Health literacy-related knowledge, attitude, perceived barriers, and practice among primary care doctors in Malaysia.

This study aimed to assess the health literacy (HL) related knowledge, attitude, perceived barriers, and practice among primary care doctors (PCDs) in Malaysia, and to determine the factors associated with HL-related practice. A cross-sectional study was conducted using an online questionnaire. Sociodemographic and work-related details were collected. HL-related knowledge, attitude, perceived barriers, and practice were assessed. Descriptive and inferential analyses using linear regression were performed. 373 PCDs were included in the study with a mean (SD) age of 37.9 (8.1) years old. The mean (SD) HL-related knowledge, attitude, and practice scores were 6.89 (1.27), 36.33 (7.04), and 30.14 (4.7), respectively. 90.9% of the participants had good HL-related knowledge scores, and 89.5% had positive HL-related attitude. More than 80% of participants found that "time constraint to implement health literacy screening" and "lack of human resources to administer HL screening tools in their settings" were among the barriers for them to implement HL practices. PCDs of Chinese and other ethnicities had lower HL-related practice scores compared to those of Malay ethnicity (adjusted b = - 1.74; 95% CI - 2.93, - 0.54, and - 2.94; 95% CI - 5.27, - 0.60, respectively). PCDs who had heard of the term "health literacy" were associated with higher HL-related practice scores (adjusted b = 2.32; 95% CI 1.17, 3.47). Age (adjusted b = 0.10; 95% CI 0.04, 0.16) had significant linear positive relationship with HL-related practice. In conclusion, the HL-related knowledge, attitude, and practice among PCDs in Malaysia were at an acceptable level. Along with educating PCDs on HL, the perceived barriers identified need to be addressed to improve the HL-related practice and ultimately patient care.

Antibacterial, Anti-Biofilm and Pro-Migratory Effects of Double Layered Hydrogels Packaged with Lactoferrin-DsiRNA-Silver Nanoparticles for Chronic Wound Therapy.

Antimicrobial resistance and biofilm formation in diabetic foot infections worsened during the COVID-19 pandemic, resulting in more severe infections and increased amputations. Therefore, this study aimed to develop a dressing that could effectively aid in the wound healing process and prevent bacterial infections by exerting both antibacterial and anti-biofilm effects. Silver nanoparticles (AgNPs) and lactoferrin (LTF) have been investigated as alternative antimicrobial and anti-biofilm agents, respectively, while dicer-substrate short interfering RNA (DsiRNA) has also been studied for its wound healing effect in diabetic wounds. In this study, AgNPs were complexed with LTF and DsiRNA via simple complexation before packaging in gelatin hydrogels. The formed hydrogels exhibited 1668% maximum swellability, with a 46.67 ± 10.33 µm average pore size. The hydrogels demonstrated positive antibacterial and anti-biofilm effects toward the selected Gram-positive and Gram-negative bacteria. The hydrogel containing AgLTF at 125 µg/mL was also non-cytotoxic on HaCaT cells for up to 72 h of incubation. The hydrogels containing DsiRNA and LTF demonstrated superior pro-migratory effects compared to the control group. In conclusion, the AgLTF-DsiRNA-loaded hydrogel possessed antibacterial, anti-biofilm, and pro-migratory activities. These findings provide a further understanding and knowledge on forming multipronged AgNPs consisting of DsiRNA and LTF for chronic wound therapy.

Alveolar Soft Part Sarcoma of Hypopharynx; A Case Report.

Alveolar soft part sarcoma (ASPS) is an aggressive soft-tissue malignancy, notorious for its metastasis to other tissues. A considerable number of cases in the head and neck have been reported but not in the hypopharynx. We describe a 31-year-old man with an incidental finding of a hypopharyngeal mass. Flexible laryngoscopy revealed a fleshy mass 2 × 2 cm2 originating from the left hypopharynx and overlying the epiglottis. Computed tomography scan demonstrated a soft tissue mass in the left wall of the oropharynx measuring about 2.2 × 1.8 cm2, projecting into the hypopharyngeal air space. Magnetic resonance imaging showed a significant thickening of the left hypopharyngeal wall forming a mass lesion occupying the left pyriform sinus and abutting the left aryepiglottic fold. Histopathology indicated that tumor cells were polygonal and epithelioid, with abundant eosinophilic to clear flocculent cytoplasm, eccentric nuclei, and prominent nucleoli. The tumor was positive for smooth muscle actin with rare cells staining for Human Melanoma Black (HMB45). Fluorescence in situ hybridization for transcription factor E3 was also performed and supported the above diagnosis. Our study reports the first case of ASPS in the hypopharynx.

