Most Indirect Pulp Capping Materials Safe for Deep Cavities Without Compromising Dentin Seal: Study

Most indirect pulp capping Materials, except for Kerr Life, do not compromise the peripheral seal to dentin in very deep cavity areas. Further, hydraulic cements can be used without negatively affecting the dentin seal.

The aim of this in-vitro study was to evaluate the effect of different indirect pulp capping (IPC) materials on bond strength to surrounding dentin. Fifty-six human third molars were used in this study. Occlusal dentin of 42 teeth was exposed. Dentin surfaces (n = 6) were left uncovered (control) or received a 1 × 1 mm central IPC (KL: Kerr life, DY: Dycal, TC: Theracal LC, CL: Calcimol LC, BD: Biodentine, and PR: ProRoot MTA) and were then bonded with Scotchbond Universal adhesive and restored with a composite resin build-up (Filtek™ Z250). After 24 h of water storage, the specimens were cut into sticks, which were marked red (1 mm distance from IPC spot), green (2 mm distance), and blue (3 mm distance). Consequently, µ-TBS tests were performed and analyzed using one-way ANOVA (P 0.05) for normal distributions and Mann–Whitney U-test (P 0.05) for non-normal distributions. Pretesting failures were recorded as 0 MPa. Fracture modes were analyzed under a fluorescence microscope, and interfaces and surfaces of 14 additional specimens were visualized under a scanning electron microscope (SEM). Results: A significant reduction in peripheral seal was only observed for KL (Mann–Whitney U-test, P 0.05). All groups showed increasing bond strengths from the IPC area to the periphery, indicating a certain contamination potential of IPC materials. IPC materials being applied in very deep cavity areas except Kerr Life do not harm peripheral seal to dentin. Especially, hydraulic cements can be used without a negative effect on the peripheral dentin seal.

Reference:

Frankenberger, R.; Koch, A.; Plohmann, L.; Beck-Broichsitter, B.; Becker, S. The Outcome of Old-School Indirect Pulp Capping over 40 Years: A Practice-Based Retrospective Evaluation. Dent. J. 2025, 13, 182. https://doi.org/10.3390/dj13050182

Keywords:

Frankenberger, R.; Koch, A.; Plohmann, L.; Beck-Broichsitter, B.; Becker, S, Outcome, Old-School, Indirect, Pulp Capping, over, 40 Years, dentistry journal

Powered by WPeMatico

Urgent Laparoscopic Cholecystectomy feasible among Older Adults with acute cholecystitis: Study

Researchers have found in a new study that urgent laparoscopic cholecystectomy (LC) with proper perioperative care is a viable treatment option for acute cholecystitis in older adults. While advanced age is linked to longer hospital stays and increased treatment costs, it does not correlate with a rise in short-term postoperative complications.

This study aimed to compare the clinical outcomes and hospital costs between younger and older adult with acute cholecystitis patients who received urgent laparoscopic cholecystectomy. A 3-year retrospective study was conducted. Patients admitted to surgical units for urgent laparoscopic cholecystectomy at Chi-Mei Hospital from January 1, 2019, to December 31, 2021, were included. Patients’ baseline data were collected from medical records review. Postoperative complications are defined by the Clavien-Dindo classification as being greater than grade I. Total costs during admission were also collected based on disease-related groups (DRG system). Results: Among 300 patients selected, 68.3% (n = 205) were aged < 60 years, 19.3% (n = 58) were aged between 60 and 69 years, and 12.3% (n = 37) were aged ≥ 70 years. Patients aged ≥ 70 years had higher rates of comorbidities, higher ASA levels, and lower platelet counts than those in patients aged < 60 years. After adjusting for possible confounders in the multivariable models, older age was significantly associated with longer hospital stays (length of stay, or LOS) (β = 0.56 for patients aged 60–69 years and 1.30 for those aged ≥ 70 years) and correspondingly higher hospital costs (β = 219.69 for patients aged 60–69 years and 302.48 for ≥ 70 years) compared to those for patients aged < 60 years. No significant associations were found between older age and the occurrence of postoperative complications. Urgent LC with adequate perioperative care is feasible for treating acute cholecystitis in older adult patients. Older age is independently associated with longer LOS and higher costs but not with short-term postoperative complications.

