Journal of pharmacy & bioallied sciences最新文献

Background: Gastric ulcer perforation remains a life-threatening emergency requiring timely surgical intervention. Multiple operative techniques exist, including primary closure, modified Graham's patch repair, gastrojejunostomy, and use of falciform ligament in cases of omental deficiency.

Materials and methods: A retrospective analysis was conducted from January 2020 to December 2024 involving 120 patients diagnosed with gastric ulcer perforation. The study included patients treated at both SRVS Medical College and a local private hospital. Based on intraoperative findings and surgeon preference, patients underwent one of the following surgical techniques: Group A (n = 40)-primary closure; Group B (n = 35)-modified Graham's patch repair; Group C (n = 25)-gastrojejunostomy for giant perforations; Group D (n = 20)-falciform ligament patch in cases with deficient greater omentum.

Results: Group A showed shorter operative time (mean 55 ± 10 min) and hospital stay (mean 6 ± 2 days), but had a 15% rate of minor leakage. Group B had a leakage rate of 8.5%, with slightly longer operative time (mean 70 ± 12 min). Group C, used in giant perforations (>2 cm), had the longest operative time (mean 95 ± 15 min) but the lowest leak rate (4%), albeit with a prolonged hospital stay (mean 10 ± 3 days). Group D showed moderate outcomes with a 10% complication rate and hospital stay of 8 ± 2 days. Mortality was highest in Group A (2 cases), likely due to delayed presentation and peritonitis.

Conclusion: Modified Graham's patch repair and gastrojejunostomy offer better outcomes in terms of leakage prevention and postoperative recovery compared to primary closure. The falciform ligament serves as a viable alternative in cases of omental deficiency.

Background: Orthodontically induced root resorption (OIRR) is a common iatrogenic consequence of orthodontic treatment, often going undetected until significant damage occurs. Noninvasive biomarkers could allow early detection and monitoring of OIRR. Salivary exosomal microRNAs (miRNAs) have emerged as potential indicators of inflammatory and resorptive processes in oral tissues.

Objective: To evaluate the expression of specific salivary exosomal miRNAs as potential biomarkers for early detection of OIRR in patients undergoing fixed orthodontic treatment.

Methods: A total of 60 patients (aged between 12 and 18 years), scheduled for fixed appliance therapy, were enrolled in a prospective cohort study. Saliva samples were collected at baseline, three months, and six months. Exosomes were isolated using ultracentrifugation, and miRNA profiling was performed using qRT-PCR. Cone-beam computed tomography (CBCT) was used to assess root resorption. The expression of miR-29a, miR-146a, and miR-155 was correlated with radiographic findings.

Results: Significant upregulation of salivary exosomal miR-146a and miR-155 was observed at three months (2.4 ± 0.7-fold and 3.1 ± 0.6-fold, respectively) and six months (3.7 ± 0.9-fold and 4.2 ± 1.1-fold, respectively; P < 0.001). Patients showing moderate-to-severe root resorption on CBCT had higher levels of these miRNAs. miR-29a showed no significant variation (P = 0.218). A strong correlation was observed between miR-155 levels and resorption scores (r = 0.79; P < 0.001).

Conclusion: Salivary exosomal miR-146a and miR-155 levels increase significantly during OIRR and may serve as early noninvasive biomarkers. This opens new avenues for chairside screening and preventive orthodontic strategies.

Background: Vitamin D is very important for insulin secretion and sensitivity, and not getting enough of it has been related to problems with glucose metabolism. Prediabetes is a stage of glucose intolerance that can be reversed. Finding modifiable risk factors, such as a lack of vitamin D, can aid with early intervention.

Materials and methods: A cross-sectional analytical investigation was done with 120 persons between the ages of 30 and 60 who had been diagnosed with prediabetes based on HbA1c readings between 5.7% and 6.4%. We used a chemiluminescent immunoassay to find out how much 25-hydroxyvitamin D [25(OH)D] was in the serum. We put the participants into three categories based on their vitamin D levels: deficient (<20 ng/mL), insufficient (20-29 ng/mL), and sufficient (≥30 ng/mL). We looked at glycemic indicators, such as fasting blood glucose (FBG), HbA1c, and homeostatic model assessment of insulin resistance among groups.

Results: Out of 120 people, 48 (40%) were low in vitamin D, 44 (36.7%) were not getting enough, and 28 (23.3%) were getting enough. The average FBG was much greater in the group that did not get enough vitamin D (112.3 ± 9.4 mg/dL) than in the group that did (102.1 ± 8.6 mg/dL) (P = 0.003). In the same way, the average HbA1c levels were 6.3% ±0.2% in the insufficient group and 5.9% ±0.3% in the sufficient group (P = 0.001). There was a strong negative connection between serum 25(OH)D and HbA1c (r = -0.42, P < 0.01).

Conclusion: A lack of vitamin D is strongly linked to poor blood sugar management in persons who are prediabetic. Checking and fixing vitamin D levels may help those who are at risk of getting type 2 diabetes delay or avoid getting it.

