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@#Resin-based pit fissure sealants (RBS) are used to prevent occlusal caries in children. The success of RBS in preventing dental caries is largely influenced by its retention on the tooth surface, which is also affected by its physicomechanical properties. The physicomechanical properties of RBS can be enhanced through the addition of fillers. With the advent of nanofillers, the physicomechanical properties were improved without altering RBS flowability. The present study developed an RBS with a 70 wt% resin matrix and 30 wt% nanofillers. The resin matrix consisted of urethane dimethacrylate (55 wt%), triethylene glycol dimethacrylate (45 wt%), camphoroquinone (0.3 wt%), and 2-(dimethylamino) ethyl methacrylate (0.7 wt%). Silane-treated rice husk-derived nanosilica (20 wt%) and nanohydroxyapatite (10 wt%) were added as fillers. Clinpro, Fissurit FX, and an unfilled sealant were controls. All RBS were tested for surface roughness, Vickers hardness, flexural strength, and flowability. Statistical analysis with oneway ANOVA revealed significant differences between groups in surface roughness, hardness, flowability (p < 0.001), flexural strength, and flexural modulus (p < 0.05). Experimental sealants had higher flexural strength (78 MPa) and flow distance (29.05+1.16 mm) than commercial controls.However, the surface roughness of experimental sealants (0.25+0.08 μm) was higher than Clinpro (0.087+0.027 μm) but lesser than Fissurit FX (0.35+0.19 μm). The Vickers hardness of experimental sealants (23+1.63 VHN) was less than Fissurit FX (28.80+1.69 VHN) but higher than Clinpro (21.74+1.68 VHN). This novel RBS had physicomechanical properties comparable to commercial sealants. The use of nanosilica from rice husk makes this pit and fissure sealer sustainable and environmentally friendly in dentistry.
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Purpose: To study the imaging and clinical perspectives of a recent epidemic of rhinocerebral mucormycosis during the COVID-19 (coronavirus disease) pandemic in India. Materials and Methods: This retrospective study included clinical and imaging data of 24 diagnosed cases of acute rhinocerebral mucormycosis who were presented to our hospital in May 2021. The clinical profile and imaging data of the patients were documented. Results: 18 patients (75.0%) had moderate to severe COVID-19 illness with a history of oral or intravenous corticosteroid intake. 19 patients (79.2%) had presented with hyperglycemia at the time of admission. Nasal discharges with or without black crusts and facial swelling (79.2%) were the most commonly reported complaints, followed by headaches or facial pain (62.5%). All cases demonstrated the involvement of one or more paranasal sinuses in imaging, with predominantly unilateral involvement. Extra sinusoidal involvement was commonly seen, with abnormalities seen in retromaxillary and masticator space, orbit, face, oral cavity, pterygopalatine fossa, and deep spaces of the neck, cavernous sinus, and brain. Conclusion: An upsurge of mucormycosis cases during the COVID-19 pandemic appears to be closely related to uncontrolled hyperglycemia and corticosteroid therapy. Computed tomography (CT) and magnetic resonance (MR) imaging are invaluable in establishing an early diagnosis, defining the extent of disease, and helping in immediate surgical planning.
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Purpose: To describe the variables that may be utilized in the optimization of three?dimensional heads?up surgeries (3D?HUS) for achieving better ergonomics among ophthalmic surgeons. Methods: A cross?sectional study was conducted at the operating room of a tertiary eye care center, equipped with an ARTEVO 800 3D surgical microscope and display monitor. The parameters noted were monitor height (MH), surgeon eye?to?floor distance (ETFD), surgeon eye?to?monitor distance (ETMD) and viewing tilt (VT) angle. The neck and eye strain of the surgeon and assistant were scored as per Borg’s CR?10 scale, before and after surgeries. Results: Thirty (13 right, 17 left) eye surgeries were analyzed. The minimum ETMD was 51 inches (in) and the eye strain reduced with shorter ETMD (within the range 51 inches to 83 inches). The VT and ETFD were higher for right eye surgeries. The optimum MH was between 50 and 55 in. Overall, the neck strain and eye strain were in the range of 0–3 and 0–1, respectively. Conclusion: The various parameters affecting the 3D image quality, neck and eye strain are chair height, VT angle, eye centration, monitor distance, laterality of the eye, and room illumination.
