Background: This study aimed to evaluate and compare the efficacy of oral premedication with ibuprofen on the anesthetic efficacy of inferior alveolar nerve block (IANB) using 2% lignocaine and 1:100000 epinephrine in tobacco-chewing (TC) and non-tobacco-chewing (NTC) patients with symptomatic irreversible pulpitis (SIP) during nonsurgical endodontic intervention (NEI). Methods: This multicenter, prospective, double-blind, two-arm parallel-group randomized controlled trial involving 160 patients was conducted for a period of 9 months. The patients were classified into the study (TC patients) and control (NTC patients) groups, which were subdivided into two subgroups 1 hour before the procedure based on oral premedication with tab ibuprofen 600 mg. Nicotine dependence was assessed using the Modified Fagerstrom Tolerance Nicotine Scale. Patients were administered an IANB injection of 2% lignocaine containing epinephrine 1:100000 after premedication. Pulpal anesthesia before NEI was confirmed using electric pulp testing and cold spraying. Patients rated their pain on the 10-point visual analog scale (VAS) during NEI thrice at the dentin, pulp, and instrumentation levels. No pain at each level indicated the success of anesthesia. Results: The success and failure rates did not differ between the premedication and non-premedication subgroups in the TC or NTC groups (P > 0.05). However, the success rate was higher in the premedication subgroup of the NTC group (52.5%) than in the TC group (45%). Most patients with premedication experienced failure at the instrumentation level, whereas patients in the non-premedication group experienced pain at the dentin level. Failure rates of IANB did not differ significantly at different levels between the groups (P > 0.05). The mean VAS scores differed significantly at the dentin level in both groups, with lower values in the premedication group (P < 0.05). Conclusions The efficacy of ibuprofen premedication with IANB during NEI did not differ significantly between the TC and NTC patients with SIP. The effect of premedication was more significant in the NTC group than in the TC group. A causal relationship between nicotine consumption and the success of premedication could not be established, and further studies are required to validate the results of the present study.

Background: This study aimed to evaluate and compare the efficacy of oral premedication with ibuprofen on the anesthetic efficacy of inferior alveolar nerve block (IANB) using 2% lignocaine and 1:100000 epinephrine in tobacco-chewing (TC) and non-tobacco-chewing (NTC) patients with symptomatic irreversible pulpitis (SIP) during nonsurgical endodontic intervention (NEI). Methods: This multicenter, prospective, double-blind, two-arm parallel-group randomized controlled trial involving 160 patients was conducted for a period of 9 months. The patients were classified into the study (TC patients) and control (NTC patients) groups, which were subdivided into two subgroups 1 hour before the procedure based on oral premedication with tab ibuprofen 600 mg. Nicotine dependence was assessed using the Modified Fagerstrom Tolerance Nicotine Scale. Patients were administered an IANB injection of 2% lignocaine containing epinephrine 1:100000 after premedication. Pulpal anesthesia before NEI was confirmed using electric pulp testing and cold spraying. Patients rated their pain on the 10-point visual analog scale (VAS) during NEI thrice at the dentin, pulp, and instrumentation levels. No pain at each level indicated the success of anesthesia. Results: The success and failure rates did not differ between the premedication and non-premedication subgroups in the TC or NTC groups (P > 0.05). However, the success rate was higher in the premedication subgroup of the NTC group (52.5%) than in the TC group (45%). Most patients with premedication experienced failure at the instrumentation level, whereas patients in the non-premedication group experienced pain at the dentin level. Failure rates of IANB did not differ significantly at different levels between the groups (P > 0.05). The mean VAS scores differed significantly at the dentin level in both groups, with lower values in the premedication group (P < 0.05). Conclusions The efficacy of ibuprofen premedication with IANB during NEI did not differ significantly between the TC and NTC patients with SIP. The effect of premedication was more significant in the NTC group than in the TC group. A causal relationship between nicotine consumption and the success of premedication could not be established, and further studies are required to validate the results of the present study.

