Dual-targeted transferrin and AS1411 aptamer conjugated micelles for improved therapeutic efficacy and imaging of brain cancer

Brain tumors represent an aggressive form of cancer, posing significant challenges in achieving complete remission. Development of advanced therapies is crucial for improving clinical outcomes in cancer patients. This study aimed to create a novel treatment approach using dual-targeted transferrin (TF) and AS1411 conjugated micelles, designed to enhance therapeutic effectiveness of docetaxel (DTX) and facilitate gadolinium (Gd) based imaging in brain cancer. Micelles were prepared using a slightly modified solvent-casting method, and the dual-targeting ligands were attached to the micelle's surface through a physical adsorption process. Average particle size of micelles ranged from 117.49 ± 3.90-170.38 ± 3.39 nm, with a low polydispersity index. Zeta potential ranged from - 1.5 ± 0.02 to - 18.7 ± 0.04 mV. Encapsulation efficiency of DTX in micelles varied from 92.64 ± 4.22-79.77 ± 4.13 %. Simultaneously, encapsulation of Gd in micelles was found to be 48.27 ± 3.18-58.52 ± 3.17, respectively. In-vitro drug release studies showed a biphasic sustained release profile, with DTX and Gd release continuing up to 72 h with their t50 % at 4.95, 11.29, and 24.14 h for GDTP, GDTP-TF and GDTP-TF-AS1411 micelles, respectively. Cytotoxicity effect of GDTP-TF-AS1411 micelles has shown significant improvement (P < 0.001) and reduced IC50 value up to 0.19 ± 0.14 μg/ml compared to Taxotere® (2.73 ± 0.73 μg/ml). Theranostic study revealed higher accumulation of GDTP-TF and GDTP-TF-AS1411 micelles free GD treated animal brains. The AUC of GDTP-TF-AS1411 micelles exhibited 23.79 ± 17.82 μg.h/ml higher than Taxotere® (14.14 ± 10.59 μg.h/ml). These findings direct enhanced effectiveness in brain cancer therapy leading to improved therapeutics in brain cancer patients. The combined targeted ligands and therapeutic agents strategy can direct advancement in brain cancer therapy and offer improved therapy for patients.

Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis

Background

Intracanal posts are commonly used to restore lost permanent/primary tooth structure and the smile of the patient.

Aim

This systematic review aims to evaluate the clinical success of intracanal posts used in primary maxillary anterior teeth and compare their mechanical properties.

Methods

An extensive literature search was performed using Medline via PubMed, Embase via embase.com, LILACS, CINAHL via EBSCO, Cochrane Oral Health Group Specialized Register, Scopus, and Web of Science until December 2021 and was updated till December 2022. In vivo and in vitro studies in the English language that assessed clinical success and mechanical properties were included. Distiller SR software was used for everything from title screening to data extraction.

Results

A total of 30 studies were analyzed, including 11 in vivo and 19 in vitro studies. Four studies were included in a meta-analysis, and all 30 studies qualified for qualitative analysis. The meta-analysis showed that fiber posts are clinically superior to composite resin posts (CRPs) (p = 0.02). No significant difference was observed between the fracture resistance of CRPs and no posts (p = 0.73). Most of the included studies showed a high risk of bias.

Conclusion

Conclusive evidence about the effectiveness of various intracanal posts cannot be established. This is due to the limited number of clinical trials and included studies of low to moderate quality with a high risk of bias. To validate the use of posts in primary maxillary anterior teeth, further research, including randomized controlled trials (RCTs) of higher quality, is required.

Clinical significance

The use of intracanal posts in primary teeth is a commonly used treatment modality among pediatric dentists. However, the quality of the evidence to support its use is low. This systematic review provides a comprehensive summary of the current literature and highlights the need for further research. Results were interpreted with caution, as the evidence supporting the use of intracanal posts in primary teeth is limited.

