Comparison of postoperative pain reduction using continuous rotation glide path system with other methods of glide path creation - a systematic review / Comparação de sistema de glide path rotatório contínuo com outros métodos de criação de glide path na redução de dor pósoperatória ­ uma revisão sistemática

Objective: Various glide path preparation techniques have been introduced, providing easiness to the practitioners. Recent literature has shown that glide path preparation influences the levels of postoperative pain occurrence in individuals receiving endodontic therapy. This systematic review aims to compare the different glide path preparation system in reduction of postoperative pain. Material and Methods: Electronic databases such as PubMed, Scopus, Cochrane Library, LILACS, Google Scholar, and European PMC were searched for published articles until July 2020. The studies included were randomized control trial (RCT) studies published during this time frame with comparison of continuous glide path system with various other glide path systems in reducing postoperative pain. The studies were reviewed using Preferred Reporting Items for Systematic reviews and Meta­Analyses (PRISMA) guidelines. The studies were reviewed independently by two reviewers who had assessed the included studies, extracted data and the quality using the Cochrane risk of bias assessment tool. Results:544 studies were received from the initial search, 11 articles were included in full text appraisal, 4 studies were obtained for qualitative analysis. Mean VAS Scores showed an increased reduction of postoperative pain in continuous glide path treated individuals (1.90-0.20) compared to reciprocating glide path (2.00-0.50) and manual glide path (3.80-0.85). The consumptions of analgesics were seen to be as follows; Manual Glide Path > Reciprocating Glide Path > Continuous Glide Path. Three out of four studies showed an overall "high" risk of bias and another study showed an overall "unclear" bias. Conclusion: From the achieved results, continuous glide path with 5.25% NaOCl irrigation has shown better reduction of postoperative pain compared to other glide path systems. Individuals who had undergone manual glide path preparation showed higher incidence of postoperative pain compared to other systems. The consumption of analgesics was seen to be higher in manual glide path prepared individuals followed by reciprocating glide path and least being continuous glide path.(AU)

Objetivo: Várias técnicas de preparação do glide path têm sido introduzidas, permitindo maior facilidade aos profissionais. A literatura tem mostrado que a forma de preparação do glide path influencia nos níveis de dor pós-operatória em indivíduos que recebem tratamento endodôntico. Esta revisão sistemática tem como objetivo comparar os diferentes sistemas de preparação do glide path na redução de dor pós-operatória. Material e Métodos: Bases de dados eletrônicas como PubMed, Scopus, Cochrane Library, LILACS, Google Escolar, e European PMC foram utilizadas para pesquisar artigos publicados até Julho de 2020. Os estudos incluídos foram ensaios clínicos randomizados controlados (ECRC) publicados até este período de tempo que compararam sistema de glide path contínuo com outros sistemas de glide path na redução de dor pós-operatória. Para revisão dos estudos, foi utilizado o 'Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines'. Dois revisores analisaram, independentemente, os estudos incluídos, os dados extraídos e a qualidade através da ferramenta de avaliação de risco de viés da Cochrane. Resultados: 544 estudos foram encontrados na pesquisa inicial, 11 artigos foram selecionados para avaliação de texto completo, 4 estudos foram obtidos para a análise qualitativa. A pontuação média do VAS mostrou um aumento na redução de dor pós-operatória em indivíduos nos quais foi utilizado o sistema de glide path rotatório contínuo (1.90-0.20) quando comparados àqueles nos quais foram utilizados o glide path reciprocante (2.00-0.50) e o glide path manual (3.80-0.85). A utilização de analgésicos foi vista da seguinte forma: Glide path Manual > Glide Path Reciprocante > Glide Path Contínuo. Três dos quatro estudos apresentaram um "alto" risco de viés geral e o outro estudo apresentou risco de viés geral "incerto". Conclusão: O glide path contínuo com irrigração de 5.25% de NaOCl mostrou a melhor redução de dor pós-operatória comparado aos demais sistemas de glide path. Indivíduos que foram submetidos à preparação de glide path pelo sistema manual apresentaram a maior incidência de dor pós-operatória. O consumo de analgésicos foi maior diante do uso do glide path manual, seguido pelo glide path reciprocante, e por último pelo glide path contínuo. (AU)

