Anhedonia among patients with Major Depressive Disorder: A comparison between patients on escitalopram and healthy controls.

BACKGROUND AND AIMS: Escitalopram has widely been recognized as one of the most frequently used antidepressants, with superior tolerability and great efficacy in preventing major depressive disorder (MDD) relapse and recurrence. However, anhedonia, which is a core symptom of MDD, remains difficult to treat. This study investigates the hedonic levels of MDD patients treated with Escitalopram. MATERIALS AND METHODS: A total of 108 participants, 26 of whom with MDD on Escitalopram, were recruited in this cross sectional study. They were evaluated using the Snaith-Hamilton Pleasure Scale (SHAPS) and Beck Depression Inventory (BDI) questionnaires to assess their hedonic state, general mental health condition and level of depression. RESULTS: Our study shows that most items in the SHAPS scores are significantly different between MDD patients on Escitalopram and the controls. CONCLUSIONS: The hedonic capacity remains different between the two groups despite patients with MDD are put on Escitalopram treatment. Escitalopram fails to alleviate the hedonic state of MDD patients. Antidepressants that improve both depressive symptoms and hedonic states should be considered when treating MDD patients in clinical settings.

Clinical factors associated with sexual dysfunction among men in methadone maintenance treatment and buprenorphine maintenance treatment: a meta-analysis study.

Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52-10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.

Acalypha wilkesiana extracts induce apoptosis by causing single strand and double strand DNA breaks.

ETHNOPHARMACOLOGICAL RELEVANCE: The seeds of Acalypha wilkesiana have been used empirically by traditional healers in Southwest Nigeria together with other plants as a powder mixture to treat patients with breast tumours and inflammation. AIM OF THE STUDY: There is an increasing interest among researchers in searching for new anticancer drugs from natural resources, particularly plants. This study aimed to investigate the anticancer properties of Acalypha wilkesiana extracts and the characteristics of DNA damage against brain and lung cancer cells. MATERIALS AND METHODS: The antiproliferative activity of Acalypha wilkesiana extracts (ethyl acetate, hexane, and ethanol) was examined on human glioma (U87MG), human lung carcinoma (A549), and human lung fibroblast (MRC5) cells. RESULTS: Cell viability MTT assay revealed that ethyl acetate extract of the plant possessed significant antiproliferative effects against both U87MG (GI(50)=28.03 ± 6.44 µg/ml) and A549 (GI(50)=89.63 ± 2.12 µg/ml) cells (p value<0.0001). The hexane extract was found to exhibit crucial antiproliferative effects on U87MG (GI(50)=166.30 ± 30.50 µg/ml) (p value<0.0001) but not on A549 cells. Neither plant extract possessed noticeable antiproliferative effects on the non-cancerous MRC5 cells (GI(50)>300 µg/ml). The ethanol extract showed no antiproliferative effects on any cell line examined. Haematoxylin & Eosin (H & E) staining and single cell gel electrophoresis (SCGE) comet assay confirmed that plant extract-treated cells underwent apoptosis and not necrosis. SCGE comet assays confirmed that plant extracts caused both single strand (SSB) and double strand (DSB) DNA breaks that led to the execution of apoptosis. CONCLUSION: The extracts (especially ethyl acetate and hexane) of Acalypha wilkesiana possess valuable cytotoxic effects that trigger apoptosis in U87MG and A549 cancer cells through induction of DNA SSBs and DSBs.

Cross-reactivity of Malaysian rat cytomegalovirus strains with its human counterpart.

This study probes into the prospect of cross-reactivity of HCMV with RCMV which has not been acknowledged to date. We describe the uncovering of a protein with an estimated size of between 61-68 kDa from local RCMV strains which reacted with HCMV positive sera. Our findings are a first disclosure of a plausible immunological cross-reactivity between RCMV with its human counterpart which grounds substantial interest implying existence of conserved determinants between rat and human CMV polypeptides. The cross-reactive protein most likely represents an enveloped glycoprotein, though the precise identification and its degree of similarity needs to be evidently defined and further elucidated in forthcoming experiments.

