Effect of Integrated Naturopathy Interventions on Systemic Inflammatory Markers and Quality of Life in Patients With Active Rheumatoid Arthritis: A Randomized Controlled Trial.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy, a research-based complementary and alternative medicine, may be useful in these patients, but there is little data on the effect of Naturopathy interventions on inflammation and disease activity in RA. OBJECTIVE: To explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients. METHODS: A total of 100 RA patients were randomized into two groups: the naturopathy group (integrated naturopathy interventions with routine medical therapy) and the control group (only with routine medical therapy). Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points. RESULTS:  The results of the present study show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003) and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06).  Conclusions: The findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.

Comparative assessment of changes in pharyngeal airway space in cases of obstructive sleep apnoea with a customized mandibular repositioning appliance - a clinical study.

OBJECTIVES: The present study aims at evaluating the effects of a customized mandibular repositioning appliance on the pharyngeal airway, nocturnal sleep patterns, daytime discomfort and occlusal changes in established cases of adult obstructive sleep apnoea. MATERIAL AND METHODS: Ten consecutive patients with a complaint of snoring and disturbed sleep were included in the study. The primary diagnosis was established by the Epworth sleepiness scale, clinical examination, history and subsequently the diagnosis was substantiated through assessment of the pharyngeal airway space on a lateral cephalogram and polysomnography. A customized mandibular repositioning appliance was used to advance the mandible sequentially every 6 months, using 4 sets of the appliance. Pre and post-treatment evaluations were performed to establish, effects and changes in the outcome of obstructive sleep apnoea. RESULTS: The study revealed significant increase in the mean pharyngeal widths of upper airway and velum dimension with antero-superior repositioning of hyoid bone. Epworth sleepiness scale score improved significantly from baseline with clinically evident change in daytime discomforts. Significant decline in the mean apnoea/hypopnea index, oxygen desaturation index, respiratory disturbance index, heart rate, snoring and a significant increase in mean oxygen saturation of arterial blood was observed. No evident change noticed in occlusion except lower incisor inclination. CONCLUSION: The customized mandibular repositioning appliances are effective in the management of adult obstructive sleep apnoea with a significant improvement observed in the airway patency and polysomnography parameters with clinically non-significant effects on dental occlusion..

A Comparison of the Rate of Retraction with Low-level Laser Therapy and Conventional Retraction Technique.

BACKGROUND AND OBJECTIVES: A major concern of orthodontic patients is treatment time. Reducing the treatment time requires increasing the rate of orthodontic tooth movement. Research has proved that bone resorption is the rate-limiting step in tooth movement. Therefore, any procedure that potentiates osteoclastic activity is capable of increasing the rate of orthodontic tooth movement. Low-level laser has been indicated to have the capability to facilitate the differentiation of the osteoclastic and osteoblastic cells, which are responsible for the bone remodeling process. The purpose of this study was to evaluate whether the low-level laser therapy can accelerate orthodontic tooth movement during en masse retraction. METHOD: The study was a split-mouth design. The experimental side was exposed to biostimulation using 810 nm gallium-aluminium-arsenide diode laser. A total of 10 irradiations for 10 s per site were given 5 on the buccal side and 5 on the palatal side of the tooth. The total energy density at each application was 10 J with an interappointment gap of 3 weeks. The retraction was carried using a constant force of 150 gm. A digital vernier caliper measurement was used to measure the distance between the contact points of the maxillary canine and second premolar on 1st and 84th day. RESULTS: The rate of orthodontic tooth movement was faster on the experimental side, and the difference between the two sides was statistically significant (P < 0.014). INTERPRETATION AND CONCLUSION: It was concluded that biostimulation carried out using an 810 nm diode laser is capable of increasing the rate of extraction space closure. Hence, it is capable of increasing the rate of orthodontic tooth movement.

A Comparative Evaluation of Interleukin 1 Beta and Prostaglandin E2 with and without Low-level Laser Therapy during En masse Retraction.

