Impact of the Habit of Alcohol Consumption on the Success of the Implants: A Retrospective Study.

Introduction: A recent study has demonstrated that social factors have an impact on the condition of dental implants. The present investigation investigated how varied alcohol intake quantities might alter the condition of dental implants and related peri-implant inflammation. Materials and Methods: This retrospective research was piloted in a tertiary care center, and implants inserted between 2010 and 2022 were evaluated through a retrospective cohort analysis. Within 3 months following implant implantation, information on alcohol intake was gathered from the health maintenance records and employed as the predictor variable. The implant results as well as peri-implantitis were examined at follow-up visits. Using the logistic regression model, the Wald test analysis analyzed the statistical consequences of each parameter. The findings were translated using an odds ratio that was determined with a 95% confidence level. The data were generated and analyzed using descriptive statistics, with statistical significance defined as P < 0.05. Results: At the time of implant placement, the enrolled patients were 59 ± 11.3 years old on average. The median time before peri-implantitis occurred was 31.3 ± 22.2 months. Within the first 2 years following implant implantation, the majority of people experienced peri-implantitis. The incidence of peri-implantitis was the lowest among light and moderate alcoholics (11.5%) and the highest among heavy alcoholics (46.2%). Moderate alcohol use was associated with a 79.1% decrease in peri-implantitis when compared to not drinking (P = 0.0365), whereas light alcohol consumption was connected to a 51.3% decrease (P = 0.026). The incidence of peri-implantitis among heavy drinkers was significantly significant (P = 0.0001). Conclusion: According to the findings of the current retrospective cohort analysis, drinking alcohol at mild-to-moderate levels is connected to a reduction in the incidence rate of peri-implantitis compared to heavy drinkers. In contrast, high alcohol consumption was found to be associated with an increase in the prevalence of peri-implantitis among the participants who had dental implants.

Assessment of the Efficacy of TMJ Arthroscopy-Assisted Masseter Nerve Avulsion on Hemimasticatory Spasm: An Original Research.

The goal of this study is to find a cure for the masticatory muscle disease known as hemimasticatory spasm (HMS). This retrospective investigation intends to find a more efficient therapeutic approach for HMS patients by examining the clinical effectiveness of masseteric nerve avulsion performed on HMS using a temporomandibular arthroscope. A clinical study was piloted where the subjects were treated for masseter nerve avulsion by TMJ arthroscopy. The follow-up was done till 2 years, and the subjects were evaluated for the various characteristics like difficulties, masticatory abilities, and various sounds at the joint for the various functions of the joint. The diagnosis was done using the electrophysiological electromyogram (EMG) at the designated time intervals. There was a complete remission in all the subjects. The masseter nerve avulsion was effective since the scores lowered. Within 3 years of the operation, electrophysiological EMG depicted no discharge potential with a high frequency, and the total efficiency when paired with the clinical effectiveness was deemed acceptable. The maximal masseter power between the treated and nontreated sides was comparable. The mastication, on comparing, was also as effective as the normal side; however, lower mastication was noted in the first year. The avulsed nerve tissues lacked any apparent demyelination. Masseteric nerve avulsion with temporomandibular arthroscope assistance provided acceptable and stable total effectiveness for the intervention of the hemimasticatory spasm. While the strength of the muscle of the afflicted side was only marginally reduced, its masticatory effectiveness was optimally preserved.

Novel Antidiabetic Medications in Polycystic Ovary Syndrome.

Polycystic ovary syndrome is a very common endocrine disorder prevalent in premenopausal women. Patients with polycystic ovary syndrome present with abnormal menstruation, ovulation disorders, and hyperandrogenemia. They are often accompanied by insulin resistance, metabolic disorders, and other cardiovascular abnormalities. Also, they have comorbidities, such as dyslipidemia, obesity, diabetes type 2, non-alcoholic fatty liver disease, which all influence the treatment plan. Metformin has been defined as a treatment option in patients with polycystic ovary syndrome. However, the clinical responses to metformin are limited. Thus, the need for novel treatments with a broad range of coverage for the complications is warranted. Sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, incretin analogs are novel drugs approved for treating type-2 diabetes. Because of their recorded benefit with weight loss, improved insulin resistance, and cardiovascular benefits in recent studies, they may help polycystic ovary syndrome women address the polycystic ovary syndrome-related risk of metabolic, reproductive, and psychological consequences. Limited literature is available on the safety and efficacy of these novel antidiabetic drugs in patients with polycystic ovary syndrome. Thus, this review is investigating the role and effectiveness of novel antidiabetic medication as an early therapeutic option in polycystic ovary syndrome.