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Correlational study and evaluation of pollution indices of toxic metals distribution in soil and crops of a population are imperative for assessing the risk of chronic diseases associated with these metals. Correlational analysis for the distribution of; lead (Pb), cadmium (Cd), chromium (Cr) and mercury (Hg) in soil (S), bean (B) and maize (M) was conducted around Bunkure (BKR), Danbatta (DBT), Gwarzo (GRZ), Ungogo (UGG) and Wudil (WDL) as sampling zones around Kano State, Nigeria. The samples were collected from farm harvests in each of the sampling zones. The metal concentration was determined using atomic absorption spectrometry (AAS). Results in mg/kg across the local governments indicate respective ranges for Hg, Pb, Cd, and Cr of; 0.33 - 3.13, 0.14 - 0.84, 0.02 - 0.05 and 0.01- 0.49 in soil, 0.04-4.23, 0.06-0.23, 0.02-0.04 and 0.00-0.10 in maize and 0.20-4.23, 0.16-0.19, 0.03-0.04 and 0.00-0.03 in beans. Although with the exception of mercury, the ranges of the toxic metals are within the tolerable range set by International Standard Tolerable Limits and European Regulatory Standard. Potential hazard may be speculated because the detected levels are on higher tolerable ranges. A higher level of mercury in almost all the samples indicates potential hazards associated with human activities in those areas. A strong positive correlation between soils samples in respect to the level of some of the toxic metal may suggest a common nature of the soil, while the negative correlation may be due to variation in agrochemicals in-use. For the pollution load index, Wudil had the highest soil pollution load index for Hg (3.13 ± 0.16), Cd (1.6×10-2 ± 0.01) and Cr (4.9×10-3 ± 0.01), while Ungogo had the highest pollution load for Pb. Also, all grains within the study zones exhibited a positive transfer factor, except Cr in Bunkure, Danbatta and Gwarzo. It may be concluded that crops grown in those areas may bioaccumulate some of these toxic metals, thereby incorporating them into the food chain, hence potential health risk.
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Introduction: Methotrexate, a folic acid antagonist is used as a first line drug for the treatment of a number of malignancies and immune disorders like rheumatoid arthritis. Due to hepatoxicity its dose needs to be monitored and sometimes it has to be stopped. In the present study we intend to do a detailed histopathological investigation after methotrexate toxicity on the relatively neglected organ i.e. kidney of rat. Subjects and Methods: Albino rats were divided into four groups (1, 2, 3, and 4) of six animals each. Control group 1 was given distilled water whereas experimental groups 2, 3, and 4 were given low, therapeutic and high doses of methotrexate orally for 28 days. Results: The results showed congestion and infiltration of the glomeruli and interstitial edema and tubular degeneration which were dose dependent. Conclusion: The degenerative changes necessitate extra precautions to be taken while using drug for prolonged period. The study merits due to great social impact.
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Introduction: Olanzapine an atypical anti-psychotic drug is widely used in a number of disorders like schizophrenia and bipolar disorder. Olanzipine shows affinity for a number of muscarinic, dopaminergic and histaminic receptors in the body due to which its effects can be seen on a number of organs in the body. The present study was conducted to see the adverse effects of the drug on the histology of urinary bladder and vas deference as data is not availabe on these organs. Subjects and Methods: Twelve male albino rats divided into equal number of experimental and control groups i.e. 6 rats each. Olanzapine was injected intraperitoneally in experimental rats at a dose of 4mg/kg for 6 weeks daily. Results: Control group received same volume of normal saline, daily, intraperitoneally for the same period. Conclusion: Histopathological and histomorphometric changes conformed degeneration in urinary bladder & vas deferens.
