Evaluating Trust in the Patient-Dentist Relationship: A Mixed-Method Study.

BACKGROUND: The objective of this article was to understand the trust of study participants in dental providers and trust-building practices used by dentists to establish and maintain trust with their patients. METHODS: This study used a concurrent cross-sectional mixed-methods design to measure the participants' trust in their dental providers. An 11-item Dental Trust Scale (DTS) questionnaire was administered to 150 White, Black, and Hispanic study participants. In addition, the research team conducted semistructured interviews with 7 dentists in order to understand their perspectives related to patient trust. The internal consistency of the DTS was tested using Cronbach's α. Univariate and multivariable logistic regression models were run to test the association between the DTS mean score and individual participant factors. Qualitative information from interviews was analyzed using a thematic analysis approach. RESULTS: The overall mean score of dental trust for the entire sample was 3.4. The DTS had good internal consistency (α = 0.93). Overall, dental trust was significantly higher in participants who had a regular dentist (F = 8.74, P = 0.003). The qualitative data were grouped under these key thematic categories: the importance of trust, building trust, and trust in treatment planning. Qualitative analysis also showed that the 2 main trust-building tools used by dentists were communication and understanding the patient's lifestyle or social determinants of health. KNOWLEDGE TRANSFER STATEMENT: This study provides insight into the dentist-patient relationship. It increases our understanding of levels of dental trust among patients and examines methods used by the dentist to build trust. The outcomes of this study can be considered by dentists in their everyday practice as they seek to build trust with their patients.

Distribution, geochemical behavior, and risk assessment of arsenic in different floodplain aquifers of middle Gangetic basin, India.

The present study interprets the distribution and geochemical behavior of As in groundwaters of different regions along the floodplains of Ganga river (Varanasi, Ghazipur, Ballia), Ghaghara river (Lakhimpur Kheri, Gonda, Basti), and Rapti river (Balrampur, Shrawasti) in the middle Gangetic basin, India for risk assessment (non-carcinogenic and carcinogenic). The concentration of As in groundwaters of these floodplains ranged from 0.12 to 348 µg/L (mean 24 µg/L), with around ~ 37% of groundwater samples exceeding the WHO limit of 10 µg/L in drinking water. Highest As concentration (348 µg/L) was recorded in groundwater samples from Ballia (Ganga Floodplains), where 50% of the samples had As > 10 µg/L in groundwater. In the study area, a relatively higher mean concentration was recorded in deep wells (28.5 µg/L) compared to shallow wells (20 µg/L). Most of the high As-groundwaters were associated with the high Fe, bicarbonate and low nitrate and sulfate concentrations indicating the release of As via reductive dissolution of Fe oxyhydroxides. The saturation index values of the Fe minerals such as goethite, hematite, ferrihydrite, and siderite showed the oversaturation to near equilibrium in groundwater, suggesting that these mineral phases may act as source/sink of As in the aquifers of the study area. The health risk assessment results revealed that a large number of people in the study area were prone to carcinogenic and non-carcinogenic health risks due to daily consumption of As-polluted groundwater. The highest risks were estimated for the aquifers of Ganga floodplains, as indicated by their mean HQ (41.47) and CR (0.0142) values.

Acculturation and Dental Care-Related Anxiety: An Exploratory Assessment from the Hispanic Community Health Study / Study of Latinos.

This study aimed to determine the associations between acculturation, dental anxiety, and dental utilization among Hispanics/Latinos living in the US. A proxy measure of dental anxiety was available for 7539 adults who had not visited a dentist within the last year. All completed the Short Acculturation Scale for Hispanics (SASH). Bivariate logistic regression and adjusted multivariable logistic regression analysis were conducted. Approximately 22% of the sample was dentally anxious. Dental anxiety was significantly associated with SASH language scale score (OR 1.09, 95%CI 1.02, 1.18, p = 0.04), years in US (OR 1.53, 95%CI 1.23, 1.91, p < 0.0001), and preferred Spanish language (OR 1.30, 95%CI 1.05, 1.63, p = 0.0192); lower acculturation corresponded to higher dental anxiety. Adjusting for sex, age, education, income, insurance, and oral health status, level of acculturation was associated with dental anxiety (AOR 0.87, 95%CI 0.75, 0.91, p = 0.009), but neither were associated with utilization. Acculturation may be an important predictor of dental anxiety for Hispanics/Latinos living in the US.

