Publications by authors named "Ashwini Deshpande"

33 Publications

Nanostructured lipid carrier-mediated lung targeted drug delivery system to enhance the safety and bioavailability of clofazimine.

Drug Dev Ind Pharm 2021 Mar 1;47(3):385-393. Epub 2021 Mar 1.

School of Pharmacy & Technology Management, SVKM's NMIMS, Shirpur, India.

Tuberculosis (TB) disease is caused due to the infection of bacilli which reside in alveolar macrophages (AMs). Clofazimine (CLF) has been reinstated clinically for the treatment of TB. However, major challenge of using CLF is its severe side-effects after oral administration. The present research was aimed to establish the safety and enhance the bioavailability of CLF by loading it into nanostructured lipid carriers (CLF-NLCs) and mannosylated NLCs (M-CLF-NLCs) to selectively target the drug toward AMs. The safety of CLF-NLCs and M-CLF-NLCs was evaluated by hemocompatibility studies, cell viability studies on macrophage J774 cell lines, and acute inhalation toxicity studies. The bioavailability was estimated by single-dose pharmacokinetics and biodistribution studies. Hemocompatibility studies showed normal RBCs count and least hemolysis of 0.23 ± 0.081% for M-CLF-NLCs treated group. Cell viability studies revealed greater safety of NLCs than CLF-drug dispersion in the concentration range of 2.5-25 μg/ml. acute toxicity studies revealed no physiological or behavioral changes and no mortality recorded over 14 days period. In pharmacokinetic studies, a maximum concentration of the drug () of 35.44 ± 0.34 μg/g from M-CLF-NLCs after 48 h and longer residence time in lung tissues observed due to its sustained release and mannose receptor-mediated endocytosis. M-CLF-NLCs showed a maximum AUC value of 2691.83 h μg/ml in lungs that indicated twofold greater bioavailability as compared to CLF-drug dispersion. Thus, mannosylated NLCs can be used as promising carriers for the safe and effective delivery of CLF via inhalation route for the management of TB disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/03639045.2021.1892743DOI Listing
March 2021

Atypical presentation of tuberculosis.

J Oral Maxillofac Pathol 2020 May-Aug;24(2):404. Epub 2020 Sep 9.

Department of Oral Medicine and Radiology, People's Dental Academy, Bhopal, Madhya Pradesh, India.

Developing countries such as India face an intense situation with communicable diseases such as tuberculosis (TB). It is an inflammatory infectious granulomatous disease commonly affecting the lungs. Extrapulmonary TB presentations have been documented, with the orofacial region also being involved. TB usually presents as an ulcer in the oral cavity with tongue and lip being the favored sites. TB presenting as a lip swelling is unusual even if it is a secondary lesion with a primary pulmonary involvement. We present a lip swelling and discuss the differential diagnosis. Investigation of ultrasonography revealed a vascular lesion which was disproved, suggesting an increase in vascularity even in diseases such as TB. We present a case of a lip swelling which led to the diagnosis of recurrent pulmonary TB which the patient was unaware of. Findings of histopathology revealing the absence of bacilli are also discussed. Monetary constraints frequently cause a neglect of dangerous diseases such as TB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_56_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802856PMC
September 2020

Early Effects of Lockdown in India: Gender Gaps in Job Losses and Domestic Work.

Indian J Labour Econ 2020 Oct 6:1-4. Epub 2020 Oct 6.

Ashoka University, Sonipat, India.

India imposed one of the strictest lockdowns in the world to contain the spread of COVID-19 pandemic. According to the Stringency Index developed by the Blavatnik School of Government at the University of Oxford, by the 25th of March, 2020, India had already reached the highest possible level of stringency (index value = 100). This involved a near-complete shutdown of all economic activity. What were the labour market implications of this shutdown? The first-order effects are evident in the massive increase in total unemployment. However, is the pandemic and its aftermath a great leveller? Are the labour implications of the lockdown gender neutral? How did the lockdown affect domestic time allocation, in particular time spent on domestic work and with friends? Were these changes gender neutral, given that the lockdown was gender blind?
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s41027-020-00261-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537959PMC
October 2020

Comparison of antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of primary teeth.

J Indian Soc Pedod Prev Dent 2020 Apr-Jun;38(2):164-170

Department of Conservative Dentistry and Endodontics, Government College of Dentistry, Indore, Madhya Pradesh, India.

Aim: Sodium hypochlorite, though considered an ideal root canal irrigant, cannot be used at required concentrations in children, due to its undesirable effects. Hence, it is imperative to search for an ideal root canal irrigant to avoid these undesirable effects which we hope to achieve with this study. The antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of the primary teeth has been compared.

Materials And Methods: Sixty patients between 4 and 8 years of age with a single-rooted deciduous tooth indicated for pulpectomy were included. The infected teeth were randomly allocated to one of the three treatment groups based on the irrigating agents used, namely normal saline, green tea extract, or ozonated water. Specimens for anaerobic culture were collected three times from the teeth: before irrigation, after initial irrigation, and on the 3 day after final irrigation.

Results And Conclusion: Mean colony forming unit (CFU) count after both initial and final irrigation with ozonated water was significantly lower when compared with green tea and normal saline. Further, it was observed that the mean CFU count with green tea was significantly lower than the counts obtained with normal saline on the 3 day after final irrigation. Hence, both ozonated water and green tea could be considered a good alternative to conventional root canal irrigants in the primary teeth. Larger sample sizes with a larger variety of irrigants are recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JISPPD.JISPPD_119_20DOI Listing
July 2020

Analytical Methods for Determination of Apremilast from Bulk, Dosage Form and Biological Fluids: A Critical Review.

