Characterization of meningitis-causing bacteria, with focus on genomic and pangenomic study of multi-drug resistant Streptococcus pneumoniae from cerebrospinal fluid.

Streptococcus pneumoniae is a major cause of meningitis in under developed countries with low vaccination rates and high antibiotic resistance. This study aimed to analyze 83 suspected meningitis patients in Karachi for the detection of S. pneumoniae followed by its whole genome sequencing and Pan Genome analysis. Out of the 83 samples collected, 33 samples with altered physical (turbidity), cytological (white blood cell count) and biochemical (total protein and total glucose concentrations) parameters indicated potential meningitis cases, while these parameters were within normal healthy ranges in remaining 50 samples. Latex particle agglutination (LPA) was performed on the 33 samples, revealing 20 positive cases of bacterial meningitis. The PCR and culturing methods revealed 5 S. pneumoniae isolates. Antibiotic susceptibility tests showed that one S. pneumoniae strain was resistant to erythromycin, levofloxacin, and tetracycline. Whole-genome sequencing of this resistant strain was performed and S. pneumoniae was confirmed with MLST analysis, while it had > 2.3 Mb genome and a single repUS43 plasmid. In CARD analysis, the strain had tet(M), ermB, RlmA(II), patB, pmrA, and patA ARGs, which could provide resistance against tetracycline, macrolide, fluoroquinolone, and glycopeptide antibiotics. Phylogenetic analysis revealed that the isolate was closely related to strains from Hungary and the USA. Pan-genome analysis with 144 genome assemblies from NCBI database showed that 1101 non-redundant core genes were shared between all strains. This study gives valuable understanding into the prevalence and characterization of meningitis-causing bacteria in Karachi, Pakistan  with prime focus on multi-drug resistant S. pneumoniae.

A prospective, observational, multicentre study to evaluate the efficacy of brivaracetam as adjuvant therapy for epilepsy: The Bravo study.

Background: Epilepsy is a persistent tendency to experience epileptic seizures and can lead to various neurobiological disorders, with an elevated risk of premature mortality. This study evaluates the efficacy of brivaracetam adjuvant therapy in patients with epilepsy. Methods: A prospective observational multicentre study that was conducted in Pakistan from March to September 2022, by using a non-probability convenience sampling technique. The population consisted of 543 individuals with a diagnosis of epilepsy for whom adjunctive brivaracetam (Brivera; manufactured by Helix Pharma Pvt Ltd., Sindh, Pakistan) was recommended by the treating physician. The research sample was drawn from various private neurology clinics of Karachi, Lahore, Rawalpindi, Islamabad and Peshawar. Data originating from routine patient visits, and assessments at three study time points, were recorded in the study case report form. Results: Across 18 clinical sites, 543 individuals participated, with a mean age of 32.9 years. The most prescribed dosages were 50 mg BD, followed by 100 mg BD. Notably, brivaracetam combined with divalproex sodium was the most prevalent treatment, followed by brivaracetam with levetiracetam. At both the 14th and 90th day assessments, a significant reduction in seizure frequency was observed, with 63.1% of individuals showing a favourable response by day 90. Treatment-naive individuals exhibited higher rates of seizure freedom and response compared with treatment-resistant individuals. Conclusions: The study demonstrates the effectiveness of brivaracetam combination therapy in epilepsy management, with notable reductions in seizure frequency and favourable clinical responses observed, particularly in treatment-naive individuals.

Yellow scorpion (Buthus sinidicus) venom peptides induce mitochondrial-mediated apoptosis in cervical, prostate and brain tumor cell lines.

