Nevin Manimala

J Conserv Dent Endod. 2025 Sep;28(9):899-904. doi: 10.4103/JCDE.JCDE_91_25. Epub 2025 Sep 5.

ABSTRACT

CONTEXT: The removal of intracanal medicament is necessary to promote adequate sealing.

AIMS: This study evaluated three techniques (conventional irrigation, Ultrasonic activation, and XP-endo Finisher) to remove intracanal medication (Ultracal XS and Bio-C Temp) using micro-computed tomography.

MATERIALS AND METHODS: The roots were randomly divided into six groups (n = 10) according to the intracanal medication and the irrigation protocol employed to remove the pastes: Ultracal and Manual (UC/M); Ultracal and XP-endo Finisher (UC/XP); Ultracal and Ultrasonic activation (UC/US); Bio-C Temp and Manual (BIO/M); Bio-C Temp and XP-endo Finisher (BIO/XP) and Bio-C Temp and Ultrasonic activation (BIO/US) The samples were then subjected to microcomputed tomography scan to assess the total volume of filling and remaining medication after removal protocol.

STATISTICAL ANALYSIS USED: The Shapiro-Wilk normality test indicated a normal distribution of the data. Then, to compare the groups, one-way ANOVA and Tukey’s post hoc tests were performed. For all statistical tests used, the significance level established was 5%.

RESULTS: When the samples were evaluated after applying the protocols regarding the root canal thirds, there was a greater remaining volume of Bio C Temp in the cervical third compared to the middle and apical thirds in the Bio C Temp/M and Bio C Temp/XP groups (P < 0.05). Ultrasonic activation removed the volume of Bio C Temp from the cervical third to similar levels of the middle and apical thirds (P > 0.05). In the cervical third, the Bio C Temp/XP, Bio C Temp/M group obtained a greater volume of remaining material than Bio C Temp/US, Ultracal/M, Ultracal/XP, and Ultracal/US (P < 0.05).

CONCLUSION: In the present study, the activation methods of intracanal medications did not differ in the removal capacity between the two types of root canal dressing and none of the removal protocols were able to completely remove dressings from the root canal.

PMID:40964648 | PMC:PMC12440337 | DOI:10.4103/JCDE.JCDE_91_25

J Conserv Dent Endod. 2025 Sep;28(9):892-898. doi: 10.4103/JCDE.JCDE_83_25. Epub 2025 Sep 5.

ABSTRACT

AIM: Despite the advancement in dental care, dental caries remains the most prevalent oral disease, necessitating the need for effective, preventive, and minimally invasive treatment options. The aim of this study was to evaluate the effectiveness of silver diamine fluoride (SDF) in arresting initial approximal carious lesions in adults.

MATERIALS AND METHODS: This study was a randomized, triple-blinded, placebo-controlled clinical trial. Participants were randomly assigned to one of two arms (A or B). One randomly selected lesion received either treatment (SDF solution) or placebo (water). Lesions were followed at 6- and 12-month using bitewing radiographs. Lesion progression was assessed via three evaluation methods: (1) pairwise comparison of bitewing radiographs (visual assessment), (2) assessment of subtraction radiographs (digital subtraction radiography [DSR]), and (3) histogram analysis of subtraction radiographs (HA). All the statistical analyses were performed using R software (the R Foundation, Vienna, Austria) at the 5% significance level.

RESULTS: Over 12-month period, more than 90% of the lesions were arrested in both groups. The SDF group performed significantly better according to the DSR method between baseline and 6 months (P = 0.05). There were no significant differences between the groups at the 12-month follow-up.

CONCLUSION: SDF treatment was superior in arresting initial approximal caries lesions during the first 6 months of use. This is significant for disease control in high-risk individuals who present to the clinic with multiple initial approximal caries lesions. Further studies are needed to confirm its effectiveness.

PMID:40964644 | PMC:PMC12440336 | DOI:10.4103/JCDE.JCDE_83_25

J Conserv Dent Endod. 2025 Sep;28(9):937-942. doi: 10.4103/JCDE.JCDE_468_25. Epub 2025 Sep 5.

ABSTRACT

BACKGROUND: The constant demand for innovative and minimally invasive procedures aimed at preserving tooth structure challenges the effectiveness of conventional methods. One such approach is partial radicular pulpotomy, which necessitates further clinical trials to validate its efficacy over traditional full pulpectomies and root canal treatments.

