Journal of Pharmaceutical Research International

Objective: To assess the diagnostic accuracy of Color Doppler ultrasonography in patients with Deep Venous Thrombosis by using venography as gold standard at Radiology department of Civil Hospital Karachi.

Methodology: This cross-sectional study was carried out from August 2014 to March 2015 at Radiology Unit, Civil Hospital Karachi. Patients of either gender with deep venous thrombosis were included based on clinical examination and observation. For Doppler ultrasound, the combinations of spectral scanning, color compression, and grey scale were used. Potential anomalies including existing or non-existing thrombus along with its magnitude were evaluated. Color Doppler Sonographic results included incompressible, lack of phasicity, site of flow space and absence of increasing trend. Scan diagnosis was subsequently contrasted with venographic reports and recorded in self-made proforma. Data was analyzed by using SPSS version 20.

Results: Total 104 patients were studied and their average age was 52.4±9.4 years. Males and females were 56% and 44% respectively. Color Doppler ultrasonography findings showed 99% sensitivity and 80% specificity. Positive predictive value 99% and negative predictive value 80% and accuracy was 98%.

Conclusion: Color Doppler ultrasonography is cost-effective, efficient, safe, and non-invasive method to diagnose the deep venous thrombosis of acute nature.

Vitamin D is well known for its essential role in maintaining healthy bones. Deficiency of this causes the bones to become soft and weak, a disease known as rickets in children and osteomalacia in adults. Vitamin D is produced via skin under the action of sunlight, with smaller amounts from dietary sources. A self-administered questionnaire was prepared consisting of 10 questions. The questionnaire consisted of open ended and close ended type of questions. The survey was conducted among the IT (Information Technology) employees of a particular region. The survey was conducted via online platform. The results were collected, analysed and interpreted. The results conveyed that a majority (83%) of the IT employees were aware that the vitamin D deficiency mainly causes obesity. 50% of the IT employees were aware that vitamin D deficiency causes mainly skin cancer. 52.1% of the IT employees were aware that vitamin D levels support lung function and cardiovascular health. The present study concluded that the IT employees were well aware about the vitamin D deficiency and its risk factors. They had a good knowledge on the fact that vitamin D deficiency causes obesity and many other health issues.

In this study, the functional and virulent classes of proteins that are targeted by ferulic acid are identified from the most common dental pathogens like Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Streptococcus mutans and Enterococcus faecalis by an in silico approach. The target proteins were selected using STITCH tool, the functional class of proteins was predicted using VICMpred. The predicted virulent proteins were further subjected to BepiPred analysis, which returned the number of peptide epitopes present in the protein. Further, the subcellular location of the proteins was confirmed by the PSORTb tool. Ferulic acid was found to interact with virulence factors such as dihydrolipoyl dehydrogenase of Streptococcus mutans, putative lipoprotein of P. gingivalis and phosphogluconate dehydrogenase of T. forsythia. The findings of the study emphasize the promising interactive role of ferulic acid and their potential protein targets in common oro-dental pathogens which requires further experimental validation in-vivo and in-vitro.

A nanoparticle is an ultra-fine particle with at least one dimension between 1-100 nanometers (nm). Metallic nanoparticles are considered as most promising as they contain remarkable antibacterial properties. Gold nanoparticles are of high importance in research. Aspartic acid is an alpha amino acid and contains one amino group and one carboxylic group. The aim of the current study was to bio synthesize gold nanoparticles using aspartic acid. Gold Chloride (AuCl3) and Aspartic acid (C₄H₇NO₄) were used for the study. AuCL3 solution (0.266 M) was slowly added to 250 aspartic acid with stirring at 45°C. The mixture of the solutions was kept in a long-necked borosilicate flask and continuously stirred on a magnetic stirrer. The formation of gold nanoparticles was confirmed by the change of the colorless solution to a reddish hue. Characterization of the newly formed nanoparticles was then done. After approximately 9 hour incubation and intermittent stirring with a magnetic stirrer the solution color changed from colorless to a reddish hue, which indicated the formation of AuNPs. The spectrometric reading was recorded at a scanning range of 400–700 nm. AuNPs nanoparticles at 24 hours showed an increased intensity and a Surface Plasmon Resonance (SPR) band at 575 nm. The gold nanoparticles by Transmission electron microscopy were confirmed to be spherical in shape and of 20 nm. A simple and efficient method for the synthesis of AuNPs from the aspartic acid was demonstrated. Nano particles were formed in approx. 9 hours with peak absorbance at 24 hours at 575nm. The synthesized nanoparticles were spherical in shape, with an average size of 20 nm. The synthesized nanoparticles showed excellent plasmon resonance and optical properties.