Crit Rev Anal Chem 2020 Feb 5:1-10. Epub 2020 Feb 5.

School of Pharmacy & Technology Management, SVKM's NMIMS, Shirpur, Maharashtra, India.

Apremilast is an anti-inflammatory agent. It has been a flourishing molecule in the field of dermatology. In the year 2014, Apremilast got its approval for treatment of psoriatic arthritis. Presently it is known to treat a number of other conditions, including atopic dermatitis and plaque psoriasis. Apremilast a phthalimide derivative, is non-hygroscopic in nature. It is practically insoluble in water. Apremilast acts by inhibiting the activity of phosphodiesterase 4 (PDE4), an intracellular enzyme. Analytical method plays a key role to understand the physio-chemical properties of a drug molecule. Because of poor solubility and low permeability, analytical method development and formulation becomes challenging. Till date, there are no standard test methods available to analyze Apremilast. So, a critical review of the analytical techniques of Apremilast was carried out. The literature search was done by screening the papers reporting analytical techniques of Apremilast from year 2014 to 2019. Methodologies particularly UV spectroscopy, HPTLC, HPLC, X-ray diffraction, NMR, LC-MS were collected and reviewed. Interminable efforts are made by the researchers to develop simple, accurate, robust and cost-effective methods of analysis. In pharmaceutical research, this information will aid in the development of new delivery systems. The review will prove beneficial and advantageous pre-formulation studies and will guide the formulation development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10408347.2020.1718481DOI Listing
February 2020

Mannosylated nanocarriers mediated site-specific drug delivery for the treatment of cancer and other infectious diseases: A state of the art review.

J Control Release 2020 04 25;320:239-252. Epub 2020 Jan 25.

School of Pharmacy & Technology Management, SVKM's NMIMS, Shirpur, Maharashtra, India. Electronic address:

The non-modified nanocarriers-based therapies for the treatment of cancer and other infectious diseases enhanced the chemical stability of therapeutically active agents, protected them from enzymatic degradation and extended their blood circulation time. However, the lack of specificity and off-target effects limit their applications. Mannose receptors overexpressed on antigen presenting cells such as dendritic cells and macrophages are one of the most desirable targets for treating cancer and other infectious diseases. Therefore, the development of mannosylated nanocarrier formulation is one of the most extensively explored approaches for targeting these mannose receptors. The present manuscript gives readers the background information on C-type lectin receptors followed by the roles, expression, and distribution of the mannose receptors. It further provides a detailed account of different mannosylated nanocarrier formulations. It also gives the tabular information on most relevant and recently granted patents on mannosylated systems. The overview of mannosylated nanocarrier formulations depicted site-specific targeting, enhanced pharmacokinetic/pharmacodynamic profiles, and improved transfection efficiency of the therapeutically active agents. This suggests the bright future ahead for mannosylated nanocarriers in the treatment of cancer and other infectious diseases. Nevertheless, the mechanism behind the enhanced immune response by mannosylated nanocarriers and their thorough clinical and preclinical evaluation need to explore further.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jconrel.2020.01.046DOI Listing
April 2020

Evaluation of Nanocarrier-Based Dry Powder Formulations for Inhalation with Special Reference to Anti-Tuberculosis Drugs.

Crit Rev Ther Drug Carrier Syst 2019 ;36(3):239-276

School of Pharmacy and Technology Management, SVKM's NMIMS, Shirpur, Maharashtra, India.

Pulmonary tuberculosis (TB) is a leading cause of death worldwide and is caused by the pathogen Mycobacterium tuberculosis (MTb). As treatment for TB, dry powders for inhalation (DPIs) are considered stable compared with nebulizers and metered dose inhalers and are suitable for high-dose formulations. Although extensive research has been done over the last two to three decades on nanocarrier-based DPIs for targeting MTb infection, none of the anti-TB DPI formulations have reached the market. Challenges in the proper assessment of nanocarrier-based DPIs due to the complexity of lungs is one of the reasons. In this review, the details of in vitro evaluation parameters of nanocarriers and nanocarrier-based DPIs along with their need and basic principles are discussed. Further, the thorough in vitro, ex vivo, and in vivo pharmacological evaluations, together with their procedures wherever required, are covered. The different evaluation parameters during process development, release specifications, and stability studies suggested by U.S. Food and Drug Administration Center for Drug Evaluation and Research to apply for new drug applications and abbreviated new drug applications of DPIs are also discussed. Lastly, the evaluation parameters for DPIs provided in European, United States, British, and Indian pharmacopeias are summarized.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1615/CritRevTherDrugCarrierSyst.2018024397DOI Listing
February 2020

Local Social Inequality, Economic Inequality, and Disparities in Child Height in India.

Demography 2019 08;56(4):1427-1452

The Population Research Center, University of Texas, Austin, TX, USA.

This study investigates disparities in child height-an important marker of population-level health-among population groups in rural India. India is an informative context in which to study processes of health disparities because of wide heterogeneity in the degree of local segregation or integration among caste groups. Building on a literature that identifies discrimination by quantifying whether differences in socioeconomic status (SES) can account for differences in health, we decompose height differences between rural children from higher castes and rural children from three disadvantaged groups. We find that socioeconomic differences can explain the height gap for children from Scheduled Tribes (STs), who tend to live in geographically isolated places. However, SES does not fully explain height gaps for children from the Scheduled Castes (SC) and Other Backward Classes (OBCs). Among SC and OBC children, local processes of discrimination also matter: the fraction of households in a child's locality that outrank her household in the caste hierarchy predicts her height. SC and OBC children who are surrounded by other lower-caste households are no shorter than higher-caste children of the same SES. Our results contrast with studies from other populations where segregation or apartheid are negatively associated with health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13524-019-00794-2DOI Listing
August 2019

Authors' awareness of concepts in the authorship of scientific publications: Viewpoints of the dental faculty in India.

