Medicine and Health Sciences Commons^™

Indonesian Clinical Practice Guidelinesfor Systemic And Biologic Agents For Adults With Plaque Psoriasis, Novianto E, Budianti Wk, Fitri Em, Wiryadi Be, Soebaryo Rw, Pusponegoro Ehd, Effendi Eh, Rahmayunita G

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.
Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, …

Plasma Malondialdehyde Levels Related To Acne Vulgaris Severity, Fitri Puspita, Nelva Karmila Jusuf, Ariyati Yosi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris (AV) is a multifactorial disorder characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Oxidative stress plays a role in the pathogenesis of AV. Reactive Oxygen Species (ROS), especially lipid peroxides (LPO), plays a role in mediating acne inflammation. Malondialdehyde (MDA) is one of the byproducts of LPO commonly used as a biomarker of cell damage.
Methods: This cross-sectional analytic study consisted of sixty patients with AV. The samples were taken from the blood plasma of AV subjects. An enzyme-linked immunosorbent assay (ELISA) examination was performed. The normality of data …

Management Of Basal Cell Carcinoma With Excision Followed By Rotation Advancement Flap, Remenda Siregar, Fitri Puspita, Widyaningsih Oentari, Ari Karmila Sari

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect.
Case Illustration: We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of …

Intense Pulsed Light (Ipl) As Adjuvant Therapy For Acne Vulgaris: A Case Series, Widyaningsih Oentari, Angie Regina Sutrisno, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment.
Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the …

The Differences Of Blood Type In Relation To Psoriasis And Its Onset: Cross Sectional Study, Nugrohoaji Dharmawan, Suci Widhiati, Triasari Oktavriana, Irene Jessica Pinarsinta Harahap

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis.
Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of …

Generalized Pustular Psoriasis And Cushing’S Syndrome In Childhood Due To Corticosteroids Misuse, Fitri Azizah, Yusnita Rahman, Rahadi Rihatmadja, Triana Agustin, Rinadewi Astriningrum, Githa Rahmayunita

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.
Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake …

Dermoscopic Features Of Uncomplicated Tinea Versus Steroid-Modified Tinea: An Observational Study In Indian Patients, Mithila Ninad Gadekar, Nausheen Syed, Ashutosh Chate, Sushrut Save

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Tinea is one of the most common superficial fungal skin infections. Steroid-modified tinea infections may present with atypical morphology. This study aims to observe the difference between dermoscopic features of uncomplicated dermatophytosis and steroid-modified dermatophytosis.
Methods: This observational study was conducted in 60 patients with tinea cruris, tinea corporis and tinea faciei in the outpatient dermatology department of a tertiary care center. Patients were divided into group A and group B. Group A included 30 patients with no history of steroid use in the past three months. Group B included 30 patients with a history of steroid …

Platelet-Rich-Fibrin For Venous Leg Ulcer Therapy, Karin Rachmani, Lis Surachmiati Suseno, Mutiara Ramadhiani

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It’s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF.
Case Illustration: A 47-year-old male came with an ulcer on the lower left leg for one year. The ulcer was preceded with a reddish, tender nodule with …

The Effect Of Heparinoid As Systemic Prophylactic Anticoagulants On Covid-19 Patient Mortality And Its Safety Profiles: A Systematic Review And Meta-Analysis, Ariska Deffy Anggarany, Rani Sauriasari, Muhammad Alkaff, Famila Takhwifa, Hayatun Nufus, Diana Paramita

Pharmaceutical Sciences and Research

Coagulopathy is one of the complications of COVID-19 and is associated with a higher risk of mortality. However, evidence regarding the effectiveness and safety of anticoagulant therapy in various doses among COVID-19 patients is limited. This systematic review and meta-analysis aims to review and explore the effect of using heparinoids as a systemic anticoagulant at prophylactic doses on mortality in COVID-19 patients. Systematic searches were conducted of various databases (Pubmed, ScienceDirect, SpringerLink, Scopus, and ProQuest) covering the period 2019-2021. We assessed the quality of the articles using the STROBE checklist. Studies with a high risk of bias were excluded before …

