Early response to chemotherapy in children with Langerhans cell histiocytosis predicts long-term disease-free survival

Background: Langerhans cell histiocytosis (LCH) is a rare clonal malignancy of the monocyte-macrophage system. Patients with lesions in 搑isk organs� have significantly higher risk of mortality than patients with lesions limited to 搉on-risk� sites. The influence of early response to therapy on long-term survival in this heterogeneous multi-system disease was analyzed. Methods: During a 7-year period, we retrospectively analyzed the findings in 24 consecutive patients who required systemic chemotherapy for LCH [single system with multifocal bone involvement and multisystem involvement with or without risk organ (RO) involvement]. All patients were started on vinblastine and prednisolone. Progressive disease was treated with salvage protocols or targeted therapy. Positron emission tomography-computed tomography (PET-CT)/conventional CT based response assessment was performed at week 6 of chemotherapy, and if needed after week 12 of chemotherapy. Results: MFO bone, MS ROneg, and MS ROpos LCH was observed in 3, 4, and 17 patients, respectively. Age range of patients varied from 1 month�years (median = 18 months). The EFS and OS were 100% and 100% for MFO bone, 50% and 100%, respectively, for MS ROneg and 35% and 52%, respectively, for MS ROpos. OS was 93% and 100% for CR attained at 6 and 12 weeks respectively regardless of the risk status (P < 0.01). Conclusion: Rapid early response, that is, complete remission at 6 and 12 weeks was associated with significantly improved overall survival. In slow responders, early salvage with alternative regimens or targeted therapy may result in better outcomes

Study on awareness, knowledge, and practices towards antibiotic use among the educated and uneducated people of Khyber Pakhtunkhwa Province, Pakistan

INTRODUCTION: Antimicrobial resistance developed through the inadequate use of antibiotics; is an overriding task for global public health. OBJECTIVE: To explore awareness, knowledge, and practices, and compare the elements associated with antibiotic misuse in different University students and uneducated people of Khyber Pakhtunkhwa Province, Pakistan. METHODS: Cross-sectional study was conducted from July to December 2020 using a validated questionnaire. Data were collected from eleven different university students and uneducated people of Khyber Pakhtunkhwa, Pakistan. RESULTS: 3,600 questionnaires were completed, consisting of 56.9% Male and 43.0% Female. 1,999 (55.5%) of the antibiotic users reported through the survey used non-prescription antibiotics within a one-month study period. Out of the participants, 230 (6.3%) were uneducated or their education level was below matric rest were university students. 1999 (55.5%) reported buying Antibiotics with Medical Prescription. Most self-medicated participants (56.9%) stop taking antibiotics when they feel better. More than 90% of the respondents answered that doctors and pharmacist staff do not guide them well that how to use antibiotics. 2,171 (60.03%) respondents mistakenly believed that antibiotics improve restoration from coughs and colds. Only 720 (20%) respondents knew that antibiotics also disturb normal flora and 547 participants (15.9%) agree that unnecessary use of antibiotics causes bacterial resistance. CONCLUSION: Finding from this study may have important implications for public health policy in Khyber Pakhtunkhwa, Pakistan given the growing global resistance to antibiotics and the reported health issues related to their improper use.

Binge eating disorder and food addiction occurrences among adult Jordanian women with obesity

@#Introduction: The aim of the study was to estimate the occurrences of binge eating disorder (BED) and food addiction (FA) in Jordanian women with obesity and to explore their relationships with selected potential risk factors for obesity. Methods: A descriptive case series design that involved a total of 842 women with obesity was conducted. The occurrences of BED and FA were evaluated using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) and Yale Food Addiction Scale 2.0 (YFAS 2.0). Results: The overlapping of BED and FA (BED+FA) was the most frequent category constituting 53.7%. The second highest category was BED comprising 25.0%, followed by FA comprising 9.0%. Body mass index (BMI) and waist circumference (WC) were significantly higher in the BED+FA group as compared to all other groups. The FA group (41.3%) had significantly the lowest level of sleeping hours. BED (58.0%) and BED+FA (66.1%) groups were significantly higher in consuming more than three snacks per day. BED and/or FA-free group had significantly higher level of water intake of >5 cups/day. Conclusions: The frequencies of BED and FA were relatively high among obese Jordanian women. The study demonstrated an overlap between BED and FA, highlighting its associations with increased BMI and WC in a selected sample of obese women. The study suggested that BED, FA, and the overlapping of both conditions were associated with greater tendencies towards an unhealthy pattern of eating practices, fluid intake, and sleeping habits.