Scorpion venoms are known to contain over 100,000 biologically active constituents. However, only a few of them have been studied. The major constituents of venom are proteins and peptides, which exhibit various biological and pharmacological properties, including anticancer activities. In the current study, the venom of yellow scorpions (Buthus sindicus) found in Sindh, Pakistan, was extracted and evaluated for its anti-cancer and anti-inflammatory activities. The crude venom showed a dose dependent inhibition of phagocyte oxidative burst from human whole blood cells (28.3% inhibition at highest tested concentration of 300 µg/mL). In-vitro cytotoxicity of crude venom was evaluated against human prostrate (PC3), cervical (HeLa) and neuroblastoma (U87-MG) cell lines, along with cytotoxicity against normal human fibroblast (BJ) cells. Crude venom was cytotoxic to all cell lines, with prominent inhibitory effect on PC3 cells. Crude venom was fractionated through RP-UPLC, resulted in fifteen fractions, followed by evaluation of their anticancer potential. Among all, the fraction I significantly (P < 0.001) reduced the cell viability of all three cancer cell lines, and exhibited insignificant cytotoxicity against normal cell line. Furthermore, the apoptotic cell death pathway was evaluated for crude venom, and fraction I, in most sensitive cell line PC3, by using flow-cytometry analysis. Both crude venom and its fraction I caused a mitochondrial-mediated apoptosis in prostate cancer cells (PC3). To the best of our knowledge, this is the first report of the anticancer and anti-inflammatory activity of venom of Pakistani yellow scorpions. Results indicate their therapeutic potential, and a case for further purification and validation studies.

Age-Related Decline in Cervical Proprioception and Its Correlation with Functional Mobility and Limits of Stability Assessed Using Computerized Posturography: A Cross-Sectional Study Comparing Older (65+ Years) and Younger Adults.

Cervical proprioception and its implications on postural stability are crucial in older adults. Understanding their relationship is important in understanding and preventing falls in older adults. This research aims to evaluate the proprioceptive, functional mobility, and limits of stability (LOS) variables among two age groups: individuals aged 65 and above and those below 65. A secondary goal of the study is to analyze the relationship between cervical proprioception, functional mobility, and the LOS. METHODS: In this cross-sectional study, 100 participants each were included in the older and younger groups. Researchers employed the target reposition technique to assess cervical proprioception and measured the joint position error (JPE) in degrees. Functional mobility was estimated using the Berg balance scale (BBS) and timed up-and-go test (TUG). In addition, dynamic posturography was utilized to evaluate variables related to the LOS, including reaction time, maximum excursion, and directional control. RESULTS: The magnitudes of the mean cervical JPE are larger (p < 0.001), and functional mobility (p < 0.001) and the LOS (p < 0.001) are impaired in older individuals compared to the younger ones. The cervical proprioception is significantly associated with functional mobility (p < 0.001), and the LOS (p < 0.001). CONCLUSION: In older adults aged above 65 years, cervical proprioception, functional mobility, and the LOS are impaired. Older adults with greater cervical JPE had more impaired functional mobility and LOS parameters. When evaluating or treating older adults with problems with their balance or falls, these factors should be considered.

Chromate Removal by Enterobacter cloacae Strain UT25 from Tannery Effluent and Its Potential Role in Cr (VI) Remediation.

An indigenous chromate-resistant bacterial strain isolated from tannery effluent was identified based on morphological, biochemical, and 16S rRNA gene sequencing, as Enterobacter cloacae UT25. It was found to resist heavy metal ions such as Cr (VI), Pb (II), Cu (II), Co (II), Ni (II), Hg (II), and Zn (II) and antibiotics. The strain was able to remove 89 and 86% chromate, after 24 h of incubation in a Luria-Bertani (LB) medium at an initial Cr (VI) concentration of 1000 and 1500 µg/ml, respectively. Minimum inhibitory concentration (MIC) was observed for chromate to be 80,000 and 1850 µg/ml, after 48 h of incubation in LB and acetate minimal media (AMM), respectively. Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) analysis showed discrete cells with intact and smooth cell walls and homogenous cytoplasm in the absence of metal stress, whereas chromate stress caused cell lysis and reduction in size, which was a characteristic response to Cr (VI) toxicity. Energy Dispersive X-Ray Spectroscopy (EDX) confirmed the adsorption of oxyanions to the cell wall which was one of the Cr (VI) removal mechanisms by the bacterium. Atomic Force Microscopy (AFM) micrographs of chromate-untreated and treated cells revealed Root Mean Square roughness (Rq) values of 16.25 and 11.26 nm, respectively, indicating less roughness in the presence of stress. The partial gene sequence of class 1 integrons (intI1) of strain UT25 showed 94% homology with intI1 gene of strain Enterobacter hormaechei strain ECC59 plasmid pECC59-1. The present analysis highlighted the potential of E. cloacae UT25 as a promissory bacterium that could be applied in removing chromate from polluted environments.