How to cite this article

Shanmugam Y, Raghu A, Muthu MS, et al. Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(S-3):S293-S305.

Current Advances in Nanotheranostics for Molecular Imaging and Therapy of Cardiovascular Disorders

Cardiovascular diseases (CVDs) refer to a collection of conditions characterized by abnormalities in the cardiovascular system. They are a global problem and one of the leading causes of mortality and disability. Nanotheranostics implies to the combination of diagnostic and therapeutic capabilities inside a single nanoscale platform that has allowed for significant advancement in cardiovascular diagnosis and therapy. These advancements are being developed to improve imaging capabilities, introduce personalized therapies, and boost cardiovascular disease patient treatment outcomes. Significant progress has been achieved in the integration of imaging and therapeutic capabilities within nanocarriers. In the case of cardiovascular disease, nanoparticles provide targeted delivery of therapeutics, genetic material, photothermal, and imaging agents. Directing and monitoring the movement of these therapeutic nanoparticles may be done with pinpoint accuracy by using imaging modalities such as cardiovascular magnetic resonance (CMR), computed tomography (CT), positron emission tomography (PET), photoacoustic/ultrasound, and fluorescence imaging. Recently, there has been an increasing demand of noninvasive for multimodal nanotheranostic platforms. In these platforms, various imaging technologies such as optical and magnetic resonance are integrated into a single nanoparticle. This platform helps in acquiring more accurate descriptions of cardiovascular diseases and provides clues for accurate diagnosis. Advances in surface functionalization methods have strengthened the potential application of nanotheranostics in cardiovascular diagnosis and therapy. In this Review, we have covered the potential impact of nanomedicine on CVDs. Additionally, we have discussed the recently developed various nanoparticles for CVDs imaging. Moreover, advancements in the CMR, CT, PET, ultrasound, and photoacoustic imaging for the CVDs have been discussed. We have limited our discussion to nanomaterials based clinical trials for CVDs and their patents.

Variations in Primary Molar Contact and Approximal Caries in Children: A Three-Year Prospective Cohort Study

Purpose: To evaluate the association between the contact areas of primary molar teeth and approximal caries after three years of observation. Methods: This prospective cohort study included 1,119 caries-free children, aged three to four years, from Puducherry, India. At base- line, 4,476 contacts were assessed using the OXIS criteria, which denotes O for open contact and X, I, and S for closed contacts. X contact represents a point contact, I is a straight contact, and S is a curved contact. Two calibrated dentists measured dental caries at one-year intervals following the International Caries Detection and Assessment System for three years. Poisson regression analysis with a multilevel approach was used to determine the association between contact type and approximal caries. Results: Of 3,848 contacts observed at the end of three years, 499 (13 percent) were carious. The adjusted analysis revealed a significant association between contact type and approximal caries (P<0.05). The risk ratios for the development of approximal caries were 2.3 for X-type contacts (0.5 to 11.4, P=0.307), 12.7 for I-type (4.1 to 39.6, P<0.05), and 22.5 for S-type (7.2 to 70.6, P<0.05) when compared with O-type. Conclusions: Compelling evidence suggests that variations in contacts between teeth are significant in the development of approximal caries. The S-type contact is the most susceptible to approximal caries, followed by the I-type.

EGFR targeted albumin nanoparticles of oleanolic acid: In silico screening of nanocarrier, cytotoxicity and pharmacokinetics for lung cancer therapy

