Comparative Evaluation Of Effect Research Articles

Comparative Evaluation of Effectiveness of Lesser Toe Surgical Correction

INTRODUCTION: The relevance of improving algorithms of surgical correction of lesser toes (SCLT) is due to a high incidence of hammertoe deformity syndrome, its negative impact on the working capacity and quality of life, and to a considerable degree of dissatisfaction of patients with the results of surgical treatment. AIM: To evaluate the effectiveness of an improved SCLT algorithm using a modified fixed B. Helal osteotomy and combined plantar plate (PP) and toe flexor tendon repair. MATERIALS AND METHODS: The prospective study included 167 female patients with a severe deformity of the second lesser toe. In 83 patients of the control group, the stability of the metatarsophalangeal joint was restored through surgical PP repair. In the main group (n = 84), along with elimination of PP defect, the second toe flexor tendon repair was performed. The condition of the second lesser toe before and one year after its surgical correction was evaluated using clinical and X-ray methods and a questionnaire. RESULTS: At the stage of assessing the long-term results of treatment in the main group, the integral score of ACFAS Module 2 scale increased by 63 points relative to the preoperative value, which appeared to be 22 points more (Uemp = 3687, Ucr = 4894, р ˂ 0.01) than a similar change in the control group. One year after surgery, the incidence of the floating toe syndrome and its residual hyperextension in the main group decreased by 10.8% (φ*emp = 0.007, р ˂ 0.05) and 8.8% (φ*emp = 0.016, р ˂ 0.05), respectively. CONCLUSIONS: Application of the improved algorithm permitted to improve the SCLT effectiveness, which was confirmed by a statistically significant improvement of the long-term results of treatment of patients in the main group compared to the control group.

Comparative Evaluation of Effectiveness of Lesser Toe Surgical Correction

INTRODUCTION: The relevance of improving algorithms of surgical correction of lesser toes (SCLT) is due to a high incidence of hammertoe deformity syndrome, its negative impact on the working capacity and quality of life, and to a considerable degree of dissatisfaction of patients with the results of surgical treatment. AIM: To evaluate the effectiveness of an improved SCLT algorithm using a modified fixed B. Helal osteotomy and combined plantar plate (PP) and toe flexor tendon repair. MATERIALS AND METHODS: The prospective study included 167 female patients with a severe deformity of the second lesser toe. In 83 patients of the control group, the stability of the metatarsophalangeal joint was restored through surgical PP repair. In the main group (n = 84), along with elimination of PP defect, the second toe flexor tendon repair was performed. The condition of the second lesser toe before and one year after its surgical correction was evaluated using clinical and X-ray methods and a questionnaire. RESULTS: At the stage of assessing the long-term results of treatment in the main group, the integral score of ACFAS Module 2 scale increased by 63 points relative to the preoperative value, which appeared to be 22 points more (Uemp = 3687, Ucr = 4894, р ˂ 0.01) than a similar change in the control group. One year after surgery, the incidence of the floating toe syndrome and its residual hyperextension in the main group decreased by 10.8% (φ*emp = 0.007, р ˂ 0.05) and 8.8% (φ*emp = 0.016, р ˂ 0.05), respectively. CONCLUSIONS: Application of the improved algorithm permitted to improve the SCLT effectiveness, which was confirmed by a statistically significant improvement of the long-term results of treatment of patients in the main group compared to the control group.

Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study.

This investigation aimed to observe the effects of Dycal, mineral trioxide aggregate (MTA), and TheraCal LC, as indirect pulp-capping materials in primary molars. About 75 children with lower primary molars aged between 4 and 7 years suggested for IPC were selected and randomly allocated into: Group I - Dycal, group II - MTA, and group III - TheraCal LC. An immediate postoperative radiograph was taken after the procedure. Recall examination was done after 3 and 6 months for clinical and radiographic assessment. The radiographs were digitized, and the amount of thickness of dentin was assessed using Corel Draw software. The values were tabulated and subjected to paired t-tests and independent t-tests for intra and intergroup analysis, respectively. The p-value < 0.05 was considered statistically significant. There was a statistically significant increase in dentin thickness in the first 3 months compared to the 6-month follow-up. At the end of the research phase, TheraCal LC had more tertiary dentin deposited than MTA, followed by Dycal. TheraCal LC can be a reliable indirect pulp-capping agent in primary teeth. Indirect pulp capping (IPC) is a very extensively employed treatment regimen to manage extensive caries. For many decades, calcium hydroxide has been regarded as the benchmark of pulp capping materials. With several advancements in materials for restoration, TheraCal LC a resin-modified, light-cured calcium silicate-filled liner serves as a pulp-capping agent and dentin protector, promoting pulp healing and preserving vitality as an obstacle cum protector of the dental pulp complex. How to cite this article: Thomas NA, Jobe J, Thimmaiah C, et al. Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study. J Contemp Dent Pract 2024;25(4):365-371.