Diet is a major etiological factor for enamel erosion and dental caries. The proportionality of dental caries increases with the increase in duration of food in the oral cavity. This study was undertaken with the aim of assessing the level of salivary calcium with the consumption of beverages. Major chemical constituents of beverages include, carbohydrates, sweeteners, acids (pH-2.5 to 3.5) phenolic compounds, steroids, nitrogen compounds, ethanol (for alcoholic beverages) and carbon dioxide (for carbonated soft drinks). The presence of carbon in the soft drinks reduces the pH leading to demineralisation and erosion of enamel layer when consumed. The sugars and carbon present in the soft drinks are responsible for dissolution of enamel. Thus the aim of the current study is to analyse the effect of carbonated soft drinks on salivary calcium level. In this study 25 subjects were selected. All were given 200ml of carbonated soft drinks immediately after opening the soft drinks bottle to avoid cessation of carbon dioxide. The level of salivary calcium is measured and analysed by paired sampling using a commercially available analyser kit and the results were statistically analysed, compared and interpreted. There is an increase in the salivary calcium level after the consumption of carbonated soft drinks because of its acidic ph and sugar content. The acidic environment causes demineralisation of the enamel making the enamel brittle and weaker. From this Study, it can be verified that the level of calcium in the saliva increases due to the action of the carbon and sucrose present in the soft drinks on the enamel. This can be verified with the significant p value (p<0.005).

Potentially malignant disorders are “the risk of malignancy being present in a lesion or condition either at the time of initial diagnosis or at a future date” include mainly leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis. Biomarkers were of immense help in diagnosis in recent years but a very few molecular biomarkers have been reported in the literature which are not significantly accurate. The current study aims at quantifying the levels of Transforming growth factor (TGF- β), Platelet derived growth factors (PDGF) and receptor of advanced glycosylation end products (RAGE) in saliva of patients with potentially malignant disorders and oral squamous cell carcinoma. Unstimulated saliva of oral squamous cell carcinoma and potentially malignant disorder patients was collected and stored in sub zero temperature. Further biochemical analysis was performed with Raybio ELISA kits. One way ANOVA was performed. The mean concentration of RAGE, PDGF and TGF- β was increased in oral squamous cell carcinoma groups and potentially malignant disorders when compared to healthy controls.p-0.000 (p<0.05).These combined assays can be used as potential biomarkers for indicating the prognosis of the disease and can be used as a diagnostic tool for screening and early detection as these combined assays give more reliable and accurate diagnosis when compared to single biomarker assays.

Green tea is a popular beverage and in vitro studies have shown that green tea phenols inhibit the growth and cellular adherence of periodontal pathogens and their production of virulence factors. The antioxidants, bacteria battling catechins and other micronutrients in green tea fortify tooth structures, whitens teeth, keep breath fresh, and dissolves plaque. Green tea controls bacteria and lowers the acidity of saliva and dental plaque, it may be a useful tool in preventing cavities. Green tea’s anti-inflammatory powers seem to help control periodontal (gum) disease. The aim of this present survey was to establish awareness of the therapeutic benefits of green tea among the dental fraternity. A descriptive survey was conducted among dental students of Saveetha Dental college using a questionnaire in the google form. The questionnaire consists of 15 questions that were framed based on the knowledge of the therapeutic benefits of green tea in oral health and sent to 75 subjects. The data was collected and systematically analyzed that 62% of participants reported that green tea removes bad breath, 68% of participants reported that green tea has anti-inflammatory effects that heal gum diseases. About 64% of participants reported that frequent intake of green tea would decrease dental caries formation. About 60% of participants reported that green tea has curative properties against dental caries, gingivitis, periodontitis, and oral malignancy. Based on this survey, the knowledge and awareness about the therapeutic benefits of green tea among the dental fraternity have been known by the majority of persons.

Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine. The aim of this study was to assess the knowledge and awareness of Articaine use among dental students. A cross-sectional study was done to assess the knowledge and awareness of articaine use among dental students. The sample size of the study was about 100 participants and the survey instrument was a self-administered questionnaire administered online. The responses were collected and statistically analyzed. 59% of the students were aware of articaine use in dentistry. The study concluded that there is a moderate level of awareness about articaine use among dental students.

