Disinfection of Impression Materials with Glutaraldehyde, Ultraviolet Radiation, and Autoclave: A Comparative Study.

BACKGROUND: The present study was conducted to compare various methods of disinfection of impression materials such as glutaraldehyde, ultraviolet (UV) radiation, and autoclave. MATERIALS AND METHODS: The present study was conducted on eighty alginate impression materials which were disinfectant with 2.2% glutaraldehyde, UV radiation, and autoclave. The pre- and postbacterial count was assessed. RESULTS: The mean premicrobial contamination in Group I was 362.2 106 colony-forming unit (CFU)/ml, in Group II was 306.4 106 CFU/ml, and in Group III was 336.2 106 CFU/ml. The mean postmicrobial contamination in Group I was 65.2 106 CFU/ml, in Group II was 76.7 106 CFU/ml, and in Group III was 28.4 106 CFU/ml. CONCLUSION: The authors found that autoclave proved to be better in terms of reduction in bacterial colonies as compared to glutaraldehyde and UV radiation.

A Comparative Evaluation of Marginal Accuracy of Co-Cr Metal Copings Fabricated Using Traditional Casting Techniques and Metal Laser Sintering.

AIMS AND OBJECTIVES: The aim and objective of the study were to determine the amount of marginal discrepancy produced by cobalt-chromium (Co-Cr) copings fabricated using two different fabrication methods, i.e., traditional casting and direct metal laser-sintering (DMLS), and compare the values obtained between each fabrication technique and to evaluate if the fabrication technique can produce prosthesis that is within the standards of clinical acceptance of marginal discrepancy. MATERIALS AND METHODS: Twenty metal copings each were fabricated by laser sintering and traditional casting method. The marginal gap at the buccal, lingual, mesial, and distal areas was measured using the silicone replica technique. The stereomicroscope and optical microscope were used to measure the marginal discrepancy between the working die and the copings. Statistical analysis was done using a t-test using Open-epi calculator software. RESULTS: The values indicate that the marginal gap was less for the copings fabricated using Co-Cr alloy crowns that were fabricated with direct metal laser-sintered technique than Co-Cr alloy crowns fabricated with conventional casting technique. HOW TO CITE THIS ARTICLE: Gautam N, Khajuria RR, Ahmed R, et al. A Comparative Evaluation of Marginal Accuracy of Co-Cr Metal Copings Fabricated Using Traditional Casting Techniques and Metal Laser Sintering. Int J Clin Pediatr Dent 2021;14(1):128-132.

Comparison of clinical characteristics and outcomes between COVID-19 pneumonia and H1N1 influenza.

INTRODUCTION: The COVID-19 pandemic has been likened to the 2009 H1N1 influenza pandemic. We aim to study the similarities and differences between patients hospitalized with COVID-19 and H1N1 influenza in order to provide better care to patients, particularly during the co-circulation of Influenza A Subtype H1N1 and SARS-CoV-2. MATERIAL AND METHODS: A retrospective cohort study was conducted in order to compare clinical characteristics, complications, and outcomes of hospitalized patients with PCR-confirmed H1N1 influenza pneumonia and COVID-19 at a tertiary care center in Karachi, Pakistan. RESULTS: A total of 115 patients hospitalized with COVID-19 were compared with 55 patients with H1N1 Influenza A pneumonia. Median age was similar in both COVID-19 patients (54 years) and in patients with H1N1 influenza (59 years), but there was male predominance in COVID-19 patients (OR = 2.95; 95% CI: 1.12-7.79). Patients with COVID-19 pneumonia were 1.34 (95% CI: 1.14-1.62) times more likely to have a greater duration of illness prior to presentation compared to H1N1 influenza patients. COVID-19 patients were 4.59 times (95% CI: 1.32-15.94) more likely to be admitted to a general ward compared to H1N1 pneumonia patients. Moreover, patients with COVID-19 were 7.62 times (95% CI: 2.42-24.00) more likely to be treated with systemic steroids compared to patients with H1N1 pneumonia. The rate of nosocomial infections as well as mortality was similar in both H1N1 and COVID-19 pneumonia. CONCLUSION: Our study found a male predominance and longer duration of illness in hospitalized patients with COVID-19 compared to H1N1 influenza patients but no difference in outcomes with either infection.

Adult congenital heart disease: frequency, risk factors and outcomes of acute kidney injury in postoperative period.

