Τετάρτη, 6 Μαρτίου 2019

Crow Moon,τα κοράκια και άλλα πουλιά εμφανίζονται καθώς ο χειμώνας τραβάει το τέλος.March’s full moon is commonly called the Full Worm Moon. This is because of the earthworms that wriggle out of the ground as the earth begins to thaw in March.


One of its other names is the Chaste Moon, symbolizing the purity of early spring. The Pueblo tribe named it the Moon When the Leaves Break Forth, while in Shoshone culture it was known as the Warming Moon. Sometimes it is called the Crow Moon, after the crows and other birds that appear as winter draws to a close. Other times, it's called the Crust Moon, because of the snow that becomes crusty when it thaws in the sun and freezes in the moonlight. 
In India, March's full moon is also seen as a symbol of the arrival of spring, and coincides with the festival of Holi. This is a riotous party where Indian communities all around the world engage in a huge water fight. Everyone goes out into the streets and sprays each other with colored water and powders, singing and dancing with strangers and loved ones alike. Playing and feasting together is a chance for you to repair relationships that have gone bad, reaffirming your existing social bonds as you move forward together into the new year.

Clinical Practice

Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture
Q Liu, J Cao, JJ Kong

Nigerian Journal of Clinical Practice 2019 22(3):289-292

Objective: This study aims to discuss the clinical effect of balloon kyphoplasty on elderly patients with multiple osteoporotic vertebral fractures. Methods: The observation group was treated with balloon kyphoplasty, and the control group was managed with conservative treatment. Image indices, pain degree, daily life disturbance, and occurrences of complications were compared between the two groups. Results: In total, 116 elderly patients with multiple osteoporotic vertebral fracture admitted in our hospital from January 2016 to June 2017 were chosen and divided randomly into observation (n = 58) and control groups (n = 58). The observation group showed a significantly higher trailing edge, leading edge, and midcourt line and larger upper thoracic kyphosis compared with the control group (P < 0.05). Before the treatment, no statistically significant differences were observed between the two groups in terms of visual analog scale (VAS) score and daily life disturbance score (P > 0.05). However, the VAS score and the daily life disturbance score of the two groups decreased sharply after the treatment (P < 0.05). Moreover, the VAS score and the daily life disturbance score of the observation group were significantly lower than those of the control group (P < 0.05). The observation group showed lower occurrence rate of complications compared with the control group (P < 0.05). Conclusions: Balloon kyphoplasty can significantly improve the image indices of patients with multiple osteoporotic vertebral fractures and relieve their pain degree and daily life disturbance. Balloon kyphoplasty exhibited a low occurrence rate of complications and high safety and is, thus, worthy of clinical applications. 


A cross-sectional study of cytomegalovirus retinitis in HIV-1 infected adults in Nigeria
MA Adeiza, AG Habib

Nigerian Journal of Clinical Practice 2019 22(3):293-297

Background: Cytomegalovirus (CMV) retinitis is one of the most important opportunistic infections in HIV-infected patients in developing countries before the introduction of highly active antiretroviral therapy. In Nigerian and African HIV populations, CMV retinitis is under-reported. Patients and Methods: In a cross-sectional study, 250 HIV-infected adults ≥18 years were recruited by systematic random sampling from March to August 2013. Using a structured questionnaire, information was obtained on socio-demographic characteristics and symptoms of visual impairment. HIV disease was staged according to the WHO clinical staging, and CD4+ T-lymphocyte count was measured. Participants with symptoms of impaired vision and/or CD4+ T-lymphocyte count <50 cells/μL had indirect ophthalmoscopic examination of the retina to detect CMV related eye lesions. Results: Two hundred and fifty adults were HIV-infected, out of which 114 (46%) were males and 136 (54%) were females. The mean age of study participants was 35 years. History of impaired vision was reported by 21 (8.4%) of participants. The right eye was involved in 7 (33%), the left eye in 4 (19%), and both eyes in 10 (48%) of participants. The predominant symptoms were blurred vision 9 (43%), floaters 9 (43%), and blindness 3 (14%). Among participants who had indirect ophthalmoscopy, 3 (1.2%) had characteristic retinal changes suggestive of CMV retinitis. Two (67%) of patients with CMV retinitis were females and 1 (33%) was male. Mean CD4+ count was 25.33 ± 14.19 and all were WHO HIV clinical stage 4 with death occurring within 6 months of diagnosis. Conclusion: CMV retinitis though rare is associated with advanced HIV disease and attendant morbidity and mortality. We recommend integration of CMV diagnostic services and ophthalmological services as routine in HIV care and treatment programs in Nigeria targeted toward high-risk patients. 


Factors associated with intraventricular hemorrhage among preterm neonates in Aminu Kano teaching hospital
CC Egwu, WN Ogala, ZL Farouk, AM Tabari, AH Dambatta

Nigerian Journal of Clinical Practice 2019 22(3):298-304

Background: Intraventricular hemorrhage (IVH) is a severe complication among preterm neonates which can result in hydrocephalus, cerebral palsy, behavioural disorders, learning disabilities, or death. It is important to identify the factors associated with IVH in order to prevent these neurological consequences and reduce the resultant burden of neurological disease. Aim: To determine the factors associated with IVH among preterm neonates. Design: The study was prospective cross-sectional in design. Subjects and Methods: Ninety-nine preterm neonates who were < 37 completed weeks of gestation were recruited consecutively from the Special Care Baby Unit of a Tertiary Hospital. Transfontanelle ultrasonography was used to detect IVH and the factors associated with IVH were classified into: neonatal, maternal (prenatal), and clinical factors. Data were analyzed using SPSS version 16.0 for windows. Chi-squared test and Fisher's exact probability test were used as appropriate. The level of significance was set at P < 0.05. The association between these factors and IVH was evaluated by univariate and multivariate logistic regression analyses. Results: Among the 99 preterm neonates studied, 36 (36.4%) of them were between 28 and 31 weeks of gestation, whereas 63 (63.6%) were between 32 and 36 weeks of gestation. In univariate analysis, the factors found to be associated with IVH were lower gestational age <32 weeks gestation, low Apgar score of <3 in 1 and 5 min, respectively, outborn status of neonates, lower social class, need for respiratory support, and blood transfusion. However, the lower gestational age (odds ratio [OR]: 10.9, 95% confidence interval [CI]:1.95–61.04) and respiratory support (continuous positive airway pressure (CPAP)) [OR: 52.24; CI: 3.40–721.84] were retained as significant predictors of IVH in the multivariate logistic regression model. Conclusion: The lower gestational age and respiratory support (CPAP) are independent predictors for IVH. Prevention of preterm delivery and improvement in interventions of neonatal care (CPAP) are necessary to prevent the risk for IVH especially in the early preterm neonates. 