Total Transit Time and Probiotic Persistence in Healthy Adults: A Pilot Study

Background/Aims@#Motility, stool characteristics, and microbiota composition are expected to modulate probiotics’ passage through the gut but their effects on persistence after intake cessation remain uncharacterized. This pilot, open-label study aims at characterizing probiotic fecal detection parameters (onset, persistence, and duration) and their relationship with whole gut transit time (WGTT). Correlations with fecal microbiota composition are also explored. @*Methods@#Thirty healthy adults (30.4 ± 13.3 years) received a probiotic (30 × 10 9 CFU/capsule/day, 2 weeks; containing Lactobacillus helveticus R0052, Lacticaseibacillus paracasei HA-108, Bifidobacterium breve HA-129, Bifidobacterium longum R0175, and Streptococcus thermophilus HA-110). Probiotic intake was flanked by 4-week washout periods, with 18 stool collections throughout the study. WGTT was measured using 80% recovery of radio-opaque markers. @*Results@#Tested strains were detected in feces ~1-2 days after first intake and persistence after intake cessation was not significantly different for R0052, HA-108, and HA-129 (~3-6 days). We identified 3 WGTT subgroups within this population (named Fast, Intermediate, and Slow), which could be classified by machine learning with high accuracy based on differentially abundant taxa. On average, R0175persisted significantly longer in the intermediate WGTT subgroup (~8.5 days), which was mainly due to 6 of the 13 Intermediate participants for whom R0175 persisted ≥ 15 days. Machine learning classified these 13 participants according to their WGTT cluster (≥ 15 days or < 5 days) with high accuracy, highlighting differentially abundant taxa potentially associated with R0175 persistence. @*Conclusion@#These results support the notion that host-specific parameters such as WGTT and microbiota composition should be considered when designing studies involving probiotics, especially for the optimization of washout duration in crossover studies but also for the definition of enrollment criteria or supplementation regimen in specific populations.

Prevalence of chronic pain and contributing factors: a cross-sectional population-based study among 2,379 Iranian adolescents

Background@#This study aimed to determine the prevalence of chronic pain and its contributing factors among teenagers aged 12–21 years in Shiraz, Iran. @*Methods@#This cross-sectional study was conducted on adolescents aged 12–21 years. Demographic variables of the adolescents and their parents as well as the pain characteristics were assessed. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors. @*Results@#The prevalence of chronic pain was 23.7%. The results revealed no significant difference between the male and female participants regarding the pain characteristics, except for the home medications used for pain relief. The results of a chi-square test showed that the mother’s pain, education, and occupation, and the father’s education were associated significantly with chronic pain in adolescents (P < 0.05). Multinomial logistic regression also showed the mother’s history of pain played a significant role in the incidence of adolescents’ chronic pain. @*Conclusions@#The prevalence of chronic pain was relatively high in these adolescents. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as anxiety, depression, school problems, sleep, and physical activity are suggested in future longitudinal studies.

Use of Social Media to View and Post Dentistry-related Information in Bahrain: A Cross-Sectional Study / 대한의료정보학회지

Objectives@#Healthcare-related information sharing via social media is on the rise following the coronavirus disease 2019 (COVID-19) pandemic. Dental practices primarily use social media to search, share, and communicate health-related information. Considering the increasing trend of using social media, the primary aim of the present study was to identify the use of social media by dentists and laypeople to post and view dentistry-related content in Bahrain. @*Methods@#This questionnaire-based cross-sectional study included adult participants and dentists. A pretested validated questionnaire was administered. The chi-square test for association was used to assess the association between categorical outcomes. A p-value of ≤ 0.05 was considered statistically significant. @*Results@#In total, 249 adult participants and 53 dentists were included. A substantial majority (83.5%) of the participants reported that they always used social media to view dentistry-related content, and 69.8% of the dentists felt that patients who use social media have better oral health awareness. A longer duration of social media usage showed significant associations with particularly viewing dentistry-related content (p = 0.008) and contacting dentists directly through social media for consultation (p = 0.055). @*Conclusions@#An extremely high percentage of the younger population in Bahrain is using various social media to discuss dentistry. This engagement should be wisely managed to promote dentistry-related information sharing, which can lead to increased awareness related to overall dental health. There is a definite need to enforce certain standard operating procedures in every country that will prevent the misuse of this technological advancement.

Effect of aerobic exercise training on EEG: event-related potential and neuropsychological functions in depressed elderly with mild cognitive impairment / Efeito do treinamento de exercício aeróbio no EEG: potencial relacionado a eventos e funções neuropsicológicas em idosos deprimidos com comprometimento cognitivo leve