Evaluation of New Alkasite Based Restorative Material for Restoring Non- Carious Cervical Lesions- Randomized Controlled Clinical Trial.

Two different restoration materials, an alkasite-based resin composite and a resinmodified glass ionomer cement were used to assess restoration of non-carious cervical dental lesions. This split mouth randomized controlled trial included 40 patients. After randomization both sides of the dental arch were restored with either an alkasite-based (Cention N, Ivoclar Vivadent) or a resin-modified glass ionomer cement (Voco GmbH) restoration. The placed fillings were evaluated by blinded additional operators 1, 6 months and 1 year after to the USPHS criteria (retention, marginal integrity and discoloration, anatomical form and secondary caries). Data were analyzed using Kendall's Coefficient of Concordance test and Chi-square tests using SPSS software (SPSS Inc., Version 20) (P=0.05). As for retention and anatomic form both materials performed similar after one month. However, the retention and anatomic form for alkasite based restorative Cention showed significantly better results after 6 months (p=0.013/p=0.003) and one year (p=0.026/p=0.008). The resin modified glass ionomer restoration showed higher discoloration after 6 months (p=0.025) and one year (p=0.018), while Cention performed better regarding marginal integrity at all time intervals. No secondary caries occurred. Alkasite based restorative materials displayed superior technical, mechanical and aesthetical performance in a follow-up period of one year and can therefore be recommended as an alternative to resin-modified glass ionomer cements.

The mitochondrial genomes of two Pre-historic Hunter Gatherers in Sri Lanka.

Sri Lanka is an island in the Indian Ocean connected by the sea routes of the Western and Eastern worlds. Although settlements of anatomically modern humans date back to 48,000 years, to date there is no genetic information on pre-historic individuals in Sri Lanka. We report here the first complete mitochondrial sequences for Mesolithic hunter-gatherers from two cave sites. The mitochondrial haplogroups of pre-historic individuals were M18a and M35a. Pre-historic mitochondrial lineage M18a was found at a low prevalence among Sinhalese, Sri Lankan Tamils, and Sri Lankan Indian Tamil in the Sri Lankan population, whereas M35a lineage was observed across all Sri Lankan populations with a comparatively higher frequency among the Sinhalese. Both haplogroups are Indian derived and observed in the South Asian region and rarely outside the region.

MMP-9 Levels and NaOCl Lavage in Randomized Trial on Direct Pulp Capping.

Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant (P < 0.001 and P = 0.004, respectively) impact on pulp survival, while mild preoperative discomfort did not. In conclusion, MMP-9/TP showed great promise as a predictive local biomarker, and NaOCl lavage considerably improved the survival time of cariously exposed and directly capped pulps.

Oral Health of African Immigrants: A participatory approach to needs assessment.

OBJECTIVE: Dental care service use is lower in the immigrant population in the US, with the African immigrant population increasing at a much higher rate. We aimed to evaluate the barriers faced by the African immigrant community through a participatory needs assessment approach. METHODS: Photovoice, a qualitative research method was used to collect the data. Thirty participants were recruited from community events, churches, and African community-serving organizations. Participants took photographs related to oral health research questions. Focus groups were conducted with the participants to discuss the clicked pictures. The focus group data were transcribed and analyzed using an inductive and thematic approach using Atlas Ti®. RESULTS: The response rate was 90% and six focus groups were conducted. Focus group data demonstrated participants' knowledge of good oral health and preventive oral behaviors; physical, financial and psychosocial barriers to accessing dental care; and cultural and social beliefs of the community. The participants had good knowledge about oral hygiene habits and dietary factors impacting the oral health of their community. Several barriers including, lack of perceived oral health needs, transportation, time, insurance, fear, and trust were identified that prevent them to access dental care. CONCLUSION: Further research is warranted to understand the cultural norms and perceived needs of the African immigrant community. Increasing our understanding of such knowledge can support in improving the cultural competency of the oral health workforce.

What Can We Learn from Parents of Caries-Free and Caries-Active Hispanic Children?