Community practices of face mask use and associated knowledge and attitude in a Malaysian town during the COVID-19 pandemic.

Objectives: Among the vital measures to effectively curb the incidence of COVID-19 is the use of face masks. Little is known about what people understand and how they perceive and use face masks. This study aimed to determine the community's knowledge, attitude, and practice on the correct use of face masks. Design: A cross-sectional study. Setting: The study was carried out in Seremban 2, Malaysia using a self-administered questionnaire adapted from validated questionnaires of two previous studies. Participants: Through opportunistic sampling, three hundred and ninety-two literate adults (above 18) residing in Seremban 2, Malaysia, participated in this study. Main outcome measure: Knowledge, attitude, and practice scores were assessed among the participants. Results: Three hundred seventy (94.4%) respondents demonstrated satisfactory knowledge. A satisfactory attitude score was achieved by 349 (89%) respondents, while 281 (71.7%) achieved a satisfactory practice score. Better knowledge was significantly associated with college or university education (p=0.028). Female gender (p=0.011) and college or university education (p=0.043) were significantly associated with better practice (p<0.05). Significant but weak to fair correlations between knowledge, attitude and practice were observed. Conclusion: Overall, there was satisfactory knowledge, attitude, and practice of face mask use among the Seremban 2 adult population in Malaysia. However, future public health education targeted toward the use of face masks requires more emphasis on proper usage and disposal to translate good knowledge into a good attitude and practice of face mask use to ensure the effectiveness in curbing the spread of infection. Funding: None declared.

Antibiotic prescription in the management of endodontic infections amongst Iraqi final-year undergraduate dental students

Aim This study aimed to examine the prescription of antibiotics for endodontic infections among undergraduate dental students. Methods Two government Iraqi dental schools [(the University of Baghdad (UOB) (n=99) and University of Babylon (UB) (n=70)], and one private dental school [Osouldeen University College (OUC) (n=103)] were included in this survey study. A paper-based questionnaire composed of seven questions was distributed to students, and collected. A chi-square test was used for data analysis, and the level of significance was set at 0.05 (P=0.05). Results A statistically significant difference (P<0.05) was identified between students' answers in the three dental schools regarding antibiotic selection for endodontic infections in which patients had no known allergies (P=0.001). In comparison to other dental schools, a statistically significantly higher proportion of respondents from UOB (32%) favored Azithromycin 500mg for treating patients with penicillin hypersensitivity (P=0.003). A high percentage of participants (62.1%) selected antibiotic prescription in cases with necrotic pulp and symptomatic apical periodontitis (with swelling and moderate/severe preoperative symptoms). However, there were no significant differences between the 3 dental schools (P>0.05). Conclusion In conclusion, a significantly greater percentage of UB chose amoxicillin for the treatment of endodontic infection in patients with no medical allergies. Azithromycin 500mg was selected by UOB as the preferred option in patients who were sensitive to penicillin. Our findings support the need for the implementation of strategies to raise awareness of good antibiotic prescribing practices among dentists in Iraq.

The impact of virtual learning on students' educational behavior and pervasiveness of depression among university students due to the COVID-19 pandemic.

