Experimental nano calcium aluminate/tri calcium silicate root repair: Synthesis, physical and mechanical properties compared to mineral trioxide aggregate and Biodentine / Reparo radicular experimental de nano aluminato de cálcio/silicato de tri cálcio: Síntese, propriedades físicas e mecânicas em comparação com agregado de trióxido mineral e Biodentine

Objective: Endodontic perforation is a challenging mishap that should be repaired with a biocompatible material, Mineral trioxide aggregate (MTA) and Biodentine are the most commonly used repair materials. However, these materials are expensive, (MTA) has prolonged setting time and difficult manipulation. The purpose of this study is to prepare the experimental nano calcium-aluminate/tri-calcium-silicate (CA/C3S) material and comparing its physical properties with biodentine and MTA, to evaluate the experimental material eligibility to compete the commercial repair materials. And to perform part two (animal study) that will evaluate the cytotoxicity, the biocompatibility and the efficacy of (CA/C3S) in furcal perforation repair compared to diode laser. Material and Methods: A mixture of calcium carbonate and aluminum oxide was used to formulate calcium aluminate phase (CA), tri-calcium-Silicate phase (C3S) was formulated by firing of calcium carbonate and quartz. The produced powders were investigated by X-ray diffraction, then (CA) and (C3S) mixed with water.(CA/ C3S) compared with MTA and biodentine for setting-time, micro-hardness, dimensional-stability and solubility. Results: Mean setting time of (CA/C3S) was (32.70±0.75min) which is significantly higher than MTA and Biodentine. The Mean microhardness of (CA/C3S) was (56.50±7.41VHN) which has no statical difference with MTA and Biodentine. Solubility results showed weight increase for (CA/C3S) as following (6.29±3.05)and loss of weight for MTA and Biodentine. The percentage of change in dimensions for(CA/C3S) increased as following (0.64±0.78) while decreased for MTA and Biodentine. Conclusion: The experimental (CA/C3S) material showed good microhardness, dimensional stability and acceptable setting time that could be improved in further work (AU)

Objetivo: A perfuração endodôntica é um percalço desafiador que deve ser reparado com um material biocompatível, Agregado de trióxido mineral (MTA) e Biodentina são os materiais de reparo mais comumente usados. No entanto, esses materiais são caros, (MTA) tem tempo de presa prolongado e difícil manipulação. O objetivo deste estudo é preparar o material experimental de nano aluminato de cálcio/silicato tricálcico (CA/C3S) e comparar suas propriedades físicas com biodentina e MTA, para avaliar a elegibilidade do material experimental para competir com os materiais de reparo comerciais. E realizar a segunda parte (estudo animal) que avaliará a citotoxicidade, a biocompatibilidade e a eficácia do (CA/C3S) no reparo de perfuração de furca em comparação ao laser de diodo.Material e Métodos: Uma mistura de carbonato de cálcio e óxido de alumínio foi usada para formular a fase de aluminato de cálcio (CA), a fase tri-cálcio-silicato (C3S) foi formulada por queima de carbonato de cálcio e quartzo. Os pós produzidos foram investigados por difração de raios X, em seguida (CA) e (C3S) misturados com água. (CA/ C3S) comparados com MTA e biodentina para tempo de presa, microdureza, estabilidade dimensional e solubilidade. Resultados: O tempo médio de presa de (CA/C3S) foi (32,70±0,75min) que é significativamente maior que MTA e Biodentine. A microdureza média de (CA/C3S) foi (56,50±7,41VHN) que não tem diferença estática com MTA e Biodentine. Os resultados de solubilidade mostraram aumento de peso para (CA/C3S) conforme a seguir (6,29±3,05) e perda de peso para MTA e Biodentine. A porcentagem de mudança nas dimensões para (CA/C3S) aumentou como segue (0,64±0,78), enquanto diminuiu para MTA e Biodentine. Conclusão: O material experimental (CA/C3S) apresentou boa microdureza, estabilidade dimensional e aceitável tempo de presa, que pode ser melhorado em trabalhos futuros (AU)