Low-Calorie Diet Improves Pasi Score In Psoriasis Patients With Obesity: An Evidence-Based Case Report, Kristian Kuniawan, Alessa Fahira, Edwin Ti Ramadan, Windy Keumala Budianti

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: The association between psoriasis and metabolic syndrome is appealing as the two may share a similar cross-linking systemic inflammation process. The inflammation processes occurring in obesity and psoriasis may aggravate one another. This raised the question of whether a low-calorie diet would possibly reverse the aforementioned process. This study aims to determine whether calorie restriction reduces psoriasis area and severity index (PASI) in obese patients with moderate-to-severe psoriasis receiving conventional treatment compared to no calorie restriction.
Methods: We searched Pubmed/Pubmed Central, ScienceDirect, Cochrane library, EBSCOhost, and Scopus databases using keywords derived from our clinical question. The inclusion …

Comparative Analytical Study Of Phytochemicals In Selected Antidiabetic Medicinal Plant Seeds In Sri Lanka, Gowri Rajkumar, Mihiri Rangika Jayasinghe, Vinotha Sanmugarajah

Pharmaceutical Sciences and Research

Medicinal plants are universally used in the management of various diseases in different medical practices. A varied diversity of compounds extracted from plants may show anticancer, antibacterial, and antidiabetic activities. Comparative laboratory studies and scientific approach of efficacy related to phytochemicals found in medicinal plants in Sri Lanka have not been reported yet. This study aims to evaluate the phytochemicals in selected four different plant seeds such as Syzygium cumini (L.) Skeels, Brassica alba (L.) Rabenh, Trigonella foenum-graecum L. and Nigella sativa L., which are used in the management of diabetes mellitus in Sri Lanka. The ethanol extracts of …

Survival Rate Of Critically Ill Coronavirus Disease 2019 Patients On Tracheostomy In Indonesia, Aris Ramdhani, Dita Aditianingsih, Raihanita Zahra, Muhammad A. Putra, Wuryantoro Soeharto, Melvin D.B. Kwa

The New Ropanasuri Journal of Surgery

Introduction. During COVID-19 global pandemic, tracheostomy is often performed on critically ill COVID-19 patients. There is no available data on the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. This study aimed to find the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia.

Methods. A descriptive survival analysis study enrolled critically ill COVID-19 patients in RSUI who underwent a tracheostomy procedure. Baseline data, including clinical characteristics and laboratory findings before tracheostomy, were recorded. Survival analysis was conducted using the Kaplan-Meier plot.

Results. Forty-two subjects were enrolled in the study: 25 males (59.5%) and 17 …

Cutaneous Horn On The Right Supraclavicular Region In An Adolescent Female, A Rare Case Report, Rohit Gupta, Manoj Kumar, Ruchi Sinha, Reva Shankar Sahu

The New Ropanasuri Journal of Surgery

Cutaneous horn (CH) is an outgrowth from the skin surface, composed of keratin, and associated with benign to malignant skin lesions. We report a case of CH in a 15-year-old female associated with Keratoacanthoma. It is uncommon in young people and is associated with a good prognosis because of its benign nature. This case needs to be reported as it highlights the rare occurrence of this condition in the younger age group and its good prognosis. Surgical excision is the treatment of choice, with histopathologic diagnosis playing a critical role in determining the nature and further treatment of this condition …

Retropharyngeal Abscess And Pott’S Disease Due To Tuberculosis: A Case Report, Bailey N. Hassman, Steven D. Curry, Jonathan H. Ryder, Angela L. Hewlett, Jayme R. Dowdall

Graduate Medical Education Research Journal

Introduction: Extrapulmonary mycobacterial infection can lead to vertebral spondylitis and osteomyelitis (Pott’s disease). Retropharyngeal abscess with concurrent spinal osteomyelitis is a rare presentation of tuberculosis in the US. Chart review on a patient was completed, and the relevant published literature was reviewed.