BACKGROUND: One of the worst pandemics of recent memory, COVID-19, severely impacted the public. In particular, students were physically and mentally affected by the lockdown and the shift from physical person-to-person classrooms to virtual learning (online classes). This increased the prevalence of psychological stress, anxiety, and depression among university students. In this study, we investigated the depression levels in Saudi Arabian university students who were learning virtually because of the COVID-19 pandemic and examined its impact on their educational proficiency. METHODS: The study focused on two points: first, examining the depression levels among undergraduate students in Saudi Arabia, by adapting the Zung (Self-Rating Depression Scale) questionnaire. Second, whether there is an association between the levels of depression and various distress factors associated with virtual (online) learning resulting from the COVID-19 pandemic and its impact on students' educational behaviors. The questionnaire was prepared using a monkey survey and shared online, via email, and on WhatsApp groups, with participants in two universities, a public and private university in the largest city of Saudi Arabia. A total of 157 complete responses were received. Data were analyzed using SPSS-24, the chi-square test, descriptive statistics, and multilinear regression. RESULTS: The results indicated that three-fourths of the university students suffered from different depressive symptoms, half of which had moderate to extreme levels of depression. Our study confirmed that a boring virtual (online) learning method, stress, fear of examinations, and decreased productivity were significantly associated with increased depression. In addition, 75% and 79% of the students suffered from stress and fear of examinations, respectively. About half of the students were associated with increased depression. The outcome also indicated that female students experienced extreme depression, stress, and fear of examinations more than males. CONCLUSION: These findings can inform government agencies and representatives of the importance of making swift, effective decisions to address students' depression levels. It is essential to provide training for students to change their educational experience mindset, which might help decrease "depression and stress-related growth." There is also a need to search for a better virtual teaching delivery method to lessen students' stress and fear of examinations.

Impact of the residential green space environment on the prevalence and mortality of Type 2 diabetes mellitus.

OBJECTIVE: The residential green space environment plays a significant role in the progression of social, neuropsychological, behavioral, and public health. Green spaces are considered one of the most important components of healthy life events. This study investigated the impact of the green space environment on the prevalence and mortality of type 2 diabetes mellitus. MATERIALS AND METHODS: In this study, 110 research articles were initially identified through search engines (Web of Science, Pub-Med, Medline, EMBASE, Scopus) using the keywords "green space, environment, prevalence, mortality, diabetes mellitus." Finally, out of 110, 16 (14.54%) original research publications were included in the analysis, and the remaining 94 (85.45%) articles were excluded. The sample size of these 16 studies was 4,615,359. These studies originated from China (4), Canada (3), the United States of America (2), Australia (2), and one study each from the United Kingdom, Hong Kong, Korea, Belgium, and Bangladesh. The data on prevalence and diabetes mellitus were recorded and analyzed. RESULTS: Worldwide total of 16 studies met the selection criteria. The results showed that a high green space environment was significantly associated with a decreased prevalence of diabetes mellitus (13 studies; OR=0.875, 95% CI=0.859-0.891; p<0.001; I2=61.0%) and mortality (3 studies; HR=0.917, 95% CI=0.904-0.930; p<0.001; I2=75.4%). The findings support the hypothesis that a green space environment significantly reduces the prevalence and mortality of diabetes mellitus. CONCLUSIONS: The residential green space environment significantly decreases the prevalence and mortality of type 2 diabetes mellitus. It is suggested to establish strategies to keep residential areas and living environment green and clean to minimize air pollution and fight diabetes mellitus.

Threat to Professional Autonomy and Physicians' Intention to Use Acupuncture: A Study From Malaysia.

Despite its popularity, registered medical practitioners (RMPs) are reluctant to use acupuncture in their practice. The aim of this study is to determine the impact of Threat to Professional Autonomy (TPA) on RMPs' intention to use acupuncture in Malaysia. A cross sectional study was conducted using an online survey form. The survey was distributed to 250 registered medical practitioners who are affiliated with the Malaysian Medical Association. The questionnaire followed a modified technology acceptance theoretical framework including the three main constructs of ease of use, usefulness and intention to use with addition of TPA as a predictor of physician intention. Structural equation modeling (SEM) was utilized to test the relationship between the 4 constructs. Measurement model, discriminant validity and path analysis statistics were presented. Two hundred and seventeen returned the completed questionnaire yielding a response rate of 86.8%. In the measurement model, all items within each construct were highly correlated. The minimum average variance extracted (AVE) was 0.741. All constructs achieved a minimum of 0.896 reliability estimates. Discriminant validity was ascertained with the findings that the square root of AVE is larger than the correlation between each two constructs. TPA has a significant negative impact on ease of use (p < 0.001) and perceived usefulness (p = 0.002). There was no significant direct effect of TPA on intention (p = 0.0561). Fit indices showed adequate fit. In conclusion, TPA affects the intention to use acupuncture indirectly through its negative effect on perceived ease of use and perceived usefulness of acupuncture.

