The Effect of Premedication with Curcumin on Post-Operative Pain in Single Visit Endodontic Treatment of Acute Pulpitis in Mandibular Molars: A Randomized Controlled Trial

Objective: The purpose of this randomized double-blind clinical trial was to compare the effect of a single pretreatment dose of Curcumin and placebo on post-operative pain for patients diagnosed with symptomatic irreversible pulpitis in mandibular molars treated in single visit. Methods: Forty-four patients with severe to moderate pain randomly received either Curcumin (400mg +20 mg pepper) or placebo (420 mg Starch) one hour before starting root canal treatment (n = 22 per group). Participants rated their pain using visual analogue pain scale (VAS): preoperatively and at 5 time points: immediately post-operative, 8, 12, 24 and 48 hours postoperative. Patients also stated emergency analgesic intake. The need for supplemental anesthesia during treatment was recorded. Mann-Whitney U-test compared the two groups at each time point, while Repeated-Measure ANOVA and Wilcoxon Signed Rank test compared time points within each group. A p-value <0.05 was considered statistically significant. Results: Baseline characteristics of both groups showed non-significant differences (P > 05). Curcumin group at 8, 12 and 24 hours revealed statistically significantly less VAS values (44.2, 26.7, 19.1) than the placebo (58.5, 43.3, 30.3), respectively, (P > 05). All patients in Curcumin group did not need emergency analgesics. Curcumin group revealed statistically significantly lower percentages for the need of supplemental anesthesia (27.3%) compared to placebo (68.2%), (P < 05). Conclusion: Single preoperative oral dose of Curcumin proved to be an effective premedication that reduced post-operative pain as well as the need of supplemental anesthesia for patients diagnosed with symptomatic irreversible pulpitis of mandibular molars.

Comparison of Effects of Different Endodontic Irrigating Solutions on Post-Operative Pain during Single Visit RCT

Aims: Comparing the effects of normal saline, 5.25% sodium hypochlorite and 2% chlorhexidine on the post-operative pain intensity after a single visit root canal treatment. Methods: A total of 120 male and female patients requiring an endodontic treatment for necrotic teeth with chronic apical periodontitis were randomly divided into three equal groups (40 each) according to the type of root canal irrigating solution, i.e. group A (normal saline {NaCl}), group B (sodium hypochlorite {5.25% NaOCl}) and group C (chlorhexidine {2.0% CLX}) . The post-operative pain intensity was determined using a self-explanatory questionnaire with four-point pain intensity scale at 6 hrs and 24 hrs and on 4th, 7th and 10th day after a single visit endodontic procedure. Tukey’s test was used to compare significant pain intensity among three root canal irrigating solution. Results: Among group A (NaCl) participants, most of them experienced mild pain at 6th hr. The mean pain score was further compared among the three irrigant groups at different time intervals by Post hoc comparison using Tukey’s HSD test, which showed that group A (NaCl) had a significant difference (p ≤ 0.05) with a mean pain value of 0.66±1 at 6th hr post-endodontic pain determination as compared to group B (5.25% NaOCl) and group C (2.0% CLX) where the mean pain value was 1.05±0.91 and 2.48±0.55 respectively. Conclusion: The present study concludes that normal saline should not be used as the sole root canal irrigant during the endodontic treatment especially when the involved teeth are having necrotic pulp and chronic peri-radicular periodontitis to avoid the incidence of post-endodontic pain. Keywords: Endodontics, Irrigant, Pain, Chlorhexidine.

Comparative Efficiency of Native Insect Pollinators in Reproductive Performance of Medicago sativa L. in Pakistan

Lucerne (Medicago sativa L.) is a cross-pollinated crop and requires entomophilous pollination for tripping of flowers and subsequent pod and seed set. To discover the best pollinators for lucerne seed production, a two-year field trial was carried out at the research farm of MNS University of Agriculture, Multan, Pakistan. Abundance and diversity of insect pollinators along with the foraging behavior were recorded in terms of tripping efficiency, stay time, visitation rate and pollen harvest. The single-visit efficiency of abundant insect pollinators was also evaluated in terms of number of seeds and seed weight per raceme along with germination percentage. Ten most abundant floral visitors (five solitary bee species, three honeybee species and two syrphid fly species) were tested for their pollination efficiency. Honeybees were most abundant in both the years followed by the solitary bees and syrphid flies. Single-visit efficacy in terms of number of pods of raceme, number of seeds per raceme, 1000 seed weight and germination percentage revealed Megachile cephalotes as the most efficient insect pollinator followed by Megachile hera and Amigella sp. Future studies should investigate the biology and ecology of these bee species with special emphasis on their nesting behavior and seasonality.

Validation of Rapid Interactive Screening Test for Autism in Toddlers Using Autism Diagnostic Observation Schedule™ Second Edition in Children at High-Risk for Autism Spectrum Disorder

The Rapid Interactive screening Test for Autism in Toddlers (RITA-T) is a fast and inexpensive early screening measure for autism spectrum disorder (ASD) that was tested previously in children 18–36 months-old; the current validation study compared the RITA-T with the Autism Diagnostic Observation Schedule™ Second Edition (ADOS-2). The hypothesis is to validate the RITA-T with comparison to the ADOS-2. Thirty-five individuals (18–84 months-old) identified as at risk for ASD received the RITA-T and the ADOS-2 during a single visit. Participants were split into two age groups and both whole-group and sub-group data analysis were conducted. With all participants, RITA-T scores correlated significantly with ADOS-2 total scores (P &lt; 0.001), social affect (SA) sub-scores (P &lt; 0.001), and restrictive and repetitive behavior (RRB) sub-scores (P &lt; 0.05). Similarly, ADOS-2 total and SA scores were significantly correlated in both age groups, while the RRB sub-score was only significant in females (P &lt; 0.05). Lastly, correlations using subgroups based on ethnicity were only significant in the minority (“Other”) group for ADOS-2 total scores and in the Asian group for SA sub-scores (P &lt; 0.05). Our receiver operating characteristic analysis showed that the optimal cut-off score of the RITA-T was consistently at 14, with a sensitivity of 81% and a specificity of 89% in the combined age group with the ADOS-2 and with a sensitivity 74% and specificity 50% with the DSM-5; The area under the curve was 0.84 (95%CI: 0.69–0.99) for ASD classified by ADOS-2 and 0.89 (95%CI: 0.79–0.99) for ASD diagnosed by DSM-5. The RITA-T performed similarly to the ADOS-2 when both were administered in a single visit. Significant correlations between the measures help validate the potential usefulness of the RITA-T as a rapid early screening measure of ASD. This study helps to show that the RITA-T may be used in a larger age range than originally reported and in different ethnic groups. The study involves human participants and was reviewed and approved by the Institutional Review Board (IRB) of Massachusetts General Hospital (MGH, 2017P0000857).