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)

Comparison of the modified lateral position and prone position techniques in percutaneous nephrolithotomy

Objectives: To evaluate the feasibility, operative time, efficacy and safety of the modified lateral position in percutaneous nephrolithotomy [PCNL] for renal calculi, comparing it with the standard prone position PCNL

Material and Method: The patient is placed with the thorax in the lateral position and the pelvis in an oblique position. Then the lower limbs are split and bent in the lowest position. Initial placement of a retrograde ureteral catheter, tract formation, stone fragmentation and retrieval, and optional extra procedures were accomplished with the patient in the same position

Results: The study comprised 82 patients; 29 in split-leg modified lateral position [SL-MLP] group and 53in conventional prone position [PP] group. Three patients [all in PP group] underwent sequential bilateral percutaneous nephrolithotomy [PNL] during the study period and each procedure was considered as an independent case. So, the studied cases, according to the number of PNL procedures, were 85; 29 in SL-MLP group and 56 in PP group

Conclusions: split-leg modified lateral position in percutaneous nephrolithotomy [SL-MLP PNL] has significantly lower operative time compared with conventional PP PNL. The stone free rate, need for ancillary procedures and complication rate were equal in both groups

The Median Time to Develop Recurrent Tuberculosis at a Tertiary Hospital in Kota Bharu, Kelantan, Malaysia.

This study has the intention to determine the median time to develop recurrent tuberculosis [TB] in TB patients attending the Chest Clinic at Hospital Raja Perempuan Zainab II [HRPZ II], Kelantan, Malaysia. Records of 114 recurrent TB patients from 1/1/2003-31/12/2009 were analyzed. Kaplan-Meier analysis was used to examine the median time for recurrence of TB. The overall median time to develop TB recurrence in registered TB recurrent patients was six months [95%CI: 4.58, 7.42] after the previous episode. It was found that recipients of Streptomycin (S), Isoniazid (H) and Rifampicin (R) twice weekly (S2H2R2) drug regimen [p=0.026] or daily HR drug regimen [p=0.049] during the continuation phase took a longer duration to develop recurrent TB than non-recipients of these medicines by Kaplan-Meier analysis. Moreover, there also existed a significant time difference [P = 0.006] between the defaulters and non-defaulters of treatment to develop recurrent TB. Patients should take the complete course of therapy, to reduce recurrent TB infection. The drug regimens must contain the two most potent first line drugs Isoniazid [H] and Rifampicin [R] during the continuation phase.

coexistence of dual form of malnutrition in a sample of rural Malaysia

The co-existence of under and over nutrition might be influenced by a marked shift in dietary and lifestyle practices of people in developing countries. This study aims to identify the factors associated with the occurrence of a dual form of malnutrition in the same households in a rural district in Peninsular Malaysia. This study was conducted in two phases. The first phase involved a survey of 223 mother-child pairs that fit the required criteria [223 non-pregnant, non-lactating mothers aged 18 to 55 years old and 223 children aged 2 to 12 years old]. Anthropometric indices: Weight-for-age Z score [WAZ] /= 25 kg/m2 was used to measure overweight status among mothers. The results showed that the prevalence of overweight mother/underweight child [OWM/UWC] pairs was 66 [29.6%], and that the prevalence of normal weight mother/normal weight child [NWM/NWC] pairs was 34 [15.2%]. The second phase of the study involved a case-control comparison of the 66 OWM/UWC pairs and the 34 NWM/NWC pairs. A pre-tested questionnaire was used to gather socio-economic-demographic data, whereas food frequency questionnaire was used to assess diet diversity. The results indicated that 61.0% of the children were underweight and 61.4% were stunted, whereas the prevalence of overweight and obesity in women were 35% and 17%, respectively. The study did not report any association between the dual burden of malnutrition and household size, number of children, educational level of the mother, total income, income per capita, and food expenditure. The only association reported was with household type [OR: 5.01; 95% CI; 63, 15.34; P = 0.005]. In general, the total diet diversity score of both types of mother-child pairs was low. Compared with overweight mothers, normal weight mothers had a higher diet diversity score for at least six food groups and for the total diet diversity score, although these differences were not significant. The clustering of dual forms of malnutrition in the same household poses big challenges for food intervention programs. Although, this study cannot make an inference for the whole population, the results shed light on a serious public health issue that must be addressed

Factors affecting hemagglutination activity of avian influenza virus subtype H5N1

Hemagglutination [HA] and hemagglutination inhibition [HI] tests for avian influenza [AI] virus [H5N1] were standardized using varying various factors like erythrocytes from different species, type of diluent, incubation temperature and incubation period. The virus was peropagated in embryonated chicken eggs [9-11 days]. The allantoic fluid [AF] was harvested 36 hours post incubation and was confirmed by slide hemagglutination test. The maximum HA titres were obtained using 1% RBCs of chicken, sheep, duck, geese, pigeon, quails and turkey for 30-40 minutes. The haemagglutination activity showed best titer when used phosphate buffer saline than normal saline and also when incubated at 25[degree sign] C instead of 37[degree sign] C

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

National response to neurological diseases in Malaysia: planning for the future.

The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.

Serum leptin concentration and insulin resistance in women with preeclampsia

The objective of this study was to investigate whether maternal serum leptin levels are greater in women with preeclampsia than in matched normal pregnant women and whether serum leptin levels in these women are related to fasting insulin levels. Levels of fasting serum leptin, insulin and glucose were compared in the 3 groups of women with either preeclampsia [n = 30] or matched normal pregnant women [n = 30]. Maternal leptin levels were significantly elevated in preeclamptic women compared to normal pregnant women. Serum leptin levels in severe preeclamptic group were also significantly higher than those in the mild preeclamptic group. While, there was a statistically significant difference in the mean insulin preeclamptic women and normal pregnant women. The mean serum glucose level had no significant difference in the preeclamptic women compared to the normal pregnant women. A significant positive correlation was found between the serum leptin and fasting serum insulin levels