Prevalence of COVID-19 Pandemic, Self-Esteem and Its Effect on Depression Among University Students in Saudi Arabia.

Background and Aims: University students are commonly identified as susceptible, suffering from higher anxiety, stress, and depression than the overall population. During the Corona Virus Disease pandemic (COVID), education was shifted to the virtual learning environment. Students' ambiguity regarding academic accomplishment, imminent careers, changes in social life, and other concerns all these factors played a role in amplifying their stress levels, anxiety, and depression worldwide. This study investigates university students' self-esteem and depressions after they have been online learning for over 1 year due to the COVID-19 pandemic in Saudi Arabia. Methods: For this research, an adapted questionnaire of Rosenberg (Self-Esteem Scale) and Zung (Self-Rating Depression Scale) was used to get the responses of the participants of public and private universities in Saudi Arabia during March-April 2021. We received a total of 151 valid responses from respondents. For data analysis, we used descriptive statistics, ANOVA, multiple regression and binary logistic regression. Findings: The results showed that 75% of the students experienced different levels of depressions, with half (37.5%) having moderate to extreme levels of depression. A total of 41% of students experienced low self-esteem (38% females and 45% males). The regression results indicated depressive symptoms for low self-esteem. Furthermore, results of logistic regression showed that high self-esteem reduces the chances of getting depressive symptoms by 17%. The depressive symptoms were higher in female students than their male counterparts; furthermore, males experienced depressive symptoms less than females by 38%. Conclusions: Based on the current research results, it is concluded that the presence of the COVID-19 pandemic has dramatically increased the depressive symptoms in students, especially in female students. The findings suggested instant consideration and support for students. It is also suggested to the quest for potential managing policies that have been known and effective during the pandemic. Moreover, training should be provided for students to shift their educational experience mindset to an adaptive mindset, which can help them adapt to the new ways of learning and education.

Measuring the Effectiveness of Adaptive Random Forest for Handling Concept Drift in Big Data Streams.

We are living in the age of big data, a majority of which is stream data. The real-time processing of this data requires careful consideration from different perspectives. Concept drift is a change in the data's underlying distribution, a significant issue, especially when learning from data streams. It requires learners to be adaptive to dynamic changes. Random forest is an ensemble approach that is widely used in classical non-streaming settings of machine learning applications. At the same time, the Adaptive Random Forest (ARF) is a stream learning algorithm that showed promising results in terms of its accuracy and ability to deal with various types of drift. The incoming instances' continuity allows for their binomial distribution to be approximated to a Poisson(1) distribution. In this study, we propose a mechanism to increase such streaming algorithms' efficiency by focusing on resampling. Our measure, resampling effectiveness (ρ), fuses the two most essential aspects in online learning; accuracy and execution time. We use six different synthetic data sets, each having a different type of drift, to empirically select the parameter λ of the Poisson distribution that yields the best value for ρ. By comparing the standard ARF with its tuned variations, we show that ARF performance can be enhanced by tackling this important aspect. Finally, we present three case studies from different contexts to test our proposed enhancement method and demonstrate its effectiveness in processing large data sets: (a) Amazon customer reviews (written in English), (b) hotel reviews (in Arabic), and (c) real-time aspect-based sentiment analysis of COVID-19-related tweets in the United States during April 2020. Results indicate that our proposed method of enhancement exhibited considerable improvement in most of the situations.

Improving the Retrieval of Arabic Web Search Results Using Enhanced k-Means Clustering Algorithm.

