Background: Isolated ectopic gastric varices (IGV2) are present either in the body or antrum of the stomach or upper duodenum. The prevalence, natural history and clinical significance of these varices has not been adequately described. Materials and Methods: Consecutive patients with portal hypertension, prospectively studied and diagnosed to have IGV2, were assessed for their time of appearance – primary (at first presentation) or secondary (after obliteration of oesophageal varices), association with other varices, portal hypertensive gastropathy and any overt bleeding. Results: Fifty-three of the 1,128 (4.7%) patients had IGV2. The IGV2 were commonly seen in the antrum (53%), duodenum (32%), or at both sites (11%) and rarely in body and fundus (4%). IGV2 were predominantly (84.9%) secondary in origin, developing after oesophageal variceal obliteration. The median time for emergence of secondary IGV2 was 8.2 months for patients with cirrhosis, 12.8 months for non-cirrhotic portal fibrosis and 10.8 months for extra-hepatic portal vein obstruction. Eight (15%) patients had primary IGV2, 6 of them had underlying portal vein obstruction. Portal gastropathy (p < 0.05) and UGI bleeding were more common in the secondary than in primary IGV2. Bleeding due to IGV2 was seen only in 3 (5.7%) patients during a mean follow-up of 36.3 ± 12.1 months, and could be successfully managed with endoscopic ligation or obliteration. Conclusions: Isolated ectopic gastric varices are not uncommon and generally develop following obliteration of main variceal columns. They rarely bleed and often can be managed with endoscopic interventions.

Aim of the Study:This study aims to evaluate the effects three different conditioning agents on the shear bond strength of resin-modified glass ionomers to human dentin.Materials and Methods:One hundred and twenty recently extracted, caries-free premolars and molars will be cleaned of debris and disinfected in a 0.5% solution of sodium hypochlorite and sterile water for 30 min. The occlusal surface of each tooth will be reduced using conventional model trimmer with water to produce the dentin surface. Then, three different resin-modified glass ionomer cements (GICs) were triturated and mixed according to the manufacturer's instructions, 10 specimens will be made of each group. The excess restorative material will be removed from matrix band dentin interface with a sharp number 25 bard parker blade. Samples were shear tested with Instron universal testing machine with a crosshead speed of 0.5 mm/min. A shearing bar beveled to a 1 mm thick contact surface area will be placed at the junction of dentin and plastic band matrix. The load required for the failure will be recorded in pounds and converted to megapascals.Results:Statistical analysis was done with analysis of variance and Tukey's test. Ketac primer as conditioning agent along with Fuji II LC as restorative material had the highest shear bond value whereas intact smear layer which was unmodified dentin had the least value.Conclusion:Within the limitations of the present study, it can be concluded that surface conditioning of dentin resulted significantly higher bond strength than unconditioned dentin surfaces.Clinical Significance:Resin-modified glass ionomers have several advantages compared to chemically cured GICs. The advantages include command cure, ease of handling, improved physical properties, and esthetics. Resin.modified glass ionomers have been marketed as direct restorative materials for Class V lesions as well as liners, bases, and luting agents. Several conditioning agents have been evaluated to condition dentin before the application of conventional glass ionomers and resin-modified glass ionomers. These have mainly included polyacrylic acid, citric acid, phosphoric acid, and ethylenediamine tetra.acetic acid. Of late, manufactures have recommended other conditioners to replace polyacrylic acid which includes Ketac primer as one of the conditioning agents.

Context:Achieving a high degree of conversion (DC) is one of the major concerns during photopolymerization of bulk-fill composites.Aims:To evaluate the effect of light energy densities (11.2 J/cm2 and 20 J/cm2) on the DC and variation of DC in the 24-h postcuring of four bulk-fill composites: SDR, Venus Bulk Fill, MI FIL, and Tetric N-Ceram Bulk Fill at simulated clinically relevant filling depths.Settings and Design:This was an in vitro comparative study.Subjects and Methods:A total of twenty samples were prepared using a teflon mold. VALO curing light was used with two light intensity modes of 1000 mW/cm2 for curing time of 20 s and 1400 mW/cm2 for curing time of 8 s. The energy density was calculated as follows: energy density (J/cm2) is the light intensity (mW/cm2) applied during a certain time (s) divided by 1000. The DC was measured at two time intervals: immediately postcure and after 24-h storage in artificial saliva using an Fourier-transform infrared spectroscopy equipped with attenuated total reflectance accessory.Statistical Analysis Used:ANOVA and Bonferroni test at P < 0.05.Results:High energy density (20 J/cm2) leads to higher DC. Thickness, type of composites, and postcuring phase strongly influence the DC. DC values of the top surface for all the bulk-fill materials investigated were found significantly greater (P < 0.005) than those of their bottom surface. Among composites, SDR showed highest DC. DC strongly increased after 24-h postcure by 32% on top surface and 76% on bottom surface.Conclusions:Energy density more than 20 J/cm2, derived by increasing curing time and low power density, helps obtain a high DC of bulk-fill composites for adequate clinical performance.