Sodium glucose co-transport 2 inhibitors for gout treatment.

Hyperuricemia remains the most prevalent cause of gout. Gout patients present with joint inflammation and uric acid crystals deposition manifesting as tophi. The association of gout with increased risk of insulin resistance, diabetes, metabolic disorders, increased cardiometabolic risk, and kidney disease is well established. These factors influence the treatment plan, and current treatment options have limited cardiovascular risk reduction. So the need for novel treatments with a broad range of coverage for the complications is warranted. Sodium-glucose co-transporter 2 inhibitors are novel drugs approved for treating type-2 diabetes. They prevent glucose reabsorption and lower serum uric acid levels. Recently few studies have studied their association with reducing the risk of gout. They may help address the gout related complications through their recorded benefit with weight loss, improved insulin resistance, and cardiovascular benefits in recent studies. . SGLT2-Is may be useful to reduce the risk of gout in individuals with type 2 diabetes. Limited literature is available on the safety and efficacy of these novel antidiabetic drugs in patients with gout. This review is aimed to summarize the current knowledge on the role and effectiveness of novel antidiabetic medication as an early therapeutic option in gout patients.

Dietary Changes Leading to Euglycemic Diabetic Ketoacidosis in Sodium-Glucose Cotransporter-2 Inhibitor Users: A Challenge for Primary Care Physicians?

BACKGROUND: The use of euglycemic diabetic ketoacidosis (EDKA) related to sodium-glucose cotransporter 2 inhibitors (SGLT2i) use in people with diabetes has been increasingly reported. The causes are multifactorial, and dietary changes in SGLT2i users were observed to trigger EDKA. A ketogenic diet or very low-carbohydrate diet (VLCD) enhances body ketosis by breaking down fats into energy sources, causing EDKA. This study aimed to understand the patient specific risk factors and clinical characteristics of this cohort. METHODS: Several databases were carefully analyzed to understand the patients' symptoms, clinical profile, laboratory results, and safety of dietary changes in SGLT2i's. Thirteen case reports identifying 14 patients on a ketogenic diet and SGLT2i's diagnosed with EDKA were reviewed. RESULTS: Of the 14 patients, 12 (85%) presented with type-2 diabetes mellitus (DM) and 2 (15%) presented with type-1 DM. The duration of treatment with SGLT2i before the onset of EDKA varies from 1 to 365 days. The duration of consuming a ketogenic diet or VLCD before EDKA onset varies from 1 to 90 days, with over 90% of patients hospitalized <4 weeks after starting the diet. At presentation, average blood glucose was 167.50±41.80 mg/dL, pH 7.10±0.10, HCO3 8.1±3.0 mmol/L, potassium 4.2±1.1 mEq/L, anion-gap 23.6±3.5 mmol/L, and the average hemoglobin A1c was 10%±2.4%. The length of hospital stay ranged from 1 to 15 days. None of the patients were reinitiated on SGLT2i's, and 50% (2/4) of the patients reported were on the ketogenic diet or VLCD upon patient questioning. CONCLUSION: Despite the popularity of the ketogenic diet and VLCD for weight loss, their use in diabetics taking SGLT2i's is associated with EDKA. Physicians should educate patients with diabetes taking SGLT2i's about the risk of EDKA. In addition, patients should be encouraged to include their physicians in any decision related to significant changes in diet or exercise routines. Further research is needed to address if SGLT2i's should be permanently discontinued in patients with diabetes on SGLT2i and whether the ketogenic diet developed EDKA.

Role of Salivary Physicochemical and Peptide Levels in Dental Caries among Children: An Original Research.

Introduction: Dental caries is a common oral disease that still needs to be thoroughly evaluated for understanding the pathophysiology. Hence, in our study, we evaluate the physicochemical and the peptide properties of the saliva and their role in dental caries among children. Materials and Methods: We conducted an observational in vitro study among 100 subjects of age 5-15 years. Decayed, missing, and filled surface (DMFT)/dmft was used to calculate the caries activity. The unstimulated saliva was evaluated for the peptides "LL-37, human neutrophil peptide (HNP) 1-3, and human beta-defensin-3" by ELIZA and for the "pH, buffer, and flow rate" of the saliva. The data thus obtained were analyzed to correlate caries and the salivary physiochemical and peptides using the "linear regression analysis." P < 0.05 was deliberated as significant. Results: Although no statistically significant variation was seen between low and high caries risk groups and the salivary parameters in our study, we observed a negative correlation of the salivary peptides and caries. For the salivary peptide "HNP1-3," there was a statistically significant variation. Conclusion: The salivary peptides may be carioprotective. However, further research has to be done to establish the mechanism of the action of these substances against caries.

