Group IB Research Articles

Comparison of Return to Sports and Competition After the Arthroscopic Bristow-Latarjet Procedure Versus Arthroscopic Bankart Repair in Adolescents With Recurrent Anterior Shoulder Instability

Background: The use of isolated soft tissue repair versus bone block stabilization for the treatment of recurrent anterior shoulder instability in adolescents has no scientific evidence. Purpose: To compare the clinical outcomes of adolescent patients who underwent isolated arthroscopic Bankart (iB) repair with those who underwent the arthroscopic Bristow-Latarjet procedure in addition to Bankart (BLB) repair. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 60 shoulders in adolescents (aged 13-18 years) were reviewed with a minimum 2 years’ follow-up: iB repair (n = 36) and arthroscopic Bankart repair with an additional Bristow-Latarjet procedure (BLB; n = 24). The characteristics of the patients in each group in terms of age at the first instability episode, age at surgery, hyperlaxity, participation in at-risk sports, and Instability Severity Index Score were comparable. The mean follow-up was longer in the iB group (7.7 vs 4.1 years, respectively), whereas the rates of patients engaged in competition and those with glenoid lesions were higher in the BLB group. The primary outcome measures were failure, defined as the recurrence of instability (clinical dislocation or subluxation), and return to sports. The mean follow-up was 6.2 years (range, 2-16 years). Results: At the last follow-up, the rate of recurrence was significantly higher in the iB group, with 22% (8/36) failures, than in the BLB group, with 8% (2/24) instability recurrences (P < .05). The rate of return to sports at the same level was significantly higher after the BLB repair than after iB repair (79% vs 47%, respectively; P < .001). No statistical difference was found in patient-reported outcome scores between treatment groups (P > .05). Although failures occurred early after the BLB repair, 88% of failures after iB repair occurred after 2 years. On multivariate analysis, adolescents in the iB group with >3 episodes of preoperative dislocation and shoulder hyperlaxity (external rotation >90°) had a 60% recurrence rate (P < .005). Conclusion: Adolescent patients undergoing the BLB repair had a lower rate of recurrent instability and higher rates of return to sports and competition than those undergoing iB repair. Patients with shoulder hyperlaxity (external rotation >90°) and >3 dislocations had an unacceptable failure rate of 60% after iB repair.

Leucoma salicis nucleopolyhedrovirus (LesaNPV) genome sequence shed new light on the origin of the Alphabaculovirus orpseudotsugatae species

LesaNPV (Leucoma salicis nucleopolyhedrovirus) is an alphabaculovirus group Ib. Potentially, it can be an eco-friendly agent to control the white satin moth Leucoma salicis population. In this study, we have established the relationship between LesaNPV and other closely related alphabaculoviruses. Environmental samples of late instar of white satin moth collected in Poland infected with baculovirus have been homogenized, polyhedra were purified and subjected to scanning and transmission electron microscopy. Viral DNA was sequenced using the Illumina platform and the whole-genome sequence was established by de novo assembly of paired reads. Genome annotation and phylogenetic analyses were performed with the use of bioinformatics tools. The genome of LesaNPV is 132 549 bp long with 154 ORFs and 54.9% GC content. Whole-genome sequencing revealed deletion of dUTPase as well as ribonucleoside reductases small and large subunits region in LesaNPV genome compared to Dasychira pudibunda nucleopolyhedrovirus (DapuNPV) and Orgyia pseudotsugata multiple nucleopolyhedrovirus (OpMNPV) where this region is complete. Phylogenetic analysis of Baculoviridae family members showed that LesaNPV is less divergent from a common ancestor than closely related species DapuNPV and OpMNPV. This is interesting because their hosts do not occur in the same area. The baculoviruses described in this manuscript are probably isolates of one species and could be assigned to recently denominated species Alphabaculovirus orpseudotsugatae, historically originating from OpMNPV. This finding could have significant implications for the classification and understanding of the phylogeographical spread of baculoviruses.

