[Effect of incorporating nano-hydroxyapatite and nano-zinc oxide into resin modified glass lonomer cement on metal bracket debonding]

Fluoride releasing adhesives are favorable for bracket bonding since they decrease the risk of demineralization around orthodontic brackets given that they provide acceptably high shear bond strength [SBS]. The aim of this study was to evaluate the SBS of resin-modified glass ionomer cements [RMGIC] reinforced by nano-zinc oxide [NZnO] and nano-hydroxyapatite [NHA] particles in comparison with composite resins.In this experimental study, 80 extracted human premolars were used. The teeth were randomly divided into 4 groups as follows: Group 1: Transbond XT as the control group, Group 2: RMGIC [Fuji II LC], Group 3: RMGIC with 5% NHA and Group 4: RMGIC with 2% NZnO. After enamel etching, brackets were bonded. The SBS was calculated for each group. The percentage of adhesive remained on the enamel was quantified by calculating the adhesive remnant index [ARI]. The data were analyzed using one-way ANOVA and the Kruskal Wallis test.According to the results of ANOVA, there were no significant differences in SBS of groups [P=0.075]. The mean SBS in groups 1 to 4 was 15.43 +/- 4.61, 14.95 +/- 4.34, 17.97 +/- 3.65 and 17.08 +/- 3.59 MPa, respectively. According to the Kruskal-Wallis test, there were no significant differences in degree of ARI among groups [P=0.413]. The SBS was similar among all groups and adding NZnO and NHA particles had no negative effect on SBS of RMGIC. In all groups, less than half the adhesive remained on the enamel after bond failure

Efeito da rotação da cabeça na pressão intraocular em decúbito ventral: estudo randomizado / The effect of head Rotation on intraocular pressure in prone position: a randomized trial / Efecto de la rotación de la cabeza en la presión intraocular en decúbito ventral: estudio aleatorio

JUSTIFICATIVA E OBJETIVOS: A elevação da pressão intraocular (PIO), que diminui a pressão de perfusão do nervo óptico, é aumentada pelo posicionamento em decúbito ventral. O objetivo de nosso estudo foi comparar o efeito da rotação lateral da cabeça a 45º em decúbito ventral no aumento da PIO de olhos posicionados para cima e olhos posicionados para baixo em pacientes submetidos à nefrolitotomia percutânea (NLPC). MÉTODOS: Quarenta e cinco pacientes foram randomicamente alocados em dois grupos. A PIO dos pacientes foi registrada bilateralmente em posição supina antes do início da operação. Os pacientes foram posicionados em decúbito ventral. A cabeça foi posicionada sobre um apoio sem compressão externa direta em ambos os olhos. Os pacientes do Grupo I foram estritamente mantidos em pronação neutra, enquanto os pacientes do Grupo II foram posicionados em pronação com rotação da cabeça a 45º para o lado direito. No fim da operação, os pacientes foram reposicionados em decúbito dorsal e a PIO foi imediatamente medida. RESULTADOS: Não houve diferença entre os dados demográficos, na duração da cirurgia, perda de sangue e reposição de líquido dos pacientes. Os valores pós-cirúrgicos da PIO em decúbito ventral aumentaram significativamente em comparação com os valores pré-operatórios em ambos os grupos (p < 0,05). Após a cirurgia em decúbito ventral, os valores da PIO nos olhos posicionados para cima no Grupo II foram significativamente menores do que no Grupo I e nos olhos posicionados para baixo no Grupo II (p < 0,05). CONCLUSÃO: A posição em decúbito ventral aumenta a PIO. Nos pacientes posicionados em decúbito ventral com rotação lateral da cabeça a 45º, a PIO nos olhos posicionados para cima foi significativamente menor.

BACKGROUND AND OBJECTIVES: The increased intraocular pressure (IOP) - which decreases perfusion pressure on the optic nerve - increases by prone positioning (1). The aim of our study was to compare the effect of head rotation 45o laterally in prone position on the increase in IOP of upper placed and lower placed eyes in patients undergoing percutaneous nephrolithotomy (PCNL). METHODS: Forty-five patients were randomly divided into 2 Groups. IOP of the patients were recorded bilaterally in supine position before the operation had started. Patients were turned to prone position. The head was placed on a prone headrest without external direct compression to both eyes. Patients in Group I were kept in strictly neutral prone position where as patients in Group II were placed prone with their heads rotated 45º laterally to the right side. At the end of the operation, patients were turned to supine position and their IOP was measured immediately. RESULTS: There was no difference related to demographics, duration of surgery, blood loss and fluid input data. IOP values after surgery in prone position increased significantly compared to preoperative values in both groups (p < 0.05). After surgery in prone position IOP values of the upper positioned eyes in Group II were significantly lower than Group I and lower positioned eyes in Group II (p < 0.05). CONCLUSION: prone positioning increases IOP. In patients with prone position with a head rotation of 45o laterally, IOP in the upper positioned eye was significantly lower.