Primary molar pulpotomies with different hemorrhage control agents and base materials: A randomized clinical trial
G Atasever, TI Keceli, S Uysal, HC Gungor, S Olmez

Nigerian Journal of Clinical Practice 2019 22(3):305-312

Objective: To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide–eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials. Methods: In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months. Results: One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1–4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1–4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05). Conclusion: Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy. 


In Vitro evaluation of the wear of primary tooth enamel against different ceramic and composite resin materials
A Bolaca, Y Erdogan

Nigerian Journal of Clinical Practice 2019 22(3):313-319

Background: Although there are several studies on permanent tooth wear caused by dental materials, studies concerning primary teeth are limited. Aim: To evaluate the wear of primary tooth enamel against different ceramic and composite resin materials. Settings and Design: In vitro study. Materials and Methods: We assessed five materials (n = 10 per group): monolithic zirconia (group Z), lithium disilicate glass ceramic (group L), resin nanoceramic (group R), nanohybrid composite resin (group C), and primary tooth enamel (group E). The mesiopalatal cusps of primary maxillary second molars were used as antagonists. Wear tests were performed in a dual-axis chewing simulator, and the volume loss in the antagonist tooth was evaluated using a laser scanner and three-dimensional profiling system. Statistical Analysis Used: Data were statistically analyzed using one-way analysis of variance with Tukey's post hoc tests (P < 0.05). Results: The maximum antagonist tooth wear was observed in group L (3.84 ± 0.7 mm3), followed by groups C (3.68 ± 0.76 mm3), R (3.48 ± 0.71 mm3), Z (2.66 ± 0.65 mm3), and E (1.66 ± 0.42 mm3). Volume loss was significantly lesser in group Z than in groups L and C (P < 0.05), whereas there were no significant differences among groups L, C, and R. Conclusion: Within the limitations of this in vitro study, our findings suggest that zirconia should be used for full coronal coverage in primary tooth restorations because it causes lesser antagonist tooth wear than does lithium disilicate, resin nanoceramic, and nanohybrid composite resin. 


The evaluation of preoperative and postoperative fetuin-A levels in patients with primary hyperparathyroidism
M Keskin, C Culha, NE Gulcelik, LI Al, M Senes, Y Aral

Nigerian Journal of Clinical Practice 2019 22(3):320-327

Objectives: Our objective was to evaluate preoperative and postoperative serum fetuin-A levels in female patients with primary hyperparathyroidism (PHPT) and search for the relationship with parathyroid hormone (PTH) and vitamin D (25OHD). Although a role for fetuin-A is suggested in regulating bone mineralization, its function has not been completely defined. Materials and Methods: In this cross-sectional study, 43 female patients with PHPT and 30 healthy women were recruited as the control group. We evaluated 73 women because we had only women patients with PHPT. Of the 43 patients, 10 symptomatic and 23 asymptomatic patients were surgically treated, whereas 10 patients were not operated. In all 43 patients, 25OHD, PTH, fetuin-A levels, and bone mineral densitometry were evaluated. The biochemical parameters of 33 operated patients were reevaluated at the postoperative sixth week. Results: Fetuin-A levels of the patients with PHPT were significantly higher than that in the controls (56.6 ± 13.8 vs. 42.6 ± 20.7 ng/mL; P = 0.010). Fetuin-A levels of the operated patients were higher than nonoperated group. Furthermore, serum fetuin-A levels of the nonoperated patients were not different from those of controls. After parathyroidectomy, fetuin-A (41.5 ± 25.2 vs. 56.4 ± 13.7 ng/mL; P = 0.003), PTH [80.0 (51.5–137.5) vs. 211.0 (151.5–278.5) pg/mL; P < 0.001], and calcium (9.2 ± 0.7 vs. 10.7 ± 0.8 mg/dL; P < 0.001) values were found to be decreased significantly. Conclusion: In this study, fetuin-A levels of patients with PHPT were higher than those of the controls and significantly decreased after parathyroidectomy compared with the preoperative levels. Fetuin-A levels could be a beneficial marker to determine the changes in bone metabolism of the patients with PHPT and to detect the patients suitable for surgery. 


Evaluation of the influence of various restoration techniques on fracture resistance of endodontically treated teeth with different cavity wall thicknesses
ET Basaran, Y Gokce

Nigerian Journal of Clinical Practice 2019 22(3):328-334

Aims: The aim of this study was to compare the effect of different restoration techniques on fracture resistance of endodontically treated teeth with different wall thicknesses. Materials and Methods: Extracted and endodontically treated 210 premolars were randomly divided into three thickness groups [2 mm (A), 1.5 mm (B), and 1 mm (C)] and, each group was further divided into seven restoration subgroups (n = 10): direct composite (control) (K), composite with fiber on cavity floor (KT), composite with fiber on occlusal level (KO), fiber post and composite (FP), inlay (L), fiber on cavity floor and inlay (LT), and inlay and fiber on occlusal level (LO). Fracture test was performed, and data were compared with Kruskal–Wallis and Mann–Whitney U tests (P < 0.05). Results: There were no differences between the subgroups in A and C statistically (P > 0.05). However, in B, KO subgroup showed statistically higher values (P = 0.039). Conclusion: Wall support of 2 mm was adequate, and support of 1 mm was completely insufficient. When the wall thickness was 1.5 mm, direct restoration with fiber at the occlusal level significantly improved resistance. 


Effect of different surface treatments and ceramic primers on shear bond strength of self-adhesive resin cement to zirconia ceramic
NE Saleh, MC Guven, G Yildirim, F Erol

Nigerian Journal of Clinical Practice 2019 22(3):335-341

Aims: To evaluate the effect of different surface treatments and ceramic primers on the shear bond strength (SBS) of self-adhesive resin cement to zirconia ceramic. Materials and Methods: A total of 40 zirconia discs (10 mm in diameter and 3 mm in height; StarCeram Z-Med, H.C. Starck, Selb, Germany) were prepared from pre-sintered zirconia blocks. Discs were divided into two groups according to surface treatment: (a) airborne particle abrasion (sandblasting) with 50-μm Al2O3 particles and (b) 9.5% hydrofluoric acid etching. Each of these groups was subdivided into two groups according to the type of primer applied: (a) Z-Prime Plus primer and (b) Clearfil Ceramic Primer. A self-adhesive resin cement (Multilink Speed, Ivoclar Vivadent, Schaan, Liechtenstein) was used to bond with polyethylene molds. All specimens were tested at thermocycled (5000 cycles at 5–55°C for 30 s) conditions. The SBS of the luting cement to the ceramic was measured in a universal testing machine (1 mm/min). Results: The sandblasted groups showed significantly higher SBS values than the acid-etched groups for both primers (P = 0.0001). Independent of the surface treatment, the Z-Prime Plus primer groups showed higher SBS values than the Clearfil Ceramic Primer groups (P = 0.0001). Conclusions: Sandblasting is a more effective method to increase bond strength on zirconia ceramics than hydrofluoric acid etching, and the application of Z-Prime Plus primer increases SBS better than Clearfil Ceramic Primer. 