J Oral Biol Craniofac Res 2018 Sep-Dec;8(3):151-153. Epub 2016 May 20.

Department of Oral Medicine and Radiology, People's Dental Academy, Bhopal, India.

Background: There is a great deal of enthusiasm amongst the contemporary dental academicians and researchers to publish their research findings and interesting cases. The competitive atmosphere has fostered a 'publish or perish' sentiment following which authors sideline certain essential and valid concepts in authorship and at times resort to unethical behavior knowingly or unknowingly to expand their publication list.

Materials And Method: We attempted to assess the current knowledge of the Indian dental teaching faculty regarding some important basic concepts in scientific authorship by means of a questionnaire-based pilot study. The respondents were asked questions pertaining to their knowledge of terms such as "authorship criteria", "conflict of interest", "plagiarism", and other authorship issues.

Results: Our findings suggested significant lacunae regarding the authors' understanding of important basic concepts in scientific writing.

Conclusion: We suggest possible measures to address this concern and also aim to survey a larger section of the academia in the future.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jobcr.2016.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108114PMC
May 2016

Comparative study to evaluate bone loss during osteotomy using standard drill, bone trephine, and alveolar expanders for implant placement.

J Indian Prosthodont Soc 2018 Jul-Sep;18(3):226-230

Department of Implantology, Peoples University, Bhopal, Madhya Pradesh, India.

Statement Of Problem: Various osteotomy modalities seem to have an impact on the primary and secondary stability of the dental implant. The available literature lacks the comparison of various available osteotomy modalities used for the dental implant placement and its effects on the initial surgical bone removal.

Purpose: The purpose of this study is to compare and evaluate the osteotomy sites created using standard drill, bone trephine, and alveolar expanders for dental implant surgery.

Materials And Methods: The study was done on ten goat hemimandibles. Three osteotomy sites were prepared at the inferior border of the mandible using standard drill, trephine, and alveolar expander in each hemimandibles and the sites were subjected to cone-beam computed tomography (CBCT). The CBCT images obtained were compared for the amount of cortical bone and bone marrow loss at osteotomy sites in different techniques.

Results: The mean and standard deviation of loss of cortical bone with standard drills, trephines, and alveolar expanders was 3.62 ± 4.216 × 10, 3.6 ± 4.681 × 10 and 3.15 ± 7.071 × 10. At the middle-third region, the loss of marrow bone was 3.38 ± 7.88 × 10, 2.15 ± 8.498 × 10 and 0.03 ± 9.487 × 10, and at lower third region, it was 2.3 ± 4.714 × 10, 0.02 ± 6.325 × 10, and 0.0, respectively.

Conclusion: CBCT images showed minimum bone loss with the use of alveolar expander which may be due to the lateral bone condensation rather the removal of the marrow. Trephine showed less marrow removal in comparison to the standard drill used for dental implant surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jips.jips_310_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070850PMC
December 2017

Innovative strategies in the diagnosis and treatment of tuberculosis: a patent review (2014-2017).

Expert Opin Ther Pat 2018 08 13;28(8):615-623. Epub 2018 Aug 13.

a School of Pharmacy & Technology Management , SVKM's NMIMS , Shirpur , India.

Introduction: Tuberculosis (TB) is a disease caused due to an infection of Mycobacterium tuberculosis (M TB) bacilli affecting millions of people worldwide. It is the ninth leading cause of death and ranks above the HIV/AIDS. The unique intracellular life cycle, more dangerous drug-resistant forms of bacilli, and insufficient investments in the TB research and development hindered the occurrence of optimum diagnostic, preventive, and treatment strategy against this disease.

Areas Covered: The aim of this review is to provide an update and overview of the current trends in the diagnosis, prevention, and treatment of the disease. It summarizes a recent patent literature (2014-2017) available on the same.

Expert Opinion: Some questions like 'why most of these inventions do not reach up to the market for public use? Are these inventions being explored only to get a financial return to a particular industry or do they have any societal benefit?' emphatically come to mind. Together with the efforts taken by various governmental and nongovernmental organizations, a public awareness about the recent advancements in the diagnosis and treatment of the disease is of the highest importance to make 'the end of TB' from the universe.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13543776.2018.1508454DOI Listing
August 2018

Nanostructured lipid carriers-based drug delivery for treating various lung diseases: A State-of-the-Art Review.

Int J Pharm 2018 Aug 1;547(1-2):209-225. Epub 2018 Jun 1.

School of Pharmacy & Technology Management, SVKM's NMIMS, Shirpur, Maharashtra, India. Electronic address:

According to the list published by the WHO for global top ten causes of death, lung diseases contribute nearly one-third of the total mortality. The current treatment on lung diseases provide only symptomatic relief rather than restoring the complete lung functions. Nanostructured lipid carriers-based drug delivery system (NLCs-based DDS) provide a breakthrough in treating various lung diseases. This review provides the readers with background information for rationale behind focusing lung diseases and selection of targeted drug delivery to treat these diseases. This review discusses different hurdles in targeting the lung diseases and possible remedy in the form of NLCs-based DDS. The review gives an overview of the existing literature about the quality, safety, and efficacy of the NLCs-based DDS for pulmonary targeting. Different surface-engineered NLCs enormously proved their effectiveness in targeting the drug and other bioactive agents to the site of infection. Their results of safety and efficacy studies in in-vitro and in-vivo evaluations are encouraging. This advises the bright future of NLCs-based DDS for pulmonary targeting. To bring this optimistic NLCs-based DDS to the market, a thorough pre-clinical and clinical investigation hold prime importance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijpharm.2018.05.070DOI Listing
August 2018

Orodispersible Films: A Systematic Patent Review.