Reference:

Kao, YM., Lu, CY. Impact of age on outcomes and hospital costs of urgent laparoscopic cholecystectomy for acute cholecystitis: a retrospective cohort study. BMC Surg 25, 228 (2025). https://doi.org/10.1186/s12893-025-02963-0

Keywords:

Urgent, Laparoscopic, Cholecystectomy, feasible, among, Older, Adults, acute cholecystitis, Study, Kao, YM., Lu, CY, Urgent laparoscopic cholecystectomy, Medical costs, Prognosis, Older adults

Powered by WPeMatico

Aging Women with PANDO Face Higher Risk of Acute Dacryocystitis, suggests study

Researchers have discovered that age, especially in older women with primary acquired nasolacrimal duct obstruction (PANDO), strongly predicts the development of acute dacryocystitis (AD), an inflammatory and potentially serious infection of the lacrimal sac. A recent study was conducted by Amber D. published in the British Journal of Ophthalmology. The research also reveals that weather-related factors like temperature and humidity are not significantly correlated with the prevalence of AD.

This single-center, retrospective observational study examined data on all clinically diagnosed adult patients with acute dacryocystitis between January 2000 and February 2020. Patient data were compared to environmental data collected from the Royal Meteorological Institute of Belgium in order to determine if weather conditions may have influenced AD occurrence. Patients were divided into three groups according to the condition of their nasolacrimal ducts: PANDO, non-PANDO, or unclassified, as a function of whether lacrimal syringing information was present. Principal patient variables were age and sex, and the investigators used multivariate regression analysis to analyze risk factors.

Results

  • 106 first-onset AD patients were included in the analysis. Of these, 86 (81%) were women and 20 (19%) were men, with an average age of 64.9 years.

  • PANDO was diagnosed in 50% of the cases, and 20% had non-PANDO forms, and the other 30% could not be classified clearly.

  • Risk for AD increased significantly with age.

  • For each 5-year increase in age, the total incidence of AD increased by 14.5% (p=0.012, Exp(B)=1.145).

  • This risk with age was particularly notable in the PANDO group, where the incidence increased by 22.1% for each 5-year increase in age (p<0.002, Exp(B)=1.221).

  • This age-dependent increase was not noted in PANDO-negative patients.

  • The examination did not identify any statistically significant relationships between AD incidence and weather factors such as temperature, humidity, atmospheric pressure, or rainfall.

Acute dacryocystitis occurs much more frequently in older women, especially those with primary acquired nasolacrimal duct obstruction. A high-risk predictor was identified as age, particularly in the PANDO subgroup, while meteorological factors had no significant correlation. These results justify proactive counseling and preventive surgical procedures such as dacryocystorhinostomy for elderly female patients with symptomatic PANDO in an effort to limit the burden of AD.

Reference:

Demeuleneere A, Kusmierczyk J, Mombaerts I. Risk factors for the development of acute dacryocystitis in adults. Br J Ophthalmol. 2025 Jun 18:bjo-2024-326753. doi: 10.1136/bjo-2024-326753. Epub ahead of print. PMID: 40533106.

Powered by WPeMatico

Icotrokinra Shows High Efficacy and Safety in Treating Adolescent Psoriasis: Study

A new subgroup analysis reveals that adolescents with moderate-to-severe plaque psoriasis treated with once-daily icotrokinra (JNJ-2113) achieved significantly higher skin clearance at 16 weeks compared to placebo. Notably, 84.1% reached IGA 0/1 and 70.5% attained PASI 90. No new safety concerns emerged, supporting the drug’s efficacy and safety in both adolescents and adults.

 Icotrokinra is a first-in-class investigational targeted oral peptide that selectively blocks the IL-23 receptor and is being studied in adults and adolescents 12 years of age and older with moderate-to-severe plaque PsO.