ABSTRACT. Increased depressive severity has been linked to neurocognitive impairment. Aerobic exercise (AE) is an efficient technique for improving cognitive function. However, studies indicating the importance of AE to neurophysiological and neuropsychological functions in the depressed elderly using event-related potentials (ERPs) are scarce. Objectives: This study aimed to identify the potential benefits of AE on neurophysiological and neuropsychological functions. Methods: A total of 30 depressed older adults (AE group: n=15; control group (CG): n=14) were recruited based on the inclusion and exclusion criteria. The AE group was subjected to an 8-week-period AE program (3 times/week for 30 min per session) at moderate intensity, determined using heart rate maximum (HRmax). The training intensity was set at 50% HRmax and increased by 5% in subsequent weeks. Pre- and post-training measures for neurophysiological function were tested using ERP-P300 (amplitude-μV and latency-ms) and also for neuropsychological functions using the trail making test (TMT), mini mental status examination (MMSE), and everyday cognition questionnaire (ECog). Results: In the experimental group, statistically significant improvements were observed when analyzed for all 3 (group-by-time interaction effect, main effect of time, and main effect of group), in both neurophysiological functions (*p<0.001) and neuropsychological functions (*p<0.001), except for ECog scores, where the results were insignificant for the main effect of a group. Correlation analysis demonstrated no association between neurophysiological and neuropsychological functions (*p>0.05). Conclusion: Findings showed that 8 weeks of AE training may be a promising approach to improve cognitive functions in depressed older adults. However, considering relatively small number of patients, the question arises for effectiveness in other populations.

RESUMO. O aumento da gravidade de quadros de depressão tem sido associado a comprometimento neurocognitivo. O exercício aeróbico (EA) é uma técnica eficiente para melhorar a função cognitiva. No entanto, estudos sugerindo a importância de EA para funções neurofisiológicas e neuropsicológicas usando potenciais relacionados a eventos (PRE) em idosos deprimidos são escassos. Objetivo: Identificar os potenciais benefícios do EA nas funções neurofisiológicas e neuropsicológicas. Métodos: Vinte e nove idosos deprimidos (grupo EA: n=15; grupo controle: GC: n=14) foram recrutados segundo critérios de inclusão e exclusão. O grupo EA foi submetido a um programa de EA de oito semanas (3 vezes/semana em sessões de 30 minutos cada) em intensidade moderada, determinada pela frequência cardíaca máxima (FCmáx). A intensidade do treinamento foi fixada em 50% da FCmax e aumentada em 5% nas semanas subsequentes. As medidas pré- e pós-treinamento para a função neurofisiológica foram testadas pelo ERP-P300 (amplitude-μV e latência-ms) e também para as funções neuropsicológicas usando o Trail Making Test (TMT), o Mini Mental Status Examination (MMSE) e o Everyday Cognition Questionnaire (ECog). Resultados: No grupo experimental, melhorias estatisticamente significativas foram observadas quando analisadas para todos os 3 (efeito de interação grupo por tempo, efeito principal do tempo e efeito principal do grupo), em ambas as funções neurofisiológicas (*p<0,001) e funções neuropsicológicas (*p<0,001), exceto para escores ECog, onde os resultados foram insignificantes para o efeito principal de um grupo. A análise de correlação não demonstrou nenhuma associação entre funções neurofisiológicas e neuropsicológicas (*p>0,05). Conclusão: Os achados mostraram que 8 semanas de treinamento de EA podem ser uma abordagem promissora para melhorar as funções cognitivas em idosos deprimidos. No entanto, considerando um número relativamente pequeno de pacientes, surge a questão da eficácia em outra população.

Disparity between cost variation of antibiotics in northern and western India: A cross - sectional study

Background - About 58% of India’s health expenditure is out of pocket expenditure. There is a wide variation in the cost of different brands of the same generic drug. Prescription of expensive brands of antibiotics contributes to the development of antibiotic resistanc e. There is literature available on the cost variation and cost ratio of antibiotics but none on the regional disparity. Materials and Methods - An observational cross - sectional study design was adopted. The study was conducted at the medical stores of Ali garh (Uttar Pradesh) and Mumbai (Maharashtra). The maximum and minimum cost/unit in Rupees (INR) of each antibiotic manufactured by multiple pharmaceutical companies was noted. Furthermore, Cost per daily defined dose (cost/DDD) was calculated for the most expensive and least expensive drug. Results - ALIGARH - The highest percent cost variation of 1897.14 and cost ratio of 19.97 was found for Piperacillin 4000mg + Tazobactam 500mg tablets. The least percent cost variation of 48.92 and cost ratio of 1.49 was found for ciprofloxacin 200mg vial. MUMBAI - The highest cost variation of 3031.05 and cost ratio of 31.31 was found for cefixime 200 mg tablets. The least percent cost variation of 6.43 and cost ratio of 1.06 was found for ciprofloxacin 200 mg vial. Concl usions - There is disparity in the cost variation and ratio between the two cities Aligarh and Mumbai in this study, which can be attributed to availability of different brands, under a generic group, in the different regions of the country

Chronic mucocutaneous candidiasis and rheumatoid arthritis in autoimmune polyendocrinopathy

Chronic mucocutaneous candidiasis is a heterogeneous group of disorders characterized by early-onset chronic recurrent mucocutaneous infections with Candida albicans. It is associated with several endocrinopathies such as hypoparathyroidism, hypoadrenalism, and hypogonadism with or without other autoimmune diseases such as vitiligo, alopecia areata, pernicious anemia, and hepatitis. Here, we describe a case of chronic mucocutaneous candidiasis with polyendocrinopathy with unusual presentations and rheumatoid arthritis.