This study aimed to develop cetuximab (CTX) functionalized albumin nanoparticles (ALB-NPs) of oleanolic acid for EGFR targeted lung cancer therapy. The molecular docking methodology has been applied for a selection of suitable nanocarrier. Various physicochemical parameters like particle size, polydispersity, zeta potential, morphology, entrapment efficiency, and in-vitro drug release of all the ALB-NPs were analyzed. Furthermore, the in-vitro qualitative and quantitative cellular uptake study revealed that higher uptake of CTX conjugated ALB-NPs than nontargeted ALB-NPs in A549 cells. The in-vitro MTT assay revealed that the IC50 value of CTX-OLA-ALB-NPs (4.34 ± 1.90 μg/mL) was significantly reduced (p < 0.001) than OLA-ALB-NPs (13.87 ± 1.28 μg/mL) in A-549 cells. CTX-OLA-ALB-NPs caused apoptosis in A-549 cells at concentrations equivalent to its IC50 value and blocked the cell cycle in the G0/G1 phases. The hemocompatibility, histopathology and lung safety study confirmed the biocompatibility of the developed NPs. In vivo ultrasound and photoacoustic imaging confirmed the targeted delivery of the NPs to lung cancer. The findings demonstrated that CTX-OLA-ALB-NPs have potential for site-specific delivery of OLA for effective and targeted therapy of lung carcinoma.

Chitosan-g-estrone Nanoparticles of Palbociclib Vanished Hypoxic Breast Tumor after Targeted Delivery: Development and Ultrasound/Photoacoustic Imaging

Breast cancer is the leading cause of death among women globally. Approximately 80% of all breast cancers diagnosed are overexpressed with estrogen receptors (ERs). In this study, we have developed an estrone (Egen)-grafted chitosan-based polymeric nanocarrier for the targeted delivery of palbociclib (PLB) to breast cancer. The nanoparticles (NPs) were prepared by solvent evaporation using the ionic gelation method and characterized for particle size, zeta potential, polydispersity, surface morphology, surface chemistry, drug entrapment efficiency, cytotoxicity assay, cellular uptake, and apoptosis study. The developed PLB-CS NPs and PLB-CS-g-Egen NPs had a particle size of 116.3 ± 1.53 nm and 141.6 ± 1.97 nm, respectively. The zeta potential of PLB-CS NPs and PLB-CS-g-Egen NPs was found to be 18.70 ± 0.416 mV and 12.45 ± 0.574 mV, respectively. The morphological analysis demonstrated that all NPs were spherical in shape and had a smooth surface. An in vitro cytotoxicity assay was performed in estrogen receptor (ER)-expressing MCF7 cells and T47D cells, which suggested that targeted NPs were 57.34- and 30.32-fold more cytotoxic compared to the pure PLB, respectively. Additionally, cell cycle analysis confirmed that cell cycle progression from the G1 into S phase was blocked more efficiently by targeted NPs compared to nontargeted NPs and PLB in MCF7 cells. In vivo pharmacokinetic studies demonstrated that entrapment of the PLB in the NPs improved the half-life and bioavailability by ∼2-3-fold. Further, ultrasound and photoacoustic imaging of DMBA induced breast cancer in the Sprague-Dawley (SD) rat showed that targeted NPs completely vanished breast tumor, reduced hypoxic tumor volume, and suppressed tumor angiogenesis more efficiently compared to the nontargeted NPs and free PLB. Further, in vitro hemocompatibility and histopathology studies suggested that NPs were biocompatible and safe for clinical use.

Assessment of OXIS contacts-a comparison of three methods

PURPOSE

To compare OXIS contacts by means of Replication using Sectional die Models (RSM) and Photographs of the Models (PM) with Direct Clinical Examination (DCE) in a sample of preschool children aged 3-4 years.

METHODS

A retrospective cross-sectional study was performed using existing records of sectional die models and their photographs among 4257 contacts of 1104 caries-free pre-school children. Two calibrated examiners scored the contacts between the distal surface of the primary first molar and mesial surface of the primary second molar using OXIS criteria from the occlusal view using the RSM & PM methods. These were compared to the OXIS scores from DCE method which was available from previous records. Kappa agreement was used to compare results obtained RSM and PM methods with DCE.

RESULTS

The kappa agreement between the RSM and DCE methods was 98.48%; and between the PM and DCE methods was 99.42%, both of which indicated perfect agreement.