In the study, 84.1% of adolescent patients treated with once daily icotrokinra achieved an Investigator’s Global Assessment (IGA)b score of 0/1 (clear or almost clear skin) and 70.5% achieved a Psoriasis Area and Severity Index (PASI)c 90 response, compared to 27.3% and 13.6% receiving placebo, respectively, at Week 16.

Response rates continued to improve through Week 24 where 86.4% of adolescents achieved IGA 0/1 (clear or almost clear skin) and 88.6% achieved PASI 90.1 Further, at Week 24, 75% of adolescents achieved IGA 0 (completely clear skin) and 63.6% achieved PASI 100.

“Data from the Phase 3 ICONIC LEAD subgroup analysis demonstrate impressive efficacy rates, showing the promise of this novel therapeutic option in the treatment of adolescents with moderate-to-severe plaque psoriasis who’ve often not yet received an advanced therapy,” said Lawrence Eichenfield, M.D., Chief of Pediatric and Adolescent Dermatology at Rady Children’s Hospital-San Diego, and Professor of Pediatrics and Medicine (Dermatology), at the University of California, San Diego (UCSD) School of Medicine, ICONIC-LEAD presenter.d “Young patients with plaque psoriasis face unique challenges due to the visible and uncomfortable nature of the disease, making effective treatment options that align with their needs and preferences all the more important.”

Icotrokinra demonstrated a favorable safety profile. At Week 16, 50% of adolescents treated with icotrokinra experienced ≥1 adverse event (AE), compared to 73% of adolescents receiving placebo, with no new safety signals identified.

“Adolescents living with moderate to severe plaque psoriasis shouldn’t have to wait for effective treatments options that have the potential to deliver completely clear skin, which is the driving force for studying this younger population as part of the pivotal ICONIC program,” said Liza O’Dowd, Vice President, Immunodermatology Disease Area Lead, Johnson & Johnson Innovative Medicine. “These data underscore the promise of next-generation therapies and the potential for icotrokinra to offer adolescents with moderate-to-severe plaque psoriasis the unique combination of a favorable safety profile and complete skin clearance in a once-daily pill.”

About Plaque Psoriasis

Plaque psoriasis (PsO) is a chronic immune-mediated disease resulting in overproduction of skin cells, which causes inflamed, scaly plaques that may be itchy or painful.9 It is estimated that 8 million Americans and more than 125 million people worldwide live with the disease.10 Nearly one-quarter of all people with plaque PsO have cases that are considered moderate to severe.11 On Caucasian skin, plaques typically appear as raised, red patches covered with a silvery white buildup of dead skin cells or scale.11 On skin of color, the plaques may appear darker and thicker and more of a purple, gray or dark brown color.12 Plaques can appear anywhere on the body, although they most often appear on the scalp, knees, elbows, and torso.12 Living with plaque PsO can be a challenge and impact life beyond a person’s physical health, including emotional health, relationships, and handling the stressors of life.12 Psoriasis on highly visible areas of the body or sensitive skin, such as the scalp, hands, feet, and genitals, can have an increased negative impact on quality of life.12,13

About Icotrokinra (JNJ-77242113, JNJ-2113)

Investigational icotrokinra is the first targeted oral peptide designed to selectively block the IL-23 receptor,14 which underpins the inflammatory response in moderate-to-severe plaque PsO, ulcerative colitis and offers potential in other IL-23-mediated diseases.15,16 Icotrokinra binds to the IL-23 receptor with single-digit picomolar affinity and demonstrated potent, selective inhibition of IL-23 signaling in human T cells.17 The license and collaboration agreement established between Protagonist Therapeutics, Inc. and Janssen Biotech, Inc., a Johnson & Johnson company, in 2017 enabled the companies to work together to discover and develop next-generation compounds that ultimately led to icotrokinra.18

Icotrokinra was jointly discovered and is being developed pursuant to the license and collaboration agreement between Protagonist and Johnson & Johnson. Johnson & Johnson retains exclusive worldwide rights to develop icotrokinra in Phase 2 clinical trials and beyond, and to commercialize compounds derived from the research conducted pursuant to the agreement against a broad range of indications.19,20,21

Icotrokinra is being studied in the pivotal Phase 3 ICONIC clinical development program in moderate-to-severe plaque psoriasis and active psoriatic arthritis and the Phase 2b ANTHEM-UC study in moderately to severely active ulcerative colitis.