A Study on Screening of Glaucoma among Patients Attending Tertiary Eye Care Hospital at One of the Cities of Western India

Introduction : Glaucoma is the leading cause of irreversible visual loss in world and also in India. Because of the relatively asymptomatic initial phase of the disease, it is often detected by chance and is frequently associated with extensive and irreversible damage at the time of diagnosis. Objectives: To screen for Glaucoma among patients eligible as per inclusion criteria, to classify the glaucoma cases according to clinical presentation and to correlate the occurrence of glaucoma with different variables. Method: The present study was conducted at one of the tertiary care hospitals of Ahmedabad city during celebration of “World Glaucoma Week - 2021”. Total 1421 patients were offered opportunistic screening after oral informed consent during 6-12 March 2021, who attended the institute. After applying exclusion criteria, 945 were found eligible who underwent a comprehensive ophthalmic examination like visual acuity, intra- ocular pressure measurement, gonioscopy, optical disc and visual filed examinations were carried out as per standard protocols. Sociodemographic details, any relevant ophthalmic history pertaining to glaucoma and systemic illnesses were also assessed. The data were entered and analyzed in MS excel. Results: The incidence of newly diagnosed cases of glaucoma among opportunistic screened cohort was 36.71% (n=347). Of total newly diagnosed, the presentation as per clinical classification was as follows: Primary open angle glaucoma (POAG) - 202 (58.21%), Primary angle closure glaucoma (PACG) - 77 (22.19%), Primary angle closure suspect (PACS) – 41 (11.82%), Ocular hypertension (OHT) – 6 (1.73%), Normal tension glaucoma (NTG) – 10 (2.88%), Secondary glaucoma – 9 (7.09%) and Congenital glaucoma – 2 (0.58%). In yield, 25 (19.68%) were ?40 years and 36 (28.35%) had positive family history of glaucoma. Conclusion: Presence of stand-alone Diabetes and Hypertension or presence of both accompanying – all three conditions were found to be statistically significant determinant for occurrence of particular variety of Glaucoma. There was highly significant statistical association between cup-disc ratio level at the time of presentation and clinical variety of glaucoma

Evaluation of drug utilisation pattern and cost associated with diabetes mellitusType 2 management in Saudi Arabia

Abstract Diabetic mellitus is an emerging disease in Saudi Arabia. In this regard, a cross-sectional retrospective study was conducted to evaluate drug utilization pattern and the cost associated with non-insulin-dependent diabetes mellitus disease management in Saudi Arabia. Data retrieved from the electronic pharmacy records during the last one year were employed in this study. World Health Organization (WHO) Defined Daily Dose (DDD) method was employed to compute the daily price of each oral hypoglycaemic agent. The American Diabetes Association (ADA) guidelines and protocols were used to evaluate the level of adherence. A total of 17057 patients were enrolled in the study. Out of the 17057 patients enrolled in the study, 60.06 % (10246) were males and the rest females. In monotherapy, biguanides (metformin) were the most recommended and utilised drugs among 5673 patients (33.25%). The most commonly used drug combination was found to be sitagliptin+metformin (1754 units). The cost per unit dose was highest for liraglutide (A10BJ02) 258.32SR (68.79USD), and lowest for metformin (A10BA02) 0.49SR (0.13 USD). Metformin was the choice drug for the diabetes patients; biguanides (metformin) and DPP-4 (sitagliptins) were the most familiar established dose combination employed. Generic drugs should be used in order to reduce overall cost.

Evaluation of temperature effect on cyclic fatigue resistance of nickel-titanium instruments in a double-curved canal: a comparative study / Avaliação do efeito da temperatura na resistência a fadiga cíclica de instrumento níquel titânio em canal com dupla curvatura: estudo comparativo

