Efficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial.

BACKGROUND: Prediabetes and diabetes involve alterations in glucose homeostasis, including increased fasting blood glucose and impaired glucose tolerance. Berberine has been identified as a potential regulator of glucose homeostasis with implications on the management of type 2 diabetes mellitus (DM). Given a paucity of data on berberine in prediabetes, evaluation of its effect in individuals with prediabetes may prove clinically valuable. OBJECTIVE: The present pilot study aimed to investigate the effect of daily oral berberine on markers of glycemic control and insulin resistance among individuals with prediabetes. METHODS: A randomized, double-blinded, placebo-controlled trial was conducted for 12 weeks among 34 individuals with prediabetes as defined by the American Diabetes Association (fasting plasma glucose (FPG) between 5.6 and 6.9 mmol/L, glycosylated hemoglobin (HbA1c) between 5.7% and 6.4%, or 2-hour 75-gram oral glucose tolerance test (2 h-OGTT) between 7.8 and 11.1 mmol/L). HIMABERB® 500 mg was given three times daily to the treatment group, and placebo was administered three times daily to the control group. Glycemic control markers and physical parameters were evaluated for both groups on days 0, 28, 56, and 84. The glycemic control markers assessed included FPG, fasting insulin (FI), 2 h-OGTT, HbA1c, and homeostatic model assessment-insulin resistance (HOMA-IR). The observed outcomes were analyzed using independent t-test statistics to determine the significance of differences over time after treatment initiation and between treatment and control groups. RESULTS: Significant decreases in all markers of glycemic control were observed in the treatment group at intermediate time points and the endpoint of the study compared to baseline levels and to the control group. For the treatment group, FPG decreased from 6.75 ± 0.23 mmol/L to 5.33 ± 0.28 mmol/L, FI from 9.81 ± 0.36 to 7.88 ± 0.52 mmol/L, 2 h-OGTT from 10.44 ± 0.52 to 8.12 ± 0.40 mmol/L, HbA1c from 6.40% ± 0.20-5.43% ± 0.21%, and HOMA-IR from 3.61 ± 0.31 to 2.41 ± 0.14. The decreases in glycemic control markers compared to the control group were clinically and statistically significant (p<10- 5). No severe adverse effects, kidney or liver toxicity were detected. CONCLUSION: After 12 weeks, berberine (HIMABERB®) intervention in individuals with prediabetes significantly reduced glycemic control markers, with mean FPG and 2 h-OTGG being reduced to below prediabetic thresholds, supporting the investigation of the use of HIMABERB® for delaying progression to diabetes mellitus. TRIAL REGISTRATION: http://ctri.nic.in (CTRI/2021/12/038751) (20/12/2021).

Knowledge and Awareness of First Aid of Avulsed Tooth among Physicians and Nurses of Hospital Emergency Department.

INTRODUCTION: Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. MATERIALS AND METHODS: A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department. RESULTS: With 100% response rate, the data obtained was subjected to statistical analysis. Results showed lack of knowledge and confidence in both groups. About 66.7% (n = 100) nurses and 74.7% (n = 112) considered reimplantation of avulsed tooth. There was overbalanced confusion regarding storage/transport media and handling of avulsed tooth. CONCLUSION: The findings from the results suggested a definite inadequacy in knowledge, demanding need for appropriate training for delivering treatment with more predictability and better prognosis.

Comparative Evaluation of Fluoride Recharge Ability of Conventional and Hydroxyapatite Modified Glass Ionomer Cement with Daily Low Fluoride Exposure- An Invitro Study.

