COVID-19 and Health System Response for Management of Diabetes in Bangladesh: A national qualitative study of patients with diabetes and key healthcare professionals/policy makers

Background: Uncontrolled diabetes can lead to exacerbation of symptoms and life-threatening complications. Consequently, there is a need to explore patient experience regarding the prevention and treatment of diabetic patients amidst the restrictions and lockdown measures in response to COVID-19. The objective of this study was to assess the response of the healthcare system for preventive care and treatment of people with diabetes in Bangladesh during COVID-19, and to analyze the health-seeking behavior of diabetes patients amidst social distancing and lockdown measures Method: A descriptive qualitative design was used to collect data regarding the ability of people living with diabetes to access medication, laboratory services, and preventative care during the pandemic. The data collection process involved 12 focus group discussions (FGDs) with people living with diabetes, and 30 key informant interviews (KIIs) with senior diabetologist, health service managers, leaders of different diabetes-related associations, and policymakers from the local to the national level. The discussion issues were structured around the WHO framework that describes health systems in terms of six building blocks. In addition, different treatment guidelines, scientific articles, relevant reports, and 20 well-circulated newspapers were analyzed concerning the treatment of diabetic patients. Results: 44% of the respondents were aged 55-60 years, with an informed noticeable disruption of essential diabetes care services, intensified by high COVID-19 infection rates. Besides, 78% of the service receiver participants reported not seeing any government-issued public announcements regarding diabetes management on television or newspapers. There are also concerns with the current heath sector. Conclusions: The study findings highlighted major concerns surrounding the healthcare response to deliver care for patients with diabetes during the pandemic, driven mainly by restricted access to treatment under lockdown measures coupled with a reluctance from health care providers to see patients due to high COVID-19 infection rates arising from concerns with a lack of personal protective equipment. Necessary measures can gradually bring some change in the healthcare system promote healthy lifestyles and adherence to prescribed medicines together with raising awareness about the potential risk factors of diabetes.

Gestational Anemia and its effects on neonatal outcome, in the population of Hyderabad, Sindh, Pakistan.

BACKGROUND: Anemia in pregnancy is a globally health-related issue, that affects both mothers and their newborn. Anemia during pregnancy across the world involves approximately 38% of the world population. To evaluate the effect of gestational anemia on perinatal outcome in the population. The aim of present study is to evaluate the effect of gestational anemia on perinatal outcome in the population of Hyderabad, Sindh, Pakistan. METHODS: A cross-sectional comparative analysis was conducted among pregnant mothers who were listed to give birth at Liaquat University of medical and health sciences Jamshoro/Hyderabad during the period of September 2018 to September 2019. The study population 400 were selected by convenient random sampling, and grouped into 2 on the basis of their Hb levels, with Hb < 11 gm% they were classified as anemic mothers, Hb ≥ 11 gm% were termed as non-anemic mothers, data was collected on the preformed questionnaire, and was analyzed on SPSS 21. RESULTS: The prevalence of anemia was 51.5% in in total population out of which, the incidence of normocytic normochromic anemia was highest 52.4 %microcytic hypochromic anemia was found in 19.4%, Overall, extremely low Apgar was found in 53 anemics, and 8 non. anemic mother's infants, LBW incidence was 47.5 %; in anemic mothers, and 15.4 % in non-anemic group, the term, small for gestational age infants were 14.5% in anemic mothers, and 3.6% in non-anemic mothers, there were 36 preterm births to anemic mothers and 10 in non-anemic mothers. The incidence of caesarian section is 53.3% in anemic mothers compared to 30.9% in non-anemic mothers. CONCLUSIONS: Anemia in pregnancy significantly increases risks of low Apgar, LBW, term SGA, preterm birth, and an increase incidence of caesarian section.

Effect of fortified feed with olive leaves extract on the haematological and biochemical parameters of Oreochromis niloticus (Nile tilapia).