Background: This study aimed to evaluate and compare the efficacy of oral premedication with ibuprofen on the anesthetic efficacy of inferior alveolar nerve block (IANB) using 2% lignocaine and 1:100000 epinephrine in tobacco-chewing (TC) and non-tobacco-chewing (NTC) patients with symptomatic irreversible pulpitis (SIP) during nonsurgical endodontic intervention (NEI). Methods: This multicenter, prospective, double-blind, two-arm parallel-group randomized controlled trial involving 160 patients was conducted for a period of 9 months. The patients were classified into the study (TC patients) and control (NTC patients) groups, which were subdivided into two subgroups 1 hour before the procedure based on oral premedication with tab ibuprofen 600 mg. Nicotine dependence was assessed using the Modified Fagerstrom Tolerance Nicotine Scale. Patients were administered an IANB injection of 2% lignocaine containing epinephrine 1:100000 after premedication. Pulpal anesthesia before NEI was confirmed using electric pulp testing and cold spraying. Patients rated their pain on the 10-point visual analog scale (VAS) during NEI thrice at the dentin, pulp, and instrumentation levels. No pain at each level indicated the success of anesthesia. Results: The success and failure rates did not differ between the premedication and non-premedication subgroups in the TC or NTC groups (P > 0.05). However, the success rate was higher in the premedication subgroup of the NTC group (52.5%) than in the TC group (45%). Most patients with premedication experienced failure at the instrumentation level, whereas patients in the non-premedication group experienced pain at the dentin level. Failure rates of IANB did not differ significantly at different levels between the groups (P > 0.05). The mean VAS scores differed significantly at the dentin level in both groups, with lower values in the premedication group (P < 0.05). Conclusions The efficacy of ibuprofen premedication with IANB during NEI did not differ significantly between the TC and NTC patients with SIP. The effect of premedication was more significant in the NTC group than in the TC group. A causal relationship between nicotine consumption and the success of premedication could not be established, and further studies are required to validate the results of the present study.

Background: This study aimed to evaluate and compare the efficacy of oral premedication with ibuprofen on the anesthetic efficacy of inferior alveolar nerve block (IANB) using 2% lignocaine and 1:100000 epinephrine in tobacco-chewing (TC) and non-tobacco-chewing (NTC) patients with symptomatic irreversible pulpitis (SIP) during nonsurgical endodontic intervention (NEI). Methods: This multicenter, prospective, double-blind, two-arm parallel-group randomized controlled trial involving 160 patients was conducted for a period of 9 months. The patients were classified into the study (TC patients) and control (NTC patients) groups, which were subdivided into two subgroups 1 hour before the procedure based on oral premedication with tab ibuprofen 600 mg. Nicotine dependence was assessed using the Modified Fagerstrom Tolerance Nicotine Scale. Patients were administered an IANB injection of 2% lignocaine containing epinephrine 1:100000 after premedication. Pulpal anesthesia before NEI was confirmed using electric pulp testing and cold spraying. Patients rated their pain on the 10-point visual analog scale (VAS) during NEI thrice at the dentin, pulp, and instrumentation levels. No pain at each level indicated the success of anesthesia. Results: The success and failure rates did not differ between the premedication and non-premedication subgroups in the TC or NTC groups (P > 0.05). However, the success rate was higher in the premedication subgroup of the NTC group (52.5%) than in the TC group (45%). Most patients with premedication experienced failure at the instrumentation level, whereas patients in the non-premedication group experienced pain at the dentin level. Failure rates of IANB did not differ significantly at different levels between the groups (P > 0.05). The mean VAS scores differed significantly at the dentin level in both groups, with lower values in the premedication group (P < 0.05). Conclusions The efficacy of ibuprofen premedication with IANB during NEI did not differ significantly between the TC and NTC patients with SIP. The effect of premedication was more significant in the NTC group than in the TC group. A causal relationship between nicotine consumption and the success of premedication could not be established, and further studies are required to validate the results of the present study.