Cross-reactivity of Malaysian rat cytomegalovirus strains with its human counterpart

This study probes into the prospect of cross-reactivity of HCMV with RCMV which has not been acknowledged to date. We describe the uncovering of a protein with an estimated size of between 61-68 kDa from local RCMV strains which reacted with HCMV positive sera. Our findings are a first disclosure of a plausible immunological cross-reactivity between RCMV with its human counterpart which grounds substantial interest implying existence of conserved determinants between rat and human CMV polypeptides. The cross-reactive protein most likely represents an enveloped glycoprotein, though the precise identification and its degree of similarity needs to be evidently defined and further elucidated in forthcoming experiments.

Development of a quantitative real-time RT-PCR for kinetic analysis of immediate-early transcripts of rat cytomegalovirus.

One-step real-time RT-PCR assay was developed for quantification of the immediate-early (IE), namely IE1 and IE2 transcripts of Rat cytomegalovirus (RCMV), strain ALL-03 in rat embryonic fibroblast cells (REF). This in-house SYBR Green I based RT-PCR was shown to have higher amplification efficiency and detection limit as compared to a commercially available real-time RT-PCR kit in quantifying these two transcripts. The quantification histogram revealed the divergence of transcription activities of the two IE genes. The IE1 transcript had a concentration peak at 7 hrs post infection (p.i.), whereas IE2 transcript at 20 hrs p.i. Regulation of IE expression is critical for determination, whether the infection is going to be abortive, lytic or latent. Therefore, this in-house developed quantitative RT-PCR assay offers an alternative for diagnosis and monitoring of the acute cytomegalovirus (CMV) infection directed at IE transcript detection.

Pathogenesis and antibody response to a cytomegalovirus infection in newborn rats.

The present study described the kinetics of Rat cytomegalovirus (RCMV) infection in newborn rats by monitoring infectious virus and viral antigens in various organs, viral DNA in the blood (DNAemia) and antibody response. These parameters were evaluated quantitatively using double-antibody sandwich ELISA (DAS-ELISA), real-time PCR, indirect ELISA and virus infectivity assay. For the first time DAS-ELISA was used for detection of RCMV antigen directly from organ samples. The relationships between the presence of viral antigens in the infected organs and antibody levels were established by the Spearman's rank test. It was found that the virus was present in the blood, spleen, liver, lungs, and kidneys earlier than in the salivary glands. Furthermore, the early immunity of the newborn rats led to a delayed seroconversion. We suggested that the prolonged presence of the virus in salivary glands could augment the antibody response that conversely might be responsible for a reduction of viremia. This study expanded our understanding of RCMV pathogenesis leading to improved therapeutic and preventive treatment regimens particularly for the neonatal Human cytomegalovirus (HCMV) infections. Additionally, the detection procedures developed in this study such as DAS-ELISA and real-time PCR could serve as alternative techniques for rapid screening of large number of samples.

Characterization of a novel rat cytomegalovirus (RCMV) infecting placenta-uterus of Rattus rattus diardii.

A new rat cytomegalovirus (RCMV) isolated from the placenta/uterus of a house rat (Rattus rattus diardii) was found to productively infect rat embryo fibroblast (REF) cells. The virus produced typical herpesvirus-like cytopathic effects characterized by a lytic infection. The well-known herpesvirus morphology was confirmed by electron microscopy. Its slow growth in cell culture indicated that the virus is belonging to subfamily Betaherpesvirinae. Electron microscopy techniques and immunohistochemistry confirmed the presence of herpesviral inclusion bodies and virus related particles in the cytoplasm and nucleus of infected cells. Hyperimmune serum against the Maastricht strain of RCMV revealed the virus identity in neutralization test, immunoperoxidase and immunofluorescence techniques. Despite typical characteristics of CMV, the viral genome is significantly different from that of Maastricht, English, UPM/Sg and UPM/Kn strains. The dissimilarities, which have not been reported before, had been confirmed by mean of restriction endonuclease analysis. The new RCMV strain, a virus that infects placenta and uterus of rats, has been named as ALL-03.

