Dentigerous Cyst in a Pediatric Patient: A Case Report.

One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an 11-year-old boy, who had a swelling over his left cheek, which was determined to be a dentigerous cyst by radiological imaging and clinical examination. Over the course of two months, the peanut-sized mass grew to 3x2 cm. A massive, well-defined cystic lesion connected to an unerupted premolar tooth was found on a CT scan of the left maxillary alveolar arch and sinus floor. Under general anesthesia, the patient had a Caldwell-Luc surgery to remove the cyst. In order to avoid difficulties related to cyst formation, which can invade surrounding tissues and even result in cancer if left untreated, early detection using radiological imaging is essential. Complete excision of the cyst is the treatment, particularly for big lesions, in order to limit morbidity and lower the likelihood of aggressive behavior. This case emphasizes the necessity of thorough examination and surgical intervention when necessary, underscoring the significance of early identification and adequate therapy to minimize potential problems related to dentigerous cysts. In cases of dentigerous cysts, early intervention, and appropriate surgical procedures are critical to reducing morbidity and improving patient outcomes.

Evaluation of microbial contamination in removable dental prosthesis at different time of usage.

Aim: The current study evaluates and compares the percentage distribution of different microorganisms according to their strains and occurrence among the three studied groups. Method and Methodology: Sample of 30 removable dental prosthesis wearing patients was selected: wearing either complete dentures or partial dentures and without any significant medical history or on prescription medication for the past 3-6 months. Samples were obtained in three subcategories based on the duration of prostheses worn by the patient. A sterile swab made up of cotton moistened with phosphate buffer saline (PBS) was scrubbed on the dental prosthesis at the fitting surfaces and the denture-bearing area of the oral cavity. Within two hours, the collected swab sample was infused in the sterile tube containing 1 ml of 0.84% PBS solution maintained at pH 7-7.2 and sent for microbiological analysis. The samples were then inoculated into different medias. Microbial growth was checked after incubating the culture plates for 48 h at 37°C. Microorganisms were recognized and counted by calibrated colony counter. Gram's stain was used to stain the colony smear and biochemical tests such as coagulase, catalase, oxidase, sugar fermentation with acid and gas production (triple sugar iron), methyl red test, test for indole production, hydrogen sulphide (H2S) production, citrate utilization, urease test, germ tube tests were performed. Statistical Analysis: Descriptive statistics included calculation of means and standard deviation using multivariate analysis. All values were considered statistically significant for a value of P < 0.05. Results: Streptococcus species, Coagulase-negative staphylococcus, Staphylococcus aureus, Candida albicans and Klebsiella pneumoniae showed the maximum positive culture among the secluded microorganisms in all three groups. Conclusion: A progressive increase in the microbial contamination was directly proportional to the duration of removable prosthesis usage.

Differential expression of lipid metabolic genes in hypercholesterolemic rabbit placenta predisposes the offspring to develop atherosclerosis in early adulthood.

AIMS: Maternal hypercholesterolemia (MHC) is a pathological condition that may cause atherosclerosis in the adulthood of the offspring. The study aims to identify the role of in-utero programming by the placenta in atherogenesis and associated liver pathology in offspring. MAIN METHODS: Female New Zealand white rabbits with normal lipid profiles were fed a 0.3 % HFD after mating. Lipid levels were monitored, and pregnant rabbits were sacrificed at the end of trimester 1, trimester 2, and trimester 3. Placental histology and expression of lipid metabolism genes were studied. Lipid levels, aortic lesions, and mRNA expression of cholesterol synthesis genes were investigated in fetuses at the end of gestation. A group of fetuses was allowed to attain early adulthood to investigate the liver lipid metabolism and atherogenesis with and without an HFD. KEY FINDINGS: Elevated maternal lipid levels and placental gene expression were differentially modulated in HFD-fed mothers. HFD-fed rabbits demonstrated differential expression of the placental genes involved in receptor-mediated endocytosis of cholesterol, lipogenesis, and lipolysis in all three trimesters. It resulted in significant lipid depositions in the placenta, hyperlipidemia, and a decrease in hepatic cholesterol synthesis in fetuses at the end of gestation. There was no atherogenesis in the aorta of offspring at trimester 3, but such offspring of HFD-fed mothers developed atherosclerosis and non-alcoholic fatty liver (NAFL) with profound steatosis in their early adulthood with and without HFD. SIGNIFICANCE: Diet-induced MHC differentially expressed placental lipid genes that may program the offspring to develop atherosclerosis and associated NAFL in early adulthood.

