Building the health-economic case for scaling up the WHO-HEARTS hypertension control package in low- and middle-income countries / Argumentos de la economía de la salud para ampliar las medidas de control de la hipertensión de la iniciativa HEARTS de la OMS en los países de ingresos medianos y bajos / Ampliação do pacote de controle da hipertensão OMS-HEARTS em países de baixa e média renda: argumentos a partir da perspectiva da economia em saúde

ABSTRACT Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in low- and middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an average <US$ 5 per patient per year in the public sector. This health economic evidence will make a compelling case for government ownership and financial support for national scale hypertension control programs.

RESUMEN En general, los programas de control de la hipertensión son costo-eficaces, incluso en los países de ingresos bajos y medios. Aun así, es poco probable que los gobiernos nacionales y la sociedad civil apoyen los programas de control de la hipertensión a menos que se demuestre su valor en términos de beneficios para la salud pública, impacto presupuestario y valor de la inversión para el contexto individual del país. La Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) implementaron la iniciativa HEARTS, un enfoque mundial estandarizado y simplificado para el control de la hipertensión, que incluye los medicamentos antihipertensivos y los dispositivos de medición de la presión arterial de preferencia. El objetivo de este estudio es informar sobre los estudios en el ámbito de la economía de la salud relativos al costo de las medidas de control de la hipertensión previstas en HEARTS (especialmente, de los medicamentos), la costo-efectividad y el impacto presupuestario, así como describir los modelos matemáticos diseñados para traducir los datos de este programa en un enfoque óptimo para la prestación y el financiamiento de los servicios de atención de la hipertensión, especialmente en países de ingresos medianos y bajos. Los primeros resultados indican que las intervenciones de HEARTS para el control de la hipertensión son de bajo costo o costo-eficaces, que el conjunto de medidas HEARTS es asequible, a un precio que oscila entre US$ 18 y US$ 44 al año por paciente tratado, y que los medicamentos antihipertensivos podrían tener un precio lo suficientemente bajo como para alcanzar un estándar medio mundial de <US$ 5 por paciente al año en el sector público. Estos datos del ámbito de la economía de la salud serán argumentos convincentes para que los gobiernos se involucren en los programas de control de la hipertensión a escala nacional y les brinden apoyo financiero.

RESUMO Geralmente, os programas de controle de hipertensão são custo-efetivos, inclusive em países de baixa e média renda, mas os governos dos países e a sociedade civil provavelmente não apoiarão tais programas a menos que demonstrem valor em termos de benefícios à saúde pública, impacto orçamentário e retorno sobre o investimento no contexto individual do país. A Organização Mundial da Saúde (OMS) e a Organização Pan-Americana da Saúde (OPAS) criaram a Global HEARTS, uma abordagem padrão e simplificada ao controle da hipertensão arterial, que inclui medicamentos anti-hipertensivos preferidos e dispositivos para aferição da pressão arterial preferidos. O objetivo deste estudo é relatar os estudos de economia em saúde que analisaram o custo (especialmente custos de medicamentos), custo-benefício e impacto orçamentário do pacote HEARTS para controle da hipertensão e descrever modelos matemáticos elaborados para traduzir os dados do programa de controle de hipertensão em uma abordagem ideal para a prestação e financiamento de serviços de atenção às pessoas com hipertensão, especialmente em países de baixa e média renda. Os primeiros resultados sugerem que as intervenções HEARTS para controle da hipertensão são de baixo custo ou custo-efetivas, que o pacote HEARTS é acessível (custando de US$ 18 a 44 por pessoa tratada por ano) e que o preço dos medicamentos anti-hipertensivos poderia ser baixo o suficiente para atingir uma média global de <US$ 18 por paciente por ano no setor público. Estas evidências do campo da economia em saúde serão um argumento convincente para que os governos se responsabilizem por programas de controle de hipertensão em escala nacional e os dotem de recursos financeiros.

