Impact of supragingival scaling on the outcomes of subgingival instrumentation completed after 1 week: a split-mouth randomized clinical trial.

OBJECTIVE: To investigate the impact of supragingival scaling on the clinical outcomes of subgingival instrumentation completed after 1 week. METHOD AND MATERIALS: In 27 patients with Stage II and Stage III periodontitis, pairs of contralateral quadrants were randomly assigned into test group 1 (single sitting scaling and root planing) and test group 2 (supragingival scaling followed by subgingival instrumentation after 1 week). Periodontal parameters were recorded at baseline, 2, 4, and 6 months; Gingival crevicular fluid vascular endothelial growth factor (VEGF) estimation was done at baseline in both groups and 7 days after supragingival scaling in test group 2. RESULTS: At 6 months, significantly better improvement in test group 1 at sites with periodontal probing depth (PPD) > 5 mm; (∆PPD = 2.32 mm vs 1.41 mm, P = .001; ∆clinical attachmen level [CAL] = 2.34 mm vs 1.39 mm, P = .001) was observed. Supragingival scaling resulted in significant reduction in gingival crevicular fluid VEGF (42.46 to 27.88 pg/site) after 1 week. Regression analysis explained 14% variance in VEGF to baseline PPD at sites with PPD > 4 mm; and 21% variance in CAL improvement to VEGF at sites with PPD > 5 mm. The percentage of sites with PPD = 5 to 8 mm reaching the clinical endpoint was 52% and 40% for test group 1 and test group 2, respectively. Better results were noticed in bleeding on pocket probing-positive sites in both groups. CONCLUSION: The sites with PPD > 5 mm where supragingival scaling was followed by subgingival instrumentation after 1 week resulted in less favourable treatment outcomes. (Clinical trial registry NCT05449964).

Comparative Evaluation of Serum High-sensitivity C-Reactive Protein and Complete Hemogram Indices in Subjects with and without Apical Periodontitis: A Prospective Interventional Study.

INTRODUCTION: This study aimed to compare the levels of high-sensitivity C-reactive protein (hsCRP) and complete hemogram (CH) parameters before and after root canal treatment in patients with apical periodontitis (AP) and healthy controls. METHODS: Twenty-five patients with asymptomatic AP in a single permanent tooth were recruited along with age- and sex-matched healthy controls. Baseline serum hsCRP and CH parameters were recorded in both groups. Root canal treatment was performed in teeth with AP, and biochemical parameters were re-evaluated at the 6-month follow-up. Mann-Whitney and chi-square tests were used to analyze data quantitatively and qualitatively, respectively. Spearman correlation was applied to explore the relation between hsCRP with AP and periapical healing. Multivariate linear regression tests were used to assess the effect of independent variables such as age, sex, body mass index, and periapical index score on levels of hsCRP. RESULTS: A baseline comparison between patients with AP (3.37 ± 2.69 mg/L) and controls (1.69 ± 2.2 mg/L) revealed a significant difference in hsCRP levels. However, all CH parameters were within the reference range. A total of 22 patients in the AP group completed follow-up, and based on the periapical index score and clinical presentations, 72.2% of patients were classified as healed. At follow-up, hsCRP significantly reduced to 1.79 ± 1.65 mg/L in the AP group. A significant correlation between AP and hsCRP was observed. CONCLUSIONS: Patients with AP had a significantly higher inflammatory burden than healthy controls, which significantly reduced after root canal treatment. No significant change was detected in CH indices.

Assessment of clinical and virological outcomes of rural and urban populations: COVID-19.

Objective: To assess the clinical and virological status in urban and rural populations. Methods: A cross-sectional study was conducted in a tertiary care hospital, Postgraduate Institute of Medical Sciences, Rohtak for a period of six months. Upper respiratory tract (URT) specimens including nasopharyngeal and oropharyngeal swabs were collected from the patients and their contacts and processed by RT-PCR technique for COVID-19 detection. Further, clinical and virological response in both the population were assessed and compared. Results: A total of 37,724 URT samples were tested, out of which 20,144 (53%) samples were from the rural population and 17,580 (47%) from the urban population. Out of the total samples from urban and rural population, COVID-19 positivity was 13.9% in urban population and 6.2% in rural population. Around 86% patients or contacts were asymptomatic in both the rural and urban population and rests were symptomatic 14%. Among the symptomatic patients, sore throat was seen as the most common presenting symptom (95-100%) followed by fever (80-83%), dry cough (55-61%), nasal discharge (18-23%), and breathlessness (3-5%) in both the rural and urban population. Conclusion: Our outcomes provide novel facts that the COVID-19 epidemic severely affected both rural and urban populations but with few differences. In our study, positivity rate in case of urban population was 13.9% as compared to 6.2% in rural population. There are two foremost facets that contributed variation in positivity in both the population. First, better immune response in rural population as compared to urban population which can be due to the fact that rural people in India are more exposed to various pathogens during their early lifetime thus, improving their immune status. Second, factor could be elevated population densities in urban areas which can contribute to increased infectiousness thus higher positivity rate. In addition, people living in urban population have to commute more for their work and are exposed to more people throughout the day thus, having more possibility to get infection of COVID-19 as compared to the rural population. To the best of our knowledge, there are no studies conducted on COVID-19, among rural population of Haryana. Hence, this study will allow us to fill the gap in knowledge about the variation in contagion spread and immune response in both rural and urban populations.

Majocchi's granuloma of the face in an immunocompetent patient.

Majocchi's granuloma is a condition with chronic erythematous and indurated plaques that is a result of the rupture of a dermatophyte-infected infundibulum as a result of trauma. It is frequently seen on the anterior aspect of the legs of women. Herein, we present a case of Majocchi's granuloma of face, a site rarely involved, in an immunocompetent patient. Diagnosis was confirmed by histological and mycological examination. Histological examination revealed hyphae and arthrospores in the hair follicles and in the dermis with a diffuse dermal infiltrate consisting of lymphoplasmacytic cells, and focal collections of epithelioid cells, neutrophils and mild interstitial edema. Mycological examination confirmed the presence of fungus, Trichophyton rubrum, and the diagnosis of Majocchi's granuloma of the face was made. No concrete predisposing factor was found to be associated with the occurrence of the lesions on the face. However, the history of prolonged veiling of the face by a cloth by the patient, perhaps contributing to the occurrence of lesions on face, is a point of dubious significance.