Case reports: the use of intermaxillary screws to achieve intermaxillary fixation in the treatment of mandibular fractures.

INTRODUCTION: Treatment of mandibular fractures commonly involves the use of arch bars in temporary maxillo-mandibular fixation (also called intermaxillary fixation) to aid bone plating, for the postoperative application of light elastic traction to correct minor occlusal discrepancies and intermaxillary fixation for post reduction immobilisation. The purpose of this paper is to describe a quick and simple alternative for intermaxillary fixation. CLINICAL PICTURE: Three cases of mandibular fractures are presented to demonstrate the use of intermaxillary screws instead of conventional arch-bar wiring. TREATMENT: Two cases were treated with closed reduction methods while the other case was treated with open reduction. OUTCOME: Subsequent fracture healing was not compromised using this technique. CONCLUSIONS: With careful case selection, successful treatment outcome may be achieved using this time-saving and technically simple procedure. Some of the advantages and disadvantages of the intermaxillary screws are discussed.

Trigeminal neuralgia. A retrospective survey of a sample of patients in Singapore and Malaysia.

This survey was undertaken to study the clinical features of trigeminal neuralgia in an Asian population. Demographic data of 44 patients treated at the Dental Faculty of the National University of Singapore and at the University of Malaya were reviewed. The results of the survey were analysed and comparisons made with those of Caucasian patients as reported in other studies where there was a general similarity in the clinical findings. Trigeminal neuralgia presented predominantly in females. Right-sided involvement occurred at a greater frequency, and the peak age at onset was between the sixth and seventh decades of life. The only significant variant in the present sample was the greater involvement of the mandibular branch of the trigeminal nerve rather than the maxillary division. In addition, there was a much greater representation from Chinese patients over Malays as compared with their ratios in the general population.

Root morphology of the maxillary first premolar in Singaporeans.

Extracted teeth were collected from clinical procedures performed in the Faculty of Dentistry, National University of Singapore. A selected sample of 957 maxillary first premolars were subjected to visual examination and digital radiography. There was a higher incidence of two-root form (50.6 per cent) than previously reported for the Singaporean dentition. In the two-root category, 307 teeth exhibited the fused-root form (two fused roots with two root canals) and 177 were distinctively of the two-root form (two separate roots with two root canals and two foramina). The fused-root form was emphasized as an entity in this study. The one-root form accounted for 49.4 per cent. No three-root form was detected.

Bilateral coronoid hyperplasia--a report with a view on its management.

Bilateral coronoid hyperplasia requires surgery (coronoidectomy) to improve mouth opening. An intra-oral approach is preferred with direct fibre-optic anaesthetic intubation. Myotomy of the masseter muscle is recommended in cases where fibrotic and calcifying effects have occurred. Pre-operative physiotherapy counselling and post-operative jaw exercises are important to the final success of the management.

Coronal morphology of the mandibular second premolar in the Singaporean Chinese.

Five hundred and sixty-four patients of Singaporean Chinese origin with bilateral second premolars present were screened. Morphological features of the crown, number and position of cusps and the sex of the patient were recorded. The mesio-distal dimensions of the crowns were measured. Three hundred and seventy-four (66.3 per cent) exhibited bilateral 2-cusp forms; 143 (25.4 per cent) were 3-cusp forms; and 47 (8.3 per cent) were mixed. There was no sex predilection in the three groups. In the 2-cusp forms, the predominant occlusal pattern was H-shaped (75.9 per cent). The 3-cusp type with a Y-shaped pattern and a squarish outline is a significant morphological and racial characteristic in the local population. The presence of 2-cusp and 3-cusp forms in an individual is an unusual developmental phenomenon.