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Introduction: Streptomycin and Kanamycin, an aminoglycosidic antibiotic, is known to destroy the ventral cochlear nuclei of brainstem in man. Ototoxicity is well known side effect of kanamycin, the effect on central nervous system in general and central auditory pathway in particular is still unclear. Subjects and Methods: Thirty albino rats were divided into three groups I, II and III of ten animals each. Group III was control. Group I and II received Streptomycin (30mg/Kg body weight) and kanamycin (400mg/kg body weight) intramuscular injections, daily for 3 weeks. Paraffin embedded sections of cerebellum, spinal cord, dorsal cochlear nucleus, inferior colliculus nucleus and auditory cortex were stained with haematoxylin and eosin stains and perikarya measured using slide and ocular micrometres. Results: Size of cerebellar Purkinje cells increased significantly in control rats for streptomycin and kanamycin intoxicated animals respectively. Ventral horn cells of spinal cord are affected highly significantly only by streptomycin. Vestibular nucleus also showed similar results i.e. neuronal body. Neurons of dorsal cochlear nucleus is affected significantly by both the drugs i.e. streptomycin and kanamycin. Conclusion: Streptomycin causes an increase in diameter of auditory cortical cells on other hand kanamycin led to highly significant decrement in size of cells of same region. Preferential affinity and differential effects were noticed. The latter throws some clues about mechanism of action.
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Introduction: Mosquito coils are the most preferred anti-mosquito products in many households of Asian countries like India. Short-term exposure to allethrin has been reported to cause toxic effects on respiratory system. Subjects and Methods: Thirty albino rats were divided into five groups (A, B, C, D, and E) of six animals each. Except group A (Control) rest (Group B-E) were exposed to mosquito coil smoke for 4, 6, 8 and 10 weeks respectively. Blood from all the animals was processed to estimate TLC (Total leucocyte count) and results thus attained were analysed using one-way ANOVA test. Rats were sacrificed to procure lung tissue, which was processed by paraffin embedding to obtain haematoxylin and Eosin stained sections. Results: There was significant increase (p value, 0.001) in TLC in all experimental groups compared to control ones. Conclusion: Degenerative changes were obtained in lung tissue of all experimental rats with maximum effect in group Adequate measures should be taken to ensure minimal exposure to coil smoke during domestic use.
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Introduction: Mosquitoes have long been identified as the main vectors of many human and animal diseases like West Nile fever, malaria, dengue, etc. Mosquito coils are the most preferred mosquito repellent products used especially in low-income communities, due to cheap price. The most common active ingredients in mosquito coils pyrethroids, are known to cause nephrotoxicity and,haematoxicity. However substantial data is lacking on the effects of mosquito coils containing d-trans allethrin. Subjects and Methods: In this study we report the histological and haematological effects of smoke from such coil on albino rat (Wistar). The study was performed on Thirty albino rats divided into five groups (A, B, C, D, E) of six animals each. Control group A we left unexposed to coil smoke while rest (B-E) were exposed for 4, 6,8,10 weeks respectively. Results: We observed a statistically significant increase in the levels of serum urea and creatinine in experimental groups C, D and E. Levels of serum sodium and potassium remained unaffected in the experimental animals. Histopathological studies on kidneys revealed generalised degenerative changes proportional to quantity of coil smoke exposure. Conclusion: General human masses should be made aware about such possible hazards and adequate measures should be taken to ensure minimal exposure to coil smoke during domestic use
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Background: Choosing an appropriate Drug Delivery System (DDS) influences the acceptability, adherence and better outcome of the therapy in the patients. The present study was planned to evaluate the second year MBBS students on standardized patients (SP) using Group Objective Structured Clinical Encounters (GOSCE) after content delivery by traditional power point class versus experiential teaching methodology.Methods: DDS practical class was held in two larger groups after adding two odd sub-groups (1+3) as ‘A’ (64 students) and even sub-groups (2+4) as ‘B’ (66 students). The formative GOSCE evaluation was done 2 weeks after the classes by the trained physician examiners as per the Medical Council of Canada pre-determined scoring instruments.Results: The average magnitude of change in GOSCE scoring is extremely statistical significant on t-test (P< 0.0001) in favour of experiential teaching methodology for all the skills. The statistical significant percentage of students were able to extract the treatment history in respect of eliciting problem, reasons for non-compliance, methods of intake, explain the technique and showed the courteous professional behaviours.Conclusions: The clinical cases as SP in pharmacology teaching for developing competency based communication skills and GOSCE are the appropriate methodology for evaluation of large student group for experiential DDS training.