2009 H1N1 influenza A in children: a descriptive clinical study

The 2009 H1N1 was a new influenza virus causing illness in people. Especially those younger than 5 years of age and those who have high-risk medical conditions are at increased risk for influenza-related complications. In the present study, we describe the clinical presentation of the H1N1 cases attending Jeddah Clinic Hospital-Al Kandarah [JCH-K] in the time period from October 2009 to January 2010, and identified the high-risk age groups. Prospective study at JCH-K from October 2009 through January 2010. All pediatric patients [up to 15 years old] presenting with influenza-like illnesses in the clinics during the specified period were clinically examined and tested using reverse transcriptase polymerase chain reaction. Only confirmed H1 N1 cases were included in the study. Over a 4-month period, 89 cases of laboratory-confirmed H1N1 were reported in JCH-K. Thirty-four patients [38.2%] were younger than 5 years of age. Forty-six [51.6%] cases were males. Thirty-three cases were Saudis [37.1%]. The most commonly reported symptom was fever, which was noted in all cases. Twenty-eight cases [31.5%] had pneumonia. Fourteen cases [15.7%] were known asthmatics. Fifty-two [58.4%] cases were lymphopenic and 32 [35.9%] cases were leucopenic. Sixty-five [73%] patients were hospitalized, and five of them were treated in the intensive care unit. Even though the majority of cases of the 2009 pandemic influenza A H1N1 were mild, a severe disease does occur in children. In view of delayed PCR results, clinical presentation and lymphopenia were used as diagnostic criteria to start antiviral treatment as early as possible. No deaths were attributed to the 2009 pandemic

Live donor hepatectomy for liver transplantation in Egypt: lessons learned

To retrospectively review anesthesia and intensive care management of 145 consented volunteers subjected to right lobe or left hepatectomy between 2003 and 2011. After local ethics committee approval, anesthetic and intensive care charts, blood transfusion requirements, laboratory data, complications and outcome of donors were analyzed. One hundred and forty-three volunteers successfully tolerated the surgery with no blood transfusion requirements, but with a morbidity rate of [50.1%]. The most frequent complication was infection [21.1%] [intraabdominal collections], followed by biliary leak [18.2%]. Two donors had major complications: one had portal vein thrombosis [PVT] treated with vascular stent. This patient recovered fully. The other donor had serious intraoperative bleeding and developed postoperative PVT and liver and renal failure. He died after 12 days despite intensive treatment. He was later reported among a series of fatalities from other centers worldwide. Epidural analgesia was delivered safely [n=90] with no epidural hematoma despite significantly elevated prothrombin time [PT] and international normalization ratio [INR] postoperatively, reaching the maximum on Day 1 [16.9 +/- 2.5 s and 1.4 +/- 0.2, P < 0.05 when compared with baseline]. Hypophosphatemia and hypomagnesemia were frequently encountered. Total Mg and phosphorus blood levels declined significantly to 1.05 +/- 0.18 mg/dL on Day 1 and 2.3 +/- 0.83 mg/dL on Day 3 postoperatively. Coagulation and electrolytes need to be monitored perioperatively and replaced adequately. PT and INR monitoring postoperatively is still necessary for best timing of epidural catheter removal. Live donor hepatectomy could be performed without blood transfusion. Bile leak and associated infection of abdominal collections requires further effort to better identify biliary leaks and modify the surgical closure of the bile ducts. Donor hepatectomy is definitely not a complication-free procedure; reported complication risks should be available to the volunteers during consenting

phase 2 study of the combination of gemcitabine and cisplatin in patients with locally advanced or metastatic breast cancer previously treated with anthracyclines with/ without taxanes