Recent Pat Drug Deliv Formul 2018 ;12(2):110-120

School of Pharmacy & Technology Management, SVKM`s NMIMS, Shirpur, Maharashtra, India.

Background: Nowadays, Oral Film Technology (OFT) has gained much attention among all the oral drug delivery systems. Fast dissolving film, fast disintegrating film, and orodispersible film are some synonymous words for this dosage form. Without a need of liquid for administration, this dosage form dissolves in the mouth. Typically, fast dissolving film dissolves from 1 to 30 seconds.

Objective: At the root of its originality, many researchers patented their work on the aspect of orodispersible films using different drugs, polymers, excipients and employing various methods of preparation. The review focuses on details related to orodispersible films and their patents from 1979-2017, collected from various sources like USPTO, Google patent, Espacenet, Intellectual Property India.

Results: For the ease of discussion, collected patents are segregated on the basis of drugs, polymers, and method of preparation. It was found that many researchers are shifting towards fast dissolving films for better patient compliance, extended efficacy, high bioavailability, fast dissolution, and disintegration. With the help of polymers blend suitable for the drug release and improved method of preparation various parameters like tensile strength, thickness, and pH etc. can be controlled.

Conclusion: It was observed that judicial selection of polymers and polymers blends and methods of preparation are key parameters in the formulation of orodispersible film.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1872211312666180509100216DOI Listing
November 2018

Critical Review on the Analytical Methods for the Estimation of Clofazimine in Bulk, Biological Fluids and Pharmaceutical Formulations.

Crit Rev Anal Chem 2018 Nov 5;48(6):492-502. Epub 2018 Apr 5.

a School of Pharmacy & Technology Management, SVKM's NMIMS , Shirpur , Maharashtra , India.

Clofazimine (CFZ), a riminophenazine derivative and a crucial drug in the treatment of lepromatous leprosy, has been reintroduced clinically to treat multidrug-resistant tuberculosis. CFZ holds both antimycobacterial and anti-inflammatory properties. But, due to its highly hydrophobic, polar and photosensitive nature, it is challenging to extract and quantify the drug from different biological fluids and its pharmaceutical formulations. This has also hampered the pharmacokinetic evaluation of the CFZ. This article accentuates various analytical methods viz. Identification methods, titrimetric methods, spectrometric methods such as colorimetric, fluorometric, mass spectroscopy and UV/Vis spectroscopy, Chromatographic methods like paper chromatography, thin-layer chromatography, high-performance thin layer chromatography, high-performance liquid chromatography, liquid chromatography tandem mass spectrometry for the estimation of CFZ in bulk, biological fluids and its pharmaceutical formulations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10408347.2018.1451298DOI Listing
November 2018

Targeting pulmonary tuberculosis using nanocarrier-based dry powder inhalation: current status and futuristic need.

J Drug Target 2019 01 3;27(1):12-27. Epub 2018 Apr 3.

b Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management , SVKM's NMIMS , Mumbai , Maharashtra , India.

Tuberculosis (TB) is a disease caused by the pathogen Mycobacterium tuberculosis. Prolonged administration of high dose antibiotics using oral and injectable routes and their associated side effects show limitations to successful treatment outcome of TB. Nanocarrier-based dry powder inhalers (DPIs) may provide a breakthrough as an alternative therapeutic approach because of their stable, non-invasive nature and ability to target the drug at the site of infection. The current review focuses on the roadmap of the respiratory system, drug deposition and targeting at the site of infection via the pulmonary route. This review will provide readers with an overview of the existing literature of nanocarrier-based DPIs of anti-TB drugs. Among different nanocarriers, results of most of the proliposomes and polymeric particles-based DPIs with respect to their characterisation parameters like encapsulation efficiency, drug loading, storage stability and aerodynamic properties are not encouraging, whereas surface engineered, nanostructured lipid carriers (NLCs), i.e. ligand attached-NLCs-based dry powder inhalers (NLCs-DPI) show promising results. But still, there is a need to investigate them for in vitro, ex vivo, in vivo and toxicity studies to achieve a market approval.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/1061186X.2018.1455842DOI Listing
January 2019

Mechanism of the formation of microphase separated water clusters in a water-mediated physical network of perfluoropolyether tetraol.

Soft Matter 2018 Mar 1;14(12):2339-2345. Epub 2018 Mar 1.

Solvay Specialty Polymers, Viale Lombardia 20 - 20021 Bollate (MI), Italy.

