Color Stability of Pediatric Restorative Material Over Pediatric Drug Formulation.

AIM:  To investigate the color stability of light-cured (LC) restorative material in different pediatric drug formulations. METHOD:  Two distinct restorative materials, specifically LC resin and LC glass ionomer cement (GIC), were employed to create 88 disc-shaped specimens. These comprised 44 specimens fabricated from each material. Each specimen had a diameter of 5 mm and a height of 3 mm. To conduct the experiment, specimens were randomly allocated into four experimental groups, each containing 11 specimens made of each material. This division was accomplished through the use of a stratified random sampling method. The five experimental groups and their respective liquid medications were as follows: Group 1 - montelukast sodium and levocetirizine dihydrochloride syrup, Group 2 - cefixime, Group 3 - sodium valproate, and Group 4 - metronidazole. To ensure thorough exposure to the medications, all samples underwent a two-minute agitation cycle, which was repeated every 12 h over the course of one week. Following the immersion period, the color stability of all specimens was assessed using a spectrophotometer. The data obtained from the color stability measurements were subjected to statistical analysis using one-way analysis of variance (ANOVA), followed by a post hoc test. The aim was to determine whether significant differences in color stability were observed among the groups studied. RESULTS:  The mean values and standard deviations of ΔE were calculated. The highest values of ΔE were observed in Group 3 (4.70 ± 1.89), followed by Group 4 (4.04 ± 2.10). Conversely, the lowest ΔE values were observed in Group 2 (3.23 ± 2.02) and Group 1 (3.24 ± 2.31). The calculated p-value was 0.298, and the F-value was 1.269. CONCLUSION:  This study concludes that both restorative materials, LC composite and LC GIC, are susceptible to discoloration. Sodium valproate exhibited the greatest staining effect on both materials. Conversely, cefixime had the least impact on the color of the LC composite, whereas montelukast had the least effect on the color of LC GIC.

Porokeratotic Variant of Lichen Planus.

A 44-year-old woman presented with mildly itchy, brownish-black plaques for the last 2 years. The lesions first appeared on the upper back, followed by involvement of the face and upper arms within 4-5 months. Individual lesions began as small papules that gradually evolved into small, annular, and barely palpable plaques. There were no systemic complaints, photosensitivity, or history of intake of prolonged medication. Cutaneous examination revealed multiple, well-demarcated, and hyperpigmented oval to round plaques on the photo-exposed area, including the face, bilaterally on arms, and upper trunk, measuring about 1 × 1-3 × 3 cm2 in size (Figures 1A and 1B). Dermatoscopic examination established rolled-out, thread, double-marginated border with central atrophy with a brownish reticular background. Multiple brownish to black globules and dark lacunae were also observed (Figures 1C and 1D). No Wickham's striae were viewed. Combination of clinical presentation with dermatoscopic findings indicated a provisional clinical diagnosis of disseminated superficial porokeratosis. Biopsy performed on the upper back revealed hyperkeratotic epidermis with mild lymphocytic exocytosis and spongiosis with pigmentary incontinence. The coronoid lamina was not revealed in any of the pathologic sections examined, including further deeper sections and in a repeat biopsy. Clinical morphology, dermatoscopic features, and pathology were considered compatible with the diagnosis of porokeratotic variant of lichen planus (LP). The patient was counseled and started on topical steroids (fluticasone). She is on regular follow-up.

A comparative evaluation of therapeutic response in warts to intralesional vitamin D3 versus intralesional measles, mumps, and rubella vaccine.