Objective: To investigate the effect of room and body temperatures on cyclic fatigue resistance of three endodontic nickel-titanium rotary files: Hyflex EDM (HEDM) (Coltene/Whaledent, Switzerland), WaveOne Gold (WOG) (Dentsply Maillefer, Switzer), and EdgeOne Fire (EOF) (EdgeEndo, Albuquerque, New Mexico, USA) in a double- curved canal. Material and Methods: In this study, Sixty NiTi rotary files were used. These files were divided into three groups (n = 20 for each group). Group A: HEDM (size 25, taper 0.08), group B: WOG (size 25, taper 0.07), and group C: EOF (size 25, taper 0.07). Each group was subdivided into two subgroups (n=10 for each subgroup). One of the subgroup was subjected to cyclic fatigue test at room temperature (20±1°C), while the other subgroup was subjected to cyclic fatigue test at body temperature (37±1°C). These files were tested by using a custom-made artificial canal with a double curvature (coronal curve: 60° curvature with 5 mm radius; apical curve: 70° curvature with 2 mm radius). All instruments were rotated according to the manufacturer instructions until the fracture occurred by using electric endodontic motor (Wave One, Dentsply Maillefer, Ballaigues, Switzerland). The number of cycles to fracture (NCF) and the fractured fragment length (FL) were recorded for each endodontic file. The data were gathered and statistically analyzed using shapiro-wilk test and two-way ANOVA test. The statistical significance was set at 0.05. Results: The NCF of WOG and EOF were significantly lower at body temperature as compared to room temperature (p ≤ 0.05), whereas no difference was observed in NCF of HEDM at body and room temperatures (p>0.05). At 20±1°C, the results showed a non-significant difference between NCF of WOG and EOF (p>0.05), while the NCF of HEDM was significantly lower than the other groups (p ≤ 0.05). At 37±1°C, the results showed a non-significant difference in NCF among the tested endodontic files (p ≤ 0.05). There is non-significant difference in FL of each group at (20±1°C) and (37±1°C) (p>0.05). No statistical difference in FL among the tested files at room and body temperatures (p>0.05). Conclusion: The temperature has a significant effect on cyclic fatigue resistance of EOF and WOG, whereas no effect was observed on cyclic fatigue resistance of HEDM. WOG and EOF had a comparable NCF, while HEDM had a lower NCF than other groups at room temperature. At body temperature, all tested files have a comparable NCF. These results were attributed to the type of the alloy and heat treated that was used to manufacture these endodontic files. The cyclic fatigue test should be done at body temperature (AU)

Objetivo : Investigar o efeito das temperaturas ambiente e corpórea na resistência a fadiga cíclica em três instrumentos endodônticos rotatório de níquel-titânio: Hyflex EDM (HEDM)(coltene/Whaledent, Switzerland), WaveOne Gold (WOG) Dentsply Maillefer, Switzer), e EdgeOne Fire (EOF) (EdgeEndo, Albuquerque, New Mexico, USA) em canais com dupla curvatura. Material e Métodos : Neste estudo foram utilizadas sessenta limas endodônticas rotatórias. Esses grupos foram divididos em três grupos (n=20). Grupo A: HEDM (tamanho 25, conicidade 0.08), grupo B: WOG (tamanho 25, conicidade 0.07), e grupo C: EOF (tamanho 25, conicidade 0.07). Cada grupo foi subdivididos em dois subgrupos (n=10). Um dos subgrupos foi submetido ao teste de fadiga cíclica em temperatura ambiente (20±1°C), enquanto o outro subgrupo foi submetido a ao teste de fadiga cíclica em temperatura corpórea (37±1°C). Essas limas foram testadas em um canal artificial feito sob medida com duas curvaturas (curva coronal: curvatura de 60º e com 5 mm de raio; curva apical: curvatura de 70º com 2mm de raio); Todos os instrumentos foram rotacionados de acordo com a instrução do fabricante até que a fratura ocorresse utilizando um motor endodôntico elétrico (Wave One, Dentsply Maillefer, Ballaigues, Switzerland). O número de ciclos até a fratura (NCF) e a comprimento do fragmento fraturado (FL) foram registrados para cada lima endodôntica. Os dados foram coletados e analisados pelo teste shopiro-wilk e ANOVA two-way. A significância estatística foi 0.05. Resultados: O NCF do WOG e do WOF foi significantemente menor na temperatura corpórea em comparação à temperatura ambiente (p ≤ 0.05), enquanto não foi observada diferença entre NCF em HEDM em temperatura corpórea e temperatura ambiente (p>0.05). Em 20±1°C, os resultados mostraram diferença não significativa entre o NFC com WOG e EOF (p>0.05), enquanto o NCF com HEDM foi significante menor que os demais grupos (p ≤ 0.05). A 37±1°C, os resultados mostraram diferença não significativa em NCF entre as limas endodônticas testadas (p ≤ 0.05). Há diferença não significativa no FL de cada grupo (20±1°C) e (37±1°C) (p>0.05). Não houve diferença estatisticamente diferente no FL entre as limas testadas nas temperaturas ambiente e corporal (p>0,05). Conclusão: A temperatura tem efeito significativo na resistência a fadiga cíclica do EOF e WOG, enquanto não foi observado nenhum efeito na resistência a fadiga cíclica do HEDM. WOG e EOF tiveram um NCF comparável, enquanto HEDM teve um NCF menor do que os outros grupos em temperatura ambiente. À temperatura corporal, todas as limas testas apresentam semelhante NCF. Esses resultados foram atribuídos ao tipo de liga e ao tratamento térmico que foi utilizado na fabricação. O teste de fadiga cíclica deve ser feito à temperatura corporal (AU)

Interaction of dental anxiety and ABO secretor status of blood group on dental caries in a group of children / Interação da ansiedade odontológica e o status secretor do grupo sanguíneo ABO na carie dental em um grupo de crianças

