing preventive measures in some countries. Only a few studies, however, have examined the efficacy of dental caries vaccines in humans. Although several years have passed, active immunization against caries remains a goal yet to be achieved. The successful development of vaccines against oral diseases requires a concerted effort by industry, government, and academia and also it is a matter of great importance to ensure safety along with effective protection.

Concomitant occurrence of cemento-ossifying fibroma and adenomatoid odontogenic tumor with bilateral impacted permanent canines in the mandible.

Adenomatoid odontogenic tumor (AOT) is an uncommon, benign and slow growing odontogenic tumor, which is usually located in an anterior region of the maxilla without pain. Cemento-ossifying fibroma (COF) is a relatively rare benign tumor of the jaw. Here we present 2 lesions presenting in unusual forms, follicular variant of AOT in the mandible and COF associated with impacted canine in the mandible, occurring concomitantly in the same patient. Both lesions presented classic histopathologic features.

Diuretic effect of chloroform extract of benincasa hispida rind (Pericarp) in sprague-dawley rats.

The diuretic activity of Benincasa hispida fruit rind extract (outer thick pericarp) was investigated and its activity was compared to control (normal saline) and standard diuretic hydrochlorothiazide in albino rats. Total of 54 adult male Sprague-Dawley rats were taken whose weights ranged from 175-225 gm. The rats were divided into three groups of 18 rats each (control, standard and test). Control group received 0.9% normal saline 25ml/kg orally. Standard group received hydrochlorothiazide 2.5mg/kg body weight orally along with normal saline keeping the volume of the fluid administered constant. Test group received aqueous extract of rind of Benincasa hispida at the dose of 100mg/kg orally along with normal saline 25ml/kg. Urine was collected for a period of 5 hours by placing the animals in metabolic cages. The urinary volume, pH, and urinary excretion of sodium, potassium and chloride were measured and compared. The extract produced significant increase (p<0.001) in urine volume, sodium and chloride levels, and significant decrease (p<0.001) in potassium excretion. Benincasa hispida rind extract possesses significant diuretic activity.

Achalasia cardia in an infant.

Achalasia cardia is a neuromuscular disorder of the oesophagus, characterized by abnormal oesophageal motility and failure of lower esophageal sphincter relaxation. It usually manifests in the fourth and fifth decades of life. It is unusual in childhood and is extremely rare under the age of one year. We report a 7-month-old child with oesophageal achalasia treated with laparoscopic Heller’s oesophagomyotomy.

Efficacy of temporalis myofascial flap as an interpositional graft material in the management of tmj ankylosis:.

Temporo-mandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance and hygiene. Surgery of TMJ ankylosis needs careful evaluation and planning to yield predictable results. Ankylosis may be corrected surgically by an array of procedures like gap arthroplasty, joint reconstruction and interpositional arthroplasty. Though many types of autogenous grafts and alloplastic materials are available for the interpositioning, the temporalis muscle graft offers significant advantages like ease of harvesting, minimal donor site morbidity and effective coverage of the arthroplasty site. The efficacy of the same is highlighted in this article by its application in four cases of TMJ ankylosis.

Diagnosis of hepatitis C virus infection by ELISA, RIBA and RT-PCR: a comparative evaluation.

OBJECTIVES: To evaluate the efficacy of second-generation ELISA (ELISA-2), third-generation ELISA (ELISA-3) and third-generation recombinant immunoblot assay (RIBA 3.0) for detection of antibodies to hepatitis C virus (anti-HCV) in comparison with reverse transcriptase-polymerase chain reaction (RT-PCR) to detect HCV RNA for the diagnosis of hepatitis C. METHODS: Sera of 108 patients with chronic liver disease (CLD) were analyzed by ELISA-2, ELISA-3, RIBA 3.0 and RT-PCR in the first part of the study; in the second part, sera of 105 patients with non-chronic liver disease were evaluated with ELISA-3, RIBA 3.0 and RT-PCR. RESULTS: In the CLD group, anti-HCV was positive in 4.6%, 14.8% and 16.6% by ELISA-2, ELISA-3 and RIBA 3.0, respectively. Among these anti-HCV positive cases, HCV RNA was positive in 100%, 58.9% and 64%, respectively. ELISA-2 did not give false-positive results, but missed substantial number of anti-HCV positive cases (p < 0.001). In the second group, anti-HCV was positive in 76.3% by ELISA-3 and 68.6% by RIBA 3.0 (p:ns). HCV-RNA was positive in 88.7% of ELISA- and RIBA-positive cases; in 60% of ELISA-positive, RIBA-indeterminate cases; and in 46.4% of ELISA-negative, RIBA-negative cases. CONCLUSIONS: ELISA-2 is not a suitable assay for routine screening. ELISA-3 was at par with RIBA 3.0 and it can be recommended for routine screening for anti-HCV. RT-PCR for HCV is of value in detecting early viremic, anti-HCV negative cases; this may be of importance in the treatment of hepatitis C.