Background: Interpreting pulmonary function tests (PFTs) accurately is essential for diagnosing and monitoring respiratory disorders. However, manual interpretation is subject to interobserver variability. Artificial intelligence (AI) offers a promising tool to enhance diagnostic consistency and accuracy.

Objectives: To evaluate the diagnostic accuracy of an AI-based interpretation system for PFTs in comparison with expert pulmonologist consensus and to assess its applicability in clinical settings.

Methods: A cross-sectional diagnostic accuracy study was conducted among 200 adult patients undergoing spirometry and full PFT. AI software analyzed raw PFT data to classify patterns as normal, obstructive, restrictive, or mixed. Three pulmonologists independently reviewed the same data, and their consensus was considered the reference standard. Diagnostic performance metrics, including sensitivity, specificity, accuracy, and Cohen's kappa, were calculated.

Results: The AI system correctly identified 38/40 normal, 76/80 obstructive, 44/50 restrictive, and 27/30 mixed patterns, with an overall diagnostic accuracy of 92%. Sensitivity and specificity were 91.5% and 93.2%, respectively. Cohen's kappa was 0.86, indicating strong agreement with expert interpretations.

Conclusion: AI-assisted interpretation of PFTs demonstrates high diagnostic concordance with pulmonologist consensus and holds potential for standardized, efficient respiratory diagnostics.

Background: Cognitive impairments, often termed "brain fog," have emerged as prevalent sequelae among individuals recovering from COVID-19. Despite increasing recognition, systematic neuropsychological evaluation data remain limited.

Methods: A prospective observational study was conducted between February 2023 and December 2024 in a tertiary care neurorehabilitation center. One hundred twenty post-COVID-19 patients (mean age 44.6 ± 11.3 years; 58.3% male) presenting with cognitive complaints at least 3 months after recovery were recruited. Patients underwent evaluation using the Montreal Cognitive Assessment (MoCA), Trail Making Test A and B (TMT-A, TMT-B), and Digit Span Test. A control group of 60 age- and education-matched individuals without prior COVID-19 served as comparison. Statistical analysis included independent t-tests, chi-square tests, and multivariate logistic regression (P < 0.05).

Results: Cognitive impairment (MoCA score <26) was observed in 66.7% of post-COVID-19 participants compared to 15.0% of controls (P < 0.001). Post-COVID patients showed significantly slower TMT-A (43.7 ± 12.9 vs 31.2 ± 9.6 sec; P < 0.001) and TMT-B times (95.8 ± 22.4 vs 76.5 ± 17.8 sec; P < 0.001). Working memory (Digit Span backward) was also impaired (mean score: 4.2 ± 0.9 vs 5.3 ± 0.8; P < 0.001). Severity of initial infection (hospitalized vs non-hospitalized) was associated with increased odds of impairment (OR: 2.87; 95% CI: 1.22-6.74; P = 0.015).

Conclusion: Cognitive deficits are common in post-COVID-19 patients, particularly affecting attention, processing speed, and working memory. Structured cognitive screening and rehabilitation may be essential components of long-term COVID-19 care.

Background: Periodontal intrabony defects pose a significant therapeutic challenge in periodontitis management. The single-flap approach (SFA) is a minimally invasive alternative to conventional open-flap debridement (OFD), aiming to improve healing outcomes and reduce surgical trauma.

Aim: To compare the clinical and radiographic outcomes of SFA and OFD, both combined with calcium phosphosilicate (CPS) bone graft in the treatment of intrabony defects.

Materials and methods: This randomized clinical trial included 24 systemically healthy patients with chronic periodontitis and comparable intrabony defects. Patients were allocated into two groups: Group A (SFA + CPS putty) and Group B (OFD + CPS putty). Clinical parameters, including plaque index (PI), gingival index (GI), oral hygiene index-simplified (OHI-S), probing pocket depth (PPD), and relative attachment level (RAL), were measured at baseline, 3, 6, 9, and 12 months. Radiographic assessment using CBCT was conducted at baseline and 12 months to determine percentage bone fill.

Results: Both techniques resulted in significant improvements. However, SFA showed superior reductions in PPD and better clinical attachment gain. Radiographically, the SFA group demonstrated significantly greater bone fill at 12 months (P = 0.043).

Conclusion: SFA combined with CPS graft provides a less invasive and effective alternative to OFD, offering enhanced clinical outcomes and faster healing.

Background: The longevity and biocompatibility of dental implants are critically dependent on their surface characteristics and resistance to corrosion. However, contamination with oral fluids, such as saliva, during surgical placement may compromise these properties. This study aimed to evaluate the effect of salivary contamination on the surface integrity and corrosion resistance of titanium dental implants.

Materials and methods: A total of 40 commercially pure titanium implants were divided into two groups (n = 20 each). Group A (control) received no salivary exposure, while Group B (experimental) was exposed to human whole saliva for 30 min before undergoing thermocycling and immersion in artificial saliva for seven days. Surface topography was assessed using scanning electron microscopy (SEM) and atomic force microscopy. Corrosion resistance was measured by potentiodynamic polarization in simulated body fluid. Statistical analysis was conducted using independent t-tests, with significance set at P < 0.05.