Perfluoropolyether tetraol (PFPE tetraol) possesses a hydrophobic perfluoropolyether chain in the backbone and two hydroxyl groups at each chain terminal, which facilitates the formation of hydrogen bonds with water molecules resulting in the formation an extended physical network. About 3 wt% water was required for the formation of the microphase separated physical network of PFPE tetraol. The mechanism responsible for the microphase separation of water clusters in the physical network was studied using a combination of techniques such as NMR spectroscopy, molecular dynamics (MD) simulations and DSC. MD simulation studies provided evidence for the formation of clusters in the PFPE tetraol physical network and the size of these clusters increased gradually with an increase in the extent of hydration. Both MD simulations and NMR spectroscopy studies revealed that these clusters position themselves away from the hydrophobic backbone or vice versa. The presence of intra- and inter-chain aggregation possibility among hydrophilic groups was evident. DSC results demonstrated the presence of tightly and loosely bound water molecules to the terminal hydroxyl groups of PFPE tetraol through hydrogen bonding. The data from all the three techniques established the formation of a physical network driven by hydrogen bonding between the hydrophilic end groups of PFPE tetraol and water molecules. The flexible nature of the PFPE tetraol backbone and its low solubility parameter favour clustering of water molecules at the terminal groups and result in the formation of a gel.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1039/c7sm02181jDOI Listing
March 2018

High performance liquid chromatography determination of dexamethasone in plasma to evaluate its systemic absorption following intra-space pterygomandibular injection of twin-mix (mixture of 2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone): randomized control trial.

Oral Maxillofac Surg 2016 Sep 10;20(3):259-64. Epub 2016 Jun 10.

Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, TN, India.

Purpose: To determine systemic absorption of dexamethasone by detection of plasma concentration using high performance liquid chromatography following its administration along with local anesthetic agent as a mixture via pterygomandibular space.

Methods: A prospective randomized double-blind clinical study was undertaken to analyze the plasma concentration of dexamethasone after intra-space pterygomandibular injection along with local anesthesia. The study was performed as per split mouth model where the mandibular quadrant allocation was done on a random basis considering each of the 30 patients is included in the two study interventions (SS and CS). For the study site (SS) procedures, dexamethasone was administered as a mixture (2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone) intra-space. In the control site (CS) procedures, a regular standard inferior alveolar nerve block was administered, and dexamethasone was given as intramuscular injection. The plasma dexamethasone determination was done in venous blood 30- and 60-min post injection using high performance liquid chromatography (HPLC). The clinical parameters like pain; swelling; and mouth opening on the first, third, and seventh post-operative day were analyzed and compared.

Results: No significant difference was found in the clinical parameters assessed; comparative evaluation showed less swelling in the SS interventions. The plasma concentration of dexamethasone for the CS interventions was 226 ± 47 ng/ml at 30-min and 316 ± 81.6 ng/ml at 60-min post injection, and for SS, it was 221 ± 81.6 ng/ml at 30-min and 340 ± 105 ng/ml at 60-min post injection. On inter-site (CS and SS) comparison, no statistically significant difference was ascertained in dexamethasone plasma concentration at 30-min post injection (P = 0.77) and at 60-min post injection. (P = 0.32).

Conclusion: Intra-space (pterygomandibular space) administration of dexamethasone can achieve statistically similar plasma concentration of the drug as when the same dose is administered intramuscularly with demonstration of similar clinical effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10006-016-0564-3DOI Listing
September 2016

Intraoral Periapical Radiographs with Grids for Implant Dentistry.

J Maxillofac Oral Surg 2014 Dec 10;13(4):603-5. Epub 2013 Apr 10.

Department Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Center, People's Campus, Bhanpur, Bhopal, Madhya Pradesh 462037 India ; Oral and Maxillofacial Surgeon, H-3/2, B.D.A Colony, Nayapura, Lal Ghati, Airport Road, Bhopal, Madhya Pradesh 462032 India.

There are ample modern diagnostic imaging tools available, but the affordability, availability and radiation exposure remains the concern. Intraoral periapical radiographs (IOPAR) are widely used for the preoperative planning and evaluation for most minor oral surgical procedures owing to it simplicity, significantly lower cost, less radiation exposure and easy availability in a dental clinical set-up. Using these radiographs with a grid aids in increasing the accuracy of the linear measurements for the treatment planning.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12663-013-0499-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518771PMC
December 2014

Comparative Analysis of the Anesthetic Efficacy of 0.5 and 0.75 % Ropivacaine for Inferior Alveolar Nerve Block in Surgical Removal of Impacted Mandibular Third Molars.

J Maxillofac Oral Surg 2014 Dec 28;13(4):431-4. Epub 2013 May 28.

Department of Oral Medicine and Radiology, People's Dental Academy, People's Campus, Bhanpur, Bhopal, 462037 MP India.

Introduction: Ropivacaine belongs to pipecoloxylidide group of local anesthetics. There are reports supporting the use of ropivacaine as a long acting local anesthetic in oral and maxillofacial surgical procedures, with variable data on the concentration that is clinically suitable.

Materials And Methods: A prospective randomized double-blind study protocol was undertaken to assess the efficacy of 0.5 and 0.75 % ropivacaine for inferior alveolar nerve block in surgical extraction of impacted mandibular third molars. A total of 60 procedures were performed, of which thirty patients received 0.5 % and thirty received 0.75 % concentration of the study drug.

Results: All the patients in both the study groups reported subjective numbness of lip and tongue. The time of onset was longer for 0.5 % ropivacaine when compared to 0.75 % solution. 90 % of the study patients in 0.5 % ropivacaine group reported pain corresponding to VAS ≥3 during bone guttering and 93.3 % patients reported pain corresponding to VAS >4 during tooth elevation. None of the patients in 0.75 % ropivacaine group reported VAS >3 at any stage of the surgical procedure. The duration of soft tissue anesthesia recorded with 0.75 % ropivacaine was average 287.57 ± 42.0 min.

Conclusion: 0.75 % ropivacaine was found suitable for inferior alveolar nerve blocks in surgical extraction of impacted mandibular third molars.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12663-013-0534-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518782PMC
December 2014

Temporomandibular joint arthrocentesis for internal derangement with disc displacement without reduction.

