ABSTRACT
BACKGROUND@#Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. @*METHODS@#To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. @*RESULTS@#Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction.Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/ without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. @*CONCLUSION@#PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.
ABSTRACT
BACKGROUND@#Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. @*METHODS@#To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. @*RESULTS@#Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction.Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/ without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. @*CONCLUSION@#PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.
ABSTRACT
Background and Objective: Short stature is defined as height below 3[rd] centile. Causes of short stature can range from familial, endocrine disorders, chronic diseases to chromosomal disorders. Most common cause in literature being idiopathic short stature. Early detection and management of remedial disorders like malnutrition and vitamin D deficiency, Endocrine disorders like growth hormone deficiency and hypothyroidism can lead to attainment of expected height. Pakistani data shows idiopathic short stature as the most common cause of short stature. Our study aimed at detecting causes of short stature in children/adolescents at an Endocrine referral center
Methods: A retrospective study was conducted at WILCARE Center for Diabetes, Endocrinology and Metabolism, Lahore on 70 well-nourished children/adolescents. The patients had been evaluated clinically, biochemically and radiologically as needed. Biochemical testing included hormonal testing as well to detect endocrine causes. Data was entered and analyzed in SPSS 20.0
Results: Leading cause of short stature in our population was Growth Hormone [GH] deficiency seen in 48 out of 70 [69%] patients. Second most common endocrine abnormality seen in these patients was Vitamin D deficiency [44 out of 70 patients [63%]]. Primary hypothyroidism; pan-hypopituitarism and adrenal insufficiency were other endocrine causes. The weight for age was below 3rd percentile in 57 [81%] patients, with no association with other major causes
Conclusion: Growth hormone and Vitamin D deficiency constitute one of the major causes of short stature among well-nourished children with short stature in Pakistan
ABSTRACT
Aims: The prevalence of heart failure with preserved ejection fraction [HFpEF] has increased in the past two decades. Although it has been demonstrated that left ventricular [LV] diastolic and vascular functional abnormalities are generally observed in HFpEF, it remains to be clinically elucidated how an asymptomatic stage progresses to symptomatic HFpEF. We aimed to identify risk factors associated with incident HFpEF and to compare it with systolic heart failure [SHF]
Methods and Results: The study included 100 patients of heart failure, 50 patients were having ejection fraction /=50%. We included patients of heart failure who were admitted in coronary care unit of services hospital Lahore or they had more than one visit to the outpatient clinic of services hospital Lahore and had en echocardiographic report recorded. Patients with serum creatinine >/= 2.0 mg/dL and patients with significant valvular heart diseases were excluded from the study. Mean age of patients was 53 +/- 9Y. Mean hemoglobin of patients was 11+/-2g/dl.62% patients were smokers and 38% were nonsmoker. 57% patients were female and 43% were male. 63% of all patients were suffering from coronary artery disease and 37% patients were not.66% patients were obese and 34% patients were not obese. 65% patients were suffering from Diabetes mellitus and 35% patients were not. 54% patients were hypertensive and 46% patients were not suffering from hypertension. 43% patients had restrictive dysfunction on echocardiography and 43% patients had non restrictive pattern on echocardiography. Among those with EF>/= 50 80% patients were smokers and 20% were non smokers [P=>0.00]. 75% patients of EF>/= 50 were female and 25% patients were male [P=0.001]. 35% patients were diabetics and 65% patients were non diabetics. [P=9] 65% patients were hypertensive and 35% patients were not. [p=0.028]. 36% patients were suffering from coronary artery disease and 65% patients were not suffering from coronary artery disease [P=0.00]. 46% of these patients were having restrictive echocardiographic abnormalities on mitral valve inflow interrogation [p=0.00]. 26% of these patients were obese [P=0.00]. Multiple logistic regression analysis revealed that obesity, female gender, age, smoking, and impaired LV compliance and history of hypertension were independently associated with the prevalence of HFpEF whereas anemia and diabetes mellitus was not
Conclusions: Female gender, history of hypertension, age, smoking and obesity was independently associated with the prevalence of HFpEF whereas anemia diabetes mellitus was not
ABSTRACT
Objective: to determine the relationship of C- reactive protein with essential hypertension at 1st presentation and effect of angiotensin-11 receptor blockade on micro-inflammation
Material and Methods: twenty healthy controls and forty patients of stage 1 and stage 2 essential hypertension diagnosed at their 1st presentation at outpatient department of Services Hospital Lahore was studied. Blood of all patients was checked for CRP at 1st presentation and at the end of twelve weeks. Patients were divided in two groups A and B, group A received valsartan 80 to 160 mg per day and group B received amlodipine 5 to 20 mg per day. None of the patients required additional antihypertensive therapy
Results: the mean change in hsCRP was 0.09 mg/L among those allocated to amlodipine compared with 0.08 mg/L among those allocated to valsartan. When the means of hsCRP were compared in three groups, it was found that initial hsCRP levels were high in hypertensive group and after twelve week treatment with antihypertensive medicines there was significant drop in hsCRP levels [p<0.05]. Within the groups neither amlodipine nor valsartan showed the individual benefit on each other [p>0.05], both of them were equally effective in reducing hsCRP. No relationship was observed between hsCRP change and change of blood pressure
Conclusion: it is concluded that C-reactive protein is high in hypertensive patients and adequate control of blood pressure is required to prevent the vasculature from atherosclerotic damage