CONCLUSION

The RSM and PM methods were found to have an excellent agreement in scoring OXIS contacts when compared to the DCE method. PM was found to be slightly more accurate than the RSM method for scoring OXIS contacts.

Theranostics of metal-organic frameworks: image-guided nanomedicine for clinical translation

Metal-organic frameworks (MOFs)-based theranostic nanomedicine has demonstrated enormous potential for cancer diagnosis and therapy due to its versatile physiochemical properties, such as structural and morphological properties, specific cellular targeting, tunable pore and particle size, higher surface area, drug-loading capacity, biodegradability and biocompatibility. Notably, MOFs, loaded with diagnostic and therapeutic agents and functionalized with targeting moiety, are capable of catering to both targeted imaging and therapy simultaneously. Additionally, MOFs have demonstrated excellent potential in drug delivery, drug targeting, bioimaging, biosensing, biocatalysis and so on. However, major challenges associated with MOFs include improving their stability, biocompatibility and therapeutic efficacy and reducing the toxicity. This special report sheds light on the historical development, synthesis, recent advancements, toxicity and challenges associated with MOFs-based cancer nanotheranostics for their clinical translation.

Bite force of children and adolescents: a systematic review and meta-analysis

This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measuring device. Studies on participants with systemic conditions were excluded. Databases such as PubMed, Embase, LILACS, and the Cochrane library were searched until September 2022, for which screening and quality assessment were performed. Newcastle-Ottawa, modified Newcastle-Ottawa and ROBINS-I tools were used to assess the Risk-of-bias. All observational studies reporting overall bite force values of participants were included for meta-analyses. A total of 8864 participants (3491 males and 3623 females) were included from 61 studies. Meta-analyses were conducted to evaluate mean average bite force value for each included dentition using R software v2.4-0. Estimation was done to derive an average BF value for variables such as age (dentition), gender, side, site, device and ethnicity. MVBF values were reported as mean average in the form of MLN with 95% CI (Confidence Interval). Using a random-effects model, 29 forest plots were generated. I² values varied between 90% and 100%. Bite force ranged from 246.22 N (220.47; 274.98) to 311.72 N (255.99; 379.59) and 489.35 N (399.86; 598.87) in primary, mixed, and permanent dentitions, respectively. Six different sites for recording bite force and 11 different types of devices were reported with portable occlusal bite force gauge being the most common device. Outcomes of this review provide useful baseline reference values of bite force for clinicians and researchers.

Subthreshold Doses of Inflammatory Mediators potentiate one another to Elicit Reflex Cardiorespiratory Responses in Anesthetized Rats

BACKGROUND

Reflex cardio-vascular and respiratory (CVR) alterations evoked by intra-arterial instillation of nociceptive agents are termed vasosensory reflexes. Such responses elicited by optimal doses of inflammatory mediators have been described in our earlier work.

OBJECTIVE

The present study was designed to evaluate the interactions between subthreshold doses of inflammatory mediators on perivascular nociceptive afferents in urethane anesthetized rats.

METHODS

Healthy male adult rats (Charles-Foster strain) were anesthetized with an intraperitoneal injection of urethane. After anesthesia, the right femoral artery was cannulated. Respiratory movements, blood pressure, and electrocardiogram were recorded. The interactions between subthreshold doses of algogens in the elicitation of vasosensory reflex responses were studied by instillation of bradykinin (1 nM) and histamine (100 µM) into the femoral artery one after the other, in either temporal combination in separate groups of rats. The CVR responses obtained in these groups were then compared with the responses produced by 100 µM histamine and 1 nM bradykinin in saline-pretreated groups, which served as control.