J Maxillofac Oral Surg 2015 Jun 28;14(2):454-9. Epub 2012 Nov 28.

Department of Physiotherapy and Rehabilitation, L.N. Medical College & Research Center and J.K. Hospital, J.K. Town, Sarvdharm C-Sector, Kolar Road, Bhopal, 462042 Madhya Pradesh India.

Temporomandibular joint (TMJ) disc derangement is defined as a malpositioning of the articular disc relative to the condyle and eminence. Arthrocentesis of the TMJ is a minimally invasive chair side procedure for the patients with TMJ internal derangement. This case report presents convincing results to keep arthrocentesis as an imperative procedure to relieve such patients of their acute symptoms. TMJ dynamics has also been discussed for an in-depth understanding of the pathology in cases with internal derangement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12663-012-0447-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444679PMC
June 2015

Vertically unstable fractured mandibular segment with attached genial tubercles as a parameter for difficulty during intubation for general anaesthesia.

J Maxillofac Oral Surg 2015 Mar 14;14(1):13-6. Epub 2014 Jan 14.

Department of Oral Medicine and Radiology, Peoples Dental Academy, Peoples University, Bhanpur, Bhopal, MP India.

Purpose: It remains vital for the trauma management team including the anaesthetist and the operating surgeon to assess and evaluate the anticipated difficulty in intubation to secure airway and for administration of anaesthesia. This study assesses the difficulty in intubating patients with vertically unstable mandibular parasymphysis fracture with attached genial tubercles and associated musculature to the fractured segment.

Methods: Randomized sampling was done from the cases with maxillofacial trauma planned for a surgical procedure under general anaesthesia. The inclusion criteria was to prospectively identify ten patients each of unilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment, with bilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment and with unilateral favourable mandibular parasymphysis fracture with genial tubercle attached to the un-displaced segment. All the patients were intubated by a single anaesthetist, who documented the difficulty in nasoendotracheal intubation using Intubation Difficulty Scale.

Results: Nasoendotracheal intubation was found relatively easy in the study group with unilateral favourable mandibular parasymphysis fracture with genial tubercle attached to the un-displaced segment. Clinical difficulty in intubating the patients was maximum in the study group with bilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment.

Conclusion: Displacement of fractured mandible and resultant displacement of the genial musculature should be considered as a vital parameter for assessing difficulty during intubation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12663-013-0610-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339325PMC
March 2015

Patent review on photostability enhancement of avobenzone and its formulations.

Recent Pat Drug Deliv Formul 2015 ;9(2):121-8

School of Pharmacy and Technology Management, Mumbai-Agra Road, Bank of Tapi River, Babulde, Shirpur - 425405, Dhule, Maharashtra, India.

By the virtue of their nature, cosmetic products are used to clean, perfume, change the appearance of the human body's various external parts and maintain them in a good condition. Their main sites of action may be exemplified by the nails, the hair system, the epidermis, the external genital organs and the mucous membranes of the oral cavity. Sunscreen preparations consist of organic chemicals and inorganic materials. Inorganic materials include chemicals that scatter UV light physically like TiO2 and ZnO. Organic materials such as avobenzone reduce the amount of UV light to which the human skin is exposed by absorbing the radiation and subsequent disposal in different ways. One of the way of disposal may be by undergoing photoinduced decompositions which not only cause a reduction of the sunscreen UV-protective capacity during usage but may precipitate allergic or toxic degradates. Thus undoubtedly a high photostability is an important requirement for the effectiveness of sunscreen products. Many researchers patented their work on this aspect of protection of avobenzone from photodegradation using varying methodologies. This review article discusses some of the patented works done in enhancing the photostability of avobenzone and its formulations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1872211309666150131141414DOI Listing
March 2016

Analgesic efficacy of acetaminophen for controlling postextraction dental pain.

Ann Maxillofac Surg 2014 Jul-Dec;4(2):176-7

Department of Oral Medicine and Maxillofacial Radiology, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India.

Background: Considering the clinical safety of acetaminophen over other nonsteroidal anti-inflammatory drugs, this clinical trial was formulated to assess the analgesic efficacy of acetaminophen for controlling postextraction dental pain when compared to commonly prescribed ibuprofen.

Aim: The aim was to assess the analgesic efficacy of paracetamol/acetaminophen in postextraction dental pain.

Settings And Design: Double-blind, randomized prospective clinical trial.

Materials And Methods: A total of 30 patients requiring bilateral maxillary and mandibular premolar extraction for their orthodontic treatment were included in the study to evaluate the efficacy of acetaminophen in controlling postextraction dental pain.

Statistical Analysis Used: Unpaired t-test.

Results And Conclusions: Clinically, both the postoperative analgesics exerted similar pain control with minor variations of recorded visual analog scale scores by the patients in both the groups. It may be concluded from the findings of this study that paracetamol at a dosage of 500 mg thrice a day (1.5 g) is sufficient to achieve reliable pain control following exodontia provided the surgical trauma caused to the investing tissues is minimal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2231-0746.147117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293838PMC
January 2015

Diverse imaging characteristics of a mandibular intraosseous vascular lesion.

Imaging Sci Dent 2014 Mar 19;44(1):67-73. Epub 2014 Mar 19.

Department of Oral Pathology and Microbiology, Peoples Dental Academy, Bhopal, India.