Comparison of three behavior modification techniques for management of anxious children aged 4–8 years

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6–11-year-old children during local anesthesia administration—a novel approach

BACKGROUND: The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6–11-year-old children during local anesthesia administration. METHODS: The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6–8 years while group 2 consisted of 15 children aged 9–11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. RESULTS: The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. CONCLUSIONS: The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

Experimental and iatrogenic poisoning by sodium selenite in pigs / Intoxicação iatrogênica e experimental por selenito de sódio em suínos

Following a case of iatrogenic selenium poisoning in a young pig, an experimental study was carry out. Sodium selenite was orally and parenterally administered to 13 pigs that were subdivided into three groups (G1, G2 and G3). The animals in groups G1 and G3 received sodium selenite intramuscularly (IM), G1 received a comercial formula, and G3 received sodium selenite mixed with distilled water at different dosages, and those in group G2 were fed commercial sodium selenite. Acute and subacute poisoning was observed in both groups, although the onset of clinical signs was slower in group G2. Only one pig (in group G1) that had received the highest dose showed a peracute course. Apathy, anorexia, dyspnea, vomiting, muscular tremors, proprioceptive deficit, ataxia and paresis of the hind limbs progressing to the front limbs evolving to tetraplegia were observed. Postmortem findings differed whether the animals received the injected (G1 and G3) or oral (G2) sodium selenite. The liver was moderately atrophic in some animals of G2. Some of the animals in groups G1 and G3 presented with lung edema. One pig in G3 had yellowish-brown areas in the ventral horns of the cervical intumescences of the spinal cord. The most important histological changes were present in the ventral horns of the cervical and lumbar intumescences of the spinal cord. In one animal, changes were present in the brainstem and mesencephalon. The initial lesion was a perivascular and astrocyte edema that progressing to lysis and death of astrocytes and neurons. In the chronic stage of the lesions, there were extensive areas of liquefaction necrosis with perivascular lymphocytic and histiocytic infiltration and occasional eosinophils. It seems that disruption of the blood-brain barrier due to astrocyte edema is the most likely mechanism of CNS lesion.(AU)

A partir de um caso de intoxicação iatrogênica por selenito de sódio injetável em suíno verificaram-se alguns aspectos patogenéticos não esclarecidos, o que ensejou o estudo experimental. Selenito de sódio foi administrado pelas vias oral e parenteral a 13 suínos, subdivididos em três grupos (G1, G2 e G3). Os grupos G1 e G3 receberam selenito de sódio por via intra-muscular (IM); (G1 - fórmula comercial e G3 - selenito de sódio misturado à água destilada, em diversas dosagens) e o grupo G2, por via oral (VO), misturado à ração. Quadros de evolução aguda e subaguda foram observados em todos os grupos, embora o início dos sintomas tenha sido mais lento no grupo G2. Um único porco (do grupo G1), que havia recebido a dose mais alta, apresentou evolução superaguda. Apatia, anorexia, dispneia, vômito, tremores musculares, déficit proprioceptivo, ataxia e paresia dos membros posteriores com progressão para os anteriores e evolução para tetraplegia foram observados. Os achados de necropsia foram diferentes entre os animais que receberam o selenito de sódio injetável (IM - G1 e G3) e oral (G2). Havia moderada atrofia hepática em alguns animais do G2. Parte dos animais dos grupos G1 e G3 apresentaram edema pulmonar. Em um suíno (G3) notaram-se áreas marrom-amareladas nos cornos ventrais da intumescência cervical. As alterações histológicas mais importantes ocorreram nos cornos ventrais do "H" medular das intumescências cervical e lombar. Em um animal, as alterações envolviam o tronco cerebral e o mesencéfalo. Inicialmente, a lesão caracterizava-se por edema perivascular e astrocitário que progredia para lise e necrose de astrócitos e neurônios. O estágio crônico das lesões caracterizava-se por extensas áreas de necrose liquefativa e infiltração perivascular linfocítica e histiocítica, com raros eosinófilos. Sugere-se que a ruptura da barreira hematoencefálica por edema astrocitário seja o mecanismo mais provável da lesão no SNC.(AU)

Composition and distribution of the health workforce in India: estimates based on data from the National Sample Survey.