Powered by WPeMatico

Creatinine has key role in Predicting Hyperuricemia in Breast Cancer Patients: Study

According to a new study Creatinine emerged as the most significant factor linked to hyperuricemia in breast cancer patients. It was independently associated with the condition and demonstrated strong predictive performance.

A study was done to explore the factors influencing hyperuricemia in breast cancer patients based on the National Health and Nutrition Examination Survey (NHANES) database. The univariate and multivariate generalized linear regression were used to screen the influencing factors of hyperuricemia. Logistic and XGBoost algorithms were used to rank the importance of influencing factors. Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA) curves were used to assess the predictive performance and clinical benefit. Trend analysis, Restricted cubic spline (RCS) analysis, and generalized additive model were used to explore the relationship between key factor and hyperuricemia. Results: A total of 359 patients with breast cancer were included, of whom 99 patients had hyperuricemia. Among all variables collected, BMI, total calcium, creatinine, hypertension, and gout were found as independent factors of hyperuricemia (all p < 0.05). Among them, Both the 2 algorithms indicated that importance of creatinine on hyperuricemia ranked first. Further, BMI and creatinine levels had higher area under the curve than other variables (BMI: 0.626 [95%CI: 0.574-0.685]; creatinine: 0.722 [95%CI: 0.674-0.777]), but prediction performance difference between them was insignificant (P for Delong test = 0.051). DCA next indicated that creatinine achieved better clinical net benefit than BMI. Further, a detailed positive association between creatinine and hyperuricemia was determined (P for trend<0.001), with a linear relationship (P for non-linear = 0.428). Creatinine was identified as the most important factor of hyperuricemia in breast cancer patients, as it had independent association with hyperuricemia and favorable prediction performance.

Reference:

Meng TT, Wang WR, Zheng YQ, Liu GD. Key factors determination of hyperuricemia and association analysis among patients with breast cancer: results from NHANES data. Front Nutr. 2025 Mar 26;12:1535879. doi: 10.3389/fnut.2025.1535879. PMID: 40206955; PMCID: PMC11978644.

Keywords:

Creatinine, key role, Predicting, Hyperuricemia, Breast Cancer, Patients, Study, NHANES; breast cancer; creatinine; hyperuricemia; influencing factors, Meng TT, Wang WR, Zheng YQ, Liu GD

Powered by WPeMatico

High Inflammatory Index Linked to Poor Outcomes in Heart Patients with Sleep Apnea: Study

China: A new prospective cohort study from Beijing Anzhen Hospital has found that elevated systemic inflammatory response index (SIRI) significantly increases the risk of major cardiovascular and cerebrovascular complications in individuals diagnosed with both acute coronary syndrome (ACS) and obstructive sleep apnea (OSA). The study, published in the Journal of Inflammation Research, was led by Qian He and colleagues from the Center for Coronary Artery Disease, Capital Medical University.

The research sought to assess whether SIRI—a biomarker derived from neutrophil, monocyte, and lymphocyte counts—could serve as a reliable predictor of long-term adverse cardiovascular events in this high-risk population. SIRI reflects the degree of systemic inflammation, which is known to play a critical role in atherosclerosis and cardiovascular disease progression.

The study included a total of 1,011 patients diagnosed with ACS and OSA, between June 2015 and January 2020. SIRI levels were measured upon hospital admission, and based on an optimal cutoff value of ≥1.16 × 10⁹/L derived from receiver operating characteristic (ROC) curve analysis, patients were divided into high and low SIRI groups.

The following were the key findings of the study:

  • Over a median follow-up period of 2.8 years, 179 patients experienced major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, recurrent myocardial infarction, stroke, or ischemia-driven revascularization.
  • Kaplan–Meier analysis revealed a significantly higher incidence of MACCE in the high SIRI group.
  • After adjusting for clinical confounders, high SIRI levels were independently associated with a 44% increased risk of MACCE (adjusted hazard ratio: 1.44).