Ever Changing perception of beauty from childhood to old age is changing with the revolution in cosmeceuticals science. Aesthetics are an individual’s perception since time immemorial. Standards of beauty have changed through the centuries with increased awareness about aesthetics. The youthfulness despite advancing age includes smooth, charming skin without skin folds, volume loss, and skin laxity, all these are possible only due to these cosmetic procedures mainly due to Botox treatment. The aim of the study is to assess the awareness of Botox injection among college students. The survey questionnaire consisted of 20 questions and was circulated among the college students. The sample size of the study was 100 and the results were tabulated accordingly. The results show that around 65.7% of the college students are unaware that  Botox injection should be used only after the age of 25 whereas the remaining 34.3% of the college students are aware of this fact. Around 45.4% of the college students are unaware of the risks associated with cosmetic procedures whereas the remaining 38% of the population are aware of the problem associated with cosmetic procedures and the remaining 18% of the population comes under other categories. Around 54.8% of the population is aware that using Botox may cause side effects like infection, inflammation, and swelling and the rest of the population that is 45.2% are unaware of these effects. From this study, it is very much evident that college students are not much aware of the age limits and the risks associated with the usage of Botox treatment.

Postoperative pain control after extraction of third molars is important for patients because of the effect of pain symptoms on the healing process and quality of life. The aim of this study was to assess the knowledge and awareness of dental students towards the use of preemptive analgesics in third molar extractions. A questionnaire based survey was conducted among 100 dental students. Questionnaire was distributed through a survey link. Results were collected and analysed using IBM SPSS Statistical Analyzer (23.0 version). Frequency distribution and descriptive analysis were carried out. The variables were analysed using Pearson Chi square test. P Value less than or equal to 0.05 was considered to be statistically significant. The results of the study showed that the knowledge and awareness of dental students about the usage of preemptive analgesics in day to day practice varied according to their year of study. Interns were observed to have more knowledge and awareness regarding preemptive analgesics in comparison to third years and final years. Preemptive analgesics play a significant role in the elimination of postoperative pain in patients after removal of third molars. Therefore, it is of utmost importance for dental students to gain sufficient knowledge regarding the usage and importance of preemptive analgesics in dentistry.

Articaine is a short acting local anesthetic agent which is used for minor surgeries. Although there is reluctance to use it on children, studies have shown that it is safe to use it in pediatric patients above the age of 4 years. This survey aimed to analyse the awareness on the use of articaine in children among dentists. A questionnaire containing questions about articaine, it’s properties and the participant’s general view about the local anesthetic was distributed to the dental students and private practitioners in Chennai. The results were statistically analyzed using Chi Square test. Moreover, 65% of the participants were using articaine in children, 26.51% preferred using articaine in children below the age of 4. On the other hand, 43.18% were unsure about the choice of articaine as their default local anesthetic agent. This survey showed that dental students and the participants with 0-5 years of experience used articaine as a local anesthetic in children with the difference being statistically not significant(p>0.05). Moreover, male dentists showed more willingness to prefer articaine as their default local anesthetic agent compared to females, however the difference was not statistically significant (p>0.05).

Sugar is used in medicine for coating, adding volume or texture, and flavouring the medicine. It can also act as a preservative and antioxidant. Sucrose is often used in medications to impart a more pleasant taste to often unpalatable chemicals. Sucrose can be found in many medicinal forms such as chewable tablets, syrups and lozenges. The aim of the study is to create awareness on concentration of sugar in medicines among college students. A survey was administered  through survey planet link with sample size 100. The questionnaire consisted of 14 questions based on awareness on concentration of sugar. In the present study majority of the  participants felt addition of sweeteners in syrups and tablets should be decreased. Adults and children who are administered to long term medicines are prone to caries and other health problems. Chronically ill children are exposed to a greater sugar load from oral medications than healthy children leading to a greater risk of developing caries as a side effect of the treatment. Awareness may be created on the concentration of sugar in medicines and its deleterious effect on health.