Human Plasma Metabolomics Identify 9-cis-retinoic Acid and Dehydrophytosphingosine Levels as Novel biomarkers for Early Ventricular Fibrillation after ST-elevated Myocardial Infarction.

The relevant metabolite biomarkers for risk prediction of early onset of ventricular fibrillation (VF) after ST-segment elevation myocardial infarction (STEMI) remain unstudied. Here, we aimed to identify these imetabolites and the important metabolic pathways involved, and explore whether these metabolites could be used as predictors for the phenotype. Plasma samples were obtained retrospectively from a propensity-score matched cohort including 42 STEMI patients (21 consecutive VF and 21 non-VF). Ultra-performance liquid chromatography and mass spectrometry in combination with a comprehensive analysis of metabolomic data using Metaboanalyst 5.0 version were performed. As a result, the retinal metabolism pathway proved to be the most discriminative for the VF phenotype. Furthermore, 9-cis-Retinoic acid (9cRA) and dehydrophytosphingosine proved to be the most discriminative biomarkers. Biomarker analysis through receiver operating characteristic (ROC) curve showed the 2-metabolite biomarker panel yielding an area under the curve (AUC) of 0.836. The model based on Monte Carlo cross-validation found that 9cRA had the greatest probability of appearing in the predictive panel of biomarkers in the model. Validation of model efficiency based on an ROC curve showed that the combination model constructed by 9cRA and dehydrophytosphingosine had a good predictive value for early-onset VF after STEMI, and the AUC was 0.884 (95% CI 0.714-1). Conclusively, the retinol metabolism pathway was the most powerful pathway for differentiating the post-STEMI VF phenotype. 9cRA was the most important predictive biomarker of VF, and a plasma biomarker panel made up of two metabolites, may help to build a potent predictive model for VF.

Project-based Learning for Control Education during COVID-19 Pandemic.

The paper presents a project-based learning approach for the undergraduate level first course on control systems in the context of electrical and computer engineering program. We share the experience of a complex engineering project model that assumes no access to lab facility due to the COVID-19 pandemic but targets learning outcomes of a fundamental control system course, i.e., system modeling, performance investigation, analysis, design of analog or digital controller for a selected open-loop unstable system. The project utilizes Tinkercad Circuits which is a free online circuit simulator. The approach provides a solution to one of the challenges of remote or virtual engineering labs, i.e., a requirement of having high-performance expensive hardware and resource-intensive software support. Results are presented in terms of student samples and learning outcomes achieved at the end of the project.

Terahertz dual-band asymmetric transmission for a single cross-polarized linear wave.

The reported dual-band asymmetric transmission is usually an effect of mutual polarization conversion, where one polarized wave is converted to its cross-polarization in the first band while the other polarized wave is converted to its cross-polarization in the second band. In this work, we experimentally demonstrate a dual-band asymmetric transmission effect only for one-polarized linear wave in the terahertz band. It is measured that the cross-polarization transmission coefficient Tyx reaches two peaks of 0.715 and 0.548 at the frequency of 0.74 THz and 1.22 THz, respectively. While the transmission coefficient Txy is lower than 0.2 in the wide-band from 0.5 THz to 1.5 THz. Firstly, the multiple interference model is used to discuss the physical mechanism of the dual-band asymmetric transmission. However, the second band of the calculated spectrum is offset due to the strong near field coupling between the two metal layers. The coupled-mode theory is then introduced and the fitting result of the coupled-mode theory is in good agreement with that of the experiment in the two bands. This research would provide new theoretical instructions in designing and analyzing multiband asymmetric transmission in the terahertz, microwave or the optical bands.

