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SUMMARY: Anatomy is a three-dimensional subject which needs face-to-face interaction and faced major challenges during the pandemic warranted changes in medical education. A narrative review was conducted to assess the attitude and perception of students and teaching faculty of healthcare professional courses towards Anatomy online teaching in the Kingdom of Saudi Arabia (KSA). A five stage framework narrative reviews outlined by Arksey & O'Malley (2005) was adopted for the current study. Inclusion criteria was studies conducted in Saudi Arabian healthcare professional colleges regarding online Anatomy teaching during the pandemic from March 2020 to April 2023. PRISMA-ScR search strategy was employed for identifying relevant studies which were managed using Endnote reference manager version 20. Nine articles were included in the review out of which two were mixed method studies, two were qualitative and five were quantitative studies. Students and teachers were mostly found to be satisfactory of the Anatomy e-learning experience. Major setbacks found were student and teaching faculty's negative attitude towards online practical teaching and concerns regarding academic dishonesty in students during online examination. Role of digital proficiency of teachers and students in the success of e-learning was emphasized by the review. This narrative review has mapped out the strengths and gaps in remote Anatomy teaching in Saudi Arabia during COVID-19 pandemic. There is a generally successful transition to e-learning in KSA from conventional teaching in Anatomy during the pandemic notwithstanding a few challenges that need to be addressed to improve the teaching and learning experience of Anatomy. Keywords: Anatomy, Online, E-learning, Saudi Arabia.
La anatomía es un tema tridimensional que necesita una interacción cara a cara y enfrentó grandes desafíos durante la pandemia, que justificó cambios en la educación médica. Se realizó una revisión narrativa para evaluar la actitud y la percepción de los estudiantes y profesores de cursos para profesionales de la salud, hacia la enseñanza en línea de Anatomía en el Reino de Arabia Saudita. Para el estudio actual, se adoptó una revisión narrativa del marco de cinco etapas delineada por Arksey & O'Malley (2005). Los criterios de inclusión fueron estudios realizados en colegios profesionales del área de la salud de Arabia Saudita, con respecto a la enseñanza de anatomía en línea durante la pandemia desde marzo de 2020 hasta abril de 2023. Se empleó la estrategia de búsqueda PRISMA-ScR para identificar estudios relevantes que se administraron utilizando el administrador de referencia Endnote versión 20. Se incluyeron nueve artículos en la revisión, de los cuales dos eran estudios de métodos mixtos, dos eran estudios cualitativos y cinco eran estudios cuantitativos. Se encontró que los estudiantes y profesores, en su mayoría estaban satisfechos con la experiencia de aprendizaje electrónico de Anatomía. Los principales contratiempos encontrados fueron la actitud negativa de los estudiantes y profesores hacia la enseñanza práctica en línea y las preocupaciones sobre la deshonestidad académica de los estudiantes durante los exámenes en línea. La revisión enfatizó el papel de la competencia digital de profesores y estudiantes en el éxito del aprendizaje electrónico. Esta revisión narrativa ha mapeado las fortalezas y brechas en la enseñanza remota de anatomía en Arabia Saudita, durante la pandemia de COVID-19. En general, hay una transición exitosa al aprendizaje electrónico en Arabia Saudita desde la enseñanza convencional de Anatomía durante la pandemia, a pesar de algunos desafíos que deben abordarse para mejorar la experiencia de enseñanza y aprendizaje de Anatomía.
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Humans , Education, Distance , COVID-19 , Anatomy/education , Saudi Arabia , PandemicsABSTRACT
Background: Taenia solium infections in humans include the infection by the adult tapeworm, these infections are of public health concern and are among the most important afflictions of humans who live in areas of poverty in the developing world and least developed countries. T. solium, a zoonotic disease, transmitted between pigs and humans and among humans, is common in developing countries. Aims and Objectives: The aim of the study was to estimate the detection rate of T. solium taeniasis among patients and random community screening with an indication of intestinal parasitic infection by routine stool examination. Materials and Methods: Stool samples were collected from the community and patients. Those who were willing, samples were screened for the cysts/ova/egg by direct microscopic examination by saline, iodine, concentration technique, and modified acid fast staining, were performed to differentiate species of T. solium and Taenia saginata. Results: Overall samples were 2030, out of which 870 stool samples were from community field screening 585 (28.81%) were positive. 1160 from tertiary care center, 668 (32.90%) were positive gave a total prevalence of intestinal parasitic infection of 61.72%. The prevalence of T. solium taeniasis was 194 (9.55%) out of which 92 (4.53%) were from community and 102 (5.02%) were from tertiary care center. Conclusion: The high prevalence of intestinal parasitic infestation might be due to the poor sanitary, contaminated water, and lack of education that is prevalent in the studied region as in other pockets in rural India. Our study showed the usefulness of the Ziehl-Neelsen modified acid-fast stain for identification of Taenia species.