Case Presentation: A previously healthy 34-year-old male originally from Sudan presented to an outside hospital with a 2-month history of neck pain, sore throat, odynophagia, fevers, and chills. MRI showed a retropharyngeal abscess and suspected cervical spine osteomyelitis. Acid-fast bacillus (AFB) smear was positive from a neck drain specimen, but sputum was negative. Chest imaging did not show …

Point Of Care Spirometry Assessment For Pediatric Asthma Prevalence In A Family Homeless Shelter In Omaha, Nebraska, Nathaniel Mattison, Dale Agner, Breanne Parets, Haley Mathews, Emily Saliga, Maria Vacha, Jamicah Harris, Ryan Saliga

Graduate Medical Education Research Journal

Abstract:

Introduction: The few studies on pediatric asthma in US homeless shelters describe a 27.9 – 39.8% prevalence, and historically Omaha has had a high incidence of fatal pediatric asthma. Thereby, Clarkson Family Medicine (CFM) residency began a pediatric asthma outreach to a local family-homeless shelter to assess the prevalence of pediatric asthma and follow-up appointment attendance.

Methods: We obtained a voluntary parent-child assessment of the child’s respiratory history and an Asthma Control Test (ACT) between ages 4-18 for children residing at the family-homeless shelter. We obtained a pre-albuterol and post-albuterol mobile spirometer assessment using the Global Initiative for …

Student Pharmacists’ Emotional Responses And Coping During The Covid-19 Pandemic, Hannah E. Johnson, Deaundre Bumpass, Aric Schadler, Jeffrey Cain

Journal of Wellness

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Optimizing Empiric Vancomycin Use In Febrile Neutropenia Patients, Nicole Tadros, Erika Dittmar, Radhan B. Gopalani

Nursing & Health Sciences Research Journal

Introduction: National guidelines do not support routine empiric vancomycin use in the initial management of febrile neutropenia (FN) and only recommend it in patients with specific clinical indications. This bi-phasic quality improvement project aimed to evaluate current vancomycin use in FN and improve compliance with a guideline-driven algorithm (GDA) to ensure appropriate prescribing and therapy duration in a community hospital.

Methods: Phase I was a retrospective review of charts of adults receiving empiric vancomycin therapy for FN at a community hospital. Phase II was a prospective review of charts of patients with FN, who received pharmacist-led interventions, to improve de-escalation …

Eradication Of Enterococcus Faecalis In Conventional Endodontic Retreatments (A Randomized Clinical Trial), Fadl H. Khaled, Roula S. Abiad, Khaled Abd El Galil, Essam Osman

BAU Journal - Creative Sustainable Development

Enterococcus faecalis is the most common bacteria isolated in conventional endodontic retreatments. Aim: To compare the impact of three irrigation modalities on the elimination of the isolated microbial strains of Enterococcus faecalis. Materials and Methods: Thirty patients requiring conventional endodontic retreatment for one of their mandibular premolars and tested positive for E. faecalis were chosen. Patients were randomly divided into three groups (n=10) according to the irrigation modality to be used; group I: syringe irrigation (NaOCl 2.625%), group II: NaOCl 2.625%+EndoActivator and group III: NaOCl 2.625%+diode laser. Before obturation, samples S2 were collected and PCR analysis was performed to identify …

Outer Surface Protein C Typing Of Borrelia Burgdorferi In The Tick Populations Of The Upper Susquehanna River Basin, New York, Neha Shaikh, Emilie Ernst, Ariel S. Makower, Christine M. Hurley, Ralph M. Garruto, Michel Shamoon-Pour

Binghamton University Undergraduate Journal

Lyme disease, the most common zoonotic disease in the United States, is caused by the spirochete Borrelia burgdorferi. In order to manage and confront the notable rise in Lyme disease cases, it is crucial to cultivate a deeper understanding of B. burgdorferi and its genes. The outer surface protein C (ospC) gene is highly polymorphic and commonly used as a genetic marker due to its crucial role in establishing mammalian infection. We report novel data on the prevalence of B. burgdorferi ospC genotypes in the infected tick populations of the Upper Susquehanna River Basin of New York …

The Association Of Rs187238, Rs19465518 And Rs1946519 Il-8 Polymorphisms With Acute Kidney Injury In Preterm Infants, Fiva Aprilia Kadi

BioMedicine

ABSTRACT

Background: Interleukin 18 (IL-18) promoter polymorphisms (-656G>T, -607C>A, and -137G>C) affect serum IL-18 (sIL-18) levels and are associated with renal injury.