Nephroprotective effect of ethanol extract and fractions of a sea lettuce, Ulva fasciata against cisplatin-induced kidney injury in rats.

Cisplatin is widely used in anticancer therapy, but a substantial percentage of patients who receive the therapeutic dose of cisplatin develop nephrotoxicity. Hepatotoxicity may also develop after a single dose or low repeated doses of cisplatin. Ulva fasciata is an edible seaweed, commonly known as sea lettuces have also been shown various biological activities. In this study, ethanol extract and its solvent fractions (n-hexane and chloroform) of U. fasciata were given (orally) to different groups of rats for 10 days. Injury to the kidney was induced by administrating cisplatin, intraperitoneally (i.p.) to rats at a dose of 7 mg/kg body weight (b.w.) dissolved in 1 mL saline, at 5th day of the experiment. At 10th day rats were sacrificed and kidney parameters (creatinine, urea, and blood urea nitrogen (BUN)) and electrolyte balance (Ca++, Mg++, K+, and Na+) in serum were determined, while oxidative stress markers glutathione (GSH), catalase (CAT) and malondialdehyde (MDA), and inflammatory cytokines, tumor necrosis factor (TNF α), and interleukin (IL-6) were determined in kidney tissues. Histological examination of the kidney was also performed to examine the changes in kidney tissues. Cisplatin caused adverse effects on blood parameters, antioxidants, and inflammatory markers with severe renal tubular injury in kidney tissues. Ethanol extract of U. fasciata and its fractions effectively improved these disorders and diminished the renal dysfunction. However, ethanol extract was found more effective in attenuating the adverse effect of cisplatin than its fractions. n-Hexane-soluble fraction that was subjected to GC-FID and GC-MS analysis revealed the presence of several compounds and some of them are new from this source. It could be concluded that the U. fasciata possesses nephroprotective effect and can attenuate cisplatin-induced renal dysfunction. Since U. fasciata is an edible seaweed, it may be used as a diet supplement.

Metagenomic analysis of drinking water samples collected from treatment plants of Hyderabad City and Mehran University Employees Cooperative Housing Society.

The quality assessment of water, supplied to the end user, is an essential part to assess the physical, chemical, and biological status of water, which impacts on human health. For the quality assessment of drinking water treatment plants and distribution systems of Hyderabad City and Mehran University of Engineering and Technology, Jamshoro, Pakistan, 13 surface drinking water samples were collected from three treatment plants, two of Hyderabad City, including WASA treatment plant and its distribution system (n = 5), Hala Nakka treatment plant and its distribution system (n = 6), and Mehran University Employees Cooperative Housing Society (MUECHS) treatment plant and its distribution system (n = 2). Physicochemical parameters of all drinking water samples were in the range compared to EPA and WHO guidelines, except in L-12 sample. Notably, no free-chlorine was detected in all samples. In metagenomics analysis, targeting V3-V4 hypervariable region of 16S rRNA gene, in QIIME2 environment, high bacterial prevalence was observed in all samples. On average, 348 OTUs were observed per sample. Among all samples, treated water sample from the Hala Nakka Treatment Plant (HNTR) was the most diverse sample in bacterial composition (Shannon 7.51 and Simpsons reciprocal indices 0.98). Overall, Proteobacteria, Bacteroidetes, Cyanobacteria, Verrucomicrobia, and Actinobacteria were the five most abundant phyla (relative abundances of 43.6, 37.9, 8.5, 2.5, and 2.4 percent, respectively). Notably, Cyanobacteria are well-known toxin producers which effect the human, and animal health. At genus level, Flavobacterium (4.86%) and Aquirestis (3.77%) were the most abundant genera. Functional predictions, based on 16S rRNA gene by PICRUSt, predicted 6909 KEGG orthologies, relating to 245 KEGG pathways. Among the predicted pathways of KEGG orthologies, pathways to human infections were also found. In conclusion, this study gave a deep insight into bacterial contamination in drinking water samples of Hyderabad City and MUECHS treatment plants and water quality status in Hyderabad and Mehran University of Engineering and Technology.