Clinical and radiographic characterization of primary seminomas and nonseminomatous germ cell tumors
L Gu, L Zhang, N Hou, M Li, W Shen, X Xie, Y Teng

Nigerian Journal of Clinical Practice 2019 22(3):342-349

Background: Primary malignant mediastinal germ cell tumors (PMMGCTs) including seminomas and nonseminomatous germ cell tumors (NSGCTs) are rare, and sometimes the diagnosis is very difficult. Purpose: The purpose of this study is to compare the clinical characteristics, biomarkers, and imaging findings of seminomas and NSGCTs and to determine whether these features could help distinguish these two types of PMMGCT. Material and Methods: A retrospective study of 24 male patients with histopathologically proven PMMGCT was performed. We collected the information of computed tomography (CT) (the scan area ranged from the apex of lung to the costophrenic angles) and magnetic resonance imaging blood test and histology characteristics of these patients. Results: Twelve of 24 cases were confirmed to be seminomas, whereas the other 12 cases were NSGCTs. Alfa-fetoprotein (AFP) was found to be elevated in all patients with NSGCT, whereas none of the patients with seminomas had elevated AFP level. Beta-human chorionic gonadotropin (β-HCG) level was elevated in all the patients with seminomas (seven/seven), whereas in NSGCT only two of seven patients had elevated β-HCG. Lactate dehydrogenase level was increased in five of the nine patients with seminomas, as well as in the eight patients with NSGCT. CT imaging revealed that 12 masses from the seminoma group were homogeneous, soft tissue opacity and showed minimal contrast enhancement. On the contrary, all 12 NSGCT cases showed cystic and solid masses; on contrast-enhanced CT, heterogeneous enhancement was found on the capsule of the tumor, septum, and solid masses. Conclusion: Seminomas and NSGCT showed different profiles of tumor biomarkers and radiographic features. Evidence from serum test, histopathological analysis, and imaging should be combined to ensure the accurate diagnosis of these two types of PMMGCT. 


An In-vitro study on thermal changes during implant drilling with different irrigation volumes
U Mercan, M Sumer, OA Kaya, I Keskiner, DG Meral, O Erdogan

Nigerian Journal of Clinical Practice 2019 22(3):350-354

Objective: Irrigation with saline is one of the essential methods for reducing the heat generated during dental implant osteotomy. High irrigation volume impairs visibility of the surgical field, thus complicates the surgery. In this study, we aimed to determine the optimal irrigation volume for heat reduction during dental implant drilling. Materials and Methods: Thirty-two implant osteotomies were prepared on four fresh cow ribs. Heat generated during the final implant drilling was measured both with infrared thermography and thermocouple method. Initial and maximum temperatures were measured at four different irrigation volumes; 32, 44, 56, and 68 ml/min. Results: Both measurement methods showed that the amount of temperature rise is associated with the irrigation volume during implant drilling. There is no further decrease in temperature rise above irrigation volume of 56 ml/min. Conclusion: Saline irrigation with 56 ml/min provides sufficient heat reduction during dental implant drilling and higher irrigation volumes are not necessary. 


Pharmacognosy

Quality assessment of pollen typhae by high-performance liquid chromatography fingerprint, hierarchical cluster analysis, and principal component analysis
Xin Ma, Haimiao Zou, Yibin Pan, Jing Su, Yujiao Qiu, Mingfeng Qiu

Pharmacognosy Magazine 2019 15(61):177-182

Aim: This study aims to establish the quality assessment methods of Pollen Typhae. Materials and Methods: High performance liquid chromatography (HPLC) fingerprint analysis, hierarchical cluster analysis (HCA), and principal component analysis (PCA) were used for quality evaluation of Pollen Typhae from different origins together with microscopic identification. Then, the quantity of 43 crude Pollen Typhae samples in the market was collected and analyzed. Results: In true and false test, four False Pollen Typhae samples, 13 Net Pollen Typhae (NPT) samples, and 26 Grass Pollen Typhae (GPT) samples were identified by microscopic identification. In quality test, the amounts and percentages of Qualified Pollen Typhae, Unqualified Pollen Typhae were 24 (55.81%) and 19 (44.19%), respectively with typhaneoside and isorhamnetin-3-O-neohesperidoside determined by HPLC according to China Pharmacopeia. We analyzed 43 samples from 20 regions and established their fingerprints, then selected 31 peaks as characteristic peaks and calculated their relative peak areas. To express the HPLC fingerprints quantitatively, peak 16, 18, 22, 23, and 26 were verified as typhaneoside, isorhamnetin-3-O-neoheptanoside, rutin, quercetin, and isorhamnetin. The similarity of correlation coefficients in chromatogram was 0.954 ± 0.007 and 0.922 ± 0.004 for NPT and GPT, respectively, while 0.67 ± 0.008 for 43 samples. The analysis of HCA and PCA can distinguish true or false, qualified or unqualified of Pollen Typhae. Conclusion: HPLC fingerprint combined with HCA and PCA provides a very efficient and comprehensive method for quality evaluation of Pollen Typhae. Abbreviations used: HCA: Hierarchical cluster analysis; PCA: Principal component analysis; FPT: False Pollen Typhae; NPT: Net Pollen Typhae; GPT: Grass Pollen Typhae; QPT: Qualified Pollen Typhae; UPT: Unqualified Pollen Typhae; RSDs: The relative standard deviations; CASE: Computer Aided Similarity Evaluation; TCM: Traditional Chinese medicine. 