OBJECTIVE: This study evaluated strength-based motivators within Hispanic families that support the creation of health in their children. A mixed-methods approach was used to understand differences in Hispanic parental factors between caries-free (CF) and caries-active (CA) children. METHODS: A cross-sectional survey was conducted with 200 parent-child triads (primary child: between 0 and 6 y; reference child: between 0 and 10 y) recruited from health centers in the Denver Metro area. All the participating children received an oral examination, and the triads were grouped as CF or CA based on the caries status of the primary child. Qualitative data were collected through in-depth individual interviews with the parents. The analysis only involved the primary child. Bivariable analysis were conducted between parent factors (independent variables) and presence or absence of caries (outcome variable). The variables with P < 0.20 in the bivariable analysis were subjected to 2 multivariable logistic regression models. The children in the CF group had mean (SD) age of 2.8 (1.28) y compared to the CA group at 4.0 (1.55) y (P < 0.001). Bivariable analysis demonstrated that parents in the CF group reported higher oral hygiene behavior scores (P = 0.047), perceived fewer barriers (P = 0.009) to accessing preventive dental care, and considered their children more susceptible to cavities (P = 0.001) compared to parents in the CA group. Multivariable model (adjusting for socioeconomic characteristics) demonstrated that parents of CF children perceived high susceptibility to caries for their children (P = 0.040). Multivariable model (adjusting for acculturation) demonstrated an association of parental oral hygiene behavior (P = 0.040) and parent-perceived susceptibility to caries (P = 0.010) with CF child status. Qualitative interviews revealed that parents in the CF group were concerned about their children's higher susceptibility to caries and tried to establish good oral hygiene routines for their children. CONCLUSION: The results of this study demonstrated that parental behaviors and health beliefs could be significant determinants of caries status in Hispanic children. KNOWLEDGE TRANSFER STATEMENT: Results of this study indicate that parental oral health beliefs and behaviors are significant determinants of caries status in children of Hispanic population. Parental beliefs could motivate them to take action or establish behavior that prevents dental caries in their children. Health care providers and caries prevention efforts can incorporate this information to tailor oral health promotional messaging and approaches to improve the oral health of Hispanic children.

Mitochondrial diversity of Yoruba and Fulani chickens: A biodiversity reservoir in Nigeria.

Poultry are the most widely distributed type of livestock in Nigeria. Indigenous chickens are extremely common throughout the country. Indeed, approximately 83 million chickens are raised in extensive systems and 60 million in semi-intensive systems. To provide the first comprehensive overview of the maternal lineages in Southwest Nigeria, we analyzed 96 mitochondrial DNA control region sequences from 2 indigenous chicken ecotypes: Fulani and Yoruba. All samples belonged to the most frequent haplogroup (E) in Africa and Europe and showed noticeably low haplotype diversity. Although only 11 different haplotypes were detected, with 2 of them never found before in Nigeria, the presence of unique sequences among our indigenous samples testified to their status as an important genetic resource to be preserved. Furthermore, a total of 7,868 published sequences were included in the comparative analysis, which revealed an east-west geographic pattern of haplogroup distribution and led to the conclusion that the gene flow from Southeastern Asia mainly involved one mitochondrial clade. Moreover, owing to the extensive genetic intermixing among Nigerian chickens, conservation efforts are required to safeguard the extant mitochondrial variability in these indigenous ecotypes and establish future improvement and selection programs.

A high-spin ground-state donor-acceptor conjugated polymer.

Interest in high-spin organic materials is driven by opportunities to enable far-reaching fundamental science and develop technologies that integrate light element spin, magnetic, and quantum functionalities. Although extensively studied, the intrinsic instability of these materials complicates synthesis and precludes an understanding of how fundamental properties associated with the nature of the chemical bond and electron pairing in organic materials systems manifest in practical applications. Here, we demonstrate a conjugated polymer semiconductor, based on alternating cyclopentadithiophene and thiadiazoloquinoxaline units, that is a ground-state triplet in its neutral form. Electron paramagnetic resonance and magnetic susceptibility measurements are consistent with a high-to-low spin energy gap of 9.30 × 10-3 kcal mol-1. The strongly correlated electronic structure, very narrow bandgap, intramolecular ferromagnetic coupling, high electrical conductivity, solution processability, and robust stability open access to a broad variety of technologically relevant applications once thought of as beyond the current scope of organic semiconductors.

Association between Medical Well-Child Visits and Dental Preventive Visits: A Big Data Report.