Clinical and radiographic outcomes around 4 mandibular implant-retained overdentures in individuals with type 2 diabetes: A long-term retrospective study

ObjectivesTo report the implant survival rates, clinical, and radiographic status after a period of more than 5 years in the function of 4 inter-foraminal implants retaining mandibular overdentures (OVDs) in individuals with T2DM. Methods78 completely edentulous participants with type 2 diabetic mellitus (T2DM) who had worn mandibular OVDs retained by 4 inter-foraminal implants for long-term functional life were selected for this study. The participants were divided into 2 groups according to glycosylated haemoglobin A1c (HbA1c) levels before implant placement: group I with an HbA1c value > 6.5 % (inadequately controlled T2DM), and group II with an HbA1c value ≤6.5 % (well-controlled T2DM). The inadequately controlled T2DM was further subdivided into 2 groups: Group IA with an HbA1c value > 6.5 % and ≤8 % (moderately controlled), and Group IB has an HbA1c value > 8 % (poorly controlled). Implant survival rate, plaque index (PI), bleeding on probing (BOP), probing depth (PD), and radiographic crestal bone level (CBL) around implants were measured. ResultsAmong 312 implants, 6 failed, 4 in well-controlled diabetics, and 2 in inadequately controlled diabetics. The overall survival rate was 98.07 %. The mean PI in group Ι was 36.4 (group IA =37.76, group IB = 34.27), and in group ΙΙ it was 19. The mean BOP in group Ι was 45.5 (group IA =47.84, group IB = 41.76), and in group ΙΙ it was 22. The mean PD in group Ι was 4.1 (group IA =4.3, group IB = 3.85) and in group ΙΙ was 2.2. The mean radiographic CBL in group Ι was 3.4 (group IA =3.7, group IB = 2.9), and in group ΙΙ was 1.5. Group IA exhibited a significantly greater level of PI, BOP, PD, and CBL compared to group IB and group IΙ (P1=0.017, P2=0.001). ConclusionsIndividuals with T2DM can benefit from 4 inter-foraminal implants retained mandibular OVDs, and their inability to maintain proper glucose control may not exclude implant success. Clinical significanceThis study is a significant step toward improving knowledge of options available for treatment and anticipated outcomes for T2DM completely edentulous populations undergoing implant therapy.

A Randomized Comparison Between Anterior Talofibular Ligament Repair Using Broström Operation with and without an Internal Brace

The aim of the study was to compare the intermediate-term (>24 months) clinical outcomes between anterior talofibular ligament repair using Broström operation with and without an internal brace. Nineteen patients underwent surgery using an arthroscopic traditional Broström repair with an internal brace technique (IB) and Eighteen patients underwent surgery using an arthroscopic traditional Broström repair without an internal brace technique (TB) . All patients were evaluated clinically using the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). According to FAAM, sports activity scores of TB and IB groups were 83.33 ± 5.66 and 90.63 ± 6.21 at the final follow-up (p = .02). There were no significant differences in preoperative and postoperative stress radiographs between the two groups. Total medical expense was more in the IB group (p < .001). It also has a significant superiority in the terms of FAAM scores at sports activity. However, there was no difference during daily life.

The Role of TNF-α in the Pathogenesis of Idiopathic Nephrotic Syndrome and Its Usefulness as a Marker of the Disease Course.

Background: The pathogenesis of idiopathic nephrotic syndrome (INS) has not been fully explained. Among the likely factors, tumor necrosis factor - alpha (TNF-α) is considered. We aimed to evaluate the TNF-α (sTNF-α, uTNF-α) levels in the serum and urine of INS children, with the aim of determining its association with proteinuria, and of determining its usefulness as a marker of the disease severity. Methods: Fifty-one examined patients were divided into subgroups depending on the number of relapses as follows: group IA-first episode; group IB-more than two relapses, and according to treatment modality; group IIA-glucocorticosteroids (GS) alone; and group IIB-GS with immunosuppressants. Healthy age-matched children served as the control group. Results: sTNF-α and uTNF-α levels were significantly increased in active phases in the whole INS group compared to the control group. They decreased in remission, but remained significantly higher when compared to the control group. During remission in the IB group, sTNF-α levels were significantly higher than in IA, whereas, in the relapse phase, these values were similar. In the IA group, a positive correlation between proteinuria and sTNF-α was demonstrated. Conclusions: Our findings suggest that TNF-α plays a role in the development of INS, and may be used as a prognostic marker, as well as an indicator for the continuation of therapy. Additional research is required to verify this statement.

Molecular Cloning and Functional Analysis of Secretory Phospholipase A2 from Apostichopus japonicus.