Chamuangone-enriched Garcinia cowa leaf extract with rice bran oil: Extraction and cytotoxic activity against cancer cells
Pirunrat Sae-Lim, Supreeya Yuenyongsawad, Pharkphoom Panichayupakaranant

Pharmacognosy Magazine 2019 15(61):183-188

Background: Chamuangone has been isolated from Garcinia cowa leaves and exhibited various biological activities, i.e., antibacterial, anti-Leishmania major, and cytotoxic activity against cancer cells. n-Hexane has been reported to be the most suitable solvent for extraction of chamuangone. Objectives: Some vegetable oils were determined as an alternative green solvent for extraction of an anticancer compound, chamuangone from G. cowa leaf. The chamuangone-enriched extract was standardized and evaluated for cytotoxic activity against human cancer cell lines. Materials and Methods: Microwave-assisted extraction and high-performance liquid chromatography were used for extraction and standardization. The cytotoxic activity was determined using a sulforhodamine B assay. Results: The chamuangone-enriched extract was obtained using rice bran oil as the alternative green solvent and standardized to contain 1.97 mg/mL chamuangone. The extract exhibited cytotoxic activity against human lung adenocarcinoma, human breast adenocarcinoma, and human colorectal adenocarcinoma cell lines, with IC50 values of 15.3, 15.9, and 12.8 μg/mL, respectively, but was nontoxic to human gingival fibroblasts, a normal cell line, at a concentration of 50 μg/mL. Moreover, the extract contained several natural antioxidants, including α-tocopherol (76.7 mg/100 g), γ-oryzanol (cycloartenol ferulate: 67.1 μg/mL and 24-methylenecycloartanol ferulate: 85.6 μg/mL), and antioxidant capacity determined as ascorbic acid (258.7-mM ascorbic acid equivalent per gram). Conclusion: Based on these findings, the chamuangone-enriched extract may be considered as a novel functional food in cancer chemopreventive action. Abbreviations used: AAE/g: Ascorbic acid equivalent per gram; CEO: Chamuangone-enriched Garcinia cowa leaf extract with rice bran oil; DMEM: Dulbecco's Modified Eagle Medium; FBS: Fetal bovine serum; HGF: Human gingival fibroblasts; HPLC: High-performance liquid chromatography; IC50:50% Inhibitory concentration; MAE: Microwave-assisted extraction; MHz: Megahertz; MUFAs: Monounsaturated fatty acids; NMR: Nuclear magnetic resonance; ODS: Octadecylsilane; PUFAs Polyunsaturated fatty acids; SD: Standard deviation; SFAs: Saturated fatty acids; SRB: Sulforhodamine B; TCA: Trichloroacetic acid; UFAs: Unsaturated fatty acids; UV: Ultraviolet; W: Watt. 


Impact of ginsenoside-Rg3 on catecholamine secretion in the perfused model of the rat adrenal medullae
Ki-Hwan Kim, Hyo-Jeong Lim, Young-Jae Ki, Dong-Yoon Lim

Pharmacognosy Magazine 2019 15(61):189-198

Background: The present study was the first attempt to explore the characteristics of ginsenoside-Rg3 (Rg3) on release of catecholamines (CA) in the perfused rat adrenal medullae and also to verify the underlying action mechanism. Materials and Methods: The adrenal medulla was separated by some modification of the previous method and perfused with Krebs solution. CA was assayed directly by the fluorometry. Results: Rg3 reduced acetylcholine (ACh)-produced CA release in a dose- and time-dependent manner. Rg3 time-dependently depressed CA release produced by 3-(m-chloro-phenyl-carbamoyl-oxy)-2-butynyltrimethyl ammonium chloride (McN-A-343), 1,1-dimethyl-4-phenyl piperazinium iodide, and angiotensin II. In the presence of Rg3, the CA release produced by high K+, veratridine, cyclopiazonic acid, and methyl-1,4-dihydro-2,6-dimethyl-3-nitro-4- (2-trifluoromethyl-phenyl)-pyridine-5-carboxylate (Bay-K-8644) was also markedly suppressed. However, during the simultaneous perfusion of Rg3 and Nω-nitro-l-arginine methyl ester hydrochloride (l-NAME), the release of CA produced by ACh, angiotensin II, Bay-K-8644, and veratridine was restored closely to the level of each control, in contrast to that of Rg3-treatment alone. The nitric oxide (NO) release was significantly elevated by Rg3-treatment. Furthermore, in the coexistence of Rg3 and fimasartan, ACh-produced CA release was more significantly reduced as compared to that of fimasartan-treatment alone. Conclusions: We present the first evidence that Rg3 markedly depresses the CA secretion produced by activation of neuronal cholinergic and angiotensinergic receptors. Rg3-produced inhibition appears to be evoked not only by blocking the inflow of Na+ and Ca2+ into adrenomedullary cells but also by preventing the Ca2+ release from intracellular storage, partly through enhancement of NO release by NO synthase activation. Coadministration of Rg3 and fimasartan may be clinically beneficial for the treatment of cardiovascular diseases. Abbreviations used: Rg3: Ginsenoside-Rg3; VDCC: L-type voltage-dependent Ca2+ channels; Bay–K-8644: Methyl-1,4-dihydro-2,6-dimethyl-3-nitro-4-(2-trifluoromethyl-phenyl)-pyridine-5-carboxylate; ACh: Acetylcholine; McN-A-343: 3-(m-chloro-phenyl-carbamoyl-oxy)-2-butynyltrimethyl ammonium; DMPP: 1.1-dimethyl-4-phenyl piperazinium; NO: Nitric oxide; L-NAME: Nω-nitro-l-arginine methyl ester; nNOS: Neuronal NO synthase. 


New bioactive C15 acetogenins from the red alga Laurencia obtusa
Mohamed A Ghandourah, Walied M Alarif, Nahed O Bawakid

Pharmacognosy Magazine 2019 15(61):199-203

Background and Objective: With regard to the uniqueness of the red algae of the genus Laurencia as the source of C15-acetogenins, along with the diversity of biological applications; the acetogenin content of the Red Sea Laurencia obtusa was investigated. Materials and Methods: Fractionation and purification of the CH2Cl2/MeOH extract were carried out by applying several chromatographic techniques, including column and preparative thin-layer chromatography; followed by a series of 1H nuclear magnetic resonance measurements to give rise of some interesting notes. Toxicity to Artemia salina was evaluated. The apoptosis induced by these two compounds was demonstrated by DNA fragmentation assay and microscopic observation. Results: A new rare chloroallene-based C15 acetogenin, laurentusenin (1) along with a new furan ring containing C15 acetogenin, laurenfuresenin (2), were isolated from the red alga L. obtusa. Comparing 1D and 2D NMR, MS, ultraviolet and infrared radiation spectral data for the newly isolated compounds with the reported bromoallene containing acetogenins spectral data was played the crucial role for characterization of their chemical structures. 1 and 2 exhibited bare toxicity (LD50 >12 mM) in test organism, A. salina and induced apoptotic death confirmed by DNA fragmentation and microscopic investigations. Conclusion: The isolated metabolite 1 showed unusual substituted allene side chain, while 2 inserted furan ring as a new acetogenin nucleus. Both compounds may play a role in apoptosis induction and initiation and propagation of inflammatory responses. Abbreviations used: NMR: Nuclear magnetic resonance; MS: Mass spectrometry; UV: Ultraviolet spectroscopy; IR: infrared radiation; EIMS: Electron ionization mass spectra; TLC: Thin-layer chromatography; PPP: Platelet poor plasma; PRPDS: platelet-rich plasma derived serum. DEPT: Destortionless Enhancement by Polarization Transfer; NOESY: Nuclear Overhauser Effect Spectroscopy; HSQC: Heteronuclear Single Quantum Coherence; HMBC: Heteronuclear Multiple-quantum Correlation; 1H-1H COSY: Correlation Spectroscopy. 


