Margalla Institute of Health Sciences

Ibuprofen sodium (IBP) is a commonly used NSAID for multiple pain conditions. However, despite its extensive use, it is associated with multiple GIT adverse effects after oral administration. In the present study, we have fabricated thermoresponsive gel depot using Poly (N-vinylcaprolactam) and sodium alginate as polymers. The designed formulations are intended to be used as IBP depot after being administered subcutaneously. The sol-gel phase transition temperature and gelation time of gel samples were optimized by tube inversion, rheological exploration and optical transmittances. Temperature sweep experiments confirmed that optimized gel samples have sol-gel transition between 32°C and 37°C. Swelling and in vitro drug release displayed that optimized gels have maximum swelling and IBP release at pH 7.4 and at 35°C confirming their pH/thermo sensitivity. The degradation profile of hydrogels displayed controlled degradation for 6 days that with increasing contents. MTT assay showed L929 cells displayed more than 90% cell viability against blank and IBP-loaded PNVCL/NaAlg hydrogels at optimized concentrations. Fourier transform infrared spectroscopy confirmed the polymer blend hydrogels structure formation. Thermogravimetric analysis confirmed the presence of thermoresponsive moieties and thermal stability of polymer blend hydrogel sample. While scanning electron microscopy showed that hydrogel has channels in structure that might facilitate the diffusion of solvent. Results concluded that PNVCL/NaAlg hydrogels can be utilized as IBP sustained depot following subcutaneous application invivo and GIT adverse effects could be avoided associated with its oral administration.

Patient-reported outcomes (PROs) capture the patient's direct perspective on treatment effectiveness. This study evaluated PROs after root canal treatment (RCT) performed by dental interns on quality of life using pre- and post-RCT Oral Health Impact Profile (OHIP) scores. It also examined associations between demographics, baseline pulpal/periapical diagnosis, and OHIP scores.

A prospective study was conducted at the Operative Dentistry Department of a dental institution (January-June 2023) with 317 patients requiring RCT and meeting inclusion criteria. The Wilcoxon signed-rank test compared pre- and post-RCT OHIP scores. Differences in OHIP scores based on gender, arch, and tooth position were assessed with the Mann-Whitney U test. The Kruskal-Wallis test examined OHIP score variations by pulpal/periapical diagnosis and age, with Dunn's post hoc test for pairwise comparisons. Significance level was set at < .05.

The final sample comprised 266 participants. OHIP scores significantly reduced post-RCT indicating enhanced quality of life after RCT (P < .05). Males had higher pre- and post-RCT OHIP scores than females with statistical significance (P < .05). Patients aged 51+ had the lowest pre-RCT OHIP scores (P < .05). Those with acute apical abscess and asymptomatic apical periodontitis had significantly higher pre-RCT OHIP scores (P < .05), with acute apical abscess patients showing the greatest post-RCT improvement as depicted by reduction in OHIP scores (P < .05).

From the patients' perspective, regardless of demographics or pulpal/periapical diagnosis, RCT significantly improved quality of life. Male participants had greater perceived discomfort before and after treatment as compare with females. Patients aged 51+ perceived a lower impact of pulpal or periapical disease both before and after RCT. Greater post-RCT improvement was observed in participants diagnosed with acute apical abscess.

Diabetes mellitus is a recognized risk factor for impaired wound healing and greater postoperative complications. Thus, this study was conducted to assess the effect of diabetes on outcomes of hernia management in high-risk patients, including wound healing, recurrence, and postoperative infections.

This retrospective observational study was carried out between March and August 2024 and features 120 recruited patients who underwent elective hernia repair. The patients were stratified into two groups: group A (diabetics; n=60) and group B (non-diabetics; n=60). Age, BMI, comorbidities, and the American Society of Anesthesiologists (ASA) score were recorded as preoperative data. Operative time, wound healing duration, incidence of surgical site infections (SSIs), and recurrence over six months were analyzed during intraoperative and postoperative periods from surgical records. Statistical analysis was carried out with SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), using the chi-square test and independent t-test with a p-value < 0.05 as statistically significant.

Diabetics had significantly longer operative times (p = 0.001). Patients in group A (with prolonged drainage time) had longer wound healing (17.2 ± 3.4 vs. 12.5 ± 2.7 days, p < 0.001), higher incidence of SSI (21.7% vs. 6.7%, p = 0.015), and longer drain retention (p < 0.001). Diabetics also had significantly longer hospital stays (6.3 vs. 4.5 days; p < 0.001). Diabetic recurrence was more than in non-diabetics at six months (11.7% vs. 3.3%), despite a p-value of 0.085. Diabetic patients also expressed trends towards increased formation of seroma and chronic pain.

Diabetic patients requiring hernia repair are at higher risk for delayed healing of wounds, surgical site infection, and longer hospitalization.