Estimation of Red-complex Bacteria in Diode Laser Treated Chronic Periodontitis Patients: A Clinical and Microbiological Study.

CONTEXT: Laser has been widely accepted as a substitute to traditional periodontal treatment. Only a finite number of studies are available based on the use of diode laser as a supplement to scaling and root planing (SRP) in the reduction of red-complex bacteria. AIM: This split-mouth study was aimed to determine the clinical and microbiological effects of diode laser as a supplement to SRP. MATERIALS AND METHODS: For this split-mouth study, systemically healthy 34 patients with chronic periodontitis were selected. In the test quadrant, SRP + laser therapy was carried out, whereas in control quadrants, SRP alone was performed. Clinical and microbiological data were acquired at baseline and 3 months postoperative, and statistical analysis was carried out on the findings. RESULTS: The results showed that both the treatment modalities were impelling. Considerable reduction in the mean probing depth and a notable improvement in the attachment level were observed in both groups in comparison to baseline, with a statistically significant reduction in the laser group. Microbiological analysis results showed more reduction in red-complex bacteria in the laser group compared to the SRP group, but they were statistically insignificant. CONCLUSION: Within the limitation of this study, it is recommended that both the SRP and SRP + laser are effective in chronic periodontitis management, but using laser with SRP has propitious results. Thus, in the forthcoming years, clinical experiments with a greater sample size may be chosen to further analyze the fringe benefits of laser as a supplement to SRP.

In Vitro Antibacterial Efficacy of Sutures Coated With Aloe vera and Ciprofloxacin: A Comparative Evaluation.

BACKGROUND: Sutures which are used for wound approximation can act as a reservoir of microbes at the surgical site leading to increased chances of surgical site infection (SSI). Sutures used in oral cavity are continuously bathed in saliva which results in wicking. Several studies on sutures treated with nanoparticles, antibacterial agent and various drugs to advance the therapeutical value of surgical sutures are in consideration, drug-eluting sutures has been notable in research to deliver localized effect on the site of incision. Ciprofloxacin and Aloe vera are routinely used agents in coating sutures. AIM: This study is to evaluate the antibacterial efficacy and oral biofilm inhibition of Ciprofloxacin and Aloe vera coated 3-0 silk sutures in comparison to uncoated sutures against E.coli. MATERIAL AND METHODS: Equal segments of ciprofloxacin and aloe vera coated 3-0 silk sutures are to be incubated in E.coli culture media (blood agar) at 37°C for 24 hours in aerobic atmosphere. Plain uncoated suture served as control. Assessment was done using Total Colony Forming Units and biofilm inhibition potential of sutures. Results awaited. RESULTS: The zone of inhibition around ciprofloxacin coated suture is nearly double than that of with Aloe vera indicted that antibacterial efficacy of ciprofloxacin is more comparatively. No inhibition zone around uncoated plain 3-0 braided silk shows that it has no significant antibacterial activity. CONCLUSION: Within limitation of our study, it can be concluded that both ciprofloxacin and Aloe vera coated sutures have antibacterial property against gram negative E. coli and can have a promising role in prevention of SSI although it would require further in vivo validation.

Physical activity but not sedentary activity is reduced in primary Sjögren's syndrome.

