Antibacterial Efficacy of Mineral Trioxide Aggregate, Bioactive Glass and Epoxy-Resin Based Sealer: An In-Vitro Interventional Study.

Aim: The aim and objective of this in vitro study was to evaluate the antibacterial efficacy of mineral trioxide aggregate, bioactive glass sealer, and epoxy-resin-based sealer. Materials and Methods: In the present study, 22 Mueller Hinton agar (MH agar) plates were employed and equally divided into two groups. Three holes were made by removal of agar at equidistant points and filled with root canal sealers. The strains of the bacteria used in this study were S. aureus (ATCC 6538) and C. albicans (ATCC 10231) and were divided into two groups and root canal sealers were divided into three subgroups: mineral trioxide aggregate (MTA) fillapex Sealer, Nishika Bioactive Glass sealer, and Syntex Epoxy Resin base sealer. For Staphylococcus aureus, peptone water was placed in a 2 mL test tube and bacteria were extracted from blood agar plates using a nichrome wire loop and poured into the peptone water-containing test tube and incubated for 2 hours and for C. albicans, fungi were grown at 37°C for 24 hours in MH Broth and seeded into MH agar to produce turbidity of 0.5 on the McFarland scale, which corresponds to a concentration of 108 CFU/mL. This MH broth was used as a second layer. The seeded agar was then added over the plates immediately after the insertion of sealer cement. After incubation, the diameters of zones of inhibition around the plates were measured. Results: The results of this study showed that the highest inhibition was recorded in Syntex sealer against Staphylococcus aureus followed by MTA fillapex sealer and Nishika sealer, whereas MTA fillapex showed the highest inhibition against C. albicans followed by Syntex sealer and Nishika sealer. Conclusion: Syntex sealer exhibits better antibacterial efficacy against Staphylococcus aureus and MTA fillapex exhibit better antibacterial efficacy against C. albicans.

Transcriptomic Analysis of Alzheimer's Disease Pathways in a Pakistani Population.

Background: Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder that is most prevalent in elderly individuals, especially in developed countries, and its prevalence is now increasing in developing countries like Pakistan. Objective: Our goal was to characterize key genes and their levels of expression and related molecular transcriptome networks associated with AD pathogenesis in a pilot case-control study in a Pakistani population. Methods: To obtain the spectrum of molecular networks associated with pathogenesis in AD patients in Pakistan (comparing cases and controls), we used high-throughput qRT-PCR (TaqMan Low-Density Array; n = 33 subjects) coupled with Affymetrix Arrays (n = 8) and Ingenuity Pathway Analysis (IPA) to identify signature genes associated with Amyloid processing and disease pathways. Results: We confirmed 16 differentially expressed AD-related genes, including maximum fold changes observed in CAPNS2 and CAPN1. The global gene expression study observed that 61% and 39% of genes were significantly (p-value 0.05) up- and downregulated, respectively, in AD patients compared to healthy controls. The key pathways include, e.g., Amyloid Processing, Neuroinflammation Signaling, and ErbB4 Signaling. The top-scoring networks in Diseases and Disorders Development were Neurological Disease, Organismal Injury and Abnormalities, and Psychological Disorders. Conclusions: Our pilot study offers a non-invasive and efficient way of investigating gene expression patterns by combining TLDA and global gene expression method in AD patients by utilizing whole blood. This provides valuable insights into the expression status of genes related to Amyloid Processing, which could play potential role in future studies to identify sensitive, early biomarkers of AD in general.

Five Hundred Patients with Memory Loss in One Clinic in India: Does the Prevalence Vary Between Communities?

This observational study reports on the cause of memory loss in 500 consecutive patients. It confirms the previously reported finding in a smaller sample of 100 patients. There have been several publications suggesting that the prevalence of dementia is lower in certain communities but the reason is not known. This study was conducted to see if it could explain the variation between communities. Also, the observation that dementia with Lewy bodies (24.4%) outnumbers cases of Alzheimer's disease (5.8%) has not been reported by any other investigators and needs to be verified. This finding could open a new topic of research and also help in the management of patients.

Neurodevelopmental disorders in children aged 2-9 years: Population-based burden estimates across five regions in India.