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A good voice is the basic need of humans. For professional voice users, voice governs their livelihood and social attraction. A good singing voice is attained by the regular vocal exercises and vocal training. Singing involves the skills like respiration, phonation, resonance and articulation. Bhramari Pranayama (BP) involves both humming and respiration. Humming is the resultant of the activity vocal structures which may have effect on the quality of the voice. Aim: To evaluate the effect of Bhramari Pranayama (BP) on voice quality Settings and Design: The study is an open clinical trial involving 30 healthy prospective singers fulfilling the inclusion and exclusion criteria, consenting for the study, who were enrolled through a survey in music schools in the region of Belagavi, Karnataka. Methods and Material: The voice of the 30 healthy prospective singers was recorded using PRAAT software with standard vocal tasks on day 0 of the study. Participants practiced 21 cycles of Bhramari Pranayama in the morning for 30 days. On Day 30, after the practice the voice was re-recorded with same vocal tasks and standard operative procedures being maintained. The recorded voice samples were saved and were subjected for voice analysis using softwares PRAAT, Vaghmi, CSL at AIISH, Mysuru. Statistical analysis used: Statistical analysis was done using SPSS 21 and Paired ‘t’ test was applied to derive the results. Statistical Significance was set up at p<0.05. Results: Bhramari pranayama showed highly significant results in the root mean square values of the Singing power ratio - SPR (p<0.01) and singing power difference (p<0.01). Significant results in the lowest value of the singing amplitude (p<0.05), singing amplitude range (p<0.01) and mean formant frequency of second formant of vowel /u/(p<0.05). Conclusion: Bhramari Pranayama improved the resonance characteristics of the voice and there by improved the quality of singing voice in prospective singers.
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Similia Similibus Curantur is also called the law of similars. That is, when a drug produces pathological/pathogenic symptoms in healthy individual means, the same drug can relieve similar kinds of symptoms in individuals with the disease. The biological, pharmacological and toxicological action of capsaicin alkaloids is a perfect example to explain the Similia Similibus Curantur principle. Most of the drugs in homoeopathic materia medica contain toxicological, pharmacological, drug-proving, and traditional use-related symptoms and indications. Abnormal sensations and symptoms of the disease are caused by the involvement of a specific receptor or molecular pathway and gene functions. These receptors or molecules may be stimulated or suppressed by environmental, natural or artificial agents. In such conditions, the administration of specific homoeopathic medicine having a similar kind of affinity towards the particular receptors or molecules involved in the disease process leads to modulation of such receptor or molecular pathways (e.g., desensitization, sensitization, inhibition). These kinds of actions cause the betterment of symptoms or curative effects. So “Similia similibus curanter” can be understood as a similar receptor or molecular pathway involved in both drug molecules biological/ pharmacological and toxicological action and disease pathogenesis". The selection of medicine is by comparing the similarity between the receptor or molecular pathway in disease pathogenesis and drug pathogenesis. To avoid unwanted aggravations or side effects while using mother tinctures or solutions, administer them less than their physiological dose. The theory of the pharmacological basis of Similia Similia Curantur creates a rational method to apply this Similia Principle. Based on this theory, there is a possibility of discovering Novel drugs in the future that acts and gives a cure in similia similibus curantur way.
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Background@#Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. @*Methods@#This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. @*Results@#Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) @*Conclusion@#The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.