Traditional information retrieval systems return a ranked list of results to a user's query. This list is often long, and the user cannot explore all the results retrieved. It is also ineffective for a highly ambiguous language such as Arabic. The modern writing style of Arabic excludes the diacritical marking, without which Arabic words become ambiguous. For a search query, the user has to skim over the document to infer if the word has the same meaning they are after, which is a time-consuming task. It is hoped that clustering the retrieved documents will collate documents into clear and meaningful groups. In this paper, we use an enhanced k-means clustering algorithm, which yields a faster clustering time than the regular k-means. The algorithm uses the distance calculated from previous iterations to minimize the number of distance calculations. We propose a system to cluster Arabic search results using the enhanced k-means algorithm, labeling each cluster with the most frequent word in the cluster. This system will help Arabic web users identify each cluster's topic and go directly to the required cluster. Experimentally, the enhanced k-means algorithm reduced the execution time by 60% for the stemmed dataset and 47% for the non-stemmed dataset when compared to the regular k-means, while slightly improving the purity.

CodSeqGen: A tool for generating synonymous coding sequences with desired GC-contents.

Identification of regulatory elements is essential for understanding the mechanism behind regulating gene expression. These regulatory elements-located in or near gene-bind to proteins called transcription factors to initiate the transcription process. Their occurrences are influenced by the GC-content or nucleotide composition. For generating synthetic coding sequences with pre-specified amino acid sequence and desired GC-content, there exist two stochastic methods, multinomial and maximum entropy. Both methods rely on the probability of choosing the codon synonymous for usage in regard to a specific amino acid. In spite the latter exhibited unbiased manner, the produced sequences are not exactly obeying the GC-content constraint. In this paper, we present an algorithmic solution to produce coding sequences that follow exactly a primary amino acid sequence and a desired GC-content. The proposed tool, namely CodSeqGen, depends on random selection for smaller subsets to be traversed using the backtracking approach.

Deferasirox in thalassemia: a comparative study between an innovator drug and its copy among a sample of Iraqi patients.

BACKGROUND: The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral® and its innovator drug deferasirox (Exjade®). METHODS: A prospective observational study including 223 patients receiving the branded medicine Exjade® and 101 patients receiving the copy Osveral® was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferritin (SF), serum creatinine (SC), and alanine aminotransferase (ALT). Data were analyzed with SPSS version 22 software (SPSS, Chicago, IL, USA). RESULTS: The median age of the sample was 8 years. There was no significant difference in gender distribution between the two groups (p = 0.625). Nausea was the most frequently reported adverse effect followed by diarrhea and abdominal pain in both groups. Patients receiving Exjade® had a higher relative reduction of SF at the end of the study compared with the Osveral® group (19.9% versus 9.93%, p = 0.028). SC was found to be significantly higher in the Osveral® group than in the Exjade® group throughout the study period. The mean platelet count was higher in the Exjade® group. ALT was significantly higher among patients receiving Osveral® over the last three months of the study. CONCLUSIONS: Exjade® showed a better ability to reduce SF, with less liver toxicity, and better hemostasis profile. No congenital anomalies associated with short-term use of both drugs during pregnancy were observed or reported.

Impact of non-surgical periodontal therapy on OHRQoL in an obese population, a randomised control trial.

BACKGROUND: Oral Health Related Quality of Life (OHRQoL) is an important measure of disease and intervention outcomes. Chronic periodontitis (CP) is an inflammatory condition that is associated with obesity and adversely affects OHRQoL. Obese patients with CP incur a double burden of disease. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis. MATERIALS AND METHODS: This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. A total of 66 obese patients with chronic periodontitis were randomly allocated into the treatment group (n=33) who received NSPT, while the control group (n=33) received no treatment. Four participants (2 from each group) were non-contactable 12 weeks post intervention. Therefore, their data were removed from the final analysis. The protocol involved questionnaires (characteristics and OHRQoL (Oral Health Impact Profile-14; OHIP-14)) and a clinical examination. RESULTS: The OHIP prevalence of impact (PI), overall mean OHIP severity score (SS) and mean OHIP Extent of Impact (EI) at baseline and at the 12-week follow up were almost similar between the two groups and statistically not significant at (p=0.618), (p=0.573), and (p=0.915), respectively. However, in a within-group comparison, OHIP PI, OHIP SS, and OHIP EI showed a significant improvement for both treatment and control groups and the p values were ((0.002), (0.008) for PI), ((0.006) and (0.004) for SS) and ((0.006) and (0.002) for EI) in-treatment and control groups, respectively. CONCLUSION: NSPT did not significantly affect the OHRQoL among those obese with CP. Regardless, NSPT, functional limitation and psychological discomfort domains had significantly improved. TRIAL REGISTRATION: ( NCT02508415 ). Retrospectively registered on 2nd of April 2015.