Assessment of Mandibular Canal Using Cone-Beam Computed Tomography (CBCT) and Its Relevance in Post-Operative Neurosensory Disturbances Following Bilateral Sagittal Split Osteotomy Setback.

AIM: Damage to the inferior alveolar nerve (IAN) during bilateral sagittal split osteotomy (BSSO) causes neurosensory disturbances (NSD) of the lower lip and chin. The study aims to investigate the pre-operative position and course of the mandibular canal using cone-beam computed tomography (CBCT) and orthopantomogram (OPG) and compare if there is any difference in NSD following the BSSO setback procedure. MATERIALS AND METHODS: This is an observational study. This study was conducted in the Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, from November 2017 to October 2019. Thirty patients undergoing BSSO setbacks are selected based on the inclusion and exclusion criteria and randomly grouped into two groups - group A (15) and study group B (15). OPG was done for both groups as it was required during surgical orthodontic evaluation and preoperative assessment of the mandibular canal was done using CBCT in group B. Neurosensory assessment was done in all the patients and compared the results. RESULTS: NSD were reported in all the patients on the first postoperative day. The correlation between subjective and objective evaluation showed absolute coincidence but nearly all the patients returned to their presurgical situation within six months in group B and one year in group A who had NSD problems. CONCLUSION: From the study, it can be concluded that a CBCT scan is a useful and reliable modality in the pre-operative evaluation of the mandibular canal in patients undergoing BSSO setback procedures, which helps to improve the patient's post-operative care and quality of life.

UV-activated persulfates oxidation of anthraquinone dye: Kinetics and ecotoxicological assessment.

Sulfate radical-based advanced oxidation processes (SR-AOPs) are gaining popularity as a feasible alternative for removing recalcitrant pollutants in an aqueous environment. Persulfates, namely peroxydisulfate (PDS) and peroxymonosulfate (PMS) are the most common sulfate radical donors. Persulfates activation by ultraviolet (UV) irradiation is considered feasible due to the high concentration of radicals produced as well as the lack of catalysts leaching. The research focuses on determining the impact of activated PDS and PMS on the degradation of anthraquinone dye, i.e., Acid Blue 129 (AB129). UV-activated PDS and PMS can quickly degrade the AB129 as well as restrict the formation of by-products. This could explain the reduced ecotoxicity levels of the treated water after degradation, using an aquatic plant (Lemna minor) and a crustacean (Daphnia magna). This, on the other hand, can ensure that the sulfate radical-based processes can be an environmentally friendly technology.

Identifying the Presence, Activity, and Status of Extraintestinal Manifestations of Inflammatory Bowel Disease Using Natural Language Processing of Clinical Notes.