Comparison of Light-Emitting Diode-Curing Unit and Halogen-Based Light-Curing Unit for the Polymerization of Orthodontic Resins: An In vitro Study.

AIMS AND OBJECTIVES: Conventionally, composites are cured using halogen-based light-curing units (LCUs). However, recently, light-emitting diode (LED) LCUs have been introduced commercially, claiming many advantages, yet producing comparable bond strength even when cured with single LED LCUs. This present study was undertaken to compare the shear bond strength of orthodontic brackets bonded to teeth with conventional halogen LCU (3M ESPE Elipar 2500) and LED LCU (3M ESPE Elipar FreeLight 2) and to determine the site of bond failure. MATERIALS AND METHODS: Fifty extracted human bicuspid teeth were randomly divided into two groups of 25 each. All the teeth were etched and primed. Then, orthodontic brackets were bonded onto the teeth with the light-cured adhesive (Transbond XT, 3M Unitek), and the adhesive was cured with halogen LCU and LED LCU for Group I and Group II, respectively. The brackets were then subjected to shear stress using a Hounsfield universal testing machine at a crosshead speed of 1 mm/min. The force was recorded in Kgf and converted to MPa. The residual adhesive was scored based on the modified adhesive remnant index (ARI) using an optical stereomicroscope. The data were analyzed using the Student's t-test and the Mann-Whitney test at a significance level of 0.05. RESULTS: The results have shown that there is no significant difference between the shear bond strengths and the ARI scores of both the groups. CONCLUSION: From this study, it can be concluded that (1) LED LCUs containing even only a single LED can cure the composite as well as a halogen-based LCU; (2) there is no statistically significant difference in the shear bond strengths of the two groups; and (3) the ARI scores show no significant difference.

A Comparative Evaluation of Canine Retraction Using Ceramic Bracket and Ceramic Bracket with Metal Slot with Conventional Preadjusted Edgewise Appliance Bracket Systems: A Clinical Study.

AIMS AND OBJECTIVES: The introduction of ceramic brackets was a much-heralded development in the field of orthodontics. However, the increased frictional resistance with these brackets led to the development of ceramic brackets with metal slots, which claimed to combine the esthetics of ceramic brackets with the low frictional resistance of metal brackets. Hence, this study was undertaken to evaluate the rate of canine retraction and the amount of anchor loss while using ceramic brackets and ceramic brackets with metal slots and with conventional preadjusted edgewise appliance (PEA) metal brackets. MATERIALS AND METHODS: The patient sample consists of 12 patients. Six patients received ceramic brackets on one canine and conventional PEA metal brackets on the opposite canine within the same arch. The other six patients received ceramic brackets with metal slot on one canine and conventional PEA metal brackets on the opposite canine within the same arch. Unpaired t-test was used to analyze the data using SPSS version 20 (3M Unitek, Bangalore, Karnataka, India). The rate of retraction was calculated for individual canine retraction after initial leveling and aligning. Anchor loss was also calculated using the pterygoid vertical to the mesiobuccal cusp of the upper first molar on the lateral cephalograms. RESULTS: The result of this study showed that the difference in the rate of retraction between ceramic brackets with metal slot and conventional PEA metal brackets and ceramic bracket while clinically significant was not statistically significant. The difference in the amount of loss of anchorage of both the groups was not statistically significant. CONCLUSIONS: Incorporation of the metal slot in ceramic brackets has reduced frictional resistance for more efficient and desired tooth movement. Ceramic brackets with metal slot generate lower frictional forces than ceramic brackets but higher than conventional PEA metal brackets.

In vitro anticancer activities of Withania coagulans against HeLa, MCF-7, RD, RG2, and INS-1 cancer cells and phytochemical analysis.