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Diabetes is a fast-growing chronic metabolic disorder that is widely associated with foot ulcers. The major challenge among these ulcers is wound infections, altered inflammatory responses, and a lack of angiogenesis that can complicate limb amputation.The foot, because of its architecture, becomes the part most prone to complications and the infection rate is higher mainly between the toes due to the humid nature. Therefore, the infection rate is significantly higher. Wound healing in diabetes is a dynamic process usually delayed due to poor immune function. Diabetes-related pedal neuropathy and perfusion disturbances can lead to a loss of sensation in the foot. This neuropathy can further be a risk factor for ulcer development due to repetitive mechanical stress that later might get infected by the invasion of microorganisms extending to the bone and causing an infection called pedal osteomyelitis. This review details the pathophysiology, the biomaterials aiding in the infection cure and regeneration of bone along with their limitations, as well as their future prospects.
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Background & objectives: A subset of diabetic individuals are known to develop progressive renal insufficiency without albuminuria, referred to as normoalbuminuric chronic kidney disease (NACKD). There is, however, a paucity of studies regarding this condition in India. So, this study, aimed to find the prevalence of normoalbuminuric renal dysfunction and its clinical associations in diabetic Indian population. Methods: Medical record search of patients with type 2 diabetes mellitus at a tertiary care centre was done. Based on the urinary albumin:creatinine ratio (>30 mg/g creatinine) and estimated glomerular filtration rate (e-GFR) (<60 ml/min/1.73m2), individuals were classified as having, (i) no kidney disease (NKD), (ii) chronic kidney disease (CKD), (iii) albuminuria alone (ALB), (iv) normoalbuminuric low e-GFR (NACKD) and (v) albuminuria with low e-GFR albuminuric CKD (ACKD). Furthermore, the clinical and biochemical parameters of these groups were also compared. Results: Data from 3534 diabetes patients with a mean age of 53.8±10.9 yr and mean duration of diabetes of 10.3±7.5 yr were available for the analysis. NACKD constituted 39.1 per cent of the patients with reduced e-GFR, NACKD was found in 2.1 per cent and ACKD in 3.4 per cent of all diabetic patients. Compared to NKD patients, was found an independent association between NACKD and higher age, male sex, lower body weight and statin intake but not with glycated haemoglobin, fasting and postprandial plasma glucose. Patients with NACKD were found to be older than those with ACKD. Retinopathy was found to be more prevalent in the ACKD patients, whereas the rates of macrovascular complications were found to be similar between the groups. The prevalence of NACKD relative to ACKD decreased in CKD stages 3b, 4 and 5. Interpretation & conclusions: The results of this study suggest that NACKD constituted greater than one third of patients with diabetes and decreased e-GFR, which showed a strong association with age but not with duration or severity of hyperglycaemia or the presence of retinopathy. Both NACKD and ACKD showed similar associations with macrovascular disease
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Cysticercosis has been reported as the most common illness affecting the central nervous system by cystic stage of Taenia. solium pork tapeworm. It is also referred as food borne zoonotic infection with T.solium larva or cysticercus stage in humans. Cysticercosis which affects central nervous system is called neurocysticercosis (NCC). The clinical manifestation of NCC largely depends on the number, type, size of the cysts, stage of development of cyst and degree of host immune response against the parasite. The present study aimed to assess the burden of Objectives: neurocysticercosis infection by CT imaging and antigen detection by ELISA in the community as well as hospital based patients. Blood samples were collected and antigen detection of cysticercosis by ELISA were done and CT Brain was Methods: done to con?rm the diagnosis of neurocysticercosis among the participants. The overall clinical presentation among Results: 640 subjects showed seizure as the major presentation 446 (69.69%). The overall results of the commercial-Ag-ELISA revealed 61 of 446 sera to be positive for Cysticercus antigen, and thus con?rming 13.68% total prevalence of neurocysticercosis in the study region. High index of exposure to T. solium cysticercosis in the study region of south Indian. An early Conclusion: diagnosis and appropriate treatment management can improve the quality of life of a patient.
