Effectiveness of oral hygiene educational interventional programs on participants with Parkinson's disease: a randomized controlled study

OBJECTIVE

To evaluate oral health - related knowledge, to compare the effectiveness of three different oral health education interventions (OHEI) on plaque removal in a cohort with Parkinson's disease (PD).

METHOD AND MATERIALS

The three-arm, parallel-group, randomized controlled trial included 63 PD stage 1 and 2 patients aged ≥ 40 years and scores ≥26 in both Montreal Cognitive Assessment test and Mini-Mental State Exam. These patients were allocated to 3 OHEI groups - lectures, presentation, and demonstration. The validated questionnaire assessed knowledge level at baseline (0), 1; 2, and 3 months. Oral hygiene at 0 and 3 months was assessed by the Plaque index (PI) and the Patient Hygiene Performance Index (PHPI). UWS was collected to assess the salivary flow rate.

RESULTS

Pair-wise comparison using ANOVA showed a significant decrease in mean percentage knowledge 0, 1, 2 and 3 months in all 3 groups (P< 0.001). After Tukey's Post hoc analysis presentation group had significantly higher knowledge (P= 0.03).ANOVA showed that the percentage of knowledge decreased as time passed (P= 0.001). Comparison of means of PI and PHPI scores by MANOVA followed by Tukey's Post hoc analysis, showed significant decrease in PI scores from 0 to 3 months (P=0.001). No significant change in the UWS flow rate was noted.

CONCLUSION

Pictorial representation of OHEI is a better mode of intervention compared to lectures and demonstrations in PD stage 1 and 2 patients. In spite of the decline in knowledge with time, PI scores reduced significantly implying that this form OHEI offers positive benefits.

Comparative analysis of sulfiredoxin and total oxidative stress levels in diabetic individuals with periodontitis: A case-control study

BACKGROUND

The delicate balance between oxidative stress and its antioxidant system can be disrupted in diabetes mellitus (DM), making the tissue susceptible to injury. Hence, this case-control study aims to estimate and correlate the gingival tissue sulfiredoxin and crevicular total oxidative stress (TOS) levels in generalized periodontitis Stage II individuals Grade C (PSII) with and without type II DM.

MATERIAL AND METHODS

A total of 72 individuals were grouped based on their glycosylated hemoglobin (HbA1c) levels and clinical parameters: group I, periodontally healthy non-diabetic (HbA1c < 5.7%) (n = 24); group II, non-diabetic with PSII (n = 24); and group III, diabetic individuals (HbA1c > 6.5%) with PSII (n = 24). Gingival tissues and crevicular fluid samples were collected. The samples with adequate protein concentrations (n = 72) were further estimated for sulfiredoxin and TOS levels by enzyme-linked immunosorbent assay (ELISA) and calorimetric method, respectively.

RESULTS

Tissue sulfiredoxin and crevicular TOS levels are increased significantly in the periodontitis group compared to the non-periodontitis group (p < 0.001).The tissue sulfiredoxin levels did not vary significantly between the two periodontitis groups (p < 0.179). The TOS levels are significantly higher in the diabetic compared to non-diabetic periodontitis group (p < 0.001). Correlation statistics showed a significant positive correlation (r = 0.65 and p < 0.005) between sulfiredoxin and TOS levels in diabetes with PSII group, however, no such significant correlation was observed in the non-diabetic PSII group (r = 0.255 and p < 0.422).

CONCLUSION

Diabetic individuals showed inadequate sulfiredoxin-mediated antioxidant response to an increase in oxidative stress levels in periodontitis Stage II Grade C individuals.

Does the diabetes status of an individual have effects on mechanical and biologic properties of platelet-rich fibrin? An in vitro comparative evaluation

OBJECTIVE

Clinical research in the field of regeneration presents challenges for regulating inflammation and speeding up healing and regenerative processes, which are lacking in individuals with diabetes. Platelet-rich fibrin (PRF) has shown promising results in regeneration. Variations in its properties are attributed mainly to the centrifugation method and other parameters. Hence, the present in vitro study on leukocyte-PRF (L-PRF) and advanced-PRF (A-PRF) membranes, with varying protocols amongst diabetes, was conducted.

