Evaluation of antimicrobial efficacy of Triphala (an Indian Ayurvedic herbal formulation) and 0.2% chlorhexidine against Streptococcus mutans biofilm formed on tooth substrate: an in vitro study.

BACKGROUND: Streptococcus mutans is one of the most important cariogenic species of the human oral microbial flora. Biofilm style of microbial growth thought to resist the actions of antimicrobials. AIM: The purpose of this study was to evaluate the antimicrobial efficacy of Triphala, and 0.2% chlorhexidine against S. mutans biofilm formed on tooth substrate. SETTINGS AND DESIGN: Randomized control trial. METHODS: Extracted human mandibular premolars sectioned below the cemento-enamel junction were placed in the tissue culture wells exposing the crown surface to S. mutans to form a biofilm. At the end of 3 rd and 7 th day, all groups were treated for 10 min with the test solutions and control and were analyzed qualitatively and quantitatively. STATISTICAL ANALYSIS USED: One-way ANOVA. RESULTS: Qualitative assay with 3 days biofilm showed complete inhibition of bacterial growth with Triphala, but 0.2% chlorhexidine and saline showed the presence of bacterial growth. In quantitative analysis, 0.2% chlorhexidine and Saline treated tooth samples have shown 1052 Χ 10(4) ± 15.1 Χ 10(4) CFU/ml, 141.3 Χ 10(9) ± 2.1Χ10(9) CFU/ml, respectively. Qualitative assay with 7 days biofilm on crown portion showed dense growth when treated with 0.2% chlorhexidine and saline, whereas Triphala has shown minimal growth. In Quantitative analysis, Triphala showed statistically significant result when compared with 0.2% chlorhexidine and saline. CONCLUSION: Triphala showed statistically significant antibacterial activity against S. mutans biofilm formed on tooth substrate. The incorporation of Triphala in mouth rinse could prove to be effective in reducing S. mutans count in the oral cavity.

Regioselective synthesis of 2-(2-hydroxyaryl)pyridines from the reactions of benzynes with pyridine N-oxides.

By modifying the conditions from those in Larock's reported synthesis of 3-(2-hydroxyaryl)pyridines from benzynes, and pyridine N-oxides, we altered the regioselectivity of the reaction toward an efficient synthesis of 2-substituted pyridines. The presence of ethyl propiolate altered the regioselectivity to afford 3-substituted pyridine products instead. We conducted appropriate control experiments that enable a full understanding of the mechanism.

Pediatric cholelithiasis and laparoscopic management: A review of twenty two cases.

AIM: To evaluate the role of laparoscopic cholecystectomy (LC) in the management of cholelithiasis in children. MATERIALS AND METHODS: A retrospective review of our experience with LC for cholelithiasis at our institution, between April 2006 and March 2009 was done. Data points reviewed included patient demographics, clinical history, haematological investigations, imaging studies, operative techniques, postoperative complications, postoperative recovery and final histopathological diagnosis. RESULTS: During the study period of 36 months, 22 children (10 males and 12 females) with cholelithiasis were treated by LC. The mean age was 9.4 years (range 3 to 18 years). Twenty-one children had symptoms of biliary tract disease and one child was incidentally detected with cholelithiasis during an ultrasonogram of the abdomen for an unrelated cause. Only five (22.7%) children had definitive etiological risk factors for cholelithiasis and the remaining 13(77.3%) cases were idiopathic. Twenty cases had pigmented gallstones and two had cholesterol gallstones. All the 22 patients underwent LC, 21 elective and one emergency LC. The mean operative duration was 74.2 minutes (range 50-180 minutes). Postoperative complications occurred in two (9.1%) patients. The average duration of hospital stay was 4.1 days (range 3-6 days). CONCLUSION: Laparoscopic chloecystectomy is confirmed to be a safe and efficacious treatment for pediatric cholelithiasis. The cause for an increased incidence of pediatric gallstones and their natural history need to be further evaluated.

Heat radiation vs air drying to remove interfacial water from self-etch adhesives.

The clinician's quest for time-saving and technique-insensitive technology has led to the development of simplified self-etch adhesives that are predominantly water or solvent based. Several studies have shown that conventional air-drying procedures are incapable of eliminating all the residual water in the adhesive and that it may even cause collapse of the underlying collagen matrix. We hypothesized that heat from a light source may be effective in removing water from these adhesives. The aim of this study was, therefore, to evaluate the effectiveness of heat vs conventional air drying in eliminating water droplets from self-etch adhesive. A self-etch adhesive was applied to bur-cut dentin surfaces, which were then allotted to one of two treatment procedures for eliminating residual water from the adhesive: conventional air drying or the experimental heat application. Specimens were then prepared and analyzed using SEM. Specimens in the experimental group showed no evidence of water treeing within the adhesive layer. Thus, it was concluded that heat radiation was an effective method to remove residual water from simplified adhesives.

Laparoscopic appendicectomy is a favorable alternative for complicated appendicitis in children.

AIM: To evaluate the role of laparoscopy in complicated appendicitis in children. MATERIALS AND METHODS: A total of 119 children were operated for appendicitis between October 2005 and May 2008 at SRMC, Chennai. Forty-one patients underwent open appendicectomy (OA), and 71 patients underwent laparoscopic appendicectomy (LA). Twenty-six cases among the LA group and 16 among the OA group had complicated appendicitis. Twenty-six cases were completed laparoscopically, and 2 needed conversion to OA. RESULTS: Out of 26 patients in the LA group, 23 made an uneventful recovery without any complications. One had minor port site infection, and 2 had prolonged loose stools. Out of 16 in the OA group, 7 had complications. Three had wound infection, 2 had loose stools, 1 had fecal fistula and another required subsequent surgeries. Operative duration in LA was 86.7 min (range: 75 to 120 min) and 90.3 min (range: 70 to 150 min) in OA. Oral feed resumption in LA was done at average of 2.7 days and in OA at 4.3 days. IV antibiotics were administered for an average of 3.6 days in LA and 4.8 days in OA, parenteral analgesic for 2.7 days in LA and 4.2 days in OA. The length of hospital stay was 5.4 days in LA and 7.3 days in OA. CONCLUSION: LA is a favorable alternative in children with complicated appendicitis in view of less postoperative pain, fewer postoperative complications and quicker return to normal activity.