Safety and efficacy of melatonin as an adjuvant therapy in COVID-19 patients: Systematic review and meta-analysis.

BACKGROUND: Melatonin might be beneficial to coronavirus disease 2019 (COVID-19) patients in terms of both prevention and treatment. We investigated how melatonin affected various clinical and laboratory results in COVID-19 patients. METHODS: PubMed, Scopus, Cochrane Library and Web of Science databases were utilized for searching eligible articles fulfilling our inclusion criteria up to December 2022. We used random effect model in case of significant heterogeneity; in other cases, a fixed model was applied. RevMan was used for meta-analysis. RESULTS: We included 11 studies in our review. Clinical improvement rate was found to be statistically significantly higher in patients taking melatonin than in the control group (OR: 5.09; 95% CI: 2.60-9.96, p â€‹< â€‹0.001). Patients receiving melatonin showed a non-significant difference in mortality rate compared to the control group (OR: 0.37; 95% CI: 0.07-1.81, p â€‹= â€‹0.22). However, in the randomized controlled trials subgroup, melatonin-treated patients showed significantly lower mortality than did the controls (OR: 0.17; 95% CI: 0.08-0.38, p â€‹< â€‹0.001). CRP level was statistically significantly lower due to melatonin treatment (weighted mean difference [WMD] â€‹= â€‹-9.85; 95% CI: -18.54 to -1.16, p â€‹= â€‹0.03). Length of hospital stay was statistically significantly shorter in patients taking melatonin compared to controls (WMD â€‹= â€‹-4.05; 95% CI: -5.39 to -2.7, p â€‹< â€‹0.001). CONCLUSION: Melatonin was found to have substantial effects on COVID-19 patients when used as adjuvant therapy, enhancing clinical improvement and decreasing time to recovery with a shorter length of hospital stay and a shorter duration of mechanical ventilation.

Comparative Evaluation of 3 Commercial Mouthwash Formulations on Clinical Parameters of Chronic Gingivitis.

BACKGROUND Chlorhexidine (CHX) is not prescribed as a mouthwash for long-term use; therefore, probiotic/herbal mouthwashes are being investigated. This study compared the effect of 3 commercial mouthwashes on plaque index (PI), gingival index (GI), and bleeding index (BI) in patients with chronic gingivitis. MATERIAL AND METHODS Forty-five patients (all with moderate plaque) were randomly allocated into 3 groups (Gp): Gp 1 (CHX), Gp 2 (Manuka), and Gp 3 (Pro-Dental). Three periodontal clinical parameters - PI, GI, and BI - were recorded at baseline and on days 7, 14, and 28. An oral hygiene maintenance program was followed by a double-blinded intervention (coded bottle containing mouthwash). Both inter-group and intra-group comparisons were made using analysis of variance (ANOVA) with multiple t tests. All probable values were considered to have various levels of significance at P<0.05 or below. RESULTS All indices for all groups showed higher values (mean) at baseline, which were lower on days 7, 14, and 28. No differences in any clinical parameter at any point of time existed between Gp 1 and Gp 2. There were, however, significant differences (P<0.05) between Gp 1/Gp 3 and Gp 2/Gp 3 for all clinical parameters at all observed time periods (days 7, 14, 28). Intra-group comparison for all groups demonstrated highly significant differences between baseline values and other time points. CONCLUSIONS For managing chronic gingivitis, Manuka mouthwash is as effective as a CHX mouthwash, as there were no differences observed in any clinical parameters at any point points.

Assessment of Antibacterial and Anti-biofilm Effects of Vitamin C Against Pseudomonas aeruginosa Clinical Isolates.