METHOD AND MATERIALS

Sixty-four PRF membranes from 30 individual's venous blood samples (16 nondiabetic and 16 diabetic) were assessed for platelet parameters, tensile strength, strain, and growth factor release. The resulting data were statistically analyzed.

RESULTS

The A-PRF membrane had better tensile strength, strain, and growth factor level in comparison with the L-PRF membrane in healthy individuals. Significantly (P < .05) higher strain and growth factor levels in the A-PRF membrane and marginally higher tensile strength in the L-PRF membrane were seen in diabetic individuals.

CONCLUSIONS

The nondiabetic A-PRF membrane had better tensile strength, strain, and growth factor release. Well-controlled diabetic individuals had higher growth factor release, suggesting the use of A-PRF membrane as a suitable autogenous regenerative material.

Does Cigarette Smoking Induce Changes in Biologic and Mechanical Properties of Platelet-Rich Fibrin Membranes?

Smoking has a profound effect on platelet morphology and activation and has also been shown to affect hemostasis, coagulation, and healing cascade. To date, no previous reports are available to assess the impact of cigarette smoke on leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) membranes. Therefore, this study aims to analyze the impact of cigarette smoking on the mechanical and biologic properties of L-PRF and A-PRF membranes. Sixty blood samples from both smokers (n = 34) and nonsmokers (n = 26) who were matched for age and other factors were collected and subjected to complete blood count and platelet indices (mean platelet volume, platelet distribution width, platelet large cell ratio, and plateletcrit). The L-PRF membrane (2,700 rpm; 12 minutes) and A-PRF membrane (1,500 rpm; 14 minutes) were prepared using a standard protocol. A total of 64 experimental L-PRF and A-PRF membranes from 16 individuals selected randomly from the two groups were subjected to tensile strength evaluation using a micro universal testing machine and growth factor release analysis (platelet-derived growth factor [PDGF-AB], vascular endothelial growth factor [VEGF], and bone morphogenic protein-2 [BMP-2]) using ELISA (enzyme-linked immune sorbent assay). Results were tabulated, and statistical analysis was done using Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests. Tensile strengths of L-PRF and A-PRF did not show a statistical difference between groups (P = .47). BMP-2 was not detected in any of the groups. A high initial release of PDGF-AB and VEGF was noticed in A-PRF samples from smokers. Although statistically insignificant, cigarette smoking does affect platelet activation and influences the tensile strength of L-PRF membranes as well as growth factor release in A-PRF membranes in smokers.

Influence of antibacterial effects of tetracycline, laser, and photodynamic therapy on cell viability, cell damage, and virulence of Porphyromonas gingivalis

INTRODUCTION

This study compares and evaluates the efficacy of tetracycline, laser and photodynamic therapy on bacterial counts, cell damage, cell viability and neutralization of gingipains.

MATERIAL AND METHODS

P.gingivalis (ATCC 33,277) was cultured anaerobically. The minimal inhibitory concentration (MIC) for 50% inhibition of P.gingivalis by tetracycline, laser, and toluidine blue (TB) was determined using spectrophotometry. The antibacterial effects, cell viability, cell damage and neutralization of gingipains of the treated groups was evaluated by microbial culture and counting, 2,3 Bis 2 Methyloxy-4 Nitro-5 Sulphophenyl 2 H tetrazolium-5-Carboxaanilide (MTT) assay, lactate dehydrogenase (LDH) assay, and gingipain assay (BAPNA).

RESULTS

The MIC of tetracycline, toulidine, diode laser (810nmm; 0.5 Watts) is 1 µg/mL, 50 µg/mL and 15 s respectively. Comparative analysis for bacterial colony reduction was highest in tetracycline followed by PDT and then laser group at p < 0.01. MTT assay shows a significantly lesser number of viable cells in the tetracycline and PDT group when compared to laser group p < 0.01. Comparative analysis for cell damage using LDH shows the highest results for PDT followed by tetracycline and laser at p < 0.01. The highest neutralization of the gingipains is seen in the PDT group followed by tetracycline and laser groups at p < 0.01.

CONCLUSION

PDT shows highest antibacterial activity, gingipain neutralization, cell damage, and least number of viable cells in comparison with tetracycline and laser.