Background: The availability of reliable and comprehensive information on the health workforce is crucial for workforce planning. In India, routine information sources on the health workforce are incomplete and unreliable. This paper addresses this issue and provides a comprehensive picture of India’s health workforce. Methods: Data from the 68th round (July 2011 to June 2012) of the National Sample Survey on the Employment and unemployment situation in India were analysed to produce estimates of the health workforce in India. The estimates were based on self-reported occupations, categorized using a combination of both National Classification of Occupations (2004) and National Industrial Classification (2008) codes. Results: Findings suggest that in 2011–2012, there were 2.5 million health workers (density of 20.9 workers per 10 000 population) in India. However, 56.4% of all health workers were unqualified, including 42.3% of allopathic doctors, 27.5% of dentists, 56.1% of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners, 58.4% of nurses and midwives and 69.2% of health associates. By cadre, there were 3.3 qualified allopathic doctors and 3.1 nurses and midwives per 10 000 population; this is around one quarter of the World Health Organization benchmark of 22.8 doctors, nurses and midwives per 10 000 population. Out of all qualified workers, 77.4% were located in urban areas, even though the urban population is only 31% of the total population of the country. This urban–rural difference was higher for allopathic doctors (density 11.4 times higher in urban areas) compared to nurses and midwives (5.5 times higher in urban areas). Conclusion: The study highlights several areas of concern: overall low numbers of qualified health workers; a large presence of unqualified health workers, particularly in rural areas; and large urban–rural differences in the distribution of qualified health workers.

Comparative study to evaluate the accuracy of polyether occlusal bite registration material and occlusal registration wax as a guide for occlusal reduction during tooth preparation.

Introduction: The use of different materials and techniques has been studied to decide the safest quantum of reduction of the occlusal surfaces. However, these methods provide limited information as to the actual amount of reduction with limitations in accuracy, accessibility and complexity. Objective: The objective of this study was to compare and evaluate the reliability of the most commonly used occlusal registration wax that with polyether bite registration material as a guide for occlusal reduction required during tooth preparations. Materials and Methods: For the purpose of this study, 25 abutment teeth requiring tooth preparation for fixed prosthesis were selected and tooth preparations carried out. Modeling wax strips of specific dimensions were placed onto the cast of prepared tooth, which was mounted on maximum intercuspation on the articulator and the articulator was closed. The thickness of the wax registration was measured at three zones namely two functional cusps and central fossa. Similar measurements were made using the polyether bite registration material and prosthesis at the same zones. The data was tabulated and was subjected to statistical analysis using anova test and Tukey honestly significant difference test. Results: The differences in thickness between wax record and prosthesis by 0.1346 mm, whereas the difference between polyether and prosthesis was 0.02 mm with a P value of 0.042, which is statistically significant. This means that the wax record was 8.25% larger than the prosthesis while polyether was just 1.27% larger than the prosthesis. Conclusion: The clinical significance of the above analysis is that Ramitec polyether bite registration material is most suitable material when compared with commonly used modeling wax during the tooth preparation.

Cephalometric Comparison of Frankforts Horizontal Plane And Occlusal Plane With Variations In Ala- Tragus Line.

The glossary of prosthodontic terms defines occlusal plane as an average plane established by the incisal and occlusal surfaces of the teeth. Generally, it is not a plane but represents the planar mean of the curvature of these surfaces. Another definition defines it as the surface of wax occlusion rims contoured to guide in the arrangement of denture teeth. Ala-tragus line according to the glossary of prosthodontic terms is defined as a line running from the inferior border of the ala of the nose to some defined point on the tragus of the ear, usually considered to be the tip of the tragus. It is frequently used, with a third point on the opposing tragus, for the purpose of establishing the ala-tragus plane. Ideally, the ala-tragus plane is considered to be parallel to the occlusal plane. The occlusal plane is at an angle of approximately 10 degrees relative to the Frankfort horizontal plane, when viewed in midsagittal plane. No precise, scientific method exists for determining the level of the occlusal plane in edentulous patients. Several principles have been postulated for determining the occlusal plane. The use of ala-tragus line to orient the occlusal plane has been controversial. This controversy is primarily due to disagreement on the exact point of reference for this line.Therefore the main objective of this study was to find out a reference line most parallel to the natural occlusal plane so that this reference point on the tragus can be used to determine the occlusal plane during the fabrication of complete denture

"A Microleakage Study of Class V Restorations Uisng Thee Self- Etching Adhesives And Microfill Conposite Resin- An Vitro Stereo Microscopic Study.

