Periodontitis is an infectious illness which leads to the inflammation of protective tissues around the teeth and the continuous loss of alveolar bone and conjunctive tissue. Biomarker analysis in serum and saliva helps in the evaluation of disease progression and activity. It is also established that every inflammatory change along with resultant damage of tissues ends up in altered pH values in the fluids and tissues. Aim: To correlate the connection of pH levels in both blood as well as saliva in healthy, periodontitis, and gingivitis patients. Materials and Methods: The current research involved 145 subjects amidst the age of 20 and 55 years. The subjects were split into three different groups: healthy (Group A), gingivitis (Group B), and finally chronic periodontitis (Group C). The recording of clinical parameters was done by gingival index (GI), probing depth (PD), and plaque index (PI). pH of saliva and blood was analyzed with the help of digital single electrode pH meter. Subjects have gone through scaling and root planning (SRP) coupled with the instructions of oral hygiene. They were recalled post 4 weeks, and saliva and blood samples were gathered for analyzing pH. Results: Clinical parameters GI and PI were statistically important in both group C as well as group B post SRP. A crucial change has been observed in attachment levels (AL) and PD in the case of periodontitis group post SRP. The difference in the salivary pH values were significant between group B vs. C and A vs. C before the treatment because the values for group C were acidic, whereas in groups B and A the pH was alkaline. After the treatment, the values were still significant because the pH has become more alkaline compared to preoperative value in both group B and C. Saliva’s pH levels have demonstrated a statistically significant reduction in group C post SRP. Conclusion: Salivary pH levels and blood evidently became alkaline in the group C patients post SRP and there is a positive correlation between them and the clinical parameters.

The long-term solution to managing the current COVID-19 pandemic is through mass immunization of the population. However, uncertainty or unwillingness to receive the vaccine could be a barrier in attaining sufficient vaccine coverage. Therefore, understanding the psychology of the population towards the vaccines against COVID-19 is of paramount importance. Our study was aimed at determining the predictors of COVID-19 vaccine intention in the Saudi Arabian population. A structured questionnaire guided by the ‘Report of the SAGE working group on vaccine hesitancy’ was administered during a span of two months among the general population from all administrative regions of Saudi Arabia, proceeding the launch of the vaccination campaign. In total, 879 out of 1600 subjects responded and completed the survey (response rate 54.9%). About 56 percent of the participants intended to be vaccinated. The predictors of a higher intention to vaccinate included those 50 years of age or older, male subjects, people suffering from systemic disease/s, subjects who were not previously infected with COVID-19, those who follow the updates about COVID-19 vaccines, and adults with a higher level of anxiety about contracting coronavirus (p < 0.05). Results from our study and other similar studies can aid policy makers and stakeholders in planning effective strategies based on the changing behavior of the population.

In-depth studies on essential oil–based nanoemulsions (NEs) have centered on a variety of oral health issues. NEs improve the delivery of nonpolar active agents to sites and thereby boost the dissolution and distribution of the agents. Metronidazole-peppermint oil-tranexamic acid self-nanoemulsifying drug delivery systems (MZ-PO-TX-SNEDDS) were created and loaded into novel lozenges to act as antifungal, hemostatic, antimicrobial, and analgesic dosage forms after dental extractions. The design-of-experiments approach was used in creating them. To generate the NEs, different concentrations of MZ-PO (240, 180, and 120 mg), 2% TX (600, 450, and 300 mg), and S_mix1:1 (600, 400, and 200 mg) were used. The ideal formulation had serum levels of 1530 U/mL of interleukin-6, a minimal inhibitory concentration against bacteria of 1.5 µg/mL, a droplet size of 96 nm, and a blood coagulation time of 16.5 min. Moreover, the produced NE offered better MZ release. The adopted design was used to produce the ideal formulation; it contained 240 mg of MZ-PO, 600 mg of 2% TX, and 600 mg of S_mix1:1. It was incorporated into lozenges with acceptable characteristics and an improved capability for drug release. These lozenges had reasonable coagulation times, IL-6 serum levels, and MIC values. All of these characteristics are desirable for managing symptoms following tooth extractions. Therefore, these lozenges loaded with MZ-PO-TX-SNEDDs might be considered a beneficial paradigm for relieving complications encountered after tooth extractions.