BACKGROUND: Extraintestinal manifestations (EIMs) occur commonly in inflammatory bowel disease (IBD), but population-level understanding of EIM behavior is difficult. We present a natural language processing (NLP) system designed to identify both the presence and status of EIMs using clinical notes from patients with IBD. METHODS: In a single-center retrospective study, clinical outpatient electronic documents were collected in patients with IBD. An NLP EIM detection pipeline was designed to determine general and specific symptomatic EIM activity status descriptions using Python 3.6. Accuracy, sensitivity, and specificity, and agreement using Cohen's kappa coefficient were used to compare NLP-inferred EIM status to human documentation labels. RESULTS: The 1240 individuals identified as having at least 1 EIM consisted of 54.4% arthritis, 17.2% ocular, and 17.0% psoriasiform EIMs. Agreement between reviewers on EIM status was very good across all EIMs (κ = 0.74; 95% confidence interval [CI], 0.70-0.78). The automated NLP pipeline determining general EIM activity status had an accuracy, sensitivity, specificity, and agreement of 94.1%, 0.92, 0.95, and κ = 0.76 (95% CI, 0.74-0.79), respectively. Comparatively, prediction of EIM status using administrative codes had a poor sensitivity, specificity, and agreement with human reviewers of 0.32, 0.83, and κ = 0.26 (95% CI, 0.20-0.32), respectively. CONCLUSIONS: NLP methods can both detect and infer the activity status of EIMs using the medical document an information source. Though source document variation and ambiguity present challenges, NLP offers exciting possibilities for population-based research and decision support in IBD.

Extraintestinal manifestations of inflammatory bowel disease impact on patient experience, but are poorly captured by electronic health records. Natural language processing systems are capable of not only detecting extraintestinal manifestations, but also inferring activity information by automated analysis of clinical notes.

Equitable Research PRAXIS: A Framework for Health Informatics Methods.

OBJECTIVES: There is growing attention to health equity in health informatics research. However, the literature lacks a comprehensive framework outlining critical considerations for health informatics research with marginalized groups. METHODS: Literature review and experiences from nine equity-focused health informatics conducted in the United States and Canada. Studies focus on disparities related to age, disability or chronic illness, gender/sex, place of residence (rural/urban), race/ethnicity, sexual orientation, and socioeconomic status. RESULTS: We found four key equity-related methodological considerations. To assist informaticists in addressing equity, we contribute a novel framework to synthesize these four considerations: PRAXIS (Participation and Representation, Appropriate methods and interventions, conteXtualization and structural competence, Investigation of Systematic differences). Participation and representation refers to the necessity for meaningful participation of marginalized groups in research, to elevate the voices of marginalized people, and to represent marginalized people as they are comfortable (e.g., asset-based versus deficit-based). Appropriate methods and interventions mean targeting methods, instruments, and interventions to reach and engage marginalized people. Contextualization and structural competence mean avoiding individualization of systematic disparities and targeting social conditions that (re-)produce inequities. Investigation of systematic differences highlights that experiences of people marginalized according to specific traits differ from those not so marginalized, and thus encourages studying the specificity of these differences and investigating and preventing intervention-generated inequality. We outline guidance for operationalizing these considerations at four research stages. CONCLUSIONS: This framework can assist informaticists in systematically addressing these considerations in their research in four research stages: project initiation; sampling and recruitment; data collection; and data analysis. We encourage others to use these insights from multiple studies to advance health equity in informatics.

Cyclodextrin-based strategies for removal of persistent organic pollutants.

Water could be considered one of the essential natural resources on our planet. However, water contamination has become virtually ubiquitous during the past decades due to several factors, e.g., world population growth, water use in chemical production, and agriculture. Among contaminants, persistent organic pollutants (POPs) were widely spread during the last few decades and are now present all around the world. POPs are connected with several different illnesses, and therefore the removal of these pollutants from water is a challenge for coming years. Cyclodextrins (CDs) are environmentally friendly and cheap pollutant adsorbents due to their peculiar physicochemical properties. Moreover, CDs are relatively easy to use, and many techniques are reported for their functionalization. In addition, several CD derivatives are known and some of them are commercially available. CDs and CD-functionalized materials could be used for removal of different pollutants by using various methods, e.g., adsorption/extraction, soil washing, and electrokinetic/catalytic processes. This is the first review article that provides an overview of CDs/CD-based materials and their use in the remediation of POPs listed under the Stockholm Convention. The mechanisms of the POPs removal by CDs are also discussed.

Delay in Reaching Institutional Delivery Service Utilization among Mothers Attending Jimma Medical Center, Ethiopia.