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Previously believed to solely play a supportive role in the central nervous system, astrocytes are now considered active players in normal brain function. Evidence in recent decades extends their contributions beyond the classically held brain glue role; it's now known that astrocytes act as a unique excitable component with functions extending into local network modulation, synaptic plasticity, and memory formation, and postinjury repair. In this review article, we highlight our growing understanding of astrocyte function and physiology, the increasing role of gliotransmitters in neuron-glia communication, and the role of astrocytes in modulating synaptic plasticity and cognitive function. Owing to the duality of both beneficial and deleterious roles attributed to astrocytes, we also discuss the implications of this new knowledge as it applies to neurological disorders including Alzheimer disease, epilepsy, and schizophrenia.
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Adhesives , Alzheimer Disease , Astrocytes , Brain , Central Nervous System , Cognition , Epilepsy , Memory , Nervous System Diseases , Neuronal Plasticity , Physiology , SchizophreniaABSTRACT
The fracture of complete dentures constitutes a challenge and remains an unresolved problem. A midline fracture of single maxillary complete denture base especially in patients who have retained their natural mandibular teeth is an inevitable problem. Several factors have been attributed for the midline fracture including flexural fatigue resulting from cyclic deformation and those which exacerbate the deformation of the base or alter its stress. The present case report deals with oral rehabilitation of completely edentulous maxillary arch by incorporating metal denture base in place of the conventional Poly Methyl Methacrylate material to improve the longevity of the prosthetic replacement, at the same time prevent resorption of the underlying residual maxillary ridge.
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Type 2 diabetes mellitus [DM] is one of the major global health challenges of the 21st century. Owing to their diversified metabolic characteristics and functions, various metals such as zinc [Zn], copper [Cu], chromium [Cr], manganese [Mn], iron [Fe], and magnesium [Mg] are considered to be essential for human health. Deficiency of some essential trace elements may lead to the development of DM. The present study aimed to evaluate the contents of Zn, Cu, Cr, Mn, and Mg in the scalp hair samples of patients with type 2 DM from Jeddah [Saudi Arabia]. The hair samples were collected from 55 patients with DM aged 45-65 years. Also, 55 age-matched nondiabetic healthy subjects were selected from the same city for a comparative analysis. Zn, Cr, Mn, and Mg levels in hair were found to be significantly lower [P < 0.05] in the group of patients with type 2 DM than in nondiabetic subjects. However, the Cu level in hair was significantly higher [P < 0.05] in patients with type 2 DM than in nondiabetic subjects. The results revealed that hair Cu concentrations in patients with DM were positively related to body mass index [BMI], whereas Zn, Cr, Mn, and Mg concentrations were inversely related to BMI. Finally, the concentrations of these trace elements in the scalp hair and serum samples of patients with DM were compared
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Liver transplantation [LT] is the treatment of choice for localized hepatocellular carcinoma [HCC] associated with cirrhosis. Extra hepatic metastasis is the most common cause of death in these patients. There is very little evidence regarding the natural history and treatment options for patients developing HCC recurrence after LT
Surgical resection offers a unique opportunity for solitary metastasis