Comparison of postoperative pain reduction using continuous rotation glide path system with other methods of glide path creation - a systematic review / Comparação de sistema de glide path rotatório contínuo com outros métodos de criação de glide path na redução de dor pós-operatória ­ uma revisão sistemática

Objective: Various glide path preparation techniques have been introduced, providing easiness to the practitioners. Recent literature has shown that glide path preparation influences the levels of postoperative pain occurrence in individuals receiving endodontic therapy. This systematic review aims to compare the different glide path preparation system in reduction of postoperative pain. Material and Methods: Electronic databases such as PubMed, Scopus, Cochrane Library, LILACS, Google Scholar, and European PMC were searched for published articles until July 2020. The studies included were randomized control trial (RCT) studies published during this time frame with comparison of continuous glide path system with various other glide path systems in reducing postoperative pain. The studies were reviewed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The studies were reviewed independently by two reviewers who had assessed the included studies, extracted data and the quality using the Cochrane risk of bias assessment tool. Results: 544 studies were received from the initial search, 11 articles were included in full text appraisal, 4 studies were obtained for qualitative analysis. Mean VAS Scores showed an increased reduction of postoperative pain in continuous glide path treated individuals (1.90-0.20) compared to reciprocating glide path (2.00-0.50) and manual glide path (3.80-0.85) The consumptions of analgesics were seen to be as follows: Manual Glide Path > Reciprocating Glide Path > Continuous Glide Path. Three out of four studies showed an overall "high" risk of bias and another study showed an overall "unclear" bias. Conclusion: From the achieved results, continuous glide path with 5.25% NaOCl irrigation has shown better reduction of postoperative pain compared to other glide path systems. Individuals who had undergone manual glide path preparation showed higher incidence of postoperative pain compared to other systems. The consumption of analgesics was seen to be higher in manual glide path prepared individuals followed by reciprocating glide path and least being continuous glide path (AU)

Objetivo: Várias técnicas de preparação do glide path têm sido introduzidas, permitindo maior facilidade aos profissionais. A literatura tem mostrado que a forma de preparação do glide path influencia nos níveis de dor pós-operatória em indivíduos que recebem tratamento endodôntico. Esta revisão sistemática tem como objetivo comparar os diferentes sistemas de preparação do glide path na redução de dor pós-operatória. Material e Métodos: Bases de dados eletrônicas como PubMed, Scopus, Cochrane Library, LILACS, Google Escolar, e European PMC foram utilizadas para pesquisar artigos publicados até Julho de 2020. Os estudos incluídos foram ensaios clínicos randomizados controlados (ECRC) publicados até este período de tempo que compararam sistema de glide path contínuo com outros sistemas de glide path na redução de dor pós-operatória. Para revisão dos estudos, foi utilizado o 'Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines'. Dois revisores analisaram, independentemente, os estudos incluídos, os dados extraídos e a qualidade através da ferramenta de avaliação de risco de viés da Cochrane. Resultados: 544 estudos foram encontrados na pesquisa inicial, 11 artigos foram selecionados para avaliação de texto completo, 4 estudos foram obtidos para a análise qualitativa. A pontuação média do VAS mostrou um aumento na redução de dor pós-operatória em indivíduos nos quais foi utilizado o sistema de glide path rotatório contínuo (1.90-0.20) quando comparados àqueles nos quais foram utilizados o glide path reciprocante (2.00-0.50) e o glide path manual (3.80-0.85). A utilização de analgésicos foi vista da seguinte forma: Glide path Manual > Glide Path Reciprocante > Glide Path Contínuo. Três dos quatro estudos apresentaram um "alto" risco de viés geral e o outro estudo apresentou risco de viés geral "incerto". Conclusão: O glide path contínuo com irrigração de 5.25% de NaOCl mostrou a melhor redução de dor pós-operatória comparado aos demais sistemas de glide path. Indivíduos que foram submetidos à preparação de glide path pelo sistema manual apresentaram a maior incidência de dor pós-operatória. O consumo de analgésicos foi maior diante do uso do glide path manual, seguido pelo glide path reciprocante, e por último pelo glide path contínuo. (AU)