Evaluation of gingival tissue samples for predicting the time of death using histological and biochemical tests

Thanatochemistry also known as chemistry of death and is used to determine post mortem interval (PMI). It is arguably one of the critical steps in forensic investigation. Recent addition of analyzing biochemical changes along with the traditional methods have gained importance, as they help us to record very early changes in the tissue specimens. In this view, our study aimed to correlate both histological changes and enzymatic changes in gingival tissue samples at intervals of immediate, 1 h, 5 h, 24 h and 48 h after death. Histologic changes noted were loss of epithelial architecture, chromatin clumping, nuclear vacuolation, karryopyknosis, eosinophilia and wide intercellular junctions. Two enzymes which differentiate between the autolytic phase (acid phosphatase) and putrefactive phase (ammonia) of decomposition were evaluated using UV spectrometer. Results in our study demonstrated there were variations as in gradual increase in ammonia levels (1.13±0.24-26.6±2.09) and gradual decrease in acid phosphatase levels (5.61±0.67-1.25±0.53) at different time intervals till 48 h. The cellular changes in gingival tissue could also be related to time. The result of our study helps us to identify potential of enzymatic changes which when correlated with histological reports helps us to predict the time of death accurately. Replicating this experiment in various known taphonomic conditions and other enzymes could highlight the usefulness of gingival tissue samples in determining time of death.

Coefficient of variation of red cell distribution width has correlations to periodontal inflamed surface area in non-obese hypertensive patients

AIMS

To test the hypothesis that higher periodontal inflamed surface area (PISA) positively correlates with the coefficient of variation of red cell distribution width (RDW-CV) in non-obese hypertensive patients.

MATERIALS AND METHODS

Hypertensive subjects aged between 40-60 years with and without periodontitis were enrolled for the study. They completed a structured questionnaire that included gender, height, weight, and other variables. Body mass index was calculated to exclude obese individuals. Clinical periodontal parameters were recorded. PISA was calculated, and participants were divided into four groups: Group 1: Non-hypertension without periodontitis, Group 2: Non-hypertensive with periodontitis, Group 3: Hypertensive without periodontitis, and Group 4: Hypertensive with periodontitis. The hematologic evaluation included red cell distribution width analysis.

RESULTS

ANOVA showed age and diastolic blood pressure were significantly related to RDW-CV at p < 0.001. Periodontal parameters showed significant association with RDW-CV in both hypertensive and non-hypertensive groups at p < 0.001. Pearson correlation test showed a significant association between RDW-CV and PISA. Multivariate regression models showed PISA to be a significant predictor for RDW-CV in the periodontitis group compared to a non-periodontitis group.

CONCLUSIONS

The increase in the RDW-CV in the periodontitis group in both hypertensive and non-hypertensive indicates the independent role of increased inflammation on pathogenic alteration of red cell morphology.

Utility of procalcitonin as an early diagnostic marker of bacteremia in individuals with periodontitis Stage II and III

BACKGROUND

The aim of the present study is to assess the ability of procalcitonin (PCT) to differentiate between periodontal health and Stage II and III periodontitis. We further assessed, if PCT can reflect early bacteremia induced by non-surgical periodontal treatment (NSPT).

METHODS

Sixty-four systemically healthy individuals were divided into Group I, periodontally healthy, and Group II, Stage II and III periodontitis. NSPT was done for both the groups. Standardized serum and salivary samples were obtained and analyzed for PCT levels using highly sensitive double antibody sandwich enzyme-linked immunosorbent assay at baseline and 2 weeks. In addition, the serum levels of PCT were recorded at immediate and 1-hour post-NSPT.

RESULTS

Mean PCT levels (saliva = 0.03 ng/mL and serum = 0.05 ng/mL) in periodontally healthy group were considerably lower than that in the periodontitis group (saliva = 0.22 ng/mL and serum = 1.85 ng/mL) with significant intergroup comparison at P < 0.001. Post NSPT the mean serum PCT values increased from 1.854 ng/mL to 1.871 ng/mL at the immediate interval and remained at 0.879 ng/mL after 2 weeks at P < 0.001. Spearman correlation showed highly significant positive correlation between serum and salivary PCT values to clinical attachment level (CAL) at P < 0.001 and rho = 0.78 and 0.75, respectively. Linear regression model showed serum PCT to be a significant predictor for CAL.

