Category: Nevin Manimala

Med Oral Patol Oral Cir Bucal. 2023 Oct 12:25861. doi: 10.4317/medoral.25861. Online ahead of print.

ABSTRACT

BACKGROUND: Oral Lichen Planus is a potential malignant disorder and shares clinical and histopathological features with other similar lesions. ALDH1 is a specific biomarker for stem cells identification, however its role in stromal cells of immune inflammatory infiltrate has not been explored. The aim of this study was to investigate the ALDH1 immunoexpression in epithelial and stromal cells of Oral Lichen Planus and other lesions with lichenoid inflammatory infiltrate.

MATERIAL AND METHODS: 64 samples of Oral Lichen Planus, Oral Lichenoid Lesions, Oral Leukoplakia and Unspecific Chronic Inflammation were included. ALDH1 was evaluated in both epithelium and stromal cells. ALDH1+ cells ≥ 5% were considered positive in epithelium. Stromal cells were evaluated semi quantitatively. Fields were ranked in scores, according to criteria: 1 (0 to 10%); 2 (11 to 50%) and 3 (>50%). The mean value of the sum of the fields was the final score. Statistical differences among groups were investigated, considering p < 0.05.

RESULTS: ALDH1 expression in epithelium was low in all groups without difference among them. ALDH1+ cells in the lamina propria were higher for Lichen Planus [2.0], followed by Leukoplakia [1.3], Lichenoid lesions [1.2] and control [1.1] (p<0.05).

CONCLUSIONS: ALDH1 immunoexpression in epithelium of lichenoid potential malignant disorders did not show a contributory tool, however ALDH1 in stromal cells of lichen planus might be involved in the complex process of immune regulation associated with the pathogenesis of this disease.

PMID:37823302 | DOI:10.4317/medoral.25861

Med Oral Patol Oral Cir Bucal. 2023 Oct 12:26170. doi: 10.4317/medoral.26170. Online ahead of print.

ABSTRACT

BACKGROUND: The present study aimed to evaluate the ultrasonographic findings of submandibular and submental lymph nodes in patients with and without odontogenic infection.

MATERIAL AND METHODS: Systemically healthy patients aged 18-30 years old with or without odontogenic infections were included in this study. Clinical examinations were performed on all patients; those with any odontogenic infection were placed in the study group, and those without were placed in the control group. Ultrasonographic examinations of bilateral submental and submandibular lymph nodes were performed for both groups. The data were statistically analyzed using Pearson’s Chi-square test and Student’s t-test.

RESULTS: A total of 150 patients voluntarily participated (female: n=86 (57%), male: n=64 (43%)), 75 in the study group and 75 in the control group. During the ultrasonographic examination, patients in the study group had more than one lymph node the same patient was mostly detected, in the study group (right submandibular: n=42, 56%, and left submandibular: n=43, 57.3%). The long-axis diameter of the submandibular lymph nodes was 9.305.30 mm and 5.505.20 mm in the study and control groups, respectively.

CONCLUSIONS: Ultrasonography revealed that the presence, number, and long-axis diameter of the submandibular lymph nodes in the patients with and without odontogenic infection were statistically different.

PMID:37823301 | DOI:10.4317/medoral.26170

Med Oral Patol Oral Cir Bucal. 2023 Oct 12:26193. doi: 10.4317/medoral.26193. Online ahead of print.

ABSTRACT

BACKGROUND: The transcutaneous electrical nerve stimulation (TENS) stimulus inhibits the activity of nociceptive neurons of the central nervous system. Pain relief is achieved by increasing the pulse amplitude of TENS to induce a non-painful paranesthesia beneath the electrodes. This study aimed to assess the effect of TENS on acute pain, edema, and trismus after surgical removal of impacted third molars.