Objective: To evaluate the interaction of the dental anxiety precedents at the first dental examination and the AB secretor status of blood groups (A, B, AB, and O) on dental caries experience and severity in a group of school children. Material and Methods: This is a cross-sectional study included 81 healthy children aged 6-8 years from primary schools in Baghdad; with negative previous dental visit. Dental anxiety represented by physiological measures was measured by pulse oximeter. Dental caries experience and severity was recorded. Unstimulated salivary samples were taken from the children to determine the salivary secretor status for AB blood type. Results: The anxiety was decreased as age increases; boys were more anxious than girls; and more anxious children were found in non-secretor group; Dental caries was higher in non-secretor anxious children all with non-significant difference. Conclusion: There is little evidence that the AB secretor status and anxiety to have influence on dental caries experience and severity, as there are many factors may interact to propagate the caries experience and severity. (AU)

Objetivo: Avaliar a interação dos precedentes da ansiedade odontológica no primeiro atendimento e o status secretor do grupo sanguíneo ABO (A, B, AB, and O) na experiência e severidade de carie dental em um grupo de crianças em fase escolar. Material e Métodos: Este estudo cruzado incluiu 81 crianças saudáveis, com 6-8 anos de idade de escola primária em Baghdad; sem atendimento odontológico prévio. A ansiedade odontológica representada por medidas fisiológicas foi avaliada pelo oxímetro de pulso. A experiência à cárie bem como a severidade foram registradas. Amostras de saliva não estimulada foram coletadas das crianças para se determinar o status secretor salivar para tipo sanguíneo AB. Resultados: A ansiedade diminuiu conforme a idade aumentava; meninos foram mais ansiosos do que as meninas; e crianças mais ansiosas foram encontradas no grupo não secretor. A cárie dental foi maior no grupo não secretor de crianças ansiosas sem diferença significante. Conclusão: Há uma pequena evidência de que o status secretor AB e ansiedade tem influência na experiência e na severidade da cárie dental, assim como há vários fatores que podem interagir para propagar a experiência de cárie e sua severidade.(AU)

Green synthesis of gold nanaoparticles using Delphinium Chitralense tuber extracts, their characterization and enzyme inhibitory potential

Abstract Green synthesis has been introduced as an alternative to chemical synthesis due to the serious consequences. Metal nanoparticles synthesized through green approach have different pharmaceutical, medical and agricultural applications. The present study followed a green and simple route for the preparation of potentially bioactive gold nanoparticles (Au NPs). Au NPs were prepared via green synthesis approach using crude basic alkaloidal portion of the tuber of Delphinium chitralense. The green synthesized Au NPs were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD) fourier transform infrared (FTIR), and UV-Visible spectrophotometer. Morphological analysis shows that Au NPs have cubic geometry with different sizes. UV-Vis spectroscopic analysis confirmed the synthesis of Au NPs while XRD proved their pure crystalline phase. The Au NPs showed promising dose dependent inhibition of both AChE and BChE as compared to the crude as well as standard drug.

Resumo A síntese verde foi introduzida como uma alternativa à síntese química devido às graves consequências. As nanopartículas metálicas sintetizadas através da abordagem verde têm diferentes aplicações farmacêuticas, médicas e agrícolas. O presente estudo seguiu uma rota verde e simples para a preparação de nanopartículas de ouro potencialmente bioativas (Au NPs). As NPs de Au foram preparadas via abordagem de síntese verde usando a porção alcaloide básica bruta do tubérculo de Delphinium chitralense. As NPs de Au sintetizadas verdes foram caracterizadas por microscopia eletrônica de transmissão (TEM), microscopia eletrônica de varredura (MEV), difração de raios X (DRX), infravermelho com transformada de Fourier (FTIR) e espectrofotômetro UV-Visível. A análise morfológica mostra que as NPs de Au possuem geometria cúbica com tamanhos diferentes. A análise espectroscópica UV-Vis confirmou a síntese de Au NPs enquanto a XRD provou sua fase cristalina pura. O Au NPs mostrou inibição dependente da dose promissora de AChE e BChE em comparação com a droga bruta e padrão.

Green synthesis of gold nanaoparticles using Delphinium Chitralense tuber extracts, their characterization and enzyme inhibitory potential / Síntese verde de nanaopartículas de ouro utilizando extratos de tubérculos Delphinium chitralense, sua caracterização e potencial inibitório enzimático

Greeen synthesis has been introduced as an alternative to chemical synthesis due to the serious consequences. Metal nanoparticles synthesized through green approach have different pharmaceutical, medical and agricultural applications. The present study followed a green and simple route for the preparation of potentially bioactive gold nanoparticles (Au NPs). Au NPs were prepared via green synthesis approach using crude basic alkaloidal portion of the tuber of Delphinium chitralense. The green synthesized Au NPs were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD) fourier transform infrared (FTIR), and UV-Visible spectrophotometer. Morphological analysis shows that Au NPs have cubic geometry with different sizes. UV-Vis spectroscopic analysis confirmed the synthesis of Au NPs while XRD proved their pure crystalline phase. The Au NPs showed promising dose dependent inhibition of both AChE and BChE as compared to the crude as well as standard drug.