Background: Maternal delay in the utilization of delivery services is one of the contributing factors for high maternal mortality in developing countries. However, it is preventable by timely arrival for obstetric care. The difference between life and death in obstetrics might be a matter of timely arrival and management. The objective of this study was to assess factors associated with maternal delay in reaching institutional delivery service utilization among mothers attending Jimma Medical Center. Method: Facility-based cross-sectional study design was employed. The sample size was determined by a single population proportion formula and entered into epi data version 3.1, then exported to SPSS version 23. The data was presented using texts and tables. Binary and multivariable logistic regression analysis with 95% CI for odds ratio (OR) was used to assess the factors. Result: The prevalence of maternal delay in reaching institutional delivery service utilization was 163(40.2%). Low husbands' educational levels were significantly associated with delay in reaching: illiterate (AOR=4.22, 95% CI: 1.10-16.19), primary (AOR=3.88, 95% CI: 1.24-12.1). Mothers who live in rural areas have been delayed 2 times more than mothers who live in urban areas (AOR=2.22, 95% CI: 1.044-4.73). Likewise, mothers who live a long distance from health facilities are 13 times more likely to delay than mothers who live ≤ 10 kilometers (AOR= 12.89,95%CI:6.66-24.94). Conclusion: Delay in reaching institutional delivery service was high. Factors such as husband's education, distance of health facility, and living area were significant factors with delay in reaching.

Gum Hydrocolloids Reinforced Silver Nanoparticle Sponge for Catalytic Degradation of Water Pollutants.

The accumulation of organic contaminants including dyes in aquatic systems is of significant environmental concern, necessitating the development of affordable and sustainable materials for the treatment/elimination of these hazardous pollutants. Here, a green synthesis strategy has been used to develop a self-assembled gum kondagogu-sodium alginate bioconjugate sponge adorned with silver nanoparticles, for the first time. The properties of the nanocomposite sponge were then analyzed using FTIR, TGA, SEM, and MicroCT. The ensued biobased sponge exhibited hierarchical microstructure, open cellular pores, good shape memory, and mechanical properties. It merges the attributes of an open cellular porous structure with metal nanoparticles and are envisaged to be deployed as a sustainable catalytic system for reducing contaminants in the aqueous environment. This nanocomposite sponge showed enhanced catalytic effectiveness (km values up to 37 min-1 g-1 and 44 min-1 g-1 for methylene blue and 4-nitrophenol, respectively), antibacterial properties, reusability, and biodegradability (65% biodegradation in 28 days).

Enhanced degradation of sulfamethoxazole by a modified nano zero-valent iron with a ß-cyclodextrin polymer: Mechanism and toxicity evaluation.

Rising concern about emerging and already persisting pollutants in water has urged the scientific community to develop novel remedial techniques. A new group of remediation methods is based on the modification of nanoscale zero-valent iron particles (nZVI), which are well known for treating volatile organic compounds and heavy metals. The properties of nZVI may be further enhanced by modifying their structure or surface using "green" polymers. Herein, nZVI was modified by a ß-cyclodextrin polymer (ß-CDP), which is considered an environmentally safe and inexpensive adsorbent of contaminants. This composite was used for the first time for the degradation of sulfamethoxazole (SMX). Coating by ß-CDP not only enhanced the degradation of SMX (>95%, under 10 min) by the nanoparticles in a wide pH range (3-9) and enabled their efficient reusability (for three cycles) but also made the coated nZVI less toxic to the model bioindicator microalga Raphidocelis subcapitata. Moreover, degradation products of SMX were found to be less toxic to Escherichia coli bacteria and R. subcapitata microalga, contrary to the SMX antibiotic itself, indicating a simple and eco-friendly cleaning process. This research aims to further stimulate and develop novel remedial techniques based on nZVI, and provides a potential application in the degradation of antibiotics in a wide pH range. Moreover, the wealth of available cyclodextrin materials used for surface modification may open a way to discover more efficient and attractive composites for environmental applications.

