The use of integrin binding domain loaded hydrogel (RGD) with minimally invasive surgical technique in treatment of periodontal intrabony defect: a randomized clinical and biochemical study

Abstract Periodontal regeneration faces multiple challenges, the most important being cellular insufficiency. In an attempt to improve defect cellularity, we aimed to demonstrate enhancing cellular attraction using arginine-glycine-aspartic acid (RGD) adhesion molecule legend blended hydrogel within the intrabony defects. Methodology Forty-five intrabony defects were selected from patients with stage III or IV - grade A or B periodontitis and divided randomly into three equal groups of 15 each: group1 (G1): received minimally invasive surgical technique (MIST) alone, group2 (G2): received MIST and placebo hydrogel injection, and group3 (G3): were treated with MIST and RGD hydrogel injection. Primary outcomes 6 months following therapy were; defect base fill (DBF) and defect width measurement (DW); secondary outcomes were clinical attachment level (CAL), pocket depth (PD), plaque index (PI), gingival index (GI), and biochemical analysis of bone morphogenetic protein (BMP-2) evaluated at 1,7,14 and 21 days following therapy. Results Significant improvements in DBF, CAL, and PD were observed in the three studied groups 6 months following therapy compared to baseline (p<0.05). A significant improvement in DBF was reported in G3 compared to G1 and 2 (p=0.005). Additionally, a significantly higher CAL gain was reported in G3 compared to that of G1 (p=0.02). Group 3 was associated with a significantly higher level of BMP-2 compared to G1 and G2 in all reported periods. Conclusion RGD peptide carried on a hydrogel delivery agent and contained with a minimally invasive flap could be a reliable option in improving the outcomes of periodontal therapy.

Evaluation of gastro-oesophageal reflux disease in wheezy infants using 24-h oesophageal combined impedance and pH monitoring

Background and study aims: Gastro-oesophageal reflux disease [GERD] is incriminated as a cause of non-asthmatic infantile wheeze. To date, no diagnostic test is considered standard for GERD-related airway reflux diagnosis. Oesophageal combined multiple channel intraluminal impedance and pH [MII-pH] monitoring is proposed to be a sensitive tool for evaluation of all GERD including infantile wheeze. We aimed to determine the GERD prevalence amongst wheezy infants in the first year of life using combined MII-pH versus pH monitoring alone and evaluate the sensitivity and specificity of objective MII-pH monitoring parameters in GERD-associated infantile wheeze diagnosis compared to those of lipid-laden macrophage index [LLMI]

Patients and methods: Thirty-eight wheezy infants below 1 year of age were evaluated for GERD using oesophageal combined MII-pH monitoring and LLMI

Results: Totally, 60.5% of cases had abnormal MII-pH; only 7.9% of them had abnormal pH monitoring. LLMI was significantly higher in wheezy infants with abnormal MII-pH than infants with normal MII-pH monitoring [112 +/- 88 versus 70 +/- 48; P = 0.036]. The current definitions of abnormal MII-pH study, reflux index >/= 10% and distal reflux episodes >/= 100, had low sensitivity [23%] but high specificity [100% and 96%, respectively] in GERD-related aspiration diagnosis defined by LLMI >/= 100. Using ROC curves, bolus contact time >/= 2.4% and proximal reflux episodes >/= 46 had 61% and 54% sensitivity and 64% and 76% specificity, respectively, in GERD-related aspiration diagnosis

Conclusion: Combined MII-pH is superior to pH monitoring in reflux-associated infantile wheeze diagnosis. Objective data including proximal reflux episodes and bolus contact time should be combined with the current parameters used in reflux-associated infantile wheeze diagnosis

Comparison of arteriovenous fistulae having blood flow equalto and higher than 800 ml / min as regards clinical and laboratory parameters

Background: According to KDOQI guidelines, the lower limit of arteriovenous fistula blood flow accounting for 600 ml / min. We have observed that this limit was not enough, at least for our patients. The aim of this work was to prove the hypothesis that this limit must be higher for performing adequate dialysis

Patiemts and methods: Fifty patients on prevalent hemodialysis were included in this study. They were divided into 3 groups; group I: 12 patients formed low flow group, group II: 18 patients formed moderate flow group, and group III: 20 patients formed high flow group. Complete physical examination including clinical fistula examination for patency, were performed for all patients. Laboratory tests performed for all patients included :urea reduction ratio [URR %], serum calcium ,serum phosphorus, calcium - phosphorus product, serum albumin, hemoglobin, serum Iron, serum ferritin, TIBC, Transferrin saturation [TSAT %], Kt / V [number used to quantify hemodialysis treatment adequacy], serum creatinine, together with blood urea before and after session. Fistula blood flow and static venous pressure were determined by Doppler ultrasound. Fistulogram was performed to confirm the fistula stenosis site, whenever detected by Doppler