We report a 61 year old male with solitary right adrenal metastasis 15 months post LT which was managed with open adrenalectomy. The patient is alive and disease free 24 months after the surgery. The case, histo-pathological findings and literature review is discussed
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The present study aimed to investigate the association of serum and urine magnesium [Mg] levels of the patients living in Jeddah, Saudi Arabia, with type 2 diabetes mellitus [T2 DM] without complications. The effect of Mg deficiency on the prevalence of DM and its related complications has received great attention. Serum and urine Mg, fasting serum glucose [FSG], glycated hemoglobin [HbA1c], and urine creatinine [Creat] levels were determined in 68 diabetic subjects and 62 age-matched nondiabetic subjects [controls] using auto-analyzer and atomic absorption spectrometer. Body mass indices [BMI] of the subjects were also determined. The serum Mg levels in the patients with T2 DM were significantly lower than that in controls. BMI and the levels of FSG, HbA1c, and urine Mg were significantly higher and urine Creat level lower in diabetic subjects compared with nondiabetic subjects. Significantly lower serum Mg and significantly higher urinary Mg levels were observed in diabetic subjects with poor glycemic control [HbA1c >7%] compared with the nondiabetic population. The present correlation study revealed a highly significant correlation between FSG and HbA1c [r = 0.846, P = 0.000]. Aging and increasing duration of DM alter the metabolism of Mg by decreasing its serum concentration and increasing its urinary excretion. This study also showed a significant negative association between serum Mg and FSG [r = -0.408, P = 0.039 and HbA1c [r = -0.478, P = 0.043]. Also, a significant negative association was observed between serum Mg and age of both patients with T2 DM [r = -0.787, P = 0.044] and controls [r = -0.798, P = 0.041]. Again, a significant negative correlation [r = -0.452, P = 0.018] was observed between serum Mg and urine Mg levels of the diabetic population of the study. DM and poor glycemic control alter the metabolism of Mg by increasing its urinary excretion and lowering its serum levels. Its clinical implications were discussed in this study
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Aims: The study was conducted to investigate the frequently encountered allergenic pollen grains in the environment of Riyadh, Saudi Arabia as well as to determine their seasonal and annual growth pattern in the region. Study Design: Volumetric air sampling of two City sites with qualitative and quantitative comparison of data on seasonal and diurnal concentrations of weed pollen aeroallergens. Place and Duration of Study: The work was conducted in the capital City of Riyadh, Saudi Arabia and the sampling was conducted for a continuous 12 month period from January to December 2012. Methodology: Using two Burkard 7-Day Volumetric Air Sampler, airborne pollen grain for two sites in Riyadh City (City Center site in the middle of City) and Riyadh airport site (40 km away from the city) was studied. The data were collected for at least 12 months period in both sites. Results: The pollen grains from grasses, weeds and trees were identified. However, the weeds pollen dominated the pollen flora by a ratio of 70% followed by trees 20%, and grasses 10%. The major weeds pollen identified were: Amaranthus viridis, Artemisia monosperma, Atriplex nummularia, Chenopodium murale, Plantago boissieri, Ricinus communis, Rumex vesicarius and Salsola imbricata. Riyadh City Center site constituted higher percentage of total weeds (69%) compared to Riyadh airport site (31%). Conclusion: Seasonal periodicities of major allergens, reveal a trend that would help allergists and allergic patients for diagnosis and prevention.