Factors Affecting Quality of Life in Zygomatic Fractures: An Original Research.

Introduction: Zygoma is one of the facial bones that are impacted in the accidents. Hence, we aim to evaluate the patient's profiles in the fracture associated with zygomatic bone. Materials and Methods: We conducted a prospective clinical study with 60 subjects who were divided equally into cases (30) and controls (30); controls were general population and the cases underwent surgery of zygomatic complex fracture. Health-related quality of life (HRQoL) was assessed by the means of the questionnaire. The values were compared for the significance keeping P < 0.05 as significant. Results: The preoperative 15D score was lesser for cases than controls. Soon after surgery, it was statistically least and after a month, the mean score surpassed the controls. Infraorbital sensory loss was seen even after 6 months. Conclusions: As expected, the HRQoL decreases only to improve after the surgery. However, the infra-orbital nerve sensory loss may continue for over 6 months after the zygomatic complex fracture.

Bile Cast Nephropathy: A Comprehensive Review.

Bile cast nephropathy (BCN) or cholemic nephropathy (CN) is an acute renal dysfunction, including acute kidney injury (AKI) in the setting of liver injury. It is a common phenomenon in patients with liver disease and is associated with significant morbidity and mortality. CN is characterized by hemodynamic changes in the liver, kidney, systemic circulation, intratubular cast formation, and tubular epithelial cell injury. CN has been overlooked as a differential diagnosis in chronic liver disease patients due to more importance to hepatic injury. However, frequent and considerable reporting of case reports recently has further investigated this topic in the last two decades. This review determines the evidence behind the potential role of bile acids and bilirubin in acute renal dysfunction in liver injury, summarizing the implied pathophysiology risk factors, and incorporating the therapeutic mechanisms and outcomes.

Diagnosing Frailty in Primary Care Practice.

Frailty is a complex age-related clinical condition with increased vulnerability to negative health outcomes that manifest as a multidimensional syndrome and hence, a challenge to identify at-risk populations. We aim to summarize the implementation of strategies to diagnose fragility in family practice using current evidence. We searched the PubMed and Google Scholar databases for relevant articles, using the Medical Subject Headings (MeSH) terms "Frailty," "Frailty Scales," and "Primary Health Care." All original research articles on the elderly population (65 years of age or older) published in English and the last five years were included. Frailty diagnosis has resulted in positive outcomes in the overall literature. Recent hospital admission may indicate a health problem that can end up in a negative outcome and has been often described as associated with frailty. It was also shown to affect the intensive care units' mortality, in-hospital mortality, and long-term mortality. However, multiple screening instruments have been developed and validated to improve feasibility in clinical practice. The frequent lack of agreement between frailty instruments has slowed the broad implementation of these tools. The impacts of frailty warrant an upstream, proactive, holistic, interprofessional primary care approach to its identification, assessment, and management. It is a preventable disorder; identifying elderly patients at risk in primary care can help shape appropriate care processes tailored to their needs. This literature review aims to demonstrate the importance and strategies in identifying frailty in primary care settings and assess its impact on several outcomes.

Reliability of odontometric parameters in stature analysis.

BACKGROUND: To emphasize the role of odontometric parameters which may be used as a reliable forensic tool especially in cases with partial remains of the individual. AIM: To assess the reliability of odontometric parameters in stature analysis. MATERIALS AND METHODS: The study was conducted on 100 patients (50 male and 50 Female). Mesiodistal width of anterior teeth, inter-canine width, Inter-premolar width and maxillary arch length were the parameters included. The results were tabulated with a linear regression formula obtained for each parameter. STATISTICAL ANALYSIS: The data collected was statistically analysed using SPSS version 20 and a linear regression formula was obtained thereafter. RESULTS: Mesio-distal widths of individual maxillary canines, total mesiodistal width of maxillary anteriors and arch length showed a significant co-relation with stature. The combined linear regression formula was obtained for all parameters. CONCLUSION: Odontometric parameters of mesio - distal widths of individual maxillary canines, total mesiodistal width of maxillary anteriors and arch length can be used as reliable parameters for stature analysis.

A Comparative Evaluation of Transbuccal versus Transoral Approach for the Management of Mandibular Angle Fractures: A Prospective, Clinical, and Radiographic Study.