#2628 A haemodialysis patient-centred model of care with a multidisciplinary programme: what is its clinical and health efficiency impact?

Abstract Background and Aims Chronic kidney disease (CKD) constitutes a public health concern due to its notable morbidity &amp; mortality and associated costs. The Patient Care Coordination program (PCC) provides comprehensive and personalized care to haemodialysis (HD) patients. This study evaluated the cost-effectiveness of PCC compared to standard of care (SoC). Method The study included patients in 9 HD clinics (5 PCC, 4 SoC) in Catalonia, Spain, in 2020-2021. A comparative effectiveness evaluation was conducted to compare change in Individual Patient Performance Score (IPPS, score 0-100, evaluates parameters such as vascular access, adequacy of HD, anaemia, mineral bone disease, arterial hypertension, nutrition/hydration status) and number of hospitalisations of PCC patients vs SoC during the first year in the program. Instrumental variables (IV) regression analysis was performed to address potential confounding; number of interactions with program specialists was a valid IV to estimate degree of PCC use. An incremental cost-effectiveness analysis (iCEA) through microsimulation was performed using the effectiveness data from the previous step, population data from the renal patient registry of Catalonia, and the cost of hospitalisations obtained from the Public Health System. Results 127 patients in PCC and 363 patients in SoC were included. The degree of PCC use had a positive impact on IPPS variation during the first year of the program (p = 0.012). In the iCEA the PCC program resulted in a mean gain of 3.4 additional IPPS points, a reduction of 0.2 hospitalisations per patient, and reduced mean costs of €1,265 per patient in the first year compared to SoC, resulting to be a dominant alternative (Fig. 1). Conclusion The holistic and interdisciplinary approach to the patient has further highlighted the relevance of programme use and not only belonging to the programme in achieving clinical goals. The PCC program represents thus a dominant alternative, with greater effectiveness and total cost savings that could sum up to €5.5 million per year in the region due to reduced hospitalizations. This approach may be an alternative to address the challenges of CKD and optimise the allocation of healthcare resources.

Comparative Evaluation of Icon Resin Infiltration and Clinpro XT Varnish Effects on Surface Characteristics in Artificially Induced White Spot Lesions

Comparative Evaluation of Icon Resin Infiltration and Clinpro XT Varnish Effects on Surface Characteristics in Artificially Induced White Spot Lesions

Comparative evaluation of effectiveness of three versus four mini-implants for simultaneous intrusion and retraction of maxillary anterior teeth: A 3D FEM study.

To evaluate and compare the displacement pattern of maxillary anterior teeth in the sagittal and vertical planes and evaluate the stress distribution in pdl, bone, teeth of the maxillary anterior region, and around the mini-implants during simultaneous en-masse retraction and intrusion using two, three, and four mini-implants combinations. A three-dimensional FEM model of maxillary teeth and periodontal ligament housed in the alveolar bone with extracted first premolarswasgenerated. The models were broadly divided into three groups according to the number of mini-implants. Mini-implants were placed bilaterally between the second premolar and molar in group I, and along with bilateral implants, an additional mid-implant was placed between the central incisors as in group II, whereas in group III, anterior mini-implants were placed in between lateral incisors and canine bilaterally. The two mini-implant model showed the maximum amount of retraction in the sagittal plane followed by three and four mini-implant models. In the vertical plane, all six anterior teeth showed intrusion only in the four mini-implant model. The stress in cortical bone, cancellous bone, PDL, around the mini-implants, and in lateral incisor was maximum in the three mini-implant model, followed by four mini-implants with the least stress in the two mini-implant model. The four mini-implant model is better than the three and two mini-implants model as there is a more even distribution of force in the four mini-implants model as compared to the three mini-implants model.

