A recent study has shown that dexamethasone is superior to saline in relieving postoperative pain when utilized as the final intracanal rinse after root canal instrumentation. This study's findings were published in the Journal of the College of Physicians and Surgeons Pakistan.
Sixty patients aged 18 to 50 years, who had been diagnosed with symptomatic irreversible pulpitis were specifically chosen based on set criteria. Root canal therapy (RCT) was initiated under rubber dam after obtaining informed consent. The treatment included a pulpectomy followed by canal preparation. Patients were divided into two groups: Group A (the experimental group) received dexamethasone (4 mg/mL in a 5-mL syringe) as a final rinse, and Group B (the control group) received saline as the final rinse. They were followed up after 1 week to determine the improvement of their pain. Following data collection, teeth were filled, and permanent restoration was placed. The Chi-square test was utilized for the analysis of the data.
Dexamethasone showed a significantly higher efficacy compared to saline as a final intracanal rinse, 86.67% and 20.0%, respectively (p value < 0.05), in alleviating postoperative pain in teeth diagnosed with symptomatic irreversible pulpitis.
The above study demonstrated that dexamethasone has greater efficacy compared to saline in alleviating postoperative pain when utilized as the final intracanal rinse following root canal instrumentation. 
 

A network meta-analysis found a combination of probiotics and laxative effective at treating pediatric functional constipation. 
Pediatric constipation affects 0.7% to 29.6% of children globally, with functional constipation accounting for 95% of cases. Despite its prevalence, pharmacological treatments have limited efficacy, with a 60% success rate. Probiotic supplements have shown potential benefits in randomized controlled trials (RCTs), though the probiotic strains used varied significantly across studies. 
This network meta-analysis (NMA) aimed to evaluate the efficacy and acceptability of various probiotic supplements in managing pediatric functional constipation. The analysis included nine RCTs with 710 participants (mean age: 5.5 years; 49.4% girls), assessing the impact of probiotics, alone or with laxatives, on bowel movement frequency and treatment acceptability.
Results demonstrated that most probiotics, whether used individually or with laxatives, significantly improved bowel movement and stool frequency compared to placebo/control. Protexin combined with laxatives showed the greatest improvement (SMD = 1.87, 95% CI: 0.85 to 2.90), outperforming all other products. Among single probiotic treatments, only Lactobacillus casei rhamnosus Lcr35 achieved significant efficacy compared to placebo/control (SMD = 1.37, 95% CI: 0.32 to 2.43). All probiotic products had similar rates of fecal incontinence and dropouts as the control groups. 
This NMA supports the use of combined probiotics and laxatives for pediatric functional constipation, provided no contraindications exist, and highlights the importance of specific probiotic strains in treatment efficacy.
 

Cough sounds can be distinct based on the underlying cause of cough. Clinicians can get a lead to diagnosis, based on the analysis of cough sounds. Some of the common cough sounds are listed below:
1. A brassy cough occurs when an intrathoracic tumor (such as an aneurysm or mediastinal tumor) compresses the trachea, resulting in a cough with a metallic or harsh tonal quality, typically involving the trachea or bronchi.
2. A bovine cough manifests when a tumor affects the recurrent laryngeal nerve, altering the normal vocal cord movement. This results in a prolonged, less forceful cough often accompanied by wheezing.
3. A whooping cough is identified by a characteristic "whoop" sound as air is forcefully inhaled between coughing fits, common in pertussis.
4. A hysterical cough is typically loud and repetitive, often with a bark-like quality, and can be psychogenic in origin.
5. A barking cough (commonly associated with croup) involves noisy, high-pitched breathing sounds during both inhalation and exhalation due to subglottic pathology.
6. A paroxysmal cough is marked by intense, violent coughing episodes, often seen in conditions like bronchial asthma or heart failure.
7. A persistent cough with productive sputum, especially worse in the mornings and lasting for months or years, is characteristic of chronic bronchitis.
This classification aids in the clinical assessment of coughs, helping identify underlying pathologies based on auditory characteristics.
 

A recent study suggests that appropriate dose modifications in selinexor in response to adverse events (AEs) were associated with improved efficacy, reduced AE rates and improved quality of life (QoL) in patients with relapsed/refractory multiple myeloma. The study’s findings were published in the journal, Clinical Lymphoma, Myeloma & Leukemia. 
The BOSTON study, a phase III, open label, randomized, controlled trial included 195 patients with relapsed/refractory multiple myeloma. They were randomized either to once-weekly (QW) 100 mg of selinexor, QW subcutaneous bortezomib (1.3 mg/m2), QW with 20 mg of twice-weekly dexamethasone or to a standard subcutaneous bortezomib and dexamethasone twice-weekly. Primary endpoint was progression-free survival (PFS). Secondary endpoints included Overall response rate (ORR), ≥ very good partial response (VGPR) rate, overall survival (OS), duration of response (DoR), time to next treatment (TTNT), and time to response (TTR) 
Of the total 195 patients enrolled, 126 patients had selinexor dose reductions. The median progression-free survival for patients who received dose reductions was 16.6 months (95% CI 12.9 – NR), while it was 9.2 months (95% CI 6.8, 15.5) for those who did not with a hazard ratio of 0.57 (95% CI 0.36, 0.89). The ORR was 81.7% (95% CI 73.9%, 88.1%) vs 66.7% (95% CI 54.3%, 77.6%) for patients with dose reductions vs in those without dose reductions, respectively. DOR was not reached (95% CI 13.8, NE) in the dose reduction group and was 12.0 months (95% CI 8.3, NE) in the group without reduction (HR = 0.59 [95% CI 0.34, 1.04]). TTNT was 22.6 months (95% CI 14.6, NE) for patients who received selinexor dose reductions, whereas it was 10.5 months (95% CI 6.3, 18.2) for patients who did not receive dose reductions.  
On the EORTC QLQ-C30 Global Health Status/QoL scale, the mean best change from baseline was 10.0 ± 20.5 (95% CI 6.3, 13.7) in the dose reduction group as opposed to 4.0 ± 20.9 (95% CI −1.4, 9.3) in those without dose reduction. After selinexor dose reduction, AE rates that were lower included thrombocytopenia (62.5% before vs. 47.6% after), fatigue (28.1% before vs. 9.9% after), nausea (31.6% before vs. 7.3% after), anemia (17.9% before vs. 10.3% after), diarrhea (12.9% before vs. 5.2% after), and diarrhea (21.5% before vs. 6.4% after).
Based on the above results, it can be concluded that appropriate dose reductions of 100 mg selinexor starting dose may be associated with improved efficacy, reduced AE rates and improved QoL