RESULTS

Subthreshold doses of histamine elicited transient tachypnoeic, hyperventilatory, hypotensive, and bradycardiac responses, in rats pretreated with subthreshold doses of bradykinin [P <0.01, two-sided Dunnett's test] but not in saline pretreated groups [P >0.05, two-sided Dunnett's test]. Similar responses were elicited by bradykinin after histamine pretreatment compared to the saline-pretreated group. Furthermore, CVR responses produced by histamine in the bradykinin-pretreated group were greater in magnitude as compared to bradykinin-induced responses in the histamine-pretreated group [P <0.05, two-sided Dunnett's test].

CONCLUSION

The present study demonstrates that both bradykinin and histamine potentiate one another in the elicitation of vasosensory reflex responses, and bradykinin is a better potentiator than histamine at the level of perivascular nociceptive afferents in producing reflex CVR changes.

Advances in solid-phase extraction techniques: Role of nanosorbents for the enrichment of antibiotics for analytical quantification

Antibiotics are life-saving medications for treating bacterial infections; however it has been discovered that resistance developed by bacteria against these incredible agents is the primary contributing factor to rising global mortality rates. The fundamental cause of the emergence of antibiotic resistance in bacteria is the presence of antibiotic residues in various environmental matrices. Although antibiotics are present in diluted form in environmental matrices like water, consistent exposure of bacteria to these minute levels is enough for the resistance to develop. So, identifying these tiny concentrations of numerous antibiotics in various and complicated matrices will be a crucial step in controlling their disposal in those matrices. Solid phase extraction, a popular and customizable extraction technology, was developed according to the aspirations of the researchers. It is a unique alternative technique that could be implemented either alone or in combination with other approaches at different stages because of the multitude of sorbent varieties and techniques. Initially, sorbents are utilized for extraction in their natural state. The basic sorbent has been modified over time with nanoparticles and multilayer sorbents, which have indeed helped to accomplish the desired extraction efficiencies. Among the current traditional extraction techniques such as liquid-liquid extraction, protein precipitation, and salting out techniques, solid-phase extractions (SPE) with nanosorbents are most productive because, they can be automated, selective, and can be integrated with other extraction techniques. This review aims to provide a broad overview of advancements and developments in sorbents with a specific emphasis on the applications of SPE techniques used for antibiotic detection and quantification in various matrices in the last two decades.

Systematic Review of Clinical Practice Guidelines for Traumatic Dental Injuries

BACKGROUND/AIMS

Traumatic Dental Injuries (TDI) are considered a public health problem due to their high prevalence and associated physical, economic, psychological and social consequences. Hence, good Clinical Practice Guidelines are essential to achieving a favourable prognosis. The aim of this review was to appraise the existing Clinical Practice Guidelines (CPGs) on TDI using AGREE II and AGREE-REX.

MATERIALS AND METHODS

A systematic search for existing guidelines on TDI was performed on PubMed, EMBASE, CINAHL, Cochrane Library, ProQuest, National Institute for Health Care Excellence, BMJ Best Practice, Trip database, Guideline International Network, Scottish Intercollegiate Guidelines Network, World Health Organisation, Web of Science and 'Ministry of Health worldwide' databases. Four appraisers independently appraised the included CPGs. The AGREE II tool was applied to assess the methodological quality, while AGREE REX assessed the quality of recommendations of the included guidelines.

RESULTS

Of the 7736 titles screened, three guidelines, namely, the International Association of Dental Traumatology Guidelines (IADT), and the Italian and Malaysian guidelines, were included for the final analysis. These guidelines were published between 2019-2020. The AGREE II analysis demonstrated scores above 80% for the IADT and Italian guidelines for the scope and purpose domain. Overall, the Malaysian guidelines achieved the highest score for all domains. The AGREE REX analysis indicated variability in implementation across the nine items, with five that scored above the midpoint of 4.0 on the response scale. Both the Italian and the IADT guidelines had a similar score for the values and preference domains (36.36%).

CONCLUSIONS

Several deficiencies exist in the methodological quality of existing CPGs on TDI. Future guidelines should consider improvements for domains such as "rigour of development", "stakeholder involvement", and "applicability" to overcome the existing limitations.