An efficient method for significant motifs discovery from multiple DNA sequences.

Identification of transcription factor binding sites or biological motifs is an important step in deciphering the mechanisms of gene regulation. It is a classic problem that has eluded a satisfactory and efficient solution. In this paper, we devise a three-phase algorithm to mine for biologically significant motifs. In the first phase, we generate all the possible string motifs, this phase is followed by a filtering process where we discard all motifs that do not meet the constraints. And in the final phase, motifs are scored and ranked using a combination of stochastic techniques and [Formula: see text]-value. We show that our method outperforms some very well-known motif discovery tools, e.g. MEME and Weeder on well-established benchmark data suites. We also apply the algorithm on the non-coding regions of M. tuberculosis and report significant motifs of size 10 with excellent [Formula: see text]-values in a fraction of the time MEME and MoSDi did. In fact, among the best 10 motifs ([Formula: see text]-value wise) in the non-coding regions of M. tuberculosis reported by the tools MEME, MoSDi and ours, five were discovered by our approach which included the third and the fourth best ones. All this in 1/17 and 1/6 the time which MEME and MoSDi (respectively) took.

Performance of the Malay Audit of Diabetes Dependent Quality of Life-18 and Associates of Quality of Life among Patients with Type 2 Diabetes Mellitus from Major Ethnic Groups of Malaysia.

INTRODUCTION: Diabetes Mellitus (DM) is notorious for its metabolic effect, acute and chronic complications and impact on Quality of Life (QoL). Successful intervention to improve QoL necessitates a valid and reliable measurement tool to identify areas of concern to patients with diabetes. OBJECTIVES: To (1) assess the factor structure of the Malay Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) questionnaire; (2) determine the impact of DM on QoL; and (3) identify areas of concern to patients with type 2 DM from three major ethnic groups in Malaysia. METHODS: Data was obtained from a cross sectional study involving 256 patients with type 2 DM attending the diabetes clinic of the National University of Malaysia Medical Centre. The Malay version of ADDQoL-18 survey was translated from its English version according to standard guidelines and administered by a trained research assistant. Exploratory Factor Analysis (EFA) with oblimin rotation was used to determine factor structure of the data. Confirmatory Factor Analysis (CFA) was used to confirm the factor structure. Hierarchical liner regression was used to determine factors associated with QoL. RESULTS: Unforced factor solution yielded two factors for the whole sample. Forced one factor solution was ascertained for the whole sample and for each ethnic group. Loadings ranged between 0.588 and 0.949. Reliability coefficients were all higher than 0.955. CFA showed that the two factor model had better fit statistics. QoL was associated with the use of insulin and desired glycaemic control, longer diabetes duration, worry about diabetes, and diabetes complications. CONCLUSIONS: The Malay ADDQoL-18 is a valid tool to be used among patients with diabetes from different ethnic groups in Malaysia. The use of insulin to achieve desired glycaemic control had more negative impact on QoL than the use of tablets and/or dietary changes.

Ellagic Acid Increases Osteocalcin and Alkaline Phosphatase After Tooth Extraction in Nicotinic-Treated Rats.

