One-year radiographic and clinical performance of bioactive materials in primary molar pulpotomy: A randomized controlled trial.

OBJECTIVES: Mineral Trioxide Aggregate (MTA) is considered the gold standard material for pulpotomy procedures. However, some drawbacks such as poor handling and long setting time are challenging when it is used as pulpotomy dressing in primary molars in children. Hence, the purpose of this study was to compare the radiographic and clinical performance of a premixed, fast setting bioceramic root repair material (BC RRM-F) with MTA in vital pulpotomy procedures of primary molars, with or without the added seal of a stainless steel crown (SSC). METHODS: In this double blinded, four-arm, parallel group randomized contolled trial (RCT), 64 primary molars were randomly allocated to one of the four treatment groups: MTA (PDTM MTA WHITE)+SSC, MTA+GI (bulk fill glass ionomer with glass hybrid technology GC EQUIA Forte® HT), BC RRM-F+GI and BC RRM-F+SCC. All molars were evaluated clinically and radiographically according to the modified Zurn and Seale criteria at 1, 3, 6, and 12 months follow up. Multivariate cox regression models and Kaplan-Meier curves were used for survival analysis. RESULTS: There was no statistically significant difference between the success of both pulp capping materials used. Overall survival analysis showed that using GI instead of SCC as a final restorative material was significantly associated with increased risk of failure. CONCLUSIONS: TotalFill® BC RRM™ Fast Set Putty can be used as an alternative to MTA in primary molar pulpotomy. Regardless of the pulp capping material, one year survival of pulpotomized primary molars restored with SSC is higher compared to those restored with GC EQUIA Forte® HT. CLINICAL SIGNIFICANCE: Clinicians' preference and cost effectiveness may justify the use of either material in primary molar pulpotomy. Parents insisting on tooth-colored restorations for their children's pulpotomized teeth cannot be told that the expectation for success is the same as those restored with SSC, even if calcium silicate-based pulp capping materials are used.

Intraoperative and Postoperative Outcomes of Modified Bidirectional Intra-Umbilical Incision versus Infra-Umbilical Incision for Direct Trocar Insertion in Gynaecological Laparoscopy: A randomised controlled trial.

Objectives: This study aimed to describe a modified, curved, deep, bidirectional, intra-umbilical, vertical incision for primary trocar insertion and prospectively compare its intraoperative and postoperative outcomes with an infra-umbilical incision in gynaecologic laparoscopy. Methods: Between August 2019 and March 2021, 110 patients subjected to the direct trocar insertion technique for laparoscopic intervention were classified into two groups. Group A comprised 55 cases of infra-umbilical incision, whereas group B comprised 55 cases of a modified, curved, longitudinal, deep, bidirectional, intra-umbilical incision. Afterwards, intraoperative and postoperative assessments were performed. Results: The increase in the numbers of parity, gravidity and previous caesarean sections was found to be statistically significant; a smaller number of infertility complaints were observed in group B. Similarly, group B expressed a statistically significant less peri-trocar CO2 leakage (46 [83.6%] patients versus 28 [50.9%] patients) and more tightness of the primary portal entry (45 [81.8%] patients versus 30 [54.5%] patients) when compared to group A throughout the whole operation. After a one-month follow-up, a statistically significant (P = 0.029) decrease in the Observer Scar Assessment Scale and Patient Scar Assessment Scale scores in group B (10.4 ± 4.2 and 11.8 ± 4.3, respectively), demonstrating better cosmoses when compared to group A (13.3 ± 5.7 and 16.0 ± 6.8, respectively). Conclusion: Performing a modified, curved, deep, bidirectional, intra-umbilical, vertical incision for the insertion of a primary laparoscopic trocar (i.e. Darwish laparoscopic entry) is a simple and fast step that results in the elimination of intraoperative gas leakage and trocar slippage without the need for any additional sutures. Aesthetically, it results in a better scar with satisfactory cosmoses when compared to an infra-umbilical incision.

Prevalence and risk assessment of microplastics in the Nile Delta estuaries: "The Plastic Nile" revisited.

Recent research is directed toward studying plastic pollution in rivers, and estuaries due to the importance of freshwater bodies in all aspects of life. The river deltas and estuaries are interesting for studying the flux of plastics into the oceans. The Nile River has been identified as a hot spot of plastic litter flux in the eastern Mediterranean basin. In addition, it was nicknamed "Plastic Nile", yet this major river is largely unexplored with a lack of field measurements and adequate surveys. The current study was based on bridging this scientific gap. Three trips were conducted, covering 30 km in the Rosetta branch and 23 km in the Damietta branch, during the high water level in summer 2021, and 10 km off the inlet of Lake Burullus, in spring 2021. Microplastics in surface water ranged from 761 ± 319 to 1718 ± 1008 MPs/m3, and from 167 ± 137 to 1630 ± 1303 MPs/kg of dry sediments. Land use/ land cover mapping using Sentinel-2 images showed several sources of pollution that contribute to plastic contamination in the study area. Thermal analysis indicated seven plastic polymers; including, PE, PP, PET, PEVA, and PTFE, using discarded plastic products as reference materials. Microplastics were composed of colored and glossy fragments of sizes <500 µm, originating from land-based sources. Pollution load, polymer risk assessment, and ecological risk indices were calculated. Based on field observations macro-plastics were retained within the extensive network of infrastructure and dam systems. 80-106 billion MPs/year were estimated to flux from the Nile estuaries into the Mediterranean Sea. The current situation urges the development of binding plans to reduce plastic waste in the Nile Delta, as well as setting environmental monitoring points along the Deltaic coast.

Simplification of Vaginoscopic Surgery Using a Self-Retaining External Vulvar Sheet (Darwish sheet).

OBJECTIVE: One of the main difficulties of vaginoscopy is continuous leakage of distension medium from the introitus hindering proper visualization. This study evaluates the effectiveness and success of performing diagnostic or operative vaginoscopic surgery via a tight self-retaining external vulvar sheet (Darwish sheet) expressed as tight vaginoscopy (TV) compared with conventional vaginoscopy (CV). PATIENTS AND METHODS: Females referred for vaginoscopy were initially examined by diagnostic CV followed by TV, and whenever indicated, operative TV via Darwish sheet was performed. RESULTS: Diagnostic TV was more feasible with excellent visualization if compared with CV. The mean infused distension fluid volume was 325 ml versus 485 ml, and the mean leaked fluid volume was 37 ml versus 94 ml in diagnostic TV versus CV, respectively. Operative TV via Darwish sheet was done in 21 cases (56.7%) that required surgery with 100% success rate without any reported complications. CONCLUSIONS: Accomplishing vulvar tightness using a cheap self-retaining external vulvar sheet (Darwish sheet) during vaginoscopy (TV) is associated with a clearer visualization of vagina or cervix, a lesser amount of irrigating fluid and lesser leakage as compared with CV.