Many patients with relapsed metastatic breast cancer are pre-treated with taxanes and anthracyclines, which are usually given in the neoadjuvant/adjuvant setting or as first-line treatment for metastatic disease. The primary objective of this study was to determine the overall response rate for combination treatment with gemcitabine and cisplatin in patients with locally advanced or metastatic breast cancer who had relapsed after receiving one adjuvant/neoadjuvant or first-line metastatic chemotherapy regimen containing an anthracycline with/without a taxane. Secondary endpoints included duration of response, time to progression, one-year survival probability, and toxicity. A single-arm, open-label, phase 2 study conducted at 1 7 investigative sites in Egypt. Treatment consisted of gemcitabine [1250 mg/m[2]] on Days 1 and 8 and cisplatin [70 mg/m[2]] on Day 1 of each 21-day cycle. Treatment continued until disease progression or a maximum of 6 cycles. Of 144 patients all were evaluable for safety and 132 patients were evaluable for efficacy. The overall response rate was 33.3% and 45.5% of the patients with stable disease as their best response. The median time to progression was 5.1 months and the one-year survival probability was 73%. The most common grade 3/4 adverse events were nausea/vomiting [20.1%], neutropenia [19.4%], anemia [13.9%], asthenia [11.1%], diarrhea [9.7%], stomatitis [7.6%], leucopenia [7.6%], and thrombocytopenia [6.2%]. Twelve [8.3%] patients had serious adverse events. The results of this study indicate that gemcitabine and cisplatin were active and generally well tolerated in pretreated patients with locally advanced or metastatic breast cancer

Dental caries experience, oral health status and treatment needs of dental patients with autism

OBJECTIVES: Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children. MATERIAL AND METHODS: 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test of significance were used to compare groups. RESULTS: The autism group had a male-to-female ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0 percent (36/61) or fair 37.8 percent (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0 percent (59/61) of the autistic children had gingivitis. CONCLUSIONS: Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.

Psychosocial Impacts of Mentally Retarded Children on Parents in Sudan

This study was conducted on a community sample from Khartoum state; Sudan to explore the psychological and social impacts of the mentally retarded child on his/her parents. The study hypothesized that these effects are directly related to the age; number of handicapped children in the family as well as the degree of mental retardation Methods and population: Seven centers for teaching and training of handicapped children were recruited in Khartoum State. Ninety-one children aged 5-16 years were randomly selected and their intelligence quotient (I.Q) was etermined. Interviews for 82 mothers and 64 fathers of these children were held using a standardized anonymous questionnaire including socio-demographic data and information about the psychological and social impacts of the disability of children on their parents. The parents also completed the Hospital Anxiety and Depression Scale (HADS) to assess the presence of anxiety and depression. Results and discussion: The parents reported different psychological effects when they realized the children's disability. However; they tend to overcome their problem and become adapted to the situation. Sometimes; problems arise in the marital life and in social participation. The research showed that most parents suffered from degrees of anxiety and depression ranging mainly from severe to moderate. The number; age or degree of retardation of the children did not affect the social and psychological impacts on the parents significantly. The study recommends preventative measures to reduce the factors that lead to mental retardation. It also recommends the provision of rehabilitation services and training of children in schools and special institutes; besides supporting their families psychologically and socially to reduce their burden

Effects of Temperatures on Larval Development of Chrysomya megacephala (Fabricius) and Chrysomya rufifacies (Macquart) (Diptera: Calliphoridae): Application in Forensic Science / Jurnal Sains Kesihatan Malaysia

Chrysomya megacephala (Fabricius) and Chrysomya rufifacies (Macquart) are two important species of blow flies that could be utilised as indicators to estimate the Post Mortem Interval (PMI) of corpses in forensic science. Determination of PMI of corpses is based on the larva size and its development stages. Development studies of eggs, larvae and pupae of Ch. megacephala and Ch. rufifacies at 27ºC, 30ºC and 33ºC were carried out using an insect growth chamber. Data from these studies were used to construct growth curves and Accumulated Degree Hours (ADH) for both species. Ch. megacephala needs 9.15 days to complete one life cycle at 27ºC, 8.54 days at 30ºC and 6.76 days at 33ºC. Development for Ch. rufifacies is slower than Ch. megacephala and takes 9.92 day at 27ºC, 9.13 days at 30ºC and 7.44 days at 33ºC. Eggs of the two species hatch faster at 33ºC compared to the two other temperatures. Low value of ADH shows shorter life cycle of that particular species. This study’s findings are useful in estimating PMI of the corpses found under various environmental temperatures.

