Snophia Suresh

A study on the hypoglycemic and hypolipidemic effects of an ayurvedic drug Rajanyamalakadi in diabetic patients

A study was undertaken for evaluating the hypoglycemic and hypolipidemic effects of an ayurvedic medicine “Rajanyamalakadi” containing Curcuma longa, Emblica officinalis and Salacia oblonga in type II diabetic patients over a period of 3 months. Ethical committee consent for the study was given by the Director, Indian Systems of Medicine, Kerala. A total of 43 patients with established diabetes mellitus as adjudged from clinical features and FBS values, appeared for the camp (Age group 35–75 yrs). An informed consent for the study was obtained from each patient. The clinical proforma was given to each patient to collect data such as height, weight, diet pattern, previous history of illness etc. The ongoing antidiabetic medications were stopped under medical supervision and the patients were provided with ‘Rajanyamalakadi’ tablets (dose 1–2 tablets each weighing 500mg). The dosage of the drug was decided by the supervising medical officer on a case to case basis, taking note of the clinical conditions and responsiveness of the patients. The patients were monitored for three months, who were divided into 6 groups based on their age and again into two groups, 5 & 6, based on their mean FBS values. ie; Normal Persons, Diabetics of age groups 35–45yrs, 46–55yrs, >55yrs and those with FBS < 145.9 mg% and > 145.9 mg%. The Ayurvedic medicine “Rajanyamalakadi” has showed significant antidiabetic, hypolipidemic and antioxidant effects. In addition to that significant ameliorating effects on the elevated serum AST and ALT activities were also demonstrated by the treatment. The nutraceuticals present in the drug like Terpenoids, Polyphenols, Curcumin etc are responsible for the medicinal effects.

Evaluation of anti-inflammatory effect of statins in chronic periodontitis.

Objectives: Statins are the group of lipid-lowering drugs commonly used to control cardiovascular and cerebrovascular diseases. Statins have potential anti-inflammatory effect by blocking the intermediate metabolites of the mevalonate pathway. The objective of this study was to evaluate the anti-inflammatory effect of statin medication in chronic periodontitis patients. Materials and Methods: Thirty patients of age group between 40 and 60 years were selected from the outpatient pool of Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai. Thirty patients selected were grouped into two groups, Group-I consists of patients with generalized chronic periodontitis and on statin medication and Group-II consists of patients with generalized chronic periodontitis. Clinical parameters were recorded and gingival crevicular fluid (GCF) samples were analyzed for interleukin (IL)-1β using commercially available enzyme-linked immunosorbent assay. Results: The mean GCF IL-1β levels in generalized chronic periodontitis patients who are on statin medication (Group-I) were lower than the generalized chronic periodontitis patients without statin medication (Group-II). Conclusion: Reduction of GCF IL-1β levels in statin users indicate that statins have anti-inflammatory effect on periodontal disease.

Correlations of Insulin Resistance and Serum Testosterone Levels with LH:FSH Ratio and Oxidative Stress in Women with Functional Ovarian Hyperandrogenism

Functional ovarian hyperandrogenism (FOH) is a form of polycystic ovary syndrome (PCOS) characterized by elevated circulating levels of androgens derived from the ovary. Insulin resistance (IR) is the most common etiological factor in women with FOH. IR causes the generation of increased oxidative stress (OS) and diminished antioxidant status. OS is directly correlated with both IR and testosterone levels, which consequently contribute to endocrine and biochemical alterations in FOH women. In the current study, elevations in total testosterone, free testosterone and luteinizing hormone (LH) levels accompanied by a decrease in follicle stimulating hormone (FSH) level leading to higher LH:FSH ratio were the prominent endocrine changes observed in women with FOH. A significant increase in fasting blood levels of glucose and insulin, as well as an elevated IR were also seen in FOH women, as compared to their age matched controls. Women with FOH have higher pro-oxidant and lower anti-oxidant levels in blood than their age matched controls. In FOH women, elevations in LH:FSH ratio and OS are correlated more with hyperandrogenemia than with IR. Of the androgens, free rather than total testosterone has better positive correlations with elevated LH:FSH ratio and OS, and hence, the former is a better predictive marker for the development of biochemical PCOS in women with FOH.