Secretory phospholipase A2 (sPLA2) plays important roles in phospholipid metabolism, skin barrier maintenance, immune response and other processes in organisms. sPLA2 of sea cucumber A. japonicus (AjPLA2) has not yet been reported. This study successfully amplified the AjPLA2 sequence. The total cDNA of AjPLA2 is 931bp, including a 480bp ORF that encodes 159 amino acids. The AjPLA2 protein includes a 16-aa signal peptide, a 5-aa precursor peptide and a 138-aa mature peptide. Homologous alignment showed that AjPLA2 and the sPLA2s from starfish have the typical domains of the Group IB sPLA2. And additional amino acid sequences were found around the β-Wing, which is different from the Group IB sPLA2. These results showed that AjPLA2 and sPLA2s from starfish all belong to a new group in the Group I sPLA2 family. AjPLA2 is widely distributed in sea cucumber tissues. The functional analysis also showed that AjPLA2 was upregulated in the intestine by feeding. Whenthe body wall was damaged, it was significantly upregulated around the wound. And the expression levels of AjPLA2 were significantly increased in V. splendens-infected sea cucumbers. The results indicated that AjPLA2 plays roles in the sea cucumber immunologicprocess. Combined with the upregulation of unsaturated fatty acids (PUFAs) content in A. japonicus, it demonstrated that AjPLA2 could participate in the immune of A. japonicus by hydrolyzing phospholipid and releasing PUFAs. This study had a solid foundation for the further research of AjPLA2 gene function in vivo, development and application of AjPLA2 protein.

Correlation of Platelet Indices in Patients With Type 2 Diabetes Mellitus and Associated Microvascular Complications: A Hospital-Based, Prospective, Case-Control Study.

Background Diabetic patients exhibit increased platelet activity. Insulin inhibits the activation of platelets. Therefore, a relative or absolute deficiency of insulin would increase platelet reactivity. Theyounger (larger) platelets are also more metabolically and enzymatically active.If detected early, microvascular complications could alert us regarding the possible macrovascular complications.Thus, the aims and objectives of the present study were to determine platelet indices in patients with type 2 diabetes mellitus withcontrols (non-diabetics) and to find an association of platelet indices with microvascular complications. Material & methods In this prospective case-control study conducted from 2021 to 2022 (2 years), a total number of 200 subjects were taken and were divided into two groups of 100 each,cases (I) andcontrols (II). The cases included patients of diabetes mellitus (DM) ofa duration of more than 5 years, which were further divided into two groups of 50 each, IA and IB. Group IA consisted of patients with diabetes mellitus of a duration of more than five years with at least one microvascular complication and group IB wasdiabetics of more than five years duration without any microvascular complications, which includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. An automated cell counter (Thermo Fisher Scientific, Waltham, MA, US) provided hemoglobin values along with the platelet count and platelet indices, i.e. mean platelet volume (MPV), platelet large cell ratio (P-LCR), and platelet distribution width (PDW). Results The present study consisted of 200 subjects divided into 2 groups of 100 each, cases (I) andcontrols (II). The average MPV (9.4-12.3 femtolitre) in diabetics was 12.089±1.450 fLas compared to the controls where it was 9.464±1.424 fL with a statistically significant p-value of 0.001. PDWamong the cases was 16.868±2.352 fL while in controls, it was 12.753±10.559 fL (p=0.001). The mean P-LCR was 34.975±8.056% amongthe cases, in comparison to the mean P-LCR amongthe controls, which was 26.031±7.004 (p=0.001). In this study, the MPV, PDW, and P-LCR were significantly raised in individuals having diabetes with microvascular complications when compared with patients without complications. The mean MPV in diabetics with complications was 12.5960±0.95660 fL and in those without complications was 11.5820±1.67609 fL (with a p-value of P = 2×10-3)which is statistically significant. Similar results were obtained in cases of PDW and P-LCR. The mean PDW in diabetics with complications was 17.1140±2.58228 fL and without complications was 15.6220±2.10532 fL ((with a p-value of P = 2×10-3)). The mean P-LCR in diabetics with microvascular complications was 35.408±3.5490% and without complications was 33.542±4.8694% (with a p-value of P = 3.1×10-3). Conclusion Based on the findings of the present study, there is a statistical correlation between type 2 diabetes and variations in platelet indices, resulting in the associated microvascular complications. Higher MPV, PDW, and P-LCR values suggest that these parameters are more reliable predictors of early vascular complications in individuals with type 2 diabetes mellitus and can be utilized as an easy-to-use, low-cost method. They are a readily available, economical, practical, noninvasive, and simple-to-understand approach for assessing platelet dysfunction, which in turn helps anticipate the existence of microvascular complications.