Results: Group B exhibited a significant increase in surface roughness (Ra: 0.71 ± 0.09 µm) compared to Group A (Ra: 0.52 ± 0.06 µm) (P = 0.002). SEM images revealed micro-pitting and biofilm residues in Group B. Electrochemical analysis showed a lower corrosion potential (-245 ± 15 mV) and higher corrosion current density (1.9 ± 0.3 µA/cm²) in Group B compared to Group A (-175 ± 12 mV, 1.2 ± 0.2 µA/cm²), with statistically significant differences (P < 0.01).

Conclusion: Salivary contamination before implant placement significantly impairs surface integrity and reduces corrosion resistance. These findings underscore the importance of maintaining strict aseptic conditions during implant surgery to ensure optimal implant longevity.

Background: The long-term success of implant-supported prostheses relies not only on osseointegration but also on the prevention of prosthodontic complications. Two common retention methods-screw-retained and cement-retained crowns-exhibit distinct clinical advantages and potential drawbacks.

Materials and methods: A prospective observational study was conducted on 100 patients receiving implant-supported single crowns-50 with screw-retained and 50 with cement-retained designs. All patients were followed up for 12 months to evaluate complications, such as screw loosening, crown fracture, marginal gap, cement washout, peri-implantitis, and prosthesis decementation. Data were analyzed using Chi-square and t-tests (P < 0.05 considered significant).

Results: Screw loosening was more prevalent in screw-retained crowns (18%) compared to cement-retained (4%) (P = 0.032). Marginal discrepancies and cement washout were more common in the cement-retained group (marginal gap: 20%, cement washout: 14%) than in screw-retained (8%, 2%, respectively) (P < 0.05). Peri-implantitis was higher in cement-retained crowns (10%) versus screw-retained (4%) (P = 0.146, not significant). No significant difference was found in crown fractures (screw-retained: 4%, cement-retained: 6%, P = 0.712).

Conclusion: Both systems have distinct complication profiles. Screw-retained crowns showed higher mechanical issues, while cement-retained crowns demonstrated increased biological complications. Appropriate case selection and clinical protocols can minimize these issues.

Background: Precision in implant placement is a critical determinant of clinical success in implant dentistry. Computer-aided navigation systems, including static and dynamic modalities, have been developed to enhance accuracy. However, comparative data evaluating their effectiveness remain limited.

Objective: This study aimed to compare the accuracy of implant placement using dynamic navigation versus static guided systems in terms of angular deviation, global entry deviation, and apical deviation.

Materials and methods: A total of 40 implants were placed in 20 partially edentulous patients. Each patient received two implants: one using static navigation and the other with dynamic navigation. Postoperative cone beam computed tomography scans were analyzed using specialized implant planning software to calculate deviations in implant position relative to preoperative planning. Mean deviations were compared using paired t-tests.

Results: The mean angular deviation was significantly lower in the dynamic navigation group (2.15° ±0.68°) compared to the static group (3.74° ±1.12°; P < 0.001). Entry point deviation averaged 0.78 ± 0.25 mm for dynamic navigation and 1.14 ± 0.38 mm for static guidance (P = 0.003). Apical deviation was 1.12 ± 0.31 mm for dynamic navigation versus 1.55 ± 0.49 mm for static navigation (P = 0.001).

Conclusion: Dynamic navigation demonstrated superior accuracy compared to static guidance in implant placement. These findings suggest that dynamic systems may offer clinicians enhanced control and precision, especially in anatomically complex cases.

Background: This study aimed to compare the performance of flow cytometry and enzyme-linked immunosorbent assay (ELISA) in detecting Ki-67 and HLA-DR in whole blood from individuals with active TB, latent TB infection (LTBI), and healthy controls.

Methods: A total of 60 participants were enrolled and categorized into three groups: active TB (n = 20), LTBI (n = 20), and healthy controls (n = 20). Whole-blood samples were analyzed using flow cytometry for intracellular Ki-67 and surface HLA-DR expression in T cells, and ELISA for quantification of their soluble forms. Statistical comparisons were performed using ANOVA and Pearson correlation.

Results: Flow cytometry revealed significantly elevated Ki-67 (12.4 ± 2.1%) and HLA-DR (18.7 ± 3.6%) expression in active TB compared to LTBI (5.6 ± 1.4%, 9.5 ± 2.1%) and controls (1.9 ± 0.7%, 3.2 ± 1.2%), respectively (P < 0.001). ELISA also detected increased concentrations of both markers in active TB (Ki-67: 4.2 ± 1.1 ng/mL; HLA-DR: 6.8 ± 1.7 ng/mL) but with reduced sensitivity. A strong positive correlation was observed between flow cytometry and ELISA results for both biomarkers (r > 0.75, P < 0.01).

Conclusion: Flow cytometry offers high sensitivity for TB immune markers, while ELISA is a practical alternative. Ki-67 and HLA-DR are promising biomarkers for TB diagnosis and monitoring.