Development of IgM-ELISA for diagnosis of recent infection of Japanese encephalitis virus in equines.

Japanese encephalitis (JE) is a re-emerging mosquito borne disease, for which equines are most susceptible amongst all animals. Detection of specific immunoglobulin 'M' (IgM) is considered as an ideal way to diagnose recent JE virus infection in equines due to low virus load and short-term viremia. The present study was undertaken to develop a sensitive and specific recombinant NS1 protein based indirect IgM-ELISA and IgM capture (MAC) ELISA to diagnose recent infection of JEV in equines. Indirect IgM ELISA was standardized with relative diagnostic sensitivity and specificity of 100% and 88.5%, respectively. The validation of indirect IgM-ELISA in different laboratories revealed excellent reproducibility with Cohen's kappa value ranging between 0.84 and 1. The standardization of MAC ELISA was attempted using checker board titration method and non-specific binding of polyclonal anti-equine IgM capture antibody with anti-porcine IgG conjugate and with hyperimmune serum raised in swine against the antigen was observed. Hence, the MAC ELISA was standardized with monoclonal capture antibody; however, its diagnostic performance could not meet the satisfactory limit. Due to better sensitivity and less turnaround time, indirect IgM-ELISA was employed to screen 821 equine serum samples revealing 33.73% positivity of IgM antibodies against JEV in equine population of India. The high JEV sero-positivity warrants the need for vaccination in Indian equine population along with the demand for research focused towards anti-viral therapy. The indirect IgM-ELISA developed in the present study could be useful to diagnose acute or recent infection of JEV in equines as well as in sero-epidemiological studies.

Comparative Evaluation of Antimicrobial Efficacy of Sodium Hypochlorite, Triphala, Eucalyptus, and Carvacrol against Enterococcus faecalis: An In Vitro study.

Objective: This study aimed to evaluate the antimicrobial effect of sodium hypochlorite (NaOCl), Triphala, Eucalyptus, and carvacrol on Enterococcus faecalis as the most common microorganism isolated from infected root canals. Materials and methods: Seventy-five mandibular premolar teeth were randomly distributed into five study groups: 5.25% NaOCl, 10% Triphala, 1.25% Eucalyptus, 0.6% carvacrol, and negative control (saline) group. Samples were taken using paper points from the canal spaces and using Gates-Glidden (GG) drills from dentinal tubules; after sample culturing, the colony forming unit (CFU) were counted, which was analyzed by the Wilcoxon signed-rank test. Results: All irrigants have shown a reduction of microorganisms in the root canal space. After the use of NaOCl and Eucalyptus, the bacterial count was significantly reduced in the canal, as well as dentin sampling, as compared to Triphala and carvacrol. The antimicrobial efficiency of all irrigants against E. faecalis revealed a significant difference (p < 0.05). Conclusion: All irrigants exerted significant antimicrobial activity against E. faecalis. Around 1.25% of Eucalyptus was the most effective irrigant than 5.25% of NaOCl, Triphala, and carvacrol. How to cite this article: Panchal VV, Dahake PT, Kale YJ, et al. Comparative Evaluation of Antimicrobial Efficacy of Sodium Hypochlorite, Triphala, Eucalyptus, and Carvacrol against Enterococcus faecalis: An In Vitro study. Int J Clin Pediatr Dent 2022;15(5):514-519.

Development of a Self-Adjuvanting, Cross-Protective, Stable Intranasal Recombinant Vaccine for Shigellosis.