Olive leaves have been used traditionally to improve the immunity against several infections. Current study aimed to examine the effect of fortified feed with olive leaves extract on haematological and biochemical parameters of Oreochromis niloticus. Total 400 healthy fish were divided randomly into four groups and were cultured for two months in glass tanks of 250 L water capacity in triplicate. Fortified feed was prepared with various extract, 1%, 1.5% and 2% concentration in diet, while, control-group diet was without extraction. Results showed that all the haematological parameters including WBC, RBC, Hb, PCV and plasma protein were significantly increased while the biochemical parameters such as globulin albumen ratio increased in fish which fed on 1% of extract, but the level of cholesterol and triglycerides was decreasing by increasing the concentration of extract. It was concluded that olive leaves extract can be used to enhance the immunity, growth and health of fish.

Dental Caries and Associated Risk Indicators among Married Saudi Women.

OBJECTIVE: The aim of this study was to evaluate decayed, missing, and filled teeth (DMFT) experience among married females in Saudi Arabia and provide an exploratory data for subsequent primary prevention. MATERIALS AND METHODS: A cross-sectional quantitative study was conducted at a general hospital in Hofuf, Saudi Arabia. All married women attending the general hospital from March 1st to April 15th, 2021 were requested to participate. Data was collected on a validated self-reported questionnaire consisting of sociodemographic factors, medical history, dietary pattern, and DMFT. Descriptive and regression analyses were performed using p ≤0.050. RESULTS: Four hundred forty-eight married females with the mean age of 30.81 ± 6.11 years, mean duration of marriage of 9.55 ± 6.58 years, and having average number of children 2.32 ± 1.69 participated in the study. 61.7% mothers had ≥10 years of education. 63.6% were non-working and 56.5% were found with low family income. 66% participants reported of doing exercise less or more often yet 51.7% were ≥overweight. Consumption of energy drinks and dairy products was found significantly associated with increasing number of DMFT. Use of fluoridated toothpaste and dental visits was also found associated with increasing number of dental caries. Increasing age (p = 0.040), increasing number of children, and middle family income were also significantly associated with higher DMFT, respectively (p = 0.002, p = 0.022). In multi-logistic adjusted analysis, only consumption of dairy products, dental visits, and the unsure status of the use of fluoridated toothpaste were significantly associated with DMFT ≥1. CONCLUSION: DMFT status in married Saudi women was associated with participants' dietary habits, oral health-related practices, family income, married years, and number of children.

Optimizing nitrogen supply promotes biomass, physiological characteristics and yield components of soybean (Glycine max L. Merr.).

Avoidable or inappropriate nitrogen (N) fertilizer rates harmfully affect the yield production and ecological value. Therefore, the aims of this study were to optimize the rate and timings of N fertilizer to maximize yield components and photosynthetic parameter of soybean. This field experiment consists of five fertilizer N rates: 0, 75, 150, 225 and 300 kg N ha-1 arranged in main plots and four N fertilization timings: V5 (trifoliate leaf), R2 (full flowering stage) and R4 (full poding stage), and R6 (full seeding stage) growth stages organized as subplots. Results revealed that 225 kg N ha-1 significantly enhanced grain yield components, total chlorophyll (Chl), photosynthetic rate (P N), and total dry biomass and N accumulation by 20%, 16%, 28%, 7% and 12% at R4 stage of soybean. However, stomatal conductance (g s ), leaf area index (LAI), intercellular CO2 concentration (Ci) and transpiration rate (E) were increased by 12%, 88%, 10%, 18% at R6 stage under 225 kg N ha-1. Grain yield was significantly associated with photosynthetic characteristics of soybean. In conclusion, the amount of nitrogen 225 kg ha-1 at R4 and R6 stages effectively promoted the yield components and photosynthetic characteristics of soybean.

Contrasting effects of maize residue, coal gas residue and their biochars on nutrient mineralization, enzyme activities and CO2 emissions in sandy loess soil.

