Diabetes mellitus (DM) is a leading risk factor for age-related dementia, but the mechanisms involved remain to be elucidated. We previously discovered that hyperglycemia-induced impaired myogenic response (MR) and cerebral blood flow (CBF) autoregulation in 18-month-old DM rats associated with blood-brain barrier (BBB) leakage, impaired neurovascular coupling, and cognitive impairment. In the present study, we examined whether reduction of plasma glucose with a sodium-glucose co-transporter 2 inhibitor (SGLT2i) luseogliflozin can ameliorate cerebral vascular and cognitive function in diabetic rats. Plasma glucose and HbA1c levels of 18-month-old DM rats were reduced, and blood pressure was not altered after treatment with luseogliflozin. SGLT2i treatment restored the impaired MR of middle cerebral arteries (MCAs) and parenchymal arterioles, and surface and deep cortical CBF autoregulation in DM rats. Luseogliflozin treatment also rescued neurovascular uncoupling, reduced BBB leakage and cognitive deficits in DM rats. However, SGLT2i did not have direct constrictive effects on vascular smooth muscle cells and MCAs isolated from normal rats, although it decreased reactive oxygen species production in cerebral vessels of DM rats. These results provide evidence that normalization of hyperglycemia with an SGLT2i can reverse cerebrovascular dysfunction and cognitive impairments in rats with long-standing hyperglycemia, possibly by ameliorating oxidative stress-caused vascular damage.

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Introduction: The facial appearance depends on several oral and extraoral factors including colour of facial skin and pigmentation of gingival epithelium. The colour of the gingiva varies among individuals and is thought to be associated with cutaneous pigmentation which ranges from light to dark brown or black colour. Objective: To assess the prevalence of physiological gingival pigmentation, gingival biotype and their association with skin colur in Nepalese subjects visiting Kantipur Dental College and Hospital (KDCH). Methods: This was an analytical cross-sectional study which was carried out from February 2020 to June 2020 in all patients of age-group 16 to 80 years visiting the Department of Periodontics at KDCH after ethical approval. Patients were recruited by convenience sampling and examined thoroughly to find out gingival biotype and extent of gingival pigmentation intraorally as well as skin colour extraorally. Results: In this study, 210 patients were examined among which, 105 (50%) were males and 105 (50%) were females. Out of 210, 33 (15.7%) had pink tissue without pigmentation, 84 (40%) had pigmentation only in attached gingiva, 58 (27.6%) in attached gingiva and interdental papilla, 32 (15.2%) had diffuse pigmentation involving all parts of gingiva, 2 (1%) had in marginal gingiva only, and 1 (0.5%) in marginal gingiva and interdental papilla. Conclusion: A strong association was found between gingival pigmentation and facial skin colour in present study (P <0.001). Establishing the pattern of gingival pigmentation in Nepalese population will help to choose a specific depigmentation therapy that will harmonise with skin colour.

The colour of gingiva is usually considered as “coral pink” which is determined by thickness and degree of keratinization, vascular supply, pigmentation like melanin, and various exogenous substances like tobacco, colouring agents in foods, etc. Gingival hyperpigmentation may be a pathological condition but it is usually a physiological condition that is a major esthetic problem for a patient with a high smile line. Gingival depigmentation is a periodontal plastic surgical procedure that reduces or eliminates the degree of pigmentation. Different treatment modalities for gingival depigmentation have been documented, such as scalpel, electrosurgery, diamond burs, chemical methods, cryosurgery, lasers, and micro-needling with ascorbic acid. This article reports the depigmentation procedure of hyperpigmented gingiva with electrocautery in 25 years old male patient.

Gingival enlargement is an increase in the size of gingiva. It is one of the side effects of systemic administration of antihypertensives, anticonvulsants, and immunosuppressants. Amlodipine, a new third-generation dihydropyridine, very useful in middle-aged to older aged patients for various cardiovascular conditions can cause gingival enlargement. Treatment modalities for drug induced gingival enlargement include removal of local irritating factors, meticulous plaque removal and drug substitution after consultation with a physician. This article reports an amlodipine induced gingival enlargement and its treatment in a 40 years old hypertensive male patient.