Results: Mineral bone profile markers, Iron profile markers, together with malnutrition - inflammation complex indicators, were all in favour of moderate and high flow groups, mainly the moderate flow group II due to the presence of much less complications than the other groups

Conclusion: We have to try to perform arteriovenous fistulae for ESRD patients needing regular dialysis, in such a way that fistula blood flow is above 800 ml / min, and it is better to be within the range of 801 - 1600 ml / min

[ critical view of Arabic curriculum as a requirement for medical schools, Gezira University]

We compared the present Arabic syllabus used in Gezira University Medical School with previous ones. We also surveyed students and Arabic professors in medical sciences on their views on the content and teaching/evaluation procedures and how these contributed to students' understanding of the medical science syllabus. The current syllabus was designed to provide students with Arabic language skills with particular reference to scientific language. The students' opinions differed regarding their understanding of clinical medicine and their interaction with patients and also the benefits to them of research procedures and reporting. The professors considered the syllabus was adequate to achieve its aims but emphasized the importance of varying teaching methods and evaluation

Changes in serum calcium, phosphate, albumin and parathyroid hormone before and after hemodialysis in Sudanese patients with end-stage renal failure

To determine the concentrations of serum parathyroid hormone [PTH] and bone minerals and their association before and after hemodialysis. A cross sectional study was done on patients with end-stage renal disease [ESRD] on treatment with maintenance hemodialysis [HD]. Levels of serum calcium, phosphate, urea, creatinine, albumin, and intact parathormone [iPTH] were measured. The total number of patients studied was 50 [40 males; 10 females], the mean age was 40.3 +/- 26.5 years, and the average duration on hemodialysis [HD] was 53 months. Serum PTH level was significantly lower after hemodialysis treatment; it was 945.8 +/- 995.9pg/ml and 781.7 +/- 928.1 pg/ml before and after HD respectively, but still over the normal range. Serum phosphate concentration was remarkably differ before and after HD [5.59 +/- 1.8 mg/ml vs 4.38 +/- 1.2 mg/ml respectively]. In contrast, the mean value of serum calcium concentration was changed significantly after HD [6.7 +/- 1.5 mg/dl] compared with the level before HD [5.6 +/- 6.7 mg/dl]. PTH correlated positively with phosphate [r=0.30, p=0.03], and negatively with calcium [r=-0.299, p=0.04] levels. A significant decrease in serum urea and creatinine levels was reported after HD. Serum albumin showed no significant difference before and after HD. PTH was remarkably decreased post dialysis in our patients with definite increased serum Ca[+]. There is no significant difference between PTH and patient's age, sex and duration in HD Sudanese patients

Cerebral metabolites concentrations determined by quantitative proton MR spectroscopy in patients of intracerebral haematomas

This study was made to investigate serial metabolic changes in frontal lobes of patients with deep intracerebral hemorrhage [ICH] to found any correlation between N-acetylaspartate [NAA] and degree of motor impairment or clinical outcome. Forty three patients with deep ICH were examined with proton magnetic resonance spectroscopy by multivoxel method [voxel=10 X 10 X 20 mm; 64 voxels]. NAA/creatine ratios in the white matter of the primary motor and premotor areas on both sides were measured sequentially: within 48 hours, at 2 weeks, and 1 month after onset using National Institutes of Health Stroke Scale We found, in the primary motor area on the affected side, the NAA/ creatine ratio decreased sequentially. At 48 hours and 2 weeks after onset, a negative correlation was detected between NAA/creatine and hematoma volume, but there was no correlation 1 month later. At 2 weeks, NAA/ creatine correlated negatively with motor impairment. In conclusions, there is delayed gradual reduction of NAA/creatine ratio in the frontal lobes correlating with motor deficit and clinical outcome after deep ICH

Experimental study of antioxidant and hepatoprotective effects of clove and cardamom in ethanol induced hepatotoxicity