AIM: This study aims to evaluate and compare the outcome of full pulpotomy and partial radicular pulpotomy using Biodentine, in mature permanent molars with symptomatic irreversible pulpitis and spontaneous pain.

METHODS: Fifty patients with exposed carious pulp and symptomatic irreversible pulpitis were included, aged 15-35 years, randomly allocated to two groups: full pulpotomy (Group I) and partial radicular pulpotomy (Group II). Both the pulpotomies were performed following standardized protocols, with Biodentine.

STATISTICAL ANALYSIS: Success was assessed clinically and radiographically for up to 12 months using the intragroup Friedman test and the intergroup Mann-Whitney test.

RESULTS: Group I exhibited 78.3%, while for Group II, it was 86.4% success at 12 months, but the results were nonsignificant (P > 0.05).

CONCLUSION: Partial radicular pulpotomy can be introduced as a successful new treatment option in cases of symptomatic irreversible pulpitis in mature permanent molars.

PMID:40964643 | PMC:PMC12440327 | DOI:10.4103/JCDE.JCDE_468_25

J Conserv Dent Endod. 2025 Sep;28(9):925-930. doi: 10.4103/JCDE.JCDE_463_25. Epub 2025 Sep 5.

ABSTRACT

CONTEXT: Successful root canal treatment (RCT) depends on effective irrigant activation to enhance disinfection and minimize the risk of apical periodontitis. Laser-activated irrigation (LAI) has shown promise; however, its periapical safety remains to be fully evaluated.

AIMS: The aim of this study was to assess and compare the periapical safety of erbium:yttrium-aluminum-garnet (Er: YAG) and diode laser irrigation protocols with passive ultrasonic irrigation (PUI) during RCT.

SETTINGS AND DESIGN: This was a quantitative in vitro experimental study.

METHODS: Sixty-six extracted human single-rooted teeth were standardized and fixed into a 96-well plate containing 300 μL of a pH indicator solution. Teeth were randomly allocated to three groups: PUI, diode laser, and Er: YAG laser. Irrigation with 5.25% sodium hypochlorite (NaOCl) was activated using the designated technique. Apical extrusion of NaOCl was quantified using ELISA-based spectrophotometry.

STATISTICAL ANALYSIS USED: Kruskal-Wallis and post hoc pairwise comparison tests were performed (P < 0.05).

RESULTS: All groups showed apical extrusion. The Er: YAG group had significantly less extrusion than the diode and PUI groups (P < 0.05).

CONCLUSIONS: Within the study’s limitations, Er: YAG and diode LAI reduced apical NaOCl extrusion compared to PUI, indicating improved periapical safety. Further clinical studies are needed.

PMID:40964642 | PMC:PMC12440348 | DOI:10.4103/JCDE.JCDE_463_25

J Conserv Dent Endod. 2025 Sep;28(9):911-915. doi: 10.4103/JCDE.JCDE_413_25. Epub 2025 Sep 5.

ABSTRACT

BACKGROUND: Irrigation is an essential component of successful endodontics. Various chemical irrigants have been assessed for their efficacy. Newer alternatives are being currently investigated to overcome the shortcomings of the currently used irrigants.

AIMS: The aim of the study was to compare the effectiveness of phytic acid in calcium ion removal and its effect on the microhardness of the root canal dentin during endodontic procedure.

SUBJECTS AND METHODS: This was an in vitro study conducted on 45 recently extracted single-rooted human mandibular premolars. They were decoronated and sectioned. One half of the tooth was used to evaluate calcium ion loss, while the other half was used to analyze microhardness.

STATISTICAL ANALYSIS: The data were analyzed using analysis of variance and Tukey’s post hoc analysis was used. P <0.001 was considered significant.

RESULTS: There was a less significant decrease in calcium level of root dentin after treatment with phytic acid as compared with ethylenediaminetetraacetic acid (EDTA). There was no significant difference between phytic acid and EDTA in relation to calcium ion loss and microhardness with their respective control group.

CONCLUSION: 1% Phytic acid is a suitable irrigating solution compared to 17% EDTA, due to its less demineralizing effect on radicular dentin.

PMID:40964641 | PMC:PMC12440339 | DOI:10.4103/JCDE.JCDE_413_25

BMC Psychol. 2025 Sep 17;13(1):1011. doi: 10.1186/s40359-025-03370-z.