CONCLUSION

Screening for serum PCT levels in patients with periodontitis could act not only as a guide to assess the bacterial load and use of antibiotics but also as a predictor for CAL loss in patients with periodontitis.

Effect of Cigarette Smoking on Morphologic Characteristics of Two Different Platelet-Rich Fibrin Membranes: A Scanning Electron Microscopic Study

PURPOSE

Platelet concentrates are used for regenerative periodontal and implant therapy. Up to now, no study has reported the influence of smoking on platelet-rich fibrin membranes. Hence, this cross-sectional in vitro study aimed to analyze the influence of cigarette smoking on platelet morphology and fiber characteristics of both leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes.

MATERIALS AND METHODS

Sixty blood samples from both smokers (n = 34) and nonsmokers (n = 26) based on power analysis were collected and subjected for complete blood count and platelet morphology indices (mean platelet volume, platelet distribution width, platelet-large cell ratio, and plateletcrit). Leukocyte- and platelet-rich fibrin membrane (2,700 revolutions per minute for 12 minutes) and advanced platelet-rich fibrin membrane (1,500 revolutions per minute for 14 minutes) were prepared using a standard protocol. Thirty-two platelet-rich fibrin membranes from 16 individuals were selected randomly from the two groups and were subjected to morphologic examination using a scanning electron microscope.

RESULTS

Both of the groups were matched for age. Red cell counts and white cell counts showed no statistical difference between the groups. Platelet indices of smokers did show slightly higher values than the nonsmoking group. Scanning electron microscopic analysis showed variations in the fiber width and pattern among smokers in both the leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes. Platelet cell morphology of the smoking group demonstrated spiky architecture, suggesting an active state, while in the nonsmoking group, the platelet cells were seen in clusters, suggesting a resting state.

CONCLUSION

Scanning electron microscopic results show that long-term cigarette smoking does affect the thickness and arrangement of fiber architecture in both leukocyte- and platelet-rich fibrin and advanced platelet-rich fibrin membranes and also could have an impact on activation of platelets.

Comparative evaluation of 2% turmeric extract with nanocarrier and 1% chlorhexidine gel as an adjunct to scaling and root planing in patients with chronic periodontitis: A pilot randomized controlled clinical trial

Context

Nanoparticles, owing to their smaller size, penetrate regions inaccessible to other delivery systems, such as periodontal pockets. Thus, the present study aimed to comparatively evaluate efficacy of 2% curcumin with nanocarrier and 1% chlorhexidine gel as a local drug delivery (LDD) in the treatment of periodontal pockets.

Materials and Methods

Forty-five chronic periodontitis patients with pocket depth 5-7 mm in two or more teeth were selected. Full-mouth scaling and root planing (SRP) was done for all patients followed by random allocation to the three treatment groups, namely SRP group (Group 1), 2% curcumin with nanogel (Group 2), and 1% chlorhexidine gel (Group 3). Clinical parameter assessment and microbiological analysis of subgingival plaque samples for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was done at baseline, 21^st day, and 45^th day.

Results

The results showed that when the two LDD agents were used as an adjunct to SRP in chronic periodontitis, there was an improvement in all clinical parameters. Evaluation of microbiological parameters also showed a significant reduction in Aa, Pg, and Tf levels. Comparison of 2% turmeric extract with a nanocarrier system with 1% chlorhexidine gel showed that both the agents had a comparable antibacterial effect on the three selected periodontopathic bacteria.

Conclusion

The present study showed that both the LDD agents showed an effective improvement of clinical and microbiologic parameters. 2% curcumin delivered with a nanocarrier system showed results comparable to chlorhexidine gel and hence shows promising future as an LDD agent in the treatment of periodontal pockets.