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Objective: The aim of this cross-sectional study in Central District of Karachi [CDK] was to assess the prevalence of oral soft tissue lesions and to investigate associations which may exist between oral conditions and Betel nut [BN] chewing among the young school goingchildren
Study Design: Cross-Sectional Study
Place and Duration of Study: This study was conducted at Dental Department, Baqai University, Karachi, from April 2011 to July 2011
Materials and Methods: Questionnaire based research was conducted. Three hundred and sixty students from 17 different schools participated in the study. The mean age was 13.86 +/- 1.2 years with the age range of 12 to 16 years. Out of these 360 students, 175 were females and 185 were males
Results: The results showed a high prevalence of the pre-cancerous lesion, oral submucous fibrosis among BN chewers [BNC] compared to non-chewers [NBNC][19% and 3% respectively]. The high prevalence of BN chewing [59% of the low socio-economic young population studied] should be addressed at local and government level through support for effective preventive programs and health promotion campaigns
Conclusion: Promotion of oral health and eradication of BN chewing are important goals for the prevention of oral cancer among this population
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Nonmuscle invasive (NMI) urothelial cancer (UC) is associated with varied biological potential. It is characterized by frequent recurrence and progression, which thus worsens the oncological outcome. Nearly three-quarters of NMI UCs recur within 5 years, whereas half can progress during follow-up. Progression is particularly seen in T1 and carcinoma in situ (CIS). Undoubtedly, NMI UC is one of the most expensive cancers to manage. The European Organisation for Research and Treatment of Cancer (EORTC) risk calculator is a commonly used tool for assessing the recurrence and progression potential of a newly diagnosed cancer. The parameters used in the assessment are tumor size and number, pathological stage and grade of the cancer, presence of CIS, and prior recurrence rate. The main advantages of the EORTC tool are its ease of use and the lack of need to run expensive molecular tests. However, reproducibility of pathologic stage and grade is modest, which is a concern to clinicians. Molecular markers have potential for predicting the clinical outcome of NMI UC, given that clinico-pathologic variables are not sufficient for prediction of prognosis in an individual. Significant work has been done in the past 2 decades in understanding the molecular biology of bladder cancer; however, the translational value of this knowledge remains poor. The role for molecular markers in predicting recurrence seems limited because multifocal disease and incomplete treatment are probably more important for recurrence than the molecular features of a resected tumor. Urinary markers have very limited value in prognostication of bladder cancer and are used (mainly as an adjunct to cytology) for detection and surveillance of urothelial cell cancer recurrence. Prediction of progression with molecular markers holds considerable promise. Nevertheless, the contemporary value of molecular markers over clinico-pathologic indexes is limited.
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Humans , Age Factors , Biomarkers, Tumor/metabolism , Carcinoma, Transitional Cell/diagnosis , Disease Progression , Prognosis , Recurrence , Risk Assessment/methods , Urinary Bladder Neoplasms/diagnosisABSTRACT
To determine the medium and long-term outcome of orthotopic continent urinary diversion with ileal [Studer] neo-bladder following radical cystectomy. Case series. Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1998 to September 2010. Thirty eight patients underwent radical cystectomy for invasive bladder tumor with ileal neo-bladder [Studer type] reconstruction. Peri-operative and late complications, functional outcome of neo-bladder, urinary continence, metabolic and upper urinary tract status and overall survival were evaluated in all patients. A total of 29 patients [23 males and 6 females] with mean age of 59 +/- 12 years were included for the final analysis. The mean duration of surgery [both radical cystectomy and urinary diversion] was 520 +/- 70 minutes. Perioperative complication rate was 24% [n=7] with surgical site infection in 4 patients, sepsis in 1 patient and 2 had ureteroileal leak. At 6 months follow-up, 22 patients were fully continent while 7 patients had minimal stress / nocturnal incontinence. The continence rate was 93% [n=27] at one year follow-up. The mean capacity of neo-bladder at 6 months was 384 +/- 66 mLs. The late complication rate was 17% [n=5]. Three patients developed anastomotic stricture requiring transurethral incision of neo bladder neck, one formed stone in neo-bladder and one developed incision hernia. All patients had preserved renal functions on follow-up. The survival rate was 80% [n=23] at a median follow-up of 66.4 +/- 36 months. Two patients developed local recurrence and four developed distant metastasis. Studer ileal neo-bladder is a safe and effective option for urinary diversion in select patients with good oncological and functional outcomes comparable to contemporary literature, even in a low volume center
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Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.