ABSTRACT
Periodontal disease is a chronic inflammatory disease which destructs the supporting structures of the tooth and causes tooth loss. Dental plaque is the most common causative agent for periodontal diseases. Based on the location, dental plaque are of two types – supra gingival and sub gingival plaque. Supra gingival plaque is responsible for caries and gingival disease whereas sub gingival plaque is responsible for periodontal destruction. Plaque control can be achieved by combination of mechanical and chemical methods. Mechanical methods aid in removing the irritants during initial phase of treatment, and to maintain the condition, chemical methods like mouthwash, floss and interdental brushes were used. Chlorhexidine is the most commonly used antimicrobial mouthwash for many periodontal conditions and it is known for its substantivity property. Although it has various advantages, prolonged usage of chlorhexidine causes sensitivity of teeth and other side effects. Most of the researches were performed to find an alternative to chlorhexidine mouthwash to overcome its side effects and they believed that herbal mouthwashes with various combinations can be used for prophylactic measures which has no side effects and also act as good anti-microbial agents. Herbal mouthwashes contain phytochemicals that contains anti-microbial and anti-inflammatory effect which works without alcohol, artificial preservatives, flavour, or colours. “Triphala” is among the most common formulas used in traditional ayurvedic medicine. It contains fruits of three trees, and they are Indian gooseberry Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica), and Haritaki (Terminalia chebula). It has anti-plaque effect due to the presence of tannic acid which adheres to the bacterial cell surface and causes protein denaturation and ultimately to bacterial cell death. Triphala also has antioxidant, anti-inflammatory, anti-collagenase activity. It inhibits the collagenases derived from leukocytes which are responsible for connective tissue destruction in periodontal disease. Hence the usage of Triphala mouthwash treatment of periodontal disease becomes significant. The reason for this review is to give detailed information about the effects of Triphala mouthwash in periodontal disease. Most commonly chlorhexidine mouthwash is used in periodontal therapy even though it has several disadvantages. This review helps in providing effects comparatively similar to chlorhexidine without any adverse effects.
ABSTRACT
Microalgae based biofuel is an attractive alternative energy source due to its rapid growth rate and high lipid accumulation efficiency. In this study, we screened high lipid content microalga with the favourable fatty acid composition suitable for biodiesel production. Totally twelve different microalgal species were isolated from freshwater habitats. The isolates were identified as Micractinium sp., Chlorella sorokiniana, Scenedesmus bajacalifornicus, Desmodesmus sp., Scenedesmus obliquus, Coelastrum proboscideum, Chlamydomonas moewusii, Chlamydomonas debaryana, Chlamydomonas dorsoventralis, Coelastrum sp., and Ankistrodesmus sp. based on morphological features and ITS region similarity. Among the isolates, highest lipid content (33±0.07%) and lipid productivity (0.27±0.06 g L-1) were obtained from Ankistrodesmus sp. Intracellular lipid droplets of Ankistrodesmus sp. were observed through Nile red staining. The lipid content was enhanced up to 45% under the nitrogen deficient (5 mg L-1) BG-11 medium. Ankistrodesmus sp. fatty acid profile shows the presence of palmitic (16.39%), stearic (15.67%), oleic (25.66%), linolenic (21.62%), and alpha-linoleic acids (14.34%). The oleic acid was the dominant fatty acid 25.66% in the nitrogen deficient condition.
ABSTRACT
Background: To analyze the prescribing patterns of statins a hypolipidemic agents by using HMIS database in outdoor patients at tertiary care teaching hospital of central India.Methods: In this retrospective study Using HMIS database, 1000 prescriptions were analyzed for statin use for various WHO prescription indicators using ATC code of statins, the ratio of prescribed daily dose (PDD) and defined daily dose (DDD) was calculated.Results: Atorvastatin was the only statin which was prescribed as monotherapy (61.1%), whereas as combination with aspirin (38.9%). While analyzing the prescriptions, it was found that patients having abnormal lipid profiles (51.8%) and normal lipid profiles (48.2%) were prescribed atorvastatin. Hypertension with diabetes (37%) was the most common disease followed by hypertension (21.2%) and diabetes mellitus (21%) for which atorvastatin was prescribed. The average number of drugs per prescription were 3.8±1.65.Conclusions: This study depicts the use of atorvastatin in various disease conditions, both as primary and secondary preventive measures. There was no polypharmacy. Such studies should be done to educate the physicians on good prescribing practices and to rationalize use of hypolipidemic drugs.
ABSTRACT
BACKGROUND: Studies addressing the appropriateness of laboratory testing have revealed approximately 20% overutilization. We conducted a narrative review to (1) describe current interventions aimed at reducing unnecessary laboratory testing, specifically in hospital settings, and (2) provide estimates of their efficacy in reducing test order volume and improving patient-related clinical outcomes. METHODS: The PubMed, Embase, Scopus, Web of Science, and Canadian Agency for Drugs and Technologies in Health-Health Technology Assessment databases were searched for studies describing the effects of interventions aimed at reducing unnecessary laboratory tests. Data on test order volume and clinical outcomes were extracted by one reviewer, while uncertainties were discussed with two other reviewers. Because of the heterogeneity of interventions and outcomes, no meta-analysis was performed. RESULTS: Eighty-four studies were included. Interventions were categorized into educational, (computerized) provider order entry [(C)POE], audit and feedback, or other interventions. Nearly all studies reported a reduction in test order volume. Only 15 assessed sustainability up to two years. Patient-related clinical outcomes were reported in 45 studies, two of which found negative effects. CONCLUSIONS: Interventions from all categories have the potential to reduce unnecessary laboratory testing, although long-term sustainability is questionable. Owing to the heterogeneity of the interventions studied, it is difficult to conclude which approach was most successful, and for which tests. Most studies had methodological limitations, such as the absence of a control arm. Therefore, well-designed, controlled trials using clearly described interventions and relevant clinical outcomes are needed.