A new antifungal aminobenzamide derivative from the endophytic fungus Fusarium sp.
Sabrin R M. Ibrahim, Gamal A Mohamed, Maan T Khayat, Rwaida A Al Haidari, Amal A El-Kholy, Mohamed F Zayed

Pharmacognosy Magazine 2019 15(61):204-207

Background: Endophytic fungi attracted attention as a prolific source of bioactive natural products with a potent pharmaceutical activity and unique structure. Objective: The main goal of the study is to separate and identify the bioactive constituents from the endophytic fungus Fusarium sp. as well as to evaluate the antimicrobial of the new metabolites. Materials and Methods: The fungus was cultured on a rice medium, and then, the cultures were extracted with ethyl acetate (EtOAc). The EtOAc extract was chromatographed utilizing different chromatographic methods to give five metabolites. The structural determination of these metabolites was carried out by the analyses of various spectroscopic data, in addition to comparison with the formerly reported data. The antifungal and antibacterial potentials were evaluated toward various microbial strains using disc diffusion assay. Results: A new aminobenzamide derivative, namely fusaribenzamide A (2), and four known metabolites: (22E,24R)-stigmasta-5,7,22-trien-3-β-ol (1), adenosine (3), p-hydroxyacetophenone (4), and tyrosol (5) were isolated. Fusaribenzamide A (2) possessed significant antifungal activity toward Candida albicans with minimum inhibitory concentration (MIC) value 11.9 μg/disc compared to nystatin (MIC 4.9 μg/disc). Conclusion: The endophytic fungus Fusarium sp. could be considered as a wealthy pool for the isolation of aminobenzamide derivatives. Fusaribenzamide A may be a candidate for the discovery of a promising antifungal agent. Abbreviations Used: CC: Column chromatography; CHCl3: Chloroform; COSY: Correlations spectroscopy; DBE: double bond equivalent; EtOAc: Ethyl acetate; DMSO: Dimethyl sulfoxide; H2SO4: Sulfuric acid; HMBC: Heteronuclear multiple bond correlation experiment; HRMS: High-resolution mass spectrometry; HRESIMS: High-resolution electrospray ionization mass spectrometry; HSQC: Heteronuclear single quantum correlation; IR: Infrared; IZD: Inhibition zone diameter; KBr: Potassium bromide; LTQ: Linear trap quadrupole; MeOH; Methanol; MIC: Minimum inhibitory concentration; NMR: Nuclear magnetic resonance; RP: Reversed phase; SiO2: Silica gel; TLC: Thin-layer chromatography; UV: Ultraviolet; VLC: Vacuum liquid chromatography. 


Optimization of infrared-assisted extraction of bioactive lactones from Saussurea lappa L. and their effects against gestational diabetes
Karim Raafat, Nada El-Darra, Fatima A Saleh, Hiba N Rajha, Nicolas Louka

Pharmacognosy Magazine 2019 15(61):208-218

Background: Saussurea lappa (S. lappa, Asteraceae) have immunomodulatory effects and used in the management of many metabolic disorders. Gestational diabetes is one of the metabolic disorders affecting globally one in seven pregnant women. Objectives: The aim of the current study is to optimize an infrared-assisted extraction (IR-AE) method for S. lappa bioactive constituents, phytochemically investigate its content, isolate its most active constituent, and to assess their biological effects against gestational diabetes. Materials and Methods: To optimize IR-AE conditions, four main factors were studied including solvent concentration, extraction time, powder size, and IR power in the yielded extract (SL-IR). Reversed-phase high-performance liquid chromatography coupled with bio-guided fractionation and isolation procedures using 1H and 13C NMR method were utilized. Solid–liquid (SL-SLE) and ultrasound (SL-US) extraction methods were also done. Results: The optimal IR-AE extraction conditions were found to be 20% aqueous phase concentration, 60-min extraction time, 70 mesh powder size, and 70 W IR power. Phytochemically, four major lactones were identified, including costunolide, dehydrocostuslactone, isoalantolactone, and alantolactone (ATL). ATL was the most active lactone. SL-IR, SL-US, SL-SLE, or ATL showed a significant (P < 0.05) and dose-dependent hypoglycemia in pregnant diabetic group, adequate fetus weight percentage elevation and did not show any external anomalies. The best control of gestational diabetes, insulin secretagogue potentials, elevation in serum catalase and reduced glutathione levels, and lipid peroxidation decrease were demonstrated by SL-IR 250 mg/Kg. The antioxidant and the insulin secretagogue activities might be among the main mechanisms, whereby the SL-IR controls gestational diabetes and decreases offspring anomalies. Conclusion: Currently, it is the first time to optimize an IR-AE method for extracting bioactive lactones from S. lappa. The optimized IR-AE technique has shown to be a rapid and efficient extraction method with SL-IR showing superiority in controlling gestational diabetes for pregnant groups coupled with high safety profile on the offspring. Abbreviations used: IR-AE: Infrared-assisted extraction; SL: Saussurea lappa, S. lappa; SL-IR: Saussurea lappa infrared extract; SL-US: Saussurea lappa ultrasound extract; SL-SLE: Saussurea lappa solid–liquid extract; ATL: Alantolactone; NDC: Nondiabetic control; DC: Diabetic control; MTF: Metformin; TBARS: Thiobarbituric acid; GSH: Reduced glutathione; CAT: Catalase; APA: Adequate for pregnancy age; LPA: Large for pregnancy age; SPA: Small for pregnancy age. 