Premna integrifolia: A Review on the Exploration of its Potential Pharmacological and Therapeutic Properties

Abstract:

Several Premna species can be found over the entire tropical and subtropical regions of Australia, Asia, and Africa. Many conventional herbal preparations using P. integrifolia (Lamiaceae) have been reported for their potential health advantages. The P. integrifolia is taxonomically ambiguous because of the wide variation in specimens obtained from various geographic locations. The plant is extensively used to treat immune-related disorders, skin conditions, inflammatory conditions, and stomach issues. The root of P. integrifolia is broadly utilized in the manufacture of Ayurvedic pharmaceutical products, such as Dasamula Kvatha and Chayawanprash Avaleha. It has also been identified to have antibacterial, hepatoprotective, and antifungal properties. The current study aims to investigate the antioxidant and cytotoxic activity of P. integrifolia against various cancers, as well as its antiinflammatory activity, antidiabetic, cardiac-stimulant, anti-obesity, hepatoprotective, immunomodulatory, analgesic, antiarthritic, antiparasitic, and wound healing activity, as well as the presence of various secondary metabolites in different parts of the plant used in a variety of formulations.

V, Tiwari P, Setia A, Malik AK, Singh SK, Tilak R, Muthu MS. Design of novel bioadhesive chitosan film loaded with bimetallic gold-silver nanoparticles for antibiofilm and wound healing activity

Microbial infections and antibiotic resistance are among the leading causes of morbidity and mortality worldwide. The bimetallic chitosan-capped gold-silver nanoparticles (CS-AuAg-NPs) were prepared by the seeded growth synthesis technique. The nanoparticles were optimized for particle size, zeta potential and antibacterial activity by Box-Behnken Design at three levels and three factors. The developed CS-AuAg-NPs were polydispersed with mean hydrodynamic particle size in the range of 55 nm to 289 nm and zeta potential ranges from+8.53mV to +38.6 mV. The optimized CS-AuAg-NPs found to have a minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of 1.625±0.68 and 3.25±0.74 µg/ml towards multidrug resistant (MDR) S. aureus ATCC 25923 (MDR AT) and 3.25 ± 0.93 and 3.25 ± 0.86 µg/ml towards MDR S. aureus clinical isolate MDR1695 (MDR CI) strain, respectively. The CS-AuAg-NPs were much more effective against MDR AT and MDR CI compared to clindamycin standard. The live/dead assay of clinical isolates strain demonstrated significant reduction of bacterial cells ̴ 67.52 folds compared to control group in 12 h. The hemolysis study suggested that CS-AuAg-NPs were non-hemolytic and safer for application in the wound. Furthermore, CS-AuAg-NPs were distributed in the chitosan film, which showed 87 % wound recovery after 7 days in mice model. Hence, we concluded that CS-AuAg-NPs was safer and more effective against MDR bacteria and capable of skin regeneration in the infected wound.

OXIS contacts and approximal caries in preschool children- A prospective cohort study

The present prospective cohort study was conducted to evaluate the susceptibility of OXIS contact areas namely O (open type), X (point type), I (straight type) and S (curved type) in the development of approximal caries. We conducted this study among 953 school children with 3812 contacts in Puducherry, India. At baseline, the contacts were assessed in accordance with OXIS criteria. At the end of 12 months, two calibrated dentists measured dental caries following the International Caries Detection and Assessment (ICDAS) criteria. Information about feeding practices, diet, and oral hygiene was collected by means of a structured questionnaire from each child's parent. Data were analyzed by unadjusted and adjusted Poisson regression analysis with a multilevel approach. The two levels of analysis were tooth and child. Of 3,812 contacts observed during the follow-up, 127 (3.3%) were observed as carious. Poisson regression analysis revealed a significant association between type of contact and caries prevalence (p < 0.05). The risk ratios for the development of approximal caries in X contacts were 2.4 (0.3-17.2), p value 0.38; in I contacts - 4.9 (1.2-19.9), p value 0.027; and in S contacts 8.2 (1.9-34.2), p value 0.004, when compared with the O contacts. Among the child variables, male gender (RR=2.1; 95%CI-1.3,3.5), parental supervision while toothbrushing (RR=1.6; 95%CI-1.1,2.4) and the use of toothpaste (RR=1.9; 95%CI-1.3,3.1) were found to be associated with approximal caries after adjustment for the other variables. Among the OXIS contacts, the S type was most susceptible to approximal caries due to its complex morphology, followed by I, X, and O.