Mismanagement of crop straw and coal gas residue threatens the atmosphere and the economy. Nevertheless, thermal-pyrolysis is an option for management that turns bio-waste into biochar; its viability and adoption by the public as soil amendments is dependent on the agronomic and environmental values compared between biochar and the raw materials. We undertook a 60-day short-term analysis to assess the impact of various wastes and biochars, as well as inorganic nutrients (N), on carbon dioxide (CO2) fluxes, soil enzyme activities, soil fertility status, and microbial activities. There were eight treatments of soil amendments: without an amendment (CK), Nutrients (N), straw + nutrients (S+N), straw biochar + nutrients (SB+N), coal gas residue + nutrients (C+N), coal gas residue biochar + nutrients (CB+N), straw + straw biochar + nutrients (S+SB+N) and coal gas residue waste + coal gas residue biochar + nutrients (C+ CB +N). The results indicated that soil EC, pH, nitrate N (NO3 -- N), SOC, TN and available K were significantly (p < 0.05) increased coal gas residue biochar and combined with coal fly ash as compared to maize straw biochar and combined with maize straw and N treatments. The higher concentrations of soil MBC and MBN activities were increased in the maize straw application, while higher soil enzyme activity such as, invertase, urease and catalase were enhanced in the coal fly ash derived biochar treatments. The higher cumulative CO2 emissions were recorded in the combined applications of maize straw and its biochar as well as coal gas residue and its biochar treatment. Our study concludes, that maize straw and coal fly ash wastes were converted into biochar product could be a feasible substitute way of discarding, since land amendment and decreased CO2 fluxes and positive changes in soil microbial, and chemical properties, and can be confirmed under long-term conditions for reduction of economical and environment issues.

Frequency distribution and association of Fat-mass and obesity (FTO) gene SNP rs-9939609 variant with Diabetes Mellitus Type-II population of Hyderabad, Sindh, Pakistan.

BACKGROUND/AIM: Diabetes Mellitus (DM) is one of the important public health issues worldwide. The Fat mass obesity (FTO) gene rs-9939609 variant identified single nucleotide polymorphism (SNP) with the T to A missense mutation, and has a strong association with T2DM. FTO gene is present on chromosome "16q12.2" comprising of nine exons. FTO gene rs-9939609 a variant is commonly found in the Pakistani Population. The purpose of the study was to alert the population about the rs-9939609 variant SNP, having a strong association with T2DM. MATERIAL AND METHODS: Total of 190 participants were included in the present cross-sectional study. To collect the samples non-probability convenience technique was used. subjects were recruited and divided into three groups, normal healthy subjects, obese and T2DM. The patients were selected from the Medicine department Jamshoro/Hyderabad by filling the pre-designed proforma, as well as verbal and written consent taken from study participants. To analysed the data ANOVA Post hoc (Tukey-test) was applied for comparison among groups (P < 0.05) and "SNP-STAT" online software was used for frequencies. RESULTS: The BMI, neck circumference, waist circumference and lipid profile, fasting blood sugar and HbA1c was found significant (p < 0.001) in both genders as compared to control. Homozygous and heterozygous distribution of allelic and genotyping frequency was found in study participants. 37.9 %T/A, 57.4% T/T, and A/A were 4.7%. The FTO gene rs-9939609 variant amplified and have an increased risk of developing T2DM in the Sindh population. Codominant model odd ratio of T/A showed 2.42 (CI)1.23-3.84, with significant p < 0.032. CONCLUSION: The present study concluded that the FTO gene SNP rs-9939609 variant was found in the population of Hyderabad, Sindh and having strong association with T2DM and obese individuals. Increase BMI, neck and waist circumference are the biomarkers of obesity and causative factors of T2DM.

Emerging Role of Epigenetics in Explaining Relationship of Periodontitis and Cardiovascular Diseases.