BACKGROUND: Acute kidney injury (AKI) after surgery for congenital heart disease (CHD) in adults is poorly studied despite being well-recognized as a postoperative complication after cardiac surgery in adults. The primary aim of our study was to determine the frequency of AKI in adults undergoing surgery for CHD. We also aimed to determine risk factors and predictors of AKI in this patient population, and to explore outcomes in terms of duration of mechanical ventilation, intensive care unit (ICU) stay, and hospital stay. METHODS: This retrospective cross-sectional study included all adult patients (18 years) who underwent cardiac surgery with cardiopulmonary bypass for their congenital heart problems from January 2011 to December 2016 in a tertiary-care private hospital. RESULTS: A total of 166 patients with a mean age of 32.05 ± 12.11 years were included in this study. The postoperative course was complicated by AKI in 29.5% of patients. Thirty-two percent of these patients had moderate-to-severe kidney disease. Two patients (4%) developing AKI required renal replacement therapy in the form of transient hemodialysis. All patients in our study showed complete resolution of AKI, with no mortalities in the postoperative period. On univariable analysis, (Risk adjusted classification for congenital heart surgery-1) RACHS-1 category 2 and 3, aortic valve replacement, preoperative creatinine clearance, ventricular septal defect closure, cardiopulmonary bypass time, aortic cross-clamp time, intra-operative excessive blood loss, intra-operative ionotropic score, and postoperative hypotension were found to be significant predictors for the development of AKI. On age-adjusted multivariable analysis, RACHS-1 category 2 (OR = 3.49; CI = 1.22-9.95) and category 3 (OR = 3.28 = 1.15-9.36), and intra-operative excessive blood loss (OR = 2.9; CI = 1.07-7.85) were significant predictors of AKI development in the postoperative period. Moreover, development of AKI postoperatively was a predictor of a significantly longer cardiac intensive care unit (CICU) stay (OR = 1.21; CI = 1.08-1.37). CONCLUSION: We found that preoperative creatinine clearance, ACC time, intraoperative excessive blood loss, and RACHS-1Category 2 and 3 are potential risk factors for postoperative AKI development. Moreover, patients who develop AKI are likely to have a significantly longer CICU stay. Our study has tried to fill the lacunae with regard to AKI in adults undergoing surgery for CHD. However, there is a need for more studies with larger cohorts involving more complex surgeries to truly estimate the incidence and potential risk factors for AKI in this group of patients.

A Comparative Study to Evaluate the Accuracy of Various Spacer Thickness for Polyvinyl Siloxane Putty-wash Impression Techniques: An In Vitro Study.

INTRODUCTION: An accurate impression is one of the prime factors for success of any restoration, more so in field of fixed prosthodontics. The critical aspect is to reproduce fine surface details along with ease of use. Knowledge of impression materials and the techniques to which each is best suited is essential in achieving consistent results. OBJECTIVE OF THE STUDY: The purpose of this study is to evaluate the accuracy of various putty-wash techniques in a laboratory model that simulated the clinical practice. MATERIALS AND METHODS: A metal master model, containing three full crowns fixed partial denture (FPD) abutment preparations, was fabricated. A perforated custom tray was fabricated that can be placed in the same position on the master model for each impression. For each technique, 10 impressions of the master model were made and poured using a die stone. The measurements were made of the models using a measuroscope and the accuracy of the impressions was recorded. RESULTS: The statistical comparison between groups I, II, III, and IV casts measurements by using the Mann-Whitney test showed highly significant statistical difference between the various groups from each other (p < 0.001). CONCLUSION: The accuracy of the working casts obtained from group III impression (two-step using 1 mm coping) was the best, whereas it was least with group II impression (two-step using polyethylene spacer). HOW TO CITE THIS ARTICLE: Gautam N, Ahmed R, Sharma S, et al. A Comparative Study to Evaluate the Accuracy of Various Spacer Thickness for Polyvinyl Siloxane Putty-wash Impression Techniques: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(5):536-542.

Granulomatosis with polyangiitis: a 17 year experience from a tertiary care hospital in Pakistan.

