Journal of pharmacy & bioallied sciences最新文献

Background: Tooth loss significantly affects oral function and quality of life. While conventional complete dentures (CDs) have long been the standard treatment for edentulous patients, implant-supported overdentures (IODs) offer improved retention, stability, and function.

Materials and methods: A total of 40 completely edentulous patients aged between 50 and 75 years were enrolled in this comparative study. Participants were divided into two groups: Group A (n = 20) received conventional maxillary and mandibular dentures, while Group B (n = 20) received mandibular IODs retained with two implants and conventional maxillary dentures. Patient satisfaction was assessed using a standardized questionnaire comprising ten items related to comfort, stability, speech, and aesthetics using a 5-point Likert scale. Masticatory efficiency was evaluated using the sieving method with standardized food particles (peanuts) and measuring particle size distribution after chewing.

Results: Patients in the IOD group (Group B) reported significantly higher satisfaction scores (mean = 45.2 ± 3.1) compared to the CD group (mean = 36.7 ± 4.5), P < 0.001. Masticatory efficiency was also significantly better in Group B, with a greater percentage of finely chewed particles (mean = 72.5% ±5.4%) compared to Group A (mean = 54.3% ±6.7%), P < 0.001. Improvements in stability, comfort during mastication, and confidence in social settings were notable in the IOD group.

Conclusion: IODs provide superior patient satisfaction and masticatory efficiency compared to conventional CDs. They significantly enhance oral function and quality of life for edentulous individuals and should be considered a preferred treatment option when feasible.

Background: Abnormal uterine bleeding (AUB), particularly heavy menstrual bleeding (HMB), significantly impairs women's health and quality of life. Levonorgestrel intrauterine system (LNG-IUS) offers a uterus-sparing alternative to surgical interventions.

Objective: To evaluate the efficacy and safety of LNG-IUS in the long-term management of AUB unrelated to intrauterine pathology.

Materials and methods: A prospective observational study was conducted on 30 parous women aged 33-48 years with recurrent HMB. LNG-IUS was inserted within 7 days of menstruation onset, and patients were followed at 1, 3, 6, 12, and 24 months. Bleeding intensity and side effects were recorded.

Results: Out of 30 patients, 21 (70%) reported a significant reduction in bleeding. Only 9 patients (30%) required a hysterectomy. Mild side effects were reported in 33.3% of cases.

Conclusion: LNG-IUS is an effective, well-tolerated, long-term treatment for AUB and can reduce the need for hysterectomy.

Achieving a natural aesthetic outcome in completely edentulous patients is often challenging, especially when unique oral tissue characteristics such as mucosal pigmentation are present. Conventional denture bases may provide adequate function but frequently fail to reproduce individualized soft-tissue appearance, which can influence the patient's confidence, facial harmony, and social comfort. This case report describes a 72-year-old male with complete edentulism and pigmented keratinized mucosa in both arches. After standard denture fabrication, internal tinting techniques were used to characterize the denture base using heat-cure monomer mixed with specialized pigments. Layered coloration was applied to replicate the natural transitional shades of gingiva and alveolar mucosa. The processed prosthesis showed superior life-like texture and esthetics without affecting strength or fit. The patient reported improved appearance, comfort, phonetics, and masticatory efficiency, with no complications during follow-up. This technique demonstrates that internal denture base characterization is a simple, predictable, and cost-effective method to enhance the esthetic realism of complete dentures and can contribute significantly to psychological well-being and patient satisfaction.

Background: Removing impacted third molars in the lower jaw can often cause problems, such as pain, swelling, and slow regrowth of tissue. Postoperative healing is often improved using platelet-rich fibrin (PRF) and collagen membranes.

Materials and methods: Sixty patients needing the removal of bilateral mandibular third molars were randomly assigned to the two groups (30 patients in each group). Group A used PRF put into the extraction socket, and Group B placed a collagen membrane. Pain (based on visual analog scale), swelling (measured), and soft tissue healing (using the Landry's healing index) were compared on the 3^rd, 7^th, and 14^th postoperative days. Researchers used SPSS version 25.0 with a significance of P < 0.05.