Association of Insulin Resistance with Adipocytokine Levels in Patients with Metabolic Syndrome

Metabolic syndrome (MetS) results from the derangement of adipocyte physiology and carbohydrate metabolism. Obesity and insulin resistance (IR) are integral features of MetS. The adipokine alterations in MetS often correlate with IR and body fat content. High adipose tissue content is associated with a decreased production of adiponectin and excessive production of tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6), all of which induce IR. The present study evaluated the adipokine alterations in MetS and their association with IR. The findings of the current study indicate that MetS is associated with significant decrease in adiponectin and increase in TNF-α and IL-6. The present study also found that the adipocyte derived inflammatory adipokines, TNF-α and IL-6 correlate with IR while the anti-inflammatory adipokines, adiponectin does not correlate with the degree and severity of IR.

Comparative analysis of gingival crevicular fluid neopterin levels in health and periodontal disease: A biochemical study

BACKGROUND Periodontitis involves intricate interactions of the biofilm with the host immunoinflammatory response and subsequent alterations in bone and connective tissue homeostasis. Neopterin is a marker, belonging to the class of pteridines, which is associated with cell-mediated immunity. It is produced by interferon-γ stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies and allograft rejections. This investigation was designed to estimate the levels of neopterin in gingival crevicular fluid (GCF) in health, chronic gingivitis and chronic periodontitis. MATERIALS AND METHODS Thirty subjects were divided into three groups of ten subjects each as with healthy periodontium (Group 1), chronic gingivitis (Group 2) and chronic periodontitis (Group 3). The GCF samples were obtained from the subjects by placing color-coded calibrated, volumetric, micro-capillary pipettes extracrevicularly. The samples were placed in plastic vials and stored at -70°C until the time of neopterin estimation using enzyme immunoassay. RESULTS The mean neopterin level in Group 3 (126.28 ± 37.70 nmol/L) is significantly higher than the mean neopterin level in Group 1 (48.66 ± 18.82 nmol/L) and Group 2 (70.68 ± 18.26 nmol/L) (P < 0.05). However, there is no significant relationship between neopterin levels and various clinical parameters in each study group (P > 0.05). CONCLUSIONS The results of our study indicate that the neopterin levels in GCF are positively associated with periodontal disease, which may provide a useful tool in monitoring its progression. Nevertheless, further longitudinal studies are required with larger sample sizes in which neopterin levels are progressively estimated and compared to baseline values.

Comparative Analysis of GCF Resistin Levels in Obese Subjects with and without Periodontal Disease.

INTRODUCTION Resistin is an adipocyte derived hormone that has been shown to play a substantial role in the development of insulin resistance. Resistin acts as a pro-inflammatory molecule and stimulates the synthesis and secretion of pro-inflammatory cytokines. Recent studies have reported the association of Gingival Crevicular Fluid (GCF) resistin levels with periodontal condition. AIM The aim of this study was to assess and compare the GCF resistin levels in obese subjects with periodontal health and disease and to correlate the disease severity with GCF resistin levels. MATERIALS AND METHODS Ninety subjects of both the sexes with age between 20-45 years were selected for the study and were categorized into four groups: 25 obese or overweight subjects with generalized chronic periodontitis (Group-I), 25 obese or overweight subjects with healthy periodontium (Group-II), 25 non-obese subjects with generalized chronic periodontitis (Group-III) and 15 non obese subjects with healthy periodontium (Group-IV). The demographic variables like age, Body Mass Index (BMI), Waist Circumference (WC) were recorded and the clinical periodontal parameters such as Plaque Index (PI), Gingival Index (GI), and Clinical Attachment Level (CAL) were also assessed in all the groups. GCF was collected and assessed for resistin levels. RESULTS The mean GCF resistin levels in Groups I, II, III & IV were 15.14, 9.06, 12.74 and 5.41 ng/dl respectively and the difference in mean GCF resistin level was statistically significant with the p-value<0.001. The mean GCF resistin levels in Group-I was higher compared to Group II and III and the differences in mean GCF resistin levels were statistically significant. GCF resistin levels were positively correlated with BMI, WC and CAL in Group I and CAL correlated with GCF resistin in Group III and this correlation was statistically significant. CONCLUSION From our study we report that obese subjects with periodontitis have more GCF resistin levels compared to non-obese subjects with healthy periodontium.