Purpose: This study aimed to determine the diagnostic utility of sIL-18 and urine IL-18 (uIL-18) as biomarkers for acute kidney injury (AKI) and analyse the association of IL-18 polymorphisms to AKI in preterm infants.

Methods: Blood and urine samples were collected from 56 preterm infants with AKI and 56 without AKI to measure serum creatinine (SCr), sIL-18, and uIL-18. Genotyping of polymorphisms was performed and analysed, with AUC-ROCs analysis used to evaluate …

Median And Ulnar Nerve Injuries In Cyclists: A Narrative Review, Dinesh C. Sirisena, Shauna H-S Sim, Ivan Lim, Vaikunthan Rajaratnam

BioMedicine

Cycling is popular internationally as a mode of transport and sport. Cyclists often report sensory and motor changes in the hands during rides. In the past, assessment of these symptoms was based on clinical history, physical examination and neurophysiology. The aim of this narrative review was to evaluate existing publications and determine if there are areas for further improvement in the clinical setting. Methods: Searches were undertaken in accordance with the PRISMA guidelines using four online databases: PUBMED, OVID, CINAHL and WEB OF SCIENCE. Articles were evaluated using adapted versions of guidelines for case and cohort studies. Results: 2630 articles …

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.

A Rare Combination Of Persistent Left Superior Vena Cava And Partial Anomalous Pulmonary Venous Return, Sang Lee, Bishoy Elbebawy, Neena Joy, George Demosthenes, William Deluccia

Advances in Clinical Medical Research and Healthcare Delivery

A persistent left superior vena cava (LSCV) is a form of anomalous venous drainage of the superior vena cava into the left atrium. We present a case of LSCV and partial anomalous pulmonary venous return (PAPVR) in a patient with progressively worsening dyspnea on exertion. A 57-year-old female with a history of aortic valve stenosis, and tobacco abuse presented with dyspnea on exertion for 4 days. On presentations her vitals were unremarkable except elevated blood pressure and oxygen saturation of 94% on 5L oxygen. Physical exam was pertinent for 3/6 crescendo-decrescendo murmur with a radiation to the right carotid, mild …

A Rare Case Of Severe Amlodipine-Induced Gingival Overgrowth: A Case Report, Marika Shahid, Yong W. Lee, Gande Li, Chisom Mogbo, Roger Vega

Advances in Clinical Medical Research and Healthcare Delivery

Gingival overgrowth, or gingival hyperplasia is the hypertrophy of periodontium caused by local systemic diseases or medications. These medications can be broadly categorized into three main groups including immunosuppressants, anticonvulsants, and calcium channel blockers (CCBs). Amlodipine-induced gingival overgrowth (AIGO) is a less documented phenomenon. This is a unique case of 68-year-old African American woman who developed severe AIGH after taking amlodipine for three years for essential hypertension. The gingival overgrowth happened over a period of two weeks and was so extreme that the patient was unable to approximate her lips or tolerate any oral intake. Labs, images, and biopsies were …

Community And Provider Acceptability Of The Covid-19 Vaccine: A Systematic Review And Meta-Analysis, Christian Akem Dimala, Benjamin Momo Kadia, Hai Nguyen, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Background:

The novel coronavirus disease (COVID-19) vaccines may help control the current pandemic but would require immunization levels that would achieve herd immunity. This study aimed to quantify current COVID-19 vaccine acceptance rates, as well as characterize the determinants, enablers and barriers to vaccine acceptability across the globe by synthesizing published evidence.