MATERIAL AND METHODS: This randomized, double blind, split-mouth clinical trial was conducted on 37 patients with bilaterally impacted mandibular third molars. The angle and body of mandible at the site of surgery in one randomly selected quadrant underwent TENS immediately after surgery (50 Hz, 100-µs short pulse, 15 minutes for 6 days). The TENS stimulator device was used in off mode for the placebo quadrant. The pain score (primary outcome) was measured for 7 days postoperatively, and edema and trismus (secondary outcomes) were assessed at 2, 4 and 7 days, postoperatively. The results were analyzed by repeated measures ANOVA using R software (alpha=0.05).

RESULTS: The overall mean pain score was significantly lower in the TENS than the placebo group (P<0.05). The number of taken analgesics in the first 3 days was significantly lower in the TENS group (P<0.001). Postoperative edema in the TENS group was lower than the placebo group but only the difference was not statistically significant (P>.05). The inter-incisal distance, as an index to assess trismus, was not significantly different between the two group at day 2, but it was significantly higher in the TENS group after the second day (P<0.001).

CONCLUSIONS: TENS effectively decreased pain and trismus following impacted third molar surgery, and may be recommended as a non-pharmaceutical method to relieve postoperative symptoms.

PMID:37823292 | DOI:10.4317/medoral.26193

Med Oral Patol Oral Cir Bucal. 2023 Oct 12:25860. doi: 10.4317/medoral.25860. Online ahead of print.

ABSTRACT

BACKGROUND: Third molars have the highest prevalence of impaction in teeth and can cause pathological damage on the adjacent second molars. This study aims to evaluate the effects of factors related to impacted third molars on external root resorption (ERR) in adjacent second molars using cone-beam computed tomography (CBCT).

MATERIAL AND METHODS: In CBCTs, the effect of impacted third molars on the root surface of adjacent second molars was investigated. Inclusion criteria for subjects were being older than 16 and younger than 55, presence of at least one impacted third molar and adjacent second molar. Exclusion criteria were pathology, a follicle gap greater than 5 mm, crowned second molar, severe decay, an artifact on a radiologic image, and previous surgery on the second or third molars. The investigations were made based on age range, gender, tooth inclination, Pell-Gregory classification, retention type, contact area, root formation, pericoronal width, and tooth absence on the same quadrant for potential risk factors. The collected data were statistically analyzed with R software. The Chi-Square test was used to find out any significant difference. Logistic regression analyses were done for potential risk factors for ERR.

RESULTS: A total of 437 impacted third molars and adjacent second molars were investigated using CBCT. Of these, 381 met the inclusion criteria. Mesioangular and horizontal inclination, Pell-Gregory Class B-C, contact area, and retention type were found the statistically potential risk factors for ERR.

CONCLUSIONS: The impacted third molar with horizontal or mesioangular position, and osseous retention, with Pell and Gregory Class B and C, are more likely to cause external root resorption in adjacent second molars.

PMID:37823291 | DOI:10.4317/medoral.25860

Am J Epidemiol. 2023 Oct 11:kwad196. doi: 10.1093/aje/kwad196. Online ahead of print.

ABSTRACT

Propensity score analysis is a common approach to addressing confounding in non-randomized studies. Its implementation, however, requires important assumptions (e.g., positivity). The disease risk score is an alternative confounding score that can relax some of these assumptions. Like the propensity score, the disease risk score summarizes multiple confounders into a single score, on which conditioning by matching allows the estimation of causal effects. However, matching relies on arbitrary choices for pruning out data (e.g., matching ratio, algorithm and caliper width) and may be computationally demanding. Alternatively, weighting methods, common in propensity score analysis, are easy to implement and may entail fewer choices, yet none have been developed for the disease risk score. We present two weighting approaches: one derives directly from inverse probability weighting (IPW); the other named target distribution weighting (TDW) relates to importance sampling. We empirically show IPW and TDW display a performance comparable to matching techniques in terms of bias but outperform them in terms of efficiency (mean squared error) and computational speed (up to >870 times faster in an illustrative study). We illustrate implementation of the methods in two case studies where we investigate placebo treatments for multiple sclerosis and administration of Aspirin in stroke patients.