BACKGROUND AND OBJECTIVES: Orthodontic forces are known to produce mechanical damage and inflammatory mediators such as prostaglandins (PGs) and interleukin (IL)-1, in the periodontium and dental pulp. Low-level laser therapy (LLLT) is a stimulator of the on-going biological process in tissue and found to be effective in modulating cell activity, which is involved in orthodontic tooth movement. Here, a humble effort has been made to study two such cytokines, namely IL-1 ß and PG E2 (PGE2) which are partially responsible for bone turnover. The purpose of this study was to compare the changes occurring in the values of IL-1 ß and PGE2 in the gingival crevicular fluid (GCF) during en masse retraction with and without LLLT. METHODOLOGY: GCF was collected using micropipettes from the distal ends of upper canines. The experimental side was exposed to biostimulation using 810 nm gallium-aluminum-arsenide diode laser and the contralateral side taken as control. A total of 10 irradiations for 10 s per site were given, five on the buccal side and five on the palatal side, to cover the entire periodontal fibers and the alveolar process around the tooth. After 7 days and 21 days of retraction, GCF sample was collected. Quantitative analysis of IL-1 ß and PGE2 in the GCF samples was assessed using a commercially available Raybiotech® IL-1 ß and Human PGE2. RESULTS: (1) IL-1 ß and PGE2 levels showed significant results from baseline to 21 days after LLLT irradiation. (2) LLLT-assisted retraction was significantly faster than conventional retraction. INTERPRETATION AND CONCLUSION: It was concluded from the study that IL-1 ß and PGE2 levels peaked after LLLT. The difference in the levels of both cytokines was statistically significant.

Efficacy of Acupuncture in the Management of Primary Dysmenorrhea: A Randomized Controlled Trial.

INTRODUCTION: Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age. The present study was conducted to evaluate the efficacy of acupuncture in the management of primary dysmenorrhea. MATERIALS AND METHODS: Sixty females aged 17-23 years were randomly assigned to either a study group or a control group. The study group received acupuncture for the duration of 20 minutes/day, for 15 days/month, for the period of 90 days. The control group did not receive acupuncture for the same period. Baseline, during, and post assessments of both the groups were taken on day 1; day 30 and day 60; and day 90, respectively. Statistical analysis was performed by repeated measures of analysis of variance followed by post hoc analysis with Bonferroni adjustment for multiple comparisons, independent samples t test for visual analog scale score, and Mann-Whitney U test for rest of the variables using statistical package for the social sciences, version 16. RESULTS: This study showed a significant reduction in all the variables such as the visual analog scale score for pain, menstrual cramps, headache, dizziness, diarrhea, faint, mood changes, tiredness, nausea, and vomiting in the study group compared with those in the control group. CONCLUSION: Acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.

Histomorphometric effects of gemcitabine on Swiss albino mice spermatogenesis.

BACKGROUND: Spermatogenesis is a highly conserved and regulated process and it is sensitive to fluctuations in the physical and chemical environment. Gemcitabine is a novel antimetabolic anticancer drug used frequently in the treatment of many cancers. This study aimed to investigate the histomorphometric effects of gemcitabine on spermatogenesis in Swiss albino mice. MATERIALS AND METHODS: Gemcitabine in high and low doses (80 and 40 mg/kg) injected intraperitoneally to inbred Swiss albino mice. Gross testicular features and seminiferous tubular histomorphometry was studies at the end of 7(th), 14(th) day and at 2 months sperm shape abnormalities were studied. RESULTS: Seminiferous tubular morphology was altered significantly, showing a reduction in height, perimeter and area in a dose dependent manner. Sertoli cell number decreased. Basement membrane thickness was reduced and it appeared to be permanent, with statistically insignificant changes even after 2 months. There was a reduction of intertubular spaces. Sperms have shown banana heading, decapitation and loss of normal hook of head. The effects were partially reversible at the end of 2 months. CONCLUSION: It was concluded that gemcitabine affects the process of spermatogenesis adversely in a dose and time dependent manner and the effects are partially reversible.