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Objective: We present outcome data on hematopoietic stem cell transplantation (HSCT) in children with inborn errors of metabolism (IEM). Methods: We retrospectively analyzed data on children up to 18 years of age, diagnosed with IEM, who underwent HSCT between January, 2002 and December, 2020. Results: 24 children, (mucopolysaccharidosis – 13, Gaucher disease – 4, X-linked adrenoleukodystrophy – 4, metachromatic leukodystrophy – 2, Krabbe disease – 1) were included. Donors were matched family donors in 24%, matched unrelated donors in 34%, and haploidentical fathers in 42% of the transplants, with engraftment in 91% of children. Overall survival was 72% (55-100%) with a median followup of 76.5 (10-120 ) months, and progression-free survival of 68% (MPS-76%, X-ALD - 60%, Gaucher disease – 50%, and 100% in MLD and Krabbe disease). Conclusion: HSCT is an available curative option, and early age at HSCT prevents end-organ damage.
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The latest WHO (2017) classification describes the hematological abnormalities of Down's syndrome as a separate entity under 'Myeloid proliferations associated with Down's syndrome'. It includes Transient Abnormal Myelopoiesis and Myeloid leukemia of Down's syndrome. Here we report a case of a 3 days old neonate with Down's syndrome, presenting with a leukemic blood picture. The baby had icterus, fever and hepatosplenomagaly. Peripheral blood showed megakaryoblasts and giant platelets. A diagnosis of transient abnormal myelopoiesis was made by confirming with karyotyping and immunophenotyping. We attempt to address all the diagnostic challenges faced by a clinician and pathologist same, upon encountering such a case,by following an algorithmic approach. The mandatory need for follow up and cytogenetic studies in identifying high risk cases that will become myeloid leukemia of Down's syndrome are stressed. Our case also throws light upon the significance of identification of GATA1 mutation in diagnosing and prognostication of such cases.
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Abstract Introduction: Type A acute aortic dissection (AAD) remains a challenging cardiac emergency despite the availability of various management strategies. This study compared the outcomes of supracoronary ascending aortic replacement (SCAAR) with aortic valve (AV) resuspension with those of modified Bentall's operation for type A AAD and the progression of aortic regurgitation (AR), long-term dilatation of aortic root and proximal arch, and long-term mortality in SCAAR patients. Methods: Sixty patients underwent surgery for type A AAD (January 2005 to December 2015). Forty-three patients underwent SCAAR with AV resuspension and 17 underwent modified Bentall's operation. All patients were followed up. Results: Upon follow-up of SCAAR patients (n=40), there was significant reduction in aortic root size (preoperative 39.3 mm [9.4] vs. postoperative 33.1 mm [9.1]; P<0.001). Three of these patients worsened to severe AR while others had similar or lesser degree of AR. On comparison between preoperative and postoperative dimensions of all patients (n=53), there was no significant difference in distal ascending aorta size (35.7 mm [8.1] vs. 34.4 mm [8.9]; P=0.52). However, an increase in descending thoracic aorta size (28.8 mm [7.8] vs. 33.7 mm [9.9]; P<0.001) was observed. In-hospital and late mortalities for SCAAR vs. modified Bentall's procedure were 11.7% (seven patients) (7% [3] vs. 23.5% [4]) and 28% (15 patients) (15% [6] vs. 69% [9]), respectively. Conclusion: SCAAR with AV resuspension is a safe surgical option for type A AAD. Preservation of AV is associated with better long-term outcomes and reduced mortality. Modified Bentall's operation may be associated with long-term mortality.
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BACKGROUND: Calf muscle tightness is a very common occurring condition in athlete. Stretching is form of physical exercise in which a specific muscle or tendon (muscle group) is deliberately flexed or stretched in order to improve the muscle's elasticity and achieve comfortable muscle tone. Flexibility helps with injury prevention, reduction of soreness following a workout, and a general sense of well-being. There are different stretching technique and protocol for improvement in calf extensibility and flexibility. The purpose of this study was to investigate the effectiveness of two techniques PNF and SELF STRAP STRETCHING for improving calf flexibility among collegiate athletes. MATERIALS AND METHOD: The selected 30 college athletes were randomly allocated to 2 groups equally. Group1 (n= 15) were given PNF and Group2 (n=15) were given self-strap stretching technique. Calf flexibility for each group was measured using goniometer and knee to wall test.Treatment was given for four days a week for 4 weeks. RESULT: The collected values were analyzed using paired 't' test and independent 't' test. The result showed an increase in the values of goniometric measurement and knee to wall test of the PNF technique (group A) compared to baseline value of self-strap stretching (group B) 16.4 and 10.88 at the end of 4 weeks. CONCLUSION: This study concluded that PNF technique is found to bemore effective in improving the calf muscle among collegiate athletes.