PMID:37823269 | DOI:10.1093/aje/kwad196

Pediatrics. 2023 Oct 12:e2022059112. doi: 10.1542/peds.2022-059112. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric patients with behavioral needs are frequently admitted to the hospital for medical care; when behavioral crises occur, patients and staff are at risk for injury. Our aim was to implement a behavior response team (BRT) to increase the days between employee injury due to aggressive patient interactions on the inpatient medical units from 99 to 150 over 1 year.

METHODS: A multidisciplinary team used quality improvement methods to design and implement the BRT system that includes 2 options: huddle to proactively plan for patients exhibiting early signs of escalation and STAT for immediate help for patients with imminent risk of harm to self or others. Using run and statistical process control charts, we tracked events per month, days between Occupational Safety & Health Administration-recordable events, and violent restraint use over time for 1 year after implementation. Staff pre and postimplementation surveys were compared to assess staff perception of safety and support provided by the BRT intervention.

RESULTS: The BRT was implemented across the inpatient system in July 2020, with an average number of 13 events per month. Days between Occupational Safety & Health Administration-recordable events remained stable with a maximum of 134 days. Restraint use remained stable at 0.74 per 1000 patient days. The perception of behavioral support available to staff increased significantly pre to postsurvey.

CONCLUSIONS: The implementation of a BRT can improve staff perception of support and confidence in safely caring for patients with behavior needs on the inpatient medical unit, although additional provider- and system-level improvements are needed to prevent employee injuries.

PMID:37823246 | DOI:10.1542/peds.2022-059112

Food Sci Nutr. 2023 Jul 4;11(10):6133-6139. doi: 10.1002/fsn3.3549. eCollection 2023 Oct.

ABSTRACT

The present study aimed to assess the association between diet quality and nonalcoholic fatty liver disease (NAFLD) predictor indices in patients with metabolic syndrome (MetS). This cross-sectional study was carried out among 344 adult patients with MetS. The diet quality of patients was calculated by Healthy Eating Index-2015 (HEI-2015). NAFLD predictor indices (Hepatic Steatosis Index [HSI], Triglyceride-Glucose Index [TyG], and Fatty Liver Index [FLI]) were calculated and compared according to the HEI-2015 quartiles. The relationship between the HEI-2015 score and HSI, FLI, and TyG Index was estimated using multiple linear regression analysis. The findings of the present study revealed that patients with the highest HEI score had the lowest FLI score (p = .003) and HSI score (p = .05). There was an inverse relationship between the HEI-2015 score and FLI (β = -0.49; p < .001), HSI (β = -0.05; p = .25), and TyG Index (β = -0.002; p = .34). According to our result, after adjusting for possible confounding factors, there was a statistically significant inverse association between HEI-2015 and FLI.

PMID:37823171 | PMC:PMC10563747 | DOI:10.1002/fsn3.3549

Food Sci Nutr. 2023 Jun 30;11(10):5967-5977. doi: 10.1002/fsn3.3530. eCollection 2023 Oct.

ABSTRACT

This study evaluated how daily vitamin C administration impacts systemic oxidative stress and inflammation and its safety in T2D patients. This randomized, double-blinded, placebo-controlled, parallel-arm clinical trial included 70 patients with T2D. They were allocated to receive either 500 mg/day of vitamin C or a matching placebo for 8 weeks. Of the 70 subjects assigned to the trial, 57 were included in the statistical analysis (vitamin C: n = 32, placebo: n = 25). Inflammatory and oxidative markers, including advanced glycation end products (AGEs), malondialdehyde (MDA), advanced oxidation protein products (AOPP), oxidized low-density lipoprotein (ox-LDL), highly sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and ferric reducing ability of plasma (FRAP) were measured at baseline and the end of the trial. In addition, vitamin C tolerance was evaluated. A nutritionist visited all participants for a standard diabetic regimen. Following vitamin C supplementation, the serum levels of MDA (p-value < .001) and AGEs (p-value = .002) demonstrated a significant decrease after controlling for multiple confounders, including age, blood pressure, waist circumference, HbA1C, TG, and LDL-C, while no significant changes were observed for AOPP (p-value = .234) and ox-LDL (p-value = .480). The FRAP showed an increasing trend as an antioxidant marker but was not statistically significant (p-value = .312). The hs-CRP and TNF-α had no significant changes (p-value: .899 and .454, respectively). Also, no major adverse events were observed. Vitamin C supplementation may be beneficial in reducing AGEs and MDA in patients with T2D.

