Background: To assess the effectiveness of hyperbaric oxygen therapy (HBOT) as an adjunct to standard treatment in early-stage oral submucous fibrosis (OSMF), focusing on mouth opening, burning sensation, pain, and systemic inflammation. Methods: A randomized comparative study was conducted on early-stage OSMF patients divided into two groups. Group 1 received HBOT along with intralesional triamcinolone, hyaluronidase, and oral antioxidants. Group 2 received only the standard intralesional therapy with antioxidants. Clinical parameters—interincisal distance, burning sensation, and pain—were recorded at baseline, first, and second followup. Serum C-reactive protein (CRP) levels were measured pre- and post-treatment. Statistical analysis included unpaired t-tests and chisquare tests. Results: Both groups improved clinically, but Group 1 showed significantly greater reductions in burning sensation (p= 0.020), pain, and CRP levels (p= 0.033). Although intergroup differences in mouth opening were not statistically significant, Group 1 showed greater improvement over time. Fibrotic band distribution remained unchanged in both groups. No complications were reported with HBOT. Conclusion HBOT provides enhanced symptomatic relief and anti-inflammatory effects in early-stage OSMF when used alongside conventional therapy. While it may not reverse fibrosis, its safety and noninvasive nature support its role in multimodal OSMF management.

Background/Aims: MicroRNA (miRNA) isoforms (isomiRs) broaden the regulatory landscape of canonical miRNAs, but their role in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unknown. We aimed to characterize the hepatic isomiR landscape in MASLD and define their association with disease activity and fibrosis. Methods: Small RNA (sRNA) sequencing was performed on liver biopsies from 79 patients across the histological spectrum of MASLD. IsomiRs were annotated and quantified. Their association to disease activity and fibrosis score was assessed by differential expression, ordinal regression, and machine learning. Parallel mRNA sequencing and pathway enrichment were used to map isomiR–mRNA interactions and regulatory networks, which were validated against an independent dataset. Results: MiRNAs accounted for 75% of sRNAs in liver tissue, of which 67% were isomiRs. Across MASLD severity, 173 isomiRs correlated with disease activity and 58 with fibrosis stage. Key findings included a miR-122 isomiR uniquely targeting INSIG1 (cholesterol metabolism) and a miR-21 isomiR targeting PPARA and HMGCS2 (lipid and fibrosis pathways). Integration with mRNA data revealed 33 dysregulated pathways, including PPAR signaling, insulin resistance, and TGF-β response. Several novel isomiRs from miR-26b, let-7c, and miR-32 families were also linked to lipid metabolism and fibrosis progression. Conclusions IsomiRs represent the majority of hepatic miRNAs and uncover novel regulatory networks masked by canonical miRNA analysis. These findings provide new insights into the molecular heterogeneity of MASLD, highlight candidate pathways driving disease progression, and identify potential biomarkers and therapeutic targets for precision hepatology.

Background: Maxillofacial trauma presents with a myriad of complications, including functional disability and aesthetic compromise. Optimal treatment includes management of bone and soft tissue injuries along with dental rehabilitation. Prompt management, including open reduction and internal fixation (ORIF) combined with immediate dental implant rehabilitation, facilitates both functional recovery and aesthetic restoration, thereby leading to improved quality of life. Methods: A total of 36 patients with maxillofacial bony trauma, along with non-restorable fractured, avulsed, or missing teeth, were managed with ORIF with dental rehabilitation. Eighteen patients underwent delayed implant placement after 6 months of ORIF, and the other 18 underwent immediate implant rehabilitation during ORIF. The outcomes measured included implant stability, crestal bone loss, and evaluation of pain, swelling, and patient satisfaction. All follow-up visits were scheduled with reference to the post-implant placement period in both groups. Results: Implant stability was significantly increased in the immediate implant placement group of patients at the third- and sixth month follow-up post-implant placement (p< 0.001). Pain assessment revealed that the immediate implant group experienced significantly higher pain scores than the delayed implant group on the first day (p< 0.001), seventh day (p< 0.001), and 28th day (p< 0.001) following implant placement. Significant differences in facial swelling were observed at the third and sixth months (p= 0.009), with the immediate implant group exhibiting lower swelling. Swelling was significantly higher along the tragal-commissure line in the immediate implant group on the first and seventh days (p< 0.001). Patient satisfaction was initially higher in the delayed implant group on the first day (p= 0.047) and remained so by the third month (p< 0.001). However, by the sixth month, both groups demonstrated similar levels of satisfaction after implant placement. Conclusion Immediate implant rehabilitation during ORIF in patients sustaining maxillofacial trauma improves implant success rates, reduces morbidity, and ultimately enhances patients’ overall quality of life.

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes. Hence, we sought to conduct a retrospective analysis on the impact of diabetic status in NAFLD patients, referencing non-diabetic NAFLD individuals. Methods: Data from the National Health and Nutrition Examination Survey 1999–2018 was used. Hepatic steatosis was defined with United States Fatty Liver Index (US-FLI) and FLI at a cut-off of 30 and 60 respectively, in absence of substantial alcohol use. A multivariate generalized linear model was used for risk ratios of binary outcomes while survival analysis was conducted with Cox regression and Fine Gray model for competing risk. Results: Of 32,234 patients, 28.92% were identified to have NAFLD. 36.04%, 38.32% and 25.63% were non-diabetic, prediabetic and diabetic respectively. Diabetic NAFLD significantly increased risk of cardiovascular disease (CVD), stroke, chronic kidney disease, all-cause and CVD mortality compared to non-diabetic NAFLD. However, prediabetic NAFLD only significantly increased the risk of CVD and did not result in a higher risk of mortality. Conclusions Given the increased risk of adverse outcomes, this study highlights the importance of regular diabetes screening in NAFLD and adoption of prompt lifestyle modifications to reduce disease progression. Facing high cardiovascular burden, prediabetic and diabetic NAFLD individuals can benefit from early cardiovascular referrals to reduce risk of CVD events and mortality.

Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. Methods: Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. Results: From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.