ABSTRACT

BACKGROUND: Depression is a prevalent mental health concern among university students, particularly those in healthcare fields like pharmacy. The introduction of the Doctor of Pharmacy (PharmD) program in Egypt has brought new academic and professional pressures, making it critical to evaluate its impact on students’ mental well-being.

METHODS: A cross-sectional study was conducted among 576 PharmD students in Egypt using an online survey. The survey collected demographic information and assessed depression levels using the Beck Depression Inventory (BDI). Statistical analyses, including Mann-Whitney U tests and logistic regression, were used to identify predictors of depression.

RESULTS: The study found that 40.5% of participants exhibited borderline to moderate depression, while 24.7% displayed significant depressive symptoms. Key predictors of higher depression scores included socioeconomic status and type of university. Students attending public universities had significantly higher depression scores compared to those in private institutions (p = 0.033). Financial strain was strongly associated with higher depression levels, with students experiencing insufficient funds throughout the year showing the highest depression scores. Other demographic factors, such as sex, residence, and family involvement in healthcare, were not significantly associated with depression levels.

CONCLUSION: Depression is highly prevalent among PharmD students in Egypt, particularly those facing financial challenges or attending public universities. These findings underscore the urgent need for targeted mental health interventions and financial support programs to alleviate the psychological burden on pharmacy students.

PMID:40963148 | DOI:10.1186/s40359-025-03370-z

J Eat Disord. 2025 Sep 17;13(1):204. doi: 10.1186/s40337-025-01407-7.

ABSTRACT

BACKGROUND: Eating disorders (EDs) affect individuals across all genders, but men remain underrepresented in ED treatment settings. Stigma related to EDs in men may impede help-seeking, particularly for symptoms that deviate from traditional masculine ideals. This study investigates whether stigma-related perceptions of EDs in men specifically moderate the association between disordered eating symptoms and help-seeking intentions in men, i.e., whether there is a gender-specific component of ED stigma.

METHODS: In a cross-sectional survey, n = 242 men and n = 249 women completed questionnaires on various disordered eating symptoms (“traditional” thinness-oriented, muscularity-oriented, orthorexic, and avoidant/restrictive eating behaviors), stigma-related perceptions of EDs in men, and help-seeking intentions. Moderator analyses were conducted by gender to explore interactions between symptom severity and stigma in predicting help-seeking intentions.

RESULTS: Help-seeking intentions increased with the severity of disordered eating symptoms in both men and women, except for avoidant/restrictive eating behavior in both genders and muscularity-oriented symptoms in men. Stigma-related perceptions of EDs in men moderated the association between symptoms and help-seeking intentions in men, which was exclusively the case for “feminized” ED symptoms (i.e., thinness and weight concerns). No moderation effects were observed for other symptom domains or among women.

CONCLUSIONS: Results support the notion of a gender-specific role of stigma in men’s help-seeking behaviors for EDs. Such stigma, which seems to be related to “feminized” ED symptoms, may contribute to men’s reluctance to seek help for EDs. These findings emphasize the need for interventions tailored to reduce stigma, particularly regarding men’s experiences of EDs, to support equal access to healthcare.

PMID:40963138 | DOI:10.1186/s40337-025-01407-7

Isr J Health Policy Res. 2025 Sep 18;14(1):56. doi: 10.1186/s13584-025-00718-z.

ABSTRACT

BACKGROUND: The gradual increase in referrals to the busy Emergency Departments (ED) raises concerns about the potential negative effect on the quality of medical care and patient satisfaction. Urgent Care Center (UCC) provides an alternative to the ED for non-life saving medical conditions. This study aimed to compare the admission rates, reasons for referrals and patient’s satisfaction amongst UCCs based on their distance from the nearest ED.

METHODS: This cross-sectional study included all medical records of four UCCs between 2017 and 2020. Admission rates, reasons for referrals, and patients’ satisfaction were compared between UCCs located near and ED located farther away.

RESULTS: The study included 216,903 patients with an average age of 32.4±24.4 years. Most referrals were independent, with 37.7% occurring on weekends. The average triage time and total time spent in the UCCs were approximately 5.3 minutes and 62.8 minutes, respectively. The proportion of residents visiting UCCs in cities with an ED was 14.4% with a level of satisfaction of 91.5%, compared with UCCs in cities without ED where these figures were 23.7% and 84.4%, respectively. UCCs in northern Israel treated more patients with trauma/injury (33.0%) than UCCs in southern Israel (28.2%).