Effectiveness of SCAR-Q for assessment of incisional SCAR after implant-based reconstruction in breast cancer patients: Can it be a tool for incision selection?

Incisional scarring is a factor of cosmetic appearance evaluated after breast reconstruction, along with the shape, position, and size of the breast. This study aimed to examine the effect of the incision scar location on patient satisfaction after breast reconstruction. Using the Japanese version of the SCAR-Q, we assessed the scar appearance, symptoms and psychosocial effects. Plastic surgeons performed assessments using the Manchester Scar Scale. The patients were divided into two groups: those with scars on the margins of the breast (MB group) and those with scars in the breast area (IB group). The results revealed that patients in the MB group reported significantly higher satisfaction with the scar appearance and psychological impact than those in the IB group. However, assessments using the Manchester Scar Scale did not reveal any significant differences between the two groups. In conclusion, this study underscores the importance of patient-reported outcomes in the evaluation of scar satisfaction after breast reconstruction. Patients tend to prefer and have higher satisfaction with scars along the breast margin, which offers valuable insights into surgical decisions. Further studies with larger and more diverse sample sizes are required for validation.

Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research.

Early childhood caries (ECC) remains one of the most prevalent diseases mutilating the primary dentition. It is a multifactorial disease that severely affects the quality of life of affected children. One of the risk indicators reported in the literature is the presence of viable mutans streptococci (MS) and protective factors such as salivary immunoglobulin A (SIgA). Hence, it is important to identify such risks and protective factors associated with ECC using simple yet reliable methods supported by advanced technology and a fully automated platform to improve the results. A retrospective analysis was done on 40 children who were divided into two groups: group I (experimental) and group II (control). Group I comprised 30 healthy children who were further divided into three subgroups of 10 children each. Group IA with decayed, missing, filled teeth/decayed, extracted, filled teeth (dmft/deft) = 1-2, group IB with dmft/deft = 3-4, group IC with dmft/deft ≥5, and group II, comprising 10 healthy children having no caries by using World Health Organization (WHO) 2013 Oral Health Survey criteria. Unstimulated saliva was collected by drooling saliva into a sterile container. The samples were transported to the central research laboratory for SIgA by the immunoturbidimetry method by a fully automated Abbott Architect c system. The data obtained was subjected to statistical analysis. On comparison of SIgA in between varying severities of dental caries and caries-free children between age-group of 3 and 6 years, it was found to be below the grand median 0.20 mg/mL for subgroups IA and control group II. A significant negative statistical correlation (r = -0.948) was present between the SIgA and varying severities of ECC and the control group. The low dmft/deft group was found to be relatively closer to the caries-free groups as their mean dmft was 1.50, standard deviation (SD) ± 0.53. A slight change in dmft/deft score and SIgA could be used as a potential biomarker for assessing the severity of ECC in children between age-group of 3 and 6 years. Sharma V, Bagchi A, Dutta B, et al. Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research. Int J Clin Pediatr Dent 2024;17(3):316-320.

Bronchiectasis in renal transplant patients: a cross-sectional study

BackgroundBronchiectasis is a chronic airway disease characterized by permanent and irreversible abnormal dilatation of bronchi. Several studies have reported the development of bronchiectasis after renal transplantation (RT), but no prospective study specifically assessed bronchiectasis in this population. This study aimed to compare features of patients with bronchiectasis associated with RT to those with idiopathic bronchiectasis.MethodsNineteen patients with bronchiectasis associated with RT (RT-B group) and 23 patients with idiopathic bronchiectasis (IB group) were prospectively included in this monocentric cross-sectional study. All patients underwent clinical, functional, laboratory, and CT scan assessments. Sputum was collected from 25 patients (n = 11 with RT-B and n = 14 with IB) and airway microbiota was analyzed using an extended microbiological culture.ResultsDyspnea (≥ 2 on mMRC scale), number of exacerbations, pulmonary function tests, total bronchiectasis score, severity and prognosis scores (FACED and E-FACED), and quality of life scores (SGRQ and MOS SF-36) were similar in the RT-B and IB groups. By contrast, chronic cough was less frequent in the RT-B group than in the IB group (68% vs. 96%, p = 0.03). The prevalence and diversity of the airway microbiota in sputum were similar in the two groups.ConclusionClinical, functional, thoracic CT scan, and microbiological characteristics of bronchiectasis are overall similar in patients with IB and RT-B. These results highlight that in RT patients, chronic respiratory symptoms and/or airway infections should lead to consider the diagnosis of bronchiectasis. Further studies are required to better characterize the pathophysiology of RT-B including airway microbiota, its incidence, and impact on therapeutic management.