GPIIb/IIIa Receptor Targeted Rutin Loaded Liposomes for Site-Specific Antithrombotic Effect

Rutin (RUT) is a flavonoid obtained from a natural source and is reported for antithrombotic potential, but its delivery remains challenging because of its poor solubility and bioavailability. In this research, we have fabricated novel rutin loaded liposomes (RUT-LIPO, nontargeted), liposomes conjugated with RGD peptide (RGD-RUT-LIPO, targeted), and abciximab (ABX-RUT-LIPO, targeted) by ethanol injection method. The particle size, ζ potential, and morphology of prepared liposomes were analyzed by using DLS, SEM, and TEM techniques. The conjugation of targeting moiety on the surface of targeted liposomes was confirmed by XPS analysis and Bradford assay. In vitro assessment such as blood clot assay, aPTT assay, PT assay, and platelet aggregation analysis was performed using human blood which showed the superior antithrombotic potential of ABX-RUT-LIPO and RGD-RUT-LIPO liposomes. The clot targeting efficiency was evaluated by in vitro imaging and confocal laser scanning microscopy. A significant (P < 0.05) rise in the affinity of targeted liposomes toward activated platelets was demonstrated that revealed their remarkable potential in inhibiting thrombus formation. Furthermore, an in vivo study executed on Sprague Dawley rats (FeCl₃ model) demonstrated improved antithrombotic activity of RGD-RUT-LIPO and ABX-RUT-LIPO compared with pure drug. The pharmacokinetic study performed on rats demonstrates the increase in bioavailability when administered as liposomal formulation as compared to RUT. Moreover, the tail bleeding assay and clotting time study (Swiss Albino mice) indicated a better antithrombotic efficacy of targeted liposomes than control preparations. Additionally, biocompatibility of liposomal formulations was determined by an in vitro hemolysis study and cytotoxicity assay, which showed that they were hemocompatible and safe for human use. A histopathology study on rats suggested no severe toxicity of prepared liposomal formulations. Thus, RUT encapsulated nontargeted and targeted liposomes exhibited superior antithrombotic potential over RUT and could be used as a promising carrier for future use.

Single nucleotide polymorphisms of enamel formation genes and early childhood caries - systematic review, gene-based, gene cluster and meta-analysis

Introduction

Genetic polymorphisms of genes regulating amelogenesis can alter susceptibility to Early Childhood Caries (ECC). This systematic review aims to analyze associations between single-nucleotide polymorphisms of enamel formation genes and ECC.

Methods

Search was conducted across PUBMED, CINAHL, LILACS, SCOPUS, EMBASE, Web of Science, Genome-Wide Association Studies databases from January 2003 to September 2022. This was supplemented by hand search. Totally 7124 articles were identified and 21 articles that satisfied the inclusion criteria proceeded to data extraction. Quality assessment was done using the Q-Genie tool.

Results

Quantitative synthesis revealed that homozygous genotype AA of rs12640848 was significantly higher in children with ECC with an odds ratio of 2.36. Gene-based analysis revealed significant association between six variants of AMBN, four variants of KLK4, two variants of MMP20, and a single variant of each of MMP9 and MMP13 genes and ECC. The Bonferroni corrected-log10 P value of amelogenesis gene Cluster was 2.25 (0.05/88 = 5.6 × 10^-4). Search Tool for Retrieval of Interacting Genes and Proteins plot constructed to comprehend the protein-protein interaction revealed the presence of four functional clusters. Gene function prediction using Multiple Association Network Integration Algorithm revealed that physical interaction between these genes was 69.3%.