Comparative evaluation of effects of manual and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health- an in-vivo study

To evaluate and compare the effects of manual tooth brushing and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health of the patient undergoing orthodontic treatment.This randomized controlled clinical trial comprised a total of 36 patients in the age group 15-25 years, coming to Outpatient Department (OPD) of Orthodontics and Dentofacial Orthopedics and undergoing orthodontic treatment. Periodontal evaluation was performed for each patient at four intervals of time, before oral prophylaxis, 1 week after oral prophylaxis, after 3 months of bonding and after 6 months of bonding which constituted the readings at T, T, T and T, respectively. Patients were instructed to use manual toothbrushes for 3 months after bonding. Post 3 months, the patients were divided into two groups- Group I and II as Group I- patients using powered toothbrush and Group II- patients using manual toothbrush, for next 3 months. At both the intervals (T and T), two brackets were debonded from central incisors and second premolars from each patient and studied under scanning electron microscope for biofilm formation.Powered toothbrushing was more effective in reducing API and SBI scores, statistically high significant difference was seen in API score (P = .004) and SBI score (P &amp;#60; .001) between T &amp; T time intervals on comparing both the groups. Both the manual and powered toothbrushing had equal effect on GI scores, no significant difference was seen in GI score (P = .540) between T &amp; T time intervals on comparing both the groups. On inter group comparison of amount of biofilm formation between T2 &amp; T3 time intervals in anterior and posterior region, higher amount of biofilm formation in both the anterior and posterior regions in group II patients (Anterior region= 12.05±6.90, P = .001, posterior region= 10.32±9.75, P = .001).Powered toothbrushes are more effective in removing plaque and thus reducing gingival inflammation in patients with fixed orthodontic appliances.

Comparative evaluation of effect of modified triple antibiotic paste and calcium hydroxide as intracanal medicament on microhardness of root dentin: An in vitro study

ABSTRACT Aim: To assess and compare the impact of modified triple antibiotic paste (MTAP) and calcium hydroxide (CH) as intracanal medicament on microhardness (MH) of root dentin. Materials and Methods: Twenty single-rooted, noncarious, single-canaled permanent teeth were selected. They were decoronated and vertically sectioned into two equal parts to acquire 40 samples. These samples were submerged in acrylic blocks with their pulpal surfaces exposed. These samples were enclosed within acrylic blocks, with their pulp surfaces visible. They were then randomly allocated into four groups (n = 10). MH was measured at three steps: initial measurement of MH before irrigation with 3% sodium hypochlorite (NaOCl); after irrigation with 3% NaOCl; and after interaction with medications (MTAP or CH pastes at an interval of 7 days or 30 days). The degree of reduction in MH percentage was computed. The collected data underwent statistical examination at a significance threshold of P &lt; 0.05. Results: All procedures led to a noteworthy decline in MH values when compared to both prior and initial measurement. The highest reduction in MH was seen after irrigation with 3% NaOCl (P &lt; 0.05). CH showed a greater reduction in MH as compared to MTAP (P &lt; 0.05). More reduction in MH was seen after 30 days as compared to that after 7 days for both CH and MTAP (P &lt; 0.05). Conclusion: Use of intracanal irrigants and medicaments reduces the MH of root dentin. Lesser reduction in MH was observed when utilization of MTAP as compared to CH.

Comparative Evaluation of Antimicrobial Effectiveness and Compressive Strength in Neem and Lemongrass-Modified Glass Ionomer Cement: An In Vitro Study.