One-stage Intraconal Volume Modification for Exposed and Nonexposed Ball Implants.

To assess long-term outcomes and reinterventions for exposed and nonexposed intraconal orbital implants after single-stage socket revisional surgery. Retrospective case-note review of patients with exposed or nonexposed orbital ball implants, who underwent a single-stage ball exchange (Group I) or ball removal with dermis-fat graft (Group II); Group I was subdivided as having either exposed (A) or nonexposed (B) implants. Outcomes were compared with similar cohorts undergoing multistage surgery. Of 172 patients (54% male), 153 (89%) underwent ball exchange (Group I) and 19 (11%) had dermis-fat graft (Group II). With a mean follow up of 7.8 years, Group I patients without ball exposure (Group IB) had a slightly higher rate of reintervention for persistent volume deficit (21% vs. 9%; p = 0.163) and implant migration (6% vs. 0%; p = 0.091), while Group IA patients-having surgery for exposed implants-had more reexposures (7% vs. 3%; p = 0.270). Single-stage and 2-stage surgery had similar reintervention rates, with the exception of a trend toward fewer volume enhancements for those with nonexposed implants (17% vs. 30%; p = 0.380), and a shorter time to (re)exposure for exposed implants after 2-stage procedures (mean 0.33 vs. 3.5 years; p = 0.571). Group II patients required further volume enhancement in 32% of 1-stage procedures, and one patient needed graft removal. Single-stage volume modification is effective and the results are comparable to staged surgery for either exposed or nonexposed implants. Most patients report a stable prosthesis and satisfactory cosmesis, after a faster rehabilitation.

Diagnostic efficacy of metaepiphyseal osteomyelitis in young children: a prospective study

INTRODUCTION: Modern and effective diagnosis of osteomyelitis is the basis for successful therapy; at the same time the problem of establishing this pathology, especially in the early stages of the development of the process, has not been completely resolved.OBJECTIVE: To develop of ultrasound imaging of metaepiphyseal osteomyelitis in young children, depending on the duration of the disease.MATERIAL AND METHODS: 108 children (boys — 65% (70/108), girls — 35 (38/108)) from 1 month to 2 years were examined. Children's age from 2 up to 8 months — 57% (62/108), newborns — 26% (27/108). The age of other children: 12% (13/108) — 9–12 months, 5% (6/108) — 1– 2 years. All children underwent x-ray and ultrasound study. The diagnosis of osteomyelitis was verified by joint puncture (n=102), bone puncture (n=57), drainage of periarticular phlegmon (n=12).Statistics: processing of the study results was carried out using the Statistica 13.0 application package (TIBCO Software Inc, 2017). To assess the effectiveness of ultrasound in the diagnosis of acute osteomyelitis, the diagnostic effectiveness and predictive value of positive or negative results were calculated, and the likelihood ratio was calculated.RESULTS: 3 groups were identified depending on the duration of the disease at the time of admission to the hospital: Ia — 1–3 days, Ib — 4–7 days, Group II — 8–14 days, Group III — 15–21 days from the onset of the disease. DE indicators for patients of group Ia: sensitivity — 81.8%, specificity — 60.0%, accuracy — 75%, PV(+)=81.82%; PV(–)=60.00%; OR=4.50. DE indicators for patients in group Ib: sensitivity — 86.6%, specificity — 66.6%, accuracy — 80.95%, PV(+)=87.5%; PV(–)=60.0%; OR=7.00. DE indicators for patients in group II: sensitivity — 92.98%, specificity — 80.0%, accuracy — 93.44%, PV(+)=98.15%; PV(–)=57.14%; OR=37.86. DE indicators for patients of group III: sensitivity — 91.66%, specificity — 91.0%, accuracy — 91.66%, PV(+)=100.0%.DISCUSSION: Ultrasound imaging of acute osteomyelitis in children of group Ia included nonspecific changes in periarticular tissues and had the lowest diagnostic accuracy (75%). Diagnostic accuracy increased in group Ib to 85% due to initial structural changes in the zone of preliminary calcification and hyaline cartilage of the epiphysis. Disease progression in group II was characterized by more distinct structural changes in the metaphysis with an increase in diagnostic accuracy to 93%. In patients of group III, the highest rates of diagnostic accuracy (91.67%) were obtained due to visualization of destructive changes in the epiphysis, metaphysis and zone of preliminary calcification.CONCLUSION: The ability to detect ultrasound signs of acute hematogenous metaepiphyseal osteomyelitis in children will allow the use of this method in the early diagnosis for the timely selection of an adequate treatment tactics.