Cardiovascular diseases such as ischemic heart diseases or stroke are among the leading cause of deaths globally, and evidence suggests that these diseases are modulated by a multifactorial and complex interplay of genetic, environmental, and lifestyle factors. Genetic predisposition and chronic exposure to modifiable risk factors have been explored to be involved in the pathophysiology of CVD. Environmental factors contribute to an individual's propensity to develop major cardiovascular risk factors through epigenetic modifications of DNA and histones via miRNA regulation of protein translation that are types of epigenetic mechanisms and participate in disease development. Periodontal disease (PD) is one of the most common oral diseases in humans that is characterized by low-grade inflammation and has been shown to increase the risk of CVDs. Risk factors involved in PD and CVD are determined both genetically and behaviorally. Periodontal diseases such as chronic inflammation promote DNA methylation. Epigenetic modifications involved in the initiation and progression of atherosclerosis play an essential role in plaque development and vulnerability. Epigenetics has opened a new world to understand and manage human diseases, including CVDs and periodontal diseases. Genetic medicine has started a new era of epigenetics to overcome human diseases with various new methodology. Epigenetic profiling may aid in better diagnosis and stratification of patients showing potential predisposed states for disease. A better understanding of the exact regulatory mechanisms of epigenetic pathways driving inflammation is slowly emerging and will aid in developing novel tools for the treatment of disease.

Clinical efficacy of scaling and root planing with and without metronidazole on glycemic control: three-arm randomized controlled trial.

BACKGROUND: Treating periodontitis through non-surgical periodontal therapy (NSPT) may improve glycemic control in type-2 Diabetes Mellitus (T2DM) patients. However, the evidence to maintain this improvement beyond four months is insufficient. Hence, this trial was conducted to assess clinical efficacy of NSPT on glycemic control in T2DM patients. METHODS: This three-arm randomized controlled trial recruited 150 known T2DM participants (35-65 years), suffering from moderate to severe periodontitis, having HbA1c level ≥ 6.5% at baseline. Participants were followed up at 3 and 6 months. Intervention for test group-1 included scaling and root planing (SRP) with metronidazole (MET) and oral hygiene instructions (OHI). Test group-2 was intervened with SRP + OHI and control group with OHI only. Stata v. 14 was used to observe inter and intragroup mean changes in glycemic [glycated hemoglobin (HbA1c), fasting blood glucose (FBG)] and periodontal variables [bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL)] using ANOVA and RMANOVA. Proportion of change in outcome variable (HbA1c) was assessed between treatment groups using chi-square test. Change was considered significant at p-value ≤ 0.05. RESULTS: A significant reduction was observed in BOP, PPD, CAL, HbA1c and FBG over time [p < 0.05]. Significant reductions were observed in same variables in both test groups in comparison to control arm [p < 0.05]. No change between the two test groups was observed [p > 0.05]. CONCLUSION: Scaling and root planing improves glycemic control of T2DM patients independently of the use of MET. Therefore, SRP after every 6 months may be suggested and included as a part of overall diabetes management for patients suffering from T2DM. Clinical trial registration NCT 03,343,366 [Date of Registration: 17/11/2017].

Oral health of individuals with dementia and Alzheimer's disease: A review.

This paper explores the epidemiological evidence about oral health of individuals with neurodegenerative conditions of Alzheimer's disease (AD) and dementia. PubMed, Web of Science, and Scopus were searched to identify the relevant research papers published during January 2012 to June 2020. All cross-sectional, case-control, and cohort studies reporting oral and dental morbid conditions for status and association with AD and dementia were explored. The explored literature from 22 studies shows that oral health parameters of oral health and levels of oral inflammatory markers were deranged and exaggerated in patients suffering from AD and dementia. Many studies have observed poor oral hygiene as result of lack or irregularity in toothbrushing. Regarding decayed, missing, and filled teeth status in AD/dementia populations, no significant difference is reported. Periodontal diseases have been noted at raised levels in AD and dementia patients and shown progression with aggravation in neurological disorders. Both edentulousness and low chewing efficacies are associated with low cognition. Stomatitis and coated tongue and other oral pathologies are significantly higher in AD patients. AD patients have demonstrated higher bacterial load and inflammation levels than controls, and consequently, inflammatory biomarker levels are also raised. AD patients have reduced salivary secretions and with low buffering capacity. Evidence from the current literature update postulates that individuals suffering from AD and dementia have special oral health-care needs. Appropriate oral health management may thus significantly improve their oral health-related and general quality of life.