PURPOSE: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). METHODS: Singleton term newborns with BA and < or =72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. RESULTS: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. CONCLUSION: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.
Alanine Transaminase ; Apgar Score ; Aspartate Aminotransferases ; Asphyxia Neonatorum ; Asphyxia* ; Hepatitis ; Humans ; Hypoxia, Brain ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Ischemia ; Jaundice ; L-Lactate Dehydrogenase ; Liver* ; Parturition* ; Prospective Studies ; Transaminases

OBJECTIVES: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. MATERIALS AND METHODS: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. RESULTS: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. CONCLUSION: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.
Free Tissue Flaps ; Incidence ; India ; Maxillofacial Injuries* ; Neck ; Reconstructive Surgical Procedures ; Wound Infection

PURPOSE: This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi. MATERIALS AND METHODS: A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis. RESULTS: A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidently differentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66, respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. CONCLUSIONS: Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality.
Adult ; Apatites/analysis ; Calcium Oxalate/analysis ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods ; Kidney Calculi/chemistry/pathology/*radiography ; Magnesium Compounds/analysis ; Male ; Middle Aged ; Phosphates/analysis ; Prospective Studies ; Radiation Dosage ; Tomography, X-Ray Computed/methods ; Ureteral Calculi/chemistry/pathology/*radiography ; Uric Acid/analysis ; Waist Circumference ; Young Adult

A laboratory experiment was conducted to study the induction of constricting rings and test predation of Dactylaria brochopaga isolates against second stage juveniles (J2s) of Meloidogyne graminicola. Among the five fungal isolates, isolate D showed the greatest number of predatory rings and, consequently, trapped the maximum number of M. graminicola J2s in dual cultures. Another pot experiment was conducted to study the effect of D. brochopaga (isolate D) on the management of wheat root-knot disease. Applying a mass culture (10 g/pot) and a spore suspension of the fungus with and without cow dung manure to soil infested with 2,000 M. graminicola juveniles significantly improved plant height, root length, weights of shoots, roots, panicles and grains per hill compared to those in the control. Moreover, the fungus significantly reduced the number of root-knots, the number of egg masses, juveniles, and females per hill compared to those in the control. Bio-efficacy of the fungus was heightened when the mass culture and a spore suspensions were used in combination with cow dung manure to improve the plant growth parameters and reduce the number of root-knot and reproductive factors. Further investigations should be conducted to identify the impact of this fungus in the field.
Edible Grain ; Female ; Fungi ; Humans ; Manure ; Ovum ; Plants ; Soil ; Spores ; Suspensions ; Triticum ; Tylenchoidea ; Weights and Measures

Analgesia, Epidural ; Female ; Humans ; Labor, Obstetric ; Pregnancy

Despite its efficacy against malaria,the relatively low yield (0.01％-0.8％) of artemisinin in Artemisia annua is a serious limitation to the commercialization of the drug.A better understanding of the biosynthetic pathway of artemisinin and its regulation by both exogenous and endogenous factors is essential to improve artemisinin yield.Increasing evidence has shown that microRNAs (miRNAs) play multiple roles in various biological processes.In this study,we used previously known miRNAs from Arabidopsis and rice against expressed sequence tag (EST) database of A.annua to search for potential miRNAs and their targets in A.annua.A total of six potential miRNAs were predicted,which belong to the miR414 and miR1310 families.Furthermore,eight potential target genes were identified in this species.Among them,seven genes encode proteins that play important roles in artemisinin biosynthesis,including HMG-CoA reductase (HMGR),amorpha-4,11-diene synthase (ADS),farnesyl pyrophosphate synthase (FPS) and cytochrome P450.In addition,a gene coding for putative AINTEGUMENTA,which is involved in signal transduction and development,was also predicted as one of the targets.This is the first in silico study to indicate that miRNAs target genes encoding enzymes involved in artemisinin biosynthesis,which may help to understand the miRNA-mediated regulation of artemisinin biosynthesis in A.annua.