Impact of adding 3% titanium oxide nanoparticles in different denture base materials on some of the biological, physical, and mechanical properties properties: In-vitro study

Background/aim Acrylic resin denture base material with all its varieties and curing techniques enormously influence their physical, biological, and mechanical properties. This study designed to evaluate and compare the impact of acrylic resin reinforcement with titanium oxide nanoparticles (TiO2NP) on physical, biological, and mechanical criteria of two dissimilar denture base materials. Materials and methods This study was constructed on 120 specimens of 2 different types of acrylic resin denture base materials. The specimens were divided equally into 2 groups (60 each), group I (heat cured acrylic resin) and group II (microwave cured acrylic resin). Each group was additionally divided into two subgroups (each 30). Subgroup A as control, while subgroup B was modified with 3% TiO2NP. Biological evaluation was performed on Enterococcus faecalis by using antimicrobial assay by agar diffusion test color stability via employing spectrophotometer, and the Modulus of elasticity through universal testing machine. Results Regarding the results of biological assessment, groups IA and IIA (control groups) revealed no inhibitory zone, while groups modified with 3% TiO2NP group IIB demonstrated significantly higher (P &lt; 0.05) inhibitory zone when compared with group IB. Concerning color stability, Regarding color stability, Group IA and IIA (control groups) demonstrated the highest color changes, while Group IB and IIB(modified groups) demonstrated the lowest color changes. In modulus of elasticity, groups IB and IIB were significantly higher (P&lt;0.05) than groups IIA and IIB. Conclusion Adding 3% TiO2NP to heat and microwave cured resins induced antibacterial characteristics against E. faecalis. Besides improvement of the evaluated mechanical (modulus of elasticity) and color stability properties.

Pain perception in 4-6-year-old children following intraoral dental injection with 26 and 31-gauge needles: a randomized controlled trial.

Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

Influence of Diabetes Mellitus and Universal Adhesive Application Mode on the Bond Strength of Composite Resin to Dentine.

The aim of the current study was to evaluate the influence of diabetes mellitus and the mode of applying a universal adhesive on the shear bond strength of composite resin to dentin. Forty teeth were extracted from diabetic individuals who had been living with diabetes for a period of 5 to 15 years. These forty teeth were divided into two groups: twenty molars from patients with type 1 diabetes and twenty molars from patients with type 2 diabetes. The remaining twenty sound human molars were collected from non-diabetic patients. The collected teeth were assigned into 3 groups, and each group was further divided into 2 subgroups. Group A (n = 20): non-diabetic (ND) where sub group IA: Universal adhesive applied in the total-etch mode (n = 10) and sub group IIA: Universal adhesive applied in the self-etch mode (n = 10). Group B (n = 20): diabetic type 1 (D1) where sub group IB: Universal adhesive applied in the total-etch mode (n = 10) and sub group IIB: Universal adhesive applied in the self-etch mode (n = 10). Group C (n = 20): diabetic type 2 (D2). Where Sub group IC: Universal adhesive applied in the total-etch mode (n = 10) and sub group IIC: Universal adhesive applied in the self-etch mode (n = 10). A Teflon mold measuring 3mm in diameter was attached to the dentin surface, used to build Filtek Z550 to a height of 3mm. The specimens were fixed to the universal testing to measure shear bond strength. There was a statistically significant difference of Mean ±SD of shear bond strength among the three tested groups. In group A, the Mean ±SD were (21.710 ± 0.638), it was decreased in group B to (14.626 ± 0.726) and group C to (17.740 ± 0.668). Subgroup I had lower shear bond strength values than subgroup II in all tested groups. The difference between each subgroup in groups A, B, and C was significant. 1. Diabetes mellitus has an adverse effect on the shear bond strength of composite to dentine. 2. Type 1 diabetes mellitus significantly reduces the shear bond strength of composite resin to dentin. 3. Shear bond strength of the universal adhesive was higher when applied to dentin using the self-etch mode, as compared to the total etch mode, in all groups, regardless of whether the participants had diabetes or not. Key words:Diabetes Mellitus, Universal Adhesive, Application Mode, Shear bond Strength, Dentine, Composite.