Anxiolytic activity of ultra-diluted Aconitum napellus on Wistar rats

BackgroundAnxiety disorders are highly prevalent that affect millions of people worldwide. Homeopathic system is gaining popularity due to its efficacy in chronic diseases. Ultra-diluted Aconitum napellusis a homeopathic medicine used by clinicians for treatment ofacute anxiety.AimObjective of this study is to test the efficacy of Aconiteon experimental anxiety models of Wistar rats. Methodology18 Female Wistar rats were dividedinto Control, Anxiety, andAnxiety + Aconite(ANX+ACO) groups. Acute stress was induced by restraining the rats for sixhours daily for fivedays in Anxiety and ANX + ACO groups. After fivedays of stress,a single dose of Aconite200cH was given to ANX + ACO group through oral gavage, whereas control and anxiety group rats were maintainedwith a normaldiet. Following this, behavioral assessment was done. Histological sections of the hippocampal area weretaken and stained with Hematoxylin and Eosin and also Cresyl violet stain. ResultsIt was observedthat the Aconitetreated group had morenumber of entries and also the percentage of time spent in the open arm was higher than the stressed anxiety group. Histological study of the brain tissue procured from all three groups was analyzed. ConclusionIt was inferred that ultra-diluted homeopathicAconitehas decreased anxiety in Wistar rats which were subjectedto acute restrainstress. However,the decrease was not statistically significant to deduce Aconiteas an anxiolytic.(AU)

A Validated Stability Indicating Rp-Hplc Method Development For Anti Cancer Drug Enzalutamide In Bulk And Pharmaceuticals

A reproducible stability-indicating Reverse Phase-HPLC technique for the quantification of enzalutamide in in pharmaceuticals was developed and validated. Chromatography was achieved on Inertsil-ODS-C18 (250mm×4.6 mm) 5µmanalytical column with acetonitrile: methanol: water in 40:30:30% v/v proportion as mobile phase and flow rate of 1 ml/min. Enzalutamide was detected at 237 nm UV-wavelength maximum. In the present work mobile phase used as a diluent. Developed technique was validated over 20-150 µg/ml linear concentration range for enzalutamide. This method established with linearity coefficient value of 0.99 and the percentage recovery was found to be 99.3%. This method was proven with LOD and LOQ values of 0.53 µg/mL and 1.61µg/ml respectively. The drug was degraded in acid and alkaline conditions and the percentage degradation values were 3.10 % and 4.54 % respectively. There was no degradation of drug when exposed to neutral, UV, thermal, sun-light and oxidative conditions.Drug was undergoing degradation when exposed to acid and alkaline conditions. The developed technique was useful in the routine quantitation of enzalutamide.

Investigation of Mode of Action of Anti Bacterial Activity of Salacia Oblonga Extract Against Drug Resistant Pathogen

Abstract Salacia oblonga Wall belonging to family Celastraceae contains vital phytoconstituents and has been used since long for the treatment of diabetes, inflammation and burn wounds. S. oblonga ethyl acetate root extract was evaluated for antibacterial activity towards drug resistant pathogens Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae. Further 260 nm absorbing material was estimated in the control and treated cells. Interestingly 260 nm absorbance material is higher in the Staphylococcus aureus. Further the effect of the plant extract on drug resistant pathogen S. aureus was examined by scanning electron microscopy (SEM). SEM results have shown that treated bacterial cells have changed in morphology, size and reduced in number. Based on these results it can be concluded that S. oblonga extract acts on membrane of the drug resistant pathogen S. aureus.

Impact of methylene blue staining in the retrieval of lymph nodes in resected colorectal cancer specimens.

Adequate lymph node harvest in resected colorectal cancer (CRC) specimens is important in staging and choosing appropriate therapeutic options. The yield of lymph nodes and metastatic nodes by methylene blue dye injection in 30 randomly selected resected CRC specimens was compared with an equal number of CRC specimens (control) with matched grade and stage.The mean number of lymph nodes retrieved in the study group was 22 ± 9 compared to 17 ± 8 in the control group which was statistically significant (P = 0.04).Methylene blue technique is an effective aid in increasing the yield of lymph nodes in the resected CRC specimens.

