Pravara Institute of Medical Sciences

Objectives: The study aims to compare the clinical and radiographic periapical healing outcomes between continuous and sequential chelation irrigation protocols (SCIP) in teeth diagnosed with periapical pathology. Methods: This double-blinded randomized controlled trial with parallel design compares the effectiveness of two irrigation protocols in root canal treatment of teeth diagnosed with periapical pathology, which are radiographically scored less than four on the Periapical Index (PAI) score. Forty samples were included in the study, meeting the specified inclusion criteria. The patients were randomly allocated to two equal groups: Sequential chelation (3% sodium hypochlorite [NaOCl] and 17% Ethylenediaminetetraacetic acid [EDTA]) and continuous chelation (3% NaOCl and 9% 1-hydroxyethane- 1,1-diphsphonic acid [HEDP]) irrigation protocols with passive ultrasonic activation. Root canal treatment was performed in multiple visits, and radiographic and clinical assessment of periapical lesion healing was evaluated at baseline, three months, and six months using the PAI score and healing scores, respectively. These evaluations were subjected to statistical analysis ( p < .05). Results: Both groups demonstrated significant improvements in clinical and radiographic outcomes at the three- and six-month follow-ups compared to baseline ( p < .001). Intergroup comparisons revealed no statistically significant differences in periapical healing or clinical symptoms at any assessment interval ( p > .05). Conclusion: Both sequential and continuous chelation irrigation protocols effectively promoted clinical and radiographic periapical healing at six-month follow-up. Hence, selecting an irrigation protocol may rely on clinician preference and procedural convenience. CTRI Registration: CTRI/2023/06/053912 (The Clinical Trials Registry-India).

Non-communicable diseases (NCDs) cause 4.7 million deaths annually in India. Floods increasingly disrupt NCD care, especially in Bihar, one of India’s most flood-prone and socioeconomically disadvantaged states. This study aims to strengthen the capacity of the community and primary healthcare systems to improve NCD outcomes during annual flooding in Bihar. We describe a type II, hybrid implementation-effectiveness parallel cluster randomised controlled trial with an embedded qualitative process evaluation. A multi-component, co-developed intervention targeting primary care and community settings will be implemented and evaluated over two flood seasons in 26 flood-prone community development blocks in three districts of Bihar. Normalisation Process Theory (NPT) will guide the interpretation and adaptation of the intervention for broader applicability. Data will be collected through baseline and follow-up cross-sectional surveys conducted immediately after and 6 months following each annual flood season. Mixed-methods implementation and effectiveness outcomes will be evaluated using the RE-AIM-QuEST (Reach, Effectiveness, Adoption, Implementation, and Maintenance, Qualitative Evaluation for Systematic Translation) framework. Co-primary outcomes are patient medication adherence and availability of a flood-proof kit with medication and clinical handover information during floods. A preliminary health economic evaluation will estimate the cost-effectiveness of the intervention from a healthcare and societal perspective, with and without the use of early-warning flood forecasting. The FUSION (Floods, UnderStanding clImate change and nON communicable disease) trial will generate evidence on effective and scalable strategies to enhance health system and community resilience for the continuity of NCD care during recurrent flooding in India. Findings will inform public health policy and disaster preparedness efforts in similar resource-constrained, climate-vulnerable settings. CTRI/2025/07/092055 [Registered on 30/07/2025] http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=138142; ISCTRN18019775 [Registered on 12/08/2025] https://www.isrctn.com/ISRCTN18019775

Screening is essential to bridge the significant care gap that exists for depression. PHQ-9 is a brief, valid, and reliable questionnaire, making it a valuable tool for detecting depression in both clinical and community settings. However, there is a lack of culturally and contextually appropriate local language versions of the PHQ-9, especially in India. This study aims to culturally adapt the existing Marathi version of the PHQ-9 for a rural Marathi-speaking population and evaluate its diagnostic accuracy and psychometric properties for detecting depression. We followed the World Health Organization’s guidelines for the cultural adaptation of the PHQ-9, followed by the assessment of criterion, construct, and convergent and divergent validity, as well as reliability. We compared the performance of the Marathi version of the PHQ-9 with that of the semi-structured diagnostic interview. We also assessed test-retest and inter-rater reliability by estimating the Intraclass Correlation Coefficient (ICC) and internal consistency by calculating Cronbach’s alpha. For the Marathi version of PHQ-9, Area Under the Curve (AUROC) was 0.88 (95

This study compared oral health status, dental caries, and salivary biomarkers (flow rate, pH, sialic acid, and total antioxidant capacity [TAC]) in children with β-thalassaemia and healthy controls and examined their associations and predictive value for caries risk. This analytical case–control study involved 80 children aged 5–12 years (40 with β-thalassaemia major and 40 age- and sex-matched controls). The unstimulated saliva was analysed for flow rate, pH, sialic acid (acidic ninhydrin method), and TAC (phosphomolybdenum method). Clinical indices included DMFT/dmft, gingival bleeding, periodontal scores, and probing depths. Statistical analyses included t-tests/Mann–Whitney U tests, Spearman correlations, multivariable logistic regression, and ROC curves (SPSS v26.0; p < 0.05). Thalassaemic children had significantly higher DMFT/dmft (median 4.5 vs. 2, p < 0.001), worse periodontal health, reduced flow rate (0.68 ± 0.26 vs. 1.7 ± 0.43 mL/min), lower pH (6.47 ± 0.17 vs. 7.21 ± 0.54), elevated sialic acid (51.23 ± 12.38 vs. 20.97 ± 3.48 μg/mL), and lower TAC (303.32 ± 88.36 vs. 888.33 ± 319.16 μmol/L; all p < 0.001). Biomarker–DMFT correlations were present in controls but absent in the thalassaemia group. Multivariable regression showed that elevated sialic acid level was the strongest predictor of high caries risk (DMFT/dmft > 3; OR = 2.50, 95

Prostate cancer (PCa) management has evolved with biomarker-driven strategies, yet biological heterogeneity, adaptive resistance, and an immunosuppressive microenvironment limit their efficacy. Galectin-3 (Gal-3) has emerged as a central node in PCa pathobiology, influencing tumor survival, metastasis, and immune escape. This review comprehensively reviews Gal-3’s dual role as a biomarker and a therapeutic target. We first delineate the limitations of the current diagnostic, prognostic, and predictive biomarkers in PCa, establishing the unmet need. We then elucidate the multifunctional biology of Gal-3, detailing its compartment-specific roles in anti-apoptosis, angiogenesis, epithelial-to-mesenchymal transition, and, notably, its function as a master regulator of immunosuppression. The interaction between Gal-3 and prostate-specific antigen (PSA) is explored as a key regulatory interface. Furthermore, we catalog and analyze emerging Gal-3-targeted therapies, emphasizing their rationale for combination with immune checkpoint blockade to reverse therapeutic resistance. Finally, we outline a translational roadmap, advocating for standardized Gal-3 biomarker assays and biomarker-enriched clinical trials. Integrating Gal-3 into the PCa precision medicine toolkit offers a novel strategy to address heterogeneity and improve therapeutic durability.