Dictamnus dasycarpus Turcz., root bark alleviates oxazolone-induced atopy-like dermatitis in mice
Beodeul Yang, Ji Hyo Lyu, Sura Kim, Young Chul Park, Koanhoi Kim, Hyungwoo Kim

Pharmacognosy Magazine 2019 15(61):219-225

Background: Dictamnus dasycarpus Turcz., is one of the most frequently used herbal medicine to treat dermatosis associated with psoriasis, pruritus, scabies, and eczema. Objective: We investigated the anti-inflammatory effects of D. dasycarpus extract (DDE) using a mouse model with atopic dermatitis (AD)-like dermatitis. Materials and Methods: The therapeutic effects of DDE on skin lesion, tone of color, and inhibitory effects on histopathological changes and cytokine production in skin tissues were assessed in mice with AD-like dermatitis induced by oxazolone. Results: Topical application of DDE alleviated skin lesions such as erythema, scaling and excoriations, and ameliorated erythema and the melanin index. In addition, DDE effectively prevented skin enlargement induced by oxazolone, while also preventing epidermal hyperplasia, spongiotic change, and hyperkeratosis and reducing the production of tumor necrosis factor-alpha and interleukin (IL)-4 and IL-5 in inflamed tissues. Finally, DDE did not affect changes in body weight and spleen–body weight ratio relative to dexamethasone. Conclusion: These results indicate that D. dasycarpus can be used as a topical agent for inflammatory skin diseases with relative safety. Abbreviation used: HM: Herbal medicine; DNFB: Dinitrofluorobenzene, ICAM-1: Intercellular adhesion molecule-1, AD: Atopic dermatitis, DDE: Dictamnus dasycarpus extract, AOO: Vehicle composed of acetone and olive oil, DEX: Dexamethasone, CBA: Cytometric bead array. 


Antidepressant-like effects of methanol extract and fractions of Hypericum juniperinum kunth in the forced swimming test
Laura A Mejía-Agudelo, Maritza A Rojas, Mario F Guerrero-Pabón, Freddy A Ramos, Leonardo Castellanos, Juan Camilo Marín-Loaiza

Pharmacognosy Magazine 2019 15(61):226-231

Background: Some members of the genus Hypericum have been shown to demonstrate antidepressant-like effects. In Colombia, approximately 54 species of Hypericum have been reported, and only a few have been investigated chemical and pharmacologically. Objective: The aim of this study was to evaluate the antidepressant-like effects of a methanol extract, as well as ethyl acetate and butanol fractions, obtained from aerial parts of Hypericum juniperinum K. Materials and Methods: Behavioral and locomotor activities were evaluated in the open field test (OFT). Antidepressant-like activity was measured in the forced swimming test (FST) in male Swiss albino mice. Preliminary phytochemical screening as well as a high-performance liquid chromatography (HPLC) profile of the active fractions of H. juniperinum was performed. Results: Treatment with the methanol extract at 500 mg/kg and the ethyl acetate and butanol fractions at 150 and 300 mg/kg resulted in a decrease in the immobility times in FST. In the OFT, none of the treatments presented altered behavior or locomotor activity of mice. Preliminary phytochemical screening identified terpenes/steroids, flavonoids, phenol derivatives, tannins, and saponins. In the HPLC analysis of the fractions, rutin, quercitrin, and quercetin were identified with the help of coinjection of standards. Conclusion: This is the first report of the antidepressant-like activity of extracts and fractions obtained from H. juniperinum in the FST model of depression. Flavonoids may be responsible for the antidepressant-like action of H. juniperinum. Abbreviations used: FST: Forced swimming test; HJE: Methanol extract of Hypericum juniperinum; HJEAF: Ethyl acetate fraction obtained from the methanol extract of Hypericum juniperinum; HJEBF: Butanol fraction obtained from the methanol extract of Hypericum juniperinum; HPE: Methanol extract of Hypericum perforatum; HPLC: High-performance liquid chromatography; IMI: Imipramine; MeOH: Methanol; OFT: Open field test; tR: Retention time; UV: Ultra violet; VEH: Vehicle. 


Biological evaluation and molecular docking study of metabolites from Salvadora Persica L. Growing in Egypt
Mohammed M Ghoneim, Wael M Afifi, Mohamed Ibrahim, Mohamed Elagawany, Maan T Khayat, Mohamed H Aboutaleb, Ahmed M Metwaly

Pharmacognosy Magazine 2019 15(61):232-237

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a resistant staph bacterium to several antibiotics causing several lives-threating diseases such as pneumonia and sepsis. Meswak, Salvadora persica, exhibited promising antimicrobial properties before. Objective: Exploring the anti-MRSA activity of S. persica L. metabolites and its mechanism of action on a molecular level. Materials and Methods: Structure elucidation of the isolated metabolites was carried out by spectroscopic data (one-dimensional and two-dimensional nuclear magnetic resonance). The biological activities of the isolated metabolites against MRSA were evaluated and the molecular mode of action against the dehydrosqualene synthase enzyme have been done. Results: Four compounds have been isolated and identifies to be; apigenin (1), luteolin (2), astragalin (3), and kaempferol-3-O-rhamnoside (4). Compounds 1–4 showed good anti-MRSA activities with IC50 values of 10.3, 11.5, 3.5, and 4.5 μg/mL, respectively. In consistent, astragalin and kaempferol-3 rhamnoside showed close high docking scores. Herein, we are reporting the molecular determinates of activity of these new scaffolds as anti-MRSA, which would be of great importance to developing new anti-MRSA candidates. Abbreviations Used: 1D: One-dimensional; 2D: Two-dimensional; CC: Column chromatography; COSY: Correlations spectroscopy; DMSO: Dimethyl sulfoxide; HMBC: Heteronuclear multiple-bond correlation experiment; HRESIMS: High-resolution electrospray ionization mass spectrometry; HSQC: Heteronuclear single-quantum correlation; IR: Infrared; MRSA: Methicillin-resistant Staphylococcus aureus; NMR: Nuclear magnetic resonance; RP: Reversed phase; TLC: Thin-layer chromatography; UV: Ultraviolet; VLC: Vacuum liquid chromatography. 