Intraosseous vascular lesions of the maxillofacial region are rare, and the differential diagnosis of intraosseous vascular malformations from other jaw lesions can be challenging. In the present case, magnetic resonance imaging and three-dimensional computed tomographic angiography (CTA) was used for diagnosis, and the lesion was treated wih surgical excision. Diverse characteristics such as the "honeycomb" and "sunburst" radiographic appearances and the absence of major peripheral feeder vessels in the CTA were noted. Intraosseous vascular malformations have a varied radiographic appearance, and the nomenclature of these lesions is equally diverse, with several overlapping terms. Pathologists do not generally differentiate among intraosseous vascular lesions on the basis of histopathology, although these lesions may present with contrasting immunohistochemical and clinical behaviors requiring varied treatment strategies. This case report highlights the need for multiple imaging modalities to differentiate among vascular lesions, as well as to better understand the behaviors of these unique lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5624/isd.2014.44.1.67DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972408PMC
March 2014

Validation of data on the use of twin mix in minor oral surgery: comparative evaluation of efficacy of twin mix versus 2 % lignocaine with 1:200000 epinephrine based on power analysis and an UV spectrometry study for chemical stability of the mixture.

Oral Maxillofac Surg 2015 Mar 21;19(1):37-41. Epub 2014 Mar 21.

Department of Oral and Maxillofacial Surgery, Peoples College of Dental Sciences, Peoples University, Bhanpur, Bhopal, M.P, India,

Introduction: There is convincing evidence supporting the addition of dexamethasone to lignocaine and its administration as an intra-space injection to achieve benefit of a single dose steroid after third molar surgery. This study was undertaken to validate the existing data on the use of twin mix in minor oral surgery based on power analysis, statistical sample size estimation and an ultraviolet (UV) spectrometry study for chemical stability of the mixture.

Material And Methods: A prospective, randomized, double-blind trial was designed to validate the pilot study on the efficacy of twin mix and 2 % lignocaine with 1:200,000 epinephrine in the surgical removal of impacted mandibular third molars. Clinical parameters of anaesthetic latency, anaesthetic duration, efficacy of twin mix as an anaesthetic and post-operative patient discomfort were assessed. The stability of active ingredients in the solution was assessed using a double beam UV-visible spectrophotometery.

Results: The results of the study showed better post-operative outcome with administration of dexamethasone and lignocaine as an intra-space injection in decreasing the post-operative patient discomfort. The anaesthetic efficacy of the twin-mix admixture was found statistically similar to the control solution of 2 % lignocaine with 1:200,000 epinephrine. The λmax recorded for dexamethasone and local anaesthetic individually was obtained with the twin-mix solution, which indicated no change in the active pharmacological compounds.

Discussion: Clinical anaesthetic efficacy of twin mix is comparable to 2 % lignocaine with 1:200,000 epinephrine when administered in the pterygomandibular space with the additional advantage of a single prick co-administration of dexamethasone with local anaesthetic, lesser sting of the local anaesthetic injection, shorter anaesthetic latency, prolonged duration of the soft tissue anaesthesia and decrease in post-operative discomfort after the oral surgical procedure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10006-014-0446-5DOI Listing
March 2015

Guidelines of the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections: As Applied to Oral and Maxillofacial Clinical Practice.

J Maxillofac Oral Surg 2013 Sep 5;12(3):354-8. Epub 2012 Apr 5.

Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, India.

Purpose: The purpose of this paper was to undertake a systematic review of literature on methicillin-resistant Staphylococcus aureus infections in oral and maxillofacial online data-bases and discuss the Infectious Diseases Society of America (IDSA) guidelines and its applications in maxillofacial clinical practice.

Materials And Methods: The available literature in oral and maxillofacial online databases was searched. The only inclusion criterion was to review published reports, abstracts and retrospective studies with emphasis on the treatment of clinical cases with methicillin-resistant S. aureus infections. Clinical Practice Guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant S. aureus infections in adults and children was reviewed and included in the study.

Results: Out of 18 articles found with the search terms "Methicillin-resistant S. aureus" and "MRSA" in the online databases 12 articles met the inclusion criteria for this study. The relevant data was extracted and tabulated.

Conclusions: Conclusions were drawn and discussed based on the reviewed maxillofacial literature and the Guidelines by the IDSA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12663-012-0374-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777035PMC
September 2013

Dental orthopantomogram biometrics system for human identification.

J Forensic Leg Med 2013 Jul 26;20(5):399-401. Epub 2013 Feb 26.

Department of Forensic Medicine and Toxicology, L.N. Medical College and Research Center & J.K. Hospital, Bhopal, MP, India.

Fingerprinting is the most widely accepted method of identification of people. But in cases of disfigured, decomposed, burnt or fragmented bodies, it is of limited value. Teeth and dental restorations on the other hand are extremely resistant to destruction by fire. They retain a number of their original characteristics, which are often unique and hence offer a possibility of rather accurate and legally acceptable identification of such remains. This study was undertaken to evaluate the utility of orthopantomography for human identification and propose a coding system for orthopantomogram (OPG), which can be utilized as an identification tool in forensic sciences.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jflm.2013.02.001DOI Listing
July 2013

Initial inflammatory response of skeletal muscle to commonly used suture materials: an animal model study to evaluate muscle healing after surgical repair - histopathological perspective.

Med Oral Patol Oral Cir Bucal 2013 May 1;18(3):e491-6. Epub 2013 May 1.

Department of Oral and Maxillofacial Surgeon, Peoples College of Dental Sciences & Research Center, Bhopal (MP), India.

Objectives: To evaluate initial inflammatory response of skeletal muscle to a few commonly used suture materials for muscle repair namely nylon, polydiaxonone (PDS II), plain catgut and polygalactin 910 which in turn determines the scarring of muscle and loss of function.

