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Antibacterial effectiveness of novel polyherbal gel, chlorhexidine gluconate, and calcium hydroxide as intracanal medicaments in infected root canals using real-time PCR: a randomized controlled trial

2026-06-03T00:00:00Z

Title: Antibacterial effectiveness of novel polyherbal gel, chlorhexidine gluconate, and calcium hydroxide as intracanal medicaments in infected root canals using real-time PCR: a randomized controlled trial Authors: Roopali M; Anil V. Ankola, Vinuta Hampiholi, Ram Surath Kumar,Manohar S. Kugaji, Sankeshwari Varkey Nadakkavukaran Santhosh, Atrey J. Pai Khot,Kavitha Ragu, Mohammed Mustafa, Ahmed A. Almokhatieb Abstract: Purpose: This study aimed to evaluate the antibacterial effectiveness of three intracanal medicaments: Achyranthes aspera and Trachyspermum ammi based novel polyherbal gel, chlorhexidine gluconate gel, and calcium hydroxide paste, against Enterococcus faecalis in infected root canals by means of Real- Time Polymerase Chain Reaction (qPCR) for bacterial quantification. Methods: A triple-arm, randomized controlled trial was conducted on 45 permanent mandibular and maxillary incisor and canine teeth diagnosed with asymptomatic apical periodontitis. Participants were randomly divided into three equal groups (n = 15), each receiving a different intracanal medicament. Microbiological samples were collected using sterile absorbent paper points at two time points: before instrumentation and after 7-day of intracanal medicament placement. The intracanal medicaments tested were a novel polyherbal gel, 1% (w/w) chlorhexidine gluconate gel, and calcium hydroxide paste. Total DNA of Enterococcus faecalis was extracted from these samples, and qPCR was performed to determine the bacterial quantification at both intervals. The primary outcome was the reduction in Enterococcus faecalis load, indicating the antibacterial efficacy of each medicament. Results: All the groups showed a significant reduction in Enterococcus faecalis counts from baseline to day 7. However, the chlorhexidine gel and calcium hydroxide paste exhibited significantly greater reductions than the polyherbal gel (p < 0.05). Conclusions: All three intracanal medicaments tested were effective in significantly reducing Enterococcus faecalis counts. However, the chlorhexidine gel and calcium hydroxide paste demonstrated significantly greater reductions compared to the polyherbal gel. For routine endodontic practice, chlorhexidine gel and calcium hydroxide remain more reliable choices for intracanal disinfection against Enterococcus faecalis and should be preferred in cases with high microbial load. The polyherbal gel, while antibacterial, may be better suited as an adjunct rather than a primary medicament in endodontic disinfection protocols.

AI In Leukemia Diagnostics: Complementing the Pathologist's Role

2026-06-25T00:00:00Z

Title: AI In Leukemia Diagnostics: Complementing the Pathologist's Role Authors: Sayandeep K. Das, Kusal K. Das Abstract: Artificial intelligence (AI) is reshaping every stage of leukemia diagnostics, from digital morphology and multiparameter flow cytometry to next-generation sequencing, multi-omics analysis, and emerging computational frontiers such as quantum-inspired feature selection. This review outlines how contemporary AI tools can automate labor-intensive quantitation, flag diagnostically salient patterns, and standardize interpretation, while the pathologist or hematologist retains authority over validation, context-specific integration, and clinical decision-making. We present an illustrative “human-in-the-loop” workflow that embeds AI modules within current laboratory information systems, emphasizing points where expert oversight mitigates algorithmic bias and resolves discordant findings. We further map the validator–integrator role across morphology, flow cytometry, and genomic/multi-omic interpretation and provide practical training competencies and use cases for AI-assisted hematopathology. Beyond technical deployment, the article addresses the educational transformation required for sustainable adoption. Drawing on in-ternational competency frameworks, including the Digital Health Competencies in Medical Education Framework and recently proposed AI-specific Entrustable Professional Activities, we map core skills that future hematopathologists must master: data-science literacy, critical appraisal of AI outputs, and ethical governance. We highlight evaluated training models such as the Pathology Informatics Essentials for Residents curriculum, Stanford Artificial Intelligence in Machine and Imaging workshops,and College of American Pathologists bootcamps and propose integration strategies adaptable across resource settings. By pair-enabling rigorous validation with targeted education, AI can elevate rather than eclipse the diagnostic role of the leukaemia specialist,enabling more timely, reproducible, and personalised patient care