INTRODUCTION: In the facial bones, the angle of the mandible is the common site of fractures. Furthermore, it is the site with the highest number of complications after fracture and hence needs an efficient fixation. The right approach is still debatable for the angle fractures. In the light of these factors, we evaluated the transoral and the transbuccal approaches for the treatment of fractures at the angle of the mandible. MATERIALS AND METHODS: Twenty patients were equally divided into two groups of transoral and transbuccal methods. The parameters such as ease of access, surgical time, occlusion, postsurgical infection, fracture gaps, scarring, and complications were noted, and the values that were compared were statistically analyzed. P < 0.05 was considered statistically significant. RESULTS: No significant variations were seen in the variables such as ease of access, occlusion, postsurgical infection, and fracture gaps. Surgical time was significantly less for the transoral method. Negligible scarring was noted in the transbuccal method. CONCLUSION: Although both the methods were comparable, the transbuccal approach was more efficient for the mandibular angular fracture treatment.

Cardiovascular Complications and its Impact on outcomes in COVID-19: An Original Research.

INTRODUCTION: The viral infection COVID-19 is highly infectious and has claimed many lives till date and is still continuing to consume lives. In the COVID-19, along with pulmonary symptoms, cardiovascular (CV) events were also recorded that have known to significantly contribute to the mortality. In our study, we designed and validated a new risk score that can predict CV events, and also evaluated the effect of these complications on the prognosis in COVID-19 patients. MATERIALS AND METHODS: A retrospective, multicenter, observational study was done among 1000 laboratory-confirmed COVID-19 patients between June 2020 and December 2020. All the data of the clinical and laboratory parameters were collected. Patients were randomly divided into two groups for testing and validating the hypothesis. The identification of the independent risk factors was done by the logistic regression analysis method. RESULTS: Of all the types of the clinical and laboratory parameters, ten "independent risk factors" were identified associated with CV events in Group A: male gender, older age, chronic heart disease, cough, lymphocyte count <1.1 × 109/L at admission, blood urea nitrogen >7 mmol/L at admission, estimated glomerular filtration rate <90 ml/min/1.73 m2 at admission, activated partial thromboplastin time >37 S, D-dimer, and procalcitonin >0.5 mg/L. In our study, we found that CV events were significantly related with inferior prognosis (P < 0.001). CONCLUSIONS: A new risk scoring system was designed in our study, which may be used as a predictive tool for CV complications among the patients with COVID-19 infection.

A Rare Case of Massive Ovarian Mucinous Cystadenoma With Postmenopausal Bleeding.

Mucinous cystadenomas are among the most common benign ovarian neoplasms. They are known for their massive size causing compressive effects ranging from pressure, pain, bloating, and urinary symptoms. Over time, these adnexal masses can lead to fatal complications, such as ovarian torsion or hemorrhage. Incidental findings of these tumors are common as many of these patients are asymptomatic. Pelvic examinations and imaging studies can be used to further diagnose symptomatic patients and aid physicians in developing an appropriate course of treatment. We report a rare case of a large mucinous cystadenoma, with a size of 25 × 25 cm and concurrent management of postmenopausal bleeding. We present the data from the admission of the patient to her discharge, including history and physical examination, diagnostic reports, transabdominal ultrasound, CT scan, surgical evaluation, and surgical-pathology reports. Abdominal pain can present in a variety of different scenarios, and ovarian masses only represent a small portion of the differentials. Mucinous cystadenomas constitute an even smaller percentage of these ovarian growths. As discussed in this case report, a large ovarian mucinous cystadenoma was compressing the surrounding structures resulting in a wide array of symptoms. The case describes the importance of extensive diagnostic evaluation and prompt surgical management of these ovarian tumors. It also brings attention to the significance of diagnosing a medical condition such as postmenopausal bleeding promptly to avoid potential negative outcomes.

Minimal guided bone regeneration procedure for immediate implant placement in the esthetic zone.

The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.

Spontaneous Reversibility of an Iatrogenic Orthodontic Elastic Band-induced Localized Periodontitis Following Surgical Intervention – Case Report

Orthodontic elastic bands are an important iatrogenic etiologic factor in the causation of periodontal attachment apparatus breakdown. Appropriate diagnosis and a well constructed treatment plan tailor-made to suit the requirements of the particular patient is imperative for management of periodontal lesions induced by subgingival retention of rubber band. There are conflicting reports regarding the reattachment and regeneration of lost periodontal supporting tissues in such cases. The present case report highlights the spontaneous reversal and correction of periodontal destruction due to iatrogenic orthodontic elastic band displacement deep into the subgingival tissues.