Material And Methods: Inflammation and healing of muscle post repair was evaluated in the lateral thigh muscle (biceps femoris) of 8 adult healthy male Rattus norvegicus. The inflammatory reaction & healing of the skeletal muscle was evaluated histologically at the end of 48 hours, 1 week and 3 weeks.

Results: At 48 hours post-surgery, Nylon samples showed severe inflammation followed by Catgut and Polygalactin. At 1 week post-surgery, the catgut group demonstrated increased macrophages infiltration while Nylon demonstrated persistant lymphocytic pro-inflammatory component. PDS sutures elicited minimal inflammatory response all through.

Conclusion: In the present study the most desirable suture material was determined to be PDS due to its minimal tissue response and superior handling qualities. However the fact that the presence of macrophages in healing muscle enhances the repair process would be a pointer to create an environment which contains the sustained presence of macrophages to enhance optimal healing of skeletal muscle in the presence of an ideal suture material.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668878PMC
http://dx.doi.org/10.4317/medoral.18608DOI Listing
May 2013

Effects of intra-space injection of Twin mix versus intraoral-submucosal, intramuscular, intravenous and per-oral administration of dexamethasone on post-operative sequelae after mandibular impacted third molar surgery: a preliminary clinical comparative study.

Oral Maxillofac Surg 2014 Sep 20;18(3):293-6. Epub 2013 Mar 20.

Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences & Research Center, People's Campus, Bhanpur, Bhopal 462037, Madhya Pradesh, India,

Introduction: A prospective randomised double-blind study was undertaken to compare the effects of intra-space injection of 'Twin mix' versus intraoral-submucosal, intramuscular, intravenous and per-oral administration of dexamethasone on post-operative sequelae after mandibular impacted third molar surgery.

Material And Methods: A randomised double-blind clinical trial was conducted on 60 patients with class II position B impaction of mandibular third molars. Sixty transalveolar extractions were performed prospectively with ten patients randomly allocated to each of the six study groups (group T: intra-space injection of Twin mix; group S: submucosal dexamethasone; group M: intramuscular dexamethasone; group V: intravenous dexamethasone; group O: per-oral dexamethasone; group C: control group, no dexamethasone). A ten-point visual analogue scale was used to assess the overall pain intensity/patient discomfort, and specific facial measurements were recorded to assess the post-operative facial swelling. Maximal mouth opening was compared pre and post-operatively to assess the trismus.

Results: Mean operative visual analogue scale scores did not show statistical variation, and post-operative visual scores indicated better patient comfort in the steroid groups with statistically significant difference between group T and the control group on the first, third and the seventh post-operative day. Mean increase in distances between tragus and soft tissue menton to assess facial swelling showed strong statistically significant difference between the first and the third post-operative day between the control group and group T (p value <0.0001). Association of trismus was found less with the steroid treatment groups when compared to the control group.

Conclusion: Steroid groups had a better clinical outcome with improved quality of life post-operatively when compared to the nonsteroid study group. Intra-space injection of dexamethasone in pterigomandibular space as Twin mix was found to have similar clinical effects as conventional methods of administering steroids via intraoral-submucosal, intramuscular, intravenous and per-oral routes. This, however, is a small study which would now benefit from larger numbers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10006-013-0412-7DOI Listing
September 2014

A prospective randomized double-blind study to assess the latency and efficacy of twin-mix and 2% lignocaine with 1:200,000 epinephrine in surgical removal of impacted mandibular third molars: a pilot study.

Oral Maxillofac Surg 2013 Dec 10;17(4):275-80. Epub 2012 Nov 10.

Department of Oral and Maxillofacial Surgery, Peoples College of Dental Sciences, Peoples University, Bhanpur, Bhopal, (M.P), India,

Introduction: A prospective randomized double-blind study was conducted to assess the latency and duration of pterygomandibular nerve block with a mixture of 1.8 ml 2% lignocaine with 1:200,000 epinephrine and 1 ml of 4 mg dexamethasone and its impact on postoperative sequelae of surgical extraction of impacted mandibular third molars.

Material And Methods: The study was conducted as a prospective randomized double-blind clinical trial on 20 patients with bilateral impaction of mandibular third molars. A total of 40 interventions were included for the study, 20 with 2% lignocaine with 1:200,000 epinephrine (study group C, control) and 20 with the twin-mix (study group T, twin-mix), with a gap of 1 month between two interventions in a single patient. After injection of the anesthetic solution, the time to anesthetic effect, duration of anesthesia, and the need to re-anesthetize the surgical site were recorded. A 10-point visual analog scale (VAS) was used to assess the overall pain intensity while injecting the study drug, during surgery, and in the postoperative period. pH of the test anesthetic solutions was also determined using a pH meter.

Results: Twin-mix was found to be more basic than 2% lignocaine with 1:200,000 epinephrine. Mean VAS value for the pain/sting on local anesthetic injection/block was less in study group T. Time of onset of the local anesthetic was significantly less for the study group T, 51 ± 17.5 s when compared with patients in study group C (P less than 0.0001). The duration of soft tissue anesthesia was longer for all the patients in the study group T. On comparative evaluation between study group C and study group T, patients in the control group had more sever swelling and reduction in mouth opening in the postoperative period.

Discussion: The addition of dexamethasone to lignocaine and its administration as an intra-space injection significantly shortens the latency and prolongs the duration of the soft tissue anesthesia, with improved quality of life in the postoperative period after surgical extraction of mandibular third molars.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10006-012-0372-3DOI Listing
December 2013