Alopecia areata: An update.

Alopecia areata (AA) is a common form of non-scarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Patchy AA is the most common form. Atopy and autoimmune thyroiditis are most common associated conditions. Peribulbar and intrabulbar lymphocytic infl ammatory infi ltrate resembling “swarm of bees” is characteristic on histopathology. Treatment is mainly focused to contain the disease activity. Corticosteroids are the preferred treatments in form of topical, intralesional, or systemic therapy. Camoufl age in the form of wigs may be an alternative option in refractory cases.

Risk factor profiles of head and neck cancer patients of Andhra Pradesh, India.

Objective: To define the demographic risk profile and stage at diagnosis among the head and neck cancer (HNC) patients reported in two hospital-based cancer registries in Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted in patients with histologically confirmed diagnosis of squamous cell carcinoma of the head and neck during 2002-2006. Data on the demographic profile and clinical information were obtained from hospital and clinical records. Staging was based on the American Joint Committee on Cancer and included primary tumor size (T), regional neck status (N), and group stage. The site of cancer was classified based on the International Classification of Disease for oncology (ICD-02). Results: A total of 5458 cases of HNC were included in this study. Majority of the subjects were in the age range of 40-69 years with a significant male preponderance in all the age groups (P<0.001). The most common habit was the combination of smoking, alcohol, and chewing in both males and females (20.1 and 35.1%, respectively) (P<0.001). Tongue and buccal mucosa were the most common sites of cancer in both males (26.8 and 12.8%, respectively) and females (22.9 and 19.8%, respectively) (P<0.001). Tongue was the commonest site of cancer occurrence with respect to all the habits (both singly and in combination) except for chewing tobacco where buccal mucosa was the most common site. Males were more likely to be diagnosed in stage 3 (37.6%) and 4 (20.6%), while females were diagnosed in stage 1 (36.3%) and 2 (32.7%) (P<0.001). Conclusion: A male preponderance of cancer occurrence and combination of all the three habits (smoking, alcohol, and chewing) were found to be the significant risk factors. Males were more likely to be diagnosed later than females.

Green tea [Camellia sinensis (L.) O. Kuntze] extract reverses the despair behaviour in reserpinised and diabetic mice.

Green tea (C. sinensis) extract (GTE) dose dependently produced reversal of despair in normal, reserpinised and diabetic mice, thereby demonstrating an antidepressant effect. Although the exact mechanism is yet to be explored, the possible inhibition of catechol-o-methyl transferase and monoamine oxidase enzymes may be responsible for antidepressant activity of GTE.

Quercetin attenuates thermal hyperalgesia and cold allodynia in STZ-induced diabetic rats.

Neuropathic pain is one of the important microvascular complications of diabetes. Oxidative stress and superoxide play a critical role in the development of neurovascular complications in diabetes. Aim of the present study was to evaluate the effect of quercetin, a bioflavonoid on thermal nociceptive responses in streptozotocin (STZ)-induced diabetic rats assessed by tail-immersion and hot plate methods. After 4-weeks of a single intravenous STZ injection (45 mg/kg body weight), diabetic rats exhibited a significant thermal hyperalgesia and cold allodynia along with increased plasma glucose and decreased body weights as compared with control rats. Chronic treatment with quercetin (10 mg/kg body weight; p.o) for 4-weeks starting from the 4th week of STZ-injection significantly attenuated the cold allodynia as well as hyperalgesia. Results indicate that quercetin, a natural antioxidant, may be helpful in diabetic neuropathy.

Heterotopic neuroglial tissue in hard palate.

Heterotopic neuroglial condition is a rare congenital anomaly in children. Most of the reported cases have been located in nose. To date, there was no recorded case of heterotopic neuroglial tissue in hard palate without any other congenital anomaly. The purpose of this report is to present a rare case of heterotopic neuroglial tissue in hard palate to add to literature we reviewed.