Evaluation of plasma reactive oxygen metabolites levels in obese subjects with periodontal disease

Background: Obesity represents the systemic condition capable of influencing the onset and progression of periodontal disease. Obesity is associated with oxidative stress. Plasma level of reactive oxidative metabolites (ROMs) is measured as an indicator of oxidative stress in the body. The aim of this study is to assess and compare the plasma ROM levels in obese subjects with healthy and inflammatory periodontal status. Materials and Methods: Sixty subjects selected were grouped as 15 obese or overweight subjects with generalized chronic periodontitis, 15 obese or overweight subjects with generalized chronic gingivitis, 15 obese or overweight subjects with healthy periodontium, and 15 nonobese and healthy periodontium. The clinical periodontal parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were measured. Blood samples were obtained to measure the plasma levels of ROM. Result and Conclusion: In this study, obese subjects with chronic periodontitis (Group I) had mean plasma ROM levels (442.3 ± 15.65 Carratelli unit [CARR U]) showing 100% subjects with high oxidative stress. Obese subjects with chronic gingivitis (Group II) had mean plasma ROM levels (358.7 ± 20.61 CARR U) indicating 86.7% subjects with oxidative stress. Obese subjects with healthy periodontium (Group III) had 46.7% subjects with slight oxidative stress, and the mean ROM level was 320.2 ± 17.57. Nonobese subjects with healthy periodontium (Group IV) had 80% of subjects with normal oxidative stress and the mean plasma ROM level was 296.9 ± 20.35 CARR U. The intra- and inter-group comparison showed significant difference (P < 0.001). From our study, we report that obese subjects with periodontitis have more oxidative stress compared to obese subjects with healthy periodontium.

Low-level laser therapy: A biostimulation therapy in periodontics

Low-level laser therapy (LLLT) is a light source treatment that generates light of a single wavelength. The low-level lasers do not cause temperature elevation within the tissue, but rather produce their effects from photobiostimulation effect within the tissues. Low-level lasers do not cut or ablate the tissue. The therapy performed with low-level lasers ia called as LLLT. LLLT devices include the gallium arsenide, gallium aluminum arsenide infrared semiconductor (gallium-aluminum-arsenide), and helium-neon lasers. The output powers range from 50 to 500 mW with wavelengths in the red and near infrared of the electromagnetic spectrum, from 630 to 980 nm with pulsed or continuous-wave emission. The application of LLLT has become popular in a variety of clinical applications in periodontics including promotion of wound healing and reduction of pain following nonsurgical and surgical procedures.

Clinical efficacy of low-level laser therapy as an adjunct to nonsurgical treatment of chronic periodontitis

Aims and Objective : In recent years, there has been a growing interest in the use of dental lasers for the treatment of periodontal diseases. The purpose of this randomized, split-mouth clinical trial was to evaluate the clinical efficacy of low-level laser therapy (LLLT) as an adjunct to conventional scaling and root planning (SRP). Materials and Methods: A total of 10 patients with untreated chronic periodontitis were randomly assigned in a split-mouth design to receive SRP with or without adjunctive LLLT. Clinical parameters including plaque index, gingival index, probing pocket depth were recorded at baseline, 1 st month and 3 rd month after the treatment. Gingival crevicular fluid (GCF) was collected for the assay of interleukin-1b (IL-1b) levels at baseline, 1 st week and 1 st month. Results: Both laser and control sides showed a significant reduction in IL-1b levels in GCF at 1 st week and 1 st month (P < 0.001). On comparing, laser sides showed a significant reduction in IL-1b levels at 1 st week (P = 0.041). No significant difference in IL-1b levels were found between laser and control sides at 3 rd month (P = 0.450). All the clinical parameters showed a significant difference (P < 0.05) at 1 st and 3 rd month after the treatment between laser and control sides. Conclusion: The present study suggests that LLLT could be a beneficial adjunct to nonsurgical treatment of chronic periodontitis on a short-term basis.

Management of ankyloglossia by diode laser

Frenum is a fold of tissue or muscle connecting the lips, cheek, or tongue to the jawbone. It is also known as frenulum, frenulums, frenula, frenums, or frena. Ankyloglossia, commonly known as tongue tie, is a congenital anomaly characterized by an abnormally short/tight lingual frenulum, which restricts mobility of the tongue tip. Though the ankyloglossia or tongue tie is not a serious manifestation, it may lead to a host of problems including infant feeding difficulties, speech disorders, and various mechanical and social issues related to the inability of the tongue to protrude. Lingual frenectomy is advised for the management of ankyloglossia. The present paper discusses one case of successful management of ankyloglossia or tongue tie with diode laser. Clinical Relevance to Interdisciplinary Dentistry Ankyloglossia is commonly associated with speech problems. Tongue tie can be corrected by lingual frenectomy The common problem during scalpel frenectomy is excessive bleeding. To reduce bleeding during surgery and improve postoperative healing, laser-assisted frenectomy is preferred.