Background: Bedaquiline (BDQ), delamanid (DLM), and linezolid (LZD) are core drugs for multidrug-resistant tuberculosis (MDR-TB) treatment. Comprehensive regional data on phenotypic susceptibility and genotypic resistance-associated mutations are essential to guide optimized therapy. This study aimed to characterize phenotypic and genotypic resistance in treatment-naïve MTBC isolates by determining MICs of BDQ, DLM, and LZD and identifying associated genetic mutations. Methods: Minimum inhibitory concentrations (MICs) of BDQ, DLM, and LZD were determined for 71 Mycobacterium tuberculosis isolates (30 fully drug-susceptible and 41 MDR-TB) collected in the Cukurova region of Southern Türkiye between 2021 and 2023 using the MGIT 960/EpiCenter system. Sequencing of resistance-associated genes was analyzed: atpE and Rv0678 for BDQ, ddn and fbiA for DLM, and rrl and rplC for LZD. Results: MICs ranged from ≤0.025–6.4 µg/mL for BDQ, 0.005–0.32 µg/mL for DLM, and 0.125–2 µg/mL for LZD. According to WHO breakpoints, resistance rates were 7.0% for BDQ, 4.2% for DLM, and 7% for LZD, all confined to MDR-TB isolates. Nine MDR-TB isolates (12.7%) harbored atpE mutations, including both previously reported and putatively novel substitutions. A single ddn mutation was detected in a DLM-susceptible isolate. No mutations were observed in Rv0678, fbiA, rrl, or rplC. Conclusion: BDQ, DLM and LZD showed strong activity against MDR-TB isolates. However, the presence of atpE variants in both resistant and susceptible isolates demonstrated genotype-phenotype discordance of resistance. These results underline the necessity of the combination of genetic and phenotypic testing for detection of resistance and guidance for treatment.

Background: To determine the molecular relationship between pyrazinamide (PZA) and bedaquiline (BDQ) resistance mechanisms in multidrug-resistant tuberculosis (MDR-TB) and drug-susceptible Mycobacterium tuberculosis (M. tuberculosis) isolates to improve treatment strategies. Methods: Phenotypic drug susceptibility testing (DST), resistance gene amplification and sequencing (pncA, panD, hadC, and Rv0678), and efflux pump gene expression (mmpS5 and mmpL5) by qRT-PCR were performed on 71 clinical MTBC isolates from seven provinces in Southern Türkiye (2022-2023). Results: PZA resistance was closely associated with MDR-TB (χ² = 38.0, p < 0.0001), exclusively detected in MDR isolates (42% overall; 73% of MDR). pncA mutations were detected in 77% of PZA-resistant isolates with strong genotype-phenotype correlation (p = 0.009, r = 0.45), while panD mutations were present in 40% and showed less association (p = 0.14). No hadC or Rv0678 mutations were identified despite significant overexpression of efflux genes mmpS5 and mmpL5 in MDR strains (p < 0.001). Conclusions: PZA and BDQ resistance arise through distinct, non-overlapping mechanisms. PZA-resistant MDR-TB without Rv0678 mutations confirms bedaquiline's independent therapeutic value and success in treating PZA-resistant cases.

Introduction: The adhesion of bacteria to implanted devices in the human body is a major risk factor that can affect the long-term success of these devices. Staphylococcus epidermidis (S. epidermidis) have few virulence factors which have been identified and reported including autolysin (AtlE), Polysaccharide Intercellular Adhesin (PIA), Fibrinogen Binding Protein (SdrG) and Lipase enzymes (GehC and GehD). These virulence factors play an important role in the pathogenesis of S. epidermidis. Aim: To investigate the role of some of the virulence factors of S. epidermidis in the adhesion to three different types of intravascular cannulae used in hospitals. Materials and Methods: Three different types of most commonly used intravascular cannulae in hospitals were tested in this study. Polytetrafluoroethylene (PTFE), Siliconized Polytetrafluoroethylene (SPTFE) and Vialon cannulae were incubated with different S. epidermidis strains, including the mutant strains that were deficient in a specific virulence factor, each separately. The virulence factors tested with each strain were AltE, PIA, SdrG and Lipase enzymes (GehC and GehD). The number of detached bacteria were determined by plating serial dilutions on agar plates. Experiments were repeated and expressed as means and standard deviations with at least three experiments. Results were computed and analysed using Statistical Package for Social Sciences (SPSS) version20 program. Tabulated values were compared with a student's t-test. Statistical significance was defined as p<0.05. Results: All three types of intravascular cannulae showed significant reduction in adhesion by means of cfu/mL with the mutant strains deficient in adhesion factors when compared to the wild strains. The reduction in the percentages of adhesion of AtlE-strain when compared to wild type strain were 35% for PTFE, 38% for SPTFE and 48% for Vialon cannula. This was statistically significant. PTFE (p-value=0.005), SPTFE (p-value=0.02), and Vialon (p-value=0.001). Likewise, all three types of cannulae showed reduction that was statistically significant except for one mutant strain which was deficient in GehC lipase. However, GehD lipase showed statistically significant reduction in adhesion of bacterial colonies similar to mutant strains for PIA and SdrG indicating a role of these virulence factors in the process of adhesion to biomaterials. Conclusion: The virulence factors of S. epidermidis; AtlE, PIA, SdrG and Lipase GehD, play an important role in the adhesion to intravascular cannulae. Further researches are needed to investigate the involvement of other virulence factors in order to understand and prevent such mechanism.