The aim of the study was to evaluate the levels of physical activity in individuals with primary Sjögren's syndrome (PSS) and its relationship to the clinical features of PSS. To this cross-sectional study, self-reported levels of physical activity from 273 PSS patients were measured using the International Physical Activity Questionnaire-short form (IPAQ-SF) and were compared with healthy controls matched for age, sex and body mass index. Fatigue and other clinical aspects of PSS including disease status, dryness, daytime sleepiness, dysautonomia, anxiety and depression were assessed using validated tools. Individuals with PSS had significantly reduced levels of physical activity [median (interquartile range, IQR) 1572 (594-3158) versus 3708 (1732-8255) metabolic equivalent of task (MET) × min/week, p < 0.001], but similar levels of sedentary activity [median (IQR) min 300 (135-375) versus 343 (223-433) (MET) × min/week, p = 0.532] compared to healthy individuals. Differences in physical activity between PSS and controls increased at moderate [median (IQR) 0 (0-480) versus 1560 (570-3900) MET × min/week, p < 0.001] and vigorous intensities [median (IQR) 0 (0-480) versus 480 (0-1920) MET × min/week, p < 0.001]. Correlation analysis revealed a significant association between physical activity and fatigue, orthostatic intolerance, depressive symptoms and quality of life. Sedentary activity did not correlate with fatigue. Stepwise linear regression analysis identified symptoms of depression and daytime sleepiness as independent predictors of levels of physical activity. Physical activity is reduced in people with PSS and is associated with symptoms of depression and daytime sleepiness. Sedentary activity is not increased in PSS. Clinical care teams should explore the clinical utility of targeting low levels of physical activity in PSS.

Health-related utility values of patients with primary Sjögren's syndrome and its predictors.

OBJECTIVES: EuroQoL-5 dimension (EQ-5D) is a standardised preference-based tool for measurement of health-related quality of life and EQ-5D utility values can be converted to quality-adjusted life years (QALYs) to aid cost-utility analysis. This study aimed to evaluate the EQ-5D utility values of 639 patients with primary Sjögren's syndrome (PSS) in the UK. METHODS: Prospective data collected using a standardised pro forma were compared with UK normative data. Relationships between utility values and the clinical and laboratory features of PSS were explored. RESULTS: The proportion of patients with PSS reporting any problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 42.2%, 16.7%, 56.6%, 80.6% and 49.4%, respectively, compared with 5.4%, 1.6%, 7.9%, 30.2% and 15.7% for the UK general population. The median EQ-5D utility value was 0.691 (IQR 0.587-0.796, range -0.239 to 1.000) with a bimodal distribution. Bivariate correlation analysis revealed significant correlations between EQ-5D utility values and many clinical features of PSS, but most strongly with pain, depression and fatigue (R values>0.5). After adjusting for age and sex differences, multiple regression analysis identified pain and depression as the two most important predictors of EQ-5D utility values, accounting for 48% of the variability. Anxiety, fatigue and body mass index were other statistically significant predictors, but they accounted for <5% in variability. CONCLUSIONS: This is the first report on the EQ-5D utility values of patients with PSS. These patients have significantly impaired utility values compared with the UK general population. EQ-5D utility values are significantly related to pain and depression scores in PSS.

Autonomic symptoms are common and are associated with overall symptom burden and disease activity in primary Sjogren's syndrome.

OBJECTIVES: To determine the prevalence of autonomic dysfunction (dysautonomia) among patients with primary Sjögren's syndrome (PSS) and the relationships between dysautonomia and other clinical features of PSS. METHODS: Multicentre, prospective, cross-sectional study of a UK cohort of 317 patients with clinically well-characterised PSS. Symptoms of autonomic dysfunction were assessed using a validated instrument, the Composite Autonomic Symptom Scale (COMPASS). The data were compared with an age- and sex-matched cohort of 317 community controls. The relationships between symptoms of dysautonomia and various clinical features of PSS were analysed using regression analysis. RESULTS: COMPASS scores were significantly higher in patients with PSS than in age- and sex-matched community controls (median (IQR) 35.5 (20.9-46.0) vs 14.8 (4.4-30.2), p<0.0001). Nearly 55% of patients (vs 20% of community controls, p<0.0001) had a COMPASS score >32.5, a cut-off value indicative of autonomic dysfunction. Furthermore, the COMPASS total score correlated independently with EULAR Sjögren's Syndrome Patient Reported Index (a composite measure of the overall burden of symptoms experienced by patients with PSS) (ß=0.38, p<0.001) and disease activity measured using the EULAR Sjögren's Syndrome Disease Activity Index (ß=0.13, p<0.009). CONCLUSIONS: Autonomic symptoms are common among patients with PSS and may contribute to the overall burden of symptoms and link with systemic disease activity.