The infection of keratinocytes by human papilloma virus (HPV) causes warts. These are of different types based on morphological and anatomical grounds. This has led to the development of strategies involved in the treatment of warts by induction of delayed hypersensitivity reactions. The current study aims to compare the therapeutic response and side effect profile of intralesional vitamin D3 and measles, mumps, and rubella (MMR). The aim of this study is to study the therapeutic response of two intralesional immunotherapies in warts and compare their efficacies and side effects. A single-blind randomized control trial was conducted over 12 months on 100 patients using the purposive sampling technique. Randomly, half of the participants received one of the two immunotherapies. The clinical response was evaluated on the basis of decrease in wart size, wart number, wart distribution, and photographic comparison. The mean size of the largest wart in the vitamin D3 group was found to be 0.70 cm, and in the MMR group, it was 0.79 cm in breadth. The mean onset of first response was 3.55 weeks in the vitamin D3 group and 3.85 weeks in the MMR group. Complete response was seen in 54% and 62% of study participants in the vitamin D3 and MMR groups respectively. The study recommends that both intralesional vitamin D3 and MMR are efficacious in treating cutaneous warts, with MMR agents being moderately better compared to vitamin D3 in terms of warts clearance and side effects profile.

Preoperative Serum Albumin Level as a Predictor of Abdominal Wound-Related Complications After Emergency Exploratory Laparotomy.

Background Serum albumin is generally considered to be a predictor of patients' nutritional status. Previous studies have used serum albumin to assess postoperative morbidity, mortality, and various other surgical outcomes in cardiac surgeries and elective gastrointestinal surgeries. In this study, we used preoperative serum albumin levels to assess postoperative surgical site wound complications in patients who underwent emergency exploratory laparotomy. Methodology Preoperative serum albumin level was observed in 60 patients who underwent emergency exploratory laparotomy due to various pathological conditions and were divided into those with hypoalbuminemia (serum albumin level <3.5 g/dl and >3.5 g/dL). Postoperative surgical site infections, wound dehiscence, and various complications, such as duration of hospital stay, prolonged ileus, the incidence of enterocutaneous fistula, the incidence of anastomotic leak, and 30-day mortality, were assessed. Results In our study, about 65% of the patients had hypoalbuminemia. Among them, 56.4% of the patients had surgical site infections according to the Southampton grade, with a statistically significant p-value of <0.001. Moreover, 87.2% of the patients had wound dehiscence according to the World Union Wound Healing Societies Surgical Wound Dehiscence wound grading, with a statistically significant p-value of <0.001. In addition, statistical significance was noted between preoperative hypoalbuminemia and increased postoperative hospital stay, with a p-value of <0.001. Conclusions Preoperative serum albumin value is a formidable predictor of postoperative surgical site infections, wound dehiscence, and duration of hospital stay in patients who underwent emergency exploratory laparotomy.

Fisetin targets YB-1/RSK axis independent of its effect on ERK signaling: insights from in vitro and in vivo melanoma models.

The anti-proliferative activity of dietary flavonoid fisetin has been validated in various cancer models. Establishing its precise mechanism of action has proved somewhat challenging given the multiplicity of its targets. We demonstrated that YB-1 promotes epithelial-to-mesenchymal transition and its inhibition suppressed tumor cell proliferation and invasion. The p90 ribosomal S6 kinase (RSK), an important ERK effector, activates YB-1 to drive melanoma growth. We found that fisetin treatment of monolayer/3-D melanoma cultures resulted in YB-1 dephosphorylation and reduced transcript levels. In parallel, fisetin suppressed mesenchymal markers and matrix-metalloproteinases in melanoma cells. Data from cell-free/cell-based systems indicated that fisetin inhibited RSK activity through binding to the kinase. Affinity studies for RSK isoforms evaluated stronger interaction for RSK2 than RSK1. Competition assays performed to monitor binding responses revealed that YB-1 and RSK2 do not compete, rather binding of fisetin to RSK2 promotes its binding to YB-1. Fisetin suppressed YB-1/RSK signaling independent of its effect on ERK, and reduced MDR1 levels. Comparable efficacy of fisetin and vemurafenib for inhibiting melanoma growth was noted albeit through divergent modulation of ERK. Our studies provide insight into additional modes of regulation through which fisetin interferes with melanoma growth underscoring its potential therapeutic efficacy in disease progression.