Ameliorative effects of tannic acid on lipopolysaccharide-induced sepsis and acute lung injury in mice
Ruirui Zhang, Minyan Dang, Shoutian Qiu, Hongyan Gu, Pingping He, Gang Guo, Tao Zhang

Pharmacognosy Magazine 2019 15(61):238-243

Background: Acute lung injury (ALI) caused by endotoxins is a severe complication causing lethal conditions. Prevention of the inflammatory response is necessary to overcome this condition. Tannic acid is a polyphenol known for its pharmacological properties such as antioxidant, antimicrobial, anti-inflammatory, anticancer, antitumor, and antimutagenic. This study aims to investigate the anti-inflammatory mechanism of tannic acid on lipopolysaccharide (LPS)-induced sepsis and ALI in mice. Materials and Methods: Male BALB/c mice were divided into five groups (n = 12) and induced with LPS (50 mg/kg body weight) and treated with tannic acid (25, 50, and 100 mg/kg) after 1 h. The bronchoalveolar lavage fluids were collected to determine the myeloperoxidase activity and levels of inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-6, and IL-1 β). Nuclear factor-kappa-β (NF-κβ) activities were examined through Western blot analysis, and hematoxylin and eosin staining was done for histopathological alterations of lung tissues. Results: Results of the study showed that tannic acid was able to prevent the infiltration of inflammatory cells and cytokines into the site of ALI which is also connected to the suppression of NF-κβ activation as shown in the Western blot analysis. The histopathological results further support these results. The safety of tannic acid was also proven on the survival of RAW264.7 cells. Conclusion: The anti-inflammatory mechanism of tannic acid on LPS-induced ALI and sepsis can be credited to the inhibition of inflammatory cytokines production mediated by NF-κβ pathway suppression. Abbreviations used: ALI: Acute lung injury; BALFs: Bronchoalveolar lavage fluids; NO: Nitric oxide; COX-2: Cyclooxygenase-2; iNOS: Inducible nitric oxide synthase; TNF-α: Tumor necrosis factor-α; IL-1β: Interleukin-1 β; IL-6: Interleukin-6. 


Oral Research and Review

Oral Health Status of Martyr Memorial Residential School Children of Sunsari, Nepal
Santosh Kumari Agrawal, Ashish Shrestha, Tarakant Bhagat

Journal of Oral Research and Review 2019 11(1):1-6

Context: Students, who are healthy, active, and well nourished, are likely to attend schools regularly which accelerate their learning process. Poor oral health has a profound effect on general health and quality of life. Aims: The aim of this study was to assess the oral health status of Martyr Memorial Residential School Children of Sunsari, Nepal, during 5-year period and also to assess the effectiveness of school oral health program. Settings and Design: A retrospective longitudinal study was carried out among Martyr Memorial Residential School children. Subjects and Methods: Aretrospective longitudinal study was performed among 411 school children of Martyr Memorial Residential School, Sunsari, Nepal. Five years' data of children were collected from the department record forms from 2009 to 2014. Data on demographic parameters, oral health condition (Decayed, Missing, and Filled Teeth [DMFT], oral hygiene status, type of dentition, malocclusion, and diet history), and treatment done for each child were collected from the surveyed forms. Statistical Analysis Used: Frequency distribution, prevalence, and incidence of dental caries were calculated. Results: This study showed that the prevalence of dental caries in 2009, 2010, 2011, 2012, 2013, and 2014 was 21.0%, 23%, 29.1%, 10.0%, 13.5%, and 30.9%, respectively. The incidence of dental caries in permanent dentition was high (22.0%) in 2011 follow-up. None of the dentition developed new cavity in 2010 follow-up period. More than half of the children had good oral hygiene status in 2012, whereas only 32.9% had so in 2009. Majority (95.5%) of the enrolled children had normal occlusion. Conclusions: This study showed the overall positive impact on the children's prevalence and incidence of dental caries as well as on oral hygiene status. The incidence of developing new caries in both types of dentition decreased. There was an increase in filled component of DMFT/decayed, filled teeth index. Most of them had good oral hygiene status at the end of the study. 


Assessment of child's mental health problems using Strengths and Difficulties Questionnaire
Miranda George, Shweta Chandak, Milind Wasnik, Sneha Khekade, Niharika Gahlod, Harshita Shukla

Journal of Oral Research and Review 2019 11(1):7-11

Background: While a number of studies in the Western countries have provided estimates of prevalence for child psychiatric morbidity and associated risk factors, relatively little is known about child psychiatric problems and risk factors in developing countries like India. Aim: The aim of this study was to assess the patients' emotional status in an age group of 3–14 years to evaluate children's cooperative potential. Methodology: The Goodman's Strengths and Difficulties Questionnaire assessing the mental health status of the child was distributed to the Vidharbhan population attending the dental hospital. A cross-sectional survey including 168 children aged 3–14 years who were instructed how to fill the questions participated in the study. Results: Overall 53% of the children belonged to the normal category, whereas 33% and 14% were under abnormal and borderline categories, respectively. The abnormal category was slightly higher in the age groups of 3.1–5 (35%) and 11.1–14 (28%) years. Similar to certain studies, the mental health problems with males (52.9%) were higher than that of females (47.6%). Conclusion: Identifying the mental health problems of the child seeking dental treatment will help the dentist to formulate an idea of the child's emotional status at the time of treatment and thereby make proper amendments during the treatment procedure. There is a need for developing programs to train, sensitize, and mobilize teachers and parents regarding children's psychological, emotional, and behavioral problems, with special attention to the common population. 


The importance of oral health education in patients receiving orthodontic treatment
Emad E M. Alzoubi, Valentina Tabone Borg, Gabriella Gatt, Anne Marie Aguis, Nikolai Attard

Journal of Oral Research and Review 2019 11(1):12-19

Introduction: Evaluation of the effectiveness of a well-targeted educational campaign specially designed toward the improvement of oral health and maintenance of removable orthodontic appliances should be considered during an orthodontic treatment. Objectives: The objective of this study was to assess the impact of the oral hygiene protocol on oral health through assessing plaque accumulation on the removable orthodontic appliance, to establish the impact of oral hygiene protocol on oral health through assessing the patients' plaque accumulation on the tooth surface and gingival bleeding, and to evaluate the degree of halitosis between the intervention and control groups. Materials and Methods: The study involved 80 patients who were equally assigned to the intervention and control removable orthodontic treatment groups. Data were collected by means of questionnaires, soft-tissue examination, breath checker, and staining the appliance with methylene blue disclosing solution. Results: The plaque score of both groups at Review 2 emphasized a significant difference (P = 0.021), yet neither differences at baseline (P = 0.989) nor Review 1 (P = 0.786) were found. The odor score of both groups at Review 2 showed a significant difference (P = 0.012). All interventional patients and only 10% of the control group patients were aware of appliance removal during sport. There was no significant difference (P = 0.211) between the responses of patients concerning the cleaning method of the appliance. The patients showed a higher user rate of mouthwash, and they were more successful with respect to when it should be used. Conclusion: The effectiveness of an educational session has been demonstrated in some aspects of the research. 