A síntese verde foi introduzida como uma alternativa à síntese química devido às graves consequências. As nanopartículas metálicas sintetizadas através da abordagem verde têm diferentes aplicações farmacêuticas, médicas e agrícolas. O presente estudo seguiu uma rota verde e simples para a preparação de nanopartículas de ouro potencialmente bioativas (Au NPs). As NPs de Au foram preparadas via abordagem de síntese verde usando a porção alcaloide básica bruta do tubérculo de Delphinium chitralense. As NPs de Au sintetizadas verdes foram caracterizadas por microscopia eletrônica de transmissão (TEM), microscopia eletrônica de varredura (MEV), difração de raios X (DRX), infravermelho com transformada de Fourier (FTIR) e espectrofotômetro UV-Visível. A análise morfológica mostra que as NPs de Au possuem geometria cúbica com tamanhos diferentes. A análise espectroscópica UV-Vis confirmou a síntese de Au NPs enquanto a XRD provou sua fase cristalina pura. O Au NPs mostrou inibição dependente da dose promissora de AChE e BChE em comparação com a droga bruta e padrão.

In Silico Screening of Natural Products as Potential Inhibitors of SARS-CoV-2 Using Molecular Docking Simulation / 中国结合医学杂志

OBJECTIVE@#To explore potential natural products against severe acute respiratory syndrome coronavirus (SARS-CoV-2) via the study of structural and non-structural proteins of human coronaviruses.@*METHODS@#In this study, we performed an in-silico survey of 25 potential natural compounds acting against SARS-CoV-2. Molecular docking studies were carried out using compounds against 3-chymotrypsin-like protease (3CLPRO), papain-like protease (PLPRO), RNA-dependent RNA polymerase (RdRp), non-structural protein (nsp), human angiotensin converting enzyme 2 receptor (hACE2R), spike glycoprotein (S protein), abelson murine leukemia viral oncogene homolog 1 (ABL1), calcineurin-nuclear factor of activated T-cells (NFAT) and transmembrane protease serine 2.@*RESULTS@#Among the screened compounds, amentoflavone showed the best binding affinity with the 3CLPRO, RdRp, nsp13, nsp15, hACE2R. ABL1 and calcineurin-NFAT; berbamine with hACE2R and ABL1; cepharanthine with nsp10, nsp14, nsp16, S protein and ABL1; glucogallin with nsp15; and papyriflavonol A with PLPRO protein. Other good interacting compounds were juglanin, betulinic acid, betulonic acid, broussooflavan A, tomentin A, B and E, 7-methoxycryptopleurine, aloe emodin, quercetin, tanshinone I, tylophorine and furruginol, which also showed excellent binding affinity towards a number of target proteins. Most of these compounds showed better binding affinities towards the target proteins than the standard drugs used in this study.@*CONCLUSION@#Natural products or their derivatives may be one of the potential targets to fight against SARS-CoV-2.

Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria

Background: Risky sexual behavior (RSB) is common among youths which predispose them to sexually transmitted infections. This study sets out to identify the factors associated with RSB among undergraduates in Osun state. Methods: The study design was descriptive cross sectional and a total of 550 respondents from two universities in Osun state were sampled using a multistage sampling technique, out of which data from 266 sexually experienced respondents was further analyzed. Data collected via a semi­structured self-administered questionnaire and analyzed using univariate, bivariate and multivariate analyses. Results: The 266 respondents consisted of 54.5% males and 45.5% females and larger percentage of them were in the age group 15-24years. Seven out of ten respondents (69.9%) were sexually active while 65.8% were involved in at least one RSB. Of the 266 respondents, 28.6% ever had concurrent multiple sexual partners, 15.8% used alcohol/drugs at last sex while 48.1% did not use condom at last sex. More males (71.7%), alcohol users (76.8%), drug users (78.0%), pornography watchers (82.7%), internet users (71.2%) respondents "not in good terms with mum" (86.7%) and "those whose mum doesn't instruct them morally" (84.2%) were involved in RSB compared to their respective counterparts (p<0.05). However, there were no identifiable predictors of RSB on regression analysis. Conclusion: Risky Sexual Behavior is prevalent among undergraduates with males being more involved, among other associated factors. Concerned stakeholders should engage youths via behavioral change communication strategies so as to significantly reduce their involvement in RSB

Post operative analgesia using Modified PEC 2 Block in patient posted for Modified Radical Mastectomy - A Case Series

Patients undergoing modified radical mastectomy (MRM) experience lot of pain and require higher doses of analgesics. The modified pectoral nerves (m-PEC 2) block for post-operative analgesia for patients undergoing MRM has proven highly efficacious and best alternative to avoid high dose opioid induced side effects. The m -PEC 2 block was given to 5 patients undergoing modified radical mastectomy for post operative analgesia, decrease in the VAS score was noted and decrease need of rescue analgesia was seen