BACKGROUND: The Pakistani Salt Range has a rich floral diversity including Withania coagulans from the Solanaceae family. METHODS: The crude methanolic extracts of the root, leaf, leaf stalk, and fruit of this plant were screened for their cytotoxic activity against human (HeLa, MCF-7, RD) and rat (RG2 and INS-1) cancer cell lines at 20 µg/mL and compared to methotrexate. The IC50 values indicated that leaf stalk and fruit extracts exert an 80% or higher cytotoxic activity against all cell lines at 24 hours. RESULTS: The leaf stalk extract showed the highest cytotoxic efficacy against all tested cell lines, with IC50 values ranging from 0.96 ± 0.01 µg/mL to 4.73 ± 0.05 µg/mL followed by the fruit extract with IC50 values of 0.69 ± 0.01-6.69 ± 0.06 µg/mL after 48-72 hours incubation. The leaf stalk and seed extracts were analyzed for polyphenols and flavonoids using RP-HPLC. The total flavonoid content (TFC) was calculated for all tested samples, and the highest TFC was recorded for the root extract (394.34 ± 1.26 µg/g). The total phenolic content (TPC) was found in the seed extract (307.86 ± 9.42 µg/g) of W. coagulans. The highest contents of myricetin (358.46 ± 2.91 µg/g) were noted in the leaf extract, and highest quercetin was recorded in the seed extract (21.43 ± 0.13 µg/g). The highest gallic acid concentration (83.62 ± 0.71 µg/g) was recorded in leaf stalk extract and p-hydroxybenzoic acid in the seed extract (157.46 ± 1.43 µg/g). CONCLUSION: The present study gives a scientific insight and comparative analysis of various plant parts in this medicinally important plant species from the Salt Range of Pakistan against both human and rat cancer cells.

In vitro Evaluation of Shear Bond Strength of Orthodontic Brackets Bonded with Different Adhesives.

BACKGROUND: There is necessary of dry operating field for bonding of orthodontic brackets. The presence of moisture can alter the bond strength. Hence, the aim of the present study was to evaluate the shear bond strength of orthodontic brackets with different adhesives. MATERIALS AND METHODS: In this in vitro study, a total of 100 orthodontically extracted premolars with sound crown structure were divided into 4 equal groups of different primers. Bonding on the buccal surface of all teeth was done after acid etching with upper premolar brackets using different primers followed by light curing. Shear bond strength was evaluated with or without salivary contamination with both adhesives. A shear force for deboning the bracket was done with universal testing machine. The debonded specimens were examined at ×10 magnification to check site of bond failure and remaining adhesive on tooth using adhesive remnant index (ARI). The obtained data were statistically evaluated using SPSS 20 for Windows (SPSS Inc., Chicago, IL, USA) using ANOVA, Kolmogorov-Smirnov, and Levene's test at the statistical significance of P < 0.05. RESULTS: Transbond Plus showed higher shear bond strength of 8.92 MPa under dry and 5.65 MPa with saliva contamination over Transbond XT of 7.24 MPa under dry and 2.43 MPa with saliva contamination, respectively. Higher ARI score was found without contamination in both adhesives. CONCLUSION: Transbond Plus hydrophilic resin had good shear bond strength under both dry and contamination condition compared to hydrophobic Transbond XT resin material.

Metagenomic Characterization of Bacterial Communities in Drinking Water Supply System of a Mega City.

Supplying safe water to consumers is vital for protection of public health. With population of > 15 million, Karachi is the main economical hub of Pakistan. Lake Keenjhar serves as the main source of fresh water while Hub dam is the secondary water reservoir for Karachi. In this study, bacterial community of the drinking water supply system (DWSS) of Karachi was studied from source to tap using metagenomics approach. For this purpose, we collected 41 water samples from different areas of the city (n = 38) and water reservoirs (n = 3). 16S rDNA metagenomic sequencing of water samples revealed that 88% sequences were associated with Proteobacteria (52%), Planctomycetes (15%), Becteroidetes (12%), and Verrucomicrobia (6%). On the class level, α-proteobacteria (6-56%) were found to be the most abundant followed by ß- (8-41%) and γ-proteobacteria (6-52%). On the genus level, substantial diversity was observed among the samples. Bacterial communities in water from Hub dam was found to be distantly related while among the residential towns, Lyari was highly distant from the others. Twenty-four bacterial genera were found to be exclusively present in residential area samples in comparison to the source waters which is suggestive of their resistance against treatment procedures and/or contamination. Metagenomic analysis revealed abundance of Pseudomonas, Legionella, Neisseria, Acinetobacter, Bosea, and Microcystis genera in residential areas water samples. The present metagenomic analysis of DWSS of Karachi has allowed the evaluation of bacterial communities in source water and the water being supplied to the city. Moreover, measurement of heavy metals in water samples from Karachi revealed arsenic concentration according to WHO standards which is in contrast of recent study which reported extensive arsenic contamination in aquifers in the Indus valley plain. To the best of our knowledge, this is the first metagenomic study of DWSS of Karachi.