Long-term use of ethanol results in serious liver damage. The contribuling mechanism still remains uncertain. However, there is accumulating evidence that alcohol toxicity may be associated with increased free radical production, increased oxidative stress and increased lipid peroxidation. The present study aimed to evaluate the hepatoprotective and anlioxidant effects of clove [Fugenia Caryophyllata-Syzygium aromaticum] and cardamom [Amomum Subulatum.] against ethanol induced hepatotoxicity in rats. Forty white albino rats were classified into four groups: Group 1 served as control. Group II received ethanol [3gm/kg] for three weeks, whereas Group III and IV received extract of cardamom and cloves [500mg/kg] for one week followed by extract of cardamom and cloves one hour before ethanol administration for three weeks. The hepatotoxic of ethanol and the hepato-protecive effect of cardamom and clove were estimated by their effects on the liver function test, serum lipid profile, levels of lipid peroxidation product malonaldehyde [MDA], the acivity of two liver antioxidant enzymes: superoxide dismutase [SOD], and glutathione reductase [GSH-Rd] and liver trace element levels. Our results showed that ethanol feeding caused elevation of serum liver enzymes and serum total lipid, total cholesterol and triglyceride levels. Also, there was significant increase in lipid peroxidation product, malonaldehyde [MDA], and decrease in anlioxidant enzyme, trace element levels in liver homogenate. On the other hand, the hepatoprotective effect of cardamom and clove was reflected by the significantly lower level of liver enzymes and serum lipid profile in rats pretreated with their extract before ethanol. On the other hand, MDA level was significantly reduced as compared to ethanol fed group, whereas, levels of SOD, and GSH-Rd activity and trace element level were significantly increased by clove and cardamom pretreatment. All these effects were more pronounced with clove compared to cardamom reflecing its potent antioxidant activity compared to cardamom. It can be concluded that ethanol induced hepatotoxic effect can be counteracted by clove and cardamom feeding and the anlioxidant effect of clove is more powerful than cardamom

Influence of therapy on early development of osteoporosis in male smoker subjects with hypoandrogenism influenced by life style and schistosomal hepatic fibrosis

The study aims to evaluate the multifact outcome of hypoandrogenemia colinked with the impact of oxidative stress induced by glucose intolerance, Schistosomal hepatic fibrosis [SHF] and cumulative smoking influence on bone remodeling and early development of osteoporotic manifestations. The effect on vascular endothelium immune mediated mechanisms and antioxidant capacity were monitored in cases of 30 middle aged selected male cases involving 20 subjects with hypoandrogenemia who were either smokers and subjected to sedentary life style, glucose intolerance and SHF [GI] or without [GII] as well as cases of GI after following 6 months therapy [GIII] compared to controls [GIV]. Monitoring of clinical picture and biochemical assessments of osteoporotic indices [osteocalcin, bone alkaline phosphatase, parathyroid hormone, urinary cyclic AMP], hypoandrogenism [dehydroepiandrosterane sulphate "DHEAS" and testosterone] glycemic determinant [insulin] immunoinflammatory response [interleukein-6 "IL-6", tumor necrosis factor a "TNF-alpha", E-selectin, ceruloplasmin] smoking index [serum cotinine], tolal antioxidant capacity [AOC] and lipid peroxidation product [malonedialdehyde] were done before and after 6 months therapeutic program involving supplement of DHEAS, chromium picolinate, and megavit zinc alongside smoking cessation and physical exercise daily for at least 30 minutes. It was evident that the adjustment of hormonal status and antioxidant potential should be dealt with smoking cessation to maintain physical fitness and to retard the early onset of osteoporosis. the recognition of the profound impact of life style choices on bone health, risk factors of which the most frequent include smoking, hypoandrogenemia and glucose intolerance besides metabolic and immunoinflammatory derangement posed by SHF all of which induce oxidative stress and potentiate the early development of osteoporosis in middle aged male smokers. Cessation of smoking and adopting active life style with at least half hour daily sportive exercise besides supplements with DHEAS, chromium, zinc and multivitamin-mineral supplement for six months had retarded and readjusted osteoprotic manifestations in studied group

Effect of L-carnitine supplementation on growth and immunological status of children with chronic renal failure on regular hemodialysis

Children with chronic renal failure, including those on hemodialysis are most commonly presented with growth failure and immunological disorders. Deficiency of L-Carnitine, the endogenous intermediate involved in fatty acid metabolism, is commonly encountered in patients with end stage renal disease [ESRD]. This study has been conducted to evaluate the effect of L-Carnitine supplementation on growth and immunological status of children with ESRD. The study was conducted on twenty children with ESRD on regular hemodialysis for 1-6 years. Twelve age and sex matched healthy children were chosen to represent the control group. The growth status was monitored by the routine anthropometric measurements as well as measuring serum levels of insulin-like growth factor-1 [IGF-1]. The immunological status was monitored by measuring serum levels of adenosine deaminase [ADA] enzyme activity as well as serum levels of immunoglobulins G and M [IgG and IgM]. L-Carnitine supplementation was given to all patients in a dose of 50 mg/kg/day orally for 6-months. Basal and post 6-months L-Carnitine supplementation levels of IGF-1, ADA, IgG and IgM were compared to values of healthy controls. L-Carnitine supplementation improves IGF-1 level. Where basal values were significantly lower than those of control while post supplementation values showed insignificant difference when compared to control group. Although ADA activity significantly increased in ESRD patients after L-Carnitine supplementation in comparison to their corresponding basal values, both values were significantly lower when compared to control group. L-Carnitine supplementation had no significant effect on serum levels of IgG and IgM which showed insignificant difference when compared to control group. L-Carnitine supplementation plays an important role in improving both growth and immunological disorders in children with chronic renal failure and it should be considered an intergeral therapy for children on regular hemodialysis