Background Glass ionomer cement (GIC) demonstrates biocompatibility and fluoride ion release, indicating their potential to inhibit a wide range of bacteria, although this remains uncertain. Lemongrass and neem are recognized for their potent antimicrobial activity against numerous pathogenic microorganisms. The objective of the study is to evaluate the antimicrobial effectiveness and compressive strength of GIC modified with neem and lemongrass. Methodology Lemongrass and neem were incorporated into conventional GIC at varying concentrations. Group I - neem-modified GIC (0.5%, 1%, 2%), group II - lemongrass-modified GIC (0.5%, 1%, 2%), and group III (non-modified GIC as a control group). The disk-shaped specimens were then compared to unmodified GIC (control). Antimicrobial effectiveness was assessed using the minimal inhibitory concentration (MIC) assay against Streptococcus mutans and Lactobacillus. Compressive strength was assessed using a Universal Testing Machine, with a crosshead speed set to 0.5 mm per minute. Statistical analysis was conducted with a significance level set at p < 0.05. Results Neem modification displayed superior antimicrobial effectiveness against both Streptococcus mutans and Lactobacillus at all concentrations when compared to the control, with 2% showing the least mean value of 0.262. In contrast, lemongrass modification exhibited a significant difference in effectiveness against Streptococcus mutans but no difference against Lactobacillus. Neem modification demonstrated superior performance compared to lemongrass (p < 0.05). Both modified groups showed no significant impact on compressive strength. Conclusions Neem-modified GIC demonstrated the highest antimicrobial efficacy against Streptococcus mutans and Lactobacillus without altering its compressive strength. This suggests its potential as a promising alternative material in restorative dentistry. Additional in vivo investigations are needed to assess the extended-term effectiveness of the material.

Comparative evaluation of effectiveness of chemical, mechanical and chemico-mechanical methods of denture cleaning for removal of stains from heat polymerised acrylic resin denture base - An in- vitro study

An essential quality of acrylic resin denture bases is colour stability. Over time, acrylic resin bases have a tendency to attract stains, which causes the denture base's colour to alter. These modifications sometimes make the denture less aesthetically pleasing for the wearer, which leads to patient unhappiness and higher replacement costs. The study's objective was to evaluate and compare the effectiveness of cleaning dentures using chemical, mechanical, and chemico-mechanical methods for removing stains from the heat polymerized acrylic resin denture base.A total of 120 samples of heat polymerised acrylic resin were fabricated and stained using sambhar solution for 10 days under controlled conditions. The baseline optical density of the samples was determined. The samples were then subjected to stain removal procedure by either - chemical, mechanical or chemico-mechanical method. After which the optical density was again determined. The efficiency of the three methods used was determined by the difference in the optical density after staining and post cleaning and compared with the baseline optical density measured previously. The data was analysed using One-way ANOVA test. Post hoc comparison was made by Bonferroni t-test. p&amp;#60;0.0.5 was considered as statistically significant. Data analysis was done using the statistical software STATA version 13.0.The results suggested that the chemico-mechanical method was the best method for stain removal from the acrylic samples. However, the mechanical method of denture cleaning was found to be equally effective. The chemical method was least effective in removing stains from the surface of heat polymerised acrylic resin. The chemico-mechanical method was 95.16% effective and the mechanical method used was 92.12% effective, proving that the chemico-mechanical was the most effective method for removing stains from the acrylic resin amongst the 3 techniques compared.

Comparative evaluation of anti-anemic effect of Sucrosomial iron in experimental model of iron deficiency anemia in Wistar rats

Abstract Anemia is a grave public health issue that affects 25% of the global population. Conventional iron formulations used in treatment have drawbacks such as poor bioavailability and gastric intolerability. The current study aimed to evaluate the anti-anemic effects of different iron salts in Wistar rats with iron deficiency anemia (IDA). IDA was induced by the validated pre-clinical model by retro-orbital bloodletting (1 ml) for 21 days along with an iron-deficient diet in Wistar rats. The rats (n=48) were assigned into 8 groups: Control group, IDA rats, IDA rats receiving either vehicle or different iron salts (ferrous sulfate, ferrous ascorbate, ferrous fumarate, and Sucrosomial iron) for 21 days at a dose of 30 mg/kg p.o. Hematological parameters and iron store indices were assessed at each visit. Anemia induction markedly reduced hemoglobin levels in all IDA groups on day 21. In contrast, iron supplements showed significant improvement in hematological profile after 21 days of treatment. Interestingly, the Sucrosomial iron-supplemented group (group 8) showed significantly higher improvement in hemoglobin levels and hematocrit than did conventional iron supplements such as ferrous sulfate (group 5), ferrous ascorbate (group 6) and ferrous fumarate (group 7) (p &lt;0.05 for each group, respectively). Sucrosomial iron also showed slightly better improvement in iron store indices (serum iron &amp; ferritin levels, total iron binding capacity and transferrin saturation [%]) when compared with other iron supplements (non-significant difference). Authors concluded that Sucrosomial iron has a significant potential to improve IDA in Wistar rats compared to conventional iron salts. Sucrosomial iron can be useful for the management of IDA either prophylactically or therapeutically.