Nanofinishing of BK7 glass using a magnetorheological solid rotating core tool.

Surface finishing is a promising method to improve the optical characteristics of crown glass. BK7 finds its applications in transmissive optics, i.e., lenses of binoculars, lenses of microscopes, lenses of telescopes, and light-emitting diodes. The magnetorheological (MR) nanofinishing of optical glasses using a solid rotating core tool is found more advantageous than the other advanced finishing processes in aspects such as precision and accuracy. In the present research, the MR nanofinishing with a solid rotating core tool is carried out on the BK7 glass of size 10×10×3 mm. Response surface methodology is conducted in order to find the optimum process parameters. The effects of process parameters on the percentage change in surface roughness are analyzed. The best surface roughness Ra and Rq values are achieved at 22 nm and 32 nm from the initial of 41 nm and 57 nm in 30 min of the finishing time cycle. To study the surface morphology of nanofinished BK7 glass, scanning electron microscopy is performed with sputter coating of gold on a glass specimen.

Bioconjugated graphene oxide-based Raman probe for selective identification of SKBR3 breast cancer cells.

In this article, we demonstrate the use of bio-conjugated 2D graphene oxide (bio-GO) nanostructure to probe breast cancer cell (SKBR3) with excellent discrimination over other types of circulating tumor cells. We distinctly observed that bio-GO nanostructure targets and bind SKBR3 cell selectively in the cell mixture. Longer incubation of SKBR3 cell with bio-GO causes Raman signal "turn off" when excited with 532 nm laser. This is attributed to penetration of the bio-GO through the plasma membrane of the cell by generating transient hole. Extraction of GO after cell digestion also support the internalization rubric of 2D graphene through cell membrane. Our experimental data with the HaCaT healthy cell line, as well as with LNCaP prostate cancer cell line clearly demonstrated that this Raman scattering assay is highly selective to SKBR3. The mechanism of selectivity and the assay's response change have been verified and discussed utilizing fluorescence properties of GO and various other techniques. The experimental results open up a possibility of new label free Raman scattering assay, for reliable diagnosis of cancer cell lines by monitoring "turn-off" of the Raman signal from Bio-GO nanostructure.

Does magnetic resonance imaging appearance of supraspinatus muscle atrophy change after repairing rotator cuff tears?

BACKGROUND: This study was conducted to determine whether supraspinatus muscle atrophy appearance changes after arthroscopic rotator cuff repair and to quantify the change in appearance on magnetic resonance imaging (MRI), if any, based on age and tendon retraction. METHODS: We retrospectively reviewed patients who underwent arthroscopic rotator cuff repair and considered only 209 patients who had both preoperative and immediate postoperative MRI. Patients were grouped by age <60 years and >60 years. They were further subdivided into stage 1 (mild), stage 2 (moderate), and stage 3 (severe), depending on preoperative supraspinatus tendon retraction on the coronal view of MRI according to Patte classification. The postoperative occupancy ratio was compared with the preoperative occupancy ratio within the subgroups, and change in the occupancy ratio was used for comparison between the subgroups. RESULTS: There was a significant increase in the occupancy ratio in the mild (P =.001) and moderate-severe (P =.003) subgroup from their preoperative values. In the mild subgroup, the occupancy ratio was significantly greater in the group aged <60 years compared with the group aged >60 years (P =.010). But in the moderate subgroup there was no significant difference between the 2 age groups (P =.710). CONCLUSIONS: A significant change in supraspinatus muscle atrophy occurs in every patient, provided the patient has some tendon retraction preoperatively. The amount of change in supraspinatus muscle atrophy after surgery depends on the age to some extent, but tendon retraction is the most important thing that decides how much change in atrophy can occur postoperatively.

Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series.