OBJECTIVE: This study evaluated the impact of well-child visits (WCVs) on promoting preventive visits to the dentist. Effects by age, race, gender, and dental diagnosis were investigated. METHODS: Administrative claims data for 1.85 million Medicaid-enrolled children aged 4 or less in 13 states in 2013 were identified from the Truven MarketScan Medicaid Database. A cohort for all children who had a WCV in 2013 was generated and followed for 365 d to identify the date of closest preventive dental visit. RESULTS: The cohort included 1,308,719 Medicaid-enrolled children with a WCV in 2013. Three percent of children under the age of 1 with a WCV had an oral health assessment within 1 y compared to only 0.4% of all Medicaid-enrolled children in that age group. Similar patterns were seen in all age groups: age 1 (13% vs. 9%), age 2 (32% vs. 23%), age 3 (50% vs. 37%), and age 4 (59% vs. 48%). On average, about 1.4% of children received an oral health assessment during their WCV, and another 0.6% were diagnosed with a dental condition. These children had a higher proportion of visits to the dentist for a preventive visit after a WCV. Children of all races (White, Hispanic, and Black) with a prior WCV had higher preventive dental compared to total enrolled. However, Hispanic children with a WCV reported the highest preventive dental visits within 1 y (White 24%, Black 29%, and Hispanic 46%). Furthermore, Hispanic children visited the dentist earlier than White and Black children; 16.9% of Hispanic children visited the dentist within 90 d of the WCV compared to 8.5% of White and 10% of Black children. CONCLUSION: This study demonstrated increased utilization of dental preventive visits for the children who received a well-child visit. KNOWLEDGE TRANSFER STATEMENT: Results of this study indicate a higher number of preventive dental visits for children with prior WCV. Clinical implications of this study would be to continually increase and promote the inclusion of oral health within primary care. This can increase the likelihood of preventative dental visits and, ultimately, better dental health in children.

Elucidation of diversity among F1 hybrids to examine heterosis and genetic inheritance for horticultural traits and ToLCV resistance in tomato.

Genetic diversity during prebreeding or postbreeding programme, is the key pillar to characterize the valuable traits and gene of interest. Whereas, superior or inferior heterotic performance of F1 depend on the diverse nature of their pedigree. Therefore, the aim of this study was to see the diversity between the interspecific crosses and effect of heterosis, and inheritance for the morphological traits and ToLCV resistance. All the 24 F1 interspecific crosses were classified into four clusters on the basis of morphological traitsas well as simple sequence repeat (SSR) markers. Among the F1 hybrids, 23 were grouped into clusters II, III and IV with different phylogeny, while PBC×EC 521080 was individual with cluster I. On the basis of visual observation of fruit colour, deep red and green colours in the crosses of S. pimpinellifolium (EC 521080) and S. habrochaites (EC 520061) exhibited dominant effects. In context of heterosis breeding, the crosses which were made using Solanum pimpinellifolium (EC 521080), S. chmielewskii (EC 520049) and S.cerasiforme (EC 528372) were better for yield capacity and the crosses of S. habrochaites (EC 520061) exhibited low and negative heterosis for ToLCV resistance. The F1 progenies were segregated in various Mendelian ratio as follows 3:1, 1:2:1, 1:3, 13:3, 15:1, 12:3:1 and 9:6:1 for ToLCV disease reaction of incidence, plant growth habit and fruit colour appearance, respectively. Therefore, these interspecific crosses can be utilized for developing high yield, impressive fruit colour combiners and resistant hybrids/varieties of tomato.

Calibration of a multi-anvil high-pressure apparatus to simulate planetary interior conditions.

This paper presents the setup and pressure calibration of an 800-ton multi-anvil apparatus installed at the Vrije Universiteit (Amsterdam, the Netherlands) to simulate pressure-temperature conditions in planetary interiors. This high-pressure device can expose cubic millimeter sized samples to near-hydrostatic pressures up to ~ 10 GPa and temperatures exceeding 2100 °C. The apparatus is part of the Distributed Planetary Simulation Facility (DPSF) of the EU Europlanet 2020 Research Infrastructure, and significantly extends the pressure-temperature range that is available through international access to this facility.

Maternal Factors Associated with Early Childhood Caries in Urban Latino Children.