With the acquirement of antibiotic resistance, Shigella has resulted in multiple epidemics of shigellosis, an infectious diarrheal disease, causing thousands of deaths per year. Unfortunately, there are no licensed vaccines, primarily due to low or serotype-specific immunogenicity. Thus, conserved subunit vaccines utilizing recombinant invasion plasmid antigens (Ipa) have been explored as cross-protective vaccine candidates. However, achieving cross-protection against Shigella dysenteriae 1, which caused multiple pandemics/epidemics in the recent past, has been difficult. Therefore, a rational approach to improve cross-protection in the preparation for a possible pandemic should involve conserved proteins from S. dysenteriae 1 (Sd1). IpaC is one such conserved immunogenic protein that is less explored as an independent vaccine due to its instability/aggregation. Therefore, to improve cross-protection and potential immunogenicity and to be prepared for a future epidemic/pandemic, herein, we stabilized recombinant Sd1 IpaC, expressed without its chaperone, using a previously reported stabilizing detergent (LDAO) in a modified protocol and assessed its vaccine potential without an adjuvant. The protein assembled into heterogeneous complex spherical structures in the presence of LDAO and showed improved stability at storage temperatures of -80, -20, 4, 25, and 37 °C while providing enhanced yield and concentration. The protein could also be stably lyophilized and reconstituted, increasing the convenience of transportation and storage. Upon intranasal administration in BALB/c mice, the stabilized-IpaC-immunized groups generated significant antibody response and were not only protected against a high intraperitoneal dose of homologous S. dysenteriae 1 but also showed 100% survival against heterologous Shigella flexneri 2a without an adjuvant, while the control animals showed visible diarrhea (bloody-Sd1 challenge), lethargy, and weight loss with 0% survival. Overall, this work demonstrates that stabilized IpaC can be explored as a minimalist, self-adjuvanting, cross-protective, intranasal, single-antigen Shigella vaccine.

Influence of catalyst zeta potential on the activation of persulfate.

The effect of the zeta potential of nano zero-valent iron (nZVI) and carbocatalyst on the activation of persulfate was investigated. The oxidation experiments were performed on three different compounds, with variously modified nZVI and three distinct carbocatalysts. From the obtained results, an evident linear correlation between nanoparticles' zeta potential and reaction rate constants of these three compounds oxidation may be observed. This phenomenon is not mechanism-specific and occurs for the radical and non-radical processes. The present work indicates the critical influence of the surface charge of nZVI and carbocatalysts on the persulfate catalytic activation.

Chitosan/Gelatin/Silver Nanoparticles Composites Films for Biodegradable Food Packaging Applications.

The food packaging industry explores economically viable, environmentally benign, and non-toxic packaging materials. Biopolymers, including chitosan (CH) and gelatin (GE), are considered a leading replacement for plastic packaging materials, with preferred packaging functionality and biodegradability. CH, GE, and different proportions of silver nanoparticles (AgNPs) are used to prepare novel packaging materials using a simple solution casting method. The functional and morphological characterization of the prepared films was carried out by using Fourier transform infrared spectroscopy (FTIR), UV-Visible spectroscopy, and scanning electron microscopy (SEM). The mechanical strength, solubility, water vapor transmission rate, swelling behavior, moisture retention capability, and biodegradability of composite films were evaluated. The addition of AgNPs to the polymer blend matrix improves the physicochemical and biological functioning of the matrix. Due to the cross-linking motion of AgNPs, it is found that the swelling degree, moisture retention capability, and water vapor transmission rate slightly decrease. The tensile strength of pure CH-GE films was 24.4 ± 0.03, and it increased to 25.8 ± 0.05 MPa upon the addition of 0.0075% of AgNPs. The real-time application of the films was tested by evaluating the shelf-life existence of carrot pieces covered with the composite films. The composite film containing AgNPs becomes effective in lowering bacterial contamination while comparing the plastic polyethylene films. In principle, the synthesized composite films possessed all the ideal characteristics of packaging material and were considered biodegradable and biocompatible food packaging material and an alternate option for petroleum-based plastics.

Alkenyl succinic anhydride modified tree-gum kondagogu: A bio-based material with potential for food packaging.