OBJECTIVES: -To examine the effect of nicotine (Ni) on bone socket healing treated with Ellagic acid (EA) after tooth extraction in rat. MATERIALS AND METHODS: Thirty-Two Sprague Dawley (SD) male rats were divided into four groups. The group 1 was administrated with distilled water intragastrically and injected sterile saline subcutaneously. The group 2 was administrated with EA orally and injected with sterile saline subcutaneously. The groups 3 & 4 were subcutaneously exposed to Ni for 4 weeks twice daily before tooth extraction procedure, and maintained Ni injection until the animals were sacrificed. After one month Ni exposure, the group 4 was fed with EA while continuing Ni injection. All the groups were anesthetized, and the upper left incisor was extracted. Four rats from each group were sacrificed on 14(th) and 28(th) days. Tumour necrosis factor alpha (TNFα), Interleukin-1 beta (IL-1ß) and Interleukin-6 (IL-6) were applied to assess in serum rat at 14th and 28(th) days. Superoxide dismutase (SOD) and Thiobarbituric acid reactive substances (TBRAS) levels were assessed to evaluate the antioxidant status and lipid peroxidation accordingly after tooth extraction in homogenized gingival maxilla tissue of rat at 14(th) and 28(th) days. The socket hard tissue was stained by eosin and hematoxylin (H&E); immunohistochemical technique was used to assess the healing process by Osteocalcin (OCN) and Alkaline Phosphatase (ALP) biomarkers. RESULTS: Ni-induced rats administered with EA compound (Group 4) dropped the elevated concentration of pro-inflammatory cytokines significantly when compared to Ni-induced rats (Group 3) (p<0.05). Ni-induced rats administrated with EA compound (Group 4) showed significant production of SOD and recession in TBRAS level when compared to Ni-induced rats (Group 3) (p<0.05). The immunohistochemistry analysis has revealed that OCN and ALP have presented stronger expression in Ni-induced rats treated with EA (Group 4), as against Ni-induced rats (Group 3). CONCLUSION: We have concluded that, Ni-induced rats, treated with EA have exerted positive effect on the trabecular bone formation after tooth extraction in nicotinic rats could be due to the antioxidant activity of EA which lead to upregulate of OCN and ALP proteins which are responsible for osteogenesis.

Anesthetic management of a patient with Weaver syndrome undergoing emergency evacuation of extra-dural hematoma: A case report and review of the literature.

Weaver syndrome is a rare disorder of unknown etiology characterized by skeletal overgrowth, distinctive craniofacial and digital abnormalities and advanced bone age. In general, craniofacial abnormalities that cause difficulty with tracheal intubation may improve, worsen, or remain unchanged as craniofacial structures mature. Furthermore, there is an estimated risk in these children of ≤1.09% of rhabdomyolysis or malignant hyperpyrexia. We report a case of a boy with Weaver syndrome who underwent emergency evacuation of extra-dural hematoma under general anesthesia.

An alternative in situ gel-formulation of levofloxacin eye drops for prolong ocular retention.

INTRODUCTION: Delivering drugs to ocular region is a challenging task. Eye physiological barriers lead to relatively less therapeutic and bioavailability effect by the conventional eye drops. This may be overcome by the use of in situ gel delivery system. OBJECTIVE: The objective of our work was to formulate an ocular delivery system of levofloxacin, based on the concept of ion (sodium alginate) and pH (chitosan) activated in situ gelation concept. Due to its elastic properties, in situ gels resist the ocular drainage of drug leading to longer contact times with ocular surface. MATERIALS AND METHODS: The formulation was evaluated for physicochemical characteristics, in vitro drug release. Ocular retention studies were carried out by Gamma scintigraphy. Time activity curve was plotted between marketed formulation and developed formulation for comparing drug drainage from the eye with time. Ocular tolerance test was performed by handheld infra-red camera. RESULTS AND DISCUSSION: The formulations showed a first-order release pattern over 12 h. Both in vitro release studies and in vivo gamma scintigraphy precorneal retention studies indicated better therapeutic efficacy compared with standard eye drops. CONCLUSION: The results demonstrated that the developed in situ gel of levofloxacin is nonirritant, has prolonged action and is a better option in terms of retention, ocular bioavailability and patient compliance when compared with plain eye drops formulation.