Comparative evaluation of two suturing models for preclinical training
Triveni Kale, Shruti Shankarrao Lendhey, Varsha Ranmare, Govind Bhartiya, Anuja Hudwekar, Pranav Lendhey

Journal of Oral Research and Review 2019 11(1):20-24

Introduction: Demonstration and training on the live subject are not always an optimal means of introducing students to suturing technique. The use of live patient as a test subject is not acceptable with today's ethical standard. It would be advantageous to use a preclinical training model that impersonates real-life conditions, through which manual dexterity and a high degree of psychomotor skill can be achieved. This helps to master the suturing technique under semi-realistic circumstances at an affordable cost. The model most closely resembling the actual condition should be considered. Materials and Methods: A total of 54 postgraduate students participated in the study. The material required for both the models were distributed among participants and asked to prepare the models. Then, suturing was performed on models, and the questionnaires were given for feedback. Model 1: Require orange peel, alginate impression material, and dental stone. Model 2: Require mackintosh, sponge, alginate impression material, and glass slab. Depending on the questionnaire, response results were calculated. Results: All participants experienced that glass slab model was more durable than the orange model. Thirty-six participants experienced that orange model is easy to prepare compared to glass slab model. There was a significant linear trend among the ordered categories seen using Chi-square test. Conclusion: According to the participant's preference orange model was better in all aspects such as ease of preparation, the passage of suture needle, and the time required for suturing compared to glass slab model which was more durable and less gaping experienced with it. Hence, we concluded that orange model was better for preclinical suturing training. 


Salivary duct carcinoma of minor salivary gland: A case report with review of literature
Arshdeep Kaur, Chetan Dev Singh Boparai, Anusha Rangare Lakshman, Gogineni Subhas Babu

Journal of Oral Research and Review 2019 11(1):25-28

Salivary duct carcinoma (SDC) is a rare, highly aggressive neoplasm representing about 1%–3% of all malignant salivary gland tumors. Approximately, 85% of the cases occur in the parotid gland followed by the submandibular gland and minor salivary gland. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as “SDC.” This article highlights a case of rapidly growing swelling in the left mandibular region in a 60-year-old female. As this entity is rare and highly aggressive, an early detection followed by appropriate treatment is very important to improve the survival rate of the patient. 


Acquired maxillary double lip
Chaithra Kalkur, Krishna Burde, Anusha R L, Nilofer Halim, Atul Sattur

Journal of Oral Research and Review 2019 11(1):29-31

Double lip is a rare deformity of the face, which can occur as congenital and acquired anomaly. It most often appears as syndromic variety along with systemic manifestations. It is a rare occurrence with slight male predilection. This article is a report of a 20-year-old female presented with the acquired double upper lip for 1 year developed after orthodontic treatment. 


Is drug substitution always a solution? Phenytoin induced gingival enlargement – A case report
Chandni Gupta, Ritika Arora, Himani Sharma

Journal of Oral Research and Review 2019 11(1):32-36

Gingival enlargement is the most common side effect which is reported with the administration of the anti-epilepsy drug phenytoin (PHT). It is of vital importance as it greatly affects the esthetics and also interferes with the mastication and oral hygiene practices. It is now well known that the presence of gingival inflammation resulting from poor oral hygiene acts as a major risk factor and leads to worsening the condition. Therefore, the patients taking PHT should be made aware of the possible outcomes and the importance of maintaining oral hygiene and periodontal maintenance therapy. This case report describes a case of PHT-induced gingival enlargement in which surgical intervention was done to correct the gingival enlargement, and in spite of patient not discontinuing the drug (PHT), no recurrence of enlargement was seen even after 1 year. 


Endodontic management of badly broken down tooth with radix entomolaris using the canal projection technique
Huma Iftekhar

Journal of Oral Research and Review 2019 11(1):36-40

The management of teeth with minimal coronal structure can be a challenging task when root canal treatment is required as a part of oral rehabilitation. Coronal leakage, isolation complexities, and risk of interappointment coronal-radicular fracture may be major contributors to endodontic failure. It is a great challenge to an endodontist to maintain root canal patency while isolating grossly destructed tooth with open pulp chamber, without blocking the root canals with restorative material. Pre-endodontic build-up of the coronal tooth structure following caries removal and identification of all the canal orifices while maintaining the canal patency can facilitate the endodontic process by providing a strong core and coronal seal. Hence, a restoration before endodontic treatment is mandatory during management of these teeth. This can be achieved successfully by the canal projection technique, wherein a tapered plastic sleeve is used to maintain the canal patency, projecting the canal from pulp chamber to cavosurface margin. Taking into consideration the limited worldwide availability and cost of original projectors, the aim of the present case is to highlight a simple yet effective method of placement of a pre-endodontic restoration using the canal projection technique by custom made plastic sleeves. This case report demonstrates the use of an innovative technique for canal projection, as an efficient method for managing complex cases. 


An update on nicotine replacement therapy
KA Kamala, S Sankethguddad, SG Sujith

Journal of Oral Research and Review 2019 11(1):41-47

Tobacco use is the single greatest preventable cause of death in the world. Most tobacco users want to quit but find it difficult to stop due to the addictiveness of nicotine. Interventions for tobacco cessation are important in enabling tobacco users to stop using, which includes pharmacological and nonpharmacological approaches to aid tobacco cessation. Pharmacological approaches include nicotine replacement therapy (NRT) and nonnicotine medications (bupropion and varenicline). NRT delivers nontoxic forms of nicotine to help tobacco user's deal with nicotine cravings and maintains stimulation of the nicotine receptors. Forms of delivery for NRT include the following: nicotine chewing gum, nicotine lozenge, transdermal patch, nicotine inhaler, nicotine nasal spray, and nicotine sublingual tablets. These NRTs are in general well tolerated and have minimal adverse effects. The present review gives an overview about various modes of NRT methods currently used to treat nicotine dependence. 


Periodontal implications of argyrophilic nucleolar organizer region: A mini reviewPeriodontal implications of argyrophilic nucleolar organizer region: A mini review
Vandana Kharidi Laxman, GS Madhushankari, Mini Saluja, Shivani Singh

Journal of Oral Research and Review 2019 11(1):48-51

The periodontal lesions with cellular proliferation can be assessed by various methods. One of the methods to determine the proliferative activity is silver-staining argyrophilic nucleolar organizer region (AgNOR) staining. AgNOR can be used as diagnostic and prognostic tool for many of periodontal lesions which are proliferative in nature and may be quantitative marker of incipient cellular alterations before the histologic hallmarks appear. Hence, this paper reviewed about the periodontal applications of AgNOR staining. 


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