Synthesis and anti‐inflammatory activity of diversified heterocyclic systems

In continuation with our research program on the development of novel bioactive molecules, we report herein the design and synthesis of a series of diversified heterocycles ( 4 – 22 ). The synthesized compounds were evaluated for their anti‐inflammatory activity. The chemical structures of the newly synthesized compounds have been confirmed by NMR, FTIR, and microanalysis.     

The treatment of mandibular condyle fractures: A meta-analysis

BackgroundThe treatment for mandibular condyle fractures remains controversial. Conservative management (CM) and open reduction/internal fixation (ORIF) are both used, but the evidence to support superiority of one method over the other has not been assessed.MethodsWe performed a meta-analysis of studies comparing CM versus ORIF in patients with condyle fractures. The primary outcome was post-treatment function; we looked at the status of the post-treatment occlusion, mouth opening, protrusion, facial height, pain and the presence of postoperative ankylosis. Furthermore, in studies evaluating ORIF, adverse effects such as facial nerve weakness and scarring, were also recorded.ResultsTwenty (20) studies enrolling 1596 patients were eligible. These included four randomized controlled trials (RCTs) and 16 non-randomized case series. Only 1186 of these patients were analyzed by the studies; the reasons for exclusion were rarely clarified. All four RCTs were prospective but the majority (69%) of the remaining studies were retrospective. The inclusion criteria were described in all four RCTs; however, this was not the case in half of the remaining studies (44%). Only four (20%) studies were blinded. Across all included studies, we recorded great variation between treatment protocols, follow-up periods, and outcomes measured. This precluded any quantitative synthesis. In nine studies (45%) the superiority of ORIF over CM reached statistical significance. The incidence of facial nerve weakness following ORIF averaged 6% and it was temporary for the majority of the patients. The identified RCTs were small (160 patients) and suffered from a number of methodological shortcomings. All of them reached statistically significant conclusions favoring ORIF over CM.ConclusionThe current meta-analysis suggests that ORIF for condylar fractures may be as good or better than CM. The morbidity associated with the operation is low. However, the available evidence is of poor quality and not strong enough to change clinical practice.     

Evaluation of Long-Term Outcomes, Cytogenetic and Molecular Responses with Imatinib Mesylate in Early and Late Chronic-Phase Chronic Myeloid Leukemia: A Report from a Single Institute

Here we compare the management and survival outcomes of chronic myeloid leukemia (CML) patients who had early or late imatinib mesylate (IM) therapy. The cytogenetic and molecular responses of 189 CML patients were analyzed. Of this group, 121 patients were classified as the early chronic phase (ECP) group and started IM within 12 months of diagnosis. The other 68 patients were classified as the late chronic phase (LCP) group who had been treated with interferon (IFN)-alpha-2 and crossed over to IM more than 12 months after diagnosis. The overall rates of complete cytogenetic response (CCyR) and major molecular response (MMR) at last follow-up were 83.6 and 78.1% in the ECP and LCP groups, respectively. The CCyR rates were 89.3 (for ECP patients) versus 73.5% (for LCP patients; p < 0.0001). At last follow-up, 82.4% ECP and 64.2% LCP patients had achieved an MMR (p < 0.0001). No significant differences were noted between the two groups with regard to survival outcomes. Our experience reveals that IM is an effective rescue therapy in most CML LCP patients who are intolerant or in whom IFN-alpha therapy fails. Such therapeutic options should be considered in LCP patients, particularly in countries where IM may not be available.     

Relationships between sex steroids of the seminal fluid and milt quality parameters of Persian sturgeon, Acipenser persicus Borodin, 1897

To investigate the role of sex steroids of the seminal fluid on sperm quality, the relationships between sex steroids and milt quality parameters (sperm motility and sperm production) were investigated in the Persian sturgeon. The seminal fluid levels of 17α,20β,21-trihydroxy-4-pregnen-3-one (20βs), and 11-ketotestosterone (11-KT) had positive relationships with sperm motility characteristics (percentage and duration of motility) and sperm density. Also, no relationships were found between other sex steroids including: Testosterone (T), progesterone (P), 17α-hydroxyprogesterone (OHP), and milt quality parameters. The good correlation of 20βs and 11-KT of the seminal fluid with sperm motility and sperm density suggests that these steroids may be important hormones involving in final maturation of the Persian sturgeon spermatozoa.     

Simultaneous custom-made replacement of the temporomandibular joint and cranioplasty

A 23-year-old man presented with a history of fibrous ankylosis of the left temporomandibular joint (TMJ), scarring and shortening of the left temporalis muscle secondary to transection, and surgically-induced neuropathic pain after previous decompression of the temporal bone. There was evident hollowing of the left temporal fossa, and mouth opening was limited to 5 mm. The aims of the operation were to treat the ankylosis, improve cosmesis, and reduce his medication. His left TMJ was reconstructed with a custom-made alloplastic joint, and a simultaneous custom-made cranioplasty. At follow-up after 2 years he was free of pain and taking no drugs. He had no obvious cranial deformity, and his mouth opening had increased to 35 mm. To our knowledge this is the first reported case of simultaneous custom-made cranioplasty and reconstruction of the TMJ.     

Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial

International Journal of Paediatric Dentistry 2013; 23: 56–63 Objective. To compare clinical and radiographic outcomes of pulpotomy treatment using calcium‐enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious‐exposed vital immature permanent first molars. Design. Fifty‐one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and randomly assigned to one of the treatment groups (CEM [26 teeth; 59 roots], MTA [25 teeth; 59 roots]). After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored. Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs were evaluated for complete/partial apical closure. The data were analysed using chi‐square test and generalized estimating equation (GEE) model. Results. There was no significant difference at the baseline between the two experimental groups. All available cases (49 teeth) showed pulp survival and signs of continuous root development after 12 months. Overall, complete apical closure (apexogenesis) occurred in 76.8% and 73.8% of radiographically interpreted roots in CEM cement and MTA groups, respectively. There was no statistical difference in terms of radiographic outcomes between two groups. Conclusions. Calcium‐enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries‐exposed permanent molars.