Monitoring of organochlorine and organophosphorus pesticide residues in water during different seasons of Tighra reservoir Gwalior, Madhya Pradesh, India

Analysis of pesticides during different seasons for pesticidal contamination in water samples of Tighra reservoir was carried out on gas chromatograph-electron capture detector with capillary columns following multiresidual analytical technique. Organochlorine pesticides, viz., hexachlorobenzene (HCB), alpha-benzene hexachloride (BHC), beta-BHC, γ-BHC, heptachlor, aldrin, alpha-endosulfan, beta-endosulfan, p,p-DDE, dieldrin, o,p-dichlorodiphenyldichloroethane (DDD), p,p-DDD, p,p-dichlorodiphenyltrichloroethane (DDT), and endrin, and organophosphorus pesticides, viz., choloropyrifos, methyl parathion, diazion, dicholorovos, ethion, malathion, and parathion, were detected in water samples during different seasons. However, the pesticide concentration varied during different seasons at different sites. The prominent reason of contamination is the use of pesticides (both organochlorine and organophosphorus) in the agricultural fields near Tighra reservoir. On the basis of our observations, more extensive monitoring studies need to be carried out, covering all wetlands of Madhya Pradesh to enforce the policies for the restricted application of pesticides in agricultural fields adjacent to wetlands.

Concentration of Organochlorine and Organophosphorus Pesticides in Different Molluscs from Tighra Reservoir, Gwalior, India

Concentration of organochlorine and organophosphorus pesticides and their metabolites were determined in whole body homogenate of L. acuminata, I. exustus, V. dissimilis, V. bengalensis, from Tighra Reservoir during summer and post monsoon season using GC-MS technique. The different types of pesticides viz., HCB, heptachlor, aldrin, endosulfan, dieldrin, p,p-DDT, choloropyrifos, methyl parathion, dicholorovos, ethion, malathion, parathion were found in resident molluscs studied. Concentration of these pesticides varied independently during the summer and the post monsoon season at monitored sites. The study concluded that presence of pesticides in Tighra Reservoir is a major concern on public and ecosystem health and use of biopesticides in the adjacent area of Reservoir is highly recommended.

Avifaunal occurrence and distribution of wetland birds in Sakhya Sagar and Madhav Lakes in Madhav National Park, Shivpuri, India

The present study on wetland birds was carried out at Madhav National Park, Shivpuri, M.P., India. This Park comprises of two lakes namely Sakhya Sagar and Madhav Lakes, which support fascinating wildlife. These lakes are winter resorts for variety of migratory birds for shelter, breeding, nesting and provide a suitable habitat for several resident and local migratory wetland bird species. This paper assesses the occurrence of 73 wetland birds (18 families and 8 orders) with their distribution in different locations and habitats. The present study provides a comprehensive checklist of wetland birds of Sakhya Sagar and Madhav Lakes by covering 15 locations and 10 habitats utilized by migratory, resident migratory and resident wetland bird species during different seasons of year and at various sighting frequencies.

Water quality and conservation management of Ramsagar reservoir, Datia, Madhya Pradesh

The aim of this study is to assess physico-chemical characteristics, trophic status, pollution studies and macrophytic community of Ramsagar reservoir from April 2003 to March 2005. The range of various parameters of reservoir water (water temperature 15.92-31.87 degrees C, water depth 2.90-8.25 m, transparency 66.59-116.00 cm, electrical conductivity 108-246.30 microS cm(-1), turbidity 2.17-16.72 NTU, total dissolved solids 166.37-239.00 mg l(-1), pH 7 41-8.95, dissolved oxygen 6.78-11.59 mg I(-1), free carbon dioxide nil-6.32 mg l(-1), total alkalinity 64.25-146.25 mg l(-1), total hardness 34.00-75.25 mg l(-1), chlorides 13.13-22.36 mg l(-1), calcium 11.21-33.81 mg l(-1), sulphates 1.50-8.87 mg l(-1), nitrates 0.011-0.033 mg l(-1), nitrites 0.004-0.029 mg l(-1), phosphates 0.013-0.054 mg l(-1), silicates 0.65-8.42 mg l(-1), ammonia nil-0.84 mg l(-1), biochemical oxygen demand 0.93-4.68 mg l(-1), chemical oxygen demand 3.60-17.40 mg l(-1), magnesium 1.17-5.60 mg l(-1), sodium 16.75-34.30 mg l(-1) and potassium 1.97-4.86 mg l(-1)) exhibit monthly as well as seasonal fluctuations. The nutrients including silicates, sulphates, phosphates, nitrates and potassium are in sufficient quantities for the growth of aquatic plants and animals in the reservoir. In all 13 species of macrophytes were recorded from the reservoir. Macrophytic diversity was higher at the points where nallahas join the reservoir and in the areas where agricultural practices are performed. This was due to allocthonous nutrients brought into the reservoir from the surrounding catchments area. The above study indicated that the Ramsagar reservoir is under the category of mesotrophic water body slightly inclined towards eutrophication. Therefore, the conservation and management of this water body are very much required.