Association of BMI, Diet, Physical Activity, and Oral Hygiene Practices with DMFT Index of Male Dental Students at King Faisal University, Al-Ahsa.

Despite sufficient knowledge of good oral hygiene habits, dental students still suffer from oral health problems owing to dietary habits, obesity, and a sedentary lifestyle. This cross-sectional study was conducted to evaluate an association of BMI (body mass index), diet, physical activity, and oral hygiene practices with DMFT (decayed, missing, and filled teeth) of male dental students and interns at King Faisal University, Saudi Arabia, from August to September 2020. One hundred and eighty-five male participants completed the study questionnaire. The questionnaire consisted of sociodemographic information and nineteen close-ended questions about current diet, physical activity, and oral hygiene practices. Students' height (cm) and weight (kg) were measured to calculate BMI. The principal investigator performed the oral clinical examinations for the DMFT status in the dental clinic. The chi-square test was used for the dichotomous variables and a t-test was used for the continuous variables. Linear and multinomial logistic regression were performed to detect the significant predictors of the DMFT score. The mean age of participants was 22.29 ± 2.13 years, and the BMI was 24.94 ± 3.36 (Kg/m2). Parents' higher education and income levels were significantly (p < 0.001) associated with a higher BMI. Most dietary variables, especially sugar products, and low physical activity, were significantly (<0.047) associated with higher BMI. All oral hygiene practices, except miswak and mouthwash, were significantly (<0.003) associated with higher BMI. Decayed and missing teeth were significantly (<0.001) higher in the overweight and obese. A simple linear regression analysis demonstrated association between BMI and decayed teeth, with an R = 0.35 (<0.001); BMI and missing teeth had an R = 0.12 (p = 0.867); BMI and filled teeth had an R = 0.15 (p = 0.033), and BMI with DMFT had an R = 0.33 ((<0.001). This study demonstrated a strong significant association of the decayed and missing teeth with higher BMI levels. In addition, BMI was significantly associated with diet and physical activity, despite acceptable oral hygiene practices.

COVID-19, Type-2 Diabetes, and Associated Health Outcomes in China: Results from a Nationwide Survey of 10,545 Adults