AIM: This study evaluates marginal sealing ability of currently available three self-etching adhesives in class V micro fill composite restorations. Materials and methods: Forty five human central incisors, divided in to three groups and class V cavities were prepared on the facial surface of teeth with occlusal margin in enamel and gingival margin in dentin/cementum. The cavities were restored with microfill composite in two increments using three different adhesives, Ader prompt (3M Dental products), AdheSE (Ivolar Vicadent) and I-Bond (Heraeus Kulzer). Each group containing fifteen teeth were subjected to thermocycling and dye penetration. The teeth were mlunted and sectioned buccolingually with a hard tissue microtome, the two sections from earch tooth obtained from the both mesial and distal acute angles of the cavity preparation, examined under stereomicrscope. The values were analyzed with Chi-Square test and Fisher exact. Results: The results show less leakage in enamel and dentin margin for AdheSE. This is significantly less than Adper Prompt an IBond which showed no statistically significant difference. Conclusion: At enamel and dentin/ Cementum margins, two step self etch adhesive AdheSE performed better than one step self etch adhesives Adper Prompt and I-Bond.

A study to correlate the incidence of cross arch balance and working side occlusal wear facets among different age groups: An in vivo study.

Introduction: The prevalence of group function and canine guided occlusion is common in natural dentition, but cross arch balance is not often seen. Hence, a study was carried out with following objectives: Analysis of incidence of cross arch balance in different age groups and working side occlusal wear facets in following subjects. Materials and Methods: A total of 200 patients with natural dentition were included in the study. Subjects with cross arch balance were analyzed for working side occlusal wear facets. Data were analyzed statistically by Chi-square test. Results: The incidence of cross arch balance in the study group was 0.7%. On examination, subjects with group function on the working side and cross arch balance on the non-working side had more occlusal wear facets. Conclusion: From the study, it was observed that there was no significant variation in the number and extent of wear facets between the cross arch and without cross arch subjects due the smaller sample size hence it was difficult to conclude the relationship non-working side contact as interference and its influence in wearing of dentition in this study.

An in vivo study to determine the range of posterior teeth disclusion on working side in canine-guided occlusion.

Background and Objectives: This study was done with the objectives to determine the range of functional zone between the intercuspal positions and edge to edge position, the range of incomplete and complete disclusion of posterior teeth in canine-guided occlusion, and to have a gender comparison and comparison between right and left sides of the obtained values. Materials and Methods: Thirty-five subjects showing canine-guided occlusion and Angle's class I canine and molar relation were chosen for the study. Maxillary midline and a corresponding line on the mandible were marked in maximum intercuspation with marker pen in the patient's mouth. Lines from 1 to 5 mm were marked on maxillary central incisor with marker pen. A dental floss was looped around the distal surface of mandibular last molar and the subject was asked to make left lateral movement (working side) at 1-mm intervals. The point at which floss was freed posteriorly was considered as initial disclusion and the point at which edges of maxillary and mandibular canines contacted was considered as complete disclusion. Results: Most of the male and female subjects in the study showed progressive disclusion on right side and delayed disclusion on left side. The range of complete disclusion was 3-4 mm in males and 2-3 mm in females irrespective of the side. The range of functional zone was 1-4 mm irrespective of side or gender. Interpretation and Conclusion: There is a need to redefine canine guidance in terms of immediate disclusion, delayed disclusion, and progressive disclusion.

Multifocal cutaneous melanoacanthoma with ulceration: A case report with review of literature.

We report a case of a 58-year-old female patient who presented with multiple, asymptomatic, slowly-growing, raised pigmented lesions all over her body for the past 10 years with ulceration in one of the lesions on the trunk for the past five months. Histopathology of the lesion revealed features consistent with melanoacanthoma. Here, we report the first case of cutaneous melanoacanthoma presenting with an ulcerated plaque and the third case of cutaneous melanoacanthoma with multiple lesions. To the best of our knowledge, ulceration has not yet been reported as a feature of cutaneous melanoacanthoma in the medical literature.

Socio-economic inequalities in the financing of cardiovascular & diabetes inpatient treatment in India.