Water quality and pollution status of Chambal river in National Chambal Sanctuary, Madhya Pradesh

The physico-chemical characteristics of Chambal river water in National Chambal sanctuary (Madhya Pradesh) have been studied. The stretch of Chambal river contained in the National Chambal sanctuary (located at 25 degrees 23'-26 degrees 52'N, 76 degrees 28'-79 degrees 15'E) is extending up to 600 km downstream from Kota (Rajasthan) to the confluence of the Chambal with Yamuna river (Etawah). The river flow in Madhya Pradesh spans up to approximately 400 km. Three sampling stations viz., Station A--near Palighat, district Sheopurkalan, Station B--near Rajghat, district Morena and Station C--near Baraighat, district Bhind were established for the collection of water samples during April, 2003 to March, 2004. The water quality parameters namely transparency (12.12-110 cm), colour (transparent-very turbid), turbidity (1-178 TNU), electrical conductivity (145.60-884 microS cm(-1)), total dissolved solids (260-500 mgl(-1)), pH (7.60-9.33), dissolved oxygen (4.86-14.59 mgl(-1)), free carbon dioxide (0-16.5 mgl(-1)), total alkalinity (70-290 mgl(-1)), total hardness (42-140 mgl(-1)), chloride (15.62-80.94 mgl(-1)), nitrate (0.008-0.025 mgl(-1)), nitrite (0.002-0.022 mgl(-1)), sulphate (3.50-45 mgl(-1)), phosphate (0.004-0.050 mgl(-1)), silicate (2.80-13.80 mgl(-1)), biochemical oxygen demand (0.60-5.67 mgl(-1)), chemical oxygen demand (2.40-26.80 mgl(-1)), ammonia (nil-0.56 mgl(-1)), sodium (14.30-54.40 mgl(-1)) and potassium (2.10 mgl(-1)-6.30 mgl(-1)) reflects on the pristine nature of the river in National Chambal sanctuary. On the basis of various parameters studied, Chambal river in this stretch can be placed under the category of oligosaprobic. The water quality analysis, indicated that the riverwater in the sanctuary area is pollution free and can serve as a good habitat for many aquatic animals including endangered species.

Hepatic pathology in AIDS: a pathological study from Mumbai, India

OBJECTIVES

To assess the spectrum of hepatic disorders in AIDS, liver specimens from 171 patients (155 autopsies and 16 biopsies) were reviewed.

METHODS

A retrospective and prospective study of 171 autopsy and biopsy specimens was carried out at a tertiary level hospital in Mumbai, India.

RESULTS

Of the patients included in the study, 127 (74%) were male and 44 (26%) were female. The heterosexual route was the predominant mode of HIV transmission, identified in 163 (95%) patients. A total of 99 of 171 patients (58%) showed significant pathological lesions, and the most common pathological processes involving the liver appeared to be secondary to infections. None of our patients showed isolated infectious diseases of the liver. The spectrum of liver diseases identified was as follows: tuberculosis in 70 patients (41%), cryptococcosis in eight (5%), cytomegalovirus infection in six (3%), hepatitis B infection in five (3%), candidiasis in one (0.5%), malaria in one (0.5%), cirrhosis in six (3%), amyloidosis in one (0.5%) and primary hepatic lymphoma in one (0.5%).

CONCLUSIONS

AIDS patients were found to have a high prevalence of underlying hepatic abnormalities. The spectrum of disease among patients with AIDS in India differs from that in developed countries. Our results suggest that hepatic tuberculosis is more common in AIDS than previously recognized, and that liver specimens should be examined routinely for the presence of acid-fast bacilli.