ObjectiveThis study examined the associations between type-2 diabetes (T2DM) and self-reported/familial COVID-19 infection and investigated health-related outcomes among those with diabetes during Chinas nationwide quarantine. MethodsThe 2020 China COVID-19 Survey was administered anonymously via social media (WeChat) across China. It was completed by 10,545 adults in all of mainland Chinas 31 provinces. The survey consisted of 74 items covering sociodemographic characteristics, preventive measures for COVID-19, lifestyle behaviors, and health-related outcomes during the period of quarantine. Regression models examined associations among study variables, adjusting for covariates. ResultsDiabetes was associated with a six-fold increased risk of reporting COVID-19 infection among respondents or their family members. Among patients with diabetes, individuals who rarely wore masks had double the risk of suspected COVID-19 infection compared with those who always wore masks, with an inverse J-shaped relationship between face mask wearing and suspected COVID-19 infection. People with T2DM tended to have both poor knowledge of COVID-19 and poor compliance with preventive measures, despite perceiving a high risk of personal infection (40.0% among respondents reporting T2DM and 8.0% without T2DM). Only 54-55% of these respondents claimed to consistently practice preventive measures, including wearing face masks. Almost 60% of those with T2DM experienced food or medication shortages during the quarantine period, which was much higher than those without T2DM. Importantly, respondents who experienced medication shortages reported a 63% higher COVID-19 infection rate. ConclusionsT2DM was associated with an increased risk of self-reported personal and family member COVID-19 infection, which is mitigated by consistent use of face masks. FundingThe project is supported in part by research grants from the China Medical Board (Grant number: 16-262), the National Key Research and Development Program of China (Grant Number: 2017YFC0907200 & 2017YFC0907201), the University Alliance of the Silk Road (Grant number: 2020LMZX002), and Xian Jiaotong University Global Health Institute. Research in ContextO_ST_ABSEvidence before this studyC_ST_ABSDuring the COVID-19 pandemic, it has become increasingly clear that the risk factors for initial infection and subsequent poor health outcomes include, but are not limited to, social vulnerability, economic status, older age, and obesity. While community-wide masking has been recommended by the World Health Organization to control COVID-19, its overall effectiveness has not been clearly evaluated. Added value of this studyThrough an anonymous survey disseminated and promoted through WeChat, the largest social media platform in China, we sought to understand the impact of COVID-19 on the health, wellbeing, and health-related behaviors of adults in China. Specifically, this study examined how individuals with chronic diseases managed the threat, including their COVID-19 related knowledge, attitudes, and adherence to preventive measures such as wearing face masks, and their disease-related self-care. Implications of the available evidenceThis study demonstrates that type-2 diabetes mellitus is associated with an increased risk of COVID-19 infection, which is mitigated by consistent use of face masks.

Awareness of Parents About the Emergency Management of Avulsed Tooth in Eastern Province and Riyadh.

Objective: To assess the level of parents knowledge about the emergency management of tooth avulsion in Eastern Province and Riyadh. Methods: A cross-sectional study was carried out by means of a questionnaire-based internet survey in which 1201 parents from Eastern Province and Riyadh participated. The questionnaire contained 10 closed-ended questions and was used to assess the knowledge of parents about the emergency management of avulsed teeth in Eastern Province and Riyadh. Chi-square test was used for data analysis. Results: In response to closed-ended questions, the statistically significant result was obtained for the history of child dental trauma in which 35% (P=0.04) of parents reported history of dental trauma in their children. These parents were belong to Eastern province (51%) and Riyadh (49%). Furthermore, only 31.3% of the parents were aware of possible storage media for transportation of avulsed tooth while 68.7% (49.5% in Eastern Province and 50.5% in Riyadh) were unaware (P=0.02) of it. Conclusion: That the majority of the parents were unaware of emergency management for tooth avulsion in two densely populated regions of Saudi Arabia. Education of parents should be initiated at a national level.

Evaluation of HbA1c in type-2 diabetes mellitus patients with periodontitis: preliminary findings of three-arm clinical trial.

OBJECTIVE: To assess a relationship and predict changes in glycaemic control due to chronic periodontitis in type-2 diabetic patients. METHODS: Chronic periodontitis (CP) of a cross-section of 118 patients (age ?32 years) was determined using bleeding on probing (BOP), periodontal pocket depth (PPD) and clinical attachment loss (CAL). Their HbA1c, fasting blood glucose (FBG), fasting serum insulin (FSI) and homeostasis assessment model of insulin resistance (HOMA-IR) levels were also tested. Stata 11.0 was used to assess correlation between periodontal and glycaemic measures. Univariate analysis followed by multiple regression analysis through stepwise forward selection process was used to explore significant variables that may predict change in HbA1c. Multi-collinearity and heteroskedasticity were assessed at p-value > 0.05. RESULTS: Results of participants (n=95) showed significantly positive correlations (r) between HbA1c and BOP [r = 0.34, p-value = 0.002], PPD [r = 0.36, p-value = 0.003] and CAL [r=0.42, p-value = 0.002]. However, FBG and HOMA-IR were not found correlated with any of the periodontal measures; except CAL with FBG [r=0.27, p-value=0.02]. In addition to healthy controlled diet, cultural background, education and FBG, CAL was found significant [coef. = 0.746, p-value = 0.001, CI = 0.339, 1.153] to predict change in HbA1c in the final model [R2 = 0.549, p-value < 0.001] with no multicollinearity [mean VIF =1.30] and heteroskedasticity [chi 2 =0.02, p-value= 0.878] in fi n al model. CONCLUSIONS: Increased CAL is estimated to increase HbA1c level by 0.75% in T2DM patients after controlling other factors. It is suggested that periodontal prophylactic management may be planned with an aim to reduce HbA1c. CLINICAL TRIAL REGISTRATION NO: NCT03343366.