Background & objectives: Cardiovascular disease (CVD) and diabetes have become a leading threat to public health in India. This study examines socio-economic differences in self-reported morbidity due to CVD and diabetes, where people having these conditions seek care, how much households pay for and how they finance hospital treatment for these conditions. Methods: Data for this study are taken from the National Sample Survey Organization (NSSO) 60th round on ‘Morbidity and Health Care’ conducted between January and June 2004. Information from 2,129 and 438 individuals hospitalized for CVD and diabetes was analyzed. Results: The self-reported prevalence among adults was 12 per cent for CVD, 4 per cent (7% urban and 3% rural) for heart disease and 6 per cent (10% in urban and 4% in rural) for diabetes. Both self-reported CVD and diabetes appeared to afflict the wealthier more. The private sector was the main provider of outpatient and inpatient care for CVD and diabetes treatment, though the poor depended more on the public sector. Out-of-pocket payments (OOPS) for hospital treatment claimed a large share of annual household expenditures; 30 per cent for CVD and 17 per cent for diabetes. The OOPS share for diabetes treatment declined with increasing income. The majority of OOPS for hospital treatment paid by the poor was financed through borrowings. Interpretation & conclusions: The considerable financial strain which households, particularly the poor, face in treating CVD and diabetes is alarming. As the burden due to CVD and diabetes increases in India, more households will be subject to these financial strains and unfortunately, the economically vulnerable among them will be the worst affected. While primary prevention of these conditions need more emphasis, in addition, insurance schemes targeted at the poor like the RSBY have an important role to play in financially protecting vulnerable households.

Treatment of electroplating effluents for reduction of chromium.

Chromium (VI) is moderate to severe toxic which is responsible to produce deleterious effects in human beings and animals. The sources of contamination of chromium in natural waters and in the environment are from electroplating, tanning industries and waste solution from oxidative dyeing and leaching from sanitary land – fills. Hence the determination of chromium is of great interest to analytical and environmental chemists. The present study deals with the determination of physico-chemical parameters of electroplating effluents collected from a local industry. Probable reduction of hexa valent chromium was also attempted using standard iron (II) sulphate solution.

Direct and derivative spectrophotometric determination of palladium (ii) in presence of micellar medium in hydrogination catalyst samples, synthetic alloy samples and in water samples using 4-hdroxy 3, 5 dimethoxy benzaldehyde-4-hydroxy benzoylhydrazone (HDMBHBH).

A rapid, simple, sensitive and selective spectrophotometric method has been developed for the determination of Palladium (II) using newly synthesized reagent 4-Hdroxy3,5dimethoxybenzaldehyde-4- hydroxybenzoylhydrazone (HDMBHBH) in neutral surfactant of TritonX-100-5% (micellar medium). Palladium (II) forms a brown coluored water-soluble complex with 4-Hdroxy 3, 5dimethoxybenzaldehyde-4- hydroxybenzoylhydrazone in the pH range 1.0-6.0. The complex shows maximum absorbance at lmax 373 nm and in the pH range 3.0-4.0. However, at this wavelength, the reagent shows considerable absorbance. At lmax 373 nm, the complex shows maximum absorbance while the reagent blank shows negligible absorbance. Hence, analytical studies are carried out at lmax 373 nm and at pH 3.0 (Phosphate buffer) against reagent blank. Beer's law is obeyed in the range 0.106-1.064 μg ml-1 and the optimum concentration range from ringbom plot is 0.212-0.957 mg/ml of Palladium (II). The molar absorptivity and Sandell's sensitivity for the coloured solution are found to be 7.5 x 104L mol-1 cm-1 and 0.0015-μg. cm-2 respectively. The interference effect of various diverse ions has been studied. The complex shows 1:1 [Pd (II): HDMBHBH] stoichiometry with stability constant 7.29 x 106. The standard deviation of the method in the determination of 0.638 - μg ml-1 of Palladium (II) is 0.003 and the Relative standard deviation is 0.71%. First and second order derivative spectroscopic method is developed at lmax 422 nm and lmax 444 nm respectively for the determination of Palladium (II), which is more sensitive than the zero order method. The developed method has been employed for the determination of Palladium (II) in hydrogenation catalyst samples and in synthetic alloy samples. The results are in good agreement with the certified values.

An in vitro study to evaluate the effect of storage time and application of subsequent layers on the variation in thickness of three commercially available die spacers.