BACKGROUND: Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. METHODS AND FINDINGS: We assessed 3,964 children (with almost equal number of boys and girls distributed in 2-<6 and 6-9 year age categories) identified from five geographically diverse populations in India using cluster sampling technique (probability proportionate to population size). These were from the North-Central, i.e., Palwal (N = 998; all rural, 16.4% non-Hindu, 25.3% from scheduled caste/tribe [SC-ST] [these are considered underserved communities who are eligible for affirmative action]); North, i.e., Kangra (N = 997; 91.6% rural, 3.7% non-Hindu, 25.3% SC-ST); East, i.e., Dhenkanal (N = 981; 89.8% rural, 1.2% non-Hindu, 38.0% SC-ST); South, i.e., Hyderabad (N = 495; all urban, 25.7% non-Hindu, 27.3% SC-ST) and West, i.e., North Goa (N = 493; 68.0% rural, 11.4% non-Hindu, 18.5% SC-ST). All children were assessed for vision impairment (VI), epilepsy (Epi), neuromotor impairments including cerebral palsy (NMI-CP), hearing impairment (HI), speech and language disorders, autism spectrum disorders (ASDs), and intellectual disability (ID). Furthermore, 6-9-year-old children were also assessed for attention deficit hyperactivity disorder (ADHD) and learning disorders (LDs). We standardized sample characteristics as per Census of India 2011 to arrive at district level and all-sites-pooled estimates. Site-specific prevalence of any of seven NDDs in 2-<6 year olds ranged from 2.9% (95% CI 1.6-5.5) to 18.7% (95% CI 14.7-23.6), and for any of nine NDDs in the 6-9-year-old children, from 6.5% (95% CI 4.6-9.1) to 18.5% (95% CI 15.3-22.3). Two or more NDDs were present in 0.4% (95% CI 0.1-1.7) to 4.3% (95% CI 2.2-8.2) in the younger age category and 0.7% (95% CI 0.2-2.0) to 5.3% (95% CI 3.3-8.2) in the older age category. All-site-pooled estimates for NDDs were 9.2% (95% CI 7.5-11.2) and 13.6% (95% CI 11.3-16.2) in children of 2-<6 and 6-9 year age categories, respectively, without significant difference according to gender, rural/urban residence, or religion; almost one-fifth of these children had more than one NDD. The pooled estimates for prevalence increased by up to three percentage points when these were adjusted for national rates of stunting or low birth weight (LBW). HI, ID, speech and language disorders, Epi, and LDs were the common NDDs across sites. Upon risk modelling, noninstitutional delivery, history of perinatal asphyxia, neonatal illness, postnatal neurological/brain infections, stunting, LBW/prematurity, and older age category (6-9 year) were significantly associated with NDDs. The study sample was underrepresentative of stunting and LBW and had a 15.6% refusal. These factors could be contributing to underestimation of the true NDD burden in our population. CONCLUSIONS: The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions.

Distribution of Types of Dementia in the First 100 Patients Seen at a Dementia Clinic in India.

The aim of our study was to determine if the distribution of types of dementia could explain the reported lower prevalence of dementia in India. The study is an observational study of the first 100 cases of dementia. All patients were evaluated clinically and with blood tests and MRI of the brain. The causes of dementia were: Lewy body dementia (22%), depression (20%), Alzheimer's disease (13%), and mild cognitive impairment (18%). Other dementias were less common. The distribution of dementia types in this series is different from that reported globally. The observation of Lewy body dementia being the most common cause of dementia needs to be verified.

An in vitro comparison of penetration depth of two root canal sealers: An SEM study.

AIM: The aim of this study was to examine in vitro penetration depth of two resin-based sealers (AH plus and Resino Seal) and Zinc Oxide Eugenol sealer into the dentinal tubules after removing smear layer by passive ultrasonic irrigation. MATERIALS AND METHODS: Thirty freshly extracted maxillary central incisors were used. The teeth were decoronated, working length established and prepared upto size 40 file. Each root was subjected to passive ultrasonic irrigation with 2.5% sodium hypochlorite. Three different sealers and gutta-percha were used for obturation. Roots were sectioned using hard tissue microtome. These sections were gold sputtered and examined under scanning electron microscope. RESULTS: Statistical analyses of the data were performed using Kruskal-Wallis and Mann-Whitney tests. Statistically significant difference was found between AH Plus sealer and Resino Seal sealer and Zinc Oxide Eugenol sealer. CONCLUSION: The results showed that AH Plus had maximum penetration depth into dentinal tubules.

Reorienting health systems in South-East Asia to deliver care for mental and neurological disorders.