Aim: The purpose of this study was to evaluate the effectiveness of intranasal administration of dexmedetomidine during therapeutic extraction.
Materials and Methods: The study design is a split mouth double blinded randomized control trial. Patients who visited the department of oral and maxillofacial surgery for the therapeutic extraction of premolars were assessed for enrollment. Each subject participated in two surgical sessions, with the extraction of premolars of the upper and lower quadrant of the same side during a single session. A week later subjects were asked to report back for the extraction of the upper and lower premolar on the contralateral side. The patients were randomized by a computer generated number into two groups. Group A received intranasal dexmedetomidine (100 mcg/ml) and group B received intranasal saline at the first session. An alternate regimen was used during the second session during which group A received intranasal saline and in group B intranasal dexmedetomidine was administered. A mucosal atomization device was used to deliver the drug. Pain from local anesthesia infiltration was rated on the numerical rating scale from 0 (no pain) to 10 (worst pain imaginable). Sedation status was measured using the Observer's Assessment of Sedation. Blood pressure and heart rate of the patient were also monitored.
Original Research Article
Xavier et al.; JPRI, 32(18): 112-119, 2020; Article no.JPRI.59782
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Results: A total of 14 patients were involved in the study. Observer assessment scale indicated that significant sedation was obtained in group A when compared to group B. Compared to group B there was a significant reduction in heart rate and blood pressure in group A at the end of 10 minutes and 40 minutes. These parameters were normalized to the baseline at the end of 60 minutes. There was no significant difference in pain score noted during the local anesthesia infiltration. None of the patients had bradycardia, hypotension, and respiratory depression in this trial.
Conclusion: In this study, we conclude that the intranasal administration of dexmedetomidine controls the patient's fear and anxiety during the therapeutic extraction but not the pain during the administration of local anesthesia.

Calcium hydroxide (CH) is an intracanal medicament that has been widely used in endodontics, which can eliminate bacteria because of its high alkalinity. However, E. faecalis is resistant to CH. Triple antibiotic paste (TAP) is a mixture of ciprofloxacin, minocycline, and metronidazole, and is highly effective against E. faecalis. Hence the main aim of this study was to find the antimicrobial efficacy of CH and TAP combination against E. faecalis. The study was done by agar diffusion method, three wells were punched in Tryptone soya agar and filled with CH, TAP, and the combination of both. The zone of inhibition values was recorded and subjected to statistical analysis using SPSS. One way ANOVA and Post Hoc tests were used to compare the means. The combination of CH with TAP was found to be significantly better than CH and TAP used alone (p-value <0.05).Within the limits of this study, it can be concluded that TAP is more efficient when compared with CH,The combination of CH and TAP proved to be more effective when compared to the two when used alone.

Introduction: Candida albicans and Enterococcus faecalis are the most predominant microorganisms found in the canals of failed root canal treated teeth. Thorough debridement of an infected root canal and complete elimination of microorganisms are objectives of effective endodontic therapy. For thousands of years, humans have used herbs as the primary means to sort out health issues and illnesses. Not all herbs have shown to provide scientific evidence as medicine to illness. Neem is a Botanical herb that is truly remarkable with its scientific value, a tropical evergreen native to India. Although different agents have been suggested as root canal irrigants, sodium hypochlorite and EDTA are the most popularly used.

Aim: To compare the antimicrobial efficacy of commercially available irrigants, 17% EDTA and a herbal product, neem leaf extract compared with 3% sodium hypochlorite as a control against Enterococcus faecalis and Candida albicans.

Materials and Methods: The antimicrobial activity was determined using the agar well diffusion method. Freshly prepared neem leaf extracts, 17% EDTA, 3% Sodium hypochloriteStandard strain of E. Faecalis and C. Albicans were used in this study. These isolates were subcultured on to Brain heart infusion agar (BHI agar) and HI-chrome candidal differential media respectively. The agar well diffusion test was performed in brain heart infusion media and broth. The plates were incubated at 37°C for 24 hours and the zone of inhibition was recorded and analyzed statistically.

Results: Zones of inhibition were present with Neem leaf extract suggestive of antimicrobial properties. Zones of inhibition were greater with Neem extract than 17% EDTA. Hence, further research should be directed towards the use of this herbal extract as an irrigant clinically with endodontic therapy.

Conclusion: Within the limitation of this study, it was found that neem leaf extract had a significant antimicrobial effect against E. Faecalis and C. Albicans compared to EDTA and Sodium Hypochlorite. Since the study is a qualitative analysis, further testing needs to be done to final quantitative analysis of the antimicrobial activity of neem leaf extract.