Aims : The application of a paint-on die spacer onto the dies prior to the fabrication of cast crowns is an acceptable procedure to improve the fit of the restoration. The primary purpose of this study was to evaluate the variation in thickness of different brands of die spacer based on the effect of storage time and application of additional layers. Materials and Methods: Dies were duplicated from a master model of ivorine teeth, with a full ceramic preparation. Dies obtained were then painted with one, two, and three coats of each brand of die-spacers separately. These dies were embedded in die stone and sectioned bucco-lingually. The same procedure was done after three and six months. The thickness of the paint on die spacer was measured at five points on the die using an optical microscope, and the data were statistically analyzed. Results and Conclusion : There was a definite variation in the thickness of the die spacer with all the three brands and at various points on the die. Two coat thicknesses were found to be in the range of tolerance of 20-40 microns. Thickness at occlusal groove was noted to be the maximum with least at occlusoaxial line angles. Thickness also showed a very significant increase when bottles were stored for a period of three to six months and then applied.

Effect of axial groove and resin luting cements on the retention of complete cast metal crowns

Background: the design of the tooth preparation and the cementing medium are important considerations in the retention of crowns and fixed partial dentures. The purpose of this invitro study was to determine the effect of axial groove on the retention of complete cast metal crowns using two resin luting cements

Methods: forty freshly extracted intact human molar teeth were prepared in their long axis to receive complete cast metal crowns. The specimens were randomly divided into two groups [one control and one study group]. An axial groove of uniform size and shape was made on the prepared teeth under the study group. Axial surface area of prepared teeth specimens was measured. Complete cast metal crowns were fabricated for each specimen. Specimens of each group were divided into subgroups of 10 samples and were cemented with two resin luting cements, RelyX Unicem® and Calibra®, respectively. The cemented crowns were loaded in tension using a Universal Instron testing machine. The maximal tensile strength was recorded. Data were compared using the Mann-Whitney U test [alpha=0.05]

Results: no significant differences in the tensile stress values were noted between the control [mean: 5.76 +/- 0.392 MPa] and study [mean: 5.93 +/- 0.751 MPa] groups cemented with RelyX Unicem. No significant differences in the tensile stress values were noted between the control [mean: 4.92 +/- 0.641 MPa] and study [mean: 5.15 +/- 0.478 MPa] groups cemented with Calibra. However, significant difference in the tensile stress values was found between the two resin cements in the control and study groups

Conclusion: axial groove placed in tooth preparations for resin bonded complete cast metal crowns had no statistically significant effect on retention. The use of [RelyX Unicem®] yielded greater retention values when compared to Calibra®

HIV sero-prevalance in general population of Warangal, A.P., South India.

HIV/AIDS pandemic has devastated many countries reversing national development; HIV was not seen in Asia and India till 1980. Now India has become epicenter of AIDS pandemic. During April 2002 to March 2003 the HIV+ ve pregnant women and their husbands were encouraged to enroll in the prospective study with informed consent. The study results consist of most of the females who are in the age group between 16-25 years who were affected by HIV High infection is observed in people with lower socio-economic and education background. High infection rate is observed in house wives (26.7%), laborers (23%) and agricultural workers (12.1%) followed by toddy tapers (5%), drivers (5.96%) and others (6 47%). HIV +ve subjects at Mother To Child Transmission (MTCT) centers are surprisingly clinically very healthy. No disease manifestation was noticed.

Enfermidades associadas à intoxicação por selênio em animais / Diseases associated with selenium poisoning in animals

Por meio de revisão da literatura pertinente foram coligidos e são apresentados os principais dados relativos à intoxicação por selênio em animais domésticos. Foram abordados e discutidos os aspectos epidemiológicos, clínicos, anátomo e histopatológicos e patogenéticos atribuídos a Alkali Disease, Blind Staggers, intoxicação aguda e poliomielomalácia simétrica focal dos suínos. O trabalho tem como objetivo esclarecer pontos obscuros relativos à intoxicação por selênio, bem como alertar para os riscos que a suplementação com esse elemento pode representar.

Trough a critical literature review, the main data of selenium poisoning in domestic animals are presented. Epidemiological, clinical, anatomic and histopathological aspects attributed to Alkali Disease, Blind Staggers, acute poisoning and focal symmetrical poliomielomalacia of swine are discussed. The main objective of the paper is to clarify obscure points of selenium poisoning, as well to point out the risks that supplementation with this element can represent.