Objective Mechanisms of abdominal pain in children are not fully understood due to patient heterogeneity. We aimed to identify abdominal pain phenotypes in children to facilitate the investigation of phenotypic-genotypic associations and to determine risk factors for abdominal pain.Design This study included 13,789 children from a large birth cohort. The comorbidities of children and mothers and single nucleotide polymorphisms in children were investigated. Machine learning (ML) was used to identify clusters of patients with homogenous characteristics; subsequently, genome-wide association studies and enrichment analyses were performed. The factors contributing to predictive models were identified using ML.Results A total of 1,274 children experienced abdominal pain (9.2 %) (average age: 8.4 ± 1.1 years old, male/female: 615/659), who were classified into 3 clusters: cluster 1 with an allergic predisposition (n = 137), cluster 2 with mother’s comorbidities (n = 676), and cluster 3 with minimal comorbidities (n = 340). Enrichment analysis indicated that genetic pathways related to the intestinal barrier or bile acid biosynthesis were associated with abdominal pain in cluster 1; bile acid biosynthesis was also involved in cluster 2. Predictive models demonstrated modest fidelity with AUC values up to 0.65 in predicting children’s abdominal pain, showing mother’s and children’s comorbidities formed significant risk factors.Conclusion The risk factors and phenotypes of paediatric abdominal pain are embedded within phenotype-genotype associations, which can be targeted in future studies. In particular, the link between allergy and intestinal barrier may be of mechanistic and therapeutic importance.### Competing Interest StatementThe authors have declared no competing interest.### Funding StatementThis study was supported by JA Niigata Kouseiren Grant (Niigata University School of Medicine).### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:The study used human data that are available with permission.I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesAll data produced in the present study are available upon reasonable request to the authors.

OBJECTIVE: To evaluate and compare the influence of three local anesthetic dental formulations manufactured in France (Septodont), Korea (Medicaine) and Pakistan (HD-Caine) in terms of cytotoxicity and anti-bacterial activities. METHODOLOGY: 90 commercially available local anesthetic cartridges of similar composition (2% lidocaine with epinephrine 100,000) viz. Septodont, Medicaine and HD-Caine were randomly collected from three different Pakistani cities and were assigned as Group S, Group M and Group H, respectively. The cartridges were further divided into three sub-groups each consisting of 10 cartridges to first evaluate cytotoxicity on Mesenchymal Stem Cells (MSCs) using a flow cytometer and secondly to investigate anti-bacterial activity by measuring zones of inhibition and through Broth Dilution Method against five bacterial strains. RESULTS: The results indicated that Septodont (94.5±0.1) and Medicaine (94.7±0.0) showed the highest viability percentage with no significant difference when the two were compared (P=0.6). HD-Caine (93.9±0.0) showed the least, being significantly (P<0.01) different from Septodont and Medicane. A statistically significant (P<0.05) difference was identified between the three study groups regarding the anti-bacterial activity. HD-Caine showed the highest anti-bacterial potential, followed by Medicaine and Septodont. CONCLUSION: Mild toxicity was observed by all the three groups in human MSCs, justifying their safe use in clinical practice. Additionally, Medicane and HD-Caine showed significant anti-bacterial activity indicating their possible use as sterile irrigants. KEYWORDS: Dental anesthesia, Lidocaine, Epinephrine, Antibacterial activity HOW TO CITE: Imran E, Moeen F, Satti H, Rahman L. Investigating the cytotoxic and anti-bacterial activity of commercially available local anesthetics: An in-vitro analysis. J Pak Dent Assoc 2020;29(4):185-192.