Evaluation of the effectiveness of fresh frozen plasma transfusion as adjuvant treatment in acute organophosphate-poisoned patients: A randomized clinical trial.

Organophosphorus (OP) poisoning is a significant cause of morbidity and mortality worldwide. Recent research has explored new approaches to improving treatment options, which present several challenges. This study aimed to evaluate the role of fresh frozen plasma (FFP) as an adjunctive therapy for acute OP intoxication. A prospective single-blinded randomized clinical trial was conducted on patients of both sexes admitted to the Intensive Care Unit (ICU) of the Poison Control Center at Ain Shams University Hospital (PCC-ASUH) with acute OP toxicity during the period from the beginning of August 2022 to the end of July 2023. According to the Peradeniya score, Group I consisted of 48 patients (52%) with moderate OP poisoning, and Group II consisted of 44 patients (48%) with severe OP poisoning. Patients in the moderate group were assigned to receive either standard treatment (Group Ia, n = 24) or standard treatment plus FFP (Group Ib, n = 24). In addition, patients in the severe group were assigned to receive either standard treatment (Group IIa, n = 22) or standard treatment plus FFP (Group IIb, n = 22). A total of 46 patients received FFP transfusion. The authors demonstrated that the early use of a total of nine packs of FFP (250mL each) over three consecutive days significantly reduced the total doses of atropine and oximes, the total hospitalization period, and the requirement for mechanical ventilation in patients with OP poisoning, both in the moderate and severe groups.

Reactivity-matched synthesis of monodisperse Ag(In,Ga)S2 QDs with efficient luminescence.

I-III-VI quantum dots (QDs) have gained widespread attention owing to their significant advantages of non-toxicity, large structural tolerance, and efficient photoluminescence potential. However, the disbalance of reactivity between the elements will result in undesired products and compromised optical properties. Reducing the activity of highly reactive group IB elements is the most common approach, but it will reduce the overall reactivity and lead to a wide dispersion of QD sizes. In this study, we propose a method to improve the overall reactivity of the reaction system using the highly active IIIA precursor InI3, which triggers rapid nucleation and promotes the formation of Ag(In,Ga)S2 (AIGS) QDs, resulting in monodisperse particle size distributions and a significantly improved photoluminescence quantum yield (PLQY) (from 12% to 72%). Furthermore, narrow band edge emission is realized by coating a gallium sulfide (GaSx) shell on the basis of obtaining high-quality AIGS QDs. The core/shell QDs exhibit a 90% PLQY with a full width at half maximum (FWHM) of only 31 nm at 530 nm. This study provides a viable design strategy to synthesize monodisperse AIGS QDs with a narrow peak width and efficient luminescence, promoting the application of AIGS QDs in the field of luminescent displays.

Pediatric chronic kidney disease: blood cell count indexes as inflammation markers.

Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

Effect of physiotherapeutic procedures on the bioelectric activity of the masseter muscle and the range of motion of the temporomandibular joints in the female population with chronic pain: a randomized controlled trial