CONCLUSIONS: UCCs in the two locations without an ED received a higher volume of patients, while their satisfaction levels were lower. UCC serves as an alternative to ED for non-lifesaving medical conditions.

PMID:40963136 | DOI:10.1186/s13584-025-00718-z

BMC Prim Care. 2025 Sep 18;26(1):283. doi: 10.1186/s12875-025-03007-5.

ABSTRACT

BACKGROUND: The German rehabilitation system has some peculiar features, such as the predominance of inpatient medical rehabilitation. Most patients receive inpatient rehabilitation due to chronic illnesses like chronic backpain or psychosomatic diseases. General practitioners play a special role in the German healthcare system as they are often the first point of contact for health issues. The study aims to provide an overview of the involvement of general practitioners in inpatient medical rehabilitation in Germany as well as identifying barriers and facilitators. By doing this, a basis for optimizing general practitioners’ involvement can be generated.

METHODS: A scoping review was conducted to ascertain the current state of scientific knowledge, employing the methodological approach of the Joanna Briggs Institute. The search was carried out between February and March 2024. Eight databases were screened: PubMed, Web of Science Core Collection, PubPsych, EBSCOhost, BeLit, LIVIVO, ProQuest, and German National Library. Publications in German and English in the publication period from 1980 to February 2024 were sought. A thematic analysis was conducted to evaluate the included publications. The research process and generation of findings were recorded utilizing the PRISMA-ScR checklist.

RESULTS: The search resulted in a total of 2231 records, of which 102 were screened on a full text level. Fifty-four publications were included in the review. Following the thematic analysis, fourteen themes were identified and assigned to four topic areas. In the area of access, general practitioners take on a gatekeeper function (addressed by 10 publications) among other things. In follow-up care, there is involvement in prescription (5 publications), like referral to outpatient medical specialists. Barriers to involvement relate, for example, to a lack of knowledge on the part of general practitioners (10 publications) and facilitators include education and training (10 publications).

CONCLUSIONS: The results confirm the important role of general practitioners in providing access to inpatient medical rehabilitation in Germany and follow-up care. However, various barriers for general practitioners’ involvement were revealed. In order to maintain and optimize the involvement, further scientific research and efforts based on this in practice are necessary, involving relevant stakeholders.

PMID:40963134 | DOI:10.1186/s12875-025-03007-5

BMC Nurs. 2025 Sep 17;24(1):1172. doi: 10.1186/s12912-025-03776-5.

ABSTRACT

BACKGROUND: Toxic leadership undermines morale, job satisfaction, and retention among nurses. While previous studies have established its detrimental effects, the moderating role of nurses’ agility-a capacity for adaptation and resilience-remains underexplored, especially in the Egyptian healthcare context.

OBJECTIVE: This study examines the direct impact of toxic leadership on nurses’ quality of work life and explores whether nurses’ agility can mitigate these negative effects.

DESIGN AND METHODS: A cross-sectional, correlational design was used involving 265 full-time nurses across three hospitals in the Beni-Suef governorate, Egypt. Data collection instruments included the Toxic Leadership Scale, the Work-Related Quality of Life Scale, and the Workforce Agility Scale. Statistical analyses involved Pearson’s correlation, multiple linear regression, and moderation analysis via Hayes’ PROCESS macro.

RESULTS: Toxic leadership had a statistically significant negative impact on nurses’ quality of work life (r = -0.503, p < 0.001). Conversely, agility was positively associated with both toxic leadership (r = 0.159) and quality of work life (r = 0.425). Moderation analysis showed that nurses’ agility significantly buffered the negative effect of toxic leadership on quality of work life (β = 0.0049, p < 0.05).

CONCLUSION: Toxic leadership erodes nurses’ quality of work life, but nurses with high agility experience less deterioration in work satisfaction and well-being. This suggests that agility operates as a protective factor.

IMPLICATIONS FOR NURSING & POLICY: Healthcare institutions must address toxic leadership through leadership development programs and should proactively enhance nurses’ agility through training in adaptability, stress management, and situational problem-solving. This dual strategy can improve nurse retention and ultimately, patient care outcomes.

PATIENT OR PUBLIC CONTRIBUTION: Not applicable.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40963132 | DOI:10.1186/s12912-025-03776-5