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Dentists may encounter patients with numerical dental anomalies in clinical practice and understanding of these conditions would allow early detection as well as intervention. The absence of one or more teeth congenitally is referred as hypodontia. This dental anomaly is rarely reported in primary dentition and the most commonly affected teeth in the primary dentition are mandibular lateral incisors and primary canines are remarkably very rare and this entity has not been often reported. This case study was aimed to report a 3-year-old Indian girl with the absence of three canines primary dentition and also evaluate the overall dental development pattern of developing permanent teeth. Furthermore, a new finding for pediatric dentists that the development of permanent canines in case of missing primary canines.
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Objective@#Dendritic cells (DCs) are administered as immunotherapeutic adjuvants after the completion of standard treatment in most settings. However, our Phase I trial indicated that one patient out of four, who received autologous tumor lysate-pulsed dendritic cell (TLDC) also received cisplatin chemotherapy and experienced complete regression of her lung lesion, continuing to be disease free till date. Hence, the objective of our current study is to evaluate the sustenance or augmentation of immune responses when autologous human papillomavirus positive cervical tumor lysate pulsed DC- are combined with cisplatin, using co-culture assays in vitro. @*Methods@#Before treatment, peripheral blood and punch biopsy samples were collected from 23 cervical cancer patients after obtaining an informed consent. DC functionality was confirmed through phenotypic and functional assays using autologous peripheral blood mononuclear cells as responders. For cisplatin experiments, the drug was added at 150, 200 (clinical dose equivalent), and 400 µM concentrations to DCs alone or DC-T cell co-cultures. Phenotypic assessment and functional characterization of DCs was done using flow cytometry. Cytokine enzyme-linked immunosorbent assay and interferon (IFN)-γ enzyme-linked immune absorbent spot assays were also performed. @*Results@#The functionality of TLDCs was not compromised upon cisplatin treatment in vitro even at the highest (400 μM) concentration. Even though cisplatin treatment reduced the secretion of IFN-γ and interleukin (IL)-12p40 in co-cultures stimulated with TLDCs, this effect was not significant (p>0.05). A doubling of IFN-γ secretion following cisplatin treatment was observed in at least one of three independent experiments. Additional experiments showed a reduction in both FOXP3+ regulatory T cells and IL-10 levels. @*Conclusion@#Our results provide evidence that cisplatin treatment may be given after autologous TLDC administration to maintain or improve a productive anti-tumor response in vaccinated patients.
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Robots are man-made machines; created to increase the performance of an action. They are either autonomous or semi-autonomous in the hands of the user. The medical field has evolved and revolutionized over the decades. It is the hour of the robot-assisted medical care to successfully change the clinical scenario of patient care. Employment of robotics in diverse fields of medical care has increased the effectiveness of the treatment and in return the effectiveness of the healthcare professionals. Our aim is to emphasize the advances in robot-assisted procedures over their comparable facets and highlight the unresolved challenges of robotics in medical care for the near future.