BACKGROUND: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. MATERIALS AND METHODS: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. RESULTS: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. CONCLUSION: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair.

Alizarin Dye based ultrasensitive plasmonic SERS probe for trace level Cadmium detection in drinking water.

Alizarin functionalized on plasmonic gold nanoparticle displays strong surface enhanced Raman scattering from the various Raman modes of Alizarin, which can be exploited in multiple ways for heavy metal sensing purposes. The present article reports a surface enhanced Raman spectroscopy (SERS) probe for trace level Cadmium in water samples. Alizarin, a highly Raman active dye was functionalized on plasmonic gold surface as a Raman reporter, and then 3-mercaptopropionic acid, 2,6-Pyridinedicarboxylic acid at pH 8.5 was immobilized on the surface of the nanoparticle for the selective coordination of the Cd (II). Upon addition of Cadmium, gold nanoparticle provide an excellent hotspot for Alizarin dye and Raman signal enhancement. This plasmonic SERS assay provided an excellent sensitivity for Cadmium detection from the drinking water samples. We achieved as low as 10 ppt sensitivity from various drinking water sources against other Alkali and heavy metal ions. The developed SERS probe is quite simple and rapid with excellent repeatability and has great potential for prototype scale up for field application.

Hydroxyapatite crystals as a bone graft substitute in benign lytic lesions of bone.

BACKGROUND: Bone grafts are required to fill a cavity created after curettage of benign lytic lesions of the bone. To avoid the problems associated at donor site with autologous bone graft, we require allograft or bone graft substitutes. We evaluated the healing of lytic lesions after hydroxyapatite (HA) grafting by serial radiographs. MATERIALS AND METHODS: Forty cases of benign lytic lesions of bone were managed by simple curettage and grafting using HA blocks. Commercially available HA of bovine origin (Surgiwear Ltd., Shahjahanpur, India) was used for this purpose. Mean duration of followup was 34.8 months (range 12-84 months). Mean patient age was 19.05 years (range 3-55 years). Radiological staging of graft incorporation was done as per criteria of Irwin et al. 2001. RESULTS: In our series, two cases were in stage I. A total of 11 cases were in stage II and 27 were in stage III. Graft incorporation was radiologically complete by 15 months. Clinical recovery was observed before radiological healing. The average time taken to return to preoperative function was 3 months. Recurrence was observed in giant cell tumor (n = 3) and chondromyxoid fibroma (n = 1). There was no incidence of graft rejection, collapse, growth plate disturbances or antigenic response. CONCLUSIONS: We conclude that calcium HA is biologically acceptable bone graft substitute in the management of benign lytic lesions of bone.

In vitro comparison of resistance to implant failure in unstable trochanteric fractures fixed with intramedullary single screw versus double screw device.

BACKGROUND: The purpose of this study was to compare the resistance of intramedullary single screw device (Gamma nail) and double screw device proximal femoral nail (PFN) in unstable trochanteric fractures in terms of the number of cycles sustained, subsidence and implant failure in an axial loading test in cadaveric femora. MATERIALS AND METHODS: The study was conducted on 18 dry cadaveric femoral specimens, 9 of these were implanted with a Gamma nail and 9 with PFN. There was no significant difference found in average dual energy X-ray absorptiometry value between both groups. The construct was made unstable (AO type 31A3.3) by removing a standard sized posteromedial wedge. These were tested on a cyclic physiological loading machine at 1 cycle/s with a load of 200 kg. The test was observed for 50,000 loading cycles or until implant failure, whichever occurred earlier. Peak displacements were measured and analysis was done to determine construct stiffness and gap micromotion in axial loading. RESULT: It was observed that there was statistically significant difference in terms of displacement at the fracture gap and overall construct stiffness of specimens of both groups. PFN construct group showed a mean subsidence of 1.02 mm and Gamma nail construct group showed mean subsidence of 2.36 mm after cycling. The average stiffness of Gamma nail group was 62.8 ± 8.4 N/mm which was significantly lower than average stiffness of the PFN group (80.4 ± 5.9 N/mm) (P = 0.03). In fatigue testing, 1 out of 9 PFN bone construct failed, while 5 of 9 Gamma nail bone construct failed. CONCLUSION: When considering micromotion (subsidence) and incidence of implant/screw failure, double screw device (PFN) had statistically significant lower micromotion across the fracture gap with axial compression and lower incidence of implant failure. Hence, double screw device (PFN) construct had higher stability compared to single screw device (GN) in an unstable trochanteric fracture femur model.

