Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.
Dental Care ; Dental Pulp ; Hand ; Humans ; Inflammation ; Neurophysiology ; Pulpitis

Objectives: Patients with coronavirus disease 2019 (COVID-19) present with a variety of oral manifestations. Therefore, we conducted a systematic review to estimate the prevalence of oral lesions among COVID-19 patients. Methods: An extensive literature search of several electronic bibliographic databases (PubMed, Scopus, Science Direct, Litcovid) was conducted to retrieve all articles published in the English language from January 1, 2020 to March 31, 2023 that reported the prevalence of oral manifestations among COVID-19 patients. A meta-analysis of pooled prevalence was performed using Jamovi ver. 2.3 (2022). The I2 and Q statistics were used to assess heterogeneity between studies, and p-values < 0.01 were considered statistically significant. Results: In total, 79 studies with data from 13,252 patients were included. The articles were predominantly published in 2020 (n = 33), and Italy was the most common country (n = 14). Most of the affected patients more than 50 years old and women (56.6%). The most common sites of involvement were the tongue (n = 65), followed by the oral mucosa (n = 37) and lips (n = 19). High heterogeneity was found between studies. The most common oral manifestation was taste alteration, followed by xerostomia and ulceration, showing pooled prevalence rates of 48%, 35%, and 21%, respectively. Conclusion COVID-19 patients show various oral manifestations that may help clinicians identify the disease promptly. Recognition of the signs and symptoms of COVID-19 is critical for an early diagnosis and better prognosis.

PURPOSE: The p38 mitogen-activated protein kinase (MAPKs) play a crucial role in the production of pro-inflammatory cytokines and over-expression of it increase cytokines which promote cancer. Among four isoforms, p38α has been well studied in head and neck squamous cell carcinoma (HNSCC) and other cancers as a therapeutic target. p38δ has recently emerged as a potential disease-specific drug target. Elevated serum p38α level in HNSCC was reported earlier from our lab. This study aims to estimate the levels of p38 MAPK-isoforms in the serum of HNSCC and design peptide inhibitor targeting the same. MATERIALS AND METHODS: Levels of p38 MAPK isoforms in the serum of HNSCC and healthy controls were quantified by surface plasmon resonance technology. The peptide inhibitor for p38 MAPK was designed by molecular modeling using Grid-based Ligand Docking with Energetics tools and compared with known specific inhibitors. RESULTS: We have observed highly elevated levels of all four isoforms of p38 MAPK in serum of HNSCC patients compared to the control group. Further, serum p38α, p38β, and p38δ levels were down regulated after therapy in follow-up patients, while p38γ showed no response to the therapy. Present study screened designed peptide WFYH as a specific inhibitor against p38δ. The specific inhibitor of p38δ was found to have no effect on p38α due to great structural difference at ATP binding pocket. CONCLUSION: In this study, first time estimated the levels of p38 MAPK isoforms in the serum of HNSCC. It can be concluded that p38 MAPK isoforms can be a diagnostic and prognostic marker for HNSCC and p38δ as a therapeutic target.
Adenosine Triphosphate ; Carcinoma, Squamous Cell* ; Cytokines ; Epithelial Cells* ; Follow-Up Studies ; Head* ; Humans ; Models, Molecular ; Neck* ; p38 Mitogen-Activated Protein Kinases ; Protein Isoforms* ; Protein Kinases ; Surface Plasmon Resonance

STUDY DESIGN: Prospective clinical study. PURPOSE: The present study aimed to examine the neurological recovery pattern in cervical spondylotic myelopathy (CSM) after anterior cervical decompression and compare it with the existing reports in the literature. OVERVIEW OF LITERATURE: Neurological recovery and regression of myelopathy symptoms is an important factor that determines the outcomes of surgical decompression. The present findings contribute to the literature on the pattern of neurological recovery and patient prognosis with respect to the resolution of myelopathy symptoms after surgery. METHODS: This prospective study was conducted in Government Medical College in Jammu, North India between November 2012 and October 2014, a total of 30 consecutive patients with CSM were included and treated with anterior decompression and stabilization. They were prospectively followed up for 1 year and were evaluated for their neurological recovery pattern. The postoperative outcome was evaluated using the modified Japanese Orthopaedic Association (mJOA) score. The recovery rate was calculated using Hirabayashi's method. The JOA score was assessed before the operation and postoperatively at 1 week, 2 weeks, 1 month, 3 months, 4 months, 6 months, and 1 year. RESULTS: The postoperative mJOA score was 0 in the 1st month, 12.90±3.57 in the 3rd month, 13.50±3.55 in the 4th month, 14.63±3.62 in the 6th month, and 14.9±3.24 at the final follow-up of 1 year. The average recovery rate during the 1st month follow-up was 0%, and that during the 3rd month follow-up was 12.91% with a range of 0%–50%. The average recovery rate during the 4th month was 32.5%, with a range of 0%–60%, while that during the 6th month was 72.83%, with a range of 0%–100%. The average recovery rate during the final follow-up of 1 year was 54.3%. CONCLUSIONS: Neurological recovery after surgical decompression starts from the 3rd postoperative month and progresses until the 6th postoperative month; thereafter, it gradually plateaus over the subsequent 6 months until it steadies. Symptom duration is an important factor that requires consideration while determining postoperative neurological recovery.
Asian Continental Ancestry Group ; Clinical Study ; Decompression ; Decompression, Surgical ; Follow-Up Studies ; Humans ; India ; Methods ; Prognosis ; Prospective Studies ; Spinal Cord Diseases

The COVID-19 pandemic has revealed sex-based differences in anti-viral responses, with a higher rate of SARS-CoV-2 infections as well as a higher rate of morbidity and mortality in men than in women. Males and females also show disparate immune responses to COVID-19 infection, which may be important contributors to lower rates of infection, disease severity and deaths in women than in men. Here, the authors review sex differences in SARSCoV- 2 infections, anti-viral immunity and vaccine responses, putting forth the importance of sex, the underappreciated variables in vaccine response and disease infectivity.