JUSTIFICATIVA Y OBJETIVOS: La elevación de la presión intraocular (PIO), que disminuye la presión de perfusión del nervio óptico, es aumentada por el posicionamiento en decúbito ventral. El objetivo de nuestro estudio, fue comparar el efecto de la rotación lateral de la cabeza a 45o en decúbito ventral en el aumento de la PIO de ojos posicionados hacia arriba y ojos posicionados hacia abajo en pacientes sometidos a la nefrolitotomia percutánea (NLPC). MÉTODOS: Cuarenta y cinco pacientes fueron aleatoriamente divididos en dos grupos. La PIO de los pacientes fue registrada bilateralmente en posición supina antes del inicio de la operación. Los pacientes fueron posicionados en decúbito ventral. La cabeza fue posicionada sobre un apoyo sin compresión externa directa en ambos ojos. Los pacientes del Grupo I fueron estrictamente mantenidos en pronación neutra, mientras que los pacientes del Grupo II fueron posicionados en pronación con rotación de la cabeza a 45º hacia el lado derecho. Al final de la operación, los pacientes fueron reposicionados en supinación y la PIO fue inmediatamente medida. RESULTADOS: No hubo diferencia entre los datos demográficos, la duración de la cirugía, la pérdida de sangre y la reposición de líquido de los pacientes. Los valores postquirúrgicos de la PIO en decúbito ventral aumentaron significativamente en comparación con los valores preoperatorios en ambos grupos (p < 0,05). Después de la cirugía en decúbito ventral, los valores de la PIO en los ojos posicionados hacia arriba en el Grupo II fueron significativamente menores que en el Grupo I y en los ojos posicionados hacia abajo en el Grupo II (p < 0,05). CONCLUSIONES: La posición en decúbito ventral aumenta la PIO. En los pacientes posicionados en decúbito ventral con rotación lateral de la cabeza a 45o, la PIO en los ojos posicionados hacia arriba fue significativamente menor.

Deployment of inferior vena cava filters; efficacy and safety

Objective: to study the patient's profile, indications and procedural success of placement of Inferior Vena Cava [IVC] filters at AFIC/NIHD Rawalpindi, Pakistan

Design: a retrospective observational study

Place and Duration of Study: the patients were studied in the department of Interventional Cardiology of AFIC/NIHD from May 2004 to Jun 2005

Material and Methods: 16 patients of either sex who revealed clinical and investigative evidence of recurrent pulmonary embolism [PE] due to deep vein thrombosis [DVT] of lower limbs were selected. All efforts including history, physical examination and laboratory investigations were carried out in order to ascertain the etiology. A note was made of the associated conditions, past and family history of DVT and PE. IVC filter was deployed through femoral vein in all patients as a lifesaving treatment modality. The procedure was uncomplicated and all patients had smooth post procedural recovery

Results: through femoral vein, IVC filters [Trap Ease Cordis J and J] were successfully deployed below the renal veins. In one patient, another filter was deployed immediately below the tricuspid valve

Conclusion: IVC filter placement is a simple, safe and effective procedure in stabilizing patients who have recurrent pulmonary embolism

proposed study frisk factors of heart disease in rural population of Punjab [Pakistan] - time to act!

In Pakistan, not only the urban but also the rural population has a high-risk potential for cardiovascular diseases [CVD]. However, unfortunately the identification of risk factors in the rural population and the rural health education regarding CVDs has not been a hallmark of our health promoting efforts. Actually, there is little population-based data available in Pakistan

Now is the time to focus our attention and resources on the identification and the prevalence of major risk factors like tobacco consumption, hypertension and obesity in our rural population, which constitutes more than half of the country's population. A pilot project is designed to fulfill the need of the hour. Moreover, various strategies and methodologies are recommended for the prevention and control, thereby emphasizing upon the fact that "PREVENTION IS BETTER THAN CURE"

[Comparison of the efficacy of two combinations; sodium valproate with lithium and sodium valproate with olanzapine treatment of acute mania]