Transdermal delivery is a non-invasive route of drug administration through the skin surface that can deliver the drug at a predetermined rate across the dermis to achieve a local or systemic effect. It is potentially used as an alternative to oral routes of drugs and hypodermic injections. The aim of this study was to assess the knowledge and awareness of transdermal drug patches among dental students. A structured self-assessed online questionnaire having 15 questions on transdermal drug patches was prepared and distributed to the dental students who have clinical exposure including 3rd BDS, final BDS, interns, and postgraduates of all specialties. It was circulated using online software, survey planet, and the response was collected through it. Statistical analysis was done using SPSS software. Considering the responses, it can be interpreted that the knowledge regarding transdermal drug patches is above average among dental students. Also, postgraduate students were more knowledgeable than undergraduate students. Interns showed more awareness than a third-year or final year undergraduate students. Educational workshops, conferences, and CDE’s are essential for both undergraduates and postgraduates to improve their knowledge regarding various transdermal drug patches and their adverse reactions.

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. This study aims to assess the knowledge and awareness of herbal substitutes for root canal disinfectants among dental students. This study was a cross-sectional study, which was conducted among the clinical students of Saveetha Dental College. The questionnaire consisted of 14 multiple choice questions Once the students have answered the questionnaire, the data obtained from the survey were analyzed using statistical sciences (SPSS) version and results were obtained. A total of 100 students which comprised 3rd year, 4^th year, and Final year students had actively participated and taken up the survey and completed the survey successfully. The results of this survey show that the students who attempted the questionnaire had a fair knowledge about herbal substitutes in root canal disinfection. From this survey, we can see that the dental students have fair knowledge and awareness about the herbal substitutes for root canal disinfection and It is very important to educate and create awareness and increase the knowledge of our traditional folk medicine where herbs are used to treat and cure individuals among the health care members.

The aim of the study is to evaluate comparatively the cytotoxicity of diclofenac sodium and calcium hydroxide on L929 fibroblasts. L929 fibroblast cells were cultured and grown on Dulbecco modified Eagle’s medium. Intracanal medicaments tested were Diclofenac sodium, 5.0, 7.5, 10.0 mM/ml) and calcium hydroxide. The human fibroblast cell lines cultured in Dulbecco Modified Eagle’s medium were used as control group. Cytotoxicity was evaluated by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. The results showed that there was a significant difference in cell viability as compared with the control group (P<0.05). There was no significant difference in the group treated with diclofenac sodium and calcium hydroxide (1.0 mM/ml). However, diclofenac sodium at concentration more than 5 mM/ml was found to be cytotoxic. The study concludes that diclofenac sodium is cytotoxic at 5 mM/ml and above. Therefore, further studies are recommended to establish the antimicrobial efficacy of the medicament. Within the limitations of the study, Diclofenac sodium at concentration more than 5mM/ml was found to be cytotoxic for the cells. The inhibitory concentration (IC₅₀) of Diclofenac sodium at which the cells were viable was found to be 5.2 mM/ml. Further studies should be done to establish the antimicrobial efficacy of the medicament at these concentrations.

Anxiolytic drugs are a class of drugs that reduce the anxiety levels in the individuals by nonspecifically binding to the GABAα located throughout the central nervous system. The aim of this study was to compare the anxiolytic effects of diazepam and Zolpidem in patients undergoing extraction. This was a cross-sectional study conducted at a university setting, with a sample size of 100 patients, of the age group 25-45 years. 50 patients were administered with Tab. Diazepam and 50 patients with Tab. Zolpidem one hour before the surgical procedure. The Hamilton Anxiety Rating Scale (HAM-A Scale) was used to record the patient's anxiety levels before and during the extraction procedure. These data were then recorded in MS Excel Sheet and imported to SPSS for statistical analysis. From this study, it can be seen that most of the patients were females and mainly between the age group 25-35 years. Diazepam had significantly lesser post sedation anxiety levels in comparison with its post sedation levels than zolpidem with, a statistically significant difference (p<0.001). Therefore, it can be concluded that diazepam had better post sedation effects than zolpidem in patients undergoing extraction as patients presented with lesser severity in their anxiety levels.

Fear or anxiety towards dental procedures can discourage patients from getting dental treatment done. The management of anxious patients undergoing dental treatment is still a challenge in clinical practices. The increased use of sedative and hypnotics in dental practices appears to indicate that the assessment of dental student’s awareness of it, is essential. This survey is carried out to determine the awareness of sedatives and hypnotics used in dental practices among dental students. A questionnaire-based survey study was conducted among 100 undergraduate students at Saveetha Dental College and hospital. The study revealed 94% of the students are aware of the commonly used sedatives and hypnotics in dental practices.