Antimicrobial resistance (AMR) is a global health issue that plays a significant role in morbidity and mortality, especially in immunocompromised patients. It also becomes a serious threat to the successful treatment of many bacterial infections. The widespread and irrelevant use of antibiotics in hospitals and local clinics is the leading cause of AMR. Under this scenario, the study was conducted in a tertiary care hospital in Lahore, Pakistan, from 2 August 2021 to 31 October 2021 to discover the prevalence of bacterial infections and AMR rates in COVID-19 patients admitted in surgical intensive care units (SICUs). Clinical samples were collected from the patients and we proceeded to identify bacterial isolates, followed by antibiotic susceptibility testing (AST) using the Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC). The data of other comorbidities were also collected from the patient’s medical record. The current study showed that the most common pathogens were E. coli (32%) and Klebsiella pneumoniae (17%). Most E. coli were resistant to ciprofloxacin (16.8%) and ampicillin (19.8%). Klebsiella pneumoniae were more resistant to ampicillin (13.3%) and amoxycillin (12.0%). The most common comorbidity was chronic kidney disease (CKD) and urinary tract infections (UTIs). Around 17 different types of antibiotic, the carbapenem, fluoroquinolones, aminoglycoside, and quinolones, were highly prevalent in ICU patients. The current study provides valuable data on the clinical implication of antibiotics consumed by COVID-19 patients in SICUs and the AMR rates, especially with different comorbidities.

Herbal products are gaining popularity in dental and medical practice nowadays due to their biocompatibility, higher antimicrobial activity, antioxidant and anti-inflammatory properties. Herbal medicine has experienced rapid growth in recent years due to its beneficial properties, ease of availability, and lack of side effects. As pathogenic bacteria become more resistant to antibiotics and chemotherapeutic agents, researchers are becoming more interested in alternative products and treatment choices for oral diseases. As a result, natural phytochemicals separated from plants and utilized in traditional medicine are suitable substitutes for synthetic chemicals. The aim of this review article is to list and understand several herbal alternatives that are currently accessible for use as efficient endodontic medicaments. The herbal products used in endodontics have several advantages, including safety, ease of use, increased storability, low cost, and a lack of microbial tolerance. However, preclinical and clinical testing and interactions with other materials and adverse effects are required for these herbal products.

Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey’s multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals.

Background: Sequential chemical application for irrigating a root canal during chemomechanical debridement can affect the dentin microstructure. Understanding the effects of various irrigants on chemical properties of dentin can elucidate their effects on physical properties and thereby explain the higher incidence of structural failure in endodontically treated teeth. This in vitro research aimed to compare and evaluate the effects of three different irrigating solutions on the chemical structure of root canal dentin in extracted human teeth. Methods: Forty-eight extracted single-rooted mandibular premolar teeth were sectioned at the cemento–enamel junction by a diamond disc and were then randomly assigned to four groups of twelve samples each. The groups were irrigated using 5.25% NaOCl, ozonated olive oil, silver citrate, or distilled water. Dentin sections measuring 1.5 mm were obtained from the root portion and each section and were analyzed using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and electron-dispersive spectroscopy (EDS). FTIR and EDS values are reported as means ± standard deviations. Data were analyzed using an ANOVA and a post hoc Bonferroni test (p < 0.05). Results: A comparison of the FTIR and EDS values among the groups using ANOVA revealed statistically significant differences in the organic and inorganic peak values among the groups. An intergroup comparison between NaOCl with silver citrate and ozonated olive oil revealed significant reductions in the carbonate and phosphate peak values in the NaOCl group (p < 0.05). The EDS values tabulated for the carbon, oxygen, phosphorous, and calcium peak levels showed significant differences between the groups using an ANOVA. An SEM analysis was conducted under 1500× magnification, which revealed smear layer removal in the silver citrate group. Conclusions: The silver citrate solution and the ozonated olive oil caused less changes in the organic and mineral contents of dentin than sodium hypochlorite.

Aim: This study compares the microhardness, water sorption and solubility of nano-zirconia-reinforced biodentin groups to commercially available biodentine. Materials and Methods: Samples were prepared by adding different percentages of nano zirconia to biodentin. Four groups were categorized as follows: group 1 used Biodentin as the control group, group 2 used 10% nano zirconia and 90% Biodentine, group 3 used 20% nano zirconia and 80% Biodentine, and group 4 used 30% nano zirconia and 70% Biodentine. A Vickers microhardness tester was used to measure the microhardness of the groups according to ISO 4049/2000. The water sorption and solubility of the divided groups were assessed using disk-shaped molds. The second weight was measured on an electronic weight machine after two weeks, and values were recorded. FTIR analysis was performed. Vickers microhardness, water sorption and solubility were analyzed using a one-way ANOVA, and for multiple comparisons, a post hoc Tukey’s HSD test with a significance level of p < 0.05 was performed. Group 3 had the highest mean microhardness measurement among all groups. The microhardness values for all groups in descending order are as follows: group 3, group 2, group 1 and group 4 (p = 0.008). Group 2 showed the lowest mean of water sorption compared among all groups. Group 2 has the lowest mean of water sorption, followed by group 3, group 1 and group 4 (p = 0.002). Group 4 showed the highest water sorption among all groups. Group 4 exhibited the highest solubility mean among all groups. Group 1 had the lowest mean of solubility, followed by group 2, group 3 and group 4 (p = 0.000). The FTIR spectra of different types of biodentin showed the absorbance peaks of the precipitates of each modified biodentin. The absorbance peaks fell between 474.63 cm⁻¹ and 3438.33 cm⁻¹. Conclusion: Biodentin is a competitive biomimetic material, but it lacks hardness and has more solubility. Thus, adding nano zirconia improved microhardness and reduced water sorption. The solubility of 20% nano zirconia added to biodentin was almost close to biodentin but with no significance. The 20% nano-zirconia-modified biodentin showed overall better properties compared to biodentin. The 20% nano-zirconia-modified biodentin can be used in deep cavities as a single restorative material instead of multi-layered restorations to increase longevity without microleakage and failure of restoration.

Background: The authorities of the world had to take extraordinary containment measures due to the coronavirus (COVID-19) pandemic spreading across the globe. The only way to stay active during the pandemic was at-home physical activity (PA). The current study evaluates how these preventative measures impacted the PA and well-being of students. Methods: This study is multicentral and was conducted in Malaysia, India, Cambodia, and Saudi Arabia; participants were recruited from four different regions to answer the online questionnaire provided via a link shared using their personal WhatsApp, Facebook Messenger, and Twitter social media. Results: The means of vigorous, moderate, and light PA (min/day) between the active and inactive groups were significantly different (p = 0.001, 0.007, and 0.001), respectively. In comparison with pre-COVID-19, the participants reported that it became more challenging to engage in regular exercise since the onset of social distance, associated with a lack of motivation followed by “less confidence”, “less enjoyment”, “less support, and fewer opportunities to engage in exercise”; moreover, it was “difficult to maintain close relationships” and “hard to voice their options on contentious matters” (p = 0.001). Public health measures affected the PA and well-being of active and inactive students; this demonstrates that health promotion strategies aimed at enhancing levels of PA in inactive students may be necessary to improve students’ well-being.