Novel hormonal therapy versus standard of care-A registry-based comparative effectiveness evaluation for mCRPC-patients.

This paper presents results from one of the few comparative effectiveness evaluations of novel antiandrogen medications (NHT) against standard of care (SoC) for patients suffering from metastatic castrate-resistant prostate cancer (mCRPC). The design and the analysis are published in a protocol before accessing outcome data. Two groups of patients are balanced on hundreds of important covariates measured before the prostate cancer diagnosis and up to the date of the prescription. While the design yields balance on the observed covariates, one cannot discard the possibility that unobserved confounders are not balanced. The unconfoundedness assumption is assessed by estimating placebo regressions on two health measures, not included in the design but added together with the outcome data after protocol publication. We find a substantial (64 percent) increase in mortality for patients prescribed with NHT rather than SoC. However, based on the results from one of the two placebo regressions, we cannot rule out that the difference in mortality may be due to confounding. Using a bounding strategy of the effect, we can, however, rule out that NHT reduces mortality compared to SoC. Under an empirical valid assumption that most mCRPC patients who die suffer from bone metastases, we have a strong indication of increased skeleton-related events in patients if prescribed NHT against SoC. Generally, the SoC for this group of patients is docetaxel. Given the substantially higher costs of many of the NHT, the finding of no positive effects from NHT on both mortality and SRE is important. More comparative studies, including studies analysing quality of life outcomes, are thus needed.

Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study.

To evaluate the remineralizing potential of glass ionomer cement (GIC) and silver diamine fluoride (SDF) on artificially induced enamel caries lesions in primary teeth. The initial baseline surface microhardness (SMH) of 40 primary teeth was tested using Vickers hardness tester, followed by the creation of artificial caries lesions by immersion in the demineralizing solution. Microhardness assessments of demineralized samples were done, and samples were randomly divided into two groups of 20 specimens: in group I, GIC was applied on demineralized enamel, and in group II, SDF was applied on demineralized enamel. Samples were subjected to pH cycling. For group I, GIC from the enamel samples was carefully removed using a surgical blade, and changes in the SMH from both groups were analyzed using Vickers microhardness test. Surface microhardness (SMH) value after pH cycling of GIC (45 ± 10.23) and SDF (47.76 ± 6.69) is statistically highly significant (<0.001) compared to the baseline SMH of both test groups. Comparison of SMH between the two groups showed statistically nonsignificant results. The remineralization potential of SDF is comparable to GIC. So, SDF can be used as a remineralizing agent for incipient enamel caries. Owing to the remineralizing ability of GIC underneath the restorations, it can be used as a therapeutic sealant for incipient enamel caries lesions, where SDF staining is not always acceptable. A 38% SDF also can be used as a remineralizing agent for incipient enamel caries lesions in situations like noncompliant patients, inaccessibility to dental care, or conditions in which esthetics is not of concern. Sunny S, Sargod SS, Bhat SS, et al. Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(6):858-863.

­­­A Comparative Evaluation of Antimicrobial Effect of Snuhi-Apamarg-Ksharsutra and Udumbara-Ksheer Sutra in the Management of Bhagandara (Fistula-In-Ano)