A clinical investigation of the management of oral lichen planus with CO 2 laser surgery.

Ten patients with an established histologic diagnosis of lichen planus on various sites of the oral cavity were treated with CO 2 laser therapy under local anesthesia. Power output of 5 W at continuous mode was applied to vaporize the lesions. Eradication was achieved by aiming the laser in a moving criss-cross pattern with defocused spatial overlap. Depth of removal was subepithelial. No suturing of the wound was done. Follow-up occurred at intervals from 6 months to 4 years. The average length was about 3 years. Postlaser healing was uneventful, with little pain, swelling, or bleeding. There was immediate relief in all patients of associated burning sensations and a tolerance to hot and spicy foods. This symptomatic improvement lasted throughout the follow-up. Reepithelialization produced little visible scarring, and the mucosa color and texture were close to normal. Alterations in the immunologic status of the patients were implicated. Histologic rebiopsy in two cases suggested significant improvement, normalization of the epithelium, and a reduction of the subepithelial infiltrate. The CO 2 laser is effective in the immediate relief of symptoms and contributes to the clinical improvement of oral lichen planus. Immunologic studies and long-term follow-up are suggested.

The treatment of epulis fissuratum of the oral cavity by CO 2 laser surgery.

A clinical study was conducted on a group of 20 patients who presented with epulis fissuratum caused by denture wearing. CO 2 laser surgery was used to treat these patients and the cases were followed up over a two-year period. The advantage of CO 2 laser surgery on oral tissues was evident by the good response to healing four weeks postoperatively and beyond. No sutures or packing of any kind were used and the wound was allowed to granulate. Re-epithelialization occurred in all patients within 14 days and was complete after about 4 weeks. The lack of wound contraction, scarring, and good re-epithelialization combined with precise tissue destruction make CO 2 laser surgery ideal for this procedure when compared with conventional surgical techniques. The advantage of using CO 2 laser surgery has been demonstrated clinically in the patients treated in this study.

Mongoloid features of the permanent mandibular second molar in Singaporean Chinese.

The permanent mandibular second molar is usually described as four-cusped, two placed buccally and two lingually. It has been reported that five-cusp forms were more commonly present in dentitions of mongoloid origin. The prevalence and features of this tooth form were examined in a Singaporean sample of 380 subjects with bilateral presence of the mandibular second molars. One-hundred and sixty four cases (43.1 per cent) were found to have bilateral occurrence of five-cusp forms and thirty-four cases (8.9 per cent) with unilateral occurrence. Six-cusp forms were detected in three cases. There was almost equal prevalence in both sexes and both sides were equally involved in unilateral cases. The extra cusp was smallest, placed disto-buccally and sometimes midway at the distal border. The occlusal outline of five-cusp second molars was rectangular with a somewhat similar groove pattern to the first molar. There was an increase in the mesio-distal width of the crown. The high incidence was comparable with other studies of mongoloid dentitions and it could be considered as an important morphological and racial characteristic of the Singaporean Chinese.

Primitive neuroectodermal tumour in the oral cavity. Case report.

Primitive neuroectodermal tumour is regarded as a rarely seen lesion as it occurs mainly within the central nervous system. However, this neoplasm does occasionally occur elsewhere in the body. One such case which occurred in the posterior part of the palate in a child is reported. Following a combined therapeutic approach comprising surgery, radiotherapy and chemotherapy, the patient has been well for nine years since treatment.

A ten-year follow-up case report following surgical correction of anterior open bite.

A case is reported whereby an anterior open-bite was treated with the Köle osteotomy in an adult Chinese girl. This study documents cephalometrically the post-treatment changes occurring in the dento-alveolar complex over a ten year follow-up period and describes the possible mechanisms contributing to the remarkable stability of the open-bite correction.