The study further emphasized that SIRI’s prognostic power goes beyond traditional OSA severity indicators such as the apnea-hypopnea index. The biomarker offers a more comprehensive view of immune activation and systemic inflammation, which could explain its strong association with cardiovascular outcomes.

However, the authors acknowledge several limitations. The study was conducted at a single center, and the diagnosis of OSA was based on portable polygraphy, which may underestimate its severity. Moreover, the lack of post-discharge data on OSA treatment adherence and seasonal variability in blood sample timing could affect the findings. Patients with recent infections or corticosteroid therapy were also not excluded, introducing potential selection bias.

Despite these limitations, the study presents compelling evidence that SIRI could serve as a valuable tool for identifying high-risk patients with ACS and OSA. The researchers call for future investigations to evaluate whether interventions guided by SIRI measurements can help reduce cardiovascular events in this vulnerable group.

Reference:

He Q, Zhou Y, Tong X, Zhen L, Shi S, Gong W, Nie S. Prognostic Value of the Systemic Inflammatory Response Index in Patients with Acute Coronary Syndrome and Obstructive Sleep Apnea. J Inflamm Res. 2025;18:7515-7527. https://doi.org/10.2147/JIR.S515437

Powered by WPeMatico

RNT Doctor Death Case: Postmortem discrepancies spark hunger strike by Resident Doctors

Udaipur: Following the tragic death of Dr Ravi Sharma at the postgraduate hostel of Ravindranath Tagore (RNT) Medical College, Udaipur, resident doctors have escalated their protests, demanding justice, accountability, and announcing a hunger strike. This comes after a serious discrepancy between two postmortem reports surfaced, raising concerns about a possible cover-up on the matter. 

Two separate postmortems were conducted – one by a team from RNT Medical College and another by SMS Medical College in Jaipur – both revealed different conclusions. The first postmortem, carried out by a team at RNT Medical College, noted only superficial injuries. The report mentioned marks of abrasions on Dr. Ravi Sharma’s body and an injury on the back of his head “caused by electric shock,” but did not clearly state electrocution as the cause of death. Investigators collected a sample of normal skin and sent it to the Forensic Science Laboratory (FSL) for analysis.

Also read- Tragic: Doctor electrocuted to death at RNT College Hostel

Dissatisfied with the initial findings, resident doctors asked for a second opinion. A team from SMS Medical College in Jaipur, led by Dr. Deepali Pathak and including specialists in plastic surgery, pathology, and another forensic expert, re-examined the body. Their report confirmed electrocution as the cause of death, noting three distinct electric injuries. They also sent a sample from the exact area where the current passed to the FSL, though they pointed out that no such samples had been taken in the first postmortem, reports TOI

Despite the confirmation of electrocution by SMS Medical College, RNT authorities have not yet officially acknowledged it as the cause of death. This lack of response has further angered resident doctors, who allege that the administration is attempting to cover up the real cause of death.

In protest, resident doctors from RNT Medical College have announced a hunger strike, intensifying their ongoing agitation that started on June 18, the day Dr Ravi died. 

Dr. Tejpal, Udaipur Resident Doctors Association (URDA) media coordinator, told IANS, “I would like to inform all the people of Rajasthan, especially our healthcare workers and the administration, that as you all know, Dr. Ravi passed away due to administrative negligence. Since then, our movement to get him justice is ongoing. Even after giving an ultimatum, there has been no positive response or action from the administration. In this process, we have raised this issue repeatedly to demand justice…”

Medical dialogues had reported that a 35-year-old doctor was allegedly electrocuted while taking water from a cooler at the postgraduate hostel of Ravindranath Tagore (RNT) Medical College in Udaipur, who was about to join the Maharana Bhupal Government Hospital.  Despite giving immediate CPR and rushing him to the hospital, the doctor could not be revived and was pronounced dead. The deceased, Dr Ravi Sharma, arrived in Udaipur recently ahead of his scheduled joining at the hospital. He was staying with his cousin, also a doctor, in the college PG hostel.

His sudden death led to widespread anger among resident doctors and students at the institution, who ceased their work and launched a protest on campus on Thursday, raising slogans and demanding the resignation of college officials – the principal and hostel warden.