Tree gums are a class of abundantly available carbohydrate polymers that have not been explored thoroughly in film fabrication for food packaging. Films obtained from pristine tree gums are often brittle, hygroscopic, and lack mechanical strength. This study focuses on the chemical modification of gum kondagogu using long-chain alkenyl groups of dodecenyl succinic anhydride (DDSA), an esterifying agent that introduces a 12-carbon hydrophobic chain to the kondagogu structure. The esterification reaction was confirmed by 1H nuclear magnetic resonance and Fourier-transform infrared spectroscopy. The effect of nano-cellulose as an additive on various film properties was investigated. The developed films were characterized for their mechanical, morphological, optical, barrier, antibacterial, and biodegradable properties. The inclusion of long-chain carbon groups acted as internal plasticizers and resulted in an amorphous structure with better film-forming ability, improved hydrophobicity, and higher elongation at break values. The modified films exhibited antibacterial properties and excellent biodegradability under aerobic conditions.

Delay in Seeking Institutional Delivery Service Utilization and Associated Factors Among Mothers Attending Jimma Medical Center, Jimma, Ethiopia.

BACKGROUND: Pregnancy and childbirth-related complications are unpredictable; however, it is preventable by timely care-seeking to obstetric care service. OBJECTIVE: To assess delay in seeking institutional delivery service utilization and associated factors among mothers attending Jimma medical center, Southwest Ethiopia. METHODS: Facility-based cross-sectional study design was employed. The sample size was determined by a single population proportion formula. Data were collected from 405 mothers by face-to-face interview and entered using epi-data version 3.1, then exported to SPSS version 23 for analysis. Binary and multivariable logistic regression analysis with 95% CI for odds ratio (OR) was used to identify significant factors. RESULTS: The prevalence of delay in seeking institutional delivery service utilization was 189 (46.7%). Husbands' educational status was found to be significantly associated with a maternal delay in seeking care, (AOR= 4.9; 95% CI=2.1-11.3). Unemployed mothers and mothers with a low income had shown higher odds of delay (AOR= 6.0; 95% CI=1.7-21.2), (AOR=2.1; 95% CI=1.2-3.7) respectively. Similarly, mothers who live >10 kilometers from health facility delayed about 2times, (AOR=1.8; 95% CI= 1.0-3.2). Moreover, the likelihood of mothers with no antenatal care follow-up was found to have higher delay than mothers who have antenatal care follow-up (AOR =2.8; 95% CI =1.1-6.7). CONCLUSION: Delay in seeking institutional delivery service was high. Factors such as the husband's educational status, distance from the health facility, income, Antenatal care follow-up, and occupation of the mother were found significant factors of delay in seeking care. Therefore, it is important to reduce delay in seeking care for institutional delivery service utilization by working on barriers, plus empowering women, promoting antenatal care, and education.

Antifungal activity of Syzygium samarangense leaf extracts against Candida.

Candida species are opportunistic human fungal pathogens that cause acute and chronic infections against which only few antifungal agents are available. Here we have elucidated the antifungal effect of Syzygium samarangense leaf extracts (SSLE). Antifungal activity of SSLE was studied against Candida albicans, C. krusei, C. parapsilosis, C. glabrata, C. auris and C. tropicalis. Following experiments were performed: minimum fungicidal concentration (MFC) determination, agar well disc diffusion assays, fungal morphology analysis using scanning electron microscope (SEM), ex vivo fungal survival assays on porcine tongue and skin and in vivo fungal survival assays using Drosophila melanogaster fly model. Results demonstrated MFC of SSLE ranges between 100 and 125 mg ml-1 . SEM images showed cell wall degradation of C. albicans when treated with SSLE. Around 75% decrease in C. albicans viability was observed when infected porcine tongue and skin were treated using SSLE. The C. albicans infected D. melanogaster when fed with SSLE showed significant decrease (around 80%) of fungal count than the infected control. Furthermore, agar plate disc diffusion assays demonstrated that the antifungal activity of SSLE could be due to chalcone, which is one of the active constituents in SSLE. Our study demonstrated that SSLE could be used for the topical treatment of Candida infections.