Tumor necrosis factor [TNF] in children with chronic liver diseases

TNF-alpha is a cytokine produced from monocytes and macrophages and has multiple biological activities. Serum TNF levels were determined by radioimmunoassay in 11 children with chronic liver diseases. TNF level was significantly increased in children with chronic liver diseases when compared with reference group [10 healthy children]. There was a significant positive correlation between TNF and liver enzymes [AST and ALT] and a significant negative one between TNF and Hb% and red cell count. TNF production may be related to hepatitis activity or viral replication. Elevations of TNF may contribute in a degree to bone marrow depression in those patients

Esotropia and binocular vision in young age group

Bimedial rectus resecion more than the traditional 5.mm [6 mm] proved to be an effective surgical procedure for cases of congenital esotropia. It gives good post- operative alignment especially when the angle of deviation was less than 45 D. The success rate in our series was 60%. The remaining 40% developed post-operative residual angle which ranged from 10- 12 D [pre- operative angle of deviation was more than 50 D]. It can be considered as a success because the residual angle was corrected by hyperopic glasses. Early interference for cases of congenital esotropia helps to improve binocular vision and minimizes the development of amblyopia, the older the child the less will be the improvement in binocular vision. Cases of accommodative esotropia with large AC/A ratio and poor response to hyperopic correction for 6 months are better to be operated upon early by 2 or 3 muscle surgeries according to the pre- operative angle of deviation

Effects of meniscrectomy on temporomandibular joint structure in dogs

Although the value of meniscectomy has been recently questioned the operation has been indicated in certain types of temporom and ibular joint diseases. This study aimed to evaluate roentgenographically and histologically the changes following unilateral meniscectomy in dogs. The results indicated that the operated as well as the unoperated sides demonstrated degenerative changes including flattening, resorption, erosion and osteophytes formation on the articular surfaces

Role of vasoconstrictor in intraligamentary anaesthetic solution on the incidence of dry socket

A clinical study was performed to investigate the role of vasoconstrictor in intraligamentary anesthetic solution on the incidence of dry socket. A total of 286 m and ibular first molar extractions were under investigation. The results indicated that intraligamentary anesthetic solution with adrenaline resulted in a higher incidence of dry socket [3.2%] than that without adrenaline [2.7%]; however, this was statistical insignificant. Also, a nonsignificant difference between intraligamentary anesthetic technique [3.04%] and inferior alveolar nerve block [2.4%] was statistically observed

Induction of genetic variabilities in Saccharomyces cerevisiae G104-g using UV and nitrosoguanidin treatment for bakery II Revised carbohydrates, proteins and amino acid content

1112 mutants were selected by exposing the haploid strain. S. cerevisiae G104-g to differing doses of UV or NTG. The mutants produced by using UV followed by dark having a protein value that varied between 28.5% to 41.08%. While the corresponding value presented in the same mutants produced by UV followed by light was ranged from 37.52% to 52.17%. The total carbohydrates of the mutant produced by the former method realized slightly higher level than that of the latter one. On the other hand, mutants obtained by NTG treatment in different time show that the protein index number could be descendingly arranged from 55.07% to 56.1%. While the total reserved carbohydrates reached 39.55% as a maximum value in the mutant B/NTG 90/12, it reached only 28.56% and 28.48% in the mutant B/NTG 30/8 and C/NTG 60/17, but also proved that the carbohydrates of the mutants formed with UV followed by light were approximately within the range of the chemical treatment. The best selected mutants B/NTG 90/ 12 and L/4/11 contained approximately similar identified amino acids of S. cerevisiae G104-g [the wild type] with a real difference in their values. This may show a way to improve the concentration of specified amino acids. Balady bread based on mutant B/NTG 90/12 as well as mutant L/4,/11 came in the first organoleptic evaluation order in relation to those made with the wild type, B/NTG 90/12, L/4/11. S. cerevisiae B and the commercial S. cerevisiae. Mutants lead to the production of bread of higher quality