Enhancing targeted tumor treatment by near IR light-activatable photodynamic-photothermal synergistic therapy.

For several decades, cancer has been one of the most life-threatening diseases. For enhancing anticancer efficiency with minimum side effects, combination therapy is envisioned. The current manuscript reports for the first time the development of a methylene blue (MB) bound nanoplatform, which is capable of delivering targeted diagnostic and combined synergistic photothermal and photodynamic treatment of cancer. Experimental data found that, once the nanoparticle binds with the target cell surface, it can detect LNCaP human prostate cancer cell selectively using fluorescence imaging. Our result shows that the therapeutic actions can be controlled with external NIR light. No cytotoxicity was observed in the absence of NIR light. Targeted photodynamic and photothermal treatment using 785 nm NIR light indicates that the multimodal treatment enhances the possibility of destroying LNCaP prostate cancer cells in vitro dramatically. We discuss the operating principle for the targeted imaging and possible mechanisms for combined therapeutic actions. Our experimental data show that NIR light activated combined therapy for cancer may become a highly effective treatment procedure in clinical settings.

Multifunctional hybrid graphene oxide for label-free detection of malignant melanoma from infected blood.

This communication reports for the first time the development of multifunctional graphene oxide for the ultra-sensitive and label-free detection of malignant melanoma from an infected blood sample.

A surface enhanced Raman scattering probe for highly selective and ultra sensitive detection of iodide in water and salt samples.

Iodine is a biophilic and essential trace element for all life and especially for vertebrates, which require it to produce indispensable thyroid hormones in their thyroid glands. As a result, the adequate measurement of iodine in water and food samples is crucial to lead a healthy life. Motivated by its importance, this is the first time in the literature that the highly selective and ultra sensitive (30 ppt limit) surface enhanced Raman scattering (SERS)-based detection of iodide ions (I(-)) from environmental and food samples has been reported. The desired sensitivity and selectivity has been achieved by measuring the change in the SERS intensity originating from Rh6G-adsorbed 30 nm gold nanoparticles (GNPs) upon the addition of I(-). The strong chemical affinity offered by I(-) towards the gold surface results in extra negative charge being deposited on it. As a result, the GNP surface attracts a greater number of positively charged Rh6G molecules and induces a marked increase in the number of hot spots through aggregation, providing a significant enhancement of the Raman signal intensity. The oxidation of I(-) to molecular iodine (I(2)) by hydrogen peroxide (H(2)O(2)) is employed for the successful screening of the bromide ion (Br(-)) which shows substantial interference at higher concentrations.

Popcorn-shaped magnetic core-plasmonic shell multifunctional nanoparticles for the targeted magnetic separation and enrichment, label-free SERS imaging, and photothermal destruction of multidrug-resistant bacteria.