Bhagandara one of the eight grave disorders, pertaining the perianal region is arduous to treat, has been described in detail by Acharaya Sushruta. The Ayurvedic description of Bhagandara can be identified as associated with an anal fistula. An anal fistula is defined as an internal opening in the altered skin or mucosa of the anal canal or rectum and an exterior opening in the perianal skin region. Among the various modalities available for the treatment of bhagandara, ksharasutra is described as gold standards for treatment and cure. The ksharasutra possess antimicrobial properties and can be established as first line of treatment for bhagandar(fistula-in-ano). The modern approach for fistula-in-ano is surgical procedure. Antibiotics are commonly used along with surgery for the treatment of fistula-in-ano. The aim of this study was to comparatively evaluate the antimicrobial properties amongst Snuhi-apamarga kshar sutra and Udumbara ksheer sutra. A total no. of 60 participants were enrolled as per the criteria for the study and pus samples were collected as per the standard operating procedure. Samples of Snuhi-apamarga kshar sutra and Udumbar ksheer sutra were already given in laboratory for testing the sensitivity. Reports were collected and analyzed on different parameters and conclusion was drawn accordingly. It was concluded that gram positive monomicrobial infections were more common especially involving staphylococci. Also, in the culture and sensitivity test Snuhi- apamarga ksharsutra was found to be more effective in comparison to Udumbara ksheer sutra as the microbes were highly sensitive to the Snuhi Apamarga kshar sutra. This can be contributed to the multiple contents in Snuhi Apamarga kshar sutra.

Comparative evaluation of effectiveness and safety of meropenem in term and preterm neonates with neonatal sepsis

Background: Neonatal sepsis is one of the most common causes of substantial neonatal morbidity and mortality. In India, it is estimated that 7.5 lakh neonates die every year, which is the highest neonatal mortality rate (NMR) in the world. This is despite the fact that NMR declined from 44/1000 lives birth in 2000–28/1000 live births in 2013. The rate of decline has been slow and lags behind that of the infant mortality rate and the under-five mortality rate. Aims and Objectives: To study the effectiveness and safety of meropenem in the treatment of sepsis affecting term and preterm neonates. Materials and Methods: The study was a prospective, observational study conducted at Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. A total of 76 subjects were enrolled (38 term and 38 preterm neonates). All neonates, preterm or term, admitted to the Neonatal Intensive Care Unit with neonatal sepsis, either clinical or culture-proven sepsis, who had not received meropenem before admission and would be given meropenem as empirical or culture-sensitive were included. All enrolled neonates were evaluated for the effectiveness of meropenem. Pre- and post-meropenem dose clinical and laboratory data were evaluated using the presumptive clinical cure score (PCCS). Results: There was a significant difference between pre- and post-PCCS of all the neonates (P &lt; 0.001) in both groups. There was no significant difference in the effectiveness of meropenem therapy in neonatal sepsis in term and preterm neonates (P = 0.253). There was no significant difference in the adverse reaction profile between preterm and term neonates for skin rash (P = 0.614) and diarrhea (P = 1.00). Conclusion: Meropenem is quite effective and safe for neonatal sepsis in both term and preterm neonates. So, giving meropenem as a second or third line in a dose of 20–40 mg/kg 8 hours a day according to gestation is a good drug for the treatment of neonatal sepsis.

Star anise and oregano essential oil: A comparative evaluation of antibacterial effect

Star anise and oregano essential oil: A comparative evaluation of antibacterial effect

In vitro comparative evaluation of antioxidative effect of selenium alone and in combination with green tea and alpha-tocopherol on the shear bond strength of universal composite resin to enamel after in-office bleaching.

Antioxidant application soon after bleaching process increases the shear bond strength (SBS) of composite resin to enamel. The aim of the study was to evaluate the antioxidant effects of selenium alone and in combination with alpha-tocopherol (αT) and green tea (GT) on SBS of composite resin to enamel following in-office bleaching with 38% hydrogen peroxide (HP). Sixty extracted human single -rooted premolar teeth were cleaned and embedded in acrylic resin blocks at the level of cementoenamel junction(CEJ) followed by bleaching with 38% hydrogen peroxide (HP) and arbitrarily divided into seven groups (n=10) for antioxidant application: Group I (negative control): intact teeth, Group II (positive control): only bleaching, Group III: 10% selenium (Se), Group IV: 10% alpha tocopherol (αT), Group V: 10% αT +10% Se, Group VI: 10% Green tea (GT), Group VII: 10%GT+10% Se. In all groups, self-etch adhesive was applied and composite restoration was done, and specimens were stored in distilled water for 24h followed by SBS evaluation. One-way analysis of variance and post hoc Tukey's tests were used (P < 0.05). The highest SBS was found in negative control Group I (intact teeth) and least in positive control Group II (bleached teeth), whereas in experimental groups, Group VII (GT + Se) showed highest followed by Groups V (αT + Se), III (Se), and VI (GT) and least in Group IV (αT). Combination of selenium with green tea and alpha tocopherol enhanced the SBS of composite resin following in-office bleaching.

