Antimicrobial photocatalysis using bio-hydrothermally synthesized Zinc oxide nanoparticles in the management of periodontitis: a prospective split-mouth, double-blind, randomized, controlled clinical trial.

BACKGROUND: The antimicrobial activity of metallic nanoparticles (NPs) has been confirmed to fight a broad spectrum of microorganisms, through antimicrobial effects that are amplified when these particles are irradiated with light of the proper wavelength. This is the first study to use phytoconjugated Zinc oxide (ZnO) NPs containing traces of active biomolecules derived from Emblica officinalis (E. officinalis) plant extract in antimicrobial photocatalysis (PCT) during non-surgical periodontal therapy. OBJECTIVES: This study aimed to evaluate the effects of repeated PCT application in the treatment of periodontitis, using a gel containing bio-hydrothermally synthesized ZnO NPs and visible light as an adjunct to scaling and root planing (SRP). METHODOLOGY: In total, 16 systemically healthy volunteers with stage 3 grade B generalized periodontitis were recruited for this prospective double blind, randomized placebo-controlled trial. After receiving SRP, the subjects received the following interventions in a split-mouth design at baseline, 1 week and 1 month: Group 1 - Placebo gel + Sham PCT; Group 2 - Nano ZnO gel + Sham PCT; Group 3 - Placebo gel + PCT; and Group 4 - Nano ZnO gel + PCT. The site-specific profile of Porphyromonas gingivalis in the subgingival plaque and clinical parameters (Plaque Index, Gingival Index, Gingival Bleeding Index, Probing pocket Depth and Clinical Attachment Level) were assessed at baseline, 1 month and 3 months. RESULTS: All interventions tested caused participants' clinical and microbiological parameters to generally improve after 3 months. Subjects who received the Nano ZnO gel + PCT combination showed a sustained and progressive improvement in their treatment outcomes, a result that presented statistically significant differences from the outcomes obtained through the remaining interventions, at all time points during the study period. CONCLUSIONS: The repeated application of PCT using bio-hydrothermally synthesized ZnO NPs can effectively complement SRP in the non-surgical treatment of Periodontitis.

Antimicrobial photocatalysis using bio-hydrothermally synthesized Zinc oxide nanoparticles in the management of periodontitis: a prospective split-mouth, double-blind, randomized, controlled clinical trial

Abstract The antimicrobial activity of metallic nanoparticles (NPs) has been confirmed to fight a broad spectrum of microorganisms, through antimicrobial effects that are amplified when these particles are irradiated with light of the proper wavelength. This is the first study to use phytoconjugated Zinc oxide (ZnO) NPs containing traces of active biomolecules derived from Emblica officinalis (E. officinalis) plant extract in antimicrobial photocatalysis (PCT) during non-surgical periodontal therapy. Objectives This study aimed to evaluate the effects of repeated PCT application in the treatment of periodontitis, using a gel containing bio-hydrothermally synthesized ZnO NPs and visible light as an adjunct to scaling and root planing (SRP). Methodology In total, 16 systemically healthy volunteers with stage 3 grade B generalized periodontitis were recruited for this prospective double blind, randomized placebo-controlled trial. After receiving SRP, the subjects received the following interventions in a split-mouth design at baseline, 1 week and 1 month: Group 1 - Placebo gel + Sham PCT; Group 2 - Nano ZnO gel + Sham PCT; Group 3 - Placebo gel + PCT; and Group 4 - Nano ZnO gel + PCT. The site-specific profile of Porphyromonas gingivalis in the subgingival plaque and clinical parameters (Plaque Index, Gingival Index, Gingival Bleeding Index, Probing pocket Depth and Clinical Attachment Level) were assessed at baseline, 1 month and 3 months. Results All interventions tested caused participants' clinical and microbiological parameters to generally improve after 3 months. Subjects who received the Nano ZnO gel + PCT combination showed a sustained and progressive improvement in their treatment outcomes, a result that presented statistically significant differences from the outcomes obtained through the remaining interventions, at all time points during the study period. Conclusions The repeated application of PCT using bio-hydrothermally synthesized ZnO NPs can effectively complement SRP in the non-surgical treatment of Periodontitis.

Mucinous Cystic Neoplasm of the Liver and Extrahepatic Biliary Tract with Ascending Cholangitis: a Case Report and Review of the Literature.