INTRODUCTION: Glass ionomer cement (GIC) has best suited paediatric dentists and is well recognised in the preventive era of dentistry. However its use is affected by its inferior mechanical properties. Hydroxyapatite whiskers have been lately introduced as strengthening additive without affecting its fluoride releasing property, but literature lacks data related to its effect on recharging ability of glass ionomer cement. AIM: To evaluate and compare fluoride release from hydroxyapatite incorporated glass ionomer cement following recharging with low fluoride dentifrices. MATERIALS AND METHODS: An 8% Hydroxyapatite whiskers were added to Conventional Glass ionomer powder and 40 specimens each of conventional and Hydroxyapatite Glass ionomer cement were prepared using customised Teflon mould (5mm x 2mm) and were suspended in deionised water. Recharging of aged specimens was done using low fluoridated dentifrices containing 500ppm fluoride, twice daily and water was replenished every 24 hours. Fluoride release was analysed daily for 7 days and then weekly till 21 days using Sension 4 pH/ion selective electrode. Data thus obtained was statistically analysed by descriptive analysis followed by repeated measures ANOVA. RESULTS: Significant (p<0.01) increase in fluoride release was observed in both the materials following recharging regimen. Recharge pattern of hydroxyapatite glass ionomer was found to be similar to conventional glass ionomer cement. CONCLUSION: Within the limitations of this study it can be evinced that fluoride rechargability and re-release remains unaffected by the addition of hydroxyapatite whiskers and hence proves to be more acceptable additive to glass ionomer cement to improve its mechanical properties widening its arena of usage by clinicians.

Microtensile Bond Strength of Embrace Wetbond Hydrophilic Sealant in Different Moisture Contamination: An In-Vitro Study.

AIM: Contamination of etched enamel with saliva has been shown to result in sealant failure. Recently, a hydrophilic sealant has been introduced. In absence of documented literature, this in vitro study was undertaken to ascertain the efficacy of Embrace Wet Bond without reduction of microtensile bond strength in the different moisture contamination. MATERIALS AND METHODS: A 5mm block of sealant were built over prepared occlusal surface of 40 non-carious therapeutically extracted third molars which were sectioned into 1mm thick stick and tested using Zwick micro tensile tester. Obtained data were subjected to descriptive analysis, one-way ANOVA and Scheffe's post-hoc tests. RESULTS: Mean microtensile bond strength of Embrace sealant was not significantly lowered in different moisture contamination groups except Group 3 (air drying), which showed very highly significant (p<0.001) decrease in µTBS as compared to Group 1 (non-contaminated). CONCLUSION: Mean µTBS of Embrace sealant remains largely unchanged even in presence of moisture. Owing to its hydrophilic property, this sealant can be a great help in cases where maintaining isolation is difficult.

Vanishing roots: first case report of idiopathic multiple cervico-apical external root resorption.

Idiopathic root resorption is a very rare phenomenon. Resorption in tooth is brought about by odontoclastic activity. Special mechanisms in the periodontal ligament exist to prevent mineralization of the periodontal ligament and these periodontal ligament cells produce factors that inhibit mineralized tissue resorption and are capable of regulating bone and cementum formation. When this mechanism is disturbed it manifests in resorption of root structure. This case report is of a 28-year-old male with a very rare phenomenon where external resorption of both cervical and apical portion of root of multiple teeth was observed and it is documented for the first time.

Non syndromic familial bilateral decidious taurodontism - a first case report.

Taurodontism is anatomical and morphological alteration in the shape of the tooth. In taurodontism the crowns appear larger and the roots shorter compared to the normal anatomy of the respective tooth. The incidence of taurodontism in deciduous is very low and is also not very common in permanent dentition. The endodontic treatment protocol of taurodontic tooth is challenging. Taurodontic tooth requires a very cautious approach in identifying the root canal orientation and presence of any extra or lateral canals.

Hutchinson-gilford progeria syndrome: a rare genetic disorder.

Hutchinson-Gilford progeria syndrome (HGPS) is a rare pediatric genetic syndrome with incidence of one per eight million live births. The disorder is characterised by premature aging, generally leading to death at approximately 13.4 years of age. This is a follow-up study of a 9-year-old male with clinical and radiographic features highly suggestive of HGPS and presented here with description of differential diagnosis and dental consideration. This is the first case report of HGPS which showed pectus carinatum structure of chest.

Bisphosphonate-induced osteoradionecrosis.

Bisphosphonates (BPs) are a class of agents used to treat osteoporosis and malignant bone metastasis. Despite these benefits, osteonecrosis of the jaws has recently emerged as a significant complication in a subset of patients receiving these drugs. This case presentation focuses on a 62-year-old man with a 3-year history of monthly use of Zometa (zolendronic acid) for treatment of multiple myeloma, resulting in BP-related osteoradionecrosis of the jaws (BRONJ). This new entity remains a challenge with diagnosis as well as treatment. The goal of this paper is to improve clinicians understanding and provide a guideline for establishing a stage-specific diagnosis and prevention of BRONJ.