Evaluation of vitamin E against deltamethrin toxicity in broiler chicks.

Deltamethrin toxicity was studied in broilers and vitamin E was evaluated for therapeutic management. Day old male broiler chicks were randomly divided into 3 groups consisting of 6 chicks in each. Group 1 was maintained as control for 6 wks, group 2 was fed on deltamethrin (100 mg/kg feed) for 6 wks and group 3 was fed on deltamethrin for the first 4 wks and during the subsequent 2 wks with vitamin E (300 mg/kg feed) with out deltamethrin. Weekly body weights, feed conversion ratio, glutathione (GSH) concentration and high density lipoproteins (HDL) were significantly (P < 0.05) reduced, while the activities of glutathione peroxidase (GSH-Px), glutathione reductase (GSH-R), catalase, aspartate aminotransferase (AST) and lactate dehydrogenase (LDH), and the lipid profile and renal biomarkers were increased significantly (P < 0.05) in group 2 and 3 at the end of 4th wk as compared to group 1. Following treatment with vitamin E during the last 2 wks in group 3, all the parameters in study revealed improvement. From this study, it is concluded that deltamethrin induces toxicity by oxidative damage in biological system and supplementing vitamin E in feed is useful in treating accidental toxicity.

Acute reversible left ventricular dysfunction following general anesthesia.

Acute reversible left ventricular dysfunction due to myocardial stunning is a known phenomenon during acute myocardial infarction, coronary angiography, coronary angioplasty or after coronary artery bypass surgery. We report a rare case of acute reversible dysfunction of the myocardium as a complication of general anesthesia in a patient with normal coronary arteries. This is a potentially fatal complication unless recognized early and treated aggressively.

Primary choriocarcinoma of stomach.

A 45 year old patient wad admitted with pain abdomen and a palpable mass in the epigastrium of 3 months duration. Endoscopy revealed growth in the stomach and biopsy showed poorly differentiated Carcinoma. Distal radical subtotal gastrectomy was done. Histopathology revealed choriacarcinoma with Syncytiotrophoblastic and cytotrophoblastic and foci of adenocarcinoma. Postoperatively urine and serum had very high levels of beta-human chorionic gonogotrophins (B-HCG). Immunochemistry showed positivity for B-HCG. Clinically and on scan both the testis were normal. Because of its rarity, we are presenting this case with brief review of literature.

Importance of monitoring calcium & calcium related properties in carrier detection for Duchenne muscular dystrophy.

Calcium and calcium dependent enzymes viz., calcium ATPase, protein kinase C and calcium activated neutral protease (milli CANP mCANP) were studied in the erythrocytes, platelets and lymphocytes of obligate carriers, in order to assess the usefulness of these indices for detection of carriers for Duchenne muscular dystrophy (DMD). With the exception of mCANP and lymphocyte calcium ATPase, other calcium dependent enzyme activities showed considerable overlap between carriers and control. Since the increase in the level of platelet mCANP was found in all affected boys (no false negatives) and obligate carriers, and patients with other myopathic conditions and some neurogenic causes did not show high platelet mCANP activity, this parameter could be considered as a good phenotypic index. Unlike SCK, the platelet mCANP of carriers did not overlap that of controls, hence tests are to be carried out to verify its usefulness as an index of carrier state in mutations other than DNA deletion since testing of non-deletion is both costly and has practical limitations.

Determination of pyrazinamide in human by high performance liquid chromatography.

A facile and sensitive high performance liquid chromatographic (HPLC) technique has been developed for the determination pyrazinamide (PZA) in human plasma. Nicotinamide(NIA) is used as internal standard(IS). Plasma is deproteinized with 0.7 M perchloric acid; clear supernatant is neutralized with 1M NaOH and injected onto HPLC. The separation of pyrazinamide and the internal standard is carried out on a Supelco LC-18 (DB) column with a basic mobile phase. Pyrazinoic acid, the major metabolite, other anti-tuberculous drugs and endogenous components do not interfere with measurement of pyrazinamide. The limit of detection of pyrazinamide with this method is 0.2 mg/0.2 ml plasma (CV 8.2%).