El impacto de la oesofagogastroduodenoscopia de rutina en el plan de manejo antes de la colecistectomia: un estudio prospectivo / The Impact of Routine Oesophagogastroduodenoscopy on the Management Plan before Cholecystectomy: A Prospective Study

Introducción: La colecistectomía laparoscópica se ha convertido rápidamente en el procedimiento de elección de rutina para la enfermedad de la vesícula biliar, y actualmente es el procedimiento abdominal mayor que se realiza con mayor frecuencia en los países occidentales; la mayoría de los autores sugieren que es seguro observar a pacientes con cálculos biliares asintomáticos, y que la colecistectomía solo se realiza por aquellos pacientes que desarrollan síntomas. El quince por ciento de los pacientes persiste teniendo síntomas posteriores a la colecistectomía. Este estudio tuvo como objetivo evaluar el uso de la esofagogastroduodenoscopía previa a la colecistectomía laparoscópica y su impacto en el manejo. Método: Este fue un estudio clínico prospectivo que involucró a pacientes con cálculos biliares ingresados en el Hospital Docente de Al-Basra, Departamento de Cirugía General desde enero de 2016 hasta diciembre de 2019. Todos los pacientes fueron seguidos desde el momento del ingreso hasta seis meses después. Estos pacientes se dividieron en siete grupos según la edad. A todos los pacientes se les realizó una ecografía abdominal para diagnosticar la presencia de colelitiasis y descartar otros problemas abdominales. Todos los pacientes programados para colecistectomía laparoscópica se sometieron a una endoscopia del tracto gastrointestinal superior antes de la operación. Resultados: Se incluyeron un total de 1200 pacientes con rango de edad de 21 a 82 años (mujeres, 83,33%, hombres, 16,66%) con colelitiasis. La proporción de mujeres a hombres fue de 5:1. Se observaron hallazgos endoscópicos positivos en 380 (31,6%) pacientes. En estos pacientes se modificó el plan de manejo con hallazgos positivos por endoscopia y se pospuso su cirugía hasta recibir el tratamiento adecuado. Conclusión: El uso rutinario de esofagogastroduodenoscopia previa a la colecistectomía disminuiría la colecistectomía innecesaria en pacientes con colelitiasis y hallazgos endoscópicos positivos, lo que disminuye la persistencia de síntomas post colecistectomía.

Introduction: Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder disease, and it is currently the most performed major abdominal procedure in Western countries, most authors suggest that it's safe to observe patients with asymptomatic gallstones, with cholecystectomy only being performed for those patients who develop symptoms. Fifteen percent of patients persist to have post cholecystectomy symptoms. This study aimed to evaluate the use of oesophagogastroduodenoscopy prior to laparoscopic cholecystectomy, and its impact on the management. Method: This was a prospective clinical study involving patients with gallstone admitted to the Al-Basra Teaching Hospital, Department of General Surgery from January 2016 to December 2019. All patients were followed up from the time of admission until six months later. These patients were divided into seven groups according to age. All patients were having an abdominal ultrasound examination in order to diagnose the presence of cholelithiasis and to exclude other abdominal problems. All patients scheduled for laparoscopic cholecystectomy underwent upper GIT endoscopy preoperatively. Results: A total of 1200 patient age range from 21 to 82 years were included (women, 83.33%, men, 16.66%) had cholelithiasis. Female to male ratio was 5:1. Positive endoscopic findings were observed in 380(31.6 %) patients. The management plan was changed in these patients with positive findings by endoscopy and their surgery was postponed until they received proper treatment. Conclusion: The routine use of oesophagogastroduodenoscopy prior to cholecystectomy would decrease the unneeded cholecystectomy in patients with cholelithiasis and positive endoscopic findings, which decrease post cholecystectomy persistence of symptoms.

The future of precision medicine in opioid use disorder: inclusion of patient-important outcomes in clinical trials

Opioid use has reached an epidemic proportion in Canada and the United States that is mostly attributed to excess availability of prescribed opioids for pain. This excess in opioid use led to an increase in the prevalence of opioid use disorder (OUD) requiring treatment. The most common treatment recommendations include medication-assisted treatment (MAT) combined with psychosocial interventions. Clinical trials investigating the effectiveness of MAT, however, have a limited focus on effectiveness measures that overlook patient-important outcomes. Despite MAT, patients with OUD continue to suffer negative consequences of opioid use. Patient goals and personalized medicine are overlooked in clinical trials and guidelines, thus missing an opportunity to improve prognosis of OUD by considering precision medicine in addiction trials. In this mixed-methods study, patients with OUD receiving MAT (n=2,031, mean age 39.1 years [SD 10.7], 44% female) were interviewed to identify patient goals for MAT. The most frequently reported patient-important outcomes were to stop treatment (39%) and to avoid all drugs (25%). These results are inconsistent with treatment recommendations and trial outcome measures. We discuss theses inconsistencies and make recommendations to incorporate these outcomes to achieve patient-centered and personalized treatment strategies.