Mixed dentition space analysis in kodava population: a comparison of two methods.

AIMS: To evaluate the reliability of Tanaka and Johnston and Moyer's (75th percentile) mixed dentition prediction methods in Kodava population sample, to formulate regression equations for predicting the mesiodistal widths of unerupted canines and premolars and to construct probability tables for the Kodava population. SETTINGS AND DESIGN: Data was obtained from Kodava subjects visiting the clinics for routine dental check up. MATERIALS AND METHODS: Dental models of 30 male and 30 female Kodava subjects (age range is 16 - 23 yr) were used. Teeth measured included mandibular permanent incisors, maxillary and mandibular permanent canines, first and second premolars. Digital caliper calibrated to 0.01mm was used to record mesiodistal dimensions. The actual teeth measurements were then statistically compared with the predicted values derived from the Tanaka and Johnston's equations and Moyers probability tables at the 75(th) percentile. STATISTICAL ANALYSIS USED: Descriptive statistics including means, standard deviations were calculated for the actual and predicted tooth sizes. Student's t-tests were performed to compare the differences between the measured mesiodistal widths of canine, first and second premolars and the predicted values derived from Moyers. Correlation and regression analysis were performed to formulate standard regression equations. RESULTS: Tanaka and Johnston prediction equations overestimated the mesiodistal widths of permanent canines and premolars in both the arches. Moyers 75(th) percentile also overestimated the actual measurements except for the maxillary arch in female subjects. The percentage of overestimation was more for Tanaka - Johnston prediction method than that of Moyers (75(th) percentile). Correlation and regression analysis were performed between the predicted and actual tooth size and standard regression equations were developed for the Kodava population. Probability tables were also constructed from the data obtained. CONCLUSION: The data from present study illustrates the limitation of Tanaka and Johnston regression equations and Moyer's (75(th) percentile) chart when applied to Kodava population. From this data, regression equations and probability tables were derived for tooth size prediction for Kodava population. This would be more accurate when applied to local children of Kodava community.

Solid pseudopapillary tumor of pancreas with sickle cell trait: a rare case report.

Solid pseudopapillary tumor of pancreas is a rare pancreatic neoplasm affecting young women, has low malignant potential and amenable for surgical excision with good long-term survival. Sickle cell trait is benign condition, which involves one normal beta-globin chain and one HbS chain. Although it is a benign condition, individuals are prone to have rare complications that may predispose to death under certain circumstances. We report a rare coexistence of solid pseudopapillary tumor of pancreas with sickle cell trait in an 18-year-old female who underwent distal pancreatectomy with splenectomy. Histopathological examination and haemoglobin electrophoresis confirmed the diagnosis.

Colon Obstruction due to an Anticoagulant Induced Intramural Haematoma; A Rare Case Report.

A spontaneous, intramural, intestinal haematoma is a rare complication of the anticoagulant therapy. We are reporting here, a rare case of a 63-years-old male, who presented with intestinal obstruction which was caused by an intramural and a submucosal colonic haematoma, which had resulted from warfarin administration. This patient rapidly improved after taking conservative treatment. A history of anticoagulant use with a prolonged INR value in patients who present with abdominal pain, should alert the physicians or surgeons to search for this entity. It is extremely important to recognize this syndrome at its early stages, to avoid an unnecessary operation, since the outcome is usually excellent after a conservative treatment.

Unusual case of a projecting intraoral giant sialolith.

Sialolithiasis is the most common disease of the salivary glands. This report describes the case of a patient who had an unusually large submandibular gland ductal sialolith that had protruded out into the oral cavity.

[Not Available].

Ascariasis is the most common helminthic infection to infest man. Usually the adult worm lives in the small intestine. Rarely it migrates through the ampulla of vater and enters the common bile duct. We are reporting a case of gall bladder ascariasis causing acute cholecystitis treated by laparoscopic cholecystectomy. Presence of Ascaris lumbricoides in gallbladder is rare entity as it is difficult to reach there due to the narrow and tortuous cystic duct.