Traditionally, care for mental and neurological disorders has been concentrated in tertiary care hospitals located in large cities. These custodial types of facility were designed to 'protect' the community from patients with a mental illness, as such persons were considered dangerous and a threat to the community. Given the state of medical knowledge in the 19th and 20th centuries, this mode of care was considered appropriate. However, in recent decades more humane and effective concepts of care have evolved. These concepts recognise the stigma attached to hospital-based care and also its limited outreach to the community, leaving out the vast majority of people living in rural and remote areas. Violation of human rights, sometimes seen in mental hospitals, has also been of concern.

Maxillary molar with two palatal roots: Two case reports.

An awareness and understanding of the presence of an additional root and unusual root canal morphology is essential as it determines the successful outcome of endodontic treatment. Aberrations in root canal anatomy are commonly occurring phenomena. A thorough knowledge of basic root canal anatomy and its variation is necessary for successful completion of endodontic treatment. This report points to the importance of looking for additional roots and canals because knowledge of their existence would enable clinician to treat a case successfully that otherwise might end in failure.

Responding to the mental health and psychosocial needs of the people of Sri Lanka in disasters.

This paper describes the mental health and psychosocial response to the Boxing Day tsunami in Sri Lanka. The need to deal with the immediate psychological distress of survivors and provide psychosocial support after the tsunami was recognized early by the President of Sri Lanka and advisory group set up. In conjunction with the WHO regional office and local representatives, a National Plan of action for management and delivery of psychosocial and mental health care needs was set up. Advice was provided on the right type of psychological approaches to use when dealing with survivors--for example, not forcing people to relive their experiences, listening without offering opinions and not diagnosing or labelling people as suffering from post-traumatic stress disorder (PTSD). The early response and community level work are described in this paper as well as how this has led to a new level of disaster preparedness and a new national mental health policy and proposals for new mental health legislation.

Mental health and psychosocial support after the tsunami: observations across affected nations.

The countries affected by the tsunami responded to the natural disaster promptly but with different results and outcomes. The reasons for this varied response were many. The outcome depended upon a number of factors, including the extent of the damage to property and lives, accessibility of the areas and existing disaster plans. In this paper we present the overall observations and suggest the way forward.

Panel 2.6: mental and psychosocial effects of the Tsunami on the affected populations.

This is a summary of the presentations and discussion of Panel 2.6, Mental and Psychosocial Effects of the Tsunami on the Affected Populations of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to mental and psychological aspects as pertaining to the damage created by the Tsunami. It is presented in the following major sections: (1) responses; (2) needs assessment; (3) coordination; (4) gap filling; (5) capacity building; (6) stakeholder agreement; and (7) conclusions and recommendations. In the responses discussion, issues included: (1) psychosocial support services; (2) mental health services; and (3) the Thai response. Subsections in the stakeholder agreement section include: (1) public-private partnerships; and (2) preparedness.

Hemoglobin levels and Alzheimer disease: an epidemiologic study in India.

OBJECTIVE: Anemia is common in developing countries, where populations are aging rapidly. The authors explored the cross-sectional relationship between hemoglobin concentration and Alzheimer disease (AD) in a rural elderly sample in Ballabgarh, India. METHODS: A clinical diagnostic evaluation for dementia and a hemoglobin estimation were performed in 605 persons selected by screening a larger community-based sample age 55+ years. Twenty-six participants met criteria for AD. RESULTS: Hemoglobin was inversely associated with AD after adjustment for age, sex, and literacy. CONCLUSION: Low hemoglobin is associated with AD and should be investigated further as a modifiable risk factor.

Data management and quality assurance for an International project: the Indo-US Cross-National Dementia Epidemiology Study.

BACKGROUND: Data management and quality assurance play a vital but often neglected role in ensuring high quality research, particularly in collaborative and international studies. OBJECTIVE: A data management and quality assurance program was set up for a cross-national epidemiological study of Alzheimer's disease, with centers in India and the United States. METHODS: The study involved (a) the development of instruments for the assessment of elderly illiterate Hindi-speaking individuals; and (b) the use of those instruments to carry out an epidemiological study in a population-based cohort of over 5000 persons. Responsibility for data management and quality assurance was shared between the two sites. A cooperative system was instituted for forms and edit development, data entry, checking, transmission, and further checking to ensure that quality data were available for timely analysis. A quality control software program (CHECKS) was written expressly for this project to ensure the highest possible level of data integrity. CONCLUSIONS: This report addresses issues particularly relevant to data management and quality assurance at developing country sites, and to collaborations between sites in developed and developing countries.