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  1. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies
    Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P
    Clin Oral Investig, 2018 Mar;22(2):655-670.
    PMID: 29372445 DOI: 10.1007/s00784-018-2345-x
    OBJECTIVES: Reduction of microbial load from the root canal systems is a pre-requisite for healing of lesions of endodontic origin. Such microbial reduction is influenced by the method of irrigant delivery and activation. The aim of this systematic review was to compare the effect of ultrasonically activated irrigation (UAI) with other irrigation techniques on the reduction of microorganisms during root canal disinfection.

    MATERIALS AND METHODS: The research question was created based on the PICO strategy. Two reviewers independently performed a comprehensive literature search in electronic databases. Following application of inclusion and exclusion criteria to the selected articles, a systematic data extraction sheet was constructed. The selected articles were assessed using methodological quality scoring protocol. The risk of bias in selected studies was critically assessed by two reviewers.

    RESULTS: A total of 15 articles were included for the systematic review. The included studies were heterogeneous in study design; hence, meta-analysis was not performed. The overall risk of bias for the selected studies was moderate. Overall, UAI showed superior reduction of microbial counts, resulting in better disinfection compared to other irrigation systems chosen for comparison in this review.

    CONCLUSION: The use of UAI can bring about superior microbial reduction within the root canal system compared to other irrigant activation techniques.

    CLINICAL RELEVANCE: Activation of irrigants with ultrasonic brings about significant bacterial reduction from the root canal systems compared to other methods of irrigant activation and conventional syringe irrigation. This might help in improving the outcome of root canal treatment.

  2. Fulltext Recommendations for the optimal care of patients with recent-onset psychosis in the Asia-Pacific region
    Lo TL, Warden M, He Y, Si T, Kalyanasundaram S, Thirunavukarasu M, et al.
    Asia Pac Psychiatry, 2016 Jun;8(2):154-71.
    PMID: 27062665 DOI: 10.1111/appy.12234
    Providing optimal care to patients with recent-onset psychosis can improve outcomes and reduce relapse. However, there is a lack of consistency of the implementation of guidelines for such patients across the Asia-Pacific region. We determined a pragmatic set of recommendations for use on a day-to-day basis to help provide optimal care at this crucial stage of illness. The recommendations were developed over a series of meetings by an international faculty of 15 experts from the Asia-Pacific region, Europe, and South Africa. A structured search of the PubMed database was conducted. This was further developed based on the faculty's clinical experience and knowledge of the literature into 10 key aspects of optimal care for patients during the first five years of a diagnosis of a psychotic disorder, with particular relevance to the Asia-Pacific region. Several common principles emerged: adherence to antipsychotic medications is crucial; substance abuse, psychiatric and medical comorbidities should be addressed; psychosocial interventions play a pivotal role; and family members can play a vital role in overall patient care. By following these recommendations, clinicians may improve outcomes for patients with recent-onset psychosis.
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