SummaryIntroductionPhysical therapy (PT) methods applied in dentistry are increasingly discussed nowadays. Taking into account a rapidly growing number of temporomandibular disorders (TMDs) and orofacial pain patients, it is reasonable to determine which of the available physiotherapeutic (PT) methods are more effective than others, especially in terms of their possible analgesic and myorelaxant effects.ObjectiveTo assess manual and physical factors influencing pain reduction or elimination and increased muscle tension in patients with TMD; yet the influence of the applied forms of PT on the range of motion (ROM) of temporomandibular joints (TMJ).Material and methodsA randomized, parallel-group, RCT, single-blind, equi-randomized (1:1) study was conducted in DC/TMD Group Ib patients (20–45 years of age). An experimental group (G1, n = 104) and a control group without TMD (G2, n = 104) were created according to CONSORT guidelines. Diagnostic measurements were performed in both groups (mass sEMG, temporomandibular joint range of motion-ROM, pain intensity - NRS). Group G1 was randomly divided (envelope method) into 4 therapeutic groups, in which therapy was carried out for 10 days: magnetostimulation (MS), magnetoledotherapy (MLE), magnetolaserotherapy (MLA), manual therapy (MT). Each time after the therapy, ROM and NRS measurements were performed, and after the 5th and 10th day sEMG.ResultsStatistically significant differences were found in the sEMG values of the masseter muscles, TMJ ROM and the pain intensity in G1 and G2 (p < 0.00). The largest decrease in sEMG (% MVC) of the masseter muscle occurred in the subgroup in which the manual therapy (MT) procedures were applied, p < 0.000. There was no clinically significant difference in and between other subgroups. There was a distinct mandible ROM increase noted in the MT group, with minimal changes in the MLA and MLE groups and no changes in the MS group. There was a clear increase in the lateral mobility of both right and left TMJ in the MT group. There were no differences in the course of the study in the MS group, and slight increases in the MLA and MLE groups. In the case of pain measurements, the greatest decrease in pain intensity was observed in the MT subgroup.ConclusionsAccording to our results manual therapy is an effective form of treatment in patients with pain, increased masticatory muscle tension and limitation in mandible ROM. Dental physiotherapy should become an integral part of multimodal TMD patients’ treatment.

Risk stratification of poor short-term prognosis in patients with high-risk pulmonary embolism

Background. Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality. High-risk PE patients have more severe course of disease and poor prognosis. The question of additional factors which may be associated with prognosis in such patients remains poorly understood. The aim is to identify factors associated with mortality in high-risk PE patients and to determine contribution of these factors to the risk stratification of death. Materials and methods. A retrospective analysis of 635 medical cards of patients with PE diagnosis hospitalized in Kharkiv City Clinical Hospital 8 from January 1, 2017 to January 1, 2023 was conducted. The diagnosis was verified by multispiral computed tomography pulmonary angiography (CTPA) and/or by autopsy. Patients were divided into groups: group І — high-risk (113 — 17.8 %); group II — low-risk (522 — 82.2 %). Group I was divided into subgroups: IA — 63 (55.8 %) individuals, who were discharged from the hospital with improved status, IB — 50 (44.2 %) people, who died in hospital. Clinical, anamnestic, laboratory and instrumental parameters were measured. Statistical analysis was performed. Results. Patients from group I were older, there were more women among them. In subgroup ІВ, there are more women, more cases of obesity and deep vein thrombosis. Patients from group IB had lower blood oxygen saturation (SpO2) and systolic blood pressure (SBP), lower left ventricular ejection fraction (LVEF) measured by echocardiography. Bilateral segmental pulmonary embolism according to CTPA was more common in IB group. According to uni- and multivariate analysis, independent factors affecting in-hospital mortality in patients with high-risk PE were determined, among them: female gender, presence of bifurcation thrombus, lower SBP, SpO2, LVEF. Using the additional regression analysis, the formula for individual prediction of the risk of in-hospital mortality in high-risk PE patients was created. According to the receiver operating characteristic analysis, the sensitivity of the formula is 64.0 %, specificity is 92.1 %. The SBAFS (S — SpO2, B — Bifurcation thrombus, A — Arterial hypotension, F — left ventricular ejection Fraction, S — female Sex) score was formed, where the score of 2 or more indicates additional high risk of in-hospital mortality in high-risk PE patients. Conclusion. The high-risk PE patients who died during hospitalization had more cases of obesity, hypertension, lower SpO2, SBP, and LVEF, and there were more women among them. According to the multivariate logistic regression analysis, additional independent factors associated with in-hospital mortality in high-risk PE patients are female sex, thrombus in bifurcation of the pulmonary trunk, SpO2, SBP, LVEF. The formula for risk stratification of in-hospital death in high-risk PE patients was created and validated. The SBAFS score was formed to indicate additional high risk of in-hospital mortality in high-risk PE patients.