The objective of this investigation was to describe maternal psychosocial, behavioral, and acculturation factors associated with early childhood caries in a sample of urban Latino mother-child dyads. A cross-sectional survey was conducted with 100 mothers whose children (under the age of 6 y) were patients at the Dental Center at Children's Hospital Colorado in Aurora, Colorado. All children participating in the study received an oral examination to measure decayed, missing, filled, surfaces (dmfs). Participating mothers were given the option to sign the consent form and complete the survey in English or Spanish, according to their preferred language. The survey used demographic, behavioral, knowledge, and several psychosocial variables. Bivariate analysis was conducted with dmfs as a dependent variable. The associations between independent variables and dmfs were modeled using negative binomial regression. Mean ± SD dmfs for the entire sample was about 11 ± 16.85. The mothers who spoke Spanish had children with significantly (P = 0.046) higher dmfs scores (15.2) compared to mothers who spoke English (7.56). Preference of Spanish language was significantly associated with self-efficacy (P = 0.0043), oral health knowledge (P = 0.0024), and 3 subscales of the health belief model: perceived severity (P = 0.057), perceived barriers (P = 0.0002), and perceived susceptibility (P = 0.008). Both in the univariate and the multivariate models, oral health behavior and preferential use of Spanish remained significantly associated with higher dmfs scores. Results of this study demonstrate that maternal oral health behaviors and preferred language are significant factors associated with early childhood caries in urban Latino children. Knowledge Transfer Statement: Results of this study indicate that maternal oral health behaviors and the level of acculturation are significantly associated with caries in urban Latino children. Caries prevention efforts in this population could use this information to tailor oral health messaging according to the level of acculturation in mothers.

Clinical and laboratory repercussions in patient with hemoglobin SD-Punjab disease: a case report / Repercussões clínicas e laboratoriais em paciente com hemoglobinopatia SD-Punjab: relato de caso

ABSTRACT We report the first case of hemoglobin SD-Punjab disease, a rare form of sickle-cell disease, in the state of Bahia. Detection was possible by a test for the identification of hemoglobin (Hb) variants with the high-resolution liquid chromatography technique. By means of the molecular study of chromosomal polymorphism with beta-globin S gene, the Bantu haplotype was observed. According to studies, there is strong association between the prevalence of Bantu haplotype and reduced levels of fetal Hb and Hb D-Punjab as a stimulating factor for S polymerization, what contributes to the hematological disorders of the disease and organ damage, as gallstones and aseptic necrosis of the femoral head.

RESUMO Reportamos o primeiro caso de hemoglobinopatia SD-Punjab, uma forma rara da doença falciforme, no estado da Bahia. A detecção ocorreu pelo exame para identificação de hemoglobinas (Hb) variantes com técnica de cromatografia líquida de alta resolução. Através do estudo molecular do polimorfismo no cromossomo com gene da betaglobina S, verificou-se a presença do haplótipo Bantu. Segundo estudos, existe forte associação de prevalência do haplótipo Bantu e níveis reduzidos da Hb fetal e da Hb D-Punjab como fator de estímulo à polimerização da S, o que contribui para os distúrbios hematológicos da doença e a lesão de órgãos, como cálculos biliares e necrose asséptica de cabeça de fêmur.

[A study of recombinant human sestrin 1 and sestrin 2 proteins produced in a prokaryotic system].

Sestrins are highly conserved stress-inducible proteins capable of suppressing the production of ROS and signalling through mTORC1. Here we report a study of human sestrin1 (sesn1) and sestrin2 (sesn2) proteins produced in a pET28^(+) vector based prokaryotic system. Mass spectrometry analysis, western blot and surface plasmon resonance (SPR) of affinity purified sesn1 and sesn2 proteins confirmed their identity; biophysical characteristics were observed using circular dichroism (CD) showing that sesn1 and sesn2 have a predominant α-helical structure. Here we describe a simple, one step purification process to purify a large amount of sestrin proteins with significant yield. Further study of recombinant human sestrins may further facilitate the understanding of their roles in eukaryotic cells.

Stress, Anxiety, and Immunomodulation: A Pharmacological Analysis.