Effect of Sodium Bicarbonate Mouth Wash on Salivary pH and Interleukin-1ß Levels among Smokers.

OBJECTIVE: Smoking induces changes in salivary pH and inflammatory biomarker levels associated with oral diseases. This study examined the effect of alkaline oral rinse to modify this effect of smoking on salivary study parameters. MATERIALS AND METHODS: A double-blind randomized controlled trial (RCT) on systemically healthy smokers was conducted. A total of 78 smokers, aged 18 to 40 years, were enrolled as per exclusion/inclusion criteria. An alkaline mouthwash was provided to the intervention group and a placebo to control group. Salivary pH and inflammatory biomarker interleukin (IL)-1ß levels were evaluated at baseline and at follow-up (14 ± 2 days). STATISTICAL ANALYSIS: Chi-squared test, independaent t-test, and paired t-test were used to observe the changes in parameters among and between groups before and after intervention using SPSS v16 with a significance level of p≤0.050. RESULTS: Sixty eight salivary samples were analyzed. All study parameters of the study sample were statistically insignificant between both intervention and control groups at baseline. pH level was 6.56 ± 0.53 at baseline and 6.62 ± 0.45 at follow-up in the intervention group; respective values for control group were 6.70 ± 0.36 and 6.83 ± 0.44 and the changes were not significant (p≥0.071). IL-1ß level was 9.39 ± 10.23 pg/µL at baseline and 5.40 ± 6.62 pg/µL at a follow-up in the intervention group and the change was significant (p = 0.001); respective values for the control group were 10.63 ± 11.50, and 9.33 ± 11.73 and the difference was nonsignificant (p = 0.076). CONCLUSION: This randomized trial indicated that sodium bicarbonate mouth rinse is effective in decreasing IL-1ß levels and increasing salivary pH favorable for prevention of oral diseases.

Early Evidence of Shifts in Alpine Summit Vegetation: A Case Study From Kashmir Himalaya.

Under the contemporary climate change, the Himalaya is reported to be warming at a much higher rate than the global average. However, little is known about the alpine vegetation responses to recent climate change in the rapidly warming Himalaya. Here we studied vegetation dynamics on alpine summits in Kashmir Himalaya in relation to in situ measured microclimate. The summits, representing an elevation gradient from treeline to nival zone (3530-3740 m), were first surveyed in 2014 and then re-surveyed in 2018. The initial survey showed that the species richness, vegetation cover and soil temperature decreased with increasing elevation. Species richness and soil temperature differed significantly among slopes, with east and south slopes showing higher values than north and west slopes. The re-survey showed that species richness increased on the lower three summits but decreased on the highest summit (nival zone) and also revealed a substantial increase in the cover of dominant shrubs, graminoids, and forbs. The nestedness-resultant dissimilarity, rather than species turnover, contributed more to the magnitude of ß-diversity among the summits. High temporal species turnover was found on south and east aspects, while high nestedness was recorded along north and west aspects. Thermophilization was more pronounced on the lower two summits and along the northern aspects. Our study provides crucial scientific data on climate change impacts on the alpine vegetation of Kashmir Himalaya. This information will fill global knowledge gaps from the developing world.