Results: On the third day, the pain score was lower on average in the PRF group (3.2) than in the collagen group (4.5). In Group A, the swelling was lower (4.1 ± 0.6 mm) compared to Group B (5.6 ± 0.9 mm). By the fourteenth day, tissues in the PRF group (4.6 ± 0.4) scored higher for healing, proving they healed faster compared to the collagen group (3.9 ± 0.6) (P < 0.01). Everyone involved in the study reported no negative experiences.

Conclusion: During the first few days after having third molar teeth removed, patients who used PRF experienced better pain management, a reduction in swelling, and swifter healing of the tissues than those who used collagen membranes.

Background: Gynecologic oncology surgeries are often extensive and associated with significant physiological stress and inflammation. Anesthetic technique may modulate perioperative immune and stress responses, potentially influencing postoperative outcomes.

Methods: A prospective, randomized clinical study was conducted on 80 patients (aged 35-65 years) undergoing gynecologic oncology surgeries. Patients were randomly assigned to two groups: Group T (TIVA with propofol and remifentanil) and Group I (IA with sevoflurane and fentanyl). Blood samples were collected preoperatively (T0), immediately after surgery (T1), and 24 hours postoperatively (T2) to measure interleukin-6 (IL-6), C-reactive protein (CRP), cortisol, and epinephrine levels. Hemodynamic stability and postoperative complications were also evaluated.

Results: IL-6 and CRP levels were significantly lower in Group T at T1 and T2 (IL-6 at T2: 65.3 ± 12.4 pg/mL vs. 94.1 ± 14.8 pg/mL, P < 0.001; CRP at T2: 3.9 ± 0.7 mg/dL vs. 5.6 ± 1.1 mg/dL, P < 0.001). Cortisol and epinephrine levels were also significantly reduced in Group T at T1 (cortisol: 422.6 ± 60.3 nmol/L vs. 569.7 ± 82.1 nmol/L, P < 0.01). Group T demonstrated better hemodynamic control and fewer postoperative nausea and vomiting episodes.

Conclusion: TIVA attenuated the inflammatory and stress biomarker response more effectively than inhalational anesthesia in patients undergoing gynecologic oncology surgeries. TIVA may offer potential benefits in perioperative immune modulation and recovery in this patient population.

Introduction: Periodontitis is an infection of the tissues, surrounding and supporting the teeth. Certain systemic conditions affect periodontal tissues and vice-versa. The research investigates how systemic illness influence periodontal health of medically frail patients, came to obtain oral healthcare in teaching hospitals of Riyadh City.

Materials and methods: A retrospective study design was employed, analyzing patient files from the past 10 years. Patients diagnosed with medically compromised conditions (e.g., diabetes, cardiovascular diseases, immunosuppressive disorders) and with complete periodontal records were included. Chi-square test was done.

Results: Chi-square test was done to compare between the groups and the findings showed that overall there was no statistically significant difference among the groups except when compared on the basis of plaque index and percentage bone loss (P value. 002 and. 030, respectively).

Conclusion: From the present study it was concluded that, though diabetes and hypertension, showed greater plaque build-up and poor periodontal health outcomes.

Introduction: Anticipation of a difficult airway is essential for safe anesthesia. Unanticipated difficult intubations remain a major cause of morbidity and mortality in the perioperative period. Several bedside airway assessment tests exist, but their accuracy varies.

Aim: To compare the predictive value of the Modified Mallampati Test (MMT), Upper Lip Bite Test (ULBT), and Thyromental Distance (TMD) against the Cormack-Lehane (CL) grading for predicting difficult intubation.

Materials and methods: A prospective observational study was conducted on 150 ASA I-II patients (18-60 years) scheduled for elective surgery under general anesthesia. Preoperative airway assessment included MMT, ULBT, and TMD performed by a single anesthesiologist. Direct laryngoscopy was performed under standardized anesthesia, and CL grades were recorded. Grades III-IV were considered difficult intubation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each bedside test were calculated using CL grading as the gold standard.