Mucinous cystic neoplasms of the liver involving the extrahepatic biliary tract is a rare slow-growing benign neoplasm of biliary system that has an early clinical presentation with obstructive jaundice. These tumors have a high risk of malignant transformation, which is difficult to diagnose preoperatively by radiology or endoscopy. We present a 31-year-old female patient who presented with complaints of pain abdomen, vomiting, fever, and obstructive jaundice. Ultrasound abdomen showed features suggestive of cholangitic abscess. Computed tomography abdomen showed features suggestive of cholangitic abscess and abrupt termination of the proximal CBD secondary to the stricture. A left hemi-hepatectomy was performed which showed a multiloculated cystic liver lesion with the involvement of extrahepatic duct, cystic duct, and proximal common bile duct. Histopathology showed cyst was lined by mucin secreting columnar epithelium without nuclear atypia, the wall the cysts showed ovarian-like stroma, and the diagnosis of mucinous cystic neoplasms of the liver and extrahepatic biliary tract with ascending cholangitis was made. Regular follow-up by clinical and radiological examination at 6 months did not reveal any recurrence.

Endometriosis: A Clinicopathological Study in a Tertiary Care Hospital.

Background Endometriosis (EM) is an estrogen-dependent disease characterized by the presence of endometrial gland and stroma outside the uterus. It is commonly seen in the reproductive age group and is a leading cause of infertility. Patients present with chronic pelvic pain, menstrual abnormalities, dyspareunia, or mass per abdomen. Surgical excision is the treatment of choice with postoperative medications and progesterone agents. Aims and Objectives This study aims at determining the distribution of EM in terms of age, parity, symptoms, site, morphological features. We also analyzed the management of EM in these cases. Methodology This is a retrospective study done in a tertiary care hospital in Mangalore, India. The case records of 77 histopathologically confirmed cases of EM during the 7 years between June 2012 and May 2019 were studied. Demographic profiles, parity, presenting complaints, site of the lesion, morphological features, treatment given, follow-up, and recurrence were noted and analyzed. Results Of the 77 patients with EM, the most common age group was the fourth decade (40%). The majority (31, 40.25%) of the patients in this study were nulliparous. Chronic pelvic pain was the most common symptom. The most frequent site was ovary. Conclusion The most frequent site of EM is ovary, leading to infertility. With the advent of laparoscopy, early diagnosis and excision have been feasible. The histopathological examination should be done for confirmation. Awareness of this disease among health care professionals is necessary whenever a woman in reproductive age presents with chronic pelvic pain and infertility.

An in vitro analysis of the effect of adjunctive use of ozonated oil with a desensitizing agent on dentinal tubule occlusion.

INTRODUCTION: Dentinal hypersensitivity (DH), is a commonly encountered clinical problem, the management of which is by two main approaches that involve blockage of nerve activity and tubular occlusion. Desensitizing agents containing arginine and calcium carbonate have emerged effective in occluding tubules. Ozone removes the smear layer and opens up the dentinal tubules for easy penetration of these desensitizing agents. OBJECTIVE: To comparatively evaluate the effect of ozonated oil on the patency and occlusion of dentinal tubules with and without adjunctive application of a desensitizing agent containing arginine. MATERIALS AND METHODS: 80 dentin specimens that were distributed into 4 groups as Group 1 (control), Group 2 (ozonated oil), Group 3 (desensitizing agent) and Group 4 (desensitizing agent following the application of ozonated oil), underwent an acid challenge. Scanning electron microscopic (SEM) images of the dentin specimens were obtained prior to any treatment, after the application of the therapeutic agents and after acid challenge and mean tubule occlusion scores were recorded in each case employing a suitable scoring system. The statistical analysis employed One-way ANOVA test followed by Tukey's Post hoc test and Student Paired t-test for intergroup and intragroup comparisons of the mean tubule occlusion scores respectively. RESULTS: Group 2, treated with ozonated oil alone showed a statistically significant increase in the number of open dentinal tubules. Group 4 showed more compact deposits of desensitizing agent and more densely occluded tubules as compared to Group 3 which was more retained in the former even after acid challenge. CONCLUSION: Adjunctive application of the desensitizing agent containing arginine, with ozonated oil has a synergistic effect, where the latter causes opening of dentinal tubules allowing more compact penetration of the former and thus may be a potentially more effective treatment approach in the management of DH.

Comparison of the antimicrobial properties of charcoal-infused and non-charcoal-infused toothbrushes: an in vitro study.