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Human Papilloma Viruses (HPV) have been implicated to cause 5% of human cancers. The role of HPV as an etiological agent in the development of precancerous lesions and cancers of head and neck is increasingly being explored. The wide variation in prevalence of HPV has, to some extent, impeded a full understanding of association between HPV and benign and malignant lesions of head and neck. We wanted to determine the proportion of Human Papilloma Virus in squamous epithelial lesions of head and neck using Polymerase Chain Reaction (PCR) studying snap frozen fresh biopsy samples.METHODSThis is a descriptive study of cases presenting to the Department of Pathology, Govt. T D Medical College, Alappuzha, Kerala, conducted over a period of one year. 40 cases of clinically suspicious premalignant or malignant squamous lesions of head and neck were biopsied and were subjected to histopathological study and PCR using primer MY11/GP6. Data was entered in Excel sheet. The association of HPV positivity with lesions of head and neck was assessed using SPSS softwareRESULTSOf the 40 cases studied, the mean age of the cases studied was 55.98 years. Male to female ratio was 29:11. Most of the cases were alcoholics (60%), with smokers (55%) and the habit of pan chewing in 20% of the cases. The histopathological lesions studied were mostly malignant cases (squamous cell carcinoma- 77.5% of cases) and rest were oral keratosis, vocal cord polyp and a lesion showing chronic inflammation only. The predominant site of biopsy was from oral cavity (80%), followed by larynx (16%) and oropharynx (13%). HPV positivity was obtained in 2.5% of the cases, which was not statistically significant. HPV positivity did not show statistically significant association with any of the risk factor behaviours like alcoholism, smoking or pan chewing. The morphological diagnosis associated with HPV was moderately differentiated, which was also not statistically significant.CONCLUSIONSHPV positivity was obtained in 2.5% of the cases studied with no significant correlation between HPV and squamous epithelial lesions of head and neck.
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Objectives@#To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. @*Materials and Methods@#The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. @*Results@#Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. @*Conclusions@#QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.
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Objectives@#To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants. @*Materials and Methods@#The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains. @*Results@#Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute. @*Conclusions@#QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.
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Objectives@#This study aimed to summarize the outcome of in vitro studies comparing the antibacterial effectiveness of QMix with other irrigants against Enterococcus faecalis. @*Materials and Methods@#The research question was developed by using population, intervention, comparison, outcome, and study design framework. The literature search was performed using 3 electronic databases: PubMed, Scopus, and EBSCOhost until October 2019. The additional hand search was performed from the reference list of the eligible studies. The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0). @*Results@#Fourteen studies were included in this systematic review. The overall risk of bias for the selected studies was moderate. QMix was found to have a higher antimicrobial activity compared to 2% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), mixture of tetracycline isonomer, an acid and a detergent (MTAD), 0.2% Cetrimide, SilverSol/H2O2, HYBENX, and grape seed extract (GSE). QMix had higher antibacterial efficacy compared to NaOCl, only when used for a longer time (10 minutes) and with higher volume (above 3 mL). @*Conclusions@#QMix has higher antibacterial activity than 17% EDTA, 2% CHX, MTAD, 0.2% Cetrimide, SilverSol/H2O2, HYBENX, GSE and NaOCl with lower concentration. To improve the effectiveness, QMix is to use for a longer time and at a higher volume.
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Background@#Human adipose tissue is a great source of translatable biomaterials owing to its ease of availability and simple processing. Reusing discardable adipose tissue for tissue regeneration helps in mimicking the exact native microenvironment of tissue. Over the past 10 years, extraction, processing, tuning and fabrication of adipose tissue have grabbed the attention owing to their native therapeutic and regenerative potential. The present work gives the overview of next generation biomaterials derived from human adipose tissue and their development with clinical relevance. @*Methods@#Around 300 articles have been reviewed to widen the knowledge on the isolation, characterization techniques and medical applications of human adipose tissue and its derivatives from bench to bedside. The prospective applications of adipose tissue derivatives like autologous fat graft, stromal vascular fraction, stem cells, preadipocyte, adipokines and extracellular matrix, their behavioural mechanism, rational property of providing native bioenvironment, circumventing their translational abilities, recent advances in featuring them clinically have been reviewed extensively to reveal the dormant side of human adipose tissue. @*Results@#Basic understanding about the molecular and structural aspect of human adipose tissue is necessary to employ it constructively. This review has nailed the productive usage of human adipose tissue, in a stepwise manner from exploring the methods of extracting derivatives, concerns during processing and its formulations to turning them into functional biomaterials. Their performance as functional biomaterials for skin regeneration, wound healing, soft tissue defects, stem cell and other regenerative therapies under in vitro and in vivo conditions emphasizes the translational efficiency of adipose tissue derivatives. @*Conclusion@#In the recent years, research interest has inclination towards constructive tissue engineering and regenerative therapies. Unravelling the maximum utilization of human adipose tissue derivatives paves a way for improving existing tissue regeneration and cellular based therapies and other biomedical applications.