Optimizing Root Canal Therapy: An In Vitro Comparative Study of Innovative File Systems on Mandibular Premolar Fracture Resistance.

INTRODUCTION AND AIM:  Root canal therapy is a vital procedure for saving teeth by removing infection and cleaning the complex root canal system. However, a delicate balance exists between thorough cleaning and preserving tooth strength. The study aims to evaluate the instrumentation effect of three innovative file systems, XP-endo® shaper, Reciproc®, and Self-adjusting file (SAF) on fracture resistance of mandibular premolars. MATERIALS AND METHODS: Thirty single-rooted mandibular premolars were collected; a standard access cavity was prepared and the working length was established 1 mm short of the apex. The teeth were randomly divided into three groups(n=10). In Group 1, the shaping of the specimens was achieved using XP-endo® shaper; in Group 2, it was instrumented using Reciproc® file; and in Group 3, it was instrumented using SAF. All samples were decoronated and the roots were mounted vertically in acrylic resin and subjected to fracture resistance under a universal testing machine. RESULTS: Intergroup analysis was done by one-way ANOVA followed by Bonferroni post hoc test, which did not report a statistically significant difference (p>0.05). CONCLUSION: All three tested file systems were similar in fracture resistance. XP-endo® shaper exhibited better fracture resistance on root canal instrumentation when compared to Reciproc® and SAF although they are not statistically significant.

Adolescent tuberculosis in the ICU.

TB is a major concern in the paediatric age group, especially in India. More than 3.33 lakh children between 0 and 14 years of age are affected by TB. Adolescent tuberculosis has been a neglected area and this age group accounts for about 800,000 cases of tuberculosis (TB) cases every year. Information regarding adolescent tuberculosis patient requiring ICU admission/care is very scanty (unlike adult tuberculosis), and the authors believe that the mode of ICU presentation and challenges in adolescents would almost be the same as in adults, although the outcome is generally expected to be better in the adolescent population in view of lesser comorbidities when compared to adults. ARDS, multiorgan dysfunction and meningitis are the most common reasons for admission to ICU. Critically ill patients with TB carry a high mortality and the increased mortality is likely due to multiorgan dysfunction, nosocomial infections and sepsis. Advanced disease with chronic undernourishment influences not just morbidity but mortality as well. Further, the heavy financial burden incurred for ICU care in TB patients with poor expected outcome is a major concern since TB occurs predominantly in low socio-economic populations.

An Interesting Case of Dengue Encephalitis With Parkinsonism Sequela.

Expanded dengue syndrome has been associated with various neurological manifestations. In this report, we present a rare and interesting case of parkinsonism secondary to dengue encephalitis in a young female. A 25-year-old female was admitted to the ICU with high-grade fever, generalized weakness, and altered sensorium for two days. Meningoencephalitis workup was negative but she tested positive for dengue non-structural 1 (NS1) antigen. MRI brain showed a "double doughnut sign" consistent with viral encephalitis. She was managed with neuroprotective measures, a short course of steroids, and invasive mechanical ventilation via tracheostomy. During the course of her treatment, she developed left upper limb rigidity, involuntary movements, and gait abnormalities with generalized bradykinesia suggestive of dengue-associated parkinsonism. She responded well to trihexyphenidyl and levodopa with significant neurological recovery and was discharged from the hospital in a condition where she could independently walk with significant improvement in dystonia. Central nervous system involvement has been well documented in arboviral illnesses caused by neurotropic viruses. Dengue encephalitis with sequelae like parkinsonism is potentially treatable when identified appropriately and in a timely manner.

Free-ranging dogs show age related plasticity in their ability to follow human pointing.

Differences in pet dogs' and captive wolves' ability to follow human communicative intents have led to the proposition of several hypotheses regarding the possession and development of social cognitive skills in dogs. It is possible that the social cognitive abilities of pet dogs are induced by indirect conditioning through living with humans, and studying free-ranging dogs can provide deeper insights into differentiating between innate abilities and conditioning in dogs. Free-ranging dogs are mostly scavengers, indirectly depending on humans for their sustenance. Humans can act both as food providers and as threats to these dogs, and thus understanding human gestures can be a survival need for the free-ranging dogs. We tested the responsiveness of such dogs in urban areas toward simple human pointing cues using dynamic proximal points. Our experiment showed that pups readily follow proximal pointing and exhibit weaker avoidance to humans, but stop doing so at the later stages of development. While juveniles showed frequent and prolonged gaze alternations, only adults adjusted their behaviour based on the reliability of the human experimenter after being rewarded. Thus free-ranging dogs show a tendency to respond to human pointing gestures, with a certain level of behavioural plasticity that allows learning from ontogenic experience.