Stress and stressful events are common occurrences in our daily lives and such aversive situations bring about complex changes in the biological system. Such stress responses influence the brain and behavior, neuroendocrine and immune systems, and these responses orchestrate to increase or decrease the ability of the organism to cope with such stressors. The brain via expression of complex behavioral paradigms controls peripheral responses to stress and a bidirectional link exists in the modulation of stress effects. Anxiety is a common neurobehavioral correlate of a variety of stressors, and both acute and chronic stress exposure could precipitate anxiety disorders. Psychoneuroimmunology involves interactions between the brain and the immune system, and it is now being increasingly recognized that the immune system could contribute to the neurobehavioral responses to stress. Studies have shown that the brain and its complex neurotransmitter networks could influence immune function, and there could be a possible link between anxiogenesis and immunomodulation during stress. Physiological and pharmacological data have highlighted this concept, and the present review gives an overview of the relationship between stress, anxiety, and immune responsiveness.

Nitric Oxide and Anxiety.

Anxiety is a common neuropsychiatric disorder which affects both physical and mental health. Complex neurobiological mechanisms are involved in the genesis of anxiety, and the drugs used to date, though effective, are not free from shortcomings. Conventional agents like the classical benzodiazepines and the atypical nonbenzodiazepine agents like buspirone have their own limitations. There is thus need to explore newer neurochemical pathways to develop efficacious and safer drugs for the disorder. Nitric oxide (NO) is a unique neuromodulator substance, with the ability to influence and modulate several other conventional messengers which play an important role in anxiety. The currently available experimental and clinical data indicate that NO may be involved in the regulation of anxiety-like behavior induced by a variety of stimuli. These studies have explored the pharmacological and biochemical basis of nitrergic mechanisms in anxiety, and the data available are equivocal. This chapter reviews the research data available in this specific area and suggests that in view of the nature of the existing data, there is considerable scope for future research in this field.

Anticandidal synergistic activity of green tea catechins, antimycotics and copper sulphate as a mean of combinational drug therapy against candidiasis.

The present investigation aims at evaluating synergistic herbal based composition of purified catechins with fluconazole, amphotericin B and copper sulphate against Candida albicans (MTCC 3017) and Candida glabrata (MTCC 3019). The catechins were isolated from green tea leaves of Assam, Himachal Pradesh and Uttarakhand regions of India. The synergistic activity of combinations against Candida species was assessed following microdilution checkerboard technique and time kill assay. The inhibitory action of most significant combination on treated Candida cells was assessed by scanning electron microscopy. Cytotoxicity of synergistic compositions was further analyzed by performing MTT assay on Vero cell lines. Purified catechins of Assam and Himachal Pradesh green tea showed synergistic activity with fluconazole and amphotericin B against Candida species. Time kill assay depicted synergistic activity at minimum inhibitory concentration and twice of minimum inhibitory concentration of purified catechins and antimycotics. Further, Copper sulphate increased anticandidal efficacy of synergistic combinations by 0.4% to 6.63%. SEM analysis revealed morphological distortions of treated Candida cells. Cytotoxicity analysis of synergistic composition depicted high percentage viability (≥91.4% to≥100%) of Vero cell line, which suggests non-cytotoxic activity of proposed composition on healthy cells. It can be inferred that present evaluated synergistic composition can confer promising anticandidal efficacy and requires further investigation of safety and translational guidelines for effective and safer green tea based potent therapeutic drug.

An appraisal of the bioavailability enhancers in Ayurveda in the light of recent pharmacological advances.

The concept of bioavailability enhancer is new to the modern system of medicine. Basically, this concept originated in Ayurveda and being used in this system of medicine since centuries. Bio-enhancers augment the bioavailability or biological activity of drugs when co-administered with principal drug at low doses. Ayurveda is using several drugs such as Piper longum Linn., Zingiber officinale Rosc., and Glycyrhhiza glabra Linn. as bio-enhancers and different methods for bio-enhancing since centuries. The bio-enhancement leads to reduction in therapeutic dose of principal drug, thus reducing the possibilities of toxicity and side effects of drug, potentiating the efficacy, reducing the resistance, decreasing the requirement of raw material for drug manufacture, and ultimately benefitting to the world economy by reducing the treatment cost. This review article attempts to consolidate different drugs as well as methods being used traditionally for enhancing bioavailability in Ayurvedic system of medicine and to discuss their possible mechanism of action. Authentic subject material has been reviewed from different Ayurvedic texts and from different related research and review articles. Thus, it is a humble effort to explore the different aspects of bio-enhancers including therapeutic techniques such as Shodhana, the drugs such as Pippali, and properties such as Yogavahi and Rasayana, which have been described in Ayurveda along with their mechanism of action and uses wherever available.