OBJECTIVE: Granulomatosis with Polyangiitis (GPA) is an autoimmune, multi-system, small and medium vessel vasculitis with granulomatous inflammation. Aim of this study was to assess the clinical and radiological presentations of patients with GPA amongst the Pakistani population. It is a single centre retrospective single observation study. RESULTS: Study was conducted at the Aga Khan University Hospital, Karachi with records were reviewed from January 2000 to December 2017. Definitive diagnosis was made using a combination of serological anti-neutrophil cytoplasmic antibody (ANCA) testing along with the clinical and radiological presentation. A total of 51 patients met the diagnostic criteria in the time frame of the study. There were 23 males and 28 females with mean age of 44.0 ± 17.8 years on presentation. Arthritis was the most common symptom present in 41.2% of the cases followed by cough in 32.0%. Sixteen patients showed pulmonary infiltrates on chest X-ray. C-ANCA was positive in all of the patients compared with 21.6% p-ANCA positivity. A total of 13 biopsies were done. The median Birmingham Vasculitis Activity Score was 12. We report a 17.6% mortality rate with 5 deaths occurring due to respiratory failure. GPA is a diagnostic challenge leading to late diagnosis which can contribute to significant morbidity and mortality specially in the Third World.

Just a mirage: heterotopic intrauterine and twin ectopic pregnancy mimicked by mirror imaging on ultrasound.

Heterotopic pregnancies are rare and are usually diagnosed by transvaginal ultrasound. Despite the routine use of sonography in early pregnancy, artifact created by mirror imaging can drastically and erroneously alter medical decision making by interfering with image interpretation. A heterotopic pregnancy with a single intrauterine gestation and twin left adnexal ectopic gestational sacs was observed on ultrasound in a woman presenting with abdominal pain. During laparoscopy, an ectopic pregnancy was not identified, and subsequent intraoperative ultrasound reproduced the heterotopic pregnancy through manipulation of bowel, confirming mirror image artifact. This phenomenon is rarely seen in obstetric imaging; therefore, lack of awareness can lead to false diagnosis of heterotopic pregnancy. Techniques to verify correct diagnosis should be used to resolve potential mirror artifact before proceeding with surgical management.

Hospitalizations for students with an alcohol-related sanction: gender and pregaming as risk factors.

OBJECTIVE: The purpose of this study is to investigate whether pregaming (ie, drinking prior to a social event) is a risk factor for hospitalization. PARTICIPANTS: Participants (N = 516) were undergraduate students with an alcohol-related sanction. METHODS: Participants completed a survey about alcohol use, as well as behaviors and experiences, prior to and during the referral event. The dependent variable was whether participants received medical attention at an emergency department during the sanction event. RESULTS: Results indicated that older students, females who pregame, students with higher alcohol use screening scores, lighter drinkers, and higher numbers of drinks before the referral event all increased the odds of receiving medical attention. Pregaming alone was not significantly related to receiving medical attention in the multivariate analysis. CONCLUSIONS: Female students who pregame appear to be at risk for requiring hospitalization after drinking when controlling for the number of drinks consumed.

Molecular characterization and evolution of self-incompatibility genes in Arabidopsis thaliana: the case of the Sc haplotype.

The switch from an outcrossing mode of mating enforced by self-incompatibility to self-fertility in the Arabidopsis thaliana lineage was associated with mutations that inactivated one or both of the two genes that comprise the self-incompatibility (SI) specificity-determining S-locus haplotype, the S-locus receptor kinase (SRK) and the S-locus cysteine-rich (SCR) genes, as well as unlinked modifier loci required for SI. All analyzed A. thaliana S-locus haplotypes belong to the SA, SB, or SC haplotypic groups. Of these three, the SC haplotype is the least well characterized. Its SRKC gene can encode a complete open-reading frame, although no functional data are available, while its SCRC sequences have not been isolated. As a result, it is not known what mutations were associated with inactivation of this haplotype. Here, we report on our analysis of the Lz-0 accession and the characterization of its highly rearranged SC haplotype. We describe the isolation of its SCRC gene as well as the subsequent isolation of SCRC sequences from other SC-containing accessions and from the A. lyrata S36 haplotype, which is the functional equivalent of the A. thaliana SC haplotype. By performing transformation experiments using chimeric SRK and SCR genes constructed with SC- and S36-derived sequences, we show that the SRKC and SCRC genes of Lz-0 and at least a few other SC-containing accessions are nonfunctional, despite SCRC encoding a functional full-length protein. We identify the probable mutations that caused the inactivation of these genes and discuss our results in the context of mechanisms of S-locus inactivation in A. thaliana.