Toothbrushes act as a reservoir for a variety of microorganisms, possibly leading to oral infection. Some manufacturers are marketing toothbrushes that incorporate materials such as charcoal in their bristles and claiming that they reduce bacterial contamination. The present study aimed to explore the antimicrobial nature of charcoal-infused and non-charcoal-infused bristles and to characterize both bristle types physically and morphologically to ascertain any differences that might influence their antimicrobial activity. The antimicrobial property was analyzed using separate standard microbial solutions of Streptococcus mutans and Candida albicans to contaminate 40 commercially available toothbrushes of each bristle type, charcoal-infused and non-charcoal-infused (80 toothbrushes total), and microbial colonies were established. Each toothbrush head was rinsed 4 times in sterile tap water to simulate the brushing cycle, and the microbial counts of the rinsing solutions were recorded after the second and fourth rinses. After the fourth rinse, the toothbrush heads were left to dry for 20 hours, and the final microbial retention counts were recorded. The physical and morphologic characteristics of both bristle types were analyzed using Laser Raman spectroscopy, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. The microbiologic analysis showed a statistically significant decrease in colony counts from initial exposure to final retention of both microbes for both types of toothbrush (P < 0.05; Wilcoxon signed rank test). However, intergroup comparisons showed no significant differences between the brush types in final retention of either microbe. Raman spectroscopy showed similar carbon compositions for both types of bristle. No significant difference was found between the 2 types of toothbrushes regarding their characterization or antimicrobial activity. Therefore, before charcoal-infused toothbrushes are marketed as a means to reduce contamination, there is a need to identify an appropriate concentration, ascertain the mechanism of action, and identify the pathogen-specific action of charcoal.

Neuroendocrine Carcinoma of Duodenum-an Uncommon Tumour at an Unusual Site.

Neuroendocrine carcinoma rarely occurs in the duodenum, and most cases of neuroendocrine carcinoma in the duodenum show rapid progression of the disease. Such cases have poor prognosis even with radical surgery with or without chemotherapy with low 5-year survival rate. We present a case of a 52-year-old man who presented with abdominal pain of 1-month duration and one episode of vomiting. Upper gastrointestinal endoscopy revealed polypoidal lesions in the first and second part of the duodenum. Whipple's procedure was performed. Diagnosis of poorly differentiated neuroendocrine carcinoma was made with extension to pancreas with peripancreatic lymph node metastases. The patient expired on post operative day 17 following cardiac arrest.

Molecular characterization of the interaction of sialic acid with the periplasmic binding protein from Haemophilus ducreyi.

The primary role of bacterial periplasmic binding proteins is sequestration of essential metabolites present at a low concentration in the periplasm and making them available for active transporters that transfer these ligands into the bacterial cell. The periplasmic binding proteins (SiaPs) from the tripartite ATP-independent periplasmic (TRAP) transport system that transports mammalian host-derived sialic acids have been well studied from different pathogenic bacteria, including Haemophilus influenzae, Fusobacterium nucleatum, Pasteurella multocida, and Vibrio cholerae SiaPs bind the sialic acid N-acetylneuraminic acid (Neu5Ac) with nanomolar affinity by forming electrostatic and hydrogen-bonding interactions. Here, we report the crystal structure of a periplasmic binding protein (SatA) of the ATP-binding cassette (ABC) transport system from the pathogenic bacterium Haemophilus ducreyi The structure of Hd-SatA in the native form and sialic acid-bound forms (with Neu5Ac and N-glycolylneuraminic acid (Neu5Gc)), determined to 2.2, 1.5, and 2.5 Å resolutions, respectively, revealed a ligand-binding site that is very different from those of the SiaPs of the TRAP transport system. A structural comparison along with thermodynamic studies suggested that similar affinities are achieved in the two classes of proteins through distinct mechanisms, one enthalpically driven and the other entropically driven. In summary, our structural and thermodynamic characterization of Hd-SatA reveals that it binds sialic acids with nanomolar affinity and that this binding is an entropically driven process. This information is important for future structure-based drug design against this pathogen and related bacteria.

Phyto-Fabrication of ZnO Nanoparticles Using Piper betel Aqueous Extract and Evaluation of its Applicability in Dentistry.