Methods:

A systematic review and meta-analysis of studies was performed on studies assessing the acceptability of a COVID-19 vaccine published between November 1^st, 2019, and November 30^th, 2020. PubMed, Embase and Cochrane central were searched for eligible studies. Data extracted from retained studies was …

Acute Induced Scurvy: Implications For Covid-19 And The Cytokine Storm, Chawki Belhadi

Field Notes: A Journal of Collegiate Anthropology

Using an evolutionary genetic disease model, this review considers Vitamin C (VC) and its potential for treating COVID-19 (CV-19). The model’s validity rests on VC’s potent antioxidant property and the mutation sustained by the primate ancestor (est.) 61 MYA that left humans unable to produce VC. The result is humans cannot -by diet or oral supplementation- achieve plasma VC concentrations typical of vitamin C synthesizers. This may leave humans chronically vulnerable to infectious disease (hypoascorbemia). VC deficiency can become more acute during severe disease (anascorbemia) and, because of the relationship between disease severity and oxidative stress, can intensify the oxidative …

Pain Characteristics Among Patients With Knee Osteoarthritis In Aden, Yemen, Abdulsalam Abdullah Hadi Mohsen

Hadhramout University Journal of Natural & Applied Sciences

Knee osteoarthritis in adults is very common and is one of the most common causes of joint pain. The aim of the study was to describe the demographic characteristics and to analyze the clinical finding. It was a retrospective study conducted in Aden during the years 2015 to 2017. Data was obtained from patients’ charts and presented as frequencies, percentages, means and standard deviation. Significance was considered at P value < 0.05. The patients were 367, (males 44.4% and females 55.6%). The older patients (≥ 55 years) were (77.1%). About (39.5%) patients were mostly suffered from right knee osteoarthritis, (25.1%) suffered from left knee and (35.4%) patients have both knee osteoarthritis. Knee pain was mild in (61%) patients and in (30%) patients was moderate. The female to male ratio was 1.3:1 and their mean age was 61.0 ± 9.5 years (age ranged between 35 and 83 years). There was a significant correlation between mean ages of both genders (p = 0.001). The mean uric acid was 6.9 ± 1.6 mg/dL and the relationship between means in both genders was significant (p = 0.000). Patients were higher in the age group ≥ 55 years. Most of the right knee osteoarthritis were in females (28.6%), while bilateral osteoarthritis were predominant in males (22.1%) (P = 0.000). The relationship between the severity of knee pain and side involvement of the knee joint was highly statically significant (P = 0.000). Further prospective studies are needed.

Frequency Of Hepatitis B, Hepatitis C And Human Immunodeficiency Virus In Patients Undergoing Cataract Surgery, Mahfouth Abdalla Bamashmus, Ahmed Mousa Abdulrahim

Hadhramout University Journal of Natural & Applied Sciences

The aim of this study is to assess the frequency of Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency (HIV) viral infections in patients undergoing cataract surgery. This study was conducted among 1,203 patients above the age of 17 years who were scheduled for cataract surgery at Yemen Magrabi Hospital from January 1st, through December 31st, 2012. Patients had investigations for HBV, HCV and HIV and findings were analyzed. The total number of patients screened was 1,203 including 603 (51.1%) males and 600 (49.9%) females. The mean (+SD) age was 59.96 + 12.39 years. Out of the 1,203 cataract …

Effect Of Different Irrigation Regimens On Enterococcus Faecalis Elimination From Infected Root Canals (An In-Vitro Comparative Study), Fadl Khaled, Roula Abiad, Khaled Abd El Galil, Essam Osman

BAU Journal - Health and Wellbeing

Microorganisms harbored in the complexities of root canal systems might lead to endodontic failures and development of apical periodontitis. Enterococcus faecalis is the most common isolated bacteria in these cases. Aim: This study was conducted to compare the efficiency of four irrigation regimens on the elimination of an inoculated strain of E. faecalis. Materials and Methods: Forty single rooted extracted premolars were inoculated with a standard strain of Enterococcus faecalis (ATCC 29212) and incubated at 37˚C for two weeks to allow infection of the dentinal tubules. The bacterial suspension was replaced with a new one every 48 hours. The teeth …