Patterns of extrapulmonary tuberculosis and the role of cartridge based nucleic acid amplification test in the diagnosis of extrapulmonary tuberculosis

2026-03-01T00:00:00Z

Title: Patterns of extrapulmonary tuberculosis and the role of cartridge based nucleic acid amplification test in the diagnosis of extrapulmonary tuberculosis Authors: Shivanand Gundalli, Surekha U. Arakeri Abstract: Background: Extrapulmonary tuberculosis (EPTB) was underdiagnosed due to its varying and nonspecific symptoms and limited diagnostic tools. Recent data suggest that there is an increase in the incidence of EPTB due to the availability of the newer diagnostic tools. Objectives: This study aims to evaluate the patterns and role of newer diagnostic tools, such as cartridge‑based nucleic acid amplification test (CBNAAT), in EPTB. Methods: Six hundred and thirty‑six patients with a presumptive diagnosis of EPTB were subjected to diagnostic tools, such as cartridge‑CBNAATs, Ziehl–Neelsen (Z–N) stain, and cytology or histopathology. Results: Out of 636 presumptive cases of EPTB, 116 cases were positive for tuberculosis. The cartridge‑CBNAAT showed positivity in all 116 cases. Out of these 116 EPTB cases, only 10 cases were positive on Z–N stain, and 24 cases were positive on cytology and histopathology. The most common sites affected were the lymph nodes and the pleural cavities. Conclusion: Cartridge‑CBNAAT gives a rapid result and plays a significant role in the diagnosis of EPTB.

Role of immunohistochemistry in the diagnosis and clinicopathological stratification of gliomas

2026-03-01T00:00:00Z

Title: Role of immunohistochemistry in the diagnosis and clinicopathological stratification of gliomas Authors: Pragya Jaiswal , Mamatha K , Basavaraj Badadal Abstract: Introduction Gliomas are common primary brain tumors. Immunohistochemical components, such as isocitrate dehydrogenase (IDH) mutations, GFAP (glial fibrillary acidic protein), ATRX (alpha-thalassemia/mental retardation, X-linked), and Ki-67, play a pivotal role in glioma diagnostic classification and risk stratification in prior literature. This study aimed to evaluate the association of IDH1 (R132H) IHC as a surrogate marker within the World Health Organization (WHO) integrated framework and to correlate the expression of IDH1 (R132H) with clinicopathological parameters in gliomas. Methods A hospital-based cross-sectional study was conducted on 30 histologically confirmed glioma cases, with an age range from 1 to 70 years. Clinicopathological parameters such as age of the patient, gender, tumor location, histological type, and World Health Organization tumor grade were recorded. Immunohistochemistry for IDH1 (R132H), Ki-67, GFAP, and ATRX was performed. Associations were assessed using Fisher's exact test (2×2 tables) and Fisher-Freeman-Halton exact test (r×c tables), with p < 0.05 considered significant. Results IDH1 (R132H) immunopositivity was seen in 19 cases (63.3%). ATRX retention was observed in 63.3% of cases, GFAP positivity in 93.3%, and a high Ki-67 index in 50% of cases. IDH1 (R132H) IHC status showed a statistically significant association with age, histological type, and WHO grade. No statistically significant association was observed with gender, ATRX, GFAP, or Ki-67 expression. Conclusion IDH1 (R132H) immunohistochemical expression showed a significant association with established clinicopathological indicators, including patient age, histological type, and WHO tumor grade. In this hospital-based cross-sectional study, IDH1 (R132H) IHC-negative status was more frequently observed in higher-grade tumors. These findings support the use of immunohistochemistry as an accessible adjunct in glioma diagnosis and clinicopathological stratification; outcome-based prognostic significance requires longitudinal follow-up.