Descriptions of the Larval Instars of Chrysomya rufifacies (Macquart) (Diptera: Calliphoridae), a Species of Forensic Importance in Malaysia / Jurnal Sains Kesihatan Malaysia

The anatomical structures of the first, second and third instars of Chrysomya rufifacies (Macquart) were examined by light microscopy. Observations were documented on the three main characteristics; the cephalopharyngeal skeleton, anterior spiracle and posterior spiracle. The first instar larva bore cornuae of fairly pigmented delineation with slim hypostomal sclerite and distinct dental sclerite. First instar did not have obscured anterior spiracle but posterior spiracles were obscured with thin lining of opened peritreme. Intersegmental spines were evident. The second instar larva displayed a prominent anterodorsal process approaching closer to hypostomal sclerite while upper margin of the dorsal cornua was slightly pigmented. Each anterior spiracle consisted of nine to ten papillae, arranged in a single row. Peritreme of the posterior spiracle thick, opening at the end of peritreme was not wide and confined to two spiracular slits. The third instar larva showed a prominent arch of the ventral cornua with broad and bold appearance. It approached the dorsal cornua and became narrow at the incision median. The anterior spiracle consisted of a single row of nine to ten papillae while intersegmental spine could be identified with one to three dark pigmented tips. A dark pigmented and wide periterime was observed confining three short and thick spiracular slits while button was poorly pigmented. The most distinctive feature of this second and third instar larva was the slender, thorn-like tubercle with numerous spined tips on the middle line segment of the body. These findings provide identification features of C. rufifacies larvae instars.

Assessment of physicians' recordings in admitted patient's charts: Al-Gaumhoria Teaching Hospital, Aden

This study was designed to assess the admitted patient's charts at Al-Gaumhoria Teaching Hospital, Aden. The total patients' charts were 172 [60 from the medical wards and 112 from the surgical wards] who were admitted to the medical and surgical wards during September to November 2005 and discharged alive. Fourteen variables from the chart were chosen. They were demographic data, date of admission, chief complain, history of present illness, past history, family history, physical examination, differential diagnosis, initial therapy, signature and stamp of physician who admitted and discharged the patient, final diagnosis, daily follow up, and date of discharge. The parameter for the findings was the percentage of registered and unregistered variable. For the total charts, we found deficiency in recording the variables of signature and stamp of physicians by discharging patient 65.1%, final diagnosis 55.8%, demographic data 43%, date of discharge 40.1%, family history 34.3% and past history 27.9%. The rest unregistered variables ranged between 12.2% and 3.5%. We concluded that negligence of physicians and deficiency in recording the full items in patient's chart is attributed to the following factors: deficiency of supervision of head of departments, deficiency in knowledge of medical ethics and importance of patient's chart, deficiency of guidelines and lack of the coordination between faculty of medicine, teaching-hospitals administrations and the Yemeni Council for medical Postgraduate studies

epidemiological profile of malaria in Aden

In order to study the epidemiology of malaria in Aden, we retrospectively collected and analyzed data of patients examined for malaria in all governmental health institutions in Aden Governorate, during the year 2005. The total examined patients were 46201 and the identified positive malaria cases were 2450. The incidence rate of malaria infection was 412 per 100000 people. Malaria species were mostly due to P. falciparum [96.4%], while P. vivax was [3.6%]. The predominant malaria infections occurred in winter [November - March], showing a seasonal variation that coincides with the increased movement of people, especially workers from other governorates to Aden. The most malaria cases were observed in Sheikh-Othman District [52%] followed by Khormaksar District [14.5%] and Al-Mansoora District [10.7%]. A significant increase noted in the number of cases among children less than 10 years and people aged 10-49 years as a whole and in both genders. The difference between male and female patients was not significant [P > 0.05]. However, we concluded that the continued presence of malaria in Aden poses a significant health problem, especially in the presence of the malaria vector