Results: Difficult intubation was encountered in 20 patients (13.33%), with 18 graded CL III and 2 graded CL IV. Sensitivity and specificity were: MMT - 45% and 96.15%; TMD - 65% and 94.61%; ULBT - 80% and 96.92%. ULBT showed the highest predictive accuracy.

Conclusion: ULBT demonstrated superior sensitivity and specificity among the tests evaluated, but no single bedside test was sufficiently accurate to predict all difficult intubations. A combination of tests is recommended for preoperative airway assessment.

Background: Obstructive sleep apnea (OSA) is a chronic condition characterized by intermittent upper airway obstruction during sleep. Temporomandibular disorders (TMDs), often linked with chronic pain and disturbed sleep, may coexist with OSA, but the association remains unclear.

Aim: To assess the prevalence of TMD in patients diagnosed with OSA and evaluate the relationship between TMD phenotypes and severity of sleep apnea.

Materials and methods: This cross-sectional observational study was conducted among 70 OSA-diagnosed individuals using the ApneaLink Air device. TMD was assessed through RDC/TMD clinical criteria. Associations were evaluated with statistical significance set at P < 0.05.

Results: TMD signs/symptoms were found in 8.6% of OSA patients, with myofascial pain being the predominant phenotype. No significant association was observed between TMD phenotype and OSA severity (P = 0.265).

Conclusion: TMDs are present in a subset of OSA patients, predominantly as muscle disorders. However, the relationship between TMD phenotypes and OSA severity is inconclusive, necessitating further longitudinal research.

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality globally. Resistance to chemotherapy, particularly to first-line regimens such as FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin), remains a critical barrier to successful treatment.

Methods: This prospective observational study enrolled 96 patients with stage II-IV colorectal adenocarcinoma receiving first-line FOLFOX chemotherapy. Plasma samples were collected at baseline, post-cycle 3, and post-cycle 6 for ctDNA quantification and sequencing of KRAS, NRAS, and TP53 mutations. Radiological tumor response was assessed by RECIST v1.1 criteria. Statistical analysis included ANOVA, Chi-square tests, and logistic regression.

Results: Among 96 patients (mean age 60.3 ± 8.2 years; 58.3% male), 34 (35.4%) exhibited chemoresistance. Baseline ctDNA levels were significantly higher in resistant patients (38.7 ± 10.5 ng/mL) compared to responders (25.4 ± 9.3 ng/mL, P < 0.001). TP53 mutations were more frequent in resistant patients (58.8% vs. 27.9%, P = 0.004). A >20% reduction in ctDNA by cycle 3 was associated with treatment response (OR 4.12, 95% CI 1.76-9.67, P = 0.001). ROC curve analysis yielded an AUC of 0.84 for ctDNA reduction as a predictor of chemoresistance.

Conclusion: Elevated baseline ctDNA levels and persistent TP53 mutations are associated with chemoresistance in colorectal cancer. Early reduction in ctDNA during therapy may serve as a robust predictor of response, supporting its integration into personalized treatment strategies.

Background: CBCT is widely used in dental diagnostics, but image artifacts from prosthodontic crowns can reduce diagnostic clarity. This study evaluated the effect of crown materials-metal, PFM, and zirconia-on CBCT visibility.

Materials and methods: CBCT scans of patients with different crowns were retrospectively analyzed. Key landmarks such as the periapical area, lamina dura, and bone were assessed using the diagnostic visibility score (DVS, 0-4). Two observers independently evaluated the scans.

Results: Metal crowns produced the most artifacts, followed by PFM crowns. Zirconia crowns caused minimal distortion, preserving visibility. Differences among groups were statistically significant with high interobserver agreement.

Conclusion: Zirconia crowns provide better diagnostic visibility in CBCT scans. Crown material selection plays a vital role in image interpretation accuracy.