BACKGROUND: Facile, environmental friendly synthesis of metal oxide nanoparticles is of paramount importance when its biological applications are considered. OBJECTIVE: Current study reports phyto-fabrication of Zinc oxide nanoparticles using aqueous extract of Piper betel leaves as stabilizing and capping agent using co-precipitation method. RESULTS: P betel synthesized ZnO nanoparticles (PZnO) was characterized using Powder X-ray diffraction, UV-Visible spectroscopy, scanning electron microscopy and dynamic light scattering. PXRD pattern demonstrated hexagonal wurtzite structure with preferred orientation (100) plane confirmed by JCPDS file 36-1451. UV- Vis spectroscopy showed peak at 370 nm due to band edge of semiconductor, the PZnO. The average particle size determined by DLS measurement was 69 nm and morphologically the particles were short rod shaped and agglomerated as demonstrated by SEM images. Antibacterial activity of PZnO against dental pathogens namely Streptococcus mutans and Lactobacillus acidphillus was performed using well-diffusion method and antioxidant activity against 2, 2 diphenyl 1 picrylhydrazyl (DPPH) free radicals and were compared with ZnO used in clinical dentistry (DZnO). PZnO showed higher antioxidant activity of ~70% at 200 µg/mL with consistent activity at lower aliquots. PZnO showed higher antimicrobial activity than DZnO against both tested microbes and also exhibited inhibitory effects in concentration as low as 3.25 µg/mL. Cytotoxicity study using Balb 3T3 mouse fibroblast cell lines showed <40% cellular growth inhibition by both PZnO and DZnO, indicating their benignity towards selected cell lines. CONCLUSION: Phyto-fabricated facile PZnO nanoparticles having demonstrable antibacterial and antioxidant activity can be considered for use in clinical dentistry after further clinical trials.

Highly and moderately aggressive mouse ovarian cancer cell lines exhibit differential gene expression.

Patients with advanced epithelial ovarian cancer often experience disease recurrence after standard therapies, a critical factor in determining their five-year survival rate. Recent reports indicated that long-term or short-term survival is associated with varied gene expression of cancer cells. Thus, identification of novel prognostic biomarkers should be considered. Since the mouse genome is similar to the human genome, we explored potential prognostic biomarkers using two groups of mouse ovarian cancer cell lines (group 1: IG-10, IG-10pw, and IG-10pw/agar; group 2: IG-10 clones 2, 3, and 11) which display highly and moderately aggressive phenotypes in vivo. Mice injected with these cell lines have different survival time and rates, capacities of tumor, and ascites formations, reflecting different prognostic potentials. Using an Affymetrix Mouse Genome 430 2.0 Array, a total of 181 genes were differentially expressed (P < 0.01) by at least twofold between two groups of the cell lines. Of the 181 genes, 109 and 72 genes were overexpressed in highly and moderately aggressive cell lines, respectively. Analysis of the 109 and 72 genes using Ingenuity Pathway Analysis (IPA) tool revealed two cancer-related gene networks. One was associated with the highly aggressive cell lines and affiliated with MYC gene, and another was associated with the moderately aggressive cell lines and affiliated with the androgen receptor (AR). Finally, the gene enrichment analysis indicated that the overexpressed 89 genes (out of 109 genes) in highly aggressive cell lines had a function annotation in the David database. The cancer-relevant significant gene ontology (GO) terms included Cell cycle, DNA metabolic process, and Programmed cell death. None of the genes from a set of the 72 genes overexpressed in the moderately aggressive cell lines had a function annotation in the David database. Our results suggested that the overexpressed MYC and 109 gene set represented highly aggressive ovarian cancer potential biomarkers while overexpressed AR and 72 gene set represented moderately aggressive ovarian cancer potential biomarkers. Based on our knowledge, the current study is first time to report the potential biomarkers relevant to different aggressive ovarian cancer. These potential biomarkers provide important information for investigating human ovarian cancer prognosis.

A rare case of verrucous carcinoma of penis in an human immunodeficiency virus- infected patient.

Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects. Verrucous carcinoma is a peculiarly slow evolving, but relentlessly expanding variant of epidermoid carcinoma that is extremely reluctant to metastasize. A 60-year-old unmarried male patient presented with urethral discharge of 3 weeks duration. Dorsal slit of the prepuce revealed an ulceroproliferative growth measuring 3 cm × 3 cm arising from prepuce and involving glans. Biopsy from the growth in the prepuce showed histopathological features of verrucous carcinoma. Partial amputation of the penis was done. Human papillomavirus DNA by polymerase chain reaction was negative. The patient was started on antiretroviral therapy.

Limited density of an antigen presented by RMA-S cells requires B7-1/CD28 signaling to enhance T-cell immunity at the effector phase.