Over the last few years, one of the most important and complex problems facing our society is treating infectious diseases caused by multidrug-resistant bacteria (MDRB), by using current market-existing antibiotics. Driven by this need, we report for the first time the development of the multifunctional popcorn-shaped iron magnetic core-gold plasmonic shell nanotechnology-driven approach for targeted magnetic separation and enrichment, label-free surface-enhanced Raman spectroscopy (SERS) detection, and the selective photothermal destruction of MDR Salmonella DT104. Due to the presence of the "lightning-rod effect", the core-shell popcorn-shaped gold-nanoparticle tips provided a huge field of SERS enhancement. The experimental data show that the M3038 antibody-conjugated nanoparticles can be used for targeted separation and SERS imaging of MDR Salmonella DT104. A targeted photothermal-lysis experiment, by using 670 nm light at 1.5 W cm(-2) for 10 min, results in selective and irreparable cellular-damage to MDR Salmonella. We discuss the possible mechanism and operating principle for the targeted separation, label-free SERS imaging, and photothermal destruction of MDRB by using the popcorn-shaped magnetic/plasmonic nanotechnology.

Theranostic magnetic core-plasmonic shell star shape nanoparticle for the isolation of targeted rare tumor cells from whole blood, fluorescence imaging, and photothermal destruction of cancer.

Cancer is one of the most life-threatening diseases, which causes 7.6 million deaths and around 1 trillion dollars economic loss every year. Theranostic materials are expected to improve early detection and safe treatment through personalized medicine. Driven by the needs, we report the development of a theranostic plasmonic shell-magnetic core star shape nanomaterial based approach for the targeted isolation of rare tumor cells from the whole blood sample, followed by diagnosis and photothermal destruction. Experimental data with whole blood sample spiked with SK-BR-3 cancer cell shows that Cy3 attached S6 aptamer conjugated theranostic plasmonic/magnetic nanoparticles can be used for fluorescence imaging and magnetic separation even in 0.001% mixtures. A targeted photothermal experiment using 1064 nm near-IR light at 2-3 W/cm(2) for 10 min resulted in selective irreparable cellular damage to most of the SK-BR-3 cancer cells. We discuss the possible mechanism and operating principle for the targeted imaging, separation, and photothermal destruction using theranostic magnetic/plasmonic nanotechnology. After the optimization of different parameters, this theranostic nanotechnology-driven assay could have enormous potential for applications as contrast agent and therapeutic actuators for cancer.

Sensitive and selective detection of trivalent chromium using Hyper Rayleigh Scattering with 5,5'-dithio-bis-(2-nitrobenzoic acid)-modified gold nanoparticles.

Hyper Rayleigh Scattering (HRS) and absorption spectral assays using surface-modified gold nanoparticles (AuNP) have been developed for sensitive and selective detection of trivalent chromium (Cr3+) from other metal ions including hexavalent chromium (as Cr2O72-). Gold nanoparticles of 13 nm, covalently attached with 5,5'-dithio-bis-(2-nitrobenzoic acid) (AuNP-DTNBA), is used as a probe for both the absorption and HRS assays. AuNP-DTNBA is able to detect Cr3+ at 20 ppb level at pH 6.0 using absorption spectral change of the AuNP-DTNBA. Visible color change can be observed when mixed with 250 ppb of Cr3+, while there is no color change when mixed with 2 ppm level of some of the most common metal ions such as Cr2O72-, Hg2+, Ba2+, Fe3+, Pb2+, Na+, Zn2+, Cd2+, Co2+, Mn2+, Ca2+, and Ni2+. However, a color change is observed when mixed with Ni2+, Zn2+, and Cd2+ at a concentration higher than 2 ppm. The detection limit for the HRS assay is on a remarkable 25 ppt level, and there is no detectable HRS signal at 2 ppm level for Cr2O72-, Hg2+, Ba2+, Fe3+, Pb2+, Na+, Zn2+, Cd2+, Co2+, Mn2+, Ca2+, and Ni2+.

Mandibular first premolar with three roots: a case report.

Anatomy of the root canal system always effects endodontic treatment outcome. Mandibular premolar teeth show extreme variations in root canal morphology. First premolars usually exhibit basic one root and one canal anatomy. The occurrence of three roots in mandibular first premolar has not been commonly reported in literature. This article reports a case of successful nonsurgical endodontic management of mandibular first premolar with three canals and three different apical foramina.