There is a persistent need to look for alternative therapeutic modalities to help control the pandemic of antimicrobial resistance. Assessment of antibacterial and anti-biofilm effects of vitamin C (ascorbic acid) was the aim of the current study. The micro-dilution method determined the minimal inhibitory concentration (MIC) of ascorbic acid or antibiotics alone and in combinations against Pseudomonas aeruginosa (P. aeruginosa) clinical isolates. The micro-titer plate method monitored the effect of ascorbic acid on the biofilm-producing isolates of P. aeruginosa. The effect of ascorbic acid on the differential expression of different antibiotic-resistant genes and biofilm encoding genes of P. aeruginosa isolates were also tested using real-time polymerase chain reaction (PCR). For in vivo assessment of the antibacterial effects of ascorbic acid alone or combined with an antibiotic, rats were infected with P. aeruginosa clinical isolate followed by different treatment regimens. MICs of ascorbic acid among P. aeruginosa isolates were in the range of 156.2-1,250 µg/ml, while MIC50 and MIC90 were 312.5 and 625 µg/ml, respectively. At sub-inhibitory concentrations (19.5-312.5 µg/ml), ascorbic acid had 100% biofilm inhibitory effect. Furthermore, ascorbic acid-treated bacteria showed downregulation of genes underpinning biofilm formation and antibiotic resistance. In vivo assessment of vitamin C and ceftazidime in rats showed that administration of both at a lower dose for treatment of pseudomonas infection in rats had a synergistic and more powerful effect. Vitamin C shows excellent in vitro results as an antibacterial and anti-biofilm agent. Vitamin C should be routinely prescribed with antibiotics to treat bacterial infections in the clinical setting.

A Clinical Study Comparing the Efficacy of SesameOil with Desensitizing Tooth Paste in Reducing Dentinal Hypersensitivity: A Randomized Controlled Trial.

OBJECTIVES: The objective of this study was to evaluate the efficacy of sesame oil therapy in reduction of dentin hypersensitivity, as compared to desensitizing dentifrice. Design, setting, participants. We conducted a single blinded randomized controlled trial in 100 patients reported to Diagnostic Department of King Khalid University-College of Dentistry between March 2018 and December 2019. Interventions. Patients were given desensitizing tooth paste or sesame oil to apply for the specified time. Main outcome measures. A Visual Analogue Scale was used to record sensitivity scores for controlled air stimulus and tactile method at the first visit and after 8th week of treatment. Measured outcome was reduction in dentinal hypersensitivity. RESULTS: Hypersensitivity degree before treatment in case of desensitizing tooth paste was 6.90 ± 1.04, and posttreatment showed a score of 4.70 ± 1.37. In case of sesame oil groups, subjects included had a score of 7.14 ± 0.90 which showed a drop to a score of 4.52 ± 1.16. CONCLUSIONS: Desensitizing tooth paste showed 30.5% reduction in sensitivity, whereas sesame oil application showed 36.2% reduction. The belief of considering oil therapy in oral health is just a placebo effect and may not be considered anymore. Efficacy can be established with many more studies including long follow-up and varying time periods.

Impact of Tooth Loss and Other Risk Factors on Cognitive Impairment in Saudi Female Population.

INTRODUCTION: It is known that cognitive impairment is linked to aging and neurobiological, psychological, and social factors. Recently, however, mastication and the number of teeth has also attracted attention, with a previous case control study reporting a correlation between the loss of teeth and Alzheimer's disease. OBJECTIVE: To investigate possible relationships between cognitive function and various demographic variables, stress, medical history, and number of natural teeth in a specified female population. MATERIALS & METHODS: A sample of the Saudi female population, 40-65 years of age, who visited the King Khalid University College of Dentistry (Abha, Saudi Arabia), was studied. Education, occupation, perceived stress, and medical history, along with the number of remaining teeth, were assessed. The Mini-Mental State Examination (MMSE) was used to assess cognitive performance and the results were statistically analyzed. RESULTS: Subjects were divided into those with mild, moderate, and severe impairment based on MMSE score; the association between age, education, occupation, medical history, and cognitive function demonstrated statistically significant results. Fifty percent of subjects with 0-16 teeth exhibited severe cognitive impairment. Of the cognitive abilities, attention, recall, and language skills were linked to the number of remaining teeth. When subjects were categorized into only high and low cognitive impairment based on MMSE score, regression analysis did not reveal a significant correlation between any of the studied variables and cognitive impairment. CONCLUSION: Results of the present study add to the recent data and head towards the theory of likely connection between the number of teeth and hippocampus-dependent cognitive functioning. Results of regression analysis revealed an absence of conclusive relation in the latter part of study. Longitudinal analyses including comprehensive clinical dental data with brain-imaging will shed further light on probable causal relationship(s).