Acute mania is a psychiatric emergency state that often requires rapid management. There are many different therapeutic protocols for this emergent situation. One of them is combination of moodstabilizers and antipsychotics. Olanzapine which is now available in our country can be used for this purpose. In this study, we compared the effectiveness, rapidity of response and side effects of sodium valproate plus olanzapine [group I] with sodium valproate plus lithium [group II] in acutely manic or mixed bipolar patients. In this randomized, double blind, parallel group study, 44 acutely manic or mixed patients according to DSM IV-TR criteria were randomly assigned to receive combinations of sodium valproate [20mg/kg per day] with either olanzapine [5-15mg/day] or lithium [900mg/day] during a ten-day course. Efficacy was measured with Young Mania Rating Scale [YMRS]. Effectiveness measures included YMRS response [YMRS reduction >/= 50%] and YMRS remission [YMRS<=12]. Data was entered in SPSS11 software program and analyzed by Mann-Whitney, Fisher exact test and Wilcoxon tests [P-values < 0.05 were significant]. Total number of patients were 44 [mean age 27.18 +/- 7.34], 21 in group I and 23 in group II. Response rate was 85.7% [18 patients] and 73.9% [17 patients] in group I and II, respectively; with no significant differences between the two groups[P=0.33]. Remission rate was 42.9%[9 patients] and 43.5% [10 patients] in group I and II, respectively; with no significant differences between two groups[P=0.97]. The reduction in total scores in YMRS on the 2nd, 7th and 10th days of study were significant in both groups [P<0.05], but the rapidity of response was similar. The rates of adverse effects between two groups were not statistically significant. Both combinations of drugs were effective in acutely manic or mixed patients. Both treatments were safe and well tolerated

Effect of single cell protein as a protein source in Drosophila culture

The effects of biomass of Phanerochaete chrysosporium at various concentrations (1; 2.5; 5; 10; 25; 50; 75 and 100 percent) on the growth of Drosophila melanogaster have been investigated. Biomass was used as a protein source instead of corn flour in Standard Drosophila Medium (SDM). It was seen that it causes increments in both body size of larvae and the numbers of offsprings, specially at higher concentrations (50, 75 and 100 percent) at the application of 100 percent concentration, metamorphosis accelerated and was completed one day before the control. There were phenotypic abnormalities in both control (0.64 percent) and applications with low concentrations (0.02-0.19 percent), while they were not observed at the application of 100 percent concentration.

Boltulismo en una lactante / Boltulism in an infant

Se describe el caso de una paciente de 2 meses de edad, sin antecedentes mórbidos. Sus manifestaciones clínicas consistieron en constipación, rechazo alimentario e hipotonía agregándose luego dificultad respiratoria progresiva, diplejía facial y pupilas hiporreactivas. Se descartó una enfermedad metabólica e infecciosa. La punción lumbar fue normal y la TAC cerebral normal. La electromiografía fue sugerente de botulismo certificándose el diagnóstico con detección de toxina botulínica tipo A en deposiciones. Requirió ventilación mecánica por 37 días. Presenta mejoría espontánea dándose de alta a los 98 días de hospitalización con hipotonía leve

High altitude pulmonary edema in the Karakorums

Seventy nine subjects who were acclimatised to a height of 7000 feet [average duration 4Ll months] were investigated. Out of these 12 were control subjects [Group 1] and 67 were those who had developed high altitude pulmonary oedema [Group 2]. Both groups were investigated at Rawalpindi [1500 feet] within three weeks of their arrival. Clinical examination, chest X-ray, ECG, 2D echocardiogram, haematological tests and pulmonary functions were normal. On exercise testing the blood pressure response was exaggerated in Group 2 compared to Group 1 [P <0.01]. Cardiac catheterisation [performed in 7 subjects in Group 1 and 22 subjects in Group 2] revealed no difference in the resting intracardiac pressures. With cold pressor test the pulmonary artery and aortic pressures rose significantly in Group 2 as compared to Group 1[P <0.01 for both pulmonary artery and aortic pressure]. Repeat exercise testing and right heart catheterisation [performed in 5 subjects in Group 1 and 12 subjects in Group 2] 10-12 weeks after the arrival to Rawalpindi showed similar blood pressure and pulmonary artery pressures. It is concluded therefore that [a] pulmonary and systemic vascular beds are hyperrespoasive to exercise and cold in susceptible subjects and [b] the effect of acclimatisation vanish in 10-12 weeks in the susceptible group

High altitude pulmonary oedema - response to exercise and cold on systemic and pulmonary vascular beds

Fourteen subjects who were acclimatised to a height of 7000 feet [average duration 3 +/- months] were investigated. Five were normal subjects [Group I] and 9 were those who developed high altitude pulmonary oedema [Group 2]. At the National Institute of Heart Diseases, Rawalpindi, clinical examination, chest X-ray, electrocardiogram, haematological tests, thyroid functions, echocardiography and lung function tests were normal. During exercise testing the blood pressure response was exaggerated in Group 2 compared to Group 1 [P < 0.01]. Cardiac catheterisation revealed no significant difference in the intracardiac pressures in the resting state in the two groups [P = NS]. With cold pressor test the pulmonary pressure and aortic pressure rose significantly in Group 2 as compared to Group 1 [P < 0.01]. It is suggested, therefore, that pulmonary and systemic vascular beds are hyper-responsive to cold in the susceptible subjects [Group 2]. This phenomenon may be further aggravated by exertion, hypoxia, and other undetermined factors in producing pulmonary oedema