Comparison of visual acuity, refractive outcomes, and satisfaction between LASIK performed with a microkeratome and a femto laser.

PURPOSE: To compare refractive outcomes, visual acuities, and satisfaction of patients between those treated with laser-assisted in situ keratomileusis (LASIK) using a Hansatome microkeratome (HM) and femto-assisted laser (FAL). METHODS: This was a retrospective analysis of 1,366 eyes in 687 patients who underwent LASIK with an HM (n=1,137) and an FAL (n=229) at the two centers of Hashmanis Hospital, Karachi, Pakistan. Refractive outcomes, including sphere, cylinder, and spherical equivalent in diopters (D), and visual acuities were assessed both preoperatively and at 1 month follow-up. Patient satisfaction was gauged by contacting the patient at the time of chart review. RESULTS: The postoperative median sphere, cylinder, and spherical equivalent values for those treated with FAL were 0.3±0.7 (-5.5-1.8), -0.5±0.6 (-5.0-1.0), and 0.0±0.7 (-6.0-1.6), respectively. For the HM arm, they were 0.0±1.28 (-10.8-6.8), -0.5±0.5 (-4.5-1.5), and -0.3±1.3 (-11.6-6.8), respectively. All preoperative values were statistically insignificant between the groups, while postoperative values were significant with P-values <0.001. Predictability and efficacy index was higher for the FAL (92.1%, 1.00) than the HM group (82.2%, 0.84). Similarly, patient satisfaction was slightly higher for those treated with FAL (93.3%) than HM (91.4%). CONCLUSION: Our large retrospective analysis of eyes that have undergone LASIK using HM and FAL shows superior refractive outcomes in the latter, with special regard to procedural efficacy and predictability.

Insights into the state of radiation protection among a subpopulation of Indian dental practitioners

PURPOSE: Radiographs is an integral part of patient management in dentistry, despite their detrimental effects. As the literature pertaining to radiation protection among Indian dental practitioners is sparse, exploring such protection is needed. MATERIALS AND METHODS: All private dental practitioners in Mangalore, India were included in the study. A structured, pre-tested, self-administered questionnaire was employed to assess the knowledge, attitudes, practices, previous training, perceptions towards the need to spread awareness, and willingness to gain and implement knowledge about radiation hazards and protection. Information regarding each respondent's age, gender, education, and type and duration of practice was collected. RESULTS: Overall, 87 out of 120 practitioners participated in the study. The mean knowledge, attitude, and practice scores were 9.54+/-2.54, 59.39+/-7.01, and 5.80+/-3.19, respectively. Overall, 25.3% of the respondents had undergone training in radiation protection, 98.9% perceived a need to spread awareness, and 94.3% were willing to improve their knowledge. Previous training showed a significant correlation with age, sex, and duration of practice; attitude was significantly correlated with education and type of practice; and knowledge scores showed a significant correlation with type of practice. CONCLUSION: Although the knowledge and practices of respondents were poor, they had a positive attitude and were willing to improve their knowledge. Age, sex, and duration of practice were associated with previous training; education and type of practice with attitude scores; and type of practice with knowledge scores. The findings of this study suggest a policy is needed to ensure the adherence of dental practitioners to radiation protection guidelines.