Stimuli-Responsive Naphthalene Diimide as Invisible Ink: A Rewritable Fluorescent Platform for Anti-Counterfeiting.

Herein, we report an approach to combat counterfeiting and storage of valuable information based on the solid-state fluorescence switching behavior of isoniazid functionalized naphthalene diimide (ISO_NDI) in response to an external stimuli (i. e., HCl vapor). The unique feature of ISO_NDI is further utilized to develop an invisible ink (ISO_NDI-PVA) with commercial polymer polyvinyl alcohol (PVA). A solid-state fluorescence recovery was observed while loading with HCl vapors. This exclusive property of the material could be applied directly as a security ink for confidential data storage purpose. Based on above strategy, we successfully realized the rewritable application by using ISO_NDI-PVA ink and confirm its practical efficacy on various substrates by creating different patterns. The solid-state fluorescence switching behavior of ISO_NDI-PVA ink exhibited reversible on/off signal for multiple cycles under the influence of HCl/NH3 vapors. Mechanistic investigation supports a clear participation of intermolecular charge transfer (ICT) phenomenon in the solid-state fluorescence switching property. The ease of fabricating the ink with invisible to visible characteristics in response to HCl vapors provides new opportunities for exploring the application of ISO_NDI-PVA as invisible ink for targeted security applications.

Conjugated Polymer-Based Electrical Sensor for Ultratrace Vapor-Phase Detection of Nerve Agent Mimics.

Considering the vital need to strengthen the national security emanating from chemical threats, a low-cost, portable ultrasensitive electrical sensor for real-time monitoring of diethylchlorophosphate (DCP) (nerve gas mimic) has been developed. The device consists of a "simple to be fabricated" two-terminal resistor and an electronic combinational circuit for rapid onsite detection of lethal nerve gas vapors with high degree of accuracy in milliseconds. This device is a smart readout electronic model that detects ultratrace DCP vapors by bright visual alerts from light-emitting diode (LED) and loud alarm signal without the need for employing a sophisticated instrument. To obtain high sensitivity and discriminating response, a novel amine-functionalized conjugated polymer (CP) is designed as a sensory channel material for two-terminal sensor. The low-powered poly(3-(9,9-dioctyl-9H-fluoren-2-yl)benzene-1,2-diamine) (PFPDA) fabricated two-terminal electrical sensor is tested at ambient conditions, which shows excellent sensitivity toward nerve gas mimic DCP, with a rapid response in 3 s and a very low limit of detection (LOD) of 5.88 ppb. The amine moiety of PFPDA CP plays a vital role in redox interaction between the semiconductor CP and organophosphates, which ultimately leads to the amplified current signal. The redox interactions occurring among the organophosphate analytes and the amine functional group on the PFPDA backbone provided insights into the mechanism of sensing, which formed the basis of the excellent sensitivity and discriminating ability of this sensor device. The newly designed PFPDA CP-based portable electrical sensor device demonstrates a key contribution in the field of portable electronics for defense safety and environmental monitoring applications.

Erupt of malaria, dengue and chikungunya in Pakistan: Recent insights about prevalence, diagnosis and treatment.

Malaria, dengue and chikungunya are the most rampant mosquito-borne infections predominantly in Pakistan. They pose a serious threat and cause a havoc for the victims owing to the life threatening signs and symptoms marked with elevated morbidity and mortality rate. It seems hard to discriminate due to common indications, consequently, deserves appropriate diagnosis prior elevated toll of death. Present article encompasses depth insights about their prevalence, diagnosis and clinical manifestation if erupt in the pandemic. However, host-vector-host cycle is the root cause of transmission and diverse mosquito species confer dissimilar infections. Indeed these infections are seasonal but other factors like flood, open irrigation channels, immense agricultural land, rich fauna and water reservoirs can't be overlooked. Dire need was felt to acknowledge and aware the public about local transmission, vector control, entomologic, research resources, diagnosis and advancement in healthcare system to alleviate them absolutely in future.