PMID:37823170 | PMC:PMC10563761 | DOI:10.1002/fsn3.3530

Food Sci Nutr. 2023 Jul 11;11(10):6223-6230. doi: 10.1002/fsn3.3562. eCollection 2023 Oct.

ABSTRACT

In this work, a storage study was conducted to find suitable packaging material for tomato powder storage. Experiments were laid out in a single factor completely randomized design (CRD) to study the effect of packaging materials on lycopene, vitamin C moisture content, and water activity of tomato powder; The factor (packaging materials) has three levels (low-density polyethylene bag, polypropylene bottle, wrapped with aluminum foils, and packed in low-density polyethylene bag) and is replicated three times. During the study, a twin layer solar tunnel dried tomato slices of var. Galilea was used. The dried tomato slices were then ground and packed (40 g each) in the packaging materials and stored at room temperature. Samples were drawn from the packages at 2-month interval for quality analysis and SAS (version 9.2) software was used for statistical analysis. From the result, higher retention of lycopene (80.13%) and vitamin C (49.32%) and a nonsignificant increase in moisture content and water activity were observed for tomato powder packed in polypropylene bottles after 6 months of storage. For low-density polyethylene packed samples and samples wrapped with aluminum foil and packed in a low-density polyethylene bag, 57.06% and 60.45% lycopene retention and 42.9% and 49.23% Vitamin C retention were observed, respectively, after 6 months of storage. Considering the results found, it can be concluded that lycopene and vitamin C content of twin layer solar tunnel dried tomato powder can be preserved at ambient temperature storage by packing in a polypropylene bottle with a safe range of moisture content and water activity levels for 6 months.

PMID:37823153 | PMC:PMC10563716 | DOI:10.1002/fsn3.3562

Food Sci Nutr. 2023 Aug 11;11(10):6626-6633. doi: 10.1002/fsn3.3611. eCollection 2023 Oct.

ABSTRACT

We investigated the associations of one-carbon metabolism (OCM)-related metabolites, including choline, betaine, dimethylglycine (DMG), and methionine with fetal growth of twins. This hospital-based cohort study included dichorionic twin gestations. Blood samples were collected at a median of 14.7 weeks of gestation. Blood plasma metabolite levels were measured using high-performance liquid chromatography-triple quadrupole mass spectrometry. Generalized estimating equations and mixed effects models were used to explore associations between plasma metabolite levels and fetal growth. In total, 115 women with dichorionic diamniotic pregnancies were included. The maternal plasma DMG level was negatively correlated with fetal birth weight (β = -43.5, 95% confidence interval [CI] = -74.1 to -12.8, p < .05) and head circumference (β = -0.23, 95% CI = -0.39 to -0.07, p < .05). Other metabolites were not significantly associated with birth weight, body length, head circumference (HC), or chest circumference. Analysis of the relationships between plasma metabolite levels and fetal biological parameters on ultrasound revealed that the maternal choline level was negatively correlated with fetal abdominal circumference (AC) (β = -0.12, 95% CI = 0.24 to -0.004, p < .05); the maternal DMG level was negatively correlated with fetal AC (β = -0.17, 95% CI = 0.28-0.07, p < .05), femur length (β = 0.02, 95% CI = 0.04-0.003, p < .05), and estimated fetal weight (β = 26.4, 95% CI = -41.6 to -11.2, p < .05), but not with HC. The maternal methionine level was negatively correlated with HC (β = -0.08, 95% CI = -0.14 to -0.02, p < .05). The plasma level of the OCM-related metabolite DMG during the second trimester was negatively correlated with fetal intrauterine growth and birth weight. However, further studies with larger samples are needed.

PMID:37823151 | PMC:PMC10563705 | DOI:10.1002/fsn3.3611