Conclusion

Polymorphisms of genes regulating amelogenesis can influence the susceptibility to ECC. AA genotype of rs12640848 may increase the susceptibility to ECC. Gene-based analysis revealed a significant association between multiple polymorphisms of genes regulating amelogenesis and ECC.

Sustainable development goals and ending ECC as a public health crisis

Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from untreated dental caries of primary teeth. The consequences of such untreated dental caries not only limit the child's chewing and eating abilities but also, significantly impact the child's overall growth. Research has demonstrated that ECC is associated with nearly 123 risk factors. ECC has also been associated with local pain, infections, abscesses, and sleep pattern. Furthermore, it can affect the child's emotional status and decrease their ability to learn or perform their usual activities. In high-income countries, dental care continues to endorse a "current treatment-based approach" that involves high-technology, interventionist, and specialized approaches. While such approaches provide immediate benefit at an individual level, it fails to intercept the underlying causes of the disease at large. In low-income and middle-income countries (LMICs), the "current treatment approach" often remains limited, unaffordable, and unsuitable for the majority of the population. Rather, dentistry needs to focus on "sustainable goals" and integrate dental care with the mainstream healthcare system and primary care services. Dental care systems should promote "early first dental visits," when the child is 1 year of age or when the first tooth arrives. The serious shortages of appropriately trained oral healthcare personnel in certain regions of the world, lack of appropriate technologies and isolation of oral health services from the health system, and limited adoption of prevention and oral health promotion can pose as critical barriers. The oral health care systems must focus on three major keystones to combat the burden of ECC-1. Essential oral health services are integrated into healthcare in every country ensuring the availability of appropriate healthcare accessible and available globally, 2. Integrating oral and general healthcare to effectively prevent and manage oral disease and improve oral health, 3. Collaborating with a wide range of health workers to deliver sustainable oral health care tailored to cater to the oral health care needs of local communities.

Comparison of viscosities of human breast milk versus infant milk formulae with and without addition of sweetening agents

CONTEXT

Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk.

AIM

To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents.

MATERIALS AND METHODS

All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM.

STATISTICAL ANALYSIS

Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA.

RESULTS

Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP.

CONCLUSIONS

HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

Association of Sleep-Time Feeding Practices with Early Childhood Caries: A Case-Control Study

Early childhood caries (ECC) remains a public health challenge globally, more so in developing countries. The association between sleep-time feeding practices and ECC remains obscure. The study evaluated this association using Feeding At Sleep Time (FeAST) scale. A case-control study was planned among 627 toddlers, were cases included children with ECC while controls were children without ECC. Three patterns of feeding associated with sleep were recorded: beginning of sleep, during the course of sleep, and early morning hours sleep. Dental caries was scored using International Caries Detection and Assessment System (ICDAS II). The study participants included 302 (48%) cases and 325 (52%) controls. Adjusted odds ratios (AORs) for breastfeeding at the beginning of sleep, during the course of sleep, and early morning hours sleep were 6.7, 6.5, and 3.7, respectively (p = 0.001), on comparing cases versus controls. Similarly, AORs for bottle-feeding at the beginning of sleep, course of sleep, and early morning hours sleep were 5.1, 8.3, and 3.7, respectively (p = 0.001). Addition of sweeteners yielded an AOR = 2.84, while the intake of solids during sleep yielded an AOR of 6.02(p = 0.001). Other feeding modes like sippers, tumblers, etc., had a statistically significant association (p = 0.001). Sleep-time feeding practices increase the risk for ECC in 12- to 36-month-old children.