Resident doctors at RNT Medical College are deeply upset over how the death of Dr. Ravi Sharma has been handled. They believe the first postmortem report, done by their own college, did not give a clear reason for his death. Although the report mentioned injuries that looked like they were caused by electric shock, it did not confirm that electrocution was the cause. The doctors feel this is a serious mistake and an attempt to hide the truth. They believe this delay and confusion could stop the family from getting proper justice and compensation.

Since June 18, resident doctors at RNT Medical College have been boycotting all non-emergency services. Their protest has gained support from the Jaipur Association of Resident Doctors (JARD) and resident doctors from SN Medical College, Jodhpur, who have been observing a daily two-hour pen-down strike from 8 a.m. to 10 a.m.

According to a report by Bhaskar, over 600 resident doctors across all hospitals affiliated with RNT Medical College held a strike for four consecutive days, accusing the college administration of hiding the truth and tampering with evidence. The residents say they will continue the strike until there is action against the administration. They want the truth about Dr Ravi Sharma’s death to come out and those responsible to be punished.

Starting Wednesday, resident doctors at SP Medical College in Bikaner and Government Medical College in Kota will join their Udaipur colleagues in a full strike. All outpatient (OPD) and inpatient (IPD) services, as well as emergency care and operations, will remain suspended until their demands are met. They said the strike would be observed to demand compensation for the family of the resident doctor

Speaking to TOI, Dr Bharat Pareek, President of JARD, Rajasthan, said, “The tragic death of Dr Ravi Sharma shook the state’s medical fraternity. The State Human Rights Commission has sought an explanation from principals of RNT Medical College and SMS Medical College, Jaipur.”

Raising concerns about the discrepancies in the postmortem report, a delegation from JARD met medical education secretary Ambrish Kumar on Tuesday to demand suspension of officials responsible for Dr Sharma’s death, financial compensation, and a judicial inquiry into the discrepancies in the postmortem reports.

Dr Prashant Sharma, the cousin of the deceased, claimed that Ravi died from an electric shock caused by a faulty water cooler in the hostel. He said the first report by RNT is misleading and hides the truth. He accused the medical college of tampering with samples to protect the administration. He added, “If an educated doctor can die like this without justice, what must be happening to ordinary people? I feel dead inside. This is a failure of the system.”

Also read- Twin Tragedy rocks Rajasthan: Suicide, Electrocution of young doctors sparks statewide outrage

Powered by WPeMatico

Tripura: 25-year-old woman during Treatment, medical negligence alleged

Agartala: In a tragic incident, a 25-year-old woman allegedly lost her life on Monday while undergoing treatment at Janapriya Medical Hall in Teliamura, sparking widespread public outrage and raising serious concerns about alleged medical negligence at the facility.

According to news reports, the deceased, a young mother, had visited a medical hall complaining of back pain. She was reportedly attended by a doctor who informed her that fluid needed to be urgently drained from her lungs.

For more information, click on the link below:

Tripura: 25-year-old woman during Treatment, medical negligence alleged

Powered by WPeMatico

NEET 2025: NTA Opposes Re-Exam Plea, Claims Power Outage did not impact performance

Indore: The National Testing Agency (NTA) has submitted that the one-hour power outage during the National Eligibility-Entrance Test Undergraduate (NEET-UG) 2025 examination at the examination centres in Indore did not affect the performance of the candidates, who had approached the Madhya Pradesh High Court seeking relief.

Filing pleas before the HC bench, medical aspirants alleged that the power outage at the NEET exam centres across Indore affected their performance, and they had to complete their NEET UG 2025 exam using emergency lamps or candles.

For more information, click on the link below:

NEET 2025: NTA Opposes Re-Exam Plea, Says Performance Not Affected due to Power Outage

Powered by WPeMatico

One in five packaged foods and drinks sold in the US contains synthetic dyes, study shows

As many as 19% of packaged foods and beverages sold by top US food manufacturers contain synthetic food dyes, according to new research evaluating the content of 39,763 American grocery store products.

Powered by WPeMatico