The association of B7-1/CD28 between antigen presenting cells (APCs) and T-cells provides a second signal to proliferate and activate T-cell immunity at the induction phase. Many reports indicate that tumor cells transfected with B7-1 induced augmented antitumor immunity at the induction phase by mimicking APC function; however, the function of B7-1 on antitumor immunity at the effector phase is unknown. Here, we report direct evidence of enhanced T-cell antitumor immunity at the effector phase by the B7-1 molecule. Our experiments in vivo and in vitro indicated that reactivity of antigen-specific monoclonal and polyclonal T-cell effectors against a Lass5 epitope presented by RMA-S cells is increased when the cells expressed B7-1. Use of either anti-B7-1 or anti-CD28 antibodies to block the B7-1/CD28 association reduced reactivity of the T effectors against B7-1 positive RMA-S cells. Transfection of Lass5 cDNA into or pulse of Lass5 peptide onto B7-1 positive RMA-S cells overcomes the requirement of the B7-1/CD28 signal for T effector response. To our knowledge, the data offers, for the first time, strong evidence that supports the requirement of B7-1/CD28 secondary signal at the effector phase of antitumor T-cell immunity being dependent on the density of an antigenic peptide.

Extraosseous ameloblastoma of maxillary gingiva- a case report.

Amelobasltoma is a benign neoplasm of the jaw bones that originate from the odontogenic epithelium. They are more common on the mandible than the maxilla. Rarely such tumours arise outside these bones, when they are termed extraosseous or peripheral ameloblastoma. We report a case of extraosseous ameloblastoma in a 30 year old woman, who presented with a painless lesion on the upper gingiva. The lesion was excised completely and the histopathology was suggestive of extraosseous ameloblastoma.

Primary mucinous carcinoma of buccal mucosa: a rare case report.

Minor salivary gland tumors of oral cavity are very rarely encountered in day-to-day practice. Mucinous adenocarcinoma is very rare, and is commonly seen in elderly males. Palate and buccal mucosa is the commonest site. Wide local excision is the treatment. Histology shows tumor cells floating in pools of mucin, compartmentalized by fibrous tissue. Metastasis is a close mimicker, however with an evidence of negative scan and minor salivary gland proliferation in adjacent tissue diagnosis can be made. Mucin stains and immunohistochemistry can be used to support the diagnosis in problematic cases. We are presenting a rare case of mucinous adenocarcinoma-cheek in a 54-year-old male who came with gradually progressive swelling in the left buccal mucosa since 3 months and after wide excision, no evidence of recurrence was noted in 1 year and 3 months of follow up period.

Juvenile spondyloarthritis with microscopic colitis.

We report an adolescent girl with long standing spondyloarthritis and chronic diarrhea. Colonoscopy and biopsy revealed microscopic colitis. All serology and HLA-B27 were negative. This case is reported for its rarity and the need to evaluate gut in chronic arthritis to achieve clinical remission.

NsdC and NsdD affect Aspergillus flavus morphogenesis and aflatoxin production.

The transcription factors NsdC and NsdD are required for sexual development in Aspergillus nidulans. We now show these proteins also play a role in asexual development in the agriculturally important aflatoxin (AF)-producing fungus Aspergillus flavus. We found that both NsdC and NsdD are required for production of asexual sclerotia, normal aflatoxin biosynthesis, and conidiophore development. Conidiophores in nsdC and nsdD deletion mutants had shortened stipes and altered conidial heads compared to those of wild-type A. flavus. Our results suggest that NsdC and NsdD regulate transcription of genes required for early processes in conidiophore development preceding conidium formation. As the cultures aged, the ΔnsdC and ΔnsdD mutants produced a dark pigment that was not observed in the wild type. Gene expression data showed that although AflR is expressed at normal levels, a number of aflatoxin biosynthesis genes are expressed at reduced levels in both nsd mutants. Expression of aflD, aflM, and aflP was greatly reduced in nsdC mutants, and neither aflatoxin nor the proteins for these genes could be detected. Our results support previous studies showing that there is a strong association between conidiophore and sclerotium development and aflatoxin production in A. flavus.

Expression profiling of non-aflatoxigenic Aspergillus parasiticus mutants obtained by 5-azacytosine treatment or serial mycelial transfer.

Aflatoxins are carcinogenic secondary metabolites produced by the fungi Aspergillus flavus and Aspergillus parasiticus. Previous studies found that repeated serial mycelial transfer or treatment of A. parasiticus with 5-azacytidine produced colonies with a fluffy phenotype and inability to produce aflatoxins. To understand how these treatments affect expression of genes involved in aflatoxin production and development, we carried out expressed sequence tag (EST)-based microarray assays to identify genes in treated clones that are differentially expressed compared to the wild-type. Expression of 183 genes was significantly dysregulated. Of these, 38 had at least two-fold or lower expression compared to the untreated control and only two had two-fold or higher expression. The most frequent change was downregulation of genes predicted to encode membrane-bound proteins. Based on this result we hypothesize that the treatments cause changes in the structure of cellular and organelle membranes that prevent normal development and aflatoxin biosynthesis.