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Does HIV infection affect the survival of dental implants? A systematic review and meta-analysis

Sivakumar I, Arunachalam S, Choudhary S, Buzayan MM

J Prosthet Dent, 2021 Jun;125(6):862-869.
PMID: 32694022 DOI: 10.1016/j.prosdent.2020.04.001

STATEMENT OF PROBLEM: Immunosuppression and coinfections associated with human immunodeficiency virus (HIV) infection pose a relative contraindication for dental implant therapy. However, although implants have been placed in patients with HIV with reasonable success, how HIV infection affects their survival is unclear.
PURPOSE: The purpose of this systematic review of the literature and meta-analysis was to analyze the data on the survival of dental implants in patients with HIV.
MATERIAL AND METHODS: A search for relevant articles published up to November 2019 was performed in PubMed/Medline and Cochrane databases, Clinicaltrials.gov, and Google Scholar. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted for the conduct of the systematic review. The most pertinent data were extracted and pooled for qualitative and quantitative analyses with 95% confidence intervals. Heterogeneity was analyzed by using I-squared statistics.
RESULTS: A total of 8 studies involving 411 individuals with HIV and 1109 implants were included in the meta-analysis. The mean follow-up period was 2.8 years. A pooled estimate of 95% of implant survival rate with 95% confidence interval(92% to 96%) was noted. Heterogeneity across the 8 studies was found to be 41% with moderate true variability.
CONCLUSIONS: This systematic review demonstrated that HIV infection does not pose a serious threat to implant survival on short-term evaluation, but the evidence is of low quality.
Stomach specific polymeric low density microballoons as a vector for extended delivery of rabeprazole and amoxicillin for treatment of peptic ulcer

Choudhary S, Jain A, Amin MCIM, Mishra V, Agrawal GP, Kesharwani P

Colloids Surf B Biointerfaces, 2016 May 01;141:268-277.
PMID: 26859118 DOI: 10.1016/j.colsurfb.2016.01.048

The study was intended to develop a new intra-gastric floating in situ microballoons system for controlled delivery of rabeprazole sodium and amoxicillin trihydrate for the treatment of peptic ulcer disease. Eudragit S-100 and hydroxypropyl methyl cellulose based low density microballoons systems were fabricated by employing varying concentrations of Eudragit S-100 and hydroxypropyl methyl cellulose, to which varying concentrations of drug was added, and formulated by stirring at various speed and time to optimize the process and formulation variable. The formulation variables like concentration and ratio of polymers significantly affected the in vitro drug release from the prepared floating device. The validation of the gastro-retentive potential of the prepared microballoons was carried out in rabbits by orally administration of microballoons formulation containing radio opaque material. The developed formulations showed improved buoyancy and lower ulcer index as compared to that seen with plain drugs. Ulcer protective efficacies were confirmed in ulcer-bearing mouse model. In conclusion, greater compatibility, higher gastro-retention and higher anti-ulcer activity of the presently fabricated formulations to improve potential of formulation for redefining ulcer treatment are presented here. These learning exposed a targeted and sustained drug delivery potential of prepared microballoons in gastric region for ulcer therapeutic intervention as corroborated by in vitro and in vivo findings and, thus, deserves further attention for improved ulcer treatment.
Do Highly Active Antiretroviral Therapy Drugs in the Management of HIV Patients Influence Success of Dental Implants?

Sivakumar I, Arunachalam S, Choudhary S, Mahmoud-Buzayan M, Tawfiq O, Sharan J

AIDS Rev, 2020;22(1):3-8.
PMID: 32167505 DOI: 10.24875/AIDSRev.20000107

HIV infection is a global pandemic that affects CD4 cells in the immune system and leads to lethal opportunistic infections. The advent of highly active antiretroviral therapy (HAART) has induced a marked reduction in the viral load and an increase in the CD4 cell count, thereby changing the course of the disease from an acute life-threatening condition to chronic disease. Accordingly, need and demand for oral rehabilitation in HIV positive population have increased in recent years. However, few drugs used in the HAART regimen have also known to be associated with osteopenia and osteoporosis. Although HAART reduces the morbidity in HIV patients, it remains unknown to what extent the therapy influences the implant healing. Few scientific literatures have identified osteoporosis and HIV infection as an unconducive milieu for dental implant placement and survival but demonstrated favorable outcomes in short-term assessments. The long-term impact of bone metabolic effects of HAART on implant success remains a conundrum.
Brain Tumor Classification Using Deep Neural Network and Transfer Learning

Kumar S, Choudhary S, Jain A, Singh K, Ahmadian A, Bajuri MY

Brain Topogr, 2023 Apr 15.
PMID: 37061591 DOI: 10.1007/s10548-023-00953-0

In the field of medical imaging, the classification of brain tumors based on histopathological analysis is a laborious and traditional approach. To address this issue, the use of deep learning techniques, specifically Convolutional Neural Networks (CNNs), has become a popular trend in research and development. Our proposed solution is a novel Convolutional Neural Network that leverages transfer learning to classify brain tumors in MRI images as benign or malignant with high accuracy. We evaluated the performance of our proposed model against several existing pre-trained networks, including Res-Net, Alex-Net, U-Net, and VGG-16. Our results showed a significant improvement in prediction accuracy, precision, recall, and F1-score, respectively, compared to the existing methods. Our proposed method achieved a benign and malignant classification accuracy of 99.30 and 98.40% using improved Res-Net 50. Our proposed system enhances image fusion quality and has the potential to aid in more accurate diagnoses.
Male Infertility: Causes and Management at a Tertiary Care Center in India

Choudhary S, Mishra V, Kumari P, Sheth H, Ahmad R, Haque M, et al.

Cureus, 2023 Sep;15(9):e45584.
PMID: 37736241 DOI: 10.7759/cureus.45584

Background Infertility and problems of impaired fecundity have been a concern through the ages and are also considerable clinical problems today, affecting many couples worldwide. Most infertility cases are primarily attributed to male factors, which play a significant role. Additionally, a substantial number of these patients exhibit suboptimal sperm parameters. The study is mainly designed for individual intervention and outcome. We aim to evaluate the demographics, etiology, utilization of treatments, and outcomes of males undergoing infertility treatment. Methodology We retrospectively enrolled infertile couples from January 2021 to March 2023, covering the past two years. All patients were evaluated and investigated per the study protocol to identify the cause of infertility. Results Two thousand three hundred forty-eight males were enrolled in the study, of whom 1,484 (63%) were found to have a standard semen analysis. A total of 868 (37%) had abnormal semen parameters. Two hundred and seventy-two (12%) patients completed the evaluation. All parameters, except for hypospermia, displayed lower percentages of motility compared to normozospermia. All semen parameters, except for hypospermia, showed a significantly lower normal morphology in comparison to normozospermia. This reduction increased by 10% for each year of age increment. Conclusions The study concluded by following a protocol for evaluating male patients. If an abnormal sperm parameter is identified before considering intracytoplasmic sperm injection (ICSI), it is recommended to conduct at least karyotyping and microdeletion analysis on the Y-chromosome's q arm.