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.

Comparative effectiveness and cost evaluation of Risankizumab and Adalimumab in the management of psoriasis: a real-world study in Saudi Arabia

BackgroundPsoriasis, an immune-mediated chronic inflammatory disease primarily affecting skin and joints, has varying prevalence rates globally. It manifests in five types, with chronic plaque psoriasis being the most common. Treatment, which has no definitive cure, aims for complete resolution of skin symptoms and depends on disease extent, severity, and impact on patients’ lives. Biologics are an emerging treatment for psoriasis, targeting specific inflammatory pathways for potentially safer, more effective outcomes. However, these come with significant costs, necessitating more research to ensure value for money. This study aimed to compare the effectiveness of Risankizumab versus Adalimumab, the most commonly utilized biologic for managing psoriasis in Saudi Arabia.MethodsThis study retrospectively compared the effectiveness and direct medical cost of Risankizumab and Adalimumab in treating chronic plaque psoriasis in adults from two Saudi Arabian healthcare centers. The Psoriasis Area and Severity Index (PASI) and body surface area (BSA) were used to assess treatment effectiveness, with patient data sourced from electronic medical records. Multiple regression analysis was performed to examine various factors affecting treatment outcomes. An economic evaluation was conducted to examine the cost-effectiveness of the two drugs, considering four scenarios with varying dosage patterns and costs. Analysis was performed from the perspective of public healthcare payers and considered all utilized health services.ResultsThe data for 70 patients were analyzed, with comparable baseline characteristics between groups. While Risankizumab led to a greater reduction in PASI scores and BSA affected, these results were not statistically significant. The annual treatment cost for Risankizumab was higher than Adalimumab. Various scenarios were studied, considering real acquisition costs, double dosing for Adalimumab, and the use of biosimilars. A scenario assuming double dosing for Adalimumab and a 40% discount for Risankizumab demonstrated both cost and efficacy advantages in 71.25% of cases.ConclusionsThis study compared the effectiveness and cost of Risankizumab and Adalimumab for treating chronic plaque psoriasis in Saudi Arabian hospitals. Although Risankizumab showed a greater reduction in symptoms, the difference was not statistically significant. However, under certain scenarios, Risankizumab demonstrated cost and efficacy advantages. These findings may influence treatment decisions for psoriasis, but further research is needed.

Comparative evaluation of the effectiveness of a prostaglandin analogue and fixed-dose combination drug containing brinzolamide 1% and timolol maleate 0.5% (an experimental study)

PURPOSE. Comparative evaluation of anti-hypertensive effectiveness of tafluprost 0.0015% (Taflotan), and a fixed-combination of benzolamide 1% and timolol maleate 0.5% (Azarga) preparation in an experimental animal model with artificially induced steroidal ophthalmic hypertension.METHODS. The study experiments were performed on 30 sexually mature Chinchilla rabbits (60 eyes) with steroid-induced glaucoma modeled by ocular instillations of dexamethasone.The animals were divided into 3 groups each consisting of 10 rabbits. The first group was the controls that were divided into two subgroups; they were instilled dexamethasone 0.1% two drops per day into the right eye (the left eye remained as control) for 20 days in subgroup 1, and for 30 days in subgroup 2.The animals in group 2 received Azarga, group 3 — Taflotan. Animals of group 2 and 3 were divided into three subgroups: in subgroup 1 the animals were instilled the studied drugs for 10 days, in subgroup 2 — for 20 days, in subgroup 3 — for 30 days.RESULTS. Both drugs reduced the intraocular pressure down to the reference range, i.e. 18–25 mm Hg. Animals that received instillations of Taflotan achieved the refe rence range values after 10 days, while the animals receiving Azarga — after 20 days.CONCLUSIONS. Under the conditions of steroidal ophthalmic hypertension, instillations of both Azarga and Taflotan yield satisfactory results in terms of IOP reduction. The use of Taflotan allowed achieving the reference range values after 10 days, Azarga — after 20 days. Taking into account the ease of administration of Taflotan, it can be recommended as the most convenient and effective drug in terms of reducing intraocular pressure.